166 research outputs found

    Proceedings XXIII Congresso SIAMOC 2023

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    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

    Exercise-Induced Hypoalgesia in people with chronic low back pain

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    Chronic low back pain (CLBP) is one of the most prevalent musculoskeletal disorders and a major contributor to disability worldwide. Exercise is recommended in guidelines as a cornerstone of the management of CLBP. One of the manifold benefits of exercise is its influence on endogenous pain modulation. An acute bout of exercise elicits a temporary decrease in pain sensitivity, described as exercise-induced hypoalgesia (EIH). This thesis explores EIH in people with CLBP via a systematic review and observational studies. The systematic review included 17 studies in people with spinal pain. Of those, four studies considered people with CLBP revealing very low quality evidence with conflicting results. EIH was elicited following remote cycling tasks (two studies, fair risk of bias), but EIH was altered following local repetitive lifting tasks (two studies, good/fair risk of bias). The observational studies investigated EIH following three different tasks in participants with and without CLBP and explored the stability of EIH results. Conflicting results from quantitative sensory testing were found for whether EIH is impaired in people with CLBP. EIH was only elicited in asymptomatic participants following a repeated lifting task, but both participants with and without CLBP showed EIH following a lumbar resistance and a brisk walking task. This thesis demonstrates the first evidence of stability of EIH over multiple sessions. However, the interpretation of the results can be challenging as stability was poor and changes in lumbar pressure pain thresholds also occurred after rest only. These findings are important to inform future studies contributing to the elucidation of the complex phenomenon of EIH in people with/without CLBP, specifically as the stability is a prerequisite for future research

    Alterations in the preferred direction of individual arm muscle activation after stroke

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    IntroductionStroke survivors have challenges appropriately coordinating the multiple muscles, resulting in a deficit in motor control. Therefore, comprehending the mechanism underlying abnormal intermuscular coordination becomes crucial in developing effective rehabilitation strategies. Quantitative analyses have been employed at pairwise or multi-dimensional levels to understand the underlying mechanism of abnormal intermuscular coordination and its relationship to motor impairment. However, how alterations in individual muscle activation contribute to abnormal intermuscular coordination, motor impairment, and motor performance remains unclear. Thus, we investigated the alterations in the preferred direction of individual muscles after stroke and their relationship with stroke-induced changes in intermuscular coordination, clinical motor impairment, and qualities of motor performance during isometric force generation in the upper extremity.MethodsTwenty-four stroke survivors and six age-matched controls were recruited and performed isometric force target matches while recording electromyographic signals from eight upper limb muscles. We determined the preferred activation direction of each muscle, evaluated abnormal intermuscular coordination through a muscle synergy analysis, assessed motor impairment using upper extremity Fugl-Meyer Assessment scores, and examined motor performance characteristics defined by force trajectory features.ResultsThe post-stroke alterations in the preferred direction of the brachioradialis, anterior, middle, and posterior deltoid were correlated with the motor impairment level and attributed to the changes in muscle synergy characteristics. Only alterations in the preferred direction of the brachioradialis and posterior deltoid activation in forward-backward and upward-downward axes were associated with the qualities of isometric force generation, respectively.DiscussionThese findings imply that alterations in the preferred direction of individual muscle activation contribute to various aspects of motor deficit following stroke. This insight may serve as a foundation for the development of innovative stroke neurorehabilitation approaches that take into account specific attributes of individual muscle activation, including their preferred activation direction

    Ego-perspective enhanced fitness training experience of AR Try to Move game

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    AR, a recent emerging technology, has been widely used in entertainment to provide users with immersive, interactive, and, sometimes, engaging experiences. The process of rehabilitation treatment and motor training process is often boring, and it is well known that users' exercise efficiency is often not as efficient as in a rehabilitation institution. Thus far, there is no effective upper limb sports rehabilitation training game based on the ego-perspective. Hence, with the objective of enhancing the enjoyment experience in rehabilitation and more effective remote rehabilitation training, this work aims to provide an AR Try to Move game and a convolutional neural network (CNN) for identifying and classifying user gestures from a self-collected AR multiple interactive gestures dataset. Utilizing an AR game scoring system, users are incentivized to enhance their upper limb muscle system through remote training with greater effectiveness and convenience.Comment: 6 pages, 2 figures, 2 tables, 2023 International Conference on Machine Learning and Automation (CONF-MLA 2023

    Motor patterns evaluation of people with neuromuscular disorders for biomechanical risk management and job integration/reintegration

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    Neurological diseases are now the most common pathological condition and the leading cause of disability, progressively worsening the quality of life of those affected. Because of their high prevalence, they are also a social issue, burdening both the national health service and the working environment. It is therefore crucial to be able to characterize altered motor patterns in order to develop appropriate rehabilitation treatments with the primary goal of restoring patients' daily lives and optimizing their working abilities. In this thesis, I present a collection of published scientific articles I co-authored as well as two in progress in which we looked for appropriate indices for characterizing motor patterns of people with neuromuscular disorders that could be used to plan rehabilitation and job accommodation programs. We used instrumentation for motion analysis and wearable inertial sensors to compute kinematic, kinetic and electromyographic indices. These indices proved to be a useful tool for not only developing and validating a clinical and ergonomic rehabilitation pathway, but also for designing more ergonomic prosthetic and orthotic devices and controlling collaborative robots

    TMS application in both health and disease

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    Transcranial magnetic stimulation (TMS) can be useful for therapeutic purposes for a variety of clinical conditions. Numerous studies have indicated the potential of this noninvasive brain stimulation technique to recover brain function and to study physiological mechanisms. Following this line, the articles contemplated in this Research Topic show that this field of knowledge is rapidly expanding and considerable advances have been made in the last few years. There are clinical protocols already approved for Depression (and anxiety comorbid with major depressive disorder), Obsessive compulsive Disorder (OCD), migraine headache with aura, and smoking cessation treatment but many studies are concentrating their efforts on extending its application to other diseases, e.g., as a treatment adjuvant. In this Research Topic we have the example of using TMS for pain, post-stroke depression, or smoking cessation, but other diseases/injuries of the central nervous system need attention (e.g., tinnitus or the surprising epilepsy). Further, the potential of TMS in health is being explored, in particular regarding memory enhancement or the mapping of motor control regions, which might also have implications for several diseases. TMS is a non-invasive brain stimulation technique that can be used for modulating brain activation or to study connectivity between brain regions. It has proven efficacy against neurological and neuropsychiatric illnesses but the response to this stimulation is still highly variable. Research works devoted to studying the response variability to TMS, as well as large-scale studies demonstrating its efficacy in different sub-populations, are therefore of utmost importance. In this editorial, we summarize the main findings and viewpoints detailed within each of the 12 contributing articles using TMS for health and/or disease applications.publishe

    Challenges of neural interfaces for stroke motor rehabilitation

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    More than 85% of stroke survivors suffer from different degrees of disability for the rest of their lives. They will require support that can vary from occasional to full time assistance. These conditions are also associated to an enormous economic impact for their families and health care systems. Current rehabilitation treatments have limited efficacy and their long-term effect is controversial. Here we review different challenges related to the design and development of neural interfaces for rehabilitative purposes. We analyze current bibliographic evidence of the effect of neuro-feedback in functional motor rehabilitation of stroke patients. We highlight the potential of these systems to reconnect brain and muscles. We also describe all aspects that should be taken into account to restore motor control. Our aim with this work is to help researchers designing interfaces that demonstrate and validate neuromodulation strategies to enforce a contingent and functional neural linkage between the central and the peripheral nervous system. We thus give clues to design systems that can improve or/and re-activate neuroplastic mechanisms and open a new recovery window for stroke patients

    Upper limb movement control after stroke and in healthy ageing: does intensive upper limb neurorehabilitation improve motor control and reduce motor impairment in the chronic phase of stroke?

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    Stroke affects people of all ages, but many are in the elderly population. 75% of stroke survivors have residual upper limb motor impairment and resultant disability. This thesis firstly examines upper limb motor control in chronic stroke. Evidence is emerging that high dose, high intensity complex neurorehabilitation interventions in chronic stroke patients produce unprecedented gains on clinical outcome scores of motor impairment, function and activity. But whether these clinical improvements represent behavioural repair or merely behavioural compensation remains undetermined. To address this question, upper limb movement kinematics, strength and joint range and clinical scores were measured in 52 chronic stroke patients before and after an intensive three-week treatment intervention. 29 chronic stroke patients who had not undergone treatment were similarly assessed, three-weeks apart. Significant improvements in motor control, arm strength and joint range in addition to gains on clinical scores were observed in the impaired arm of the intervention group. Crucially, changes in motor control occurred independently of changes in strength and joint range. Improvements in motor control were retained in a cohort of 28 patients in the intervention group, also assessed 6-weeks and 6-months after treatment had ended, demonstrating persistent changes in motor behaviour. These results suggest that behavioural restitution has occurred. Secondly, knowledge of the effects of normal healthy ageing on upper limb motor control is essential to informing research and delivery of clinical services. To this end, movement kinematics were measured in both arms of 57 healthy adults aged 22 to 82 years. A decline in motor control was observed as age increased, particularly in the non-dominant arm. However, motor control in healthy adults of all ages remained significantly better than in chronic stroke patients pre- and post-intervention. This thesis provides new evidence that treatment-driven improvements in motor control are achievable in the chronic post-stroke upper limb, which strongly suggests that motor control should remain a therapeutic target well beyond the current three to six-month post-stroke window. It will inform the continued development and delivery of high dose, high intensity upper limb neurorehabilitation treatment interventions for stroke patients of all ages
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