Evaluation of Dietary Supplementation in Patients With Gastrointestinal Disorders.

Probiotics such as Lactobacillus and Bifidobacterium can interact with immune cells, promoting the synthesis of anti-inflammatory cytokines such as IL-10. Studies have shown that they can significantly reduce inflammatory markers such as TNF-α and C-reactive protein (CRP) in conditions such as nonalcoholic hepatic steatosis.

Prebiotics, on the other hand, are substances that are not digestible by the body and are intended to assist the function of probiotics: prebiotics such as β-frucans and galacto-oligosaccharides selectively stimulate beneficial gut bacteria, which can attenuate inflammation in inflammatory bowel disease models. In addition, the production of short-chain fatty acids from prebiotic fermentation is linked to the reduction of systemic inflammation, as shown by decreased CRP levels in subjects consuming different prebiotic mixtures.

The combined use of probiotics and prebiotics, in addition to modulating inflammation, could also influence motor and cognitive function. Recent studies have demonstrated the beneficial effects of probiotics and prebiotics on coordination and motor function in various models, including Parkinson's disease.

Patients referred to the UOS Post-Acute Rehabilitation, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, who meet the inclusion criteria will be recruited. Patients will be randomly divided into two groups as specified below. One group (G-TrioB), without making any changes to the current therapeutic routine, will take 1 sachet of TrioBiotix360® daily for 3 months (12 weeks) and will receive a pamphlet with a series of postural hygiene exercises to be performed at home (at least 30 minutes per day, 5 days per week); the other group (G-CON) will receive only a pamphlet with a series of postural hygiene exercises to be performed at home (at least 30 minutes per day, 5 days per week) for a period of 3 months.

In addition, studies have shown the effect of probiotics on cognitive function, particularly in individuals with mild cognitive impairment and Alzheimer's disease; prebiotics, by enhancing the efficacy of probiotics, may promote a favorable environment for the gut microbiota, which is critical for cognitive health.

Triobiotix360® is a dietary supplement that combines prebiotics and probiotics to support the balance of intestinal bacterial microflora. The prebiotic component is characterized by the presence of Bioecolicans® gluco-oligosaccharide fiber, while the probiotic component is characterized by the presence of Bifidobacterium animalis ssp. Lactis BLC1 (DSM 17741), Lactobacillus acidophilus LA3 (DSM 17742), Lactobacillus rhamnosus IMC 501 (DSM 16104), Lactobacillus paracasei IMC 502 (DSM 16105) and Streptococcusther-mophilus SP4 (DSM 19385). This effect is enhanced by the presence of hyaluronic acid and a mineralized extract of Lithothamnion, a source of calcium, which contributes to the normal functioning of digestive enzymes. Innovative T\_win packaging technology preserves the viability of the mixture of 5 different starter culture bacterial strains, selected and blended to maximize product functionality.

• Short Physical Performance Battery (SPPB) [Срок оценки: Change from Baseline SPPB at 3 months and at 6 months]
• Timed 25 Foot Walk (T25FW) [Срок оценки: Change from Baseline T25FW at 3 months and at 6 months]
• Timed Up&Go Test (TUG) [Срок оценки: Change from Baseline TUG at 3 months and at 6 months]
• Trail Making Test (TMT) [Срок оценки: Change from Baseline TMT at 3 months and at 6 months]
• Symbol Digit Modalities Test (SDMT) [Срок оценки: Change from Baseline SDMT at 3 months and at 6 months]
• Stroop Colour Word Test (SCWT) [Срок оценки: Change from Baseline SCWT at 3 months and at 6 months]
• Hospital Anxiety and Depression Scale (HADS) [Срок оценки: Change from Baseline HADS at 3 months and at 6 months]
• Modified Fatigue Impact Scale (MFIS) [Срок оценки: Change from Baseline MFIS at 3 months and at 6 months]
• EuroQoL- 5D (EQ-5D) [Срок оценки: Change from Baseline EQ-5D at 3 months and at 6 months]
• Irritable Bowel Syndrome-Quality of Life (IBS-QOL) [Срок оценки: Change from Baseline IBS-QOL at 3 months and at 6 months]
• Silver Index (SI) [Срок оценки: Change from Baseline SI at 3 months and at 6 months]
• Bioimpedance analysis (BIA) [Срок оценки: Change from Baseline BIA at 3 months and at 6 months]