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Armand S, Sawacha Z, Goudriaan M, Horsak B, van der Krogt M, Huenaerts C, Daly C, Kranzl A, Boehm H, Petrarca M, Guiotto A, Merlo A, Spolaor F, Campanini I, Cosma M, Hallemans A, Horemans H, Gasq D, Moissenet F, Assi A, Sangeux M. Current practices in clinical gait analysis in Europe: A comprehensive survey-based study from the European society for movement analysis in adults and children (ESMAC) standard initiative. Gait Posture 2024; 111:65-74. [PMID: 38653178 DOI: 10.1016/j.gaitpost.2024.04.014] [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: 11/21/2023] [Revised: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Clinical gait analysis (CGA) is a systematic approach to comprehensively evaluate gait patterns, quantify impairments, plan targeted interventions, and evaluate the impact of interventions. However, international standards for CGA are currently lacking, resulting in various national initiatives. Standards are important to ensure safe and effective healthcare practices and to enable evidence-based clinical decision-making, facilitating interoperability, and reimbursement under national healthcare policies. Collaborative clinical and research work between European countries would benefit from common standards. RESEARCH OBJECTIVE This study aimed to review the current laboratory practices for CGA in Europe. METHODS A comprehensive survey was conducted by the European Society for Movement Analysis in Adults and Children (ESMAC), in close collaboration with the European national societies. The survey involved 97 gait laboratories across 16 countries. The survey assessed several aspects related to CGA, including equipment used, data collection, processing, and reporting methods. RESULTS There was a consensus between laboratories concerning the data collected during CGA. The Conventional Gait Model (CGM) was the most used biomechanical model for calculating kinematics and kinetics. Respondents also reported the use of video recording, 3D motion capture systems, force plates, and surface electromyography. While there was a consensus on the reporting of CGA data, variations were reported in training, documentation, data preprocessing and equipment maintenance practices. SIGNIFICANCE The findings of this study will serve as a foundation for the development of standardized guidelines for CGA in Europe.
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Affiliation(s)
- Stéphane Armand
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
| | - Zimi Sawacha
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Marije Goudriaan
- Utrecht University, University Corporate Offices, Student and Academic Affairs Office, Utrecht, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam, the Netherlands
| | - Brian Horsak
- Center for Digital Health and Social Innovation, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Marjolein van der Krogt
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
| | - Catherine Huenaerts
- Clinical Motion Analysis Laboratory, University Hospital Leuven, Leuven, Belgium
| | - Colm Daly
- National Centre for Movement Analysis, Central Remedial Clinic, Dublin, Ireland; CP-Life Research Centre, Royal College of Surgeons, Dublin, Ireland
| | - Andreas Kranzl
- Laboratory for Gait and Movement Analysis, Orthopaedic Hospital Speising, Vienna, Austria
| | - Harald Boehm
- Orthopaedic Hospital for Children, Aschau im Chiemgau, Germany
| | - Maurizio Petrarca
- Movement Analysis and Robotics Laboratory, "Bambino Gesù" Children's Hospital - IRCCS, Rome, Italy
| | - Anna Guiotto
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Andrea Merlo
- Gait & Motion Analysis Laboratory, Sol et Salus Hospital, Rimini, Italy; LAM - Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, San Sebastiano Hospital, Correggio, Italy
| | - Fabiola Spolaor
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Isabella Campanini
- LAM - Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, San Sebastiano Hospital, Correggio, Italy
| | - Michela Cosma
- Motion Analysis Laboratory, Neuroscience and Rehabilitation Department, University Hospital of Ferrara, Italy
| | - Ann Hallemans
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
| | - Herwin Horemans
- Department of Rehabilitation, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - David Gasq
- Department of Functional Physiological Explorations, University Hospital of Toulouse, Hôpital de Rangueil, Toulouse, France; ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - Florent Moissenet
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Ayman Assi
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Morgan Sangeux
- University Children's Hospital Basel, Basel, Switzerland
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Kiper P, Guzik A, Petrarca M, Oliva-Pascual-Vaca A, Luque-Moreno C. Editorial: New approaches for central nervous system rehabilitation. Front Neurol 2024; 15:1367519. [PMID: 38356885 PMCID: PMC10864656 DOI: 10.3389/fneur.2024.1367519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 01/22/2024] [Indexed: 02/16/2024] Open
Affiliation(s)
- Pawel Kiper
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, Venice, Italy
| | - Agnieszka Guzik
- Department of Physiotherapy, College of Medical Sciences, Institute of Health Sciences, University of Rzeszów, Rzeszów, Poland
| | - Maurizio Petrarca
- Movement Analysis and Robotics Laboratory (MARlab), Neurorehabilitation Unit, Neurological Science and Neurorehabilitation Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Angel Oliva-Pascual-Vaca
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
| | - Carlos Luque-Moreno
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
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Favetta M, Romano A, Valè N, Cieslik B, Federico S, Girolami A, Mazzarotto D, Pregnolato G, Righetti A, Salvalaggio S, Castelli E, Smania N, Bargellesi S, Kiper P, Petrarca M. A scoping review of scientific concepts concerning motor recovery after stroke as employed in clinical trials. Front Neurol 2023; 14:1221656. [PMID: 38146442 PMCID: PMC10749504 DOI: 10.3389/fneur.2023.1221656] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/23/2023] [Indexed: 12/27/2023] Open
Abstract
The scientific literature on poststroke rehabilitation is remarkably vast. Over the last decades, dozens of rehabilitation approaches have been investigated. However, sometimes it is challenging to trace new experimental interventions back to some of the known models of motor control and sensorimotor learning. This scoping review aimed to investigate motor control models' diffusion among the literature on motor recovery after stroke. We performed a literature search on Medline, Cochrane, Web of Science, Embase, and Scopus databases. The last search was conducted in September 2023. This scoping review included full-text articles published in English in peer-reviewed journals that provided rehabilitation interventions based on motor control or motor learning frameworks for at least one individual with stroke. For each study, we identified the theoretical framework the authors used to design the experimental treatment. To this aim, we used a previously proposed classification of the known models of motor control, dividing them into the following categories: neuroanatomy, robotics, self-organization, and ecological context. In total, 2,185 studies were originally considered in this scoping review. After the screening process, we included and analyzed 45 studies: 20 studies were randomized controlled trials, 12 were case series, 4 were case reports, 8 were observational longitudinal pilot studies, and 1 was an uncontrolled trial. Only 10 studies explicitly declared the reference theoretical model. Considering their classification, 21 studies referred to the robotics motor control model, 12 to the self-organization model, 8 to the neuroanatomy model, and 4 to the ecological model. Our results showed that most of the rehabilitative interventions purposed in stroke rehabilitation have no clear theoretical bases on motor control and motor learning models. We suggest this is an issue that deserves attention when designing new experimental interventions in stroke rehabilitation.
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Affiliation(s)
- Martina Favetta
- Movement Analysis and Robotics Laboratory (MARlab), Neurorehabilitation Unit, Neurological Science and Neurorehabilitation Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alberto Romano
- Movement Analysis and Robotics Laboratory (MARlab), Neurorehabilitation Unit, Neurological Science and Neurorehabilitation Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Department of Health Systems Management, Ariel University, Ariel, Israel
| | - Nicola Valè
- Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Blazej Cieslik
- Laboratory of Healthcare Innovation Technology, IRCCS San Camillo Hospital, Venice, Italy
| | - Sara Federico
- Laboratory of Healthcare Innovation Technology, IRCCS San Camillo Hospital, Venice, Italy
| | - Alessia Girolami
- Spondilos Lab Centro Medico and Riabilitazione, Pordenone, Italy
| | - Deborah Mazzarotto
- Medicina Fisica e Riabilitazione, ULSS 4 Veneto Orientale, Jesolo, Italy
| | - Giorgia Pregnolato
- Laboratory of Healthcare Innovation Technology, IRCCS San Camillo Hospital, Venice, Italy
| | - Anna Righetti
- Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Silvia Salvalaggio
- Laboratory of Computational Neuroimaging, IRCCS San Camillo Hospital, Venice, Italy
- Padova Neuroscience Center, Università Degli Studi di Padova, Padua, Italy
| | - Enrico Castelli
- Movement Analysis and Robotics Laboratory (MARlab), Neurorehabilitation Unit, Neurological Science and Neurorehabilitation Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Nicola Smania
- Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Stefano Bargellesi
- Physical Medicine and Rehabilitation Unit, Azienda ULSS 3 Serenissima, Venezia, Italy
| | - Pawel Kiper
- Laboratory of Healthcare Innovation Technology, IRCCS San Camillo Hospital, Venice, Italy
| | - Maurizio Petrarca
- Movement Analysis and Robotics Laboratory (MARlab), Neurorehabilitation Unit, Neurological Science and Neurorehabilitation Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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4
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Loro A, Borg MB, Battaglia M, Amico AP, Antenucci R, Benanti P, Bertoni M, Bissolotti L, Boldrini P, Bonaiuti D, Bowman T, Capecci M, Castelli E, Cavalli L, Cinone N, Cosenza L, Di Censo R, Di Stefano G, Draicchio F, Falabella V, Filippetti M, Galeri S, Gimigliano F, Grigioni M, Invernizzi M, Jonsdottir J, Lentino C, Massai P, Mazzoleni S, Mazzon S, Molteni F, Morelli S, Morone G, Nardone A, Panzeri D, Petrarca M, Posteraro F, Santamato A, Scotti L, Senatore M, Spina S, Taglione E, Turchetti G, Varalta V, Picelli A, Baricich A. Balance Rehabilitation through Robot-Assisted Gait Training in Post-Stroke Patients: A Systematic Review and Meta-Analysis. Brain Sci 2023; 13:brainsci13010092. [PMID: 36672074 PMCID: PMC9856764 DOI: 10.3390/brainsci13010092] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/21/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Balance impairment is a common disability in post-stroke survivors, leading to reduced mobility and increased fall risk. Robotic gait training (RAGT) is largely used, along with traditional training. There is, however, no strong evidence about RAGT superiority, especially on balance. This study aims to determine RAGT efficacy on balance of post-stroke survivors. METHODS PubMed, Cochrane Library, and PeDRO databases were investigated. Randomized clinical trials evaluating RAGT efficacy on post-stroke survivor balance with Berg Balance Scale (BBS) or Timed Up and Go test (TUG) were searched. Meta-regression analyses were performed, considering weekly sessions, single-session duration, and robotic device used. RESULTS A total of 18 trials have been included. BBS pre-post treatment mean difference is higher in RAGT-treated patients, with a pMD of 2.17 (95% CI 0.79; 3.55). TUG pre-post mean difference is in favor of RAGT, but not statistically, with a pMD of -0.62 (95%CI - 3.66; 2.43). Meta-regression analyses showed no relevant association, except for TUG and treatment duration (β = -1.019, 95% CI - 1.827; -0.210, p-value = 0.0135). CONCLUSIONS RAGT efficacy is equal to traditional therapy, while the combination of the two seems to lead to better outcomes than each individually performed. Robot-assisted balance training should be the focus of experimentation in the following years, given the great results in the first available trials. Given the massive heterogeneity of included patients, trials with more strict inclusion criteria (especially time from stroke) must be performed to finally define if and when RAGT is superior to traditional therapy.
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Affiliation(s)
- Alberto Loro
- Department of Health Sciences, Università del Piemonte Orientale “Amedeo Avogadro”, 28100 Novara, Italy
- Physical Medicine and Rehabilitation Unit, AOU Maggiore della Carità University Hospital, 28100 Novara, Italy
- Correspondence: or
| | - Margherita Beatrice Borg
- Department of Health Sciences, Università del Piemonte Orientale “Amedeo Avogadro”, 28100 Novara, Italy
- Physical Medicine and Rehabilitation Unit, AOU Maggiore della Carità University Hospital, 28100 Novara, Italy
| | - Marco Battaglia
- Department of Health Sciences, Università del Piemonte Orientale “Amedeo Avogadro”, 28100 Novara, Italy
- Physical Medicine and Rehabilitation Unit, AOU Maggiore della Carità University Hospital, 28100 Novara, Italy
| | - Angelo Paolo Amico
- Physical Medicine and Rehabilitation Unit, Polyclinic of Bari, 70124 Bari, Italy
| | - Roberto Antenucci
- Rehabilitation Unit, Castel San Giovanni Hospital, 29015 Piacenza, Italy
| | - Paolo Benanti
- Theology Department, Pontifical Gregorian University, 00187 Rome, Italy
| | - Michele Bertoni
- Physical Medicine and Rehabilitation, ASST Sette Laghi, 21100 Varese, Italy
| | - Luciano Bissolotti
- Casa di Cura Domus Salutis, Fondazione Teresa Camplani, 25100 Brescia, Italy
| | - Paolo Boldrini
- Robotic Rehabilitation Section, Italian Society of Physical and Rehabilitative Medicine (SIMFER), 00187 Rome, Italy
| | - Donatella Bonaiuti
- Robotic Rehabilitation Section, Italian Society of Physical and Rehabilitative Medicine (SIMFER), 00187 Rome, Italy
| | - Thomas Bowman
- Neurorehabilitation Department, IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy
| | - Marianna Capecci
- Experimental and Clinic Medicine Department, Università Politecnica delle Marche (UNIVPM), 60126 Ancona, Italy
| | - Enrico Castelli
- Neurorehabilitation Unit, Bambino Gesù Children’s Hospital, 00165 Rome, Italy
| | - Loredana Cavalli
- Physical Medicine and Rehabilitation Unit, Centro Giusti, 50125 Florence, Italy
| | - Nicoletta Cinone
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, 71100 Foggia, Italy
| | - Lucia Cosenza
- Rehabilitation Unit, Department of Rehabilitation, “Santi Antonio e Biagio e Cesare Arrigo” National Hospital, 15122 Alessandria, Italy
| | - Rita Di Censo
- Unit of Neurorehabilitation, Department of Neuroscience, Biomedicine, and Movement Sciences, University Hospital of Verona, University of Verona, 37126 Verona, Italy
| | - Giuseppina Di Stefano
- Robotic Rehabilitation Section, Italian Society of Physical and Rehabilitative Medicine (SIMFER), 00187 Rome, Italy
| | - Francesco Draicchio
- Dipartimento Medicina, Epidemiologia, Igiene del Lavoro e Ambientale, Istituto Nazionale Assicurazione Infortuni sul Lavoro (INAIL), 00192 Rome, Italy
| | - Vincenzo Falabella
- Italian Federation of Persons with Spinal Cord Injuries (FISH), 00197 Rome, Italy
| | - Mirko Filippetti
- Unit of Neurorehabilitation, Department of Neuroscience, Biomedicine, and Movement Sciences, University Hospital of Verona, University of Verona, 37126 Verona, Italy
| | - Silvia Galeri
- Neurorehabilitation Department, IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy
| | - Francesca Gimigliano
- Department of Physical and Mental Health and Prevention Medicine, Luigi Vanvitelli University of Campania, 81100 Naples, Italy
| | - Mauro Grigioni
- Department of New Technologies in Public Healthcare, Italian National Institute of Health (ISS), 00161 Rome, Italy
| | - Marco Invernizzi
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera Santi Antonio e Biagio e Cesare Arrigo, 15122 Alessandria, Italy
| | - Johanna Jonsdottir
- Neurorehabilitation Department, IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy
| | - Carmelo Lentino
- Rehabilitation Unit, Santa Corona Hospital, 17027 Pietra Ligure, Italy
| | - Perla Massai
- Tuscany Rehabilitation Clinic, 52025 Montevarchi, Italy
| | - Stefano Mazzoleni
- Department of Electrical Engineering and Information Technology, Polytechnic University of Bari, 70126 Bari, Italy
- The BioRobotics Institute, Scuola Superiore Sant’Anna, 56025 Pontedera, Italy
| | - Stefano Mazzon
- Azienda Unità Locale Socio Sanitaria Euganea (AULSS 6), 35100 Padua, Italy
| | - Franco Molteni
- Rehabilitation Department, Valduce Villa Beretta Hospital, 23845 Costa Masnaga, Italy
| | - Sandra Morelli
- Department of New Technologies in Public Healthcare, Italian National Institute of Health (ISS), 00161 Rome, Italy
| | - Giovanni Morone
- Neurorehabilitation Unit, Santa Lucia Foundation IRCCS, 00179 Rome, Italy
| | - Antonio Nardone
- Pediatric, Diagnostical and Clinical-Surgical Sciences Department, University of Pavia, 27100 Pavia, Italy
- Neurorehabilitation Unit, Istituto Clinico-Scientifico Maugeri SPA IRCCS, 27100 Pavia, Italy
| | - Daniele Panzeri
- Pediatric Rehabilitation Unit, IRCCS Eugenio Medea, 23842 Bosisio Parini, Italy
| | - Maurizio Petrarca
- Neurorehabilitation Unit, Bambino Gesù Children’s Hospital, 00165 Rome, Italy
| | | | - Andrea Santamato
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, 71100 Foggia, Italy
| | - Lorenza Scotti
- Department of Translational Medicine, Università del Piemonte Orientale “Amedeo Avogadro”, 28100 Novara, Italy
| | - Michele Senatore
- Italian Association of Occupational Therapists (AITO), 00136 Rome, Italy
| | - Stefania Spina
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, 71100 Foggia, Italy
| | - Elisa Taglione
- Rehabilitation Unit, Istituto Nazionale Assicurazione Infortuni sul Lavoro (INAIL), 56048 Volterra, Italy
| | | | - Valentina Varalta
- Unit of Neurorehabilitation, Department of Neuroscience, Biomedicine, and Movement Sciences, University Hospital of Verona, University of Verona, 37126 Verona, Italy
| | - Alessandro Picelli
- Unit of Neurorehabilitation, Department of Neuroscience, Biomedicine, and Movement Sciences, University Hospital of Verona, University of Verona, 37126 Verona, Italy
| | - Alessio Baricich
- Department of Health Sciences, Università del Piemonte Orientale “Amedeo Avogadro”, 28100 Novara, Italy
- Physical Medicine and Rehabilitation Unit, AOU Maggiore della Carità University Hospital, 28100 Novara, Italy
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Carmignano SM, Fundarò C, Bonaiuti D, Calabrò RS, Cassio A, Mazzoli D, Bizzarini E, Campanini I, Cerulli S, Chisari C, Colombo V, Dalise S, Gazzotti V, Mazzoleni D, Mazzucchelli M, Melegari C, Merlo A, Stampacchia G, Boldrini P, Mazzoleni S, Posteraro F, Benanti P, Castelli E, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzon S, Molteni F, Morone G, Petrarca M, Picelli A, Senatore M, Turchetti G, Andrenelli E. Robot-assisted gait training in patients with Parkinson's disease: Implications for clinical practice. A systematic review. NeuroRehabilitation 2022; 51:649-663. [PMID: 35570502 DOI: 10.3233/nre-220026] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 01/11/2023]
Abstract
BACKGROUND Gait impairments are common disabling symptoms of Parkinson's disease (PD). Among the approaches for gait rehabilitation, interest in robotic devices has grown in recent years. However, the effectiveness compared to other interventions, the optimum amount of training, the type of device, and which patients might benefit most remains unclear. OBJECTIVE To conduct a systematic review about the effects on gait of robot-assisted gait training (RAGT) in PD patients and to provide advice for clinical practice. METHODS A search was performed on PubMed, Scopus, PEDro, Cochrane library, Web of science, and guideline databases, following PRISMA guidelines. We included English articles if they used a robotic system with details about the intervention, the parameters, and the outcome measures. We evaluated the level and quality of evidence. RESULTS We included twenty papers out of 230 results: two systematic reviews, 9 randomized controlled trials, 4 uncontrolled studies, and 5 descriptive reports. Nine studies used an exoskeleton device and the remainders end-effector robots, with large variability in terms of subjects' disease-related disability. CONCLUSIONS RAGT showed benefits on gait and no adverse events were recorded. However, it does not seem superior to other interventions, except in patients with more severe symptoms and advanced disease.
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Affiliation(s)
- Simona Maria Carmignano
- Centro Terapeutico Riabilitativo (CTR), Potenza, Italy.,University of Salerno, Salerno, Italy
| | - Cira Fundarò
- Neurophysiopatology Unit, Istituti Clinici Scientifici Maugeri, IRCCS Montescano, Pavia, Italy
| | | | | | - Anna Cassio
- Spinal Cord Unit and Intensive Rehabilitation Medicine, Ospedale di Fiorenzuola d'Arda, AUSL Piacenza, Piacenza, Italy
| | - Davide Mazzoli
- Gait and Motion Analysis Laboratory, Sol et Salus Ospedale Privato Accreditato, Rimini, Italy
| | - Emiliana Bizzarini
- Department of Rehabilitation Medicine, Spinal Cord Unit, Gervasutta Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), Udine, Italy
| | - Isabella Campanini
- Department of Neuromotor and Rehabilitation, LAM-Motion Analysis Laboratory, San Sebastiano Hospital, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Simona Cerulli
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Carmelo Chisari
- Department of Translational Research and New Technologies in Medicine and Surgery, Neurorehabiltation Section, University of Pisa, Pisa, Italy
| | | | - Stefania Dalise
- Department of Translational Research and New Technologies in Medicine and Surgery, Neurorehabiltation Section, University of Pisa, Pisa, Italy
| | - Valeria Gazzotti
- Centro Protesi Vigorso di Budrio, Istituto Nazionale Assicurazione Infortuni sul Lavoro (INAIL), Bologna, Italy
| | - Daniele Mazzoleni
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | | | | | - Andrea Merlo
- Gait and Motion Analysis Laboratory, Sol et Salus Ospedale Privato Accreditato, Rimini, Italy.,Department of Neuromotor and Rehabilitation, LAM-Motion Analysis Laboratory, San Sebastiano Hospital, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Paolo Boldrini
- Italian Society of Physical Medicine and Rehabilitation (SIMFER), Rome, Italy
| | - Stefano Mazzoleni
- Department of Electrical and Information Engineering, Politecnico di Bari, Bari, Italy
| | - Federico Posteraro
- Department of Rehabilitation, Versilia Hospital - AUSL12, Viareggio, 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 Mazzon
- Rehabilitation Unit, ULSS (Local Health Authority) Euganea, Camposampiero Hospital, 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
| | - Michele Senatore
- Associazione Italiana dei Terapisti Occupazionali (AITO), Rome, Italy
| | | | - Elisa Andrenelli
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
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6
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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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Stampacchia G, Gazzotti V, Olivieri M, Andrenelli E, Bonaiuti D, Calabro RS, Carmignano SM, Cassio A, Fundaro C, Companini I, Mazzoli D, Cerulli S, Chisari C, Colombo V, Dalise S, Mazzoleni D, Melegari C, Merlo A, Boldrini P, Mazzoleni S, Posteraro F, Mazzucchelli M, Benanti P, Castelli E, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzon S, Molteni F, Morone G, Petrarca M, Picelli A, Senatore M, Turchetti G, Bizzarrini E. Gait robot-assisted rehabilitation in persons with spinal cord injury: A scoping review. NeuroRehabilitation 2022; 51:609-647. [PMID: 36502343 DOI: 10.3233/nre-220061] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 12/13/2022]
Abstract
BACKGROUND Many robots are available for gait rehabilitation (BWSTRT and ORET) and their application in persons with SCI allowed an improvement of walking function. OBJECTIVE The aim of the study is to compare the effects of different robotic exoskeletons gait training in persons with different SCI level and severity. METHODS Sixty-two studies were included in this systematic review; the study quality was assessed according to GRADE and PEDro's scale. RESULTS Quality assessment of included studies (n = 62) demonstrated a prevalence of evidence level 2; the quality of the studies was higher for BWSTRT (excellent and good) than for ORET (fair and good). Almost all persons recruited for BWSTRT had an incomplete SCI; both complete and incomplete SCI were recruited for ORET. The SCI lesion level in the persons recruited for BWSTRT are from cervical to sacral; mainly from thoracic to sacral for ORET; a high representation of AIS D lesion resulted both for BWSTRT (30%) and for ORET (45%). The walking performance, tested with 10MWT, 6MWT, TUG and WISCI, improved after exoskeleton training in persons with incomplete SCI lesions, when at least 20 sessions were applied. Persons with complete SCI lesions improved the dexterity in walking with exoskeleton, but did not recover independent walking function; symptoms such as spasticity, pain and cardiovascular endurance improved. CONCLUSION Different exoskeletons are available for walking rehabilitation in persons with SCI. The choice about the kind of robotic gait training should be addressed on the basis of the lesion severity and the possible comorbidities.
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Affiliation(s)
| | - Valeria Gazzotti
- Centro Protesi Vigorso di Budrio, Istituto Nazionale Assicurazione Infortuni sul Lavoro (INAIL), Bologna, Italy
| | | | - Elisa Andrenelli
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | | | | | - Simona Maria Carmignano
- Rehabilitation Therapeutic Center (CTR), Potenza, Italy.,University of Salerno, Salerno, Italy
| | - Anna Cassio
- Spinal Cord Unit and Intensive Rehabilitation Medicine, Ospedale di Fiorenzuola d'Arda, AUSL Piacenza, Piacenza, Italy
| | - Cira Fundaro
- Neurophysiopathology Unit, Istituti Clinici Scientifici Maugeri, IRCCS Montescano, Pavia, Italy
| | - Isabella Companini
- Department of Neuromotor and Rehabilitation, LAM-Motion Analysis Laboratory, San Sebastiano Hospital, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - David Mazzoli
- Gait and Motion Analysis Laboratory, Sol et Salus Ospedale Privato Accreditato, Rimini, Italy
| | - Simona Cerulli
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Carmelo Chisari
- Department of Translational Research and New Technologies in Medicine and Surgery, Neurorehabiltation Section, University of Pisa, Pisa, Italy
| | | | - Stefania Dalise
- Department of Translational Research and New Technologies in Medicine and Surgery, Neurorehabiltation Section, University of Pisa, Pisa, Italy
| | - Daniele Mazzoleni
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | | | - Andrea Merlo
- Gait and Motion Analysis Laboratory, Sol et Salus Ospedale Privato Accreditato, Rimini, Italy
| | - Paolo Boldrini
- Italian Society of Physical Medicine and Rehabilitation (SIMFER), Rome, Italy
| | - Stefano Mazzoleni
- Department of Electrical and Information Engineering, Politecnico di Bari, Bari, Italy
| | - Federico Posteraro
- Department of Rehabilitation, Versilia Hospital - AUSL12, Viareggio, 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 Mazzon
- Rehabilitation Unit, ULSS (Local Health Authority) Euganea, Camposampiero Hospital, 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
| | - Michele Senatore
- Associazione Italiana dei Terapisti Occupazionali (AITO), Rome, Italy
| | | | - Emiliana Bizzarrini
- Department of Rehabilitation Medicine, Spinal Cord Unit, Gervasutta Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), Udine, Italy
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8
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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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9
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Mazzucchelli M, Mazzoleni D, Campanini I, Merlo A, Mazzoli D, Melegari C, Colombo V, Cerulli S, Piscitelli D, Perin C, Andrenelli E, Bizzarini E, Calabro RS, Carmignano SM, Cassio A, Chisari C, Dalise S, Fundaro C, Gazzotti V, Stampacchia G, Boldrini P, Mazzoleni S, Posteraro F, Benanti P, Castelli E, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzon S, Molteni F, Morone G, Petrarca M, Picelli A, Senatore M, Turchetti G, Bonaiuti D. Evidence-based improvement of gait in post-stroke patients following robot-assisted training: A systematic review. NeuroRehabilitation 2022; 51:595-608. [PMID: 36502342 DOI: 10.3233/nre-220024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/12/2022]
Abstract
BACKGROUND The recovery of walking after stroke is a priority goal for recovering autonomy. In the last years robotic systems employed for Robotic Assisted Gait Training (RAGT) were developed. However, literature and clinical practice did not offer standardized RAGT protocol or pattern of evaluation scales. OBJECTIVE This systematic review aimed to summarize the available evidence on the use of RAGT in post-stroke, following the CICERONE Consensus indications. METHODS The literature search was conducted on PubMed, Cochrane Library and PEDro, including studies with the following criteria: 1) adult post-stroke survivors with gait disability in acute/subacute/chronic phase; 2) RAGT as intervention; 3) any comparators; 4) outcome regarding impairment, activity, and participation; 5) both primary studies and reviews. RESULTS Sixty-one articles were selected. Data about characteristics of patients, level of disability, robotic devices used, RAGT protocols, outcome measures, and level of evidence were extracted. CONCLUSION It is possible to identify robotic devices that are more suitable for specific phase disease and level of disability, but we identified significant variability in dose and protocols. RAGT as an add-on treatment seemed to be prevalent. Further studies are needed to investigate the outcomes achieved as a function of RAGT doses delivered.
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Affiliation(s)
| | - Daniele Mazzoleni
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Isabella Campanini
- Department of Neuromotor and Rehabilitation, LAM-Motion Analysis Laboratory, San Sebastiano Hospital, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Merlo
- Department of Neuromotor and Rehabilitation, LAM-Motion Analysis Laboratory, San Sebastiano Hospital, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Gait and Motion Analysis Laboratory, Sol et Salus Ospedale Privato Accreditato, Rimini, Italy
| | - Davide Mazzoli
- Gait and Motion Analysis Laboratory, Sol et Salus Ospedale Privato Accreditato, Rimini, Italy
| | | | | | - Simona Cerulli
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Daniele Piscitelli
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.,School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Cecilia Perin
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.,San Donato Group, Istituti Clinici Zucchi, Monza, Italy
| | - Elisa Andrenelli
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Emiliana Bizzarini
- Department of Rehabilitation Medicine, Spinal Cord Unit, Gervasutta Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), Udine, Italy
| | | | | | - Anna Cassio
- Spinal Cord Unit and Intensive Rehabilitation Medicine, Ospedale di Fiorenzuola d'Arda, AUSL Piacenza, Piacenza, Italy
| | - Carmelo Chisari
- Department of Translational Research and New Technologies in Medicine and Surgery, Neurorehabiltation Section, University of Pisa, Pisa, Italy
| | - Stefania Dalise
- Department of Translational Research and New Technologies in Medicine and Surgery, Neurorehabiltation Section, University of Pisa, Pisa, Italy
| | - Cira Fundaro
- Neurophysiopathology Unit, Istituti Clinici Scientifici Maugeri, IRCCS Montescano, Pavia, Italy
| | - Valeria Gazzotti
- Centro Protesi Vigorso di Budrio, Istituto Nazionale Assicurazione Infortuni sul Lavoro (INAIL), Bologna, Italy
| | | | - Paolo Boldrini
- Italian Society of Physical Medicine and Rehabilitation (SIMFER), Rome, Italy
| | - Stefano Mazzoleni
- Department of Electrical and Information Engineering, Politecnico di Bari, Bari, Italy
| | - Federico Posteraro
- Department of Rehabilitation, Versilia Hospital - AUSL12, Viareggio, 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 Mazzon
- Rehabilitation Unit, ULSS (Local Health Authority) Euganea, Camposampiero Hospital, 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
| | - Michele Senatore
- Associazione Italiana dei Terapisti Occupazionali (AITO), Rome, Italy
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10
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Castelli E, Beretta E, De Tanti A, Arduini F, Biffi E, Colazza A, Di Pede C, Guzzetta A, Lucarini L, Maghini I, Mandalà M, Nespoli M, Pavarelli C, Policastro F, Polverelli M, Rossi A, Sgandurra G, Boldrini P, Bonaiuti D, Mazzoleni S, Posteraro F, Benanti P, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzon S, Molteni F, Morone G, Petrarca M, Picelli A, Senatore M, Turchetti G, Saviola D, Turchetti G. Robot-assisted rehabilitation for children with neurological disabilities: Results of the Italian consensus conference CICERONE. NeuroRehabilitation 2022; 51:665-679. [PMID: 36530098 DOI: 10.3233/nre-220036] [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 The use of robotic technologies in pediatric rehabilitation has seen a large increase, but with a lack of a comprehensive framework about their effectiveness. OBJECTIVE An Italian Consensus Conference has been promoted to develop recommendations on these technologies: definitions and classification criteria of devices, indications and limits of their use in neurological diseases, theoretical models, ethical and legal implications. In this paper, we present the results for the pediatric age. METHODS A systematic search on Cochrane Library, PEDro and PubMed was performed. Papers published up to March 1st, 2020, in English, were included and analyzed using the methodology of the Centre for Evidence-Based Medicine in Oxford, AMSTAR2 and PEDro scales for systematic reviews and RCT, respectively. RESULTS Some positives aspects emerged in the area of gait: an increased number of children reaching the stance, an improvement in walking distance, speed and endurance. Critical aspects include the heterogeneity of the studied cases, measurements and training protocols. CONCLUSION Many studies demonstrate the benefits of robotic training in developmental age. However, it is necessary to increase the number of trials to achieve greater homogeneity between protocols and to confirm the effectiveness of pediatric robotic rehabilitation.
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Affiliation(s)
| | - Elena Beretta
- IRCCS Eugenio Medea, La Nostra Famiglia, Ponte Lambro, Italy
| | - Antonio De Tanti
- KOS-CARE, Santo Stefano Rehabilitation, Cardinal Ferrari Center, Parma, Italy
| | | | - Emilia Biffi
- IRCCS Eugenio Medea, La Nostra Famiglia, Ponte Lambro, Italy
| | | | - Chiara Di Pede
- IRCCS Eugenio Medea, La Nostra Famiglia, Ponte Lambro, Italy
| | - Andrea Guzzetta
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italy.,Dipartimento di Neuroscienze dello Sviluppo, IRCCS Stella Maris, Pisa, Italy
| | | | - Irene Maghini
- Department of Women's and Children's Health, Pediatric Pain and Palliative Care Service, University of Padua, Padua, Italy
| | - Martina Mandalà
- IRCCS Santa Maria Nascente - Fondazione Don C. Gnocchi, Milan, Italy
| | | | - Claudia Pavarelli
- Servizio di Neuropsichiatria Infanzia e dell'Adolescenza (NPIA), Vignola, Italy
| | - Francesca Policastro
- Dipartimento Scienze Mediche e Chirurgiche, Università degli Studi di Trieste, Trieste, Italy
| | - Marco Polverelli
- Dipartimento Riabilitazione, Azienda Ospedaliera Nazionale SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Andrea Rossi
- ASST Spedali Civili di Brescia, Ospedale dei Bambini, Brescia, Italy
| | - Giuseppina Sgandurra
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italy.,Dipartimento di Neuroscienze dello Sviluppo, IRCCS Stella Maris, Pisa, Italy
| | - Paolo Boldrini
- Italian Society of Physical Medicine and Rehabilitation, (SIMFER), Rome, Italy
| | - Donatella Bonaiuti
- Italian Society of Physical Medicine and Rehabilitation, (SIMFER), Rome, Italy
| | - Stefano Mazzoleni
- Department of Electrical and Information Engineering, Politecnico di Bari, Bari, Italy
| | - Federico Posteraro
- Department of Rehabilitation, Versilia Hospital - AUSL12, Viareggio, 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 Mazzon
- Rehabilitation Unit, ULSS (Local Health Autority) Euganea, Camposampietro Hospital, 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
| | - Michele Senatore
- Associazione Italiana dei Terapisti Occupazionali (AITO), Rome, Italy
| | | | - Donatella Saviola
- KOS-CARE, Santo Stefano Rehabilitation, Cardinal Ferrari Center, Parma, Italy
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11
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Favetta M, Romano A, Summa S, Colazza A, Minosse S, Vasco G, Castelli E, Petrarca M. Influence of sagittal pelvic attitude on gait pattern in normally developed people and interactions with neurological pathologies: A pilot study. Front Hum Neurosci 2022; 16:797282. [PMID: 35992946 PMCID: PMC9386486 DOI: 10.3389/fnhum.2022.797282] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 07/15/2022] [Indexed: 11/21/2022] Open
Abstract
Background Gait Analysis of healthy people, imitating pathological conditions while walking, has increased our understanding of biomechanical factors. The influence of the pelvis as a biomechanical constraint during gait is not specifically studied. How could mimicking a pelvic attitude influence the dynamic mechanical interaction of the body segments? We proposed an investigation of the pelvic attitude role on the gait pattern of typically developed people when they mimicked pelvic anteversion and posteroversion. Materials and methods Seventeen healthy volunteers were enrolled in this study (mean age 24.4 ± 5.5). They simulated a pelvic anteversion and posteroversion during walking, exaggerating these postures as much as possible. 3D gait analysis was conducted using an optoelectronic system with eight cameras (Vicon MX, Oxford, United Kingdom) and two force plates (AMTI, Or-6, Watertown, MA, United States). The kinematic, kinetic, and spatio-temporal parameters were compared between the three walking conditions (anteversion, posteroversion, and normal gait). Results In Pelvic Anteversion gait (PA) we found: increased hip flexion (p < 0.0001), increased knee flexion during stance (p = 0.02), and reduction of ankle flexion-extension Range of Motion (RoM) compared with Pelvic Normal gait (PN). In Pelvic Posteroversion gait (PP) compared with PN, we found: decreased hip flexion-extension RoM (p < 0.01) with a tendency to hip extension, decreased knee maximum extension in stance (p = 0.033), and increased ankle maximum dorsiflexion in stance (p = 0.002). Conclusion The configuration of PA contains gait similarities and differences when compared with pathologic gait where there is an anteversion as seen in children with Cerebral Palsy (CP) or Duchenne Muscular Dystrophy (DMD). Similarly, attitudes of PP have been described in patients with Charcot-Marie-Tooth Syndrome (CMT) or patients who have undergone Pelvic Osteotomy (PO). Understanding the dynamic biomechanical constraints is essential to the assessment of pathological behavior. The central nervous system adapts motor behavior in interaction with body constraints and available resources.
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Affiliation(s)
- Martina Favetta
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Alberto Romano
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Susanna Summa
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
- *Correspondence: Susanna Summa,
| | - Alessandra Colazza
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Silvia Minosse
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Gessica Vasco
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Enrico Castelli
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Maurizio Petrarca
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
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12
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Tofani M, Santecchia L, Conte A, Berardi A, Galeoto G, Sogos C, Petrarca M, Panuccio F, Castelli E. Effects of Mirror Neurons-Based Rehabilitation Techniques in Hand Injuries: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2022; 19:5526. [PMID: 35564920 PMCID: PMC9104298 DOI: 10.3390/ijerph19095526] [Citation(s) in RCA: 2] [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: 03/31/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 02/04/2023]
Abstract
Background: Hand trauma requires specific rehabilitation protocol depending on the different structures involved. According to type of surgical intervention, and for monitoring pain and edema, post-operative rehabilitation of a hand that has experienced trauma involves different timings for immobilization. Several protocols have been used to reduce immobilization time, and various techniques and methods are adopted, depending on the structures involved. Objective: To measure the effects of mirror neurons-based rehabilitation techniques in hand injuries throughout a systematic review and meta-analysis. Methods: The protocol was accepted in PROSPERO database. A literature search was conducted in Cinahl, Scopus, Medline, PEDro, OTseeker. Two authors independently identified eligible studies, based on predefined inclusion criteria, and extracted the data. RCT quality was assessed using the JADAD scale. Results: Seventy-nine suitable studies were screened, and only eleven were included for qualitative synthesis, while four studies were selected for quantitative analysis. Four studies were case reports/series, and seven were RCTs. Nine investigate the effect of Mirror Therapy and two the effect of Motor Imagery. Quantitative analyses revealed Mirror Therapy as effective for hand function recovery (mean difference = −14.80 95% Confidence Interval (CI) = −17.22, −12.38) (p < 0.00001) in the short term, as well as in long follow-up groups (mean difference = −13.11 95% Confidence Interval (CI) = −17.53, −8.69) (p < 0.00001). Clinical, but not statistical, efficacy was found for manual dexterity (p = 0.15), while no benefit was reported for range of motion. Conclusions: Mirror neurons-based rehabilitation techniques, combined with conventional occupational and physical therapy, can be a useful approach in hand trauma. Mirror therapy seems to be effective for hand function recovery, but, for motor imagery and action observation, there is not sufficient evidence to recommend its use. Further research on the efficacy of the mirror neurons-based technique in hand injury is recommended.
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Affiliation(s)
- Marco Tofani
- Professional Development, Continuous Education and Research Service, Bambino Gesù Children’s Hospital, 00165 Rome, Italy
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (A.B.); (G.G.); (C.S.)
| | - Luigino Santecchia
- Orthopedic Unit, Department of Surgery, Bambino Gesù Children’s Hospital, 00100 Rome, Italy;
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (A.B.); (G.G.); (C.S.)
- Neuromed IRCCS, 86077 Pozzili, Italy
| | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (A.B.); (G.G.); (C.S.)
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (A.B.); (G.G.); (C.S.)
- Neuromed IRCCS, 86077 Pozzili, Italy
| | - Carla Sogos
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (A.B.); (G.G.); (C.S.)
| | - Maurizio Petrarca
- Department of Intensive Neurorehabilitation and Robotics, Bambino Gesù Children’s Hospital, 00100 Rome, Italy; (M.P.); (E.C.)
| | | | - Enrico Castelli
- Department of Intensive Neurorehabilitation and Robotics, Bambino Gesù Children’s Hospital, 00100 Rome, Italy; (M.P.); (E.C.)
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13
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Minosse S, Favetta M, Romano A, Pisano A, Summa S, Schirinzi T, Vasco G, Castelli E, Petrarca M. Comparison of the Gait Biomechanical Constraints in Three Different Type of Neuromotor Damages. Front Hum Neurosci 2022; 16:822205. [PMID: 35422690 PMCID: PMC9001917 DOI: 10.3389/fnhum.2022.822205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 02/28/2022] [Indexed: 11/14/2022] Open
Abstract
Background and Objective Absolute angle represents the inclination of a body segment relative to a fixed reference in space. This work compares the absolute and relative angles for exploring biomechanical gait constraints. Methods Gait patterns of different neuromotor conditions were analyzed using 3D gait analysis: normal gait (healthy, H), Cerebral Palsy (CP), Charcot Marie Tooth (CMT) and Duchenne Muscular Dystrophy (DMD), representing central and peripheral nervous system and muscular disorders, respectively. Forty-two children underwent gait analysis: 10 children affected by CP, 10 children by CMT, 10 children by DMD and 12 healthy children. The kinematic and kinetic parameters were collected to describe the biomechanical pattern of participants’ lower limbs. The absolute angles of thigh, leg and foot were calculated using the trigonometric relationship of the tangent. For each absolute series, the mean, range, maximum, minimum and initial contact were calculated. Kinematic and kinetic gait data were studied, and the results were compared with the literature. Results Statistical analysis of the absolute angles showed how, at the local level, the single segments (thigh, leg and foot) behave differently depending on the pathology. However, if the lower limb is studied globally (sum of the kinematics of the three segments: thigh, leg and foot), a biomechanical constraint emerges. Conclusion Each segment compensates separately for the disease deficit so as to maintain a global biomechanical invariance. Using a model of inter-joint co-variation could improve the interpretation of the clinical gait pattern.
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Affiliation(s)
- Silvia Minosse
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Martina Favetta
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Alberto Romano
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Alessandra Pisano
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Susanna Summa
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
- *Correspondence: Susanna Summa,
| | - Tommaso Schirinzi
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Gessica Vasco
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Enrico Castelli
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Maurizio Petrarca
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
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14
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Romano A, Favetta M, Summa S, Schirinzi T, Bertini ES, Castelli E, Vasco G, Petrarca M. Upper Body Physical Rehabilitation for Children with Ataxia through IMU-Based Exergame. J Clin Med 2022; 11:jcm11041065. [PMID: 35207341 PMCID: PMC8876617 DOI: 10.3390/jcm11041065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 01/18/2022] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Children with ataxia experience balance and movement coordination difficulties and needs intensive physical intervention to maintain functional abilities and counteract the disorder. Exergaming represents a valuable strategy to provide engaging physical intervention to children with ataxia, sustaining their motivation to perform the intervention. This paper aims to describe the effect of a home-conducted exergame-based exercise training for upper body movements control of children with ataxia on their ataxic symptoms, walking ability, and hand dexterity. Methods: Eighteen children with ataxia were randomly divided into intervention and control groups. Participants in the intervention group were asked to follow a 12-week motor activity program at home using the Niurion® exergame. Blind assessments of participants’ ataxic symptoms, dominant and non-dominant hand dexterity, and walking ability were conducted. Results: On average, the participants performed the intervention for 61.5% of the expected time. At the end of the training, participants in the intervention group showed improved hand dexterity that worsened in the control group. Conclusion: The presented exergame enhanced the participants’ hand dexterity. However, there is a need for exergames capable of maintaining a high level of players’ motivation in playing. It is advisable to plan a mixed intervention to take care of the multiple aspects of the disorder.
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Affiliation(s)
- Alberto Romano
- Movement Analysis and Robotics Laboratory (MAR Lab), Intensive Neurorehabilitation and Robotics Department, “Bambino Gesù” Children’s Hospital, IRCCS, 00050 Rome, Italy; (A.R.); (M.F.); (E.C.); (G.V.); (M.P.)
| | - Martina Favetta
- Movement Analysis and Robotics Laboratory (MAR Lab), Intensive Neurorehabilitation and Robotics Department, “Bambino Gesù” Children’s Hospital, IRCCS, 00050 Rome, Italy; (A.R.); (M.F.); (E.C.); (G.V.); (M.P.)
| | - Susanna Summa
- Movement Analysis and Robotics Laboratory (MAR Lab), Intensive Neurorehabilitation and Robotics Department, “Bambino Gesù” Children’s Hospital, IRCCS, 00050 Rome, Italy; (A.R.); (M.F.); (E.C.); (G.V.); (M.P.)
- Correspondence:
| | - Tommaso Schirinzi
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Enrico Silvio Bertini
- Unit of Neuromuscolar and Neurodegenerative Diseases, Department of Neurosciences, “Bambino Gesù” Children’s Hospital, IRCCS, 00146 Rome, Italy;
| | - Enrico Castelli
- Movement Analysis and Robotics Laboratory (MAR Lab), Intensive Neurorehabilitation and Robotics Department, “Bambino Gesù” Children’s Hospital, IRCCS, 00050 Rome, Italy; (A.R.); (M.F.); (E.C.); (G.V.); (M.P.)
| | - Gessica Vasco
- Movement Analysis and Robotics Laboratory (MAR Lab), Intensive Neurorehabilitation and Robotics Department, “Bambino Gesù” Children’s Hospital, IRCCS, 00050 Rome, Italy; (A.R.); (M.F.); (E.C.); (G.V.); (M.P.)
| | - Maurizio Petrarca
- Movement Analysis and Robotics Laboratory (MAR Lab), Intensive Neurorehabilitation and Robotics Department, “Bambino Gesù” Children’s Hospital, IRCCS, 00050 Rome, Italy; (A.R.); (M.F.); (E.C.); (G.V.); (M.P.)
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15
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Turolla A, Kiper P, Mazzarotto D, Cecchi F, Colucci M, D'Avenio G, Facciorusso S, Gatti R, Giansanti D, Iosa M, Bonaiuti D, Boldrini P, Mazzoleni S, Posteraro F, Benanti P, Castelli E, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzon S, Morone G, Petrarca M, Picelli A, Senatore M, Turchetti G, Molteni F. Reference theories and future perspectives on robot-assisted rehabilitation in people with neurological conditions: A scoping review and recommendations from the Italian Consensus Conference on Robotics in Neurorehabilitation (CICERONE). NeuroRehabilitation 2022; 51:681-691. [PMID: 36530100 DOI: 10.3233/nre-220160] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Robot-based treatments are developing in neurorehabilitation settings. Recently, the Italian National Health Systems recognized robot-based rehabilitation as a refundable service. Thus, the Italian neurorehabilitation community promoted a national consensus on this topic. OBJECTIVE To conceptualize undisclosed perspectives for research and applications of robotics for neurorehabilitation, based on a qualitative synthesis of reference theoretical models. METHODS A scoping review was carried out based on a specific question from the consensus Jury. A foreground search strategy was developed on theoretical models (context) of robot-based rehabilitation (exposure), in neurological patients (population). PubMed and EMBASE® databases were searched and studies on theoretical models of motor control, neurobiology of recovery, human-robot interaction and economic sustainability were included, while experimental studies not aimed to investigate theoretical frameworks, or considering prosthetics, were excluded. RESULTS Overall, 3699 records were screened and finally 9 papers included according to inclusion and exclusion criteria. According to the population investigated, structured information on theoretical models and indications for future research was summarized in a synoptic table. CONCLUSION The main indication from the Italian consensus on robotics in neurorehabilitation is the priority to design research studies aimed to investigate the role of robotic and electromechanical devices in promoting neuroplasticity.
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Affiliation(s)
- Andrea Turolla
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum Università di Bologna, Bologna, Italy
- Division of Occupational Medicine, IRCCS Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | | | - Deborah Mazzarotto
- Medicina Fisica e Riabilitazione, ULSS 4 Veneto Orientale, San Donà di Piave, Italy
| | - Francesca Cecchi
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, Florence, Italy
- IRCSS Fondazione Don Carlo Gnocchi, Firenze, Italy
| | | | - Giuseppe D'Avenio
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, Rome, Italy
| | | | - Roberto Gatti
- Humanitas University, Department of Biomedical Sciences, via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy
- Humanitas Clinical and Research Center - IRCCS, Milan, Italy
| | - Daniele Giansanti
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, Rome, Italy
| | - Marco Iosa
- Department of Psychology, Sapienza Università di Roma, Rome, Italy
- Smart Lab, IRCSS Santa Lucia Foundation, Rome, Italy
| | | | - Paolo Boldrini
- Italian Society of Physical and Rehabilitation Medicine (SIMFER), Rome, Italy
| | - Stefano Mazzoleni
- Department of Electrical and Information Engineering, Politecnico di Bari, Bari, Italy
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Federico Posteraro
- Department of Rehabilitation, AUSL Toscana Nord Ovest - Camaiore, Versilia Hospital, Lucca, Italy
| | | | - Enrico Castelli
- Department of Neurorehabilitation and Robotics, 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 Mazzon
- Rehabilitation Unit, ULSS (Local Health Authority) Euganea, Camposampiero Hospital, Padua, Italy
| | - Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- San Raffaele Institute of Sulmona, Sulmona, 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
| | - Michele Senatore
- Associazione Italiana dei Terapisti Occupazionali (AITO), Rome, Italy
| | | | - Franco Molteni
- Villa Beretta Rehabilitation Center, Valduce Hospital, Lecco, Italy
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16
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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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Calabrò RS, Cassio A, Mazzoli D, Andrenelli E, Bizzarini E, Campanini I, Carmignano SM, Cerulli S, Chisari C, Colombo V, Dalise S, Fundarò C, Gazzotti V, Mazzoleni D, Mazzucchelli M, Melegari C, Merlo A, Stampacchia G, Boldrini P, Mazzoleni S, Posteraro F, Benanti P, Castelli E, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzon S, Molteni F, Petrarca M, Picelli A, Senatore M, Turchetti G, Morone G, Bonaiuti D. What does evidence tell us about the use of gait robotic devices in patients with multiple sclerosis? A comprehensive systematic review on functional outcomes and clinical recommendations. Eur J Phys Rehabil Med 2021; 57:841-849. [PMID: 34547886 DOI: 10.23736/s1973-9087.21.06915-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION There is growing evidence on the efficacy of gait robotic rehabilitation in patients with multiple sclerosis (MS), but most of the studies have focused on gait parameters. Moreover, clear indications on the clinical use of robotics still lack. As part of the CICERONE Italian Consensus on Robotic Rehabilitation, the aim of this systematic review was to investigate the existing evidence concerning the role of lower limb robotic rehabilitation in improving functional recovery in patients with MS. EVIDENCE ACQUISITION We searched for and systematically reviewed evidence-based studies on gait robotic rehabilitation in MS, between January 1st, 2010 and December 31st, 2020, in the following databases: Cochrane Library, PEDro, PubMed and Google Scholar. The study quality was assessed by the 16-item assessment of multiple systematic reviews 2 (AMSTAR 2) and the 10-item PEDro scale for the other research studies. EVIDENCE SYNTHESIS After an accurate screening, only 17 papers were included in the review, and most of them (13 RCT) had a level II evidence. Most of the studies used the Lokomat as a grounded robotic device, two investigated the efficacy of end-effectors and two powered exoskeletons. Generally speaking, robotic treatment has beneficial effects on gait speed, endurance and balance with comparable outcomes to those of conventional treatments. However, in more severe patients (EDSS >6), robotics leads to better functional outcomes. Notably, after gait training with robotics (especially when coupled to virtual reality) MS patients also reach better non-motor outcomes, including spasticity, fatigue, pain, psychological well-being and quality of life. Unfortunately, no clinical indications emerge on the treatment protocols. CONCLUSIONS The present comprehensive systematic review highlights the potential beneficial role on functional outcomes of the lower limb robotic devices in people with MS. Future studies are warranted to evaluate the role of robotics not only for walking and balance outcomes, but also for other gait-training-related benefits, to identify appropriate outcome measures related to a specific subgroup of MS subjects' disease severity.
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Affiliation(s)
| | - Anna Cassio
- Spinal Cord and Intensive Rehabilitation Medicine Unit, AUSL Piacenza, Castel San Giovanni, Piacenza, Italy
| | - Davide Mazzoli
- OPA Sol et Salus Gait and Motion Analysis Laboratory, Torre Pedrera, Rimini, Italy
| | - Elisa Andrenelli
- Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - Emiliana Bizzarini
- Spinal Cord Unit, Department of Rehabilitation Medicine, Gervasutta Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Isabella Campanini
- LAM-Motion Analysis Laboratory, Department of Neuromotor and Rehabilitation Sciences, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | | | - Simona Cerulli
- University Polyclinic Foundation A. Gemelli IRCCS, Rome, Italy
| | - Carmelo Chisari
- Section of Neurorehabilitation, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | - Stefania Dalise
- Section of Neurorehabilitation, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Cira Fundarò
- Unit of Neurophysiopathology, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Pavia, Italy
| | - Valeria Gazzotti
- Vigorso Prostheses Center, National Institute for Insurance against Accidents at Work (INAIL), Budrio, Bologna, Italy
| | - Daniele Mazzoleni
- School of Physical and Rehabilitation Medicine, Bicocca University of Milan, Milan, Italy
| | - Miryam Mazzucchelli
- School of Physical and Rehabilitation Medicine, Bicocca University of Milan, Milan, Italy
| | | | - Andrea Merlo
- OPA Sol et Salus Gait and Motion Analysis Laboratory, Torre Pedrera, Rimini, Italy.,LAM-Motion Analysis Laboratory, Department of Neuromotor and Rehabilitation Sciences, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | | | - Paolo Boldrini
- Italian Society of Physical and Rehabilitation Medicine (SIMFER), Rome, Italy
| | - Stefano Mazzoleni
- Department of Electrical and Information Engineering, Polytechnical University of Bari, Bari, Italy
| | | | | | - Enrico Castelli
- Department of Pediatric Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, National Institute for Insurance against Accidents at Work (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 Mazzon
- Rehabilitation Unit, ULSS Euganea, Camposampiero Hospital, Padua, Italy
| | - Franco Molteni
- Villa Beretta Rehabilitation Center, Valduce Hospital, Costa Masnaga, Lecco, 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
- Italian Association of Occupational Therapists (AITO), Rome, Italy
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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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19
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Gandolfi M, Valè N, Posteraro F, Morone G, Dell'orco A, Botticelli A, Dimitrova E, Gervasoni E, Goffredo M, Zenzeri J, Antonini A, Daniele C, Benanti P, Boldrini P, Bonaiuti D, Castelli E, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzon S, Molteni F, Petrarca M, Picelli A, Senatore M, Turchetti G, Giansanti D, Mazzoleni S. State of the art and challenges for the classification of studies on electromechanical and robotic devices in neurorehabilitation: a scoping review. Eur J Phys Rehabil Med 2021; 57:831-840. [PMID: 34042413 DOI: 10.23736/s1973-9087.21.06922-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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 The rapid development of electromechanical and robotic devices has profoundly influenced neurorehabilitation. Growth in the scientific and technological aspects thereof is crucial for increasing the number of newly developed devices, and clinicians have welcomed such growth with enthusiasm. Nevertheless, improving the standard for the reporting clinical, technical, and normative aspects of such electromechanical and robotic devices remains an unmet need in neurorehabilitation. Accordingly, this study aimed to analyse the existing literature on electromechanical and robotic devices used in neurorehabilitation, considering the current clinical, technical, and regulatory classification systems. EVIDENCE ACQUISITION Within the CICERONE Consensus Conference framework, studies on electromechanical and robotic devices used for upper- and lower-limb rehabilitation in persons with neurological disabilities in adulthood and childhood were reviewed. We have conducted a literature search using the following databases: MEDLINE, Cochrane Library, PeDro, Institute of Electrical and Electronics Engineers, Science Direct, and Google Scholar. Clinical, technical, and regulatory classification systems were applied to collect information on the electromechanical and robotic devices. The study designs and populations were investigated. EVIDENCE SYNTHESIS Overall, 316 studies were included in the analysis. More than half (52%) of the studies were randomised controlled trials (RCTs). The population investigated the most suffered from strokes, followed by spinal cord injuries, multiple sclerosis, cerebral palsy, and traumatic brain injuries. In total, 100 devices were described; of these, 19% were certified with the CE mark. Overall, the main type of device was an exoskeleton. However, end-effector devices were primarily used for the upper limbs, whereas exoskeletons were used for the lower limbs (for both children and adults). CONCLUSIONS The current literature on robotic neurorehabilitation lacks detailed information regarding the technical characteristics of the devices used. This affects the understanding of the possible mechanisms underlying recovery. Unfortunately, many electromechanical and robotic devices are not provided with CE marks, strongly hindering the research on the clinical outcomes of rehabilitation treatments based on these devices. A more significant effort is needed to improve the description of the robotic devices used in neurorehabilitation in terms of the technical and functional details, along with high-quality RCT studies.
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Affiliation(s)
- Marialuisa Gandolfi
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Neurorehabilitation Unit, University Hospital of Verona, Italy -
| | - Nicola Valè
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Posteraro
- Rehabilitation Department Versilia Hospital, ASL Toscana Nord-Ovest, Italy
| | | | - Antonella Dell'orco
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Neurorehabilitation Unit, University Hospital of Verona, Italy
| | - Anita Botticelli
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Neurorehabilitation Unit, University Hospital of Verona, Italy
| | - Eleonora Dimitrova
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Michela Goffredo
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Pisana, Rome, Italy
| | - Jacopo Zenzeri
- Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
| | | | | | | | - Paolo Boldrini
- Italian Society of Physical Medicine and Rehabilitation (SIMFER), Italy
| | | | - Enrico Castelli
- Pediatric Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Rome, Italy
| | - Vincenzo Falabella
- President Italian Federation of Persons with Spinal Cord Injuries (Flip Onlus), Rome, Italy
| | | | - Francesca Gimigliano
- Department of Mental and 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 Mazzon
- ULSS 6 (Unique Sanitary Local Company) Euganea Padova - Distretto IV Alta Padovana, Padova, Italy
| | | | - Maurizio Petrarca
- The Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Rome, Italy
| | - Alessandro Picelli
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Neurorehabilitation Unit, University Hospital of Verona, Italy
| | | | | | - Daniele Giansanti
- 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, Italy
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20
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Calabrò RS, Sorrentino G, Cassio A, Mazzoli D, Andrenelli E, Bizzarini E, Campanini I, Carmignano SM, Cerulli S, Chisari C, Colombo V, Dalise S, Fundarò C, Gazzotti V, Mazzoleni D, Mazzucchelli M, Melegari C, Merlo A, Stampacchia G, Boldrini P, Mazzoleni S, Posteraro F, Benanti P, Castelli E, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzon S, Molteni F, Morone G, Petrarca M, Picelli A, Senatore M, Turchetti G, Bonaiuti D. Robotic-assisted gait rehabilitation following stroke: a systematic review of current guidelines and practical clinical recommendations. Eur J Phys Rehabil Med 2021; 57:460-471. [PMID: 33947828 DOI: 10.23736/s1973-9087.21.06887-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Stroke is the third leading cause of adult disability worldwide, and lower extremity motor impairment is one of the major determinants of long-term disability. Although robotic therapy is becoming more and more utilized in research protocols for lower limb stroke rehabilitation, the gap between research evidence and its use in clinical practice is still significant. The aim of this study was to determine the scope, quality, and consistency of guidelines for robotic lower limb rehabilitation after stroke, in order to provide clinical recommendations. EVIDENCE ACQUISITION We systematically reviewed stroke rehabilitation guideline recommendations between January 1, 2010 and October 31, 2020. We explored electronic databases (N.=4), guideline repositories and professional rehabilitation networks (N.=12). Two independent reviewers used the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, and brief syntheses were used to evaluate and compare the different recommendations, considering only the most recent version. EVIDENCE SYNTHESIS From the 1219 papers screened, ten eligible guidelines were identified from seven different regions/countries. Four of the included guidelines focused on stroke management, the other six on stroke rehabilitation. Robotic rehabilitation is generally recommended to improve lower limb motor function, including gait and strength. Unfortunately, there is still no consensus about the timing, frequency, training session duration and the exact characteristics of subjects who could benefit from robotics. CONCLUSIONS Our systematic review shows that the introduction of robotic rehabilitation in standard treatment protocols seems to be the future of stroke rehabilitation. However, robot assisted gait training (RAGT) for stroke needs to be improved with new solutions and in clinical practice guidelines, especially in terms of applicability.
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Affiliation(s)
| | - Gregorio Sorrentino
- Department of Medicine and Rehabilitation, Polyclinic of Monza, Monza-Brianza, Italy
| | - Anna Cassio
- Spinal Cord Unit and Intensive Rehabilitation Medicine, AUSL Piacenza, Villanova sull'Arda and Castel San Giovanni, Piacenza, Italy
| | - Davide Mazzoli
- Gait and Motion Analysis Laboratory OPA Sol et Salus, Torre Pedrera, Rimini, Italy
| | - Elisa Andrenelli
- Department of Experimental and Clinical Medicine Università Politecnica delle Marche (UNIVPM), Ancona, Italy
| | - Emiliana Bizzarini
- Spinal Cord Unit, Department of Rehabilitation Medicine, Gervasutta Hospital, Udine, Italy.,Azienda Sanitaria Universitaria Friuli Centrale (ASU-FC), Udine, Italy
| | - Isabella Campanini
- Neuromotor and Rehabilitation Department, LAM-Motion Analysis Laboratory, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | | | - Simona Cerulli
- IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Carmelo Chisari
- Section of Neurorehabilitation, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | - Stefania Dalise
- Section of Neurorehabilitation, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Cira Fundarò
- Unit of Neurophysiopathology, ICS Maugeri, Montescano Institute, Pavia, Italy
| | - Valeria Gazzotti
- Centro Protesi Vigorso di Budrio, Istituto Nazionale Assicurazione Infortuni sul Lavoro (INAIL), Budrio, Bologna, Italy
| | - Daniele Mazzoleni
- School of Physical and Rehabilitation Medicine, University of Milano-Bicocca, Milan, Italy
| | | | | | - Andrea Merlo
- Gait and Motion Analysis Laboratory OPA Sol et Salus, Torre Pedrera, Rimini, Italy.,Neuromotor and Rehabilitation Department, LAM-Motion Analysis Laboratory, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | | | - Paolo Boldrini
- Italian Society of Physical and Rehabilitation Medicine (SIMFER), Rome, Italy
| | - Stefano Mazzoleni
- Department of Electrical and Information Engineering, Polytechnic of Bari, Bari, Italy
| | | | | | - Enrico Castelli
- 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 Mazzon
- Unit of Rehabilitation, ULSS (Local Health Authority) Euganea, Camposampiero Hospital, Padua, Italy
| | - Franco Molteni
- Villa Beretta Rehabilitation Center, Valduce Hospital, Costa Masnaga, Lecco, 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
- Associazione Italiana Terapisti Occupazionali (AITO), Rome, Italy
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21
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Picelli A, Capecci M, Filippetti M, Varalta V, Fonte C, DI Censo R, Zadra A, Chignola I, Scarpa S, Amico AP, Antenucci R, Baricich A, Benanti P, Bissolotti L, Boldrini P, Bonaiuti D, Castelli E, Cavalli L, DI Stefano G, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Jonsdodttir J, Lentino C, Massai P, Mazzoleni S, Mazzon S, Molteni F, Morelli S, Morone G, Panzeri D, Petrarca M, Posteraro F, Senatore M, Taglione E, Turchetti G, Bowman T, Nardone A. Effects of robot-assisted gait training on postural instability in Parkinson's disease: a systematic review. Eur J Phys Rehabil Med 2021; 57:472-477. [PMID: 33826278 DOI: 10.23736/s1973-9087.21.06939-2] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Postural instability is a cardinal feature of Parkinson's disease, together with rest tremor, rigidity and bradykinesia. It is a highly disabling symptom that becomes increasingly common with disease progression and represents a major source of reduced quality of life in patients with Parkinson's disease. Rehabilitation aims to enable patients with Parkinson's disease to maintain their maximum level of mobility, activity and independence. To date, a wide range of rehabilitation approaches has been employed to treat postural instability in Parkinson's disease, including robotic training. Our main aim was to conduct a systematic review of current literature about the effects of robot-assisted gait training on postural instability in patients with Parkinson's disease. EVIDENCE ACQUISITION A systematic search using the following MeSH terms "Parkinson disease," "postural balance," "robotics," "rehabilitation" AND string "robotics [mh]" OR "robot-assisted" OR "electromechanical" AND "rehabilitation [mh]" OR "training" AND "postural balance [mh]" was conducted on PubMed, Cochrane Library and Pedro electronic databases. Full text articles in English published up to December 2020 were included. Data about patient characteristics, robotic devices, treatment procedures and outcome measures were considered. Every included article got checked for quality. Level of evidence was defined for all studies. EVIDENCE SYNTHESIS Three authors independently extracted and verified data. In total, 18 articles (2 systematic reviews, 9 randomized controlled trials, 4 uncontrolled studies and 3 case series/case reports) were included. Both end-effector and exoskeleton devices were investigated as to robot-assisted gait training modalities. No clear relationship between treatment parameters and clinical conditions was observed. We found a high level of evidence about the effects of robot-assisted gait training on balance and freezing of gait in patients with Parkinson's disease. CONCLUSIONS This systematic review provides to the reader a complete overview of current literature and levels of evidence about the effects of robot-assisted gait training on postural instability issues (static and dynamic balance, freezing of gait, falls, confidence in activities of daily living and gait parameters related to balance skills) in patients with Parkinson's disease.
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Affiliation(s)
- Alessandro Picelli
- Unit of Neurorehabilitation, Department of Neuroscience, Biomedicine, and Movement Sciences, University Hospital of Verona, University of Verona, Verona, Italy -
| | | | - Mirko Filippetti
- Unit of Neurorehabilitation, Department of Neuroscience, Biomedicine, and Movement Sciences, University Hospital of Verona, University of Verona, Verona, Italy
| | - Valentina Varalta
- Unit of Neurorehabilitation, Department of Neuroscience, Biomedicine, and Movement Sciences, University Hospital of Verona, University of Verona, Verona, Italy
| | - Cristina Fonte
- Unit of Neurorehabilitation, Department of Neuroscience, Biomedicine, and Movement Sciences, University Hospital of Verona, University of Verona, Verona, Italy
| | - Rita DI Censo
- Unit of Neurorehabilitation, Department of Neuroscience, Biomedicine, and Movement Sciences, University Hospital of Verona, University of Verona, Verona, Italy
| | - Alessandro Zadra
- Unit of Neurorehabilitation, Department of Neuroscience, Biomedicine, and Movement Sciences, University Hospital of Verona, University of Verona, Verona, Italy
| | - Irene Chignola
- Unit of Neurorehabilitation, Department of Neuroscience, Biomedicine, and Movement Sciences, University Hospital of Verona, University of Verona, Verona, Italy
| | - Stefano Scarpa
- Unit of Neurorehabilitation, Department of Neuroscience, Biomedicine, and Movement Sciences, University Hospital of Verona, University of Verona, Verona, Italy
| | | | | | | | | | | | - Paolo Boldrini
- Italian Society of Physical and Rehabilitative Medicine, Rome, Italy
| | | | | | | | | | | | | | | | | | | | | | | | - Perla Massai
- Tuscany Rehabilitation Clinic, Montevarchi, Arezzo, Italy
| | - Stefano Mazzoleni
- Polytechnic University of Bari, Bari, Italy.,The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Pisa, Italy
| | | | - Franco Molteni
- Valduce Villa Beretta Hospital, Costa Masnaga, Lecco, Italy
| | | | | | | | | | | | - Michele Senatore
- Italian Association of Occupational Therapists (AITO), Rome, Italy
| | | | | | - Thomas Bowman
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.,The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Pisa, Italy
| | - Antonio Nardone
- University of Pavia, Pavia, Italy.,ICS Maugeri SPA SB (IRCCS), Pavia, Italy
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22
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Curcio A, Mou S, Palumbo L, Lupi S, Petrarca M. Selection rules for the orbital angular momentum of optically produced THz radiation. Opt Lett 2021; 46:1514-1517. [PMID: 33793468 DOI: 10.1364/ol.416814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
In this work, we theoretically study the transduction of orbital angular momentum (OAM) l for infrared pump lasers into the THz domain. In the case of optical rectification, the transduction of OAM occurs only through a spin-orbit interaction, with the selection rule on the OAM l=0 valid for any kind of polarization of the pump, which means that there is no transfer of OAM along the propagation axis. In difference frequency generation, the selection rule for the difference Δl between the OAM of the pump fields with linear or circular polarization is l=Δl, whereas l ranges from Δl-2 to Δl+2 in cases of both radial and azimuthal polarization. Moreover, for THz generation in the latter case, the high diffraction obtained with tightly focused pumps yields l tending to Δl±2, while l tends to zero in the opposite case of large pump beams.
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23
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Petrarca M, Frascarelli F, Carniel S, Colazza A, Minosse S, Tavernese E, Castelli E. Robotic-assisted locomotor treadmill therapy does not change gait pattern in children with cerebral palsy. Int J Rehabil Res 2021; 44:69-76. [PMID: 33290305 DOI: 10.1097/mrr.0000000000000451] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although robotic-assisted locomotor treadmill therapy is utilized on children with cerebral palsy (CP), its impact on the gait pattern in childhood is not fully described. We investigated the outcome of robotized gait training focusing on the gait pattern modifications and mobility in individuals with CP. An additional intention is to compare our results with the previous literature advancing future solutions. Twenty-four children with diplegic CP (average age 6.4 years old with Gross Motor Functional Classification System range I-IV) received robotized gait training five times per week for 4 weeks. Gait analysis and Gross Motor Function Measurement (GMFM) assessments were performed before and at the end of the treatment. Gait analysis showed inconsistent modifications of the gait pattern. GMFM showed a mild improvement of the dimension D in all subjects, while dimension E changed only in the younger and more severely affected patients. In this study, a detailed investigation comprehensive of electromyography patterns, where previous literature reported only sparse data without giving information on the whole gait pattern, were conducted. We carried on the analysis considering the age of the participants and the severity of the gait function. The findings differentiate the concept of specific pattern recovery (no gait pattern changes) from the concept of physical training (mild GMFM changes).
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Affiliation(s)
- Maurizio Petrarca
- Paediatric Neurorehabilitation Division, 'Bambino Gesù' Children's Hospital - IRCCS, Rome, Italy
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24
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Bowman T, Gervasoni E, Amico AP, Antenucci R, Benanti P, Boldrini P, Bonaiuti D, Burini A, Castelli E, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzon S, Mazzoleni S, Mestanza Mattos FG, Molteni F, Morone G, Petrarca M, Picelli A, Posteraro F, Senatore M, Turchetti G, Crea S, Cattaneo D, Carrozza MC. What is the impact of robotic rehabilitation on balance and gait outcomes in people with multiple sclerosis? A systematic review of randomized control trials. Eur J Phys Rehabil Med 2021; 57:246-253. [PMID: 33541044 DOI: 10.23736/s1973-9087.21.06692-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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 In recent years, robot-assisted gait training (RAGT) has been proposed as therapy for balance and gait dysfunctions in people with multiple sclerosis (PwMS). Through this systematic review, we aimed to discuss the impact of RAGT on balance and gait outcomes. Furthermore, characteristics of the training in terms of robots used, participants characteristics, protocols and combined therapeutic approaches have been described. EVIDENCE ACQUISITION As part of the Italian Consensus on robotic rehabilitation "CICERONE" a systematic search was provided in PubMed, the Cochrane Library and PEDro to identify relevant studies published before December 2019. Only randomized control trials (RCT) involving RAGT for PwMS were included. PEDro scale was used to assess the risk of bias and the Oxford Center for Evidence-Based Medicine (OCEBM) was used to assess level of evidence of included studies. EVIDENCE SYNTHESIS The search on databases resulted in 336 records and, finally, 12 studies were included. RAGT was provided with Exoskeleton in ten studies (6-40 session, 2-5 per week) and with end-effector in two studies (12 sessions, 2-3 per week) with large variability in terms of participants' disability. All the exoskeletons were combined with bodyweight support treadmill and movement assistance varied from 0% to 100% depending on participants' disability, two studies combined exoskeleton with virtual reality. The end-effector speed ranged between 1.3 and 1.8 km/h, with bodyweight support starting from 50% and progressively reduced. In seven out of twelve studies RAGT was provided in a multimodal rehabilitation program or in combination with standard physical therapy. There is level 2 evidence that RAGT has positive impact in PwMS, reaching the minimally clinically importance difference in Berg Balance Scale, six-minute walking test and gait speed. CONCLUSIONS In available RCT, RAGT is mostly provided with exoskeleton devices and improves balance and gait outcomes in a clinically meaningful way. Considering several advantages in terms of safety, motor assistance and intensity of training provided, RAGT should be promoted for PwMS with severe disability in a multimodal rehabilitation context as an opportunity to maximize recovery.
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Affiliation(s)
- Thomas Bowman
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy - .,The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Pisa, Italy -
| | | | - Angelo P Amico
- Spinal Unit, Policlinico di Bari University Hospital, Bari, Italy
| | - Roberto Antenucci
- Unit of Rehabilitation Medicine, Hospital of Castelsangiovanni, AUSL, Piacenza, Italy
| | - Paolo Benanti
- Department of Moral Theology, Pontifical Gregorian University, Rome, Italy
| | - Paolo Boldrini
- Italian Society of Physical and Rehabilitation Medicine (SIMFER), Rome, Italy.,General Secretary European Society of Physical and Rehabilitation Medicine (ESPRM), Rotterdam, the Netherlands
| | - Donatella Bonaiuti
- Italian Society of Physical and Rehabilitation Medicine (SIMFER), Rome, Italy
| | | | - Enrico Castelli
- Department of Intensive Neurorehabilitation and Robotics, Bambino Gesù Children's Hospital, Passoscuro Fiumicino, 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
| | - Silvia Galeri
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, 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 Mazzon
- Unit of Rehabilitation, ULSS (Local Health Authority) Euganea - Camposampiero Hospital, Padua, Italy
| | - Stefano Mazzoleni
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Pisa, Italy.,Department of Electrical and Information Engineering (DEI), Polytechnic University of Bari, Bari, Italy
| | | | - Franco Molteni
- Valduce Villa Beretta Hospital, Costa Masnaga, Lecco, Italy
| | | | - Maurizio Petrarca
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARlab), Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alessandro Picelli
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Posteraro
- Department of Rehabilitation, Versilia Hospital, AUSL Toscana Nord Ovest, Camaiore, Lucca, Italy
| | - Michele Senatore
- Italian Association of Occupational Therapists (AITO), Rome, Italy
| | | | - Simona Crea
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.,The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Pisa, Italy
| | | | - Maria C Carrozza
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.,The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Pisa, Italy
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25
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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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26
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Summa S, Tartarisco G, Favetta M, Buzachis A, Romano A, Bernava GM, Sancesario A, Vasco G, Pioggia G, Petrarca M, Castelli E, Bertini E, Schirinzi T. Validation of low-cost system for gait assessment in children with ataxia. Comput Methods Programs Biomed 2020; 196:105705. [PMID: 32846316 DOI: 10.1016/j.cmpb.2020.105705] [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] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 08/06/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Ataxic syndromes include several rare, inherited and acquired conditions. One of the main issues is the absence of specific, and sensitive automatic evaluation tools and digital outcome measures to obtain a continuous monitoring of subjects' motor ability. OBJECTIVES This study aims to test the usability of the Kinect system for assessing ataxia severity, exploring the potentiality of clustering algorithms and validating this system with a standard motion capture system. METHODS Gait evaluation was performed by standardized gait analysis and by Kinect v2 during the same day in a cohort of young patient (mean age of 13.8±7.2). We analyzed the gait spatio-temporal parameters and we looked at the differences between the two systems through correlation and agreement tests. As well, we tested for possible correlations with the SARA scale as well. Finally, standard classification algorithm and principal components analysis were used to discern disease severity and groups. RESULTS We found biases and linear relationships between all the parameters. Significant correlations emerged between the SARA and the Speed, the Stride Length and the Step Length. PCA results, highlighting that a machine learning approach combined with Kinect-based evaluation shows great potential to automatically assess disease severity and diagnosis. CONCLUSIONS The spatio-temporal parameters measured by Kinect cannot be used interchangeably with those parameters acquired with standard motion capture system in clinical practice but can still provide fundamental information. Specifically, these results might bring to the development of a novel system to perform easy and quick evaluation of gait in young patients with ataxia, useful for patients stratification in terms of clinical severity and diagnosis.
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Affiliation(s)
- S Summa
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
| | - G Tartarisco
- National Research Council of Italy (CNR), Institute for Biomedical Research and Innovation (IRIB), Messina, Italy.
| | - M Favetta
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
| | - A Buzachis
- Department of Mathematics and Computer Science, University of Messina, Italy.
| | - A Romano
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
| | - G M Bernava
- National Research Council of Italy (CNR), Institute for Biomedical Research and Innovation (IRIB), Messina, Italy.
| | - A Sancesario
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
| | - G Vasco
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
| | - G Pioggia
- National Research Council of Italy (CNR), Institute for Biomedical Research and Innovation (IRIB), Messina, Italy.
| | - M Petrarca
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
| | - E Castelli
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
| | - E Bertini
- Unit of Neuromuscolar and Neurodegenerative Diseases, Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Rome, Italy.
| | - T Schirinzi
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy; Department Systems Medicine, University of Roma Tor Vergata, Rome, Italy.
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27
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Summa S, Tartarisco G, Favetta M, Buzachis A, Romano A, Bernava GM, Vasco G, Pioggia G, Petrarca M, Castelli E, Bertini E, Schirinzi T. Spatio-temporal parameters of ataxia gait dataset obtained with the Kinect. Data Brief 2020; 32:106307. [PMID: 32984487 PMCID: PMC7498847 DOI: 10.1016/j.dib.2020.106307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 08/17/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 02/06/2023] Open
Abstract
Ataxic syndromes include several rare, inherited and acquired conditions. One of the main issues is the absence of specific, and sensitive automatic evaluation tools and digital outcome measures to obtain a continuous monitoring of subjects' motor ability. Gait evaluation was performed by Kinect v2 in a cohort of young participant affected by ataxia syndrome. The dataset is composed of the spatio-temporal parameters calculated by the skeleton acquired by the Kinect sensor, by the diagnosis of each participant, and by the total score of the clinical scale SARA. These parameters have been previously validated and corrected as requested by the Bland-Altman test.
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Affiliation(s)
- S Summa
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy
| | - G Tartarisco
- National Research Council of Italy (CNR)-Institute for Biomedical Research and Innovation (IRIB), Messina Italy
| | - M Favetta
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy
| | - A Buzachis
- Department of Mathematics and Computer Science, University of Messina, Italy
| | - A Romano
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy
| | - G M Bernava
- National Research Council of Italy (CNR)-Institute for Biomedical Research and Innovation (IRIB), Messina Italy
| | - G Vasco
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy
| | - G Pioggia
- National Research Council of Italy (CNR)-Institute for Biomedical Research and Innovation (IRIB), Messina Italy
| | - M Petrarca
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy
| | - E Castelli
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy
| | - E Bertini
- Unit of Neuromuscolar and Neurodegenerative Diseases, Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - T Schirinzi
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.,Department Systems Medicine, University of Roma Tor Vergata, Rome, Italy
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28
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Gilardi F, De Falco F, Casasanta D, Andellini M, Gazzellini S, Petrarca M, Castelli E, Raponi M, Magnavita N, Zaffina S. Human factor of The Use Of Robotic Technology In Pediatric neurorehabilitation. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1385] [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] [Indexed: 11/13/2022] Open
Abstract
Abstract
Robotic technology represents a new rehabilitation opportunity that, with an approach similar to a video game, increases the motivation to treat children and seems able to activate brain plasticity, at the basis of the functional recovery due to its interactivity and intensity of the training experience. Literature reports few studies that evaluate the ergonomic aspects of devices for neurorehabilitation, from the point of view of both the operator and the patient. Similar studies in the pediatric field are rare. This study aims to evaluate the response of workers, patients and their parents to this new technology.
The study considered the response of the workers (perception of the workload, satisfaction), that of the patients and their parents (expectations, benefits) by comparing the answers to subjective questionnaires of those who made use of the new technology with those who used the traditional technique. Twelve workers, 46 patients and 47 parents were enrolled in the study.
Significant differences were recorded in the total workload score of operators who use the robotic technology compared to the traditional therapy (p < 0.001). Patients reported a higher quality of life and satisfaction after the use of robotic neurorehabilitation therapy. The parents of patients undergoing robotic therapy have moderately higher expectations and satisfaction than those undergoing traditional therapy. None of the parameters checked was worse in the new therapeutic technique than in the traditional one.
In this pilot study, the robotic neurorehabilitation technique induced an increase in the expectations and satisfaction of patients and their parents. As is frequent in the introduction of new technologies, workers perceived a greater workload. Subsequent studies are needed to verify the results achieved. This study is being developed in an Italian pediatric hospital, with the collaboration and funding of the Italian Ministry of Health, coauthor of this study.
Key messages
Robotic therapy presents a higher workload compared to traditional one. Robotic technique induced an increase in quality of life of patients and in expectations and satisfaction of their parents.
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Affiliation(s)
- F Gilardi
- Health Directorate, Occupational Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - F De Falco
- Health Directorate, Occupational Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - D Casasanta
- Health Directorate, Occupational Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Andellini
- Health Directorate, Occupational Medicine Unit, UdR & HTA Re, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - S Gazzellini
- Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Petrarca
- Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - E Castelli
- Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Raponi
- Health Directorate, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - N Magnavita
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - S Zaffina
- Health Directorate, Occupational Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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29
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Summa S, Schirinzi T, Favetta M, Romano A, Minosse S, Diodato D, Olivieri G, Martinelli D, Sancesario A, Zanni G, Castelli E, Bertini E, Petrarca M, Vasco G. A wearable video-oculography based evaluation of saccades and respective clinical correlates in patients with early onset ataxia. J Neurosci Methods 2020; 338:108697. [DOI: 10.1016/j.jneumeth.2020.108697] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 03/19/2020] [Accepted: 03/19/2020] [Indexed: 11/28/2022]
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30
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Summa S, Schirinzi T, Bernava GM, Romano A, Favetta M, Valente EM, Bertini E, Castelli E, Petrarca M, Pioggia G, Vasco G. Development of SaraHome: A novel, well-accepted, technology-based assessment tool for patients with ataxia. Comput Methods Programs Biomed 2020; 188:105257. [PMID: 31846831 DOI: 10.1016/j.cmpb.2019.105257] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/20/2019] [Accepted: 11/30/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Early onset ataxias (EOAs) are a heterogeneous group of neurological conditions, responsible for severe motor disability in paediatric age, which still lack reliable outcome measures. Available scales to assess ataxia, such as the Scale for Assessment and Rating of Ataxia (SARA), are based on subjective assessment of specific motor and language tasks by an examiner, and therefore is age dependent and lacks accuracy in detecting small variations in disease severity. In last years, novel technologies, including computer interfaces and videogames, have emerged for clinical applications and the advent of Internet of Medical Things and of Information Communication Technology have allowed the remote control of such technologies. This pilot study describes a newly developed tool (SaraHome) for the assessment at home of EOA evaluating its feasibility and acceptability on a small sample of children. METHODS Ten EOA children and ten caregivers have been enrolled for a preliminary outpatient evaluation. The Microsoft Kinect 2.0 and Leap Motion Controller (LMC) connected to a personal computer with an ad hoc software have been set-up, for the acquisition of standardized motor tasks performed by the patients with the caregivers' assistance. Acceptance and practicability have been tested by QUEST 2.0 and IMI questionnaires in caregivers and patients respectively. RESULTS The SaraHome software was developed, based on a collection of services provided by a complex architecture that consists of a Restful interface, which enables to access a series of plugins for the execution of different tasks. A graphical user interface allows the acquisition of the patient movements while performing a motor task. A protocol of standard tasks inspired by SARA was established, and a system of video-assisted instruction provided. The set-up for the optimal acquisition of such protocol by Kinect and LMC has been defined. Both patients and caregivers accomplished the SaraHome assessment with good feedback at the technology acceptance questionnaires. CONCLUSIONS SaraHome represents a newly developed tool for the assessment of ataxia in patients, resulting from the integration of low-cost and easy-accessible technologies. This pilot application highlighted the feasibility and the acceptability of the system, suggesting the potential use in clinical practice.
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Affiliation(s)
- Susanna Summa
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
| | - Tommaso Schirinzi
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy; Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy.
| | - Giuseppe Massimo Bernava
- Institute for Biomedical Research and Innovation (IRIB-CNR), Via Torre Bianca, Mortelle, Istituto Marino, 98164 Messina, Italy.
| | - Alberto Romano
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
| | - Martina Favetta
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
| | - Enza Maria Valente
- Department of Molecular Medicine, Unit of Genetics, Università degli studi di Pavia, Pavia, Italy; IRCCS Mondino Foundation, Pavia, Italy.
| | - Enrico Bertini
- Unit of Neuromuscolar and Neurodegenerative Diseases, Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Rome, Italy.
| | - Enrico Castelli
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
| | - Maurizio Petrarca
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB-CNR), Via Torre Bianca, Mortelle, Istituto Marino, 98164 Messina, Italy.
| | - Gessica Vasco
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
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Curcio A, Petrarca M. Saturation regime of THz generation in nonlinear crystals by pumps with arbitrary spectral modulations. Opt Lett 2020; 45:1619-1622. [PMID: 32235957 DOI: 10.1364/ol.386341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/24/2020] [Indexed: 06/11/2023]
Abstract
A self-consistent analytic formalism of the description of saturation effects in optical rectification is provided. It is shown that a nonlinear absorption term arises from this process that is dominant over two-photon absorption, deriving instead from the nonlinear susceptibility of the third order. An analytical expression for the saturation intensity is provided and compared to experiments in literature. Moreover, it is shown how the saturation effects modify the transfer of the pump spectral phase and amplitude into the terahertz domain.
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Flux E, van der Krogt M, Cappa P, Petrarca M, Desloovere K, Harlaar J. The Human Body Model versus conventional gait models for kinematic gait analysis in children with cerebral palsy. Hum Mov Sci 2020; 70:102585. [DOI: 10.1016/j.humov.2020.102585] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 12/06/2019] [Accepted: 01/15/2020] [Indexed: 11/25/2022]
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Rinaldi M, Petrarca M, Romano A, Vasco G, D'Anna C, Schmid M, Castelli E, Conforto S. EMG-based Indicators of Muscular Co-Activation during Gait in Children with Duchenne Muscular Dystrophy. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:3845-3848. [PMID: 31946712 DOI: 10.1109/embc.2019.8856892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Muscular weakness is one of the main signs associated with the onset and progression of Duchenne Muscular Dystrophy. During motor functions, this disease also determines deviations in muscular activity, especially in terms of coordination and activation between muscles acting on the same joints. In this study, surface EMG activity of the lower limb muscles of 10 children with Duchenne Muscular Dystrophy at different times from disease onset were recorded along with kinematics during unconstrained gait. Muscular co-activation of muscle pairs was then evaluated by extracting different co-activation indicators, and linking them with kinematic markers of motor function. The combination of disease progression and pharmacological treatment resulted in a significant decrease in terms of co-activation indexes for two pairs of agonist-antagonist muscles, and for one of these two pairs the decrease in co-activation was correlated with a decrease in the motor function of gait.
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Summa S, Gori R, Castelli E, Petrarca M. Development of a dynamic oriented rehabilitative integrated system. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:5245-5250. [PMID: 31947041 DOI: 10.1109/embc.2019.8857814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Moving platform are introduced in the field of the study of posturography since '70 years. Commercial platforms have some limits: a limited number of degrees of freedom; preconfigured protocols and usually they are expensive. In order to overcome these limits, we developed a robotized platform: DORIS. We aimed at realizing a versatile solution that can be applied both for research purpose but also for personalizing the training of equilibrium and gait. We reached these goals by means of a Stewart platform that was realized with linear actuators and a supporting plate. Each actuator is provided by a monoaxial ad hoc built load cell. Position and force control allow a multipurpose range of movement and a reactive interaction with the force applied by the subject. TCP/IP protocol guarantees the communication between the platform and other systems. Therefore, we integrated DORIS with motion analysis system, EMG system and virtual reality. The adopted solution offers the opportunity to manipulate available information by means of different coupling of visual, vestibular and plantar feet pressure inputs. The full control of its movement and of human dynamic interaction is a further benefit for the identification of innovative solutions for research and physical rehabilitation in a field that is strongly investigated, but still open.
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35
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Curcio A, Bisesto F, Costa G, Biagioni A, Anania MP, Pompili R, Ferrario M, Petrarca M. Modeling and diagnostics for plasma discharge capillaries. Phys Rev E 2019; 100:053202. [PMID: 31869917 DOI: 10.1103/physreve.100.053202] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Indexed: 11/07/2022]
Abstract
In this paper, we show how plasma discharge capillaries can be numerically modeled as resistors within an RLC-series discharge circuit, allowing for a simple description of these systems, while taking into account heat and radiation losses. An analytic radial model is also provided and compared to the numerical model for plasma discharge capillaries at thermal equilibrium, with corrections due to radiation losses. Finally, diagnostic techniques based on visible spectroscopy of plasma emission lines are discussed both for atomic and molecular gases, comparing experimental results with numerical simulations and theoretical calculations.
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Affiliation(s)
| | | | - G Costa
- INFN LNF, Frascati (Rome), Italy
| | | | | | | | | | - M Petrarca
- S.B.A.I. Department of the Roma University "La Sapienza," Rome, Italy and INFN Roma1, Rome, Italy
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36
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Schirinzi T, Favetta M, Romano A, Sancesario A, Summa S, Minosse S, Zanni G, Castelli E, Bertini E, Petrarca M, Vasco G. One-year outcome of coenzyme Q10 supplementation in ADCK3 ataxia (ARCA2). Cerebellum Ataxias 2019; 6:15. [PMID: 31890231 PMCID: PMC6916514 DOI: 10.1186/s40673-019-0109-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 12/11/2019] [Indexed: 11/10/2022]
Abstract
Background The recessive ataxia ARCA2 is a rare disorder characterized by Coenzyme Q10 (CoQ10) deficiency due to biallelic mutations in ADCK3 gene. Despite the pathophysiological role, available data are not univocal on clinical efficacy of CoQ10 supplementation in ARCA2. Here we described the long-term motor outcome of 4 untreated ARCA2 patients prospectively followed-up for one year after starting CoQ10 oral supplementation (15 mg/kg/day). Methods Clinical rating scales (SARA; 9 holes peg test; 6 min walking test; Timed 25-Foot Walk) and videoelectronic gait analysis were performed at baseline and every 6 months (T0, T1, T2) to evaluate the motor performances. Since two patients discontinued the treatment at the 7th month, we could provide comparative analysis between longer and shorter supplementation. Results At T2, the gait speed (Timed 25-Foot Walk test) significantly differed between patients with long and short treatment; overall, the clinical condition tended to be better in patients continuing CoQ10. Conclusions Although preliminarily, this observation suggests that only prolonged and continuous CoQ10 supplementation may induce mild clinical effects on general motor features of ARCA2. Dedicated trials are now necessary to extend and validate such observation.
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Affiliation(s)
- Tommaso Schirinzi
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy.,2Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Martina Favetta
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
| | - Alberto Romano
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
| | - Andrea Sancesario
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy.,2Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Susanna Summa
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
| | - Silvia Minosse
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
| | - Ginevra Zanni
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
| | - Enrico Castelli
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
| | - Enrico Bertini
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
| | - Maurizio Petrarca
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
| | - Gessica Vasco
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
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Romano A, Favetta M, Schirinzi T, Summa S, Minosse S, D'Amico A, Catteruccia M, Petrarca M, Castelli E, Bertini E, Vasco G. Evaluation of gait in Duchenne Muscular Dystrophy: Relation of 3D gait analysis to clinical assessment. Neuromuscul Disord 2019; 29:920-929. [PMID: 31791868 DOI: 10.1016/j.nmd.2019.10.007] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 08/26/2019] [Accepted: 10/28/2019] [Indexed: 10/25/2022]
Abstract
Walking ability in Duchenne Muscular Dystrophy (DMD) deteriorates progressively until complete loss of the function. Interventions aimed at maintaining ambulatory ability relies on accurate clinical-based scores and evaluations of walking. This kind of assessment has intrinsic limitations. A 3D optoelectronic system could provide elements useful for the functional evaluation of patients with DMD. Nineteen boys with DMD were evaluated using the 6-Minutes Walking Test, North Star Ambulatory Assessment and 3D gait analysis. Participants' gait parameters were compared to those of an age-matched control group and correlated with standard clinical scores. Seventeen kinematic variables differed between DMD and control groups. Strong correlations with North Star Ambulatory Assessment were found for stride width, gait velocity and ankle angles on the sagittal plane. The 6-Minutes Walking test did not correlate with investigated kinematic variables but showed a correlation with North Star Ambulatory Assessment. Our data support the reported DMD gait pattern characterized by increased anterior pelvic tilt and ankle plantar flexion. The stride width and ankle kinematics emerged as the main representative gait parameters of DMD global ambulatory status. Although preliminary, our findings suggest that 3D gait analysis may provide useful objective and accurate parameters reflecting the functional ability of individuals with DMD.
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Affiliation(s)
- Alberto Romano
- Department of Neuroscience, Unit of Neurorehabilitation, Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Via della torre di Palidoro, snc, Fiumicino, Rome, Italy
| | - Martina Favetta
- Department of Neuroscience, Unit of Neurorehabilitation, Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Via della torre di Palidoro, snc, Fiumicino, Rome, Italy
| | - Tommaso Schirinzi
- Department of Neuroscience, Unit of Neurorehabilitation, Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Via della torre di Palidoro, snc, Fiumicino, Rome, Italy; Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Susanna Summa
- Department of Neuroscience, Unit of Neurorehabilitation, Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Via della torre di Palidoro, snc, Fiumicino, Rome, Italy
| | - Silvia Minosse
- Department of Neuroscience, Unit of Neurorehabilitation, Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Via della torre di Palidoro, snc, Fiumicino, Rome, Italy
| | - Adele D'Amico
- Department of Neuroscience, Unit of Neuromuscular and Neurodegenerative Disease, Bambino Gesù Children's Hospital, Rome, Italy
| | - Michela Catteruccia
- Department of Neuroscience, Unit of Neuromuscular and Neurodegenerative Disease, Bambino Gesù Children's Hospital, Rome, Italy
| | - Maurizio Petrarca
- Department of Neuroscience, Unit of Neurorehabilitation, Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Via della torre di Palidoro, snc, Fiumicino, Rome, Italy.
| | - Enrico Castelli
- Department of Neuroscience, Unit of Neurorehabilitation, Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Via della torre di Palidoro, snc, Fiumicino, Rome, Italy
| | - Enrico Bertini
- Department of Neuroscience, Unit of Neuromuscular and Neurodegenerative Disease, Bambino Gesù Children's Hospital, Rome, Italy
| | - Gessica Vasco
- Department of Neuroscience, Unit of Neurorehabilitation, Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Via della torre di Palidoro, snc, Fiumicino, Rome, Italy
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Montefiori E, Modenese L, Di Marco R, Magni-Manzoni S, Malattia C, Petrarca M, Ronchetti A, de Horatio LT, van Dijkhuizen P, Wang A, Wesarg S, Viceconti M, Mazzà C. Linking Joint Impairment and Gait Biomechanics in Patients with Juvenile Idiopathic Arthritis. Ann Biomed Eng 2019; 47:2155-2167. [PMID: 31111329 PMCID: PMC6838035 DOI: 10.1007/s10439-019-02287-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/08/2019] [Indexed: 11/27/2022]
Abstract
Juvenile Idiopathic Arthritis (JIA) is a paediatric musculoskeletal disease of unknown aetiology, leading to walking alterations when the lower-limb joints are involved. Diagnosis of JIA is mostly clinical. Imaging can quantify impairments associated to inflammation and joint damage. However, treatment planning could be better supported using dynamic information, such as joint contact forces (JCFs). To this purpose, we used a musculoskeletal model to predict JCFs and investigate how JCFs varied as a result of joint impairment in eighteen children with JIA. Gait analysis data and magnetic resonance images (MRI) were used to develop patient-specific lower-limb musculoskeletal models, which were evaluated for operator-dependent variability (< 3.6°, 0.05 N kg-1 and 0.5 BW for joint angles, moments, and JCFs, respectively). Gait alterations and JCF patterns showed high between-subjects variability reflecting the pathology heterogeneity in the cohort. Higher joint impairment, assessed with MRI-based evaluation, was weakly associated to overall joint overloading. A stronger correlation was observed between impairment of one limb and overload of the contralateral limb, suggesting risky compensatory strategies being adopted, especially at the knee level. This suggests that knee overloading during gait might be a good predictor of disease progression and gait biomechanics should be used to inform treatment planning.
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Affiliation(s)
- Erica Montefiori
- Department of Mechanical Engineering, University of Sheffield, Sheffield, UK.
- INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, UK.
| | - Luca Modenese
- INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, UK
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Roberto Di Marco
- INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, UK
- Department of Mechanical and Aerospace Engineering, "Sapienza" University of Rome, Rome, Italy
| | - Silvia Magni-Manzoni
- Pediatric Rheumatology Unit, IRCCS "Bambino Gesù" Children's Hospital, Passoscuro, Rome, Italy
| | - Clara Malattia
- Pediatria II - Reumatologia, Istituto Giannina Gaslini, Genoa, Italy
| | - Maurizio Petrarca
- Movement Analysis and Robotics Laboratory (MARLab), Neurorehabilitation Units, IRCCS "Bambino Gesù" Children's Hospital, Passoscuro, Rome, Italy
| | - Anna Ronchetti
- UOC Medicina Fisica e Riabilitazione, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Pieter van Dijkhuizen
- Paediatric Immunology, University Medical Centre Utrecht Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - Anqi Wang
- Visual Healthcare Technologies, Fraunhofer IGD, Darmstadt, Germany
| | - Stefan Wesarg
- Visual Healthcare Technologies, Fraunhofer IGD, Darmstadt, Germany
| | - Marco Viceconti
- Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Bologna, Italy
- Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Claudia Mazzà
- Department of Mechanical Engineering, University of Sheffield, Sheffield, UK
- INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, UK
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Beretta E, Storm FA, Strazzer S, Frascarelli F, Petrarca M, Colazza A, Cordone G, Biffi E, Morganti R, Maghini C, Piccinini L, Reni G, Castelli E. Effect of Robot-Assisted Gait Training in a Large Population of Children With Motor Impairment Due to Cerebral Palsy or Acquired Brain Injury. Arch Phys Med Rehabil 2019; 101:106-112. [PMID: 31562873 DOI: 10.1016/j.apmr.2019.08.479] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/19/2019] [Accepted: 08/23/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate retrospectively the effect of robotic rehabilitation in a large group of children with motor impairment; an additional goal was to identify the effects in children with cerebral palsy (CP) and acquired brain injury (ABI) and with different levels of motor impairment according to the Gross Motor Function Classification System. Finally, we examined the effect of time elapsed from injury on children's functions. DESIGN A cohort, pretest-posttest retrospective study was conducted. SETTING Hospitalized care. PARTICIPANTS A total of 182 children, 110 with ABI and 72 with CP and with Gross Motor Function Classification System (GMFCS) levels I-IV, were evaluated retrospectively. INTERVENTIONS Patients underwent a combined treatment of robot-assisted gait training and physical therapy. MAIN OUTCOME MEASURES All the patients were evaluated before and after the training using the 6-minute walk test and the Gross Motor Function Measure. A linear mixed model with 3 fixed factors and 1 random factor was used to evaluate improvements. RESULTS The 6-minute walk test showed improvement in the whole group and in both ABI and CP. The Gross Motor Function Measure showed improvement in the whole group and in the patients with ABI but not in children with CP. The GMFCS analysis showed that all outcomes improved significantly in all classes within the ABI subgroup, whereas improvements were significant only for GMFCS III in children with CP. CONCLUSIONS Children with motor impairment can benefit from a combination of robotic rehabilitation and physical therapy. Our data suggest positive results for the whole group and substantial differences between ABI and CP subgroups, with better results for children with ABI, that seem to be consistently related to time elapsed from injury.
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Affiliation(s)
- Elena Beretta
- Scientific Institute, IRCCS "E. Medea," Acquired Brain Injury Unit, Bosisio Parini, Lecco, Italy.
| | - Fabio Alexander Storm
- Scientific Institute, IRCCS "E. Medea," Bioengineering Laboratory, Bosisio Parini, Lecco, Italy
| | - Sandra Strazzer
- Scientific Institute, IRCCS "E. Medea," Acquired Brain Injury Unit, Bosisio Parini, Lecco, Italy
| | | | - Maurizio Petrarca
- Bambino Gesù Children's Hospital, Neurorehabilitation Units, Rome, Italy
| | - Alessandra Colazza
- Bambino Gesù Children's Hospital, Neurorehabilitation Units, Rome, Italy
| | - Giampietro Cordone
- Bambino Gesù Children's Hospital, Neurorehabilitation Units, Rome, Italy
| | - Emilia Biffi
- Scientific Institute, IRCCS "E. Medea," Bioengineering Laboratory, Bosisio Parini, Lecco, Italy
| | - Roberta Morganti
- Scientific Institute, IRCCS "E. Medea," Bioengineering Laboratory, Bosisio Parini, Lecco, Italy
| | - Cristina Maghini
- Scientific Institute, IRCCS "E. Medea", Functional Rehabilitation Unit, Bosisio Parini, Lecco, Italy
| | - Luigi Piccinini
- Scientific Institute, IRCCS "E. Medea", Functional Rehabilitation Unit, Bosisio Parini, Lecco, Italy
| | - Gianluigi Reni
- Scientific Institute, IRCCS "E. Medea," Bioengineering Laboratory, Bosisio Parini, Lecco, Italy
| | - Enrico Castelli
- Bambino Gesù Children's Hospital, Neurorehabilitation Units, Rome, Italy
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Curcio A, Petrarca M. Diagnosing plasmas with wideband THz pulses: errata. Opt Lett 2019; 44:4427. [PMID: 31465419 DOI: 10.1364/ol.44.004427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Indexed: 06/10/2023]
Abstract
In this erratum Fig. 3 of Opt. Lett.44, 1011 (2019)OPLEDP0146-959210.1364/OL.44.001011 has been updated. A diagnostic method for the electron plasma density and temperature based on the exploitation of wide-band THz pulses is presented. The model accompanying the diagnostic method is described and it is shown useful to characterize the plasma density and temperature profile along a symmetry axis. This diagnostic is particularly interesting for plasma-acceleration schemes or laser-produced plasma channels.
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41
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Montefiori E, Modenese L, Di Marco R, Magni-Manzoni S, Malattia C, Petrarca M, Ronchetti A, de Horatio LT, van Dijkhuizen P, Wang A, Wesarg S, Viceconti M, Mazzà C. An image-based kinematic model of the tibiotalar and subtalar joints and its application to gait analysis in children with Juvenile Idiopathic Arthritis. J Biomech 2019; 85:27-36. [DOI: 10.1016/j.jbiomech.2018.12.041] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 10/06/2018] [Accepted: 12/28/2018] [Indexed: 01/08/2023]
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42
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Curcio A, Petrarca M. Diagnosing plasmas with wideband terahertz pulses. Opt Lett 2019; 44:1011-1014. [PMID: 30768036 DOI: 10.1364/ol.44.001011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 01/17/2019] [Indexed: 06/09/2023]
Abstract
A diagnostic method for the electron plasma density and temperature based on the exploitation of wideband THz pulses is presented. The model accompanying the diagnostic method is described, and it is shown useful to characterize the plasma density and temperature profile along a symmetry axis. This diagnostic is particularly interesting for plasma-acceleration schemes or laser-produced plasma channels.
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43
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McLean K, Glasbey J, Borakati A, Brooks T, Chang H, Choi S, Goodson R, Nielsen M, Pronin S, Salloum N, Sewart E, Vanniasegaram D, Drake T, Gillies M, Harrison E, Chapman S, Khatri C, Kong C, Claireaux H, Bath M, Mohan M, McNamee L, Kelly M, Mitchell H, Fitzgerald J, Bhangu A, Nepogodiev D, Antoniou I, Dean R, Davies N, Trecarten S, Henderson I, Holmes C, Wylie J, Shuttleworth R, Jindal A, Hughes F, Gouda P, Fleck R, Hanrahan M, Karunakaran P, Chen J, Sykes M, Sethi R, Suresh S, Patel P, Patel M, Varma R, Mushtaq J, Gundogan B, Bolton W, Khan T, Burke J, Morley R, Favero N, Adams R, Thirumal V, Kennedy E, Ong K, Tan Y, Gabriel J, Bakhsh A, Low J, Yener A, Paraoan V, Preece R, Tilston T, Cumber E, Dean S, Ross T, McCance E, Amin H, Satterthwaite L, Clement K, Gratton R, Mills E, Chiu S, Hung G, Rafiq N, Hayes J, Robertson K, Dynes K, Huang H, Assadullah S, Duncumb J, Moon R, Poo S, Mehta J, Joshi K, Callan R, Norris J, Chilvers N, Keevil H, Jull P, Mallick S, Elf D, Carr L, Player C, Barton E, Martin A, Ratu S, Roberts E, Phan P, Dyal A, Rogers J, Henson A, Reid N, Burke D, Culleton G, Lynne S, Mansoor S, Brennan C, Blessed R, Holloway C, Hill A, Goldsmith T, Mackin S, Kim S, Woin E, Brent G, Coffin J, Ziff O, Momoh Z, Debenham R, Ahmed M, Yong C, Wan J, Copley H, Raut P, Chaudhry F, Nixon G, Dorman C, Tan R, Kanabar S, Canning N, Dolaghan M, Bell N, McMenamin M, Chhabra A, Duke K, Turner L, Patel T, Chew L, Mirza M, Lunawat S, Oremule B, Ward N, Khan M, Tan E, Maclennan D, McGregor R, Chisholm E, Griffin E, Bell L, Hughes B, Davies J, Haq H, Ahmed H, Ungcharoen N, Whacha C, Thethi R, Markham R, Lee A, Batt E, Bullock N, Francescon C, Davies J, Shafiq N, Zhao J, Vivekanantham S, Barai I, Allen J, Marshall D, McIntyre C, Wilson H, Ashton A, Lek C, Behar N, Davis-Hall M, Seneviratne N, Esteve L, Sirakaya M, Ali S, Pope S, Ahn J, Craig-McQuaide A, Gatfield W, Leong S, Demetri A, Kerr A, Rees C, Loveday J, Liu S, Wijesekera M, Maru D, Attalla M, Smith N, Brown D, Sritharan P, Shah A, Charavanamuttu V, Heppenstall-Harris G, Ng K, Raghvani T, Rajan N, Hulley K, Moody N, Williams M, Cotton A, Sharifpour M, Lwin K, Bright M, Chitnis A, Abdelhadi M, Semana A, Morgan F, Reid R, Dickson J, Anderson L, McMullan R, Ahern N, Asmadi A, Anderson L, Boon Xuan JL, Crozier L, McAleer S, Lees D, Adebayo A, Das M, Amphlett A, Al-Robeye A, Valli A, Khangura J, Winarski A, Ali A, Woodward H, Gouldthrope C, Turner M, Sasapu K, Tonkins M, Wild J, Robinson M, Hardie J, Heminway R, Narramore R, Ramjeeawon N, Hibberd A, Winslow F, Ho W, Chong B, Lim K, Ho S, Crewdson J, Singagireson S, Kalra N, Koumpa F, Jhala H, Soon W, Karia M, Rasiah M, Xylas D, Gilbert H, Sundar-Singh M, Wills J, Akhtar S, Patel S, Hu L, Brathwaite-Shirley C, Nayee H, Amin O, Rangan T, Turner E, McCrann C, Shepherd R, Patel N, Prest-Smith J, Auyoung E, Murtaza A, Coates A, Prys-Jones O, King M, Gaffney S, Dewdney C, Nehikhare I, Lavery J, Bassett J, Davies K, Ahmad K, Collins A, Acres M, Egerton C, Cheng K, Chen X, Chan N, Sheldon A, Khan S, Empey J, Ingram E, Malik A, Johnstone M, Goodier R, Shah J, Giles J, Sanders J, McLure S, Pal S, Rangedara A, Baker A, Asbjoernsen C, Girling C, Gray L, Gauntlett L, Joyner C, Qureshi S, Mogan Y, Ng J, Kumar A, Park J, Tan D, Choo K, Raman K, Buakuma P, Xiao C, Govinden S, Thompson O, Charalambos M, Brown E, Karsan R, Dogra T, Bullman L, Dawson P, Frank A, Abid H, Tung L, Qureshi U, Tahmina A, Matthews B, Harris R, O'Connor A, Mazan K, Iqbal S, Stanger S, Thompson J, Sullivan J, Uppal E, MacAskill A, Bamgbose F, Neophytou C, Carroll A, Rookes C, Datta U, Dhutia A, Rashid S, Ahmed N, Lo T, Bhanderi S, Blore C, Ahmed S, Shaheen H, Abburu S, Majid S, Abbas Z, Talukdar S, Burney L, Patel J, Al-Obaedi O, Roberts A, Mahboob S, Singh B, Sheth S, Karia P, Prabhudesai A, Kow K, Koysombat K, Wang S, Morrison P, Maheswaran Y, Keane P, Copley P, Brewster O, Xu G, Harries P, Wall C, Al-Mousawi A, Bonsu S, Cunha P, Ward T, Paul J, Nadanakumaran K, Tayeh S, Holyoak H, Remedios J, Theodoropoulou K, Luhishi A, Jacob L, Long F, Atayi A, Sarwar S, Parker O, Harvey J, Ross H, Rampal R, Thomas G, Vanmali P, McGowan C, Stein J, Robertson V, Carthew L, Teng V, Fong J, Street A, Thakker C, O'Reilly D, Bravo M, Pizzolato A, Khokhar H, Ryan M, Cheskes L, Carr R, Salih A, Bassiony S, Yuen R, Chrastek D, Rosen O'Sullivan H, Amajuoyi A, Wang A, Sitta O, Wye J, Qamar M, Major C, Kaushal A, Morgan C, Petrarca M, Allot R, Verma K, Dutt S, Chilima C, Peroos S, Kosasih S, Chin H, Ashken L, Pearse R, O'Loughlin R, Menon A, Singh K, Norton J, Sagar R, Jathanna N, Rothwell L, Watson N, Harding F, Dube P, Khalid H, Punjabi N, Sagmeister M, Gill P, Shahid S, Hudson-Phillips S, George D, Ashwood J, Lewis T, Dhar M, Sangal P, Rhema I, Kotecha D, Afzal Z, Syeed J, Prakash E, Jalota P, Herron J, Kimani L, Delport A, Shukla A, Agarwal V, Parthiban S, Thakur H, Cymes W, Rinkoff S, Turnbull J, Hayat M, Darr S, Khan U, Lim J, Higgins A, Lakshmipathy G, Forte B, Canning E, Jaitley A, Lamont J, Toner E, Ghaffar A, McDowell M, Salmon D, O'Carroll O, Khan A, Kelly M, Clesham K, Palmer C, Lyons R, Bell A, Chin R, Waldron R, Trimble A, Cox S, Ashfaq U, Campbell J, Holliday R, McCabe G, Morris F, Priestland R, Vernon O, Ledsam A, Vaughan R, Lim D, Bakewell Z, Hughes R, Koshy R, Jackson H, Narayan P, Cardwell A, Jubainville C, Arif T, Elliott L, Gupta V, Bhaskaran G, Odeleye A, Ahmed F, Shah R, Pickard J, Suleman Y, North A, McClymont L, Hussain N, Ibrahim I, Ng G, Wong V, Lim A, Harris L, Tharmachandirar T, Mittapalli D, Patel V, Lakhani M, Bazeer H, Narwani V, Sandhu K, Wingfield L, Gentry S, Adjei H, Bhatti M, Braganza L, Barnes J, Mistry S, Chillarge G, Stokes S, Cleere J, Wadanamby S, Bucko A, Meek J, Boxall N, Heywood E, Wiltshire J, Toh C, Ward A, Shurovi B, Horth D, Patel B, Ali B, Spencer T, Axelson T, Kretzmer L, Chhina C, Anandarajah C, Fautz T, Horst C, Thevathasan A, Ng J, Hirst F, Brewer C, Logan A, Lockey J, Forrest P, Keelty N, Wood A, Springford L, Avery P, Schulz T, Bemand T, Howells L, Collier H, Khajuria A, Tharakan R, Parsons S, Buchan A, McGalliard R, Mason J, Cundy O, Li N, Redgrave N, Watson R, Pezas T, Dennis Y, Segall E, Hameed M, Lynch A, Chamberlain M, Peck F, Neo Y, Russell G, Elseedawy M, Lee S, Foster N, Soo Y, Puan L, Dennis R, Goradia H, Qureshi A, Osman S, Reeves T, Dinsmore L, Marsden M, Lu Q, Pitts-Tucker T, Dunn C, Walford R, Heathcote E, Martin R, Pericleous A, Brzyska K, Reid K, Williams M, Wetherall N, McAleer E, Thomas D, Kiff R, Milne S, Holmes M, Bartlett J, Lucas de Carvalho J, Bloomfield T, Tongo F, Bremner R, Yong N, Atraszkiewicz B, Mehdi A, Tahir M, Sherliker G, Tear A, Pandey A, Broyd A, Omer H, Raphael M, Chaudhry W, Shahidi S, Jawad A, Gill C, Fisher IH, Adeleja I, Clark I, Aidoo-Micah G, Stather P, Salam G, Glover T, Deas G, Sim N, Obute R, Wynell-Mayow W, Sait M, Mitha N, de Bernier G, Siddiqui M, Shaunak R, Wali A, Cuthbert G, Bhudia R, Webb E, Shah S, Ansari N, Perera M, Kelly N, McAllister R, Stanley G, Keane C, Shatkar V, Maxwell-Armstrong C, Henderson L, Maple N, Manson R, Adams R, Semple E, Mills M, Daoub A, Marsh A, Ramnarine A, Hartley J, Malaj M, Jewell P, Whatling E, Hitchen N, Chen M, Goh B, Fern J, Rogers S, Derbyshire L, Robertson D, Abuhussein N, Deekonda P, Abid A, Harrison P, Aildasani L, Turley H, Sherif M, Pandey G, Filby J, Johnston A, Burke E, Mohamud M, Gohil K, Tsui A, Singh R, Lim S, O'Sullivan K, McKelvey L, O'Neill S, Roberts H, Brown F, Cao Y, Buckle R, Liew Y, Sii S, Ventre C, Graham C, Filipescu T, Yousif A, Dawar R, Wright A, Peters M, Varley R, Owczarek S, Hartley S, Khattak M, Iqbal A, Ali M, Durrani B, Narang Y, Bethell G, Horne L, Pinto R, Nicholls K, Kisyov I, Torrance H, English W, Lakhani S, Ashraf S, Venn M, Elangovan V, Kazmi Z, Brecher J, Sukumar S, Mastan A, Mortimer A, Parker J, Boyle J, Elkawafi M, Beckett J, Mohite A, Narain A, Mazumdar E, Sreh A, Hague A, Weinberg D, Fletcher L, Steel M, Shufflebotham H, Masood M, Sinha Y, Jenvey C, Kitt H, Slade R, Craig A, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher S, Hewitt C, Stoddart M, Kerai A, Trist A, Cole S, Knight C, Stevens S, Cooper G, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins T, Reehal R, Bookless L, McLean R, Stone E, Wright E, Abdikadir H, Roberts C, Spence O, Srikantharajah M, Ruiz E, Matthews J, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani S, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith D, Mistry B, Hickling S, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Patel B, Carter D, Khonsari P, Burgess A, Kong C, Ponweera A, Cody A, Tan Y, Ng A, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh A, McKerr C, Edison M, Patel B, Dear K, Hardy M, Williams P, Hassan S, Sajjad U, O'Neill E, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo S, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim J, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith A, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui Z, Lim S, Piquet A, Anderson S, McCormack D, Gulati J, Ibrahim A, Murray S, Walsh S, McGrath A, Ziprin P, Chua E, Lou C, Bloomer J, Paine H, Osei-Kuffour D, White C, Szczap A, Gokani S, Patel K, Malys M, Reed A, Torlot G, Cumber E, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye M, Cheung F, Coffey D, Heer R, Singh S, Seager E, Cumming S, Suresh R, Verma S, Ptacek I, Gwozdz A, Yang T, Khetarpal A, Shumon S, Fung T, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor B, Shanahan D, Yan A, Jafree D, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis P, Miranda B, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates J, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett R, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee J, Abdulmajid A, Chung A, Warwick H, Livesey A, Holton P, Theodoreson M, Jenkin S, Turner J, Entwisle J, Marchal S, O'Connor S, Blege H, Aithie J, Sabine L, Stewart G, Jackson S, Kishore A, Lankage C, Acquaah F, Joyce H, McKevitt K, Coffey C, Fawaz A, Dolbec K, O'Sullivan D, Geraghty J, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill P, Harbhajan Singh G, Loughran D, Golding D, Keeling R, Williams R, Whitham R, Yoganathan S, Nachiappan R, Egan R, Owasil R, Kwan M, He A, Goh R, Bhome R, Wilson H, Teoh P, Raji K, Jayakody N, Matthams J, Chong J, Luk C, Greig R, Trail M, Charalambous G, Rocke A, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown E, Khanijau R, Gandhi K, Morris S, Boulton A, Chandan N, Barthorpe A, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer C, Clarke A, Heskin J, Hurst P, Farmer J, O'Flynn L, Doan L, Shuker B, Stott G, Vithanage N, Hoban K, Nesargikar P, Kennedy H, Grossart C, Tan E, Roy C, Sim P, Leslie K, Sim D, Abul M, Cody N, Tay A, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing V, Mills H, Li M, Barrow T, Balaji S, Jordan H, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi A, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison C, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie H, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Ghaffar MKA. Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study. Br J Anaesth 2019; 122:42-50. [PMID: 30579405 DOI: 10.1016/j.bja.2018.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. METHODS This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. RESULTS Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. CONCLUSIONS After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.
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Minosse S, Pisano A, Petrarca M, Favetta M, Romano A, Summa S, Castelli E. 293. Exploring the biomechanical constraints in different pathologies with gait analysis. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.302] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Schirinzi T, Vasco G, Aiello C, Rizzo C, Sancesario A, Romano A, Favetta M, Petrarca M, Paone L, Castelli E, Bertini ES, Cappa M. Natural history of a cohort of ABCD1 variant female carriers. Eur J Neurol 2018; 26:326-332. [PMID: 30295399 DOI: 10.1111/ene.13816] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 10/03/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND PURPOSE The therapeutic scenario of X-linked adrenoleukodystrophy (X-ALD) is rapidly changing. Whereas the disease is well characterized in men, the condition remains to be fully clarified in women carrying ATP binding cassette subfamily D member 1 (ABCD1) variants. Specifically, data on clinical progression are needed, in order to recommend any appropriate management. The objective of this study was to outline the natural history of a cohort of untreated ABCD1 heterozygous female carriers. METHODS Longitudinal data from a single-center population of 60 carriers were retrospectively reviewed. Demographics, anthropometrics, serum very long chain fatty acid (VLCFA) levels, clinical parameters and the Adult ALD Clinical Score (AACS) were collected from every recorded visit in a 7-year period and analyzed to define the phenotype modifications, to determine factors associated with clinical features, and to estimate the annual progression rate and the subsequent sample size for interventional trials. RESULTS Thirty-two patients were eligible for the study, and 59.4% were symptomatic at baseline. Clinical severity worsens with age which increases risk of symptom onset, the cut-off of 41 years being crucial for phenoconversion. VLCFA levels were not predictive and did not change over time. Symptomatic carriers were followed up for 3.45 ± 2.1 years. The AACS increased at an annual rate of 0.24 points. The estimated sample size for 30% reduction in annual progression at 80% power was 272. CONCLUSIONS This study provides data on the natural disease progression of untreated ABCD1 heterozygous female carriers, demonstrating the relevance of aging. The estimated annual increase of the AACS will be useful for future interventional studies.
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Affiliation(s)
- T Schirinzi
- Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Rome, Italy.,Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - G Vasco
- Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - C Aiello
- Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - C Rizzo
- Division of Metabolism and Research Unit of Metabolic Biochemistry, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - A Sancesario
- Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Rome, Italy.,Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - A Romano
- Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - M Favetta
- Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - M Petrarca
- Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - L Paone
- Unit of Endocrinology, Department of Pediatrics, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - E Castelli
- Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - E S Bertini
- Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - M Cappa
- Unit of Endocrinology, Department of Pediatrics, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
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Schirinzi T, Romano A, Favetta M, Sancesario A, Burattini R, Summa S, Della Bella G, Castelli E, Bertini E, Petrarca M, Vasco G. Non-invasive Focal Mechanical Vibrations Delivered by Wearable Devices: An Open-Label Pilot Study in Childhood Ataxia. Front Neurol 2018; 9:849. [PMID: 30356679 PMCID: PMC6189288 DOI: 10.3389/fneur.2018.00849] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 08/03/2018] [Accepted: 09/21/2018] [Indexed: 11/13/2022] Open
Abstract
Non-invasive focal mechanical vibrations (NIFMV) now represent a strategy of increasing interest to improve motor control in different neurological diseases. Nanotechnology allowed the creation of wearable devices transforming thermal variations into mechanical energy with focal vibrations. This kind of wearable stimulators (WS) has produced encouraging preliminary results when used in the treatment of movement disorders and ataxia in adults. In this open label pilot study we first evaluated the feasibility, safety and effectiveness of NIFMV by WS in a cohort of 10 patients with childhood ataxia, a phenomenological category including different conditions still lacking of effective symptomatic therapies. Through the assessment of both clinical rating scales and spatio-temporal gait parameters via standardized gait analysis, we observed that a 4 weeks long treatment with WS Equistasi® was safe and provided significantly different effects in stride features of patients with slow/non-progressive cerebellar ataxia and Friedreich's Ataxia. Although limited by the sample size, the absence of a placebo-controlled group, the poor compliance of enrolled population to the original experimental design and the partial accuracy of outcome measures in pediatric subjects, we suggest that NIFMV by WS could support locomotion of patients with childhood slow/non-progressive cerebellar ataxia with preserved sensory system and no signs of peripheral neuropathy. Future studies are definitely necessary to confirm these preliminary results and define criteria for successful NIFMV-based treatment
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Affiliation(s)
- Tommaso Schirinzi
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy.,Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Alberto Romano
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | - Martina Favetta
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | - Andrea Sancesario
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy.,Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Riccardo Burattini
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | - Susanna Summa
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Enrico Castelli
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | - Enrico Bertini
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | - Maurizio Petrarca
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | - Gessica Vasco
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
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Curcio A, Dolci V, Lupi S, Petrarca M. Terahertz-based retrieval of the spectral phase and amplitude of ultrashort laser pulses. Opt Lett 2018; 43:783-786. [PMID: 29443993 DOI: 10.1364/ol.43.000783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 01/11/2018] [Indexed: 06/08/2023]
Abstract
Terahertz (THz) radiation is of great interest for a variety of applications, e.g., particle accelerations, spectroscopy investigations of quantum systems, and high-field study of materials. One of the most common laser-based processes to produce THz pulses is optical rectification, which transduces an infrared pump laser to the THz domain (0.1-20 THz). In this work, we propose and theoretically describe a method to characterize the amplitude and phase of the electric field of the pump laser pulse relying on THz generation and detection. We demonstrate with a numerical example how THz radiation can be used as diagnostics to characterize laser pulses with temporal length at the femtosecond level.
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Abstract
In this paper, an alternative perspective for the generation of millimetric high-gradient resonant plasma waves is discussed. This method is based on the plasma-wave excitation by energetic single-cycle THz pulses whose temporal length is comparable to the plasma wavelength. The excitation regime discussed in this paper is the quasi-nonlinear regime that can be achieved when the normalized vector potential of the driving THz pulse is on the order of unity. To investigate this regime and determine the strength of the excited electric fields, a Particle-In-Cell (PIC) code has been used. It has been found that by exploiting THz pulses with characteristics currently available in laboratory, longitudinal electron plasma waves with electric gradients up to hundreds MV/m can be obtained. The mm-size nature of the resonant plasma wave can be of great utility for an acceleration scheme in which high-brightness electron bunches are injected into the wave to undergo a strong acceleration. The long-size nature of the acceleration bucket with respect to the short length of the electron bunches can be handled in a more robust manner in comparison with the case when micrometric waves are employed.
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Affiliation(s)
- A Curcio
- Department of Basic and Applied Sciences for Engineering (SBAI), "Sapienza" University of Rome, Via A. Scarpa 14, 00161, Rome, Italy.,INFN-LNF, via Enrico Fermi 40, 00044, Frascati, Italy
| | - A Marocchino
- Department of Basic and Applied Sciences for Engineering (SBAI), "Sapienza" University of Rome, Via A. Scarpa 14, 00161, Rome, Italy.,INFN-LNF, via Enrico Fermi 40, 00044, Frascati, Italy
| | - V Dolci
- Department of Basic and Applied Sciences for Engineering (SBAI), "Sapienza" University of Rome, Via A. Scarpa 14, 00161, Rome, Italy.,Roma1-INFN, P.le Aldo Moro, 2, 00185, Rome, Italy
| | - S Lupi
- Roma1-INFN, P.le Aldo Moro, 2, 00185, Rome, Italy.,Department of Physics, "Sapienza" University of Rome, Piazzale A. Moro 2, I-00185, Rome, Italy
| | - M Petrarca
- Department of Basic and Applied Sciences for Engineering (SBAI), "Sapienza" University of Rome, Via A. Scarpa 14, 00161, Rome, Italy. .,Roma1-INFN, P.le Aldo Moro, 2, 00185, Rome, Italy.
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49
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Benedetti MG, Beghi E, De Tanti A, Cappozzo A, Basaglia N, Cutti AG, Cereatti A, Stagni R, Verdini F, Manca M, Fantozzi S, Mazzà C, Camomilla V, Campanini I, Castagna A, Cavazzuti L, Del Maestro M, Croce UD, Gasperi M, Leo T, Marchi P, Petrarca M, Piccinini L, Rabuffetti M, Ravaschio A, Sawacha Z, Spolaor F, Tesio L, Vannozzi G, Visintin I, Ferrarin M. SIAMOC position paper on gait analysis in clinical practice: General requirements, methods and appropriateness. Results of an Italian consensus conference. Gait Posture 2017; 58:252-260. [PMID: 28825997 DOI: 10.1016/j.gaitpost.2017.08.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 07/31/2017] [Accepted: 08/02/2017] [Indexed: 02/06/2023]
Abstract
Gait analysis is recognized as a useful assessment tool in the field of human movement research. However, doubts remain on its real effectiveness as a clinical tool, i.e. on its capability to change the diagnostic-therapeutic practice. In particular, the conditions in which evidence of a favorable cost-benefit ratio is found and the methodology for properly conducting and interpreting the exam are not identified clearly. To provide guidelines for the use of Gait Analysis in the context of rehabilitation medicine, SIAMOC (the Italian Society of Clinical Movement Analysis) promoted a National Consensus Conference which was held in Bologna on September 14th, 2013. The resulting recommendations were the result of a three-stage process entailing i) the preparation of working documents on specific open issues, ii) the holding of the consensus meeting, and iii) the drafting of consensus statements by an external Jury. The statements were formulated based on scientific evidence or experts' opinion, when the quality/quantity of the relevant literature was deemed insufficient. The aim of this work is to disseminate the consensus statements. These are divided into 13 questions grouped in three areas of interest: 1) General requirements and management, 2) Methodological and instrumental issues, and 3) Scientific evidence and clinical appropriateness. SIAMOC hopes that this document will contribute to improve clinical practice and help promoting further research in the field.
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Affiliation(s)
| | - Ettore Beghi
- IRCCS Istituto di Ricerche Farmacologiche, Milano, Italy
| | | | - Aurelio Cappozzo
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Italy
| | | | | | - Andrea Cereatti
- POLCOMING Department, Bioengineering unit, University of Sassari, Italy
| | - Rita Stagni
- Department of Electric, Electronic and Information Engineering "Guglielmo Marconi" - DEI Università di Bologna, Italy
| | - Federica Verdini
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Mario Manca
- Azienda Ospedaliero-Universitaria di Ferrara, Italy
| | - Silvia Fantozzi
- Department of Electric, Electronic and Information Engineering "Guglielmo Marconi" - DEI Università di Bologna, Italy
| | - Claudia Mazzà
- Department of Mechanical Engineering and Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, UK
| | - Valentina Camomilla
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Italy
| | - Isabella Campanini
- Motion Analysis Laboratory - Rehab. Dept, AUSL Reggio Emilia and Dept. of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | | | | | | | - Ugo Della Croce
- POLCOMING Department, Bioengineering unit, University of Sassari, Italy
| | - Marco Gasperi
- Ospedale Riabilitativo Villa Rosa, Azienda Provinciale Servizi Sanitari di Trento, Italy
| | - Tommaso Leo
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Pia Marchi
- Azienda Ospedaliero-Universitaria di Ferrara, Italy
| | | | | | | | | | - Zimi Sawacha
- Department of Information Engineering, University of Padova, Italy
| | - Fabiola Spolaor
- Department of Information Engineering, University of Padova, Italy
| | - Luigi Tesio
- Università degli Studi and Istituto Auxologico Italiano-IRCCS, Milano, Italy
| | - Giuseppe Vannozzi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Italy
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50
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Michot J, Bouabdallah R, Doorduijn J, Vitolo U, Chiappella A, Kersten M, Zinzani P, Sarmiento R, Mosulen S, Petrarca M, Pourdehnad M, Hege K, Yang Z, Nikolova Z, Ribrag V. PHASE IB STUDY OF CC-122 IN COMBINATION WITH OBINUTUZUMAB (GA101): RELAPSED OR REFRACTORY (R/R) PATIENTS WITH B-CELL NON-HODGKIN LYMPHOMAS (NHL). Hematol Oncol 2017. [DOI: 10.1002/hon.2437_37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- J.M. Michot
- Hematology; Institut Gustave Roussy; Villejuif France
| | - R. Bouabdallah
- Department of Hematology; Institut Paoli-Calmettes; Marseilles France
| | - J.K. Doorduijn
- Hematology; Erasmus MC Cancer Institute; Rotterdam Netherlands
| | - U. Vitolo
- Dipartimento di Oncologia ed Ematologia; Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino; Torino Italy
| | - A. Chiappella
- Dipartimento di Oncologia ed Ematologia; Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino; Torino Italy
| | - M.J. Kersten
- Hematology; Academic Medical Center; Amsterdam Netherlands
| | - P.L. Zinzani
- Institute of Hematology "Seràgnoli"; University of Bologna; Bologna Italy
| | - R. Sarmiento
- Translational Development; Celgene Institute for Translational Research Europe; Seville Spain
| | - S. Mosulen
- Translational Development; Celgene Institute for Translational Research Europe; Seville Spain
| | - M. Petrarca
- Translational Medicine; Celgene Corporation; San Francisco California USA
| | - M. Pourdehnad
- Translational Medicine; Celgene Corporation; San Francisco California USA
| | - K. Hege
- Translational Medicine; Celgene Corporation; San Francisco California USA
| | - Z. Yang
- BioStats, Celgene Corporation; Berkeley Heights; New Jersey USA
| | - Z. Nikolova
- Executive Research; Celgene Institute for Translational Research Europe; Seville Spain
| | - V. Ribrag
- Hematology; Institut Gustave Roussy; Villejuif France
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