To describe a new test to quantitatively evaluate hand function in patients affected by Charcot-Marie-Tooth neuropathy (CMT). The sensor-engineered glove test (SEGT) was applied to CMT patients (N: 26) and compared with a cohort of healthy controls (HC, N: 26). CMT patients were further divided into subjects with clinically normal (group 1) or impaired hand (group 2) function. The SEGT parameters evaluated were touch duration, inter-tapping interval, and movement rate parameters of two different sequences: finger tapping (FT) and index-medium-ring-little (IMRL) performed at self-paced mode (SPM) and maximum velocity (MV). Hand function and strength were assessed by the 9-hole peg test (9HPT) and dynamometry. Disability of patients was measured by the CMT neuropathy score. CMT patients had significantly worst performances at SEGT than controls regarding the rate of execution of both FT (at MV) and IMRL sequences (at SPM and MV). The rate parameter at MV in IMRL sequence showed a significant trend of decreasing in its average between HC (n: 26, rate = 3.08 ± 0.52 Hz), group 1 (n: 9, rate = 2.64 ± 0.66 Hz) and group 2 (n: 17, rate = 2.19 ± 0.45 Hz) (p for trend <0.001). No correlations were found with either 9HPT, dynamometry, electrophysiology, and the CMT neuropathy score. The SEGT test is sensitive to show hand dysfunction in CMT patients, with and without clinically impaired hands.

Purpose To translate and culturally adapt the anterior cruciate ligament-return to sport after injury (ACL-RSI) scale into Italian (ACL-RSI(IT)) and examine and evaluate the psychometric properties of the Italian version in individuals who have undergone anterior cruciate ligament (ACL) reconstruction. Methods The ACL-RSI was forward and back translated, culturally adapted and validated one hundred and twenty nine Italian individuals who had undergone ACL reconstruction (94 males, 35 females; age 28 ± 9 years). All patients completed the translated ACL-RSI, Knee injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee subjective knee form (IKDC), Tampa Scale of Kinesiophobia (TSK) and the 12-item short form health survey (SF-12). We then analysed the internal consistency, reliability and validity of the newly formed ACLRSI (IT). ResultsThe ACL-RSI(IT) showed excellent internal consistency (Cronbach's alpha 0.94) and was signiicantly correlated with the KOOS 'quality of life' (r = 0.61, p < 0.00001), 'symptoms' (r = 0.34, p < 0.00001), 'pain' (r = 0.44, p < 0.00001), and 'sports' (r = 0.40, p < 0.00001) subscales. The ACL-RSI(IT) also correlated signiicantly with the IKDC (r = 0.34, p < 0.001), TSK (r = − 0.48, p < 0.00001) and SF-12 (r = − 0.40, p < 0.0001) scores. ConclusionThe Italian version of the ACL-RSI scale was valid, discriminant, consistent and reliable in patients who had undergone ACL reconstruction. This score could be useful to evaluate the efect of psychological factors on return to sport following ACL surgery. Level of evidence II.

Objective: Robotic surgical systems offer better workplace in order to relieve surgeons from prolonged physical efforts and improve their surgical outcomes. However, robotic surgery could produce musculoskeletal disorders due to the prolonged sitting position of the operator, the fixed position of the console viewer and the movements of the limbs. Until today, no one study has been reported concerning the association between robotics and musculoskeletal pain. The aim of this work was verify the prevalence of musculoskeletal disorders among Italian robotic surgeons. Material and methods: Between July 2011 and April 2012 a modified Standardized Nordic Questionnaire was delivered to thirty-nine Italian robotic centres. Twentytwo surgeons (56%) returned the questionnaires but only seventeen questionnaires (43.5%) were evaluable. Results: Seven surgeons (41.2%) reported musculoskeletal disorders, by since their first use of the robot which significantly persisted during the daily surgical activity (P < 0.001). Regarding the body parts affected, musculoskeletal disorders were mainly reported in the cervical spine (29.4%) and in the upper limbs (23.5%). Six surgeons (35.3%) defined the robotic console as less comfortable or neither comfortable/uncomfortable with a negative influence on their surgical procedures. Conclusions: In spite of some important limitations, our data showed musculoskeletal disorders due to posture discomfort with negative impact on daily surgical activity among robotic surgeons. These aspects could be due to the lack of ergonomic seat and to the fixed position of the console viewer which could have produced an inadequate spinal posture. The evaluation of these postural factors, in particular the development of an integrated and more ergonomic chair, could further improve the comfort feeling of the surgeon at the console and probably his surgical outcomes. SummaryNo conflict of interest declared.

Lower limbs position sense is a complex yet poorly understood mechanism, influenced by many factors. Hence, we investigated the position sense of lower limbs through feet orientation with the use of Immersive Virtual Reality (IVR). Participants had to indicate how they perceived the real orientation of their feet by orientating a virtual representation of the feet that was shown in an IVR scenario. We calculated the angle between the two virtual feet (α-VR) after a high-knee step-in-place task. Simultaneously, we recorded the real angle between the two feet (α-R) (T1). Hence, we assessed whether the acute fatigue impacted the position sense. The same procedure was repeated after inducing muscle fatigue (T2) and after 10 min from T2 (T3). Finally, we also recorded the time needed to confirm the perceived position before and after the acute fatigue protocol. Thirty healthy adults (27.5 ± 3.8: 57% women, 43% men) were immersed in an IVR scenario with a representation of two feet. We found a mean difference between α-VR and α-R of 20.89° [95% CI: 14.67°, 27.10°] in T1, 16.76° [9.57°, 23.94°] in T2, and 16.34° [10.00°, 22.68°] in T3. Participants spent 12.59, 17.50 and 17.95 s confirming the perceived position of their feet at T1, T2, T3, respectively. Participants indicated their feet as forwarding parallel though divergent, showing a mismatch in the perceived position of feet. Fatigue seemed not to have an impact on position sense but delayed the time to accomplish this task.

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