Biomedical subjects

M Rabuffetti

Publications and source records attributed to M Rabuffetti.

At least 19 recordsLinked to original sources

PubMed2006

Impact of subthalamic nucleus stimulation on the initiation of gait in Parkinson's disease.

The effects of subthalamic nucleus (STN) stimulation on the anticipatory postural actions associated with the initiation of gait were studied in ten patients with idiopathic Parkinson's disease undergoing therapeutic deep brain stimulation. Kinematic, dynamic and electromyographic analysis was performed before and while subjects were starting gait in response to an external cue. Effects of STN stimulation on the standing posture preceding the go signal included significant improvement of the vertical alignment of the trunk and shank, decrease of the hip joint moment, backward shift of the center of pressure (CoP) and reduction of abnormal tonic and/or rhythmic activity in the thigh and leg muscles. Responses to bilateral STN stimulation were more consistent than those evoked by unilateral stimulation. Moreover, comparison between postural changes induced by STN stimulation applied prior to the gait initiation cue and during simple quiet standing revealed more significant responses in the former condition. Effects on the actual gait initiation process included shortening of the imbalance phase, larger backward/lateral displacement of CoP and more physiological expression of the underlying anticipatory muscular synergy. Additional changes were shortening of the unloading phase, shortening of the first-swing phase and increase in the length of the first step. Results demonstrate substantial influence of STN stimulation on functionally basic motor control mechanisms. In particular, the evidence of more significant responses upon attention-demanding conditions and the remarkable effects on postural programmes sub-serving feed-forward regulation of the onset of complex multijoint movements, suggests a consistent action on postural sub-systems relying on cognitive data processing and internal models of body mechanics.

Aged↗

PubMed2005

Experimental protocol for the kinematic analysis of the hand: definition and repeatability.

A quantitative and objective method based on the optoelectronic kinematic analysis of hand segments and on the calculation of global and partial parameters, which provide measures of the degree of long finger and thumb extension is proposed for the evaluation of the hand's voluntary range of motion and maximal opening of the fingers and thumb. To test the precision and repeatability of the method, the protocol was applied on 14 healthy subjects (28 hands). The proposed parameters are repeatable and show a precision between 5.5 degrees and 10.4 degrees (mean value: 7.3 degrees), comparable to values obtained with other methods. Advantages of the present approach include simultaneous analysis of all fingers, absence of cumbersome connecting cables and no need for individually customized devices. The method, also applied to the paretic hands of two hemiplegic stroke patients before and after electrical stimulation of the wrist and finger extensor muscles, has shown encouraging results for its clinical feasibility and utility in addition to functional tests.

Adult↗

PubMed2005

Procedure for the quantitative evaluation of motor disturbances in cerebellar ataxic patients.

Cerebellar ataxia is a complex motor disturbance that involves the planning and execution of movements and reduces movement accuracy and co-ordination. The quantification of ataxic signs is commonly realised through visual examination of motor tasks performed by the patient and assignment of scores to specific items composing the international co-operative ataxia rating scale (ICARS). The present work studied an experimental procedure to characterise specific aspects of motor disturbances in ataxia objectively. Four tests belonging to the ICARS were considered: walking, knee-tibia test, finger-to-nose and finger-to-finger test. Through a kinematic analysis performed during the above tests, specific indices were defined to quantify velocity, linearity, asymmetry, tremor, instability and smoothness of movement or posture. The procedure was applied to five patients with cerebellar ataxia and to ten healthy adult subjects. Results demonstrated that the patients moved significantly more slowly than the healthy subjects (0.67 against 0.97m s(-1) and 0.81 against 1.02 m s(-1), respectively, for straight walk and finger-to-nose tests) and showed poorer linearity and smoothness behaviour. Velocity, linearity, tremor, smoothness and instability indices showed moderate to good correlation with the corresponding ICARS score. Some of these indices can separately evaluate aspects that are combined in single ICARS subscores. It is concluded that the combination of clinical assessments and instrumental evaluations allows a better insight into ataxic patients' motor disturbances and is a useful tool for the definition and follow-up of rehabilitation programmes.

Adult↗

PubMed2005

Trans-femoral amputee gait: socket-pelvis constraints and compensation strategies.

The paper deals with the identification of motor strategies adopted by trans-femoral amputees to compensate for the constraints of hip motion induced by the interference of the socket with the pelvis and, particularly, with the ischial tuberosity. A group of 11 subjects with trans-femoral amputation, three of whom wore two different prostheses, giving a sample size of 14 cases, were studied by gait-analysis protocols: the present paper focuses on the pelvis-thigh kinematics at foot strike. The results showed that, at the prosthetic side, the hip is significantly less flexed and less extended, respectively, at the ipsilateral and contralateral foot strike. Moreover, the pelvis is significantly more anterior tilted at sound foot strike. The anterior step length showed a decreased sound limb anterior step in 12 out of 14 cases. The authors interpret these results as a combination of mechanical constraints and compensatory actions: the reduced prosthetic hip extension is determined by the mechanical constraint involved in the pelvis-socket interference; and the increased pelvis tilt and sound hip flexion occurring at the same time are compensating strategies, adopted by the amputees, in order to obtain a functional step length and symmetrical thigh inclinations. Those factors determine a gait pattern which is functional, only slightly slower than normal gait, and without any perceivable alterations. On the other hand, the authors show that the increased pelvis tilting necessarily overloads the lumbar tract of the spine and may be related to the frequent occurrence of low-back pain in amputee subjects, despite the positive functional gait recovery.

Adult↗

PubMed2004

Kinematics of head-trunk movements while entering and exiting a car.

The study of free and natural accessibility movements for a medium-sized car was carried out, recording the motor performances of ten participants by means of a motion analysis system. The experimental protocol used passive markers to implement a two-segment biomechanical model for the analysis of the head-trunk complex. The kinematic variables quantify the motor patterns, and showed specific features that can be related to the individual anthropometric characteristics and to the car geometry differences: tall participants used a neck flexion and a leftwards bending of the head, while short participants extended the neck and bent the head to the right. The different seat positions (short participants move forwards the seat) along with the principal need to avoid any body interference with the car, can explain the observed strategies. From the wider analysis of the movements in relation to the vehicle's features and to the anthropometric size of the participants, this approach could lead to an extension of the design criteria for those structural components of the car which have been demonstrated to significantly influence the human-machine interaction.

Abdomen↗

PubMed2004

Microprocessor-controlled optical stimulating device to improve the gait of patients with Parkinson's disease.

Different types of visual cue for subjects with Parkinson's disease (PD) produced an improvement in gait and helped some of them prevent or overcome freezing episodes. The paper describes a portable gait-enabling device (optical stimulating glasses (OSGs) that provides, in the peripheral field of view, different types of continuous optic flow (backward or forward) and intermittent stimuli synchronised with external events. The OSGs are a programmable, stand-alone, augmented reality system that can be interfaced with a PC for program set-up. It consists of a pair of non-corrective glasses, equipped with two matrixes of 70 micro light emitting diodes, one on each side, controlled by a microprocessor. Two foot-switches are used to synchronise optical stimulation with specific gait events. A pilot study was carried out on three PD patients and three controls, with different types of optic flow during walking along a fixed path. The continuous optic flow in the forward direction produced an increase in gait velocity in the PD patients (up to + 11% in average), whereas the controls had small variations. The stimulation synchronised with the swing phase, associated with an attentional strategy, produced a remarkable increase in stride length for all subjects. After prolonged testing, the device has shown good applicability and technical functionality, it is easily wearable and transportable, and it does not interfere with gait.

Aged↗

PubMed2003

Real-time human motion estimation using biomechanical models and non-linear state-space filters.

In the field of sports biomechanics and rehabilitation engineering, the possibility of computing, in real time, the angular displacements and derivatives of human joints, from a video of motion sequences, represents an appealing goal. In particular, applications of biofeedback protocols in rehabilitation can benefit from this capability. The focus of the investigation was concerned with the application of biomechanical models, comprising of a kinematic chain and surface envelopes, and state-space filters, to the computation, in real time and with high accuracy, of the angular data and derivatives. By minimising the distances, measured with TV cameras, between the 2D marker projections and the corresponding back-projected markers located on the mannequin, the configuration of the biomechanical model was automatically updated. The use of state-space estimation allowed the computation of smooth derivatives of the orientation data. Owing to the non-linearity of the functions involved, the derivatives of the observation model were obtained through a multidimensional extension of Stirling's interpolation formula. Proper algorithms were developed to cope with the model calibration, initialisation and data labelling. Extensive experiments on real and simulated motions proved the reliability (maximum angular error less than 1 degree, maximum point reconstruction less than 1 mm) of the developed system, which is robust to false matching caused by marker occlusions. Moreover, orientation artifacts due to skin motion can be reduced by a factor of 50%.

Algorithms↗

PubMed2003

Optimised procedure for the calibration of the force platform location.

An innovative optimised method, including an experiment and a mathematical model, for the calibration of the force platform location in the optoelectronic reference frame is proposed. The calibration experiment adopts a bearing-marker testing object contacting the platform and does not directly measure the platform location. The experiment is designed in order to avoid the main drawbacks possibly occurring in commonly adopted methods. The mathematical model of the experiment estimates the expected ground reaction. An optimisation algorithm identifies the optimal platform location as the one that best matches the measured outcome of the calibration experiment with the corresponding model estimate. The innovative calibration procedure has been assessed in terms of inter-tester reliability and compared with commonly used calibration procedures of platform location. These results evidenced how the introduction of such optimised procedure could improve the reliability of the calibrated platform location and, consequently, of the kinetic variables considered in posture and gait analysis.

Algorithms↗

PubMed2002

Touch-screen system for assessing visuo-motor exploratory skills in neuropsychological disorders of spatial cognition.

A new computerised test adopting touch-screen technology has been developed to assess the visuo-motor exploration of extra-personal space. The test was derived from well-known paper-and-pencil cancellation tasks used widely in the diagnosis and quantitative assessment of unilateral spatial neglect (USN), a neuropsychological syndrome that is more frequent and severe after damage to the right cerebral hemisphere. A main component deficit of USN is the defective visuo-motor exploration of the side of space contralateral to the side of the lesion (contralesional), namely, in right-sided brain-damaged patients it occurs on the left side and vice versa. The computer-based paradigm consisted of a visuo-motor spatial exploratory task: the subjects were instructed to touch, in any order they wished, all the targets they detected on a computer touch-screen. This measured the time of occurrence and the spatial co-ordinates of each touch event and forwarded the data to the computer for storage; the computer provided feedback to the subject by 'tagging' the touched target. The paradigm allowed the calculation of accuracy and latency indexes and recorded the exploratory pathway taken by each subject. A pilot study was performed in ten normal subjects and 15 brain-damaged patients, with and without psychometric evidence of USN; the results showed that the equipment was able to provide quantitative indexes related to the spatial-temporal aspects of exploratory ability, which are useful for diagnostic purposes, and revealed significant differences between the controls and patients with USN: the overall average values of latency and crossing indexes increased in patients with USN, compared with the controls (latency from 0.77 to 1.90s; path crossing index from 7.0% to 59.5%), and the significantly negative USN patient latency gradient (-2.79 against a null control value) evidenced a worsening of performance towards the left side.

Aged↗

PubMed2002

Self-marking of anatomical landmarks for on-orbit experimental motion analysis compared to expert direct-marking.

The on-orbit application of movement analysis methodology, on-board space stations, for studying the gravity role in motor functions, requires a careful adaptation of the currently adopted techniques in order to obtain reliable data. In those operative conditions, differently from common on-ground experimental activities, a non-specialist operator, an astronaut of the space station crew, is expected to self-administer the experimental protocol, particularly self-marking specific anatomical landmarks. The present paper proposes a movement analysis methodology, which fits the specific constraints of space activity and matches the objective of maximising reliability and minimising on-orbit time, and reports normative data about accuracy and precision of the self-marking of an extended set of anatomical landmarks. The same set of landmarks has been considered also for direct-marking performed by experts in motion analysis and their results have been compared to self-marking ones. The paper contents will support the design of future space experimental campaigns and is, in general, applicable to any on-ground scientific investigation, possibly increasing data reliability.

Adult↗

PubMed2001

Spot check of the calibrated force platform location.

In a movement analysis laboratory, stereophotogrammetric motion capture systems and force platforms must share one absolute reference frame that allows the computation of joint moments and powers. The correct calibration of the platform location identifies the transformation between force plate and absolute reference systems, which determines the spatial coherence among the equipments' measurements. The aim of this study was to develop and test a spot check for the assessment of platform location calibration. Platform location calibration was assessed by comparing the measured outcome of an experiment performed with a pointed rigid rod bearing a set of markers with the corresponding expected results, computed with a model. A set of indices was then proposed to define a confidence volume in which the true ground reaction force is expected to be. The spot check was applied to a real laboratory setup and the effects of simulated platform mislocations were analysed. It was verified that the hip joint moment may be equally affected by a single marker misplacement of about 20mm during platform location calibration, an occurrence that was clearly identified by the spot check, and by a hip centre location inaccuracy of 30mm.

Biomechanical Phenomena↗

PubMed2001

Ground reaction: intrinsic and extrinsic variability assessment and related method for artefact treatment.

Ground reaction (GR) components measured by a dynamometric platform represent the dynamic interaction of the moving human body with the ground and depend on the subject-platform relative position and orientation. The observed variability among the GR measurements of the walking trials of an individual is either due to variability in the motor performance (intrinsic variability) or due to changes in the direction of walking and in the position and orientation of the striking foot relative to the platform (extrinsic variability). A method, based on the median operator, is presented here which lets us quantify the two components of variability. The application of the method to a large data set of normal subjects evidenced changes in progression direction/foot orientation (95th percentile value is 6.9 degrees ), which can dramatically change the patterns of GR components. This result warns about improper analysis of ground reaction measurement. An algorithm for restoring GR measurements affected by artefact was derived from the above method. This tool can be of valuable aid in clinical practice where patients' conditions suggest to not insist on repetition of trials even if the required number of correct foot placements has not been achieved. The artefact correction algorithm has been applied to a large data set artificially corrupted to evaluate its robustness.

Adult↗

PubMed2001

Production of leukotrienes in a model of focal cerebral ischaemia in the rat.

1. The aim of this work was to evaluate the role of leukotrienes in brain damage in vivo in a model of focal cerebral ischaemia in the rat, obtained by permanent occlusion of middle cerebral artery. 2. A significant (P < 0.01) elevation of LTC(4), LTD(4) and LTE(4) (cysteinyl-leukotrienes) levels occurred 4 h after ischaemia induction in the ipsilateral cortices of ischaemic compared to sham-operated animals (3998 +/- 475 and 897 +/- 170 fmol g(-1) tissue, respectively, P < 0.01). 3. The NMDA receptor antagonist MK-801 and the adenosine A(2A) receptor antagonist SCH 58261 were administered in vivo at doses known to reduce infarct size and compared with the leukotriene biosynthesis inhibitor MK-886. 4. MK-886 (0.3 and 2 mg kg(-1) i.v.) and MK-801 (3 mg kg(-1) i.p.) decreased cysteinyl-leukotriene levels (-78%, P < 0.05; -100%, P < 0.01; -92%, P < 0.01, respectively) 4 h after permanent occlusion of the middle cerebral artery, whereas SCH 58261 (0.01 mg kg(-1) i.v.) had no significant effects. 5. MK-886 (2 mg kg(-1) i.v.) was also able to significantly reduce the cortical infarct size by 30% (P < 0.05). 6. We conclude that cysteinyl-leukotriene formation is associated with NMDA receptor activation, and that it represents a neurotoxic event, the inhibition of which is able to reduce brain infarct area in a focal ischaemic event.

Animals↗

PubMed2000

Inhibition of caspase-1-like activity by Ac-Tyr-Val-Ala-Asp-chloromethyl ketone induces long-lasting neuroprotection in cerebral ischemia through apoptosis reduction and decrease of proinflammatory cytokines.

Broad spectrum caspase inhibitors have been found to reduce neurodegeneration caused by cerebral ischemia. We studied whether blockade of group I caspases, mainly caspase-1, using the inhibitor Ac-YVAD.cmk reduced infarct volume and produced prolonged neuroprotection. Ac-YVAD.cmk (300 ng/rat) was injected intracerebroventricularly 10 min after permanent middle cerebral artery occlusion in the rat. Drug treatment induced a significant reduction of infarct volume not only 24 hr after ischemia (total damage, percentage of hemisphere volume: control, 41.1 +/- 2.3%; treated, 26.5 +/- 2.1%; p < 0.05) but also 6 d later (total damage: control, 30.6 +/- 2.2%; treated, 23.0 +/- 2.2%; p < 0.05). Ac-YVAD. cmk treatment resulted in a reduction not only of caspase-1 (control, 100 +/- 20.3%; treated, 3.4 +/- 10.4%; p < 0.01) but also of caspase-3 (control, 100 +/- 30.3%; treated, 13.2 +/- 9.5%; p < 0.05) activity at 24 hr and led to a parallel decrease of apoptosis as measured by nucleosome quantitation (control, 100 +/- 11.8%; treated, 47 +/- 5.9%; p < 0.05). Six days after treatment no differences in these parameters could be detected between control and treated animals. Likewise, brain levels of the proinflammatory cytokines IL-1beta and TNF-alpha were reduced at 24 hr (39.5 +/- 23.7 and 51.9 +/- 10.3% of control, respectively) but not at 6 d. Other cytokines, IL-10, MCP-1, MIP-2, and the gaseous mediator nitric oxide, were not modified by the treatment. These findings indicate that blockade of caspase-1-like activity induces a long-lasting neuroprotective effect that, in our experimental conditions, takes place in the early stages of damage progression. Finally, this effect is achieved by interfering with both apoptotic and inflammatory mechanisms.

Amino Acid Chloromethyl Ketones↗

PubMed1999

Instrumented staircase for ground reaction measurement.

A staircase was developed to record ground reactions during stair climbing at different slopes (inclinations). Each step is instrumented with six strain-gauge-based force transducers which allow the measurement of three-dimensional ground reaction force and moment as well as the centre of pressure (COP) location. A specific sensor arrangement permits accurate recording, especially of the COP location. The overall design of the staircase and details of a single instrumented step are presented. Static and dynamic characteristics have been evaluated by different experimental procedures. Preliminary results of ground reaction forces are shown.

Biomechanical Phenomena↗

PubMed1999

Are perception and action affected differently by the Titchener circles illusion?

In the present study, we investigated the effects of the Titchener circles illusion in perception and action. In this illusion, two identical discs can be perceived as being different in size when one is surrounded by an annulus of smaller circles and the other is surrounded by an annulus of larger circles. This classic size-contrast illusion, known as Ebbinghaus or Titchener Circles Illusion, has a strong perceptual effect. By contrast, it has recently been demonstrated that when subjects are required to pick up one of the discs, their grip aperture during reaching is largely appropriate to the size of the target. This result has been considered as evidence of a clear dissociation between visual perception and visuomotor behaviour in the intact human brain. In this study, we suggest and investigate an alternative explanation for these results. We argue that, in a previous study, while perception was subjected to the simultaneous influence of the large and small circles displays, in the grasping task only the annulus of circles surrounding the target object was influential. We tested this hypothesis by requiring 18 subjects to perceptually estimate and grasp a disc centred in a single annulus of Titchener circles. The results showed that both the perceptual estimation and the hand shaping while grasping the disc were similarly influenced by the illusion. Moreover, the stronger the perceptual illusion, the greater the effect on the grip scaling. We discuss the results as evidence of an interaction between the functional pathways for perception and action in the intact human brain.

Adult↗

PubMed1999

Long-term adaptation of postural control in microgravity.

Orbital microgravity represents a unique environment, which allows the isolation of variables assumed to be involved in the mechanism of body positioning in space. In this context, the alignment of the trunk axis along allocentric references and the positioning of the body center of mass inside the supporting base compete for the role of the primary-controlled variable when assuming erect posture. This paper reports the quantitative evaluation of the postural strategies exhibited by two subjects with feet fixed to the floor of the space module along a 4-month period of exposure to microgravity. With respect to previous findings in parabolic flights and short term space missions, the analysis focused on long-term process of sensorimotor adaptation to weightlessness. Results show that while trunk-axis orientation is preserved and used as a stable postural frame of reference, the positioning of the body center of mass appears to be significantly biased backward and turns out to be involved in a long-term process of adaptation throughout the entire flight towards the re-emergence of a typically terrestrial postural regulation compatible with equilibrium.

Adult↗

PubMed1999

Kinematic characteristics of standing disequilibrium: reliability and validity of a posturographic protocol.

OBJECTIVE: To investigate retest reliability and concurrent validity of the fundamental measurements made of a posturographic protocol that employs quiet standing to quantify the severity and the nature of patients' postural disturbances. STUDY DESIGN: Retrospective complete block design. SETTING: Geriatric rehabilitation department. PARTICIPANTS: Thirty-six participants (age range, 67 to 86 yrs) having normal, moderate, or severe levels of disequilibrium. METHODS: Quiet standing was evaluated on three occasions using a three-dimensional motion analysis system and a force platform. Eight testing conditions, designed to vary task difficulty by controlling the contributions of vision, foot proprioception, and base-of-support width, were administered. MAIN OUTCOME MEASURES: Retest reliability of body sway, joint alignment, body position, and motor coordination indicators were evaluated by intraclass correlation coefficients (ICCs). Concurrent validity of protocol measures was evaluated by the prediction of disequilibrium from a stepwise linear discriminant analysis. RESULTS: ICCs indicated high level of retest reliability for all variables but those of motor coordination, which was not influenced by testing conditions. Discriminant analysis resulted in a four-factor discriminator that included measures of body sway, position, alignment, and motor coordination. The derived linear discriminate function correctly classified 96% of the patients' level of disequilibrium. CONCLUSIONS: The posturographic protocol has the potential to be a useful tool for evaluating severity and nature of postural instability and the effects of pharmacologic and rehabilitative treatment. Results also indicate that combining direct body measurements with force-plate data has the potential to expose the underlying impairments that cause disequilibrium, determine their pathogenesis, and evaluate compensatory strategies.

Aged↗