Autore: TDSRRT31

  • Sfruttare la Connessione Mente-Corpo: Esplorazione del Potenziale Terapeutico dell’Immaginazione Motoria nel Alleviare il Dolore al Piede

    Harnessing the Mind-Body Connection: Exploring the Therapeutic Potential of Motor Imagery for Foot Pain Relie

    Introduction

    Motor imagery, the cognitive process of mentally simulating movements without physical execution, has been widely studied in various contexts, including rehabilitation, sports performance, and pain management. It involves activating the same neural networks as actual movement and has shown potential benefits in enhancing motor learning, motor performance, and functional recovery[ 1 ]. In the realm of pain, motor imagery has gained attention as a potential therapeutic approach for individuals experiencing foot pain[ 2 ]. Understanding the relationship between motor imagery and foot pain is crucial for developing effective rehabilitation strategies and optimizing pain management approaches.

    Methods

    This review examines relevant articles [3,4] that investigate motor imagery in the context of foot pain. The studies encompass participants with different foot pain conditions, including leg amputation, chronic leg pain, complex regional pain syndrome, and Achilles tendinopathy. Various methodologies were employed to assess motor imagery abilities, including motor cortical mapping, foot laterality recognition tasks, EEG recordings, and treatment interventions incorporating motor imagery.

    Results

    The findings reveal several important insights. Individuals with leg amputation displayed functional reorganization in upper-limb motor cortical maps, accompanied by a breakdown in the inhibitory relationship between foot and hand representations. Participants with chronic leg pain exhibited slower and less accurate performance on foot laterality recognition tasks compared to healthy controls. Complex regional pain syndrome patients demonstrated distinct motor imagery strategies and varied responses to first-person and third-person perspectives. EEG studies highlighted differences in brain activity during motor imagery tasks under pain-free and pain conditions. Treatment interventions incorporating motor imagery showed promising outcomes in improving functional outcomes and reducing pain levels.

    Discussion and Conclusion

    Motor imagery appears to play a significant role in foot pain conditions, although further research is needed to establish consistent evidence and understand the underlying mechanisms. The integration of motor imagery into rehabilitation and pain management approaches holds promise for optimizing treatment outcomes in individuals with foot pain. Future research should focus on standardizing motor imagery assessment protocols, identifying specific patient populations that may benefit most from motor imagery interventions, and exploring the long-term effects of motor imagery-based interventions. By advancing our understanding of motor imagery in the context of foot pain, healthcare professionals can develop targeted and effective strategies to improve functional outcomes and enhance the overall well-being of individuals with foot pain.

    REFERENCES

    [ 1 ]Cooper LA, Shepard RN. Mental transformations in the identification of left and right hands. J Exp Psychol Hum Percept Perform. 1975 Feb;104(1):48-56.

    [ 2 ]Sekiyama K. Kinesthetic aspects of mental representations in the identification of left and right hands. Percept Psychophys. 1982 Aug;32(2):89-95.

    [ 3 ]Marconi B, Koch G, Pecchioli C, Cavallari P, Caltagirone C. Breakdown of inhibitory effects induced by foot motor imagery on hand motor area in lower-limb amputees. Clin Neurophysiol. 2007 Nov;118(11):2468-78.

    [ 4 ]Rio EK, Stanton TR, Wand BM, Debenham JR, Cook J, Catley MJ, Moseley GL, Butler P, Cheng K, Mallows AJ, Wilson MVB, Girdwood M. Implicit Motor Imagery of the Foot and Hand in People with Achilles Tendinopathy: A Left Right Judgement Study. Pain Med. 2021 Dec 11;22(12):2998-3007.

  • Teleriabilitazione per l’osteoartrosi del ginocchio: Valutazione dell’efficacia, dell’aderenza e degli esiti del paziente

    Tele-Rehabilitation for Knee Osteoarthritis: Evaluating Efficacy, Compliance, and Patient Outcomes

    Introduction

    The COVID-19 pandemic has brought significant challenges to the healthcare system, including the care of individuals with osteoarthritis (OA)[ 1 ]. Tele-rehabilitation (TR) has emerged as a valuable tool for managing OA through remote exercise interventions, offering potential benefits in reducing costs. This study aims to evaluate the efficacy of TR in managing knee OA, hypothesizing that evidence-based exercise programs delivered through TR can achieve comparable outcomes to traditional clinic-based interventions while potentially reducing overall healthcare costs. By improving adherence and providing a familiar, protected environment for patients, TR has the potential to enhance chronic disease management and quality of life while also offering cost-saving advantages. Understanding the effectiveness of TR in OA care can inform decision-making and help optimize healthcare resources in the post-pandemic era.

    Methods

    This randomized controlled trial included 50 participants with knee osteoarthritis. They were randomly assigned to either the experimental or control group (25 participants each). Both groups performed the same exercise interventions, including seated knee exercises, isometric quadriceps exercises, sit-to-stand exercises, and wall squats [ 2 ][ 3 ]. The intervention consisted of 12 sessions, three times a week. In the experimental group, participants received home-based rehabilitation through tele-rehabilitation supervised by a dedicated physiotherapist. The control group received conventional rehabilitation at the institute, also supervised by a dedicated physiotherapist. Assessments were conducted at baseline, post-treatment, and at a 1-month follow-up, measuring pain reduction using the Numeric Pain Rating Scale (NRPS)[ 4 ] and secondary outcomes.

    Results

    In the independent samples t-tests, conducted to compare the two groups, the results showed the following: At the Baseline assessment, there was no statistically significant difference between the groups in terms of NPRS scores (t = 0.170, df = 53, p = 0.865), with a mean difference of 0.070 (SE = 0.413, Cohen’s d = 0.046). Similarly, at the End of Treatment assessment, no significant difference was found in NPRS scores between the groups (t = -0.333, df = 53, p = 0.741), with a mean difference of -0.167 (SE = 0.502, Cohen’s d = -0.090). The results at the After 3-month assessment also revealed no significant difference between the groups in terms of NPRS scores (t = 0.337, df = 53, p = 0.737), with a mean difference of 0.186 (SE = 0.551, Cohen’s d = 0.091). These findings suggest that there were no significant differences in pain levels between the two groups at any of the assessment points.

    Discussion and Conclusion

    This study compared the effectiveness of home-based tele-rehabilitation and hospital-based rehabilitation in reducing knee osteoarthritis-related pain. Both groups showed significant pain improvement after one month of targeted exercises. No significant difference was found between the groups, indicating that home-based tele-rehabilitation was as effective as hospital-based rehabilitation. Pain improvement was sustained at the three-month follow-up. These findings suggest that home-based tele-rehabilitation can be a viable alternative to hospital-based rehabilitation, improving accessibility and convenience. In conclusion, both treatment modalities effectively reduce knee osteoarthritis-related pain, with home-based tele-rehabilitation offering comparable benefits and the potential to revolutionize care delivery.

    REFERENCES

    [ 1 ] Ragni, E., Mangiavini, L., Viganò, M., Brini, A.T., Peretti, G.M., Banfi, G., de Girolamo, L., 2020. Management of Osteoarthritis During the COVID‐19 Pandemic. Clin Pharmacol Ther 108, 719–729. https://doi.org/10.1002/cpt.1910

    [ 2 ] Janssen, W.G.M., Bussmann, H.B.J., Stam, H.J., 2002. Determinants of the sit-to-stand movement: a review. Phys Ther 82, 866–879.

    [ 3 ] Skou, S.T., Pedersen, B.K., Abbott, J.H., Patterson, B., Barton, C., 2018. Physical Activity and Exercise Therapy Benefit More Than Just Symptoms and Impairments in People With Hip and Knee Osteoarthritis. J Orthop Sports Phys Ther 48, 439–447. https://doi.org/10.2519/jospt.2018.7877

    [ 4 ] Childs, J.D., Piva, S.R., Fritz, J.M., 2005. Responsiveness of the numeric pain rating scale in patients with low back pain. Spine (Phila Pa 1976) 30, 1331–1334. https://doi.org/10.1097/01.brs.0000164099.92112.29