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Objective To report the cognitive features of severe COVID-19 patients entering in the post-acute phase, to understand whether COVID-19 acute respiratory distress syndrome itself could result in long-term cognitive deficits and whether neuropsychological treatment after the acute stage might represent a specific rehabilitation need. Design Case series. Setting Rehabilitation hospital. Participants We assessed the general cognitive functioning, through tablet-supported video-call, in 9 of 12 consecutive patients admitted to the hospital at least 30 days earlier for acute respiratory distress syndrome due to COVID-19. None of these patients presented cognitive symptoms before the hospitalization. Main Outcome Measures General Cognitive functioning, measured using the Mini-Mental State Examination Test. Results A general cognitive decay was observed in three patients (33.3%), who had a pathological score at the Mini-Mental State Examination (MMSE), with a specific decline in attention, memory, language and praxis abilities. The cognitive (mal)functioning seems to be linearly associated with the length of stay (in days) in the intensive care unit (ICU): the higher the number of days spent in the ICU, the lower the MMSE score (indicating a lower global cognitive functioning). Conclusions Our results indicate that some COVID-19 patients might also benefit from a neuropsychological rehabilitation, given their possible global cognitive decay. The link between the neuropsychological functioning and the length of stay in the ICU suggests that neurocognitive rehabilitative treatments should be directed explicitly towards patients who are treated in the ICU care, rather than towards every patient who suffered from acute respiratory distress syndrome due to COVID-19. However, given the limitation of a case series study, those hypotheses should be tested with future studies with larger samples and a longer follow-up.

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Background and aim:The reporting of clinical studies in rehabilitation has been criticized in several aspects, including the reporting of patient characteristics. This paper aims to contribute to the improvement of the reporting of patient characteristics in rehabilitation trials. Specifically, we want to determine the type of information that should be reported in rehabilitation trials that is specific to rehabilitation patients, and how this information is captured by current reporting standards.Methods: In the first step, we made a conceptual analysis of characteristics of rehabilitation patients by addressing the specifics of the field of medical rehabilitation, including the definition of rehabilitation and a description of its beneficiaries. In the second step we compared this reference framework to the current reporting standards, especially the CONSORT statement and its extensions, as well as standards for the reporting of clinical guidelines (AGREE, RIGHT). Results: Patients included in rehabilitation interventions should be distinguished by specific information. From a clinical perspective, patients dealt with in rehabilitation comprise broader diagnostic groups compared to other clinical settings. Information on comorbidities should be added in the description of the patients. Also, a description of baseline characteristics of patients should always include functioning characteristics of the patients, including information on relevant context factors, i.e. environmental and personal factors. The CONSORT statement aims to provide patient characteristic to enable transferability of results to users. It is represented in terms of selection (inclusion/exclusion) criteria and the description of the resulting samples.Extensions of the CONSORT statement specified that information on socioeconomic variables should be added, and the selection of patient characteristics to be reported at baseline should be based on the selection of outcome variables. Also, all relevant prognostic variables should be

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With Motor imagery (MI), movements are mentally rehearsed without overt actions; this procedure has been adopted in motor rehabilitation, primarily in brain-damaged patients. Here we rather tested the clinical potentials of MI in purely orthopaedic patients who, by definition, should maximally benefit of mental exercises because of their intact brain. To this end we studied the recovery of gait after total knee arthroplasty and evaluated whether MI combined with physiotherapy could speed up the recovery of gait and even limit the occurrence of future falls. We studied 48 patients at the beginning and by the end of the post-surgery residential rehabilitation program: half of them completed a specific MI training supported by computerized visual stimulation (experimental group); the other half performed a nonmotoric cognitive training (control group). All patients also had standard physiotherapy. By the end of the rehabilitation, the experimental group showed a better recovery of gait and active knee flexionextension movements, and less pain. The number of falls or near falls after surgery was significantly lower in the experimental group. These results show that MI can improve gait abilities and limit future falls in orthopaedic patients, without collateral risks and with limited costs.

The Covid-19 outbreak put enormous stress on the health system worldwide, and objective data to handle the emergency are still needed. We aimed to objectively assess the consequence of severe symptoms of Covid-19 infection on sleep quality through wrist actigraphy monitoring of four patients during the sub-acute recovery stage of the disease. The sleep of those patients who had experienced the most severe respiratory symptoms and who had needed prolonged intensive care unit (ICU) stay showed lower Sleep Efficiency and Immobility Time and higher Fragmentation Index compared to those patients who had experienced only mild respiratory symptoms and not requiring ICU stay. Wrist actigraphy assessment provided important clinical information about the sleep and activity levels of Covid-19 patients during the post-acute rehabilitation management.

Miniaturized wearable Inertial Measurement Units (IMU) offer new opportunities for the functional assessment of motor functions for medicine, sport, and ergonomics. Sparse reliability validation studies have been conducted without a common specific approach and protocol. A set of guidelines to design validation protocol for these systems is proposed hereafter. They are based on the comparison between video analysis and the gold standard optoelectronic motion capture system for Gait Analysis (GA). A setup of the protocol has been applied to a wearable device implementing an inertial measurement unit and a dedicated harmonic oscillator kinematic model of the center of mass. In total, 10 healthy volunteers took part in the study, and four trials of walking at a self-selected speed and step length have been simultaneously recorded by the two systems, analyzed, and compared blindly (40 datasets). The model detects the steps and the foot which supports body weight. The stride time and the cadence have a mean absolute percentage error of 5.7% and 4.9%, respectively. The mean absolute percentage error in the measurement of step’s length and step’s speed is 5.6% and 13.5%, respectively. Results confirm that the proposed methodology is complete and effective. It is demonstrated that the developed wearable system allows for a reliable assessment of human gait spatio-temporal parameters. Therefore, the goal of this paper is threefold. The first goal is to present and define structured Protocol Design Guidelines, where the related setup is implemented for the validation of wearable IMU systems particularly dedicated to GA and gait monitoring. The second goal is to apply these Protocol Design Guidelines to a case study in order to verify their feasibility, user-friendliness, and efficacy. The third goal is the validation of our biomechanical kinematic model with the gold standard reference.