{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T18:03:30Z","timestamp":1760551410297,"version":"build-2065373602"},"reference-count":41,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T00:00:00Z","timestamp":1616457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009157","name":"National Institute on Disability, Independent Living, and Rehabilitation Research","doi-asserted-by":"publisher","award":["90REGE0005-01"],"award-info":[{"award-number":["90REGE0005-01"]}],"id":[{"id":"10.13039\/100009157","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIH\/NICHD","award":["1R01HD072080"],"award-info":[{"award-number":["1R01HD072080"]}]},{"name":"Marie Curie Integration Grant","award":["FP7-PEOPLE-2012-CIG-334201 (REMAKE)"],"award-info":[{"award-number":["FP7-PEOPLE-2012-CIG-334201 (REMAKE)"]}]},{"DOI":"10.13039\/501100006245","name":"Ministry of Science and Technology, Israel","doi-asserted-by":"publisher","award":["Joint Israel-Italy lab in Biorobotics \u201cArtificial somatosensation for humans and humanoids\u201d"],"award-info":[{"award-number":["Joint Israel-Italy lab in Biorobotics \u201cArtificial somatosensation for humans and humanoids\u201d"]}],"id":[{"id":"10.13039\/501100006245","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007729","name":"Ministry of Foreign Affairs","doi-asserted-by":"publisher","award":["Unit for S\/T cooperation"],"award-info":[{"award-number":["Unit for S\/T cooperation"]}],"id":[{"id":"10.13039\/501100007729","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Background: The recovery of upper limb mobility and functions is essential for people with cervical spinal cord injuries (cSCI) to maximize independence in daily activities and ensure a successful return to normality. The rehabilitative path should include a thorough neuromotor evaluation and personalized treatments aimed at recovering motor functions. Body-machine interfaces (BoMI) have been proven to be capable of harnessing residual joint motions to control objects like computer cursors and virtual or physical wheelchairs and to promote motor recovery. However, their therapeutic application has still been limited to shoulder movements. Here, we expanded the use of BoMI to promote the whole arm\u2019s mobility, with a special focus on elbow movements. We also developed an instrumented evaluation test and a set of kinematic indicators for assessing residual abilities and recovery. Methods: Five inpatient cSCI subjects (four acute, one chronic) participated in a BoMI treatment complementary to their standard rehabilitative routine. The subjects wore a BoMI with sensors placed on both proximal and distal arm districts and practiced for 5 weeks. The BoMI was programmed to promote symmetry between right and left arms use and the forearms\u2019 mobility while playing games. To evaluate the effectiveness of the treatment, the subjects\u2019 kinematics were recorded while performing an evaluation test that involved functional bilateral arms movements, before, at the end, and three months after training. Results: At the end of the training, all subjects learned to efficiently use the interface despite being compelled by it to engage their most impaired movements. The subjects completed the training with bilateral symmetry in body recruitment, already present at the end of the familiarization, and they increased the forearm activity. The instrumental evaluation confirmed this. The elbow motion\u2019s angular amplitude improved for all subjects, and other kinematic parameters showed a trend towards the normality range. Conclusion: The outcomes are preliminary evidence supporting the efficacy of the proposed BoMI as a rehabilitation tool to be considered for clinical practice. It also suggests an instrumental evaluation protocol and a set of indicators to assess and evaluate motor impairment and recovery in cSCI.<\/jats:p>","DOI":"10.3390\/s21062243","type":"journal-article","created":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T23:59:41Z","timestamp":1616543981000},"page":"2243","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Recovery of Distal Arm Movements in Spinal Cord Injured Patients with a Body-Machine Interface: A Proof-of-Concept Study"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8108-9363","authenticated-orcid":false,"given":"Camilla","family":"Pierella","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, 16132 Genoa, Italy"},{"name":"Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genoa, 16145 Genoa, Italy"},{"name":"Department of Physiology, Northwestern University, Chicago, IL 60611, USA"},{"name":"Shirley Ryan Ability Lab, Chicago, IL 60611, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6476-5112","authenticated-orcid":false,"given":"Elisa","family":"Galofaro","sequence":"additional","affiliation":[{"name":"Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genoa, 16145 Genoa, Italy"},{"name":"Assistive Robotics and Interactive Exosuits (ARIES) Lab, Institute of Computer Engineering (ZITI), University of Heidelberg, 69117 Heidelberg, Germany"}]},{"given":"Alice","family":"De Luca","sequence":"additional","affiliation":[{"name":"Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genoa, 16145 Genoa, Italy"},{"name":"Movendo Technology, 16128 Genoa, Italy"},{"name":"Recovery and Functional Reeducation Unit, Santa Corona Hospital, ASL2 Savonese, 17027 Pietra Ligure, Italy"}]},{"given":"Luca","family":"Losio","sequence":"additional","affiliation":[{"name":"S.C. Unit\u00e0 Spinale Unipolare, Santa Corona Hospital, ASL2 Savonese, 17027 Pietra Ligure, Italy"},{"name":"Italian Spinal Cord Laboratory (SCIL), 17027 Pietra Ligure, Italy"}]},{"given":"Simona","family":"Gamba","sequence":"additional","affiliation":[{"name":"S.C. Unit\u00e0 Spinale Unipolare, Santa Corona Hospital, ASL2 Savonese, 17027 Pietra Ligure, Italy"},{"name":"Italian Spinal Cord Laboratory (SCIL), 17027 Pietra Ligure, Italy"}]},{"given":"Antonino","family":"Massone","sequence":"additional","affiliation":[{"name":"S.C. Unit\u00e0 Spinale Unipolare, Santa Corona Hospital, ASL2 Savonese, 17027 Pietra Ligure, Italy"},{"name":"Italian Spinal Cord Laboratory (SCIL), 17027 Pietra Ligure, Italy"}]},{"given":"Ferdinando A.","family":"Mussa-Ivaldi","sequence":"additional","affiliation":[{"name":"Department of Physiology, Northwestern University, Chicago, IL 60611, USA"},{"name":"Shirley Ryan Ability Lab, Chicago, IL 60611, USA"},{"name":"Department of Physical Medicine and Rehabilitation, Northwestern University, Evanston, IL 60208, USA"},{"name":"Department of Biomedical Engineering, Northwestern University, Evanston, IL 60208, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2338-8995","authenticated-orcid":false,"given":"Maura","family":"Casadio","sequence":"additional","affiliation":[{"name":"Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genoa, 16145 Genoa, Italy"},{"name":"Department of Physiology, Northwestern University, Chicago, IL 60611, USA"},{"name":"Italian Spinal Cord Laboratory (SCIL), 17027 Pietra Ligure, Italy"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"637","DOI":"10.2340\/16501977-0231","article-title":"Rehabilitation outcome of upper extremity skilled performance in persons with cervical spinal cord injuries","volume":"40","author":"Spooren","year":"2008","journal-title":"J. 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