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Choosing Wisely Italy. Doing more does not mean doing better (Fare di più non significa fare meglio)

Italian Association of Physiotherapists (AIFI)

Some reviews show the ineffectiveness of therapeutic ultrasound in the treatment of these disorders. Its therapeutic efficacy on pain or functionality is not superior to placebo in rotator cuff tendinopathy, while in ankle sprains the effect is clinically negligible, in particular at 2-4 weeks after the injury. The available evidences on low back pain do not highlight the effectiveness of this therapeutic approach. For all the considered disorders, there is a lack of high-quality randomized ...

Choosing Wisely Italy. Doing more does not mean doing better (Fare di più non significa fare meglio)

Italian Association of Physiotherapists (AIFI)

Many studies have shown that it is not possible to selectively activate the vastus medialis obliquus (VMO) with respect to vastus medialis longus or even to vastus lateralis. At the same time, no correlation between vastus medialis symptoms and its level of strength or activation has been demonstrated, while a general quadriceps strengthening program has the same effectiveness as selective strengthening programs, considerably more complex, expensive and time- consuming.

Choosing Wisely Italy. Doing more does not mean doing better (Fare di più non significa fare meglio)

Italian Association of Physiotherapists (AIFI)

Some systematic reviews and international guidelines show that tractions have no or minimal impact on pain intensity, functionality, overall improvement and return to work in patients with low back pain, in presence or absence of radicular pain. Minimal positive effects, clinically not relevant, have been demonstrated in some studies with reduced samples and high risk of bias. On the contrary, over 20% of the studies considered reported negative effects of traction, such as increased pain, ...

Choosing Wisely Italy. Doing more does not mean doing better (Fare di più non significa fare meglio)

Italian Association of Physiotherapists (AIFI)

Some systematic reviews and some recent randomized clinical trials highlight the ineffectiveness of continuous passive mobilization (CPM) in patients following total knee or hip prosthesis surgery or anterior cruciate ligament (ACL) reconstruction. The only studies that show a possible temporary benefit and, in any case, not clinically relevant, use CPM for several hours per day, while in Italy it is generally prescribed only for 1-2 hours per day, making the therapy completely useless.

Choosing Wisely Italy. Doing more does not mean doing better (Fare di più non significa fare meglio)

Italian Association of Hospital Medicine Nurses (ANIMO)

Given the limited temporal horizon, the mobilization and the wound care performed routinely do not bring any benefit to the dying patient. Instead, these procedures can engender discomfort and cause unnecessary pain. At the end of life you need to redefine the goals of care and target them to the comfort and control of the disturbing symptoms. In particular, it is essential to assess the risk of pressure sores and use anti-decubitus devices without mobilizing the patient routinely but only ...