THE ROLE OF ORTHOTICS IN THE FOOTBALL

The prevention of injury of foot is the true focus of the biomechanical approach applied to the foot in the sports medicine. This work will analyse the roles of the orthotics devices in the treatment of some injuries of the foot in the soccer players. The pathological processes that can developed in the foot are caused by either simple acute traumas from contact or microtraumas from repeated stressed to the foot. Method and Material: We have examined and treated 120 soccer players afflicted from foot’s pathologies from overload. The follow up is 2 years. The diagnostic approach has included an objective examination with a diagnostic X-rays images, and after an evaluation of reaction behaviour of the ground with the foot. The ground reaction was analyzed during both walking and running, to define as precisely as possible the characteristics of pressures and forces aging on the foot. Results: in our clinic we have realized that the treatment of foot’s injuries (tab.1) involves beyond a biomechanical control with orthotics and after a propioceptional rehabilitative programme for 1 month. The results of the pathologies’ treatment with plantar orthotics have demonstrated that this method has a positive interaction ( tab.2) in the control of the foot’s biomechanical disorders. Discussion: Several studies support the impression that orthotic devices reduce biomechanical stress and the incidence of injury. Taunton et al. have demonstrated a decrease in calcaneal eversion during the support phase of running and Bates et al. have demonstrated a reduction in the period and in the maximum extent of pronation in running wearing orthotic devices. Our experience about the use of the plantar orthotic is that the orthotic devices should be of elastic and absorbing at various level material because our data suggest that controlling the velocity of eversion is more important than controlling the degree of eversion, and also that with those materials is possible to good reduce the vertical forces that are applied on the plantar surface of the foot and to well control the good aliment of the leg with the foot. The technical construction should be related to the pattern of the individual ground reaction. Conclusion: The plantar orthotic is an ideal support able to control excessive motion of S.T.J. and to reduce the vertical and horizontal forces and the rotational movement of the foot

THE FOOT-GROUND REACTION IN THE SOCCER PLAYER

Soccer is a sport of movement and contact with the basic aim to gain on and to hold the ball. The development's possibility of an action, at any frequency, is strictly correlated to the balance between internal and external forces. The purpose of this study is to confront the foot-ground reaction in male (40) and female (15) elite soccer players by means of a dinarnometric plateform, both during a normal gait and a running at 10 kmh. Results: The parameters of foot-ground reaction in both the groups show a significant identity concerning the Fz, Fy and Fx components, The morphology of the vectograms in male and in female players is the same. The only difference between male and female player concerns the first value of Fz parameter: in the male group, this is bigger of 15% of the b.w

PLANTAR FASCIITIS: AN UPDATE ON CLINICAL AND BIOMECHANICAL FEATURES

Plantar fasciitis is an inflammatory condition, characterized by pain in the medial, central and lateral plantar compartments, accompanied by stiffness. The purpose of this study is to compared 30 runner affected by plantar fasciitis to a. control group and to point out 1) the different areas of pain and referred pain, 2) the isokinetic muscular performance of the plantar flexor muscle, by means of a Cibex 6000 isokinetic dynamometer and tests performed concentrically and eccentrically at 30, 60, 90, 180 deg/sec. 3) the data of the foot-ground reaction got by means of a. dynamometric platform. Results: In all the three sectors of plantar fascia there are different areas of pain and referred pain. An high incidence of plantar flexor muscle strength deficits has been showed both during concentric and eccentric contraction, and in addition the ankle range of motion is reduced. The gait analysis has shown a persistent alteration of the foot-ground reaction's parameters. The Aa. present the results of the treatment based on the correction of biomechanical deficits with follow-up of three years

The FOOT GROUND REACTION ON THE SOCCER AND RUGBY PLAYER

Introduction The body’s motion must be interpreted a succession of elementary movements that can be studied as the combination of translational and rotational motions. The correct expression of a motion is dependent on the balance between internal and external forces. The vector and scalar characteristics of the reaction are related to the physical and mechanical characteristics of two structures coming in contact Methods and Materials The analysis is performed during the normal strike and the running of the soccer and the rugby player. We have used a dynamometric platform Kistler that provided the complete progression of the foot ground reaction which deve1opes during the stage of placing of the fool on the ground.24 soccer p layers of Italian national team and 40 soccer players with high ability and performance and 50 rugby players are examined and the tests are correlated with a control reference group of normal subjects. Results The analysis of the soccer players’ foot-ground reaction on the sagittal plane has revealed: during the normal strike an impact phase characterized by high force both maximum and medium and high velocity of progression of application's point. A support phase characterized by velocity of progression of application point lower compared to the impact phase and by the backward inclination of vectors. A propulsive phase with a presence of a peak of force lower than the first one in the contact phase and with rotational moment significantly increased compared to the normal. The trace diagram show a wider extension of internal rotation during the contact phase and movement with a predominance of an external rotation during the support phase. The analysis of the rugby players' fool-ground reaction has revealed on the sagittal plane: during the normal strike an impact phase with high force both maximum and medium and high velocity of progression of application's point. In comparison of the soccer player’s ground reaction the data show values reduced of force during the impact phase. A support phase shows backward inclination of vectors and a reduced velocity of progression compared to the impact phase. A propulsive phase demonstrate a presence of a peak of force same that the first one during the contact phase. On the horizontal plane, the trace diagram shows a normal extension of internal rotation and a significantly extension of external rotation. Conclusions: The ground reaction pattern of the professional soccer player is repetitive, typical and different by the pattern of the vectorial diagram of the rugby player

THE INFLUENCE OF VISCO-ELASTIC INSOLES ON GROUND REACTION FORCES DISPLAYED BY ACHILLES TENDONITIS PATIENTS

INTRODUCTION: In our paper we describe the results obtained by quantifying the ground reaction forces with a Kistler force platform of 19 adults affected by achilles tendonitis, before during and after treatment with personalized viscoelastic insoles. Our goal was to quantify the functional deficit determined by that pathology, and quantify the recovery of normal function by treatment with personalized visco-elastic insoles. METHODS: We considered 19 adults athletes (runners) who got achilles tendonitis, to be put in causal relation with their sport activity; they were males and female, 19-63 aged (35 y.o in mean). They all made gait analysis, and the time evolution of the 3 components of ground reaction force was compared with 'normal' ones, so defined in the article by Chao and al. (1983) for healthy female and male adults, that matched with our patients for age, gender and gait velocity. From this comparison we found out some characteristics of the ground reaction of subjects affected by Achilles tendonitis, particularly for what is about the vertical and the antero-posterior components, that are related to the exercise of force on the ground in the first and the last moment of stance, and that for our patients resulted depressed than the normal data. After this first gait analysis the subjects were treated only with personalized visco-elastic insoles, for a mean period of 12 weeks (8 weeks - 6 months), to 'normalize' the foot-ground interaction during stance phase; the gait analysis was repeated at about the mean time of the treatment, and 18 months in mean (12 - 24 months) after his end. RESULTS: This treatment determined not only full remission of symptoms, but a recovery of good functionality of affected lower limbs, as we could verify by repeating gait analysis in the mean time of the treatment, and after 18 months in mean from his end, and performin a statistical elaboration of the data with the Student 't' test. We found that during the treatment functionality improves gradually, and after his end it remaines good, so that visco-elastic insoles resulted effective in avoiding relapses of pathology

-Dual nucleoside therapy for HIV infection: analysis of results and factors influencing viral response and long term efficacy.

We performed a retrospective analysis of our experience with dual nucleoside regimens to look for predictors of long term benefit. We evaluated a cohort of 68 HIV-infected patients treated at 3 Italian hospital-based facilities. The results were analysed using univariate and multivariate statistical analyses. Fourty-three males and 25 females were treated for 22 ± 14 months. Sixty three patients (92.6%) suffered no or low-grade side-effects. Thirty-four patients (50 %) reached a viral load 150/μl pre-treatment viremia 1,500/μl, and no previous exposure to NRTI. Total lymphocyte counts and CD4+ T-cells showed a significant correlation. Dual NRTI regimens may be still considered for patients unable to tolerate HAART regimens and presenting with favourable predictors of response

A gene signature for post-infectious chronic fatigue syndrome

Background: At present, there are no clinically reliable disease markers for chronic fatigue syndrome. DNA chip microarray technology provides a method for examining the differential expression of mRNA from a large number of genes. Our hypothesis was that a gene expression signature, generated by microarray assays, could help identify genes which are dysregulated in patients with post-infectious CFS and so help identify biomarkers for the condition. Methods: Human genome-wide Affymetrix GeneChip arrays (39,000 transcripts derived from 33,000 gene sequences) were used to compare the levels of gene expression in the peripheral blood mononuclear cells of male patients with post-infectious chronic fatigue (n = 8) and male healthy control subjects (n = 7). Results: Patients and healthy subjects differed significantly in the level of expression of 366 genes. Analysis of the differentially expressed genes indicated functional implications in immune modulation, oxidative stress and apoptosis. Prototype biomarkers were identified on the basis of differential levels of gene expression and possible biological significance Conclusion: Differential expression of key genes identified in this study offer an insight into the possible mechanism of chronic fatigue following infection. The representative biomarkers identified in this research appear promising as potential biomarkers for diagnosis and treatment

High cocoa polyphenol rich chocolate may reduce the burden of the symptoms in chronic fatigue syndrome

<p>Abstract</p> <p>Background</p> <p>Chocolate is rich in flavonoids that have been shown to be of benefit in disparate conditions including cardiovascular disease and cancer. The effect of polyphenol rich chocolate in subjects with chronic fatigue syndrome (CFS) has not been studied previously.</p> <p>Methods</p> <p>We conducted a double blinded, randomised, clinical pilot crossover study comparing high cocoa liquor/polyphenol rich chocolate (HCL/PR) in comparison to simulated iso-calorific chocolate (cocoa liquor free/low polyphenols(CLF/LP)) on fatigue and residual function in subjects with chronic fatigue syndrome. Subjects with CFS having severe fatigue of at least 10 out of 11 on the Chalder Fatigue Scale were enrolled. Subjects had either 8 weeks of intervention in the form of HCL/PR or CLF/LP, with a 2 week wash out period followed by 8 weeks of intervention with the other chocolate.</p> <p>Results</p> <p>Ten subjects were enrolled in the study. The Chalder Fatigue Scale score improved significantly after 8 weeks of the HCL/PR chocolate arm [median (range) Exact Sig. (2-tailed)] [33 (25 - 38) vs. 21.5 (6 - 35) 0.01], but that deteriorated significantly when subjects were given simulated iso-calorific chocolate (CLF/CP) [ 28.5 (17 - 20) vs. 34.5 (13-26) 0.03]. The residual function, as assessed by the London Handicap scale, also improved significantly after the HCL/PR arm [0.49 (0.33 - 0.62) vs. 0.64 (0.44 - 0.83) 0.01] and deteriorated after iso-calorific chocolate [00.44 (0.43 - 0.68) vs. 0.36 (0.33 - 0.62)0.03]. Likewise the Hospital Anxiety and Depression score also improved after the HCL/PR arm, but deteriorated after CLF/CP. Mean weight remained unchanged throughout the trial.</p> <p>Conclusion</p> <p>This study suggests that HCL/PR chocolate may improve symptoms in subjects with chronic fatigue syndrome.</p

Impact of social determinants on antiretroviral therapy access and outcomes entering the era of universal treatment for people living with HIV in Italy

Background: Social determinants are known to be a driving force of health inequalities, even in high income countries. Aim of our study was to determine if these factors can limit antiretroviral therapy (ART) access, outcome and retention in care of people living with HIV (PLHIV) in Italy. Methods: All ART naïve HIV+ patients (pts) of Italian nationality enrolled in the ICONA Cohort from 2002 to 2016 were included. The association of socio-demographic characteristics (age, sex, risk factor for HIV infection, educational level, occupational status and residency area) with time to: ART initiation (from the first positive anti-HIV test), ART regimen discontinuation, and first HIV-RNA &lt; 50 cp/mL, were evaluated by Cox regression analysis, Kaplan Meier method and log-rank test. Results: A total of 8023 HIV+ pts (82% males, median age at first pos anti-HIV test 36 years, IQR: 29-44) were included: 6214 (77.5%) started ART during the study period. Women, people who inject drugs (PWID) and residents in Southern Italy presented the lowest levels of education and the highest rate of unemployment compared to other groups. Females, pts aged &gt; 50 yrs., unemployed vs employed, and people with lower educational levels presented the lowest CD4 count at ART initiation compared to other groups. The overall median time to ART initiation was 0.6 years (yrs) (IQR 0.1-3.7), with a significant decrease over time [2002-2006 = 3.3 yrs. (0.2-9.4); 2007-2011 = 1.0 yrs. (0.1-3.9); 2012-2016 = 0.2 yrs. (0.1-2.1), p &lt; 0.001]. By multivariate analysis, females (p &lt; 0.01) and PWID (p &lt; 0.001), presented a longer time to ART initiation, while older people (p &lt; 0.001), people with higher educational levels (p &lt; 0.001), unemployed (p = 0.02) and students (p &lt; 0.001) were more likely to initiate ART. Moreover, PWID, unemployed vs stable employed, and pts. with lower educational levels showed a lower 1-year probability of achieving HIV-RNA suppression, while females, older patients, men who have sex with men (MSM), unemployed had higher 1-year risk of first-line ART discontinuation. Conclusions: Despite median time to ART start decreased from 2002 to 2016, socio-demographic factors still contribute to disparities in ART initiation, outcome and durability