Introduction: Recent evidence suggests that tissue accumulation of senescent p16^INK4a-positive cells during the life span would be deleterious for tissue functions and could be the consequence of inherent age-associated disorders. Osteoarthritis (OA) is characterized by the accumulation of chondrocytes expressing p16^INK4a and markers of the senescence-associated secretory phenotype (SASP), including the matrix remodeling metalloproteases MMP1/MMP13 and pro-inflammatory cytokines interleukin-8 (IL-8) and IL-6. Here, we evaluated the role of p16^INK4a in the OA-induced SASP and its regulation by microRNAs (miRs). Methods: We used IL-1-beta-treated primary OA chondrocytes cultured in three-dimensional setting or mesenchymal stem cells differentiated into chondrocyte to follow p16^INK4a expression. By transient transfection experiments and the use of knockout mice, we validate p16^INK4a function in chondrocytes and its regulation by one miR identified by means of a genome-wide miR-array analysis. Results: p16^INK4a is induced upon IL-1-beta treatment and also during in vitro chondrogenesis. In the mouse model, Ink4a locus favors in vivo the proportion of terminally differentiated chondrocytes. When overexpressed in chondrocytes, p16^INK4a is sufficient to induce the production of the two matrix remodeling enzymes, MMP1 and MMP13, thus linking senescence with OA pathogenesis and bone development. We identified miR-24 as a negative regulator of p16^INK4a. Accordingly, p16^INK4a expression increased while miR-24 level was repressed upon IL-1-beta addition, in OA cartilage and during in vitro terminal chondrogenesis. Conclusions: We disclosed herein a new role of the senescence marker p16^INK4a and its regulation by miR-24 during OA and terminal chondrogenesis.

Background: Low back pain (LBP) is a leading cause of disability worldwide, often driven by distinct pain mechanisms: nociceptive, neuropathic, and central sensitization. Accurate classification of these mechanisms is critical for guiding effective, targeted treatments. Methods: A scoping review was conducted following the Joanna Briggs Institute methodology and reported according to PRISMA-ScR guidelines. A comprehensive literature search was performed in MEDLINE, Cochrane CENTRAL, Scopus, PEDro, and Web of Science. Eligible studies included adults with LBP and focused on clinical criteria for classifying pain mechanisms. Data on study methods, population characteristics, and outcomes were extracted and synthesized. Results: Nine studies met the inclusion criteria. Nociceptive pain was characterized by localized symptoms proportional to mechanical triggers, with no neurological signs. Neuropathic pain was associated with burning sensations, dysaesthesia, and a positive neurodynamic straight leg raise (SLR) test. Central sensitization featured widespread pain, hyperalgesia, and disproportionate symptoms. Tools such as painDETECT, DN4, and the Central Sensitisation Inventory (CSI) were validated for neuropathic and central sensitization pain. Central sensitization and neuropathic pain were linked to greater disability and psychological distress compared to nociceptive pain. Conclusions: This review aims to provide a historical perspective on pain mechanism classifications and to explore how previous frameworks have influenced current diagnostic concepts in physiotherapy practice. By synthesizing key clinical criteria used to differentiate between nociceptive, neuropathic, and central sensitization pain, this review proposes a practical framework to improve the accuracy of pain classification in clinical settings.

Background: Complex Regional Pain Syndrome (CRPS) is a chronic condition characterized by severe pain and functional impairment. Graded Motor Imagery (GMI) and Mirror Therapy (MT) have emerged as potential non-invasive treatments; this review evaluates the effectiveness of these therapies in reducing pain, improving function, and managing swelling in CRPS patients. Methods: A systematic review was conducted including randomized controlled trials (RCTs) that investigated GMI and MT in CRPS patients. This review was registered in PROSPERO (CRD42024535972) to ensure transparency and adherence to protocols. This review included searches of PubMed, Cochrane, SCOPUS, and Web of Science databases. Out of 81 studies initially screened, 6 were included in the final review. Studies were assessed for quality using the PEDro and RoB-2 scales. The primary outcomes were pain reduction, functional improvement, and swelling reduction. Results: Graded Motor Imagery (GMI) and Mirror Therapy (MT) reduced pain by an average of 20 points on the Neuropathic Pain Scale (NPS) and resulted in functional improvements as measured by the Task-Specific Numeric Rating Scale (NRS). GMI also contributed to some reduction in swelling. MT, particularly in post-stroke CRPS patients, showed significant pain reduction and functional improvements, with additional benefits in reducing swelling in certain studies. However, the included studies had small sample sizes and mixed designs, which limit the generalizability of the findings. The studies varied in sample size and design, with some risk of bias noted. Conclusions: Graded Motor Imagery (GMI) and Mirror Therapy (MT) have proven to be effective interventions for managing Complex Regional Pain Syndrome (CRPS), with significant improvements in pain reduction and functional recovery. These non-invasive treatments hold potential for integration into standard rehabilitation protocols. However, the small sample sizes and variability in study designs limit the generalizability of these findings. Future research should focus on larger, more homogeneous trials to validate the long-term effectiveness of GMI and MT, ensuring more robust clinical application.

Objective: The primary objective of this randomized controlled trial was to evaluate the effectiveness of tele-rehabilitation (TR) compared to conventional rehabilitation (CT) in reducing pain (as measured by the Numeric Pain Rating Scale [NPRS]) in patients with knee osteoarthritis (OA). Secondary objectives included assessing changes in physical function and quality of life, as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Short Form-36 (SF-36) health survey, respectively. Methods: Fifty-five patients diagnosed with knee OA were randomly allocated to either the TR group ( n = 29), receiving remote physiotherapy sessions three times a week for four weeks, or the CT group ( n = 26), undergoing traditional outpatient rehabilitation with the same exercise regimen. Outcomes were measured at baseline and after a three-month follow-up period. Results: At baseline, there were no significant differences between groups in terms of NPRS and WOMAC scores. After three months, both the CT and the TR groups showed significant improvements in pain reduction (NPRS, p < 0.001), WOMAC score ( p < 0.001), and in some subscales of the SF-36 (i.e., physical functioning, role limitation attributable to physical problems, energy, and pain). Conclusion: Tele-rehabilitation is an effective alternative to CT for reducing pain and improving quality of life in patients with knee OA. These findings suggest that TR can be incorporated alongside conventional approaches to provide a comprehensive treatment strategy for managing knee OA, enhancing patient outcomes in various dimensions of well-being. Trial registration NCT05719350; Telerehabilitation in Patients With Osteoarthritis (TABLET).

Background: Parkinson’s disease (PD) is a neurodegenerative disorder characterized by motor symptoms such as tremors, rigidity, and bradykinesia. Rehabilitation utilizing mirror neurons leverages the brain’s capacity for action observation (AO) and motor imagery (MI) to enhance motor function. This approach involves patients imitating movements observed in therapists or videos, aiming to improve gait, coordination, and overall quality of life. Mirror neuron activation facilitates motor learning and may decelerate disease progression, thus enhancing patient mobility and independence. Methods: This scoping review aimed to map current evidence on PD therapies employing mirror neuron-based rehabilitation. Databases searched included PubMed, PEDro, and Cochrane. The review included randomized controlled trials (RCTs) and systematic reviews that examined the effects of AO and MI in PD rehabilitation. Results: Five studies met the inclusion criteria, encompassing various rehabilitation techniques focusing on AO and MI. These studies consistently demonstrated positive outcomes, such as reduced disease severity and improved quality of life, gait, and balance in PD patients. The activation of mirror neurons through AO and MI was shown to facilitate motor learning and contribute to improved functional mobility. Conclusions: Although the included studies support the beneficial impact of AO and MI techniques in PD rehabilitation, numerous questions remain unresolved. Further research is necessary to evaluate the potential integration of these techniques into standard physiotherapy routines for PD patients. This review highlights the promise of AO and MI in enhancing motor rehabilitation for PD, suggesting the need for more comprehensive studies to validate and refine these therapeutic approaches.

Background: Focal mechanical vibration therapy has gained attention as a potential intervention to improve motor function while decreasing spasticity and pain in post-stroke patients. Despite promising results, there remains variability in study designs and outcomes, warranting a review of its clinical efficacy. Methods: A review was conducted to evaluate randomized controlled trials (RCTs) investigating the effects of focal mechanical vibration therapy on post-stroke rehabilitation. Six studies were included, assessing outcomes such as spasticity reduction (using the Modified Ashworth Scale), motor function recovery (Wolf Motor Function Test, Fugl-Meyer Assessment), and pain management (Visual Analog Scale, Numerical Rating Scale). The quality of studies was evaluated using the PEDro scale and RoB-2 tool. An overview review was conducted to provide a comprehensive analysis of the topic. Results: The included studies demonstrated significant reductions in spasticity and improvements in motor function in most patients receiving focal vibration therapy. Notable improvements were observed when focal vibration was combined with other rehabilitation techniques, such as progressive modular rebalancing or robotic rehabilitation. Pain levels were also reduced in several studies. However, differences in vibration parameters (frequency, amplitude), small sample sizes, and short follow-up periods limit the generalizability of the findings. Conclusions: Focal mechanical vibration therapy appears to be an effective adjunct in post-stroke rehabilitation, particularly for reducing spasticity and improving motor function. Although short-term benefits are promising, further research is required to determine long-term efficacy and optimal treatment parameters. This review evaluates the effectiveness of focal vibration therapy in treating motor deficits and spasticity in post-stroke patients. The results suggest its potential to improve these conditions, though further studies with larger sample sizes are needed to confirm its long-term efficacy.