This provisional PDF corresponds to the article as it appeared upon acceptance.A copyedited and fully formatted version will be made available soon. The final version may contain major or minor changes. Subscription: Information about subscribing to Minerva Medica journals is online at:http://www.minervamedica.it/en/how-to-order-journals.php Reprints and permissions: For information about reprints and permissionssend an email to: journals.dept@minervamedica.it -journals2.dept@minervamedica.it -journals6.dept@minervamedica.it EDIZIONI MINERVA MEDICA ABSTRACT BACKGROUND: Early interventions maximizing patient's involvement are essential to promote gait restoration and motor recovery after stroke. AIM: To evaluate the effects of a multimodal biofeedback training involving cycling augmented by Functional Electrical Stimulation (FES) and balance exercises on walking ability and motor recovery. DESIGN: Randomized controlled trial (NCT02439515). SETTING: Inpatient rehabilitation facility. POPULATION: Subacute stroke survivors (less than 6 months from the first event) with an age of up to 90 years old. METHODS: 68 participants were randomly allocated to an experimental group, performing 15 sessions of biofeedback FES-cycling training followed by 15 sessions of biofeedback balance training (20 minutes each) in addition to usual care (70 minutes), and a control group performing 30 sessions (90 minutes) of usual care. Participants were evaluated before training, after 15 sessions, after 30 sessions, and at 6-month follow-up through: gait speed (primary outcome), spatio-temporal gait parameters, Six Minute Walking Test, Functional Independence Measure, Motricity Index, Trunk Control Test, Berg Balance Scale, and Fall Efficacy Scale. RESULTS: Both groups significantly improved over time, but no group and interaction effects were found for any outcomes. The 73% of the experimental group achieved a clinically meaningful change in gait speed compared to the 38% of the control group (p-value=0.048).These percentages were even more unbalanced for patients with a moderate to severe gait impairment at baseline (91% versus 36%; p-value=0.008). COPYRIGHT© EDIZIONI MINERVA MEDICAThis document is

Recent studies advocated the use of active cycling coupled with functional electrical stimulation to induce neuroplasticity and enhance functional improvements in stroke adult patients. The aim of this work was to evaluate whether the benefits induced by such a treatment are superior to standard physiotherapy. A single-blinded randomized controlled trial has been performed on post-acute elderly stroke patients. Patients underwent FES-augmented cycling training combined with voluntary pedaling or standard physiotherapy. The intervention consisted of fifteen 30-minutes sessions carried out within 3 weeks. Patients were evaluated before and after training, through functional scales, gait analysis and a voluntary pedaling test. Results were compared with an age-matched healthy group. Sixteen patients completed the training. After treatment, a general improvement of all clinical scales was obtained for both groups. Only the mechanical efficiency highlighted a group effect in favor of the experimental group. Although a group effect was not found for any other cycling or gait parameters, the experimental group showed a higher percentage of change with respect to the control group (e.g. the gait velocity was improved of 35.4% and 25.4% respectively, and its variation over time was higher than minimal clinical difference for the experimental group only). This trend suggests that differences in terms of motor recovery between the two groups may be achieved increasing the training dose. In conclusion, this study, although preliminary, showed that FES-augmented active cycling training seems to be effective in improving cycling and walking ability in post-acute elderly stroke patients. A higher sample size is required to confirm results.

Single-treatment approaches seem to be more effective than mixed approaches, independently from the duration (4 or 10 weeks). RAGT seems to have similar effect with respect to the traditional TOP, at least over 10 weeks.

Together with the upcoming market for wearable consumer technologies, noninvasive and continuous health monitoring has become a new trend in the healthcare landscape. In recent years, significant research has been targeted toward the development of wearable sensing devices for monitoring biomarker levels in nonobtrusively accessible biofluids such as tears, urine, saliva, and sweat. Sweat could be an ideal candidate for prolonged, semicontinuous, and nonobtrusive health monitoring because sweat is a continuously accessible biofluid containing physiologically and metabolically rich information. However, challenges still remain toward commercialized wearable sweat-sensing devices, and the correlation between biomarker concentrations in sweat with health conditions still seems to be not fully understood. This review article aims to display the full scope of sweat sensing for health monitoring, starting from the fundamentals of human sweat, via modeling of the sweat gland physiology toward wearable sweat-sensing devices in research and commercialization efforts. Finally, the challenges of sweat sensing that still have to be overcome toward the utilization of sweat sensing in the conventional healthcare settings are discussed.