Emilia Biffi

Emilia Biffi
IRCCS Eugenio Medea · Bioengineering lab

Research fellow

About

86
Publications
14,260
Reads
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893
Citations
Introduction

Publications

Publications (86)
Article
Full-text available
Spinal orthoses produced using additive manufacturing show great potential for obtaining patient-specific solutions in clinical applications, reducing manual operations, time consumption, and material waste. This study was conducted to evaluate the production process of spinal orthoses produced by additive manufacturing, and to test the effects of...
Article
Full-text available
A large number of people in the world need to use a wheelchair because of different disabilities. Driving a wheelchair requires complex physical and cognitive abilities which need to be trained. Virtual training helps users acquire driving skills in a safe environment. The aim of this paper is to describe and technically validate simulation models...
Chapter
The post-COVID syndrome is emerging as a new chronic condition, characterized by symptoms of breathlessness, fatigue, and decline of neurocognitive functions. Rehabilitation programs that include physical training seem to be beneficial to reduce such symptoms and improve patients’ quality of life. Given this, and considering the limitations imposed...
Article
Full-text available
During the COVID-19 outbreak, we experienced the suspension of both work-related and spare activities, with the closure of shops, companies, services, as well as schools. Children probably are the ones who have suffered the most from this situation, due to the limited socialization with peers and boredom experienced at home. In this context, school...
Article
Full-text available
Gait training in a virtual reality (VR) environment is promising for children affected by different disorders. However, the efficacy of VR therapy is still under debate, and more research is needed to clarify its effects on clinical conditions. The combination of VR with neuroimaging methods, such as the electroencephalography (EEG), might help in...
Article
Full-text available
Game activity is fundamental for children’s cognitive and social development. During recent years, technology development has led to changes in several areas, including the ludic one. However, while in the literature, there are plenty of studies that report the importance of technology-based games in rehabilitation program, little attention has bee...
Article
It has been proposed that impairments of the predictive function exerted by the cerebellum may account for social cognition deficits. Here, we integrated cerebellar functions in a predictive coding framework to elucidate how congenital, non-progressive cerebellar alterations could affect the predictive processing of others’ behavior. Experiment 1 d...
Article
Active exoskeletons can help adults with muscular dystrophy regain independence and self-esteem, which have been limited due to their severe and progressive muscular weakness. A four degrees-of-freedom fully actuated upper limb exoskeleton, equipped with a spring-based anti-gravity system, has been designed, prototyped, and tested on end-users. Whi...
Article
The effects of robotic-assisted gait training on upper and lower body strategy during gait in diplegic children with Cerebral Palsy (CP) were quantified using summary parameters (Upper Body Profile Score (UBPS) and Gait Profile Score (GPS)). Firstly, the upper body strategy during gait was assessed in 73 children with CP and 15 healthy children (Co...
Article
Full-text available
Robot assisted gait training (RAGT) and virtual reality plus treadmill training (VRTT) are two technologies that can support locomotion rehabilitation in children and adolescents affected by acquired brain injury (ABI). The literature provides evidence of their effectiveness in this population. However, a comparison between these methods is not ava...
Article
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The use of 3D digitizing tools is becoming the base for subject-specific products, such as the orthopaedic production process of orthoses and prostheses. This paper aims at comparing the metrological behaviour of low-cost devices (Kinect 1 and 2 by Microsoft, Structure Sensor by Occipital) and high-resolution active sensors (O&P Scan by Rodin4D, Ne...
Article
Interpersonal distance is a core aspect of mother-child interaction. While conventional measures based on human coders do not fully capture the dynamics of this feature, computational methods provide automatic measures which can detect even small changes and more accurate estimates both spatially and temporally. Using RGB-D sensors (Microsoft Kinec...
Preprint
Full-text available
It has been proposed that impairments of the predictive function exerted by the cerebellum may account for social cognition deficits. Here, we integrated cerebellar functions in a predictive coding framework to elucidate how cerebellar alterations could affect the predictive processing of others' behavior. Experiment 1 demonstrated that cerebellar...
Article
Full-text available
Background Upper limb assistive devices can compensate for muscular weakness and empower the user in the execution of daily activities. Multiple devices have been recently proposed but there is still a lack in the scientific comparison of their efficacy. Methods We conducted a cross-over multi-centric randomized controlled trial to assess the func...
Article
Full-text available
Purpose: Human navigation skills are essential for everyday life and rely on several cognitive abilities, among which visual-spatial competences that are impaired in subjects with cerebral palsy (CP). In this work, we proposed navigation tasks in immersive virtual reality (IVR) to 15 children with CP and 13 typically developing (TD) peers in order...
Article
Full-text available
In recent years, 3D printing gained considerable attention in the orthopedic sector. This work evaluates the feasibility of producing orthopedic scoliosis braces by 3D printing, comparing performance and costs with classical thermoforming procedures. Critical parameters, such as manufacture time, mechanical properties, weight, and comfort are caref...
Article
Full-text available
The notion of “vitality form” has been coined by Daniel Stern to describe the basic features of action, which may reflect the mood or affective state of an agent. There is general consensus that vitality forms substantiate social interactions in children as well in adults. Previous studies have explored children with Autism Spectrum Disorder (ASD)’...
Article
Full-text available
The Performance of the Upper Limb (PUL) module is an externally-assessed clinical scale, initially designed for the Duchenne muscular dystrophy population. It provides an upper extremity functional score suitable for both weaker ambulatory and non-ambulatory phases up to the severely impaired patients. It is capable of characterizing overall progre...
Article
Full-text available
Patients at risk of developing respiratory dysfunctions, such as patients with severe forms of muscular dystrophy, need a careful respiratory assessment, and periodic follow-up visits to monitor the progression of the disease. In these patients, at-home continuous monitoring of respiratory activity patterns could provide additional understanding ab...
Article
Posterior cranial fossa (PCF) tumors in childhood are often associated with ataxia as well as other motor, neurobehavioral and linguistic impairment. The use of a reliable outcome measure is mandatory to evaluate the severity of impairment and monitor rehabilitation effectiveness. The aim of this work is to explore the validity of the Scale for the...
Article
Full-text available
Objective: The minimum clinically important difference (MCID) is a standard way of measuring clinical relevance. The objective of this work was to establish the MCID for the 6-minute walking test (6minWT) and the Gross Motor Function Measure (GMFM-88) in pediatric gait disorders. Methods: A cohort, pretest-posttest study was conducted in a hospi...
Article
Full-text available
Wearable sensors are becoming increasingly popular for complementing classical clinical assessments of gait deficits. The aim of this review is to examine the existing knowledge by systematically reviewing a large number of papers focusing on the use of wearable inertial sensors for the assessment of gait during the 6-minute walk test (6MWT), a wid...
Article
Full-text available
Virtual reality (VR) creates computer-generated virtual environments where users can experience and interact in a similar way as they would do in real life. VR systems are increasingly being used for rehabilitation goals, mainly with adults, but also with children, extending their application to the educational field. This report concerns a study o...
Article
Continuous monitoring of breathing frequency (fB) could foster early prediction of adverse clinical effects and exacerbation of medical conditions. Current solutions are invasive or obtrusive and thus not suitable for prolonged monitoring outside the clinical setting. Previous studies demonstrated the feasibility of deriving fB by measuring inclina...
Article
Full-text available
Background: Patients with cerebellar malformations exhibit not only movement problems, but also important deficits in social cognition. Thus, rehabilitation approaches should not only involve the recovery of motor function but also of higher-order abilities such as processing of social stimuli. In keeping with the general role of the cerebellum in...
Preprint
Full-text available
Background: Patients with cerebellar malformations exhibit not only movement problems, but also important deficits in social cognition. Thus, rehabilitation approaches should not only involve the recovery of motor function but also of higher-order abilities, such as processing of social stimuli. In keeping with the general role of the cerebellum in...
Preprint
Background: Patients with cerebellar malformations exhibit not only movement problems, but also important deficits in social cognition. Thus, rehabilitation approaches should not only involve the recovery of motor function but also of higher-order abilities, such as processing of social stimuli. In keeping with the general role of the cerebellum in...
Article
Full-text available
Background: This study is aimed at better understanding the role of a wearable and silent ElectroMyoGraphy-based biofeedback on motor learning in children and adolescents with primary and secondary dystonia. Methods: A crossover study with a wash-out period of at least 1 week was designed; the device provides the patient with a vibration proport...
Article
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Aim: To assess changes in locomotion and balance in adolescents affected by ataxia secondary to acquired brain injury after a rehabilitation treatment with physiotherapy and the Gait Real-time Analysis Interactive Lab (GRAIL), an immersive virtual reality platform. Methods: 11 ataxic adolescents (16(5) years old, 4.7(6.7) years from injury) unde...
Chapter
The present work aims to present the current virtual design process of scoliosis braces and propose an improvement by considering the internal geometry. Starting from the external scanning it is possible to apply only corrections that do not consider the interaction with the human body. For this reason we propose to embed the 3D model reconstructio...
Article
Objective: To evaluate retrospectively the effect of robotic rehabilitation in a large group of children with motor impairment; an additional goal was to identify the effects in children with cerebral palsy and acquired brain injury and with different levels of motor impairment according to the Gross Motor Function Classification System. Finally,...
Conference Paper
Being able to perform a lost movement is an important experience towards increased independence and self-esteem, particularly for neuromuscular patients, who see their muscles weaken day after day. In this pilot study, preliminary results on the testing of a motorized upper-limb exoskeleton for muscular dystrophy patients are presented. The mechatr...
Preprint
Background: Patients with cerebellar malformations exhibit not only movement problems, but also important deficits in social cognition. Thus, rehabilitation approaches should not only involve the recovery of motor function but also of higher-order abilities, such as processing of social stimuli. In keeping with the general role of the cerebellum in...
Chapter
Full-text available
Restore a lost function is a special experience for people affected by neuromuscular evolutive diseases as muscular dystrophy. Upper limb stiffness and activity limitations have a crucial role in reducing patients’ autonomy and worsening quality of life. Even if the commercial products might assure a benefit to some users and meet most of their req...
Article
Full-text available
Breathing frequency (fB) is an important vital sign that—if appropriately monitored—may help to predict clinical adverse events. Inertial sensors open the door to the development of low-cost, wearable, and easy-to-use breathing-monitoring systems. The present paper proposes a new posture-independent processing algorithm for breath-by-breath extract...
Article
Full-text available
Quantitative evaluation of gait has been considered a useful tool with which to identify subtle signs of motor system peculiarities in autism spectrum disorder (ASD). However, there is a paucity of studies reporting gait data in ASD as well as investigating learning processes of locomotor activity. Novel advanced technologies that couple treadmills...
Article
Full-text available
Background: Children with cerebral palsy (CP) and acquired brain injury (ABI) often exhibit upper limb impairment, with repercussions in their daily activities. Robotic rehabilitation may promote their functional recovery, but evidence of its effectiveness is often based on qualitative functional scales. The primary aim of the present work was to...
Conference Paper
The present paper aims at discussing the current manufacturing processes of chest orthoses, considering patients affected by Osteogenesis Imperfecta (OI) and a possible future scenario. OI is a genetic disease caused primarily by the genes responsible for collagen production. One of the most common symptoms among the groups of living subjects affec...
Conference Paper
Full-text available
One of the major issues for the success of assistive robotics concerns the question whether patients not only accept the technology and profit from it, but also whether they can effectively use it. This is especially relevant when patients are highly impaired and present several functional limitations. Therefore, it is important to enable patients...
Article
Full-text available
Low-cost 3D sensors are nowadays widely diffused and many different solutions are available on the market. Some of these devices were developed for entertaining purposes, but are used also for acquisition and processing of different 3D data with the aim of documentation, research and study. Given the fact that these sensors were not developed for t...
Conference Paper
Low-cost 3D sensors are nowadays widely diffused and many different solutions are available on the market. Some of these devices were developed for entertaining purposes, but are used also for acquisition and processing of different 3D data with the aim of documentation, research and study. Given the fact that these sensors were not developed for t...
Article
BACKGROUND: Duchenne muscular dystrophy (DMD) is characterized by progressive degeneration, wasting, and weakness of skeletal musculature, including respiratory muscles. Cough is also compromised with disease progression. Among cough-augmentation techniques, mechanical insufflation-exsufflation (MI-E) has demonstrated several clinical benefits in...
Article
Immersive virtual reality (IVR) offers new possibilities to perform treatments in an ecological and interactive environment with multimodal online feedbacks. Sixteen school-aged children (mean age 11 ± 2.4 years) with Bilateral CP—diplegia, attending mainstream schools were recruited for a pilot study in a pre–post treatment experimental design. Th...
Article
Full-text available
Acquired brain injuries (ABIs) can lead to a wide range of impairments, including weakness or paralysis on one side of the body known as hemiplegia. In hemiplegic patients, the rehabilitation of the upper limb skills is crucial, because the recovery has an immediate impact on patient quality of life. For this reason, several treatments were develop...
Article
Robotically-driven orthoses (RDO) are promising for treating gait impairment in children with hemiplegia after acquired brain injury (ABI). Despite this, existing literature on the employment of RDO in ABI is scanty, and cohorts' age spans throughout the adult age, with no specific focus on the developmental age. We aim to compare a treatment solel...
Conference Paper
Full-text available
This paper presents a device for breathing frequency assessment over the long period, based on low cost, wearable inertial units. Performances of the device were evaluated in static conditions on 9 healthy subjects and the estimated parameters were compared to those obtained with an already validated method (Optoelectronic Plethysmography). We obta...
Article
Background: Robot-Assisted Gait Training (RAGT) is a widespread approach for locomotion rehabilitation but information about intervention frequency and duration is still lacking. Objective: To evaluate the effect of frequency and duration of a RAGT on motor outcome of children affected by Cerebral Palsy (CP). Methods: Forty-four CP children (a...
Article
Motor planning is not a monolithic process, and distinct stages of motor planning are responsible for encoding different levels of abstractness. However, how these distinct components are mapped into different neural substrates remains an open question. We studied one of these high-level motor planning components, defined as second-order motor plan...
Article
Recently, a few software applications (apps) have been developed to enhance vocabulary and conceptual networks to address the needs of children with language impairments (LI), but there is no evidence about their impact and their usability in therapy contexts. Here, we try to fill this gap presenting a system aimed at improving the semantic compete...
Article
Background: Acquired brain injury (ABI) may result in lifelong impairment of physical, cognitive, and psychosocial functions. Several rehabilitative treatments are often needed to support walking recovery, thus participants' engagement becomes a crucial aspect, especially when patients are children. In the last few years, traditional physiotherapy...
Conference Paper
The Gait Real-time Analysis Interactive Lab (GRAIL) is an innovative platform based on immersive Virtual Reality (VR), providing amazing scenarios where the subjects are asked to walk or change their load and posture to get points and conclude exergames. The system captures in real-time the kinematic and kinetic of the motion and gives multi sensor...
Article
Full-text available
Neuronal spike sorting algorithms are designed to retrieve neuronal network activity on a single-cell level from extracellular multiunit recordings with Microelectrode Arrays (MEAs). In typical analysis of MEA data, one spike sorting algorithm is applied indiscriminately to all electrode signals. However, this approach neglects the dependency of al...
Chapter
The functional recovery of upper limbs is one of the goals of the rehabilitation of children affected by Acquired Brain Injury. Sensorimotor stimulation exercises, particularly the Constraint-Induced Movement Therapy (CIMT) and robot-aided therapy are promising in children. However, exhaustive data about their effectiveness in the clinical practice...
Chapter
With the progression of Duchenne Muscular Dystrophy (DMD), muscular weakness affects also respiratory muscles compromising cough, a fundamental mechanism that allows to clear the airway preventing chest infections. Mechanical insufflation-exsufflation is a therapy in which the lung is alternatively inflated and deflated using positive and negative...
Data
Full-text available
The supplementary material includes the description of the Matlab toolbox for neuronal spike sorting presented and validated in the work (see Results 1.1). In particular, guidelines on how to use the ‘test data' GUI as well as the ‘real data' off-line and on-line GUIs are here provided together with graphical examples.
Article
Full-text available
To tackle the limits of the literature investigating biofeedback training in children with secondary dystonia, the current study employs a wearable and silent EMG-based biofeedback device that aims at improving control over the impaired muscle by providing the patient with a vibration proportional to muscle activation. The device is tested on two c...
Article
Introduction: This article is part of the Focus Theme of Methods of Information in Medicine on "Methodologies, Models and Algorithms for Patients Rehabilitation". Objectives: The great potential of robots in extracting quantitative and meaningful data is not always exploited in clinical practice. The aim of the present work is to describe a simp...
Conference Paper
In the past few years, new devices for children and disabilities has proliferated thanks to the development of more and more inexpensive mobile technology and to the availability of free-downloadable software applications. In this work we describe the design, development and testing of an integrated system which combines the use of a tablet, a grou...
Article
Background: Few systematic studies describe rehabilitation trainings for upper limb in diplegic CP children, who - especially if grown up - are often not considered as a target for rehabilitation interventions. Aim: In this pilot study we describe the details and the effectiveness of an intensive, technology assisted intervention for upper limb....
Conference Paper
Full-text available
Improving walking ability is one of the main goals of a rehabilitation procedure. New technologies based on Virtual Reality (VR) has been recently flanked standard therapies. In this study, 4 children suffering from acquired brain injury (ABI) underwent a 5 session treatment with the Gait Real-time Analysis Interactive Lab (GRAIL), to improve walki...
Article
Full-text available
Two binding requirements for in vitro studies on long-term neuronal networks dynamics are (i) finely controlled environmental conditions to keep neuronal cultures viable and provide reliable data for more than a few hours and (ii) parallel operation on multiple neuronal cultures to shorten experimental time scales and enhance data reproducibility....