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

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 is 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

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

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

Extracorporeal Shock Waves in the Treatment of Equinovarus Foot in a Duchenne Patient: A Case Report

Background: Duchenne muscular dystrophy (DMD) is characterized by a progressive muscular weakness, with loss of independent ambulation. When the disease results in the complete loss of ambulation, one of the purposes of treatment during the latest phase is to prevent or reduce complications such as foot deformities.&nbsp;A 20-year-old DMD patient had a complete loss of muscular strength in the inferior and superior limbs and a severe bilateral clubfoot deformity.&nbsp; Active movements were not possible, while passive motion was very limited in dorsiflexion and pronation, inversion and eversion, with stronger limitation on the right foot.&nbsp;First, the patient was treated with gentle manipulation and casting for two weeks, but no improvement in passive range of motion was detected.&nbsp;The treatment was then modified by adding a session of focused extracorporeal shock wave therapy for five consecutive weeks.Results: After five shock wave sessions, both limbs showed a bilateral correction of the talo-metatarsal angle, respectively 26° on the right and 19° on the left foot. The most relevant improvements were estimated in the passive dorsiflexion of both ankles: with a gentle manipulation, both feet could return to the anatomical position, in such a way to allow the patient to wear his own shoes.Conclusions: There is increasing evidence that nitric oxide (NO) and vascular endothelial growth factor (VEGF) dysregulation is involved in DMD progression; on the other hand, extracorporeal shock wave therapy (ESWT) induces NO and VEGF production, thus promoting angiogenesis, and has proven effective in reducing muscular hypertone. ESWT shows a potential role in the treatment of Duchenne complications such as foot deformities, as part of a multidisciplinary rehabilitation program.</p

GONIOMETRIC EVALUATION OF 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\uae, 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\u2019s or postural kyphosis, idiopathic scoliosis) and healthy controls were included. Two physician measured spinal curves with the surface goniometer IncliMed\uae 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: 139 subjects participated to the inter-rater reliability assessment; 30 to the intra-rater reliability assessment. Inter-observer variability for IncliMed\uae measurements was \ub111\ub0 both for kyphosis and for lordosis. The intra-observer variability for kyphosis and lordosis measurements was \ub111\ub0 and \ub112\ub0. CONCLUSIONS: IncliMed\uae is a reliable, non-invasive tool to screen and monitor spinal curves in paediatric populations