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Le Grazie di Ancona, Italy

Maranesi E.,Marche Polytechnic University | Ghetti G.,Posture and Movement Analysis Laboratory | Rabini R.A.,INRCA Geriatric Hospital | Fioretti S.,Marche Polytechnic University
Gait and Posture | Year: 2014

Functional reach (FR) is a clinical measure, defined as the maximum distance one can reach, forward beyond arm's length, able to identify elderly subjects at risk of recurrent falls. Subjects, exhibiting the same FR can perform the motor task in different ways: a kinematic analysis of the FR, task can help to identify the motor strategy adopted. The FR test was applied to 17 diabetic non-neuropathic, (CTRL) and 37 neuropathic (DN) subjects. Motor strategies adopted were defined as: "hip" or "other" strategy; the latter included: "mixed" and "trunk rotation" strategies. Principal Component Analysis and non-parametric statistical tests were used to study the different execution modalities of the FR test. Results show that, in CTRL, the most important parameters are those related to trunk flexion in the sagittal plane. Instead, for DN, the main features are related not only to trunk flexion but also to trunk rotation in the transverse plane. Percentages of subjects who used "hip" or "other" strategies are similar for CTRL and DN subjects. However, within the "other" strategy group, the percentage of DN that used a "trunk rotation" strategy was much higher than for CTRL. Results show that individuals, although exhibiting the same reaching distance, adopt different movement strategies. Consequently it is important to evaluate the kinematic behaviour and not only the clinical measure, because the evaluation of the motor strategy might be useful in the early detection of subjects at risk of postural instability. © 2013 Elsevier B.V. Source


Maranesi E.,Marche Polytechnic University | Di Nardo F.,Marche Polytechnic University | Ghetti G.,Posture and Movement Analysis Laboratory | Burattini L.,Marche Polytechnic University | Fioretti S.,Marche Polytechnic University
MESA 2014 - 10th IEEE/ASME International Conference on Mechatronic and Embedded Systems and Applications, Conference Proceedings | Year: 2014

Basic prerequisites for gait analysis are the assessment of spatiooral gait parameters and the analysis of movements within subsequent stride cycles. The aim of the present study is to propose a new method to assess spatiooral gait parameters using only 1-degree-of-freedom electrogoniometers positioned on hip and knee joints. The model validation is performed comparing the model results with those automatically obtained from another gait analysis system: GAITRite. The results underline the model reliability and show that the model could be a valid alternative to the traditional methods that use foot switches, ground reaction forces or accelerometers. These results show that essential spatiooral gait parameters can be determined during overground walking using only two 1-dof electrogoniometers. The method is easy-to-use and does not interfere with regular walking patterns. © 2014 IEEE. Source


Fioretti S.,Marche Polytechnic University | Scocco M.,Marche Polytechnic University | Ladislao L.,Marche Polytechnic University | Ghetti G.,Posture and Movement Analysis Laboratory | Rabini R.A.,INRCA Geriatric Hospital
Gait and Posture | Year: 2010

Background: An early diagnosis of peripheral neuropathy in diabetic patients is useful in order to slow down the progress of this complication. Nerve conduction tests are the gold standard for this diagnosis but they are challenging for the patients. This study examines whether it is possible to assess the presence of diabetic neuropathy at an early stage by static posturography tests. Methods: Static posturography tests were performed on 37 type-2 diabetic subjects (25 neuropathic patients and 12 non-neuropathic control subjects). Each subject was tested twice under two visual conditions: open and closed eyes. Both " global" (classic) and " structural" (model-based) posturographic parameters (PP) were derived from centre-of-pressure trajectories. A total of 65 PP were computed but only five were selected, normalized and fed to a linear classifier based on linear discriminant analysis. Results: This method correctly classified 86.5% of the patients. Five subjects were misclassified and only 2 false negatives out of 25 neuropathic subjects were erroneously diagnosed as control subjects. Conclusions: This paper shows that " global" and " structural" parameters derived by static posturography tests, and classic linear statistical approaches, can be used for the diagnosis of neuropathy provided PP are properly chosen and normalized. © 2010 Elsevier B.V. Source


Maranesi E.,Marche Polytechnic University | Maranesi E.,Posture and Movement Analysis Laboratory | Fioretti S.,Marche Polytechnic University | Ghetti G.G.,Posture and Movement Analysis Laboratory | And 4 more authors.
Journal of Electromyography and Kinesiology | Year: 2015

This study proposes a comprehensive assessment of myoelectric activity of the main muscles involved in the Functional Reach (FR) test, in 24 elderly subjects. A specific protocol for the surface electromyography (sEMG) signal acquisition during FR-test was developed. Results show that anterior muscles activate following a caudo-cranial order. Tibialis Anterior (TA) is the first to be activated (-18.0. ±. 16.3% of the FR-period), together with Rectus Femoris (-10.4. ±. 17.9%). Then, Rectus Abdominis (19.7. ±. 24.7%) and Sternocleidomastoideus (19.9. ±. 15.6%) activate after the FR-start. Hamstrings, Soleus, and L4-level Erectores Spinae (posterior muscles) activate after the FR-start in this order (11.4. ±. 16.8%, 17.7. ±. 16.6%, and 35.2. ±. 29.0%, respectively) and remain active until the movement end. The analysis of the kinematic strategies adopted by subjects revealed an association between TA-activation patterns and two kinematic strategies (hip/mixed strategy), quantified by an increase (p <. 0.05) of TA-activity duration in subjects adopting the hip strategy (89.9. ±. 34.5) vs. subjects adopting the mixed strategy (27.0. ±. 16.8). This suggests that TA sEMG activity could be able to discriminate among kinematic strategies, providing different information on balance control. Thus, the present analysis represents the first attempt to quantify the sEMG activity during FR-test in elderly subjects, providing an early contribution in building a reference frame for balance assessment in clinical context. © 2015 Elsevier Ltd. Source


Maranesi E.,Marche Polytechnic University | Di Nardo F.,Marche Polytechnic University | Ghetti G.G.,Posture and Movement Analysis Laboratory | Mercante O.,Posture and Movement Analysis Laboratory | And 3 more authors.
Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS | Year: 2015

This study was designed to assess, in elderly neuropathic diabetic (DN) patients, the activation patterns of the main muscles involved in the Functional Reach (FR) Test, a well-recognized method to identify elderly subjects at risk of recurrent falls. Surface electromyographic (sEMG) analysis of Sternocleidomastoideus (Scm), Rectus Abdominis (RAbd), Erectores Spinae at L4 level (L4), Rectus Femoris (RF), Hamstrings (Ham), Tibialis Anterior (TA) and Soleus (Sol) was performed to this aim. Results in DN patients are compared with a control group (CH) of healthy age-matched subjects. In DN patients, TA is identified as the first muscle to be recruited (ON at -34% of the FR-period) before the movement start, in order to initiate the body forward displacement. RF is the first muscle to be recruited after TA and, togheter with RAbd, showed a progressive earlier onset from CH group. Sol and Ham (ON after the FR-start), followed by L4, act mainly as tonic muscles, opposing the movement and preventing falls. Compared to the CH group, the DN subjects show an anticipatory recruitment (-34%±6%) of TA, showing a statistically significant difference (p<0.05) in comparison to CH group, together with the Scm activation. Results suggest a trend of DN patients in anticipating the activation of the anterior muscles of the body. This is likely due to an attempt to compensate the neuropathy-related proprioception dysfunction and to adjust the movement timing. In conclusion, the present study shows that sEMG is a suitable tool to deepen the interpretation of the FR-test execution and proposes the earlier start of TA as a possible element to identify the presence of neuropathy in diabetic subjects. © 2015 IEEE. Source

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