Neuromuscular electrical stimulation allows a slightly better functional recovery after total knee arthroplasty, especially in the first period, with more evident benefits in patients with a severe lack of muscular activation. Nevertheless, there is no difference at medium-long term.

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Introduction: Therapeutic ultrasound (US) has been used in physiotherapy for more than 50 years to treat acute and chronic inflammatory diseases in joints, muscles, tendons, ligaments and so on. Despite of its widespread use in rehabilitative practice and the large number of studies, low scientific, statistically assessed evidences of therapeutic US effectiveness are available. As a matter of fact, details about the treatment modalities and the way in which the patients' feedback was collected are often missing. The aim of our study is to assess the therapeutic US effectiveness in shoulder disease management when a "customized" treatment to each patient is delivered and the clinical outcome is globally monitored.Methods: Patients with shoulder pain who underwent rehabilitative treatment, including Ultrasound Therapy (US) in our Department of Physical Therapy and Rehabilitation Medicine at Turin University from May to September 2015 were enrolled. Clinical, functional and sonographycal evaluation of the shoulder was performed before US treatment (T0), and at the end of the US therapy (T1) using Numeric Rating Scale, Constant Score, DASH questionnaire and sonography. Results:Statistically relevant improvements of the clinical outcome were observed in all the considered parameters, with a significant reduction of shoulder pain and functional limitation in all patients. Sonographic images support clinical data. Conclusions:Although studies involving a larger number of patients are required, the effectiveness of 'customized' US treatment evaluated with different approaches, including sonography, is assessable and lead to statistically significant results.

This paper discusses a sciatic nerve palsy developed after a right total hip revision with a Burch-Schneider metal cage. A sciatalgic nerve pain appeared after surgery, while the palsy developed in about fifteen days. An electromyography showed the delay of the nerve impulse gluteal level. During the surgical exploration of the hip, a compression of the nerve on the metal cage was observed. The nerve was isolated, released from the fibrotic tissue and from the impingement, and was protected with a muscular flap. The recover from the pain was immediate, while the palsy recovered one month later.

Purpose: Incontinentia pigmenti (IP), or Bloch-Sulzberger syndrome, is a rare X-linked dominant genetic disorder with multisystem involvement. To our knowledge, there are no previous reports about rehabilitation in IP adult with intact cognitive development. We report a 20-year-old lady with IP managed and followed into adulthood. Method: Patient management and rehabilitation programs from birth to the last follow-up. Results: There was normal cognitive development despite magnetic resonance imaging (MRI) evidence of white matter, corpus callosum and brainstem hypoplasia. Extensor spasticity was present on both lower limbs for which she underwent rehabilitation from the age of one. Botulinum toxin injections were performed and when she was 15 years old she underwent functional surgery. Conclusion: The absence of mental retardation in our patient enabled us to carry out an active rehabilitation program and provide her with maximum independence in locomotion and in activities of daily living.ä Implications for Rehabiliation Incontinentia pigmenti (Bloch-Sulzberger syndrome). Incontinentia pigmenti is a rare X-linked dominant genetic disorder with multisystemic involvement. Skin lesions, neurological impairments, motormental retardation, skeletal congenital defects and ophthalmologic involvement are IP most frequent manifestations. Due to the complex multisystem involvement resulting in severe long-term disability, patients with IP require a multidisciplinary team approach for rehabilitation. In IP patients, rehabilitation interventions should always take into consideration the individual phenotype expression, child's physical development and personal needs.