Neoplasms

Musculoskeletal Diseases

All Conditions

Diseases and Abnormalities at or Before Birth

Skin and Connective Tissue Diseases

Nutritional and Metabolic Diseases

Symptoms and General Pathology

Behaviors and Mental Disorders

Rare Diseases

Osteochondroma

Exostoses, Multiple Hereditary

Osteochondromatosis

Exostoses

Osteophyte

Enchondromatosis

Neoplasms, Bone Tissue

Neoplasms, Connective Tissue

Neoplasms, Connective and Soft Tissue

Neoplasms by Histologic Type

Osteochondrodysplasias

Mucopolysaccharidosis IV

Bone Diseases

Bone Diseases, Developmental

Hyperostosis

Syndrome

Neoplastic Syndromes, Hereditary

Genetic Diseases, Inborn

Quality of Life

Hereditary Multiple Osteochondromas

Ollier Disease

Mucopolysaccharidosis Type IV

Patients affected by Multiple Osteochondromas. The Registry will include also data on foetuses (prenatal).

Marina Mordenti, PhD

Manila Boarini, MSc

Luca Sangiorgi, MD, PhD, MS

REM is a retrospective and prospective registry, finalized to care and research. It is articulated in main sections - strongly related and mutually dependent on each other - corresponding to different data domains: personal information, clinical data, genetic data, genealogical data, surgeries, etc..

This approach has been individuated in order to corroborate and integrate data from different resources and aspects of the diseases and to correlate genetic background and phenotypic outcomes, in order to better investigate diseases pathophysiology.

The common way to collect patient information is frequently chaotic and inconvenient (sometimes even unsafe), particularly when dealing with rare diseases. The need to simplify the diagnostic process and to overcome the difficulties of data storage and analysis, suggested in 2013 to implement the Registry of Multiple Osteochondromas (REM).

The REM relies on an IT Platform named Genotype-phenotype Data Integration platform -GeDI.This solution, realized by a collaboration among Medical Genetic Department and a local software-house (NSI - Nier IT Solution), is a General Data Protection Regulation (GDPR)-compliant, multi-client, web-accessible system and it has been designed according to current medical informatics standards (Orphanet code, ICD-10, Human Genome Variants Society, Findability Accessibility Interoperability Reusability Principles). GeDI is continuously implemented to improve management of persons with Multiple Osteochodromas and to help researchers in analysing collected information. REM is articulated in main sections:

* Personal data: it comprises general information, birth details and residence data
* Patient data: including the patients internal code, the hospital code and other details on patients
* Diagnosis: the diagnosis, the status (affected, suspect, etc.), age at diagnosis, comorbidities, allergies, etc.
* Genogram: a tool to design family transmission of the disease, flanked by info on diseases status of all included relatives
* Clinical events: records more than 20 signs and symptoms of Multiple Osteochondromas and 12 additional items to describe the disease
* Genetic Analysis and Alteration: including technique, sample information, duration of analysis, etc. In addition, this section comprises detailed information on detected pathological variants (gene, international reference, DNA change, Protein change, genomic position, etc.)
* Visits: it includes the typology of the visit (genetic, orthopaedic, rehabilitation, paediatric, etc.), the date of the visit, treatment, prescription, imaging, etc.
* Surgeries: this section contains information on the surgeries type, the age of the patients, the site/localization of the procedures, etc.
* Documents: this repository is allowed to store all type of documents (radiological reports, imaging, consents, clinical reports, etc.)
* Consents: this section comprises a complete overview of all collected consents, including the date of collection.
* Samples: it comprises the type of samples (DNA, tissue, whole peripheral blood, etc.)

Whole peripheral blood, DNA, lymphocytes, cartilage tissues, bone tissues

Registry of Multiple Osteonchodromas

Registry of Multiple Osteochondromas That Collects Clinical, Functional, Genetic, Genealogical, Imaging, Surgical, Quality of Life Data. Data Are Linked to Patients Biological Sample

This outcome aims to investigate the evolution of Multiple Osteochondromas during time. This will be evaluated within the families and among the families.

Main clinical features, such as height (cm), number and localization of osteochondromas, number and localization of deformities, number and localization of limitations will be collected both retrospectively and prospectively for paediatric population. An evaluation of these parameters will be performed at each visit to keep trace on the progression of the clinical manifestations.

In adult population, the disease evolution is centered on malignant transformation.

To maintain an established registry in order to assess epidemiology and natural history (such as incidence, prevalence, etc.) of Multiple Osteochondromas.

Collection of:

1. physical examinations data: assessment of severity of the disease (defined according to Mordenti et al classification)
2. orthopaedic and functional data: stature (cm), weight (kg), number and localization of sites affected by osteochondromas, site of malignant transformation, definition of deformities (localization and number), definition of limitations (localization and number)
3. surgical procedures: type, number and site of surgeries disease-related and age at surgeries
4. genetics background: target gene, type of mutation, type of variant detected, clinical significance
5. family history: inheritance in maternal or paternal line

Clinical, orthopaedic and functional features are updated at each follow up. Clinical reports, medical charts, genetic report and imaging are the primary source of data.

The secondary outcome comprises the correlation between genotype and phenotype. This includes, but is not limited to clinical features and genetic background. This will be pursued using the information collected during visits and follow-ups and the genetic information resulting from molecular investigations.

Luca Sangiorgi

Head of Departement of Rare Skeletal Disorders

Osteogenesis Imperfecta

Rheumatic Diseases

Collagen Diseases

Connective Tissue Diseases

NGS molecular screening

The coming out of Next Generation Sequencing (NGS) technologies, with documented advantages and reduced costs respect to Sanger sequencing, has provided new appealing approaches to diagnostic testing. Despite this, its use for routine diagnostic purposes requires certification in terms of reliability, as well as a cost-effectiveness evaluation.

To test the feasibility of using the Ion Torrent Personal Genome Machine (PGM) in clinical diagnosis, we assessed its performance to detect point mutations and big rearrangements previously identified with standard techniques. The diagnostic accuracy and the cost-effectiveness will be evaluated by Health Technology Assessment (HTA) analyses.

NGS Strategy Effectiveness in Molecular Diagnosis

The accuracy of the Ion Torrent Personal Genome (PGM) to identify disease-causing mutations in patients affected by Multiple Osteochondromas (MO) and Osteogenesis Imperfecta (OI) needs to be validated for its routine diagnostic clinical use. To asses this, we will compare results obtained with the new NGS approach with those previously obtained with standard techniques (DHPLC/Sanger + MLPA) in a number of MO and OI patients.

To demonstrate the pertinence in the use of this innovative technology in health care, we will examine the medical, social and economic implications according with Health Technology Assessment (HTA), a multi-disciplinary field of policy analysis applied to many different health care technologies before their diffusion and use. HTA aims at evaluating the real effectiveness of medical interventions, their proper use, access criteria and qualitative improvements, the clinical and organizational benefits, therefore suggesting how to manage, promote and discourage them.

Catholic University of the Sacred Heart

Regione Emilia-Romagna

Istituto Ortopedico Rizzoli

* Sailing activity (4 h/die)
* Stretching exercises pre and post-sailing activity
* Post-activity debriefing

5-day sailing activity

Luca Sangiorgi, MD, PhD

Background Individuals with rare skeletal disorders frequently experience psychological distress, social isolation, unmet needs, and significant challenges due to limited treatment options. Adventure Therapy, employing exposure to natural environments, has shown promise in improving self-esteem, autonomy, and social skills in chronic illness and disability populations. This pilot study explores the feasibility and preliminary efficacy of a sailing-based intervention for enhancing physical, social, and psychological well-being in this specific population.

Outcome Measures The primary outcome is to investigates the feasibility of sailing to improve well-being and quality of life in patients living with rare skeletal disorders.

Furthermore, the investigators hypothesize that participation in a sailing program led by occupational therapists will lead to improvements in:

* Movement confidence: assessing whether sailing enhances participants' ability to move and perform daily activities.
* Mental health: evaluating if sailing reduces anxiety and fear and promotes self-esteem.
* Social interaction: exploring if sailing fosters social connection and reduces feelings of isolation.

Methods The study will use a prospective, single-arm, longitudinal design. Eight participants with rare skeletal disorders will be enrolled in a 5-day sailing-based occupational therapy intervention. Comprehensive pre- and post-intervention assessments will measure psychosocial factors, quality of life, functional mobility, kinesiophobia, and body segment movement using questionnaires and functional scales.

Rare skeletal diseases represent a significant global health burden, affecting millions of people worldwide. These chronic, debilitating conditions necessitate the development of optimized clinical pathways and comprehensive support systems.

Adventure therapy (AT) has emerged as a promising intervention for individuals with chronic conditions, demonstrating improvements in self-esteem, autonomy, and social skills. Sailing, a form of AT, offers opportunities for physical activity, social inclusion, and emotional well-being in individuals with disabilities.

This study aims to assess the feasibility of using sailing as an occupational therapy intervention for patients with rare skeletal diseases. We hypothesize that sailing can enhance physical, cognitive, and social functioning in this patient population.

A pilot program of sailing lessons for patients with rare skeletal diseases will be conducted. Participants will undergo assessments of physical, cognitive, and social skills before and after the intervention.

This study will be the first to explore the use of sailing-based AT for this patient population. The findings will inform the development of larger-scale studies and contribute to the optimization of rehabilitation programs for this patient population.

Ready to Sail: Evaluating Sailing's Feasibility as Ergotherapy

Pronti A Salpare: Studio di fattibilità Sull'Impatto Della Vela Come Ergoterapia in Pazienti Con Malattie Rare Scheletriche - Ready to Sail: Evaluating Sailing's Feasibility as Ergotherapy for Rare Skeletal Diseases

EuroQol 5-Dimension (EQ-5D) instrument offers valuable information about patient-reported health status. EQ-5D assesses health status in terms of five dimensions of health, mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, and with EQ-5D visual analogue scale. It is considered a 'generic' questionnaire because these dimensions are not specific to any one patient group or health condition.

The World Health Organisation Disability Assessment Schedule (WHODAS 2.0) is a standardized method for measuring health and disability by assessing the same individual before and after the intervention. WHODAS 2.0 is a 36-item questionnaire and captures the level of functioning in six domains of life: Cognition - understanding and communicating, Mobility - moving and getting around, Self-care - attending to one's hygiene, dressing, eating and staying alone, Getting along - interacting with other people, Life activities - domestic responsibilities, leisure, work and school, Participation - joining in community activities, participating in society.

Rosenberg Self-Esteem Scale: 10-item scales, ranging from 0-30. Scores between 15 and 25 are within normal range; scores below 15 suggest low self-esteem.

Rosenberg Self-Esteem Scale is a 10-item scale that assesses the self-esteem, ranging from 0-30. Scores between 15 and 25 are within normal range; scores below 15 suggest low self-esteem.

Performance Oriented Mobility Assesment (Tinetti Balance Scale) is an administered 16-item task-oriented test that measures gait and balance abilities, it uses a 3-point ordinal scale of 0, 1 and 2. Gait is scored over 12 and balance is scored over 16 totalling 28.

Berg Balance Scale is a 14-item objective measure that assesses static balance and fall risk, item-level scores range from 0-4, determined by ability to perform the assessed activity, the item scores are then summed with a maximum of 56.

Tampa Scale is a self-reported questionnaire that quantifies fear of movement, or (re)injury, it uses a 4-point Likert scale (Strongly Disagree-Disagree-Agree-Strongly Agree) with statements that have been later linked to the model of fear-avoidance, fear of work-related activities, fear of movement, and fear of re-injury.

Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) is a self-report measure of psychological distress designed to be administered during a course of treatment to determine treatment response. It compries 34 questions about how the participants have been feeling over the last week, using a 5-point scale. The scale covers four dimensions: Subjective well-being, Problems/symptoms, Life functioning, and Risk/harm.

Pediatric Outcomes Data Collection (PODCI) evaluates functional health status through an 83-item questionnaire, and consists of scores on seven core scales, four encompassing physical function and three assessing psychological well-being.

Director of the Rare Skeletal Disorders Department

Infections

Respiratory Tract (Lung and Bronchial) Diseases

COVID-19

Facies

Virus Diseases

Coronavirus Infections

Severe Acute Respiratory Syndrome

Acute Graft Versus Host Disease

Maffucci Syndrome

Luca Sangiorgi, MD, Phd

In the COVID-19 outbreak context, people living with rare diseases have been highly troubled with anxiety, loneliness, and depression. The project evaluates resilience and coping strategies to address pandemic impact by discussion in a dedicated focus group using a web-based platform. The goal is to improve, in a sustainable manner, the coping skills and psychological well-being of children, adolescents, and young adults affected by rare skeletal diseases.

March 11th, 2020, the World Health Organization (WHO) declared the SARS-CoV-2 pandemic accordingly with the spread and size of the infection.

The restrictions implemented by the governments have substantially changed people's lifestyles, facilitating the emergence of emotions such as fear, anxiety, and a sense of loneliness.

The age groups most involved by these burdens have been childhood, adolescence, and young adults. These groups have experienced dramatic changes in their daily life in order the relational, educational, and social networks. Nonetheless, these links outline the ideal environment for the development of resilience and the promotion of coping strategies to face traumatic events.

These lifestyle challenges and their consequences are even more evident in the context of the rare diseases since the outbreak containment measures have emphasized the troubles with which people affected by these conditions are daily forced to confront, in terms of access to care and treatments, resulting in increased stress and anxiety.

The current phase represents a sensitive step for the resumption of the activities in charge of the health and social service aimed at the citizens and especially to people with special needs, such as people suffering from rare diseases.

The pandemic experience has promoted new forms of meeting and contact between individuals using web-based platforms, playing a fundamental role in preserving the community and "sociality" dimensions.

In this scenario, the rare diseases could be an attractive model since the pandemic impinges over their bio-psycho-social characteristics at different levels. Resilience and coping strategies adopted by rare diseases patients could configure as an exemplum to face the psychological distress resulting from anti-pandemic measures, suggesting new approaches of taking charge by health service.

This study evaluates resilience and coping strategies to address pandemic impact by discussion in a dedicated focus group using a web-based platform. The goal is to improve, in a sustainable manner, the coping skills and psychological well-being of children, adolescents, and young adults affected by rare skeletal diseases.

Resilience and Coping in a Rare Skeletal Disease Population to Face Coronavirus (COVID-19) Outbreak Distress: a Longitudinal Study

Exploring Resilience and Coping Strategies of Young Population in Response to Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) Outbreak: a Longitudinal Study in a Cohort of Patients Affected by Rare Skeletal Disorders.

Ego-Resiliency Scale (ER89); 14 items; 4-point Likert scale (1=does not apply at all; 2=applies slightly, if at all; 3=applies somewhat; and 4=applies very strong); Score Resiliency Trait: 47-56 Very High, 35-46 High, 23-34 Undetermined, 11-22 Low, 0-10 Very Low

Hospital Anxiety and Depression Scale (HADS); 14 items: 7 items relate to anxiety and 7 relate to depression; a 4-point (0-3) Likert-scale; Cutoffs for both HADS-anxiety and HADS-depression as \>= 8, and for HADS-total \>= 15

UCLA Loneliness Scale (Version 3); 20-item scale; 4-point rating scale (1=Never; 2=Rarely; 3=Sometimes; and 4=Often); score ranging from 20 to 80.

UCLA Loneliness Scale (Version 3); UCLA Loneliness Scale (Version 3); 20-item scale; 4-point rating scale (1=Never; 2=Rarely; 3=Sometimes; and 4=Often); score ranging from 20 to 80.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Registry of Multiple Osteonchodromas	NCT04133285	Multiple Osteoc...		-	Istituto Ortopedico Rizzoli
NGS Strategy Effectiveness in Molecular Diagnosis	NCT03557567	Multiple Osteoc... Osteogenesis Im...	NGS molecular s...	-	Istituto Ortopedico Rizzoli
Ready to Sail: Evaluating Sailing's Feasibility as Ergotherapy	NCT06397443	Multiple Osteoc... Ollier Disease Osteogenesis Im...	5-day sailing a...	12 Years -	Istituto Ortopedico Rizzoli
Ready to Sail: Evaluating Sailing's Feasibility as Ergotherapy	NCT06397443	Multiple Osteoc... Ollier Disease Osteogenesis Im...	5-day sailing a...	12 Years -	Istituto Ortopedico Rizzoli
Resilience and Coping in a Rare Skeletal Disease Population to Face Coronavirus (COVID-19) Outbreak Distress: a Longitudinal Study	NCT04844697	Multiple Osteoc... Osteogenesis Im... Ollier Disease Maffucci Syndro...		8 Years - 24 Years	Istituto Ortopedico Rizzoli
NGS Strategy Effectiveness in Molecular Diagnosis	NCT03557567	Multiple Osteoc... Osteogenesis Im...	NGS molecular s...	-	Istituto Ortopedico Rizzoli

Spots Global Cancer Trial Database for multiple osteochondroma