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Taborri J, Palermo E, Rossi S. WARNING: A Wearable Inertial-Based Sensor Integrated with a Support Vector Machine Algorithm for the Identification of Faults during Race Walking. Sensors (Basel) 2023; 23:s23115245. [PMID: 37299975 DOI: 10.3390/s23115245] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/22/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023]
Abstract
Due to subjectivity in refereeing, the results of race walking are often questioned. To overcome this limitation, artificial-intelligence-based technologies have demonstrated their potential. The paper aims at presenting WARNING, an inertial-based wearable sensor integrated with a support vector machine algorithm to automatically identify race-walking faults. Two WARNING sensors were used to gather the 3D linear acceleration related to the shanks of ten expert race-walkers. Participants were asked to perform a race circuit following three race-walking conditions: legal, illegal with loss-of-contact and illegal with knee-bent. Thirteen machine learning algorithms, belonging to the decision tree, support vector machine and k-nearest neighbor categories, were evaluated. An inter-athlete training procedure was applied. Algorithm performance was evaluated in terms of overall accuracy, F1 score and G-index, as well as by computing the prediction speed. The quadratic support vector was confirmed to be the best-performing classifier, achieving an accuracy above 90% with a prediction speed of 29,000 observations/s when considering data from both shanks. A significant reduction of the performance was assessed when considering only one lower limb side. The outcomes allow us to affirm the potential of WARNING to be used as a referee assistant in race-walking competitions and during training sessions.
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Affiliation(s)
- Juri Taborri
- Department of Economics, Engineering, Society and Business Organization, University of Tuscia, 01110 Viterbo, Italy
| | - Eduardo Palermo
- Department of Mechanical and Aerospace Engineering (DIMA), "Sapienza" University of Rome, 00185 Roma, Italy
| | - Stefano Rossi
- Department of Economics, Engineering, Society and Business Organization, University of Tuscia, 01110 Viterbo, Italy
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Castelli Gattinara Di Zubiena F, Menna G, Mileti I, Zampogna A, Asci F, Paoloni M, Suppa A, Del Prete Z, Palermo E. Machine Learning and Wearable Sensors for the Early Detection of Balance Disorders in Parkinson's Disease. Sensors (Basel) 2022; 22:s22249903. [PMID: 36560278 PMCID: PMC9782434 DOI: 10.3390/s22249903] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/06/2022] [Accepted: 12/14/2022] [Indexed: 05/28/2023]
Abstract
Dynamic posturography combined with wearable sensors has high sensitivity in recognizing subclinical balance abnormalities in patients with Parkinson's disease (PD). However, this approach is burdened by a high analytical load for motion analysis, potentially limiting a routine application in clinical practice. In this study, we used machine learning to distinguish PD patients from controls, as well as patients under and not under dopaminergic therapy (i.e., ON and OFF states), based on kinematic measures recorded during dynamic posturography through portable sensors. We compared 52 different classifiers derived from Decision Tree, K-Nearest Neighbor, Support Vector Machine and Artificial Neural Network with different kernel functions to automatically analyze reactive postural responses to yaw perturbations recorded through IMUs in 20 PD patients and 15 healthy subjects. To identify the most efficient machine learning algorithm, we applied three threshold-based selection criteria (i.e., accuracy, recall and precision) and one evaluation criterion (i.e., goodness index). Twenty-one out of 52 classifiers passed the three selection criteria based on a threshold of 80%. Among these, only nine classifiers were considered "optimum" in distinguishing PD patients from healthy subjects according to a goodness index ≤ 0.25. The Fine K-Nearest Neighbor was the best-performing algorithm in the automatic classification of PD patients and healthy subjects, irrespective of therapeutic condition. By contrast, none of the classifiers passed the three threshold-based selection criteria in the comparison of patients in ON and OFF states. Overall, machine learning is a suitable solution for the early identification of balance disorders in PD through the automatic analysis of kinematic data from dynamic posturography.
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Affiliation(s)
| | - Greta Menna
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy
| | - Ilaria Mileti
- Mechanical Measurements and Microelectronics (M3Lab) Laboratory, Engineering Department, University Niccolò Cusano, 00166 Rome, Italy
| | - Alessandro Zampogna
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Francesco Asci
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- IRCCS Neuromed Institute, 86077 Pozzilli, Italy
| | - Marco Paoloni
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, 00185 Rome, Italy
| | - Antonio Suppa
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- IRCCS Neuromed Institute, 86077 Pozzilli, Italy
| | - Zaccaria Del Prete
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy
| | - Eduardo Palermo
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy
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Colamarino E, de Seta V, Toppi J, Pichiorri F, Conforti I, Mileti I, Palermo E, Mattia D, Cincotti F. Distinctive physiological muscle synergy patterns define the Box and Block Task execution as revealed by electromyographic features. Annu Int Conf IEEE Eng Med Biol Soc 2022; 2022:5124-5127. [PMID: 36086602 DOI: 10.1109/embc48229.2022.9871699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Stroke survivors experience muscular pattern alterations of the upper limb that decrease their ability to perform daily-living activities. The Box and Block test (BBT) is widely used to assess the unilateral manual dexterity. Although BBT provides insights into functional performance, it returns limited information about the mechanisms contributing to the impaired movement. This study aims at exploring the BBT by means of muscle synergies analysis during the execution of BBT in a sample of 12 healthy participants with their dominant and non-dominant upper limb. Results revealed that: (i) the BBT can be described by 1 or 2 synergies; the number of synergies (ii) does not differ between dominant and non-dominant sides and (iii) varies considering each phase of the task; (iv) the transfer phase requires more synergies. Clinical Relevance- This preliminary study characterizes muscular synergies during the BBT task in order to establish normative patterns that could assist in understanding the neuromuscular demands and support future evaluations of stroke deficits.
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Zampogna A, Mileti I, Martelli F, Paoloni M, Del Prete Z, Palermo E, Suppa A. Early balance impairment in Parkinson's Disease: Evidence from Robot-assisted axial rotations. Clin Neurophysiol 2021; 132:2422-2430. [PMID: 34454269 DOI: 10.1016/j.clinph.2021.06.023] [Citation(s) in RCA: 3] [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: 04/20/2021] [Revised: 05/27/2021] [Accepted: 06/06/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Early postural instability (PI) is a red flag for the diagnosis of Parkinson's disease (PD). Several patients, however, fall within the first three years of disease, particularly when turning. We investigated whether PD patients, without clinically overt PI, manifest abnormal reactive postural responses to ecological perturbations resembling turning. METHODS Fifteen healthy subjects and 20 patients without clinically overt PI, under and not under L-Dopa, underwent dynamic posturography during axial rotations around the longitudinal axis, provided by a robotic mechatronic platform. We measured reactive postural responses, including body displacement and reciprocal movements of the head, trunk, and pelvis, by using a network of three wearable inertial sensors. RESULTS Patients showed higher body displacement of the head, trunk and pelvis, and lower joint movements at the lumbo-sacral junction than controls. Conversely, movements at the cranio-cervical junction were normal in PD. L-Dopa left reactive postural responses unchanged. CONCLUSIONS Patients with PD without clinically overt PI manifest abnormal reactive postural responses to axial rotations, unresponsive to L-Dopa. The biomechanical model resulting from our experimental approach supports novel pathophysiological hypotheses of abnormal axial rotations in PD. SIGNIFICANCE PD patients without clinically overt PI present subclinical balance impairment during axial rotations, unresponsive to L-Dopa.
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Affiliation(s)
- Alessandro Zampogna
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Ilaria Mileti
- Mechanical Measurements and Microelectronics (M3Lab) Lab, Engineering Department, University Niccolò Cusano, 00166 Rome, Italy
| | - Francesca Martelli
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy
| | - Marco Paoloni
- Department of Physical Medicine and Rehabilitation, Sapienza University of Rome, 00161 Rome, Italy
| | - Zaccaria Del Prete
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy
| | - Eduardo Palermo
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy
| | - Antonio Suppa
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; IRCCS Neuromed, 86077 Pozzilli, IS, Italy.
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Mileti I, Serra A, Wolf N, Munoz-Martel V, Ekizos A, Palermo E, Arampatzis A, Santuz A. Muscle Activation Patterns Are More Constrained and Regular in Treadmill Than in Overground Human Locomotion. Front Bioeng Biotechnol 2020; 8:581619. [PMID: 33195143 PMCID: PMC7644811 DOI: 10.3389/fbioe.2020.581619] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 07/09/2020] [Accepted: 09/15/2020] [Indexed: 11/24/2022] Open
Abstract
The use of motorized treadmills as convenient tools for the study of locomotion has been in vogue for many decades. However, despite the widespread presence of these devices in many scientific and clinical environments, a full consensus on their validity to faithfully substitute free overground locomotion is still missing. Specifically, little information is available on whether and how the neural control of movement is affected when humans walk and run on a treadmill as compared to overground. Here, we made use of linear and non-linear analysis tools to extract information from electromyographic recordings during walking and running overground, and on an instrumented treadmill. We extracted synergistic activation patterns from the muscles of the lower limb via non-negative matrix factorization. We then investigated how the motor modules (or time-invariant muscle weightings) were used in the two locomotion environments. Subsequently, we examined the timing of motor primitives (or time-dependent coefficients of muscle synergies) by calculating their duration, the time of main activation, and their Hurst exponent, a non-linear metric derived from fractal analysis. We found that motor modules were not influenced by the locomotion environment, while motor primitives were overall more regular in treadmill than in overground locomotion, with the main activity of the primitive for propulsion shifted earlier in time. Our results suggest that the spatial and sensory constraints imposed by the treadmill environment might have forced the central nervous system to adopt a different neural control strategy than that used for free overground locomotion, a data-driven indication that treadmills could induce perturbations to the neural control of locomotion.
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Affiliation(s)
- Ilaria Mileti
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Rome, Italy
| | - Aurora Serra
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Rome, Italy
| | - Nerses Wolf
- Department of Electrical Engineering and Informatics, Technische Universität Berlin, Berlin, Germany
| | - Victor Munoz-Martel
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Antonis Ekizos
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Eduardo Palermo
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Rome, Italy
| | - Adamantios Arampatzis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Alessandro Santuz
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, Germany
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Mileti I, Zampogna A, Santuz A, Asci F, Del Prete Z, Arampatzis A, Palermo E, Suppa A. Muscle Synergies in Parkinson's Disease. Sensors (Basel) 2020; 20:E3209. [PMID: 32517013 PMCID: PMC7308810 DOI: 10.3390/s20113209] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 05/06/2020] [Revised: 05/28/2020] [Accepted: 06/03/2020] [Indexed: 01/01/2023]
Abstract
Over the last two decades, experimental studies in humans and other vertebrates have increasingly used muscle synergy analysis as a computational tool to examine the physiological basis of motor control. The theoretical background of muscle synergies is based on the potential ability of the motor system to coordinate muscles groups as a single unit, thus reducing high-dimensional data to low-dimensional elements. Muscle synergy analysis may represent a new framework to examine the pathophysiological basis of specific motor symptoms in Parkinson's disease (PD), including balance and gait disorders that are often unresponsive to treatment. The precise mechanisms contributing to these motor symptoms in PD remain largely unknown. A better understanding of the pathophysiology of balance and gait disorders in PD is necessary to develop new therapeutic strategies. This narrative review discusses muscle synergies in the evaluation of motor symptoms in PD. We first discuss the theoretical background and computational methods for muscle synergy extraction from physiological data. We then critically examine studies assessing muscle synergies in PD during different motor tasks including balance, gait and upper limb movements. Finally, we speculate about the prospects and challenges of muscle synergy analysis in order to promote future research protocols in PD.
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Affiliation(s)
- Ilaria Mileti
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy; (I.M.); (Z.D.P.); (E.P.)
| | - Alessandro Zampogna
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.Z.); (F.A.)
| | - Alessandro Santuz
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany; (A.S.); (A.A.)
- Berlin School of Movement Science, Humboldt-Universität zu Berlin, 10115 Berlin, Germany
- Atlantic Mobility Action Project, Brain Repair Centre, Department of Medical Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Francesco Asci
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.Z.); (F.A.)
| | - Zaccaria Del Prete
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy; (I.M.); (Z.D.P.); (E.P.)
| | - Adamantios Arampatzis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany; (A.S.); (A.A.)
- Berlin School of Movement Science, Humboldt-Universität zu Berlin, 10115 Berlin, Germany
| | - Eduardo Palermo
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy; (I.M.); (Z.D.P.); (E.P.)
| | - Antonio Suppa
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.Z.); (F.A.)
- IRCCS Neuromed, 86077 Pozzilli (IS), Italy
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Martelli F, Palermo E, Del Prete Z, Rossi S. Using an ankle robotic device for motor performance and motor learning evaluation. Heliyon 2020; 6:e03262. [PMID: 32021934 PMCID: PMC6994316 DOI: 10.1016/j.heliyon.2020.e03262] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 05/14/2019] [Accepted: 01/15/2020] [Indexed: 11/18/2022] Open
Abstract
In this paper we performed the evaluation of ankle motor performance and motor learning during a goal-directed task, executed using the pediAnklebot robot. The protocol consisted of 3 phases (Familiarization, Adaptation, and Wash Out) repeated one time for each movement direction (plantarflexion, dorsiflexion, inversion, and eversion). During Familiarization and Wash out subjects performed goal-directed movements in unperturbed environment, whereas during Adaptation phase, a curl viscous force field was applied and it was randomly removed 10 times out of 200. Ankle motor performance was evaluated by means of a set of indices grouped into: accuracy, smoothness, temporal, and stopping indices. Learning Index was calculated to study the motor learning during the adaptation phase, which was subdivided into 5 temporal intervals (target sets). The outcomes related to the ankle motor performance highlighted that the best performance in terms of accuracy and smoothness of the trajectories was obtained in dorsiflexion movements in the sagittal plane, and in inversion rotations in the frontal plane. Differences between movement directions revealed an anisotropic behavior of the ankle joint. Results of the Learning index showed a capability of the subjects to rapidly adapt to a perturbed force field depending on the magnitude of the perceived field.
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Affiliation(s)
- Francesca Martelli
- Department of Mechanical and Aerospace Engineering (DIMA), Sapienza University of Rome, Roma, Italy
- Corresponding author.
| | - Eduardo Palermo
- Department of Mechanical and Aerospace Engineering (DIMA), Sapienza University of Rome, Roma, Italy
| | - Zaccaria Del Prete
- Department of Mechanical and Aerospace Engineering (DIMA), Sapienza University of Rome, Roma, Italy
| | - Stefano Rossi
- Department of Economics, Engineering, Society and Business Organization (DEIM), University of Tuscia, Viterbo, Italy
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Erra C, Mileti I, Germanotta M, Petracca M, Imbimbo I, De Biase A, Rossi S, Ricciardi D, Pacilli A, Di Sipio E, Palermo E, Bentivoglio AR, Padua L. Immediate effects of rhythmic auditory stimulation on gait kinematics in Parkinson's disease ON/OFF medication. Clin Neurophysiol 2019; 130:1789-1797. [PMID: 31401487 DOI: 10.1016/j.clinph.2019.07.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 02/14/2019] [Revised: 06/21/2019] [Accepted: 07/05/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Gait impairment is a highly disabling symptom for Parkinson's disease (PD) patients. Rhythmic auditory stimulation (RAS), has shown to improve spatio-temporal gait parameters in PD, but only a few studies have focused on their effects on gait kinematics, and the ideal stimulation frequency has still not been identified. METHODS We enrolled 30 PD patients and 18 controls. Patients were evaluated under two conditions (with (ON), and without (OFF) medications) with three different RAS frequencies (90%, 100%, and 110% of the patient's preferred walking cadence). Spatial-temporal parameters, joint angles and gait phases distribution were evaluated. A novel global index (GPQI) was used to quantify the difference in gait phase distribution. RESULTS Along with benefits in spatial-temporal parameters, GPQI improved significantly with RAS at a frequency of 110% for both ON and OFF medication conditions. In the most severe patients, the same result was observed also with RAS at 100%. CONCLUSIONS RAS administration, at a frequency of 110% of the preferred walking frequency, can be beneficial in improving the gait pattern in PD patients. SIGNIFICANCE When rhythmic auditory stimulation is provided to patients with PD, the selection of an adequate frequency of stimulation can optimize their effects on gait pattern.
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Affiliation(s)
- Carmen Erra
- Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy; Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ilaria Mileti
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Italy
| | | | - Martina Petracca
- Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | | | - Alessandro De Biase
- Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Stefano Rossi
- Department of Economics, Engineering, Society and Business Organization (DEIM), University of Tuscia, 01100 Viterbo, Italy
| | - Diego Ricciardi
- Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy
| | - Alessandra Pacilli
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Italy
| | | | - Eduardo Palermo
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Italy
| | - Anna Rita Bentivoglio
- Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy; Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Luca Padua
- Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy; Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Palermo E, Hayes DR, Russo EF, Calabrò RS, Pacilli A, Filoni S. Translational effects of robot-mediated therapy in subacute stroke patients: an experimental evaluation of upper limb motor recovery. PeerJ 2018; 6:e5544. [PMID: 30202655 PMCID: PMC6128258 DOI: 10.7717/peerj.5544] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 04/07/2018] [Accepted: 08/09/2018] [Indexed: 11/20/2022] Open
Abstract
Robot-mediated therapies enhance the recovery of post-stroke patients with motor deficits. Repetitive and repeatable exercises are essential for rehabilitation following brain damage or other disorders that impact the central nervous system, as plasticity permits to reorganize its neural structure, fostering motor relearning. Despite the fact that so many studies claim the validity of robot-mediated therapy in post-stroke patient rehabilitation, it is still difficult to assess to what extent its adoption improves the efficacy of traditional therapy in daily life, and also because most of the studies involved planar robots. In this paper, we report the effects of a 20-session-rehabilitation project involving the Armeo Power robot, an assistive exoskeleton to perform 3D upper limb movements, in addition to conventional rehabilitation therapy, on 10 subacute stroke survivors. Patients were evaluated through clinical scales and a kinematic assessment of the upper limbs, both pre- and post-treatment. A set of indices based on the patients' 3D kinematic data, gathered from an optoelectronic system, was calculated. Statistical analysis showed a remarkable difference in most parameters between pre- and post-treatment. Significant correlations between the kinematic parameters and clinical scales were found. Our findings suggest that 3D robot-mediated rehabilitation, in addition to conventional therapy, could represent an effective means for the recovery of upper limb disability. Kinematic assessment may represent a valid tool for objectively evaluating the efficacy of the rehabilitation treatment.
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Affiliation(s)
- Eduardo Palermo
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Rome, Italy
| | - Darren Richard Hayes
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Rome, Italy
- Seidenberg School of Computer Science and Information Systems, Pace University, New York, NY, USA
| | | | | | - Alessandra Pacilli
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Rome, Italy
| | - Serena Filoni
- Fondazione Centri di Riabilitazione Padre Pio Onlus, San Giovanni Rotondo, Italy
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10
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Palermo E, Suppa A. Deep brain stimulation and motor synergies in Parkinson's disease. Clin Neurophysiol 2018; 129:1309-1310. [PMID: 29661596 DOI: 10.1016/j.clinph.2018.03.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 03/30/2018] [Indexed: 10/17/2022]
Affiliation(s)
- E Palermo
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Italy
| | - A Suppa
- Department of Human Neuroscience, Sapienza University of Rome, Italy; IRCCS Neuromed Institute, Pozzilli IS, Italy.
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11
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Sorgini F, Massari L, D'Abbraccio J, Palermo E, Menciassi A, Petrovic PB, Mazzoni A, Carrozza MC, Newell FN, Oddo CM. Neuromorphic Vibrotactile Stimulation of Fingertips for Encoding Object Stiffness in Telepresence Sensory Substitution and Augmentation Applications. Sensors (Basel) 2018; 18:E261. [PMID: 29342076 PMCID: PMC5795525 DOI: 10.3390/s18010261] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 12/16/2017] [Revised: 01/10/2018] [Accepted: 01/12/2018] [Indexed: 01/07/2023]
Abstract
We present a tactile telepresence system for real-time transmission of information about object stiffness to the human fingertips. Experimental tests were performed across two laboratories (Italy and Ireland). In the Italian laboratory, a mechatronic sensing platform indented different rubber samples. Information about rubber stiffness was converted into on-off events using a neuronal spiking model and sent to a vibrotactile glove in the Irish laboratory. Participants discriminated the variation of the stiffness of stimuli according to a two-alternative forced choice protocol. Stiffness discrimination was based on the variation of the temporal pattern of spikes generated during the indentation of the rubber samples. The results suggest that vibrotactile stimulation can effectively simulate surface stiffness when using neuronal spiking models to trigger vibrations in the haptic interface. Specifically, fractional variations of stiffness down to 0.67 were significantly discriminated with the developed neuromorphic haptic interface. This is a performance comparable, though slightly worse, to the threshold obtained in a benchmark experiment evaluating the same set of stimuli naturally with the own hand. Our paper presents a bioinspired method for delivering sensory feedback about object properties to human skin based on contingency-mimetic neuronal models, and can be useful for the design of high performance haptic devices.
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Affiliation(s)
- Francesca Sorgini
- Sant'Anna School of Advanced Studies, The BioRobotics Institute, 56025 Pisa, Italy.
| | - Luca Massari
- Sant'Anna School of Advanced Studies, The BioRobotics Institute, 56025 Pisa, Italy.
| | - Jessica D'Abbraccio
- Sant'Anna School of Advanced Studies, The BioRobotics Institute, 56025 Pisa, Italy.
| | - Eduardo Palermo
- Department of Mechanical and Aerospace Engineering, "Sapienza" University of Rome, 00185 Roma, Italy.
| | - Arianna Menciassi
- Sant'Anna School of Advanced Studies, The BioRobotics Institute, 56025 Pisa, Italy.
| | - Petar B Petrovic
- Production Engineering Department, Faculty of Mechanical Engineering, University of Belgrade, 11120 Belgrade, Serbia.
- Academy of Engineering Sciences of Serbia (AISS), 11120 Belgrade, Serbia.
| | - Alberto Mazzoni
- Sant'Anna School of Advanced Studies, The BioRobotics Institute, 56025 Pisa, Italy.
| | | | - Fiona N Newell
- School of Psychology and Institute of Neuroscience, Trinity College, 2 Dublin, Ireland.
| | - Calogero M Oddo
- Sant'Anna School of Advanced Studies, The BioRobotics Institute, 56025 Pisa, Italy.
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Palermo E, Rossi S, Patanè F, Laut J, Porfiri M. In Memoriam: Paolo Cappa. Sensors (Basel) 2017; 17:s17112661. [PMID: 29156582 PMCID: PMC5713654 DOI: 10.3390/s17112661] [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] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 11/14/2017] [Accepted: 11/15/2017] [Indexed: 11/16/2022]
Abstract
Prof. Paolo Cappa passed away on 26 August 2016, at the age of 59, after a long and courageous fight against cancer. Paolo Cappa was a Professor in Mechanical and Thermal Measurements and Experimental Biomechanics in the Department of Mechanical and Aerospace Engineering of Sapienza University of Rome, where he had also served as the Head of the Department, and a Research Professor in the Department of Mechanical and Aerospace Engineering of New York University Tandon School of Engineering. During his intense, yet short, career, he made several significant scientific contributions within the discipline of Mechanical and Thermal Measurements, pioneering fundamental applications to Biomechanics. He co-founded the Motion Analysis and Robotics Laboratory (MARLab) within the Neurorehabilitation Division of IRCCS Pediatric Hospital “Bambino Gesu”, in Rome, to fuel transitional research from the laboratory to clinical practice. Through collaboration with neurologists and physiatrists at MARLab, Prof. Cappa led the development of a powerful array of novel mechanical solutions to wearable robotics for pediatric patients, addressing dramatic needs for children’s health and contributing to the training of an entire generation of Mechanical Engineering students.
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Affiliation(s)
- Eduardo Palermo
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Rome 00184, Italy.
| | - Stefano Rossi
- Department of Economics, Engineering, Society and Business Organization (DEIM), University of Tuscia, Viterbo 01100, Italy.
| | - Fabrizio Patanè
- Niccolò Cusano University, via Don Gnocchi, Rome 00166, Italy.
| | - Jeffrey Laut
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA.
| | - Maurizio Porfiri
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA.
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Mordenti P, Lucchini S, Zaffignani E, Capuano D, Palermo E, Scagnelli P, Zanlari L, Achilli R, Galli M, Marazzi E, Mazzocchi M, Gandolfi S, Granelli B, Sfulcini M, Terzoni D, Zanatta G, Cavanna L. Surgery and the elderly: when an apparent overtreatment becomes safe and effective. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx436.025] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
The aim of the study is to design a novel protocol to characterize the ankle movements during dorsal and plantar flexion reaching tasks using the pediAnklebot. Five healthy children were instructed to control a pointer and hit targets appearing on the monitor, by moving their ankle alternatively up and down. The protocol consisted of 60 targets, 30 up and 30 down, reachable via dorsiflexion and plantarflexion movements, respectively. Ankle angular displacements and torques were gathered by encoders and load cells embedded in the robot. Ankle motor performance was evaluated by means of kinematic, submovements and dynamic indices. Results suggest that (i) plantarflexion movements are faster and more accurate than the dorsiflexion ones, but children are able to perform with a higher level of smoothness the latter ones; (ii) children are able to stop the ankle movement more easily at the end of dorsiflexion rather than plantarflexion; (iii) the central nervous system plans plantarflexion and dorsiflexion movements with the same efficiency; (iv) children apply different torque levels during the two motor tasks and they cannot balance the inversion and eversion moments during dorsiflexion. These findings provide an important starting point for the assessment of a reference baseline of motor indices for the ankle joint.
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Germanotta M, Taborri J, Rossi S, Frascarelli F, Palermo E, Cappa P, Castelli E, Petrarca M. Spasticity Measurement Based on Tonic Stretch Reflex Threshold in Children with Cerebral Palsy Using the PediAnklebot. Front Hum Neurosci 2017; 11:277. [PMID: 28611612 PMCID: PMC5447033 DOI: 10.3389/fnhum.2017.00277] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 11/04/2016] [Accepted: 05/11/2017] [Indexed: 11/13/2022] Open
Abstract
Nowadays, objective measures are becoming prominent in spasticity assessment, to overcome limitations of clinical scales. Among others, Tonic Stretch Reflex Threshold (TSRT) showed promising results. Previous studies demonstrated the validity and reliability of TSRT in spasticity assessment at elbow and ankle joints in adults. Purposes of the present study were to assess: (i) the feasibility of measuring TSRT to evaluate spasticity at the ankle joint in children with Cerebral Palsy (CP), and (ii) the correlation between objective measures and clinical scores. A mechatronic device, the pediAnklebot, was used to impose 50 passive stretches to the ankle of 10 children with CP and 3 healthy children, to elicit muscles response at 5 different velocities. Surface electromyography, angles, and angular velocities were recorded to compute dynamic stretch reflex threshold; TSRT was computed with a linear regression through angles and angular velocities. TSRTs for the most affected side of children with CP resulted into the biomechanical range (95.7 ± 12.9° and 86.7 ± 17.4° for Medial and Lateral Gastrocnemius, and 75.9 ± 12.5° for Tibialis Anterior). In three patients, the stretch reflex was not elicited in the less affected side. TSRTs were outside the biomechanical range in healthy children. However, no correlation was found between clinical scores and TSRT values. Here, we demonstrated the capability of TSRT to discriminate between spastic and non-spastic muscles, while no significant outcomes were found for the dorsiflexor muscle.
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Affiliation(s)
| | - Juri Taborri
- Department of Mechanical and Aerospace Engineering, “Sapienza” University of RomeRome, Italy
| | - Stefano Rossi
- Industrial Engineering, Department of Economics and Management, University of TusciaViterbo, Italy
| | - Flaminia Frascarelli
- Neurorehabilitation Units, Movement Analysis and Robotics Laboratory, IRCCS Bambino Gesù Children's HospitalRome, Italy
| | - Eduardo Palermo
- Department of Mechanical and Aerospace Engineering, “Sapienza” University of RomeRome, Italy
| | - Paolo Cappa
- Department of Mechanical and Aerospace Engineering, “Sapienza” University of RomeRome, Italy
| | - Enrico Castelli
- Neurorehabilitation Units, Movement Analysis and Robotics Laboratory, IRCCS Bambino Gesù Children's HospitalRome, Italy
| | - Maurizio Petrarca
- Neurorehabilitation Units, Movement Analysis and Robotics Laboratory, IRCCS Bambino Gesù Children's HospitalRome, Italy
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Palermo E, Laut J, Nov O, Cappa P, Porfiri M. A natural user interface to integrate citizen science and physical exercise. PLoS One 2017; 12:e0172587. [PMID: 28231261 PMCID: PMC5322974 DOI: 10.1371/journal.pone.0172587] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 02/07/2017] [Indexed: 11/25/2022] Open
Abstract
Citizen science enables volunteers to contribute to scientific projects, where massive data collection and analysis are often required. Volunteers participate in citizen science activities online from their homes or in the field and are motivated by both intrinsic and extrinsic factors. Here, we investigated the possibility of integrating citizen science tasks within physical exercises envisaged as part of a potential rehabilitation therapy session. The citizen science activity entailed environmental mapping of a polluted body of water using a miniature instrumented boat, which was remotely controlled by the participants through their physical gesture tracked by a low-cost markerless motion capture system. Our findings demonstrate that the natural user interface offers an engaging and effective means for performing environmental monitoring tasks. At the same time, the citizen science activity increases the commitment of the participants, leading to a better motion performance, quantified through an array of objective indices. The study constitutes a first and necessary step toward rehabilitative treatments of the upper limb through citizen science and low-cost markerless optical systems.
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Affiliation(s)
- Eduardo Palermo
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States of America
- Department of Mechanical and Aerospace Engineering, “Sapienza” University of Rome, Rome, Italy
| | - Jeffrey Laut
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States of America
| | - Oded Nov
- Department of Technology Management and Innovation, New York University Tandon School of Engineering, Brooklyn, NY, United States of America
| | - Paolo Cappa
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States of America
- Department of Mechanical and Aerospace Engineering, “Sapienza” University of Rome, Rome, Italy
| | - Maurizio Porfiri
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States of America
- * E-mail:
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Taborri J, Palermo E, Rossi S, Cappa P. Gait Partitioning Methods: A Systematic Review. Sensors (Basel) 2016; 16:s16010066. [PMID: 26751449 PMCID: PMC4732099 DOI: 10.3390/s16010066] [Citation(s) in RCA: 147] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 12/24/2015] [Accepted: 01/04/2016] [Indexed: 12/03/2022]
Abstract
In the last years, gait phase partitioning has come to be a challenging research topic due to its impact on several applications related to gait technologies. A variety of sensors can be used to feed algorithms for gait phase partitioning, mainly classifiable as wearable or non-wearable. Among wearable sensors, footswitches or foot pressure insoles are generally considered as the gold standard; however, to overcome some inherent limitations of the former, inertial measurement units have become popular in recent decades. Valuable results have been achieved also though electromyography, electroneurography, and ultrasonic sensors. Non-wearable sensors, such as opto-electronic systems along with force platforms, remain the most accurate system to perform gait analysis in an indoor environment. In the present paper we identify, select, and categorize the available methodologies for gait phase detection, analyzing advantages and disadvantages of each solution. Finally, we comparatively examine the obtainable gait phase granularities, the usable computational methodologies and the optimal sensor placements on the targeted body segments.
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Affiliation(s)
- Juri Taborri
- Department of Mechanical and Aerospace Engineering, Sapienza University of Roma, Via Eudossiana 18, Roma I-00184, Italy.
| | - Eduardo Palermo
- Department of Mechanical and Aerospace Engineering, Sapienza University of Roma, Via Eudossiana 18, Roma I-00184, Italy.
| | - Stefano Rossi
- Department of Economics and Management, Industrial Engineering (DEIM), University of Tuscia, Via del Paradiso 47, Viterbo I-01100, Italy.
| | - Paolo Cappa
- Department of Mechanical and Aerospace Engineering, Sapienza University of Roma, Via Eudossiana 18, Roma I-00184, Italy.
- MARLab, Movement Analysis and Robotics Laboratory, Neurorehabilitation Division, IRCCS Children's Hospital "Bambino Gesù", Via Torre di Palidoro snc, Fiumicino (RM) I-00050, Italy.
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Taborri J, Rossi S, Palermo E, Patanè F, Cappa P. A novel HMM distributed classifier for the detection of gait phases by means of a wearable inertial sensor network. Sensors (Basel) 2014; 14:16212-34. [PMID: 25184488 PMCID: PMC4208171 DOI: 10.3390/s140916212] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [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: 06/13/2014] [Revised: 08/05/2014] [Accepted: 08/26/2014] [Indexed: 11/28/2022]
Abstract
In this work, we decided to apply a hierarchical weighted decision, proposed and used in other research fields, for the recognition of gait phases. The developed and validated novel distributed classifier is based on hierarchical weighted decision from outputs of scalar Hidden Markov Models (HMM) applied to angular velocities of foot, shank, and thigh. The angular velocities of ten healthy subjects were acquired via three uni-axial gyroscopes embedded in inertial measurement units (IMUs) during one walking task, repeated three times, on a treadmill. After validating the novel distributed classifier and scalar and vectorial classifiers-already proposed in the literature, with a cross-validation, classifiers were compared for sensitivity, specificity, and computational load for all combinations of the three targeted anatomical segments. Moreover, the performance of the novel distributed classifier in the estimation of gait variability in terms of mean time and coefficient of variation was evaluated. The highest values of specificity and sensitivity (>0.98) for the three classifiers examined here were obtained when the angular velocity of the foot was processed. Distributed and vectorial classifiers reached acceptable values (>0.95) when the angular velocity of shank and thigh were analyzed. Distributed and scalar classifiers showed values of computational load about 100 times lower than the one obtained with the vectorial classifier. In addition, distributed classifiers showed an excellent reliability for the evaluation of mean time and a good/excellent reliability for the coefficient of variation. In conclusion, due to the better performance and the small value of computational load, the here proposed novel distributed classifier can be implemented in the real-time application of gait phases recognition, such as to evaluate gait variability in patients or to control active orthoses for the recovery of mobility of lower limb joints.
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Affiliation(s)
- Juri Taborri
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Via Eudossiana 18, I-00184 Roma, Italy.
| | - Stefano Rossi
- Department of Economics and Management, Industrial Engineering (DEIM), University of Tuscia, Via del Paradiso 47, I-01100 Viterbo, Italy.
| | - Eduardo Palermo
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Via Eudossiana 18, I-00184 Roma, Italy.
| | - Fabrizio Patanè
- School of Mechanical Engineering, Niccolò Cusano University, Via Don Carlo Gnocchi 3, I-00166 Roma, Italy.
| | - Paolo Cappa
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Via Eudossiana 18, I-00184 Roma, Italy.
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Palermo E, Rossi S, Patanè F, Cappa P. Experimental evaluation of indoor magnetic distortion effects on gait analysis performed with wearable inertial sensors. Physiol Meas 2014; 35:399-415. [PMID: 24499774 DOI: 10.1088/0967-3334/35/3/399] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Magnetic inertial measurement unit systems (MIMU) offer the potential to perform joint kinematics evaluation as an alternative to optoelectronic systems (OS). Several studies have reported the effect of indoor magnetic field disturbances on the MIMU's heading output, even though the overall effect on the evaluation of lower limb joint kinematics is not yet fully explored. The aim of the study is to assess the influence of indoor magnetic field distortion on gait analysis trials conducted with a commercial MIMU system. A healthy adult performed gait analysis sessions both indoors and outdoors. Data collected indoors were post-processed with and without a heading correction methodology performed with OS at the start of the gait trial. The performance of the MIMU system is characterized in terms of indices, based on the mean value of lower limb joint angles and the associated ROM, quantifying the system repeatability. We find that the effects of magnetic field distortion, such as the one we experienced in our lab, were limited to the transverse plane of each joint and to the frontal plane of the ankle. Sagittal plane values, instead, showed sufficient repeatability moving from outdoors to indoors. Our findings provide indications to clinicians on MIMU performance in the measurement of lower limb kinematics.
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Affiliation(s)
- E Palermo
- Department of Mechanical and Aerospace Engineering, 'Sapienza' University of Rome, Via Eudossiana 18, I-00184 Roma, Italy. Movement Analysis and Robotics Laboratory (MARLab), Neurorehabilitation Division, IRCCS Children's Hospital 'Bambino Gesù', Via Torre di Palidoro, I-00050 Passoscuro (Fiumicino) Roma, Italy
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Abaid N, Cappa P, Palermo E, Petrarca M, Porfiri M. Gait detection in children with and without hemiplegia using single-axis wearable gyroscopes. PLoS One 2013; 8:e73152. [PMID: 24023825 PMCID: PMC3762857 DOI: 10.1371/journal.pone.0073152] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2013] [Accepted: 07/18/2013] [Indexed: 11/24/2022] Open
Abstract
In this work, we develop a novel gait phase detection algorithm based on a hidden Markov model, which uses data from foot-mounted single-axis gyroscopes as input. We explore whether the proposed gait detection algorithm can generate equivalent results as a reference signal provided by force sensitive resistors (FSRs) for typically developing children (TD) and children with hemiplegia (HC). We find that the algorithm faithfully reproduces reference results in terms of high values of sensitivity and specificity with respect to FSR signals. In addition, the algorithm distinguishes between TD and HC and is able to assess the level of gait ability in patients. Finally, we show that the algorithm can be adapted to enable real-time processing with high accuracy. Due to the small, inexpensive nature of gyroscopes utilized in this study and the ease of implementation of the developed algorithm, this work finds application in the on-going development of active orthoses designed for therapy and locomotion in children with gait pathologies.
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Affiliation(s)
- Nicole Abaid
- Department of Engineering Science and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, United States of America
| | - Paolo Cappa
- Department of Mechanical and Aerospace Engineering, “Sapienza” University of Rome, Rome, Italy
- Department of Neuroscience and Neurorehabilitation, MARlab Movement Analysis and Robotics Laboratory, “Bambino Gesù” Children’s Hospital, Rome, Italy
| | - Eduardo Palermo
- Department of Mechanical and Aerospace Engineering, “Sapienza” University of Rome, Rome, Italy
- Department of Neuroscience and Neurorehabilitation, MARlab Movement Analysis and Robotics Laboratory, “Bambino Gesù” Children’s Hospital, Rome, Italy
| | - Maurizio Petrarca
- Department of Neuroscience and Neurorehabilitation, MARlab Movement Analysis and Robotics Laboratory, “Bambino Gesù” Children’s Hospital, Rome, Italy
| | - Maurizio Porfiri
- Department of Mechanical and Aerospace Engineering, Polytechnic Institute of New York University, Brooklyn, New York, United States of America
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De Marco M, Falco A, Basile A, Rosati A, Festa M, d'Avenia M, Pascale M, Dal Piaz F, Bisogni R, Barcaroli D, Coppola G, Piscione F, Gigantino A, Citro R, De Rosa R, Vitulano G, Virtuoso N, Manganelli F, Palermo E, Siano F, Rosato G, Hahne M, Tiberti C, De Laurenzi V, Turco MC. Detection of soluble BAG3 and anti-BAG3 antibodies in patients with chronic heart failure. Cell Death Dis 2013; 4:e495. [PMID: 23412388 PMCID: PMC3734839 DOI: 10.1038/cddis.2013.8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Palermo E, Si M, Occhiogrosso R, Berndt C, Rudomen G, Rafailovich M. Effects of Supercritical Carbon Dioxide on Phase Homogeneity, Morphology, and Mechanical Properties of Poly(styrene-blend-ethylene-stat-vinyl acetate). Macromolecules 2005. [DOI: 10.1021/ma051335+] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Berni A, Tromba L, Falvo L, Barhoumi L, Palermo E. [Postural vertigo and basilar artery flow increment]. J Mal Vasc 2003; 28:206-8. [PMID: 14618111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
PURPOSE Research was focused on cerebral arterial flow in normal individuals and in patients suffering from short-term vertigo when sitting up rapidly from a lying position. PATIENTS AND METHODS The research was performed in normal subjects and 46 patients affected by short term vertigo who underwent transcranial Doppler 32. In normal subjects (16 with an average age of 25 and 16 with an average age of 61) cerebral artery flow was recorded in a sitting and lying position, in Trendelenburg position and during transition from one position to another. In subjects suffering from short-term vertigo, arterial flow was recorded at baseline and during short-term vertigo. RESULTS In normal subjects the flow remained unchanged in all body positions as well as during transition from one position to another. In subjects with short-term vertigo basilar artery flow increased with the onset of dizziness and returned to normal when dizziness ceased. CONCLUSIONS In normal subjects cerebral self-regulation maintains constant flow in any body position. Increased basilar artery flow during short term vertigo is probably either due to altered self-regulation or its reduction in the carotid area with compensatory basilar artery hyperflow, or else to over-response in vertebro-basilar territory.
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Affiliation(s)
- A Berni
- Surgical Sciences Department of the La Sapienza , University in Rome, V. le Regina Elena n. 324, 00161 Rome, Italy.
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Palermo E. Remarriage: parental perceptions of steprelations with children and adolescents. J Psychiatr Nurs Ment Health Serv 1980; 18:9-13. [PMID: 6246238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This study was designed to determine if relationships between stepparents and adolescents differed from those between stepparents and younger children. Utilizing a questionnaire developed by Duberman, responses from remarried couples (N-50) were used to determine a steprelationship score for each child. The scores for children under age 13 and 13 and over both at the time of the parental marriage termination and the remarriage were compared. Chi-square techniques were used in the data analysis. No significant differences were found between the two groups. The results of this study suggest that factors, other than the child's age, may influence the steprelationship. Possibilities suggested include unresolved conflicts in the child and/or parents, the child's relationship with one or both natural parents, or the natural parents' relationship. This population merits further research consideration as society attempts to assimilate the growing number of these families.
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Palermo E. Mental health consultation in a home care agency. J Psychiatr Nurs Ment Health Serv 1978; 16:21-3. [PMID: 213597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A mental health nurse, educationally and clinically prepared as a specialist, can be effectively utilized as a consultant to aid nurse generalists in assessment and intervention of patients in a home health care agency. An individual staff nurse consulting with the specialist or a group of nurses provides the setting for consultant led case discussions. Consultation is a highly efficient use of specialist's knowledge and skills in health care delivery, and also provides learning opportunities for staff.
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Signorini LF, Palermo E. [Suicide as a public health problem: a statistico-epidemiological study made in the province of Ascoli Piceno]. G Ig Med Prev 1969; 10:105-28. [PMID: 5405961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Palermo E, Candela R, Pellegrini MG. [Juvenile delinquency in March. Results of a statistico-epidemiological survey]. G Ig Med Prev 1968; 9:187-210. [PMID: 5748344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Palermo E. [A new device for selective fluorescence applicable to the Beckman DU spectrophotometer]. Boll Soc Ital Biol Sper 1964; 40:1059-62. [PMID: 5876653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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