Angelo Iovane

Monitoring of fracture calluses with color Doppler sonography.

Fracture callus formation is closely associated with vascular invasion, and the use of color Doppler sonography has been suggested as a means to monitor, earlier than gray‐scale sonography, the first stages of the healing process. We report the findings in a series of patients with tibial fractures in whom both gray‐scale sonography and color Doppler imaging were employed to monitor new bone formation at the fracture site.

The effects of physical training without equipment on pain perception and balance in the elderly: A randomized controlled trial

BACKGROUND: Research supports a link between exercise and falls prevention in the older population. OBJECTIVES: Our aims were to evaluate pain perception and balance skills in a group of elderly subjects and to examine the consequences of a standardized equipment-free exercise program intervention on these variables. The study utilized a randomized controlled trial method. METHODS: 92 subjects were recruited from a rural Sicilian village (Resuttano, Sicily, Italy). Subjects were randomly split into two groups, an experimental group (EG; n = 49) and a control group (CG; n = 43). Qualified fitness instructors delivered the standardized physical exercise program for the EG whilst the CG did not receive this exercise intervention. The Berg Balance Scale and the Oswestry Disability Index were administered in both groups before (T0) and after the intervention (T1). RESULTS: At T1, the EG group significantly improvement in balance (p < 0.0001) and pain perception (p < 0.0001). No significant differences were found within the CG both in BBS and ODI, respectively. CONCLUSIONS: Our findings suggest that a 13-weeks standardized exercise equipment-free program is effective in improving balance and perception of pain in the elderly. This type of intervention can consequently provide a low cost strategy to counteract the rate of disability in elderly.

A rare case of Enchondromatosis of the knees and hands with involvement of Hoffa's fat pad and peri-articular soft-tissues

We report a case of a 56-year old man with chronic pain in both knees for several years. This patient had already undergone surgery on his left knee in 2002 after an x-ray showed multiple lytic and well margined lesions in the distal femur and proximal tibia with ground-glass matrix, involving Hoffas fat pad and the patellar ligament. Histology was consistent with an enchondroma. The most recent MRI examination showed enchondromatosis involving both knees with bilateral extension into Hoffas fat pad and the patellar ligament. Subsequently, we performed an additional radiographic examination of the hands and feet, as well as an MRI of both hands to identify other possible enchondromas in the most common sites for this disease. Enchondromatosis with soft tissue involvement is extremely rare, and involvement of Hoffas fat pad has not been reported in the scientific literature. The clinical presentation of this case and the general aspects of Enchondromatosis are discussed.

Comparison of posturographic parameters between young taekwondo and tennis athletes

[Purpose] Physical activity can influence the development of postural control and balance. Therefore, the aim of study was to use posturography assessment to compare balance control on the Romberg test between athletes in two very different sports, taekwondo and tennis. [Participants and Methods] Twenty-nine young athletes participated in the study, 11 forming the taekwondo group and 18 the tennis group. Posturography was performed using the FreeMed system (Sensor Medica). Between-group differences were evaluated using unpaired Student’s t-test. [Results] There was a significance between-group difference in the centre of pressure and the ellipse surface area with no between-group difference in frontal and sagittal plane postural control. [Conclusion] The taekwondo athletes displayed greater stability than tennis athletes, with a smaller ellipse area and a decrease in the amplitude of oscillations of the centre of pressure along the frontal plane, adaptations which likely reflect the demands of the taekwondo. Further studies are needed to support these conclusions.

Effects of physical activity on postural balance in children with juvenile idiopathic arthritis: results from a pilot study

Background: The juvenile idiopathic arthritis (JIA) is the main rheumatic disease in pediatric age. The rheumatic diseases are main causes of physical disability and have high economic costs for society. The aim of this study was to evaluate if the physical activity can prevent the decline in balance related diseases in children with previous diagnosis of JIA. Materials and Methods: Fifty-six subjects were enrolled in this study. Thirty-nine healthy subjects were included in the control group (CG) and seventeen in juvenile idiopathic arthritis group (JIAG). Subsequently, the JIAG was stratified in two ones, respectively: JIAG active (JIAG-ACT) and JIAG sedentary (JIAG-SED). The analysis was measured through the FreeMed posturography system (by Sensor Medica). STATISTICA software was adopted to perform an unpaired t test. A P value lower than 0.05 was considered to be statistically relevant. Results: Significant differences were identified in JIAG-SED vs CG in many parameters considered (Length of sway path of the CoP, P< 0,0001; Ellipse surface, p<0,05; Y mean, p<0,05). Against, except Length of sway path (p<0,05), the JIAG-ACT showed a similar trend respect to CG. Conclusion: This pilot confirms the benefits for children with JIA to perform a training program due to prevent future diseases and increase the balance levels. Clearly, the sample is not adequate to make conclusions. More data coming from larger sample size studies are necessary to confirm these results.

The relation between moderate hearing loss with balance and postural control

Background. Balance is a complex process that involves multiple sensory integrations. The auditory, visual and vestibular systems are the main contributors. Hearing loss or hearing impairment may induce inappropriate postural strategies that could affect the spine and consequently balance. The aim of this study was to understand if hearing loss could influence balance and posture Methods. 13 patients (61±13 year; 161.8±11.0 cm; 70.5±15.9 Kg) with moderate hearing loss (Right ear -60±21 dB; Left ear -61±24 dB) underwent: 1) an audiometric examination 2) a postural examination (with open and closed eyes) through a stabilometric platform, and 3) a sternocleidomastoid EMG examination. Results. No differences were found between right and left hemibody between the audiometric, posturographic, and the EMG amplitude. EMG parameters have shown no association with hearing loss, for both right or left head rotation. Multiple regression analysis has shown a negative regression coefficient (R2 -0.69) between hearing loss and the posturographic parameters. Conclusions. Hearing loss is associated to increased posturographic measures (CoP, ellipse X and Y deviations) underlining a reduced postural control in people with hearing impairment. No association has been found between neck activation and hearing loss.

Evaluation of Fitness and the Balance Levels of Children with a Diagnosis of Juvenile Idiopathic Arthritis: A Pilot Study

Background: Juvenile idiopathic arthritis is a main cause of physical disability and has high economic costs for society. The purpose of this study was to assess the fitness levels and the postural and balance deficits with a specific test battery. Methods: Fifty-six subjects were enrolled in this study. Thirty-nine healthy subjects were included in the control group and seventeen in the juvenile idiopathic arthritis group. All subjects were evaluated using a posturography system. The fitness level was evaluated with a battery of tests (Abalakov test, sit-up test, hand grip test, backsaver sit and reach, the toe touch test). An unpaired t-test was used to determine differences. Pearson’s correlation coefficient was used to evaluate the correlation between the tests. Results: The battery of tests demonstrated that subjects in the juvenile idiopathic arthritis group have lower fitness levels compared to the control group. The juvenile idiopathic arthritis group showed low postural control with respect to the control group. Pearson analysis of the juvenile idiopathic arthritis group data showed significant correlations between variables. Pearson’s results from the control group data showed a similar trend. Conclusions: The results suggest that the battery of tests used could be an appropriate tool. However, we highlight that these conclusions need to be supported by other studies with a larger population scale.

Treatment of chronic pain associated with bruxism through Myofunctional therapy

Temporomandibular disorders such as bruxism may cause painful clinical conditions and over time lead to chronic facial pain. A combination of therapeutic strategies that are usually undertaken by dentists and gnathologists to reduce bruxism episodes and consequently pain, are myofunctional therapy, pharmacological treatment, intraoral interventions and behavioural treatments. The aim of this work was to understand if myofuntional therapy alone can be a useful therapy for the reduction of chronic facial pain. 24 patients, 9 male and 15 female, age ranging between 25 and 45, were treated with a myofunctional therapy for 9 month. Each patient was evaluated through a numeric pain intensity scale ranging from 0 to 10 and the number of bruxism episodes/hour per patient were also recorded; electromyographic examinations of the temporal, masseter, sternocleidomastoid and digastric muscles were performed to evaluate muscle activation. Each patient was tested before (T0) and after (T1) the treatment period. Pain intensity decreased from T0 to T1 (8.13±0.39 vs. 1.75±2.43, respectively, p<0.01). The number of bruxism episodes also significatively decreased between T0 and T1 (24 vs. 9, p<0.01). Electromyographic assessment showed a decrease in the tonic activity of the masseter muscle (T0: 1.88±0.31 vs. T1: 1.4±0.25 μV; p<0.05) and a reduction of the electric activity of the temporal and digastric muscles during serration of the mandible (T0: 167.9±19.6 μV Vs T1: 144.6+16.43 μV; p<0.05 and T0: 58.97+8.38 μV Vs T1: 52.79+7.44 μV; p<0.05, respectively). Myofunctional therapy could be used to reduce facial pain as a consequence of bruxism episodes.

Effects of a ludic-motor program on motor development and early literacy skills in preschool children

There is insufficient evidence in the literature about many correlations between motor and cognitive skills in 3-5 year old children [1]. The aim of this study was to explore the relationship between the development of the gross motor skills and the prerequisites of reading/writing following a ludic-motor program (LMP) in pre-school children. This study has involved 189 children (age: 4.62 ± 0.97 years; height: 107.83 ± 7.82 cm, body weight: 19.84 ± 4.95 kg) attending 8 kindergartens in Palermo. The children were randomly divided in a control group (C, n= 29), a 1-intervention group (I-1, n= 120) and a 2-intervention group (I-2, n= 40). I-1 and I-2 respectively performed 4 and 10 hours/week of a 16-week LMP carried out by outside experts; while C children do not perform any LMP. This program was planned in 21 learning modules aimed to develop bodily schemes, basic motor skills, fine motor control and coordination abilities. Before and after the LMP, locomotor and object control skills were evaluated with the Test of Gross Motor Development, while early reading/writing skills with the PRCR-2 test. Analyses of covariance were performed to compare outcomes for I1, I2 and C groups at post-test and the covariate was the participants’ measure of cognitive skills at pre-test. Statistical significance was defined at p<0.05. I-1 and I-2 groups showed a significant increase in both motor skills compared with C group after the LMP. A significant decrease in the number of errors concerning the serial work skills from left to right, the visual analysis and memory was found in I-1 and I-2 groups compared with C group following the LMP. Moreover, in I-2 group we observed a positive correlation between the pre-requisites of writing/reading and the Quotient of Gross-Motor Ability. The level of motor skills of children of 3-5 years is dependent on the amount of structured physical activity executed. More the level of motor skills reached is high more is correlates with a greater learning of cognitive skills. Therefore, this activity may be a tool to encourage academic achievement of all children and, even more, of those with specific learning disorders.This work was supported by a grant from the Municipality of Palermo

One repetition maximum bench press performance: a new approach for its evaluation in inexperienced males and females. A pilot study

The aim of this study was to evaluate a new method to perform the one repetition maximum (1RM) bench press test, by combining previously validated predictive and practical procedures. Eight young male and 7 female participants, with no previous experience of resistance training, performed a first set of repetitions to fatigue (RTF) with a workload corresponding to ⅓ of their body mass (BM) for a maximum of 25 repetitions. Following a 5-min recovery period, a second set of RTF was performed with a workload corresponding to ½ of participants’ BM. The number of repetitions performed in this set was then used to predict the workload to be used for the 1RM bench press test using Mayhew’s equation. Oxygen consumption, heart rate and blood lactate were monitored before, during and after each 1RM attempt. A significant effect of gender was found on the maximum number of repetitions achieved during the RTF set performed with ½ of participants’ BM (males: 25.0 ± 6.3; females: 11.0x± 10.6; t = 6.2; p < 0.001). The 1RM attempt performed with the workload predicted by Mayhew’s equation resulted in females performing 1.2 ± 0.7 repetitions, while males performed 4.8 ± 1.9 repetitions. All participants reached their 1RM performance within 3 attempts, thus resulting in a maximum of 5 sets required to successfully perform the 1RM bench press test. We conclude that, by combining previously validated predictive equations with practical procedures (i.e. using a fraction of participants’ BM to determine the workload for an RTF set), the new method we tested appeared safe, accurate (particularly in females) and time-effective in the practical evaluation of 1RM performance in inexperienced individuals.