International Journal of Environmental Research and Public Health, Jul 11, 2020
Background: Subjects with Down Syndrome (DS) are characterized by specific physiological alterati... more Background: Subjects with Down Syndrome (DS) are characterized by specific physiological alterations, including musculoskeletal abnormalities. Flat Foot (FF), caused by hypotonia and ligament laxity, represents one of the most common disabling disorders in this population. Conservative treatments promote the use of orthopaedic insoles and plantar supports. The aim of this study was to evaluate the impact of Foot Orthoses (FOs) on the gait pattern of subjects with DS, assessing the biomechanical effects associated with their use. Methods: Twenty-nine subjects were screened under two conditions-walking barefoot (WB); with shoes and insoles (WSI), during three trials for each. Assessments were performed through the 3D gait analysis, using an optoelectronic system, force platforms, and video recording. Specifically, synthetic indices of gait kinematics, i.e., gait profile score (GPS) and gait variable score (GVS) were calculated and compared with Wilcoxon signed-rank test, to evaluate between-conditions. Results: Significant variations were found in GVS foot progression index, representative of foot rotation during walking, in adolescents only. Conclusions: Bilateral FOs has a positive immediate impact on gait quality in adolescents with DS, as confirmed by quantitative analysis. FOs prescription is an evidence-based early approach to slow down biomechanical abnormalities and prevent relative symptoms.
The aim of this study was to assess the inter-limb symmetry during gait in post-stroke patients u... more The aim of this study was to assess the inter-limb symmetry during gait in post-stroke patients using the synchronized cyclograms technique. In total, 41 individuals with stroke (21 left and 20 right hemiplegic patients; age: 57.9 ± 12.8 years; time stroke event 4.6 ± 1.8 years) and 48 age-, sex-, and height-matched individuals (control group: CG; age: 54.4 ± 12.5 years) were assessed via 3D gait analysis. Raw kinematic data were processed to compute spatio-temporal parameters (speed, stride length, cadence, stance, swing, and double support phases duration) and angle–angle diagrams (synchronized cyclograms), which were characterized in terms of area, orientation, and trend symmetry indices. The results reveal that all spatio-temporal parameters are characterized by abnormal values, with reduced speed, stride length, cadence, and swing phase duration and increased stance and double support phases duration. With respect to inter-limb symmetry, higher values were found in post-stroke ...
The aim of this review was to present an overview of the state of the art in the use of the Micro... more The aim of this review was to present an overview of the state of the art in the use of the Microsoft Kinect camera to assess gait in post-stroke individuals through an analysis of the available literature. In recent years, several studies have explored the potentiality, accuracy, and effectiveness of this 3D optical sensor as an easy-to-use and non-invasive clinical measurement tool for the assessment of gait parameters in several pathologies. Focusing on stroke individuals, some of the available studies aimed to directly assess and characterize their gait patterns. In contrast, other studies focused on the validation of Kinect-based measurements with respect to a gold-standard reference (i.e., optoelectronic systems). However, the nonhomogeneous characteristics of the participants, of the measures, of the methodologies, and of the purposes of the studies make it difficult to adequately compare the results. This leads to uncertainties about the strengths and weaknesses of this tech...
Background Gait Profile Score (GPS) was validated as quality measure for the Gait Analysis (GA) i... more Background Gait Profile Score (GPS) was validated as quality measure for the Gait Analysis (GA) in several patholgies, but GPS was never compared with clinical scales in post-stroke patients. Objective The aim of the study was to quantify functional limitation of post-stroke hemiparetic patients using clinical-functional scales and GPS and to assess the presence of correlation between GPS and the clinical-based outcome scales. Methods Thirty-three patients were assessed with the Berg Balance Scale (BBS), Trunk Impairment Scale (TIS), Functional Ambulation Category (FAC), Functional Independence Measure (FIM) and Ten-Meter Walk Test (10-MWT); GPS was obtained by GA. Results GPS showed a fair relationship with FAC (p = 0.017; r = –0.412), TIS (p = 0.011, r = –0.436) and 10-MWT (p = 0.009, r = 0.49) and good correlation with BBS (p = 0.001; r = –0.561). The three regression models were statistically significant: Model 1 showed that FAC, GPS and FIM had a statistically significant effect in the determination of the BBS, in model 2 and 3, FIM presented a statistically significant effect on TIS determination. Conclusion GPS seems to be an independent linear predictor of balance performance in stroke patient, and GVSs on sagittal plane might help clinicians to investigate the acquired compensatory strategies. LAY ABSTRACT The relationship between Gait Profile Score and clinical assessments in 33 post-stroke patients was investigated in this study. The results exhibited that the Gait Profile Score showed a fair relationship with Functional Ambulation Category, Trunk Impairment Scale and Ten-Meter Walk Test and good correlation with the Berg Balance Scale in the hemiparetic group. This study may have clinical implications for rehabilitation evaluation of poststroke hemiparetic patients. This will enable rehabilitation clinicians to quantify the rehabilitation needs of patients more easily, measure rehabilitation progress, and study the relationship between balance and gait impairment.
International Journal of Environmental Research and Public Health, 2020
Background: Subjects with Down Syndrome (DS) are characterized by specific physiological alterati... more Background: Subjects with Down Syndrome (DS) are characterized by specific physiological alterations, including musculoskeletal abnormalities. Flat Foot (FF), caused by hypotonia and ligament laxity, represents one of the most common disabling disorders in this population. Conservative treatments promote the use of orthopaedic insoles and plantar supports. The aim of this study was to evaluate the impact of Foot Orthoses (FOs) on the gait pattern of subjects with DS, assessing the biomechanical effects associated with their use. Methods: Twenty-nine subjects were screened under two conditions—walking barefoot (WB); with shoes and insoles (WSI), during three trials for each. Assessments were performed through the 3D gait analysis, using an optoelectronic system, force platforms, and video recording. Specifically, synthetic indices of gait kinematics, i.e., gait profile score (GPS) and gait variable score (GVS) were calculated and compared with Wilcoxon signed-rank test, to evaluate b...
Journal of NeuroEngineering and Rehabilitation, 2007
Background: Being severely overweight is a distinctive clinical feature of Prader-Willi Syndrome ... more Background: Being severely overweight is a distinctive clinical feature of Prader-Willi Syndrome (PWS). PWS is a complex multisystem disorder, representing the most common form of genetic obesity. The aim of this study was the analysis of the gait pattern of adult subjects with PWS by using three-Dimensional Gait Analysis. The results were compared with those obtained in a group of obese patients and in a group of healthy subjects. Methods: Cross-sectional, comparative study: 19 patients with PWS (11 males and 8 females, age: 18-40 years, BMI: 29.3-50.3 kg/m 2 ); 14 obese matched patients (5 males and 9 females, age: 18-40 years, BMI: 34.3-45.2 kg/m 2 ); 20 healthy subjects (10 males and 10 females, age: 21-41 years, BMI: 19.3-25.4 kg/m 2 ). Kinematic and kinetic parameters during walking were assessed by an optoelectronic system and two force platforms. Results: PWS adult patients walked slower, had a shorter stride length, a lower cadence and a longer stance phase compared with both matched obese, and healthy subjects. Obese matched patients showed spatio-temporal parameters significantly different from healthy subjects. Furthermore, Range Of Motion (ROM) at knee and ankle, and plantaflexor activity of PWS patients were significantly different between obese and healthy subjects. Obese subjects revealed kinematic and kinetic data similar to healthy subjects. PWS subjects had a gait pattern significantly different from obese patients. Despite that, both groups had a similar BMI. We suggest that PWS gait abnormalities may be related to abnormalities in the development of motor skills in childhood, due to precocious obesity. A tailored rehabilitation program in early childhood of PWS patients could prevent gait pattern changes.
Background: Required Coefficient of Friction (RCOF) is one of the most critical gait parameters a... more Background: Required Coefficient of Friction (RCOF) is one of the most critical gait parameters associated to the occurrence of slipping in individuals affected by neurological disorders characterized by balance impairments. This study aims to calculate RCOF in people with Multiple Sclerosis (MS) on the basis of three-dimensional Gait Analysis (GA) data. Methods: This study enrolls 22 people with MS (pwMS) who were characterized by an Expanded Disability Status Score in the range 1.5-6 and 10 healthy controls (HC). All participants underwent to three-dimensional GA from which we extracted kinematic and kinetic data (i.e. the Ground Reaction Forces, GRF, and joint moments and powers in the sagittal plane). RCOF was calculated as the ratio of the shear to normal GRF components during the stance phase of gait cycle, and normalized by the walking velocity. Thus, the following variables were extracted: first peak (named P1COF), valley (named V1COF), and second peak (named P2COF) in RCOF curve; also computating the maximum ankle dorsi-plantarflexion moment (MOMmax) and the maximum ankle joint power (PWRmax). Results: Our data revealed that P2COF results are significantly lower in pwMS when compared to HC (p=0.043; Z=−2.025). In pwMS, the study found a moderate, positive correlation between V1COF and MOMmax (r=0.558; p & $2lt;0.001) and a moderate, positive correlation between EDSS score and MOMmax (rho=0.622; p=0.001). While, in HC group, the study detected a moderate positive correlation between P1COF and MOM max (r=0.636; p=0.008). Conclusion: Friction during mid stance and push off phases is critically important to determine whether the frictional capabilities of foot/floor interface are sufficient to prevent slips in pwMS. The impaired ankle moment in MS group causes increased P2COF in comparison to HC, increasing the risk of slipping in the critical phase of transmission of the developed forces to kinematic chain. Also, the correlation analysis among RCOF values and kinetic variables describe the interplay between V1COF and MOMmax: the higher V1COF is, the higher is MOMmax; and the different correlation the study found between COF and kinetic parameters in MS and HC group highlightes the different gait patterns of the two classes of subjects. 1. Background Multiple Sclerosis (MS) is a demyelinating disease characterized by an abnormal response of the immune system directed against self components of the central nervous system (CNS) (Scheinberg et al., 1980). Eighty five per cent of people with MS (pwMS) report gait disturbance as their main complain (Cameron and Lord, 2010). Also, a range of symptoms including muscle weakness, sensory and cerebellar
Journal of Neuroengineering and Rehabilitation, Apr 22, 2011
Objective: the aim of this study was to assess whether reduced balance capacity in obese subjects... more Objective: the aim of this study was to assess whether reduced balance capacity in obese subjects is secondary to altered sensory information.
In the last two decades, whole-body vibration training (WBVT), involving exercising on a vibratin... more In the last two decades, whole-body vibration training (WBVT), involving exercising on a vibrating platform, emerged as an alternative exercise modality for the treatment of obesity. In this chapter, the possible clinical use of WBVT in obese individuals is addressed, involving its effect on body composition, muscle strength, and cardiovascular function.
International Journal of Osteopathic Medicine, Mar 1, 2016
Abstract Background Prader–Willi syndrome (PWS) is the most frequent type of syndromic obesity an... more Abstract Background Prader–Willi syndrome (PWS) is the most frequent type of syndromic obesity and major clinical features include muscular hypotonia, early onset of obesity, short stature, scoliosis, developmental delays, reduced spontaneous physical activity, gait and postural disorders. Improving balance and walking ability in these patients could enhance their health status and quality of life. Objective The aim of this study was to quantify the effects of an Osteopathic Manipulative Treatment (OMT) session on gait pattern and posture in adults with PWS. Methods Ten patients with PWS (age: 37.0 + 4.3 years) were evaluated at admission (PRE session) and 24 h after the conclusion of one single 45-min OMT session (POST session), using gait analysis and static posturography. Two control groups were recruited: the first one included 15 obese subjects and the second group included 20 normal weight subjects. Results After the OMT treatment, significant effects on posture and on walking were reported. In particular, significant improvements were observed in knee kinematics (knee position at initial contact and in mid-stance) and ankle kinetics (in terms of the peaks of ankle moment and power during terminal stance), with higher value of ground reaction force at push-off. Significant improvements were found in terms of postural analysis of the centre of pressure, which decreased its excursion in antero-posterior and medio-lateral direction and its trace length. Conclusions These preliminary results suggest that OMT within a comprehensive rehabilitation program could reduce costs and increase effectiveness of the rehabilitation treatment of these patients.
Archives of Physical Medicine and Rehabilitation, Oct 1, 2008
Conclusions: There is a statistically significant correlation between the variables, suggesting t... more Conclusions: There is a statistically significant correlation between the variables, suggesting that perception of functionality can play an important role in the QOL of patients with MS.
In recent years, the use of inertial-based systems has been applied to remote rehabilitation, ope... more In recent years, the use of inertial-based systems has been applied to remote rehabilitation, opening new perspectives for outpatient assessment. In this study, we assessed the accuracy and the concurrent validity of the angular measurements provided by an inertial-based device for rehabilitation with respect to the state-of-the-art system for motion tracking. Data were simultaneously collected with the two systems across a set of exercises for trunk and lower limbs, performed by 21 healthy participants. Additionally, the sensitivity of the inertial measurement unit (IMU)-based system to its malpositioning was assessed. Root mean square error (RMSE) was used to explore the differences in the outputs of the two systems in terms of range of motion (ROM), and their agreement was assessed via Pearson’s correlation coefficient (PCC) and Lin’s concordance correlation coefficient (CCC). The results showed that the IMU-based system was able to assess upper-body and lower-limb kinematics wit...
Rehabilitation interventions in the patient with obesity, 2020
The aim of this chapter is to present a practical overview of the most common equipment for patie... more The aim of this chapter is to present a practical overview of the most common equipment for patient handling and rehabilitation technologies for a clinical setting, focusing the attention on devices suited for obese individuals. In details, the equipment, devices, aids, and resources designed as alternative to manual handling are described. We have reviewed the equipment related to lifting, transferring, repositioning, moving, and mobilizing of obese patients ensuring that patients are cared for safely preventing consequences of immobility, while maintaining a safe work environment for employees.
Lymphedema of the lower limbs often contributes to the mobility impairment of morbidly obese pati... more Lymphedema of the lower limbs often contributes to the mobility impairment of morbidly obese patients. Defining novel cost-effective protocols is important for reducing treatment costs. The study aimed to assess if Capacitive and Resistive Energy Transfer (TECAR) can reduce edema and the minimum number of sessions needed to observe volume reduction. Forty-eight severely obese subjects (age range: 46-78 years; BMI >40 kg/m2) with bilateral lower limb lymphedema were divided into three groups undergoing either manual lymphatic drainage, pressure therapy, or TECAR, in addition to a multidisciplinary rehabilitation program. They were compared to a control group composed by 12 women (age: 67.4 ± 8.9 years, BMI: 44.6 ± 4.1 Kg/m2) undergoing only the rehabilitation program. A handheld laser scanner 3D system was used for volume measurements. In addition, patients were evaluated with a Timed Up and Go (TUG) test and pain/heaviness of the lower limbs with a Visual Analog Scale (VAS). A si...
Computer Methods in Biomechanics and Biomedical Engineering, 2020
Most studies on locomotion of individuals with the Prader-Willi Syndrome (PWS) have been performe... more Most studies on locomotion of individuals with the Prader-Willi Syndrome (PWS) have been performed in a laboratory setting using quantitative motion analysis. Recently, wireless inertial sensors have been successfully employed for gait analysis in different pathological states with the advantages of reproducing a testing condition very close to those encountered in daily living. Using such devices, it is possible not only to characterize the conventional spatio-temporal parameters, but also extract information on further less conventional metrics, such as the harmonic ratio (HR), a measure of step-to-step symmetry based on trunk acceleration processing. In the present study, this technique was used to quantify gait parameters during level walking in 20 adults with PWS who were compared to 20 unaffected individuals. While no differences between the two groups were found in terms of spatio-temporal parameters, individuals with PWS exhibited significantly reduced values of HR in the antero-posterior and vertical directions. Such results, which indicate a poorer gait symmetry in PWS, suggest that upper body accelerations, as well as HR, provide novel information on gait in people with PWS that could not be extracted from spatio-temporal parameters only.
International Journal of Environmental Research and Public Health, Jul 11, 2020
Background: Subjects with Down Syndrome (DS) are characterized by specific physiological alterati... more Background: Subjects with Down Syndrome (DS) are characterized by specific physiological alterations, including musculoskeletal abnormalities. Flat Foot (FF), caused by hypotonia and ligament laxity, represents one of the most common disabling disorders in this population. Conservative treatments promote the use of orthopaedic insoles and plantar supports. The aim of this study was to evaluate the impact of Foot Orthoses (FOs) on the gait pattern of subjects with DS, assessing the biomechanical effects associated with their use. Methods: Twenty-nine subjects were screened under two conditions-walking barefoot (WB); with shoes and insoles (WSI), during three trials for each. Assessments were performed through the 3D gait analysis, using an optoelectronic system, force platforms, and video recording. Specifically, synthetic indices of gait kinematics, i.e., gait profile score (GPS) and gait variable score (GVS) were calculated and compared with Wilcoxon signed-rank test, to evaluate between-conditions. Results: Significant variations were found in GVS foot progression index, representative of foot rotation during walking, in adolescents only. Conclusions: Bilateral FOs has a positive immediate impact on gait quality in adolescents with DS, as confirmed by quantitative analysis. FOs prescription is an evidence-based early approach to slow down biomechanical abnormalities and prevent relative symptoms.
The aim of this study was to assess the inter-limb symmetry during gait in post-stroke patients u... more The aim of this study was to assess the inter-limb symmetry during gait in post-stroke patients using the synchronized cyclograms technique. In total, 41 individuals with stroke (21 left and 20 right hemiplegic patients; age: 57.9 ± 12.8 years; time stroke event 4.6 ± 1.8 years) and 48 age-, sex-, and height-matched individuals (control group: CG; age: 54.4 ± 12.5 years) were assessed via 3D gait analysis. Raw kinematic data were processed to compute spatio-temporal parameters (speed, stride length, cadence, stance, swing, and double support phases duration) and angle–angle diagrams (synchronized cyclograms), which were characterized in terms of area, orientation, and trend symmetry indices. The results reveal that all spatio-temporal parameters are characterized by abnormal values, with reduced speed, stride length, cadence, and swing phase duration and increased stance and double support phases duration. With respect to inter-limb symmetry, higher values were found in post-stroke ...
The aim of this review was to present an overview of the state of the art in the use of the Micro... more The aim of this review was to present an overview of the state of the art in the use of the Microsoft Kinect camera to assess gait in post-stroke individuals through an analysis of the available literature. In recent years, several studies have explored the potentiality, accuracy, and effectiveness of this 3D optical sensor as an easy-to-use and non-invasive clinical measurement tool for the assessment of gait parameters in several pathologies. Focusing on stroke individuals, some of the available studies aimed to directly assess and characterize their gait patterns. In contrast, other studies focused on the validation of Kinect-based measurements with respect to a gold-standard reference (i.e., optoelectronic systems). However, the nonhomogeneous characteristics of the participants, of the measures, of the methodologies, and of the purposes of the studies make it difficult to adequately compare the results. This leads to uncertainties about the strengths and weaknesses of this tech...
Background Gait Profile Score (GPS) was validated as quality measure for the Gait Analysis (GA) i... more Background Gait Profile Score (GPS) was validated as quality measure for the Gait Analysis (GA) in several patholgies, but GPS was never compared with clinical scales in post-stroke patients. Objective The aim of the study was to quantify functional limitation of post-stroke hemiparetic patients using clinical-functional scales and GPS and to assess the presence of correlation between GPS and the clinical-based outcome scales. Methods Thirty-three patients were assessed with the Berg Balance Scale (BBS), Trunk Impairment Scale (TIS), Functional Ambulation Category (FAC), Functional Independence Measure (FIM) and Ten-Meter Walk Test (10-MWT); GPS was obtained by GA. Results GPS showed a fair relationship with FAC (p = 0.017; r = –0.412), TIS (p = 0.011, r = –0.436) and 10-MWT (p = 0.009, r = 0.49) and good correlation with BBS (p = 0.001; r = –0.561). The three regression models were statistically significant: Model 1 showed that FAC, GPS and FIM had a statistically significant effect in the determination of the BBS, in model 2 and 3, FIM presented a statistically significant effect on TIS determination. Conclusion GPS seems to be an independent linear predictor of balance performance in stroke patient, and GVSs on sagittal plane might help clinicians to investigate the acquired compensatory strategies. LAY ABSTRACT The relationship between Gait Profile Score and clinical assessments in 33 post-stroke patients was investigated in this study. The results exhibited that the Gait Profile Score showed a fair relationship with Functional Ambulation Category, Trunk Impairment Scale and Ten-Meter Walk Test and good correlation with the Berg Balance Scale in the hemiparetic group. This study may have clinical implications for rehabilitation evaluation of poststroke hemiparetic patients. This will enable rehabilitation clinicians to quantify the rehabilitation needs of patients more easily, measure rehabilitation progress, and study the relationship between balance and gait impairment.
International Journal of Environmental Research and Public Health, 2020
Background: Subjects with Down Syndrome (DS) are characterized by specific physiological alterati... more Background: Subjects with Down Syndrome (DS) are characterized by specific physiological alterations, including musculoskeletal abnormalities. Flat Foot (FF), caused by hypotonia and ligament laxity, represents one of the most common disabling disorders in this population. Conservative treatments promote the use of orthopaedic insoles and plantar supports. The aim of this study was to evaluate the impact of Foot Orthoses (FOs) on the gait pattern of subjects with DS, assessing the biomechanical effects associated with their use. Methods: Twenty-nine subjects were screened under two conditions—walking barefoot (WB); with shoes and insoles (WSI), during three trials for each. Assessments were performed through the 3D gait analysis, using an optoelectronic system, force platforms, and video recording. Specifically, synthetic indices of gait kinematics, i.e., gait profile score (GPS) and gait variable score (GVS) were calculated and compared with Wilcoxon signed-rank test, to evaluate b...
Journal of NeuroEngineering and Rehabilitation, 2007
Background: Being severely overweight is a distinctive clinical feature of Prader-Willi Syndrome ... more Background: Being severely overweight is a distinctive clinical feature of Prader-Willi Syndrome (PWS). PWS is a complex multisystem disorder, representing the most common form of genetic obesity. The aim of this study was the analysis of the gait pattern of adult subjects with PWS by using three-Dimensional Gait Analysis. The results were compared with those obtained in a group of obese patients and in a group of healthy subjects. Methods: Cross-sectional, comparative study: 19 patients with PWS (11 males and 8 females, age: 18-40 years, BMI: 29.3-50.3 kg/m 2 ); 14 obese matched patients (5 males and 9 females, age: 18-40 years, BMI: 34.3-45.2 kg/m 2 ); 20 healthy subjects (10 males and 10 females, age: 21-41 years, BMI: 19.3-25.4 kg/m 2 ). Kinematic and kinetic parameters during walking were assessed by an optoelectronic system and two force platforms. Results: PWS adult patients walked slower, had a shorter stride length, a lower cadence and a longer stance phase compared with both matched obese, and healthy subjects. Obese matched patients showed spatio-temporal parameters significantly different from healthy subjects. Furthermore, Range Of Motion (ROM) at knee and ankle, and plantaflexor activity of PWS patients were significantly different between obese and healthy subjects. Obese subjects revealed kinematic and kinetic data similar to healthy subjects. PWS subjects had a gait pattern significantly different from obese patients. Despite that, both groups had a similar BMI. We suggest that PWS gait abnormalities may be related to abnormalities in the development of motor skills in childhood, due to precocious obesity. A tailored rehabilitation program in early childhood of PWS patients could prevent gait pattern changes.
Background: Required Coefficient of Friction (RCOF) is one of the most critical gait parameters a... more Background: Required Coefficient of Friction (RCOF) is one of the most critical gait parameters associated to the occurrence of slipping in individuals affected by neurological disorders characterized by balance impairments. This study aims to calculate RCOF in people with Multiple Sclerosis (MS) on the basis of three-dimensional Gait Analysis (GA) data. Methods: This study enrolls 22 people with MS (pwMS) who were characterized by an Expanded Disability Status Score in the range 1.5-6 and 10 healthy controls (HC). All participants underwent to three-dimensional GA from which we extracted kinematic and kinetic data (i.e. the Ground Reaction Forces, GRF, and joint moments and powers in the sagittal plane). RCOF was calculated as the ratio of the shear to normal GRF components during the stance phase of gait cycle, and normalized by the walking velocity. Thus, the following variables were extracted: first peak (named P1COF), valley (named V1COF), and second peak (named P2COF) in RCOF curve; also computating the maximum ankle dorsi-plantarflexion moment (MOMmax) and the maximum ankle joint power (PWRmax). Results: Our data revealed that P2COF results are significantly lower in pwMS when compared to HC (p=0.043; Z=−2.025). In pwMS, the study found a moderate, positive correlation between V1COF and MOMmax (r=0.558; p & $2lt;0.001) and a moderate, positive correlation between EDSS score and MOMmax (rho=0.622; p=0.001). While, in HC group, the study detected a moderate positive correlation between P1COF and MOM max (r=0.636; p=0.008). Conclusion: Friction during mid stance and push off phases is critically important to determine whether the frictional capabilities of foot/floor interface are sufficient to prevent slips in pwMS. The impaired ankle moment in MS group causes increased P2COF in comparison to HC, increasing the risk of slipping in the critical phase of transmission of the developed forces to kinematic chain. Also, the correlation analysis among RCOF values and kinetic variables describe the interplay between V1COF and MOMmax: the higher V1COF is, the higher is MOMmax; and the different correlation the study found between COF and kinetic parameters in MS and HC group highlightes the different gait patterns of the two classes of subjects. 1. Background Multiple Sclerosis (MS) is a demyelinating disease characterized by an abnormal response of the immune system directed against self components of the central nervous system (CNS) (Scheinberg et al., 1980). Eighty five per cent of people with MS (pwMS) report gait disturbance as their main complain (Cameron and Lord, 2010). Also, a range of symptoms including muscle weakness, sensory and cerebellar
Journal of Neuroengineering and Rehabilitation, Apr 22, 2011
Objective: the aim of this study was to assess whether reduced balance capacity in obese subjects... more Objective: the aim of this study was to assess whether reduced balance capacity in obese subjects is secondary to altered sensory information.
In the last two decades, whole-body vibration training (WBVT), involving exercising on a vibratin... more In the last two decades, whole-body vibration training (WBVT), involving exercising on a vibrating platform, emerged as an alternative exercise modality for the treatment of obesity. In this chapter, the possible clinical use of WBVT in obese individuals is addressed, involving its effect on body composition, muscle strength, and cardiovascular function.
International Journal of Osteopathic Medicine, Mar 1, 2016
Abstract Background Prader–Willi syndrome (PWS) is the most frequent type of syndromic obesity an... more Abstract Background Prader–Willi syndrome (PWS) is the most frequent type of syndromic obesity and major clinical features include muscular hypotonia, early onset of obesity, short stature, scoliosis, developmental delays, reduced spontaneous physical activity, gait and postural disorders. Improving balance and walking ability in these patients could enhance their health status and quality of life. Objective The aim of this study was to quantify the effects of an Osteopathic Manipulative Treatment (OMT) session on gait pattern and posture in adults with PWS. Methods Ten patients with PWS (age: 37.0 + 4.3 years) were evaluated at admission (PRE session) and 24 h after the conclusion of one single 45-min OMT session (POST session), using gait analysis and static posturography. Two control groups were recruited: the first one included 15 obese subjects and the second group included 20 normal weight subjects. Results After the OMT treatment, significant effects on posture and on walking were reported. In particular, significant improvements were observed in knee kinematics (knee position at initial contact and in mid-stance) and ankle kinetics (in terms of the peaks of ankle moment and power during terminal stance), with higher value of ground reaction force at push-off. Significant improvements were found in terms of postural analysis of the centre of pressure, which decreased its excursion in antero-posterior and medio-lateral direction and its trace length. Conclusions These preliminary results suggest that OMT within a comprehensive rehabilitation program could reduce costs and increase effectiveness of the rehabilitation treatment of these patients.
Archives of Physical Medicine and Rehabilitation, Oct 1, 2008
Conclusions: There is a statistically significant correlation between the variables, suggesting t... more Conclusions: There is a statistically significant correlation between the variables, suggesting that perception of functionality can play an important role in the QOL of patients with MS.
In recent years, the use of inertial-based systems has been applied to remote rehabilitation, ope... more In recent years, the use of inertial-based systems has been applied to remote rehabilitation, opening new perspectives for outpatient assessment. In this study, we assessed the accuracy and the concurrent validity of the angular measurements provided by an inertial-based device for rehabilitation with respect to the state-of-the-art system for motion tracking. Data were simultaneously collected with the two systems across a set of exercises for trunk and lower limbs, performed by 21 healthy participants. Additionally, the sensitivity of the inertial measurement unit (IMU)-based system to its malpositioning was assessed. Root mean square error (RMSE) was used to explore the differences in the outputs of the two systems in terms of range of motion (ROM), and their agreement was assessed via Pearson’s correlation coefficient (PCC) and Lin’s concordance correlation coefficient (CCC). The results showed that the IMU-based system was able to assess upper-body and lower-limb kinematics wit...
Rehabilitation interventions in the patient with obesity, 2020
The aim of this chapter is to present a practical overview of the most common equipment for patie... more The aim of this chapter is to present a practical overview of the most common equipment for patient handling and rehabilitation technologies for a clinical setting, focusing the attention on devices suited for obese individuals. In details, the equipment, devices, aids, and resources designed as alternative to manual handling are described. We have reviewed the equipment related to lifting, transferring, repositioning, moving, and mobilizing of obese patients ensuring that patients are cared for safely preventing consequences of immobility, while maintaining a safe work environment for employees.
Lymphedema of the lower limbs often contributes to the mobility impairment of morbidly obese pati... more Lymphedema of the lower limbs often contributes to the mobility impairment of morbidly obese patients. Defining novel cost-effective protocols is important for reducing treatment costs. The study aimed to assess if Capacitive and Resistive Energy Transfer (TECAR) can reduce edema and the minimum number of sessions needed to observe volume reduction. Forty-eight severely obese subjects (age range: 46-78 years; BMI >40 kg/m2) with bilateral lower limb lymphedema were divided into three groups undergoing either manual lymphatic drainage, pressure therapy, or TECAR, in addition to a multidisciplinary rehabilitation program. They were compared to a control group composed by 12 women (age: 67.4 ± 8.9 years, BMI: 44.6 ± 4.1 Kg/m2) undergoing only the rehabilitation program. A handheld laser scanner 3D system was used for volume measurements. In addition, patients were evaluated with a Timed Up and Go (TUG) test and pain/heaviness of the lower limbs with a Visual Analog Scale (VAS). A si...
Computer Methods in Biomechanics and Biomedical Engineering, 2020
Most studies on locomotion of individuals with the Prader-Willi Syndrome (PWS) have been performe... more Most studies on locomotion of individuals with the Prader-Willi Syndrome (PWS) have been performed in a laboratory setting using quantitative motion analysis. Recently, wireless inertial sensors have been successfully employed for gait analysis in different pathological states with the advantages of reproducing a testing condition very close to those encountered in daily living. Using such devices, it is possible not only to characterize the conventional spatio-temporal parameters, but also extract information on further less conventional metrics, such as the harmonic ratio (HR), a measure of step-to-step symmetry based on trunk acceleration processing. In the present study, this technique was used to quantify gait parameters during level walking in 20 adults with PWS who were compared to 20 unaffected individuals. While no differences between the two groups were found in terms of spatio-temporal parameters, individuals with PWS exhibited significantly reduced values of HR in the antero-posterior and vertical directions. Such results, which indicate a poorer gait symmetry in PWS, suggest that upper body accelerations, as well as HR, provide novel information on gait in people with PWS that could not be extracted from spatio-temporal parameters only.
Uploads
Papers by manuela Galli