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Introduction: Unlike the most common training approaches for bodybuilding, powerlifting programs are generally based on maximum and submaximal loads, putting enormous stresses on the lumbar spine. The flexion relaxation phenomenon evaluation is a clinical tool used for low back pain (LBP) assessment. This study aimed to evaluate the role of the flexion relaxation phenomenon in the analysis of LBP in the powerlifters. Methods: Healthy professional powerlifters participated in the study. In fact, we divided the participants into a LBP-low-risk group and a LBP-high-risk group, based on a prior history of LBP. Outcome measures included flexion relaxation ratio (FRR) and trough surface electromyography collected during trunk maximum voluntary flexion; furthermore, during a bench press lifting, we measured the height of the arched back (ARCH), using a camera and the Kinovea video editing software, to consider a potential correlation with the risk of LBP. Results: We included a group of 18 male (aged 24–39 y) powerlifters of 93 kg category. We measured a nonsignificant mean difference of ARCH between low-risk LBP group and high-risk LBP subjects. Curiously, maximum voluntary flexions were both above the threshold of 3.2 μV; therefore, with an absence of appropriate myoelectric silence, on the contrary, the FRR ratios were higher than 9.5, considering the presence of the phenomenon, exclusively for the low-risk group. The lumbar arched back measurement data did not report any association with the LBP risk, regarding the maximum voluntary flexion value, and even more than the FRR there is a relationship with the presence or the absence of LBP risk. Conclusions: FRR could be considered as a useful parameter for studying the risk of LBP in powerlifting. The FRR index not only refers to the possible myoelectric silence of the lumbar muscles in trunk maximum forward flexion but also takes into account the energy value delivered by the lumbar muscles during the flexion. Furthermore, we can indicate that the size of the powerlifter ARCH may not be a determining factor in the occurrence of LBP. [ABSTRACT FROM AUTHOR]

Clodronate (Clod), a first-generation bisphosphonate, acts as a natural analgesic inhibiting vesicular storage of the nociception mediator ATP by vesicular nucleotide transporter (VNUT). Epidermal keratinocytes participate in cutaneous nociception, accumulating ATP within vesicles, which are released following different stimulations. Under stress conditions, keratinocytes produce microvesicles (MVs) by shedding from plasma membrane evagination. MV secretion has been identified as a novel and universal mode of intercellular communication between cells. The aim of this project was to evaluate if two nociceptive stimuli, Capsaicin and Potassium Hydroxide (KOH), could stimulate MV shedding from human keratinocytes, if these MVs could contain ATP, and if Clod could inhibit this phenomenon. In our cellular model, the HaCaT keratinocyte monolayer, both Capsaicin and KOH stimulated MV release after 3 h incubation, and the released MVs contained ATP. Moreover, Clod (5 µM) was able to reduce Caps-induced MV release and abolish the one KOH induced, while the Dansylcadaverine, an endocytosis inhibitor of Clod uptake, partially failed to block the bisphosphonate activity. Based on these new data and given the role of the activation of ATP release by keratinocytes as a vehicle for nociception and pain, the "old" bisphosphonate Clodronate could provide the pharmacological basis to develop new local analgesic drugs. [ABSTRACT FROM AUTHOR]

Malignant pleural mesothelioma (MPM) represents a significant clinical challenge due to limited therapeutic options and poor prognosis. Beyond mere survivorship, setting up an effective framework to improve functioning and quality of life is an urgent need in the comprehensive management of MPM patients. Therefore, this study aims to review the current understanding of MPM sequelae and the effectiveness of rehabilitative interventions in the holistic approach to MPM. A narrative review was conducted to summarize MPM sequelae and their impact on functioning, disability, and quality of life, focusing on rehabilitation interventions in MPM management and highlighting gaps in knowledge and areas for further investigation. Our findings showed that MPM patients experience debilitating symptoms, including fatigue, dyspnea, pain, and reduced exercise tolerance, decreasing quality of life. Supportive and rehabilitative interventions, including pulmonary rehabilitation, physical exercise improvement, psychological support, pain management, and nutritional supplementation, seem promising approaches in relieving symptoms and improving quality of life but require further research. These programs emphasize the pivotal synergy among patient-tailored plans, multidisciplinary team involvement, and disease-specific focus. Despite advancements in therapeutic management, MPM remains a challenging disease with limited effective interventions that should be adapted to disease progressions. Rehabilitative strategies are essential to mitigate symptoms and improve the quality of life in MPM patients. Further research is needed to establish evidence-based guidelines for rehabilitative interventions tailored to the unique needs of MPM patients. [ABSTRACT FROM AUTHOR]

Chronic nonspecific low back pain (NSLBP) is a prevalent condition with socioeconomic and healthcare challenges. The flexion–relaxation phenomenon (FRP) evaluation is a valid clinical tool for low back pain (LBP) assessment. Yoga, a holistic mind–body practice, has been explored as an LBP intervention. This study aimed to evaluate the impact of yoga asanas on the FRP in women with NSLBP. The study included healthy and chronic NSLBP females who underwent an eight‐session yoga asanas program, with the first session conducted in‐clinic and the rest delivered with tele‐approach. Outcome measures included pain intensity, flexion–relaxation ratio (FRR), and trough surface electromyography collected during trunk maximum voluntary flexion (MVF). The study included 11 healthy and 10 NSLBP women. Repeated measures test in chronic NSLBP group showed a significant decrease in pain intensity after the 4 weeks follow‐up (visual analog scale [VAS]: 6.80 ± 1.48 vs. 3.30 ± 1.25; p < 0.001) and an FRR improvement after the intervention (5.12 ± 0.93 vs. 9.49 ± 0.92; p < 0.001). VAS and FRR effect sizes were 0.77 and 0.47, respectively. Therefore, we performed a Prophet evaluation to assess FRR trends, finding a growth rate (k) of 0.405 ± 0.448, with a forecast 1 month after the end of the intervention approaching the trend line of the control group. The findings suggested that tele‐yoga asana might have a positive impact on pain intensity and the FRP in chronic LBP. Further research is warranted to confirm the long‐term effects of yoga for managing LBP. [ABSTRACT FROM AUTHOR]

BACKGROUND: Hemophilic arthropathy is a detrimental condition that crucially affects functional outcomes in hemophilic patients. In recent years, due to the advances in systemic therapies, growing attention has been raised in the rehabilitation field in order to improve functional outcomes of hemophilic patients. However, the optimal rehabilitation modalities in these patients are far from being fully characterized. OBJECTIVE: The present study aimed to assess the effects of different rehabilitation interventions on physical functioning and health-related quality of life of hemophilic arthropathic patients. METHODS: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Five databases were systematically searched for randomized controlled trials (RCTs) published until June 22nd, 2023. The selection criteria included adult patients with hemophilia A and B receiving rehabilitation interventions. The outcomes were muscle strength, physical function, pain intensity, physical performance, and health-related quality of life. RESULTS: Out of 1,743 identified records, 17 studies were included in the qualitative synthesis. Rehabilitation interventions were categorized into exercise intervention, fascial therapy, and multimodal intervention. The findings suggested positive outcomes in terms of muscle modifications, range of motion improvements, joint health enhancements, pain intensity reduction, and quality of life improvements. More in detail, meta-analyses showed significant improvements in pain intensity [ES: - 1.10 cm (- 1.37, - 0.82), p < 0.00001], joint health [ES: - 1.10 (- 1.38, - 0.82), p < 0.00001], In accordance, exercise interventions showed significant benefits in terms of joint health [ES: - 2.54 (- 3.25, - 1.83), p < 0.00001)] and quality of life [ES: 1.17 (0.48, 1.86), p < 0.0000)]. CONCLUSION: Rehabilitation interventions have a positive impact on functional outcomes and health-related quality of life of hemophilic arthropathic patients. Further studies are needed to better elucidate the role of a comprehensive intervention combining different rehabilitation approaches to treat hemophilic arthropathy. [ABSTRACT FROM AUTHOR]

BACKGROUND: Vertebral fragility fractures (VFFs) commonly result from low bone mass and microarchitecture deterioration of bone tissue. spinal orthoses are common non-pharmacological options for managing vertebral fracture pain. However, the effects of spinal orthoses on pain, physical functioning, and quality of life (QoL) are still debated. OBJECTIVE: This survey aimed to investigate the patients-reported outcomes of a dynamic spinal orthosis prescribed in the routine clinical practice of VFFs management. METHODS: This multi-center national-wide prospective cohort study assessed older patients (aged > 60 years) diagnosed with acute VFFs and prescribed with a dynamic spinal orthosis (Spinfast®). A survey questionnaire was realized and included sections on patient characterization, osteoporosis characterization, spinal orthosis, clinical outcomes, pain medications, and osteoporosis medications. The questionnaire was administered at baseline and after three months. A total of 68 patients completed the questionnaire at three months. Most patients had one or two VFFs and were treated with pain medications and osteoporosis medications. Compliance and tolerability of the spinal orthosis were assessed, and clinical outcomes such as pain intensity, physical functioning, and QoL were measured. RESULTS: The results showed no significant differences in outcomes between age subgroups. Italian physical medicine and rehabilitation physicians were commonly involved in the management of VFFs patients. Sixty-six patients completed the questionnaire. The results showed that pain intensity, physical functioning and QoL improved after three months of spinal orthosis wearing (p < 0.0001). CONCLUSION: The correct management of VFFs is mandatory to improve pain and reduce disability, and our findings suggested a positive role of dynamic spinal orthosis to improve the comprehensive management of VFFs patients. However, high-quality research trials are warranted to provide clear recommendations for the correct clinical management of VFF. [ABSTRACT FROM AUTHOR]

Background and Objectives: Although the growing literature is now focusing on the long-term effects of Deep Brain Stimulation (DBS) in Parkinson's disease (PD), there is still a large gap of knowledge about its long-term implications in rehabilitation. Therefore, this study aimed at investigating the effects of rehabilitation in PD patients years after DBS implantation. Materials and Methods: This retrospective case–control study analyzed records from Moriggia-Pelascini Hospital, Italy from September 2022 to January 2024. Data of PD patients (n = 47) with (DBS group, n = 22) and without (control group, n = 25) DBS were considered. All study participants underwent a daily rehabilitation program lasting four weeks, including warm-up, aerobic exercises, strength training, postural exercises, and proprioceptive activities. The outcomes assessed were the Unified Parkinson's Disease Rating Scale (UPDRS), Berg Balance Scale (BBS), Timed Up and Go (TUG), 6 Min Walk Test (6MWT), and Self-Assessment Parkinson Disease Scale (SPDDS). Results: DBS group showed significant improvements in terms of all outcome measures after the rehabilitation intervention (UPDRS III: −7.0 (−11.5 to −1.0); p = 0.001; UPDRS I II IV: −12.0 (−19.0 to −4.5); p = 0.001; BBS: 7.0 (3.8 to 10.3); p < 0.001; TUG (s): −2.8 (−5.7 to −1.1); p < 0.001; SPDDS: −8 (−13.0 to −4.0); p < 0.001; 6MWT (m): 81 (37.3 to 132.3); p < 0.001). No differences were reported in the between-group analysis (p: NS). Conclusions: This study emphasizes positive rehabilitation effects on PD patients irrespective of DBS status. Further research is essential to elucidate long-term effects of DBS on rehabilitation outcomes of PD patients. [ABSTRACT FROM AUTHOR]

Although rehabilitation medicine emphasizes a holistic health approach, there is still a large gap of knowledge about potential interventions aimed at improving overall wellbeing through cosmetic interventions. Therefore, this narrative review investigates the role of different rehabilitative techniques in enhancing aesthetics, quality of life, and psychosocial wellbeing for patients with disabilities. The study follows the SANRA framework quality criteria for a narrative review. Literature searches across PubMed/Medline, Web of Science, and Scopus identified articles focusing on rehabilitation strategies within the aesthetic rehabilitation domain. The review identified evidence supporting injection procedures, such as Botulinum Toxin, Platelet-Rich Plasma, Hyaluronic Acid, Ozone, and Carboxytherapy, and assessing their applications in several disabling disorders. Additionally, physical therapies like Extracorporeal Shock Wave Therapy, Laser Therapy, Microcurrent Therapy, Tecar Therapy, and physical exercises were explored for their impact on cutaneous microcirculation, cellulite treatment, wound healing, and scar appearance improvement. Lastly, the manuscript underlines the role of manual therapy techniques in addressing both physical discomfort and aesthetic concerns, discussing their effectiveness in adipose tissue therapy, scar tissue mobilization, and regional fat thickness reduction. Taken together, this review emphasizes the role of a multidisciplinary approach, aiming to provide valuable insights into potential benefits for both functional and aesthetic outcomes. [ABSTRACT FROM AUTHOR]

This article, published in Frontiers in Endocrinology, discusses the role of bone-muscle crosstalk in secondary osteoporosis. Secondary osteoporosis is a condition that is often linked to chronic inflammation, hormonal dysregulation, medications, and lifestyle factors. The article emphasizes the importance of understanding the relationship between bone and muscle health in order to develop effective therapeutic strategies for patients with secondary osteoporosis. It also highlights the need for integrated care approaches and the potential use of biomarkers to assess muscle and bone health. The article concludes by discussing the complex interconnections between inflammatory conditions, osteoporosis, and sarcopenia, and the importance of a holistic approach to managing these conditions. [Extracted from the article]

BACKGROUND: Hip osteoarthritis (OA) is a chronic progressive disease that impresses a noticeable burden to society and healthcare systems. Physical exercise constitutes the first-line hip OA treatment approach, nevertheless, there is currently no gold standard method to treat this disease. OBJECTIVE: To evaluate the efficacy of proprioceptive neuromuscular facilitation (PNF) on functioning in patients with hip OA. METHOD: A pilot randomized controlled trial (RCT) was carried out on patients with painful bilateral hip OA with a body mass index (BMI) < 30 kg/m2. After the randomization, the experimental group was treated with PNF protocol and the control group with conventional physical therapy (10 sessions of manual therapy, 5 sessions/week for 2 weeks). The Harris Hip Score (HHS) was the primary outcome, whereas we assessed as secondary outcomes: pain, range of motion, and muscle strength of hip, physical performance, and quality of life. RESULTS: Twenty patients (40 hips) were enrolled and randomized into two groups: PNF group (mean age: 70.7 ± 8.07; BMI: 25.1 ± 3.07; 7 females and 3 males) and control group (mean age: 74.9 ± 10.72; BMI: 26.8 ± 3.78; 6 females and 4 males). The results showed a statistically significant improvement of HHS in the study group (T1: 90.6 ± 5.63) than in the control group (T1: 77.3 ± 10.9) (between-group p value < 0.001). Three months after the treatment we have statistically significant maintenance in the PNF group (T2:89.6 ± 6.32, within-group Δ T0-T2 p < 0.01) while the control group did not maintain the improvements recorded at T1 (T2: 71.4 ± 15.8). CONCLUSION: The results of this pilot RCT showed that incorporating PNF exercises into the rehabilitation program yielded notable enhancements in improving lower limb function, strength and ROM in hip OA patients. Nonetheless, further prospective studies including wider sample size are needed to implement scientific knowledge on this physical therapy approach, in patients with hip osteoarthritis. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the impact of add-on pelvic floor exercises on a weight management rehabilitation program. Patients and methods: This proof of principle study was conducted between July 2019 and December 2019. Ninety-three adult female inpatients with obesity and diagnosis of urinary incontinence (UI) were assessed for inclusion, and the suitable patients were randomly assigned to the experimental group and the control group. Both groups underwent a weight management rehabilitation program, while the experimental group also performed pelvic floor exercises. The primary outcome was UI severity, assessed by the 1-h pad test. Secondary outcomes were urinary symptoms, assessed by the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Patient Global Impression of Improvement (PGI-I), and Incontinence Quality of Life Questionnaire (I-QOL). Results: Sixty female inpatients were randomly assigned to the experimental group [n=30; median age: 64.50 (51.25 to 70.50) years] or the control group [n=30; median age: 67.50 (58.50 to 74.75) years]. The experimental group showed a statistically significant reduction in UI severity [pad test: 2.08 (1.21 to 8.85) g vs. 0.54 (0.24 to 1.13) g, p<0.01; ICIQ-SF: 14.00 (10.25 to 17.00) vs. 8.00 (6.25 to 11.75), p<0.01; I-QOL: 56.37 (42.28 to 73.64) vs. 78.64 (64.32 to 90.68), p<0.01]. Statistically significant differences were found in the between-groups analysis [pad test: 0.54 (0.24 to 1.13) g vs. 1.08 (0.83 to 3.86) g, p<0.01; ICIQ-SF: 8.00 (6.25 to 11.75) vs. 12.00 (10.00 to 16.00), p<0.01; I-QOL: 78.64 (64.32 to 90.68) vs. 68.18 (60.00 to 84.32), p<0.01]. Conclusion: Including pelvic floor exercises might provide additional benefits compared to standard rehabilitation in reducing UI symptoms in obese women. [ABSTRACT FROM AUTHOR]