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Perpetuini D, Russo EF, Cardone D, Palmieri R, De Giacomo A, Intiso D, Pellicano F, Pellegrino R, Merla A, Calabrò RS, Filoni S. Assessing the Impact of Electrosuit Therapy on Cerebral Palsy: A Study on the Users' Satisfaction and Potential Efficacy. Brain Sci 2023; 13:1491. [PMID: 37891858 PMCID: PMC10605024 DOI: 10.3390/brainsci13101491] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/13/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
The aim of this study is to evaluate the effectiveness of electrosuit therapy in the clinical treatment of children with Cerebral Palsy, focusing on the effect of the therapy on spasticity and trunk control. Moreover, the compliance of caregivers with respect to the use of the tool was investigated. During the period ranging from 2019 to 2022, a total of 26 children (18 M and 8 F), clinically stable and affected by CP and attending the Neurorehabilitation Unit of the "Padre Pio Foundation and Rehabilitation Centers", were enrolled in this study. A subset of 12 patients bought or rented the device; thus, they received the administration of the EMS-based therapy for one month, whereas the others received only one-hour training to evaluate the feasibility (by the caregivers) and short-term effects. The Gross Motor Function Classification System was utilized to evaluate gross motor functions and to classify the study sample, while the MAS and the LSS were employed to assess the outcomes of the EMS-based therapy. Moreover, between 80% and 90% of the study sample were satisfied with the safety, ease of use, comfort, adjustment, and after-sales service. Following a single session of electrical stimulation with EMS, patients exhibited a statistically significant enhancement in trunk control. For those who continued this study, the subscale of the QUEST with the best score was adaptability (0.74 ± 0.85), followed by competence (0.67 ± 0.70) and self-esteem (0.59 ± 0.60). This study investigates the impact of the employment of the EMS on CP children's ability to maintain trunk control. Specifically, after undergoing a single EMS session, LSS showed a discernible improvement in children's trunk control. In addition, the QUEST and the PIADS questionnaires demonstrated a good acceptability and satisfaction of the garment by the patients and the caregivers.
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Affiliation(s)
- David Perpetuini
- Department of Engineering and Geology, University G. D’Annunzio of Chieti-Pescara, 65127 Pescara, Italy; (D.P.); (D.C.); (A.M.)
| | - Emanuele Francesco Russo
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy; (E.F.R.); (F.P.)
| | - Daniela Cardone
- Department of Engineering and Geology, University G. D’Annunzio of Chieti-Pescara, 65127 Pescara, Italy; (D.P.); (D.C.); (A.M.)
| | - Roberta Palmieri
- Translational Biomedicine and Neuroscience Department (DiBraiN), University of Bari “Aldo Moro”, 70124 Bari, Italy; (R.P.); (A.D.G.)
| | - Andrea De Giacomo
- Translational Biomedicine and Neuroscience Department (DiBraiN), University of Bari “Aldo Moro”, 70124 Bari, Italy; (R.P.); (A.D.G.)
| | - Domenico Intiso
- Unit of Neuro-Rehabilitation, IRCCS “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy; (D.I.); (S.F.)
| | - Federica Pellicano
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy; (E.F.R.); (F.P.)
| | - Raffaello Pellegrino
- Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, 6912 Lugano, Switzerland;
| | - Arcangelo Merla
- Department of Engineering and Geology, University G. D’Annunzio of Chieti-Pescara, 65127 Pescara, Italy; (D.P.); (D.C.); (A.M.)
| | | | - Serena Filoni
- Unit of Neuro-Rehabilitation, IRCCS “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy; (D.I.); (S.F.)
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Perpetuini D, Russo EF, Cardone D, Palmieri R, De Giacomo A, Pellegrino R, Merla A, Calabrò RS, Filoni S. Use and Effectiveness of Electrosuit in Neurological Disorders: A Systematic Review with Clinical Implications. Bioengineering (Basel) 2023; 10:680. [PMID: 37370612 DOI: 10.3390/bioengineering10060680] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Electrical stimulation through surface electrodes is a non-invasive therapeutic technique used to improve voluntary motor control and reduce pain and spasticity in patients with central nervous system injuries. The Exopulse Mollii Suit (EMS) is a non-invasive full-body suit with integrated electrodes designed for self-administered electrical stimulation to reduce spasticity and promote flexibility. The EMS has been evaluated in several clinical trials with positive findings, indicating its potential in rehabilitation. This review investigates the effectiveness of the EMS for rehabilitation and its acceptability by patients. The literature was collected through several databases following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Positive effects of the garment on improving motor functions and reducing spasticity have been shown to be related to the duration of the administration period and to the dosage of the treatment, which, in turn, depend on the individual's condition and the treatment goals. Moreover, patients reported wellbeing during stimulation and a muscle-relaxing effect on the affected limb. Although additional research is required to determine the efficacy of this device, the reviewed literature highlights the EMS potential to improve the motor capabilities of neurological patients in clinical practice.
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Affiliation(s)
- David Perpetuini
- Department of Engineering and Geology, University G. D'Annunzio of Chieti-Pescara, 65127 Pescara, Italy
| | | | - Daniela Cardone
- Department of Engineering and Geology, University G. D'Annunzio of Chieti-Pescara, 65127 Pescara, Italy
| | - Roberta Palmieri
- Translational Biomedicine and Neuroscience Department (DiBraiN), University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Andrea De Giacomo
- Translational Biomedicine and Neuroscience Department (DiBraiN), University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Raffaello Pellegrino
- Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, 6912 Lugano, Switzerland
| | - Arcangelo Merla
- Department of Engineering and Geology, University G. D'Annunzio of Chieti-Pescara, 65127 Pescara, Italy
| | | | - Serena Filoni
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy
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Luo J, Liu Q, Gama Z, Gesang D, Zhu Y, Yang L, Bai D, Zhao Q, Xiao M. Factors Influencing Utilization of Assistive Devices by Tibetan Seniors on the Qinghai-Tibet Plateau: Based on Research Strategy of Triangulation. Patient Prefer Adherence 2023; 17:401-411. [PMID: 36815130 PMCID: PMC9939664 DOI: 10.2147/ppa.s400346] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
PURPOSE To investigate the current situation of assistive device (AD) usage among seniors in Tibet, China, and explore its influencing factors. METHODS A mixed-methods design was used. Cognition, attitude, behavior, and preference toward ADs were assessed by a self-designed questionnaire. Additionally, participants responded to the open-ended questions. Anderson's behavior model analyzed the impacts of the prerequisite factors, enabling factors, and demand factors influencing the utilization of ADs by Tibetan seniors. RESULTS Of the 211 Tibetan seniors, 149 (70.6%) Tibetan seniors expressed the willingness to utilize ADs. Binary Logistic regression analysis showed that one prerequisite factor: age; one enabling factor: care situation, and one demand factor: dysfunctional condition were factors influencing the utilization of ADs. Qualitative comments described: psychological, physical environment, and social support factors were the main influencing factors. CONCLUSION This study presents the current situation to utilize ADs by Tibetan seniors on the Qinghai-Tibet Plateau, incorporates Anderson's behavioral model for quantitative analysis, and combines qualitative research to explore the facilitating and hindering factors, to provide reference and basis for the development of ADs for seniors and policy formulation. The sample size of this study is relatively small and limited to ethnic groups, and we plan to increase the sample size and include more ethnic groups in the future study.
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Affiliation(s)
- Jun Luo
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Qing Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Zhujizhaba Gama
- Department of Rehabilitation Medicine, Tibet Autonomous Region People’s Hospital, Tibet, People’s Republic of China
| | - Deji Gesang
- Department of Rehabilitation Medicine, Tibet Autonomous Region People’s Hospital, Tibet, People’s Republic of China
| | - Ying Zhu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Lining Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Dingqun Bai
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Correspondence: Mingzhao Xiao, 1st Youyi Road, Chongqing, 400016, People’s Republic of China, Tel +86 13608399433, Email
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Electro-suit treatment of children with unilateral cerebral palsy alters nonlinear dynamics of walking. Clin Biomech (Bristol, Avon) 2022; 98:105714. [PMID: 35839741 DOI: 10.1016/j.clinbiomech.2022.105714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 06/23/2022] [Accepted: 07/01/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cerebral palsy (CP) is characterized by spasticity and muscle contracture development and associated with mild to severe motor impairments including reduced gait function. Treatment with the Exopulse® suit has been shown to reduce spasticity of the affected muscles and constitutes a non-invasive alternative to pharmaceutical agents and surgical denervation. The present study investigated the effect of systematic treatment with the Exopulse® suit on the nonlinear dynamics and variability of trunk accelerations during walking in children with unilateral CP. METHODS Twelve patients (mean age: 12 years, range 7-17 years) with unilateral CP (GMFCS level 1 and 2) received 24 weeks Exopulse® suit treatment with patient-specific muscle stimulation. Before and after the treatment, the patients completed 4 min treadmill walking while trunk accelerometry was obtained. The nonlinear dynamics was quantified by the largest Lyapunov exponent and the complexity index from the multiscale entropy and movement variability was quantified by the root mean square ratio. Pre- vs post-treatment differences were evaluated by a paired Student's t-test. FINDINGS The largest Lyapunov exponent (p-value = 0.041) and the complexity index (p-value = 0.030) of the acceleration in the anterior-posterior direction was significantly lower post-treatment. No other between-trial differences were observed. INTERPRETATION The present study suggests that 24 weeks of Exopulse® suit treatment alters the nonlinear dynamics but not the variability of the trunk accelerations during walking in children with unilateral CP. The temporal structure of the trunk acceleration in the anterior-posterior direction was altered towards that of healthy individuals.
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Flodström C, Viklund Axelsson SA, Nordström B. A pilot study of the impact of the electro-suit Mollii® on body functions, activity, and participation in children with cerebral palsy. Assist Technol 2021; 34:411-417. [PMID: 33151822 DOI: 10.1080/10400435.2020.1837288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Electrical stimulation has been used to treat spasticity in children with cerebral palsy. Building on the benefits of electrical stimulation, a new assistive device, electro-suit Mollii® with imbedded electrodes has been tested. The aim of the study was to evaluate the possible effect of Mollii® on body function, activity and participation in self-selected activities. Six children, five to ten years of age, used the electro-suit for one hour, every other day for three months. The impact was evaluated after four weeks and after three months by measuring passive range of motion (ROM), muscle tone, pain, gross motor function and participation. All participants improved in the total score for Canadian Occupational Performance Measure (COPM), three of them showed significant clinical improvements. Pain was reduced for children who estimated pain when the study started. There were also small changes in Electro-suit Mollii® had a positive impact on activity and participation in self-selected activities among the children in this study. Further studies with more children over a longer time are necessary to evaluate the impact and usefulness over time.
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Affiliation(s)
- Camilla Flodström
- Department of Research and Development, Region Norrbotten, Luleå, Sweden
| | - Sari-Anne Viklund Axelsson
- Department of Research and Development, Region Norrbotten, Luleå, Sweden.,Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Birgitta Nordström
- Department of Research and Development, Region Norrbotten, Luleå, Sweden.,Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
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Hedin H, Wong C, Sjödén A. The effects of using an electrodress (Mollii®) to reduce spasticity and enhance functioning in children with cerebral palsy: a pilot study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2020.1807602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - Christian Wong
- Orthopaedic Department, Hvidovre Hospital, Hvidovre, Denmark
| | - Ann Sjödén
- Orthopaedics and Spasticity Treatment at the Neuropediatric Clinic, Falun Hospital, Sweden
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