Physical Therapy, Sports Therapy and Rehabilitation, Multidisciplinary
15
Scopus Publications
Scopus Publications
Can Coastal Rowing Be Made Safer Through Auxetics-Inspired Personal Protective Equipment? Joseph N. Grima, Giovanni Ficarra, Dario Cerasola, Przemysław Szatan, James N. Grima‐Cornish, Grace Anne Muscat, Giuseppe Recca, Gianluca Cicala, Giuseppe Giglia, Alessandra Bitto, Ruben Gatt, Daphne Attard Physica Status Solidi B Basic Research, 2026 We report the results of a survey aimed at assessing how beach sprint coastal rowers perceive their sport in terms of injury likelihood and overall risk, their willingness to use personal protective equipment (PPE) and the factors that discourage PPE adoption. Building on these findings, this study demonstrates how auxetics can be exploited in the design of next‐generation PPE for use in this new Olympic discipline. By examining well‐known auxetic motifs based on the rotating squares/triangles mechanisms, we explore how that PPE can be engineered to provide improved conformal fit enabling the equipment to adapt dynamically to body contours during movement without imposing significant restrictions on mobility. This and other attributes such as enhanced breathability and visual appeal directly address the factors influencing beach sprint coastal rowers’ decisions regarding the use of PPE.
Nutraceuticals in orthopedic implant osseointegration: Mechanisms, evidence, and clinical perspectives Gabriele Ricciardi, Domenico Donadio, Giovanni Ficarra, Chiara Nasso, Pietro Foglia, Alessandra Bitto, Rosa Scarfì, Guido Fadda, Flavio Corpina, Erica Cutè, Maurizio Martini, Marco Ferlazzo Bone, 2026 Total joint replacement is one of the most successful interventions in modern orthopedics, but long-term outcomes depend on effective osseointegration. Pharmacological strategies such as bisphosphonates, estrogens, and monoclonal antibodies can enhance bone-implant integration, but their clinical use is limited by adverse effects. Nutraceuticals, including polyphenols, carotenoids, and polyunsaturated fatty acids, have emerged as promising adjuncts to support bone health and osseointegration, thanks to their safety profile and biological activity. This review summarizes the molecular mechanisms involved in osseointegration, analyzes preclinical and clinical evidence on nutraceuticals, and critically assesses their translational potential. These compounds promote osteoblastogenesis, inhibit osteoclast differentiation, and mitigate oxidative stress, thereby improving peri-implant bone stability. Despite encouraging results, the clinical translation of nutraceuticals remains limited. Most available data are preclinical or based on surrogate endpoints such as bone mineral density, whereas true clinical success is determined by bone-to-implant contact and implant survival, which are rarely investigated in randomized controlled trials (RCTs). Advances in bioavailability strategies (liposomes, nanoemulsions, nanostructured lipid carriers) may improve systemic exposure, but future research must standardize dosages and provide high-quality RCTs to clarify the role of nutraceuticals as complementary tools in orthopedic implant surgery.
EXERCISE PRESCRIPTION AND LEGISLATIVE ADVANCEMENTS: ANALYZING THE POTENTIAL IMPACT OF THE NEW BILL PROPOSED BY THE ITALIAN GOVERNMENT Francesca Bottega, Elena Maria Ticozzi, Andrea Comelli, Roberto Faccincani, Giuseppe Stirparo Euromediterranean Biomedical Journal, 2026 Mass gathering events (MGEs) place a strain on public health systems and require careful planning of healthcare resource allocation, including ambulances and personnel. The Maurer’s algorithm is commonly used to determine resource allocation, taking into account event type, location, participants, and potential public order issues. A working group from the Italian Regional Emergency and Urgency Agency (AREU) analyzed critical aspects of Maurer’s algorithm and developed the G.A.M.E.S. algorithm (Management Assistance for Sporting Events). The G.A.M.E.S. algorithm optimizes health care resource planning for MGEs and addresses the shortcomings of Maurer’s algorithm. Compared to Maurer, G.A.M.E.S. shows improved accuracy, especially for smaller events. Standardized event categorization and sports event prioritization improve resource allocation. The G.A.M.E.S. algorithm is a useful tool for predicting resource needs, especially for small and medium-sized events. Prospective validation studies are essential to assess its applicability across a wider range of contexts.
Post-mastectomy pain syndrome and sleep disorders: effects of physical activity Marco Calapai, Luisa Puzzo, Giuseppe Bova, Daniele Alfio Vecchio, Rosario Blandino, Alessia Barbagallo, Ilaria Ammendolia, Luigi Cardia, Filippo Firenzuoli, Fabrizio Calapai, Mariaconcetta Currò, Giovanni Ficarra, Emanuela Esposito, Fabio Trimarchi, Debora Di Mauro, Gioacchino Calapai, Carmen Mannucci Frontiers in Sports and Active Living, 2025 Introduction Aim of the study was the evaluation of physical activity effects on chronic post-surgery pain perception, sleep quality and related biomarkers (melatonin, AdrenoCorticoTropic Hormone, and cortisol) in women undergoing postmastectomy. Methods A prospective observational unicentric cohort study was designed by recruiting women undergoing unilateral or bilateral mastectomy. One hundred and eighty (180) women were enrolled in the study according to inclusion and exclusion criteria. The mean age of the sample of patients recruited for the study was 50.34 ± 11.9 years (range 28–72 years, median age 53.5 years). The mean BMI was 21.59 ± 1.49. All the participants were Caucasian. Pain assessment, quality of sleep and motor activity of each participant in the study was measured 3 and 6 months after the intervention as well as biomarkers. Results show that level of physical activity measured through International Physical Activity Questionnaire reduces intensity of pain and its interference with quality of life, moreover, in women with higher physical activity, results show a reduction of sleep disturbance, cortisol and ACTH levels and an increase of melatonin, compared with women with minor motor activity and lower physical activity level. Conclusions Physical activity seems to reduce pain intensity, reduce sleep disorders together with a reduction of cortisol and ACTH and an increase of melatonin. (Clinical Trial.gov identifier: NCT06803563)
Handles with Reentrant Cells for Use as Oar Handles: Design Considerations, Physical Characteristics, and End-Users’ Perceptions James N. Grima‐Cornish, Daphne Attard, Alfred Gatt, Giovanni Ficarra, Dario Cerasola, Claire Saliba Thorne, Andrew Albanozzo, Paul Albanozzo, Ruben Gatt, Cynthia Formosa, Joseph N Grima Physica Status Solidi B Basic Research, 2024 Rowing is a sport that requires athletes to perform the action of pulling and rotating an oar by hand, applying forces of considerable magnitude. Herein, inspired by the notion that auxetic materials and metamaterials behave differently compared to their conventional counterparts, it is examined how a handle prototype, specifically designed to incorporate the classic re‐entrant motif, behaves and how end‐users perceive it. Physical experiments conducted on such prototype, which measured the contact pressures, suggest that on average, higher pressures are measured when pulling with this reentrant grip compared to its non reentrant counterpart, indicating that this re‐entrant prototype should feel firmer. More importantly, respondents of a survey are asked to give their feedback, and different views on which handle they would prefer to use are provided. The ones who preferred the prototype with the reentrant features report that they preferred it because it felt firmer and allowed for a better grip. This suggests that there is potential for further investigation into whether handles, oar handles in particular, made from auxetic components, re‐entrant cells, or other motifs which are well known for their negative Poisson's ratio characteristics, could provide a better and more secure grip and be used in sports applications.
A case report on dietary needs of the rowing athlete winner of the triple crown Giovanni Ficarra, Carmen Mannucci, Alessio Franco, Alessandra Bitto, Fabio Trimarchi, Debora Di Mauro Heliyon, 2024 Sports nutrition is a topic that is often misinterpreted and sometimes abused. The often-used "shot-gun" method to meeting caloric needs by simply increasing caloric intake disregarding nutrient source is scientifically contrary to the need for a more careful study of the nutritional requirements of rowers. Rowing by itself is a very demanding sport as typical training sessions use exercise intensities that range from very low submaximal work to short term supramaximal efforts. The intake in calories should take into account also the type of race that the athlete will afford. In the case of the rower Giovanni Ficarra who won, in 16 months, three world competitions in the three different rowing disciplines, his dietary needs and training schedule significantly changed according to the type of competition, to be prepared for the extreme load of physical effort required to get the podium in such different conditions. This article in intended to provide recommendation for both coaches and athletes that are approaching rowing in its whole meaning and disciplines as Giovanni Ficarra did.
Testosterone/cortisol ratio: gender effect and prediction of podium results in beach sprint master rowers Giovanni Ficarra, Michelangelo Rottura, Carmen Mannucci, Daniela Caccamo, Alessandra Bitto, Fabio Trimarchi, Debora Di Mauro Frontiers in Sports and Active Living, 2024 ObjectiveThe purpose of this study was to address the lack of data on the stress and motivation response in master athletes during competitions, as athletic performance in this age group can be significantly impacted by stress rather than appropriate training.MethodsCoastal rowing beach sprint master athletes aged 43–57 years were examined to assess the saliva levels of stress biomarkers, cortisol, and testosterone. Specifically, samples were collected at awakening and before and after the boat race.ResultsMean values of cortisol remained unchanged from awakening and raised at the end of the competition, while testosterone levels increased before the race, suggesting an aggressive/competitive behavior. Cortisol levels were significantly higher when comparing pre-race levels with post-race (p = 0.001) levels and early morning with post-race (p = 0.006) levels. No gender effect was observed in this case. Testosterone values did not demonstrate significance when compared between time points, not even when stratifying by gender. Considering the 24 athletes, a higher testosterone/cortisol ratio was correlated with a worse podium position (B = 3.705; p = 0.009). When stratified by gender, the testosterone/cortisol ratio demonstrated an association with a worse outcome of the race only in female rowers (B = 4.012; p = 0.022). Male athletes demonstrated no significant correlation between hormone ratio and race results (B = 3.288; p = 0.292).ConclusionIt emerged from this study that the amateur rowers who approach competitive sport during adulthood may have problems in coping with the race-related stress and thus the outcome of their performance might be affected, as in adolescents.
Effects of Physical Exercise and Motor Activity on Depression and Anxiety in Post-Mastectomy Pain Syndrome Marco Calapai, Luisa Puzzo, Giuseppe Bova, Daniele Alfio Vecchio, Rosario Blandino, Alessia Barbagallo, Ilaria Ammendolia, Luigi Cardia, Fabrizio Calapai, Mariaconcetta Currò, Giovanni Ficarra, Emanuela Esposito, Fabio Trimarchi, Debora Di Mauro, Gioacchino Calapai, Carmen Mannucci Life, 2024 Background: Chronic post-surgical pain is a condition persisting for not less than 3 months after surgical intervention. It is evaluated that 25–60% of women who underwent breast cancer excision suffer from post-mastectomy pain syndrome, and anxiety, depression, sleep disturbance, and catastrophizing. Physical activity can reduce the risk of chronic diseases and has a good impact on mood and cognitive function. The aim of this study was to estimate the influence of physical activity on the intensity of pain, depression, and anxiety in women who underwent mastectomy for breast cancer removal. Methods: A prospective observational unicentric cohort study was performed. Patients were females who underwent unilateral or bilateral mastectomy. The Numerical Rating Scale (NRS) was used to measure pain intensity, Beck’s Depression Inventory (BDI) for depression, and Generalized Anxiety Disorders-7 (GAD-7) for anxiety evaluation. Physical activity was assessed by the International Physical Activity Questionnaire (IPAQ). Interleukin (IL)-17, IL-1β, cortisol, adrenocorticotropic hormone (ACTH), and brain-derived neurotrophic factor (BDNF) were also evaluated in the blood of patients. All evaluations were assessed 3 and 6 months after the surgery. Results: Adequate physical activity reduced the intensity of pain, depression, and anxiety symptoms in women affected by post-mastectomy pain syndrome. Moreover, adequately active women showed a reduction in biomarkers of inflammation, cortisol, ACTH, and an increase of BDNF. Conclusions: Our results suggest that physical activity can improve the quality of life, reduce the intensity of pain and inflammatory markers, and be useful in the reduction of associated anxiety and depression.
Testosterone:cortisol ratio as a predictor of podium in adolescent rowing athletes Giovanni Ficarra, Daniela Caccamo, Michelangelo Rottura, Alessandra Bitto, Fabio Trimarchi, Debora Di Mauro Heliyon, 2023 Purpose: There is a lack of data regarding the stress and motivation response in adolescent athletes during competitions. The athletic performance can be highly influenced by stress rather than appropriate training, at this age. The aim of this investigation is to evaluate the level of stress markers in adolescent rowers in different competition settings that might alter their stress status and performance. Methods: Adolescent rowing athletes (12-18 yrs) have been tested for determining saliva content of stress biomarkers, cortisol and testosterone, before and after competitions that have been performed indoor and outdoor. Specifically, samples have been taken in the morning, before and after the race in 2 different settings: 1) an indoor rowing competition with an ergometer, 2) an outdoor rowing competition on boats. Results: A reduction in cortisol levels has been observed in athletes right before the outdoor race, while testosterone levels increased at the same time point before either the ergometer or boat competition and kept rising at the end of the race. Significant differences have been found comparing the testosterone/cortisol ratio between indoor and outdoor data, being higher in the indoor race at all considered time-point. Furthermore, the linear regression demonstrated that the increased ratio correlated with a better podium position in the indoor race. Conclusion: Despite the age differences among athletes might have an influence on their hormone levels, these data suggest that rowing athletes subjected to different kind of competitions show a different stress and motivation response profile that might influence their performance.
