Background and aims: Many patients look for procedures that can achieve similar results to surgical lift avoiding the risks and possible complications of surgery. Endolift® and multi-wavelength (MW) Laser photobiomodulation (PBM) are considered two of the most effective procedures in the treatment of skin laxity and superficial wrinkles. We aimed to investigate the reduction of skin laxity of the lower third of the face treated with the Endolift® technique alone or in combination with MW Laser PBM. Materials and Methods: From June 2016 to June 2018, 96 subjects (18 M; 78 F) were included in this randomized controlled trial (RCT) conducted in two Italian institutions. The area treated was the lower third of the face. The subjects were classified using the Ptosis Scale (grade I-V) at T0, with a Pinch Test <1.9 mm. We selected only subjects’ grade 4, both males and females, 45-55-years old. Thirty-two subjects (6M; 26F) (group 1) were treated with the Endolift® procedure followed by a session of MW Laser PBM using a simultaneous nonsurgical laser therapy emission of three different wavelengths (532 nm, 808 nm, 1064 nm). The MW Laser PBM was repeated after 7, 14 and 21 days. Thirty-two subjects (6M; 26F) (group 2) underwent only the Endolift® session. 32 subjects (6M; 26F) (group 3) received only MW Laser PBM. Follow up visits were performed at days 60 (T60), 120 (T120) and 540 (T540) after the treatments. The study ended in December 2019 when all the subjects had been followed for 18 months. Results: The results of the three groups were evaluated using the Ptosis Scale at T0, T60, T120 and T540. The combination of the two treatments (group 1) achieved more rapid effects, while MW Laser PBM alone treatment (group 3) achieved the slowest effect. The median test for independent samples showed that all the differences between groups are statistically significant at each follow-up (p=0.000). Conclusions: The Endolift® laser in the last 15 years allows to achieve exceptional results in the treatment of skin laxity reaching the desired ‘soft’ rejuvenation model which is increasingly desired. MW Laser PBM, in combination with Endolift®, obtains better results. Although significant at T540, the effects of MW Laser PBM alone are slower to reach.

Introduction: Although older adults are particularly vulnerable to the effects of climate change, they seem to be overall less concerned about it, and less inclined to support climate policies. The study aims to identify the communication strategies that have been evaluated in promoting awareness and/or climate friendly behaviors in older adults.Methods: We searched multiple electronic databases for studies that evaluated the effects of any interventions aimed at communicating climate change to older persons (over 65 years) and assessed the results as awareness and /or behavioral changes. We selected quantitative, qualitative and mixed methods studies, and we also included systematic reviews for cross-referencing. Risk of bias of included studies was evaluated using different tools according to the study design.Results: From a total of 5,486 articles, only 3 studies were included. One mixed-method study engaged older adults to assess the community vulnerability to climate change and to develop adaptation recommendations based on their perspectives; one qualitative study conducted focus groups to identify the more effective language, values and themes based on participants’ responses to narratives; one quantitative study utilized a 360-degree audio-visual platform allowing users to engage with immersive visualizations of sea-level rise scenarios.Discussion: Despite the paucity of literature, this review demonstrates the potential for different strategies to increase the awareness of older persons about climate change. The involvement of older adults in the communication process, the identification of their priorities, and the integration of technology in their daily lives are promising approaches but more research, including both quantitative and qualitative studies is recommended on this topic.Systematic review registeration: For further details about the protocol, this systematic review has been registered on PROSPERO on July 1, 2023 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023438256).

The Muscle Shortening Maneuver (MSM) is derived from Feldman’s λ model of motor control, and seems to induce a more balanced agonist- antagonist-muscular action. The hypothesized mechanism of actio...

Background: The Motricity Index (MI) is a commonly used method of measuring muscle strength in post-stroke hemiparesis. This study aimed to produce the MI Italian version (MI-IT) and assess its reliability in subjects with stroke. Methods: Phase-1: stepwise approach to MI-IT production and pilot-testing with 10 health professionals to ensure clarity of each item and instructions for administration and scoring. Phase-2: evaluation of MI-IT reliability on stroke subjects, each independently assessed by 2 raters randomly selected from a group of 10 physiotherapists; the first rater re-administered the MI-IT 1–3 days later. Intraclass correlation coefficients, Spearman’s rho and, limited to the more affected side, non-parametric limits of agreement (LOA) were computed for total MI-IT scores, squared weighted kappa and percentage of observed agreement for individual item scores. Results: The back-translated versions showed no discrepancies with original MI, but 3 items were revised after pilot-testing. Complete data on 50 (test–retest) and 51 (inter-rater) participants demonstrated excellent reliability of all MI-IT total scores on the more affected side (Spearman’s rho range: test–retest 0.953–0.975; inter-rater: 0.965–0.970), with LOA ranging from 9–25%), but poor inter-rater reliability for some scores on the less affected side (Spearman’s rho range: test–retest, 0.816–0.976; inter-rater: 0.508–0.721). Moderate to almost perfect agreement was found for all individual item scores, except for 2 items on the less affected side. Conclusions: The MI-IT is sufficiently reliable to evaluate motor impairment of the more affected side after stroke, with acceptable measurement error for all scores.

Objective: This study aimed to develop the Italian version of the modified Barthel Index and assess its reliability within stroke survivors. Design: Single-centre, prospective observational study for measure validation. Subjects/Patients: To pre-test the pre-final scale, stroke survivors, caregivers, and health professionals were enrolled. For reliability, only stroke survivors were enrolled. Inclusion of stroke survivors: adults presenting ADL limitation; exclusion: severe visual/hearing impairment, Mini-Mental State Examination <21; severe language disorder, clinical instability. Methods: The Italian modified Barthel Index was developed through forward-and-back translation, and interdisciplinary review. Clarity was evaluated by a sample of all participants. Inter-rater reliability was assessed by 2 independent physiotherapists, and test–retest examined 1–3 days later. Intraclass correlation coefficient (ICC), Spearman’s correlation, quadratic weighted Kappa, and agreement percentages were calculated. Results: Clarity was evaluated with 30 participants (10 per group); minor semantic adjustments were made. Reliability was assessed within 51 stroke survivors, showing Spearman’s correlation of 0.990 (test–retest) and 0.985 (inter-rater). ICCs were 0.990 and 0.987, respectively. Weighted Kappa values ranged from 0.76 to 0.98. Conclusion: The Italian Modified Barthel Index showed high reliability, supporting its use in Italian-speaking stroke populations. The validation of its other psychometric properties needs further research.