Aims. To evaluate the quality of systematic reviews on telerehabilitation. Methods. The AMSTAR - Assessment of Multiple Systematic Reviews - checklist was used to appraise the evidence related to the systematic reviews. Results. Among the 477 records initially identified, 10 systematic reviews matched the inclusion criteria. Fifty percent were of high quality; anyway the majority of them did not report the following aspects: i) analysis of the grey literature; ii) a list of the excluded studies and their characteristics; iii) the identification of possible source of bias and the assessment of its likehood; iv) an appropriate method to combine the findings of the included studies addressing the heterogeneity as well. From the main findings of the high-scored systematic reviews telerehabilitation resulted at least as effective as usual care: 1) in the short term treatment of mental health related to people affected by spinal cord injury; 2) in rural communities for treating patients affected by chronic conditions; 3) in treating common pathologies (mainly asthma) affecting children and adolescents. As for stroke, evidence is currently insufficient to reach conclusions about its effectiveness. As for costs, there is insufficient evidence to confirm that telerehabilitation is a cost-saving or cost-effective solution. Conclusions. In the authors' knowledge this is the first attempt to evaluate the quality of systematic reviews on telerehabilitation. This work also identified the main findings related to the high-scored systematic reviews; the analysis confirms that there is a mounting evidence concerning the effectiveness of telerehabilitation, at least for some pathologies.

BACKGROUND: Since 2006, the Italian National Institute of Health (ISS) has been conducting independent scientific activities to standardize the technical assessment of plantar pressure measurement devices (PMDs). MATERIAL AND METHODS: On the basis of the ISS results, in 2010 the Pedobarographic Group of the International Foot and Ankle Biomechanics community (i-FAB-PG) promoted a consensus activity about the main technical requirements for the appropriate use of PMDs. The activity relied on a moodlebased on-line forum, documents exchange, discussions, reviews, meetings and a final survey. RESULTS: The participation of clinical and technical researchers, users, and manufacturers, contributed to the delivery of the hereby reported recommendations which specifically regard Medical PMDs in the form of platforms. CONCLUSIONS: The i-FAB-PG community reached overall agreement on the recommendations, with a few minor objections which are reported and commented in the document. RELEVANCE: The present document, the highest result achievable within a small scientific community, will hopefully represent the starting point of the wider process of establishing official international guidelines or standards, within scientific communities and standardization organizations.

BACKGROUND: A partire dal 2006, l'Istituto Superiore di Sanità (ISS) ha condotto attività scientifiche indipendenti mirate alla standardizzazione della valutazione tecnica di dispositivi per la misura della pressione plantare (PMDs). MATERIALI E METODI: A partire dai risultati dell'ISS, nel 2010 il Gruppo Pedobarografico della International Foot and Ankle Biomechanics community (i-FAB-PG) ha lanciato un'attività di consensus relativa ai requisiti tecnici essenziali per un uso appropriato dei PMD. L'attività si è basata su; un forum su piattaforma moodle; scambio, discussione e revisione di documenti; incontri finalizzati; verifica finale di agreement. RISULTATI: La partecipazione di ricercatori, utilizzatori clinici e tecnici, e produttori, ha contribuito alla definizione delle raccomandazioni qui di seguito riportate, che si riferiscono nello specifico a PMD utilizzati in ambito clinico, in forma di piattaforme. CONCLUSIONI: La comunità i-FAB-PG ha raggiunto un accordo generale sul documento, con solo qualche residua minore obiezione, riportata e commentata nel documento. RILEVANZA: È auspicabile che il documento, che costituisce il massimo risultato raggiungibile all'interno di una piccola comunità scientifica, possa rappresentare il punto di partenza di un più ampio processo per la definizione di linee guida ufficiali e di standard, nell'ambito di società scientifiche e di enti normatori.

A worldwide scientific discussion has been started in 2010 on the need for standardisation, assessment, and delivery of recommendations in the field of plantar pressure distribution measurement at different levels: hardware performance, measuring protocols, data processing, parameters and indicators in diagnosis and therapy. The Italian National Institute of Health (Istituto Superiore di Sanità, ISS) has been conducting for years a scientific project and several activities aimed to design, validate and implement dedicated testing methods and recommendations in the field of pressure measurement devices (PMDs). The present commentary contains a summary of the activities conducted up to now and some future steps which are going to be done at an international level.

Accurate plantar pressure measurements are mandatory in both clinical and research contexts. Differences in accuracy, precision, reliability of pressure measurement devices (PMDs) prevented so far the onset of standardization processes and of reliable reference datasets. The Italian National Institute of Health (ISS) approved and conducted a scientific project aimed to design, validate and implement dedicated testing methods for both in-factory and on-the-field PMD assessment. A general-purpose experimental set-up was built, complete and suitable for the assessment of PMDs based on different sensor technology, electronic conditioning and mechanical solutions. Preliminary assessments have been conducted on 5 commercial PMDs. The study lead to the definition of: i) an appropriate set of instruments and procedures for PMD technical assessment; ii) a minimum set of significant parameters for the technical characterization of the PMD performance; iii) some recommendations to both manufacturers and end users for an appropriate use in clinics and in research context

Misure accurate della pressione plantare sono fondamentali in contesti clinici e nella ricerca. Differenze di accuratezza, precisione e affidabilità dei dispositivi di misura di pressione (PMD) hanno impedito fino ad ora la messa in atto di processi di standardizzazione e la costruzione di database di riferimento affidabili. L'Istituto Superiore di Sanità (ISS) ha approvato e condotto un progetto scientifico al fine di progettare, validare ed implementare metodi di test dedicati, per la valutazione tecnica di PMD sia in fabbrica che sul campo. È stato costruito un set-up sperimentale, completo e adattabile all'assessment di PMD basato su differenti tecnologie, condizionamento elettronico, soluzioni meccaniche. Valutazioni preliminari sono state condotte su 5 PMD commerciali. Lo studio ha portato alla definizione di: i) un appropriato set di strumenti e procedure per l'assessment tecnico dei PMD; ii) un set minimo di parametri significativi per la caratterizzazione tecnica delle loro prestazioni metrologiche; iii) raccomandazioni a fabbricanti e utilizzatori per un utilizzo appropriato dei PMD in clinica e in contesti di ricerca