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Manzari L, Tramontano M. Otolithic and canal functions assessment during the acute phase of benign paroxysmal positional vertigo. Eur Arch Otorhinolaryngol 2024; 281:2253-2257. [PMID: 37924366 DOI: 10.1007/s00405-023-08312-2] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 10/23/2023] [Indexed: 11/06/2023]
Abstract
PURPOSE Assess otolith and canal involvement in patients with Benign Paroxysmal Positional Vertigo (BPPV) during the acute phase. METHODS Ninety patients with BPPV in the acute phase underwent a vestibular assessment that included an assessment with videonistagmography, video Head Impulse Test (vHIT) to evaluate horizontal and vertical semicircular canals, and ocular vestibular evoked myogenic potentials (oVEMPs) for the otolithic function. RESULTS Ninety patients had an involvement of the posterior canal, fifty-five out of ninety patients presented a BPPV of the right ear. No asymmetry of the otolithic functions was found for the utricular macula. Furthermore, no reduction of the Vestibular Ocular Reflex gain was found for the examined canal functions. CONCLUSIONS The lack of asymmetry suggests that during the acute phase of BPPV, the otolithic function is balanced between the affected and unaffected ears. Moreover, the preserved VOR gain for the examined canal functions suggests that the VOR responses for the examined channels were intact.
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Affiliation(s)
- L Manzari
- MSA ENT Academy Center, 03043, Cassino, Italy.
| | - M Tramontano
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, via Massarenti 9, 40138, Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, via Pelagio Palagi 9, 40138, Bologna, Italy
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Tramontano M, Orejel Bustos AS, Montemurro R, Vasta S, Marangon G, Belluscio V, Morone G, Modugno N, Buzzi MG, Formisano R, Bergamini E, Vannozzi G. Dynamic Stability, Symmetry, and Smoothness of Gait in People with Neurological Health Conditions. Sensors (Basel) 2024; 24:2451. [PMID: 38676068 PMCID: PMC11053882 DOI: 10.3390/s24082451] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 04/04/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024]
Abstract
Neurological disorders such as stroke, Parkinson's disease (PD), and severe traumatic brain injury (sTBI) are leading global causes of disability and mortality. This study aimed to assess the ability to walk of patients with sTBI, stroke, and PD, identifying the differences in dynamic postural stability, symmetry, and smoothness during various dynamic motor tasks. Sixty people with neurological disorders and 20 healthy participants were recruited. Inertial measurement unit (IMU) sensors were employed to measure spatiotemporal parameters and gait quality indices during different motor tasks. The Mini-BESTest, Berg Balance Scale, and Dynamic Gait Index Scoring were also used to evaluate balance and gait. People with stroke exhibited the most compromised biomechanical patterns, with lower walking speed, increased stride duration, and decreased stride frequency. They also showed higher upper body instability and greater variability in gait stability indices, as well as less gait symmetry and smoothness. PD and sTBI patients displayed significantly different temporal parameters and differences in stability parameters only at the pelvis level and in the smoothness index during both linear and curved paths. This study provides a biomechanical characterization of dynamic stability, symmetry, and smoothness in people with stroke, sTBI, and PD using an IMU-based ecological assessment.
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Affiliation(s)
- Marco Tramontano
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, 40138 Bologna, Italy;
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Amaranta Soledad Orejel Bustos
- Santa Lucia Foundation IRCCS (Institute for Research and Health Care), 00179 Rome, Italy; (A.S.O.B.); (V.B.); (M.G.B.); (R.F.)
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis, 00135 Roma, Italy;
| | - Rebecca Montemurro
- Santa Lucia Foundation IRCCS (Institute for Research and Health Care), 00179 Rome, Italy; (A.S.O.B.); (V.B.); (M.G.B.); (R.F.)
| | - Simona Vasta
- Santa Lucia Foundation IRCCS (Institute for Research and Health Care), 00179 Rome, Italy; (A.S.O.B.); (V.B.); (M.G.B.); (R.F.)
| | - Gabriele Marangon
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Valeria Belluscio
- Santa Lucia Foundation IRCCS (Institute for Research and Health Care), 00179 Rome, Italy; (A.S.O.B.); (V.B.); (M.G.B.); (R.F.)
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis, 00135 Roma, Italy;
| | - Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
- San Raffaele Institute of Sulmona, 67039 Sulmona, Italy
| | | | - Maria Gabriella Buzzi
- Santa Lucia Foundation IRCCS (Institute for Research and Health Care), 00179 Rome, Italy; (A.S.O.B.); (V.B.); (M.G.B.); (R.F.)
| | - Rita Formisano
- Santa Lucia Foundation IRCCS (Institute for Research and Health Care), 00179 Rome, Italy; (A.S.O.B.); (V.B.); (M.G.B.); (R.F.)
| | - Elena Bergamini
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis, 00135 Roma, Italy;
- Department of Management, Information and Production Engineering, University of Bergamo, Via Pasubio 7b, 24044 Dalmine, BG, Italy
| | - Giuseppe Vannozzi
- Santa Lucia Foundation IRCCS (Institute for Research and Health Care), 00179 Rome, Italy; (A.S.O.B.); (V.B.); (M.G.B.); (R.F.)
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis, 00135 Roma, Italy;
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Origo D, Buffone F, Montini G, Belluto D, Tramontano M, Dal Farra F. Foot Posture Index Does Not Correlate with Dynamic Foot Assessment Performed via Baropodometric Examination: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:814. [PMID: 38667576 PMCID: PMC11050396 DOI: 10.3390/healthcare12080814] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/29/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Clinicians employ foot morphology assessment to evaluate the functionality of the method and anticipate possible injuries. This study aims to correlate static foot posture and the dynamic barefoot evaluation in a sample of healthy adult participants. METHODS The foot posture was evaluated using the Foot Posture Index-6 (FPI-6) and the dynamics were evaluated through baropodometric examination. Two operators independently assessed the participants' foot posture through FPI-6, and then a dynamic evaluation was performed by asking them to walk 8 times across a platform. One hundred participants (mean age: 32.15 ± 7.49) were enrolled. RESULTS The inter-rater agreement between the two assessors was found to be excellent. The majority of the feet belonged to the 0 < FPI < 4 class (32%), followed by the 4 < FPI < 8 (31%) and the FPI > 8 ranges (19.5%). Our "area of contact" analysis showed a significant poor correlation between FPI and total foot, midfoot, and the second metatarsophalangeal joint (MTPJ) (-0.3 < r < 0). Regarding "force" parameters, the analysis showed a poor correlation between the midfoot, hallux, and the second toe (-0.2 < r < 2); finally the "pressure" analysis showed a poor correlation between FPI, the fourth MTPJ, and the second toe (-0.2 < rs < 0.3) and a moderate correlation between the hallux (r = 0.374) and the fifth MTPJ (r = 0.427). CONCLUSIONS This study emphasizes the constrained correlation between static foot posture observation and dynamic barefoot examination.
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Affiliation(s)
- Daniele Origo
- Department of Research, SOMA Osteopathic Institute Milan, 20126 Milan, Italy; (D.O.); (F.B.); (G.M.); (D.B.); (F.D.F.)
| | - Francesca Buffone
- Department of Research, SOMA Osteopathic Institute Milan, 20126 Milan, Italy; (D.O.); (F.B.); (G.M.); (D.B.); (F.D.F.)
- Division of Pediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy
- Principles and Practice of Clinical Research (PPCR), Harvard T.H. Chan School of Public Health–ECPE, Boston, MA 02115, USA
| | - Gabriele Montini
- Department of Research, SOMA Osteopathic Institute Milan, 20126 Milan, Italy; (D.O.); (F.B.); (G.M.); (D.B.); (F.D.F.)
| | - Daniele Belluto
- Department of Research, SOMA Osteopathic Institute Milan, 20126 Milan, Italy; (D.O.); (F.B.); (G.M.); (D.B.); (F.D.F.)
| | - Marco Tramontano
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, 40126 Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Fulvio Dal Farra
- Department of Research, SOMA Osteopathic Institute Milan, 20126 Milan, Italy; (D.O.); (F.B.); (G.M.); (D.B.); (F.D.F.)
- Department Information Engineering, University of Brescia, Via Branze 38, 25123 Brescia, Italy
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Tramontano M, Argento O, Orejel Bustos AS, DE Angelis S, Montemurro R, Bossa M, Belluscio V, Bergamini E, Vannozzi G, Nocentini U. Cognitive-motor dual-task training improves dynamic stability during straight and curved gait in patients with multiple sclerosis: a randomized controlled trial. Eur J Phys Rehabil Med 2024; 60:27-36. [PMID: 37997324 DOI: 10.23736/s1973-9087.23.08156-x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
BACKGROUND Multiple Sclerosis (MS) is a chronic inflammatory, demyelinating, degenerative disease of the central nervous system and the second most frequent cause of permanent disability in young adults. One of the most common issues concerns the ability to perform postural and gait tasks while simultaneously completing a cognitive task (namely, dual-task DT). AIM Assessing cognitive-motor dual-task training effectiveness in patients with Multiple Sclerosis (PwMS) for dynamic gait quality when walking on straight, curved, and blindfolded paths. DESIGN Two-arm single-blind randomized controlled trial. Follow-up at 8 weeks. SETTING Neurorehabilitation Hospital. POPULATION A sample of 42 PwMS aged 28-71, with a score of 4.00±1.52 on the Expanded Disability Status Scale were recruited. METHODS Participants were randomized in conventional (CTg) neurorehabilitation and dual-task training (DTg) groups and received 12 sessions, 3 days/week/4 weeks. They were assessed at baseline (T0), after the treatment (T1), and 8 weeks after the end of the treatment (T2) through Mini-BESTest, Tinetti Performance Oriented Mobility Assessment, Modified Barthel Index, and a set of spatiotemporal parameters and gait quality indices related to stability, symmetry, and smoothness of gait extracted from initial measurement units (IMUs) data during the execution of the 10-meter Walk Test (10mWT), the Figure-of-8 Walk Test (Fo8WT) and the Fukuda Stepping Test (FST). RESULTS Thirty-one PwMS completed the trial at T2. Significant improvement within subjects was found in Mini-BESTest scores for DTg from T0 to T1. The IMU-based assessment indicated significant differences in stability (P<0.01) and smoothness (P<0.05) measures between CTg and DTg during 10mWT and Fo8WT. Substantial improvements (P<0.017) were also found in the inter-session comparison, primarily for DTg, particularly for stability, symmetry, and smoothness measures. CONCLUSIONS This study supports the effectiveness of DT in promoting dynamic motor abilities in PwMS. CLINICAL REHABILITATION IMPACT Cognitive-motor DT implemented into the neurorehabilitation conventional program could be a useful strategy for gait and balance rehabilitation.
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Affiliation(s)
- Marco Tramontano
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy -
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy -
| | - Ornella Argento
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | - Amaranta S Orejel Bustos
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Sara DE Angelis
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | - Rebecca Montemurro
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | - Michela Bossa
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
| | - Valeria Belluscio
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Elena Bergamini
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Giuseppe Vannozzi
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Ugo Nocentini
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, Rome, Italy
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
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Tramontano M, Manzari L, Bustos ASO, De Angelis S, Montemurro R, Belluscio V, Bergamini E, Vannozzi G. Instrumental assessment of dynamic postural stability in patients with unilateral vestibular hypofunction during straight, curved, and blindfolded gait. Eur Arch Otorhinolaryngol 2024; 281:83-94. [PMID: 37382626 DOI: 10.1007/s00405-023-08082-x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 06/15/2023] [Indexed: 06/30/2023]
Abstract
PURPOSE To characterise dynamic postural stability of gait in patients with vestibular hypofunction (PwVH) using a sensor-based assessment while performing dynamic tasks and to correlate the results of this evaluation with clinical scales. METHODS This cross-sectional study involved 22 adults between 18 and 70 years old from a healthcare hospital centre. Eleven patients suffering from chronic vestibular hypofunction (PwVH) and eleven healthy controls (HC) were evaluated through a combined inertial sensor-based and clinical scale assessment. Participants were equipped with five synchronised inertial measurement units (IMUs) (128 Hz, Opal, APDM, Portland, OR, USA): three IMUs were located on the occipital cranium bone, near the lambdoid suture of the head, at the centre of the sternum, and at L4/L5 level, just above the pelvis, and were used to quantify gait quality parameters, while the other two were located slightly above lateral malleoli and used to perform stride and step segmentation. Three different motor tasks were performed in a randomized order: the 10-m Walk Test (10mWT), the Figure of Eight Walk Test (Fo8WT) and the Fukuda Stepping Test (FST). A set of gait quality parameters related to stability, symmetry and smoothness of gait were extracted from IMU data and correlated with the clinical scale scores. PwVH and HC results were compared to test for significant between-group differences. RESULTS Significant differences were found for the three motor tasks (10mWT, Fo8WT and FST) when comparing PwVH and HC groups. For the 10mWT and the Fo8WT, significant differences between the PwVH and HC groups were found for the stability indexes. Considering the FST, significant differences between the PwVH and HC groups were also found in the stability and symmetry of gait. A significant correlation was found between the Dizziness Handicap Inventory and gait indices during the Fo8WT. CONCLUSIONS In this study, we characterized the dynamic postural stability alterations during linear, curved, and blindfolded walking/stepping in PwVH combining an instrumental IMU-based with traditional clinical scales approach. Combining instrumental and clinical evaluation for dynamic stability of gait alterations in PwVH is useful in thoroughly evaluating the effects of unilateral vestibular hypofunction.
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Affiliation(s)
- M Tramontano
- Fondazione Santa Lucia IRCCS, 00179, Rome, Italy
| | | | - A S Orejel Bustos
- Fondazione Santa Lucia IRCCS, 00179, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135, Rome, Italy
| | - S De Angelis
- Fondazione Santa Lucia IRCCS, 00179, Rome, Italy
| | - R Montemurro
- Fondazione Santa Lucia IRCCS, 00179, Rome, Italy
| | - V Belluscio
- Fondazione Santa Lucia IRCCS, 00179, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135, Rome, Italy
| | - E Bergamini
- Fondazione Santa Lucia IRCCS, 00179, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135, Rome, Italy
| | - G Vannozzi
- Fondazione Santa Lucia IRCCS, 00179, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135, Rome, Italy
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Morone G, Princi AA, Iosa M, Montemurro R, Ciancarelli I, Coiro P, Lisi D, Savo R, Granieri MN, De Angelis D, Tramontano M. Effects of shoulder brace usage on postural stability in stroke survivors: A pilot randomized controlled trial. NeuroRehabilitation 2024; 54:449-456. [PMID: 38457159 DOI: 10.3233/nre-230250] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
BACKGROUND Despite advances in stroke rehabilitation, challenges in upper limb motor recovery and postural stability persist, negatively affecting overall well-being. Arm slings and shoulder braces have been proposed to address these issues, but their efficacy in promoting postural stability remains unclear. OBJECTIVE This pilot randomized controlled study aimed to evaluate the impact of a new shoulder brace (N1-Neurosling) on trunk postural stability during walking, pain, and upper limb muscle strength in chronic stroke survivors. METHODS Twenty-four adult chronic stroke patients were involved and randomly assigned to the shoulder brace group (SBg) or control group (CTRLg). Were assessed at baseline (T0) and after 4 weeks (T1) through the Trunk Control Test, the Numerical Rating Scale, the Motricity Index, Manual Muscle Test, and instrumental wearable-based assessment. RESULTS After 4 weeks, the SBg showed significant improvement in Trunk Control Test scores (p = 0.020) and smoothness of gait measured by log dimensionless jerk along the Antero-Posterior axis (- 5.31±0.25 vs. - 5.18±0.27, p = 0.018) compared to the CTRLg. The SBg also demonstrated a reduction in pain in the shoulder girdle and enhanced upper limb muscle strength. CONCLUSION The use of the N1-Neurosling shoulder brace led to improvements in postural stability and smoothness of gait in stroke patients.
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Affiliation(s)
- Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- San Raffaele Institute of Sulmona, Sulmona, Italy
| | | | - Marco Iosa
- Fondazione Santa Lucia IRCCS, Rome, Italy
- Department of Psychology, Sapienza University, Rome, Italy
| | | | - Irene Ciancarelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | | | - Danilo Lisi
- UOC Risk Management, Azienda Ospedaliera Rilievo Nazionale Sant'Anna e San Sebastiano, Caserta, Italy
| | | | | | | | - Marco Tramontano
- Department of Biomedical and Neuromotor Sciences - DIBINEM, Alma Mater Università di Bologna, Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy
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Cinnera AM, Bonnì S, D'Acunto A, Maiella M, Ferraresi M, Casula EP, Pezzopane V, Tramontano M, Iosa M, Paolucci S, Morone G, Vannozzi G, Koch G. Cortico-cortical stimulation and robot-assisted therapy (CCS and RAT) for upper limb recovery after stroke: study protocol for a randomised controlled trial. Trials 2023; 24:823. [PMID: 38129910 PMCID: PMC10740274 DOI: 10.1186/s13063-023-07849-1] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Since birth, during the exploration of the environment to interact with objects, we exploit both the motor and sensory components of the upper limb (UL). This ability to integrate sensory and motor information is often compromised following a stroke. However, to date, rehabilitation protocols are focused primarily on recovery of motor function through physical therapies. Therefore, we have planned a clinical trial to investigate the effect on functionality of UL after a sensorimotor transcranial stimulation (real vs sham) in add-on to robot-assisted therapy in the stroke population. METHODS A randomised double-blind controlled trial design involving 32 patients with a single chronic stroke (onset > 180 days) was planned. Each patient will undergo 15 consecutive sessions (5 days for 3 weeks) of paired associative stimulation (PAS) coupled with UL robot-assisted therapy. PAS stimulation will be administered using a bifocal transcranial magnetic stimulator (TMS) on the posterior-parietal cortex and the primary motor area (real or sham) of the lesioned hemisphere. Clinical, kinematics and neurophysiological changes will be evaluated at the end of protocol and at 1-month follow-up and compared with baseline. The Fugl-Meyer assessment scale will be the primary outcome. Secondly, kinematic variables will be recorded during the box-and-block test and reaching tasks using video analysis and inertial sensors. Single pulse TMS and electroencephalography will be used to investigate the changes in local cortical reactivity and in the interconnected areas. DISCUSSION The presented trial shall evaluate with a multimodal approach the effects of sensorimotor network stimulation applied before a robot-assisted therapy training on functional recovery of the upper extremity after stroke. The combination of neuromodulation and robot-assisted therapy can promote an increase of cortical plasticity of sensorimotor areas followed by a clinical benefit in the motor function of the upper limb. TRIAL REGISTRATION ClinicalTrials.gov NCT05478434. Registered on 28 Jul 2022.
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Affiliation(s)
- Alex Martino Cinnera
- Scientific Institute for Research, Hospitalization and Health Care IRCCS Santa Lucia Foundation, Rome, Italy.
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.
| | - Sonia Bonnì
- Scientific Institute for Research, Hospitalization and Health Care IRCCS Santa Lucia Foundation, Rome, Italy
| | - Alessia D'Acunto
- Scientific Institute for Research, Hospitalization and Health Care IRCCS Santa Lucia Foundation, Rome, Italy
| | - Michele Maiella
- Scientific Institute for Research, Hospitalization and Health Care IRCCS Santa Lucia Foundation, Rome, Italy
| | - Matteo Ferraresi
- Scientific Institute for Research, Hospitalization and Health Care IRCCS Santa Lucia Foundation, Rome, Italy
| | - Elias Paolo Casula
- Scientific Institute for Research, Hospitalization and Health Care IRCCS Santa Lucia Foundation, Rome, Italy
- Department of System Medicine, University of Tor Vergata, Rome, Italy
| | - Valentina Pezzopane
- Scientific Institute for Research, Hospitalization and Health Care IRCCS Santa Lucia Foundation, Rome, Italy
| | - Marco Tramontano
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marco Iosa
- Scientific Institute for Research, Hospitalization and Health Care IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Psychology, Sapienza University of Rome, 00185, Rome, Italy
| | - Stefano Paolucci
- Scientific Institute for Research, Hospitalization and Health Care IRCCS Santa Lucia Foundation, Rome, Italy
| | - Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Giuseppe Vannozzi
- Scientific Institute for Research, Hospitalization and Health Care IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Giacomo Koch
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
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Lucatello S, De Angelis S, Di Lorenzo C, Iosa M, Magnotti L, Di Paolo M, De Luca M, Buzzi MG, Tramontano M. FunctionaL Assessment Scale of Hemianopia (FLASH): A New Multidisciplinary Tool to Assess Hemianopia in Patients with Severe Acquired Brain Injury. Healthcare (Basel) 2023; 11:2883. [PMID: 37958027 PMCID: PMC10647452 DOI: 10.3390/healthcare11212883] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/23/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Severe acquired brain injury (sABI) encompasses a range of neurological impairments. Visual dysfunction, particularly homonymous visual field defects (HVFDs) and homonymous hemianopia (HH), commonly afflicts sABI survivors, affecting their cognitive and motor rehabilitation. This study presents the FunctionaL Assessment Scale of Hemianopia (FLASH), developed to analyze the most common postural behaviors exhibited by sABI patients with hemianopia during activities of daily living. A comparison to traditional static automated perimetry for diagnosing visual field deficits (VFDs) to determine the sensitivity and specificity of the FLASH was used. Additionally, this study also aimed to assess its reliability. METHODS Fifty-six patients (25 F, 31 M, mean age 60.59 ± 14.53) with strokes in the sub-acute phase (<6 months from the onset) were assessed with both FLASH and a Humphrey Field Analyzer. RESULTS After removing two items found to be less reliable than others, FLASH showed high sensitivity (81%) and specificity (77%) when compared to static automated perimetry. Inter-rater reliability was also high, with an intra-class correlation coefficient of 0.954, as well as the internal consistency computed by Cronbach's alpha, equal to 0.874. CONCLUSION FLASH could offer a valuable and cost-effective screening tool for VFD in sABI patients during neurorehabilitation, with potential implications for healthcare cost reduction.
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Affiliation(s)
- Susanna Lucatello
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.L.); (S.D.A.); (C.D.L.); (L.M.); (M.D.L.); (M.G.B.)
| | - Sara De Angelis
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.L.); (S.D.A.); (C.D.L.); (L.M.); (M.D.L.); (M.G.B.)
| | - Concetta Di Lorenzo
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.L.); (S.D.A.); (C.D.L.); (L.M.); (M.D.L.); (M.G.B.)
| | - Marco Iosa
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.L.); (S.D.A.); (C.D.L.); (L.M.); (M.D.L.); (M.G.B.)
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Luisa Magnotti
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.L.); (S.D.A.); (C.D.L.); (L.M.); (M.D.L.); (M.G.B.)
| | - Marta Di Paolo
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.L.); (S.D.A.); (C.D.L.); (L.M.); (M.D.L.); (M.G.B.)
| | - Maria De Luca
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.L.); (S.D.A.); (C.D.L.); (L.M.); (M.D.L.); (M.G.B.)
| | - Maria Gabriella Buzzi
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.L.); (S.D.A.); (C.D.L.); (L.M.); (M.D.L.); (M.G.B.)
| | - Marco Tramontano
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, Via Massarenti 9, 40138 Bologna, Italy;
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9, 40138 Bologna, Italy
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9
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Baroni F, Schleip R, Arcuri L, Consorti G, D’Alessandro G, Zegarra-Parodi R, Vitali AM, Tramontano M, Lunghi C. Functional Neuromyofascial Activity: Interprofessional Assessment to Inform Person-Centered Participative Care-An Osteopathic Perspective. Healthcare (Basel) 2023; 11:2886. [PMID: 37958030 PMCID: PMC10667998 DOI: 10.3390/healthcare11212886] [Citation(s) in RCA: 1] [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: 09/07/2023] [Revised: 10/23/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
Introduction: Health professionals and bodyworkers may be pivotal in promoting prevention programs, providing tailored advice and guidance to patients' adherence to self-care strategies, such as physical activity. Contemporary evidence encourages manual therapists to involve patients in decision-making and treatment procedures integrating passive and active approaches in treatment planning. This manuscript provides a definition and applications of neuromyofascial movement patterns, discusses the significance of functional assessment, and gives an example of clinical applications in the osteopathic field to highlight how this assessment can promote interdisciplinarity. Methods: The reporting framework used in the current manuscript followed guidelines for writing a commentary. Results: The manuscript highlights the crucial role that the neuromyofascial system plays in human movement and overall well-being and the importance of a functional neuromyofascial activity assessment in the context of person-centered participative care. Conclusions: Understanding individual neuromyofascial patterns could help healthcare practitioners, movement specialists, and bodyworkers in tailoring treatment plans, meeting patients' unique needs, and promoting a more effective personalized approach to care. The current perspective could spark debates within the professional community and provide a research roadmap for developing an evidence-informed interprofessional framework.
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Affiliation(s)
- Francesca Baroni
- BMS Formation, 75116 Paris, France; (F.B.); (C.L.)
- Osteopatia Lunghi-Baroni Private Practice, 00146 Rome, Italy
| | - Robert Schleip
- Department of Sport and Health Sciences, Conservative and Rehabilitative Orthopedics, Technical University of Munich, 80333 Munich, Germany;
| | - Lorenzo Arcuri
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65121 Pescara, Italy
| | - Giacomo Consorti
- Education Department of Osteopathy, Istituto Superiore di Osteopatia, 20126 Milan, Italy
| | - Giandomenico D’Alessandro
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65121 Pescara, Italy
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy
| | | | | | - Marco Tramontano
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40126 Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40126 Bologna, Italy
| | - Christian Lunghi
- BMS Formation, 75116 Paris, France; (F.B.); (C.L.)
- Osteopatia Lunghi-Baroni Private Practice, 00146 Rome, Italy
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10
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Orejel Bustos AS, Tramontano M, Morone G, Ciancarelli I, Panza G, Minnetti A, Picelli A, Smania N, Iosa M, Vannozzi G. Ambient assisted living systems for falls monitoring at home. Expert Rev Med Devices 2023; 20:821-828. [PMID: 37610096 DOI: 10.1080/17434440.2023.2245320] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION Monitoring systems at home are critical in the event of a fall, and can range from standalone fall detection devices to activity recognition devices that aim to identify behaviors in which the user may be at risk of falling, or to detect falls in real-time and alert emergency personnel. AREAS COVERED This review analyzes the current literature concerning the different devices available for home fall detection. EXPERT OPINION Included studies highlight how fall detection at home is an important challenge both from a clinical-assistance point of view and from a technical-bioengineering point of view. There are wearable, non-wearable and hybrid systems that aim to detect falls that occur in the patient's home. In the near future, a greater probability of predicting falls is expected thanks to an improvement in technologies together with the prediction ability of machine learning algorithms. Fall prevention must involve the clinician with a person-centered approach, low cost and minimally invasive technologies able to evaluate the movement of patients and machine learning algorithms able to make an accurate prediction of the fall event.
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Affiliation(s)
| | | | - Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- San Raffaele Institute of Sulmona, Sulmona, Italy
| | - Irene Ciancarelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Giuseppe Panza
- Dipartimento delle scienze mediche e della lungodegenza, U.O.C. di Medicina Interna A.O.R.N. "San Pio", P.O. "G. Rummo", Benevento, Italy
| | | | - Alessandro Picelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Canadian Advances in Neuro-Orthopaedics for Spasticity Congress (CANOSC), Kingston, Canada
| | - Nicola Smania
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Marco Iosa
- Fondazione Santa Lucia IRCCS, Rome, Italy
- Department of Psychology, Sapienza University, Rome, Italy
| | - Giuseppe Vannozzi
- Fondazione Santa Lucia IRCCS, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Roma, Italy
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11
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D’Alessandro G, Ruffini N, Aquino A, Galli M, Innocenti M, Tramontano M, Cerritelli F. Correction: Differences between experimental and placebo arms in manual therapy trials: a methodological review. BMC Med Res Methodol 2023; 23:48. [PMID: 36809991 PMCID: PMC9942421 DOI: 10.1186/s12874-023-01865-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Affiliation(s)
- Giandomenico D’Alessandro
- Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, 65121 Pescara, Italy ,Centre Pour L’Etude, La Recherche Et La Diffusion Ostéopathiques “C.E.R.D.O”, 00199 Rome, Italy
| | - Nuria Ruffini
- Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, 65121 Pescara, Italy ,Foundation C.O.ME. Collaboration, National Centre Germany, 10825 Berlin, Germany
| | - Alessandro Aquino
- Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, 65121 Pescara, Italy ,grid.4708.b0000 0004 1757 2822Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Matteo Galli
- Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, 65121 Pescara, Italy ,Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Mattia Innocenti
- Centre Pour L’Etude, La Recherche Et La Diffusion Ostéopathiques “C.E.R.D.O”, 00199 Rome, Italy
| | - Marco Tramontano
- grid.417778.a0000 0001 0692 3437Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Francesco Cerritelli
- Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, 65121, Pescara, Italy.
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Consorti G, Castagna C, Tramontano M, Longobardi M, Castagna P, Di Lernia D, Lunghi C. Reconceptualizing Somatic Dysfunction in the Light of a Neuroaesthetic Enactive Paradigm. Healthcare (Basel) 2023; 11:healthcare11040479. [PMID: 36833014 PMCID: PMC9957393 DOI: 10.3390/healthcare11040479] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/27/2022] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Background: Palpatory findings are considered a central element of osteopathic practice, especially when associated with a patient's altered regulative functions than with named somatic dysfunctions. Although osteopathic theories for somatic dysfunction could be plausible, the clinical applicability of the concept is debated, especially because it is largely related to simple cause-effect models of osteopathic care. In contrast to a linear kind of diagnosis of a "tissue as a producer of symptoms", this perspective article aims to provide a conceptual and operational framework in which the somatic dysfunction evaluation process is seen as a neuroaesthetic (en)active encounter between osteopath and patient. Subsections relevant to the subject: To summarize all concepts of the hypothesis, the enactive neuroaesthetics principles are proposed as a critical foundation for the osteopathic assessment and treatment of the person, specifically addressing a new paradigm for somatic dysfunction. Conclusions, and future directions: The present perspective article represents a proposition to blend technical rationality informed by neurocognitive and social sciences, and professional artistry clinical experience informed by traditional tenets, to overcome the controversy around somatic dysfunction, rather than dismissing the concept.
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Affiliation(s)
- Giacomo Consorti
- Education Department of Osteopathy, Istituto Superiore di Osteopatia, 20126 Milan, Italy
- Correspondence:
| | - Carmine Castagna
- Education Department of Osteopathy, Istituto Superiore di Osteopatia, 20126 Milan, Italy
| | - Marco Tramontano
- Fondazione Santa Lucia Istituto di Ricovero e Cura a Carattere Scientifico, 00179 Rome, Italy
- Centre Pour l’Etude, la Recherche et la Diffusion Osteopathiques, 00199 Rome, Italy
| | | | - Paolo Castagna
- Education Department of Osteopathy, Istituto Superiore di Osteopatia, 20126 Milan, Italy
| | - Daniele Di Lernia
- Human Technology Laboratory, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20100 Milan, Italy
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13
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Gabriele L, De Angelis S, Roncagli V, Tramontano M, Manzari L, Gabriele D. Visual function impairment in patients suffering from visually induced motion sickness. A preliminary observational longitudinal study. Hearing, Balance and Communication 2023. [DOI: 10.1080/21695717.2023.2165370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Tramontano M, Cascioli S, Magnotti L, Sovani M, Gaita A, Galeoto G, Berardi A, Valente D, De Angelis S, Salvia A. Therapeutic educational workshops for caregivers of patients with severe acquired brain injury. Clin Ter 2023; 174:14-22. [PMID: 36655639 DOI: 10.7417/ct.2023.5003] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Abstract Severe acquired brain injury (sABI) leads to a wide range of functional limitations in cognitive, moto and behavioural abilities. These changes impact the patient's family in terms of the feeling of emotional and physical health, social life and financial condition. Caregivers are often intensely involved in the patient's management exposing them to negative effects of caregiving including stress, mood disorders and decreased quality of life. Implementing forms of active involvement of caregivers in the rehabilitative program could be useful. Thus, in the present study, therapeutic educational workshops (TEWs) for caregivers during the post-acute intensive hospitalization were organized during the post-acute intensive hospitalization of patients with sABI. The caregivers were asked to participate in the workshops to actively involve them in the patient's care and neurorehabilitation program. Each workshop session provided indications regarding the management of the patient with aphasia, neglect, behavioural and swallowing disorders. A questionnaire of 22 items has been designed in order to represent possible indicators of usefulness and effectiveness of the TEWs. The primary aim of this study was to develop a reliable and valid questionnaire able to assess the caregivers' satisfaction with the modalities of carrying out the TEW as a novel activity during the post-acute hospitalization of patients with sABI. The second aim was to assess the caregivers' satisfaction with the utility of the TEW as a tool to enhance their skills in the management of patients' disabilities. 100 caregivers of patients with sABI who attended at least one TEW session and completed the questionnaire were included in the analysis. In conclusion the administered questionnaire has proven to be a valid and reliable tool to evaluate sABI caregivers' satisfaction with TEW. Moreover, caregivers were satisfied with the organization of the TEW and with their usefulness in the management of the patients with sABI.
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Affiliation(s)
| | - S Cascioli
- Santa Lucia Foundation, IRCCS Rome, Italy
| | - L Magnotti
- Santa Lucia Foundation, IRCCS Rome, Italy
| | - M Sovani
- Santa Lucia Foundation, IRCCS Rome, Italy
| | - A Gaita
- Santa Lucia Foundation, IRCCS Rome, Italy
| | - G Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - A Berardi
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - D Valente
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | | | - A Salvia
- Santa Lucia Foundation, IRCCS Rome, Italy
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Tramontano M, Belluscio V, Bergamini E, Allevi G, De Angelis S, Verdecchia G, Formisano R, Vannozzi G, Buzzi MG. Vestibular Rehabilitation Improves Gait Quality and Activities of Daily Living in People with Severe Traumatic Brain Injury: A Randomized Clinical Trial. Sensors (Basel) 2022; 22:8553. [PMID: 36366250 PMCID: PMC9657265 DOI: 10.3390/s22218553] [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] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/03/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
Neurorehabilitation research in patients with traumatic brain injury (TBI) showed how vestibular rehabilitation (VR) treatments positively affect concussion-related symptoms, but no studies have been carried out in patients with severe TBI (sTBI) during post-acute intensive neurorehabilitation. We aimed at testing this effect by combining sensor-based gait analysis and clinical scales assessment. We hypothesized that integrating VR in post-acute neurorehabilitation training might improve gait quality and activity of daily living (ADL) in sTBI patients. A two-arm, single-blind randomized controlled trial with 8 weeks of follow-up was performed including thirty sTBI inpatients that underwent an 8-week rehabilitation program including either a VR or a conventional program. Gait quality parameters were obtained using body-mounted magneto-inertial sensors during instrumented linear and curvilinear walking tests. A 4X2 mixed model ANOVA was used to investigate session−group interactions and main effects. Patients undergoing VR exhibited improvements in ADL, showing early improvements in clinical scores. Sensor-based assessment of curvilinear pathways highlighted significant VR-related improvements in gait smoothness over time (p < 0.05), whereas both treatments exhibited distinct improvements in gait quality. Integrating VR in conventional neurorehabilitation is a suitable strategy to improve gait smoothness and ADL in sTBI patients. Instrumented protocols are further promoted as an additional measure to quantify the efficacy of neurorehabilitation treatments.
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Affiliation(s)
- Marco Tramontano
- IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Roma, Italy
| | - Valeria Belluscio
- IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Roma, Italy
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis 15, 00135 Roma, Italy
| | - Elena Bergamini
- IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Roma, Italy
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis 15, 00135 Roma, Italy
| | - Giulia Allevi
- IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Roma, Italy
| | - Sara De Angelis
- IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Roma, Italy
| | | | - Rita Formisano
- IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Roma, Italy
| | - Giuseppe Vannozzi
- IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Roma, Italy
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis 15, 00135 Roma, Italy
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Manzari L, Perez-Fernandez N, Tramontano M. Editorial: Gaze and postural stability rehabilitation. Front Neurol 2022; 13:1034012. [PMID: 36341124 PMCID: PMC9635923 DOI: 10.3389/fneur.2022.1034012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 09/26/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Leonardo Manzari
- MSA ENT Academy Center, Cassino, Italy
- *Correspondence: Leonardo Manzari
| | | | - Marco Tramontano
- Fondazione Santa Lucia IRCCS, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
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17
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Manzari L, Orejel Bustos AS, Princi AA, Tramontano M. Video Suppression Head Impulses and Head Impulses Paradigms in Patients with Vestibular Neuritis: A Comparative Study. Healthcare (Basel) 2022; 10:healthcare10101926. [PMID: 36292373 PMCID: PMC9601449 DOI: 10.3390/healthcare10101926] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/13/2022] [Accepted: 09/27/2022] [Indexed: 11/04/2022] Open
Abstract
Background: This study aims to explore the clinical relevance of the Suppression Head Impulse Paradigm (SHIMP) to better understand if it represents an additional clinical value compared to the Head Impulse Paradigm (HIMP) in patients with vestibular neuritis (VN) in different stages of the disease. Methods: From January 2020 to June 2022, patients with unilateral VN were found in a database of an ENT vestibular clinic. Clinical presentation, vestibular test outcomes, therapy, and recovery were examined in medical records. Results: A total of 42 patients (16 Females, mean age 51.06 ± 12.96; 26 Male, mean age 62.50 ± 9.82) met the inclusion criteria and were enrolled in the study. The means of the VOR gain for both paradigms were respectively 0.38 ± 0.12 (SHIMP) and 0.46 ± 0.13 (HIMP) at T0 and 0.55 ± 0.20 (SHIMP) and 0.64 ± 0.19 (HIMP) at T1 for the lesional side. For the HIMP, the gain value <0.76 identified the affected side of VN with 100% sensitivity (92−100) and 100% specificity (91−100). For the SHIMP, the gain value <0.66 identified the affected side of VN with 100% sensitivity (92−100) and 100% specificity (91−100) and an AUC of 1.0 (0.96−1.0, p < 0.0001). Conclusion: The SHIMP paradigm has a diagnostic accuracy equal to the classic HIMP paradigm in patients with VN. The assessment of VOR slow phase velocity and vestibulo-saccadic interaction in patients with VN could be easier with the use of the SHIMPs paradigm. SHIMPs paradigm provides helpful information about the evaluation of VOR slow phase velocity and vestibulo-saccadic interaction as new recovery strategies in patients with VN.
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Affiliation(s)
| | - Amaranta Soledad Orejel Bustos
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | | | - Marco Tramontano
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
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18
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Lorusso M, Tagliamonte NL, Tramontano M, Fresch A, Granelli G, Smania N, Tamburella F. Technology-assisted balance assessment and rehabilitation in individuals with spinal cord injury: A systematic review. NeuroRehabilitation 2022; 51:213-230. [DOI: 10.3233/nre-220060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Balance is a crucial function of basic Activities of Daily Living (ADL) and is often considered the priority in Spinal Cord Injury (SCI) patients’ rehabilitation. Technological devices have been developed to support balance assessment and training, ensuring an earlier, intensive, and goal-oriented motor therapy. OBJECTIVE: The aim of this systematic review is to explore the technology-assisted strategies to assess and rehabilitate balance function in persons with SCI. METHODS: A systematic review was conducted in the databases PubMed, Scopus, IEEE Xplore, Cochrane Library, and Embase. Full reports on Randomized Clinical Trials (RCTs) of parallel-group or cross-over design and non-RCTs were included according to the following criteria: i) publication year from 1990 to 2021; ii) balance considered as a primary or secondary outcome; iii) population of individuals with SCI with age over 18 years old, regardless of traumatic or non-traumatic lesions, Time Since Injury, lesion level, Asia Impairment Scale score and gender. The methodological quality was determined for each included study according to the recognized Downs and Black (D&B) tool. RESULTS: Nineteen articles met the inclusion criteria and were included in the analysis. Four articles focused on balance assessment while 15 targeted rehabilitation interventions to improve balance by using Treadmill-Based Devices (TBD), OverGround Devices (OGD) and Tilt Table Devices (TTD). Statistically significant effects on balance can be found in TBD subcategory, in the hip-knee guidance subcategory of OGD and in the study of TTD category. CONCLUSION: Although different studies reported positive effects, improvements due to technology-assisted rehabilitation were not greater than those obtained by means of other rehabilitation therapies. The heterogeneity, low methodological quality, and the small number of the studies included do not allow general conclusions about the usefulness of technology-assisted balance assessment and training in individuals with SCI, even if significant improvements have been reported in some studies.
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Affiliation(s)
| | | | - Marco Tramontano
- IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Anna Fresch
- Neurorehabilitation Unit, University Hospital of Verona, Verona, Italy
| | - Giulia Granelli
- Neurorehabilitation Unit, University Hospital of Verona, Verona, Italy
| | - Nicola Smania
- Neurorehabilitation Unit, University Hospital of Verona, Verona, Italy
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Arcuri L, Consorti G, Tramontano M, Petracca M, Esteves JE, Lunghi C. “What you feel under your hands”: exploring professionals’ perspective of somatic dysfunction in osteopathic clinical practice—a qualitative study. Chiropr Man Therap 2022; 30:32. [PMID: 36045398 PMCID: PMC9429724 DOI: 10.1186/s12998-022-00444-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background Despite controversy regarding its validity and clinical usefulness, manual examination findings still have an important role for manipulative therapies. As an example, somatic dysfunction (SD) remains central to osteopathic practice.This study aims to explore the experienced osteopaths' attitudes concerning SD and its role in osteopathic practice. This qualitative research could contribute to building a consistent paradigm for manual intervention in all musculoskeletal manipulations. Methods A thematic analysis with grounded theory elements was used. Data were collected through semi-structured interviews carried out between February and April 2021. A purposive sample of twenty professional osteopaths with past experience in osteopathic care was chosen to reflect the phenomenon's variety. The data analysis was done inductively and in tandem with the recruiting to keep track of data saturation. Results Eleven osteopaths participated in the study. Three main themes emerged from the data analysis: (1) SD as a safe tissue-touch-based communication tool between operator and person complex adaptive health system; (2) The treatment of SD is shareable between osteopaths, other health professionals, and the patients involved in the therapeutic pathway improving body awareness and health; (3) The development of the SD concept in research and practice to better clarify osteopathic profession identity and definition. Conclusions A panel of expert osteopaths consider the concept of SD as a valuable tool integrated into the osteopathic evaluation and treatment process. The shared concept and clinical application of SD is informed by person-centered care concepts and from the fields of neuroscience, cognitive and complexity science. Our study reports a common need among osteopaths to develop an evidence-based framework of SD to allow the best development of the osteopathic profession. Supplementary Information The online version contains supplementary material available at 10.1186/s12998-022-00444-2.
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Ruffini N, D’Alessandro G, Pimpinella A, Galli M, Galeotti T, Cerritelli F, Tramontano M. The Role of Osteopathic Care in Gynaecology and Obstetrics: An Updated Systematic Review. Healthcare (Basel) 2022; 10:healthcare10081566. [PMID: 36011223 PMCID: PMC9408311 DOI: 10.3390/healthcare10081566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/30/2022] [Accepted: 08/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Many efforts are made to find safer and more feasible therapeutic strategies to improve gynaecological care. Non-pharmacological treatments, such as osteopathic interventions, could be used as complementary strategies to better manage different gynaecological conditions. This review aims to report the effectiveness of osteopathic treatment in the gynaecology and obstetrics field, updating the previous review published in 2016. The secondary aim was to elucidate the role of somatic dysfunction (SD) in osteopathic assessment and treatment procedures, as well as their health and economic implications. Methods: An electronic search was conducted in the following databases: Embase, MEDLINE (PubMed), and Science direct. All types of clinical studies published between May 2014 and December 2021 have been included: randomised controlled trial (RCT), controlled before/after, interrupted time series quasi RCT, case controls, case reports, case series, observational, clinical studies involving any type of osteopathic treatment, (standardised, semi-standardised or patients’ need-based treatment) performed alone or in combination with other treatments, were included). Results: A total of 76,750 were identified through database searching and other sources. After the removal of duplicates, 47,655 papers were screened based on title and abstract. A total of 131 full-text articles were consequently assessed for eligibility. Twenty-one new articles were included in the synthesis. A total of 2632 participants with a mean age of 28.9 ± 10.5 years were included in the review. Conclusions: Results showed an effectiveness of osteopathic care in gynaecology and obstetrics, but the studies were too heterogeneous to perform quantitative analysis and make clinical recommendations. Nevertheless, osteopathic care could be considered a safe complementary approach to traditional gynaecological care.
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Affiliation(s)
- Nuria Ruffini
- National Centre Germany, Foundation COME Collaboration, 10825 Berlin, Germany
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy
| | - Giandomenico D’Alessandro
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65121 Pescara, Italy
| | - Annalisa Pimpinella
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy
| | - Matteo Galli
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65121 Pescara, Italy
- Research Department, SOMA, Istituto Osteopatia Milano, 20126 Milan, Italy
| | - Tiziana Galeotti
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy
| | - Francesco Cerritelli
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65121 Pescara, Italy
- Correspondence:
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Dal Farra F, Arippa F, Arru M, Cocco M, Porcu E, Tramontano M, Monticone M. Effects of exercise on balance in patients with non-specific low back pain: a systematic review and meta-analysis. Eur J Phys Rehabil Med 2022; 58:423-434. [PMID: 34636528 PMCID: PMC9980551 DOI: 10.23736/s1973-9087.21.07293-2] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Non-specific low back pain (NS-LBP) is one of the most common musculoskeletal conditions related to medical expenses and disability. Evidence suggests that changes in motion patterns could induce trunk instability and impaired postural control. Therefore, this systematic review investigated the effects of exercise on balance in patients with NS-LBP. EVIDENCE ACQUISITION A systematic review and meta-analysis were conducted. Findings were reported following the 2020 PRISMA statement and the main databases were searched for RCTs. Studies were independently screened through a standardized form and their internal validity assessed by using the Cochrane risk of bias (RoB) tool. Pooled effects were calculated at post-treatment and quality of evidence was assessed through the GRADE framework. EVIDENCE SYNTHESIS Twelve articles were included in the review, eight in the meta-analysis. None of the studies were judged at low RoB. There is very low-quality evidence that exercise is effective in reducing Centre of Pressure (CoP) displacement (-16.99 [-27.29, -6.68]; P=0.001) and in improving single-leg stance test performance (-28.7 [-48.84, -8.67]; P=0.005) and dynamic balance (-4.74 [-8.02, -1.46]; P=0.005). Conversely, no significant results were observed in "ellipse area" and in "limits of stability" indexes. Other results were summarized in a qualitative synthesis. CONCLUSIONS Exercise could be effective in improving both static and dynamic balance in patients with NS-LBP over a short-term period. However, quality of evidence was estimated as very low, hence further double-blinded, high-quality RCTs are needed to address clinical practice and research.
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Affiliation(s)
- Fulvio Dal Farra
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Federico Arippa
- Unit of Neurorehabilitation, Department of Neuroscience and Rehabilitation, ARNAS G. Brotzu, Cagliari, Italy -
| | - Mauro Arru
- Unit of Physical and Rehabilitation Medicine, Department of Clinical Sciences and Translational Medicine, Tor Vergata University, Rome, Italy
| | - Martina Cocco
- Unit of Physical and Rehabilitation Medicine, Department of Clinical Sciences and Translational Medicine, Tor Vergata University, Rome, Italy
| | - Elisa Porcu
- Unit of Physical and Rehabilitation Medicine, Department of Clinical Sciences and Translational Medicine, Tor Vergata University, Rome, Italy
| | - Marco Tramontano
- IRCCS Santa Lucia Foundation, Rome, Italy.,Department of Movement, Human and Health Sciences, Interuniversity Center of Bioengineering of the Human Neuromusculoskeletal System, Foro Italico University of Rome, Rome, Italy
| | - Marco Monticone
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Neurorehabilitation, Department of Neuroscience and Rehabilitation, ARNAS G. Brotzu, Cagliari, Italy
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Lorusso M, Tramontano M, Casciello M, Pece A, Smania N, Morone G, Tamburella F. Efficacy of Overground Robotic Gait Training on Balance in Stroke Survivors: A Systematic Review and Meta-Analysis. Brain Sci 2022; 12:brainsci12060713. [PMID: 35741599 PMCID: PMC9221355 DOI: 10.3390/brainsci12060713] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/23/2022] [Accepted: 05/30/2022] [Indexed: 12/29/2022] Open
Abstract
Strokes often lead to a deficit in motor control that contributes to a reduced balance function. Impairments in the balance function severely limit the activities of daily living (ADL) in stroke survivors. The present systematic review and meta-analysis primarily aims to explore the efficacy of overground robot-assisted gait training (o-RAGT) on balance recovery in individuals with stroke. In addition, the efficacy on ADL is also investigated. This systematic review identified nine articles investigating the effects of o-RAGT on balance, four of which also assessed ADL. The results of the meta-analysis suggest that o-RAGT does not increase balance and ADL outcomes more than conventional therapy in individuals after stroke. The data should not be overestimated due to the low number of studies included in the meta-analysis and the wide confidence intervals. Subgroup analyses to investigate the influence of participant’s characteristics and training dosage were not performed due to lack of data availability. Further well-designed randomized controlled trials are needed to investigate the efficacy of o-RAGT on balance in individuals with stroke.
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Affiliation(s)
- Matteo Lorusso
- Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy; (M.L.); (M.C.); (F.T.)
| | - Marco Tramontano
- Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy; (M.L.); (M.C.); (F.T.)
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00185 Rome, Italy
- Correspondence:
| | - Matteo Casciello
- Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy; (M.L.); (M.C.); (F.T.)
| | - Andrea Pece
- Ospedale Israelitico di Roma, Via Fulda 14, 00148 Rome, Italy;
| | - Nicola Smania
- Neurorehabilitation Unit, University Hospital of Verona, 37124 Verona, Italy;
| | - Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Federica Tamburella
- Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy; (M.L.); (M.C.); (F.T.)
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23
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Berardi A, Graziosi G, Ferrazzano G, Casagrande Conti L, Grasso MG, Tramontano M, Conte A, Galeoto G. Evaluation of the Psychometric Properties of the Revised Piper Fatigue Scale in Patients with Multiple Sclerosis. Healthcare (Basel) 2022; 10:healthcare10060985. [PMID: 35742037 PMCID: PMC9222278 DOI: 10.3390/healthcare10060985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/11/2022] [Accepted: 05/23/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Fatigue is one of the most common symptoms in patients with multiple sclerosis (MS), and has a major impact on their quality of life. Measurement tools that assess the patient’s condition are commonly used in the neurological field, though diagnostic tools are currently unable to distinguish potential alternative causes of fatigue in individual patients. The Revised Piper Fatigue Scale (PFS-R) is a self-administered assessment scale that is internationally used for fatigue measurement. Aim: This study aimed to evaluate the reliability and validity of the Italian version of the PFS-R in patients with MS. Methods: Forty-one individuals were included in this study. Each participant in the study was given a dossier, in paper format, containing the informed consent form, a personal data sheet, the Fatigue Symptoms and Impacts Questionnaire in Relapsing Multiple Sclerosis (FSIQ-RMS), the Fatigue Severity Scale (FSS), and the PFS-R. Results: The PFS-R was found to have strong internal consistency, with a value of α equal to 0.977. Correlations between PFS-R, FSS, and FSIQ-RMS scores were analyzed using the Pearson correlation coefficient, and all scales showed statistically significant correlations. Conclusion: The PFS-R is a new self-administered tool to assess fatigue in patients with MS. It evaluates fatigue characteristics, difficulty in carrying out daily life activities, and how the individual feels as a result of this symptom. This tool was previously validated for use in cancer patients, which also allows us to make a comparison between different pathologies and rehabilitation treatments.
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Affiliation(s)
- Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, 001859 Rome, Italy; (G.F.); (A.C.)
- Correspondence: (A.B.); (G.G.)
| | - Giulia Graziosi
- School of Occupational Therapy, Sapienza University of Rome, 00185 Rome, Italy;
| | - Gina Ferrazzano
- Department of Human Neurosciences, Sapienza University of Rome, 001859 Rome, Italy; (G.F.); (A.C.)
| | - Laura Casagrande Conti
- Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy; (L.C.C.); (M.G.G.); (M.T.)
| | - Maria Grazia Grasso
- Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy; (L.C.C.); (M.G.G.); (M.T.)
| | - Marco Tramontano
- Santa Lucia Foundation IRCCS, Via Ardeatina, 306, 00179 Rome, Italy; (L.C.C.); (M.G.G.); (M.T.)
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, 001859 Rome, Italy; (G.F.); (A.C.)
- IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, 001859 Rome, Italy; (G.F.); (A.C.)
- IRCCS Neuromed, 86077 Pozzilli, Italy
- Correspondence: (A.B.); (G.G.)
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Tamburella F, Lorusso M, Tramontano M, Fadlun S, Masciullo M, Scivoletto G. Overground robotic training effects on walking and secondary health conditions in individuals with spinal cord injury: systematic review. J Neuroeng Rehabil 2022; 19:27. [PMID: 35292044 PMCID: PMC8922901 DOI: 10.1186/s12984-022-01003-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 07/05/2021] [Accepted: 02/14/2022] [Indexed: 12/12/2022] Open
Abstract
Overground powered lower limb exoskeletons (EXOs) have proven to be valid devices in gait rehabilitation in individuals with spinal cord injury (SCI). Although several articles have reported the effects of EXOs in these individuals, the few reviews available focused on specific domains, mainly walking. The aim of this systematic review is to provide a general overview of the effects of commercial EXOs (i.e. not EXOs used in military and industry applications) for medical purposes in individuals with SCI. This systematic review was conducted following the PRISMA guidelines and it referred to MED-LINE, EMBASE, SCOPUS, Web of Science and Cochrane library databases. The studies included were Randomized Clinical Trials (RCTs) and non-RCT based on EXOs intervention on individuals with SCI. Out of 1296 studies screened, 41 met inclusion criteria. Among all the EXO studies, the Ekso device was the most discussed, followed by ReWalk, Indego, HAL and Rex devices. Since 14 different domains were considered, the outcome measures were heterogeneous. The most investigated domain was walking, followed by cardiorespiratory/metabolic responses, spasticity, balance, quality of life, human–robot interaction, robot data, bowel functionality, strength, daily living activity, neurophysiology, sensory function, bladder functionality and body composition/bone density domains. There were no reports of negative effects due to EXOs trainings and most of the significant positive effects were noted in the walking domain for Ekso, ReWalk, HAL and Indego devices. Ekso studies reported significant effects due to training in almost all domains, while this was not the case with the Rex device. Not a single study carried out on sensory functions or bladder functionality reached significance for any EXO. It is not possible to draw general conclusions about the effects of EXOs usage due to the lack of high-quality studies as addressed by the Downs and Black tool, the heterogeneity of the outcome measures, of the protocols and of the SCI epidemiological/neurological features. However, the strengths and weaknesses of EXOs are starting to be defined, even considering the different types of adverse events that EXO training brought about. EXO training showed to bring significant improvements over time, but whether its effectiveness is greater or less than conventional therapy or other treatments is still mostly unknown. High-quality RCTs are necessary to better define the pros and cons of the EXOs available today. Studies of this kind could help clinicians to better choose the appropriate training for individuals with SCI.
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Affiliation(s)
- Federica Tamburella
- I.R.C.C.S. Santa Lucia Foundation (FSL), Via Ardeatina, 306, 00179, Rome, Italy.
| | - Matteo Lorusso
- I.R.C.C.S. Santa Lucia Foundation (FSL), Via Ardeatina, 306, 00179, Rome, Italy
| | - Marco Tramontano
- I.R.C.C.S. Santa Lucia Foundation (FSL), Via Ardeatina, 306, 00179, Rome, Italy
| | - Silvia Fadlun
- I.R.C.C.S. Santa Lucia Foundation (FSL), Via Ardeatina, 306, 00179, Rome, Italy
| | - Marcella Masciullo
- I.R.C.C.S. Santa Lucia Foundation (FSL), Via Ardeatina, 306, 00179, Rome, Italy
| | - Giorgio Scivoletto
- I.R.C.C.S. Santa Lucia Foundation (FSL), Via Ardeatina, 306, 00179, Rome, Italy
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Lunghi C, Baroni F, Amodio A, Consorti G, Tramontano M, Liem T. Patient Active Approaches in Osteopathic Practice: A Scoping Review. Healthcare (Basel) 2022; 10:healthcare10030524. [PMID: 35327002 PMCID: PMC8955940 DOI: 10.3390/healthcare10030524] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 12/20/2022] Open
Abstract
Background: In the field of manual therapies there is a growing interest in moving from passive hands-on approaches to patient active approaches. In the osteopathic field there are both active and passive methods described as integrated in the process of care. However, this prospective linkage has not been formally explored and is not well shared in the community of practice. The present review aims to appraise the relevant literature on the functioning and principles of Patient active osteopathic approaches (PAOAs) and explore a prospective model for selecting the different types of PAOA, highlighting their integration into patient management strategies. Methods: A scoping review was conducted to analyze the relevant literature on the functioning and the different principles of PAOA and to obtain a comprehensive perspective on the phenomenon. Results: The eligible articles provide insights into the mechanisms of functioning and principles of application of active approaches to be integrated with hands-on approaches. These results provide new insights into the relevance of PAOA to clinical practice. Conclusions: The proposal, emerging from the review, may promote discussions in the community of practice and provide a road map for research towards achieving an evidence-based structure for PAOA.
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Affiliation(s)
- Christian Lunghi
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65100 Pescara, Italy; (C.L.); (G.C.)
- Research Department, Osteopathie Schule Deutschland, 22297 Hamburg, Germany;
| | - Francesca Baroni
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65100 Pescara, Italy; (C.L.); (G.C.)
- Correspondence:
| | | | - Giacomo Consorti
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65100 Pescara, Italy; (C.L.); (G.C.)
- Education Department of Osteopathy, Istituto Superiore di Osteopatia, 20126 Milan, Italy
| | - Marco Tramontano
- Centre Pour l’Etude, la Recherche et la Diffusion Osteopathiques, 00199 Rome, Italy;
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Torsten Liem
- Research Department, Osteopathie Schule Deutschland, 22297 Hamburg, Germany;
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Tramontano M, Polo N, Bustos AO, Lisi D, Galeoto G, Farsetti P. Changes in neurorehabilitation management during the COVID-19 pandemic: A scoping review. NeuroRehabilitation 2022; 51:23-32. [PMID: 35404296 DOI: 10.3233/nre-220014] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND The SARS-CoV-2 infection (COVID-19) has generated a threat to global health, determining the need for healthcare for large numbers of people in an extremely short timeOBJECTIVE:To investigate the management changes in the neurorehabilitation services during the COVID-19 pandemic. METHODS An electronic search was conducted in September 2021 by 2 independent reviewers in the following databases: MEDLINE (PubMed), the Physiotherapy Evidence Database, and the Cochrane Database of Systematic Reviews. All studies on organizational and welfare changes resulting from the COVID-19 pandemic in neurorehabilitation services were included. Screening of titles, abstracts, and full texts and data extraction were undertaken independently by pairs of reviewers. RESULTS The summary of results was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews.Electronic searches after the screening of title and abstract identified 80 studies, 13 studies met the inclusion criteria. A narrative summary of results of all included studies were reported in a tabular format. CONCLUSIONS Different organizational models were adopted in neurorehabilitation during the COVID-19 pandemic impacting the therapies time frame, the physical and mental health of healthcare professionals and the caregiver's workload. There is still uncertainty about the effectiveness of these new therapeutic strategies on the management of neurorehabilitation services and future studies should explore the effect on the patients' needs.
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Affiliation(s)
- Marco Tramontano
- Fondazione Santa Lucia IRCCS, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | | | - Amaranta Orejel Bustos
- Fondazione Santa Lucia IRCCS, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Danilo Lisi
- Azienda Ospedaliera Rilievo Nazionale Sant'Anna e San Sebastiano, UOC Risk Management, Caserta, Italy
| | - Giovanni Galeoto
- Department of Public Health and Infection Disease, Sapienza University of Rome, Rome, Italy
| | - Pasquale Farsetti
- Department of Orthopedic Surgery, University Hospital 'Tor Vergata', Rome, Italy
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Tramontano M, Tamburella F, Dal Farra F, Bergna A, Lunghi C, Innocenti M, Cavera F, Savini F, Manzo V, D’Alessandro G. International Overview of Somatic Dysfunction Assessment and Treatment in Osteopathic Research: A Scoping Review. Healthcare (Basel) 2021; 10:28. [PMID: 35052192 PMCID: PMC8775713 DOI: 10.3390/healthcare10010028] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 11/16/2021] [Revised: 12/13/2021] [Accepted: 12/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Osteopathic manipulative treatment (OMT) is a patient-centred, whole-body intervention aimed at enhance the person's self-regulation. OMT interventions are focused on somatic dysfunctions (SD) that can be defined as an altered regulative function associated with inflammatory signs palpable in the body framework in different body regions. The conceptual model that sustains SD, as well as its usefulness for the osteopathic profession, is still being discussed by the osteopathic community. Understanding the role and the application of SD is the aim of this scoping review. METHODS A literature search was carried out through the main biomedical databases: Pubmed (Medline), Cochrane, Central (Cochrane), Embase, PEDro and Scopus. Grey literature was considered via Google Scholar and the Osteopathic Research Web. The review was prepared by referring to the "Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews" (PRISMA-ScR). RESULTS A total of 37,279 records were identified through database searching and other sources. After the duplicates were removed, 27,023 titles and abstracts were screened. A total of 1495 full-text articles were assessed for eligibility. The qualitative synthesis included 280 studies. CONCLUSIONS Treating SD is an important part of osteopathic practice that varies from country to country. SD should be considered as a clinical value that assists in the clinical assessment and guides the decision-making process of osteopathic practitioners. Further studies should be designed to better understand why and how to choose the different assessment and intervention modalities to approach SD and to evaluate new osteopathic models.
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Affiliation(s)
| | | | - Fulvio Dal Farra
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.D.F.); (A.B.)
| | - Andrea Bergna
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.D.F.); (A.B.)
- AISO-Associazione Italiana Scuole di Osteopatia, 65125 Pescara, Italy
| | - Christian Lunghi
- Clinical-Based Human Research Department, Research Division, Foundation COME Collaboration, 65121 Pescara, Italy; (C.L.); (G.D.)
| | - Mattia Innocenti
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy; (M.I.); (F.C.); (F.S.); (V.M.)
| | - Fabio Cavera
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy; (M.I.); (F.C.); (F.S.); (V.M.)
| | - Federica Savini
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy; (M.I.); (F.C.); (F.S.); (V.M.)
| | - Vincenzo Manzo
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy; (M.I.); (F.C.); (F.S.); (V.M.)
| | - Giandomenico D’Alessandro
- Clinical-Based Human Research Department, Research Division, Foundation COME Collaboration, 65121 Pescara, Italy; (C.L.); (G.D.)
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy; (M.I.); (F.C.); (F.S.); (V.M.)
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Baroni F, Tramontano M, Barsotti N, Chiera M, Lanaro D, Lunghi C. Osteopathic structure/function models renovation for a person-centered approach: a narrative review and integrative hypothesis. J Complement Integr Med 2021; 0:jcim-2021-0430. [PMID: 34758518 DOI: 10.1515/jcim-2021-0430] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/02/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES The construct of the osteopathic structure-function models is reported as a cornerstone of clinical reasoning and treatment processes. Nevertheless, there are no shared procedures described for their use in clinical practice. The present narrative review aims to analyze a more comprehensive perspective on the phenomenon. METHODS A structured narrative review was conducted. A database search was conducted using Pubmed, ScienceDirect, and Google Scholar. Peer-reviewed papers without specifying limits on dates and design were included. RESULTS Twenty-five findings were reported and grouped into two main themes: 1) Debate on models and theoretical frameworks for osteopathic care; 2) Clinical reasoning and decision-making process in the osteopathic field. CONCLUSIONS An integrated osteopathic care approach based on the structure/function models represents a starting point to establish a shared osteopathic diagnostic and clinical reasoning and an evidence-informed practice promoting health in an interdisciplinary person-centered care process. The present review highlights the limited amount of literature on using osteopathic conceptual models in decision-making and treatment strategies. A research plan is required to develop a common framework for an evidence-based osteopathic practice that promotes well-being in an interdisciplinary person-centered care process.
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Affiliation(s)
- Francesca Baroni
- Clinical-Based Human Research Department, Research Division, Foundation COME Collaboration, Pescara, Italy
| | | | - Nicola Barsotti
- Clinical-Based Human Research Department, Research Division, Foundation COME Collaboration, Pescara, Italy
- Research Commission on Manual Therapies and Mind-Body Disciplines, Società Italiana di Psico Neuro Endocrino Immunologia, Rome, Italy
| | - Marco Chiera
- Clinical-Based Human Research Department, Research Division, Foundation COME Collaboration, Pescara, Italy
- Research Commission on Manual Therapies and Mind-Body Disciplines, Società Italiana di Psico Neuro Endocrino Immunologia, Rome, Italy
| | - Diego Lanaro
- Clinical-Based Human Research Department, Research Division, Foundation COME Collaboration, Pescara, Italy
- Research Commission on Manual Therapies and Mind-Body Disciplines, Società Italiana di Psico Neuro Endocrino Immunologia, Rome, Italy
| | - Christian Lunghi
- Clinical-Based Human Research Department, Research Division, Foundation COME Collaboration, Pescara, Italy
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Manzari L, Tramontano M. Identifying the Clinical Signs on the Healthy Side Using Video Head Impulse Test During Different Stages of Vestibular Neuritis. J Int Adv Otol 2021; 17:433-437. [PMID: 34617895 PMCID: PMC8975428 DOI: 10.5152/iao.2021.21155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective: To evaluate the presence of anti-compensatory saccades (AcS) using the video head impulse test (vHIT) in the healthy inner ear in patients with vestibular neuritis (VN) during the acute and subacute stages of VN. Methods: We retrospectively considered a chart review of 2420 patients evaluated for acute vestibular syndrome from 2016 to 2020 in the Cassino (Italy) clinic. Nine hundred fifty-four patients with acute onset of vestibular syndrome who received an instrumental otoneurological assessment within 24 hours from the onset of the symptoms, evaluated by simultaneously using a combination of vHIT, ocular vestibular-evoked myogenic potential (VEMP), and cervical VEMP, were included in the study. Results: Thirty-two patients with superior VN that showed an altered horizontal canal function when tested with vHIT and quick AcS on the healthy side were enrolled. We found that all patients with VN, evaluated in the first 24 hours from the onset of the symptoms, showed AcS when their head was abruptly and passively turned toward the healthy inner ear side. At follow-up within 8 weeks from the first evaluation, 29 out of 32 patients did not show increased AcS. Conclusions: Our findings support the hypothesis that the AcS on the healthy side are a clinical sign of vestibular canal hypofunction or paresis in patients affected by the acute stage of VN.
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Tramontano M, Princi AA, De Angelis S, Indovina I, Manzari L. Vestibular rehabilitation in patients with persistent postural-perceptual dizziness: a scoping review. Hearing, Balance and Communication 2021. [DOI: 10.1080/21695717.2021.1975986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Marco Tramontano
- Fondazione Santa Lucia IRCCS, Rome, Italy
- Department of Movement, Human and Health Sciences, Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome ‘Foro Italico’, Roma, Italy
| | | | | | - Iole Indovina
- Fondazione Santa Lucia IRCCS, Rome, Italy
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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Tramontano M, De Angelis S, Galeoto G, Cucinotta MC, Lisi D, Botta RM, D’ippolito M, Morone G, Buzzi MG. Physical Therapy Exercises for Sleep Disorders in a Rehabilitation Setting for Neurological Patients: A Systematic Review and Meta-Analysis. Brain Sci 2021; 11:brainsci11091176. [PMID: 34573197 PMCID: PMC8467393 DOI: 10.3390/brainsci11091176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/26/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Sleep occupies one-third of human life and is essential for health and for emotional, physical, and cognitive well-being. Poor or insufficient sleep is associated with a wide range of dysfunctions that involve different body systems, such as the endocrine, metabolic, and immune systems, thus compromising the higher cortical functions, cognitive performance, mood, and post-physical activity recovery. The present systematic review and meta-analysis aimed to explore the effectiveness of physical therapy exercises on sleep disorders in patients with neurological disorders. Our systematic review identified 10 articles that investigated the effects of physical therapy on sleep disorders in patients with neurological disorders, 6 of which were included in the meta-analysis. Results suggest that physical therapy exercises are a safe and useful strategy for managing sleep disorders in neurorehabilitation.
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Affiliation(s)
- Marco Tramontano
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (M.C.C.); (M.D.); (G.M.); (M.G.B.)
- Correspondence: ; Tel.: +39-0651501420
| | - Sara De Angelis
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (M.C.C.); (M.D.); (G.M.); (M.G.B.)
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy;
- IRCCCS Neuromed, 86077 Pozzilli, IS, Italy
| | - Maria Carmela Cucinotta
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (M.C.C.); (M.D.); (G.M.); (M.G.B.)
| | - Danilo Lisi
- Azienda Ospedaliera Rilievo Nazionale Sant’Anna e San Sebastiano, UOC Risk Management, 81100 Caserta, Italy;
| | | | - Mariagrazia D’ippolito
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (M.C.C.); (M.D.); (G.M.); (M.G.B.)
| | - Giovanni Morone
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (M.C.C.); (M.D.); (G.M.); (M.G.B.)
| | - Maria Gabriella Buzzi
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (M.C.C.); (M.D.); (G.M.); (M.G.B.)
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Tramontano M, De Angelis S, Mastrogiacomo S, Princi AA, Ciancarelli I, Frizziero A, Iosa M, Paolucci S, Morone G. Music-based techniques and related devices in neurorehabilitation: a scoping review. Expert Rev Med Devices 2021; 18:733-749. [PMID: 34162284 DOI: 10.1080/17434440.2021.1947793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction:The music as a powerful, and versatile stimulus for the brain, is at the date sometimes used in neurorehabilitation and proposed as a promising complementary strategy provided in combination with other therapy in individuals with neurological disorders. Different techniques and devices have been developed in the field of the music-based neurorehabilitation.Areas covered:This scoping review analyzes the current scientific literature concerning the different techniques and devices used in the music-supported neurorehabilitation, also focusing on the devices used in music-based therapies in patients with neurological disorders: 46 studies met the inclusion criteria and were included.Expert opinion:Included studies, highlight the potentiality and the versatility of the music-based therapy in the rehabilitation of neurological disorders. The variety of existing techniques allow to applied the music-based therapy in different situations and conditions. Moreover, the wide range of used devices that ranging from the simple musical instruments to the more advanced technologies, allows to develop customized exercises based on the needs of the patient. This review may be considered as a starting point to better design future RCTs that would investigate the effectiveness of music therapy on neurological disorders.
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Affiliation(s)
| | | | | | | | - Irene Ciancarelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Antonio Frizziero
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Marco Iosa
- Fondazione Santa Lucia IRCCS, Rome, Italy.,Department of Psychology, University of Rome La Sapienza, Rome, Italy
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Tramontano M, Morone G, LA Greca FM, Marchegiani V, Palomba A, Iosa M, Musto G, Simonelli M. Sunnybrook Facial Grading System reliability in subacute stroke patients. Eur J Phys Rehabil Med 2021; 57:685-690. [PMID: 34105919 DOI: 10.23736/s1973-9087.21.06629-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND A lack of evidence on the reliability limits the utility of the Sunnybrook Facial Grading System (SFGS) in individuals affected by stroke both in clinical and research settings. AIM To examine the test-retest reliability and the inter-rater reliability of the SFGS in patients affected by subacute stroke. DESIGN A repeated-assessments design (fifteen days apart) was used to examine the test-retest reliability of the SFGS. SETTING Inpatient rehabilitation unit. POPULATION Thirty-two inpatients with subacute stroke. METHODS Thirty-two inpatients with subacute stroke participated in the test-retest reliability study. All patients were video-recorded in sitting position and uncovered face for about two minutes, in static position to evaluate symmetry at rest, then assessing symmetry of voluntary movement and synkinesis. For the inter-rater reliability, fifteen experts in neurorehabilitation were selected as raters. The facial function was assessed using the Italian version of the SFGS was used as grading system on a recorded video of each patient. The inter-rater reliability was carried out through the ICC, Intraclass Correlation Coefficient, while the intra-rater reliability was assessed comparing for each rater the scores evaluated at T0 and T1 using Wilcoxon signed-rank test. RESULTS Evaluations at T0 and T1 showed a significant correlation with a total ICC (T0 + T1) of 0.901 (95% CI 0.852-0.942; p-value <0.001). The ICC of T0 scores is 0.914 (95% CI 0.869-0.950; p-value <0.001), while the ICC of T1 scores is 0.886 (95% CI 0.829-0.995; p-value <0.001). The scores of the "voluntary movement symmetry" area are correlated with ICC of 0.916 (95% CI 0.835-0.958; p-value <0.001). The scores of the "resting symmetry" area show correlation with ICC of 0.567 (95% CI 0.277-0.762; p-value <0.001). The area of "synkinesis" shows a lower correlation with ICC of 0.175 (95% CI -0.180-0.489; p-value <0.001). The scores attributed to the patients in the two different moments of observation resulted not significantly different from 12 out of 15 raters. CONCLUSIONS The SFGS resulted reliable in its overall score to assess the facial palsy also in patients affected by stroke. CLINICAL REHABILITATION IMPACT The findings of this study provide empirical evidence of reliable properties of the SFGS for assessing central facial palsy in patients with stroke.
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Affiliation(s)
| | | | | | | | - Angela Palomba
- Multidisciplinary Department of Medicine for Surgery and Orthodontics, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Marco Iosa
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
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Iosa M, Galeoto G, De Bartolo D, Russo V, Ruotolo I, Spitoni GF, Ciancarelli I, Tramontano M, Antonucci G, Paolucci S, Morone G. Italian Version of the Pittsburgh Rehabilitation Participation Scale: Psychometric Analysis of Validity and Reliability. Brain Sci 2021; 11:brainsci11050626. [PMID: 34068212 PMCID: PMC8153139 DOI: 10.3390/brainsci11050626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 03/23/2021] [Revised: 05/04/2021] [Accepted: 05/12/2021] [Indexed: 12/30/2022] Open
Abstract
Patient’s active participation in therapy is a key component of successful rehabilitation. In fact, low participation has been shown to be a prognostic factor of poor outcome; however, participation is rarely assessed in clinical settings. The Pittsburgh Rehabilitation Participation Scale (PRPS) is a validated, quick, and accurate measure of participation, relying on clinicians’ observation, and not requiring any self-report by patients. The aim of this study was to validate an Italian version of the PRPS. Following forward and back-translation of PRPS into Italian, the translated version was validated in a total of 640 therapy sessions, related to a cohort of 32 patients admitted to an Italian hospital. It was tested for concurrent validity, finding significant correlations with Barthel Index (R > 0.58, p < 0.001) and SF-36 Physical and Mental Health (R > 0.4, p < 0.02), for predictive validity, finding significant correlation with the effectiveness of rehabilitation (R = 0.358, p = 0.045), and for inter-rater and intra-rater reliability, computing an Intra-class correlation coefficient (ICC = 0.926 and 0.756, respectively). These psychometric properties results were similar to those of the original version of this scale. The proposed PRPS can be helpful for Italian clinicians in the assessment of patient’s participation during rehabilitation.
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Affiliation(s)
- Marco Iosa
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (D.D.B.); (V.R.) (G.A.)
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (G.F.S.); (M.T.); (S.P.); (G.M.)
- Correspondence: ; Tel.: +39-0651-501-077
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome Italy; (G.G.); (I.R.)
- IRCCS Neuromed Pozzilli, 86077 Isernia, Italy
| | - Daniela De Bartolo
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (D.D.B.); (V.R.) (G.A.)
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (G.F.S.); (M.T.); (S.P.); (G.M.)
| | - Valentina Russo
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (D.D.B.); (V.R.) (G.A.)
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (G.F.S.); (M.T.); (S.P.); (G.M.)
| | - Ilaria Ruotolo
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome Italy; (G.G.); (I.R.)
| | - Grazia Fernanda Spitoni
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (G.F.S.); (M.T.); (S.P.); (G.M.)
- Department of Dynamic, Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Rome, Italy
| | - Irene Ciancarelli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Marco Tramontano
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (G.F.S.); (M.T.); (S.P.); (G.M.)
| | - Gabriella Antonucci
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (D.D.B.); (V.R.) (G.A.)
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (G.F.S.); (M.T.); (S.P.); (G.M.)
| | - Stefano Paolucci
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (G.F.S.); (M.T.); (S.P.); (G.M.)
| | - Giovanni Morone
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (G.F.S.); (M.T.); (S.P.); (G.M.)
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Manzari L, Princi AA, De Angelis S, Tramontano M. Clinical value of the video head impulse test in patients with vestibular neuritis: a systematic review. Eur Arch Otorhinolaryngol 2021; 278:4155-4167. [PMID: 33893851 DOI: 10.1007/s00405-021-06803-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 10/20/2020] [Accepted: 04/07/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE The aim of this systematic review was to evaluate the clinical application potential of the video head impulse test (vHIT) in diagnosing vestibular neuritis (VN). METHODS An electronic search was conducted in the following databases: Embase, MEDLINE, ScienceDirect, Google scholar, and the Cochrane Database of Systematic Reviews. Clinical studies were included in which an evaluation was made using vHIT either alone or in combination with other tests or bedside algorithms. Evaluations that were carried out using unvalidated tools were excluded. Only studies of patients with VN (superior, inferior, or in toto) were included. Screening of titles, abstracts, full texts, and data extraction were undertaken independently by pairs of reviewers. Included studies were quality appraised using a modified version of the Newcastle-Ottawa scale. RESULTS Results were reported according to the preferred reporting items for systematic reviews and meta-analyses. Our search yielded 1309 unique records, 21 of which remained after screening titles and abstracts. Sixteen studies were included, i.e., for a total of 933 patients including 474 patients with a diagnosis of VN. CONCLUSIONS The diagnostic value of vHIT is high for VN, as it is a high-frequency measurement tool. vHIT is a useful complement or alternative to caloric and rotational tests as an indicator of lesions of vestibular canal functioning, especially at the time of onset. This tool can provide useful clues about the clinical progress of recovery from the lesion through the value of the vestibulo ocular reflex gain and the consequent evolution of the saccade pattern, which allows the patient to stabilize vision on the retina.
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Affiliation(s)
| | | | | | - Marco Tramontano
- Fondazione Santa Lucia IRCCS, Rome, Italy.,Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
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De Angelis S, Princi AA, Dal Farra F, Morone G, Caltagirone C, Tramontano M. Vibrotactile-Based Rehabilitation on Balance and Gait in Patients with Neurological Diseases: A Systematic Review and Metanalysis. Brain Sci 2021; 11:brainsci11040518. [PMID: 33921655 PMCID: PMC8072538 DOI: 10.3390/brainsci11040518] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 02/04/2021] [Revised: 04/10/2021] [Accepted: 04/14/2021] [Indexed: 01/06/2023] Open
Abstract
Postural instability and fear of falling represent two major causes of decreased mobility and quality of life in cerebrovascular and neurologic diseases. In recent years, rehabilitation strategies were carried out considering a combined sensorimotor intervention and an active involvement of the patients during the rehabilitation sessions. Accordingly, new technological devices and paradigms have been developed to increase the effectiveness of rehabilitation by integrating multisensory information and augmented feedback promoting the involvement of the cognitive paradigm in neurorehabilitation. In this context, the vibrotactile feedback (VF) could represent a peripheral therapeutic input, in order to provide spatial proprioceptive information to guide the patient during task-oriented exercises. The present systematic review and metanalysis aimed to explore the effectiveness of the VF on balance and gait rehabilitation in patients with neurological and cerebrovascular diseases. A total of 18 studies met the inclusion criteria and were included. Due to the lack of high-quality studies and heterogeneity of treatments protocols, clinical practice recommendations on the efficacy of VF cannot be made. Results show that VF-based intervention could be a safe complementary sensory-motor approach for balance and gait rehabilitation in patients with neurological and cerebrovascular diseases. More high-quality randomized controlled trials are needed.
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Affiliation(s)
- Sara De Angelis
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (A.A.P.); (G.M.); (C.C.)
| | | | | | - Giovanni Morone
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (A.A.P.); (G.M.); (C.C.)
| | - Carlo Caltagirone
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (A.A.P.); (G.M.); (C.C.)
| | - Marco Tramontano
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (A.A.P.); (G.M.); (C.C.)
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00185 Rome, Italy
- Correspondence: ; Tel.: +39-06-5150-1420
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Raglio A, Panigazzi M, Colombo R, Tramontano M, Iosa M, Mastrogiacomo S, Baiardi P, Molteni D, Baldissarro E, Imbriani C, Imarisio C, Eretti L, Hamedani M, Pistarini C, Imbriani M, Mancardi GL, Caltagirone C. Hand rehabilitation with sonification techniques in the subacute stage of stroke. Sci Rep 2021; 11:7237. [PMID: 33790343 PMCID: PMC8012636 DOI: 10.1038/s41598-021-86627-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 03/17/2021] [Indexed: 11/25/2022] Open
Abstract
After a stroke event, most survivors suffer from arm paresis, poor motor control and other disabilities that make activities of daily living difficult, severely affecting quality of life and personal independence. This randomized controlled trial aimed at evaluating the efficacy of a music-based sonification approach on upper limbs motor functions, quality of life and pain perceived during rehabilitation. The study involved 65 subacute stroke individuals during inpatient rehabilitation allocated into 2 groups which underwent usual care dayweek) respectively of standard upper extremity motor rehabilitation or upper extremity treatment with sonification techniques. The Fugl-Meyer Upper Extremity Scale, Box and Block Test and the Modified Ashworth Scale were used to perform motor assessment and the McGill Quality of Life-it and the Numerical Pain Rating Scale to assess quality of life and pain. The assessment was performed at baseline, after 2 weeks, at the end of treatment and at follow-up (1 month after the end of treatment). Total scores of the Fugl-Meyer Upper Extremity Scale (primary outcome measure) and hand and wrist sub scores, manual dexterity scores of the affected and unaffected limb in the Box and Block Test, pain scores of the Numerical Pain Rating Scale (secondary outcomes measures) significantly improved in the sonification group compared to the standard of care group (time*group interaction < 0.05). Our findings suggest that music-based sonification sessions can be considered an effective standardized intervention for the upper limb in subacute stroke rehabilitation.
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Affiliation(s)
- Alfredo Raglio
- Istituti Clinici Scientifici Maugeri, I.R.C.C.S., Istituti Clinici Scientifici Maugeri, Music Therapy Research Laboratory, Scientific Institute of Pavia , Via Maugeri 10, 27100, Pavia, Italy.
| | - Monica Panigazzi
- Istituti Clinici Scientifici Maugeri, I.R.C.C.S., Istituti Clinici Scientifici Maugeri, Music Therapy Research Laboratory, Scientific Institute of Pavia , Via Maugeri 10, 27100, Pavia, Italy
| | - Roberto Colombo
- Istituti Clinici Scientifici Maugeri, I.R.C.C.S., Istituti Clinici Scientifici Maugeri, Music Therapy Research Laboratory, Scientific Institute of Pavia , Via Maugeri 10, 27100, Pavia, Italy
| | | | - Marco Iosa
- Fondazione S. Lucia, I.R.C.C.S., Rome, Italy
| | | | - Paola Baiardi
- Istituti Clinici Scientifici Maugeri, I.R.C.C.S., Istituti Clinici Scientifici Maugeri, Music Therapy Research Laboratory, Scientific Institute of Pavia , Via Maugeri 10, 27100, Pavia, Italy
| | - Daniele Molteni
- Istituti Clinici Scientifici Maugeri, I.R.C.C.S., Istituti Clinici Scientifici Maugeri, Music Therapy Research Laboratory, Scientific Institute of Pavia , Via Maugeri 10, 27100, Pavia, Italy
| | | | - Chiara Imbriani
- Istituti Clinici Scientifici Maugeri, I.R.C.C.S., Istituti Clinici Scientifici Maugeri, Music Therapy Research Laboratory, Scientific Institute of Pavia , Via Maugeri 10, 27100, Pavia, Italy
| | - Chiara Imarisio
- Istituti Clinici Scientifici Maugeri, I.R.C.C.S., Istituti Clinici Scientifici Maugeri, Music Therapy Research Laboratory, Scientific Institute of Pavia , Via Maugeri 10, 27100, Pavia, Italy
| | - Laura Eretti
- Istituti Clinici Scientifici Maugeri, I.R.C.C.S, Montescano, PV, Italy
| | - Mehrnaz Hamedani
- Neurological Clinic, S. Martino Hospital, University of Genoa, Genoa, Italy
| | - Caterina Pistarini
- Istituti Clinici Scientifici Maugeri, I.R.C.C.S., Nervi (GE), Pavia, Italy
| | - Marcello Imbriani
- Istituti Clinici Scientifici Maugeri, I.R.C.C.S., Istituti Clinici Scientifici Maugeri, Music Therapy Research Laboratory, Scientific Institute of Pavia , Via Maugeri 10, 27100, Pavia, Italy
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Tramontano M, Lunghi C, Pagnotta S, Manzo C, Manzo F, Consolo S, Manzo V. Response to a letter to editor from Hohenschurz-Schmidt et al. J Osteopath Med 2021; 121:447-448. [PMID: 33694355 DOI: 10.1515/jom-2021-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/10/2021] [Indexed: 11/15/2022]
Affiliation(s)
| | | | - Simone Pagnotta
- Centre Pour l'Etude, la Recherche et la Diffusion Osteopathiques, Rome, Italy
| | - Camilla Manzo
- Centre Pour l'Etude, la Recherche et la Diffusion Osteopathiques, Rome, Italy
| | - Francesca Manzo
- Centre Pour l'Etude, la Recherche et la Diffusion Osteopathiques, Rome, Italy
| | - Stefano Consolo
- Centre Pour l'Etude, la Recherche et la Diffusion Osteopathiques, Rome, Italy
| | - Vincenzo Manzo
- Centre Pour l'Etude, la Recherche et la Diffusion Osteopathiques, Rome, Italy
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Manzari L, Koch G, Tramontano M. Selective Asymmetry of Ocular Vestibular-Evoked Myogenic Potential in Patients with Acute Utricular Macula Loss. J Int Adv Otol 2021; 17:58-63. [PMID: 33605223 PMCID: PMC7901419 DOI: 10.5152/iao.2020.18012020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 11/02/2020] [Accepted: 11/05/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES We retrospectively evaluated a chart review of 3,525 patients evaluated for any acute disturbance. A total of 1,504 patients with acute vestibular syndrome (AVS) received an instrumental vestibular assessment within 72 h from the onset of the symptoms evaluated using simultaneously a combination of ocular vestibular-evoked myogenic potential (oVEMPs), cervical vestibular-evoked myogenic potential (cVEMPs), video head-impulse test (vHIT), and subjective visual vertical (SVV) were included in this study. MATERIALS AND METHODS A total of 41 patients with AVS that showed a normal horizontal canal function tested with vHIT, a normal cVEMP function, unilaterally reduced or absent oVEMP n10, and an altered SVV were enrolled. RESULTS We found that although these patients referred acute vertigo and presented spontaneous nystagmus, they showed physiological values of vHIT and a normal saccular function, as shown by symmetrical cVEMPs. CONCLUSION Our findings support the hypothesis that a percentage of patients evaluated during an AVS using an instrumental vestibular assessment could present selective utricular macula dysfunction.
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Affiliation(s)
| | - Giacomo Koch
- Fondazione Santa Lucia IRCCS, Rome, Italy;Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
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Tramontano M, Consorti G, Morone G, Lunghi C. Vertigo and Balance Disorders - The Role of Osteopathic Manipulative Treatment: A Systematic Review. Complement Med Res 2020; 28:368-377. [PMID: 33361695 DOI: 10.1159/000512673] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 08/12/2020] [Accepted: 10/28/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Balance disorders are among the most frequent reasons for consultation and referral to specialist care. Osteopathic Manipulative Treatment (OMT) can influence the proprioceptive system by inducing alterations in the proprioceptive stimuli, hence affecting postural control. OBJECTIVE The present systematic review aimed to explore the effects of OMT in managing patients with vertigo and balance disorders. METHODS MEDLINE (PubMed), ScienceDirect, and Google Scholar were searched. Clinical trials and prospective observational studies were considered. Only studies that considered OMT as the main intervention, provided alone or combined with other interventions, were included. The methodological quality of the evidence was assessed with a modified version of the Newcastle-Ottawa Scale. RESULTS Five studies that enrolled a total of 114 subjects met our inclusion criteria. Overall, it has been observed that there is a positive effect on balance disorders through different outcomes in all of the included studies. Only two studies (9 subjects) mentioned low to moderate adverse events after OMT. CONCLUSIONS OMT showed weak positive effects on balance function, encouraging the connection of conventional medicine and evidence-based complementary medicine for integrative clinical practice and interprofessional work. However, full-sized adequately powered randomized trials are required to determine the effectiveness of OMT for vertigo and balance disorders.
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Affiliation(s)
| | - Giacomo Consorti
- Clinical-Based Human Research Department, Centre for Osteopathic Medicine Collaboration, Pescara, Italy.,Educational Department of Osteopathy, Istituto Superiore Osteopatia, Milan, Italy
| | | | - Christian Lunghi
- Clinical-Based Human Research Department, Centre for Osteopathic Medicine Collaboration, Pescara, Italy
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Curcio A, Temperoni G, Tramontano M, De Angelis S, Iosa M, Mommo F, Cochi G, Formisano R. The effects of aquatic therapy during post-acute neurorehabilitation in patients with severe traumatic brain injury: a preliminary randomized controlled trial. Brain Inj 2020; 34:1630-1635. [PMID: 32991207 DOI: 10.1080/02699052.2020.1825809] [Citation(s) in RCA: 4] [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] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The primary aim is to verify the effectiveness of an aquatic training (AT) in inpatients with severe Traumatic Brain Injury (sTBI) on balance. The secondary aims are to explore the effects on gait, activities of daily living, and quality of life, comparing to a land-based conventional protocol. METHODS Two-arm, randomized controlled trial. Twenty inpatients with sTBI, Glasgow Coma Scale score ≤8, and Level of Cognitive Functioning ≥7 were recruited and randomly assigned to the aquatic therapy group (ATG) or to the Conventional Training Group (CTG). Patients underwent 12 individual rehabilitation sessions (3 days/week, 4 weeks), in a rehabilitation pool during the post-acute intensive neurorehabilitation. The primary outcome measure was the Berg Balance Scale (BBS). Secondary outcome measures were the Modified Barthel Index (MBI), Disability Rating Scale (DRS), Tinetti Gait Balance Scale (TBG) and Quality of Life After Brain Injury (QOLIBRI). All the evaluations were performed at the baseline and after 4 weeks of training. RESULTS The within-subjects analysis showed a significant improvement both in ATG and CTG in MBI, BBS, TBG, and QOLIBRI. CONCLUSION Our results may support the use of AT during post-acute phase to improve motor functions and quality of life in patients with sTBI.
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Affiliation(s)
- A Curcio
- Fondazione Santa Lucia IRCCS , Rome, Italy
| | | | - Marco Tramontano
- Fondazione Santa Lucia IRCCS , Rome, Italy.,Department of Movement, Human and Health Sciences, University of Rome "Foro Italico," Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System , Rome, Italy
| | | | - M Iosa
- Fondazione Santa Lucia IRCCS , Rome, Italy
| | - F Mommo
- Fondazione Santa Lucia IRCCS , Rome, Italy
| | - G Cochi
- Fondazione Santa Lucia IRCCS , Rome, Italy
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Verna V, De Bartolo D, Iosa M, Fadda L, Pinto G, Caltagirone C, De Angelis S, Tramontano M. Te.M.P.O., an app for using temporal musical mismatch in post-stroke neurorehabilitation: A preliminary randomized controlled study. NeuroRehabilitation 2020; 47:201-208. [DOI: 10.3233/nre-203126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND: Recently, the potential rehabilitation value of music has been examined and music-based interventions and techniques such as the Negative Mismatch (MMN) have been increasingly investigated in the neurological rehabilitation context. OBJECTIVE: The aim of this study was to investigate the effectiveness of a negative mismatch-based therapy on the disability and quality of life in patients with stroke in sub-acute phase. METHODS: Thirty patients with a stroke diagnosis in sub-acute phase were randomly assigned to one of two groups: Mismatch (Mg) or Control (CTRLg) group. Both groups used an innovative Android application: Temporal Musical Patterns Organisation (Te.M.P.O). The Disability Rating Scale (DRS), the Modified Barthel Index (MBI) and the Stroke Specific Quality of Life scale (SSQoL) were used at the baseline (T0) and after four weeks of training (T1), in order to assess changes over time. RESULTS: Statistical analysis was performed using the data of 24 (Mg = 12, CTRLg = 12) subjects. The results show a major improvement of the Mg with respect to the CTRLg in all clinical scales score. CONCLUSION: The temporal negative mismatch-based therapy performed with the Te.M.P.O. application could be useful in improving the disability and the quality of life in stroke survivors in a sub-acute phase.
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Affiliation(s)
| | - Daniela De Bartolo
- PhD Program in Behavioral Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Marco Iosa
- Fondazione Santa Lucia IRCCS, Rome, Italy
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Belluscio V, Bergamini E, Tramontano M, Formisano R, Buzzi MG, Vannozzi G. Does Curved Walking Sharpen the Assessment of Gait Disorders? An Instrumented Approach Based on Wearable Inertial Sensors. Sensors (Basel) 2020; 20:s20185244. [PMID: 32937877 PMCID: PMC7570481 DOI: 10.3390/s20185244] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 07/30/2020] [Revised: 09/07/2020] [Accepted: 09/10/2020] [Indexed: 11/25/2022]
Abstract
Gait and balance assessment in the clinical context mainly focuses on straight walking. Despite that curved trajectories and turning are commonly faced in our everyday life and represent a challenge for people with gait disorders. The adoption of curvilinear trajectories in the rehabilitation practice could have important implications for the definition of protocols tailored on individual’s needs. The aim of this study was to contribute toward the quantitative characterization of straight versus curved walking using an ecological approach and focusing on healthy and neurological populations. Twenty healthy adults (control group (CG)) and 20 patients with Traumatic Brain Injury (TBI) (9 severe, sTBI-S, and 11 very severe, sTBI-VS) performed a 10 m and a Figure-of-8 Walk Test while wearing four inertial sensors that were located on both tibiae, sternum and pelvis. Spatiotemporal and gait quality indices that were related to locomotion stability, symmetry, and smoothness were obtained. The results show that spatiotemporal, stability, and symmetry-related gait patterns are challenged by curved walking both in healthy subjects and sTBI-S, whereas no difference was displayed for sTBI-VS. The use of straight walking alone to assess gait disorders is thus discouraged, particularly in patients with good walking abilities, in favor of the adoption of complementary tests that were also based on curved paths.
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Affiliation(s)
- Valeria Belluscio
- Department of Movement, Human and Health Sciences, Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Piazza Lauro de Bosis 15, 00135 Roma, Italy; (V.B.); or (G.V.)
- IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Roma, Italy; (R.F.); (M.G.B.)
| | - Elena Bergamini
- Department of Movement, Human and Health Sciences, Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Piazza Lauro de Bosis 15, 00135 Roma, Italy; (V.B.); or (G.V.)
- Correspondence: ; Tel.: +39-0636-733-506
| | - Marco Tramontano
- Department of Movement, Human and Health Sciences, Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Piazza Lauro de Bosis 15, 00135 Roma, Italy; (V.B.); or (G.V.)
- IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Roma, Italy; (R.F.); (M.G.B.)
| | - Rita Formisano
- IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Roma, Italy; (R.F.); (M.G.B.)
| | - Maria Gabriella Buzzi
- IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Roma, Italy; (R.F.); (M.G.B.)
| | - Giuseppe Vannozzi
- Department of Movement, Human and Health Sciences, Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Piazza Lauro de Bosis 15, 00135 Roma, Italy; (V.B.); or (G.V.)
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44
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Tramontano M, Morone G, Palomba A, De Angelis S, Mercuro A, Caltagirone C, Grasso MG. Effectiveness of a sensor-based technology in upper limb motor recovery in post-acute stroke neurorehabilitation: a randomized controlled trial. J BIOL REG HOMEOS AG 2020; 34:165-174. Technology in Medicine. [PMID: 33386046] [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] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Sensor-based technological therapy devices could be a possible neurorehabilitation strategy for motor rehabilitation in patients with stroke during the post-acute hospitalization, especially for treating upper extremities function limitations. The audio-visual feedback devices are characterized by interactive therapy games that allow training the movement of shoulders, elbows, and wrist, measuring the strength and the active range of motion of upper limb, registering data in an electronic database to quantitatively monitoring measures and therapy progress. This study aimed to investigate the effects of sensor-based motor rehabilitation in add-on to the conventional neurorehabilitation for improving the upper limb functions in patients with subacute stroke. Thirty-seven patients were enrolled in the study and randomly assigned to the experimental group and the control group. The training consisting of twelve sessions of upper limb training compared with twelve sessions of upper limb sensory-motor training, without robotic support. Both rehabilitation programs were performed for 40 minutes three times a week, for 4 weeks, in addition to conventional therapy. All patients were evaluated at the baseline (T0) and after 4 weeks of training (T1). The within-subject analysis showed a statistically significant improvement in both groups in all clinical scales. The analysis of effectiveness revealed that, compared with baseline (T0), the improvement percentage in the Modified Barthel Index was greater in the experimental group than the control group. The use of a sensor-based training with audio-video-feedback could be a useful complementary strategy for improving upper limb motor functions in patients with stroke during post-acute neurorehabilitation.
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Affiliation(s)
| | - G Morone
- Fondazione Santa Lucia IRCCS, Rome, Italy
| | - A Palomba
- Multidisciplinary Department of Medicine for Surgery and Orthodontics, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | - A Mercuro
- Fondazione Santa Lucia IRCCS, Rome, Italy
| | | | - M G Grasso
- Fondazione Santa Lucia IRCCS, Rome, Italy
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45
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Manzari L, Graziano D, Tramontano M. The Different Stages of Vestibular Neuritis from the Point of View of the Video Head Impulse Test. Audiol Res 2020; 10:31-38. [PMID: 33704148 PMCID: PMC7768365 DOI: 10.4081/audiores.2020.248] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 07/13/2019] [Accepted: 09/22/2019] [Indexed: 11/22/2022] Open
Abstract
Vestibular neuritis (VN) is one of the most common causes of acute vestibular syndrome (AVS). Quantifying the vestibulo-ocular reflex (VOR) gain by the video Head Impulse Test (vHIT) could provide useful information to diagnose VN. This study aims to retrospectively evaluate the VOR gain values during the acute and subacute stages of the VN and to correlate these values with the patients’ dizziness-related handicap. Medical record of 28 patients with VN were reviewed. Patients were assigned to two groups according to the time since the acute vestibular syndrome (AVS). One group with patients assessed within seventy-two hours since the AVS (AVSg) and one group with patients evaluated from four days to six weeks since the AVS (PAVSg). VOR gain was evaluated in all selected patients and correlated to Dizziness Handicap Inventory (DHI). Significant differences were found in the between-subjects analysis in DHI score (p = 0.000) and in the ipsilesional hVOR gain values (p = 0.001). The correlation analysis showed significant results (p = 0.017) between DHI score (40 ± 16.08) and ipsilesional VOR gain (0.54 ± 0.09) in the PAVSg. Patients evaluated within 72 h since the AVS showed anticompensatory saccades (AcS) turning the head toward the contralesional side. Patients with unilateral Superior VN (SVN) could have dissimilar hVOR gain values and DHI score according to the damage of the VIII pair of cranial nerves. AcS in the contralesional side is a sign of acute phase in patients with unilateral SVN.
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Affiliation(s)
| | | | - Marco Tramontano
- IRCCS Santa Lucia Foundation, Rome, Italy.,Department of Movement, Human and Health Sciences, University of Rome "Foro Italico",Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, P.zza Lauro de Bosis 15, 00135 Roma, Italy
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46
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Ghanbari Ghoshchi S, De Angelis S, Morone G, Panigazzi M, Persechino B, Tramontano M, Capodaglio E, Zoccolotti P, Paolucci S, Iosa M. Return to Work and Quality of Life after Stroke in Italy: A Study on the Efficacy of Technologically Assisted Neurorehabilitation. Int J Environ Res Public Health 2020; 17:ijerph17145233. [PMID: 32698430 PMCID: PMC7399919 DOI: 10.3390/ijerph17145233] [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: 06/05/2020] [Revised: 07/16/2020] [Accepted: 07/17/2020] [Indexed: 12/25/2022]
Abstract
Cerebrovascular diseases, including stroke, are historically considered diseases of old adults so only in a few studies has “return to work” (RTW) been considered as an index of rehabilitative outcome. At the moment, data on RTW in patients with stroke are highly variable: four different reviews reported the following ranges: 11–85%, 19–73%, 22–53%, and 40–45%. The absence of re-integration to work after a stroke is shown to be associated with an increase of cardiac disorders and depression, with a higher level of mortality, with social isolation and with insufficient adaptive skills. The aim of this study was to verify the effectiveness of technological treatment, performed with optic (SonicHand) and wearable (Riablo™) systems providing auditory and visual biofeedback, on RTW in patients with stroke. RTW was found to be associated with a higher independence in the activities of daily living (assessed by the Modified Barthel Index). No significant differences were found between technological versus conventional rehabilitation in terms of RTW, despite the former showing a higher odds ratio than the latter (OR = 9 vs. 6). Assistive devices were mainly used in patients who had not returned to work. Finally, quality of life was found higher in those patients who returned to work with the same conditions (work duties and time) as before stroke.
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Affiliation(s)
- Sheyda Ghanbari Ghoshchi
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy; (S.G.G.); (S.D.A.); (G.M.); (M.T.); (P.Z.); (S.P.)
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Sara De Angelis
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy; (S.G.G.); (S.D.A.); (G.M.); (M.T.); (P.Z.); (S.P.)
| | - Giovanni Morone
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy; (S.G.G.); (S.D.A.); (G.M.); (M.T.); (P.Z.); (S.P.)
| | - Monica Panigazzi
- Istituti Clinici Scientifici Maugeri IRCSS, Occupational Therapy and Ergonomics Unit, 27040 Montescano, Italy;
- Istituti Clinici Scientifici Maugeri IRCSS, Occupational Therapy and Ergonomics Unit, 27100 Pavia, Italy;
| | - Benedetta Persechino
- Italian Workers’ Compensation Authority (INAIL), Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Monte Porzio Catone, 00078 Rome, Italy;
| | - Marco Tramontano
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy; (S.G.G.); (S.D.A.); (G.M.); (M.T.); (P.Z.); (S.P.)
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, 00135 Rome, Italy
| | - Edda Capodaglio
- Istituti Clinici Scientifici Maugeri IRCSS, Occupational Therapy and Ergonomics Unit, 27100 Pavia, Italy;
| | - Pierluigi Zoccolotti
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy; (S.G.G.); (S.D.A.); (G.M.); (M.T.); (P.Z.); (S.P.)
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Stefano Paolucci
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy; (S.G.G.); (S.D.A.); (G.M.); (M.T.); (P.Z.); (S.P.)
| | - Marco Iosa
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy; (S.G.G.); (S.D.A.); (G.M.); (M.T.); (P.Z.); (S.P.)
- Correspondence:
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47
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Temperoni G, Curcio A, Iosa M, Mangiarotti MA, Morelli D, De Angelis S, Vergano S, Tramontano M. A Water-Based Sequential Preparatory Approach vs. Conventional Aquatic Training in Stroke Patients: A Randomized Controlled Trial With a 1-Month Follow-Up. Front Neurol 2020; 11:466. [PMID: 32655473 PMCID: PMC7326023 DOI: 10.3389/fneur.2020.00466] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 04/29/2020] [Indexed: 12/26/2022] Open
Abstract
Background: Many studies hypothesize that people who have suffered stroke could benefit from water-based exercises to improve their strength and ability to perform the activities of daily living. Objective: The study aim was to compare the effects of a water-based sequential preparatory approach (SPA) and conventional aquatic therapy in improving motor functions and quality of life in patients with chronic stroke. Methods: Thirty-three chronic stroke outpatients diagnosed with hemiplegia were recruited and randomly assigned to the experimental or control group. Subjects in the experimental group underwent a trial water-based SPA balance training, and patients in the control group were given traditional water balance training. Both groups of participants underwent 45 min of therapy twice a week for 4 weeks. All patients were evaluated before treatment (T0), after 4 weeks of training (T1), and 4 weeks after the end of training (T2) using the Berg balance scale (BBS), the modified Barthel index (MBI), the Tinetti balance and gait scale (TBG), the Stroke Specific Quality Of Life Scale (SS-QOL), and the modified Ashworth scale (MAS). Results: After the training, statistically significant differences (p < 0.05) were found between the groups in their score averages on the BBS (p = 0.01) and the SS-QOL scale (p = 0.03). Furthermore, the SPAg showed a significantly greater percentage of improvement on the BBS (p = 0.02) and the SS-QOL (p = 0.03). Both groups obtained a significantly improved MAS score (p < 0.01). Conclusion: Results indicate that water training based on an SPA is more effective than traditional aquatic training for balance rehabilitation of chronic poststroke patients.
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Affiliation(s)
| | | | - Marco Iosa
- Fondazione Santa Lucia IRCCS, Rome, Italy
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Tramontano M, Pagnotta S, Lunghi C, Manzo C, Manzo F, Consolo S, Manzo V. Assessment and Management of Somatic Dysfunctions in Patients With Patellofemoral Pain Syndrome. J Osteopath Med 2020; 120:165-173. [DOI: 10.7556/jaoa.2020.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Abstract
Context
Patellofemoral pain syndrome (PFPS) is one of the most common determinants of knee pain. The causes of PFPS are multifactorial, and most treatment approaches are conservative. There are many kinds of therapy for this syndrome, which are based on building strength, flexibility, proprioception, and endurance. Training is functional and progression is gradual. Our hypothesis is that total-body osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) focused on the management of somatic dysfunctions could be useful for managing the pain of patients with PFPS.
Objective
To investigate the effect of OMTh on pain reduction in patients with PFPS.
Methods
This pilot study was randomized, controlled, and single-blinded with 2 months of follow-up. Qualified participants were randomly assigned to 1 of 2 groups: OMTh group or placebo group. Each participant received either 4 sessions of OMTh or 4 sessions of manual placebo intervention that consisted of passive touching without joint mobilization in a protocolled order. A visual analogue scale (VAS) was used to assess general knee pain, peripatellar pain, pain after prolonged sitting, pain during the patellar compression test, and pain during stair ascent and descent. Pain assessment was performed before the baseline (T0), second (T1), third (T2), and fourth (T3) sessions, and follow-up (T4) was performed 8 weeks after T3.
Results
Thirty-five participants were enrolled the study. The VAS score was significantly reduced and clinically relevant in the OMTh group after each treatment and after 2 months of follow-up. The change in the VAS score before each treatment indicates that the most improved areas at T1 compared with T0 were lumbar and sacral with improvements in 83% and 40% of patients, respectively. At T2 compared with T1, the most improved areas were cervical and sacral with improvements found in 58% and 36% of patients, respectively. The number of dysfunctions that were diagnosed decreased during the baseline to T3 period (40% change). The correlation analysis showed significant results for the dysfunction and the compression test at T2 (P=.01, ρ=0.543).
Conclusion
Significant differences in VAS scores were found between the OMTh and placebo groups. These findings underline how OMTh can lead to reduced pain in patients with PFPS.
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Tramontano M, Morone G, De Angelis S, Casagrande Conti L, Galeoto G, Grasso MG. Sensor-based technology for upper limb rehabilitation in patients with multiple sclerosis: A randomized controlled trial. Restor Neurol Neurosci 2020; 38:333-341. [PMID: 32925119 DOI: 10.3233/rnn-201033] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Sensor-based technological therapy devices may be good candidates for neuromotor rehabilitation of people with Multiple Sclerosis (MS), especially for treating upper extremities function limitations. The sensor-based device rehabilitation is characterized by interactive therapy games with audio-visual feedback that allows training the movement of shoulders, elbows, and wrist, measuring the strength and the active range of motion of upper limb, registering data in an electronic database to quantitatively monitoring measures and therapy progress. OBJECTIVE This study aimed to investigate the effects of sensor-based motor rehabilitation in add-on to the conventional neurorehabilitation, on increasing the upper limb functions of patients with MS. METHODS Thirty patients were enrolled in the study and randomly assigned to the experimental group and the control group. The training consisting of twelve sessions of upper limb training was compared with twelve sessions of upper limb sensory-motor training, without robotic support. Both rehabilitation programs were performed for 40 minutes three times a week, for 4 weeks, in addition to conventional therapy. All patients were evaluated at the baseline (T0) and after 4 weeks of training (T1). RESULTS The within-subject analysis showed a statistically significant improvement in both groups, in the Modified Barthel Index and in the Rivermead Mobility Index scores and a significant improvement in Multiple Sclerosis Quality of Life-54 in the experimental. The analysis of effectiveness revealed that, compared with baseline (T0), the improvement percentage in all clinical scale scores was greater in the experimental group than the control group. CONCLUSIONS Proposed training provides an intensive and functional-oriented rehabilitation that objectively evaluates achieved progress through exercises. Therefore, it can represent a good complementary strategy for hand rehabilitation in MS patients.
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Affiliation(s)
- Marco Tramontano
- Santa Lucia Foundation, IRCCS, Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Rome, Italy
| | | | | | | | - Giovanni Galeoto
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
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Belluscio V, Bergamini E, Tramontano M, Orejel Bustos A, Allevi G, Formisano R, Vannozzi G, Buzzi MG. Gait Quality Assessment in Survivors from Severe Traumatic Brain Injury: An Instrumented Approach Based on Inertial Sensors. Sensors (Basel) 2019; 19:s19235315. [PMID: 31816843 PMCID: PMC6928771 DOI: 10.3390/s19235315] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 11/15/2019] [Accepted: 11/28/2019] [Indexed: 12/21/2022]
Abstract
Despite existing evidence that gait disorders are a common consequence of severe traumatic brain injury (sTBI), the literature describing gait instability in sTBI survivors is scant. Thus, the present study aims at quantifying gait patterns in sTBI through wearable inertial sensors and investigating the association of sensor-based gait quality indices with the scores of commonly administered clinical scales. Twenty healthy adults (control group, CG) and 20 people who suffered from a sTBI were recruited. The Berg balance scale, community balance and mobility scale, and dynamic gait index (DGI) were administered to sTBI participants, who were further divided into two subgroups, severe and very severe, according to their score in the DGI. Participants performed the 10 m walk, the Figure-of-8 walk, and the Fukuda stepping tests, while wearing five inertial sensors. Significant differences were found among the three groups, discriminating not only between CG and sTBI, but also for walking ability levels. Several indices displayed a significant correlation with clinical scales scores, especially in the 10 m walking and Figure-of-8 walk tests. Results show that the use of wearable sensors allows the obtainment of quantitative information about a patient’s gait disorders and discrimination between different levels of walking abilities, supporting the rehabilitative staff in designing tailored therapeutic interventions.
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Affiliation(s)
- Valeria Belluscio
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, P.zza Lauro de Bosis 15, 00135 Roma, Italy; (V.B.); (E.B.); (M.T.); (A.O.B.)
- IRCSS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Roma, Italy; (G.A.); (R.F.); (M.G.B.)
| | - Elena Bergamini
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, P.zza Lauro de Bosis 15, 00135 Roma, Italy; (V.B.); (E.B.); (M.T.); (A.O.B.)
| | - Marco Tramontano
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, P.zza Lauro de Bosis 15, 00135 Roma, Italy; (V.B.); (E.B.); (M.T.); (A.O.B.)
- IRCSS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Roma, Italy; (G.A.); (R.F.); (M.G.B.)
| | - Amaranta Orejel Bustos
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, P.zza Lauro de Bosis 15, 00135 Roma, Italy; (V.B.); (E.B.); (M.T.); (A.O.B.)
| | - Giulia Allevi
- IRCSS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Roma, Italy; (G.A.); (R.F.); (M.G.B.)
| | - Rita Formisano
- IRCSS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Roma, Italy; (G.A.); (R.F.); (M.G.B.)
| | - Giuseppe Vannozzi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, P.zza Lauro de Bosis 15, 00135 Roma, Italy; (V.B.); (E.B.); (M.T.); (A.O.B.)
- Correspondence: ; Tel.: +39-063673-3522
| | - Maria Gabriella Buzzi
- IRCSS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Roma, Italy; (G.A.); (R.F.); (M.G.B.)
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