物理治疗与身体康复杂志

This comparative analysis explores the distinctive features of Osteochondritis Dissecans (OCD) and Avascular Necrosis (AVN), two orthopedic conditions characterized by compromised blood supply leading to bone pathology. While sharing the commonality of vascular compromise, OCD primarily affects the knee joint, resulting in the detachment of subchondral bone and overlying articular cartilage, often attributed to repetitive micro trauma. In contrast, AVN exhibits a broader spectrum of etiologies and frequently involves weight-bearing joints, with the hip being a common site, leading to ischemia-induced bone cell death. Through a comprehensive examination of pathophysiology, clinical presentation, diagnostic approaches and treatment strategies, this analysis aims to provide clinicians with valuable insights for differentiating between and managing these distinct orthopedic entities.

Pars interarticularis fractures, commonly associated with spondylolysis, present a challenging clinical scenario often requiring surgical intervention. Minimally Invasive Surgery (MIS) has emerged as a promising approach for treating these fractures, offering potential benefits in terms of reduced tissue trauma, shorter recovery times and improved patient outcomes. This comprehensive review explores the current state of MIS techniques for pars interarticularis fractures, encompassing procedural aspects, clinical outcomes and potential complications. By synthesizing existing literature, we aim to provide insights into the evolving landscape of minimally invasive strategies in the management of these fractures.

Ischemic stroke remains a significant global health concern, necessitating exploration of novel therapeutic avenues. Garlic, with its rich bioactive compounds, has been implicated in various health benefits, including potential neuroprotective effects. This study investigates the neuroprotective mechanisms of garlic in the context of ischemic stroke, focusing on its antioxidant and anti-inflammatory properties. Utilizing in vitro and in vivo models, we assess the impact of garlic extracts on oxidative stress markers and inflammatory mediators in ischemic conditions. Our findings elucidate the potential of garlic to mitigate neuronal damage and modulate inflammatory responses, offering insights into its therapeutic relevance in ischemic stroke.

Music- and sonification-assisted rehabilitation is being increasingly investigated in motor recovery after stroke, but only few studies have thus far involved patients in the acute phase of the disease.

In this quasi-experimental study (no randomization has been applied), patients with motor deficit of the upper limb fulfilling predefined inclusion criteria were sequentially enrolled onto a program of sonification-based exercises through a serious game, id est. an adapted piano-keyboard as an add-on to standard rehabilitation treatment. Based on the potential efficacy of the auditory-motor networks, the aim was to further stimulate the patient on tactile stimulation, limb lifting and finger motor individualization. Starting 2 to 7 days after stroke onset and for an overall 21-day duration, the experiences were performed in the hospital. After the enrollment of 13 patients as experimental group, 12 more patients were enrolled as control group and underwent standard physiotherapy treatment.

For all patients, the Action Research Arm Test (ARAT) was administered at T0 (prior to therapy), T1 (after 10 days) and T2 (end of treatment) while the quality of life, as assessed by the SF-36 scale, was evaluated at T0 and T2.

For the ARAT, statistical analyses were performed by Student’s T test for paired and unpaired samples, respectively. In both groups, ARAT scores significantly improved from T0 to T1, but the sole experimental group displayed a significant motor improvement from T1 to T2.

Again, only in the case of the experimental group quality of life showed a significant improvement in the perception of physical health.

Overall, add-on treatment with sonification exercises was feasible in the acute phase of stroke, leading to recovery which tended to be more lasting than in the control group. Motor recovery of upper limb function paralleled an improvement in the perception of physical health.

These results are the basis for a future randomized controlled study on the effect of sonification add-on therapy in the acute phase of stroke.