University of Pisa leads one of Europe’s largest cerebral palsy research project

Pisa – It’s aimed to open new perspectives for clinical evaluation, care and rehabilitation treatment in children with cerebral palsy. We’re talking about one of the most important scientific research that in Europe will clinically validate new artificial intelligence algorithms to develop evidence-based clinical decision support tools for the functional diagnosis of children with hemiplegia (paralysis on one of the two sides of the body) building tele-rehabilitation systems at home. These systems will permit not only to carry out the personalized assessment of the child's clinical motor profile but also to set up the personalized rehabilitation treatment of "action observation", a new rehabilitation model based on the functioning of mirror neurons.

Leading this important project, funded for almost 6 million euros (precisely 5,999,942€) by the European Union under the EU Horizon Framework Program, will be the Italian team of the University of Pisa, led, as scientific coordinator, by the researcher Dr. Giuseppina Sgandurra of the Department of Clinical and Experimental Medicine, together with a group of researchers from the Computer Science Department of the University of Pisa coordinated by Professor Giuseppe Prencipe. The clinical trial will be handled by the IRCCS Stella Maris Foundation of Calambrone (prof. Giovanni Cioni); the Scuola Superiore Sant'Anna with the Institute of Biorobotics (Eng. Matteo Cianchetti) for the development of new sensorized devices with robotic technology and the Institute of Management (Prof. Giuseppe Turchetti) for the sustainability of the project in the European health system. The University of Salento (prof Fiorella Battaglia) will deal with the ethical aspects of the use of artificial intelligence in the developmental age. For the first time, FightTheStroke Foundation, with its operational arm FTS SME, the main Italian group in support of parents of children with cerebral palsy, takes part from the design phase and will bring the voice of the needs of families co- creating solutions designed around young patients; as well as the presence in the consortium of three companies in the sector: Khymeia for the development of software and tele-healthcare architecture; Noldus Information Technology for the development of a new innovative software platform for the observation phase of the action observation treatment, and Tyromotion GMBH which will guide the daily monitoring of the evaluation of the upper limbs. As international partners there will be Universidad De Castile - La Mancha (Spain), Katholieke Univesiteit Leuven (Belgium) who together with Stella Maris will take care of the clinical part, providing for the involvement of at least 200 children, The University of Queensland (Australia) for finetuning the development of artificial intelligence algorithms to be integrated into the model.

What does it mean and what are the main goals of the project?
"The project is very broad and complex - says dr. Giuseppina Sgandurra researcher at the University of Pisa and Head of the INNOVATE Laboratory of the Stella Maris Foundation - who adds - the AInCP project aims to develop an ethical and sustainable decision-making process to provide a personalized and validated approach for the monitoring and tele-rehabilitation of hemiplegia in children with cerebral palsy, thanks to the use of artificial intelligence. It will be a significant example of a transdisciplinary approach thanks to a consortium in which clinicians, data scientists, physicists, engineers, economists, ethics experts, small and medium-sized enterprises, children and parents' associations will work, all together in a synergical way for co-creation of diagnostic and rehabilitative approaches, highly innovative, clinically validated and capable of being sustainable and adequate to the reality of European health systems ".

The voices of some of the protagonists highlight the complexity and relevance of the AlnCP Project. "It is a great satisfaction to be able to make a contribution, together with other colleagues from our Department, to this important and exciting project - said prof. Giuseppe Prencipe and prof. Paolo Ferragina, as Deputy Dean of Computer Science of the University of Pisa and member of the group of researchers of the Computer Science Department involved in the project - not only for the scientific aspects underlying the definition and development of new Big Data Analytics technologies and Artificial Intelligence for functional diagnosis and the personalized tele-rehabilitation of children with hemiplegia, but also and above all for the rehabilitative and social repercussions that these potentially will have on children and their families.

Professor Giovanni Cioni, Scientific Director of IRCCS Stella Maris Foundation highlights the possible repercussions on children and families: "This is a project of great importance that opens up new perspectives of diagnosis and therapy for the most serious and frequent motor disturbance in children, cerebral palsy; the project partners are from many countries, but the essential core is the result of the synergy between 3 institutions in Pisa, as well as the University, the Scuola Superiore Sant'Anna and the IRCCS Stella Maris which has always followed these young patients. The coordinator, Giuseppina Sgandurra, was a student of all 3 of these Institutions and was able to exploit what she learned to compete successfully and prevail over the many projects presented. Above all, we will be able to personalize our intervention more and more and provide each child and his family with the right care with the greatest guarantee of being able to develop their adaptive functions ".

High technology within simple objects. "Within the project - explains Matteo Cianchetti, researcher at the Institute of BioRobotics of the Scuola Superiore Sant'Anna - we will develop high-tech devices that will lead to the creation of a sensorized platform in all its parts. Taking advantage of our experience in the field of mechatronic technologies and soft robotics, we will transform simple toys and objects commonly used in children, into non-invasive systems for monitoring the movements of the upper limbs. "

The AlnCP Project wants to be immediately applicable in health systems. "Our contribution - explains Giuseppe Turchetti, Full Professor of the Institute of Management of the Scuola Superiore Sant'Anna - will be aimed, on one hand, at evaluating, from an HTA perspective, the economic implications related to the technologies that will be developed in the project and, on the other hand, to design new organizational models for patient management that favor the rapid introduction into clinical practice of innovations within a framework of sustainability for our National Health Service and other similar services in Europe. "

The role of parents will be central. "We’re proud to be part of this consortium and to set the pace for innovation in medicine, capitalizing on our previous experiences in the field of 'action observation', with the Mirrorable platform, and involving families in a real process of co-design - explains dr. Francesca Fedeli, Director of FTS srl -. Personalized medicine, data analysis, patient and family centered design: these are our skills, typical of the 'community-led healthcare' model. In this way, we hope to be able to contribute to an improvement in the living conditions of our children, in line with a new proximity medicine, for better management and rehabilitation of the most fragile categories ".

AlnCP is the acronym of the EU Project "Clinical validation of Artificial Intelligence for providing a personalized motor clinical profile assessment and rehabilitation of upper limb in children with unilateral Cerebral Palsy" - Horizon Europe Framework Program (HORIZON).

This article was first published on 1 March 2022 by University of Pisa.