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S Negrini

Publications and source records attributed to S Negrini.

At least 19 recordsLinked to original sources
PubMed2006

Efficacy of the symmetric, patient-oriented, rigid, three-dimensional, active (SPoRT) concept of bracing for scoliosis: a prospective study of the Sforzesco versus Lyon brace.

AIM: Bracing is considered to be effective in the treatment of adolescent idiopathic scoliosis. The concept prevailing today includes an asymmetrical construction, mainly using a mechanical three-point system. We developed the new Sforzesco brace, based on the SPoRT concept (Symmetric, Patient-oriented, Rigid, Three-dimensional, active). The aim of this study is to verify the results of this concept and brace, compared to three-point classical systems. METHODS: We performed a prospective, pair-controlled study. It was possible to match 15 patients, out of the first 18 consecutively treated with the Sforzesco brace (Group SPoRT), with previous patients treated with the Lyon brace (Group LY). SPoRT included 14.2+/-1.7 year old patients, with 47+/-7 degrees Cobb worst curves, and 11+/-4 degrees Bunnell; LY included 13.6+/-1.6 year old patients, with 43+/-7 degrees Cobb and 12+/-5 degrees Bunnell. The brace had to be worn 23 h per day and patients were evaluated after 6 months both clinically and radiographically (without the brace). Appropriate statistics were used. RESULTS: At the baseline there were slight differences between the groups, with SPoRT worse than LY. All radiographic and clinical parameters decreased significantly with treatment in both groups, apart from thoracic Cobb degrees in LY. SPoRT had better results than LY (P<0.05) radiographically (worst curve -10+/-5 degrees vs -5+/-7 degrees, all curves -8+/-7 degrees vs -6+/-7 degrees), for sagittal profile (distance from plumbline: T12 -6+/-9 mm vs +2+/-8 and L3 -7+/-12 vs 0+/-10) and aesthetics of the shoulders (9 improved and 6 unchanged vs 5 and 8) and waists (10 improved and 5 unchanged vs 5 and 8). Finally, clinical results in terms of patient recovery were better in SPoRT than LY (12 improved and 3 unchanged vs 8 and 5). CONCLUSION: When a new treatment is introduced, it is not possible to wait years (end of therapy) before verifying its utility, and in scoliosis bracing a short term study already gives very important clues. This study confirms the immediate efficacy of brace treatment (even in such high degree cases) whatever the brace concept used, with only 2 (out of 30) progressed curves. In SPoRT we had no progressions, and obtained a statistically significant 80% better radiographic results than LY in the worst scoliosis curve, and 40% in the average of all curves, as well as improved aesthetics and sagittal profile (that is crucial in scoliosis bracing). The Sforzesco brace should be used, and the SPoRT concept explored in the long term to verify if the classical three-point system should be totally (or partially) abandoned.

Adolescent↗
PubMed2006

'SOSORT consensus paper on brace action: TLSO biomechanics of correction (investigating the rationale for force vector selection)'.

BACKGROUND: The effectiveness of orthotic treatment continues to be controversial in international medical literature due to differences in the reported results and conclusions of various studies. Heterogeneity of the samples has been suggested as a reason for conflicting results. Besides the obvious theoretical differences between the brace concepts, the variability in the technical factors can also explain the contradictory results between same brace types. This paper will investigate the degree of variability among responses of scoliosis specialists from the Brace Study Ground of the International Society on Scoliosis Orthopedic and Rehabilitation Treatment SOSORT. Ultimately, this information could be a foundation for establishing a consensus and framework for future prospective controlled studies. METHODS: A preliminary questionnaire on the topic of 'brace action' relative to the theory of three-dimensional scoliosis correction and brace treatment was developed and circulated to specialists interested in the conservative treatment of adolescent idiopathic scoliosis. A particular case was presented (main thoracic curve with minor lumbar). Several key points emerged and were used to develop a second questionnaire which was discussed and full filed after the SOSORT consensus meeting (Milano, Italy, January 2005). RESULTS: Twenty-one questionnaires were completed. The Chêneau brace was the most frequently recommended. The importance of the three point system mechanism was stressed. Options about proper pad placement on the thoracic convexity were divided 50% for the pad reaching or involving the apical vertebra and 50% for the pad acting caudal to the apical vertebra. There was agreement about the direction of the vector force, 85% selecting a 'dorso lateral to ventro medial' direction but about the shape of the pad to produce such a force. Principles related to three-dimensional correction achieved high consensus (80%-85%), but suggested methods of correction were quite diverse. CONCLUSION: This study reveals that among participating SOSORT specialists there continues to be a strongly held and conflicting if not a contentious opinion regarding brace design and treatment. If the goal of a 'treatment consensus' is realistic and achievable, significantly more effort will be required to reconcile these differences.

Journal Article↗
PubMed2006

Functional assessment of the lumbar spine through the optoelectronic ZooMS system. Clinical application.

AIM: The radiographic method remains the main imaging technique for the physiological, anatomical and possibly pathological analysis of the spine thanks to its ease of use, precision and reliability. Despite this, the technique is inadequate for functional and dynamic studies. This paper aims to apply a dedicated noninvasive methodology based on optoelectronic techniques for the functional evaluation of the lumbar spine. METHODS: A reference data set for typical movements (i.e. flexion/extension, lateral bending, axial rotation) of the lumbar spine has been developed. Twenty healthy subjects have been recruited (10 males and 10 females) to create the databases of healthy subjects; one subject who suffers from lumbar spine diseases has been analyzed and his mobility has been compared to healthy subjects. RESULTS: Two databases have been created: in the former, the entire movement is normalized in time with respect to its duration; in the latter, all movements are classified in characteristic phases and each single phase is normalized to a defined duration. These databases include both the global movement of the lumbar tract of the spine and the movement of the single functional units (2 vertebrae, the intervertebral disk and the intervening surrounding soft tissues). Moreover, these databases are divided into male and female databases according to the natural differences in range of motion and pattern of movement. A clinical application for pathologic subjects is shown demonstrating the applicability and usability of this protocol. CONCLUSION: This method allows to assess both the quality and the quantity of lumbar spine movement (both global and metameric level) of the subject and to distinguish the patient from the healthy subject.

Biomechanical Phenomena↗
PubMed2005

Bronchial hyperreactivity and spirometric impairment in patients with allergic rhinitis.

BACKGROUND: The Link between allergic rhinitis and asthma is well known. Bronchial hyperreactivity (BHR) may be present in rhinitics. The present study is aimed at evaluating a large group of subjects suffering from allergic rhinitis alone to investigate the presence of spirometric impairment and BHR both during and outside the pollen season. METHODS: 360 rhinitics (subdivided in 3 groups: seasonal, SAR, perennial, PAR, and polysensitized, PolysR) were investigated by spirometry and methacholine challenge. RESULTS: There was a significant seasonal difference concerning the number of rhinitics with impaired FEV1 (p<0.01 for SAR, p<0.02 for PAR, and p<0.03 for PolysR) and FEF25-75 (p<0.05 for SAR, p<0.03 for PAR, and p<0.05 for PolysR) as well as with BHR (p<0.05 for SAR and p<0.03 for PAR). CONCLUSIONS: This study evidences that an impairment of spirometric parameters and BHR may be observed in patients with allergic rhinitis alone. Thus, careful evaluation of lower airways should be performed in patients with allergic rhinitis alone.

Adult↗
PubMed2005

ZooMS: a non invasive analysis of global and metameric movement of the lumbar spine.

AIM: The assessment of spine mobility is an important parameter to define its functionality. In the last decades a lot of research has been carried out mainly through radiographic investigations; non invasive methods demonstrated not to be sufficiently accurate, not to allow free movement, not to provide metameric assessment and suitable for everyday clinical practice. The aim of this study is the development of a new experimental non invasive protocol, called Zoom on mobility of the spine (ZooMS) to assess the mobility of lumbar spine, from the 11th thoracic to the sacrum bone and the pelvis, with the possibility of identifying the metameric contribution of each rotation around all the axes correlated to the global movement. METHODS: We developed a dedicated non invasive methodology based on optoelectronic techniques for 3D target recording to be applied to the functional evaluation of the mobility of the lumbar spine in young healthy males. Ten subjects participated in the method validation, performing free rotations (flexion/extension, lateral bending and axial rotation) from standing to the maximum excursion and back. RESULTS: The comparison of the range of motion (RoM) with those presented in literature was satisfactory, although some differences were shown (above all in axial rotation, which however gives the minor contribution to the mobility of the lumbar spine). The validation of the protocol was successful in terms of intraoperator, interoperator and circadian remarking, the 3 factors eventually affecting its repeatability. CONCLUSION: The RoM of the whole lumbar spine and of each functional unit, together with the pattern of movement may so represent an innovative and important aspect in clinical applications.

Adult↗
PubMed2004

Non-antigen specific CD8+ T suppressor lymphocytes.

The homeostasis of peripheral immune system function is maintained by the activity of regulatory lymphocytes. Among these cells, a subset of CD8+CD28- T suppressor lymphocytes has recently been characterized for the capacity to mediate their effects without antigen restriction. These non-antigen-specific CD8+ T suppressor lymphocytes originate from circulating CD8+CD28- T lymphocytes after stimulation with interleukin-2 and interleukin-10. CD8+ suppressor cells inhibit both antigen-specific CD4+ T cell proliferation and cellular cytoxicity through secretion of cytokines such as interferon-gamma, interleukin-6, and interleukin-10. The function of CD8+ suppressor cells is impaired in patients with systemic lupus erythematosus in relapse as well as in patients with systemic sclerosis with disease progression, suggesting the involvement of CD8+ suppressor cells in the pathogenesis of autoimmune diseases. Interestingly, CD8+ suppressor cells have been found among tumor-infiltrating lymphocytes, which could be related to tumor-induced-immunosuppression. Failure to generate CD8+ suppressor cells from the peripheral blood is frequently observed in HIV-infected patients. It remains to be clarified whether this phenomenon is due to depletion and/or functional impairment of this cell subset or to their compartmentalization in peripheral tissues and immunocompetent organs where they could contribute to the induction of immunodeficiency.

Animals↗
PubMed2004

Functional rehabilitation of low back disorders.

Musculoskeletal disorders of which low back pain (LBP) accounts for more than 50% are now the most common cause of chronic incapacity in industrialized countries. The traditional approach in looking for the reason (etiology) for musculoskeletal disorders is to search structural failures but, in most cases, it is difficult to find an explicit reason for back pain. Many scientists now consider spine disorders as multifactorial, bio-psycho-social problems. Pain has clear effects on motor control. Therefore, LBP can also induce changes in neuromuscular control and motor performance, i.e., causing various functional deficits. Another feature, which deserves special consideration with reference to back problems, concerns the numerous psychological factors, which are involved in mediating the relationships between physical impairment, pain and disability. The new scientific knowledge on functional deficits is increasingly being transferred to clinical applications, where the aim is to reverse them with physical rehabilitation. As a result of the recognition of the behavioral (psychological) problems with LBP, psychological, behavioral and educational interventions are commonly combined with the physical rehabilitation for LBP also. Basically, functional rehabilitation includes systematic quantification of both the physical function and psychological factors, which drive the therapeutic process. The exercises used in the functional rehabilitation usually revolve around the treatment of the spine as a functional unit. Thus many programs for functional rehabilitation use rehabilitation equipment (iso-inertial/isokinetic) by properly trained physiotherapists. However, some centers use regular fitness equipment or aerobics-type exercises. Furthermore, some relaxation and ergonomic exercises are typically proposed, and psychological support provided along the treatment. There exists both an outpatient and an inpatient functional rehabilitation approach. They are described in the paper together with the first results obtained in Italy with the outpatient approach.

Journal Article↗
PubMed2004

Experience in Italy in the development and application of clinical guidelines for low back pain.

UNLABELLED: Clinical Guidelines (CG) reflect the up to date scientific knowledge in the treatment of Low Back Pain (LBP). The diffusion of CG and their everyday application by health care professionals is a significant problem. As most CG are developed in English, the concerns are obviously greater in non English-speaking countries. The first CG on LBP by the Quebec Task Force (1987) was introduced in 1990 by the Gruppo di Studio della Scoliosi (GSS). Some studies where planned to verify their everyday application. The first one was carried on in Mantua, and evaluated the assessment of patients by General Practitioners (GPs): there is a clear tendency to over-prescribe examinations in acute cases, while in chronic cases under-prescription is sometimes seen. An educational approach was then proposed through a number of meetings, with fable RESULTS: A third experience verified the help GPs could receive through two different educative interventions such as a booklet and a direct access to a classical Back School. In acute patients a Booklet is useful, while Back School is not; at long term follow-up, chronic cases were significantly reduced only by the Back School approach. Finally, the Abruzzo Study's results on GPs management through computer-assisted evaluation is reported. The second part of the paper deals on the new experiences that are underway on the application of Diagnostic-Therapeutic Pathways (DTP) to Low Back Disorders.

Journal Article↗
PubMed2004

The backpack load in schoolchildren: clinical and social importance, and efficacy of a community-based educational intervention. A prospective controlled cohort study.

AIM: The aims of this paper were: to establish the efficacy of an educational intervention in reducing school backpack weight and, possibly, back pain; to verify the content of backpacks and the social importance of the problem; to confirm existing data in the literature. METHODS DESIGN: controlled prospective educational intervention. SETTING: community. PARTICIPANTS: the entire Year 6 population (402 pupils) of 2 randomly chosen rural school districts of the province of Mantua (Italy); of these, we took 108 (selected according to position in the class register): 82.4% completed the study; 402 parents and 124 teachers entered the study, 77.1% and 37.1% respectively completed it. INTERVENTION: instructive meeting and written material for teachers, and a leaflet for parents on backpack management. MAIN OUTCOME MEASURES: backpack weight and content; back pain; subjective perceptions of backpack load; packing and carrying methods; backpack load: importance, management and education; backpack characteristics. RESULTS: We obtained a statistically significant reduction in the backpack weight in each of the groups (study 11.2%; control 7.9% - not a statistically significant difference); 90.1% of the material carried is necessary. Backpacks are considered a problem by 95.1% of parents, 73% of teachers, and 60.3% of pupils. Backpack weight: 8.75+/-1.26 kg (19.9+/-5.3% of body weight); fatigue during backpack carrying: 72.7%; back pain life prevalence: 58.4%; fatigue during backpack carrying and considering backpacks a problem were associated with back pain (odds ratios 4.4 and 5). CONCLUSIONS: Educational intervention is not the answer to the problem and solutions, like the clear legal limits established for adults, need to be found.

Journal Article↗