CROSS-CULTURAL VALIDATION OF THE ACTIVITIES SCALE FOR KIDS PERFORMANCE VERSION: PROOF OF RELIABILITY AND VALIDITY IN ITALIAN CHILDREN WITH CEREBRAL PALSY

Physical functioning is crucial to participation in life activities and it should always be accurately assessed in children with cerebral palsy, as it is a key element in the rehabilitation of individuals with disabilities. The Activities Scale for Kids (ASK) is one of the few reliable and responsive outcome measures that allows children and adolescents to accurately report their physical functioning in typical activities for this age. The performance version of the ASK has recently been translated and culturally adapted to the Italian context and, in its original language, is currently used to assess children with cerebral palsy, although its psychometric properties have never been investigated in a wide sample of this population. This PhD Thesis has been implemented to validate the Italian ASK performance version in children with cerebral palsy. Three cross-sectional studies were carried out to: a) provide a description of the ASKp score distribution in a population of 209 Italian healthy school aged individuals, b) test its internal consistency and construct validity in a population of 206 children with cerebral palsy; c) collect evidence of construct convergent validity of the ASKp in a population of 60 children with cerebral palsy, by comparing its results with the 66-item Gross Motor Function Measure (GMFM-66) and with the Gross Motor Function Classification System (GMFCS) and testing the ASKp\u2019s ability to discriminate between individuals with different functional capabilities. In conclusion, the ASKp is valid to assess physical functioning, a crucial domain in the rehabilitation of children with cerebral palsy

Single-Subject Design: Experimental Designs for Research and for Clinical Practice

Background: The individual variability among people presenting motor impairments often leads to the difficulty to obtain an adequate sample size in the conduction of trials in physiotherapy. Furthermore, in clinical practice, it is often difficult to recognize the relationship between the administration of a treatment and its expected results. Psychological and educational sciences often use single-subject design (SSD) studies to explore behaviours under experimental conditions. This study design allows to test the relationship between an independent variable, the treatment, and a dependent variable, the main outcome of interest. The purpose of this work is to present researchers and clinicians the methodology of the SSD studies and their application in physiotherapy both in research context and everyday practice [1]

Inhibitor Specificity via Protein Dynamics Insights from the Design of Antibacterial Agents Targeted Against Thymidylate Synthase

AbstractStructure-based drug design of species-specific inhibitors generally exploits structural differences in proteins from different organisms. Here, we demonstrate how achieving specificity can be aided by targeting differences in the dynamics of proteins. Thymidylate synthase (TS) is a good target for anticancer agents and a potential target for antibacterial agents. Most inhibitors are folate-analogs that bind at the folate binding site and are not species specific. In contrast, α156 is not a folate-analog and is specific for bacterial TS; it has been shown crystallographically to bind in a nonconserved binding site. Docking calculations and crystal structure-based estimation of the essential dynamics of TSs from five different species show that differences in the dynamics of TSs make the active site more accessible to α156 in the prokaryotic than in the eukaryotic TSs and thereby enhance the specificity of α156

Rehabilitation of COPD patients: which training modality?

Non pharmacological therapy has been gaining more interest and has been evolving rapidly over the last decade as an essential part of therapy for COPD patients. Pulmonary Rehabilitation (PR), the most important non pharmacological treatment in patients with COPD, has a primary goal: to achieve the highest possible level of individual exercise tolerance, thus reducing the primary and/or secondary health care utilisation. The aim of the present review is to focus the role of exercise training in these patients as well as to address the question on which training methods are the most beneficial. We have therefore undertaken a MEDLINE-based search including the terms: pulmonary rehabilitation, exercise, lung disease/obstructive. Several strategies based on endurance or strength training are nowadays implemented during PR programmes in order to maximise the benefits for each patient. The impaired function of ambulation muscles causing breathlessness as one of the more frequent symptoms in many COPD, suggests that training the lower extremities is the most important goal to achieve during pulmonary rehabilitation of these patients. On the other hand, as muscle strength appears to be an independent contributor to survival and utilisation of health care resources, it seems largely justified also to include this further modality in the PR program of these patients. In conclusion, both modalities are effective and useful for COPD patients. However, whether resistance training should be administered to all COPD and which is the optimal length of strength training still needs to be elucidated

Occupational Therapy in Complex Patients: A Pilot Randomized Controlled Trial

INTRODUCTION: To determine effect size and feasibility of experimental occupational therapy (OT) intervention in addition to standard care in a population of complex patients undergoing rehabilitation in a hospital-home-based setting. METHOD: 40 complex patients admitted to the rehabilitation ward of the Local Health Authority-Research Institute of Reggio Emilia (Italy) were randomized in a parallel-group, open-label controlled trial. Experimental OT targeting occupational needs in the areas of self-care, productivity, and leisure was delivered by occupational therapists. Standard care consisted of task-oriented rehabilitation delivered by a multiprofessional team. RESULTS: The experimental OT intervention was completed by 75% of patients assigned to this group. The average changes in the Canadian Occupational Performance Measure (COPM) performance score significantly and clinically favored experimental OT [-3,06 (-4.50; -1.61); delta > 2 points, resp.]. Similar trends were detected for COPM satisfaction and independence in instrumental activities of daily living (ADL). At follow-up, level of social participation was higher for patients treated with experimental OT (p = 0.043) than for controls. CONCLUSIONS: Experimental OT was feasible in complex patients in a hospital-home-based setting. It ameliorated both patients' performance and satisfaction in carrying out relevant activities and improved independence in instrumental ADL. The trial is registered with ClinicalTrials.gov NCT02677766

Commencing rehabilitation in the ICU.

Rehabilitation is an integral part of the management of patients inIntensive Care Units (ICUs).The most important aim in this area isto enhance the patient's overall functional capacity and to restorehis/her respiratory and physical independence, thus decreasing the risks of bed-rest and associated complications.The evidence for applying a weaning protocol and physiotherapytechniques (postures, percussion/vibration, limb exercise, and active mobilization) in these patients has proved to be effective according to the application rationale of each process. However, todate, there are only strong recommendations concerning the evidence-based strategies to speed weaning from mechanical ventilation.Early physiotherapy may be effective in the ICU: nonetheless,most techniques need to be further studied in a wider population.In particular, evidence supporting physiotherapy interventionsis limited as there are no studies examining the specific effectsof interventions on long-term outcomes

Employment rate and predictors of return to work in people treated for oncologic diseases: a systematic review

Countries with an high development index are experiencing increase in both life expectation and in working age. This features will bring aged people with chronic disease, including cancer, in the workforce. Epidemiologic data show that approximately half of the new diagnosis and more than 1/3 of cancer survivors are people between 15 and 64 years [1]. Return to work (RTW) is a significant issue in this population because it might help to maintain or restore a satisfactory health status, to preserve social participation and social role, to restore self-perception of own identity and also to increase quality of life. Additionally, RTW has relevant direct negative effects on the social cost supported by Health Services, patients and families. In Italy, the socio-economic influence of loss of productivity due to cancer related consequences, was estimated in more than 8 billions of impact on the employing companies [2]. For this reason, we conducted this systematic review of the literature with the aim to investigate the employment status in European cancer survivors

Activities Carried Out during the First COVID-19 Lockdown by Italian Citizens

: The SARS-CoV-2 pandemic has altered how citizens engage in activities. This study describes the new activities citizens engaged in during the first lockdown, factors that helped them cope with the confinement, the supports they used the most, and which supports they would have liked to receive. This cross-sectional study consists of an online survey made of 49 questions that was completed by the citizens of the province of Reggio Emilia (Italy) from 4 May until 15 June 2020. The outcomes of this study were explored by focusing on four of the survey questions. Of the 1826 citizens who responded, 84.2% had started new leisure activities. Males, participants who lived in the plain or foothills, and those who experienced nervousness engaged less in new activities, while those whose employment status changed, whose lifestyle worsened, or whose use of alcohol increased engaged in more activities. The support of family and friends, leisure activities, continuing to work, and an optimistic attitude were perceived to be of help. Grocery delivery and hotlines providing any type of information and mental health support were used frequently; a lack of health and social care services and of support in reconciling work with childcare was perceived. Findings may help institutions and policy makers to better support citizens in any future circumstances requiring prolonged confinement