Advanced rehabilitation strategies of the upper limb in stroke patients focus on the recovery of the most important daily activities. In this study we analyzed quantitatively and qualitatively the motor strategies employed by stroke patients when reaching and drinking from a glass. We enrolled 6 hemiparetic poststroke patients and 6 healthy subjects. Motion analysis of the task proposed (reaching for the glass, bringing it to the mouth, and putting it back on the table) with the affected limb was performed. Clinical assessment using the Fugl-Meyer Assessment for Upper Extremity was also included. During the reaching for the glass the patients showed a reduced arm elongation and trunk axial rotation due to motor deficit. For this reason, as observed, they carried out compensatory strategies which included trunk forward displacement and head movements. These preliminary data should be considered to address rehabilitation treatment. Moreover, the kinematic analysis protocol developed might represent an outcome measure of upper limb rehabilitation processes.

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Monitoring gait quality in daily activities through wearable sensors has the potential to improve medical assessment in Parkinson’s Disease (PD). In this study, four gait partitioning methods, two based on thresholds and two based on a machine learning approach, considering the four-phase model, were compared. The methods were tested on 26 PD patients, both in OFF and ON levodopa conditions, and 11 healthy subjects, during walking tasks. All subjects were equipped with inertial sensors placed on feet. Force resistive sensors were used to assess reference time sequence of gait phases. Goodness Index (G) was evaluated to assess accuracy in gait phases estimation. A novel synthetic index called Gait Phase Quality Index (GPQI) was proposed for gait quality assessment. Results revealed optimum performance (G < 0.25) for three tested methods and good performance (0.25 < G < 0.70) for one threshold method. The GPQI resulted significantly higher in PD patients than in healthy subjects, showing a moderate correlation with clinical scales score. Furthermore, in patients with severe gait impairment, GPQI was found higher in OFF than in ON state. Our results unveil the possibility of monitoring gait quality in PD through real-time gait partitioning based on wearable sensors.

Patients affected by Charcot-Marie-Tooth (CMT) disease experience an impaired balance. Although the causes of the postural instability are not fully understood, somatosensory system seems to play a key role. Mechanical vibration seems to act on the somatosensory system and to improve its function. The aim of our study was to evaluate the effects of focal mechanical vibration (fMV) on the balance of CMT 1A patients. We enrolled 14 genetically confirmed CMT 1A patients (8 female and 6 male, mean age 492 years, range 32-74, mean duration of disease: 13 years, range 1-30). Patients underwent a 3-day fMV treatment on quadriceps and triceps surae and were evaluated before the treatment as well as 1 week and 1 month after the end of the treatment. The primary outcome measure was the Berg Balance Scale (BBS) and the secondary were the Dynamic Gait Index (DGI), the 6 Min Walking Test (6MWT), the muscular strength of lower limbs, the Quality of Life (QoL) questionnaire and the stabilometric variables. The statistical analysis showed a significant modification of the BBS due to the effect of treatment (p < 0.05). A significant modification was also found in the DGI (p < 0.05). Concerning the stabilometric variables we found significant changes only for the eyes closed condition; in particular, a significant decrease was found in VelocityML (p < 0.05) and Sway path length (p < 0.05). The fMV treatment applied on lower limbs of CMT 1A patients determined an improvement of balance as detected by the BBS. The concurrent improvement of stabilometric variables in the eyes closed condition only suggests that fMV acts mostly on somatosensory afferences. Further studies are needed to confirm these data on a larger sample of CMT patients.