The Effect of Manual Therapy Plus Exercise in Patients with Lateral Ankle Sprains: A Critically Appraised Topic with a Meta-Analysis

A high percentage of patients with lateral ankle sprains report poor outcomes and persistent neuromuscular impairment leading to chronic ankle instability and re-injury. Several interventions have been proposed and investigated, but the evidence on manual therapy combined with therapeutic exercise for pain reduction and functional improvement is still uncertain. The purpose was to study the effectiveness of adding manual therapy to therapeutic exercise in patients with lateral ankle sprains through a critically appraised topic. The literature search was performed in PubMed, PEDro, EMBASE and CINAHL databases, and only randomized clinical trials were included according to following criteria: (1) subjects with acute episodes of lateral ankle sprains, (2) administered manual therapy plus therapeutic exercise, (3) comparisons with therapeutic exercise alone and (4) reported outcomes for pain and function. Three randomized clinical trials (for a total of 180 patients) were included in the research. Meta-analyses revealed that manual therapy plus exercise was more effective than only exercises in improving dorsal (MD = 8.79, 95% CI: 6.81, 10.77) and plantar flexion (MD = 8.85, 95% CI 7.07, 10.63), lower limb function (MD = 1.20, 95% CI 0.63, 1.77) and pain (MD = -1.23; 95% IC -1.73, -0.72). Manual therapy can be used with therapeutic exercise to improve clinical outcome in patients with lateral ankle sprains

Changes in Shoulder Pain and Disability After Thrust Manipulation in Subjects Presenting With Second and Third Rib Syndrome

AbstractObjectiveThe purpose of this preliminary study was to investigate changes in shoulder pain, disability, and perceived level of recovery after 2 sessions of upper thoracic and upper rib high-velocity low-amplitude (HVLA) thrust manipulation in patients with shoulder pain secondary to second and third rib syndrome.MethodsThis exploratory study evaluated 10 consecutive individuals with shoulder pain, with or without brachial pain, and a negative Neer impingement test, who completed the Shoulder Pain and Disability Index (SPADI), the numeric pain rating scale (NPRS), and the global rating of change. Patients received 2 sessions of HVLA thrust manipulation targeting the upper thoracic spine bilaterally and the second and third ribs on the symptomatic side. Outcome measures were completed after the first treatment session, at 48 hours, 1 month, and 3 months.ResultsPatients showed a significant decrease in SPADI (F = 59.997; P = .001) and significant decrease in resting shoulder NPRS (F = 63.439; P = .001). For both NPRS and SPADI, there were significant differences between the pretreatment scores and each of the postintervention scores through 3-month follow-up (P < .05). Large within-group effect sizes (Cohen's d ≥ 0.8) were found between preintervention data and all postintervention assessments in both outcomes. Mean global rating of change scores (+6.8 at 3 months) indicated "a very great deal better" outcome at long-term follow-up.ConclusionThis group of patients with shoulder pain secondary to second and third rib syndrome who received upper thoracic and upper rib HVLA thrust manipulations showed significant reductions in pain and disability and improvement in perceived level of recovery

Development, validity and reliability of the Italian version of the Copenhagen neck functional disability scale

BACKGROUND: Valid and reliable patient-reported outcome measures support health professionals in evaluating the results of clinical research and practice. The Copenhagen Neck Functional Disability Scale (CNFDS) has shown promising measurement properties to measure disability in patients with neck pain, but an Italian version of this questionnaire is not available. The objective of this study was to cross-culturally adapt the CNFDS into Italian (CNFDS-I), and to assess its validity and reliability in patients with neck pain. METHODS: The CNFDS-I was developed according to well-established guidelines for cross-cultural adaptation of patient-reported outcome measures. A cross-sectional clinimetric study was conducted to evaluate its v

Understanding Contextual Factors Effects and Their Implications for Italian Physiotherapists: Findings from a National Cross-Sectional Study

An online cross-sectional survey was conducted using Google Docs software. The aim was to understand the management of contextual factors and to identify which are most relevant and which clinicians underestimate. A total of 1250 physiotherapists were chosen from the database of the Manual Therapists group mailing list (GTM-IFOMPT MO) from July to August 2020. A total of 699 responses were received that were considered valid (56%). Participants (40.83%) identified contextual factors (CFs) as “any element, even involuntary, with which the patient interacts during treatment”. Physiotherapists individually chose the representation of CF with the “therapeutic relationship” (82.9%), followed by “therapeutic setting” (75.8%). This choice differed between participants belonging to different age groups. Participants favor communication strategies (76.93%). More than half (57.88%) pay attention to patient involvement during the course of care; and in response to the patients’ doubts about the use of treatments with limited scientific efficacy, they suggest different medical treatments. The patient’s previous clinical experience is not considered significant and does not influence the choice of treatment. Subsequently, however, the participants reported that they stimulate the patients’ positive expectations of the success of the clinical outcome (45.27%). Knowledge of contextual factors in physiotherapy appears limited and very heterogeneous. Future research could increase the focus on professional development

L’efficacia del bendaggio elastico nel ridurre il volume del moncone nei pazienti con amputazione degli arti inferiori: revisione della letteratura

Esistono svariate tecniche di bendaggio per contenere e ridurre l’edema del moncone nei pazienti amputati ma c’è molta incertezza su quale sia la più efficace. Obiettivo della revisione di valutare l’efficacia del bendaggio elastico rispetto ad altri tipi di bendaggio nella riduzione del volume del moncone nei pazienti che subiscono l’amputazione degli arti inferiori. Materiali e metodi. È stata fatta una revisione della letteratura fino ad aprile 2011 sulle banche dati biomediche MEDLINE, TRIP DATABASE, OVID, CINAHL, Pedro. È stata valutata era la riduzione dell’edema e del volume del moncone espressa sia come circonferenza del moncone che giorni trascorsi tra l’operazione e la protesizzazione. Risultati. Sono stati identificati 10 articoli, di cui 5 studi randomizzati controllati, 1 studio comparativo non randomizzato, 1 studio comparativo retrospettivo multicentrico, 1 audit retrospettivo, 1 studio caso-controllo, 1 revisione sistematica della letteratura. I pazienti trattati con bendaggio elastico hanno tempi di riduzione del volume del moncone più lunghi rispetto a quelli trattati con bendaggio rigido o semirigido rimuovibile anche se il vantaggio era registrabile solo nelle prime due settimane. Discussione. Il bendaggio semirigido e semirigido rimovibile è più efficace nella riduzione dell’edema del moncone dell’arto inferiore rispetto al bendaggio elastico, ma solo nel breve e medio periodo. Restano, invece, contrastanti i risultati sulla maggiore efficacia del bendaggio semirigido nella riduzione dell’edema anche nel lungo periodo (>3 settimane)

Rasch analysis of the Neck Bournemouth Questionnaire to measure disability related to chronic neck pain

To determine the psychometric properties of the Neck Bournemouth Questionnaire in patients with chronic neck pain, using Rasch analysis

Aggressive Vertebral Hemangioma and Spinal Cord Compression: A Particular Direct Access Case of Low Back Pain to Be Managed—A Case Report

Hemangiomas are the most common benign tumours affecting the spine, with an incidence of 10-12% of the general population. Although most hemangiomas are asymptomatic, there are aggressive forms which can develop symptoms, leading patients to show signs of disability. This case report aims to highlight the importance of red flags screening, and to report the physiotherapist's clinical reasoning that led him to refer his patient to other healthcare professionals. This case also illustrated the pre- and post-surgical treatment of a specific low back pain case in a patient affected by aggressive vertebral hemangioma and spinal cord compression. The patient is a 52-year-old man, who reported intense pain in his sacral region about three months prior, which worsened while in sitting position. The physiotherapist proceeded with a complete medical history investigation and clinical examination. After an impaired neurological examination, the patient was referred to another health professional, who diagnosed multiple vertebral hemangiomas in the patient's lumbosacral tract. The therapeutic intervention included the patient's post-surgical rehabilitation following a vascular embolization. This case report shows the importance of proper patient screening. Indeed, during patients' assessment, it is paramount to recognize red flags and to investigate them appropriately. An early referral of patients with conditions that require the support and expertise of other professionals can lead to a timely diagnosis and avoid costly and unnecessary rehabilitation procedures. In this case, the interdisciplinary collaboration between physiotherapist and neurosurgeon was crucial in guiding the patient towards recovery

World's oldest heart transplant donor: age is just a number

World's oldest heart transplant donor: age is just a numbe