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Article: Improving Adherence to a Home Rehabilitation Plan for Chronic Neck Pain through Immersive Virtual Reality: A Case Report.

Cioeta, Matteo / Pournajaf, Sanaz / Goffredo, Michela / Giovannico, Giuseppe / Franceschini, Marco

2023 Volume 12, Issue 5

Abstract: Idiopathic chronic neck pain is a highly disabling musculoskeletal condition. Immersive virtual reality shows a promising efficacy in the treatment of chronic cervical pain through the mechanism of distraction from the pain. This case report describes ... ...

Abstract	Idiopathic chronic neck pain is a highly disabling musculoskeletal condition. Immersive virtual reality shows a promising efficacy in the treatment of chronic cervical pain through the mechanism of distraction from the pain. This case report describes the management of C.F., a fifty-seven-year-old woman, who suffered from neck pain for fifteen months. She had already undergone a cycle of physiotherapy treatments including education, manual therapy, and exercises, following international guidelines. The patient's poor compliance did not allow adherence to the exercise's prescription. Home exercise training through virtual reality was therefore proposed to the patient to improve her adherence to the treatment plan. The personalization of the treatment allowed the patient to resolve in a short time period her problem and return to live with her family peacefully.
Language	English
Publishing date	2023-02-28
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12051926
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Article ; Online: The Minimal Clinically Important Difference Changes Greatly Based on the Different Calculation Methods: Response.

Franceschini, Marco / Boffa, Angelo / Pignotti, Elettra / Andriolo, Luca / Zaffagnini, Stefano / Filardo, Giuseppe

The American journal of sports medicine

2023 Volume 51, Issue 13, Page(s) NP55–NP56

MeSH term(s)	Humans ; Minimal Clinically Important Difference ; Quality of Life
Language	English
Publishing date	2023-11-02
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	197482-8
ISSN	1552-3365 ; 0363-5465
ISSN (online)	1552-3365
ISSN	0363-5465
DOI	10.1177/03635465231193411
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Article ; Online: The Minimal Clinically Important Difference: Response.

Franceschini, Marco / Boffa, Angelo / Pignotti, Elettra / Andriolo, Luca / Zaffagnini, Stefano / Filardo, Giuseppe

The American journal of sports medicine

2023 Volume 51, Issue 13, Page(s) NP52

MeSH term(s)	Humans ; Minimal Clinically Important Difference
Language	English
Publishing date	2023-11-02
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	197482-8
ISSN	1552-3365 ; 0363-5465
ISSN (online)	1552-3365
ISSN	0363-5465
DOI	10.1177/03635465231189222
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Article ; Online: Medial meniscal lesions increase antero-posterior laxity in knees with anterior cruciate ligament injury.

Franceschini, Marco / Reale, Davide / Boffa, Angelo / Andriolo, Luca / Tortorella, Fabio / Grassi, Alberto / Filardo, Giuseppe / Zaffagnini, Stefano

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA

2024 Volume 32, Issue 1, Page(s) 135–142

Abstract: Purpose: The aim of this study was to quantify the impact of concomitant meniscal lesions on knee laxity using a triaxial accelerometer in a large population of patients affected by anterior cruciate ligament (ACL) injury.: Methods: A total of 326 ... ...

Abstract	Purpose: The aim of this study was to quantify the impact of concomitant meniscal lesions on knee laxity using a triaxial accelerometer in a large population of patients affected by anterior cruciate ligament (ACL) injury. Methods: A total of 326 consecutive patients (261 men and 65 women, mean age 31.3 ± 11.3) undergoing primary ACL reconstruction, were preoperatively evaluated through Lachman and pivot shift tests using a triaxial accelerometer to quantify knee laxity. An analysis based on the presence of meniscal tears assessed during surgery was performed to evaluate the impact of meniscal lesions on knee laxity. Results: The anterior tibial translation (Lachman test) presented significantly higher values in patients with medial meniscal lesions (7.3 ± 1.7 mm, p = 0.049) and both medial and lateral meniscal lesions (7.7 ± 1.6 mm, p = 0.001) compared to patients without concomitant meniscal lesions (6.7 ± 1.3 mm). Moreover, patients with both medial and lateral meniscal lesions presented significantly higher values of anterior tibial translation compared to patients with lateral meniscal lesions (p = 0.049). No statistically significant differences were found between the groups in terms of tibial acceleration (pivot shift test). Conclusion: This study demonstrated that the contribution of concomitant meniscal lesions to knee laxity can be objectively quantified using a triaxial accelerometer in ACL-injured knees. In particular, medial meniscus lesions, alone or in association with lateral meniscus lesions, determine a significant increase of the anterior tibial translation compared to knees without meniscus tears. Level of evidence: Level IV.
MeSH term(s)	Male ; Humans ; Female ; Young Adult ; Adult ; Anterior Cruciate Ligament Injuries/complications ; Anterior Cruciate Ligament Injuries/diagnosis ; Anterior Cruciate Ligament Injuries/surgery ; Joint Instability/etiology ; Joint Instability/complications ; Knee Joint/surgery ; Menisci, Tibial/surgery ; Tibia/surgery
Language	English
Publishing date	2024-01-05
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1159064-6
ISSN	1433-7347 ; 0942-2056
ISSN (online)	1433-7347
ISSN	0942-2056
DOI	10.1002/ksa.12036
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Article ; Online: The Minimal Clinically Important Difference Changes Greatly Based on the Different Calculation Methods.

Franceschini, Marco / Boffa, Angelo / Pignotti, Elettra / Andriolo, Luca / Zaffagnini, Stefano / Filardo, Giuseppe

The American journal of sports medicine

2023 Volume 51, Issue 4, Page(s) 1067–1073

Abstract: Background: The minimal clinically important difference (MCID) for patient-reported outcome measures (PROMs) expresses both the extent of the improvement and the value that patients place on it. MCID use is becoming increasingly widespread to understand ...

Abstract	Background: The minimal clinically important difference (MCID) for patient-reported outcome measures (PROMs) expresses both the extent of the improvement and the value that patients place on it. MCID use is becoming increasingly widespread to understand the clinical efficacy of a given treatment, define guidelines for clinical practice, and properly interpret trial results. However, there is still large heterogeneity in the different calculation methods. Purpose: To calculate and compare the MCID threshold values of a PROM by applying various methods and analyzing their effect on the study results interpretation. Study design: Cohort study (Diagnosis); Level of evidence, 3. Methods: The data set used to investigate the different MCID calculation approaches was based on a database of 312 patients affected by knee osteoarthritis and treated with intra-articular platelet-rich plasma. MCID values were calculated on the International Knee Documentation Committee (IKDC) subjective score at 6 months using 2 approaches: 9 methodologies referred to an anchor-based approach and 8 methodologies to a distribution-based approach. The obtained threshold values were applied to the same series of patients to understand the effect of using different MCID methods in evaluating patient response to treatment. Results: The different methods employed led to MCID values ranging from 1.8 to 25.9 points. The anchor-based methods ranged from 6.3 to 25.9, while the distribution-based ones were from 1.8 to 13.8 points, showing a 4.1× variation of the MCID values within the anchor-based methods and a 7.6× variation within the distribution-based methods. The percentage of patients who reached the MCID for the IKDC subjective score changed based on the specific calculation method used. Among the anchor-based methods, this value varied from 24.0% to 66.0%, while among the distribution-based methods, the percentage of patients reaching the MCID varied from 44.6% to 75.9%. Conclusion: This study proved that different MCID calculation methods lead to highly heterogeneous values, which significantly affect the percentage of patients achieving the MCID in a given population. The wide-ranging thresholds obtained with the different methodologies make it difficult to evaluate the real effectiveness of a given treatment questioning the usefulness of MCID, as currently available, in the clinical research.
MeSH term(s)	Humans ; Minimal Clinically Important Difference ; Cohort Studies ; Treatment Outcome ; Knee Joint ; Osteoarthritis, Knee/diagnosis ; Osteoarthritis, Knee/therapy
Language	English
Publishing date	2023-02-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	197482-8
ISSN	1552-3365 ; 0363-5465
ISSN (online)	1552-3365
ISSN	0363-5465
DOI	10.1177/03635465231152484
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Article ; Online: Causes and length of stay of readmission among individuals with traumatic spinal cord injury: a prospective observational cohort study.

Franceschini, Marco / Cecconi, Lorenzo / Bonavita, Jacopo / Pournajaf, Sanaz / Ferro, Salvatore / Pagliacci, Maria Cristina

Spinal cord

2023 Volume 61, Issue 7, Page(s) 383–390

Abstract: Background: Secondary conditions may reduce function and participation in individuals with chronic Spinal Cord Injury (SCI). The knowledge of reasons for readmission to the hospital may be enlightening to prevent them and remodel the health services.: ...

Abstract	Background: Secondary conditions may reduce function and participation in individuals with chronic Spinal Cord Injury (SCI). The knowledge of reasons for readmission to the hospital may be enlightening to prevent them and remodel the health services. Study design: Multicenter prospective observational study of all consecutive readmissions of persons with SCI after rehabilitation completion. Objectives: To explore the characteristics of individuals with SCI readmitted to the hospital, the reasons for readmissions and the burden on hospitalization in terms of length of stay (LoS) for different conditions. Setting: 31 Italian specialized SCI centers. Methods: Data on people with traumatic SCI readmitted to SCI centers were recorded about: age, sex, SCI level and severity group, geographical origin, readmission causes, clinical interventions during hospitalization, LoS and discharge destination. Linear and multiple logistic regression analyses were performed considering LoS (days) as dependent variable for correlations with independent variables. All tests were two-sided. Results: Among 1039 persons with traumatic SCI enrolled (mean age 46, males 85%, tetraplegia 43%), 59.09% of the readmissions were caused by urological problems, 39.74% by pressure injury and 35.41% by spasticity (68% readmitted for ≥2 causes, associated with longer LoS). The mean LoS was 48 days: pressure injury, rehabilitative needs, sexual, bowel, and pain problems were associated with longer and urological problems with shorter LoS. People from the South of the country were frequently (68%) readmitted to the northern centers. Conclusions: Urological problems, pressure injury and spasticity were the most frequent causes of re-hospitalization in individuals with traumatic SCI. The migration trend seeking SCI-specific treatments suggests geographic areas to which health care organizations need to pay more attention.
MeSH term(s)	Male ; Humans ; Middle Aged ; Length of Stay ; Patient Readmission ; Spinal Cord Injuries/complications ; Spinal Cord Injuries/epidemiology ; Spinal Cord Injuries/therapy ; Pressure Ulcer/etiology ; Prospective Studies
Language	English
Publishing date	2023-02-25
Publishing country	England
Document type	Observational Study ; Multicenter Study ; Journal Article
ZDB-ID	1316161-1
ISSN	1476-5624 ; 1362-4393
ISSN (online)	1476-5624
ISSN	1362-4393
DOI	10.1038/s41393-023-00874-6
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Article ; Online: The 50 most-cited clinical articles in cartilage surgery research: a bibliometric analysis.

Franceschini, Marco / Boffa, Angelo / Andriolo, Luca / Di Martino, Alessandro / Zaffagnini, Stefano / Filardo, Giuseppe

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA

2022 Volume 30, Issue 6, Page(s) 1901–1914

Abstract: Purpose: Articular cartilage lesions remain a challenge for orthopedic surgeons. The identification of the most important articles can help identifying the most influential techniques of the past, the current prevalent focus, and emerging strategies. ... ...

Abstract	Purpose: Articular cartilage lesions remain a challenge for orthopedic surgeons. The identification of the most important articles can help identifying the most influential techniques of the past, the current prevalent focus, and emerging strategies. The aim of this study was to identify milestones and trends in cartilage research. Methods: This study is a bibliometric analysis based on published articles. All citation count data included in the "Scopus database" were used to identify eligible studies up to December 2020. The 50 most-cited articles on cartilage surgery were ranked based on the citation count and analyzed regarding citation density and quality (Coleman score and RoB 2.0 tool). A further search was performed to identify the most promising clinical studies among the latest publications on cartilage surgery. Results: Different kinds of cartilage treatments were investigated in the 50 most-cited clinical articles. Regenerative techniques with chondrocytes were the most reported with a total of 23 articles, followed by microfracture technique in 17 articles and mosaicplasty or osteochondral autograft transplantation (OAT) in 11. Forty-five articles focused on the knee. A higher citation density was found in the most recent articles (p = 0.004). The study of the most promising landmarks of the most recent articles showed new cell-free or tissue engineering-based procedures and an overall increasing quality of the published studies. Conclusion: This bibliometric analysis documented an increasing interest in cartilage surgery, with efforts toward high-quality studies. Over the years, the focus switched from reconstructive toward regenerative techniques, with emerging options including cell-free and tissue-engineering strategies to restore the cartilage surface. Level of evidence: IV.
MeSH term(s)	Bibliometrics ; Cartilage, Articular/surgery ; Chondrocytes/transplantation ; Humans ; Tissue Engineering ; Transplantation, Autologous
Language	English
Publishing date	2022-01-16
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1159064-6
ISSN	1433-7347 ; 0942-2056
ISSN (online)	1433-7347
ISSN	0942-2056
DOI	10.1007/s00167-021-06834-y
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Article ; Online: Which items of the modified Barthel Index can predict functional independence at discharge from inpatient rehabilitation? A secondary analysis retrospective cohort study.

Pournajaf, Sanaz / Pellicciari, Leonardo / Proietti, Stefania / Agostini, Francesco / Gabbani, Debora / Goffredo, Michela / Damiani, Carlo / Franceschini, Marco

International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation

2023 Volume 46, Issue 3, Page(s) 230–237

Abstract: The modified Barthel Index (mBI) is a well-established patient-centered outcome measure commonly administrated in rehabilitation settings to evaluate the functional status of patients at admission and discharge. This study aimed to detect which mBI items ...

Abstract	The modified Barthel Index (mBI) is a well-established patient-centered outcome measure commonly administrated in rehabilitation settings to evaluate the functional status of patients at admission and discharge. This study aimed to detect which mBI items collected on admission can predict the total mBI at discharge from first inpatient rehabilitation in large cohorts of orthopedic (n = 1864) and neurological (n = 1684) patients. Demographic and clinical data (time since the acute event 11.8 ± 17.2 days) at patients' admission and mBI at discharge were collected. Univariate and multiple binary logistic regressions were performed to study the associations between independent and dependent variables for each cohort separately. In neurological patients, the shorter time between the acute event and rehabilitation admission, shorter length of stay, and being independent with feeding, personal hygiene, bladder, and transfers were independently associated with higher total mBI at discharge (R 2 = 0.636). In orthopedic patients, age, the shorter time between the acute event and rehabilitation admission, shorter length of stay, and being independent with personal hygiene, dressing, and bladder were independently associated with higher total mBI at discharge (R 2 = 0.622). Our results showed that different activities in neurological (i.e. feeding, personal hygiene, bladder, and transfer) and orthopedic sample (i.e. personal hygiene, dressing, and bladder) are positively associated with better function (measured by mBI) at the discharge. Clinicians have to take into account these predictors of functionality when they plan an appropriate rehabilitation treatment.
MeSH term(s)	Humans ; Patient Discharge ; Functional Status ; Retrospective Studies ; Inpatients ; Hospitalization ; Length of Stay ; Treatment Outcome ; Recovery of Function
Language	English
Publishing date	2023-06-16
Publishing country	England
Document type	Journal Article
ZDB-ID	533323-4
ISSN	1473-5660 ; 0342-5282
ISSN (online)	1473-5660
ISSN	0342-5282
DOI	10.1097/MRR.0000000000000584
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Article ; Online: Biological intra-articular augmentation for osteotomy in knee osteoarthritis: strategies and results : A systematic review of the literature from the ESSKA Orthobiologics Initiative.

Reale, Davide / Feltri, Pietro / Franceschini, Marco / de Girolamo, Laura / Laver, Lior / Magalon, Jeremy / Sanchez, Mikel / Tischer, Thomas / Filardo, Giuseppe

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA

2023 Volume 31, Issue 10, Page(s) 4327–4346

Abstract: Purpose: To assess whether there is evidence supporting the use of augmentation strategies, either cartilage surgical procedures or injective orthobiologic options, to improve the results of osteotomies in knees with osteoarthritis (OA).: Methods: A ... ...

Abstract	Purpose: To assess whether there is evidence supporting the use of augmentation strategies, either cartilage surgical procedures or injective orthobiologic options, to improve the results of osteotomies in knees with osteoarthritis (OA). Methods: A systematic review of the literature was performed on the PubMed, Web of Science and the Cochrane databases in January 2023 on osteotomies around the knee associated with augmentation strategies (either cartilage surgical procedures or injective orthobiologic options), reporting clinical, radiological, or second-look/histological outcomes at any follow-up. The methodological quality of the included studies was assessed with the Coleman Methodology Score (CMS). Results: Out of the 7650 records identified from the databases, 42 articles were included for a total of 3580 patients and 3609 knees treated; 33 articles focused on surgical treatments and 9 on injective treatments performed in association with knee osteotomy. Out of the 17 comparative studies with surgical augmentation, only 1 showed a significant clinical benefit of an augmentation procedure with a regenerative approach. Overall, other studies showed no differences with reparative techniques and even detrimental outcomes with microfractures. Regarding injective procedures, viscosupplementation showed no improvement, while the use of platelet-rich plasma or cell-based products derived from both bone marrow and adipose tissue showed overall positive tissue changes which translated into a clinical benefit. The mean modified CMS score was 60.0 ± 12.1. Conclusion: There is no evidence to support the effectiveness of cartilage surgical treatments combined with osteotomies in terms of pain relief and functional recovery of patients affected by OA in misaligned joints. Orthobiologic injective treatments targeting the whole joint environment showed promising findings. However, overall the available literature presents a limited quality with only few heterogeneous studies investigating each treatment option. This ORBIT systematic analysis will help surgeons to choose their therapeutic strategy according to the available evidence, and to plan further and better studies to optimize biologic intra-articular osteotomy augmentation. Level of evidence: Level IV.
MeSH term(s)	Humans ; Osteoarthritis, Knee/surgery ; Injections, Intra-Articular ; Knee Joint/surgery ; Cartilage ; Osteotomy/methods ; Treatment Outcome
Language	English
Publishing date	2023-06-18
Publishing country	Germany
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	1159064-6
ISSN	1433-7347 ; 0942-2056
ISSN (online)	1433-7347
ISSN	0942-2056
DOI	10.1007/s00167-023-07469-x
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Article: Retrospective Robot-Measured Upper Limb Kinematic Data From Stroke Patients Are Novel Biomarkers.

Goffredo, Michela / Pournajaf, Sanaz / Proietti, Stefania / Gison, Annalisa / Posteraro, Federico / Franceschini, Marco

Frontiers in neurology

2021 Volume 12, Page(s) 803901

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2021-12-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2021.803901
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