The Nice Project

Start –up meeting Santiago November 10th- 11th 2010

Start –up meeting Santiago November 10- 11 20010

Agenda

The NICE project Presentation

NICE = New Italian Chilean Excellence

The project started from the collaboration between Italy and Chile

A project supported by

The partners Teleton Gait Analysis Lab

A long collaboration: from 2002

Teleton Gait Analysis Lab

A long collaborationbased on

gait and movement analysis

The aim of the project Definition of protocols for the evaluation of

the functional limitation and cerebral activity in children with disability before and

after specific rehabilitative treatments.

MOVEMENT BRAIN

The labs

“Luigi Divieti”Movement analysis

LabLaboratory EDSB

Why? Actually the literature introduces new

studies focused on the relationship between mental function and motor

evaluation.

OUTPUT: MOVEMENTINPUT: BRAIN

From a clinical point of view? It is important to study the movement

and the brain activity in children with CP and in particular in pre and post

treatment

MOVEMENT IMPROVEMENTBRAIN: ???

Cerebral palsyPRE and POST

Quantified w

ith

motion Labs

Partner presentation

• Chilean partner presentation •“Luigi Divieti” Gait Analysis Lab•EDSB Lab

Detailed description of the project

Beginning of the activities: July 2010

The project is focused on

Children with CP before and after

treatments

Quantitative movement analysis Brain quantitative analysis

The project is divided in the following points:

1) the definition of the experimental protocol (set up of the equipments);

2) the identification of tasks and parameters for the characterization of the motor gesture and of the associated cerebral activity;

3) the realization of dedicated reports;

4) the application of the defined protocols to a group of subjects without disability in order to obtain the reference parameters related to a control population;

The main activities of the project

5) the transfer of the protocols to the clinics, in particular to the Chilean partner.

The considered treatments are the principal treatments for the reduction of the spasticity, that is a consequence of cerebral palsy, for instance botulinum toxin, treatments for the functional recovery like orthopaedic surgery, specific rehabilitative treatments with orthesis and rehabilitative exercises;

The main activities of the project

Timetable

1) A1 Start Up meeting November 2010.Involved staff: staff of the Bioengineering Department/University of

Chile/Rehabilitation Centre Teleton.Place: Santiago del ChileDuration: 2 days 2) A2 activity – realization of the project web siteInvolved staff: staff of the Bioengineering DepartmentPlace: Bioengineering Department, Politecnico di Milanowww.nice.polimi.it

DONE

Work

in progre

ss

timetable

3) A3 activity – Equipment set upInvolved staff: Bioengineering Department staff.Place: Laboratory “Luigi Divieti” and Laboratory “EDSB”, Bioengineering

Department

Synthetic description of the activity: equipment set up and purchase of the consumable materials necessary for

the realization of the project.

Work in progress

Timetable

4) A4 activity – set up of protocols for the patients’ evaluationPlace: Laboratory “Luigi Divieti” and Laboratory “EDSB”, Bioengineering Department

Synthetic description of the activity:definition of protocols for the movement acquisition and for the recording of cerebral activity. The employed resources are the instrumental resources already present in the laboratories “Luigi Divieti “ and “EDSB” of the Bioengineering Department and the staff of the Bioengineering Department.The Chilean partner will also be involved for the definition of these protocols.Inside this activity attention will be paid to the definition of the kind of movement to be evaluated, that be particularly significant for the evaluation of the functional limitation in the paediatric patient, to the modality of the experimental trials, to the definition of models for the biomechanical evaluation of the movement, to the identification of clinical parameters useful for the characterization of the movement.

December-January

For the discussion: which tasks??

Timetable

5) A5 activity – selection of the patientsPlace: University of Medicine, Santiago del Chile

Synthetic description of the activity:Paediatric subjects will be selected. Based on the single patient the specific treatment to be applied will be identified (pharmacological treatment, surgery, orthesis, rehabilitation,…) together with the schedules of the post treatment acquisitions (depending on the typology of treatment).

December-January

For the discussion: Subjects selection criteria??

Timetable

6) A6 activity – transfer of the protocols for the evaluation of movement and EEG activity to the Chilean partner

Involved staff: staff of the Bioengineering Department, staff of the Medicine UniversityPlace: Santiago del Chile. Laboratory of Movement and EEG Analysis of the Teleton

Rehabilitation Centre.

Synthetic description of the activity:Acquisition on subjects before (pre) treatment.

Once the protocols have been defined they will be transferred to the Chilean partner during a visit of the Bioengineering Department researchers to the university and the clinical centre (Teleton rehabilitation centre). The instrumental resources to be used will be the ones located in the Movement Analysis Laboratory of the Teleton clinical centre. The staff from the Bioengineering department will follow both with in loco visits and remotely the application of the protocols to the patients, with an in loco presence of one month, guaranteeing a remote support in the following period.

March 2011

For the discussion: availability of an EEG system in Chile??

timetable

7) A7 activity – normality of referenceParticipants: staff of the Bioengineering DepartmentPlace: “Luigi Divieti” and Laboratory “EDSB”, Bioengineering DepartmentDuration: 6 monthsSynthetic description: the staff of the Bioengineering Department will work, in the

laboratories, to the acquisition of normal subjects in order to create a reference normality.

Involved staff: staff of Politecnico di Milano 8) A8 activity – application of the rehabilitative treatmentsPlace: Santiago del ChileDuration: 6 monthsInvolved staff: staff of the University of MedicineSynthetic description of the activity: the Chilean partner will apply the selected treatments

to the patients.

March –September 2011

For the discussion: how many subjects/patients??

timetable

9) A9 activity – post-treatment evaluationPlace: Laboratory of Movement Analysis, Teleton centre, Chile

Involved staff: staff of the University of Medicine and of Politecnico di MilanoSynthetic description of the activity: the protocols will be applied after the treatment

(post treatment) and the data will be collected by the staff of Politecnico, who will attend to some of the post treatment acquisitions and will transfer the data to Politecnico di Milano.

10) A10 activity – data elaboration and analysisThe Bioengineering Department will attend to the elaboration of the normal and

pathological subjects’ (pre and post treatment) data. The Bioengineering Department will look after the analysis of the EEG signal acquired at the clinical centres.

Involved staff: staff of the Bioengineering Department

September December 2011

Timetable

11) 11 activity – presentation of the results and final meetingPlace: Santiago del ChileInvolved staff: the whole participants to the projectVia web meetings between the coordinators will be organized in order

to verify the progress of the scheduled activities, as indicated by the management plan.

Jan or March 2012

Discussion

1. availability of EEG equipment in Chile;2. selection criteria for the pathological subjects;3. which task (gait, posture, upper limb)?4. how many subjects?5. rehabilitative treatments considered.

timetable

Motion analysis and EEG

MA and EEG

Place University LabEEG and touch screeen provided by PolitecnicoStaff for the acquisition Politecnico and Chilean staff

Treatment Botulinum Toxin injection

Movement Upper limb

Numberof patientsat least 20 patients (before and after injectionor before and after CIMT)PRE April 2010POST September 2011

Selection criteria• Functional limitation of upper limbs in program for Botulinum Toxin injection for upper limb• Hemiplegic and diplegic patients• Age: homogeneous age

MA and EEG

Patients

Movements• Reaching movement (just touch and go back, with

touch screen)

• In hemiplegic patients movement required with the plegic and non-plegic side

• In diplegic patients movement required with the both sides

MA and EEG

Clinical evaluations

• Ashworth• GMFM• Questionnaire

MA and EEG

Motion analysis

MA

Place Teleton LabStaff for the acquisition Chilean staff

Movement pre and post Treatment • Gait 34 Botulinum Toxin injection (7Botox vs 7 chinese),already done

• STS Strenght training and FSE and Physioterpahy , …• Posture Lokomat,?? vibratory platform (110 patients) already done