Pneumatic Compression Combined with Standard Treatment after Total Hip Arthroplasty and Its Effects on Edema of the Operated Limb and on Physical Outcomes: A Pilot Clinical Randomized Controlled Study.

Total hip arthroplasty (THA) is one of the most successful orthopedic procedures and is highly effective at improving function and quality of life. However, patients commonly experience edema immediately after hospitalization and also after discharge, which can lead to health consequences and a lower quality of life. For these reasons, the aim of this study (NCT05312060) was to evaluate the effectiveness of a specific intermittent leg pneumatic compression on lower limb edema and physical outcomes in patients after total hip arthroplasty, compared to standard conservative treatment. A total of 47 patients were enrolled and randomly allocated into two groups: the pneumatic compression group (PG = 24) and the control group (CG = 23). The CG performed the standard venous thromboembolism therapy, which included pharmacological prophylaxis, compressive stockings, and electrostimulation, while the PG combined pneumatic compression with standard VTE therapy. We evaluated thigh and calf circumferences, knee and ankle ranges of motion, pain, and walking autonomy. Our results showed a greater reduction in thigh and calf circumferences for PG (p < 0.001), while other outcomes were similar for the two groups (p > 0.05). The combination of standard therapy with pneumatic leg compression was more effective at reducing lower limb edema and thigh and calf circumferences than standard treatment. Our results suggest that pressotherapy treatment is a valuable and efficient option for managing lower limb edema after THA.

Childhood Obesity and Incorrect Body Posture: Impact on Physical Activity and the Therapeutic Role of Exercise.

Obesity is associated with various dysfunctions of the organism, including musculoskeletal problems. In this narrative review, we aim to consider postural problems in children and adolescents with obesity, focusing on the relationship with its negative impact on physical activity, and to discuss the role of exercise as a therapeutic approach. The body reacts to excess weight by changing its normal balance, and the somatosensory system of children with obesity is forced to make major adjustments to compensate for postural problems. These adaptations become more difficult and tiring if activities that require continuous postural changes and multi-tasking are engaged in. Children with obesity have less body control and functional ability due to the excess fat mass, which reduces their ability to perform motor skills and take part in physical activity. Appropriate early interventions for the management of musculoskeletal problems are needed to ensure healthy growth and to prevent comorbidities in childhood and adulthood. Prevention programs must be based not only on the reduction of body weight but also on the definition of correct postural habits from an early age. It is equally important to provide correct information on the types and doses of physical activity that can help prevent these problems.

eHealth, telehealth, and telemedicine in the management of the COVID-19 pandemic and beyond: Lessons learned and future perspectives.

In this article, we discuss evidence supporting the effective implementation of eHealth, telehealth, and telemedicine during the coronavirus disease 2019 pandemic, with a view towards its permanent future integration in healthcare. We performed a literature search for articles describing the use of telehealth/ telemedicine in the pandemic context using five databases. The articles selected describe the use of telemedicine as its advantages in terms of practicality and cost-effectiveness. This synthesis of articles is applicable to high-, middle- and low-income countries. Some of the notable benefits include breaking down geographical and time barriers, reducing waiting lists and crowding in healthcare facilities, and saving on national healthcare expenditure. However, there are a number of difficulties with the widespread implementation of telemedicine services that mainly relate to bureaucratic and regulatory concerns. Moreover, it is also important to make healthcare professionals and providers aware of the limits of this tool to avoid potential cases of negligence. Patients in turn will have to be made aware of and be educated on the use of this new healthcare modality before it is accepted by them. In the current socio-economic climate, it is therefore essential to implement a telehealth model aimed at efficiency and continuity of healthcare, as well as leading to an improvement in the quality of life of patients, whilst optimising existing resources and reducing costs. In that regard, the adoption of eHealth, telehealth, and telemedicine services should be considered highly timely, despite current existing limitations.

Acute Effects of Self-Correction on Spine Deviation and Balance in Adolescent Girls with Idiopathic Scoliosis.

Background: Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of spine and trunk with a higher incidence in girls. AIS alters and reduces postural control and balance. Self-correction movement (SCM) is a well-known non-invasive approach to ameliorate spine curve in AIS subjects. We aimed to evaluate the effects of SCM on the spine and on the balance of adolescents with AIS with a new non-invasive instrumentation. Methods: A total of 38 girls with AIS were recruited. To evaluate the acute effects of SCM and the oscillations of center of pressure (COP), we used LiDAR technology combined with a stabilometric platform to evaluate both changes in spinal curves and balance at the same time. Two tests were carried out simultaneously using the two instruments: before the execution of SCM, in the spontaneously assumed position of each subject (SP) and after the execution of SCM, during the achieved position (SC). Sway area, COP medio-lateral and antero-posterior directions, eccentricity of the ellipse and vertebral lateral deviation were recorded. The two conditions were compared with a Wilcoxon signed-rank test. Results: In general, all measures showed lower values in SC condition (p < 0.05), except the variation along the Y axis. Conclusions: Thanks to objective measured data, the therapists observed real-time changes during the performance of SCM, appreciating its efficacy on curve correction.

Displacement of Centre of Pressure during Rehabilitation Exercise in Adolescent Idiopathic Scoliosis Patients.

BACKGROUND: Adolescent idiopathic scoliosis (AIS) is included into the category of pathologies that could affect postural control. Rarely AIS shows symptoms but often compromises the normal positioning of the head, trunk and, more generally, of the limbs in the space. We used a stabilometric platform to evaluate the motor control outcomes during a self-elongation in girls with AIS. METHODS: In 10 girls with AIS, we evaluated the center of pressure (COP) modifications on a baropodometric platform in a standing position and after a self-elongation correction. RESULTS: All the outcomes (except the eccentricity) showed an increasement during the self-elongation exercise even if the significant differences were not found. CONCLUSION: SE correction contributes to ameliorate the COP symmetry with a better repercussion on the balance management. This highlights the importance of repetitions during all activities of daily life.

The Effects of Insole-Based Visual Feedback on Weight-Bearing in Patients Undergoing Total Hip Replacement.

This study aimed to investigate the visual biofeedback effect of a sensorized system for plantar pressure dynamic evaluation of in patients with a total hip replacement. Experimental group followed the rehabilitation training wearing sensorized insoles that provided images on three monitors. The control group followed the verbal instructions of physiotherapists during training. Weight bearing percentage healthy limb (WBPH), weight bearing percentage surgical limb (WBPS), swing healthy limb (SWH) and swing surgical limb (SWS) improved significantly more in the experimental group. The results underline the effectiveness of visual biofeedback based on sensorized system with dynamic evaluation of the plantar pressure.

Comparison of an Inertial Measurement Unit System and Baropodometric Platform for Measuring Spatiotemporal Parameters and Walking Speed in Healthy Adults.

Spatiotemporal parameters of walking are used to identify gait impairments and provide a tailored therapy program. Baropodometric platforms are not often used for measuring spatiotemporal parameters and walking speed and it is required to determine accuracy. The aim of this study was to compare FreeMed® Platform gait outcomes with a validated inertial measurement unit. There were 40 healthy adults without walking impairments enrolled. Each subject walked along a 15-m walkway at self and slow self-selected speed wearing an inertial measurement unit on the FreeMed® Platform. Stride length and time, right and left stance, swing time, and walking speed were recorded. Walking speed, stride length, and step time showed a very high level of agreement at slow walking speed and a high and moderate level of agreement at normal walking speed. FreeMed® Platform is useful to assess gait outcomes and could improve the exercise prescription.

The Effect of High Velocity Low Amplitude Cervical Manipulations on the Musculoskeletal System: Literature Review.

In manual therapy, high velocity low amplitude (HVLA) cervical manipulation techniques are frequently used, but often the physiological and biomechanical effects that can be obtained are not completely clear. The techniques are mostly used for the treatment of biomechanical joint dysfunction, but little is yet known about the possibility of using them in order to achieve better performance on healthy subjects. The objective of the study is to describe how cervical manipulation can impact on a musculoskeletal disorder. A systematic search was carried out on the Pubmed electronic database from the beginning of January to March 2020. Two independent reviewers conducted the screening process through the PRISMA diagram to determine the eligibility of the articles. The inclusion criteria covered randomized controlled trial (RCT) manuscripts published in peer-reviewed journals with individuals of all ages from 2005 to 2020. The included intervention was thrust manipulation or HVLA directed towards the cervical spine region. After reviewing the literature, 21 of 74 articles were considered useful and relevant to the research question. The results of the research show that HVLA techniques, on subjects with musculoskeletal disorders, are able to influence pain modulation, mobility and strength both in the treated area and at a distance. Cervical manipulations are effective in management of cervicalgia, epicondylalgia, temporomandibular joint disorders and shoulder pain. With regard to results on strength in healthy subjects, given the divergent opinions of the authors, we cannot yet state that manipulation can significantly influence this parameter. Cervical manipulations can also have risks for the patient if applied when not appropriate but the frequency of complications due to vertebral manipulation are very low. However, the manipulation techniques might be limited by low patients tolerance or the presence of contraindications. In addition, the optimal number of manipulations to be performed and the long-term benefits produced are unknown.