Physical Medicine and Rehabilitation Unit

Rome, Italy

Physical Medicine and Rehabilitation Unit

Rome, Italy

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Peskine A.,Physical Medicine and Rehabilitation Unit | Peskine A.,University Pierre and Marie Curie | Rosso C.,Stroke Unit | Picq C.,Physical Medicine and Rehabilitation Unit | And 3 more authors.
Brain Injury | Year: 2010

Primary objective: Cardiac arrest can cause neurological impairment. The aim of this study is to confirm the disability and the predominant part of executive and behavioural impairments after cardiac arrest. Research design: A retrospective study is proposed. Methods and procedures: All consecutive patients admitted to the Department of Rehabilitation for Neurological Impairments following cerebral anoxia after cardiac arrest between 19952007 were included. Clinical and neuropsychological assessment was proposed. Main outcomes and results: Thirty patients, 19 men, were examined. Ages ranged from 1658 (mean 39.5). Fourteen patients presented with severe disability and 16 patients presented with moderate disability. In the first group (severe disability) no patients were autonomous for daily life activities. They presented with dysexecutive syndrome and behavioural disorders associated with amnesia syndrome; 64 of them presented with motor disorders. In the second group, patients with moderate disability were autonomous in daily life but not for the complex activities or functioning. They had no motor impairment but suffered from executive and memory impairments. Behavioural changes were noted. Medical history or demographic data did not differ between the two groups. Conclusion: The study confirms the predominant part of executive, memory and behavioural impairments after cardiac arrest. This retrospective study cannot provide prognosis factors and further prognosis studies are needed. © 2010 Informa UK Ltd.


Paoloni M.,University of Rome La Sapienza | Tavernese E.,Bambino Gesu Childrens Hospital | Ioppolo F.,Physical Medicine and Rehabilitation Unit | Fini M.,IRCCS San Raffaele Pisana | And 2 more authors.
Foot | Year: 2014

We report the case of a 46-year-old woman with no known history for gluten sensitivity who presented severe heel pain, and was successfully managed with a gluten-free diet. Previously she had been unsuccessfully treated with several conservative remedies. The presence of musculoskeletal problems in patients with gluten sensitivity is not rare. To the best of our knowledge, however, this is the first case report mentioning the successful management of plantar fasciitis with a gluten-free diet. The case report highlights the importance of considering gluten sensitivity among other possible differential diagnosis for musculoskeletal pain insensitive to traditional therapies. © 2014 Elsevier Ltd.


Paoloni M.,Physical Medicine and Rehabilitation Unit | Paoloni M.,University of Rome La Sapienza | Di Sante L.,Physical Medicine and Rehabilitation Unit | Dimaggio M.,University of Rome La Sapienza | And 6 more authors.
Clinical Biomechanics | Year: 2012

Background: A growing body of evidence points to the efficacy of intra-articular injections of hyaluronic acid, in dealing with pain and function in hip osteoarthritis. To date, however, no data exist as to this treatment's effect on walking pattern. Methods: We performed a prospective, open study in order to verify, in a group of 20 hip osteoarthritis patients (12 men, 8 women, mean age 60.5, range 47-73), the clinical effects of 3 intra-articular injections of 2 ml of hyaluronic acid in the hip (1/week) in terms of pain and function at 1 (T1), 3 (T2) and 6-month (T3) follow-ups, as well as changes in the kinematics and kinetics of gait at 6-month follow-up. Findings: Pain as measured with visual analog scale significantly dropped after this procedure (P < 0.0001). A significant improvement was noted regarding stiffness (P = 0.005) and disability (P = 0.04), as measured by the Western Ontario and McMaster Universities osteoarthritis index. As regards gait analysis, patients at T3 walked with higher cadence (P = 0.004) and stride length (P = 0.02) compared to T0. Moreover, a significant increase for the pelvic tilt at heel contact (P = 0.0004) and for hip flexion-extension moment at loading response sub-phases of gait cycle (P = 0.02) was noted at T3. Interpretation: In line with current literature, our patients display clinical improvement 6 months after intra-articular injections of hyaluronic acid, accompanied by changes in walking pattern, as measured by instrumental gait analysis. The kinematic and kinetic changes observed may be the consequence of the therapeutic effect of intra-articular injections of hyaluronic acid. © 2012 Elsevier Ltd.


Paoloni M.,Physical Medicine and Rehabilitation Unit | Bernetti A.,University of Rome La Sapienza | Fratocchi G.,Physical Medicine and Rehabilitation Unit | Mangone M.,University of Rome La Sapienza | And 6 more authors.
European Journal of Physical and Rehabilitation Medicine | Year: 2011

Background. Kinesio Taping (KT) has proved to be effective in various musculoskeletal conditions. Although its precise working mechanism has yet to be fully understood, it is believed to interact with neuromuscular function through mechanoceptor activation. No studies designed to assess the effects of KT in chronic low back pain (CLBP) patients have yet been conducted. Aim. The aim of this study was to determine the effects of KT on pain, disability and lumbar muscle function in sufferers of CLBP, both immediately and at a one-month follow-up examination. Design. The study consisted of two phases: phase I was based on an intra-subject pre-test/post-test procedure; phase II was based on a randomized, singleblinded controlled trial. Setting. Outpatient facility. Population. Thirty-nine CLBP patients were enrolled. Methods. KT plus exercise, KT alone or exercise alone have been used for four weeks. Pain, disability and lumbar muscle function were evaluated before and after the treatment period. Results. The patients in all three groups displayed a significant reduction in pain after treatment, though only the exercise-alone group displayed reduced disability. A return to normal lumbar muscle function was observed in 28% of patients, but was not related to a reduction in pain. Conclusion. When applied to CLBP patients, KT leads to pain relief and lumbar muscle function normalization shortly after its application; these effects persist over a short follow-up period. Clinical rehabilitation impact. KT may represent an effective adjunct therapy in the physical rehabilitation program of CLBP patients for immediate and acute pain control.


Fratocchi G.,Physical Medicine and Rehabilitation Unit | Di Mattia F.,Physical Medicine and Rehabilitation Unit | Rossi R.,Physical Medicine and Rehabilitation Unit | Mangone M.,University of Rome La Sapienza | And 4 more authors.
Journal of Science and Medicine in Sport | Year: 2013

Objectives: To investigate the effect of Kinesio Taping (KT) applied over the biceps brachii on maximal isokinetic elbow torque. Design: This study followed a single-blinded, placebo controlled, repeated measures design. Methods: Isokinetic eccentric and concentric elbow peak torques were evaluated without taping (NT), with KT or placebo taping (PT) in 20 healthy participants. Furthermore, all the participants were required to perform a proprioceptive task of elbow joint position sense (JPS) in the same experimental conditions. Results: A significant effect of taping condition was found for concentric elbow peak torque (p= 0.01). Post hoc analysis revealed a statistically significant concentric elbow peak torque improvement between NT and KT (p< 0.05) but not between NT and PT. As regards eccentric elbow peak torque, we found a significant effect of taping condition (p< 0.0001). Significant eccentric elbow peak torque differences were observed between NT and PT (p< 0.01) and between KT and PT (p< 0.001), while the increase observed from NT to KT conditions failed to reach significance at a post hoc analysis. Conclusions: When applied over the biceps brachii, KT increases concentric elbow peak torque in a population of healthy participants, if compared with a PT. © 2012 Sports Medicine Australia.


Ioppolo F.,Physical Medicine and Rehabilitation Unit | Tattoli M.,Physical Medicine and Rehabilitation Unit | Di Sante L.,Physical Medicine and Rehabilitation Unit | Venditto T.,University of Rome La Sapienza | And 6 more authors.
Archives of Physical Medicine and Rehabilitation | Year: 2013

Objectives: To evaluate the effectiveness of shock wave therapy (SWT) for functional improvement and the reduction of pain in patients with calcific tendinitis of the shoulder, and to determine the rate of disappearance of calcifications after therapy at 6 months' follow-up. Data Sources: Articles were searched from the Cochrane Library, MEDLINE, Embase, CINAHL, and Ovid database. Study Selection: We included randomized controlled trials from 1992 to 2011, and their quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Data Extraction: Studies were evaluated by 2 independent reviewers for their methodologic quality. Disagreements were settled by a third reviewer. Data were then extracted and cross-checked for accuracy. The reviewers were not blinded to the authors of the articles. Data Synthesis: In 4 of the 6 studies included for review, the resorption of calcifications was evaluated using meta-analysis because the studies had 2 treatment groups, while the other 2 studies were analyzed descriptively because they had 3 treatment groups. Fixed- and random-effects models were used to meta-analyze total and partial resorption ratios, and I2 statistics were calculated to assess heterogeneity. Conclusions: We found a clinical improvement with a pooled total resorption ratio of 27.19 (95% confidence interval [CI], 7.20-102.67) and a pooled partial resorption ratio of 16.22 (95% CI, 3.33-79.01). SWT increases shoulder function, reduces pain, and is effective in dissolving calcifications. These results were maintained over the following 6 months. © 2013 by the American Congress of Rehabilitation Medicine.


Paolucci T.,Physical Medicine and Rehabilitation Unit | Saraceni V.M.,Physical Medicine and Rehabilitation Unit | Piccinini G.,Physical Medicine and Rehabilitation Unit
Journal of Pain Research | Year: 2016

Osteoporosis (OP) is a pathological condition that manifests clinically as pain, fractures, and physical disability, resulting in the loss of independence and the need for long-term care. Chronic pain is a multidimensional experience with sensory, affective, and cognitive aspects. Age can affect each of these dimensions and the pain that is experienced. In OP, chronic pain appears to have sensory characteristics and properties of nociceptive and neuropathic pain. Its evaluation and treatment thus require a holistic approach that focuses on the specific characteristics of this population. Pain management must therefore include pharmacological approaches, physiotherapy interventions, educational measures, and, in rare cases, surgical treatment. Most rehabilitative treatments in the management of patients with OP do not evaluate pain or physical function, and there is no consensus on the effects of rehabilitation therapy on back pain or quality of life in women with OP. Pharmacological treatment of pain in patients with OP is usually insufficient. The management of chronic pain in patients with OP is complicated with regard to its diagnosis, the search for reversible secondary causes, the efficacy and duration of oral bisphosphonates, and the function of calcium and vitamin D. The aim of this review is to discuss the most appropriate solutions in the management of chronic pain in OP. © 2016 Paolucci et al.


PubMed | Physical Medicine and Rehabilitation Unit
Type: | Journal: Journal of pain research | Year: 2016

Osteoporosis (OP) is a pathological condition that manifests clinically as pain, fractures, and physical disability, resulting in the loss of independence and the need for long-term care. Chronic pain is a multidimensional experience with sensory, affective, and cognitive aspects. Age can affect each of these dimensions and the pain that is experienced. In OP, chronic pain appears to have sensory characteristics and properties of nociceptive and neuropathic pain. Its evaluation and treatment thus require a holistic approach that focuses on the specific characteristics of this population. Pain management must therefore include pharmacological approaches, physiotherapy interventions, educational measures, and, in rare cases, surgical treatment. Most rehabilitative treatments in the management of patients with OP do not evaluate pain or physical function, and there is no consensus on the effects of rehabilitation therapy on back pain or quality of life in women with OP. Pharmacological treatment of pain in patients with OP is usually insufficient. The management of chronic pain in patients with OP is complicated with regard to its diagnosis, the search for reversible secondary causes, the efficacy and duration of oral bisphosphonates, and the function of calcium and vitamin D. The aim of this review is to discuss the most appropriate solutions in the management of chronic pain in OP.


PubMed | Physical Medicine and Rehabilitation Unit and University of Rome La Sapienza
Type: Journal Article | Journal: Medical ultrasonography | Year: 2016

To compare the efficacy of ultrasound-guided intra-articular (IA) treatment with platelet-rich plasma (PRP) versus viscosupplementation (hyaluronic acid HA) in hip osteoarthritis.METHODS: A total of 43 patients affected bymonolateral severe hip osteoarthritis (OA) were included in the study. Patients were randomized to receive either intra-articularPRP (3 ml) or HA (30 mg/2 ml; 1,000-2,900 kDa), 3 injections in total - 1/week. Clinical assessments for each patient weremade at baseline (T0), 4 (T1), and 16 weeks (T2) of follow-up. The primary efficacy outcome was pain reduction as measuredby VAS and by WOMAC pain subscale.Data analysis revealed that, compared to T0, in the PRP-treated group VAS scores significantly decreased at T1 but not at T2, thereby indicating an early effect on pain which was not maintained at alonger term follow-up. In the HA group a significant decrease of both VAS and WOMAC values was registered only betweenT0 and T2.Intra-articular PRP had an immediate effect on pain that was not maintained at longer term follow-up when, on the contrary, the effects of intra-articular HA were evident.


Di Sante L.,Physical Medicine and Rehabilitation Unit
American journal of physical medicine & rehabilitation / Association of Academic Physiatrists | Year: 2010

To determine the effect on pain, function, and ultrasonographic findings of ultrasonography-guided Baker's cyst aspiration followed by corticosteroid injection in a group of patients with Baker's cyst secondary to knee osteoarthritis. Prospective observational study. Twenty-six subjects participated in this study. Clinical and instrumental evaluations were performed at baseline (T0), 1 wk (T1), and 4 wks (T2) after procedure. Mean Visual Analog Scale scores significantly dropped after the procedure (T0 = 6.2 [1.2]; T1 = 4.48 [1.5]; T2 = 4.32 [1.3]; T0 vs. T1 and P < 0.0001). A significant difference between preprocedure and postprocedure Western Ontario and McMaster Universities scores was found for pain (P < 0.0001) but not for joint stiffness (P = 0.7239) and disability (P = 0.6318). Ultrasonographic evaluation showed a significant reduction for both axial (P = 0.006) and sagittal (P = 0.01) areas of Baker's cyst, but no correlation was found between pain relief and Baker's cyst volume reduction. Cyst aspiration with corticosteroid injection give pain relief and cyst volume reduction in patients with Baker's cyst and concomitant knee osteoarthritis. However, when compared with current literature, our results are similar to those obtained with intra-articular knee corticosteroid injection.

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