Shock Waves and Therapeutic Exercise in Greater Trochanteric Pain Syndrome: A Prospective Randomized Clinical Trial with Cross-Over.

This study aimed to verify the comparative effectiveness of shock wave therapy versus therapeutic exercise, including the possibility of combining both therapies, in patients who did not respond to the first treatment. A prospective randomized clinical trial was carried out, predicting the possibility of a cross-over between the two treatment options, with patients who did not respond to either treatment. Treatments were, respectively, eccentric therapeutic exercise consisting of 30 min sessions of stretching and strengthening exercises, 5 days a week for 4 weeks (Groups A and D) and Extracorporeal Shock Waves Therapy (ESWT) according to a protocol of three sessions, one per week, each of 2000 pulses at a 4 Hz frequency and administering an energy flux density (EFD) varying between 0.03 mJ/mm2 and 0.17 mJ/mm2 (Groups B and C). Patients were evaluated at baseline (T0), 2 (T1), 4 (T2) and 6 months (T3) after the last session, using the Numeric Rating Scale (NRS), Low Extremity Functional Scale (LEFS) and Roles and Maudsley Scale (RMS). The whole study population demonstrated a progressive clinical reduction in pain according to NRS, a recovery from disability according to LEFS and a perception of recovery according to RMS within 6 months, with no significant differences between the four protocols (exercise; ESWT; exercise + ESWT; and ESWT + exercise). Both therapies are therefore valid options in patients with trochanteritis; the combination of the two therapies could be evaluated for those patients who do not respond to the single treatment.

The Efficacy of Temperature-Controlled High-Energy Polymodal Laser Therapy in Tendinopathy of the Shoulder.

BACKGROUND: Rotator cuff tendinopathy is a common diagnosis among patients with shoulder pain and dysfunction. Laser therapy is recommended for the treatment of this tendon disease due to the possibility of increasing tissue biostimulation. The aim of this study was to investigate the effects of HELT (high-energy laser therapy) in relation to the wavelengths of 650 nm, 810 nm, 980 nm, and 1064 nm administered. METHODS: The study design was prospective and observational. Thirty patients with shoulder tendinopathy were recruited and treated in one of two high-energy laser therapy groups (5 Watt/cm2, 450 Joule, super-pulsed mode). Group A received a high-energy laser therapy protocol with a single wavelength (1064 nm); group B received a high-energy laser therapy program with four wavelengths (650 nm, 810 nm, 980 nm, and 1064 nm). Pain (VAS), function (ASES), and disability (DASH) were monitored at the time of recruitment (T0), 1 month later (T1), and 6 months later (T2). Roles and Maudsley scores were also evaluated at T1 and T2. RESULTS: Both protocols resulted in improvement of pain and in functional and disability recovery at the two times of assessment, without statistically significant differences. In group B, treated with the four wavelengths, a trend emerged, bordering on statistical significance, for a greater reduction in pain. CONCLUSIONS: The high-energy laser proved to be an effective therapy for the treatment of rotator cuff tendinopathy. The possibility of modulating the choice of wavelengths could allow the customization of the protocol in relation to the patient's clinical condition.

Epidemiology of injuries in water board sports: trauma versus overuse injury.

BACKGROUND: Surfing is an increasingly popular sport in the world, but it is not sufficiently investigated in terms of epidemiology of injuries and possible prevention strategies. Moreover, there are different surfing disciplines, with specific characteristics and therefore different potential risks of injury. The aim of this study was to look at the injuries of recreational surfers in an Italian cohort, distinguishing between trauma and overuse lesions and putting in evidence any difference between specific water board sports. METHODS: The design is that of a retrospective observational study. An online survey was distributed to a group of Italian surfers that are members of a surfing association. The survey comprised: demographic data, surfing information such as number of sessions per year and years of experience, and surfing injuries story. The sample size consisted of 126 recreational surfers who practiced four different types of surfing: surf, kitesurf, windsurf and stand-up paddle. RESULTS: The incidence of trauma was significantly higher than the incidence of overuse lesions in all four water board sports evaluated (e.g. in surf, 81% for trauma vs. 27% for overuse, with a difference of 55% , P<0.0001). There was a statistically significant effect of the number of surfing sessions per year both for trauma (W=6.36, P=0.0117) and for total injuries (trauma + overuse; W=4.30, P=0.0381), with a 12-times increased risk for the surfers who performed more than 80 sessions per year. The risk of overuse injuries was higher for those who practice surf for more than seven years (P=0.0193). CONCLUSIONS: Traumas are more frequent than overuse injuries for all the investigated surfing disciplines. The risk of injury increases as the number of annual sessions and the years of practice increase, demonstrating that experience is not a protective factor, whereas higher exposure is certainly a risk factor. New injury prevention strategies should be based on athletic training and preparation programs, traditionally lacking among recreational surfers.

How the Italian Nursing students deal the pandemic Covid-19 condition.

BACKGROUND AND AIM OF THE WORK: Since December 2019, a new infectious disease known as Coronavirus disease (Covid-19) has rapidly spread globally until it has been declared a pandemic by the World Health Organization. At the same time, if we consider the University context, there is little attention paid during basic nursing education to emergency response, and faculty members report feeling poorly prepared to teach students about this topic. The present study aims to investigate how the Covid-19 pandemic condition influenced the psychological well-being of the Italian nursing students. METHODS: An online questionnaire was administered to Italian nursing students which contains two parts: a demographic section and the assessment to the psychological well-being nursing student with the Impact of Event Scale-Revised and the Patient Health Questionnaire-9. RESULTS: Given the emergency health situation from Covid-19, our initial concern was to find a large number of students with difficulties in mentally processing this situation even with problems such as depression, as their future profession is heavily involved in the management of this pandemic. Fortunately our results have denied our initial hypothesis since both the impact management levels of the event, assessed with the IES-R scale, and the depression levels, assessed with the PHQ-9 recorded values ​​that were almost normal. CONCLUSIONS: Nursing students are better able to face the situation since they find themselves in the role of spectators and not in the role of actors in the care of patients with Covid-19. If the training ameliorates psychological well being, therefore, it is necessary to provide and preserve nurses expertise to encourage teaching in nursing degree courses on maxi emergencies to prepare future nurses to face them adequately.