Simona Ferrante

• PhD in Bioengineering
• Professor (Associate) at Politecnico di Milano

Background Spinal cord injury (SCI) severely affects physical function, leading to muscle atrophy and reduced bone density. Sport-therapy, incorporating recreational and competitive activities, has shown promise in enhancing recovery for individuals with SCI. Functional Electrical Stimulation (FES)-cycling combines exercise benefits with stimulatio...

BACKGROUND Technology use is increasingly integrated into daily life, including among older adults, whose adoption and engagement with technology warrant closer examination. According to the matching person and technology model, technology adoption is more likely when a person’s preferences and needs align with a device’s functions and features and...

Background Early administration of reading, writing and math standardised tests allows us to assess the risk of developing a learning disorder and to plan a specific intervention. The ease of access to technological tools and past pandemic restrictions have led to the abandonment of face-to-face assessment in favour of teleassessment methods. Altho...

Background: Spinal cord injury (SCI) severely affects physical function, leading to muscle atrophy and reduced bone density. Sport-therapy, incorporating recreational and competitive activities, has shown promise in enhancing recovery for individuals with SCI. Functional Electrical Stimulation (FES)-cycling combines exercise benefits with stimulati...

Background: Spinal cord injury (SCI) severely affects physical function, leading to muscle atrophy and reduced bone density. Sport-therapy, incorporating recreational and competitive activities, has shown promise in enhancing recovery for individuals with SCI. Functional Electrical Stimulation (FES)-cycling combines exercise benefits with stimulati...

To improve the screening of handwriting disorders in children, a technology-enhanced telemedicine approach is presented. A co-design and process resulted into two clinical tests: (1) a dysorthography test, to be performed on tablet, and (2) a dysgraphia test, to be performed on paper with a smart ink pen. Clinicians and children tested the platform...

The Coma Recovery Scale-revised (CRS-r) is the gold standard for the behavioral assessment of patients with Disorders of Consciousness (DoCs). However, the misdiagnosis rate is around 40%. For this reason, recent guidelines suggested enhancing the assessment with neurophysiological measures: among these, surface electromyography (sEMG) represents a...

Ageing is a physiological phenomenon associated with cognitive and functional decline which, in the long term, could hamper the execution of daily life activities and threaten both social and independent life. The onset of chronic diseases can intensify this process, increasing the risk of hospitalisation and admission to long term care. This repre...

The early detection of mild cognitive impairment, a condition of increasing impact in our aging society, is a challenging task with no established answer. One promising solution is the deployment of robotic systems and ambient assisted living technology in the houses of older adults for monitoring and assistance. In this work, we address and discus...

Background Functional Electrical Stimulation (FES) represents a promising technique for promoting functional recovery in individuals with neuromuscular diseases. Traditionally, current pulses are delivered through self‐adhesive hydrogel Ag/AgCl electrodes, which allow a good contact with the skin, are easy‐to‐use and have a moderate cost. However,...

Background: The rise in life expectancy is associated with an increase in long-term and gradual cognitive decline. Treatment effectiveness is enhanced at the early stage of the disease. Therefore, there is a need to find low-cost and ecological solutions for mass screening of community-dwelling elderly people. Objective: This work aimed to explo...

This study aimed to identify the constructs related to successful aging in the context of engagement in social and productive activities. A qualitative design was used to explore three viewpoints on the aging period with 9 focus groups (3 each for adults 65 years or older, older adults’ family members, and health professionals) and 18 interviews wi...

Background: Movement sonification has been recently introduced into the field of neuromotor rehabilitation alongside Neurologic Music Therapy and music-based interventions. This study introduces the use of musical auditory cues encompassing the melodic-harmonic aspect of music. Methods: Nineteen patients with Parkinson’s disease were randomly assig...

Early screening of handwriting difficulties is key to start remediation activities that help distinguishing between a simple delay and dysgraphia. Technology is fundamental in this process, as also claimed by guidelines for dysgraphia diagnosis: it allows to implement artificial intelligence techniques to help in the discrimination of the difficult...

BACKGROUND Older adults’ engagement in daily activities was severely impeded during the COVID-19 lockdowns, negatively affecting their physical and mental health. Although technology flourished as a means of performing daily activities in this complex situation, older adults often struggled to use these opportunities effectively. Despite the import...

Background During COVID-19 lockdowns, older adults’ engagement in daily activities was severely affected, causing negative physical and mental health implications. Technology flourished as a means of performing daily activities in this complex situation; however, older adults often struggled to effectively use these opportunities. Despite the impor...

Dyslexia is a Specific Learning Disorder (SLD) characterized by subpar reading abilities in terms of accuracy and/or speed. Dyslexia can have a lifelong negative impact on academic and day-to-day life. However, early identification and subsequent training can help dyslexic children overcome their reading difficulties. For instance, tachistoscopic r...

The COVID-19 lockdown affected children, especially those with autism spectrum disorder, due to the disruption in rehabilitation and educational activities. We conducted a cross-sectional study of 315 preschool-aged children, 35 of which had autism, to investigate this impact. A questionnaire was administered to explore socio-demographic status, fa...

Date Presented 04/20/2023 Seniors often have difficulty establishing a new routine after retirement. There is not one 'tailored suit' for successful aging, and OT practitioners have an important role in promoting self-management during this time. Primary Author and Speaker: Michal Tsadok-Cohen Additional Authors and Speakers: Sara Rosenblum, Sonya...

BACKGROUND The rise in life expectancy is associated with an increase in long-term and gradual cognitive decline. Treatment effectiveness is enhanced at the early stage of the disease. Therefore, there is a need to find low-cost and ecological solutions for mass screening of community-dwelling older adults. OBJECTIVE This work aims to exploit auto...

Dysgraphia is a neurodevelopmental disorder specific to handwriting. Classical diagnosis is based on the evaluation of speed and quality of the final handwritten text: it is therefore delayed as it is conducted only when handwriting is mastered, in addition to being highly language-dependent and not always easily accessible. This work presents a so...

Easy-to-use evaluation of Range Of Motion (ROM) during walking is necessary to make decisions during neurological rehabilitation programs and during follow-up visits in clinical and remote settings. This study discussed goniometer applications (DrGoniometer and Angles - Video Goniometer) that measure knee joint ROM during walking through smartphone...

Introduction Since the uptake of digitizers, quantitative spiral drawing assessment allowed gaining insight into motor impairments related to Parkinson's disease. However, the reduced naturalness of the gesture and the poor user-friendliness of the data acquisition hamper the adoption of such technologies in the clinical practice. To overcome such...

Dysgraphia is a learning disability that causes handwritten production below expectations. Its diagnosis is delayed until the completion of handwriting development. To allow a preventive training program, abilities not directly related to handwriting should be evaluated, and one of them is visual perception. To investigate the role of visual percep...

Handwriting learning delays should be addressed early to prevent their exacerbation and long-lasting consequences on whole children’s lives. Ideally, proper training should start even before learning how to write. This work presents a novel method to disclose potential handwriting problems, from a pre-literacy stage, based on drawings instead of wo...

Objective The Rey Osterrieth complex figure (ROCF) is one of the most used neuropsychological tests for the assessment of mild cognitive impairment (MCI) and dementia. In the copy test, the patient has to draw a replica of a 18-pattern image and the outcome is a score based on the accuracy of the overall drawing. The standard scoring system however...

Handwriting difficulties need to be addressed early to avoid several problems to children, both at school and in everyday life, but dysgraphia diagnosis cannot be performed before handwriting maturation. To solve this issue, we hypothesize that the analysis of drawings produced in a pre-literacy stage can predict handwriting problems that will occu...

There is a need for unobtrusive and valid tools to collect gait parameters in patients with Parkinson’s disease (PD). The novel promising tools are pressure-sensing insoles connected to a smartphone app; however, few studies investigated their measurement properties during simple or challenging conditions in PD patients. This study aimed to examine...

Personal computers, tablets, and smartphones may support older adults' engagement when people are required to stay home and opportunities to engage in meaningful activities are reduced during the COVID-19 period. This study aims to screen older adults’ technology-use characteristics across social, leisure, and education domains during the COVID-19...

Cycling by means of Functional Electrical Stimulation (FES) has proven to be a valid technique for the rehabilitation of patients with Spinal Cord Injuries (SCI). In particular, it can be seen not only as a therapeutical approach but also as an accessible form for people with disabilities to perform sport activity. In this case study, carried out i...

Systems for monitoring of Parkinson's disease (PD) patients, able to complement clinical assessment, are needed. These solutions should be objective, based on technology that captures physical characteristics of the pathology, and capable of providing frequent measures conducted both on-site and remotely. Since one of the most typical clinical hall...

Brain-Computer Interface (BCI) has become an established technology to interconnect a human brain and an external device. One of the most popular protocols for BCI is based on the extraction of the so-called P300 wave from electroencephalography (EEG) recordings. P300 wave is an event-related potential with a latency of 300 ms after the onset of a...

Background Little is known about the perceived impact of the COVID-19 pandemic and subsequent lockdown measures on young patients with tic disorders. Previous studies focused on clinician and parent ratings of tic severity, whereas the only international self-report data are available for adult populations. We present the first findings from a case...

The integration of Ambient Assisted Living (AAL) frameworks with Socially Assistive Robots (SARs) has proven useful for monitoring and assisting older adults in their own home. However, the difficulties associated with long-term deployments in real-world complex environments are still highly under-explored. In this work, we first present the MoveCa...

Introduction: Electronic pressure-sensitive walkways are commonly available solutions to quantitatively assess gait parameters for clinical and research purposes. Many studies have evaluated their measurement properties in different conditions with variable findings. In order to be informed about the current evidence of their reliability for optim...

Il disturbo specifico dell'apprendimento è tra i disturbi del neurosviluppo più frequentemente rilevati in età evolutiva. Il progetto Indipote(dn)s è mirato a identificare precocemente i bambini con difficoltà scolastiche che potrebbero sviluppare un disturbo specifico dell'apprendimento (o altri disturbi del neurosviluppo) negli anni successivi. C...

This case study was designed starting from our experience at CYBATHLON 2020. The specific aim of this work was to compare the effectiveness of different fatigue reducing stimulation strategies during cycling induced by Functional Electrical Stimulation (FES). The compared stimulation strategies were: traditional constant frequency trains (CFTs) at...

Handwriting skills could be highly impaired in patients affected by Parkinson's disease (PD), and for this reason its analysis had always been considered relevant. In handwriting assessment, Archimedes spiral drawing is one of the most proposed tasks, due to its peculiar shape and ease of execution. In the last decades, digitizing tablets had been...

We conducted a cross-sectional study to compare the impact of social distancing and lifestyle changes that occurred during Corona Virus Disease 2019 (COVID-19) lockdown on children and adolescents with and without Neurodevelopmental Disorders (NDDs). An online questionnaire was administered in order to investigate the effects of NDD condition, soci...

Dysgraphia is a learning disability that causes handwritten production below the expectancies. Its diagnosis is delayed until handwriting development should be completed, with the possible worsening of children's weaknesses. To allow a preventive empowerment program, abilities not directly related to handwriting should be evaluated, and one of them...

Dysgraphia negatively impacts school-aged children, but its diagnosis is still unsatisfactory. Among its criticalities, it relies on a subjective evaluation of the final product, and it can be delayed as professional consultation might be difficult to be reached. To address these problems, we proposed to leverage two digital tools, a smart ink pen,...

Dysgraphia is a Learning Disability that prevents from mastering handwriting. It is belatedly diagnosed, with negative consequences on children's life. To anticipate Dysgraphia screening to a pre-literacy age, we present Play-Draw-Write, a tablet-based application designed to assess handwriting-related features, starting from drawing. It focuses on...

Global ageing of the population is deeply affecting the everyday lives of the frailest, by exposing them to increasing isolation and loneliness that, in turn, can cause or accelerate cognitive decline. The use of digital technologies and, in particular, social networks can be an effective tool to mitigate this phenomenon, by helping older age peopl...

Background: Robotic systems combined with Functional Electrical Stimulation (FES) showed promising results on upper-limb motor recovery after stroke, but adequately-sized randomized controlled trials (RCTs) are still missing. Objective: To evaluate whether arm training supported by RETRAINER, a passive exoskeleton integrated with electromyograph...

Background Early detection of gait impairments in older adults allows the early uncovering of fall risk and/or cognitive deficits, resulting in timely interventions. Dual-task paradigms have been shown to be more sensitive than single-task conditions for the detection of subtle yet relevant gait impairments. Research question Can a system - encomp...

Objective: We present the development of a novel smart ink pen instrumented with force and motion sensors designed for the quantitative and ecological assessment of daily-life handwriting. This work aims at testing the pen’s sensors and algorithms, and the use of the smart pen to detect age-related changes of writing and tremor parameters during da...

Background: Dementia is a major and growing health problem, and early diagnosis is key to its management. Objective: With the ultimate goal of providing a monitoring tool that could be used to support the screening for cognitive decline, this study aims to develop a supervised, digitized version of 2 neuropsychological tests: Trail Making Test a...

Background Difficulties in handwriting, such as dysgraphia, impact several aspects of a child’s everyday life. Current methodologies for the detection of such difficulties in children have the following three main weaknesses: (1) they are prone to subjective evaluation; (2) they can be administered only when handwriting is mastered, thus delaying t...

Telemonitoring is one of the most expedient answers to the strong need for preventive care imposed by the rapidly aging society. We propose an innovative solution to the detection of early signs of frailty by presenting a serious game controlled by a smart sensorized soft plastic ball, designed to achieve continuous home-based monitoring of muscle...

As Europe sees its population aging dramatically, Assisted Daily Living for the elderly becomes a more and more important and relevant research topic. The Movecare Project focuses on this topic by integrating a robotic platform, an IoT system, and an activity center to provide assistance, suggestions of activities and transparent monitoring to user...

Objective To investigate the effects of cycling with functional electrical stimulation on walking, muscle power and tone, balance and activities of daily living in subacute stroke survivors. Data Sources Ten electronic databases were searched from inception to February 2020. Review methods Inclusion criteria were: subacute stroke survivors (<6 mo...

Failing to master handwriting, as in the case of Dysgraphia, has negative consequences on children’s lives. Unfortunately, Dysgraphia diagnosis is delayed and not easily achievable. Thus, the aim of this work is to propose a valid tool to anticipate Dysgraphia screening at a preliteracy age. We developed a tablet application to analyze characterist...

The analysis of the writing gesture has been successfully investigated in the diagnosis of age-related diseases, but the current technologies and methods still do not allow the ecological daily monitoring of handwriting, mostly because they rely on standardized writing protocols. In this study, we first designed and validated a novel electronic ink...

BACKGROUND Difficulties in handwriting, such as dysgraphia, impact several aspects of a child’s everyday life. Current methodologies for the detection of such difficulties in children have the following three main weaknesses: (1) they are prone to subjective evaluation; (2) they can be administered only when handwriting is mastered, thus delaying t...

Background Clinical registries are powerful tools for collecting uniform data longitudinally, thus making it possible to evaluate the outcome of patients affected by a specific pathology. In the context of total joint arthroplasty, registries serve also as post-market surveillance. Adoption of registries is a heavy burden for clinical settings in t...

Background: Muscle synergies analysis can provide a deep understanding of motor impairment after stroke and of changes after rehabilitation. In this study, the neuro-mechanical analysis of leg cycling was used to longitudinally investigate the motor recovery process coupled with cycling training augmented by Functional Electrical Stimulation (FES)...

BACKGROUND Dementia is a major and growing health problem and early diagnosis is key. OBJECTIVE With the ultimate goal of providing a monitoring tool that could be of support in the screening for cognitive decline, we developed a supervised digitized version of two neuropsychological tests: Trail Making Test and Bells Test. The system consists in...

Handwriting is a complex gesture whose monitoring can disclose age-related modifications or the presence of frailty conditions throughout lifespan. An important biomarker that has the potential to detect subtle yet relevant changes in motor tasks is the Speed-Accuracy tradeoff (SAT). Due to the complexity of handwriting, SAT still lacks a quantitat...

Background: Early interventions maximizing patient's involvement are essential to promote gait restoration and motor recovery after stroke. Aim: To evaluate the effects of a multimodal biofeedback training involving cycling augmented by Functional Electrical Stimulation (FES) and balance exercises on walking ability and motor recovery. Design:...

Background: The Brief Balance Evaluation Systems Test (Brief-BESTest) could be a useful tool for balance assessment. Although some psychometric characteristics have been examined, others still need to be clarified. Objective: The objective was to assess the structural validity, convergent validity, discriminant validity, and internal consistency...

This study aimed at evaluating whether people with a normal cognitive function can be discriminated from subjects with a mild impairment of cognitive function based on a set of acoustic features derived from spontaneous speech. Voice recordings from 90 Italian subjects (age >65 years; group 1: 47 subjects with MMSE>26; group 2: 43 subjects with 20≤...

Objective: To develop and evaluate a hybrid robotic system for arm recovery after stroke, combining EMG-triggered Functional Electrical Stimulation (FES) with a passive exoskeleton for upper limb suspension. Methods: The system was used in a structured exercise program resembling activities of daily life. Exercises execution was continuously con...

Aquatic exercises have been demonstrated to benefit the facilitation of motor recovery and the enhancement of well-being in middle-aged adults and the elderly. Personalization, immersiveness, and biofeedback are key for amplifying and accelerating any rehabilitation process in neurological and orthopedic patients. However, a therapist can neither p...

MoveCare develops and field tests an innovative multi-actor platform that supports the independent living of the elder at home by monitoring, assist and promoting activities to counteract decline and social exclusion. It is being developed under H2020 framework and it comprises 3 hierarchical layers: (1) A service layer provides monitoring and inte...

Cycling induced by Functional electrical stimulation (FES) was proposed as a method to improve motor recovery after stroke. This study aimed at assessing the effects of this training on motor patterns of muscle co-activations, referred as muscle synergies. Seven post-acute patients underwent 15 sessions of FES-cycling training. Outcome measures wer...

Cycling induced by Functional Electrical Stimulation (FES) is a promising rehabilitative approach for stroke patients, mainly in the post-acute phase. This systematic review summarizes the current evidence about its effectiveness. Seven randomized controlled trials involving 221 subjects were found. Overall, a slight trend but no significant differ...

Grip Strength reduction is a marker of the age-related functional decline. The present work developed an exergame to continuously and transparently monitor handgrip strength and endurance in older persons. The game was tested on ten young adults reporting positive results, both in terms of usability and correlation with clinical standards, thus rep...

This work presents the preliminary results of a randomized controlled trial aimed at evaluating the efficacy of a novel hybrid robotic system for arm rehabilitation after stroke. The system was developed within the European project RETRAINER and consists of a passive exoskeleton for weight relief combined with an arm EMG-triggered neuroprosthesis....

BACKGROUND In recent years, different smartphone apps have been validated for joint goniometry, but none for goniometric assessment of gait after stroke. OBJECTIVE The aims of our work were to assess:1) to assess intra-rater reliability of an image-based goniometric app – DrGoniometer- in the measurement of the extension, flexion angles and range...

Background: Current models of pain behaviour suggest that kinesiophobia prevents the reacquisition of normal function, promotes the development of maladaptive coping strategies, and contributes to the disability associated with chronic neck pain (NP). Aim: Comparing two brief cognitive-behavioural programmes aimed at managing kinesiophobia to un...

The ageing of the population deeply impacts on the social costs relative to health care. The use of modern technologies is one of the most promising approaches, under current study, to reduce such impact. In this demonstration, we propose a framework that can be employed for at-home assessment of Mild Cognitive Impairment (MCI). It is composed by a...

Introduction/Background Stroke is the main cause of acquired adult disability with major impact on arm function. The combined use of Functional Electrical Stimulation (FES) and robotic technologies is strongly advocated to improve rehabilitation outcomes after stroke. We present the preliminary data of a multi-center Randomized Controlled Trial aim...

Robotic systems to restore, augment and support human capabilities hinder the natural interaction with the world. Different approaches based on physiological measurements such as brain activity, muscle contraction, kinematics, or eye movement, can be exploited to automatically and reliably detect the intention of the user to perform a movement. Onc...

Stroke disease involves an increasing number of subjects due to the aging population. In clinical practice‚ the presence of widely accessible rehabilitative interventions to facilitate the patients’ motor recovery‚ especially in the early stages after injury when wider improvement can be gained‚ is crucial to reduce social and economical costs. The...

The need of evidence-based medicine is a key factor in the current clinical rehabilitative approach. A randomized controlled trial (RCT) is a rigorous scientific methodology used to test the efficacy and efficiency of a service in healthcare‚ such as a new technology‚ methodology‚ treatment or drug therapy. RCTs are becoming a milestone to establis...

Objective: To design and implement an electromyography (EMG)-based controller for a hand robotic assistive device, which is able to classify the user's motion intention before the effective kinematic movement execution. Methods: Multiple degrees-of-freedom hand grasp movements (i.e. pinching, grasp an object, grasping) were predicted by means of...

The dysgraphic disorder is usually underestimated and belatedly diagnosed. The need of prevention and early intervention focused on prewriting exercises emerges from the literature. We explore exergames to supply this need, together with an adequate assessment module of the training results. The exergames were designed in collaboration with clinici...

Objective The clinical use of Transcranial Magnetic Stimulation (TMS) as a technique to assess corticospinal excitability is limited by the time for data acquisition and the measurement variability. This study aimed at evaluating the reliability of Stimulus-Response (SR) curves acquired with a recently proposed rapid protocol on tibialis anterior m...