Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"A PRISMA systematic review through time on predictive musculoskeletal simulations.","authors":"Menthy Denayer, Eligia Alfio, María Alejandra Díaz, Massimo Sartori, Friedl De Groote, Kevin De Pauw, Tom Verstraten","doi":"10.1186/s12984-025-01686-w","DOIUrl":"10.1186/s12984-025-01686-w","url":null,"abstract":"<p><p>This PRISMA systematic review covers the literature on predictive, musculoskeletal simulations. First, we define predictive movement for musculoskeletal systems, as the current literature suffers from inconsistent nomenclature. We distinguish two methods of prediction. The first uses neural models, like muscle-reflex-based and central pattern generator models. The second uses optimization, to make up for the lack of a neural model, like optimal control and deep reinforcement learning. For each method, we illustrate the main concepts and report accuracies, simulation times and limitations. Moreover, we identified key works over the past 50 years, which are fundamental for the current state-of-the-art. The majority of works employ optimization. We recognize six classes of cost function terms and note they are often combined using linear combinations. We describe musculoskeletal models, their muscle model, ground contact model and personalization. Similarly, we identify key software like OpenSim and SCONE. Additionally, we provide an overview of simulated movements, pathologies and assistive devices. We emphasize the difference in tracking simulations and prediction, while clarifying the benefits of using experimental data to predict movement. Finally, we call for quantitative validation to establish comprehensive comparisons between methods. To this end, we share a list of works open-sourcing their codes.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"149"},"PeriodicalIF":5.2,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564837","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":"Exploratory development of human-machine interaction strategies for post-stroke upper-limb rehabilitation.","authors":"Kang Xia, Xue-Dong Chang, Chong-Shuai Liu, Yu-Hang Yan, Han Sun, Yi-Min Wang, Xin-Wei Wang","doi":"10.1186/s12984-025-01680-2","DOIUrl":"10.1186/s12984-025-01680-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Stroke and its related complications, place significant burdens on human society in the twenty-first century, and lead to substantial demands for upper limb rehabilitation. To fulfill the rehabilitation needs, human-machine interaction (HMI) technology strives continuously. Depends on the involvement of subject, HMI strategy can be classified as passive or active. Compare to passive modalities, active strategies are believed to be more effective in promoting neuroplasticity and motor recovery for post-stroke survivors in sub-acute and chronic phase. However, post-stroke survivors usually experience weak upper arms, limited range of motion (ROM) and involuntary excessive movement patterns. Distinguishing between complex subtle motion intentions and excessive involuntary movements in real-time remains a challenge in current research, which impedes the application of active HMI strategies in clinical practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;An Up-limb Rehabilitation Device and Utility System (UarDus) is proposed along with 3 HMI strategies namely robot-in-charge, therapist-in-charge and patient-in-charge. Based on physiological structure of human upper-limb and scapulohumeral rhythm (SHR) of shoulder, a base exoskeleton with 14 degrees of freedoms (DoFs) is designed as foundation of the 3 strategies. Passive robot-in-charge and therapist-in-charge strategies provides fully-assisted rehabilitation options. The active patient-in-charge strategy incorporates data acquisition matrices and a new deep learning model, which is developed based on Convolutional Neural Network (CNN) and Transformer structure, aims to capture subtle motion intentions. Motors' current is monitored and the surge in the current is identified adopting Discrete Wavelet Transform (DWT) method for safety concerns.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Kinematically, the work space of the base exoskeleton is presented first. Utilizing motion capture technology, the glenohumeral joint (GH) centers of both human and exoskeleton exhibit well-matched motion curves, suggesting a comfortable dynamic wear experience. For robot-in-charge and therapist-in-charge strategy, the desired and measured angle-time curve present good correlation, with low phase difference, which serve the purpose of real-time control. Featuring the patient-in-charge strategy, Kernel Density Estimation (KDE) result suggesting reasonable sensor-machine-human synergy. Applying K-fold (K = 10) cross-validation method, the classification accuracy of the proposed model with outstanding response time achieves an average of 99.7% for the designated 15 actions, signifies its capability for subtle motion intention recognition in real-time. Additionally, signal surge is easily identified with DWT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;An upper-limb exoskeleton hardware device named UarDus is constructed, along with three HMI modalities, offering both passive and active rehabilitation approaches. The propo","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"144"},"PeriodicalIF":5.2,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560417","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":"Effectiveness of a rehabilitation program involving functional proprioceptive stimulation for postural control and motor recovery among stroke patients: a double-blinded, randomized, controlled trial.","authors":"Agnieszka Wiśniowska-Szurlej, Justyna Leszczak, Justyna Brożonowicz, Gabriela Ciąpała, Héctor Hernández-Lázaro, Agnieszka Sozańska","doi":"10.1186/s12984-025-01678-w","DOIUrl":"10.1186/s12984-025-01678-w","url":null,"abstract":"","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"147"},"PeriodicalIF":5.2,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564839","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":"Real-time cortical activity during virtual reality practice in people with multiple sclerosis: a pilot fNIRS study.","authors":"Rotem Lavi, Massimiliano Pau, Sapir Dreyer-Alster, Tali Drori, Eleonora Cocco, Alon Kalron","doi":"10.1186/s12984-025-01681-1","DOIUrl":"10.1186/s12984-025-01681-1","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is a neuroinflammatory disorder affecting motor and cognitive functions. Virtual reality (VR) is increasingly used in rehabilitation, offering controlled environments for motor training and for integrating cognitive challenges into physical tasks through dual-task paradigms. Functional near-infrared spectroscopy (fNIRS) is a promising tool for assessing cortical activation in VR-based rehabilitation, yet its application in people with MS (pwMS) remains underexplored. This study aimed to examine cortical activation in pwMS during an upper-limb daily life activity performed in VR versus actual performance (AP), and to assess the additional impact of an explicit cognitive challenge implemented as a memory recall and sequencing task performed simultaneously with the motor activity.</p><p><strong>Methods: </strong>A pilot fNIRS case-control study was conducted with 14 pwMS and 14 healthy controls, matched for age and sex. Participants completed a dishwashing task under four conditions: (1) VR, (2) VR with a cognitive challenge (VR-cog), (3) AP, and (4) AP with a cognitive challenge (AP-cog). fNIRS measured relative changes in the concentrations of oxyhemoglobin (ΔHbO), deoxyhemoglobin (ΔHbR), and total hemoglobin (ΔHbT) in the supplementary motor area (SMA), premotor cortex (PMC), and somatosensory association cortex (SAC). A general linear model and repeated-measures ANOVA assessed cortical activation across conditions.</p><p><strong>Results: </strong>PwMS exhibited reduced ΔHbT concentrations in the SMA and PMC compared to healthy controls during both VR and AP tasks (p = 0.019 and p = 0.038, respectively), suggesting diminished neurovascular activation. Within-group analyses revealed significant task-dependent modulation in healthy controls, with greater neurovascular responses in the SMA and PMC. In contrast, pwMS showed no significant differences in cortical activation across task conditions, indicating impaired neurovascular adaptability. No significant differences between groups were observed in the VR-cog and AP-cog conditions, suggesting that the cognitive challenge did not further differentiate neurovascular responses.</p><p><strong>Conclusions: </strong>While no significant differences in overall cortical activation were found between VR and real-world tasks, pwMS exhibited reduced neurovascular responses compared to healthy controls, indicating impaired adaptability. These findings support VR's feasibility for motor rehabilitation while highlighting the need for further studies on neuroplasticity, cognitive-motor integration, and lesion-related neurovascular changes in pwMS.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"148"},"PeriodicalIF":5.2,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564841","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":"Impact of sensorimotor mismatch on virtual reality sickness and user experience: age-related differences in a randomized trial.","authors":"Elisabeth Jochmann, Thomas Jochmann, Maximilian Weber, Karolin Weigel, Carsten Klingner","doi":"10.1186/s12984-025-01677-x","DOIUrl":"10.1186/s12984-025-01677-x","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality (VR) technology offers immersive and interactive experiences and is increasingly being explored for rehabilitation therapies. However, concerns about side effects such as nausea and dizziness-collectively referred to as VR sickness-are holding back clinical translation. Sensorimotor mismatches, while potentially beneficial for motor learning, may exacerbate these effects. The age groups in VR applications differ, with younger users common in gaming and older adults prevalent in rehabilitation. This study investigated whether sensorimotor mismatches in a VR-based motor task make the experience more uncomfortable and whether older adults are more affected by these mismatches.</p><p><strong>Methods: </strong>We conducted a randomized controlled trial with 104 healthy right-handed adults, including elderly participants up to 84 years old, to cover the relevant demographics for rehabilitation. Participants were divided into three intervention groups and performed a VR ball-throwing task using an Oculus Rift S head-mounted display. The groups differed in task difficulty and exposure to deliberately induced sensorimotor mismatches. The design avoided visual-vestibular conflicts typically responsible for VR sickness and instead introduced proprioceptive mismatches during hand-object interaction. VR sickness was measured using the Simulator Sickness Questionnaire (SSQ), and user experience was assessed through a self-developed questionnaire. Statistical analysis was performed using rank-transformed ANOVA, ordinal logistic regression, and Spearman's rho with FDR correction for multiple comparisons.</p><p><strong>Results: </strong>Results indicated no significant differences in SSQ scores among the three intervention groups, suggesting that sensorimotor mismatches do not increase VR sickness. However, the Mismatch group reported higher levels of exhaustion and frustration compared to the Error-based and Errorless groups, indicating the impact of cognitive strain and task difficulty on user experience. Interestingly, younger participants reported higher (worse) SSQ scores, while older participants experienced weaker symptoms.</p><p><strong>Conclusions: </strong>VR environments with sensorimotor mismatches during hand-object interaction tasks may be feasible for rehabilitation, as they did not lead to significant discomfort in this setting. Moreover, despite concerns about age-related susceptibility to dizziness, older adults showed high tolerance to VR, supporting its potential for broader applications in rehabilitation settings. This study was reported in accordance with the CONSORT guidelines. It was registered in the German Clinical Trials Register (DRKS00034901).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"143"},"PeriodicalIF":5.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560418","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":"Real-time locomotion mode detection in individuals with transfemoral amputation and osseointegration.","authors":"Bahareh Ahkami, Morten B Kristoffersen, Max Ortiz-Catalan","doi":"10.1186/s12984-025-01672-2","DOIUrl":"10.1186/s12984-025-01672-2","url":null,"abstract":"<p><strong>Background: </strong>Despite notable advancements in prosthetic leg technology, commercially available devices with embedded algorithms utilizing bioelectric signals for prosthetic leg control are lacking. This untapped potential could enhance current prosthetic leg capabilities, enabling more natural movements. However, individuals with short residual limbs have limited available muscle and it has not been investigated if different locomotion modes can be predicted in real-time in this population. Here, we explored the feasibility of using electromyographic signals in individuals with short residual limbs and osseointegrated implants to infer locomotion modes.</p><p><strong>Methods: </strong>We recorded data from five participants with transfemoral amputation and osseointegration while walking on level ground, stairs, and ramps. Electromyography, acceleration, angular velocity, and ground reaction force were collected using wireless sensors. Two sessions of recordings for offline and real-time evaluation were conducted, with 30 rounds and 15 rounds, respectively. Decoding was performed using a mode-specific, phase-dependent classifier. The method was implemented in LocoD, an existing open-source platform, allowing for further development by the community and allowing easy comparison between different classification algorithms. The evaluation of the platform and prediction algorithm relies on quantifying the transition error, signifying instances where the algorithm falls short in predicting shifts between different walking surfaces.</p><p><strong>Results: </strong>In this study, a participant exhibited an average error as low as 1.2%, indicating precise predictions. Conversely, the highest average error was found at 23% in a different participant. This variation could be the result of factors related to the amputation such as residual limb length, remaining muscles, and the surgical technique used while performing the amputation, as well as differences in performing the movements. On average, offline classification resulted in a mean error of 5.7%, while the corresponding mean error during online (real-time) evaluation was 11.6%.</p><p><strong>Conclusion: </strong>Our findings suggest that myoelectric signals can be potentially used in the control of prosthetic legs for individuals with short residual limbs with osseointegrated implants. Further research into understanding and compensating for variations in the locomotion detection accuracy for different participants is crucial.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"142"},"PeriodicalIF":5.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual muscle strengths in rehabilitation outcomes of distal radius fracture.","authors":"Lunjian Li, Xuanchi Liu, Lihai Zhang","doi":"10.1186/s12984-025-01669-x","DOIUrl":"10.1186/s12984-025-01669-x","url":null,"abstract":"<p><strong>Background: </strong>Distal radius fractures (DRFs) are common fracture types and elderly patients often struggle to achieve functional recovery, which could be overcome by precise rehabilitation. This study aims to develop an innovative approach for acquiring patient-specific musculoskeletal models to provide guidelines for therapists to tailor rehabilitation plans individually.</p><p><strong>Method: </strong>A wearable EMG detector (Myo armband) and a dynamometer (KDG grip strength tester, EH101) were used to collect EMG signals and grip forces from 20 volunteers at 0, 30, 50, 70, and 100 N, which were considered low-level gripping. The collected data was used to train neural networks to predict maximum grip force from low-level grip data only. Based on a novel scaling function, personalized models were scaled from a standard musculoskeletal model and were validated by comparing their results with experiments. Sequentially, the musculoskeletal forces of two volunteers with different muscle strengths (one strong in muscle strength and the other is weak, compared to baseline) were simulated under extension exercises to investigate the impact of individual muscle strengths on rehabilitation outcomes.</p><p><strong>Results: </strong>The trained model predicts the maximum grip force by EMG signals well. Based on the scaling function, the corresponding personalized musculoskeletal models can simulate grip forces that align well with experiment observations. The muscle loadings were also scaled proportionally to their scaling coefficients. However, the contact forces are not linear to the scaling coefficients. The healing outcome of weak individuals shows satisfactory improvement while that of strong individuals performs ordinarily.</p><p><strong>Conclusion: </strong>This study has successfully developed a convenient approach to detect the maximum grip strength of patients and verified the feasibility of scaling the musculoskeletal models. The non-linear relationship of contract forces to the scaling coefficients indicates the complexity of the musculoskeletal system. The healing outcomes from the case studies suggest that while adequate mechanical stimuli are beneficial, excessive or inappropriate stimuli can impede the healing process.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"140"},"PeriodicalIF":5.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of virtual reality training on dual-task performance in older adults: a systematic review and meta-analysis.","authors":"Xiaoyu Wei, Chun Huang, Xinyue Ding, Zhining Zhou, Yufeng Zhang, Xiaofan Feng, Suwang Zheng, Tingting Li, Jiaojiao Lü","doi":"10.1186/s12984-025-01675-z","DOIUrl":"10.1186/s12984-025-01675-z","url":null,"abstract":"<p><strong>Background: </strong>Age-related decline in dual-task (DT) performance is closely associated with falls in older adults, posing a significant public health concern. Virtual reality (VR) training has emerged as a novel intervention to enhance motor-cognitive integration, yet its effects on dual-task performance require systematic evaluation.</p><p><strong>Objective: </strong>The purpose of this systematic review and meta-analysis was to assess the impact of VR training on dual-task performance in older adults.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we searched four databases for randomized controlled trials (RCTs) evaluating VR training in adults aged ≥ 60 years. Inclusion criteria required comparisons between VR training and non-VR control groups, with outcome measures including dual-task cost (DTC), dual-task timed up-and-go (DT-TUG), DT gait parameters (speed, stride length, cadence), and DT cognitive performance. Methodological quality was assessed using the Cochrane Risk of Bias tool, and meta-analysis were conducted using RevMan 5.4.</p><p><strong>Results: </strong>Twenty-one RCTs (935 participants) were included. Meta-analysis revealed significant improvements in VR groups for DTC of gait speed [SMD = -0.32, 95% CI (-0.57, -0.07), P = 0.01], stride length [SMD = -0.58, 95% CI: (-0.90 to -0.26), P < 0.001] and cadence [SMD = -0.32, 95% CI (-0.64, 0.00), P = 0.05]. DT-TUG time decreased significantly [SMD = -0.54, 95% CI (-0.89, -0.19), P = 0.002]. VR training also enhanced dual-task gait speed [SMD = 0.38 95% CI (0.03, 0.73), P = 0.03] and stride length [SMD = 1.15, 95% CI (0.81, 1.49), P < 0.001]. Subgroup analyses showed VR brought more notable improvements for MCI and PD patients. For VR interventions, durations over 1 h per session, more than 4 - week duration, and 3-5 sessions per week yielded better results. Yet, no significant improvements were observed in other DT aspects like cognitive reaction times and rapid gait speed.</p><p><strong>Conclusion: </strong>VR training effectively reduces DT performance decline in older adults, particularly by lowering DTC and enhancing functional mobility, supporting its potential as a fall prevention strategy.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"141"},"PeriodicalIF":5.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of virtual reality-based exercise intervention in young people with attention-deficit/ hyperactivity disorder: a systematic review.","authors":"Jia-Ling Sun, Xiao-Jun Chaw, Shane Fresnoza, Hsiao-I Kuo","doi":"10.1186/s12984-025-01671-3","DOIUrl":"10.1186/s12984-025-01671-3","url":null,"abstract":"<p><strong>Background: </strong>Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder among the young population in the world. Young people with ADHD are often affected in their performance of attention, behavior, and executive functions (EFs), leading to a limited quality of life. Recently, Virtual reality (VR)-based exercise has been used as an intervention for young people with ADHD. Therefore, this review aims to evaluate the effectiveness of VR-based exercise in improving EFs and reducing ADHD symptoms in young people.</p><p><strong>Method: </strong>This review aims to systematically review the effects of VR-based exercise on the overall EFs and their subdomains, as well as ADHD symptoms in young people with ADHD. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42024604205) and was funded by the National Science and Technology Council, R.O.C., with the project number 112-2314-B002-119-MY3. Studies were identified in five databases (Cochrane Library, Web of Science, PubMed, SCOPUS, and Embase) from September 2010 through September 2024. Studies that applied VR-based exercise intervention on young participants with ADHD were included in this systematic review. A total of 6 studies met the inclusion criteria and were considered high quality according to standardized assessment lists.</p><p><strong>Results: </strong>Based on the 6 included studies and a total of 192 participants, the results showed that VR-based exercise with moderate to vigorous intensity provides positive effects on multiple subdomains of EFs (inhibitory control, attention, working memory, switching, and planning) and clinical symptoms in young people with ADHD. Furthermore, fully immersive and semi-immersive VR-based exercise interventions yielded similar results.</p><p><strong>Conclusion: </strong>VR-based exercise effectively improves EFs and is feasible for young people with ADHD, with benefits observed across ages and with sessions over 30 min. However, more evidence is essential for VR-based exercise intervention, which may compare the effects to other intervention types. Additionally, studies with rigorous experimental design are warranted.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"139"},"PeriodicalIF":5.2,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modifying lumbar flexion pain thresholds in patients with chronic low back pain through visual-proprioceptive manipulation with virtual reality: a cross-sectional study.","authors":"Jaime Jordán-López, María D Arguisuelas, Julio Doménech, M Lourdes Peñalver-Barrios, Marta Miragall, Rocío Herrero, Rosa M Baños, Juan J Amer-Cuenca, Juan F Lisón","doi":"10.1186/s12984-025-01664-2","DOIUrl":"10.1186/s12984-025-01664-2","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Background: </strong>Movement-evoked pain may serve as a protective response influenced by visual-proprioceptive cues signaling potentially threatening movements. This study aimed to assess the impact of manipulating visual-proprioceptive feedback using virtual reality (VR) during lumbar flexion on movement-evoked pain thresholds. Additionally, we explored whether individuals with elevated pain, kinesiophobia, and catastrophizing were more susceptible to visual-proprioceptive manipulation.</p><p><strong>Methods: </strong>Fifty participants with non-specific chronic low back pain (cLBP) were included. We assessed lumbar flexion-evoked pain thresholds alongside pain levels, pain interference, kinesiophobia, and catastrophizing. Participants performed lumbar flexion movements in three conditions: (1) without VR (control, F), (2) with a virtual illusion shortening the perceived arm length by 20% (understated condition, F-), and (3) with a virtual illusion elongating arm length by 20% (overstated condition, F +). Range of motion (ROM) was measured using an electro-goniometer. One-way ANOVA with Bonferroni post-hoc tests examined differences among conditions, and three two-sample t-tests explored whether individuals with higher pain, kinesiophobia, and catastrophizing were more affected by visual-proprioceptive manipulation.</p><p><strong>Results: </strong>Understating the flexion task (F-) led to a 5% increase in movement compared to the control (P = 0.04; 95% CI [0.6%, 10.7%]) and a 7% increase compared to the overstated condition (F +) (P < 0.001; 95% CI [2.6%, 11.6%]). Additionally, individuals with higher pain levels and pain interference, exhibited a more pronounced response to the understated condition (F-).</p><p><strong>Conclusions: </strong>Manipulating visual-proprioceptive feedback through VR significantly influenced pain thresholds during lumbar flexion in cLBP patients. The understated condition (F-) extended pain-free movement, delaying pain onset. Furthermore, pain intensity and interference modulated susceptibility to visual feedback manipulation. These findings enhance our understanding of how visual-proprioceptive feedback influences pain perception and movement patterns in cLBP. They suggest new avenues for pain assessment, therapeutic interventions, and clinical strategies, particularly for individuals with high pain levels, interference, kinesiophobia, and catastrophizing. TRIAL REGISTRATION  : This study was retrospectively registered in the ClinicalTrials.gov with identifier NCT06750887.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"138"},"PeriodicalIF":5.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}