82 results on '"Carla Vanti"'
Search Results
2. Sexual Disability in Low Back Pain: Diagnostic and Therapeutic Framework for Physical Therapists
- Author
-
Carla Vanti, Silvano Ferrari, Marco Chiodini, Cesare Olivoni, Arianna Bortolami, and Paolo Pillastrini
- Subjects
low back pain ,sexual behavior ,disability ,physical therapy ,referral ,consultation ,Medicine - Abstract
Background: The literature shows a relationship between sexual activity and low back pain (LBP). The aim of this work is to provide a theoretical framework and practical proposal for the management of sexual disability in individuals with LBP. Methods: Based on a literature review, a team of specialized physical therapists developed a pattern for the management of LBP-related sexual disability. Results: A patient reporting LBP-related sexual disability may be included in one of four clinical decision-making pathways corresponding to one of the following: #1 standard physical therapy (PT); #2 psychologically informed physical therapy (PIPT); #3 PIPT with referral; or #4 immediate referral. Standard PT concerns the management of LBP-related sexual disability in the absence of psychosocial or pathological issues. It includes strategies for pain modulation, stiffness management, motor control, stabilization, functional training, pacing activities comprising education, and stay-active advice. PIPT refers to patients with yellow flags or concerns about their relationship with partners; this treatment is oriented towards a specific psychological approach. “PIPT with referral” and “Immediate referral” pathways concern patients needing to be referred to specialists in other fields due to relationship problems or conditions requiring medical management or pelvic floor or sexual rehabilitation. Conclusions: The proposed framework can help clinicians properly manage patients with LBP-related sexual disability.
- Published
- 2023
- Full Text
- View/download PDF
3. Lumbar spondylolisthesis: STATE of the art on assessment and conservative treatment
- Author
-
Carla Vanti, Silvano Ferrari, Andrew A. Guccione, and Paolo Pillastrini
- Subjects
Miscellaneous systems and treatments ,RZ409.7-999 - Abstract
Abstract Introduction There is weak relationship between the presence of lumbar spondylolisthesis [SPL] and low back pain that is not always associated with instability, either at the involved lumbar segment or at different spinal levels. Therefore patients with lumbar symptomatic SPL can be divided into stable and unstable, based on the level of mobility during flexion and extension movements as general classifications for diagnostic and therapeutic purposes. Different opinions persist about best treatment (conservative vs. surgical) and among conservative treatments, on the type, dosage, and progression of physical therapy procedures. Purpose and importance to practice The aim of this Masterclass is to provide clinicians evidence-based indications for assessment and conservative treatment of SPL, taking into consideration some subgroups related to specific clinical presentations. Clinical implications This Masterclass addresses the different phases of the assessment of a patient with SPL, including history, imaging, physical exam, and questionnaires on disability and cognitive-behavioral components. Regarding conservative treatment, self- management approaches and graded supervised training, including therapeutic relationships, information and education, are explained. Primary therapeutic procedures for pain control, recovery of the function and the mobility through therapeutic exercise, passive mobilization and antalgic techniques are suggested. Moreover, some guidance is provided on conservative treatment in specific clinical presentations (lumbar SPL with radiating pain and/or lumbar stenosis, SPL complicated by other factors, and SPL in adolescents) and the number/duration of sessions. Future research priorities Some steps to improve the diagnostic-therapeutic approach in SPL are to identify the best cluster of clinical tests, define different lumbar SPL subgroups, and investigate the effects of treatments based on that classification, similarly to the approach already proposed for non-specific LBP.
- Published
- 2021
- Full Text
- View/download PDF
4. Vertical traction for lumbar radiculopathy: a systematic review
- Author
-
Carla Vanti, Luca Turone, Alice Panizzolo, Andrew A. Guccione, Lucia Bertozzi, and Paolo Pillastrini
- Subjects
Traction ,Sciatica ,Radiating pain ,Low Back pain ,Pain management ,Intervertebral disc disease ,Miscellaneous systems and treatments ,RZ409.7-999 - Abstract
Abstract Background Only low-quality evidence is currently available to support the effectiveness of different traction modalities in the treatment of lumbar radiculopathy (LR). Yet, traction is still very commonly used in clinical practice. Some authors have suggested that the subgroup of patients presenting signs and symptoms of nerve root compression and unresponsive to movements centralizing symptoms may benefit from lumbar traction. The aim of this study is to conduct a systematic review of randomized controlled trials (RCTs) on the effects of vertical traction (VT) on pain and activity limitation in patients affected by LR. Methods We searched the Cochrane Controlled Trials Register, PubMed, CINAHL, Scopus, ISI Web of Science and PEDro from their inception to March 31, 2019 to retrieve RCTs on adults with LR using VT to reduce pain and activity limitation. We considered only trials reporting complete data on outcomes. Two reviewers selected the studies, extracted the results, and performed the quality assessment using the Risk of Bias and GRADE tools. Results Three studies met the inclusion criteria. Meta-analysis was not possible due to the heterogeneity of the included studies. We found very low quality evidence for a large effect of VT added to bed rest when compared to bed rest alone (g = − 1.01; 95% CI = -2.00 to − 0.02). Similarly, VT added to medication may have a large effect on pain relief when compared to medication alone (g = − 1.13; 95% CI = -1.72 to − 0.54, low quality evidence). Effects of VT added to physical therapy on pain relief were very small when compared to physical therapy without VT (g = − 0.14; 95% CI = -1.03 to 0.76, low quality evidence). All reported effects concerned short-term effect up to 3 months post-intervention. Conclusions With respect to short-term effects, VT may have a positive effect on pain relief if added to medication or bed rest. Long-term effects of VT are currently unknown. Future higher quality research is very likely to have an important impact on our confidence in the estimate of effect and may change these conclusions.
- Published
- 2021
- Full Text
- View/download PDF
5. Does the awareness of having a lumbar spondylolisthesis influence self-efficacy and kinesiophobia? A retrospective analysis
- Author
-
Silvano Ferrari, Rosa Striano, Eric Lucking, Paolo Pillastrini, Marco Monticone, and Carla Vanti
- Subjects
Spondylolisthesis ,Pain self-efficacy ,Fear of movement ,Spinal pain ,Outcome measures ,Miscellaneous systems and treatments ,RZ409.7-999 - Abstract
Abstract Background High pain self-efficacy and low kinesiophobia seem related to a better prognosis in patients complaining of low back pain (LBP). The literature stresses the potential negative effects of anatomical defect diagnosis (e.g. lumbar spondylolisthesis) on the psychological profile. The aim of this study is to investigate the relationships between awareness of having a spondylolisthesis, pain self-efficacy and kinesiophobia. Methods A secondary retrospective analysis was done. Ninety-eight subjects with subacute and chronic LBP were included: 49 subjects with diagnosed symptomatic lumbar spondylolisthesis and 49 subjects with diagnosed non-specific LBP. The pain self-efficacy measured with the Pain Self-Efficacy Questionnaire and the fear of movement measured with the Tampa Scale of Kinesiophobia were considered variables to investigate, whereas diagnosis and demographic/clinical variables were considered predictors or potential confounders. Results By comparing the two groups, the awareness of having a spondylolisthesis did not significantly influence neither pain self-efficacy (p = 0.82), nor kinesiophobia (p = 0.75). Higher perceived pain reduces pain self-efficacy and increases kinesiophobia in both groups (p = 0.002 and p = 0,031 respectively). Conclusions It seems that the awareness of an anatomical defect as spondylolisthesis does not significantly affect the beliefs of carry out activities and movements despite the pain. Other studies with wider samples are required, to confirm these preliminary results.
- Published
- 2019
- Full Text
- View/download PDF
6. Is there a relationship between self-efficacy, disability, pain and sociodemographic characteristics in chronic low back pain? A multicenter retrospective analysis
- Author
-
Silvano Ferrari, Carla Vanti, Marta Pellizzer, Luca Dozza, Marco Monticone, and Paolo Pillastrini
- Subjects
Pain self-efficacy ,Spinal pain ,Outcome measures ,Disability ,Musculoskeletal disorders ,Miscellaneous systems and treatments ,RZ409.7-999 - Abstract
Abstract Background Pain-related self-efficacy is defined as the beliefs held by people with chronic pain that certain activities can be carried out despite the pain. Poor self-efficacy is an obstacle to the recovery and predicts long-term disability. The aims of this study are to investigate the prevalence of poor pain self-efficacy in Italian subjects with chronic low back pain (LBP), and to inquire the relationships between self-efficacy, disability, pain, and main demographic and clinical characteristics. Methods A secondary multicenter retrospective analysis was done on 310 outpatients with chronic non-specific LBP. The pain self-efficacy measured with the Pain Self-Efficacy Questionnaire (PSEQ), the disability measured with the Roland & Morris Disability Questionnaire, and the pain intensity measured with the Numerical Rating Scale were considered variables to investigate, whereas demographic and clinical variables were considered predictors or potential confounders. A 40/60 PSEQ score was adopted as cut-off to distinguish between good and poor self-efficacy. Results 199 subjects (64.2% of the sample) showed poor self-efficacy. The odds of having poor self-efficacy appeared significantly related to female gender (OR = 1.80, 95%CI [1.12;2.90]; p = 0.015) and drugs use (OR = 1.68, 95%CI [1.06;2.70]; p = 0.029). Significant relationships also emerged between disability and higher age (β = 0.07, 95%CI [0.01; 0.12]; p = 0.02), being female (β = 1.80, 95%CI [0.32;3.29]; p = 0.018), low educational level (β = − 1.68, 95%CI [− 2.59;-3.29]; p
- Published
- 2019
- Full Text
- View/download PDF
7. The Management of Sexual Disability Related to Low Back Pain: A Cross-Sectional Survey of Italian Physiotherapists
- Author
-
Carla, Vanti, Silvano, Ferrari, Silvia, Brovelli, Celeste, Marinucci, Alessandro, Seggiaro, Andrea, Turolla, and Paolo, Pillastrini
- Published
- 2024
- Full Text
- View/download PDF
8. Effectiveness of physical therapy in addition to occlusal splint in myogenic temporomandibular disorders: protocol of a randomised controlled trial
- Author
-
Cristina Incorvati, Antonio Romeo, Adele Fabrizi, Luca Defila, Carla Vanti, Maria Rosaria Antonella Gatto, Claudio Marchetti, and Paolo Pillastrini
- Subjects
Medicine - Published
- 2020
- Full Text
- View/download PDF
9. The Effectiveness of Pump Techniques and Pompages: A Systematic Review
- Author
-
Carla Vanti, Matteo Golfari, Giacomo Pellegrini, Alice Panizzolo, Luca Turone, Silvia Giagio, and Paolo Pillastrini
- Subjects
osteopathy ,manipulation ,manual therapy ,physical therapy ,Technology ,Engineering (General). Civil engineering (General) ,TA1-2040 ,Biology (General) ,QH301-705.5 ,Physics ,QC1-999 ,Chemistry ,QD1-999 - Abstract
Background: Osteopathic manual procedures called pump techniques include thoracic, abdominal, and pedal pumps. Similar techniques, called pompages, are also addressed to joints and muscles. Despite their widespread use, no systematic review has been published on their effectiveness. (2) Methods: CINAHL, Cochrane Controlled Trials Register, ISI Web of Science, PEDro, PubMed, and Scopus databases were searched until July 2020. Randomized Controlled Trials (RCTs) on adults were included. Subjective (e.g., pain, physical function) and objective (e.g., pulmonary function, blood collection) outcomes were considered. The Risk of Bias tool (RoB 2) and the GRADE instrument were used to evaluate the quality of evidence. (3) Results: 25 RCTs were included: 20 concerning the pump techniques and five concerning pompages. Due to the extensive heterogeneity of such studies, it was not possible to perform a meta-analysis. The risk of bias resulted from moderate to high and the quality of the evidence was from very low to high. Singular studies suggested some effectiveness of pump techniques on pain and length of hospitalization. Pompage seems also to help improve walking distance and balance. (4) Conclusions: Although several studies have been published on manual pump techniques, the differences for population, modalities, dosage, and outcome measures do not allow definite conclusions of their effectiveness.
- Published
- 2021
- Full Text
- View/download PDF
10. 5th National Congress of the Italian Society of Physiotherapy
- Author
-
Alessandro Aina, Marco Barbero, Barbara Cagnie, Elena Castelli, Chad Cook, Silvano Ferrari, Andrea Foglia, Paolo Bizzarri, Donatella Giraudo, Chris Littlewood, Paolo Pillastrini, Daniele Piscitelli, Michele Romano, Andrea Tettamanti, Carla Vanti, Stefano Vercelli, Lennard Voogt, Aceto Maria, Spina Emanuele, Paone Paolo, Silvestre Francesco, Carotenuto Antonio, Cerillo Ilaria, Orefice Giuseppe, Bassi Raffaele, Fiorito Serena, Aina Alessandro, M. Bonfanti, M. Pasquetti, Bortolami Arianna, Pillastrini Paolo, Vanti Carla, D. Brioschi, M. Vitali, A. Pedretti, G. Fraschini, A. Tettamanti, G. Castellini, S. Gianola, S. Bonovas, G. Banfi, L. Moja, Greta Castellini, Silvia Gianola, Pamela Frigerio, Michela Agostini, Rosa Bolotta, Davide Corbetta, Monica Gasparini, Paolo Gozzer, Erica Guariento, Linda Li, Valentina Pecoraro, Valeria Sirtori, Andrea Turolla, A. Andreano, Lorenzo Moja, G Castellini, S Gianola, S Bonovas, L Moja, Alessandro Chiarotto, Caroline B. Terwee, Maarten Boers, Raymond W. Ostelo, Lara J. Maxwell, George A. Wells, Peter Tugwell, Ron Clijsen, Cesar Fernandez-de-las-Penas, Ciceri Matteo, Rossetti Sara, Vercelli Stefano, M. Cislaghi, G. Penone, G. Marinelli, G. Rezzan, G. Melegati, R. Gatti, Colombo Claudio, Tolosa Francesca, Andrea Moriondo, Stefano Doronzio, Matteo Paci, Marco Monticone, Garzonio Fabiola, Zanetta Anna, Bargeri Serena, Cerone Giorgia, Sartorio Francesco, Filippo Ghirlanda, Alessandro Schneebeli, Corrado Cescon, G. Gioia, S. Faccendini, A. Aina, G. Granzotto, L. Coppola, I. Gava, M. Frassinelli, F. Gattinoni, Lorenzo Guidotti, Marco Postiglione, Bruna Lombardi, Diego Leoni, Davide Storer, Roberto Gatti, Michele Egloff, Magno Tiziano, Tettamanti Andrea, Daniele Maremmani, Sebastiano Cencini, Giuseppe Plebani, Federica Moresi, Matteo Isnardi, Alberto Gallace, N. Moretti, Maselli, M. Testa, Stefano Negrini, Sabrina Donzelli, Francesco Saveri, Alessandra Negrini, Silvana Parzini, Fabio Zaina, Leonardo Nesi, Francesco Ferrarello, Valeria Anna Maria Bianchi, Luca Nannetti, Giuditta Mini, Mariangela Marchettini, Fabio Piccolo, Federica Agosta, Elisabetta Sarasso, Paola Adamo, Federico Temporiti, Andrea Falini, Massimo Filippi, Roberto Meroni, Leonardo Pellicciari, Marco A. Mondelli, Thomas Favaron, Cesare G. Cerri, Enrico A. Tallarita, Ravizzotti Elisa, Aleksandra Tomić, Silvia Basaia, Nataša Dragašević, Marina Svetel, Massimiliano Copetti, Vladimir S. Kostic, Matteo Mastrantonio, Negrini Stefano, Valentina Redaelli, Emiliano Soldini, M. Segat, O. Casonato, M. Margelli, S. Pillon, V. Spunton, R. Fenini, R. Garofalo, M. Conti, G. Valagussa, V. Balatti, L. Trentin, S. Melli, M. Norsi, E. Grossi, Massimiliano Vanossi, Sara Taioli, Ivan Gardenghi, Lucia Bertozzi, Anna Rosso, Antonio Romeo, Martina Ruggeri, Bellini Filippo, Cristina Conti, Federica Faresin, Raffaella Piccarreta, Villanova Luca, Violini Claudia, Cenci Marco Joseph, Delconte Carmen, Pisano Fabrizio, S. Youssef, M. Montesano, M. Picardi, P. De Giampaulis, M. Corbo, L. Pisani, and Ruella Carolina
- Subjects
Miscellaneous systems and treatments ,RZ409.7-999 - Abstract
Table of contents S1 Criteria for exercises selection in subjects with low back pain Alessandro Aina S2 Recent advances in pathophysiology and treatment of myofascial trigger points Marco Barbero S3 Rehabilitation of scapular dyskinesia Barbara Cagnie S4 Musculoskeletal rehabilitation in subjects affected by neurological disorders Elena Castelli S5 Which examination tests suggest the best candidates for manual therapy Chad Cook S6 Case study: the role of the measurements for the identification of targets and guidance of the treatment Silvano Ferrari S7 Assessment of joint mobility: state of the art Andrea Foglia, Paolo Bizzarri S8 Core stabilization exercises in the treatment of urinary incontinence Donatella Giraudo S9 Preventing surgical subacromial decompression through rotator cuff rehabilitation Chris Littlewood S10 Methodological aspects of Clinical Prediction Rules in the rehabilitation of Low Back Pain Paolo Pillastrini S11 Interpretability of outcome measures in musculoskeletal rehabilitation Daniele Piscitelli S12 Conservative treatment of the misalignment of the spine: state of the art and perspectives Michele Romano S13 Balance training in subjects with musculoskeletal disorders Andrea Tettamanti S14 Dosage of manual therapy: principles for clinical practice Carla Vanti S15 Are there speed limits in post-surgery lower limb rehabilitation? Stefano Vercelli S16 Classification of predominant neuropathic, nociceptive or central sensation pain Lennard Voogt P1 A wearable proprioceptive stabilizer (Equistasi®) for rehabilitation of balance disorders in multiple sclerosis patients: preliminary results of a randomized, double-blind, versus placebo controlled study Aceto Maria, Spina Emanuele, Paone Paolo, Silvestre Francesco, Carotenuto Antonio, Cerillo Ilaria, Orefice Giuseppe P2 Effect of repeated neck retraction movements on strength and EMG activity of the upper limbs, range of motion and cervical posture Bassi Raffaele, Fiorito Serena, Aina Alessandro P3 Hamstring injuries: clinical assessment or image evaluation? Bonfanti M., Pasquetti M. P4 Effectiveness of the physical therapy treatment on pelvic floor muscles in pelvic girdle pain. A literature review Bortolami Arianna, Pillastrini Paolo, Vanti Carla P5 Scapulo-humeral muscles electromiographic activity during the elevation movement of the upper limb in subjects with rotator cuff lesion Brioschi D, Vitali M, Pedretti A, Fraschini G, Tettamanti A P6 Mechanical low back pain: secular trend and intervention topics of randomized controlled trials Castellini G, Gianola S, Bonovas S, Banfi G, Moja L P7 Quality of reporting in rehabilitation interventions for low back pain: a review of published randomised controlled trials Greta Castellini, Silvia Gianola, Pamela Frigerio, Michela Agostini, Rosa Bolotta, Davide Corbetta, Monica Gasparini, Paolo Gozzer, Erica Guariento, Linda Li, Valentina Pecoraro, Valeria Sirtori, Andrea Turolla, Andreano A, Lorenzo Moja P8 Power analysis and sample size reporting in rehabilitation of low back pain: review of randomized controlled trials included in Cochrane systematic review Castellini G, Gianola S, Bonovas S, Moja L P9 A core outcome set for clinical trials in non-specific low back pain Alessandro Chiarotto, Caroline B. Terwee, Maarten Boers, Raymond W. Ostelo P10 Roland & Morris Disability Questionnaire and Oswestry Disability Index: which has better measurement properties? A systematic review and meta-analysis Alessandro Chiarotto, Lara J. Maxwell, Caroline B. Terwee, George A. Wells, Peter Tugwell, Raymond W. Ostelo P11 Prevalence of myofascial trigger points in spinal pain disorders: systematic review and meta-analysis Alessandro Chiarotto, Ron Clijsen, Cesar Fernandez-de-las-Penas, Marco Barbero P12 Post-surgical scar rating scales in physiotherapy: a systematic review Ciceri Matteo, Rossetti Sara, Vercelli Stefano P13 Efficacy of action observation pre-operative training in functional recovery after hip and knee prosthesis Cislaghi M, Penone G, Marinelli G, Rezzan G, Melegati G, Gatti R P14 The use of Kinesio Taping in the treatment of hematomas: can we distinguish fancy from the effects? Colombo Claudio, Tolosa Francesca, Andrea Moriondo, Vercelli Stefano P15 Who is able to perform explicit motor imagery after stroke? Stefano Doronzio, Matteo Paci P16 Responsiveness of the Bridge tests in Symptomatic Lumbar Spondylolisthesis Silvano Ferrari, Carla Vanti, Marco Monticone P17 The relationship between number of sessions and clinical results in lumbar symptomatic spondylolisthesis Silvano Ferrari, Carla Vanti, Marco Monticone P18 Conservative treatments for upper extremity tendinopathies in occupational medicine: narrative review Garzonio Fabiola, Zanetta Anna, Bargeri Serena, Cerone Giorgia, Sartorio Francesco P19 The time-related effect of roller-massager on extensibility of the hamstring muscles Filippo Ghirlanda, Alessandro Schneebeli, Corrado Cescon, Marco Barbero P20 Effect of two different exercise programs on pain, disability and quality of life in people with subacute and chronic nonspecific neck pain Gioia G, Faccendini S, Aina A, Tettamanti A P21 A bridge between clinical practice and research: how health professionals can study literature and learn on the job Granzotto G, Coppola L, Gava I, Frassinelli M, Gattinoni F P22 Walking capacity improves after neuromotor physiotherapy in stroke patients Lorenzo Guidotti, Marco Postiglione, Bruna Lombardi, Matteo Paci P23 Intra and inter-session reliability of the angle between pain onset and submaximal pain during upper limb neurodynamics test 1: a study in healty individuals Diego Leoni, Davide Storer, Roberto Gatti, Michele Egloff, Marco Barbero P24 Effects of an AO-MI training on balance task in patients affected by multiple sclerosis Magno Tiziano, Tettamanti Andrea P25 Outcomes of treatment with neuromuscular stimulator for chronic anterior knee pain: a clinical case Daniele Maremmani, Sebastiano Cencini, Giuseppe Plebani P26 Consistency in locating pressure stimuli over the lumbar spine on a digital body chart: a comparison between chronic low back pain patients and healthy subjects Federica Moresi, Marco Barbero, Matteo Isnardi, Alberto Gallace, Corrado Cescon, Roberto Gatti P27 Malignant Cord Compression in the thoraco-lumbar spine. Early signs and symptoms in the differential diagnosis of low back pain Moretti N, Maselli, Testa M. P28 End growth results of exercise treatment to avoid bracing in adolescents with idiopathic scoliosis: a prospective cohort controlled study Stefano Negrini, Sabrina Donzelli, Francesco Saveri, Alessandra Negrini, Silvana Parzini, Michele Romano, Fabio Zaina P29 Reliability of the Ashworth scale and its modified versions: systematic review and meta-analysis Leonardo Nesi, Francesco Ferrarello, Valeria Anna Maria Bianchi, Matteo Paci P30 Differences in motor recovery between upper and lower limbs in stroke subtypes Matteo Paci, Luca Nannetti, Bruna Lombardi P31 Influence of clinical experience on the reliability of the Salford Gait Tool Giuditta Mini, Mariangela Marchettini, Francesco Ferrarello, Matteo Paci P32 A somatosensory discrimination training induces brain functional changes in healthy young subjects Fabio Piccolo, Federica Agosta, Elisabetta Sarasso, Paola Adamo, Federico Temporiti, Andrea Falini, Roberto Gatti, Massimo Filippi P33 Effects of dynamic tilt-table with integrated robotic stepping associated with functional electrical stimulation: a cross-over study Daniele Piscitelli, Roberto Meroni, Leonardo Pellicciari, Marco A. Mondelli, Thomas Favaron, Cesare G. Cerri, Enrico A. Tallarita P34 Manual therapy techniques in the treatment of whiplash and its associated disorders: a systematic review Ravizzotti Elisa, Vercelli Stefano P35 The Patient and Observer Scar Assessment Scale (POSAS) as a screening tool for early detection of pathologic post-surgical scars in physiotherapy Rossetti Sara, Ciceri Matteo, Vercelli Stefano P36 The anatomical basis of genetic dystonia: a multimodal MRI study Elisabetta Sarasso, Federica Agosta, Aleksandra Tomić, Silvia Basaia, Nataša Dragašević, Marina Svetel, Massimiliano Copetti, Vladimir S. Kostic, Massimo Filippi P37 The relative inclination of the end vertebrae of a scoliotic single curve can influence the results of the conservative treatment? A pilot study Francesco Saveri, Michele Romano, Matteo Mastrantonio, Alessandra Negrini, Fabio Zaina, Negrini Stefano P38 Physiotherapy for myofascial pain syndromes: reported methodological quality of randomized controlled trials indexed in the PEDro database Alessandro Schneebeli, Greta Castellini, Valentina Redaelli, Emiliano Soldini, Marco Barbero P39 Is the patellar pubic percussion test useful to diagnose only femur fractures or something else? Two case reports Segat M, Casonato O, Margelli M, Pillon S. P40 Effectiveness of new rehab method for MDI Spunton V, Fenini R, Garofalo R, Conti M P41 Toe walking and autism: cross-sectional study on clinical presentation patterns and correlation with language delay Valagussa G, Balatti V, Trentin L, Melli S, Norsi M, and Grossi E P42 Active Kyphosis Value (AKV): a new test for the evaluation of the kyphotisation mobility of the thoracic spine Massimiliano Vanossi, Francesco Saveri, Michele Romano P43 Pain Drawing and psychological distress in low back pain - systematic review and meta-analysis Carla Vanti, Sara Taioli, Ivan Gardenghi, Lucia Bertozzi, Anna Rosso, Antonio Romeo, Paolo Pillastrini P44 Responsiveness of the Oswestry Disability Index in symptomatic lumbar spondylolisthesis Carla Vanti, Silvano Ferrari, Martina Ruggeri, Marco Monticone P45 The relationship between instability tests, pain and disability in non-specific low back pain Carla Vanti, Bellini Filippo, Cristina Conti, Federica Faresin, Martina Ruggeri, Raffaella Piccarreta, Silvano Ferrari P46 Smartphone applications (apps) for physical therapists: a review Villanova Luca, Vercelli Stefano P47 A randomized controlled pilot trial of hand robotic training compared with a sensory-motor training program in post stroke patients Violini Claudia, Cenci Marco Joseph, Delconte Carmen, Pisano Fabrizio P48 Critical Illness PolyNeuroMyopathy (CIPNM): chance for a good prognosis Youssef S, Montesano M, Picardi M, De Giampaulis P, Corbo M, Pisani L. P49 The EdUReP approach plus manual therapy for the management of insertional Achilles tendinopathy: a case study Zanetta Anna, Garzonio Fabiola, Ruella Carolina, Sartorio Francesco
- Published
- 2016
- Full Text
- View/download PDF
11. Some conservative interventions are more effective than others for people with chronic non-specific neck pain
- Author
-
Greta Castellini, Paolo Pillastrini, Carla Vanti, Silvia Bargeri, Silvia Giagio, Elena Bordignon, Francesco Fasciani, Francesco Marzioni, Tiziano Innocenti, Alessandro Chiarotto, Silvia Gianola, Lucia Bertozzi, Health Economics and Health Technology Assessment, AMS - Musculoskeletal Health, APH - Methodology, and General Practice
- Subjects
Adult ,Neck Pain ,Disability ,Network Meta-Analysis ,Pain ,Physical Therapy, Sports Therapy and Rehabilitation ,Musculoskeletal Manipulations ,Pharmacological interventions ,Chronic neck pain ,SDG 3 - Good Health and Well-being ,Humans ,Chronic Pain ,Pain Measurement ,Conservative interventions - Abstract
Question: Which is the most effective conservative intervention for patients with non-specific chronic neck pain (CNSNP)? Design: A systematic review and network meta-analysis of randomised clinical trials. Participants: Adults with CNSNP of at least 3 months duration. Interventions: All available pharmacological and non-pharmacological interventions. Outcome measures: The primary outcomes were pain intensity and disability. The secondary outcome was adverse events. Results: Overall, 119 RCTs (12,496 patients; 32 interventions) were included. Risk of bias was low in 50.4% of trials, unclear in 22.7% and high in 26.9%. Compared with inert treatment, a combination of active and/or passive multimodal non-pharmacological inventions (eg, exercise and manual therapy) were effective for pain on a 0-to-10 scale at 1 month (MD range 0.84 to 3.74) and at 3 to 6 months (MD range 1.06 to 1.49), and effective on disability on a 0-to-100 scale at 1 month (MD range 10.26 to 14.09) and 3 to 6 months (MD range 5.60 to 16.46). These effects ranged from possible to definite clinical relevance. Compared with inert treatment, anti-inflammatory drugs alone or in combination with another non-pharmacological treatment did not reduce pain at 1 month or 3 to 6 months. At 12 months, no superiority was found over inert treatment on both outcomes. Most mild adverse events were experienced following acupuncture/dry needling intervention. On average, the evidence varied from low to very low certainty. Conclusions: While multimodal non-pharmacological interventions may reduce pain and disability for up to 3 to 6 months of follow-up when compared with inert treatment, the evidence was very uncertain about their effects. Better quality and larger trials are needed to improve the certainty of evidence.
- Published
- 2022
12. Italian Version of The Cumberland Ankle Instability Tool (CAIT-I)
- Author
-
Angela Contri, Francesco Ballardin, Gianluca De Marco, Matteo Gaucci, Angela Scariato, Veronica Zanoni, Carla Vanti, and Paolo Pillastrini
- Subjects
Orthopedics and Sports Medicine ,Podiatry ,Chronic Ankle Instability CAIT Italian Translation Psychometrics Ankle sprain Cross-cultural adaptation - Published
- 2023
13. The Italian version of the Unité Rhumatologique des Affections de la Main (URAM) for Dupuytren’s disease: The URAM-I(10)
- Author
-
T. Fairplay, P. Arcuri, Francesco Marinelli, E. Lanfranchi, Carla Vanti, M. Lando, Paolo Pillastrini, Lanfranchi E., Fairplay T., Arcuri P., Lando M., Marinelli F., Pillastrini P., and Vanti C.
- Subjects
030203 arthritis & rheumatology ,030222 orthopedics ,medicine.medical_specialty ,disability evaluation ,business.industry ,Italian language ,Disease ,Outcome assessment ,medicine.disease ,health care ,03 medical and health sciences ,Dupuytren’s disease ,0302 clinical medicine ,Dupuytren's contracture ,Health care ,medicine ,Orthopedics and Sports Medicine ,business ,Psychiatry ,outcome assessment - Abstract
Introduction Several general hand functional assessment tools for Dupuytren’s disease have been reported, but none of the patient-reported-outcome measures specific to Dupuytren’s disease-associated disabilities are available in the Italian language. The purpose of this study was to culturally adapt the Unité Rhumatologique des Affections de la Main (URAM) into Italian (URAM-I) and determine its measurement properties. Methods Cross-cultural adaptation was performed according to the current guidelines. Construct validity (convergent and divergent validity) was measured by comparing the URAM-I with the Pain-Rated Wrist/Hand Evaluation (PRWHE-I), Short-Form 36 (SF-36-I) scale and finger range of motion, respectively. Factor analysis was used to investigate the URAM-I’s internal structure. Reliability was assessed by internal consistency (Cronbach’s alpha) and test-retest reliability by Intra-Class Correlation Coefficient (ICC). Results This study included 96 patients (males = 85%, age = 66.8 ± 9.3). Due to the cultural adaptation, we divided the original item #1 into two separate items, thus generating the URAM-I(10). Convergent validity analysis showed a strong positive (r = 0.67), significant (p Conclusion The URAM-I(10) demonstrates moderate construct validity, high internal consistency and test-retest reliability, and showed a 2-factor internal structure. Its evaluative use can be suggested for the Italian Dupuytren’s population.
- Published
- 2021
14. Lumbar spondylolisthesis: STATE of the art on assessment and conservative treatment
- Author
-
Silvano Ferrari, Paolo Pillastrini, Andrew A. Guccione, Carla Vanti, Vanti, Carla, Ferrari, Silvano, Guccione, Andrew A, and Pillastrini, Paolo
- Subjects
medicine.medical_specialty ,Rehabilitation ,Referred pain ,business.industry ,Weak relationship ,medicine.medical_treatment ,MEDLINE ,RZ409.7-999 ,Physical Therapy, Sports Therapy and Rehabilitation ,Low back pain ,Conservative treatment ,Masterclass ,Lumbar ,None ,medicine ,Physical therapy ,medicine.symptom ,business ,Miscellaneous systems and treatments ,Lumbar spondylolisthesis - Abstract
IntroductionThere is weak relationship between the presence of lumbar spondylolisthesis [SPL] and low back pain that is not always associated with instability, either at the involved lumbar segment or at different spinal levels. Therefore patients with lumbar symptomatic SPL can be divided into stable and unstable, based on the level of mobility during flexion and extension movements as general classifications for diagnostic and therapeutic purposes. Different opinions persist about best treatment (conservative vs. surgical) and among conservative treatments, on the type, dosage, and progression of physical therapy procedures.Purpose and importance to practiceThe aim of this Masterclass is to provide clinicians evidence-based indications for assessment and conservative treatment of SPL, taking into consideration some subgroups related to specific clinical presentations.Clinical implicationsThis Masterclass addresses the different phases of the assessment of a patient with SPL, including history, imaging, physical exam, and questionnaires on disability and cognitive-behavioral components. Regarding conservative treatment, self- management approaches and graded supervised training, including therapeutic relationships, information and education, are explained. Primary therapeutic procedures for pain control, recovery of the function and the mobility through therapeutic exercise, passive mobilization and antalgic techniques are suggested. Moreover, some guidance is provided on conservative treatment in specific clinical presentations (lumbar SPL with radiating pain and/or lumbar stenosis, SPL complicated by other factors, and SPL in adolescents) and the number/duration of sessions.Future research prioritiesSome steps to improve the diagnostic-therapeutic approach in SPL are to identify the best cluster of clinical tests, define different lumbar SPL subgroups, and investigate the effects of treatments based on that classification, similarly to the approach already proposed for non-specific LBP.
- Published
- 2021
15. Vertical traction for lumbar radiculopathy: a systematic review
- Author
-
Lucia Bertozzi, Luca Turone, Carla Vanti, Alice Panizzolo, Andrew A. Guccione, Paolo Pillastrini, Vanti, Carla, Turone, Luca, Panizzolo, Alice, Guccione, Andrew A, Bertozzi, Lucia, and Pillastrini, Paolo
- Subjects
medicine.medical_specialty ,Disability evaluation ,medicine.medical_treatment ,Physical Therapy, Sports Therapy and Rehabilitation ,Review ,CINAHL ,Bed rest ,Low Back pain ,law.invention ,Sciatica ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Traction ,law ,medicine ,030212 general & internal medicine ,lcsh:Miscellaneous systems and treatments ,Referred pain ,Rehabilitation ,business.industry ,Radiating pain ,Traction (orthopedics) ,lcsh:RZ409.7-999 ,Low back pain ,Pain management ,Intervertebral disc disease ,Randomized controlled trials ,Physical therapy ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Background Only low-quality evidence is currently available to support the effectiveness of different traction modalities in the treatment of lumbar radiculopathy (LR). Yet, traction is still very commonly used in clinical practice. Some authors have suggested that the subgroup of patients presenting signs and symptoms of nerve root compression and unresponsive to movements centralizing symptoms may benefit from lumbar traction. The aim of this study is to conduct a systematic review of randomized controlled trials (RCTs) on the effects of vertical traction (VT) on pain and activity limitation in patients affected by LR. Methods We searched the Cochrane Controlled Trials Register, PubMed, CINAHL, Scopus, ISI Web of Science and PEDro from their inception to March 31, 2019 to retrieve RCTs on adults with LR using VT to reduce pain and activity limitation. We considered only trials reporting complete data on outcomes. Two reviewers selected the studies, extracted the results, and performed the quality assessment using the Risk of Bias and GRADE tools. Results Three studies met the inclusion criteria. Meta-analysis was not possible due to the heterogeneity of the included studies. We found very low quality evidence for a large effect of VT added to bed rest when compared to bed rest alone (g = − 1.01; 95% CI = -2.00 to − 0.02). Similarly, VT added to medication may have a large effect on pain relief when compared to medication alone (g = − 1.13; 95% CI = -1.72 to − 0.54, low quality evidence). Effects of VT added to physical therapy on pain relief were very small when compared to physical therapy without VT (g = − 0.14; 95% CI = -1.03 to 0.76, low quality evidence). All reported effects concerned short-term effect up to 3 months post-intervention. Conclusions With respect to short-term effects, VT may have a positive effect on pain relief if added to medication or bed rest. Long-term effects of VT are currently unknown. Future higher quality research is very likely to have an important impact on our confidence in the estimate of effect and may change these conclusions.
- Published
- 2021
16. The Effectiveness of Pump Techniques and Pompages: A Systematic Review
- Author
-
Silvia Giagio, Giacomo Pellegrini, Carla Vanti, Luca Turone, Matteo Golfari, Paolo Pillastrini, Alice Panizzolo, Vanti, Carla, Golfari, Matteo, Pellegrini, Giacomo, Panizzolo, Alice, Turone, Luca, Giagio, Silvia, and Pillastrini, Paolo
- Subjects
Technology ,medicine.medical_specialty ,QH301-705.5 ,QC1-999 ,Population ,CINAHL ,Pulmonary function testing ,law.invention ,03 medical and health sciences ,Walking distance ,0302 clinical medicine ,Randomized controlled trial ,law ,Medicine ,physical therapy ,General Materials Science ,030212 general & internal medicine ,Biology (General) ,education ,QD1-999 ,Instrumentation ,Fluid Flow and Transfer Processes ,030222 orthopedics ,education.field_of_study ,Modalities ,business.industry ,Physics ,Process Chemistry and Technology ,General Engineering ,Engineering (General). Civil engineering (General) ,Computer Science Applications ,manual therapy ,Chemistry ,osteopathy ,Osteopathy, Manipulation, Manual Therapy, Physical Therapy ,Osteopathy ,manipulation ,Physical therapy ,TA1-2040 ,Manual therapy ,business - Abstract
Background: Osteopathic manual procedures called pump techniques include thoracic, abdominal, and pedal pumps. Similar techniques, called pompages, are also addressed to joints and muscles. Despite their widespread use, no systematic review has been published on their effectiveness. (2) Methods: CINAHL, Cochrane Controlled Trials Register, ISI Web of Science, PEDro, PubMed, and Scopus databases were searched until July 2020. Randomized Controlled Trials (RCTs) on adults were included. Subjective (e.g., pain, physical function) and objective (e.g., pulmonary function, blood collection) outcomes were considered. The Risk of Bias tool (RoB 2) and the GRADE instrument were used to evaluate the quality of evidence. (3) Results: 25 RCTs were included: 20 concerning the pump techniques and five concerning pompages. Due to the extensive heterogeneity of such studies, it was not possible to perform a meta-analysis. The risk of bias resulted from moderate to high and the quality of the evidence was from very low to high. Singular studies suggested some effectiveness of pump techniques on pain and length of hospitalization. Pompage seems also to help improve walking distance and balance. (4) Conclusions: Although several studies have been published on manual pump techniques, the differences for population, modalities, dosage, and outcome measures do not allow definite conclusions of their effectiveness.
- Published
- 2021
17. The Dance Functional Outcome Survey: Cultural Adaptation and Psychometric Validation in Italian (DFOS-IT)
- Author
-
Paolo Pillastrini, Giorgio Breda, Shaw Bronner, Carla Vanti, Angela Contri, Contri, Angela, Breda, Giorgio, Vanti, Carla, Pillastrini, Paolo, and Bronner, Shaw
- Subjects
Adult ,Cross-Cultural Comparison ,Activities of daily living ,Psychometrics ,SF-36 ,Intraclass correlation ,Disability Evaluation ,History and Philosophy of Science ,Surveys and Questionnaires ,Activities of Daily Living ,Ballet ,Humans ,Receiver operating characteristic ,Repeated measures design ,Construct validity ,Reproducibility of Results ,Musculoskeletal Injurie ,General Medicine ,Exploratory factor analysis ,Modern Dance ,Wellness, Health ,Italy ,Psychology ,Clinical psychology - Abstract
OBJECTIVE: To translate, culturally adapt, and validate the psychometric characteristics of the Italian version of the Dance Functional Outcome Survey (DFOS-IT) in adult dancers. DESIGN: Clinical measurement study. METHODS: The DFOS-IT was forward translated, reconciled, backward translated, and reviewed by an expert committee to establish optimal correspondence with the original English DFOS. We examined test-retest reliability in 58 dancers within a 10-day period, using intraclass correlation coefficients (ICC2,1). In a sample of 265 healthy and injured dancers, the following were examined: 1) construct validity, comparing the DFOS-IT to SF-36 using Pearson correlations; 2) exploratory factor analysis and internal consistency; and 3) sensitivity, by generating receiver operating characteristic curves and determining area under the curve (AUC). In a subgroup of 44 dancers, we determined internal responsiveness across three time-points using repeated measures ANOVA (p
- Published
- 2020
18. Effectiveness of Mechanical Traction for Lumbar Radiculopathy: A Systematic Review and Meta-Analysis
- Author
-
Luca Turone, Andrew A. Guccione, Carla Vanti, Alice Panizzolo, Francesco Saverio Violante, Paolo Pillastrini, Lucia Bertozzi, Vanti, Carla, Panizzolo, Alice, Turone, Luca, Guccione, Andrew A, Violante, Francesco Saverio, Pillastrini, Paolo, and Bertozzi, Lucia
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Physical Therapy, Sports Therapy and Rehabilitation ,law.invention ,External validity ,Sciatica ,03 medical and health sciences ,Disability Evaluation ,0302 clinical medicine ,Randomized controlled trial ,law ,Traction ,medicine ,Humans ,030212 general & internal medicine ,Radiculopathy ,Physical Therapy Modalities ,Pain Measurement ,Randomized Controlled Trials as Topic ,Referred pain ,business.industry ,Traction (orthopedics) ,Low back pain ,Confidence interval ,Meta-analysis ,Randomized Controlled Trial ,Physical therapy ,Radiating Pain ,medicine.symptom ,business ,Low Back Pain ,030217 neurology & neurosurgery - Abstract
Objective Lumbar radiculopathy (LR) is a pain syndrome caused by compression/irritation of the lumbar nerve root(s). Traction is a well-known and commonly used conservative treatment for LR, although its effectiveness is disputed. The purpose of this systematic review and meta-analysis of randomized controlled trials was to evaluate the effects of different types of traction added to or compared with conservative treatments on pain and disability. Methods Data were obtained from CENTRAL, PUBMED, CINAHL, Scopus, ISI Web of Science, and PEDro from their inception to April 2020. All randomized controlled trials on adults with LR, using mechanical traction, and without any restriction regarding publication time or language were considered. Two reviewers selected the studies, evaluated the quality assessment, and extracted the results. Meta-analysis used a random-effects model. Eight studies met the inclusion criteria, and 5 were meta-analyzed. Results Meta-analyses of results from low-quality studies indicated that supine mechanical traction added to physical therapist treatments had significant effects on pain (g = −0.58 [95% confidence interval = −0.87 to −0.29]) and disability (g = −0.78 [95% confidence interval = −1.45 to −0.11]). Analyses of results from high-quality studies of prone mechanical traction added to physical therapist intervention for pain and disability were not significant. These results were also evident at short-term follow-up (up to 3 months after intervention). Conclusion The literature suggests that, for pain and disability in LR, there is short-term effectiveness of supine mechanical traction when added to physical therapist intervention. Impact This systematic review may be relevant for clinical practice due to its external validity because the treatments and the outcome measures are very similar to those commonly used in a clinical context.
- Published
- 2020
19. Low back pain and sexual disability from the patient’s perspective: a qualitative study
- Author
-
Saad Youssef, Silvano Ferrari, Silvia Giagio, Arianna Bortolami, Carla Vanti, Christine Cedraschi, Margherita Anesi, Paolo Pillastrini, Ferrari S., Vanti C., Giagio S., Anesi M., Youssef S., Bortolami A., Cedraschi C., and Pillastrini P.
- Subjects
Sexual behavior ,spinal diseases ,sexual behavior ,Qualitative research ,medicine ,Humans ,Disabled Persons ,Low back pain ,physical therapy ,Physical Therapy Modalities ,Sexual dysfunctions ,ddc:617 ,Rehabilitation ,Perspective (graphical) ,Institutional repository ,sexual dysfunction ,Sexual life ,ddc:618.97 ,medicine.symptom ,Psychology ,Physical therapy ,qualitative research ,Clinical psychology ,Spinal diseases - Abstract
Purpose: The aim of this qualitative study is to investigate, from patient’s perspective, the aspects of the relationship between low back pain and sexual life on physical, psychological and social aspects of individual’s life. In addition, this study aims to explore patients’ opinions on the role of health care providers in addressing and treating low back pain-related sexual problems. Materials and Methods: Semi-structured interviews were conducted with 26 outpatients referred to physical therapy for subacute or chronic non-specific low back pain; the questions investigated the presence of sexual disability and aspects related to patient’s behaviour. Two independent physical therapists, supervised by a third expert physical therapist and a clinical psychologist proficient in qualitative methodology, performed thematic content analysis to identify categories and themes. Results: Patients with low back pain consider sexual disability severely limiting and correlated to pain. This study emphasized the perception of invalidity, the importance of the relationship with the partner, the emotions and gender roles in the couple, and the relevance for health care providers to take part in the clinical management. The physical therapist is believed to be a qualified figure to address this issue and specific suggestions on sexual activity could be useful. Conclusion: Sexual disability in patients with subacute or chronic LBP acquires an important and individual meaning that can be investigated within the therapeutic context, especially by physical therapists.Implications for Rehabilitation Sexual disability related to low back pain is considered an important and meaningful topic from the patient’s perspective. This reflects the importance of the emotional relationship with the partner. Within the therapeutic context, it is important to provide information to help manage pain during sexual activity. The physical therapist is seen to be a qualified figure to address this issue.
- Published
- 2020
20. Does the awareness of having a lumbar spondylolisthesis influence self-efficacy and kinesiophobia? A retrospective analysis
- Author
-
Marco Monticone, Eric Lucking, Carla Vanti, Silvano Ferrari, Paolo Pillastrini, Rosa Striano, Ferrari, Silvano, Striano, Rosa, Lucking, Eric, Pillastrini, Paolo, Monticone, Marco, and Vanti, Carla
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Affect (psychology) ,Outcome measures ,Outcome measure ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Retrospective analysis ,030212 general & internal medicine ,lcsh:Miscellaneous systems and treatments ,Lumbar spondylolisthesis ,General Environmental Science ,Self-efficacy ,Rehabilitation ,business.industry ,Confounding ,Pain self-efficacy ,lcsh:RZ409.7-999 ,medicine.disease ,Low back pain ,Spondylolisthesis ,Spinal pain ,Physical therapy ,General Earth and Planetary Sciences ,medicine.symptom ,business ,Fear of movement ,030217 neurology & neurosurgery ,Research Article - Abstract
BackgroundHigh pain self-efficacy and low kinesiophobia seem related to a better prognosis in patients complaining of low back pain (LBP). The literature stresses the potential negative effects of anatomical defect diagnosis (e.g. lumbar spondylolisthesis) on the psychological profile. The aim of this study is to investigate the relationships between awareness of having a spondylolisthesis, pain self-efficacy and kinesiophobia.MethodsA secondary retrospective analysis was done. Ninety-eight subjects with subacute and chronic LBP were included: 49 subjects with diagnosed symptomatic lumbar spondylolisthesis and 49 subjects with diagnosed non-specific LBP. The pain self-efficacy measured with the Pain Self-Efficacy Questionnaire and the fear of movement measured with the Tampa Scale of Kinesiophobia were considered variables to investigate, whereas diagnosis and demographic/clinical variables were considered predictors or potential confounders.ResultsBy comparing the two groups, the awareness of having a spondylolisthesis did not significantly influence neither pain self-efficacy (p = 0.82), nor kinesiophobia (p = 0.75). Higher perceived pain reduces pain self-efficacy and increases kinesiophobia in both groups (p = 0.002 and p = 0,031 respectively).ConclusionsIt seems that the awareness of an anatomical defect as spondylolisthesis does not significantly affect the beliefs of carry out activities and movements despite the pain. Other studies with wider samples are required, to confirm these preliminary results.
- Published
- 2019
21. Cervical Radiculopathy: Effectiveness of Adding Traction to Physical Therapy—A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- Author
-
Carla Vanti, Andrew A. Guccione, Antonio Romeo, Paolo Pillastrini, Lucia Bertozzi, Valerio Boldrini, Martina Ruggeri, Pillastrini, Paolo, Romeo, Antonio, Vanti, Carla, Boldrini, Valerio, Ruggeri, Martina, Guccione, Andrew, and Bertozzi, Lucia
- Subjects
medicine.medical_specialty ,Physical Therapy ,medicine.medical_treatment ,MEDLINE ,Physical Therapy, Sports Therapy and Rehabilitation ,CINAHL ,Cervical spine disorder ,law.invention ,03 medical and health sciences ,Cervical radiculopathy ,0302 clinical medicine ,Randomized controlled trial ,law ,Mechanical Traction ,Medicine ,Cervical Radicular Pain ,Cervical Radiculopathy ,030222 orthopedics ,business.industry ,Traction (orthopedics) ,medicine.disease ,Manual Therapy ,Data extraction ,Meta-analysis ,Physical therapy ,business ,030217 neurology & neurosurgery - Abstract
Background Cervical radiculopathy (CR) is a common cervical spine disorder. Cervical traction (CT) is a frequently recommended treatment for patients with CR. Purpose The purpose of this study was to conduct a review and meta-analysis of randomized controlled trials (RCTs) on the effect of CT combined with other physical therapy procedures versus physical therapy procedures alone on pain and disability. Data Sources Data were obtained from COCHRANE Controlled Trials Register, PubMed, CINAHL, Scopus, ISI Web of Science, and PEDro, from their inception to July 2016. Study Selection All RCTs on symptomatic adults with CR, without any restriction regarding publication time or language, were considered. Data Extraction Two reviewers selected the studies, conducted the quality assessment, and extracted the results. Meta-analysis employed a random-effects model. The evidence was assessed using GRADE criteria. Data Synthesis Five studies met the inclusion criteria. Mechanical traction had a significant effect on pain at short- and intermediate-terms (g = –0.85 [95% CI = –1.63 to –0.06] and g = –1.17 [95% CI = –2.25 to –0.10], respectively) and significant effects on disability at intermediate term (g = –1.05; 95% CI = –1.81 to –0.28). Manual traction had significant effects on pain at short- term (g = –0.85; 95% CI = –1.39 to –0.30). Limitations The most important limitation of the present work is the lack of homogeneity in CR diagnostic criteria among the included studies. Conclusions In light of these results, the current literature lends some support to the use of the mechanical and manual traction for CR in addition to other physical therapy procedures for pain reduction, but yielding lesser effects on function/disability.
- Published
- 2018
22. Author Response
- Author
-
Antonio Romeo, Carla Vanti, Valerio Boldrini, Martina Ruggeri, Andrew A Guccione, Paolo Pillastrini, Lucia Bertozzi, Romeo, Antonio, Vanti, Carla, Boldrini, Valerio, Ruggeri, Martina, Guccione, Andrew A., Pillastrini, Paolo, and Bertozzi, Lucia
- Subjects
Publishing ,Traction ,Humans ,Physical Therapy, Sports Therapy and Rehabilitation ,Radiculopathy ,Physical Therapy Modalities ,Randomized Controlled Trials as Topic - Abstract
Reply to the letter to the Editor “Complete transparency of a systematic review for readers”. First of all, we thank for the contribution aimed to improve a complete transparency of our systematic review for readers. It allows us to clarify some aspects that we did not specify in the published manuscript. We agree with you on the importance of the PRISMA statement that guided our systematic review, because the first author of its original paper, Prof. Liberati Alessandro, who disappeared prematurely, was our mentor. This can be an opportunity to remember him and his great commitment to the scientific community. Therefore, we confirm that we followed the PRISMA statement suggestions concerning the methods used for the systematic review. More specifically, despite we did not register the study protocol, we did not amend in any case our research design after the initiation of our study. A protocol exists but it was not made public and it is a “data not shown”. In the protocol we established a priori the objectives and methods of our review, the outcomes, the methods of data extraction and those for qualitative and quantitative synthesis. The protocol was not modified during the editing of the systematic review. Moreover, we extracted data in an agreed beforehand report, an excel cartel with color codes. We verified the report on some randomly selected studies and then it was improved accordingly. Subsequently two authors extracted all the data independently. The disagreements were solved by discussion among all the authors and if consent was not reached the decision was made by the most expert author. It was not necessary contacting other authors for more information. We searched data about the characteristics of participants (e.g. age, diagnosis, symptoms, red flags, inclusion and exclusion criteria), the characteristics of interventions (e.g. type, dosage, position, and time of traction, and type of physical therapy interventions), the characteristics of outcome measures for pain and disability. The data we extracted from included studies were about authors (names of Authors, countries, and publication years), characteristics of participants (number of participants for each group, mean age, and gender), outcome measures employed for pain and disability (e.g. VAS, NRS, Neck Pain and Disability Scale, etc.), follow-up timing (e.g. immediately post-treatment and/or at different post-treatment intervals), results (means and standard deviations at pre- and post-treatment for each outcome measure and for each follow-up time), and adverse events. We hope that these clarifications will improve the readability of the systematic review on the effectiveness of traction added to physical therapy interventions in cervical radiculopathy.
- Published
- 2019
23. Sexual disability in patients with chronic non-specific low back pain-a multicenter retrospective analysis
- Author
-
Luca Frigau, Martina Ruggeri, Francesco Mola, Silvano Ferrari, Paolo Pillastrini, Carla Vanti, Andrew Anthony Guccione, Marco Monticone, Ferrari, Silvano, Vanti, Carla, Frigau, Luca, Guccione, Andrew Anthony, Mola, Francesco, Ruggeri, Martina, Pillastrini, Paolo, and Monticone, Marco
- Subjects
030506 rehabilitation ,medicine.medical_specialty ,Sexual function ,Population ,Physical Therapy, Sports Therapy and Rehabilitation ,Odds ,03 medical and health sciences ,0302 clinical medicine ,medicine ,education ,Oswestry Disability Index ,education.field_of_study ,business.industry ,030229 sport sciences ,Low back pain ,Spinal pain ,Rumination ,Physical therapy ,Marital status ,Anxiety ,Original Article ,medicine.symptom ,0305 other medical science ,business - Abstract
[Purpose] Oswestry Disability Index includes an item (Oswestry Disability Index-8) aiming to assess sexual disability associated to low back pain. The aim of this study is to investigate the percentage of participants who answered the Oswestry Disability Index-8, and the relevance and characteristics of sexual disability due to low back pain in Italian patients. [Participants and Methods] Design: multicenter retrospective analysis. Population: six hundred and ninety-seven outpatients with non-specific low back pain. Variables: pain characteristics (amount, localization, and duration of perceived pain), disability, and psychological variables (anxiety, depression, catastrophizing, kinesiophobia, pain acceptance, and pain vigilance and awareness). [Results] Seventy-seven participants (11.05%) did not answer the Oswestry Disability Index-8. The odds of being not responding to the Oswestry Disability Index-8 item appeared related to age (odds=7.50 for over 60), gender (odds=2.65 for females), and marital status (odds=2.33 for not married). Concerning the psychological variables, Activity Avoidance (coefficient=0.071), Depression (coefficient=0.068), and Rumination (coefficient=0.031) showed a positive impact on sexual disability. [Conclusion] In Italian patients, the percentage of not-responding to Oswestry Disability Index-8 was relatively low. In addition, sexual disability was related to depression, activity avoidance, and rumination.
- Published
- 2019
24. Comparative effectiveness of conservative and pharmacological interventions for chronic non-specific neck pain Protocol of a systematic review and network meta-analysis
- Author
-
Lucia Bertozzi, Paolo Pillastrini, Alessandro Chiarotto, Francesco Marzioni, Silvia Gianola, Francesco Fasciani, Greta Castellini, Carla Vanti, Epidemiology and Data Science, Pillastrini, Paolo, Castellini, Greta, Chiarotto, Alessandro, Fasciani, Francesco, Marzioni, Francesco, Vanti, Carla, Bertozzi, Lucia, Gianola, Silvia, General Practice, Health Economics and Health Technology Assessment, and AMS - Ageing and Morbidity
- Subjects
medicine.medical_specialty ,neck pain, network meta-analysis, rehabilitation, review, therapeutics ,medicine.medical_treatment ,neck pain ,Network Meta-Analysis ,MEDLINE ,review ,CINAHL ,rehabilitation ,03 medical and health sciences ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Study Protocol Systematic Review ,medicine ,therapeutics ,Humans ,Pain Management ,030212 general & internal medicine ,Grading (education) ,network meta-analysis ,Protocol (science) ,Neck pain ,Rehabilitation ,Neck Pain ,business.industry ,Chronic pain ,General Medicine ,medicine.disease ,030220 oncology & carcinogenesis ,Meta-analysis ,Physical therapy ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,medicine.symptom ,Chronic Pain ,business ,Research Article - Abstract
Supplemental Digital Content is available in the text, Background: Neck Pain (NP) has been ranked as one of the top chronic pain conditions in terms of prevalence and years lived with disability in the latest Global Burden of Disease. NP has remarkable socio-economic consequences however, research efforts are limited. Discrepancies among guidelines recommendations on management of chronic neck pain exist. The purpose of this study protocol is to provide the methods for a review with network meta-analysis to identify the most effective interventions for chronic neck pain. Methods: The following databases will be searched from their inception to February 2019: Cochrane Controlled Trials Register (CENTRAL), PubMed, CINAHL, Scopus, ISI Web of Science and PEDro. Randomized controlled trials (RCTs) on pharmacological and not pharmacological interventions will be included and their risk of bias will be evaluated using the Cochrane Risk of bias tool. Primary outcomes will be reduction in pain and disability. A network meta-analysis will be carried out and pairwise meta-analysis will be conducted using Stata 15 software. Grading of recommendations assessment, development, and evaluation (GRADE) will be applied to assess quality of the body of the evidence. Results: The results of this review will be submitted to a peer-review journal for publication. Conclusion: This network meta-analysis will provide a comprehensive review on the most effective treatments for the management of chronic neck pain providing key evidence-based information to patients, clinicians and other relevant stakeholders. Registration: PROSPERO (registration number CRD42019124501).
- Published
- 2019
25. Evidence for managing chronic low back pain in primary care: a review of recommendations from high-quality clinical practice guidelines
- Author
-
Roberto Meroni, Claudio Ravasio, Lucia Bertozzi, Daniele Piscitelli, Cecilia Perin, Giovanni De Vito, Paolo Pillastrini, Cesare Cerri, Andrew A. Guccione, Carla Vanti, Meroni, R, Piscitelli, D, Ravasio, C, Vanti, C, Bertozzi, L, De Vito, G, Perin, C, Guccione, A, Cerri, C, Pillastrini, P, Meroni, Roberto, Piscitelli, Daniele, Ravasio, Claudio, Vanti, Carla, Bertozzi, Lucia, De Vito, Giovanni, Perin, Cecilia, Guccione, Andrew A, Cerri, Cesare G, and Pillastrini, Paolo
- Subjects
030506 rehabilitation ,medicine.medical_specialty ,disability evaluation ,media_common.quotation_subject ,medicine.medical_treatment ,MEDLINE ,Low back pain ,practice guideline ,rehabilitation ,primary health care ,chronic pain ,Low back pain, practice guideline, rehabilitation, primary health care, chronic pain, disability evaluation ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Quality (business) ,Intensive care medicine ,media_common ,Rehabilitation ,business.industry ,Chronic pain ,food and beverages ,World population ,medicine.disease ,Chronic low back pain ,Clinical Practice ,MED/34 - MEDICINA FISICA E RIABILITATIVA ,Evidence-Based Practice ,Practice Guidelines as Topic ,medicine.symptom ,0305 other medical science ,business ,030217 neurology & neurosurgery - Abstract
Aim: Chronic low back pain represents a major problem throughout the world which is increasing largely because of the aging world population. Clinical practice Guidelines can be powerful tools for promoting evidence-based practice, as they integrate research findings in order to support decision making. This study aimed to review recommendations for the management of Chronic low Back Pain in primary care based on high-quality recent and recently updated Clinical practice Guidelines. Methods: CINHAL, PubMed, EMBASE, PEDro, Google Scholar, Government websites, Scientific Association websites were searched until April 2019. The retrieved documents underwent several consecutive selection steps: semi-automated duplicate screening, documents selection based on title and abstract screening. Finally, three independent investigators screened the documents for the selected inclusion criteria and reviewed the retrieved documents by means of the AGREE II instrument. Results: A total of 3055 records were retrieved, of which 10 Clinical practice Guidelines met the inclusion criteria. The overall quality of these Clinical practice Guidelines was moderately variable. The recommendations of four Clinical practice Guidelines deemed as "excellent" were extracted and summarized. Although we tried to implement the most comprehensive research strategies, some Clinical practice Guidelines may be missing due to publication bias or incomplete indexing. Conclusions: This study showed a partial progress in respect of the methodological quality of the Clinical practice Guidelines. Several AGREE II domains demonstrated low scores, particularly the "applicability" and "monitoring and auditing criteria" are the domains most susceptible to amendments in future. Implications for rehabilitation Clinicians should be aware that among recently published/updated clinical practice guidelines for the management of chronic low back pain in primary care only few were deemed to have high quality. Increasing evidence suggests the efficacy for self-management to improve low back pain outcome. Physical treatments are recommended in order to improve low back pain outcome while many physical modalities such as TENS, ultrasound, laser therapy are not. Psychological treatments are recommended and should be included as part of a broader treatment plan. Aim: Chronic low back pain represents a major problem throughout the world which is increasing largely because of the aging world population. Clinical practice Guidelines can be powerful tools for promoting evidence-based practice, as they integrate research findings in order to support decision making. This study aimed to review recommendations for the management of Chronic low Back Pain in primary care based on high-quality recent and recently updated Clinical practice Guidelines. Methods: CINHAL, PubMed, EMBASE, PEDro, Google Scholar, Government websites, Scientific Association websites were searched until April 2019. The retrieved documents underwent several consecutive selection steps: semi-automated duplicate screening, documents selection based on title and abstract screening. Finally, three independent investigators screened the documents for the selected inclusion criteria and reviewed the retrieved documents by means of the AGREE II instrument. Results: A total of 3055 records were retrieved, of which 10 Clinical practice Guidelines met the inclusion criteria. The overall quality of these Clinical practice Guidelines was moderately variable. The recommendations of four Clinical practice Guidelines deemed as “excellent” were extracted and summarized. Although we tried to implement the most comprehensive research strategies, some Clinical practice Guidelines may be missing due to publication bias or incomplete indexing. Conclusions: This study showed a partial progress in respect of the methodological quality of the Clinical practice Guidelines. Several AGREE II domains demonstrated low scores, particularly the “applicability” and “monitoring and auditing criteria” are the domains most susceptible to amendments in future.Implications for rehabilitation Clinicians should be aware that among recently published/updated clinical practice guidelines for the management of chronic low back pain in primary care only few were deemed to have high quality. Increasing evidence suggests the efficacy for self-management to improve low back pain outcome. Physical treatments are recommended in order to improve low back pain outcome while many physical modalities such as TENS, ultrasound, laser therapy are not. Psychological treatments are recommended and should be included as part of a broader treatment plan.
- Published
- 2019
- Full Text
- View/download PDF
26. The effectiveness of walking versus exercise on pain and function in chronic low back pain: a systematic review and meta-analysis of randomized trials
- Author
-
Carla Vanti, Andrew A. Guccione, Silvia Borghi, Simone Andreatta, Paolo Pillastrini, Lucia Bertozzi, Vanti, Carla, Andreatta, Simone, Borghi, Silvia, Guccione, Andrew Anthony, Pillastrini, Paolo, and Bertozzi, Lucia
- Subjects
030506 rehabilitation ,medicine.medical_specialty ,meta-analysi ,law.invention ,03 medical and health sciences ,walking ,0302 clinical medicine ,Randomized controlled trial ,systematic review ,law ,Medicine ,Humans ,Disabled Persons ,Low back pain ,Randomized Controlled Trials as Topic ,exercise ,business.industry ,Rehabilitation ,Chronic low back pain ,Exercise Therapy ,Treatment Outcome ,Meta-analysis ,Physical therapy ,Quality of Life ,medicine.symptom ,Chronic Pain ,0305 other medical science ,business ,human activities ,030217 neurology & neurosurgery - Abstract
Walking is commonly recommended to relieve pain and improve function in chronic low back pain. The purpose of this study was to conduct a systematic review and meta-analysis of randomized controlled trials concerning the effectiveness of walking interventions compared to other physical exercise on pain, disability, quality of life and fear-avoidance, in chronic low back pain.Randomized controlled trials investigating the effects of walking alone compared to exercise and to exercise with added walking on adults with chronic low back pain were identified using the MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), Cochrane Central Register of Controlled Trials (CENTRAL), PsychINFO, and SPORT DiscusMeta-analysis of five randomized controlled trials meeting inclusion criteria was performed. The effectiveness of walking and exercise at short-, mid-, and long-term follow-ups appeared statistically similar. Adding walking to exercise did not induce any further statistical improvement, at short-term.Pain, disability, quality of life and fear-avoidance similarly improve by walking or exercise in chronic low back pain. Walking may be considered as an alternative to other physical activity. Further studies with larger samples, different walking dosages, and different walking types should be conducted. Implications for Rehabilitation Walking is commonly recommended as an activity in chronic low back pain. Pain, disability, and fear-avoidance similarly improve by walking or exercise. Adding walking to exercise does not induce greater improvement in the short-term. Walking may be a less-expensive alternative to physical exercise in chronic low back pain.
- Published
- 2019
27. Effectiveness of Global Postural Re-education in Patients With Chronic Nonspecific Neck Pain: Randomized Controlled Trial
- Author
-
Fernanda de Lima e Sá Resende, Jorge Hugo Villafañe, Anna Burioli, Emanuele Di Ciaccio, Paolo Pillastrini, Andrew A. Guccione, Carla Vanti, Federico Banchelli, Pillastrini, Paolo, de Lima E Sá Resende, Fernanda, Banchelli, Federico, Burioli, Anna, Di Ciaccio, Emanuele, Guccione, Andrew A, Villafañe, Jorge Hugo, and Vanti, Carla
- Subjects
Adult ,Male ,medicine.medical_specialty ,Randomization ,Adolescent ,Visual analogue scale ,Posture ,Physical Therapy, Sports Therapy and Rehabilitation ,law.invention ,Disability Evaluation ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Randomized controlled trial ,law ,Intervention (counseling) ,medicine ,Humans ,Pain Management ,Physical Therapy Modalities ,Reference group ,Aged ,Pain Measurement ,Aged, 80 and over ,030222 orthopedics ,Neck pain ,Neck Pain ,business.industry ,Chronic pain ,Middle Aged ,medicine.disease ,Treatment Outcome ,Physical therapy ,Female ,Ergonomics ,Chronic Pain ,Manual therapy ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Background Global postural re-education (GPR) has shown positive results for patients with musculoskeletal disorders, but no previous randomized controlled trial (RCT) has investigated its effectiveness as the sole procedure for adult patients with chronic nonspecific neck pain (NP). Objective The purpose of this study was to evaluate the effectiveness of applying GPR compared with a manual therapy (MT) intervention to patients with chronic nonspecific NP. Design An RCT was conducted. Patients Ninety-four patients with chronic nonspecific NP (72 women and 22 men; average age=47.5 years, SD=11.3) were randomly assigned to receive either a GPR intervention or an MT intervention. Outcome Measures Pain intensity (visual analog scale), disability (Neck Disability Index), cervical range of motion, and kinesiophobia (Tampa Scale of Kinesiophobia) were assessed. Methods The experimental group received GPR, and the reference group received MT. Both groups received nine 60-minute-long sessions with one-to-one supervision from physical therapists as the care providers. All participants were asked to follow ergonomic advice and to perform home exercises. Measures were assessed before treatment, following treatment, and at a 6-month follow-up. Results No important baseline differences were found between groups. The experimental group exhibited a statistically significant reduction in pain following treatment and in disability 6 months after the intervention compared with the reference group. Limitations Randomization did not lead to completely homogeneous groups. It also was noted that the time spent integrating the movements practiced during the session into daily routines at the end of each session was requested only of participants in the GPR group and may have had an impact on patient adherence that contributed to a better outcome. Conclusions The results suggest that GPR was more effective than MT for reducing pain after treatment and for reducing disability at 6-month follow-up in patients with chronic nonspecific NP.
- Published
- 2016
28. Can physical therapy centred on cognitive and behavioural principles improve pain self-efficacy in symptomatic lumbar isthmic spondylolisthesis? A case series
- Author
-
Silvano Ferrari, Francesco Costa, Carla Vanti, Maurizio Fornari, and VANTI, CARLA
- Subjects
Adult ,Male ,Complementary and Manual Therapy ,Health Knowledge, Attitudes, Practice ,medicine.medical_specialty ,medicine.medical_treatment ,Physical Therapy, Sports Therapy and Rehabilitation ,Disability Evaluation ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,Lumbar ,Physical medicine and rehabilitation ,medicine ,Humans ,Cognitive-behavioural treatment ,Physical Therapy Modalities ,Pain Measurement ,Self-efficacy ,030222 orthopedics ,Lumbar Vertebrae ,Rehabilitation ,Cognitive Behavioral Therapy ,business.industry ,Chronic pain ,Middle Aged ,medicine.disease ,Self Efficacy ,Exercise Therapy ,Chronic low back pain ,Exercise movement technique ,Complementary and alternative medicine ,Chronic Disease ,Physical therapy ,Female ,Pain catastrophizing ,Spondylolisthesis ,business ,Exercise Movement Techniques ,Low Back Pain ,030217 neurology & neurosurgery - Abstract
Summary Purpose Pain-related self-efficacy is defined as "the beliefs held by people with chronic pain that were able to carry out certain activities, even when experiencing pain", and it is considered a relevant mediator in the relationship between pain and disability in chronic low back pain. This case series describes a treatment aiming to improve pain self-efficacy in patients with symptomatic lumbar spondylolisthesis. Method Ten consecutive outpatients with lumbar spondylolisthesis and chronic LBP referred to a rehabilitative clinic participated in this study. Cognitive and behavioural principles were integrated with functional and graded approach in each individual physical therapy program. The outcome measures concerned clinical instability and endurance tests, pain, disability and self-efficacy. Results Pain self-efficacy and lumbar function improved in 7 out of 10 patients; clinical tests improved in 9 out of 10 patients. Conclusion A rehabilitation program carried out by a physical therapist, centred on cognitive and behavioural principles, appeared useful in improving pain self-efficacy and lumbar function. These results may be interesting for future controlled trials.
- Published
- 2016
29. Pain Self-Efficacy and Fear of Movement are Similarly Associated with Pain Intensity and Disability in Italian Patients with Chronic Low Back Pain
- Author
-
Alessandro Chiarotto, Carla Vanti, Silvano Ferrari, Marta Pellizzer, Marco Monticone, Silvano, Ferrari, Alessandro, Chiarotto, Marta, Pellizzer, Carla, Vanti, Marco, Monticone, Health Economics and Health Technology Assessment, Epidemiology and Data Science, and EMGO - Musculoskeletal health
- Subjects
medicine.medical_specialty ,Fear of movement ,03 medical and health sciences ,0302 clinical medicine ,pain self-efficacy ,medicine ,fear of movement ,030212 general & internal medicine ,Self-efficacy ,pain intensity ,business.industry ,Confounding ,Association model ,Pain Self-efficacy ,Intensity (physics) ,Chronic low back pain ,Anesthesiology and Pain Medicine ,disability ,Fear of Movement ,Physical therapy ,chronic low back pain ,Pain catastrophizing ,Pain Intensity ,business ,Psychosocial ,030217 neurology & neurosurgery - Abstract
The purpose of this study was to investigate cross-sectional associations of pain self-efficacy and fear of movement with pain intensity and disability in Italian patients with chronic low back pain (CLBP). One hundred and three adult outpatients with nonspecific CLBP were included in the study. Socio-demographic and clinical characteristics were assessed, together with Italian versions of self-reported questionnaires to measure the four constructs of interest. Multiple linear regression models were built with psychosocial constructs as main determinants, and pain intensity and disability as outcomes. Potential confounding of socio-demographic and clinical characteristics was assessed. Pain self-efficacy and fear of movement displayed moderate correlations with pain intensity (r = −0.41 and 0.42, respectively) and disability (−0.55 and 0.54). Association models adjusted for pain intensity showed that both pain self-efficacy (β = −0.35, 95% CI = −0.5; −0.2, R2 = 41%) and fear of movement (β = 0.65, 95% CI = 0.36; 0.93, R2 = 40%) are significantly and strongly associated with disability. Pain self-efficacy was no longer significantly associated with pain intensity when disability was added as a confounder to the model, whereas fear of movement retained its significant association (β = 0.06, 95% CI = 0.00;0.11, R2 = 30%). No other variables acted as confounders in these associations. Pain self-efficacy and fear of movement are very similarly associated with main outcomes in this sample of Italian patients with CLBP. The results of this study suggest that both psychosocial constructs should be considered in clinical management. Future studies should investigate whether these findings can be replicated in other samples, in longitudinal designs and if other variables not measured in this study confound the associations.
- Published
- 2016
30. Effectiveness of physical therapy in addition to occlusal splint in myogenic temporomandibular disorders: protocol of a randomised controlled trial
- Author
-
Paolo Pillastrini, Claudio Marchetti, Maria Rosaria Gatto, Cristina Incorvati, Luca Defila, Adele Fabrizi, Antonio Romeo, Carla Vanti, Incorvati C., Romeo A., Fabrizi A., Defila L., Vanti C., Gatto M.R.A., Marchetti C., and Pillastrini P.
- Subjects
Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Dentistry and Oral Medicine ,Physical examination ,Context (language use) ,Musculoskeletal disorders ,law.invention ,Randomized controlled trial ,ORAL MEDICINE ,law ,Informed consent ,Rehabilitation medicine ,medicine ,Humans ,Physical Therapy Modalities ,Randomized Controlled Trials as Topic ,medicine.diagnostic_test ,business.industry ,Musculoskeletal disorder ,Occlusal Splints ,Multimodal therapy ,General Medicine ,Temporomandibular Joint Disorders ,Treatment Outcome ,Italy ,Physical therapy ,Medicine ,Manual therapy ,business ,Splint (medicine) ,Oral medicine - Abstract
IntroductionTemporomandibular disorders (TMDs) are considered a collection of musculoskeletal conditions involving the masticatory muscles, the temporomandibular joint and associated structures. The myogenous group appears to represent the most frequently diagnosed category. In the context of a multimodal approach, splint therapy and musculoskeletal physiotherapy are often considered as a preferred therapy. The purpose of this study will be to investigate the effects of musculoskeletal physiotherapy combined with occlusal splint and education versus occlusal splint and education alone in the treatment of chronic myogenous TMD on pain and mandibular range of motion.Methods and analysisAll consecutive adults complaining of TMDs presented to the Department of Biomedical and Neuromotor Sciences of the University of Bologna will be considered eligible. Inclusion criteria shall be based on the presence of myogenous TMDs, as diagnosed through clinical examination in reference to the international diagnostic criteria of TMDs. Randomisation, concealed allocation, blinded assessment and intention-to-treat analysis will be employed. The splint therapy will consist of the use of the splint every night and concurrent delivery of an educational programme; the protocol shall have a duration of three consecutive months. The combined musculoskeletal physiotherapy, splint therapy and education will additionally consist of manual therapy techniques and exercise; such protocol shall consist of a duration of three consecutive months, inclusive of 10 sessions for the enhanced elements. All outcome measures will be collected at baseline, after treatment and at a 6 months follow-up.Ethics and disseminationEthical approval has been obtained from the Independent Ethic Committee in Clinical Research of AUSL Bologna-Italy (47/2018/SPER/AUSLBO). Pursuant to applicable rules,we will obtain informed consent from each participant and collect data anonymously to maintain privacy. Results will be disseminated to clinicians and researchers through peer-reviewed publications and conferences.Trial registration numberNCT03726060
- Published
- 2020
31. Effectiveness of a 'Spring Pillow' Versus Education in Chronic Nonspecific Neck Pain: A Randomized Controlled Trial
- Author
-
Claudia Marino, Paolo Pillastrini, Andrea Puccetti, Andrew A. Guccione, Federico Banchelli, Carla Vanti, Vanti, Carla, Banchelli, Federico, Marino, Claudia, Puccetti, Andrea, Guccione, Andrew A, and Pillastrini, Paolo
- Subjects
Adult ,Male ,medicine.medical_specialty ,Chest Pain ,Education, Pillow, Neck Pain, Sleep Quality, Ergonomics ,Polyurethanes ,Physical Therapy, Sports Therapy and Rehabilitation ,Viscoelastic Substances ,law.invention ,Occupational medicine ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Randomized controlled trial ,Patient Education as Topic ,law ,Outcome Assessment, Health Care ,Confidence Intervals ,Medicine ,Humans ,Young adult ,Aged ,Pain Measurement ,Original Research ,Aged, 80 and over ,030222 orthopedics ,Neck pain ,Cross-Over Studies ,Neck Pain ,Sleep quality ,business.industry ,Headache ,Bedding and Linens ,Equipment Design ,Middle Aged ,University hospital ,Crossover study ,Confidence interval ,Sample Size ,Physical therapy ,Female ,medicine.symptom ,Chronic Pain ,business ,030217 neurology & neurosurgery - Abstract
Background Different types of pillows have been proposed for neck pain, but no previous randomized controlled trial has investigated the effectiveness of a “spring pillow” for adults with chronic nonspecific neck pain. Objective We evaluated the effectiveness of using a pillow made from viscoelastic polyurethane and 60 independent springs compared with an educational intervention in individuals with chronic nonspecific neck pain. Design This was a randomized controlled trial with crossover study design. Setting The setting was the Occupational Medicine Unit, University Hospital, Bologna (Italy). Participants We recruited 70 adults with chronic nonspecific neck pain, of whom 64 completed the trial. Intervention Participants were randomly assigned to 2 groups. One group used the spring pillow for 4 weeks, and the other group followed educational advice for 4 weeks while continuing to use their own pillows. After 4 weeks of treatment and 4 weeks of washout, groups were crossed over. Pain perceived in the neck, thoracic, and shoulder areas and headache were the primary outcome measures. In addition, disability, sleep quality, subjective improvement, and pillow comfort were assessed. Measures were captured at pretreatment, after 4 weeks, after the 4-week washout period, and 4 weeks after crossover. The mean differences (MD) in outcomes between groups were assessed. Results Treatment with the spring pillow appeared to reduce neck pain (MD = −8.7; 95% confidence interval [CI] = −14.7 to −2.6), thoracic pain (MD = −8.4; 95% CI = −15.2 to −1.5), and headache (MD = −16.0; 95% CI = −23.2 to −8.7). Reductions in shoulder pain were not statistically significant between groups (MD = −6.9; 95% CI = −14.1–0.3). Neither the crossover sequence nor the period (first vs second intervention administration) significantly affected the results. Limitations Education may not have been the best comparator for the spring pillow; drug consumption, actual pillow use, and the implementation of the educational suggestions as prescribed were not controlled. Conclusions Use of the spring pillow in this study was more effective than an educational intervention for improving cervical, thoracic, and head pain. Whether a spring pillow is more effective than other ergonomic pillows remains to be tested.
- Published
- 2018
32. Responsiveness of the bridge maneuvers in subjects with symptomatic lumbar spondylolisthesis: A prospective cohort study
- Author
-
Carla Vanti, Silvano Ferrari, Pedro Berjano, Jorge Hugo Villafañe, Marco Monticone, Carla Vanti, Silvano Ferrari, Pedro Berjano, Jorge Hugo Villafañe, and Marco Monticone
- Subjects
Adult ,Male ,Humans ,Female ,Responsivene ,Prospective Studies ,Middle Aged ,Spondylolisthesis ,Bridge maneuver ,Low Back Pain ,Physical Therapy Modalities ,Pain Measurement - Abstract
To date no study was made on the responsiveness of Bridge tests (BTs) in subjects with low back pain and spondylolisthesis (SPL) submitted to a physical therapy program. The objective of this study is to examine the responsiveness of the BTs in subjects with symptomatic lumbar SPL.One hundred twenty patients with symptomatic SPL received physical therapy treatments for a number of sessions depending on the individual patient's needs. Each session included supervised exercises and the teaching of home exercises aiming to improve the lumbar stability, for about 1 hr in total. At the beginning and immediately after the last session of treatment, participants completed the Oswestry Disability Index - Italian version and the Pain Numerical Rating Scale, and performed the supine bridging (SBT) and the prone bridging (PBT). The global perception of effectiveness was measured with a seven-point Likert scale Global Perceived Effect questionnaire.The mean post-treatment change score (95% confidence interval [CI]) was 18.2 s (14.5; 21.9) for the PBT and 43.9 s (35.1; 52.8) for the SBT, all p .001. The area under the receiver operating characteristic curve for the PBT was 0.83 (95% CI 0.74-0.91) and for the SBT was 0.703 (95% CI 0.61-0.80). The optimal cutoff points were 19.5 s for the PBT and 62.5 s for the SBT. Logistic regression revealed that PBT (odds ratio = 0.952) was associated with the type of SPL. The final regression model explained 36.4% (RBridge maneuvers proved to be responsive, because their results were significantly related to pain and disability changes. BTs may be suggested to detect clinical changes after physical therapy treatment in symptomatic SPL. Copyright © 2017 John WileySons, Ltd.
- Published
- 2016
33. Reliability of Handgrip Strength Test in Elderly Subjects with Unilateral Thumb Carpometacarpal Osteoarthritis
- Author
-
Carla Vanti, Paolo Pillastrini, Alberto Borboni, Jorge Hugo Villafañe, Kristin Valdes, and VANTI, CARLA
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,Test–retest . Thumb . Carpometacarpal osteoarthritis . Grip strength ,business.industry ,Osteoarthritis ,Thumb ,medicine.disease ,Article ,Test (assessment) ,Carpometacarpal osteoarthritis ,Test–retest ,body regions ,Grip strength ,medicine.anatomical_structure ,Orthopedics and Sports Medicine ,Surgery ,Grip Strength Test ,Orthopedic surgery ,medicine ,Physical therapy ,business ,Reliability (statistics) - Abstract
Background The grip strength test is widely used; however, little has been investigated about its reliability when used in elderly with subjects thumb carpometacarpal (CMC) osteoarthritis (OA). The purpose of this study was to examine the test–retest reliability of the grip strength test in elderly subjects with thumb CMC OA. Methods A total of 78 patients with unilateral thumb CMC OA, 84.6 % female (mean±SD age 83±5 years), were recruited. Each patient performed three pain free maximal isometric contractions on each hand in two occasions, 1 week apart. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and 95 % limits of agreement (LOA) were calculated. Results Test–retest reliability was excellent for side affected (ICC=0.947; p=0.001) and contralateral (ICC=0.96; p=0.001) thumb CMC OA. Conclusions The present results indicate that maximum handgrip strength can be measured reliably, using the Jamar hand dynamometer, in patients with thumb CMC OA, which enables its use in research and in the clinic to determine the effect of interventions on improving grip.
- Published
- 2014
34. Relationship between female pelvic floor dysfunction and sexual dysfunction: an observational study
- Author
-
Andrew A. Guccione, Arianna Bortolami, Federico Banchelli, Carla Vanti, Paolo Pillastrini, Arianna Bortolami, Carla Vanti, Federico Banchelli, Andrew A. Guccione, and Paolo Pillastrini
- Subjects
Adult ,medicine.medical_specialty ,Sexual Dysfunction ,Physical Therapy ,Urology ,Endocrinology, Diabetes and Metabolism ,Libido ,Population ,Urinary incontinence ,Pelvic Floor Muscle ,Endocrinology ,Internal medicine ,Surveys and Questionnaires ,Vaginismus ,medicine ,Odds Ratio ,Humans ,Sexual Dysfunctions, Psychological ,education ,Physical Examination ,Aged ,Gynecology ,education.field_of_study ,Pelvic floor ,Pelvic Floor ,Middle Aged ,medicine.disease ,Self Concept ,Psychiatry and Mental health ,Sexual dysfunction ,medicine.anatomical_structure ,Urinary Incontinence ,Reproductive Medicine ,Quality of Life ,Vulvodynia ,Female ,medicine.symptom ,Psychology ,Sexual function - Abstract
Introduction The ability to express one's sexuality and engage in sexual activity requires multisystemic coordination involving many psychological functions as well as the integrity of the nervous, hormonal, vascular, immune, and neuromuscular body structures and functions. Aim The purpose of this study was to investigate the associations among pelvic floor function, sexual function, and demographic and clinical characteristics in a population of women initiating physical therapy evaluation and treatment for pelvic floor–related dysfunctions (urinary incontinence, pelvic organ prolapse, vulvodynia, vaginismus, and constipation). Methods We consented and collected completed demographic data and data related to symptoms and clinical condition on 85 consecutive patients in an outpatient physical therapy clinic. Clinical and anthropometric characteristics were analyzed descriptively. Analysis of variance and linear regression analyses were used to analyze Female Sexual Function Index (FSFI) scale ratings, whereas zero-inflated beta-binomial regression was applied to the pain subscale. Main Outcome Measures Main outcome measure was FSFI score, whereas the secondary outcome measure was the FSFI subscale score related to pain. Results Women in our sample were 38 years old on average, 33% of whom had given birth and 82% of whom had high tone pelvic floor. Being in the middle-tercile age group and exhibiting low pelvic floor tone (Beta = 6.8; 95% confidence interval [CI] = [1.4; 12.0]) were significantly associated with lower levels of sexual dysfunction. Women with low tone pelvic floor also reported lower pain (odds ratio = 4.0; 95% CI = [1.6; 9.6]), whereas younger aged and physically unsatisfied subjects were more likely not to have sexual activity in the month prior to scale measurement. Conclusion In female patients with pelvic floor muscle dysfunction undergoing physical therapy and rehabilitation, sexual dysfunction appears to be significantly correlated with age and high pelvic floor muscle tone.
- Published
- 2015
35. Italian Version of the Physical Therapy Patient Satisfaction Questionnaire: Cross-Cultural Adaptation and Psychometric Properties
- Author
-
Daniele Ceron, Raffaella Piccarreta, Paolo Pillastrini, Andrew A. Guccione, Carla Vanti, Marco Monticone, Francesca Bonetti, Vanti C, Monticone M, Ceron D, Bonetti F, Piccarreta R, Guccione AA, and Pillastrini P
- Subjects
Employment ,Male ,medicine.medical_specialty ,Psychometrics ,Visual analogue scale ,Culture ,Population ,Physical Therapy, Sports Therapy and Rehabilitation ,Outcome measures ,Outcome Assessment (Health Care) ,Sex Factors ,Patient satisfaction ,Cronbach's alpha ,Surveys and Questionnaires ,medicine ,Humans ,education ,Physical Therapy Modalities ,Reliability (statistics) ,Quality of Health Care ,Measurement ,education.field_of_study ,business.industry ,Age Factors ,Discriminant validity ,Reproducibility of Results ,Middle Aged ,Outcome and Process Assessment, Health Care ,Italy ,Efficiency: Organizational ,Language Arts ,Patient Satisfaction ,Scale (social sciences) ,Physical therapy ,Female ,Clinical Competence ,Factor Analysis, Statistical ,business ,Health care administration - Abstract
BackgroundPatient satisfaction is an important measure for evaluating interventions in health care. No patient satisfaction questionnaire for physical therapy treatment has been validated to date for use in an Italian outpatient population.ObjectiveThe aim of this study was to translate, culturally adapt, and validate the Italian version of the Physical Therapy Patient Satisfaction Questionnaire (PTPSQ-I).DesignA measurement study was conducted.MethodsThe PTPSQ-I was developed through forward-backward translation, final review, and pre-final version. An acceptability analysis was first conducted. Reliability was measured by internal consistency (Cronbach α), and a factor analysis was applied to investigate the internal structure. Divergent validity was measured by comparing the PTPSQ-I with a visual analog scale (VAS) and with a 5-point Likert-type scale evaluating the global perceived effect (GPE) for the physical therapy treatment.ResultsThe process for developing the PTPSQ-I required 3 months using data on 315 outpatients. Based on our initial analyses, 5 items were deleted from the PTPSQ-I, which was renamed the PTPSQ-I(15). The PTPSQ-I(15) showed high internal consistency (α=.905). Divergent validity was moderate for the GPE (r=.33) but not significant for the VAS (r=−.07). A factor analysis revealed evidence for a 2-factor structure related to perceived “Overall Experience” and “Professional Impression” that explained 62% of the total variance. A third factor, “Efficiency and Convenience,” brought explained total variance to near 70%.LimitationsIt may be necessary to add items to the PTPSQ-I(15) to assess other dimensions not currently represented by these 15 items.ConclusionThe PTPSQ-I(15) showed good psychometric properties, and its use can be recommended with Italian-speaking outpatient populations.
- Published
- 2013
36. Manual therapy and therapeutic exercise in the treatment of osteoarthritis of the hip: a systematic review
- Author
-
Tiziana Nava, Anthony A. Romeo, S. Parazza, Marco Boschi, Carla Vanti, and VANTI, CARLA
- Subjects
medicine.medical_specialty ,Functional training ,lcsh:Internal medicine ,MEDLINE ,lcsh:Medicine ,Osteoarthritis ,CINAHL ,Cochrane Library ,Osteoarthritis, Hip ,law.invention ,Physical medicine and rehabilitation ,Rheumatology ,Quality of life ,Randomized controlled trial ,law ,Medicine ,Humans ,lcsh:RC31-1245 ,business.industry ,Osteoarthritis, Hip, Exercise. Manual Therapy ,lcsh:R ,medicine.disease ,Musculoskeletal Manipulations ,Exercise Therapy ,Osteoarthritis, Hip, Exercise, Manual therapy ,Physical therapy ,Manual therapy ,business - Abstract
This systematic review aimed at investigating the role of therapeutic exercise and/or manual therapy in the treatment of hip osteoarthritis (OA). Two independent reviewers (AR, CV) searched PubMed, Cinahl, Cochrane Library, PEDro and Scopus databases and a third one (SP) was consulted in case of disagreement. The research criteria were publication period (from May 2007 to April 2012) and publication language (English or Italian). Ten randomized controlled trials matched inclusion criteria, eight of which concerning therapeutic exercise and two manual therapy. Few good quality studies were found. At mid- and long-term follow-up land-based exercises showed insufficient evidence of effectiveness with respect to pain and quality of life, but positive results were found for physical function. Water exercises significantly reduced fall risk when combined with functional exercises. Programs containing progressive and gradual exposure of difficult activities, education and exercises promoted better outcomes, higher adherence to home program and increased amount of physical activity, especially walking. Manual therapy seemed to reduce pain and decrease disability at short-term. Less use of nonsteroidal anti-inflammatory drugs was statistically significant at long-term follow-up in patients treated with manual therapy. The relationship between clinical results and radiological grade of OA was not investigated. Encouraging results were found in recent literature for manual therapy and functional training. Further research is needed to elucidate this issue through high-quality trials, especially addressing the aspects that have not been thoroughly explored yet, for instance type, amount and scheduling of conservative treatment.
- Published
- 2013
37. The Prolo Scale: history, evolution and psychometric properties
- Author
-
Donatella Prosperi, Carla Vanti, Marco Boschi, and VANTI, CARLA
- Subjects
Questionnaires ,Orthopedic surgery ,medicine.medical_specialty ,outcome assessment, questionnaires, orthopedic surgery, spinal fusion, low back pain ,Scale (ratio) ,Psychometrics ,business.industry ,Review Article ,Outcome assessment ,History, 20th Century ,History, 21st Century ,Spinal surgery ,Orthopedics ,Spinal Fusion ,Outcome Assessment, Health Care ,Physical therapy ,medicine ,Humans ,Orthopedics and Sports Medicine ,Surgery ,Low back pain surgery ,Low back pain ,business ,Cognitive psychology - Abstract
Background: Prolo Scale (PS) is a widely accepted assessment tool to evaluate lumbar spine surgery. However, a lack of consensus is reported in literature about its application, threefold values and validity. Purpose: The purpose of this review is to investigate the evolution of the Prolo Scale (PS) from its introduction in 1986 to the present, including an analysis of different versions of the scale and a research of the existing studies which investigated its psychometric properties. Matherials and Methods: The main electronic databases were searched between July and December 2012. Studies in English, Italian, French, Spanish and German published from1986 to 2011 were analyzed. Results: The original lumbar surgery outcome scale consisted of two Likert-type scales (Economic and Functional). There are three more versions of the scale: Schnee proposed one consisting of 10 items, Brantigan made one with 20 items and introduced two more subscales (Pain and Medication), Davis adapted the scale for cervical spine. Conclusion: The PS is often mentioned without any specific reference as to the version used, therefore a homogeneous comparison of studies is difficult to achieve. Several authors agree on the needing to embrace a multidimensional measuring system to evaluate Low Back Pain (LBP), but there is still no consensus regarding the most reliable tool. To date, PS has been mostly used as secondary outcome measure, in association with validated primary measures for LBP. The PS has been adopted for clinical examination for twenty years because it is easy-to-administer and useful to compare significant amount of data from surgical studies carried out at different times. Albeit several authors demonstrated the scale sensibility among a battery of tests, no thorough validation study was found in current literature.
- Published
- 2013
38. Responsiveness and Minimal Important Change of the Pain Self-Efficacy Questionnaire and Short Forms in Patients With Chronic Low Back Pain
- Author
-
Paolo Pillastrini, Fernanda de Lima e Sá Resende, Silvano Ferrari, Raymond W. J. G. Ostelo, Christine Cedraschi, Alessandro Chiarotto, Carla Vanti, Health Economics and Health Technology Assessment, Chiarotto, Alessandro, Vanti, Carla, Cedraschi, Christine, Ferrari, Silvano, Resende, Fernanda de Lima E Sà, Ostelo, Raymond W, Pillastrini, Paolo, Epidemiology and Data Science, and EMGO - Musculoskeletal health
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Psychometrics ,Validity ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Surveys and Questionnaires ,pain self-efficacy ,medicine ,Humans ,short forms ,030212 general & internal medicine ,Young adult ,Aged ,Pain Measurement ,Self-efficacy ,Receiver operating characteristic ,business.industry ,Catastrophization ,Chronic pain ,Middle Aged ,medicine.disease ,Low back pain ,Self Efficacy ,Chronic low back pain ,Anesthesiology and Pain Medicine ,Neurology ,ddc:618.97 ,Physical therapy ,Female ,Neurology (clinical) ,measurement ,Chronic Pain ,medicine.symptom ,business ,Low Back Pain ,030217 neurology & neurosurgery - Abstract
The Pain Self-Efficacy Questionnaire (PSEQ) is a valid and reliable patient-reported instrument used to assess pain self-efficacy in patients with chronic low back pain (CLBP). Recently, the 2-item (PSEQ-2) and the 4-item (PSEQ-4) short versions were developed showing satisfactory measurement properties in mixed populations with chronic pain. The aim of this study was to examine responsiveness and minimal important change (MIC) of PSEQ, PSEQ-2, and PSEQ-4 in patients with CLBP. We used a sample of 104 patients undergoing multimodal physical therapy designed to partly change pain self-efficacy beliefs. Responsiveness was assessed by testing 16 a priori formulated hypotheses regarding effect sizes, areas under the curve, and correlations with changes in other instruments measuring other constructs. The MIC was calculated using an external anchor specific for pain self-efficacy and the receiver operator characteristic (ROC) method. The PSEQ and the PSEQ-4 met all hypotheses, whereas the PSEQ-2 met all but 1. The MICs were 5.5 for the PSEQ (9% of the scale range) and 1.5 for PSEQ-2 (13% scale range) and PSEQ-4 (6% scale range). MIC values were different for patients with low or high baseline values for all 3 instruments. The PSEQ and its short versions are adequately responsive instruments in patients with CLBP. Perspective This study suggests that the PSEQ and its short versions are responsive measures of pain self-efficacy in patients with CLBP, adding to previous literature on their validity and reliability. Considering their similar responsiveness, the 4-item PSEQ could replace the original 10-item version in busy clinical or research settings.
- Published
- 2016
39. The effect of Global Postural Reeducation on body weight distribution in sitting posture and on musculoskeletal pain. A pilot study
- Author
-
Fernanda, De Lima E Sá Resende, Carla, Vanti, Federico, Banchelli, José Geraldo, Trani Brandao, José Benedito, Oliveira Amorim, Jorge Hugo, Villafañe, Andrew, Guccione, and Paolo, Pillastrini
- Subjects
Occupational Diseases ,Musculoskeletal Pain ,Body Weight ,Posture ,Directive Counseling ,Humans ,Pain Management ,Female ,Pilot Projects - Abstract
To quantify body weight distribution (BWD) in seated posture with an office chair instrumented with load cells and to evaluate the effects of ergonomic advice and Global Postural Reeducation (GPR) on seated BWD and on musculoskeletal pain.Nineteen healthy females were randomly assigned: nine to the experimental group and 10 to the control group. Control group (CG) received only ergonomic verbal advice (EVA) regarding BWD in a seated position. Experimental group (EG) also received EVA and furthermore attended eight GPR sessions. Difference in the effects of the different therapeutic approaches was investigated using the non-parametric Wilcoxon-Mann-Whitney test.After treatments, there was no significant difference between the two groups as regards seated BWD. EG improved musculoskeletal pain significantly more than CG (p0.005). Instead, musculoskeletal pain frequency decreased (p0.005) only in EG (after EVA and GPR sessions), in neck, cervical, thoracic, lumbar, shoulders and wrists areas.Despite both interventions did not induce any significant improvement on seated BWD, adding GPR to EVA was related to a better reduction on musculoskeletal pain in young health females.
- Published
- 2016
40. Reflections on the diagnostic accuracy of the Upper Limb Neurodynamic Test 1
- Author
-
Carla Vanti, Paolo Pillastrini, Roberta Bonfiglioli, Martina Ruggeri, Vanti, Carla, Bonfiglioli, Roberta, Ruggeri, Martina, and Pillastrini, Paolo
- Subjects
030222 orthopedics ,medicine.medical_specialty ,business.industry ,MEDLINE ,Diagnostic accuracy ,Physical Therapy, Sports Therapy and Rehabilitation ,General Medicine ,Median nerve ,Test (assessment) ,Median Nerve ,Upper Extremity ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Physical medicine and rehabilitation ,medicine ,Upper limb ,Humans ,business ,030217 neurology & neurosurgery - Abstract
We congratulate Bueno-Gracia and colleagues for their study on the diagnostic accuracy of the Upper Limb Neurodynamic Test 1 (ULNT1), which stressed the target of identifying clear and shared criteria for positive and/or negative results (Vanti et al., 2012). This study reinforces that ULNT1 “must be interpreted in combination with other clinical findings and diagnostic studies” (Vanti et al., 2011). Nevertheless, some methodological aspects deserve comment, as they are able to affect estimates of sensibility and specificity of a diagnostic procedure. The usefulness of an index test is determined by comparison to a reference standard test that has previously been shown through experience to establish a definitive diagnosis of the disease under study. Scientific evidence states that electrodiagnostic studies should be used to confirm a clinical diagnosis of CTS. Bueno-Gracia and colleagues recruited patients in the presence of “hand, wrist or forearm symptoms referred to “X” for median nerve NCS”; this criterion seems too comprehensive to be considered a clinical diagnosis of CTS. In fact, stricter consensus criteria have been proposed in literature (Rempel et al., 1998). Furthermore, criteria for abnormal nerve conduction findings are usually defined in statistically computed terms (e.g., range and mean ± 2 SD) from a reference population formed of individuals believed to be free of the disease and comparable to subjects on whom the protocol is being applied (Jablecki et al., 2002). These criteria should be clearly described, to allow the replication of the research protocol. Particular attention should also be paid when defining cut-offs for specific conditions that require the use of normative data collected from a subset of patients with specific medical conditions (e.g. diabetes, which accounts for more than 17% in the study group) (Werner, 2013). The definition of positive and negative results for the index test is also detrimental to the investigation of a diagnostic test. An evocation of symptoms during ULNT1 in areas different from the typical complaints of those suffering from CTS (e.g. the neck), is likely unrelated to a compression at the carpal tunnel. Otherwise, an induction of symptoms typical of median nerve compression at the wrist, but dissimilar to the patients' own symptoms, could be interpreted as a simple response to the nerve traction, having poor diagnostic usefulness. According to their criterion A, Bueno-Gracia and colleagues considered ULNT1 positive when patients' clinical symptoms were reproduced and changed during structural differentiation. Which symptoms had to be reproduced? Each kind of symptom on hand, wrist or forearm? In our opinion, this could be too approximate to diagnose CTS and risk yielding false positive results. The adherence to rigorous and unambiguous criteria, both for the reference and the index test, may help researchers in the correct evaluation of diagnostic procedure performance. We thank the Editor for giving the Authors the possibility to comment on this study, and hope to have provided productive feedback.
- Published
- 2016
41. The relationship between clinical instability and endurance tests, pain, and disability in nonspecific low back pain
- Author
-
Raffaella Piccarreta, Silvano Ferrari, Cristina Conti, Federica Faresin, Carla Vanti, and VANTI, CARLA
- Subjects
Adult ,Male ,medicine.medical_specialty ,Supine position ,MUSCULOSKELETAL DISEASES ,Physical examination ,LOW BACK PAIN ,Instability ,03 medical and health sciences ,Disability Evaluation ,0302 clinical medicine ,Physical medicine and rehabilitation ,Lumbar ,Rating scale ,Medicine ,Humans ,JOINT INSTABILITY, MUSCULOSKELETAL DISEASES, PHYSICAL EXAMINATION, LOW BACK PAIN, PHYSICAL ENDURANCE ,PHYSICAL EXAMINATION ,030222 orthopedics ,Core (anatomy) ,Lumbar Vertebrae ,medicine.diagnostic_test ,business.industry ,Middle Aged ,PHYSICAL ENDURANCE ,Low back pain ,JOINT INSTABILITY ,Oswestry Disability Index ,Treatment Outcome ,Muscle Fatigue ,Physical therapy ,Female ,Chiropractics ,medicine.symptom ,Musculoskeletal Disease ,business ,030217 neurology & neurosurgery - Abstract
Objective The aims of this study were (1) to investigate the relationship between clinical tests detecting spinal instability and the perceived pain and disability in nonspecific low back pain and (2) to investigate the relationship between endurance and instability tests. Methods Four instability tests (aberrant movements, active straight leg raising, prone instability test, and passive lumbar extension test) and 2 endurance tests (prone bridge test [PBT] and supine bridge test [SBT]) were performed on 101 participants. Their results were compared with the Numerical Rating Scale and the Oswestry Disability Index evaluating pain and disability, respectively. Results A low to moderate significant relationship between pain, disability, and all tests with the exception of PBT was observed. A low to moderate significant relationship between endurance tests and instability tests was also shown. The results of PBT and SBT were significantly related to the duration of symptoms ( P = .0014 and P = .0203, respectively). Conclusion The results of endurance and instability tests appear to be related to the amount of pain and the disability in nonspecific low back pain. The persistence of pain significantly reduces anterior and posterior core muscle endurance.
- Published
- 2016
42. Effects of Action Observation Therapy in Patients Recovering From Total Hip Arthroplasty. Arthroplasty: A Prospective Clinical Trial
- Author
-
Carla Vanti, Riccardo Buraschi, Stefano Negrini, Jorge Hugo Villafañe, Maria Isgrò, Caterina Pirali, and VANTI, CARLA
- Subjects
medicine.medical_specialty ,business.industry ,Visual analogue scale ,Tinetti test ,medicine.medical_treatment ,Rehabilitation ,Hip Replacement ,Repeated measures design ,Arthroplasty ,Gait ,Clinical trial ,03 medical and health sciences ,Chiropractics ,0302 clinical medicine ,Physical medicine and rehabilitation ,Quality of life ,Physical therapy ,medicine ,030212 general & internal medicine ,business ,Range of motion ,030217 neurology & neurosurgery ,Original Research - Abstract
OBJECTIVE: The purpose of this study was to investigate the effectiveness of action observation therapy (AOT) compared with written information in patients submitted to a physical therapy program after primary total hip arthroplasty (THA). METHODS: We conducted a prospective clinical trial. Twenty-four patients with THA, 62.5% female (aged 69.0 ± 8.5 years), received AOT in addition to conventional physical therapy (experimental group) or written information in addition to conventional physical therapy (exercise and information group) for 10 sessions. Outcomes used were visual analog scale, hip active and passive range of motion, Barthel Index, Short Form 36 (SF-36) Health Survey, Tinetti Scale, and Lequesne Index measurements. All measures were collected at baseline and at the end of the intervention. Repeated measures analysis of variance was used to examine the interventions effects within groups and between groups. RESULTS: No relevant baseline differences were observed between groups. Both treatments produced statistically significant improvements on visual analog scale, active and passive range of motion, Barthel Index, SF-36, Tinetti Scale, and Lequesne Index immediately after the intervention (all, P < .001). SF-36 (physical functioning subscale) revealed a statistically significant intergroups difference (P = .02) after treatment. CONCLUSIONS: Both treatments were effective at improving pain, functional status, quality of life, and gait features in patients with primary THA. In addition to conventional physical therapy, AOT improved perceived physical function more than written information.
- Published
- 2016
43. Clinical presentation and physiotherapy treatment of 4 patients with low back pain and isthmic spondylolisthesis
- Author
-
Caroline O'Reilly, Silvano Ferrari, and Carla Vanti
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Case Report ,Physical examination ,Isthmic spondylolisthesis ,medicine.disease ,Low back pain ,Spondylolisthesis ,Surgery ,Vertebral body ,Lumbar ,Physical therapy ,Medicine ,Chiropractics ,Presentation (obstetrics) ,medicine.symptom ,business ,Pathological - Abstract
Spondylolisthesis is a pathological condition characterized by the slipping of a vertebral body, compared with the underlying one, following structural and/or degenerative changes of the spine. The purpose of this case series is to describe clinical presentations and the conservative physiotherapy management of 4 patients with low back pain and lumbar isthmic spondylolisthesis.Four patients aged 25, 43, 36, and 50 years presented with low back pain of various duration. Radiographs confirmed the presence of lumbar isthmic spondylolisthesis. Outcome measures included numerical rating scale, disability outcome measure (Oswestry Disability Index), spinal instability tests (Prone Instability Test, Passive Lumbar Extension test), and muscle function tests (Aberrant Movement Patterns, Active Straight Leg Raising, Prone and Supine Bridge Tests).Treatment consisted of postural reeducation, stretching, and strengthening exercises. Over the course of individualized treatment, ranging from 8 to 10 treatment visits, outcomes improved for all 4 patients.This report describes varying clinical presentations and treatment of 4 patients with isthmic spondylolisthesis, suggesting that different pain generators could be managed by different conservative approaches.
- Published
- 2012
44. Development of the Italian version of the Pain Catastrophising Scale (PCS-I): cross-cultural adaptation, factor analysis, reliability, validity and sensitivity to change
- Author
-
Calogero Foti, Silvano Ferrari, Paolo Pillastrini, Carla Vanti, Raffaele Mugnai, Paola Baiardi, Marco Monticone, Barbara Rocca, Monticone M, Baiardi P, Ferrari S, Foti C, Mugnai R, Pillastrini P, Rocca B, and Vanti C
- Subjects
Adult ,Cross-Cultural Comparison ,Male ,medicine.medical_specialty ,Psychometrics ,Adolescent ,Assessment ,Catastrophising ,Low back pain ,Validation ,Aged ,Catastrophization ,Chronic Disease ,Disability Evaluation ,Factor Analysis, Statistical ,Female ,Humans ,Italy ,Low Back Pain ,Middle Aged ,Pain Measurement ,Reproducibility of Results ,Surveys and Questionnaires ,Young Adult ,Public Health, Environmental and Occupational Health ,Medicine (all) ,Cross-cultural ,Medicine ,Sensitivity to change ,Adaptation (computer science) ,business.industry ,Environmental and Occupational Health ,Statistical ,Cross-cultural studies ,humanities ,RELIABILITY VALIDITY ,Settore MED/34 - Medicina Fisica e Riabilitativa ,Scale (social sciences) ,Physical therapy ,Public Health ,medicine.symptom ,business ,Factor Analysis ,Clinical psychology - Abstract
The aim of this study was to create an Italian version of the Pain Catastrophising Scale (PCS-I) and evaluate its psychometric properties in a sample with chronic low back pain.The PCS was culturally adapted in accordance with international standards. The psychometric testing included factor analysis, reliability by internal consistency (Cronbach's alpha) and test-retest repeatability (intraclass coefficient correlations), and concurrent validity by comparing the PCS-I with a numerical rating scale (NRS), the Tampa Scale of Kinesiophobia (TSK), the Roland Morris Disability Questionnaire (RMDQ), the Hospital Anxiety and Depression Scale (HADS) and the Positive Affect and Negative Affect Scale (PANAS) (Pearson's correlation).It took 4 months to develop an agreed version of the PCS-I, which was satisfactorily administered to 180 subjects with chronic low back pain. Factor analysis revealed a three-factor 13-item solution (68% of explained variance). The questionnaire was internally consistent with one exception (α = 0.92 as a whole; 0.89 for Helplessness, 0.87 for Rumination and 0.56 for Magnification subscales) and showed a high degree of test-retest reliability (ICC = 0.842). Concurrent validity showed moderate correlations with the NRS (r = 0.44), TSK (r = 0.59), RMDQ (r = 0.45), HADS (Anxiety: r = 0.57; Depression r = 0.46) and PANAS (Negative Affect r = 0.54). The minimum detectable change was 10.45. The subscales were also psychometrically analysed.The successfully translated Italian version of the PCS has good psychometric properties replicating those of other versions.
- Published
- 2011
45. Responsiveness of the Oswestry Disability Index and the Roland Morris Disability Questionnaire in Italian subjects with sub-acute and chronic low back pain
- Author
-
Silvano Ferrari, Calogero Foti, Raffaele Mugnai, Paolo Pillastrini, Paola Baiardi, Marco Monticone, Carla Vanti, MONTICONE M, BAIARDI P, VANTI C, FERRARI S, PILLASTRINI P, MUGNAI R, and FOTI C.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Roland Morris Disability Questionnaire ,OSWESTRY DISABILITY INDEX ,LOW BACK PAIN ,Sub acute ,Outcome measures ,RESPONSIVENESS ,Disability Evaluation ,Physical medicine and rehabilitation ,Surveys and Questionnaires ,health services administration ,medicine ,Humans ,Low back pain ,Orthopedics and Sports Medicine ,Oswestry Disability Index ,Pain Measurement ,business.industry ,Chronic pain ,ROLAND MORRIS DISABILITY QUESTIONNAIRE ,Responsiveness ,OUTCOME MEASURES ,Middle Aged ,Acute Disease ,Chronic Disease ,Chronic Pain ,Female ,Italy ,Low Back Pain ,Outcome and Process Assessment (Health Care) ,Treatment Outcome ,Surgery ,medicine.disease ,nervous system diseases ,Chronic low back pain ,Settore MED/34 - Medicina Fisica e Riabilitativa ,Clinical trial ,Outcome and Process Assessment, Health Care ,Physical therapy ,Original Article ,medicine.symptom ,business - Abstract
INTRODUCTION: An ability to assess longitudinal changes in health status is crucial for the outcome measures used in treatment efficacy trials. The aim of this study was to verify the responsiveness of the Italian versions of the Oswestry Disability Index (ODI) and the Roland Morris Disability Questionnaire (RMDQ) in subjects with subacute or chronic low back pain (LBP). MATERIAL AND METHODS: At the beginning and end of an 8 week rehabilitation programme, 179 patients completed a booklet containing the ODI, the RMDQ, a 0-10 numerical rating scale (NRS), and the 36-item Short-Form Health Survey (SF-36). A global perception of change scale was also completed at the end of the programme, and collapsed to produce a dichotomous outcome (i.e. improved vs. not improved). Responsiveness was assessed by means of distribution methods [minimum detectable change (MDC); effect size (ES); standardised response mean (SRM)] and anchor-based methods (ROC curves). RESULTS: The MDC for the ODI and RMDQ was, respectively, 13.67 and 4.87; the ES was 0.53 and 0.68; and the SRM was 0.80 and 0.81. ROC analysis revealed an area under the curve of 0.71 for the ODI and 0.64 for the RMDQ, thus indicating discriminating capacity; the best cut-off point for the dichotomous outcome was 9.5 for the ODI (sensitivity 76% and specificity 63%) and 2.5 for the RMDQ (sensitivity 62% and specificity 55%). These estimates were comparable between the subacute and chronic subjects. Both the ODI and the RMDQ moderately correlated with the SF-36 and NRS (Spearman's and Pearson's correlation coefficients of >0.30). CONCLUSION: The Italian ODI and RMDQ proved to be sensitive in detecting clinical changes after conservative treatment for subacute and chronic LBP. Our findings are consistent with those published in the literature, thus allowing cross-cultural comparisons and stimulating cross-national studies.
- Published
- 2011
46. Development of the Italian Version of the Oswestry Disability Index (ODI-I)
- Author
-
Gustavo Zanoli, Silvano Ferrari, Carla Vanti, Raffaele Mugnai, Marco Monticone, Paola Baiardi, Paolo Pillastrini, Calogero Foti, M. Monticone, P. Baiardi, S. Ferrari, C. Foti, R. Mugnai, P. Pillastrini, C. Vanti, and G. Zanoli
- Subjects
Adult ,Male ,Cross-Cultural Comparison ,medicine.medical_specialty ,Adolescent ,Psychometrics ,Visual analogue scale ,OSWESTRY DISABILITY INDEX ,Concurrent validity ,PSYCHO¬METRIC PROPERTIES ,LOW BACK PAIN ,Italian validation ,Low Back Pain ,Oswestry Disability Index ,Outcome measures ,Psycho-metric properties ,Aged ,Aged, 80 and over ,Factor Analysis, Statistical ,Female ,Humans ,Italy ,Language ,Middle Aged ,Predictive Value of Tests ,Reproducibility of Results ,Severity of Illness Index ,Young Adult ,Disability Evaluation ,Surveys and Questionnaires ,Neurology (clinical) ,Orthopedics and Sports Medicine ,ITALIAN VALIDATION ,Cronbach's alpha ,80 and over ,Medicine ,Reliability (statistics) ,business.industry ,Construct validity ,OUTCOME MEASURES ,Statistical ,Settore MED/34 - Medicina Fisica e Riabilitativa ,Roland Morris Disability Questionnaire ,Physical therapy ,business ,Factor Analysis - Abstract
STUDY DESIGN Evaluation of the psychometric properties of a translated, culturally adapted questionnaire. OBJECTIVE Translating, culturally adapting, and validating the Italian version of the Oswestry Disability Index (ODI-I), allowing its use in Italian-speaking patients with low back pain inside and outside Italy. SUMMARY OF BACKGROUND DATA Growing attention is devoted to standardized outcome measures to improve interventions for low back pain. A translated form of the ODI in patients with low back pain has never been validated within the Italian population. METHODS The ODI-I questionnaire was developed involving forward-backward translation, final review by an expert committee and test of the prefinal version to establish as better as possible proper correspondence with the original English latest version (2.1a). Psychometric testing included factor analysis, reliability by internal consistency (Cronbach alpha) and test-retest repeatability (Intraclass Coefficient Correlation), concurrent validity by comparing the ODI-I to Visual Analogue Scale, (Pearson correlation), and construct validity by comparing the ODI-I to Roland Morris Disability Questionnaire, RMDQ, and to Short Form Health Survey, Short Form Health Survey-36 (Pearson correlation). RESULTS The authors required a 3-month period before achieving a shared version of the ODI-I. The questionnaire was administered to 126 subjects, showing satisfying acceptability. Factor analysis demonstrated a 1-factor structure (45% of explained variance). The questionnaire showed high internal consistency (alpha = 0.855) and good test-retest reliability (ICC = 0.961). Concurrent validity was confirmed by a high correlation with Visual Analogue Scale (r = 0.73, P < 0.001), Construct validity revealed high correlations with RMDQ (r = 0.819, P < 0.001), and with Short Form Health Survey-36 domains, highly significant with the exception of Mental Health (r = -0.139, P = 0.126). CONCLUSION The ODI outcome measure was successfully translated into Italian, showing good factorial structure and psychometric properties, replicating the results of existing language versions of the questionnaire. Its use is recommended in research practice.
- Published
- 2009
47. Manual therapy for non-specific thoracic pain in adults: Review of the literature
- Author
-
Paolo Pillastrini, Daniele Tosarelli, Silvano Ferrari, Carla Vanti, Filomena Morsillo, VANTI C, FERRARI S, MORSILLO F, TOSARELLI D, and PILLASTRINI P
- Subjects
medicine.medical_specialty ,SPINAL MANIPULATION ,medicine.diagnostic_test ,Intraclass correlation ,business.industry ,Rehabilitation ,Validity ,Physical Therapy, Sports Therapy and Rehabilitation ,Physical examination ,CINAHL ,MANUAL THERAPY ,Cochrane Library ,Chest pain ,BACK PAIN ,Inter-rater reliability ,Physical medicine and rehabilitation ,Physical therapy ,Medicine ,Orthopedics and Sports Medicine ,Manual therapy ,medicine.symptom ,business ,PHYSICAL EXAMINATION - Abstract
Objective: The aims of this work are to evaluate the validity and reliability of manual assessment and treatment, and the effectiveness of manual therapy for non-specific adult thoracic pain. Data sources: Review of the literature. Databases consulted: PubMed, Embase, CINAHL, PEDro, and the Cochrane Library. Study selection: Articles were selected if they concerned the thoracic spine and rib cage, and outcome measures were within the scope of manual therapy practice. Data extraction: Studies about diagnostic tests were excluded if the study population was less than 10 subjects, and Cohen’s Kappa scores or Pearson’s Correlation Coefficients or Intraclass Correlation Coefficients were not calculated. Studies about treatment were excluded if the PEDro score was less than 4/10. Data synthesis: Studies concerning physical examination procedures have shown a good intrarater, but poor interrater reliability. Studies of the mechanical effects of manipulation have given discordant results, while those on the clinical effects of manipulation have given positive results. Conclusions: Procedures of physical examination did not show sufficient interexaminer reliability. Manipulative treatment seems to be clinically effective, but whether manual treatment is more effective than non-treatment, other treatments or placebo, cannot be established.
- Published
- 2008
48. The accuracy of pain drawing in identifying psychological distress in low back pain-systematic review and meta-analysis of diagnostic studies
- Author
-
Antonio Romeo, Anna Rosso, Andrew A. Guccione, Paolo Pillastrini, Jorge Hugo Villafañe, Carla Vanti, Lucia Bertozzi, Bertozzi, Lucia, Rosso, Anna, Romeo, Antonio, Villafañe, Jorge Hugo, Guccione, Andrew A., Pillastrini, Paolo, and Vanti, Carla
- Subjects
medicine.medical_specialty ,Pain drawing ,business.industry ,Area under the curve ,Psychological distress ,Physical Therapy, Sports Therapy and Rehabilitation ,PsycINFO ,Review ,Bioinformatics ,Likelihood ratios in diagnostic testing ,Low back pain ,Meta-analysis ,Physical therapy ,medicine ,Diagnostic odds ratio ,Stress psychological ,medicine.symptom ,business - Abstract
[Purpose] The aim of this systematic review and meta-analysis was to estimate the accuracy of qualitative pain drawings (PDs) in identifying psychological distress in subacute and chronic low back pain (LBP) patients. [Subjects and Methods] Data were obtained from searches of PubMed, EBSCO, Scopus, PsycINFO and ISI Web of Science from their inception to July 2014. Quality assessments of bias and applicability were conducted using the Quality of Diagnostic Accuracy Studies-2 (QUADAS-2). [Results] The summary estimates were: sensitivity=0.45 (95% CI 0.34, 0.61), specificity=0.66 (95% CI 0.53, 0.82), positive likelihood ratio=1.23 (95% CI 0.93, 1.62), negative likelihood ratio=0.84 (95% CI 0.70, 1.01), and diagnostic odds ratio=1.46 (95% CI 0.79, 2.68). The area under the curve was 78% (CI, 57 to 99%). [Conclusion] The results of this systematic review do not show broad and unqualified support for the accuracy of PDs in detecting psychological distress in subacute and chronic LBP.
- Published
- 2015
49. Investigation of the effect of conservative interventions in thumb carpometacarpal osteoarthritis: systematic review and meta-analysis
- Author
-
Lucia Bertozzi, Kristin Valdes, Jorge Hugo Villafañe, Paolo Pillastrini, Stefano Negrini, Carla Vanti, Bertozzi L, Valdes K, Vanti C, Negrini S, Pillastrini P, and Villafañe JH
- Subjects
physical therapy modalitie ,medicine.medical_specialty ,Orthotic Devices ,Carpometacarpal joint ,Psychological intervention ,MEDLINE ,Osteoarthritis ,CINAHL ,Thumb ,law.invention ,Randomized controlled trial ,law ,medicine ,Humans ,Randomized Controlled Trials as Topic ,business.industry ,Rehabilitation ,medicine.disease ,Musculoskeletal Manipulations ,Orthotic device ,Exercise Therapy ,body regions ,medicine.anatomical_structure ,Meta-analysis ,hand joint ,Physical therapy ,osteoarthriti ,thumb carpometacarpal ,Metacarpus ,business - Abstract
Purpose: The purpose of this study was to conduct a current review of randomized controlled trials regarding the effect of conservative interventions on pain and function in people with thumb carpometacarpal (CMC) osteoarthritis (OA), perform a meta-analysis of the findings and summarize current knowledge. Method: Data were obtained from MEDLINE, CINAHL, Embase, PEDro and CENTRAL databases from their inception to May 2014. Reference lists of relevant literature reviews were also searched. All published randomized trials without restrictions to time of publication or language were considered for inclusion. Study subjects were symptomatic adults with thumb CMC OA. Two reviewers independently selected studies, conducted quality assessment and extracted results. Data were pooled in a meta-analysis, when possible, using a random-effects model. Quality of the body evidence was assessed using GRADE approach. Results: Sixteen RCTs involving 1145 participants met the inclusion criteria. Twelve were of high quality (PEDro score > 6). We found moderate quality evidence that manual therapy and therapeutic exercise combined with manual therapy improve pain in thumb CMC OA at short- and intermediate-term follow-up, and from low to moderate quality evidences that magneto therapy improves pain and function at short-term follow-up. Orthoses (splints) were found to improve function at long-term follow-up and pinch strength at short-term follow-up. Finally, we found from very low to low-quality evidence that other conservative interventions provide no significant improvement in pain and in function at short- and long-term follow-up. Conclusions: Some of the commonly performed conservative interventions performed in therapy have evidence to support their use to improve hand function and decrease hand pain. Additional research is required to determine the efficacy of other therapeutic interventions that are performed with patients with thumb CMC OA. Implications for Rehabilitation Manual therapy and exercise are an effective means of improving pain and function at short-term follow-up by patients with thumb CMC OA. Magneto therapy, manual therapy, manual therapy and exercise and Orthoses (splints) were found to have clinically significant results. Very few of the included studies showed a clinically significant effect size in favor of treatment.
- Published
- 2015
50. Exercise and tropism of the multifidus muscle in low back pain: A short review
- Author
-
Silvano Ferrari, Andrea Cupello, Jorge Hugo Villafañe, Carla Vanti, Paolo Pillastrini, Silvia Rattin, Pillastrini P, Ferrari S, Rattin, Cupello A, Villafañe, JH, and Vanti C.
- Subjects
medicine.medical_specialty ,Multifidus muscle ,medicine.diagnostic_test ,business.industry ,Ultrasound ,Motor control ,Physical Therapy, Sports Therapy and Rehabilitation ,Magnetic resonance imaging ,Computed tomography ,Review ,Low back pain ,Lumbar ,Diagnosis ,medicine ,Physical therapy ,medicine.symptom ,business ,Exercise ,Tropism ,Diagnosi - Abstract
[Purpose] The purpose of this review was to investigate the types of exercises that can improve the tropism of the multifidus muscles, based on clinical evidence. [Methods] Following to the PICO (Problem, Intervention, Comparison, Outcome) model, we considered studies of subjects with specific or non-specific LBP that used exercises aimed at activating the lumbar multifidus muscle and measured its cross-sectional area or thickness with ultrasound, computed tomography or magnetic resonance imaging. [Results] This review found that most studies compared different types of exercises for lumbar muscles, but without specifically investigating the multifidus muscle. However, a few studies showed that the cross-sectional area and thickness of the multifidus muscle can be increased by activating this muscle, and they progressed from motor control to increased static and dynamic loads. [Conclusion] A review of the literature revealed that specific supervised and home exercises may improve the symmetry of the multifidus muscle.
- Published
- 2015
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.