Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"Two decades of breakthroughs: charting the future of NeuroEngineering and Rehabilitation.","authors":"Paolo Bonato, David Reinkensmeyer, Mario Manto","doi":"10.1186/s12984-025-01580-5","DOIUrl":"10.1186/s12984-025-01580-5","url":null,"abstract":"<p><p>The Journal of NeuroEngineering and Rehabilitation (JNER) has become a major actor for the dissemination of knowledge in the scientific community, bridging the gaps between innovative neuroengineering and rehabilitation. Major fields of innovations have emerged these last 25 years, such as machine learning and the ongoing AI revolution, wearable technologies, human machine interfaces, robotics, advanced prosthetics, functional electrical stimulation and various neuromodulation techniques. With the major burden of disorders impacting on the central/peripheral nervous system and the musculoskeletal system both in adults and in children, successful tailored neurorehabilitation has become a major objective for the research and clinical community at a world scale. JNER contributes to this challenging goal, publishing groundbreaking cutting-edge research using the open access model. The multidisciplinary approaches at the crossroads of biomedical engineering, neuroscience, physical medicine and rehabilitation make of the journal a unique growing platform welcoming breakthrough discoveries to reshape the field and restore function.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"59"},"PeriodicalIF":5.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624960","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":"Exploration of working memory retrieval stage for mild cognitive impairment: time-varying causality analysis of electroencephalogram based on dynamic brain networks.","authors":"Yi Jiang, Zhiwei Guo, Xiaobo Zhou, Ning Jiang, Jiayuan He","doi":"10.1186/s12984-025-01594-z","DOIUrl":"10.1186/s12984-025-01594-z","url":null,"abstract":"<p><strong>Background: </strong>Mild Cognitive Impairment (MCI) is an intermediate stage between the expected cognitive decline of normal aging and Alzheimer's disease (AD). Its management is crucial for it helps intervene and slow the progression of cognitive decline to AD. However, the understanding of the MCI mechanism is not completely clear. As working memory (WM) damage is a common symptom of MCI, this study focused on the core stage of WM, i.e., the memory retrieval stage, to investigate information processing and the causality relationships among brain regions based on electroencephalogram (EEG) signals.</p><p><strong>Method: </strong>21 MCI and 20 normal cognitive control (NC) participants were recruited. The delayed matching sample paradigm with two different loads was employed to evaluate their WM functions. A time-varying network based on the Adaptive transfer function (ADTF) was constructed on the EEG of the memory retrieval trials.to perform the dynamic brain network analysis.</p><p><strong>Results: </strong>Our results showed that: (a) Behavioral data analysis: there were significant differences in accuracy and accuracy / reaction time between MCI and NC in tasks with memory load capacity of low load-four and high load-six, especially in tasks with memory load capacity of four. (b) Dynamic brain network analysis: there were significant differences in the dynamic changes of brain network patterns between the two groups during the memory retrieval stage of the WM task. Specifically, in low load WM tasks, the dynamic brain network changes of NC were more regular to accommodate for efficient information processing, with important core nodes showing a transition from bottom to up, while MCI did not display a regular dynamic brain network pattern. Further, the brain functional areas associated with low load WM disorders were mainly located in the left prefrontal lobe (FC1) and right occipital lobe (PO8). Compared with low load WM task, during the high load WM task, the dynamic brain network changes of NC during the memory retrieval stage were regular, and the core nodes exhibited a consistent transition phenomenon from up to bottom to up, which were not observed in MCI.</p><p><strong>Conclusions: </strong>Behavioral data in the low load WM task paradigm and abnormal electrophysiological signals in the left prefrontal (FC1) and right occipital lobes (PO8) could be used for MCI diagnosis. This is the first time based on large-scale dynamic network methods to investigate the dynamic network patterns of MCI memory retrieval stages under different load WM tasks, providing a new perspective on the neural mechanisms of WM deficits in MCI patients and providing some reference for the clinical intervention treatment of MCI-WM memory disorders.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"58"},"PeriodicalIF":5.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624959","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":"Exploring the impact of myoelectric prosthesis controllers on visuomotor behavior.","authors":"Kodi Y Cheng, Heather E Williams, Ahmed W Shehata, Patrick M Pilarski, Craig S Chapman, Jacqueline S Hebert","doi":"10.1186/s12984-025-01604-0","DOIUrl":"10.1186/s12984-025-01604-0","url":null,"abstract":"<p><strong>Background: </strong>Prosthesis users often rely on vision to monitor the activity of their prosthesis, which can be cognitively demanding. This compensatory visual behaviour may be attributed to an absence of feedback from the prosthesis or the unreliability of myoelectric control. Unreliability can arise from the unpredictable control due to variations in electromyography signals that can occur when the arm moves through different limb positions during functional use. More robust position-aware control systems have been explored using deep learning methods, specifically ones that utilize data from different limb positions, that show promising improvements in control characteristics. However, it is unclear how these novel controllers will affect visuomotor behaviour. Specifically, the extent to which control interventions can influence gaze behaviours remain unknown, as previous studies have not yet demonstrated the sensitivity of eye metrics to these interventions. This study aims to explore how visuomotor behaviours change when individuals operate a simulated myoelectric prosthesis using a standard control strategy compared to a position-aware control strategy.</p><p><strong>Methods: </strong>Participants without limb difference tested two control strategies in a within-subject crossover study design. They controlled a simulated myoelectric prosthesis using a standard control strategy and an advanced position-aware control strategy designed to address the limb position effect. The order in which these control strategies were evaluated was randomized. Eye tracking and motion capture data were collected during functional task execution to assess if using the position-aware control strategy changed visuomotor behaviour compared to the standard controller.</p><p><strong>Results: </strong>There was less visual fixation on the prosthetic hand in the fully extended and cross-body arm position when using the position-aware controller compared to the standard controller. These changes were associated with shorter grasp phase duration and increased smoothness of prosthesis movements. These findings indicated that using the position-aware control strategy may have resulted in less reliance on vision to monitor the prosthesis actions in limb positions where they had better prosthesis control.</p><p><strong>Conclusions: </strong>This research suggests that visuomotor metrics may be sensitive to prosthesis control interventions, and therefore the use of eye tracking should be considered for performance assessment of prosthesis control.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"57"},"PeriodicalIF":5.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615759","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":"Grip and manipulation forces are controlled independently in a coupled bimanual task.","authors":"Clara Günter, Niklas Heimburger, David W Franklin, Raz Leib","doi":"10.1186/s12984-025-01600-4","DOIUrl":"10.1186/s12984-025-01600-4","url":null,"abstract":"<p><strong>Background: </strong>Grasping and manipulating objects requires humans to adapt both grip and manipulation forces. When handling an object with both hands, the additional degrees of freedom introduce more levels to the redundancy of the object manipulation since we can distribute the contribution of the grip and manipulation forces between hands.</p><p><strong>Methods: </strong>In this study, we investigated the forces produced by both hands during coupled bimanual manipulation of a needle object in a virtual environment. The task objective was to puncture a virtual tissue, modeled as a linear spring, and stop immediately after, with the hands arranged in front and back positions in the movement direction.</p><p><strong>Results: </strong>We show that during tissue interaction, grip forces are modulated consistently between front and back hands across participants, but manipulation forces are not. That is, the back hand consistently produced excessive grip force compared to the front hand regardless of hand configuration, while manipulation force distribution between the two hands was variable. After the tissue puncture, we again observed consistent grip force behavior during the reactive response to the force drop following the puncture. The grip force signal exhibited a consistent temporal profile in both the front and back hands with amplitude modulation according to the tissue stiffness in the front hand.</p><p><strong>Conclusions: </strong>Overall, our results support the idea of distinct control mechanisms for grip and manipulation forces which rely on hand position rather than hand dominance.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"56"},"PeriodicalIF":5.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605026","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":"Evaluating the health and fitness benefits of a 6-month FES-cycling program on a recumbent trike for individuals with motor complete SCI: a pilot study.","authors":"N Sanna, R Nossa, E Biffi, E Guanziroli, E Diella, S Ferrante, F Molteni, D Peruzzo, N Casali, A Mastropietro, G Rizzo, M Tarabini, A Pedrocchi, E Ambrosini","doi":"10.1186/s12984-025-01585-0","DOIUrl":"10.1186/s12984-025-01585-0","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury (SCI) severely affects physical function, leading to muscle atrophy and reduced bone density. Sport-therapy, incorporating recreational and competitive activities, has shown promise in enhancing recovery for individuals with SCI. Functional Electrical Stimulation (FES)-cycling combines exercise benefits with stimulation advantages, and recent integration with mobile recumbent trikes adds further potential. This study aimed to evaluate the effects of a 6-month FES-cycling sport therapy using a recumbent trike on individuals with motor complete SCI.</p><p><strong>Methods: </strong>Five participants engaged in bi-weekly FES-cycling sessions using an instrumented recumbent trike. A comprehensive assessment was conducted before training, at 3 and 6 months of training, and at 1-month follow-up. Outcome measures included maximal muscle Cross-Sectional Area (maxCSA) from Magnetic Resonance Images, bone mineral density, clinical scales, and questionnaires on spasticity, pain, bowel dysfunction, psychological well-being, and sport motivation. Additionally, maximal power output and cycling endurance were assessed.</p><p><strong>Results: </strong>The FES-cycling program led to a significant increase in muscle mass of 34% after 6 months of training, correlated to an improved cycling performance (maxCSA versus peak power). A slight decrease of muscle mass was observed as expected at follow-up. Participants reported high well-being and strong motivation throughout the training program. Bone health, spasticity, bowel dysfunction, and pain levels did not significantly change overall.</p><p><strong>Conclusions: </strong>FES-cycling on a recumbent trike shows potential as a therapeutic and recreational activity for individuals with SCI. It significantly improved muscle mass and physical performance while positively impacting psychological well-being and motivation. Further research with larger cohorts is necessary to confirm these benefits and optimize protocols, establishing FES-cycling as a valuable sport-therapy model for SCI.</p><p><strong>Trial registration: </strong>The study protocol was retrospectively registered on clinicaltrials.gov (NCT06321172).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"55"},"PeriodicalIF":5.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597231","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":"Human interactions remain at the heart of rehabilitation with advanced technology: a practice-embedded longitudinal qualitative study with allied health clinicians.","authors":"Louise Michelle Nettleton Pearce, Leanne Hassett, Catherine Sherrington, Julie Pryor","doi":"10.1186/s12984-025-01576-1","DOIUrl":"10.1186/s12984-025-01576-1","url":null,"abstract":"<p><strong>Background: </strong>Technology is gaining momentum in rehabilitation. While evidence is emerging, a growing number of rehabilitation facilities are implementing devices, though with variable success. A public-private rehabilitation provider in Australia recently opened a technology therapy centre with robotic and virtual reality devices. This study was embedded in the setting, which saw substantial clinician uptake of devices and presented a unique opportunity to explore clinician experiences, perceptions and factors influencing uptake, implementation and sustainment of advanced technology in practice.</p><p><strong>Methods: </strong>A longitudinal qualitative study was conducted, involving interviews with clinicians at three timepoints across the first 16 months of the centre opening. Allied health clinicians in the organisation (n = 119) were invited to participate in interviews, which were audio-recorded, transcribed, coded and analysed using an inductive thematic approach.</p><p><strong>Results: </strong>In total, 63 interviews were conducted with 25 allied health clinicians across inpatient, outpatient and community rehabilitation services. An overarching finding that human interactions remain at the heart of rehabilitation with advanced technology, comprised three major themes with 12 subthemes. (1) Technology integration involves cognitive and emotional labour for clinicians, stemming from determining the value-add of advanced technology, juggling learning demands and negotiating patients' high expectations of technology. (2) Contextual factors shape clinician uptake and ongoing use of technology, including organisational culture, professional discipline, rehabilitation setting, patient characteristics and device features. (3) Shared understanding and priorities promote technology implementation and sustainment, including understanding advanced technology in relation to conventional therapy, creating a well-designed training model, equipping clinicians to manage patient expectations and maintaining a commitment to evidence-based practice.</p><p><strong>Conclusions: </strong>While further high-quality evidence regarding the effectiveness of technology in rehabilitation is required, clinicians in this study perceived advanced technology as an adjunct to conventional therapy, with benefits for enhancing therapy dosage, patient engagement, manual handling and providing objective feedback. Important practice-derived considerations for integrating advanced technologies in rehabilitation include: developing clinician technical, clinical reasoning and interpersonal skills, reducing contextual barriers and fostering a positive organisational culture with strong leadership and targeted initiatives to support clinicians. Successful implementation of advanced rehabilitation technologies relies on clinician buy-in to champion change within an enabling person-centered context.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"52"},"PeriodicalIF":5.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573165","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":"Non-invasive cerebral and spinal cord stimulation for motor and gait recovery in incomplete spinal cord injury: systematic review and meta-analysis.","authors":"Agustin Hernandez-Navarro, Aina Ros-Alsina, Muhammed Yurtseven, Mark Wright, Hatice Kumru","doi":"10.1186/s12984-025-01557-4","DOIUrl":"10.1186/s12984-025-01557-4","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury (SCI) leads to gait impairment and loss of motor function and can be traumatic or non-traumatic in nature. Recently there has been important progress in the field of non-invasive central nervous stimulation, which can target the brain or spinal cord. In this review we aim to compare the effect of non-invasive cerebral and spinal cord stimulation on gait recovery and motor strength of lower limbs in subjects with SCI.</p><p><strong>Methods: </strong>We conducted a search (from September 2022 until March 2024) using the PubMed, Cochrane, and PEDro databases, including all studies published since the year 2000. The protocol of the review followed PRISMA guidelines and only RCTs scoring above 5 on the PEDro scale were selected.</p><p><strong>Results: </strong>A total of 12 RCTs with 341 participants were included. When all studies were pooled together, non-invasive central nervous system stimulation had significant effects on Lower Extremity Motor Scale (LEMS) score and gait speed. However, data was less apparent when subgrouped by type and level of stimulation. Repetitive transcranial magnetic stimulation (rTMS) showed large effect on LEMS, however transcranial direct current stimulation (tDCS) displayed a small effect on motor strength and gait speed. No meta-analysis could be performed for non-invasive spinal cord stimulation due to a lack of studies.</p><p><strong>Conclusions: </strong>When all non-invasive stimulation techniques were pooled together, significant effects on motor strength and gait function were observed. However, subgroup analyses based on stimulation types and levels revealed a significant reduction in these effects, particularly when categorized by stimulation type (rTMS and tDCS). Furthermore, a meta-analysis could not be conducted for non-invasive spinal cord stimulation due to a lack of studies (only one study each on tsDCS and tSCS). Therefore, more randomized controlled trials are needed to evaluate neuromodulation interventions in spinal cord injury, particularly at the spinal cord level. Registration This systematic review with meta-analysis was registered in PROSPERO under the ID 512864.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"53"},"PeriodicalIF":5.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573200","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":"Rehabilitation training robot using mirror therapy for the upper and lower limb after stroke: a prospective cohort study.","authors":"Xixi Wu, Xu Qiao, Yudi Xie, Qingyan Yang, Wenting An, Lingfeng Xia, Jiatao Li, Xiao Lu","doi":"10.1186/s12984-025-01590-3","DOIUrl":"10.1186/s12984-025-01590-3","url":null,"abstract":"<p><strong>Background: </strong>This prospective cohort study was designed to investigate and compare the effectiveness of rehabilitation training robots versus conventional rehabilitation training on stroke survivors by monitoring alterations in brain network of stroke patients before and after robot intervention.</p><p><strong>Methods: </strong>Between September 2020 and November 2021, stroke patients at four grade-A tertiary hospitals underwent limb rehabilitation training. Of the total of participants, 117 patients received conventional limb rehabilitation, 93 patients participated in upper-limb robot training, and 103 patients underwent lower-limb robot training. The measured outcomes included modified Barthel Index (MBI), Fugl-Meyer assessment subscale (FMA), and manual muscle testing (MMT). Functional magnetic resonance imaging (fMRI) was conducted on 30 patients to assess changes in the brain network. Data were mainly analyzed based on the Intention-to-Treat (ITT) principle.</p><p><strong>Results: </strong>Post-interventional analysis utilizing linear mixed models in ITT analysis revealed that the robot training group had greater enhancements compared to the conventional limb rehabilitation training group. Notably, the shoulder flexor strength (P = 0.043) was significantly higher in the upper-limb group. On the other hand, hip flexor strength (P < 0.001), hip extensor strength (P < 0.001), knee extensor strength (P = 0.013), ankle dorsiflexion strength (P < 0.001) and ankle plantarflexor strength (P < 0.001) were significantly higher in the lower-limb group. In the upper-limb group, region-of-interest (ROI) -to-ROI analysis revealed enhanced functional connectivity between the left hemisphere's motor control region and the auditory network. ROI-to-ROI analysis primarily showed enhanced interhemispheric functional connectivity in the lower-limb group, specifically between right the hemisphere's motor control region (central opercular cortex) and left hemisphere's primary motor area in the precentral gyrus.</p><p><strong>Conclusions: </strong>According to our research findings, upper- and lower-limb rehabilitation robots demonstrated great potential in promoting motor function recovery in stroke patients. Robot-assisted training offers an alternative treatment method with comparable efficacy to traditional rehabilitation. Large-scale randomized controlled trials are needed to confirm these results.</p><p><strong>Trial registration: </strong>The study was registered on the Chinese Clinical Trial Registry (ChiCTR1800019783).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"54"},"PeriodicalIF":5.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585942","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":"Submovements in manual tracking: people with Parkinson's disease produce more submovements than age-matched controls.","authors":"Lior Noy, Sharon Hassin-Baer, Tsvia Fay-Karmon, Noora Kattouf, Simon Israeli-Korn, Robrecht van der Wel, Jason Friedman","doi":"10.1186/s12984-025-01592-1","DOIUrl":"10.1186/s12984-025-01592-1","url":null,"abstract":"<p><strong>Background: </strong>In general, people are unable to produce slow, smooth movements - as movements become slower (i.e., with longer durations), they become jerkier. A hallmark feature of Parkinson's disease is bradykinesia - slowness of movement. In this study, we investigate the intersection of these two observations - how do people with Parkinson's disease (PwP) perform in a slow tracking task, and how does it vary as a function of movement frequency? On the one hand, as PwP move more slowly in day-to-day life, they may be better in a slow tracking task. On the other hand, their general impairment in movement production may lead to worse tracking outcomes.</p><p><strong>Methods: </strong>We used a well-tested tracking task known as the one-person mirror game, where participants control the left-right movement of an ellipse on a graphics tablet. They did so using a stylus and were instructed to match the horizontal location of a stimulus, an ellipse moving in a sinusoidal fashion at different movement frequencies and peak velocities. We calculated the submovement rate, identifying both type 2 (acceleration zero crossings) and type 3 (jerk zero crossings) from the trajectories, as well as relative position error (dX) and mean timing error (dT). To account for age-related performance decline, we tested three groups: PwP (N = 31), age-matched controls (OC; N = 29), and younger controls (YC; N = 30) in a cross-sectional study, and used mixed-design ANOVAs to compare across groups and movement frequencies.</p><p><strong>Results: </strong>We reproduced earlier results showing that slow movements (i.e., with lower frequencies) require more submovements to track. PwP also generally performed more submovements than the other two groups, but only for type 3 submovements, whereas OC and YC performed submovements at a similar rate. Younger controls (YC) performed fewer tracking errors than older participants (both PwP and OC), and OC performed better than PwP.</p><p><strong>Conclusions: </strong>The ability to smoothly track showed an age-related decline, with PwP producing more errors and using more submovements. This may be due to reduced automaticity in movement production. The findings of the study can be used to guide optimal movement frequencies for motor training for older adults and PwP.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"51"},"PeriodicalIF":5.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573203","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":"Combined effects and timing of robotic training and botulinum toxin on upper limb spasticity and motor function: a single‑blinded randomized controlled pilot study.","authors":"Joon-Ho Shin, Gyulee Park, Hayeon Kim, Duk Youn Cho, Suncheol Kwon","doi":"10.1186/s12984-025-01584-1","DOIUrl":"10.1186/s12984-025-01584-1","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the combined effects of robotic training (RT) and botulinum toxin (BTX) injections on motor function and spasticity in individuals with post-stroke upper limb spasticity (ULS). We also sought to investigate the optimal timing of RT and BTX administration.</p><p><strong>Methods: </strong>Forty-two participants with chronic stroke-induced ULS were initially enrolled and randomized into four groups: Group B4R4 (RT + BTX at 4 weeks [W4]), Group B0R0 (RT + BTX at baseline [W0]), Group B0R4 (BTX at W0, RT at W4), and Group B4R0 (RT at W0, BTX at W4). Clinical assessments and robotic kinematic evaluations were performed at W0, W4, and 8 weeks (W8). The primary outcome was the Fugl-Meyer assessment (FMA) score, and secondary outcomes included the modified Ashworth scale (MAS) of the elbow and kinematic parameters, such as spectral arc length, mean speed, hand path ratio, and movement deviation in various tasks. Changes in outcome measures over time were analyzed using a linear mixed-effects regression model or ordinal logistic regression.</p><p><strong>Results: </strong>Of the 42 participants, 40 completed the study. From W0 to W4, Group B0R0 exhibited the most favorable outcomes in terms of spasticity (MAS-elbow flexor and extensor) and kinematic variables, suggesting that the combined application of BTX and RT is superior to sole interventions in improving motor function and spasticity. From W0 to W8, Group B0R4 demonstrated the most substantial improvements in FMA scores and kinematic parameters, indicating that the combined use of BTX and RT, particularly when RT is initiated 1 month after BTX injection, results in superior functional outcomes compared to other intervention timings.</p><p><strong>Conclusions: </strong>The combination of RT and BTX is more effective in enhancing motor function and reducing spasticity in individuals with ULS than either intervention alone or no intervention. Furthermore, the timing of RT relative to BTX injection plays a critical role in maximizing therapeutic benefits in individuals with stroke and ULS, given the distinct modes of action of each intervention.</p><p><strong>Trial registration: </strong>clinicaltrials.gov NCT02228863. The study was retrospectively registered on August 23, 2014.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"50"},"PeriodicalIF":5.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573162","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}