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Biomedical subjects

R Saggini

Publications and source records attributed to R Saggini.

At least 19 recordsLinked to original sources
PubMed2006

Frailty in the elderly: the physical dimension.

Frailty may be considered as a vulnerable status, which can precede the onset of overt disability. Operational definitions of frailty vary widely according to the conceptual framework: some authors consider frailty in a broad sense, which encompasses the physical, social, cognitive, psychological dimensions and comorbidity, whereas others define the syndrome more restrictively, mainly on the basis of performance parameters, such as gait speed, grip strength and physical activity. All these definitions are provided of a high predictive value for adverse outcomes, such as disability, hospitalization and mortality. Sarcopenia (i.e. the reduction of muscular mass and function) plays a predominant role in the pathogenesis of frailty. Among the factors responsible for sarcopenia (such as proinflammatory cytokines, low growth hormone and testosterone levels, increased production of oxygen free radicals, malnutrition and reduced neurological drive), immobility and lack of exercise have a preponderant role. Therefore, the diagnosis of frailty is mandatory for the early identification of a subset of elderly subjects at high risk, which can receive benefit from rehabilitation. A self-report and objective evaluation of physical performance are the best indicators of frailty in elderly subjects, a poor performance suggesting the need of an early and proper intervention. Structured exercise programs are effective in contrasting the progression of frailty, but an healthy and active lifestyle may be sufficient for delaying the onset of disability. In conclusion, there is clear evidence for prescription of exercise within the mainstream of the medical practice, rather than as an optional adjunct to standard care of the oldest old, given the public health implication of frailty, whose prevalence is going to increase in western populations.

Aged↗
PubMed2006

Submaximal aerobic exercise with mechanical vibrations improves the functional status of patients with chronic fatigue syndrome.

AIM: Chronic fatigue syndrome (CFS) is an illness characterised by disabling fatigue of uncertain aetiology and other nonspecific symptoms. Typically CFS patients complain of a severe fatigue made worse by exercise, with a consistent reduction of working activity. A physical deconditioning could explain CFS features as well as a neuromuscular dysfunction, of central or peripheric origin. METHODS: Ten CFS patients were enrolled in a protocol of a rehabilitative treatment over a six-month period: they underwent a submaximal and predominantly aerobic exercise with a reduced O2 consumption using a Galileo 2000 system that provides mechanical vibrations characterised by sinusoid vertical sollecitations. Before and after such treatment, all patients underwent a pressure pain thresholds profile, an evaluation of physical and psychosocial parameters using the visual analogue scale (VAS) of Scott-Huskisson, and a muscle performance analysis by the CIBEX 6000 dynamometer. RESULTS: After the six-month period of study there was an overall improvement of the above described parameters as compared to the basal determinations. CONCLUSION: We conclude that the rehabilitative exertion provides an useful treatment for CFS patients particularly to realize an effective training of the explosive strength.

Adult↗
PubMed2004

Efficacy of two micro-gravitational protocols to treat chronic low back pain associated with discal lesions: a randomized controlled trial.

AIM: Chronic low back pain is the most expensive benign illness in the industrialized world and is defined as a bio-psycho-social syndrome where the biological aspect has a very reduced importance when compared to the psychological and social aspects. The rehabilitative treatment of mechanical chronic lower back pain aims to modify the pain first and then postural local and general disorders. Rehabilitation in water is characterized by the possibility of reducing the gravity environment and the resistance to all motion and also of improving the proprioceptors and baroceptors sensation. Another modality exists in order to generate within a reduced gravity impact by means of the use of support systems during gait. The aim of this study is to compare the efficacy of these rehabilitative treatments in chronic low back pain. METHODS: Forty patients suffering from chronic low-back pain aged 50 years or less, (average age 43.46 years - max 50, min 28) were randomly divided into 2 groups (A and B) homogeneous for sex and age. They had an imaging exam that was positive for lumbar hernia or protrusion and were able to perform the defined rehabilitation with a 3 times frequency for 7 weeks. The people were studied for 1 year. Outcome measurements included the VAS and BACKILL scales. RESULTS: At the end of rehabilitation, all groups showed a statistically significant decrease of VAS values (p<0.01) and increase in Backill values (p<0.01). VAS and BK levels 1 year after treatment did not change in group B and remained significantly different from basal values, whereas in group A they were significantly different from the values at the end of treatment. The NSAIDs-intake was significantly reduced both at the end of treatment and after 1 year (p<0.01) in both groups. CONCLUSIONS: Body relief locomotion proved to give better results then aquatic rehabilitation in chronic low back pain patients, even if placebo controlled studies are needed to definitively prove the efficacy of the method.

Journal Article↗
PubMed1999

Spatial-temporal parameters of gait: reference data and a statistical method for normality assessment.

Spatial and temporal parameters of gait are of recognised clinical relevance in the assessment of motor pathologies, because they normally occur in established combinations which can be altered by pathologies. The data collected from 596 healthy subjects have been used to establish relationships among these parameters and a procedure to estimate deviation from normality based on the comparison between measured values and values estimated by exploiting these relationships. The applied multiple linear regression method (MLRM) was preliminarily validated by comparing its outputs with those of corresponding equations found in the literature, and by applying it to a control group of 12 healthy subjects.

Adult↗
PubMed1998

Alteration of spatial-temporal parameters of gait in Chronic Fatigue Syndrome patients.

Chronic Fatigue Syndrome (CFS) has been widely studied and a lot of information is available in the literature regarding the immunological, virological, neuroendocrinal and psychiatric aspects of the disease, but its aetiology is still poorly understood. Great attention has also been paid to the alteration of the muscular function caused by CFS. The aim of the present work was to study CFS patients' gait in order to find out objective measures which can better characterize the pathology. Spatial and temporal parameters of gait were collected from a group of 12 CFS informed volunteers by using the typical instrumentation of movement analysis, and raw data were statistically elaborated. Comparisons with reference data from a population of healthy subjects revealed significant abnormalities in the symmetry indices of the bilateral parameters and in the linear relationships among parameters, and between these parameters and the physical characteristics of the patients. Interestingly, the abnormalities were present as from the beginning of the gait, which indicates that they are unlikely to be caused by the rapid increasing fatigue. This strengthens the hypothesis of a direct involvement of the central nervous system (CNS) in the onset of the disease.

Adult↗
PubMed1998

Sports injuries in the pelvis and hip: diagnostic imaging.

We discuss the role of imaging techniques in examining the athletes with sports injuries involving the pelvis and the hip. Pelvis and hip pain is of difficult clinical clarification because of the various athletic injuries which may affect the bone or soft tissues at different anatomic sites. Moreover, the symptoms of pelvis and hip injuries are similar in most cases and they are often diffuse and atypical. Diagnostic imaging can play an essential role because treatment success depends on a correct diagnosis and these techniques can actually differentiate the most frequent causes of pelvis and hip sports injuries such as groin strain, osteitis pubis, ischial intersection syndrome, snapping hip, stress fractures, hernias and avulsion fractures. Finally, we discuss the role of magnetic resonance imaging in detecting the causes of hip pain other than sports injuries, such as avascular necrosis, reflex sympathetic dystrophy syndrome, herniation pit, acetabular labrum injuries. To conclude, diagnostic imaging techniques currently permit the direct and noninvasive depiction of pelvis and hip conditions. Particularly, magnetic resonance imaging is very helpful in detecting injury site, extent and characteristics; it can also predict the time period an athlete will be disabled and help define the best treatment planning.

Athletic Injuries↗
PubMed1997

The influence of different floor stiffness on mechanical efficiency of leg extensor muscle.

The mechanical behaviour of skeletal muscle is influenced by internal factors (e.g. re-use of elastic energy) and/or external conditions (e.g. floor compliance, shoe structure etc.). These factors have an effect on muscular work economy-this was investigated in the present study. Eight subjects were tested during three different series of jumps. Each series consisted of rhythmical vertical jumps performed at desired frequency and height for 1 min. The first (1) series was executed on the laboratory floor without rebound condition (subjects were asked to maintain 1 s period in an isometric condition before concentric work was performed), the second (II) and the third (III) series were performed in rebound conditions respectively on a laboratory floor (hard surface) and on a special panel possessing high compliance (a special foam rubber panel with stiffness of 14.4 kN/m). Expired air was collected during the test and recovery for determination of energy expenditure. Mechanical work was calculated from the vertical displacement of the body during the jumps. The results indicated that the net efficiency in the jumps without prestretch of the leg extensor muscles (series I) was the lowest (19.4%). In contrast, the net efficiency observed in rebound jumps (series II and III) was respectively 30.8% and 33.1%, demonstrating that the reuse of elastic energy (Wel) plays an important role for muscular work efficiency. However, the contribution of Wel to the total work performed was different p < 0.05, Student's t-test) in jumps on the special panel (41%) compared to the normal surface (37%), even if the total amount of stored elastic energy was the same in both conditions. The different efficiency observed between series II and III was attributed to the compliance of the surface on which the tests were executed. It was suggested that man could change his neuromuscular pattern to adapt muscular behaviour for matching the damped properties shown by the high compliance surface. Finally, the soft surface may favour a very low rate of running injuries.

Adult↗
PubMed1996

Effects of prolonged L-carnitine administration on delayed muscle pain and CK release after eccentric effort.

Eccentric muscle effort is known to induce delayed muscle soreness (DOMS) and muscle damage which are not responsive to medical treatment with the most common analgesic agents. The aim of the study was to investigate the effects of oral L-carnitine supplementation on pain (VAS scale), tenderness (pain thresholds) and CK release induced by a 20-min eccentric effort of the quadriceps muscle. A single-blind study was carried out on 6 untrained subjects (mean age: 26 +/- 3.8 yrs; mean height: 173 +/- 4.6 cm; mean body weight, 68.3 +/- 4.5 kg) over 7 weeks during which each subject: a) was given 3 g/day of placebo for 3 weeks and, after a week's interval, 3 g/day of L-carnitine for 3 weeks: b) performed 2 step tests on the first day of the 3rd and 7th week inverting the order of the exercising limb. In a separate set of experiments carried out 8 months later, the possible effects of training on pain parameters and CK levels were also investigated in the same subjects who performed 2 step tests at a 4-weeks' interval, without medication. L-carnitine significantly reduced pain, tenderness and CK release after the effort with respect to placebo. In contrast, no significant difference was found in the parameters measured between the two tests performed without medication. It is concluded that L-carnitine has a protective effect against pain and damage from eccentric effort. This effect is mainly attributed to the vasodilatation property of the compound, which both improves energetic metabolism of the hypoxic/damaged muscle and enhances wash-out of algogenic metabolites.

Adult↗
PubMed1996

Myofascial pain syndrome of the peroneus longus: biomechanical approach.

OBJECTIVE: The aim of the study was to investigate the role played by anatomical (lower limb length discrepancy) and biomechanical (alterations in the dynamics of movement) factors in the pathophysiology of myofascial pain syndrome (MPS) of the peroneus longus. DESIGN: Patients affected with MPS of the peroneus longus of one side were submitted to either correction of their lower limb discrepancy by heel lift (6 patients) or normalization of altered biomechanical parameters during movement, as measured via ground-foot reaction analysis (g-f) by dynamic insoles (6 patients) for 60 days. At days 7, 15, 30, and 60, the effect of treatment was verified on painful symptoms [VAS scale, presence of the active trigger point (TrP) in the muscle] and on g-f parameters [peaks of vertical force (F1 and F3 of Fz) and of lateral shear force (Fx)]. RESULTS: Treatment with heel lift produced a moderate, significant reduction of the spontaneous pain and of the abnormal Fx peak in the affected leg after 7 to 14 days with no further improvement afterward. Treatment with dynamic insoles caused a marked, significant reduction of the pain at 7 days, with complete resolution of the painful symptoms at 30 days and concomitant disappearance of the active TrP in the muscle. It also produced a significant and progressive reduction of the abnormal Fx peak in the affected leg starting at the 7th day and continuing until the 60th day. CONCLUSION: Both anatomical and biomechanical alterations of the dynamics of movement play a role in the painful symptoms of MPS of the peroneus longus, but the biomechanical factor is by far the more prominent.

Adult↗
PubMed1991

Myofascial pain syndromes: clinical and pathophysiological aspects.

The criteria for performing a diagnosis of myofascial pain syndromes caused by trigger points (TrPs) are defined and the clinical features of pain and related phenomena due to these syndromes are examined together with the sensory modifications of the parietal tissues at TrPs and target level in the case of both active and latent TrPs. The factors presumably responsible for the occurrence of TrPs in myofascial structures are then considered, with particular emphasis on the microtraumatic event caused by biomechanical alterations during movement, evaluated by the analysis of the ground-foot reaction. With this respect, some examples of myofascial pain syndromes of the lower limbs are reported in which the correction of these alterations, performed via dynamic orthosis, produces a long-lasting remission of the subjective and objective symptomatology.

Humans↗