Marina Ramella

• PM&R
• Medical Doctor at Fondazione Don Carlo Gnocchi

This perspective article addresses the critical and up-to-date problem of task-specific musician’s dystonia (MD) from both theoretical and practical perspectives. Theoretically, MD is explored as a result of impaired sensorimotor interplay across different brain circuits, supported by the most frequently cited scientific evidence—each referenced do...

(1) Background: Telemedicine is a vital tool for enhancing healthcare accessibility and outcomes at reduced costs. This study aimed to assess the usability of the Maia Connected Care telemedicine platform for managing spasticity in patients receiving botulinum toxin type-A, focusing on the perspectives of Italian physiatrists with expertise in this...

Background: Despite the widely recognised benefits of assistive technology (AT) in everyday life, AT abandonment rate due to unmet user needs or expectations is high. World Health Organisation emphasised the importance of evaluating AT outcomes as a top research priority, but comprehensive approaches to assess users' needs and AT impact are still...

Background Several earlier studies showed a female predominance in idiopathic adult-onset dystonia (IAOD) affecting the craniocervical area and a male preponderance in limb dystonia. However, sex-related differences may result from bias inherent to study design. Moreover, information is lacking on whether sex-related differences exist in expressing...

This paper describes the results of using a parametric design platform to configure and 3D print assistive devices (AD) and how they compare with a commercial counterpart (CommAD). The configurable AD (ConfAD) was a fork/spoon holder. Five subjects with cerebral palsy participated in the study and each had a ConfAD made to fit their dominant hand....

Purpose: Digital fabrication, like 3D printing, is a new opportunity for rehabilitation professionals to produce customized assistive devices. It allows for empowerment and collaboration in device procurement, but practical implementations are scarcely described. We describe the workflow, discuss feasibility and propose directions for future work....

This study aims to test the construct validity and reliability of the Quebec User Evaluation of Satisfaction with assistive Technology 2.0 (QUEST)–device, an eight-item questionnaire for measuring satisfaction with assistive devices. We collected 250 questionnaires from 79 patients and 32 caregivers. One QUEST was completed for each assistive devic...

The World Health Organization has defined assistive technologies (AT) as the fourth pillar of global health and supported identifying AT outcomes among the five top priorities in AT research. In this framework, the research study OMAT (Outcomes of Mobility Assistive Technology in rehabilitation pathways) was developed by Fondazione Don Carlo Gnocch...

After an initial lock-down phase in 2020, the measures subsequently adopted in Italy to limit the spread of the SARS-CoV-2 virus made it impossible for people residing in nursing homes to have contacts with the outside world. Here we want to report how the DAT (Home automation, Assistive Technology and Occupational Therapy) service of Fondazione Do...

Background Musician's Focal Dystonia (MFD) is the most common adult-onset dystonia involving the hand and can cause a professional music career to end. MFD affects about 1% of professional musicians and is a challenging clinical condition to treat. This work aimed to validate the Technical Ability and Performing Scale (TAPS), a newly-developed pati...

Smoothness (i.e. non-intermittency) of movement is a clinically important property of the voluntary movement with accuracy and proper speed. Resting head position and head voluntary movements are impaired in cervical dystonia. The current work aims to evaluate if the smoothness of voluntary head rotations is reduced in this disease. Twenty-six cerv...

Background: The International Classification of Functioning, Disability and Health (ICF) parsimonious Generic set can provide identification of functional profiles and recovery after rehabilitation in persons post stroke. Aim: To explore concurrent validity of the ICF Generic-6_Functioning score with the Barthel Index (BI) and responsiveness aft...

Background Adult-onset focal dystonia can spread to involve one, or less frequently, two additional body regions. Spread of focal dystonia to a third body site is not fully characterized. Materials and methods We retrospectively analyzed data from the Italian Dystonia Registry, enrolling patients with segmental/multifocal dystonia involving at lea...

In literature there is a growing evidence that in cervical dystonia (CD) rehabilitation, both in person and remotely, is an efficacious add on treatment to botulinum neurotoxins (BoNT) injections, but there is no consensus about protocols. We present here two rehabilitation programs implemented by our neuro‐rehabilitative multidisciplinary team. Th...

Purpose: This study aimed to assess the effectiveness of the "modified graded motor imagery" (mGMI) protocol as a rehabilitative treatment of musician's focal dystonia (MFD). Methods: Six musicians with MFD (age 43.83±17.24 yrs) performed the home-based mGMI protocol (laterality training, imagined hand movements and visual mirror feedback) once...

Background Idiopathic cervical dystonia (ICD) is a focal dystonia affecting neck muscles. Botulinum neurotoxin (BoNT) is the first-line treatment of ICD and different physical therapies (including exercise) are often proposed as adjunct treatments. However, the actual effectiveness of exercise in ICD is unclear. The aim of the current work is to as...

Cervical dystonia (CD) is characterized by involuntary, abnormal movements and postures of the head and neck with pain and reduced quality of life. Current views are that the pathophysiology is “maladaptive plasticity” with a faulty sensory-motor integration. Efficacy of BoNT has been demonstrated and in literature rehabilitative approaches has bee...

The aim of the present case report is to describe a new rehabilitation approach for traumatic brain injury (TBI). TBI is a heterogeneous disorder that could be associated with cognitive and behavioral impairments. The clinical complexity of TBI patients requires a specialized and integrated approach that involves several rehabilitation experts (Maz...

Prolonged and incorrect postures are one of the main risk factors for the development of musculoskeletal pathologies. The aims of this study were to study the prevalence of incorrect postures among conservatory students; to identify if the use of an asymmetric instrument represents a risk factor for developing postural disorders; and to investigate...

Focal dystonia (FD) is a movement disorder that frequently affects instrumental musicians. Distinguishing between primary dystonic movement and secondary compensatory abnormal movement is crucial for the correct treatment planning in FD. Such distinction is complex in musicians because of the complexity, speed, and smallness of involved movement. T...

Epidermolysis bullosa (EB) comprises a group of illnesses genetically determined and characterized by the presence of bullous skin lesions which develop spontaneously or after even slight trauma. Epidermolysys bullosa dystrophica (EBD) has variations with autosomal recessive (EBDR) and variations with autosomal dominant transmission, but in both ty...

Reconstruction of complex lesions of the third distal of the leg and foot has always been one of the most arduous. The algorithm for selecting the flap is often difficult and depends on many factors. In recent years, inverted circle island flaps in particular have been added to the wide array of available solutions. Loco-regional flaps are restrict...