Stefano Negrini

• MD, PhD
• Professor (Full) at Università degli Studi di Milano

Medicine has become increasingly receptive to the use of artificial intelligence (AI). This overview of systematic reviews (SRs) aims to categorise current evidence about it and identify the current methodological state of the art in the field proposing a classification of AI model (CLASMOD-AI) to improve future reporting. PubMed/MEDLINE, Scopus, C...

The growing relevance of rehabilitation in healthcare to address increasing patient needs necessitates robust Physical and Rehabilitation Medicine (PRM) integration into medical education and practice. Academic PRM, rooted in medical faculties, is vital for developing the medical speciality as an academic discipline across Europe, where it faces ch...

Background: While the importance of the upper and lower limbs in locomotion is well understood, the kinematics of the trunk during walking remains largely unexplored. Two decades ago, a casual observation was reported indicating spine lengthening in a small sample of mostly children during walking, but this observation was never replicated. Objecti...

The global demand for end-stage hip and knee osteoarthritis surgical treatment is rising, as is the need of optimal postoperative rehabilitation. Patient stratification is key to provide rehabilitation professionals and policy makers with real-life data in support of early discharge planning and continuous care provision. The aim of this retrospect...

Background/Objectives: The aim of our study was to verify whether the application of Kinesiotaping in addition to the usual treatment was superior to the usual treatment alone regarding functional outcome, pain, and edema in the first 13 days after total knee arthroplasty (TKA) surgery. Methods: The study sample (n = 71) comprised 42.3% men and the...

Despite recognized need and reasonable demand, health systems and rehabilitation communities keep working in silos, independently with minimal recognition to the issues of those who require rehabilitation services. Consolidated effort by health systems and rehabilitation parties, recognizing the value, power and promise of each other, is a need of...

Randomized controlled trials (RCTs) are considered the gold standard of evidence guiding intervention selection in rehabilitation. However, conduct of sufficiently powered RCTs in rehabilitation can be expensive, pose ethical and attrition concerns when participants are assigned to ineffective treatment as usual conditions, and are infeasible with...

Purpose Understanding idiopathic scoliosis (IS) natural history during growth is essential for shared decision-making between patients and physicians. We developed a retrospective model with the largest available sample in the literature and we aimed to investigate if using three peri-pubertal growth periods provides better prediction than a unique...

Introduction In 2022, Cochrane Rehabilitation developed a new definition of rehabilitation for research purposes with 80 global stakeholders, aiming to support and improve the production and reporting of primary and evidence‐synthesis rehabilitation studies. Objective 1. To compare how Cochrane Systematic Review (CSR) authors describe rehabilitati...

Throughout 2023, Cochrane Rehabilitation’s primary focus was on the Fifth Cochrane Rehabilitation Methodological Meeting, aiming to improve the current state of evidence in rehabilitation, enhancing comprehension of evidence production and synthesis for practical application, and exploring various study designs. Ongoing projects were advanced, such...

According to Cochrane Rehabilitation's recently published definition for research purposes, rehabilitation is inherently complex. Rehabilitation teams frequently implement multiple strategies concurrently, draw on input from a range of different health professionals, target multiple outcomes, and personalize therapeutic plans. The success of rehabi...

Background: The Sforzesco brace is a very rigid push-up brace effective in adolescent idiopathic scoliosis (AIS). We recently developed a new Sforzesco brace based on modularity (the Modular Italian brace—MI brace) that could allow standardization, facilitating global expertise diffusion, increased modifiability and adaptability, and cost savings d...

Introduction: The evidence on the utility and effectiveness of rehabilitation interventions delivered via telerehabilitation is growing rapidly. Telerehabilitation is expected to have a key role in rehabilitation in the future. Aim: The aim of this evidence-based position paper (EBPP) is to improve PRM physicians' professional practice in telere...

Background and Objectives. This overview of Cochrane systematic reviews (CSRs) reports on current evidence on the effectiveness of rehabilitation interventions for persons with upper limb fractures (ULFs), and the quality of the evidence. Materials and Methods. Following the inclusion criteria defined by the World Health Organization, all CSRs tagg...

Background: Adolescent idiopathic scoliosis (AIS) is a pathology that changes the three-dimensional shape of the spine and trunk. While AIS can progress during growth and cause cosmetic issues, it is usually asymptomatic. However, a final spinal curvature above the critical threshold of 30° increases the risk of health problems and curve progressi...

This article was published in volume 58, issue 6 of publishing year 2022, with a mistake in Table II. The correct Table II is the one included in this erratum.

Rehabilitation providers and policymakers need valid evidence to make informed decisions about the healthcare needs of the population. Whenever possible, these decisions should be informed by randomized controlled trials (RCTs). However, there are circumstances when evidence needs to be generated rapidly, or when RCTs are not ethical or feasible. T...

Research on health policy, systems, and services (HPSSR) has seen significant growth in recent decades and received increasing attention in the field of rehabilitation. This growth is driven by the imperative to effectively address real-life challenges in complex healthcare settings. A recent resolution on 'Strengthening rehabilitation in health sy...

Adolescent idiopathic scoliosis (AIS) is a three-dimensional spine and trunk deformity. Bracing is an effective treatment for medium-degree curves. Thermal sensors help monitor patients’ adherence (compliance), a critical issue in bracing treatment. Some studies investigated adherence determinants but rarely through sensors or in highly adherent co...

This study aimed to synthesize evidence from studies that addressed the influence of bias domains in randomized controlled trials on rehabilitation intervention effect estimates and discuss how these findings can maximize the trustworthiness of an RCT in rehabilitation. We screened studies about the influence of bias on rehabilitation intervention...

Purpose Radiation-free systems based on dorsal surface topography can potentially represent an alternative to radiographic examination for early screening of scoliosis, based on the ability of recognizing the presence of deformity or classifying its severity. This study aims to assess the effectiveness of a deep learning model based on convolutiona...

The paper introduces the Special Sections of the European Journal of Physical and Rehabilitation Medicine dedicated to the 5th Methodological Meeting of Cochrane Rehabilitation. It introduces Cochrane Rehabilitation; its vision, mission and goals; discusses why the Methodological Meetings were created; and reports on their organisation and previous...

The Italian Spine Youth Quality of Life (ISYQOL) is a validated health-related quality of life (HRQOL) questionnaire for teenagers with adolescent idiopathic scoliosis (AIS). We culturally- adapted ISYQOL to traditional Chinese (ISYQOL-TC) and then recruited 133 conservatively treated teenagers with AIS to complete the ISYQOL-TC and the Chinese ver...

Adolescent idiopathic scoliosis (AIS) is a common disease that, in many cases, can be conservatively treated through bracing. High adherence to brace prescription is fundamental to gaining the maximum benefit from this treatment approach. Wearable sensors are available that objectively monitor the brace-wearing time, but their use, combined with ot...

Purpose The study aims to assess if the angle of trunk rotation (ATR) in combination with other readily measurable clinical parameters allows for effective non-invasive scoliosis screening. Methods We analysed 10,813 patients (4–18 years old) who underwent clinical and radiological evaluation for scoliosis in a tertiary clinic specialised in spina...

Patients with scoliosis have a high prevalence of back pain (BP). It is possible that scoliosis patients present with specific features when experiencing back or leg pain pathology. The aim of this systematic review is to report the signs, symptoms and associated features of BP in patients with scoliosis compared to adults without scoliosis during...

Idiopathic scoliosis is common in adulthood and can impact patients’ physical and psychological health. The Scoliosis Research Society-22 Questionnaire (SRS-22) has been designed to assess health-related quality of life (HRQOL) in idiopathic scoliosis, and it is the most used disease-specific outcome tool from adolescence to adulthood. More recentl...

Background: Adolescent idiopathic scoliosis and its treatments can severely impact health-related quality of life. The Italian Spine Youth Quality of Life (ISYQOL) questionnaire, initially developed in Italian and tested on Italian people, was created to measure quality of life in young persons with spine changes. ISYQOL was created using the Rasc...

Purpose Treatment selection for idiopathic scoliosis is informed by the risk of curve progression. Previous models predicting curve progression lacked validation, did not include the full growth/severity spectrum or included treated patients. The objective was to develop and validate models to predict future curve angles using clinical data collect...

Background: We need good outcome predictors to maximize the treatment efficiency of adolescents with idiopathic scoliosis (AIS). The in-brace correction has shown an important predictive effect on brace failure, while the influence of other variables is still debated. We aimed to identify new outcome predictors from a big prospective database of A...

Aim This overview of Cochrane systematic reviews (CSRs) reports on current evidence on the effectiveness of rehabilitation interventions for individuals with cerebral palsy (CP) and the quality of the evidence. Method Following the inclusion criteria defined by the World Health Organization, all CSRs tagged in the Cochrane Rehabilitation database...

Background: In clinics and the literature, there are doubts about the indications and contraindications of sports to support rehabilitation treatment for adolescents with idiopathic scoliosis (IS). Aim: The aim of the study is to assess sports activities' effect and frequency in a large population of adolescents with idiopathic scoliosis (IS)....

Objective: To Identify evidence-based rehabilitation interventions for persons with non-specific low back pain (LBP) with and without radiculopathy and to develop recommendations from high-quality clinical practice guidelines (CPGs) to inform the World Health Organization's (WHO) Package of Interventions for Rehabilitation (PIR). Data source: We...

The aim of this paper was to provide an overview of Cochrane Systematic Reviews (CSRs), which synthesizes the quality and quantity of available evidence on the effectiveness of rehabilitation interventions in rheumatoid arthritis (RA). The World Health Organization (WHO) requested Cochrane Rehabilitation the CSRs search to develop the Package of In...

Background: To increase people's access to rehabilitation services, particularly in the context of the COVID-19 pandemic, we need to explore how the delivery of these services can be adapted. This includes the use of home-based rehabilitation and telerehabilitation. Home-based rehabilitation services may become frequently used options in the recov...

Scoliosis is a three-dimensional deformity of the spine and trunk [...]

Purpose Some teenagers with adolescent idiopathic scoliosis (AIS) display compromised lung function. However, the evidence regarding the relations between pulmonary impairments and various spinal deformity parameters in these patients remains unclear, which affects clinical management. This systematic review and meta-analysis aimed to summarize the...

Introduction: Rehabilitation focuses on impairments, activity limitations and participation restrictions being informed by the underlying health condition. In the current absence of direct "evidence on" rehabilitation interventions for people with post-COVID-19 condition (PCC), we can search and synthesize the indirect "evidence relevant to" comin...

Cochrane Rehabilitation developed a series of actions to provide the global rehabilitation community with the best available evidence to respond to the COVID-19 pandemic. These initiatives constituted the REH-COVER (Rehabilitation COVID-19 evidence-based response) action. In March 2020, the first initiative started in agreement with the European Jo...

Introduction: Rehabilitation focuses on impairments, activity limitations and participation restrictions being informed by the underlying health condition. In the current absence of direct "evidence on" rehabilitation interventions for people with post-COVID-19 condition (PCC), we can search and synthesize the indirect "evidence relevant to" comin...

Introduction: Rehabilitation focuses on impairments, activity limitations and participation restrictions being informed by the underlying health condition. In the current absence of direct "evidence on" rehabilitation interventions for people with post COVID-19 condition (PCC), we can search and synthesize the indirect "evidence relevant to" comin...

Introduction: Currently, no evidence exists on specific treatments for post COVID-19 condition (PCC). However, rehabilitation interventions that are effective for similar symptoms in other health conditions could be applied to people with PCC. With this overview of systematic reviews with mapping, we aimed to describe the Cochrane evidence on reha...

Introduction: Currently, no evidence exists on specific treatments for post COVID-19 condition (PCC). However, rehabilitation interventions that proved effective for similar symptoms in other health conditions could be applied to people with PCC. With this overview of systematic reviews with mapping, we aimed to describe the Cochrane evidence on r...

This paper is supported and co-published by the following journals, and their Editors in Chief: Annals of Physical and Rehabilitation Medicine − Dominic Pérennou American Journal of Physical Medicine & Rehabilitation − Walter Frontera Developmental Neurorehabilitation − Wendy Machalicek European Journal of Physical and Rehabilitation Medicine − Ste...

Objective: To systematically map the current evidence about the characteristics of health systems, providers and patients to design rehabilitation care for post coronavirus disease 2019 (COVID-19) condition. Methods: We conducted a scoping review by searching the databases: MEDLINE®, Embase®, Web of Science, Cochrane COVID-19 Registry and Cochra...

This special paper reflects on trustworthiness and its implications for scientific medical journals and all the communities they serve: health professionals, policymakers, the public, and a specific discipline, in our case, Physical and Rehabilitation Medicine. We start from a recent episode: a paper claimed the untrustworthiness of two randomised...

There is a common agreement that bracing is appropriate for curves between 20 and 40° for the Cobb angle during growth, but for larger curves, the experts' opinions are not consistent. We designed this systematic review to report the updated evidence about the effectiveness of bracing in scoliosis patients with curves ≥40° and a residual growth per...

Purpose The association between idiopathic scoliosis (IS) and sports activities remains vague. We aimed to analyse their effect on full-time braced adolescents with IS. Methods We retrospectively recruited all the consecutive patients of a tertiary referral Institute of age ≥ 10 (adolescents), with a juvenile (JIS) or adolescent (AIS) IS diagnosis...

This study aimed to assess the reliability of a qualitative scoring system based on the movement analysis of the spine in different populations and after usual care rehabilitative intervention. If proven true, the results could further future research development in quantitative indexes, leading to a possible subclassification of chronic low back p...

Objective: We provide guidance for considering equity in rapid reviews through examples of published COVID-19 rapid reviews. Study design and setting: This guidance was developed based on a series of methodological meetings, review of internationally renowned guidance such as the Cochrane Handbook and the Preferred Reporting Items for Systematic...

Background Context Idiopathic scoliosis (IS) can significantly alter the quality of life of adolescents. Some of the available questionnaires in French measuring the quality of life in this population show weak psychometric properties. The newly developed Italian Spine Youth Quality of Life (ISYQOL) questionnaire promises better properties. Purpos...

Objective This paper aims to describe the evidence on rehabilitation interventions for persons with spinal cord injury (SCI) identified in Cochrane Systematic Reviews (CSRs) selected for inclusion in the WHO PIR. Data Sources The CSRs search was led by Cochrane Rehabilitation team, using the tagging process, using the terms “spinal cord injury” an...

Introduction: There is a global unmet need for rehabilitation to meet which the World Health Organization, in collaboration with Cochrane Rehabilitation, is developing the Package of Interventions for Rehabilitation with the aim of identifying rehabilitation interventions relevant to a range of key health conditions, including chronic obstructive...

Background: This review examined the effectiveness of behavioral interventions for adults with post-traumatic stress disorder (PTSD) triggered by physical injury or medical trauma. It discusses implications in support of rehabilitation management for COVID-19 survivors diagnosed with PTSD. Methods: This study adhered to the Preferred Reporting I...

We introduced pelvis semi-rigid material (ethylene vinyl acetate) (Free-Pelvis) to improve the comfort and adaptability of very rigid braces (VRBs) for adolescents with idiopathic scoliosis (AIS), but this can also negatively impact the corrective forces on the trunk. Study Design: This was a matched retrospective cohort study. The inclusion criter...

Purpose The focus of SPINE20 is to develop evidence-based policy recommendations for the G20 countries to work with governments to reduce the burden of spine disease, and disability. Methods On September 17–18, 2021, SPINE20 held its annual meeting in Rome, Italy. Prior to the meeting, the SPINE20 created six proposed recommendations. These recomm...

Since its foundation, Cochrane Rehabilitation has faced challenges with rehabilitation definitions because existing definitions did not indicate what rehabilitation includes and what it excludes. We aimed to develop a comprehensive and shared rehabilitation definition for research purposes to: (1) support the conduct of primary studies and systemat...

Objective: Since its foundation, Cochrane Rehabilitation has faced challenges with rehabilitation definitions because existing definitions did not indicate what rehabilitation includes and what it excludes. We aimed to develop a comprehensive and shared rehabilitation definition for research purposes to: 1) support the conduct of primary studies a...

Background: The World Health Organization has identified an unmet global need for rehabilitation interventions concerning 20 non-communicable diseases, traumatic brain injury included. This overview compiles and synthesizes the quality and quantity of available evidence on the effectiveness of rehabilitation interventions for traumatic brain injur...

Spinal dysraphism (SD) or Spina bifida (SB) is a congenital deformity that results from embryonic neural tube closure failure during fetal development. This evidence-based position paper represents the official position of the European Union through the UEMS PRM Section. This paper aims to evaluate the role of the physical and rehabilitation medici...

Purpose To analyze temporal and kinematic parameters of chronic Low-Back Pain (cLBP) subjects compared to healthy subjects during Timed Up and Go Test (TUG) execution implemented with an Inertial Measurement Unit and to explore the correlations of those parameters with pain and disability. Methods Observational cross-sectional study. Thirty-one su...

Introduction: In experimental trials, new methods are tested against the 'best' or 'usual' care. To appraise control group (CG) interventions provided as "usual care", we focused on stroke as a leading cause of disability demanding rehabilitation as a complex intervention. Evidence acquisition: For this methodological appraisal, we conducted a s...

Background: The Roussouly classification, based on the functional parameter sacral slope (SS), describes the normal sagittal balance in adults and has proved useful for surgery. Reference values in children should be defined, since they are an important treatment target of conservative treatment. Moreover, during growth, there are few correlations...

Purpose In-brace radiograph of adolescents with idiopathic scoliosis (AIS) has been shown to reflect brace efficacy and the possibility of achieving curve correction. Conversely, the first out-of-brace radiograph could demonstrate the patient’s ability to maintain the correction. We aimed to determine which of the two radiographs is the best predic...

Purpose Studies have shown that bracing is an effective treatment for patients with idiopathic scoliosis. According to the current classification, almost all braces fall in the thoracolumbosacral orthosis (TLSO) category. Consequently, the generalization of scientific results is either impossible or misleading. This study aims to produce a classifi...

This review presents the state of the art according to the current evidence on nonoperative treatment for adolescent idiopathic scoliosis, focusing on bracing. The definition of braces for the treatment of adolescent idiopathic scoliosis and a short history are provided. The analysis includes biomechanics, types, existing classifications, indicatio...

Since its foundation, Cochrane Rehabilitation has faced challenges with rehabilitation definitions because existing definitions did not indicate what rehabilitation includes and what it excludes. We aimed to develop a comprehensive and shared rehabilitation definition for research purposes to: 1) support the conduct of primary studies and systemati...

Objective: We provide guidance for considering equity in rapid reviews through examples of published COVID-19 rapid reviews. Study design and setting: This guidance was developed based on a series of methodological meetings, review of internationally renowned guidance such as the Cochrane Handbook and the Preferred Reporting Items for Systematic Re...

To facilitate the interaction between the health professional and the patient, a framework to guide the rehabilitation process is needed. This framework would encompass three interwoven aspects: the rehabilitation management plan, Individual Rehabilitation Project (IRP), and rehabilitation cycle(s). All three framework aspects focus on the patient...

Aim: Identifying existing interventions for rehabilitation and related evidence presents a crucial step in developing the World Health Organization's (WHO) Package of Interventions for Rehabilitation. This paper reports the results of a systematic search that aimed to identify clinical practice guidelines (CPGs) relevant to the rehabilitation of p...

The paper compares three assessment methods for the measurement of the trunk range of motion (ROM) in flexion-extension movements of subjects suspected of lumbar vertebrae instability (LVI). For five male adults affected by low-back pain and with morpho-dynamic prescription for suspected LVI, ROM was computed: from the analysis of morpho-dynamic ra...

This paper presents a novel approach to support rehabilitation employing Action Observation Therapy (AOT), mixed reality (MR) and wearable technologies to foster common rehabilitative methods in restoring motor function. Here, the platform was specifically designed to support the standard physical treatments in post-stroke patients during upper lim...