Publications by authors named "Germana Cappellini"

Article Synopsis
  • Cerebral Palsy (CP) significantly affects children's ability to walk, and using robotic assistive devices like the Moonwalker exoskeleton can improve mobility and quality of life.
  • A study involving 22 children with severe gait impairments showed that after 20 training sessions and five months of home use, many exhibited improved walking endurance and engaging arm movements.
  • The Moonwalker was found to be beneficial in facilitating home-based walking activities, enhancing social interactions and overall development, while also receiving positive feedback from families.
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  • - Exoskeletons are increasingly used for helping children with neurological disorders improve their gait, but evaluating their effectiveness remains complex due to impacts on sensorimotor interactions and potential gait abnormalities.
  • - This study explored how a specific exoskeleton affected muscle activity and spinal motor output in children during gait rehabilitation, focusing on the neuromechanics involved.
  • - Results indicated that even at slower walking speeds, muscle activation levels during exoskeleton use were similar to normal walking, suggesting that children's locomotor systems actively engaged during exoskeleton-assisted stepping.
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  • - The location of motoneurons in the spinal cord is shaped by evolution and function to improve motor control and reflexive responses, particularly in relation to daily movements like walking.
  • - This article reviews two decades of research on spinal motoneuron activation during locomotion, highlighting how factors like child development, aging, and neurological disorders affect spinal activity.
  • - Understanding the relationship between motoneuron activity and gait mechanics can enhance neuroprosthetics and therapies for individuals with walking difficulties.
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  • - The study investigates how children with cerebral palsy (CP) adjust their locomotion when changing direction from forward to sideways, revealing insights into their mobility challenges compared to typically developing (TD) children.
  • - Results show that only about two-thirds of CP participants could successfully step sideways, often defaulting to forward movements and exhibiting poor trunk rotation and limb coordination.
  • - The findings suggest that sideways locomotion, along with backward movement, could be beneficial for rehabilitation, as it encourages children with CP to adapt to new movement tasks and improve their overall motor skills.
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Introduction: Children start to run after they master walking. How running develops, however, is largely unknown.

Methods: We assessed the maturity of running pattern in two very young, typically developing children in a longitudinal design spanning about three years.

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When does modular control of locomotion emerge during human development? One view is that modularity is not innate, being learnt over several months of experience. Alternatively, the basic motor modules are present at birth, but are subsequently reconfigured due to changing brain-body-environment interactions. One problem in identifying modular structures in stepping infants is the presence of noise.

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Article Synopsis
  • Recent research has shown that while kinematic and kinetic measurements are useful for assessing walking performance in exoskeletons, they fall short in providing insight into neural control strategies and muscle coordination.
  • The PEPATO software has been developed as a benchmarking tool to evaluate changes in spinal cord activity during walking in exoskeletons, correlating this data with normal walking references.
  • An example demonstrated the software's capability to analyze EMG activity during walking in a specially designed exoskeleton, revealing significant insights into muscle activation patterns and spinal motor control, crucial for rehabilitation.
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Locomotor movements are accommodated to various surface conditions by means of specific locomotor adjustments. This study examined underlying age-related differences in neuromuscular control during level walking and on a positive or negative slope, and during stepping upstairs and downstairs. Ten elderly and eight young adults walked on a treadmill at two different speeds and at three different inclinations (0°, +6°, and -6°).

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Previous studies found significant modification in spatiotemporal parameters of backward walking in healthy older adults, but the age-related changes in the neuromuscular control have been considered to a lesser extent. The present study compared the intersegmental coordination, muscle activity and corresponding modifications of spinal montoneuronal output during both forward and backward walking in young and older adults. Ten older and ten young adults walked forward and backward on a treadmill at different speeds.

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Surface electromyography (sEMG) can be used to assess the integrity of the neuromuscular system and its impairment in neurological disorders. Here we will consider several issues related to the current clinical applications, difficulties and limited usage of sEMG for the assessment and rehabilitation of children with cerebral palsy. The uniqueness of this methodology is that it can determine hyperactivity or inactivity of selected muscles, which cannot be assessed by other methods.

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The first years of life represent an important phase of maturation of the central nervous system, processing of sensory information, posture control and acquisition of the locomotor function. Cerebral palsy (CP) is the most common group of motor disorders in childhood attributed to disturbances in the fetal or infant brain, frequently resulting in impaired gait. Here we will consider various findings about functional maturation of the locomotor output in early infancy, and how much the dysfunction of gait in children with CP can be related to spinal neuronal networks vs.

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How does gait-specific pattern generation evolve in early infancy? The idea that neural and biomechanical mechanisms underlying mature walking and running differ to some extent and involve distinct spinal and supraspinal neural circuits is supported by various studies. Here we consider the issue of human gaits from the developmental point of view, from neonate stepping to adult mature gaits. While differentiating features of the walk and run are clearly distinct in adults, the gradual and progressive developmental bifurcation between the different gaits suggests considerable sharing of circuitry.

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Article Synopsis
  • Mature locomotion involves complex spinal drives that create distinct patterns of muscle activation during movement, but how these patterns develop is still uncertain.
  • Newborns display two types of movement: spontaneous kicking, which is frequent both before and after birth, and weight-bearing stepping, which occurs when they first stand on the ground.
  • The study found that kicking has adult-like activation patterns but lacks stable muscle coordination, while stepping shows fewer patterns with better muscle synergy, suggesting that development in locomotion integrates experiences from both behaviors.
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To investigate how early injuries to developing motor regions of the brain affect different forms of gait, we compared the spatiotemporal locomotor patterns during forward (FW) and backward (BW) walking in children with cerebral palsy (CP). Bilateral gait kinematics and EMG activity of 11 pairs of leg muscles were recorded in 14 children with CP (9 diplegic, 5 hemiplegic; 3.0-11.

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Detailed descriptions of gait impairments have been reported in cerebral palsy (CP), but it is still unclear how maturation of the spinal motoneuron output is affected. Spatiotemporal alpha-motoneuron activation during walking can be assessed by mapping the electromyographic activity profiles from several, simultaneously recorded muscles onto the anatomical rostrocaudal location of the motoneuron pools in the spinal cord, and by means of factor analysis of the muscle activity profiles. Here, we analyzed gait kinematics and EMG activity of 11 pairs of bilateral muscles with lumbosacral innervation in 35 children with CP (19 diplegic, 16 hemiplegic, 2-12 years) and 33 typically developing (TD) children (1-12 years).

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In human and animal locomotion, sensory input is thought to be processed in a phase-dependent manner. Here we use full-field transient visual scene motion toward or away from subjects walking on a treadmill. Perturbations were presented at three phases of walking to test 1) whether phase dependence is observed for visual input and 2) whether the nature of phase dependence differs across body segments.

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Motion of the upper limbs is often coupled to that of the lower limbs in human bipedal locomotion. It is unclear, however, whether the functional coupling between upper and lower limbs is bi-directional, i.e.

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Gravity reduction affects the energetics and natural speed of walking and running. But, it is less clear how segmental coordination is altered. Various devices have been developed in the past to study locomotion in simulated reduced gravity.

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Human stepping movements emerge in utero and show several milestones during development to independent walking. Recently, imaging has become an essential tool for investigating the development and function of pattern generation networks in the spinal cord. Here we examine the development of the spinal segmental output by mapping the distribution of motoneuron activity in the lumbosacral spinal cord during stepping in newborns, toddlers, preschoolers, and adults.

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Background: On Earth only a few legged species, such as water strider insects, some aquatic birds and lizards, can run on water. For most other species, including humans, this is precluded by body size and proportions, lack of appropriate appendages, and limited muscle power. However, if gravity is reduced to less than Earth's gravity, running on water should require less muscle power.

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How rudimentary movements evolve into sophisticated ones during development remains unclear. It is often assumed that the primitive patterns of neural control are suppressed during development, replaced by entirely new patterns. Here we identified the basic patterns of lumbosacral motoneuron activity from multimuscle recordings in stepping neonates, toddlers, preschoolers, and adults.

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During gradual speed changes, humans exhibit a sudden discontinuous switch from walking to running at a specific speed, and it has been suggested that different gaits may be associated with different functioning of neuronal networks. In this study we recorded the EMG activity of leg muscles at slow increments and decrements in treadmill belt speed and at different levels of body weight unloading. In contrast to normal walking at 1 g, at lower levels of simulated gravity (<0.

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Gravity has a strong effect on gait and the speed of gait transitions. A gait has been defined as a pattern of locomotion that changes discontinuously at the transition to another gait. On Earth, during gradual speed changes, humans exhibit a sudden discontinuous switch from walking to running at a specific speed.

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During the evolution of bipedal modes of locomotion, a sequential rostrocaudal activation of trunk muscles due to the undulatory body movements was replaced by more complex and discrete bursts of activity. Nevertheless, the capacity for segmental rhythmogenesis and the rostrocaudal propagation of spinal cord activity has been conserved. In humans, motoneurons of different muscles are arranged in columns, with a specific grouping of muscles at any given segmental level.

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Vision can improve bipedal upright stability during standing and locomotion. However, during locomotion, vision supports additional behaviors such as gait cycle modulation, navigation, and obstacle avoidance. Here, we investigate how the multiple roles of vision are reflected in the dynamics of trunk control as the neural control problem changes from a fixed to a moving base of support.

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