Role of Physiotherapy and Physical Agent Modalities for Musculoskeletal Disorders: Present and Future

A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Biosciences and Bioengineering".

Deadline for manuscript submissions: closed (30 August 2022) | Viewed by 22808

Special Issue Editors


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Guest Editor
Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", 88100 Catanzaro, Italy
Interests: rehabilitation; orthopaedics; sports medicine; spine; physical exercise; scoliosis; biomechanics; osteoarthritis; gait; musculoskeletal disorders
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", 88100 Catanzaro, Italy
Interests: rehabilitation; sports medicine; injuries; physical exercise; pain management; physical therapy; biomechanics; musculoskeletal disorders; sports sciences; spine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Musculoskeletal disorders are recognized as the second most common reason for disability worldwide. Conventional pain management approaches are focused on pharmacological interventions; however, functional outcomes of chronic pain have often been underestimated and undertreated. In this context, the role of physiotherapy and physical agent modalities (PAMs) dates back to the early days of the development of the physical and rehabilitation medicine field. PAMs are managed by physiatrists and physical therapists to deliver a desired therapeutic effect and are gaining growing attention in the domain of research, not only in terms of functional recovery but also in recovering from musculoskeletal pain. In this outline, we center the benefits of PAMs, including technological advances could play a key role in musculoskeletal rehabilitation. Thus, understanding the effects, contraindications, and precautions of each modality is crucial for proper use. Starting from clinical evidence, physiotherapy and PAMs might be useful to counteract musculoskeletal pain disorders. Therefore, this Special Issue aims to provide a broad and clear overview of PAMs in musculoskeletal rehabilitation. 

Prof. Dr. Alessandro de Sire
Prof. Dr. Antonio Ammendolia
Dr. Nicola Marotta
Guest Editors

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Keywords

  • cryotherapy
  • deep heat
  • diathermy
  • electrotherapy
  • extracorporeal shock wave therapy
  • hydrotherapy
  • infrared
  • interferential current
  • laser therapy
  • microwave
  • moxibustion
  • oxygen-ozone therapy
  • physical agent modalities
  • physical therapy
  • transcutaneous electrical nerve stimulation
  • ultrasound
  • vibration therapy

Published Papers (7 papers)

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Editorial

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4 pages, 200 KiB  
Editorial
Role of Physiotherapy and Physical Agent Modalities for Musculoskeletal Disorders: Present and Future
by Nicola Marotta, Alessandro de Sire and Antonio Ammendolia
Appl. Sci. 2023, 13(11), 6461; https://doi.org/10.3390/app13116461 - 25 May 2023
Cited by 3 | Viewed by 1182
Abstract
Musculoskeletal disorders are believed to be the second most frequent cause of disability worldwide [...] Full article

Research

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13 pages, 2211 KiB  
Article
Effectiveness of Decision Support to Treat Complex Regional Pain Syndrome
by Larisa Ryskalin, Giulia Ghelarducci, Chiara Marinelli, Gabriele Morucci, Paola Soldani, Nicolò Bertozzi, Paolo Annoscia, Andrea Poggetti and Marco Gesi
Appl. Sci. 2022, 12(18), 8979; https://doi.org/10.3390/app12188979 - 07 Sep 2022
Cited by 3 | Viewed by 1576
Abstract
Background: Complex regional pain syndrome (CRPS) type 1 is a rare but disabling pain condition, usually involving distal extremities such as the wrist, hand, ankle, and foot due to either direct or indirect traumas. CRPS type 1 is characterized by a complex set [...] Read more.
Background: Complex regional pain syndrome (CRPS) type 1 is a rare but disabling pain condition, usually involving distal extremities such as the wrist, hand, ankle, and foot due to either direct or indirect traumas. CRPS type 1 is characterized by a complex set of symptoms where no correlation can be identified between the severity of the initial injury and the ensuing painful syndrome. Over the years, numerous treatment strategies have been proposed for CRPS management, but therapies remain controversial. At present, no successful therapeutic intervention exists for this condition. The aim of the present study was to propose and assess the effectiveness of a rehabilitative treatment algorithm for CRPS, which is actually in use at our institution. Methods: We retrospectively reviewed all the patients that underwent physical rehabilitative treatment algorithm for hand CRPS between 2011 and 2017 at our Institution. Results: All the parameters taken into consideration, namely the Purdue Pegboard Test (PPT), Disability of the Arm, Shoulder and Hand (DASH), Visual Analog Scale (VAS), as well hand edema, were significantly improved at the end of the rehabilitation protocol. Conclusions: The results obtained in the present study demonstrated that our rehabilitation protocol was able to achieve substantial improvement in pain and quality of life scores. Thus, an early and skillful rehabilitation intervention is of paramount importance for CPRS type 1 management to achieve a stable and optimal functional recovery while preventing the onset of deformities. Full article
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12 pages, 993 KiB  
Article
Effects of Radial Extracorporeal Shock Wave Therapy in Reducing Pain in Patients with Temporomandibular Disorders: A Pilot Randomized Controlled Trial
by Nicola Marotta, Martina Ferrillo, Andrea Demeco, Vera Drago Ferrante, Maria Teresa Inzitari, Raffaello Pellegrino, Ilaria Pino, Ilaria Russo, Alessandro de Sire and Antonio Ammendolia
Appl. Sci. 2022, 12(8), 3821; https://doi.org/10.3390/app12083821 - 10 Apr 2022
Cited by 29 | Viewed by 3743
Abstract
Temporomandibular disorders (TMD) are primarily characterized by pain as well as issues concerning the proper functioning of individual elements of the stomatognathic system. The aim of the study was to assess the safety and efficacy of physical exercise, with or without radial Extracorporeal [...] Read more.
Temporomandibular disorders (TMD) are primarily characterized by pain as well as issues concerning the proper functioning of individual elements of the stomatognathic system. The aim of the study was to assess the safety and efficacy of physical exercise, with or without radial Extracorporeal Shock Wave Therapy (rESWT), in patients with TMD. Eligible patients were adults (≥18 years) with diagnosed myofascial pain with or without mouth opening limitation (Group Ia, Ib) based on the Diagnostic Criteria for TMD (DC/TMD). Enrolled patients (n = 15) were randomly assigned 1:1 to receive physical exercise combined with rESWT (n = 8) or sham rESWT (n = 7) for four weeks. The primary endpoint was the pain intensity measured by a visual analogue scale (VAS). The secondary endpoints were muscle activity and function assessed through the surface electromyography evaluation of the anterior temporalis and the masseter muscles. The rESWT group (mean age: 28.50 ± 8.85 years) showed a statistically significant pain reduction (VAS Right side: ΔT0-T1 MD = −3.00; p = 0.023, Left side: ΔT0-T1, MD = 3.57, p = 0.021), whereas patients in the sham WBV group (mean age: 30.71 ± 8.98 years), did not reach statistical significance (VAS: Right side: ΔT0-T1 MD = 1.00, p = 0.155; Left side: ΔT0-T1 MD = 1.25 SE = 0.25, p = 0.094). Concurrently, muscle activity and performance significantly improved in the active rESWT group, with an improvement in the percentage of the overlapping coefficient (POC) compared to the control group. No dropouts and no side effects were recorded. Taken together, the findings of this pilot RCT suggested that rESWT combined with physical therapy could be effective in relieving pain and improving function in muscle-related TMD patients. Full article
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Review

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16 pages, 8506 KiB  
Review
Clinical Impact of Balneotherapy and Therapeutic Exercise in Rheumatic Diseases: A Lexical Analysis and Scoping Review
by Lucrezia Tognolo, Daniele Coraci, Antonella Fioravanti, Sara Tenti, Anna Scanu, Giacomo Magro, Maria Chiara Maccarone and Stefano Masiero
Appl. Sci. 2022, 12(15), 7379; https://doi.org/10.3390/app12157379 - 22 Jul 2022
Cited by 11 | Viewed by 1762
Abstract
Objective: To review the evidence regarding the clinical effect of spa therapy for rheumatic diseases, with particular attention given to association protocols between balneotherapy and rehabilitation interventions, and to support the literature research and studies’ selection with lexical analysis. Methods: A lexical analysis [...] Read more.
Objective: To review the evidence regarding the clinical effect of spa therapy for rheumatic diseases, with particular attention given to association protocols between balneotherapy and rehabilitation interventions, and to support the literature research and studies’ selection with lexical analysis. Methods: A lexical analysis was performed considering a list of words representing diseases and outcome measures linked to the theme studied in our review. Then, two independent researchers conducted a literature search on PubMed using the string employed for lexical analysis, including Randomized Controlled Trials regarding spa therapy’s clinical effects on patients affected by rheumatic diseases published in the last 30 years. After the exclusion of works that did not meet the eligibility criteria, 14 studies were included in the final scoping review. Results: Spa therapy has shown a favourable effect on pain, function and quality of life in patients with Osteoarthritis, Fibromyalgia and Rheumatoid Arthritis. Different treatment modalities and types of water have demonstrated beneficial long-term clinical improvement. Furthermore, the association between thermal therapy and rehabilitation treatments has shown better clinical outcomes, probably due to the synergistic effect between the peculiar properties of the thermal waters and the therapeutic exercise program, if conducted in the same context. Conclusions: The combination of balneotherapy and rehabilitative interventions seems to be effective in ameliorating several outcomes in patients with rheumatic diseases. However, due to the wide variety of methodologies and interventions employed, these findings need to be further investigated. The lexical analysis should represent an auxiliary support for an extensive evaluation of scientific literature. Full article
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18 pages, 576 KiB  
Review
Whole-Body Cryostimulation in Fibromyalgia: A Scoping Review
by Jacopo Maria Fontana, Michele Gobbi, Paolo Piterà, Emanuele Maria Giusti and Paolo Capodaglio
Appl. Sci. 2022, 12(9), 4794; https://doi.org/10.3390/app12094794 - 09 May 2022
Cited by 4 | Viewed by 2176
Abstract
Currently, all available therapies for the control and management of fibromyalgia (FM) are mostly focused on relieving patients’ symptoms and improving their quality of life. The purpose of this review is to provide an up-to-date overview of the evidence supporting the beneficial effects [...] Read more.
Currently, all available therapies for the control and management of fibromyalgia (FM) are mostly focused on relieving patients’ symptoms and improving their quality of life. The purpose of this review is to provide an up-to-date overview of the evidence supporting the beneficial effects of whole-body cryostimulation (WBC) in patients with FM and evidence-based guidance on the possible adjuvant use of WBC in the treatment of FM. We searched the most recent literature by retrieving 10 eligible studies, 4 of which were abstracts only, from a total of 263 records. Thermal stress caused by cryostimulation induces an analgesic effect, improving pain, redox balance, and inflammatory symptoms in an exercise-mimicking fashion. In addition, it reduces the feeling of fatigue, improves mood, and reduces mental health deterioration with positive consequences on depressive states and improved sleep quality. Although the studies included in this review are not of sufficient quality and quantity to draw definitive conclusions about the effectiveness of WBC in FM, initial evidence indicates WBC as a promising add-on option in the multidisciplinary treatment of FM, due to its rapid action and high patients’ compliance. The application of WBC protocols has the potential to expand therapeutic options for the treatment of FM and related disorders; however, larger, high-quality primary studies are still needed. Full article
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15 pages, 746 KiB  
Review
The Efficacy of Instrumental Physical Therapy through Extracorporeal Shock Wave Therapy in the Treatment of Plantar Fasciitis: An Umbrella Review
by Francesco Agostini, Massimiliano Mangone, Nikolaos Finamore, Marta Di Nicola, Federico Papa, Giuliano Alessio, Luigi Vetrugno, Angelo Chiaramonte, Giorgia Cimbri, Andrea Bernetti, Marco Paoloni and Teresa Paolucci
Appl. Sci. 2022, 12(6), 2841; https://doi.org/10.3390/app12062841 - 10 Mar 2022
Cited by 6 | Viewed by 4058
Abstract
(1) Background: Plantar fasciitis (PF) is the most common cause of heel pain in adults. Extracorporeal shockwave therapy (ESWT) is a minimally invasive treatments commonly used for treating PF. Our aim is to provide a complete overview of which treatments have been compared [...] Read more.
(1) Background: Plantar fasciitis (PF) is the most common cause of heel pain in adults. Extracorporeal shockwave therapy (ESWT) is a minimally invasive treatments commonly used for treating PF. Our aim is to provide a complete overview of which treatments have been compared to ESWT, with a focus on the modalities that have been used. (2) Methods: A thorough search of the literature was performed on Medline via Pubmed, Cochrane Database of Systematic Reviews (CDSR) of the Cochrane Library and Physiotherapy Evidence Databases (PEDro) up to 18 November 2021. In the study were included only systematic reviews and meta-analysis in English language, published from 2010 to date. (3) Results: A total of 14 systematic reviews and meta-analysis were included in the umbrella review. A total of eight studies compared the efficacy of ESWT treatment with placebo, three studies compared ESWT with another therapy (two studies compared ESWT and corticosteroids, one study ESWT and ultrasound therapy), and three studies had more than one comparison. (4) Conclusions: When compared to placebo, ESWT demonstrated to be effective. More randomized trials with specific comparisons between different types and intensity of SW are needed to obtain more precise information on SW effectiveness. Full article
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Other

6 pages, 1215 KiB  
Case Report
Treatment of Medial Collateral Ligament Injuries of the Knee with Focused Extracorporeal Shockwave Therapy: A Case Report
by Lucrezia Tognolo, Daniele Coraci, Andrea Bernini and Stefano Masiero
Appl. Sci. 2022, 12(1), 234; https://doi.org/10.3390/app12010234 - 27 Dec 2021
Cited by 1 | Viewed by 6393
Abstract
Medial collateral ligament (MCL) injuries are the most frequent ligamentous injuries of the knee. Focused extracorporeal shock wave therapy (f-ESWT) is progressively expanding its field of application to many musculoskeletal pathologies. Although there is evidence surrounding the efficacy of f-ESWT in tendinopathies, no [...] Read more.
Medial collateral ligament (MCL) injuries are the most frequent ligamentous injuries of the knee. Focused extracorporeal shock wave therapy (f-ESWT) is progressively expanding its field of application to many musculoskeletal pathologies. Although there is evidence surrounding the efficacy of f-ESWT in tendinopathies, no studies have described the usefulness of ultrasound (US)-guided f-ESWT in the treatment of ligament injuries. Herein, we report a case of a MCL injury treated with f-ESWT. Moreover, our case shows the importance of using ultrasonography in determining the effect of treatment. A 60-year-old man with a focal area of lesion in the deep fibers underwent 4 weekly sessions of US-guided f-ESWT to the injured ligament area. His pain decreased to a visual analog scale (VAS) of 3 at the end of the treatment and was completely resolved at the 1-month follow-up visit, with these results being maintained at 4-month follow-up. The US examination showed an initial deposition of “newly formed tissue” at the site of previous injury of the proximal MCL insertion, and a reduction in MCL thickness together with an improvement in echostructure. Based on this result, we speculate that non-surgical ligament injuries could be a new indication for f-ESWT. However, further investigation on the effects of f-ESWT for ligament injuries is needed. Full article
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