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Search Results: 1 - 10 of 400731 matches for " Chiappedi M "
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Easy quantitative methodology to assess visual-motor skills
Chiappedi M,Toraldo A,Mandrini S,Scarpina F
Neuropsychiatric Disease and Treatment , 2013,
Abstract: Matteo Chiappedi,1 Alessio Toraldo,2 Silvia Mandrini,3 Federica Scarpina,2 Melissa Aquino,2 Francesca Giulia Magnani,2 Maurizio Bejor31Don Carlo Gnocchi ONLUS Foundation, Milan, Italy; 2University of Pavia, Department of Psychology, Pavia, Italy; 3University of Pavia, Department of Surgical, Resuscitative, Rehabilitative and Transplant Sciences, Pavia, ItalyIntroduction: Visual-motor skills are the basis for a great number of daily activities. To define a correct rehabilitation program for neurological patients who have impairment in these skills, there is a need for simple and cost-effective tools to determine which of the visual-motor system levels of organization are compromised by neurological lesions. In their 1995 book, The Visual Brain in Action (Oxford: Oxford University Press), AD Milner and MA Goodale proposed the existence of two pathways for the processing of visual information, the “ventral stream” and “dorsal stream,” that interact in movement planning and programming. Beginning with this model, our study aimed to validate a method to quantify the role of the ventral and dorsal streams in perceptual and visual-motor skills.Subjects and methods: Nineteen right-handed healthy subjects (mean age 22.8 years ± 3.18) with normal or corrected-to-normal vision were recruited. We proposed that a delayed pointing task, a distance reproduction task, and a delayed anti-pointing task could be used to assess the ventral stream, while the dorsal stream could be evaluated with a grasping task and an immediate pointing task. Performance was recorded and processed with the video-analysis software Dartfish ProSuite.Results: Results showed the expected pattern of predominance of attention for the superior left visual field, predominance of the flexor tone in proximal peri-personal space arm movements, tendency toward overestimation of short distances, and underestimation of long distances.Conclusion: We believe that our method is advantageous as it is simple and easily transported, but needs further testing in neurologically compromised patients.Keywords: dorsal stream, ventral stream, visual-motor skills, rehabilitation, neurological disorders
Inpatient rehabilitation outcome: a matter of diagnosis?
Bejor M, Ramella FC, Dalla Toffola E, Comelli M, Chiappedi M
Neuropsychiatric Disease and Treatment , 2013, DOI: http://dx.doi.org/10.2147/NDT.S39922
Abstract: patient rehabilitation outcome: a matter of diagnosis? Original Research (480) Total Article Views Authors: Bejor M, Ramella FC, Dalla Toffola E, Comelli M, Chiappedi M Published Date February 2013 Volume 2013:9 Pages 253 - 257 DOI: http://dx.doi.org/10.2147/NDT.S39922 Received: 04 November 2012 Accepted: 30 November 2012 Published: 18 February 2013 Maurizio Bejor,1 Francesca Chiara Ramella,1 Elena Dalla Toffola,1 Mario Comelli,2 Matteo Chiappedi3 1University of Pavia, Department of Surgical, Resuscitative, Rehabilitative and Transplant Sciences, Pavia, Italy; 2University of Pavia, Department of Brain Sciences, Medical Statistics Section, Pavia, Italy; 3Don Carlo Gnocchi ONLUS Foundation, Milan, Italy Background: Patients with comorbidities are becoming more and more common in Italian rehabilitative wards. These comorbidities are considered a major problem for inpatient rehabilitation, due to the fact that they cause longer lengths of stay, higher costs, and lower functional results. Methods: To investigate the possible relationships between comorbidity, functional impairment, age, and type of discharge in patients hospitalized in postacute rehabilitation facilities, we planned an observational study. A total of 178 consecutive inpatients (average age: 78 years [range: 39–99]) from postacute rehabilitation facilities were recruited. Primary diagnosis, comorbidity rating (Cumulative Illness Rating Scale – Geriatric version, CIRS-G) and functional impairment score (Functional Independence Measure, FIM ) were evaluated at admission. The FIM rating was also assessed at hospital discharge. Results: A total of 178 of the 199 enrolled patients completed the rehabilitation treatment (89.4%). The average length of stay was 46 ± 24 days. CIRS-G showed an average comorbidity score for each patient of 4.45 ± 1.69. The average FIM rating was 79 ± 24.88 at admission, and 91.9 ± 25.7 at discharge. Diagnosis at admission (grouped according to the International Classification of Diseases 9-CM) seemed to correlate with functional results, since lower rehabilitative efficiency was obtained for patients who had a history of stroke. Conclusion: The number and type of comorbidities (CIRS-G) in rehabilitation inpatients do not seem to affect functional outcomes of treatment. The determining factor for a lower level of functional recovery seems to be the diagnosis at admission.
Easy quantitative methodology to assess visual-motor skills
Chiappedi M, Toraldo A, Mandrini S, Scarpina F, Aquino M, Magnani FG, Bejor M
Neuropsychiatric Disease and Treatment , 2013, DOI: http://dx.doi.org/10.2147/NDT.S37187
Abstract: sy quantitative methodology to assess visual-motor skills Methodology (1397) Total Article Views Authors: Chiappedi M, Toraldo A, Mandrini S, Scarpina F, Aquino M, Magnani FG, Bejor M Published Date January 2013 Volume 2013:9 Pages 93 - 100 DOI: http://dx.doi.org/10.2147/NDT.S37187 Received: 21 August 2012 Accepted: 23 October 2012 Published: 14 January 2013 Matteo Chiappedi,1 Alessio Toraldo,2 Silvia Mandrini,3 Federica Scarpina,2 Melissa Aquino,2 Francesca Giulia Magnani,2 Maurizio Bejor3 1Don Carlo Gnocchi ONLUS Foundation, Milan, Italy; 2University of Pavia, Department of Psychology, Pavia, Italy; 3University of Pavia, Department of Surgical, Resuscitative, Rehabilitative and Transplant Sciences, Pavia, Italy Introduction: Visual-motor skills are the basis for a great number of daily activities. To define a correct rehabilitation program for neurological patients who have impairment in these skills, there is a need for simple and cost-effective tools to determine which of the visual-motor system levels of organization are compromised by neurological lesions. In their 1995 book, The Visual Brain in Action (Oxford: Oxford University Press), AD Milner and MA Goodale proposed the existence of two pathways for the processing of visual information, the “ventral stream” and “dorsal stream,” that interact in movement planning and programming. Beginning with this model, our study aimed to validate a method to quantify the role of the ventral and dorsal streams in perceptual and visual-motor skills. Subjects and methods: Nineteen right-handed healthy subjects (mean age 22.8 years ± 3.18) with normal or corrected-to-normal vision were recruited. We proposed that a delayed pointing task, a distance reproduction task, and a delayed anti-pointing task could be used to assess the ventral stream, while the dorsal stream could be evaluated with a grasping task and an immediate pointing task. Performance was recorded and processed with the video-analysis software Dartfish ProSuite. Results: Results showed the expected pattern of predominance of attention for the superior left visual field, predominance of the flexor tone in proximal peri-personal space arm movements, tendency toward overestimation of short distances, and underestimation of long distances. Conclusion: We believe that our method is advantageous as it is simple and easily transported, but needs further testing in neurologically compromised patients.
Corpus callosum agenesis and rehabilitative treatment
Matteo Chiappedi, Maurizio Bejor
Italian Journal of Pediatrics , 2010, DOI: 10.1186/1824-7288-36-64
Abstract: Etiology and pathogenetic mechanisms have been better understood in recent years, due to the availability of more adequate animal models and the relevant progresses in developmental neurosciences. These recent findings are reviewed (through a MedLine search including papers published in the last 5 years and most relevant previously published papers) in view of the potential impact on children's global functioning and on the possible rehabilitative treatment, with an emphasis on the possibility to exploit brain plasticity and on the use of the ICF-CY framework.Corpus Callosum Agenesis (CCA) is among the most common brain malformations observed in humans [1]. Its incidence varies as a function of both diagnostic techniques and sample populations: in the general population, its estimated prevalence is 3-7 per 1000 birth, while in children with developmental disabilities it is 2-3 per 100 [2-4]. It is often associated with other anomalies such as Chiari II malformation (also known as proper Chiari malformation) with abnormal development of cerebellar vermis and medulla oblongata, which tend to descend into the foramen magnum, usually accompanied by myelomeningocele, basilar type encephalocele and disorders of neural migration (which occurs concurrently in human brain development) such as schizencephaly, lissencephaly, pachygyria, marked neuronal heterotopias. Recent neuroradiological findings [5] suggest that CCA might lie along a dysgenetic spectrum, including all commissural anomalies as part of an overall cerebral dysgenesis. Abnormal sulcation is common and suggests more diffuse white matter dysgenesis in these foetuses [6], even if some authors do not consider this as an additional brain abnormality [7]. The isolated form of CCA is however listed in OMIM (217990) and ORPHAnet (ORPHA200).Patients with CCA have a clinical syndrome which had originally been thought to be a consequence of hemispheres' disconnection. Recent studies, however, pointed out that patients wi
Complete Corpus Callosum Agenesis: Can It Be Mild?
Matteo Chiappedi,Anna Fresca,Ilaria Maria Carlotta Baschenis
Case Reports in Pediatrics , 2012, DOI: 10.1155/2012/752751
Abstract: Corpus callosum agenesis is a relatively common brain malformation. It can be isolated or included in a complex alteration of brain (or sometimes even whole body) morphology. Etiology and pathogenetic mechanisms have been better understood in recent years due to the availability of more adequate animal models and the relevant progresses in developmental neurosciences. We present the case of a girl with a complete agenesis of the corpus callosum discovered at birth. She had mild learning difficulties, but reached satisfactory levels of autonomy after an individually tailored rehabilitative treatment. Her story is discussed in light of recent findings, which emphasize the possibility to exploit brain plasticity and the utility of an individually tailored approach, defined on the basis of a dialogue with the family and the patient.
Autism and classification systems: a study of 84 children
Matteo Chiappedi, Giorgio Rossi, Maura Rossi, Maurizio Bejor, Umberto Balottin
Italian Journal of Pediatrics , 2010, DOI: 10.1186/1824-7288-36-10
Abstract: We tried to classify them according to ICD 10, DSM IV TR, CFTMEA-R, "operational classification" (Manzano and Palacio) and de Ajuriaguerra's classification.We found a good correspondence between DSM IV TR and ICD 10 and the use of psychodynamic classification systems (in particular CFTMEA-R) was useful to differentiate clinical subtypes collected under the PDD NOS etiquette according to DSM IV TR.To rationalize research efforts and find better tailored therapies, we need to improve PDD classification systems, using contributions coming from every field of child psychiatry and neurology: it's possible that 0-3 Classification could help this.A number of studies have shown that current classification systems (ICD 10 [1], DSM IV TR [2]) have limitations when applied to children with Autism Spectrum Disorders. According to Cohen and Volkmar [3] classification systems should aim at improving communication, through their features (internal consistency, use easiness, good definition of categories) and being widely accepted. Cantwell [4] underlines that a classification system should provide a description unifying clinical, biochemical, genetical, neurophysiological and neuroimaging findings to identify specific categories with a unique natural history, prognosis and (if possible) therapy. This system should also be logical and easy to use in clinical settings. The term Autism Spectrum Disorders comes from the theoretical work of many Authors and includes a continuum moving from the "classical" autism described by Kanner, to Asperger's syndrome, to autistic-like forms and even to autistic traits in mental retardation [5].Phenomenological polymorphism and a natural course not moving towards "normality" are among the main factors which make it difficult to reach a shared classification system. After the important contributions by Rutter and Ritvo, DSM III was the first system to use the Pervasive Developmental Disorders (PDD) category, which meant to be an a-theoretical defini
Listening to the patient as a possible route to cost-effective rehabilitation: a case report
Attilia Grandi, Marcella Mazzola, Lucia Angelini, Matteo Chiappedi
Journal of Medical Case Reports , 2012, DOI: 10.1186/1752-1947-6-19
Abstract: We present the case of a 17-year-old Italian male patient with hemiplegia who had received standard physiotherapy and, ultimately, after a period of adapted physical activity performed in a group, was under consideration for discharge. However, due to unsatisfactory hand control, he asked for help to reach a personal goal, the ability to drive a motorbike, without surgery. Functional taping showed efficacy, but was neither cost-effective nor practical for the patient and his family; by contrast, a dynamic orthosis associated with training in a real-life environment was instead successful.The present case underlines the importance of considering solutions involving the motivation and compliance of the patient in order to improve his activity and participation.Adolescents with a mild form of cerebral palsy often do not need a specific rehabilitative treatment [1], however, they can present specific requests which need to be considered in order to increase their wellbeing. From a biopsychosocial point of view, as suggested by the World Health Organization [2], their needs should be understood not only in terms of impairment (problems in body functions and/or structures), but also with respect to activity limitations (difficulties in executing activities) and/or participation restrictions (limitations an individual may experience in social involvement) in a dynamic interaction with environmental factors. The recent version of the International Classification of Functioning, Disability and Health (ICF) for Children and Youth [3] adds that the temporal perspective should not be neglected, with the related changes in terms of body functions and structures, but also of interests, desires and relevant activities and participations.The reported case highlights the importance of paying attention to specific needs indicated by a patient, but also the utility and cost-effectiveness of using orthosis in this context.Our Italian male patient was first seen in the Rehabilitation Ce
Complete Corpus Callosum Agenesis: Can It Be Mild?
Matteo Chiappedi,Anna Fresca,Ilaria Maria Carlotta Baschenis
Case Reports in Pediatrics , 2012, DOI: 10.1155/2012/752751
Abstract: Corpus callosum agenesis is a relatively common brain malformation. It can be isolated or included in a complex alteration of brain (or sometimes even whole body) morphology. Etiology and pathogenetic mechanisms have been better understood in recent years due to the availability of more adequate animal models and the relevant progresses in developmental neurosciences. We present the case of a girl with a complete agenesis of the corpus callosum discovered at birth. She had mild learning difficulties, but reached satisfactory levels of autonomy after an individually tailored rehabilitative treatment. Her story is discussed in light of recent findings, which emphasize the possibility to exploit brain plasticity and the utility of an individually tailored approach, defined on the basis of a dialogue with the family and the patient. 1. Introduction Corpus callosum agenesis (CCA) is among the most common brain malformations observed in humans [1]. Its incidence varies as a function of both diagnostic techniques and sample populations: in the general population, its estimated prevalence is 3–7 per 1000 birth, while in children with developmental disabilities it is 2-3 per 100 [2]. It is often associated with other anomalies such as Chiari II malformation (also known as proper Chiari malformation) with abnormal development of cerebellar vermis and medulla oblongata, which tend to descend into the foramen magnum, usually accompanied by myelomeningocele, basilar type encephalocele, and disorders of neural migration (which occurs concurrently in human brain development) such as schizencephaly, lissencephaly, pachygyria, and marked neuronal heterotopias. Recent neuroradiological findings [3] suggest that CCA might lie along a dysgenetic spectrum, including all commissural anomalies as part of an overall cerebral dysgenesis. The isolated form of CCA is however listed in OMIM (217990) and Orphanet (Orpha 200). Patients with CCA have a clinical syndrome which had originally been thought to be a consequence of hemispheres’ disconnection. Recent studies, however, pointed out that besides the already described abnormalities of sulcation, patients with CCA have abnormal microstructure and reduced volume of the ventral cingulum bundle, suggesting that abnormalities in intrahemispheric white-matter tracts may be an important factor [4]. Another interesting recent finding is a reduction in number of von Economo neurons, large spindle-shaped neurons localized to anterior cingulated cortex, and frontoinsular cortex in patients with CCA; this is considered another consequence
Abilities of preschoolers: comparing different tools
Matteo Chiappedi, Erika Maffioletti, Fausta Piazza, Nicole D'Adda, Marta Tamburini, Umberto Balottin
Italian Journal of Pediatrics , 2012, DOI: 10.1186/1824-7288-38-3
Abstract: We evaluated 58 children attending for the first time the last year of the Scuola dell'Infanzia. Parental view was obtained with Child Behaviour Check-List and Conners' Rating Scales - Revised, and family socio-economic status was evaluated using Hollingshead's Four Factor Index; teacher compiled the IPDA questionnaire; children were administered Raven's Progressive Matrices, Modified Bell Cancellation Test, BVN 5-11 (a neuropsychological battery).A correlational analysis was conducted using Spearman's Rho (since variables were not normally distributed). These asymptomatic children show a good global cognitive functioning, but also a deficit of attention and of Executive Functions. Some of the tests used seem more cost-effective than others and there are some redundancies in information obtained.Our data show that there are significant correlations between different neuropsychological and behavioural measures. It is therefore possible to rationalize diagnostic protocols without a significant information reduction. A deeper analysis will require a preliminary definition of the psychometric properties of used tools.Different neuropsychological functions have been shown in pre-schoolers to be more closely correlated to successive school achievement [1]: the integration of several cognitive and perceptual-motor skills is required since the beginning of primary school [2]. English-based literature has focused on letter recognition, spelling ability, phonemic awareness for reading and writing [1,3] and number recognition, quantity processing and counting for mathematical skills [4,5]. Given that Italian, unlike English, has an almost fully transparent orthography, it is perhaps understandable that studies conducted in Italy have shown a preminent role of metaphonological skills [6]. It has been written that these abilities represent a crystallized knowledge, deriving from experiences conducted at home, at the nursery or in other social contests; the role of the so called
Gilles de la Tourette's syndrome in a patient with 47(XXX) syndrome: a case report
Matteo Chiappedi, Silvia de Vincenzi, Roberta Dolci, Sara De Luca, Maurizio Bejor
Journal of Medical Case Reports , 2011, DOI: 10.1186/1752-1947-5-542
Abstract: An Italian Caucasian girl was referred at the age of 11 to our Rehabilitation Center for anxiety and learning difficulties. The girl had already been diagnosed as having 47(XXX) syndrome; she had some rather typical features of the chromosomal abnormality, but she also showed a high level of anxiety and the presence of motor and vocal tics. When an accurate history was taken, a diagnosis of Gilles de la Tourette's Syndrome emerged.The possible interaction between peculiar features of these two syndromes in terms of neuropsychological and affective functioning is both interesting for the specific case and to hypothesize models of rehabilitation for patients with one or both syndromes. Executive functions are specifically reduced in both syndromes, therefore it might be hard to discriminate the contribution of each one to the general impairment; the same applies to anxiety. Moreover, mental retardation (with a significantly lower verbal cognitive functioning) poses relevant problems when suggesting cognitive behavioral or psychoeducational rehabilitative approaches.47(XXX) syndrome, also known as triple X syndrome, was first described in 1959 by Jacobs and coworkers in a woman with ovarian failure [1]. The 47(XXX) karyotype has a frequency of one in 1000 female newborns, but this syndrome is not usually suspected at birth or childhood and is often diagnosed incidentally with prenatal diagnosis or following medical testing for infertility. Diagnosis is confirmed by karyotype analysis and the most common cause is lack of disjunction during maternal meiosis [2]. Patients with 47(XXX) syndrome do not usually present with major malformations, but rather subtle and highly variable clinical features such as high stature, poor motor coordination, language delay, and learning disabilities (often mild) [3]. In some cases patients may present some behavioral problems, such as hyperactivity, poor social interaction, depressive traits or mild depression: even though these psychopa
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