Exercise Combined with Electrotherapy Enhances Motor Function in an Adolescent with Spinal Muscular Atrophy Type III

Background. Electrotherapy is widely used in physical therapy to increase muscle mass, improve motor function, and assist physical activity in several neurologic conditions. However, concerning Spinal Muscular Atrophy (SMA), limited evidence exists on the role of electrotherapy as an adjunct for improving muscle strength and function. Case Report. An adolescent (13 y.o.) with SMA type III underwent an 18-week strengthening program divided into two stages. During Phase I (weeks: 1-8), a home-based program for quadriceps strengthening through neuromuscular electrical stimulation (NMES) was provided. In Phase II (weeks: 9-18), at-home NMES was combined with functional electrical stimulation (FES) assisting volitional cycling for a broader, systemic conditioning. The treatment improved patient's structural and functional motor outcomes (quadriceps circumference and strength, Tinetti scale, and Hammersmith scale) as well as independence in stair climbing. Clinical Rehabilitation Impact. The purpose of this report is to raise awareness of the potential role of electrotherapy to help improving motor performance in SMA patients and, secondly, to foster further research aimed at assessing the actual contribution this intervention may have as an add-on therapy to existing care

Hand Passive Mobilization Performed with Robotic Assistance: Acute Effects on Upper Limb Perfusion and Spasticity in Stroke Survivors

This single arm pre-post study aimed at evaluating the acute effects induced by a single session of robot-assisted passive hand mobilization on local perfusion and upper limb (UL) function in poststroke hemiparetic participants. Twenty-three patients with subacute or chronic stroke received 20 min passive mobilization of the paretic hand with robotic assistance. Near-infrared spectroscopy (NIRS) was used to detect changes in forearm tissue perfusion. Muscle tone of the paretic UL was assessed by the Modified Ashworth Scale (MAS). Symptoms concerning UL heaviness, joint stiffness, and pain were evaluated as secondary outcomes by self-reporting. Significant (p=0.014) improvements were found in forearm perfusion when all fingers were mobilized simultaneously. After the intervention, MAS scores decreased globally, being the changes statistically significant for the wrist (from 1.6±1.0 to 1.1±1.0; p=0.001) and fingers (from 1.2±1.1 to 0.7±0.9; p=0.004). Subjects reported decreased UL heaviness and stiffness after treatment, especially for the hand, as well as diminished pain when present. This study supports novel evidence that hand robotic assistance promotes local UL circulation changes, may help in the management of spasticity, and acutely alleviates reported symptoms of heaviness, stiffness, and pain in subjects with poststroke hemiparesis. This opens new scenarios for the implications in everyday clinical practice. Clinical Trial Registration Number is NCT03243123

Lifestyles and socio-cultural factors among children aged 6-8 years from five Italian towns: The MAPEC-LIFE study cohort

Background: Lifestyles profoundly determine the quality of an individual’s health and life since his childhood. Many diseases in adulthood are avoidable if health-risk behaviors are identified and improved at an early stage of life. The aim of the present research was to characterize a cohort of children aged 6–8 years selected in order to perform an epidemiological molecular study (the MAPEC_LIFE study), investigate lifestyles of the children that could have effect on their health status, and assess possible association between lifestyles and socio-cultural factors. Methods: A questionnaire composed of 148 questions was administered in two different seasons to parents of children attending 18 primary schools in five Italian cities (Torino, Brescia, Pisa, Perugia and Lecce) to obtain information regarding the criteria for exclusion from the study, demographic, anthropometric and health information on the children, as well as some aspects on their lifestyles and parental characteristics. The results were analyzed in order to assess the frequency of specific conditions among the different seasons and cities and the association between lifestyles and socio-economic factors. Results: The final cohort was composed of 1,164 children (50.9 boys, 95.4% born in Italy). Frequency of some factors appeared different in terms of the survey season (physical activity in the open air, the ways of cooking certain foods) and among the various cities (parents’ level of education and rate of employment, sport, traffic near the home, type of heating, exposure to passive smoking, ways of cooking certain foods). Exposure to passive smoking and cooking fumes, obesity, residence in areas with heavy traffic, frequency of outdoor play and consumption of barbecued and fried foods were higher among children living in families with low educational and/or occupational level while children doing sports and consuming toasted bread were more frequent in families with high socio-economic level. Conclusions: The socio-economic level seems to affect the lifestyles of children enrolled in the study including those that could cause health effects. Many factors are linked to the geographical area and may depend on environmental, cultural and social aspects of the city of residence

Influence of workload and posture on handcycling efficiency

Handbike (HB) is an arm propelled device of locomotion for subjects with lower limbs disabilities. Handcycling has become a Paralympics discipline, increasing the need to study how lesion level may influence posture on HB and energy cost during exercise. The aim was also to test how postures different from the free chosen one might influence functional parameters during exercise

Influenza di un pasto di carboidrati sulla prestazione motoria di sciatori

Obiettivo. Valutare l\u2019influenza di un pasto di carboidrati sulla prestazione motoria in soggetti praticanti attivit\ue0 sciisti- ca per l\u2019intera giornata. Metodi. Dieci sciatori amatoriali (et\ue0 25-39 anni) hanno partecipato allo studio. L\u2019elettromiogramma di superficie dal muscolo vasto laterale e l\u2019oscillazione di forza intorno al bersaglio di forza sono stati rilevati e analizzati nel dominio del tempo durante contrazioni isometriche di 15 s con modulazione di forza di tipo triangolare (0-100-0% della mas- sima contrazione volontaria, MCV) e con modulazione di forza sinusoidale (0,1, 0,3, 0,5 Hz nell\u2019ambito 30-40% MCV) della tensione degli estensori del ginocchio. Le registrazioni sono state eseguite dopo 3 ore di pratica sciistica a stomaco vuoto (condizione controllo, C) e dopo pasto di carboidrati (condizione AM). Risultati. La MCV non \ue8 stata influenzata dal pasto (C: 617\ub1158,8 N e AM: 587\ub1213,5 N). L\u2019elettromiogramma non ha mai presentato differenze durante gli esercizi in C e AM. L\u2019oscillazione di forza ha presentato un\u2019ampiezza minore nel- la condizione AM (differenza statisticamente significativa durante la modulazione triangolare e sinusoidale a 0,1 Hz). L\u2019errore relativo (% della differenza tra forza esercitata e quella richiesta dalla funzione target) ha mostrato una tendenza ad essere pi\uf9 piccola nella condizione AM. Conclusioni. I nostri risultati suggeriscono che la digestione di un pasto di carboidrati non influenza negativamente la qualit\ue0 della prestazione neuromuscolare. Infatti in questa condizione l\u2019ampiezza dell\u2019EMG o dell\u2019oscillazione di for- za non denunciano un maggior coinvolgimento o un peggior rendimento del sistema di controllo motorio ne durante l\u2019intero ambito della modulazione triangolare di forza ne durante la impegnativa modulazione sinusoidale della forza dalle basse alle alte frequenze. Una sostenuta attivit\ue0 fisica pu\uf2 determinare alterazioni della glicemia e delle scorte di glicogeno muscolare con specifiche manifestazioni di fatica. Il pasto che \ue8 stato somministrato nel nostro esperimen- to, dato che non ha interferito con la prestazione motoria, potrebbe essere un aiuto senza controindicazioni per limi- tare gli aspetti di fatica correlati con la pratica dell\u2019attivit\ue0 sciistica giornaliera

An experimental method to estimate upper limbs inertial parameters during handcycling

This study proposes an experimental method to estimate personalized inertia parameters of upper limbs during handcycling by using a planar dynamic model. The handle forces are expressed as a product of a matrix describing the kinematics terms and a vector of inertial parameters of arm and forearm. The parameters are estimated by measuring the handle forces during a suitable “passive test” and inverting the mentioned matrix. The data was acquired while an operator actuated the handle, and the subject’s muscles were relaxed. To validate the estimation procedure, it was applied to a custom-made artificial arm mechanism and the results were compared to its known parameters. The method was then used to estimate the inertia parameters of six human subjects. The estimated parameters were used to compute the exchanged forces and compared with the measured ones obtaining an average error of 14 % both for Fx, and Fy. These errors are significantly smaller than those obtained using dynamic parameters extracted from the literature to compute the forces, which were 50 % for Fx and 19 % for Fy. An individual evaluation of inertia parameters better describes interaction forces during handcycling, especially for subjects whose body structures are different from average population