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[This corrects the article DOI: 10.3389/fcvm.2022.802183.].

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The Thoracic Outlet Syndrome is a clinical potentially disabling condition characterized by a group of upper extremity signs and symptoms due to the compression of the neurovascular bundle passing through the thoracic outlet region. Because of the non-specific nature of signs and symptoms, to the lack of a consensus for the objective diagnosis, and to the wide range of etiologies, the actual figure is still a matter of debate among experts. We aimed to summarize the current evidence about the pathophysiology, the diagnosis and the treatment of the thoracic outlet syndrome, and to report a retrospective analysis on 324 patients followed for 5 years at the Padua University Hospital and at the Naples Fatebenefratelli Hospital in Italy, to verify the effectiveness of a specific rehabilitation program for the syndrome and to evaluate if physical therapy could relieve symptoms in these patients.

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The aim of the study was to identify the variables related to therapeutic success of intramuscular oxygen-ozone (O2O3) in patients with chronic low back pain (LBP). Twenty-one patients underwent an eight-session intramuscular-paravertebral O2O3 treatment with a weekly frequency. Numeric Rating Score for pain (NRSp), anxiety (NRSa), mood (NRSm), Oswestry Disability Index (ODI) and Physical and Mental Component Summary scores (PCS and MCS) of Short Form 12 (SF-12) were assessed baseline, after the treatment and at six-months follow-up. The ODI and NRSp scores showed significant improvement at the end of the treatment: the improvement in pain was maintained also at 6 months' follow-up. A significant correlation between baseline NRSa and the variation of the NRSp and ODI was observed. There was a correlation between NRSm at baseline and the variation of the ODI. A moderate correlation between MCS-12 at baseline and the variation of the NRSp score was found. Surprisingly, patients with a more compromised psychological well-being due to LBP had better results after oxygen-ozone therapy. Therefore, NRSa, NRSm and MCS-12 scores could be useful predictors of good therapeutic outcome.

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Complex regional pain syndrome (CRPS) is characterized by hyperalgesia, autonomic and trophic alterations of bones, muscles and skin. It is supported by neurogenic inflammation and impairment of sympathetic nervous system. Botulinum Toxin (BTX) is an option for the management of pain, with level B evidence of efficacy in neuropathic, joint and myofascial pain syndrome. We report a case of CRPS treated with intra articular injection of BTX-A (IaBI). BTX-A 100 U in 2 cc Na Cl 0,9% was injected into the gleno-humeral joint. Visual analogue scale (VAS) pain score and McGill Pain Questionnaire (MPQ) were administered at T0 (baseline), T1 (one month after IaBI) and T2 (four months after IaBI). Autonomic and trophic skin disorders were clinically monitored. Pain decreased at T1, with a lasting effect at T2, associated with improvement of range of motion (ROM). No improvement in terms of autonomic and trophic skin disorders were reported neither at T1 nor T2. These findings support a possible antinociceptive role of BTX-A in the management of CRPS pain related to inhibition of pain neurotransmitters release. A literature revision of IaBI is provided.

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BACKGROUND: The comparison between Cobb angle and hump height measured using a humpmeter in idiopathic scoliosis have produced contradictory findings concerning the association between the two variables in growing subjects. AIM: To analyze the relationship between the hump height and the Cobb angle and the effect of age on the first. DESIGN: Cross-sectional, descriptive analytical study. SETTING: A tertiary university hospital. POPULATION: One thousand two-hundred forty-five subjects with diagnosed idiopathic scoliosis or with a hump without spine deformity, aged between 3-21. METHODS: The hump was measured with subjects in a forward-bending position using a pocket humpmeter; the Cobb angle was determined on a traditional radiograph. A linear regression estimated the Cobb angle in relation to the hump height, and a multiple regression based on standardized regression coefficients (ß) and coefficients of determination (R2) assessed the contribution of age and the Cobb angle to hump variations. RESULTS: The hump height was between 0-50 mm and the Cobb angle was between 0-78°. Based on regression coefficients, every unit (1 mm) increase in the thoracic/thoracolumbar and lumbar humps corresponded to an average increase in the Cobb angle of 1.542° (SE 0.037°; P=0.000) and 1.857° (SE 0.095°; P=0.000), respectively. The 95% confidence intervals for the estimated mean Cobb angles and those for the individual angles with respect to a given hump height lead to various hypotheses regarding the interconnection between the two entities. ß values for age were low with respect to ß values for the Cobb angle both at the thoracic level (0.095 vs. 0.807) and at the lumbar one (0.138 vs. 0.651), and R2, after the age-variable was excluded, decreased slightly from 70.3% to 69.4% and from 48.5% to 46.7%, respectively. CONCLUSIONS: Humpmeter measurements can thus be considered reliable in diagnosed idiopathic scoliosis and in asymmetric children - having a hump without deformity in spine - regardless of age. CLINICAL REHABILITATION IMPACT: Hump severity can be considered the balance needle when children with idiopathic scoliosis and asymmetric children are being treated and/or monitored. The humpmeter technique, coupled with Cobb angle measurement, can facilitate the clinical evaluation.

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The World Health Organization warns that, in 2000, as many as 33 million Europeans suffered from diabetes, approximately 15% will likely develop foot ulcers, and approximately 15-20% of these patients will face lower-extremity amputation. Changes in some gait parameters that appear to be specific in diabetes have been identified in the literature: shorter stride length, reduced walking speed, and altered lower limb and trunk mobility. The present study aimed at evaluating the role of altered muscle activity in gait alterations of diabetic subjects with and without neuropathy. This study involved 50 subjects: 10 controls (BMI 24.4 ± 2.8, age 61.2 ± 5.07), 20 diabetics (BMI 26.4 ± 2.5, age 56.53 ± 13.29) and 20 neuropathics (BMI 26.8 ± 3.4, age 61.2 ± 7.7). The electrical activity of six muscles was collected bilaterally on the lower limb during gait: gluteus medius, rectus femoris, tibialis anterior, peroneous longus, gastrocnemius lateralis, and extensor digitorum communis. Electromyographic activity was represented through linear envelopes. Time and space parameters were also evaluated by means of two Bertec force plates and a six cameras motion capture system (BTS, 60-120 Hz). At initial contact and loading response, an early peak of rectus femoris activity occurred in diabetic subjects with and without neuropathy. During midstance a delay of gastrocnemius activity was observed in diabetic non-neuropathic subjects. During terminal swing a delay of rectus femoris and gluteus medius activity was seen in diabetic non-neuropathic subjects'. The results suggest that important muscle activity deviations are present in diabetic subjects although these are not directly related to neuropathy.

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