roberta pili - Academia.edu (original) (raw)
Papers by roberta pili
Background: The use of rhythmic auditory stimulation (RAS) has been proven useful in the manageme... more Background: The use of rhythmic auditory stimulation (RAS) has been proven useful in the management of gait disturbances associated with Parkinson's disease (PD). Typically, the RAS consists of metronome or music-based sounds (artificial RAS), while ecological footstep sounds (ecological RAS) have never been used for rehabilitation programs. Objective: The aim of this study was to compare the effects of a rehabilitation program integrated either with ecological or with artificial RAS. Methods: An observer-blind, randomized controlled trial was conducted to investigate the effects of 5 weeks of supervised rehabilitation integrated with RAS. Thirty-eight individuals affected by PD were randomly assigned to one of the two conditions (ecological vs. artificial RAS); thirty-two of them (age 68.2 ± 10.5, Hoehn and Yahr 1.5-3) concluded all phases of the study. Spatio-temporal parameters of gait and clinical variables were assessed before the rehabilitation period, at its end, and after a 3-month follow-up. results: Thirty-two participants were analyzed. The results revealed that both groups improved in the majority of biomechanical and clinical measures, independently of the type of sound. Moreover, exploratory analyses for separate groups were conducted, revealing improvements on spatio-temporal parameters only in the ecological RAS group. Conclusion: Overall, our results suggest that ecological RAS is equally effective compared to artificial RAS. Future studies should further investigate the role of ecological RAS, on the basis of information revealed by our exploratory analyses. Theoretical, methodological, and practical issues concerning the implementation of ecological sounds in the rehabilitation of PD patients are discussed.
The International Journal of Psychiatry in Medicine, 2011
Objective: The authors sought to evaluate lifetime prevalence of mental disorders in patients aff... more Objective: The authors sought to evaluate lifetime prevalence of mental disorders in patients affected by metabolic syndrome compared with patients affected by central obesity alone. Methods: One hundred eighty-six (63.5%) patients affected by central obesity and 107 (36.5%) affected by metabolic syndrome according to ICF criteria were interviewed by means of SCID I and SCID II. Results: Axis I and axis II lifetime prevalence were respectively 53.8% and 30.1% among patients with central obesity, 50.5% and 28% among patients with metabolic syndrome, differences which were not significant. No statistically significant differences were found between groups as far as each single axis I and II diagnostic category was considered. Conclusion: Metabolic syndrome is not associated with a higher risk of mental disorders compared to central obesity alone.
2016 IEEE International Symposium on Medical Measurements and Applications (MeMeA), 2016
Assessment of gait abnormalities in individuals affected by Parkinson's Disease (PD) is essen... more Assessment of gait abnormalities in individuals affected by Parkinson's Disease (PD) is essential in evaluating the disease progression and the effectiveness of pharmacologic and rehabilitative treatments. However, in the clinical routine qualitative and subjective methods are often employed to this aim, despite the availability of sophisticated equipment able to supply accurate and detailed quantitative information. In this study, we propose the use of motion capture systems based on optoelectronic stereophotogrammetry to investigate the main spatio-temporal and kinematics parameters of gait in a cohort of 28 individuals with PD of age > 60. In particular, we aimed to describe the gait kinematics on the basis of concise measures (Gait Profile Score, GPS and Gait Variable Score, GVS) obtained from a quantitative three-dimensional analysis of gait. The results show that peculiar features are identifiable, especially in terms of functional limitations of hip and knee joints and...
2018 IEEE International Symposium on Medical Measurements and Applications (MeMeA), 2018
This study aims to objectively quantify and describe the diurnal patterns of physical activity (P... more This study aims to objectively quantify and describe the diurnal patterns of physical activity (PA) in people with Parkinson’s disease (pwPD) with mild-moderate disability. Eighteen pwPD wore a tri-axial accelerometer on their nondominant wrist 24/h day for 3 months. Data was processed using three different algorithms previously validated for PD and for healthy older individuals, to calculate daily steps and calculate amount and intensity of PA. The results show that participants tend to perform higher level of PA in the morning time slots and to be more sedentary in afternoon and evening. Such findings might help clinicians in suggesting proper strategies either to increase PA levels or optimally distribute it across the whole day.
Frontiers in Neurology, 2016
Movement rehabilitation by means of physical therapy represents an essential tool in the manageme... more Movement rehabilitation by means of physical therapy represents an essential tool in the management of gait disturbances induced by Parkinson's disease (PD). In this context, the use of rhythmic auditory stimulation (RAS) has been proven useful in improving several spatio-temporal parameters, but concerning its effect on gait patterns, scarce information is available from a kinematic viewpoint. In this study, we used three-dimensional gait analysis based on optoelectronic stereophotogrammetry to investigate the effects of 5 weeks of supervised rehabilitation, which included gait training integrated with RAS on 26 individuals affected by PD (age 70.4 ± 11.1, Hoehn and Yahr 1-3). Gait kinematics was assessed before and at the end of the rehabilitation period and after a 3-month follow-up, using concise measures (Gait Profile Score and Gait Variable Score, GPS and GVS, respectively), which are able to describe the deviation from a physiologic gait pattern. The results confirm the effectiveness of gait training assisted by RAS in increasing speed and stride length, in regularizing cadence and correctly reweighting swing/stance phase duration. Moreover, an overall improvement of gait quality was observed, as demonstrated by the significant reduction of the GPS value, which was created mainly through significant decreases in the GVS score associated with the hip flexion-extension movement. Future research should focus on investigating kinematic details to better understand the mechanisms underlying gait disturbances in people with PD and the effects of RAS, with the aim of finding new or improving current rehabilitative treatments.
Parkinsonism & Related Disorders, 2016
Frontiers in neurology, 2018
In persons with Parkinson's disease (PD), gait dysfunctions are often associated with abnorma... more In persons with Parkinson's disease (PD), gait dysfunctions are often associated with abnormal neuromuscular function. Physical therapy combined with auditory stimulation has been recently shown to improve motor function and gait kinematic patterns; however, the underlying neuromuscular control patterns leading to this improvement have never been identified. (1) Assess the relationships between motor dysfunction and lower limb muscle activity during gait in persons with PD; (2) Quantify the effects of physical therapy with rhythmic auditory stimulation (PT-RAS) on lower limb muscle activity during gait in persons with PD. Participants (15 with PD) completed a 17-week intervention of PT-RAS. Gait was analyzed at baseline, after 5 weeks of supervised treatment (T5), and at a 12-week follow-up (T17). For each session, motor dysfunction was scored using the United Parkinson Disease Rating Scale, and muscle activation amplitude, modulation, variability, and asymmetry were measured fo...
Parkinson's Disease
Background. Although physical activity (PA) is known to be beneficial in improving motor symptoms... more Background. Although physical activity (PA) is known to be beneficial in improving motor symptoms of people with Parkinson’s disease (pwPD), little is known about the relationship between gait patterns and features of PA performed during daily life. Objective. To verify the existence of possible relationships between spatiotemporal and kinematic parameters of gait and amount/intensity of PA, both instrumentally assessed. Methods. Eighteen individuals affected by PD (10F and 8M, age 68.0 ± 10.8 years, 1.5 ≤ Hoehn and Yahr (H&Y) < 3) were required to wear a triaxial accelerometer 24 h/day for 3 consecutive months. They also underwent a 3D computerized gait analysis at the beginning and end of the PA assessment period. The number of daily steps and PA intensity were calculated on the whole day, and the period from 6:00 to 24:00 was grouped into 3 time slots, using 3 different cut-point sets previously validated in the case of both pwPD and healthy older adults. 3D gait analysis prov...
Neurology International
This study aimed to investigate possible differences in spatio-temporal gait parameters of people... more This study aimed to investigate possible differences in spatio-temporal gait parameters of people with Parkinson’s Disease (pwPD) when they are tested either in laboratory using 3D Gait Analysis or in a clinical setting using wearable accelerometers. The main spatio-temporal gait parameters (speed, cadence, stride length, stance, swing and double support duration) of 31 pwPD were acquired: i) using a wearable accelerometer in a clinical setting while wearing shoes (ISS); ii) same as condition 1, but barefoot (ISB); iii) using an optoelectronic system (OES) undressed and barefoot. While no significant differences were found for cadence, stance, swing and double support duration, the experimental setting affected speed and stride length that decreased (by 17% and 12% respectively, P<0.005) when passing from the clinical (ISS) to the laboratory (OES) setting. These results suggest that gait assessment should be always performed in the same conditions to avoid errors, which may lead ...
Frontiers in Neurology
Background: The use of rhythmic auditory stimulation (RAS) has been proven useful in the manageme... more Background: The use of rhythmic auditory stimulation (RAS) has been proven useful in the management of gait disturbances associated with Parkinson's disease (PD). Typically, the RAS consists of metronome or music-based sounds (artificial RAS), while ecological footstep sounds (ecological RAS) have never been used for rehabilitation programs. Objective: The aim of this study was to compare the effects of a rehabilitation program integrated either with ecological or with artificial RAS. Methods: An observer-blind, randomized controlled trial was conducted to investigate the effects of 5 weeks of supervised rehabilitation integrated with RAS. Thirty-eight individuals affected by PD were randomly assigned to one of the two conditions (ecological vs. artificial RAS); thirty-two of them (age 68.2 ± 10.5, Hoehn and Yahr 1.5-3) concluded all phases of the study. Spatio-temporal parameters of gait and clinical variables were assessed before the rehabilitation period, at its end, and after a 3-month follow-up. results: Thirty-two participants were analyzed. The results revealed that both groups improved in the majority of biomechanical and clinical measures, independently of the type of sound. Moreover, exploratory analyses for separate groups were conducted, revealing improvements on spatio-temporal parameters only in the ecological RAS group. Conclusion: Overall, our results suggest that ecological RAS is equally effective compared to artificial RAS. Future studies should further investigate the role of ecological RAS, on the basis of information revealed by our exploratory analyses. Theoretical, methodological, and practical issues concerning the implementation of ecological sounds in the rehabilitation of PD patients are discussed.
The Open Psychology Journal, 2015
Previous studies have demonstrated that physical therapy accompanied by Rhythmic Auditory Stimula... more Previous studies have demonstrated that physical therapy accompanied by Rhythmic Auditory Stimulation (RAS) can improve the motor skills of patients with Parkinson’s disease and, in particular, their gait disturbances. In the present work we describe the neurological bases and perceptual-motor deficits generally associated with Parkinson’s disease, with a specific focus on gait disturbances. Within this framework, we review the role of auditory cueing in the modulation of patients’ gait, addressing this issue from the cognitive, neurological and biomechanical perspectives. In particular, we focus on the new frontiers of both assessment and intervention. With regards to the assessment, we describe the advantages of the three-dimensional quantitative multifactorial gait analysis. As concerns the intervention, we illustrate the potential impact of the administration of ecological footstep sounds as rhythmic cues.
Parkinsonism & Related Disorders, 2016
Background: The use of rhythmic auditory stimulation (RAS) has been proven useful in the manageme... more Background: The use of rhythmic auditory stimulation (RAS) has been proven useful in the management of gait disturbances associated with Parkinson's disease (PD). Typically, the RAS consists of metronome or music-based sounds (artificial RAS), while ecological footstep sounds (ecological RAS) have never been used for rehabilitation programs. Objective: The aim of this study was to compare the effects of a rehabilitation program integrated either with ecological or with artificial RAS. Methods: An observer-blind, randomized controlled trial was conducted to investigate the effects of 5 weeks of supervised rehabilitation integrated with RAS. Thirty-eight individuals affected by PD were randomly assigned to one of the two conditions (ecological vs. artificial RAS); thirty-two of them (age 68.2 ± 10.5, Hoehn and Yahr 1.5-3) concluded all phases of the study. Spatio-temporal parameters of gait and clinical variables were assessed before the rehabilitation period, at its end, and after a 3-month follow-up. results: Thirty-two participants were analyzed. The results revealed that both groups improved in the majority of biomechanical and clinical measures, independently of the type of sound. Moreover, exploratory analyses for separate groups were conducted, revealing improvements on spatio-temporal parameters only in the ecological RAS group. Conclusion: Overall, our results suggest that ecological RAS is equally effective compared to artificial RAS. Future studies should further investigate the role of ecological RAS, on the basis of information revealed by our exploratory analyses. Theoretical, methodological, and practical issues concerning the implementation of ecological sounds in the rehabilitation of PD patients are discussed.
The International Journal of Psychiatry in Medicine, 2011
Objective: The authors sought to evaluate lifetime prevalence of mental disorders in patients aff... more Objective: The authors sought to evaluate lifetime prevalence of mental disorders in patients affected by metabolic syndrome compared with patients affected by central obesity alone. Methods: One hundred eighty-six (63.5%) patients affected by central obesity and 107 (36.5%) affected by metabolic syndrome according to ICF criteria were interviewed by means of SCID I and SCID II. Results: Axis I and axis II lifetime prevalence were respectively 53.8% and 30.1% among patients with central obesity, 50.5% and 28% among patients with metabolic syndrome, differences which were not significant. No statistically significant differences were found between groups as far as each single axis I and II diagnostic category was considered. Conclusion: Metabolic syndrome is not associated with a higher risk of mental disorders compared to central obesity alone.
2016 IEEE International Symposium on Medical Measurements and Applications (MeMeA), 2016
Assessment of gait abnormalities in individuals affected by Parkinson's Disease (PD) is essen... more Assessment of gait abnormalities in individuals affected by Parkinson's Disease (PD) is essential in evaluating the disease progression and the effectiveness of pharmacologic and rehabilitative treatments. However, in the clinical routine qualitative and subjective methods are often employed to this aim, despite the availability of sophisticated equipment able to supply accurate and detailed quantitative information. In this study, we propose the use of motion capture systems based on optoelectronic stereophotogrammetry to investigate the main spatio-temporal and kinematics parameters of gait in a cohort of 28 individuals with PD of age > 60. In particular, we aimed to describe the gait kinematics on the basis of concise measures (Gait Profile Score, GPS and Gait Variable Score, GVS) obtained from a quantitative three-dimensional analysis of gait. The results show that peculiar features are identifiable, especially in terms of functional limitations of hip and knee joints and...
2018 IEEE International Symposium on Medical Measurements and Applications (MeMeA), 2018
This study aims to objectively quantify and describe the diurnal patterns of physical activity (P... more This study aims to objectively quantify and describe the diurnal patterns of physical activity (PA) in people with Parkinson’s disease (pwPD) with mild-moderate disability. Eighteen pwPD wore a tri-axial accelerometer on their nondominant wrist 24/h day for 3 months. Data was processed using three different algorithms previously validated for PD and for healthy older individuals, to calculate daily steps and calculate amount and intensity of PA. The results show that participants tend to perform higher level of PA in the morning time slots and to be more sedentary in afternoon and evening. Such findings might help clinicians in suggesting proper strategies either to increase PA levels or optimally distribute it across the whole day.
Frontiers in Neurology, 2016
Movement rehabilitation by means of physical therapy represents an essential tool in the manageme... more Movement rehabilitation by means of physical therapy represents an essential tool in the management of gait disturbances induced by Parkinson's disease (PD). In this context, the use of rhythmic auditory stimulation (RAS) has been proven useful in improving several spatio-temporal parameters, but concerning its effect on gait patterns, scarce information is available from a kinematic viewpoint. In this study, we used three-dimensional gait analysis based on optoelectronic stereophotogrammetry to investigate the effects of 5 weeks of supervised rehabilitation, which included gait training integrated with RAS on 26 individuals affected by PD (age 70.4 ± 11.1, Hoehn and Yahr 1-3). Gait kinematics was assessed before and at the end of the rehabilitation period and after a 3-month follow-up, using concise measures (Gait Profile Score and Gait Variable Score, GPS and GVS, respectively), which are able to describe the deviation from a physiologic gait pattern. The results confirm the effectiveness of gait training assisted by RAS in increasing speed and stride length, in regularizing cadence and correctly reweighting swing/stance phase duration. Moreover, an overall improvement of gait quality was observed, as demonstrated by the significant reduction of the GPS value, which was created mainly through significant decreases in the GVS score associated with the hip flexion-extension movement. Future research should focus on investigating kinematic details to better understand the mechanisms underlying gait disturbances in people with PD and the effects of RAS, with the aim of finding new or improving current rehabilitative treatments.
Parkinsonism & Related Disorders, 2016
Frontiers in neurology, 2018
In persons with Parkinson's disease (PD), gait dysfunctions are often associated with abnorma... more In persons with Parkinson's disease (PD), gait dysfunctions are often associated with abnormal neuromuscular function. Physical therapy combined with auditory stimulation has been recently shown to improve motor function and gait kinematic patterns; however, the underlying neuromuscular control patterns leading to this improvement have never been identified. (1) Assess the relationships between motor dysfunction and lower limb muscle activity during gait in persons with PD; (2) Quantify the effects of physical therapy with rhythmic auditory stimulation (PT-RAS) on lower limb muscle activity during gait in persons with PD. Participants (15 with PD) completed a 17-week intervention of PT-RAS. Gait was analyzed at baseline, after 5 weeks of supervised treatment (T5), and at a 12-week follow-up (T17). For each session, motor dysfunction was scored using the United Parkinson Disease Rating Scale, and muscle activation amplitude, modulation, variability, and asymmetry were measured fo...
Parkinson's Disease
Background. Although physical activity (PA) is known to be beneficial in improving motor symptoms... more Background. Although physical activity (PA) is known to be beneficial in improving motor symptoms of people with Parkinson’s disease (pwPD), little is known about the relationship between gait patterns and features of PA performed during daily life. Objective. To verify the existence of possible relationships between spatiotemporal and kinematic parameters of gait and amount/intensity of PA, both instrumentally assessed. Methods. Eighteen individuals affected by PD (10F and 8M, age 68.0 ± 10.8 years, 1.5 ≤ Hoehn and Yahr (H&Y) < 3) were required to wear a triaxial accelerometer 24 h/day for 3 consecutive months. They also underwent a 3D computerized gait analysis at the beginning and end of the PA assessment period. The number of daily steps and PA intensity were calculated on the whole day, and the period from 6:00 to 24:00 was grouped into 3 time slots, using 3 different cut-point sets previously validated in the case of both pwPD and healthy older adults. 3D gait analysis prov...
Neurology International
This study aimed to investigate possible differences in spatio-temporal gait parameters of people... more This study aimed to investigate possible differences in spatio-temporal gait parameters of people with Parkinson’s Disease (pwPD) when they are tested either in laboratory using 3D Gait Analysis or in a clinical setting using wearable accelerometers. The main spatio-temporal gait parameters (speed, cadence, stride length, stance, swing and double support duration) of 31 pwPD were acquired: i) using a wearable accelerometer in a clinical setting while wearing shoes (ISS); ii) same as condition 1, but barefoot (ISB); iii) using an optoelectronic system (OES) undressed and barefoot. While no significant differences were found for cadence, stance, swing and double support duration, the experimental setting affected speed and stride length that decreased (by 17% and 12% respectively, P<0.005) when passing from the clinical (ISS) to the laboratory (OES) setting. These results suggest that gait assessment should be always performed in the same conditions to avoid errors, which may lead ...
Frontiers in Neurology
Background: The use of rhythmic auditory stimulation (RAS) has been proven useful in the manageme... more Background: The use of rhythmic auditory stimulation (RAS) has been proven useful in the management of gait disturbances associated with Parkinson's disease (PD). Typically, the RAS consists of metronome or music-based sounds (artificial RAS), while ecological footstep sounds (ecological RAS) have never been used for rehabilitation programs. Objective: The aim of this study was to compare the effects of a rehabilitation program integrated either with ecological or with artificial RAS. Methods: An observer-blind, randomized controlled trial was conducted to investigate the effects of 5 weeks of supervised rehabilitation integrated with RAS. Thirty-eight individuals affected by PD were randomly assigned to one of the two conditions (ecological vs. artificial RAS); thirty-two of them (age 68.2 ± 10.5, Hoehn and Yahr 1.5-3) concluded all phases of the study. Spatio-temporal parameters of gait and clinical variables were assessed before the rehabilitation period, at its end, and after a 3-month follow-up. results: Thirty-two participants were analyzed. The results revealed that both groups improved in the majority of biomechanical and clinical measures, independently of the type of sound. Moreover, exploratory analyses for separate groups were conducted, revealing improvements on spatio-temporal parameters only in the ecological RAS group. Conclusion: Overall, our results suggest that ecological RAS is equally effective compared to artificial RAS. Future studies should further investigate the role of ecological RAS, on the basis of information revealed by our exploratory analyses. Theoretical, methodological, and practical issues concerning the implementation of ecological sounds in the rehabilitation of PD patients are discussed.
The Open Psychology Journal, 2015
Previous studies have demonstrated that physical therapy accompanied by Rhythmic Auditory Stimula... more Previous studies have demonstrated that physical therapy accompanied by Rhythmic Auditory Stimulation (RAS) can improve the motor skills of patients with Parkinson’s disease and, in particular, their gait disturbances. In the present work we describe the neurological bases and perceptual-motor deficits generally associated with Parkinson’s disease, with a specific focus on gait disturbances. Within this framework, we review the role of auditory cueing in the modulation of patients’ gait, addressing this issue from the cognitive, neurological and biomechanical perspectives. In particular, we focus on the new frontiers of both assessment and intervention. With regards to the assessment, we describe the advantages of the three-dimensional quantitative multifactorial gait analysis. As concerns the intervention, we illustrate the potential impact of the administration of ecological footstep sounds as rhythmic cues.
Parkinsonism & Related Disorders, 2016