Maurizio Panunzio

The assessment of Chronic Musculoskeletal Pain (CMP) is fundamental for its management. An evaluation parameter that is gaining consensus in clinical practice is the Phase Angle (PA), obtained through bioelectrical monitoring with body Bioimpedance Analysis (BIA). To evaluate the reliability of the PA for CMP assessment, data from 53 patients (mean age 60 years) were observed. They had been evaluated through the Numeric Pain Rating Scale (NPRS) and the BIA, before (T0) and after (T1) a cycle of 10 treatment sessions with Ion Cyclotron Resonance (ICR). Following ICR applications, we detected a significant reduction in NPRS and a positive but not significant increase in PA values. Furthermore, given the misalignment in the significance of the positive trend of the two observed variables, it was not possible to define a clear correlation between pain and the bioelectrical values of patients. The study confirms the efficacy of ICR as a therapy for CMP. However, it was not possible to define a clear role of PA as a specific diagnostic tool for CMP. Although PA showed a promising trend, its non-significant correlation to the pain trend suggests investigating the topic in a more thorough and rigorous manner.

Background: In the cardio-respiratory rehabilitation field, thermal medicine represents an interesting complementary therapy approach. It can aid in complex medical contexts characterized by cardio-respiratory deficiency, functional limitation, and pain determined by the invasiveness of pharmacological and surgical treatments in combination with limited post-surgical physical activity. Methods: We investigated the evolution of cardio-respiratory and functional performances following the application of the Integrated Thermal Care (ITC) protocol in 11 mastectomized/quadrantectomized women (mean age of 54 years). The ITC protocol consisted of hydroponic treatments, steam inhalations treatment, hydrokinesitherapy, and manual treatments. Patients were assessed before and after a cycle of 1 h long treatment sessions, which were performed 5 days a week for 4 weeks. The outcomes were measured through the following scales and tests: Piper Fatigue Scale (PIPER), 6-Minute Walking Test (6MWT), Five Times Sit-to-Stand (5STS), Range of Arm Motion (ROM), Disability of the Arm–Shoulder–Hand Scale (DASH), and Numeric Pain Rating Scale (NPRS). Results: We found appreciable improvements in cardio-respiratory efficiency and in pain perception exemplified by a reduction of PIPER, 5STS, DASH, and NPRS values together with an increase in 6MWT and ROM values. Conclusions: We conclude that ITC is a promising rehabilitative tool to enhance cardio-respiratory and functional performance and reduce pain after mastectomy/quadrantectomy.

Background/Objectives: Chronic Musculoskeletal Pain (CMP) is a rather widespread and heterogeneous health problem whose evaluated framework can be of fundamental importance to intervene effectively and rapidly on the causes and consequences of the pathology, as well as on the dominant symptom of pain. One of the evaluation parameters that is increasingly gaining consensus in the assessment of the health status is the Phase Angle (PA), obtained through bioelectrical monitoring with body Bioimpedance Analysis (BIA); Methods: To evaluate the reliability of the PA as a tool for assessing CMP, data from 53 patients, with an average age of 60 years, were observed. They underwent assessment of perceived pain using the Numeric Pain Rating Scale (NPRS) and of the body's bioelectrical status using the BIA, before the beginning (T0) and after the end (T1) of a cycle of 10 treatment sessions with Ion Cyclotron Resonance - Bioresonance Therapy (ICR-BT); Results: At the end of the observation we detected a significant reduction in the NPRS value and a positive but not statistically significant increase in the PA value. Furthermore, given the misalignment in the significance of the positive trend of the two observed variables, it was not possible to define a clear correlation between pain and the bioimpedenziometric values ​​of patients. Conclusions: The study confirms the efficacy of ICR-BT as a therapeutic tool in the presence of CMP. However, it was not possible to define a clear reliability of PA as a diagnostic tool for CMP. Although PA has shown a promising trend during the study, its non-significant correlation to the pain trend would suggest investigating the topic more deeply, through larger and better structured experimental studies.

Background/Objectives: Nowadays there is a progressive increase in surgical interventions in the fields of cardiology and oncology. This situation increasingly involves the need to identify strategies for managing complications that may affect patients in the post-surgical period, during the rehabilitation phase. Among the symptoms most frequently encountered in this context are pain and postural dysfunction, for which a decisive support could derive from the application of Focused Mechano-Acoustic Vibrations (FMAVs) therapy. Methods: In this pilot observational study, 20 patients (12 women and 8 men; average age of 48 years) who underwent cardiac or oncological surgery were observed during the execution of a FMAVs treatment protocol applied in the post-operative period. Patients were evaluated at the beginning and at the end of the protocol through the Numeric Pain Rating Scale (NPRS) and the computerized postural analysis for the calculation of the Postural Biometric Index (PBI), that quantifies postural dysfunctions. All patients were treated with 8 biweekly sessions of FMAVs applied on specific Myofascial Trigger Points (MTrPs). Results: At the end of the protocol, significant reductions of 26.4% for pain detected by NPRS and 17.9% for postural dysfunction detected by PBI were observed. Conclusions: Treatment with FMAVs can determine improvements in pain and postural dysfunction in cardiac and oncological patients subjected to surgery. This preliminary study lays the foundation for further in-depth research on the topic.

Background and Objectives: Irritable bowel syndrome (IBS) is an invasive and potentially disabling syndrome characterized by a multitude of symptoms capable of reducing the quality of life of patients. Among the most disabling symptoms of IBS is certainly physical pain, which manifests itself mainly at the abdominal level but can also appear in other areas of the body, particularly in the form of chronic low-back pain (CLBP). Among the non-invasive methods of treating organ-specific pathologies and organ-related musculoskeletal problems, the use of Bioresonance Therapy (BT)—based on the administration of self-modulating Extremely Low-Frequency Electromagnetic Fields, capable of determining a rebalance of bio-electrical and metabolic activity in the presence of various functional alterations—is currently gaining acceptance. Therefore, we decided to monitor results obtained from patients suffering from IBS and CLBP subjected to a cycle of treatments with BT. Materials and Methods: We monitored 20 patients (12 women and 8 men, average age of 51 years) suffering from CLBP and other visceral symptoms related to IBS. Patients were monitored through the use of the Bristol Stool Form Scale (BSFS), the Fecal Calprotectin test and the Short-Form Health Survey 36 (SF-36), collected before (T0) and after (T1) the execution of the cycle of treatments. They undertook a treatment protocol consisting of eight sessions of BT carried out over about a month. Results: At the end of the treatments with BT, it was possible to observe a general and significant improvement in all the parameters observed, as well as a close inversely proportional correlation between the Calprotectin values detected and the quality of life experienced by the patients in relation to their perceived IBS symptoms. Conclusions: Overall, our pilot study would seem to suggest a potential beneficial effect of BT in modulating organic and musculoskeletal symptoms derived from IBS.

Musculoskeletal pain is a common symptom of Parkinson's disease (PD) that is not adequately treated with current dopaminergic drugs. This pilot study sought to investigate the effect of focal muscle vibration (fMV) on a group of Parkinson's disease patients suffering from chronic cervical pain. In addition to conventional physiotherapy, twenty-two patients with idiopathic Parkinson's disease (Hoehn and Yahr stages II-III) received three weeks of bilateral focal musclevibration to the trapezius muscles. The Visual Analogue Scale (VAS), the Short-form McGill, and the Present PainIntensity scales were used to assess pain at baseline (T0), after three weeks of treatment (T1), one week after the last treatment session (T2), and three weeks after T2 (T3). Pain intensity decreased significantly from baseline to T1 across all pain scales (p < 0.0001). Furthermore, the beneficial effect of fMV on cervical pain lasted up to one month after treatment. Our findings show that fMV, in combination with conventional physiotherapy, is effective at reducing pain intensity in PD patients, with results visible even after a month of follow-up.

Background: Parkinsons’s disease is characterized by progressive worsening of gait, posture and balance with disability in daily life activities and to improvement in chronic musculoskeletal pain, often in neck pain associated with worsening of balance. The aim of the study is to investigate the correlation between scoliosis, balance and cervical pain in Parkinson’s disease. Methods: Cross-sectional, pilot study. A total of 16 Parkinson’s patients were enrolled in the study. The Pain Visual analogue scale and the short form McGill pain questionnaire measured neck cervical pain; static balance, Tinetti, Berg Balance and Short Physical Performance Battery scales(SPPB) were used to evaluate dynamic balance. Whole-spine standard X-ray assess spinal scoliosis with Cobb angles measurement .An observational statistical analysis was performed with the patients subdivided into a non-scoliosis (NS) group and a true scoliosis (TS) group based on whether they presented a Cobb’s angle below or ≥10°. Results: Frequency of neck pain in the NS group was 37% compared to 50% in the TS group. A non-statistically significant difference was found in terms of static, dynamic balance and cervical pain scores between NS and TS groups. Conclusions: Scoliosis, cervical pain and postural imbalance are significant yet often overlooked complaints in PD.

Intra-articular (IA) ultrasound-guided hip injections are currently considered a cornerstone of the conservative management of symptomatic hip osteoarthritis (HOA), although their effect on clinical outcomes has not been fully elucidated.The purpose of this study is to investigate the effectiveness of ultrasound-guided IA hip injections of hyaluronic acid (HA) with or without corticosteroids (CS) on pain relief and functional improvement in patients with HOA. In total, 167 patients with HOA were assessed at baseline (T0) and 12 months after injection (T1) using the VAS and GLFS scores. The sample consisted mainly of female subjects (58.1%), presenting an average age of 70.6 ± 12.2 years and grade 3 HOA (63.9%) according to the Kellgren–Lawrence classification. Most of the patients (76.2%) underwent unilateral hip injection with a combination of medium-high molecular weight HA (1500–2000 kDa) and CS. At T1, lower use of anti-inflammatory drugs, an increase in the consumption of chondroprotectors, and an overall reduction of instrumental physical therapies and therapeutic exercise were recorded. In addition, a statistically significant intragroup and between-group decrease observed at T1 for both the VAS and GLFS. Study results suggested that intra-articular hip injections with HA alone and with CS could represent a useful therapeutic tool for pain reduction and functional improvement for patients with hip osteoarthritis.

Background: The aim of this study was to evaluate the effects of integrated thermal rehabilitation care (ITRC) on postural balance and health-related quality of life in subjects with basic autonomy. Materials and Methods: From June to December 2021, a total of 50 individuals with six points on the Katz Index of Independence in Activities of Daily Living (ADL) and a mean age of 66 (DS ± 12), comprising 27 (54%) males and 23 (46%) females, were selected. This study was carried out at the Thermal Medical Center of Castelnuovo della Daunia (Foggia, Italy), which operates within the National Health Service. The outcome measures were baropodometry (static exam, dynamic exam, and stabilometric exam), a biometric evaluation system, and the EuroQol 5-Dimension (EQ-5D-5L). Results: Statistical analysis of the data showed how balance affected postural control and how ITRC was able to reduce the body’s imbalance and improve quality of life. The vertical angles in frontal projection displayed an increment in the values (head/shoulder, p = 0.009; head/pelvis, p = 0.001; right hip/knee, p = 0.01; right hip/ankle, p = 0.008). In a dynamic analysis, the podalic weight percentage was shown to have a reduction in imbalance on both sides (left side, p = 0.01; right side, p = 0. 01). EQ-5D-5L showed a statistically significant improvement in quality of life and perception of quality of life. Indeed, the health status score improved in all items and in the total rate of the EQ index. In all subjects, walking motility (p = 0.005), self-care (p = 0.002), and habitual activity (p = 0.002) showed statistically significant increments in their values. Pain/discomfort (p = 0.001) and anxiety (p = 0.006) were also reduced. In addition, there was a statistically significant increment in the Visual Analogue Scale (VAS) score (p = 0.001) for life perception. Conclusions: The ITRC approach showed how small adjustments and postural rebalancing led to a significant improvement in quality of life. ITRC can be considered an effective treatment with good tolerability for a variety of musculoskeletal disorders.