PHOENICS: PHysiotherapy and action-Observation thErapy: aN Integrated approaCh supported by novel technologieS

The conventional physiotherapeutic approach is traditionally focused on the treatment of peripheral components through the repeated execution of the movement to be recovered, thus declining as a "motor learning" process in which lost skills aim to be reacquired through practice. Recently, based on the paradigm of the "mirror neuron" system, a new rehabilitation strategy known as Action Observation Therapy (AOT) has been introduced; this approach is specifically focused on the visual observation of the motor realization of actions performed by individuals that are external to the subject and subsequent repetition of these actions by the subject himself. This new approach has been proven to be effective for the recovery and/or maintenance of motor function in the treatment of different neurological (i.e. Parkinson's disease, stroke and autism) and non-neurological (e.g. knee/hip arthroplasty following gonarthrosis, coxarthrosis and fracture of femur) pathologies. AOT presents high levels of novelty and impact in the rehabilitation field, but at present it exposes shortcomings related to the standardization of the rehabilitation protocol and the possibility of carrying out "patient-specific" treatments. 

Main Objectives
The PHOENICS project, through the fusion of different methods - aimed at optimizing the visual stimulus and the creation and identification of specific models at the basis of the motor gesture - and technologies - oriented to the tracking of the movement of the subject - aims at the realization and validation of a new methodology that integrates conventional physiotherapy and AOT through a "computer-assisted" approach, oriented to a use both in clinical environment and for "telecare" applications. In order to achieve this main objective, PHOENICS project presents three different sub-objectives:
  • AOT Analysis and Optimization: the initial phase of the project focuses in particular on the need to optimize the AOT from a methodological point of view, focusing on the visual cues, and involves the use of experimental crossover designs with repeated EEG measurements on the same subject.
  • Design and development of the computer-assisted rehabilitation system: the second phase represents the technological core of the project and involves the design, development and integration of the technologies and methodologies necessary to support the AOT, specifically including virtual reality/mixed reality and motion tracking.
  • Clinical Trial: the final phase involves the application of the optimized technique on subjects with motor impairment (i.e. post-stroke patients), with pilot studies conducted according to the experimental proof of concept design.
An example of the system prototype for the upper limb rehabilitation in post-stroke patients is reported in figure 1.
Figure 1. System prototype for the upper limb rehabilitation in post-stroke patients.

Operating Units
  • Università degli Studi di Brescia - Dipartimento di Ingegneria dell’Informazione (DII) | Dipartimento di Scienze Cliniche e Sperimentali (DSCS)
  • Consiglio Nazionale delle Ricerche – Istituto di Neuroscienze (URT Parma)
  • BTS Bioengineering SpA
  • IRCCS Fondazione Don Carlo Gnocchi – Onlus (Spalenza Center, Rovato)
Principal Investigator
Nicola Francesco Lopomo
Dipartimento: Dipartimento di Ingegneria dell’Informazione (DII)

Università degli Studi di Brescia – Bando “Health & Wealth” 2015 (Internal Competitive Call)