Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"Characterizing spinal reflexes evoked by sensory spinal cord stimulation in people with lower-limb amputation.","authors":"Rohit Bose, Ashley N Dalrymple, Devapratim Sarma, Bailey A Petersen, Beatrice Barra, Ameya C Nanivadekar, Tyler J Madonna, Monica F Liu, Isaiah Levy, Eric R Helm, Vincent J Miele, Marco Capogrosso, Lee E Fisher, Douglas J Weber","doi":"10.1186/s12984-025-01720-x","DOIUrl":"https://doi.org/10.1186/s12984-025-01720-x","url":null,"abstract":"<p><strong>Background: </strong>People with lower-limb amputation lack sensory inputs from their missing limb, which increases their risk of falling. We recently demonstrated that spinal cord stimulation (SCS) can restore sensation in the missing lower limb. Previous studies have shown that SCS can affect motor control by exciting spinal reflex pathways after stroke or spinal cord injury. The effects of SCS on spinal reflex activation have not been studied in people with lower-limb amputation. Furthermore, it is unknown if SCS-evoked spinal reflex activation would perturb walking. Therefore, the goal of this study was to characterize SCS-evoked spinal reflexes in people with lower-limb amputation and quantify effects on gait parameters, including step cycle duration and limb alternation symmetry.</p><p><strong>Methods: </strong>We implanted percutaneous SCS electrodes over the lumbosacral enlargement in 3 people with transtibial amputation (2 diabetic neuropathy; 1 traumatic) for 28 or 84 days. SCS was delivered to restore sensation in the missing limb during walking based on signals from a pressure-sensing insole in the shoe under the prosthesis. We used electromyography (EMG) to record posterior root-muscle (PRM) reflexes in the residual limb while participants were seated, standing, or walking. We characterized rate-dependent depression and recruitment properties of the PRM reflexes. We used pressure data from instrumented insoles to measure the step cycle duration and limb alternation symmetry with and without SCS.</p><p><strong>Results: </strong>SCS evoked PRM reflexes in the residual limb muscles in all participants, which was confirmed by the presence of rate-dependent depression at stimulation frequencies ≥ 2 Hz. Overall, there was broad activation of residual limb muscles with SCS that varied with the position of the stimulating electrode relative to the lumbar spinal cord. PRM reflexes were also activated during walking, as confirmed by the presence of rate-dependent depression. However, SCS-evoked PRM reflexes did not disrupt gait, with similar step cycle duration or limb alternation symmetry with and without SCS.</p><p><strong>Conclusions: </strong>Restoring sensation in the missing limb using SCS excites spinal reflexes according to the expected rostral-caudal myotomes but does not disrupt the step cycle duration or limb alternation symmetry in people with transtibial amputation. Therefore, SCS can restore sensory feedback in the missing limb without disrupting the existing motor activation of the residual limb muscles.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"205"},"PeriodicalIF":5.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A time-efficient continuous ramp protocol for data-driven walking energy expenditure estimation across multiple speeds.","authors":"Jeong Hyunho, Park Sukyung","doi":"10.1186/s12984-025-01707-8","DOIUrl":"https://doi.org/10.1186/s12984-025-01707-8","url":null,"abstract":"<p><strong>Background: </strong>Recent research has sought to use data-driven models to estimate walking energy expenditure across multiple speeds via wearable devices. Many studies employ a discrete step protocol-repeatedly walking at a constant speed for several minutes-because indirect calorimetry depends on time-delayed respiratory responses. However, this approach becomes time-inefficient when constructing sufficiently diverse datasets for deep learning, which requires large amounts of distinctive data. To address this issue, we integrated a data-driven approach with a previously proposed continuous protocol wherein walking speeds are gradually increased within a single trial. The purpose of this study is to compare the effectiveness of such a continuous dataset for energy expenditure estimation against a conventional discrete approach.</p><p><strong>Methods: </strong>Fourteen subjects walked on a treadmill wearing four IMUs, while energy expenditure was measured using an indirect calorimetry. In the continuous ramp protocol, subjects walked for 10 mins at speeds linearly increasing from 1.0 to 1.75 m/s. The discrete step protocol involved five speeds within the same range, each maintained for 6 mins. In the continuous ramp protocol, energy expenditure was mapped to each speed after compensating for respiratory delay, whereas in the discrete step protocol, we used averaged breath-by-breath measurements of the final 3 minutes. We compared the kinematics, kinetics, and energy expenditure between the two protocols. Subsequently, 13 additional subjects were recruited to compare a commercial smartwatch with linear and deep learning models trained on datasets from each protocol.</p><p><strong>Results: </strong>After compensating for respiratory delays, no differences in energy expenditure were observed between the two protocols, although kinematic differences appeared at speeds above 1.5 m/s. These differences did not impair estimation accuracy: deep learning models trained on the discrete and continuous datasets showed comparable performance (13.1% vs. 10.7% mean error, respectively), both significantly outperforming the smartwatch. Furthermore, when trained on the more diverse data from the continuous ramp protocol, a deep learning model achieved uniformly low error across a broad speed range with only a single IMU.</p><p><strong>Conclusion: </strong>The continuous ramp protocol can generate a valid walking motion-energy expenditure dataset in a time-efficient manner, improving model performance by providing richer data diversity. This approach is not limited to walking speed but can be applied to other continuously changing exercise intensities across various forms of locomotion, thus promoting efforts to replace indirect calorimetry, traditionally requires extensive laboratory experiments.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"206"},"PeriodicalIF":5.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal interaction between muscle impairments and gait pathology in growing children with Duchenne muscular dystrophy.","authors":"Ines Vandekerckhove, Geert Molenberghs, Marleen Van den Hauwe, Nathalie Goemans, Liesbeth De Waele, Anja Van Campenhout, Friedl De Groote, Kaat Desloovere","doi":"10.1186/s12984-025-01718-5","DOIUrl":"https://doi.org/10.1186/s12984-025-01718-5","url":null,"abstract":"<p><strong>Background: </strong>Children with Duchenne muscular dystrophy (DMD) present with progressive gait pathology due to progressive muscle weakness and contractures. However, the associations between specific muscle impairments and specific gait features have never been quantified. Therefore, the aim of this longitudinal observational cohort study was to investigate the longitudinal interaction between progressive muscle impairments and progressive gait pathology in growing boys with DMD.</p><p><strong>Methods: </strong>Thirty-one boys with DMD (aged 4.6-16.4 years) were repeatedly measured between 2015 and 2022, resulting in a total dataset of 152 observations. Fixed dynamometry, goniometry and 3D gait analysis were used to assess lower limb muscle weakness, passive range of motion and gait. Joint random-effect models between gait and muscle outcomes were fitted. The correlation between the random intercepts (r_a) and random slopes (r_b) indicated the relationship between the initial values and progression rates over time of two outcomes, respectively.</p><p><strong>Results: </strong>Specific muscle impairments were related to specific gait features, both in terms of initial values (r_a=0.470-0.757; p < 0.029) and progression rates (r_b=0.547-0.812; p < 0.024). Decreased hip extension strength was associated with increased maximal posterior trunk angle (r_b=-0.588; p = 0.0004), increased maximal anterior pelvic tilt angle (r_a=-0.543; p = 0.0040 and r_b=-0.812; p < 0.0001), and reduced maximal hip extension moment (r_a=0.536; p = 0.0289). Decreased hip abduction strength was associated with increased step width (r_a=-0.549; p = 0.0021) and increased maximal internal foot progression angle (r_b=-0.547; p = 0.0117). Decreased knee extension strength was associated with reduced maximal knee extension moment (r_a=0.702; p < 0.0001), reduced maximal knee power absorption (r_a=0.757; p < 0.0001), and reduced dorsiflexion angle at initial contact (r_b=0.684; p = 0.0237). Decreased dorsiflexion range of motion was associated with reduced dorsiflexion angle at initial contact (r_a=0.732; p < 0.0001 and r_b=0.627; p = 0.0202) and reduced maximal dorsiflexion angle in swing (r_a=0.663; p < 0.0001).</p><p><strong>Conclusion: </strong>This is the first study that objectively quantified the longitudinal interaction between muscle impairments and gait features, providing valuable insights into the underlying mechanisms of pathological gait in DMD. The observed associations highlight the importance of targeted clinical assessments. These findings offer a foundation for optimizing rehabilitation strategies, orthotic management, and orthopedic interventions, ultimately improving clinical decision-making and enhancing mobility outcomes in children with DMD.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"207"},"PeriodicalIF":5.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analgesic effects and neural oscillatory mechanisms of music-synchronized virtual reality intervention.","authors":"Qi-Hao Yang, Shu-Hao Du, Le Tang, Yong-Hui Zhang, Xue-Qiang Wang","doi":"10.1186/s12984-025-01740-7","DOIUrl":"10.1186/s12984-025-01740-7","url":null,"abstract":"<p><p>Chronic pain affects over 30% of the global population, yet non-pharmacological interventions with clear neurophysiological mechanisms remain limited. While virtual reality (VR) and music therapy independently show promise in pain management, the neural oscillatory underpinnings of rhythm-synchronized audiomotor integration in VR therapy remain poorly understood. This study aimed to investigate whether music-synchronized virtual reality (MSVR) enhances analgesia through distinct neural mechanisms compared to conventional distraction-based VR or non-immersive interventions. 90 healthy adults (45 female, 22 ± 2 years) were randomized to a single session of: (1) MSVR (rhythm-synchronized visuomotor tasks with music), (2) conventional VR (identical tasks with white noise), or (3) non-immersive 2D control. Pressure pain thresholds (PPT) were measured at five movement-generating muscle sites. Conditioned pain modulation (CPM) efficiency was assessed using PPT and cold-water stimulation. 64-channel EEG recorded theta, alpha, beta, and gamma oscillations. Outcomes included PPT changes, CPM efficiency, cold pain intensity/unpleasantness, and neural spectral power. MSVR significantly increased PPTs across all sites (15-25% vs. control, P < 0.001; superior to VR in upper limbs, P < 0.05) and enhanced CPM efficiency by 18% (vs. control, P = 0.010; vs. VR, P = 0.046). Cold pain intensity decreased by 22% with MSVR (P < 0.05 vs. both groups). MSVR uniquely enhanced parietal alpha oscillations during and post-intervention (P = 0.001). MSVR also induced greater immersion and realism than VR (P < 0.001). MSVR significantly enhances endogenous pain inhibition and elevates pain thresholds more effectively than conventional VR or 2D interventions, primarily through rhythmic audiomotor integration modulating parietal alpha-oscillation modulation. These findings suggest MSVR as a scalable digital therapeutic strategy for pain management.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"202"},"PeriodicalIF":5.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intelligent prediction of dynamic characteristics during exercise in patients with stroke.","authors":"Qinghua Meng, Nan Zhang, Chunyu Bao, Luxing Zhou, Miaomiao Xiao, Zhiyuan Yang, Hongshuai Leng","doi":"10.1186/s12984-025-01734-5","DOIUrl":"10.1186/s12984-025-01734-5","url":null,"abstract":"<p><strong>Background: </strong>Accurate estimation of lower limb kinetic characteristics is critical for evaluating gait impairments and guiding rehabilitation in patients with stroke. Traditional three-dimensional (3D) optical motion capture systems provide high-precision measurements but are costly, require a laboratory environment, and are sensitive to marker placement errors. Inertial measurement unit (IMU) sensors, combined with machine learning models, may offer a portable and clinically feasible alternative.</p><p><strong>Methods: </strong>Thirty patients with stroke performed level walking and stair negotiation tasks while wearing IMU sensors. Joint kinematic data derived from the IMUs were processed using principal component analysis (PCA) for dimensionality reduction, and lower limb joint torques were predicted using a backpropagation (BP) neural network. The proposed Principal Component Analysis - Back Propagation (PCA-BP) model was evaluated using normalized root mean square error (NRMSE), root mean square error (RMSE), mean absolute percentage error (MAPE), and coefficient of determination (R²).</p><p><strong>Results: </strong>The PCA-BP model achieved high prediction accuracy for hip, knee, and ankle joint torques across sagittal, coronal, and transverse planes during both walking and stair tasks. Performance metrics indicated good agreement between predicted values and those obtained from OpenSim simulations based on IMU-derived kinematics.</p><p><strong>Conclusion: </strong>IMU-based gait analysis in patients with stroke demonstrated the potential to serve as an alternative to traditional 3D optical motion capture systems, particularly in non-laboratory or resource-limited settings. This approach offers portability and practicality for sports scientists and clinicians, supporting its potential integration into routine clinical rehabilitation assessments.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"203"},"PeriodicalIF":5.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical effects of the Össur Power Knee with phase-based and default control during sitting, standing, and walking.","authors":"T Kevin Best, C Andrew Seelhoff, Jeffrey Wensman, Robert D Gregg","doi":"10.1186/s12984-025-01729-2","DOIUrl":"10.1186/s12984-025-01729-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;A lack of evidence of compelling clinical benefits is a key factor limiting the adoption of commercialized powered robotic knee prostheses into mainstream clinical practice. Previous studies have demonstrated mixed results, potentially due to a combination of limitations in prosthetic hardware, control algorithms, and testing methodologies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We investigated the clinical effects of a commercialized robotic knee prosthesis (the latest generation Össur Power Knee&lt;sup&gt;TM&lt;/sup&gt;) with n=7 above-knee amputee participants. Participants with both higher (K4) and lower mobility (K3) completed a series of experiments including repeated sitting and standing, a stand, walk, sit shuttle test, and fast walking on a treadmill. We tested both standard (ÖSSR) and novel (HKIC) control policies and compared the resulting clinical metrics to those found with the users' prescribed passive prostheses. Our experiments were physically demanding, which could help elucidate the potential benefits of powered knees.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The clinical effects of the Power Knee varied with mobility level and the control policy used. The phase-based controller often produced stronger walking and sit/stand improvements for the higher mobility group compared to the default controller, though it also presented a steeper learning curve and reduced walk-to-sit transition speed. Conversely, the default control policy was perceived as easier to master but was less assistive to the higher mobility group and produced slower sit/stand cycles. Lower mobility participants experienced improvements in standing speed (HKIC: [Formula: see text]% faster, [Formula: see text]; ÖSSR: [Formula: see text]% faster, [Formula: see text]), inter-limb ground reaction force symmetry (HKIC: [Formula: see text], [Formula: see text]; ÖSSR: [Formula: see text], [Formula: see text]), and inter-limb peak knee moment symmetry (HKIC: [Formula: see text], [Formula: see text]; ÖSSR: [Formula: see text], [Formula: see text]) during sit-to-stand tasks relative to their passive prostheses. In contrast, higher mobility participants benefited less in sit/stand but showed improvements while walking including increased toe clearance (HKIC: [Formula: see text] mm, [Formula: see text]; ÖSSR: [Formula: see text] mm, [Formula: see text]), greater early stance knee flexion (HKIC: [Formula: see text], [Formula: see text]; ÖSSR: [Formula: see text], [Formula: see text]), and, for the HKIC policy, a reduced swing-phase peak hip flexion moment (HKIC: [Formula: see text] Nm/kg/(m/s), [Formula: see text]). Despite these biomechanical improvements and qualitative reports of reduced effort, neither control policy produced significant benefits in endurance or repeated task performance compared to the passive condition. Sit-to-stand cycle count in the lower mobility group was unchanged (HKIC: [Formula: see text], ÖSSR: [Formula: see text]), and it was reduced in th","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"200"},"PeriodicalIF":5.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of wrist and finger function in healthy children through music-based video game therapy.","authors":"Javier Urbina-Alarcón, Ana Angulo, Victoria E Abarca, Dante A Elias","doi":"10.1186/s12984-025-01742-5","DOIUrl":"10.1186/s12984-025-01742-5","url":null,"abstract":"<p><strong>Background: </strong>The loss of hand and wrist function significantly impairs an individual's ability to perform everyday tasks, resulting in reduced independence and a lower quality of life. Neurological disorders, such as cerebral palsy, are among the leading causes of such impairments. These conditions often lead to difficulties with muscle strength, coordination, and motor control, impacting an individual's ability to manipulate objects. Cerebral palsy is a prevalent neurological disorder in children that often causes severe impairments in hand and wrist function. Traditional rehabilitation methods, such as physiotherapy, are effective but often suffer from poor adherence, especially in pediatric populations. Therefore, the use of engaging interventions, such as music-based and game-based therapies, holds significant promise for improving therapy adherence and effectiveness in children with cerebral palsy.</p><p><strong>Methods: </strong>The proposed rehabilitation system integrates a wearable data glove with a music-based serious game to promote hand and wrist function in children with neurological impairments. The data glove, equipped with two inertial measurement unit sensors, detects hand and wrist movements, serving as the primary input device for the game. The game design incorporates music therapy elements, including metronome-based rhythms and volume feedback to motivate movement and enhance neuroplasticity. Three distinct games are designed to target wrist flexion and extension, ulnar and radial deviation, and gross motor grip.</p><p><strong>Results: </strong>Ten healthy pediatric participants completed all sessions under both music and no-music conditions. As the data were non-normal, the Wilcoxon signed-rank test was used. Statistically significant differences were found in all games, although effect sizes were small. These results suggest that music may subtly modulate motor performance. For example, in the Rocket game, music reduced variability and range of motion, suggesting more controlled wrist flexion/extension. In the Squirrel and Bubble games, music contributed to smoother movements and greater consistency in pinch grip, respectively. Usability survey data revealed high levels of user satisfaction and enjoyment, with items related to clarity, comfort, engagement, and particularly relaxation showing significant differences above neutral ([Formula: see text]).</p><p><strong>Conclusions: </strong>This study provides exploratory evidence supporting the feasibility of music-based, game-driven rehabilitation tools in pediatric populations. Although the observed effects were modest, the system demonstrated high usability and acceptability. Future studies should include clinical populations, assess longer-term retention effects, and further investigate how music-induced relaxation may support engagement and treatment adherence in rehabilitation contexts.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"198"},"PeriodicalIF":5.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative assessment of dynamic movement reveals deficits due to hemiparetic stroke.","authors":"Aleksandra Kalinowska, Millicent Schlafly, Kyra Rudy, Julius P A Dewald, Todd D Murphey","doi":"10.1186/s12984-025-01719-4","DOIUrl":"10.1186/s12984-025-01719-4","url":null,"abstract":"<p><p>The absence of sensitive tools for quantifying movement dysfunction hinders our ability to study the underlying causes of motor impairments and makes it difficult to demonstrate the effectiveness of therapeutic approaches. Consequently, it slows down progress in developing novel treatment protocols, including personalized impairment-targeted interventions. While there exist well-established metrics of static and quasi-static motion, such as reaching range, little emphasis has been placed on quantifying dynamic response-controlled and timing-sensitive movements where the continuous modulation of motor activity is required to respond to real-time stimuli. In this study, we employ robot-assisted virtual tasks that require dynamic motion in the upper limb, and develop metrics that assess dynamic capabilities by quantifying the frequency spectra of movement during these tasks. We assess chronic survivors of hemiparetic stroke across three dynamic tasks (n=13 for the first two tasks and n=48 for the third task). We find that hemiparetic stroke causes a significant decline in dynamic response at frequencies above 1.5Hz in the paretic upper limb, with the degree of functional loss dependent on the clinically assessed severity of motor impairment. Frequency-based metrics of dynamic motion could be used to assess performance during everyday activities, such as brushing teeth, cooking, or cleaning. A versatile quantitative assessment of dynamic motion can accelerate progress in understanding and rehabilitating functional dynamic motion in individuals with neuromotor disorders.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"199"},"PeriodicalIF":5.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of 10-Hz rTMS over the leg motor cortex using a double-cone coil on lower limb motor recovery in subacute stroke: a randomised, double-blind, sham-controlled study.","authors":"Guilan Huang, Hewei Wang, Weiwei Zhao, Jinyu Yang, Ze Zheng, Wang Yao, Yu Yao, Yao Qian, Chenchen Cheng, Zhipeng Pan, Bin Su, Li Zhang","doi":"10.1186/s12984-025-01745-2","DOIUrl":"10.1186/s12984-025-01745-2","url":null,"abstract":"<p><strong>Background: </strong>Lower limb dysfunction following stroke poses important challenges to patients' mobility and quality of life. Repetitive transcranial magnetic stimulation (rTMS) using double-cone coils for deep stimulation offers a promising avenue for the improved motor recovery of these patients. However, the efficacy and safety of this approach remain underexplored.</p><p><strong>Methods: </strong>A total of 56 subacute stroke patients were randomised to rTMS or sham stimulation (n = 28 per group), over 15 sessions in 3 weeks. The primary outcome was that of Fugl-Meyer assessment of the lower extremity (FMA-LE) at T3, with secondary outcomes, including those of Berg Balance Scale (BBS), modified Barthel index (MBI) and Brunnstrom scale. TecnoBody balance equipment was used to quantify sway length (SL) and sway area (SA). All outcome assessments were performed at baseline (T0), after 1 week (T1), after 2 weeks (T2) and 3 weeks (T3) of intervention. Intention-to-treat and per-protocol analyses were performed.</p><p><strong>Results: </strong>Among the 212 inpatients screened, 56 patients (age, 61.50 ± 5.41 years; 17 women, 46 ischemic) were enrolled in the study. Significant group-by-time interactions occurred, with the rTMS group displaying greater improvements than the sham group in FMA-LE (F = 2.883, P = 0.038) and BBS (F = 3.379, P = 0.020). No significant interactions were observed for MBI (F = 2.245, P = 0.085) or Brunnstrom scale (F = 1.565, P = 0.200). At T3, the rTMS group showed a 1.5 point significantly higher FMA-LE scores (95% confidence interval: 0.567-2.433, P = 0.002) compared with the sham group. TecnoBody balance assessments also showed superior results of the rTMS group for SA (F = 6.902, P < 0.001) and SL (F = 6.837, P < 0.001).</p><p><strong>Conclusions: </strong>Application of 10 Hz rTMS over the leg motor cortex with a double-cone coil holds potential to improve lower-limb motor function in subacute stroke patients.</p><p><strong>Trial registration: </strong>This trial was registered under ClinicalTrials.gov ID No. ChiCTR2100051566, prospectively registered, on September 26, 2021.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"201"},"PeriodicalIF":5.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating big data and artificial intelligence to predict progression in multiple sclerosis: challenges and the path forward.","authors":"Hamza Khan, Sofie Aerts, Ilse Vermeulen, Henry C Woodruff, Philippe Lambin, Liesbet M Peeters","doi":"10.1186/s12984-025-01748-z","DOIUrl":"10.1186/s12984-025-01748-z","url":null,"abstract":"<p><p>Multiple sclerosis (MS) remains a complex and costly neurological condition characterised by progressive disability, making early detection and accurate prognosis of disease progression imperative. While artificial intelligence (AI) combined with big data promises transformative advances in personalised MS care, integration of multimodal, real-world datasets, including clinical records, magnetic resonance imaging (MRI), and digital biomarkers, remains limited. This perspective paper identifies a critical gap between technical innovation and clinical implementation, driven by methodological constraints, evolving regulatory frameworks, and ethical concerns related to bias, privacy, and equity. We explore this gap through three interconnected lenses: the underuse of integrated real-world data, the barriers posed by regulation and ethics, and emerging solutions. Promising strategies such as federated learning, regulatory initiatives like DARWIN-EU and the European Health Data Space, and patient-led frameworks including PROMS and CLAIMS, offer structured pathways forward. Additionally, we highlight the growing relevance of foundation models for interpreting complex MS data and supporting clinical decision-making. We advocate for harmonised data infrastructures, patient-centred design, explainable AI, and real-world validation as core pillars for future implementation. By aligning technical, regulatory, and ethical domains, stakeholders can unlock the full potential of AI to enhance prognosis, personalise care, and improve outcomes for people with MS.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"204"},"PeriodicalIF":5.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}