Valutazione funzionale dell'arto superiore con confronto fra scale di valutazione cliniche e misure strumentali: studio pilota su bambini con p.c.i. forma emiplegica spastica

INTRODUZIONE: Nella pratica clinica e nel mondo della fisioterapia sono molte le scale di valutazione di cui ci si avvale per lo studio dell’arto superiore. Negli ultimi anni sono state introdotte le tecniche strumentali di analisi del movimento già in uso per l’arto inferiore, allo scopo di ottenere valutazioni obiettive di cinematica articolare tridimensionale, parametri spazio-temporali, velocità e rettilineità della traiettoria seguita. OBIETTIVO: L’obiettivo di questo studio è individuare e sperimentare una valutazione quantitativa strumentale per valutare task motori dell’arto superiore tipici della vita quotidiana tratti dalla scala di valutazione Melbourne Assessment of Unilateral Upper Limb Function su un campione di bambini con Paralisi Cerebrale Infantile (PCI) a forma emiplegica spastica, e di comparare i risultati ottenuti con la compilazione della stessa, e confrontarli con i risultati ottenuti da un campione di controllo composto da soggetti con sviluppo neuro-motorio normale della stessa età. MATERIALI E METODI: 3 soggetti con PCI a forma emiparesi spastica (gruppo caso), e 2 con sviluppo neuro-motorio normale (gruppo controllo) hanno eseguito 6 task presenti nella Melbourne Assessment: “pointing anteriore”, in “abduzione” e in “adduzione”, “mano-bocca”, “mano-gluteo”, “fronte-nuca”. Sono stati registrati e confrontati i parametri di velocità, fluidità, precisione e ampiezza. RISULTATI: Sono stati riportati i risultati della somministrazione della scala di valutazione Melbourne nei tre bambini emiplegici. Sono stati inoltre riportati gli indici strumentali proposti dal protocollo per la valutazione quantitativa dei gesti. L’ultimo gesto, il “fronte-nuca”, non è stato elaborato tramite la valutazione strumentale per la difficoltà di adattare il protocollo al task in questione. CONCLUSIONE: Nell’analisi dei risultati strumentali è emerso che, come riscontrato in letteratura, il movimento con l’arto affetto è complessivamente più lento, meno fluido e la velocità di picco è più bassa e viene raggiunta prima nel pointing in abduzione e nel mano-bocca, più lentamente negli altri due task; la fase di aggiustamento è maggiore sia in termini di tempo, sia come lunghezza delle oscillazioni. A livello articolare si sono evidenziati, nei gesti effettuati con l’arto plegico, una maggiore flessione anteriore, rotazione ed inclinazione controlaterale di tronco, con aumento di abduzione, flessione ed intrarotazione di spalla (come strategia di compenso per il deficit in supinazione e di estensione di gomito) e della flessione del polso.ope

Evaluation of muscle energy in isometric maintenance as an index of muscle fatigue in roller speed skating

Roller speed skating is a discipline in which muscle fatigue plays an important role in athletes; in this work, we wanted to evaluate whether a methodological approach based on the energy required to maintain an isometric muscle contraction for one minute, indexed on the MVIC (maximum voluntary isometric contraction), i.e. % RMS/MVIC can give results similar to the frequency decay analysis/time in terms of usability for athlete training and injury prevention. Right and left gluteus maximus and vastus lateralis muscles (involved in the propulsive phase of skating ) were examined separately by surface electromyography in three competitive athletes in short-track speed skating on asphalt. The results showed an asymmetry between the right (less resistant) and left (more resistant) lower limb, in all three athletes, from the point of view of fatigue, in both investigated muscles. Furthermore, a trend in terms of fatigue resistance was found that was directly proportional to skill in both muscles studied. This can be of help in better planning the training of street speed skaters (which although similar to the discipline on ice is not completely superimposable) with the dual purpose of improving their performance and preventing injuries, often linked to the degree of right-left muscle asymmetry

The Rehabilitation Tailor: Applying Personalized Medicine to Cancer Recovery

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Roller Speed Skating Kinematics and Electromyographic Analysis: A Methodological Approach

Roller speed skating is a discipline similar to hockey and ice skating from a biomechanical point of view, but there are no specific functional protocols for rehabilitation and performance improvement for these athletes. The aim of the study is to create a dedicated functional, kinematic and electromyographic protocol to be used as a tool for future studies on the subject. The protocol was created, starting from a correct and repeatable movement as a case study, on a world speed skating champion, using an inertial sensor positioned at the level of the first sacral vertebra, eight electromyographic probes positioned on one or the other lower limb, and a high-definition camera at 50 Hz. The results show the electromyographic activity of the muscles investigated, the degree of absolute muscle activation and compared to their maximum voluntary isometric contraction (MVIC), the level of co-activation of the agonist/antagonist muscles, and the accelerations of the body on the three axes of space. The results will represent the basis for physiotherapy and specific training use. Future developments will include the analysis of a sample of elite athletes to be able to build a normal range on the parameters investigated, and the possibility of treating in the most appropriate way possible muscle injuries (which mostly occur in the groin in such athletes) once they have occurred, even with oriented MVIC or co-activation oriented exercises

Pulsed radiofrequency on peripheral nerve as a rehabilitation aid

The work described below explores the field of the effects of pulsed radiofrequency for pain relief purposes. While the effects of this technique on pain modulation (A-delta and C fibers) are relatively well-known, little has been written yet about the potential of pulsed radiofrequency interactions with other fibers. The proposed algorithm, specifically elaborated, investigates the effect of this technique on neuromuscular fatigue, through a surface electromyographic study of the femoral nerve of a patient with residual pain after knee arthroplasty surgery, before and after the treatment. This work yields a preliminary result that is encouraging for subsequent large-scale studies

Case report: Movement analysis in oncological rehabilitation: proposal of a kinematic and surface electromyographic protocol in breast oncology

Introduction: Breast cancer disease often affects the ipsilateral shoulder joint, with pain and joint limitation. Proper pain management, which can be obtained using, for example, pulsed radiofrequency of the suprascapular nerve, can help the physiotherapist mitigate patient pain. The modern technologies of kinematic analysis and surface electromyography of movement analysis can give further support in building a personalized rehabilitation program, based on the quantitative study of movement, in this case of the upper limb. Methods: A brief case report was conceived to develop and test the evolution of a shoulder joint analysis protocol based on an inertial accelerometer and noninvasive surface electromyography. Results: An analysis algorithm was defined to adapt to the needs of patients operated on at the breast based on a kinematic component (ROM - range of movement - and Jerk index) and an electromyographic one (study of muscle behavior in groups of four). The coactivations were also evaluated, both as an average value and in graphical form, to offer the physiotherapist a complete overview of the movement of the upper limb. Discussion: The promising protocol results underline its strengths, including the simplicity of use, combined with the reduced time required for processing the reports and the portability of the PC-sensors complex, making these analyses potentially valuable for patient care

Pulsed Radiofrequency as a Standalone Treatment for Adhesive Capsulitis

Adhesive capsulitis is a pathology that affects the shoulder and can have a particularly long and disabling course. The usual therapies are treatment with non-steroidal anti-inflammatory drugs (NSAID) and painkillers, steroid injections, physiotherapy, and surgical treatment. This case report describes the effect of a single treatment with pulsed radiofrequency of the suprascapular nerve in a diabetic patient affected by this pathology, for whom steroid injections were contraindicated. Three weeks after the treatment, the reduction of pain and the improvement of ROM (range of movement) allowed the patient to start an adequate physiotherapy treatment, which was not feasible until that moment due to the severe pain despite NSAIDS therapy. The peculiarity of this work consists in the accurate measure of the impact of the analgesic treatment alone in improving the ROM and muscular activation in the patient. The patient was able to correctly perform physiotherapy only once the pain was reduced, after PRF (pulsed radio frequency) treatment. This study has two limitations: being a case report and not a prospective randomized study, and observing the kinematic and pain aspects for a limited period of time. Finally, the case report draws attention to the importance of cooperation between the various health figures involved in the treatment of patients suffering from adhesive capsules

Canine leishmaniosis in the Italian northeastern Alps: A survey to assess serological prevalence in dogs and distribution of phlebotomine sand flies in the Autonomous Province of Bolzano - South Tyrol, Italy

Abstract The Autonomous Province of Bolzano-South Tyrol (APB), located in the northernmost territory of the Italian eastern Alps, is still considered non-endemic for canine leishmaniosis (CanL) despite clinical cases being observed and a competent Leishmania infantum vector (Phlebotomus perniciosus) having been recorded since 2008. A serological survey of leishmaniosis among a randomly-selected subpopulation of registered owned dogs was carried in 2018, followed by entomological investigations performed in 2019 and driven by canine survey results. A total of 457 resident dogs from all over the APB territory were examined through IFAT for antibodies against L.infantum, of which 63 (13.8%) tested positive. Thirty-five seropositive cases (7.7%) were considered autochthonous to APB, i.e. dogs born and lived in the province, or imported dogs with no travel history in the past 5 years. Most of these animals showed an antibody titre at the threshold level of 1:40, suggesting a low degree of parasite transmission/contacts. In 2 autochthonous cases with moderately high IFAT titre, the infection was confirmed by nested-PCR in peripheral blood. Thirty-one georeferenced sites were monitored for sand flies by means of interception (sticky papers) and attraction (CDC miniature light traps) collection devices. Traps were set during summer approximately on monthly basis, and extended up to October for positive sites. Only 2 sites were found positive for a total of 317 phlebotomine specimens collected by sticky traps, which included a previously known P. perniciosus-endemic site near Bolzano town. Sergentomyia minuta was by far the most prevalent (98.1%) and the only recorded sand fly species in the most northerly Italian site ever investigated (Coldrano municipality in Venosta valley). For the first time, Leishmania serology and n-PCR positive dogs autochthonous to APB were identified, however the spread of sand flies competent for L. infantum transmission could not be demonstrated in several places where endemic seropositive cases were recorded. APB can be considered a territory of low CanL endemicity, however awareness and continuous monitoring are needed to detect changes in the epidemiological status of the zoonosis

NGC 2992: The interplay between the multiphase disk, wind and radio bubbles

We present an analysis of the gas kinematics in NGC 2992, based on VLT/MUSE, ALMA and VLA data, aimed at characterising the disk, the wind and their interplay in the cold molecular and warm ionised phases. CO(2-1) and H$\rm \alpha~$ arise from a multiphase disk with inclination 80 deg and radii 1.5 and 1.8 kpc, respectively. We find that the velocity dispersion of the cold molecular phase is consistent with that of star forming galaxies at the same redshift, except in the inner 600 pc region, and in the region between the cone walls and the disk. This suggests that a disk-wind interaction locally boosts the gas turbulence. We detect a clumpy ionised wind distributed in two wide opening angle ionisation cones reaching scales of 7 kpc. The [O III] wind expands with velocity exceeding -1000 km/s in the inner 600 pc, a factor of 5 larger than the previously reported wind velocity. Based on spatially resolved electron density and ionisation parameter maps, we infer an ionised outflow mass of $M_{\rm of,ion} = (3.2 \pm 0.3) \times \, 10^7 \, M_{\odot}$, and a total ionised outflow rate of $\dot M_{\rm of,ion}=13.5\pm1$ \sfr. We detected clumps of cold molecular gas located above and below the disk reaching maximum projected distances and velocities of 1.7 kpc and 200 km/s, respectively. On these scales, the wind is multiphase, with a fast ionised component and a slower molecular one, and a total mass of $M_{\rm of, ion+mol}= 5.8 \times 10^7 \, M_{\odot}$, of which the molecular component carries the bulk of the mass. The dusty molecular outflowing clumps and the turbulent ionised gas are located at the edges of the radio bubbles, suggesting that the bubbles interact with the surrounding medium through shocks. We detect a dust reservoir co-spatial with the molecular disk, with a cold dust mass $M_{\rm dust} = (4.04 \pm 0.03) \times \, 10^{6} \, M_{\odot}$.Comment: 19 pages, 17 figures, 6 tables; Accepted by A&

Breaking down barriers: live or dehydrated dietary whole black soldier fly larvae supplementation in slow growing chickens preserve meat quality and sensory traits

This study investigated the effects of supplementing the diet of a slow-growing autochthonous chicken breed with dehydrated or live Black Soldier Fly Larvae (BSFL) on meat quality and sensory attributes. The research, conducted at the University of Turin, Italy, involved 144 male birds distributed in three experimental groups. The control group (C) was fed a basal diet in which soybean meal was completely substituted with alternative ingredients. The 2 experimental groups were administered a diet identical to the control group but supplemented with either whole dehydrated black soldier fly larvae (DL) or whole live black soldier fly larvae (LL) at a level equal to 5% expected daily feed intake of dry matter. We evaluated the following parameters: nutrient intake, slaughtering performance, physical and nutritional meat quality, fatty acid composition, proteomics, and sensory characteristics. The results demonstrated BSFL supplementation to have no detrimental effects on overall meat quality or sensory attributes. Specifically, there were no significant differences in physical meat quality parameters, nutritional composition, lipid oxidation, or protein digestibility between control and BSFL-fed groups. Fatty acid analysis revealed higher concentrations of lauric and myristic acids in BSFL-fed chicken breast (p < 0.005), suggesting potential nutritional benefits from the supplement. The proteomic analysis also showed no significant differences in the expression of abundant proteins in the breast meat between groups, indicating minimal physiological impact of BSFL supplementation. Overall, this study provides reassurance to consumers and industries about the suitability of BSFL as a sustainable feed supplement for poultry that also offers potential benefits in terms of optimizing the fatty acid profile of chicken meat.publishedVersio