Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"Association between lower extremity movement patterns and ACL loading in CAI patients across varied ankle sprain frequencies within a year.","authors":"Zeyi Zhang, Shengmeng Wei, Hanlin Shi, Youping Sun","doi":"10.1186/s12984-025-01552-9","DOIUrl":"https://doi.org/10.1186/s12984-025-01552-9","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the relationship between the biomechanical characteristics of lower extremity and anterior cruciate ligament (ACL) loading during single-leg landing in patients with chronic ankle instability (CAI) who have different ankle sprain frequencies within a year.</p><p><strong>Study design: </strong>Cross-sectional study; Level of evidence, 3.</p><p><strong>Methods: </strong>The incidence of ankle sprains among 74 male participants was meticulously documented over a one-year period. The participants had an average age of 21.78 years, a height of 176.37 cm, and a weight of 72.61 kg. Subsequently, a one-year monitoring period was implemented to assess the incidence of ankle sprains among the participants. The participants were classified into five groups according to their documented frequency of ankle sprains. The categories were as follows: The 2, 3, 4, 5, and 6 or more ankle sprain groups. Kinematic, kinetic, and electromyographic data were collected while participants performed a single-leg landing task. Lower extremity muscle force and ACL loading were modeled using OpenSim software.</p><p><strong>Results: </strong>CAI patients with more than four ankle sprains had higher peak ACL loading during single-leg landing than those with only two or three ankle sprains (P < 0.05). Additionally, CAI patients with more than four ankle sprains exhibited a limited range of ankle dorsiflexion and biceps femoris muscle force, which was significantly correlated with ACL loading (P < 0.05). CAI patients with more than 5 ankle sprains had greater ankle inversion angle, inversion angular velocity, vertical ground reaction force (GRF), rectus femoris muscle strength, and lower gastrocnemius, soleus muscle force during single-leg landing, and these biomechanical indices were significantly correlated with ACL strain (P < 0.05).</p><p><strong>Conclusion: </strong>Based on these findings, it appears that experiencing four ankle sprains within a year might be a threshold for the development of knee compensation in CAI patients. This compensation could result in a significant increase in ACL loading. The study also found that CAI patients with more than four ankle sprains commonly exhibited altered motor characteristics such as limited ankle dorsiflexion angle, increased ankle inversion angle, excessive vertical GRF, and insufficient gastrocnemius and soleus muscle force during the landing phase. These characteristics might be responsible for the observed increase in ACL loading. In the future, clinical practice and scientific research may benefit from targeted interventions to prevent ACL injuries in CAI patients with different sprain histories, in accordance with the findings of this study.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"72"},"PeriodicalIF":5.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788386","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":"Abnormal activity in the brainstem affects gait in a neuromusculoskeletal model.","authors":"Daisuke Ichimura, Makoto Sawada, Kenji Wada, Ritsuko Hanajima","doi":"10.1186/s12984-025-01596-x","DOIUrl":"https://doi.org/10.1186/s12984-025-01596-x","url":null,"abstract":"<p><strong>Background: </strong>The ability to start and stop locomotion in response to different situations is an essential survival strategy in mammals. Mammalian locomotion is controlled by central pattern generators in the spinal cord, which are modulated by higher centers, particularly by the stimulation of the midbrain locomotor region. The midbrain locomotor region consists of the pedunculopontine nucleus and cuneiform nucleus, each having different roles in animals. Optogenetic activation of the cuneiform nucleus increases locomotion activities, whereas that of pedunculopontine nucleus decreases them. In neurological disorders such as Parkinson's disease, patients exhibit disturbed locomotion controls, including freezing of gait, which is defined as \"a brief, episodic absence or marked reduction in the forward progression of the feet despite the intention to walk.\" However, the details and pathophysiological mechanisms of freezing of gait remain unclear.</p><p><strong>Methods: </strong>In this study, we aimed to elucidate the mechanisms underlying freezing of gait using a two-dimensional neuromusculoskeletal model fixed on the sagittal plane. This model consisted of a body with seven links and 18 muscles as well as a neural system including the brainstem and spinal cord. We developed a normal condition model and then derived a model of abnormal brainstem activity by modifying the parameters of the pedunculopontine nucleus and cuneiform nucleus during the initial 3 s of walking.</p><p><strong>Results: </strong>The normal models walked successfully following internal parameter optimization using standard genetic algorithms. In an abnormal model, 156 freezing of gait events were detected among 40,000 parameter sets using a freezing of gait-identifying algorithm. Hierarchical cluster analysis identified four clusters of parameters, based on the intensities of the pedunculopontine nucleus and cuneiform nucleus activity, differentiated in physiological movement types during freezing of gait events that were similar to the clinical classification types of freezing of gait.</p><p><strong>Conclusions: </strong>Our results indicate that pedunculopontine nucleus and cuneiform nucleus activities could be linked with freezing of gait and that different modifications of those activities could generate observed freezing of gait subtypes. Our models can provide insights relevant for understanding the pathophysiological mechanisms of freezing of gait and are expected to assist in the classification of freezing of gait subtypes.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"73"},"PeriodicalIF":5.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788299","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":"Can motion capture improve task-based fMRI studies of motor function post-stroke? A systematic review.","authors":"Zakaria Belkacemi, Liesjet E H van Dokkum, Andon Tchechmedjiev, Matthieu Lepetit-Coiffe, Denis Mottet, Emmanuelle Le Bars","doi":"10.1186/s12984-025-01611-1","DOIUrl":"10.1186/s12984-025-01611-1","url":null,"abstract":"<p><strong>Background: </strong>Variability in motor recovery after stroke represents a major challenge in its understanding and management. While functional MRI has been used to unravel interactions between stroke motor function and clinical outcome, fMRI alone cannot clarify any relation between brain activation and movement characteristics.</p><p><strong>Objectives: </strong>We aimed to identify fMRI and kinematic coupling approaches and to evaluate their potential contribution to the understanding of motor function post-stroke.</p><p><strong>Method: </strong>A systematic literature review was performed according to PRISMA guidelines on studies using fMRI and kinematics in post-stroke individuals. We assessed the internal, external, statistical, and technological validity of each study. Data extraction included study design and analysis procedures used to couple brain activity with movement characteristics.</p><p><strong>Results: </strong>Of the 404 studies found, 23 were included in the final review. The overall study quality was moderate (0.6/1). Thirteen studies used kinematic information either parallel to the fMRI results, or as a real-time input to external devices, for instance to provide feedback to the patient. Ten studies performed a statistical analysis between movement and brain activity by either using kinematics as variables during group or individual level regression or correlation. This permitted establishing links between movement characteristics and brain activity, unraveling cortico-kinematic relationships. For instance, increased activity in the ipsilesional Premotor Cortex was related to less smooth movements, whereas trunk compensation was expressed by increased activity in the contralesional Primary Motor Cortex.</p><p><strong>Conclusion: </strong>Our review suggests that the coupling of fMRI and kinematics may provide valuable insight into cortico-kinematic relationships. The optimization and standardization of both data measurement and treatment procedures may help the field to move forward and to fully use the potential of multimodal cortico-kinematic integration to unravel the complexity of post-stroke motor function and recovery.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"70"},"PeriodicalIF":5.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780140","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":"Wearable sensors for measuring spontaneous upper limb use in children with unilateral cerebral palsy and typical development.","authors":"Elena Beani, Mattia Franchi de 'Cavalieri, Silvia Filogna, Veronica Barzacchi, Matteo Cianchetti, Martina Maselli, Giada Martini, Valentina Menici, Giuseppe Prencipe, Elisa Sicola, Giovanni Cioni, Giuseppina Sgandurra","doi":"10.1186/s12984-025-01601-3","DOIUrl":"10.1186/s12984-025-01601-3","url":null,"abstract":"<p><strong>Background: </strong>Unilateral Cerebral Palsy (UCP) is a clinical condition which mainly involves the movement and muscle tone of one side of the body, often impacting the general manual function. While there are some clinical assessment tools aimed to quantify the Upper Limbs (UpLs) use and the manual abilities, acquiring information regarding the motor abilities outside the clinical environment, such as the UpLs use and their asymmetry during daily life, could provide a more complete evaluation of the child and open a new clinical reasoning. For this purpose, wearable sensors are one of the newest approaches for continuously monitoring UpLs functions without being invasive. The aim of this study was to use wearable sensors to compare spontaneous/daily UpLs usage and asymmetry with the Assisting Hand Assessment (AHA) test, as well as comparing the daily UpLs usage behavior of children with UCP with respect to Typical Developing (TD) peers.</p><p><strong>Methods: </strong>Eighty children (54 with UCP and 26 TD) wore an Actigraph sensor on each wrist during the AHA test and then at least for the following week of daily life. The amount of use of each hand and the asymmetry were analyzed during both the AHA and the following week of daily life using linear regression analysis and ANOVA models.</p><p><strong>Results: </strong>Significant relationships were found between the asymmetry detected during the week and both the AHA scores and the asymmetry detected during the test. UCP and TD children week asymmetry distributions were significantly different; moreover, some differences were found when grouping them by MACS levels.</p><p><strong>Conclusion: </strong>This paper proposes a new and easy technological methodology for monitoring UpLs behavior in daily life. Through wearable sensor data analysis, we demonstrate a linear correlation between asymmetry measured during smi-structured assessments and daily life. Additionally, we provide evidence of distinct patterns of UpLs usage between typically developing children and children with UCP in daily life.</p><p><strong>Trial registration: </strong>Clinical Trials.gov (NCT03054441).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"71"},"PeriodicalIF":5.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780148","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":"Frequency-specific modulation of motor cortical excitability by transcranial alternating current stimulation.","authors":"Lei Tingting, Chen Lilin, Wang Chuangjia, Si Jiamen, Zhang Shuxian, Ai Yinan, Liu Hanjun, Zheng Haiqing","doi":"10.1186/s12984-025-01610-2","DOIUrl":"10.1186/s12984-025-01610-2","url":null,"abstract":"<p><strong>Background: </strong>Transcranial alternating current stimulation (tACS) is a non-invasive technique that modulates neural oscillations, yet its specific effects on cortical excitability are not well-understood. This study investigated the effects of tACS on neuroplasticity in the primary motor cortex (M1) across different frequencies.</p><p><strong>Methods: </strong>In this randomized, sham-controlled, crossover study, 18 healthy young adults received β-tACS γ-tACS, and sham stimulation over the M1. Neurophysiological responses were assessed using motor evoked potentials (MEPs), electroencephalograms (EEG), and transcranial evoked potentials (TEPs) to determine the frequency-specific effects of tACS on cortical excitability and neuroplasticity.</p><p><strong>Results: </strong>γ-tACS significantly enhanced cortical excitability, as reflected by larger MEP amplitudes compared to both β-tACS and sham stimulation. In addition, γ-tACS resulted in significantly smaller M1-P15 amplitudes in TEP than other stimulation conditions. In contrast, β-tACS did not produce significant changes in either MEPs or TEPs compared to sham stimulation.</p><p><strong>Conclusion: </strong>These findings provide evidence that tACS induces frequency-dependent effects on cortical excitability and neuroplasticity within the M1. This selective modulation of cortical excitability with γ-tACS suggests its potential as a therapeutic intervention for optimizing motor function and rehabilitation.</p><p><strong>Trial registration: </strong>This study was registered in the Chinese Clinical Trial Registry (ChiCTR2300074898, date of registration: 2023/08/18).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"69"},"PeriodicalIF":5.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730377","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":"Neural modifications of transtibial prosthesis (TTP) users: an event-related potentials study.","authors":"Ampika Nanbancha, Weerawat Limroongreungrat, Manunchaya Samala, Jutima Rattanakoch, Gary Guerra, Wisavaporn Niamsang, Kittichai Tharawadeepimuk","doi":"10.1186/s12984-025-01606-y","DOIUrl":"10.1186/s12984-025-01606-y","url":null,"abstract":"<p><strong>Background: </strong>Individuals with lower-limb amputations are highly dependent upon prostheses to perform daily activities and adapt to environmental changes. Transtibial prosthesis (TTP) users in particular, experience greater challenges in motor control and demonstrate impaired cognitive functions, when compared to able-bodied persons. The identification of neural mechanisms underlying adaptation or compensation may contribute to the development and expansion of rehabilitation strategies.</p><p><strong>Objective: </strong>To examine neuroplasticity changes in transtibial amputees by analyzing event-related potentials (ERPs) obtained from Electroencephalogram (EEG) during Go/No-Go tasks to assess cognitive control and neural adaptations.</p><p><strong>Methods: </strong>Twenty-eight TTP users and twenty-eight able-bodied persons were recruited. EEG was recorded in eyes-open resting states, and ERPs during a Go/No-go task.</p><p><strong>Results: </strong>Our findings demonstrate that, during the resting-state, the TTP users group exhibited no significant differences in brain activity across regions. However, during Go/No-go task, an increase of N2 amplitude was observed, and significant reduction in the amplitude of P3 amplitude was noted when compared to able-bodied group.</p><p><strong>Conclusion: </strong>These findings demonstrated neural modifications by individuals with transtibial amputation, particularly in relation to inhibitory control, which is essential for effective attentional control. Deficits in inhibitory control may interfere with decision-making processes, thereby impairing the execution of daily activities that require sustained attention and cognitive flexibility. Based on these findings of neural adaptions, it may be necessary to consider targeted interventions aimed at enhancing cognitive control and incorporating specific cortical training strategies for TTP users.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"68"},"PeriodicalIF":5.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719894","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":"EEG-fMRI neurofeedback versus motor imagery after stroke, a randomized controlled trial.","authors":"Simon Butet, Mathis Fleury, Quentin Duché, Elise Bannier, Giulia Lioi, Lou Scotto di Covella, Emilie Lévêque-Le Bars, Anatole Lécuyer, Pierre Maurel, Isabelle Bonan","doi":"10.1186/s12984-025-01598-9","DOIUrl":"10.1186/s12984-025-01598-9","url":null,"abstract":"<p><p>Neurofeedback (NF), an advanced technique enabling self-regulation of brain activity, was used to enhance upper limb motor recovery in chronic stroke survivors. A comparison was conducted between the efficacy of NF versus motor imagery (MI) training without feedback. We hypothesized that employing a bimodal EEG-fMRI based NF training approach would ensure precise targeting, and incorporating progressive multi-target feedback would provide a more effective mean to enhance plasticity. Thirty stroke survivors, exhibiting partial upper-limb motor impairment with a Fugl-Meyer Assessment Upper Extremity score (FMA-UE) > 21 and partially functional corticospinal tract (CST) were randomly allocated to the NF and MI groups. The NF group (n = 15) underwent a bimodal EEG-fMRI NF training focused on regulating activity in ipsilesional motor areas (M1 and SMA), while the MI group (n = 15) engaged in MI training. Demographic and stroke clinical data were collected. The primary outcome measure was the post-intervention FMA-UE score. Change in bold activations in target regions, EEG and fMRI laterality index (LI) and fractional anisotropy (FA) asymmetry of the CST were assessed after the intervention in both groups (respectively ΔEEG LI, ΔMRI LI and ΔFA asymmetry) and correlated with FMA-UE improvement (ΔFMA). Participants from both groups completed the 5-week training, with the NF group successfully modulating their brain activity in target regions. FMA-UE improvement post-intervention tended to be higher in the NF group than in the MI group (p = 0.048), and FMA-UE increased significantly only in the NF group (p = 0.003 vs p = 0.633 for MI). This improvement persisted at one-month in the NF group (p = 0.029). Eight out 15 patients in the NF group positively responded (i.e., improved by at least for 4 points in FMA-UE) compared to 3 out 15 in the MI group. No significant between-group differences were found in the evolution of ipsilesional M1 (t = 1.43, p = 0.16) and SMA (t = 0.85, p = 0.40) activation maps. The NF group exhibited a more pronounced lateralisation in unimodal EEG LI (t = - 3.56, p = 0.0004) compared to the MI group, but no significant difference was observed for MRI LI. A non-significant difference in ΔFA asymmetry of the CST between the two groups was found (t = 25; p = 0,055). A non-significant correlation between unimodal ΔEEG LI and ΔFMA (r = 0.5; p = 0.058) was observed for the NF group. Chronic stroke survivors can effectively engage themselves in a NF task and can benefit from a bimodal EEG-fMRI NF training. This demonstrates potential for NF in enhancing upper-limb motor recovery more efficiently than MI training.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"67"},"PeriodicalIF":5.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710115","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":"Efficacy of high- versus moderate-intensity spatially distributed sequential stimulation in subjects with spinal cord injury: an isometric study.","authors":"Ehsan Jafari, Petar Kajganic, Vance Bergeron, Julie Di Marco, Amine Metani, Lana Popovic-Maneski","doi":"10.1186/s12984-025-01567-2","DOIUrl":"10.1186/s12984-025-01567-2","url":null,"abstract":"<p><p>For producing isometric contractions, spatially distributed sequential stimulation (SDSS) has been demonstrated to be superior to conventional single electrode stimulation (SES) in terms of fatigue reduction and the power output produced by the muscle. However, the impact of stimulation parameters, particularly stimulation intensity, on the effectiveness of SDSS is not sufficiently understood. The aim of this work is to compare the fatigue-reducing capabilities of SDSS at two significantly different electrical stimulation intensities in individuals with lower-limb motor-complete spinal cord injuries, in order to understand the impact of stimulation intensity on the effectiveness of SDSS. Two experiments were conducted, focusing on isometric contractions of the quadriceps muscle group (Experiment 1) and the vastus lateralis muscle (Experiment 2). The effectiveness of high-intensity SDSS was compared to that of moderate-intensity SDSS, with SES serving as a reference. Seven subjects with spinal cord injuries participated in the study. Fatigue and force metrics, including time to fatigue (TTF) and force-time integral (FTI), were analyzed for both electrical stimulation intensity levels. Statistical analysis indicated that the advantages of SDSS over SES in reducing muscle fatigue and enhancing force generation were significantly diminished at high intensity compared to moderate intensity. These findings provide valuable scientific insights into the practical applications of SDSS and contribute to a deeper understanding of its mechanisms in mitigating muscle fatigue. Further research is recommended to explore the effects of various stimulation parameters to optimize SDSS for different muscle groups and functional tasks.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"65"},"PeriodicalIF":5.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692378","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":"Customization of manual wheelchair components: a state-of-the-art review.","authors":"Sameer More, Michelle Dunn, Shannon A Rios, Rachael McDonald","doi":"10.1186/s12984-025-01547-6","DOIUrl":"10.1186/s12984-025-01547-6","url":null,"abstract":"<p><p>Custom wheelchairs, tailored to users' unique needs, have gained increasing attention because of their potential to increase mobility, comfort, and overall quality of life for the people using them. Employing a state-of-the-art review methodology, this literature review systematically categorizes the existing body of research on the design and manufacture of customizable manual wheelchair components, identifies current practices, and suggests areas for further research. We found that the literature to date has focused on the design and manufacture of custom-contoured cushions, and few studies have focused on other components or wheelchair customization as a whole. Technological advances in the past decade have seen the move from manual, time-consuming customization processes to digital workflows with the support of design tools. Advanced technologies such as 3D scanning, parametric modeling, product configuration systems, and finite element analysis have emerged as tools for enhancing the performance and aesthetics of wheelchair components. While the published literature provides a valuable foundation, the field of wheelchair customization is rapidly evolving, driven by ongoing innovations from manufacturers. This review highlights the need for further research to bridge the gap between academic knowledge and real-world progress in the design and manufacturing of custom manual wheelchairs.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"66"},"PeriodicalIF":5.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700730","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":"Wearable fall risk assessment by discriminating recessive weak foot individual.","authors":"Zhen Song, Jianlin Ou, Shibin Wu, Lin Shu, Qihan Fu, Xiangmin Xu","doi":"10.1186/s12984-025-01599-8","DOIUrl":"10.1186/s12984-025-01599-8","url":null,"abstract":"<p><strong>Background: </strong>Sensor-based technologies have been widely used in fall risk assessment. To enhance the model's robustness and reliability, it is crucial to analyze and discuss the factors contributing to the misclassification of certain individuals, enabling purposeful and interpretable refinement.</p><p><strong>Methods: </strong>This study identified an abnormal gait pattern termed \"Recessive weak foot (RWF),\" characterized by a discontinuous high-risk gait on the weak foot side, observed through weak foot feature space. This condition negatively affected the training and performance of fall risk assessment models. To address this, we proposed a trainable threshold method to discriminate individuals with this pattern, thereby enhancing the model's generalization performance. We conducted feasibility and ablation studies on two self-established datasets and tested the compatibility on two published gait-related Parkinson's disease (PD) datasets.</p><p><strong>Results: </strong>Guided by a customized index and the optimized adaptive thresholds, our method effectively screened out the RWF individuals. Specifically, after fine adaptation, the individual-specific models could achieve accuracies of 87.5% and 73.6% on an enhanced dataset. Compared to the baseline, the proposed two-stage model demonstrated improved performance, with an accuracy of 85.4% and sensitivity of 87.5%. In PD dataset, our method mitigated potential overfitting from low feature dimensions, increasing accuracy by 4.7%.</p><p><strong>Conclusions: </strong>Our results indicate the proposed method enhanced model generalization by allowing the model to account for individual differences in gait patterns and served as an effective tool for quality control, helping to reduce misdiagnosis. The identification of the RWF gait pattern prompted connections to related studies and theories, suggesting avenues for further research. Future investigations are needed to further explore the implications of this gait pattern and verify the method's compatibility.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"64"},"PeriodicalIF":5.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670188","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}