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National scientific qualification (NSQ) is a procedure to regulate access to Italian academic positions. An increased use of self-citations could favor the achievement of the minimum bibliometric requirements. The aim of this study was to retrospectively analyze the self-citing behavior of successful candidates who applied for the NSQ in the Allied Health Professions (AHP) scientific field. Bibliometric indexes of all candidates qualified in the three first sessions (2012, 2013, and 2016) were retrieved from the Scopus database. We developed a new index (ΔSCR) to detect changes in the candidate's habits based on the difference between the Self Citation Rate (SCR) in the year preceding NSQ and that of the previous 10 years. The Kruskal–Wallis test was used to analyze the ΔSCR between sessions. Multivariate regressions were run to investigate the relationship between ΔSCR and six independent factors. Differences in ΔSCR were found between 2012 and 2013 (p = 0.008), between 2013 and 2016 (p < 0.0001), but not between 2012 and 2016 (p = 1.000). Regressions showed highest R2 in ΔSCR ≥ 10 subsets (2012: R2 = 0.373; 2013: R2 = 0.645; 2016: R2 = 0.511). The difference in citation habits (ΔC) was a significant ΔSCR predictor in 2012 and 2013, while publication habits (ΔP) and the difference in the H-index with vs. without self-citations (ΔH) were significant variables in 2012 and 2016, respectively. In the AHP sector, there was an increase in the use of self-citations in the 2013 session. Higher ΔSCR was associated with ΔC, ΔH and ΔP.

Smartphone-based measurement could represent a portable and cheap solution to assess the Nordic Hamstring break-point angle (BPA). We investigated the following: (1) the reproducibility of the DrGoniometer app, (2) its agreement with a computerized video analysis software used as a reference method, and (3) the effects of raters' experience. Fifty recordings were processed by four independent raters. Intraclass correlation coefficient (ICC), SEM, and minimum detectable change (MDC) were calculated. Bland-Altman plots verified the limits of agreement (LoA) with the reference method. The effect of raters' clinical experience was investigated by unpaired t-tests. The app showed excellent intra-rater (ICC = 0.89, 95% CI, 0.84-0.92) and inter-rater reliability (ICC = 0.82, 95% CI, 0.74-0.89), low error (SEM = 2°; MDC = 5.5°), and substantial agreement with video analysis [95% LoA = ±6.7°; mean difference = 1.0°]. Rater experience did not affect results (P > 0.05). The smartphone-based app offers a reliable, valid, quick, and portable method for measuring the BPA in Nordic Hamstring exercise.

to investigate lifestyle, health-related behaviours, and nutritional knowledge among a sample of Italian university students and to identify social determinants of - and barriers to - healthier lifestyles.cross-sectional observational study.students attending degree courses in health professions in a single university in Northern Italy (No. 1,495) were invited to participate in a structured web survey.a comprehensive, validated questionnaire was used. Questions regarded nutritional knowledge and habits, smoking habit, physical activity, self-efficacy, and barriers to change. Anthropometric and sociodemographic information was collected. Descriptive statistics were used to summarize results. With single and multiple regression models, differences between subgroups and ranked predictors of students' attitudes towards healthy behaviours were analysed. Statistical significance was set at p0.05.a total of 554 subjects completed the survey (participation rate: 42%; completion rate: 88%). Students showed good nutritional knowledge (73%), but some deficiencies related to low fruit/high sweets consumption, and a lack of basic macronutrients information. Only 30% of the students led a very active lifestyle and physical inactivity was greatest among overweight/obese students. Sedentary lifestyle and unhealthy diet were mainly associated with modifiable risk factors, e.g., being overweight and smoking.this study provides evidence that health profession students have good knowledge, but their health-related lifestyle is a concern, especially given the role of prescribers that they will play. Structured programmes need to be developed to address the modifiable risk factors associated with detrimental behaviours manifest already during the university years.

the relationship between physical exercise and gut microbiota has opened new therapeutic frontiers for many inflammatory diseases. However, there is still a lot of uncertainty about how to administer exercise.to review the literature to bridge this gap and examine the relationship between cardiorespiratory fitness (CRF) and microbiota.systematic review.studies involving humans who undergoing exercise programmes of any lengths, intensities, and types were included. The research was carried out through PubMed, Scopus, and Web of Science.the primary outcome was change in gut microbiota composition (α and β-diversity), while the secondary outcome was the CRF level.the 15 studies included (all with PEDro scale=5) used aerobic training alone or combined with resistance exercises. In general, exercise has shown positive effects on the microbiota, influencing the faecal count of some bacterial phyla (in particular Bacteroidetes, Firmicutes, and Proteobacteria), with a weak tendency towards proportionality in relation to training duration and intensity. However, the evidence supporting the exercise effects on the gut microbiota and the relationship with CRF are of low quality.despite the weak evidence in favour of the effects of the practice of physical exercise on the intestinal microbiota, there are still many aspects that need to be explored. In particular, future studies shall have higher quality and methodological rigour, standardize the methods for outcome assessment, and determine type and thresholds of interventions intensity and duration.

Patient's satisfaction with device is an important clinical outcome in prosthetics and orthotics. The Client Satisfaction with Device (CSD) - one of the five modules of the Orthotics and Prosthetics Users' Survey (OPUS) - has been defined as the only outcome measure specifically developed to measure user satisfaction with a prosthesis or an orthosis. The aim of this study was to provide a comprehensive review of the psychometric properties of the CSD, summarizing the present evidence on this measure, and verifying if the scoring system is consistent in the literature. A systematic literature search was conducted utilizing PRISMA guidelines. Articles were searched in PubMed and Scopus databases using search terms relating to the psychometric properties of the CSD. Thirteen articles assessing the psychometric properties of the CSD met the inclusion criteria for this review. The CSD has been translated and validated in several languages. However, these versions are not consistent across the studies since they include different number of items, with different number of response options, and scoring systems. The CSD - where used in its eight-item version, rated with a four-point rating scale - can be judged as a tool with acceptable psychometric properties for assessing satisfaction with devices in prosthesis and orthosis users. This CSD version seems the best one for optimizing coverage and psychometric quality with the fewest number of items. Further studies are warranted to assess the degree of suitability of this scale in specific populations of users of prostheses or orthoses and to analyze its psychometric properties in further cultural contexts.

Background The Swiss containment strategy for the COVID-19 pandemic during the first wave in spring 2020 resulted in a moratorium on non-urgent physiotherapy via regular direct patient contact. Consequently, such physiotherapy sessions declined by 84%. This study investigates the impact of this moratorium on the use of digital remote physiotherapy in Switzerland during this period and the perceptions of its use by Swiss physiotherapists (PTs). Methods A cross-sectional online questionnaire was distributed between June and August of 2020 via the Swiss Physiotherapy Association (physioswiss) and various associations of physiotherapy specialists (e.g., sport, pediatric) working in both inpatient and outpatient settings. The questionnaire was designed to capture the demographics of participants and the perceptions of PTs using 33 questions in the following domains: Demography; Attitudes towards digital technology; Private and professional use of digital technology; Use of digital technology during therapy; and, Support requirements. Closed and open-ended questions were included and the frequency of answers was analyzed. Non-parametric inferential statistics were used to identify differences, where appropriate. The Checklist for Reporting Results of Internet E-Surveys (CHERRIES) was adopted. Results Participants in the survey were 742 PTs (23.5% male, mean age of 43 years, mean working experience of 18 years) from the German-speaking (75.5%), French-speaking (15.1%), and Italian-speaking (9.4%) regions of Switzerland. The percentage of PTs using digital remote therapy increased from 4.9% prior to the lockdown to 44.6% during the lockdown period. The majority of PTs did not consider that digital remote therapy could complement usual physiotherapy practice and did not plan to continue with digital remote therapy after the pandemic. Conclusions During the lockdown, Swiss PTs adopted various low-cost and easily accessible digital technologies. However, several barriers hampered further implementation of this modality. Specific education and training programs need to be provided among PTs, appropriate digital technologies should be introduced, and a correct reimbursement scheme should be developed. Trial registration COVIDPhysio Registry of World Physiotherapy, registered 15th June 2020 (https://world.physio/covid-19-information-hub/covid-19-covidphysio-registry).

The aim of this study was to investigate the reliability and validity of the Trunk Control Measurement Scale (TCMS) among children with cerebral palsy (CP) who were living in Tanzania. Two physiotherapy trainees, each blinded to the other’s test findings, independently administered the TCMS to 38 children with CP (16 female; M age = 7.2, SD = 4.8 years) twice over sessions separated by a 30-day interval. We assessed internal consistency and intra/inter-rater reliability using Cronbach’s alpha and the Intraclass Correlation Coefficient (ICC), respectively. We examined measurement error through Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC). We assessed construct validity with Spearman's correlation coefficient between the TCMS and both the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS). We found a frank floor effect. Internal consistency (α = 0.945) and reliability indices were excellent for the total scale (ICC for intra-rater reliability = 0.985, inter- reliability = 0.997) and for each sub-scale score. We found low values of SEM (1.7 points) and MDC (4.8 points). Construct validity was supported by moderate and strong correlations between the TCMS and the GMFCS and MACS in this sample. We conclude that the psychometric properties of the TMCS support its clinical and research use for youth with CP in low-income settings.

ispartof: JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE vol:27 issue:4 pages:373-374 ispartof: location:United States status: published

Capacitive and resistive electric transfer (CRET) therapy is a physical treatment modality commonly used to treat musculoskeletal pain. It normally uses a longwave radiofrequency of ~0.5 MHz. The system consists of a neutral plate and two different electrodes that can transfer energy in two modalities: capacitive and resistive. The aim of this systematic review was to identify and summarize the available data in the literature on this physical modality. From a search of articles published before December 2019 in MEDLINE and Scopus indexed journals, we retrieved 276 articles, 13 of which met the inclusion criteria for this review. Most articles dealt with musculoskeletal disorders, mainly spine disorders and knee osteoarthritis. More than 75% of the studies used a similar range of frequency (440-600 KHz). Almost all described an improvement in strength and function and reduced pain intensity after the treatment. Although nine of the 13 studies (70%) were randomized controlled trials, only two had a low risk of bias according to the Cochrane library assessment tool. CRET seems to be an effective therapy to decrease pain, and improve the quality of life and disability of patients affected by musculoskeletal disorders. There is no study on symptoms of patients with neurological disorders. Further research is necessary to standardize the therapeutic protocols across different orthopedic diseases, and to assess the benefits of CRET in other fields such as neurological or rheumatologic disorders.

Background Dexterity impairments caused by carpal tunnel syndrome (CTS) make working and daily activities challenging. We aimed to investigate: i) the relationship between dexterity and nerve conduction studies (NCS) in workers with classic symptoms presentation; ii) the ability of the Functional Dexterity Test (FDT) to discriminate different levels of CTS severity as classified by NCS; iii) the diagnostic accuracy of a clinical battery composed of the FDT, Phalen’s test and Tinel’s sign. Methods In a convenience sample of individuals diagnosed with CTS, we correlated FDT net scores with the NCS-based classification by means of Spearman’s (rho) test. Discriminative ability of the FDT was assessed by ANOVA, and a ROC curve determined cutoff thresholds. Sensitivity, specificity, and likelihood ratios (LRs) were used to investigate the diagnostic accuracy of the clinical battery. Results Data from 180 hands were collected. The FDT was significantly correlated (rho = 0.25, p 95% 0.83–0.99; LR+: 14.49, CI95% 2.09–100.53). Conclusions Sensorimotor impairments related to CTS can affect hand dexterity. The FDT discriminated patients with severe NCS involvement. Positive results on the clinical battery (Phalen, Tinel, and FDT) could help to confirm the CTS diagnosis, showing a very high specificity and LR+. On the contrary, the low sensitivity is not able to rule out CTS in individuals with negative results.

The Patient and Observer Scar Assessment Scale (POSAS) is one of the most robust instruments to assess scar quality, but there is no Italian version, and no other competing instruments are available in Italian. The aim of this study was to translate and validate an Italian version of POSAS (POSAS-I). POSASv2.0 was culturally adapted in accordance with international standards. The psychometric assessment included acceptability/feasibility, internal consistency, reproducibility, construct validity and sensitivity to change. Cultural equivalence of POSAS-I with the English version was confirmed. The validation study included 102 subjects with surgical scars. Both subscales demonstrated acceptable internal consistency (Cronbach's α = 0·72–0·80). Reproducibility of the OSAS-I (ICCs = 0·93–0·94; SEM = 1·8 points; MDC95 = 5·1 points) was superior to that of PSAS-I (ICC = 0·65; SEM = 5·7 points; MDC95 = 15·7 points). OSAS-I showed moderate to good correlations with the Vancouver Scar Scale (VSS), Global Rating of Change Scale (GRCS) and PSAS-I. Sensitivity to change was large for PSAS-I (effect size = 1·08; standardised response mean = 0·96) and moderate to large for OSAS-I (ES = 0·69; SRM = 0·92). This study confirmed that POSAS-I can be used to assess patients with surgical scars in the Italian population. OSAS-I is useful for clinical and research purposes, while PSAS-I should be better used to capture patients' own opinions and symptoms in clinical settings.

Objectives: Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) are broadly studied in high-income countries, but data concerning their functioning are lacking in developing countries. Therefore, we analyzed their reliability and sensitivity to change in children with cerebral palsy in Tanzania. Methods: GMFCS and MACS are two ordinal grading systems used to assess motor functions while observing children’s performances. Forty-nine children were classified by two independent physiotherapy students at baseline, after one month and after one year. Reliability and sensitivity to change were analyzed using intraclass correlation coefficient (ICC), effect size (ES), standard response mean (SRM), standard error of measurement (SEM), and minimal detectable change (MDC). Results: Inter- (ICC = 0.97/0.95 for GMFCS/MACS) and intra-rater reliability (ICC = 0.98/0.96 GMFCS/MACS) were excellent. Sensitivity to change was small (ES = −0.14/0.11, SRM = −0.24;/0.24 GMFCS/MACS). SEM was 0.2 points, resulting in MDC = 0.5/0.7 for GMFCS/MACS, respectively. Conclusions: GMFCS and MACS demonstrated excellent reliability, but not sensitivity to change.

Background: The Patient and Observer Scar Assessment Scale (POSAS) v2.0 is a widely used instrument to evaluate postsurgical scars. Its two subscales respectively investigate the patient's and clinician's opinion on the scar quality. However, psychometric studies of the POSAS have indicated that its metric performance is suboptimal, and structural adjustments may be appropriate. The authors aimed to verify through Rasch analysis the measurement properties of the POSAS v2.0, and propose eventual structural refinements for an easier and more confident use of the scale in clinical practice and research. Methods: Consecutive patients admitted to two rehabilitation centers for postsurgery rehabilitation over a 2-year period underwent scar assessments with the POSAS v2.0. We performed Rasch analysis to examine the scale's dimensionality, rating categories, item fit, reliability indices, local item independence, and differential item functioning. Results: The study population consisted of 115 patients. The 10 response options of the POSAS showed malfunctioning, and thus were collapsed, forming a parsimonious five-level rating scale, which helped to improve the measurement accuracy. After that, unidimensionality of both subscales was confirmed. Then, internal construct validity of the POSAS v2.0 was demonstrated (through item fit to the Rasch model). Reliability indices were high (≥0.80). No significant differential item functioning was detected concerning age or sex. Conclusion: This study demonstrates the good psychometric properties of a simplified Rasch-based version of the Patient and Observer Scar Assessment Scale with five response options (POSAS v2.1) in patients with postsurgical linear scars, and provides insights for future refinement of the tool.

Insertional Achilles tendinopathy (IAT) is a challenging overuse disorder. The aim of this case report was to study the feasibility of a comprehensive rehabilitative approach according to the Education, Unloading, Reloading, and Prevention (EdUReP) framework combined with Instrument-Augmented Soft Tissue Mobilization (I-ASTM). An active 51-year-old man patient with chronic IAT was studied. Clinical assessment battery was composed by visual analogue scale for pain during the Achilles tendon palpation test, passive straight leg raise test, single leg hop test, Patient-Specific Functional Scale, and Foot and Ankle Ability Measure. The patient was treated over a 8 weeks period using the EdUReP guidelines plus 8 sessions of I-ASTM, applied with a solid instrument to the Achilles tendon and to the muscle fibrotic areas previously identified during evaluation. Clinically significant improvements were observed in all outcome measures, and a resume of patient's usual sports activities without pain or limitations was possible after treatment. Results lasted over a 6-month follow-up. To the best of our knowledge, this is the first study applying a comprehensive approach based on accurate physical assessment, and using the EdUReP theoretical model. The combination of the EdUReP model and manual therapy was effective in resolving the patient's symptoms and restore his usual sport activities. While these results cannot be generalized, the present findings could provide a valuable foundation for future researches.

Introduction In the geriatric population, independent mobility is a key factor in determining readiness for discharge following acute hospitalization. The Cumulated Ambulation Score (CAS) is a potentially valuable score that allows day-to-day measurements of basic mobility. The CAS was developed and validated in older patients with hip fracture as an early postoperative predictor of short-term outcome, but it is also used to assess geriatric in-patients with acute medical illness. Despite the fast-accumulating literature on the CAS, to date no systematic review synthesizing its psychometric properties has been published. Therefore, we aimed to provide a comprehensive review of the psychometric properties of the CAS, summarizing the present evidence on this measure as a basis for further research to investigate its applicability across a wider range of functional abilities and care settings. Evidence acquisition A literature search was conducted on research articles published between 2006 and June 2016 in journals indexed by MEDLINE and Scopus databases using as a search item "Cumulated Ambulation Score"[All Fields], and selecting studies that presented a psychometric analysis of the scale. Of 49 studies identified, 17 examined the psychometric properties of the CAS. Evidence synthesis Most papers dealt with patients after hip fracture surgery, and only 4 studies assessed the CAS psychometric characteristics also in geriatric in-patients with acute medical illness. Two versions of CAS (CAS1 and the more detailed CAS2 version) and two different methods to calculate the total score (1-day and 3-day CAS) were used in the selected papers. Most of the papers assessed reliability and validity, using different statistics, and only one showed evidence of sensitivity to change of the score. Conclusions This systematic review shows international interest of researchers in the CAS, despite the short time frame since its first publication in 2006. The results support the reliability, validity, and sensitivity to change of the tool. Since different versions of CAS are available and two scores are commonly used, we suggest that clinicians and researchers in the future choose the more detailed CAS2 version, already used by the large majority of studies, and report whether they used the 1- or 3-day score.

The aim of this study was to review and critically assess the most used and clinimetrically sound outcome measures currently available for postsurgical scar assessment in rehabilitation. We performed a systematic review of the Medline and Embase databases to June 2015. All published peer-reviewed studies referring to the development, validation, or clinical use of scales or questionnaires in patients with linear scars were screened. Of 922 articles initially identified in the literature search, 48 full-text articles were retrieved for assessment. Of these, 16 fulfilled the inclusion criteria for data collection. Data were collected pertaining to instrument item domains, validity, reliability, and Rasch analysis. The eight outcome measures identified were as follows: Vancouver Scar Scale, Dermatology Life Quality Index, Manchester Scar Scale, Patient and Observer Scar Assessment Scale, Bock Quality of Life (Bock QoL) questionnaire, Stony Brook Scar Evaluation Scale, Patient-Reported Impact of Scars Measure, and Patient Scar Assessment Questionnaire. Scales were examined for their clinimetric properties, and recommendations for their clinical or research use and selection were made. There is currently no absolute gold standard to be used in rehabilitation for the assessment of postsurgical scars, although the Patient and Observer Scar Assessment Scale and the Patient-Reported Impact of Scars Measure emerged as the most robust scales.

Background In a clinical science-based profession such as physiotherapy, research is mandatory to update knowledge and to provide cost-effective, high quality treatments. This study aimed to provide point prevalence of Italian physiotherapists who are academics, holding a PhD degree, or being authors of scientific papers. The scientific journal productivity of physiotherapists was also thoroughly analyzed. Methods A descriptive cross-sectional study was carried out on all Italian physiotherapists. Academics, postdoctoral research fellows, and PhD graduates were identified by searching the Italian Ministry of Education, University and Research (MIUR), Italian Society of Physiotherapy, and university websites. Then, authors of articles indexed in Scopus were searched. The following data were extracted: type of affiliation, authorship order, H-index, number of publications and citations, name of journals, year of publication, and journal’s Impact Factor. Results The prevalence of academics, physiotherapists holding a PhD, or being author was 0.01%, 0.05%, and 0.56%, respectively. We identified 1083 papers co-authored by Italian physiotherapists, and their number has progressively increased over the years (p

Objective To perform a comprehensive analysis of the psychometric properties and dimensionality of the Upper Limb Functional Index (ULFI) using both classical test theory and Rasch analysis (RA). Design Prospective, single-group observational design. Setting Freestanding rehabilitation center. Participants Convenience sample of Italian-speaking subjects with upper limb musculoskeletal disorders (N=174). Interventions Not applicable. Main Outcome Measures The Italian version of the ULFI. Data were analyzed using parallel analysis, exploratory factor analysis, and RA for evaluating dimensionality, functioning of rating scale categories, item fit, hierarchy of item difficulties, and reliability indices. Results Parallel analysis revealed 2 factors explaining 32.5% and 10.7% of the response variance. RA confirmed the failure of the unidimensionality assumption, and 6 items out of the 25 misfitted the Rasch model. When the analysis was rerun excluding the misfitting items, the scale showed acceptable fit values, loading meaningfully to a single factor. Item separation reliability and person separation reliability were .98 and .89, respectively. Cronbach alpha was .92. Conclusions RA revealed weakness of the scale concerning dimensionality and internal construct validity. However, a set of 19 ULFI items defined through the statistical process demonstrated a unidimensional structure, good psychometric properties, and clinical meaningfulness. These findings represent a useful starting point for further analyses of the tool (based on modern psychometric approaches and confirmatory factor analysis) in larger samples, including different patient populations and nationalities.

The Patient and Observer Scar Assessment Scale (POSAS) is one of the most robust instruments to assess scar quality, but there is no Italian version, and no other competing instruments are available in Italian. The aim of this study was to translate and validate an Italian version of POSAS (POSAS‐I). POSASv2.0 was culturally adapted in accordance with international standards. The psychometric assessment included acceptability/feasibility, internal consistency, reproducibility, construct validity and sensitivity to change. Cultural equivalence of POSAS‐I with the English version was confirmed. The validation study included 102 subjects with surgical scars. Both subscales demonstrated acceptable internal consistency (Cronbach's α = 0·72–0·80). Reproducibility of the OSAS‐I (ICCs = 0·93–0·94; SEM = 1·8 points; MDC(95) = 5·1 points) was superior to that of PSAS‐I (ICC = 0·65; SEM = 5·7 points; MDC(95) = 15·7 points). OSAS‐I showed moderate to good correlations with the Vancouver Scar Scale (VSS), Global Rating of Change Scale (GRCS) and PSAS‐I. Sensitivity to change was large for PSAS‐I (effect size = 1·08; standardised response mean = 0·96) and moderate to large for OSAS‐I (ES = 0·69; SRM = 0·92). This study confirmed that POSAS‐I can be used to assess patients with surgical scars in the Italian population. OSAS‐I is useful for clinical and research purposes, while PSAS‐I should be better used to capture patients' own opinions and symptoms in clinical settings.

The aim of this study was to assess the reliability of a smartphone-based application developed for photographic-based goniometry, DrGoniometer (DrG), by comparing its measurement of the knee joint angle with that made by a universal goniometer (UG). Joint goniometry is a common mode of clinical assessment used in many disciplines, in particular in rehabilitation. One validated method is photographic-based goniometry, but the procedure is usually complex: the image has to be downloaded from the camera to a computer and then edited using dedicated software. This disadvantage may be overcome by the new generation of mobile phones (smartphones) that have computer-like functionality and an integrated digital camera. This validation study was carried out under two different controlled conditions: (i) with the participant to measure in a fixed position and (ii) with a battery of pictures to assess. In the first part, four raters performed repeated measurements with DrG and UG at different knee joint angles. Then, 10 other raters measured the knee at different flexion angles ranging 20-145° on a battery of 35 pictures taken in a clinical setting. The results showed that inter-rater and intra-rater correlations were always more than 0.958. Agreement with the UG showed a width of 18.2° [95% limits of agreement (LoA)=-7.5/+10.7°] and 14.1° (LoA=-6.6/+7.5°). In conclusion, DrG seems to be a reliable method for measuring knee joint angle. This mHealth application can be an alternative/additional method of goniometry, easier to use than other photographic-based goniometric assessments. Further studies are required to assess its reliability for the measurement of other joints.

Objectives To analyze the effects of kinesio taping (KT) -applied with three different strains that induced or not the formation of skin creases (called convolutions)- on color intensity of post-surgical superficial hematomas. Design Single-blind paired study. Setting Rehabilitation clinic. Participants A convenience sample of 13 inpatients with post-surgical superficial hematomas. Interventions The tape was applied for 24 consecutive hours. Three tails of KT were randomly applied with different degrees of strain: none (SN); light (SL); and full longitudinal stretch (SF). We expected to obtain correct formation of convolutions with SL, some convolutions with SN, and no convolutions with SF. Main outcome measures The change in color intensity of hematomas, measured by means of polar coordinates CIE L*a*b* using a validated and standardized digital images system. Results Applying KT to hematomas did not significantly change the color intensity in the central area under the tape (p > 0.05). There was a significant treatment effect (p 0.05). Conclusions The changes observed along the edges of the tape could be related to the formation of a pressure gradient between the KT and the adjacent area, but were not dependent on the formation of skin convolutions.

DrGoniometer. Medicine. Apple (iOS 7.0 or later). Available for iPhone, iPad and iPod touch. iOS €11.99, US$11.99. DrGoniometer is the first app validated for image-based goniometry.1 Its aim is to provide quick, simple measurement of joint mobility with all the advantages of photographic or video goniometry. Measurement is obtained by positioning a virtual goniometer—represented by two or three markers visible on the smartphone screen—on a photograph or video obtained via the smartphone camera (figure 1⇓–3). Picture taking is supported with perpendicular reference to ground level, iPhone alignment identification and patient central position referencing. The clinician chooses the desired joint or goniometric procedure from a list and the respective motion to measure (eg, flexion and extension), then simply takes a photo of the limb, saves it, measures the joint angle and observes the value.1 DrGoniometer also offers the possibility to analyse …

«Assessment of dexterity and diagnostic accuracy of the Functional Dexterity Test in patients with carpal tunnel syndrome». Background: The diagnosis of carpal tunnel syndrome (STC) is centered on the symptoms. However, patients also show an impairment of sensorimotor functions, but the relationship between STC and manual dexterity has never been investigated. Objectives: To analyze the correlation between manual dexterity and severity of the STC. Another objective was the diagnostic accuracy of the clinical battery including provocative tests (Phalen, Tinel) and Functional Dexterity Test (FDT). Methods: A sample of 80 subjects with suspected STC was subdivided into 4 groups based on EMG (severe/extreme-GrA, moderate-GrB, mild/minimal-GrC, negative-GrD) and evaluated in blind by Phalen, Tinel and FDT. The relationship between the FDT and the allocation of subjects was investigated by Spearman’s rho, while the groups were compared with univariate ANOVA and Tukey’s post hoc analysis. Diagnostic accuracy of the clinical battery was expressed by sensitivity, specificity, and likelihood ratios (LR). Results: A moderate (r=0.48, p

The advent of social media such as Facebook has introduced new opportunities for knowledge sharing and professional networking. Currently, little is known on how physiotherapists participate in virtual communities, and there are opposing views regarding the benefits and pitfalls of professional use of social media. In this letter, theoretical frameworks are proposed by analyzing the behavior of users and the post contents on Italian pages dedicated to physiotherapy. There is also an urgent need to evaluate whether virtual communities may improve final patient outcomes.

Background Patient-reported outcome measures can improve the management of patients with non-specific neck pain. The choice of measure greatly depends on its content and psychometric properties. Most questionnaires were developed for English-speaking people, and need to undergo cross-cultural validation for use in different language contexts. To help Italian clinicians select the most appropriate tool, we systematically reviewed the validated Italian-language outcome measures for non-specific neck pain, and analyzed their psychometric properties and clinical utility. Methods The search was performed in MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, and Cochrane Library. All articles published in English or Italian regarding the development, translation, or validation of patient-reported outcome measures available in the Italian language were included. Two reviewers independently selected the studies, extracted data, and assessed methodological quality using the COSMIN checklist. Results Out of 4891articles screened, 66 were eligible. Overall, they were of poor or fair methodological quality. Four instruments measuring function and disability (Neck Disability Index, Neck Pain and Disability Scale, Neck Bournemouth Questionnaire, and Core Outcome Measures Index), and one measuring activity-related fear of movement (NeckPix©) were identified. Each scale showed some psychometric weaknesses or problems with functioning, and none emerged as a gold standard. Conclusions Several patient-reported outcome measures are now available for assessing Italian people with non-specific neck pain. While the Neck Disability Index is the one most widely used, the Neck Bournemouth Questionnaire appears the most promising tool from a psychometric point of view.

To investigate dimensionality and the measurement properties of the Italian Lower Extremity Functional Scale using both classical test theory and Rasch analysis methods, and to provide insights for an improved version of the questionnaire.Rasch analysis of individual patient data.Rehabilitation centre.A total of 135 patients with musculoskeletal diseases of the lower limb.Patients were assessed with the Lower Extremity Functional Scale before and after the rehabilitation. Rasch analysis showed some problems related to rating scale category functioning, items fit, and items redundancy. After an iterative process, which resulted in the reduction of rating scale categories from 5 to 4, and in the deletion of 5 items, the psychometric properties of the Italian Lower Extremity Functional Scale improved. The retained 15 items with a 4-level response format fitted the Rasch model (internal construct validity), and demonstrated unidimensionality and good reliability indices (person-separation reliability 0.92; Cronbach's alpha 0.94). Then, the analysis showed differential item functioning for six of the retained items. The sensitivity to change of the Italian 15-item Lower Extremity Functional Scale was nearly equal to the one of the original version (effect size: 0.93 and 0.98; standardized response mean: 1.20 and 1.28, respectively for the 15-item and 20-item versions).The Italian Lower Extremity Functional Scale had unsatisfactory measurement properties. However, removing five items and simplifying the scoring from 5 to 4 levels resulted in a more valid measure with good reliability and sensitivity to change.

These authors use a custom-fabricated orthotic device to improve hand motion and function for a client with hand dystonia after stroke. Clinical observation and reasoning resulted in an effective solution to control the dystonia that was acceptable to the client. - Kristin Valdes, OTD, OT, CHT, Practice Forum Editor.

Franchignoni F, Giordano A, Sartorio F, Vercelli S, Pascariello B, Ferriero G. Suggestions for refinement of the Disabilities of the Arm, Shoulder and Hand Outcome Measure (DASH): a factor analysis and Rasch validation study. Objective To perform a comprehensive psychometric analysis of Disabilities of the Arm, Shoulder and Hand (DASH) to examine its properties and provide insights for an improved version. Design Methodologic research on cross-sectional data from a convenience sample. Setting A free-standing rehabilitation center. Participants Outpatients and inpatients (N=238; 56% men; mean age, 52.2y) with upper-extremity musculoskeletal disorders. Main Outcome Measure The official Italian version of DASH was analyzed by factor (both explorative and confirmatory) and Rasch analysis for evaluating dimensionality, functioning of rating scale categories, item fit, hierarchy of item difficulties, and reliability indices. Interventions Not applicable. Results Factor analysis established the presence of 3 underlying constructs related to manual functioning (items 1–5, 7–11, 16–18, 20, 21), shoulder range of motion (items 6, 12–15, 19), and symptoms and consequences (items 22–30). Rating scale diagnostics showed category malfunctioning. The fit to the Rasch model was good for all items except 4 (items 20, 21, 25, 26). Ten item pairs had high residual correlations after subtraction of the Rasch dimension (local dependency). A test model based on the 3 subscales suggested by factor analysis and corrected categories still showed misfitting in items 21 ("Sexual Activities") and 26 ("Tingling") and the presence of some dependent items. Conclusions Unidimensionality and the key domains identified by the original developers as the theoretic framework of DASH were not confirmed by our analyses. The response categories showed misfunctioning. "Sexual Activities" and "Tingling" misfit the Rasch model. Further detailed investigations of DASH are warranted, both to confirm these results in different health conditions and cultures, and to reanalyze in-depth content validity issues regarding the questionnaire.

The Mini-Balance Evaluation Systems Test (Mini-BESTest) has been identified as the most comprehensive balance measure for community-dwelling adults and elderly individuals. It can be used to assess balance impairments in several other conditions, mainly Parkinson's disease and stroke. Despite increasing use of the Mini-BESTest since it was first published 5 years ago, no systematic review synthesizing its psychometric properties is available. The aim of this study was to provide a comprehensive review of the psychometric properties of the Mini-BESTest when administered to patients with balance deficits because of different diseases. A literature search was performed on articles published before July 2015 in journals indexed by MEDLINE and Scopus databases. The search produced 98 papers, 24 of which fulfilled the inclusion criteria for this review. Most papers (n=19) focused on patients affected by neurological diseases, mainly Parkinson's disease. In 21 papers, the psychometric characteristics were analyzed using Classical Test Theory methods and in only three papers was Rasch analysis carried out. This review shows the interest of researchers in the Mini-BESTest despite the short time frame since its first publication. The Mini-BESTest is used widely in both clinical practice and research. The results support the reliability, validity, and responsiveness of this instrument and it can be considered a standard balance measure. However, it would be valuable to learn more about how this scale performs in different diseases causing balance deficits and to better define the minimal clinically important difference for each disease.

In the last few years, the incidence of upper limbs tendon injuries has seen a dramatic increase among workers. Conservative treatment is the first choice to relieve symptoms, allowing a safe return to work. However, the scientific evidence of its efficacy is widely debated.Research and literature review on the efficacy of conservative treatment of upper limbs tendon injuries in occupational settings.A total of 271 references were found on Medline and Embase up to May 2015. 116 papers were excluded, 155 articles were included and the full text read.After a timely diagnosis, a prompt start of the rehabilitation programme and a limitation of complete rest are useful to relieve pain, increase functionality and reduce work absenteeism in the long term. Conservative treatment combinations, such as manual therapy, specific exercises focused on increasing flexibility and muscle strength and specific-gesture training, achieves more significant results than a single isolated treatments. Currently, there is no strong scientific evidence to support prolotherapy and Platelet-Rich Plasma (PRP). However, current promising results will encourage further studies. Awareness among both employers and employees about prevention and risk factors should be enhanced.

his daily running session), a reddish-colored urine reappeared. Our patient was advised to stop WBV training and to take fluid before and during exertion. He did not experience any episode of HT during a 1-year follow-up with periodic check-ups, in spite of the continuation of his sporting career. The concomitance of the two types of trauma – daily running and WBV – could have been critical in this case for producing HT. In particular, we think that platforms providing side-alternating vibration (such as the Galileo platform) may pose some health risks if the feet are positioned too far from the axis of rotation.

Background The break-point angle (BPA) obtained during the Nordic Hamstring Test (NHT) can be used for preventive purposes to identify individuals with low eccentric hamstring strength. Video analysis is the preferred standard method, but there lacks an easily accessible and highly reproducible method for field use. Objective To establish the reproducibility (reliability and agreement) of the smartphone application ‘DrGoniometer’ (DrG) for measuring BPA in healthy adults. Design Diagnostic study. Setting Clinical setting. Patients (or Participants) Five volunteers and four raters (two physiotherapists and two physiotherapy students). Interventions (or Assessment of Risk Factors) Ten NHT videos per subject were obtained by smartphone camera (total=50 videos). Raters independently measured the BPA, first using DrG app set in blind modality on two separate occasions (one week apart), then by standardized video analysis software on a PC. Main Outcome Measurements Intra- and inter-rater reliability of DrG was calculated with ICC(2,1) (95% IC). Longitudinal standard error of measurement (SEM) and inter-rater agreement within 5° and 10° were also calculated. The agreement of DrG with video analysis was expressed as 95% limits of agreement (LoA) with the Bland-Altman method. Results Intra- and inter-rater reliability of the DrG were excellent, with ICC=0.885 (95% IC=0.836–0.918) and .821 (95%IC=0.738–0.885), respectively. The SEM was 2°. All four raters had substantial inter-rater agreement within the limits of 5° (68% and 78%) and 10° (94% and 100%) for the DrG and video analysis methods, respectively. The agreement between the two methods was good, with 95% LoA equal to 13.4° (mean difference=1.0±6.7°). Conclusions DrG proved to be a highly reproducible method for measuring the BPA in the NHT in healthy subjects. Given its wide availability, low cost, and ease of use, the DrG app can be considered a good resource for field-based BPA measurement.

In universities around the world, physical therapist experts with a scientific background are appointed as professors of physical therapy. In the Italian academia, however, only 2 physical therapists have been appointed as professors in the academic sector known as “Sciences of nursing, rehabilitation and neuropsychiatric techniques” (MED/48).1 A total of 85 university programs of physical therapy are being taught in Italy, and thousands of credits are entrusted to physical therapists—yet most of these therapists are not officially part of the Italian academic world. In 2010, there was an expectation that this situation would change when the Italian Ministry of Education, University and Research (MIUR) introduced a new process for the appointment of Italian university professors.2 The first step of this new process (started in 2012) is national qualification for each scientific sector, with qualification awarded by specific commissions on the basis of the applicant's educational and research productivity. Only researchers who are qualified by one of these commissions are subsequently permitted to participate in the second step for becoming an Italian university professor: a competitive examination issued locally by each university. Italian physical therapists had great hope for this new process, because a growing number of physical therapists in Italy are involved in scientific activities and publish in indexed journals.3 In 2010, …

Valid and reliable outcome measures are fundamental for evaluating and comparing the effects of rehabilitation. Among the different tools used for the assessment of musculoskeletal disorders of the lower limb, the Foot and Ankle Ability Measure (FAAM) has been shown to have good psychometric properties. However, it has not yet been translated into Italian. The module regarding the performance of daily living activities (FAAM/ADL), in particular, can be applied also in an occupational setting.To obtain an Italian version of the FAAM, and to validate the FAAM-I/ADL.The cultural adaptation was performed according to international guidelines for forward/backward translation. The activities of daily living (ADL) module of the FAAM-I (FAAM-I/ADL) was validated with classical test theory methods in a convenience sample of 57 patients. Different parameters were calculated: internal consistency (Cronbach's α and item-to-total correlation); criterion validity, through Pearson's correlation (r) with the Lower Extremity Functional Scale (LEFS); test-retest reliability (ICC2,1); Standard Error of Measurement (SEM); and Minimal Detectable Change (MDC95).The statistical analysis showed good internal consistency (Cronbach's α=.96, item-to-total correlation ranged between .51 and .85), high criterion validity (r=.66, plt;0.01) and excellent test-retest reliability (ICC2, 1=.98, CI95%=.97-.99). The SEM was 2.7 points, with a MDC95 of 7.5 points.FAAM-I/ADL shows good psychometric properties, together with speed and ease of administration and scoring. Its use will facilitate the comparison of Italian data with international studies, ensuring greater uniformity of assessment.