• Home
  • Marco Schieppati
Marco Schieppati

Marco Schieppati
Independent Researcher · NA

MD - Neurologist

About

231
Publications
32,084
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
11,713
Citations
Citations since 2017
30 Research Items
3408 Citations
20172018201920202021202220230100200300400500600
20172018201920202021202220230100200300400500600
20172018201920202021202220230100200300400500600
20172018201920202021202220230100200300400500600
Additional affiliations
November 2000 - August 2015
University of Pavia
Position
  • Professor (Full)
January 2000 - December 2016
Istituti Clinici Scientifici Maugeri IRCCS
Position
  • Consultant
January 1999 - December 2001
University of Burgundy
Position
  • Professor
Education
November 1974 - July 1976
University of Pavia
Field of study
  • Neurology
November 1974 - July 1977
University of Pavia
Field of study
  • Neurology
November 1967 - July 1973
University of Milan
Field of study
  • Medicine

Publications

Publications (231)
Article
Full-text available
When a person stands upright quietly, the position of the Centre of Mass (CoM), the vertical force acting on the ground and the geometrical configuration of body segments is accurately controlled around to the direction of gravity by multiple feedback mechanisms and by integrative brain centres that coordinate multi-joint movements. This is not alw...
Article
Full-text available
Different measurements of body oscillations in the time or frequency domain are being employed as markers of gait and balance abnormalities. This study investigates basic relationships within and between geometric and spectral measures in a population of young adult subjects. Twenty healthy subjects stood with parallel feet on a force platform with...
Article
Full-text available
Background Several investigations have addressed the process of balance adaptation to external perturbations. The adaptation during unperturbed stance has received little attention. Further, whether the current sensory conditions affect the adaptation rate has not been established. We have addressed the role of vision and haptic feedback on adaptat...
Article
Full-text available
We addressed postural instability during stance with eyes closed (EC) on a compliant surface in healthy young people. Spectral analysis of the centre of foot pressure oscillations was used to identify the effects of haptic information (light-touch, EC-LT), or vision (eyes open, EO), or both (EO-LT). Spectral median frequency was strongly reduced by...
Article
Full-text available
Locomotion in people with Parkinson’ disease (pwPD) worsens with the progression of disease, affecting independence and quality of life. At present, clinical practice guidelines recommend a basic evaluation of gait, even though the variables (gait speed, cadence, step length) may not be satisfactory for assessing the evolution of locomotion over th...
Article
Full-text available
Background: Locomotion along curved trajectories requires fine coordination among body segments. Elderly people may adopt a cautious attitude when steering. A simple, expeditious, patient-friendly walking protocol can be a tool to help clinicians. We evaluated the feasibility of a procedure based upon a newly designed Figure-of-eight (nFo8) path an...
Article
The foot‐sole cutaneous receptors (section 2), their function in stance control (sway minimisation, exploratory role) (2.1), and the modulation of their effects by gait pattern and intended behaviour (2.2) are reviewed. Experimental manipulations (anaesthesia, temperature) (2.3 and 2.4) have shown that information from foot sole has widespread infl...
Article
Full-text available
Various diseases are associated with the impaired control of the medio-lateral (ML) position of the centre of feet pressure (CoP), and several manoeuvres have been proposed for enhancing the CoP symmetry. Here, we assessed in healthy standing subjects the feasibility and outcome of a novel protocol entailing a reaction to a continuous asymmetric ML...
Article
Full-text available
When humans are administered continuous and predictable perturbations of stance, an adaptation period precedes the steady state of balancing behaviour. Little information is available on the modulation of adaptation by vision and perturbation frequency. Moreover, performance of supra-postural tasks may modulate adaptation in as yet unidentified way...
Article
Background Balance problems in Parkinson’s Disease (PD) require appropriate evaluation. While the Mini-BESTest is commonly used to assess dynamic balance, some of its psychometric properties have not yet been addressed. Research question What is the responsiveness and the Minimal Clinically Important Difference (MCID) of the Mini-BESTest in patien...
Article
Purpose: Walking is an attention-demanding task that affects and is affected by cognitive performance. Since treadmill walking (TW) assists gait automaticity, we have hypothesized that TW affects cognitive performance to a smaller extent than overground walking (OW). Methods: Thirty young adults were recruited. Each subject walked overground ove...
Article
Full-text available
This short narrative review article moves from early papers that described the behaviour of healthy subjects balancing on a motorized platform continuously translating in the antero-posterior direction. Research from the laboratories of two of the authors and related investigations on dynamic balancing behaviour are briefly summarized. More recent...
Article
Full-text available
Vision favors head stabilization in space during perturbations of standing balance. This is particularly obvious under conditions of continuous predictable perturbations as during sinusoidal antero-posterior (A-P) translations of the supporting platform. We tested here the hypothesis that under this condition the head can instead undergo large A-P...
Article
Full-text available
In this review, we briefly recall the fundamental processes allowing us to change locomotion trajectory and keep walking along a curved path and provide a review of contemporary literature on turning in older adults and people with Parkinson's Disease (PD). The first part briefly summarizes the way the body exploits the physical laws to produce a c...
Article
Full-text available
Unilateral axial muscle vibration, eliciting a proprioceptive volley, is known to incite steering behavior. Whole-body rotation while stepping in place also occurs as an after-effect of stepping on a circular treadmill (podokinetic after-rotation, PKAR). Here, we tested the hypothesis that PKAR is modulated by axial muscle vibration. If both phenom...
Article
Background: Under static conditions, the objective and subjective measures of postural stability correlate well. However, age-related changes in postural control and task-related anxiety may modify the relationship between these subjective and objective measures. Ultimately, patients' symptoms represent subjective reports, thus understanding this...
Article
Full-text available
Subjects with low vision often use a cane when standing and walking autonomously in everyday life. One aim of this study was to assess differences in the body stabilizing effect produced by the contact of the cane with the ground or by the fingertip touch of a firm surface. Another aim was to estimate the promptness of balance stabilization (or des...
Article
Full-text available
Background Several patients with Parkinson´s disease (PD) can walk normally along straight trajectories, and impairment in their stride length and cadence may not be easily discernible. Do obvious abnormalities occur in these high-functioning patients when more challenging trajectories are travelled, such as circular paths, which normally implicate...
Article
Objectives: Several studies have investigated the effects of focal vibration on muscle strength. Non-univocal results have been found. The aim of this study was to evaluate the effect of prolonged focal vibratory stimulation on quadriceps muscle strength at two different frequencies (80 and 300 Hz). The evaluation of muscle strength was performed...
Article
Full-text available
We hypothesised that rehabilitation specifically addressing balance in Parkinson’s disease patients might improve not only balance but locomotion as well. Two balance-training protocols (standing on a moving platform and traditional balance exercises) were assessed by assigning patients to two groups (Platform, n=15 , and Exercises, n=17 ). The pla...
Article
Purpose Today's orthotics should be designed to apply the external orthosis moment to the knee joint solely during the stance phase instead of the entire gait cycle. The aim of this study was to validate the reliability of a simple device for measuring forces at the leg–orthosis interface and describe the behavior of an innovating dynamic unloader...
Article
Full-text available
Haptic cues are important for balance. Knowledge of the temporal features of their effect may be crucial for the design of neural prostheses. Touching a stable surface with a fingertip reduces body sway in standing subjects eyes closed (EC), and removal of haptic cue reinstates a large sway pattern. Changes in sway occur rapidly on changing haptic...
Article
Study objective: To assess whether gait abnormalities in COPD depend on mere impairment of respiratory function. Methods: In 40 patients with COPD at different GOLD stages and 28 controls, we evaluated: forced expiratory volume in 1s (FEV1); partial pressure of oxygen; Mini-Mental State Examination (MMSE); dynamic balance through the Mini-BESTes...
Article
Full-text available
Training subjects to step-in-place eyes open on a rotating platform while maintaining a fixed body orientation in space [podokinetic stimulation (PKS)] produces a posteffect consisting in inadvertent turning around while stepping-in-place eyes closed [podokinetic after-rotation (PKAR)]. Since the rationale for rehabilitation of curved walking in Pa...
Article
Full-text available
Balance stability correlates with cerebellar vermis volume. Furthermore, the cerebellum is involved in precise timing of motor processes by fine-tuning the sensorimotor integration. We tested the hypothesis that any cerebellar action in stance control and in timing of visuomotor integration for balance is impaired by continuous theta-burst stimulat...
Article
The aim of this study was to develop a methodology based on muscle synergies to investigate whether rectilinear and curvilinear walking shared the same neuro-motor organization, and how this organization was fine-tuned by the walking condition. Thirteen healthy subjects walked on rectilinear and curvilinear paths. Electromyographic data from thirte...
Article
Aim of this study was to test the effects of a concurrent cognitive task on the promptness of the sensorimotor integration and reweighting processes following addition and withdrawal of vision. Fourteen subjects stood in tandem while vision was passively added and removed. Subjects performed a cognitive task, consisting of counting backwards in ste...
Article
Introduction L’initiation de la marche nécessite un déplacement du centre de pression (CP) vers la jambe pendulaire pour déplacer le centre de gravité (CG) vers l’autre jambe (Brenière et Do, 1986). L’ajustement postural anticipateur (APA) permet de générer les conditions favorables à l’exécution du pas. D’après Winter (1995), l’activation des musc...
Article
Significance statement: We mapped the neuronal population responses in the hindlimb motor cortex to hindlimb kinematics and hindlimb muscle synergies across a spectrum of natural locomotion behaviors. Robust task-specific neuronal population responses revealed that the rat motor cortex displays similar modulation as other mammals during locomotion...
Article
Objective The critical action for gait initiation involves lifting of the swing leg while shifting the centre of mass (CoM) of the body over the stance leg. This action is made possible by the initial displacement of the centre of pressure (CoP) in the direction of the swing leg. We hypothesised that the CoP displacement requires a coordinated acti...
Article
Objective Turning around while stepping in place can be produced voluntarily. One way of producing involuntary turning around while stepping-in-place eyes closed is by training subjects onto a rotating platform while stepping-in-place and maintaining a fixed body orientation in space. This task produces a post-effect called “podokinetic after-rotat...
Article
Full-text available
Gait initiation (GI) involves passing from bipedal to unipedal stance. It requires a rapid movement of the center of foot pressure (CoP) towards the future swing foot and of the center of mass (CoM) in the direction of the stance foot prior to the incoming step. This anticipatory postural adjustment (APA) allows disengaging the swing leg from the g...
Article
Full-text available
Motor adaptation due to task practice implies a gradual shift from deliberate control of behavior to automatic processing, which is less resource- and effort-demanding. This is true both for deliberate aiming movements and for more stereotyped movements such as locomotion and equilibrium maintenance. Balance control under persisting critical condit...
Article
Background The effect of neck proprioception was tested on self-motion perception elicited by asymmetric whole-body yaw oscillations in the dark, in the hypothesis that intense and repetitive activation of neck proprioceptive system induces immediate and sustained effects on vestibular-dependent motion perception. Methods Oscillation consisted of...
Article
Full-text available
Training subjects to step in place on a rotating platform while maintaining a fixed body orientation in space produces a posteffect consisting in inadvertent turning around while stepping in place eyes closed (podokinetic after-rotation, PKAR). We tested the hypothesis that voluntary turning around while stepping in place also produces a posteffect...
Article
Purpose: Cycle ergometer training improves gait in the elderly, but its effect in patients with Parkinson's disease (PD) is not completely known. Methods: Twenty-nine PD inpatients were randomized to treadmill (n = 13, PD-T) or cycle ergometer (n = 16, PD-C) training for 3 weeks, 1 hour/day. Outcome measures were distance travelled during the 6-...
Article
Full-text available
We investigated the integration time of haptic and visual input and their interaction during stance stabilization. Eleven subjects performed four tandem-stance conditions (60 trials each). Vision, touch, both vision and touch were added and withdrawn. Further, vision was replaced with touch and vice versa. Body sway, tibialis anterior, and peroneus...
Article
Full-text available
To show that neck proprioceptive input can induce long-term effects on vestibular-dependent self-motion perception. Motion perception was assessed by measuring the subject's error in tracking in the dark the remembered position of a fixed target during whole-body yaw asymmetric rotation of a supporting platform, consisting in a fast rightward half-...
Article
Full-text available
Turning involves complex reorientation of the body and is accompanied by asymmetric motion of the lower limbs. We investigated the distribution of the forces under the two feet, and its relation to the trajectory features and body medio-lateral displacement during curved walking. Twenty-six healthy young participants walked under three different ra...
Article
Full-text available
This review article deals with some effects of neck muscle proprioception on human balance, gait trajectory, subjective straight-ahead (SSA), and self-motion perception. These effects are easily observed during neck muscle vibration, a strong stimulus for the spindle primary afferent fibers. We first remind the early findings on human balance, gait...
Article
Full-text available
Maintaining equilibrium is basically a sensorimotor integration task. The central nervous system (CNS) continually and selectively weights and rapidly integrates sensory inputs from multiple sources, and coordinates multiple outputs. The weighting process is based on the availability and accuracy of afferent signals at a given instant, on the time-...
Article
Full-text available
Background Previous studies have assessed reliability of insole technology for evaluating foot pressure distribution during linear walking. Since in natural motion straight walking is intermingled with turns, we determined the test-retest reliability of insole assessment for curved as well as linear trajectories, and estimated the minimum number of...
Article
Full-text available
In the single-stance phase of gait, gravity acting on the center of mass (CoM) causes a disequilibrium torque, which generates propulsive force. Triceps surae activity resists gravity by restraining forward tibial rotation thereby tuning CoM momentum. We hypothesized that time and amplitude modulation of triceps surae activity determines the kinema...
Article
Purpose: To investigate whether the response to rehabilitation differs between patients with abnormalities of balance and gait due to vascular or to degenerative cerebellar disease. Methods: We reviewed the outcome of 27 cerebellar patients. Fourteen patients with vascular and 13 with degenerative cerebellar disease underwent a 3-week inpatient...
Article
To compare the gait pattern in patients affected by different types of neuropathy. We recruited healthy subjects (HS, n=38), patients with Charcot-Marie-Tooth disease type 1A (CMT1A) (n=10) and patients with diabetic neuropathy (DNP) (n=12). Neuropathy impairment score and neuropathy score were assessed. Body sway during quiet stance, and spatio-te...
Article
Full-text available
Despite numerous studies addressing the issue, it remains unclear whether the triceps surae muscle group generates forward propulsive force during gait, commonly identified as 'push-off'. In order to challenge the push-off postulate, one must probe the effect of varying the propulsive force while annulling the effect of the progression velocity. Th...
Article
Full-text available
Self-motion perception and the vestibulo-ocular reflex (VOR) were investigated in healthy subjects during asymmetric whole-body yaw plane oscillations while standing on a platform in the dark. Platform oscillation consisted of two half-sinusoidal cycles of the same amplitude (40°) but different duration, featuring a fast (FHC) and a slow half-cycle...
Article
Objectives: We investigated the pattern of activity of the tibialis anterior (TA), soleus (SOL) and peroneus longus (PER) muscles of both legs during tandem stance, in order to highlight their respective role in maintaining balance. Methods: Twelve young healthy subjects were asked to stand with feet in line for successive 15s-epochs, on a dynam...
Article
Objectives Vision and touch rapidly lead to postural stabilization in sighted subjects. Is touch-induced stabilization more rapid in blind than in sighted subjects, owing to cross-modal reorganization of function in the blind? Methods We estimated the time-period elapsing from onset of availabilityofhapticsupportto onset of lateral stabilization i...
Article
Early Parkinson's disease (PD), in which the motor disorder is mostly unilateral, allows to investigate the presence of side-related pathophysiological changes in the responses to balance perturbations prior to any confounding effect of therapy. These patients offer the possibility of answering the question whether the initial abnormalities affect...
Article
Fifteen patients with Charcot-Marie-Tooth type 1A (CMT1A) disease and 46 normal controls were studied. In the patients, leg muscle strength, touch-pressure, vibration and joint position sense were reduced; lower limb ten-don reflexes were absent in 12 or markedly decreased. Motor and sensory conduction velocity (CV) of leg nerves was either reduced...
Article
Vision (V) and touch (T) help stabilize our standing body, but little is known on the time-interval necessary for the brain to process the sensory inflow (or its removal) and exploit the new information (or counteract its removal). We have estimated the latency of onset and the time-course of the changes in postural control mode following addition...
Article
In the single-stance phase of gait, gravity acting on the center of mass (CoM) causes a disequilibrium torque, which generates propulsive force. Triceps surae activity resists gravity by restraining forward tibial rotation thereby tuning CoM momentum. We hypothesized that time and amplitude modulation of triceps surae activity determines the kinema...
Article
Sudden addition or removal of visual information can be particularly critical to balance control. The promptness of adaptation of stance control mechanisms is quantified by the latency at which body oscillation and postural muscle activity vary after a shift in visual condition. In the present study, volunteers stood on a force platform with feet p...
Article
Self-motion perception and vestibulo-ocular reflex (VOR) were studied during whole body yaw rotation in the dark at different static head positions. Rotations consisted of four cycles of symmetric sinusoidal and asymmetric oscillations. Self-motion perception was evaluated by measuring the ability of subjects to manually track a static remembered t...
Article
We investigated the adaptation of balancing behavior during a continuous, predictable perturbation of stance consisting of 3-min backward and forward horizontal sinusoidal oscillations of the support base. Two visual conditions (eyes-open, EO; eyes-closed, EC) and two oscillation frequencies (LF, 0.2 Hz; HF, 0.6 Hz) were used. Center of Mass (CoM)...
Article
To assess the efficacy of a balance rehabilitation treatment by using both a powered platform on which subjects stand and specific physical exercises (EXs). Crossover trial. Physical and rehabilitation medicine department in Italy. Patients (N=33) with balance disorders (14 vestibular origin, 19 peripheral neuropathy origin). Patients underwent pow...
Article
Curved walking requires complex adaptations, including shift of body weight to counteract the ensuing centrifugal force, and the production of strides of different length between legs. We hypothesized that gait capacities would be more stressed in hemiparetic patients than in healthy subjects when walking along curved, compared with straight, traje...
Article
This review addresses the issue whether instrumental evaluations of balance may be helpful in orienting the clinical decision regarding balance rehabilitation. The aptitude of instrumental assessment of balance in supporting decision making in patients with balance disorders connected with ageing and with neurological diseases is considered. Among...
Article
During the administration of timed bilateral alternate vibration to homonymous leg or trunk muscles during quiet upright stance, Parkinsonian (PD) patients undergo cyclic antero-posterior and medio-lateral transfers of the centre of foot pressure. This event might be potentially exploited for improving gait in these patients. Here, we tested this h...
Article
Balance control depends on the interaction of multiple inputs originating from different sensory systems. Here, we investigated the effect on quiet human stance of changing the visual condition prior to a proprioceptive perturbation produced by vibration of dorsal neck muscles. In complete absence of visual references, the amplitude of the postural...