Bone remodelling in osteoarthrosic subjects undergoing a physical exercise program S.Bellometti, F. Bertè, P. Richelmi, T. Tassoni, L. Galzigna P.d'Abano Scientific Research Center, L.go Marconi 8, Abano T (PD), Italy. simonab@studitermali.org BACKGROUND: The connection between osteoarthritis (OA) and osteoporosis (OP) has attracted considerable attention but reports about bone mass density (BMD) in OA are often contradictory. Some data indicate that BMD is higher in OA patients than in healthy subjects, whereas other studies showed no differences. It has been observed that mud pack treatment (MPT) induces a decrease in cytokines with bone-resorbing effects. The aim of this study is to evaluate the response of bone and connective tissue to physical exercise and thermal treatment. METHODS: Forty osteoarthrosic patients were divided in group A (physical exercise and MPT), and group B (physical exercise alone). Blood and urine samples were collected before and after the treatments to assay blood metabolic markers and urinary hydroxyproline. RESULTS: In group A, some parameters show statistically significant differences before and after mud pack treatment (MPT). In group B, all parameters present no statistical significant changes before and after the physical exercise program. CONCLUSIONS: Few studies established the importance of exercise to maintain normal cartilage and bone metabolism. In group A of the present study, an influence on all the parameters of bone metabolism is evident. It is possible that physical exercise only if combined with MPT stimulates physiologic bone metabolism and favors skeletal health. Copyright 2002 Elsevier Science B.V. riabilitazione Clin Chim Acta. Nov;325(1-2):97-104,2002 Aquatic therapy in the rehabilitation of athletic injuries. J.Prins, D.Cutner Department of Kinesiology and Leisure Science, University of Hawaii at Manoa, Honolulu, USA. Water is the ideal environment for active physical therapy. By taking advantage of the physical properties of water, early resumption of rehabilitation is possible. An individualized program in aquatic rehabilitation requires the attending clinician to have specialized knowledge and experience in design and supervision. This article provides an overview of aquatic physical therapy and includes suggestions for the treatment of common athletic injuries. riabilitativa Clin Sports Med. Apr;18(2):447-61,1999 Hydrotherapy of patients with intermittent claudication: a novel approach to improve systolic ankle pressure and reduce symptoms. S.Elmståhl, B.Lilja, D. Bergqvist, J. Brunkwall University of Lund, Malmö General Hospital, Sweden. OBJECTIVE.To study the effects of alternating cold and hot water therapy on walking ability and systolic blood pressure in claudicants. EXPERIMENTAL DESIGN. A prospective case study with repeated measurements before and 1, 4 and 12 months after treatment. The systolic blood pressure levels were measured with an occlusion cuff for brachial and ankle and with a strain gauge for the first toe.STUDY POPULATION. Twenty consecutively included patients, 11 women and 9 men; mean age 73.9 yrs, with intermittent claudication according to clinical examination and ankle-arm systolic blood pressure (AAI) below 0.90. INTERVENTION. Alternate hot and cold hydrotherapy of the legs were given at ten 25-minute treatments during a three-week period. The outcome measures were maximal walking ability (MW), walking ability before pain (PW) and systolic blood pressures of toe, ankle, arm and AAI. RESULTS. Fourteen patients (70%) reported reduced pain after treatment and their PW increased from 134 +/- 29 m to 415 +/- 119 m 12 months later (p minore 0.05) and the MW in the total group increased form 348 +/- 75 m to 523 +/- 103 m. Systolic blood pressure increased in right ankle and toe one month after treatment in the total group. Among those who reported improved walking ability one year after treatment, systolic blood pressure in both right and left ankles and toes increased; e.g. right toe increasing from 72 +/- 7 to 86 +/- 2 (p minore 0.001). Improvements of systolic blood pressure in left and right leg and changes of walking ability were correlated, in the order of 0.60 to 0.81, p minore 0.05. CONCLUSIONS. Showering the legs of claudicants improved walking ability and blood pressures which sustained up to 1-year later. This therapy might be an additional alternative to conservative treatment of intermittent claudication. riabilitazione Int Angiol.Dec;14(4):389-94.,1995