Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"From simulation to stimulation: a predictive synergy-based control strategy for functional electrical stimulation cycling in a person with spinal cord injury.","authors":"Alexandre B Peres, Gabriel G Carmona, Ana Carolina C de Sousa, Roberto S Baptista","doi":"10.1186/s12984-026-02024-4","DOIUrl":"https://doi.org/10.1186/s12984-026-02024-4","url":null,"abstract":"<p><strong>Background: </strong>Functional electrical stimulation (FES) cycling stimulation strategies are often derived from heuristics, or able-bodied kinematics and electromyography, which may be unsafe and non-representative for people with complete spinal cord injury. Optimally controlled predictive musculoskeletal simulations with synergy implementation offer a way to generate individualized, physiologically plausible muscle trajectories without prior experimental data. Building on a previous proof of concept, this study developed and experimentally validated a simulation-derived stimulation strategy for FES cycling.</p><p><strong>Methods: </strong>A two-stage musculoskeletal predictive simulation framework was implemented using OpenSim Moco. First, a speed-tracking optimal control problem optimized the model's kinematics and individual muscle trajectories. Second, muscle excitations were decomposed into functional synergies using non-negative matrix factorization, producing coordinated activation patterns for quadriceps and hamstrings muscle groups. Subject-specific constraints were incorporated into the model. The resulting activation profile was then processed and converted to a crank-angle lookup table for real-time control. Experimental validation was conducted in one subject with complete spinal cord injury (SCI), comparing the simulation-derived control signal (CS) with a refined empirical bang-bang (BB) protocol used in the Cybathlon 2024 edition.</p><p><strong>Results: </strong>Simulations generated stable synergy-based muscle trajectories aligned with expected cycling dynamics. Experimentally, performance varied with trial order, with both CS and BB enabling unassisted FES cycling. BB produced higher average power and cadence, while CS delivered more symmetrical left-right balance and showed partial recovery in performance in higher stimulation intensities.</p><p><strong>Discussion: </strong>Although BB outperformed CS in power and cadence, the CS approach proved to be feasible and has methodological advantages. The consistent and physiologically structured behavior of the CS signal demonstrates that predictive simulation can provide a safe, reproducible baseline for individualized FES cycling control, particularly for new users or research groups.</p><p><strong>Conclusion: </strong>This was the first implementation in cycling of optimal control-driven FES combined with muscle synergies, generating feasible, physiologically grounded stimulation profiles for FES cycling in an individual with complete SCI. While not surpassing a highly refined empirical strategy, the simulation-derived signal performed reliably and represents a promising foundation for model-based personalization of FES control.</p><p><strong>Trial registration: </strong>Universidade de Brasília Ethics Committee, 75441323.4.0000.8093.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"23 1","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224298","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":"Correction: Characteristics of plantar pressure during walking in stroke patients with hemiplegia of different brunnstrom stages: a study based on five-region smart insoles.","authors":"Jingsong Mu, Xue Liu, Yan Yuan, Songran Wang, Xingyu Dou, Shujie Hao, Chaobing Zhang, Wenming Fei, Baohu Hu, Yong Wang","doi":"10.1186/s12984-026-02163-8","DOIUrl":"10.1186/s12984-026-02163-8","url":null,"abstract":"","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"23 1","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182117","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":"In Memoriam: V. Reggie Edgerton.","authors":"Richard L Lieber, David J Reinkensmeyer, Joel W Burdick, Arun Jayaraman","doi":"10.1186/s12984-026-02152-x","DOIUrl":"10.1186/s12984-026-02152-x","url":null,"abstract":"","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"23 1","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081091","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":"Electrical bioimpedance spectral markers distinguish balance ability in older adults without provoking fall risk.","authors":"Abdelakram Hafid, Mia Folke","doi":"10.1186/s12984-026-02155-8","DOIUrl":"10.1186/s12984-026-02155-8","url":null,"abstract":"<p><strong>Background: </strong>Balance assessment in older adults is central to fall-risk evaluation and rehabilitation planning, yet widely used clinical tests such as the single-leg stance require postures most likely to provoke a fall. A method capturing neuromuscular contributions to postural control during safer, static postures would meaningfully advance clinical and home-based assessment.</p><p><strong>Method: </strong>We investigated whether electrical bioimpedance (EBI) recorded over the extensor digitorum longus (EDL), a muscle contributing to fine ankle-level postural adjustments, carries spectral signatures reflecting balance ability without provocative testing. Twenty-eight community-dwelling adults aged 60 to 74 years were stratified into two balance-ability groups by single-leg-stance performance, and EBI was recorded using a tetrapolar configuration during sitting, stable standing, and tandem standing. After standardized preprocessing, signals were analyzed in the time and frequency domains using spectral and time-frequency decomposition with peak-band and transient-event detection. From 61 candidate features, a non-redundant primary set of 25 was retained through predefined reduction rules and correlation screening. Between-group differences were evaluated using activity-adjusted, feature-wise generalized estimating equations, validated by participant-level permutation testing, with multiple-comparison control across the retained feature set.</p><p><strong>Results: </strong>Physiologically meaningful spectral power was concentrated within 0-10 Hz across all three postures. After activity adjustment, two frequency-domain features remained significant under false discovery rate correction and one survived Bonferroni correction. Participants with better balance exhibited stronger oscillatory organization of the EBI signal, reflected in greater power concentration within identifiable spectral peaks and a greater peak count, whereas participants with poorer balance showed a less peak-dominated, more broadband profile with larger and more irregular low-frequency amplitude fluctuations.</p><p><strong>Conclusion: </strong>Low-frequency spectral features of muscle EBI, recorded during safe static postures, distinguish balance ability in older adults and reveal differences in the temporal organization of distal postural-control activity. These findings support EBI-derived spectral markers as candidate muscle-level biomarkers of balance-control quality, offering a path toward safer, sensor-based assessment that does not require older adults to adopt postures associated with increased fall risk. The approach is well suited to integration with rehabilitation monitoring and could complement existing clinical balance evaluations in both supervised and unsupervised settings.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"23 1","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956234","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 a soft robotic exoskeleton for upper-limb rehabilitation in subacute stroke inpatient rehabilitation: a randomised controlled trial.","authors":"Kai Wen Elvina Tay, Pui Kit Tam, Qi Xie, Hwa Sen Lai, Wai Kin Yuen, Xiao Min Lilian Lim, Shu Ling Ng, Max Lim, Lee Mei Ong, Weiying Amelia Tan, Syamil Rosli, Jeong Hoon Lim","doi":"10.1186/s12984-026-02133-0","DOIUrl":"10.1186/s12984-026-02133-0","url":null,"abstract":"<p><strong>Background: </strong>Soft robotic devices may be a useful adjunct for stroke rehabilitation by providing higher intensity training, while allowing comfort and portability compared to rigid exoskeletons. We evaluated the efficacy of a sensor-assisted soft robotic glove (SSR) during inpatient stroke rehabilitation.</p><p><strong>Methods: </strong>This assessor-blinded, randomised controlled trial was conducted in 2 inpatient rehabilitation units. Adults aged 21-90 years old, with ischaemic or haemorrhagic stroke and unilateral upper-limb impairment were recruited between July 2023 and May 2025. Participants were randomised to either [1] SSR or [2] supervised Graded Repetitive Arm Supplementary Programme (GRASP) training for up to 15 sessions, 30-45 min/session; 5 days/week for up to 3 weeks. The primary outcome was Fugl-Meyer Assessment of Upper Extremity (FMA-UE). Secondary outcomes included Stroke Upper Limb Capacity Scale, the DuruÖz Hand Index, and Stroke Impact Scale-16 (SIS-16). Outcomes were assessed at baseline (T1), post-intervention (T2) and follow-up at 3 months (T3).</p><p><strong>Results: </strong>Recruitment ceased before the planned sample size was reached due to funding constraints. Therefore, the trial was underpowered to detect the prespecified between-group difference. Of 323 screened individuals, 61 were randomised. 3 participants did not complete T2 assessment resulting in a modified intention-to-treat population of 58 (SSR n = 28, control n = 30). Both groups showed improvement across primary and secondary outcomes, with no statistically significant differences observed between them. In a post-hoc exploratory subgroup analysis with baseline FMA-UE < 35 and ≥ 10 sessions (n = 38), a statistically significant difference in FMA-UE distal sub-score at T2 was observed, favouring the SSR group (mean difference 3.06, 95% confidence interval [CI] 0.02 to 6.09, p = 0.049) but not at T3. A numerically higher proportion of participants in the SSR group achieved minimal clinically important difference value for SIS-16 (77.8% vs. 55.0%, adjusted odds ratio 6.52 (95% CI 1.00 to 42.58, absolute risk difference 22.8% [95% CI -7.2% to 47.4%], p = 0.050) at T2, but did not reach statistical significance.</p><p><strong>Conclusion: </strong>Sensor-assisted soft robotic glove training did not demonstrate superiority over supervised GRASP for upper limb function post-stroke. Exploratory subgroup analyses identified a signal suggesting improved distal hand motor recovery in participants with greater baseline impairment with sufficient therapy exposure.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"23 1","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008611","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 an actuated ankle exoskeleton on walking stability in healthy adults: a controlled laboratory study.","authors":"Cagla Kettner, Melina Beyerlein, Charlotte Marquardt, Miha Dežman, Tamim Asfour, Thorsten Stein","doi":"10.1186/s12984-026-02151-y","DOIUrl":"10.1186/s12984-026-02151-y","url":null,"abstract":"<p><strong>Background: </strong>Ankle exoskeletons are widely used to reduce the metabolic cost of walking, yet their effects on walking stability during unperturbed gait remain insufficiently understood. Walking stability can be characterized using complementary measures that capture stride-to-stride variability, global temporal organization, and local dynamic stability. Understanding how walking with an actuated ankle exoskeleton system influences these different aspects of gait stability is essential for the safe design and control of wearable robotic devices.</p><p><strong>Methods: </strong>Eighteen healthy adults walked on a treadmill at a constant speed (1.1 m/s) with and without an actuated bilateral ankle exoskeleton in a randomized crossover design. Spatiotemporal variability was quantified using coefficients of variation (CoV) of stride length, step width, and stance ratio. Global gait stability was assessed using detrended fluctuation analysis of stride time. Local dynamic stability was evaluated using maximum Lyapunov exponent calculated for the trunk, hip, upper leg, lower leg, and foot. Paired-samples two-sided t-tests were used to compare conditions.</p><p><strong>Results: </strong>Walking with the ankle exoskeleton resulted in increased stride-to-stride spatiotemporal variability, reflected by higher CoV values for stride length (p < 0.001) and stance ratio (p = 0.005), while mean stride length and step width remained unchanged. Mean stance ratio was reduced in the exoskeleton condition (p < 0.001). Global gait stability did not differ between conditions, indicating preserved long-range temporal gait organization. Local dynamic stability increased at the lower leg (p < 0.001) and foot (p = 0.019) when walking with the exoskeleton.</p><p><strong>Conclusions: </strong>Walking with the actuated ankle exoskeleton alters gait control across multiple levels during steady walking. While stride-to-stride variability in stride length and stance ratio increased, global gait stability remained unchanged. Local dynamic stability was increased at the lower leg and foot, suggesting segment-specific effects of ankle-level assistance close to the assisted joint. However, these findings should be interpreted as the combined effect of wearing the exoskeleton and receiving active assistance, rather than the isolated effect of plantarflexion assistance. These results provide insight for the design and control of ankle exoskeletons with respect to stability-related effects during walking.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"23 1","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912276","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":"Cortical neuromodulation by vibration-induced illusion of movement is observed in older individuals, but not in individuals with acute stroke: a cross-sectional fNIRS study.","authors":"Brieuc Léger, Pascal Auzou, Élodie Fourdrinoy, Mathilde Sarrazin, Sylvine Celot, Céline Gay, Barbara de Dieuleveult, Clara Cohen, Canan Özsancak, Stéphane Perrey","doi":"10.1186/s12984-026-02129-w","DOIUrl":"10.1186/s12984-026-02129-w","url":null,"abstract":"<p><strong>Background: </strong>Together with the aging of the world population, stroke incidence is expected to increase in the coming years. Stroke is frequently associated with sensorimotor impairments of the upper limb, including proprioceptive deficits, that substantially impair motor control and quality of life. Understanding how physiological aging and acute stroke affect proprioceptive processing is therefore crucial for developing targeted rehabilitation strategies.</p><p><strong>Methods: </strong>Vibration-induced illusion of movement was administered to 28 young, 30 older, and 23 individuals with acute stroke to the distal tendon of the triceps brachii. In healthy participants, vibration was applied to both arms, whereas in participants with acute stroke, it was applied to the paretic left arm. Vibration-induced illusion of movement was delivered either with or without visual feedback of the vibrated arm. Each condition consisted of six 15-s vibrations at 80 Hz. The illusion was quantified using the Standardized Kinesthetic Illusion Procedure scale, while cerebral hemodynamic activity within frontoparietal and sensorimotor areas was assessed using fNIRS through changes in (de)oxyhemoglobin concentrations. Subsequently, activation profiles were established, and group cerebral hemodynamics and functional neural efficiency were compared.</p><p><strong>Results: </strong>Older adults exhibited more extensive bilateral activation in the frontoparietal and sensorimotor cortices compared with young adults, suggesting age-related changes in neural recruitment during proprioceptive processing. In contrast, participants with acute stroke showed no significant task-related cortical activation and displayed an overall reduction in cerebral activity compared with both healthy groups. Despite this reduced activation, neural efficiency in participants with acute stroke was comparable to that observed in older participants.</p><p><strong>Conclusion: </strong>Together, these findings suggest that preserved compensatory mechanisms may still be engaged early after stroke, and suggest potential implications of vibration-induced illusion of movement to limit age-related proprioceptive decline and to support early rehabilitation after stroke.</p><p><strong>Clinical trial registration: </strong>NCT06218563-2024-01-12.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"23 1","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865253","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 variable stiffness orthosis: customizable mechanics for assistance and rehabilitation.","authors":"Nikko Van Crey, David Lam, Emily Bywater, Max Shepherd, Elliott Rouse","doi":"10.1186/s12984-025-01805-7","DOIUrl":"10.1186/s12984-025-01805-7","url":null,"abstract":"<p><strong>Background: </strong>Challenges with community mobility are among the most prevalent disabilities worldwide, yet the passive orthoses available for daily use have remained largely unchanged for centuries. In contrast, the powered orthoses developed by researchers have advanced rapidly, but without a matching rate of user impact. To date, there are no powered ankle-foot orthoses available for daily use, stemming from challenges with reliability, safety, weight, noise, and cost. This work aims to explore the untapped potential of passive mechanisms, as a pathway that could more rapidly translate improved functionality to the people who rely on orthoses. To this end, we developed an orthosis with passive and quasi-passive mechanisms that render capabilities typically attributed to powered devices, blurring the line between powered and passive functionality.</p><p><strong>Methods: </strong>In this work, we present the Variable Stiffness Orthosis, an ankle-foot orthosis that strikes a balance between powered and passive orthoses in terms of functionality and daily-use practicality. The Variable Stiffness Orthosis has torque-angle relationships that can be customized with a cam-based transmission, interchanged between gait phases with a cam-switching mechanism, and softened or stiffened between activities with a motorized spring support. These mechanisms enable precise control over the torque-angle relationship, including continuously variable stiffness, decoupled energy storage and return, step-to-step adjustment of stiffness magnitude, exchanging energy between gait phases, changing equilibrium angle between gait phases, negative stiffness, and extreme stiffness. These capabilities were validated on a rotary dynamometer and pilot tested on participants with and without sciatic nerve injury.</p><p><strong>Results: </strong>Dynamometer testing verified the capabilities of the VSO. In pilot testing, the participants had activity-dependent stiffness preferences spanning a large range. Using the VSO, the participant with sciatic nerve injury had reduced foot drop, increased total ankle moments, reduced biological ankle moments, reduced toe striking, and reduced steppage on their AFO side compared to walking with and without their daily-use device.</p><p><strong>Conclusions: </strong>This work demonstrated that the passive and quasi-passive mechanisms within the VSO can replicate many powered functions, extending the capabilities of unpowered devices. The VSO also showed promise as a daily-use device, a clinical tool for orthotic prescription, and a research tool for investigating unexplored passive mechanics.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"23 1","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818795","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":"Brain-computer interface for upper limb functional recovery post-stroke: a meta-analysis of improvement in upper limb motor function and changes in neurophysiological markers.","authors":"Huanhuan Zhang, Runzhi Xian, Yuchi Zhang, Xiaoyu Liu, Guoqiang Yang, Guiquan Chen","doi":"10.1186/s12984-026-02080-w","DOIUrl":"10.1186/s12984-026-02080-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Brain-Computer Interface (BCI) has emerged as a promising intervention, facilitating recovery of upper limb motor function, enhancing associated neurophysiological markers, and improving activities of daily living (ADL) performance, which is measured using the Modified Barthel Index (MBI). Nevertheless, most existing research has centered on individual outcome domains, and thus critical questions remain unanswered. These questions include heterogeneity in treatment efficacy across different post-stroke phases, in addition to the consistency of BCI's effects across specific functional assessment scales, such as the Fugl-Meyer Upper Extremity Scale (FMA-UE) and the Action Research Arm Test (ARAT)-and on neurophysiological markers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To perform a systematic review and meta-analysis of the effects of BCI-mediated rehabilitation versus conventional rehabilitation on upper limb motor function, functional activities, neurophysiological markers, and MBI performance in patients with stroke.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Systematic searches were performed in 7 databases for this study: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wan Fang Data, and China Biology Medicine Database (CBM). Inclusion criteria were randomized controlled trials (RCTs) comparing BCI-mediated rehabilitation with conventional rehabilitation in patients with upper limb dysfunction following stroke. The primary outcome measure was FMA-UE scores. Secondary outcome measures included functional activity levels as assessed by ARAT, neurophysiological markers (e.g., motor evoked potentials, MEPs, electroencephalography, EEG indices), and MBI scores. The methodological quality of the included studies was assessed using the validated evidence-based Cochrane Collaboration's RoB 2.0. In the meta-analysis, if the results of the heterogeneity test were less than 25%, the fixed-effect model was employed; otherwise, the random-effects model was used. For each outcome measure, the mean difference (MD) or standardized mean difference (SMD), together with their corresponding 95% confidence intervals (95% CI), were calculated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After screening against the inclusion and exclusion criteria, 16 eligible randomized controlled trials (RCTs) were ultimately included, encompassing a total of 1761 patients. Compared with conventional rehabilitation interventions, BCI rehabilitation interventions exert a certain effect on improving patients 'upper limb motor function (SMD = 0.49, 95%CI;0.26-0.73, p = 0.037).Additionally, significant improvements were observed in ARAT scores (SMD = 0.53, 95% CI: 0.14-0.91, p = 0.035),neurophysiological markers(SMD = 0.53, 95% CI;0.08-0.98, p &lt; 0.05)and MBI scores(SMD = 0.85, 95% CI;0.55-1.14, p &lt; 0.001).Subgroup analyses of BCI-mediated rehabilitation interventions for upper limb motor function recovery in stroke patients demonst","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"23 1","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813320","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":"Network-oriented neurorehabilitation after stroke: a paradigmatic approach.","authors":"Fabio M Conti, Roger Gassert, Naz Doganci, Adrian G Guggisberg","doi":"10.1186/s12984-026-02052-0","DOIUrl":"https://doi.org/10.1186/s12984-026-02052-0","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Stroke recovery increasingly demands a reconceptualization of the brain as a dynamic network system. This opinion paper advocates for a network-oriented neurorehabilitation paradigm, grounded in the understanding that functional recovery relies on the reorganization of distributed, interconnected neural systems across the central nervous system. While traditional rehabilitation approaches often target isolated impairments, a broader challenge is in the insufficient specification and documentation of therapeutic processes and their underlying mechanisms, which are often incompletely described and difficult to systematically replicate or compare across studies. We argue that effective therapy must integrate cognitive, motor, sensory, as well as perceptual, emotional, and motivational processes through strategically designed, goal-directed exercises that activate residual plastic hubs and promote adaptive connectivity. From this perspective, rehabilitation becomes a process of guided network modulation, in which task demands are dynamically adjusted to the patient's evolving capacities in order to optimize engagement and learning. Importantly, this approach responds to the need for clearer identification of treatment components, mechanisms of action, and active ingredients, enabling a more transparent and theoretically grounded description of therapeutic interventions. To illustrate these principles, we highlight key features of Cognitive Multisensory Rehabilitation (CMR) and its subsequent development into the Comparison of Actions (CTA) approach, which emphasizes action simulation and comparison within a network-oriented framework. Building on this rationale, we present a Model Structure for Network-Based Therapeutic Exercises, consisting of a five-phase model derived from a network-oriented interpretation of the CMR/CTA framework. This model provides an operational structure for translating theoretical principles into clinical practice, while making the underlying cognitive and sensorimotor processes of therapeutic action explicitly identifiable and parametrically modulable, thereby supporting greater clarity, reproducibility, and consistency in therapeutic design and implementation. In addition, we discuss how emerging technologies, such as robotics and virtual reality, may further support network engagement by enabling the controlled delivery, monitoring, and adaptation of these processes within structured therapeutic frameworks. By aligning therapeutic planning with network neuroscience, this model offers a structured yet flexible approach to personalized rehabilitation. It allows therapeutic tasks to be systematically adapted across distinct phases based on the patient's neuropsychological profile, sensorimotor status, and functional goals, while making treatment components and mechanisms more explicit and clinically interpretable. In doing so, it supports a more individualized, functionally relevant, and theoretically grounded approach","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"23 1","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794244","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}