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...
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.
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...
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...
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.
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...
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Papers by manuela Galli