Instrumented treadmill for run biomechanics analysis: a comparative study

This study aims compare the spatiotemporal and kinematic running parameters obtained by the WalkerView (Tecnobody, Bergamo, Italy) with those recorded by a optoelectronic 3D motion capture system. Seventeen participants were simultaneously recorded by the WalkerView and a motion capture system during running tests on the WalkerView at two different speeds (i.e., 8 km/h and 10 km/h). Per each parameter and speed the Root Mean Square Error (RMSE), the intraclass correlation coefficient (ICC), and the mean of the difference (MOD) and limits of agreement (LOAs) indexes obtained from Bland-Altman analysis were used to compare the two systems. ICCs show an excellent agreement for the mean step time and the cadence at both testing speeds (ICC=0.993 at 8 km/h; ICC=0.998 at 10 km/h); a lower agreement was found for all the kinematic variables. Small differences for some spatio-temporal parameters and greater differences for the kinematic variables were found. Therefore, WalkerView could represent a practical, accessible, and less expensive tool for clinicians, researchers, and sports trainers to assess the characteristics spatio-temporal parameters of running in non-laboratory settings.

A novel estimate of biological aging by multiple fitness tests is associated with risk scores for age-related diseases

Introduction: Recent research highlights the need for a correct instrument for monitoring the individual health status, especially in the elderly. Different definitions of biological aging have been proposed, with a consistent positive association of physical activity and physical fitness with decelerated aging trajectories. The six-minute walking test is considered the current gold standard for estimating the individual fitness status in the elderly. Methods: In this study, we investigated the possibility of overcoming the main limitations of assessing fitness status based on a single measure. As a result, we developed a novel measure of fitness status based on multiple fitness tests. In 176 Sardinian individuals aged 51-80 years we collected the results of eight fitness tests to measure participants' functional mobility, gait, aerobic condition, endurance, upper and lower limb strength, and static and dynamic balance. In addition, the participants' state of health was estimated through validated risk scores for cardiovascular diseases, diabetes, mortality, and a comorbidity index. Results: Six measures contributing to fitness age were extracted, with TUG showing the largest contribution (beta = 2.23 SDs), followed by handgrip strength (beta = -1.98 SDs) and 6MWT distance (beta = -1.11 SDs). Based on fitness age estimates, we developed a biological aging measure using an elastic net model regression as a linear combination of the results of the fitness tests described above. Our newly developed biomarker was significantly associated with risk scores for cardiovascular events (ACC-AHA: r = 0.61; p = 0.0006; MESA: r = 0.21; p = 0.002) and mortality (Levine mortality score: r = 0.90; p = 0.0002) and outperformed the previous definition of fitness status based on the six-minute walking test in predicting an individual health status. Discussion: Our results indicate that a composite measure of biological age based on multiple fitness tests may be helpful for screening and monitoring strategies in clinical practice. However, additional studies are needed to test standardisation and to calibrate and validate the present results.

Preliminary Assessment of a Flexible Multi-Sensor Wearable System Based on Fiber Bragg Gratings for Respiratory Monitoring of Hemiplegic Patients

Respiratory diseases are common in post-stroke hemiplegic patients and represent a major social problem as they worsen the quality of life and reduce the life span. As a consequence, being able to monitor respiratory parameters such as the respiratory rate (RR) and assess the presence of respiratory asynchronies could be of paramount importance to define hemiplegics' health status. Moreover, RR is a useful parameter to investigate the level of fatigue and distress that these patients undergo during rehabilitation processes. Although motion capture systems and flowmeters are the leading instruments for respiratory pattern evaluation, smart wearable systems are gaining ever more acceptance since they allow continuous monitoring by detecting chest wall breathing displacements, ensuring reduced costs and no need for dedicated spaces. Among other sensing technologies, fiber Bragg grating (FBG) sensors have emerged thanks to their high sensitivity to strain, lightness, and multiplexing capability. In this work, a wearable system composed of four flexible dumbbell-shaped sensing modules is proposed for respiratory monitoring in hemiplegic patients. The system is light and easy to wear and can be adapted to any anthropometry thanks to the modular anchoring system. Its feasibility assessment in RR evaluation was performed on seven hemiplegic volunteers in eupnea and tachypnea breathing conditions. In addition, an explorative investigation was conducted to assess the system's ability to detect asynchronies between torso compartments. The good results suggest that this device could be a useful instrument to support clinicians and operators in hemiplegic patients' management.

Investigating Stroke Effects on Respiratory Parameters Using a Wearable Device: A Pilot Study on Hemiplegic Patients

Quantitatively assessing personal health status is gaining increasing attention due to the improvement of diagnostic technology and the increasing occurrence of chronic pathologies. Monitoring physiological parameters allows for retrieving a general overview of the personal health status. Respiratory activity can provide relevant information, especially when pathologies affect the muscles and organs involved in breathing. Among many technologies, wearables may represent a valid solution for continuous and remote monitoring of respiratory activity, thus reducing healthcare costs. The most popular wearables used in this arena are based on detecting the breathing-induced movement of the chest wall. Therefore, their use in patients with impaired chest wall motion and abnormal respiratory kinematics can be challenging, but literature is still in its infancy. This study investigates the performance of a custom wearable device for respiratory monitoring in post-stroke patients. We tested the device on six hemiplegic patients under different respiratory regimes. The estimated respiratory parameters (i.e., respiratory frequency and the timing of the respiratory phase) demonstrated good agreement with the ones provided by a gold standard device. The promising results of this pilot study encourage the exploitation of wearables on these patients that may strongly impact the treatment of chronic diseases, such as hemiplegia.

A Wearable System Composed of FBG-Based Soft Sensors for Trunk Compensatory Movements Detection in Post-Stroke Hemiplegic Patients

In this study, a novel wearable system for the identification of compensatory trunk movements (CTMs) in post-stroke hemiplegic patients is presented. The device is composed of seven soft sensing elements (SSEs) based on fiber Bragg grating (FBG) technology. Each SSE consists of a single FBG encapsulated into a flexible matrix to enhance the sensor’s robustness and improve its compliance with the human body. The FBG’s small size, light weight, multiplexing capability, and biocompatibility make the proposed wearable system suitable for multi-point measurements without any movement restriction. Firstly, its manufacturing process is presented, together with the SSEs’ mechanical characterization to strain. Results of the metrological characterization showed a linear response of each SSE in the operating range. Then, the feasibility assessment of the proposed system is described. In particular, the device’s capability of detecting CTMs was assessed on 10 healthy volunteers and eight hemiplegic patients while performing three tasks which are representative of typical everyday life actions. The wearable system showed good potential in detecting CTMs. This promising result may foster the use of the proposed device on post-stroke patients, aiming at assessing the proper course of the rehabilitation process both in clinical and domestic settings. Moreover, its use may aid in defining tailored strategies to improve post-stoke patients’ motor recovery and quality of life.

Validation and Assessment of a Posture Measurement System with Magneto-Inertial Measurement Units

Inappropriate posture and the presence of spinal disorders require specific monitoring systems. In clinical settings, posture evaluation is commonly performed with visual observation, electrogoniometers or motion capture systems (MoCaps). Developing a measurement system that can be easily used also in non-structured environments would be highly beneficial for accurate posture monitoring. This work proposes a system based on three magneto-inertial measurement units (MIMU), placed on the backs of seventeen volunteers on the T3, T12 and S1 vertebrae. The reference system used for validation is a stereophotogrammetric motion capture system. The volunteers performed forward bending and sit-to-stand tests. The measured variables for identifying the posture were the kyphosis and the lordosis angles, as well as the range of movement (ROM) of the body segments. The comparison between MIMU and MoCap provided a maximum RMSE of 5.6° for the kyphosis and the lordosis angles. The average lumbo-pelvic contribution during forward bending (41.8 ± 8.6%) and the average lumbar ROM during sit-to-stand (31.8 ± 9.8° for sitting down, 29.6 ± 7.6° for standing up) obtained with the MIMU system agree with the literature. In conclusion, the MIMU system, which is wearable, inexpensive and easy to set up in non-structured environments, has been demonstrated to be effective in posture evaluation.

The use of biomimetic tools for water quality monitoring: passive samplers versus sentinel organisms

To evaluate the performance of artificial and biological integrative sampling strategies, dissolved concentrations of polychlorinated biphenyl (PCBs) and metals (Cu and Mn) were measured with passive sampler devices (PSD) enclosing hydrophobic and chelating phases, and Asiatic clams were transplanted to a polluted area in the Rio de la Plata. Water concentrations based on PSD were compared with spot water samples collected at 0, 15, 32, and 63 days of exposition. PCBs and metals displayed linear accumulation kinetics both in PSDs and bivalves, but with different slopes. PCBs slopes were 2-27 times higher in bivalves (0.3-7.9 vs. 0.1-2.6 ng g^-1 d^-1 in PSDs) reflecting active filtration and uptake from particles, colloids, and dissolved phase, whereas metal slopes were 2.5-11 times lower in bivalves (0.04-0.18 vs. 0.10-2.00 μg g^-1 d^-1 in PSDs) suggesting metal bioregulation. Truly dissolved PCB concentrations from PSD (4.0-6.9 ng.l^-1) represented average 13±4 % of PCB concentrations from filtered spot water samples reflecting the operational discrimination of the PSD diffusion membrane on competing dissolved and colloidal organic phases. In contrast, PSD dissolved Cu concentrations (2.3-8.2 μg l^-1) were equivalent to the spot water values (3.2-3.8 μg l^-1) suggesting that Cu speciation was adequately integrated by passive sampling. On the other hand, PSD-dissolved Mn concentrations (49±38 μg l^-1) were higher (p<0.05) than those from spot water samples (7±11μg l^-1) possibly due to phase changes of Mn distribution related to variable redox conditions in the water. Results evidenced that the PSDs are efficient accumulators of metals and organic compounds from the truly dissolved fraction.

THE EFFECTIVENESS OF EXTRACORPOREAL SHOCK WAVE THERAPY ON BREAST CANCER-RELATED LYMPHEDEMA: A LITERATURE REVIEW

Lymphedema is one of the most dreaded complications related to breast cancer surgery, commonly resulting in upper limb functional, esthetic, and psychological impairment. The necessity to improve the efficacy of conventional treatments and the promising effect of extracorporeal shock wave therapy (ESWT) on lymphangiogenesis in vitro and animal models, has prompted studies involving women affected by breast-cancer related lymphedema. Since intervention modalities and treatment protocols used are different, a review is necessary to verify the effectiveness of ESWT, evaluating the quality of existing studies and the eventual need for further research. Data were obtained from PubMed, Scopus, Google Scholar, Cochrane Library and PEDro, including articles published until January 2019. Five studies met the inclusion criteria. Evident heterogeneity emerged among selected studies permitting only a purely descriptive analysis of their data and strongly limiting their comparison. When compared to other treatment modalities, ESWT showed a significant effect on measured outcomes. It is clear that further high quality research is necessary to assert with confidence the effects and possible superiority of ESWT over other conservative therapies in the management of breast-cancer related lymphedema.

Robotic hand treatment of patients affected by chronic stroke: a monocentric longitudinal pilot study

Few studies investigated the effects of a robotic treatment in hand motor recovery after stroke. Aim of the present study was to evaluate the efficacy of treatment by means of Gloreha Sinfonia® robotic glove in hand motor recovery of a chronic stroke sample of patients with different impairment severity. Thirteen chronic stroke subjects were assigned to either active-assisted robotic treatment or passive robotic treatment according to their ability to actively extend wrist for at least 20 degrees. All subjects underwent 20 sessions of treatment with Gloreha Sinfonia® and were evaluated before (T0), after treatment (T1) and after one month (T2) with clinical scales testing motor performance [Motor Power (MP); Fugl Meyer Upper-Extremity (FMUE)] and spasticity [Modified Ashworth Scale (MAS)]. Both groups showed significant motor recovery and spasticity reduction. Further randomized controlled trials with larger samples are needed to confirm our results.

Concurrent validity and inter trial reliability of a single inertial measurement unit for spatial-temporal gait parameter analysis in patients with recent total hip or total knee arthroplasty

BACKGROUND

Osteoarthritis (OA) is one of the main causes of disability and its frequent hip and knee joint localization requires surgical joint replacement treatment. Patients after total hip (THA) or knee (TKA) arthroplasty often show gait abnormalities, whose comprehension is crucial in order to plan an appropriate rehabilitative treatment. Wearable sensor devices can be a valid tool for gait assessment in clinical practice, being relatively inexpensive and easy to use.

RESEARCH QUESTION

Does the use of crutches influence the ability of a single inertial measurement unit (IMU), placed on the lower trunk, to correctly record the spatial-temporal gait parameters in patients after recent THA or TKA?

METHODS

20 patients walking with crutches after recent THA or TKA and 10 healthy subjects were recruited. Each participant was recorded simultaneously with an IMU and with an optoelectronic motion capture system during 5 consecutive walking tests.

RESULTS

Intraclass correlation index of spatial-temporal parameters recorded with the IMU showed moderate to excellent reliability results both for healthy subjects (ICC range 0.626-0.897) and for patients (ICC range 0.596-0.951). In terms of concurrent validity, Pearson's r coefficient of healthy subjects, showed strong to very strong levels of correlations for some spatial-temporal parameters (speed, mean cadence, left and right stride length and stride duration) (r range 0.646-0.977) and very week to moderately week levels of correlation for gait cycle phases (swing, stance, single support and double support) (r range 0.390-0.633). Patients' data analysis showed similar results for general spatial-temporal parameters (r range 0.704-0.986) and slightly lower values for gait cycle phases (r range 0.077-0.464).

SIGNIFICANCE

We can consider the single IMU as a reliable tool for the detection of some spatial-temporal gait parameters. Crutches seem to interfere with the detection of the gait cycle phases.

The effectiveness of extracorporeal shock wave therapy on breast cancer-related lymphedema: A literature review

Lymphedema is one of the most dreaded complications related to breast cancer surgery, commonly resulting in upper limb functional, esthetic, and psychological impairment. The necessity to improve the efficacy of conventional treatments and the promising effect of extracorporeal shock wave therapy (ESWT) on lymphangiogenesis in vitro and animal models, has prompted studies involving women affected by breast cancer-related lymphedema. Since intervention modalities and treatment protocols used are different, a review is necessary to verify the effectiveness of ESWT, evaluating the quality of existing studies and the eventual need for further research. Data were obtained from PubMed, Scopus, Google Scholar, Cochrane Library and PEDro, including articles published until January 2019. Five studies met the inclusion criteria. Evident heterogeneity emerged among selected studies permitting only a purely descriptive analysis of their data and strongly limiting their comparison. When compared to other treatment modalities, ESWT showed a significant effect on measured outcomes. It is clear that further high quality research is necessary to assert with confidence the effects and possible superiority of ESWT over other conservative therapies in the management of breast cancer-related lymphedema.

Urban geochemistry and potential human health risks in the Metropolitan Area of Buenos Aires: PAHs and PCBs in soil, street dust, and bulk deposition

Soil, street dust, and bulk deposition (dry and wet deposition) were collected in the Metropolitan Area of Buenos Aires (MABA), Argentina, to assess the polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs) pollution and the potential risks to human health. Compared with other countries, the mean concentration of PAHs and PCBs in surface soils, street dust and bulk deposition of MABA were at a low or moderate level. Average PAHs and PCBs concentrations in bulk deposition (5.7 ± 5.1 and 0.41 ± 0.25 µg g^-1, respectively) were five and ten times higher than those of soil (1.08 ± 0.98 and 0.02 ± 0.01 µg g^-1) and street dust (1.2 ± 0.95 and 0.04 ± 0.03 µg g^-1), respectively. Different compositional profiles, observed in the three matrices for both groups of contaminants, could be attributed to dissimilar source contribution, partition processes between gas and particulate phases, and transformation. The most contaminated bulk deposition presented higher values for cancer and non-cancer risks relative to soil and street dust. In all matrices, non-carcinogenic risks were below the safety threshold (HI < 1). Regarding carcinogenic risks, exposure to both bulk deposition and soil indicated a moderated potential for cancerous development (Incremental lifetime cancer risk ~ 3.0 × 10^-6).

A Triple Application of Kinesio Taping Supports Rehabilitation Program for Rotator Cuff Tendinopathy: a Randomized Controlled Trial

BACKGROUND

Rotator cuff tendinopathy (RoCT) is a common pathology among adults. Kinesio-taping (KT) represents a possible rehabilitative treatment. The aim of the present study is to investigate the efficacy of a combination of three different applications of KT combined with a standardized protocol of rehabilitative exercises in reducing pain and in functional recovery in patients affected by RoCT.

MATERIALS AND METHODS

21 patients were enrolled in a real group (RG) and 19 in a sham group (SG). RG received a real KT application and SG received a sham KT application. Both groups received the same rehabilitative protocol. A Numeric Rating Scale (NRS) for shoulder pain, Medical Research Council (MRC) Scales for shoulder strength assessment and Costant Murley Score (CMS) were administered before (T0) and at the end of treatment (T1).

RESULTS

Within-group analysis for RG at T1 showed significant improvement in: NRS at-rest (p=0.002), during-movement (p&lt;0.001); CMS (p&lt;0.001); MRC shoulder flexion (p=0.003), extension (p=0.005), abduction (p=0.003), adduction (p=0.007), external rotation (p=0.011), internal rotation (p=0.002), elbow flexion (p=0.008) and extension strength (p=0.011). Within-group analysis for SG at T1 showed significant improvement in: during-movement NRS (p=0.010); CMS (p&lt;0.001).

CONCLUSIONS

1. KT application combined with conventional rehabilitative treatment can facilitate immediate pain reduction during rehabilitative treatment. 2. KT application combined with conventional rehabilitative treatment can increase function recovery. 3. KT application combined with conventional rehabilitative treatment can increase strength recovery. 4. Our findings however are not strong enough to recommend the application of KT during rehabilitative treatment for RoCT. 5. These results are the basis for future prospective, randomized controlled trials of larger samples of patients.

Interactions between Proteins and the Membrane Surface in Multiscale Modeling of Organic Fouling

In the present paper, an improved multiscale modeling aimed at describing membrane fouling in the UltraFiltration (UF) process was proposed. Some of the authors of this work previously published a multiscale approach to simulate ultrafiltration of Bovine Serum Albumin (BSA) aqueous solutions. However, the noncovalent interactions between proteins and the membrane surface were not taken into account in the previous formulation. Herein, the proteins-surface interactions were accurately computed by first-principle-based calculations considering also the effect of pH. Both the effective surface of polysulfone (PSU) and the first layer of proteins adsorbed on the membrane surface were accurately modeled. Different from the previous work, the equilibrium distance between proteins was calculated and imposed as lower bound to the protein-protein distances in the compact deposit accumulated on the membrane surface. The computed BSA surface charges were used to estimate the protein potential and the charge density, both necessary to formulate a forces balance at microscopic scale. The protein surface potential was compared with Z-potential measurements of BSA aqueous solution, and a remarkable agreement was found. Finally, the overall additional resistance, as due to both the compact and loose layers of the deposit, was computed, thus allowing the final transition to a macroscopic scale, where an unsteady-state mass transfer model was formulated to describe the behavior of a typical dead-end UF process. A good agreement between simulated and experimental permeate flux decays was observed.

Unusual jaw metastasis from squamous cell lung cancer in heavy smoker: Two case reports and review of the literature

RATIONALE

Jaw metastasis is a very rare condition associated with lung cancer evolution. In this paper we present two cases of patients who underwent different approach.Lung cancer is the leading cause of cancer related death worldwide. Survival depends on the staging and biology of tumor. Smoking may affect the prognosis.

PATIENT CONCERNS

There are herein reported the cases of two patients affected by squamous cell lung cancer with spread to mandibular bone.

DIAGNOSES

In the first case a computed tomography (CT scan) showed a large mass located in upper right lung , then bronchoscopy was performed with biopsies and the histology revealed a squamous cell carcinoma P63+ and TTF-. In the second case upper right lung mass with metastases to mediastinal bilateral lymph nodes was found at CT scan. A bronchial biopsy revealed a squamous cell carcinoma p63 positive and TTF-1 negative.

INTERVENTIONS

The first, a 65-years old man, current heavy smoker who quit and relapsed, at initial stage of IIa (T2aN1M0), after initial neo-adjuvant chemotherapy underwent lung lobectomy and lymph nodes resection. Three months later a metastasis located on mandibular bone was found out. The second case, a 68-years old female heavy smoker, at initial stage IIIb not available for surgery because of involvement of bilateral lymph nodes, underwent first line course chemotherapy with cisplatin and vinorelbine and second line with erlotinib.

OUTCOMES

The first patient underwent hyperthermia and radiotherapy but a sepsis developed and patients died. In the second case, after two months from the beginning of II line the patient developed a jaw metastasis and underwent surgery with resection of hemi-mandible, but soon after she died because of pulmonary embolism.

LESSONS

These cases highlight the poor prognosis of patients current smokers affected by squamous cell lung cancer. The jaw bone localization is very rare and different approach could be applied.

Perceptive rehabilitation and trunk posture alignment in patients with Parkinson disease: a single blind randomized controlled trial

BACKGROUND

Recent studies aimed to evaluate the potential effects of perceptive rehabilitation in Parkinson Disease reporting promising preliminary results for postural balance and pain symptoms. To date, no randomized controlled trial was carried out to compare the effects of perceptive rehabilitation and conventional treatment in patients with Parkinson Disease.

AIM

To evaluate whether a perceptive rehabilitation treatment could be more effective than a conventional physical therapy program in improving postural control and gait pattern in patients with Parkinson Disease.

DESIGN

Single blind, randomized controlled trial.

SETTING

Department of Physical and Rehabilitation Medicine of a University Hospital.

POPULATION

Twenty outpatients affected by idiopathic Parkinson Disease at Hoehn and Yahr stage ≤3.

METHODS

Recruited patients were divided into two groups: the first one underwent individual treatment with Surfaces for Perceptive Rehabilitation (Su-Per), consisting of rigid wood surfaces supporting deformable latex cones of various dimensions, and the second one received conventional group physical therapy treatment. Each patient underwent a training program consisting of ten, 45-minute sessions, three days a week for 4 consecutive weeks. Each subject was evaluated before treatment, immediately after treatment and at one month of follow-up, by an optoelectronic stereophotogrammetric system for gait and posture analysis, and by a computerized platform for stabilometric assessment.

RESULTS

Kyphosis angle decreased after ten sessions of perceptive rehabilitation, thus showing a substantial difference with respect to the control group. No significant differences were found as for gait parameters (cadence, gait speed and stride length) within Su-Per group and between groups. Parameters of static and dynamic evaluation on stabilometric platform failed to demonstrate any statistically relevant difference both within-groups and between-groups.

CONCLUSIONS

Perceptive training may help patients affected by Parkinson Disease into restoring a correct midline perception and, in turn, to improve postural control.

CLINICAL REHABILITATION IMPACT

Perceptive surfaces represent an alternative to conventional rehabilitation of postural disorders in Parkinson Disease. Further studies are needed to determine if the association of perceptive treatment and active motor training would be useful in improving also gait dexterity.

The efficacy and safety of a combination of glucosamine hydrochloride, chondroitin sulfate and bio-curcumin with exercise in the treatment of knee osteoarthritis: a randomized, double-blind, placebo-controlled study

BACKGROUND

Knee osteoarthritis (OA) conservative treatment aims to delay cartilage degeneration; chondroprotective agents are a valid approach in this sense. A commercially available dietary supplement, CartiJoint Forte, containing glucosamine hydrochloride (GH), chondroitin sulfate (CS) and Bio-Curcumin BCM-95®, was used in this trial.

AIM

The aim of this study was to assess efficacy and safety of CartiJoint Forte combined with physical therapy in treating subjects with knee OA.

DESIGN

A multicenter, prospective, randomized, double blind, placebo-controlled clinical trial.

SETTING

Outpatients referred to the Rehabilitation Departments of two University Hospitals.

POPULATION

Fifty-three patients were randomly assigned to an experimental group (N=26) or a control group (N.=27). Experimental subjects received two tablets of CartiJoint Forte each day for 8 weeks, while those in the control group were provided with a placebo. Three subjects dropped out during the course of the study.

METHODS

The two groups both received 20 sessions of physical therapy during the course of the trial. Primary outcome was pain intensity, measured both at motion and at rest, using the Visual Analogue Scale (VAS). A secondary outcome was an assessment of knee function by Western Ontario and McMaster Universities Arthritis Index and Lequesne Index, knee ROM, and two inflammation markers (C-reactive protein and erythrocyte sedimentation rate). Each assessment was carried out at baseline (T0), at 8 weeks (T1) and at 12 weeks (T2).

RESULTS

VAS at rest was found to be reduced between T0 and T1, as well as between T0 and T2 (F=13.712; P=0.0001), with no differences between groups (F=1.724; P=0.191). VAS at motion revealed a significant "group × time-check" interaction (F=2.491; P=0.032), with increasing effect of time on VAS reduction (F=17.748; P=0.0001). This was most pronounced in the experimental group at 8 weeks (F=3.437; P=0.045). The Lequesne Index showed reductions at T1 and T2 compared to T0 (F=9.535; P=0.0001), along with group effect, since the experimental group presented a lower score at T2 (F=7.091; P=0.009). No significant changes were found in the knee ROM and inflammation markers.

CONCLUSION

CartiJoint Forte, added to physical therapy, may ameliorate pain and help to improve algofunctional score in knee OA patients.

CLINICAL REHABILITATION IMPACT

Treatment of knee OA with curcuminoids plus glycosaminoglycans, added to physical therapy, improves VAS at motion and Lequesne Index scores.

Optoelectronic plethysmography to evaluate the effect of posture on breathing kinematics in spinal cord injury: a cross sectional study

BACKGROUND

Spinal cord injured patients often suffer from respiratory muscles impairment. Spirometry studies showed that in supine position vital capacity increases in such patients since diaphragm increases its inspiratory excursion. To our opinion, however, respiratory kinematics in spinal cord injured patients is disadvantaged in supine position.

AIM

To evaluate the effect of posture (sitting and supine) on respiratory kinematics in chronic spinal cord injured patients using optoelectronic plethysmography.

DESIGN

Cross-sectional study.

SETTING

Outpatients referring to the Movement Analysis Laboratory of a Physical and Rehabilitation Medicine Unit.

POPULATION

Twenty chronic spinal cord injured patients (9 tetraplegics, with lesional level ranging from C3 to C7 and 11 paraplegics with lesional level ranging from T1 to T8) and twenty healthy subjects matched for gender, age and smoking habits.

METHODS

All subjects underwent optoelectronic evaluation in sitting and supine position during quiet breathing and hyperventilation. Additional trials were performed to derive respiratory functional parameters (vital capacity and forced expiratory volume in the first second) in sitting and in supine position. Compartmental volumes and respiratory functional parameters were analyzed by means of analysis of variance. Post-hoc comparisons by means of t-tests were performed to analyze differences within and between study groups (spinal cord injured patients and healthy subjects, paraplegics and tetraplegics). Phase angle analysis and Konno and Mead diagrams were performed to evaluate if thoracic and abdominal compartments were moving in synchrony during breathing and the results were compared by paired t-tests.

RESULTS

Supine position increases vital capacity and forced expiratory volume in the first second. This could be due to the more favorable length of the diaphragm in supine than in sitting position. However in such posture the phase shift between thorax and abdomen during breathing increases.

CONCLUSION

Optoelectronic plethysmography measurements showed that even if in supine position there is an improvement in respiratory functional parameters, the respiratory kinematics of the chest wall is disadvantaged.

CLINICAL REHABILITATION IMPACT

Our study suggests that the use of abdominal binders could reproduce in sitting position the positive effect of supine position on diaphragm, that could work at a more favorable point of its length tension curve.

Evaluation of optoelectronic Plethysmography accuracy and precision in recording displacements during quiet breathing simulation

Opto-electronic Plethysmography (OEP) is a motion analysis system used to measure chest wall kinematics and to indirectly evaluate respiratory volumes during breathing. Its working principle is based on the computation of marker displacements placed on the chest wall. This work aims at evaluating the accuracy and precision of OEP in measuring displacement in the range of human chest wall displacement during quiet breathing. OEP performances were investigated by the use of a fully programmable chest wall simulator (CWS). CWS was programmed to move 10 times its eight shafts in the range of physiological displacement (i.e., between 1 mm and 8 mm) at three different frequencies (i.e., 0.17 Hz, 0.25 Hz, 0.33 Hz). Experiments were performed with the aim to: (i) evaluate OEP accuracy and precision error in recording displacement in the overall calibrated volume and in three sub-volumes, (ii) evaluate the OEP volume measurement accuracy due to the measurement accuracy of linear displacements. OEP showed an accuracy better than 0.08 mm in all trials, considering the whole 2m(3) calibrated volume. The mean measurement discrepancy was 0.017 mm. The precision error, expressed as the ratio between measurement uncertainty and the recorded displacement by OEP, was always lower than 0.55%. Volume overestimation due to OEP linear measurement accuracy was always <; 12 mL (<; 3.2% of total volume), considering all settings.

Comparative analysis and quantitative evaluation of ankle-foot orthoses for foot drop in chronic hemiparetic patients

BACKGROUND

Ankle-foot-orthoses (AFOs) are frequently prescribed for hemiparetic patients to compensate for the foot drop syndrome. However, there is not a systematic study either on the effectiveness of AFOs in the gait recovery process or pointing out the therapeutic differences among the various types of AFOs available on the market.

AIM

To perform a comparative evaluation of solid and dynamic Ankle-Foot-Orthoses (AFOs) on hemiparetic patients affected by foot drop syndrome by means of spatio-temporal, kinematic and electromyographic indicators.

DESIGN

Crossover design with randomization for the interventions.

SETTING

A rehabilitation center for adults with neurologic disorders.

POPULATION

Ten chronic hemiparetic patients with foot drop syndrome met inclusion criteria and volunteered to participate.

METHODS

Biomechanical gait analysis was carried out on hemiparetic subjects with foot drop syndrome under 3 conditions with randomized sequences: 1) without AFO; 2) wearing a solid AFO; 3) wearing a dynamic AFO. Significant changes in spatio-temporal, kinematic and electromyographic features of gait were investigated.

RESULTS

Gait analysis outcomes showed that there were no significant differences among the solid and the dynamic AFO on the spatio-temporal parameters. Both AFOs led to a reduction of the range of motion of the ankle dorsi-plantar-flexion during stance with respect to the ambulation without AFO. They also had the effect of reducing the asymmetry between the paretic and the contralateral limb in terms of ankle angle at initial contact and hip flexion. The solid AFO generally led to an increase of the co-contraction of the couples of muscles involved in the gait.

CONCLUSION

The proposed set of indicators showed that the AFOs were capable of limiting the effect of the foot-drop in hemiparetic patients and balancing the two limbs. Main differences between the two orthoses were related to muscular activity, being the level of co-contraction of the two couples of analysed muscles typically lower when the dynamic AFO was worn and closer to a normal pattern.

CLINICAL REHABILITATION IMPACT

A more extensive use of the proposed indicators in the clinical practice is expected in order to enable the definition of clinical guidelines for the prescription of the two devices.

Low temperature laser scanning microscopy of a superconducting radio-frequency cavity

An apparatus was developed to obtain, for the first time, 2D maps of the surface resistance of the inner surface of an operating superconducting radio-frequency niobium cavity by a low-temperature laser scanning microscopy technique. This allows identifying non-uniformities of the surface resistance with a spatial resolution of about 2.4 mm and surface resistance resolution of ~1 μΩ at 3.3 GHz. A signal-to-noise ratio of about 10 dB was obtained with 240 mW laser power and 1 Hz modulation frequency. The various components of the apparatus, the experimental procedure and results are discussed in detail in this contribution.

Evaluation of natural reductants protecting red blood cell membranes against oxidative damage in psoriatic patients

OBJECTIVE

Psoriasis is a chronic skin disease and one of its main causes could be the oxidative stress. The use of natural reductants, in the treatment of several diseases, is well known but the effects of such treatments on the chronic psoriasis are not clear. The aim of this study is to evaluate the efficacy of the treatment with organic matrix, deriving from micro-flora, grown in shallow hyper thermal water tubs at Guardia Piemontese-Acquappesa (CS) Italy, in patients affected by moderate psoriasis.

MATERIALS AND METHODS

The study has been performed on 10 subjects with plaque psoriasis and on 10 healthy control subjects. Clinical severity of psoriasis was determined according to Psoriasis and Severity Index (PASI). The treatment efficacy was observed trough the evaluation of membrane fluidity, by fluorescence polarization, lipid peroxidation, anion permeability and haemolysis in red blood cells.

RESULTS

After 12 days of patients' treatment, a significant reduction of PASI score was observed, this result is supported by a significant improvement of all studied parameters.

CONCLUSIONS

The results, obtained by the evaluation of all studied parameters in patients treated with the organic matrix, are evidence of the efficacy of this treatment, according to PASI evaluation. Thus our results, suggest that this therapeutic line may be useful in the treatment of moderate psoriatic lesions and also in improving the life quality of psoriatic patients.

Mesenchymal stem cells cultured on a collagen scaffold: In vitro osteogenic differentiation

OBJECTIVE

Management of periodontal defects has always been a challenge in clinical periodontics. Recently mesenchymal stem cells (MSC) have been proposed for tissue regeneration in periodontal disease and repair of large bone defects. Bone regeneration has to be supported by a scaffold which has to be biocompatible, biodegradable, and able to support cell growth and differentiation. The aim of this study was to evaluate osteogenic differentiation of MSC seeded on a collagen scaffold.

DESIGN

MSC were obtained from adult rat bone marrow, expanded and cultured in plastic dishes or seeded in a collagen scaffold (Gingistat). MSC were induced towards osteogenic differentiation using osteogenic supplements. Cell differentiation and calcium deposits were evaluated by immunoblotting, immunohistochemistry, histochemical techniques, enzymatic activity assay, and SEM-EDX analysis. Biomaterial in vitro degradation was evaluated by measuring mass reduction after incubation in culture medium.

RESULTS

Rat MSC osteogenic differentiation was demonstrated by osteopontin and osteocalcin expression and an increase in alkaline phosphatase activity. MSC were distributed homogeneously in the collagen scaffold. Nodular aggregates and alizarin red stained calcium deposits were observed in MSC induced towards osteogenic differentiation cultured in dishes or seeded in the collagen scaffold. SEM-EDX analysis demonstrated that calcium co-localized with phosphorous. The biomaterial in vitro degraded in 4-5 weeks.

CONCLUSIONS

MSC from bone marrow differentiate towards osteogenic lineage, representing a suitable cell source for bone formation in periodontal regeneration. Gingistat collagen scaffold supports MSC distribution and differentiation, but its short degradation time may be a limitation for a future application in bone tissue regeneration.

[Effect of sulphurous Bioglea on psoriasis]

OBJECTIVE

The efficacy of biological sulphurous Bioglee on psoriasis was investigated using an organic matrix derived from the metabolism of microflora growing in shallow hyper thermal waters possessing high sulphur concentrations and in thermal mud at Guardia Piemontese-Acquappesa (CS). Such a matrix forms part of the "Sulphuretum" ecological matrix which is dominated by cyanobacteria and sulfobacteria. The effect of this matrix on psoriasis was evaluated through the typical symptoms such as desquamation, cutaneous erythema and itching.

METHODS

The study was carried out on 20 patients wich gave informed consent, suffering from psoriasis. Image analysis was used to monitor the intensity of psoriasic lesions prior to and at the conclusion of the therapy which consisted of topical applications of the thermal matrices twice a day for 12 days.

RESULTS

Image analysis illustrated a reduction in the intensity of psoriasic lesions at the conclusion of the therapy with significant reductions in desquamation, erythema and itching.

CONCLUSIONS

The anti-psoriasic action of the thermal matrix used in this study may be attributable to the substances such as carotene, hydro and lipo-soluble vitamins and naturally occuring phytosterols. These substances may not only be anti-inflammatory but may also work synergistically with the mineral components of the thermal matrix to attenuate the symptoms of psoriasis.

Primary- and secondary-school environmental health science education and the education crisis: a survey of science teachers in Ohio

There is a science education crisis in the United States, with studies showing that U.S. high school graduates are not as well-versed in science as graduates in other countries. Studies also suggest that students are better learners when the environment is used as an integrating theme. Therefore, the time is right to discuss opportunities for integrating environmental health science into kindergarten through 12th grade (K-12) curriculum. The research presented here takes a step toward developing the use of environmental health science as a multidisciplinary theme in the K-12 curriculum. Almost 500 K-12 science teachers in Ohio were surveyed for their opinions about the science education crisis and the role of environmental health science in their current courses of instruction. These teachers had been identified as having an interest in environmental education because of their participation in the Environmental Education Council of Ohio. Nevertheless, the results of the survey suggest that these environmentally oriented science teachers are currently not aware of existing environmental health science learning opportunities. Environmental health practitioners have work to do to educate science teachers about the field and about the ways in which studying environmental health science could alleviate the science education crisis.

Drug delivery systems for topical ophthalmic medication

Two new topical ophthalmic delivery systems are described. The modes of delivery were compared with conventionally administered eyedrops on the basis of intraocular pressure lowering effect, dependability in delivery of prescribed dosage, and patient acceptance of the system. Pilocarpine delivered by each of the systems was found to control IOP as well as conventional pilocarpine drops. Although some patients took a longer time than others to adjust to a new mode of delivery, patient acceptance of the systems was high.