An instrumental approach for monitoring physical exercises in a visual markerless scenario: A proof of concept

none8This work proposes a real-time monitoring tool aimed to support clinicians for remote assessing exercise performances during home-based rehabilitation. The study relies on clinician indications to define kinematic features, that describe five motor tasks (i.e., the lateral tilt of the trunk, lifting of the arms, trunk rotation, pelvis rotation, squatting) usually adopted in the rehabilitation program for axial disorders. These features are extracted by the Kinect v2 skeleton tracking system and elaborated to return disaggregated scores, representing a measure of subjects performance. A bell-shaped function is used to rank the patient performances and to provide the scores. The proposed rehabilitation tool has been tested on 28 healthy subjects and on 29 patients suffering from different neurological and orthopedic diseases. The reliability of the study has been performed through a cross-sectional controlled design methodology, comparing algorithm scores with respect to blinded judgment provided by clinicians through filling a specific questionnaire. The use of task-specific features and the comparison between the clinical evaluation and the score provided by the instrumental approach constitute the novelty of the study. The proposed methodology is reliable for measuring subject's performance and able to discriminate between the pathological and healthy condition.Capecci, Marianna; Ceravolo, Maria Gabriella; Ferracuti, Francesco; Grugnetti, Martina; Iarlori, Sabrina; Longhi, Sauro; Romeo, Luca; Verdini, FedericaCapecci, Marianna; Ceravolo, Maria Gabriella; Ferracuti, Francesco; Grugnetti, Martina; Iarlori, Sabrina; Longhi, Sauro; Romeo, Luca; Verdini, Federic

The role of training intensity in outpatient rehabilitation of people with Parkinson's disease: A retrospective cohort study of disability progression with 4-month follow-up

Background and aims. Rehabilitation has been shown effective at improving functional abilities of people with Parkinson’s disease (pwPD), through task-oriented and aerobic training, though the exact role of exercise intensity has not yet been determined. The study is aimed at evaluating the impact of different intensity rehabilitation protocols on the short and medium term progression of disability in pwPD. Methods: Using a retrospective cohort study design, the medical records of pwPD who consecutively underwent task-oriented outpatient rehabilitation from 2008 to 2016 at a University Hospital were retrieved. Subjects were considered eligible if they: a) had undergone a single cycle/year of gait and balance training, b) had stable drug therapy during the whole study period, and c) the UPDRS II subscore was available both at the baseline, at the end of treatment and 4 + 2 months after. The UPDRS part-III, TUG test, 6MWT, FOG-Q, Falls Efficacy Scale (FES) and PDQ-39 were also looked for as secondary outcome measures. Results: Eighty out of 420 records met the eligibility criteria. A Low-Intensity (LIT) (39 cases) and a High-Intensity Training (HIT) (41 cases) group were defined according to a total training duration of less or more than 1000 minutes, respectively. HIT group included a greater rate of responders than LIT (65% cases with a meaningful gain in the UPDRS II, vs 35%; Chi2:3.8;p=.04). At variance with the LIT group, HIT subjects also showed a persistent improvement in UPDRS scores (F:14.5;p<.0001) and in FES (F:6.7;p=.002) at the 4-month follow-up. No significant between-group differences were found comparing TUG, 6MWT and PDQ-39 changes. Conclusion: A total training duration of 60/90 minute/session per 20 sessions of task-oriented and aerobic training is recommended in pwPD, in order to ensure a clinically meaningful and persistent reduction of their disease-related disability