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.

Lectin-dependent cell-mediated cytotoxicity: assessment of cytotoxic reactivity following challenge with syngeneic tumors.

Spleen cells from syngeneic tumor-bearing mice were examined for direct cell-mediated cytotoxicity (DCMC) and lectin-dependent cell-mediated cytotoxicity (LDCC). In the DCMC assay specific cytotoxicity against the homologous tumor cell was assessed. In the LDCC assay cytotoxicity was nonspecifically assessed against EL-4 cells in the presence of concanavalin A or phytohemagglutinin. Most tumor lines tested (19/22) produced no cytotoxic reactivity in either the DCMC or LDCC assays. In the case of the remaining tumor lines (EL-4, BW5147-3, and P815 Y-3), significant LDCC, but not DCMC, was detected, which indicated that although cytotoxic effector cells had been activated, the reactivity was not directed toward the homologous tumor cell or could not be expressed in the DCMC assay. The EL-4 and BW5147-3 cell lines proved to be sporadic in terms of their ability to induce LDCC, whereas the P815 Y-3 cell line produced consistent LDCC. Reactivity induced by P815 Y-3 cells appeared to be due to the constitutive production and release of a soluble component which could activate cytotoxic T-cells in vivo.