A straw tube detector for the PANDA experiment

The PANDA experiment will be built at the FAIR facility in Darmstadt (Germany) to perform accurate tests of the strong interaction through pp and pA annihilations. This paper will address the design issue of the Straw Tube Tracker (STT), one of the two options proposed for the PANDA Central Tracker

Beneficial Effects of Robot-Assisted Gait Training on Functional Recovery in Women after Stroke: A Cohort Study

Background and Objectives: Robot-assisted gait training (RAGT) could be a rehabilitation option for patients after experiencing a stroke. This study aims to determine the sex-related response to robot-assisted gait training in a cohort of subacute stroke patients considering mixed results previously reported. Materials and Methods: In this study, 236 participants (145 males, 91 females) were admitted to a rehabilitation facility after experiencing a stroke and performed RAGT within a multidisciplinary rehabilitation program. Functional Independence Measure (FIM) and Functional Ambulatory Category (FAC) were assessed at admission and discharge to determine sex-related outcomes. Results: At the baseline, no significant difference among sexes was observed. At the end of rehabilitation, both males and females exhibited significant improvements in FIM (71% of males and 80% of females reaching the MCID cut-off value) and FAC (∆score: men 1.9 ± 1.0; women 2.1 ± 1.1). A more remarkable improvement was observed in women of the whole population during the study, but statistical significance was not reached. When analysing the FAC variations with respect to the total number of RAGT sessions, a more significant improvement was observed in women than men (p = 0.025). Conclusion: In conclusion, among subacute stroke patients, benefits were observed following RAGT during a multidisciplinary rehabilitation program in both sexes. A greater significant recovery for women with an ischemic stroke or concerning the number of sessions attended was also highlighted. The use of gait robotics for female patients may favour a selective functional recovery after stroke

Motor Cortical Activation Assessment in Progressive Multiple Sclerosis Patients Enrolled in Gait Rehabilitation: A Secondary Analysis of the RAGTIME Trial Assisted by Functional Near-Infrared Spectroscopy

This study aimed to determine cortical activation responses to two different rehabilitative programs, as measured through functional near-infrared spectroscopy (fNIRS). As a secondary analysis of the RAGTIME trial, we studied 24 patients with progressive multiple sclerosis (MS) and severe disability who were randomized to a regimen of robot-assisted gait training (RAGT) or overground walking (OW). Cortical activation during a treadmill walking task, assessed through fNIRS recordings from the motor and premotor cortexes (M1/PM), was calculated as the area under the curve (AUC) of oxyhemoglobin for each hemisphere and the total area (Tot-OxyAUC). Gait speed, endurance, and balance were also measured, along with five healthy control subjects. At baseline, Tot-OxyAUC during walking was significantly increased in MS patients compared to healthy people and was significantly higher for those with more severe disabilities; it was also inversely correlated with physical performance. After rehabilitation, significant opposite variations in Tot-OxyAUC were observed, with activity levels being increased after OW and decreased after RAGT (+242,080 ± 361,902 and −157,031 ± 172,496 arbitrary units, respectively; p = 0.002), particularly in patients who were trained at a lower speed. Greater reductions in the cortical activation of the more affected hemisphere were significantly related to improvements in gait speed (r = −0.42) and endurance (r = −0.44). Cortical activation, assessed through fNIRS, highlighted the brain activity in response to the type and intensity of rehabilitation

Telerehabiltation in Italy During the COVID-19 Lockdown: A Feasibility and Acceptability Study

This study examined the feasibility and acceptability of a telerehabilitation program during the COVID-19 pandemic in a sample of adult patients with physical disabilities. Of the twenty-three patients enrolled, 11 agreed to participate in a video-based telerehabilitation program. Barriers and facilitators to the adoption of telerehabilitation were identified and clinical, demographic, and psychological variables were analysed as predictors of success. Age, cognitive reserve, and resilience were significant predictors of satisfaction with telerehabilitation (p<0.05). The telerehabilitation program was perceived as feasible and was well accepted by patients, despite some technology challenges. However, patients who took advantage of telerehabilitation perceived differences in the quality of service and preferred traditional in-person treatment to service delivery via telerehabilitation

Epidemiology and clinical outcomes in a multicentre regional cohort of patients with severe acquired brain injury

Purpose: To evaluate epidemiological and clinical data on patients with severe acquired brain injury (sABI) admitted to rehabilitation units in the first 6 years since the inception of a regional register (2005–2010) in the Emilia-Romagna region (Italy). Method: Retrospective multicentre study of a regional cohort using data from an online regional register (GraviCerebrolesioni Emilia-Romagna – GRACER). The study included 318 patients who suffered sABI (defined by Glasgow Coma Scale score ≤8 recorded in the initial 24 h following injury), who were admitted to and subsequently discharged from rehabilitation units. Physical and cognitive functions were evaluated at admission and discharge. Other data recorded included aetiology, presence of secondary conditions and need for specific medical support. Results: Three-quarters of patients displayed improvements in physical and/or cognitive function at discharge from rehabilitation units, with 71.4% of patients returning home. Better outcomes at discharge were associated in particular with younger age, traumatic brain injury (versus non-traumatic), or absence of tracheostomy at admission. Conclusion: The GRACER register is a useful tool for the assessment of epidemiological and clinical information on sABI patients. In light of the positive impact on patient outcomes, rehabilitation in specialised units is highly encouraged and should occur as soon as possible.Implications for RehabilitationThere is a need for more epidemiological and clinical data associated with severe acquired brain injury, particular regarding those of non-traumatic origin.In a retrospective multicentre study of a regional cohort using data from an online regional register in Italy (GRACER), more than three-quarters of patients displayed improvements in physical and/or cognitive function at discharge from the rehabilitation units. Better outcomes at discharge were associated in particular with younger age, traumatic brain injury (versus non-traumatic) or absence of tracheostomy at admission.Admission to a specialised rehabilitation unit is highly encouraged for patients with severe acquired brain injury, and should occur as soon as possible.Policy-makers and service planners should continue to develop strategies and allocate adequate resources for rehabilitation services due to their positive impact on patient outcomes. In particular, patients with conditions associated with increased likelihood of poor outcomes may require special attention during rehabilitation to improve outcomes at discharge

Bilateral M1 anodal transcranial direct current stimulation in post traumatic chronic minimally conscious state: a pilot EEG-tDCS study

Objective: We tested the preliminary effects of bilateral anodal transcranial direct current stimulation (tDCS) in patients with disorders of consciousness. Design: Open label pilot study. Subjects: Ten chronic (greater than 12 months) patients in a minimally conscious state (MCS) following severe traumatic brain injury. Methods: The patients received 10 sessions of bilateral M1 anodal tDCS. Behavioural changes were assessed with the Coma Recovery Scale-Revised (CRS-R) before stimulation (T-1, T0), after five sessions (T1), at the end of the stimulation (T2), after two weeks (T3) and after three months (T4). Moreover, an EEG assessment was conducted. Results: Eight out of 10 patients showed new clinical signs of consciousness; specifically, a 2-point CRS-R improvement was detected in the last follow-up (p = 0.004). EEG upper α bandwidth was greater in the parietal site at T1 (p < 0.034). In addition, we found a significant correlation between behavioral and EEG indices at T1 (r =  0.89; p =  0.001). Conclusion: This preliminary study presents several limitations (small sample size and no control group). However, it provides important initial data that can be used to design randomized clinical trials testing this novel approach in MCS and to further explore EEG as a neural marker for the effects of tDCS

Soluble neural cell adhesion molecule and behavioural recovery in minimally conscious patients undergoing transcranial direct current stimulation

Transcranial direct current stimulation (tDCS) is used for therapeutic purpose in severely brain-injured patients. The relationship between the recovery after tDCS and potential biomarkers in plasma has been limitedly investigated in patients with minimal conscious state (MCS)

Variations in Health-Related Quality of Life After Stroke: Insights From a Clinical Trial on Arm Rehabilitation With a Long-Term Follow-Up

Despite rehabilitation, stroke patients continue to have impaired function and reduced health-related quality of life (HRQoL) even in a chronic stage. However, no clear information is available on long-term variations in HRQoL. In this study, we aimed to report the short- and long-term changes in HRQoL in a subacute stroke sample that was enrolled in a clinical trial on arm rehabilitation. Thirty-nine stroke survivors (62% male, mean age 68 years) were assessed using the Stroke Impact Scale Version 2.0 (SIS 2.0) pre and post rehabilitation and at 6 months and 6 years follow-up. Long-term changes in physical function were explored through clinically meaningful changes in the Stroke Impact Scale-16 (SIS-16). After rehabilitation (P &lt; .001), an overall improvement was found in all SIS domains except the memory and thinking, emotions, and communication domains. The baseline SIS-16 score (P &lt; .001), the presence of a sensory deficit, and rehabilitation setting (P &lt; .05) were factors related to the SIS-16 domain scores at the end of rehabilitation and at 6 months follow-up. Patients showed the most deterioration in the mobility (P &lt; .001), strength (P &lt; .003), and hand function (P &lt; .05) domains 6 years after stroke. Stroke severity, male gender, and age &gt;65 years are related with a long-term HRQoL reduction after stroke

Telemedicine from research to practice during the pandemic. "Instant paper from the field" on rehabilitation answers to the Covid-19 emergency

Covid-19 pandemic is creating collateral damage to outpatients, whose rehabilitation services have been disrupted in most of the European countries. Telemedicine has been advocated as a possible solution. This paper reports the contents of the third Italian Society of Physical and Rehabilitation Medicine (SIMFER) webinar on "experiences from the field" Covid-19 impact on rehabilitation ("Covinars"). It provides readily available, first-hand information about the application of telemedicine in rehabilitation. The experiences reported were very different for population (number and health conditions), interventions, professionals, service payment, and technologies used. Commonalities included the pushing need due to the emergency, previous experiences, and a dynamic research and innovation environment. Lights included feasibility, results, reduction of isolation, cost decrease, stimulation to innovation, satisfaction of patients, families, and professionals beyond the starting diffidence. Shadows included that telemedicine can integrate but will never substitute face-to-face rehabilitation base on the encounter among human beings; age, and technology barriers (devices absence, bad connection and human diffidence) have also been reported. Possible issues included privacy and informed consent, payments, cultural difficulties in understanding that telemedicine is a real rehabilitation intervention. There was a final agreement that this experience will be incorporated by participants in their future services: technology is ready, but the real challenge is to change PRM physicians' and patients' habits, while better specific regulation is warranted

Epidemiology and clinical outcomes in a multicentre regional cohort of patients with severe acquired brain injury

Purpose: To evaluate epidemiological and clinical data on patients with severe acquired brain injury (sABI) admitted to rehabilitation units in the first 6 years since the inception of a regional register (2005–2010) in the Emilia-Romagna region (Italy). Method: Retrospective multicentre study of a regional cohort using data from an online regional register (GraviCerebrolesioni Emilia-Romagna – GRACER). The study included 318 patients who suffered sABI (defined by Glasgow Coma Scale score ≤8 recorded in the initial 24 h following injury), who were admitted to and subsequently discharged from rehabilitation units. Physical and cognitive functions were evaluated at admission and discharge. Other data recorded included aetiology, presence of secondary conditions and need for specific medical support. Results: Three-quarters of patients displayed improvements in physical and/or cognitive function at discharge from rehabilitation units, with 71.4% of patients returning home. Better outcomes at discharge were associated in particular with younger age, traumatic brain injury (versus non-traumatic), or absence of tracheostomy at admission. Conclusion: The GRACER register is a useful tool for the assessment of epidemiological and clinical information on sABI patients. In light of the positive impact on patient outcomes, rehabilitation in specialised units is highly encouraged and should occur as soon as possible.Implications for RehabilitationThere is a need for more epidemiological and clinical data associated with severe acquired brain injury, particular regarding those of non-traumatic origin.In a retrospective multicentre study of a regional cohort using data from an online regional register in Italy (GRACER), more than three-quarters of patients displayed improvements in physical and/or cognitive function at discharge from the rehabilitation units. Better outcomes at discharge were associated in particular with younger age, traumatic brain injury (versus non-traumatic) or absence of tracheostomy at admission.Admission to a specialised rehabilitation unit is highly encouraged for patients with severe acquired brain injury, and should occur as soon as possible.Policy-makers and service planners should continue to develop strategies and allocate adequate resources for rehabilitation services due to their positive impact on patient outcomes. In particular, patients with conditions associated with increased likelihood of poor outcomes may require special attention during rehabilitation to improve outcomes at discharge