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Poli P.,University of Padua | Morone G.,Clinical Laboratory of Experimental Neurorehabilitation | Morone G.,University of Padua | Rosati G.,University of Padua | Masiero S.,University of Padua
BioMed Research International

Introduction. The role of robotics in poststroke patients' rehabilitation has been investigated intensively. This paper presents the state-of-the-art and the possible future role of robotics in poststroke rehabilitation, for both upper and lower limbs. Materials and Methods. We performed a comprehensive search of PubMed, Cochrane, and PeDRO databases using as keywords "robot AND stroke AND rehabilitation." Results and Discussion. In upper limb robotic rehabilitation, training seems to improve arm function in activities of daily living. In addition, electromechanical gait training after stroke seems to be effective. It is still unclear whether robot-assisted arm training may improve muscle strength, and which electromechanical gait-training device may be the most effective for walking training implementation. Conclusions. In the field of robotic technologies for stroke patients' rehabilitation we identified currently relevant growing points and areas timely for developing research. Among the growing points there is the development of new easily transportable, wearable devices that could improve rehabilitation also after discharge, in an outpatient or home-based setting. For developing research, efforts are being made to establish the ideal type of treatment, the length and amount of training protocol, and the patient's characteristics to be successfully enrolled to this treatment. © 2013 Patrizia Poli et al. Source

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

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. Source

Morone G.,Neuroelectrical Imaging and BCI Laboratory | Morone G.,Clinical Laboratory of Experimental Neurorehabilitation | Pisotta I.,Experimental Neurorehabilitation Laboratory | Pichiorri F.,Neuroelectrical Imaging and BCI Laboratory | And 7 more authors.
Archives of Physical Medicine and Rehabilitation

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. Source

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

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. Source

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

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. Source

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