{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T02:39:06Z","timestamp":1777516746402,"version":"3.51.4"},"reference-count":72,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,5,11]],"date-time":"2025-05-11T00:00:00Z","timestamp":1746921600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,5,11]],"date-time":"2025-05-11T00:00:00Z","timestamp":1746921600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Italian Ministry of Healh, Ricerca Finalizzata 2021","award":["GR-2021-12372038"],"award-info":[{"award-number":["GR-2021-12372038"]}]},{"name":"National Recovery and Resilience Plan"},{"name":"Italian Ministry of University and Research"},{"name":"European Union \u2013 NextGenerationEU","award":["ECS_00000035"],"award-info":[{"award-number":["ECS_00000035"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cent Nerv Syst Dis"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Action Observation Therapy (AOT) and Neuromuscular Electrical Stimulation (NMES) are widely adopted techniques for upper-limb rehabilitation in post-stroke patients. Although AOT and NMES are individually effective, studies investigating a potential synergistic effect on enhancing rehabilitative outcomes are lacking.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Objectives:<\/jats:bold>\n                    This study aims at comparing the effect of AOT and NMES applied together (AOT-NMES) on muscle synergies with respect to either AOT alone or a Motor Neutral Observation treatment alone (MNO, involving neither AOT nor NMES) on motor function recovery of upper limb.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design:<\/jats:bold>\n                    Randomized Controlled Trial (RCT) with n = 60 post-stroke patients with resulting upper limb disability, randomly allocated (1:1:1 ratio) in three interventional arms: AOT-NMES (n = 20), AOT (n = 20) and MNO (n = 20).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods and Analyses:<\/jats:bold>\n                    All rehabilitation treatments will consist of n\u00b015 60\u00a0min-long rehabilitative sessions. Primary outcome measure will be upper limb motor function, assessed using the Fugl-Meyer Assessment scale for upper limb (FM-UL), collected at the baseline (T0), post-intervention (T1) and at follow-up (T2, 6-months after T1). Other outcome measures will be collected through a multidimensional evaluation including assessing stroke-associated quality of life, neurophysiological data, biomechanical and MRI measures. The innovative protocol will also be evaluated for usability and safety.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Discussion:<\/jats:bold>\n                    We expect to determine the efficacy, usability and safety of the AOT-NMES rehabilitation approach for the recovery of upper limb motor function in post-stroke patients. The obtained results will also help reveal the neural underpinnings of motor recovery, as assessed by neurophysiological data, biomechanical and MRI measures.\n                  <\/jats:p>","DOI":"10.1177\/11795735251331511","type":"journal-article","created":{"date-parts":[[2025,5,11]],"date-time":"2025-05-11T10:31:36Z","timestamp":1746959496000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of a Rehabilitation Treatment Using Action Observation Therapy Enhanced by Muscle Synergy-Derived Electrical Stimulation (OTHELLO) in Post-Stroke Patients: A RCT Study Protocol"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6256-1722","authenticated-orcid":false,"given":"Monia","family":"Cabinio","sequence":"first","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi ONLUS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiziana","family":"Lencioni","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi ONLUS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arturo","family":"Nuara","sequence":"additional","affiliation":[{"name":"Universit\u00e0 di Parma"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Rossetto","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi ONLUS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeria","family":"Blasi","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi ONLUS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaia","family":"Bailo","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi ONLUS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Cardini","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, Universit\u00e0 deglistudi di Milano, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Bertoni","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi ONLUS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Vigan\u00f2","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi ONLUS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariangela","family":"Bianco","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi ONLUS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Comanducci","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi ONLUS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Avanzini","sequence":"additional","affiliation":[{"name":"Istituto di Neuroscienze"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Ferrarin","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi ONLUS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Fornia","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi ONLUS"},{"name":"Universit\u00e0 Degli Studi di Milano"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6145-5274","authenticated-orcid":false,"given":"Francesca","family":"Baglio","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi ONLUS"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,5,11]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00252-0"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10020190"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-12-162"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2020.04.001"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0b013e318296aeca"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awr039"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.84716"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.508184"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bht190"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrn.2016.135"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2022.793849"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2022.119825"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2025979118"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692155221116820"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2007.03.043"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/1545968314527350"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2013.0185"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.14262"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2012.04334.x"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/1545968311427406"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2021.04.024"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-35664-w"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/1545968319826053"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0188642"},{"key":"e_1_3_5_26_2","volume-title":"2019 Surveillance of Stroke Rehabilitation in Adults (NICE Guideline CG162)","author":"National Institute for Health and Care Excellence (NICE)","year":"2019","unstructured":"National Institute for Health and Care Excellence (NICE). 2019 Surveillance of Stroke Rehabilitation in Adults (NICE Guideline CG162). London: National Institute for Health and Care Excellence (NICE); 2019. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK551817\/ [Accessed August 23, 2023]."},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/ejn.15140"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00221-018-5454-5"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bspc.2019.101723"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1089\/cyber.2022.0176"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1080\/09593985.2020.1831114"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.3389\/fncom.2013.00051"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0500199102"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1212056109"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1152\/jn.00625.2019"},{"key":"e_1_3_5_36_2","doi-asserted-by":"crossref","unstructured":"Chan A-WM Tetzlaff JG Altman D SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158:200-207. https:\/\/www.acpjournals.org\/doi\/10.7326\/0003-4819-158-3-201302050-00583. Accessed 6 June 2023.","DOI":"10.7326\/0003-4819-158-3-201302050-00583"},{"key":"e_1_3_5_37_2","doi-asserted-by":"publisher","DOI":"10.1162\/jocn.2009.21058"},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-30912-w"},{"key":"e_1_3_5_39_2","doi-asserted-by":"publisher","DOI":"10.1177\/1545968317732662"},{"key":"e_1_3_5_40_2","doi-asserted-by":"publisher","DOI":"10.1177\/1545968307305353"},{"key":"e_1_3_5_41_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638280802240498"},{"key":"e_1_3_5_42_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40258-022-00772-7"},{"key":"e_1_3_5_43_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.10.2131"},{"key":"e_1_3_5_44_2","first-page":"469","article-title":"Quality of life in stroke survivors: first results from the reliability and validity of the Italian version of the Stroke Impact Scale 3.0","volume":"22","author":"Vellone E","year":"2010","unstructured":"Vellone E, Savini S, Barbato N, Carovillano G, Caramia M, Alvaro R. Quality of life in stroke survivors: first results from the reliability and validity of the Italian version of the Stroke Impact Scale 3.0. Ann Ig. 2010;22:469-479.","journal-title":"Ann Ig"},{"key":"e_1_3_5_45_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-014-1995-y"},{"key":"e_1_3_5_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2010.01.103"},{"key":"e_1_3_5_47_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.29249"},{"key":"e_1_3_5_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnss.2020.04.004"},{"key":"e_1_3_5_49_2","doi-asserted-by":"publisher","DOI":"10.1053\/apmr.2002.35473"},{"key":"e_1_3_5_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(98)00138-3"},{"key":"e_1_3_5_51_2","first-page":"412","volume-title":"Cram\u2019s Introduction to Surface Electromyography","author":"Criswell E","year":"2011","unstructured":"Criswell E. Cram\u2019s Introduction to Surface Electromyography. 2nd ed. Burlington, MA: Jones & Bartlett Learning; 2011:412.","edition":"2"},{"key":"e_1_3_5_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1050-6411(00)00027-4"},{"key":"e_1_3_5_53_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.20.7.864"},{"key":"e_1_3_5_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2006.11.008"},{"key":"e_1_3_5_55_2","doi-asserted-by":"publisher","DOI":"10.1177\/1541931213571042"},{"key":"e_1_3_5_56_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(16)30121-1"},{"key":"e_1_3_5_57_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.21022"},{"key":"e_1_3_5_58_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e5840"},{"key":"e_1_3_5_59_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2021.117731"},{"key":"e_1_3_5_60_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2021.102639"},{"key":"e_1_3_5_61_2","doi-asserted-by":"publisher","DOI":"10.1089\/brain.2013.0147"},{"key":"e_1_3_5_62_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2022.818385"},{"key":"e_1_3_5_63_2","doi-asserted-by":"publisher","DOI":"10.1088\/1741-2552\/ac76e0"},{"key":"e_1_3_5_64_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.003168"},{"key":"e_1_3_5_65_2","first-page":"744","article-title":"Cortex integrity relevance in muscle synergies in severe chronic stroke","volume":"8","author":"Garc\u00eda-Cossio E","year":"2014","unstructured":"Garc\u00eda-Cossio E, Broetz D, Birbaumer N, Ramos-Murguialday A. Cortex integrity relevance in muscle synergies in severe chronic stroke. Front Hum Neurosci. 2014;8:744.","journal-title":"Front Hum Neurosci"},{"key":"e_1_3_5_66_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12984-022-01045-z"},{"key":"e_1_3_5_67_2","doi-asserted-by":"publisher","DOI":"10.2147\/MDER.S123464"},{"key":"e_1_3_5_68_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2021.102931"},{"key":"e_1_3_5_69_2","doi-asserted-by":"publisher","DOI":"10.1177\/1545968311411054"},{"key":"e_1_3_5_70_2","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.22682"},{"key":"e_1_3_5_71_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrn2805"},{"key":"e_1_3_5_72_2","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00009.2013"},{"key":"e_1_3_5_73_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2021.735508"}],"container-title":["Journal of Central Nervous System Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795735251331511","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11795735251331511","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795735251331511","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:59:52Z","timestamp":1777391992000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11795735251331511"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,11]]},"references-count":72,"alternative-id":["10.1177\/11795735251331511"],"URL":"https:\/\/doi.org\/10.1177\/11795735251331511","relation":{},"ISSN":["1179-5735","1179-5735"],"issn-type":[{"value":"1179-5735","type":"print"},{"value":"1179-5735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,11]]},"article-number":"11795735251331511"}}