BACKGROUND CONTEXT Global Postural Reeducation (GPR) has shown positive results for patients with musculoskeletal disorders, but no previous randomized controlled trial (RCT) has investigated its effectiveness as the sole procedure for adult patients with chronic nonspecific Neck Pain (NP). PURPOSE We evaluated the effectiveness of applying GPR compared to a manual therapy (MT) intervention to patients with chronic nonspecific NP. STUDY DESIGN RCT. PATIENT SAMPLE 94 patients, 72 women and 22 men, average age 47.5 ± 11.3 years, with chronic nonspecific NP were randomly assigned to receive a GPR or a MT treatment. OUTCOME MEASURES Pain intensity [Visual Analogue Scale (VAS)], disability [Neck Disability Index (NDI)], cervical Range of Motion (ROM), and kinesiophobia [Tampa Scale of Kinesiophobia (TSK)] were assessed. METHODS The experimental group received GPR, whereas the reference group received MT. Both groups received nine 60-minutes long sessions with one-to-one supervision from physical therapists as the care providers. All subjects were asked to follow ergonomic advice and to perform home exercises. Measures were assessed at pre-treatment, at post-treatment and at a 6-months follow-up. RESULTS No important baseline differences between groups. Subjects in the experimental GPR group exhibited a statistically significant reduction in pain at post-treatment (P=0.0043), and disability at six months after the intervention (P=0.0113), compared to the reference group. CONCLUSIONS Our results suggest that GPR was more effective than MT for improving pain at post-treatment and disability at six month follow-up in patients with chronic nonspecific NP.
The COVID-19 pandemic has put several healthcare systems under severe pressure. The present analysis investigates how the first wave of the COVID-19 pandemic affected the myocardial infarction (MI) network of Emilia-Romagna (Italy). Based on Emilia-Romagna mortality registry and administrative data from all the hospitals from January 2017 to June 2020, we analysed: i) temporal trend in MI hospital admissions; ii) characteristics, management, and 30-day mortality of MI patients; iii) out-of-hospital mortality for cardiac cause. Admissions for MI declined on February 22, 2020 (IRR -19.5%, 95%CI from -8.4% to -29.3%, p = 0.001), and further on March 5, 2020 (IRR -21.6%, 95%CI from -9.0% to -32.5%, p = 0.001). The return to pre-COVID-19 MI-related admission levels was observed from May 13, 2020 (IRR 34.3%, 95%CI 20.0%-50.2%, p<0.001). As compared to those before the pandemic, MI patients admitted during and after the first wave were younger and with fewer risk factors. The 30-day mortality remained in line with that expected based on previous years (ratio observed/expected was 0.96, 95%CI 0.84–1.08). MI patients positive for SARS-CoV-2 were few (1.5%) but showed poor prognosis (around 5-fold increase in 30-day mortality). In 2020, the number of out-of-hospital cardiac deaths was significantly higher (ratio observed/expected 1.17, 95%CI 1.08–1.27). The peak was reached in April. In Emilia-Romagna, MI hospitalizations significantly decreased during the first wave of the COVID-19 pandemic. Management and outcomes of hospitalized MI patients remained unchanged, except for those with SARS-CoV-2 infection. A concomitant increase in the out-of-hospital cardiac mortality was observed. None.