Introduction and objectivesPhysical deformities caused by adolescent idiopathic scoliosis (AIS) coupled with conservative treatment of AIS with orthesis unavoidably impacts on patients' quality of life (QoL). The present study aimed at evaluating the QoL in patients affected by AIS treated with brace. The study also sought to determine the ability of different QoL questionnaires to monitor QoL over the course of treatment.Materials and methodsData were collected in 108 consecutive patients (96 females, 16 males) affected by AIS admitted to the outpatient orthopaedic clinic of the Catholic University of the Sacred Heart in Rome (Italy). Patients were subjected to full-time (i.e., 22 hrs per day) conservative treatment with the progressive action short brace (PASB), the Lyon brace or a combination of PASB + Lyon brace. Three instruments were used for QoL determination: the Scoliosis Research Society 22 (SRS-22), Bad Sobernheim Stress Questionnaire (BSSQ) and the Brace Questionnaire (BrQ).ResultsA significant correlation was detected among the 3 scores (p < 0.001). The BrQ possesses a higher capacity to detect changes in QoL in relation to the patient gender, type of brace, curve severity at baseline and at the completion of treatment, and curve type. Overall, boys displayed a higher QoL than girls. In all 3 questionnaires, higher QoL scores were determined in patients treated with the PASB compared with those using the Lyon brace. QoL scores were significantly correlated with the curve severity. Higher QoL scores were obtained by participants with thoraco-lumbar curves as compared with those with other curves.ConclusionsThe 3 questionnaires are effective in capturing changes in QoL in AIS patients subjected to conservative treatment. However, the BrQ possesses a higher discriminatory capacity compared with the other questionnaires tested. PASB-based treatment is associated with better QoL than the Lyon bracing.

Capacitive and resistive electric transfer (CRET), an endogenous diathermy treatment, has been demonstrated to reduce pain and improve quality of life in numerous orthopedic degenerative and inflammatory problems but not in knee osteoarthritis (KOA). The aim of this prospective randomized controlled trial was to evaluate whether a 2-week program of CRET can reduce pain, stiffness and functional limitations in KOA compared with a sham treatment. Patients with KOA were randomly assigned to a study group (n = 31) or a control one (n = 22). The study group underwent six intermittent CRET applications, whereas the controls underwent a sham protocol without application of energy. The outcome measures were the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) (primary outcome) and the visual analogue scale (VAS) for pain and Medical Research Council Scale (secondary outcomes). All patients were evaluated before treatment (T0), at the end of treatment (T1), and at 1 (T2) and 3 months after treatment (T3). Results showed that CRET significantly improved strength, physical function and pain in patients with KOA. In the study group a reduction in WOMAC and VAS scores was observed at T1, T2, and T3 compared with T0. No significant changes of WOMAC and VAS scores were observed in the control group across all time points. Considering the small number of sessions, low cost and long-term benefits, CRET might be a useful therapeutic option for the conservative management of KOA to reduce pain, stiffness and functional limitation.

Hyperthermia provides short-term improvements in pain and function in patients with mild to moderate carpal tunnel syndrome.

Homotaurine is a natural compound of red algae, which has been demonstrated to have a neuroprotective effect and has been evaluated as a possible therapeutic agent for Alzheimer's disease. This was a single blind, randomized, controlled study to evaluate the safety and efficacy of homotaurine in patients with Parkinson's disease (PD) and cognitive impairment. Patients were evaluated at baseline and 6 months later. Assessments included, the evaluation of: motor and non-motor conditions and complications (Unified Parkinson's Disease Rating Scale, UPDRS); disability and quality of life; depression; excessive daytime sleepiness and fatigue. An extensive neuropsychological tests battery was administered evaluating specific cognitive domains: memory, phonemic verbal fluency, executive functions and selective visual attention. After baseline testing, patients were allocated to one of the two groups: (A) treatment group: patients treated with homotaurine 100 mg; (B) control group: patients not treated with homotaurine. Forty-seven patients were evaluated at baseline, 24 (51 %) completed the study (PD-homotaurine: n = 11; 44 % and PD-controls: n = 13; 59 %); discontinuation rate was similar across subjects (p = 1.0). Intention to treat analyses to evaluate homotaurine safety showed mild side effects (gastrointestinal upsetting) in 3 patients. Per protocol analyses of homotaurine efficacy showed no difference between groups. Within group analyses showed that PD-homotaurine patients had better score at UPDRS-I at the end of the study compared to baseline (p = 0.017) and at Epworth Sleepiness Scale (p = 0.01). No other differences were found. No significant difference arose for the PD-ctrl group. Homotaurine is a safe drug. Our data suggest a beneficial effect of homotaurine on excessive sleepiness. Future studies are encouraged to confirm this promising role of homotaurine in promoting the sleep/awake cycle in patients with PD.