World Master: Karen’s week with Isico

World Master: Karen’s week with Isico

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Isico offers those taking its ONLINE MASTER COURSE “Principles and Practice of Scoliosis Conservative Treatment”, which has now been running for three years, the chance to see clinical practice in operation at our institute’s Milan headquarters.

Dr Karen Amaya Solìs, one of the 2019 course participants, decided to take advantage of this opportunity and flew over from Peru specially. While she was here, we decided to ask her about her experience as one of our “students”. Thank you for the chat, Karen!

Could you tell us about your studies?
I studied medicine at Ricardo Palma University (Lima, Peru), and then specialised in physical medicine and rehabilitation at Universidad Nacional Mayor de San Marcos (also in Lima).

What is your profession?
I am a medical doctor, a specialist in physical and rehabilitation medicine. I work at the National Institute of Rehabilitation “Dra Adriana Rebaza Flores” Amistad Perú – Japón in Lima, Peru (South America).

Why you did register for the World Master course?
Because I was interested in expanding my knowledge about how to manage scoliosis, using the most recent quality information and following current clinical practice guidelines. 

What makes the World Master different from other educational courses and masters programs?
It allows you to share information and experiences with colleagues around the world. You can also plan your study time around your own schedule.

Are you satisfied with what you have learned?
Totally. I obtained accurate and well-structured information about scoliosis that I can now use in my clinical practice.

If you were asked to recommend the course, what would you say?
That it is a great opportunity to learn from the best teachers — doctors who have extensive experience in scoliosis. The best thing is that you can interact with them and resolve your doubts.

Stefano Negrini and Isico enter the Expertscape “hall of fame”

Stefano Negrini and Isico enter the Expertscape “hall of fame”

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“We couldn’t possibly have asked for a better piece of news than this to mark June, which is World Scoliosis Awareness month” commented Prof. Stefano Negrini, scientific director of Isico. “This recognition from Expertscape is a source of huge satisfaction not only for me but for the entire organisation I represent”.

Because while Prof. Negrini features among the world’s top 20 experts in the rehabilitation and surgical treatment of scoliosis (he is listed 11th to be precise: http://www.expertscape.com/ex/scoliosis), Isico finds itself in 38th place in the classification of clinical institutes. What is more, Prof. Negrini is not the only Isico specialist to appear in the classification: Drs Fabio Zaina (24th), Michele Romano and Sabrina Donzelli are also included.

Negrini’s ranking is based on 55 articles published since 2008.

What is Expertscape? It is an American rating agency that classifies the world’s leading experts in the various medical disciplines on the basis of the   analysis of a series of parameters and variables. With reference to the past 10 years, the site uses the National Institutes of Health PubMed database to identify and rank medical expertise across more than 27,000 topics.

The site was created to make it easier to find top specialists in any field of medicine. The site managers specify that they evaluate “scientific knowledge”; other criteria clearly cannot be taken into account in their evaluation, given that some of the top experts might be involved solely in research, and not in daily clinical practice with patients.

In the case of Isico, and its specialists, this recognition reflects the constant research and scientific publishing activity that accompanies their daily clinical involvement with thousands of patients.

Learn more about Expertscape’s methodology and how to increase your ranking.

What’s on worldwide?

What’s on worldwide?

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ISSLS meeting: Zaina appointed chair of Membership Committee

Prof. Stefano Negrini, scientific director of Isico, and Dr Fabio Zaina, physiatrist, were among the participants at the ISSLS meeting, from 3 to 7 June in Kyoto. Prof. Negrini gave an oral presentation (Identification through movement analysis of chronic low back pain pathological spinal movements patterns and their sensibility to change during exercise treatment).

Dr Zaina has instead been appointed chair of the Membership Committee next year.

Scoliosis: a sensor for better bracing treatment

Scoliosis: a sensor for better bracing treatment

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“Ever since 2010, we at Isico have been using Thermobrace, a heat sensor that is applied to the brace in order to establish how much it is actually being worn. We see this as a way of fostering a better doctor-patient relationship, as well as a means of collecting real-life data that can be used to optimise the use of the brace”

explains Dr Sabrina Donzelli, Isico physiatrist and author of a study entitled “In defense of adolescents: They really do use braces for the hours prescribed, if good help is provided. Results from a prospective everyday clinic cohort using thermobrace”, published in the journal Scoliosis. “Our implementation of this heat sensor, which is the most suitable of those currently available on the market, has been a gradual process” she says. “Initially, we applied it to the braces of just a handful of patients, precisely because until recently literature opinion on the use of this kind of instrument was divided. We have actually found that it helps to strengthen the doctor-patient relationship, as it allows us to make therapeutic choices on the basis of real-life data obtained from the sensor, and these data can thus be used to optimise the use of the brace”.

The most surprising finding was that the patients who have the highest number of prescribed brace-wearing hours were the ones who showed the best compliance with the treatment. It emerged that 45% of the patients used the brace for the number of hours prescribed, or for just an hour less,  while 55% claimed to be wearing the brace for a number of hours that was very close to the actual number (a difference of 1 hour at most), and 60% showed 90% compliance.

Patients and parents tend to overestimate compliance, hence the reason for developing an objective assessment based on the use of heat sensors.

Whereas the authors of other studies set out only to verify actual compliance with the prescribed number of brace-wearing hours, our aim was to test the sensor as a tool for improving clinical practice. Accordingly, we have never used the sensor without a patient’s knowledge. We do not see Thermobrace as a means of “checking up” on patients, but rather as a tool for collecting real-life data that can be used to optimise treatments.

Indeed, these sensors enable doctors to be more precise as they endeavour to make the best clinical decisions. Along with brace quality and some disease factors, compliance is a key element in the efficacy of brace treatment: “In patients known to comply reliably with the treatment, we should be able to get a much more accurate idea of the true effectiveness of braces” added Dr Donzelli.

Sabrina Donzelli and Alessandra Negrini speakers in Barcelona

Sabrina Donzelli and Alessandra Negrini speakers in Barcelona

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Isico once again played an active part in the Spanish national course on the rehabilitation of spinal deformities organised by the Rehabilitation Service of the Vall d’Hebron University Hospital in collaboration with the European Spine Surgery Group. Now in its third year, the event was held in Barcelona on 20 and 21 June.

The course combines oral presentations with a number of practical sessions. Dr Sabrina Donzelli, physiatrist at Isico and Alessandra Negrini, physiotherapist, gave several presentations: Dr Donzelli presented the classification of the sagittal profile that is used in children, as well as evidence on conservative and surgical treatment of spinal problems in the sagittal plane. Alessandra Negrini, having given a talk on sagittal alignment, led two workshops on the usefulness of SEAS exercises in adult scoliosis and one focusing on the role of sport in idiopathic scoliosis.

SEAS: after Serbia, China wraps things up

SEAS: after Serbia, China wraps things up

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From 14 to 16 June, Michele Romano, our director of physical therapy, held a SEAS I course in Novi Sad. The event was our first in Serbia and it attracted over 20 participants, coming not only from Serbia, but also from Croatia, Israel, the Netherlands, North Macedonia and Montenegro.

Novi Sad was also the venue, on 29 June, for the ScoSym International Symposium on “Current Trends in Research on Scoliosis and Other Spinal Deformities”, where Romano was an invited speaker and gave a talk on the topic of sport and scoliosis.

Finally, at the end of July, Romano will be on the move again, flying to China to lead the last SEAS courses before the summer break. These will be held in Shanghai and Zhenzhou.

WCPT: reports from Alessandra Negrini and Michele Romano

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From May 10th to 13th, Alessandra Negrini, physiotherapist, and Michele Romano,  director of physical therapy at Isico, were at the WCPT (World Confederation for Physical Therapy) Congress in Geneva, Switzerland.

WCPT is the sole international “voice” for physical therapy, representing more than 450,000 physical therapists worldwide. Alessandra Negrini talked about Sport and Scoliosis by presenting the study SPORTS ACTIVITY REDUCES THE RISK OF PROGRESSION AND BRACING: AN OBSERVATIONAL STUDY OF 511 ADOLESCENTS WITH IDIOPATHIC SCOLIOSIS; whereas Michele Romano held a presentation on the results of the recently published study  Specific exercises reduce the need for bracing in adolescents with idiopathic scoliosis: A practical clinical trial which had investigated on the efficacy of specific exercises to reduce the prescription of braces.
Remarkable the participation in the event which saw over 4000 people from all over the world.

ISSLS: Isico will be in Kyoto, too

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Isico will be at the forthcoming ISSLS Annual Meeting in Kyoto (June 3 to 7), a training event of the highest scientific and cultural level aimed at those dealing with spinal disorders. 

Founded in 1974, the International Society for the Study of the Lumbar Spine (ISSLS) is a non-profit organisation whose purpose is to bring together those individuals, throughout the world, who, by their contributions and activities both in the area of research and clinical study, have, or are developing, an interest in the lumbar spine in health and in disease.

With just 260 members worldwide, it is an exclusive society in which Isico is represented by Prof. Stefano Negrini as a member since 1997 and Dr Fabio Zaina since 2010. These two specialists will present different studies in Kyoto: Prof. Negrini will be giving an oral presentation (Identification through movement analysis of chronic low back pain pathological spinal movement patterns and their sensitivity to change during exercise treatment) and presenting a poster, and Dr Zaina will also be giving a poster presentation. In addition, both appear as co-authors of other posters being presented at the event.

ISYQOL performs better than SRS22

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An Isico study entitled  The Italian Spine Youth Quality of Life questionnaire measures health-related quality of life of adolescents with spinal deformities better than the reference standard, the Scoliosis Research Society 22 questionnaire, by Antonio Caronni, Sabrina Donzelli, Fabio Zaina and  Stefano Negrini, was recently published in Clinical Rehabilitation.

The aim of this cross-sectional study was to compare the validity of the Italian Spine Youth Quality of Life questionnaire (ISYQOL) with that of the Scoliosis Research Society 22 (SRS22) questionnaire, the criterion standard instrument for health-related quality of life (HRQOL) measurement in adolescents with spinal deformities.

The Scoliosis Research Society–22 questionnaire (SRS22) is the most common measure of quality of life in scoliosis patients. It is a five-domain questionnaire developed according to the classical test theory and, in this framework, it showed satisfactory psychometric properties such as concurrent validity and reliability. SRS22 is the criterion standard instrument for measuring quality of life in adolescent idiopathic scoliosis and it is also widely used for measuring quality of life in hyperkyphosis. 

“We considered 742 idiopathic scoliosis patients aged between 10 and 18 years of age, 542 of whom were brace wearers”, explains Dr Fabio Zaina, one of the authors of the study. “The ISYQOL is the first instrument developed by using the Rasch analysis to measure quality of life in spine deformity patients during growth. ISYQOL is a quality of life measure that fully complies with requirements of a fundamental measure”

ISYQOL consists of 20 items, each assigned a score of 0, 1 or 2. By means of Rasch analysis, the ordinal ISYQOL total score is converted to an interval measure (i.e. ISYQOL measure), which is expressed on a scale of 0%–100% (with 100% indicating great quality of life). Seven ISYQOL items assess the impact of bracing on quality of life and are to be administered only to people wearing a brace. Thanks to the Rasch analysis, it is possible to compare the ISYQOL score of people not wearing a brace (who answer only 13 of the 20 items) with the ISYQOL score of those wearing a brace (who complete the full questionnaire).  The Spearman’s correlation coefficient (rho) between ISYQOL and SRS22 was used to assess ISYQOL concurrent validity. Sex, age, severity, bracing, trunk appearance and deformity type were assessed for known-groups validity.  

 “The concurrent validity analysis showed the high validity of the ISYQOL measure with respect to the criterion standard measure of quality of life” concludes Dr Zaina. “Moreover, ISYQOL performs better than SRS22, having better known-groups validity and (contrary to SRS22) detecting the impact of disease severity on HRQOL.”

Bracing herself to dance! A video experience

Bracing herself to dance! A video experience

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Alessia Mancini, 17,  a patient at our centre since she was just 10 years old, has become the star  of a brief video recounting her exciting and remarkable journey. Although the video last only a few minutes, this is long enough to convey the  heartwarming story of this young patient, a dancer who loves nothing more than dancing en pointe!

Despite the uphill battle she faced, Alessia, her head full of dreams and fortunate enough to be able to draw on great strength of character, proved equal to the challenge. Now, through a collaboration with a young director, Riccardo, and a young director of photography and video operator, Sophia, a video has been made telling Alessia’s inspiring story.

“It all began years ago, when my parents noticed that my back, which had three scoliotic curves, the worst one measuring 40 degrees, was getting worse” Alessia begins. “We consulted Isico, where I was prescribed a brace, to be worn for 23 hours a day”.

For Alessia, who was already passionate about dancing, it was like being told to wear a suit of armour.  

“I love dancing” Alessia goes on, “and in fact I hope to dance professionally. In the end, I can say that I have been helped, in my pursuit of this ambition, both by my dancing and by my treatment, which came to an end a month ago, when I was finally told I could leave the brace off for good”.

For Alessia, living day in day out with her brace has been like living constantly in the company of both a friend and an unwelcome companion, an experience that she first recounted a few years ago when she entered, and won, the “Concorsetto”, a national competition organised  by Isico and open to our brace-wearing patients.

“I have always felt best able to express myself through art” Alessia tells us. “It was wonderful to be invited by Sophia and Riccardo to make this video about my story, and the important part that dance has played in it. Working with them was a fantastic experience. They are both wonderful artists who really managed to bring out my qualities, both as a dancer and as a person. In this way, they helped me to connect with the audience, and I hope I may serve as an example for the many others that find themselves in a similar position”.

The director. Riccardo, 22, from Naples. “I study directing and screenwriting at the national film academy in Bologna and I directed this video” Riccardo says. “I was struck by Alessia’s story and by what a strong person she is. Thanks to her outstanding qualities, it proved easy to create a story that conveyed, through music, dance and expressions, the many challenges this girl has overcome. All this has been a new experience for me, different and very stimulating”.

Riccardo’s meeting with Alessia came about thanks to Sophia, 23, a young mother and photographer: “I was fascinated  by the idea of  taking true stories, like Alessia’s, and bringing them to life through cinema. Late one Sunday night — it was midnight —, I called Alessia and Riccardo and told them that I had decided that, rather than doing the planned photoshoot, two days later we would instead be filming a video. I had realised that simple photos were not enough. I wanted to recreate Alessia’s seven-year experience through a full range of audiovisual stimuli.

Even though it was all a race against time, both Riccardo and Alessia did an absolutely wonderful job, giving it their very best” .

Thank you so much, Alessia, for sharing your story, and Riccardo and Sophia for making such a beautiful video!