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Skeletal muscle consists of long plurinucleate and contractile structures, able to regenerate and repair tissue damage by their resident stem cells: satellite cells (SCs). Reduced skeletal muscle regeneration and progressive atrophy are typical features of sarcopenia, which has important health care implications for humans. Sarcopenia treatment is usually based on physical exercise and nutritional plans, possibly associated with rehabilitation programs, such as vibratory stimulation. Vibrations stimulate muscles and can increase postural stability, balance, and walking in aged and sarcopenic patients. However, the possible direct effect of vibration on SCs is still unclear. Here, we show the effects of focused vibrations administered at increasing time intervals on SCs, isolated from young and aged subjects and cultured in vitro. After stimulations, we found in both young and aged subjects a reduced percentage of apoptotic cells, increased cell size and percentage of aligned cells, mitotic events, and activated cells. We also found an increased number of cells only in young samples. Our results highlight for the first time the presence of direct effects of mechanical vibrations on human SCs. These effects seem to be age-dependent, consisting of a proliferative response of cells derived from young subjects vs. a differentiative response of cells from aged subjects.
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Sarcopenia , Células Satélites de Músculo Esquelético , Idoso , Envelhecimento/fisiologia , Humanos , Músculo Esquelético/patologia , Sarcopenia/patologia , Células Satélites de Músculo Esquelético/patologia , VibraçãoRESUMO
[Purpose] Our study aimed to estimate the effects of a supervised, intensive, home-based-pulmonary-rehabilitation (HBPR) program for mild and moderate chronic-obstructive-pulmonary-disease (COPD) patients. [Participants and Methods] A retrospective, case-control study. Forty-three (N=43) patients were observed, divided into Treatment-Group (TG) and Control-Group (CG). The TG (N=23) underwent a 4-week training program, consisting of endurance and strength training sessions, performed 4-times per week. In addition, inspiration muscle training was performed, with a threshold device. The primary outcome was dyspnea improvements, measured by the modified-Borg-scale (mBS), and the secondary outcome was the determination of diaphragm excursion and function, using ultrasound (US) assessment to measure clinical parameters. [Results] The results suggested significantly improved mBS scores, measured for the ΔT0-T1 and ΔT0-T2 time points; improved diaphragm-excursion (Dia-Ex) at ΔT0-T1 and ΔT0-T2; and improved maximum Dia-Ex at ΔT0-T1 and ΔT1-T2 in the TG compared with the CG. Moreover, the results showed improvements over time for all parameters in the TG versus CG, suggesting a constant improvement in respiratory pathology. [Conclusion] A supervised HBPR plan was effective in reducing dyspnea by the mBS, and improving diaphragmatic function, as determined by US evaluation, and lastly improving quality of life in patients with mild-to-moderate COPD.
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BACKGROUND: Determine the effects of an integrated rehabilitation protocol, including botulinum toxin and conventional rehabilitation exercise plus end-effector (EE) robotic training for functional recovery of the upper limb (UL) compared to training with the robot alone in post-chronic stroke patients with mild to severe spasticity, compared to training with the robot alone. METHODS: In this prospective, observational case-control study, stroke patients were allocated into 2 groups: robot group (RG, patients who underwent robotic treatment with EE) and robot-toxin group (RTG, patients who in addition have carried out the injection of botulinum toxin for UL recovery). All patients were assessed by Fugl-Meyer Assessment (FMA), Motricity Index (MI), modified Ashworth scale (MAS), numeric rating scale (NRS), Box and Block Test (BBT), Frenchay Arm Test (FAT), and Barthel Index (BI) at baseline (T0), T1 (end of treatment), and T2 (3 months of follow-up). RESULTS: Forty-four patients were included and analyzed (21RG; 23RTG). From the analysis between groups, the results suggested how there was a statistically significant difference in favor of RTG, specifically ΔT0-T1 and ΔT0-T2 for B&B p = 0.009 and p = 0.035; ΔT0-T1 and ΔT0-T2 for FAT with p = 0.016 and p = 0.031; ΔT0-T1 for MAS shoulder p = 0.016; ΔT0-T1 and ΔT0-T2 with p = 0.010 and p = 0.005 for MAS elbow; and ΔT0-T1 and ΔT0-T2 with p = 0.001 and p = 0.013 for MAS wrist. CONCLUSION: Our results suggest, in line with the literature, a good efficacy in the reduction of spasticity and in the improvement of the function of the UL, with the reduction of pain, adopting a rehabilitation protocol integrated with BoTN, robot-assisted training, and traditional physiotherapy.
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Toxinas Botulínicas , Procedimentos Cirúrgicos Robóticos , Robótica , Reabilitação do Acidente Vascular Cerebral , Toxinas Botulínicas/uso terapêutico , Estudos de Casos e Controles , Humanos , Estudos Prospectivos , Recuperação de Função Fisiológica , Resultado do Tratamento , Extremidade SuperiorRESUMO
The aquatic environment has a high potential in rehabilitation treatment of acute lesions and in chronic diseases. The Safe Bearing Back method is proposed to stimulate the reorganization of deteriorated sensory neuromotor skills. The aim of the present study was to verify the effectiveness and the long-term maintenance of the benefits of a specific thermal rehabilitation training in neuromotor and neurological disabilities. Seventy four patients were evaluated using the Functional Independence Measure (FIM), Tinetti Gait-Balance Scale (TIN), and Visual Analog Scale (VAS) for pain. In addition, a general health index was developed, conceived as a linear combination, with unit weights, of the normalized FIM, TIN, and VAS indicators. Measurements were made at T1 (baseline before treatment), T2 (after a five-month treatment, which was the end of treatment), and T3 (6 months after the end of treatment). Self-sufficiency, walking ability, and subjective pain perception were improved after the treatment. The improvement tapered off during the six-month-long follow-up, but the patients' condition remained well compared with the baseline level before the implementation of the treatment program. We conclude that hydrokinesitherapy with the Safe Bearing Back method demonstrates is clearly effective in the immediate and medium-term rehabilitation of neuromotor diseases.
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Doenças do Sistema Nervoso/reabilitação , Água , Ausência de Peso , Doença Crônica , Marcha , Humanos , Resultado do Tratamento , CaminhadaRESUMO
Lung cancer is one of the leading causes of cancer death worldwide. Surgical removal remains the best option for most tumors of this type. Reduction of cigarette consumption in patients with lung cancer candidates for the surgery could limit the impact of tobacco on postsurgical outcomes. Breathing exercises appear to help combat cigarette cravings. Yoga exercise benefits have been studied in lung cancer survivors, rather than in the preoperative setting. In this study, we have recruited 32 active smokers affected by lung cancer and being candidates for pulmonary surgery. The patients were randomly assigned to two groups: one treated by standard breathing and the other treated by yoga breathing (YB). The groups were evaluated at times T0 (baseline) and T1 (after 7 days of treatment) to compare the effects of the two breathing treatments on pulmonary performance in a presurgery setting. Pulmonary and cardiocirculatory functions have been tested using a self-calibrating computerized spirometer and a portable pulse oximetry device. The findings demonstrate appreciable short-term improvement in lung function assessed by spirometry. We conclude that yoga breathing can be a beneficial preoperative support for thoracic surgery.
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Exercícios Respiratórios/métodos , Carcinoma Pulmonar de Células não Pequenas/reabilitação , Neoplasias Pulmonares/reabilitação , Fumantes/estatística & dados numéricos , Yoga , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/fisiopatologia , Feminino , Humanos , Pulmão/fisiopatologia , Neoplasias Pulmonares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Testes de Função Respiratória , EspirometriaRESUMO
Low back pain frequently involves a multifactorial etiology and requires medical attention. The aim of the study was to assess the associations among pain, posture, and autonomic nervous system function in patients with low back pain, using neuromuscular manual therapy versus a generic peripheral manual stimulation (back massage therapy). Twenty young patients with low back pain were enrolled into the study. The patients were randomly divided into two groups: treated with neuromuscular manual therapy performed after a specific structural evaluation and treated with back massage therapy. Both groups performed eight sessions of 30 min each, once a week for two months. There were three main time points of the assessment: during the first, the fourth, and the last eighth session. In each of these three sessions, data were collected before onset of session (baseline), 5 min from onset, at end of session, and 5 min after the end. All patients were subjected to stabilometric evaluation and were assessed on a visual analogue scale to quantify postural and pain changes. Tabletop capnography and pulse oximetry were used to monitor autonomic changes. The findings were that the improvement in posture and pain reduction were appreciably better in patients subjected to neuromuscular manual therapy than in those subjected to back massage therapy, with a comparable autonomic response in both groups. In conclusion, the study demonstrates that posture modification was significantly more advantageous in patient treated with neuromuscular manual therapy.
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Sistema Nervoso Autônomo/fisiologia , Dor Lombar/reabilitação , Massagem/métodos , Manipulações Musculoesqueléticas/métodos , Postura/fisiologia , Adulto , Feminino , Humanos , Masculino , Escala Visual Analógica , Adulto JovemRESUMO
INTRODUCTION: Osteoporosis is a systemic disease of the skeleton characterized by a reduction in bone mass and alterations in microarchitecture accompanied by increase in fracture risk, with a relevant decline in quality of life and important social, economic, and health implications, representing one of the most common causes of disability and a major financial item of health cost in many Countries. The best therapy for osteoporosis is prevention, consisting in measures to avoid or slow the onset of the disease. Treatment includes measures aimed at osteoporotic individuals, with or without previous fractures and a high risk of a first or additional fracture. METHOD: We enrolled thirty post-menopausal osteoporotic women, allocated in the first group underwent a 6-month personalized drug therapy and focused mechanoacoustic vibration (2 sessions per week, each lasting 15 minutes); women allocated in the second group underwent only 6-month personalized drug therapy. Patients were evaluated performing dual-energy X-ray absorptiometry (DXA) and isokinetic machine evaluation, and administration of Tinetti scale and ECOS-16 questionnaire. RESULT: Show improvement of bone mineral density (BMD) and T-score at the lumbar spine and femoral neck, handgrip strength and isokinetic strength of the knee estensors, balance and gait, and quality of life. CONCLUSION: Hence, the combined treatment with focused mechano-acoustic vibration and pharmacological therapy has a beneficial effect on BMD and T-score as well as on the muscle strength and quality of life of osteoporotic subjects.
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The purpose of this study was to evaluate the acute and long-term effects of local high-intensity vibration (HLV, f = 300 Hz) on muscle performance and blood hormone concentrations in healthy young men. Totally 18 subjects (cV group) were studied in two sessions, either without (control) or with HLV treatment. The protocol was the same on both control and test days, except that, in the second session, subjects underwent HLV treatment. Counter-movement jumping (CMJ), maximal isometric voluntary contraction (MVC) test, and hormonal levels were measured before the procedure, immediately thereafter, and 1 h later. To assess the long-term effects of HLV, the cV group was subjected to HLV on the leg muscles for 4 weeks, and a second group (cR group, n = 18) embarked upon a resistance training program. All subjects underwent an MVC test and an isokinetic (100 deg/s) test before training, 4 weeks after training, and 2 months after the end of training. The HLV protocol significantly increased the serum level of growth hormone (GH, P < 0.05) and creatine phosphokinase (CPK, P < 0.05), and decreased the level of cortisol (P < 0.05). None of GH, CPK or testosterone levels were altered in controls. There was a significant improvement in MVC (P < 0.05). After 4 weeks, both the cV and cR groups demonstrated significant improvement in MVC and isokinetic tests (P < 0.05). This increase persisted for at least 2 months. Our results indicate that HLV influences the levels of particular hormones and improves neuromuscular performance. Our results indicate that HLV has a long-term beneficial effect comparable to that of resistance training.
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Sistema Endócrino/fisiologia , Força Muscular/fisiologia , Vibração , Adulto , Algoritmos , Creatina Quinase/sangue , Creatina Quinase/metabolismo , Sistema Endócrino/metabolismo , Exercício Físico/fisiologia , Humanos , Hidrocortisona/análise , Hidrocortisona/sangue , Hidrocortisona/metabolismo , Masculino , Músculo Esquelético/fisiologia , Treinamento Resistido/métodos , Corrida/fisiologia , Testosterona/análise , Testosterona/sangue , Fatores de Tempo , Vibração/efeitos adversos , Adulto JovemRESUMO
BACKGROUND: Aging has been associated with the progressive depletion of lean mass, reductions in muscle strength and the coordination of the lower extremities, accompanied by decreased gait assurance and balance control. Also, less balance control favors falling which is the leading cause of injury among the elderly. The aim of this systematic review is to identify and evaluate existing evidence regarding the use of focused vibration (FV) to improve balance and reduce the risk of falling during the rehabilitation of elderly populations. METHODS: The PICO question is what are the effects of focal/segmental/local vibration training on the assessment of balance and the risk of falls among the elderly population? A thorough literature review was conducted between May 1, 2009, and June 30, 2019, for studies in English, randomized clinical trials, including crossover and prospective design studies with assessing balance and the risk of falls in elderly populations (age > 60 years). RESULTS: Eight articles (N = 8) satisfied the inclusion criteria and were considered, of which 6 are RTC, one cross-sectional study and one clinical study, for a total of 635 participants. A total of 6 different vibration devices were used, each of which was associated with different FV frequency and amplitude characteristics and different treatment protocols. CONCLUSION: In conclusion, FV can be effective in decreasing the risk of falls and improving the assessment of balance, but more evidence is necessary considering the limits of the studies; however, it does look an important promise during rehabilitative treatment.
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Equilíbrio Postural , Vibração , Idoso , Estudos Transversais , Terapia por Exercício , Humanos , Estudos ProspectivosRESUMO
INTRODUCTION: By 6 months following a stroke, approximately 65% of stroke survivors cannot incorporate into daily activities, resulting completely dependent. The aim of this study is to assess the overall outcome in psychological and physical well-being, increase in residual abilities, reintegration and social inclusion for people with chronic disabilities resulting from stroke, after home rehabilitation. MATERIALS AND METHODS: We assessed the functional outcome of a group of 600 patients with disability related to several pathological conditions and undergoing home rehabilitation therapy (twice a week for 40 sessions per year) as granted by the Public Health. We evaluated the outcome with Barthel and Functional Independence Measure (FIM) scales. Furthermore, in a group of 73 persons with chronic stroke we also carried out an overall evaluation, by using specific rating scales (FIM, Stroke Impact Scale, Motricity Index, Tinetti Balance Scale, 10-m Walking Test, 6-min Walking Test, 5 Repetitions Sit-to-Stand Test, and Hamilton Depression Scale) after 120 days (114 ± 6) from the end of the home rehabilitation program. RESULTS: The results highlighted a statistically significant improvement between T0 and T1 and a significant worsening between T1 and T2 (follow-up at 3 months). Hamilton Depression Scale is the only parameter that significantly improves both at the time T1 and T2. CONCLUSIONS: Territorial rehabilitation system should consider some fundamental aspects: centrality of the person and the individual health project; identification of specific and personalized rehabilitation plan and prognosis based on the results of a follow-up; ultra-specialization of interventions; multidisciplinary team; highlight of the emerging needs; and coordination of the different care pathways.
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Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Atividades Cotidianas , Humanos , Itália , SobreviventesRESUMO
OBJECTIVE: To examine the pain-reducing effects of intra-articular oxygen-ozone (O2O3) injections and mechanical focal vibration (mFV) versus O2O3 injections alone in patients with knee osteoarthritis. METHODS: Patients with chronic pain (>6 weeks) due to knee osteoarthritis (II-III on the Kellgren-Lawrence scale) were consecutively enrolled and divided into two groups: O2O3 (n = 25) and O2O3-mFV (n = 24). The visual analog scale (VAS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Medical Research Council (MRC) Manual Muscle Testing scale were administered at baseline (before treatment), after 3 weeks of treatment, and 1 month after the end of treatment. Patients received three once-weekly intra-articular injections of O2O3 into the knee (20 mL O3, 20 µg/mL). The O2O3-mFV group also underwent nine sessions of mFV (three sessions per week). RESULTS: The VAS score, KOOS, and MRC score were significantly better in the O2O3-mFV than O2O3 group. The within-group analysis showed that all scores improved over time compared with baseline and were maintained even 1 month after treatment. No adverse events occurred. CONCLUSION: An integrated rehabilitation protocol involving O2O3 injections and mFV for 3 weeks reduces pain, increases autonomy in daily life activities, and strengthens the quadriceps femoris.
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Osteoartrite do Joelho , Ozônio , Humanos , Ácido Hialurônico , Osteoartrite do Joelho/tratamento farmacológico , Oxigênio , Ozônio/uso terapêutico , Dor , Resultado do Tratamento , Vibração/uso terapêuticoRESUMO
Skeletal muscle regeneration relies on satellite cells, a population of myogenic precursors. Inflammation also plays a determinant role in the process, as upon injury, macrophages are attracted by the damaged myofibers and the activated satellite cells and act as key elements of dynamic muscle supportive stroma. Yet, it is not known how macrophages interact with the more profound stem cells of the satellite cell niche. Here we show that in the presence of a murine macrophage conditioned medium (mMCM) a subpopulation of multipotent cells could be selected and expanded from adult rat muscle. These cells were small, round, poorly adhesive, slow-growing and showed mesenchymal differentiation plasticity. At the same time, mMCM showed clear myogenic capabilities, as experiments with satellite cells mechanically isolated from suspensions of single myofibers showed that the macrophagic factors inhibited their tendency to shift towards adipogenesis. In vivo, intramuscular administrations of concentrated mMCM in a rat model of extensive surgical ablation dramatically improved muscle regeneration. Altogether, these findings suggest that macrophagic factors could be of great help in developing therapeutic protocols with myogenic stem cells.
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Meios de Cultivo Condicionados/química , Macrófagos/metabolismo , Células-Tronco Multipotentes/fisiologia , Desenvolvimento Muscular/fisiologia , Músculo Esquelético , Células Satélites de Músculo Esquelético/fisiologia , Animais , Diferenciação Celular/fisiologia , Linhagem Celular , Proliferação de Células , Humanos , Macrófagos/citologia , Masculino , Camundongos , Células-Tronco Multipotentes/citologia , Músculo Esquelético/citologia , Músculo Esquelético/fisiologia , Ratos , Ratos Wistar , Regeneração/fisiologia , Células Satélites de Músculo Esquelético/citologiaRESUMO
Electromagnetic fields (EMFs) provide a non-invasive, safe, and easy method to treat pain with respect to musculoskeletal diseases. The purpose of this systematic review was to describe the use of electromagnetic therapy in the rehabilitation field by investigating the efficacy in acute and chronic pain in the musculoskeletal disorders. A database search was conducted using the following resources: PubMed, Cochrane, PEDro, SCOPUS, and WoS. The following MESH terms were used: [Electromagnetic field AND/OR Rehabilitation], [Electromagnetic field AND/OR Pain], [Pulsed Magnetic field AND/OR Rehabilitation] and [Pulsed Magnetic field AND/OR Pain], [Pulsed Electromagnetic field AND/OR Rehabilitation] and [Pulsed Electromagnetic field AND/OR Pain], per the guidelines of the PRISMA statement. Articles published between January 1, 2009 and December 31, 2018 were included as assessment of musculoskeletal pain conditions, randomized clinical trial including crossover and prospective design studies, full English text available, population age > 18 years; instead were excluded neurological randomized clinical trials, transcranial magnetic stimulation application, neuropathic pain, animal/in vitro studies, and articles without English abstract or English full text. Three independent investigators (AMC, NG, and LP) retrieved all the information. Twenty-one RTC (N=21) were considered for the inclusion and exclusion criteria. The results showed as pulsed magnetic fields at low intensity and frequency (from 1 Hz up to 100 Hz) are commonly used with efficacy in resolving musculoskeletal pain. EMFs therapy is a well tolerated, effective with no negative side effects, which can be integrated with rehabilitation for the treatment of chronic and acute pain in musculoskeletal diseases, but further studies are needed to examine the use of more standardized protocols.
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PURPOSE: Facet joint syndrome (FJS) is an arthritis-like condition of the spine that can be a significant source of low back pain (LBP). Ozone therapy (OT) could be an additional treatment method. We evaluated the therapeutic results of percutaneous injection of ozone to ablate acute LBP caused by FJS. METHODS: A 73-year-old Caucasian woman was treated by OT: one ozone injection (20 µg/mL) per week for 3 weeks under ultrasound guidance. After a break of 1 week, she performed exercises for aquatic rehabilitation (twice a week for 4 weeks). RESULTS: The outcome measure was pain relief for ≥6 months according to the Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), and Brief Pain Inventory (BPI) test. From baseline to 1 month after OT, a reduction in pain was documented and the result was maintained at 6-month follow-up. CONCLUSION: OT followed by aquatic exercises could be efficacious against the LBP caused by FJS.
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OBJECTIVE: To determine whether asymptomatic flexible flat feet show specific postural assessment with respect to neutral feet in 6-year-old children. METHODS: In this cross-sectional observational study, 164 subjects were observed and divided into two groups: 57 with flexible flat feet and 107 with neutral feet. A non-quantitative inspection by podoscopy and baropodometry were performed to evaluate plantar support, and a clinical examination to assess postural setting. RESULTS: The prevalence of flexible flat feet was 34.8%. The differenceinthe mean centre of pressure (CoP) between the two groups was significant (p=0.028), regarding the antero-posterior direction of CoP only. There was no significant differencein the presence of postural growth disharmony between the neutral and flat-feet groups. CONCLUSION: The flattening of the plantar archseems to be linked to a displacement of CoP Y, more posterior in flat feet than in neutral feet; on the other hand, postural harmony in 6-year-old children during growth is not influenced by flat feet.
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OBJECTIVE: To investigate whether chronic pain (CP) patients with somatization reported higher alexithymic traits than those without somatization and to study the different relationships between psychological characteristics, pain, health-related quality of life (HRQL), and somatization. METHOD: A consecutive sample of 134 CP treatment-seeking outpatients were evaluated for alexithymia (TAS-20), somatization (PHQ-15), distress (HADS), HRQL (SF-12), and pain (BPI). RESULTS: Patients with somatization (37.04%) reported significantly higher TAS-20 total scores (p < 0.001) and difficulty in identifying feelings (DIF) (p < 0.001) than those without somatization. The somatizer group had also a significantly higher disease duration, severity and interference of pain, distress, and lower HRQL than the non-somatizer group. Hierarchical regression analysis showed that although distress, pain interference and the mental HRQL component are closely related to somatization (R 2 = 0.55), DIF was the strongest predictor of severity of somatization (ß = 0.31). A sequential indirect effect from DIF to somatization via distress symptoms and pain interference turned out to be significant [95% CI (0.01, 0.09)]. Support was also found for sequential mediation paths from DIF to somatization via distress and mental HRQL [95% CI (0.01, 0.11)]. CONCLUSIONS: Our results pointed-out that alexithymia, particularly DIF, may be major factor for somatization risk in CP patients. Longitudinal observations are needed for evaluating the role of alexithymia in clinical outcomes.
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BACKGROUND: Telerehabilitation (TR) in chronic stroke patients has emerged as a promising modality to deliver rehabilitative treatment-at-home. The primary objective of our methodical clinical study was to determine the efficacy of a novel rehabilitative device in terms of recovery of function in daily activities and patient satisfaction and acceptance of the medical device provided. METHODS: A 12-week physiotherapy program (balance exercises, upper and lower limb exercises with specific motor tasks using a biofeedback system and exergaming) was administered using the WeReha device. Twenty-five (N = 25) chronic stroke outpatients were enrolled, and the data of 22 patients was analyzed. Clinical data and functional parameters were collected by Berg Balance scale (BBS), Barthel Index (BI), Fugl-Meyer scale (FM), Modified Rankin scale (mRS), and Technology Acceptance Model (TAM) questionnaire at baseline (T0), after treatment (T1), and at the 12-week follow-up (T2). Statistical tests were used to detect significant differences (P < .05), and Cohen's (Co) value was calculated. RESULTS: BI scores improved significantly after treatment (P = .036; Co 0.776, medium), as well as BBS scores (P = .008; Co 1.260, high). The results in FM scale (P = .003) and mRS scores (P = .047) were significant post treatment. Follow-up scores remained stable across all scales, except the BI. The A and C sub-scales of the TAM correlated significantly to only a T2 to T1 difference for BI scores with P = .021 and P = .042. CONCLUSION: Currently, the WeReha program is not the conventional therapy for stroke patients, but it could be an integrative telerehabilitative resource for such patients as a conventional exercise program-at-home.ClinicalTrials.gov identifier: NCT03964662.
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The present randomised placebo controlled trial explored the extent to which osteopathic manipulative treatment (OMT) affects brain activity, particularly the insula, during both an "interoceptive awareness" and "exteroceptive awareness" task in a sample of 32 right-handed adults with chronic Low Back Pain (CLBP) randomly assigned to either the OMT or sham group. Patients received 4 weekly sessions and fMRI was performed at enrolment (T0), immediately after the first session (T1) and at 1 month (T2). The results revealed that the OMT produced a distinct and specific reduction in BOLD response in specific brain areas related to interoception, i.e., bilateral insula, ACC, left striatum and rMFG. The observed trend across the three time points appears uncharacteristic. At T1, a marginal increase of the BOLD response was observed in all the above-mentioned areas except the rMFG, which showed a decrease in BOLD response. At T2, the response was the opposite: areas related to interoception (bilateral insula and ACC) as well as the rMFG and left striatum demonstrated significant decreased in BOLD response. The findings of this study provide an insight into the effects of manual therapies on brain activity and have implications for future research in the field.
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Encéfalo/diagnóstico por imagem , Interocepção/fisiologia , Dor Lombar/terapia , Osteopatia/métodos , Adulto , Atenção , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Ortopedia , Medição da Dor , Percepção , Adulto JovemRESUMO
Dysfunctions of the pelvic floor related to mixed urinary incontinence in women are pathologies extremely limiting for patients bodily and psychosocial conditions, altering their quality of life. The aim of this study was to determine the effects of focal mechanical vibrations in mixed urinary incontinence. In this retrospective observational case-control study, 65 patients were randomized and divided into 2 groups: treatment group by focal mechanical vibrations (VISS-10 sessions) (N = 33) and a control group in waiting list (N = 32). Also, both groups received home-based postural ergonomic instructions to reinforce pelvic floor. Data were collected at T0 (baseline), T1 (end of treatment), and T2 (follow-up = after 1 month): rheological muscle parameters were assessed by MyotonPRO respect to evaluate the gluteus maximus muscle. Then, to measure the general disability of the pelvic floor and the impact of urogenital problems on daily activities the Pelvic Floor Disability Index (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7) were used. Groups were matched perfectly before treatment for age (58.20 ± 4.37 vs. 58.73 ± 5.19) and BMI (26.15 ± 2.22 vs. 25.85 ± 2.11); for the two-way ANOVA analysis, a difference in gluteus variables over time and between groups except for GMDR (group p-value = 0.60) was showed. The two-way ANOVA shows statistically significant effects of treatment and time for PDFI-20 and PFIQ-7 (p-value <0.001). An improvement in incontinence symptoms and quality of life in the PDFI-20 and PFIQ-7 scores were reported and VISS may favor muscles stiffness for exercises by improving the normalization of basal tone. Our results were encouraging and suggested the use of focal mechanical vibration as a novel tool for treating mix urinary incontinence in women to complete and help the rehabilitative therapeutic protocol.
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OBJECTIVES: This study aims to verify whether neuromuscular therapy (NMT) or pharmacology therapy (PT) is more effective for reducing symptoms in women affected by primary dysmenorrhea and the effects associated with each treatment. DESIGN: A controlled, randomized, single-blind clinical trial within the framework of the chair of physical medicine and rehabilitation of the University "G. d'Annunzio" of Chieti-Pescara. The study was conducted on a sample of 60 women suffering from primary dysmenorrhea. Subjects were randomly divided in two groups (A and B). Group A was treated with NMT and group B with PT. Group B was given ibuprofen or naproxen because they are considered the best painkillers for this condition. Group A was treated with 8 neuromuscular manual lumbosacral and abdominal therapy sessions twice per week for 4 weeks. Results were analyzed at the beginning (T0) and end (T1) of the study with a menstrual distress questionnaire, brief pain inventory, and visual analogue scale. Twenty patients from Group A were selected for evaluation of their maintenance of the eventual improvement that was detected in T1 at follow-up (T2). RESULTS: Both therapies had significant short-term effects in reducing the perception and duration of pain. However, NMT appears to give more improvements in the duration of pain. NMT had a long-term effect on perception of pain because patients conserved the positive effects of treatment after 4 weeks. NMT also had a long-term effect on duration of pain because patients conserved benefits of treatment, but this improvement started to decrease after 4 weeks. CONCLUSIONS: In the treatment of primary dysmenorrhea, NMT represents a valid therapeutic alternative method to PT. NMT is free from potential adverse effects of analgesics, is noninvasive, and is easy to perform.