“The show must go on”. The experience of injury among Italian dancers: fears, thoughts, and beliefs. A qualitative study.

“The show must go on”. The experience of injury among Italian dancers: fears, thoughts, and beliefs. A qualitative study.

Autori

Bigi Elisabetta [ Reggio Emilia, Italy]

Contri Angela [Cento, Italy]

Menozzi Andrea [Reggio Emilia, Italy]

Introduction

Dancers face a high risk of sustaining one or more injuries during their career. Despite dealing with pain almost daily, many dancers report experiencing fear and anxiety related to injury and believing in a stigma existing around the injured dancer. Dancers often tend to hide symptoms, self-manage pain and delay reporting injury to healthcare professionals, possibly making long-standing problems worse. This may be due to the strict culture diffused in many dance environments, high competitivity between dancers and the often uncertain work conditions.

Research shows better outcomes in terms of dancers satisfaction and confidence and a more positive relationship with the medical profession in countries where dance medicine experts are easy to reach for dancers (eg. The Netherlands). Up to date, there are no studies investigating these aspects in Italy, where dance medicine is far less developed compared to other Western countries.

This qualitative, cross-sectional study aims at understanding the experience of Italian dancers with injury by investigating their thought, beliefs and behaviors related to the topic.

Methods

Study population: Professional dancers or students who dance >8 hours/week regardless of age, sex and dance style will be included in the study, including those who are unable or limited in their activity due to an injury at the present time. Dancers who could not participate in group interviews due to language barriers will not be included.

Participants will be aggregated in focus groups and administered semi-structured interviews questioning experience, thoughts and beliefs about injury. Those who cannot take part to group interviews will be administered the interviews online. All participant will have to complete a demographic and anamnestic questionnaire and the  Italian Dance functional outcome Survey (DFOS)

The Interviews will be recorded and then transcribed for qualitative and thematic data analysis, using the Framework Methods and NVivo Software

Results

This is study is a work in progress. Participants recruiting is currently in progress.

Interviews are expected to take place in June-July 2024 and data analysis in August-September. The study should be completed by October 2024.

Researchers expect dancers to report one or more recent injuries, and experiences of fear, anxiety, insecurity and social stigma related to injury. Researchers also expect dancers to report strategies of self-management of pain and hiding injury or delaying injury reporting.

Discussion and Conclusion

This will be the first study collecting qualitative data on injury experience amongst Italian Dancers. Results from this study should highlight the unique needs and psychosocial characteristics of the dance population, and could be used to enhance adequate strategies for injury prevention, treatment, and education interventions.

REFERENCES

Air M. Health Care Seeking Behavior and Perceptions of the Medical Profession among Pre- and Post-Retirement Age Dutch Dancers. Journal of dance medicine & science : official publication of the International Association for Dance Medicine & Science. 2009;13:42-50.

Bowling A. Injuries to dancers prevalence, treatment, and perceptions of causes. British Medical Journal. 1989;298:731-734.

Brinson P, Dick F. Fit to dance?: The report of the national inquiry into dancers’ health and injury. Calouste Gulbenkian Foundation; 1996.

Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC medical research methodology. 2013;13:117

Vassallo AJ, Pappas E, Stamatakis E, Hiller CE. Injury Fear, Stigma, and Reporting in Professional Dancers. Saf Health Work. 2019;10:260-264.

McEwen K, Young K. Ballet and pain: reflections on a risk-dance culture. Qualitative Research in Sport, Exercise and Health. 2011;3:152-173.

“Nonsi? Spunnapeti ci fù!” Il patrimonio linguistico attiva strutture nervose come facilitatore nel recupero delle attività sensomotorie

“Nonsi? Spunnapeti ci fù!” (It’s a trap!) How language heritage activates nerve structures as a facilitator in the recovery of sensorimotor activities

Autori

Teresa Pintaudi (Università degli studi di Messina, Messina, Italia)

Mariachiara Ceccio (Università degli studi di Messina, Messina, Italia)

Francesco Bonanno (Università degli studi di Messina, Messina, Italia)

Filippo Cavallaro (AOU “G. Martino”, Messina, Italia )

Introduction

From a spontaneous statement expressed by a patient during a declination of sequential recognition in a cognitive therapeutic exercise (CTE), We thought about the role of past memories and events related to family-like experiences and how they can contribute during the exercise.

This reaction braked the subject in his decision-making process to reevaluate the experience, repeating it independently.

Methods

At the end of May 2024 during the daily physiotherapy session, Mr. “Fabrizio,” who was being followed for right encephalic stroke outcomes, was performing CTE exercises. Suddenly and unexpectedly he exclaimed: “Nonsi? Spunnapeti ci fù!” (it’s a trap!)

He realized that what he had so far perceived could not match the proposal that had been presented. He opened his arms and stopped what he was doing.

He returned to contact with the grant with a different focus and awareness for recognition.

Results

Complexity is an epistemic property, while freedom should belong to the intrinsic properties of that ontology system.

In fact, the structures that constitute the living being have a specific organization characterized by a complexity of connections, linkages, relationships that answer to its properties and conditions of self-determination and survival. These structures have a freedom to assert their existence by learning opportunities wit the aim to adapt experiences and changes the body (disease) and the environment (context).

Complex systems are predictable, knowing their initial conditions, in fact they are simulated in electronic computers. Therefore, the study and the deepening of knowledge in biology, physiology, psychology and sociology’s fields and all the disciplines which relate to man as a living being, can allow, those involved in the recovery of functions related to motor skills, the  using of knowledge pathways for the acquisition of motor skills and abilities.

“Fabrizio”, who was guided during the recognition experience, notices a condition of unbalance, non-alignment and a lack of coherence, between the experience he was describing and the recent memory of the grants.

To reinforce the discovery he retrieves a Sicilian phraseology coming from deeper memories that can enrich the way the experience is valued. Consequently, in the complexity field of connections, it is  activated a transdisciplinarity phenomenon (citing Jean Piaget).

Discussion and Conclusion

Everyone manifests in movements and behaviors, their personality, their culture and their freedom. This is even more evident in learning. In order to add an element among its skills, the person must modify itself both in the connections that characterize the functions of balance and coordination, and in the structures for weighing, speed, comfort.

During the experience of illness the body asks us to be guided among its complexities to unravel its wires and find those that can give opportunities for recovery to win over the pathological drift.

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“Una survey per fisioterapisti per indagare il management riabilitativo delle pazienti con POP e confrontarlo con la letteratura”

“A survey for physiotherapists to investigate the rehabilitation management of patients with POP and compare it with the literature

Autori

Dott.ssa Silvia Baccini, fisioterapista, Master riabilitazione del pavimento pelvico

Dott.ssa Cantù Daniela

Introduction

A questionnaire based on the most recent evidence about pelvic organs prolapse has been
created and issued to a pool of physiotherapists specialised in pelvic floor rehabilitation.
The final goal is to compare all of the data available in literature with the actual
professional clinical execution.

Methods

Research on the latest POP rehabilitation revisions has been performed, together with
analysing guidelines and RCT which have been published on the PubMed platform
between the years 2020 and 2023. Based on its results, a list of 22 questions, subdivided
into 4 main topics, has been drawn up: 1) competencies, training and clinical experience of
the physiotherapist; 2) profile of the patient with POP who receives the physiotherapeutic
treatment; 3) treatment tools and techniques; 4) outcome and modality of its achievement;
5) pre and post surgery physiotherapy. The data gathered has finally been discussed and
compared to the relevant evidence outlined in specialised literature.

Results

The questionnaire has been filled out by 86 physiotherapists who are either expert or
specialised in pelvic floor rehabilitation. The collected data has been compared both with
guidelines and the most recent articles issued in relation to the physiotherapeutic treatment
of patients affected by POP. The data concerning the choices of treatment has come out to
be different compared to what it would have been expected based on the evidence in
literature. The choice to use PFMT as a treatment technique for POP patients’
rehabilitation, has involved 67% of the physiotherapists. This percentage has been rather
unexpected considering that popular guidelines such as NICE 2019 recommend it as an
option for patients affected by POP. Also, other figures emerged to be in disagreement
with the current literature: this is the case of hypopressive exercise and the use of pessary.

Discussion and Conclusion

The future objective would be to implement qualitative and meaningful studies and
research in order to recognise the effectiveness of physical rehabilitative techniques for
POP patients, including radiofrequency and hypopressive exercise, for which there is not
much evidence still.
It is necessary to strengthen studies and scientific evidence of the rehabilitative treatment
applied in prevention of post-surgery relapse. Currently, there are no studies that can
compare the long-term outcome preservation within groups of patients with prolapse
setbacks, who have been treated with physiotherapy both before and after surgery, versus
similar patients who have not undergone a physiotherapeutic cycle. Another relevant piece
of data is about physiotherapists proposing pessary as a treatment option: only a very
minimal percentage of colleagues do so. It is crucial to identify the reasons behind this, in
light of the large amount of literature in support of the many benefits and advantages of
this therapy option.

REFERENCES

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La formazione degli studenti e dei professionisti sanitari riguardo alla presa in carico degli utenti transgender (TGD): un’overview di revisioni sistematiche

Education of healthcare professionals and students about the care of transgender (TGD) individuals: an overview of systematic reviews

Autori

Brizzi Lorenzo (Unit of Functional Rehabilitation, Department of Allied Health Professions, Azienda USL Toscana Centro, Italy)

Ferrarello Francesco (Unit of Functional Rehabilitation, Department of Allied Health Professions, Azienda USL Toscana Centro, Italy)

Serafini Isabella (Unit of Functional Rehabilitation, Department of Allied Health Professions, Azienda USL Toscana Centro, Italy)

Introduction

Transgender individuals (TGDs) are characterized by gender identity (male, female, or other) and biological sex (male, female, or intersex) incongruence. This can cause gender dysphoria, a mood disorder that can lead TGDs to a gender transition. This is an important diagnostic, therapeutic and care pathway that requires multidisciplinary management by healthcare professionals (HCPs), including physiotherapists and speech-language pathologists. Although the importance of education on the management of health needs of TGDs is acknowledged, it is not clear whether existing teaching and learning methods facilitate the development of the necessary level of knowledge and skill. Our aim was to investigate if education programs are effective in changing knowledge, attitudes, prejudice, skills, and level of comfort in clinical practice of HCPs and healthcare students (HCSs) in TGDs care.

Methods

Design: overview of systematic reviews.                                                                                                                                                                                                                  Data sources: MEDLINE, PsycInfo and Embase databases. Last data search, 31 January 2024.
Eligibility criteria: systematic reviews or meta-analyses published in English language since 2018, involving HCPs and HCSs, and focusing on educational interventions aimed at facilitating access to care and reducing health inequalities in the TGD population. We extracted data on the characteristics of the studies included. Specifically, we investigated study design, sample size, target population, participants’ professional profile, interventions’ features
(e.g., educational strategies, delivery modality, setting, duration), and outcome measures. We systematically assessed the methodological quality of the included studies with the AMSTAR-2 tool. We synthesized the findings through qualitative analysis.

Results

Four systematic reviews were retrieved, including 13, 21, 26, and 29studies, respectively.^1-4 One systematic review focused on LGBTQ-related prejudices, two of them were about LGTQ+ health in HCSs’ education, and one highlighted outcomes of gender-sensitivity education in HCPs. Overall, the reviews focused on the implementation of educational interventions to improve knowledge, skills and comfort level in clinical practice, and to reduce prejudices. Interventions were based on didactic lectures, role-playing, multimodal pedagogy with and without simulation, and others. Multimodal and practice-oriented trainings were the most implemented. The studies included in the reviews showed a wide heterogeneity in study design; interventions researched, and reported outcome variables. The outcome measures were often non-validated. According to the AMSTAR-2 tool the reviews had critically low levels of confidence.

Discussion and Conclusion

The included reviews suggest that educating health professionals and students about TGDs’ health is appropriate, but there is not clear evidence on the most effective intervention. There is a lack of well-designed primary studies on teaching strategies, their combination and delivery methods, aimed at reducing healthcare inequalities and discrimination against TGDs. The results of our overview also suggest the need to establish general agreement on validated outcome measures in order to compare the effectiveness of educational programs. In future developments, the agreement on outcome measures may allow a better comprehension of the effectiveness of interventions. It will increase the understanding of the impact of strategies and their combinations on the behaviour of HCPs and HCSs and, consequently, on the healthcare-related experiences of the TGDs. Our study can be a stimulus for the promotion of education on the management of TGDs’ health needs.

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Trattamento Riabilitativo Intensivo e Costante (TRIC) in pazienti con Malattia di Parkinson: uno studio pilota.

Constant and Intensive Rehabilitation Treatment (TRIC) in patients with Parkinson’s disease: a pilot study.

Autori

Christian Gelao [Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Unit of Bari Institute, Italy]

F. Angeloro [Associazione Parkinson Puglia ODV BARI]

C. Palmirotta [Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Neuropsychology, Bari Institute, Italy]

S. Tagliente [Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Neuropsychology, Bari Institute, Italy]

G. Lagravinese [Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Neuropsychology, Bari Institute, Italy]

S. Aresta [Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Unit of Bari Institute, Italy]

P. Battista [Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Neuropsychology, Bari Institute, Italy] [Global Brain Health Institute (GBHI), University of California San Francisco, CA, USA.]

P. Fiore [Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Unit of Bari Institute, Italy] [Department of Physical and Rehabilitation Medicine, University of Foggia, Foggia, Italy]

B. Minafra [Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Unit of Bari Institute, Italy]

Introduction

The scientific literature widely supports the importance of exercise as a component of Parkinson’s disease (PD) patients‘ lifestyle. According to some studies, exercise could be considered as a disease-modifying factor. Exercise associated with aerobic and resistance training could result in positive effects by increasing the rehabilitation outcome of patients with PD. 1 Structured therapeutic approach to exercise improved patients’ motor performances; however, this improvement was maintained for a limited time period.2
Thus, the purpose of this study is to evaluate whether consistent rehabilitation treatment can lead to improved motor performances and quality of life over a longer period of time.

Methods

Twenty consecutive patients with PD were enrolled with stable dopaminergic therapy for at least 4 weeks.
Patients who were participating in other rehabilitation programs, with visual and hearing impairment, with DBS, or with internist comorbidities unable to support intense physical exercise were excluded.
Patients underwent Intensive and Constant Rehabilitation Treatment (TRIC), performing 36 training sessions, for 12 consecutive weeks. Each training session lasted 60 minutes, according to a progression-modulated schedule.
All patients underwent neurological assessment at baseline (T0) and after 3 months (T1). Assessments were performed in ON therapy.
At T0 and T1, the following assessment scales were administered: MDS-UPDRS III, PDQ-39-IT, 6MWT, TUG, BBS, Conley Scale; the time required to perform postural transitions was also measured.

Results

Our sample was characterized as follows: age 75.55±8.99 years, H&Y between 1 and 2.5, MDS-UPDRS-III 25.8±9.88.

All patients completed all phases of the study.

At T1, all patients achieved significant improvement on all rating scales (p<0.001), also reduced the risk of falls with a positive trend.

Discussion and Conclusion

The results of this pilot study indicate that physical activity can result in sustained improvement of specific impaired motor functions in individuals with Parkinson’s disease. Adherence to treatment and the absence of droup out demonstrates the feasibility of the rehabilitation program. However, longer follow-up is needed to demonstrate the long-term effectiveness of TRIC.

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