Eloy Opisso

• PhD
• Innovation Director at Institut Guttmann

Since the publication of “What is the Current and Future Status of Digital Mental Health Interventions?” the exponential growth and widespread adoption of ChatGPT have underscored the importance of reassessing its utility in digital mental health interventions. This review critically examined the potential of ChatGPT, particularly focusing on its a...

Purpose: Our study aimed to: i) Assess the readability of textbook explanations using established indexes; ii) Compare these with GPT-4's default explanations, ensuring similar word counts for direct comparisons; iii) Evaluate GPT-4's adaptability by simplifying high-complexity explanations; iv) Determine the reliability of GPT-3.5 and GPT-4 in pr...

Background Stroke now represents the condition with the highest need for physical rehabilitation worldwide, with only low or moderate-level evidence testing telerehabilitation compared to in-person care. We compared functional ambulation in subacute patients with stroke following telerehabilitation and matched in-person controls with no biopsychoso...

ChatGPT often “hallucinates” or misleads, underscoring the need for formal validation at the professional level for reliable use in nursing education. We evaluated two free chatbots (Google Gemini and GPT-3.5) and a commercial version (GPT-4) on 250 standardized questions from a simulated nursing licensure exam, which closely matches the content an...

Background and Purpose Aquatic therapy (AT), though potentially effective, lacks studies on clinical efficacy in patients with spinal cord injury (SCI). A recent study analyzing interviews with rehabilitation professionals on its clinical application reported that the scarce evidence of AT benefits was one of the actual barriers to its successful i...

Introduction The ABLE Exoskeleton has been tested to be safe and feasible for persons with spinal cord injury (SCI) to complete basic skills in clinical settings but has not been tested for use in home and community environments. A user-centered design process was employed to test the feasibility of the current ABLE Exoskeleton (designed for clinic...

Background To overcome the application limitations of functional electrical stimulation (FES), such as fatigue or nonlinear muscle response, the combination of neuroprosthetic systems with robotic devices has been evaluated, resulting in hybrid systems that have promising potential. However, current technology shows a lack of flexibility to adapt t...

High-quality and accessible education is crucial for advancing neuropsychology. A recent study identified key barriers to board certification in clinical neuropsychology, such as time constraints and insufficient specialized knowledge. To address these challenges, this study explored the capabilities of advanced Artificial Intelligence (AI) languag...

Context/objective: Community integration (CI) is a crucial rehabilitation goal after spinal cord injury (SCI). There is a pressing need to enhance our understanding of the factors associated with CI for individuals with traumatic or non-traumatic etiologies, with the latter being notably understudied. Accordingly, our research explores the associa...

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Purpose Existing literature on pediatric traumatic spinal cord injury (PTSCI) demonstrates large variations in characteristics, incidence, time-periods and etiology, worldwide. Epidemiological studies addressing injuries to the total spine, conducted in Southern European regions are remarkably scarce; therefore we aimed to investigate long-term tre...

Background: Most studies focus on the risk factors associated with the development of pressure ulcers (PUs) during acute phase or community care for individuals with spinal cord injury (SCI). Objectives: This study aimed to i) compare clinical and demographic characteristics of inpatients after SCI with PUs acquired during rehabilitation vs inpa...

Background Acquired brain injury (ABI) is a prominent cause of disability globally, with virtual reality (VR) emerging as a promising aid in neurorehabilitation. Nonetheless, the diversity among VR interventions can result in inconsistent outcomes and pose challenges in determining efficacy. Recent reviews offer best practice recommendations for de...

Background: Most research focuses around impairments in body function and structure, with relatively only a small number exploring their social impact. Objectives: 1) compare characteristics for individuals who before stroke were blue collar vs. white collar workers 2) identify clinical, functional, and job-related factors associated with return...

Introduction Digital solutions for cognitive assessment are currently not only widely used in experimental contexts but can also be useful in clinical practice for efficient screening and longitudinal follow-up. The “Guttmann Cognitest”®, which includes seven computerized tasks designed to assess main cognitive functions, revealed in a previous val...

Background As the world population continues to age, the prevalence of neurological diseases, such as dementia, poses a significant challenge to society. Detecting cognitive impairment at an early stage is vital in preserving and enhancing cognitive function. Digital tools, particularly mHealth, offer a practical solution for large-scale population...

Introduction Tele‐rehabilitation in spinal cord injury (teleSCI) is a growing field that can improve access to care and health outcomes in patients with spinal cord injury (SCI). The clinical effectiveness of teleSCI is not known. Objectives To compare independence in activities of daily living and mobility capacity in patients following teleSCI a...

Objectives: To compare independence in activities of daily living (ADLs) in post-acute patients with stroke following tele-rehabilitation and matched in-person controls. Materials and methods: Matched case-control study. A total of 35 consecutive patients with stroke who followed tele-rehabilitation were compared to 35 historical in-person patie...

BACKGROUND Acquired brain injury (ABI) is a prominent cause of disability globally, with virtual reality (VR) emerging as a promising aid in neurorehabilitation. Nonetheless, the diversity among VR interventions can result in inconsistent outcomes and pose challenges in determining efficacy. Recent reviews offer best practice recommendations for de...

Background: Cognitively impaired neurological rehabilitation inpatients are at an increased risk for falls; yet, little is known regarding fall risk of different groups, such as stroke versus traumatic brain injury. Objectives: To determine if rehabilitation patients' fall characteristics differ for patients with stroke versus patients with trau...

Social media is a crucial communication tool (e.g., with 430 million monthly active users in online forums such as Reddit), being an objective of Natural Language Processing (NLP) techniques. One of them (word embeddings) is based on the quotation, “You shall know a word by the company it keeps,” highlighting the importance of context in NLP. Meanw...

Background: Post-stroke arm impairment at rehabilitation admission as predictor of discharge arm impairment was consistently reported as extremely useful. Several models for acute prediction exist (e.g. the Scandinavian), though lacking external validation and larger time-window admission assessments. Objectives: (1) use the 33 Fugl-Meyer Assess...

Background: Robotic lower-limb exoskeletons have the potential to provide additional clinical benefits for persons with spinal cord injury (SCI). However, high variability between protocols does not allow the comparison of study results on safety and feasibility between different exoskeletons. We therefore incorporated key aspects from previous st...

No Spanish-language tool exists to assess physical activity in people with spinal cord injuries. This work aimed to provide a valid Spanish version of the Physical Activity Recall Assessment for People with Spinal Cord Injury (PARA-SCI). It was conducted in three phases. First, translation and cross-cultural adaptation. Second, a reliability assess...

Background Community integration (CI) is often regarded as the foundation of rehabilitation endeavors after stroke; nevertheless, few studies have investigated the relationship between inpatient rehabilitation (clinical and demographic) variables and long-term CI. Objectives To identify novel classes of patients having similar temporal patterns in...

Context: Being able to survive in the long-term independently is of concern to patients with spinal cord injury (SCI), their relatives, and to those providing or planning health care, especially at rehabilitation discharge. Most previous studies have attempted to predict functional dependency in activities of daily living within one year after inj...

Objectives: To i) determine fall characteristics (e.g. cause, location, witnesses) of inpatients with spinal cord injury (SCI) and whether they were different for ambulatory persons vs. wheelchair users, ii) visualize the total number of daily falls per clock-hour for different inpatients' features (e.g. cause of injury, age) iii) compare clinical...

Purpose This study describes the development of a questionnaire for assessing the usability of assistive technologies accessible to people with neurological diseases. Methods A Delphi study was conducted to identify relevant items for the questionnaire. After that, the content validity was addressed to identify the essential items. Once the questi...

This project explores the feasibility of remote patient monitoring based on the analysis of 3D movements captured with smartwatches. We base our analysis on the Kinematic Theory of Rapid Human Movement. We have validated our research in a real case scenario for stroke rehabilitation at the Guttmann Institute (https://www.guttmann.com/en/) (neuroreh...

This project explores the feasibility of remote patient monitoring based on the analysis of 3D movements captured with smartwatches. We base our analysis on the Kinematic Theory of Rapid Human Movement. We have validated our research in a real case scenario for stroke rehabilitation at the Guttmann Institute5 (neurorehabilitation hospital), showing...

Thanks to technological advances, the administration of cognitive assessments via digital solutions continues to increase, both in research and clinical practice. “Guttmann Cognitest”°ledR is a digital solution for cognitive assessment which includes seven computerized tasks designed to assess main cognitive functions requiring approximately 20 min...

Background: Predicting the ability to walk after traumatic spinal cord injury is of utmost importance in the clinical setting. Nevertheless, only a small fraction of predictive models are evaluated on their performance by other authors using external data. The Dutch Clinical Prediction Rule for long-term walking ability was developed and validated...

Compare community integration of people with stroke or traumatic brain injury (TBI) living in the community before and during the coronavirus severe acute respiratory syndrome coronavirus 2 disease (COVID-19) when stratifying by injury: participants with stroke (G1) and with TBI (G2); by functional independence in activities of daily living: indepe...

Background: Stroke is a major worldwide cause of serious long-term disability. Most previous studies addressing functional independence included only inpatients with limited follow-up. Objective: To identify novel classes of patients having similar temporal patterns in motor functional independence and relate them to baseline clinical features....

Introduction: The role of gender in functional independence for activities of daily living after ischemic stroke is still controversial. We aim to a) compare clinical characteristics of men and women at inpatient rehabilitation admission b) compare their functional independence at admission and discharge c) identify predictors of functional indepe...

Recovering walking ability is one of the main goals of patients having suffered a stroke or a spinal cord lesion. Lower extremity robotic exoskeletons and neuroprosthesis are intended to compensate walking deficits or to provide gait training following lower limb paralysis. Prior to the design of exoskeletons and neuroprosthesis, the designers have...

Introduction Even in nonpandemic times, persons with disabilities experience emotional and behavioral disturbances which are distressing for them and for their close persons. We aimed at comparing the levels of stress in emotional and behavioral aspects, before and during coronavirus disease 2019 (COVID-19), as reported by informal family caregiver...

Resumen Introducción y objetivo Proponemos valorar el impacto del nivel educativo en las pruebas cognitivas al ingreso y al alta tras un periodo de rehabilitación cognitiva en los pacientes jóvenes tras un ictus isquémico. Materiales y métodos Consideramos educación secundaria y superior (grupo A) y menos de 6 años de educación reglada (grupo B)....

Background: Many efforts have been devoted to identify predictors of functional outcomes after stroke rehabilitation. Though extensively recommended, there are very few external validation studies. Objective: To externally validate two predictive models (Maugeri model 1 and model 2) and to develop a new model (model 3) that estimate the probabil...

We aimed to (1) apply cluster analysis techniques to mixed-type data (numerical and categorical) from baseline neuropsychological standard and widely used assessments of patients with acquired brain injury (ABI) (2) apply state-of-the-art cluster validity indexes (CVI) to assess their internal validity (3) study their external validity considering...

Electrical enabling motor control (eEmc) through transcutaneous spinal cord stimulation offers promise in improving hand function. However, it is still unknown which stimulus intensity or which muscle force level could be better for this improvement. Nine healthy individuals received the following interventions: (i) eEmc intensities at 80%, 90% and...

BACKGROUND Topic modeling and word embeddings’ studies of Twitter data related to COVID-19 are being extensively reported. Another social media platform that experienced a tremendous increase in new users and posts due to COVID-19 was Reddit, offering a much less explored alternative, especially the submissions’ titles, due to their format (≤ 300 c...

Context/objective Compare community integration, quality of life, anxiety and depression of people with chronic spinal cord injury (SCI) living in the community before the outbreak of coronavirus SARS-CoV-2 disease (COVID-19) and during it. Design Prospective observational cohort study. Setting In-person follow-up visits (before COVID-19 outbreak...

Objectives: i) identifying relationships between functional and psychological aspects with community integration and quality of life (QoL) assessments in people with chronic traumatic spinal cord injury (TSCI) ii) analyzing clinical and demographic predictors of QoL dimensions. Design: Observational cohort study, correlation coefficients were ca...

BACKGROUND Stroke is a worldwide cause of disability, 40% of stroke survivors sustain cognitive impairments, most of them follow inpatient rehabilitation at specialized clinical centers. Web-based cognitive rehabilitation tasks are already integrated into clinical settings. The impact of a task execution depends on the ratio between the skills of t...

Background Stroke is a worldwide cause of disability; 40% of stroke survivors sustain cognitive impairments, most of them following inpatient rehabilitation at specialized clinical centers. Web-based cognitive rehabilitation tasks are extensively used in clinical settings. The impact of task execution depends on the ratio between the skills of the...

Background: Stroke is the most relevant cause of acquired persistent disability in adulthood. The relationship between patient's weight during rehabilitation and stroke functional outcome is controversial, previous research reported positive, negative and no effects, with scarce studies specifically addressing working-age patients. Aim: To evalu...

Background Thanks to technological advances the administration of cognitive assessments via computers, tablets or smartphones continues to increase, both in research and clinical practice. Several systems are commercially available and have been validated. However, there are limited tools that provide a baseline assessment and guide a personalized...

Severe stroke patients are known to be associated with larger rehabilitation length of stay (LOS) but other factors besides severity may be contributing. We aim to identify LOS predictors within a population of mostly severe patients and analyze the impact of socioeconomic situation in functionality at admission. A retrospective observational cohor...

Background: About one-third of adult stroke patients suffer from aphasia when they are discharged from hospital. Aphasia seems to be a negative predictive factor affecting post-stroke functional recovery after rehabilitation, but this association has been scarcely addressed in previous research. Objectives: We aim to evaluate the impact of aphas...

Objective To evaluate whether introducing gamification in BCI rehabilitation of the upper limbs of post-stroke patients has a positive impact on their experience without altering their efficacy in creating motor mental images (MI). Design A game was designed purposely adapted to the pace and goals of an established BCI-rehabilitation protocol. Reh...

Introduction: In the vast majority of cases stroke entails long-term limitations in the use of the upper extremities that are affected. Robotic technologies provide beneficial results in motor rehabilitation, but the optimal levels of intensity are not known. Aims: To review the scientific literature (over the last 10 years) on robotic therapies (i...

Background: Stroke-related falls occur at especially high rates in rehabilitation settings. Inpatient-hospital falls have been identified as one of the most common medical complications after stroke, negatively influencing recovery, nevertheless, the role of cognition in relation to falls during inpatient rehabilitation is largely unexplored. Objec...

The effect of Jendrassik Maneuver (JM) has been extensively studied on monosynaptic reflexes in numerous muscles below the level at which the maneuver was performed. Here we hypothesize that the effect of JM could be observed also on other reflexes, indicating a widespread influence of performing a motor act such as the JM. We examined polysynaptic...

Introduction: Stroke is a leading cause of long-term disabilities worldwide. A great deal of meta-analyses of Randomized Controlled Trials (RCTs) address rehabilitation in chronic stroke, several of them with focus on activities and participation, considered critical outcomes of successful rehabilitation. Nevertheless, substantial heterogeneity mi...

BACKGROUND Traumatic Brain Injury (TBI) is a leading cause of disability across all ages worldwide. TBI patients are characterized by a wide heterogeneity, considered one of the most significant barriers to finding effective therapeutic interventions. Cluster analysis (CA) allows for identification of homogeneous subgroups based on similarities in...

Background: Traumatic brain injury (TBI) is a leading cause of disability worldwide. TBI is a highly heterogeneous disease, which makes it complex for effective therapeutic interventions. Cluster analysis has been extensively applied in previous research studies to identify homogeneous subgroups based on performance in neuropsychological baseline...

Hemiparesis is one of the most frequent poststroke conditions, which causes muscle weakness and/or inability to move one side of the body. Physical rehabilitation is the main treatment for hemiparesis recovery, and physiotherapists agree that using the impaired arm in the activities of daily living (ADLs) is crucial for a complete recovery. Current...

Controlling advanced robotic systems with brain signals promises substantial improvements in health care, for example, to restore intuitive control of hand movements after severe stroke or spinal cord injuries (SCI). However, such integrated, brain- or neural-controlled robotic systems have yet to enter broader clinical use or daily life environmen...

The original version of this article contained an error in the title of the paper, which was ‘Traumatic spinal cord injury due to human tower accident in catolonia’. This has now been corrected to ‘Traumatic spinal cord injury due to human tower accident in Catalonia’ in both the PDF and HTML versions of the article.

Background: Stroke is a leading cause of disabilities worldwide. One of the key disciplines in stroke rehabilitation is physical therapy which is primarily aimed at restoring and maintaining activities of daily living (ADL). Several meta-analyses have found different interventions improving functional capacity and reducing disability. Objectives:...

Study design: Retrospective case series. Objectives: The aim of this paper was to review the cases of SCI associated with human towers in the neurorehabilitation hospital Guttmann in Barcelona, clarify the mechanisms of these accidents and classify the injuries. Settings and methods: Data and history were retrospectively reviewed to detect SCI...

Pain caused by a lesion or a disease affecting the somatosensory nervous system is known as Neuropathic pain . It has been shown that neuropathic pain can be treated with the combination of simultaneous transcranial direct current stimulation and the generation of the visual illusion that the patient retains control of the affected limbs. For pers...

Purpose This work represents the efforts of the SIU-ICUD workgroup on this topic and comprehensive literature search of English language manuscripts regarding urologic surgery in spinal cord injury using key words of urologic surgery and spinal cord injury. Articles were compiled, and recommendations in the chapter are based on group discussion and...

Stroke produces immense health and economic burdens globally. Stroke survivors typically have paralysis and/or balance problems. They receive impaired proprioceptive feedback to maintain a correct posture as well as other feedback from therapists during rehabilitation. In this scenario, wearable technologies properly configured by therapists can he...

Background: The increasing number of patients with acquired brain injury and the current subjectivity of the conventional upper extremity (UE) assessment tests require new objective assessment techniques. Objective: This research proposes a novel objective motor assessment (OMA) methodology based on the Fugl-Meyer assessment (FMA). The goals are...

Objective Repetitive application of peripheral electrical stimuli paired with transcranial magnetic stimulation (rTMS) of M1 cortex at low frequency, known as paired associative stimulation (PAS), is an effective method to induce motor cortex plasticity in humans. Here we investigated the effects of repetitive peripheral magnetic stimulation (rPMS)...

One of the most relevant post-stroke conditions is the hemiparesis, which causes muscle weakness and/or the inability to move one side of the body. Physical and occupational therapy plays an important role in the rehabilitation of patients suffering this condition. On the other hand, daily life use of the impaired arm is crucial for improving and a...

Purpose: (1) To assess a robotic device (Handexos) during the design process with regard to usability, end user satisfaction and safety, (2) to determine whether Handexos can improve the activities of daily living (ADLs) of spinal cord injury (SCI) patients and stroke patients with upper-limb dysfunction. Methods: During a 2-year development sta...

Purpose: (1) To develop a smart jacket with sensors embedded in the sleeve that monitors the upper limb movement through a User Centered Design (UCD) process and (2) to assess by means of a Usability Test whether this tool can be used in upper limb rehabilitation of people with neurological diseases such as spinal cord injuries or strokes. Methods:...

Direct brain control of advanced robotic systems promises substantial improvements in health care, for example, to restore intuitive control of hand movements required for activities of daily living in quadriplegics, like holding a cup and drinking, eating with cutlery, or manipulating different objects. However, such integrated, brain- or neural-c...

El Proyecto PERSSILAA “PERsonalised ICT Supported Services for Independent Living and Active Ageing” es un proyecto europeo financiado por el FP7 en el que se desarrolla y valida un nuevo modelo de servicio, para detectar y prevenir la fragilidad en comunidades de personas mayores, integrando los dominios cognitivos, físico y nutricional. PERSSILAA...

This paper introduces a new approach for upper limb neurorehabilitation based on customized devices for monitoring and interacting with virtual environments. A proof-of-concept test involving eight patients at the Guttmann Neurorehabilitation Hospital shows patient's good acceptance and usability scores and demonstrates the technically feasibility...

Plasticity is one of the most important physiological mechanisms underlying motor recovery from brain lesions. Rehabilitation methods, such as mirror visual feedback therapy, which are based on multisensory integration of motor, cognitive, and perceptual processes, are considered effective methods to induce cortical reorganization. The present stud...

Esta investigación propone la valoración objetiva del control motor de la extremidad superior (ES) de pacientes con Daño Cerebral Adquirido (DCA) en neurorrehabilitación funcional, basada en la automatización de las pruebas de la evaluación Fugl-Meyer (FM). El objetivo principal de este trabajo es calcular una medida objetiva, puntuando de forma au...

Resumen Esta investigación propone la valoración objetiva del control motor de la extremidad superior (ES) de pacientes con Daño Cerebral Adquirido (DCA) en neurorrehabilitación funcional, basada en la automatización de las pruebas de la evaluación Fugl-Meyer (FM). El objetivo principal de este trabajo es calcular una medida objetiva, puntuando de...

Non-stationarity and inherent variability of the noninvasive electroencephalogram (EEG) makes robust recognition of spontaneous EEG patterns challenging. Reliable modulation of EEG patterns that a BCI can robustly detect is a skill that users must learn. In this paper, we present a novel online co-adaptive BCI training paradigm. The system autonomo...

This paper proposes a first approach for the automation of the Fugl-Meyer assessment scale used in physical neurorehabilitation. The main goal of this research is to automatically estimate an objective measurement for five Fugl-Meyer scale items related to the assessment of the upper limb motion. An objective score has been calculated for 7 patient...

Brain-computer interfaces (BCIs) translate oscillatory electroencephalogram (EEG) patterns into action. Different mental activities modulate spontaneous EEG rhythms in various ways. Non-stationarity and inherent variability of EEG signals, however, make reliable recognition of modulated EEG patterns challenging. Able-bodied individuals who use a BC...

The main objective of this roadmap is to provide a global perspective on the BCI field now and in the future. For readers not familiar with BCIs, we introduce basic terminology and concepts. We discuss what BCIs are, what BCIs can do, and who can benefit from BCIs. We illustrate our arguments with use cases to support the main messages. After readi...

The brain-computer interface (BCI) field has grown dramatically over the past few years, but there are still no coordinated efforts to ensure efficient communication and collaboration among key stakeholders. The European Commission (EC) has recently renewed their efforts to establish such a coordination effort by funding a coordination and support...