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  1. Article ; Online: Effects of Upper Limb Robot-Assisted Rehabilitation Compared with Conventional Therapy in Patients with Stroke: Preliminary Results on a Daily Task Assessed Using Motion Analysis.

    Germanotta, Marco / Cortellini, Laura / Insalaco, Sabina / Aprile, Irene

    Sensors (Basel, Switzerland)

    2023  Volume 23, Issue 6

    Abstract: Robotic rehabilitation of the upper limb has demonstrated promising results in terms of the improvement of arm function in post-stroke patients. The current literature suggests that robot-assisted therapy (RAT) is comparable to traditional approaches ... ...

    Abstract Robotic rehabilitation of the upper limb has demonstrated promising results in terms of the improvement of arm function in post-stroke patients. The current literature suggests that robot-assisted therapy (RAT) is comparable to traditional approaches when clinical scales are used as outcome measures. Instead, the effects of RAT on the capacity to execute a daily life task with the affected upper limb are unknown, as measured using kinematic indices. Through kinematic analysis of a drinking task, we examined the improvement in upper limb performance between patients following a robotic or conventional 30-session rehabilitation intervention. In particular, we analyzed data from nineteen patients with subacute stroke (less than six months following stroke), nine of whom treated with a set of four robotic and sensor-based devices and ten with a traditional approach. According to our findings, the patients increased their movement efficiency and smoothness regardless of the rehabilitative approach. After the treatment (either robotic or conventional), no differences were found in terms of movement accuracy, planning, speed, or spatial posture. This research seems to demonstrate that the two investigated approaches have a comparable impact and may give insight into the design of rehabilitation therapy.
    MeSH term(s) Humans ; Stroke Rehabilitation/methods ; Robotics/methods ; Stroke ; Upper Extremity ; Outcome Assessment, Health Care ; Recovery of Function ; Treatment Outcome
    Language English
    Publishing date 2023-03-13
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2052857-7
    ISSN 1424-8220 ; 1424-8220
    ISSN (online) 1424-8220
    ISSN 1424-8220
    DOI 10.3390/s23063089
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Implementation of a robot-mediated upper limb rehabilitation protocol for a customized treatment after stroke: A retrospective analysis.

    Pavan, Arianna / Fasano, Alessio / Cortellini, Laura / Lattanzi, Stefania / Papadopoulou, Dionysia / Insalaco, Sabina / Germanotta, Marco / Aprile, Irene

    NeuroRehabilitation

    2024  Volume 54, Issue 3, Page(s) 411–420

    Abstract: Background: Many authors have emphasized the need for individualized treatments in rehabilitation, but no tailored robotic rehabilitation protocol for stroke patients has been established yet.: Objective: To evaluate the effectiveness of a robot- ... ...

    Abstract Background: Many authors have emphasized the need for individualized treatments in rehabilitation, but no tailored robotic rehabilitation protocol for stroke patients has been established yet.
    Objective: To evaluate the effectiveness of a robot-mediated upper limb rehabilitation protocol based on clinical assessment for customized treatment of stroke patients.
    Methods: Clinical data from 81 patients with subacute stroke, undergoing an upper limb robot-mediated rehabilitation, were analyzed retrospectively. 49 patients were treated using a customized robotic protocol (experimental group, EG) based on a clinically guided flowchart, while 32 were treated without it (control group, CG). Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Motricity Index (MI), modified Barthel Index (mBI) and Numerical Rating Scale (NRS) measured before (T0) and after (T1) rehabilitation intervention were used as clinical outcomes.
    Results: There was statistically significant improvement in both groups in terms of FMA-UE, MI, and mBI, while no change in NRS. Intergroup analysis showed significantly greater improvement of the FMA-UE (P = 0.002) and MI (P < 0.001) in the EG, compared with the CG.
    Conclusion: The implementation of our robotic protocol for customized treatment of stroke patients yielded greater recovery in upper limb motor function and strength over robotic treatment without a defined protocol.
    MeSH term(s) Humans ; Stroke Rehabilitation/methods ; Male ; Female ; Upper Extremity/physiopathology ; Retrospective Studies ; Robotics ; Middle Aged ; Aged ; Stroke/physiopathology ; Treatment Outcome ; Recovery of Function/physiology ; Adult
    Language English
    Publishing date 2024-04-09
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1087912-2
    ISSN 1878-6448 ; 1053-8135
    ISSN (online) 1878-6448
    ISSN 1053-8135
    DOI 10.3233/NRE-230367
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Muscle quality improvement in subacute post-stroke patients after rehabilitation: Usefulness of segmental phase angle from bioelectrical impedance analysis.

    Guerrini, Alessandro / Siotto, Mariacristina / Germanotta, Marco / Cipollini, Valeria / Cortellini, Laura / Pavan, Arianna / Insalaco, Sabina / Khazrai, Yeganeh Manon / Aprile, Irene

    Clinical nutrition (Edinburgh, Scotland)

    2023  Volume 43, Issue 1, Page(s) 224–231

    Abstract: Background & aims: During stroke rehabilitation, the whole-body Phase Angle (PhA) from Bioelectrical Impedance Analysis (BIA) is measured to assess whole-body muscle quality, which reflects cellular integrity and function. The segmental BIA is a ... ...

    Abstract Background & aims: During stroke rehabilitation, the whole-body Phase Angle (PhA) from Bioelectrical Impedance Analysis (BIA) is measured to assess whole-body muscle quality, which reflects cellular integrity and function. The segmental BIA is a valuable method for assessing the body composition of specific body segments, such as the arms, legs, and hemisoma. After a stroke insult, patients frequently experience hemiparesis, and segmental PhA from segmental BIA appears to be an appropriate parameter for examining the muscle quality of affected and unaffected limbs separately. This study aims to investigate whether segmental PhA is more informative than whole-body PhA in (a) assessing the deterioration of muscle quality in post-stroke patients and (b) monitoring its recovery following rehabilitative treatment.
    Methods: This longitudinal study recruited subacute post-stroke patients who were admitted to our rehabilitation center. At admission, demographic, anamnestic, and clinical information, such as the presence of comorbidities, were recorded. BIA was used to evaluate the whole-body PhA and segmental PhA of the affected and unaffected hemisoma, arms, and legs at admission (T0) and after a six-week rehabilitation program (T1). The modified Barthel Index (mBI), Fugl-Meyer Assessment for the Upper Extremity (FMA-UE), and Motricity Index of the Upper (MI-UE) and Lower (MI-LE) Extremities were evaluated at T0 and T1 to determine the patient's Activity of Daily Living (ADL) performance, upper limb motor performance, and upper and lower limb muscle strength, respectively.
    Results: We evaluated segmental and whole-body BIA in 70 subacute post-stroke patients (women n = 34, ischemic n = 56, mean age 70 ± 11) at T0 and T1. Whole-body PhA values of the patients were below the normal range. Considering segmental data, the affected hemisoma, arm, and leg had considerably lower PhA values as compared to the unaffected body segments. Furthermore, at T1, the PhA values of all affected body segments improved, while those of the unaffected ones and whole-body PhA did not. At both T0 and T1, the segmental PhA values of the affected body segments showed to be related with all clinical outcome measures, while whole-body PhA correlated only with mBI.
    Conclusions: This study emphasizes the significance of measuring segmental PhA in hemiparetic subacute stroke patients undergoing rehabilitation treatment. Segmental PhA is a more accurate parameter to evaluate rehabilitation treatment in patients with hemiparesis because it can distinguish affected from unaffected body segments, hence facilitating accurate monitoring of muscle quality improvements resulting from a rehabilitation program.
    MeSH term(s) Humans ; Female ; Middle Aged ; Aged ; Aged, 80 and over ; Male ; Longitudinal Studies ; Electric Impedance ; Quality Improvement ; Stroke/complications ; Upper Extremity ; Muscles ; Paresis/etiology
    Language English
    Publishing date 2023-12-04
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 604812-2
    ISSN 1532-1983 ; 0261-5614
    ISSN (online) 1532-1983
    ISSN 0261-5614
    DOI 10.1016/j.clnu.2023.12.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Systemic Oxidative Stress in Subacute Stroke Patients Undergoing Rehabilitation Treatment.

    Cocco, Carola / Siotto, Mariacristina / Guerrini, Alessandro / Germanotta, Marco / Galluccio, Caterina / Cipollini, Valeria / Cortellini, Laura / Pavan, Arianna / Lattanzi, Stefania / Insalaco, Sabina / Ruco, Elisabetta / Mosca, Rita / Campana, Biagio / Aprile, Irene

    Antioxidants (Basel, Switzerland)

    2024  Volume 13, Issue 3

    Abstract: The imbalance in oxidative stress in acute stroke has been extensively studied; on the contrary, its investigation in the subacute phase is limited. The aim of this study was to analyse the variation in the systemic oxidative status in subacute post- ... ...

    Abstract The imbalance in oxidative stress in acute stroke has been extensively studied; on the contrary, its investigation in the subacute phase is limited. The aim of this study was to analyse the variation in the systemic oxidative status in subacute post-stroke patients before (T0) and after a six-week rehabilitation treatment (T1) and to investigate the relationship between systemic oxidative status and rehabilitation outcomes. We enrolled 109 subjects in two different centres, and we analysed their serum hydroperoxide levels (d-ROMs), biological antioxidant power (BAP), thiol antioxidant components (-SHp), and relative antioxidant capacity (OSI and SH-OSI indices). Activity of Daily Living (ADL), hand grip strength, and walking endurance were evaluated using the modified Barthel Index, the Hand Grip test, and the 6-min walk test, respectively. At T0, most of the patients showed very high levels of d-ROMs and suboptimal levels of the BAP, OSI, and SH-OSI indices. Comparing the T1 and T0 data, we observed an improvement in the rehabilitation outcomes and a significant decrease in d-ROMs (549 ± 126 vs. 523 ± 148,
    Language English
    Publishing date 2024-03-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2704216-9
    ISSN 2076-3921
    ISSN 2076-3921
    DOI 10.3390/antiox13030354
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Oxidative Stress Status in Post Stroke Patients: Sex Differences.

    Siotto, Mariacristina / Germanotta, Marco / Santoro, Massimo / Canali, Raffaella / Pascali, Simona / Insalaco, Sabina / Cipollini, Valeria / Papadopoulou, Dionysia / Antonacci, Erika / Aprile, Irene

    Healthcare (Basel, Switzerland)

    2022  Volume 10, Issue 5

    Abstract: After a cerebral stroke insult, there is an overproduction of Reactive Oxygen Species (ROS), which overcome the antioxidant defenses, causing further tissues damage. The status of oxidative stress in stroke patients over time, particularly in those ... ...

    Abstract After a cerebral stroke insult, there is an overproduction of Reactive Oxygen Species (ROS), which overcome the antioxidant defenses, causing further tissues damage. The status of oxidative stress in stroke patients over time, particularly in those undergoing rehabilitation treatments, has been poorly investigated. We analyzed the oxidative stress status in 61 subacute stroke patients (33 females and 28 males) admitted to our rehabilitation center by measuring, in serum: hydroperoxides levels (d-ROMs), antioxidant activity (BAP test), and the relative antioxidant capacity (OSI index). We also analyzed patients for glucose levels and lipid profile. In addition, we analyzed the correlation between oxidative stress status biomarkers and motor deficits, disability, and pain. Almost all patients showed high or very high levels of d-ROMs, while BAP levels were apparently in the reference range of normality. Females had lower BAP values (females: 2478 ± 379; males: 2765 ± 590;
    Language English
    Publishing date 2022-05-09
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2721009-1
    ISSN 2227-9032
    ISSN 2227-9032
    DOI 10.3390/healthcare10050869
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Efficacy of Robot-Assisted Gait Training Combined with Robotic Balance Training in Subacute Stroke Patients: A Randomized Clinical Trial.

    Aprile, Irene / Conte, Carmela / Cruciani, Arianna / Pecchioli, Cristiano / Castelli, Letizia / Insalaco, Sabina / Germanotta, Marco / Iacovelli, Chiara

    Journal of clinical medicine

    2022  Volume 11, Issue 17

    Abstract: Recently, the use of robotic technology in gait and balance rehabilitation of stroke patients has been introduced, with positive results. The purpose of this study was to evaluate the effectiveness of robotic gait and trunk rehabilitation compared to ... ...

    Abstract Recently, the use of robotic technology in gait and balance rehabilitation of stroke patients has been introduced, with positive results. The purpose of this study was to evaluate the effectiveness of robotic gait and trunk rehabilitation compared to robotic gait training alone on balance, activities, and participation measures in patients with subacute stroke. The study was a randomized, controlled, single blind, parallel group clinical trial. Thirty-six patients with first ischemic or hemorrhagic stroke event were enrolled, and they were randomized in two groups: Gait Group (GG), where they received only robotic treatment for gait rehabilitation through an end-effector system, and Gait/Trunk Group (GTG) where they performed end-effector gait rehabilitation and balance with a robotic platform, 3 times/week for 12 sessions/month. At the end of the study, there was an improvement in balance ability in both groups. Instead, the lower limb muscle strength and muscle tone significantly improved only in the GTG group, where we found a significant reduction in the trunk oscillations and displacement during dynamic exercises more than the GG group. The robotic platform which was added to the gait robotic treatment offers more intense and controlled training of the trunk that positively influences the tone and strength of lower limb muscles.
    Language English
    Publishing date 2022-08-31
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm11175162
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