Benedetto Giardulli

Objectives: To map how sleep has been assessed in osteoarthritis (OA) and/or inflammatory arthritis (IA), and to synthesize the evidence on the prevalence, characteristics and relationships between sleep disturbances and these conditions. Methods: We conducted a scoping review following the JBI guidelines and reported it following the PRISMA extension guidelines for scoping reviews (PRISMA-ScR). Medline (PubMed), EMBASE, CINAHL, Cochrane Central, PsycINFO, grey literature sources and ClinicalTrials.gov were searched. Using the RU-SATED framework, we categorized and narratively synthesized sleep dimensions and assessment methods and tracked the clinical impact of sleep disturbances in OA and IA. Results Two hundred and eighty-three: records (265 published studies; 18 registered trials) were included. They comprised 171 studies on IA, 77 on OA and 17 on mixed populations, which were considered separately where appropriate. Sleep assessment methods varied across studies, favouring subjective over objective measurements. Studies primarily focused on sleep satisfaction, duration, efficiency and sleepiness, overlooking regularity and timing. Global sleep disturbances were observed in ∼40–90% of OA and IA participants, with prevalence estimates varying substantially according to definitions, assessment methods and study populations. A consistent pattern of discrepancies between subjective and objective sleep metrics was identified. Conclusion: Sleep disturbance is a prevalent and clinically significant feature of both OA and IA, yet it remains under-represented in research and routine care. This review highlights substantial heterogeneity in sleep assessment and consistent discrepancies between subjective and objective measures. These findings support the need for standardized, multimethod approaches and for integrating sleep evaluation into rheumatology research and clinical guidelines.

Understanding how young people interact with health apps and wearables might help develop innovative strategies to support health management and improvement adopting a technology they are already familiar with. This study aimed to investigating the user experience of young adults who use apps or wearables for health purposes. A qualitative study using focus groups was conducted. Participants were eligible if they were between 18 and 26 years old and used an app or wearable to track at least one health variable (e.g., physical activity, diet, mental health). Transcripts were analysed using Reflexive Thematic Analysis (RTA) to identify themes grounded in the data. Sixteen people participated (mean age: 24.3 ± 1.9 years; men/women: 9/7) and five themes were generated: I) My health easily all in one place: one click away; II) Exploring and learning health through catchy, personalised and user-friendly graphics; III) From monitoring my variables to empowerment: road to healthy habits; IV) Collecting achievements and connecting with others to improve my health; and V) Be careful in managing and giving too much weight to health variables!. Young adults viewed apps and wearables as useful and powerful tools for managing their health, helping them gain a clear overview of different health aspects and how they interact. Features such as user-friendliness, personalisation, and achievement-based feedback were widely appreciated. In contrast, educational and community features were mentioned less often. Preventive and emergency functions were also valued, even among this young population. Despite these benefits, participants raised concerns about data accuracy and the potential negative impact of overly detailed information on people who are sensitive to tracking.

Background and Purpose: Degenerative Diseases of the Lumbar Spine (DDLS) are typically managed with conservative treatments, while surgery is reserved for cases with severe motor and/or sensory deficits. Preoperative physiotherapy has been shown to improve postoperative outcomes in shoulder, hip, and knee surgeries. However, its effects on the lumbar spine have been poorly investigated. This systematic review aimed to evaluate the efficacy of preoperative physiotherapy on pain, disability, and hospitalisation in individuals with DDLS. Methods: A literature search was conducted in MEDLINE, Cochrane CENTRAL, Scopus, PEDro and EMBASE. Two reviewers independently screened the studies, extracted the data, and assessed the risk of bias. We included randomised controlled trials (RCTs) in which preoperative interventions were delivered by physiotherapists and compared to usual care or other interventions. We conducted meta‐analyses on primary outcomes. Results: We screened 9.803 studies and included 6 with 5 different study populations. All studies were RCTs that evaluated the efficacy of preoperative physiotherapy compared with usual care in pain and disability. The preoperative interventions were heterogeneous, varying between therapeutic exercise, cognitive‐behavioural therapies, and multimodal interventions. The meta‐analyses showed no difference between interventions. All studies had a high risk of bias. Conclusion: The effects of preoperative physiotherapy, compared with usual care, on pain, disability, and hospitalisation among patients with DDLS, are minimal. However, the risk of bias of the included studies and the certainty of evidence, based on the GRADE approach, were very low. Future high‐quality, low‐bias trials are needed to clarify its effectiveness and identify patient subgroups that may benefit the most.

Due to the increasing burden of chronic diseases, the European Recovery Plan aims to enhance community-based healthcare services across Europe by 2026. The

Objectives: This systematic review and meta-analysis examined how axial spondyloarthritis (axSpA), and its specific disease features, impact sexual function. Methods: Systematic review of medical literature databases PsycINFO, CINAHL, MEDLINE, Embase, and Cochrane Central from their inception to February 2025. Studies reporting sexual function outcomes in men or women with axSpA were included. After narrative synthesis of included studies, random-effects meta-analysis was used to pool a subset of outcomes. Study quality was assessed using a modified version of the ROBINS-E tool. Results: From the initial 342 identified studies, 37 were included. Nineteen (50%) examined sexual function in men only, 13 (34%) across both genders, five (13%) in women only, and one (3%) did not specify. Nine studies (24%) reported general sexual dysfunction prevalence in people with axSpA, ranging from 32% to 71%. A meta-analysis of studies (n = 4) examining the International Index of Erectile Function in men with axSpA found that all domain scores, except sexual desire, were worse compared with controls. In women with axSpA, a meta-analysis (n = 4) of Female Sexual Function Index data revealed significantly poorer total sexual function scores, and arousal, pain, lubrication and desire sub-domain scores compared with controls. Conclusion: Between one- to two-thirds of people with axSpA report a sexual dysfunction. Pooling of data from a small subset of studies demonstrated statistically, and at times clinically, poorer sexual function scores in both men and women compared with controls. This conclusion is constrained by a lack of high-quality research and a notable scarcity of data concerning women.

Background and Purpose: Pelvic floor muscle training (PFMT) is a first‐line conservative treatment for urinary incontinence (UI), often involving invasive devices such as vaginal or anal biofeedback. However, these devices can cause discomfort, negatively impacting PFMT engagement. We aimed to explore the experiences of individuals with UI regarding the use of invasive devices during PFMT.Methods: A qualitative study was conducted using semi‐structured interviews. Participants were recruited through purposive sampling and interviews were conducted online. Data were analysed using Reflexive Thematic Analysis.Results: Fourteen participants (50% women; 50% men; age: 58 ± 17 years) who underwent PFMT involving invasive devices were interviewed. Four themes were generated: (1) ‘A Tool for Pelvic Floor Muscles: From Obligation to Acceptance’ as participants initially expressed discomfort and anxiety, which gradually evolved into acceptance. (2) ‘Building Trust Through Gradual Exposure and Tailored Guidance’ since supportive, patient‐centred communication and gradual exposure were key elements to alleviating discomfort. (3) ‘A Compact Trainer for PFMT’ since devices enhanced pelvic floor muscle awareness and self‐management through biofeedback, fostering independence and adherence. (4) ‘”Users” Needs: Privacy, Accessibility, Usability, and Autonomy’ emphasising barriers like lack of privacy, high costs, and need for user‐friendly designs to enhance accessibility and integration into daily life.Discussion: The study highlights the journey of individuals using invasive devices during PFMT: from discomfort to acceptance. Gradual introduction, empathetic communication, and tailored rehabilitation approaches by physiotherapists seemed to improve user engagement and adherence with the devices. Participants emphasised the need for accessible, user‐friendly devices to overcome logistical and psychological barriers.

The increase in long-term conditions and healthcare costs in Europe requires a strategic approach, prioritizing the establishment of Community-Based Interprofessional Teams (CBIT). Health and social care professionals (HSCP) in community primary care and CBIT require specific transversal skills and competencies (S&C). This rapid review synthesized the essential transversal S&C across European countries and identified corresponding curricula learning objectives. The Mixed Methods Appraisal Tool (MMAT) was adopted to assess quality evidence. Identified S&C were clustered following the European Skills, Competences, Qualifications, and Occupations (ESCO) Framework, which clusters transversal S&C into six groups: Social and Communication, Self-Management, Thinking, Life, Core, and Physical & Manual S&C. Eight qualitative studies met our coherence eligibility criteria. Among ESCO clusters, Social and Communication S&C was emphasized as crucial, encompassing effective communication, team support, collaboration, leadership, and adherence to ethical codes. Self-management S&C highlighted efficient work and a learning-oriented mind-set, while Thinking S&C emphasized information processing, holistic thinking, and planning. Life S&C focused emphasized health-related applications, and Core S&C highlighted digital proficiency. No skills from the Physical and Manual S&C cluster were reported. To classify these S&C in learning objectives, Bloom's Taxonomy was adopted. Most learning objectives fell under "Procedural Knowledge," emphasizing understanding "How to do something." Future studies should explore the benefits of transversal S&C to enhance work in community primary care and CBIT practices.

Spinal muscular atrophy (SMA) is a genetic disorder causing motor neuron loss and progressive muscle weakness, significantly affecting daily activities and breathing in severe cases. While rehabilitation is a crucial component of SMA management, no standardised rehabilitation guidelines currently exist. This review synthesised physiotherapy and respiratory interventions for SMA patients based on a comprehensive literature search from 1990 to 2024. Eighteen studies were analysed: eleven on physiotherapy and seven on respiratory rehabilitation. Five physiotherapy approaches were reported: electrical stimulation, electrotherapy with cycling, strengthening exercises, aerobic training, and hydrotherapy-based rehabilitation. Respiratory interventions, such as non-invasive ventilation and cough assistance, were mainly studied in SMA Type I, reporting prolonged survival and improved respiratory function. A few studies found that combining pharmacotherapy with intensive physiotherapy led to significantly better motor improvements than drugs alone. Despite these promising reported results, the lack of standardised methodologies and long-term clinical trials prevents definitive conclusions. Research should prioritise randomised controlled trial studies with standardised methodologies and larger sample sizes to investigate the efficacy of physiotherapy and respiratory interventions and, secondly, inform evidence-based rehabilitation protocols and clinical guidelines.