169,839 research outputs found
Capitolo "Strumenti di cura: Programma farmacologico" in: Foti C, Monticone M. "Manuale di medicina fisica e riabilitativa". EDRA, Milano, 2021
No full text
Management of spasticity with onabotulinumtoxinA: practical guidance based on the italian real-life post-stroke spasticity survey
No full textThe present paper provides practical guidance on the management of adult spasticity with OnabotulinumtoxinA. Advisory Board members reviewed the available evidence and discussed their personal experiences in order to address the unmet needs in the management of spasticity with botulinum toxin type A identified by the recent Italian Real-Life Post-Stroke Spasticity Survey. Stroke patients should be referred to spasticity services that have adequate facilities and multidisciplinary teams with the necessary training, competence and expertise. The current literature shows a strong correlation between the development of post-stroke spasticity and the degree of central sensorimotor system destruction/disorganization. Use of tools such as the Poststroke Checklist may help clinicians in the long-term follow-up of stroke patients. The maximum dose of onabotulinumtoxinA - according to the current literature this ranges from 300U to 400U for upper limb and from 500U to 600U for lower limb aggregate postures - should be re-considered. In addition, there is a need for future consensus (also based on pharmacoeconomic considerations) on consistent clinical care models for the management of patients with post-stroke spasticity
Clinimetric properties and clinical utility in rehabilitation of postsurgical scar rating scales: a systematic review
No full textThe aim of this study was to review and critically assess the most used and clinimetrically sound outcome measures currently available for postsurgical scar assessment in rehabilitation. We performed a systematic review of the Medline and Embase databases to June 2015. All published peer-reviewed studies referring to the development, validation, or clinical use of scales or questionnaires in patients with linear scars were screened. Of 922 articles initially identified in the literature search, 48 full-text articles were retrieved for assessment. Of these, 16 fulfilled the inclusion criteria for data collection. Data were collected pertaining to instrument item domains, validity, reliability, and Rasch analysis. The eight outcome measures identified were as follows: Vancouver Scar Scale, Dermatology Life Quality Index, Manchester Scar Scale, Patient and Observer Scar Assessment Scale, Bock Quality of Life (Bock QoL) questionnaire, Stony Brook Scar Evaluation Scale, Patient-Reported Impact of Scars Measure, and Patient Scar Assessment Questionnaire. Scales were examined for their clinimetric properties, and recommendations for their clinical or research use and selection were made. There is currently no absolute gold standard to be used in rehabilitation for the assessment of postsurgical scars, although the Patient and Observer Scar Assessment Scale and the Patient-Reported Impact of Scars Measure emerged as the most robust scales
Aftereffect induced by prisms of different power in the rehabilitation of neglect: A multiple single case report.
No full textPost stroke: valutazione del livello di igiene orale in pazienti affetti da emiplegia. Studio sperimentale.
No full textSCOPO DEL LAVORO: dimostrare che lo stato di salute orale è negativamente influenzato dagli esiti di uno stroke.
MATERIALI E METODI: studio sperimentale condotto su due Gruppi di pazienti, Gruppo stroke composto da soggetti affetti da emiplegia destra o sinistra post stroke, e Gruppo Controllo, soggetti sani appaiati a quelli emiplegici per caratteristiche socio economiche. Tutti i pazienti sono stati sottoposti a visita odontoiatrica con il rilevamento di dati riferibili a: tonicità muscoli facciali, labbra e lingua; capacità di deglutizione; alitosi; consistenza e quantità saliva; stato di salute e di igiene di dentatura, parodonto, mucose orali; linfonodi peri-mandibolari; sintomatologia ATM. Si è inoltre valutato il grado di efficienza motoria ed intellettiva con il Mini Mental State Examination Test e il test di Aprassia Bucco-Facciale.
RISULTATI: il valore di: indice di placca (NMPS, p=0.0002), indice semplificato d’igiene orale (OHI-S, p=0.0012), indice d’infiammazione gengivale (GI, p=0.0021), indice di presenza di residui alimentari sui manufatti protesici (p=0.002) e nei fornici della cavità orale (p < 0.0001) è risultato aumentato in modo altamente significativo nel Gruppo Stroke.
CONCLUSIONI: le condizioni igieniche orali dei pazienti emiplegici sono peggiori rispetto a quelle dei soggetti sani a loro appaiati, situazione da imputare al deterioramento cognitivo ed intellettivo (p=0.016) oltre che motorio (p=0.0001) conseguente all’evento cerebrovascolare. L’igienizzazione del cavo orale dei pazienti emiplegici deve essere eseguita con maggiore impegno per evitare uno stato infiammatorio cronico del parodonto che influenza negativamente non solo le condizioni orali e sistemiche ma anche quelle legate ai rapporti interpersonali
Repeatability of electrically evoked EMG signals in the human vastus medialis muscle
No full textMUSCLE AND NERV
The value of adding mirror therapy for upper limb motor recovery of subacute stroke patients: a randomized controlled trial.
No full textUpper limb paresis remains a relevant challenge in stroke rehabilitation.To evaluate if adding mirror therapy (MT) to conventional therapy (CT) can improve motor recovery of the upper limb in subacute stroke patients.Prospective, single-center, single-blind, randomised, controlled trial.Subacute stroke patients referred to a Physical and Rehabilitation Medicine Unit between October 2009 and August 2011.Twenty-six subacute stroke patients (time from stroke <4 weeks) with upper limb paresis (Motricity Index ≤ 77).Patients were randomly allocated to the MT (N.=13) or to the CT group (N.=13). Both followed a comprehensive rehabilitative treatment. In addition, MT Group had 30 minutes of MT while the CT group had 30 minutes of sham therapy. Action Research Arm Test (ARAT) was the primary outcome measures. Motricity Index (MI) and the Functional Independence Measure (FIM) were the secondary outcome measures.After one month of treatment patients of both groups showed statistically significant improvements in all the variables measured (P<0.05). Moreover patients of the MT group had greater improvements in the ARAT, MI and FIM values compared to CT group (P<0.01, Glass's Δ Effect Size: 1.18). No relevant adverse event was recorded during the study.MT is a promising and easy method to improve motor recovery of the upper limb in subacute stroke patients.While MT use has been advocated for acute patients with no or negligible motor function, it can be usefully extended to patients who show partial motor recovery. The easiness of implementation, the low cost and the acceptability makes this therapy an useful tool in stroke rehabilitation
A prospective observational study of the clinical efficacy and safety of intra-articular sodium hyaluronate in synovial joints with osteoarthritis
No full textBackground: Clinical trials have demonstrated the safety and efficacy of hyaluronic acid-based products for the treatment of synovial joints affected by osteoarthritis (OA), but data from observational studies of normal medical practice are sparse. Aim: This study investigated the safety and efficacy of intra-articular (IA) sodium hyaluronate (MW 1500-2000 KDa; Hyalubrix ®) in the treatment of synovial joint OA. Design: This is prospective, and observational study. Setting: This study was carried out at 47 specialist centers for physiatrists, orthopedics and rheumatology in Italy; the enrolled population, 1266 outpatient, was predominantly female (.66%, 840/1266), with a mean age of 66 years, and a mean weight of 74 kg. Population: The Participants with OA received IA injections of the study treatment (2 mL) once per week for 3 weeks. The knee was the joint most commonly affected by OA (right knee 802/1266 [63%]; left knee 598/1266 [47%]), and the longest median duration of disease occurred in the carpal joint (right carpal joint 40 months; left carpal joint 60 months). Methods: The primary endpoints were tolerability and details of usage of the IA sodium hyaluronate syringe device. Efficacy parameters included assessment of self-reported pain via the Visual Analogue Scale (VAS), and evaluation of motor function via the Health Assessment Questionnaire (HAQ). Quality of life (QoL) was assessed using the Euro QoL questionnaire (Clinical Trial Registration Number: ISRCTN 42690497). Results: Data from 1266 participants were collected. The adverse event (AE) rate was 0.8% (95% CI, 0.4 to 1.5). Thirteen AEs were reported, 12 of which were mild or moderate in severity. Only one participant discontinued study treatment following an AE. No serious adverse events occurred. Coadministration of local anesthetic was required by up to 10% of patients. Statistically significant improvements in VAS, HAQ and EuroQoL were recorded in multiple joints (P<0.0001 for each). Conclusion: The study treatment was safe and well tolerated. Clinical rehabilitation impact: The study treatment reduced pain, improved mobility, and increased QoL in participants with OA.
Clinical trials have demonstrated the safety and efficacy of hyaluronic acid-based products for the treatment of synovial joints affected by osteoarthritis (OA), but data from observational studies of normal medical practice are sparse.
AIM:
This study investigated the safety and efficacy of intra-articular (IA) sodium hyaluronate (MW 1500-2000 KDa; Hyalubrix®) in the treatment of synovial joint OA.
DESIGN:
This is prospective, and observational study.
SETTING:
This study was carried out at 47 specialist centers for physiatrists, orthopedics and rheumatology in Italy; the enrolled population, 1266 outpatient, was predominantly female (66%, 840/1266), with a mean age of 66 years, and a mean weight of 74 kg.
POPULATION:
The Participants with OA received IA injections of the study treatment (2 mL) once per week for 3 weeks. The knee was the joint most commonly affected by OA (right knee 802/1266 [63%]; left knee 598/1266 [47%]), and the longest median duration of disease occurred in the carpal joint (right carpal joint 40 months; left carpal joint 60 months).
METHODS:
The primary endpoints were tolerability and details of usage of the IA sodium hyaluronate syringe device. Efficacy parameters included assessment of self-reported pain via the Visual Analogue Scale (VAS), and evaluation of motor function via the Health Assessment Questionnaire (HAQ). Quality of life (QoL) was assessed using the Euro QoL questionnaire (Clinical Trial Registration Number: ISRCTN 42690497).
RESULTS:
Data from 1266 participants were collected. The adverse event (AE) rate was 0.8% (95% CI, 0.4 to 1.5). Thirteen AEs were reported, 12 of which were mild or moderate in severity. Only one participant discontinued study treatment following an AE. No serious adverse events occurred. Coadministration of local anesthetic was required by up to 10% of patients. Statistically significant improvements in VAS, HAQ and EuroQoL were recorded in multiple joints (P<0.0001 for each).
CONCLUSION:
The study treatment was safe and well tolerated. CLINICAL REHABILITATION IMPACT:. The study treatment reduced pain, improved mobility, and increased QoL in participants with O
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