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The recovery of functional gait is the main target for subjects who have suffered a stroke. The methods designed to improve balance and gait appear to be essential for skills and autonomy and to reduce the costs of assistance. The aim of our study was to evaluate the improvement of stroke victims in the chronic phase through the rehabilitation of gait, balance and posture using postural re-alignment with specific body weight support. The study includes 20 subjects with residual hemiparetic gait after stroke. Evaluation with international rating scales, gait analysis and stabilometric test was carried out at the beginning and after the 1 st and the 3 rd month of therapy; a follow-up control was made 3 months after the end of the rehabilitation program. All subjects underwent the rehabilitation protocol with Dynamic Antigravity Postural System 2 times a week for 3 months and were also treated with high efficiency focused acoustic waves (ViSS) to increase strength and muscular endurance (300Hz) or to reduce spastic hypertonia (200–120 Hz). The study shows a significant improvement in gait and balance with the persistence of results at the follow-up 3 months after the end of treatment. The subjects showed an increase in walking speed, greater stability and a consequent reduction of sedentary lifestyle with less risk of complications or recurrence. In conclusion this rehabilitation program is efficient for posture and walking quality.

The aim of this study was to evaluate the efficacy of the treatment of chronic ulcers with unfocused shock waves. Between March 2009 and February 2012 we studied a group of 124 patients, aged between 28 and 80 years, with serious wounds arisen over three months and who met the inclusion criteria for treatment. The patients were randomly divided into groups A and B, both treated with unfocused ESWT but with an average energy density for each impulse equal to 0.10 mJ/mm 2 in group A (total energy equal to 1.7 mJ for each shot) and an average energy density for each impulse equal to 0.04 mJ/mm 2 in group B (total energy equal to 3.3 mJ for each shot). The pulses were administered at a frequency of 4 Hz in both groups. Wounds were classified according to: location, width, length, percentage of granulation tissue, necrotic tissue, fibrous tissue, presence of bacterial exudation and pain (assessed by VAS). Their evolution was monitored by photo capture. The patients were treated with a frequency of 1 session every 7 days for 7 weeks. During the treatment period, the possible occurrence of side effects was monitored. Before treatment the wounds in group A had an average area equal to 3.85 cm 2 and the average value of the VAS pain scale was equal to 5.8 (range 2–9); the wounds in group B had an average area equal to 3.4 cm 2 and the average value of the VAS pain scale was equal to 5.7 (range 3–9). At the end of the treatment protocol the mean area in group A decreased by 80% (final mean area 0.93 cm 2 ), and the average pain on VAS scale dropped by 79%; the mean area in group B decreased by 67% (final mean area 1.2 cm 2 ) and the average score on VAS scale dropped by 48%. None of the treated patients experienced adverse reactions to treatment. None of the treated wounds developed infection during treatment. In conclusion, shock waves can act on difficult wounds, stimulating the reparative physiological process; therefore it represents an effective and safe procedure to accelerate the healing process, reducing the operating costs and avoiding more complex interventions.

In aging, there is a gradual decrease in muscle mass (sarcopenia) and muscle strength which contributes to a decline in physical functions, increased disability, frailty, and loss of independence. Physical activity can reduce functional decline due to aging. Randomized controlled trials (RCT) are needed to determine the effectiveness of different exercise stimuli on muscle strength and balance in the sarcopenic elderly. Forty male volunteers diagnosed with sarcopenia (CDCP) (70.9±5.2yrs) were enrolled in this study. A randomized, controlled trial, with blind assessment, was designed to study the effect of global sensorimotor, high intensity focused vibrational (intensity: 300Hz) and resistance training (intensity: 60–80% of maximum theoretical force, 10–12 repetitions for 3 sets) stimuli on muscle strength and balance confidence. The subjects were randomly assigned to three different training programs or a control group which was encouraged to maintain their habitual activity level. The training was performed for 12 weeks in all groups: 2 sessions/week in Gsm and Ret groups; 1 session/week for the first 8 weeks and 3 sessions/week for the last 4 weeks in Vam group. The main outcome was maximal force contraction of the lower limbs, and secondary outcomes were static and dynamic balance confidence. All the training regimens increased isometric strength. Both the sensorimotor and the vibrational training increased stability with a reduction of sway area and of ellipse surface (p

The purpose of this study is to evaluate the effects of rehabilitative approach using MJS and dynamic antigravity postural system (SPAD) with extracorporeal Shockwave therapy (ESWT) on rotator cuff syndrome associated tendon supraspinatus and infraspinatus medium tear (1–3 cm) of the tendons. In the last few years, ESWT has been proposed as an elective treatment in somatic diseases with encouraging short-term results. For this study the authors enrolled 108 patients who underwent 3 treatments with ESWT associated with 24 rehabilitation sessions over 3 weeks. Outcome measures were the VAS for pain and the Constant Murley Scale. The outcomes were measured pre-training, post-training and at 2, 4, 6 month follow-ups. Additional follow-up evaluation sessions were performed every year for 5 years by a telephone interview to evaluate changes in pain and function and the efficacy of treatment. Our study shows that the therapeutic efficacy of rehabilitative approach with ESWT in the rotator cuff syndrome with medium tears persists over time and significantly improves the patient's quality of life. The results obtained are certainly to be attributed to the biological mechanisms that ESWT are able to engage in tissues of the rotator cuff. The results seen at the conclusion of the treatment were maintained over the following years, thanks to the use of MJS and SPAD. In our opinion a conservative treatment with extracorporeal shock-wave (ESW), dynamic antigravity postural system (SPAD) and multi joint system (MJS) should be considered as an alternative and effective treatment for rotator cuff syndromes with medium tears.

The aim of the study was to show that the addition of extracorporeal shockwave therapy (ESWT) may significantly improve beneficial effects of eccentric training together with high efficiency focused acoustic waves for jumper's knee. We speculate that such an effect may be due to increased mechanotransduction effects on affected tissues. We assessed changes in pain and function in 42 male football players (aged 1834 years) after a treatment protocol consisting of I session with focused ESWT per week combined with 3 physiotherapy sessions per week, for 3 consecutive weeks. While treatment protocol was administered, ordinary activities, but not playing football were permitted. Their condition was evaluated before treatment, at the end of the rehabilitation period (3 weeks) and at 2 months, 4 months and 6 months after the end of treatment by clinical examination, instrumental analysis and VAS for pain assessment. Functional ability related to symptoms was assessed with VISA score. At the end of 2005,2006,2007,2008 and 2009 we carried out a telephone interview to investigate changes in pain and function and the efficacy of the treatment over time. Follow-up controls showed a reduction of average VAS score; after 6 months, tendons showed a structure closer to normal at ultrasonographic investigation. At the last telephone interview in 2009 many patients reported to consider ESWT as an effective treatment and described a significant improvement in their functional abilities, a significant reduction in drug consumption and 88% of subjects continued to play agonistic football. In conclusion, our results showed that, through the addition of ESWT, the effects of the classic vibration and eccentric training combination were improved compared to those found in our experience without ESWT. Although a control group was not included in the study (vibration and eccentric training without ESWT), results show a promising improvement and justify future prospective studies with a control group and more case series.

The aim of this study is to evaluate the prevalence of rheumatoid arthritis in the south of Jordan. The study was carried out between January, 2005 and December, 2008; 2,220 adults aged between 16 and 75 years were evaluated for the presence of rheumatoid arthritis disease according to the American Rheumatism Association 1987 criteria. The results showed that the prevalence of rheumatoid arthritis was 0.36% in the general population; the prevalence in males was 0.34% and in females it was 0.39%. In conclusion, the prevalence of rheumatoid arthritis is extremely low in the south of Jordan with a slight female predominance. American Rheumatism Association criteria continued to be the most useful criteria for the diagnosis of rheumatoid arthritis.

Cancer survivors are exposed to greater risk than the general population for several diseases: second primary and/or recurring cancer, sarcopenic obesity, metabolic syndrome and the related cardiovascular diseases, osteoporosis, decreased fatigue endurance, accelerated functional impairment and postural dysfunction; this is due to many factors, not only chemo/radiotherapy for cancer treatment and genetic predisposition, but also inappropriate lifestyle behaviour. The main interest of research on survival should be focused on the identification of the interventions capable of preventing premature mortality and on improving the patient's quality of life (QoL). Rehabilitating exercise and physical activity are effective tools to reach this goal, especially if combined with an appropriate lifestyle tailored to the individual needs, to provide a new comprehensive welfare model developed under the oncologist's supervision.