Research on scars

Research carried out by the Dr. Raggi’s staff of Posturologists: Paolo Beretta, Giovanni Castellani, Alida Cambieri. Data examined by Diego Caimi.

1. Introduction
Since any scar involves not only the skin but also the connective, fascial, and muscular tissue, through the muscular chains it can interfere with the whole musculoskeletal system and therefore with posture.
The aim of this research is to evaluate, through objective and subjective tests, what kind of changes can be brought about by a treatment of the present scars in terms of posture, function, and pain.

2. Materials and methods
The research was carried out on 40 patients divided in two groups of 20 people each: one group was treated on Pancafit using a global non-compensated posture (group A), whereas the other one was treated without Pancafit (group B).
Each subject had at least one scar that we tested at the beginning of the research.
Then using the MPQ test and the VAS scales we carried out other subjective tests, stabilometric and baropodometric measurements using a DIASU platform, flexibility tests by asking the patients to bend forward, and photographs taken with subjects in posture using a scoliosometer.
5 treatments were carried out on all the scars of each subject, once a week for five weeks.
Once we had finished with the treatments, we repeated the initial tests and evaluated the changes. After a period of 4 months there was a check in order to verify whether the changes had lasted in time.

3. Results
At the end of the research the evaluation tests were carried out again in order to estimate the changes obtained from the beginning to the end of the treatments and to compare the results obtained in the two different groups (A and B).
The research highlighted a good relationship between scars treatment and pain reduction. There was a significant improvement for both groups but the results appeared better for group A (in posture) as it is showed by the MPQ test and by VAS scale (Chart 1 and 2).

	Graphic 1: Comparison between the improvements obtained in the MPQ test in group A and group B. Each class includes adjectives to describe pain. It is clear that for each class the percentage of people using adjectives to describe their pain at the end of the research decreased, which means people felt less pain after the treatments.

Graphic 2: In group A the improvement of the pain was of 60% against 59% of group B. The worsening was of 31% for group A against 29% of group B. The results did not change for 9% of the subjects in group A and for 12% of the subjects in group B.
Apart from a reduction of the pain, the results showed a higher flexibility in the bending test. Group A, even though it started from a higher average value than group B, obtained a more significant result (Chart 1 and 3).

Chart 1: The data reported in the starting and ending columns indicate the distance between the patients’ fingers and the ground evaluated through the bending test. In column G you can see the difference expressed in centimeters between the initial and the final test. The positive values showed that patients did a wider flexion of the trunk, whereas negative results showed that the flexion was reduced.

Graphic 3: Comparison between initial and final average of values for the bending test in group A and group B and comparison of the average improvement for the two groups. Also through an instrumental analysis carried out using a stabilometric platform DIASU a variation of the different parameters comes to light after treating the scars. We measured the differences in the dead load, the bearing surfaces and the variation in the projection of the barycenters on the ground, and then we compared initial and final results (Chart 4). There was an improvement for both groups and the relevant result was that the rate of the worsened subjects was lower in group A.

Graphic 4: In group B patients who showed an improvement of the static barycenters were 50% against 45% of group A. 35% of the patients in group B showed a worsening against 10% of group A.
Patients showing the improvement of the dead load were in both groups 55%, whereas patients showing a worsening in it were 30% in group B and 25% in group A. The percentage of patients who had an improvement in the balance of the bearing surfaces was 40% in group B and 50% in group A, whereas patients experiencing a worsening were 35% in group B against 15% of group A.
After 4 months a control exam was carried out on all the subjects in order to verify whether the results had been maintained after the end of the research.
Both groups had maintained the positive effects of the treatment and many patients reported to have experienced a further reduction of the pain during those months obtaining positive changes also at the end of the sessions. It emerged that from the end of the treatment the number of patients who worsened was higher among those who had not been treated in posture (group B) (Chart 2).

Chart 2: Pain reduced in 39,7% of the cases in group B and in 53,3% in group A, it worsened in 41,4% of the patients in group B and in 26,7% in group A. The cases of unvaried pain were 18,9% in group B and 20% in group A.
The patients who improved in group B were 56,2% against 64,8% of group A; the patients who worsened their situation were 31,3% against 17,6% of group B. The unvaried cases, instead, were 12,5% in group A and 17,6% in group B.