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Evaluation and Rehabilitation of Cerebral Palsy

Research Center
Research Area

Supervisor

Dott. Luigi Piccinini
Physiatrist, Director of Functional Rehabilitation Unit
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Team

Dott.ssa Cristina Maghini
Physiatrist

Dott.ssa Barbara Bonaiti
Physiatrist

Dott.ssa Chiara Gagliardi
Child Neuropsychiatrist

Dott.ssa Chiara Germiniasi
Physiatrist

Dott.ssa Claudia Guerra
Physiatrist

Dott.ssa Simona Manzoni
Physiatrist

Dott.ssa Anna Carla Turconi
Physiatrist

Contacts

+39 031 877866

+39 031 877829 - Secretary

Description

Cerebral Palsy (CP) is a group of permanent but not unchangeable disorders of movement and posture that cause a limitation of activities, attributed to events occurring before the brain has completed its development in fetus, newborn or infant.
Motor disturbances are prevalent but not exclusive and can accompany problems of sensory-perceptions, cognition, communication, behavior, critical phenomena and secondary skeletal muscle problems. CP is therefore a condition due to central nervous system changes due to pre-, post- or post-natal causes before it completes growth and development, extremely heterogeneous in terms of etiology, type and severity of the disorder itself. Classification systems allow the functional framing of the patient and a common language recognized at international level, in particular:
GMFCS for the evaluation of gross-motor skills
MACS for Bimanual Skills Assessment
CFCS for assessing the effectiveness of communication
EDACS for assessing the ability in eating and drinking
VFCS for evaluating the use of visual function
Instrumental examinations can be performed for complex motor evaluations: isokinetics, surface EMG, stabilometry, Gait analysis, oxygen consumption.
The rehabilitation approach should respect the child's centrality and provide for customized functional activities while safeguarding the emotional dimension of the child
The treatment, aimed at building adaptive functions, is the result of an integrated process, not only motor but also perceptual, visual, cognitive, praxic-manipulative. It is therefore necessary to provide a multidisciplinary approach that should be premature and of high intensity with the involvement of the family.
These include early integrated treatment and constraint induced movement therapy (CIMT) consisting in the therapeutic penalization of the limb maintained and directed to patients with hemiplegia.
Robotic rehabilitation is considered a therapeutic option in treating patients with motor impairment with neurological aetiology.
Robotic systems are particularly well suited to training motor functions because they allow to produce and control with high precision different forces, allowing for personalization of rehabilitation and stimulation of tactile, perceptual and visual sensory systems.
The main devices used in this field are the DGO (Driven Gait Orthosis) (Lokomat) for the robotic gait rehabilitation and the Armeo for upper limb treatment. It is currently considered that the use of robotic systems is an integral part of the rehabilitation program. In experimental projects, a rehabilitation system was also introduced through immersive virtual reality.

Selected publications

Partnership

  • Neurological Institute “C. Besta”- Milan
  • Italian Group for Cerebral Palsy (GIPCI)
  • Gillette Children’s Specialty Healthcare – Saint Paul – MN – USA
  • Karolinska Institutet - Ann-Christin Eliasson – Stockolm
  • Kinderspital – Zurich – Andreas Meyer
  • Hokoma – Motek Force – Floris Morang

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