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Biomedical subjects

E Dalla Toffola

Publications and source records attributed to E Dalla Toffola.

10 recordsLinked to original sources
PubMed2003

A functional assessment methodology for alcohol dependent patients undergoing rehabilitative treatments.

PURPOSE: We propose a functional assessment approach for patients with alcoholic dependence of working age undergoing aerobic training. The background is the WHO indication (ICIDH-2) to use measurable 'activities' as a means to assess the individual 'participation' in social life which also implies work capacity. Defining sustainable energetic levels for the individual is an important issue for both the quantification of an effective training and the evaluation of possible improvements following training. METHODS: Fifty-six 'alcohol dependent' patients, as defined by DSM IV (Diagnostic and Statistical Manual of Mental Disorders), admitted to our Unit in a 16 month-period participated in the study. Eighteen healthy subjects served as controls (Group C). Out of all the 56 patients, 33 (Group A) underwent an aerobic training and 23 subjects (Group N) underwent the same pharmacological and psychological therapy but without aerobic training. Patients were assigned to the treatment (A) or no treatment (N) group according to a 'quasi-experimental' design (i.e. temporal selection criteria). The evaluation protocol consisted of submaximal symptom-limited tests. The tests consisted of bouts of 'basic' activities (walking, lifting, arm-work) to be performed at different intensities. We estimated the total energetic work (TW) performed in the tests by means of formulas available in the literature. The maximal energetic intensity (EI) reached during the tests was also estimated and expressed in MET (multiple of the basal metabolism). RESULTS: Significant differences in work capacity were observed between patients and healthy subjects at baseline. Group A significantly increased TW after rehabilitation, while Group N did not increment their performance at the re-test. CONCLUSIONS: The proposed approach could be useful in the functional assessment of deconditioned subjects with alcohol dependence in working age, and could monitor the changes in work capacity following training.

Adult↗
PubMed2002

3D kinematic analysis and clinical evaluation of neck movements in patients with whiplash injury.

In recent decades whiplash injuries, being a major reason for compensation claims, have become increasingly important in forensic medicine. In view of this, a reliable diagnostic method of assessing cervical range of motion (ROM) is needed. The aim of the present study was to evaluate neck function with a 3D kinematic method compared with clinical evaluation in whiplash injury. Seventy consecutive patients (M/F = 18/52) with a history of whiplash injury (WH) and 46 healthy volunteers (M/F = 24/22), mean age, respectively 33 +/- 9 and 28 +/- 6 years (mean+/-SD) entered the study. Patients suffered from neck pain and/or unilateral headache. A computerized kinematic analysis of the ROM (Elite system) using passive markers and two infrared TV cameras was used. Clinical evaluation of active ROM was also performed both in patients and in 61 controls (M/F = 23/38; mean age 47 +/- 18 years). Thirty out of 70 patients were tested at the time of their first consultation (T0) and 6 months later (T6), and 12 were also followed up after a year (T12). All neck movements, except extension, were significantly reduced in WH subjects compared with controls, in particular lateral bending. Comparing ROM at T0, T6 and T12, no significant differences were found. A global index of motion (GIM), obtained by calculating the sum of ROM in absolute value for all the movements acquired, was significantly reduced in WH compared with control subjects. The interobserver reliability of the clinical evaluation was globally acceptable. On the basis of the clinical evaluation, a significantly reduced ROM was found in all movements in WH subjects compared with an age-matched population. Computing the number of impaired cervical movements (ICMs), a significantly higher number was observed in WH patients than in controls, showing a decreasing trend at T6 and T12, with a significant improvement at T6 vs. T0. The computerized study of neck ROM may constitute a useful tool in the evaluation of WH at baseline and follow-up.

Adult↗
PubMed1987

Complications following surgery for severe head injury.

The number of patients who survive, after severe head injuries, is becoming more and more consistent due to the remarkable progress made in intensive care and rehabilitation units. The aim of this study is to identify, in addition to direct structural damage, medical and neurological problems and describe their frequency within a group of patients with severe head injuries. Neurologic, metabolic, gastrointestinal, genitourinary, respiratory, cardiovascular, cutaneous and endocrinologic problems were more frequently found. All these problems, which were identified during the first month after head injury, are discussed regarding their clinical significance, therapeutic approach, and morbidity.

Adolescent↗
PubMedDate not supplied

[Residual postural changes after cranial trauma].

A group of 29 clinically stable post-traumatic brain injury patients were studied for postural disturbances utilizing both a balance force platform and the Tinetti equilibrium test. The stabilometric exam included 6 different aspects of balance, with the goal of evaluating the importance of the sensory afferents on postural control. Posturographic data revealed a global reduction of postural control. TBI patients tended to rely more on visual feedback in postural control than did age-matched controls, and exhibited problems with sensory integration as the complexity of the balance tasks was increased. The site of lesion correlated positively with postural control problems, with brainstem and subcortical gray matter lesions most frequently being involved.

Adolescent↗
PubMedDate not supplied

[Rehabilitation in multiple sclerosis: clinico-instrumental correlations].

The Authors report their experience in a patient with Multiple Sclerosis. The planning and the follow up of rehabilitative treatment were based on clinical, functional, electrophysiological and posturographic evaluation. The impairment degree was evaluated by Kurtzke's Expanded Disability Status Scale. The electrophysiological evaluation showed an abnormal recruitment flexor pattern at exteroceptive stimulus and posturography confirmed postural control disorder. The treatment was based on PNF techniques and postural feedback on standing balance platform. After rehabilitative treatment the clinical and functional improvement has been confirmed by normal exteroceptive flexion reflex and better stabilometric parameters.

Electromyography↗
PubMedDate not supplied

[Clinical and EMG evaluation of the trapezius muscle in cerebrovascular disorders].

A bilateral evaluation of the trapezius muscle was carried out, clinically and by surface electromyography, in 11 stroke patients, in order to compare the activation amplitude of the upper trapezius muscle in different movements of upper limb, using the healthy side as comparison parameter. At our request of analytical activation of the trapezius (consisting in raising their shoulders), we noted in all of them a contraction, both clinically and by EMG valuable. On the contrary at our request of the fixation activity of the shoulder girdle by the trapezius (humeral flexion) we couldn't notice a considerable activation in 4 patients. These data suggest that the trapezius is more active during voluntary movements than in postural fixation, and suggest the use of rehabilitation techniques focusing on the voluntary control.

Adult↗