298 research outputs found
Proceedings XXIII Congresso SIAMOC 2023
Il congresso annuale della Società Italiana di Analisi del Movimento in Clinica (SIAMOC), giunto quest’anno alla sua ventitreesima edizione, approda nuovamente a Roma.
Il congresso SIAMOC, come ogni anno, è l’occasione per tutti i professionisti che operano nell’ambito dell’analisi del movimento di incontrarsi, presentare i risultati delle proprie ricerche e rimanere aggiornati sulle più recenti innovazioni riguardanti le procedure e le tecnologie per l’analisi del movimento nella pratica clinica.
Il congresso SIAMOC 2023 di Roma si propone l’obiettivo di fornire ulteriore impulso ad una già eccellente attività di ricerca italiana nel settore dell’analisi del movimento e di conferirle ulteriore respiro ed impatto internazionale.
Oltre ai qualificanti temi tradizionali che riguardano la ricerca di base e applicata in ambito clinico e sportivo, il congresso SIAMOC 2023 intende approfondire ulteriori tematiche di particolare interesse scientifico e di impatto sulla società . Tra questi temi anche quello dell’inserimento lavorativo di persone affette da disabilità anche grazie alla diffusione esponenziale in ambito clinico-occupazionale delle tecnologie robotiche collaborative e quello della protesica innovativa a supporto delle persone con amputazione. Verrà infine affrontato il tema dei nuovi algoritmi di intelligenza artificiale per l’ottimizzazione della classificazione in tempo reale dei pattern motori nei vari campi di applicazione
Design and Development of Biofeedback Stick Technology (BfT) to Improve the Quality of Life of Walking Stick Users
Biomedical engineering has seen a rapid growth in recent times, where the aim to facilitate and equip humans with the latest technology has become widespread globally. From high-tech equipment ranging from CT scanners, MRI equipment, and laser treatments, to the design, creation, and implementation of artificial body parts, the field of biomedical engineering has significantly contributed to mankind. Biomedical engineering has facilitated many of the latest developments surrounding human mobility, with advancement in mobility aids improving human movement for people with compromised mobility either caused by an injury or health condition. A review of the literature indicated that mobility aids, especially walking sticks, and appropriate training for their use, are generally prescribed by allied health professionals (AHP) to walking stick users for rehabilitation and activities of daily living (ADL). However, feedback from AHP is limited to the clinical environment, leaving walking stick users vulnerable to falls and injuries due to incorrect usage. Hence, to mitigate the risk of falls and injuries, and to facilitate a routine appraisal of individual patient’s usage, a simple, portable, robust, and reliable tool was developed which provides the walking stick users with real-time feedback upon incorrect usage during their activities of daily living (ADL).
This thesis aimed to design and develop a smart walking stick technology: Biofeedback stick technology (BfT). The design incorporates the approach of patient and public involvement (PPI) in the development of BfT to ensure that BfT was developed as per the requirements of walking stick users and AHP recommendations. The newly developed system was tested quantitatively for; validity, reliability, and reproducibility against gold standard equipment such as the 3D motion capture system, force plates, optical measurement system for orientation, weight bearing, and step count. The system was also tested qualitatively for its usability by conducting semi-informal interviews with AHPs and walking stick users. The results of these studies showed that the newly developed system has good accuracy, reported above 95% with a maximum inaccuracy of 1°. The data reported indicates good reproducibility. The angles, weight, and steps recorded by the system during experiments are within the values published in the literature. From these studies, it was concluded that, BfT has the potential to improve the lives of walking stick users and that, with few additional improvements, appropriate approval from relevant regulatory bodies, and robust clinical testing, the technology has a huge potential to carve its way to a commercial market
Pathophysiology of Spinal Cord Injury (SCI)
Spinal cord injury (SCI) leads to paralysis, sensory, and autonomic nervous system dysfunctions. However, the pathophysiology of SCI is complex, and not limited to the nervous system. Indeed, several other organs and tissue are also affected by the injury, directly or not, acutely or chronically, which induces numerous health complications. Although a lot of research has been performed to repair motor and sensory functions, SCI-induced health issues are less studied, although they represent a major concern among patients. There is a gap of knowledge in pre-clinical models studying these SCI-induced health complications that limits translational applications in humans. This reprint describes several aspects of the pathophysiology of spinal cord injuries. This includes, but is not limited to, the impact of SCI on cardiovascular and respiratory functions, bladder and bowel function, autonomic dysreflexia, liver pathology, metabolic syndrome, bones and muscles loss, and cognitive functions
Evaluating footwear “in the wild”: Examining wrap and lace trail shoe closures during trail running
Trail running participation has grown over the last two decades. As a result, there have been an increasing number of studies examining the sport. Despite these increases, there is a lack of understanding regarding the effects of footwear on trail running biomechanics in ecologically valid conditions. The purpose of our study was to evaluate how a Wrap vs. Lace closure (on the same shoe) impacts running biomechanics on a trail. Thirty subjects ran a trail loop in each shoe while wearing a global positioning system (GPS) watch, heart rate monitor, inertial measurement units (IMUs), and plantar pressure insoles. The Wrap closure reduced peak foot eversion velocity (measured via IMU), which has been associated with fit. The Wrap closure also increased heel contact area, which is also associated with fit. This increase may be associated with the subjective preference for the Wrap. Lastly, runners had a small but significant increase in running speed in the Wrap shoe with no differences in heart rate nor subjective exertion. In total, the Wrap closure fit better than the Lace closure on a variety of terrain. This study demonstrates the feasibility of detecting meaningful biomechanical differences between footwear features in the wild using statistical tools and study design. Evaluating footwear in ecologically valid environments often creates additional variance in the data. This variance should not be treated as noise; instead, it is critical to capture this additional variance and challenges of ecologically valid terrain if we hope to use biomechanics to impact the development of new products
Applied Mathematics to Mechanisms and Machines
This book brings together all 16 articles published in the Special Issue "Applied Mathematics to Mechanisms and Machines" of the MDPI Mathematics journal, in the section “Engineering Mathematics”. The subject matter covered by these works is varied, but they all have mechanisms as the object of study and mathematics as the basis of the methodology used. In fact, the synthesis, design and optimization of mechanisms, robotics, automotives, maintenance 4.0, machine vibrations, control, biomechanics and medical devices are among the topics covered in this book. This volume may be of interest to all who work in the field of mechanism and machine science and we hope that it will contribute to the development of both mechanical engineering and applied mathematics
Biomanufacturing Technologies for Tissue Engineering
Il seguente lavoro di tesi ha come obiettivo lo studio e la realizzazione di device biomedicali realizzati tramite la manifattura additiva. La manifattura additiva sta avendo una forte crescita negli ultimi anni grazie soprattutto alla possibilità di realizzare facilmente geometrie complesse. Questa caratteristica permette di personalizzare i prodotti ad un costo competitivo. Inoltre, lo spreco di materiale viene ridotto moltissimo dal principio di fabbricazione. Tutte queste proprietà hanno fatto in modo che negli ultimi anni la manifattura additiva prendesse sempre più piede in campi come l’automotive, l’aerospace e il biomedicale.
Questo lavoro di tesi è focalizzato sull’utilizzo di alcune tra le più diffuse tecnologie additive per la produzione di device biomedicali. In particolare, il lavoro si è concentrato principalmente sulla realizzazione di due modelli, il primo per lo studio dello sviluppo dei black floaters all’interno del corpo vitreo dell’occhio, il secondo per l’emulazione del comportamento dell’osso mandibolare durante la foratura per l’installazione di impianti dentali.
Il modello dell’occhio è composto da due elementi principali, un supporto e un hydrogel. Il supporto serve a contenere e supportare l’hydrogel. Deve essere trasparente, biocompatibile facilmente manovrabile in laboratorio. La sua realizzazione è avvenuta tramite stereolitografia. L’hydrogel, invece, ha lo scopo di fornire un’ambiente 3D per la crescita e sviluppo delle cellule. Deve perciò anche lui essere biocompatibile e con adeguate caratteristiche meccaniche e di stampabilità . La struttura 3D è stata realizzata tramite material extrusion.
Il modello di osso mandibolare è stato realizzato tramite fused filament fabrication. Il modello si compone di due parti, una parte esterna piena per emulare l’osso corticale, e una parte interna porosa per emulare l’osso trabecolare. Le prove di foratura sono state realizzate con un trapano dentistico agganciato a robot collaborativi.
La ricerca ha infine toccato ulteriori due ambiti, lo studio delle proprietĂ di strutture lattice realizzate tramite laser based- powder bed fusion e la valutazione di diversi trattamenti di finitura superficiale.
La tesi, dunque, ha la seguente organizzazione. Il capitolo 1 presenta un’introduzione sull’additive manufacturing e il bioprinting. Le tecnologie ed i materiali utilizzati sono brevemente descritti e sono riportati alcuni esempi di applicazione della manifattura additiva nel campo biomedicale. I capitoli seguenti, invece, riportano gli articoli pubblicati o in corso di pubblicazione riguardo alle diverse tematiche affrontate. Nello specifico, il capitolo 2 riporta la ricerca sulle strutture lattice e la loro realizzazione. I capitoli 3 e 4 comprendono gli studi relativi al modello dell’occhio. Il capitolo 3 si concentra sulla realizzazione del supporto, il 4 sulla formulazione e la valutazione dell’hydrogel. Il capitolo 5 approfondisce lo studio del modello per l’emulazione del comportamento dell’osso mandibolare a foratura mentre il capitolo 6, l’ultimo di questo elaborato, si concentra sui processi di finitura superficiale.
Per concludere, la manifattura additiva include processi molto diversi tra loro, ma che presentano molti punti in comune come la flessibilità , libertà di progettazione e personalizzazione. Sfruttando queste proprietà è possibile realizzare oggetti su misura, soprattutto in campi come quello biomedicale dove la personalizzazione e la specificità sono fondamentali.The following thesis aims to study and to develop biomedical devices made through additive manufacturing. Additive manufacturing has been experiencing a strong growth in recent years, mainly due to its ability to easily realize complex geometries. This feature allows customization of products at a competitive cost. In addition, material waste is greatly reduced by the manufacturing principle. All these properties helped the recent years diffusion of additive manufacturing in fields such as automotive, aerospace and biomedical.
This thesis focuses on the use of some of the most popular additive technologies for the production of biomedical devices. In particular, the work focused mainly on the fabrication of two models, the first to study the development of black floaters within the vitreous body of the eye, and the second to emulate the mandibular bone behavior during drilling for the installation of dental implants.
The eye model consists of two main elements, a scaffold and a hydrogel. The scaffold contains and provides support to the hydrogel. It must be transparent, biocompatible easily handled in the laboratory. It is printed by stereolithography. The hydrogel, on the other hand, is intended to provide a 3D environment for cell growth and development. Therefore, it must be biocompatible and have adequate mechanical properties together with good printability. The 3D scaffold structure was made by material extrusion.
The mandibular bone model was made by fused filament fabrication. The model consists of two parts, a solid outer part to emulate cortical bone, and a porous inner part to emulate trabecular bone. Drilling tests were performed with a dental drill attached to collaborative robots.
Finally, the research covered two additional areas, the study of the properties of lattice structures made by laser-based- powder bed fusion and the evaluation of different surface finish treatments.
The following thesis, therefore, has the following organization. Chapter 1 presents an introduction on additive manufacturing and bioprinting. The technologies and materials used are briefly described, and examples of additive manufacturing applications in the biomedical field are given. The following chapters, on the other hand, report published or forthcoming articles regarding the various topics mentioned above. Specifically, Chapter 2 reports the research on lattice structures and their fabrication. Chapters 3 and 4 include studies related to the eye model. Chapter 3 focuses on the fabrication of the support, and Chapter 4 on the formulation and evaluation of the hydrogel. Chapter 5 presents the study of the model for emulating the behavior of mandibular bone upon drilling, while Chapter 6, the last of this work, focuses on surface finishing processes.
In conclusion, additive manufacturing includes various processes that are very different from each other but have many common points such as flexibility, freedom of design, and customization. By exploiting these properties, it is possible to make tailored objects, especially important in fields such as the biomedical one, where customization and specificity are a great added value
Developments in circular external fixators: a review
Circular external fixators (CEFs) are successfully used in orthopedics owing to their highly favorable stiffness characteristics which promote distraction osteogenesis. Although there are different designs of external fixators, how these features produce optimal biomechanics through structural and component designs is not well known. Therefore, the aim of this study was to conduct a review on CEFs following the PRISMA statement. A search for relevant research articles was performed on Scopus and PubMed databases providing the related keywords. Furthermore, a patent search was conducted on the Google Patent database. 126 records were found to be eligible for the review. Different designs of CEFs were summarized and tabulated based on their specific features. A bibliometric analysis was also performed on the eligible research papers. Based on the findings, the developments of CEFs in terms of materials, automation, adjustment methods, component designs, wire-clamping, and performance evaluation have been extensively discussed. The trends of the CEF design and future directions are also discussed in this review. Significant research gaps include a lack of consideration towards ease of assembly, effective wire-clamping methods, and CEFs embedded with online patient-monitoring systems, among others. An apparent lack of research interest from low-middle and low-income countries was also identified
Innovative Evidence-Based Assessment and Treatment of Oropharyngeal Dysphagia and Communication Disorders in Infants and Young Children at High Risk of Cerebral Palsy
Infants with cerebral palsy (CP) have concomitant feeding and communication disorders with lifelong detrimental consequences, including premature death. Early detection and intervention for these deficits is under-researched. This thesis investigates evidence, current practice, innovative assessment, and novel intervention for these domains.
To critically appraise evidence for all interventions for children with CP, a large-scale systematic review was conducted. There is high level evidence to support the use of electrical stimulation alongside oral sensory motor interventions, and Functional Chewing Training. Low positive evidence exists supporting direct intervention for literacy, parent training and augmentative alternative communication for language and communication disorders.
An international survey of dysphagia practice revealed lack of alignment with evidence, with few patients receiving gold standard assessments, adaptation over direct treatment, and children receiving less-intensive treatment than adults.
Ultrasound and Fibreoptic Endoscopic Evaluation of Swallowing were piloted as novel instrumental assessments of OPD in infants with CP. These tools show promise for safe early detection of OPD and warrant more research to establish psychometrics.
A second systematic review was undertaken to determine evidence for OPD interventions specifically for infants with CP. Results found that neuroplasticity and motor learning-based interventions are most promising.
The Baby Intensive Early Active Treatment (BabiEAT) program was then designed to harness plasticity and was tested against standard care in a pilot randomised control trial. Results showed that BabiEAT was feasible and acceptable, and conferred superior gains in feeding and parental quality of life while maintaining health and safety.
To limit preventable death and optimise outcomes, speech pathologists must keep abreast of evidence, upskill, and implement new successful approaches
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