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Editorial

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Open AccessEditorial

Musculoskeletal Rehabilitation: State-of-the-Art

by Alessandro de Sire and Marco Invernizzi

Appl. Sci. 2021, 11(14), 6243; https://doi.org/10.3390/app11146243 - 6 Jul 2021

Cited by 4 | Viewed by 2557

Abstract

Musculoskeletal rehabilitation has been receiving growing attention in the scientific research field taking into account the functional consequences of chronic pain that have been frequently underestimated and undertreated. The usual rehabilitative care of a wide range of diseases affecting physical function and independence [...] Read more.

Musculoskeletal rehabilitation has been receiving growing attention in the scientific research field taking into account the functional consequences of chronic pain that have been frequently underestimated and undertreated. The usual rehabilitative care of a wide range of diseases affecting physical function and independence in activities of daily living needs to be improved with novel approaches. In this scenario, the recent literature has highlighted the great advantages of multidisciplinary and comprehensive pain management. The Special Issue highlights the importance of advancements in musculoskeletal rehabilitation in terms of instrumental physical therapies, therapeutic exercise, osteopathic manual therapy, innovative approaches and the correlation with dentistry. Physicians should be aware of the presence of novel therapeutic approaches that are changing the clinical scenario of musculoskeletal rehabilitation. Full article

(This article belongs to the Special Issue Musculoskeletal Rehabilitation)

Research

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17 pages, 3265 KiB

Open AccessArticle

Alexander Technique vs. Targeted Exercise for Neck Pain—A Preliminary Comparison

by Jordan J. Becker, Tara L. McIsaac, Shawn L. Copeland and Rajal G. Cohen

Appl. Sci. 2021, 11(10), 4640; https://doi.org/10.3390/app11104640 - 19 May 2021

Cited by 4 | Viewed by 6030

Abstract

Background: Alexander technique private lessons have been shown to reduce chronic neck pain and are thought to work by different mechanisms than exercise. Group classes may also be effective and would be cost-effective. Design: A two-group pre-test/post-test design. Participants were assigned [...] Read more.

Background: Alexander technique private lessons have been shown to reduce chronic neck pain and are thought to work by different mechanisms than exercise. Group classes may also be effective and would be cost-effective. Design: A two-group pre-test/post-test design. Participants were assigned to either a general Alexander technique class or an exercise class designed to target neck pain. Both groups met over 5 weeks for two 60 min sessions/week. Participants: A total of 16 participants with chronic neck pain (aged 50+/−16 years) completed this study. Interventions: The Alexander class used awareness-building methods to teach participants to reduce habitual tension during everyday activities. The exercise class was based on physical therapy standard of care to strengthen neck and back muscles thought to be important for posture. Measures: We assessed neck pain/disability, pain self-efficacy, activation of the sternocleidomastoid muscles during the cranio-cervical flexion test, and posture while participants played a video game. Results: Both groups reported decreased neck pain/disability after the interventions. Sternocleidomastoid activation decreased only in the Alexander group. Conclusion: In this small preliminary study, Alexander classes were at least as effective as exercise classes in reducing neck pain and seemed to work via a different mechanism. Larger, multi-site studies are justified. Full article

(This article belongs to the Special Issue Musculoskeletal Rehabilitation)

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13 pages, 8266 KiB

Open AccessArticle

Efficacy of Joint Mobilization Apparatus in Treating Frozen Shoulder

by Cheng-Ju Wu, Hua Ting, Chuan-Chao Lin, Yi-Chung Chen, Ming-Che Chao and Shin-Da Lee

Appl. Sci. 2021, 11(9), 4184; https://doi.org/10.3390/app11094184 - 4 May 2021

Cited by 4 | Viewed by 7605

Abstract

This purpose of this study is to investigate the efficacy of shoulder joint mobilization generated by an innovative servomotor joint mobilization apparatus that was developed in this research for patients suffering from frozen shoulder. Forty-eight patients with frozen shoulder were recruited and stratified [...] Read more.

This purpose of this study is to investigate the efficacy of shoulder joint mobilization generated by an innovative servomotor joint mobilization apparatus that was developed in this research for patients suffering from frozen shoulder. Forty-eight patients with frozen shoulder were recruited and stratified randomly assigned into one of two groups: joint mobilization apparatus (posterior and inferior gliding, 80 N, 5 Hz, 30 min) combined with regular therapy (experimental group; EG) versus a regular therapy alone group (control group; CG), three times a week for eight weeks. The visual analogue scale (VAS) for pain and shoulder range of motion (ROM) were measured before, during, and the end of the treatment. Results showed that the shoulder flexion, abduction, internal rotation, and external rotation of the EG improved by 36%, 51%, 81%, and 88%, respectively, while VAS pain scores decreased by 62% when compared with the baseline. Furthermore, the shoulder flexion, abduction, internal rotation, external rotation, and pain score of the EG was 11%, 25%, 41%, 24%, and 34% better than those of the CG, respectively. No complaint as well as no side effects were found during or after usage of the joint mobilization apparatus in EG. This study suggests that the joint mobilization apparatus operated by a very small amount of professional manpower and combined with physical therapy further improves shoulder ROM and pain in patients with frozen shoulder compared to regular physical therapy alone and could be one of the new therapeutic regimens in the future. Full article

(This article belongs to the Special Issue Musculoskeletal Rehabilitation)

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11 pages, 562 KiB

Open AccessArticle

The Effects of Visuomotor Training on the Functional Recovery of Post-Surgery Musculoskeletal Conditions: A Randomized Controlled Trial

by Elisa Andrenelli, Luciano Sabbatini, Maurizio Ricci, Maria Gabriella Ceravolo and Marianna Capecci

Appl. Sci. 2021, 11(9), 4053; https://doi.org/10.3390/app11094053 - 29 Apr 2021

Cited by 2 | Viewed by 2012

Abstract

(1) Background: Musculoskeletal conditions show increasing prevalence and high economic/human burden. Recovery for hip or knee surgery may require more than 26 weeks, while universally accepted rehabilitation guidelines are missing. Provided that multisensory-based training enhances motor learning, the study aims to verify if [...] Read more.

(1) Background: Musculoskeletal conditions show increasing prevalence and high economic/human burden. Recovery for hip or knee surgery may require more than 26 weeks, while universally accepted rehabilitation guidelines are missing. Provided that multisensory-based training enhances motor learning, the study aims to verify if visuomotor training accelerates the recovery of lower limb motor function after orthopedic surgery. (2) Methods: Post-surgery subjects were randomly assigned to receive visuomotor training as an add-on to the conventional physical therapy (VTG), or receive the conventional therapy alone (CG). Subjects performed 40 one-hour training sessions in 8 weeks. The primary endpoint was the improvement in the Lower Extremity Functional Scale (LEFS) over the minimally clinical important difference (MCID) at 4 weeks post-randomization. The secondary endpoint included pain reduction. (3) Results: Eighteen patients were equally distributed into the VTG and CG groups. While LEFS and pain scores significantly improved in both groups, the VTG exceeded the LEFS MCID by 12 points and halved the pain value after the first 4 weeks of treatment, while the CG reached the endpoints only after treatment end (p = 0.0001). (4) Conclusions: Visuomotor training offers an innovative rehabilitation approach that accelerates the recovery of lower limb motor function in patients undergoing orthopedic surgery. Full article

(This article belongs to the Special Issue Musculoskeletal Rehabilitation)

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17 pages, 1285 KiB

Open AccessArticle

High Intensity Training Increases Muscle Area Occupied by Type II Muscle Fibers of the Multifidus Muscle in Persons with Non-Specific Chronic Low Back Pain: A Pilot Trial

by Anouk Agten, Jonas Verbrugghe, Sjoerd Stevens, Bert O. Eijnde, Annick Timmermans and Frank Vandenabeele

Appl. Sci. 2021, 11(8), 3306; https://doi.org/10.3390/app11083306 - 7 Apr 2021

Cited by 6 | Viewed by 2422

Abstract

Low back pain is a prevalent musculoskeletal disorder with high disability. Although exercise therapy is an important part of the multidisciplinary treatment of non-specific chronic low back pain (NSCLBP), the impact of exercise therapy on muscle morphology of the paraspinal muscles is largely [...] Read more.

Low back pain is a prevalent musculoskeletal disorder with high disability. Although exercise therapy is an important part of the multidisciplinary treatment of non-specific chronic low back pain (NSCLBP), the impact of exercise therapy on muscle morphology of the paraspinal muscles is largely unknown. The main aim of this study is to evaluate the effects of a high intensity training (HIT) program on muscle fiber characteristics of the multifidus (MF) and the erector spinae (ES) musculature in persons with NSCLBP and to compare these results with the effects of a moderate intensity training (MIT) program, which is used as a control group. In total, 38 participants with NSCLBP were randomly assigned to a HIT or MIT intervention group. Participants performed a 12-week training program. At baseline and after the training program, biopsy samples from the lumbar MF and ES were obtained. Muscle fiber characteristics were analyzed by immunofluorescence. For the ES, no significant changes were found in muscle fiber CSA and distribution of muscle fiber types in response to a training program at moderate or at high intensity. For the MF, a significant higher muscle area occupied by type II muscle fibers, referred to as the relative cross-sectional area (RCSA), was found in the HIT group. Based on muscle fiber characteristics in biopsy samples, a HIT program of 12 weeks seems to result in a more glycolytic profile in the MF. Full article

(This article belongs to the Special Issue Musculoskeletal Rehabilitation)

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17 pages, 3511 KiB

Open AccessArticle

DNN-Based FES Control for Gait Rehabilitation of Hemiplegic Patients

by Suhun Jung, Jae Hwan Bong, Seung-Jong Kim and Shinsuk Park

Appl. Sci. 2021, 11(7), 3163; https://doi.org/10.3390/app11073163 - 1 Apr 2021

Cited by 8 | Viewed by 4061

Abstract

In this study, we proposed a novel machine-learning-based functional electrical stimulation (FES) control algorithm to enhance gait rehabilitation in post-stroke hemiplegic patients. The electrical stimulation of the muscles on the paretic side was controlled via deep neural networks, which were trained using muscle [...] Read more.

In this study, we proposed a novel machine-learning-based functional electrical stimulation (FES) control algorithm to enhance gait rehabilitation in post-stroke hemiplegic patients. The electrical stimulation of the muscles on the paretic side was controlled via deep neural networks, which were trained using muscle activity data from healthy people during gait. The performance of the developed system in comparison with that of a conventional FES control method was tested with healthy human subjects. Full article

(This article belongs to the Special Issue Musculoskeletal Rehabilitation)

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8 pages, 518 KiB

Open AccessArticle

Lymphedema Rehabilitation Using Self-Adaptive Inelastic Compression in Breast Cancer: A Proof-of-Principle Study

by Alessandro de Sire, Nicola Fusco, Elham Sajjadi, Lorenzo Lippi, Carlo Cisari and Marco Invernizzi

Appl. Sci. 2021, 11(4), 1901; https://doi.org/10.3390/app11041901 - 22 Feb 2021

Cited by 14 | Viewed by 3787

Abstract

Inelastic compression (IC) has been proposed as a therapeutic option in the management of breast cancer-related lymphedema (BCRL). To date, no studies have investigated the reliability of IC in the rehabilitative management of BCRL. Thus, we aimed at evaluating the safety and tolerability [...] Read more.

Inelastic compression (IC) has been proposed as a therapeutic option in the management of breast cancer-related lymphedema (BCRL). To date, no studies have investigated the reliability of IC in the rehabilitative management of BCRL. Thus, we aimed at evaluating the safety and tolerability of an instantly adjustable IC device for BCRL patients. We included BCRL patients referred to an Oncological Rehabilitation Unit. They were subjected to complex decongestion therapy using a self-adaptive IC device. The primary outcome was safety and tolerability of IC in the rehabilitation treatment of BCRL patients. Secondary outcomes were: BCRL volume modifications; disability; quality of life; IC application time. Outcomes were assessed at the baseline (T0), at the end of the 2-week rehabilitation treatment (T1), and at 1 month (T2). Nine BCRL women, mean aged 56.7 ± 4.4 years, were enrolled. None showed side effects, except for a low discomfort and moderate swelling reported by 1 patient (11.1%). BCRL volume significantly reduced at T1 (p = 0.001) with a positive trend at T2. IC timing was significantly reduced at T1 (p = 0.035) and T2 (p = 0.003). Taken together, these findings suggested that IC could be considered as a safe, well-tolerated, and effective tool in the rehabilitative management of BCRL patients. Full article

(This article belongs to the Special Issue Musculoskeletal Rehabilitation)

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12 pages, 669 KiB

Open AccessArticle

Postural Evaluation in Sports and Sedentary Subjects by Rasterstereographic Back Shape Analysis

by Andrea Bernetti, Francesco Agostini, Angelo Cacchio, Valter Santilli, Pierangela Ruiu, Teresa Paolucci, Marco Paoloni and Massimiliano Mangone

Appl. Sci. 2020, 10(24), 8838; https://doi.org/10.3390/app10248838 - 10 Dec 2020

Cited by 11 | Viewed by 2795

Abstract

Posture is defined as the position of the body in space, the aim of which is to maintain balance, both in static and dynamic conditions. Our purpose was to study various postural variables involved in postural adaptations of athletes practicing symmetric and asymmetric [...] Read more.

Posture is defined as the position of the body in space, the aim of which is to maintain balance, both in static and dynamic conditions. Our purpose was to study various postural variables involved in postural adaptations of athletes practicing symmetric and asymmetric sports at professional level. Methods: Patients include sedentary subjects, competitive athletes practicing symmetrical and asymmetrical sports. Postural evaluation of the three different groups was performed using the rasterstereographic-system Formetric-4D. Results: 157 subjects were recruited. From the comparison between subjects playing symmetrical and asymmetrical sports, arises a statistically significant difference on cervical (p = 0.041) and lumbar (p = 0.047) flèche of Stagnara, with higher values for symmetrical athletes’ group. Hemipelvis torsion (p = 0.031) and lumbar flèche (p ≤ 0.001) of Stagnara are higher in symmetrical athletes’ group (sedentary). Hemipelvis torsion, cervical and lumbar flèche resulted to be higher among athletes (sedentary) (p = 0.016, p = 0.003, p = 0.027). Conclusions: In addition to the competitive sports’ medical examination, a screening with rasterstereographic-system Formetric-4D is suggested to all sedentary subjects, without serious skeletal pathologies which want to start athletic activity. Rasterstereographic-system Formetric-4D is also suggested to all athletes practicing sports, with the aim to identify eventual unknown postures, consequent to reiterated repetition of specific movements. Full article

(This article belongs to the Special Issue Musculoskeletal Rehabilitation)

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9 pages, 441 KiB

Open AccessArticle

Acute Effect of the Compression Technique on the Electromyographic Activity of the Masticatory Muscles and Mouth Opening in Subjects with Active Myofascial Trigger Points

by Michał Ginszt, Grzegorz Zieliński, Marcin Berger, Jacek Szkutnik, Magdalena Bakalczuk and Piotr Majcher

Appl. Sci. 2020, 10(21), 7750; https://doi.org/10.3390/app10217750 - 2 Nov 2020

Cited by 14 | Viewed by 2568

Abstract

Active myofascial trigger points (MTrPs) in masticatory muscles are associated with a reduced range of motion and muscle weakness within the stomatognathic system. However, it is hard to identify the most effective treatment technique for disorders associated with MTrPs. The objective of this [...] Read more.

Active myofascial trigger points (MTrPs) in masticatory muscles are associated with a reduced range of motion and muscle weakness within the stomatognathic system. However, it is hard to identify the most effective treatment technique for disorders associated with MTrPs. The objective of this study was to analyze the acute effect of the compression technique (CT) on active maximal mouth opening (MMO) and electromyographic activity of the masseter (MM) and temporalis anterior (TA) muscles in subjects with active myofascial trigger points in the MM muscles. The study group comprised 26 women (mean age 22 ± 2) with bilateral active myofascial trigger points (MTrPs) in the MM. The control group comprised 26 healthy women (mean age 22 ± 1) without the presence of MTrPs in the MM. Masticatory muscle activity was recorded in two conditions (during resting mandibular position and maximum voluntary clenching) before and after the application of the CT to the MTrPs in MM. After the CT application, a significant decrease in resting activity (3.09 μV vs. 2.37 μV, p = 0.006) and a significant increase in clenching activity (110.20 μV vs. 139.06 μV, p = 0.014) within the MM muscles were observed in the study group, which was not observed within TA muscles. Controls showed significantly higher active MMO values compared to the study group before CT (50.42 mm vs. 46.31 mm, p = 0.024). The differences between the study group after CT and controls, as well as among the study group before and after CT did not reach the assumed level of significance in terms of active MMO. The compression technique appears to be effective in the improvement of the active maximal mouth opening and gives significant acute effects on bioelectric masticatory muscle activity. Therefore, CT seems to be effective in MTrPs rehabilitation within the stomatognathic system. Full article

(This article belongs to the Special Issue Musculoskeletal Rehabilitation)

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7 pages, 761 KiB

Open AccessCommunication

Trunk Posture Adaptations during Sitting on Dynamic Stool: A Validation Study

by Alessandro Picelli, Giuliano Mazzocco and Nicola Smania

Appl. Sci. 2020, 10(21), 7567; https://doi.org/10.3390/app10217567 - 27 Oct 2020

Cited by 7 | Viewed by 4568

Abstract

Back pain is a complex condition that results from multiple factors including sitting issues such as the chair type and spinal sitting posture. The physiological spinal curvature on the sagittal plane represents a typical feature of good body posture. Sitting postures matching the [...] Read more.

Back pain is a complex condition that results from multiple factors including sitting issues such as the chair type and spinal sitting posture. The physiological spinal curvature on the sagittal plane represents a typical feature of good body posture. Sitting postures matching the physiological shape of the spine on the sagittal plane during standing are deemed advantageous from a postural point of view. The aim of this study was to validate a novel dynamic stool by comparing trunk posture adaptations on the sagittal plane during dynamic sitting vs. conventional sitting (standard stool) in healthy people. In total, 100 healthy adults were included. Age, sex and body mass index were recorded. Thoracic kyphosis and lumbar lordosis were measured with the IncliMed^® goniometer during standing posture, conventional sitting posture (standard stool) and dynamic sitting posture (novel dynamic stool). Sitting posture was maintained for 2 min before evaluation. Thoracic kyphosis and lumbar lordosis were significantly different between standing vs. sitting (dynamic and conventional) posture (p < 0.001) and between dynamic vs. conventional sitting posture (p < 0.001). Sitting on the novel dynamic stool tested in this study was shown to provide a greater match of thoracic kyphosis and lumbar lordosis with the physiological spinal curvature on the sagittal plane during standing than conventional sitting. Full article

(This article belongs to the Special Issue Musculoskeletal Rehabilitation)

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Review

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15 pages, 11466 KiB

Open AccessReview

Acupressure for Managing Osteoarthritis: A Systematic Review and Meta-Analysis

by Lin Ang, Eunhye Song, Hyewon Lee and Myeongsoo Lee

Appl. Sci. 2021, 11(10), 4457; https://doi.org/10.3390/app11104457 - 14 May 2021

Cited by 3 | Viewed by 3927

Abstract

This review aims to evaluate the effectiveness of acupressure as a treatment method for osteoarthritis. Fourteen electronic databases were searched from the date of inception until 16 March 2021, for eligible studies. Studies comparing acupressure with sham acupuncture, no intervention or conventional intervention [...] Read more.

This review aims to evaluate the effectiveness of acupressure as a treatment method for osteoarthritis. Fourteen electronic databases were searched from the date of inception until 16 March 2021, for eligible studies. Studies comparing acupressure with sham acupuncture, no intervention or conventional intervention were eligible for inclusion. The risk of bias of the included studies was assessed using the Cochrane Collaboration’s Risk of Bias Assessment tool Version 2.0. A total of eight trials were included in this review, focusing on the seven trials investigating knee osteoarthritis. The risk of bias is judged as low in only two trials and concerning in the remaining six trials. The meta-analysis showed that acupressure has equivalent effects in reducing pain (p = 0.12), relieving stiffness (p = 0.38), and improving physical function (p = 0.12), as compared to sham acupressure. Pooled results also showed similar results where acupressure has an equivalent effect in reducing pain (p = 0.09), and relieving stiffness (p = 0.68), but showed a favorable effect in improving physical function of joints (MD –6.30, CI 95%: −11.69 to −0.92, p = 0.02), as compared to no intervention. For acupressure complementing conventional intervention, pooled results showed superior effects for easing pain compared to conventional intervention alone (MD −3.72, 95% CI: −4.84 to −2.61, p < 0.00001). Overall, the studies included in this review have concerning quality and suffer from small sample sizes, and the findings of this review should be interpreted with caution. More clinical trials with proper methodology are needed to confirm the effectiveness of acupressure for osteoarthritis. Full article

(This article belongs to the Special Issue Musculoskeletal Rehabilitation)

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10 pages, 3262 KiB

Open AccessFeature PaperReview

Percutaneous Electrical Nerve Stimulation (PENS) as a Rehabilitation Approach for Reducing Mixed Chronic Pain in Patients with Musculoskeletal Disorders

by Alessandro de Sire, Antonio Ammendolia, Lorenzo Lippi, Giacomo Farì, Carlo Cisari and Marco Invernizzi

Appl. Sci. 2021, 11(9), 4257; https://doi.org/10.3390/app11094257 - 8 May 2021

Cited by 17 | Viewed by 9493

Abstract

“Mixed pain” is a term recently introduced to define the overlapping of nociceptive, neuropathic and nociplastic pain. To date, it has been reported that pharmacological treatments might have a modest effectiveness on patients affected by mixed chronic pain, with detrimental consequences in terms [...] Read more.

“Mixed pain” is a term recently introduced to define the overlapping of nociceptive, neuropathic and nociplastic pain. To date, it has been reported that pharmacological treatments might have a modest effectiveness on patients affected by mixed chronic pain, with detrimental consequences in terms of disability, physical function and health-related quality of life. In this scenario, Percutaneous Electrical Nerve Stimulation (PENS), a mini-invasive neuromodulation technique, has been recently suggested as a promising approach for the complex management of mixed pain in musculoskeletal disorders. Albeit PENS showed to be effective in reducing unspecified pain in several chronic pain conditions, there is still a lack of evidence in the literature about its role in the management of neuropathic or mixed pain not responsive to pharmacological treatments. Therefore, by the present scoping review, we portray the potential effects of PENS in the multidisciplinary and multidimensional management of mixed chronic pain in patients with musculoskeletal disorders. Full article

(This article belongs to the Special Issue Musculoskeletal Rehabilitation)

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29 pages, 35637 KiB

Open AccessReview

The Effectiveness of Pump Techniques and Pompages: A Systematic Review

by Carla Vanti, Matteo Golfari, Giacomo Pellegrini, Alice Panizzolo, Luca Turone, Silvia Giagio and Paolo Pillastrini

Appl. Sci. 2021, 11(9), 4150; https://doi.org/10.3390/app11094150 - 1 May 2021

Cited by 1 | Viewed by 4708

Abstract

Background: Osteopathic manual procedures called pump techniques include thoracic, abdominal, and pedal pumps. Similar techniques, called pompages, are also addressed to joints and muscles. Despite their widespread use, no systematic review has been published on their effectiveness. (2) Methods: CINAHL, Cochrane Controlled Trials [...] Read more.

Background: Osteopathic manual procedures called pump techniques include thoracic, abdominal, and pedal pumps. Similar techniques, called pompages, are also addressed to joints and muscles. Despite their widespread use, no systematic review has been published on their effectiveness. (2) Methods: CINAHL, Cochrane Controlled Trials Register, ISI Web of Science, PEDro, PubMed, and Scopus databases were searched until July 2020. Randomized Controlled Trials (RCTs) on adults were included. Subjective (e.g., pain, physical function) and objective (e.g., pulmonary function, blood collection) outcomes were considered. The Risk of Bias tool (RoB 2) and the GRADE instrument were used to evaluate the quality of evidence. (3) Results: 25 RCTs were included: 20 concerning the pump techniques and five concerning pompages. Due to the extensive heterogeneity of such studies, it was not possible to perform a meta-analysis. The risk of bias resulted from moderate to high and the quality of the evidence was from very low to high. Singular studies suggested some effectiveness of pump techniques on pain and length of hospitalization. Pompage seems also to help improve walking distance and balance. (4) Conclusions: Although several studies have been published on manual pump techniques, the differences for population, modalities, dosage, and outcome measures do not allow definite conclusions of their effectiveness. Full article

(This article belongs to the Special Issue Musculoskeletal Rehabilitation)

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10 pages, 552 KiB

Open AccessReview

Type I Collagen-Based Devices to Treat Nerve Injuries after Oral Surgery Procedures. A Systematic Review

by Andrea Roccuzzo, Pedro Molinero-Mourelle, Martina Ferrillo, Carlos Cobo-Vázquez, Luis Sanchez-Labrador, Antonio Ammendolia, Mario Migliario and Alessandro de Sire

Appl. Sci. 2021, 11(9), 3927; https://doi.org/10.3390/app11093927 - 26 Apr 2021

Cited by 22 | Viewed by 2842

Abstract

The regeneration of nerve injuries after oral surgery procedures is a quite often attempted procedure in dental medicine. Despite several proposed technical approaches, there is still a lack of consensus on which should be considered the gold standard procedure, even-though in the last [...] Read more.

The regeneration of nerve injuries after oral surgery procedures is a quite often attempted procedure in dental medicine. Despite several proposed technical approaches, there is still a lack of consensus on which should be considered the gold standard procedure, even-though in the last decades, the use of collagen-based devices allowing a tension-free direct neurorrhaphy has been used. A systematic search of multiple electronic databases and hand searching was conducted to assess the level of evidence behind the use of type I collagen devices to treat nerve injuries after oral surgery procedures. After screening, four articles (one case series and three retrospective studies) including overall 65 patients suffering from inferior alveolar (IAN)/lingual nerve (LN) injury after mandibular wisdom tooth extraction, met the inclusion criteria and could be included. The Oxford Centre for evidence-based medicine (OCEBM) scaling system was used to evaluate the quality of the included studies. Positive clinical results in terms of sensorial improvements were recorded at least 3 months after surgery, even-though the overall level of evidence is low. The use of collagen membranes to enhance nerve regeneration in oral surgery results in promising results. Nevertheless, additional clinical comparative trials with larger sample sizes are needed. Full article

(This article belongs to the Special Issue Musculoskeletal Rehabilitation)

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17 pages, 21542 KiB

Open AccessReview

Ultrasound-Guided Procedures in Common Tendinopathies at the Elbow: From Image to Needle

by Kamal Mezian, Jakub Jačisko, Tomáš Novotný, Laura Hrehová, Yvona Angerová, Karolína Sobotová and Ondřej Naňka

Appl. Sci. 2021, 11(8), 3431; https://doi.org/10.3390/app11083431 - 12 Apr 2021

Cited by 3 | Viewed by 10531

Abstract

Elbow pain is a prevalent condition in musculoskeletal physicians’ settings. The majority of cases present with periarticular pathologies (varying from tendinopathy to nerve entrapment syndrome). Nevertheless, in some cases, the underlying cause can be intra-articular, e.g., loose bodies or rheumatic disease. Progress in [...] Read more.

Elbow pain is a prevalent condition in musculoskeletal physicians’ settings. The majority of cases present with periarticular pathologies (varying from tendinopathy to nerve entrapment syndrome). Nevertheless, in some cases, the underlying cause can be intra-articular, e.g., loose bodies or rheumatic disease. Progress in ultrasound (US) technology has yielded high-resolution assessment of the elbow and, importantly, allows real-time, radiation-free guidance for interventions. Particularly in ambiguous cases, US imaging is necessary to arrive at the correct diagnosis. The following four clinical conditions are covered: tennis elbow, golfer’s elbow, distal biceps, and distal triceps tendinopathy. The present review illustrates cadaveric elbow anatomy, corresponding US images, and exemplary pathologies. Additionally, the authors also discuss the existing evidence on ultrasound-guided procedures in the conditions mentioned above. Full article

(This article belongs to the Special Issue Musculoskeletal Rehabilitation)

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11 pages, 881 KiB

Open AccessFeature PaperReview

Efficacy of TENS in Cervical Pain Syndromes: An Umbrella Review of Systematic Reviews

by Teresa Paolucci, Francesco Agostini, Marco Paoloni, Alessandro de Sire, Simone Verna, Mirko Pesce, Luca Ribecco, Massimiliano Mangone, Andrea Bernetti and Raoul Saggini

Appl. Sci. 2021, 11(8), 3423; https://doi.org/10.3390/app11083423 - 11 Apr 2021

Cited by 4 | Viewed by 7309

Abstract

Neck pain is defined as perceived pain, originating in an area bounded above by the nuchal line, below by an imaginary line passing through the spinous process of T1 and laterally by the sagittal plane tangent to the lateral edges of the neck. [...] Read more.

Neck pain is defined as perceived pain, originating in an area bounded above by the nuchal line, below by an imaginary line passing through the spinous process of T1 and laterally by the sagittal plane tangent to the lateral edges of the neck. Our purpose is to investigate the effectiveness of transcutaneous electrical nerve stimulation (TENS) in patients suffering from both acute and chronic cervical pain syndromes. The literature research was conducted by consulting the following databases: PubMed, PEDro, Cochrane, and Google Scholar. To formulate the scientific question correctly, the PICO model was used. This umbrella review includes all systematic reviews with or without meta-analysis, in English, which analyze the use of TENS in subjects suffering from acute or chronic cervical pain. To evaluate the methodological quality of the studies, the AMSTAR model. A total of eleven systematic reviews with or without meta-analyses were included. The results of the study show how TENS seems to have an effect in reducing the intensity of acute and chronic cervical pain, especially in the short term. However, it was not possible to provide precise recommendations in this regard. Based on our result, it is desirable to carry out further studies that support the effectiveness of using TENS in patients suffering from acute and chronic neck pain. Full article

(This article belongs to the Special Issue Musculoskeletal Rehabilitation)

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13 pages, 557 KiB

Open AccessReview

Efficacy and Effectiveness of Physical Agent Modalities in Complex Regional Pain Syndrome Type I: A Scoping Review

by Antimo Moretti, Francesca Gimigliano, Marco Paoletta, Sara Liguori, Giuseppe Toro, Milena Aulicino, Stefano Conversano and Giovanni Iolascon

Appl. Sci. 2021, 11(4), 1857; https://doi.org/10.3390/app11041857 - 20 Feb 2021

Cited by 8 | Viewed by 7719

Abstract

Complex regional pain syndrome type I (CRPS-I) is a rare condition with huge variability in triggering factors and clinical scenarios. The complexity of the pathophysiology of this condition fosters the proposal of several therapeutic options with different mechanisms of action in both research [...] Read more.

Complex regional pain syndrome type I (CRPS-I) is a rare condition with huge variability in triggering factors and clinical scenarios. The complexity of the pathophysiology of this condition fosters the proposal of several therapeutic options with different mechanisms of action in both research and clinical practice. An interdisciplinary and multimodal approach, including pharmacological and non-pharmacological interventions, particularly physical therapy, is recommended by international guidelines, but the benefits and harms of available interventions are poorly known. In this scoping review, the clinical rationale for use of physical agent modalities for patients with CRPS-I will be presented. We found 10 studies addressing the role of electromagnetic field therapy, electrotherapy, and laser therapy. Our findings suggest that physical therapy modalities, in particular transcutaneous electrical nerve stimulation (TENS) and pulsed electromagnetic field therapy (PEMF), may contribute to reduce pain and improve function in patients with CRPS-1. Full article

(This article belongs to the Special Issue Musculoskeletal Rehabilitation)

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