Authors: Meroni, Roberto | Piscitelli, Daniele | Bonetti, Francesca | Zambaldi, Mattia | Cerri, Cesare G. | Guccione, Andrew A. | Pillastrini, Paolo
Article Type: Research Article
Abstract: OBJECTIVE: The aim of this study was to investigate the psychometric properties of the Italian version of the Pain Catastrophizing Scale (PCS-I) in patients with chronic low back pain. METHODS: In a cross sectional study a total of 150 subjects with chronic low back pain were included. The Italian translation of the PCS was administered to all subjects. The properties of the Italian version of the PCS were explored by a Rasch analysis. RESULTS: The PCS-I, by means of few modifications, fitted the Rasch model and passed the independent t-test for a unidimensional scale. The response categories for item 2 …``I fell I can't go on'' needed to be collapsed from 4 to 3 levels. Only the item 7 ``I keep thinking to of other painful events'' showed fit residual that exceeded the chosen thresholds of ± 2.5. No Differential functioning (DIF) was observed for age, sex, marital status, BMI and smoking. CONCLUSION: The Italian version of PCS, with the purposed modifications, seems to reflect a unidimensional construct of Pain Catastrophizing. The scale seemed to be quite robust across age, sex, marital status, BMI and smoking. Targeting of the scale was moderate. A raw score to metric conversion was proposed. Show more
Keywords: Pain, PCS-I, PCS, Rasch Analysis, LBP, chronic low back pain
DOI: 10.3233/BMR-140564
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 4, pp. 661-673, 2015
Authors: Perin, Cecilia | Viganò, Barbara | Piscitelli, Daniele | Matteo, Barbara Maria | Meroni, Roberto | Cerri, Cesare Giuseppe
Article Type: Research Article
Abstract: Background: Around 253 million people worldwide suffer from irreversible visual damage. Numerous studies have been carried out in order to unveil the effects of electrical stimulation (ES) as a useful tool for rehabilitation for different visual conditions and pathologies. Objective: This systematic review aimed to 1) examine the current evidence of ES efficacy for the treatment of visual pathologies and 2) define the corresponding degree of the recommendation of different ES techniques. Methods: A systematic review was conducted in MEDLINE and Cochrane Library database to collect documents published between 2000 and 2018. For each study, Level of Evidence of Effectiveness …of ES as well as the Class of Quality for the treatment of different visual pathologies were determined. Results: Thirty-eight articles were included. Studies were grouped according to the pathology treated and the type of stimulation administered. The first group included studies treating pre-chiasmatic pathologies (age-related macular degeneration, macular dystrophy, retinal artery occlusion, retinitis pigmentosa, glaucoma, optic nerve damage, and optic neuropathy) using pre-chiasmatic stimulation; the second group included studies treating both pre-chiasmatic pathologies (amblyopia, myopia) and post-chiasmatic pathologies or brain conditions (hemianopsia, brain trauma) by means of post-chiasmatic stimulation. In the first group, repetitive transorbital alternating current stimulation (rtACS) reached level A recommendation, and transcorneal electrical stimulation (tcES) reached level B. In the second group, both high-frequency random noise stimulation (hf-RNS) and transcranial direct current stimulation (tDCS) reached level C recommendation. Conclusions: Study’s findings suggest conclusive evidence for rtACS treatment. For other protocols results are promising but not conclusive since the examined studies assessed different stimulation parameters and endpoints. A comparison of the effects of different combinations of these variables still lacks in the literature. Further studies are needed to optimize existing protocols and determine if different protocols are needed for different diseases. Show more
Keywords: Electrical stimulation, transcorneal electrical stimulation (tcES), repetitive transorbital alternating current stimulation (rtACS), high-frequency random noise stimulation (hf-RNS), transcranial direct current stimulation (tDCS), visual damage, hypovision
DOI: 10.3233/RNN-190948
Citation: Restorative Neurology and Neuroscience, vol. 38, no. 3, pp. 239-250, 2020
Authors: Tosatto, Diego | Bonacina, Daniele | Signori, Alessio | Pellicciari, Leonardo | Cecchi, Francesca | Cornaggia, Cesare Maria | Piscitelli, Daniele
Article Type: Research Article
Abstract: Background: Researchers may be tempted to favorably distort the interpretation of their findings when reporting the abstract (i.e., spin). Spin bias overemphasizes the beneficial effects of the intervention compared with the results shown in the full text. Objective: To assess the occurrence of spin bias and incompleteness in reporting abstracts in post-stroke upper limb (UL) rehabilitation randomized clinical trials (RCTs). Methods: A sample of 120 post-stroke UL rehabilitation RCTs (indexed in PEDro database), published in English between 2012 and 2020, was included. The completeness of reporting and spin were assessed using the Consolidated Standards of Reporting Trials for Abstracts (CONSORT-A) …and the spin checklist. The relationship between CONSORT-A and spin checklist scores with RCT and journal characteristics was assessed. Results: CONSORT-A and spin checklist scored 5.3±2.4 (max 15-points, higher scores indicating better reporting) and 5.5±2.0 (max 7-points, higher scores indicating presence of spin), respectively; Significant differences were detected between abstract and full-text scores in the CONSORT-A checklist (p < 0.01) and the spin checklist (p < 0.01). Items of the CONSORT-A checklist in the abstracts and full text showed a fair agreement (k = 0.31), while a moderate agreement (k = 0.59) for the spin checklist was detected. Completeness of abstract was associated (R2 = 0.46) with journal Impact Factor (p < 0.01), CONSORT Guideline endorsement (p = 0.04), and abstract word number (p = 0.02). A lower spin was associated with a higher journal Impact Factor (p = 0.01) and CONSORT Guideline endorsement (p = 0.01). Conclusions: Post-stroke UL rehabilitation RCTs abstracts were largely incomplete showing spin. Authors, reviewers, publishers, and stakeholders should be aware of this phenomenon. Publishers should consider allowing more words in abstracts to improve the completeness of reporting abstracts. Although we have investigated only stroke rehabilitation, our results suggest that health care professionals of all disciplines should avoid clinical decision-making based solely upon abstracts. Show more
Keywords: Data accuracy, stroke, abstracting and indexing, neurological rehabilitation, spin bias, randomized controlled trials
DOI: 10.3233/RNN-211247
Citation: Restorative Neurology and Neuroscience, vol. 40, no. 3, pp. 195-207, 2022
Authors: Dipasquale, Savina | Meroni, Roberto | Sasanelli, Francesco | Messineo, Ivan | Piscitelli, Daniele | Perin, Cecilia | Cornaggia, Cesare Maria | Cerri, Cesare G.
Article Type: Research Article
Abstract: Background and objective: Several studies suggest that general exercise (GE) and physical therapy programmes (PT) improve the outcomes of Parkinson’s disease (PD) patients; however, the available data do not allow a determination of which treatment is more effective. Our study aims to compare the effects of physiotherapy and general exercise in Parkinson’s disease. Methods: Design and setting: Randomized controlled trial –general hospital outpatient clinic. The participants were patients with Hoehn Yahr stage II PD. Two randomized groups: one receiving PT and one receiving GE. The outcome measures were the FIM, Hamilton Rating Scale, TUG test, and UPDRS. Results: FIM median …scores improved by 3 points in the PT group after treatment, and the improvements were maintained at follow-up. The GE FIM median scores were unchanged after treatment and were reduced by 1 point at follow-up (p < 0.05). The TUG test time was reduced in the PT group but increased in the GE group with a 3-second difference between groups at follow-up, suggesting improved functional mobility after specific physiotherapy (p < 0.05). The UPDRS median score change from baseline was significantly different between the two groups at the end of treatment (6.5 points) and at follow-up (11 points), with a benefit for the physiotherapy group. Conclusions: Physiotherapy seems to be more effective than a generic exercise programme in patients with Hoehn Yahr stage II PD. Show more
Keywords: Parkinson’s disease, physiotherapy, general exercise, physical therapy modalities
DOI: 10.3233/JPD-161015
Citation: Journal of Parkinson's Disease, vol. 7, no. 1, pp. 203-210, 2017
Authors: Mendonça, Thyciane | Brito, Rodrigo | Luna, Plínio | Campêlo, Mayara | Shirahige, Lívia | Fontes, Luís | Dias, Rebeca | Piscitelli, Daniele | Monte-Silva, Kátia
Article Type: Research Article
Abstract: Background: Repetitive transcranial magnetic stimulation (rTMS) has been applied for modulating cortical excitability and treating spasticity in neurological lesions. However, it is unclear which rTMS frequency is most effective in modulating cortical and spinal excitability in incomplete spinal cord injury (SCI). Objective: To evaluate electrophysiological and clinical repercussions of rTMS compared to sham stimulation when applied to the primary motor cortex (M1) in individuals with incomplete SCI. Methods: A total of 11 subjects (35±12 years) underwent three experimental sessions of rTMS (10 Hz, 1 Hz and sham stimulation) in a randomized order at 90%intensity of the resting motor threshold and interspersed by …a seven-day interval between sessions. The following outcome measures were evaluated: M1 and spinal cord excitability and spasticity in the moments before (baseline), immediately after (T0), 30 (T30) and 60 (T60) minutes after rTMS. M1 excitability was obtained through the motor evoked potential (MEP); spinal cord excitability by the Hoffman reflex (H-reflex) and homosynaptic depression (HD); and spasticity by the modified Ashworth scale (MAS). Results: A significant increase in cortical excitability was observed in subjects submitted to 10 Hz rTMS at the T0 moment when compared to sham stimulation (p = 0.008); this increase was also significant at T0 (p = 0.009), T30 (p = 0.005) and T60 (p = 0.005) moments when compared to the baseline condition. No significant differences were observed after the 10 Hz rTMS on spinal excitability or on spasticity. No inter-group differences were detected, or in the time after application of 1 Hz rTMS, or after sham stimulation for any of the assessed outcomes. Conclusions: High-frequency rTMS applied to M1 was able to promote increased cortical excitability in individuals with incomplete SCI for at least 60 minutes; however, it did not modify spinal excitability or spasticity. Show more
Keywords: Spinal cord injury, transcranial magnetic stimulation, excitability, spasticity, physiotherapy
DOI: 10.3233/RNN-211167
Citation: Restorative Neurology and Neuroscience, vol. 39, no. 4, pp. 291-301, 2021
Authors: Mazzucchelli, Miryam | Mazzoleni, Daniele | Campanini, Isabella | Merlo, Andrea | Mazzoli, Davide | Melegari, Corrado | Colombo, Valentina | Cerulli, Simona | Piscitelli, Daniele | Perin, Cecilia | Andrenelli, Elisa | Bizzarini, Emiliana | Calabro, Rocco Salvatore | Carmignano, Simona Maria | Cassio, Anna | Chisari, Carmelo | Dalise, Stefania | Fundaro, Cira | Gazzotti, Valeria | Stampacchia, Giulia | Boldrini, Paolo | Mazzoleni, Stefano | Posteraro, Federico | Benanti, Paolo | Castelli, Enrico | Draicchio, Francesco | Falabella, Vincenzo | Galeri, Silvia | Gimigliano, Francesca | Grigioni, Mauro | Mazzon, Stefano | Molteni, Franco | Morone, Giovanni | Petrarca, Maurizio | Picelli, Alessandro | Senatore, Michele | Turchetti, Giuseppe | Bonaiuti, Donatella
Article Type: Review Article
Abstract: BACKGROUND: The recovery of walking after stroke is a priority goal for recovering autonomy. In the last years robotic systems employed for Robotic Assisted Gait Training (RAGT) were developed. However, literature and clinical practice did not offer standardized RAGT protocol or pattern of evaluation scales. OBJECTIVE: This systematic review aimed to summarize the available evidence on the use of RAGT in post-stroke, following the CICERONE Consensus indications. METHODS: The literature search was conducted on PubMed, Cochrane Library and PEDro, including studies with the following criteria: 1) adult post-stroke survivors with gait disability in acute/subacute/chronic phase; 2) RAGT as intervention; 3) …any comparators; 4) outcome regarding impairment, activity, and participation; 5) both primary studies and reviews. RESULTS: Sixty-one articles were selected. Data about characteristics of patients, level of disability, robotic devices used, RAGT protocols, outcome measures, and level of evidence were extracted. CONCLUSION: It is possible to identify robotic devices that are more suitable for specific phase disease and level of disability, but we identified significant variability in dose and protocols. RAGT as an add-on treatment seemed to be prevalent. Further studies are needed to investigate the outcomes achieved as a function of RAGT doses delivered. Show more
Keywords: Stroke, gait, rehabilitation, robotics, lower extremity
DOI: 10.3233/NRE-220024
Citation: NeuroRehabilitation, vol. 51, no. 4, pp. 595-608, 2022