1,721,056 research outputs found
Letter to the Editor concerning: "Reliability and validity of non-radiographic methods of thoracic kyphosis measurement: A systematic review." by Barrett E, McCreesh K, Lewis J. Man Ther. 2014 Feb; 19(1):10-7
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Are Back Schools beneficial for patients with chronic non-specific low back pain? - A Cochrane Review summary with commentary
No full textThe economic and institutional determinants of trade expansion in Bronze Age Greater Mesopotamia
Full text linkThe focus of archaeologists on reconstructing exchange and communication networks in the past resulted in the enormous improvement of methods for analyzing material flows and detecting trade routes. However, our understanding of the determinants of trade patterns over time and space is still limited. To help tackle this issue, we study through regression analysis the rich economic and institutional experience of Bronze Age Greater Mesopotamia. Our testable predictions originate from three main economic theories of trade expansion. First, because of trade costs, mutually beneficial exchanges are discouraged by distance and encouraged by the relative size of markets. Second, trade expands when more suitable farming conditions in neighboring polities allow consumption risk-sharing. Finally, trade develops when interlocking exchange circuits ease the canalization of goods from the outside by providing secure routes, a more certain resolution of legal disputes and credit provision. Ordinary Least Squares—OLS—estimates based on data on 44 major Mesopotamian polities observed for each half-century between 3050 and 1750 BCE are consistent with these predictions. Our approach provides a robust theory-based empirical strategy for integrating archaeological, environmental, and historical data and calls for a tighter interdisciplinary cooperation
Approccio integrato alla cervicalgia con terapia manuale
No full textSecondo la definizione dell’IFOMT (International Federation of Orthopaedic Manipulative Therapists), “la Terapia Manuale Ortopedica è un’area specializzata della fisioterapia per il trattamento delle condizioni neuro-muscolo-scheletriche, basata sul ragionamento clinico, che utilizza approcci terapeutici altamente specializzati, comprendenti tecniche manuali ed esercizi terapeutici. Inoltre la Terapia Manuale Ortopedica comprende, ed è guidata dall’evidenza scientifica e clinica disponibile e dalla struttura biopsicosociale di ogni paziente”.
Gli obiettivi terapeutici e la programmazione dell’intervento riabilitativo dipendono dal ragionamento clinico. Dalla valutazione iniziale discende la diagnosi funzionale, che consente di individuare gli obiettivi terapeutici e, in subordine a questi, le procedure terapeutiche più indicate per ottenerli e i migliori strumenti di verifica di efficacia.
Gli obiettivi terapeutici nella cervicalgia aspecifica si rifanno alle tre fasi che caratterizzano la riabilitazione:
- controllo dell’infiammazione, riduzione dell’edema e riduzione del dolore;
- miglioramento della mobilità, del controllo motorio, della forza e della resistenza;
- educazione alla gestione del problema, per favorire il pieno ritorno alle normali attività quotidiane ed alla vita di relazione.
Alcuni esempi di obiettivi riabilitativi (O.R.) e strumenti terapeutici (S.T.) nella cervicalgia aspecifica:
1) O.R.: alleviare i sintomi. S.T.: trazione, traslazione, pompages
2) O.R.: favorire la mobilità. S.T.: mobilizzazione dei tessuti molli (massaggio, stretching), mobilizzazione articolare (mobilizzazioni, manipolazioni), mobilizzazione del sistema nervoso (neurodinamica)
3) O.R.: rieducare il controllo motorio. S.T.: tecniche rivolte a propriocezione e coordinazione; esercizi per migliorare forza e resistenza
4) O.R.: sostenere e controllare la postura. S.T.: educazione posturale, esercizi di stabilizzazione articolare
5) O.R.: informare e istruire. S.T.: approccio cognitivo-comportamentale, misure di profilassi, back school.
Secondo la definizione dell’IFOMT (International Federation of Orthopaedic Manipulative Therapists), “la Terapia Manuale Ortopedica è un’area specializzata della fisioterapia per il trattamento delle condizioni neuro-muscolo-scheletriche, basata sul ragionamento clinico, che utilizza approcci terapeutici altamente specializzati, comprendenti tecniche manuali ed esercizi terapeutici. Inoltre la Terapia Manuale Ortopedica comprende, ed è guidata dall’evidenza scientifica e clinica disponibile e dalla struttura biopsicosociale di ogni paziente”.
Gli obiettivi terapeutici e la programmazione dell’intervento riabilitativo dipendono dal ragionamento clinico. Dalla valutazione iniziale discende la diagnosi funzionale, che consente di individuare gli obiettivi terapeutici e, in subordine a questi, le procedure terapeutiche più indicate per ottenerli e i migliori strumenti di verifica di efficacia.
Gli obiettivi terapeutici nella cervicalgia aspecifica si rifanno alle tre fasi che caratterizzano la riabilitazione:
- controllo dell’infiammazione, riduzione dell’edema e riduzione del dolore;
- miglioramento della mobilità, del controllo motorio, della forza e della resistenza;
- educazione alla gestione del problema, per favorire il pieno ritorno alle normali attività quotidiane ed alla vita di relazione.
Alcuni esempi di obiettivi riabilitativi (O.R.) e strumenti terapeutici (S.T.) nella cervicalgia aspecifica:
1) O.R.: alleviare i sintomi. S.T.: trazione, traslazione, pompages
2) O.R.: favorire la mobilità. S.T.: mobilizzazione dei tessuti molli (massaggio, stretching), mobilizzazione articolare (mobilizzazioni, manipolazioni), mobilizzazione del sistema nervoso (neurodinamica)
3) O.R.: rieducare il controllo motorio. S.T.: tecniche rivolte a propriocezione e coordinazione; esercizi per migliorare forza e resistenza
4) O.R.: sostenere e controllare la postura. S.T.: educazione posturale, esercizi di stabilizzazione articolare
5) O.R.: informare e istruire. S.T.: approccio cognitivo-comportamentale, misure di profilassi, back school
The origins of political institutions and property rights
Full text linkWe study the possible cooperation between nonelites exerting an unobservable effort and elites unable to commit to direct transfers and, thus, always assure the nonelites’ participation. The elites can, however, incentivize investment by granting to the nonelites strong property rights to the input and a more inclusive political process, which entrusts them with control over fiscal policies. Adverse production conditions force the elites to enact strong nonelites’ political and property rights to convince them that a sufficient part of the returns on joint investments will be shared via public good provision. These reforms assure cooperation. When, instead, the expected investment return is large, the elites keep control over fiscal policies but refrain from weakening the nonelites’ property rights, while strengthening their own, if the production conditions are sufficiently opaque. Then, the expected cost of providing the extra public good guaranteeing the nonelites’ participation is too large. These predictions are consistent with novel data on 44 major Mesopotamian polities observed for each half-century from 3050 to 1750 BCE. While a lower growing season temperature favored a larger division of the decision-making power and stronger farmers’ use rights to land, only the latter are related to the diffusion of the very opaque viticulture. In addition, only the inclusiveness of the political process fostered the provision of public and ritual buildings as well as conscripted armies. Crucially, our results are robust to considering the trade potential, the severity of conflicts, and the degree of urbanization
Physical and rehabilitation medicine specialists in the medical approach to idiopathic scoliosis.
Full text linkEfficacy of bracing in early infantile scoliosis: a 5-year prospective cohort shows that idiopathic respond better than secondary—2021 SOSORT award winner
No full textPurpose: In conservative early onset scoliosis treatment, interest in bracing is growing because repeated general anaesthesia (required by casting) has been questioned for possible brain damages. We aimed to check the results in the medium term of bracing, comparing idiopathic (IIS) to secondary (SIS) infantile scoliosis. Methods: We performed a retrospective study in a consecutive prospective cohort. Inclusion criteria were: discovery of scoliosis and bracing below age 3; exclusion criteria: previous spine surgery, less than three consultations. We considered the following results: full (< 20° Cobb) and partial (< 30°) success; hold-up (progression < 5° but curve > 29°); partial (progression > 5°) and full (fusion) failure; statistics: ANOVA for repeated measures; linear mixed effect model with Cobb angle (dependent), time and diagnosis (independent) variables. Results: We included 34 infants (16 IIS and 18 SIS) of age 1·10 ± 0·10 (years·months), 44 ± 17° curves, 27 ± 10° rib vertebral angle difference, average observation 5·05 ± 3·03 years. We found progressive improvement of IIS and stability of SIS patients. Six IIS (37.5%) and one SIS (6%) reached brace weaning before puberty with 13 ± 5° (improvement 61 ± 15%, p < 0.001), after 4·11 ± 3·07 years of treatment. Three patients were fused, one IIS (6%) and two SIS (11%). Two IIS patients also reached end-of-growth with 18° (start 40° at 1·03 years) and 20° (start 32° at 2·12 years), respectively. Conclusion: Bracing shows promising results in the medium term for high-degree IIS, with very few hold-ups (19%) and failures (12%). Conversely, failures prevail for SIS (full 11%), even if the partial failure (39%) is still a time-buying strategy
Why X-rays are not reliable to assess sagittal profile: A cross sectional study
No full textBackground. X-rays are the gold standard evaluation for sagittal plane deformities even if, to see the spine, it's necessary to move the arms from the resting position to a forward one. The postural impact of arm positions has never been verified. The aim of this study is to measure the effect of arm positioning on surface topography measure. Methods. Study Design: cross sectional. Population: 83 consecutive adolescents (50 hyperkyphosis, 33 scoliosis). Hardware: 4-D Formetric. Methods: each subject has been consecutively evaluated in normal standing, then with progressive extension of the shoulders with extended arms (45°, 90°, 135°, 180°), then with arms crossed on the chest (CROSS) and with flexion of the shoulders and elbows, with hands steady on the shoulders (REST). All sagittal parameters given by Formetric have been considered. Statistics: ANOVA for total and sub-groups. Results. The absolute differences of angles from the standing position ranged from 4.8° to 13.3° (kyphosis) and from 4.6° to 10.4° (lordosis): they were statistically significantly different with rare exceptions. The biggest differences have been found with REST and 180°; the lowest with 45°, and CROSS. Lordosis and kyphosis did not change in the same direction, nor symmetrically: while kyphosis decreased with progressive arm extension, lordosis reached a maximum increase at 90-135°; REST and CROSS did not show consistent variations of lordosis and kyphosis. Changes were not consistent in several adolescents, and did not allow to find an ideal position. Conclusion. These results showed that arm position changes spinal posture, at least when measuring with surface topography. According to these results, it does not exist an optimal position comparable with the normal standing; moreover, it is not possible to reconstruct in individual patients what the real standing angles would be without moving the arms. Surface devices may possibly be more ecologic measurement instruments than radiographs because they allow the patient to maintain the normal position of their arms and so are more reliable. © 2012 The authors and IOS Press. All rights reserved
Letter concerning Adolescent idiopathic scoliosis: The possible harm of bracing and the likely benefit of exercise by Falk et al
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