Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"Real-time locomotion mode detection in individuals with transfemoral amputation and osseointegration.","authors":"Bahareh Ahkami, Morten B Kristoffersen, Max Ortiz-Catalan","doi":"10.1186/s12984-025-01672-2","DOIUrl":"10.1186/s12984-025-01672-2","url":null,"abstract":"<p><strong>Background: </strong>Despite notable advancements in prosthetic leg technology, commercially available devices with embedded algorithms utilizing bioelectric signals for prosthetic leg control are lacking. This untapped potential could enhance current prosthetic leg capabilities, enabling more natural movements. However, individuals with short residual limbs have limited available muscle and it has not been investigated if different locomotion modes can be predicted in real-time in this population. Here, we explored the feasibility of using electromyographic signals in individuals with short residual limbs and osseointegrated implants to infer locomotion modes.</p><p><strong>Methods: </strong>We recorded data from five participants with transfemoral amputation and osseointegration while walking on level ground, stairs, and ramps. Electromyography, acceleration, angular velocity, and ground reaction force were collected using wireless sensors. Two sessions of recordings for offline and real-time evaluation were conducted, with 30 rounds and 15 rounds, respectively. Decoding was performed using a mode-specific, phase-dependent classifier. The method was implemented in LocoD, an existing open-source platform, allowing for further development by the community and allowing easy comparison between different classification algorithms. The evaluation of the platform and prediction algorithm relies on quantifying the transition error, signifying instances where the algorithm falls short in predicting shifts between different walking surfaces.</p><p><strong>Results: </strong>In this study, a participant exhibited an average error as low as 1.2%, indicating precise predictions. Conversely, the highest average error was found at 23% in a different participant. This variation could be the result of factors related to the amputation such as residual limb length, remaining muscles, and the surgical technique used while performing the amputation, as well as differences in performing the movements. On average, offline classification resulted in a mean error of 5.7%, while the corresponding mean error during online (real-time) evaluation was 11.6%.</p><p><strong>Conclusion: </strong>Our findings suggest that myoelectric signals can be potentially used in the control of prosthetic legs for individuals with short residual limbs with osseointegrated implants. Further research into understanding and compensating for variations in the locomotion detection accuracy for different participants is crucial.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"142"},"PeriodicalIF":5.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475630","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":"Individual muscle strengths in rehabilitation outcomes of distal radius fracture.","authors":"Lunjian Li, Xuanchi Liu, Lihai Zhang","doi":"10.1186/s12984-025-01669-x","DOIUrl":"10.1186/s12984-025-01669-x","url":null,"abstract":"<p><strong>Background: </strong>Distal radius fractures (DRFs) are common fracture types and elderly patients often struggle to achieve functional recovery, which could be overcome by precise rehabilitation. This study aims to develop an innovative approach for acquiring patient-specific musculoskeletal models to provide guidelines for therapists to tailor rehabilitation plans individually.</p><p><strong>Method: </strong>A wearable EMG detector (Myo armband) and a dynamometer (KDG grip strength tester, EH101) were used to collect EMG signals and grip forces from 20 volunteers at 0, 30, 50, 70, and 100 N, which were considered low-level gripping. The collected data was used to train neural networks to predict maximum grip force from low-level grip data only. Based on a novel scaling function, personalized models were scaled from a standard musculoskeletal model and were validated by comparing their results with experiments. Sequentially, the musculoskeletal forces of two volunteers with different muscle strengths (one strong in muscle strength and the other is weak, compared to baseline) were simulated under extension exercises to investigate the impact of individual muscle strengths on rehabilitation outcomes.</p><p><strong>Results: </strong>The trained model predicts the maximum grip force by EMG signals well. Based on the scaling function, the corresponding personalized musculoskeletal models can simulate grip forces that align well with experiment observations. The muscle loadings were also scaled proportionally to their scaling coefficients. However, the contact forces are not linear to the scaling coefficients. The healing outcome of weak individuals shows satisfactory improvement while that of strong individuals performs ordinarily.</p><p><strong>Conclusion: </strong>This study has successfully developed a convenient approach to detect the maximum grip strength of patients and verified the feasibility of scaling the musculoskeletal models. The non-linear relationship of contract forces to the scaling coefficients indicates the complexity of the musculoskeletal system. The healing outcomes from the case studies suggest that while adequate mechanical stimuli are beneficial, excessive or inappropriate stimuli can impede the healing process.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"140"},"PeriodicalIF":5.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475629","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":"Effect of virtual reality training on dual-task performance in older adults: a systematic review and meta-analysis.","authors":"Xiaoyu Wei, Chun Huang, Xinyue Ding, Zhining Zhou, Yufeng Zhang, Xiaofan Feng, Suwang Zheng, Tingting Li, Jiaojiao Lü","doi":"10.1186/s12984-025-01675-z","DOIUrl":"10.1186/s12984-025-01675-z","url":null,"abstract":"<p><strong>Background: </strong>Age-related decline in dual-task (DT) performance is closely associated with falls in older adults, posing a significant public health concern. Virtual reality (VR) training has emerged as a novel intervention to enhance motor-cognitive integration, yet its effects on dual-task performance require systematic evaluation.</p><p><strong>Objective: </strong>The purpose of this systematic review and meta-analysis was to assess the impact of VR training on dual-task performance in older adults.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we searched four databases for randomized controlled trials (RCTs) evaluating VR training in adults aged ≥ 60 years. Inclusion criteria required comparisons between VR training and non-VR control groups, with outcome measures including dual-task cost (DTC), dual-task timed up-and-go (DT-TUG), DT gait parameters (speed, stride length, cadence), and DT cognitive performance. Methodological quality was assessed using the Cochrane Risk of Bias tool, and meta-analysis were conducted using RevMan 5.4.</p><p><strong>Results: </strong>Twenty-one RCTs (935 participants) were included. Meta-analysis revealed significant improvements in VR groups for DTC of gait speed [SMD = -0.32, 95% CI (-0.57, -0.07), P = 0.01], stride length [SMD = -0.58, 95% CI: (-0.90 to -0.26), P < 0.001] and cadence [SMD = -0.32, 95% CI (-0.64, 0.00), P = 0.05]. DT-TUG time decreased significantly [SMD = -0.54, 95% CI (-0.89, -0.19), P = 0.002]. VR training also enhanced dual-task gait speed [SMD = 0.38 95% CI (0.03, 0.73), P = 0.03] and stride length [SMD = 1.15, 95% CI (0.81, 1.49), P < 0.001]. Subgroup analyses showed VR brought more notable improvements for MCI and PD patients. For VR interventions, durations over 1 h per session, more than 4 - week duration, and 3-5 sessions per week yielded better results. Yet, no significant improvements were observed in other DT aspects like cognitive reaction times and rapid gait speed.</p><p><strong>Conclusion: </strong>VR training effectively reduces DT performance decline in older adults, particularly by lowering DTC and enhancing functional mobility, supporting its potential as a fall prevention strategy.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"141"},"PeriodicalIF":5.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475627","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 virtual reality-based exercise intervention in young people with attention-deficit/ hyperactivity disorder: a systematic review.","authors":"Jia-Ling Sun, Xiao-Jun Chaw, Shane Fresnoza, Hsiao-I Kuo","doi":"10.1186/s12984-025-01671-3","DOIUrl":"10.1186/s12984-025-01671-3","url":null,"abstract":"<p><strong>Background: </strong>Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder among the young population in the world. Young people with ADHD are often affected in their performance of attention, behavior, and executive functions (EFs), leading to a limited quality of life. Recently, Virtual reality (VR)-based exercise has been used as an intervention for young people with ADHD. Therefore, this review aims to evaluate the effectiveness of VR-based exercise in improving EFs and reducing ADHD symptoms in young people.</p><p><strong>Method: </strong>This review aims to systematically review the effects of VR-based exercise on the overall EFs and their subdomains, as well as ADHD symptoms in young people with ADHD. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42024604205) and was funded by the National Science and Technology Council, R.O.C., with the project number 112-2314-B002-119-MY3. Studies were identified in five databases (Cochrane Library, Web of Science, PubMed, SCOPUS, and Embase) from September 2010 through September 2024. Studies that applied VR-based exercise intervention on young participants with ADHD were included in this systematic review. A total of 6 studies met the inclusion criteria and were considered high quality according to standardized assessment lists.</p><p><strong>Results: </strong>Based on the 6 included studies and a total of 192 participants, the results showed that VR-based exercise with moderate to vigorous intensity provides positive effects on multiple subdomains of EFs (inhibitory control, attention, working memory, switching, and planning) and clinical symptoms in young people with ADHD. Furthermore, fully immersive and semi-immersive VR-based exercise interventions yielded similar results.</p><p><strong>Conclusion: </strong>VR-based exercise effectively improves EFs and is feasible for young people with ADHD, with benefits observed across ages and with sessions over 30 min. However, more evidence is essential for VR-based exercise intervention, which may compare the effects to other intervention types. Additionally, studies with rigorous experimental design are warranted.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"139"},"PeriodicalIF":5.2,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475628","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":"Modifying lumbar flexion pain thresholds in patients with chronic low back pain through visual-proprioceptive manipulation with virtual reality: a cross-sectional study.","authors":"Jaime Jordán-López, María D Arguisuelas, Julio Doménech, M Lourdes Peñalver-Barrios, Marta Miragall, Rocío Herrero, Rosa M Baños, Juan J Amer-Cuenca, Juan F Lisón","doi":"10.1186/s12984-025-01664-2","DOIUrl":"10.1186/s12984-025-01664-2","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Background: </strong>Movement-evoked pain may serve as a protective response influenced by visual-proprioceptive cues signaling potentially threatening movements. This study aimed to assess the impact of manipulating visual-proprioceptive feedback using virtual reality (VR) during lumbar flexion on movement-evoked pain thresholds. Additionally, we explored whether individuals with elevated pain, kinesiophobia, and catastrophizing were more susceptible to visual-proprioceptive manipulation.</p><p><strong>Methods: </strong>Fifty participants with non-specific chronic low back pain (cLBP) were included. We assessed lumbar flexion-evoked pain thresholds alongside pain levels, pain interference, kinesiophobia, and catastrophizing. Participants performed lumbar flexion movements in three conditions: (1) without VR (control, F), (2) with a virtual illusion shortening the perceived arm length by 20% (understated condition, F-), and (3) with a virtual illusion elongating arm length by 20% (overstated condition, F +). Range of motion (ROM) was measured using an electro-goniometer. One-way ANOVA with Bonferroni post-hoc tests examined differences among conditions, and three two-sample t-tests explored whether individuals with higher pain, kinesiophobia, and catastrophizing were more affected by visual-proprioceptive manipulation.</p><p><strong>Results: </strong>Understating the flexion task (F-) led to a 5% increase in movement compared to the control (P = 0.04; 95% CI [0.6%, 10.7%]) and a 7% increase compared to the overstated condition (F +) (P < 0.001; 95% CI [2.6%, 11.6%]). Additionally, individuals with higher pain levels and pain interference, exhibited a more pronounced response to the understated condition (F-).</p><p><strong>Conclusions: </strong>Manipulating visual-proprioceptive feedback through VR significantly influenced pain thresholds during lumbar flexion in cLBP patients. The understated condition (F-) extended pain-free movement, delaying pain onset. Furthermore, pain intensity and interference modulated susceptibility to visual feedback manipulation. These findings enhance our understanding of how visual-proprioceptive feedback influences pain perception and movement patterns in cLBP. They suggest new avenues for pain assessment, therapeutic interventions, and clinical strategies, particularly for individuals with high pain levels, interference, kinesiophobia, and catastrophizing. TRIAL REGISTRATION  : This study was retrospectively registered in the ClinicalTrials.gov with identifier NCT06750887.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"138"},"PeriodicalIF":5.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333291","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":"Classification of left and right-hand motor imagery in acute stroke patients using EEG microstate.","authors":"Shiyang Lv, Xiangying Ran, Mengsheng Xia, Yehong Zhang, Ting Pang, Xuezhi Zhou, Zongya Zhao, Yi Yu, Zhixian Gao","doi":"10.1186/s12984-025-01668-y","DOIUrl":"10.1186/s12984-025-01668-y","url":null,"abstract":"<p><strong>Background: </strong>Stroke is one of the leading causes of adult disability, often resulting in motor dysfunction and brain network reorganization. Brain-computer interface (BCI) systems offer a novel approach to post-stroke motor rehabilitation, with motor imagery (MI) serving as a key paradigm that requires decoding left and right-hand MI differences to optimize system performance. However, the neural dynamics underlying these differences, especially from the perspective of Electroencephalography(EEG) microstate, remain poorly understood in acute stroke patients.</p><p><strong>Methods: </strong>This study enrolled 14 acute stroke patients and recorded their EEG data during left and right-hand MI tasks. Four EEG microstate (A, B, C, and D) were analyzed to extract temporal feature parameters, including Duration, Occurrence Coverage, and transition probabilities(TP). Significant features were used to construct classification models using Linear Discriminant Analysis(LDA), Support Vector Machines(SVM), and K-Nearest Neighbors(KNN) algorithms.</p><p><strong>Results: </strong>Microstate analysis revealed significant differences in temporal features of microstate A and C during left and right-hand MI tasks. During left-hand MI, microstate A exhibited longer Duration(P_fdr=0.032), higher Occurrence(P_fdr=0.018), and greater Coverage(P_fdr=0.004) compared to the right-hand, whereas microstate C showed the opposite pattern(P_fdr=0.044, P_fdr=0.004, P_fdr=0.004). Additionally, the TP from microstate B→A, D→A and D→C also demonstrated significant differences(P_fdr=0.04, P_fdr<0.001, P_fdr=0.006). Among classification models, the KNN algorithm achieved the highest accuracy of 75.00%, outperforming LDA and SVM. Fisher analysis indicated that the Occurrence of microstate C was the most discriminative feature for distinguishing between left and right-hand MI tasks in acute stroke patients.</p><p><strong>Conclusion: </strong>Differences in EEG microstate features during left and right-hand MI tasks in acute stroke patients may reflect lateralized mechanisms of brain network reorganization. Microstate features hold significant potential for both post-stroke brain function assessment and the optimization of BCI systems. These features could enhance adaptive BCI strategies in acute stroke rehabilitation.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"137"},"PeriodicalIF":5.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326059","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 mechanisms underlying the improvement of gait disturbances in stroke patients through robot-assisted gait training based on QEEG and fNIRS: a randomized controlled study.","authors":"Xiang Li, Huihuang Zhang, Wanying Zhang, Jianing Wu, Lei Dai, Nasha Long, Tiefeng Jin, Lei Gu, Jianer Chen","doi":"10.1186/s12984-025-01656-2","DOIUrl":"10.1186/s12984-025-01656-2","url":null,"abstract":"<p><strong>Background: </strong>Robot-assisted gait training is more effective in improving lower limb function and walking ability in stroke patients compared to conventional rehabilitation, but the neural mechanisms remain unclear. This study aims to explore the effects of robot-assisted gait training on lower limb motor dysfunction in stroke patients and its impact on neural activity in the motor cortex, providing objective evidence for clinical application.</p><p><strong>Methods: </strong>Forty-two stroke patients meeting the inclusion criteria were randomly assigned to either the experimental group receiving robot-assisted gait training or the control group receiving conventional overground walking training. Assessments were conducted at baseline and after four weeks of treatment. Primary outcome measures included cortical activation measured by functional near-infrared spectroscopy (fNIRS), power ratio index (PRI), and delta/alpha power ratio (DAR) measured by quantitative electroencephalography (QEEG), and their correlation with the Fugl-Meyer Assessment (FMA) for lower limb motor function. Secondary outcome measures included FMA and Functional Ambulation Category (FAC).</p><p><strong>Results: </strong>Data from 36 patients (18 in each group) after four weeks of treatment were analyzed. The fNIRS results indicated better activation in the premotor and supplementary motor cortices in the robot-assisted gait training group compared to the control group. QEEG analysis showed reduced PRI and DAR in the premotor, supplementary motor, and primary motor cortices in the robot-assisted gait training group, suggesting improved motor function recovery in stroke patients. Clinical scale analysis revealed superior motor function recovery in the robot-assisted gait training group compared to the control group.</p><p><strong>Conclusions: </strong>Robot-assisted gait training significantly enhances activation in the primary motor cortex and supplementary motor area, potentially aiding stroke patients in recovering their ability to plan. PRI and DAR, particularly PRI, are valuable clinical indicators for assessing motor function recovery in stroke patients.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry (ChiCTR2200060668). Registered on June 6, 2022; https://www.chictr.org.cn/showproj.html?proj=171610 .</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"136"},"PeriodicalIF":5.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326060","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":"Use of the non-paretic arm reflects a habitual behaviour in chronic stroke.","authors":"Sebastian Sporn, E Bonyadi, R Fathana, L Tedesco Triccas, M Coll, S Bestmann, N S Ward","doi":"10.1186/s12984-025-01661-5","DOIUrl":"10.1186/s12984-025-01661-5","url":null,"abstract":"<p><strong>Background: </strong>A proportion of stroke survivors use their paretic arm less than might be expected based on their level of impairment. The resulting underuse of the paretic arm has a negative impact on participation in neurorehabilitation and functional independence. However, non-use remains poorly understood. One possibility is that prioritising the non-paretic arm reflects a habit, despite residual functional capacity in the paretic arm.</p><p><strong>Methods: </strong>30 chronic stroke survivors (Mean Fugl Meyer Upper Limb Score: 28.9 ± 11.3) participated in a simplified version of the forced response paradigm, which reliably identifies the presence of a habit. Participants were asked to choose which arm to use to maximise points scored during a reaching task. During half of the trials, the presumed habit of using the non-paretic arm yielded more points, whereas in the other half using the non-paretic arm incurred a loss of points. Participants completed two versions of this task, once with unlimited response time available and once without.</p><p><strong>Results: </strong>Participants scored fewer points in the limited response condition compared to the unlimited response conditions. This difference was driven by a selective increase in the use of the non-paretic arm in trials where the paretic arm yielded more points. The results were not mediated by former hand dominance.</p><p><strong>Conclusions: </strong>Our results demonstrate that not using the non-paretic arm may reflect a habit response that is more readily triggered in demanding (e.g. time-limited) situations. This may explain why successful neurorehabilitation does not always result in a more functionally useful arm. Our results pave the way for targeted interventions such as habit breaking techniques to be included in clinical practise.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"135"},"PeriodicalIF":5.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326061","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":"Evolution of joint power across the lifespan during walking.","authors":"Bernard X W Liew, Rachel Senden, David Rugamer, Kenneth Meijer, Qichang Mei, Kim Duffy, Kevin Netto, Matthew Taylor","doi":"10.1186/s12984-025-01647-3","DOIUrl":"10.1186/s12984-025-01647-3","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the evolution of lower-limb joint power values during walking across the lifespan.</p><p><strong>Design: </strong>Series of cross-sectional studies.</p><p><strong>Setting: </strong>This was a pooled analysis of the individual participant joint power data from six datasets, resulting in a sample size of 629 participants, between the ages of three to 91 years old.</p><p><strong>Main outcome measures: </strong>Three function-on-scalar regression models were fitted on the outcome measures of joint hip, knee, and ankle power. The covariates of this analysis included sex, age, walking speed, stride length, height, the interaction between age and speed, and a random intercept for different studies.</p><p><strong>Results: </strong>Ankle push-off (A2) power peaked with a value of 2.46 (95%CI 2.41 to 2.50) W/kg in the 3rd decade of life. Hip early-stance power (H1) peaked in the 1st decade, which followed a sharp decline with age till the 3rd decade. Hip pull-off power (H3) increased sharply to 0.86 (95%CI 0.84 to 0.88) W/kg in the 5th decade and stabilised thereafter with older age.</p><p><strong>Conclusion: </strong>Ankle push-off power appears to reach maturity in the 3rd decade of life. A strict temporal correspondence between a decline in ankle push-off power (A2) with age and a compensatory increase in hip pull-off power (H3) was not observed, challenging the distal-to-proximal alteration in propulsion strategy commonly attributed to the ageing process.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"133"},"PeriodicalIF":5.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275144","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":"AGREE: an upper limb motorized exoskeleton for restoring arm functions: a single-blinded randomized controlled trial.","authors":"Marta Gandolla, Beatrice Luciani, Valeria Longatelli, Peppino Tropea, Agnese Seregni, Massimo Corbo, Francesco Braghin, Alessandra Pedrocchi","doi":"10.1186/s12984-025-01651-7","DOIUrl":"10.1186/s12984-025-01651-7","url":null,"abstract":"<p><strong>Objectives: </strong>Technology-assisted neurorehabilitation is a promising strategy to address the healthcare system overload we are witnessing in recent years. Given the lack of concordance on the effectiveness of upper-limb exoskeletons, it is important to clinically test innovative prototypes. This randomized controlled trial evaluated AGREE, a motorized exoskeleton assisting shoulder and elbow movements with a novel unified control system, against standard care.</p><p><strong>Methods: </strong>The study involved 32 neurological patients with upper limb motor deficits at Casa di Cura del Policlinico (Italy). The randomization list was generated electronically to allocate participants into two groups. Both groups received 15 training sessions (45 min, three times weekly). The outcome measures considered were: (i) usability (System Usability Scale), (ii) clinical changes in Fugl-Meyer Assessment, Action Research Arm Test, Motricity Index, and Box and Block Test from baseline to post-treatment, and iii) treatment dosage.</p><p><strong>Results: </strong>The usability of the system was evaluated at the end of the intervention by participants with a resulting median SUS score of 68.7 (IQR = 31.8). Both groups showed comparable significant clinical improvements in all clinical outcome measures, with experimental group patients improving both according to the Fugl-Meyer ( <math><mi>Δ</mi></math>  FM = 2, IQR =4.5 ) and the Action Research Arm Test ( <math><mi>Δ</mi></math>  ARAT = 2, IQR = 4.5). The experimental group received significantly less actual treatment time than the control group, while the total number of sessions and therapy duration were equivalent for the two groups.</p><p><strong>Discussion and conclusions: </strong>Therapists operated the AGREE system independently, and no adverse events occurred. Patients reported a moderate usability of the system. While outcomes slightly favoured the control group for FM and ARAT scales, the obtained results support literature evidence, which indicates that the two treatments are globally comparable. Notably, the experimental group achieved comparable improvements with reduced treatment time, suggesting therapy consistency and frequency may be more impactful than session duration. Future research should further examine optimal rehabilitation dosing strategies.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"134"},"PeriodicalIF":5.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275142","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}