Clinical Laboratory of Experimental Neurorehabilitation

Rome, Italy

Clinical Laboratory of Experimental Neurorehabilitation

Rome, Italy
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Iosa M.,Clinical Laboratory of Experimental Neurorehabilitation | Fusco A.,Clinical Laboratory of Experimental Neurorehabilitation | Morone G.,Clinical Laboratory of Experimental Neurorehabilitation | Paolucci S.,Clinical Laboratory of Experimental Neurorehabilitation
Behavioural Brain Research | Year: 2012

In a dark environment, when vision is excluded, humans are usually able to walk towards a target the position of which was previously memorized. Changes in spatio-temporal gait parameters, the presence of obstacles on the ground or pathway tilt can affect their performances. The aim of this study was to investigate the influence of the environment on this ability. We have enrolled sixty healthy subjects, separately tested in a small indoor and in an outdoor open-field environment. In experiment 1, significant differences were found between 15 indoor and 15 outdoor blindfolded walkers. According to previous studies, the distances walked outdoors were not significantly different from the three-tested target's distances (3. m, 6. m and 10. m). Conversely, a systematic and significant undershooting was observed for blindfolded indoor walkers for all the three distances (errors: -0.34, -0.73 and -1.99. m, respectively). This indoor undershooting was found related to shorter steps not compensated by any increment of the step number. In experiment 2, also the perception of the indoor distance resulted underestimated in other two tested groups of 15 subjects each. But the perceived distance resulted poorly correlated with motor performances (R= 0.23, p= 0.410). In spite of the fact that the errors were consistent among trials, when indoor walkers could not access to environmental acoustic features, their performance resulted highly variable among subjects, but it improved, on average. At the light of these results, the environment seems acting as a selective tuning between different strategies. © 2011 Elsevier B.V.

Iosa M.,Clinical Laboratory of Experimental Neurorehabilitation | Morelli D.,Fondazione Santa Lucia IRCCS | Marro T.,Fondazione Santa Lucia IRCCS | Paolucci S.,Clinical Laboratory of Experimental Neurorehabilitation | Fusco A.,Clinical Laboratory of Experimental Neurorehabilitation
Neuropediatrics | Year: 2013

Objectives Many studies have examined how children with cerebral palsy (CP) manage to walk, but few have investigated running, yielding controversial results. The aim of this study was to quantitatively assess gait ability and its stability in children with hemiplegic CP while running and walking. Methods A group of 20 children with spastic hemiplegia due to CP (CPG, 5.1 ± 2.3 years old), and a group of 20 children with typical development (TDG, 5.9 ± 2.6 years old) underwent a 10-m walking/running test with a wearable triaxial accelerometer fixed to their lower trunk. Spatiotemporal gait parameters, root mean squares of upper body acceleration, and related harmonic and symmetry ratios were computed. Results Differences in gait speed were significantly higher during running (- 19% for CPG with respect of TDG) than during walking (- 14%, p = 0.028). Conversely, no significant changes were observed in terms of gait stability, and the differences in terms of gait harmony along anteroposterior axis recorded during walking (- 43%, p < 0.001) disappeared during running (+ 3%, p = 0.834). Conclusions During running, children with CP are slower than children with TD, but their gait was not less stable, and the harmony of their anteroposterior movements was even more similar to TDG than during walking. © 2013 Georg Thieme Verlag KG Stuttgart · New York.

PubMed | Clinical Laboratory of Experimental Neurorehabilitation and CNRS Montpellier Laboratory of Informatics, Robotics and Microelectronics
Type: | Journal: Journal of medical and biological engineering | Year: 2016

Most studies and reviews on robots for neurorehabilitation focus on their effectiveness. These studies often report inconsistent results. This and many other reasons limit the credit given to these robots by therapists and patients. Further, neurorehabilitation is often still based on therapists expertise, with competition among different schools of thought, generating substantial uncertainty about what exactly a neurorehabilitation robot should do. Little attention has been given to ethics. This review adopts a new approach, inspired by Asimovs three laws of robotics and based on the most recent studies in neurorobotics, for proposing new guidelines for designing and using robots for neurorehabilitation. We propose three laws of neurorobotics based on the ethical need for safe and effective robots, the redefinition of their role as therapist helpers, and the need for clear and transparent human-machine interfaces. These laws may allow engineers and clinicians to work closely together on a new generation of neurorobots.

Fusco A.,Foro Italico University of Rome | Fusco A.,Clinical Laboratory of Experimental Neurorehabilitation | Iosa M.,Clinical Laboratory of Experimental Neurorehabilitation | Gallotta M.C.,Foro Italico University of Rome | And 3 more authors.
Frontiers in Human Neuroscience | Year: 2014

Motor imagery (MI) is a mental representation of an action without its physical execution. Recently, the simultaneous movement of the body has been added to the mental simulation. This refers to dynamic motor imagery (dMI). This study was aimed at analyzing the temporal features for static and dMI in different locomotor conditions (natural walking, NW, light running, LR, lateral walking, LW, backward walking, BW), and whether these performances were more related to all the given conditions or present only in walking. We have been also evaluated the steps performed in the dMI in comparison with the ones performed by real locomotion. 20 healthy participants (29.3 ± 5.1 years old) were asked to move towards a visualized target located at 10 mt. In dMI, no significant temporal differences respect the actual locomotion were found for all the given tasks (NW: p = 0.058, LR: p = 0.636, BW: p = 0.096; LW: p = 0,487). Significant temporal differences between static imagery and actual movements were found for LR (p < 0.001) and LW (p < 0.001), due to an underestimation of time needed to achieve the target in imagined locomotion. Significant differences in terms of number of steps among tasks were found for LW (p < 0.001) and BW (p = 0.036), whereas neither in NW (p = 0.124) nor LR (p = 0.391) between dMI and real locomotion. Our results confirmed that motor imagery is a task-dependent process, with walking being temporally closer than other locomotor conditions. Moreover, the time records of dMI are nearer to the ones of actual locomotion respect than the ones of static motor imagery. © 2014 Fusco, Iosa, Gallotta, Paolucci, Baldari and Guidetti.

Morone G.,Santa Lucia Foundation IRCCS | Morone G.,Clinical Laboratory of Experimental Neurorehabilitation | Pisotta I.,Experimental Neurorehabilitation Laboratory | Pichiorri F.,Santa Lucia Foundation IRCCS | And 7 more authors.
Archives of Physical Medicine and Rehabilitation | Year: 2015

Objective To evaluate the feasibility of brain-computer interface (BCI)-assisted motor imagery training to support hand/arm motor rehabilitation after stroke during hospitalization. Design Proof-of-principle study. Setting Neurorehabilitation hospital. Participants Convenience sample of patients (N=8) with new-onset arm plegia or paresis caused by unilateral stroke. Interventions The BCI-based intervention was administered as an "add-on" to usual care and lasted 4 weeks. Under the supervision of a therapist, patients were asked to practice motor imagery of their affected hand and received as a discrete feedback the movements of a "virtual" hand superimposed on their own. Such a BCI-based device was installed in a rehabilitation hospital ward. Main Outcome Measures Following a user-centered design, we assessed system usability in terms of motivation, satisfaction (by means of visual analog scales), and workload (National Aeronautics and Space Administration-Task Load Index). The usability of the BCI-based system was also evaluated by 15 therapists who participated in a focus group. Results All patients successfully accomplished the BCI training. Significant positive correlations were found between satisfaction and motivation (P=.001, r=.393). BCI performance correlated with interest (P=.027, r=.257) and motivation (P=.012, r=.289). During the focus group, professionals positively acknowledged the opportunity offered by BCI-assisted training to measure patients' adherence to rehabilitation. Conclusions An ecological BCI-based device to assist motor imagery practice was found to be feasible as an add-on intervention and tolerable by patients who were exposed to the system in the rehabilitation environment. © 2015 American Congress of Rehabilitation Medicine.

PubMed | University of Rome La Sapienza, Clinical Laboratory of Experimental Neurorehabilitation, S Filippo Neri Hospital, Foro Italico University of Rome and Royal University
Type: | Journal: Evidence-based complementary and alternative medicine : eCAM | Year: 2016

Introduction/Objective. Fibromyalgia might benefit from a specific tactile and proprioceptive rehabilitation approach. The aim of this study was to perform a randomized controlled trial to determine the efficacy of perceptual surfaces (PS) and physical exercises with regard to chronic pain and physical function in fibromyalgia compared with a control group. Methods. Data from 54 females (18-60 years old) with a diagnosis of fibromyalgia and scoring >5 on the visual analog scale were divided into 3 groups and analyzed: group treated with perceptual surfaces (PS-group), physical exercises group (PE-group), and control group (CG). The Fibromyalgia Impact Questionnaire (FIQ), Health Assessment Questionnaire (HAQ), and Fibromyalgia Assessment Scale (FAS) were administered at baseline (T0), at the end of the treatment (T1) (after 10 rehabilitation sessions over a 5-week period), and at the 12-week follow-up (T2). Results. The PS-group experienced a statistically significant improvement versus the CG in FAS and HAQ scores. Good efficacy with respect to pain and function in the PE-group compared with the CG in terms of FAS, HAQ, and FIQ scores was observed. The adherence ratio was 86% for the PE-group and CG and 90% for the PS-group. Conclusions. According to the results, the PS are as promising as the physical exercises, since results were similar.

PubMed | Clinical Laboratory of Experimental Neurorehabilitation, University of Rome La Sapienza and Foro Italico University of Rome
Type: Journal Article | Journal: Restorative neurology and neuroscience | Year: 2016

Recently, Motor Imagery (MI) has been associated with the execution of movements miming in part the mentally represented action (dynamic MI, dMI). Preliminary studies have reported as dMI may improve trainings in sport, with imagery timing close to the physical execution one. This study was aimed to investigate time and spatial parameters of dMI with actual locomotion in people with stroke.Twelve patients (stroke group, SG) were compared with twelve healthy elderly (elderly group, EG) and twenty young adults (young group, YG). Subjects performed mental representations of different walking (forward, FW; lateral, LW, backward, BW), accompanied or not by movements imitating walking (dMI and static MI, sMI). Then, they performed actual locomotion (AL). Outcome measures were related to the time and the number of steps spent for completing the tasks for all the given locomotor conditions.Significant differences were found in patients with respect to healthy subjects, with time in sMI significantly shorter than in dMI (p<0.004) and AL (p<0.002), but not between dMI and AL in FW (p=0.806). In patients, times obtained in sMI and dMI was significantly shorter with respect to those of AL in LW and BW. Patients performed imagery tasks with similar times in all locomotion. Healthy groups did not reveal differences among tasks in BW, while significant differences were found in LW. Analogous results were found in terms of number of performed steps.In patients with stroke, a spatiotemporal functional equivalence with AL was found only for dMI, and not for sMI, in forward walking. This could be due to familiarity with this task. These results might have implications for the rehabilitative techniques based on MI.

Losa M.,Clinical Laboratory of Experimental Neurorehabilitation | Zoccolillo L.,IRCCS Fondazione Santa Lucia | Montesi M.,Clinical Laboratory of Experimental Neurorehabilitation | Montesi M.,University of Rome Tor Vergata | And 3 more authors.
Frontiers in Human Neuroscience | Year: 2014

Motor imagery and internal motor models have been deeply investigated in literature. It is well known that the development of motor imagery occurs during adolescence and it is limited in people affected by cerebral palsy. However, the roles of motor imagery and internal models in locomotion as well as their intertwine received poor attention. In this study we compared the performances of healthy adults (n = 8, 28.1 ± 5.1 years old), children with typical development (n = 8, 8.1 ± 3.8 years old) and children with cerebral palsy (CCP) (n = 12, 7.5 ± 2.9 years old), measured by an optoelectronic system and a trunk-mounted wireless inertial magnetic unit, during three different tasks. Subjects were asked to achieve a target located at 2 or 3 m in front of them simulating their walking by stepping in place, or actually walking blindfolded or normally walking with open eyes. Adults performed a not significantly different number of steps (p = 0.761) spending not significantly different time between tasks (p = 0.156). Children with typical development showed task-dependent differences both in terms of number of steps (p = 0.046) and movement time (p = 0.002). However, their performance in simulated and blindfolded walking (BW) were strictly correlated (R = 0.871 for steps, R = 0.673 for time). Further, their error in BW was in mean only of -2.2% of distance. Also CCP showed significant differences in number of steps (p = 0.022) and time (p < 0.001), but neither their number of steps nor their movement time recorded during simulated walking (SW) were found correlated with those of blindfolded and normal walking (NW). Adults used a unique strategy among different tasks. Children with typical development seemed to be less reliable on their motor predictions, using a task-dependent strategy probably more reliable on sensorial feedback. CCP showed less efficient performances, especially in SW, suggesting an altered locomotor imagery. © 2014 Iosa, Zoccolillo, Montesi, Morelli, Paolucciand Fusco.

Iosa M.,Clinical Laboratory of Experimental Neurorehabilitation | Fusco A.,Clinical Laboratory of Experimental Neurorehabilitation | Morone G.,Clinical Laboratory of Experimental Neurorehabilitation | Paolucci S.,Clinical Laboratory of Experimental Neurorehabilitation
The Scientific World Journal | Year: 2012

Vision can improve bipedal upright stability during standing and affect spatiotemporal parameters during walking. However, little is known about the effects of visual deprivation on gait dynamic stability. We have tested 28 subjects during walking under two different visual conditions, full vision (FV) and no vision (NV), measuring their upper body accelerations. Lower accelerations were found in NV for the reduced walking speed. However, the normalized accelerations were higher in the NV than in the FV condition, both in anteroposterior (1.05±0.21 versus 0.88±0.16, P=0.001) and laterolateral (0.99±0.26 versus 0.78±0.19, P<0.001) directions. Vision also affected the gait anteroposterior harmony (P=0.026) and, interacting with the environment, also the latero-lateral one (P=0.017). Directly (as main factor of the ANOVA) or indirectly (by means of significant interactions with other factors), vision affected all the measured parameters. In conclusion, participants showed an environment-dependent reduction of upper body stability and harmony when deprived by visual feedback. Copyright © 2012 Marco Iosa et al.

PubMed | University of Verona, Clinical Laboratory of Experimental Neurorehabilitation and University of Brescia
Type: Journal Article | Journal: Journal of back and musculoskeletal rehabilitation | Year: 2016

To date etiology of adolescent idiopathic scoliosis appears complex and still remains unclear. A distorted body schema has been proposed to be a part of a sequence of pathological events in the development of adolescent idiopathic scoliosis.To investigate the awareness of trunk misalignment in adolescents with idiopathic scoliosis.Information about 44 adolescents with idiopathic scoliosis was collected as follows: age; sex; handedness; family history of scoliosis; back pain; sport practice; shoulder and waist line symmetry; leg length; dorsal kyphosis; back hump; rehabilitation; scoliotic curve; Risser sign. We evaluated awareness of trunk misalignment with a graphic table displaying pictures of progressively increasing scoliotic curves. Patients were asked to indicate which picture corresponded to their perceived own spinal alignment.Patients with thoracolumbar scoliosis overestimated their actual thoracic spine curve. Patients with thoracic-thoracolumbar scoliosis underestimated their actual thoracolumbar spine curve and overestimated their actual lumbar spine curve. Scoliotic curve > 15, double curve, younger age, back pain, family history of scoliosis and lower Risser score related with a misperception of trunk alignment.Our results support the hypothesis that adolescents with idiopathic scoliosis have an altered corporeal awareness of their trunk alignment.

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