Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"Passive sensing of gait and medication-related fluctuations in Parkinson's disease.","authors":"Juyoung Jenna Yun, Charalambos Hadjipanayi, Arya Jahangiri, Alan Bannon, Timothy G Constandinou, Shlomi Haar","doi":"10.1186/s12984-026-02068-6","DOIUrl":"10.1186/s12984-026-02068-6","url":null,"abstract":"<p><strong>Background: </strong>Gait impairment is a hallmark symptom of Parkinson's Disease (PD). Traditional clinical assessments cannot capture real-world motor fluctuations, as they are sparsely performed. We validated the use of nearables, passive sensing technologies, including Kinect RGB-D cameras and ultra-wideband (UWB) radar, for continuous, objective assessment of gait fluctuations in PD within a home-like setting.</p><p><strong>Methods: </strong>Fifteen PD patients with mild symptoms and fourteen age- and sex-matched healthy controls (HC) performed 4-metre walking tasks in a living lab facility. Patients repeated the task during \"ON\" and \"OFF\" states of their daily medication cycle. Gait features, including stride length, stride time, and gait speed, were extracted from Kinect, radar, and a ground-truth smart floor. Data were analysed to assess inter-sensor agreements and group-level differences.</p><p><strong>Results: </strong>Stride time demonstrated the highest agreement between devices (r = 0.903), while stride length was weaker (r = 0.779). Nevertheless, stride length from both Kinect and radar distinguished PD OFF from HC (camera q = 0.020; radar q = 0.005), and radar additionally differentiated ON from OFF (q = 0.020). Neither device differentiated PD ON from HC, indicating medication reduced observable gait differences.</p><p><strong>Conclusions: </strong>Although some spatial metrics show device discrepancies, both systems demonstrate sensitivity to gait patterns and medication-dependent changes, supporting their use for longitudinal, real-world monitoring of motor symptoms.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308245","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":"Neuromodulatory effects of voluntary-motor-effort-driven wrist-hand robot in sensorimotor dynamics after stroke.","authors":"Yunxia Huo, Weidong Li, Fanjie Ding, Di Ao, Huijing Hu, Xiaoling Hu, Le Li","doi":"10.1186/s12984-026-02062-y","DOIUrl":"10.1186/s12984-026-02062-y","url":null,"abstract":"<p><strong>Background: </strong>Voluntary motor effort (VME)-driven neuromuscular electrical stimulation (NMES)-robots have demonstrated superior rehabilitative efficacy in post-stroke wrist-hand motor restoration compared with purely mechanical systems. However, their neuromodulatory mechanisms remain unclear. This study aimed to investigate cortical responses elicited by an electromyography (EMG)-driven NMES-robot assisting wrist-hand movements in individuals with chronic stroke, and to evaluate robot-nervous system interactions, using EMG to capture VME.</p><p><strong>Methods: </strong>Cortical responses during wrist-hand extension were recorded in participants with chronic stroke (n = 18) and unimpaired controls (n = 20) using functional near-infrared spectroscopy (fNIRS). The EMG-driven NMES-robot delivered somatosensory stimulation with different combinations of mechanical stimulation (MS) to the targeted joints and NMES to the forearm muscles, with or without VME.</p><p><strong>Results: </strong>Combined MS and NMES co-stimulation activated wider cortical areas than MS or NMES alone in both groups. Compared with the unimpaired group, the stroke group exhibited greater ipsilesional activations in response to NMES (p < 0.05), while MS induced comparable activations in the contralateral hemisphere to the stimulated limb in both groups (p < 0.05). When VME was required, the stroke group exhibited wider contralesional involvement with MS only (p < 0.05) but reduced contralesional involvement during sole NMES (p < 0.05), compared to those in the co-stimulation. Additionally, the MS and NMES co-stimulation resulted in similar functional connectivity patterns between the stroke and unimpaired groups.</p><p><strong>Conclusion: </strong>Combined mechano-electrical somatosensory co-stimulation with MS and NMES to the affected wrist-hand, when voluntary motor effort is generated from the residual muscles, could elicit extensive cortical activation approaching normal patterns.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry with the identifier ChiCTR2200057839.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308226","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 validation of a prediction model for activities of daily living dysfunction among stroke survivors: insights from the CHARLS cohort.","authors":"Hongying Ren, Wen Wang, Li Tao, Xiaoshu Song, Bin Bai, Min Wang, Xiaoyan Li","doi":"10.1186/s12984-026-02063-x","DOIUrl":"10.1186/s12984-026-02063-x","url":null,"abstract":"<p><strong>Background: </strong>Activities of daily living (ADL) dysfunction is prevalent in stroke survivors and places a significant burden on both patients and healthcare systems. Improved identification of individuals with ADL dysfunction may facilitate more targeted rehabilitation strategies.</p><p><strong>Methods: </strong>The China Health and Retirement Longitudinal Study (CHARLS) provided the data. A training set (n = 906) and a validation set (n = 389) were randomly selected from a total of 1,295 stroke survivors. Least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression were used to select predictors and develop a prediction model, which was visualized using a nomogram. SHapley Additive exPlanations (SHAP) were applied for model interpretation. The area under the receiver operating characteristic curve (AUC), calibration analysis, and decision curve analysis (DCA) were used to evaluate the model's performance.</p><p><strong>Results: </strong>Ten predictors were identified, including CES-D scores, age, sleep time duration, drinking, lung disease, social contact, falls, hypertension, arthritis, and sex. SHAP analysis identified CES-D scores as the most influential predictors. The model demonstrated acceptable discriminative ability in both the training set (AUC: 0.76, 95% CI: 0.73-0.79) and validation set (AUC: 0.76, 95% CI: 0.72-0.81). Calibration was satisfactory in both the training and validation sets (Hosmer-Lemeshow test, P = 0.16 and P = 0.99, respectively). Positive clinical usefulness was suggested by DCA analysis.</p><p><strong>Conclusions: </strong>The model demonstrated acceptable predictive performance and may assist in identifying individuals with prevalent ADL dysfunction. Further external validation is required before broader clinical application.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295253","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":"Proprioceptive-augmented virtual reality influences the kinematic properties of movement imitation.","authors":"Ambra Bisio, Monica Biggio, Elisa Soldi, Alice Massa, Costanza Iester, Laura Bonzano, Marco Bove","doi":"10.1186/s12984-026-02061-z","DOIUrl":"10.1186/s12984-026-02061-z","url":null,"abstract":"<p><strong>Background: </strong>Virtual Reality (VR) has been proposed as a tool in rehabilitation to create more realistic, interactive, and engaging environments that can enhance the sense of embodiment, and thus possibly the effect of the treatment itself. Previous research has shown that combining movement observation with somatosensory stimulation may further improve training outcomes. The present study aimed to examine whether a protocol integrating the observation of human movements within an VR environment with proprioceptive stimulation, thereby establishing a Proprioceptive-Augmented virtual Reality (PAR) paradigm, could enhance participants' ability to imitate the dynamic properties of movements presented in VR.</p><p><strong>Methods: </strong>Twenty-three healthy young adults were asked to imitate the features of a flexion-extension forearm movement observed in an immersive VR environment, either while receiving or not receiving 80 Hz muscle tendon vibration that induced an illusory sensation of movement congruent with the observed direction (PAR). The imitation task was performed with the stimulated forearm either after the stimulation had ended (OFFLINE imitation) or concurrently with it (ONLINE imitation). Participants' ability to reproduce the avatar's mean and maximal velocities was assessed (reproduction error). Root means square error (RMSE) between avatar and participants' trajectory was calculated. In addition, a questionnaire evaluating the sense of embodiment was administered after the OFFLINE imitation task under both conditions, as well as the evaluation of the vividness evoked by PAR and VR.</p><p><strong>Results: </strong>In the OFFLINE task the reproduction error was lower in PAR than in VR, while the opposite was obtained in the ONLINE task. In the OFFLINE task no difference emerged between PAR and VR RMSE values, whilst in the ONLINE task PAR RMSE was higher than that in VR. PAR evoked a higher sense of embodiment and higher vividness compared to VR when considering all the domain tested (body ownership, sense of agency, location of the body).</p><p><strong>Conclusions: </strong>These findings indicate that proprioceptive stimulation in the PAR condition positively affected movement reproduction during the OFFLINE imitation task, likely benefiting from the heightened sense of embodiment and vividness elicited in this condition. This suggests that muscle tendon vibration can enhance the perception of self-motion in VR, enabling richer interaction strategies and offering promising prospects for sensorimotor rehabilitation.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283974","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":"Multimodal engagement estimation in paediatric robot-assisted gait training: integrating physiological sensing and biomechanical interaction.","authors":"Elena Campilii, Francesco Romano, David Perpetuini, Lorenzo Mancini, Teresa Paolucci, Emanuele Francesco Russo, Maria Teresa Gatta, Marta Di Nicola, Giovanni Morone, Irene Ciancarelli, Antimo Moretti, Francesca Gimigliano, Sara Moccia, Arcangelo Merla, Daniela Cardone","doi":"10.1186/s12984-026-02050-2","DOIUrl":"10.1186/s12984-026-02050-2","url":null,"abstract":"<p><strong>Background: </strong>Patients' engagement plays a crucial role in the effectiveness of robot-assisted gait training (RAGT), particularly in paediatric neurorehabilitation, where motivation and active participation strongly influence functional outcomes. Despite its clinical relevance, engagement assessment is still largely based on subjective observation, limiting objectivity and scalability. Objective modelling of engagement in children with cerebral palsy remains underexplored, especially when relying on physiological signals acquired during therapy, due to logistical, ethical, and technological challenges that constrain multimodal data collection and cohort sizes. This study proposes a novel multimodal framework to automatically estimate engagement in a paediatric cerebral palsy population undergoing RAGT, capturing clinically relevant variability across patients.</p><p><strong>Methods: </strong>A cohort of 20 paediatric patients with cerebral palsy undergoing RAGT with the Hocoma Lokomat® system was monitored across multiple therapy sessions. Heart rate variability (HRV), facial infrared thermography (IRT), and exoskeleton-derived biomechanical features were acquired to capture complementary physiological and behavioural responses related to engagement. Signals were segmented into time windows and processed to extract statistical, spectral, and complexity features. Engagement was annotated by an expert clinician using a three-class scale (not engaged, neutral, engaged). A supervised multiclass machine-learning framework was then developed to estimate engagement from multimodal data, evaluating several ensemble-based classifiers under strict training-testing separation with repeated stratified splits and class-weighted learning to tackle class imbalance.</p><p><strong>Results: </strong>The combination of multimodal features with the Extra Trees classifier achieved the best performance, with a macro-F1 score of 0.658 ± 0.027. Class-wise analysis showed higher performance for extreme engagement levels (not engaged and engaged), with most misclassifications occurring between adjacent classes, particularly involving the neutral state. Feature selection and explainability analyses identified exoskeleton-derived torque features as the most influential predictors, with thermal and HRV features providing complementary autonomic and emotional information.</p><p><strong>Conclusions: </strong>This study presents a novel multimodal machine learning approach for automatic engagement estimation during RAGT in children with cerebral palsy. Beyond classification performance, it demonstrates the feasibility of objective engagement modelling in a complex clinical population by integrating physiological and robotic interaction data. The results highlight the potential of multimodal sensing to support adaptive rehabilitation systems for continuous monitoring and personalized human-robot interaction.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277677","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-world gait study of Parkinson's disease using wearable sensors: a systematic review.","authors":"Mona Michaud, Nicolas de l'Escalopier, Cyril Voisard, Laurent Oudre, Damien Ricard","doi":"10.1186/s12984-026-01957-0","DOIUrl":"10.1186/s12984-026-01957-0","url":null,"abstract":"<p><strong>Background: </strong>New technologies, such as wearable sensors, allow the quantitative assessment of gait alterations due to Parkinson's disease (PD) through Digital Mobility Outcomes (DMOs). These DMOs have the potential to complement traditional clinical assessments but must be relevant, reliable, and representative of the patient's overall condition. Real-world monitoring offers a valuable approach for this type of day-to-day evaluation of patients.</p><p><strong>Objective: </strong>This systematic review has four primary aims: 1) To identify trends in protocol design for real-world gait monitoring using wearables in patients with PD. 2) To detail the analysis of inertial data and the computation of DMOs. 3) To summarize the clinical scales and symptoms studied. 4) To outline trends in the conclusions and limitations reported by authors in this field.</p><p><strong>Methods: </strong>Three databases (MEDLINE via PubMed, Cochrane, and EMBASE) were systematically searched between September 1, 2013, and September 15, 2023. Eligibility criteria included studies involving adults with a PD diagnosis, the use of a wearable device with at least one accelerometer or gyroscope, and gait analysis conducted in real-world settings.</p><p><strong>Results and conclusion: </strong>Sixty-three studies were selected. Overall, wearables successfully provide clinically meaningful information on gait impairment in patients with PD. Stride speed as a DMO is well-established and clinically meaningful, while other metrics, such as stride length, stride duration, and cadence, show great promise for routine clinical practice and research. However, the lack of consensus on the methods of investigation and the small sample sizes remain significant barriers that must be addressed to facilitate broader adoption in clinical practice and research.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148271816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond microprocessor knees: exploring the potential of fully powered prosthetic legs.","authors":"Kyle R Embry, Chandrasekaran Jayaraman, Chen Yang, Shenan Hoppe-Ludwig, Matt McGuire, Jonathan Mendley, Chaithanya K Mummidisetty, Brian E Lawson, Kiana Mohammadian, Jasmine Hunt, Apurva Reddy, Michael Goldfarb, Keith E Gordon, Arun Jayaraman","doi":"10.1186/s12984-026-02042-2","DOIUrl":"10.1186/s12984-026-02042-2","url":null,"abstract":"<p><strong>Background: </strong>Powered knee and ankle prostheses generate mechanical energy to replicate biological leg function, yet direct comparisons with more commonly prescribed microprocessor-controlled knee prostheses are limited by methodological variability and small sample sizes.</p><p><strong>Methods: </strong>Twelve adults with transfemoral or knee disarticulation limb loss or difference who regularly used microprocessor knees were enrolled in a crossover study. After device fitting and an average of 10 training sessions with a powered knee and ankle prototype, participants completed a comprehensive battery of biomechanical, physiological, and functional assessments. Tests were repeated using each participant's prescribed prosthesis following a two-month washout period to reduce carryover effects. Paired statistical comparisons were used to evaluate differences across key outcome measures.</p><p><strong>Results: </strong>Participants walked slightly slower and exhibited marginally reduced swing time symmetry when using the powered prosthesis. However, there were no significant differences in metabolic energy cost between devices, despite the significant increase in weight of the powered prosthesis. This may suggest that the powered leg provided sufficient assistance to compensate for its added weight, but did not yield improvements in walking speed, gait symmetry, or functional endurance.</p><p><strong>Conclusions: </strong>Use of this powered knee and ankle prosthesis resulted in comparable physiological effort and postural control to microprocessor knees, but did not improve outcomes like walking speed, symmetry, or endurance. Continued development of comparative testing protocols for prototype componentry could represents a critical step in optimizing PKA design and validation for improved clinical outcomes. Trial registration This study is registered at ClinicalTrials.gov (Identifier: NCT03204513; Date: 06/27/2017).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148271892","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":"Dissociable effects of β-tACS on spectral power and network organization for proximal versus distal upper-limb recovery in subacute stroke: double-blind, randomized, sham-controlled trial with high-density EEG.","authors":"Xiao-Yu Liao, Yuxin Zhang, Yan Gong, Aisong Guo, Shangxiaoyue Li, Ailipinai Yasen, Surong Qian, Wenjun Qian, Renjie Xu, Guangxu Xu, Yu-Er Jiang, Yaxin Gao","doi":"10.1186/s12984-026-02040-4","DOIUrl":"10.1186/s12984-026-02040-4","url":null,"abstract":"<p><strong>Background: </strong>Upper-limb recovery after stroke is not unitary, and proximal and distal functions may differ in their neural constraints. We tested whether 20-Hz β-tACS paired with rehabilitation differentially affects proximal versus distal recovery in subacute stroke and which EEG changes accompany improvement.</p><p><strong>Methods: </strong>In this double-blind, randomized, sham-controlled trial, 61 first-ever stroke patients within 1-6 months after onset were enrolled; 56 (28 per group) completed the final analysis. Active stimulation consisted of 20-Hz tACS over ipsilesional M1 (2 mA peak-to-peak, 20 min/session, 10 sessions over 2 weeks) followed by standardized rehabilitation; sham used ramp-up/ramp-down only. FMA-UE total, proximal, and distal scores were assessed at baseline, post-intervention, and 1-month follow-up (F/U). High-density resting-state EEG quantified δ/β-band spectral power, connectivity, and graph metrics. Prespecified moderation analyses examined MEP status, lesion location, and stroke duration.</p><p><strong>Results: </strong>Compared with healthy controls, stroke patients showed higher δ and θ power and lower β power at baseline. Relative to sham, β-tACS reduced whole-brain δ power (F = 4.60, q = 0.037), increased β power (F = 8.29, q = 0.009), and produced a δ-band network downshift, including lower network density (F = 6.73, q = 0.012), mean edge weight (F = 6.16, q = 0.010), clustering coefficient (F = 6.77, q = 0.012), and global efficiency (F = 6.87, q = 0.010). No FDR-significant β-band connectivity main effects were observed. Clinically, within the present 10-session protocol, β-tACS was associated with greater improvement in total FMA-UE at post (F = 7.24, p = 0.007) and F/U (F = 11.33, p = 0.001), with the clearest benefit in proximal FMA-UE at post (F = 11.17, p = 0.002) and F/U (F = 24.37, p < 0.001); distal improvement did not differ significantly between groups. MEP status moderated total and proximal recovery, with larger effects in MEP-negative participants. In the active group, larger total and proximal gains were associated with larger reductions in δ-band network organization; no other EEG-behavior correlations survived FDR correction.</p><p><strong>Conclusions: </strong>Within the present 10-session protocol, 20-Hz β-tACS over ipsilesional M1 paired with standardized rehabilitation was associated with clearer proximal than distal upper-limb benefits in subacute stroke. Its physiological signature was characterized by β-band target engagement together with reduced δ power and δ-band network organization. Whether longer treatment courses or higher cumulative doses would produce additional distal gains requires further study. Trial registration The study was registered in the Chinese Clinical Trial Registry (ID: ChiCTR2400083526) on April 26, 2024. The registration submitted on March 14, 2024. The first participant enrolled on May 14, 2024.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264909","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":"Feasibility, acceptability, and functional outcomes of a home-based exergaming telerehabilitation program for adults with functional disabilities: a multi-center single-arm pilot study.","authors":"Ravi Shankar, Ruth Choo Li Ong, Emily Yee, Ramesh Duraisamy, Benedict Chung Yin Ho, Rena Sim, Christopher Wee Keong Kuah, Poo Lee Ong","doi":"10.1186/s12984-026-02055-x","DOIUrl":"10.1186/s12984-026-02055-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Community-based rehabilitation services face significant challenges including limited access, poor exercise adherence, and resource constraints. Telerehabilitation using gamified exergaming platforms offers a promising solution to extend rehabilitation services into home settings while maintaining patient engagement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This multi-center single-arm pilot study evaluated the feasibility, acceptability, and preliminary efficacy signals of a caregiver-supported, home-based telerehabilitation program comprising 30 days of active home use within an 18-week protocol, using the EvolvRehab gamified exergaming platform among community-dwelling adults with functional limitations who were receiving outpatient rehabilitation in Singapore.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Ten participants (mean age: 64.6 years, SD 8.5, range 48-78) were recruited from three community rehabilitation sites: Handicaps Welfare Association Day Rehabilitation Centre, Home Nursing Foundation, and Ren Ci Hospital Day Rehabilitation Centre. Participants underwent an 18-week protocol comprising onboarding, a 30-day period of active home-based telerehabilitation with therapist-prescribed daily exercises and remote monitoring, and follow-up. A primary caregiver was present during all home sessions to assist with device setup, supervise exercise, and support fall prevention. Functional outcomes were assessed at baseline (Week 0), post-intervention (Week 8), and follow-up (Week 18) using the Modified Barthel Index (MBI), Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), grip strength, and EQ-5D-5 L. System usability and patient-reported outcomes were evaluated using the System Usability Scale (SUS) and a non-validated custom questionnaire, the latter analysed as exploratory data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Mean exercise compliance was 80.6%, with participants exercising an average of 23.97 min daily. Within-group improvements from baseline to Week 18 follow-up were observed in MBI (75.8 to 81.2, p = 0.019), BBS (33.3 to 38.0, p = 0.037), and right-hand grip strength (15.1 to 18.0 kg, p = 0.005). SPPB improved at the post-intervention assessment (5.2 to 6.2, p = 0.015), but this change was not sustained at the Week 18 follow-up relative to baseline (6.4, p = 0.104). EQ-5D-5 L descriptive sum scores decreased (indicating reduced symptom burden) from 11.6 at baseline to 8.5 at Week 8 (p = 0.002; FDR-adjusted p = 0.048) and 8.7 at Week 18; EQ-VAS scores increased from 66.9 at baseline to 80.9 at Week 18 (p = 0.022). As an uncontrolled single-arm study, these findings represent preliminary efficacy signals rather than evidence of effectiveness, and require confirmation in controlled trials. The mean SUS score was 67.75, indicating marginal acceptability. Patient-reported outcomes showed high engagement with the gamified exercises, though concerns about cost were noted. No falls or adverse events were reported ","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and hematological markers of tDCS combined with aerobic exercise in improving executive function in patients with PSCI.","authors":"Yingying Ji, Yan Han, Huimin Zhou, Qian Lu, Haohao Zhu, Ying Shen, Kai Zheng","doi":"10.1186/s12984-026-02047-x","DOIUrl":"10.1186/s12984-026-02047-x","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the effects of combined transcranial direct current stimulation (tDCS) and aerobic exercise (AE) on executive function and hematological markers in poststroke cognitive impairment (PSCI) patients.</p><p><strong>Methods: </strong>A total of 74 PSCI patients were randomly assigned to three groups: the tDCS + AE, tDCS, and AE groups. The tDCS group received 2.0 mA anodal stimulation over the left dorsolateral prefrontal cortex (DLPFC) for 30 min, five days per week for four weeks. The AE group performed moderate-intensity exercise (60-70% HRmax) for 30 min with sham tDCS. The combined group received both interventions concurrently. Executive function was assessed using C-EXIT25, the Stroop test, the 1-back task, and word recall tests. Emotional state was evaluated with the Hamilton Depression Rating Scale (HAMD) and the Hamilton Anxiety Rating Scale (HAMA). Serum biomarkers were analyzed pre- and postintervention. Statistical analyses included repeated measures ANOVA and Spearman correlation with Bonferroni correction.</p><p><strong>Results: </strong>Executive function significantly improved in the combined group, with lower C-EXIT25 scores, faster Stroop congruent reaction times, and fewer word recall errors compared to the tDCS and AE groups. HAMD scores significantly decreased in the combined group. BDNF, NGF, DA, GABA, 5-HT, and ACh levels increased postintervention, whereas the level of Glu decreased in the combined group. An increase in BDNF correlated with faster Stroop response times, and an increase in NGF correlated with improvements in MMSE scores.</p><p><strong>Conclusion: </strong>tDCS combined with AE significantly enhanced executive function in PSCI patients. These benefits were associated with increased neurotrophic factor levels, supporting a central-peripheral integrative rehabilitation approach for PSCI treatment.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252019","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}