86 research outputs found

    A new neurocognitive interpretation of shoulder position sense during reaching: unexpected competence in the measurement of extracorporeal space

    Get PDF
    Background.The position sense of the shoulder joint is important during reaching. Objective. To examine the existence of additional competence of the shoulder with regard to the ability to measure extracorporeal space, through a novel approach, using the shoulder proprioceptive rehabilitation tool (SPRT), during reaching. Design. Observational case-control study. Methods. We examined 50 subjects: 25 healthy and 25 with impingement syndrome with a mean age [years] of 64.52 +/− 6.98 and 68.36 +/− 6.54, respectively. Two parameters were evaluated using the SPRT: the integration of visual information and the proprioceptive afferents of the shoulder (Test 1) and the discriminative proprioceptive capacity of the shoulder, with the subject blindfolded (Test 2). These tasks assessed the spatial error (in centimeters) by the shoulder joint in reaching movements on the sagittal plane. Results. The shoulder had proprioceptive features that allowed it to memorize a reaching position and reproduce it (error of 1.22 cm to 1.55 cm in healthy subjects). This ability was lower in the impingement group, with a statistically significant difference compared to the healthy group ( < 0.05 by Mann–Whitney test). Conclusions. The shoulder has specific expertise in the measurement of the extracorporeal space during reaching movements that gradually decreases in impingement syndrome

    The experience of COVID-19 ward’s patients: a narrative medicine approach

    Get PDF
    Narrative Medicine approach has increased in popularity in the medical context as an effective model to approach their patients’ experiences of illness with more understanding and compassion, offering fresh opportunities for empathic, respectful, and nourishing medical care. The goal of our work has been to study the overall experience of COVID-19 patients, putting the personal dimension at the center of the dialogue and the ability to acknowledge, absorb, interpret, and act on the stories and plights of others. Firstly, we considered their reaction to the consequences of the Lockdown, then we asked if they were fearful of potentially being infected, and finally, we asked about their illness and arrival at the hospital, having little to no information about their future. The interdisciplinary intersection between neuropsychology, micro-sociology of health, and physical and rehabilitative medicine has made it possible for us to report the following experience, providing new insights on the pre-existent doctorpatient relationship and the importance of hospitalization stories, for humane and effective medical practice

    Why evidence-based medicine is an insufficient approach to physical and rehabilitation medicine. Antithesis.

    No full text
    When philosophers of science demolished the myth of objectivity in the early decades of the 20th century, they undermined the theoretical certainty that a knowledge system comes from the cumulative development of scientific observations: here we find a criticality inherent to evidence-based medicine in relation to its claim of universality and objectivity. EBM relies on quantitative statistical models to define a treatment's effectiveness, and it has an universal character: the treatment effect is measured against the global characteristics of the general population rather than the individuals. Contemporary cognitive neuroscience takes a naturalized approach to mind and behavior, opening new inroads into investigating consciousness, motor image, bodily awareness, and intention. Common to these issues is the emphasis on the importance the person, with his or her own biology and history, as a unique and unrepeatable entity. Hence, its original aim to protect patients against arbitrary treatment notwithstanding, EBM has become largely inadequate to serve physical and rehabilitation medicine (PRM) owing to the peculiarities of its historical and narrative contents. PRM, because of its unique knowledge base, can be fully considered a science anchored in the basic sciences that underlie rehabilitation procedures. Accordingly, PRM exists within a mutual relationship with physics and biology, from which the biomedical model (well represented by EBM) originates, and is interrelated with other disciplines such as philosophy or psychology, from which the bio-psycho-social model was developed in the 1980s, leading to a comprehensive approach to health and disease. Further critical points in clinical practice include: how to translate evidence into clinical decision making; the inability to generalize experimental evidence because most studies involve selected patient samples. Despite the more than 20 years of EBM, long-established therapeutic approaches lacking scientific evidence still survive in rehabilitation. We must strive for an integrative approach to EBM, which would enable PRM, by virtue of its multifaceted theoretical and methodological approaches to persons with disability, to take the lead in redefining biomedical knowledge and, by applying this understanding, put its science into clinical practice and, perhaps, more generally, into outlining a new "ideal of science"

    Management of chronic pain in osteoporosis: Challenges and solutions

    No full text
    Osteoporosis (OP) is a pathological condition that manifests clinically as pain, fractures, and physical disability, resulting in the loss of independence and the need for long-term care. Chronic pain is a multidimensional experience with sensory, affective, and cognitive aspects. Age can affect each of these dimensions and the pain that is experienced. In OP, chronic pain appears to have sensory characteristics and properties of nociceptive and neuropathic pain. Its evaluation and treatment thus require a holistic approach that focuses on the specific characteristics of this population. Pain management must therefore include pharmacological approaches, physiotherapy interventions, educational measures, and, in rare cases, surgical treatment. Most rehabilitative treatments in the management of patients with OP do not evaluate pain or physical function, and there is no consensus on the effects of rehabilitation therapy on back pain or quality of life in women with OP. Pharmacological treatment of pain in patients with OP is usually insufficient. The management of chronic pain in patients with OP is complicated with regard to its diagnosis, the search for reversible secondary causes, the efficacy and duration of oral bisphosphonates, and the function of calcium and vitamin D. The aim of this review is to discuss the most appropriate solutions in the management of chronic pain in OP
    • …
    corecore