Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"A wearable ankle-assisted robot for improving gait function and pattern in stroke patients.","authors":"Su-Hyun Lee, Jinuk Kim, Hwang-Jae Lee, Yun-Hee Kim","doi":"10.1186/s12984-025-01624-w","DOIUrl":"https://doi.org/10.1186/s12984-025-01624-w","url":null,"abstract":"<p><strong>Background: </strong>Hemiplegic gait after a stroke can result in a decreased gait speed and asymmetrical gait pattern. Normal gait patterns and speed are typically the ultimate goals of gait function in stroke rehabilitation. The purpose of this study was to investigate the immediate effects of the Gait Enhancing and Motivating System-Ankle (GEMS-A) on gait function and pattern in stroke patients with hemiplegia.</p><p><strong>Methods: </strong>A total of 45 eligible participants was recruited for the study. The experimental protocol consisted of overground gait at a comfortable speed under 2 conditions: free gait (FG) without robot assistance and robot-assisted gait (RAG). All measurement data were collected using a 3D motion capture system with 8 infrared cameras and 2 force plates.</p><p><strong>Results: </strong>Patients in the RAG condition had significantly increased gait speed, cadence, gait symmetry, and peak flexion angle and moment of the paretic ankle joint compared to the FG condition. Moreover, the RAG resulted in higher propulsive forces by altering peak ankle force generation compared with the FG.</p><p><strong>Conclusion: </strong>The findings of this study provide evidence that a newly developed wearable ankle-assist robot, the GEMS-A, is a potentially useful walking assist device for improving gait function and pattern in stroke patients with hemiplegia.</p><p><strong>Trial registration: </strong>NCT03767205 (first registration date: 02/12/2018, URL: https://register.</p><p><strong>Clinicaltrials: </strong>gov ).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"89"},"PeriodicalIF":5.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976208","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 rehabilitation of upper-limb dyskinesia after stroke: from natural motion to neuronal microfluidics.","authors":"Honggang Wang, Junlong Guo, Yangqi Zhang, Ze Fu, Yufeng Yao","doi":"10.1186/s12984-025-01617-9","DOIUrl":"https://doi.org/10.1186/s12984-025-01617-9","url":null,"abstract":"<p><p>This review proposes an innovative closed-loop rehabilitation strategy that integrates multiple subdomains of stroke science to address the global challenge of upper-limb dyskinesia post-stroke. Despite advancements in neural remodeling and rehabilitation research, the compartmentalization of subdomains has limited the effectiveness of current rehabilitation strategies. Our approach unites key areas-including the post-stroke brain, upper-limb rehabilitation robotics, motion sensing, metrics, neural microfluidics, and neuroelectronics-into a cohesive framework designed to enhance upper-limb motion rehabilitation outcomes. By leveraging cutting-edge technologies such as lightweight rehabilitation robotics, advanced motion sensing, and neural microfluidic models, this strategy enables real-time monitoring, adaptive interventions, and personalized rehabilitation plans. Furthermore, we explore the potential of closed-loop systems to drive neural plasticity and functional recovery, offering a transformative perspective on stroke rehabilitation. Finally, we discuss future directions, emphasizing the integration of emerging technologies and interdisciplinary collaboration to advance the field. This review highlights the promise of closed-loop strategies in achieving unprecedented integration of subdomains and improving post-stroke upper-limb rehabilitation outcomes.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"87"},"PeriodicalIF":5.2,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971741","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":"Can virtual reality replace conventional vestibular rehabilitation tools in multisensory balance exercises for vestibular disorders? A non-inferiority study.","authors":"Gaël Le Perf, Guillaume Thebault, Claire Duflos, Fanchon Herman, Sylvie Cauquil-Gleizes, Isabelle Laffont","doi":"10.1186/s12984-025-01623-x","DOIUrl":"https://doi.org/10.1186/s12984-025-01623-x","url":null,"abstract":"<p><strong>Background: </strong>Vestibular rehabilitation uses multisensory balance exercises to optimize the integration and weighting of sensory inputs, including visual, vestibular, and proprioceptive signals. Head-mounted displays (HMDs) have emerged as a promising tool for these exercises, offering the ability to generate unreliable or conflicting visual stimuli, thereby enhancing vestibular and proprioceptive input weighting. This study aimed to determine whether a virtual reality (VR)-based rehabilitation program using HMDs is non-inferior to a conventional program employing an optokinetic stimulator and slaved environmental surround for multisensory balance exercises.</p><p><strong>Methods: </strong>Seventy-six participants with vestibular disorders were randomized into either the VR-based or conventional rehabilitation program for three weeks in a randomized controlled non-inferiority trial with blinded assessment. The non-inferiority margin was set at 5% of the control group's score. Both programs were multidisciplinary and included multisensory balance exercises designed to challenge sensory re-weighting. The primary outcome was the stability score, measured with eyes closed on an unstable platform using posturography, to evaluate postural control. Secondary outcomes included other variables from posturography, perceived disability assessed using the Dizziness Handicap Inventory (DHI), and tolerance to the multisensory balance exercises with unreliable or conflicting visual stimuli, assessed using the Simulator Sickness Questionnaire (SSQ).</p><p><strong>Results: </strong>The results showed that multisensory balance exercises with unreliable or conflicting visual stimuli were well tolerated in both groups, as indicated by low SSQ scores. Both rehabilitation programs led to significant pre-post improvements in postural control and perceived disability. However, the VR program did not meet the non-inferiority criterion compared to the conventional program. The primary outcome analysis revealed a difference of - 13.36 (95% CI - 29.84 to 3.11), with the lower bound of the confidence interval (- 29.84) falling below the non-inferiority margin of -2.01. Similarly, secondary outcomes, including other variables from posturography and the DHI, also failed to meet the non-inferiority criterion.</p><p><strong>Conclusion: </strong>Although VR rehabilitation shows innovative potential for multisensory balance training, its effectiveness was not demonstrated to be non-inferior to the conventional approach. Therefore, we recommend considering it as a complementary tool rather than a primary device for vestibular rehabilitation. Further research is needed to enhance the efficacy of VR-based rehabilitation for vestibular disorders while maintaining its tolerance. Trial registration NCT03838562.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"86"},"PeriodicalIF":5.2,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015820","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 comparative evidence of efficacy of non-invasive brain and nerve stimulation in diabetic neuropathy: a systematic review and network meta-analysis.","authors":"Ping-Tao Tseng, Bing-Yan Zeng, Chih-Wei Hsu, Chao-Ming Hung, Brendon Stubbs, Yen-Wen Chen, Tien-Yu Chen, Jiann-Jy Chen, Wei-Te Lei, Yow-Ling Shiue, Chih-Sung Liang","doi":"10.1186/s12984-025-01614-y","DOIUrl":"https://doi.org/10.1186/s12984-025-01614-y","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus is a highly burdensome metabolic disorder, affecting over 100 million people worldwide and leading to numerous complications. Among these, diabetic neuropathy is one of the most common, with approximately 60% of individuals with diabetes developing this condition. Current pharmacological treatments for diabetic neuropathy are often inadequate, providing limited efficacy and accompanied by a range of adverse effects. Non-invasive brain and nerve stimulation techniques have been proposed as potentially beneficial for diabetic neuropathy, though existing evidence remains inconclusive. This systematic review and network meta-analysis (NMA) aimed to evaluate the comparative efficacy of various non-invasive brain and nerve stimulation interventions in patients with diabetic neuropathy.</p><p><strong>Methods: </strong>A systematic search of electronic databases was conducted to identify randomized controlled trials (RCTs) of non-invasive brain or nerve stimulation in patients with diabetic neuropathy, from inception to September 6, 2024. The primary outcome was the change in pain severity, while secondary outcomes included changes in quality of life and sleep disturbance. Acceptability was assessed through dropout rates (i.e., withdrawal from the study before completion for any reason). A frequentist-based NMA was performed, utilizing odds ratios (OR) and standardized mean differences (SMD) with 95% confidence intervals (95%CIs) as effect size measures.</p><p><strong>Results: </strong>The NMA, which included 15 RCTs (totaling 1,139 participants, with a mean age of 61.2 years and a mean female proportion of 53.8%), evaluated 10 experimental interventions (1 control group, 4 non-invasive brain stimulation methods, and 5 non-invasive nerve stimulation methods). The analysis revealed that only transcutaneous electrical nerve stimulation (TENS) was associated with significantly greater improvements in pain severity (SMD = - 1.67, 95%CIs = - 2.64 to - 0.71) and sleep disruption (SMD = - 1.63, 95%CIs = - 2.27 to - 0.99) compared to the control group. None of the studied interventions showed significant differences in dropout rates or all-cause mortality compared to the control group.</p><p><strong>Conclusion: </strong>This study provides comparative evidence supporting the use of specific brain and nerve stimulation interventions in managing diabetic neuropathy. Future well-designed RCTs with longer treatment durations are recommended to further validate the long-term efficacy of these interventions. Trial registration PROSPERO CRD42024587660.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"88"},"PeriodicalIF":5.2,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040333","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":"Application of oscillating field stimulation in the treatment of spinal cord injury: a systematic review and meta-analysis of preclinical studies.","authors":"Guanlong Wang, Luchun Xu, Jiaojiao Fan, Guozheng Jiang, Yushan Gao, Jiawei Song, Yukun Ma, Xing Yu, Yongdong Yang","doi":"10.1186/s12984-025-01632-w","DOIUrl":"https://doi.org/10.1186/s12984-025-01632-w","url":null,"abstract":"<p><strong>Background: </strong>Oscillating Field Stimulation (OFS) is an emerging therapeutic approach for spinal cord injury (SCI) that is currently undergoing extensive investigation in preclinical in vivo studies. However, there has yet to be a comprehensive systematic review and meta-analysis of the existing literature. This systematic review and meta-analysis aims to evaluate the effectiveness of OFS technology in treating spinal cord injuries based on studies conducted with experimental animal models.</p><p><strong>Methods: </strong>A thorough search was performed across PubMed-MEDLINE, Embase, and Web of Science. Studies that were not in vivo preclinical research or were published in languages other than English were excluded. The SYRCLE tool was utilized to assess the risk of bias, and the extracted data underwent qualitative synthesis and meta-analysis.</p><p><strong>Results: </strong>Out of the 89 studies identified from the electronic databases, 8 fulfilled the inclusion criteria. Among these, 7 studies utilized a contusion model, while 1 employed a compression model. The application of OFS consistently resulted in significant enhancements in motor function scores compared to untreated SCI rats across all studies. This observed functional recovery correlated with histological improvements at the injury site. Although all studies were deemed to have a low risk of bias, some displayed incomplete reporting in specific areas.</p><p><strong>Conclusion: </strong>Our results indicate that OFS is a promising therapeutic approach for SCI, significantly enhancing functional recovery through multiple mechanisms. These include promoting nerve regeneration, aiding in myelin repair, and minimizing glial scarring. Future studies should concentrate on determining the optimal timing for OFS intervention, refining the electric field application methods, and investigating potential synergies with stem cell therapies. Thorough validation is essential before progressing to clinical applications.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"85"},"PeriodicalIF":5.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015986","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":"Resting-state hemodynamic changes and effects on upper limb function after multi-channel transcranial direct current stimulation to the ipsilesional primary motor cortex and anterior intraparietal sulcus in stroke patients: an fNIRS pilot study.","authors":"Seung Hyun Lee, Gihyoun Lee, Jinuk Kim, Zephaniah Phillips V, Heegoo Kim, Eunmi Kim, Su-Hyun Lee, Ho Choon Jeong, Seung-Ho Paik, Yun-Hee Kim, Beop-Min Kim","doi":"10.1186/s12984-025-01618-8","DOIUrl":"https://doi.org/10.1186/s12984-025-01618-8","url":null,"abstract":"<p><strong>Background: </strong>Stroke results in substantial long-term disability, necessitating effective recovery interventions. This study explored the effects of multi-channel transcranial direct current stimulation (tDCS) on hemodynamic responses and upper limb motor function in stroke patients, targeting the ipsilesional primary motor cortex (M1) and anterior intraparietal sulcus (aIPS).</p><p><strong>Methods: </strong>A double-blind, randomized, sham-controlled trial was conducted with 24 stroke patients (18 men; mean age, 57.3×14.2 years), who underwent 10 sessions of real or sham multi-channel tDCS combined with upper limb exercises. Functional near-infrared spectroscopy (fNIRS) measured resting-state cerebral hemodynamic responses for 5 min before and after each session. Motor function was evaluated using the Fugl-Meyer assessment for upper extremity (FMA-UE), box and block test (BBT), and other motor function tests before and after the interventions.</p><p><strong>Results: </strong>The real multi-channel tDCS group exhibited increases in regional accumulation of oxyhemoglobin (HbO_Acc) and stronger seeded connectivity networks within the motor cortex poststimulation. In contrast, the sham group exhibited disassociation from these areas. The group × time interaction was significant for the Box and Block Test (BBT), indicating greater improvements in gross manual dexterity in the real-tDCS group compared to the sham group. While poststimulation changes in HbOAcc were examined in relation to FMA-UE scores, no strong linear relationship was observed in the real-tDCS group.</p><p><strong>Conclusions: </strong>Multi-channel tDCS targeting the ipsilesional M1 and aIPS, combined with upper limb exercises, showed potential effects on cerebral hemodynamics and motor function in stroke patients. These findings suggest that multi-channel tDCS may have a role in motor rehabilitation, but further research is needed to validate its efficacy and clinical applicability.</p><p><strong>Clinicaltrials: </strong>GOV: This study was registered at ClinicalTrials.gov (NCT05275114).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"83"},"PeriodicalIF":5.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996474","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":"Achieving precision assessment of functional clinical scores for upper extremity using IMU-Based wearable devices and deep learning methods.","authors":"Weinan Zhou, Diyang Fu, Zhiyu Duan, Jiping Wang, Linfu Zhou, Liquan Guo","doi":"10.1186/s12984-025-01625-9","DOIUrl":"https://doi.org/10.1186/s12984-025-01625-9","url":null,"abstract":"<p><p>Stroke is a serious cerebrovascular disease, and rehabilitation following the acute phase is particularly crucial. Not all rehabilitation outcomes are favorable, highlighting the necessity for personalized rehabilitation. Precision assessment is essential for tailored rehabilitation interventions. Wearable inertial measurement units (IMUs) and deep learning approaches have been effectively employed for motor function prediction. This study aims to use machine learning techniques and data collected from IMUs to assess the Fugl-Meyer upper extremity subscale for post-stroke patients with motor dysfunction. IMUs signals from 120 patients were collected during a clinical trial. These signals were fed into a gated recurrent unit network to complete the scoring of individual actions, which were then aggregated to obtain the total score. Simultaneously, on the basis of the internal correlation between the Fugl-Meyer assessment and the Brunnstrom scale, Brunnstrom stage prediction models of the arm and hand were established via the random forest and extremely randomized trees algorithm. The experimental results show that the proposed models can score Fugl-Meyer items with a high accuracy of 92.66%. The R² between the doctors' score and the model's score is 0.9838. The Brunnstrom stage prediction models can predict high-quality stages, achieving a Spearman correlation coefficient of 0.9709. The application of the proposed method enables precision assessment of patients' upper extremity motor function, thereby facilitating more personalized rehabilitation programs to achieve optimal recovery outcomes. Trial registration: Clinical trial of telerehabilitation training and intelligent evaluation system, ChiCTR2200061310, Registered 20 June 2022-Retrospective registration.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"84"},"PeriodicalIF":5.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017512","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":"Hands-free Atalante exoskeleton in post-stroke gait and balance rehabilitation: a safety study.","authors":"Thierry Lejeune, Dijana Nuic, Stéphanie Dehem, Jean-Gabriel Previnaire, Céline Cuenot, Thierry Debugne, Jerome Kaps, Bérénice Paul, Vincent Pean, Sergi Sanz Perez, Fanny Juhel, Soultana Tatsidou, Jacques Kerdraon","doi":"10.1186/s12984-025-01621-z","DOIUrl":"https://doi.org/10.1186/s12984-025-01621-z","url":null,"abstract":"<p><strong>Background: </strong>Stroke often results in gait dysfunction, impairing daily activities and quality of life. Overground robotic exoskeletons hold promise for post-stroke rehabilitation. This study primarily aimed to assess the safety of hands-free Atalante exoskeleton training in post-stroke subjects, with a secondary aim to assess gait and balance.</p><p><strong>Methods: </strong>Forty subjects (10.2 ± 12.1 months post-stroke) with gait dysfunction (Functional Ambulation Category [FAC] score ≤ 3) underwent five training sessions over three weeks with a hands-free exoskeleton (Atalante, Wandercraft, France). Safety, the primary outcome, was evaluated by the number and severity of adverse events (AEs), judged by an independent clinical evaluation committee (CEC). A usability test was performed during the fifth training session followed by the exoskeleton use questionnaire. Gait and balance were assessed pre/post-training via walking capacity score (FAC), gait speed by 10-meter walk test (10MWT), walked distance by 6-minute walk test (6MWT), and balance by Berg Balance Scale (BBS). Spasticity was assessed with the Modified Ashworth scale. Anxiety and depression were quantified using the Hospital Anxiety and Depression Scale. Safety outcomes were analyzed using the Wilson, Lee and Dubin methods for proportions, and occurrence rates were computed. Within-group differences were compared using Wilcoxon, McNemar, and Friedman tests, with significance set at P < 0.05.</p><p><strong>Results: </strong>Thirty-one subjects completed the training sessions, while nine discontinued. The study reported two serious adverse events (SAE) (vertigo, dysarthria) and six AEs, with the CEC concluding that no SAE was linked to the device/study procedure. The average AE rate per session was 2.5 ± 1.4%, including four events possibly linked to the device/study procedure (knee pain [n = 1], skin lacerations [n = 3]), classified as negligible or minor by the CEC. A high proportion (82.6%) successfully completed the usability test and reported satisfaction (90%) on the exoskeleton use questionnaire. For gait and balance, favorable changes were observed in FAC, 10MWT, 6MWT, and BBS scores Post-training (p < 0.05, respectively). Spasticity, anxiety, and depression remained unchanged.</p><p><strong>Conclusions: </strong>This study indicates that the hands-free Atalante exoskeleton is safe, feasible, and well-tolerated for gait and balance rehabilitation in post-stroke subjects, warranting larger randomized controlled trials to assess its efficacy.</p><p><strong>Trial registration: </strong>Evaluation of the Use of the Atalante Exoskeleton in Patients Presenting an Hemiplegia Due to Cerebrovascular Accident (INSPIRE) trial was registered at ClinicalTrials.gov (NCT04694001, registered on 20201231).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"82"},"PeriodicalIF":5.2,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970423","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":"Posturographic sensory ratios provide evidence for neuroplasticity after computerized vestibular rehabilitation therapy in a single group interventional trial.","authors":"Eytan A David, Navid Shahnaz","doi":"10.1186/s12984-025-01608-w","DOIUrl":"https://doi.org/10.1186/s12984-025-01608-w","url":null,"abstract":"<p><strong>Background: </strong>Vestibular deficits are common and debilitating. Many patients do not achieve satisfactory resolution of their symptoms with standard rehabilitation techniques. This study seeks to measure changes in computerized dynamic posturography sensory ratio information after computerized vestibular retraining therapy (CVRT).</p><p><strong>Methods: </strong>This prospective, single group, interventional study enrolled adult participants with stable, unilateral vestibular deficits. Before and after twelve twice weekly sessions of CVRT, and 4-6 and 10-12 months post-treatment, participants completed the Sensory Organization Test, from which sensory ratios (somatosensory - SOM, visual - VIS, vestibular - VEST, and visual preference - PREF) were calculated.</p><p><strong>Results: </strong>13 participants completed the intervention and post-retraining assessment; 9 completed the 4-6 and 10-12 month assessments. After CVRT, VIS increased by 11.6 (1.6 to 21.7) and VEST increased by 9.5 (0.6 to 18.3) and both remained significantly above baseline 10-12 months after treatment. The SOM and PREF ratios changed negligibly. Participants with mild disability (DHI ≤ 30) showed no change while participants with moderate-to-severe disability (DHI > 30) had significantly greater improvements in VIS (P = 0.0006) and VEST (P = 0.02) across all three post-treatment assessments.</p><p><strong>Conclusions: </strong>CVRT was associated with durable improvement in VIS and VEST sensory ratios and improved postural control under conditions that favour use of vestibular information, consistent with increased weighting of vestibular information over vision.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov registration NCT04875013; 04/27/2021.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"81"},"PeriodicalIF":5.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007023","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":"Is physical therapy recommended for people with parkinson's disease treated with subthalamic deep brain stimulation? a delphi consensus study.","authors":"Matteo Guidetti, Sara Marceglia, Tommaso Bocci, Ryan Duncan, Alfonso Fasano, Kelly D Foote, Clement Hamani, Joachim K Krauss, Andrea A Kühn, Francesco Lena, Patricia Limousin, Andres M Lozano, Natale V Maiorana, Nicola Modugno, Elena Moro, Michael S Okun, Serena Oliveri, Marco Santilli, Alfons Schnitzler, Yasin Temel, Lars Timmermann, Veerle Visser-Vandewalle, Jens Volkmann, Alberto Priori","doi":"10.1186/s12984-025-01616-w","DOIUrl":"https://doi.org/10.1186/s12984-025-01616-w","url":null,"abstract":"<p><strong>Background: </strong>Although deep brain stimulation of the subthalamic nucleus (STN-DBS) induces motor benefits in people with Parkinson's disease (PwPD), its effect on motor axial symptoms (e.g., postural instability, trunk posture alterations) and gait impairments (e.g., freezing of gait) is still ambiguous. Physical therapy (PT) effectively complements pharmacological treatment to improve postural stability, gait performance, and other dopamine-resistant symptoms (e.g. freezing of gait) in the general population with PD. Despite the positive potential of combined PT and STN-DBS surgery, scientific results are still lacking. We therefore involved worldwide leading experts on DBS and motor rehabilitation in PwPD in a consensus Delphi panel to define the current level of PT recommendation following STN-DBS surgery.</p><p><strong>Methods: </strong>After summarizing the few available findings through a systematic scoping review, we identified clinically and academically experienced DBS clinicians (n = 21) to discuss the challenges related to PT following STN-DBS. A 5-point Likert scale questionnaire was used and based on the results of the systematic review, thirty-nine questions were designed and submitted to the panel-half related to general considerations on PT following STN-DBS, and half related to PT treatments.</p><p><strong>Results: </strong>Despite the low-to-moderate quality of data, the few available rehabilitation studies suggested that PT could improve dynamic and static balance, gait performance and posture in the population with PD receiving STN-DBS. Similarly, the panellists strongly agreed that PT might help improve motor symptoms and quality of life, and it may be prescribed to maximize the effects of stimulation. The experts agreed that physical therapists could be part of the multidisciplinary team taking care of the patients. Also, they agreed that conventional PT, but not massage or manual therapy, should be prescribed because of the specificity of STN-DBS implantation.</p><p><strong>Conclusions: </strong>Although RCT evidence is lacking, upon Delphi panel, PT for PwPD receiving STN-DBS can be potentially useful to maximize clinical improvement. However, more research is needed, with RCTs and well-designed studies. The rehabilitation and DBS community should expand this area of research to create guidelines for PT following STN-DBS.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"80"},"PeriodicalIF":5.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996761","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}