Fondazione Don Carlo Gnocchi ONLUS IRCCS

Firenze, Italy

Fondazione Don Carlo Gnocchi ONLUS IRCCS

Firenze, Italy
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Laveneziana P.,University Pierre and Marie Curie | Bruni G.I.,Fondazione Don Carlo Gnocchi ONLUS IRCCS | Presi I.,Fondazione Don Carlo Gnocchi ONLUS IRCCS | Stendardi L.,Fondazione Don Carlo Gnocchi ONLUS IRCCS | And 3 more authors.
Respiratory Physiology and Neurobiology | Year: 2013

Sixteen patients with stable asthma performed a symptom-limited constant work-rate CWR cycle exercise during which breathing pattern, operating lung volumes, dyspnea intensity and its qualitative descriptors were measured.An inflection in the relation between tidal volume (VT) and ventilation (V̇E) was observed in each subject. The sense of " work/effort" was the dominant dyspnea descriptor selected up to the VT/V̇E inflection, whereas after it dyspnea intensity and the selection frequency of " unsatisfied inspiration" rose steeply in 37.5% of subjects in whom inspiratory reserve volume (IRV) had decreased to a critical level of 0.6L at the VT inflection point. In contrast, dyspnea increased linearly with exercise time and V̇E, and " work/effort" was the dominant descriptor selected throughout exercise in 62.5% of subjects in whom the VT/V̇E inflection occurred at a preserved IRV.The VT inflection during exercise in patients with stable asthma marked a mechanical event with important sensory consequences only when it occurred at a critical reduced IRV. © 2012 Elsevier B.V.


Rabuffetti M.,Fondazione Don Carlo Gnocchi ONLUS IRCCS | Folegatti A.,University of Turin | Spinazzola L.,Ospedale A. Bellini | Ricci R.,University of Turin | And 3 more authors.
Frontiers in Human Neuroscience | Year: 2013

In the present study we explored the effect of prismatic adaptation (PA) applied to the upper right limb on the walking trajectory of a neglect patient with more severe neglect in far than in near space. The patient was asked to bisect a line fixed to the floor by walking across it before and after four sessions of PA distributed over a time frame of 67 days. Gait path was analysed by means of an optoelectronic motion analysis system. The walking trajectory improved following PA and the result was maintained at follow-up, fifteen months after treatment. The improvement was greater for the predicted bisection error (estimated on the basis of the trajectory extrapolated from the first walking step) than for the observed bisection error (measured at line bisection). These results show that PA may act on high level spatial representation of gait trajectory rather than on lower level sensory-motor gait components and suggest that PA may have a long lasting rehabilitative effect on neglect patients showing a deviated walking trajectory. © 2013 Rabuffetti, Folegatti, Spinazzola, Ricci, Ferrarin, Berti and Neppi-modona.


Binazzi B.,Fondazione Don Carlo Gnocchi ONLUS IRCCS | Lanini B.,Fondazione Don Carlo Gnocchi ONLUS IRCCS | Romagnoli I.,Fondazione Don Carlo Gnocchi ONLUS IRCCS | Garuglieri S.,Fondazione Don Carlo Gnocchi ONLUS IRCCS | And 4 more authors.
Respiration | Year: 2011

Background: For patients with limited physical activities who use oral communication for most social activities, the assessment of dyspnea during speech activities (DS) may provide relevant measurement criteria. Although speech production is altered by lung disease it has not been included in current dyspnea assessment tools. Objectives: We evaluated DS in patients with chronic obstructive pulmonary disease (COPD) with the aim of assessing: (i) the responsiveness to treatment of this newly developed evaluative dyspnea tool and (ii) whether DS is an independent measurement of other traditional outcomes. Methods: We assessed lung function, the 6-min walking test (6'WT), chronic exertional dyspnea (MRC and BDI/TDI), and DS using the speech section of the University of Cincinnati Dyspnea Questionnaire (UCDQ) before and after a pulmonary rehabilitation program in 31 patients with COPD. Results: The following items of the speech section of the UCDQ caused dyspnea: conversation, raising the voice, phoning, speaking to a group, talking in a noisy place, and singing. The mean overall DS score was 60 ± 23% of a maximal potential DS score. Pulmonary rehabilitation reduced each item of DS independently of change in lung function, chronic exertional dyspnea, and 6'WT. Conclusions: We concluded that DS is responsive to a respiratory rehabilitation program in patients with COPD. Evidence of independent objective measures supports the validity of a routine multivariable assessment including DS. We recommend assessment of DS particularly for patients who rely extensively on speech for communication. Copyright © 2010 S. Karger AG, Basel.


Gagliardi E.,Fondazione Don Carlo Gnocchi ONLUS IRCCS | Innocenti Bruni G.,Fondazione Don Carlo Gnocchi ONLUS IRCCS | Presi I.,Fondazione Don Carlo Gnocchi ONLUS IRCCS | Gigliotti F.,Fondazione Don Carlo Gnocchi ONLUS IRCCS | Scano G.,University of Florence
Respiratory Physiology and Neurobiology | Year: 2014

Purpose: The interrelations among chest wall kinematics (displacement and configuration), ventilatory profile and dyspnea relief following cycle exercise training (EXT) have not been systematically evaluated in hyperinflated chronic obstructive pulmonary disease (COPD) patients. We hypothesize that a decrease in ventilation affects dyspnea relief, regardless of the changes in chest wall kinematics. Methods: Fourteen patients were studied before and after 24-session exercise training program. We evaluated the volumes of chest wall and its compartments (rib cage, and abdomen) using optoelectronic plethysmography. Results: At iso-time EXT (i) reduced ventilation, respiratory frequency and dyspnea (by Borg scale), mildly improved rib cage configuration, but left operational volumes unchanged; (ii) Borg was much smaller for any comparable inspiratory reserve volume (IRVcw), and a decrease in IRVcw was tolerated much better for any given Borg. Conclusions: Regardless of the changes in chest wall kinematics, a decrease in ventilation attenuates dyspnea following EXT. © 2013 Elsevier B.V.


PubMed | Fondazione Don Carlo Gnocchi ONLUS IRCCS
Type: Journal Article | Journal: Respiration; international review of thoracic diseases | Year: 2011

For patients with limited physical activities who use oral communication for most social activities, the assessment of dyspnea during speech activities (DS) may provide relevant measurement criteria. Although speech production is altered by lung disease it has not been included in current dyspnea assessment tools.We evaluated DS in patients with chronic obstructive pulmonary disease (COPD) with the aim of assessing: (i) the responsiveness to treatment of this newly developed evaluative dyspnea tool and (ii) whether DS is an independent measurement of other traditional outcomes.We assessed lung function, the 6-min walking test (6WT), chronic exertional dyspnea (MRC and BDI/TDI), and DS using the speech section of the University of Cincinnati Dyspnea Questionnaire (UCDQ) before and after a pulmonary rehabilitation program in 31 patients with COPD.The following items of the speech section of the UCDQ caused dyspnea: conversation, raising the voice, phoning, speaking to a group, talking in a noisy place, and singing. The mean overall DS score was 60 23% of a maximal potential DS score. Pulmonary rehabilitation reduced each item of DS independently of change in lung function, chronic exertional dyspnea, and 6WT.We concluded that DS is responsive to a respiratory rehabilitation program in patients with COPD. Evidence of independent objective measures supports the validity of a routine multivariable assessment including DS. We recommend assessment of DS particularly for patients who rely extensively on speech for communication.

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