Goniometric evaluation of the spinal sagittal curves in children and adolescents: A reliability study.

BACKGROUND: Gold standard for spine deformities assessment is X rays, but the procedure bears a risk of exposure. OBJECTIVE: To investigate intra-rater and inter-rater reliability of a pocket compass needle goniometer (IncliMed®, University of Padua) to non-invasively evaluate spine curves in children and adolescents. METHODS: Prospective reliability study in a paediatric population (mean age 12.5 years ± 2.5). Children with spine deformities (Scheuermann's or postural kyphosis, idiopathic scoliosis) and healthy controls were included. Two physician measured spinal curves with the surface goniometer IncliMed® within a temporal range of 10 minutes. Participants were re-tested after a mean of 28 days for the intra-rater study. Agreement limit and coefficient of repeatability were calculated according to the linear regression analysis; the Bland and Altman method was applied to obtain average of differences and standard error of the mean of the differences. RESULTS: One hundred and thirty-nine subjects participated to the inter-rater reliability assessment; 30 to the intra-rater reliability assessment. Inter-observer variability for IncliMed® measurements was ± 11° both for kyphosis and for lordosis. The intra-observer variability for kyphosis and lordosis measurements was ± 11° and ± 12°. CONCLUSIONS: IncliMed® is a reliable, non-invasive tool to screen and monitor spinal curves in paediatric populations.

Extracorporeal shockwaves therapy versus hyaluronic acid injection for the treatment of painful non-calcific rotator cuff tendinopathies: preliminary results.

BACKGROUND: Rotator cuff tendinopathy is the most common cause of painful shoulder. The treatment is mainly conservative and several therapeutic approaches have been proposed, including NSAIDs, physiotherapy, injections and physical therapies. The aim of the current study was to compare the clinical effectiveness of low molecular weight hyaluronic acid (LMW-HA) injection versus low-energy extracorporeal shock-wave therapy (ESWT) until 3 months of follow-up for the management of painful non-calcific rotator cuff tendinopathies, evaluating also the trend over time between the groups. METHODS: A total of 34 patients affected by painful rotator cuff tendinopathy were randomly divided into 2 groups of 17 individuals. The first group (group A; mean age 58.2 years) underwent 3 injections of LMW-HA (Hyalgan®, 500-730 kDa), while in the second group (group B; mean age 58.5 years) the treatment protocol consisted of 4 sessions of low-energy ESWT. Pain level and function were assessed with the DASH and Constant-Murley questionnaires. Parameters were evaluated at baseline (V0), at the end of the treatment (V1) and after 3 months of follow-up (V2). RESULTS: Patients of both groups achieved statistically significant improve in pain and function (P<0.0001). Clinical outcome shows a different trend in time between group A and group B for DASH and Constant-Murley questionnaires. CONCLUSIONS: LMW-HA and low-energy ESWT are effective and safe in patients suffering from non-calcific rotator cuff tendinopathy until 3 months of follow-up. Intra-articular injections of LMW-HA provide prompt clinical improvement compared to ESWT, which results in more gradual improvement over time.

Muscle Injuries: A Brief Guide to Classification and Management.

Muscle injuries are frequent in athletes. Despite their high incidence, advances in clinical diagnostic criteria and imaging, their optimal management and rehabilitation strategies are still debated in literature. Furthermore, reinjury rate is high after a muscle lesion, and an improper treatment or an early return to sports can increase the rate of reinjury and complications. Most muscle injuries are managed conservatively with excellent results, and surgery is normally advocated only for larger tears. This article reviews the current literature to provide physicians and rehabilitation specialists with the necessary basic tools to diagnose, classify and to treat muscle injuries. Based on anatomy, biomechanics, and imaging features of muscle injury, the use of a recently reported new classification system is also advocated.

ISMuLT Guidelines for muscle injuries.

Muscle injuries are frequent in high demand sports. No guidelines are available in the scientific literature. ISMuLT, the "Italian Society of Muscles, Ligaments and Tendons", in line with its multidisciplinary mission, is proud to cover this gap.