Background: Ataxia is a neurological sign characterized by motor coordination during gait/voluntary limb movements impairment. Ataxic gait leads to disability and worsening of quality of life; physiotherapy intervention is recommended to improve motor function. Recent studies showed benefits due to repetitive robotized assisted gait training using a static exoskeleton in patients affected by acquired ataxias. The aim of the study was to perform a preliminary evaluation of the short-term effects of overground UAN.GO^®-assisted gait training in an adult patient with ataxia but with no clear genetic pattern. Methods: This case report study was conducted on a single male adult patient, who presented ataxic spastic gait, posterior chain tightness, pes cavus, and unstable standing position. The patient underwent two preliminary sessions to take part in the study. Treatment protocol planned 10 sessions and each one lasted 80 min, 60 of which were spent in gait training using the mobile overground exoskeleton UAN.GO^®. At T1 (start of the study) and T10 (final evaluation) assessments using the Scale for the Assessment and Rating of Ataxia, Berg Balance Scale, 6-Minute Walking Test, and Likert Scale were administered. Space-time parameters of gait cycle were also evaluated: left and right step length, stance and swing percentages. Results: improvements on the Scale for the Assessment and Rating of Ataxia, Berg Balance Scale, and in the distance travelled at 6-Minute Walking Test emerged. The patient gave a positive opinion towards the treatment, showed by Likert Scale results. Kinematic gait analysis showed more physiological step length, stance and swing percentages, joint angles. The patient completed the training program with an excellent compliance. Discussion: Since these encouraging outcomes were obtained, it is possible to consider robot-assisted gait training performed with UAN.GO^® as a therapeutic option to improve motor and functional performance in patients with ataxic gait.

Spinal cord injury (SCI) represents a complex pathological event, which requires continuous and highly specialized territorial interventions. The literature highlights disadvantages faced by people with SCI in accessing local services. This study aimed to investigate the concept of territorial continuity for SCI, reconstructing patients and healthcare professionals’ perspectives, to identify facilitators, barriers and opportunities. Methods: a Focus Group (FG) qualitative study was conducted at Piacenza Ausl; four FGs were carried out; a research team member moderated FGs using thematic guides, while an observer was responsible for noting non-verbal aspects. Meetings lasted between 90 and 120 min and were audio-recorded. Transcript analysis involved the identification of units of meaning, which were grouped into general themes. Results: Final analysis highlighted 435 verbatim, grouped into 21 initial themes, that converged into 5 emerging themes: “SCI continuity as multidisciplinary teamwork”; “The need for rehabilitation as a driver of territorial continuity”; “Reinventing everyday life after SCI”; “Barriers and facilitators”; and “The future of territorial care”. Discussion: Patients and healthcare professionals highlighted the absence of a defined treatment path and the lack of reference points, thus generating disorientation and need for information. Among the proposals, telemedicine, empowering the case manager’s role, promoting specific training courses and rethinking community hospitals were supported.

Background: Animal-assisted activities (AAA) are participative interventions, designed to lower hospitalization-related stress and anxiety, enhance communicative readiness, improve quality of life and encourage human–animal interaction. The aim of the present study was to evaluate AAA effects in the context of intensive rehabilitation of patients with spinal cord injury (SCI), traumatic brain injury (TBI), stroke. Methods: AAA in this study were structured by a local specialized association, for small groups of patients (5/7 a time), biweekly; each session lasted 60 min. Each patient participated in 10 sessions of AAA. Evaluation rating scales were administered at T0 (before the first session) and T1 (after the last session, five weeks later) as follows: Neurobehavioral Rating Scale (NRS) in case of patient with stroke/TBI without disorder of consciousness; Hospital Anxiety and Depression Scale (HADS) for SCI patients. Results: A total of 50 patients concluded the study. NRS score for joined TBI and stroke populations varied from a T0 mean value of 32.34 [C.I. 26.83–37.35] to 17.21 [C.I. 12.66–21.76] (46.7%); this difference proved to be statistically significant (p = 0.000). Stroke patients had a 57.6% NRS lowering by mean 28.10 [C.I. 20.55–35.65] points to 12 [C.I. 6.6–17.36], which was significant (p = 0.000); similarly, TBI patients showed a mean decrease of 35.8% points from the initial 41.6 points [C.I. 37.29–45.93] to 26.76 [C.I. 21.94–31.59] (p = 0.002). As for HADS scores a smaller improvement was found in the cohort of SCI patients: anxiety registered a 1 mean point decrease at T1 (21.5%), from the initial 6.5 points [C.I. 3.80–9.34] to 5.1 ones [C.I. 3.17–7.11]. This variation was near the threshold of significance (p = 0.05). Depression domain, instead, improved by 2.35 mean points (37%), from the 6.35 initial points [C.I. 3.45–9.26] to the final 4 [C.I. 2.15–5.98] with reaching of a significant p value (p = 0.03). ANCOVA did not confirm this last value and showed no influence of age and gender on outcome variations. Discussion: AAA showed preliminary evidence to decrease neurobehavioral disorders in patients with high-complexity neurological diseases, particularly stroke and TBI. The role of AAA in SCI patients remains unclear. Future studies should address confounders’ role for these populations, particularly severity of disease. Furthermore, AAA interventions will have to be studied on larger samples, deepening the exact phase to introduce AAA for neurological patients. Lastly, qualitative studies are needed to explore patients’ lived experiences.

Background and Objectives: Traumatic brain injury (TBI) is one of the leading causes of long-term disability among adults, with consequences for balance, postural stability, and quality of life. Addressing balance disorders in TBI patients requires a tailored and continuous care approach; the existing literature underlines a general framework for physiotherapy treatments, but no clear profile of technique, dosage and timing of intervention emerges. The present scoping review, therefore, aimed at mapping physiotherapy approaches to balance in TBI population, highlighting their potential effects and role through care pathways. Materials and Methods: A scoping review was conducted, according to PRISMA Extension for Scoping Reviews, with the aim of mapping physical therapy approaches to treat balance disorders in adult patients with TBI. A specific search string for each database was formulated through a PCC (Population, Concept, Context) framework. The search, limited to articles in English and published between 2015 and 2025, was conducted across five databases (PubMed, PEDro, Scopus, Embase, and Web of Science), including experimental studies, observational designs, and `case reports. Results: From the initial selection of 1052 records, six studies were included: five randomized controlled trials and a case report, published between 2016 and 2022. Results presented high heterogeneity of physiotherapy programs and outcome variations; interventions identified included virtual reality, video game therapy, adapted physical exercise, ballistic training, rapid-resistance elliptical training, and rhythmic auditory stimulation. These studies reported variable improvements in balance and mobility, not even with significant inter-group differences. Conclusions: Several techniques showed preliminary evidence in pre/post improvements of balance for TBI patients, including strength exercise, aerobic training and virtual-mediated approaches such as video game therapy and virtual reality. Rhythmic auditory stimulation has unclear effects. Future studies are needed to define the impact of each balance recovery strategy according to the baseline characteristics of the patient.