Dynamic reorganization of TMS-evoked activity in subcortical stroke patients.

Since early days after stroke, the brain undergoes a complex reorganization to allow compensatory mechanisms that promote functional recovery. However, these mechanisms are still poorly understood and there is urgent need to identify neurophysiological markers of functional recovery after stroke. Here we aimed to track longitudinally the time-course of cortical reorganization by measuring for the first time EEG cortical activity evoked by TMS pulses in patients with subcortical stroke.

Clinical features of patients who might benefit more from walking robotic training.

Background: Robotic walking training improves probability to reach an autonomous walking in non-ambulant patients affected by subacute stroke. However, little information is available regarding the prognostic factors for identifying best responder patients. The purpose of the present study is therefore to investigate the clinical features of patients with subacute stroke that might benefit more from robotic walking therapy.

Phi in physiology, psychology and biomechanics: The golden ratio between myth and science.

In recent years, there has been a renewed interest in the use of the so-called golden ratio (Phi, ϕ), an irrational number with fractal properties, used in artworks since V century BC. and now for modelling complex biological structures and functions. This number, in fact, recursively pops-up in human history, from Ancient Greeks to Renaissance, and to contemporary scientific studies.

Virtual reality in cognitive and motor rehabilitation: facts, fiction and fallacies.

Introduction: Over recent decades many researchers and clinicians have started to use Virtual Reality (VR) as a new technology for implementing innovative rehabilitation treatments in cognitive and motor domains. However, the expression 'VR' has often also been improperly used to refer to video games. Further, VR efficacy, often confused with that of video-game exercises, is still debated.

Golden Gait: An Optimization Theory Perspective on Human and Humanoid Walking.

Human walking is a complex task which includes hundreds of muscles, bones and joints working together to deliver harmonic movements with the need of finding equilibrium between moving forward and maintaining stability. Many different computational approaches have been used to explain human walking mechanisms, from pendular model to fractal approaches. A new perspective can be gained from using the principles developed in the field of Optimization theory and in particularly the branch of Game Theory.

The iFST: An instrumented version of the Fukuda Stepping Test for balance assessment.

The maintenance of the upright posture during dynamic balance requires the integration of sensory inputs regulated by the brain. After a neurological event, the assessment of balance control impairments is crucial for supporting health professionals in the design of personalized rehabilitation protocols. A commonly used test to assess balance ability is the Fukuda Stepping Test (FST).

Improvement rate of patients with severe brain injury during post-acute intensive rehabilitation.

Patients with severe acquired brain injury (SABI) may evolve towards different outcomes. The primary aim was to evaluate the clinical evolution of a large population of patients with SABI admitted to post-acute rehabilitation from 2001 to 2016, diagnosed with severe brain injury (GCS ≤ 8) in the acute phase and a coma duration of at least 24 h. The possible changes between the admission time to a post-acute rehabilitation hospital and the discharge time were measured by means of Glasgow Outcome Scale (GOS), Level of Cognitive Functioning (LCF), and Disability Rating Scale (DRS).

Post Soft Care: Italian implementation of a post-stroke checklist software for primary care and identification of unmet needs in community-dwelling patients.

The needs of community-dwelling stroke patients are often not fully addressed. The Global Stroke Community Advisory Panel had developed the Post Stroke Checklist (PSC) with the aim of standardizing long-term stroke assessment and consequently care of patients. PSC has been validated for UK and Singapore, and an Italian version has been proposed.

Multi-sensor assessment of dynamic balance during gait in patients with subacute stroke.

The capacity to maintain upright balance by minimising upper body oscillations during walking, also referred to as gait stability, has been associated with a decreased risk of fall. Although it is well known that fall is a common complication after stroke, no study considered the role of both trunk and head when assessing gait stability in this population. The primary aim of this study was to propose a multi-sensor protocol to quantify gait stability in patients with subacute stroke using gait quality indices derived from pelvis, sternum, and head accelerations.

Harmony as a convergence attractor that minimizes the energy expenditure and variability in physiological gait and the loss of harmony in cerebellar ataxia.

Background: The harmony of the human gait was recently found to be related to the golden ratio value (ϕ). The ratio between the duration of the stance and that of the swing phases of a gait cycle was in fact found to be close to ϕ, which implies that, because of the fractal property of autosimilarity of that number, the gait ratios stride/stance, stance/swing, swing/double support, were not significantly different from one another. We studied a group of patients with cerebellar ataxia to investigate how the differences between their gait ratios and the golden ratio are related to efficiency and stability of their gait, assessed by energy expenditure and stride-to-stride variability, respectively.

Robot-assisted gait training for stroke patients: current state of the art and perspectives of robotics.

In this review, we give a brief outline of robot-mediated gait training for stroke patients, as an important emerging field in rehabilitation. Technological innovations are allowing rehabilitation to move toward more integrated processes, with improved efficiency and less long-term impairments. In particular, robot-mediated neurorehabilitation is a rapidly advancing field, which uses robotic systems to define new methods for treating neurological injuries, especially stroke.

Efficacy of extremely low-frequency magnetic field in fibromyalgia pain: A pilot study.

The purpose of this pilot study was to determine the efficacy of an extremely low-frequency magnetic field (ELF-MF) in decreasing chronic pain in fibromyalgia (FM) patients. Thirty-seven females were recruited and randomized into two groups: one group was first exposed to systemic ELF-MF therapy (100 microtesla, 1 to 80 Hz) and then to sham therapy, and the other group received the opposite sequence of intervention. Pain, FM-related symptoms, and the ability to perform daily tasks were measured using the Visual Analog Scale, Fibromyalgia Impact Questionnaire (FIQ), Fibromyalgia Assessment Scale (FAS), and Health Assessment Questionnaire (HAQ) at baseline, end of first treatment cycle, beginning of second treatment cycle (after 1 mo washout), end of second treatment cycle, and end of 1 mo follow-up.

The efficacy of a preparatory phase of a touch-based approach in treating chronic low back pain: a randomized controlled trial.

Background: Massage therapy is an important element of rehabilitation in the treatment of chronic low back pain (CLBP). The objective of this study was to determine the relative efficacy of massage therapy between traditional massage and a new massage approach for CLBP. We also examined whether any reduction in pain was linked to interoceptive awareness and parasympathetic activation.

Boosting the traditional physiotherapist approach for stroke spasticity using a sensorized ankle foot orthosis: a pilot study.

Background: Spasticity is a motor disorder that is commonly treated manually by a physical therapist (PhT) stretching the muscles. Recent data on learning have demonstrated the importance of human-to-human interaction in improving rehabilitation: cooperative motor behavior engages specific areas of the motor system compared with execution of a task alone.

Objectives: We hypothesize that PhT-guided therapy that involves active collaboration with the patient (Pt) through shared biomechanical visual biofeedback (vBFB) positively impacts learning and performance by the Pt during ankle spasticity treatment.

Overcoming the limitations of the Harmonic Ratio for the reliable assessment of gait symmetry.

The Harmonic Ratio (HR) is an index based on the spectral analysis of lower trunk accelerations that is commonly used to assess the quality of gait. However, it presents several issues concerning reliability and interpretability. As a consequence, the literature provides very different values albeit corresponding to the same populations.

Does robot-assisted gait training improve ambulation in highly disabled multiple sclerosis people? A pilot randomized control trial.

Background: Robotic training is commonly used to assist walking training in patients affected by multiple sclerosis (MS) with non-conclusive results.

Objective: To compare the effect of robot-assisted gait training (RAGT) with that of conventional walking training (CWT) on gait competencies, global ability, fatigue and spasticity in a group of severely affected patients with MS.

Methods: A pilot, single-blind randomized controlled trial was conducted in 43 severe (Expanded Disability Status Scale (EDSS) score of 6-7.

The importance of trunk perception during brace treatment in moderate juvenile idiopathic scoliosis: What is the impact on self-image?

Background: The perception of body image and the deformity of the trunk in patients with adolescent idiopathic scoliosis (AIS) are a silver lining that has yet to be discussed in the relevant literature during brace rehabilitation treatment.

Objective: To determine whether and how the use of the brace changes perception of the trunk in patients with AIS by the drawing test.

Methods: We observed 32 subjects with AIS from our Rehabilitation outpatient clinic and divided them into the brace treatment (BG-16 subjects) and the non-brace treatment (CG-16 subjects).

Wearable inertial sensors for human movement analysis.

Introduction: The present review aims to provide an overview of the most common uses of wearable inertial sensors in the field of clinical human movement analysis.

Areas Covered: Six main areas of application are analysed: gait analysis, stabilometry, instrumented clinical tests, upper body mobility assessment, daily-life activity monitoring and tremor assessment. Each area is analyzed both from a methodological and applicative point of view.

Overground walking training with the i-Walker, a robotic servo-assistive device, enhances balance in patients with subacute stroke: a randomized controlled trial.

Background: Patients affected by mild stroke benefit more from physiological overground walking training than walking-like training performed in place using specific devices. The aim of the study was to evaluate the effects of overground robotic walking training performed with the servo-assistive robotic rollator (i-Walker) on walking, balance, gait stability and falls in a community setting in patients with mild subacute stroke.

Methods: Forty-four patients were randomly assigned to two different groups that received the same therapy in two daily 40-min sessions 5 days a week for 4 weeks.

Improved interoceptive awareness in chronic low back pain: a comparison of Back school versus Feldenkrais method.

Purpose: To determine the efficacy of the Feldenkrais method for relieving pain in patients with chronic low back pain (CLBP) and the improvement of interoceptive awareness.

Method: This study was designed as a single-blind randomized controlled trial. Fifty-three patients with a diagnosis of CLBP for at least 3 months were randomly allocated to the Feldenkrais (mean age 61.

Wii Fit is effective in women with bone loss condition associated with balance disorders: a randomized controlled trial.

The use of exergame for balance competencies was recently explored in women affected by balance ability reduction with non-conclusive results. The aim of the study was to evaluate the efficacy of a supervised exergame performed with the Wii Fit compared to conventional exercises on balance function, quality of life, fear of fall and well-being in women with bone loss. Thirty-eight female participants aged over 65 years, with a bone loss condition, were enrolled and random allocated in the Wii group or control group.

The Three Laws of Neurorobotics: A Review on What Neurorehabilitation Robots Should Do for Patients and Clinicians.

Most studies and reviews on robots for neurorehabilitation focus on their effectiveness. These studies often report inconsistent results. This and many other reasons limit the credit given to these robots by therapists and patients.