351 pubblicazioni classificate nel seguente modo:

Exploring Dyadic Synchrony in Naturalistic Mother-ChildInteractions: Differences between Autistic and Neurotypical Young Children
INSAR 2025 – Abstract Book
Autore/i: Orsili, Loredana; Aiello, Stefania; Carrozza, Cristina; I Famà, Francesca; Campisi, Agrippina; Leonardi, Elisa; Nest Team, The; Campisi, Simona; Bruschetta, Roberta; Tartarisco, Gennaro; Pioggia, Giovanni; Mastrogiuseppe, Marilina; Ceravolo, Maria Gabriella; Ruta, Liliana
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/349355

Assessment of Synchrony in Parent-Child Interaction in Autism: A Systematic Review of Observational Tools.
INSAR 2025 – Abstract Book
Autore/i: Orsili, Loredana; Farabolini, Gianmatteo; Carloni, Michela; Aiello, Stefania; Mastrogiuseppe, Marilina; Ruta, Liliana; Ceravolo, Maria Gabriella
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/349354

Continuous Movement Monitoring at Home Through Wearable Devices: A Systematic Review
SENSORS
Autore/i: Farabolini, Gianmatteo; Baldini, Nicolò; Pagano, Alessandro; Andrenelli, Elisa; Pepa, Lucia; Morone, Giovanni; Ceravolo, Maria Gabriella; Capecci, Marianna
Classificazione: 1 Contributo su Rivista
Abstract: Highlights: What are the main findings? Wearable sensors—especially IMUs, accelerometers, and gyroscopes—are widely used for continuous home-based motor monitoring, particularly in neurological conditions like Parkinson’s disease. Most studies report high feasibility and patient compliance (≥70%), but only 5.6% were randomized trials, limiting the strength of clinical recommendations. What are the implications of the main findings? Wearable devices are reliable tools for the real-world assessment of motor symptoms, potentially complementing traditional in-clinic evaluations. Broader clinical adoption will require overcoming challenges such as clinician awareness, standardization, data privacy, and equitable access to technology. Background: Wearable sensors are a promising tool for the remote, continuous monitoring of motor symptoms and physical activity, especially in individuals with neurological or chronic conditions. Despite many experimental trials, clinical adoption remains limited. A major barrier is the lack of awareness and confidence among healthcare professionals in these technologies. Methods: This systematic review analyzed the use of wearable sensors for continuous motor monitoring at home, focusing on their purpose, type, feasibility, and effectiveness in neurological, musculoskeletal, or rheumatologic conditions. This review followed PRISMA guidelines and included studies from PubMed, Scopus, and Web of Science. Results: Seventy-two studies with 7949 participants met inclusion criteria. Neurological disorders, particularly Parkinson’s disease, were the most frequently studied. Common sensors included inertial measurement units (IMUs), accelerometers, and gyroscopes, often integrated into medical devices, smartwatches, or smartphones. Monitoring periods ranged from 24 h to over two years. Feasibility studies showed high patient compliance (≥70%) and good acceptance, with strong agreement with clinical assessments. However, only half of the studies were controlled trials, and just 5.6% were randomized. Conclusions: Wearable sensors offer strong potential for real-world motor function monitoring. Yet, challenges persist, including ethical issues, data privacy, standardization, and healthcare access. Artificial intelligence integration may boost predictive accuracy and personalized care.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/350432

From Concept to Practice: The Development of ClinFIT for Musculoskeletal Disorders
AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION
Autore/i: Mariotti, Max; Selb, Melissa; Imamura, Marta; Alghwiri, Alia; Amatya, Bhasker; Ceravolo, Maria Gabriella; Gimigliano, Francesca; Giraldo-Prieto, Mario; Hu, Xiaolei; Kambou, Sinforian; Kiekens, Carlotte; Li, Jianan; Liu, Shouguo; Mukaino, Masahiko; Oral, Aydan; Stucki, Gerold; Van De Velde, Dominique; Perret, Claudio
Classificazione: 1 Contributo su Rivista
Abstract: Objective: This study aimed to develop ClinFIT-MSK, an International Classification of Functioning, Disability and Health (ICF)-based clinical tool for the assessment and reporting of the functioning and rehabilitation potential of patients with a musculoskeletal condition. Design: This multistep, mixed-methods tool development process encompassed developing an initial shortlist of ICF categories (comprising the aggregation of the ICF Core Sets for musculoskeletal conditions and a literature search), identifying the ClinFIT-MSK items feasible for clinical use via a two-round Delphi survey, developing a simple description for each item and deciding on the rating scale through development working group consultations. These consultations were also instrumental at each step of tool development. Results: Based on a shortlist of 33 categories, the Delphi survey generated 17 items (7 body function and 10 activity and participation categories) which can be rated with a 0-4 scale (0 = no problem to 4 = complete problem) accompanied with rating specifications or with a 0-10 numeric rating scale without specification. Conclusions: ClinFIT-MSK can be used by rehabilitation professionals to support individualized care and track functional outcomes. It can also be employed in research and public health. Psychometric testing and cross-cultural validation will be pursued to ensure ClinFIT-MSK's scientific robustness and applicability across diverse settings.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/348833

Continuous Movement Monitoring at Home Through Wearable Devices: A Systematic Review
SENSORS
Autore/i: Farabolini, Gianmatteo; Baldini, Nicolò; Pagano, Alessandro; Andrenelli, Elisa; Pepa, Lucia; Morone, Giovanni; Ceravolo, Maria Gabriella; Capecci, Marianna
Classificazione: 1 Contributo su Rivista
Abstract: Highlights: What are the main findings? Wearable sensors—especially IMUs, accelerometers, and gyroscopes—are widely used for continuous home-based motor monitoring, particularly in neurological conditions like Parkinson’s disease. Most studies report high feasibility and patient compliance (≥70%), but only 5.6% were randomized trials, limiting the strength of clinical recommendations. What are the implications of the main findings? Wearable devices are reliable tools for the real-world assessment of motor symptoms, potentially complementing traditional in-clinic evaluations. Broader clinical adoption will require overcoming challenges such as clinician awareness, standardization, data privacy, and equitable access to technology. Background: Wearable sensors are a promising tool for the remote, continuous monitoring of motor symptoms and physical activity, especially in individuals with neurological or chronic conditions. Despite many experimental trials, clinical adoption remains limited. A major barrier is the lack of awareness and confidence among healthcare professionals in these technologies. Methods: This systematic review analyzed the use of wearable sensors for continuous motor monitoring at home, focusing on their purpose, type, feasibility, and effectiveness in neurological, musculoskeletal, or rheumatologic conditions. This review followed PRISMA guidelines and included studies from PubMed, Scopus, and Web of Science. Results: Seventy-two studies with 7949 participants met inclusion criteria. Neurological disorders, particularly Parkinson’s disease, were the most frequently studied. Common sensors included inertial measurement units (IMUs), accelerometers, and gyroscopes, often integrated into medical devices, smartwatches, or smartphones. Monitoring periods ranged from 24 h to over two years. Feasibility studies showed high patient compliance (≥70%) and good acceptance, with strong agreement with clinical assessments. However, only half of the studies were controlled trials, and just 5.6% were randomized. Conclusions: Wearable sensors offer strong potential for real-world motor function monitoring. Yet, challenges persist, including ethical issues, data privacy, standardization, and healthcare access. Artificial intelligence integration may boost predictive accuracy and personalized care.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/348533

Chemosensory Impairments and Their Impact on Nutrition in Parkinson’s Disease: A Narrative Literature Review
NUTRIENTS
Autore/i: Alia, Sonila; Andrenelli, Elisa; DI PAOLO, Alice; Capecci, Marianna; Vignini, Arianna; Membrino, Valentina; Mazzanti, Laura; Fabri, Mara; Ceravolo, Maria Gabriella
Classificazione: 1 Contributo su Rivista
Abstract: Parkinson’s disease (PD) is a neurological disorder characterized by heterogeneous symptomatology, in which the classical motor features of Parkinsonism are associated with clinically significant non-motor symptoms. Olfactory alteration, as a manifestation of PD’s premotor or prodromal phase, is well known. These impairments can lead to malnutrition, decreased appetite, and depression, thereby worsening patients’ quality of life. However, only a few studies clarify the mechanisms, characteristics, and clinical diagnostic and therapeutic implications of impaired taste perception. Moreover, unlike most motor features of PD, non-motor symptoms often have limited treatment options or responses. The purpose of this review is to collate and describe all relevant studies on taste and smell alterations in patients with PD and how these alterations could affect nutritional status. Our search aimed to identify English-language research articles and reviews published in peer-reviewed journals over the past two decades (2004–2024), while also including older foundational studies when relevant. Several studies show that hyposmia in PD worsens over time, potentially linked to structural changes in the brain’s basal ganglia and piriform cortex. Severe hyposmia is also associated with a higher risk of dementia in PD patients and can negatively influence quality of life, affecting social interactions and nutrition. Regarding taste perception, recent studies have suggested that hypogeusia may occur even in the prodromal stage of PD, such as in patients with REM sleep disorder, although the exact mechanisms remain unclear. Additionally, research has explored the role of bitter taste receptors and their possible involvement in inflammation and α-synuclein misfolding, suggesting a link between taste dysfunction and immune system changes in PD. Attention was then focused on the gut microbiota’s link to the central nervous system and its contribution to gustatory dysfunctions, as well as how the nasal microbiome influences PD progression by altering the olfactory system. Nowadays, the primary role of a correct diet in the overall treatment of PD patients is becoming increasingly important for practitioners. Diet should be included among the available aids to counteract some aspects of the pathology itself. For all these reasons, it is also crucial to determine whether these chemosensory impairments could serve as disease markers, helping to better understand the underlying mechanisms of the disease.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/342802

Add-on therapies to levodopa improve pain modulation in Parkinson's disease with motor fluctuations: A prospective cohort study
PARKINSONISM & RELATED DISORDERS
Autore/i: Andrenelli, Elisa; Baldini, Nicolò; Barbini, Filippo Augusto; Benedetti, Matteo; Brambatti, Jacopo; Capecci, Marianna; Ceravolo, Maria Gabriella
Classificazione: 1 Contributo su Rivista
Abstract: Background: Pain is a common and often underestimated non-motor symptom in Parkinson's disease (PD), affecting quality of life (QOL) and frequently associated with motor fluctuations. Although the pathophysiological mechanisms underlying pain in PD remain unclear, most hypothesize the involvement of dopaminergic and non-dopaminergic pathways. Objective: To evaluate the effect of MAO-B and COMT inhibitors, used as add-on therapies to levodopa, on pain thresholds in people with PD (pwPD) with motor fluctuations, either with or without pain. Methods: This prospective cohort study enrolled 40 pwPD with motor fluctuations who were started on selegiline, rasagiline, safinamide, or opicapone. Pain thresholds (tactile, pain, and tolerance) were assessed using electrical stimulation at baseline and after 3 and 6 months. Normative data were collected from 11 healthy subjects. Outcome measures in pwPD targeted motor impairment (UPDRS), pain perception (King's PD Pain Scale), mood, fatigue, sleep, and QOL. Results: PwPD showed higher tactile thresholds and lower pain and pain tolerance thresholds than controls. At 6 months, both rasagiline and safinamide significantly improved pain thresholds and tolerance compared to opicapone. Experiencing pain was more frequent in women and was associated with anxiety, poor sleep, and motor complications. Regression analyses revealed that cognitive status, sex, disease duration, age, anxiety levels and treatment with MAO-B inhibitors were key modulators of pain processing. Conclusion: Pain processing is altered in pwPD, independently of subjective pain complaints. MAO-B inhibitors, particularly safinamide and rasagiline, appear to restore pain thresholds and improve QOL, supporting their role in managing pain in PD.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/348532

Psychometric properties and clinical correlates of the Frontal Behaviour Inventory in progressive supranuclear palsy: data from the PSP-NET
NEUROLOGICAL SCIENCES
Autore/i: Cappiello, Arianna; Cuoco, Sofia; De Micco, Rosa; Satolli, Sara; Di Biasio, Francesca; Markushi, Tiziana Benzi; Sambati, Luisa; Pilotto, Andrea; Costanzo, Matteo; Longo, Chiara; Schirinzi, Tommaso; Del Prete, Eleonora; Frosini, Daniela; Stefani, Alessandro; Malaguti, Maria Chiara; Fabbrini, Giovanni; Padovani, Alessandro; Calandra-Buonaura, Giovanna; Marchese, Roberta; Tessitore, Alessandro; Barone, Paolo; Picillo, Marina; Null, Null; Serio, Marina; Aloisio, Simone; Panetta, Salvatore; Cani, Ilaria; Borroni, Barbara; Belvisi, Daniele; Bacchin, Ruggero; Bissacco, Jacopo; Benevento, Elena; De Togni, Laura; Sala, Francesca; Cincotta, Massimo; Piccininni, Maristella; Ledda, Claudia; Lopiano, Leonardo; Turla, Marinella; Sofia, Cotelli Maria; Modugno, Nicola; Ciammola, Andrea; Altavista, Maria Concetta; Di Giacopo, Raffaella; Ceravolo, Maria Gabriella; Nicoletti, Alessandra; De Rosa, Anna; Gaetano, Failla
Classificazione: 1 Contributo su Rivista
Abstract: Objectives: Neuropsychiatric symptoms, such as apathy, disinhibition and irritability, are common in Progressive Supranuclear Palsy (PSP). The Frontal Behaviour Inventory (FBI) is a useful instrument for the evaluation of behavioural disorders in neurodegenerative diseases. The main goal of the present study was to explore the psychometric properties of the FBI in PSP. Design, setting and participants: FBI was administered to the PSP-NET cohort including Italian patients diagnosed according to the Movement Disorder Society criteria. Patients underwent a clinical interview, a motor evaluation, extensive cognitive and behavioural testing. Results: Two hundred and eight subjects were included in this study. The internal consistency was high (Cronbach’s alpha = 0.868) and no improvement of this value was noted upon removal of any item. FBI showed also good acceptability, reliability and validity. The standard error of measurement (SEM) value for FBI total score was 0.169 [SEM = SD √ (1 – Cronbach’s alpha)]. Factor analysis indicated a five-factor structure: Apathy, Behavioural disorders, Impulsivity, Motor and speech frontal behaviour and Executive disorders that explained the 54.92% of the total variance. Linear regression analysis showed that global cognitive impairment significantly affects both Apathy and Motor and speech frontal behaviour factors. Conclusions: In conclusion, FBI is a reliable and valid tool for the assessment of neuropsychiatric symptoms in PSP, despite some constructs, such as euphoria and irritability, are better measured by the NPI. Two third of the cohort was represented by Richardson’s syndrome, thus our data are mainly applicable to such common phenotype. Such data are useful in both clinical and research settings to plan adequate therapeutic interventions and to improve the quality of life of PSP patients and their caregivers.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/348832

Profiles of Vulnerability to Financial Exploitation in the Degenerative Dementias
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY
Autore/i: Cherubini, Veronica; Prata, Oscar; Fattobene, Lucrezia; Ceravolo, Maria Gabriella; Silvestrini, Mauro; Luzzi, Simona
Classificazione: 1 Contributo su Rivista
Abstract: Objective: Financial decisions are necessary for independent living. There is evidence that dementia and cognitive impairment can impair the ability to pursue financial skills and lead to vulnerability to financial exploitation. Frontotemporal dementia (FTD) and to a lesser extent Alzheimer's disease (AD) promote susceptibility to deception. There is little evidence for other forms of degenerative dementia. To explore this topic, we developed a questionnaire that assesses financial behavior in four dementias: Alzheimer's disease (AD), behavioral variant Frontotemporal Dementia (bvFTD), semantic variant of Primary Progressive Aphasia (svPPA), and dementia with Lewy bodies (LBD). Design, Setting, Participants: Participants were 166 consecutive patients with dementia (78 AD, 34 bvFTD, 22 svPPA, 32 LBD) involved in a cross-sectional study exploring financial frailty. Measurements: An experimental questionnaire, the Financial Frailty Battery (FFB), was administered to caregivers who were asked to report any behavioral changes after the onset of dementia in five domains related to financial behavior: Trust, Susceptibility to Scams, Behavioral Tendencies, Financial Management and Use of Money. Results: bvFTD showed alterations in all domains explored and was the only group prone to scams. AD and svPPA showed a greater tendency to trust people, exhibit certain behavioral tendencies, and engage in financial mismanagement, but no increased susceptibility to scams. LBD showed deficits in financial management and use of money, with preserved trust and no susceptibility to scams. Conclusion: The presence of specific profiles regarding financial behavior in different forms of degenerative dementia may be useful to creating tailored protection strategies in clinical settings.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/345405

Impact of an intensive outpatient rehabilitation on non-motor patients' reported outcomes in PD: the INTENSO study
NPJ PARKINSON'S DISEASE
Autore/i: Capecci, Marianna; Baldini, Nicolò; Andrenelli, Elisa; Lambertucci, Alice; Bisoglio, Paola; Grugnetti, Martina; Hibel, Margherita; Ceravolo, Maria Gabriella
Classificazione: 1 Contributo su Rivista
Abstract: Non-motor symptoms in Parkinson's disease (PD) can reduce quality of life and increase disability. This historical cohort study investigated how rehabilitation intensity influences non-motor symptoms. The primary outcomes were changes in non-motor symptoms in the short and medium term. Secondary outcomes were changes in disability burden, motor symptom severity, and freezing of gait after treatment. Measurements were taken before (T0) and after treatment (T1) and 6 ± 1 months after T1 (T2). According to total training duration, 24 patients with PD were assigned to High-Intensity Training group (HIT, 1800 min) and 24 to Low-Intensity Training (LIT, less than 900 minutes). At T1, only the HIT group showed clinically significant improvements in non-motor symptoms, which were maintained at T2. In contrast, the LIT group experienced worsening disability at follow-up. Multivariate analysis revealed training intensity and baseline disability as predictors of improvement. These findings support the benefits of high intensity exercise in PD management.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/345293

A Short Version of Carers' Quality of Life Questionnaire for Parkinsonism: Data from Progressive Supranuclear Palsy Network
MOVEMENT DISORDERS CLINICAL PRACTICE
Autore/i: Cappiello, Arianna; Calandra‐buonaura, Giovanna; Ceravolo, Roberto; Coralli, Saverio; Cuoco, Sofia; Del Prete, Eleonora; Di Biasio, Francesca; Frosini, Daniela; Gualtieri, Vittorio; Mascioli, Davide; Sambati, Luisa; Schirinzi, Tommaso; Stefani, Alessandro; Umbertini, Elisa; Aiello, Marco; Costanzo, Matteo; De Micco, Rosa; Fabbrini, Giovanni; Failla, Gaetano; Longo, Chiara; Malaguti, Maria Chiara; Modugno, Nicola; Olivola, Enrica; Russo, Noemi Maria Carola; Tessitore, Alessandro; Ciammola, Andrea; Colosimo, Carlo; De Rosa, Anna; De Togni, Laura; Di Fonzo, Alessio; Moschella, Vincenzo; Pilotto, Andrea; Spagnolo, Francesca; Zangaglia, Roberta; Barone, Paolo; Picillo, Marina; PSP-NET study, Group; Ceravolo, Maria Gabriella
Classificazione: 1 Contributo su Rivista
Abstract: Background and objectives: Caregivers of progressive supranuclear palsy (PSP) patients frequently show significant distress. The Parkinsonism Carers quality of life (QoL) (PQoL Carer) is a valid tool evaluating the effect of PSP on caregivers' QoL. Main aim of the present study was to develop a short version of the PQoL Carer, named PSP-ShoQoL Carer. Methods: PQoL Carer was administered within the PSP-NET. Participants underwent clinical, motor, cognitive, and behavioral evaluations. Results: Data from 344 participants were included. The final PSP-ShoQoL Carer included eight items. The internal consistency was high (Cronbach's α = 0.867) and PSP-ShoQoL Carer showed also good acceptability, reliability, and validity. The PSP-ShoQoL Carer showed a significant correlation with caregivers' standard measures of QoL and with patients' motor, cognitive, and behavioral characteristics, such as neuropsychiatric symptoms. Finally, PSP-ShoQoL Carer showed an appropriate sensitivity to change over 6-month follow up. Conclusions: PSP-ShoQoL Carer is a reliable and valid time-saving tool for the assessment of caregivers' QoL in PSP.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/348834

Physical and rehabilitation medicine for outpatients. The European PRM (UEMS PRM Section) Position Statement
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Treger, Iuly; Oral, Aydan; Giustini, Alessandro; Christodoulou, Nicolas; Ceravolo, Maria G.; Zampolini, Mauro
Classificazione: 1 Contributo su Rivista
Abstract: The need for medical rehabilitation is growing rapidly, including functional assessment and rehabilitation management of outpatients. The wide diversity of the out of the hospital PRM programs leads to define the basic principles and the role of the PRM specialist in the field. The aim of this article is to outline the core professional principles of the PRM for outpatient care, according to the Physical and Rehabilitation Medicine Section of the European Union of Medical Specialists. A Working Group (WG) on “Physical and Rehabilitation Medicine for Outpatients” was formed in March 2023. The final version was unanimously approved at the General Assembly on September 13th, 2024. The principal aspects of PRM management of outpatients, according to the UEMS PRM Section, are reported. It is essential that PRM programs for outpatients are planned, developed, and implemented according to the professional principles of Physical and Rehabilitation Medicine in appropriate settings. They must be conducted by a multiprofessional team led by a PRM physician. These efforts aim to maximize functional outcomes and enhance the quality of life for individuals at risk of disability and chronic conditions.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/344134

Telemedicine/Telerehabilitation to Expand Enhanced Recovery After Surgery Interventions in Minimally Invasive Mitral Valve Surgery
JOURNAL OF CLINICAL MEDICINE
Autore/i: Malvindi, Pietro Giorgio; Ceravolo, Maria Gabriella; Capecci, Marianna; Balestra, Stefania; Cinì, Emanuela; Antoniello, Antonia; Pepa, Lucia; Carbonetti, Antonella; Ricci, Maurizio; Berretta, Paolo; Mazzocca, Francesca; Fioretti, Marco; Volpe, Umberto; Munch, Christopher; Di Eusanio, Marco
Classificazione: 1 Contributo su Rivista
Abstract: Objectives: Having achieved a consolidated in-hospital experience with enhanced recovery after cardiac surgery, we explored the feasibility of expanding our protocol to pre-admission and post-discharge periods. Methods: A multidisciplinary team including cardiac surgeons, anaesthetists/intensivists, physiatrists, physiotherapists, perfusionists, nurses, psychiatrists, and engineers, elaborated a new therapeutic offer, based on current ERAS evidence and using telerehabilitation, to enhance preoperative communication and education and improve pre- and postoperative health and psychological state. Results: An institutional web-based platform for remote rehabilitation will host digital content that covers three main areas, including information and communication, prehabilitation and rehabilitation with the offer of respiratory and muscular exercises and aerobic activities, and psychological and patient experience evaluations. These interventions will be achieved through purposely developed video tutorials that present the hospital environments, the relevant healthcare personnel, and their role during the in-hospital patient’s journey, and illustrate tailored prehabilitation activities. A series of questionnaires will be administered to evaluate and follow the patient’s psychological state and collect patient-reported experience measures. The platform was activated in September 2024 and this service will initially involve 100 patients undergoing minimally invasive mitral valve surgery. A first review of compliance and engagement will be carried out after four months and a complete review of the results after the first year. Conclusions: ERAS is associated with improved surgical outcomes. A person-centred treatment should also address the health and psychological difficulties that patients face before hospitalisation and after discharge. Telemedicine is a valid tool to expand treatment and monitoring outside the hospital. This experience may give new insights into the feasibility and effectiveness of providing home-based remote interventions aimed at a global improvement in results throughout the overall cardiac surgery journey.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/344137

RAPIDO (teleRehabilitation for pAtient with ParkInson’s Disease at any mOment): a feasibility and acceptability analysis
ISPRM 2024 Congress, Sydney
Autore/i: Ceravolo, Maria Gabriella; Baldini, Nicolò; Antoniello, Antonia; Sabatelli, Antonio; Valenti, Simone; Pepa, Lucia; Spalazzi, Luca; Andrenelli, Elisa; Pierucci, Giulio; Tinazzi, Michele; Farabolini, Gianmatteo; Gandolfi, Marialuisa; Bonardi, Giulia; Capecci, Marianna
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/331267

RAPIDO (teleRehabilitation for pAtient with ParkInson’s Disease at any mOment): preliminary results.
10° Congresso LIMPE/DISMOV 2024
Autore/i: Bonardi, Giulia; Gandolfi, Marialuisa; Pepa, Lucia; Antoniello, Antonia; Sabatelli, Antonio; Valenti, Simone; Spalazzi, Luca; Andrenelli, Elisa; Vada, Silvia; Capecci, Marianna; Farabolini, Gianmatteo; Tinazzi, Michele; Ceravolo, Maria Gabriella
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Abstract: The current COVID-19 pandemic has revealed how fragile is the territorial care system dedicated to Parkinson's disease (PD). Thus, telemonitoring and telerehabilitation techniques are significant approaches for these people to improve their clinical health status. However, there needs to be more integration of the existing systems. In the RAPIDO (teleRehabilitation for pAtient with ParkInson’s Disease at any mOment) project, a remote monitoring system for physical exercises is proposed to enhance patients’ rehabilitation. At the same time, wearable devices collect health parameters throughout the day. These parameters are then stored on a remote server, facilitating subsequent analysis. The main objective of this study is to assess the acceptability and feasibility of an integrated telerehabilitation and telemonitoring system in patients with PD at any stage of the disease. Secondary objectives include evaluating the impact of the telerehabilitation and telemonitoring system on both motor and non-motor symptoms, the patient’s quality of life, and the caregiver's burden.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/331259

RAPIDO (teleRiabilitazione per pazienti con malattia di ParkInson in qualsiasi stadio): risultati preliminari
XXIII Congresso Nazionale S.I.R.N.
Autore/i: Bonardi, Giulia; Gandolfi, Marialuisa; Pepa, Lucia; Antoniello, Antonia; Sabatelli, Antonio; Valenti, Simone; Spalazzi, Luca; Andrenelli, Elisa; Vada, Silvia; Capecci, Marianna; Farabolini, Gianmatteo; Tinazzi, Michele; Ceravolo, Maria Gabriella
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/331269

RAPIDO (teleRehabilitation for pAtient with ParkInson’s Disease at any mOment): an interim analysis of acceptability and clinical usefulness data
24th European Congress ESPRM, Ljubjana
Autore/i: Baldini, Nicolò; Capecci, Marianna; Antoniello, Antonia; Sabatelli, Antonio; Valenti, Simone; Pepa, Lucia; Spalazzi, Luca; Andrenelli, Elisa; Pierucci, Giulio; Tinazzi, Michele; Farabolini, Gianmatteo; Gandolfi, Marialuisa; Bonardi, Giulia; Ceravolo, Maria Gabriella
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/331266

Personalized rehabilitation for people with Parkinson's disease via novel AI stratification strategies: the PREPARE project
Personalized rehabilitation for people with Parkinson's disease via novel AI stratification strategies: the PREPARE project
Autore/i: Ceravolo, Maria Gabriella; Andrenelli, Elisa; Pepa, Lucia; Farabolini, Gianmatteo; Baldini, Nicolo; Capecci, Marianna; Group, Prepare
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Abstract: Background and aims: Parkinson's disease (PD) represents the archetype of complexity. It affects multiple body functions, producing functional profiles different in severity and course, and strongly influenced by many individual variables, including response to rehabilitation. Although evidence of the effectiveness of motor training is available, the outcome observed after any rehabilitation approach varies widely among patients. A refined predictive capacity is fundamental to guarantee the right treatment for the right patient. PREPARE (1) is a European HaDEA-Horizon project with 20 partners from nine countries, involving the application of machine learning (ML) techniques on large-scale patient datasets to develop, validate and implement robust, clinically relevant and data-driven computational prediction and stratification tools. As partners of PREPARE, we contribute to the goal of developing prediction models for people with PD. Methods We started a retrospective study to collect data recorded on the database implemented at the Movement Disorders Center of a University Hospital. The Center is a referral facility for the medical diagnosis, treatment and rehabilitation of people with PD. After the diagnosis, patients undergo regular follow-ups every 4-6 months. Clinical information includes demographic data, BMI, professional activity, amount of daily physical activity, disease phenotype and duration, any drug or surgery treatment, degree of motor and non-motor impairment and functioning profile. Results: This retrospective study will provide data from 970 subjects (56% male), presenting, on their first referral to the Centre, an age of 69.8+10 years (range: 31-95), disease duration of 8.1+7 years (median 6.0), Hoehn & Yahr stage <2 in 58% of cases. The progression of the individual clinical profile has been monitored for 5 years, producing approximately 10,000 records. Analysing all the available explanatory variables will allow patients to be appropriately stratified by prognostic factors, to study disability evolution in a large and representative sample of people with PD. Conclusion: The PREPARE project is still ongoing. The predictive model based on the data retrospectively collected will be validated in a prospective study, and the generalizability of the results will be discussed within the PRM community.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/331555

Integration of Commercial Wearable Sensors and Social Robots into an Edge-Fog-Cloud Architecture to Support Rehabilitation Practice
Lecture Notes in Bioengineering
Autore/i: Capecci, M.; Andrenelli, E.; Bajrami, A.; Baldini, N.; Beraldo, G.; Ceravolo, M. G.; Crudele, F.; D'Alessandro, L.; D'Amico, M.; De Robertis, A.; Gaziano, M.; Forgia, A. L.; Laforgia, A.; Melone, G.; Palpacelli, M.; Umbrico, A.; Cortellessa, G.
Editore: Springer Science and Business Media Deutschland GmbH
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Abstract: Given the current increasing age of the population, there is a growing demand for treatment, rehabilitation, and care services for neurological disorders. With the expected demand, the major challenge is designing sustainable care processes that guarantee the required levels of intensity, personalization, and continuity. Modern technologies may play a central role in realizing innovative distributed care processes capable of optimizing resources (i.e., the workload of therapists and healthcare professionals) and facilitating communication and knowledge sharing. This work introduces a study assessing the feasibility, including acceptability and adherence, of integrating wearable sensing devices and a robotic platform into the inpatient intensive rehabilitation care process for evaluating and treating individuals with emerging neurological disabilities.

Approccio riabilitativo personalizzato per persone con Malattia di Parkinson tramite stratificazione prognostica basata sull’Intelligenza Artificiale: il progetto PREPARE
Proceedings XXIII Congresso Nazionale della Società Italiana di Riabilitazione Neurologica, SIRN 2024, Firenze 15-17 Febbraio 2024: Neuroscienze, intelligenza artificiale e riabilitazione personalizzata
Autore/i: Ceravolo, Maria Gabriella; Andrenelli, Elisa; Pepa, Lucia; Farabolini, Gianmatteo; Baldini, Nicolò; Kiekens, Carlotte; Negrini, Stefano; Zampolini, Mauro; Capecci, Marianna
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Abstract: INTRODUZIONE: Il Progetto Riabilitativo Individuale (PRI) è il principale strumento utilizzato dai fisiatri per l'erogazione delle cure a persone che esprimono o sono a rischio di sviluppare disabilità. La redazione di un PRI comporta la definizione di obiettivi basati sulla prognosi funzionale. Tuttavia, in riabilitazione, la previsione degli esiti, con la conseguente stratificazione dei pazienti, è fortemente ostacolata da molteplici variabili individuali e contestuali. La malattia di Parkinson (MdP) rappresenta l’archetipo della complessità. Colpisce molteplici funzioni corporee, producendo profili funzionali diversi per gravità e decorso, e fortemente influenzati da molte variabili individuali, tra cui la risposta ai farmaci, i tratti della personalità, le condizioni socioeconomiche, il background culturale, la comorbilità, l’ambiente familiare, i cambiamenti climatici e, non ultimo, l’attività fisica e la riabilitazione. Benché siano disponibili evidenze di efficacia di combinazioni variabili di allenamento motorio, il risultato osservato dopo qualsiasi approccio riabilitativo varia ampiamente tra i pazienti che presentano caratteristiche demografiche, motorie e non motorie diverse. Una raffinata capacità predittiva è fondamentale al fine di garantire trattamenti appropriati per contenuto e dimensione temporale a pazienti con profili funzionali differenti. MATERIALI E METODI: In qualità di partner del progetto PREPARE, contribuiamo all’obiettivo generale di sviluppare, convalidare e implementare strumenti di previsione e stratificazione computazionali robusti, clinicamente rilevanti e basati sui dati, al fine di promuovere protocolli di riabilitazione personalizzati per persone con MdP. PREPARE è un progetto europeo HaDEA-Horizon con 20 partner provenienti da nove paesi. Il progetto PREPARE è iniziato nel giugno 2023 e si concluderà nel 2027. Esso prevede l’applicazione di tecniche di machine learning (ML) su set di dati di pazienti su larga scala. Oltre alla MdP saranno considerate altre otto condizioni di salute: (1) Disturbi della mano e del polso, (2) Scoliosi, (3) Claudicatio intermittente, (4) Amputazione degli arti inferiori, (6) Artroplastica dell'anca e del ginocchio, (7) Disturbi della colonna vertebrale, (8) Disturbi temporo-mandibolari, (9) Ipertensione. I risultati dei modelli ottenuti verranno condivisi tramite la piattaforma di scienza aperta EHDEN e lo standard Common Data Model (CDM) dell'Observational Medical Outcomes Partnership (OMOP). Per sviluppare modelli di previsione validi per le persone con malattia di Parkinson è stato avviato uno studio retrospettivo di raccolta dati registrati sul database implementato presso il Centro Disturbi del Movimento della Clinica di Neuroriabilitazione, Dipartimento di Medicina Sperimentale e Clinica dell’Università Politecnica delle Marche. Il Centro è identificato a livello regionale come struttura di riferimento di terzo livello per la diagnosi medica, trattamento e riabilitazione di persone con MdP, nell’ambito del PDTA regionale dedicato. I soggetti beneficiano di una presa in carico con monitoraggio clinico-funzionale e valutazioni ogni 4-6 mesi. Le informazioni vengono registrate in una cartella clinica elettronica, e includono: dati demografici, BMI, attività professionale, livello di attività fisica, fenotipo di malattia, durata di malattia, programma di trattamento farmacologico, eventuali parametri di stimolazione cerebrale profonda, severità della compromissione motoria e funzionale (valutata mediante UPDRS-MDS parte I-II-III-IV), severità dei disturbi non motori (valutata mediante Non Motor Symptom Scale-NMSS). RISULTATI: Il database contiene dati relativi a n. 970 soggetti, 56% di sesso maschile, che al momento della presa in carico presso il Centro mostravano un’età di 69,8 + 10 anni (range: 31-95), BMI di 25,7 + 4,3 (range: 14-47), durata di malattia di 8,1 + 7 anni (mediana 6.0), stadio di malattia sec Hoehn & Yahr <2 nel 58% dei casi. I punteggi mediani (IQR) alle scale di valutazione specifiche risultavano: UPDRS-I 3 (3), UPDRS-II 11 (11), UPDRS-III 18 (17), UPDRS-IV: 0 (4), NMSS 47 (45). La progressione del profilo clinico-funzionale è stata monitorata per 5 anni in media, producendo un totale di circa 10000 record. L’analisi di tutte le variabili esplicative disponibili consentirà di stratificare opportunamente i pazienti effettuando correlazioni con l’evoluzione di malattia in un campione ampio e rappresentativa della popolazione affetta da M di Parkinson CONCLUSIONI: Il progetto PREPARE è in pieno svolgimento. Lo step successivo all’allestimento del modello predittivo sulla base dei dati raccolti durante lo studio retrospettivo consisterà nel testare il modello in uno studio prospettico (case study). Sarà interessante confrontarsi all’interno della comunità di neuroriabilitatori in merito all’esito di questo test applicativo e alla generalizzabilità dei risultati ottenuti.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/331558

Setting the European standards for training in Physical and Rehabilitation Medicine
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Barotsis, Nikolaos; Oral, Aydan; Zampolini, Mauro; Janssen, Wim; Frischknecht, Rolf; Tederko, Piotr; Ceravolo, Maria G.
Classificazione: 1 Contributo su Rivista
Abstract: The mission of the European Board of Physical and Rehabilitation Medicine (PRM) is to the ensure a consistent and high-level education for PRM physicians across Europe. An important action to accomplish this mission is the publication and continuous update of the European Training Requirements (ETRs) for the specialty of PRM. The first version of the ETRs for PRM was issued in 2017. The aim was to present the up-to-date training standards for trainees, trainers, and training institutions. The revision of the first ETRs, aiming to reflect the current standards in medical education and clinical advances in the field or PRM, started in 2022 and was completed in 2023. It was based on the Rehabilitation Competency Framework and the “Guide for using a contextualised competency framework to develop rehabilitation programmes and their curricula” published by the WHO in 2021. An important addition in the new version of the ETRs is the integration of Entrustable Professional Activities. In all endeavours of the creation of the ETRs, setting the highest standards of training in PRM was pursued.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/344136

Increased glucosylsphingosine levels and Gaucher disease in GBA1-associated Parkinson's disease
PARKINSONISM & RELATED DISORDERS
Autore/i: Marano, Massimo; Zizzo, Carmela; Malaguti, Maria Chiara; Bacchin, Ruggero; Cavallieri, Francesco; De Micco, Rosa; Spagnolo, Francesca; Bentivoglio, Anna Rita; Schirinzi, Tommaso; Bovenzi, Roberta; Ramat, Silvia; Erro, Roberto; Sorrentino, Cristiano; Sucapane, Patrizia; Pilotto, Andrea; Lupini, Alessandro; Magliozzi, Alessandro; Di Vico, Ilaria; Carecchio, Miryam; Bonato, Giulia; Cilia, Roberto; Colucci, Fabiana; Tamma, Filippo; Caputo, Elena; Mostile, Giovanni; Arabia, Gennarina; Modugno, Nicola; Zibetti, Maurizio; Ceravolo, Maria Gabriella; Tambasco, Nicola; Cossu, Giovanni; Valzania, Franco; Manganotti, Paolo; Di Lazzaro, Vincenzo; Zappia, Mario; Fabbrini, Giovanni; Tinazzi, Michele; Tessitore, Alessandro; Duro, Giovanni; Di Fonzo, Alessio
Classificazione: 1 Contributo su Rivista
Abstract: Introduction: Gaucher's disease (GD) is caused by biallelic mutations in the GBA1 gene, leading to reduced glucocerebrosidase (GCase) activity and substrate (glucosylceramide and glucosylsphingosine, GlcSph) accumulation. GBA1 variant carriers are at risk of Parkinson's disease (PD), but only those with biallelic mutations cross the threshold of GCase reduction, leading to substrate accumulation and GD. The link between GBA1 mutations, GD and PD is not fully understood. Here we aimed at reporting the results of a large PD population screening with dried blood spot tests for GD. Methods: We measured GCase activity and GlcSph levels in 1344 PD patients with dried blood spot tests, and performed GBA1 genetic sequencing. Results: While the GCase activity was reduced in GBA1-PD carriers compared to wild type PD, GlcSph was increased in GBA1-PD compared to GBA1-controls, regardless of the underlying type of GBA1 variant. 13.6 % and 0.4 % of PD patients had mono- or biallelic GBA1 mutations respectively. GCase deficiency, lipid accumulation and clinical manifestations of GD was detected in five PD patients with biallelic GBA1 mutations, of whom four had a risk combined with a GD causing variant. Conclusions: GlcSph appearing higher in PD may represent a reliable biomarker of the disease and deserves to be further investigated. This study highlights the importance of screening PD patients for possible underlying GD, which is a treatable condition that should not be missed. We diagnosed GD cases carrying a “risk” variant in one allele, which is an unprecedented finding deserving further investigation.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/344114

Relevance and use of health policy, health systems and health services research for strengthening rehabilitation in real-life settings: methodological considerations
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Frontera, Walter R.; Cordani, Claudio; Décary, Simon; DE GROOTE, Wouter; DEL FURIA, Matteo J.; Feys, Peter; Jette, Alan M.; Kiekens, Carlotte; Negrini, Stefano; Oral, Aydan; Resnik, Linda; Røe, Cecilie; Sabariego, Carla; Ceravolo, Maria Gabriella
Classificazione: 1 Contributo su Rivista
Abstract: Research on health policy, systems, and services (HPSSR) has seen significant growth in recent decades and received increasing attention in the field of rehabilitation. This growth is driven by the imperative to effectively address real-life challenges in complex healthcare settings. A recent resolution on `Strengthening rehabilitation in health systems' adopted by the World Health Assembly emphasizes the need to support societal health goals related to rehabilitation, particularly to promote high-quality rehabilitation research, including HPSSR. This conceptual paper, discussed with the participants in the 5th Cochrane Rehabilitation Methodological Meeting held in Milan on September 2023, outlines study designs at diverse levels at which HPSSR studies can be conducted: the macro, meso, and micro levels. It categorizes research questions into four types: those framed from the perspective of policies, healthcare delivery organizations or systems, defined patient or provider populations, and important data sources or research methods. Illustrative examples of appropriate methodologies are provided for each type of research question, demonstrating the potential of HPSSR in shaping policies, improving healthcare delivery, and addressing patient and provider perspectives. The paper concludes by discussing the applicability, usefulness, and implementation of HPSSR findings, and the importance of knowledge translation strategies, drawing insights from implementation science. The goal is to facilitate the integration of research findings into everyday clinical practice to bridge the gap between research and practice in rehabilitation.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/327836

The influence of bias in randomized controlled trials on rehabilitation intervention effect estimates: what we have learned from meta-epidemiological studies
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Arienti, Chiara; ARMIJO-OLIVO, Susan; Ferriero, Giorgio; Feys, Peter; Hoogeboom, Thomas; Kiekens, Carlotte; Lazzarini, Stefano G.; Minozzi, Silvia; Negrini, Stefano; Oral, Aydan; Pollini, Elisa; Puljak, Livia; TODHUNTER-BROWN, Alex; Walshe, Margaret; Ceravolo, Maria Gabriella
Classificazione: 1 Contributo su Rivista
Abstract: This study aimed to synthesize evidence from studies that addressed the influence of bias domains in randomized controlled trials on rehabilitation intervention effect estimates and discuss how these findings can maximize the trustworthiness of an RCT in rehabilitation. We screened studies about the influence of bias on rehabilitation intervention effect estimates published until June 2023. The characteristics and results of the included studies were categorized based on methodological characteristics and summarized narratively. We included seven studies with data on 227,806 RCT participants. Our findings showed that rehabilitation intervention effect estimates are likely exaggerated in trials with inadequate/ unclear sequence generation and allocation concealment when using continuous outcomes. The influence of blinding was inconsistent and different from the rest of medical science, as meta-epidemiological studies showed overestimation, underestimation, or neutral associations for different types of blinding on rehabilitation treatment effect estimates. Still, it showed a more consistent pattern when looking at patient-reported outcomes. The impact of attrition bias and intention to treat has been analyzed only in two studies with inconsistent results. The risk of reporting bias seems to be associated with overestimation of treatment effects. Bias domains can influence rehabilitation treatment effects in different directions. The evidence is mixed and inconclusive due to the poor methodological quality of RCTs and the limited number and quality of studies looking at the influence of bias and treatment effects in rehabilitation. Further studies about the influence of bias in RCTs on rehabilitation intervention effect estimates are needed.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/327832

Advancing public health through technological rehabilitation: insights from a national clinician survey
BMC HEALTH SERVICES RESEARCH
Autore/i: Capecci, Marianna; Gandolfi, Marialuisa; Straudi, Sofia; Calabrò, Rocco Salvatore; Baldini, Nicolò; Pepa, Lucia; Andrenelli, Elisa; Smania, Nicola; Ceravolo, Maria Gabriella; Morone, Giovanni; Bonaiuti, Donatella
Classificazione: 1 Contributo su Rivista
Abstract: Introduction: In the evolving healthcare landscape, technology has emerged as a key component in enhancing system efficiency and offering new avenues for patient rehabilitation. Despite its growing importance, detailed information on technology's specific use, types, and applications in clinical rehabilitation settings, particularly within the Italian framework, remains unclear. This study aimed to explore the use of technology and its needs by Physical Medicine and Rehabilitation medical doctors in Italy. Methods: We conducted a cross-sectional online survey aimed at 186 Italian clinicians affiliated with the Italian Society of Physical and Rehabilitation Medicine (SIMFER). The online questionnaire consists of 71 structured questions designed to collect demographic and geographical data of the respondents, as well as detailed insights into the prevalence and range of technologies they use, together with their specific applications in clinical settings." Results: A broad range of technologies, predominantly commercial medical devices, has been documented. These technologies are employed for various conditions, including common neurological diseases, musculoskeletal disorders, dementia, and rheumatologic issues. The application of these technologies indicates a broadening scope beyond enhancing sensorimotor functions, addressing both physical and social aspects of patient care. Discussion: In recent years, there's been a notable surge in using technology for rehabilitation across various disorders. The upcoming challenge is to update health policies to integrate these technologies better, aiming to extend their benefits to a wider range of disabling conditions, marking a progressive shift in public health and rehabilitation practices.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/338792

Shaping the future: an Italian survey unveils the unmet need to empower physical medicine and rehabilitation professionals with technological skills
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Capecci, Marianna; Gandolfi, Marialuisa; Straudi, Sofia; Calabrò, Rocco S; Baldini, Nicolò; Pepa, Lucia; Andrenelli, Elisa; Smania, Nicola; Ceravolo, Maria G; Morone, Giovanni; Bonaiuti, Donatella
Classificazione: 1 Contributo su Rivista
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/330693

Improving the quality of evidence production in rehabilitation. Results of the 5th Cochrane Rehabilitation Methodological Meeting
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Negrini, Stefano; Kiekens, Carlotte; Levack, William M.; MEYER-FEIL, Thorsten; Arienti, Chiara; Côté, Pierre; Ceravolo, Maria Gabriella
Classificazione: 1 Contributo su Rivista
Abstract: The paper introduces the Special Sections of the European Journal of Physical and Rehabilitation Medicine dedicated to the 5(th) Methodological Meeting of Cochrane Rehabilitation. It introduces Cochrane Rehabilitation; its vision, mission and goals; discusses why the Methodological Meetings were created; and reports on their organisation and previous outcomes. The core content of this editorial is the 5(th) Methodological Meeting held in Milan in September 2023. The original title for this meeting was "The Rehabilitation Evidence Ecosystem: useful study designs." The focus of the Milan meeting was informed by the lessons learned by Cochrane Rehabilitation in the past few years, by the new rehabilitation definition for research purposes, by the collaboration with the World Health Organization (WHO), and by the REH-COVER (Rehabilitation COVID-19 Evidence-Based Response) action. During the Meeting, participants discussed the current methodological evidence on the following: RCTs in rehabilitation coming from meta-epidemiological studies; observational study designs -specifically the IDEAL Framework (Idea, Development, Exploration, Assessment, Long-term study) and its potential implementation in rehabilitation and the Target Trial Emulation framework: Single Case Experimental Designs; complex intervention studies: health services research studies, and studies using qualitative approaches. The Meeting culminated in the development of a first version of a "road map" to navigate the evidence production in rehabilitation according to the previous discussions. The Special Sections' papers present all topics discussed at the meeting, and a methodological paper about choosing the right research question, presenting final results and the "road map" for evidence production in rehabilitation.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/327833

Telerehabilitation Outcome Prediction via Machine Learning
2024 IEEE 3rd International Conference on Intelligent Reality (ICIR)
Autore/i: Ciabattoni, Lucio; Ceravolo, Maria Gabriella; Capecci, Marianna; Pepa, Lucia
Editore: Institute of Electrical and Electronics Engineers Inc.
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Abstract: In this study, we propose a telerehabilitation system designed to remotely monitor patients and analyze data collected from commercial wearable devices throughout a 12-weeks physical exercise program. The system, developed under the RAPIDO project, utilizes a Random Forest (RF) model to predict patients' rehabilitation outcomes based on health metrics collected during the program. Preliminary results show that the RF model can effectively predict rehabilitation outcomes, offering valuable insights into patient progress and supporting the personalization of rehabilitation programs by only leveraging on commercial devices.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/348876

Navigating Rehabilitation: the General Index of Rehabilitation Knowledge developed by Cochrane rehabilitation through a global interprofessional Delphi process
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Gimigliano, Francesca; Moretti, Antimo; Lazzarini, Stefano G; Pollet, Joel; Arienti, Chiara; Ceravolo, Maria G; Cordani, Claudio; Kiekens, Carlotte; Negrini, Stefano
Classificazione: 1 Contributo su Rivista
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/344135

Incidence of amyotrophic lateral sclerosis before and during the COVID-19 pandemic: evidence from an 8-year population-based study in Central Italy based on healthcare utilization databases
AMYOTROPHIC LATERAL SCLEROSIS AND FRONTOTEMPORAL DEGENERATION
Autore/i: Sopranzi, Federico Maria; Faragalli, Andrea; Pompili, Marco; Carle, Flavia; Gesuita, Rosaria; Ceravolo, Maria Gabriella
Classificazione: 1 Contributo su Rivista
Abstract: Background: Amyotrophic Lateral Sclerosis (ALS) is a fatal neurodegenerative disorder with a high multidimensional burden, with an obscure etiopathogenesis. Methods: We designed a longitudinal, population-based study of people residing in Central Italy (Marche Region) who were beneficiaries of the National Health System. People with an unprecedented ALS hospitalization (335.20 ICD-9 CM) or tagged with an ALS exemption between 2014 and 2021 were considered incident cases. ALS cases residing in the region for <3 years or with an active ALS exemption or hospitalized for ALS before 2014 were excluded. We used secondary sources to identify new ALS diagnoses. The regional referral center for ALS's database was used to test the accuracy of secondary sources in detecting cases. ALS mean incidence was compared to that reported in similar studies conducted in Italy. The incidence rate trend adjusted by sex and age was evaluated using the Poisson regression model. Results: We detected 425 new ALS cases (median age: 70y) in the 2014-2021 period, with a mean incidence of 3.5:100,000 py (95%CI: 3.2-3.8; M:F = 1.2), similar to that reported in similar studies conducted in Italy. No trend was observed during 2014-2019. After including 2020-2021 in the model, we observed a mean decrease in incidence of 5.8% (95% CI 2.0%; 9.5%, p = 0.003). Conclusion: We show a decrease in the incidence rate of ALS in Marche, during the 2014-2021 period, as a possible outcome of a delayed neurological assessment and diagnosis during the pandemic. An ad hoc developed identification algorithm, based on healthcare utilization databases, is a valuable tool to assess the health impact of global contingencies.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/328433

Introduction to target trial emulation in rehabilitation: a systematic approach to emulate a randomized controlled trial using observational data
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Côté, Pierre; Negrini, Stefano; Donzelli, Sabrina; Kiekens, Carlotte; Arienti, Chiara; Ceravolo, Maria G.; Gross, Douglas P.; Battel, Irene; Ferriero, Giorgio; Lazzarini, Stefano G.; Dan, Bernard; Shearer, Heather M.; Wong, Jessica J.
Classificazione: 1 Contributo su Rivista
Abstract: Rehabilitation providers and policymakers need valid evidence to make informed decisions about the healthcare needs of the population. Whenever possible, these decisions should be informed by randomized controlled trials (RCTs). However, there are circumstances when evidence needs to be generated rapidly, or when RCTs are not ethical or feasible. These situations apply to studying the effects of complex interventions, including rehabilitation as defined by Cochrane Rehabilitation. Therefore, we explore using the target trial emulation framework by Hernán and colleagues to obtain valid estimates of the causal effects of rehabilitation when RCTs cannot be conducted. Target trial emulation is a framework guiding the design and analysis of non-randomized comparative effectiveness studies using observational data, by emulating a hypothetical RCT. In the context of rehabilitation, we outline steps for applying the target trial emulation framework using real world data, highlighting methodological considerations, limitations, potential mitigating strategies, and causal inference and counterfactual theory as foundational principles to estimating causal effects. Overall, we aim to strengthen methodological approaches used to estimate causal effects of rehabilitation when RCTs cannot be conducted.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/327837

Unveiling Muscular Engagement: Evidence of Activity in Mental Imagery and Action Observation
2024 IEEE International Symposium on Medical Measurements and Applications, MeMeA 2024 - Proceedings
Autore/i: Verdini, F.; Capecci, M.; Tigrini, A.; Scattolini, M.; Mobarak, R.; Burattini, L.; Fioretti, S.; Benedetti, M. G.; Ceravolo, M. G.; Mengarelli, A.
Editore: Institute of Electrical and Electronics Engineers Inc.
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Abstract: The cognitive processes associated with the move-ment representation in the absence of physical execution, specif-ically motor imagery (MI), or with the action observation (AO), have been extensively investigated to understand how these activities can affect the endurance and the physical strength. The observed improvements of the motor performance have been attributed not only to the modifications in the central motor program but also to changes in the peripheral neuronal and musculoskeletal systems. Despite these efforts, capturing these effects has proven challenging, with inconsistent results obtained when analyzing electromyographic activity (EMG). This study aims to explore distinctive myoelectric patterns during MI and AO tasks, contrasting them with baseline patterns associated with a resting condition. Eight healthy subjects participated in imagining and observing a fine motor task involving hand and arm. Surface EMG signals from Opponens Pollicis, Flexor Radialis Carpi and Biceps Brachialis were analyzed for both experimental conditions and compared with signals obtained during rest (REST). Features in the time and the time-frequency domains were computed and two their subsets, resulting statisti-cally different for MI and for AO, in comparison to REST, were selected. These features were then inputted into three shallow machine learning models (KNN, SVM, and LDA) to assess the consistency of muscular engagements. The KNN classifier demonstrated the best performance in terms of accuracy (87 %) for MI vs REST, utilizing a subset of features exclusively defined in the time-domain. To capture muscular activity during AO, a more comprehensive feature subset, including some time-frequency features, was required to KNN to reach an accuracy of 89%.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/333733

Supervised learning for automatic emotion recognition in Parkinson’s disease through smartwatch signals
EXPERT SYSTEMS WITH APPLICATIONS
Autore/i: Pepa, Lucia; Spalazzi, Luca; Ceravolo, Maria Gabriella; Capecci, Marianna
Classificazione: 1 Contributo su Rivista
Abstract: People with Parkinson’s Disease (PwPD) usually experience several neuropsychiatric signs such as anxiety, depression, and negative emotions that contribute to disability and worsening of quality of life. Notwithstanding, the assessment of these symptoms are largely underrated, subjective and difficult due to a large overlapping with other PD symptoms, like hypomimia and bradikinesia. The aim and novelty of the current work is to study and validate a method for automatic emotion recognition in PwPD during daily living through autonomic signals acquired by acceptable and low-cost consumer technology. The best shallow learning algorithm and the best minimal feature set are individuated. 11 PwPD and 8 subjects with no history of neurological injury or illness were enrolled in the study. Participants were asked to watch video clips purposely selected to arouse emotions, and annotate arousal and valence of emotions triggered by video clips, while their heart rate, skin conductance, and temperature were recorded by a smartwatch. Smartwatch data was used for features extraction, while participants’ reported arousal and valence were used as gold-standard to train machine learning algorithms for emotion classification (low/high arousal, positive/negative valence). Different feature sets and different algorithms (i.e.decision tree (DT), random forest (RF), support vector machine (SVM), and multilayer perceptron (MLP)) were evaluated to find the best solution for each group of participant. In each group of participants, it was possible to find a combination of feature set and algorithm to reach a classification accuracy greater than 90%. The Random Forest reached the best performance in both groups and for both valence and arousal. For each classification task (valence or arousal, PwPD or controls), the best model was selected and the minimal feature set was found by performing a recursive feature elimination based on the Shapley value. A lower accuracy of appraisal emerged for arousal compared to valence. Obtained results showed the feasibility of automatic emotion recognition in PwPDs through autonomic signals. Autonomic dysfunction in PwPDs may explain the lower arousal accuracy. The findings warrant confirmation from trials on larger samples and there are open issues to be deepened in future work.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/328054

RAPIDO: RIABILITAZIONE E MONITORAGGIO IN PAZIENTI CON MALATTIA DI PARKINSON
XXII Congresso Nazionale S.I.R.N.
Autore/i: Baldini, Nicolò; Andrenelli, Elisa; Pepa, Lucia; Spalazzi, Luca; Antoniello, Antonia; Valenti, Simone; Bonardi, Giulia; Tinazzi, Michele; Gandolfi, Marialuisa; Capecci, Marianna; Ceravolo, Maria Gabriella
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Abstract: La malattia di Parkinson (PD) è una malattia neurodegenerativa cronica che comporta una progressiva disabilità nelle attività della vita quotidiana e limitazioni della partecipazione sociale a causa dell'evoluzione dei sintomi motori e non motori. Sebbene la riabilitazione riduca la progressione della disabilità, questi pazienti richiedono un approccio continuo e a lungo termine che ad oggi rimane un aspetto non sempre garantito. Il monitoraggio continuo a distanza e la teleriabilitazione quindi sono opzioni che possono migliorare la gestione di questi pazienti, ma ad oggi sono pochi gli studi che ne hanno esplorato gli effetti. Ci proponiamo di valutare l'accettabilità e la fattibilità di un sistema integrato di teleriabilitazione e telemonitoraggio in pazienti con PD in qualsiasi fase di malattia e di indagare ulteriormente l'impatto del sistema di teleriabilitazione e telemonitoraggio sulla funzione motoria e non motoria, nonché sulla qualità della vita e sul carico dei caregiver.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/331268

TELERIABILITAZIONE PER PERSONE AFFETTE DA MALATTIA DI PARKINSON IN QUALSIASI STADIO: RISULTATI PRELIMINARI DELLO STUDIO RAPIDO
51° Congresso SIMFER Bologna 2023
Autore/i: Capecci, Marianna; Andrenelli, Elisa; Pepa, Lucia; Gandolfi, Marialuisa; Bonardi, Giulia; Vada, Silvia; Casoli, Paola; Antoniello, Antonia; Sabatelli, Antonio; Valenti, Simone; Farabolini, Gianmatteo; Baldini, Nicolò; Spalazzi, Luca; Tinazzi, Michele; Ceravolo, Maria Gabriella
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/331265

LONG HAUSERS, COME SONO I VOSTRI MUSCOLI? VALUTAZIONE ECOGRAFICA DELLA MORFOLOGIA MUSCOLARE A TRE MESI DALL’INFEZIONE DA SARS-COV2 IN UNO STUDIO PROSPETTICO CONTROLLATO
Abstract Book Congresso Nazionale Bologna 2023
Autore/i: Baldini, Nicolò; Cesaroni, Pietro; Andrenelli, Elisa; Ceravolo, Maria Gabriella; Cima, Rossella; Tarini, Fabio; Capecci, Marianna
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/331559

Clinical and Functional Evolution in Subjects with Parkinson’s Disease during SARS-CoV-2 Pandemic
APPLIED SCIENCES
Autore/i: Capecci, Marianna; Baldini, Nicolò; Campignoli, Francesca; Lombardo, Lorenzo Pasquale; Andrenelli, Elisa; Ceravolo, Maria Gabriella
Classificazione: 1 Contributo su Rivista
Abstract: The COVID-19 pandemic has been a stress test for the population, especially for people with chronic disorders such as Parkinson’s disease (PD). In addition to public health restrictions that contrast with PD management recommendations, there were deep changes in health care delivery. This retrospective study evaluates the impact of COVID-19 on the clinical and functional evolution of a cohort of 221 PD patients consecutively referred to the Movement Disorders Center between 2018 and 2021. We analyzed the trend in motor and non-motor symptoms and functional status across years based on the Unified Parkinson’s Disease Rating Scale (UPDRS) and Non-Motor Symptom Scale (NMSS). We also compared the number of emerging complications, neurologic visits, and rehabilitation sessions per subject per year. In 2020, all primary endpoint measures worsened compared to 2019, without age, disease duration, or greater neurologic impairment explaining this outcome. Concurrently, the percentage of patients receiving neurologic visits or rehabilitation sessions reduced by 53% and 58%, respectively. The subgroup analysis of 167 subjects revealed that those who received at least one cycle of rehabilitation sessions in 2020 maintained their independence level. These findings lead to emphasizing the importance of regular monitoring and rehabilitation delivery in people with chronic neurological disorders.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/310170

Consumer Devices for Health Parameter Collection and Analysis in Parkinson’s Disease Telerehabilitation
Proceedings 2023 IEEE 13th International Conference on Consumer Electronics - Berlin (ICCE-Berlin)
Autore/i: Antoniello, Antonia; Sabatelli, Antonio; Valenti, Simone; Belbusti, Caterina; Pepa, Lucia; Spalazzi, Luca; Andrenelli, Elisa; Capecci, Marianna; Tinazzi, Michele; Farabolini, Gianmatteo; Gandolfi, Marialuisa; Bonardi, Giulia; Ceravolo, Maria Gabriella
Editore: IEEE
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Abstract: Physical exercise is a significant non-pharmacological approach for individuals with Parkinson’s disease (PD) to improve their condition. In this paper, a remote monitoring system for physical exercises has been proposed toenhance patients’ rehabilitation. Wearable devices are utilized to collect health parameters throughout the day. These parameters are then stored on a remote server, facilitating subsequent analysis. The analysis employs techniques such as the Tukey test, PCA technique, and K-means clustering algorithm.The primary objectives of this analysis are twofold: first, to identify any changes in the patients’ health status over the monitoring period, and second, to assess the acceptability of the system. By analyzing the collected data, the analysis aims to detect patterns, trends, and significant variations in the health parameters, providing valuable insights into the patients’ progress. Additionally, it serves to evaluate the effectiveness and practicality of the system, ensuring its acceptability for both patients and healthcare providers involved in the rehabilitationprocess.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/331192

Telerehabilitation with ARC Intellicare to Cope with Motor and Respiratory Disabilities: Results about the Process, Usability, and Clinical Effect of the "Ricominciare" Pilot Study
SENSORS
Autore/i: Capecci, Marianna; Cima, Rossella; Barbini, Filippo A; Mantoan, Alice; Sernissi, Francesca; Lai, Stefano; Fava, Riccardo; Tagliapietra, Luca; Ascari, Luca; Izzo, Roberto N; Leombruni, Maria Eleonora; Casoli, Paola; Hibel, Margherita; Ceravolo, Maria Gabriella
Classificazione: 1 Contributo su Rivista
Abstract: Background: "Ricominciare" is a single-center, prospective, pre-/post-intervention pilot study aimed at verifying the feasibility and safety of the ARC Intellicare (ARC) system (an artificial intelligence-powered and inertial motion unit-based mobile platform) in the home rehabilitation of people with disabilities due to respiratory or neurological diseases. Methods. People with Parkin-son's disease (pwPD) or post-COVID-19 condition (COV19) and an indication for exercise or home rehabilitation to optimize motor and respiratory function were enrolled. They underwent training for ARC usage and received an ARC unit to be used independently at home for 4 weeks, for 45 min 5 days/week sessions of respiratory and motor patient-tailored rehabilitation. ARC allows for ex-ercise monitoring thanks to data from five IMU sensors, processed by an AI proprietary library to provide (i) patients with real-time feedback and (ii) therapists with information on patient adherence to the prescribed therapy. Usability (System Usability Scale, SUS), adherence, and adverse events were primary study outcomes. Modified Barthel Index (mBI), Barthel Dyspnea Index (BaDI), 2-Minute Walking Test (2MWT), Brief Fatigue Inventory (BFI), Beck Depression or Anxiety Inventory (BDI, BAI), and quality of life (EQ-5D) were also monitored pre-and post-treatment. Results. A total of 21 out of 23 eligible patients were enrolled and completed the study: 11 COV19 and 10 pwPD. The mean total SUS score was 77/100. The median patients' adherence to exercise prescriptions was 80%. Clinical outcome measures (BaDI, 2MWT distance, BFI; BAI, BDI, and EQ-5D) improved significantly; no side effects were reported. Conclusion. ARC is usable and safe for home rehabilitation. Prelimi-nary data suggest promising results on the effectiveness in subjects with post-COVID condition or Parkinson's disease.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/324312

Rehabilitation and COVID-19: systematic review by Cochrane Rehabilitation
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Arienti, Chiara; Lazzarini, Stefano G.; Andrenelli, Elisa; Cordani, Claudio; Negrini, Francesco; Pollini, Elisa; Ceravolo, Maria G.; International Multiprofessional Steering Committee of Cochrane Rehabilitation, REH-COVER Action
Classificazione: 1 Contributo su Rivista
Abstract: INTRODUCTION: Until the last update in February 2022, the Cochrane Rehabilitation COVID-19 Evidence-based Response (REH-COVER)action identified an increasing volume of evidence for the rehabilitation management of COVID-19. Therefore, our aim was to identify the best available evidence on the effectiveness of interventions for rehabilitation for CO VID -19-related limitations of functioning of rehabilitation interest in adults with COVID-19 or post COVID-19 condition (PCC).EVIDENCE ACQUISITION : We ran the searches on February 17th, 2023, in the following databases: PubMed, EMBASE, CENTRAL, CINHAL, and the Cochrane COVID-19 Study Register, applying a publication date restriction to retrieve only papers published in 2022. To retrieve papers published before 2022, we screened the reference lists of previous publications included in the REH-COVER action, covering papers from early 2020 to the end of 2022. This current review includes only randomised controlled trials and concludes the rapid living systematic reviews of the Cochrane Rehabilitation REH-COVER action. The risk of bias and certainty of evidence were evaluated in all studies using the Cochrane Risk of Bias tool and GRADE, respectively. We conducted a narrative synthesis of the evidence. PROSPERO registration number: CRD 42022374244.EVIDENCE SYNTHESIS: After duplicate removal, we identified 18,950 individual records and 53 RCTs met the inclusion criteria. Our findings suggest that the effect of breathing and strengthening exercise programs on dyspnea and physical exercise capacity compared to no treatment in non-severe CO VID-19 patients is uncertain. Multicomponent telerehabilitation may slightly increase physical exercise capacity compared to educational intervention in adults with PCC. There is, however, uncertainty about its effect on lung function and physical exercise capacity when compared to no treatment. Finally, the effect of inspiratory muscle training on maximal inspiratory pressure compared to no treatment in adults with PCC is uncertain.CONCLUSIONS: Interventions that are part of comprehensive pulmonary rehabilitation approaches may benefit dyspnea and exercise tolerance in adults with COVID-19 and PCC. The available evidence has several methodological limitations that limit the certainty of evidence and the clinical relevance of findings. Therefore, we cannot provide robust suggestions for practice. While high-quality RCTs are being conducted, clinicians should consider using high-quality evidence from other pulmonary conditions to rehabilitate patients with COVID-19 or PCC using context-specific interventions.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/327835

The Impact of Reduction Mammaplasty on Breast Sensation: A Systematic Review
AESTHETIC SURGERY JOURNAL
Autore/i: Torresetti, Matteo; Andrenelli, Elisa; Peltristo, Benedetta; Zavalloni, Yasmine; Capecci, Marianna; Ceravolo, Maria Gabriella; Di Benedetto, Giovanni
Classificazione: 1 Contributo su Rivista
Abstract: Loss of sensation is one of the most feared complications of breast reduction surgery. Although several techniques have been proposed to maximize sensitivity preservation, the scientific literature still reports contradictory findings. This systematic review aimed to assess whether breast reduction mammaplasty is associated with measurable changes in breast sensation. This review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed (National Institutes of Health, Bethesda, MD), Scopus (Elsevier, Amsterdam, the Netherlands), and Web of Science (Clarivate, Philadelphia, PA) databases were searched for clinical studies investigating breast sensation after breast reduction mammaplasty. The initial search identified 1523 studies of which 22 articles met our specific inclusion criteria. Most of the included studies are consistent in describing only transient sensation decrease or even sensation improvement after surgery compared to the presurgery condition with any approach, except those investigating outcomes after superior or superolateral pedicle reduction mammaplasty. Nevertheless, the overall quality of evidence is low or very low due to the limited availability of randomized controlled trials or controlled studies and the high risk of bias.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/324311

Automatic emotion recognition in clinical scenario: a systematic review of methods
IEEE TRANSACTIONS ON AFFECTIVE COMPUTING
Autore/i: Pepa, Lucia; Spalazzi, Luca; Capecci, Marianna; Ceravolo, Maria Gabriella
Classificazione: 1 Contributo su Rivista
Abstract: Automatic emotion recognition has powerful opportunities in the clinical field, but several critical aspects are still open, such as heterogeneity of methodologies or technologies tested mainly on healthy people. This systematic review aims to survey automatic emotion recognition systems applied in real clinical contexts, to deeply analyse clinical and technical aspects, how they were addressed, and relationships among them. The literature review was conducted on: IEEEXplore, ScienceDirect, Scopus, PubMed, ACM. Inclusion criteria were the presence of an automatic emotion recognition algorithm and the enrollment of at least 2 patients in the experimental protocol. The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Moreover, the works were analysed according to a reference model to deeply examine both clinical and technical topics. 52 scientific papers passed inclusion criteria. Most clinical scenarios involved neurodevelopmental, neurological and psychiatric disorders with the aims of diagnosing, monitoring, or treating emotional symptoms. The most adopted signals are video and audio, while supervised shallow learning is mostly used for emotion recognition. A poor study design, tiny samples, and the absence of a control group emerged as methodological weaknesses. Heterogeneity of performance metrics, datasets and algorithms challenges results comparability, robustness, reliability and reproducibility of results.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/300751

Health literacy education at the time of COVID-19: development and piloting of an educational programme for university health professional students in 4 European countries
BMC MEDICAL EDUCATION
Autore/i: Papa, Roberta; Sixsmith, Jane; Giammarchi, Cinzia; Lippke, Sonia; Mckenna, Verna; Di Furia, Lucia; Ceravolo, Maria Gabriella; De Winter, Andrea
Classificazione: 1 Contributo su Rivista
Abstract: Background: Health literacy has a strong influence on individual health outcomes and the sustainability of healthcare systems. Healthcare professionals often overestimate patients’ health literacy levels and lack adequate competencies to address limited health literacy effectively. Therefore, promoting understanding through effective health communication between professionals and citizens is becoming increasingly important. Although health literacy has recently gained more attention, health literacy educational programmes targeting future healthcare professionals are still scarce, especially in Europe. This study describes the piloting process of a pan-European health literacy educational programme and shows how the educational material is being used during time of crisis such as the COVID-19 pandemic. Methods: The educational programme was developed through the definition of an educational philosophy and iterative co-creation processes consisting of stakeholders’ consultations, material development and pilots with students. The evaluation was carried out in Italy through four pilot tests involving 107 students of health-related degrees. An evaluation questionnaire and a pre-post test were developed and used to collect students’ and educators’ feedback (quantitative and qualitative) and assess changes in health literacy awareness, respectively. Three additional pilots were organized in Italy and Germany mostly during the COVID-19 pandemic to evaluate the feasibility of the educational programme through online and hybrid learning, respectively. Results: The pilots received positive feedback from both students and educators. Students were highly satisfied with the courses, reported their relevance for their future profession and appreciated the interactive teaching methods. The pre-post test showed a significant improvement in health literacy awareness after the training. Educators reported the adequacy and flexibility of the training material, the ease of transferability of the content of the lessons into practice, and the validity of the tested options to integrate the educational programme into the curricula. Conclusions: Our comprehensive, evidence-based educational programme contributes to addressing the existing challenges in Europe, and its flexibility allows for easy integration in the curricula, through different options, hence supporting a widespread uptake in the European Union and maybe beyond. Health literacy education is a useful tool to improve citizens’ access to healthcare information and services, achieve better health outcomes and support healthcare systems’ sustainability.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/344113

Acceptability and clinical usefulness of a telemonitoring and telerehabilitation system in people with Parkinson’s Disease in different disease stages: preliminary findings from the RAPIDO study
Fourth Italian Workshop on Artificial Intelligence for an Ageing Society (AIxAS 2023)
Autore/i: Antoniello, Antonia; Sabatelli, Antonio; Valenti, Simone; Pepa, Lucia; Spalazzi, Luca; Andrenelli, Elisa; Vada, Silvia; Baldini, Nicolò; Capecci, Marianna; Tinazzi, Michele; Farabolini, Gianmatteo; Gandolfi, Marialuisa; Bonardi, Giulia; Ceravolo, Maria Gabriella
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Abstract: Telemonitoring and telerehabilitation techniques are significant approaches for people with Parkinson’s disease (PD) to improve their clinical health status. In this work, we present a system to monitor people with PD during their physical exercise sessions. Wearable devices are used to collect 24-hour health parameters, that are successively stored on a remote server and then analyzed. A clinical and technical analysis has been conducted on this data; the second one exploits techniques such as the Tukey test, PCA technique, and the K-means clustering algorithm. The main goal is to identify changes in patients’ health status over 3 months (monitoring period) and assess the acceptability of the system.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/331233

Evidence-based position paper on physical and rehabilitation medicine professional practice for persons with COVID-19, including post COVID-19 condition: the European PRM position (UEMS PRM Section)
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Ceravolo, Maria G.; Anwar, Fahim; Andrenelli, Elisa; Udensi, Cynthia; Qureshi, Jawaria; Sivan, Manoj; Kiekens, Carlotte; Zampolini, Mauro
Classificazione: 1 Contributo su Rivista
Abstract: Although multiple factors still pose challenges to inpatient/outpatient rehabilitation for survivors of COVID-19, rehabilitation plays a key role for this patient population. This study aimed to improve Physical and Rehabilitation Medicine (PR M) physician's professional practice for persons with CO VID -19-related functioning limitations, to promote functional recovery and reduce activity limitations and/or participation restrictions. A systematic review of the scientific literature was performed from December 2019 to August 2022, followed by production of recommendations through 5 Delphi rounds, by consensus among the delegates of all European countries represented in the Union of European Medical Specialists PR M Section. The systematic literature review is reported together with thirty-two recommendations resulting from the Delphi procedure. The PR M physician's role for persons with CO VID -19-related limitations of functioning is to develop, foster, and monitor the implementation of an individual rehabilitation project tailored to the patient's age, previous medical and functional status, current comorbidities and complications, activity limitations and participation restrictions and personal and environmental factors. This is done by applying the concept of a multi-specialty integrated service model with multi-professional/interdisciplinary teams, providing care at all stages of COVID-19 illness. This evidence-based position paper represents the official position of the European Union through the UEMS PR M Section.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/327834

Towards a Characterization of Late Talkers: The Developmental Profile of Children with Late Language Emergence through a Web-Based Communicative-Language Assessment
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
Autore/i: Farabolini, Gianmatteo; Ceravolo, Maria Gabriella; Marini, Andrea
Classificazione: 1 Contributo su Rivista
Abstract: Children acquire language naturally, but there is variation in language acquisition patterns. Indeed, different internal and external variables play a role in acquiring language. However, there are open research questions about the contribution of different variables to language development. Moreover, with societal changes and due to the pandemic situation, there has been a growing interest in testing digitalization related to indirect language acquisition assessment. In this study, a web-based assessment survey was developed to (1) describe the relation between expressive vocabulary, Socio-Conversational Skills (SCS), gender, parental education, executive functions (EFs), and pretend play; (2) determine whether the survey can detect differences between late talkers (LTs) and children with typical language development; (3) identify children with "overall high" and "overall low" communicative-language scores to test the validity of expressive vocabulary as a main indicator to detect LTs. The parents of 108 Italian children (51 males) aged 24-36 months participated in the study. The results showed that expressive vocabulary correlates with measures of SCS (assertiveness and responsiveness) and is reliable in identifying LTs (d = 2.73). Furthermore, SCS and EFs contribute to better characterizing the developmental profile of children aged 24-36 months.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/327831

A Robot-Assisted Framework for Rehabilitation Practices: Implementation and Experimental Results
SENSORS
Autore/i: Chiriatti, Giorgia; Carbonari, Luca; Ceravolo, Maria Gabriella; Andrenelli, Elisa; Millevolte, Marzia; Palmieri, Giacomo
Classificazione: 1 Contributo su Rivista
Abstract: One of the most interesting characteristics of collaborative robots is their ability to be used in close cooperation scenarios. In industry, this facilitates the implementation of human-in-loop workflows. However, this feature can also be exploited in different fields, such as healthcare. In this paper, a rehabilitation framework for the upper limbs of neurological patients is presented, consisting of a collaborative robot that helps users perform three-dimensional trajectories. Such a practice is aimed at improving the coordination of patients by guiding their motions in a preferred direction. We present the mechatronic setup, along with a preliminary experimental set of results from 19 volunteers (patients and control subjects) who provided positive feedback on the training experience (52% of the subjects would return and 44% enjoyed performing the exercise). Patients were able to execute the exercise, with a maximum deviation from the trajectory of 16 mm. The muscular effort required was limited, with average maximum forces recorded at around 50 N.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/328591

Visual anchoring in financial decision making in patients with Parkinson’s disease: an eye tracking study
2022 NeuroPsychoEconomics Conference Proceedings
Autore/i: Fattobene, Lucrezia; Andrenelli, Elisa; Pepa, Lucia; Baldini, Nicolo; Capecci, Marianna; Ceravolo, Maria Gabriella
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Abstract: Financial decisions are an essential part of people life and understanding the impact of cognitive deficits on financial choice is crucial to ensure consumers’ protection. To improve financial decisions, authorities worldwide are introducing disclosure documents. In the information processing phase, subjects have been shown to anchor their visual attention and their evaluation to the source of information placed in the top part of the documents. Executive functions play a crucial role in decision making and it has long been known that Parkinson’s disease (PD) disrupts the striatal dopamine system leading to dysfunctions in cortico-striatal- thalamic-cortical circuitries, thus, people with PD experience problems with value learning and may report difficulties in frontal executive functions from the early stages of the disease. The present research aims to test whether PD subjects are more prone than healthy controls to rely on the visual anchoring heuristic when comparing bank accounts as synthesized by the Payment Account Fees Information Documents (FID). To do so, we compared the oculomotor patterns, as measured by the eye-tracking methodology, of non-demented people with PD (n=49) to those of age-matched healthy controls. Data revealed that, compared to controls, PD patients exhibit a higher latency in starting to visually explore the document but a more impulsive behaviour in completing the entire visual scan of both the prospectuses. On average, PD patients tend to fail more often to recognize the advantageous product, especially when the cost items displayed in the top part of the document are lower, i.e., they are more prone to make biased financial choices. Results also showed that NonMotor Symptom Scale, MoCA, UPDRS total, and Beck Depression Inventory are clinical predictors of the reliance on the anchoring heuristics. Results are relevant given that non demented people with PD represent a large and growing part of the population engaged in financial decisions. Irrespective of age or disease duration, they may exhibit an increased tendency towards biased decisions, thus financial regulators should consider the susceptibility of frail and elderly people to visual biases when devising the format of financial prospectuses.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/331561

Impact of social distancing, due to SARS CoV-2 pandemic, on chronic stroke subjects’ disability and caregivers’ burden: A cross- sectional cohort study
The Journal of the International Society of Physical and Rehabilitation Medicine 5(Suppl 2):p S119-S411, July 2022.
Autore/i: Campignoli, Francesca; Baldini, Nicolò; Lombardo, LORENZO PASQUALE; Latanza, Arianna; Moriconi, Stefano; Carlino, Riccardo; DI GREGORIO, Sonia; Andrenelli, Elisa; Millevolte, Marzia; Ceravolo, Maria Gabriella; Capecci, Marianna; Grafeo, Sascia
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Abstract: Background and Aims: People suffering from chronic diseases have felt the impact of the COVID-19 pandemic on the healthcare system, particularly during 2020, before vaccination. The study evaluates the clinical and functional evolution of people with Parkinson’s Disease (pwPD) over four years: from 2018 to 2021. The research hypothesis is that the decreased number of specialized neurological visits and rehabilitation sessions may have led to a clinical and functional worsening in the frailest individuals. Methods: PwPD consecutively referred to our outpatient movement disorder facility were enrolled in the study if their medical records and the Unified Parkinson’s Disease Rating Scale (UPDRS) and Non-Motor Symptom Scale (NMSS) scores were available (at least one per year) in the period 2018 – 2021. Yearly neurological consultations and rehabilitation sessions were counted. Results: 221 pwPD (105 women) were eligible. In 2020, we observed a 53% reduction of neurological/physiatrists visits and a 70% reduction of rehabilitation sessions compared to 2019. In the period 2018- 2019, no health/functional status indices (UPDRS and NMSS) changed significantly, while in 2020 the UPDRS part I (p=.0003), II (p=<.0001) and III (p=<.0001) scores and the NMSS (p=.04) score significantly worsened, compared to 2019. Noticeably, UPDRS II score increased by more than 3 points in 30% of pwPD, independent of age and disease duration but with a strict relationship with a higher baseline value. In 2021, when the healthcare provisions were restored, patients’ conditions remained stable. Conclusions: PwPD with a greater level of disability at the beginning of the first lockdown worsened their functional condition permanently.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/331563

A low-cost telerehabilitation and telemonitoring system for people with Parkinson's disease: the architecture
2022 IEEE 12th International Conference on Consumer Electronics (ICCE-Berlin)
Autore/i: Antoniello, Antonia; Sabatelli, Antonio; Valenti, Simone; Di Tillo, Maria; Pepa, Lucia; Spalazzi, Luca; Andrenelli, Elisa; Capecci, Marianna; Ceravolo, Maria Gabriella
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/314960

Parkinson's disease telemonitoring and telerehabilitation based on commercial wearable sensor data analysis: a pilot study
2022 IEEE 12th International Conference on Consumer Electronics (ICCE-Berlin)
Autore/i: Sabatelli, Antonio; Valenti, Simone; Antoniello, Antonia; Di Tillo, Maria; Pepa, Lucia; Spalazzi, Luca; Andrenelli, Elisa; Capecci, Marianna; Ceravolo, Maria Gabriella
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/314967

The association between language exposure and nonword repetition performance in bilingual children: A systematic review and meta-analysis
BILINGUALISM
Autore/i: Farabolini, Gianmatteo; Taboh, Analí R.; Ceravolo, Maria Gabriella; Guerra, Federico
Classificazione: 1 Contributo su Rivista
Abstract: We conducted a systematic review and meta-analysis on the association between nonword repetition (NWR) and language exposure in bilingual children and explored whether the association is influenced by other variables. We performed a blind literature review on ERIC and Google Scholar, a random-effects model meta-analysis and subgroup analyses to test potential moderators. Out of 822 screened articles, we identified 24 works including 1399 children. Significant associations were found using either cumulative or current exposure, language-like nonwords, phoneme NWR scoring, in children with typical language development. Nonsignificant associations were found in studies either using age of first exposure, on children older than six, with less than 50 participants, using NWR lists containing 16-24 nonwords or with participants having different native languages. Weak associations were found when considering whole-word scoring or gray literature. We highlight the contributions of different variables to NWR, and evidence to optimally design NWR for bilingual language assessment.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/309918

Rehabilitation definition for research purposes. A global stakeholders' initiative by Cochrane Rehabilitation
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Negrini, Stefano; Selb, Melissa; Kiekens, Carlotte; Todhunter-Brown, Alex; Arienti, Chiara; Stucki, Gerold; Meyer, Thorsten; Ceravolo, Mg; 3rd Cochrane Rehabilitation Methodology Meeting, Participants
Classificazione: 1 Contributo su Rivista
Abstract: Since its foundation, Cochrane Rehabilitation has faced challenges with rehabilitation definitions because existing definitions did not indicate what rehabilitation includes and what it excludes. We aimed to develop a comprehensive and shared rehabilitation definition for research purposes to: 1) support the conduct of primary studies and systematic reviews, and 2) identify relevant systematic reviews for knowledge translation purposes. We performed a multimodal study including seven preliminary research and discussion papers, four Consensus Meetings and three Delphi rounds with 80 rehabilitation stakeholders. The Delphi Study aimed to obtain agreement, refine and complete the items composing the definition and meanings of rehabilitation. These stakeholders covered 5 continents, representing 11 global and continental rehabilitation organizations, 11 scientific journals, 4 Cochrane Networks and 3 Cochrane Groups, and included invited experts, and representatives of low middle-income countries (LMICs) and consumers. We had a 70% to 82.5% response rate to the three Delphi rounds, during which participants responded to all items (100%) and provided relevant comments (range 5.5-50% per item). This participation led to several refinements to the rehabilitation definition through three preliminary versions, and the final items reached an agreement between 88.9% and 100%. We structured the definition using the PICO (Population, Intervention, Comparison, Outcome) framework. We concluded that "In a health care context," rehabilitation is defined as a "multimodal, person-centered, collaborative process" (Intervention-general), including interventions targeting a person's "capacity (by addressing body structures, functions, and activities/participation) and/or contextual factors related to performance" (Intervention-specific) with the goal of "optimizing" the "functioning" (Outcome) of "persons with health conditions currently experiencing disability or likely to experience disability, or persons with disability" (Population). Rehabilitation requires that all the items of the definition are satisfied. We defined a "rehabilitation intervention" as "any intervention provided within the rehabilitation process." We developed a rehabilitation definition for research purposes achieving a broad agreement with global stakeholders. This definition provides explicit criteria to define rehabilitation. Using the proposed definition will improve rehabilitation research by standardizing the description of interventions. Our definition may require revision in the future, as further research enhances understanding and communication of the essence and complexity of rehabilitation.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/309920

Trust/untrust is not the same as true/false. Lessons learned and ethical questions on the application of untrustworthiness scales to judge individuals
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Negrini, Stefano; Ceravolo, Maria G; Ferriero, Giorgio
Classificazione: 1 Contributo su Rivista
Abstract: This special paper reflects on trustworthiness and its implications for scientific medical journals and all the communities they serve: health professionals, policymakers, the public, and a specific discipline, in our case, Physical and Rehabilitation Medicine. We start from a recent episode: a paper claimed the untrustworthiness of two randomised controlled trials (RCTs) published in the European Journal of Physical and Rehabilitation Medicine based on a newly developed trustworthiness scale, used until now only in systematic reviews. This likely represents the first case of applying such a scale focusing on a single leading author. Developing a proper answer to this case led us to present some insights from the perspective of a Journal editor. We discuss the impact of false research results, why trust is needed in science and medicine, the difference between untrust and false results, the problems in judging trustworthiness, the unfortunately weak capacity of the peer review system in preventing these issues, the problems of "post-hoc" judgements and the emerging ethical issues. We conclude with some suggestions for the future based on prevention at the system level.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/309921

Rehabilitation and COVID-19: update of the rapid living systematic review by Cochrane Rehabilitation Field as of December 31st, 2021
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Negrini, Francesco; de Sire, Alessandro; Andrenelli, Elisa; Lazzarini, Stefano G; Patrini, Michele; Ceravolo, Maria G; The International Multiprofessional Steering Committee of Cochrane Rehabilitation REH-COVER, Action
Classificazione: 1 Contributo su Rivista
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/306171

Exploring the Relationships Between Perception of Product Quality, Product Ratings, and Consumers’ Personality Traits: An Eye-Tracking Study
JOURNAL OF NEUROSCIENCE, PSYCHOLOGY, AND ECONOMICS
Autore/i: Pascucci, F.; Bartoloni, S.; Ceravolo, M. G.; Fattobene, L.; Gregori, G. L.; Pepa, L.; Raggetti, G.; Temperini, V.
Classificazione: 1 Contributo su Rivista
Abstract: The present study investigates how product ratings (positive, negative, or ambiguous) and consumers’ personality traits affect their attention behaviors and perception of product quality in online shopping environments. Findings from an eye-tracking experiment (N = 62) with the use of a simulated e-retailer product page (similar to Amazon.com) show the consumers’ attention distribution processes in response to different marketing cues (product image, technical description, rating, price, delivery time) and their impact on product quality evaluation. Extraversion was deemed the sole personality trait affecting both consumers’ attention behaviors and the relationship between a product’s rating and quality evaluation. This study expands the knowledge base of the cue utilization theory and online consumer behavior literature, providing practical implications for e-retailers and e-sellers. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/300819

Deep Reinforcement Learning-Based iTrain Serious Game for Caregivers Dealing with Post-Stroke Patients
INFORMATION
Autore/i: Maskeliunas, Rytis; Damasevicius, Robertas; Paulauskas, Andrius; Ceravolo, Maria Gabriella; Charalambous, Marina; Kambanaros, Maria; Pampoulou, Eliada; Barbabella, Francesco; Poli, Arianna; Carvalho, Carlos V.
Classificazione: 1 Contributo su Rivista
Abstract: This paper describes a serious game based on a knowledge transfer model using deep reinforcement learning, with an aim to improve the caretakers’ knowledge and abilities in post-stroke care. The iTrain game was designed to improve caregiver knowledge and abilities by providing non-traditional training to formal and informal caregivers who deal with stroke survivors. The methodologies utilized professional medical experiences and real-life evidence data gathered during the duration of the iTrain project to create the scenarios for the game’s deep reinforcement caregiver behavior improvement model, as well as the design of game mechanics, game images and game characters, and gameplay implementation. Furthermore, the results of the game’s direct impact on caregivers (n = 25) and stroke survivors (n = 21) in Lithuania using the Geriatric Depression Scale (GDS) and user experience questionnaire (UEQ) are presented. Both surveys had favorable outcomes, showing the effectiveness of the approach. The GDS scale (score 10) revealed a low number of 28% of individuals depressed, and the UEQ received a very favorable grade of +0.8.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/308681

Effects of Levodopa-Carbidopa Intestinal Gel Compared with Optimized Medical Treatment on Nonmotor Symptoms in Advanced Parkinson's Disease: INSIGHTS Study
PARKINSON'S DISEASE
Autore/i: Chung, Sun Ju; Calopa, Matilde; Ceravolo, Maria G; Tambasco, Nicola; Antonini, Angelo; Chaudhuri, K Ray; Robieson, Weining Z; Sánchez-Soliño, Olga; Zadikoff, Cindy; Jin, Man; Barbato, Luigi M
Classificazione: 1 Contributo su Rivista
Abstract: Background: Nonmotor symptoms (NMS) are common in advanced Parkinson's disease (APD) and reduce health-related quality of life. Objective: The aim of the study was to evaluate levodopa-carbidopa intestinal gel (LCIG) versus optimized medical treatment (OMT) on NMS in APD. Methods: INSIGHTS was a phase 3b, open-label, randomized, multicenter study in patients with APD (LCIG or OMT, 26 weeks) (NCT02549092). Primary outcomes assessed were total NMS (NMS scale (NMSS) and PD sleep scale (PDSS-2)). Key secondary outcomes included the Unified PD Rating Scale (UPDRS) Part II, Clinical Global Impression of Change (CGI-C), and PD Questionnaire-8 (PDQ-8). Additional secondary measures of Patient Global Impression of Change (PGIC), King's PD Pain Scale (KPPS), and Parkinson Anxiety Scale (PAS) also were evaluated. Finally, safety was assessed. Results: Out of 89 patients randomized, 87 were included in the analysis (LCIG, n = 43; OMT, n = 44). There were no significant differences in NMSS or PDSS-2 total score changes (baseline to Week 26) between LCIG and OMT; within-group changes were significant for NMSS (LCIG, p < 0.001; OMT, p = 0.005) and PDSS-2 (LCIG, p < 0.001; OMT, p < 0.001). Between-group treatment differences were nominally significant for UPDRS Part II (p = 0.006) and CGI-C (p < 0.001) at Week 26 in favor of LCIG; however, statistical significance could not be claimed in light of primary efficacy outcomes. PGIC (Week 26) and KPPS (Week 12) scores were nominally significantly reduced with LCIG versus OMT (p < 0.001; p < 0.05). There were no significant differences in PDQ-8 or PAS. Adverse events (AEs) were mostly mild to moderate; common serious AEs were pneumoperitoneum (n = 2) and stoma-site infection (n = 2) (LCIG). Conclusions: There were no significant differences between LCIG versus OMT in NMSS or PDSS-2; both LCIG and OMT groups significantly improved from baseline. AEs were consistent with the known safety profile.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/309922

Criteria for identification of advanced Parkinson’s disease: the results of the Italian subgroup of OBSERVE-PD observational study
BMC NEUROLOGY
Autore/i: Stefani, A.; Tessitore, A.; Tambasco, N.; Cossu, G.; Ceravolo, M. G.; Defazio, G.; Morgante, F.; Ramat, S.; Melzi, G.; Gualberti, G.; Merolla, R.; Onuk, K.; Lopiano, L.
Classificazione: 1 Contributo su Rivista
Abstract: Background: Frequency of Advanced Parkinson’s Disease (APD) and its clinical characteristics are still not well defined. Here, we aimed to assess APD prevalence in the Italian OBSERVE-PD cohort, as well as treatment eligibility to device-aided therapies (DAT), and to compare the APD clinical judgment with the established Delphi criteria. Methods: This sub-group analysis of the OBSERVE-PD study was performed on patients enrolled by 9 Movement Disorders centers in Italy. Motor and non-motor symptoms, PD characteristics, activities of daily living, and quality of life were assessed. Patient eligibility for DAT, response to current PD treatments, referral process, and the concordance between APD physician’s judgment and Delphi criteria were also assessed. Results: According to physician’s judgment, 60 out of 140 patients (43%) had APD. The correlation between physician’s judgment and the overall APD Delphi criteria was substantial (K = 0.743; 95%CI 0.633–0.853), mainly driven by a discrete concordance found for the presence of ≥ 2 h of daily OFF time, presence of troublesome dyskinesia, ≥ 5 times daily oral levodopa dosing, and activities of daily living limitation. Forty-four (73%) APD patients were considered eligible to DAT but only 18 of them (41%) used these therapies, while most patients, independently from their eligibility, continued to use 3–5 oral daily medications, due to fear of invasive solutions and need to have a longer time to decide. Conclusion: APD was frequent in the Italian OBSERVE-PD population. DAT in the eligible APD population proved to be underused, in spite of unsatisfactory symptoms control with oral medications in 67% of patients.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/295884

Telehealth for rehabilitation and recovery after stroke: State of the evidence and future directions
INTERNATIONAL JOURNAL OF STROKE
Autore/i: English, Coralie; Ceravolo, Maria Gabriella; Dorsch, Simone; Drummond, Avril; Gandhi, Dorcas Bc; Halliday Green, Judith; Schelfaut, Ben; Verschure, Paul; Urimubenshi, Gerard; Savitz, Sean
Classificazione: 1 Contributo su Rivista
Abstract: Aims: The aim of this rapid review and opinion paper is to present the state of the current evidence and present future directions for telehealth research and clinical service delivery for stroke rehabilitation. Methods: We conducted a rapid review of published trials in the field. We searched Medline using key terms related to stroke rehabilitation and telehealth or virtual care. We also searched clinical trial registers to identify key ongoing trials. Results: The evidence for telehealth to deliver stroke rehabilitation interventions is not strong and is predominantly based on small trials prone to Type 2 error. To move the field forward, we need to progress to trials of implementation that include measures of adoption and reach, as well as effectiveness. We also need to understand which outcome measures can be reliably measured remotely, and/or develop new ones. We present tools to assist with the deployment of telehealth for rehabilitation after stroke. Conclusion: The current, and likely long-term, pandemic means that we cannot wait for stronger evidence before implementing telehealth. As a research and clinical community, we owe it to people living with stroke internationally to investigate the best possible telehealth solutions for providing the highest quality rehabilitation.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/294312

The Individual Rehabilitation Project as the core of person-centred rehabilitation - the Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists framework for rehabilitation in Europe
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Zampolini, Mauro; Selb, Melissa; Boldrini, Paolo; Branco, Catarina A; Golyk, Volodymyr; Hu, Xiaolei; Kiekens, Carlotte; Negrini, Stefano; Nulle, Anda; Oral, Aydan; Sgantzos, Markos; Shmonin, Aleksei; Treger, Iuly; Stucki, Gerold; Ceravolo, Mg
Classificazione: 1 Contributo su Rivista
Abstract: : To facilitate the interaction between the health professional and the patient, a framework to guide the rehabilitation process is needed. This framework would encompass three interwoven aspects: the rehabilitation management plan, Individual Rehabilitation Project (IRP), and rehabilitation cycle(s). All three framework aspects focus on the patient and on the aim of rehabilitation, i.e. to optimize a person's functioning across the continuum of care. An IRP is a multi-element, person-centred rehabilitation management scheme, in which rehabilitation is generally provided by a multi-professional team under the leadership of a physical and rehabilitation medicine (PRM) physician, working in an interdisciplinary manner and together with the patient (or proxy). A reference system for operationalizing functioning and standardizing the process is the International Classification of Functioning, Disability and Health (ICF) - for assessing functioning needs, defining rehabilitation goals and outcomes. The objective of this paper is to present the IRP as a framework for rehabilitation in Europe (EUR-IRP). The specific aims are to 1) introduce the IRP and 2) describe the framework components, elements and variables of the IRP. Demonstration projects (case studies) using the EUR-IRP will be conducted. The present paper presents the efforts to date for developing the EUR-IRP, a key part of action plan of the PRM Section and Board of the European Union of Medical Specialists to implement the ICF systemwide across the care continuum. This paper serves as another step to bring together practice, science and governance in calling for contribution from rehabilitation clinicians and researchers and professional societies in PRM and beyond.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/295885

Rehabilitation and COVID-19: update of the rapid living systematic review by Cochrane Rehabilitation Field as of October 31st, 2021
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Andrenelli, Elisa; Negrini, Francesco; De Sire, Alessandro; Lazzarini, Stefano G; Patrini, Michele; Ceravolo, Maria G; International Multiprofessional Steering Committee of Cochrane Rehabilitation REH-COVER, Action
Classificazione: 1 Contributo su Rivista
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/296561

Therapeutic Exercise Protocols for People Recovering After Covid-19: A Tele-Health Approach
ForItAAL 2020: Ambient Assisted Living
Autore/i: Pepa, L.; Pigliapoco, M.; Bisoglio, P.; Lambertucci, A.; Coccia, M.; Ercolani, L.; Aringolo, M.; Hibel, M.; Gastaldi, A.; Andrenelli, E.; Cima, R.; Spalazzi, L.; Ceravolo, M. G.; Capecci, M.
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/314953

Rehabilitation and COVID-19: update of the rapid living systematic review by Cochrane Rehabilitation Field as of February 28th, 2022
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: de Sire, Alessandro; Andrenelli, Elisa; Negrini, Francesco; Lazzarini, Stefano G; Cordani, Claudio; Ceravolo, Maria G
Classificazione: 1 Contributo su Rivista
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/306159

Attention impairment in people with Parkinson– related Pisa Syndrome
November 2021 - Volume 4 - Suppl 1
Autore/i: Baldini, Nicolò; Pepa, Lucia; Andrenelli, Elisa; Capecci, Marianna; Ceravolo, Maria Gabriella
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Abstract: Background and Aims: Pisa Syndrome (PS) is a disabling postural deformity, with a strong impact on life quality of people with Parkinson’s disease (pwPD). However, it can be reversible if diagnosed and treated at an early stage. Our purpose is to analyze PS from a different perspective: the ocular behavior, through the Eye Tracking methodology. Our goal is to shed light on the association between PS and the deficit of the visuospatial and attentive functions, as explored by the Eye Tracking approach, looking into clinical predictors of reduced visuospatial abilities and inferring on the need for adapting the rehabilitation approach. Methods: This cross sectional study, comparing behavior reactions and pattern of visual scanning in a group of pwPD – with (PS+) or without (PS-) trunk postural deviation - and a group of healthy age-matched people (HC), was held using the eye tracker EyeLink 1000. The Benton Judgment of Line Orientation Test was used to create a set of stimuli consecutively presented on the screen, while tracking patients’ gaze. Results: PS+ show a deficit of visuospatial functions, attention distribution and a reduced awareness of their posture. Neuropsychological features correlate with the pattern of visual scanning, which is significantly different in PS+ from PS- and HC. Attention impairment significantly impacts patients’ performance on the Benton test. Conclusions: Visuospatial ability impairment should be taken into account when planning the rehabilitation approach to postural abnormalities in pwPD
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/331374

Visual attention and Pisa Syndrome: simple correlation or cause-effect relationship?
Abstract Congresso Bologna 2021
Autore/i: Baldini, Nicolò; Pepa, Lucia; Lala, Tisara; Andrenelli, Elisa; Capecci, Marianna; Ceravolo, Maria Gabriella
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Abstract: Background and Aims: Pisa Syndrome (PS) is a highly disabling postural deformity, with a strong impact on patients’ quality of life. However, it can be reversible if diagnosed and treated at an early stage. The neuropsychological profile is characteristic: reduced performance on visuospatial abilities, attention and language. This study aims to analyze PS from a different perspective: the ocular behavior, through the Eye Tracking methodology. The ultimate goal is to shed light on the association between PS and visuospatial and attention impairment functions, looking into clinical predictors of PS evolution. Methods: This cross sectional study compared the behavior reactions and the pattern of visual scanning in a group of pwPD – with (PS+)(n=34), or without (PS-)(n=22) trunk postural deviation - and a group of healthy age-matched people (HC)(n=11). To this scope, the Benton Judgment of Line Orientation Test (BJLOT) was used to create a set of stimuli consecutively presented on the screen, while tracking patients’ gaze, by means of the eye tracker EyeLink 1000. Results: PS+ subjects show significantly worse performances on the BJLOT and MoCA tests. Congruent, they show a characteristic pattern of visual scanning, which is significantly different from the one exhibited by PS- subjects and age-matched healthy subjects, with special impairment in the ability to process stimuli in the left hemifield. On a logistic regression analysis, the performance on the BJLOT is significantly (p<.0001) related to the severity of attention deficit (e.g. latency of first fixation of the visual stimulus and MoCA subitem score) and the severity of axial symptoms (e.g. UPDRS-III posture and freezing subitem scores). Conclusions: We confirm the association between visuospatial and attention disorders and PS; the role of cognitive disorders as early predictors of the risk for developing severe trunk abnormalities is to be sought in prospective studies on large cohorts of pwPD
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/331472

EVOLUZIONE CLINICO-FUNZIONALE IN SOGGETTI CON LA MALATTIA DI PARKINSON DURANTE LA PANDEMIA DA SARS-COV2
Abstract Congresso Nazionale Milano 2021
Autore/i: Baldini, Nicolò; Campignoli, Francesca; Lombardo, LORENZO PASQUALE; Andrenelli, Elisa; Capecci, Marianna; Ceravolo, Maria Gabriella
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Abstract: Introduzione La recente pandemia da ha rappresentato un test da stress per il sistema sanitario che ha dovuto fronteggiare l’enorme carico assistenziale richiesto dai pazienti COVID19, rinunciando contemporaneamente ad erogare prestazioni diagnostiche terapeutiche e riabilitative ai soggetti con patologie emergenti o croniche[1]. L’impatto di questi cambiamenti è stato particolarmente sentito da soggetti affetti da patologie neurodegenerative come la Malattia di Parkinson (MP). L’obiettivo del nostro studio è valutare l’evoluzione clinico-funzionale in soggetti affetti da MP nel periodo compreso tra il 2018 e il 2021, confrontando il trend degli indici di severità di malattia osservato dopo l’inizio della pandemia, rispetto a quello rilevato nel biennio 2018-2019. L’ipotesi di ricerca è che la diminuzione dell’offerta assistenziale specialistica e riabilitativa possa aver determinato un peggioramento clinico-funzionale nei soggetti più fragili. Materiali e Metodi Disegno dello studio: di coorte retrospettivo. Popolazione e Metodi. Soggetti affetti da MP Idiopatica afferiti consecutivamente nel periodo 1 gennaio 2018- 31.12.2018 all’ambulatorio dedicato alla diagnosi, cura e riabilitazione dei disordini del movimento e valutati da allora regolarmente a cadenza almeno semestrale, fino al 30.6.2021, mediante le seguenti scale di valutazione: Unified Parkinson’s Disease Rating Scale (UPDRS) totale e parti I-II-III (ON med)-IV e Non Motor Symptom Scale (NMSS). Di tutti è inoltre registrato lo schema terapeutico e valutato il dosaggio della terapia antiparkinsoniana (Levodopa Equivalent Daily Dose - LEDD). Attraverso un’analisi comparativa per dati appaiati non parametrici (Wilcoxon Rank Test), abbiamo confrontato le variazioni tra i punteggi delle scale di misura registrati tra il 2018-2019, 2019-2020 e 2020-2021. Abbiamo successivamente identificato coloro per i quali si registrava un peggioramento di almeno 4 punti alla UPDRS–parte II (ADL), (superiore alla Minimal Clinically Important Difference (1.8-2.3[3]), e indagato i fattori predittivi di questo outcome mediante un’analisi di regressione logistica delle seguenti variabili: età, durata di malattia, punteggio UPDRS II, III e totale, LEDD. Risultati Sono stati ritenuti eleggibili 75 casi, età media 73±9 anni [51-90], durata di malattia 14±7 [4-38], 30 donne. Nel 2018 la condizione clinica generale era caratterizzata dai seguenti punteggi medi (±Dev.st) [min-max]: UPDRS parte I (sintomi non motori) = 3.4±2 [0-10]; parte II =13.5±8[0-33], parte III=20.1±12[3-61], parte IV (complicanze motorie a lungo termine)=3.4±4[0-16], NMSS=63.5±33[0-158]. Nel 2019 nessuno degli indicatori si modificava significativamente, mentre tra il 2019 ed il 2020 emergeva un peggioramento statisticamente significativo dei punteggi della UPDRS parte II (Z=-3.2; p=.001) e della UPDRS parte III (Z=-3.0; p=.003). Nel 2021 la condizione rimaneva tendenzialmente stabile o in lieve peggioramento. Il 32% dei soggetti presentava, nel 2020, un peggioramento dell’UPDRS II maggiore o uguale a 4 punti, indipendente da età e durata di malattia ma correlato ad un valore basale maggiore dell’UPDRS parte II (Chi2: 3.9; p=.04 IC: 1.0-1.4), rispetto a coloro che conservavano il livello funzionale negli ultimi due anni. Conclusioni: Nei soggetti affetti da MP le misure restrittive imposte durante la pandemia da COVID19 possono determinare un impatto importante. I risultati del nostro studio indicano che i soggetti con un livello di maggiore disabilità (più fragili) all’inizio del primo lockdown hanno esibito un drastico peggioramento della condizione di dipendenza. Tale condizione non sembra essere ulteriormente evoluta nel periodo successivo, facendo ipotizzare che la riorganizzazione dei servizi sanitari e riabilitativi, anche mediante approcci di teleriabilitazione, possa aver sortito una efficacia L’ipotesi richiamata è meritevole di conferma mediante studi controllati su casistiche più numerose.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/331522

IMPATTO DELLA PANDEMIA DA SARS-COV-2 SU SOGGETTI CON ESITI CRONICI POST ICTUS ED I LORO CAREGIVERS
Abstract Congresso Nazionale Milano 2021
Autore/i: Campignoli, Francesca; Baldini, Nicolò; Lombardo, LORENZO PASQUALE; Latanza, Arianna; Ricci, Raffaele; Moriconi, Stefano; Carlino, Riccardo; DI GREGORIO, Sonia; Grafeo, Sascia; Aringolo, Michela; Ercolani, Lauredana; Coccia, Michela; Millevolte, Marzia; Ceravolo, Maria Gabriella; Capecci, Marianna
Classificazione: 4 Contributo in Atti di Convegno (Proceeding)
Abstract: Introduzione La pandemia COVID-19 ha non solo causato un elevatissimo numero di vittime, ma ha anche determinato un’importante riduzione dei servizi sanitari, come ad esempio le prestazioni riabilitative sia ambulatoriali che domiciliari.[1] Inoltre, le severe restrizioni applicate per contrastare il dilagare dei contagi hanno avuto un forte impatto dal punto di vista sociale.[2] Questi fattori hanno avuto un peso ancora maggiore nei soggetti con disabilità e, ancor di più, nei loro caregiver. [2,3] Il nostro obiettivo è stato di quello di valutare se la pandemia COVID-19 abbia influito sulle condizioni funzionali dei pazienti affetti da esiti cronici post-ictus e sul livello di stress dei loro caregivers. Materiali e Metodi Uno studio trasversale di coorte è stato condotto tra Marzo e Giugno 2021 intervistando telefonicamente i soggetti affetti da esiti cronici post-ictus cerebri ed i relativi caregiver che avevano partecipato ad una sperimentazione completata nel 2019 (studio MAGIC Horizon 2020 n. 687228) che prevedeva la somministrazione di questionari di rilevazione di dati demografici e clinici, di scale di valutazione clinico-funzionale, quali percezione personale di stato di salute (VAS 0-100), Barthel Index (BI) e Lawton IADL e di misure dello stress del caregiver, quali la Zarit Burden scale. Nel corso del presente studio, i questionari e le scale di misura citate sono state riproposte unitamente alla Beck Depression Inventory (BDI), e ad un questionario di approfondimento sull’evoluzione della condizione socioeconomica familiare emergente dopo il distanziamento sociale obbligato dalla pandemia. I dati raccolti nel 2021 sono stati confrontati con quelli omologhi, registrati nel 2019, attraverso test statistici per dati non parametrici. Risultati 23 soggetti con esiti cronici di ictus (età media 64.5(+8) anni, 11 donne, a distanza di 7(+6) anni dall’ictus, MoCA=23(+5) alla valutazione del 2019) hanno partecipato allo studio. Essi hanno percepito e riferito un peggioramento del proprio stato di salute rispetto all’anno precedente (p=.006) , unitamente ad una maggiore necessità di aiuto nelle attività di vita quotidiana, di base (BI mod. ridotto da 78(+16) a 70(+23) (p=.01)) e strumentali ( IADL:p.001). Durante la pandemia si sono ridotti gli accessi alle strutture di riabilitazione con una diminuzione delle prestazioni fisioterapiche del 55% (p=.005). Il principale caregiver è rappresentato dal familiare, in particolare il coniuge, ma non sono stati evidenziati sostanziali cambiamenti nello stato di stress o nelle ore dedicate alla cura del paziente, invece è stato riferito un netto peggioramento della condizione economica (p<.0001). Il punteggio alla scala Zarit è risultata correlare con il numero di ore dedicate all’assistenza (p=01), al punteggio della BDI (p=.001) ed è maggiore tra le donne (p=.01). Conclusioni Nella condizione di disabilità cronica descritta, la pandemia e la conseguente necessità di distanziamento sociale si sono associati ad un peggioramento delle funzioni globali e della percezione del benessere soggettivo nei pazienti e un peggioramento globale dello stato socio economico familiare.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/331523

Compendio di neuroriabilitazione. Dai quadri clinici alla presa in carico della disabilità. Ediz. ampliata
Compendio di Neuroriabilitazione
Autore/i: Ceravolo, Maria Gabriella; Costantini, Luca; Andrenelli, Elisa
Editore: Verduci Editore srl
Classificazione: 2 Contributo in Volume
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/306219

Deep brain stimulation in patients with long history of drug resistant epilepsy and poor functional status: Outcomes based on the different targets
CLINICAL NEUROLOGY AND NEUROSURGERY
Autore/i: Passamonti, C.; Mancini, F.; Cesaroni, E.; Bonifazi, S.; Ceravolo, M. G.; Capecci, M.; Zamponi, N.; Scerrati, M.; Ricciuti, R. A.
Classificazione: 1 Contributo su Rivista
Abstract: Background: Deep brain stimulation (DBS) is a widely used surgical procedure for the treatment of patients with drug resistant epilepsy (DRE) and several anatomical target have been described. Indications for DBS includes patients with focal, partial seizure and those for which resective or disconnective surgery are contraindicated, such as involvement of eloquent cortex or significant comorbidities. Despite the SANTE trial has clearly indicated the efficacy of DBS of anterior nucleus of the thalamus (ANT), specific indications regarding the best anatomical target and outcome in patients with severe disability are lacking. Here we described our case series of patients underwent DBS of three different target including ANT, centromedian thalamic nucleus (CMN) and subthalamic nucleus (STN). Method: Six patients with DRE have been treated with DBS of ANT (n = 3), STN (n = 2) and CMN (n = 1). Outcome has been expressed as seizures frequency reduction and patients functional status after surgery with a follow-up of 5–11 years. Results: Four out of six patients show no reduction of seizures frequency after DBS implant with one case of increasing atypical absence. Two cases, one ANT and one CMN, show a significant reduction of seizures frequency of 50–60%. No patients improve relative to functional outcome and one showed psychiatric symptoms worsening. Conclusions: For patients with DRE and severe functional disability, DBS may reduce seizure frequency in some cases, but it does not improve functional outcome.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/292329

Rehabilitation and COVID-19: a rapid living systematic review by Cochrane Rehabilitation Field updated as of December 31st, 2020 and synthesis of the scientific literature of 2020
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: DE Sire, Alessandro; Andrenelli, Elisa; Negrini, Francesco; Patrini, Michele; Lazzarini, Stefano G; Ceravolo, Maria Gabriella; International Multiprofessional Steering Committee of Cochrane Rehabilitation REH-COVER Action(Corporate, Author)
Classificazione: 1 Contributo su Rivista
Abstract: BACKGROUND: COVID-19 infection significantly increased mortality risk and the burden of disability in most survivors, regardless of symptom severity at onset. The rehabilitation needs of people infected are receiving growing attention, as evidenced by the increasing number of publications, including those addressing the chronic consequences of infection.OBJECTIVES: This rapid living systematic review reports the evidence published in November and December 2020 and summarises the entire body of literature on rehabilitation in COVID-19 patients published in 2020.METHODS: This update was performed using the methodology reported by the second edition conducted by Cochrane Rehabilitation REH-COVER Action. We searched PubMed, Embase, CINAHL, Scopus, Web of Science, and PEDro databases. Papers related to COVID-19 and rehabilitation were retrieved and summarised descriptively.RESULTS: The search retrieved 4441 studies. After the removal of duplicates and the screening for title and abstract, we retained 105 studies. Of these, we included 54 in the qualitative synthesis of this update. According to OCEBM 2011 Levels of Evidence Table, most studies (64.8%) fall within the category of Level 4 evidence. Up to 40.7% of papers included COVID-19 patients in the post-acute phase. In 2020, our rapid living systematic review included 230 studies; most of these (73.9%) were Level 4 studies, 25.7% were Level 3, and only one study was Level 2. The evidence level improved over time. While most studies (44.8%) included patients with acute COVID-19, we observed a gradual increase in the number of reports about chronic symptoms and the long-term consequences of the infection.CONCLUSIONS: The update of the rapid living systematic review by Cochrane Rehabilitation Field demonstrates an increase in the level of evidence of studies addressing the rehabilitation needs associated with COVID-19 infection. Although most studies are still case reports/series, there is a trend towards conducting prospective investigations of the early natural history of the disease (first months post- onset). High-quality-level studies on the efficacy of rehabilitation, and long-term monitoring of the disease and its sequelae are yet to emerge.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/289830

Rehabilitation and COVID-19: update of the rapid living systematic review by Cochrane Rehabilitation Field as of February 28th, 2021
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Andrenelli, Elisa; Negrini, Francesco; de Sire, Alessandro; Patrini, Michele; Lazzarini, Stefano G; Ceravolo, Maria Gabriella; The International Multiprofessional Steering Committee of Cochrane Rehabilitation REH-COVER action (Corporate, author)
Classificazione: 1 Contributo su Rivista
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/289831

A Mixed-apprOach program To help women wIth breast cancer stay actiVE (MOTIVE program): A pilot-controlled study
HELIYON
Autore/i: Natalucci, V.; Lucertini, F.; Vallorani, L.; Brandi, G.; Marchegiani, M.; Pistelli, M.; Berardi, R.; Ceravolo, M. G.; Barbieri, E.; Capecci, M.
Classificazione: 1 Contributo su Rivista
Abstract: Given the benefits of physical activity for breast cancer survivals, this pilot study aims to assess the feasibility of the MOTIVE program at achieving and maintaining the recommended physical activity level in women diagnosed and treated breast cancer, over 16 weeks. We conduct a pilot-controlled study of 20 women diagnosed with breast cancer stage I, II or IIIa. In this study, women of Intervention Arm (n = 10) received the MOTIVE program. This group was compared to women of Control Arm (n = 10) who received only counselling. Health-related fitness measures, and quality of life were assessed at baseline (t0) and after 4 (t1), 8 (t2) and 16 (t3) weeks. Intervention Arm women reached the recommended physical activity guidelines at t1 and t2 (eff.size = 1.9 [1.0–3.1]), and 90% continued to be active, autonomously, at t3 (eff.size = 1.12 [0.21–2.12]). Intervention Arm participants’ arm strength, fitness levels and quality of life also improved over time. No significant improvements in outcome measures were observed in Control Arm participants. These results are encouraging and suggest that the MOTIVE program may be a viable, well tolerated and effective option to help breast cancer women reaching a stable physical activity level over time, which meets prevention-related goals.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/294306

Rehabilitation and coVid-19: A rapid living systematic review 2020 by cochrane rehabilitation field. Update as of october 31st, 2020
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Negrini, F.; De Sire, A.; Andrenelli, E.; Lazzarini, S. G.; Patrini, M.; Ceravolo, M. G.; International Multiprofessional Steering Committee of Cochrane Rehabilitation REH-COVER, Action
Classificazione: 1 Contributo su Rivista
Abstract: Introduction: this living systematic review presents the monthly update of the second edition of the rapid living systematic review 2020 conducted by cochrane rehabilitation rEh-coVEr action steering committee. the aim of this study was to update the monthly coVid-19 and rehabilitation literature research up to october 31st, 2020. EVidEncE acQuisition: Methodology described in the second edition of the rapid living systematic review 2020 conducted by cochrane rehabilitation rEh-coVEr action was applied. pubMed, Embase, cinahl, scopus, Web of science, and pEdro databases were searched, and papers related to coVid-19 and rehabilitation were retrieved and summarized descriptively. EVidEncE synthEsis: the database search retrieved 2704 publications. duplicates were removed, and 1185 unique records were screened for inclusion. after screening titles, abstracts and full-texts, 22 papers were included in the present review. according to ocEbM 2011 levels of Evidence table, 17 studies (77%) fall within the level of evidence 4 category, while the remainder (23%) are categorized as level of evidence 3. Most studies (n.=19; 86%) provided epidemiological data about the disease natural history/determining factor or the clinical presentation of COVID-19 infection, while only two studies focused on health service organization and intervention efficacy. conclusions: the most recent published coVid-19 research relevant to rehabilitation primarily provides data on the clinical course and the clinical presentation of the pathology, rather than on rehabilitation interventions or service delivery. studies with high levels of evidence regarding the efficacy of interventions, long-term monitoring, or new health service organization models are lacking.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/294304

Editorial: Neurofinance
FRONTIERS IN NEUROSCIENCE
Autore/i: Raggetti, G.; Ceravolo, M. G.; Passamonti, L.; Weber, B.
Classificazione: 1 Contributo su Rivista
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/294310

Rehabilitation and COVID-19: rapid living systematic review by Cochrane Rehabilitation Field - third edition. Update as of June 30th, 2021
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Ceravolo, Maria G; Andrenelli, Elisa; Arienti, Chiara; Côté, Pierre; de Sire, Alessandro; Iannicelli, Valerio; Lazzarini, Stefano G; Negrini, Francesco; Patrini, Michele; Negrini, Stefano
Classificazione: 1 Contributo su Rivista
Abstract: Introduction: This paper updates and summarizes the current evidence informing rehabilitation of patients with COVID-19 and/or describing the consequences of the disease and its treatment. Evidence acquisition: Studies published from May 1st to June 30th, 2021 were selected, excluding descriptive studies and expert opinions. Papers were categorized according to study design, research question, COVID-19 phase, limitations of functioning of rehabilitation interest, and type of rehabilitation service involved. From this edition, we improved the quality assessment using the Joanna Briggs Institute checklists for observational studies and the Cochrane Risk of Bias Tool for randomized-controlled clinical trials (RCTs). Evidence synthesis: Twenty-five, out of 3699 papers, were included. They were three RCTs, 13 cross-sectional studies and nine cohort studies. Twenty studies reported data on symptom prevalence (N.=13) or disease natural history (N.=7); and five studies reported intervention effectiveness at the individual level. All study participants were COVID survivors and 48% of studies collected information on participants 6 months or longer after COVID-19 onset. The most frequent risks of bias for RCTs concerned weaknesses in allocation concealment, blinding of therapists, and lack of intention-to-treat analysis. Most analytical studies failed to identify or deal with confounders, describe or deal with dropouts or eventually perform an appropriate statistical analysis. Conclusions: Most studies in this updated review targeted the prevalence of limitations of functioning of rehabilitation interest in COVID-19 survivors. This is similar to past review findings; however, data in the new studies was collected at longer follow-up periods (up to one year after symptom onset) and in larger samples of participants. More RCTs and analytical observational studies are available, but the methodological quality of recently published studies is low. There is a need for good quality intervention efficacy and effectiveness studies to complement the rapidly expanding evidence from observational studies.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/294305

The Effects of Visuomotor Training on the Functional Recovery of Post-Surgery Musculoskeletal Conditions: A Randomized Controlled Trial
APPLIED SCIENCES
Autore/i: Andrenelli, E; Sabbatini, L; Ricci, M; Ceravolo, Mg; Capecci, M
Classificazione: 1 Contributo su Rivista
Abstract: (1) Background: Musculoskeletal conditions show increasing prevalence and high economic/human burden. Recovery for hip or knee surgery may require more than 26 weeks, while universally accepted rehabilitation guidelines are missing. Provided that multisensory-based training enhances motor learning, the study aims to verify if visuomotor training accelerates the recovery of lower limb motor function after orthopedic surgery. (2) Methods: Post-surgery subjects were randomly assigned to receive visuomotor training as an add-on to the conventional physical therapy (VTG), or receive the conventional therapy alone (CG). Subjects performed 40 one-hour training sessions in 8 weeks. The primary endpoint was the improvement in the Lower Extremity Functional Scale (LEFS) over the minimally clinical important difference (MCID) at 4 weeks post-randomization. The secondary endpoint included pain reduction. (3) Results: Eighteen patients were equally distributed into the VTG and CG groups. While LEFS and pain scores significantly improved in both groups, the VTG exceeded the LEFS MCID by 12 points and halved the pain value after the first 4 weeks of treatment, while the CG reached the endpoints only after treatment end (p = 0.0001). (4) Conclusions: Visuomotor training offers an innovative rehabilitation approach that accelerates the recovery of lower limb motor function in patients undergoing orthopedic surgery.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/306169

A systematic review that is ``rapid'' and ``living'': A specific answer to the COVID-19 pandemic
JOURNAL OF CLINICAL EPIDEMIOLOGY
Autore/i: Negrini, S.; Ceravolo, M. G.; Cote, P.; Arienti, C.
Classificazione: 1 Contributo su Rivista
Abstract: Objective: This study aims to describe “rapid living” systematic reviews, an innovative methodological design used to systematically synthesize emerging evidence in the field of rehabilitation during the COVID-19 pandemic. Study Design and Setting: A methodological paper, with a formative approach to rapid living systematic reviews. Results: Based on our experience, we propose the following definition of rapid living SR: ``A dynamic method of knowledge synthesis that allows for the constant updating of new emerging evidence and refinement of its methodological quality.'' This method has the benefit of accelerating the conduct of traditional systematic reviews and allows for a synergistic adaptation of methodology based on the quality of the evidence with a flexibility to update results, methods and collaborations. Conclusion: Our proposed methodology has been helpful to synthesize the rapidly evolving evidence in the field of rehabilitation during the pandemic. Similarly, it may be useful when a rapid answer is urgently needed to make informed decisions. The COVID-19 disease has shown that modern medical science has the ability to produce new knowledge at a rate never seen before. Therefore, our proposed rapid living systematic reviews provide the scientific community with a method to rapidly synthesize evidence when facing health emergencies.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/292331

Evidence based position paper on Physical and Rehabilitation Medicine (PRM) practice for people with amyotrophic lateral sclerosis (ALS)
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Lazovic, Milica; Nikolic, Dejan; Boyer, François C; Borg, Kristian; Ceravolo, Maria G; Zampolini, Mauro; Kiekens, Carlotte
Classificazione: 1 Contributo su Rivista
Abstract: Introduction: Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease that affects both upper and lower motor neurons and is fatal in its course. This evidence-based position paper represents the official position of the UEMS PRM Section. The aim of the paper is to define the role of the physical and rehabilitation medicine (PRM) physician and PRM professional practice for people with ALS. Evidence acquisition: A systematic review of the literature and a consensus procedure by means of a Delphi process have been performed involving the delegates of all European countries represented in the UEMS PRM Section. Evidence synthesis: The systematic literature review is reported together with thirty-two recommendations resulting from the Delphi procedure. Conclusions: The responsibility of the PRM physician is functional assessment of persons with ALS and delivering the optimal and most effective PRM program of care. The rehabilitation program of patients with ALS should be delivered and monitored by the multiprofessional team, with the PRM physician as principal coordinator.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/294308

Rehabilitation and COVID-19: Update of the rapid living systematic review by Cochrane Rehabilitation Field as of August 31st, 2021
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: De Sire, A.; Andrenelli, E.; Negrini, F.; Iannicelli, V.; Lazzarini, S. G.; Patrini, M.; Ceravolo, M. G.; International Multiprofessional Steering Committee of Cochrane Rehabilitation REH-COVER, Action
Classificazione: 1 Contributo su Rivista
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/294311

The impact of lifestyle interventions in high‐risk early breast cancer patients: A modeling approach from a single institution experience
CANCERS
Autore/i: Pistelli, M.; Natalucci, V.; Scortichini, L.; Agostinelli, V.; Lenci, E.; Crocetti, S.; Merloni, F.; Bastianelli, L.; Taus, M.; Fumelli, D.; Giulietti, G.; Cola, C.; Capecci, M.; Serrani, R.; Ceravolo, M. G.; Ricci, M.; Nicolai, A.; Barbieri, E.; Nicolai, G.; Ballatore, Z.; Savini, A.; Berardi, R.
Classificazione: 1 Contributo su Rivista
Abstract: A healthy lifestyle plays a strategic role in the prevention of BC. The aim of our prospective study is to evaluate the effects of a lifestyle interventions program based on special exercise and nutrition education on weight, psycho‐physical well‐being, blood lipid and hormonal profile among BC patients who underwent primary surgery. From January 2014 to March 2017, a multidisciplinary group of oncologists, dieticians, physiatrists and an exercise specialist evaluated 98 adult BC female patients at baseline and at different time points. The patients had at least one of the following risk factors: BMI ≥ 25 Kg/m2, high testosterone levels, high serum insulin levels or diagnosis of MS. Statistically significant differences are shown in terms of BMI variation with the lifestyle interventions program, as well as in waist circumference and blood glucose, insulin and testosterone levels. Moreover, a statistically significant difference was reported in variations of total Hospital Anxiety and Depression Scale (HADS) score, in the anxiety HADS score and improvement in joint pain. Our results suggested that promoting a healthy lifestyle in clinical practice reduces risk factors involved in BC recurrence and ensures psycho‐physical well‐being.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/294307

Rehabilitation and COVID-19: update of the rapid living systematic review by Cochrane Rehabilitation Field as of April 30, 2021
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Negrini, Francesco; de Sire, Alessandro; Andrenelli, Elisa; Lazzarini, Stefano G; Patrini, Michele; Ceravolo, Maria G; the International Multiprofessional Steering Committee of Cochrane Rehabilitation REH-COVER, Action
Classificazione: 1 Contributo su Rivista
Abstract: The present update follows the methodology defined in the 2nd edition of the rapid living systematic review 2020 conducted as part of the Cochrane Rehabilitation REH-COVER (Rehabilitation COVID-19 Evidence-based Response) Action.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/292330

Gender-Related Variability in Information Processing of Disclosure Documents
JOURNAL OF CONSUMER POLICY
Autore/i: Ceravolo, M. G.; Farina, V.; Fattobene, L.; Leonelli, L.; Raggetti, G.
Classificazione: 1 Contributo su Rivista
Abstract: Disclosure is used worldwide as a tool to increase transparency and help investors to make their decisions, thus partially overcoming asymmetric information in financial markets. This research seeks to explore gender-related variability in visual attention allocation to the Key Investor Information Document, and in the evaluation of product financial attractiveness. The study exploits the eye-tracking methodology to collect neural data, responding to the call for considering new data sources. The analysis shows that men tend to dedicate more attention to the sections Objectives and Past performance while women spend more time to scan the sections Risk-reward profile and Costs and charges; When evaluating product financial attractiveness, women tend to evaluate them as poorly financially attractive more often than men. Results reveal the existence of gender-related variability in the visual search strategy for relevant information, which, in turn, can impact on the phase of product evaluation. These findings highlight the professional responsibility of regulators and supervisors to monitor sellers and marketers' behaviours when they interact with consumers. Moreover, this study could provide support to develop financial disclosure documents considering individual differences and ensuring that adequate attention is allocated by investors to all financial information sources, thus raising the level of investor protection. Eventually, the study stimulates innovations to be embedded in the world-wide ongoing regulatory developments that aim at increasing transparency requirements.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/289833

One year of COVID-19 pandemics and its effect on rehabilitation: the search for the best available evidence
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Negrini, Stefano; Ceravolo, Maria Gabriella; Ferriero, Giorgio
Classificazione: 1 Contributo su Rivista
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/289829

Evidence based position paper on Physical and Rehabilitation Medicine practice for people with muscular dystrophies
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Lazovic, M.; Nikolic, D.; Boyer, F. C.; Borg, K.; Ceravolo, M. G.; Zampolini, M.; Kiekens, C.
Classificazione: 1 Contributo su Rivista
Abstract: Muscular dystrophies present a group of inherited degenerative disorder that are characterized by progressive muscular weakness. This evidence-based position paper represents the official position of the European Union through the UEMS PRM Section. The aim of the paper is to evaluate the role of the physical and rehabilitation medicine (PRM) physician and PRM practice for people with muscular dystrophies. Asystematic review of the literature and a consensus procedure by means of a Delphi process have been performed involving the delegates of all European countries represented in the UEMSPRM Section. The systematic literature review is reported together with thirty-three recommendations resulting from the Delphi procedure. The role of the PRM physician is to assess the functional status of persons with muscular dystrophy and to plan, monitor and lead PRM program in an interdisciplinary setting within a multiprofessional team.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/294309

Primary Osteoporosis Management by the Marche Region Health Care System
JOURNAL OF ADVANCED HEALTH CARE
Autore/i: David, Letizia; Ceravolo, Maria Gabriella; Mengoni, Alessandro
Classificazione: 1 Contributo su Rivista
Abstract: Osteoporosis is an illness that affects the skeleton and is characterized by progressive loss of bone mass as well as by micro architectural deterioration of bone tissue of the same. This condition exposes the person to fracture risk, a particularly feared event not only in terms of individual health but even in terms of economic burden. The fractures, in fact, are accompanied by autonomy loss, institutionalization risk, comorbidity and mortality. On an economic level, the reduction of the same absorbs many more resources than anti-osteoporosis drug therapies even in the event that all patients are reached with ascertained osteoporosis and with 100% adherence to medication. In the elderly, in addition to incurring in loss of bone density risk there is an increase of fall risk. Both of these factors add up causing an increase of fracture risk. Due to the demographic increase and life expectancy, osteoporosis and fracturing events will tend to increase, causing an increase in costs. Today, the data collected in Italy regarding osteoporosis prevalence and fragility fractures incidences are not entirely exhaustive. Concerning fractures, data is reliably collected using the "Diagnosis Related Group Classification" and refers to those of the femur. Detect and describe the pathway that the patient with primary osteoporosis follows in the Marche Region. Through the regional Single Booking Center (CUP) and the websites of the Italian League of Osteoporosis (LIOS) and the Italian Society of Osteoporosis, Mineral Metabolism and Skeleton Diseases (SIOMMMS), eleven services have been identified, belonging to the four health care companies of the Marche Region (Asur, Inrca-Irccs, AO Ospedali Riuniti Marche Nord, AOU Ospedali Riuniti Ancona), which can be contacted for an osteoporosis checkup. A questionnaire was therefore prepared based on the recommendations contained in the SIOMMMS (2012), SIMFER and SIGN (2015) guidelines and sent to the above-mentioned services. The questionnaires are seven, duly completed and used for processing data. In the Marche Region, the medical specialties that deal with osteoporosis are various, demonstrating the fact that this is a "border illness". Concerning the interception of the patient, his sending to a specialized service, the diagnostic approach and the use of risk-scoring tools, there is a substantial homogeneity throughout the regional territory. The patient is sent to the specialized center by the general practitioner (GP) or other specialist, based on the presence of risk factors for osteoporosis alone or on the basis of their presence in association with BMD measurement (body mass density measurement) already known. For the purposes of diagnosis, the investigations required are the dual-energy x-ray absorptiometry (DXA) and the blood test while the use of risk-scoring tools are mainly dictated by the need to define the threshold of pharmacological intervention and give the patient perception of its own fracture risk. The most used algorithm is DeFRA. During the evaluation of the patient, all services detect pain and fall risk. The approach to osteoporosis and fall risk is purely pharmacological. From a non-pharmacological point of view, attention is paid in informing the patient about the modifiable risk factors for osteoporosis and falls. Only some services carry out interventions aimed at promoting adherence to treatment, resorting to different actions. In conclusion, the main critical issues relating to taking care of a fracture risk patient are: accessibility to information, early and exhaustive interception of the population at risk, detection of the fracture risk in relation to bone demineralization and fall risk, adherence to therapy.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/283508

The first outstanding 50 years of “Università Politecnica delle Marche”: Research achievements in life sciences
Autore/i: Longhi, S.; Monteriu', A.; Freddi, A.; Aquilanti, L.; Ceravolo, M. G.; Carnevali, O.; Giordano, M.; Moroncini, G.
Editore: Springer International Publishing
Classificazione: 7 Curatele
Abstract: Introduction The book describes the significant multidisciplinary research findings at the Università Politecnica delle Marche and the expected future advances. It addresses some of the most dramatic challenges posed by today’s fast-growing, global society and the changes it has caused. It also discusses solutions to improve the wellbeing of human beings. The book covers the main research achievements in the various disciplines of the life sciences, and includes chapters that highlight mechanisms relevant to all aspects of human diseases, the molecular, cellular, and functional basis of therapy, and its translation into the management of people’s health needs. It also describes research on traditional and innovative foods to enhance quality, safety and functionality, and to develop bioactive/nutraceutical compounds. Further chapters address conservation and management of various environments, from the forests to the oceans, describing the studies on countermeasures against climate changes and terrestrial/aquatic pollutants, and on terrestrial/marine biodiversity, ecosystems and landscapes, erosion of genetic biodiversity, innovative aquaculture feed, sustainable crop production and management of forests. Lastly, the book reports the findings of research work on different classes of biomolecules, and on the molecular basis of antibiotic resistances and their diffusion.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/283638

Preface
The First Outstanding 50 Years of "Universita Politecnica delle Marche": Research Achievements in Life Sciences
Autore/i: Longhi, S.; Monteriu', A.; Freddi, A.; Aquilanti, L.; Ceravolo, M. G.; Carnevali, O.; Giordano, M.; Moroncini, G.
Editore: Springer International Publishing
Classificazione: 2 Contributo in Volume
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/283639

Systematic rapid "living" review on rehabilitation needs due to covid-19: update to march 31st 2020
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Ceravolo, Maria G; De Sire, Alessandro; Andrenelli, Elisa; Negrini, Francesco; Negrini, Stefano
Classificazione: 1 Contributo su Rivista
Abstract: INTRODUCTION: The outbreak of COVID-19 epidemics has challenged the provision of health care worldwide, highlighting the main flaws of some national health systems with respect to their capacity to cope with the needs of frail subjects. People experiencing disability due to COVID-19 express specific rehabilitation needs that deserve a systematic evidence-based approach. The aim of this article is to provide the rehabilitation community with updates on the latest scientific literature on rehabilitation needs due to COVID-19. The first rapid "living"review will present the results of a systematic search performed up to March 31st, 2020. EVIDENCE ACQUISITION: A systematic search in PubMed, Pedro, and Google Scholar was performed using the search terms: "COVID-19,""Coronavirus,""severe acute respiratory syndrome coronavirus 2,""rehabilitation,""physical therapy modalities,""exercise,""occupational therapy,"and "late complications."Papers published up to March 31st, 2020, in English, were included. EVIDENCE SYNTHESIS: Out of the 2758 articles retrieved, nine were included in the present review. Four of them are "calls for action", three provide recommendations about rehabilitation interventions in the acute phase, two address the needs of people quarantined at home or with restricted mobility due to the lockdown, and one provides a Core Outcome Set to be used in clinical trials to test the efficacy of health strategies in managing COVID-19 patients. CONCLUSIONS: All selected papers were based on previous literature and not on the current COVID-19 pandemic. Main messages included: 1) early rehabilitation should be granted to inpatients with COVID-19; 2) people with restricted mobility due to quarantine or lockdown should receive exercise programs to reduce the risk of frailty, sarcopenia, cognitive decline and depression; 3) telerehabilitation may represent the first option for people at home. Further updates are warranted in order to characterize the emerging disability in COVID-19 survivors and the adverse effects on the health of chronically disabled people.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/277269

Systematic rapid living review on rehabilitation needs due to Covid-19: update to April 30th 2020
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: de Sire, Alessandro; Andrenelli, Elisa; Negrini, Francesco; Negrini, Stefano; Ceravolo, Maria Gabriella
Classificazione: 1 Contributo su Rivista
Abstract: INTRODUCTION: This paper adds to the series of systematic rapid living reviews, started in April 2020, to provide the rehabilitation community with updates on the latest scientific literature on rehabilitation needs due to COVID-19 pandemic. The aim of this paper is to present the results of a systematic scientific literature search performed on papers published from April 1st to April 30th, 2020. EVIDENCE ACQUISITION: A systematic search was performed on PubMed, Embase, Scopus, CINAHL, PEDro, Web of Science and the main international guideline databases for articles published (including Epub), in English, from April 1st to April 30th, 2020. Papers were included if they reported on one of the following: 1) prevalence and features of the emerging disability after COVID-19; 2) rehabilitation strategies applied for COVID-19 patients, regardless of setting or stage; 3) information about rehabilitation services after COVID-19; 4) impact on diseases of rehabilitative interest; 5) complications of rehabilitative interest. EVIDENCE SYNTHESIS: Out of 445 articles retrieved for the time frame, 50 were finally included for qualitative analysis. They consist of seven guidelines, one scoping review, one randomized controlled trial, four descriptive studies (qualitative), one case series, one case report, and 35 expert opinions. CONCLUSIONS: This systematic rapid living review showed an increasing evidence on rehabilitation needs due to COVID-19 outbreak during April 2020. The main novelties include: 1) the first appearance of epidemiological data on the likely high incidence of neurological complications/ disabling sequelae in patients hospitalized for COVID-19; 2) rapid guidelines on the management of chronically disabled patients in the COVID-19 era; 3) advices to provide COVID-19 patients with early respiratory rehabilitation in the acute phase, and with telemonitoring and telerehabilitation in the post-acute phase. Although the overall quality of studies has increased, prospective cohort studies on disability course in COVID-19 pandemic and experimental studies on the effects of rehabilitation are still warranted.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/281666

The PRIAMO study: age- and sex-related relationship between prodromal constipation and disease phenotype in early Parkinson’s disease
JOURNAL OF NEUROLOGY
Autore/i: Picillo, M.; Palladino, R.; Erro, R.; Alfano, R.; Colosimo, C.; Marconi, R.; Antonini, A.; Barone, P.; Morgante, L.; Benincasa, D.; Quatrale, R.; Biguzzi, S.; Braga, M.; Ceravolo, G.; Capecci, M.; Meco, G.; Caravona, N.; Scala, R.; De Falco, F. A.; Pezzoli, G.; De Gaspari, D.; Bottacchi, E.; Di Giovanni, M.; Cannas, A.; Floris, G.; Gallerini, S.; Grasso, L.; Gaglio, R. M.; Gurgone, G.; Volpe, G.; Zappulla, S.; Ceravolo, R.; Kiferle, L.; Ramat, S.; Meoni, S.; Pisani, A.; Moschella, V.; Morgante, F.; Savica, R.; Pepe, F.; Ciccarelli, G.; Petretta, V.; Giglia, R. M.; Randisi, M. G.; Iemolo, F.; Avarello, T. P.; Romeno, M.; Santangelo, G.; Stocchi, F.; Sciortino, G.; Sorbello, V.; Nicoletti, A.; Tiple, D.; Fabbrini, G.; Bentivoglio, A.; Pontieri, F. E.; Guidubaldi, A.; Muoio, R.; Toni, V.; Del Dotto, P.; Logi, C.; Ciacci, G.; Ulivelli, M.; Perini, M.; Lanfranchi, S.; Griffini, S.; Troianiello, B.; Baratti, M.; Amidei, S.; Consoli, D.; Iellamo, M.; Cuomo, T.; Scaglioni, A.; Medici, D.; Manfredi, M.; Abbruzzese, G.; Di Brigida, G.; Cocco, G. A.; Agnetti, V.; Cossu, G.; Deriu, M.; Abrignani, M.; Modica, C.; Albani, G.; Milan, E.; Martinelli, P.; Scaglione, C.; Mucchiut, M.; Zanini, S.; Pennisi, F.; Soliveri, P.; Albanese, A.; Massimo, P.; Bartolomei, L.; Capus, L.; Ferigo, L.; Marano, R.; Nastasi, V.; Luciano, R.; Maiello, L.; Simone, P.; Fogli, D.; Lopiano, L.; Pesare, M.; Nordera, G.; Pilleri, E.; Scaravilli, T.; Giaccaglini, E.; Alesi, C.; Petrone, A.; Trianni, G.
Classificazione: 1 Contributo su Rivista
Abstract: Objectives: To explore the impact of sex and age on relationship between prodromal constipation and disease phenotype in Parkinson’s disease at early stages. Methods: A total of 385 Parkinson’s disease patients from the PRIAMO study were classified according to the presence of prodromal constipation and followed for 24 months. Multivariable mixed-effect models were applied. All analyses were performed separately for sex (64.1% men) and median age (different by sex: 67 years-old in men and 68 years-old in women). Results: As for sex, prodromal constipation was associated with greater odds of attention/memory complaints and apathy symptoms in women only. As for age, prodromal constipation was associated with lower cognitive and higher apathy scores in older patients only. Conclusions: Prodromal constipation anticipates lower cognitive performances and more severe apathy since the earliest stages in women and older patients. Sex- and age-related heterogeneity of prodromal markers of Parkinson’s disease may impact disease phenotype.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/289759

A fuzzy logic system for the home assessment of freezing of gait in subjects with Parkinsons disease
EXPERT SYSTEMS WITH APPLICATIONS
Autore/i: Pepa, Lucia; Capecci, Marianna; Andrenelli, Elisa; Ciabattoni, Lucio; Spalazzi, Luca; Ceravolo, Maria Gabriella
Classificazione: 1 Contributo su Rivista
Abstract: Gait dysfunctions are pathognomonic, progressive and, generally, continuous in Parkinson’s Disease (PD). The Freezing of Gait (FoG) is an episodic gait disorder involving up to 70% of people with PD, within 10 years of clinical onset, and associated with an increased risk for falls and immobility, which in turn, contributes to greater disability. Automatic and objective monitoring of FoG may help clinicians to understand and treat this phenomenon. In this work, a smartphone app for real-time FoG detection is presented and tested both in a laboratory setting and at patients’ home. The app implements a novel fuzzy logic algorithm that uses important spatio-temporal parameters of gait and is built according to clinical knowledge about FoG. The app includes a gait detection function and the evaluation of two important clinical statistics, i.e. FoG time and FoG number. The app FoG detection performance was assessed against clinicians evaluation and compared with the Moore-Bachlin FoG detection algorithm through ROC analysis, the calculation of confusion matrix, and FoG hit rate. The proposed algorithm achieved better results with respect to the Moore-Bachlin algorithm. Home reports were compared with respect to the FoG Questionnaire and laboratory reports; results indicated significant correlations for both FoG time and FoG number. The results confirm the reliability and accuracy of this app for FoG detection, supporting its wide use for diagnostic and therapeutic purposes.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/273262

Thirty Years of Parkinson's Disease Management: From a Symptom-Based Approach to a Holistic Perspective
The First Outstanding 50 Years of “Università Politecnica delle Marche”
Autore/i: Capecci, Marianna; Ceravolo, Maria Gabriella
Editore: Springer
Classificazione: 2 Contributo in Volume
Abstract: No neurological disorder other than Parkinson's disease (PD) can boast so many revolutionary events, in its history. The treatment of choice has primarily been the dopamine precursor levodopa. After its introduction, the impact of disease on mortality significantly decreased, yet affected people had to face severe drug-related side effects. Around 40 years ago, other symptomatic drugs, including monoamine oxidase type B (MAO-B) inhibitors and dopamine agonists (DA), used as first-line therapy in de novo patients, were reportedly effective at preventing the levo-Dopa long-term treatment syndrome. Afterwards, catechol-O-methyltransferase inhibitors and long-release DA were added to the toolkit, as a means to obtain a steady control on motor symptoms, but their effectiveness was overtaken, 30 years ago, by functional neurosurgery that ensured brilliant results with the bilateral subthalamic deep brain stimulation (DBS) technique. Notwithstanding such care improvement, people with PD still experienced long-lasting ever-growing disability. Over the last 10 years, evidence on the efficacy of motor training has accumulated, supporting the role of exercise for promoting activity-dependent neuroplasticity, thus opening a new perspective on non-pharmacological disease modifying interventions.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/273023

Rehabilitation and Covid-19: the Cochrane Rehabilitation 2020 rapid living systematic review
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Ceravolo, Maria Gabriella; Arienti, Chiara; De Sire, Alessandro; Andrenelli, Elisa; Negrini, Francesco; Lazzarini, Stefano; Patrini, Michele; Negrini, Stefano; The International Multiprofessional Steering Committee of Cochrane Rehabilitation REH-COVer, Action
Classificazione: 1 Contributo su Rivista
Abstract: INTRODUCTION: This paper improves the methodology of the first edition of the rapid living systematic review started in April 2020, with the aim to gather and present the current evidence informing rehabilitation of patients with COVID-19 and/or describing the consequences due to the disease and its treatment. EVIDENCE ACQUISITION: The Cochrane methodology for a rapid living systematic review was applied. Primary research papers, published from 1 January to 30 June 2020, reporting patients’ data, with no limits of study design were included. Studies were categorized for study design, research question, COVID-19 phase, limitations of functioning (disability) of rehabilitation interest and type of rehabilitation service involved. Methodological quality assessment was based on the Cochrane Risk of Bias tools, and the level of evidence table (OCEBM 2011) for all the other studies. EVIDENCE SYNTHESIS: Thirty-six, out of 3703 papers, were included. One paper was of level 2 (RCT), 7 were of level 3 (2 cohort studies, 2 cross-sectional studies and 3 case-control studies), and 28 papers of level 4 (descriptive studies); 61% of papers reported epidemiological data on clinical presentations, 5 investigated natural history/determining factors, 1 searched prevalence, 2 studies reported on intervention efficacy (though not on harms), and 5 studies looked at health service organization. CONCLUSIONS: Main issues emerging from the review: it is advised to test for COVID-19 people with neurological disorders presenting with symptom changes; dysphagia is a frequent complication after oro-tracheal intubation in COVID-19 patients admitted to the ICU; after discharge, COVID-19 survivors may report persistent restrictive ventilatory deficits regardless of disease severity; there is only sparse and low quality evidence concerning the efficacy of any rehabilitation intervention to promote functional recovery; a substantial increase in resource (staff and equipment) is needed for rehabilitation
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/283635

Rehabilitation and COVID-19: a rapid living systematic review 2020 by Cochrane Rehabilitation Field. Update as of September 30th, 2020
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Andrenelli, Elisa; Negrini, Francesco; De Sire, Alessandro; Patrini, Michele; Lazzarini, Stefano G; Ceravolo, Maria Gabriella; International Multiprofessional Steering Committee of Cochrane Rehabilitation REH-COVER action(Corporate, Author)
Classificazione: 1 Contributo su Rivista
Abstract: The COVID-19 outbreak response requires identifying and understanding the longterm consequences of this new pathology, and how to manage these. This living systematic review presents the most current and seminal information coming from the scientific literature. It is the monthly update of the second edition of the rapid living systematic review 2020 conducted by Cochrane Rehabilitation REH-COVER Action Steering Committee.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/285529

Systematic rapid living review on rehabilitation needs due to Covid-19: update to May 31st 2020
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Andrenelli, Elisa; Negrini, Francesco; De Sire, Alessandro; Arienti, Chiara; Patrini, Michele; Negrini, Stefano; Ceravolo, Maria Gabriella; International Multiprofessional Steering Committee of Cochrane Rehabilitation RECOVER, Action
Classificazione: 1 Contributo su Rivista
Abstract: Background: This paper adds to the series of systematic rapid living reviews, started in April 2020, to provide the rehabilitation community with updates on the latest scientific literature on rehabilitation needs due to the Covid-19 pandemic. Objectives: To present the results of a systematic search performed on papers published from May 1st to May 31st, 2020. Methods: An extensive search on the main medical literature databases for articles published (including Epub), in English, from May 1st to May 31st, 2020 was performed, according to the methodology already described in the previous 2 rapid reviews, with 2 important improvements: first, we made the search string more comprehensive; second, we relied on accredited terminologies to describe the study designs and report the rehabilitation settings. Results: Fifty-eight out of 618 articles were finally included for qualitative analysis. The number of primary studies has increased, with respect to the previous months, although still around 60% papers are just expert opinions. Six papers report on the prevalence and /or characteristics of emerging disability after COVID-19, 12 on rehabilitation approaches to COVID-19 patients, up to 25 on the organization of rehabilitation services after COVID-19, 13 papers on the impact of COVID-19 on health conditions of rehabilitative interest and only 2 on late complications due to COVID-19 that may be of rehabilitative interest. Conclusions: Nowadays, all patients with disability, regardless of COVID-19 infection, are suffering because of restrictions imposed to rehabilitation service delivery. Neurological involvement is often present during acute and post-acute stage, conveying the risk of a long-lasting disability. Accordingly, careful neurological monitoring should be granted. Although new therapies are under development, the main gap in the available scientific literature is the lack of high-quality primary studies, so experimental studies on the effects of rehabilitation are still warranted.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/282526

Telemedicine from research to practice during the pandemic. "Instant paper from the field" on rehabilitation answers to the Covid-19 emergency
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Negrini, Stefano; Kiekens, Carlotte; Bernetti, Andrea; Capecci, Marianna; Ceravolo, Maria Gabriella; Lavezzi, Susanna; Zampolini, Mauro; Boldrini, Paolo
Classificazione: 1 Contributo su Rivista
Abstract: Covid-19 pandemic is creating collateral damage to outpatients, whose rehabilitation services have been disrupted in most of the European countries. Telemedicine has been advocated as a possible solution. This paper reports the contents of the third Italian Society of Physical and Rehabilitation Medicine (SIMFER) webinar on "experiences from the field" Covid-19 impact on rehabilitation ("Covinars"). It provides readily available, first-hand information about the application of telemedicine in rehabilitation. The experiences reported were very different for population (number and health conditions), interventions, professionals, service payment, and technologies used. Commonalities included the pushing need due to the emergency, previous experiences, and a dynamic research and innovation environment. Lights included feasibility, results, reduction of isolation, cost decrease, stimulation to innovation, satisfaction of patients, families, and professionals beyond the starting diffidence. Shadows included that telemedicine can integrate but will never substitute face-to-face rehabilitation base on the encounter among human beings; age, and technology barriers (devices absence, bad connection and human diffidence) have also been reported. Possible issues included privacy and informed consent, payments, cultural difficulties in understanding that telemedicine is a real rehabilitation intervention. There was a final agreement that this experience will be incorporated by participants in their future services: technology is ready, but the real challenge is to change PRM physicians' and patients' habits, while better specific regulation is warranted.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/277268

Rehabilitation and COVID-19: the Cochrane Rehabilitation 2020 rapid living systematic review. Update as of July 31st, 2020
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
Autore/i: Negrini, Francesco; De Sire, Alessandro; Andrenelli, Elisa; Lazzarini, Stefano G; Patrini, Michele; Ceravolo, Maria Gabriella; The International Multiprofessional Steering Committee of Cochrane Rehabilitation REH-COVER, Action
Classificazione: 1 Contributo su Rivista
Abstract: Background. This paper is the first update of the second edition of the rapid living systemati review on the latest scientific literature informing rehabilitation of patients with COVID-19 and/or describing consequences of the disease and its treatment, as they relate to limitations in functioning of rehabilitation interest. Objectives. To report data of a systematic search performed on papers published in July 2020. Methods. The methodology described in the second edition of the rapid living systematic review was applied to search eligible papers included in the databases between July 1st, 2020 and July 31st, 2020. Results. Eight-hundred-ninety-two papers were identified through database searching (after removal of duplicates); of these, only 23 studies were included. According to OCEBM 2011 Levels of Evidence Table, they were Level 3 in 30.5% cases and Level 4 in 69.5%. No RCT was found. Nineteen papers studied COVID-19 patients, assessed in the acute (10 studies), postacute (8 studies) and chronic phase (one study). Four studies reported data on the impact of COVID-19 on subjects with pre-existing health conditions. Conclusions. The current literature production still focuses more on describing all the possible aspects and complications of the pathology than on interventions or new organization models to deal with it. Albeit evidence on handling COVID-19 from a rehabilitative point of view is improving each month, further studies are still mandatory to report the role of rehabilitation in this scenario.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/283723

Covid-19 and post intensive care syndrome: A call for action
JOURNAL OF REHABILITATION MEDICINE
Autore/i: Stam, H. J. ; Stucki G. ; Bickenbach J.; Ceravolo, Mg
Classificazione: 1 Contributo su Rivista
Abstract: Although we are currently overwhelmed by the astonishing speed of infection of the Covid-19 pandemic, and the daily onslaught of new, and ever-worsening predictions, it is vital that we begin to prepare for the aftershocks of the pandemic. Prominent among this will be the cohort of post-intensive case survivors who have been mechanically ventilated and will likely experience short- and medium-term consequences. The notion that patients surviving intensive care and mechanical ventilation for several weeks can be discharged home without further medical attention is a dangerous illusion. Post Intensive Care Syndrome and other severe conditions will require not only adequate screening but early rehabilitation and other interventions. Action must be taken now to prepare for this inevitable aftershock to the healthcare system.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/294302

Endovascular treatment and cognitive outcome after anterior circulation ischemic stroke
SCIENTIFIC REPORTS
Autore/i: Lattanzi, Simona; Coccia, Michela; Pulcini, Alessandra; Cagnetti, Claudia; Galli, Federica Lucia; Villani, Laura; Campa, Serena; Dobran, Mauro; Polonara, Gabriele; Ceravolo, Maria Gabriella; Silvestrini, Mauro
Classificazione: 1 Contributo su Rivista
Abstract: The impact of reperfusion therapies on cognition has been poorly explored and little knowledge exists. We explored the influence of endovascular treatment (EVT) on cognitive outcome in patients with anterior circulation ischemic stroke. Patients presenting with ischemic stroke due to anterior large vessel occlusion who underwent intravenous thrombolysis (IVT) alone or EVT plus IVT were recruited. Cognitive abilities were evaluated at 6 months from stroke through a neuropsychological test battery. A total of 88 patients with a mean age of 66.3 ± 12.9 years were included, of which 38 treated with IVT alone and 50 with IVT plus EVT. Compared to patients treated with IVT alone, patients who received EVT plus IVT performed significantly better at the neuropsychological tests exploring executive functions, attention, abstract reasoning, visuospatial ability, visual and verbal and memory. At multivariable regression analysis, the EVT was independently associated with the 6-month cognitive performance after the adjustment for age, sex, admission National Institutes of Health Stroke Scale score, systolic blood pressure, glucose level, Alberta Stroke Program Early CT score, side of stroke, site of occlusion, and Back Depression Inventory score [Stroop Test Word Reading: adjβ = 13.99, 95% confidence interval (CI) 8.47-19.50, p < 0.001; Stroop Test Colour Naming: adjβ = 6.63, 95% CI 2.46-10.81, p = 0.002; Trail Making Test-A: adjβ = - 92.98, 95% CI - 153.76 to - 32.20, p = 0.003; Trail Making Test-B: adjβ = - 181.12, 95% CI - 266.09 to - 96.15; p < 0.001; Digit Span Test Forward: adjβ = 1.44, 95% CI 0.77-2.10, p < 0.001; Digit Span Test Backward: adjβ = 1.10, 95% CI 0.42-1.77, p = 0.002; Coloured Progressive Matrices: adjβ = 5.82, 95% CI 2.71-8.93, p < 0.001; Rey Complex Figure Test-Copy: adjβ = 6.02, 95% CI 2.74-9.30, p < 0.001; Rey Complex Figure Test-Immediate recall: adjβ = 6.00, 95% CI 2.34-9.66, p = 0.002; Rey Complex Figure Test-Delayed recall: adjβ = 5.73, 95% CI 1.95-9.51, p = 0.003; Rey Auditory Verbal Learning Test-Immediate recall: adjβ = 12.60, 95% CI 6.69-18.52, p < 0.001; Rey Auditory Verbal Learning Test-Delayed recall: adjβ = 1.85, 95% CI 0.24-3.45, p = 0.025]. Patients treated with EVT plus IVT had better cognitive performance than patients treated with IVT alone at 6 months from anterior circulation ischemic stroke.
Scheda della pubblicazione: https://iris.univpm.it/handle/11566/284809