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Introduction: Unlike the most common training approaches for bodybuilding, powerlifting programs are generally based on maximum and submaximal loads, putting enormous stresses on the lumbar spine. The flexion relaxation phenomenon evaluation is a clinical tool used for low back pain (LBP) assessment. This study aimed to evaluate the role of the flexion relaxation phenomenon in the analysis of LBP in the powerlifters. Methods: Healthy professional powerlifters participated in the study. In fact, we divided the participants into a LBP-low-risk group and a LBP-high-risk group, based on a prior history of LBP. Outcome measures included flexion relaxation ratio (FRR) and trough surface electromyography collected during trunk maximum voluntary flexion; furthermore, during a bench press lifting, we measured the height of the arched back (ARCH), using a camera and the Kinovea video editing software, to consider a potential correlation with the risk of LBP. Results: We included a group of 18 male (aged 24–39 y) powerlifters of 93 kg category. We measured a nonsignificant mean difference of ARCH between low-risk LBP group and high-risk LBP subjects. Curiously, maximum voluntary flexions were both above the threshold of 3.2 μV; therefore, with an absence of appropriate myoelectric silence, on the contrary, the FRR ratios were higher than 9.5, considering the presence of the phenomenon, exclusively for the low-risk group. The lumbar arched back measurement data did not report any association with the LBP risk, regarding the maximum voluntary flexion value, and even more than the FRR there is a relationship with the presence or the absence of LBP risk. Conclusions: FRR could be considered as a useful parameter for studying the risk of LBP in powerlifting. The FRR index not only refers to the possible myoelectric silence of the lumbar muscles in trunk maximum forward flexion but also takes into account the energy value delivered by the lumbar muscles during the flexion. Furthermore, we can indicate that the size of the powerlifter ARCH may not be a determining factor in the occurrence of LBP. [ABSTRACT FROM AUTHOR]

Objective: The aim of this systematic review with meta-analysis was to evaluate the efficacy of conservative interventions in pain relief in patients with intracapsular temporomandibular disorders (TMD). Methods: PubMed, Scopus, and Web of Science were systematically searched until January 1st, 2022 to identify randomized controlled trials (RCTs) presenting patients with diagnosis of intracapsular TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), conservative approaches as interventions, and pain intensity as outcome. Results: Out of 3372 papers, 13 RCTs were included, with 844 study participants. Most of them (n = 7) investigated the efficacy of splint appliance. Meta-analysis revealed that rehabilitative interventions had a significant overall effect size of 0.75 [0.17, 1.34], reporting splint appliance and laser therapy as significantly effective treatments. Conclusion: Findings of this systematic review with network meta-analysis suggested that conservative approaches might be effective in pain relief of intracapsular TMD patients. [ABSTRACT FROM AUTHOR]

Background: Patients with surgical outcomes of removal of oligodendrogliomas can present several clinical manifestations that could impact functioning, autonomy, and quality of life. Rehabilitation, employing various strategies, purposes to enhance patient capacity and performance. In this scenario, the International Classification of Functioning, Disability, and Health (ICF) Generic-30 Set might be useful to help physiatrists in the management of these patients. Therefore, by the present case report we aimed to investigate the impact of a rehabilitation plan including vibration therapy in reducing and improving functioning in a patient with surgical outcomes of removal of oligodendroglioma, according to a ICF approach. Case presentation: A 39-year-old woman with surgical outcomes of removal of oligodendroglioma at 9 years old, undergone surgery. A tailored rehabilitation plan comprised including passive mobilization to counteract spasticity-related postures, vibratory therapy, trunk control exercises, and ambulation exercises was performed. The ICF Generic-30 Set was performed at the baseline (also useful to establish an adequate management) and at the end of the entire treatment. Outcome measures assessed were: spasticity, pain, trunk control, disability, and quality of life. Conclusions: The patient experienced improvements in terms of functioning after a comprehensive rehabilitation plan including vibration therapy. The ICF Generic-30 Set showed to be a useful approach not only to tailor the intervention, but also to assess the effects of an individualized rehabilitation plan. [ABSTRACT FROM AUTHOR]

Background: Temporomandibular disorders (TMD) are a set of musculoskeletal conditions involving the temporomandibular joint, masticatory muscles, and/or associated structures, characterized by symptoms as pain, joint stiffness with limited mouth opening, and joint sounds as crepitus. Rheumatic diseases (RD) are a heterogeneous group of conditions affecting the musculoskeletal system, including temporomandibular joint (TMJ). To date, there is a lack of systematic reviews that properly investigated the efficacy of conservative approaches in reducing pain in rheumatic patients affected by TMJ arthritis. Therefore, this systematic review aimed to evaluate the effectiveness of rehabilitative approaches in pain relief in rheumatic patients with TMJ arthritis. Methods: PubMed, Scopus, and Web of Science were searched from inception until February 25th, 2024, to identify studies including patients with diagnosis of rheumatic disease affecting the temporomandibular joint who underwent specific rehabilitative approaches to reduce pain intensity. The risk of bias of studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Results: Out of 479 search results, 115 duplicates were removed, and 364 studies were considered as eligible for inclusion and screened for title and abstract. Out of these, we included 19 papers for full-text screening. Then, 5 papers were included in the synthesis by this systematic review. Four studies assessed patients affected by rheumatoid arthritis, one systemic sclerodermia, and one included patients affected by ankylosing spondylitis, psoriatic arthritis, Sjogren's syndrome, fibromyalgia, common variable immunodeficiency, and chronic polyarthritis. In the included studies, the interventions consisted of intraarticular TMJ injection of corticosteroids performed with or without anesthetics, or irrigation in three studies, dextrose subcutaneous TMJ perineural injection, and lower-level laser therapy (LLLT). Conclusions: This systematic review showed that rehabilitative approaches (e.g., intra-articular injections and LLLT) might be effective in terms of pain relief in TMD RD-related. However, the heterogeneity of the rehabilitative approaches performed, and the low quality of the included studies do not allow to draw certain conclusions regarding the efficacy of these approaches. Further high-quality studies are mandatory to improve the robustness of the efficacy of the different rehabilitative techniques for pain relief in TMD patients affected by rheumatic diseases. [ABSTRACT FROM AUTHOR]

Purpose: Trapeziometacarpal osteoarthritis (TMC-OA) is a prevalent hand disorder affecting a growing number of people worldwide. While a multidisciplinary approach might provide additional advantages, the analgesic and anti-inflammatory role of intra-articular oxygen-ozone (O2O3) injections combined with physical therapy is still unknown. To assess the impact of a multimodal therapeutic approach combining O2O3 injections with physical therapy in patients with TMC-OA. Materials and methods: A prospective open-label study conducted in the Physical and Rehabilitation Medicine Unit of the "Renato Dulbecco" University Hospital of Catanzaro. We assessed patients with TMC-OA who had not responded to standard medical therapy. Participants received O2O3 therapy and targeted physical therapy for 4 weeks. Pain relief, muscle strength, and physical functioning were assessed at baseline and after 4, 12 and 24 weeks (respectively T0, T1, T2, and T3) Results: Seventeen patients with a mean age of 67.1 ± 6.1 years were included in the study. Short-term improvements in pain intensity were observed (T0: 6.221 ± 1.514; T1: 3.172 ± 1.1451; p <.001) and were maintained over a 24-week follow-up period (T0: 6.221 ± 1.514; T3: 4.393 ± 1.438; p: 0.006). Significant changes were reported also in terms of muscle strength and physical functioning. O2O3 therapy was well-tolerated with no adverse effects. Conclusions: A combination of O2O3 injections and physical therapy might be considered in patients with TMC-OA. Further investigation is warranted to assess the effectiveness of O2O3 therapy in managing TMC-OA. IMPLICATIONS FOR REHABILITATION: The addition of intra-articular trapeziometacarpal O2O3 injections to physical therapy is safe and reliable for thumb osteoarthritis O2O3 injection could be considered a second-line mini-invasive approach option when simple analgesic and non-pharmacologic interventions have failed, and surgical treatment is not yet indicated O2O3 injections in combination with physical therapy may provide benefits in terms of pain relief in patients with TMC joint OA in whom previous conventional medical therapy has been unsuccessful [ABSTRACT FROM AUTHOR]

Background: The evolution of technology has continuously redefined the landscape of rehabilitation medicine. Researchers have long incorporated virtual reality (VR) as a promising intervention, providing immersive therapeutic environments for patients. The emergence of the metaverse has recently further expanded the potential applications of VR to augment the possibilities in rehabilitation. Rehabilitation is a crucial aspect of healthcare, and technological advancements have allowed new approaches to aid in this process. One such approach is the metaverse, a virtual world where users can interact with each other and their surroundings in a simulated environment. This comprehensive review aimed to analyze the scientific evidence using the term "metaverse" in rehabilitation and its potential patient benefits. Methods: We conducted a comprehensive literature search from the inception to September 2024 in PubMed, Scopus, Web of Science, and Cochrane Database to identify studies investigating the term "metaverse" and its role in rehabilitation. We then assessed these studies based on their methodology, patient population, technology used, and therapeutic outcomes. Results: Out of 81 articles, 55 remained after removing duplicates. After screening the title, abstract, and full text, we included five articles. Conclusions: Results from these studies suggested potential benefits in various rehabilitative areas, such as cerebral palsy, intellectual disabilities, pain management, and physical performance improvement among the elderly. The metaverse presents promising avenues for enhancing rehabilitation outcomes. While VR's effectiveness is well established, the metaverse, being a newer concept, necessitates further studies for a more comprehensive understanding. [ABSTRACT FROM AUTHOR]

Background: Quality of life in patients receiving knee arthroplasty is crucial for rehabilitation. Even if the validity of the 36-Item Short Form (SF-36) was already confirmed, the Substantial Clinical Benefit (SCB) and Patient Acceptable Symptom Score (PASS) values of this score remain unknown for both Total Knee Arthroplasty (TKA) and Unicompartmental Knee Arthroplasty (UKA). Objective: The purpose of this research was to compute the Minimal Clinically Important Difference (MCID) of the SF-36 after UKA, and the SCB and PASS of SF-36 after TKA and UKA, in order to assess post-surgery quality of life in knee osteoarthritis. Methods: Overall, 59 patients (40 women and 19 men, mean age 60.3 ± 13.1 years) completed the questionnaire until six months follow-up. Of these patients, 22 underwent the TKA procedure, while 37 patients underwent the UKA procedure. The anchor question for computing the MCID and SCB thresholds was "How would you describe your health condition in relation to your previous state?". The PASS scores were determined using the ROC curve and the 75th percentile of the cumulative percentage curve of respondents who believe their symptoms are under control. Results: The MCID values of global SF-36, Physical Component Summary (PCS) and Mental Component Summary (MCS) after UKA were 11.3, 14.5 and 11.4, respectively. The SCB values of global SF-36, PCS and MCS after UKA were 23.5, 23.1 and 15, respectively. The PASS values of global SF-36, PCS and MCS after TKA were 71.2, 75 and 69.3, respectively. The PASS values of global SF-36, PCS and MCS after UKA were 70.4, 72.1 and 67.5, respectively. Conclusion: The SF-36 score represents a valid score for quality of life in patients with knee osteoarthritis. Taken together, the results showed a statistically significant improvement between inception and latest follow-up after TKA and UKA. [ABSTRACT FROM AUTHOR]

Background: Osteoarthritis is the most common form of arthritis, causing pain, functional disability, and a reduction in terms of quality of life. Minimally invasive treatments like intra-articular hip injections are a therapeutic option and ultrasound guidance might improve the results of these injections. Objective: To summarize the evidence about the effectiveness of ultrasound-guided hip injections in terms of pain and functioning in patients affected by hip osteoarthritis. Methods: A systematic search of the literature was performed on three electronic databases: PubMed, Cochrane and PEDro, using a specific search strategy. We evaluated for inclusion all articles according to the following participants, intervention, comparison, and outcomes (PICO) model: P) Population: human patients affected by hip osteoarthritis; I) Intervention: intra-articular hip injections performed with a ultrasound-guidance; C) Comparator: sham therapy or every other conservative or oral, non-invasive, minimally invasive or surgical technique; O) Outcome measures: pain assessed by Visual Analogue Scale (VAS) or Numerical Rating Scale (NRS); functional outcomes. Results: At the end of the search, 43 articles were included in the review. Several drugs have been considered in the included studies: hyaluronic acid, platelet-rich plasma, corticosteroids, micro-fragmented adipose tissue, bone marrow concentrates, amniotic suspension allograft. Conclusion: Ultrasound-guided injections of hyaluronic acid might be effective on pain relief and functioning in patients affected by hip osteoarthritis. Also, other rehabilitative infiltrative techniques (i.e., corticosteroids and platelet-rich plasma) showed a positive effect in the short-term period. [ABSTRACT FROM AUTHOR]

Introduction: Hand grip strength (HGS) is an important measure in a physiotherapy assessment and for this purpose it is necessary to have valid and reliable instruments to measure it. In this study we aimed at investigating the reliability, validity, and agreement of the new hand-held dynamometer NOD (OT-Bioelettronica, To-Italy) compared to Jamar® hydraulic dynamometer (JD), the gold standard. Methods: Fifty healthy subjects were selected; 9 trials for the dominant hand and 9 trials for the non-dominant hand were administrated to each of them: 3 trials of HGS with the JD in rung #3, 3 trials with the JD-adapted-grip (like the NOD one), and 3 trials with NOD. To verify the reliability of NOD, the Intraclass Correlation Coefficient (ICC 3,1) was calculated with a mixed effects model with the addition of adjustment variables (age, gender, dominant / non-dominant limb, trials). The model used single HGS measurements to estimate variance components, so reflecting both degree of correspondence and agreement among devices. To assess concurrent validity NOD was compared to the “gold standard” JD, in terms of ICCs and through Pearson correlation. The agreement between the methods of measurement was calculated with the Limits of Agreement (LoA) and the plots of Bland–Altman. Results: All ICCs show high inter-reliability; the results are very similar for both dynamometers. The value of the adjusted ICC of NOD was 0.90. For validity, Pearson correlations of NOD towards JD and JD-adapted-grip were high (r = 0.87 and 0.88). However, the LoA and the plots of Bland–Altman demonstrated that there is no agreement between NOD and JD and between NOD and JD-adapted-grip, with NOD showing lower mean scores than JD. Conclusions: NOD is a reliable and valid instrument for HGS. However, even if it cannot be considered interchangeable with JD because there is no agreement between them in free-living adults, NOD is easier to carry than other dynamometers, it has a Bluetooth® connection with a free App and it is a multi-purpose tool that should be considered both in daily practice and in clinical settings. [ABSTRACT FROM AUTHOR]

Background: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood, and temporomandibular joints (TMJs) are involved in 39%–78% of patients. Aim: The aim of this systematic review was to assess the effectiveness of conservative approaches in improving TMJ arthritis in children and adolescents affected by JIA. Design: PubMed, Scopus, and Web of Science were systematically searched from the inception until February 25, 2024, to identify observational studies presenting participants with a diagnosis of JIA affecting the TMJ, rehabilitative approaches for TMJ arthritis as interventions, and clinical or radiological assessment of TMJ arthritis as outcome. Results: Of 478 papers suitable for title/abstract screening, 13 studies were included. The studies evaluated the effectiveness of intra‐articular (IA) corticosteroid (CS) injections, IA infliximab injections, arthrocentesis alone or in combination with IACS injections, occlusal splint, functional appliance, and physiotherapy. The effectiveness of IACS injections was shown in eight studies. IA infliximab injections did not appear to significantly improve TMJ arthritis. Conclusion: Results of this systematic review suggested that conservative treatments, especially IACS injections, might be effective in improving TMJ arthritis in patients affected by JIA. Further studies with a higher level of evidence and more representative samples should be conducted. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and MethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONClinical practice guidelines (CPGs) are essential for guiding rehabilitation interventions. However, CPGs specifically addressing rehabilitation for osteoporosis patients remain scarce in the literature. This review aims to present, compare, and summarize recent guidelines and evidence, highlighting best practices in osteoporosis rehabilitation management.A total of 19 guidelines were identified following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Three independent appraisers assessed the quality of each CPG using the Appraisal of Guidelines for Research and Evaluation version II (AGREE II) instrument. Standardized domain and overall quality scores were calculated, and intraclass correlation coefficients (ICCs) were used to assess the level of agreement among the appraisers.Agreement among appraisers for AGREE II scores ranged from moderate to very good (ICC = 0.60 to 0.90). The quality of the included CPGs varied significantly, with AGREE sub-scores ranging from 48.25% to 75.73%. The Level of Evidence (LoE) and Grade of Recommendation (GoR) differed across the guidelines included in this review. Information on exercise types, intensity, frequency, duration, and contraindications were inconsistent among CPGs.Recommendations regarding exercise parameters were often vague and inconsistent between CPGs, necessitating critical evaluation by healthcare providers when making clinical decisions.The global incidence of osteoporosis is substantial and a proportional rise in cases is anticipated as the population’s average age continues to increase.Currently, national and international guidelines for managing fragile bones in individuals with osteoporosis lack clarity and consistency regarding the rehabilitation perspective, particularly concerning the recommended intensity, repetition, duration, and frequency of interventions.Healthcare professionals are encouraged to recommend physical activities for individuals with osteoporosis that focus on adaptive therapeutic exercises, such as weight-bearing exercises (primarily low-impact), muscle-strengthening exercises, resistance training, and balance training.The global incidence of osteoporosis is substantial and a proportional rise in cases is anticipated as the population’s average age continues to increase.Currently, national and international guidelines for managing fragile bones in individuals with osteoporosis lack clarity and consistency regarding the rehabilitation perspective, particularly concerning the recommended intensity, repetition, duration, and frequency of interventions.Healthcare professionals are encouraged to recommend physical activities for individuals with osteoporosis that focus on adaptive therapeutic exercises, such as weight-bearing exercises (primarily low-impact), muscle-strengthening exercises, resistance training, and balance training. [ABSTRACT FROM AUTHOR]

The article focuses on the potential of oxygen-ozone therapy as a treatment for musculoskeletal pain, particularly in osteoarthritis and low back pain. Topics include its anti-inflammatory and tissue-regenerative properties, comparisons with corticosteroid injections, and the integration of oxygen-ozone therapy with physical rehabilitation strategies.

BACKGROUND: Glenohumeral degenerative joint disease may affect up to 20% of the population. There are several classification systems of this disease in the scientific literature. OBJECTIVE: The aim of this study is to determine the reliability and reproducibility of glenohumeral osteoarthritis classification systems. METHODS: We assessed glenohumeral plain radiographs performed in a University Hospital. These radiographs were graded into nine radiological classification systems by two observers on two evaluations. Patients who have performed CT/MRI scan were staged according to the Walch classification. The intra-observer and inter-observer reliability of the classification schemes were determined by using Cohen's weighted kappa coefficient. RESULTS: A total of 752 patients were included in the study (52.4% females and 47.6% males), mean aged 66.2 ± 16.3 years. The intra-observer and inter-observer reliabilities were 0.543 (observer 1), 0.630 (observer 2), and 0.760 (inter-observer) for the Weinstein grading system; 0.661, 0.706, and 0.761 for the Guyette grading system; 0.575, 0.679 and 0.704 for the Kellgren and Lawrence classification; 0.817, 0.816 e 0.871 for the Samilson and Prieto classification; 0.791, 0.811 and 0.847 for the Allain modification; 0.797, 0.842 and 0.860 for the Gerber modification; 0.773, 0.827 and 0.828 for the Buscayret modification; 0.584, 0.648 and 0.755 for the Hawkins and Angelo classification; 0.661, 0.749 and 0.764 for the Rosenberg classification. Intra-observer reliability for MRI was 0.757 (observer 1) and 0.675 (observer 2), while intra-observer reliability for CT was 0.811 (observer 1) and 0.653 (observer 2). Inter-observer reliabilities were 0.790 for MRI and 0.673 for CT. CONCLUSION: The classification systems according to Weinstein, Guyette, Hawkins and Angelo, Rosenberg and the modifications of the Samilson and Prieto classification according to Allain, Gerber and Buscayret showed a comparable reliability with the commonly used glenohumeral osteoarthritis grading systems, Samilson and Prieto and Kellgren and Lawrence. Thus, they are recommended for clinical and especially scientific purposes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Osteoarthritis (OA) is a widely-known disease distinguished by the breakdown of joint cartilage, leading to pain and morning stiffness. In this context, the role of corticosteroids is well known, but there is still a gap of knowledge on the duty of oxygen-ozone therapy (O2-O3). OBJECTIVE: To evaluate for effectiveness of ultrasound-guided O2-O3 injections compared with corticosteroid injections among patients diagnosed with knee OA. METHODS: This randomized controlled clinical trial was conducted on participants with knee OA who were randomly sorted into two groups: group A, undergoing corticosteroid group (n = 47) and group B, undergoing O2-O3 (n = 49) were injected within the knee joint under ultrasound guidance. The primary outcome measure was the change in the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score between baseline and 12-weeks post-injection. Secondary outcome measures included visual analog scale scores, joint effusion and a knee flexion ROM. Assessments were recorded at baseline and 4-weeks and 12-weeks post-injection. For the examination of intra- and inter-group variations at various time points, a repeated-measure analysis of variance (two-way ANOVA) was employed. RESULTS: Ninety-six participants completed this study. Based on repeated measurement analysis of variance, a significant effect of time was found for all outcome measures in both groups. Both groups showed clinically significant improvements in knee pain, quality of life and, function. Baseline, 4-week post-injection and 12-week post-injection WOMAC scores (mean ± standard deviation) were 72.54 ± 18.89, 45,95 ± 13.30 and 37.10 ± 19.87 (p = 0.00, p = 0.00, p = 0.00; respectively) in the corticosteroid group, respectively and 68.23 ± 20.18, 42.99 ± 18.67, and 33.43 ± 18.24 (p = 0.00, p = 0.00, p = 0.00; respectively) in the ozone group, respectively. However, no significant group × time interaction was determined regarding all outcome measures. CONCLUSION: The study demonstrates the efficacy of O2-O3 compared to steroid injections regarding functioning and pain relief among patients with diagnosed knee OA. [ABSTRACT FROM AUTHOR]

Background: Mastocytosis (MS) is a rare disease that can involve various organs, including the bone. Given the incidence of the disease in the global population, MS poses a challenge for physicians, and early therapeutic intervention in the initial stages could significantly impact the quality of life of affected patients. Objective: The aim of this scoping review was to provide an overview of secondary osteoporosis in systemic mastocytosis (SM), focusing on the heterogeneity of its manifestations, the benefits of early diagnosis, and appropriate pharmacological treatment. Design: A technical expert panel (TEP) consisting of 8 physicians with expertise in metabolic bone diseases conducted the review following the PRISMA-ScR model. A strength of this study is that it provides various therapeutic approaches for patients with bone involvement in SM, although the limited available literature on the topic constituted a limitation. The TEP sought evidence regarding the following diagnostic and therapeutic modalities in the management of SM: "bisphosphonate therapy", "zoledronic acid therapy", "denosumab therapy", "IFN-alpha therapy", and "IFN-alpha therapy in combination with pamidronate". Results: Clinical data showed a correlation between densitometric outcomes, serum tryptase levels, and mast cell infiltration in the bone marrow, between increased bone mineral density and the presence of osteosclerosis in cases of advanced SM, between the severity of osteoporosis and hypertryptasemia, and also provided results on the long-term effects of bisphosphonate therapy, the therapeutic efficacy of zoledronic acid administration, the positive effect of denosumab on the reduction of serum tryptase levels (even if is proved in a limited numbers of cases) and the prevention of new fractures, and the effect of IFN-alpha in more severe cases of SM, either alone or in combination with pamidronate. Conclusions: Studies have demonstrated the effectiveness of various treatments depending on the form of mastocytosis, whether indolent systemic or advanced systemic, in the prognosis of the disease. However, this role should be further investigated in additional clinical studies, considering the limited data on the use of these interventions. [ABSTRACT FROM AUTHOR]

Purpose: Narrative Medicine complements the clinically centered approach, which focuses on the analytical and sanitary aspects, with the illness- and disorder- centered models, which deal respectively, with personal coping and social perception of a condition. Hypermobile Ehlers- Danlos Syndrome and Behçet's Disease are two rare multisystemic chronic disease experienced a myriad of clinical symptoms, psychological distress, and poor quality of life. The purpose of this report is to describe application of a multidisclipinary rehabilitation intervention according to the narrative medicine. Case description and Intervention: a 35-year-old woman with a 23-year history of Hypermobile Ehlers-Danlos Syndrome and Behçet's Disease was admitted. A multimodal rehabilitation approach was implemented and described through the patient's feelings and expected short-, medium-, and long- terms goals. Moreover, she reported her feeling with periodical interview by her therapist. History patient: The patient was seen for 32 weeks. A decreased pain, as well as improved function was recorded immediately post-intervention. Conclusion: Narration is not just an interpretation of the illness experience, but the result of reshaping the interpretations of the story that both patient and health professional. This discipline provides enrichment of care, especially when combined with rehabilitation in chronic disease, by paying attention to and using even in the therapeutic phase the stories of patients, family and health care personnel, giving the opportunity to define a tailored effectiveness rehabilitation approach at the light of the different points of view of the subjects. IMPLICATIONS FOR REHABILITATION: Narrative Medicine might play a key role in an interpretation of the illness experience to implement a multidisciplinary tailored rehabilitation approach. Narrative Medicine can help understand discomfort and difficulty associated with rehabilitation activities, thereby enhancing patient motivation and participation in interdisciplinary care. The Ehlers–Danlos Syndrome is a heterogeneous group of heritable connective tissue disorders representing a challenge in rehabilitation. Behçet's Disease is a rare multisystemic chronic disease experiencing an impaired function and a poor quality of life. A patient-oriented multimodal rehabilitation showed to be a useful approach in the case with both diseases, with a reduction of pain and an improvement of functioning. [ABSTRACT FROM AUTHOR]

BACKGROUND: Fibromyalgia is a debilitating condition marked by persistent pain and reduced functionality. Various therapeutic methods have been suggested to alleviate symptoms in individuals with fibromyalgia, yet the impact of diverse rehabilitation strategies remains unclear. OBJECTIVE: This systematic review and meta-analysis aimed at assessing the efficacy of rehabilitation interventions in improving functioning in fibromyalgia patients. METHODS: We conducted a comprehensive literature search of multiple international databases (PubMed, Scopus, and Web of Science) from their inception until November 22nd, 2023. We identified 23 randomized controlled trials (RCTs) assessing multiple rehabilitation strategies. The primary outcome was the Fibromyalgia Impact Questionnaire (FIQ). Study quality was assessed using the Cochrane Risk-of-Bias Tool for Randomized Trials (RoB 2). The study protocol was registered in PROSPERO (CRD42020197666). RESULTS: Our meta-analysis rehabilitation interventions significantly reduce FIQ scores (MD = - 11.74, 95% CI: - 16.88 to - 6.59, p < 0.0001). Notably, the subgroup analysis showed that different rehabilitation modalities seem to induce different therapeutic responses. CONCLUSIONS: Rehabilitation strategies hold promise in addressing the functional impairments and improving the overall well-being of individuals with fibromyalgia. The study underscores the need for further research to determine the optimal rehabilitation approach and its potential impact on the multilevel disability characterizing patients with fibromyalgia. [ABSTRACT FROM AUTHOR]