Dott. TOMMASO SINISGALLO

Sono un Fisioterapista libero professionista, iscritto all'albo dei fisioterapisti (n°2089), laureato presso l'Università degli studi di Firenze con il massimo dei voti.

Svolgo la mia professione con serietà, impegno e professionalità, ponendo il paziente sempre al centro del percorso riabilitativo considerando non solo la patologia specifica ma anche i suoi bisogni e le sue esigenze .

TERAPIA DOMICILIARE
Svolgo le sedute fisioterapiche a domicilio nella città di Firenze avendo a disposizione strumenti per la riabilitazione ed un lettino fisioterapico atto ai trattamenti manuali e non solo.

COLLABORAZIONI LAVORATIVE
Collaboro con studi privati del territorio fiorentino, nell'ambito della riabilitazione dei disordini dell'apparato muscolo scheletrico, nello specifico per le patologie di spalla, anca, ginocchio, rachide cervicale, dorsale, lombare nel paziente di ogni età.

ESPERIENZE & TIROCINI
Possiedo esperienza nei diversi settori riabilitativi fisioterapici specialistici, acquisita grazie ai tirocini formativi universitari nei reparti ospedalieri di medicina generale (Ospedale di Empoli e di Careggi Firenze), nelle unità di terapia intensiva e sub-intensiva (CTO Careggi), in unità spinale (Careggi Firenze), in ambito ambulatoriale (presidio sanitario di Empoli, Rifredi e Isolotto) ed infine nei reparti adibiti alla riabilitazione post chirurgia dell'arto superiore presso il GRASP (Ospedale Piero Palagi a Firenze).

Svolgo il mio lavoro attuando in primis una accurata Valutazione Fisioterapica del paziente, lavorando per raggiungere gli obbiettivi prefissati dal piano terapeutico rispettando la Prognosi funzionale e gli Obiettivi.

I trattamenti fisioterapici specifici possono comprendere l'utilizzo de: esercizio terapeutico, manipolazione fasciale, massaggio fisioterapico, terapia manuale, riabilitazione geriatrica, riabilitazione ortopedica.
Alla base della fisioterapia vi è una ricerca di un rapporto empatico e di collaborazione tra professionista e paziente, che viene definita professionalmente "alleanza terapeutica", che cerco sempre di instaurare per raggiungere i risultati del piano teraputico stabilito.

SPECIALIZZAZIONI
Ho maturato esperienza clinica e specialistica nella MANIPOLAZIONE FASCIALE (STECCO), tecnica certificata che ha come target l'apparato fasciale corporeo per curare disturbi muscolo scheletrici e/o internistici. Verranno trattati specifici punti del corpo scelti dopo un attenta valutazione che risale nel tempo l'andamento dei compensi delle strutture coinvolte. A volte, infatti, problemi attuali non sono altro che il frutto di compensi che il corpo attua per far fronte a problemi già esistenti del passato. 

Inoltre, svolgo un Master di primo livello in ortopedia e Traumatologia dello Sport per approfondire approcci chirurgici e conservativi delle varie problematiche che frequentemente si presentano nell'intero ambito sportivo. 

- Manipolazione Fasciale per problematiche muscolo-scheletriche e viscerali

- Esercizio Terapeutico

- Riattivazione motoria post-allettamento

- Massaggio decontratturante

- Massaggio linfodrenante

- Riabilitazione pre e post-operatoria

- Fisioterapia ginocchio

- Fisioterapia spalla

- Fisioterapia caviglia

- Fisioterapia gomito

- Fisioterapia sportiva (ritorno allo sport)

- Fisioterapia protocollo di stabilizzazione del rachide cervicale e lombare

Fisioterapia sportiva

Fisioterapia ortopedica e post-traumatica

Disturbi muscoloscheletrici

Lesioni muscolo-tendinee

Fratture

Riabilitazione pre e post-operatoria

Ginnastica posturale

Riattivazione motoria

Vertigini e disturbi dell'equilibrio

Cervicalgie

Dorsalgie

Lombalgie

Sciatalgie

Gonalgie

Collaboro con centri privati dell'area fiorentina.

Pubblicazione Case Report (#29) su rivista ufficiale del XXII National Congress of  Italian Pulmonology - XLVI  ITS-AIPO Congress Respiratory health. 

DOI: 10.1159/000519890

Rivista Karger

ID# 29 Intrapulmonary Percussive Ventilation in Intensive Unite Care: Case Report

Author: Giulia Montigiani, Davide Papi, Silvio Santini, Tommaso Sinisgallo, Cecilia Defraia, Alessandra Colzi, Silvia Lagomarsino, Daisy Bertarelli, Luca Bucciardini Neuroanestesia e Rianimazione, Azienda Ospedaliera Careggi, Firenze, Italy

Introduction: Intrapulmonary percussive ventilation (IPV) (C) is a technique that, using high-frequency oscillatory ventilation with a device called “Percussionator”, facilitates the removal of bronchial secretionsand the resolution of atelectasis, improving efficiency and distribution of ventilation. Objects: This device has been used for our clinical case with the aim of carrying out bronchial clearence and improving gas exchanges. Case report: Pazient B. D, aged 27, male, hospitalized at the intensive care “Neuroanestesia e Rianimazione” of the hospital of Careggi Firenze, presented a traumatic brain injury. On the sixth day of hospitalization the patient developed pneumonia due to Pseudomonas and begun antibiotic therapy. The patient was sedated and underwent tracheostomy procedure. He was bradipnoic, hypercarbic (PCO2 55), hypersecretive, ventilated in a controlled mode (SIMV, VT 580 ml, RR 18 a/m). Treatment with IPV was carried out for 6 consecutive days with a time of use of 9 minutes: 3 minutes in high frequency, 3 minutes in medium frequency, 3 minutes in low frequency, FiO2 50%. Arterial blood gas analysis (ABG) was performed before and after the treatment and repeated every two hours during the day. During the treatment with IPV, a continuous monitoring of vital parameters is provided: heart rate, arterial blood pressure, SpO₂. After the treatment and later, when necessary, the patientwassuctioned. A chest CT was performed before treatment with IPV and again after 6 days. Results: ABG carriedout immediately after the treatment shows a reduction of PaO2 of 40%. After two hours it shows an increase of 30% compared to the base value and this value isstable in the next ten hours. After 6 days of treatment the patient switched from controlled ventilation to supported ventilation (CPAP/PSV mode, 8+8).The CT of the chest (A) performed before the treatment with IPV shows amarkedlung consolidation, basal pleural effusion flap, a limited atelectasis of the left-lower-lobe. The CT scan (B) 6 days after IPV treatment shows a reduction of the lung consolidation, the anterior and posterior-basal segments are more ventilated, and partial resolution of the multiple-consolidating of the upper right and left lower lobe. Conclusions: As reported by many authors (1,2), IPV helps in the removal of a large amount of secretions and, as in our case, was considered an important help during the antibiotic therapy in bronchial clearance, in atelectasis resolution, weaning from invasive mechanical ventilation, without presenting any side effects, even though the patient was in SIMV.

References 1. Salim A, et al. J Trauma 2004;57:542–6. 2. Clini EM, et al. Intensive Care Med 2006;32:1994–2001.

Pubblicazione Case Report (#29) su rivista ufficiale del XXII National Congress of  Italian Pulmonology - XLVI  ITS-AIPO Congress Respiratory health. 

DOI: 10.1159/000519890

Rivista Karger

ID# 29 Intrapulmonary Percussive Ventilation in Intensive Unite Care: Case Report

Author: Giulia Montigiani, Davide Papi, Silvio Santini, Tommaso Sinisgallo, Cecilia Defraia, Alessandra Colzi, Silvia Lagomarsino, Daisy Bertarelli, Luca Bucciardini Neuroanestesia e Rianimazione, Azienda Ospedaliera Careggi, Firenze, Italy

Introduction: Intrapulmonary percussive ventilation (IPV) (C) is a technique that, using high-frequency oscillatory ventilation with a device called “Percussionator”, facilitates the removal of bronchial secretionsand the resolution of atelectasis, improving efficiency and distribution of ventilation. Objects: This device has been used for our clinical case with the aim of carrying out bronchial clearence and improving gas exchanges. Case report: Pazient B. D, aged 27, male, hospitalized at the intensive care “Neuroanestesia e Rianimazione” of the hospital of Careggi Firenze, presented a traumatic brain injury. On the sixth day of hospitalization the patient developed pneumonia due to Pseudomonas and begun antibiotic therapy. The patient was sedated and underwent tracheostomy procedure. He was bradipnoic, hypercarbic (PCO2 55), hypersecretive, ventilated in a controlled mode (SIMV, VT 580 ml, RR 18 a/m). Treatment with IPV was carried out for 6 consecutive days with a time of use of 9 minutes: 3 minutes in high frequency, 3 minutes in medium frequency, 3 minutes in low frequency, FiO2 50%. Arterial blood gas analysis (ABG) was performed before and after the treatment and repeated every two hours during the day. During the treatment with IPV, a continuous monitoring of vital parameters is provided: heart rate, arterial blood pressure, SpO₂. After the treatment and later, when necessary, the patientwassuctioned. A chest CT was performed before treatment with IPV and again after 6 days. Results: ABG carriedout immediately after the treatment shows a reduction of PaO2 of 40%. After two hours it shows an increase of 30% compared to the base value and this value isstable in the next ten hours. After 6 days of treatment the patient switched from controlled ventilation to supported ventilation (CPAP/PSV mode, 8+8).The CT of the chest (A) performed before the treatment with IPV shows amarkedlung consolidation, basal pleural effusion flap, a limited atelectasis of the left-lower-lobe. The CT scan (B) 6 days after IPV treatment shows a reduction of the lung consolidation, the anterior and posterior-basal segments are more ventilated, and partial resolution of the multiple-consolidating of the upper right and left lower lobe. Conclusions: As reported by many authors (1,2), IPV helps in the removal of a large amount of secretions and, as in our case, was considered an important help during the antibiotic therapy in bronchial clearance, in atelectasis resolution, weaning from invasive mechanical ventilation, without presenting any side effects, even though the patient was in SIMV.

References 1. Salim A, et al. J Trauma 2004;57:542–6. 2. Clini EM, et al. Intensive Care Med 2006;32:1994–2001.