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Tieri G, Morone G, Paolucci S, Iosa M. Virtual reality in cognitive and motor rehabilitation: facts, fiction and fallacies. Expert Rev Med Devices 2018; 15:107-117. [DOI: 10.1080/17434440.2018.1425613] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Gaetano Tieri
- SCNLab, Fondazione Santa Lucia IRCCS, Rome, Italy
- University of Rome Unitelma Sapienza, Italy
| | - Giovanni Morone
- Clinical Laboratory of Experimental Neurorehabilitation, Fondazione Santa Lucia IRCCS, Rome, Italy
| | - Stefano Paolucci
- Clinical Laboratory of Experimental Neurorehabilitation, Fondazione Santa Lucia IRCCS, Rome, Italy
| | - Marco Iosa
- Clinical Laboratory of Experimental Neurorehabilitation, Fondazione Santa Lucia IRCCS, Rome, Italy
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102
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Vaughan-Graham J. Clinician's Commentary on Richards et al. 1. Physiother Can 2018; 70:231-232. [PMID: 30311918 PMCID: PMC6158563 DOI: 10.3138/ptc.2016-97-cc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Julie Vaughan-Graham
- Physiotherapist, Physio-Logic Rehabilitation Services; Scientific Associate, Toronto Rehab Research Institute; and Adjunct Lecturer, Department of Physical Therapy, University of Toronto, Toronto;
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103
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What does best evidence tell us about robotic gait rehabilitation in stroke patients: A systematic review and meta-analysis. J Clin Neurosci 2017; 48:11-17. [PMID: 29208476 DOI: 10.1016/j.jocn.2017.10.048] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 10/11/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Studies about electromechanical-assisted devices proved the validity and effectiveness of these tools in gait rehabilitation, especially if used in association with conventional physiotherapy in stroke patients. OBJECTIVE The aim of this study was to compare the effects of different robotic devices in improving post-stroke gait abnormalities. METHODS A computerized literature research of articles was conducted in the databases MEDLINE, PEDro, COCHRANE, besides a search for the same items in the Library System of the University of Parma (Italy). We selected 13 randomized controlled trials, and the results were divided into sub-acute stroke patients and chronic stroke patients. We selected studies including at least one of the following test: 10-Meter Walking Test, 6-Minute Walk Test, Timed-Up-and-Go, 5-Meter Walk Test, and Functional Ambulation Categories. RESULTS Stroke patients who received physiotherapy treatment in combination with robotic devices, such as Lokomat or Gait Trainer, were more likely to reach better results, compared to patients who receive conventional gait training alone. Moreover, electromechanical-assisted gait training in association with Functional Electrical Stimulations produced more benefits than the only robotic treatment (-0.80 [-1.14; -0.46], p > .05). CONCLUSIONS The evaluation of the results confirm that the use of robotics can positively affect the outcome of a gait rehabilitation in patients with stroke. The effects of different devices seems to be similar on the most commonly outcome evaluated by this review.
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104
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Espinoza EM, Larsen-Clinton JM, Krzeszewski M, Darabedian N, Gryko DT, Vullev VI. Bioinspired approach toward molecular electrets: synthetic proteome for materials. PURE APPL CHEM 2017. [DOI: 10.1515/pac-2017-0309] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AbstractMolecular-level control of charge transfer (CT) is essential for both, organic electronics and solar-energy conversion, as well as for a wide range of biological processes. This article provides an overview of the utility of local electric fields originating from molecular dipoles for directing CT processes. Systems with ordered dipoles, i.e. molecular electrets, are the centerpiece of the discussion. The conceptual evolution from biomimicry to biomimesis, and then to biological inspiration, paves the roads leading from testing the understanding of how natural living systems function to implementing these lessons into optimal paradigms for specific applications. This progression of the evolving structure-function relationships allows for the development of bioinspired electrets composed of non-native aromatic amino acids. A set of such non-native residues that are electron-rich can be viewed as a synthetic proteome for hole-transfer electrets. Detailed considerations of the electronic structure of an individual residue prove of key importance for designating the points for optimal injection of holes (i.e. extraction of electrons) in electret oligomers. This multifaceted bioinspired approach for the design of CT molecular systems provides unexplored paradigms for electronic and energy science and engineering.
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Affiliation(s)
- Eli M. Espinoza
- Department of Chemistry, University of California, Riverside, CA 92521, USA
| | | | - Maciej Krzeszewski
- Department of Bioengineering, University of California, Riverside, CA 92521, USA
- Institute of Organic Chemistry, Polish Academy of Sciences, Kasprzaka 44-52, 01-224 Warsaw, Poland
| | - Narek Darabedian
- Department of Bioengineering, University of California, Riverside, CA 92521, USA
| | - Daniel T. Gryko
- Institute of Organic Chemistry, Polish Academy of Sciences, Kasprzaka 44-52, 01-224 Warsaw, Poland
| | - Valentine I. Vullev
- Department of Chemistry, University of California, Riverside, CA 92521, USA
- Department of Bioengineering, University of California, Riverside, CA 92521, USA
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105
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Russo M, Dattola V, Logiudice AL, Ciurleo R, Sessa E, De Luca R, Bramanti P, Bramanti A, Naro A, Calabrò RS. The role of Sativex in robotic rehabilitation in individuals with multiple sclerosis: Rationale, study design, and methodology. Medicine (Baltimore) 2017; 96:e8826. [PMID: 29145345 PMCID: PMC5704890 DOI: 10.1097/md.0000000000008826] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Currently, none of the available multiple sclerosis (MS) disease-modifying medications has been shown to stop or reverse gait disability. Recently, the nabiximols has been tested for the treatment of spasticity and walking impairment in MS. Nabiximols (trade name Sativex) is an oromucosal spray formulation containing 1:1 fixed ratio of delta-9-tetrahydrocannabinol and cannabidiol derived from cloned Cannabis sativa L. plant. METHOD AND ANALYSIS A single-center, prospective, parallel design, single-blind trial will be conducted at the IRCCS Neurolesi "Bonino-Pulejo" (Italy) involving MS patients affected by spasticity and undergoing a Robotic Rehabilitation training. The aim of the study is to clarify the role of Sativex coupled to a robotic neurehabilitation training in MS patients in improving motor outcomes, by means of clinical, kinematic, and neurophysiological measures. Patients will be randomly divided in 2 groups: one taking only an oral antispastic drug and the other with Sativex in add-on. After 1 month, we will evaluate the response to Sativex (responder patients' amelioration >20% at MRS score) enrolling into the study the first 20 patients with a good response to Sativex, whereas other 20 no-responder individuals will continue their antispastic drug. All the 40 subjects, were divided into 2 groups (A: Sativex + Lokomat Training, and B: other antispastic+Lokomat Training), will perform a neurorobotic-assisted gait training (each session will last at least 45 minutes, 3 times per week, for a total of 20 sessions). All the patients will undergo a complete physical and neurological examination at baseline, at the end of the robotic training (T1), and 30 days after the end of the neurorehabilitation training (T2).
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106
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Exploration of Two Training Paradigms Using Forced Induced Weight Shifting With the Tethered Pelvic Assist Device to Reduce Asymmetry in Individuals After Stroke: Case Reports. Am J Phys Med Rehabil 2017; 96:S135-S140. [PMID: 28661914 DOI: 10.1097/phm.0000000000000779] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Many robotic devices in rehabilitation incorporate an assist-as-needed haptic guidance paradigm to promote training. This error reduction model, while beneficial for skill acquisition, could be detrimental for long-term retention. Error augmentation (EA) models have been explored as alternatives. A robotic Tethered Pelvic Assist Device has been developed to study force application to the pelvis on gait and was used here to induce weight shift onto the paretic (error reduction) or nonparetic (error augmentation) limb during treadmill training. The purpose of these case reports is to examine effects of training with these two paradigms to reduce load force asymmetry during gait in two individuals after stroke (>6 mos). Participants presented with baseline gait asymmetry, although independent community ambulators. Participants underwent 1-hr trainings for 3 days using either the error reduction or error augmentation model. Outcomes included the Borg rating of perceived exertion scale for treatment tolerance and measures of force and stance symmetry. Both participants tolerated training. Force symmetry (measured on treadmill) improved from pretraining to posttraining (36.58% and 14.64% gains), however, with limited transfer to overground gait measures (stance symmetry gains of 9.74% and 16.21%). Training with the Tethered Pelvic Assist Device device proved feasible to improve force symmetry on the treadmill irrespective of training model. Future work should consider methods to increase transfer to overground gait.
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107
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Naro A, Leo A, Russo M, Casella C, Buda A, Crespantini A, Porcari B, Carioti L, Billeri L, Bramanti A, Bramanti P, Calabrò RS. Breakthroughs in the spasticity management: Are non-pharmacological treatments the future? J Clin Neurosci 2017; 39:16-27. [DOI: 10.1016/j.jocn.2017.02.044] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 02/12/2017] [Indexed: 12/16/2022]
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Biassoni V, Massimino M, Oprandi MC, Clerici CA, Veneroni L, Corti C, Schiavello E, Spreafico F, Poggi G. Rehabilitation for children and young people surviving a brain tumor, and their transition to adult services: the main challenges. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/23809000.2017.1321957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Veronica Biassoni
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumosri, Milano, Italy
| | - Maura Massimino
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumosri, Milano, Italy
| | - Maria Chiara Oprandi
- Pediatric Neuro-oncology Rehabilitation, IRCCS Eugenio Medea, Bosisio Parini (LC), Italy
| | - Carlo Alfredo Clerici
- Psychology Unit, Fondazione IRCCS Istituto Nazionale dei tumori, Milano, Italy
- Department of Oncology and Emato-Oncology, Università Statale, Milano, Italy
| | - Laura Veneroni
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumosri, Milano, Italy
| | - Claudia Corti
- Pediatric Neuro-oncology Rehabilitation, IRCCS Eugenio Medea, Bosisio Parini (LC), Italy
| | | | - Filippo Spreafico
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumosri, Milano, Italy
| | - Geraldina Poggi
- Pediatric Neuro-oncology Rehabilitation, IRCCS Eugenio Medea, Bosisio Parini (LC), Italy
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109
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Buchman AS, Boyle PA, Bennett DA. Expanding the Toolkit for Studies of Aging. JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE 2017; 4:69-70. [PMID: 29177136 DOI: 10.14283/jpad.2017.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A S Buchman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612
| | - P A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612
| | - D A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612
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110
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Calabrò RS, Russo M, Naro A, De Luca R, Leo A, Tomasello P, Molonia F, Dattola V, Bramanti A, Bramanti P. Robotic gait training in multiple sclerosis rehabilitation: Can virtual reality make the difference? Findings from a randomized controlled trial. J Neurol Sci 2017; 377:25-30. [PMID: 28477702 DOI: 10.1016/j.jns.2017.03.047] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 02/24/2017] [Accepted: 03/28/2017] [Indexed: 01/28/2023]
Abstract
Gait, coordination, and balance may be severely compromised in patients with multiple sclerosis (MS), with considerable consequences on the patient's daily living activities, psychological status and quality of life. For this reason, MS patients may benefit from robotic-rehabilitation and virtual reality training sessions. Aim of the present study was to assess the efficacy of robot-assisted gait training (RAGT) equipped with virtual reality (VR) system in MS patients with walking disabilities (EDSS 4.0 to 5.5) as compared to RAGT without VR. We enrolled 40 patients (randomized into two groups) undergoing forty RAGT±VR sessions over eight weeks. All the patients were assessed at baseline and at the end of the treatment by using specific scales. Effect sizes were very small and non-significant between the groups for Berg Balance Scale (-0.019, CI95% -2.403 to 2.365) and TUG (-0.064, 95%CI -0.408 to 0.536) favoring RAGT+VR. Effects were moderate-to-large and significant for positive attitude (-0.505, 95%CI -3.615 to 2.604) and problem-solving (-0.905, 95%CI -2.113 to 0.302) sub-items of Coping Orientation to Problem Experienced, thus largely favoring RAGT+VR. Our findings show that RAGT combined with VR is an effective therapeutic option in MS patients with walking disability as compared to RAGT without VR. We may hypothesize that VR may strengthen RAGT thanks to the entrainment of different brain areas involved in motor panning and learning.
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Affiliation(s)
| | - Margherita Russo
- IRCCS Centro Neurolesi "Bonino-Pulejo", C.da Casazza SS. 113, Messina, Italy
| | - Antonino Naro
- IRCCS Centro Neurolesi "Bonino-Pulejo", C.da Casazza SS. 113, Messina, Italy
| | - Rosaria De Luca
- IRCCS Centro Neurolesi "Bonino-Pulejo", C.da Casazza SS. 113, Messina, Italy
| | - Antonino Leo
- IRCCS Centro Neurolesi "Bonino-Pulejo", C.da Casazza SS. 113, Messina, Italy
| | | | - Francesco Molonia
- IRCCS Centro Neurolesi "Bonino-Pulejo", C.da Casazza SS. 113, Messina, Italy
| | - Vincenzo Dattola
- IRCCS Centro Neurolesi "Bonino-Pulejo", C.da Casazza SS. 113, Messina, Italy
| | - Alessia Bramanti
- IRCCS Centro Neurolesi "Bonino-Pulejo", C.da Casazza SS. 113, Messina, Italy
| | - Placido Bramanti
- IRCCS Centro Neurolesi "Bonino-Pulejo", C.da Casazza SS. 113, Messina, Italy
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111
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Furnari A, Calabrò RS, De Cola MC, Bartolo M, Castelli A, Mapelli A, Buttacchio G, Farini E, Bramanti P, Casale R. Robotic-assisted gait training in Parkinson's disease: a three-month follow-up randomized clinical trial. Int J Neurosci 2017; 127:996-1004. [DOI: 10.1080/00207454.2017.1288623] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Anna Furnari
- Neurorehabilitation Unit, HABILITA Care & Research Rehabilitation Hospitals, Zingonia di Ciserano (Bergamo), Zingonia, Italy
| | | | | | - Michelangelo Bartolo
- Neurorehabilitation Unit, HABILITA Care & Research Rehabilitation Hospitals, Zingonia di Ciserano (Bergamo), Zingonia, Italy
| | - Alberto Castelli
- Neurorehabilitation Unit, HABILITA Care & Research Rehabilitation Hospitals, Zingonia di Ciserano (Bergamo), Zingonia, Italy
| | - Alessia Mapelli
- Neurorehabilitation Unit, HABILITA Care & Research Rehabilitation Hospitals, Zingonia di Ciserano (Bergamo), Zingonia, Italy
| | - Giampiero Buttacchio
- Neurorehabilitation Unit, HABILITA Care & Research Rehabilitation Hospitals, Zingonia di Ciserano (Bergamo), Zingonia, Italy
| | - Elena Farini
- Neurorehabilitation Unit, HABILITA Care & Research Rehabilitation Hospitals, Zingonia di Ciserano (Bergamo), Zingonia, Italy
| | - Placido Bramanti
- Neurorehabilitation Unit, HABILITA Care & Research Rehabilitation Hospitals, Zingonia di Ciserano (Bergamo), Zingonia, Italy
| | - Roberto Casale
- Neurorehabilitation Unit, HABILITA Care & Research Rehabilitation Hospitals, Zingonia di Ciserano (Bergamo), Zingonia, Italy
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112
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Parallel Robot for Lower Limb Rehabilitation Exercises. Appl Bionics Biomech 2016; 2016:8584735. [PMID: 27799727 PMCID: PMC5070424 DOI: 10.1155/2016/8584735] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 07/29/2016] [Accepted: 08/16/2016] [Indexed: 01/08/2023] Open
Abstract
The aim of this study is to investigate the capability of a 6-DoF parallel robot to perform various rehabilitation exercises. The foot trajectories of twenty healthy participants have been measured by a Vicon system during the performing of four different exercises. Based on the kinematics and dynamics of a parallel robot, a MATLAB program was developed in order to calculate the length of the actuators, the actuators' forces, workspace, and singularity locus of the robot during the performing of the exercises. The calculated length of the actuators and the actuators' forces were used by motion analysis in SolidWorks in order to simulate different foot trajectories by the CAD model of the robot. A physical parallel robot prototype was built in order to simulate and execute the foot trajectories of the participants. Kinect camera was used to track the motion of the leg's model placed on the robot. The results demonstrate the robot's capability to perform a full range of various rehabilitation exercises.
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113
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Neuroprosthetics in amputee and brain injury rehabilitation. Exp Neurol 2016; 287:479-485. [PMID: 27519275 DOI: 10.1016/j.expneurol.2016.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 08/08/2016] [Indexed: 01/07/2023]
Abstract
The goals of rehabilitation medicine programs are to promote health, restore functional impairments and improve quality of life. The field of neuroprosthetics has evolved over the last decade given an improved understanding of neuroscience and the incorporation of advanced biotechnology and neuroengineering in the rehabilitation setting to develop adaptable applications to help facilitate recovery for individuals with amputations and brain injury. These applications may include a simple cognitive prosthetics aid for impaired memory in brain-injured individuals to myoelectric prosthetics arms with artificial proprioceptive feedback for those with upper extremity amputations. The integration of neuroprosthetics into the existing framework of current rehabilitation approaches not only improves quality-of-care and outcomes but help broadens current rehabilitation treatment paradigms. Although, we are in the infancy of the understanding the true benefit of neuroprosthetics and its clinical applications in the rehabilitation setting there is tremendous amount of promise for future research and development of tools to help facilitate recovery and improve quality of life in individuals with disabilities.
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