Utility of High Flow Nasal Cannula during Pulmonary Rehabilitation in COVID-19 Patients in Acute Respiratory Failure

High-flow nasal cannula (HFNC) has often been used in the treatment of acute respiratory failure during pulmonary rehabilitation setting. The aim of this retrospective study was to investigate the utility of HCFN during the early rehabilitation in COVID-19 pneumonia. Twenty-two patients (10 males and 12 females, mean age 64.5 ± 5.9 years) with COVID-19 pneumonia were considered. Medical data and rehabilitative scales were used to evaluate acute hypoxemic respiratory failure (PaO2/FiO2 p p p p p p p p < 0.05). Then, treated HFNC patients showed a good improvement in physical performance at T2 and a good compliance with treatments proved to be extremely useful in the control and reduction of dyspnea and fatigue symptoms

Utility of High Flow Nasal Cannula during Pulmonary Rehabilitation in COVID-19 Patients in Acute Respiratory Failure

High-flow nasal cannula (HFNC) has often been used in the treatment of acute respiratory failure during pulmonary rehabilitation setting. The aim of this retrospective study was to investigate the utility of HCFN during the early rehabilitation in COVID-19 pneumonia. Twenty-two patients (10 males and 12 females, mean age 64.5 &plusmn; 5.9 years) with COVID-19 pneumonia were considered. Medical data and rehabilitative scales were used to evaluate acute hypoxemic respiratory failure (PaO2/FiO2 &lt; 300), treated with HFNC three times during evaluation. Overall clinical outcomes from the evaluation of the synergy between HFNC strategy and rehabilitation were evaluated. A statistically significant improvement was observed at T2 (and of treatment) in 1 minute sit to stand test (1STST) (4 &plusmn; 3 vs. 17 &plusmn; 5, p &lt; 0.05), short physical performance battery (SPPB) (4.3 &plusmn; 2.81 vs. 9.15 &plusmn; 2.39, p &lt; 0.05), SpO2% post effort (93 &plusmn; 1.26 vs. 98 &plusmn; 1.01, p &lt; 0.05), respiratory rate post effort (RR) (24 &plusmn; 3.91 vs. 20 &plusmn; 3.13, p &lt; 0.05), heart rate (HR) (97 &plusmn; 11.9 vs. 87 &plusmn; 9.17, p &lt; 0.05), P/F rate (235 &plusmn; 7.35 vs. 331 &plusmn; 10.91, p &lt; 0.05), SpO2 (86 &plusmn; 4.54 vs. 97 &plusmn; 1.01 p &lt; 0.05), RR (20 &plusmn; 4 vs. 12 &plusmn; 1.39, p &lt; 0.05). Then, treated HFNC patients showed a good improvement in physical performance at T2 and a good compliance with treatments proved to be extremely useful in the control and reduction of dyspnea and fatigue symptoms

Robot-assisted training for upper limb in stroke (ROBOTAS): an observational, multicenter study to identify determinants of efficacy

Background: The loss of arm function is a common and disabling outcome after stroke. Robot-assisted upper limb (UL) training may improve outcomes. The aim of this study was to explore the effect of robot-assisted training using end-effector and exoskeleton robots on UL function following a stroke in real-life clinical practice. Methods: A total of 105 patients affected by a first-ever supratentorial stroke were enrolled in 18 neurorehabilitation centers and treated with electromechanically assisted arm training as an add-on to conventional therapy. Both interventions provided either an exoskeleton or an end-effector device (as per clinical practice) and consisted of 20 sessions (3/5 times per week; 6-8 weeks). Patients were assessed by validated UL scales at baseline (T0), post-treatment (T1), and at three-month follow-up (T2). The primary outcome was the Fugl-Meyer Assessment for the upper extremity (FMA-UE). Results: FMA-UE improved at T1 by 6 points on average in the end-effector group and 11 points on average in the exoskeleton group (p &lt; 0.0001). Exoskeletons were more effective in the subacute phase, whereas the end-effectors were more effective in the chronic phase (p &lt; 0.0001). Conclusions: robot-assisted training might help improve UL function in stroke patients as an add-on treatment in both subacute and chronic stages. Pragmatic and highmethodological studies are needed to confirm the showed effectiveness of the exoskeleton and end-effector devices

Robot-assisted training for upper limb in stroke (ROBOTAS): an observational, multicenter study to identify determinants of efficacy

Background: The loss of arm function is a common and disabling outcome after stroke. Robot-assisted upper limb (UL) training may improve outcomes. The aim of this study was to explore the effect of robot-assisted training using end-effector and exoskeleton robots on UL function following a stroke in real-life clinical practice. Methods: A total of 105 patients affected by a first-ever supratentorial stroke were enrolled in 18 neurorehabilitation centers and treated with electromechanically assisted arm training as an add-on to conventional therapy. Both interventions provided either an exoskeleton or an end-effector device (as per clinical practice) and consisted of 20 sessions (3/5 times per week; 6-8 weeks). Patients were assessed by validated UL scales at baseline (T0), post-treatment (T1), and at three-month follow-up (T2). The primary outcome was the Fugl-Meyer Assessment for the upper extremity (FMA-UE). Results: FMA-UE improved at T1 by 6 points on average in the end-effector group and 11 points on average in the exoskeleton group (p &lt; 0.0001). Exoskeletons were more effective in the subacute phase, whereas the end-effectors were more effective in the chronic phase (p &lt; 0.0001). Conclusions: robot-assisted training might help improve UL function in stroke patients as an add-on treatment in both subacute and chronic stages. Pragmatic and highmethodological studies are needed to confirm the showed effectiveness of the exoskeleton and end-effector devices

Botulinum toxin for the management of spasticity in multiple sclerosis: the Italian botulinum toxin network study

Botulinum toxin (BT) is an effective and safe treatment for spasticity, with limited evidence in multiple sclerosis (MS). We aim to describe the use of BT for the management of MS spasticity in the clinical practice, its combination with other anti-spastic treatments in MS and possible MS clinical correlates

A video of best practice recommendations for making botulinum toxin therapy safe during the COVID-19 pandemic

The physician and patient come into close contact during botulinum toxin treatments, increasing the chances of COVID-19 infection. Therefore, it is essential to use an effective injection method that can prevent infection with SARS-CoV-2 virus. In order to minimize the risk of SARS-CoV-2 transmission during botulinum toxin treatment in the COVID-19 era, the Italian Botulinum Toxin Network study group of the Italian Society of Neurology has prepared a video of best practice recommendations on how to organize the work of a clinic performing botulinum toxin treatments