Stroke survivors with chronic paralysis often have difficulties to perform various activities of daily living (ADLs), such as preparing a meal or eating and drinking independently. Recently, it was shown that a brain/neural hand exoskeleton can restore hand and finger function, but many stroke survivors suffer from motor deficits affecting their whole upper limb. Therefore, novel hybrid electroencephalography/electrooculography (EEG/EOG)-based brain/neural control paradigms were developed for guiding a whole-arm exoskeleton. It was unclear, however, whether hemiplegic stroke survivors are able to reliably use such brain/neural-controlled device. Here, we tested feasibility, safety, and user-friendliness of EEG/EOG-based brain/neural robotic control across five hemiplegic stroke survivors engaging in a drinking task that consisted of several subtasks (e.g., reaching, grasping, manipulating, and drinking). Reliability was assumed when at least 75% of subtasks were initialized within 3 s. Fluent control was assumed if average “time to initialize” each subtask ranged below 3 s. System's safety and user-friendliness were rated using Likert-scales. All chronic stroke patients were able to operate the system reliably and fluently. No undesired side effects were reported. Four participants rated the system as very user-friendly. These results show that chronic stroke survivors are capable of using an EEG/EOG-controlled semiautonomous whole-arm exoskeleton restoring ADLs.

The detection of gait abnormalities is essential for professionals involved in the rehabilitation of walking disorders. Instrumented treadmills are spreading as an alternative to overground gait analysis. To date, the use of these instruments for recording kinematic gait parameters is still limited in clinical practice due to the lack of validation studies. This study aims to investigate the performance of a multi-sensor instrumented treadmill (i.e., WalkerView^TM, WV) for performing gait analysis. Seventeen participants performed a single gait test on the WV at three different speeds (i.e., 3 km/h, 5 km/h, and 6.6 km/h). In each trial, spatiotemporal and kinematic parameters were recorded simultaneously by the WV and by a motion capture system used as the reference. Intraclass correlation coefficient (ICC) of spatiotemporal parameters showed fair to excellent agreement at the three walking speeds for steps time, cadence, and step length (range 0.502–0.996); weaker levels of agreement were found for stance and swing time at all the tested walking speeds. Bland–Altman analysis of spatiotemporal parameters showed a mean of difference (MOD) maximum value of 0.04 s for swing/stance time and WV underestimation of 2.16 cm for step length. As for kinematic variables, ICC showed fair to excellent agreement (ICC > 0.5) for total range of motion (ROM) of hip at 3 km/h (range 0.579–0.735); weaker levels of ICC were found at 5 km/h and 6.6 km/h (range 0.219–0.447). ICC values of total knee ROM showed poor levels of agreement at all the tested walking speeds. Bland–Altman analysis of hip ROM revealed a higher MOD value at higher speeds up to 3.91°; the MOD values of the knee ROM were always higher than 7.67° with a 60° mean value of ROM. We demonstrated that the WV is a valid tool for analyzing the spatiotemporal parameters of walking and assessing the hip’s total ROM. Knee total ROM and all kinematic peak values should be carefully evaluated, having shown lower levels of agreement.

Upper extremities limitation is a common functional impairment in patients with Multiple Sclerosis (PwMS). Novel technological devices are increasingly used in neurorehabilitation to support motor function improvement and the quantitative assessment of motor performance during training in patients with neurological diseases. In this review, we systematically report the evidence on clinical applications and robotic-assisted arm training (RAT) in functional recovery in PwMS. PubMed/MEDLINE, the Cochrane Library, and the Physiotherapy Evidence Database (PEDro) databases were systematically searched from inception to March 2021. The 10-item PEDro scale assessed the study quality for the RCT, and the AMSTAR-2 was used to assess the quality of the systematic review. The 5-item Oxford CEBM scale was used to rate the level of evidence. A total of 10 studies (161 subjects) were included. The selected studies included one systematic review, four RCTs, one randomized crossover, and four case series. The RCTs were scored as high-quality studies, while the systematic review was determined to be of low quality. Shoulder range of motion, handgrip strength, and proximal arm impairment improved after RAT. Manual dexterity, arm function, and use in daily life also ameliorated arm function. The high clinical heterogeneity of treatment programs and the variety of robot devices affects the generalizability of the study results; therefore, we emphasize the need to standardize the intervention type in future studies that evaluate the role of robotic-assisted training in PwMS. Robot-assisted treatment seems safe and useful to increase manual dexterity and the quality of movement execution in PwMS with moderate to severe disability. Additional studies with an adequate sample size and methodological rigour are warranted to drive definite conclusions.

Background: Proprioception is an important part of the somatosensory system involved in human motion control, which is fundamental for activities of daily living, exercise, and sport-specific gestures. When total knee arthroplasty (TKA) is performed, the posterior cruciate ligament (PCL) can be retained, replaced, or discarded. The PCL seems to be responsible for maintaining the integrity of the joint position sense (JPS) and joint kinesthesia. The aim of this review was to assess the effect of PCL on knee joint proprioception in total knee replacement. Methods: This systematic review was conducted within five electronic databases: PubMed, Scopus, Web of Science, Cochrane, and PEDro with no data limit from inception to May 2021. Results: In total 10 publications were evaluated. The analysis was divided by proprioception assessment method: direct assessment (JPS, kinesthesia) and indirect assessment (balance). Conclusions: The current evidence suggest that the retention of the PCL does not substantially improve the joint proprioception after TKA. Due to the high heterogeneity of the studies in terms of design, proprioception outcomes, evaluation methods, further studies are needed to confirm the conclusions. In addition, future research should focus on the possible correlation between joint proprioception and walking function.

Background: Persistent tendon pain and swelling related to mechanical loading are the main signs of Achilles tendinopathy (AT). This condition is one of the most common tendinopathies of the lower limb affecting mainly athletes involved in running and jumping sports. Methods: we included pivotal papers retrieved from the literature (Pubmed, Google Scholar, PEDro, and Scopus) to present an overview of the management of AT, with a specific focus on conservative management. Results: An accurate and timely diagnosis of AT is necessary to set up early treatments and to manage the problem conservatively. Diagnosis is primarily based on clinical assessment; instrumental imaging may be helpful in confirming the clinical diagnosis. Conservative treatment is effective in most cases, mainly using physical exercise based on eccentric training. Other non-surgical treatments such as extracorporeal shock wave therapy, thermotherapies, and injections can be added to exercise. Surgical treatment is indicated for patients where the conservative treatments of at least six months fails. Conclusions: Conflicting results from numerous studies hamper to identify gold standard treatments asking for further well-conducted level I and II research about the management of AT.