Thumb carpometacarpal osteoarthritis: A musculoskeletal physiotherapy perspective.

PROPOSAL: To perform a literature review to provide the practitioner with a description of the information and techniques to enhance the provision of conservative interventions in clinical practice. METHODS: Studies were obtained from MEDLINE, CINAHL, Embase, PEDro and CENTRAL databases from their inception to December 2017. Authors independently selected studies, conducted quality assessment, and extracted results. RESULTS: There is evidence to support a multimodal approach to the therapeutic management of the patient with CMC OA. This distinct approach includes: patient education, manual therapy, therapeutic exercise programs, and orthotic provision. CONCLUSION: There is evidence to support some of the commonly performed conservative interventions to improve hand function and decrease hand pain.

Severe Spinal Surgery Infection and Local Ozone Therapy as Complementary Treatment: A Case Report.

BACKGROUND: Infection is a serious surgical complication that significantly increases morbidity and mortality rates as well as health care expenses. Increased bacterial resistance to antibiotics makes the treatment of such events even more troublesome. OBJECTIVE: To report on a surgical infection case treated with ozone as a complementary therapy. METHODS AND MATERIALS: A female, 65 years old, submitted to a complex surgical procedure for adult kyphotic deformity correction that presented with early postsurgical infection. The patient was treated with revision surgery and antibiotics that improved the condition but were unable to delete the infection. Ozone, in its gaseous form, was injected subcutaneously and paravertebrally twice weekly for 3 weeks. RESULTS: After 3 weeks of treatment, the wound healed completely. Follow-up visits and laboratory exams for up to 1 year after surgery showed no recurrence of infection. CONCLUSIONS: Although just a single case, topical ozone therapy for surgical infections showed promising potential in this specific case.

The efficacy of physical therapy on the improvement of the motor components of visual attention in children with cerebral palsy: a case series study.

This paper has attempted to compare the effects of Bobath's concept with control's session on the improvement of visual attention in children with cerebral palsy. A 10 children sample (7 girls and 3 boys) aged 6 to 16 years (median, 12 years) was collected. The group who had received Bobath-based treatment crossed-over to control treatment and the previous control group received Bobath-based treatment for once a week. Measures were assessed at pre- and posttreatment. Outcome measure included the visual attention, we used Conners' Kiddie Continuous Performance Test (K-CPT). Bobath's session targeted to crossed-over participants produced greater improvements in K-CPT(RT) (difference=33.1, P<0.05) at posttreatment compared to the control's session group, whereas the improvement of K-CPT did not differ between groups. The results of this case series study showed a significant improvement on visual attention through the improvement of motor control functions after the Bobath's session over the control's session.

How many physical therapy sessions are required to reach a good outcome in symptomatic lumbar spondylolisthesis? A retrospective study.

BACKGROUND: There is a lack of conclusive information about the optimal dosage of physical therapy treatments in Spondylolisthesis (SPL) patients. PURPOSE: The present study attempted to evaluate the comparative effectiveness of two different doses in reaching similar clinical outcomes. METHODS: A retrospective cohort study of 64 consecutive patients admitted for physical therapy with symptomatic lumbar grade I SPL (42 ± 15years, 57% female) was conducted. At the end of the treatment, all participants were retrospectively assigned to one of two groups, receiving either 5-8 or 9-12 sessions (experimental or control group, respectively) of physical therapy treatments. The Prone Bridge Test (PBT) and the Supine Bridge Test (SBT) were used to measure muscular endurance. RESULTS: The area under the ROC curve for the PBT was 0.64 (95% CI 0.45-0.83) and for the SBT was 0.57 (95% CI 0.33-0.80). The optimal cutoff points were 25.5s for the PBT and 55.0s for the SBT. Logistic regression revealed that PBT (OR = 1.062) was associated with SPL. The final regression model explained 77.4% (R2 = 0.341; p = 0.024) of the variability. CONCLUSIONS: In this sample, the number of sessions required to achieve satisfactory outcomes ranged from 5 to 12. The clinical results of the subjects in the 5-8 sessions group were similar to the 9-12 sessions group. Individual's coping mechanisms could be considered in future studies to understand which patients will require more therapeutic sessions.

Conservative management of thumb carpometacarpal osteoarthritis: An Italian survey of current clinical practice.

OBJECTIVE: The purpose of this study was to elucidate expert opinion on the conservative treatment of thumb carpometacarpal (CMC) joint osteoarthritis (OA). METHODS: A 21-item survey to determine the practice patterns of Italian hand therapists who treat arthritis of the CMC joint was developed and distributed through a professional online survey service to assure confidentiality and anonymity. RESULTS: Of the respondents, 80.8% were physical therapists; the remaining 19.2% were occupational therapists. 84.6% of the specialists who make decisions regarding patient pain management education. CONCLUSIONS: There is variability in the knowledge and practice patterns of Italian hand therapists relating to conservative management of thumb CMC OA.

Vertebral Bone Marrow Edema (VBME) in Conservatively Treated Acute Vertebral Compression Fractures (VCFs): Evolution and Clinical Correlations.

STUDY DESIGN: Prospective observational study. OBJECTIVE: To assess (1) the evolution of vertebral bone marrow edema (VBME) in patients with A1 vertebral compression fractures (VCFs) conservatively treated and (2) the relationship between VBME and clinical symptoms, evaluated as Visual Analogue Scale (VAS) back pain and Oswestry Disability Index (ODI). SUMMARY OF BACKGROUND DATA: VBME is a marker of acute-subacute vertebral fractures. Little is known about the evolution of VBME in conservatively managed VCFs, as well as its clinical meaning. METHODS: 82 thoracic or lumbar VCFs (21 post-traumatic; 61 osteoporotic VCFs), type A1 according to the AOSpine thoracolumbar spine injury classification system, in 80 patients were treated with C35 hyperextension brace for 3 months, bed rest for the first 25 days. Patients with osteoporotic fractures also received antiresorptive therapy and vitamin D supplementation. At 0 (T0), 30 (T1), 60 (T2), and 90 (T3) days, patients underwent magnetic resonance imaging evaluation and clinical evaluation, using VAS for pain and ODI.The paired t test was used to compare changes within groups at each follow-up versus baseline. The unpaired t test after ANOVA (analysis of variance) was used to compare the 2 groups at each follow-up.The association between VBME area, VAS score, and ODI score was analyzed by the Pearson correlation test. The tests were 2-tailed with a confidence level of 5%. RESULTS: A significant VBME mean area, VAS, and ODI scores reduction was recorded at 60 and 90-days follow-ups versus baseline. A positive correlation between VBME reduction and clinical symptoms improvement (VAS and ODI scores improvement) was found in both traumatic and osteoporotic VCFs. CONCLUSION: In benign A1 VCFs conservatively managed, VBME slowly decreases in the first 3 months of magnetic resonance imaging follow-up. This VBME reduction is related to clinical symptoms improvement. LEVEL OF EVIDENCE: 4.