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Miccinilli S, Santacaterina F, Della Rocca R, Sterzi S, Bressi F, Bravi M. Efficacy of Lower Limb Orthoses in the Rehabilitation of Children Affected by Cerebral Palsy: A Systematic Review. Children (Basel) 2024; 11:212. [PMID: 38397324 PMCID: PMC10887911 DOI: 10.3390/children11020212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/02/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024]
Abstract
Lower limb orthoses are frequently used in children suffering from cerebral palsy (CP) alongside rehabilitation. The aim of this study was to analyze the effectiveness of ankle-foot orthosis (AFO) and knee-ankle-foot orthosis (KAFO) in walking, balance maintenance, spasticity, and quality of life improvement during rehabilitation in children affected by CP. The hypothesis was that the use of orthoses could improve the parameters compared to non-use. A systematic review was conducted in the main databases, including English language RCTs published about the use of AFO and KAFO in combination or not with rehabilitation methods in children affected by CP and studies mentioning walking, balance, muscle length, and quality of life as outcomes. From an initial number of 1484 results, a final number of 11 RCTs were included, comprising a total number of 442 participants and showing an overall high risk of bias in 10 studies and some concerns in one study. Six studies investigated the domain of walking, four studies investigated the domain of balance, and two studies investigated how KAFO and AFO orthoses could improve and prevent muscle contractures. Using highly heterogeneous study designs, different kinds of orthoses and different assessment tools were used. Further studies conducted with higher methodological quality are needed to establish whether AFO and KAFO are useful or not in combination with rehabilitation in improving the investigated domains.
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Affiliation(s)
- Sandra Miccinilli
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (F.S.); (R.D.R.); (S.S.); (M.B.)
- Research Unit of Physical and Reahabilitation Medicine, Department of Medicine and Surgery, Università Campus Bio-Medico di Rome, Via Alvaro del Portillo, 21, 00128 Rome, Italy
| | - Fabio Santacaterina
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (F.S.); (R.D.R.); (S.S.); (M.B.)
- Department of Engineering, Research Unit of Advanced Robotics and Human-Centred Technologies, Università Campus Bio-Medico di Rome, Via Alvaro del Portillo, 21, 00128 Rome, Italy
| | - Rebecca Della Rocca
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (F.S.); (R.D.R.); (S.S.); (M.B.)
| | - Silvia Sterzi
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (F.S.); (R.D.R.); (S.S.); (M.B.)
- Research Unit of Physical and Reahabilitation Medicine, Department of Medicine and Surgery, Università Campus Bio-Medico di Rome, Via Alvaro del Portillo, 21, 00128 Rome, Italy
| | - Federica Bressi
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (F.S.); (R.D.R.); (S.S.); (M.B.)
- Research Unit of Physical and Reahabilitation Medicine, Department of Medicine and Surgery, Università Campus Bio-Medico di Rome, Via Alvaro del Portillo, 21, 00128 Rome, Italy
| | - Marco Bravi
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (F.S.); (R.D.R.); (S.S.); (M.B.)
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Miccinilli S, Bravi M, Conti G, Bressi F, Sterzi S, Santacaterina F, Ciccozzi M. SARS-CoV-2 Infection Increases the Risk of Muscle Injury in Professional Male Soccer Players-A Retrospective Analysis of the Italian and Spanish Major Leagues. Infect Dis Rep 2023; 15:425-435. [PMID: 37623047 PMCID: PMC10454539 DOI: 10.3390/idr15040043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/06/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
A retrospective cohort study on professional soccer players from the Serie A and LaLiga was conducted to investigate the correlation between SARS-CoV-2 infection and muscle injuries. Players were divided into two groups based on whether they contracted the SARS-CoV-2 infection (C+) or not (C-) during the 2020/2021 season. In the 2019-2020 season, both championships showed a similar number of muscular injuries (MI) between C+ and C- (Serie A: p = 0.194; 95% CI: -0.044 to 0.215, LaLiga p = 0.915; 95% CI: -0.123 to 0.137). In the 2020-2021 season, C+ had a significantly higher number of MI compared to C- in both championships (Serie A: p < 0.05; 95% CI 0.731 to 1.038; LaLiga: p < 0.05; 95% CI: 0.773 to 1.054). Multiple linear regression analysis confirmed that belonging to C+ in the season 2020/2021 was the variable that most strongly influenced the probability of having a muscle injury. Survival analysis revealed a hazard ratio of 3.73 (95% CI 3.018 to 4.628) and of 5.14 (95% CI 3.200 to 8.254) for Serie A and LaLiga respectively. We found an association between SARS-CoV-2 infection and increased risk of muscle injury, emphasizing the importance of carefully considering the infection in the decision-making process for returning to sport. Therefore, SARS-CoV-2 infection should be judged as a real injury requiring specific assessment and training programs.
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Affiliation(s)
- Sandra Miccinilli
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (M.B.); (G.C.); (F.B.); (S.S.)
- Research Unit of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy
| | - Marco Bravi
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (M.B.); (G.C.); (F.B.); (S.S.)
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Giorgio Conti
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (M.B.); (G.C.); (F.B.); (S.S.)
| | - Federica Bressi
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (M.B.); (G.C.); (F.B.); (S.S.)
- Research Unit of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy
| | - Silvia Sterzi
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (M.B.); (G.C.); (F.B.); (S.S.)
- Research Unit of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy
| | - Fabio Santacaterina
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (M.B.); (G.C.); (F.B.); (S.S.)
| | - Massimo Ciccozzi
- Unit of Medical Statistics and Molecular Epidemiology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy;
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Romano C, Nicolò A, Innocenti L, Bravi M, Miccinilli S, Sterzi S, Sacchetti M, Schena E, Massaroni C. Respiratory Rate Estimation during Walking and Running Using Breathing Sounds Recorded with a Microphone. Biosensors (Basel) 2023; 13:637. [PMID: 37367002 DOI: 10.3390/bios13060637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/28/2023]
Abstract
Emerging evidence suggests that respiratory frequency (fR) is a valid marker of physical effort. This has stimulated interest in developing devices that allow athletes and exercise practitioners to monitor this vital sign. The numerous technical challenges posed by breathing monitoring in sporting scenarios (e.g., motion artifacts) require careful consideration of the variety of sensors potentially suitable for this purpose. Despite being less prone to motion artifacts than other sensors (e.g., strain sensors), microphone sensors have received limited attention so far. This paper proposes the use of a microphone embedded in a facemask for estimating fR from breath sounds during walking and running. fR was estimated in the time domain as the time elapsed between consecutive exhalation events retrieved from breathing sounds every 30 s. Data were collected from ten healthy subjects (both males and females) at rest and during walking (at 3 km/h and 6 km/h) and running (at 9 km/h and 12 km/h) activities. The reference respiratory signal was recorded with an orifice flowmeter. The mean absolute error (MAE), the mean of differences (MOD), and the limits of agreements (LOAs) were computed separately for each condition. Relatively good agreement was found between the proposed system and the reference system, with MAE and MOD values increasing with the increase in exercise intensity and ambient noise up to a maximum of 3.8 bpm (breaths per minute) and -2.0 bpm, respectively, during running at 12 km/h. When considering all the conditions together, we found an MAE of 1.7 bpm and an MOD ± LOAs of -0.24 ± 5.07 bpm. These findings suggest that microphone sensors can be considered among the suitable options for estimating fR during exercise.
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Affiliation(s)
- Chiara Romano
- Departmental Faculty of Engineering, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Andrea Nicolò
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135 Rome, Italy
| | - Lorenzo Innocenti
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135 Rome, Italy
| | - Marco Bravi
- Unit of Physical and Rehabilitative Medicine, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Sandra Miccinilli
- Unit of Physical and Rehabilitative Medicine, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Silvia Sterzi
- Unit of Physical and Rehabilitative Medicine, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Massimo Sacchetti
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135 Rome, Italy
| | - Emiliano Schena
- Departmental Faculty of Engineering, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Carlo Massaroni
- Departmental Faculty of Engineering, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
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Bressi F, Cricenti L, Bravi M, Pannunzio F, Cordella F, Lapresa M, Miccinilli S, Santacaterina F, Zollo L, Sterzi S, Campagnola B. Treatment of the Paretic Hand with a Robotic Glove Combined with Physiotherapy in a Patient Suffering from Traumatic Tetraparesis: A Case Report. Sensors (Basel) 2023; 23:3484. [PMID: 37050544 PMCID: PMC10099243 DOI: 10.3390/s23073484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/15/2023] [Accepted: 03/23/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND cervical spinal cord injury leads to loss of upper limb functionality, which causes a decrease in autonomy to perform activities of daily living. The use of robotic technologies in rehabilitation could contribute to improving upper limb functionality and treatment quality. This case report aims to describe the potential of robotic hand treatment with Gloreha Sinfonia, in combination with conventional rehabilitation, in a tetraparetic patient. MATERIAL fifteen rehabilitative sessions were performed. Evaluations were conducted pre-treatment (T0), post-treatment (T1), and at two-months follow-up (T2) based on: the upper-limb range of motion and force assessment, the FMA-UE, the 9-Hole Peg Test (9HPT), and the DASH questionnaire. A virtual reality game-based rating system was used to evaluate the force control and modulation ability. RESULTS the patient reported greater ability to use hands with less compensation at T1 and T2 assessments. Improvements in clinical scales were reported in both hands at T1, however, at T2 only did the dominant hand show further improvement. Improved grip strength control and modulation ability were reported for T1. However a worsening was found in both hands at T2, significant only for the non-dominant hand. The maximum force exerted increased from T0 to T2 in both hands. CONCLUSION hand treatment combining physical therapy and Gloreha Sinfonia seems to have benefits in functionality and dexterity in tetraparetic patient in the short term. Further studies are needed to confirm these findings, to verify long-term results, and to identify the most appropriate modalities of robotic rehabilitation.
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Affiliation(s)
- Federica Bressi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University Polyclinic Foundation of Rome, 00128 Rome, Italy
| | - Laura Cricenti
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University Polyclinic Foundation of Rome, 00128 Rome, Italy
| | - Marco Bravi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University Polyclinic Foundation of Rome, 00128 Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Fabiana Pannunzio
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University Polyclinic Foundation of Rome, 00128 Rome, Italy
| | - Francesca Cordella
- Unit of Advanced Robotics and Human-Centred Technologies, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Martina Lapresa
- Unit of Advanced Robotics and Human-Centred Technologies, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Sandra Miccinilli
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University Polyclinic Foundation of Rome, 00128 Rome, Italy
| | - Fabio Santacaterina
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University Polyclinic Foundation of Rome, 00128 Rome, Italy
| | - Loredana Zollo
- Unit of Advanced Robotics and Human-Centred Technologies, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Silvia Sterzi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University Polyclinic Foundation of Rome, 00128 Rome, Italy
| | - Benedetta Campagnola
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University Polyclinic Foundation of Rome, 00128 Rome, Italy
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Bressi F, Campagnola B, Cricenti L, Santacaterina F, Miccinilli S, Di Pino G, Fiori F, D'Alonzo M, Di Lazzaro V, Ricci L, Capone F, Pacilli A, Sterzi S, Bravi M. Upper limb home-based robotic rehabilitation in chronic stroke patients: A pilot study. Front Neurorobot 2023; 17:1130770. [PMID: 37009638 PMCID: PMC10061073 DOI: 10.3389/fnbot.2023.1130770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/27/2023] [Indexed: 03/18/2023] Open
Abstract
IntroductionRobotic therapy allow to propose sessions of controlled and identical exercises, customizing settings, and characteristics on the individual patient. The effectiveness of robotic assisted therapy is still under study and the use of robots in clinical practice is still limited. Moreover, the possibility of treatment at home allows to reduce the economic costs and time to be borne by the patient and the caregiver and is a valid tool during periods of pandemic such as covid. The aim of this study is to assess whether a robotic home-based treatment rehabilitation using the iCONE robotic device has effects on a stroke population, despite the chronic condition of patients involved and the absence of a therapist next to the patient while performing the exercises.Materials and methodsAll patients underwent an initial (T0) and final (T1) assessment with the iCONE robotic device and clinical scales. After T0 evaluation, the robot was delivered to the patient's home for 10 days of at-home treatment (5 days a week for 2 weeks).ResultsComparison between T0 and T1 evaluations revealed some significant improvements in robot-evaluated indices such as Independence and Size for the Circle Drawing exercise and Movement Duration for Point-to-Point exercise, but also in the MAS of the elbow. From the analysis of the acceptability questionnaire, a general appreciation of the robot emerged: patients spontaneously asked for the addition of further sessions and to continue therapy.DiscussionTelerehabilitation of patients suffering from a chronic stroke is an area that is still little explored. From our experience, this is one of the first studies to carry out a telerehabilitation with these characteristics. The use of robots can become a method to reduce the rehabilitation health costs, to ensure continuity of care, and to arrive in more distant places or where the availability of resources is limited.ConclusionFrom the data obtained, this rehabilitation seems to be promising for this population. Moreover, promoting the recovery of the upper limb, iCONE can improve patient's quality of life. It would be interesting to conduct RCT studies to compare a conventional treatment in structure with a robotic telematics treatment.
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Affiliation(s)
- Federica Bressi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University of Rome, Rome, Italy
| | - Benedetta Campagnola
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University of Rome, Rome, Italy
| | - Laura Cricenti
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University of Rome, Rome, Italy
- *Correspondence: Laura Cricenti
| | - Fabio Santacaterina
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University of Rome, Rome, Italy
| | - Sandra Miccinilli
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University of Rome, Rome, Italy
| | - Giovanni Di Pino
- Research Unit of Neurology, Neurophysiology and Neurobiology and Biomedical Robotics and Biomicrosystems, Campus Bio-Medico University of Rome, Rome, Italy
| | - Francesca Fiori
- Research Unit of Neurology, Neurophysiology and Neurobiology and Biomedical Robotics and Biomicrosystems, Campus Bio-Medico University of Rome, Rome, Italy
| | - Marco D'Alonzo
- Research Unit of Neurology, Neurophysiology and Neurobiology and Biomedical Robotics and Biomicrosystems, Campus Bio-Medico University of Rome, Rome, Italy
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology and Neurobiology, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Lorenzo Ricci
- Unit of Neurology, Neurophysiology and Neurobiology, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Fioravante Capone
- Unit of Neurology, Neurophysiology and Neurobiology, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | | | - Silvia Sterzi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University of Rome, Rome, Italy
| | - Marco Bravi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University of Rome, Rome, Italy
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Straudi S, Baluardo L, Arienti C, Bozzolan M, Lazzarini SG, Agostini M, Aprile I, Paci M, Casanova E, Marino D, La Rosa G, Bressi F, Sterzi S, Giansanti D, Perrero L, Battistini A, Miccinilli S, Filoni S, Sicari M, Petrozzino S, Solaro CM, Gargano S, Benanti P, Boldrini P, Bonaiuti D, Castelli E, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzoleni S, Mazzon S, Molteni F, Petrarca M, Picelli A, Posteraro F, Senatore M, Turchetti G, Morone G. Effectiveness of robot-assisted arm therapy in stroke rehabilitation: An overview of systematic reviews. NeuroRehabilitation 2022; 51:559-576. [PMID: 36530097 DOI: 10.3233/nre-220027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Robot-assisted arm therapy (RAT) has been used mainly in stroke rehabilitation in the last 20 years with rising expectations and growing evidence summarized in systematic reviews (SRs). OBJECTIVE The aim of this study is to provide an overview of SRs about the effectiveness, within the ICF domains, and safety of RAT in the rehabilitation of adult with stroke compared to other treatments. METHODS The search strategy was conducted using search strings adapted explicitly for each database. A screening base on title and abstract was realized to find all the potentially relevant studies. The methodological quality of the included SRs was assessed using AMSTAR-2. A pre-determined standardized form was used to realize the data extraction. RESULTS 18 SRs were included in this overview. Generally, positive effects from the RAT were found for motor function and muscle strength, whereas there is no agreement for muscle tone effects. No effect was found for pain, and only a SR reported the positive impact of RAT in daily living activity. CONCLUSION RAT can be considered a valuable option to increase motor function and muscle strength after stroke. However, the poor quality of most of the included SRs could limit the certainty around the results.
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Affiliation(s)
- Sofia Straudi
- Department of Neuroscience and Rehabilitation, Ferrara University, Ferrara, Italy
| | - Ludovica Baluardo
- Department of Neuroscience and Rehabilitation, Ferrara University, Ferrara, Italy
| | | | - Michela Bozzolan
- Interdepartmental Educational Service, Azienda Ospedaliero Universitaria S. Anna Ferrara, Ferrara, Italy
| | | | | | - Irene Aprile
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Matteo Paci
- AUSL (Unique Sanitary Local Company) District of Central Tuscany, Florence, Italy
| | - Emanuela Casanova
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Dario Marino
- IRCCS Neurolysis Center "Bonino Pulejo", Messina, Italy
| | | | - Federica Bressi
- Campus Bio-Medico University Hospital Foundation, Rome, Italy
| | - Silvia Sterzi
- Campus Bio-Medico University Hospital Foundation, Rome, Italy
| | - Daniele Giansanti
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, Rome, Italy
| | - Luca Perrero
- Neurorehabilitation Unit, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | | | - Serena Filoni
- Padre Pio Onlus Rehabilitation Centers Foundation, San Giovanni Rotondo, Italy
| | - Monica Sicari
- A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | | | | | - Paolo Boldrini
- Società Italiana di Medicina Fisica e Riabilitativa (SIMFER), Rome, Italy
| | | | - Enrico Castelli
- Department of Paediatric Neurorehabilitation, IRCCS Bambino Gesù Children's Hospital,, Rome, Italy
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Rome, Italy
| | - Vincenzo Falabella
- Italian Federation of Persons with Spinal Cord Injuries (Faip Onlus), Rome, Italy
| | | | - Francesca Gimigliano
- Department of Mental, Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mauro Grigioni
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, Rome, Italy
| | - Stefano Mazzoleni
- Department of Electrical and Information Engineering, Politecnico di Bari, Bari, Italy
| | - Stefano Mazzon
- AULSS6 (Unique Sanitary Local Company), Euganea Padova - Distretto 4 "Alta Padovana", Padua, Italy
| | - Franco Molteni
- Department of Rehabilitation Medicine, Villa Beretta Rehabilitation Center, Valduce Hospital, Lecco, Italy
| | - Maurizio Petrarca
- Movement Analysis and Robotics Laboratory (MARlab), IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Alessandro Picelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Posteraro
- Department of Rehabilitation, Versilia Hospital - AUSL12, Viareggio, Italy
| | - Michele Senatore
- Associazione Italiana dei Terapisti Occupazionali (AITO), Rome, Italy
| | | | - Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
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7
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Bressi F, Cricenti L, Campagnola B, Bravi M, Miccinilli S, Santacaterina F, Sterzi S, Straudi S, Agostini M, Paci M, Casanova E, Marino D, La Rosa G, Giansanti D, Perrero L, Battistini A, Filoni S, Sicari M, Petrozzino S, Solaro CM, Gargano S, Benanti P, Boldrini P, Bonaiuti D, Castelli E, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzoleni S, Mazzon S, Molteni F, Petrarca M, Picelli A, Posteraro F, Senatore M, Turchetti G, Morone G, Gallotti M, Germanotta M, Aprile I. Effects of robotic upper limb treatment after stroke on cognitive patterns: A systematic review. NeuroRehabilitation 2022; 51:541-558. [PMID: 36530099 PMCID: PMC9837692 DOI: 10.3233/nre-220149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Robotic therapy (RT) has been internationally recognized for the motor rehabilitation of the upper limb. Although it seems that RT can stimulate and promote neuroplasticity, the effectiveness of robotics in restoring cognitive deficits has been considered only in a few recent studies. OBJECTIVE To verify whether, in the current state of the literature, cognitive measures are used as inclusion or exclusion criteria and/or outcomes measures in robotic upper limb rehabilitation in stroke patients. METHODS The systematic review was conducted according to PRISMA guidelines. Studies eligible were identified through PubMed/MEDLINE and Web of Science from inception to March 2021. RESULTS Eighty-one studies were considered in this systematic review. Seventy-three studies have at least a cognitive inclusion or exclusion criteria, while only seven studies assessed cognitive outcomes. CONCLUSION Despite the high presence of cognitive instruments used for inclusion/exclusion criteria their heterogeneity did not allow the identification of a guideline for the evaluation of patients in different stroke stages. Therefore, although the heterogeneity and the low percentage of studies that included cognitive outcomes, seemed that the latter were positively influenced by RT in post-stroke rehabilitation. Future larger RCTs are needed to outline which cognitive scales are most suitable and their cut-off, as well as what cognitive outcome measures to use in the various stages of post-stroke rehabilitation.
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Affiliation(s)
- Federica Bressi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University Polyclinic Foundation, Rome, Italy
| | - Laura Cricenti
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University Polyclinic Foundation, Rome, Italy
| | - Benedetta Campagnola
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University Polyclinic Foundation, Rome, Italy,Address for correspondence: Benedetta Campagnola, Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University Polyclinic Foundation, Rome, Italy. E-mail:
| | - Marco Bravi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University Polyclinic Foundation, Rome, Italy
| | - Sandra Miccinilli
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University Polyclinic Foundation, Rome, Italy
| | - Fabio Santacaterina
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University Polyclinic Foundation, Rome, Italy
| | - Silvia Sterzi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University Polyclinic Foundation, Rome, Italy
| | - Sofia Straudi
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
| | | | - Matteo Paci
- AUSL (Unique Sanitary Local Company) District of Central Tuscany, Florence, Italy
| | - Emanuela Casanova
- Unità Operativa di Medicina Riabilitativa e Neuroriabilitazione (SC), IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Dario Marino
- IRCCS Neurolysis Center “Bonino Pulejo”, Messina, Italy
| | | | - Daniele Giansanti
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, Rome, Italy
| | - Luca Perrero
- Neurorehabilitation Unit, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Alberto Battistini
- Unità Operativa di Medicina Riabilitativa e Neuroriabilitazione (SC), IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Serena Filoni
- Padre Pio Onlus Rehabilitation Centers Foundation, San Giovanni Rotondo, Italy
| | - Monica Sicari
- A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | | | | | - Paolo Boldrini
- Società Italiana di Medicina Fisica e Riabilitativa (SIMFER), Rome, Italy
| | | | - Enrico Castelli
- Department of Paediatric Neurorehabilitation, IRCCS Bambino Gesù Children’s Hospital, Rome, Italy
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Rome, Italy
| | - Vincenzo Falabella
- Italian Federation of Persons with Spinal Cord Injuries (Faip Onlus), Rome, Italy
| | | | - Francesca Gimigliano
- Department of Mental, Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Mauro Grigioni
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, Rome, Italy
| | - Stefano Mazzoleni
- Department of Electrical and Information Engineering, Politecnico di Bari, Bari, Italy
| | - Stefano Mazzon
- AULSS6 (Unique Sanitary Local Company) Euganea Padova – Distretto 4 “Alta Padovana”, Padua, Italy
| | - Franco Molteni
- Department of Rehabilitation Medicine, Villa Beretta Rehabilitation Center, Valduce Hospital, Lecco, Italy
| | - Maurizio Petrarca
- Movement Analysis and Robotics Laboratory (MARlab), IRCCS Bambino Gesù Children’s Hospital, Rome, Italy
| | - Alessandro Picelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Posteraro
- Department of Rehabilitation, Versilia Hospital – AUSL12, Viareggio, Italy
| | - Michele Senatore
- Associazione Italiana dei Terapisti Occupazionali (AITO), Rome, Italy
| | | | | | | | | | - Irene Aprile
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
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8
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Bressi F, Cinnera AM, Morone G, Campagnola B, Cricenti L, Santacaterina F, Miccinilli S, Zollo L, Paolucci S, Di Lazzaro V, Sterzi S, Bravi M. Combining Robot-Assisted Gait Training and Non-Invasive Brain Stimulation in Chronic Stroke Patients: A Systematic Review. Front Neurol 2022; 13:795788. [PMID: 35585844 PMCID: PMC9108455 DOI: 10.3389/fneur.2022.795788] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 03/15/2022] [Indexed: 11/13/2022] Open
Abstract
Gait impairment is one of the most common disorders of patients with chronic stroke, which hugely affects the ability to carry out the activities of daily living and the quality of life. Recently, traditional rehabilitation techniques have been associated with non-invasive brain stimulation (NIBS) techniques, which enhance brain plasticity, with the aim of promoting recovery in patients with chronic stroke. NIBS effectiveness in improving gait parameters in patients with chronic stroke has been in several studies evaluated. Robotic devices are emerging as promising tools for the treatment of stroke-related disabilities by performing repetitive, intensive, and task-specific treatments and have been proved to be effective for the enhancement of motor recovery in patients with chronic stroke. To date, several studies have examined the combination of NIBS with robotic-assisted gait training, but the effectiveness of this approach is not yet well established. The main purpose of this systematic review is to clarify whether the combination of NIBS and robot-assisted gait training may improve walking function in patients with chronic stroke. Our systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Studies eligible for review were identified through PubMed/MEDLINE, Embase, Scopus, and PEDro from inception to March 15, 2021, and the outcomes considered were gait assessments. Seven studies were included in the qualitative analysis of this systematic review, with a total population of 186 patients with chronic stroke. All studies specified technical characteristics of robotic devices and NIBS used, with high heterogeneity of protocols. Methodological studies have shown a significantly greater improvement in walking capacity recorded with 6MWT. Finally, research studies have highlighted a positive effect on walking recovery by combination of robot-assisted gait training with non-invasive brain stimulation. Furthermore, future studies should identify the best characteristics of the combined therapeutic protocols.
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Affiliation(s)
- Federica Bressi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University of Rome, Rome, Italy
- *Correspondence: Federica Bressi
| | - Alex Martino Cinnera
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Giovanni Morone
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Benedetta Campagnola
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University of Rome, Rome, Italy
| | - Laura Cricenti
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University of Rome, Rome, Italy
| | - Fabio Santacaterina
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University of Rome, Rome, Italy
| | - Sandra Miccinilli
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University of Rome, Rome, Italy
| | - Loredana Zollo
- Unit of Advanced Robotics and Human-Centred Technologies, Campus Bio-Medico University of Rome, Rome, Italy
| | - Stefano Paolucci
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Vincenzo Di Lazzaro
- Unity of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Silvia Sterzi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University of Rome, Rome, Italy
| | - Marco Bravi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University of Rome, Rome, Italy
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9
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Morone G, de Sire A, Martino Cinnera A, Paci M, Perrero L, Invernizzi M, Lippi L, Agostini M, Aprile I, Casanova E, Marino D, La Rosa G, Bressi F, Sterzi S, Giansanti D, Battistini A, Miccinilli S, Filoni S, Sicari M, Petrozzino S, Solaro CM, Gargano S, Benanti P, Boldrini P, Bonaiuti D, Castelli E, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzoleni S, Mazzon S, Molteni F, Petrarca M, Picelli A, Gandolfi M, Posteraro F, Senatore M, Turchetti G, Straudi S. Upper Limb Robotic Rehabilitation for Patients with Cervical Spinal Cord Injury: A Comprehensive Review. Brain Sci 2021; 11:brainsci11121630. [PMID: 34942935 PMCID: PMC8699455 DOI: 10.3390/brainsci11121630] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/29/2021] [Accepted: 11/29/2021] [Indexed: 01/08/2023] Open
Abstract
The upper extremities limitation represents one of the essential functional impairments in patients with cervical spinal cord injury. Electromechanics assisted devices and robots are increasingly used in neurorehabilitation to help functional improvement in patients with neurological diseases. This review aimed to systematically report the evidence-based, state-of-art on clinical applications and robotic-assisted arm training (RAT) in motor and functional recovery in subjects affected by cervical spinal cord injury. The present study has been carried out within the framework of the Italian Consensus Conference on “Rehabilitation assisted by robotic and electromechanical devices for persons with disability of neurological origin” (CICERONE). PubMed/MEDLINE, Cochrane Library, and Physiotherapy Evidence Database (PEDro) databases were systematically searched from inception to September 2021. The 10-item PEDro scale assessed the study quality for the RCT and the AMSTAR-2 for the systematic review. Two different authors rated the studies included in this review. If consensus was not achieved after discussion, a third reviewer was interrogated. The five-item Oxford CEBM scale was used to rate the level of evidence. A total of 11 studies were included. The selected studies were: two systematic reviews, two RCTs, one parallel-group controlled trial, one longitudinal intervention study and five case series. One RCT was scored as a high-quality study, while the systematic review was of low quality. RAT was reported as feasible and safe. Initial positive effects of RAT were found for arm function and quality of movement in addition to conventional therapy. The high clinical heterogeneity of treatment programs and the variety of robot devices could severely affect the generalizability of the study results. Therefore, future studies are warranted to standardize the type of intervention and evaluate the role of robotic-assisted training in subjects affected by cervical spinal cord injury.
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Affiliation(s)
- Giovanni Morone
- IRCCS Santa Lucia Foundation, 00179 Rome, Italy;
- Correspondence: (G.M.); (A.d.S.); Tel.: +39-0651501005 (G.M.); +39-0961712819 (A.d.S.)
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
- Correspondence: (G.M.); (A.d.S.); Tel.: +39-0651501005 (G.M.); +39-0961712819 (A.d.S.)
| | | | - Matteo Paci
- AUSL (Unique Sanitary Local Company), 50123 Florence, Italy;
| | - Luca Perrero
- Neurorehabilitation Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 10121 Novara, Italy; (M.I.); (L.L.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 10121 Novara, Italy; (M.I.); (L.L.)
| | - Michela Agostini
- Section of Rehabilitation, Department of Neuroscience, University General Hospital of Padova, 35128 Padua, Italy;
| | - Irene Aprile
- IRCCS Fondazione Don Carlo Gnocchi, 50123 Florence, Italy;
| | - Emanuela Casanova
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Medicina Riabilitativa e Neuroriabilitazione, 40139 Bologna, Italy; (E.C.); (A.B.)
| | - Dario Marino
- IRCCS Neurolysis Center “Bonino Pulejo”, 98124 Messina, Italy;
| | - Giuseppe La Rosa
- C.S.R.—Consorzio Siciliano di Riabilitazione, 95123 Catania, Italy;
| | - Federica Bressi
- Campus Bio-Medico University Hospital, University of Rome, 00128 Rome, Italy; (F.B.); (S.S.); (S.M.)
| | - Silvia Sterzi
- Campus Bio-Medico University Hospital, University of Rome, 00128 Rome, Italy; (F.B.); (S.S.); (S.M.)
| | - Daniele Giansanti
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, 00161 Rome, Italy; (D.G.); (M.G.)
| | - Alberto Battistini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Medicina Riabilitativa e Neuroriabilitazione, 40139 Bologna, Italy; (E.C.); (A.B.)
| | - Sandra Miccinilli
- Campus Bio-Medico University Hospital, University of Rome, 00128 Rome, Italy; (F.B.); (S.S.); (S.M.)
| | - Serena Filoni
- Padre Pio Foundation and Rehabilitation Center, San Giovanni Rotondo 71013, Italy;
| | - Monica Sicari
- A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (M.S.); (S.P.)
| | - Salvatore Petrozzino
- A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, Italy; (M.S.); (S.P.)
| | | | | | - Paolo Benanti
- Department of Moral Theology, Pontifical Gregorian University, 00187 Rome, Italy;
| | - Paolo Boldrini
- Società Italiana di Medicina Fisica e Riabilitativa (SIMFER), 00198 Rome, Italy; (P.B.); (D.B.)
| | - Donatella Bonaiuti
- Società Italiana di Medicina Fisica e Riabilitativa (SIMFER), 00198 Rome, Italy; (P.B.); (D.B.)
| | - Enrico Castelli
- Paediatric Neurorehabilitation Department, IRCCS Bambino Gesù Children’s Hospital, 00163 Rome, Italy;
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, 00185 Rome, Italy;
| | - Vincenzo Falabella
- Italian Federation of Persons with Spinal Cord Injuries (Faip Onlus), 00195 Rome, Italy;
| | - Silvia Galeri
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy;
| | - Francesca Gimigliano
- Multidisciplinary Department of Medicine for Surgery and Orthodontics, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Mauro Grigioni
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, 00161 Rome, Italy; (D.G.); (M.G.)
| | - Stefano Mazzoleni
- Department of Electrical and Information Engineering, Politecnico di Bari, 70125 Bari, Italy;
| | - Stefano Mazzon
- AULSS6 (Unique Sanitary Local Company) Euganea Padova, Rehabilitation Department, 35128 Padua, Italy;
| | - Franco Molteni
- Villa Beretta Rehabilitation Center, Department of Rehabilitation Medicine, Valduce Hospital, 23845 Costa Masnaga, Italy;
| | - Maurizio Petrarca
- Movement Analysis and Robotics Laboratory MARlab, IRCCS Bambino Gesù Children’s Hospital, 00163 Rome, Italy;
| | - Alessandro Picelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy; (A.P.); (M.G.)
| | - Marialuisa Gandolfi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy; (A.P.); (M.G.)
| | - Federico Posteraro
- Rehabilitation Department Versilia Hospital, Versilia Hospital AUSL Toscana Nord Ovest, 55049 Lido di Camaiore, Italy;
| | - Michele Senatore
- AITO (Associazione Italiana Terapisti Occupazionali), 00136 Rome, Italy;
| | - Giuseppe Turchetti
- Management Institute, Sant’Anna School of Advanced Studies, 56127 Pisa, Italy;
| | - Sofia Straudi
- Neuroscience and Rehabilitation Department, Ferrara University Hospital, 44121 Ferrara, Italy;
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10
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Paloschi D, Bravi M, Schena E, Miccinilli S, Morrone M, Sterzi S, Saccomandi P, Massaroni C. Validation and Assessment of a Posture Measurement System with Magneto-Inertial Measurement Units. Sensors (Basel) 2021; 21:6610. [PMID: 34640930 PMCID: PMC8513009 DOI: 10.3390/s21196610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 09/28/2021] [Accepted: 09/30/2021] [Indexed: 12/27/2022]
Abstract
Inappropriate posture and the presence of spinal disorders require specific monitoring systems. In clinical settings, posture evaluation is commonly performed with visual observation, electrogoniometers or motion capture systems (MoCaps). Developing a measurement system that can be easily used also in non-structured environments would be highly beneficial for accurate posture monitoring. This work proposes a system based on three magneto-inertial measurement units (MIMU), placed on the backs of seventeen volunteers on the T3, T12 and S1 vertebrae. The reference system used for validation is a stereophotogrammetric motion capture system. The volunteers performed forward bending and sit-to-stand tests. The measured variables for identifying the posture were the kyphosis and the lordosis angles, as well as the range of movement (ROM) of the body segments. The comparison between MIMU and MoCap provided a maximum RMSE of 5.6° for the kyphosis and the lordosis angles. The average lumbo-pelvic contribution during forward bending (41.8 ± 8.6%) and the average lumbar ROM during sit-to-stand (31.8 ± 9.8° for sitting down, 29.6 ± 7.6° for standing up) obtained with the MIMU system agree with the literature. In conclusion, the MIMU system, which is wearable, inexpensive and easy to set up in non-structured environments, has been demonstrated to be effective in posture evaluation.
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Affiliation(s)
- Davide Paloschi
- Department of Mechanical Engineering, Politecnico di Milano, 20156 Milan, Italy;
| | - Marco Bravi
- Physical Medicine and Rehabilitative Unit, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (M.B.); (S.M.); (M.M.); (S.S.)
| | - Emiliano Schena
- Department of Engineering, Università Campus Bio-Medico di Roma, 00128 Roma, Italy; (E.S.); (C.M.)
| | - Sandra Miccinilli
- Physical Medicine and Rehabilitative Unit, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (M.B.); (S.M.); (M.M.); (S.S.)
| | - Michelangelo Morrone
- Physical Medicine and Rehabilitative Unit, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (M.B.); (S.M.); (M.M.); (S.S.)
| | - Silvia Sterzi
- Physical Medicine and Rehabilitative Unit, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (M.B.); (S.M.); (M.M.); (S.S.)
| | - Paola Saccomandi
- Department of Mechanical Engineering, Politecnico di Milano, 20156 Milan, Italy;
| | - Carlo Massaroni
- Department of Engineering, Università Campus Bio-Medico di Roma, 00128 Roma, Italy; (E.S.); (C.M.)
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11
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Bravi M, Santacaterina F, Bressi F, Papalia R, Campi S, Sterzi S, Miccinilli S. Does Posterior Cruciate Ligament Retention or Sacrifice in Total Knee Replacement Affect Proprioception? A Systematic Review. J Clin Med 2021; 10:jcm10163470. [PMID: 34441765 PMCID: PMC8396862 DOI: 10.3390/jcm10163470] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/29/2021] [Accepted: 08/04/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Proprioception is an important part of the somatosensory system involved in human motion control, which is fundamental for activities of daily living, exercise, and sport-specific gestures. When total knee arthroplasty (TKA) is performed, the posterior cruciate ligament (PCL) can be retained, replaced, or discarded. The PCL seems to be responsible for maintaining the integrity of the joint position sense (JPS) and joint kinesthesia. The aim of this review was to assess the effect of PCL on knee joint proprioception in total knee replacement. Methods: This systematic review was conducted within five electronic databases: PubMed, Scopus, Web of Science, Cochrane, and PEDro with no data limit from inception to May 2021. Results: In total 10 publications were evaluated. The analysis was divided by proprioception assessment method: direct assessment (JPS, kinesthesia) and indirect assessment (balance). Conclusions: The current evidence suggest that the retention of the PCL does not substantially improve the joint proprioception after TKA. Due to the high heterogeneity of the studies in terms of design, proprioception outcomes, evaluation methods, further studies are needed to confirm the conclusions. In addition, future research should focus on the possible correlation between joint proprioception and walking function.
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Affiliation(s)
- Marco Bravi
- Department of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (F.S.); (F.B.); (S.S.); (S.M.)
- Correspondence:
| | - Fabio Santacaterina
- Department of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (F.S.); (F.B.); (S.S.); (S.M.)
| | - Federica Bressi
- Department of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (F.S.); (F.B.); (S.S.); (S.M.)
| | - Rocco Papalia
- Department of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (R.P.); (S.C.)
| | - Stefano Campi
- Department of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (R.P.); (S.C.)
| | - Silvia Sterzi
- Department of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (F.S.); (F.B.); (S.S.); (S.M.)
| | - Sandra Miccinilli
- Department of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (F.S.); (F.B.); (S.S.); (S.M.)
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12
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Bravi M, Massaroni C, Santacaterina F, Di Tocco J, Schena E, Sterzi S, Bressi F, Miccinilli S. Validity Analysis of WalkerView TM Instrumented Treadmill for Measuring Spatiotemporal and Kinematic Gait Parameters. Sensors (Basel) 2021; 21:s21144795. [PMID: 34300534 PMCID: PMC8309770 DOI: 10.3390/s21144795] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/25/2021] [Accepted: 07/09/2021] [Indexed: 11/20/2022]
Abstract
The detection of gait abnormalities is essential for professionals involved in the rehabilitation of walking disorders. Instrumented treadmills are spreading as an alternative to overground gait analysis. To date, the use of these instruments for recording kinematic gait parameters is still limited in clinical practice due to the lack of validation studies. This study aims to investigate the performance of a multi-sensor instrumented treadmill (i.e., WalkerViewTM, WV) for performing gait analysis. Seventeen participants performed a single gait test on the WV at three different speeds (i.e., 3 km/h, 5 km/h, and 6.6 km/h). In each trial, spatiotemporal and kinematic parameters were recorded simultaneously by the WV and by a motion capture system used as the reference. Intraclass correlation coefficient (ICC) of spatiotemporal parameters showed fair to excellent agreement at the three walking speeds for steps time, cadence, and step length (range 0.502–0.996); weaker levels of agreement were found for stance and swing time at all the tested walking speeds. Bland–Altman analysis of spatiotemporal parameters showed a mean of difference (MOD) maximum value of 0.04 s for swing/stance time and WV underestimation of 2.16 cm for step length. As for kinematic variables, ICC showed fair to excellent agreement (ICC > 0.5) for total range of motion (ROM) of hip at 3 km/h (range 0.579–0.735); weaker levels of ICC were found at 5 km/h and 6.6 km/h (range 0.219–0.447). ICC values of total knee ROM showed poor levels of agreement at all the tested walking speeds. Bland–Altman analysis of hip ROM revealed a higher MOD value at higher speeds up to 3.91°; the MOD values of the knee ROM were always higher than 7.67° with a 60° mean value of ROM. We demonstrated that the WV is a valid tool for analyzing the spatiotemporal parameters of walking and assessing the hip’s total ROM. Knee total ROM and all kinematic peak values should be carefully evaluated, having shown lower levels of agreement.
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Affiliation(s)
- Marco Bravi
- Unit of Physical Medicine and Rehabilitation, Università Campus Bio-Medico di Roma, via Alvaro Del Portillo 5, 00128 Rome, Italy; (M.B.); (F.S.); (S.S.); (F.B.); (S.M.)
| | - Carlo Massaroni
- Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, via Alvaro Del Portillo 21, 00128 Rome, Italy; (J.D.T.); (E.S.)
- Correspondence:
| | - Fabio Santacaterina
- Unit of Physical Medicine and Rehabilitation, Università Campus Bio-Medico di Roma, via Alvaro Del Portillo 5, 00128 Rome, Italy; (M.B.); (F.S.); (S.S.); (F.B.); (S.M.)
| | - Joshua Di Tocco
- Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, via Alvaro Del Portillo 21, 00128 Rome, Italy; (J.D.T.); (E.S.)
| | - Emiliano Schena
- Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, via Alvaro Del Portillo 21, 00128 Rome, Italy; (J.D.T.); (E.S.)
| | - Silvia Sterzi
- Unit of Physical Medicine and Rehabilitation, Università Campus Bio-Medico di Roma, via Alvaro Del Portillo 5, 00128 Rome, Italy; (M.B.); (F.S.); (S.S.); (F.B.); (S.M.)
| | - Federica Bressi
- Unit of Physical Medicine and Rehabilitation, Università Campus Bio-Medico di Roma, via Alvaro Del Portillo 5, 00128 Rome, Italy; (M.B.); (F.S.); (S.S.); (F.B.); (S.M.)
| | - Sandra Miccinilli
- Unit of Physical Medicine and Rehabilitation, Università Campus Bio-Medico di Roma, via Alvaro Del Portillo 5, 00128 Rome, Italy; (M.B.); (F.S.); (S.S.); (F.B.); (S.M.)
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13
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Gimigliano F, Palomba A, Arienti C, Morone G, Perrero L, Agostini M, Aprile I, Paci M, Casanova E, Marino D, LA Rosa G, Bressi F, Sterzi S, Giansanti D, Battistini A, Miccinilli S, Filoni S, Sicari M, Petrozzino S, Solaro CM, Gargano S, Benanti P, Boldrini P, Bonaiuti D, Castelli E, Draicchio F, Falabella V, Galeri S, Grigioni M, Mazzoleni S, Mazzon S, Molteni F, Petrarca M, Picelli A, Posteraro F, Senatore M, Turchetti G, Straudi S. Robot-assisted arm therapy in neurological health conditions: rationale and methodology for the evidence synthesis in the CICERONE Italian Consensus Conference. Eur J Phys Rehabil Med 2021; 57:824-830. [PMID: 34128606 DOI: 10.23736/s1973-9087.21.07011-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Robot-assisted Arm Therapy (RAT) has been increasingly applied in the last years for promoting functional recovery in patients with disabilities related to neurological health conditions. Evidence of a knowledge-to-action gap for applying robot-assisted technologies in the rehabilitation of patients with neurological health conditions and the difficulty to apply and tailor the knowledge to the local contexts solicited the need for a national consensus conference on these interventions. AIM This paper aims to explain the methodology used by the working group dedicated to synthesize evidence on the effectiveness of RAT in neurological health conditions in the context of the CICERONE Italian Consensus Conference. DESIGN The methodological approach of the working group. SETTING All rehabilitation settings. POPULATION Patients with disability following a neurological health condition. METHODS Following the indications proposed by the Methodological Manual published by the Italian National Institute of Health, a Promoting Committee and a Technical Scientific Committee have been set up. Six working groups (WGs) have been composed to collect evidence on different questions, among which WG2.2 was focused on the effectiveness of RAT in neurological health conditions. RESULTS WG2.2 started its work defining the specific research questions. It was decided to adopt the ICF as the reference framework for the reporting of all outcomes. Literature search, data extraction and qualitative assessment, evidence analysis and synthesis have been performed. CONCLUSIONS This paper summarizes the methodological approaches used by the WG2.2 of the CICERONE Italian Consensus Conference to define the effectiveness of RAT in the management of patients with neurological health conditions. CLINICAL REHABILITATION IMPACT WG2.2 synthesis might help clinicians, researchers, and all rehabilitation stakeholders to address the use of RAT in the Individualized Rehabilitation Plan, to guide the allocation of resources and define clinical protocols and indications for the management of patients with different neurological health conditions.
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Affiliation(s)
- Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Angela Palomba
- Multidisciplinary Department of Medicine for Surgery and Orthodontics, University of Campania "Luigi Vanvitelli", Naples, Italy -
| | | | | | - Luca Perrero
- Neurorehabilitation Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | - Irene Aprile
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Matteo Paci
- AUSL (Unique Sanitary Local Company) District of Central Tuscany, Florence, Italy
| | - Emanuela Casanova
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Medicina Riabilitativa e Neuroriabilitazione, Bologna, Italia
| | - Dario Marino
- IRCCS Neurolysis Center "Bonino Pulejo", Messina, Italy
| | | | | | | | - Daniele Giansanti
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, Rome, Italy
| | - Alberto Battistini
- AUSL (Unique Sanitary Local Company) District of Central Tuscany, Florence, Italy
| | | | - Serena Filoni
- Padre Pio Foundation and Rehabilitation Centers, San Giovanni Rotondo, Foggia, Italy
| | - Monica Sicari
- A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | | | | | - Paolo Boldrini
- Società Italiana di Medicina Fisica e Riabilitativa (SIMFER)
| | | | - Enrico Castelli
- Paediatric Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, Rome, Italy
| | - Vincenzo Falabella
- President Italian Federation of Persons with Spinal Cord Injuries (Faip Onlus), Rome, Italy
| | | | - Mauro Grigioni
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, Rome, Italy
| | - Stefano Mazzoleni
- Department of Electrical and Information Engineering, Politecnico di Bari, Bari, Italy
| | - Stefano Mazzon
- Rehabilitation Department, AULSS6 (Unique Sanitary Local Company) Euganea Padova, Padova, Italy
| | | | - Maurizio Petrarca
- "Bambino Gesù" Children's Hospital - IRCCS, Movement Analysis and Robotics Laboratory MARlab, Rome, Italy
| | - Alessandro Picelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Posteraro
- Versilia Hospital AUSL Toscana Nord Ovest, Lido di Camaiore, Lucca, Italy
| | | | | | - Sofia Straudi
- Neuroscience and Rehabilitation Department, Ferrara University Hospital, Ferrara, Italy
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Morone G, Palomba A, Martino Cinnera A, Agostini M, Aprile I, Arienti C, Paci M, Casanova E, Marino D, LA Rosa G, Bressi F, Sterzi S, Gandolfi M, Giansanti D, Perrero L, Battistini A, Miccinilli S, Filoni S, Sicari M, Petrozzino S, Solaro CM, Gargano S, Benanti P, Boldrini P, Bonaiuti D, Castelli E, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzoleni S, Mazzon S, Molteni F, Petrarca M, Picelli A, Posteraro F, Senatore M, Turchetti G, Straudi S. Systematic review of guidelines to identify recommendations for upper limb robotic rehabilitation after stroke. Eur J Phys Rehabil Med 2021; 57:238-245. [PMID: 33491943 DOI: 10.23736/s1973-9087.21.06625-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Upper limb motor impairment is one of the most frequent stroke consequences. Robot therapy may represent a valid option for upper limb stroke rehabilitation, but there are still gaps between research evidence and their use in clinical practice. The aim of this study was to determine the quality, scope, and consistency of guidelines clinical practice recommendations for upper limb robotic rehabilitation in stroke populations. EVIDENCE ACQUISITION We searched for guideline recommendations on stroke published between January 1st, 2010 and January 1st, 2020. Only the most recent guidelines for writing group were selected. Electronic databases (N.=4), guideline repertories and professional rehabilitation networks (N.=12) were searched. We systematically reviewed and assessed guidelines containing recommendation statements about upper limb robotic rehabilitation for adults with stroke (PROSPERO registration number: CRD42020173386). EVIDENCE SYNTHESIS Four independent reviewers used the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, and textual syntheses were used to appraise and compare recommendations. From 1324 papers that were screened, eight eligible guidelines were identified from six different regions/countries. Half of the included guidelines focused on stroke management, the other half on stroke rehabilitation. Rehabilitation assisted by robotic devices is generally recommended to improve upper limb motor function and strength. The exact characteristics of patients who could benefit from this treatment as well as the correct timing to use it are not known. CONCLUSIONS This systematic review has identified many opportunities to modernize and otherwise improve stroke patients' upper limb robotic therapy. Rehabilitation assisted by robot or electromechanical devices for stroke needs to be improved in clinical practice guidelines in particular in terms of applicability.
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Affiliation(s)
| | - Angela Palomba
- Multidisciplinary Department of Medicine for Surgery and Orthodontics, Luigi Vanvitelli University of Campania, Naples, Italy
| | | | | | - Irene Aprile
- IRCCS Don Carlo Gnocchi Foundation, Florence, Italy
| | | | - Matteo Paci
- AUSL District of Central Tuscany, Florence, Italy
| | - Emanuela Casanova
- Unit of Rehabilitation and Neurorehabilitation Medicine, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Dario Marino
- IRCCS Neurolysis Center "Bonino Pulejo, " Messina, Italy
| | - Giuseppe LA Rosa
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | | | - Silvia Sterzi
- Biomedical Campus University Foundation, Rome, Italy
| | - Marialuisa Gandolfi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Daniele Giansanti
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, Rome, Italy
| | - Luca Perrero
- Unit of Neurorehabilitation, SS. Antonio e Biagio e Cesare Arrigo University Hospital, Alessandria, Italy
| | | | | | - Serena Filoni
- Padre Pio Foundation and Rehabilitation Centers, San Giovanni Rotondo, Foggia, Italy
| | | | | | | | | | | | - Paolo Boldrini
- Società Italiana di Medicina Fisica e Riabilitativa (SIMFER), Rome, Italy
| | | | - Enrico Castelli
- Unit of Pediatric Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, Rome, Italy
| | - Vincenzo Falabella
- Italian Federation of Persons with Spinal Cord Injuries (Faip Onlus), Rome, Italy
| | | | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Mauro Grigioni
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, Rome, Italy
| | - Stefano Mazzoleni
- Department of Electrical and Information Engineering, Politecnico di Bari, Bari, Italy
| | | | | | - Maurizio Petrarca
- The Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Rome, Italy
| | - Alessandro Picelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Michele Senatore
- AITO (Associazione Italiana Terapisti Occupazionali), Rome, Italy
| | | | - Sofia Straudi
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
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Miccinilli S, Bravi M, Maselli M, Santacaterina F, Morrone M, Manco D, Toglia R, Sterzi S, Bressi F. THE EFFECTIVENESS OF EXTRACORPOREAL SHOCK WAVE THERAPY ON BREAST CANCER-RELATED LYMPHEDEMA: A LITERATURE REVIEW. Lymphology 2021. [DOI: 10.2458/lymph.4664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Lymphedema is one of the most dreaded complications related to breast cancer surgery, commonly resulting in upper limb functional, esthetic, and psychological impairment. The necessity to improve the efficacy of conventional treatments and the promising effect of extracorporeal shock wave therapy (ESWT) on lymphangiogenesis in vitro and animal models, has prompted studies involving women affected by breast-cancer related lymphedema. Since intervention modalities and treatment protocols used are different, a review is necessary to verify the effectiveness of ESWT, evaluating the quality of existing studies and the eventual need for further research. Data were obtained from PubMed, Scopus, Google Scholar, Cochrane Library and PEDro, including articles published until January 2019. Five studies met the inclusion criteria. Evident heterogeneity emerged among selected studies permitting only a purely descriptive analysis of their data and strongly limiting their comparison. When compared to other treatment modalities, ESWT showed a significant effect on measured outcomes. It is clear that further high quality research is necessary to assert with confidence the effects and possible superiority of ESWT over other conservative therapies in the management of breast-cancer related lymphedema.
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Miccinilli S, Schena E, Massaroni C, Bravi M, Campiglia F, Santacaterina F, Foti C, Bressi F, Sterzi S. Use of wearable systems for the detection of chest-abdominal wall movement aimed at respiratory monitoring in sport: a scoping review on available data. J BIOL REG HOMEOS AG 2020; 34:87-96. Technology in Medicine. [PMID: 33386038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
There is a significant request for wearable systems for vital signs and athletic performance monitoring during sport practice, both in professional and non-professional fields. Respiratory rate is a rather neglected parameter in this field, but several studies show that it is a strong marker of physical exertion. The aim of the present scoping review is to evaluate the number and kind of existing studies on wearable technologies for the analysis of the chest wall movement for respiratory monitoring in sport and fitness. The review included studies investigating the use of contact-based wearable techniques for the detection of chest wall movement for respiratory monitoring during professional or amateur sport, during fitness and physical activity. The search was conducted on PubMed/Medline, Scopus and Google Scholar electronic databases using keywords. Data extracted were entered into a Microsoft Excel spreadsheet by the leading author and then double-checked by the second author. A total of 25 descriptive studies met the inclusion criteria. Few studies on small number of athletes were found, technologies were often evaluated without a reference system, data on participants are sometimes missing. To date, we are not able to draw conclusions on which is the best and most reliable device to use during sport practice.
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Affiliation(s)
- S Miccinilli
- Physical Medicine and Rehabilitation Department, Campus Bio-Medico University of Rome, Italy
- PhD Student in Research Doctorate in Tissue Engineering and Remodeling Biotechnologies For Body Function, Tor Vergata University, Rome, Italy
| | - E Schena
- Unit of Measurements and Biomedical Instrumentation, Department of Engineering, Campus Bio-Medico University, Rome, Italy
| | - C Massaroni
- Unit of Measurements and Biomedical Instrumentation, Department of Engineering, Campus Bio-Medico University, Rome, Italy
| | - M Bravi
- Physical Medicine and Rehabilitation Department, Campus Bio-Medico University of Rome, Italy
| | - F Campiglia
- Physical Medicine and Rehabilitation Department, Campus Bio-Medico University of Rome, Italy
| | - F Santacaterina
- Physical Medicine and Rehabilitation Department, Campus Bio-Medico University of Rome, Italy
| | - C Foti
- Clinical Sciences and Translational Medicine Department; Research Doctorate in Tissue Engineering And Remodeling Biotechnologies For Body Function, Tor Vergata University, Rome, Italy
| | - F Bressi
- Physical Medicine and Rehabilitation Department, Campus Bio-Medico University of Rome, Italy
| | - S Sterzi
- Physical Medicine and Rehabilitation Department, Campus Bio-Medico University of Rome, Italy
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17
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Bressi F, Bravi M, Campagnola B, Bruno D, Marzolla A, Santacaterina F, Miccinilli S, Sterzi S. Robotic treatment of the upper limb in chronic stroke and cerebral neuroplasticity: a systematic review. J BIOL REG HOMEOS AG 2020; 34:11-44. Technology in Medicine. [PMID: 33386032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Stroke is the second cause of mortality and the third cause of long-term disability worldwide. Deficits in upper limb (UL) capacity persist at 6 months post-stroke in 30-66% of hemiplegic stroke patients with major limitations in activity of daily living (ADL), thus making the recovery of paretic UL function the main rehabilitation goal. Robotic rehabilitation plays a crucial role since it allows to perform a repetitive, intensive, and task-oriented treatment, adaptable to the patients' residual abilities, necessary to facilitate recovery and the rehabilitation of the paretic UL. It has been proposed that robot-mediated training may amplify neuroplasticity by providing a major interaction of proprioceptive and/or other sensory inputs with motor outputs, with significant modifications in functional connectivity (coherence) within the fronto-parietal networks (inter- and intra-hemispheric functional connectivity) related to processes of movement preparation and execution. However, the neurophysiological mechanisms underlying this reorganization are not entirely clear yet. Therefore, the aim of this study is to revise the literature, which assesses the effect of robotic treatment in the recovery of UL deficits measured in terms of neuroplasticity in patients affected by chronic stroke. This systematic review was conducted using PubMed, PEDro, Cinahl (EBSCOhost), Scopus and Cochrane databases. The research was carried out until February 2020 it included articles written in English language, published between 2009 and 2020, and the outcomes considered were neuroplasticity assessments. We included 23 studies over 6145 records identified from the preliminary research. The selected studies proposed different methods for neuroplasticity assessment (i.e. transcranial direct current stimulation (tDCS), EEG-Based Brain Computer Interface (BCI) and Neuroimaging (fMRI)), and different Robotic Rehabilitation treatments. These studies demonstrated a positive correlation between changes in central nervous circuits and post-treatment clinical outcomes. Our study has highlighted the effectiveness of robotic therapy in promoting mechanisms that facilitate re-learning and motor recovery in patients with post-stroke chronic disabilities. However, future studies should overcome the limitations of heterogeneity found in the current literature, by proposing a greater number of high-level RCTs, to better understand the mechanisms of robot-induced neuroplasticity, follow the clinical progress, estimate a prognosis of recovery of motor function, and plan a personalized rehabilitative programme for the patients.
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Affiliation(s)
- F Bressi
- Physical Medicine and Rehabilitation Department, Campus Bio-Medico University of Rome, Italy
| | - M Bravi
- Physical Medicine and Rehabilitation Department, Campus Bio-Medico University of Rome, Italy
| | - B Campagnola
- Physical Medicine and Rehabilitation Department, Campus Bio-Medico University of Rome, Italy
| | - D Bruno
- Physical Medicine and Rehabilitation Department, Campus Bio-Medico University of Rome, Italy
| | - A Marzolla
- Physical Medicine and Rehabilitation Department, Campus Bio-Medico University of Rome, Italy
| | - F Santacaterina
- Physical Medicine and Rehabilitation Department, Campus Bio-Medico University of Rome, Italy
| | - S Miccinilli
- Physical Medicine and Rehabilitation Department, Campus Bio-Medico University of Rome, Italy
| | - S Sterzi
- Physical Medicine and Rehabilitation Department, Campus Bio-Medico University of Rome, Italy
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18
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Miccinilli S, Bravi M, Foti C, Morrone M, Maselli M, Santacaterina F, Scotto Di Luzio F, Zollo L, Sterzi S, Bressi F. Robotic hand treatment of patients affected by chronic stroke: a monocentric longitudinal pilot study. J BIOL REG HOMEOS AG 2020; 34:79-86. Technology in Medicine. [PMID: 33386037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Few studies investigated the effects of a robotic treatment in hand motor recovery after stroke. Aim of the present study was to evaluate the efficacy of treatment by means of Gloreha Sinfonia® robotic glove in hand motor recovery of a chronic stroke sample of patients with different impairment severity. Thirteen chronic stroke subjects were assigned to either active-assisted robotic treatment or passive robotic treatment according to their ability to actively extend wrist for at least 20 degrees. All subjects underwent 20 sessions of treatment with Gloreha Sinfonia® and were evaluated before (T0), after treatment (T1) and after one month (T2) with clinical scales testing motor performance [Motor Power (MP); Fugl Meyer Upper-Extremity (FMUE)] and spasticity [Modified Ashworth Scale (MAS)]. Both groups showed significant motor recovery and spasticity reduction. Further randomized controlled trials with larger samples are needed to confirm our results.
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Affiliation(s)
- S Miccinilli
- Physical and Rehabilitation Medicine Department, Campus Bio-Medico University, Rome, Italy
| | - M Bravi
- Physical and Rehabilitation Medicine Department, Campus Bio-Medico University, Rome, Italy
| | - C Foti
- Clinical Sciences and Translational Medicine Department. Tor Vergata University, Rome, Italy
| | - M Morrone
- Physical and Rehabilitation Medicine Department, Campus Bio-Medico University, Rome, Italy
| | - M Maselli
- Physical and Rehabilitation Medicine Department, Campus Bio-Medico University, Rome, Italy
| | - F Santacaterina
- Physical and Rehabilitation Medicine Department, Campus Bio-Medico University, Rome, Italy
| | - F Scotto Di Luzio
- Biomedical Robotics Laboratory and Bio-microsystems, Biomedical Engineering Laboratory, Campus Bio-Medico University, Rome, Italy
| | - L Zollo
- Biomedical Robotics Laboratory and Bio-microsystems, Biomedical Engineering Laboratory, Campus Bio-Medico University, Rome, Italy
| | - S Sterzi
- Physical and Rehabilitation Medicine Department, Campus Bio-Medico University, Rome, Italy
| | - F Bressi
- Physical and Rehabilitation Medicine Department, Campus Bio-Medico University, Rome, Italy
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Zaltieri M, Massaroni C, Lo Presti D, Bravi M, Sabbadini R, Miccinilli S, Sterzi S, Formica D, Schena E. A Wearable Device Based on a Fiber Bragg Grating Sensor for Low Back Movements Monitoring. Sensors (Basel) 2020; 20:s20143825. [PMID: 32659958 PMCID: PMC7411829 DOI: 10.3390/s20143825] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/03/2020] [Accepted: 07/07/2020] [Indexed: 02/02/2023]
Abstract
Low back pain (LBP) is one of the musculoskeletal disorders that most affects workers. Among others, one of the working categories which mainly experiences such disease are video terminal workers. As it causes exploitation of the National Health Service and absenteeism in workplaces, LBP constitutes a relevant socio-economic burden. In such a scenario, a prompt detection of wrong seating postures can be useful to prevent the occurrence of this disorder. To date, many tools capable of monitoring the spinal range of motions (ROMs) are marketed, but most of them are unusable in working environments due to their bulkiness, discomfort and invasiveness. In the last decades, fiber optic sensors have made their mark allowing the creation of light and compact wearable systems. In this study, a novel wearable device embedding a Fiber Bragg Grating sensor for the detection of lumbar flexion-extensions (F/E) in seated subjects is proposed. At first, the manufacturing process of the sensing element was shown together with its mechanical characterization, that shows linear response to strain with a high correlation coefficient (R2 > 0.99) and a sensitivity value (Sε) of 0.20 nm∙mε−1. Then, the capability of the wearable device in measuring F/E in the sagittal body plane was experimentally assessed on a small population of volunteers, using a Motion Capture system (MoCap) as gold standard showing good ability of the system to match the lumbar F/E trend in time. Additionally, the lumbar ROMs were evaluated in terms of intervertebral lumbar distances (ΔdL3−L1) and angles, exhibiting moderate to good agreement with the MoCap outputs (the maximum Mean Absolute Error obtained is ~16% in detecting ΔdL3−L1). The proposed wearable device is the first attempt for the development of FBG-based wearable systems for workers’ safety monitoring.
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Affiliation(s)
- Martina Zaltieri
- Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (M.Z.); (C.M.); (D.L.P.); (R.S.)
| | - Carlo Massaroni
- Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (M.Z.); (C.M.); (D.L.P.); (R.S.)
| | - Daniela Lo Presti
- Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (M.Z.); (C.M.); (D.L.P.); (R.S.)
| | - Marco Bravi
- Unit of Physical Medicine and Rehabilitation, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (M.B.); (S.M.); (S.S.)
| | - Riccardo Sabbadini
- Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (M.Z.); (C.M.); (D.L.P.); (R.S.)
| | - Sandra Miccinilli
- Unit of Physical Medicine and Rehabilitation, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (M.B.); (S.M.); (S.S.)
| | - Silvia Sterzi
- Unit of Physical Medicine and Rehabilitation, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (M.B.); (S.M.); (S.S.)
| | - Domenico Formica
- Unit of Neurophysiology and Neuroengineering of HumanTechnology Interaction, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy;
| | - Emiliano Schena
- Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (M.Z.); (C.M.); (D.L.P.); (R.S.)
- Correspondence:
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20
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Miccinilli S, Bravi M, Morrone M, Manco D, Bressi F, Campi S, Papalia R, Sterzi S. The effectiveness of extracorporeal shock wave therapy on adhesive capsulitis of the shoulder: a systematic review and meta-analysis. MED SPORT 2020. [DOI: 10.23736/s0025-7826.20.03667-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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21
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Bravi M, Gallotta E, Morrone M, Maselli M, Santacaterina F, Toglia R, Foti C, Sterzi S, Bressi F, Miccinilli S. Concurrent validity and inter trial reliability of a single inertial measurement unit for spatial-temporal gait parameter analysis in patients with recent total hip or total knee arthroplasty. Gait Posture 2020; 76:175-181. [PMID: 31862666 DOI: 10.1016/j.gaitpost.2019.12.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 10/07/2019] [Accepted: 12/10/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Osteoarthritis (OA) is one of the main causes of disability and its frequent hip and knee joint localization requires surgical joint replacement treatment. Patients after total hip (THA) or knee (TKA) arthroplasty often show gait abnormalities, whose comprehension is crucial in order to plan an appropriate rehabilitative treatment. Wearable sensor devices can be a valid tool for gait assessment in clinical practice, being relatively inexpensive and easy to use. RESEARCH QUESTION Does the use of crutches influence the ability of a single inertial measurement unit (IMU), placed on the lower trunk, to correctly record the spatial-temporal gait parameters in patients after recent THA or TKA? METHODS 20 patients walking with crutches after recent THA or TKA and 10 healthy subjects were recruited. Each participant was recorded simultaneously with an IMU and with an optoelectronic motion capture system during 5 consecutive walking tests. RESULTS Intraclass correlation index of spatial-temporal parameters recorded with the IMU showed moderate to excellent reliability results both for healthy subjects (ICC range 0.626-0.897) and for patients (ICC range 0.596-0.951). In terms of concurrent validity, Pearson's r coefficient of healthy subjects, showed strong to very strong levels of correlations for some spatial-temporal parameters (speed, mean cadence, left and right stride length and stride duration) (r range 0.646-0.977) and very week to moderately week levels of correlation for gait cycle phases (swing, stance, single support and double support) (r range 0.390-0.633). Patients' data analysis showed similar results for general spatial-temporal parameters (r range 0.704-0.986) and slightly lower values for gait cycle phases (r range 0.077-0.464). SIGNIFICANCE We can consider the single IMU as a reliable tool for the detection of some spatial-temporal gait parameters. Crutches seem to interfere with the detection of the gait cycle phases.
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Affiliation(s)
- Marco Bravi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University, Via Alvaro Del Portillo 5, 00128, Rome, Italy.
| | - Emilio Gallotta
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University, Via Alvaro Del Portillo 5, 00128, Rome, Italy.
| | - Michelangelo Morrone
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University, Via Alvaro Del Portillo 5, 00128, Rome, Italy.
| | - Mirella Maselli
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University, Via Alvaro Del Portillo 5, 00128, Rome, Italy.
| | - Fabio Santacaterina
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University, Via Alvaro Del Portillo 5, 00128, Rome, Italy.
| | - Rossana Toglia
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University, Via Alvaro Del Portillo 5, 00128, Rome, Italy.
| | - Calogero Foti
- Physical Medicine and Rehabilitation Unit, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.
| | - Silvia Sterzi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University, Via Alvaro Del Portillo 5, 00128, Rome, Italy.
| | - Federica Bressi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University, Via Alvaro Del Portillo 5, 00128, Rome, Italy.
| | - Sandra Miccinilli
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University, Via Alvaro Del Portillo 5, 00128, Rome, Italy.
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22
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Lo Presti D, Carnevale A, D’Abbraccio J, Massari L, Massaroni C, Sabbadini R, Zaltieri M, Di Tocco J, Bravi M, Miccinilli S, Sterzi S, Longo UG, Denaro V, Caponero MA, Formica D, Oddo CM, Schena E. A Multi-Parametric Wearable System to Monitor Neck Movements and Respiratory Frequency of Computer Workers. Sensors (Basel) 2020; 20:E536. [PMID: 31963696 PMCID: PMC7014540 DOI: 10.3390/s20020536] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 11/29/2022]
Abstract
Musculoskeletal disorders are the most common form of occupational ill-health. Neck pain is one of the most prevalent musculoskeletal disorders experienced by computer workers. Wrong postural habits and non-compliance of the workstation to ergonomics guidelines are the leading causes of neck pain. These factors may also alter respiratory functions. Health and safety interventions can reduce neck pain and, more generally, the symptoms of musculoskeletal disorders and reduce the consequent economic burden. In this work, a multi-parametric wearable system based on two fiber Bragg grating sensors is proposed for monitoring neck movements and breathing activity of computer workers. The sensing elements were positioned on the neck, in the frontal and sagittal planes, to monitor: (i) flexion-extension and axial rotation repetitions, and (ii) respiratory frequency. In this pilot study, five volunteers were enrolled and performed five repetitions of both flexion-extension and axial rotation, and ten breaths of both quite breathing and tachypnea. Results showed the good performances of the proposed system in monitoring the aforementioned parameters when compared to optical reference systems. The wearable system is able to well-match the trend in time of the neck movements (both flexion-extension and axial rotation) and to estimate mean and breath-by-breath respiratory frequency values with percentage errors ≤6.09% and ≤1.90%, during quiet breathing and tachypnea, respectively.
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Affiliation(s)
- Daniela Lo Presti
- Unit of Measurement and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (D.L.P.); (A.C.); (C.M.); (R.S.); (M.Z.); (J.D.T.)
| | - Arianna Carnevale
- Unit of Measurement and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (D.L.P.); (A.C.); (C.M.); (R.S.); (M.Z.); (J.D.T.)
- Department of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (U.G.L.); (V.D.); (C.M.O.)
| | - Jessica D’Abbraccio
- Neuro-Robotic Touch Laboratory, BioRobotics Institute, Sant’Anna School of Advanced Studies, 56025 Pisa, Italy; (J.D.); (L.M.)
| | - Luca Massari
- Neuro-Robotic Touch Laboratory, BioRobotics Institute, Sant’Anna School of Advanced Studies, 56025 Pisa, Italy; (J.D.); (L.M.)
| | - Carlo Massaroni
- Unit of Measurement and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (D.L.P.); (A.C.); (C.M.); (R.S.); (M.Z.); (J.D.T.)
| | - Riccardo Sabbadini
- Unit of Measurement and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (D.L.P.); (A.C.); (C.M.); (R.S.); (M.Z.); (J.D.T.)
| | - Martina Zaltieri
- Unit of Measurement and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (D.L.P.); (A.C.); (C.M.); (R.S.); (M.Z.); (J.D.T.)
| | - Joshua Di Tocco
- Unit of Measurement and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (D.L.P.); (A.C.); (C.M.); (R.S.); (M.Z.); (J.D.T.)
| | - Marco Bravi
- Department of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (M.B.); (S.M.); (S.S.)
| | - Sandra Miccinilli
- Department of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (M.B.); (S.M.); (S.S.)
| | - Silvia Sterzi
- Department of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (M.B.); (S.M.); (S.S.)
| | - Umile G. Longo
- Department of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (U.G.L.); (V.D.); (C.M.O.)
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (U.G.L.); (V.D.); (C.M.O.)
| | - Michele A. Caponero
- Photonics Micro-and Nanostructures Laboratory, ENEA Research Center of Frascati, 00044 Rome, Italy;
| | - Domenico Formica
- NEXT Lab, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy;
| | - Calogero M. Oddo
- Department of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (U.G.L.); (V.D.); (C.M.O.)
| | - Emiliano Schena
- Unit of Measurement and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (D.L.P.); (A.C.); (C.M.); (R.S.); (M.Z.); (J.D.T.)
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23
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Miccinilli S, Bravi M, Maselli M, Santacaterina F, Morrone M, Manco D, Toglia R, Sterzi S, Bressi F. The effectiveness of extracorporeal shock wave therapy on breast cancer-related lymphedema: A literature review. Lymphology 2020; 53:118-135. [PMID: 33350286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Lymphedema is one of the most dreaded complications related to breast cancer surgery, commonly resulting in upper limb functional, esthetic, and psychological impairment. The necessity to improve the efficacy of conventional treatments and the promising effect of extracorporeal shock wave therapy (ESWT) on lymphangiogenesis in vitro and animal models, has prompted studies involving women affected by breast cancer-related lymphedema. Since intervention modalities and treatment protocols used are different, a review is necessary to verify the effectiveness of ESWT, evaluating the quality of existing studies and the eventual need for further research. Data were obtained from PubMed, Scopus, Google Scholar, Cochrane Library and PEDro, including articles published until January 2019. Five studies met the inclusion criteria. Evident heterogeneity emerged among selected studies permitting only a purely descriptive analysis of their data and strongly limiting their comparison. When compared to other treatment modalities, ESWT showed a significant effect on measured outcomes. It is clear that further high quality research is necessary to assert with confidence the effects and possible superiority of ESWT over other conservative therapies in the management of breast cancer-related lymphedema.
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Affiliation(s)
- S Miccinilli
- Physical and Rehabilitative Medicine, Università Campus Bio-Medico di Roma, Italy
| | - M Bravi
- Physical and Rehabilitative Medicine, Università Campus Bio-Medico di Roma, Italy
| | - M Maselli
- Physical and Rehabilitative Medicine, Università Campus Bio-Medico di Roma, Italy
| | - F Santacaterina
- Physical and Rehabilitative Medicine, Università Campus Bio-Medico di Roma, Italy
| | - M Morrone
- Physical and Rehabilitative Medicine, Università Campus Bio-Medico di Roma, Italy
| | - D Manco
- Physical and Rehabilitative Medicine, Università Campus Bio-Medico di Roma, Italy
| | - R Toglia
- Physical and Rehabilitative Medicine, Università Campus Bio-Medico di Roma, Italy
| | - S Sterzi
- Physical and Rehabilitative Medicine, Università Campus Bio-Medico di Roma, Italy
| | - F Bressi
- Physical and Rehabilitative Medicine, Università Campus Bio-Medico di Roma, Italy
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24
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Zollo L, Di Pino G, Ciancio AL, Ranieri F, Cordella F, Gentile C, Noce E, Romeo RA, Bellingegni AD, Vadalà G, Miccinilli S, Mioli A, Diaz-Balzani L, Bravi M, Hoffmann KP, Schneider A, Denaro L, Davalli A, Gruppioni E, Sacchetti R, Castellano S, Di Lazzaro V, Sterzi S, Denaro V, Guglielmelli E. Restoring Tactile sensations via neural interfaces for real-time force-and-slippage closed-loop control of bionic hands. Sci Robot 2019; 4. [PMID: 31620665 DOI: 10.1126/scirobotics.aau9924] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Despite previous studies on the restoration of tactile sensation on the fingers and the hand, there are no examples of use of the routed sensory information to finely control the prosthesis hand in complex grasp and manipulation tasks. Here it is shown that force and slippage sensations can be elicited in an amputee subject by means of biologically-inspired slippage detection and encoding algorithms, supported by a stick-slip model of the performed grasp. A combination of cuff and intraneural electrodes was implanted for eleven weeks in a young woman with hand amputation, and was shown to provide close-to-natural force and slippage sensations, paramount for significantly improving the subject's manipulative skills with the prosthesis. Evidence is provided about the improvement of the subject's grasping and manipulation capabilities over time, thanks to neural feedback. The elicited tactile sensations enabled the successful fulfillment of fine grasp and manipulation tasks with increasing complexity. Grasp performance was quantitatively assessed by means of instrumented objects and a purposely developed metrics. Closed-loop control capabilities enabled by the neural feedback were compared to those achieved without feedback. Further, the work investigates whether the described amelioration of motor performance in dexterous tasks had as central neurophysiological correlates changes in motor cortex plasticity and whether such changes were of purely motor origin, or else the effect of a strong and persistent drive of the sensory feedback.
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Affiliation(s)
- Loredana Zollo
- Research Unit of Biomedical Robotics and Biomicrosystems, Università Campus Bio-Medico di Roma
| | - Giovanni Di Pino
- Research Unit of Neurophysiology and Neuroengineering of Human-Technology Interaction, Università Campus Bio-Medico di Roma
| | - Anna L Ciancio
- Research Unit of Biomedical Robotics and Biomicrosystems, Università Campus Bio-Medico di Roma
| | - Federico Ranieri
- Research Unit of Neurology, Neurophysiology, Neurobiology, Università Campus Bio-Medico di Roma
| | - Francesca Cordella
- Research Unit of Biomedical Robotics and Biomicrosystems, Università Campus Bio-Medico di Roma
| | - Cosimo Gentile
- Research Unit of Biomedical Robotics and Biomicrosystems, Università Campus Bio-Medico di Roma
| | - Emiliano Noce
- Research Unit of Biomedical Robotics and Biomicrosystems, Università Campus Bio-Medico di Roma
| | - Rocco A Romeo
- Research Unit of Biomedical Robotics and Biomicrosystems, Università Campus Bio-Medico di Roma
| | | | - Gianluca Vadalà
- Research Unit of Orthopedics and Traumatology, Università Campus Bio-Medico di Roma
| | - Sandra Miccinilli
- Research Unit of Physical Medicine and Rehabilitation, Università Campus Bio-Medico di Roma
| | - Alessandro Mioli
- Research Unit of Neurophysiology and Neuroengineering of Human-Technology Interaction, Università Campus Bio-Medico di Roma
| | - Lorenzo Diaz-Balzani
- Research Unit of Orthopedics and Traumatology, Università Campus Bio-Medico di Roma
| | - Marco Bravi
- Research Unit of Physical Medicine and Rehabilitation, Università Campus Bio-Medico di Roma
| | | | | | - Luca Denaro
- Department of Neurosciences, University of Padova
| | | | | | | | | | - Vincenzo Di Lazzaro
- Research Unit of Neurology, Neurophysiology, Neurobiology, Università Campus Bio-Medico di Roma
| | - Silvia Sterzi
- Research Unit of Physical Medicine and Rehabilitation, Università Campus Bio-Medico di Roma
| | - Vincenzo Denaro
- Research Unit of Orthopedics and Traumatology, Università Campus Bio-Medico di Roma
| | - Eugenio Guglielmelli
- Research Unit of Biomedical Robotics and Biomicrosystems, Università Campus Bio-Medico di Roma
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25
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Capone F, Miccinilli S, Pellegrino G, Zollo L, Simonetti D, Bressi F, Florio L, Ranieri F, Falato E, Di Santo A, Pepe A, Guglielmelli E, Sterzi S, Di Lazzaro V. Safety, feasibility, and efficacy of transcutaneous vagus nerve stimulation combined with upper-limb robotic rehabilitation after stroke. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2018.09.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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26
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Miccinilli S, Bravi M, Morrone M, Santacaterina F, Stellato L, Bressi F, Sterzi S. A Triple Application of Kinesio Taping Supports Rehabilitation Program for Rotator Cuff Tendinopathy: a Randomized Controlled Trial. Ortop Traumatol Rehabil 2018; 20:499-505. [PMID: 30676323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Rotator cuff tendinopathy (RoCT) is a common pathology among adults. Kinesio-taping (KT) represents a possible rehabilitative treatment. The aim of the present study is to investigate the efficacy of a combination of three different applications of KT combined with a standardized protocol of rehabilitative exercises in reducing pain and in functional recovery in patients affected by RoCT. MATERIALS AND METHODS 21 patients were enrolled in a real group (RG) and 19 in a sham group (SG). RG received a real KT application and SG received a sham KT application. Both groups received the same rehabilitative protocol. A Numeric Rating Scale (NRS) for shoulder pain, Medical Research Council (MRC) Scales for shoulder strength assessment and Costant Murley Score (CMS) were administered before (T0) and at the end of treatment (T1). RESULTS Within-group analysis for RG at T1 showed significant improvement in: NRS at-rest (p=0.002), during-movement (p<0.001); CMS (p<0.001); MRC shoulder flexion (p=0.003), extension (p=0.005), abduction (p=0.003), adduction (p=0.007), external rotation (p=0.011), internal rotation (p=0.002), elbow flexion (p=0.008) and extension strength (p=0.011). Within-group analysis for SG at T1 showed significant improvement in: during-movement NRS (p=0.010); CMS (p<0.001). CONCLUSIONS 1. KT application combined with conventional rehabilitative treatment can facilitate immediate pain reduction during rehabilitative treatment. 2. KT application combined with conventional rehabilitative treatment can increase function recovery. 3. KT application combined with conventional rehabilitative treatment can increase strength recovery. 4. Our findings however are not strong enough to recommend the application of KT during rehabilitative treatment for RoCT. 5. These results are the basis for future prospective, randomized controlled trials of larger samples of patients.
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Affiliation(s)
- Sandra Miccinilli
- Physical and Rehabilitation Medicine Department, Campus Bio-Medico University, Rome, Italy
| | - Marco Bravi
- Physical and Rehabilitation Medicine Department, Campus Bio-Medico University, Rome, Italy
| | - Michelangelo Morrone
- Physical and Rehabilitation Medicine Department, Campus Bio-Medico University, Rome, Italy
| | - Fabio Santacaterina
- Physical and Rehabilitation Medicine Department, Campus Bio-Medico University, Rome, Italy
| | - Lugi Stellato
- Radiology Department, Campus Bio-Medico University, Rome, Italy
| | - Federica Bressi
- Physical and Rehabilitation Medicine Department, Campus Bio-Medico University, Rome, Italy
| | - Silvia Sterzi
- Physical and Rehabilitation Medicine Department, Campus Bio-Medico University, Rome, Italy
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27
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Scotto di Luzio F, Simonetti D, Cordella F, Miccinilli S, Sterzi S, Draicchio F, Zollo L. Bio-Cooperative Approach for the Human-in-the-Loop Control of an End-Effector Rehabilitation Robot. Front Neurorobot 2018; 12:67. [PMID: 30364325 PMCID: PMC6193510 DOI: 10.3389/fnbot.2018.00067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 09/20/2018] [Indexed: 11/13/2022] Open
Abstract
The design of patient-tailored rehabilitative protocols represents one of the crucial factors that influence motor recovery mechanisms, such as neuroplasticity. This approach, including the patient in the control loop and characterized by a control strategy adaptable to the user's requirements, is expected to significantly improve functional recovery in robot-aided rehabilitation. In this paper, a novel 3D bio-cooperative robotic platform is developed. A new arm-weight support system is included into an operational robotic platform for 3D upper limb robot-aided rehabilitation. The robotic platform is capable of adapting therapy characteristics to specific patient needs, thanks to biomechanical and physiological measurements, and thus closing the subject in the control loop. The level of arm-weight support and the level of the assistance provided by the end-effector robot are varied on the basis of muscular fatigue and biomechanical indicators. An assistance-as-needed approach is applied to provide the appropriate amount of assistance. The proposed platform has been experimentally validated on 10 healthy subjects; they performed 3D point-to-point tasks in two different conditions, i.e., with and without assistance-as-needed. The results have demonstrated the capability of the proposed system to properly adapt to real needs of the patients. Moreover, the provided assistance was shown to reduce the muscular fatigue without negatively influencing motion execution.
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Affiliation(s)
- Francesco Scotto di Luzio
- Research Unit of Biomedical Robotics and Biomicrosystems, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Davide Simonetti
- Research Unit of Biomedical Robotics and Biomicrosystems, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Francesca Cordella
- Research Unit of Biomedical Robotics and Biomicrosystems, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Sandra Miccinilli
- Unit of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Silvia Sterzi
- Unit of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Francesco Draicchio
- INAIL, Department of Occupational & Environmental Medicine, Monte Porzio Catone, Rome, Italy
| | - Loredana Zollo
- Research Unit of Biomedical Robotics and Biomicrosystems, Università Campus Bio-Medico di Roma, Rome, Italy
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28
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Capone F, Di Pino G, Pellegrino G, Florio L, Zollo L, Simonetti D, Ranieri F, Brunelli N, Corbetto M, Miccinilli S, Bravi M, Milighetti S, Guglielmelli E, Sterzi S, Di Lazzaro V. 35. Association of robot-assisted rehabilitation and non-invasive brain stimulation to improve upper limb function in chronic stroke patients. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2017.09.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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29
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Simonetti D, Zollo L, Milighetti S, Miccinilli S, Bravi M, Ranieri F, Magrone G, Guglielmelli E, Di Lazzaro V, Sterzi S. Literature Review on the Effects of tDCS Coupled with Robotic Therapy in Post Stroke Upper Limb Rehabilitation. Front Hum Neurosci 2017; 11:268. [PMID: 28588467 PMCID: PMC5440520 DOI: 10.3389/fnhum.2017.00268] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 05/05/2017] [Indexed: 11/17/2022] Open
Abstract
Today neurological diseases such as stroke represent one of the leading cause of long-term disability. Many research efforts have been focused on designing new and effective rehabilitation strategies. In particular, robotic treatment for upper limb stroke rehabilitation has received significant attention due to its ability to provide high-intensity and repetitive movement therapy with less effort than traditional methods. In addition, the development of non-invasive brain stimulation techniques such as transcranial Direct Current Stimulation (tDCS) has also demonstrated the capability of modulating brain excitability thus increasing motor performance. The combination of these two methods is expected to enhance functional and motor recovery after stroke; to this purpose, the current trends in this research field are presented and discussed through an in-depth analysis of the state-of-the-art. The heterogeneity and the restricted number of collected studies make difficult to perform a systematic review. However, the literature analysis of the published data seems to demonstrate that the association of tDCS with robotic training has the same clinical gain derived from robotic therapy alone. Future studies should investigate combined approach tailored to the individual patient's characteristics, critically evaluating the brain areas to be targeted and the induced functional changes.
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Affiliation(s)
- Davide Simonetti
- Research Unit of Biomedical Robotics and Biomicrosystems, Università Campus Bio-Medico di RomaRome, Italy
| | - Loredana Zollo
- Research Unit of Biomedical Robotics and Biomicrosystems, Università Campus Bio-Medico di RomaRome, Italy
| | - Stefano Milighetti
- Unit of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di RomaRome, Italy
| | - Sandra Miccinilli
- Unit of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di RomaRome, Italy
| | - Marco Bravi
- Unit of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di RomaRome, Italy
| | - Federico Ranieri
- Unit of Neurology, Neurophysiology and Neurobiology, Università Campus Bio-Medico di RomaRome, Italy
| | - Giovanni Magrone
- Unit of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di RomaRome, Italy
| | - Eugenio Guglielmelli
- Research Unit of Biomedical Robotics and Biomicrosystems, Università Campus Bio-Medico di RomaRome, Italy
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology and Neurobiology, Università Campus Bio-Medico di RomaRome, Italy
| | - Silvia Sterzi
- Unit of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di RomaRome, Italy
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30
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Massaroni C, Carraro E, Vianello A, Miccinilli S, Morrone M, Levai IK, Schena E, Saccomandi P, Sterzi S, Dickinson JW, Winter S, Silvestri S. Optoelectronic Plethysmography in Clinical Practice and Research: A Review. Respiration 2017; 93:339-354. [DOI: 10.1159/000462916] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 02/06/2017] [Indexed: 11/19/2022] Open
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31
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Bressi F, Casale M, Papalia R, Moffa A, Di Martino A, Miccinilli S, Salvinelli F, Denaro V, Sterzi S. Cervical spine disorders and its association with tinnitus: The "triple" hypothesis. Med Hypotheses 2016; 98:2-4. [PMID: 28012597 DOI: 10.1016/j.mehy.2016.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 11/02/2016] [Accepted: 11/04/2016] [Indexed: 11/16/2022]
Abstract
Subjective tinnitus and cervical spine disorders (CSD) are among the most common complaints encountered by physicians. Although the relationship between tinnitus and CSD has attracted great interest during the past several years, the pathogenesis of tinnitus induced by CSD remains unclear. Conceivably, CSD could trigger a somatosensory pathway-induced disinhibition of dorsal cochlear nucleus (DCN) activity in the auditory pathway; furthermore, CSD can cause inner ear blood impairment induced by vertebral arteries hemodynamic alterations and trigeminal irritation. In genetically -predisposed CSD patients with reduced serotoninergic tone, signals from chronically stimulated DCNs could activate specific cortical neuronal networks and plastic neural changes resulting in tinnitus. Therefore, an early specific tailored CSD treatments and/or boosting serotoninergic activity may be required to prevent the creation of 'tinnitus memory circuits' in CSD patients.
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Affiliation(s)
- Federica Bressi
- Department of Physical and Rehabilitation Medicine, Campus Bio-Medico University, Rome, Italy
| | - Manuele Casale
- Department of Otolaryngology, Campus Bio-Medico University, Rome, Italy.
| | - Rocco Papalia
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Rome, Italy
| | - Antonio Moffa
- Department of Otolaryngology, Campus Bio-Medico University, Rome, Italy
| | - Alberto Di Martino
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Rome, Italy
| | - Sandra Miccinilli
- Department of Physical and Rehabilitation Medicine, Campus Bio-Medico University, Rome, Italy
| | | | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Rome, Italy
| | - Silvia Sterzi
- Department of Physical and Rehabilitation Medicine, Campus Bio-Medico University, Rome, Italy
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32
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Morrone M, Miccinilli S, Bravi M, Paolucci T, Melgari JM, Salomone G, Picelli A, Spadini E, Ranavolo A, Saraceni VM, DI Lazzaro V, Sterzi S. Perceptive rehabilitation and trunk posture alignment in patients with Parkinson disease: a single blind randomized controlled trial. Eur J Phys Rehabil Med 2016; 52:799-809. [PMID: 27171537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Recent studies aimed to evaluate the potential effects of perceptive rehabilitation in Parkinson Disease reporting promising preliminary results for postural balance and pain symptoms. To date, no randomized controlled trial was carried out to compare the effects of perceptive rehabilitation and conventional treatment in patients with Parkinson Disease. AIM To evaluate whether a perceptive rehabilitation treatment could be more effective than a conventional physical therapy program in improving postural control and gait pattern in patients with Parkinson Disease. DESIGN Single blind, randomized controlled trial. SETTING Department of Physical and Rehabilitation Medicine of a University Hospital. POPULATION Twenty outpatients affected by idiopathic Parkinson Disease at Hoehn and Yahr stage ≤3. METHODS Recruited patients were divided into two groups: the first one underwent individual treatment with Surfaces for Perceptive Rehabilitation (Su-Per), consisting of rigid wood surfaces supporting deformable latex cones of various dimensions, and the second one received conventional group physical therapy treatment. Each patient underwent a training program consisting of ten, 45-minute sessions, three days a week for 4 consecutive weeks. Each subject was evaluated before treatment, immediately after treatment and at one month of follow-up, by an optoelectronic stereophotogrammetric system for gait and posture analysis, and by a computerized platform for stabilometric assessment. RESULTS Kyphosis angle decreased after ten sessions of perceptive rehabilitation, thus showing a substantial difference with respect to the control group. No significant differences were found as for gait parameters (cadence, gait speed and stride length) within Su-Per group and between groups. Parameters of static and dynamic evaluation on stabilometric platform failed to demonstrate any statistically relevant difference both within-groups and between-groups. CONCLUSIONS Perceptive training may help patients affected by Parkinson Disease into restoring a correct midline perception and, in turn, to improve postural control. CLINICAL REHABILITATION IMPACT Perceptive surfaces represent an alternative to conventional rehabilitation of postural disorders in Parkinson Disease. Further studies are needed to determine if the association of perceptive treatment and active motor training would be useful in improving also gait dexterity.
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Affiliation(s)
- Michelangelo Morrone
- Unit of Physical and Rehabilitation Medicine, Department of Medicine, Campus Bio-Medico University, Rome, Italy -
| | - Sandra Miccinilli
- Unit of Physical and Rehabilitation Medicine, Department of Medicine, Campus Bio-Medico University, Rome, Italy
| | - Marco Bravi
- Unit of Physical and Rehabilitation Medicine, Department of Medicine, Campus Bio-Medico University, Rome, Italy
| | - Teresa Paolucci
- Unit of Physical and Rehabilitation Medicine, Umberto I Hospital, "La Sapienza" University, Rome, Italy
| | - Jean M Melgari
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University, Rome, Italy
- Movement Disorder Service, Neurology, Azienda Ospedaliera di Treviglio, Treviglio, Bergamo, Italy
| | - Gaetano Salomone
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University, Rome, Italy
| | - Alessandro Picelli
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy
| | - Ennio Spadini
- Neuromotor Rehabilitation Unit, S. Filippo Neri Hospital, "La Sapienza" University, Rome, Italy
| | - Alberto Ranavolo
- INAIL, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Monte Porzio Catone, Rome, Italy
| | - Vincenzo M Saraceni
- Unit of Physical and Rehabilitation Medicine, Umberto I Hospital, "La Sapienza" University, Rome, Italy
| | - Vincenzo DI Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University, Rome, Italy
| | - Silvia Sterzi
- Unit of Physical and Rehabilitation Medicine, Department of Medicine, Campus Bio-Medico University, Rome, Italy
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Di Lazzaro V, Capone F, Di Pino G, Pellegrino G, Florio L, Zollo L, Simonetti D, Ranieri F, Brunelli N, Corbetto M, Miccinilli S, Bravi M, Milighetti S, Guglielmelli E, Sterzi S. Combining Robotic Training and Non-Invasive Brain Stimulation in Severe Upper Limb-Impaired Chronic Stroke Patients. Front Neurosci 2016; 10:88. [PMID: 27013950 PMCID: PMC4782015 DOI: 10.3389/fnins.2016.00088] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 02/22/2016] [Indexed: 11/18/2022] Open
Abstract
Previous studies suggested that both robot-assisted rehabilitation and non-invasive brain stimulation can produce a slight improvement in severe chronic stroke patients. It is still unknown whether their combination can produce synergistic and more consistent improvements. Safety and efficacy of this combination has been assessed within a proof-of-principle, double-blinded, semi-randomized, sham-controlled trial. Inhibitory continuous Theta Burst Stimulation (cTBS) was delivered on the affected hemisphere, in order to improve the response to the following robot-assisted therapy via a homeostatic increase of learning capacity. Twenty severe upper limb-impaired chronic stroke patients were randomized to robot-assisted therapy associated with real or sham cTBS, delivered for 10 working days. Eight real and nine sham patients completed the study. Change in Fugl-Meyer was chosen as primary outcome, while changes in several quantitative indicators of motor performance extracted by the robot as secondary outcomes. The treatment was well-tolerated by the patients and there were no adverse events. All patients achieved a small, but significant, Fugl-Meyer improvement (about 5%). The difference between the real and the sham cTBS groups was not significant. Among several secondary end points, only the Success Rate (percentage of targets reached by the patient) improved more in the real than in the sham cTBS group. This study shows that a short intensive robot-assisted rehabilitation produces a slight improvement in severe upper-limb impaired, even years after the stroke. The association with homeostatic metaplasticity-promoting non-invasive brain stimulation does not augment the clinical gain in patients with severe stroke.
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Affiliation(s)
- Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di RomaRome, Italy; Fondazione Alberto Sordi - Research Institute for AgeingRome, Italy
| | - Fioravante Capone
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di RomaRome, Italy; Fondazione Alberto Sordi - Research Institute for AgeingRome, Italy
| | - Giovanni Di Pino
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di RomaRome, Italy; Fondazione Alberto Sordi - Research Institute for AgeingRome, Italy
| | - Giovanni Pellegrino
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma Rome, Italy
| | - Lucia Florio
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma Rome, Italy
| | - Loredana Zollo
- Unit of Biomedical Robotics and Biomicrosystems, Department of Engineering, Università Campus Bio-Medico di Roma Rome, Italy
| | - Davide Simonetti
- Unit of Biomedical Robotics and Biomicrosystems, Department of Engineering, Università Campus Bio-Medico di Roma Rome, Italy
| | - Federico Ranieri
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di RomaRome, Italy; Fondazione Alberto Sordi - Research Institute for AgeingRome, Italy
| | - Nicoletta Brunelli
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di RomaRome, Italy; Fondazione Alberto Sordi - Research Institute for AgeingRome, Italy
| | - Marzia Corbetto
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di RomaRome, Italy; Fondazione Alberto Sordi - Research Institute for AgeingRome, Italy
| | - Sandra Miccinilli
- Unit of Physical and Rehabilitation Medicine, Department of Medicine, Università Campus Bio-Medico di Roma Rome, Italy
| | - Marco Bravi
- Unit of Physical and Rehabilitation Medicine, Department of Medicine, Università Campus Bio-Medico di Roma Rome, Italy
| | - Stefano Milighetti
- Unit of Physical and Rehabilitation Medicine, Department of Medicine, Università Campus Bio-Medico di Roma Rome, Italy
| | - Eugenio Guglielmelli
- Unit of Biomedical Robotics and Biomicrosystems, Department of Engineering, Università Campus Bio-Medico di Roma Rome, Italy
| | - Silvia Sterzi
- Unit of Physical and Rehabilitation Medicine, Department of Medicine, Università Campus Bio-Medico di Roma Rome, Italy
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Miccinilli S, Morrone M, Bastianini F, Molinari M, Scivoletto G, Silvestri S, Ranieri F, Sterzi S. Optoelectronic plethysmography to evaluate the effect of posture on breathing kinematics in spinal cord injury: a cross sectional study. Eur J Phys Rehabil Med 2016; 52:36-47. [PMID: 25900344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Spinal cord injured patients often suffer from respiratory muscles impairment. Spirometry studies showed that in supine position vital capacity increases in such patients since diaphragm increases its inspiratory excursion. To our opinion, however, respiratory kinematics in spinal cord injured patients is disadvantaged in supine position. AIM To evaluate the effect of posture (sitting and supine) on respiratory kinematics in chronic spinal cord injured patients using optoelectronic plethysmography. DESIGN Cross-sectional study. SETTING Outpatients referring to the Movement Analysis Laboratory of a Physical and Rehabilitation Medicine Unit. POPULATION Twenty chronic spinal cord injured patients (9 tetraplegics, with lesional level ranging from C3 to C7 and 11 paraplegics with lesional level ranging from T1 to T8) and twenty healthy subjects matched for gender, age and smoking habits. METHODS All subjects underwent optoelectronic evaluation in sitting and supine position during quiet breathing and hyperventilation. Additional trials were performed to derive respiratory functional parameters (vital capacity and forced expiratory volume in the first second) in sitting and in supine position. Compartmental volumes and respiratory functional parameters were analyzed by means of analysis of variance. Post-hoc comparisons by means of t-tests were performed to analyze differences within and between study groups (spinal cord injured patients and healthy subjects, paraplegics and tetraplegics). Phase angle analysis and Konno and Mead diagrams were performed to evaluate if thoracic and abdominal compartments were moving in synchrony during breathing and the results were compared by paired t-tests. RESULTS Supine position increases vital capacity and forced expiratory volume in the first second. This could be due to the more favorable length of the diaphragm in supine than in sitting position. However in such posture the phase shift between thorax and abdomen during breathing increases. CONCLUSION Optoelectronic plethysmography measurements showed that even if in supine position there is an improvement in respiratory functional parameters, the respiratory kinematics of the chest wall is disadvantaged. CLINICAL REHABILITATION IMPACT Our study suggests that the use of abdominal binders could reproduce in sitting position the positive effect of supine position on diaphragm, that could work at a more favorable point of its length tension curve.
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Affiliation(s)
- Sandra Miccinilli
- Department of Physical and Rehabilitation Medicine Campus Bio‑Medico University, Rome, Italy -
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