Sustained involuntary muscle activity (IMA) is a highly disabling and not completely understood phenomenon that occurs after a central nervous system lesion. We tested the feasibility of in-field IMA measuring at an acute rehabilitation ward. We used wearable probes for single differential surface EMG (sEMG), inclusive of a 3D accelerometer, onboard memory and remote control. We collected 429 h of data from the biceps brachii of 10 patients with arm plegia. Data quality was first verified in the time and frequency domains. Next, IMA was automatically identified based on the steady presence of motor unit action potential (MUAP) trains at rest. Feasibility was excellent in terms of prep time and burden to the clinical staff. A total of 350.5 h of data (81.7%) were reliable. IMA was found in 85.9 h (25%). This was often present in the form of exceedingly long-lasting trains of one or a few MUAPs, with differences among patients and variability, both within and between days in terms of IMA duration, root mean square (RMS) and peak-to-peak amplitude. Our results proved the feasibility of using wearable probes for single differential sEMG to identify and quantify IMA in plegic muscles of bedridden acute neurological patients. Our results also suggest the need for long-lasting acquisitions to properly characterize IMA. The possibility of easily assessing IMA in acute inpatients can have a huge impact on the management of their postures, physiotherapy and treatments.

The Cognitive Orientation to Occupational Performance (CO-OP) Approach, a problem-solving intervention process, has been shown to improve activity performance in children with Dravet Syndrome (DS). However, some individuals with DS have cognitive, language and/or behavioral deficits that preclude their ability to participate in the problem-solving process. To date, the CO-OP Approach has never been applied to parents with the goal of enhancing children/adolescent's performance. Explore the feasibility of a telerehabilitation-based CO-OP Approach with parents of individuals with DS to improve their child/adolescent's performance in daily activities. A quasi-experimental single group design with pretest-post-test and 1-month follow-up was used with 9 parents of children/adolescents with DS (aged 9-18 years), who received eight online CO-OP sessions. Five goals were chosen, three of which were treated. Parents rated performance and satisfaction on the Canadian Occupational Performance Measure (COPM). Activity performance was rated using the Performance Quality Rating Scale (PQRS). Wilcoxon signed-rank tests were conducted to assess intervention changes. COPM results, for trained and untrained goals, for both performance and satisfaction, improved significantly at post and follow-up. PQRS results for trained goals improved significantly at post and follow-up. Positive trends were also observed for untrained goals, but significance was achieved only at follow-up. These findings provide preliminary evidence that the CO-OP Approach can be implemented with parents to improve their child/adolescent's performance on both trained and untrained goals.

Dravet syndrome (DS) is a severe form of epilepsy that affects a child's cognitive, language, behavioral, and physical abilities, leading to reduced adaptive functioning. Despite its impact, there is limited evidence supporting effective interventions for these children, particularly in addressing their occupational performance. To explore the effectiveness of the Cognitive Orientation to Daily Occupational Performance (CO-OP) approach in a telerehabilitation format for children with DS. A single-subject design with multiple baselines across goals was used with four children (aged 9-13 years) with DS, who received eight online CO-OP sessions. Five goals were set using the Canadian Occupational Performance Measure (COPM), three of which were targeted in the intervention. Activity performance was rated using the Performance Quality Rating Scale (PQRS) and analyzed using the 3SD band method. Children and parents rated perceived performance and satisfaction on the COPM. Secondary outcomes included parents' sense of competency, children's adaptive behavior, and quality of life. Significant improvements in PQRS scores were seen for 8 of the 12 trained goals and 3 of the 7 untrained (transfer) goals. COPM scores showed changes greater than 2 points in both children's and parents' perceived performance and satisfaction for trained and untrained goals. Improvements were also noted on the secondary measures for 3 of 4 participants. These findings provide preliminary evidence that the CO-OP approach in a telerehabilitation format improves both trained and untrained goals, with a positive effect on parent self-efficacy, adaptive functioning, and quality of life. Further research is needed to confirm these results.

Background: Meals are central to daily life, health, and social participation, yet their safety and enjoyment can be compromised in people with oropharyngeal dysphagia (OD). Despite the broad impact of OD on physical and psychosocial well-being and daily functioning, structured guidance for comprehensive mealtime management in clinical practice is lacking. To address this gap, a set of expert consensus-based “Do’s and Don’ts” covering four meal-related domains was developed. Methods: A modified Delphi consensus study promoted by the Italian Society of Deglutology involved a multidisciplinary panel of 53 experts in OD and related disciplines. Experts developed “Do” and “Don’t” statements across four domains: nutrition-focused diet prescription, meal preparation, mealtime experience, and patient and caregiver education. After panel conveners’ review, 61 statements underwent two rounds of online voting using a 3-point ordinal scale plus an additional option ‘unable to express an opinion’. Consensus was predefined as ≥75% agreement. Statements were revised between rounds based on participants’ comments to ensure clinical accuracy and practical applicability. Results: The response rate was 85% for Round 1 and 97.8% for Round 2. After Round 2, 57 of 61 statements (93.4%) reached the consensus threshold (≥75% agreement). Conclusions: Mealtime management in OD should be individualized and person-centered, balancing swallowing safety, nutritional requirements, quality of life, and enjoyment of eating. Management should extend beyond compensatory strategies alone to include the social and relational dimensions of meals. Active involvement and education of patients and caregivers are essential to support therapeutic adherence and daily implementation of recommendations. Interprofessional collaboration and multimodal educational strategies are crucial to ensuring a coordinated, safe, and effective nutritional approach to OD care.