Papers by Enrico Castelli
We found an excellent T-R and I-R reliability for all the antropometric measures, where differenc... more We found an excellent T-R and I-R reliability for all the antropometric measures, where differences between the two assessments were about the size of 3 mm over a range of segments lengths between 810 and 900 mm, except for I-R reliability of measurements of the left lower limb length. Reliability of spatial-temporal parameters was also very high for all measures. Differences in temporal variables measures were about the size of 10 ms. Offset angles resulted highly reliable too in both the T-R and I-R comparisons, except for flexion-extension and rotation of the right foot. In we reported the results for pelvis width measures (I-R reliability: t = 1.446, p = 0.186; BA: r = À0.417, p = 0.264; T-R reliability: t = 0.5, p = 0.631; BA: r = 0.48, p = 0.191;) and in Fig. 2 the results for double-support duration (%) of the left step (I-R reliability: t = À1.279, p = 0.237; BA: r = À0.635, p = 0.066; T-R reliability t = À0.581, p = 0.577; BA: r = 0, p = 1).
Gait & Posture, 2008
it seems necessary to deepen the study on what resources (neural, muscular, tendons, bony levers)... more it seems necessary to deepen the study on what resources (neural, muscular, tendons, bony levers) are indeed necessary to change. Introduction: It was hypothesized that gait assessment could take advantage from the definition of gait strategy through large prospective study in children affected by cerebral palsy [1]. When, in literature, the necessity to "normalize" the diplegic gait is mentioned, it is not clear what "to normalize" means. Nevertheless, it is unclear how and if it is convenient to optimize the available resources rather than to "normalize" gait. In the attempt to clarify these questions we studied diplegic gait pattern and its changes over time. In this study we describe over 5 years of gait analysis in 12 diplegic children. Patients/Materials and Methods: Gait parameters of 12 diplegic children affected by cerebral palsy was observed at baseline and at follow up and compared with 6 normal children. The mean age of diplegic children at baseline was of 6 years and 6 months (Std 3 years) and at follow up of 11 years and 8 months (Std 3 years), while the mean age of control was 9 years (Std 1 year). During the observational period (mean 5 years and 2 months) all patients were treated at least once with botulinic toxin at the triceps and 2 patients underwent to triceps lengthening surgery. Gait analysis was performed by an opto-electronic system (Vicon512) with six cameras and two force platforms (AMTI). Three gait cycles were gathered for each child and compared with normal data. We studied the following variables: cadence, step length and limb length ratio, double support duration, single support duration, maximum ankle moments and maximum ankle powers at push off. For comparison demands we compared the ratio between step length and limb length. The moments and powers were also normalized. Statistics were calculated for all parameters previously indicated using a one-way analysis of variance (ANOVA) (p = 0.05).
Area Pediatrica
Dystonia is a syndrome characterized by sustained muscle contractions, causing abnormal postures ... more Dystonia is a syndrome characterized by sustained muscle contractions, causing abnormal postures and involuntary movements. Motor impairment and cognitive-behavioural disturbances, even severe, could be developed following this condition. Medical treatment allows a partial and transient improvement of the clinical condition. For these reasons different surgical approaches, including pallidotomy and Deep brain stimulation, result in selected cases, effective symptomatic therapies.
ABSTRACT Robots for rehabilitation treatment are not only employed for the treatment and performa... more ABSTRACT Robots for rehabilitation treatment are not only employed for the treatment and performance evaluation for stroke survivors, but also to assess in healthy subjects their adaptability to dynamic fields. In this context, few studies have investigated the age-related modifications of motor control strategies [1]. Although motor control differences between adults and children have been observed [2], in our knowledge no studies have quantified them during rehabilitative robot tasks. In order to achieve this goal, we decided to comparatively examine upper limb kinematics during circle drawing tasks in healthy adults and children; that choice is justified because the previously indicated task: (i) is widely used for patients evaluation, and (ii) it requires coordination of both the shoulder and elbow joints.
IEEE ... International Conference on Rehabilitation Robotics : [proceedings], 2011
In this paper we present the alpha-prototype of a novel pediatric ankle robot. This lower-extremi... more In this paper we present the alpha-prototype of a novel pediatric ankle robot. This lower-extremity robotic therapy module was developed at MIT to aid recovery of ankle function in children with cerebral palsy ages 5 to 8 years old. This lower-extremity robotic module will commence pilot testing with children with cerebral palsy at Blythedale Childrens Hospital (Valhalla, NY), Bambino Gesu Children's Hospital (Rome, Italy), Riley Children's Hospital (Indianapolis, IN). Its design follows the same guidelines as our upper-extremity robots and adult anklebot designs, i.e. it is a low friction, backdriveable device with intrinsically low mechanical impedance. We show the ankle robot characteristics and stability range. We also present pilot data with healthy children to demonstrate the potential of this device.
Purpose Bony pelvis anomalies in bladder exstrophy have prompted a great deal of papers addressin... more Purpose Bony pelvis anomalies in bladder exstrophy have prompted a great deal of papers addressing biomechanical analysis and kinematic of walking joints. However, a direct evaluation of forces applied to each joint (moments and powers) has never been performed nor has it been correlated to osteotomy Methods Exstrophy patients in a collaborative age were asked to participate in gait studies using a Vicon MX, a 3-dimensional motion analysis system with 8 cameras – kinematics - and two force plates (AMTI, USA) - kinetics. Kinematics analysis included pelvic tilt and hip, knee and ankle flexion-extension angles. Kinetics analysis consisted in the evaluation of hip, knee and ankle moments and powers. Normal healthy peers acted as controls. Correlations were sought between exstrophy patients and controls and between patients non osteotomized (Group 1) and those with osteotomy (Group 2) In particular, were analyzed: i)knee angle at contact with floor, during load response , in late stance...
The Scientific World Journal, 2012
Caring for children in vegetative state (VS) or minimally conscious state (MCS) challenges parent... more Caring for children in vegetative state (VS) or minimally conscious state (MCS) challenges parents and impacts on their wellbeing. This study aims to evaluate caregivers' health condition, coping, anxiety and depression levels, and how these issues relate to children's disability. 35 children with VS and MCS were administered the disability rating scale (DRS) and 35 caregivers completed the Coping Orientations to Problem Experiences, Short Form-12, Beck Depression Inventory, and the Spielberger State-Trait Anxiety Inventory-Y. Children were mainly males (68.6%), hosted at domicile (77.1%), and diagnosed with VS (60%), with anoxic aetiology (45.7%). Caregivers were mainly mothers (85.7%), married (82.9%), and housewives (51.4%); 60% declared financial difficulties, and 82.9% provided full-time assistance. 57.2% reported depressive symptoms, poor mental health, and high level of state and trait anxiety. "Problem-oriented" (P < 0.001) and "emotional-oriented" (P < 0.001), were more adopted than "potentially dysfunctional" ones. DRS scores (mean = 22.0; SD = 1.9) did not significantly correlate to any psychological measure. Rehabilitative programs for children with SV and SMC should also provide interventions on surrounding systems: improving the network of psychological support and social assistance may decrease the burden of caregivers and, in turn, improve caring abilities and children quality of life.
Gait & Posture - GAIT POSTURE, 2009
level. The mechanisms through which the three components of the head acceleration are controlled ... more level. The mechanisms through which the three components of the head acceleration are controlled during level walking have been recently investigated in the literature [1], but, to our knowledge, gender differences have not been taken into account. The aim of this study is to test whether this omission could lead to erroneous conclusions.
Research in Developmental Disabilities, 2010
Psycho-Oncology, 2005
Cognitive and psychological disorders are among the most frequently observed sequelae in brain tu... more Cognitive and psychological disorders are among the most frequently observed sequelae in brain tumor survivors. The goal of this work was to verify the presence of these disorders in a group of children and adolescents diagnosed with brain tumor before age 18 years, differentiate these disorders according to age of assessment, identify correlations between the two types of impairments and define possible associations between these impairments and clinical variables. The study involved 76 patients diagnosed with brain tumor before age 18 years. Three age groups were formed, and all the patients received a standardized battery of age-matched cognitive and psychological tests. According to our findings, all three groups present with cognitive and psychological-behavioral disorders. Their frequency varies according to age of onset and is strongly associated to time since diagnosis. The performance intelligence quotient (PIQ) was more impaired than the verbal intelligence quotient (VIQ). Internalizing problems, withdrawal and social problems were the most frequent psychological disorders. Correlations were found between cognitive impairment and the onset of the main psychological and behavioral disorders. These findings are relevant as they point out the long-term outcome of brain tumor survivors. Hence, the recommendation to diversify psychological interventions and rehabilitation plans according to the patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; age.
Neuroscience Letters, 2003
Overexpression of APP and SOD induces beta-amyloid deposition and oxidative stress in Down syndro... more Overexpression of APP and SOD induces beta-amyloid deposition and oxidative stress in Down syndrome (DS) patients. Both phenomena may impair glutamate transport and decreased glutamate uptake sites have been demonstrated in patient brains at autopsy. Since alterations of APP metabolism and oxidative damage are systemic, we investigated glutamate uptake in platelets and fibroblasts from DS patients to explore whether abnormalities in this process are inherent properties of DS cells and not secondary to neurodegeneration. Glutamate uptake was significantly decreased in platelets (P , 0:005 vs. control) and fibroblasts (P , 0:001 vs. control) from DS patients, particularly in those with free trisomy and with mitochondrial point mutations. Systemic impairment of glutamate uptake in DS is suggested, probably related to APP overexpression and mitochondrial dysfunction. Such mechanisms may contribute to neurodegeneration and dementia development in these patients. q
Neurocase, 2006
We report the case of a 4.6-year-old girl born pre-term with early bilateral occipital damage. It... more We report the case of a 4.6-year-old girl born pre-term with early bilateral occipital damage. It was revealed that the child had non-severely impaired basic visual abilities and ocular motility, a selective perceptual deficit of figure-ground segregation, impaired visual recognition and abnormal navigating through space. Even if the child&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s visual functioning was not optimal, this was the expression of adaptive anatomic and functional brain modifications that occurred following the early lesion. Anatomic brain structure was studied with anatomic MRI and Diffusor Tensor Imaging (DTI)-MRI. This behavioral study may provide an important contribution to understanding the impact of an early lesion of the visual system on the development of visual functions and on the immature brain&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s potential for reorganisation related to when the damage occurred.
The Journal of Urology, 2010
The Journal of Urology, 2011
Conclusion: Penile block provided better analgesia when compared with caudal epidural in children... more Conclusion: Penile block provided better analgesia when compared with caudal epidural in children undergoing primary hypospadias repair. Postoperative urethral fistula formation was more likely in children who received caudal epidural.
Journal of the Neurological Sciences, 2009
Journal of Rehabilitation Medicine, 2009
To evaluate interjoint coordination in children with hemiplegia as they reach to grasp objects, i... more To evaluate interjoint coordination in children with hemiplegia as they reach to grasp objects, in both static and dynamic conditions. An ad hoc robotic device was used to study the dynamic condition. Observational study. Six children with hemiplegia and 6 young adults. Kinematics of the trunk and arm were studied using an optoelectronic system. In the dynamic condition the target object, a cup, was moved by the robotic device along clockwise and counterclockwise circular trajectories. Two main strategies were used to study the onset and offset of shoulder and elbow movements and their maximum velocities. The hand velocity profile was bell-shaped in the static condition and compatible with ramp movements for the more affected side in the dynamic condition. The time to object contact was higher for the more affected side in the dynamic condition. The temporal coordination index illustrated an immature and less flexible behaviour in children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s reaching in all the examined conditions. Study of the hand velocity profiles, the time to object contact and the temporal coordination index highlighted, first, the dependence of upper limb interjoint coordination on task, context, residual resources and individual solution, and secondly, the sensory-motor deficit characteristics of the children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s more affected side during dynamic reaching, raising the prospect of a promising training context in children with hemiplegia.
Journal of Rehabilitation Medicine, 2009
The aim of this pilot study was to examine changes in different aspects of impairment, including ... more The aim of this pilot study was to examine changes in different aspects of impairment, including spasticity in the upper limbs, of hemiplegic children following botulinum toxin type A intervention. Progress was assessed using standard clinical measurements and a robotic device. Design: Pre-post multiple baseline. Subjects: Six children with hemiplegia. Methods: Botulinium toxin type A injections were administered into the affected upper limb muscles. Outcomes were evaluated before and one month after the injection. Outcome assessments included: Melbourne Scale, Modified Ashworth Scale (MAS) and Passive Range of Motion. Furthermore, a robotic device was employed as an evaluation tool. Results: Patients treated with botulinum toxin type A had significantly greater reduction in spasticity (MAS, p < 0.01), which explains an improvement in upper limb function and quality movement measured with the Melbourne Scale (p < 0.01). These improvements are consistent with robot-based evaluation results that showed statistically significant changes (p < 0.01) following botulinum toxin type A injections. Conclusion: The upper limb performs a wide variety of movements. The multi-joint nature of the task during the robotmediated evaluation required active control of joint interaction forces. There was good correlation between clinical scales and robotic evaluation. Hence the robot-mediated assessment may be used as an additional tool to quantify the degree of motor improvement after botulinum toxin type A injections.
Journal of Rehabilitation Medicine, 2009
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Papers by Enrico Castelli