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Brauneis S, Araimo F, Rossi M, Russo D, Mammucari M, Maggiori E, di Marzo R, Vellucci R, Gori F, Bifarini B, Chiné E, Carpenedo R, Paolucci T, Giorgio C, Ritarossi R, Calò A, Luongo L, Natoli S. The role of mesotherapy in the management of spinal pain. A randomized controlled study. Clin Ter 2023; 174:336-342. [PMID: 37378503 DOI: 10.7417/ct.2023.2447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Background Mesotherapy is a technique through which active ingredients are administered into the thickness of the skin in order to increase the local analgesic effect. Methods 141 patients with spinal pain not responding to systemic therapy with NSAIDs were randomized to receive one or more intra-cutaneous drugs on a weekly basis. Results All patients achieved a pain reduction of at least 50% compared to baseline, and all tolerated the therapy without having to resort to systemic drug dose increases. Conclusions The data from our study show that the active ingredients infiltrated into the skin induce a mesodermal modulation between the infiltrated liquid and the cutaneous nervous and cellular structures from which the typical drug-saving effect of mesotherapy arises. Although further studies are needed to establish how to integrate mesotherapy in various clinical settings, it appears to be a useful technique available to the practicing physician. This research is also useful in guiding future clinical research.
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Affiliation(s)
- S Brauneis
- Department of Anesthesiology, Critical Care and Pain Medicine, La Sapienza University of Rome, Rome, Italy
| | - F Araimo
- Department of Anesthesiology, Critical Care and Pain Medicine, La Sapienza University of Rome, Rome, Italy
| | - M Rossi
- Section Of Anesthesia in Specialty Surgeries, Department of Emergency and Internal Medicine, Policlinico Universitario Agostino Gemelli, Sacro Cuore Catholic University, Rome, Italy
| | - D Russo
- San Marco Hospice and Palliative Care, Latina, Italy
| | | | | | - R di Marzo
- San Marco Hospice and Palliative Care, Latina, Italy
| | - R Vellucci
- alliative Care and Pain Therapy Unit - Anesthesiology and Resuscitation Department of Careggi University Hospital, Florence, Italy
| | - F Gori
- Section of Anesthesia, Intensive Care, and Pain Medicine, Santa Maria della Misericordia University Hospital, Perugia, Italy
| | - B Bifarini
- Section of Anesthesia, Intensive Care, and Pain Medicine, Santa Maria della Misericordia University Hospital, Perugia, Italy
| | - E Chiné
- Unit of Pain Therapy, Policlinic of Tor Vergata, Rome, Italy
| | - R Carpenedo
- Unit of Pain Therapy, Policlinic of Tor Vergata, Rome, Italy
| | - T Paolucci
- Department of Medical and Oral Sciences and Biotechnologies (DiSmob), Physical medicine and Rehabilitation unit, G. D'Annunzio University of Chieti-Pescara, Italy
| | - C Giorgio
- Rehabilitation Unit, F. Pirinei Hospital, Altamura, BA, Italy
| | - R Ritarossi
- Department of Anesthesiology, Critical Care and Pain Medicine, La Sapienza University of Rome, Rome, Italy
| | - A Calò
- Department of Anesthesiology, Critical Care and Pain Medicine, La Sapienza University of Rome, Rome, Italy
| | - L Luongo
- Department of experimental medicine, division of pharmacology, universita della Campania "L. Vanvitelli" Naples, Italy
| | - S Natoli
- Dept. of Clinical Science and Translational Medicine. University of Rome Tor Vergata, Italy
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Bifarini B, Gori F, Russo D, Mammucari M, Maggiori E, Di Marzo R, Migliore A, Massafra U, Ronconi G, Ferrara PE, Paolucci T, Vellucci R, Mediati D, Violo B, Natoli S, Brauneis S. Intradermal therapy (mesotherapy): the lower the better. Clin Ter 2022; 173:79-83. [PMID: 35147651 DOI: 10.7417/ct.2022.2396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Intradermal therapy (mesotherapy) is a technique used to inject drugs into the surface layer of the skin. The intradermal micro deposit allows to modulate the kinetics of drugs, slowing down its absorption and prolonging the local mechanism of action. This technique is applied in the treatment of some forms of localized pain when a systemic drug-saving effect is useful, when it is necessary to synergize with other pharmacological or non-pharmacological thera-pies, when other therapies have failed or cannot be used. AIM The purpose of our study was to evaluate the effect of a mixture with respect to its lower concentration. We also wanted to evaluate the number of sessions needed to reach the therapeutic goal (50% reduction in pain from baseline) in patients with acute or chronic neck pain. METHOD We analyzed retrospectively data from 62 patients with cervicobrachial pain treated with intradermal drugs. Group A received a mixture of drugs; group B received half the dose of drugs. RESULTS Patients who received a lower concentration of drugs achieved similar results to those who received a higher dose. The therapeutic goal was achieved on average with 3.5 + 1.7 sessions on a weekly basis (min 1; max 9). Subjects in group A required 4+1.7 treatments (min 1; max 9), while subjects in group B required 3+1.5 treatments (min 1; max 7). CONCLUSIONS Our study confirms that even a lower dose of drugs can induce a clinically useful result. This study confirms that the useful effect of mesotherapy is only partly due to the pharmacological action. Further randomized prospective studies are needed to standardize the technique in the various pain syndromes, but it is recommended to follow the guidelines of the Italian Society of Mesotherapy to ensure patients receive appropriate treatment.
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Affiliation(s)
- B Bifarini
- Section of Anesthesia, Intensive Care, and Pain Medicine, University Hospital Santa Maria Della Misericordia, Perugia, Italy
| | - F Gori
- Section of Anesthesia, Intensive Care, and Pain Medicine, University Hospital Santa Maria Della Misericordia, Perugia, Italy
| | - D Russo
- "San Marco" Hospice and Palliative Care, Latina, Italy
| | | | | | - R Di Marzo
- Member of the Italian So-ciety of Mesotherapy, Rome, Italy
| | - A Migliore
- Unit of Rheumatology, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - U Massafra
- Unit of Rheumatology, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - G Ronconi
- University Policlinic Foundation A. Gemelli IRCCS, Rome, Italy
| | - P E Ferrara
- University Policlinic Foundation A. Gemelli IRCCS, Rome, Italy
| | - T Paolucci
- Unit of Physical Medicine and Rehabilitation, G. D'Annunzio University of Chieti-Pescara, Department of Oral Medical Science and Biotechnology (DSMOB), Italy
| | - R Vellucci
- Anesthesiology department, University hospital Careggi, Florence, Italy
| | - D Mediati
- Anesthesiology department, University hospital Careggi, Florence, Italy
| | - B Violo
- Pain Therapy Unit, S. Spirito Nuovo Regina Margherita Hospital, Rome, Italy
| | - S Natoli
- Department of Clinical Science and Translational Medicine, Tor Vergata University, Rome, Italy
| | - S Brauneis
- Pain Center "Enzo Borzomati", University Hospital of Rome "Policlinico Umberto I", Rome, Italy
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Saggini R, Anastasi GP, Battilomo S, Maietta Latessa P, Costanzo G, Di Carlo F, Festa F, Giardinelli G, Macrì F, Mastropasqua L, Nardone M, Nicoletti G, Orsini A, Pastorelli M, Pellegrino R, Trevisan M, La Mesa L, Le Pera AM, Privitera MG, Ralli G, Villani C, Bricot B, Davidson RG, Hassdenteufel A, Hawamdeh ZM, Kleinrensink GJ, Matheron E, Stoev VL, Stratulat S, Tiron S, Villeneuve P, Paolucci T, Bellomo RG. Consensus paper on postural dysfunction: recommendations for prevention, diagnosis and therapy. J BIOL REG HOMEOS AG 2021; 35:441-456. [PMID: 33940790 DOI: 10.23812/20-743-a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Good fundamentals of posture and balance are essential for the efficient performance of both simple daily tasks and more complex movement patterns. In particular, postural balance is the ability to keep the body in equilibrium and to regain balance after the shift of body segments: postural control mechanisms of integration of the visual, vestibular and foot afferential channels contribute to this. This document provides recommendations based on scientific evidence, clinical practice, and consensus between experts concerning the prevention, diagnosis, and treatment of postural dysfunction at the three stages of life as the developmental age, adult age, and old age > 65 years and follows the "National Guidelines on Classification and Measuring of Posture and its Dysfunctions" per the Italian Ministry of Health (December 2017). The paper answers four main questions: i) "Which measures can be adopted to prevent postural dysfunctions?" ii) "What can we do in order to make a correct diagnosis of postural dysfunction?" iii) "What are the correct treatment programs for postural dysfunctions?" iv) Which professional competencies and experiences are useful for preventing, diagnosing and treating postural dysfunctions? By the Consensus of the Experts and the scientific evidence, emerge that the approach to postural dysfunctions requires a multidisciplinary and interdisciplinary team. Furthermore, rehabilitation treatment interventions must be specific to the age groups that have been indicated, to consider the integration of the main systems and subsystems of postural control that change with age.
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Affiliation(s)
- R Saggini
- Unit of Physical Medicine and Rehabilitation, Department of Oral, Medical and Biotechnological Sciences, University of G. d'Annunzio of Chieti-Pescara, Italy
| | - G P Anastasi
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Italy
| | | | - P Maietta Latessa
- Department for Life Quality Studies, University of Bologna, Rimini, Italy
| | - G Costanzo
- Department of Anatomy, Histology, Legal Medicine, and Orthopaedics, Sapienza, University of Rome, Rome, Italy
| | | | - F Festa
- Department of Oral, Medical and Biotechnological Sciences, University of G. d'Annunzio of Chieti-Pescara, Italy
| | - G Giardinelli
- National Institute for Occupational Safety and Health, Rome, Italy
| | - F Macrì
- Italian Society of Pediatrics, Rome, Italy
| | - L Mastropasqua
- Ophthalmic Clinic, SS Annunziata Hospital of Chieti, University of G. d'Annunzio of Chieti-Pescara, Italy
| | - M Nardone
- Italian Ministry of Health, Rome, Italy
| | | | - A Orsini
- Telematic University "San Raffaele," Rome, Italy
| | | | | | - M Trevisan
- Department of Anatomy, Histology, Legal Medicine, and Orthopaedics, Sapienza, University of Rome, Rome, Italy
| | - L La Mesa
- Italian Society of Pediatrics, Rome, Italy
| | | | | | - G Ralli
- Otolaryngology Unit, Sapienza, University of Rome, Rome, Italy
| | - C Villani
- Department of Anatomy, Histology, Legal Medicine, and Orthopaedics, Sapienza, University of Rome, Rome, Italy
| | | | - R G Davidson
- Comunication Disorders Department ARIEL University, ARIEL, Israel
| | - A Hassdenteufel
- The International Federation for Proprioceptive and Biomechanical Therapies, Sassenberg, Germany
| | - Z M Hawamdeh
- Physical Medicine and Rehabilitation, School of Rehabilitation Sciences, University of Jordan
| | - G J Kleinrensink
- Department of Neuroscience and Anatomy, University Medical Center of Rotterdam, Rotterdam, Holland
| | - E Matheron
- IRIS Group, "Physiopathologie de la Vision et Motricité Binoculaire" CNRS FR2022, Université Paris Descartes, UFR Biomédicale, Paris, France
| | - V L Stoev
- Romanian Association of Posturology, Romania
| | - S Stratulat
- University of Medicine and Pharmacy "Gr. T. Popa," Iasi, Romania
| | - S Tiron
- Romanian Association of Posturology, Romania
| | - P Villeneuve
- International Posturology Association, University de Valenciennes, Spain
| | - T Paolucci
- Unit of Physical Medicine and Rehabilitation, Department of Oral, Medical and Biotechnological Sciences, University of G. d'Annunzio of Chieti-Pescara, Italy
| | - R G Bellomo
- University of Study of Urbino Carlo Bo, Department of Biomolecular Sciences, Urbino, Italy
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Mammucari M, Russo D, Maggiori E, Paolucci T, Di Marzo R, Brauneis S, Bifarini B, Ronconi G, Ferrara PE, Gori F, Mediati RD, Vellucci R, Migliore A, Natoli S. Evidence based recommendations on mesotherapy: an update from the Italian society of Mesotherapy. Clin Ter 2021; 171:e37-e45. [PMID: 33346324 DOI: 10.7417/ct.2021.2278] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Mesotherapy, also known as local intradermal therapy, widely used all over the world, is a technique used to inject substances into the surface layer of the skin. There are no international guidelines for the correct use of this technique and in many countries, it is still applied empirically without valid patient consent. The Italian society of mesotherapy has planned a study to assess the rationale and clinical applications based on current evidence. METHODS An independent steering committee, based on the available scientific literature, has formulated a series of clinical questions. 21 experts responded by writing an evidence-based document. From this document 30 statements were obtained which were presented to 114 experts using the Delphi method. RESULTS 28 statements reached a broad agreement on definition, technique, pharmacological rationale, indications and some crucial ethical aspect. CONCLUSIONS Although further studies are needed to establish the clinical role of this technique in each field of application, our statements recommend the correct application according to the needs of the individual patient in full respect of ethics.
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Affiliation(s)
| | - D Russo
- San Marco Hospice and Palliative Care, Latina
| | | | - T Paolucci
- University G. D'Annunzio Chieti, Department of Medical and Oral Sciences and Biotechnologies, Chieti-Pescara
| | - R Di Marzo
- Member of the Italian Society of Mesotherapy, Rome
| | - S Brauneis
- Pain Center "Enzo Borzomati", University Hospital of Rome "Policlinico Umberto I", Rome
| | - B Bifarini
- Section of Anesthesia, Intensive Care, and Pain Medicine, Azienda Ospedaliera-Universitaria Santa Maria Della Misericordia, Perugia
| | - G Ronconi
- University Policlinic Foundation A. Gemelli IRCCS, Rome
| | - P E Ferrara
- University Policlinic Foundation A. Gemelli IRCCS, Rome
| | - F Gori
- Section of Anesthesia, Intensive Care, and Pain Medicine, Azienda Ospedaliera-Universitaria Santa Maria Della Misericordia, Perugia
| | - R D Mediati
- Department of Anesthesia of Careggi University Hospital, Florence
| | - R Vellucci
- Department of Anesthesia of Careggi University Hospital, Florence
| | - A Migliore
- Unit of Rheumatology, San Pietro Fatebenefratelli Hospital, Rome
| | - S Natoli
- Dept of Clinical Science and Translational Medicine, University of Rome Tor Vergata AND Unit of Pain Therapy, Polyclinic of Tor Vergata - Rome, Italy
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Celletti C, Camerota F, Paolucci T, Pezzi L, De Meo D, Castori M, Villani C, Persiani P. A proposal of rehabilitative approach in the rare disease "De Barsy Syndrome": case report. Clin Ter 2021; 171:e4-e7. [PMID: 33346319 DOI: 10.7417/ct.2021.2273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
De Barsy syndrome is an autosomal recessive condition characterized by an progeroid appearance with distinctive facial features and cutis laxa. Ophthalmological, orthopedic, and neurological anomalies are generally also present. This syndrome is rare and the complex therapeutic management, from a surgical but also rehabilitative point of view, has not been recognized. The aim of this paper is to describe a possible rehabilitative protocol, after an orthopedic surgical treatment, in a child with De Barsy Syndrome. A 6-year-old boy was born with a congenital bilateral hip dysplasia associated with bilateral congenital foot deformity (vertical talus). Moreover, he showed stereotypic dyskinetic movements and psychomotor delay with cognitive impairment and absent language; the sitting position was maintained with orthoses to support the trunk control and the standing position was not acquired. He was treated with pinstripe knee-highs for the foot and double nappy for the hips. At 19 months old, he underwent a two stage surgical approach for a bilateral pronated valgus foot with severe talonavicular subluxation. Satisfactory hip range of motion was achieved by conservative treatment alone. Afterwards, for the foot laxity and the flat-pronated foot corrective shoes were prescribed. The main rehabilitative goals were: attention improvement, visual exploration for foot-eye and hand-eye coordination, encourage the essential prerequisites of language, controlling the upright position using support, improving hip-knee-foot relationship, improving load transfer between the right and left sides of the body, and bimanual coordination. The rehabilitation process lasted six months, three times a week, for a time from 30 minutes to 60 minutes per session. The results were encouraging and the patient acquired the possibility of sitting with the indicated postural system, the possibility of assuming an upright position and taking a few steps with the aid of rollator with a postural stabilization system for the pelvis.
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Affiliation(s)
- C Celletti
- Physical Medicine and Rehabilitation Division, Umberto I University Hospital of Rome
| | - F Camerota
- Physical Medicine and Rehabilitation Division, Umberto I University Hospital of Rome
| | - T Paolucci
- Unit of Physical Medicine and Rehabilitation, G. D' Annunzio University of Chieti-Pescara, Department of Oral Medical Science and Biotechnology (DSMOB)
| | - L Pezzi
- Unit of Physical Medicine and Rehabilitation, G. D' Annunzio University of Chieti-Pescara, Department of Oral Medical Science and Biotechnology (DSMOB)
| | - D De Meo
- Department of Orthopaedic and Traumatology, Policlinico Umberto I Hospital-Sapienza University of Rome
| | - M Castori
- Divisione of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia
| | - C Villani
- Department of Orthopaedic and Traumatology, Policlinico Umberto I Hospital-Sapienza University of Rome
| | - P Persiani
- Department of Orthopaedic and Traumatology, Policlinico Umberto I Hospital-Sapienza University of Rome
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Paolucci T, Agostini F, Mangone M, Bernetti A, Cordiani B, Bellomo RG, Saggini R, Villani C. Sagittal spine alignment and postural balance in pre-puberty age: a multidisciplinary and multi-professional rehabilitative point of view. J BIOL REG HOMEOS AG 2021; 35:367-372. [PMID: 33511839 DOI: 10.23812/20-621-l] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- T Paolucci
- Department of Medical Science and Oral Biotechnology, G. D'Annunzio University of Chieti-Pescara, Italy
| | - F Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Italy
| | - M Mangone
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Italy
| | - A Bernetti
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Italy
| | - B Cordiani
- Department of Ophthalmology and Ocular Surgery, Britannico Hospital, Rome, Italy
| | - R G Bellomo
- Physical Medicine and Rehabilitation, Carlo Bò University of Urbino, Urbino, Italy
| | - R Saggini
- Department of Medical Science and Oral Biotechnology, G. D'Annunzio University of Chieti-Pescara, Italy
| | - C Villani
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Italy
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Saggini R, Paolucci T, Bramanti A, Bellomo RG. A bioprogressive approach for post-acute rehabilitation in elderly COVID-19 survivors. J BIOL REG HOMEOS AG 2020; 34:2343-2344. [PMID: 33317260 DOI: 10.23812/20-394-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- R Saggini
- Unit of Physical Medicine and Rehabilitation, G. D'Annunzio University of Chieti-Pescara, Department of Oral Medical Science and Biotechnology (DSMOB), Italy.,Centro per Neurolesi "Bonino Pulejo," IRCSS, Messina, Italy
| | - T Paolucci
- Unit of Physical Medicine and Rehabilitation, G. D'Annunzio University of Chieti-Pescara, Department of Oral Medical Science and Biotechnology (DSMOB), Italy
| | - A Bramanti
- Centro per Neurolesi "Bonino Pulejo," IRCSS, Messina, Italy
| | - R G Bellomo
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
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Spacone A, Paolucci T, Prosperi P, Giannandrea N, Pezzi L, Bellomo RG, Saggini R. Possible phenotyping of apnoea obstructive sleep of female patients. J BIOL REG HOMEOS AG 2020; 34:1545-1547. [PMID: 32957770 DOI: 10.23812/19-548-l] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A Spacone
- Respiratory Medicine Department, "Santo Spirito" Hospital, Pescara, Italy
| | - T Paolucci
- Physical Medicine and Rehabilitation Unit, Department of Medical and Oral Science and Biotechnology (DSMOB), G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - P Prosperi
- Respiratory Medicine Department, "Santo Spirito" Hospital, Pescara, Italy
| | - N Giannandrea
- Physical Medicine and Rehabilitation Unit, Department of Medical and Oral Science and Biotechnology (DSMOB), G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - L Pezzi
- Physical Medicine and Rehabilitation Unit, Department of Medical and Oral Science and Biotechnology (DSMOB), G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - R G Bellomo
- Physical Medicine and Rehabilitation, Carlo Bò University of Urbino, Urbino, Italy
| | - R Saggini
- Physical Medicine and Rehabilitation Unit, Department of Medical and Oral Science and Biotechnology (DSMOB), G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
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Paolucci T, Pezzi L, G Bellomo R, Saggini R. A novel microgravity postural rehabilitation protocol in Beckwith Wiedemann syndrome: a case report. Clin Ter 2020; 171:e471-e475. [PMID: 33151243 DOI: 10.7417/ct.2020.2259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Beckwith-Wiedemann syndrome (BWS) is a genetic overgrowth syndrome. The excess growth can manifest as whole-body or regional overgrowth in approximately 25% of patients. PURPOSE The aim of this case report is to show an original rehabilitation protocol in BWS for improving the recovery of postural control in asymmetric body growth of the body. CASE DESCRIPTION An 11-year-old male with BWS performed a rehabilitation program for 12 months, once a week (every session lasted 45 minutes), composed of postural exercises under microgravity conditions using the Dynamic-Antigravity-Postural-System (SPAD) and proprioceptive insoles. CONCLUSIONS The results showed that: SPAD improved the asymmetry of the morphology and body dynamics and could prevent further postural alterations; the proprioceptive insoles increased the postural stability of the patient with improved walking. Future research will be needed to expand these results.
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Affiliation(s)
- T Paolucci
- Department of Medical and Oral Sciences and Biotechnologies, University "G.d'Annunzio", Chieti-Pescara
| | - L Pezzi
- Department of Medical and Oral Sciences and Biotechnologies, University "G.d'Annunzio", Chieti-Pescara
| | - R G Bellomo
- Department of Biomolecular Sciences, University of Study of Urbino Carlo Bo, Urbino
| | - R Saggini
- Department of Medical and Oral Sciences and Biotechnologies, University "G.d'Annunzio", Chieti-Pescara - IRCSS Centro Neurolesi "Bonino Pulejo", Messina, Italy
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Agostini F, Mangone M, Santilli V, Paoloni M, Bernetti A, Saggini R, Paolucci T. Idiopathic facial palsy: umbrella review of systematic reviews and meta-analyses. J BIOL REG HOMEOS AG 2020; 34:1245-1255. [PMID: 32935528 DOI: 10.23812/20-339-a] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Idiopathic facial palsy is the most common disease of the VII cranial nerve. There are many treatments to facilitate recovery from this condition: pharmacological, surgical, rehabilitative, but the effectiveness of some of these treatments, especially the latter, is still under discussion. The purpose of this umbrella review of systematic reviews is to analyse the literature in order to investigate the different rehabilitation interventions in patients suffering from idiopathic facial palsy. A scientific literature search was carried out from January 2009 until August 2019, using Mesh the terms "facial palsy", "Bell's Palsy", "idiopathic facial nerve palsy", combined with "rehabilitation" and "therapy". Initially all the systematic reviews and meta-analyses of the last 10 years concerning rehabilitation treatments for the recovery of injured functions in facial palsy were included. Given the heterogeneity of the studies in the literature, which do not differentiate the different causes of facial palsy, all the causes of idiopathic facial palsy were included in the review. The research resulted in 94 published systematic reviews but only 6 were considered in respect to the inclusion criteria. All studies agree on the lack of high-quality scientific work to be able to say that Bell's physiotherapy treatments for facial palsy are effective, in particular with regard to recovery times during the rehabilitation process. Future studies are needed, in order to highlight the therapeutic implications of the different rehabilitation methods, with standardized protocols, in patients suffering from facial palsy of different aetiology.
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Affiliation(s)
- F Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - M Mangone
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - V Santilli
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - M Paoloni
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - A Bernetti
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - R Saggini
- Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - T Paolucci
- Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
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Bellomo RG, Pezzi L, Paolucci T, Porreca A, Saggini R. Primary school screening of flatfoot in 6-year-old children: a descriptive study to plan a rehabilitative approach. J BIOL REG HOMEOS AG 2020; 34:297-303. [PMID: 32133834 DOI: 10.23812/19-396-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- R G Bellomo
- Department of Biomolecular Sciences, University of Study of Urbino Carlo Bo, Urbino, Italy
| | - L Pezzi
- Department of Medical and Oral Sciences and Biotechnologies, School of specialty in physical and rehabilitative medicine, University G. d'Annunzio Chieti, Italy
| | - T Paolucci
- Department of Medical and Oral Sciences and Biotechnologies, Physical and Rehabilitative Medicine, University G. d'Annunzio Chieti- Pescara, Chieti, Italy
| | - A Porreca
- Department of Economics, University G. d'Annunzio Chieti-Pescara, Chieti, Italy
| | - R Saggini
- Department of Medical and Oral Sciences and Biotechnologies, Physical and Rehabilitative Medicine, University G. d'Annunzio Chieti- Pescara, Chieti, Italy
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12
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Paolucci T, Pezzi L, Centra MA, Porreca A, Barbato C, Bellomo RG, Saggini R. Effects of capacitive and resistive electric transfer therapy in patients with painful shoulder impingement syndrome: a comparative study. J Int Med Res 2019; 48:300060519883090. [PMID: 31680597 PMCID: PMC7783264 DOI: 10.1177/0300060519883090] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective Capacitive and resistive electric transfer therapy (CARE) reduces pain and
improves quality of life for many orthopaedic degenerative and inflammatory
disorders. The research aim was to determine the effects of CARE on painful
shoulder. The outcomes were pain reduction and recovery of shoulder
function. Methods A retrospective, observational case-control study was conducted. Participants
were 46 patients (22 in the CARE group and 24 in the SHAM group). Clinical
data, pain (visual analogic scale, VAS) and functional scale scores
(Disabilities of the Arm, Shoulder and Hand scale, and Constant–Murley
Scale) were measured at baseline T0 (before treatment), T1 (after treatment)
and follow-up T2 (2 months after the end of the treatment). Results VAS scores in the CARE group improved from 7.23 ± 1.11 at baseline to
2.68 ± 0.99 at follow-up. The SHAM group did not experience any improvement.
Similarly, functional scale scores improved in the CARE group compared with
the SHAM group. Conclusion Considering the small number of sessions needed, low cost and long-term
benefits, CARE could be a useful therapeutic option for the conservative
management of shoulder pain to restore pain-free and powerful movement to
the shoulder joint.
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Affiliation(s)
- T Paolucci
- University G. d'Annunzio Chieti, Department of Medical and Oral Sciences and Biotechnologies, Chieti-Pescara, Italy
| | - L Pezzi
- University G. d'Annunzio Chieti, Department of Medical and Oral Sciences and Biotechnologies, Chieti-Pescara, Italy
| | - M A Centra
- University G. d'Annunzio Chieti, Department of Medical and Oral Sciences and Biotechnologies, Chieti-Pescara, Italy
| | - A Porreca
- Department of Economics, 'Gabriele d'Annunzio' University, Chieti-Pescara, Italy
| | - C Barbato
- University of Study of Urbino Carlo Bo, Department of Biomolecular Sciences, Urbino, Italy
| | - R G Bellomo
- University of Study of Urbino Carlo Bo, Department of Biomolecular Sciences, Urbino, Italy
| | - R Saggini
- University G. d'Annunzio Chieti, Department of Medical and Oral Sciences and Biotechnologies, Chieti-Pescara, Italy
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13
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Paolucci T, Bellomo RG, Centra MA, Giannandrea N, Pezzi L, Saggini R. Mesotherapy in the treatment of musculoskeletal pain in rehabilitation: the state of the art. J Pain Res 2019; 12:2391-2401. [PMID: 31440078 PMCID: PMC6679691 DOI: 10.2147/jpr.s209610] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 05/29/2019] [Indexed: 01/15/2023] Open
Abstract
Background Mesotherapy can be included as an ancillary treatment in the management of localized pain in rehabilitation, but there are no definitive treatment protocols for this approach. Objectives The purpose of this review was to examine new indications for more standard protocols of mesotherapy in rehabilitation. Materials and methods This systematic review was performed using the following resources: PubMed, Cochrane, PEDro, Scopus, and Google Scholar. The following algorithm was developed, based on the PICO acronym, to evaluate the effects of mesotherapy, with pain as the primary outcome (MESH terms): [mesotherapy AND pain], [mesotherapy AND musculoskeletal], [mesotherapy AND musculoskeletal disorder], [intradermal therapy AND pain], and [intradermal therapy AND musculoskeletal disorder]. Results Seven articles (N=7) satisfied the inclusion criteria and were considered in the review: two of them treated osteoarthritis of the knee (3 sessions) and pes anserine (9 sessions) emphasizing a good efficacy of mesotherapy. Five studies analyzed spine diseases (specifically, two was about chronic and nonspecific neck pain, two about acute low back pain and one about chronic spinal pain): the results of mesotherapy treatment are encouraging both for the resolution of acute and chronic musculoskeletal vertebral pain from one to five sessions. Conclusion Mesotherapy showed a good effect to reduce acute and chronic musculoskeletal pain and, also, it is a well-tolerated treatment. Nonetheless future randomized controlled trials should be desirable for more uniform treatment protocols.
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Affiliation(s)
- T Paolucci
- University G.d'Annunzio Chieti, Department of Medical and Oral Sciences and Biotechnologies, Chieti-Pescara, Italy
| | - R G Bellomo
- University of Study of Urbino Carlo Bo, Department of Biomolecular Sciences, Urbino, Italy
| | - M A Centra
- University G.d'Annunzio Chieti, Department of Medical and Oral Sciences and Biotechnologies, Chieti-Pescara, Italy
| | - N Giannandrea
- University G.d'Annunzio Chieti, Department of Medical and Oral Sciences and Biotechnologies, Chieti-Pescara, Italy
| | - L Pezzi
- University G.d'Annunzio Chieti, Department of Medical and Oral Sciences and Biotechnologies, Chieti-Pescara, Italy
| | - R Saggini
- University G.d'Annunzio Chieti, Department of Medical and Oral Sciences and Biotechnologies, Chieti-Pescara, Italy
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14
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Paolucci T, Capobianco SV, Vinciguerra SM, Cilli M, Villani C, Saraceni VM. A novel neurocognitive rehabilitation tool in the recovery of hemiplegic hand grip after stroke: a case report. Funct Neurol 2019; 34:53-57. [PMID: 31172940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Stroke has significant physical, psychological and social consequences. Recent rehabilitation approaches suggest that cognitive exercises with dual-task (sensory-motor) exercises positively influence the recovery and function of the hemiplegic hand grip. The purpose of this study was to describe a rehabilitation protocol involving the use of a new neurocognitive tool called "UOVO" for hand grip recovery after stroke. A 58-year-old right-handed male patient in the chronic stage of stroke, presenting with left-sided hemiparesis and marked motor deficits at the level of the left hand and forearm, was treated with the UOVO, a new rehabilitation instrument based on the neurocognitive rehabilitation theory of Perfetti. The patient was evaluated at T0 (before treatment), T1 (after treatment) and T2 (2 months of follow-up). At T2, the patient showed improvements of motor functions, shoulder, elbow and wrist spasticity, motility and performance. This case report explores the possibility of improving traditional rehabilitation through a neurocognitive approach with a dual-task paradigm (including motor and somato-sensory stimulation), specifically one involving the use of an original rehabilitation aid named UOVO, which lends itself very well to exercises proposed through the use of motor imagery. The results were encouraging and showed improvements in hemiplegic hand grip function and recovery. However, further studies, in the form of randomized controlled trials, will be needed to further explore and confirm our results.
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15
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Paolucci T, Iosa M, Vulpiani M, Paolucci S, Piermattei C, De Angelis S, Saraceni V. Perception of trunk appearance and body self in adolescent idiopathic scoliosis: The significance of brace treatment. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Pelliccioni A, Zangrando F, Paolucci T, Saraceni V. Neurocognitive rehabilitation in Parkinson's disease: Case report. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.1213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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17
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Paolucci T, Morone G, Luziatelli S, Iosa M, Paolucci S, Vulpiani M, Zangrando F, Saraceni V, Baldari C, Guidetti L. The efficacy of Wii fit training vs. adapted physical activity in elderly subjects on balance: Preliminary results. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Zangrando F, Paolucci T, Vulpiani MC, Lamaro M, Isidori R, Saraceni VM. Chronic pain and motor imagery: a rehabilitative experience in a case report. Eur J Phys Rehabil Med 2014; 50:67-72. [PMID: 24622048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND The "neuromatrix" theory of Melzack and the studies of Decety on motor imagery have opened the way to an alternative rehabilitation method in chronic pain. AIM To evaluate the role of motor imagery in chronic shoulder pain rehabilitation. DESIGN Case report. SETTING University outpatient rehabilitation. POPULATION A 49-year-old female with chronic shoulder pain. METHODS Neurocognitive approach, which involves the use of a new tool called "naval battle" to achieve chronic pain relief as assessed by the Visual Analogic Scale (VAS) and McGill Pain Questionnaire (MPQ). The Shoulder Rating Questionnaire (SRQ) and Constant Scale (CS) were used to measure functional improvement. RESULTS The results indicate significant pain relief (71%) and improvement in functionality (50%). CONCLUSION The results seem to confirm the accuracy of the hypothesis on the genesis of chronic pain as a perceptive "discoherency" and that motor imagery can remake a coherence of afferences at central level in chronic pain. CLINICAL REHABILITATION IMPACT The use of motor imagery in rehabilitation can be a viable alternative in chronic shoulder pain resistant to other rehabilitation protocols.
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Affiliation(s)
- F Zangrando
- Physical Medicine and Rehabilitation Unit La Sapienza University, Policlinico Umberto I, Rome, Italy -
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19
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Paolucci T, Morone G, Di Cesare A, Grasso MR, Fusco A, Paolucci S, Saraceni VM, Iosa M. Effect of Chêneau brace on postural balance in adolescent idiopathic scoliosis: a pilot study. Eur J Phys Rehabil Med 2013; 49:649-57. [PMID: 23820877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
BACKGROUND Adolescents with idiopathic scoliosis show a postural instability compared with healthy subjects. DESIGN TYPE. Case control study. SETTING Outpatient clinic of the Complex Operative Unit of Physical Medicine and Rehabilitation of Policlinico Umberto I Hospital. POPULATION Thirteen patients (11 females and 2 males, mean age 13.3±1.7 years, mean Cobb angle 32±9, median Risser sign 2) and thirteen healthy adolescents (8 females and 5 males, mean age: 13.0±1.6 years) as age-matched control group were enrolled. METHODS Postural ability of the participants was assessed with stabilometry (under open eyes and closed eyes conditions), computing sway length, sway ellipse area, and sway velocities. Static and dynamic baropodometry (open eyes only) was used to measure the limb load, and to compute: walking speed, step length, step cadence and step width. The symmetry of left and right limb values was also investigated. RESULTS Patient's group was characterized by significantly higher postural instability than control group (P<0.05) that decreased with brace in terms of limb load symmetry (-12% in eyes open condition), sway length (-12%), velocity in anteroposterior (-16%) and latero-lateral directions (-10%). Significant correlations were found between the changes occurred when wearing Chêneau brace on load symmetry during standing and those on symmetry of gait (R>0.5, P<0.05). CONCLUSION AND CLINICAL REHABILITATION IMPACT Our results show slight changes in terms of posture when wearing Chêneau brace according with the severity of pathology and significantly affecting gait parameters. For these reasons, use of postural balance evaluation should be objectively used to verify the efficacy of Cheneau brace on body functioning of adolescents with idiopathic scoliosis.
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Affiliation(s)
- T Paolucci
- Complex Operative Unit in Physical Medicine and Rehabilitation, Policlinico Umberto I Hospital, Rome, Italy -
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20
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Vetrano M, Pournajaf S, Vulpiani MC, Santoboni F, Paolucci T, Spadini E, Ferretti A, Saraceni VM. Perceptive rehabilitation of patients with non-specific chronic low back pain: the role of body midline. A randomized controlled trial. Eur J Phys Rehabil Med 2013; 49:517-525. [PMID: 23486306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Surface for perceptive rehabilitation (Su-Per treatment) is a hopeful therapeutic system in the treatment of non-specific chronic low back pain (CLBP). During treatment, some patients poorly tolerate the presence of the less elastic cones at the back midline. AIM To assess the importance of an increased awareness of body midline through higher stimulus at interspinous line during Su-Per treatment for non-specific CLBP. DESIGN Single-blind, randomized, controlled trial. SETTING Outpatient academic hospital. POPULATION Forty patients with non-specific CLBP, for at least 12 weeks before treatment. METHODS The patients were distributed in 2 groups: Group A (20 patients) received standard Su-Per treatment; Group B (20 patients) received Su-Per treatment without higher stimulus at interspinous line. Pain was assessed using the Visual Analogue Scale and the Present Pain Intensity and Pain Rating Index of the McGill Pain Questionnaire. Disability was evaluated using the Oswestry Disability Index. RESULTS In both groups, a significant reduction of pain and disability scores was observed at the first follow-up (end of treatment), and was maintained at later evaluations (4-weeks, and 12-weeks follow up). No significant difference was observed between the two groups in all outcome measures at all time points (P>0.05 for all). CONCLUSION Su-Per treatment is a valid modality in a cognitive-perceptive therapeutic concept for non-specific CLBP. It does not necessarily require external stimulation of the body midline to be effective. CLINICAL REHABILITATION IMPACT Modifying the standard distribution of the cones, without less deformable cones along interspinous line, makes the Su-Per treatment more acceptable to patients.
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Affiliation(s)
- M Vetrano
- Physical Medicine and Rehabilitation Unit, La Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy -
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21
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Paolucci T, Morone G, Iosa M, Fusco A, Alcuri R, Matano A, Bureca I, Saraceni VM, Paolucci S. Psychological features and outcomes of the Back School treatment in patients with chronic non-specific low back pain. A randomized controlled study. Eur J Phys Rehabil Med 2012; 48:245-53. [PMID: 22095057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
BACKGROUND Low back pain is a worldwide health problem, affecting up to 80% of adult population. Psychological factors are involved in its development and maintenance. Many clinical trials have evaluated the efficacy of different interventions for chronic non-specific low back pain. In this field, Back School program has been demonstrated effective for people with chronic non-specific low back. AIM To evaluate the relationship between the effects of the Back School treatment and psychological features measured by MMPI-II of patients with chronic non-specific low back pain. DESIGN A randomised controlled trial with three and six-month follow-up. SETTING Ambulatory rehabilitative university centre. POPULATION Fifty patients with chronic non-specific low back pain out of 77 screened patients. METHODS Patients were randomly placed in a 3:2 form and were allocated into two groups (Treatment versus Control). The Treatment Group participated to an intensive multidisciplinary Back School program (BSG, N.=29), while the Control Group received medical assistance (CG, N.=21). Medication was the same in both groups. Then, patients were subgrouped in those with at least an elevation in one scale of MMPI-II, and those without it. The Short Form 36 Health Status Survey for the assessment of quality of life (primary outcome measure), pain Visual Analogue Scale, Waddel Index and Oswestry Disability Index were collected at baseline, at the end of treatment, and at the three and six-month follow-up. RESULTS Only the two treated subgroups showed a significant improvements in terms of quality of life, disability and pain. Among treated subjects, only those with at least one scale elevation in MMPI-II showed also a significant improvement in terms of Short Form 36 mental composite score and relevant subscores. CONCLUSION These results suggest that Back School program has positive effects, even in terms of mental components of quality of life in patients with scale elevations of MMPI-II. Probably these findings are due to its educational and cognitive-behavioural characteristics. CLINICAL REHABILITATION IMPACT Because of its educational purposes, the Back School treatment can have positive effects also on the mental status of patients with low back pain when it affects their psychological features.
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Affiliation(s)
- T Paolucci
- Department of Physical Medicine and Rehabiltation, Policlinico Umberto I, Sapienza University, Rome, Italy
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Cappellino F, Paolucci T, Zangrando F, Iosa M, Adriani E, Mancini P, Bellelli A, Saraceni VM. Neurocognitive rehabilitative approach effectiveness after anterior cruciate ligament reconstruction with patellar tendon. A randomized controlled trial. Eur J Phys Rehabil Med 2012; 48:17-30. [PMID: 22543555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND A proper knee rehabilitation after a surgical reconstruction of the anterior cruciate ligament (ACL) should start immediately after the injury and it should be focused on recovery of symmetry, proprioception, swelling reduction, gait training, hyperextension exercises, and even mental preparation. AIM Aim of this study was to test a neurocognitive rehabilitative approach based on proprioceptive exercises and proper motor strategy choices, compared with conventional rehabilitation, assessing baropodometric, gait and clinical changes. DESIGN Randomized controlled trial. SETTING Ambulatory University Centre. POPULATION Fourteen subjects (27.9±5.2 years) underwent to a surgical reconstruction of ACL were divided into the two groups. METHODS The subjects were randomly assigned into a group who received a specific neurocognitive and perceptive rehabilitation treatment (TG), and into a control group who received the common physical therapy (CG). The following outcome measures were assessed pre-intervention, one, three and six months later: static and dynamic baropodometry, Visual Analog Scale for pain, Short Form SF-36, Range of Motion, trophism of thigh region, edema, Manual Muscle Test, magneto-resonance imaging assessment. RESULTS Lower impairment was observed in TG in respect of CG in terms of load asymmetry during static baropodometry (from 7% to 3% vs. from 10% to 7%, interaction time per treatment: P=0.037), less wide steps during gait (effect size=1.05 vs. 0.38 for CG), swelling (treatment effect: P=0.012). A significantly higher improvement (from 35% to 100%) in terms of SF-36 was recorded only in TG for physical activity (P=0.027). CG showed a quite higher walking speed (treatment effect: P=0.049). CONCLUSION Even if further studies are needed on larger samples, the obtained results showed that a neurocognitive rehabilitative approach could be an effective treatment after ACL-reconstruction: in TG we observed a more rapid load symmetrization, the reduction of step width and a more rapid resolution of edema. CLINICAL REHABILITATION IMPACT Posture, gait, clinical features and quality of life could benefit from a neurocognitive rehabilitation after ACL surgical reconstruction.
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Affiliation(s)
- F Cappellino
- Rodi 1 Unit, San Giovanni Battista Hospital, Rome, Italy
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Morone G, Paolucci T, Alcuri MR, Vulpiani MC, Matano A, Bureca I, Paolucci S, Saraceni VM. Quality of life improved by multidisciplinary back school program in patıents with chronic non-specific low back pain: a single blind randomized controlled trial. Eur J Phys Rehabil Med 2011; 47:533-541. [PMID: 21508915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
STUDY DESIGN A three and six months follow-up in a randomized controlled trial. BACKGROUND Back School has become a widespread exercise program for low back pain (LBP), since its introduction in 1969. Back School could improve quality of life (QoL), but there are controversial data regarding its effectiveness. AIM To evaluate the effects of the Back School program on quality of life (primary outcome), disability and pain perceptions (secondary outcomes) in patients with chronic and non-specific low back pain. SETTING Rehabilitative specialized centre. POPULATION Seventy four patients with chronic non-specific LBP. METHODS Patients were randomly placed in a 3:2 form and were allocated into 2 groups (treated-control). Treatment group participated in a intensive multidisciplinary Back School program including brief education and active back exercises (BSG, N.=41), while the control group received medical assistance (CG, N.=29). Medication was the same in both groups. The Short Form 36 Health Status Survey, Waddel Index, Oswestry Disability Index and Visual Analogue Scale were collected at baseline, at the end of treatment, and at the three and six month follow-up. RESULTS Quality of life significantly improved along time more in BSG, both in Physical and Mental Composite Score (repeated measure Anova: interaction time per group: P<0.001 and P=0.002, respectively). We also observed a significant improvement in disability scores along time (P<0.001) in BSG with significant differences between groups at three and at six months for Waddell Index (P=0.006 and P=0.009 respectively) and for Oswestry Disability Index (P=0.018 and 0.011 respectively). Moreover, pain perception score VAS showed a reduction in both groups, but it was significantly lower in BSG at end of treatment and both follow-ups (P<0.001). CONCLUSION Our Back School program can be considered an effective treatment in people with chronıc non-specıfıc LBP.
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Affiliation(s)
- G Morone
- Movement and Brain Laboratory, IRCCS Santa Lucia, Rome, Italy.
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