Effects of robotic upper limb treatment after stroke on cognitive patterns: A systematic review

BACKGROUND: Robotic therapy (RT) has been internationally recognized for the motor rehabilitation of the upper limb. Although it seems that RT can stimulate and promote neuroplasticity, the effectiveness of robotics in restoring cognitive deficits has been considered only in a few recent studies. OBJECTIVE: To verify whether, in the current state of the literature, cognitive measures are used as inclusion or exclusion criteria and/or outcomes measures in robotic upper limb rehabilitation in stroke patients. METHODS: The systematic review was conducted according to PRISMA guidelines. Studies eligible were identified through PubMed/MEDLINE and Web of Science from inception to March 2021. RESULTS: Eighty-one studies were considered in this systematic review. Seventy-three studies have at least a cognitive inclusion or exclusion criteria, while only seven studies assessed cognitive outcomes. CONCLUSION: Despite the high presence of cognitive instruments used for inclusion/exclusion criteria their heterogeneity did not allow the identification of a guideline for the evaluation of patients in different stroke stages. Therefore, although the heterogeneity and the low percentage of studies that included cognitive outcomes, seemed that the latter were positively influenced by RT in post-stroke rehabilitation. Future larger RCTs are needed to outline which cognitive scales are most suitable and their cut-off, as well as what cognitive outcome measures to use in the various stages of post-stroke rehabilitation

IMPLICAZIONI GESTIONALI DELL\u2019APPLICAZIONE ESTESA DELLA TELELETTURA AI CONTATORI

L\u2019introduzione dei sistemi di telelettura dei contatori, le cui prime applicazioni erano principalmente votate a scopi di fatturazione, si sono in seguito rivelate un utile strumento per l\u2019analisi della domanda idrica a livello di dettaglio. La tecnologia consente di caratterizzare la domanda idrica svincolandosi dagli approcci top-down (bilancio idrico) o bottom-up (ricostruzione della domanda mediante tecniche stocastiche). Le letture sono infatti effettuate con scansioni temporali personalizzabili, la cui frequenza \ue8 in ogni caso largamente superiore al dato di consumo fornito (di norma semestralmente) dalla tradizionale lettura contatori. Applicazioni della telelettura sono note per la stima del livello di perdita in tempo reale (possibile in quanto i dati sono raccolti in modo sincrono), tuttavia in questo lavoro l\u2019accento verr\ue0 posto sulla caratterizzazione della domanda delle singole utenze. L\u2019obiettivo \ue8 quello di verificare se esistono delle differenze rilevanti nel consumo di acqua in relazione alle dimensioni e alle caratteristiche del nucleo familiare, nonch\ue9 alla stagionalit\ue0 Il consumo idrico preso in considerazione \ue8 quello relativo a un distretto della rete di distribuzione di Fano (PU), monitorato mediante telelettura. I dati coprono un lasso di tempo di quasi 5 anni, con diverse frequenze di campionamento, che hanno in ogni caso permesso di condurre l\u2019analisi sia sui consumi medi giornalieri sia sui consumi idrici notturni.Particolare importanza \ue8 stata attribuita alla stima del consumo notturno degli utenti (Customer Night Use); concentrandosi in particolare su utenze condominiali, i cui maggiori valori di consumo notturno risultano meno affetti dagli errori di troncamento dei contatori

La presa in carico multidisciplinare

la presa in carico multidisciplinari nei reparti di riabilitazione specialistic

Efficacy of short-term intrapulmonary percussive ventilation in patients with chronic obstructive pulmonary disease.

Background The grip strength test is widely used; however, little has been investigated about its reliability when used in elderly with subjects thumb carpometacarpal (CMC) osteoarthritis (OA). The purpose of this study was to examine the test\u2013retest reliability of the grip strength test in elderly subjects with thumb CMC OA. Methods A total of 78 patients with unilateral thumb CMC OA, 84.6%female (mean\ub1SD age 83\ub15 years), were recruited. Each patient performed three pain free maximal isometric contractions on each hand in two occasions, 1 week apart. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and 95 % limits of agreement (LOA) were calculated. Results Test\u2013retest reliability was excellent for side affected (ICC=0.947; p=0.001) and contralateral (ICC=0.96; p= 0.001) thumb CMC OA. Conclusions The present results indicate that maximumhandgrip strength can be measured reliably, using the Jamar hand dynamometer, in patients with thumb CMC OA, which enables its use in research and in the clinic to determine the effect of interventions on improving grip

Efficacy of short-term intrapulmonary percussive ventilation in patients with chronic obstructive pulmonary disease

Purpose: We evaluated the effectiveness of intrapulmonary percussive ventilation (IPV) compared to traditional standard chest physical therapy (CPT) in patients with chronic obstructive pulmonary disease (COPD) and productive cough. Methods: We conducted a quasi-experimental clinical trial. Twenty patients, 40% female (mean +/- SD age: 70 +/- 8 years), with COPD and productive cough received a multimodal respiratory treatment including IPV and CPT or a control intervention CPT for 10 days. Outcomes: P-Imax, P-Emax, heart rate, respiratory rate, SBP, DBP, Likert scale, Borg dyspnea scale and arterial blood gas analysis: PO2, PCO2, pH, HCO3 and SpO(2) measurements. All measures were collected at baseline and at the end of the intervention. We used repeated ANOVA to examine the effects of interventions within groups, between-subjects and the within-subjects. Results: A significant effect of time interaction (F = 7.27; p = 0.015, F = 6.16; p = 0.02 and F = 7.41; p = 0.014) existed for PO2, SpO(2) and dyspnea over the moderate COPD and productive cough immediately after the intervention (all, p<0.02). Both treatments are similarly effective in PImax and PEmax. No significant group effect or group-by-time interaction was detected for any of them, which suggests that both groups improved in the same way. Conclusions: This study provides evidence that a short-term combination of IPV and CPT improves PO2, SpO(2) and perceived dyspnea than a traditional standard CPT in patients with COPD and productive cough

Limited evidence for neuropsychological dysfunction in patients initially affected by severe COVID-19

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), resulting in coronavirus disease 2019 (COVID-19), has caused a pandemic. There is now considerable evidence that neuropsychological functions could be affected. We further tested this hypothesis on a sample of post COVID-19 patients, who, initially, had been severely affected. Methods: We tested 22 post COVID-19 patients who, after the intensive care unit (all but one), were admitted to our rehabilitation unit to be treated for severe post COVID-19 sequelae. All patients were administered a comprehensive neuropsychological battery including measures assessing perceptual, attentive, mnestic, linguistic, and executive functions, and overall cognitive status. The patients were also administered rehabilitation measures including scales for investigating aerobic capacity/endurance deficits, dyspnea, and fatigue. Results: Our findings revealed that evidence of neuropsychological disorders in post COVID-19 patients was very limited. Furthermore, COVID-19 severity and other relevant variables were not correlated with patients' scores on the neuropsychological tests. Conclusions: We suggest that the relation between COVID-19 and neuropsychological disorders is unclear. New studies and metanalyses are highly required to shed light on this highly complex issue

Misura delle perdite idriche e stima degli errori con monitoraggio in telelettura

Si sfruttano le opportunità date dalla telelettura dei contatori ai fini della riduzione del volume complessivo di acqua perso nelle reti di distribuzione. Vengono inoltre fornite delle stime di incertezza nel processo di acquisizione dei dati