Validation of low-cost system for gait assessment in children with ataxia.

BACKGROUND: Ataxic syndromes include several rare, inherited and acquired conditions. One of the main issues is the absence of specific, and sensitive automatic evaluation tools and digital outcome measures to obtain a continuous monitoring of subjects' motor ability. OBJECTIVES: This study aims to test the usability of the Kinect system for assessing ataxia severity, exploring the potentiality of clustering algorithms and validating this system with a standard motion capture system. METHODS: Gait evaluation was performed by standardized gait analysis and by Kinect v2 during the same day in a cohort of young patient (mean age of 13.8±7.2). We analyzed the gait spatio-temporal parameters and we looked at the differences between the two systems through correlation and agreement tests. As well, we tested for possible correlations with the SARA scale as well. Finally, standard classification algorithm and principal components analysis were used to discern disease severity and groups. RESULTS: We found biases and linear relationships between all the parameters. Significant correlations emerged between the SARA and the Speed, the Stride Length and the Step Length. PCA results, highlighting that a machine learning approach combined with Kinect-based evaluation shows great potential to automatically assess disease severity and diagnosis. CONCLUSIONS: The spatio-temporal parameters measured by Kinect cannot be used interchangeably with those parameters acquired with standard motion capture system in clinical practice but can still provide fundamental information. Specifically, these results might bring to the development of a novel system to perform easy and quick evaluation of gait in young patients with ataxia, useful for patients stratification in terms of clinical severity and diagnosis.

Carbon Modular Orthosis (Ca.M.O.): An innovative hybrid modular ankle-foot orthosis to tune the variable rehabilitation needs in hemiplegic cerebral palsy.

BACKGROUND: Hemiplegic Celebral Palsy (CP) children commonly use AFO orthoses as walking aids. It is known that AFOs may have a detrimental effect on gait. To enhance mechanical properties of AFOs we developed an innovative, custom-made, carbon, ankle-foot orthosis (Ca.M.O) which offers the opportunity to tune its response to the patient's gait characteristics and/or functional maturity. OBJECTIVE: To assess the efficacy of Ca.M.O. in improving gait in a group of hemiplegic CP children and to compare its performances with those of commonly prescribed AFO. METHODS: A clinical and instrumental gait analysis was performed on a group of 15 spastic hemiplegic children (WINTERS-GAGE type I-II) walking barefoot, with commonly prescribed AFOs and with Ca.M.O.Temporal, kinematic and kinetic data were collected with an 8 cameras optoelectronic system and 2 force plates. RESULTS: Studied variables were comparable walking with Ca.M.O. and with the commonly prescribed AFO and are significantly different (p < 0.01) with respect to barefoot condition. CONCLUSIONS: Both types of orthoses normalize the kinematics of the first and second ankle rocker. The main advantage of Ca.M.O. is its modularity that allows to tune its effect on gait in relationship with the progress or involution of the child's functional development.

Different efficacy of alcohol education tools among trainee nurses.

BACKGROUND/AIMS: The evaluation of the efficacy of two different forms of scientific information concerning alcohol-related problems (ARP), among Italian trainee nurses. METHODOLOGY: A specific questionnaire, investigating the awareness of ARP, was distributed to 193 trainee nurses, 158 enrolled in the Italian Red Cross School for Professional Nurses at S. Orsola-Malpighi Hospital in Bologna and 35 enrolled in the Professional Nursing School at the Social Security Institute in the Republic of San Marino, who had attended a scientific meeting on ARP in the last year. Eighty-one nurses (62 belonging to the Red Cross School of Bologna and 19 to the Professional Nursing School of San Marino), had previously been given an information package on ARP (Group A). One hundred twelve subjects (96 belonging to the Red Cross School of Bologna and 16 to the Professional Nursing School of San Marino) did not read the specialized material (Group B). RESULTS: The results showed a statistically significant difference in the percentage of correct answers between Group A (25.98%) and Group B (21.80%). The percentage of correct answers among the Bologna trainee nurses were always significantly lower than that of the San Marino nurses. CONCLUSIONS: These results suggest a scant awareness and interest in ARP among trainee nurses and show that courses and lectures are more effective than scientific printed material.