ABSTRACT Brain-computer interfaces (BCIs) are systems that can provide communication and environm... more ABSTRACT Brain-computer interfaces (BCIs) are systems that can provide communication and environmental control to people with severe neuromuscular disease. This study uses a previously validated study (Perego et al. J Neurosci Methods. 2012;201:239–250) to analyze difficulties, results and performance of disabled people using BCIs for psychometric assessment. We use the same protocol proposed in the previous article with an SSVEP-based BCI and the Raven Coloured Progressive Matrix test, in order to verify if BCI can be used as a tool for psychometric assessment with neurologically impaired participants. Twenty-six patients participated in the test, but only 57.7% could correctly use an SSVEP-based BCI due to involuntary movements or muscle contraction, high electrode impedance and non-cooperation; only two subjects (one bilateral cerebral palsy and one with spinal cord injury) could not elicit a sufficient SSVEP pattern to control the BCI. Results show that the presence of neurological impairment does not affect the possibility of interacting with and controlling the BCI system; furthermore no significant differences could be found in IQ index obtained through the BCI and standard tests. Despite this, the chances of failing to establish effective BCI control are much higher among pathologic participants than healthy subjects.
The package contains the application for the GRAIL system that provides multimodal analysis of ga... more The package contains the application for the GRAIL system that provides multimodal analysis of gait training in a virtual reality environment. was implemented by adding new functionalities in the Forest Road application, which was already included in the gait suite package provided by Motek, as proof of concept. In this application, gait pattern (kinetic and kinematic parameters) are detected during the walking along a road in a wooded VR environment. The application detects in real-time the gait initial contact by analysing the ground reaction force values. Once the IC (IC) is detected, a signal is sent to the Phidget (1018_2 Phidget I/O board (Phidgets Inc)), which in turns triggers the EEG system (ANT Neuro). The trigger is the same for the left and right ICs and the identification of the left and right steps is possible off-line by analysing the EMG signal acquired on both legs. Another LUA Script module automatically changes the VR environment using the VR wooded setting for th...
The full-text may be used and/or reproduced, and given to third parties in any format or medium, ... more The full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-pro t purposes provided that: • a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders. Please consult the full DRO policy for further details.
Children with cerebral palsy (CP) suffer deficits in their motor, sensory, and cognitive abilitie... more Children with cerebral palsy (CP) suffer deficits in their motor, sensory, and cognitive abilities, as well as in their visuospatial competences. In the last years, several authors have tried to correlate the visuospatial abilities with the navigational ones. Given their importance in everyday functions, navigation skills have been deeply studied using increasingly cutting-edge techniques such as virtual reality (VR). However, to our knowledge, there are no studies focused on training using immersive VR (IVR) in children with movement disorders. For this reason, we proposed an IVR training to 35 young participants with CP and conceived to improve their navigation skills in a “simil-real” environment while playing on a dynamic platform. A subgroup performed a part of the training which was specifically dedicated to the use of the allocentric strategy (i.e., looking for landmarks) to navigate the virtual environment. We then compared the children’s navigation and spatial skills pre- a...
This dataset is related to the paper "Peri E, Turconi AC, Biffi E, Maghini C, Panzeri D, Mor... more This dataset is related to the paper "Peri E, Turconi AC, Biffi E, Maghini C, Panzeri D, Morganti R, Pedrocchi A, Gagliardi C. Effects of dose and duration of Robot-Assisted Gait Training on walking ability of children affected by cerebral palsy. Technol Health Care. 2017 Aug 9;25(4):671-681. doi: 10.3233/THC-160668. PMID: 28436398." Specifically, the dataset reports GMFM-88, GMFM-D, GMFM-E and 6MWT pre and post treatment for group 1 (4 TOP sessions/week x 10 weeks) and 2 (4 RAGT sessions/week x 10 weeks). Age and GMFCS level are also reported.
Gait training in a virtual reality (VR) environment is promising for children affected by differe... more Gait training in a virtual reality (VR) environment is promising for children affected by different disorders. However, the efficacy of VR therapy is still under debate, and more research is needed to clarify its effects on clinical conditions. The combination of VR with neuroimaging methods, such as the electroencephalography (EEG), might help in answering this need. The aim of the present work was to set up and test a system for the multimodal analysis of the gait pattern during VR gait training of pediatric populations by analyzing the EEG correlates as well as the kinematic and kinetic parameters of the gait. An EEG system was integrated with the Gait Real-time Analysis Interactive Lab (GRAIL). We developed and validated, with healthy adults (n = 5) and children (n = 4, healthy or affected by cerebral palsy (CP)), the hardware and software integration of the two systems, which allowed the synchronization of the acquired signals and a reliable identification of the initial contac...
BACKGROUND Joubert Syndrome (JS) is a rare inherited neurodevelopmental disorder defined by a cha... more BACKGROUND Joubert Syndrome (JS) is a rare inherited neurodevelopmental disorder defined by a characteristic cerebellar and brainstem malformation (i.e. the molar tooth sign) and variable organ involvement. The aim of the present study was to describe functional limitations and disabilities in a large sample of adult patients with a diagnosis of JS. METHODS We administered the International Classification of Functioning (ICF) checklist to thirty-six adult Italian patients with JS or their caregivers through telephone calls. RESULTS None-to-mild impairment was documented for basic cognitive and mental functions, whereas severe deficit emerged for higher-order skills and language. A mismatch between individuals' capacity for daily activity and social participation and the actual performance in these fields emerged, suggesting that adults with JS may greatly benefit from external support from the caring environment. Indeed, specific facilitators were highlighted, including communication technologies as well as family members, healthcare professionals and peers support. Mild-to-severe barriers have been identified by adult patients with JS in the domains of services, systems and policies. CONCLUSIONS These findings highlight challenges and barriers for adults with JS in areas of daily functioning that may be improved by investing in rehabilitation care models that embed social support programs and policies into clinical interventions.IMPLICATIONS FOR REHABILITATIONChildren with Joubert Syndrome, a child-onset rare inherited neurodevelopmental condition, are growing up and becoming adults; a life course approach in rehabilitation is needed;There is a substantial lack of information on the long-term adaptive daily functioning of children with a diagnosis of Joubert Syndrome;In this paper, the International Classification of Functioning (ICF) was applied to assess the daily functioning in people with JS;Severe deficits emerged for high-order skills and language, whereas the use of communication technologies and the engagement of family members were highlighted as key facilitators;These findings highlight the need for a change of paradigm in the care model of subjects with JS, with the embedding of social support in rehabilitation programs.
Purpose:Human navigation skills are essential for everyday life and rely on several cognitive abi... more Purpose:Human navigation skills are essential for everyday life and rely on several cognitive abilities, among which visual-spatial competences that are impaired in subjects with cerebral palsy (CP). In this work, we proposed navigation tasks in immersive virtual reality (IVR) to 15 children with CP and 13 typically developing (TD) peers in order to assess the individual navigation strategies and their modifiability in a situation resembling real life.Methods:We developed and adapted to IVR an application based on a 5-way maze in a playground that was to be navigated to find a reward. The learning process, navigation strategies, and adaptation to changes were compared between participants with CP and their TD peers and correlated with visual-spatial abilities and cognitive competences.Results:Most participants with CP needed more attempts than TD participants to become proficient in navigation. Furthermore, the learning phase was correlated to visual-spatial memory but not with cogn...
The near-total absence of the cerebellum is a rare congenital condition with a wide phenotypic he... more The near-total absence of the cerebellum is a rare congenital condition with a wide phenotypic heterogeneity ranging from a severe to mild impairment of motor, cognitive, and behavioral functions. In this study, the case of a 48-year-old right-handed man with a near-total absence of the cerebellum was examined with the aim of understanding the long-term reorganization of a brain developed without a cerebellum. Clinical, neuropsychological evaluation and a neuroimaging study on a 3-T scanner were carried out. Both conventional structural diffusion tensor imaging (DTI) and functional (resting-state fMRI) data were acquired. A severe neuropsychomotor delay in infancy and adolescence involving motor skills, cognitive, and affective competencies was observed, which improved over the years. Conventional MRI findings confirmed the complete absence of the cerebellum. Analysis of DTI and resting-state fMRI data showed an impairment of the executive-control network, involving areas strongly connected with the cerebellum through the frontopontine fibers. The neuroimaging findings excluded the involvement of the extracerebellar structure. In conclusion, our data support the vascular genesis hypothesis for this rare pathology, consistent with an acquired embryonic cerebellar insult. This case also shows that it is possible to learn to live without the cerebellum over time.
ABSTRACT Brain-computer interfaces (BCIs) are systems that can provide communication and environm... more ABSTRACT Brain-computer interfaces (BCIs) are systems that can provide communication and environmental control to people with severe neuromuscular disease. This study uses a previously validated study (Perego et al. J Neurosci Methods. 2012;201:239–250) to analyze difficulties, results and performance of disabled people using BCIs for psychometric assessment. We use the same protocol proposed in the previous article with an SSVEP-based BCI and the Raven Coloured Progressive Matrix test, in order to verify if BCI can be used as a tool for psychometric assessment with neurologically impaired participants. Twenty-six patients participated in the test, but only 57.7% could correctly use an SSVEP-based BCI due to involuntary movements or muscle contraction, high electrode impedance and non-cooperation; only two subjects (one bilateral cerebral palsy and one with spinal cord injury) could not elicit a sufficient SSVEP pattern to control the BCI. Results show that the presence of neurological impairment does not affect the possibility of interacting with and controlling the BCI system; furthermore no significant differences could be found in IQ index obtained through the BCI and standard tests. Despite this, the chances of failing to establish effective BCI control are much higher among pathologic participants than healthy subjects.
The package contains the application for the GRAIL system that provides multimodal analysis of ga... more The package contains the application for the GRAIL system that provides multimodal analysis of gait training in a virtual reality environment. was implemented by adding new functionalities in the Forest Road application, which was already included in the gait suite package provided by Motek, as proof of concept. In this application, gait pattern (kinetic and kinematic parameters) are detected during the walking along a road in a wooded VR environment. The application detects in real-time the gait initial contact by analysing the ground reaction force values. Once the IC (IC) is detected, a signal is sent to the Phidget (1018_2 Phidget I/O board (Phidgets Inc)), which in turns triggers the EEG system (ANT Neuro). The trigger is the same for the left and right ICs and the identification of the left and right steps is possible off-line by analysing the EMG signal acquired on both legs. Another LUA Script module automatically changes the VR environment using the VR wooded setting for th...
The full-text may be used and/or reproduced, and given to third parties in any format or medium, ... more The full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-pro t purposes provided that: • a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders. Please consult the full DRO policy for further details.
Children with cerebral palsy (CP) suffer deficits in their motor, sensory, and cognitive abilitie... more Children with cerebral palsy (CP) suffer deficits in their motor, sensory, and cognitive abilities, as well as in their visuospatial competences. In the last years, several authors have tried to correlate the visuospatial abilities with the navigational ones. Given their importance in everyday functions, navigation skills have been deeply studied using increasingly cutting-edge techniques such as virtual reality (VR). However, to our knowledge, there are no studies focused on training using immersive VR (IVR) in children with movement disorders. For this reason, we proposed an IVR training to 35 young participants with CP and conceived to improve their navigation skills in a “simil-real” environment while playing on a dynamic platform. A subgroup performed a part of the training which was specifically dedicated to the use of the allocentric strategy (i.e., looking for landmarks) to navigate the virtual environment. We then compared the children’s navigation and spatial skills pre- a...
This dataset is related to the paper "Peri E, Turconi AC, Biffi E, Maghini C, Panzeri D, Mor... more This dataset is related to the paper "Peri E, Turconi AC, Biffi E, Maghini C, Panzeri D, Morganti R, Pedrocchi A, Gagliardi C. Effects of dose and duration of Robot-Assisted Gait Training on walking ability of children affected by cerebral palsy. Technol Health Care. 2017 Aug 9;25(4):671-681. doi: 10.3233/THC-160668. PMID: 28436398." Specifically, the dataset reports GMFM-88, GMFM-D, GMFM-E and 6MWT pre and post treatment for group 1 (4 TOP sessions/week x 10 weeks) and 2 (4 RAGT sessions/week x 10 weeks). Age and GMFCS level are also reported.
Gait training in a virtual reality (VR) environment is promising for children affected by differe... more Gait training in a virtual reality (VR) environment is promising for children affected by different disorders. However, the efficacy of VR therapy is still under debate, and more research is needed to clarify its effects on clinical conditions. The combination of VR with neuroimaging methods, such as the electroencephalography (EEG), might help in answering this need. The aim of the present work was to set up and test a system for the multimodal analysis of the gait pattern during VR gait training of pediatric populations by analyzing the EEG correlates as well as the kinematic and kinetic parameters of the gait. An EEG system was integrated with the Gait Real-time Analysis Interactive Lab (GRAIL). We developed and validated, with healthy adults (n = 5) and children (n = 4, healthy or affected by cerebral palsy (CP)), the hardware and software integration of the two systems, which allowed the synchronization of the acquired signals and a reliable identification of the initial contac...
BACKGROUND Joubert Syndrome (JS) is a rare inherited neurodevelopmental disorder defined by a cha... more BACKGROUND Joubert Syndrome (JS) is a rare inherited neurodevelopmental disorder defined by a characteristic cerebellar and brainstem malformation (i.e. the molar tooth sign) and variable organ involvement. The aim of the present study was to describe functional limitations and disabilities in a large sample of adult patients with a diagnosis of JS. METHODS We administered the International Classification of Functioning (ICF) checklist to thirty-six adult Italian patients with JS or their caregivers through telephone calls. RESULTS None-to-mild impairment was documented for basic cognitive and mental functions, whereas severe deficit emerged for higher-order skills and language. A mismatch between individuals' capacity for daily activity and social participation and the actual performance in these fields emerged, suggesting that adults with JS may greatly benefit from external support from the caring environment. Indeed, specific facilitators were highlighted, including communication technologies as well as family members, healthcare professionals and peers support. Mild-to-severe barriers have been identified by adult patients with JS in the domains of services, systems and policies. CONCLUSIONS These findings highlight challenges and barriers for adults with JS in areas of daily functioning that may be improved by investing in rehabilitation care models that embed social support programs and policies into clinical interventions.IMPLICATIONS FOR REHABILITATIONChildren with Joubert Syndrome, a child-onset rare inherited neurodevelopmental condition, are growing up and becoming adults; a life course approach in rehabilitation is needed;There is a substantial lack of information on the long-term adaptive daily functioning of children with a diagnosis of Joubert Syndrome;In this paper, the International Classification of Functioning (ICF) was applied to assess the daily functioning in people with JS;Severe deficits emerged for high-order skills and language, whereas the use of communication technologies and the engagement of family members were highlighted as key facilitators;These findings highlight the need for a change of paradigm in the care model of subjects with JS, with the embedding of social support in rehabilitation programs.
Purpose:Human navigation skills are essential for everyday life and rely on several cognitive abi... more Purpose:Human navigation skills are essential for everyday life and rely on several cognitive abilities, among which visual-spatial competences that are impaired in subjects with cerebral palsy (CP). In this work, we proposed navigation tasks in immersive virtual reality (IVR) to 15 children with CP and 13 typically developing (TD) peers in order to assess the individual navigation strategies and their modifiability in a situation resembling real life.Methods:We developed and adapted to IVR an application based on a 5-way maze in a playground that was to be navigated to find a reward. The learning process, navigation strategies, and adaptation to changes were compared between participants with CP and their TD peers and correlated with visual-spatial abilities and cognitive competences.Results:Most participants with CP needed more attempts than TD participants to become proficient in navigation. Furthermore, the learning phase was correlated to visual-spatial memory but not with cogn...
The near-total absence of the cerebellum is a rare congenital condition with a wide phenotypic he... more The near-total absence of the cerebellum is a rare congenital condition with a wide phenotypic heterogeneity ranging from a severe to mild impairment of motor, cognitive, and behavioral functions. In this study, the case of a 48-year-old right-handed man with a near-total absence of the cerebellum was examined with the aim of understanding the long-term reorganization of a brain developed without a cerebellum. Clinical, neuropsychological evaluation and a neuroimaging study on a 3-T scanner were carried out. Both conventional structural diffusion tensor imaging (DTI) and functional (resting-state fMRI) data were acquired. A severe neuropsychomotor delay in infancy and adolescence involving motor skills, cognitive, and affective competencies was observed, which improved over the years. Conventional MRI findings confirmed the complete absence of the cerebellum. Analysis of DTI and resting-state fMRI data showed an impairment of the executive-control network, involving areas strongly connected with the cerebellum through the frontopontine fibers. The neuroimaging findings excluded the involvement of the extracerebellar structure. In conclusion, our data support the vascular genesis hypothesis for this rare pathology, consistent with an acquired embryonic cerebellar insult. This case also shows that it is possible to learn to live without the cerebellum over time.
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