Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"Muscle-to-action mapping for intuitive training of muscle synergies in post-stroke upper-limb rehabilitation.","authors":"Hangil Lee, Jeong-Ho Park, Joon-Ho Shin, Jinsook Roh, Hyung-Soon Park","doi":"10.1186/s12984-025-01630-y","DOIUrl":"10.1186/s12984-025-01630-y","url":null,"abstract":"<p><strong>Background: </strong>Effective motor task execution relies on precise muscle coordination, which is often disrupted after a stroke, leading to impaired motor functions. Post-stroke, alterations in intermuscular coordination, including abnormal coupling of shoulder abductor muscles, are commonly observed and contribute to these impairments. Traditional rehabilitation often overlooks this complex intermuscular coordination, and there is a need for intuitive strategies to modify abnormal muscle synergies.</p><p><strong>Objective: </strong>This study introduced a novel \"muscle-to-action mapping\" approach to alter activation profiles of stroke affected muscle synergies. Muscle-to-action mapping trains complex muscle synergies by mapping them to intuitive motions or force directions. By mimicking target actions, patients can achieve desired muscle activation patterns. The feasibility of this approach for correcting abnormal intermuscular coordination and improving force control during reaching was tested in stroke survivors.</p><p><strong>Methods: </strong>A force tracking training system using muscle-to-action mapping was developed to modify abnormal synergy activation profiles during isokinetic reaching tasks. The system guided muscle activation by predicting the direction of endpoint force needed to activate specific muscle synergies, deviating from habitual patterns. The system's effectiveness was evaluated in eleven chronic stroke survivors, measuring changes in muscle synergies, endpoint force control, and clinical assessment scores.</p><p><strong>Results: </strong>The intervention significantly enhanced targeted muscle synergy activations and endpoint force control, demonstrating the training's ability to induce desired muscle synergy activation profiles through muscle-to-action mapping. The overall structure of muscle synergies remained mostly unchanged post-training, highlighting the potential to modify activation profiles without altering synergy vectors. Functional improvements were reflected in the Fugl-Meyer Assessment for the Upper Extremity and Wolf Motor Function Test scores, which increased by 3.36 and 6.45 points, respectively.</p><p><strong>Conclusion: </strong>This study validates muscle-to-action mapping for training muscle synergy activation profiles in stroke survivors. Using a biomechanical model to generate endpoint forces, this method effectively altered synergy activation profiles and improved force control during reaching tasks, leading to clinical improvements. These findings indicate that muscle-to-action mapping could be a valuable addition to stroke rehabilitation, offering an intuitive method for enhancing intermuscular coordination and motor recovery.</p><p><strong>Trial registration: </strong>Registered in Clinical Research Information System of Korea National Institute of Health (KCT0005803).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"99"},"PeriodicalIF":5.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968027","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":"Transcranial direct current stimulation over the motor and premotor cortex with mirror therapy improves motor control, muscle function, and brain activity in chronic stroke: a double-blind randomized sham-controlled trial.","authors":"Wan-Wen Liao, Chia-Yi Lin, Yi-Shiung Horng, Chia-Ling Chen, Tsong-Hai Lee, Ching-Yi Wu","doi":"10.1186/s12984-025-01635-7","DOIUrl":"https://doi.org/10.1186/s12984-025-01635-7","url":null,"abstract":"<p><strong>Background: </strong>Transcranial direct current stimulation (tDCS) is a popular approach to augment the effects of neurorehabilitation. Most studies stimulated the ipsilesional primary motor cortex (iM1); nonetheless, the success of iM1 stimulation was variable, suggesting that it may not be optimal for improving recovery. Ipsilesional premotor cortex (iPMC) may be an alternative candidate based on its likelihood of survival post-stroke and its contribution to functions. This study aimed to determine the effects of tDCS on the iPMC and iM1 with mirror therapy (MT) on motor control, muscle function, and brain activity in chronic stroke.</p><p><strong>Methods: </strong>Thirty-six participants were randomly distributed into (1) iPMC-tDCS with MT (PMC) (2), iM1-tDCS with MT (M1), and (3) sham tDCS with MT (sham). Motor control was assessed using kinematics. Muscle function was assessed using the modified Ashworth and the Medical Research Council Scales. The M1 and PMC activity was recorded using electroencephalography (EEG), and the event-related desynchronization and the laterality index (LI) were examined.</p><p><strong>Results: </strong>Significant within-group differences were identified in the kinematic outcomes. After interventions, the PMC group showed reduced paretic upper limb muscle spasticity and improved paretic limb control with greater movement smoothness and peak velocity. The M1 group showed reduced trunk compensation with fewer trunk displacement and flexion. However, the sham group relied more on trunk compensation, demonstrating increased trunk peak velocity and smoothness. Significant between-group differences were also found in paretic limb control and trunk displacement. Post-hoc analysis revealed that the PMC group improved paretic limb control, and the M1 group showed reduced trunk displacement more than the sham group. Significant within-and between-group differences were identified in EEG outcomes. The iM1 and contralesional PMC (cPMC) activity increased from pre-to-post intervention in the M1 group. In contrast, the iM1 activity decreased, and the LI declined from pre- to post-intervention in the sham group. Significant group differences were found in the iM1 activity, with the PMC and M1 having greater iM1 activation than the sham group.</p><p><strong>Conclusions: </strong>Differential treatment benefits were identified between iPMC- and iM1-tDCS with MT. iPMC-tDCS with MT uniquely improved paretic upper limb control with reduced muscle spasticity while iM1-tDCS with MT mitigated trunk compensation during reaching. These findings suggest that both iPMC- and iM1-tDCS could augment the effects of stroke neurorehabilitation and may be considered in clinical applications.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04655209. Registered on 15th November 2020. https://clinicaltrials.gov/study/NCT04655209 .</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"98"},"PeriodicalIF":5.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999962","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":"Exoskeleton-guided passive movement elicits standardized EEG patterns for generalizable BCIs in stroke rehabilitation.","authors":"Xinyi Zhang, Lanfang Xie, Wanting Liu, Shaoying Liang, Liyao Huang, Mingjun Wang, Lingling Tian, Li Zhang, Zhen Liang, Hai Li, Gan Huang","doi":"10.1186/s12984-025-01627-7","DOIUrl":"https://doi.org/10.1186/s12984-025-01627-7","url":null,"abstract":"<p><strong>Background: </strong>Brain-computer interfaces (BCIs) hold significant potential for post-stroke motor recovery, yet active movement-based BCIs face limitations in generalization due to inter-subject variability. This study investigates passive movement-based BCIs, driven by exoskeleton-guided rehabilitation, to address these challenges by evaluating electroencephalogram (EEG) responses and algorithmic generalization in both healthy subjects and stroke patients.</p><p><strong>Methods: </strong>EEG signals were recorded from 20 healthy subjects and 10 stroke patients during voluntary and passive hand movements. Time and time-frequency domain analyses were performed to examine the event-related potential (ERP), event-related desynchronization (ERD), and synchronization (ERS) patterns. The performance of two BCI algorithms, Common Spatial Patterns (CSP) and EEGNet, was evaluated in both within-subject and cross-subject decoding tasks.</p><p><strong>Results: </strong>Time-domain and time-frequency analyses revealed that passive movements elicited stronger, more consistent ERPs in healthy subjects, particularly in bilateral motor cortices (contralateral: <math><mrow><mo>-</mo> <mn>7.29</mn> <mo>±</mo> <mn>4.51</mn></mrow> </math>  μV; ipsilateral: <math><mrow><mo>-</mo> <mn>4.33</mn> <mo>±</mo> <mn>3.69</mn></mrow> </math>  μV). Stroke patients exhibited impaired mu/beta ERD/ERS in the affected hemisphere during voluntary movements but demonstrated EEG patterns during passive movements resembling those of healthy subjects. Machine learning evaluation highlighted EEGNet's superior performance, achieving 84.19% accuracy in classifying affected vs. unaffected movements in patients, surpassing healthy subject left-right discrimination (58.38%). Cross-subject decoding further validated passive movement efficacy, with EEGNet attaining 86.00% (healthy) and 72.63% (stroke) accuracy, outperforming traditional CSP methods.</p><p><strong>Conclusions: </strong>These findings underscore that passive movement elicits consistent neural responses, thereby enhancing the generalizability of decoding algorithms for stroke patients. By integrating exoskeleton-evoked proprioceptive feedback, this paradigm reduces inter-subject variability and improves clinical feasibility. Future work should explore the application of exoskeletons in the combination of active and passive movement for stroke rehabilitation.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"97"},"PeriodicalIF":5.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008788","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":"Development and evaluation of a non-invasive brain-spine interface using transcutaneous spinal cord stimulation.","authors":"Carolyn Atkinson, Lorenzo Lombardi, Meredith Lang, Rodolfo Keesey, Rachel Hawthorn, Zachary Seitz, Eric C Leuthardt, Peter Brunner, Ismael Seáñez","doi":"10.1186/s12984-025-01628-6","DOIUrl":"https://doi.org/10.1186/s12984-025-01628-6","url":null,"abstract":"<p><p>Motor rehabilitation is a therapeutic process to facilitate functional recovery in people with spinal cord injury (SCI). However, its efficacy is limited to areas with remaining sensorimotor function. Spinal cord stimulation (SCS) creates a temporary prosthetic effect that may allow further rehabilitation-induced recovery in individuals without remaining sensorimotor function, thereby extending the therapeutic reach of motor rehabilitation to individuals with more severe injuries. In this work, we report our first steps in developing a non-invasive brain-spine interface (BSI) based on electroencephalography (EEG) and transcutaneous spinal cord stimulation (tSCS). The objective of this study was to identify EEG-based neural correlates of lower limb movement in the sensorimotor cortex of unimpaired individuals (N = 17) and to quantify the performance of a linear discriminant analysis (LDA) decoder in detecting movement onset from these neural correlates. Our results show that initiation of knee extension was associated with event-related desynchronization in the central-medial cortical regions at frequency bands between 4 and 44 Hz. Our neural decoder using µ (8-12 Hz), low β (16-20 Hz), and high β (24-28 Hz) frequency bands achieved an average area under the curve (AUC) of 0.83 ± 0.06 s.d. (n = 7) during a cued movement task offline. Generalization to imagery and uncued movement tasks served as positive controls to verify robustness against movement artifacts and cue-related confounds, respectively. With the addition of real-time decoder-modulated tSCS, the neural decoder performed with an average AUC of 0.81 ± 0.05 s.d. (n = 9) on cued movement and 0.68 ± 0.12 s.d. (n = 9) on uncued movement. Our results suggest that the decrease in decoder performance in uncued movement may be due to differences in underlying cortical strategies between conditions. Furthermore, we explore alternative applications of the BSI system by testing neural decoders trained on uncued movement and imagery tasks. By developing a non-invasive BSI, tSCS can be timed to be delivered only during voluntary effort, which may have implications for improving rehabilitation.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"95"},"PeriodicalIF":5.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015821","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 central nervous system adjusts muscle synergy structure and tightly controls rollator-supported transitions between sitting and standing.","authors":"Michael Herzog, Frieder C Krafft, Janis Fiedler, Denise J Berger, Lizeth H Sloot, Andrea d'Avella, Thorsten Stein","doi":"10.1186/s12984-025-01622-y","DOIUrl":"https://doi.org/10.1186/s12984-025-01622-y","url":null,"abstract":"<p><strong>Background: </strong>Older individuals are at risk of falling. Assistive devices like rollators help to reduce that risk, especially by compensating for decreased leg muscle strength and balance problems. Paradoxically, rollators have been found to be a fall risk as well as being difficult to use. To investigate the causes, this study examines how different levels of rollator support (no assistance, light touch, and full support) and balance demands (standard lab floor, balance pads) affect movement coordination during standing up and sitting down movements.</p><p><strong>Methods: </strong>Twenty young participants stood up and sat down while full-body kinematics and muscle activity (30 channels) were recorded. Participants stood up and sat down using different movement strategies (e.g., forward leaning, hybrid, and vertical rise standing up movement strategies). For each movement strategy, spatial and temporal muscle synergies were extracted from the muscle activity patterns. Temporal muscle synergies provided a more compact, low-dimensional representation than spatial muscle synergies, so they were subsequently clustered with k-means++. The activation duration of the temporal muscle synergies was assessed with full-width at half-maximum at the main peak. Multivariate linear mixed models were used to investigate if the muscle weightings associated with the temporal muscle synergies differed across the support conditions.</p><p><strong>Results: </strong>The timings of the temporal muscle synergy activations, but not the shape, differed across the movement strategies for both types of movement. Across all tasks, temporal muscle synergies showed a narrower width of activation around the time of seat-off and seat-on than at the movement start and end. No support-specific temporal muscle synergies were found, but lower limb muscle weightings decreased while upper-limb muscle weightings increased with increased support.</p><p><strong>Conclusion: </strong>The narrow shape of the temporal synergy activation profiles suggests that the central nervous system controls the movements tightly, especially around seat-off and seat-on and in challenging conditions with increased balance demands. Furthermore, rollator support increases the weightings of upper body and decreases the weightings of lower limb muscles, especially around seat-off and seat-on. Future studies may further investigate how the loss of tight movement control may cause falls in older individuals.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"96"},"PeriodicalIF":5.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971794","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 clinical trial evaluating feasibility and acceptability of a brain-computer interface for telerehabilitation in patients with stroke.","authors":"Salem Mansour, Joshua Giles, Krishnan P S Nair, Rebecca Marshall, Ali Ali, Mahnaz Arvaneh","doi":"10.1186/s12984-025-01607-x","DOIUrl":"10.1186/s12984-025-01607-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;We have created a groundbreaking telerehabilitation system known as Tele BCI-FES. This innovative system merges brain-computer interface (BCI) and functional electrical stimulation (FES) technologies to rehabilitate upper limb function following a stroke. Our system pioneers the concept of allowing patients to undergo BCI therapy from the comfort of their homes, while ensuring supervised therapy and real-time adjustment capabilities. In this paper, we introduce our single-arm clinical trial, which evaluates the feasibility and acceptance of this proposed system as a telerehabilitation solution for upper extremity recovery in stroke survivors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;The study involved eight chronic patients with stroke and their caregivers who were recruited to attend nine home-based Tele BCI-FES sessions (three sessions per week) while receiving remote support from the research team. The primary outcomes of this study were recruitment and retention rates, as well as participants perception on the adoption of technology. The secondary outcomes involved assessing improvements in upper extremity function using the Fugl-Meyer Assessment for Upper Extremity (FMA_UE) and the Leeds Arm Spasticity Impact Scale.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seven chronic patients with stroke completed the home-based Tele BCI-FES sessions, with high retention (87.5%) and recruitment rates (86.7%). Although participants provided mixed feedback on setup ease, they found the system progressively easier to use, and the setup process became more efficient with continued sessions. Participants suggested modifications to enhance user experience. Following the intervention, a significant increase in FMA_UE scores was observed, with an average improvement of 3.83 points (p = 0.032). The observed improvement of 3.83 points in the FMA-UE score approaches the reported Minimal clinically important difference of 4.25 points for patients with chronic stroke.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study serves as a proof of concept, showcasing the feasibility and acceptability of the proposed Tele BCI-FES system for rehabilitating the upper extremities of stroke survivors. While some participants demonstrated significant improvements in FMA-UE scores, these findings are not generalizable, as they were derived from a small-scale feasibility study. The results should be interpreted cautiously within the study's specific context. Additionally, the intervention was not compared to other therapeutic approaches, limiting conclusions regarding its relative effectiveness. To further validate the efficacy of the proposed Tele BCI-FES system, it is essential to conduct additional research with larger sample sizes and extended rehabilitation sessions. Moreover, future studies should include comparisons with other therapeutic approaches to better evaluate the relative effectiveness of this intervention. Trial registration This clinical study is registered a","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"91"},"PeriodicalIF":5.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017508","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-based upper limb training on activity of daily living and quality of life among stroke survivors: a systematic review and meta-analysis.","authors":"Diriba Dereje Olana, Teklu Gemechu Abessa, Dheeraj Lamba, Lisa Tedesco Triccas, Bruno Bonnechere","doi":"10.1186/s12984-025-01603-1","DOIUrl":"https://doi.org/10.1186/s12984-025-01603-1","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a leading cause of disability worldwide, significantly impairing upper limb (UL) function and reducing patients' ability to perform activities of daily living (ADL) and quality of life (QoL). Virtual reality (VR) has emerged as a promising tool for UL rehabilitation, offering immersive and engaging environments for motor recovery. However, the effectiveness of VR, its integration with conventional therapy, and their efficacy across different stroke recovery stages remain unclear. Therefore, this systematic review and meta-analysis aimed to evaluate the effectiveness of VR-based UL interventions in improving ADL and QoL among stroke survivors.</p><p><strong>Method: </strong>This study adhered to PRISMA guidelines and was registered on PROSPERO (CRD42023426256). A systematic search of PubMed, Scopus, and Web of Science identified randomized controlled trials (RCTs) published in English. Inclusion criteria focused on studies using immersive VR (IVR) and non-immersive VR (NIVR) interventions to assess ADL and QoL in stroke survivors. Data extraction and quality assessment were performed independently by two reviewers using the PEDro scale to assess quality. Meta-analyses were conducted to determine the efficacy. Subgroup analyses were performed to compare IVR and NIVR, VR combined with conventional therapy versus standalone VR, and potential differences between stroke recovery stages.</p><p><strong>Result: </strong>Thirty RCTs, representing 1,661 participants, were included. Overall, VR interventions significantly improved ADL (SMD = 0.27, 95% CI [0.11; 0.43], p < 0.001) and QoL (SMD = 0.94 [0.09; 1.79], p = 0.035) compared to conventional therapy. IVR demonstrated superior outcomes for ADL compared to NIVR (SMD = 0.54 [0.13; 0.95] Vs. 0.17 [0.02; 0.36], p = 0.03). Subacute stroke survivors exhibited the most significant gains in ADL (SMD = 0.52 [0.16; 0.88], p = 0.004), compared to chronic (SMD = 0.05 [-0.36; 0.46]) or acute patients (SMD = 0.08 [-0.11; 0.27]).</p><p><strong>Conclusion: </strong>VR interventions, particularly IVR and VR combined with conventional therapy, significantly enhance ADL and QoL in stroke survivors with moderate certainty of evidence. These findings underscore the value of VR in rehabilitation, especially during the subacute phase, but highlight the need for further research into long-term effects and implementation in low-resource settings.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"92"},"PeriodicalIF":5.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996749","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":"Comparative effectiveness of electroencephalogram-neurofeedback training of 3-45 frequency band on memory in healthy population: a network meta-analysis with systematic literature search.","authors":"Wen-Hsiu Yeh, Ya-Ju Ju, Fu-Zen Shaw, Yu-Ting Liu","doi":"10.1186/s12984-025-01634-8","DOIUrl":"https://doi.org/10.1186/s12984-025-01634-8","url":null,"abstract":"<p><strong>Objective: </strong>To investigate which brain activity frequency of electroencephalogram (EEG)-neurofeedback training (NFT) was the most effective for enhancing working memory (WM) and episodic memory (EM) in healthy participants through network meta-analysis (NMA).</p><p><strong>Methods: </strong>Searched PubMed, Embase, and Cochrane Library for studies published from January 1990 to January 2025. We performed Bayesian NMA, pooling continuous outcome data using the standardized mean difference effect size (ES). Global and local evaluations of inconsistency were conducted using the chi-square test, side-splitting, and loop-specific approaches. A consistency model was applied and the global approach to inconsistency showed no significance. Efficacy ranks were determined using the surface under the cumulative ranking curve (SUCRA) for each intervention. Publication bias was assessed using the comparison-adjusted funnel plot and Egger's test. Finally, sensitivity analysis confirmed our findings' robustness.</p><p><strong>Results: </strong>Sixty studies were included, comprising 50 trials on WM and 24 trials on EM. While the global inconsistency analysis showed no significant inconsistency for WM (χ²(22) = 30.89, p = 0.10) and EM (χ²(10) = 13.48, p = 0.19), the consistency model exhibited the most significant difference between active control (AC) and alpha combined with working memory training (WMT) (ES of 6.64, p < 0.001) for WM, and between AC and alpha (ES of 0.84, p = 0.01) for EM. Alpha combined with WMT for WM (100%) and alpha NFT for EM (87.0%) also showed the highest efficacy according to the SUCRA. No publication bias was found for either type of memory. The sensitivity analysis for WM and EM aligns with the original results.</p><p><strong>Conclusion: </strong>Through NMA, alpha activity (7-13 Hz) may be a crucial frequency impacting memory. Brain activity combined with other training methods requires more robust studies for future investigation. This study registered with www.crd.york.ac.uk/prospero/ (CRD42024539656).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"94"},"PeriodicalIF":5.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986951","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 robotic rehabilitation intervention in a home setting during the Covid-19 outbreak: a feasibility pilot study in patients with stroke.","authors":"Marco Germanotta, Maria Cristina Mauro, Francesca Falchini, Francesco Scotto Di Luzio, Luca Vollero, Loredana Zollo, Irene Giovanna Aprile","doi":"10.1186/s12984-025-01633-9","DOIUrl":"10.1186/s12984-025-01633-9","url":null,"abstract":"<p><strong>Background: </strong>Telerehabilitation allows patients to engage in therapy away from healthcare facilities, often in the comfort of their homes. Studies have suggested that it can effectively improve motor and cognitive function. However, its applicability may be limited to patients with severe impairments who require physical assistance. The proposed study aims to evaluate the feasibility and effects of a home-based rehabilitation program for post-stroke patients, based on the use of a planar robot, able to overcome the limitations posed by the COVID-19 pandemic.</p><p><strong>Methods: </strong>We enrolled 20 patients with stroke (11 men, aged 66.1 ± 9.2 years). Patients underwent 20 one-hour robotic upper limb rehabilitation sessions, consisting of the execution of planar point-to-point reaching exercises, using a robotic device in their own home, with the remote supervision of a physical therapist. We assessed the feasibility of this intervention by examining adverse events, patient satisfaction (measured on a Likert scale), usability (using the System Usability Scale, SUS), acceptability (evaluated through the Technology Acceptance Model questionnaire, TAM+), and pain onset (measured with the Numeric Rating Scale). To gauge the clinical effects of the treatment, we analyzed changes in the motor and sensory components of the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) before and after the intervention.</p><p><strong>Results: </strong>The approach was safe, as we did not observe any adverse events, and patients did not experience an increase in pain levels. Patients expressed their appreciation for the treatment, providing an average Likert scale score of 8 out of 10. The usability of the treatment received high marks, with an average SUS score of 78 ± 12. Similarly, the treatment acceptability was favorable, with all examined domains scoring above 4, indicating a positive attitude towards the proposed solution. Moreover, we observed a statistically significant improvement in the motor part of the FMA-UE (p < 0.001).</p><p><strong>Conclusion: </strong>Our results demonstrate the feasibility, safety, and effectiveness of employing a rehabilitation robot for upper limb rehabilitation in post-stroke patients within a home-based environment. These findings mark a significant step in advancing innovative and easily accessible rehabilitation options for stroke survivors, ensuring uninterrupted care and creating new opportunities to enhance their functional abilities.</p><p><strong>Trial registration: </strong>clinicaltrial.gov (NCT05250934).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"93"},"PeriodicalIF":5.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005103","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":"First-in-human implementation of a bidirectional somatosensory neuroprosthetic system with wireless communication.","authors":"Sedona R Cady, Joris M Lambrecht, Karina T Dsouza, Jeremy L Dunning, J Robert Anderson, Kevin J Malone, Kyle J Chepla, Emily L Graczyk, Dustin J Tyler","doi":"10.1186/s12984-025-01613-z","DOIUrl":"10.1186/s12984-025-01613-z","url":null,"abstract":"<p><strong>Background: </strong>Limitations in upper limb prosthesis function and lack of sensory feedback are major contributors to high prosthesis abandonment rates. Peripheral nerve stimulation and intramuscular recording can restore touch and relay motor intentions for individuals with upper limb loss. Percutaneous systems have enabled significant progress in implanted neural interfaces but require chronic lead maintenance and unwieldy external equipment. Fully implanted sensorimotor systems without percutaneous leads are crucial for advancing implanted neuroprosthetic technologies to long-term community use and commercialization.</p><p><strong>Methods: </strong>We present the first-in-human technical performance of the implanted Somatosensory Electrical Neurostimulation and Sensing (iSens®) system-an implanted, high-channel count myoelectric sensing and nerve stimulation system that uses wireless communication for advanced prosthetic systems. Two individuals with unilateral transradial amputations received iSens® with four 16-channel composite Flat Interface Nerve Electrodes (C-FINEs) and four Tetra Intramuscular (TIM) electrodes. This study achieved two key objectives to demonstrate system feasibility prior to long-term community use: (1) evaluating the chronic stability of extraneural cuff electrodes, intramuscular electrodes, and active implantable devices in a wirelessly connected system and (2) assessing the impacts of peripheral nerve stimulation on three degree-of-freedom controller performance in a wirelessly connected system to validate iSens® as a bidirectional interface.</p><p><strong>Results: </strong>Similar to prior percutaneous systems, we demonstrate chronically stable extraneural cuff electrodes and intramuscular electrodes in a wirelessly connected implanted system for more than two years in one participant and four months in the second participant, whose iSens® system was explanted due to an infection of unknown origin. Using an artificial neural network controller trained on implanted electromyographic data collected during known hand movements, one participant commanded a virtual hand and sensorized prosthesis in 3 degrees-of-freedom. The iSens® system simultaneously produced stimulation for sensation while recording high resolution muscle activity for real-time control. Although restored sensation did not significantly improve initial trials of prosthetic controller performance, the participant reported that sensation was helpful for functional tasks.</p><p><strong>Conclusions: </strong>This case series describes a wirelessly connected, bidirectional neuroprosthetic system with somatosensory feedback and advanced myoelectric prosthetic control that is ready for implementation in long-term home use clinical trials.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ID: NCT04430218, 2020-06-30.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"90"},"PeriodicalIF":5.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999613","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}