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Schirinzi E, Bochicchio MA, Lochmüller H, Vissing J, Jordie-Diaz-Manerae, Evangelista T, Plançon JP, Fanucci L, Marini M, Tonacci A, Mancuso M, Segovia-Kueny S, Toscano A, Angelini C, Schoser B, Sacconi S, Siciliano G. E-Health & Innovation to Overcome Barriers in Neuromuscular Diseases. Report from the 3rd eNMD Congress: Pisa, Italy, 29-30 October 2021. J Neuromuscul Dis 2024:JND230091. [PMID: 38728200 DOI: 10.3233/jnd-230091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
Neuromuscular diseases (NMDs), in their phenotypic heterogeneity, share quite invariably common issues that involve several clinical and socio-economical aspects, needing a deep critical analysis to develop better management strategies. From diagnosis to treatment and follow-up, the development of technological solutions can improve the detection of several critical aspects related to the diseases, addressing both the met and unmet needs of clinicians and patients. Among several aspects of the digital transformation of health and care, this congress expands what has been learned from previous congresses editions on applicability and usefulness of technological solutions in NMDs. In particular the focus on new solutions for remote monitoring provide valuable insights to increase disease-specific knowledge and trigger prompt decision-making. In doing that, several perspectives from different areas of expertise were shared and discussed, pointing out strengths and weaknesses on the current state of the art on topic, suggesting new research lines to advance technology in this specific clinical field.
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Affiliation(s)
- Erika Schirinzi
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | | | - Hanns Lochmüller
- Department of Medicine, Children's Hospital of Eastern Ontario Research Institute, Division of Neurology, The Ottawa Hospital, and Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada
| | - John Vissing
- Copenhagen Neuromuscular Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jordie-Diaz-Manerae
- The John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Neurology Department, Neuromuscular Disorders Unit, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Madrid, Spain
| | - Teresinha Evangelista
- AP-HP, H. Pitié-Salpêtrière, Institut de Myologie, Unité de Morphologie Neuromusculaire, Paris, France
- AP-HP, H. Pitié-Salpêtrière, Centre de référence des maladies neuromusculaires Nord/Est/Ile de France, Paris, France
- Sorbonne Université, INSERM, Institut de Myologie, Centre de Recherche en Myologie, France
| | - Jean-Philippe Plançon
- European Patient Organisation for Dysimmune and Inflammatory Neuropathies (EPODIN) and EURO-NMD Educational board, Paris, France
| | - Luca Fanucci
- Department of Information Engineering, University of Pisa, Pisa, Italy
| | - Marco Marini
- Department of Information Engineering, University of Pisa, Pisa, Italy
| | - Alessandro Tonacci
- Institute of Clinical Physiology, National Research Council - CNR, Pisa, Italy
| | - Michelangelo Mancuso
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | | | - Antonio Toscano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Corrado Angelini
- Department Neurosciences, Padova University School of Medicine, Padova, Italy
| | - Benedikt Schoser
- Department of Neurology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Sabrina Sacconi
- Peripheral Nervous System and Muscle Department, Université Cúte d'Azur (UCA), Centre Hospitalier Universitaire de Nice, Rare Neuromuscular Disease Reference Center, ERN-Euro-NMD, Nice, France
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
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De Cola MC, Ielo A, Lo Buono V, Quartarone A, Calabrò RS. Toward social-health integration in Sicily: description of the first hub and spoke model to improve the diagnostic therapeutic care paths for neurorehabilitation. Front Public Health 2023; 11:1141581. [PMID: 37261231 PMCID: PMC10229050 DOI: 10.3389/fpubh.2023.1141581] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/13/2023] [Indexed: 06/02/2023] Open
Abstract
Introduction The study describes a hub and spoke network for neuro-rehabilitation recently activated in Sicily, and evaluates the before-after changes yielded, in terms of integrated care. Methods A set of indicators based on data contained in the administrative database of inpatients of the Regional Health System are presented and discussed. Statistical analysis was conducted both globally and separately for the 9 Sicilian provinces (Agrigento, Caltanissetta, Catania, Enna, Messina, Palermo, Siracusa, Ragusa, and Trapani). Results Results showed an increase in admissions of people residing in the province where the Spokes have been opened: Trapani (+32.4%), Messina (+7.8%) and Palermo (+4.4%); besides a significant increase of patients from healthcare facilities proportion (p = 0.001) and from acute wards (p = 0.029). In addition, we found a decrease of discharge to protected healthcare facilities (p = 0.001) and to acute wards (p < 0.001), as well as an increase of discharges to home (p = 0.018). Discussion In conclusion, it would seem that the activation of this network has facilitated the management of these patients, avoiding unnecessary migrations to other provinces and/or regions, and improving the regional care service for neuro-rehabilitation. Future research will be direct to investigate this aspect, focusing on before-after variations in hospitalization rates and origin- destination patient flows.
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Leonardi S, Maggio MG, Russo M, Bramanti A, Arcadi FA, Naro A, Calabrò RS, De Luca R. Cognitive recovery in people with relapsing/remitting multiple sclerosis: A randomized clinical trial on virtual reality-based neurorehabilitation. Clin Neurol Neurosurg 2021; 208:106828. [PMID: 34332269 DOI: 10.1016/j.clineuro.2021.106828] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) can adversely affect several domains of cognitive function, including attention, information processing, memory and learning, executive functions and visuospatial skills. In recent years, technological innovations have proven effective in improving motor and cognitive impairment in neurological patients, including those affected by MS. OBJECTIVE The study aims to evaluate cognitive outcomes after rehabilitation training with the Virtual Reality rehabilitation system (VRRS) in patients suffering from MS. METHODS All patients were randomized into either the control group (CG: 15 patients) receiving conventional cognitive rehab or the experimental group (EG) using virtual reality (VR) (15 patients). Both groups underwent the same amount of cognitive training, 3 times a week for 8 weeks. They were submitted to neuropsychological assessment before (T0) and after the rehabilitation treatment (T1). RESULTS Our data showed that both conventional and VR cognitive rehabilitation approaches improved mood (p < 0.001) and visuospatial skills. However, only in the EG a significant improvement in specific cognitive domains (p < 0.001), including learning ability, short-term verbal memory, lexical access ability, as well as quality of life related to mental states, was found. CONCLUSIONS The present study demonstrated that VR can be a motivational and effective tool for cognitive recovery in MS patients.
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Affiliation(s)
| | - Maria Grazia Maggio
- University of Catania, Department of Biomedical and Biotechnological Science, Italy
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Manuli A, Maggio MG, Tripoli D, Gullì M, Cannavò A, La Rosa G, Sciarrone F, Avena G, Calabrò RS. Patients' perspective and usability of innovation technology in a new rehabilitation pathway: An exploratory study in patients with multiple sclerosis. Mult Scler Relat Disord 2020; 44:102312. [PMID: 32585618 DOI: 10.1016/j.msard.2020.102312] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/12/2020] [Accepted: 06/16/2020] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Multiple sclerosis (MS) is an inflammatory neurodegenerative disease of the central nervous system, which causes sensori-motor and cognitive disabilities, as well as neuropsychiatric abnormalities. Technological innovations could offer a valuable way to improve neurorehabilitation outcomes. Aim of the study is to assess the feasibility and usability of new rehabilitation technologies as perceived by patients suffering from MS. MATERIALS AND METHODS MS inpatients attending the Robotic and Behavioral Neurorehabilitation Service of the IRCCS Centro Neurolesi Bonino Pulejo (Messina, Italy) from February 2017 to April 2019, were enrolled in this exploratory study. The patients were submitted to a personalized rehabilitation treatment using robotics (such as Lokomat, Geosystem, Ekso, Armeo) and virtual reality (i.e. BTS-Nirvana, CAREN, VRRS), following a dedicated innovative pathway. RESULTS All patients completed the study. Significant pre-post-treatment differences were found in the perception of patients' quality of life, regarding both physical and mental items (p<0,001), as well as in the achievement of the therapeutic goal. Finally, we observed that patients declared a high usability of the robotic devices, and that rehabilitation with the new devices was well tolerated. CONCLUSIONS our results support the idea that neurorehabilitation using innovation technologies can be useful for the commitment and motivation during the rehabilitation process, with possible positive effects on the functional and psychological outcomes of patients with MS.
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Affiliation(s)
| | | | | | - Martina Gullì
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | | | | | | | - Giuseppe Avena
- Department of Ancient and Modern Civilizations, University of Messina, Messina, Italy
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