177,103 research outputs found
Le innovazioni in materia di circostanze del reato
No full textL'aver commesso l'omicidio in occasione di delitti sessuali (art. 576, n. 5, c.p.): la ratio dell'innovazione; l'ambito applicativo della nuova circostanza; la connessione tra omicidio e delitto sessuale; l'aggravante dell'omicidio commesso dallo stalker - L'attenuante ex art. 600-sexies, quinto comma, c.p. - La nuova formulazione dell'art. 585 c.p
Kinematic IMU-Based Assessment of Postural Transitions: A Preliminary Application in Clinical Context
No full textThis study aims to develop a new methodology for assessing postural transitions, such as sit-to-stand movements, and to preliminarily apply it in a clinical setting. These movements provide valuable information about the state of movement effector system components, whether musculoskeletal, nervous, or cognitive, and their evaluation is a key point in the functional assessment in the clinical setting of patients with complex rehabilitative needs. The objective of this study was developed by pursuing three goals: verifying the ability to discriminate between healthy and pathological subjects, defining a set of parameters for movement assessment, and thus designing a preliminary evaluation paradigm for future clinical applications. We investigated the signals from a single IMU sensor applied to subjects (20 healthy and 13 patients) performing five different postural transitions. A set of six kinematic variables that allowed a quantitative assessment of motion was identified, namely total time, smoothness, fluency, velocity, jerk root mean square, and maximum jerk variation. At the end of the study, the adopted methodology and set of parameters were shown to be able to quantitatively assess postural transitions in a clinical context and to be able to distinguish healthy subjects from pathological subjects. This, together with future studies, will provide researchers and clinicians with a valuable resource for evaluating the results of a rehabilitation program, as well as for keeping track of patients' functional status in follow-up evaluations
Preliminary Comparison of Assessment Methods for the Trunk Flexion-Extension Movement in the Lumbar Vertebrae Instability Patient
No full textThe paper compares three assessment methods for the measurement of the trunk range of motion (ROM) in flexion-extension movements of subjects suspected of lumbar vertebrae instability (LVI). For five male adults affected by low-back pain and with morpho-dynamic prescription for suspected LVI, ROM was computed: from the analysis of morpho-dynamic radiographs, according to the definition proposed by i) Kapandji and ii) Yang et al.; from the analysis of the flexion-extension movement captured with an optoelectronic acquisition system iii) as the maximum angular stroke in transductors’ displacement, according to a specifically designed custom protocol. Data obtained from optoelectronic acquisitions result comparable with literature values, suggesting the suitability of optoelectronic systems as non-invasive measurement tool for the trunk ROM assessing, to support the physician in the LVI diagnosis
Is the 6MWT combined with an IMU useful in stroke rehabilitation? A pilot cross-sectional study
No full textBackground: Stroke is one of the leading cause of disability worldwide. Gait impairments, in particular are common and are the main goal of patients during rehabilitation. Only few interventions have considered one of the main issues for stroke rehabilitation, is represented by the physical deconditioning. A measure of gait quality is fundamental in this kind of patients. To evaluate the differences in functional capacity between different stroke populations, compared with an age matched healthy population in a 6-minute walking test (6MWT), while wearing an inertial measurement unit (IMU).
Methods: After ethical committee approval (6-14/04/2017). In a tertiary referral sub-acute rehabilitation centre, subject with stroke in acute phase (AP) and chronic phase (CP), were recruited if they met the following inclusion criteria: age>18, MMSE≥24, and a single stoke in acute (<1 month) or chronic phase (>6 months). Exclusion criteria: stroke affecting the cerebellum, other neurological impairments and pathologies affecting the locomotor system. The healthy group (HG) included was age-matched and had no gait impairments. 6MWT was run following ATS guidelines, while wearing an IMU on the back at L3-S1 level.
Results: 9 subjects in AP were recruited (71±11 years, 6 females, 5 left hemiparesis), 19 in CP (66±14 years, 6 females, 11 left hemiparesis) and 12 HP (64±6 years, 7 females). The HG walked several meters more than AP and CP Δ274-267m respectively (P<0.001), symmetry index differs significantly P=0.028, but only between CP and HG. For what concerns spatio-temporal parameters and gait phases the three groups were significantly different (P<0.001), but subjects in AP didn’t differ from those in CP.
Discussion: 6MWT showed the amount of impairment through the meters walked. The use of an IMU highlighted the typical stroke gait pattern of the stroke subjects, a follow up should focus on differences in gait after a rehabilitation period, and a strength program should be included in the stroke standard therapy.
Conclusion: An evaluation of functional capacity for stroke subjects should be included in the test usually applied, adding an IMU for the test will give also a measure also of gait quality and would increase the significance of this test
Preliminary Comparison of Assessment Methods for the Trunk Flexion-Extension Movement in the Lumbar Vertebrae Instability Patient
No full textThe paper compares three assessment methods for the measurement of the trunk range of motion (ROM) in flexion-extension movements of subjects suspected of lumbar vertebrae instability (LVI). For five male adults affected by low-back pain and with morpho-dynamic prescription for suspected LVI, ROM was computed: from the analysis of morpho-dynamic radiographs, according to the definition proposed by i) Kapandji and ii) Yang et al.; from the analysis of the flexion-extension movement captured with an optoelectronic acquisition system iii) as the maximum angular stroke in transductors’ displacement, according to a specifically designed custom protocol. Data obtained from optoelectronic acquisitions result comparable with literature values, suggesting the suitability of optoelectronic systems as non-invasive measurement tool for the trunk ROM assessing, to support the physician in the LVI diagnosis
La “Usual care” nella riabilitazione dello stroke : una revisione sistematica quantitativa
No full textIntroduzione. Eticamente, le nuove terapie dovrebbero essere testate rispetto alle "migliori" disponibili o, se non definite, rispetto alle "normali" cure secondo quanto stabilito dalle attuali linee guida. Negli ambiti di ricerca non farmacologici la “questione usual care” è riconosciuta, ma non ben definita. Ci siamo concentrati sulla riabilitazione dell'ictus come caso di studio perché: l'ictus è una delle principali cause di disabilità; la riabilitazione si basa su interventi multi-professionali complessi; il bisogno di riabilitazione è in aumento, a causa della crescita della cronicità e della disabilità (Organizzazione Mondiale della Sanità). Il nostro obiettivo era quello di valutare numericamente gli interventi di usual care della riabilitazione dell'ictus e di confrontare gli studi randomizzati controllati (RCT) di alta qualità con quelli di bassa qualità.
Metodi. Revisione sistematica degli RCT (2006-16). Criteri di inclusione: soggetti con esiti di ictus; intervento: riabilitazione; controllo: usual care riabilitativa; outcome: funzione dell'arto inferiore. La qualità degli studi (alta-bassa) è stata valutata con il risk of bias di Cochrane. Abbiamo identificato la terminologia utilizzata per descrivere l'Intervento del Gruppo di Controllo (CGI), abbiamo effettuato un processo di sintesi delle conoscenze e un'analisi di frequenza per ordinare l'eterogeneità attraverso l'identificazione dettagliata dei contenuti del CGI. Gli studi raggruppati per qualità, sono stati poi confrontati.
Risultati. Abbiamo incluso 86 pubblicazioni (23% a basso rischio di bias). Il nove per cento non ha descritto il CGI; negli altri 78 rimasti abbiamo identificato 64 interventi diversi: 53 proposti una sola volta, 8 proposti 2 volte, e 3 interventi proposti per 3 volte. Gli interventi maggiormente ripetuti (gait and balance) sono stati proposti rispettivamente nel 52% e nel 51% dei documenti; 4 interventi hanno raggiunto più del 30%, il rimanente meno del 15%. I risultati non differiscono per la qualità degli RCT.
Conclusioni. Questo studio ha dimostrato numericamente che il termine usual care è usato in modo inadeguato per la descrivere il CGI; che la qualità metodologica dei lavori non evita questi problemi ed infine che manca una terminologia comune per la descrizione gli interventi. Questi risultati dovrebbero essere verificati in altri campi di ricerca, con questa o altre metodologie. Tuttavia, essi sono probabilmente generalizzabili, poiché coinvolgono molti autori, revisori, riviste di settore e generaliste. Le linee guida per il reporting dovrebbero probabilmente fornire una migliore guida anche su questo tema: un miglior reporting migliorerebbe la replicabilità e la qualità metodologica dell'RCT nella riabilitazione dell'ictus. Inoltre il CGI dovrebbe essere progettato prendendo come riferimento gli ultimi e più efficaci interventi proposti dalle linee guida disponibili
Does rehabilitation changes in gait kinematic parameters in total knee arthroplasty subjects? A prospective observational pilot study
No full textBackground: Total knee arthroplasty (TKA), is a routine surgical intervention. After surgery is common practice for every subject to undergo a period of rehabilitation to recover strength, range of motion and walking ability of the affected limb. Many evaluation scales have been developed to evaluate improvements during and after rehabilitation, but the walking ability has rarely been evaluated in the acute phase (3-30 days post-surgery). Aim of the study is to evaluate the effect of rehabilitation on functional outcomes scales and gait quality, through an optoelectronic system.
Methods: After receiving Ethical approval (4-16/12/2015), in a postacute rehabilitation hospital, subjects were recruited after receiving TKA; inclusion criteria were stable clinical conditions, and no neurological or rheumatic pathologies or previous surgeries at the lower limbs. International knee society score (IKSS), Barthel Index (BI), Numerical Rating Scale (NRS), Knee Flexion (KF), and gait analysis (GA) were assessed at hospitalization (T0) and discharge (T1). The GA system is a BTS DX-400, at least 3 walks were performed. Gait was allowed with one or two crutches according to needs. The rehabilitation program was based on restoring ROM and strength of the lower limb.
Results: 20 subjects (67±12 years, 11 females, 11 left knees) met the inclusion criteria. Subjects showed a significant difference between T0 and T1 in all the functional evaluation scales (P<0.001) excluding NRS (P>0.05). None of the GA parameters showed a significant improvement (P>0.05). Neither the spatio-temporal parameters showed significant improvements (P>0.05).
Discussion: This study highlights how rehabilitation improves knee function, but for what concerns gait quality, no improvements have been retrieved in the gait of patients. Rehabilitation focused on the functional competence of the subjects, gait in this perspective was completely neglected, changing the contents of the rehabilitation program could modify the results of this study. This study has a small sample size even if the results are quite significant, the study is still ongoing to include more subjects.
Conclusion: A conventional rehabilitation program is able to restore the knee function, but did not modify gait parameters, a specific focus on gait training should be included in the rehabilitation program of TKA
Trunk asymmetry is associated with dominance preference: results from a cross-sectional study of 1029 children
No full textBackground: In some studies, an association has been reported between laterality of the curve in scoliotic adolescents and hand dominance; however, additional studies have to be performed to confirm these findings. Objective: The objective of this study is to evaluate the prevalence between trunk asymmetry and side dominance in hand, foot and visual laterality in adolescents. Methods: This was a cross-sectional study secondary analysis. In total, 1029 children (491 females) were enrolled from the Secondary School of Brescia, Italy, with a mean age of 12 (SD = 0.9 years). All subjects underwent a screening program divided into three phases: Phase 1, collection of demographic and clinical characteristics; Phase 2, spine evaluation with a plumb line and Bunnell Scoliometer; and Phase 3, evaluation of side dominance of the eye, hand and foot with a 4-item survey. Results: Our data showed a prevalence of 0.43%, 1.01% and 0.87% for thoracic, thoracolumbar and lumbar curves, respectively, with a right-side dominance and a prevalence of 2.72%, 2.54% and 0.65% for thoracic, thoracolumbar and lumbar curves, respectively, with a left-side dominance. Conclusion: The left-side dominance could have a prevalence on trunk asymmetry in thoracic and thoraco-lumbar curves. Our study suggests that the clinical evaluation of trunk asymmetry should be associated with the evaluation of laterality
Appropriate Similarity Measures for Author Cocitation Analysis
No full textWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Temporal and kinematic analyses of timed up and go test in chronic low back pain patients
No full textPurpose
To analyze temporal and kinematic parameters of chronic Low-Back Pain (cLBP) subjects compared to healthy subjects during Timed Up and Go Test (TUG) execution implemented with an Inertial Measurement Unit and to explore the correlations of those parameters with pain and disability.
Methods
Observational cross-sectional study. Thirty-one subjects with cLBP [(19 females - 61%), mean age 61 ± 19] were allocated to the case group, and 14 healthy [(10 females - 71%), mean age 62 ± 6] subjects to the control group. Instrumented TUG was administered to both groups. The Roland Morris Disability Questionnaire and Numerical Pain Rating Scale (NPRS) were also administered for disability and pain assessment in the case group.
Results
Mean TUG time to completion [12.2 ± 3.5 s for cLBP; 8.1 ± 0.9 s for healthy] and the most of sub-phases duration significantly differed between groups (p < 0.05). As for kinematic parameters, significant differences (p < 0.05) were mainly retrieved in acceleration components during the sit-to-stand and stand-to-sit phase, with the cLBP group showing lower accelerations. Significant correlation [from strong (ρ = 0.75 of time to completion) to moderate (ρ = 0.43 of sit-to-stand)] was observed between RMQD score and all temporal parameters and with most of the kinematic parameters. No correlation with NPRS score was found.
Conclusions
Instrumented TUG application into a cLBP population provides valuable information about movement behaviors with a deeper assessment of objective functional impairment and disability in respect of the classical stop-watch outcome of TUG, possibly allowing a better design of the rehabilitative intervention
- …
