High-Tech Rehabilitation Pathway for Acute Adult Neuromuscular Diseases - Fit4MedRob-Acute MND Project

Improvement in balance measured by the Berg Balance Scale (BBS), with a target improvement of at least 10 points from baseline to the end of the treatment period. BBS is used to objectively determine a patient's ability (or inability) to safely balance during a series of 14 tasks; each task ranks from 0 to 4, with a total score of 56. Higher score indicates the higher level of function.

Modified Barthel Index (MBI). The MBI is an adaptation of the original Barthel Index, designed to assess a patient's ability to perform activities of daily living (ADLs) and their level of independence. The MBI evaluates ten specific functions: Feeding, Bathing, Grooming, Dressing, Bowel control, Bladder control, Toileting, Transfers (e.g., bed to chair), Mobility (e.g., walking or wheelchair use), Stair climbing. Each item is scored on a 5-level ordinal scale. Interpretation: 0-20, Total dependency; 21-60, Severe dependency; 61-90, Moderate dependency; 91-99, Slight dependency; 100, Independence

Trunk Control Test (TCT) for non-ambulatory patients. The TCT is a clinical assessment tool used to evaluate trunk movement control in patients, particularly those who have suffered a stroke or other neurological disorders. The TCT measures four specific movements: 1) Rolling to the weak side: The patient rolls from a supine position to their weaker side; 2) Rolling to the strong side: The patient rolls from a supine position to their stronger side; 3) Balance in a sitting position: The patient sits on the edge of a bed or table without support for at least 30 seconds; 4) Sitting up from lying down: The patient moves from a lying to a sitting position. Each movement is scored on a scale from 0 to 25, with a total possible score of 100. Higher scores indicate better trunk control (Collin & Wade 1990)

2-Minute Walk Test (2MWT) for ambulatory patients. The Two-Minute Walk Test (2MWT) is a simple and quick assessment used to measure a person's walking endurance and functional mobility. It is based on the measurement of the distance that a person can walk in two minutes. The individual is instructed to walk as far as possible in two minutes, typically along a marked course. Assistive devices can be used if needed, but should be kept consistent across tests. The total distance walked in meters or feet is recorded

Modified Erasmus GBS Outcome Score (mEGOS) for Guillain-Barrè Syndrome patients: is a clinical prediction model used to estimate the likelihood of a patient with GBS being unable to walk independently six months after disease onset. This score is calculated based on three key factors: 1) Age at onset of neurological symptoms; 2) Preceding diarrhea before the onset of symptoms; 3) Severity of muscle weakness, assessed using the Medical Research Council sum score. The mEGOS provides a score ranging from 0 to 12, with higher scores indicating a higher risk of walking inability

Maximal isometric handgrip strength for both right and left hands will be measured using a digital handgrip dynamometer in units of kg/f in the standardized position recommended by the American Society of Hand Therapists, that is, sitting in a chair with a 90° backrest and 90° elbow flexion of the hand to be evaluated. Each participant exerted three trials of 3 s of maximal isometric handgrip strength alternatively for the right and left hands, with a rest period of 180 s between trials and considering the best performance of the three trials for statistical analysis

Isometric muscle strength, measured in kg, was assessed using a manual hand-held dynamometer (HHD) at the deltoid, biceps brachii, triceps brachii, wrist flexor, and wrist extensor for the upper limbs bilaterally; thigh flexor, knee extension, knee flexion, dorsiflexion, and plantarflexion for the lower limbs bilaterally

Measured using the Numeric Rating Scale (NRS). The NRS for fatigue is a simple and widely used tool to assess the intensity of fatigue. It helps patients communicate their fatigue levels to healthcare providers effectively. The NRS typically uses an 11-point scale ranging from 0 (no fatigue) to 10 ("the worst fatigue imaginable"). Patients are asked to rate their fatigue by selecting a number that best represents their pain intensity at that moment.

It will be used the 12-Item Short Form Survey (SF-12). The SF-12 is a self-reported questionnaire designed to measure health-related quality of life. It is a shortened version of the SF-36, created to reduce the burden on respondents while still providing reliable and valid results. The SF-12 covers eight health domains: Physical functioning; Role-physical (limitations due to physical health problems); Bodily pain; General health; Vitality (energy and fatigue); Social functioning; Role-emotional (limitations due to emotional problems); Mental health (psychological distress and well-being). The survey produces two summary scores: Physical Component Summary (PCS) and Mental Component Summary (MCS). These scores are norm-based, with a mean of 50 and a standard deviation of 10. Scores above 50 indicate better-than-average health-related quality of life, while scores below 50 suggest below-average health

To assess the patient perception of the technology assisted rehabilitation using the Technology Assisted Rehabilitation Patient Perception Questionnaire (TARPP-Q). The TARPP-Q consists of 10 questions with multiple choice answers, totalling 29 items. The Questionnaire assesses patients' personal experiences and perceptions of technology assisted rehabilitation, including aspects like usability, positive attitude, hindrance perception, and distress.

Will be measured these biomarkers in order to assess the levels changes during the treatment. Serum level will be measured in nanogram/milliliter

Will be measured this biomarker in order to assess the levels changes during the treatment. Plasma level will be measured in picogram/milliliter.