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The article comments on the paper "Focal Vibration in Dysphagia: A Technological Treatment for Severe Acquired Brain Injury Rehabilitation," by C. Galluccio and colleagues. Topics mentioned include the use of focal muscle vibration in a pathology, the measurement of persistent inward currents to determine the strength of monoaminergic drive to the spinal cord, and the reasons why tonic vibration reflex should be avoided.

Introduction. Foot ulcers are major complications of diabetes mellitus and are estimated to affect 0.5-3% of the global population of people with diabetes. Treatment, prevention and management of foot ulcers is of paramount importance and utilisation of different preventative strategies has been described in literature. The aim of this research study is to evaluate the possible integrative role of NeuroMuscolar Taping (NMT) in the treatment of diabetic foot ulcers. Methods. This is an observational study involving patients with 3 to 5 degree of diabetic wound classification. The Bates-Jensen Wound Assessment Tool (BJWAT) was used before and after four weeks of NeuroMuscolar Taping applications. Results. The BJWAT score significantly decreased after treatment with NMT application (p<0,05) evaluated with Friedman test. Conclusion. NMT application seems to be a useful, non invasive and low cost treatment to associate with other treatments in the management of diabetic foot ulcers. [ABSTRACT FROM AUTHOR]

De Barsy syndrome is an autosomal recessive condition characterized by an progeroid appearance with distinctive facial features and cutis laxa. Ophthalmological, orthopedic, and neurological anomalies are generally also present. This syndrome is rare and the complex therapeutic management, from a surgical but also rehabilitative point of view, has not been recognized. The aim of this paper is to describe a possible rehabilitative protocol, after an orthopedic surgical treatment, in a child with De Barsy Syndrome. A 6-year-old boy was born with a congenital bilateral hip dysplasia associated with bilateral congenital foot deformity (vertical talus). Moreover, he showed stereotypic dyskinetic movements and psychomotor delay with cognitive impairment and absent language; the sitting position was maintained with orthoses to support the trunk control and the standing position was not acquired. He was treated with pinstripe knee-highs for the foot and double nappy for the hips. At 19 months old, he underwent a two stage surgical approach for a bilateral pronated valgus foot with severe talonavicular subluxation. Satisfactory hip range of motion was achieved by conservative treatment alone. Afterwards, for the foot laxity and the flat-pronated foot corrective shoes were prescribed. The main rehabilitative goals were: attention improvement, visual exploration for foot-eye and hand-eye coordination, encourage the essential prerequisites of language, controlling the upright position using support, improving hip-knee-foot relationship, improving load transfer between the right and left sides of the body, and bimanual coordination. The rehabilitation process lasted six months, three times a week, for a time from 30 minutes to 60 minutes per session. The results were encouraging and the patient acquired the possibility of sitting with the indicated postural system, the possibility of assuming an upright position and taking a few steps with the aid of rollator with a postural stabilization system for the pelvis. [ABSTRACT FROM AUTHOR]

Apraxia affects 20% of the right brain-damaged patients and 50% of the left brain-damaged patients. This disorder of motor programming reduces patients’ independence and there are few guidelines on the rehabilitative treatment in the physiotherapy and speech therapy field. The aim of this study was to assess which therapeutic interventions are the most effective in stroke patients with apraxia in considering the mentioned purviews. Four databases were systematically searched in order to detect all available studies investigating the physical and speech rehabilitation of patients. The literature research produced five studies including 168 patients for the physiotherapy and 50 for speech therapy fields; two were eligible for meta-analysis. Quality was rated with Jadad, PEDro scale and Cochrane Risk Of Bias Tool. Both for physiotherapy and speech therapy fields, the RCTs interventions obtained statistically significant results for outcomes of interest. Despite this, it is still not possible to determine the best approach due to the low number of patients involved, the lack of maintenance of the results at follow up and the timing of the revaluation period being very short to confirm the efficacy of treatments. [ABSTRACT FROM AUTHOR]

Purpose.This study aimed to create a new quantitative and qualitative Mealtime Assessment Tool (MAT) to be administered by the not institutional caregiver to explore the dysphagic patient's mealtime behavior. Methods. The development and validation process consisted of three steps: firstly, identification of items for the questionnaire, then pilot testing phase of the first version of the instrument and finally a psychometric evaluation in which the test was administered to the target population (adult inpatients with diagnosed and undiagnosed oropharyngeal dysphagia). Results. A factorial analysis explained 51% of the variance and grouped the 12 items of the scale into three categories that defined: a) structural setting and compliance at mealtime, b) behavioral attitude at mealtime, c) structural setting as a function of possible distractibility. The concurrent validity using the Dysphagia Outcome Severity Scale and Three Oz Water Swallow Test, as the gold standard, was r =0.01. Cronbach's alpha was 0.709. Stability test-retest reliability had ICC values of 0.980 p=0.01. The ROC curve using as state variable the De Pippo test as a dichotomius variable showed the under-curve area as 0.830 (95% CI, 0.763 to 0.897). Conclusions. The validation process led to the conclusion that the MAT is a valid, reliable and stable scale for caregivers. [ABSTRACT FROM AUTHOR]

Hand functioning is often impaired in patients with Systemic sclerosis. Neuromuscular Taping is a novel application of tape able to improve functioning. The aim of this study was to evaluate the possible role of this application in the hand functionality of patients with Systemic sclerosis. Women with a diagnosis of SSc has been recruited and evaluated using different scales before and immediately after NMT application and after one, three and six months. Fifty-three women has been evaluated and Cochin Hand Functional Disability scale, Hand Mobility in Sclerodermia, Modified Rodnan Skin Score and Dreiser Algo - Functional Index scores showed statistical significant differences during all the period; moreover a reduction of pain and Raynaud Phenomenon's and an improvement of finger flexion has been observed. Application of NMT in patients with Systemic sclerosis have showed beneficial effect and future studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Background: Chronic pain has been investigated in pathophysiology and different mechanisms underlying this condition has been described. Despite the plentiful literature regarding this topic and the different pharmacological treatments proposed, patients often referred inadequate relief from medication. The aim of this narrative review was to investigate the different rehabilitative approach in the management of chronic pain and their efficacy., Methods: A systematic narrative review has been conducted considering randomize controlled trials and systematic reviews published within the past 5 years., Results: 13 papers on chronic pain and 6 papers on nociplastic pain has been described in the main aspects analyzed., Conclusions: No one treatment appears to be more effective than another but often it is the combination of several treatments that gives the best results. More studies, evaluating in particular specific exercises with clear proprioceptive elements, should be conducted to best analyzed their role in the management of chronic pain.