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      REAC neurobiological treatments in acute post-traumatic knee medial collateral ligament lesion

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          Abstract

          Objective

          Physical traumas can lead to unconscious neuropsychical alterations, which can compromise rehabilitation result and functional recovery. Aim of this interventional study is to verify if neurobiological Radio Electric Asymmetric Conveyer (REAC) treatments Neuro Postural Optimization (NPO) and Tissue Optimization (TO) are able respectively to improve neuro psychomotor strategies and facilitate recovery process in medial collateral ligaments (MCL) lesions of the knee.

          Patients and methods

          45 healthy subjects, 32 males and 13 females, with knee MCL lesion, diagnosed with MRI or ultrasound. Within 4 days after the trauma, subjects were clinically evaluated (T0), both through medical and subjective assessments. Clinical evaluation was repeated after the REAC NPO treatment (T1) and at the end of 18 REAC TO treatments (T2) and at the 30 days follow-up (T3).

          Results

          In comparison with the results commonly found in clinical practice, all REAC treated patients recovered much faster. They reported functional recovery, pain relief and joint stability, regardless of the severity of the lesion.

          Conclusion

          The combined use of REAC NPO and TO can envisage a new rehabilitative approach, which aims not only at recovering the outcomes of the physical trauma, but also at improving the neuropsychical state that can condition the rehabilitation result.

          Abstract

          Health Sciences; Musculoskeletal System; Behavioral Medicine; Evidence-Based Medicine; Clinical Research; Knee; Medial Collateral Ligament; Functional Recovery; Psychomotor Performance

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          Most cited references38

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          The Theory and Neuroscience of Cerebellar Cognition

          Cerebellar neuroscience has undergone a paradigm shift. The theories of the universal cerebellar transform and dysmetria of thought and the principles of organization of cerebral cortical connections, together with neuroanatomical, brain imaging, and clinical observations, have recontextualized the cerebellum as a critical node in the distributed neural circuits subserving behavior. The framework for cerebellar cognition stems from the identification of three cognitive representations in the posterior lobe, which are interconnected with cerebral association areas and distinct from the primary and secondary cerebellar sensorimotor representations linked with the spinal cord and cerebral motor areas. Lesions of the anterior lobe primary sensorimotor representations produce dysmetria of movement, the cerebellar motor syndrome. Lesions of the posterior lobe cognitive-emotional cerebellum produce dysmetria of thought and emotion, the cerebellar cognitive affective/Schmahmann syndrome. The notion that the cerebellum modulates thought and emotion in the same way that it modulates motor control advances the understanding of the mechanisms of cognition and opens new therapeutic opportunities in behavioral neurology and neuropsychiatry.
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            Fluctuating asymmetry: an epigenetic measure of stress.

            (1) Fluctuating asymmetry (FA) is a useful trait for monitoring stress in the laboratory and in natural environments. (2) Both genomic and environmental changes can increase FA which represents a deterioration in developmental homeostasis apparent in adult morphology. Genetic perturbations include intense directional selection and certain specific genes. Environmental perturbations include temperature extremes in particular, protein deprivation, audiogenic stress, and exposure to pollutants. (3) There is a negative association between FA and heterozygosity in a range of taxa especially fish, a result consistent with FA being a measure of fitness. (4) Scattered reports on non-experimental populations are consistent with experiments under controlled laboratory conditions. FA tends to increase as habitats become ecologically marginal; this includes exposure to environmental toxicants. (5) In our own species, FA of an increasing range of traits has been related to both environmental and genomic stress. (6) Domestication increases FA of the strength of homologous long bones of vertebrate species due to a relaxation of natural selection. (7) FA levels are paralleled by the incidence of skeletal abnormalities in stressful environments. (8) Increased FA is a reflection of poorer developmental homeostasis at the molecular, chromosomal and epigenetic levels.
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              Psychosocial factors influencing the recovery of athletes with anterior cruciate ligament injury: a systematic review.

              This review describes the psychosocial factors that affect recovery following anterior cruciate ligament (ACL) injury and reconstructive surgery in athletes. A systematic search in literature with inclusion and exclusion criteria on PubMed, PsycINFO, and Embase was performed. Articles used in this review were divided in five different parts according to the biopsychosocial model of Wiese-Bjornstal, with the addition of intervention studies. The results showed that a high internal Health Locus of Control and a high self-efficacy were useful cognitive factors to facilitate the recovery. Athletes with a low level of fear of reinjury had the best knee outcome after the injury followed by a reconstruction. In addition, athletes who returned to sport had less fear of reinjury and were more experienced and established athletes compared with athletes who did not return to sport. Furthermore, researchers showed that there was a positive relation between goal setting and adherence, which in turn yielded a positive relation with the outcome of the rehabilitation of an ACL injury. There were several psychosocial interventions that appeared to be facilitating the rehabilitation process.
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                Author and article information

                Contributors
                Journal
                Heliyon
                Heliyon
                Heliyon
                Elsevier
                2405-8440
                24 July 2020
                July 2020
                24 July 2020
                : 6
                : 7
                : e04539
                Affiliations
                [a ]Programa de Pós Graduação em Ciências da Saúde, Universidade Federal do Amapá, Macapá, Brazil
                [b ]Research Department, Rinaldi Fontani Foundation, Florence, Italy
                [c ]Department of Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, Florence, Italy
                [d ]Department of Regenerative Medicine, Rinaldi Fontani Institute, Florence, Italy
                Author notes
                []Corresponding author. srinaldi@ 123456irf.it
                [1]

                Equally contributed.

                Article
                S2405-8440(20)31383-9 e04539
                10.1016/j.heliyon.2020.e04539
                7385461
                32743108
                fa9f1f03-862c-4b0a-bd33-443bc2aeb618
                © 2020 The Author(s)

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 13 May 2020
                : 23 June 2020
                : 20 July 2020
                Categories
                Article

                health sciences,musculoskeletal system,behavioral medicine,evidence-based medicine,clinical research,knee,medial collateral ligament,functional recovery,psychomotor performance

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