Claudio Ferraro

Upper limb rehabilitation robotics after stroke: a perspective from the University of Padua, Italy.

Rehabilitation robotics is an emerging research field that aims to employ leading-edge robotic technology and virtual reality systems in the rehabilitation treatment of neuro-logical patients. In post-stroke patients with upper limb impairment, clinical trials have so far shown positive results in terms of motor recovery, but poor efficacy in terms of functional outcome. Much work is needed to develop a new generation of rehabilitation robots and clinical protocols that will be more effective in helping patients to regain their abilities in activities of daily living. This paper presents some key issues in the future perspective of upper limb robotic rehabilitation after stroke.

Healthcare service use in adolescents with non-specific musculoskeletal pain

Aim:  To estimate occurrence of non‐specific musculoskeletal pain in a wide population sample of Italian adolescents, and to investigate their use of healthcare services (seeking of medical attention, referral for diagnostic tests and treatment use).

Robot-aided intensive training in post-stroke recovery

The successful motor rehabilitation of stroke patients requires an intensive and task-specific therapy approach. The plasticity of the adult human brain provides opportunities to enhance traditional rehabilitation programs for these individuals. Intensive robot-aided sensorimotor training may have a positive effect on reducing impairment and disability and increasing reorganization of the adult brain. This approach may therefore efficaciously complement standard post-stroke multidisciplinary programs as shown by recent experimental trials.

Platelet rich plasma intra-articular injections: a new therapeutic strategy for the treatment of knee osteoarthritis in sport rehabilitation. A systematic review

Osteoarthritis (OA) is the most common joint disease and the prevalence of knee OA among athletes is higher than in the general population, especially after injury or in association with high-impact sport. We evaluated the clinical evidence and the persistence of the beneficial effects of intraarticular injections of platelet-rich plasma (PRP) in patients affected by knee OA. A systematic computerized literature search of following databases was conducted: PubMed, Medline, Cochrane, CINAHL, Embase, SportDiscus, Pedro and Google scholar. PRP has been shown to be an effective and well-tolerated treatment option in OA, with greater and longer effects in young men with a low degree of cartilage degeneration. The role of growth factors and inflammatory mediators in the pathophysiology of OA suggest that PRP may be useful in the early stages to modulate inflammatory processes. Although current studies are encouraging, more data and long-term follow-up are required before PRP can be recommended in the treatment of OA. Future PRP research should involve questions regarding the mechanism of actions, formulation, and number and timing of injections to better identify patient selection criteria.

Post-Stroke Robotic Training of the Upper Limb: A Randomized Trial Study

comparing mortality with helmet use, 10.42% of motorcyclists without a helmet died compared with 1.83% with a helmet (P .0112). In addition, 22.92% of motorcyclists without a helmet had moderate to severe TBI compared with 3.69% with a helmet (P .0001). Conclusions: NC law requires all motorcyclists to wear helmets, whereas SC requires only those 20 years old or younger to wear helmets. This study found a significant difference in helmet use between residents of NC and SC, which suggests a strong influence of the helmet laws between the 2 states. Also noted was a significantly higher mortality rate and higher frequency of moderate-to-severe TBI with nonhelmeted motorcyclists. These results serve to support the use of helmets for motorcyclists as well as enforcement through state legislation.

Goniometric evaluation of the spinal sagittal curves in children and adolescents: A reliability study

BACKGROUND Gold standard for spine deformities assessment is X rays, but the procedure bears a risk of exposure. OBJECTIVE To investigate intra-rater and inter-rater reliability of a pocket compass needle goniometer (IncliMed®, University of Padua) to non-invasively evaluate spine curves in children and adolescents. METHODS Prospective reliability study in a paediatric population (mean age 12.5 years ± 2.5). Children with spine deformities (Scheuermanns or postural kyphosis, idiopathic scoliosis) and healthy controls were included. Two physician measured spinal curves with the surface goniometer IncliMed® within a temporal range of 10 minutes. Participants were re-tested after a mean of 28 days for the intra-rater study. Agreement limit and coefficient of repeatability were calculated according to the linear regression analysis; the Bland and Altman method was applied to obtain average of differences and standard error of the mean of the differences. RESULTS One hundred and thirty-nine subjects participated to the inter-rater reliability assessment; 30 to the intra-rater reliability assessment. Inter-observer variability for IncliMed® measurements was ± 11° both for kyphosis and for lordosis. The intra-observer variability for kyphosis and lordosis measurements was ± 11° and ± 12°. CONCLUSIONS IncliMed® is a reliable, non-invasive tool to screen and monitor spinal curves in paediatric populations.

Poster 7: Effects of a Rehabilitation and Educational-Behavioral Program on Pain, Disability and Quality of Life in Patients with Ankylosing Spondylitis in Anti-TNFα Therapy: A Randomized Controlled Trial

Disclosures: S. Masiero, None. Objective: To evaluate the effects on pain, disability and quality of life of a rehabilitation and educational-behavioral program in patients with ankylosing spondylitis (AS) in anti-TNF therapy. Design: Randomized controlled trial, 6-month follow-up. Setting: Outpatients of Rheumatologic Department. Participants: Fifty-eight patients with SA in anti-TNF therapy for more than 9 months were randomly allocated to 3 groups. Interventions: Group A (n 18) received an educationalbehavioral meeting with a home guide (2 hours) associated with an intensive group exercise program under the supervision of a physiotherapist (1 hours twice a week for 5 weeks) that was then performed at home; group B (n 18) received only educational-behavioral information by a meeting with a home guide (2 hours); group C (n 17) not effected any treatment. Main Outcome Measures: Visual analogue scale (VAS) of axial pain and stiffness (last month), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Activity Index (BASDAI), Health Assessment Questionnaire (HAQ), MOS 36-item short form health survey (SF-36). Results: Group A showed significant gains at the evaluations defined as the difference between the 2 assessments (beginning and after 6 months) compared with groups B and C as resulted, respectively, for BASFI (-1.9 1.7 vs -0.89 0.9 and 0.08 0.8; P .001), BASDAI ( -1.5 1.3 vs 0.8 1.2 and 0.4 0.5; P .040) and HAQ (-039 0.11 vs -0.14 0.19 and -0.09 0.15; P .021), but not for back pain at the VAS (P .121), and SF-36 (P .161 and .06). Conclusions: Our study showed that after 6 months, attending an educational-behavioral program associated with intensive group exercise can reduce the intensity of pain and disability and improve the quality of life for patients with SA who were pharmacologically stabilized with anti-TNF therapy. This approach may effectively complement drug therapy in these patients.

Poster 8: Effects of a Rehabilitation and Educational-Behavioral Program on Spinal Mobility in Patients with Ankylosing Spondylitis in Anti-TNFα Therapy: A Randomized Controlled Trial

Disclosures: S. Masiero, None. Objective: To evaluate the effects on pain, disability and quality of life of a rehabilitation and educational-behavioral program in patients with ankylosing spondylitis (AS) in anti-TNF therapy. Design: Randomized controlled trial, 6-month follow-up. Setting: Outpatients of Rheumatologic Department. Participants: Fifty-eight patients with SA in anti-TNF therapy for more than 9 months were randomly allocated to 3 groups. Interventions: Group A (n 18) received an educationalbehavioral meeting with a home guide (2 hours) associated with an intensive group exercise program under the supervision of a physiotherapist (1 hours twice a week for 5 weeks) that was then performed at home; group B (n 18) received only educational-behavioral information by a meeting with a home guide (2 hours); group C (n 17) not effected any treatment. Main Outcome Measures: Visual analogue scale (VAS) of axial pain and stiffness (last month), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Activity Index (BASDAI), Health Assessment Questionnaire (HAQ), MOS 36-item short form health survey (SF-36). Results: Group A showed significant gains at the evaluations defined as the difference between the 2 assessments (beginning and after 6 months) compared with groups B and C as resulted, respectively, for BASFI (-1.9 1.7 vs -0.89 0.9 and 0.08 0.8; P .001), BASDAI ( -1.5 1.3 vs 0.8 1.2 and 0.4 0.5; P .040) and HAQ (-039 0.11 vs -0.14 0.19 and -0.09 0.15; P .021), but not for back pain at the VAS (P .121), and SF-36 (P .161 and .06). Conclusions: Our study showed that after 6 months, attending an educational-behavioral program associated with intensive group exercise can reduce the intensity of pain and disability and improve the quality of life for patients with SA who were pharmacologically stabilized with anti-TNF therapy. This approach may effectively complement drug therapy in these patients.