1,721,043 research outputs found
NEUROPLASTICITÀ E MOTOR LEARNING: NUOVE STRATEGIE NELLA RIABILITAZIONE DELL’ARTO SUPERIORE NEL PAZIENTE CON ICTUS CEREBRALE Neuroplasticity and motor learning: novel approaches to upper extremity stroke rehabilitation
No full textIl recupero funzionale dell’arto superiore dopo un ictus cerebrale è una delle maggiori criticità in ambito riabilitativo. Nel corso degli ultimi anni,
la riabilitazione si sta perfezionando grazie all’acquisizione di nuove conoscenze sulla neuroplasticità e sulle relazioni tra l’attività cerebrale e l’apprendimento
motorio. L’esercizio terapeutico, con le caratteristiche d’intensa ripetitività, rilevanza funzionale e con l’utilizzo di feedback durante
il movimento, è uno dei fattori più rilevanti nel determinare la plasticità corticale perché in grado di aumentare gli input somato - sensoriali provenienti
dall’arto superiore colpito. La constraint-induced movement therapy (CIMT), la terapia robotica e la realtà virtuale rappresentano strategie
emergenti con alte potenzialità di ottenere risultati efficaci in neuroriabilitazione. Una strategia alternativa per promuovere il recupero motorio
dell’arto superiore è la stimolazione cerebrale non invasiva. Studi sperimentali hanno dimostrato come l’applicazione di corrente elettrica a bassa
intensità a livello della corteccia cerebrale sia in grado di indurre fenomeni di neuromodulazione. Sembra particolarmente promettente la possibilità
di combinare tecniche di neurostimolazione con l’esercizio terapeutico riabilitativo al fine di incrementare il recupero motorio e funzionale dell’arto
superiore. Lo scopo di questa recensione è di fornire a chi s’interessa di neuroriabilitazione le conoscenze sulle tecniche riabilitative emergenti che
hanno il loro razionale in studi sperimentali, e che si candidano a essere trasferite nell’ambiente clinico per ottimizzare il recupero funzionale
dell’arto superiore paretico
Beyond therapists: Technology-aided physical MS rehabilitation delivery
No full textIn the last decade, rehabilitation technology has been developed, investigated, and entered specialized clinical settings. In this chapter, we first discuss the potential of rehabilitation technology to support the achievement of key factors in motor recovery, such as delivering massed practice with good movement quality but also question task-specificity and cognitive motor control mechanisms. Second, we discuss available technology-supported rehabilitation methods for improving gait, balance and fitness, and upper limb function. Finally, we discuss considerations in relation to the professional workforce in order to deliver optimal rehabilitation
CLINICORADIOGRAPHIC ASSESMENT OF FLEXIBLE FLATFOOT IN CHILDREN
No full textBACKGROUND: Radiographic assessment is still used to evaluate flexible flatfoot in children.
METHODS: To find a set of radiologic parameters for assessing this disease, we studied 53 children aged 10 to 14 years. The degree of plantar collapse was measured by Viladot's classification (grades 0-4). The degree of valgus deformity measured in the heel in a standing position, the presence of painful points, and functional limitation during daily-living activities were also reported. The children underwent standard radiography of the foot under load. On the dorsoplantar view, the talocalcaneal, hallux metatarsophalangeal, and first intermetatarsal angles were measured. On the lateral view, the talocalcaneal, Costa Bertani, talometatarsal, talonavicular, and tibiotalar angles were measured. The radiographic measurements were compared with the data reported in the literature and were correlated with the clinical parameters studied (degree of flatfoot, valgus deviation of the heel, pain, and functional limitation).
RESULTS: The radiographic measures that resulted increased with respect to the reference values reported in the literature for the Costa Bertani (93.1% of feet), talometatarsal (93.5%), talonavicular (89.1%), and tibiotalar (69.7%) angles, all in the lateral view. Of the angles assessed in the dorsoplantar view, the hallux metatarsophalangeal (11.1%) and first intermetatarsal (24.2%) angles were increased. The degree of flatfoot was correlated with the Costa Bertani angle (P < .0005). In the group with pain, the lateral talocalcaneal (P = .016) and first intermetatarsal (P = .02) angles were increased compared within the group without pain.
CONCLUSIONS: Despite technical limitations, we still consider standard radiography of the foot, combined with clinical examination, to be a valid tool for assessing flexible flatfoot in children, especially when surgical treatment is expected and when a basic measure of the structural setup of the foot is necessary
Relation Between EEG Measures and Upper Limb Motor Recovery in Stroke Patients: A Scoping Review
No full textCurrent clinical practice does not leverage electroencephalography (EEG) measurements in stroke patients, despite its potential to contribute to post-stroke recovery predictions. We review the literature on the effectiveness of various quantitative and qualitative EEG-based measures after stroke as a tool to predict upper limb motor outcome, in relation to stroke timeframe and applied experimental tasks. Moreover, we aim to provide guidance on the use of EEG in the assessment of upper limb motor recovery after stroke, suggesting a high potential for some metrics in the appropriate context. We identified relevant papers (N = 16) from databases ScienceDirect, Web of Science and MEDLINE, and assessed their methodological quality with the Joanna Briggs Institute (JBI) Critical Appraisal. We applied the Preferred Reporting Systems for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) Framework. Identified works used EEG to identify properties including event-related activation, spectral power in physiologically relevant bands, symmetry in brain dynamics, functional connectivity, cortico-muscular coherence and rhythmic coordination. EEG was acquired in resting state or in relation to behavioural conditions. Motor outcome was mainly evaluated with the Upper Limb Fugl-Meyer Assessment. Despite great variability in the literature, data suggests that the most promising EEG quantifiers for predicting post-stroke motor outcome are event-related measures. Measures of spectral power in physiologically relevant bands and measures of brain symmetry also show promise. We suggest that EEG measures may improve our understanding of stroke brain dynamics during recovery, and contribute to establishing a functional prognosis and choosing the rehabilitation approach
Correction to: Milani, G., Demattè, G., Ferioli, M., Dallagà, G., Lavezzi, S., Basaglia, N., & Straudi, S. (2021). Telerehabiltation in Italy During the COVID-19 Lockdown: A Feasibility and Acceptability Study . International Journal of Telerehabilitation
Full text linkIn the metadata for Milani, G., Demattè, G., Ferioli, M., Dallagà, G., Lavezzi, S., Basaglia, N., & Straudi, S. (2021). Telerehabiltation in Italy During the COVID-19 Lockdown: A Feasibility and Acceptability Study . International Journal of Telerehabilitation, 13(1). https://doi.org/10.5195/ijt.2021.6334, acceptability was misspelled in the title (i.e., acceptability) by the journal editor.
The metadata for the original article has been corrected
Clinicoradiographic assessment of flexible flatfoot in children
No full textBackground: Radiographic assessment is still used to evaluate flexible flatfoot in children.
Methods: To find a set of radiologic parameters for assessing this disease, we studied 53 children aged 10 to 14 years. The degree of plantar collapse was measured by Viladot’s classification (grades 0–4). The degree of valgus deformity measured in the heel in a standing position, the presence of painful points, and functional limitation during daily-living activities were also reported. The children underwent standard radiography of the foot under load. On the dorsoplantar view, the talocalcaneal, hallux metatarsophalangeal, and first intermetatarsal angles were measured. On the lateral view, the talocalcaneal, Costa Bertani, talometatarsal, talonavicular, and tibiotalar angles were measured. The radiographic measurements were compared with the data reported in the literature and were correlated with the clinical parameters studied (degree of flatfoot, valgus deviation of the heel, pain, and functional limitation).
Results: The radiographic measures that resulted increased with respect to the reference values reported in the literature for the Costa Bertani (93.1% of feet), talometatarsal (93.5%), talonavicular (89.1%), and tibiotalar (69.7%) angles, all in the lateral view. Of the angles assessed in the dorsoplantar view, the hallux metatarsophalangeal (11.1%) and first intermetatarsal (24.2%) angles were increased. The degree of flatfoot was correlated with the Costa Bertani angle (P < .0005). In the group with pain, the lateral talocalcaneal (P = .016) and first intermetatarsal (P = .02) angles were increased compared within the group without pain.
Conclusions: Despite technical limitations, we still consider standard radiography of the foot, combined with clinical examination, to be a valid tool for assessing flexible flatfoot in children, especially when surgical treatment is expected and when a basic measure of the structural setup of the foot is necessary
Gait performance in an original biologic reconstruction of proximal femur in a skeletally immature child: A case report
No full textBiologic reconstruction of the femoral head by a sophisticated autotransplantation of the proximal growing fibula associated with a massive bone allograft has been performed in a 4-year-old girl affected by Ewing's sarcoma. The child was treated in 1997 and then followed: clinical and functional tests were performed 2, 3, 4, 6, and 7 years after surgery. Gait and specific motor tasks were assessed by means of motion analysis instruments. The patient was followed by a specific rehabilitation program, aimed at controlling load on the treated limb, resuming good muscle function, and recovering a physiological pattern of movement during daily routine activities. The outstanding radiographic evolution 8 years after surgery with the peroneal head progressively remodeled as a femoral head, and the more than satisfactory gait pattern observed at last follow-up, makes this study a keystone of experience and knowledge to be applied to other patients
Fatigue can influence the development of late-onset pain in post-COVID-19 syndrome: An observational study
No full textBackground: Late-onset pain is frequent following COVID-19, and many pathogenetic mechanisms have been proposed. Identifying the main features of patients may help in designing tailored rehabilitative interventions.Methods: We enrolled post-COVID-19 patients with an increase in pain intensity of two points on the COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) at 52 weeks compared to the pre-COVID-19 condition. All subjects were retrospectively monitored at 12, 26, and 52 weeks. A specific pain assessment was performed to determine the characteristics and mechanisms of pain. Catastrophizing, kinesiophobia, and other psychological symptoms were evaluated. The pressure pain threshold (PPT) and temporal summation (TS) were measured and compared in age- and sex-matched healthy controls to analyse pain characteristics.Results: A total of 67 patients were recruited, with 20 of them presenting an increase in pain at 52 weeks. Subjects of the two subgroups were similar in demographic and clinical characteristics at baseline; significant differences in fatigue, anxiety, mobility, ability to perform daily activities, and general health perception were recorded at 26 weeks. Fatigue significantly predicted pain onset (beta = 0.54, p = 0.002). Sixteen different body regions were identified as painful, with a pain intensity of 6.0 +/- 1.9. Most of the samples did not show neuropathic or nociplastic mechanisms. No differences in PPT and TS were recorded between patients and healthy controls.Conclusions: Almost one out of three patients hospitalized for COVID-19 developed pain 1 year later, and fatigue seems responsible for chronicity. An overlapping of conditions may explain late-onset post-COVID-19 pain, and a comprehensive approach must be considered for patient management.Significance: Late-onset pain is frequent in post-COVID-19 syndrome and an overlapping of different mechanisms seems to be responsible for its development. Among many predisposing factors, fatigue in the months before seems to be one of the primary causes of pain one year following infection and its management may help to identify new strategies for prevention and treatment of late-onset pain
Clinical Application of Physical Therapy in Neurorehabilitation
No full textThe knowledge from basic neuroscience studies on mechanisms of motor recovery and the development of theoretical models of learning and recovery has favoured the development and implementation of neurophysiologically sounded rehabilitative interventions [...
Functional evaluation of the osteochondral allograft translantation for the treatment of post-traumatic ankle arthrosis
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