Papers by massimo caprino
Business & information systems engineering, May 29, 2024
Especially older persons are prone to disabilities and chronic diseases. These chronic conditions... more Especially older persons are prone to disabilities and chronic diseases. These chronic conditions pose a worldwide challenge, leading to deteriorating health, economic strain, loss of life, and a decline in the quality of life (QoL). Therefore, healthcare institutions seek to enhance their strategies for disease prevention and management to uphold the well-being of the community. This leads to the need to regain independence and improve QoL to properly rehabilitate the patients. Virtual Coaches (VCs) in the form of Embodied Conversational Agents are seen as a relevant digital intervention to support the continuity of care. The paper at hand reports on a Design Science Research project about implementing a VC solution to support older patients' home rehabilitation. The study underpins four pivotal design principles: Adaptivity, Coaching Strategy, Multiuser Interface, and Sustainable Infrastructure. The final artifact was tested with 80 patients which were supported in continuing their inpatient rehabilitation at home by using a VC. The evaluation shows both positive results for usability and acceptance of the intervention for four different use cases and a positive impact on the QoL. Given the comprehensive clinical evaluation, the system represents a safe and appealing solution for ensuring the continuity of medical rehabilitation care and the access to personalized cognitive and motor function treatments.
Neurological sciences, Feb 23, 2024
Smart health, Apr 1, 2024
Frontiers in Medicine
IntroductionTelerehabilitation in neurological and cardiological diseases is an alternative rehab... more IntroductionTelerehabilitation in neurological and cardiological diseases is an alternative rehabilitation that improves the quality of life and health conditions of patients and enhances the accessibility to health care. However, despite the reported benefits of telerehabilitation, it is necessary to study its impact on the healthcare system.MethodsThe systematic review aims to investigate the costs and results of telerehabilitation in neurological and cardiological diseases. MEDLINE and EMBASE databases were searched from 2005 to 2021, for studies that assess the costs and results of telerehabilitation compared to traditional rehabilitation (center-based programs) in neurological and cardiological diseases. A narrative synthesis of results was carried out.ResultsA total of 8 studies (865 participants) of 430 records were included. Three studies were related to the costs and results of telerehabilitation in neurological diseases (specifically in stroke). In total, five studies asse...
Diagnostics
Cardiac rehabilitation is an individualized outpatient program of physical exercises and medical ... more Cardiac rehabilitation is an individualized outpatient program of physical exercises and medical education designed to accelerate recovery and improve health status in heart disease patients. In this study, we aimed for assessment of patients’ perception of the involvement of technology and remote monitoring devices in cardiac recovery. During the Living Lab Phase of the Virtual Coaching Activities for Rehabilitation in Elderly (vCare) project, we evaluated eleven patients (five heart failure patients and six ischemic heart disease patients). Patient admission in the UMFCD cardiology clinical department served as a shared inclusion criterion for both study groups. In addition, the presence of II or III heart failure NYHA stage status was considered an inclusion criterion for the heart failure study group and patients diagnosed with ischemic heart disease for the second one. We conducted a system usability survey to assess the patients’ perception of the system’s technical and medica...
Journal of Public Health
Aim The vCare system is a virtual coach that involves physical and cognitive telerehabilitation a... more Aim The vCare system is a virtual coach that involves physical and cognitive telerehabilitation and a daily life monitoring system. This pilot study aims to evaluate the vCare pilot test for Parkinson’s disease (PD) patients and to analyze the usability and the satisfaction level of patients and their quality of life (QoL). Subject and methods Twenty PD patients were randomized, 10 patients into the vCare group focused on personalized home telerehabilitation [motor and cognitive rehabilitation (4 days/week for 4 months)], while the control group (10 patients) continued the clinical standard at the clinic. A pre-post clinical evaluation and a cost-utility study were performed. Results Repeated measures ANOVA showed significant improvement in the PD vCare group compared to the control group (p<.05). Specifically, the PD vCare group showed significant improvement in cognition (p=.016), and QoL dimensions of mobility (p=.008), self-care (p=.008), daily activities (p=.010) and pain/di...
Journal of Public Health
Aim The vCare system is a virtual coach that involves physical and cognitive telerehabilitation a... more Aim The vCare system is a virtual coach that involves physical and cognitive telerehabilitation and a daily life monitoring system. This pilot study aims to evaluate the vCare pilot test for Parkinson’s disease (PD) patients and to analyze the usability and the satisfaction level of patients and their quality of life (QoL). Subject and methods Twenty PD patients were randomized, 10 patients into the vCare group focused on personalized home telerehabilitation [motor and cognitive rehabilitation (4 days/week for 4 months)], while the control group (10 patients) continued the clinical standard at the clinic. A pre-post clinical evaluation and a cost-utility study were performed. Results Repeated measures ANOVA showed significant improvement in the PD vCare group compared to the control group (p<.05). Specifically, the PD vCare group showed significant improvement in cognition (p=.016), and QoL dimensions of mobility (p=.008), self-care (p=.008), daily activities (p=.010) and pain/di...
Frontiers in Medicine, Nov 29, 2022
Introduction: Telerehabilitation in neurological and cardiological diseases is an alternative reh... more Introduction: Telerehabilitation in neurological and cardiological diseases is an alternative rehabilitation that improves the quality of life and health conditions of patients and enhances the accessibility to health care. However, despite the reported benefits of telerehabilitation, it is necessary to study its impact on the healthcare system. Methods: The systematic review aims to investigate the costs and results of telerehabilitation in neurological and cardiological diseases. MEDLINE and EMBASE databases were searched from 2005 to 2021, for studies that assess the costs and results of telerehabilitation compared to traditional rehabilitation (center-based programs) in neurological and cardiological diseases. A narrative synthesis of results was carried out. Results: A total of 8 studies (865 participants) of 430 records were included. Three studies were related to the costs and results of telerehabilitation in neurological diseases (specifically in stroke). In total, five studies assessed telerehabilitation in cardiological diseases (chronic heart failure, coronary heart disease, acute coronary syndrome, and cardiovascular diseases). The duration of the telerehabilitation ranged from 6 to 48 weeks. The studies included cost-analysis, cost-benefit, cost-effectiveness, or cost-utility. In total, four studies found significant cost/savings per person between $565.66 and $2,352.00 (p < 0.05). In contrast, most studies found differences in costs and clinical effects between the telerehabilitation performed and the rehabilitation performed at the clinic. Just one study found quality-adjusted life years (QALY) significant differences between groups [Incremental costeffectiveness ratio (ICER) per QALY ($−21,666.41/QALY).
Frontiers in Medicine, Nov 29, 2022
Introduction: Telerehabilitation in neurological and cardiological diseases is an alternative reh... more Introduction: Telerehabilitation in neurological and cardiological diseases is an alternative rehabilitation that improves the quality of life and health conditions of patients and enhances the accessibility to health care. However, despite the reported benefits of telerehabilitation, it is necessary to study its impact on the healthcare system. Methods: The systematic review aims to investigate the costs and results of telerehabilitation in neurological and cardiological diseases. MEDLINE and EMBASE databases were searched from 2005 to 2021, for studies that assess the costs and results of telerehabilitation compared to traditional rehabilitation (center-based programs) in neurological and cardiological diseases. A narrative synthesis of results was carried out. Results: A total of 8 studies (865 participants) of 430 records were included. Three studies were related to the costs and results of telerehabilitation in neurological diseases (specifically in stroke). In total, five studies assessed telerehabilitation in cardiological diseases (chronic heart failure, coronary heart disease, acute coronary syndrome, and cardiovascular diseases). The duration of the telerehabilitation ranged from 6 to 48 weeks. The studies included cost-analysis, cost-benefit, cost-effectiveness, or cost-utility. In total, four studies found significant cost/savings per person between $565.66 and $2,352.00 (p < 0.05). In contrast, most studies found differences in costs and clinical effects between the telerehabilitation performed and the rehabilitation performed at the clinic. Just one study found quality-adjusted life years (QALY) significant differences between groups [Incremental costeffectiveness ratio (ICER) per QALY ($−21,666.41/QALY).
Frontiers in digital health, Oct 5, 2020
Frontiers in digital health, Oct 5, 2020
Background: In the last few years, several studies have focused on describing and understanding h... more Background: In the last few years, several studies have focused on describing and understanding how virtual coaches (ie, coaching program or smart device aiming to provide coaching support through a variety of application contexts) could be key drivers for health promotion in home care settings. As there has been enormous technological progress in the field of artificial intelligence and data processing in the past decade, the use of virtual coaches gains an augmented attention in the considerations of medical innovations. Objective: This scoping review aimed at providing an overview of the applications of a virtual coach in the clinical field. In particular, the review focused on the papers that provide tangible information for coaching activities with an active implication for engaging and guiding patients who have an ongoing plan of care. Methods: We aimed to investigate the use of the term virtual coach in the clinical field performing a methodical review of the relevant literature indexed on PubMed, Scopus, and Embase databases to find virtual coach papers focused on specific activities dealing with clinical or medical contexts, excluding those aimed at surgical settings or electronic learning purposes. Results: After a careful revision of the inclusion and exclusion criteria, 46 records were selected for the full-text review. Most of the identified articles directly or indirectly addressed the topic of physical activity. Some papers were focused on the use of virtual coaching (VC) to manage overweight or nutritional issues. Other papers dealt with technological interfaces to facilitate interactions with patients suffering from different chronic clinical conditions such as heart failure, chronic obstructive pulmonary disease, depression, and chronic pain. Conclusions: Although physical activity is a healthy practice that is most encouraged by a virtual coach system, in the current scenario, rehabilitation is the great absentee. This paper gives an overview of the tangible applications of this tool in the medical field and may inspire new ideas for future research on VC.
Pharmacological Research Communications, Sep 1, 1977
Synergism between chemotherapy and immune responses has been evidenced in animals'and mah.~ 'In a... more Synergism between chemotherapy and immune responses has been evidenced in animals'and mah.~ 'In addition, non-specific immunostimulation seems to • t ' I i increase the efficiency of anticancer chemotherapy. Up to now most of the clinica~l trials have beeh conducted applying immunoadjuvants afte_._ r initial i chemothdr,ap~utic treatment. Since presensitized immunocompetent cells t are more radib-rand chemo-resistant than non-stimulated lymphocytes, a tr]:al of lm,m,unos~,zmulation, before chemotherapy is based on rational experi-/ ! P, mentM basis. Such pi~ogram, activated in humansduring 1976, is conducted t t accordin~ to the following general scheme: 1 ;.' C}~emoth'erapy alone 2.' Clahmo'thera,py followed by BCG and recycle 3., Ch+motheralSy preceded and followed by BCG and recycle. ! protocols for breast, lung, .colorectal and ovarian cancer treatment are described.
Journal of Clinical Oncology, May 20, 2012
TPS9154 Background: Self-rated symptoms contribute to the Quality of Life (QoL) of cancer patient... more TPS9154 Background: Self-rated symptoms contribute to the Quality of Life (QoL) of cancer patients (pts) and impact on prognosis. Behavioural functions are controlled by the circadian timing system (CTS), through a network of molecular clocks that time cellular proliferation and drug metabolism (Lévi et al. ARPT 2010). Chronotherapy aims at the reduction of treatment-related symptoms through the adjustment of chemotherapy delivery to the CTS. Cancer chronotherapy is delivered at home using programmable pumps, and avoids familial and social disruption. Telemedicine tools can provide continuous information on symptoms, behavior, QoL and CTS from non hospitalized pts. Methods: The inCASA platform enables telemonitoring of multiple functions in order to help physicians to detect early warning signals in pt condition at home, and prompt adequate and timely interventions. Our pilot site investigates the clinical relevance of daily teletransmitted self assessed symptoms, body weight and rest-activity circadian rhythm in cancer pts. This system was first well understood and accepted by 14 pts (9 male, 5 female, 43-77 years) at the outpt clinic, then used by 5 pts (4 male, 1 female, 61±13 years) at home daily for 6+ weeks, while receiving chronotherapy. The pilot phase will accrue 30 pts receiving chronotherapy at home from 03/01/2012. Pts will fill in the M.D. Anderson Symptom Inventory scale on a touch-screen device, measure their body weight using a Bluetooth scale and record their circadian rest-activity rhythm using an infrared wrist-watch accelerometer over 6-weeks. The data are transmitted to the platform, then to a web portal with secured access to be daily inspected by the oncology nursing and medical team. The modelling of these continuous records will define alert thresholds for nurse-controlled graded intervention decisions. Conclusion: The assessment criteria set forth for the inCASA solution will address the issues of pt autonomy, CTS entrainment in the pt usual environment, safety of chronotherapy delivery at home and treatment costs. Its use should induce important organisational changes and perception in healthcare professionals.
Background: In the last few years, several studies have focused on describing and understanding h... more Background: In the last few years, several studies have focused on describing and understanding how virtual coaches (ie, coaching program or smart device aiming to provide coaching support through a variety of application contexts) could be key drivers for health promotion in home care settings. As there has been enormous technological progress in the field of artificial intelligence and data processing in the past decade, the use of virtual coaches gains an augmented attention in the considerations of medical innovations. Objective: This scoping review aimed at providing an overview of the applications of a virtual coach in the clinical field. In particular, the review focused on the papers that provide tangible information for coaching activities with an active implication for engaging and guiding patients who have an ongoing plan of care. Methods: We aimed to investigate the use of the term virtual coach in the clinical field performing a methodical review of the relevant literature indexed on PubMed, Scopus, and Embase databases to find virtual coach papers focused on specific activities dealing with clinical or medical contexts, excluding those aimed at surgical settings or electronic learning purposes. Results: After a careful revision of the inclusion and exclusion criteria, 46 records were selected for the full-text review. Most of the identified articles directly or indirectly addressed the topic of physical activity. Some papers were focused on the use of virtual coaching (VC) to manage overweight or nutritional issues. Other papers dealt with technological interfaces to facilitate interactions with patients suffering from different chronic clinical conditions such as heart failure, chronic obstructive pulmonary disease, depression, and chronic pain. Conclusions: Although physical activity is a healthy practice that is most encouraged by a virtual coach system, in the current scenario, rehabilitation is the great absentee. This paper gives an overview of the tangible applications of this tool in the medical field and may inspire new ideas for future research on VC.
Frontiers in Medicine
IntroductionTelerehabilitation in neurological and cardiological diseases is an alternative rehab... more IntroductionTelerehabilitation in neurological and cardiological diseases is an alternative rehabilitation that improves the quality of life and health conditions of patients and enhances the accessibility to health care. However, despite the reported benefits of telerehabilitation, it is necessary to study its impact on the healthcare system.MethodsThe systematic review aims to investigate the costs and results of telerehabilitation in neurological and cardiological diseases. MEDLINE and EMBASE databases were searched from 2005 to 2021, for studies that assess the costs and results of telerehabilitation compared to traditional rehabilitation (center-based programs) in neurological and cardiological diseases. A narrative synthesis of results was carried out.ResultsA total of 8 studies (865 participants) of 430 records were included. Three studies were related to the costs and results of telerehabilitation in neurological diseases (specifically in stroke). In total, five studies asse...
Journal of Clinical Oncology, May 20, 2012
TPS9154 Background: Self-rated symptoms contribute to the Quality of Life (QoL) of cancer patient... more TPS9154 Background: Self-rated symptoms contribute to the Quality of Life (QoL) of cancer patients (pts) and impact on prognosis. Behavioural functions are controlled by the circadian timing system (CTS), through a network of molecular clocks that time cellular proliferation and drug metabolism (Lévi et al. ARPT 2010). Chronotherapy aims at the reduction of treatment-related symptoms through the adjustment of chemotherapy delivery to the CTS. Cancer chronotherapy is delivered at home using programmable pumps, and avoids familial and social disruption. Telemedicine tools can provide continuous information on symptoms, behavior, QoL and CTS from non hospitalized pts. Methods: The inCASA platform enables telemonitoring of multiple functions in order to help physicians to detect early warning signals in pt condition at home, and prompt adequate and timely interventions. Our pilot site investigates the clinical relevance of daily teletransmitted self assessed symptoms, body weight and rest-activity circadian rhythm in cancer pts. This system was first well understood and accepted by 14 pts (9 male, 5 female, 43-77 years) at the outpt clinic, then used by 5 pts (4 male, 1 female, 61±13 years) at home daily for 6+ weeks, while receiving chronotherapy. The pilot phase will accrue 30 pts receiving chronotherapy at home from 03/01/2012. Pts will fill in the M.D. Anderson Symptom Inventory scale on a touch-screen device, measure their body weight using a Bluetooth scale and record their circadian rest-activity rhythm using an infrared wrist-watch accelerometer over 6-weeks. The data are transmitted to the platform, then to a web portal with secured access to be daily inspected by the oncology nursing and medical team. The modelling of these continuous records will define alert thresholds for nurse-controlled graded intervention decisions. Conclusion: The assessment criteria set forth for the inCASA solution will address the issues of pt autonomy, CTS entrainment in the pt usual environment, safety of chronotherapy delivery at home and treatment costs. Its use should induce important organisational changes and perception in healthcare professionals.
Digital Health Technology for Better Aging, 2021
Based on the lessons learnt from the co-design, development and integration processes, the resear... more Based on the lessons learnt from the co-design, development and integration processes, the research findings and the outputs from the engagement with a network of stakeholders over the course of the EU funded initiatives, this chapter will aim to help sketching the future policies and research funding programmes for ageing well in Europe. The chapter presents the visions and the perspectives of the running projects in the frame of the H2020 Personalized Medicine-15 call.
Frontiers in Medicine
IntroductionTelerehabilitation in neurological and cardiological diseases is an alternative rehab... more IntroductionTelerehabilitation in neurological and cardiological diseases is an alternative rehabilitation that improves the quality of life and health conditions of patients and enhances the accessibility to health care. However, despite the reported benefits of telerehabilitation, it is necessary to study its impact on the healthcare system.MethodsThe systematic review aims to investigate the costs and results of telerehabilitation in neurological and cardiological diseases. MEDLINE and EMBASE databases were searched from 2005 to 2021, for studies that assess the costs and results of telerehabilitation compared to traditional rehabilitation (center-based programs) in neurological and cardiological diseases. A narrative synthesis of results was carried out.ResultsA total of 8 studies (865 participants) of 430 records were included. Three studies were related to the costs and results of telerehabilitation in neurological diseases (specifically in stroke). In total, five studies asse...
Digital Health Technology for Better Aging, 2021
Based on the lessons learnt from the co-design, development and integration processes, the resear... more Based on the lessons learnt from the co-design, development and integration processes, the research findings and the outputs from the engagement with a network of stakeholders over the course of the EU funded initiatives, this chapter will aim to help sketching the future policies and research funding programmes for ageing well in Europe. The chapter presents the visions and the perspectives of the running projects in the frame of the H2020 Personalized Medicine-15 call.
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Papers by massimo caprino