Italian Version of the Risk Assessment and Prediction Tool: Properties and Usefulness of a Decision-Making Tool for Subjects' Discharge after Total Hip and Knee Arthroplasty

Background: Growing attention is being given to standardized outcome measures to improve interventions for total hip arthroplasty (THA) and total knee arthroplasty (TKA). We culturally adapt and validate the Italian version of the Risk Assessment and Prediction Tool (RAPT-I) to allow its predictive use after THA and TKA. Methods: The RAPT-I was adapted by forward-backward translation, a final review by an expert committee and a test of the pre-final version to establish its correspondence with the original version. The psychometric testing included test-retest reliability (intraclass correlation coefficient, ICC). The RAPT score was used to predict the subjects-destination (<6: rehabilitation unit; 6-9: additional intervention before discharging home; or >9: discharge directly at home) by comparing the actual discharge destination with the predicted destination. The predictive effects of RAPT items on the discharge destination were further described by a logistic regression model (repeated leave-one-out bootstrap procedure). Results: The questionnaire was administered to 78 subjects with THA and 70 subjects with TKA and proven to be acceptable. The questionnaire showed excellent test–retest reliability (ICC = 0.839; with 95% confidence interval (CI) of 0.725–0.934 for THA; ICC = 0.973, with 95% CI of 0.930–0.997 for TKA). The RAPT-I overall predictive validity was 87.2%, and the discharge destination was directly related to living condition (odds ratio (OR) = 2.530), mobility (OR = 2.626) and age (OR = 1.332) and inversely related to gait aids (OR = 0.623) and gender (OR = 0.474). Conclusions: The RAPT-I was successfully adapted into Italian and proven to exhibit satisfactory properties, including predictive validity in determining discharge destination

Combined Rehabilitation with Alpha Lipoic Acid, Acetyl-L-Carnitine, Resveratrol, and Cholecalciferolin Discogenic Sciatica in Young People: A randomized Clinical Trial

Background and Objectives: In the Western world, back pain and sciatica are among the main causes of disability and absence from work with significant personal, social, and economic costs. This prospective observational study aims to evaluate the effectiveness of a rehabilitation program combined with the administration of Alpha Lipoic Acid, Acetyl-L-Carnitine, Resveratrol, and Cholecalciferol in the treatment of sciatica due to herniated discs in young patients in terms of pain resolution, postural alterations, taking painkillers, and quality of life. Materials and Methods: A prospective observational study was conducted on 128 patients with sciatica. We divided the sample into 3 groups: the Combo group, which received a combination of rehabilitation protocol and daily therapy with 600 mg Alpha Lipoic Acid, 1000 mg Acetyl-L-Carnitine, 50 mg Resveratrol, and 800 UI Cholecalciferol for 30 days; the Reha group, which received only a rehabilitation protocol; and the Supplement group, which received only oral supplementation with 600 mg Alpha Lipoic Acid, 1000 mg Acetyl-L-Carnitine, 50 mg Resveratrol, and 800 UI Cholecalciferol. Clinical assessments were made at the time of recruitment (T0), 30 days after the start of treatment (T1), and 60 days after the end of treatment (T2). The rating scales were as follows: the Numeric Rating Scale (NRS); the Oswestry Disability Questionnaire (ODQ); and the 36-item Short Form Health Survey (SF-36). All patients also underwent an instrumental stabilometric evaluation. Results: At T1, the Combo group showed statistically superior results compared to the other groups for pain (p < 0.05), disability (p < 0.05), and quality of life (p < 0.05). At T2, the Combo group showed statistically superior results compared to the other groups only for pain (p < 0.05) and quality of life (p < 0.05). From the analysis of the stabilometric evaluation data, we only observed a statistically significant improvement at T2 in the Combo group for the average X (p < 0.05) compared to the other groups. Conclusions: The combined treatment of rehabilitation and supplements with anti-inflammatory, pain-relieving, and antioxidant action is effective in the treatment of sciatica and can be useful in improving postural stabilit

First patellar dislocation: from conservative treatment to return to sport

Treatment of first patellar dislocation is usually conservative and the subsequent rehabilitation program is based on specifically formulated objectives, which can be divided into different stages: stage 1: resolution of pain, swelling and inflammation; stage 2: recovery of joint motion and flexibility; stage 3: recovery of muscle strength; stage 4: recovery of motor patterns and coordination; and stage 5: recovery of the sportspecific athletic action and return to sporting activity. The aim, in the management of a patient affected by first patellar dislocation, is to achieve the best possible functional recovery: since this is a condition often affecting young athletes, this means returning them to their pre-injury conditions, both in terms of fitness and the level of sporting activity practiced. By proceeding through functional stages, the risk of recurrence of the dislocation can be reduced. The “go-ahead” to resume sporting activity can only be given in the presence of normal results on sport-specific functional tests

Italian Version of the Risk Assessment and Prediction Tool: Properties and Usefulness of a Decision-Making Tool for Subjects’ Discharge after Total Hip and Knee Arthroplasty

Abstract: Background: Growing attention is being given to standardized outcome measures to improve interventions for total hip arthroplasty (THA) and total knee arthroplasty (TKA). We culturally adapt and validate the Italian version of the Risk Assessment and Prediction Tool (RAPT-I) to allow its predictive use after THA and TKA. Methods: The RAPT-I was adapted by forward–backward translation, a final review by an expert committee and a test of the pre-final version to establish its correspondence with the original version. The psychometric testing included test–retest reliability (intraclass correlation coefficient, ICC). The RAPT score was used to predict the subjects’ destination (<6: rehabilitation unit; 6–9: additional intervention before discharging home; or >9: discharge directly at home) by comparing the actual discharge destination with the predicted destination. The predictive effects of RAPT items on the discharge destination were further described by a logistic regression model (repeated leave-one-out bootstrap procedure). Results: The questionnaire was administered to 78 subjects with THA and 70 subjects with TKA and proven to be acceptable. The questionnaire showed excellent test–retest reliability (ICC = 0.839; with 95% confidence interval (CI) of 0.725–0.934 for THA; ICC = 0.973, with 95% CI of 0.930–0.997 for TKA). The RAPT-I overall predictive validity was 87.2%, and the discharge destination was directly related to living condition (odds ratio (OR) = 2.530), mobility (OR = 2.626) and age (OR = 1.332) and inversely related to gait aids (OR = 0.623) and gender (OR = 0.474). Conclusions: The RAPT-I was successfully adapted into Italian and proven to exhibit satisfactory properties, including predictive validity in determining discharge destination

The three dimensional analysis of the Sforzesco brace correction

Scoliosis is a three dimensional deformity, and brace correction should be 3D too. There is a lack of knowledge of the effect of braces, particularly in the sagittal and transverse plane. The aim of this study is to analyse the Sforzesco Brace correction, through all the parameters provided by Eos 3D imaging system

Effect of Telerehabilitation and Outpatient Rehabilitation in Women with Breast Cancer

Telemedicine was shown to be indispensable during the SARS-CoV-2 pandemic to ensure continuity of care for fragile patients. We compared a telerehabilitation program versus an outpatient rehabilitation program in women with breast cancer undergoing quadrantectomy surgery. There were 56 women with breast cancer divided into two groups: the treatment group (TG), made up of 24 patients undergoing a remote rehabilitation project program; and the control group (CG), composed of 32 patients subjected to the same rehabilitation project program in an outpatient setting. At the time of enrollment (T0) and the end of the 8 weeks of treatment (T1), the following questionnaire scores were considered: numerical rating scale (NRS), Disabilities of the Arm, Shoulder and Hand questionnaire (Quick-DASH), Piper fatigue scale (PFS)m and Breast Cancer Therapy Functional Rating Scale (FACT-B). We observed that the CG showed greater improvements than the TG in upper limb function (7.8 ± 4.2 vs. 10.9 ± 4.9; p p p = 0.64) and fatigue (3.2 ± 1.1 vs. 3.2 ± 0.6; p = 0.66). Telerehabilitation is a valid tool in the management of women with breast cancer in the postoperative phase. However, face-to-face rehabilitation treatment may be preferred because it is more effective as it allows the construction of a specific, personalized, and targeted rehabilitation program

Safety and Efficacy of Hybrid Cooperative Complexes of Sodium Hyaluronate and Sodium Chondroitin for the Treatment of Patients with Symptomatic Knee Osteoarthritis

Abstract Introduction Knee osteoarthritis (KOA) represents a widespread degenerative disease that causes pain and motor disability. Conservative treatments mainly focus on relieving symptoms, improving joint function, and trying to delay surgery. Safety and efficacy of hybrid cooperative complexes (2.4% sodium hyaluronate and 1.6% sodium chondroitin; HA-SC) for symptomatic KOA were investigated in a single-arm, prospective, pilot study. Methods Patients with a visual analogue scale (VAS) pain score ≥ 4 and Kellgren–Lawrence Grade < 4 received a single intraarticular HA-SC injection. Patients with a VAS score change from baseline ≤ 1 received a second injection at day 30. Device-related adverse events (DR-AEs)/adverse events (AEs) were primary endpoints. Secondary endpoints included Western Ontario and McMaster Universities Osteoarthritis Index LK 3.1 (WOMAC LK 3.1), VAS, patient global assessment of disease status (PtGA), and patient proportion needing a second injection. Results Of 83 patients with KOA (Kellgren–Lawrence Grade, 2–3), 34.9% had DR-AEs at day 7. No serious DR-AEs/AEs were reported. A significant (P < 0.0001) reduction over time in VAS pain score plus WOMAC pain, stiffness, physical function limitation, and total scores was reported. Median PtGA scores indicated a ‘slight improvement’ at most follow-up visits. Only 18.1% of patients required a second injection. Conclusions A single intraarticular HA-SC injection was safe, well-tolerated, and did not lead to major deterioration in terms of reducing knee pain, stiffness, and physical function limitation in patients with symptomatic KOA