Neurodegenerative diseases are a group of pathologies that cause severe disability due to motor and cognitive limitations. In particular, cognitive impairment is a growing health and socioeconomic problem which is still difficult to deal with today. As there are no pharmacologically effective treatments for cognitive deficits, scientific interest is growing regarding the possible impacts of healthy lifestyles on them. In this context, physical activity is gaining more and more evidence as a primary prevention intervention, a nonpharmacological therapy and a rehabilitation tool for improving cognitive functions in neurodegenerative diseases. In this descriptive overview we highlight the neurobiological effects of physical exercise, which is able to promote neuroplasticity and neuroprotection by acting at the cytokine and hormonal level, and the consequent positive clinical effects on patients suffering from cognitive impairment.

Gymnastics athletes are exposed to a high risk of injury, but also of developing musculoskeletal pain. These data are still little investigated in the available scientific literature. An online survey was distributed to 79 professional athletes who practiced artistic and rhythmic gymnastics. The survey collected demographic and anthropometric data, information about the sport practice, the training sessions, the prevalence of musculoskeletal pain gymnastics-related, and lifestyle habits. Musculoskeletal pain had a high prevalence, involving 65 of 79 athletes (82.3%). A significant correlation was found between musculoskeletal pain and the duration of sports practice, both for general pain (p = 0.041) and for specific districts: right wrist pain (p = 0.031), left wrist pain (p = 0.028), right shoulder (p = 0.039), left hip (p = 0.031), right thigh (p = 0.031), and left knee (p = 0.005). Another statistical association was found between right wrist pain and BMI (p = 0.001), and hip pain and BMI (p = 0.030). Hours spent in a sitting position were also correlated with the incidence of pain (p = 0.045). Wrist pain and right shoulder pain had a statistically significant association with the age of the athletes (right wrist pain: p = 0.038; left wrist pain: p = 0.004; right shoulder pain: p = 0.035). The more the gymnasts practice this sport, the more likely they are to develop musculoskeletal pain. Increased age and a higher BMI, as well as daily prolonged sitting position, seem to be potential risk factors for the onset of musculoskeletal pain. Future studies could plan training strategies aimed at preventing musculoskeletal pain associated with gymnastics, in order to promote its further spread.

Ultrasound-guided perineural hydrodissection (HD) is a novel technique that has been found to be effective in providing mechanical release of perineural adhesions and decompression of the nerve, reducing inflammation and edema and restoring its physiological function. It has a significant impact on chronic neuropathic pain (20 ± 4 weeks with VAS < 5 or VAS diminished by 2 points after the procedure). Carpal tunnel syndrome (CTS) is a common entrapment mononeuropathy, and its distribution is typically innervated by the median nerve. Patients with mild or moderate CTS may benefit from nonsurgical treatments or conservative therapies. This review was conducted following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement guidelines. Four investigators assessed each title, abstract, and full-text article for eligibility, with disagreements being resolved by consensus with two experienced investigators. The qualitative assessment of the studies was carried out using the modified Oxford quality scoring system, also known as the modified Jadad score. Furthermore, risk of possible biases was assessed using the Cochrane collaboration tool. The results of this review suggest that US-guided HD is an innovative, effective, well-tolerated, and safe technique (11 out of 923 patients had collateral or side effects after the procedure). However, further studies comparing all drugs and with a larger sample population are required to determine the most effective substance.

Background and Objectives: Nutraceuticals are gaining more and more importance as a knee osteoarthritis (KOA) complementary treatment. Among nutraceuticals, hemp seed oil and terpenes are proving to be very useful as therapeutic support for many chronic diseases, but there are still few studies regarding their effectiveness for treating KOA, both in combination and separately. The aim of this study is thus to compare the effect of two dietary supplements, both containing hemp seed oil, but of which only one also contains terpenes, in relieving pain and improving joint function in patients suffering from KOA. Materials and Methods: Thirty-eight patients were recruited and divided into two groups. The control group underwent a 45 day treatment with a hemp seed oil-based dietary supplement, while the treatment group assumed a hemp seed oil and terpenes dietary supplement for the same period. Patients were evaluated at the enrollment (T0) and at the end of treatment (T1). Outcome measures were: Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), Short-Form-12 (SF-12), Knee Injury Osteoarthritis Outcome Score (KOOS), and Oxford Knee Score (OKS). Results: All outcome measures improved at T1 in both groups, but NRS, KOOS and OKS had a greater significant improvement in the treatment group only. Conclusions: Hemp seed oil and terpenes resulted a more effective integrative treatment option in KOA, improving joint pain and function and representing a good complementary option for patients suffering from osteoarthritis.

Background: Mild-to-moderate knee osteoarthritis (KOA) can be successfully treated using intra-articular hyaluronic acid (IA-HA). The medial infrapatellar (MIP) approach and lateral infrapatellar (LIP) approach are two of the most used techniques for performing IA-HA, but it is still not clear which one is preferable. Objectives: The study aims to find the best knee injection technique between MIP and LIP approaches. Methods: In total, 161 patients were enrolled, divided into two groups (MIP or LIP). Each technique was performed once a week for three weeks. Patients were evaluated using the Numeric Rating Scale (NRS), Knee Injury and Osteoarthritis Outcome Score (KOOS) and Roles and Maudsley Score (RMS) at T0 (before the first injection), T1 (one week after the third injection) and T2 (six months after). Results: NRS, KOOS and RMS showed a statistically significant improvement in both groups at all the detection times, without significant differences. No differences were detected between the groups in terms of systemic effect effusions, while the MIP group presented a mildly higher number of bruises in comparison with the LIP group (p = 0.034). Conclusions: Both the IA-HA techniques are equally effective in measured outcomes. The MIP approach seems to produce some local and transient side effects. So, the choice of the LIP or MIP approach depends on the operator’s skill and experience.

Shoulder pain (SP) is a common clinical complaint among wheelchair basketball (WB) players, since their shoulders are exposed to intense overload and overhead movements. The supraspinatus tendon is the most exposed to WB-related injuries and it is primarily responsible for SP in WB athletes. In these cases, SP rehabilitation remains the main treatment, but there is still a lack of specific protocols which should be customized to WB players’ peculiarities and to the supraspinatus muscle activity monitor, and the improvement of rehabilitation outcomes is slow. Thus, the aim of this study was to verify if the improvement of supraspinatus muscle activity, monitored in real time with surface electromyography (sEMG) during the execution of therapeutic exercises, could speed up SP rehabilitation outcomes in WB players. Thirty-three athletes were enrolled. They were divided into two groups. Both groups underwent the same shoulder rehabilitation program, but only the Exercise Plus sEMG Biofeedback Group executed therapeutic exercises while the activity of the supraspinatus muscles was monitored using sEMG. Participants were evaluated at enrollment (T0), at the end of 4 weeks of the rehabilitation program (T1), and 8 weeks after T1 (T2), using the following outcome measures: supraspinatus muscle activity as root mean square (RMS), Wheelchair User’s Shoulder Pain Index (WUSPI), shoulder abduction, and external rotation range of motion (ROM). The Exercise Plus sEMG Biofeedback Group improved more and faster for all the outcomes compared to the Exercise Group. The monitoring and improvement of supraspinatus muscle activity seems to be an effective way to speed up SP rehabilitation outcomes in WB players, since it makes the performance of therapeutic exercise more precise and finalized, obtaining better and faster results in terms of recovery of shoulder function.