Andrea Calderone’s research while affiliated with University of Messina and other places

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Publications (20)


The Impact of Visualization on Stroke Rehabilitation in Adults: A Systematic Review of Randomized Controlled Trials on Guided and Motor Imagery
  • Article
  • Full-text available

March 2025

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28 Reads

Andrea Calderone

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Alfredo Manuli

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Francesca Antonia Arcadi

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[...]

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Background/Objectives: Guided imagery techniques, which include mentally picturing motions or activities to help motor recovery, are an important part of neuroplasticity-based motor therapy in stroke patients. Motor imagery (MI) is a kind of guided imagery in neurorehabilitation that focuses on mentally rehearsing certain motor actions in order to improve performance. This systematic review aims to evaluate the current evidence on guided imagery techniques and identify their therapeutic potential in stroke motor rehabilitation. Methods: Randomized controlled trials (RCTs) published in the English language were identified from an online search of PubMed, Web of Science, Embase, EBSCOhost, and Scopus databases without a specific search time frame. The inclusion criteria take into account guided imagery interventions and evaluate their impact on motor recovery through validated clinical, neurophysiological, or functional assessments. This review has been registered on Open OSF with the following number: DOI 10.17605/OSF.IO/3D7MF. Results: This review synthesized 41 RCTs on MI in stroke rehabilitation, with 996 participants in the intervention group and 757 in the control group (average age 50–70, 35% female). MI showed advantages for gait, balance, and upper limb function; however, the RoB 2 evaluation revealed ‘some concerns’ related to allocation concealment, blinding, and selective reporting issues. Integrating MI with gait training or action observation (AO) seems to improve motor recovery, especially in balance and walking. Technological methods like brain–computer interfaces (BCIs) and hybrid models that combine MI with circuit training hold potential for enhancing functional mobility and motor results. Conclusions: Guided imagery shows promise as a beneficial adjunct in stroke rehabilitation, with the potential to improve motor recovery across several domains such as gait, upper limb function, and balance.

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Swallowing disorders in cerebral palsy: a systematic review of oropharyngeal Dysphagia, nutritional impact, and health risks

Italian Journal of Pediatrics

Cerebral palsy (CP) is a permanent disorder affecting movement and posture due to nonprogressive brain issues, often leading to various sensory, cognitive, and musculoskeletal challenges. Among these complications, oropharyngeal dysphagia (OPD) is prevalent, impacting up to 85% of children with CP and resulting in significant nutritional deficits. This systematic review aims to explore the prevalence and types of OPD in CP patients, its effects on nutritional status, and its associated health complications, emphasizing the need for thorough assessment and intervention to mitigate risks. The review adheres to PRISMA guidelines, searching five major databases (PubMed, Web of Science, Embase, Cochrane Library, and Scopus) without time range restrictions to capture studies addressing swallowing disorders and their impact on nutritional status in CP. This review has been registered on Open OSF (n) 3KUQX. Individuals with CP often experience swallowing impairments, including delayed pharyngeal transit and aspiration. Research indicates that 81.5% of kids with CP suffer from dysphagia, commonly associated with reduced motor skills and general health. Moreover, as a result of these swallowing difficulties, nutritional complications may occur, with elevated levels of gastroesophageal symptoms causing malnutrition and growth delays, which require thorough evaluations and personalized interventions for successful treatment. Tools like the Videofluoroscopic Swallowing Study were identified as primary methods for evaluation, but assessment remains limited by methodological inconsistencies. This systematic review underscores the significant health impacts of OPD in children with CP, which affects nutrition and overall well-being. Future research should address the need for standardized evaluation methods and effective interventions to balance nutritional needs with practical mealtime strategies.



PRISMA 2020 flow diagram of the evaluated studies.
Cont.
Parent–Child Interaction Therapy for Disruptive Behavior: A Systematic Review of Effectiveness in Different Settings

Background: Parent–child interaction therapy (PCIT) is an evidence-based intervention for children with behavioral problems. This systematic review assesses the efficacy of PCIT in reducing disruptive behavior problems (DBPs) by analyzing outcomes across diverse populations and settings. Methods: Studies were identified through an online search of the PubMed, Web of Science, Cochrane Library, and Embase databases, with a search period ranging from 2014 to 2024. This review was registered on Open OSF (n) TVFQ5. Results: Research studies demonstrate that PCIT is effective across a variety of DBP conditions, showing significant reductions in child behavioral problems and parenting stress. PCIT’s adaptability, effectiveness, and potential for widespread use have been validated in both specialized and community settings, including diverse and high-risk populations. Conclusions: This systematic review highlights PCIT’s overall effectiveness in reducing disruptive behaviors and improving parent–child relationships across diverse settings and populations. It emphasizes the need for further research into its long-term efficacy, adaptability in multicultural contexts, and potential integration with technology for enhanced dissemination and effectiveness.


Virtual horizons: Enhancing rehabilitation of neuromuscular diseases through virtual reality and gamification

January 2025

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29 Reads

Journal of Neuromuscular Diseases

Background Neuromuscular diseases (NMDs) encompass a diverse range of disorders that impair muscle function, often leading to progressive weakness and loss of independence. Objective This systematic review aims to synthesize research on how virtual reality (VR) and gamified rehabilitation approaches enhance patient engagement and outcomes, ultimately reshaping rehabilitation practices for individuals with NMDs. Methods Studies were identified from an online search of PubMed, Web of Science, and Embase databases with a search time range from 2014 to 2024. This review has been registered on Open OSF (n) RCNHE. Results Robotics, VR, and biofeedback, in turn, enriched by gamification, represent the improvement of motor function, motivation, and psychosocial well-being within rehabilitation concerning NMDs. Using emerging technologies seems promising to improve engagement, delay functional decline, and enhance quality of life. Conclusions This systematic review identified that VR and gamification provide the potential to enhance rehabilitation outcomes in patients suffering from NMDs. The future will doubtless have more subjects included and optimization of interventions to best personalize treatments, hence best practice recommendations can be made towards wider clinical implementations.


The Impact of Biofeedback in Enhancing Chronic Pain Rehabilitation: A Systematic Review of Mechanisms and Outcomes.

January 2025

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23 Reads

Heliyon

Background and objectives Chronic pain (CP), affecting approximately 20 % of adults globally, imposes a profound burden on individuals and healthcare systems. This condition, characterized by persistent pain, muscle stiffness, and emotional distress, often results in a complex interplay of physical and psychological factors that exacerbate symptoms and hinder recovery. Biofeedback (BFB), a non-invasive intervention, offers a promising rehabilitation strategy by enabling individuals to monitor and self-regulate physiological responses, such as muscle tension, heart rate, and skin temperature. Through this process, BFB disrupts the vicious cycle of pain and stress, fostering relaxation, reducing muscle strain, and alleviating emotional distress. This systematic review aimed to examine the mechanisms underlying BFB's therapeutic effects in CP rehabilitation, specifically its ability to enhance self-regulation and promote relaxation to improve pain control. Furthermore, it aimed to evaluate the impact of BFB on key outcomes, including pain severity, functional capabilities, and quality of life, with the goal of guiding its integration into contemporary rehabilitation practices. Materials and Methods Following PRISMA guidelines, a systematic search was conducted in PubMed, Web of Science, and Embase (2014–2024) to identify studies on BFB for CP. Inclusion criteria included original research involving BFB as a primary or secondary intervention for CP, with outcomes related to pain management and rehabilitation. This review is registered on Open OSF (X5HPB). Results BFB has shown consistent efficacy as a complementary therapy in CP management, offering significant reductions in pain intensity and enhancements in quality of life across diverse CP conditions. Mechanistically, BFB facilitates improved self-regulation by training patients to modulate physiological responses, such as muscle tension and heart rate variability, leading to better pain control and stress reduction. Conclusions BFB shows significant promise as a supplementary treatment for different CP disorders. The evidence that was examined shows that it is effective in improving how pain is perceived, increasing functional results, and boosting overall quality of life among a variety of patient groups.


PRISMA 2020 flow diagram of evaluated studies.
Risk of Bias (RoB) of included RCT studies.
Cochrane Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I).
Key findings of the studies.
Multisensory Stimulation in Rehabilitation of Dementia: A Systematic Review

Background/Objectives: Dementia leads to cognitive decline, affecting memory, reasoning, and daily activities, often requiring full-time care. Multisensory stimulation (MSS), combined with cognitive tasks, can slow this decline, improving mood, communication, and overall quality of life. This systematic review aims to explore methods that utilize MSS in the rehabilitation of patients with dementia. Its clinical value is rooted in its ability to offer a deep comprehension of how MSS can be successfully incorporated into rehabilitation treatments. Methods: Studies were identified from an online search of PubMed, EBSCOhost, Cochrane Library, Web of Science, Embase, and Scopus databases with a search time frame from 2014 to 2024. This review has been registered on Open OSF (n) 3KUQX. Results: Pilot studies investigating MSS interventions, encompassing Cognitive Stimulation Therapy (CST), Sonas therapy, and combined physical–cognitive exercise programs, have yielded mixed findings in individuals with dementia. CST has demonstrated significant improvements in general cognitive function, particularly in language skills, offering a promising approach for cognitive enhancement. Sonas therapy, while showing positive trends in some studies, does not consistently achieve statistically significant outcomes across all cognitive domains. Conversely, combined exercise programs have shown efficacy in improving dual-task performance, suggesting benefits for motor–cognitive integration. MSS delivered within specialized environments like Snoezelen rooms consistently produces positive effects on mood, reducing agitation and promoting relaxation. Conclusions: This review emphasizes how MSS can enhance cognitive, emotional, and behavioral results for individuals with dementia. It is essential for future research to standardize protocols, incorporate advanced technologies such as virtual reality, and rectify diversity gaps. Collaboration between different fields will improve the effectiveness and usefulness of MSS in caring for individuals with dementia.


Figure 1. Neurological complications of leprosy.
Cont.
The Neurological Impact of Leprosy: Manifestations and Treatment Approaches

November 2024

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27 Reads

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2 Citations

Background and Objectives: Leprosy primarily affects peripheral nerves, leading to significant neurological complications such as polyneuritis, mononeurosis, and autonomic dysfunction, which contribute to severe disabilities and impaired quality of life for patients. This scoping review aims to investigate the neurological manifestations and main treatments of leprosy patients. Materials and Methods: Studies were identified from an online search of PubMed, Web of Science, Cochrane Library, Embase, and Scopus databases. This review has been registered on OSF (n) PQBYH. Results: Neurological complications of leprosy, such as neuropathy and paralysis, necessitate accurate diagnosis and treatment, as immunological reactions can exacerbate nerve damage. Various studies highlight the effectiveness of personalized therapies, such as corticosteroids, multi-drug therapy (MDT), and surgical interventions, in improving symptoms and neurological function in leprosy patients. Conclusions: Managing neurological complications of leprosy necessitates careful diagnosis and treatment, as many patients experience unresolved peripheral neuropathy despite multidrug therapy. Future research should focus on improving diagnostic tools, exploring the link between neuropathic pain and psychological issues, and developing effective vaccines and treatments to enhance patient outcomes.


The benefits of mindfulness across different pathologies.
The neurobiological and neurotransmitter changes following mindfulness.
PRISMA 2020 flow diagram of evaluated studies.
Summary of studies included in the research.
Cont.
Neurobiological Changes Induced by Mindfulness and Meditation: A Systematic Review

November 2024

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350 Reads

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1 Citation

Background and Objectives: Meditation and mindfulness, rooted in ancient traditions, enhance mental well-being by cultivating awareness and emotional control. It has been shown to induce neuroplasticity, increase cortical thickness, reduce amygdala reactivity, and improve brain connectivity and neurotransmitter levels, leading to improved emotional regulation, cognitive function, and stress resilience. This systematic review will synthesize research on neurobiological changes associated with mindfulness and meditation practices. Materials and Methods: Studies were identified from an online search of PubMed, Web of Science, Cochrane Library, and Embase databases without any search time range. This review has been registered on Open OSF (n) GV2JY. Results: Mindfulness-Based Stress Reduction (MBSR) enhances brain regions related to emotional processing and sensory perception, improves psychological outcomes like anxiety and depression, and exhibits unique mechanisms of pain reduction compared to placebo. Conclusions: This review highlights that mindfulness, particularly through MBSR, improves emotional regulation and brain structure, reduces anxiety, and enhances stress resilience. Future research should focus on diverse populations and naturalistic settings to better understand and optimize these benefits.


Figure 1. The effects of neuroinflammation and neuroplasticity in TBI patients and animals.
Summary of studies included in the research.
Cont.
The Role of Neuroinflammation in Shaping Neuroplasticity and Recovery Outcomes Following Traumatic Brain Injury: A Systematic Review

October 2024

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69 Reads

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4 Citations

Neuroplasticity and neuroinflammation are variables seen during recovery from traumatic brain injury (TBI), while biomarkers are useful in monitoring injury and guiding rehabilitation efforts. This systematic review examines how neuroinflammation affects neuroplasticity and recovery following TBI in animal models and humans. Studies were identified from an online search of the PubMed, Web of Science, and Embase databases without any search time range. This review has been registered on Open OSF (n) UDWQM. Recent studies highlight the critical role of biomarkers like serum amyloid A1 (SAA1) and Toll-like receptor 4 (TLR4) in predicting TBI patients’ injury severity and recovery outcomes, offering the potential for personalized treatment and improved neurorehabilitation strategies. Additionally, insights from animal studies reveal how neuroinflammation affects recovery, emphasizing targets such as NOD-like receptor family pyrin domain-containing 3 (NLRP3) and microglia for enhancing therapeutic interventions. This review emphasizes the central role of neuroinflammation in TBI, and its adverse impact on neuroplasticity and recovery, and suggests that targeted anti-inflammatory treatments and biomarker-based personalized approaches hold the key to improvement. Such approaches will need further development in future research by integrating neuromodulation and pharmacological interventions, along with biomarker validation, to optimize management in TBI.


Citations (12)


... M. leprae is an acid-fast, obligate intracellular bacterium belonging to the genus Mycobacterium. It is one of the smallest free-living organisms known to infect humans, with a highly streamlined genome and limited metabolic capabilities [21]. Despite its simplicity, M. leprae exhibits remarkable resilience, capable of surviving and multiplying within host cells for years to decades. ...

Reference:

Exploring the Neurological Manifestations of Leprosy: Clinical Insights and Implications
The Neurological Impact of Leprosy: Manifestations and Treatment Approaches

... For instance, serotonin, a key neurotransmitter, is critical in mood stabilization, emotional resilience, and decision-making. By maintaining balanced serotonin levels through exercise, mindfulness, and proper nutrition, entrepreneurs can enhance their ability to manage stress, sustain focus, and approach challenges with a calm and adaptive mindset (Calderone et al., 2024). This neurochemical balance supports state-dependent cognitive shifts, enabling individuals to transition more effectively between high-pressure situations and creative problem-solving states (Li et al., 2013). ...

Neurobiological Changes Induced by Mindfulness and Meditation: A Systematic Review

... The NVU, comprising vascular cells (endothelial cells, pericytes, glycocalyx, tight junctions), glial cells (astrocytes, microglia, oligodendrocytes), neurons, and the extracellular matrix (ECM), is essential for regulating cerebral blood flow, maintaining BBB function, and preserving neuronal homeostasis [27,[56][57][58]. The mechanical disruption of these components triggers a cascade of molecular and cellular responses, including oxidative stress and neuroinflammation, which can amplify BBB breakdown and accelerate neurodegenerative processes [8,25,59,60]. ...

The Role of Neuroinflammation in Shaping Neuroplasticity and Recovery Outcomes Following Traumatic Brain Injury: A Systematic Review

... Extended Reality is also being applied to innovative therapeutic approaches, such as treatments to support addiction recovery (Tsamitros et al., 2024) and rehabilitation programs for children with autism or ADHD, where immersive environments can enhance engagement and facilitate skill development (Calderone et al., 2024;Oh et al., 2024). ...

Harnessing Virtual Reality: Improving Social Skills in Adults with Autism Spectrum Disorder

... Beyond these immediate applications, AC systems could enhance tools and methodologies that support progress in brain and mental healthcare, through fields such as neurology, where AI-driven innovations are already transforming diagnosis, treatment, and personalised care (Calderone et al., 2024;Voigtlaender et al., 2024). Artificial conscious agents could refine these efforts further, offering improved simulations of brain function and psychological processes. ...

Towards Transforming Neurorehabilitation: The Impact of Artificial Intelligence on Diagnosis and Treatment of Neurological Disorders

... Emerging therapies such as transcranial direct current stimulation (tDCS) and immersive virtual reality (VR)-based rehabilitation have shown promise in mitigating apraxia, but their application remains limited due to a lack of robust evidence and the need for specialized equipment [10][11][12][13][14]. In contrast, gesture training and strategy-based interventions are accessible and have demonstrated efficacy in improving apraxia and ADL performance in several studies [15][16][17][18][19][20]. ...

Effects of Virtual Rehabilitation Training on Post-Stroke Executive and Praxis Skills and Depression Symptoms: A Quasi-Randomised Clinical Trial

... In line with this, our study proved that the WB positively affected FAB (H2). In fact, prior studies indicated that WB might force employees to use feedback avoidance behaviors (FAB) as a passive coping strategy to handle WB and avoid disciplinary procedures from their leaders [25,43,85]. By operating FAB as a coping style, employees believe they are generating a safe distance, both physically and psychologically, to decrease discomfort with regard to WB [25,86,87]. ...

Coping Strategies in Patients with Acquired Brain Injury: A Scoping Review

... In fact, patients with SCI tend to have higher levels of depression and stress as well as lower self-esteem compared to healthy individuals [2]. Previous studies indicate that patients with SCI often face acute psychological distress, which can exacerbate emotional and cognitive responses, further affecting rehabilitation outcomes [15]. A significant number of individuals with SCI may face mental health challenges following their injury, with mental health disorder diagnoses ranging from 10% to as much as one-third of affected individuals [16]. ...

Cognitive, behavioral and psychiatric symptoms in patients with spinal cord injury: a scoping review

... Spinal cord injury profoundly affects multiple aspects of health, directly impacting the quality of life of those affected [1][2][3]. Spinal cord injury is associated with a range of acute and chronic impairments, including pain, motor dysfunction, sensory deficits, muscle dystonia, fatigue, atrophy, and alterations in muscle fiber composition. These physical changes often lead to reduced strength, deteriorated body composition, and gradual 2 of 13 declines in both functionality and independence, highlighting the extensive long-term challenges faced by individuals with spinal cord injury [4][5][6]. ...

The Quality of Life in Patients with Spinal Cord Injury: Assessment and Rehabilitation

... [6][7][8][9] Such method aims to restore brain function and normalize abnormal brain activity. 10,11 Typically, brain stimulation therapy modulates the activity of targeted nerve cells by directly stimulating neurons near the electrode, which then influences nearby neurons and their pathways, leading to complex patterns of excitatory and inhibitory effects. 12 These changes can help normalize pathological alterations within relevant brain networks. ...

Traumatic Brain Injury and Neuromodulation Techniques in Rehabilitation: A Scoping Review