Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"FES-Cycling at the Cybathlon 2024: assessing accuracy of power-pedals for low power output in a virtual race scenario.","authors":"Martin Schmoll, Anna Pataraia, Quang Nguyen, Bernhard Rosenauer, Erik Kornfellner, Renske S de Boer, Thomas P A Rijnbeek, Emilia Ambrosini, Nicole Sanna, Efe Anil Aksöz, Roberto de Souza Baptista, Henrique Resende Martins, Matheus Marcondes de Oliveira, Jozsef Laczko, Amelita Fodor, Winfried Mayr, Richard Crevenna","doi":"10.1186/s12984-026-02025-3","DOIUrl":"10.1186/s12984-026-02025-3","url":null,"abstract":"<p><strong>Background: </strong>The Cybathlon is a unique international competition platform for evaluating assistive technologies under real-life conditions. In the most recent edition, the FES-Cycling discipline was conducted on stationary smart trainers (Wahoo Kickr) within a virtual race environment. Participants could use either the smart trainer or a pedal-based power meter as the primary power source. As both systems were not specifically designed for the very low power outputs typically generated during FES-Cycling, the outcomes of the competition require careful interpretation.</p><p><strong>Methods: </strong>This work summarizes the FES-Cycling competition at the Cybathlon 2024 and evaluates the accuracy of pedal-based power meters used in the virtual race. Race performance data from ten pilots representing eight international teams were analyzed. Pedal-based power measurements were compared against a validated smart trainer during the competition. In addition, an assessment in a controlled environment was conducted to quantify pedal accuracy in the low-power range (< 25 W) using a crank-based power meter as reference. The influence of pedal mounting torque, ankle-orthosis mounting position, and crank-length compensation was systematically investigated.</p><p><strong>Results: </strong>Four of the ten pilots completed the full virtual race distance of 1960 m within the 8-min time limit. Mean cycling speeds (7.8-19.5 km/h) exceeded those reported for the over-ground Cybathlon 2016 race. Analysis of valid race segments revealed substantial overestimation of pedal-based power relative to the smart trainer, with relative errors ranging from 14.7 to 66.6%. Additional accuracy measurements confirmed that pedal-based power was sensitive to mounting torque and particularly to ankle-orthosis position, with lateral displacement of the foot causing pronounced overestimation. Crank-length compensation reduced systematic bias, but residual errors and increased variability persisted at higher cadences.</p><p><strong>Conclusion: </strong>Commercially available pedal-based power meters and stationary smart trainers are currently not well suited for reliable performance assessment in low-power FES-Cycling competitions within virtual race environments. While virtual formats offer clear logistical advantages, engaging training opportunities and rich performance data, traditional race formats should be reconsidered to better align with the functional goals of FES-Cycling. Future competitions should prioritize over-ground cycling, assessing externally observable outcomes such as distance and time, which may further enhance pilot motivation and public visibility.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148031712","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":"Correction: Repetitive transcranial magnetic stimulation influences cognitive-motor dual-task performance in children with cerebral palsy: a randomized controlled study.","authors":"Jingyi Zhao, Tingting Peng, Liru Liu, Lu He, Jingbo Zhang, Yuan Zhang, Qingfen Hou, Hongyu Zhou, Xubo Yang, Kaishou Xu","doi":"10.1186/s12984-026-02027-1","DOIUrl":"10.1186/s12984-026-02027-1","url":null,"abstract":"","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"23 1","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015889","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 vibration therapy on physical function, activity and participation in people with stroke: a systematic review and meta-analysis of randomized controlled trials.","authors":"Yage Wang, JingLan Wang, Beibei Lei, Di Zhang, Shenhong Ma, Heling Wang, Qiaohua Han, Weisheng Zhuang","doi":"10.1186/s12984-026-02016-4","DOIUrl":"10.1186/s12984-026-02016-4","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the effectiveness of vibration therapy (VT) in improving physical function, activity, and participation in people with stroke.</p><p><strong>Methods: </strong>We searched six databases for randomized controlled trials (RCTs) investigating VT in people with stroke. The quality of included studies was assessed using the Cochrane Risk of Bias tool, and data were analyzed using RevMan and Stata. The quality of evidence was evaluated with the GRADEpro tool.</p><p><strong>Results: </strong>Thirty-seven RCTs involving 1492 people with stroke were included. VT significantly improved physical function, including motor (SMD = 0.46, 95% CI 0.20-0.73), spasticity (SMD =  - 0.64, 95% CI - 0.99 to - 0.29), balance (SMD = 0.52, 95% CI 0.19-0.85), and gait (SMD =  - 0.41, 95% CI - 0.66 to - 0.16). Activity was also enhanced (SMD = 0.21, 95% CI 0.06-0.35), whereas participation did not show improvement (SMD = 0.01, 95% CI - 0.33 to 0.35). Subgroup analysis and meta-regression revealed that spasticity improvement was superior in people with chronic stroke (SMD =  - 0.8, 95% CI - 1.19 to - 0.4). Single-session vibration time ≥ 20 min for gait (SMD =  - 0.84, 95% CI - 1.36 to - 0.32), cumulative vibration time > 5 h for balance (SMD = 0.86, 95% CI 0.30-1.43), and intervention duration ≥ 4 weeks for spasticity (SMD =  - 0.5, 95% CI - 0.81 to - 0.2) yielded pronounced improvements.</p><p><strong>Conclusions: </strong>Low to moderate quality evidence suggests that VT effectively enhances physical function and activity in people with stroke, while its impact on participation remains unclear. Moreover, VT produced superior spasticity relief in people with chronic stroke compared to those in acute and subacute phases; single-session vibration time ≥ 20 min for gait, cumulative vibration time > 5 h for balance, and intervention duration ≥ 4 weeks for spasticity were particularly effective.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13383555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005494","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":"Evaluating upper limb movement smoothness metrics derived from markerless 3D motion tracking in children with neurological disorders.","authors":"Nikolas Hesse, Jan Lieber, Hubertus J A van Hedel","doi":"10.1186/s12984-026-02020-8","DOIUrl":"10.1186/s12984-026-02020-8","url":null,"abstract":"<p><strong>Background: </strong>Clinical assessment of movement smoothness during reaching in children is often based on subjective, ordinal-scaled therapist ratings. Markerless 3D motion tracking using an RGB-D camera offers a promising avenue for more objective and fine-grained smoothness evaluation. This study investigated the use of a new markerless RGB-D-based tracking method, SMPLify-KiDS, for the quantitative assessment of upper limb movement smoothness in a heterogeneous population of children with neurological impairments.</p><p><strong>Methods: </strong>Thirty-eight children with neurological diagnoses performed three reaching tasks from the Melbourne Assessment 2 (MA2) MA2 with their more affected arm while being recorded with an RGB-D camera. Upper limb kinematics were extracted using SMPLify-KiDS, and two widely used smoothness metrics-the log dimensionless jerk (LDJ) and the modified spectral arc length (SPARC)-were computed. The same movement sequences were independently scored by two therapists according to MA2 guidelines. Correlations between quantitative smoothness metrics and therapist scores were evaluated using Spearman's rank correlation coefficient, and smoothness metric differences between ordinal therapist score levels were analyzed using non-parametric statistical tests for individual items and averaged values.</p><p><strong>Results: </strong>Quantitative smoothness metrics showed moderate to strong correlations with therapist scores per item (for LDJ: [Formula: see text]; for SPARC: [Formula: see text]), and very strong to excellent correlations for averaged values (for LDJ: [Formula: see text], for SPARC: [Formula: see text]). Both metrics revealed statistically significant differences between ordinal therapist score levels, and LDJ strongly correlated with task duration.</p><p><strong>Conclusions: </strong>Smoothness metrics derived from markerless RGB-D motion tracking are able to discriminate between clinically assigned smoothness levels in children with neurological impairments. LDJ showed closer alignment with therapist scores than SPARC, potentially due to its relationship with movement duration-a factor that also appears relevant to clinical perception of smoothness. These findings support the integration of markerless motion capture into clinical assessments to provide objective, quantitative, and fine-grained information on movement quality, complementing established therapist-based evaluations.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987866","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":"Closed-loop movement-paired transcutaneous auricular vagus nerve stimulation for upper-limb rehabilitation: a feasibility study.","authors":"Clément Lhoste, Max Quast, Andrea Ronco, Abigail Vogel, Chris Easthope Awai, Meret Branscheidt, Olivier Lambercy, Paulius Viskaitis, Dane C Donegan","doi":"10.1186/s12984-026-02021-7","DOIUrl":"10.1186/s12984-026-02021-7","url":null,"abstract":"<p><p>Vagus nerve stimulation (VNS) paired with physical rehabilitation has shown promise for improving upper-limb function after neurological injury. In this study, we introduce SmartVNS, a wearable system that automatically delivers movement-paired transcutaneous auricular VNS using a wrist-worn intertial measurement unit (IMU) for accurate functional movement detection. We evaluated feasibility, usability and performance of the SmartVNS system in a four-week, 20-session clinical feasibility study involving nine individuals with stroke or spinal cord injury during conventional therapy. Despite a wide range of baseline upper-limb function in patients (ARAT scores 0-52), the system adapted to individual abilities and demonstrated a consistent stimulation rate between sessions and patients, averaging 14.7 stimulations/min with a low variability (SD = 3.4 stimulations/min; n = 9). The IMU-based movement detection algorithm achieved stimulation precision comparable to therapist manual triggering (precision as mean ± SEM: SmartVNS: 76.3 ± 3.1%, therapists: 82.4 ± 2.6%, video analysis used a ground truth), while delivering stimulation in double the number of movements (sensitivity as mean ± SEM: SmartVNS: 50.4 ± 5.0%, therapists: 23.4 ± 4.7%, video analysis used a ground truth). The system demonstrated high usability (patients and therapists rated UMUX: 85 ± 12%) and was well-tolerated by participants, with patients able to self-apply the device. Exploratory clinical outcomes showed consistent functional improvements across participants. These findings support the feasibility and usability of SmartVNS as a scalable neuromodulation platform to support neurorehabilitation.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981970","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":"Beyond en-bloc turning: dynamics of head-pelvis coordination in 360° turns in people with Parkinson's.","authors":"Phaedra Leveridge, Yuri Russo, Genevieve K R Williams, Jiaxi Ye, Zijing Wang, Sarah E Lamb, William R Young","doi":"10.1186/s12984-026-01996-7","DOIUrl":"10.1186/s12984-026-01996-7","url":null,"abstract":"<p><p>People with Parkinson's Disease (PD) and Freezing of Gait (FOG) reportedly turn using an 'en-bloc' strategy, where the head and pelvis rotate together, unlike the head-leading movement seen in healthy adults. However, previous research relies on discrete maximum separation angles in 180° walking turns, despite recommendations to use 360° on-the-spot turns to better induce FOG. Moreover, existing studies do not capture the time-varying coordination of body segments throughout the turn. Our study aimed to investigate head-pelvis during 360° on-the-spot turns in people with PD and FOG (PD + FOG), PD without FOG (PD-FOG), and healthy controls (HC). Fifteen PD + FOG, fourteen PD - FOG (tested ON medication), and seventeen healthy controls (HC) completed repeated 360° turns while kinematic data were collected using marker-based motion capture. Head and pelvis angles were calculated across strides in the first, middle, and final sections of the turn. Coordination was quantified using vector coding, alongside discrete measures of angular difference and turning performance. Head-pelvis angular difference did not differ between groups. However, PD + FOG showed increased coordination variability compared to HC (4.9°, p = 0.005) and PD - FOG (3.5°, p = 0.047); an observation no longer significant after adjusting for Motor Section (III) of the Movement Disorder Society-Unified PD Rating Scale (MDS-UPDRS) motor scores (p = 0.249) and Mini Balance Evaluation Systems Test (MiniBEST) score (p = 0.051). PD + FOG also took more steps than PD - FOG (34.0, p = 0.008) and HC (6.5, p < 0.001), even after adjusting for covariates (MDS-UPDRS: p = 0.037; MiniBEST: p = 0.003). These findings suggest that people with PD do not necessarily turn more en-bloc than healthy controls. While head-pelvis coordination variability is higher in PD + FOG, this does not seem to be linked to FOG pathology per se, but rather balance deficits associated with disease severity. The impact of balance training on coordination variability and turn performance should be evaluated. Increased step count seems to be related to FOG, which could be a factor that might provoke FOG, but may serve as a compensatory strategy to promote postural stability. Future work should investigate how stride length/frequency modulation during turning affects postural stability and FOG occurrence.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981651","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":"Instrumental assessment of Sit-to-Stand in Parkinson's disease: a scoping review.","authors":"Marco Trucco, Roberta Ditella, Anastasia Dhimitriadhi, Beatrice Occhetto, Martina Ballesio, Mirko Job, Marco Testa","doi":"10.1186/s12984-026-02023-5","DOIUrl":"10.1186/s12984-026-02023-5","url":null,"abstract":"<p><strong>Introduction: </strong>Parkinson's disease (PD) is a growing neurological challenge. The Sit-to-Stand (STS) transition is a key proxy for functional independence and fall risk. While sensor technology offers objective STS assessment, the methodological landscape is highly heterogeneous, lacking standardized protocols. This scoping review systematically maps the literature on the technological assessment of the STS transition in PD, focusing on sensors, tasks, settings, and variables. Additionally, the review details device accessibility and ecological validity in home-based settings, as these are two important elements for large-scale application and implementation in standardised protocols for both clinical assessment and real-world monitoring.</p><p><strong>Methods: </strong>A scoping review following Joanna Briggs Institute and PRISMA-ScR guidelines. Five major databases (PubMed, Embase, CINAHL, Scopus, Web of Science) and citation tracking were used to identify studies from 2015 to 2025. Eligibility criteria included studies with PD patients of any stage undergoing instrumental STS transition assessment. We mapped data according to sensors, tasks, settings, and variables. We performed specific subanalyses on Inertial Measurement Units (IMUs)-distinguishing research-grade 'kinematic' sensors from consumer 'Mobile' devices-and assessed ecological validity (unsupervised vs. supervised) in home-based settings.</p><p><strong>Results: </strong>From 7,368 records, 77 studies were included. Four dominant trends emerged: (1) Technology: IMUs were used in 87% of the studies. (2) Protocol: the Timed-Up-and-Go (TUG) test (60%) was more prevalent than pure STS tasks (22%), (3) Setting: Most assessments occurred in outpatient settings (79%), followed by home-based settings (25%). (4) Functional variables: despite technological sophistication, 'duration' remained the primary variable followed by linear acceleration and angular velocity. Moreover in the home setting, while 74% of studies achieved high ecological validity (unsupervised), a \"scalability gap\" emerged: 63% still utilized complex research-grade IMUs.</p><p><strong>Conclusion: </strong>Instrumental STS transition assessment in PD is a rapidly expanding field. It is dominated by IMU sensors, but fragmented by protocol heterogeneity and a critical \"scalability gap\" in home monitoring. Complex variables still require non-scalable sensors, while scalable mobile devices have not yet been validated for advanced metrics. Future work must develop robust algorithms for mobile devices and validate metrics to standardise protocols for clinical assessment versus ecological monitoring.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973139","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 use of high-density surface electromyography in amyotrophic lateral sclerosis: a scoping review.","authors":"Patricia A Bayer, Steven J O'Bryan, Hannah J Thomas, Alessandro Del Vecchio, Gayatri Jain, Dario Farina, Alessandra Ferri","doi":"10.1186/s12984-026-02022-6","DOIUrl":"10.1186/s12984-026-02022-6","url":null,"abstract":"<p><strong>Background: </strong>Amyotrophic lateral sclerosis (ALS) is characterised by progressive degeneration of motor neurons, resulting in muscle weakness and atrophy. This neuronal loss is partially compensated for by the collateral sprouting of surviving motor neurons, leading to the formation of enlarged motor units (MUs). These MU adaptations, together with hyperexcitability and altered descending messages from the brain, lead to altered characteristics of the MU action potential shape and discharge pattern, that can be captured using high-density surface electromyography (HDsEMG). The aim of this review is to survey all available literature, investigating how HDsEMG has been used in ALS, and highlight differences in methods and outcomes to allow comparison between studies.</p><p><strong>Methods: </strong>A systematic literature search was conducted using four databases (PubMed, Scopus, IEEE Xplore, and Academic Search Ultimate) to identify studies employing HDsEMG in individuals diagnosed with ALS. Eligible studies were reviewed to examine experimental protocols, hardware and software configurations and reported outcome measures.</p><p><strong>Results: </strong>Out of 168 identified articles, 26 were included in this review. High heterogeneity was observed in recording methods, analysis, and reporting strategies. Based on measurable features of MU behaviour and morphology, the outcomes reported in the studies were grouped into five main categories: fasciculations, MU properties, MU discharge characteristics, multiple discharges and number of MUs.</p><p><strong>Conclusions: </strong>HDsEMG represents a promising non-invasive technique that allows for repeated, longitudinal measurements as well as the detection of multiple MUs and their individual analysis, the potential of which has not been fully explored. HDsEMG has a strong potential for clinical use in ALS, but its application should first be based on a clear understanding of disease pathophysiology. The findings of this review highlight the urgent need for a consensus on standardised protocols and reporting practices for the application of HDsEMG in ALS research, along with the development of methods that can sensitively indicate disease-specific physiological changes to improve comparability, reproducibility. This understanding will improve how HDsEMG findings are interpreted and support the translation of HDsEMG into a diagnostic tool.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973120","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":"Heart rate monitoring using wrist photoplethysmography in Parkinson disease: feasibility and relation with autonomic dysfunction.","authors":"Kars I Veldkamp, Luc J W Evers, Twan van Laarhoven, Yordan P Raykov, Max A Little, King Chung Ho, Sooyoon Shin, Lisa Soleymani Lehmann, Bastiaan R Bloem, Marc A Brouwer, Jos Thannhauser","doi":"10.1186/s12984-026-01994-9","DOIUrl":"10.1186/s12984-026-01994-9","url":null,"abstract":"<p><strong>Background: </strong>Cardiac autonomic dysfunction is a prevalent yet underdiagnosed non-motor manifestation in Parkinson disease (PD), and difficult to monitor in daily life. Wrist-worn photoplethysmography (PPG) allows for continuous pulse rate monitoring, with potential to measure cardiac autonomic dysfunction in PD. However, motion artifacts pose significant challenges. We propose a two-step approach to account for PPG motion artifacts, and explore the association between pulse rate characteristics and cardiac autonomic dysfunction in PD.</p><p><strong>Methods: </strong>In 444 people with early PD, we used continuous wrist PPG and accelerometer data, collected during two weeks using a one research-grade device model (Verily Study Watch), with an average wear time of 22 h/day. Step 1 filters low-quality segments based on PPG morphology using a logistic regression classifier. Step 2 removes remaining segments with periodic motion artifacts (e.g. introduced by tremor). Weekly aggregates were calculated for resting (daytime, nighttime) and maximum (daytime) pulse rates. We studied the effect of filtering on the pulse rate estimates and assessed the relationship between pulse rate aggregates and both subjective and objective autonomic dysfunction measures.</p><p><strong>Results: </strong>Median proportion of high-quality PPG data was 29.2% [IQR: 24.0% to 35.9%] during the daytime, and 86.1% [IQR: 79.3% to 90.6%] during the night. Proportions of high-quality PPG data were similar across different rest tremor severity and dyskinesia scores. However, filtering out periodic motion artifacts (step 2) reduced overestimation of the maximum HR in persons with mild or severe rest tremor. More symptoms of autonomic dysfunction were associated with a lower maximum pulse rate(β:-0.17, 95% CI [-0.33, -0.00]), while resting pulse rate showed no association. No significant differences in pulse rate metrics were found between individuals with or without orthostatic hypotension.</p><p><strong>Conclusions: </strong>PPG-based heart rate estimation in PD improves when periodic motion artifacts are accommodated, representing an important step toward developing digital biomarkers of cardiac autonomic dysfunction. Maximum pulse rate in daily life only demonstrated a weak association with autonomic dysfunction, highlighting the need for more specific markers such as pulse rate variability.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973105","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":"Robot-assisted gait training on functional ambulation in patients with stroke: a retrospective real-world analysis across five robotic devices.","authors":"Dougho Park, Dahyeon Koo, Gwang-Min Park, Won Hyuk Chang, Yong Wook Kim, Seo Yeon Yoon, Deog Young Kim, Dae Hyun Kim","doi":"10.1186/s12984-026-02010-w","DOIUrl":"10.1186/s12984-026-02010-w","url":null,"abstract":"<p><strong>Background: </strong>Robot-assisted gait training (RAGT) is increasingly used in stroke rehabilitation. However, its comparative effectiveness across device types remains unclear. This study explored the effectiveness of RAGT compared to conventional treatment using real-world clinical data.</p><p><strong>Methods: </strong>This retrospective cohort study included 2,947 patients with stroke who received inpatient rehabilitation at a single center between 2015 and 2022. Patients were divided into RAGT and conventional treatment groups. Functional improvement was defined as a gain of ≥ 1 point in the Functional Ambulation Category. Multivariable logistic regression and classification and regression tree (CART) models were applied to identify predictors of favorable outcomes (effectors) and to explore clinical decision-making for device selection.</p><p><strong>Results: </strong>The RAGT group showed poorer baseline function but had a similar proportion of effectors (58.0%) compared to the control group (62.5%). Overall, RAGT was not associated with effector outcome versus control. Among RAGT devices, Morning Walk (adjusted odds ratio [aOR] = 3.25; 95% confidence interval [CI]: 1.79-5.87) and Exowalk (aOR = 4.42; 95% CI: 1.84-10.64) were significantly associated with higher odds of effector status compared to control, whereas Erigo was associated with lower odds (aOR = 0.58; 95% CI: 0.35-0.96). CART models identified clinical features, such as the Berg Balance Scale, the Mini-Mental Status Examination, and the Fugl-Meyer Assessment, as key predictors of effector status and revealed patterns in robotic device allocation.</p><p><strong>Conclusion: </strong>While RAGT was not superior to conventional treatment, certain devices were associated with improved gait function. These findings highlight the importance of tailoring robotic interventions.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973189","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}