106 results on '"Stefano Palermi"'
Search Results
2. The Role of Cardiovascular Imaging in the Diagnosis of Athlete’s Heart: Navigating the Shades of Grey
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Nima Baba Ali, Sogol Attaripour Esfahani, Isabel G. Scalia, Juan M. Farina, Milagros Pereyra, Timothy Barry, Steven J. Lester, Said Alsidawi, David E. Steidley, Chadi Ayoub, Stefano Palermi, and Reza Arsanjani
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athlete’s heart ,cardiac computed tomography ,cardiac magnetic resonance ,cardiomyopathies ,echocardiography ,strain ,Photography ,TR1-1050 ,Computer applications to medicine. Medical informatics ,R858-859.7 ,Electronic computers. Computer science ,QA75.5-76.95 - Abstract
Athlete’s heart (AH) represents the heart’s remarkable ability to adapt structurally and functionally to prolonged and intensive athletic training. Characterized by increased left ventricular (LV) wall thickness, enlarged cardiac chambers, and augmented cardiac mass, AH typically maintains or enhances systolic and diastolic functions. Despite the positive health implications, these adaptations can obscure the difference between benign physiological changes and early manifestations of cardiac pathologies such as dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), and arrhythmogenic cardiomyopathy (ACM). This article reviews the imaging characteristics of AH across various modalities, emphasizing echocardiography, cardiac magnetic resonance (CMR), and cardiac computed tomography as primary tools for evaluating cardiac function and distinguishing physiological adaptations from pathological conditions. The findings highlight the need for precise diagnostic criteria and advanced imaging techniques to ensure accurate differentiation, preventing misdiagnosis and its associated risks, such as sudden cardiac death (SCD). Understanding these adaptations and employing the appropriate imaging methods are crucial for athletes’ effective management and health optimization.
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- 2024
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3. Dry Needling in Overhead Athletes with Myofascial Shoulder Pain: A Systematic Review
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Andrea Demeco, Alessandro de Sire, Antonello Salerno, Nicola Marotta, Stefano Palermi, Antonio Frizziero, and Cosimo Costantino
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dry needling ,volleyball ,baseball ,tennis ,sports ,rehabilitation ,Sports ,GV557-1198.995 - Abstract
The treatment of myofascial pain in athletes requires a set of rehabilitation techniques that aim to be effective quickly. In this context, dry needling (DNY) has shown interesting results due to its ability to reduce pain in the short term. Thus, the aim of this study was to investigate the role of DNY in managing myofascial shoulder pain in overhead athletes. PubMed, Scopus and Web of Science were screened up to March 2024, to identify studies that met the following inclusion criteria: overhead athletes with shoulder pain with a DNY approach for myofascial trigger points (MTrPs), RCT, case–control study, feasibility study as the study design. Exclusion criteria were studies that did not include athletes, studies that did not focus on the treatment of MTrPs with DNY, other reviews, no full-text availability and papers written in a language other than English. Out of 399 articles, 165 were excluded as duplicates. Of the 234 articles screened, only 6 articles met the inclusion criteria. A total of 6 studies were included in the systematic review. Initial results showed that DNY improved pain rapidly and in the short term; however, there is still no consensus on the minimum number and the interval between treatments. Major findings reported a rapid potential decrease in perceived pain, shoulder disability and an increase in muscle strength; in this scenario, DNY might be a valid solution in a sports rehabilitation setting.
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- 2024
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4. Forward head posture and neck disability: what is the effect on lung function?
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Giada Annarumma, Alessandro Spinelli, Alessandro Serio, Tammaro Di Fraia, Carlo Maria Gallinoro, Lucrezia Caoduro, Domiziano Tarantino, Andrea Demeco, Erica Keeling, Stefano Palermi, Alessandro Biffi, and Felice Sirico
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forward head posture ,neck posture ,spirometry ,peak expiratory flow ,neck disability index ,chronic neck pain ,Other systems of medicine ,RZ201-999 - Abstract
Aim: Forward head posture (FHP) is a very common pathological neck posture among people who frequently use multimedia devices, and it could be related to some musculoskeletal disorders. However, its role in influencing lung function and its relationship with neck disability are still debated in the literature. Therefore, the aim of the present study was to investigate the influence of FHP on respiratory function, and to explore a possible relationship between FHP and neck discomfort. Methods: A cross-sectional study was conducted on a sample of 83 subjects (35.7 ± 8.4 years aged), enrolled at the Ferrari corporate wellness program “Formula Benessere”. Craniovertebral angle (CVA) was measured with a digital goniometer to assess head posture: FHP was defined with a CVA < 50° in an upright position. Spirometry was conducted according to European Respiratory Society/American Thoracic Society (ERS/ATS) criteria. Finally, subjects enrolled were evaluated through a self-administered neck disability index (NDI) questionnaire. Results: Among the 60 participants with agreement about the CVA measurements, 45 had FHP (11 females and 34 males) with lower CVA values. No significant differences were found in spirometric parameters between subjects with FHP (n = 45) and subjects without FHP (n = 15). Furthermore, the two groups did not differ either in NDI scores (P = 0.148). Conclusions: There is no clear relationship between FHP and respiratory function indices. Moreover, no differences have been found in NDI values between subjects with FHP and subjects without FHP. Respiratory rehabilitation strategies should be focused on other parameters than FHP itself.
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- 2023
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5. The Impact of the COVID-19 Pandemic on Childhood Obesity and Lifestyle—A Report from Italy
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Stefano Palermi, Marco Vecchiato, Sonia Pennella, Anna Marasca, Alessandro Spinelli, Mariarosaria De Luca, Lorena De Martino, Fredrick Fernando, Felice Sirico, and Alessandro Biffi
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COVID-19 lockdown ,childhood obesity ,eating habits ,Medicine ,Pediatrics ,RJ1-570 - Abstract
During the COVID-19 lockdown, especially in the first wave of pandemic (March 2020), sedentary lifestyle and calorie intake increase in children became considerably more prevalent. The aim of the present paper was to evaluate changes in children’s weights and nutritional habits during the COVID-19 pandemic in Italy. In this cross-sectional observational study, for 3 years, as part of the corporate wellness program (2019–2021) in Emilia Romagna region of Italy, anthropometric data of Ferrari car company employers’ children were collected, analyzed, and compared. Moreover, at the visit of November 2020, performed after the first wave of the pandemic with the most rigorous lockdown rules in Italy, a questionnaire on nutritional and lifestyle habits was administered. We evaluated 307 children (163 M, 10.1 ± 2.3 mean aged in 2019). A significant increase in BMI percentile in 2020 (65.2) compared to 2019 (49.2) was observed; it was confirmed, albeit slightly decreased, in 2021 (64.5). About one-third of participants reported an increase in consumption of fatty condiments and more than half report an increase in consumption of junk food. Levels of physical activity were still high during the COVID-19 lockdown, while sleeping time was significantly reduced. Our findings alert us to the importance of carefully monitoring eating behaviors in young to avoid the adoption of unhealthy food habits and prevent childhood obesity, especially during the period of COVID-19 lockdown.
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- 2022
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6. Managing Lower Limb Muscle Reinjuries in Athletes: From Risk Factors to Return-to-Play Strategies
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Stefano Palermi, Filippo Vittadini, Marco Vecchiato, Alessandro Corsini, Andrea Demeco, Bruno Massa, Carles Pedret, Alberto Dorigo, Mauro Gallo, Giulio Pasta, Gianni Nanni, Alberto Vascellari, Andrea Marchini, Lasse Lempainen, and Felice Sirico
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muscle injury ,athletes ,rehabilitation ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Muscle injuries and subsequent reinjuries significantly impact athletes, especially in football. These injuries lead to time loss, performance impairment, and long-term health concerns. This review aims to provide a comprehensive overview of the current understanding of muscle reinjuries, delving into their epidemiology, risk factors, clinical management, and prevention strategies. Despite advancements in rehabilitation programs and return-to-play criteria, reinjury rates remain alarmingly high. Age and previous muscle injuries are nonmodifiable risk factors contributing to a high reinjury rate. Clinical management, which involves accurate diagnosis, individualized rehabilitation plans, and the establishment of return-to-training and return-to-play criteria, plays a pivotal role during the sports season. Eccentric exercises, optimal loading, and training load monitoring are key elements in preventing reinjuries. The potential of artificial intelligence (AI) in predicting and preventing reinjuries offers a promising avenue, emphasizing the need for a multidisciplinary approach to managing these injuries. While current strategies offer some mitigation, there is a pressing need for innovative solutions, possibly leveraging AI, to reduce the incidence of muscle reinjuries in football players. Future research should focus on this direction, aiming to enhance athletes’ well-being and performance.
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- 2023
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7. Acceptability and Practicality of a Quick Musculoskeletal Examination into Sports Medicine Pre-Participation Evaluation
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Stefano Palermi, Giada Annarumma, Alessandro Spinelli, Bruno Massa, Alessandro Serio, Marco Vecchiato, Andrea Demeco, Erica Brugin, Felice Sirico, Franco Giada, and Alessandro Biffi
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musculoskeletal evaluation ,pre-participation screening ,children ,sport medicine ,Medicine ,Pediatrics ,RJ1-570 - Abstract
Background: Child musculoskeletal (MSK) diseases are common and, even if often benign, sometimes can lead to significant impairment in the future health of children. Italian pre-participation evaluation (PPE), performed by a sports medicine physician, allows for the screening of a wide range of children every year. Therefore, this study aims to evaluate the feasibility and the acceptability of pGALS (pediatric Gait, Arms, Legs and Spine) screening, a simple pediatric MSK screening examination, when performed as part of a routine PPE. Methods: Consecutive school-aged children attending a sports medicine screening program were assessed with the addition of pGALS to the routine clinical examination. Practicability (time taken) and patient acceptability (discomfort caused) were recorded. Results: 654 children (326 male, mean age 8.9 years) were evaluated through pGALS. The average time taken was 4.26 min (range 1.9–7.3 min). Acceptability of pGALS was deemed high: time taken was “adequate” (97% of parents) and caused little or no discomfort (94% of children). Abnormal MSK findings were common. Conclusions: pGALS is a practical and acceptable tool to perform in sports medicine PPE, even if performed by a non-expert in MSK medicine. Although common, abnormal MSK findings need to be interpreted in the global clinical context and assessment.
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- 2022
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8. Robotic-Assisted Rehabilitation for Post-Stroke Shoulder Pain: A Systematic Review
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Rossana Gnasso, Stefano Palermi, Antonio Picone, Domiziano Tarantino, Giampiero Fusco, Maria Michelina Messina, and Felice Sirico
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shoulder pain ,robotics ,hemiplegia ,stroke rehabilitation ,systematic review ,Chemical technology ,TP1-1185 - Abstract
Post-stroke shoulder pain (PSSP) is a debilitating consequence of hemiplegia, often hindering rehabilitation efforts and further limiting motor recovery. With the advent of robotic-assisted therapies in neurorehabilitation, there is potential for innovative interventions for PSSP. This study systematically reviewed the current literature to determine the effectiveness of robotic-assisted rehabilitation in addressing PSSP in stroke patients. A comprehensive search of databases was conducted, targeting articles published up to August 2023. Studies were included if they investigated the impact of robotic-assisted rehabilitation on PSSP. The outcome of interest was pain reduction. The risk of bias was assessed using the Cochrane database. Of the 187 initially identified articles, 3 studies met the inclusion criteria, encompassing 174 patients. The reviewed studies indicated a potential benefit of robotic-assisted rehabilitation in reducing PSSP, with some studies also noting improvements in the range of motion and overall motor function. However, the results varied across studies, with some showing more significant benefits than others, because these use different protocols and robotic equipment.
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- 2023
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9. The Long and Winding Road to Cardiac Regeneration
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Anna Maria Sacco, Clotilde Castaldo, Franca Di Meglio, Daria Nurzynska, Stefano Palermi, Rocco Spera, Rossana Gnasso, Giorgio Zinno, Veronica Romano, and Immacolata Belviso
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cardiac regeneration ,stem cell therapy ,decellularized extracellular matrix ,bioreactor ,biomaterials ,organoids ,Technology ,Engineering (General). Civil engineering (General) ,TA1-2040 ,Biology (General) ,QH301-705.5 ,Physics ,QC1-999 ,Chemistry ,QD1-999 - Abstract
Cardiac regeneration is a critical endeavor in the treatment of heart diseases, aimed at repairing and enhancing the structure and function of damaged myocardium. This review offers a comprehensive overview of current advancements and strategies in cardiac regeneration, with a specific focus on regenerative medicine and tissue engineering-based approaches. Stem cell-based therapies, which involve the utilization of adult stem cells and pluripotent stem cells hold immense potential for replenishing lost cardiomyocytes and facilitating cardiac tissue repair and regeneration. Tissue engineering also plays a prominent role employing synthetic or natural biomaterials, engineering cardiac patches and grafts with suitable properties, and fabricating upscale bioreactors to create functional constructs for cardiac recovery. These constructs can be transplanted into the heart to provide mechanical support and facilitate tissue healing. Additionally, the production of organoids and chips that accurately replicate the structure and function of the whole organ is an area of extensive research. Despite significant progress, several challenges persist in the field of cardiac regeneration. These include enhancing cell survival and engraftment, achieving proper vascularization, and ensuring the long-term functionality of engineered constructs. Overcoming these obstacles and offering effective therapies to restore cardiac function could improve the quality of life for individuals with heart diseases.
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- 2023
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10. Clinical and multi-modality imaging approach in the selection of patients for left atrial appendage closure
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Lucia Riegler, Stefano Palermi, Raffaella Scarafile, Renato Gioia, Fabio Pastore, Anna Lombardi, Gemma Marrazzo, Massimo Ragni, Gaetano Quaranta, Cesare Sirignano, Andrea Manto, and Antonello D’Andrea
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atrial fibrillation ,left atrial appendage occlusion ,stroke ,emboli ,multi-imaging ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Atrial fibrillation (AF) can lead to embolic stroke and in subjects with non-valvular AF most of thrombi are sited in the left atrial appendage (LAA). LAA is a structure located in the free wall of heart with a wide variable and complex anatomy. LAA occlusion (LAAO) could be taken in consideration in subjects with non-valvular AF and who cannot have long-term anticoagulant therapy. It is a complex preventive procedure given the high variability of patients characteristics and several LAAO devices available nowadays. Moreover, the ideal postprocedural antithrombotic strategy is still unclear. In this review we aim to describe clinical features of patients committed for LAA occlusion and the function of multimodality imaging in subjects selection, procedural management and follow up.
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- 2021
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11. High-sensitivity troponin I with or without ultra-sensitive copeptin for the instant rule-out of acute myocardial infarction
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Fabrizio Ricci, Johannes T. Neumann, Nicole Rübsamen, Nils A. Sörensen, Francisco Ojeda, Ivana Cataldo, Tanja Zeller, Sarina Schäfer, Tau S. Hartikainen, Maria Golato, Stefano Palermi, Marco Zimarino, Stefan Blankenberg, Dirk Westermann, and Raffaele De Caterina
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high-sensitivity cardiac troponin ,copeptin ,coronary artery disease ,emergency department ,myocardial infarction ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundThe instant, single-sampling rule-out of acute myocardial infarction (AMI) is still an unmet clinical need. We aimed at testing and comparing diagnostic performance and prognostic value of two different single-sampling biomarker strategies for the instant rule-out of AMI.MethodsFrom the Biomarkers in Acute Cardiac Care (BACC) cohort, we recruited consecutive patients with acute chest pain and suspected AMI presenting to the Emergency Department of the University Medical Center Hamburg-Eppendorf, Hamburg, Germany. We compared safety, effectiveness and 12-month incidence of the composite endpoint of all-cause death and myocardial infarction between (i) a single-sampling, dual-marker pathway combining high-sensitivity cardiac troponin I (hs-cTnI) and ultra-sensitive copeptin (us-Cop) at presentation (hs-cTnI ≤ 27 ng/L, us-Cop < 10 pmol/L and low-risk ECG) and (ii) a single-sampling pathway based on one-off hs-cTnI determination at presentation (hs-cTnI < 5 ng/L and low-risk ECG). As a comparator, we used the European Society of Cardiology (ESC) 0/1-h dual-sampling algorithm.ResultsWe enrolled 1,136 patients (male gender 65%) with median age of 64 years (interquartile range, 51–75). Overall, 228 (20%) patients received a final diagnosis of AMI. The two single-sampling instant rule-out pathways yielded similar negative predictive value (NPV): 97.4% (95%CI: 95.4–98.7) and 98.7% (95%CI: 96.9–99.6) for dual-marker and single hs-cTnI algorithms, respectively (P = 0.11). Both strategies were comparably safe as the ESC 0/1-h dual-sampling algorithm and this was consistent across subgroups of early-comers, low-intermediate risk (GRACE-score < 140) and renal dysfunction. Despite a numerically higher rate of false-negative results, the dual-marker strategy ruled-out a slightly but significantly higher percentage of patients compared with single hs-cTnI determination (37.4% versus 32.9%; P < 0.001). There were no significant between-group differences in 12-month composite outcome.ConclusionsInstant rule-out pathways based on one-off determination of hs-cTnI alone or in combination with us-Cop are comparably safe as the ESC 0/1 h algorithm for the instant rule-out of AMI, yielding similar prognostic information. Instant rule-out strategies are safe alternatives to the ESC 0/1 h algorithm and allow the rapid and effective triage of suspected AMI in patients with low-risk ECG. However, adding copeptin to hs-cTn does not improve the safety of instant rule-out compared with the single rule-out hs-cTn at very low cut-off concentrations.
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- 2022
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12. Physical and psychological reconditioning in long COVID syndrome: Results of an out-of-hospital exercise and psychological - based rehabilitation program
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Silvia Compagno, Stefano Palermi, Valentina Pescatore, Erica Brugin, Marzia Sarto, Ruggero Marin, Valli Calzavara, Manuele Nizzetto, Moreno Scevola, Accurso Aloi, Alessandro Biffi, Carlo Zanella, Giovanni Carretta, Silvia Gallo, and Franco Giada
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Long covid syndrome ,Multidisciplinary rehabilitation ,Psychological management ,Physical exercise training ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Long Covid Syndrome (LCS) is used to describe signs and symptoms that continue or develop after acute COVID-19 infection. Natural history and treatment of this syndrome are still poorly understood, even if evidences suggest the potential role of physical rehabilitation in improving symptoms in these patients. Aim of the study: The aim of the present study was to evaluate effectiveness, safety and feasibility of an out-of-hospital multidisciplinary rehabilitation (MDR) program, based both on physical and psychological reconditioning, in reducing symptoms and improving physical fitness and psychological parameters in patients with LCS. Methods: Thirty consecutive patients with LCS (18 males, mean age 58 years) underwent an accurate medical screening process including anthropometric and muscular strength evaluation, cardiopulmonary exercise test, quality of life (QoL) and psychological appraisal before and after a MDR program. Results: At baseline, all LCS patients were strongly symptomatic and showed severe impairments in physical performance, QoL and psychological parameters. No adverse effects and dropouts were observed during the exercise training sessions. After the MDR program, COVID-19 residual symptoms significantly decreased, and significant improvements in upper and lower limb muscular strength, cardiopulmonary parameters, perceived physical and mental health, depression and anxiety were observed. Conclusions: The present study confirms the severe physical and psychological impairment of patients with LCS and suggests that a MDR program is effective, safe and feasible in these patients and could promote their physical and psychological recovery.
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- 2022
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13. Differences in Physical Activity Levels between Healthy and Transplanted Children: Who Needs More Tips?
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Eliana Tranchita, Giulia Cafiero, Ugo Giordano, Stefano Palermi, Federica Gentili, Isabella Guzzo, Marco Spada, Federica Morolli, Fabrizio Drago, and Attilio Turchetta
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physical activity ,children ,transplant ,preventive medicine ,sedentary behaviors ,Medicine - Abstract
Background: Advances in the medical-surgical field have significantly increased the life expectancy of patients undergoing solid organ transplantation but this exposes patients to long-term complications due to chronic therapies and changes in lifestyle. It is known that children affected by pathology tend to be more sedentary and inactivity represents a further risk factor for the onset of non-communicable diseases. The aim of the present study was to compare the lifestyle of two groups of young patients: one group of healthy subjects (HG) and one group of kidney or liver transplant recipients (TG). Methods: Patients were asked to complete Physical Activity Questionnaire for Older Children (PAQ-C). Results: A total of 104 subjects were recruited (50.9% male, mean age 12.8 ± 3.16 years old). No significant differences were observed in the final score between groups when comparing subjects based on health condition (Healthy 2.69 ± 0.65 vs. Transplant Group 2.42 ± 0.88), the intensity of sports activities (Competitive 2.82 ± 0.59 vs. Not Competitive 2.53 ± 0.7) or type of transplant (Liver 2.51 ± 0.91 vs. Kidney 2.16 ± 0.75). Conclusion: The results of this study showed a worrying reality: children are engaged in low levels of physical activity regardless of their health status and in general the level of activity does not reach the recommended values even in the absence of contraindications. So, it is necessary to encourage healthy children to practice more PA and to introduce PA prescriptions for transplanted children to prevent their health from deteriorating due to sedentariness.
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- 2023
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14. Athlete's Heart: A Cardiovascular Step-By-Step Multimodality Approach
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Stefano Palermi, Elena Cavarretta, Flavio D’Ascenzi, Silvia Castelletti, Fabrizio Ricci, Marco Vecchiato, Alessandro Serio, Luna Cavigli, Eduardo Bossone, Giuseppe Limongelli, Alessandro Biffi, Emanuele Monda, Andre La Gerche, Aaron Baggish, and Antonello D’Andrea
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athlete's heart ,cardiovascular imaging ,pre-participation screening ,sports activity ,sports cardiology ,sudden cardiac death ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
“Athlete’s heart” is a spectrum of morphological, functional, and regulatory changes that occur in people who practice regular and long-term intense physical activity. The morphological characteristics of the athlete’s heart may overlap with some structural and electrical cardiac diseases that may predispose to sudden cardiac death, including inherited and acquired cardiomyopathies, aortopathies and channelopathies. Overdiagnosis should be avoided, while an early identification of underlying cardiac life-threatening disorders is essential to reduce the potential for sudden cardiac death. A step-by-step multimodality approach, including a first-line evaluation with personal and family history, clinical evaluation, 12-lead resting electrocardiography (ECG), followed by second and third-line investigations, as appropriate, including exercise testing, resting and exercise echocardiography, 24-hour ECG Holter monitoring, cardiac magnetic resonance, computed tomography, nuclear scintigraphy, or genetic testing, can be determinant to differentiate between extreme physiology adaptations and cardiac pathology. In this context, cardiovascular imaging plays a key role in detecting structural abnormalities in athletes who fall into the grey zone between physiological adaptations and a covert or early phenotype of cardiovascular disease.
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- 2023
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15. How chest press-based exercises can alleviate the burden of cardiovascular diseases
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Stefano Palermi, Nicola L. Bragazzi, Drazen Cular, Luca P. Ardigò, and Johnny Padulo
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isokinetic machine ,cardiovascular pathology ,strength traini ,Sports ,GV557-1198.995 - Abstract
Unlike in the previous decades, strength training is gaining more scientific attention owing to its numerous benefits on human health. It has major benefits on metabolic processes, cardiovascular system, musculoskeletal system, age-related processes, and mental health. In comparison with aerobic low-intensity exercises, chest press-based strength training cardiovascular adaptations have been ignored for many years. Yet, if properly prescribed and conducted, strength training has shown to be safe and effective in people with cardiovascular disease. This narrative review aims at summarizing the available evidence about the role of chest press-based strength training on the cardiovascular system.
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- 2021
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16. Overshoot of the Respiratory Exchange Ratio during Recovery from Maximal Exercise Testing in Young Patients with Congenital Heart Disease
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Marco Vecchiato, Andrea Ermolao, Emanuele Zanardo, Francesca Battista, Giacomo Ruvoletto, Stefano Palermi, Giulia Quinto, Gino Degano, Andrea Gasperetti, Massimo A. Padalino, Giovanni Di Salvo, and Daniel Neunhaeuserer
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cardiopulmonary exercise test ,CHD ,RER ,Fontan ,Fallot ,coarctation ,Pediatrics ,RJ1-570 - Abstract
Introduction: The overshoot of the respiratory exchange ratio (RER) after exercise is reduced in patients with heart failure. Aim: The present study aimed to investigate the presence of this phenomenon in young patients with congenital heart disease (CHD), who generally present reduced cardiorespiratory fitness. Methods: In this retrospective study, patients with CHD underwent a maximal cardiopulmonary exercise testing (CPET) assessing the RER recovery parameters: the RER at peak exercise, the maximum RER value reached during recovery, the magnitude of the RER overshoot and the linear slope of the RER increase after the end of the exercise. Results: In total, 117 patients were included in this study. Of these, there were 24 healthy age-matched control subjects and 93 young patients with CHD (transposition of great arteries, Fontan procedure, aortic coarctation and tetralogy of Fallot). All patients presented a RER overshoot during recovery. Patients with CHD showed reduced aerobic capacity and cardiorespiratory efficiency during exercise, as well as a lower RER overshoot when compared to controls. RER magnitude was higher in the controls and patients with aortic coarctation when compared to those with transposition of great arteries, previous Fontan procedure, and tetralogy of Fallot. The RER magnitude was found to be correlated with the most relevant cardiorespiratory fitness and efficiency indices. Conclusions: The present study proposes new recovery indices for functional evaluation in patients with CHD. Thus, the RER recovery overshoots analysis should be part of routine CPET evaluation to further improve prognostic risk stratifications in patients with CHD.
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- 2023
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17. The eSports Medicine: Pre-Participation Screening and Injuries Management—An Update
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Agostino Rossoni, Marco Vecchiato, Erica Brugin, Eliana Tranchita, Paolo Emilio Adami, Manuela Bartesaghi, Elena Cavarretta, and Stefano Palermi
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electronic sport ,eSports ,eGames ,eAthletes ,sports medicine ,cardiovascular prevention ,Sports ,GV557-1198.995 - Abstract
Recently, electronic sports (eSports) became one of the growing forms of new media due to the wide diffusion of games and online technologies. Even if there is still a debate about the definition and characterization of eSports, eAthletes train heavily, compete in tournaments, must abide by competition, association, and governing body rules, just like all other athletes. Furthermore, as in any other competitive discipline, there can be injuries. Aberrant sitting posture, repetitive movements, screen vision, prolonged playing hours, and a sedentary lifestyle can lead to several medical hazards in musculoskeletal, ophthalmology, neurological, and metabolic systems. Moreover, several cardiovascular changes occur in eAthletes. This paper aims to explore the different injuries that can occur in a professional eAthlete, suggesting how every high-level gamer could benefit from a pre-participation evaluation and a correct injury prevention strategy.
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- 2023
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18. Cardiovascular magnetic resonance reference values of mitral and tricuspid annular dimensions: the UK Biobank cohort
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Fabrizio Ricci, Nay Aung, Sabina Gallina, Filip Zemrak, Kenneth Fung, Giandomenico Bisaccia, Jose Miguel Paiva, Mohammed Y. Khanji, Cesare Mantini, Stefano Palermi, Aaron M. Lee, Stefan K. Piechnik, Stefan Neubauer, and Steffen E. Petersen
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Cardiovascular magnetic resonance ,Reference values ,Mitral valve ,Tricuspid valve ,Annulus ,Tenting area ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Mitral valve (MV) and tricuspid valve (TV) apparatus geometry are essential to define mechanisms and etiologies of regurgitation and to inform surgical or transcatheter interventions. Given the increasing use of cardiovascular magnetic resonance (CMR) for the evaluation of valvular heart disease, we aimed to establish CMR-derived age- and sex-specific reference values for mitral annular (MA) and tricuspid annular (TA) dimensions and tethering indices derived from truly healthy Caucasian adults. Methods 5065 consecutive UK Biobank participants underwent CMR using cine balanced steady-state free precession imaging at 1.5 T. Participants with non-Caucasian ethnicity, prevalent cardiovascular disease and other conditions known to affect cardiac chamber size and function were excluded. Absolute and indexed reference ranges for MA and TA diameters and tethering indices were stratified by gender and age (45–54, 55–64, 65–74 years). Results Overall, 721 (14.2%) truly healthy participants aged 45–74 years (54% women) formed the reference cohort. Absolute MA and TA diameters, MV tenting length and MV tenting area, were significantly larger in men. Mean ± standard deviation (SD) end-diastolic and end-systolic MA diameters in the 3-chamber view (anteroposterior diameter) were 2.9 ± 0.4 cm (1.5 ± 0.2 cm/m2) and 3.3 ± 0.4 cm (1.7 ± 0.2 cm/m2) in men, and 2.6 ± 0.4 cm (1.6 ± 0.2 cm/m2) and 3.0 ± 0.4 cm (1.8 ± 0.2 cm/m2) in women, respectively. Mean ± SD end-diastolic and end-systolic TA diameters in the 4-chamber view were 3.2 ± 0.5 cm (1.6 ± 0.3 cm/m2) and 3.2 ± 0.5 cm (1.7 ± 0.3 cm/m2) in men, and 2.9 ± 0.4 cm (1.7 ± 0.2 cm/m2) and 2.8 ± 0.4 cm (1.7 ± 0.3 cm/m2) in women, respectively. With advancing age, end-diastolic TA diameter became larger and posterior MV leaflet angle smaller in both sexes. Reproducibility of measurements was good to excellent with an inter-rater intraclass correlation coefficient (ICC) between 0.92 and 0.98 and an intra-rater ICC between 0.90 and 0.97. Conclusions We described age- and sex-specific reference ranges of MA and TA dimensions and tethering indices in the largest validated healthy Caucasian population. Reference ranges presented in this study may help to improve the distinction between normal and pathological states, prompting the identification of subjects that may benefit from advanced cardiac imaging for annular sizing and planning of valvular interventions.
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- 2020
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19. Uphill walking at iso-efficiency speeds
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Mirjana Milic, Marko Erceg, Stefano Palermi, Enzo Iuliano, Marta Borrelli, Emiliano Cè, Fabio Esposito, and Johnny Padulo
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gait variability heart rate locomotion kinematic analysis slope walking ,Sports medicine ,RC1200-1245 ,Biology (General) ,QH301-705.5 - Abstract
Uphill walking gait has been extensively studied, but the optimal uphill speed able to enhance the metabolic demand without increasing fatigability has so far received little attention. Therefore, the aim of this study was to assess the metabolic/kinematic demand at constant speed (6 km·h−1 G0 level, G2 2% uphill, G7 7% uphill) and at iso-efficiency speeds (G2IES 5.2 km·h−1 2% uphill and G7IES 3.9 km·h−1 7% uphill). For this aim, physically active women (n:24, Age 33.40 ± 4.97 years, BMI 21.62 ± 2.06 kg/m-2) after an 8-min warm-up were studied on a treadmill for 10ʹ for every walking condition with a 5ʹ rest in between. Average heart rate (AVG-HR), rating of perceived exertion (RPE) and kinematic variables (stance time, swing time, stride length, stride cycle, stride-length variability, stride-cycle variability and internal work) were studied. Modif ications in stance time, stride length and stride cycle (p
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- 2020
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20. Do Androgenic Pattern, Insulin State and Growth Hormone Affect Cardiorespiratory Fitness and Strength in Young Women with PCOS?
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Veronica Baioccato, Giulia Quinto, Sara Rovai, Francesca Conte, Francesca Dassie, Daniel Neunhäeuserer, Marco Vecchiato, Stefano Palermi, Andrea Gasperetti, Valentina Bullo, Valentina Camozzi, Roberto Vettor, Andrea Ermolao, and Roberto Mioni
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polycystic ovary syndrome ,cardiopulmonary exercise test ,functional capacity ,muscular strength ,exercise prescription ,Biology (General) ,QH301-705.5 - Abstract
In this study, cardiorespiratory fitness (CRF) and strength level were assessed in women with and without polycystic ovary syndrome (PCOS), matched for age, body composition, androgenic pattern and insulinemic pattern. Patients with and without PCOS were evaluated at the Endocrinology Unit and Sport Medicine Division to assess endocrinological (insulinemic, androgenic pattern and growth hormone), anthropometric (with DEXA) and functional parameters (with cardiopulmonary exercise test and handgrip test), as well as physical activity level (with the Global Physical Activity Questionnaire). A total of 31 patients with PCOS and 13 controls were included. No statistically significant differences were found between groups in terms of age, body mass index, body composition, androgenic pattern, insulin state, growth hormone and physical activity level. The PCOS group demonstrated significantly better cardiorespiratory fitness (VO2max per kg (30.9 ± 7.6 vs. 24.8 ± 4.1 mL/kg/min; p = 0.010), VO2max per kg of fat-free mass (52.4 ± 8.9 vs. 45.3 ± 6.2 mL/kg/min; p = 0.018)), strength levels (handgrip per kg (0.36 ± 0.09 vs. 0.30 ± 0.08; p = 0.009), handgrip per kg of fat-free mass (13.03 ± 2.32 vs. 11.50 ± 1.91; p = 0.001)) and exercise capacity (METs at test (14.4 ± 2.72 vs. 12.5 ± 1.72 METs; p = 0.019)). In this study, women with PCOS showed a better cardiorespiratory fitness and strength than the control group. The only determinant that could explain the differences observed seems to be the presence of the syndrome itself. These results suggest that PCOS per se does not limit exercise capacity and does not exclude good functional capacity.
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- 2022
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21. The Effectiveness of Adapted Personalized Motor Activity (AMPA) to Improve Health in Individuals with Mental Disorders and Physical Comorbidities: A Randomized Controlled Trial
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Vito Lamberti, Stefano Palermi, Andrea Franceschin, Giovanni Scapol, Vincenzo Lamberti, Chiara Lamberti, Marco Vecchiato, Rocco Spera, Felice Sirico, and Elisabetta Della Valle
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exercise-therapy ,exercise physiology ,physical activity ,mental health ,physical comorbidities ,Sports ,GV557-1198.995 - Abstract
Mental disorders are highly prevalent worldwide and have a high impact on daily functioning. Exercise therapy was found to improve health of individuals with physical and mental disorders. This study aims to investigate the effectiveness of an Adapted Personalized Motor Activity (AMPA) in improving health in individuals with physical and mental disorders. Forty-three patients affected by both mental and chronic nontransmissible conditions were randomly assigned to intervention group (AMPA intervention) and control group (no intervention). Perceived physical and mental health were assessed using the Short Form 12 (SF-12) questionaries. Moreover, subjects underwent an accurate medical screening process, complete clinical evaluation, body composition evaluation, and cardiopulmonary assessment. Repeated Measurement Analysis of the Variance (RM-ANOVA) was used to compare any changes in health and physiological parameters in-between groups. AMPA group showed a statistically significant improvement in both perceived mental and physical health. Moreover, Body Mass Index (BMI), glycolipid profile, aerobic functional capacity and cardiopulmonary parameters improved significantly among individuals from the intervention group compared with the individuals from the control group. AMPA may be considered a possible intervention to improve health in individuals suffering from multiple physical and mental disorders. Future studies should examine the effectiveness in larger and heterogeneous sample of chronically ill patients and the long-term effect of AMPA.
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- 2022
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22. External Responsiveness of the SuperOpTM Device to Assess Recovery After Exercise: A Pilot Study
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Luca Paolo Ardigò, Stefano Palermi, Johnny Padulo, Wissem Dhahbi, Luca Russo, Simone Linetti, Drazen Cular, and Mario Tomljanovic
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fatigue ,physiology ,endurance training ,training load ,recovery ,Sports ,GV557-1198.995 - Abstract
Post-exercise recovery is a complex process involving a return of performance and a physiological or perceptual feeling close to pre-exercise status. The hypothesis of this study is that the device investigated here is effective in evaluating the recovery state of professional cyclists in order to plan effective training. Ten professional male cyclists belonging to the same team were enrolled in this study. Participants performed a 7-day exercise program [D1, D4, and D7: low-intensity training; D2 and D5: passive recovery; D3: maximum oxygen consumption (VO2Max) test (for maximum mechanical power assessment only); and D6: constant load test]. During the week of monitoring, each morning before getting up, the device assessed each participant's so-called Organic Readiness {OR [arbitrary unit (a.u.)]}, based on blood pressure (BP), heart rate (HR), features of past exercise session, and following self-perceived condition. Based on its readings and algorithm, the device graphically displayed four different colors/values, indicating general exercise recommendations: green/3 = “you can train hard,” yellow/2 = “you can train averagely,” orange/1 = “you can train lightly,” or red/0 = “you should recover passively.” During the week of research, morning OR values and Bonferroni post-hoc comparisons showed significant differences between days and, namely, values (1) D2 (after low intensity training) was higher than D4 (after VO2Max test; P = 0.033 and d = 1.296) and (2) D3 and D6 (after passive recovery) were higher than D4 (after VO2Max test; P = 0.006 and d = 2.519) and D5 (after low intensity training; P = 0.033 and d = 1.341). The receiver operating characteristic analysis area under curve (AUC) recorded a result of 0.727 and could differentiate between D3 and D4 with a sensitivity and a specificity of 80%. Preliminarily, the device investigated is a sufficiently effective and sensitive/specific device to assess the recovery state of athletes in order to plan effective training.
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- 2020
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23. Indirect Structural Muscle Injuries of Lower Limb: Rehabilitation and Therapeutic Exercise
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Stefano Palermi, Bruno Massa, Marco Vecchiato, Fiore Mazza, Paolo De Blasiis, Alfonso Maria Romano, Mariano Giuseppe Di Salvatore, Elisabetta Della Valle, Domiziano Tarantino, Carlo Ruosi, and Felice Sirico
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muscle injury ,rehabilitation ,sport medicine ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Muscle injuries are the most common trauma in team and individual sports. The muscles most frequently affected are those of the lower limb, and in particular hamstrings, adductors, rectus femoris and calf muscles. Although several scientific studies have tried to propose different rehabilitation protocols, still too often the real rehabilitation process is not based on scientific knowledge, especially in non-elite athletes. Moreover, the growing use of physical and instrumental therapies has made it increasingly difficult to understand what can be truly effective. Therefore, the aim of the present paper is to review proposed therapeutic algorithms for muscle injuries, proposing a concise and practical summary. Following a three-phase rehabilitation protocol, this review aims to describe the conservative treatment of indirect structural muscle injuries, which are the more routinely found and more challenging type. For each phase, until return to training and return to sport are completed, the functional goal, the most appropriate practitioner, and the best possible treatment according to current evidence are expressed. Finally, the last section is focused on the specific exercise rehabilitation for the four main muscle groups with a structured explanatory timetable.
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- 2021
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24. Correlation between Official and Common Field-Based Fitness Tests in Elite Soccer Referees
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Veronica Romano, Manuel Tuzi, Ada Di Gregorio, Anna Maria Sacco, Immacolata Belviso, Felice Sirico, Stefano Palermi, Daria Nurzynska, Franca Di Meglio, Clotilde Castaldo, Angelo Pizzi, and Stefania Montagnani
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soccer ,referee ,fitness ,Illinois agility test ,hand-grip strength ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Official tests are used to assess the fitness status of soccer referees, and their results correlate with match performance. However, FIFA-approved tests expose the referees to high physical demands and are difficult to implement during the sportive year. The aim of our study was to evaluate the correlation between the 6 × 40-m sprint and Yo-Yo Intermittent Recovery Level 1 (IR1) official tests and other field-based tests that require no or little equipment, are not time-consuming, and impose low physical demands. All tests were performed by male referees from the Regional Section of the Italian Referee Association (n = 30). We observed a strong correlation between 6 × 40-m sprint and Illinois agility tests (r = 0.63, p = 0.001) and a moderate correlation between Yo-Yo IR1 and hand-grip strength in the dominant (r = 0.45, p = 0.014) and non-dominant hand (r = 0.41, p = 0.031). Interestingly, only a moderate correlation (r = −0.42, p = 0.025) was observed between the FIFA official tests, 6 × 40-m sprint and Yo-Yo IR1. These results suggest that Illinois agility and hand-grip tests could represent simple and low-physical-impact tools for repeated assessment and monitoring of referee fitness throughout the sportive season.
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- 2021
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25. Effect of Video Observation and Motor Imagery on Simple Reaction Time in Cadet Pilots
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Felice Sirico, Veronica Romano, Anna Maria Sacco, Immacolata Belviso, Vittoria Didonna, Daria Nurzynska, Clotilde Castaldo, Stefano Palermi, Giuseppe Sannino, Elisabetta Della Valle, Stefania Montagnani, and Franca Di Meglio
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reaction time ,pilots ,motor imagery ,video observation ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Neuromotor training can improve motor performance in athletes and patients. However, few data are available about their effect on reaction time (RT). We investigated the influence of video observation/motor imagery (VO/MI) on simple RT to visual and auditory stimuli. The experimental group comprised 21 cadets who performed VO/MI training over 4 weeks. Nineteen cadets completed a sham intervention as control. The main outcome measure was RT to auditory and visual stimuli for the upper and lower limbs. The RT to auditory stimuli improved significantly post-intervention in both groups (control vs. experimental mean change for upper limbs: −40 ms vs. −40 ms, p = 0.0008; for lower limbs: −50 ms vs. −30 ms, p = 0.0174). A trend towards reduced RT to visual stimuli was observed (for upper limbs: −30 ms vs. −20 ms, p = 0.0876; for lower limbs: −30 ms vs. −20 ms, p = 0.0675). The interaction term was not significant. Only the specific VO/MI training produced a linear correlation between the improvement in the RT to auditory and visual stimuli for the upper (r = 0.703) and lower limbs (r = 0.473). In conclusion, VO/MI training does not improve RT when compared to control, but it may be useful in individuals who need to simultaneously develop a fast response to different types of stimuli.
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- 2020
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26. Achilles Tendon Rupture: Mechanisms of Injury, Principles of Rehabilitation and Return to Play
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Domiziano Tarantino, Stefano Palermi, Felice Sirico, and Bruno Corrado
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Achilles tendon ,tendon rupture ,rehabilitation ,return to play ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
The Achilles tendon is the thickest, strongest and largest tendon in the human body, but despite its size and tensile strength, it frequently gets injured. Achilles tendon ruptures (ATRs) mainly occur during sports activities, and their incidence has increased over the last few decades. Achilles tendon tears necessitate a prolonged recovery time, sometimes leaving long-term functional limitations. Treatment options include conservative treatment and surgical repair. There is no consensus on which is the best treatment for ATRs, and their management is still controversial. Limited scientific evidence is available for optimized rehabilitation regimen and on the course of recovery after ATRs. Furthermore, there are no universally accepted outcomes regarding the return to play (RTP) process. Therefore, the aim of this narrative review is to give an insight into the mechanism of injuries of an ATR, related principles of rehabilitation, and RTP.
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- 2020
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27. Effectiveness of Workplace Yoga Interventions to Reduce Perceived Stress in Employees: A Systematic Review and Meta-Analysis
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Elisabetta Della Valle, Stefano Palermi, Irene Aloe, Roberto Marcantonio, Rocco Spera, Stefania Montagnani, and Felice Sirico
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worksite ,corporate wellness programs ,workers ,complementary medicine ,relaxation ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Work-related stress represents a relevant public health issue and solution strategies are mandatory. Yoga is a common approach to manage stress and its effectiveness has been extensively confirmed. Therefore, this study aims systematically to review the effectiveness of Yoga interventions carried out at workplace on work-related stress among employees and to assess their impact quantitatively. Springerlink, MEDLINE, PubMed, CINAHL, Web of Science, Scopus, Cochrane CENTRAL and PEDro databases were searched. Clinical trials comparing workplace Yoga interventions to control groups, and evaluating perceived stress as outcome measure, were assessed for eligibility. All forms and styles of Yoga were considered for the analysis. Out of 3392 initially identified, 6 studies were included in the meta-analysis; 266 participants practicing Yoga interventions at worksite were compared to 221 subjects in control group. Included studies showed “some concerns” about different domains of source of bias. Quantitative analysis showed an overall effect size of −0.67 [95% confidence interval (CI): −0.86, −0.49] in favor of Yoga intervention in reducing stress outcome measures. Hence, workplace Yoga interventions were more effective when compared to no treatment in work-related stress management. Further high-quality studies are needed to improve the validity of these results and to specify more characteristics of the Yoga intervention, such as style, volume, and frequency.
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- 2020
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28. Brachial Plexus Injuries in Sport Medicine: Clinical Evaluation, Diagnostic Approaches, Treatment Options, and Rehabilitative Interventions
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Immacolata Belviso, Stefano Palermi, Anna Maria Sacco, Veronica Romano, Bruno Corrado, Marcello Zappia, and Felice Sirico
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brachial plexus ,nerve injuries ,sport medicine ,rehabilitation ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
The brachial plexus represents a complex anatomical structure in the upper limb. This “network” of peripheral nerves permits the rearrangement of motor efferent fibers, coming from different spinal nerves, in several terminal branches directed to upper limb muscles. Moreover, afferent information coming from different cutaneous regions in upper limb are sorted in different spinal nerves through the brachial plexus. Severe brachial plexus injuries are a rare clinical condition in the general population and in sport medicine, but with dramatic consequences on the motor and sensory functions of the upper limb. In some sports, like martial arts, milder injuries of the brachial plexus can occur, with transient symptoms and with a full recovery. Clinical evaluation represents the cornerstone in the assessment of the athletes with brachial plexus injuries. Electrodiagnostic studies and imaging techniques, like magnetic resonance and high-frequency ultrasound, could be useful to localize the lesion and to define an appropriate treatment and a functional prognosis. Several conservative and surgical techniques could be applied, and multidisciplinary rehabilitative programs could be performed to guide the athlete toward the recovery of the highest functional level, according to the type of injury.
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- 2020
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29. Tendinopathy: Pathophysiology, Therapeutic Options, and Role of Nutraceutics. A Narrative Literature Review
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Carlo Loiacono, Stefano Palermi, Bruno Massa, Immacolata Belviso, Veronica Romano, Ada Di Gregorio, Felice Sirico, and Anna Maria Sacco
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tendinopathies ,microscopic anatomy of tendons ,pharmacological therapies ,physical therapies ,nutraceutical products ,Medicine (General) ,R5-920 - Abstract
Tendinopathies are very common in general population and a huge number of tendon-related procedures take place annually worldwide, with significant socio-economic repercussions. Numerous treatment options are commonly used for tendon disorders. Besides pharmacological and physical therapy, nutrition could represent an additional tool for preventing and treating this complex pathology that deserve a multidisciplinary approach. In recent years, nutraceutical products are growing up in popularity since these seem to favor the prevention and the healing processes of tendon injuries. This narrative literature review aims to summarize current understanding and the areas of ongoing research about the management of tendinopathies with the help of oral supplementation.
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- 2019
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30. 3-Day food record: efficacy in patients with type 2 diabetes mellitus
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Pasquale, Auletta, primary, Raffaele, D’Arco, additional, Gerardo, Corigliano, additional, Marisa, Conte, additional, Silvestre, Pagano, additional, Valentina, Genovese, additional, Umberto, De Fortuna, additional, Michele, Modestino, additional, Stefano, Palermi, additional, Mariarosaria, De Luca, additional, and Vincenzo, Guardasole, additional
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- 2023
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31. Multimodality imaging in decompensated heart failure
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Antonello D’Andrea, Federica Ilardi, Stefano Palermi, Lucia Riegler, Tiziana Miele, Francesco Giallauria, Michele D’Alto, Vincenzo Russo, Gennaro Cice, D'Andrea, Antonello, Ilardi, Federica, Palermi, Stefano, Riegler, Lucia, Miele, Tiziana, Giallauria, Francesco, D'Alto, Michele, Russo, Vincenzo, and Cice, Gennaro
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Myocardial scintigraphy ,Cardiac magnetic resonance ,Scar ,Echocardiography ,Fibrosi ,Heart failure ,Cardiology and Cardiovascular Medicine ,Strain - Abstract
Heart failure (HF) is usually suspected by clinical history, symptoms, physical examination, electrocardiogram findings, and natriuretic peptides’ values. However, echocardiography and other imaging techniques play an essential role in supporting HF diagnosis. Thanks to its non-invasiveness and safety, transthoracic echocardiography is the first-level technique of choice to assess myocardial structure and function, trying to establish the diagnosis of HF with reduced, mildly reduced, and preserved ejection fraction. The role of echocardiography is not limited to diagnosis but it represents a crucial tool in guiding therapeutic decision-making and monitoring response to therapy. Over the last decades, several technological advancements were made in the imaging field, aiming at better understanding the morphofunctional abnormalities occurring in cardiovascular diseases. The purpose of this review article is to summarize the incremental role of imaging techniques (in particular cardiac magnetic resonance and myocardial scintigraphy) in HF, highlighting their essential applications to HF diagnosis and management.
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- 2023
32. Echocardiography in the preparticipation screening: an old topic revisited
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Federica Donati, Claudio Guicciardi, Elisa Lodi, Fredrick Fernando, Stefano Palermi, Maria Grazia Modena, and Alessandro Biffi
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General Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
33. Cardiovascular disease prevention in the worksite: Where are we?
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Alessandro Biffi, Fredrick Fernando, Stefano Palermi, Felice Sirico, Lorenzo Bonatesta, Elena Cavarretta, Flavio D'Ascenzi, Josef Niebauer, Biffi, A., Fernando, F., Palermi, S., Sirico, F., Bonatesta, L., Cavarretta, E., D'Ascenzi, F., and Niebauer, J.
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Cardiovascular prevetion ,Cardiovascular Diseases ,Risk Factors ,cardiovascular prevetion ,corporate wellness ,Humans ,Corporate wellness ,Health Promotion ,Workplace ,Cardiology and Cardiovascular Medicine ,Exercise - Abstract
The current guidelines of the European Society of Cardiology on cardiovascular (CV) disease prevention highlighted the importance of implementing coordinated set of action, including worksite, aimed at eliminating or minimizing the impact of CV disease and their related disabilities. Workplace wellness programs tend to focus on modifiable risk factors of non-communicable disease, such as nutrition, physical activity, and smoking cessation. However, nowadays, corporate wellness programs are still rare and incomplete, and usually received limited attention. This represents a big public health issue since company health and wellness interventions may provide an important opportunity to identify and manage CV risk. Given the increasing of employees' average age, a progressive shifting of retirement age and an increased number of chronic diseases, these preventive programs will increasingly represent key factors of both employee's health and economic strategies of companies in the near future.
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- 2022
34. Differences in Physical Activity Levels between Healthy and Transplanted Children: Who Needs More Tips?
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Turchetta, Eliana Tranchita, Giulia Cafiero, Ugo Giordano, Stefano Palermi, Federica Gentili, Isabella Guzzo, Marco Spada, Federica Morolli, Fabrizio Drago, and Attilio
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physical activity ,children ,transplant ,preventive medicine ,sedentary behaviors - Abstract
Background: Advances in the medical-surgical field have significantly increased the life expectancy of patients undergoing solid organ transplantation but this exposes patients to long-term complications due to chronic therapies and changes in lifestyle. It is known that children affected by pathology tend to be more sedentary and inactivity represents a further risk factor for the onset of non-communicable diseases. The aim of the present study was to compare the lifestyle of two groups of young patients: one group of healthy subjects (HG) and one group of kidney or liver transplant recipients (TG). Methods: Patients were asked to complete Physical Activity Questionnaire for Older Children (PAQ-C). Results: A total of 104 subjects were recruited (50.9% male, mean age 12.8 ± 3.16 years old). No significant differences were observed in the final score between groups when comparing subjects based on health condition (Healthy 2.69 ± 0.65 vs. Transplant Group 2.42 ± 0.88), the intensity of sports activities (Competitive 2.82 ± 0.59 vs. Not Competitive 2.53 ± 0.7) or type of transplant (Liver 2.51 ± 0.91 vs. Kidney 2.16 ± 0.75). Conclusion: The results of this study showed a worrying reality: children are engaged in low levels of physical activity regardless of their health status and in general the level of activity does not reach the recommended values even in the absence of contraindications. So, it is necessary to encourage healthy children to practice more PA and to introduce PA prescriptions for transplanted children to prevent their health from deteriorating due to sedentariness.
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- 2023
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35. How chest press-based exercises can alleviate the burden of cardiovascular diseases
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Stefano Palermi, Drazen Cular, Johnny Padulo, Nicola Luigi Bragazzi, and Luca Paolo Ardigò
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Chest Press ,medicine.medical_specialty ,Cardiovascular pathology ,business.industry ,isokinetic machine, cardiovascular pathology, strength training ,Public Health, Environmental and Occupational Health ,Biophysics ,medicine ,Physical Therapy, Sports Therapy and Rehabilitation ,Intensive care medicine ,business - Abstract
Unlike in the previous decades, strength training is gaining more scientific attention owing to its numerous benefits on human health. It has major benefits on metabolic processes, cardiovascular system, musculoskeletal system, age-related processes, and mental health. In comparison with aerobic low-intensity exercises, chest press-based strength training cardiovascular adaptations have been ignored for many years. Yet, if properly prescribed and conducted, strength training has shown to be safe and effective in people with cardiovascular disease. This narrative review aims at summarizing the available evidence about the role of chest press-based strength training on the cardiovascular system.
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- 2022
36. Preliminary Evaluation of Sedentary Lifestyle in Italian Children after Solid Transplant: What Role Could Physical Activity Play in Health? It Is Time to Move
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Eliana Tranchita, Giulia Cafiero, Ugo Giordano, Isabella Guzzo, Raffaella Labbadia, Stefano Palermi, Claudia Cerulli, Manila Candusso, Marco Spada, Lucilla Ravà, Federica Gentili, Fabrizio Drago, and Attilio Turchetta
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Health, Toxicology and Mutagenesis ,transplant ,children ,physical exercise ,health ,Public Health, Environmental and Occupational Health - Abstract
Background: Advances in the medical–surgical field have significantly increased survival after solid organ transplantation in the pediatric population. However, these patients are predisposed to the development of long-term complications (e.g., cardiovascular disease). The therapeutic role of physical activity (PA) to counteract these complications is well known. The purpose of the study was to investigate the level of PA in a pediatric population after solid organ transplantation. Methods: In the first 4 weeks at the beginning of the school year, the Physical Activity Questionnaire for Older Children and Adolescents was administered to young patients who had previously undergone solid transplants at our institute. Results: Questionnaires of 49 patients (57.1% female, mean age 13.2 ± 3.5 years) were analyzed and 32.7% of subjects did not perform any exercise during school physical education classes. Only 24% practiced a moderate quantity of exercise in the previous week (2–3 times/week) and 72% engaged in sedentary behaviors during weekends. Conclusions: Preliminary data confirmed that young recipients are still far from meeting the minimum indications of the World Health Organization on PA and sedentary behavior. It will be necessary to increase their involvement in PA programs in order not only to increase their life expectancy but also to improve their quality of life.
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- 2023
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37. Intra-Articular Collagen Injections for Osteoarthritis: A Narrative Review
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Domiziano Tarantino, Rosita Mottola, Stefano Palermi, Felice Sirico, Bruno Corrado, Rossana Gnasso, Tarantino, D., Mottola, R., Palermi, S., Sirico, F., Corrado, B., and Gnasso, R.
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collagen ,collagen injection ,osteoarthritis ,knee osteoarthriti ,Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,infiltrative treatment ,intra-articular injection - Abstract
Osteoarthritis (OA) is the most frequent degenerative progressive joint disease worldwide, with the hand, hip, and knee being the most-affected joints. Actually, no treatment can alter the course of OA, and therapy is directed at reducing pain and improving function. The exogenous administration of collagen has been investigated as a possible symptomatic adjuvant or stand-alone treatment for OA. The aim of this review is to assess if intra-articular collagen administration can be considered as a valid and safe therapeutic option for OA. A search in the main scientific electronic databases to identify the available scientific articles about the effects of intra-articular collagen as an OA treatment was performed. The results of the seven included studies showed that the intra-articular administration of collagen may stimulate chondrocytes to produce hyaline cartilage and hinder the normal inflammatory response leading to fibrous tissue formation, reducing symptoms, and improving functionality. The use of type-I collagen as an intra-articular treatment for knee OA was found not only to be effective, but also safe with negligible side effects. The reported findings are strongly promising, highlighting the need for further high-quality research to confirm the consistency of these findings.
- Published
- 2023
38. Contributors
- Author
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Aaron Baggish, Eduardo Bossone, Matteo Cameli, Andreina Carbone, Silvia Castelletti, Giovanni Domenico Ciriello, Anna Correra, Antonello D’Andrea, Flavio D’Ascenzi, Marc Dweck, Francesco Gambardella, Andre La Gerche, Giuseppe Limongelli, Emanuele Monda, Stefano Palermi, Giovanni Papaccioli, Michael Papadakis, Eugenio Picano, Gianluca Pontone, Vincenzo Russo, Berardo Sarubbi, Alessandro Serio, and Simona Sperlongano
- Published
- 2023
39. Selective Functional Movement Assessment (SFMA) Reliability and Proposal of Its Use in Sports
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Andrea Aghi, Daniele Salvagnini, Giovanni Berton, Mattia Cecconi, Elisabetta Della Valle, Rocco Spera, Maria Mambelli, Stefano Palermi, Daniel Neunhaeuserer, Marco Vecchiato, Aghi, Andrea, Salvagnini, Daniele, Berton, Giovanni, Cecconi, Mattia, Della Valle, Elisabetta, Spera, Rocco, Mambelli, Maria, Palermi, Stefano, Neunhaeuserer, Daniel, and Vecchiato, Marco
- Subjects
reliability ,Health, Toxicology and Mutagenesis ,physiotherapist ,Public Health, Environmental and Occupational Health ,method assessment ,physiotherapists ,selective functional movement assessment - Abstract
Introduction: The Selective Functional Movement Assessment (SFMA) is a functional movement assessment method to observe movement restrictions in individuals with known musculoskeletal disorders, although it has also been used to evaluate healthy athletes of different sports. Aim: The present paper aimed to evaluate the applicability of SFMA in a clinical setting and to verify whether a student can correctly perform it. Methods: An introductory and explanatory email was sent to the subjects, containing the instructions needed to produce a video with SFMA evaluation movements. SFMA methodology was then used to analyze the received videos. The results between interobserver and intraobserver agreement were compared to the literature, considered the gold standard methods. Results: Twenty-eight subjects (17.71 ± 1.96 years aged) were rated. The functional non-painful scenario (FN) has been assigned more frequently by all raters. The student’s intra-rater reliability proved to be moderate (Kappa coefficient 0.49). Results for inter-rater reliability showed that the reliability degree between the senior physiotherapist and student before and after their educational path is good (Kappa coefficient 0.60 and 0.62, respectively). Conclusions: The results of this study showed SFMA intra-rater reliability to be moderate, while inter-rater reliability can be considered good. These characteristics make it a valuable tool for sport’s needs, even when used by students.
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- 2023
40. Self-Myofascial Release of the Foot Plantar Surface: The Effects of a Single Exercise Session on the Posterior Muscular Chain Flexibility after One Hour
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Luca Russo, Eleonora Montagnani, Davide Pietrantuono, Fabiola D’Angona, Tommaso Fratini, Riccardo Di Giminiani, Stefano Palermi, Francesco Ceccarini, Gian Mario Migliaccio, Elena Lupu, and Johnny Padulo
- Subjects
flexibility ,self-myofascial release ,training ,Health, Toxicology and Mutagenesis ,Settore M-EDF/02 - Metodi e Didattiche delle Attivita' Sportive ,Public Health, Environmental and Occupational Health ,sit and reach ,posterior muscular chain - Abstract
This study evaluated the effects of a single exercise session of Self-Myofascial Release (SMR) on the posterior muscular chain flexibility after one hour from the intervention. Thirty-six participants performed SMR using a rigid ball under the surface of both feet. Participants were tested with the Sit and Reach (S&R) test at four different times: before (T0), immediately after (T1), 30 (T2), and 60 (T3) minutes after the SMR intervention. The sample (n = 36) was categorized into three groups: (1) flexible, (2) average, and (3) stiff, based on the flexibility level at T0 (S&R values of >10 cm, >0 but 0.05) over time. In conclusion, this investigation demonstrated that an SMR session of both feet was able to increase posterior muscular chain flexibility up to one hour after intervention. Considering that a standard training session generally lasts one hour, our study can help professionals take advantage of SMR effects for the entire training period. Furthermore, our results also demonstrate that physical exercise practitioners should also assess individuals’ flexibility before training, as the SMR procedure used in this work does not seem necessary in flexible individuals.
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- 2023
41. Echocardiogram in athlete’s heart
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Antonello D’Andrea, Stefano Palermi, Marc Dweck, Andre La Gerche, and Matteo Cameli
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- 2023
42. The Effect of Exercise Training on Irisin Secretion in Patients with Type 2 Diabetes: A Systematic Review
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Marco Vecchiato, Emanuele Zanardo, Francesca Battista, Giulia Quinto, Chiara Bergia, Stefano Palermi, Federica Duregon, Andrea Ermolao, Daniel Neunhaeuserer, Vecchiato, M., Zanardo, E., Battista, F., Quinto, G., Bergia, C., Palermi, S., Duregon, F., Ermolao, A., and Neunhaeuserer, D.
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diabetes ,diabete ,exercise prescription ,FNDC5 ,high-intensity interval training ,physical activity ,General Medicine - Abstract
Introduction: Irisin is a myokine considered to be a potential mediator of exercise-induced energy metabolism and its secretion is known to promote the browning of beige fat cells in white adipose tissue. However, it is currently not known which exercise protocol is the best to enhance irisin concentration in patients with type 2 diabetes (T2D). Objective: The purpose of this study is to provide a review investigating the irisin response to different exercise training modalities and intensities in T2D. Methods: A systematic literature search was performed in May 2022. Results: After the selection process from 938 articles, six studies were included. Selected papers presented different exercise training interventions regarding intensity and modality. One study reported no significant differences in serum irisin levels after exercise training, whereas the other five showed a higher increase in serum irisin levels after exercise training with higher differences in irisin secretion after high-intensity training (HIT). No consideration was possible on exercise modalities. Conclusions: The impact of training intensity and modality was found to be partly discordant but data seem to suggest that HIT promotes greater irisin secretion. Despite the limited evidence, HIT, both in interval and continuous modalities, could be suggested as valid exercise training to increase circulating irisin in patients with T2D.
- Published
- 2023
43. Clinical and multi-modality imaging approach in the selection of patients for left atrial appendage closure
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Antonello D’Andrea, Andrea Manto, Cesare Sirignano, Gaetano Quaranta, Massimo Ragni, Gemma Marrazzo, Anna Lombardi, Fabio Pastore, Renato Gioia, Raffaella Scarafile, Stefano Palermi, and Lucia Riegler
- Subjects
left atrial appendage occlusion ,Patient Selection ,emboli ,General Medicine ,multi-imaging ,Multimodal Imaging ,stroke ,Treatment Outcome ,RC666-701 ,cardiovascular system ,Humans ,Diseases of the circulatory (Cardiovascular) system ,Atrial Appendage ,atrial fibrillation ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine - Abstract
Atrial fibrillation (AF) can lead to embolic stroke and in subjects with non-valvular AF most of thrombi are sited in the left atrial appendage (LAA). LAA is a structure located in the free wall of heart with a wide variable and complex anatomy. LAA occlusion (LAAO) could be taken in consideration in subjects with non-valvular AF and who cannot have long-term anticoagulant therapy. It is a complex preventive procedure given the high variability of patients characteristics and several LAAO devices available nowadays. Moreover, the ideal postprocedural antithrombotic strategy is still unclear. In this review we aim to describe clinical features of patients committed for LAA occlusion and the function of multimodality imaging in subjects selection, procedural management and follow up.
- Published
- 2021
44. Relationship Between Cardiorespiratory Fitness, Baseline Blood Pressure and Hypertensive Response to Exercise in the Ferrari Corporate Population
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Stefano Palermi, Massimo Volpe, Maria Grazia Signorello, Lorena De Martino, George Emil Manole, Alessandro Biffi, Fredrick Fernando, Giovanna Gallo, Felice Sirico, Biffi, A., Gallo, G., Fernando, F., Sirico, F., Signorello, M. G., De Martino, L., Manole, G. E., Palermi, S., and Volpe, M.
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Adult ,medicine.medical_specialty ,hypertension ,exercise stress testing ,Population ,Blood Pressure ,hypertensive response to exercise ,corporate wellness ,cardiorespiratory ftness ,Internal medicine ,Heart rate ,Internal Medicine ,medicine ,Humans ,Risk factor ,education ,Exercise ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,VO2 max ,Cardiorespiratory fitness ,Corporate wellne ,Middle Aged ,Cross-Sectional Studies ,Blood pressure ,Cardiorespiratory Fitness ,Cardiovascular Diseases ,Physical Fitness ,Cardiorespiratory fitne ,Exercise Test ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Body mass index - Abstract
Aim: To evaluate the incidence and clinical significance of impaired cardiorespiratory fitness (CRF) and the association with baseline blood pressure (BP) levels and hypertensive response to exercise (HRE). Methods: A cross-sectional study was conducted on a total sample of 2058 individuals with a mean age of 38 ± 9 years, enrolled for the first time at the Ferrari corporate wellness program “Formula Benessere”, including a maximal exercise stress testing (EST). BP and heart rate (HR) values were obtained from EST at rest, during exercise and recovery time. CRF was arbitrarily classified according to estimated VO2 max in optimal, normal, mildly and moderately reduced. Results: One-hundred and thirty-nine individuals of 2058 (6.7%) showed a moderate CRF reduction assessed by EST. Subjects with elevated resting and/or exercise BP showed a worse CRF than those with normal BP levels, also after the adjustment for age, sex, body mass index, smoking habits, peak SBP and DBP. Seventy-seven individuals (3.7%) showed an HRE during EST, with normal baseline BP levels. Conclusion: About 7% of a corporate population showed a significantly reduced CRF, assessed by EST. Individuals with lower levels of CRF have higher resting and/or peak exercising BP values after adjusting for co-variables. This study expands the role of EST outside of traditional ischemic CVD evaluation, towards the assessment of reduced CRF and HRE in the general population, as a possible not evaluated CV risk factor.
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- 2021
45. 320 THE POTENTIAL ROLE OF ECHOCARDIOGRAPHY IN THE PRE-PARTICIPATION SCREENING: RESULTS OF AN OBSERVATIONAL RETROSPECTIVE STUDY
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Federica Donati, Claudio Guicciardi, Elisa Lodi, Maria Grazia Modena, Stefano Palermi, Alessandro Biffi, and Frederick Fernando
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Cardiology and Cardiovascular Medicine - Abstract
Introduction Preparticipation screenings (PPs) have been conceived for the potential to prevent SCD in young athletes by early identification of hidden cardiac diseases. Commonly used protocols include history collection, physical examination and baseline electrocardiogram. Nevertheless, transthoracic echocardiography has been hypothesized to have a primary role in the PPs. Aim of the Study The aim of the present paper was to evaluate the potential role of echocardiogram in identifying life-threatening cardiovascular abnormalities that might be undetected by commonly used PPS. Methods We retrospectively reviewed a corporate wellness program - database and analyzed data recorded from 2017 to 2022 to compare two medical models: a “standard” PPS including medical history, physical examination, electrocardiogram (ECG) and exercise stress test (EST); an “advanced” PPS comprising history, physical examination, ECG, EST and echocardiography. The primary outcome of the study was to assess the efficacy of the advanced PPS in detecting CV abnormalities compared to the “standard” PPS. Results We analyzed data from 500 subjects (420 male, 33.69 ± 7.9 mean aged) enrolled for the first time in the corporate wellness program between 2017 and 2022. 339 (67.8%) subjects had no pathological findings at “standard” PPS and, even if would have not required further evaluation including echocardiogram, performed the ultrasound exam anyway (“advanced” PPS): 31 (9.1%) showed some abnormal findings at echocardiography. Conclusions Even if with some limitations, performing a screening echocardiogram could help to detect subjects with some form of cardiovascular morpho-functional abnormalities, otherwise difficult to diagnose with “standard” PPS protocol.
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- 2022
46. Incremental value of compression ultrasound sonography in the emergency department
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Stefano Palermi, Maria Acitorio, Andrea Vergara, Alfonso Desiderio, Franco Iodice, Alessandro Serio, Renato Gioia, Simona Sperlongano, Antonello D'Andrea, Alessandro Di Vilio, Francesco Gambardella, Di Vilio, Alessandro, Vergara, Andrea, Desiderio, Alfonso, Iodice, Franco, Serio, Alessandro, Palermi, Stefano, Gambardella, Francesco, Sperlongano, Simona, Gioia, Renato, Acitorio, Maria, and D'Andrea, Antonello
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medicine.medical_specialty ,Modern medicine ,business.industry ,Minireviews ,Emergency department ,Compression ultrasound ,medicine.disease ,Venous thrombosis ,Embolism ,Deep venous thrombosis ,medicine ,Critical care ultrasonography ,Radiology ,Thrombus ,business ,Venous ultrasound ,Venous thromboembolism ,Lower limbs venous ultrasonography ,Deep venous thrombosi - Abstract
The quick evaluation of venous thromboembolism is a key point of modern medicine since the delayed diagnosis is associated with a worse prognosis. Venous ultrasound (VU) is a sensitive and rapidly performed test in cases of suspected deep venous thrombosis. Various protocols have been proposed for its execution, such as the study of the whole deep venous circulation of the lower limb or the analysis of the femoral-popliteal area. The aim is to detect a vessel thrombus and the most sensitive element is the non-compressibility with the probe. Initially, the thrombus is hypoechogenic and adherent to the vessel; later, it tends to organize and recanalize. Usually, in the early stages, the risk of embolism is higher. The role of studying the iliac axis and calf veins is still uncertain. VU is not useful for assessing response to anticoagulation therapy and it is unclear whether the persistence of thrombotic abnormalities can guide on a possible prolongation of therapy.
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- 2021
47. Potential role of an athlete-focused echocardiogram in sports eligibility
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Fabrizio Ricci, Antonello D'Andrea, Alessandro Serio, Marco Vecchiato, Franco Iodice, Felice Sirico, Stefano Palermi, Vincenzo Russo, Juri Radmilovic, Francesco Gambardella, Palermi, S., Serio, A., Vecchiato, M., Sirico, F., Gambardella, F., Ricci, F., Iodice, F., Radmilovic, J., Russo, V., and D'Andrea, A.
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medicine.medical_specialty ,Myocarditis ,Sports medicine ,Heart disease ,Echocardiogram ,Physical examination ,Review ,Sport eligibility ,Sudden cardiac death ,Pericarditis ,Athlete ,Athletes ,Pre-participation screening ,Sport cardiology ,medicine ,Intensive care medicine ,medicine.diagnostic_test ,biology ,business.industry ,medicine.disease ,biology.organism_classification ,Grey zone ,Cardiology and Cardiovascular Medicine ,business - Abstract
Sudden cardiac death (SCD) of an athlete is a rare but tragic event and sport activity might play a trigger role in athletes with underlying structural or electrical heart diseases. Preparticipation screenings (PPs) have been conceived for the potential to prevent SCD in young athletes by early identification of cardiac diseases. The European Society of Cardiology protocol for PPs includes history collection, physical examination and baseline electrocardiogram, while further examinations are reserved to individuals with abnormalities at first-line evaluation. Nevertheless, transthoracic echocardiography has been hypothesized to have a primary role in the PPs. This review aims to describe how to approach an athlete-focused echocardiogram, highlighting what is crucial to focus on for the different diseases (cardiomyopathies, valvulopathies, congenital heart disease, myocarditis and pericarditis) and when is needed to pay attention to overlap diagnostic zone (“grey zone”) with the athlete's heart. Once properly tested, focused echocardiography by sports medicine physicians may become standard practice in larger screening practices, potentially available during first-line evaluation.
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- 2021
48. Are Football Players More Prone to Muscle Injury after COVID-19 Infection? The 'Italian Injury Study' during the Serie a Championship
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Alessandro Corsini, Andrea Bisciotti, Raffaele Canonico, Andrea Causarano, Riccardo Del Vescovo, Pierluigi Gatto, Paolo Gola, Massimo Iera, Stefano Mazzoni, Paolo Minafra, Gianni Nanni, Giulio Pasta, Ivo Pulcini, Stefano Salvatori, Marco Scorcu, Luca Stefanini, Fabio Tenore, Stefano Palermi, Maurizio Casasco, and Stefano Calza
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football ,risk factor ,COVID-19 ,epidemiology ,muscle injury ,Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health - Abstract
Introduction: Football was the first sport to resume competitions after the coronavirus disease 2019 (COVID-19) lockdown and promptly the hypothesis was raised of a potential relationship between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and musculoskeletal injuries in athletes. This study aimed to confirm the association between SARS-CoV-2 infection and muscle strain injury in a large population of elite football players and to investigate if the COVID-19 severity level could affect the risk of injury. Methods: A retrospective cohort study involving 15 Italian professional male football teams was performed during the Italian Serie A 2020–2021 season. Injuries and SARS-CoV-2 positivity data were collected by team doctors through an online database. Results: Of the 433 included players, we observed 173 SARS-CoV-2 infections and 332 indirect muscle strains. COVID-19 episodes mostly belonged to severity level I and II. The injury risk significantly increased after a COVID-19 event, by 36% (HR = 1.36, CI95% 1.05; 1.77, p-value = 0.02). The injury burden demonstrated an 86% increase (ratio = 1.86, CI95% 1.21; 2.86, p-value = 0.005) in the COVID-19 severity level II/III versus players without a previous SARS-CoV-2 infection, while level I (asymptomatic) patients showed a similar average burden (ratio = 0.92, CI95% 0.54; 1.58, p-value = 0.77). A significantly higher proportion of muscle–tendon junction injuries (40.6% vs. 27.1%, difference = 13.5%, CI95% 0.002%; 26.9%, p-value = 0.047) was found when comparing level II/III versus Non-COVID-19. Conclusions: This study confirms the correlation between SARS-CoV-2 infection and indirect muscle injuries and highlights how the severity of the infection would represent an additional risk factor.
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- 2023
49. Limited diagnostic value of questionnaire-based pre-participation screening algorithms: a 'risk-exposed' approach to sports activity
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Stefano Palermi, Felice Sirico, Fredrick Fernando, Giampietro Gregori, Immacolata Belviso, Fabrizio Ricci, Flavio D’Ascenzi, Elena Cavarretta, Mariarosaria De Luca, Francesco Negro, Stefania Montagnani, Josef Niebauer, Alessandro Biffi, Palermi, Stefano, Sirico, Felice, Fernando, Fredrick, Gregori, Giampietro, Belviso, Immacolata, Ricci, Fabrizio, D'Ascenzi, Flavio, Cavarretta, Elena, DE LUCA, Mariarosaria, Negro, Francesco, Montagnani, Stefania, Niebauer, Josef, and Biffi, Alessandro
- Subjects
Pharmacology ,Male ,Physiology ,cardiovascular prevention ,General Medicine ,questionnaires ,pre-participation screening ,sport eligibility ,Sports Medicine ,United States ,Electrocardiography ,Surveys and Questionnaires ,Drug Discovery ,Humans ,cardiovascular prevention, pre participation screening, questionnaires, sport eligibility ,Algorithms ,Aged ,Retrospective Studies ,Sports - Abstract
Background Several pre-participation screening algorithms (PPSAs) have been proposed to assess sports eligibility in different populations. They are usually based on self-administered questionnaires, without further medical assessment if no risk factors are documented. The Med-Ex “Formula Benessere” worksite program includes a complete cardiovascular (CV) screening for all participants. The purpose of this study was to assess PPSAs accuracy in detecting medical and/or CV abnormalities in the general population, comparing the results with the date derived from Med-Ex program. Methods The Med-Ex medical evaluation, consisting of medical history, physical examination (including body composition), resting electrocardiogram (ECG) and exercise stress test in 464 male subjects (38.4 aged) was analyzed and matched to several PPSAs – Physical Activity Readiness Questionnaire (PAR-Q) (2002–2020), American Heart Association (AHA)/American College of Sport Medicine (ACSM) (1998–2009–2014–2015), European Association of Cardiovascular Prevention and Rehabilitation (EACPR) (2011) – retrospectively simulated. Results Five-hundred and 67 abnormalities were detected though Med-Ex medical evaluation, and one-fourth (24%) would have been undetected applying PPSA alone. In particular 28% of high blood pressure, 21% of impaired fasting glycaemia, 21% of high Body Mass Index (BMI) values and 19% of ECG abnormalities would have been missed, on average, by all PPSAs. Conclusions The simulation analysis model performed in this study allowed to highlight the limits of PPSAs in granting sport eligibility, compared to a medical-guided CV screening. These findings emphasize the importance of a more balanced approach to pre-participation screening that includes a thorough evaluation of the cost/benefit ratio.
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- 2022
50. COVID-19 Myocarditis: Prognostic Role of Bedside Speckle-Tracking Echocardiography and Association with Total Scar Burden
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Antonello D’Andrea, Luigi Cante, Stefano Palermi, Andreina Carbone, Federica Ilardi, Francesco Sabatella, Fabio Crescibene, Marco Di Maio, Francesco Giallauria, Giancarlo Messalli, Vincenzo Russo, Eduardo Bossone, D'Andrea, A., Cante, L., Palermi, S., Carbone, A., Ilardi, F., Sabatella, F., Crescibene, F., Di Maio, M., Giallauria, F., Messalli, G., Russo, V., Bossone, E., D'Andrea, Antonello, Cante, Luigi, Palermi, Stefano, Carbone, Andreina, Ilardi, Federica, Sabatella, Francesco, Crescibene, Fabio, Di Maio, Marco, Giallauria, Francesco, Messalli, Giancarlo, Russo, Vincenzo, and Bossone, Eduardo
- Subjects
Adult ,Male ,Prognosi ,SARS-CoV-2 ,Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,COVID-19 ,Stroke Volume ,Middle Aged ,Prognosis ,cardiac magnetic resonance ,Ventricular Function, Left ,Cicatrix ,Myocarditis ,myocarditis ,speckle-tracking echocardiography ,total scar burden ,myocarditi ,Echocardiography ,Humans ,RNA, Viral ,Female ,Human - Abstract
SARS-CoV2 infection, responsible for the COVID-19 disease, can determine cardiac as well as respiratory injury. In COVID patients, viral myocarditis can represent an important cause of myocardial damage. Clinical presentation of myocarditis is heterogeneous. Furthermore, the full diagnostic algorithm can be hindered by logistical difficulties related to the transportation of COVID-19 patients in a critical condition to the radiology department. Our aim was to study longitudinal systolic cardiac function in patients with COVID-19-related myocarditis with echocardiography and to compare these findings with cardiac magnetic resonance (CMR) results. Patients with confirmed acute myocarditis and age- and gender-matched healthy controls were enrolled. Both patients with COVID-19-related myocarditis and healthy controls underwent standard transthoracic echocardiography and speckle-tracking analysis at the moment of admission and after 6 months of follow-up. The data of 55 patients with myocarditis (mean age 46.4 ± 15.3, 70% males) and 55 healthy subjects were analyzed. The myocarditis group showed a significantly reduced global longitudinal strain (GLS) and sub-epicardial strain, compared to the control (p < 0.001). We found a positive correlation (r = 0.65, p < 0.0001) between total scar burden (TSB) on CMR and LV GLS. After 6 months of follow-up, GLS showed marked improvements in myocarditis patients on optimal medical therapy (p < 0.01). Furthermore, we showed a strong association between baseline GLS, left ventricular ejection fraction (LVEF) and TSB with LVEF at 6 months of follow-up. After a multivariable linear regression analysis, baseline GLS, LVEF and TSB were independent predictors of a functional outcome at follow-up (p < 0.0001). Cardiac function and myocardial longitudinal deformation, assessed by echocardiography, are associated with TSB at CMR and have a predictive value of functional recovery in the follow-up.
- Published
- 2022
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