The functional manual therapy intervention in infants with nonsynostotic plagiocephaly: a pilot study

BACKGROUND: To document the evolution of cranial asymmetries in infants with signs of nonsynostotic occipital plagiocephaly (NSOP) who were undergo to many functional manual therapy treatments (in addition to the standard positioning recommendations) as well as to determine the feasibility of this methodology to conduct an outcome research investigating the impact of this intervention for infants with NSOP. METHODS: Pilot clinical standardization project using pre-post design in which 10 infants participated. Nine infants presented an initial Oblique Diameter Di5erence Index (ODDI) over 104%, three an initial Ear Deviation Index (EDI) over 4%, and three a Cranial Proportional Index (CPI) over 90%. Interventions: Infants received three functional manual therapy treatments for week during the <rst month of intervention and two ones for week during the second month. RESULTS: Plagiocephalometric measurememts were administered at the <rst assessment pre-intervention (T0), after 30 days (+/-5) (T1) and at a third time after 60 days (+/5) of treatment (T2). Results: 9/10 participants showed a significant decrease in ODDI under 104% between T0 and T2 assessments. 5/10 infants showed an EDI under 4%, and 3/10 showed a value about 0%. 3/10 maintained their CPI over 90% with a considerable decrease. CONCLUSIONS: These clinical findings support the hypothesis that functional manual therapy treatments contribute to the improvement of cranial asymmetries in infants younger than 6.5 months old presenting with NSOP

Pain Management through Neurocognitive Therapeutic Exercises in Hypermobile Ehlers–Danlos Syndrome Patients with Chronic Low Back Pain

Background. The hypermobile type of Ehlers–Danlos syndrome (hEDS) is likely the most common hereditary disorder of connective tissue mainly characterized by joint hypermobility. Patients with hEDS suffer joint pain, in particular low back pain, commonly resistant to drug therapy. The aim of this research was to evaluate a neurocognitive rehabilitation approach based not only on the motion and function recovery but also on the pain management. Methods. In this nonrandomized clinical trial, eighteen hEDS patients (4 males and 14 females) with mean age 21 years (range 13-55) were recruited and evaluated before and after three months of rehabilitation treatment. Results. The outcome scores showed significant statistical results after treatment in reducing pain symptoms (numerical rating scale, P=0.003; McGill (total score), P=0.03), fatigue (fatigue severity scale, P=0.03), fear of movement (Tampa scale, P=0.003), and pain-associated disability (Oswestry disability index, P=0.03). Conclusion. The clinical results observed in our study seem to confirm the role of a specific neurocognitive rehabilitation program in the chronic pain management in the Ehlers–Danlos syndrome; the rehabilitation treatment should be tailored on patient problems and focused not only in the recovery of movement but also on pain perception

Polymorphism and solid state peculiarities in imidazo[1,5-a]pyridine core deriving compounds: An analysis of energetic and structural driving forces

The polymorphism and solid-state peculiarities of imidazo[1,5-a]pyridine derivatives have been investigated by a theoretical and experimental approach to shed light on the structural and energetic features. Four couples of polymorphs and an ionic crystal form have been reported and analysed. Hirshfeld Surface and Energy Frameworks have been used to better understand the crystal packing features, in comparison with literature structures. The collection of these characterizations made possible to analyze the differences between the polymorphs, the energetic components dominating the crystal packing, and the effect of the different substitutions on the central molecular skeleton on packing disposition. To complete the solid state characterization of the molecular products, the assignment of vibrational spectra for the imidazo[1,5-a]pyridine core derivatives has been performed for the first time and the influence of substituents commented. Although the discussed polymorphs are very different in their crystal packing, from the energetic point of view they present a strong similarity. In all cases, the main interactions are π‧‧‧π stacking and C-H‧‧‧π to the aromatic rings, with some tendency to the formation of C-H‧‧‧N contacts to the central imidazo[1,5-a]pyridine nitrogen. The main energetic component is the dispersive one, with some contribution from the electrostatic component, and this situation is not modified by the presence of differing substituents. When hydrogen bond are present, the crystal packing is strongly modified and, energetically, the electrostatic component can overcome the dispersive one