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Pollet J, Buraschi R, Ranica G, Pancera S, Anastasi D, Fazio R, Monteleone S, Lena E, Floridi V, Zucchini F, Falso MV. The Effect of Personalized Shoe Insoles on Parkinson's Disease Subjects: A Triple-Blind Randomized Controlled Trial. J Clin Med 2023; 12:7204. [PMID: 38068255 PMCID: PMC10707212 DOI: 10.3390/jcm12237204] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/10/2023] [Accepted: 11/16/2023] [Indexed: 04/19/2024] Open
Abstract
Subjects with Parkinson's Disease (PD) display different motor and non-motor symptoms. Different therapies have been shown to be effective, such as plantar foot stimulation, which has proved to be effective for motor symptoms. Different stimulation methods were proposed and tested through specific devices, or insoles. Our aim was to assess the effect of a newly designed custom-made insole called PRO-STEP compared with a flat sham insole on subjects with PD. Subjects were randomized 1:1 into two arms and were asked to wear PRO-STEP or sham insoles for at least 6 h per day for 10 weeks. Participants were evaluated at four timepoints. Forty-two subjects were randomly assigned to the PRO-STEP (EG) or sham group (SG). The comparison of the EG and SG without and with insoles (T0-T1) did not show significant differences in the TUG time and in the 10MWT gait parameters. At T1, T2, and T3 TUG time, BBS, SF12-MC, and SF12-PC did not show significant differences. The satisfaction level with the PRO-STEP or sham insoles was high in both groups. PD patients were satisfied with PRO-STEP insoles; however, plantar foot stimulation is not effective from a functional perspective. Future studies should consider possible modifications to the proposed stimulation to improve its effectiveness in patients with PD.
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Affiliation(s)
- Joel Pollet
- IRCCS Fondazione Don Carlo Gnocchi, 20162 Milan, Italy; (J.P.); (R.B.); (S.P.); (D.A.); (E.L.); (V.F.); (M.V.F.)
| | - Riccardo Buraschi
- IRCCS Fondazione Don Carlo Gnocchi, 20162 Milan, Italy; (J.P.); (R.B.); (S.P.); (D.A.); (E.L.); (V.F.); (M.V.F.)
| | - Giorgia Ranica
- IRCCS Fondazione Don Carlo Gnocchi, 20162 Milan, Italy; (J.P.); (R.B.); (S.P.); (D.A.); (E.L.); (V.F.); (M.V.F.)
| | - Simone Pancera
- IRCCS Fondazione Don Carlo Gnocchi, 20162 Milan, Italy; (J.P.); (R.B.); (S.P.); (D.A.); (E.L.); (V.F.); (M.V.F.)
| | - Denise Anastasi
- IRCCS Fondazione Don Carlo Gnocchi, 20162 Milan, Italy; (J.P.); (R.B.); (S.P.); (D.A.); (E.L.); (V.F.); (M.V.F.)
| | | | | | - Eleonora Lena
- IRCCS Fondazione Don Carlo Gnocchi, 20162 Milan, Italy; (J.P.); (R.B.); (S.P.); (D.A.); (E.L.); (V.F.); (M.V.F.)
| | - Valeria Floridi
- IRCCS Fondazione Don Carlo Gnocchi, 20162 Milan, Italy; (J.P.); (R.B.); (S.P.); (D.A.); (E.L.); (V.F.); (M.V.F.)
| | | | - Maurizio Vincenzo Falso
- IRCCS Fondazione Don Carlo Gnocchi, 20162 Milan, Italy; (J.P.); (R.B.); (S.P.); (D.A.); (E.L.); (V.F.); (M.V.F.)
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Rota V, Redolfi A, Monteleone S, Arienti C, Falso M. Can COVID-19 result in cognitive dysfunctions? The need for a multidisciplinary approach in rehabilitation for post-COVID-19 people. Eur J Phys Rehabil Med 2022; 58:150-151. [PMID: 34498830 PMCID: PMC9980494 DOI: 10.23736/s1973-9087.21.07013-1] [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: 11/08/2022]
Affiliation(s)
- Vera Rota
- IRCCS Don Carlo Gnocchi, Milan, Italy -
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3
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Aprile I, Guardati G, Cipollini V, Papadopoulou D, Monteleone S, Redolfi A, Garattini R, Sacella G, Noro F, Galeri S, Carrozza MC, Germanotta M. Influence of Cognitive Impairment on the Recovery of Subjects with Subacute Stroke Undergoing Upper Limb Robotic Rehabilitation. Brain Sci 2021; 11:brainsci11050587. [PMID: 33946452 PMCID: PMC8147141 DOI: 10.3390/brainsci11050587] [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: 04/15/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 01/29/2023] Open
Abstract
Cognitive decline is often present in stroke survivors, with a significant impact on motor recovery. However, how specific cognitive domains could impact motor recovery after robotic rehabilitation in patients with stroke is still not well understood. In this study, we analyzed the relationship between cognitive impairment and the outcome of a robot-mediated upper limb rehabilitation intervention in a sample of 51 subacute stroke patients. Participants were enrolled and treated with a set of robotic and sensor-based devices. Before the intervention, patients underwent a cognitive assessment by means of the Oxford Cognitive Screen. To assess the effect of the 30-session rehabilitation intervention, patients were assessed twice with the following outcome measures: the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), to evaluate motor function; the Upper limb Motricity Index (MI), to evaluate upper limb muscle strength; the Modified Barthel Index (mBI), to evaluate activities of daily living and mobility. We found that deficits in spatial attention and executive functions impacted the mBI improvement, while language, number processing, and spatial attention deficits reduced the gains in the FMA-UE. These results suggest the importance to evaluate the cognitive functions using an adequate tool in patients with stroke undergoing a robotic rehabilitation intervention.
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Affiliation(s)
- Irene Aprile
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (I.A.); (G.G.); (V.C.); (D.P.)
| | - Giulia Guardati
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (I.A.); (G.G.); (V.C.); (D.P.)
| | - Valeria Cipollini
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (I.A.); (G.G.); (V.C.); (D.P.)
| | - Dionysia Papadopoulou
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (I.A.); (G.G.); (V.C.); (D.P.)
| | - Serena Monteleone
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20121 Milan, Italy; (S.M.); (A.R.); (R.G.); (G.S.); (F.N.); (S.G.); (M.C.C.)
| | - Alessandra Redolfi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20121 Milan, Italy; (S.M.); (A.R.); (R.G.); (G.S.); (F.N.); (S.G.); (M.C.C.)
| | - Romina Garattini
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20121 Milan, Italy; (S.M.); (A.R.); (R.G.); (G.S.); (F.N.); (S.G.); (M.C.C.)
| | - Gianluigi Sacella
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20121 Milan, Italy; (S.M.); (A.R.); (R.G.); (G.S.); (F.N.); (S.G.); (M.C.C.)
| | - Fulvia Noro
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20121 Milan, Italy; (S.M.); (A.R.); (R.G.); (G.S.); (F.N.); (S.G.); (M.C.C.)
| | - Silvia Galeri
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20121 Milan, Italy; (S.M.); (A.R.); (R.G.); (G.S.); (F.N.); (S.G.); (M.C.C.)
| | - Maria Chiara Carrozza
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20121 Milan, Italy; (S.M.); (A.R.); (R.G.); (G.S.); (F.N.); (S.G.); (M.C.C.)
- The Biorobotics Institute, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Marco Germanotta
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy; (I.A.); (G.G.); (V.C.); (D.P.)
- Correspondence: ; Tel.: +39-0633086553
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Carlomagno C, Bertazioli D, Gualerzi A, Picciolini S, Banfi PI, Lax A, Messina E, Navarro J, Bianchi L, Caronni A, Marenco F, Monteleone S, Arienti C, Bedoni M. COVID-19 salivary Raman fingerprint: innovative approach for the detection of current and past SARS-CoV-2 infections. Sci Rep 2021; 11:4943. [PMID: 33654146 PMCID: PMC7925543 DOI: 10.1038/s41598-021-84565-3] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [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: 11/30/2020] [Accepted: 02/15/2021] [Indexed: 12/20/2022] Open
Abstract
The pandemic of COVID-19 is continuously spreading, becoming a worldwide emergency. Early and fast identification of subjects with a current or past infection must be achieved to slow down the epidemiological widening. Here we report a Raman-based approach for the analysis of saliva, able to significantly discriminate the signal of patients with a current infection by COVID-19 from healthy subjects and/or subjects with a past infection. Our results demonstrated the differences in saliva biochemical composition of the three experimental groups, with modifications grouped in specific attributable spectral regions. The Raman-based classification model was able to discriminate the signal collected from COVID-19 patients with accuracy, precision, sensitivity and specificity of more than 95%. In order to translate this discrimination from the signal-level to the patient-level, we developed a Deep Learning model obtaining accuracy in the range 89-92%. These findings have implications for the creation of a potential Raman-based diagnostic tool, using saliva as minimal invasive and highly informative biofluid, demonstrating the efficacy of the classification model.
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Affiliation(s)
- C Carlomagno
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy.
| | - D Bertazioli
- Università di Milano-Bicocca, Viale Sarca 366, 20126, Milan, Italy
| | - A Gualerzi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - S Picciolini
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - P I Banfi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - A Lax
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - E Messina
- Università di Milano-Bicocca, Viale Sarca 366, 20126, Milan, Italy
| | - J Navarro
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - L Bianchi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - A Caronni
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - F Marenco
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - S Monteleone
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - C Arienti
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - M Bedoni
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy.
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Aprile I, Guardati G, Cipollini V, Papadopoulou D, Mastrorosa A, Castelli L, Monteleone S, Redolfi A, Galeri S, Germanotta M. Robotic Rehabilitation: An Opportunity to Improve Cognitive Functions in Subjects With Stroke. An Explorative Study. Front Neurol 2020; 11:588285. [PMID: 33329334 PMCID: PMC7710798 DOI: 10.3389/fneur.2020.588285] [Citation(s) in RCA: 8] [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: 07/28/2020] [Accepted: 10/21/2020] [Indexed: 12/18/2022] Open
Abstract
Background: After a stroke, up to three-quarters of acute and subacute stroke survivors exhibit cognitive impairment, with a significant impact on functional recovery, quality of life, and social engagement. Robotic therapy has shown its effectiveness on motor recovery, but its effectiveness on cognitive recovery has not fully investigated. Objective: This study aims to assess the impact of a technological rehabilitation intervention on cognitive functions in patients with stroke, using a set of three robots and one sensor-based device for upper limb rehabilitation. Methods: This is a pilot study in which 51 patients were enrolled. An upper limb rehabilitation program was performed using three robots and one sensor-based device. The intervention comprised motor/cognitive exercises, especially selected among the available ones to train also cognitive functions. Patients underwent 30 rehabilitation sessions, each session lasting 45 minutes, 5 days a week. Patients were assessed before and after the treatment with several cognitive tests (Oxford Cognitive Scale, Symbol Digit Modalities Test, Digit Span, Rey-Osterrieth Complex Figure, Tower of London, and Stroop test). In addition, motor (Fugl-Meyer Assessment and Motricity Index) and disability (modified Barthel Index) scales were used. Results: According to the Oxford Cognitive Scale domains, a significant percentage of patients exhibited cognitive deficits. Excluding perception (with only one patient impaired), the domain with the lowest percentage of patients showing a pathological score was praxis (about 25%), while the highest percentage of impaired patients was found in calculation (about 70%). After the treatment, patients improved in all the investigated cognitive domains, as measured by the selected cognitive assessment scales. Moreover, motor and disability scales confirmed the efficacy of robotics on upper limb rehabilitation in patients with stroke. Conclusions: This explorative study suggests that robotic technology can be used to combine motor and cognitive exercises in a unique treatment session. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT04164381.
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Affiliation(s)
- Irene Aprile
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Florence, Italy
| | | | | | | | | | - Letizia Castelli
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Neuroriabilitazione ad Alta Intensità, Rome, Italy
| | | | | | - Silvia Galeri
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
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Pavese C, Cecini M, Caspani P, Monteleone S, Klersy C, Dalla Toffola E. Activity limitations and participation restrictions in patients with peripheral facial palsy: a cross-sectional study over a six-year period. Eur J Phys Rehabil Med 2020; 56:725-732. [PMID: 32935953 DOI: 10.23736/s1973-9087.20.06326-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Peripheral facial palsy is a pathological condition caused by a wide range of etiologies. A damage of VII cranial nerve produces facial disfigurement and limitations in daily life activities, such as drinking, eating and speaking. As a consequence, patients may experience psychological distress and social isolation. To counsel and design a patient-tailored rehabilitation for patients affected by peripheral facial palsy, physical and social limitations should be considered. Moreover, the knowledge of factors associated with disability plays a key role in the early identification and adequate care of patients with higher risk to develop psychological distress and participation restrictions. AIM To evaluate activity limitations, psychological distress and participation restrictions of patients affected by peripheral facial palsy seeking for rehabilitation and to identify individual and disease-specific factors associated to disability. DESIGN Cross-sectional study. SETTING Consultation hour dedicated to facial palsy patients in the outpatient clinic of a Rehabilitation Unit. POPULATION One hundred eighty-six outpatients with recent or chronic peripheral facial palsy at the first assessment at our Rehabilitation Unit. METHODS Using multiple linear regression models, we evaluated the association between the two subscales of Facial Disability Index (FDI) and the composite score of Sunnybrook Facial Grading System, as well as the association between the two FDI subscales and other clinical and demographic variables. RESULTS Activity limitations correlate with the severity of palsy, while psychological distress and participation restrictions do not correlate with the neurological impairment. The correlation between the severity of palsy and both activity limitations and participation restrictions is influenced by palsy etiology. Activity limitations decrease with time from palsy onset, while psychological distress and participation restrictions are more severe in women. CONCLUSIONS Beyond severity, also etiology, time from onset and gender influence disability after facial palsy. These factors should be considered in counselling and planning a patient-tailored multidisciplinary rehabilitative treatment. CLINICAL REHABILITATION IMPACT Our study highlights the individual and pathology-associated factors related to activity limitations and participation restrictions in patients with peripheral facial palsy. These elements should be considered in the definition of a patient-tailored rehabilitative plan and in the organization of a multidisciplinary care.
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Affiliation(s)
- Chiara Pavese
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.,Neurorehabilitation and Spinal Unit, Institute of Pavia, ICS Maugeri IRCCS, Pavia, Italy
| | - Miriam Cecini
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.,Unit of Physical Medicine and Rehabilitation, ICS Maugeri IRCCS, Lissone, Monza-Brianza, Italy
| | - Patrick Caspani
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Serena Monteleone
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Catherine Klersy
- Biometry and Clinical Epidemiology Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elena Dalla Toffola
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy - .,Physical Medicine and Rehabilitation Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Petrucci L, Monteleone S, Ricotti S, Giromini E, Gullace M, Ambrosini E, Ferriero G, Dalla Toffola E. Disability after major abdominal surgery: determinants of recovery of walking ability in elderly patients. Eur J Phys Rehabil Med 2018; 54:683-689. [PMID: 29898583 DOI: 10.23736/s1973-9087.18.04348-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Increased life expectancy and improved surgical techniques have led to a sharp rise in healthcare resource consumption by older patients. In these patients early recovery of walking ability after abdominal surgery may shorten length of hospital stay and reduce overall healthcare costs, but it is important to understand what factors determine this recovery. AIM To assess preoperative and postoperative determinants of walking ability recovery after major abdominal surgery in older patients. DESIGN Prospective observational study. SETTING General Surgery Unit. POPULATION The study included 327 consecutive older inpatients who underwent major acute-care abdominal surgery. METHODS Data on demographic characteristics, diagnosis, comorbidities defined by Charlson Comorbidity Index (CCI), preoperative walking ability, and early postoperative physical deconditioning (PPDS) were gathered. All patients underwent an individually-tailored rehabilitation program. At discharge, pain (by a Visual Analogue Scale, VAS-pain, 0-10), transfers and walking ability were assessed. Number of rehabilitation sessions attended and discharge setting were recorded. RESULTS Of 320 patients included in the analysis (7 died), 72% had CCI>5, signifying presence of >1 comorbidities. Before hospitalization, 79% of patients were completely independent in walking at home, 12% needed assistive devices or direct assistance from the caregiver, and 9% were unable to walk. Complex postoperative physical deconditioning was detected in 25%. At discharge, most patients (87%) had achieved their rehabilitative goal and returned home. Only PPDS and VAS-pain were able to predict both walking ability and the discharge setting, PPDS alone showing adequate sensitivity (82%) and specificity (70%). CONCLUSIONS PPDS was the sole early postoperative predictor of recovery of walking ability and the discharge setting. Pain therapy might be a key factor influencing the postoperative functional decline. Age and severity of preoperative comorbidities seem not important determinants of functional decline in older surgical patients. CLINICAL REHABILITATION IMPACT An early postoperative assessment of physical deconditioning might be able to predict the walking ability at discharge (hence, the discharge setting), in older patients undergoing major surgery.
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Affiliation(s)
- Lucia Petrucci
- Physical Medicine and Rehabilitation Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Serena Monteleone
- Department of Physical Medicine and Rehabilitation, Scientific Institute of Lissone, IRCCS, Istituti Clinici Scientifici Maugeri, Lissone, Monza-Brianza, Italy
| | - Susanna Ricotti
- Physical Medicine and Rehabilitation Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Erica Giromini
- Unit of Physical Medicine and Rehabilitation, Department of Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Mariangela Gullace
- Unit of Physical Medicine and Rehabilitation, Department of Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Emilia Ambrosini
- Neuroengineering and Medical Robotics Laboratory, Department of Electronics, Information and Bioengineering, Polytechnic University of Milan, Milan, Italy
| | - Giorgio Ferriero
- Department of Physical Medicine and Rehabilitation, Scientific Institute of Lissone, IRCCS, Istituti Clinici Scientifici Maugeri, Lissone, Monza-Brianza, Italy
| | - Elena Dalla Toffola
- Unit of Physical Medicine and Rehabilitation, Department of Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy -
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Feltroni L, Monteleone S, Petrucci L, Carlisi E, Mazzacane B, Schieppati M, Dalla Toffola E. Potentiation of muscle strength by focal vibratory stimulation on quadriceps femoris. G Ital Med Lav Ergon 2018; 40:90-96. [PMID: 30480393] [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] [Received: 06/30/2018] [Accepted: 02/01/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Several studies have investigated the effects of focal vibration on muscle strength. Non-univocal results have been found. The aim of this study was to evaluate the effect of prolonged focal vibratory stimulation on quadriceps muscle strength at two different frequencies (80 and 300 Hz). The evaluation of muscle strength was performed at different intervals of time after the end of the vibratory stimulation in order to quantify the long-term effects and their trends over time. METHODS Twenty-seven healthy volunteers were divided into three groups, a control group (no treatment) and two groups treated with vibratory stimulation (80 or 300 Hz) of relaxed quadriceps femoris bilaterally, once a day (30 min) for 5 consecutive days. The quadriceps' strength was measured through an isokinetic dynamometer, before and at three time intervals after the treatment, with a follow-up period of 4 weeks. The outcome measure was the Peak Torque (PT, Nm) of the quadriceps femoris produced by extension movement at three defined angular velocities and during isometric contraction. RESULTS No changes in PT were observed in the control group over time, while PT increased in the treated groups. No significant difference in PT behavior was observed between these two groups. PTs recorded before and after the treatment were markedly different, and the increase in the PT persisted until the follow-up at 4 weeks, for all angular velocities tested. CONCLUSIONS Prolonged vibratory stimulation of the quadriceps femoris, both at 80 and at 300 Hz, leads to an increase in muscle strength. The vibration effect does not appear to fade at the end of treatment, but persists at the follow up, suggesting a likely underlying plastic process. The results of the current study suggest that 30-min per day, 5 day focal vibratory treatment can be helpful during the clinical practice to regain muscular strength. It does not require patient's effort during the treatment, requires a little time, its effects are long-lasting, and there are no known adverse effects.
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Affiliation(s)
- Lucia Feltroni
- Physical Medicine and Rehabilitation Unit I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy
| | - Serena Monteleone
- Physical Medicine and Rehabilitation Unit I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy
| | - Lucia Petrucci
- Physical Medicine and Rehabilitation Unit I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy
| | - Ettore Carlisi
- Physical Medicine and Rehabilitation Unit I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy
| | - Bruno Mazzacane
- Rehabilitation Unit, Azienda di Servizi alla Persona di Pavia, Italy
| | - Marco Schieppati
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia and Centro Studi Attività Motorie (CSAM), Fondazione Salvatore Maugeri (IRCCS), Scientific Institute of Pavia, Italy
| | - Elena Dalla Toffola
- Physical Medicine and Rehabilitation Unit I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy
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Ricotti S, Martinelli V, Caspani P, Monteleone S, Petrucci L, Dalla Toffola E, Klersy C. Changes in quality of life and functional capacity after lung transplantation: A single-center experience. Monaldi Arch Chest Dis 2017; 87:831. [DOI: 10.4081/monaldi.2017.831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 10/07/2017] [Accepted: 11/05/2017] [Indexed: 11/22/2022] Open
Abstract
Lung transplantation (LT) increases the life expectancy of patients affected by end stage pulmonary disease; specifically, its ultimate aims are to improve survival and health related quality of life (HRQoL). The aim of the present longitudinal study was to determine the HRQoL trajectory and changes in functional capacity from time of entry in the waiting list for LT to 2 year after LT. The study included sixty-nine outpatients enrolled in a single medical center when they entered the waiting list for LT and who subsequently received it. They were then followed up over 2 years after LT. HRQoL was assessed by the physical and mental component summary (PCS and MCS) scores of the 36-item Short Form Health Survey (SF-36) and Saint George’s Respiratory Questionnaire (SGRQ). Psychological distress was evaluated with the General Health Questionnaire (GHQ), and functional capacity was investigated using the six-minute walk test (6MWT) and forced expiratory volume (FEV1). Patients showed low SF-36 PCS (30.5±7.8) and SGRQ total (61.8±17.5) scores at entry in the waiting list, but exhibited significant changes over time after LT (p<0.001). Furthermore, patients who showed an increase of at least 50% in SF36 PCS and SGRQ scores at 6 months survived longer. Both FEV1 and 6MWT distance as well as GHQ scores significantly changed over time, with improvements occurring in the first 6 months after LT but no major changes thereafter. Out of the 69 patients enrolled, 32 died over a median follow-up of 51 months. Although mortality tended to be slightly higher for patients with lower HRQoL at the baseline assessment, this difference was not statistically significant. HRQoL evaluations appear critical in the follow-up of LT candidates, in particularly SGRQ, because of its specificity in targeting respiratory symptoms and functional wellbeing.
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Pusineri M, Monteleone S, De Bernardi E, Lanzi A, Lisi C, Dalla Toffola E, Carlisi E. Integrating and monitoring hand burn rehabilitative treatment using Virtual Reality. G Ital Med Lav Ergon 2017. [PMID: 29916601 DOI: 10.3969/j.issn.1002-7386.2017.01.035] [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] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Hand burn is not a common condition in the clinical practice and needs a long and laboured rehabilitative treatment to restore the lost function. METHODS This case report illustrates the achievable improvements in mobility and function by using innovative inertial systems for occupational exercise in a Virtual Reality, in addition to a traditional rehabilitative treatment. RESULTS Through these instruments, we could promote and concurrently assess the recovery of a functional grasp and the ability in the execution of Activities of Daily Living.
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Affiliation(s)
- Monica Pusineri
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy
| | - Serena Monteleone
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy
| | - Elisabetta De Bernardi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy
| | - Ambrogina Lanzi
- Rehabilitation Unit, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia and University of Pavia, Italy
| | - Claudio Lisi
- Rehabilitation Unit, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia and University of Pavia, Italy
| | - Elena Dalla Toffola
- Rehabilitation Unit, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia and University of Pavia, Italy
| | - Ettore Carlisi
- Rehabilitation Unit, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia and University of Pavia, Italy
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Lisi C, Monteleone S, Tinelli C, Rinaldi B, Di Natali G, Savasta S. Postural analysis in a pediatric cohort of patients with Ehlers-Danlos Syndrome: a pilot study. Minerva Pediatr 2017; 72:73-78. [PMID: 28211643 DOI: 10.23736/s0026-4946.17.04681-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The Ehlers-Danlos Syndrome (EDS) is a rare disorder affecting the connective tissue. EDS patients may suffer of proprioception and balance impairment but all the studies dealing with such symptoms have been addressed to adult subjects. The Study of such impairment in younger patients may lead to a better awareness of own motor abilities and to a focused rehabilitative intervention. Therefore, our work aims to assess the occurrence of these alterations in a pediatric cohort of EDS patients. METHODS The Research was designed as a cross-sectional study with a matching control group and performed on a pediatric cohort of 12 subjects with Ehlers-Danlos Syndrome (Classic and Hypermobility type) and on 12 healthy controls, during a follow-up visit at the Department of Pediatrics and at the Rehabilitation Unit of the Foundation IRCCS Policlinico San Matteo, in Pavia from April 2015 to October 2015. A square forceplatform was used to obtain the CoP (center of pressure) displacement during quiet standing during an open and a closed eyes trials. The comparisons between EDS and control group were performed using a t-test for independent data. P<0.05 was considered statistically significant. All tests were two-sided. RESULTS All the postural parameters considered raised at closed eyes, no significant modifications without vision were found only for the standard deviation along the antero-posterior (AP) axis for the two groups. Both at open eyes and at closed eyes, Patients with EDS showed the postural parameters significantly greater than controls (P≤0.05) and this observation was most notably for the Sway. CONCLUSIONS According to our results, a planned monitoring of age-related changes in postural parameters of patients with EDS could be really interesting to provide a perspective of the development of postural control in these patients. In fact, considering our results, it could be interesting to apply rehabilitative strategies to enhance motor coordination and postural reflexes so improving their postural control as soon as possible. Further studies about the postural control in EDS children and adolescents are required to confirm our results.
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Affiliation(s)
- Claudio Lisi
- Unit of Physical Medicine and Rehabilitation, S. Matteo Polyclinic, IRCCS and Foundation, Pavia, Italy
| | - Serena Monteleone
- Unit of Physical Medicine and Rehabilitation, University of Pavia, Pavia, Italy -
| | - Carmine Tinelli
- Unit of Clinical Epidemiology and Biometric, S. Matteo Polyclinic, IRCCS and Foundation, Pavia, Italy
| | - Berardo Rinaldi
- Department of Pediatrics, S. Matteo Polyclinic, IRCCS and Foundation, University of Pavia, Pavia, Italy
| | - Giuseppe Di Natali
- Unit of Physical Medicine and Rehabilitation, S. Matteo Polyclinic, IRCCS and Foundation, Pavia, Italy
| | - Salvatore Savasta
- Department of Pediatrics, S. Matteo Polyclinic, IRCCS and Foundation, University of Pavia, Pavia, Italy
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Carlisi E, Lisi C, Dall'angelo A, Monteleone S, Nola V, Tinelli C, Dalla Toffola E. Focused extracorporeal shock wave therapy combined with supervised eccentric training for supraspinatus calcific tendinopathy. Eur J Phys Rehabil Med 2016; 54:41-47. [PMID: 27824237 DOI: 10.23736/s1973-9087.16.04299-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Extracorporeal shockwave therapy (ESWT) is effective in reducing shoulder pain and improving function in calcific supraspinatus tendinopathy. Eccentric exercise has been introduced as an effective treatment choice for Achilles tendinopathy, but poor evidence exists about its role in the treatment of rotator cuff tendinopathy. AIM To investigate if adding a supervised eccentric training of the shoulder abductor muscles could improve the outcome of ESWT. DESIGN Pre-post intervention pilot study with matched control-group. SETTING Outpatient, University Hospital. POPULATION Twenty-two subjects affected by painful supraspinatus calcific tendinopathy. METHODS The study-group was assigned to receive focal ESWT (f-ESWT) plus a supervised eccentric training (SET) of the shoulder abductor muscles. The matched control-group received f-ESWT only. The post-treatment assessment at follow-up (T1) was performed nine weeks after the enrollment (T0). We assessed shoulder pain and function by the means of a numeric rating scale (p-NRS) and a DASH scale. As secondary outcome, we measured the isometric strength of the abductor muscles of the affected shoulder using a handheld dynamometer. RESULTS At T1, we recorded a significant decrease in pain (P<0.001) and an improvement in upper limb function (P<0.001) in both groups. However, we observed no statistical differences in favor of the study-group, in terms of p-NRS and DASH total score. A mild increase (+13% from baseline) of the maximum isometric abduction strength was noticed in the study group at T1. CONCLUSIONS Our findings did not support the hypothesis that adding a supervised eccentric training of the shoulder abductor muscles could improve the outcome (pain and function) of shock wave therapy. CLINICAL REHABILITATION IMPACT Our study confirmed that f-ESWT is effective in reducing shoulder pain and improving function in calcific supraspinatus tendinopathy. Adding a supervised eccentric training, focused on the abductor muscles, was useful to improve maximum isometric abduction strength, but appeared to give no advantage in the short-term outcome of shock wave therapy.
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Affiliation(s)
- Ettore Carlisi
- Unit of Rehabilitation, San Matteo Hospital Foundation, Institute for Research and Health Care, University of Pavia, Pavia, Italy -
| | - Claudio Lisi
- Unit of Rehabilitation, San Matteo Hospital Foundation, Institute for Research and Health Care, University of Pavia, Pavia, Italy
| | - Anna Dall'angelo
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Serena Monteleone
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Vincenza Nola
- Unit of Rehabilitation, San Matteo Hospital Foundation, Institute for Research and Health Care, University of Pavia, Pavia, Italy
| | - Carmine Tinelli
- Department of Clinical Biometrics and Epidemiology, San Matteo Hospital Foundation, Institute for Research and Health Care, Pavia, Italy
| | - Elena Dalla Toffola
- Unit of Rehabilitation, San Matteo Hospital Foundation, Institute for Research and Health Care, University of Pavia, Pavia, Italy
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Monteleone S, Dalla Toffola E, Emiliani V, Ricotti S, Bruggi M, Conte T, D'Armini AM, Orlandoni G, Petrucci L. Recovery of deambulation after cardiothoracic surgery: a single center experience. Eur J Phys Rehabil Med 2015; 51:763-771. [PMID: 25800502] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Surgical procedure and postoperative bed rest lead to musculoskeletal system alterations with a possibility of new walking dependence of patients who undergo cardiothoracic surgery, which is sometimes associated with prolonged hospitalization and increased health expenditure. AIM The aim of this study was to assess the postoperative motor disability in inpatients admitted to the cardiothoracic surgical ward, and the results of customized rehabilitation in terms of recovery of postural changes and walking capacity with respect to the preoperative condition and destination after discharge. DESIGN A prospective observational study was conducted. SETTING AND POPULATION Four hundred seventeen inpatients, who had undergone cardiothoracic surgery, were enrolled between March 2011 and January 2012 in a Hospital Unit of Cardiothoracic Surgery. METHODS A computerized system was used to collect data about ambulation at home, type and number of rehabilitation sessions proposed, ambulation at discharge, destination after discharge from ward of origin. All patients, who give their consent, undergone rehabilitative treatment on the ward of origin with an expert physiotherapist. RESULTS Three hundred seventy-five inpatients were examined in Cardiac Surgery. One patient (0.26%) refused rehabilitative treatment. Two patients (0.53%) died. At the time of discharge 236 (74.45%) patients had recovered the ability to walk independently. After discharge 87.64% of patients was transferred to a specialist ward for intensive rehabilitation. Forty-two inpatients were enrolled in thoracic surgery. Two patients died whilst in hospital. At the time of discharge, 36 patients (94.73%) were able to walk independently. After discharge 80% of patients returned home. CONCLUSION In our study, the application of an early and simple rehabilitation program on the ward of origin after surgery has made possible the recovery of ambulation of most inpatients who referred independence at home in a few days, limiting hospitalization and health expenditure. CLINICAL REHABILITATION IMPACT Data about recovery of ambulation with respect to the preoperative condition and destination after discharge resume the importance of identifying motor impairment after surgery, in order to apply an adequate, early and feasible rehabilitation protocol to inpatients, limiting hospitalization and health expenditure.
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Affiliation(s)
- S Monteleone
- Physical Medicine and Rehabilitation Unit, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, University of Pavia, Pavia, Italy -
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La Delfa GC, Catania V, Monteleone S, De Paz JF, Bajo J. Computer Vision Based Indoor Navigation: A Visual Markers Evaluation. Ambient Intelligence - Software and Applications 2015. [DOI: 10.1007/978-3-319-19695-4_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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