Dottorato in INGEGNERIA INDUSTRIALE E GESTIONALE

Titolo della tesi: Multi-modal platform design to perform upper limb assessment in subjects with neurological diseases

Neurological diseases are the leading causes of death and disability recognized by the Global Burden of Diseases Injuries and Risk Factors Study in a worldwide study; stroke represents one of the most frequent diseases in Western countries, as a result of which, the patient presents with severe cognitive and motor disorders in the lower and/or upper limbs in the contralateral side to the injured cortical area. Following the injury, the patient first undergoes a functional assessment to objectively describe the patient's condition, and based on the patient's profiling, a personalized neurorehabilitation protocol is planned with the goal of functionally improving motor and cognitive functions. One of the most widely used clinical tests in the clinical setting is the Box&Blocks test, which provides qualitative information about a patient's manual dexterity by measuring the displacement of blocks between two standard-sized compartments in a predetermined time; however, the test does not allow for an objective functional assessment for the identification of muscle disorder during its performance. This work focuses on the patient's functional assessment modalities by introducing a multimodal assessment platform based on electroencephalography, surface electromyography and biomechanics. The platform consists of two evaluative tools: the Sensorized Targeted Box&Blocks (StBBT) and the Multimodal Pointing Task (MTP). The former aims to standardize a targeted version of the Box&Blocks test, providing a new assessment paradigm, based on muscle activity and kinematics, in a standardized and reproducible background. The MTP was created with the aim of studying pointing movement, focusing on aspects of motor planning and control based on electroencephalography and electromyography. The results presented in this thesis are related to the evaluation aspects, using MTP, of the rehabilitation effects of an optimized Action Observation Therapy (AOT) administered to a group of subjects with chronic stroke, also providing a comparison of electrophysiological behavior between healthy subjects and patients during the execution of the pointing task. StBBt was used to study device performance in a sample of healthy subjects, introducing its feasibility in terms of standardization, reproducibility, and reliability of results.