Marco Germanotta

Balance in subjects with congenital or early onset strabismus: Influence of age

Few studies have investigated the relationship between strabismus and balance, and those that do exist focused on patients within a limited age range, while no studies on possible age-related changes have yet been conducted. Therefore, the aim of our study was to investigate whether the balance strategies adopted by patients with congenital or early onset strabismus change with age. Forty strabismic patients and 36 healthy subjects were enrolled in the study. Both patients and healthy subjects were divided into three subgroups according to age (children, adolescents, and adults) and underwent a stabilometric evaluation. When we compared the whole group of strabismic patients with the group of healthy subjects, we found that the center of pressure area and the trunk oscillations in the former were significantly different from those in the latter; when we considered the three age groups separately, only values in children with strabismus were different from those in the age-matched control group of healthy subjects. Strabismus was found to affect balance in children by inducing a postural strategy characterized by a reduction in physiological trunk oscillations. Gaining a better insight into postural control in strabismic subjects and its evolution with age may be crucial to improving rehabilitation in such patients and planning tailored rehabilitation treatment.

Does First Ray Amputation in Diabetic Patients Influence Gait and Quality of Life

ABSTRACT It has recently been suggested that first ray amputation in diabetic patients with serious foot complications can prolong bipedal ambulatory status, and reduce morbidity and mortality. However, no data are available on gait analysis and quality of life after this procedure. In the present case‐control study (6 amputee and 6 nonamputee diabetics, 6 healthy non‐diabetic), a sample of amputee diabetic patients were evaluated and compared with a sample of nonamputee diabetic patients and a group of age‐matched healthy subjects. Gait biomechanics, quality of life, and pain were evaluated. Compared with the other 2 groups, amputee patients displayed a lower walking speed and greater variability and lower ankle, knee, and hip range of motion values. They also tended to have a more flexed hip profile. Pain and lower quality of life were related to worsening biomechanical data. Our study results have shown that gait biomechanics in diabetic patients with first ray amputation are abnormal, probably owing to the severity of diabetes and the absence of the push‐off phase provided by the hallux. Tailored orthotics and rehabilitation programs and a specific pain management program should be considered to improve the gait and quality of life of diabetic patients with first ray amputation. Level of Clinical Evidence: 4

The Role of Cognitive Reserve in the Choice of Upper Limb Rehabilitation Treatment After Stroke. Robotic or Conventional? A Multicenter Study of the Don Carlo Gnocchi Foundation

Rehabilitation is essential after stroke and, besides conventional rehabilitation, technological one has had big growth in clinical practice. There is a growing interest in cognitive reserve (CR) that summarizes pre-morbid life of each patient and has a key role in a sudden change of individual lifestyle (for example, after a stroke). Our preliminary data suggested that CR impacts on motor rehabilitation outcome. We hypothesized that CR may help in the complex choice between technological or conventional rehabilitation. The aim of this study is to evaluate whether the CR influences the motor outcome in patients after stroke treated with conventional or robotic therapy and if CR may address towards one treatment rather than another.