1,720,997 research outputs found
Presbyastasis: from diagnosis to management
No full textCurrently, the elderly population (>65 years old) is in very growth. In fact, in Italy old age index (number of elderly per 100 persons under the age of 14 years) is estimated to be 157,7 and is projected to increase to 257,9 in the year 20651,2. The increase of the elderly population determines the increase of the age-dependent diseases including also impairment of the vestibular function, this problem is defined "presbiastasia". Patient suffering from this condition exhibit disturbances of static and dynamic postural control with far less frequent cases of relapsing objective rotatory vertigo. Occasionally, they also report a feeling of insecurity in new or unknown environments, increasing the risk of falls. These balance disorders significantly affect patients’ private and social life, as they interfere with a large number of daily activities, as transfer into bed, ambulation, car transfers, eating, using of telephone. The number of patients with this disease is expected to increase with the rise in the number of elderly population and this has important implications on the national health system's resources. Thus, the rehabilitation of these balance disorders presents serious difficulties. This explains the great number of techniques, with or without the use of equipment, which have so far been proposed. Some authors suggested to apply actual protocols, more or less modifiable according to patient characteristics; others recommended individual exercises or special equipment-aided techniques. In these cases, vestibular rehabilitation allows to stimulate the equilibrium system by preventing and slowing down the effects of aging, through the use of "adaptive, substitutive and custom" strategies
IS THERE A RELATIONSHIP BETWEEN MILD-MODERATE BACK PAIN AND FRAGILITY FRACTURES? ORIGINAL INVESTIGATION
No full textIntroduction: Fragility fractures are the cause of 43 thousand deaths: 50% are caused by femur fractures, 28% by vertebral fractures and 22% by various fractures in women, in men the percentages are 47%, 39% and 14% respectively. Vertebral fractures are the most common, 30-50% women over age 50 will experience one of them. Worldwide, is estimated that a new vertebral fracture occurs every 22 seconds. Additionally, vertebral fractures strongly predict the risk of both further fractures and re-fractures, in any skeletal segment. Vertebral fractures are often asymptomatic. Early diagnosis of these is extremely important. The aim of the study is to show, within a population of women over-50 in post-menopause, the correlation between mild-moderate back pain and fragility fractures, pain intensity and number of fractures to decide an early diagnostic path reducing new fractures risk. Materials and method: This observational study was conducted between January 2016 and January 2018 with a total examination of 4000 physiatric outpatient, 615 were over 50 years old woman with back pain for at least 3 months not responding to conservative treatment and with NRS between 2 and 4; 513 patients have been enrolled in this study. All patients are physiatric outpatient at the U.O.C. of Rehabilitation of University Hospital “P. Giaccone” of Palermo. We include Post-menopausal women over 50, having intermittent back pain for for at least 3 months, not responding to conservative treatment, with NRS between 2 and 4 and SF 36 between 60 and 100. We do not include patient with rheumatological pathologies, recent traumas, bone metastasis, osteomyelitis and previous vertebral fracture. All patients underwent a instrumental examination was also conducted with a dorsal-lombar X-Ray (L/L), in standing position. The semi-quantitative morphometric Genant method was used for the diagnosis of the vertebral fractures. Result: Data analysis showed that 41% (213/513) have vertebral fractures at dorsal-lombar X- Ray in L/L projection, using the semi-quantitative morphometric Genant method. 685 vertebral fractures have been shown with an average of 3.2 per patient: 74,59% are dorsal vertebral fractures and 24.1% are lombar. 77.5 % (165) of patients referred an NRS rate between 2 and 3 (first group) and 22.5% (48) a rate of 4 (second group). 66.1% of patients belonging to the first group showed more than 3 fractures and 33.9% from 1 to 2 vertebral fractures. 89.6% of patients belonging to second group has more than 3 fracture, 10.4% from 1 to 2 vertebral fractures. The Fischer test showed a P-value <0,001 regarding correlation between NRS and number of vertebral fragility fractures. Conclusion: As we underline in the introduction, vertebral fractures are usually asymptomatic and, consequently undiagnosed. This observational study demonstrate that mild-moderate back pain, in post menopause woman resistant to conservative therapy and still with a good quality of life, is a significant symptom for an early diagnosis of vertebral fragility fractures. © 2020 A. CARBONE Editore. All rights reserved
Efficacy of extracorporeal shock wave therapy and nutraceutical supplementation in the treatment of lateral epicondylitis: a randomized controlled trial
Full text linkIntroductionNumerous scientific papers have compared different treatment options in the management of lateral epicondylitis. Our study evaluated the efficacy of focal extracorporeal shock wave treatment (ESWT) combined with an integrative nutraceutical treatment of hyaluronic acid, collagen, vitamin C, and manganese, compared with single treatment in patients with lateral epicondylitis in terms of improvement of pain, functional capacity, muscle strength, and reduction of inflammation on ultrasound images.MethodsA single-center, randomized controlled trial (RCT) was conducted in a population of patients with lateral epicondylitis. Patients were enrolled and randomly divided into 3 groups: Group A, consisting of 15 patients who were treated with twenty sessions of therapeutic exercise and five focal ESWT sessions (one session every six days); Group B, consisting of 15 patients who performed twenty sessions of therapeutic exercise and took daily a dietary supplement consisting of Hyaluronic Acid 200 mg, Collagen 5,000 mg, Vitamin C 250 mg and Manganese 10 mg for thirty days; and Group C, consisting of 15 patients, who received a combined treatment of therapeutic exercise, focal ESWT and nutraceutical supplementation The Numerical Rating Scale (NRS) and Patient-Rated Tennis Elbow Evaluation Scale (PRTEE) were administered during the first physiatric examination (T0), at 15 days after the start of treatment (T1), and at a 30-day follow-up (T2). In addition, muscle strength (Handgrip strength) was analyzed by means of a dynamometer, and common extensor tendon thickness (CET Thickness) by ultrasound examination.ResultsData analysis showed that NRS scale scores decreased significantly only in group B at T1 (P < 0.05), and in the three groups at T2 (P < 0.05). Grip strength increased significantly after 30 days only in group C (P < 0.05), while PRTEE scores and CET Thickness decreased significantly at T2 in the three groups (P < 0.05). The comparison among the various groups also showed that the Group C showed statistically significant improvements of function and grip strength at T2, compared with the other groups (P < 0.05).DiscussionOur study demonstrated that the combination of focal ESWT, therapeutic exercise, and nutraceutical supplementation, represent a viable therapeutic option for the management of lateral epicondylitis; likewise, the proposed treatments resulted in a synergistic effect for pain relief and functional recovery in the short term, providing a decrease in the inflammatory state and an increase in muscle strength
Combination of Rehabilitative Therapy with Ultramicronized Palmitylethanolamide for Chronic Low Back Pain: An Observational Study
Full text linkChronic low ba,:k pain (LBP) caused by intervertebral disc herniation was reported in the 2010 Global Burden of Disease study to be the main reason for;zears lived wittL disability. It causes significant personal, social, and economic burdens. Many of those who suffer from LBP find convent:ional medica.l treatments to be unsatisfactory for treating their pain, so they are increasingl'g resorting tcr complementary and alternalive medicine (CAM) therapies. Given that thr: population ir; aging, there is an urgent need to characterize the combinations of complementary therapie:; that yield the best outcomes and treatments, even for prolonged periods. The multiple action of PEA in connbination with CAVI therapies may represent the multitarget approachr needed trc tackle the as-yet unsolved problem of chronic pain resistant to conventional therapie
Combined Rehabilitation with Alpha Lipoic Acid, Acetyl-L-Carnitine, Resveratrol, and Cholecalciferolin Discogenic Sciatica in Young People: A randomized Clinical Trial
Full text linkBackground and Objectives: In the Western world, back pain and sciatica are among the
main causes of disability and absence from work with significant personal, social, and economic
costs. This prospective observational study aims to evaluate the effectiveness of a rehabilitation
program combined with the administration of Alpha Lipoic Acid, Acetyl-L-Carnitine, Resveratrol,
and Cholecalciferol in the treatment of sciatica due to herniated discs in young patients in terms of
pain resolution, postural alterations, taking painkillers, and quality of life. Materials and Methods: A
prospective observational study was conducted on 128 patients with sciatica. We divided the sample
into 3 groups: the Combo group, which received a combination of rehabilitation protocol and daily
therapy with 600 mg Alpha Lipoic Acid, 1000 mg Acetyl-L-Carnitine, 50 mg Resveratrol, and 800 UI
Cholecalciferol for 30 days; the Reha group, which received only a rehabilitation protocol; and the
Supplement group, which received only oral supplementation with 600 mg Alpha Lipoic Acid, 1000
mg Acetyl-L-Carnitine, 50 mg Resveratrol, and 800 UI Cholecalciferol. Clinical assessments were
made at the time of recruitment (T0), 30 days after the start of treatment (T1), and 60 days after the end
of treatment (T2). The rating scales were as follows: the Numeric Rating Scale (NRS); the Oswestry
Disability Questionnaire (ODQ); and the 36-item Short Form Health Survey (SF-36). All patients
also underwent an instrumental stabilometric evaluation. Results: At T1, the Combo group showed
statistically superior results compared to the other groups for pain (p < 0.05), disability (p < 0.05), and
quality of life (p < 0.05). At T2, the Combo group showed statistically superior results compared
to the other groups only for pain (p < 0.05) and quality of life (p < 0.05). From the analysis of the
stabilometric evaluation data, we only observed a statistically significant improvement at T2 in the
Combo group for the average X (p < 0.05) compared to the other groups. Conclusions: The combined
treatment of rehabilitation and supplements with anti-inflammatory, pain-relieving, and antioxidant
action is effective in the treatment of sciatica and can be useful in improving postural stabilit
Effectiveness rehabilitative therapy and Pridinol Mesylate in low back pain
Full text linkBackground: Spondylarthritis is a degenerative disease involving the
intervertebral disc, vertebral bodies, and adjacent soft tissues. Treatment aims
to slow disease progression and manage symptoms through an interdisciplinary
approach. It can be conservative and rarely chirurgic.
Objective: This study aimed to evaluate the effectiveness of a rehabilitation
combined with Pridinol Mesylate in the treatment of Spondylarthritis in elderly
patients in terms of pain resolution, improving disability, and quality of life.
Materials and methods: We conducted a retrospective study on patients with
Spondylarthritis. The patients recruited (n = 86) were divided into three groups:
the Combined Group (CG:28), who received a rehabilitation combined with
Pridinol Mesylate (16 women and 12 men, age 66.4 ± 3.99); the Rehabilitation
Group (RG, n = 26), who received only rehabilitation (14 women and 12 men, age
66.2 ± 3.84); and the Drug Group (DG: 32), who received only the administration
of the Pridinol(18 women and 14 men, age of 66.3 ± 3.9).
Results: The results show, at T1 (20 days after treatment) in the CG, statistically
significant improvements for the NRS and QBPDS. In the RG, statistically
significant improvements were observed only for the QBPDS scale. In the
DG group, only pain improvement. At T2 (90 days after treatment), the CG
showed improvements in NRS, QBPDS, and (SF-36). The RG and DG showed
improvements for NRS and for QBPDS. By Bonferroni method, obtained
statistically significant values for CG versus RG and for CG versus DG. No
statistical significance was found between RG versus DG.
Conclusion: Targeted rehabilitation treatment, combined with Pridinol Mesylate,
reduced pain and improved disability in lumbar Spondylarthritis both in the short
and medium term, with improved quality of life in elderly patient
Efficacy and tolerability of a fixed dose combination of cortex phospholipid liposomes and cyanocobalermin for intramuscular use in peripheral neuropathies
No full textPeripheral neuropathies are frequently encourtered in clinical practice and are assiociated with a major impairment in quality of life . Howewvwr, their management reamans poor, and current therapies are often burdened with major side effects and can present poor efficacy on pain and functionality. Therefore, it has been suggested that the combination of two or more different drugs may improve analgesis efficacy and reduce side effects. Tricortin 1000 is formulated with 12 mg of Brain cortex phospholipid liposomes + 1000 microgrammi of Cyanocobalamin injectable (PL+ CNCb1) for intramuscolar use and is indicated in the tratment of poly-algo-neuropathic syndromes. This combination exerts a marked neurotrophic action by promoting the syntesis of endogenous phospholipids; moreover the peculiar formulation optimized the delivery of CNCb1 wich has analgesis and neurotrophic action. This paper discusses the pharmacotherapy of peripheral neuropathies, including low back pain, neck pain, post herpetic neuropathy (PHN) and focuses on the fixed dose combination PL+CNCb1 ckinical efficacy in association with other treatment or in monotherapy
2020 Reply to: Denosumab for bone health in prostate and breast cancer patients receiving endocrine therapy? A systematic review and a meta-analysis of randomized trials
No full textLa nutraceutica: uno strumento terapeutico nella gestione del dolore
No full textPer “nutraceutica” (neologismo sin
cratico tra “nutrizione” e “farmaceuti
ca” coniato nel 1989 da Stephen de
Felice) si intende una categoria di so
stanze alimentari che mostrano attivi
tà terapeutica, inglobate nella più am
pia categoria degli Integratori Alimen
tari [1]. I principi attivi presenti in tali
prodotti giocano un ruolo sempre più
importante nell’ambito della gestione
del dolore in quanto per molte di que
ste sostanze sono state riconosciute at
tività antalgiche con conseguente effi
cacia clinica. L’impiego di sostanze
nutraceutiche sul dolore è infatti oggi
abbastanza diffuso, soprattutto come
strumento di supporto alle terapie far
macologiche, finalizzato ad una ridu
zione del dosaggio del farmaco e ai
possibili effetti collaterali [2]. Appare
pertanto fondamentale approfondire
la conoscenza degli attivi e delle loro
proprietà, nonché della qualità dei
prodotti disponibili sul mercato
Effectiveness of cryo plus ultrasound therapy versus diathermy in combination with high-intensity laser therapy for pain relief in footballers with muscle injuries: A prospective study
No full textBACKGROUND: Muscle injuries are common traumatic events in the clinical practice of the rehabilitation field. There is still a
gap in the scientific literature on the effectiveness of physical agent modalities in the management of muscle injuries in athletes.
OBJECTIVE: The aim of this study was to assess the effectiveness of cryo plus ultrasound therapy com-pared to diathermy in
combination with high-intensity laser therapy (HILT) for pain relief in professional footballers with muscle injuries.
METHODS: A case-control study was conducted on 31 professional footballers with a muscle injury of the lower limbs. Of these,
17 patients, assigned to a Group A (AG), were treated with HILT and cryoultrasound therapy; the remaining 14 patients, assigned
to a Group B (BG), underwent HILT and diathermy. We assessed the extent of the pain, the size of the muscle injury, frequency of
recurrence and number of days to recovery, at the time of recruitment, at the end of the rehabilitation and 3 months after the injury.
RESULTS: Group A athletes had a greater benefit on pain (4.65 ± 0.61 vs 3.24 ± 0.63; p < 0.05) and muscle injury recurrence.
The return to play in the athletes of group A took place 4.73 days earlier.
CONCLUSION: HILT and cryo plus ultrasound therapy, in combination with therapeutic exercise, rep-resent a valid strategy in
the treatment of muscle injuries in professional footballers
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