Rehabilitation Service

Rome, Italy

Rehabilitation Service

Rome, Italy
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Monteiro R.L.,University of Sao Paulo | Facchini J.H.,Rehabilitation Service | de Freitas D.G.,Rehabilitation Service | Callegari B.,Federal University of Pará | Joao S.M.A.,University of Sao Paulo
Journal of Sport Rehabilitation | Year: 2017

Context: Pelvic-drop exercises are often used to strengthen the gluteus medius (GM) muscle with the aim of increasing or prioritizing its recruitment. However, the effect of hip rotation on the performance of the action of the GM is unknown. Objective: To evaluate the effect of hip rotation on the recruitment of the GM, tensor fasciae latae (TFL), and quadratus lumborum (QL). Method: Seventeen healthy subjects performed 2 sets of 4 repetitions of pelvic-drop exercise in random order with pelvic-drop lateral, medial, and neutral rotation of the hip. Main Outcome Measures: The electromyographic (EMG) activity of the GM, TFL, and QL was evaluated using surface electromyography. Results: There were significant increases in the activation of the GM with medial and neutral rotation compared with lateral rotation (P = .03, P = .01, respectively), and there was no difference between medial and neutral rotation (P = 1.00). There was no difference in EMG activity of the TFL and QL in any of the positions. The GM:TFL ratio was the same in all analyzed positions. Regarding the GM:QL ratio, there was a significant increase with medial rotation compared with lateral rotation (P = .02). Conclusions: Pelvic-drop exercises are more efficient for activating the GM when the hip is in medial rotation and neutral position. © 2017 Human Kinetics, Inc.


Bissolotti L.,Rehabilitation Service | Bissolotti L.,LARIN Neuromuscular and Adapted Physical Activity Laboratory | Berjano P.,IRCCS Instituto Ortopedico Galeazzi | Zuccher P.,Rehabilitation Service | And 7 more authors.
European Spine Journal | Year: 2017

Purpose: The aim of this study was to describe the disease-related sagittal balance changes in relation to the sacro-pelvic morphology of Parkinson’s Disease patients with different duration of disease. Methods: One hundred and seventy-five consecutive Parkinson’s Disease (PD) patients (102 males, 73 females; age: 55–83 years) participated in the cross-sectional study. The clinical assessment included: Hoehn Yahr (H&Y) score; Tinetti score; plumb line (PL) distance from the spinous process of C7, L3 and S1 and kyphosis apex. Lumbar lordosis (LL), thoracic kyphosis (TK), spinosacral (SSA) and spinopelvic (SPA) angles, spinal tilt, pelvic incidence (PI), sacral slope (SS) and pelvic tilt (PT) were radiographically assessed. Results: Spinosacral and spinopelvic were correlated with the duration of disease and Tinetti score, but not with age. We found a positive correlation between LL and both SSA and SPA. TK was significantly correlated with LL but not with pelvic parameters, while PI with SS and LL. Conclusions: Female gender, high PI and high LL together with a low PL-C7 distance can be considered as protective factors for spinal imbalance and fall risk; negative factors are represented by male gender, longer disease duration, higher H&Y Class, and low PL-L3 distance. Looking at the pelvis is revealing new important insights in spinal disease management, both surgical and rehabilitative. © 2017 Springer-Verlag Berlin Heidelberg


Madera M.,University of Texas at Austin | Brady J.,Rehabilitation Service | Deily S.,Rehabilitation Service | McGinty T.,Rehabilitation Service | And 4 more authors.
Journal of Neurosurgery: Spine | Year: 2017

OBJECTIVE: The purpose of this study was to provide a systematic and comprehensive review of the existing literature regarding postfusion rehabilitation. METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the authors conducted an exhaustive review of multiple electronic databases. Potential articles were screened using inclusion/exclusion criteria. Two authors independently analyzed these studies using predefined data fields, including study quality indicators such as level of evidence and availability of accepted patient-reported outcomes measures. These findings were synthesized in a narrative format. A third author resolved disagreements regarding the inclusion of a study. RESULTS: Twenty-one articles with I or II levels of evidence were included in the review. The authors divided the findings of the literature review into several groups: rehabilitation terminology, timing and duration of postfusion rehabilitation, the need for rehabilitation relative to surgery-related morbidity, rehabilitation's relationship to outcomes, and cognitive and psychosocial aspects of postsurgical rehabilitation. Current evidence generally supports formal rehabilitation after lumbar fusion surgery. Starting physical therapy at the 12-week postoperative mark results in better outcomes at lower cost than an earlier, 6-week start. Where available, psychosocial support improves outcomes. However, a number of the questions could not be answered with high-grade evidence. In these cases, the authors used "best evidence available" to make recommendations. There are many cases in which different types of caregivers use clinical terminology differently. The data supporting an optimal protocol for postfusion rehabilitation remains elusive but, using the data available, the authors have crafted recommendations and a model protocol, which is currently undergoing prospective study. CONCLUSIONS: Rehabilitation has long been a common feature in the postoperative management of patients undergoing spinal fusion. Although caregivers from multiple disciplines agree that the majority of their patients will benefit from this effort, the supporting data remain sparse. In creating a model protocol for postlumbar fusion rehabilitation, the authors hope to share a starting point for future postoperative lumbar fusion rehabilitation research. © AANS, 2017.


Lucchetti G.,Sao Paulo Medical Spiritist Association | Lucchetti A.L.G.,The Interdisciplinary Center | Badan-Neto A.M.,Service of Geriatrics | Peres P.T.,Rehabilitation Service | And 4 more authors.
Journal of Rehabilitation Medicine | Year: 2011

Objectives: To evaluate the relationship between religiousness and mental health, hospitalization, pain, disability and quality of life in older adults from an outpatient rehabilitation setting in Sao Paulo, Brazil.Design: Cross-sectional study.Subjects/patients: A total of 110 patients aged 60 years or older were interviewed during attendance at an outpatient rehabilitation service.Methods: Researchers administered a standardized questionnaire that assessed socio-demographic data, religiousness, self-reported quality of life, anxiety, physical activity limitation, depression, pain and cognition. Predictors were included in each model analysis, and a backward conditional method was used for variable selection using logistic regression (categorical outcomes) or linear regression (continuous outcomes). Results: Thirty-one patients (28.2%) fulfilled criteria for significant depressive symptoms, 27 (24.5%) for anxiety, and 10 (9.6%) for cognitive impairment. Pain was present in 89 (80.7%) patients. Limited depressive symptoms (as assessed by the Geriatric Depression Scale), and greater self-reported quality of life were related to greater self-reported religiousness, as were scores on the Mini-Mental State Examination (less cognitive impairment), and lower ratings of pain. Conclusion: Religiousness is related to significantly less depressive symptoms, better quality of life, less cognitive impairment, and less perceived pain. Clinicians should consider taking a spiritual history and ensuring that spiritual needs are addressed among older patients in rehabilitation settings. © 2011 Foundation of Rehabilitation Information.


Vinci P.,Rehabilitation Service | Paoloni M.,University of Rome La Sapienza | Ioppolo F.,University of Rome La Sapienza | Gargiulo P.,Rehabilitation Service | Santilli V.,University of Rome La Sapienza
European Journal of Physical and Rehabilitation Medicine | Year: 2010

Management of footdrop in severe Charcot-Marie-Tooth (CMT) patients is a challenge owing to the combination of quadriceps muscle weakness, distal muscular atrophy, sensory impairment and poor soft tissue resistance to the placement of an orthotic device. We present a case study of a patient who gradually became unable to use his anklefoot orthoses because they hampered the compensative movements required to stabilize his knees passively and caused pain. The aim of this report is to describe orthotic management in such a severe CMT case and to present a new orthotic device that we devised for the footdrop in this patient. We provided him with 3 different footdrop devices, each of which was highly elastic to allow knee hyperextension, and left him free to decide which one to use: 1) the silicone-ankle-foot orthoses were rapidly discarded because of pain; 2) the Codivilla support was not used because of discomfort and poor aesthetic appearance; 3) a new device, called the "Soft Footdrop Insert" (SFI), consisting of a sheet of Veolform, a reticulated polyolephinic foam, stuck to the counter of midcalf boots, was found to be effective, comfortable, pain-free and aesthetically acceptable, and was consequently used the vast majority of the time. At a 3-year follow-up, an instrumental gait analysis, in which ordinary shoes were compared with the Codivilla support and the SFI, revealed that both the Codivilla support and the SFI controlled footdrop more effectively than ordinary shoes and increased swing and mean velocity; in addition, the SFI yielded the best gait performances. We think that a soft, invisible device, such as the SFI, may satisfy the needs of CMT patients and improve compliance with orthoses-wearing for footdrop.


Orizio C.,University of Brescia | Cogliati M.,University of Brescia | Bissolotti L.,Rehabilitation Service | Diemont B.,University of Brescia | And 2 more authors.
Archives of Gerontology and Geriatrics | Year: 2016

This work aimed to verify if maximal electrically evoked single twitch (STmax) scan discloses the relative functional weight of fast and slow small bundles of fibres (SBF) in determining the contractile features of tibialis anterior (TA) with ageing. SBFs were recruited by TA main motor point stimulation through 60 increasing levels of stimulation (LS): 20 stimuli at 2 Hz for each LS. The lowest and highest LS provided the least ST and STmax, respectively. The scanned STmax was decomposed into individual SBF STs. They were identified when twitches from adjacent LS were significantly different and then subtracted from each other. Nine young (Y) and eleven old (O) subjects were investigated. Contraction time (CT) and STarea/STpeak (A/PT) were calculated per each SBF ST. 143 and 155 SBF STs were obtained in Y and O, respectively. Y: CT and A/PT range: 45-105 ms and 67-183 mN s/mN, respectively. Literature data set TA fast fibres at 34% so, from the arrays of CT and A/PT, 65 ms and 100 mN s/mN were identified as the upper limit for SBF fast ST classification. O: no SBF ST could be classified as fast. Conclusions: STmax scan reveals age-related changes in the relative contribution of fast and slow SBFs to the overall muscle mechanics. © 2016 Elsevier Ireland Ltd.


Bissolotti L.,Rehabilitation Service | Bissolotti L.,Neuromuscular and Adapted Physical Activity Laboratory | Gobbo M.,Neuromuscular and Adapted Physical Activity Laboratory | Gobbo M.,University of Brescia | And 2 more authors.
European Spine Journal | Year: 2014

Purpose: The aim of this study was to describe the disease-related sagittal balance changes in relation to the sacropelvic morphology of PD patients with different durations of disease. Methods: Thirty-one consecutive Parkinson's disease patients (26 males, 5 females; age 55-83 years) participated in the cross-sectional study. The clinical assessment included: Hoehn Yahr score; plumb line distance from the spinous process of C7, kyphosis apex, spinous process of L3 and S1. Lumbar lordosis (LL), thoracic kyphosis (TK), spinosacral angle, spinopelvic angle, spinal tilt, pelvic incidence, sacral slope (SS) and pelvic tilt were radiographically assessed. Results: Radiographic spinopelvic angles appeared normal, but many patients presented variations from normality. In particular, pelvic tilt increased and SS decreased; spinosacral and spinopelvic angles were greatly reduced compared to healthy people, and spinal tilt increased. Unlike TK, LL was well correlated with most of the parameters. Conclusions: Sagittal balance evaluation provides new valuable insights for biomechanical understanding of PD patients. Specific spinal parameters (spinosacral, spinopelvic and spinal tilt angles), and their clinical correlation, as well as pelvic parameters like pelvic tilt and sacral slope, appear particularly interesting for their clinical implications in terms of spinal deformities correction in PD population. © 2013 Springer-Verlag.


PubMed | University School of Physical Education in Wroclaw, Rehabilitation Service and University of Brescia
Type: | Journal: Archives of gerontology and geriatrics | Year: 2016

This work aimed to verify if maximal electrically evoked single twitch (STmax) scan discloses the relative functional weight of fast and slow small bundles of fibres (SBF) in determining the contractile features of tibialis anterior (TA) with ageing. SBFs were recruited by TA main motor point stimulation through 60 increasing levels of stimulation (LS): 20 stimuli at 2Hz for each LS. The lowest and highest LS provided the least ST and STmax, respectively. The scanned STmax was decomposed into individual SBF STs. They were identified when twitches from adjacent LS were significantly different and then subtracted from each other. Nine young (Y) and eleven old (O) subjects were investigated. Contraction time (CT) and STarea/STpeak (A/PT) were calculated per each SBF ST. 143 and 155 SBF STs were obtained in Y and O, respectively. Y: CT and A/PT range: 45-105ms and 67-183mNs/mN, respectively. Literature data set TA fast fibres at 34% so, from the arrays of CT and A/PT, 65ms and 100mNs/mN were identified as the upper limit for SBF fast ST classification. O: no SBF ST could be classified as fast.STmax scan reveals age-related changes in the relative contribution of fast and slow SBFs to the overall muscle mechanics.


News Article | November 4, 2016
Site: www.prweb.com

McMahon & Winters Law Firm is pleased to announce Partner Joe McMahon has joined the Board of Directors of the Drug and Alcohol Rehabilitation Service, Inc. (DARS). The Drug and Alcohol Rehabilitation Service, Inc. (DARS) center for young men began in 1972 with the mission to help young men achieve freedom from addiction and all the issues associated with it. DARS consists of three programs including the Manos House, Supervised Independent Living, and Prospect Grove High School, with the goal to guide young men recovering from addiction to successful and responsible futures. McMahon & Winters Partner, Joe McMahon, welcomes the opportunity to serve on the Board of Directors of DARS, believing it goes hand in hand with the work he does assisting troubled young men in the courtroom. “As an attorney who often assists young men caught up in the cycle of addiction, joining the DARS Board is a great opportunity for me to learn ways to break this cycle and to assist in providing help for those who need it.” – Joe McMahon, Partner, McMahon & Winters Law Firm. A native of Lancaster County, Joe McMahon is a graduate of Saint Joseph’s University and the Penn State Dickinson School of Law. His law career began in 2005, when he served as law clerk in the Lancaster County Court of Common Pleas, later accepting a position as Assistant District Attorney at the Office of the District Attorney of Lancaster County. Gaining a reputation as a tenacious, yet principled litigator, McMahon entered private practice where he focuses on Criminal Law and Family Law. A member of the Pennsylvania and Lancaster Country Bar Associations, McMahon is licensed to practice Law in the Commonwealth of Pennsylvania, the United States District Court for the Eastern District of Pennsylvania, and the Supreme Court of the United States. “Drug and Alcohol Addiction Rehabilitation Services and Manos House strive to help young men overcome addiction. It is an honor to have been asked to join this organization and make a difference in the lives of these young men.” - Joe McMahon. At McMahon & Winters Law Firm, McMahon and his partners are dedicated to delivering legal expertise along with care and compassion for their clients in order to achieve a positive outcome in each and every case. In addition to Criminal and Family Law, the professionals at McMahon & Winters offer legal counsel in DUI and Traffic Violations to the residents of Lancaster Country and the surrounding areas. Visit http://www.McMahonWinters.com to get the help you need, protect your rights, and obtain the legal counsel and advocacy you deserve. In addition, should you desire further information on the mission and efforts of DARS, please visit http://www.DARSInc.com. Bio: McMahon & Winters Law Firm of Lancaster promises to provide every client with comprehensive, expert, and committed legal advice and guidance whenever it is required. Their goal is defend their clients’ rights with authority, delivered in an honest and courteous way while producing a positive outcome in each unique case. Reach out to the legal team at McMahonWitners.com today.

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