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Article ; Online: Recovery of activities of daily living in COVID-19 patients requiring intensive care unit or medical care unit: an observational study on the role of rehabilitation in the subacute phase.

Notarstefano, Chiara / Bertolucci, Federica / Miccoli, Mario / Posteraro, Federico

Frontiers in rehabilitation sciences

2023 Volume 4, Page(s) 1256999

Abstract: Purpose: This study aims to describe the functional status of a cohort of subacute COVID-19 patients treated in a dedicated rehabilitation unit and to compare functional outcomes between patients previously hospitalized in the intensive care unit (ICU ... ...

Abstract	Purpose: This study aims to describe the functional status of a cohort of subacute COVID-19 patients treated in a dedicated rehabilitation unit and to compare functional outcomes between patients previously hospitalized in the intensive care unit (ICU group) and patients assisted in the medical care unit (MCU group). Materials and methods: Clinical and functional evaluations were performed at admission and discharge. The functional status was assessed using Barthel index (BI), functional ambulation categories (FAC), trunk control test (TCT), and dysphagia outcome and severity score (DOSS). All patients received multidisciplinary tailored rehabilitation. Results: We evaluated 171 patients (with a mean age of 67.7 ± 11.9 years, 117 were males), 110 coming from the ICU (with a mean age of 63.24 ± 10.9 years), and 61 coming from the MCU (with a mean age of 75.75 ± 9.09 years). The ICU group showed a worse functional status at admission compared with the MCU group [BI 2.5 (0-20) vs. 20 (10-60), FAC 0 (0-0) vs. 0 (0-2), TCT 61 (42-100) vs. 100 (61-100), DOSS 5 (1-7) vs. 7 (7-7)] and had significantly longer hospital stay. At discharge, all functional scales were improved with no statistically significant differences between the two groups. Conclusion: Early rehabilitation of COVID-19 survivors improves functional recovery closing the initial gap between the ICU and MCU groups. In addition, it is effective to improve the functional outcome reducing the costs for longer-term assistance of COVID-19 patients.
Language	English
Publishing date	2023-11-10
Publishing country	Switzerland
Document type	Journal Article
ISSN	2673-6861
ISSN (online)	2673-6861
DOI	10.3389/fresc.2023.1256999
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Article ; Online: Comprehensive rehabilitation treatment for sub-acute COVID-19 patients: an observational study.

Bertolucci, Federica / Sagliocco, Laura / Tolaini, Martina / Posteraro, Federico

European journal of physical and rehabilitation medicine

2021 Volume 57, Issue 2, Page(s) 208–215

Abstract: Background: COVID-19 is a respiratory infection, but it should be considered as a systemic illness with increasing interest on the survivors' sequelae and their management. Considering multi-organ disabilities, a comprehensive rehabilitation provided in ...

Abstract	Background: COVID-19 is a respiratory infection, but it should be considered as a systemic illness with increasing interest on the survivors' sequelae and their management. Considering multi-organ disabilities, a comprehensive rehabilitation provided in sub-acute phase could be considered a suitable setting for these patients. Aim: The aim of this article was to report the features and rehabilitative outcomes of patients requiring rehabilitation due to disabilities related to severe COVID-19 infection. Design: Longitudinal Observational Study. Setting: Department of Rehabilitation in General Hospital. Population: Patients showing multiple disabilities due to severe COVID-19 infection. Methods: Thirty-nine consecutive patients were admitted to a rehabilitation ward transferred from ICU or Medical wards. Barthel Index (BI) and Functional Ambulation Categories (FAC) were scored as disabilities measures. Data regarding comorbidity, rehabilitation course, swabs, procedures in acute phase, non-respiratory manifestations, dysphagia, mental confusion, PaO2/FiO2, oxygen supplementation have been collected to admission and discharge. For all patients a comprehensive rehabilitation treatment have been provided. Results: Functional outcome is good with a statistically significant improvement in BI and FAC scores. Thirty-eight patients were discharged at their home. Mean lenght of stay (LOS) in acute wards was 46 days. Mean LOS in rehabilitation was 20 day. Eleven patients still had tracheostomy at admission, none at discharge and all dysphagic patients recovered a normal oral feeding. The change in PaO2/FiO2 and the reduction of the oxygen supplementation testify a good recovery of pulmonary function. Conclusions: Our results showed a consistent recovery with little caregiver burden at discharge. Fast relocation from ICU makes beds available which are very valuable during pandemic. Comprehensive rehabilitation treatment provided in sub-acute phase for patients still positive for SARS-CoV-2, would be desirable as it seems to be an effective setting. In this setting a strong medical assistance must be ensured. Clinical rehabilitation impact: The activation of comprehensive rehabilitation settings able to assist sub-acute patients still positive would be desirable as it could be a very efficient Healthcare Systems answer to the catastrophic pandemic, decompressing acute hospital as well. Furthermore, contagious patients with swabs positivity affected by other kind of disabilities (i.e. Stroke, Femur Fracture) can be treated avoiding to lose the early rehabilitation.
MeSH term(s)	Aged ; COVID-19/epidemiology ; COVID-19/rehabilitation ; Female ; Humans ; Intensive Care Units ; Male ; Pandemics ; Retrospective Studies ; SARS-CoV-2
Language	English
Publishing date	2021-02-04
Publishing country	Italy
Document type	Journal Article ; Observational Study
ZDB-ID	2426908-6
ISSN	1973-9095 ; 1973-9087
ISSN (online)	1973-9095
ISSN	1973-9087
DOI	10.23736/S1973-9087.21.06674-0
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Article ; Online: Tele-rehabilitation for cognitive home-based treatment in young traumatic brain injury: a pilot study.

Bertolucci, Federica / Fossati, Loredana / Agostini, Barbara / Malasoma, Chiara / Sgandurra, Giuseppina / Del Lucchese, Benedetta / Miccoli, Mario / Posteraro, Federico

European journal of physical and rehabilitation medicine

2024

Language	English
Publishing date	2024-03-21
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2426908-6
ISSN	1973-9095 ; 1973-9087
ISSN (online)	1973-9095
ISSN	1973-9087
DOI	10.23736/S1973-9087.24.08379-5
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Article ; Online: Rehabilitation assisted by robotic and electromechanical devices for people with neurological disabilities: contributions for the preparation of a national conference in Italy.

Boldrini, Paolo / Bonaiuti, Donatella / Mazzoleni, Stefano / Posteraro, Federico

European journal of physical and rehabilitation medicine

2020 Volume 57, Issue 3, Page(s) 458–459

MeSH term(s)	Consensus ; Electric Power Supplies ; Humans ; Italy ; Nervous System Diseases/rehabilitation ; Robotics/methods
Language	English
Publishing date	2020-11-02
Publishing country	Italy
Document type	Editorial
ZDB-ID	2426908-6
ISSN	1973-9095 ; 1973-9087
ISSN (online)	1973-9095
ISSN	1973-9087
DOI	10.23736/S1973-9087.21.07084-2
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Article: Retrospective Robot-Measured Upper Limb Kinematic Data From Stroke Patients Are Novel Biomarkers.

Goffredo, Michela / Pournajaf, Sanaz / Proietti, Stefania / Gison, Annalisa / Posteraro, Federico / Franceschini, Marco

Frontiers in neurology

2021 Volume 12, Page(s) 803901

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2021-12-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2021.803901
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Article ; Online: Effects of Transcranial Direct Current Stimulation (tDCS) Combined With Wrist Robot-Assisted Rehabilitation on Motor Recovery in Subacute Stroke Patients: A Randomized Controlled Trial.

Mazzoleni, Stefano / Tran, Vi-Do / Dario, Paolo / Posteraro, Federico

IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society

2019 Volume 27, Issue 7, Page(s) 1458–1466

Abstract: Both transcranial direct current stimulation (tDCS) and wrist robot-assisted training have demonstrated to be promising approaches for stroke rehabilitation. However, the effects of the combination of the two treatments in subacute stroke patients are ... ...

Abstract	Both transcranial direct current stimulation (tDCS) and wrist robot-assisted training have demonstrated to be promising approaches for stroke rehabilitation. However, the effects of the combination of the two treatments in subacute stroke patients are not clear yet. To investigate the effectiveness of combining tDCS and wrist robot-assisted rehabilitation in subacute stroke patients in comparison with the wrist robotic training only, a single-blind, randomized, sham-controlled trial was performed with 40 subacute stroke patients (25 ± 7 days from stroke onset time). Patients were randomly assigned to experimental group (EG, n = 20 ) where patients receive real tDCS [2 mA, 20 min, and the anodal electrode on the primary motor cortex-M1-area of the affected hemisphere (C3/C4 in the 10-20 EEG system and the cathodal electrode on the contralateral orbit bone)] or control group (CG, n = 20 ) where patients receive sham tDCS (5 s) during wrist robotic rehabilitation training. The effects of the treatment were evaluated by means of the upper extremity, shoulder-elbow, and wrist subsections of the Fugl-Meyer assessment scale, Modified Ashworth Scale, Motricity Index and Box and Block Test together with kinematic parameters. One out of 20 patients in the CG did not complete the treatment. All the clinical outcome measures except the Modified Ashworth Scale showed a significant increase after the treatment in both groups. However, no significant difference in the average changes after treatment between groups was observed. The movement velocity and smoothness showed significant increases after the training, even though no significant difference between groups was observed. The combination of wrist robot-assisted training and tDCS did not show additional effects in comparison with wrist robot-assisted training only in subacute stroke patients. The negative results found in this paper are specific for the specific intervention. The timing of delivering the tDCS and the robot-assisted therapy has to be deeply investigated to enhance the effectiveness of the training.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Algorithms ; Biomechanical Phenomena ; Combined Modality Therapy ; Electrodes ; Electroencephalography ; Female ; Humans ; Male ; Middle Aged ; Motor Cortex ; Recovery of Function ; Robotics/methods ; Single-Blind Method ; Stroke Rehabilitation/instrumentation ; Stroke Rehabilitation/methods ; Transcranial Direct Current Stimulation/methods ; Treatment Outcome ; Upper Extremity/physiopathology ; Wrist ; Young Adult
Language	English
Publishing date	2019-06-03
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	1166307-8
ISSN	1558-0210 ; 1063-6528 ; 1534-4320
ISSN (online)	1558-0210
ISSN	1063-6528 ; 1534-4320
DOI	10.1109/TNSRE.2019.2920576
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Article ; Online: Wrist Robot-assisted Rehabilitation Treatment in Subacute and Chronic Stroke Patients: from Distal to Proximal Motor Recovery.

Mazzoleni, Stefano / Tran, Vi-Do / Dario, Paolo / Posteraro, Federico

IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society

2018

Abstract: In this study, the recovery of proximal and distal segments in stroke patients who received distal training alone was investigated. Forty (20 subacute and 20 chronic) stroke patients were recruited to perform wrist robot-assisted rehabilitation training. ...

Abstract	In this study, the recovery of proximal and distal segments in stroke patients who received distal training alone was investigated. Forty (20 subacute and 20 chronic) stroke patients were recruited to perform wrist robot-assisted rehabilitation training. The upper extremity, shoulder-elbow and wrist subsections of the Fugl-Meyer Assessment Scale were used to assess the motor recovery of distal and proximal segments. In addition, the Modified Ashworth Scale, the Motricity Index and the Box & Block test were used as clinical outcome measures together with kinematic parameters to evaluate the effects of the training. Significant increases in the wrist and shoulder-elbow subsections of the Fugl-Meyer Assessment Scale, Motricity Index and Box & Block test were found in both groups. Average changes in shoulder-elbow and upper extremity subsections of the Fugl-Meyer Assessment Scale in the subacute group (6.10 ± 6.60 and 15.65 ± 14.04) were significantly higher (p < 0.05) than those in the chronic group (2.30 ± 2.76 and 6.60 ± 4.64). In addition, significant increases in the movement velocity, movement smoothness and movement quality were observed in the subacute group. Our findings provide evidence that following a robot-assisted rehabilitation treatment there is a distal-to-proximal generalization in subacute stroke patients.
Language	English
Publishing date	2018-08-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	1166307-8
ISSN	1558-0210 ; 1063-6528 ; 1534-4320
ISSN (online)	1558-0210
ISSN	1063-6528 ; 1534-4320
DOI	10.1109/TNSRE.2018.2864935
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Article ; Online: Redefining a minimal rehabilitation assessment protocol for severe acquired brain injuries.

Lavezzi, Susanna / Bargellesi, Stefano / Cassio, Anna / DE Tanti, Antonio / Gatta, Giordano / Hakiki, Bahia / Lombardi, Francesco / Montis, Andrea / Posteraro, Federico / Scarponi, Federico / Taricco, Mariangela / Boldrini, Paolo / Cecchi, Francesca

European journal of physical and rehabilitation medicine

2022 Volume 58, Issue 4, Page(s) 584–591

Abstract: Background: The assessment of patients with severe Acquired Brain Injury (sABI) is mandatory in every phase and setting of care, and requires a multidimensional and interdisciplinary approach, to develop the individual rehabilitation project, and ... ...

Abstract	Background: The assessment of patients with severe Acquired Brain Injury (sABI) is mandatory in every phase and setting of care, and requires a multidimensional and interdisciplinary approach, to develop the individual rehabilitation project, and monitor long-term functional outcomes. In 2001 the Italian Society of Physical and Rehabilitation Medicine (SIMFER) published the minimal assessment protocol for traumatic sABI, providing a comprehensive, standardized functional assessment based on the International Classification of Functioning, Disability and Health (ICF), 2001. In 2007, a new protocol was published, extended to all sABI patients (PMGCA). In 2019, the SIMFER appointed a working group to provide a revised, updated version: the PMGCA2020. Aim: The purpose of this study was to describe the minimal assessment protocol to be applied at every stage and setting of the care process of patients with sABI. Methods: The working group, including one neurologist and 11 physiatrists experts in sABI rehabilitation, performed a review of the international recommendations for sABI assessment focusing on the following key words: "sABI assessment," "sABI rehabilitation," "sABI prognostic factors," "sABI rehabilitation assessment," "sABI outcome," in MEDLINE. Revision and integration proposals by each member were written and motivated, discussed and voted. Results: The PMGCA2020 is addressed to sABI adult patients. It investigates the main clinical problems of sABI at any time of the rehabilitation pathway. It includes a demographic/anamnestic section, a clinical/functional assessment section and an outcome measures section following the ICF model of functioning and the model of the construction of the rehabilitation project. Conclusions: The PMGCA2020 provides an updated tool for the multidimensional rehabilitation assessment of sABI patients, at any stage of the rehabilitation pathway. Further studies will allow the validation of this minimum set of variables paving the way to an assessment standardization of patients with sABI in the rehabilitation settings. Clinical rehabilitation impact: This minimum set of variables, defining patient's functioning and clinical status and outcomes, at every stage and setting of the care process to provide a framework for the standardization of the clinical evaluation of patients with sABI in rehabilitation settings.
MeSH term(s)	Adult ; Brain Injuries/rehabilitation ; Disability Evaluation ; Disabled Persons/rehabilitation ; Humans ; Italy ; Physical and Rehabilitation Medicine ; Review Literature as Topic
Language	English
Publishing date	2022-06-06
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2426908-6
ISSN	1973-9095 ; 1973-9087
ISSN (online)	1973-9095
ISSN	1973-9087
DOI	10.23736/S1973-9087.22.07451-2
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Article: Robotic Rehabilitation and Multimodal Instrumented Assessment of Post-stroke Elbow Motor Functions-A Randomized Controlled Trial Protocol.

Pilla, Alessandro / Trigili, Emilio / McKinney, Zach / Fanciullacci, Chiara / Malasoma, Chiara / Posteraro, Federico / Crea, Simona / Vitiello, Nicola

Frontiers in neurology

2020 Volume 11, Page(s) 587293

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2020-10-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2020.587293
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Article: Phase-II Clinical Validation of a Powered Exoskeleton for the Treatment of Elbow Spasticity.

Crea, Simona / Cempini, Marco / Mazzoleni, Stefano / Carrozza, Maria Chiara / Posteraro, Federico / Vitiello, Nicola

Frontiers in neuroscience

2017 Volume 11, Page(s) 261

Abstract: Introduction: ...

Abstract	Introduction:
Language	English
Publishing date	2017-05-12
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2411902-7
ISSN	1662-453X ; 1662-4548
ISSN (online)	1662-453X
ISSN	1662-4548
DOI	10.3389/fnins.2017.00261
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