Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"Combining immersive exergaming with physiotherapy in a specialized intensive Parkinson's disease rehabilitation program: a randomized controlled trial.","authors":"Daniela Pimenta Silva, Raquel Bouça-Machado, Filipa Pona-Ferreira, Teresa Lobo, Ricardo Cacho, Rebekka Anker, John W Krakauer, Joaquim J Ferreira","doi":"10.1186/s12984-025-01640-w","DOIUrl":"10.1186/s12984-025-01640-w","url":null,"abstract":"<p><strong>Background: </strong>Exergaming is a new technology for implementing innovative rehabilitation interventions for neurological conditions. Our aim was to evaluate the feasibility, safety and efficacy of a novel exergaming experience called neuroanimation, in the form of MindPod^TM Dolphin, added to an intensive physiotherapy program for Parkinson's disease (PD).</p><p><strong>Methods: </strong>MindPod Dolphin provides a 2D oceanic environment where patients make high-amplitude 3D arm movements controlling an animated dolphin. We conducted a rater-blinded, randomized-controlled trial. Eligible people with PD were assigned into two groups: MindPod Dolphin over 12-weeks combined with physiotherapy (COM) or sequentially after 6-weeks of physiotherapy alone (SEQ). Sessions occurred three times/week. Assessments occurred at baseline, 6-week, 12-week, and 4-week post-intervention. The primary outcome was change from baseline to 6-week in the Timed Up and Go (TUG) test. Secondary outcomes were change, from baseline to each evaluation timepoint, in several motor, cognitive and quality of life measures. Participants' safety was assessed. Adherence, system usability and participants' satisfaction were used as measures of feasibility.</p><p><strong>Results: </strong>Thirty individuals were recruited. Baseline characteristics were similar between groups. Our primary outcome (change in TUG from baseline to 6-week) did not significantly differ between groups [median TUG change in COM = 0.243 [-1.873, 1.176] vs. SEQ=-0.016 [-0.810, 0.350], estimated difference = 0.002 (95%CI -1.103; 1.273); p = 0.983]. Both groups improved in motor and cognitive measures with a trend favoring COM. When compared to SEQ, COM improved significantly in TUG cognitive from baseline to 16-week (p = 0.048). A main effect of time was observed for TUG cognitive in COM, and mini-BEST in SEQ. Adverse events (n = 309) were mostly mild (55%). Overall, 20 participants (67%) adhered to the study protocol, with the COM being more compliant than the SEQ group. MindPod Dolphin was considered easy to use and over 80% of participants were at least moderately satisfied with it as an intervention.</p><p><strong>Conclusions: </strong>Neuroanimation-based exergaming in PD was feasible, safe and effective in improving multiple secondary measures. The advantages of the exergame became evident at 12-weeks and beyond, suggesting that it had cumulative and delayed beneficial effects on cognitive and motor outcomes when added to a lead-in phase of intense physiotherapy.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov registration: NCT04699617.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"131"},"PeriodicalIF":5.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275143","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":"Validity and usability for digital cognitive assessment tools to screen for mild cognitive impairment: a randomized crossover trial.","authors":"Min Wu, Jialin Feng, Ruini Sun, Shangyang Zhang, Yongjin Zhang, Fengjie Yang, Xiaoyi Zhang, Yunxian Ye, Ni Gong, Jing Liao","doi":"10.1186/s12984-025-01665-1","DOIUrl":"10.1186/s12984-025-01665-1","url":null,"abstract":"<p><strong>Background: </strong>The practicality of implementing digital cognitive screening tests in primary health care (PHC) for the detection of cognitive impairments, particularly among populations with lower education levels, remains unclear. The aim of this study is to assess the validity and usability of digital cognitive screening tests in PHC settings.</p><p><strong>Methods: </strong>We utilized a randomized crossover design, whereby 47 community-dwelling participants aged 65 and above were randomized into two groups. One group completed the paper-based Mini-Mental State Examination (MMSE) and Clock Drawing Test (CDT) first, followed by the tablet-based digital version after a two-week washout period, while the other group did the reverse. Validity was assessed by Spearman correlation, linear mixed-effects models, sensitivity specificity, and area under the curve (AUC). Usability was assessed through the Usefulness, Satisfaction, and Ease of Use (USE) questionnaire, participant preferences and assessment duration. Regression analyses were conducted to explore the impact of usability on digital test scores, controlling for cognitive level, education, age, and gender.</p><p><strong>Results: </strong>Regarding validity, digital tests showed moderate correlations with paper-based versions and superior AUC performance. The AUC was 0.65 for the MMSE versus 0.82 for the electronic MMSE (eMMSE), and 0.45 for the CDT compared to 0.65 for the electronic CDT (eCDT). Regarding usability, while older participants gave positive feedback on digital tests (P < 0.001), they preferred paper-based versions. The eMMSE took significantly longer to complete than the MMSE, averaging 7.11 min versus 6.21 min (P = 0.01). Notably, digital test scores were minimally affected by subjective attitudes but strongly linked to test duration (β = -0.62, 95% CI: -1.07 to -0.17).</p><p><strong>Conclusions: </strong>Digital cognitive tests are valid and feasible in PHC settings but face implementation challenges, especially in usability and adaptability among individuals with lower education levels.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"132"},"PeriodicalIF":5.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275056","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":"A pilot study for self-guided, active robotic training of proprioception of the upper limb in chronic stroke.","authors":"Duncan T Tulimieri, GilHwan Kim, Joanna E Hoh, Fabrizio Sergi, Jennifer A Semrau","doi":"10.1186/s12984-025-01660-6","DOIUrl":"10.1186/s12984-025-01660-6","url":null,"abstract":"<p><strong>Background: </strong>Proprioceptive impairments of the upper limb are common after stroke. These impairments are not typically addressed during assessment or rehabilitation. Currently, most robotic paradigms for training of the upper limb have focused solely on improving motor function or have targeted proprioception in individuals with combined use of visual feedback. Our goal was to design a training paradigm that directly targets proprioception of the upper limb, while minimizing reliance on other sensory information to improve sensorimotor function after stroke.</p><p><strong>Methods: </strong>In this pilot study, 5 individuals with stroke and 5 age-matched controls were tested on a single-day proprioceptive training paradigm. Here, participants used a joystick with their less-affected arm to send commands to a KINARM exoskeleton that would passively move their more-affected arm. To complete the passive reaching task, participants relied only on proprioceptive feedback from the more-affected arm and were only given knowledge of results information after each trial. Sensorimotor function of the upper limb was measured pre- and post-training via robotic measures of motor function [Visually Guided Reaching (VGR)] and position sense [Arm Position Matching (APM)]. Sensorimotor function was quantified as a Task Score, which incorporated multiple task-relevant parameters for both VGR and APM. Changes in sensorimotor performance due to training were calculated as the pre- to post-training difference for VGR and APM within the control and stroke groups.</p><p><strong>Results: </strong>We found significant improvements from pre-training to post-training for VGR in individuals with stroke (p < 0.001, CLES = 100) that were not observed in control participants (p = 0.87, CLES = 80). We observed significant changes from pre- to post-training in both VGR (Posture Speed, Reaction Time, Initial Direction Angle, Min-Max Speed Difference, and Movement Time) and APM (Contraction/Expansion Ratio_x and Shift_y) parameters.</p><p><strong>Conclusions: </strong>Our novel proprioceptive training paradigm is one of the first to implement a self-guided sensory training protocol. We observed improvements in motor function and proprioception for individuals with stroke. This pilot study demonstrates the feasibility of self-guided proprioceptive training to improve motor and sensory function in individuals with stroke. Future studies aim to examine multi-day training to examine longer-term impacts on upper limb sensorimotor function.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"130"},"PeriodicalIF":5.2,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248312","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 vivo estimation of motor unit intrinsic properties in individuals with spinal cord injury.","authors":"Zhihao Duan, Asta Kizyte, Emelie Butler Forslund, Elena M Gutierrez-Farewik, Pawel Herman, Ruoli Wang","doi":"10.1186/s12984-025-01659-z","DOIUrl":"10.1186/s12984-025-01659-z","url":null,"abstract":"<p><strong>Background: </strong>Individuals who have experienced spinal cord injury (SCI) may exhibit various muscle-related neurophysiological adaptations, including alterations in motor unit (MU) size and firing behavior. However, due to the technical challenges of in vivo measurement, our understanding of the alterations in the electrophysiological parameters of these MUs remains limited. This study proposed an integrated approach using high-density electromyography (HD-EMG) decomposition and motor neuron (MN) modelling to estimate the intrinsic properties of MUs in vivo and investigated alterations of these properties in persons with SCI.</p><p><strong>Methods: </strong>HD-EMG signals were recorded during submaximal isometric dorsiflexion and plantar flexion tasks on tibialis anterior (TA), soleus, and gastrocnemius medialis muscles from twenty-six participants with SCI and eighteen non-disabled controls. The HD-EMG signals were subsequently decomposed into MN spike trains and the common synaptic input to the MN pool was estimated. A simplified leaky integrate-and-fire neuron model was then used to simulate MN spiking trains, with soma size and inert period as tunning parameters, which are crucial for MU recruitment and firing patterns, respectively. These parameters were estimated by fitting the instantaneous discharge frequencies of decomposed and simulated spike trains via a genetic algorithm.</p><p><strong>Results: </strong>The results showed a prolonged inert period in the TA of the persons with SCI. This finding suggested that the MUs in the TA have a slower recovery period before becoming excitable again, which may result in a lower firing rate of MUs in the TA muscle. No significant differences were observed in the soleus and gastrocnemius medialis muscles between the SCI and control groups for either the soma size or inert period parameters.</p><p><strong>Conclusions: </strong>The simplified leaky integrate-and-fire model exhibited robustness in estimating MN parameters in vivo, offering valuable insights into personalized MU behavior monitoring. To the best knowledge of authors, this is the first study to combine HD-EMG and MU modeling to investigate MU electrophysiological changes in persons with SCI in vivo. This novel approach offers a comprehensive understanding of MU properties adaptations following neurological disorders and informs the development of novel rehabilitation strategies.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"128"},"PeriodicalIF":5.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225700","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":"Outcome measures of instrumented gait analysis in hereditary spastic paraplegia: a systematic review.","authors":"Veronika Koch, Alzhraa Ibrahim, Juergen Winkler, Bjoern Eskofier, Martin Regensburger, Heiko Gassner","doi":"10.1186/s12984-025-01646-4","DOIUrl":"10.1186/s12984-025-01646-4","url":null,"abstract":"<p><strong>Background: </strong>Hereditary spastic paraplegias (HSPs) comprise a group of genetic movement disorders characterized by progressive spasticity and weakness of the lower limbs leading to gait deficits. Instrumented gait measures are applied to quantify gait patterns in HSP objectively. However, there is no consensus on the most relevant HSP-specific digital outcome measures for future clinical studies.</p><p><strong>Aim: </strong>This systematic review aims to summarize outcome measures of instrumented gait analysis in HSP patients, focusing on both traditional motion capture (MOCAP) and inertial sensor systems.</p><p><strong>Methods: </strong>Following PRISMA-2020 guidelines, a comprehensive literature search was conducted in PubMed, Scopus, and Web of Science to identify studies using instrumented gait analysis in HSP. Data on participant characteristics, measurement systems, outcome measures, results, and risk of bias were systematically extracted.</p><p><strong>Results: </strong>In total, 38 studies published between 2004 and 2024, including 29 observational studies and 9 interventional studies, met the inclusion criteria. Various gait parameters were used, including spatio-temporal, kinematic, kinetic, and electromyography (EMG) parameters. Walking speed and range-of-motion (ROM) knee were identified as important parameters for differentiating HSP patients from healthy controls, but these parameters are more general rather than disease-specific. Foot lift, ROM foot, and gait variability are promising, more disease-specific parameters, as they reflect disease severity and increased balance deficits. However, a deeper understanding of all gait parameter categories is necessary, particularly for the upper body. Few studies explored sub-cohorts that exhibit different HSP gait characteristics.</p><p><strong>Conclusion: </strong>While MOCAP provides valuable data in controlled hospital environments, there is a need for validated mobile sensor systems capturing the gait patterns of HSP patients in real-life without supervision. Future research must focus on better longitudinal multicenter studies with larger sample sizes to establish robust digital outcomes and monitor disease progression and therapeutic response in HSP.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"129"},"PeriodicalIF":5.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234381","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":"Biomechanical analysis of patients with mild Parkinson's disease during indoor cycling training.","authors":"Seonghyun Kang, Jin-Woo Park, Yekwang Kim, Juhui Moon, Yeji Lee, Chan-Nyoung Lee, Jaewook Kim, Seung-Jong Kim, Byung-Jo Kim","doi":"10.1186/s12984-025-01657-1","DOIUrl":"10.1186/s12984-025-01657-1","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) is characterized by significant postural instability and gait impairments, yet many individuals with PD can continue cycling even with severe gait dysfunction. While previous research has investigated the preservation of pedaling ability, how individuals with PD regulate and adapt their balance control strategies during cycling remains largely unexplored. This study aims to identify the biomechanical adaptations in cycling balance control employed by individuals with PD and how they differ from those of healthy individuals.</p><p><strong>Methods: </strong>A total of 39 PD patients and 42 age-matched healthy controls participated in a cycling task using a steerable indoor cycling system that enables sliding and tilting motions, requiring them to actively maintain balance while following a straight-line trajectory. Cycling dynamics were analyzed using a sensor-equipped system designed to capture medio-lateral balance adjustments, including force exertion on the handlebars and saddle, lateral deviations, and pedaling speed.</p><p><strong>Results: </strong>PD patients exhibited a higher coordination of upper and lower body in the medio-lateral direction (PD: 0.47 ± 0.18 vs. Control: 0.11 ± 0.30, p < 0.001), suggesting a stronger reliance on a leaning strategy for balance control. While PD patients cycled at a significantly lower freely chosen speed (6.49 ± 1.45 km/h vs. 10.28 ± 3.00 km/h, p < 0.001), their bike deviation was lower than that of healthy controls (PD: 17.1 ± 9.9 mm vs. Control: 22.8 ± 11.7 mm, p = 0.019), indicating a more constrained and controlled cycling pattern. Additionally, force distribution patterns and bike speed showed strong correlations with physical function measures, including lower limb strength and gait velocity.</p><p><strong>Conclusions: </strong>This study identifies distinct cycling balance adaptations in PD, providing insights into how individuals with PD regulate and modify their balance control strategies during cycling. The quantitative metrics derived from this study may offer a basis for future research exploring their potential as biomechanical markers for objective functional assessment and rehabilitation monitoring in PD.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"127"},"PeriodicalIF":5.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225699","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":"Postural sway serves as a predictive biomarker in balance and gait assessments for diabetic peripheral neuropathy screening: a community-based study.","authors":"Yun-Ru Lai, Wen-Chan Chiu, Chi-Ping Ting, Yi-Fang Chiang, Ting-Yin Lin, Hui-Ching Chiang, Chih-Cheng Huang, Cheng-Hsien Lu","doi":"10.1186/s12984-025-01644-6","DOIUrl":"10.1186/s12984-025-01644-6","url":null,"abstract":"<p><strong>Background: </strong>Traditional screening methods for diabetic peripheral neuropathy (DPN) can be time-consuming in community settings. Balance and gait impairments are common in individuals with DPN, but these functional impairments are often not detectable with standard neurological examinations. This study aimed to examine whether quantitative balance and gait assessment could serve as a viable alternative screening tool for DPN.</p><p><strong>Methods: </strong>All participants were recruited from a community-based daycare center and underwent peripheral nerve function assessments, including the Toronto Clinical Neuropathy Score (TCNS), sural nerve conduction studies (amplitude and velocity) for large fiber function, and Sudoscan testing for small fiber function. Subsequently, participants underwent balance and gait assessments, including static postural sway measurements and gait analysis of spatiotemporal parameters and joint range of motion (ROM) assessment during walking.</p><p><strong>Results: </strong>Of the 146 participants, 35 had diabetes, including 22 with DPN, while 111 were healthy controls. Participants with DPN demonstrate increased postural sway velocity and total path length, along with reduced gait speed, shorter stride length, and decreased range of motion in hip flexion and extension. The logistic regression analysis identified diabetes duration and postural sway velocity as the only significant predictors of DPN presence. Postural sway velocity demonstrated strong correlations with elevated TCNS, reduced sural sensory nerve action potential and sensory nerve conduction velocity, and lower Sudoscan values in hands and feet. Additionally, receiver operating characteristic analysis yielded a sensitivity of 68.2%, specificity of 85.5%, and an area under the curve of 0.76, with a cut-off value of 0.98 cm/s.</p><p><strong>Conclusions: </strong>Balance and gait impairments are prevalent among participants with DPN. This study supports the integration of balance and gait assessments into community-based screening protocols to facilitate early identification and intervention. Postural sway velocity emerged as a practical early biomarker for the screening of DPN.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"123"},"PeriodicalIF":5.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199365","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":"Delayed muscle fatigue during electrical stimulation of the proximal nerve using asymmetric random high-frequency carrier pulse cluster.","authors":"Rui Yuan, Yang Zheng, Henry Shin, Guanghua Xu, Shengnuo Fan, Zhanhong Du","doi":"10.1186/s12984-025-01658-0","DOIUrl":"10.1186/s12984-025-01658-0","url":null,"abstract":"<p><strong>Background: </strong>Transcutaneous peripheral nerve electrical stimulation using high-frequency pulse clusters has been shown to relieve muscle fatigue, though its efficacy remains limited. Furthermore, this approach tends to exacerbate pain during stimulation, which constrains its clinical applications. This paper proposed a novel stimulation waveform to reduce muscle fatigue and the discomfort associated with high-frequency electrical stimulation, and compares it with previously reported high-frequency pulsed cluster stimulation.</p><p><strong>Methods: </strong>We evaluated our waveform experimentally and through model simulations. During the experiment, two distinct high-frequency narrow pulse clusters were applied to the proximal segment of the median/ulnar nerve bundles: asymmetric random (aSymR) and previously reported symmetric (Sym) stimulation, both with a carrier frequency of 10 kHz. The two stimulation modes aimed to elicit the same contraction level and were maintained for 5 min to induce muscle fatigue. Finger force, high-density electromyographic (EMG) signals of the flexor muscles and the pain score were recorded. In addition, we developed a finite element model of the upper arm and a motor fiber model to simulate motor axon activation of the peripheral nerve induced by the two electrical stimulation modes.</p><p><strong>Results: </strong>Compared with the Sym stimulation, the aSymR stimulation resulted in less pain and a significant reduction of muscle fatigue rate, which was characterized by slower force decay rate, less absolute force decay, greater plateau force, and ultimately greater force output. In addition, the simulation results showed that the delay for different fibers to reach the threshold was increased by the aSymR mode. Consistent with this, the experiment study showed that the EMG amplitude under the aSymR stimulation condition was smaller before fatigue onset, indicating the less synchronized activation of different muscle fibers.</p><p><strong>Conclusions: </strong>Compared with the Sym stimulation, the aSymR stimulation can significantly relieve muscle fatigue possibly by reducing the synchronous activation across different fibers. This proposed aSymR stimulation mode not only reduces fatigue but also relieves pain, potentially contributing to the wide application of electrical stimulation in motor function rehabilitation for people with stroke.</p><p><strong>Trial registration: </strong>Ethics committee of the Medical College of Xi'an Jiaotong University, 2021 - 1550. Registered 4 November 2021.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"125"},"PeriodicalIF":5.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199363","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":"Patient-centered insights into virtual reality rehabilitation for stroke: a systematic review and qualitative meta-synthesis.","authors":"Kun Ding, Yan Ma, Lingling Zhang, Yufang Gu, Huixuan Pan, Zhi-E Gu, Hengzhu Zhang","doi":"10.1186/s12984-025-01641-9","DOIUrl":"10.1186/s12984-025-01641-9","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality rehabilitation (VRR) is an emerging technology that offers new possibilities for stroke recovery. Understanding stroke survivors' experiences and expectations is essential for optimizing its application.</p><p><strong>Objective: </strong>This systematic review synthesizes qualitative evidence on stroke survivors' experiences with and participation in VRR to identify benefits, challenges, and areas for improvement.</p><p><strong>Methods: </strong>This systematic review follows the meta-aggregation method guided by ENTREQ and PRISMA and uses the Critical Appraisal Skills Programme (CASP) to assess the quality of included studies. We searched eight English and Chinese databases for qualitative or mixed-method studies on stroke survivors' experiences with VRR, published by May 31, 2024. Selected studies were independently reviewed, and data were synthesized into core themes.</p><p><strong>Results: </strong>Fourteen studies were included, involving a total of 133 participants aged 13 to 85 years. The analysis identified four key themes: (1) perceived self-benefits, including physical and psychological improvements; (2) facilitators, such as user engagement and supportive environments; (3) barriers, including technical and personal limitations; and (4) expectations.The quality of the included studies was assessed using the CASP tool, with scores ranging from 26 to 30, indicating moderate to high quality across the studies.</p><p><strong>Conclusion: </strong>VRR has the potential to enhance stroke rehabilitation outcomes, but its success depends on addressing individual and systemic challenges. Personalized interventions and multidisciplinary efforts are needed to develop user-friendly, adaptable VRR systems that fully leverage the advantages of this technology.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"124"},"PeriodicalIF":5.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199364","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":"Using machine learning to identify Parkinson's disease severity subtypes with multimodal data.","authors":"Hwayoung Park, Changhong Youm, Sang-Myung Cheon, Bohyun Kim, Hyejin Choi, Juseon Hwang, Minsoo Kim","doi":"10.1186/s12984-025-01648-2","DOIUrl":"10.1186/s12984-025-01648-2","url":null,"abstract":"<p><strong>Background: </strong>Classifying and predicting Parkinson's disease (PD) is challenging because of its diverse subtypes based on severity levels. Currently, identifying objective biomarkers associated with disease severity that can distinguish PD subtypes in clinical trials is necessary. This study aims to address the clinical applicability and heterogeneity of PD using PD severity subtypes classification and digital biomarker development by combining objective multimodal data with machine learning (ML) approaches.</p><p><strong>Methods: </strong>We analyzed datasets that combine clinical characteristics, physical function and lifestyle data, gait parameters in motion analysis systems, and wearable sensors collected from persons with PD (n = 102) to perform clustering for subtype classification.</p><p><strong>Results: </strong>We identified three PD severity subtypes, each exhibiting different patterns of clinical severity, with the severity increasing as it progressed from clusters 1 to 3. We found significant mutual information between all/single modalities and the unified PD rating scale scores, identifying potential modalities with high feature importance using ML. Among all modalities, the principal components of gait parameters derived from wearable sensors were identified as the most associated indicators of PD severity. A model utilizing the first principal component of the left and right ankle achieved perfect classification with an area under the curve of 1.0, accurately distinguishing clinically severe subtypes from mild subtypes of PD. These findings suggest that gait features in both ankles can reflect asymmetry factors associated with PD severity subtypes, which contributes to high classification performance.</p><p><strong>Conclusions: </strong>Digital biomarkers obtained from wearable sensors attached bilaterally to body segments demonstrate potential for classifying PD severity subtypes and tracking disease progression. Our findings emphasized the clinical value of sensor-based gait analysis in PD management, which suggested its integration into personalized monitoring systems and therapeutic interventions for persons with PD.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"126"},"PeriodicalIF":5.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208747","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}