Article
Pharmacology & Pharmacy
Fangliang Guo, Xiaolong Zheng, Ziyu He, Ruoying Zhang, Song Zhang, Minghuan Wang, Hong Chen, Wei Wang
Summary: The study found that long-term treatment with NMD helps to improve locomotion, pain-related behaviors, and spasticity-like symptoms in rats with SCI, but has less effect on open-field activity, hind limb grip strength, and bladder function. Additionally, NMD-treated rats showed greater tissue preservation, reduced lesion areas, and increased perilesional neuronal sparing, suggesting a potential therapeutic strategy for SCI treatment.
FRONTIERS IN PHARMACOLOGY
(2021)
Review
Biochemistry & Molecular Biology
Liliana Elena Stanciu, Madalina Gabriela Iliescu, Liliana Vladareanu, Alexandra Ecaterina Ciota, Elena-Valentina Ionescu, Claudia Ileana Mihailov
Summary: This study aims to determine the importance and/or use of hydrotherapy in the therapeutic management of spinal cord injury patients. The analysis of several databases between 2000 and 2021 found only four scientific publications supporting the benefits of hydrotherapy for SCI patients, but the limited number of studies requires more standardized methodology to prove the improvements in lower limb functioning. Clinical trials in the future are necessary.
Article
Clinical Neurology
Paul Aarne Koljonen, Anna Sternin Virk, Yoon Jeong, Michael McKinley, Juan Latorre, Amaya Caballero, Yong Hu, Yat Wa Wong, Kenneth Cheung, Homayoon Kazerooni
Summary: The study examined the safety and efficacy of ambulation utilizing a semi-passive and lightweight powered exoskeleton for SCI patients. Results showed that participants reported high levels of comfort and confidence while using the device, especially those with incomplete spinal cord injuries.
FRONTIERS IN NEUROLOGY
(2021)
Article
Clinical Neurology
Alessio Baricich, Marco Battaglia, Daria Cuneo, Lucia Cosenza, Marzia Millevolte, Michela Cosma, Mirko Filippetti, Stefania Dalise, Valentina Azzollini, Carmelo Chisari, Stefania Spina, Nicoletta Cinone, Lorenza Scotti, Marco Invernizzi, Stefano Paolucci, Alessandro Picelli, Andrea Santamato
Summary: This study aims to clarify the role of BoNT-A in the context of non-stroke spasticity (NSS). BoNT-A demonstrated significant improvement in spasticity severity, pain, and quality of life. The effect persistence over time varies depending on the diagnosis and the number of treated sites.
FRONTIERS IN NEUROLOGY
(2023)
Review
Neurosciences
Kylie J. Nabata, Emmanuel K. Tse, Tom E. Nightingale, Amanda H. X. Lee, Janice J. Eng, Matthew Queree, Matthias Walter, Andrei Krassioukov
Summary: The systematic review found that cannabinoid use can significantly reduce pain and spasticity in people with SCI, but the magnitude and clinical significance of its effects are unclear. More long-term studies are needed to further understand the effects of cannabinoid use in people with SCI.
CURRENT NEUROPHARMACOLOGY
(2021)
Review
Biochemistry & Molecular Biology
Ramiro Palazon-Garcia, Ana Maria Benavente-Valdepenas
Summary: Botulinum toxin, known for about three centuries, is considered one of the most powerful toxins but has found medical applications in the treatment of spasticity, particularly in strokes and cerebral palsy. Despite not being approved for use in spinal cord injury spasticity, it is being used in such cases.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Review
Cell Biology
Kelsey E. Hudson, James W. Grau
Summary: The neurotransmitter GABA normally inhibits neural activity, but spinal cord injury can weaken this inhibitory effect. The change is linked to the increase in intracellular Cl- concentration, leading to over-excitation and the development of various neural disorders.
Article
Health Care Sciences & Services
Zackery J. Billington, Austin M. Henke, David R. Gater
Summary: Spasticity is a common comorbidity of spinal cord injury, with both beneficial and problematic effects. This manuscript discusses the anatomy and physiology of neuromuscular reflexes, the pathophysiology of post-SCI, assessment of spasticity, and management strategies.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Review
Physiology
Zuliyaer Talifu, Yunzhu Pan, Han Gong, Xin Xu, Chunjia Zhang, Degang Yang, Feng Gao, Yan Yu, Liangjie Du, Jianjun Li
Summary: The balance of ion concentrations inside and outside neurons is crucial for physiological activities. NKCC1 and KCC2 play essential roles in regulating chloride ion concentrations and the GABAergic system. Imbalances of NKCC1 and KCC2 after spinal cord injury disrupt chloride homeostasis, altering neural networks and leading to symptoms like spasticity and neuropathic pain. KCC2 is also a crucial target for motor function reconstruction after spinal cord injury.
FRONTIERS IN PHYSIOLOGY
(2022)
Article
Clinical Neurology
Saeed Oraee-Yazdani, Roozbeh Tavanaei, Seyyed Saeed Rezaee-Naserabad, Samin Khannejad, Siamak Alizadeh Zendehrood, Kaveh Oraii Yazdani, Alireza Zali
Summary: This study evaluated the safety and potential efficacy of selective dorsal rhizotomy (SDR) in chronic spinal cord injury-induced spasticity. The results showed that SDR is a safe procedure and all secondary outcome measures improved significantly over the study period. However, larger and more authoritative clinical trials are needed to validate the findings regarding efficacy.
WORLD NEUROSURGERY
(2023)
Article
Neurosciences
Ashraf S. Gorgey, Jacob Goldsmith, Ahmad Alazzam, Robert Trainer
Summary: This case report highlights the potential of spinal cord epidural stimulation (SCES) to improve physical function and cardiovascular autonomic regulation in individuals with spinal cord injury (SCI). The results demonstrate that SCES intended for walking can also benefit cardiovascular autonomic control and attenuate spasticity. Using a single SCES configuration that targets multiple functions may accelerate clinical translation.
FRONTIERS IN NEUROSCIENCE
(2023)
Review
Clinical Neurology
Hemant Kumar, Ankita Bhagwani, Manjeet Chopra
Summary: Traumatic spinal cord injury can result in long-lasting complications such as chronic neuropathic pain and spasticity, which significantly impact the daily activities of patients. Current medical treatments for SCI-related neuropathic pain are limited due to the complex mechanisms involved, but restoring inhibitory GABAergic tone and preventing excitotoxicity may provide neuroprotective and analgesic effects.
Article
Rehabilitation
Tim C. Crul, Marcel W. M. Post, Johanna M. A. Visser-Meily, Janneke M. Stolwijk-Swuste
Summary: This study aimed to investigate the prevalence and characteristics of SCI-related pain during initial inpatient rehabilitation and explore their relationships with demographic and lesion characteristics. The results showed that SCI-related pain was highly prevalent during inpatient rehabilitation and different factors such as sex, age, and type of injury were associated with the presence of pain.
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
(2023)
Article
Neurosciences
Steffen Franz, Laura Heutehaus, Anke Tappe-Theodor, Norbert Weidner, Rolf-Detlef Treede, Sigrid Schuh-Hofer
Summary: Investigating the response of individuals with spinal cord injury (SCI) to noxious heat stimuli, this study found that SCI patients had significantly higher response rates and reflex magnitude compared to non-disabled controls. The motor hyperresponsiveness to heat was correlated with spasticity, but not neuropathic pain.
FRONTIERS IN HUMAN NEUROSCIENCE
(2023)
Article
Medicine, General & Internal
Md Akhlasur Rahman, Niraj Singh Tharu, Sylvia M. Gustin, Yong-Ping Zheng, Monzurul Alam
Summary: Spinal cord injury (SCI) is a debilitating injury with severe complications, but recent development of noninvasive electrical neuromodulation treatments offers hope for rehabilitation. Trans-spinal direct current stimulation (tsDCS) and trans-spinal pulsed current stimulation (tsPCS) have shown promising results in improving sensorimotor and autonomic functions.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Clinical Neurology
Silvia Corbianco, Gabriella Cavallini, Marco Dini, Ferdinando Franzoni, Carla D'Avino, Adriana Gerini, Giulia Stampacchia
Summary: The study evaluated energy cost and psychological impact during a rehabilitation program using two different types of robotic rehabilitation systems for spinal cord injury patients. Results showed that robotic overground walking required higher cognitive and cardiovascular efforts compared to robotic treadmill walking. Overground walking with Ekso GT resulted in higher metabolic responses and MET values than treadmill walking with Lokomat.
NEUROLOGICAL SCIENCES
(2021)
Article
Chemistry, Analytical
Manuel Andres Velez-Guerrero, Mauro Callejas-Cuervo, Stefano Mazzoleni
Summary: This study focuses on the design, development, and preliminary testing of a wearable robotic exoskeleton prototype with autonomous AI-based control. Results show that the device is suitable for providing support for diagnosing and rehabilitating neuromotor functions, though further optimizations and rigorous clinical validation are needed.
Article
Clinical Neurology
Giulia Stampacchia, Adriana Gerini, Riccardo Morganti, Giorgio Felzani, Manuela Marani, Antonino Massone, Maria Pia Onesta, William Capeci, Elena Andretta, Giuliana Campus, Carlo Marchino, Valentina Cicioni
Summary: The study confirmed a high prevalence of pain in individuals with SCI, with distinct nociceptive and neuropathic pain characteristics. Only old age and female gender were found to be highly associated with pain development.
Article
Rehabilitation
Francesca Gimigliano, Angela Palomba, Chiara Arienti, Giovanni Morone, Luca Perrero, Michela Agostini, Irene Aprile, Matteo Paci, Emanuela Casanova, Dario Marino, Giuseppe La Rosa, Federica Bressi, Silvia Sterzi, Daniele Giansanti, Alberto Battistini, Sandra Miccinilli, Serena Filoni, Monica Sicari, Salvatore Petrozzino, Claudio M. Solaro, Stefano Gargano, Paolo Benanti, Paolo Boldrini, Donatella Bonaiuti, Enrico Castelli, Francesco Draicchio, Vincenzo Falabella, Silvia Galeri, Mauro Grigioni, Stefano Mazzoleni, Stefano Mazzon, Franco Molteni, Maurizio Petrarca, Alessandro Picelli, Federico Posteraro, Michele Senatore, Giuseppe Turchetti, Sofia Straudi
Summary: This study aims to explain the methodological approach used by a working group in a Italian consensus conference in evaluating the effectiveness of RAT in patients with neurological health conditions, adopting the ICF as a reference framework for outcome reporting. The working group conducted literature search, data extraction, qualitative assessment, evidence analysis, and synthesis to define the effectiveness of RAT in managing patients with neurological health conditions.
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
(2021)
Review
Rehabilitation
Rocco S. Calabro, Anna Cassio, Davide Mazzoli, Elisa Andrenelli, Emiliana Bizzarini, Isabella Campanini, Simona M. Carmignano, Simona Cerulli, Carmelo Chisari, Valentina Colombo, Stefania Dalise, Cira Fundaro, Valeria Gazzotti, Daniele Mazzoleni, Miryam Mazzucchelli, Corrado Melegari, Andrea Merlo, Giulia Stampacchia, Paolo Boldrini, Stefano Mazzoleni, Federico Posteraro, Paolo Benanti, Enrico Castelli, Francesco Draicchio, Vincenzo Falabella, Silvia Galeri, Francesca Gimigliano, Mauro Grigioni, Stefano Mazzon, Franco Molteni, Maurizio Petrarca, Alessandro Picelli, Michele Senatore, Giuseppe Turchetti, Giovanni Morone, Donatella Bonaiuti
Summary: The review found that robotic rehabilitation for gait in patients with MS can lead to improvements in gait speed, endurance, and balance, especially in more severe cases. The use of robotics can also have positive effects on non-motor outcomes such as spasticity, fatigue, and pain. However, clear clinical indications on treatment protocols are still lacking.
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
(2021)
Review
Rehabilitation
Marialuisa Gandolfi, Nicola Vale, Federico Posteraro, Giovanni Morone, Antonella Dell'orco, Anita Botticelli, Eleonora Dimitrova, Elisa Gervasoni, Michela Goffredo, Jacopo Zenzeri, Arianna Antonini, Carla Daniele, Paolo Benanti, Paolo Boldrini, Donatella Bonaiuti, Enrico Castelli, Francesco Draicchio, Vincenzo Falabella, Silvia Galeri, Francesca Gimigliano, Mauro Grigioni, Stefano Mazzon, Franco Molteni, Maurizio Petrarca, Alessandro Picelli, Michele Senatore, Giuseppe Turchetti, Daniele Giansanti, Stefano Mazzoleni
Summary: The study analyzed the existing literature on electromechanical and robotic devices used in neurorehabilitation, taking into account the current clinical, technical, and regulatory classification systems. It was found that most literature lacks detailed information on the technical characteristics of the devices used, affecting the understanding of potential recovery mechanisms. Greater efforts are needed to improve the description of robotic devices used in neurorehabilitation in terms of technical and functional details, as well as conduct high-quality randomized controlled trials.
EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
(2021)
Article
Chemistry, Analytical
Manuel Andres Velez-Guerrero, Mauro Callejas-Cuervo, Stefano Mazzoleni
Summary: This paper discusses the integration and testing of a high-torque, servo-driven joint and its electronic controller in a robotic exoskeleton prototype. Control of the servo-driven joint in terms of torque, rotational velocity, and position was achieved through a closed-loop control architecture. Experimental results show consistent performance, demonstrating potential applications in robotic exoskeletons for human performance enhancement, rehabilitation, and support for daily living activities.
Article
Chemistry, Multidisciplinary
Sofia Straudi, Marco Tramontano, Emanuele Francesco Russo, Luca Perrero, Michela Agostini, Marialuisa Gandolfi, Irene Aprile, Matteo Paci, Emanuela Casanova, Dario Marino, Giuseppe La Rosa, Federica Bressi, Silvia Sterzi, Daniele Giansanti, Alberto Battistini, Sandra Miccinilli, Serena Filoni, Monica Sicari, Salvatore Petrozzino, Claudio Marcello Solaro, Stefano Gargano, Paolo Benanti, Paolo Boldrini, Donatella Bonaiuti, Enrico Castelli, Francesco Draicchio, Vincenzo Falabella, Silvia Galeri, Francesca Gimigliano, Mauro Grigioni, Stefano Mazzoleni, Stefano Mazzon, Franco Molteni, Maurizio Petrarca, Alessandro Picelli, Federico Posteraro, Michele Senatore, Giuseppe Turchetti, Giovanni Morone
Summary: This review systematically reports the evidence on the clinical applications and functional recovery effects of robotic-assisted arm training (RAT) in patients with Multiple Sclerosis (PwMS). The study found that RAT improved shoulder range of motion, handgrip strength, and proximal arm impairment, as well as manual dexterity, arm function, and daily life use. However, the high clinical heterogeneity of treatment programs and the variety of robot devices call for standardization of intervention types in future studies. Overall, robot-assisted treatment appears safe and useful for improving manual dexterity and movement execution quality in PwMS with moderate to severe disability. Further studies with larger sample sizes and rigorous methodologies are needed to draw definitive conclusions.
APPLIED SCIENCES-BASEL
(2022)
Letter
Respiratory System
A. Di Paco, S. Mazzoleni, M. Vitacca, L. Comini, N. Ambrosino
Article
Chemistry, Analytical
Manuel Andres Velez-Guerrero, Mauro Callejas-Cuervo, Juan C. Alvarez, Stefano Mazzoleni
Summary: This paper proposes an evaluation protocol and assesses the mechanical support properties of a servo-controlled robotic exoskeleton prototype for rehabilitation in upper limbs. The use of soft materials provides satisfactory outcomes in the motion transfer and support to the limb. This study lays the groundwork for a future assessment of the prototype in a controlled laboratory environment using human test subjects.
Article
Medicine, General & Internal
Sanaz Pournajaf, Rocco Salvatore Calabro, Antonino Naro, Michela Goffredo, Irene Aprile, Federica Tamburella, Serena Filoni, Andreas Waldner, Stefano Mazzoleni, Antonella Focacci, Francesco Ferraro, Donatella Bonaiuti, Marco Franceschini
Summary: This study investigated the efficacy of stationary robot-assisted gait rehabilitation in comparison to conventional overground gait training for subacute stroke survivors. The results showed that robot-assisted training improved walking ability better than conventional training, with significant improvements in walking speed observed.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Neurosciences
Alberto Loro, Margherita Beatrice Borg, Marco Battaglia, Angelo Paolo Amico, Roberto Antenucci, Paolo Benanti, Michele Bertoni, Luciano Bissolotti, Paolo Boldrini, Donatella Bonaiuti, Thomas Bowman, Marianna Capecci, Enrico Castelli, Loredana Cavalli, Nicoletta Cinone, Lucia Cosenza, Rita Di Censo, Giuseppina Di Stefano, Francesco Draicchio, Vincenzo Falabella, Mirko Filippetti, Silvia Galeri, Francesca Gimigliano, Mauro Grigioni, Marco Invernizzi, Johanna Jonsdottir, Carmelo Lentino, Perla Massai, Stefano Mazzoleni, Stefano Mazzon, Franco Molteni, Sandra Morelli, Giovanni Morone, Antonio Nardone, Daniele Panzeri, Maurizio Petrarca, Federico Posteraro, Andrea Santamato, Lorenza Scotti, Michele Senatore, Stefania Spina, Elisa Taglione, Giuseppe Turchetti, Valentina Varalta, Alessandro Picelli, Alessio Baricich
Summary: This study aims to determine the efficacy of robotic gait training (RAGT) on the balance of post-stroke survivors. The results show that RAGT is equally effective as traditional therapy, and the combination of the two may lead to better outcomes. Therefore, future experimentation should focus on robot-assisted balance training.
Proceedings Paper
Engineering, Biomedical
C. Camardella, G. Cappiello, Z. Curto, M. Germanotta, I. Aprile, S. Mazzoleni, A. Scoglio, A. Frisoli
Summary: Robotic-based rehabilitation administered through serious games offers highly personalized therapy but often lacks long-term information on treatment outcomes. This paper presents a Random-Forest based system that predicts the final outcome of rehabilitation using clinical scale scores and robotic measurements. The system achieved an accuracy of 60% to 73% on selected scales, providing valuable insights into relevant variables for therapy outcomes.
2022 INTERNATIONAL CONFERENCE ON REHABILITATION ROBOTICS (ICORR)
(2022)
Proceedings Paper
Biophysics
M. A. Velez-Guerrero, M. Callejas-Cuervo, J. C. Alvarez, Stefano Mazzoleni, Antonio M. Lopez, Diego Alvarez, Leticia Gonzalez
Summary: The study proposes a testing protocol to assess the mechanical and structural features of a prototype upper limb robotic exoskeleton, and also includes a literature review and description of the materials used for evaluation technologies.
2022 GLOBAL MEDICAL ENGINEERING PHYSICS EXCHANGES/PAN AMERICAN HEALTH CARE EXCHANGES (GMEPE/PAHCE)
(2022)
Article
Chemistry, Analytical
Luigi Truppa, Lorenzo Nuti, Stefano Mazzoleni, Pietro Garofalo, Andrea Mannini
Summary: This study proposes instrumental analysis to examine the physiological and biomechanical adaptation of football players to fatigue protocol after the COVID-19 lockdown. The results suggest a good recovery in physiology and ballistic performance, but incomplete recovery in explosive skills.
