Michela Goffredo

Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Pisana · Neuromotor Rehabilitation Unit

After a neurological injury, neurorehabilitation aims to restore sensorimotor function of patients. Technological assessments can provide high-quality data on a patient’s performance and support clinical decision making towards the most appropriate therapy. In this study, the ArmeoPower, a robotic exoskeleton for the upper extremities, was used to...

Postamputation pain is a common condition in patients with lower limb amputation (LLA), which compromises amputees’ rehabilitation, use of the prosthesis, and quality of life. The aim of our study was to investigate the prevalence of phantom limb pain (PLP), residual limb pain (RLP), or both types of pain among individuals with LLA, and to identify...

Background Exercise has been proposed as the “Universal Prescription for Parkinson’s Disease”; however, the specificity of exercise dose in terms of frequency, intensity, duration, and type to be prescribed remains to be elucidated. The 2018 US updated guidelines and WHO Guidelines on Physical Activity and Sedentary Behavior recommend older adults...

Background/Objectives: This study is based on data collected from a medical health record review to assess whether multidisciplinary intensive rehabilitation treatment in Parkinson’s disease (PD) patients can improve global cognitive functioning and executive functions. Methods: The data related to PD patients were extrapolated from a clinical data...

Stroke, a leading cause of long-term disability worldwide, manifests as motor, speech language, and cognitive impairments, necessitating customized rehabilitation strategies. In this context, telerehabilitation (TR) strategies have emerged as promising solutions. In a multi-center longitudinal pilot study, we explored the effects of a multi-domain...

Background: The implementation of regular prolonged, and effective rehabilitation in people with Parkinson's disease is essential for ensuring a good quality of life. However, the continuity of rehabilitation care may find barriers related to economic, geographic, and social issues. In these scenarios, telerehabilitation could be a possible soluti...

The modified Barthel Index (mBI) is a well-established patient-centered outcome measure commonly administrated in rehabilitation settings to evaluate the functional status of patients at admission and discharge. This study aimed to detect which mBI items collected on admission can predict the total mBI at discharge from first inpatient rehabilitati...

Background: People with chronic neurological diseases, such as Parkinson's Disease (PD) and Multiple Sclerosis (MS), often present postural disorders and a high risk of falling. When difficulties in achieving outpatient rehabilitation services occur, a solution to guarantee the continuity of care may be telerehabilitation. This study intends to ex...

Background: The efficacy of upper limb (UL) robot-assisted therapy (RAT) on functional improvement after stroke remains unclear. However, recently published randomized controlled trials have supported its potential benefits in enhancing the activities of daily living, arm and hand function, and muscle strength. Task-specific and high-intensity exe...

Background: In the last few years, new noninvasive strategies have emerged as rehabilitative treatments for patients with stroke. Action observation treatment (AOT) is a rehabilitation approach based on the properties of the mirror neuron system with a positive impact on modifying cortical activation patterns and improving the upper limb kinematic...

Advance assessment of the potential functional improvement of patients undergoing a rehabilitation program is crucial in developing precision medicine tools and patient-oriented rehabilitation programs, as well as in better allocating resources in hospitals. In this work, we propose a novel approach to this problem using machine learning algorithms...

Background The Shoulder and Pain Disability Index (SPADI) is a widely used outcome measure. The aim of this study is to explore the reliability and validity of SPADI in a sample of patients with idiopathic frozen shoulder. Methods The SPADI was administered to 124 patients with idiopathic frozen shoulder. A sub-group of 29 patients were retested a...

Idiopathic chronic neck pain is a highly disabling musculoskeletal condition. Immersive virtual reality shows a promising efficacy in the treatment of chronic cervical pain through the mechanism of distraction from the pain. This case report describes the management of C.F., a fifty-seven-year-old woman, who suffered from neck pain for fifteen mont...

Background: Although stroke survivors can benefit from robotic gait rehabilitation, stationary robot-assisted gait training needs further investigation. In this paper, we investigated the efficacy of this approach (with an exoskeleton or an end-effector robot) in comparison to the conventional overground gait training in subacute stroke survivors....

Background: The literature on upper limb robot-assisted therapy showed that robot-measured metrics can simultaneously predict registered clinical outcomes. However, only a limited number of studies correlated pre-treatment kinematics with discharge motor recovery. Given the importance of predicting rehabilitation outcomes for optimizing physical th...

BACKGROUND In the last few years, new noninvasive strategies have emerged as rehabilitative treatments for patients with stroke. Action observation treatment (AOT) is a rehabilitation approach based on the properties of the mirror neuron system with a positive impact on modifying cortical activation patterns and improving the upper limb kinematics....

Background The Action Observation Therapy (AOT) is a well-established post-stroke rehabilitation treatment based on the theoretical framework of the Mirror Neuron System (MNS) activation. However, AOT protocols are still heterogeneous in terms of video contents of observed actions. Objective The aim of this study was to analyze electroencephalogra...

(1) Background: In neurorehabilitation, Wearable Powered Exoskeletons (WPEs) enable intensive gait training even in individuals who are unable to maintain an upright position. The importance of WPEs is not only related to their impact on walking recovery, but also to the possibility of using them as assistive technology; however, WPE-assisted commu...

Background: In 2020, the world was surprised by the spread and mass contamination of the new Coronavirus (COVID-19). COVID-19 produces symptoms ranging from a common cold to severe symptoms that can lead to death. Several strategies have been implemented to improve the well-being of patients during their hospitalization, and virtual reality (VR) h...

Background: The Shoulder and Pain Disability Index (SPADI) is a broadly used outcome measure. The aim of this study is to explore its psychometric properties in a sample of idiopathic frozen shoulder patients. Methods: The SPADI was administered to 124 patients with idiopathic frozen shoulder. The SPADI scores were compared with Disabilities of the...

By stating “All people, everywhere, deserve the right care, right in their community,” [21] . the World Health Organization sets, in an exhortative way, the fundamental assumption for primary health care. Under these premises, we developed an augmented and extended approach to a home-rehabilitation system to provide intensive care to chronic stro...

Background: The efficacy of upper-limb Robot-assisted Therapy (ulRT) in stroke subjects is well-established. The robot-measured kinematic data can assess the biomechanical changes induced by ulRT and the progress of patient over time. However, literature on the analysis of pre-treatment kinematic parameters as predictive biomarkers of upper limb re...

In the last two decades, a growing interest has been focused on gait and balance robot-assisted rehabilitation in children with neurological disabilities. Robotic devices allow the implementation of intensive, task-specific training fostering functional recovery and neuroplasticity phenomena. However, limited attention has been paid to the protocol...

Background and objective Multiple sclerosis is an inflammatory and neurodegenerative disorder of the central nervous system that can lead to severe motor disability. The aim of this study was to verify the health care effects of an integrated telerehabilitation approach involving dual-domains (motor and cognitive) in people with multiple sclerosis...

Background: Virtual reality (VR) and serious games (SGs) are widespread in rehabilitation for many orthopaedic and neurological diseases. However, few studies have addressed the effects of rehabilitation with VR-based SGs on clinical, gait, and postural outcomes in individuals with total knee replacement (TKR). Objective: The primary objective w...

In rehabilitation, the upper limb function is generally assessed using clinical scales and functional motor tests. Although the Box and Block Test (BBT) is commonly used for its simplicity and ease of execution, it does not provide a quantitative measure of movement quality. This study proposes the integration of an ecological Inertial Measurement...

Introduction: The rapid development of electromechanical and robotic devices has profoundly influenced neurorehabilitation. Growth in the scientific and technological aspects thereof is crucial for increasing the number of newly developed devices, and clinicians have welcomed such growth with enthusiasm. Nevertheless, improving the standard for th...

Background: Several instruments have been proposed to investigate restricted, repetitive behaviors (RRBs) in individuals with Autism Spectrum Disorder (ASD). Systematic video observations may overcome questionnaire and interview limitations to investigate RRBs. This study aimed to analyze stereotypic patterns through video recordings and to determ...

Background: Overground Robot-Assisted Gait Training (o-RAGT) appears to be a promising stroke rehabilitation in terms of clinical outcomes. The literature on surface ElectroMyoGraphy (sEMG) assessment in o-RAGT is limited. This paper aimed to assess muscle activation patterns with sEMG in subjects subacute post stroke after training with o-RAGT an...

Lower limb amputation (LLA) is still a health issue requiring rehabilitation and long-term care even in industrial societies. Several studies on subjects with LLA have been focused on the efficacy of rehabilitation and factors influencing the use of prosthesis. However, literature data on the recovery of ability to walk outdoors, and thus to partic...

Background: Overground Robot-Assisted Gait Training (o-RAGT) provides intensive gait rehabilitation. This study investigated the efficacy of o-RAGT in subacute stroke subjects, compared to conventional gait training. Methods: A multicenter randomized controlled trial was conducted on 75 subacute stroke subjects (38 in the Experimental Group (EG)...

Background: The limitation to the use of ElectroMyoGraphy (sEMG) in rehabilitation services is in contrast with its potential diagnostic capacity for rational planning and monitoring of the rehabilitation treatments, especially the overground Robot-Assisted Gait Training (o-RAGT). Objective: To assess the barriers to the implementation of a sEMG-ba...

Objective: Functional outcome represents the most central objective of rehabilitation programs. Understanding which factors could affect functional status at discharge is crucial for the planning of appropriate treatments in both neurological and orthopedic patients. The aim of this study was to investigate which clinical and demographic variables...

Background: Subjects with Down Syndrome (DS) are characterized by specific physiological alterations, including musculoskeletal abnormalities. Flat Foot (FF), caused by hypotonia and ligament laxity, represents one of the most common disabling disorders in this population. Conservative treatments promote the use of orthopaedic insoles and plantar s...

Background: Intensive Rehabilitation Centres, known in Italy as "code 56", admit patients who need to recover from an acute episode. Different Rehabilitation Impact Indices have been proposed as composite rehabilitation outcomes measuring the rate of improvement due to a rehabilitation program. The most widely employed measure the performance of A...

In this data article, we present a dataset made up of personal, social and clinical records related to patients undergoing a rehabilitation program. Data refers to records registered in the ”Acceptance/Discharge Report for the rehabilitation area (ADR) which implements the Italian law (DGR 731/2005) and refer to hospitalization at the rehabilitatio...

Background: Wearable powered exoskeletons provide intensive overground gait training with patient's active participation: these features promote a successful active motor relearning of ambulation in stroke survivors. Aim: The aim of this study was to investigate the feasibility and the clinical effects of an overground exoskeleton-assisted gait...

Background: Upper limb robot-assisted therapy (RT) provides intensive, repetitive, and task-specific treatment, and its efficacy for stroke survivors is well established in literature. Biomechanical data from robotic devices has been widely employed for patient's assessment, but rarely it has been analysed for tracking patient progress during RT....

BACKGROUND: Parkinson's Disease (PD) is a progressive neurological disorder characterized, among other symptoms, by a significant modified posture. Although a detailed assessment of postural abnormalities can be performed using quantitative movement analysis, the output of such procedure might be not suitable for a routine clinical use due to its i...

Background: End-effector robots allow intensive gait training in stroke subjects and promote a successful rehabilitation. A comparison between conventional and end-effector Robot-Assisted Gait Training (RAGT) in subacute stroke patients is needed. Objective: To investigate the efficacy of end-effector RAGT in subacute stroke patients. Methods:...

INTRODUCTION Knee osteoarthritis patients lead to balance deficits and increased Centre Of Pressure (COP)variation, even after Total Knee Replacement (TKR) [1]. A study on Virtual Reality Rehabilitation (VRR) showed its efficacy in improvingmotor skills, compared to traditional therapy[2], but no evidence is available on postural sway. This pilot s...

Background: Although gait disorders strongly contribute to perceived disability in people with Parkinson's disease, clinical trials have failed to identify which task-oriented gait training method can provide the best benefit. Freezing of gait remains one of the least investigated and most troublesome symptoms. Objective: We aimed to compare the...

Background: Despite the importance of walking recovery in real life contexts, only 7% of stroke survivors at discharge from neuro-rehabilitation units recover independent walking in the community. However, studies on outcome indicators of walking ability restoration following stroke rarely regard the community ambulation. Aim: The aim of the stu...

Objective. Despite gait disorders strongly contribute to perceived disability in people with Parkinson’s Disease, clinical trials fail to identify which of the different taskoriented gait training can provide a greater benefit. However, freezing of gait stays one of the least investigated and most troublesome symptoms to face. The study’s main aim...

Gait recovery is one of the main goals of post-stroke rehabilitation and Robot-Assisted Gait Training (RAGT) has shown positive outcomes. However, there is a lack of studies in the literature comparing the effects of different devices. This paper aims to study the effects, in terms of clinical and gait outcomes, of treadmill-based and overground RA...

This study aims to analyse the long-term effects (6 months follow-up) of upper limb Robot-assisted Therapy (RT) compared to Traditional physical Therapy (TT), in subacute stroke patients. Although the literature on upper-limb rehabilitation with robots shows increasing evidence of its effectiveness in stroke survivors, the length of time for which...

Introduction/Background Gait recovery in post-stroke patients is one of the main goals of post-stroke rehabilitation. Wearable over-ground powered exoskeletons allow individuals with gait dysfunctions to perform an over-ground gait training. Literature lacks of clinical studies on exoskeleton-supported gait rehabilitation in stroke patients and on...

Background Upper limb recovery is one of the main goals of post-stroke rehabilitation due to its importance for autonomy in Activities of Daily Living (ADL). Although the efficacy of upper limb Robot-assisted Therapy (RT) is well established in literature, the impact of the initial status of the patient on the effects of RT is still understudied. T...

Database (n = 60). Original data. (XLSX)

Official documentation Italian Data Protection Authority ITA. Italian version of the Data Protection Authority (01 March 2012, Official Gazette No.72 of March 26, 2012). (PDF)

Summary Official documentation Italian Data Protection Authority ENG. English version of the Data Protection Authority (01 March 2012, Official Gazette No.72 of March 26, 2012). (PDF)

INTRODUCTION Impaired proprioceptive accuracy could be a risk factor for progression of gait limitations in knee osteoarthritis patients, even after the Total Knee Replacement (TKR) [1]. Recent studies on Virtual Reality (VR) in rehabilitation show its efficacy in restoring proprioceptive capacity, postural control and gait [2]. However, literature...

Reading-writing learning is the result of the interaction between individual cognitive maturation and standard and informal educational experiences solicited by the environment. A relationship between phonologic awareness and reading-writing learning has been hypothesized; thus, it is important studying the development of the meta-phonologic abilit...

A method for the analysis of Electrically Evoked Auditory Brainstem Responses (EABR) in subjects with cochlear implants is presented. The extraction of the III and V waves, which correspond to the cochlear nuclei and the inferior colliculi respectively, has been achieved with a template-based approach based on the Dynamic-Time-Warping algorithm. Ex...

We present a novel system for the markerless shape analysis of bicipital contraction. The study of the soft tissue deformation due to the biceps muscular activity is achieved by analysing video sequences obtained from a RGB-D sensor and applying geometric morphometrics and parallel transport algorithms. In particular, we tested for differences betw...

Literature has shown the importance of studying alertness and attention in drivers by means of electroencephalographic (EEG) indexes. Moreover, many kinematic parameters can be used to give information about the safety of the road depending on the traffic flow. To our knowledge, no study, has focused the attention on the relationship between alertn...

The aim of this study is to introduce a new platform, called En Plein, for the kinesthetic practice of phonological skills by preschool children and to examine its feasibility in combination with more traditional teaching methods. The rationale is that the manipulation of structural phonological units is important to train the necessary prerequisit...

The aim of this study is to assess if predictive information can be used to implement visual biofeedback (VBF) systems to improve postural performance. The Centre of Pressure (CoP) coordinates, extracted directly from a force plate, are used to implement two different realtime VBF, which respectively use current CoP coordinates (VBFreal-time) and p...

Purpose – A novel model of the upper arm under transcutaneous electrical stimulation with multi-pad electrodes is presented and experimentally validated. The model aims at simulating and analysing the effects of surface electrical stimulation on biceps brachii. The paper aims to discuss these issues. Design/methodology/approach – Both the passive...

Several studies have showed the positive effect that real-time presentation of centre of pressure (COP) has on stability. Typically the COP position is depicted in real-time on the screen and it is required that the participant uses this additional information to regulate his/her postural sway. In order to perform the motor task, it requires an att...

Several studies have shown the effect of visual biofeedback (VBF) on postural control with real-time presentation of centre of pressure (CoP). However, up to now no study has yet focussed on the effect that a predictive VBF could have on postural control. The aim of this study is thus to determine whether the Time-to-Boundary function (TtB) could b...

Nowadays, international collaboration and teamwork are fundamental skills in modern project development. Therefore, it is important to prepare university students to handle this working approach and to have this mindset. However, these skills are neglected in the curricula of most universities. The aim of the Erasmus Intensive Programme TrabHCI (Te...

A system for practicing 3D reaching movements in a visual augmented reality is proposed. Two visual feedback modalities are compared in order to understand how depth information can be more easily learned by subjects performing the tasks. Results on 6 subjects show that the synthetic object representation influences the task performance and size fe...

The general aim of this research is to build up a haptic system for rehabilitation in motor control of hand, intended as upper limb proximal extremity. The system is made of a commercial haptic interface called “Falcon”, by Novint, connected to a PC. Healthy subjects were requested to perform exercises moving the handle of the interface. Data on ha...

This communication introduces a novel approach for quantitatively evaluating the role of color space decomposition in digital nailfold capillaroscopy analysis. It is clinically recognized that any alterations of the capillary pattern, at the periungual skin region, are directly related to dermatologic and rheumatic diseases. The proposed algorithm...

In the context of BCI-driven electrical stimulation for tremor suppression, a model of the upper limb is presented. The model simulates arm behaviour in terms of nerve recruitment and muscle contraction when current pulses are applied on the skin surface. Tests with array electrodes show that the proposed arm model is a good tool for selecting the...