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Purpose: The Fugl-Meyer Assessment is the most used and highly recommended clinical assessment of sensorimotor function after stroke. A standardized use of the scale in different countries requires translation and cultural validation to the target language. The objective of the study was to develop an official Italian version of the scale by transcultural translation and validation.Methods: A standardized multistep translation protocol was adopted to achieve optimal conceptual and semantic equivalence. The developed Italian version was validated in 10 post-stroke hemiparetic patients. Items with low intra- and interrater agreement, quantified as percentage of agreement

There is consistent evidence that robotic rehabilitation is at least as effective as conventional physiotherapy for upper extremity (UE) recovery after stroke, suggesting to focus research on which subgroups of patients may better respond to either intervention. In this study, we evaluated which baseline variables are associated with the response after the two approaches. This is a secondary analysis of a randomized-controlled trial comparing robotic and conventional treatment for the UE. After the assigned intervention, changes of the Fugl-Meyer Assessment UE score by ≥ 5 points classified patients as responders to treatment. Variables associated with the response were identified in a univariate analysis. Then, variables independently associated with recovery were investigated, in the whole group, and the two groups separately. A sample of 190 patients was evaluated after the treatment; 121 were responders. Age, baseline impairment, and neglect were significantly associated with worse response to the treatment. Age was the only independently associated variable (OR 0.967, p = 0.023). Considering separately the two interventions, age remained negatively associated with recovery (OR 0.948, p = 0.013) in the conventional group, while none of the variables previously identified were significantly associated with the response to treatment in the robotic group. We found that, in our sample, age is significantly associated with the outcome after conventional but not robotic UE rehabilitation. Possible explanations may include an enhanced positive attitude of the older patients towards technological training and reduced age-associated fatigue provided by robotic-assisted exercise. The possibly higher challenge proposed by robotic training, unbiased by the negative stereotypes concerning very old patients’ expectations and chances to recover, may also explain our findings. NCT02879279.

Aims To investigate the frequency, the prognostic effect on functional status and the urodynamic patterns of post-stroke urinary incontinence (UI) in a sample of in-patients affected by ischemic stroke. Methods One hundred six patients with recent ischemic stroke admitted to a neurorehabilitation unit were enrolled. Stroke localization was made according to the Oxfordshire Community Stroke Project (OCSP) stroke subtypes and assessment of stroke severity using the National Institute of Health Stroke Scale (NIHSS). The presence of UI was associated with functional status, measured with Barthel Index and Functional Independence Measure (FIM). At admission, urodynamic studies were performed on all the patients and repeated in 63 patients after 30 days. Results Eighty-four patients (79%) were incontinent. Incontinence was associated with age (P

Objective: To determine the prognostic value of clinical assessment and motor evoked potentials for upper limb strength and functional recovery after acute stroke, and to establish the possible use of motor evoked potentials in rehabilitation. Design: A prospective study. Subjects: Fifty-two patients with hemiparesis were enrolled one month post-stroke; 38 patients concluded the study at 12 months. Methods: Motor evoked potentials were recorded at baseline and after one month. Upper limb muscular strength (Medical Research Council Scale, MRC) and functional tests (Frenchay Arm Test, Barthel Index) were used as dependent outcome variables 12 months later. Motor evoked potentials were classified as present or absent. Predictive values of motor evoked potentials and MRC were evaluated. Results: At 12 months, patients with baseline recordable motor evoked potentials showed a good functional recovery (positive predictive value 94%). The absence of motor evoked potentials did not exclude muscular strength recovery (negative predictive value 95%). Motor evoked potentials had a higher positive predictive value than MRC only in patients with MRC < 2. Conclusion: Motor evoked potentials could be a supportive tool to increase the prognostic accuracy of upper limb motor and functional outcome in hemiparetic patients, especially those with severe initial paresis (MRC < 2) and/or with motor evoked potentials absent in the post-stroke acute phase.

To investigate the frequency, the prognostic effect on functional status and the urodynamic patterns of post-stroke urinary incontinence (UI) in a sample of in-patients affected by ischemic stroke.One hundred six patients with recent ischemic stroke admitted to a neurorehabilitation unit were enrolled. Stroke localization was made according to the Oxfordshire Community Stroke Project (OCSP) stroke subtypes and assessment of stroke severity using the National Institute of Health Stroke Scale (NIHSS). The presence of UI was associated with functional status, measured with Barthel Index and Functional Independence Measure (FIM). At admission, urodynamic studies were performed on all the patients and repeated in 63 patients after 30 days.Eighty-four patients (79%) were incontinent. Incontinence was associated with age (P0.05) and functional disability (P=0.01), but not with sex, side of stroke, or time from stroke to entry in the study. Urodynamic studies, performed on all 106 patients at admission, showed normal studies in 15%, detrusor overactivity (DO) in 56%, detrusor overactivity with impaired contractility (DOIC) in 14%, and detrusor underactivity (DU) in 15%. After 1 month urodynamic studies, repeated on 63 patients, showed normal studies in 30%, DO in 48%, DOIC in 6%, and DU in 16%.Incontinent patients showed a worse functional outcome compared to continent patients. Post-stroke incontinence may be associated with different urodynamic patterns, each of which may necessitate different treatment strategies. Urodynamic findings in patients with ischemic stroke vary depending upon timing of the study.

Magnesium oxide reacts with dimethylammonium dimethylcarbamate, [Me2NH2][O2CNMe2], in toluene yielding the carbonato-carbamato complex [Me2NH2]3[Mg8(CO3)2(O2CNMe2)15] 1, which gradually loses [Me2NH2][O2CNMe2] upon mild heating or by lowering the carbon dioxide pressure to give products of intermediate composition [Me2NH2]n[Mg8(CO3)2(O2CNMe2)12+n] with n ranging from 3 to 0, the neutral complex [Mg8(CO3)2(O2CNMe2)12], 2, being obtained upon exhaustive treatment in vacuo. The equilibria may be shifted back from 2 to 1 by using an excess of [Me2NH2][O2CNMe2]. The same products were obtained in low yields by reacting magnesium with [Me2NH2][O2CNMe2]: in this case the reaction proceeds slowly, being presumably promoted by the presence of some MgO and/or H2O. The crystal and molecular structure of 1 has been studied by single-crystal X-ray diffraction methods, the anion containing a ring of eight edge- or apex-sharing {MgO6} distorted octahedra, with Mg–O distances in the range from 1.921 to 2.313 A. The framework is kept together by two μ6-carbonato ligands and by the fifteen carbamato ligands. The ionic aggregates [NH2Me2]3[Mg8(CO3)2(OCONMe2)15] are alternated in the crystal with heptane molecules and only weak van der Waals interactions are present between adjacent octanuclear aggregates, in agreement with the solubility of the substance in toluene. To cite this article: D. Belli Dell'Amico et al., C. R. Chimie 7 (2004).