Journal of NeuroEngineering and Rehabilitation最新文献

{"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":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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}

{"title":"Spinal cord neuromodulation for autonomic recovery following spinal cord injury: a scoping review.","authors":"Vivek K Pandey, Marco Law, Chris Shamatutu, Karina C Martin, Manvir Taunk, Parag Gad, Tom E Nightingale, Zakari R Dymock, Andrei V Krassioukov, Rahul Sachdeva","doi":"10.1186/s12984-026-02032-4","DOIUrl":"10.1186/s12984-026-02032-4","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury (SCI) disrupts autonomic control, leading to cardiovascular, bowel, lower urinary tract (LUT), and sexual dysfunctions. Spinal cord stimulation (SCS) has shown therapeutic promise, but a comprehensive review of its effects on autonomic recovery after SCI has not been performed.</p><p><strong>Purpose: </strong>To synthesize evidence on the effects of SCS on autonomic functions, specifically cardiovascular, bowel, LUT, and sexual function, in animal models and individuals with SCI.</p><p><strong>Data sources: </strong>PubMed, EMBASE, and Web of Science; from date of inception to September 2025.</p><p><strong>Study selection: </strong>Studies were included if they investigated the effects of SCS on cardiovascular, bowel, LUT, or sexual function in humans or animals with SCI. Of 2079 studies screened, 68 met inclusion criteria: 15 animals, 50 humans, and 3 involving both species.</p><p><strong>Data extraction: </strong>Data were independently extracted, and final inclusion decisions were reached by consensus among authors.</p><p><strong>Data synthesis: </strong>Both animal and human studies show that SCS enhances autonomic function after SCI. It improves bladder control, cardiovascular stability, and bowel motility in animals; and additionally alleviates neurogenic bowel symptoms, increases bladder capacity and compliance in humans. Improvements in sexual function were observed in both animal and human studies.</p><p><strong>Limitations: </strong>Evidence primarily comprises case reports, case series, and cohort studies, with few controlled trials. Mechanistic studies remain limited, and methodological heterogeneity restricts comparisons.</p><p><strong>Conclusions: </strong>SCS shows promise in improving autonomic dysfunction after SCI and enhancing quality of life. These findings inform priority areas for RCTs and mechanistic studies to optimize protocols and patient selection.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239385","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":"Functional reorganization of the contralesional precentral gyrus following acute subcortical ischemic stroke and its association with gene expression profile.","authors":"Xueqin Jiang, Qiuhong Lu, Yang Liu, Huachun Huang, Yuansheng Bi, Zhijian Liang","doi":"10.1186/s12984-026-02048-w","DOIUrl":"10.1186/s12984-026-02048-w","url":null,"abstract":"<p><strong>Background: </strong>Motor recovery after ischemic stroke involves complex functional reorganization, yet the underlying molecular and cellular mechanisms remain poorly understood. This study integrated longitudinal neuroimaging and brain-wide transcriptomic data to characterize the functional dynamics and their gene-expression correlates during motor recovery following subcortical ischemic stroke.</p><p><strong>Methods: </strong>We recruited 34 patients with acute right subcortical ischemic stroke and 32 age- and sex-matched healthy controls. All participants underwent baseline resting-state functional magnetic resonance imaging, with 22 patients completing a 3-month follow-up scan. Spontaneous neural activity was assessed using the amplitude of low-frequency fluctuations (ALFF), followed by seed-based whole-brain functional connectivity (FC) analysis from regions with longitudinal ALFF differences. We then applied partial least squares (PLS) regression to spatially correlate longitudinal ALFF changes with transcriptomic data from the Allen Human Brain Atlas, identifying a gene expression profile spatially associated with these ALFF changes. These genes were subsequently subjected to functional enrichment and cell-type specificity analyses.</p><p><strong>Results: </strong>Compared with healthy controls, acute-stage stroke patients showed significantly decreased ALFF in the contralesional precentral gyrus. At 3-month follow-up, ALFF in this region significantly increased, accompanied by strengthened interhemispheric FC with its ipsilesional homologue. Critically, these longitudinal changes in ALFF and interhemispheric FC were significantly correlated with motor recovery. Based on PLS regression, we further identified a specific gene expression profile spatially correlated with the observed ALFF changes. This gene set was specifically enriched in excitatory and inhibitory neurons and was primarily involved in synaptic structure and signaling.</p><p><strong>Conclusions: </strong>By linking macroscale imaging dynamics with microscale molecular features, this study demonstrates that the contralesional precentral gyrus plays a supportive role in motor recovery during the subacute phase of subcortical ischemic stroke, with neuronal synaptic plasticity as a potential mechanism. Collectively, these findings inform stage-specific strategies to target interhemispheric inhibition.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239452","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":"How few channels suffice? A hierarchical validation framework for minimal-channel wearable sEMG in upper-limb rehabilitation gesture recognition.","authors":"Xiangyang Li, Huayue Liu, Aoying Shangguan, Huanghe Zhang","doi":"10.1186/s12984-026-02039-x","DOIUrl":"10.1186/s12984-026-02039-x","url":null,"abstract":"<p><strong>Background: </strong>Surface electromyography (sEMG) is widely adopted in upper-limb rehabilitation for decoding motor intent. However, current wearable systems typically require eight or more channels, imposing penalties on device complexity, power consumption, and patient comfort. Reducing channel count without sacrificing recognition accuracy remains an open challenge for user-independent rehabilitation scenarios. We hypothesize that systematically optimizing channel configurations under high-fidelity acquisition conditions can identify a minimal viable topology suitable for clinical deployment.</p><p><strong>Methods: </strong>We present a hierarchical validation framework integrating three pillars of evidence. First, we developed a custom acquisition system achieving a common-mode rejection ratio exceeding 112 dB, ensuring that observed inter-channel differences reflect physiology rather than hardware artifacts. Second, we performed an exhaustive subset search across all 63 non-empty combinations of six channels in 24 healthy subjects under leave-one-subject-out (LOSO) cross-validation. Third, a dual-track sensitivity analysis was conducted by training on physiologically augmented data while testing under hardware-degraded conditions.</p><p><strong>Results: </strong>Results reveal a tiered structure: the 3-channel configuration serves as the efficiency knee point (91.65%), exceeding the 90% clinical reliability threshold, although its cross-subject generalizability is limited by a maximum regret of 10.5% and only 8/24 subjects achieving zero regret under the global 3-channel topology. The 4-channel configuration acts as the recommended optimal (94.44%), eliminating worst-case blind spots ([Formula: see text]). An overlap ratio analysis confirms high alignment between global and individual optima, with 67% of subjects achieving zero regret under the global 4-channel topology. The dual-track sensitivity analysis demonstrates a 16% robustness gain under low-SNR conditions, validating that high-fidelity acquisition is the functional prerequisite for channel reduction.</p><p><strong>Conclusions: </strong>Within the six-site candidate pool studied here, the globally fixed 4-channel topology achieved performance close to the 6-channel baseline under rigorous LOSO validation. While the 3-channel configuration meets the 90% clinical threshold on average, its substantial inter-subject regret (up to 10.5%) limits its suitability as a universal solution. The optimal 4-channel topology converges on four forearm muscles spanning the wrist's two kinematic degrees of freedom, providing an anatomically grounded, patient-independent design principle. These findings offer a practical pathway toward lightweight, comfortable, and clinically viable rehabilitation interfaces that could improve patient compliance and therapeutic outcomes.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239209","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":"Biomechanical effects of passive exosuit assistance on tibiofemoral loading and dynamic stability during downhill walking.","authors":"Alireza Nasirzadeh, WooIhl Kim, Jaeha Yang, Harry G Driscoll, Giuk Lee","doi":"10.1186/s12984-026-02044-0","DOIUrl":"10.1186/s12984-026-02044-0","url":null,"abstract":"<p><strong>Background: </strong>Downhill walking demands significant eccentric muscle activity at the knee, which increases tibiofemoral joint contact force (TFCF) and challenges gait stability. However, it remains unclear whether passive exosuits can reduce TFCF during downhill walking without compromising dynamic stability. This study investigated the biomechanical effectiveness of a passive trunk-to-thigh soft exosuit in decreasing TFCF and examining its effects on dynamic stability during downhill walking.</p><p><strong>Methods: </strong>Fourteen healthy male participants walked on an instrumented treadmill set at a - 15° decline at 1.0 m·s⁻¹ under both unassisted and assisted conditions. Knee joint kinetics, TFCF, and dynamic stability parameters were estimated using a subject-specific full-body musculoskeletal model. Statistical Parametric Mapping (SPM) and paired t-tests were used to analyze continuous waveforms and discrete metrics, respectively.</p><p><strong>Results: </strong>The exosuit decreased biological stance phase TFCF impulse by ~7% (axial) and ~6% (resultant). Notably, participants adopted shorter, higher-cadence, and wider steps with the exosuit, suggesting that the reduced loading was driven concurrently by both the device's direct support and user-driven gait adaptations. SPM identified a significant decrease in knee joint power generation during mid-stance (23-29% gait cycle (GC)). Additionally, the ML margin of stability (MoS) significantly increased by 7.4%, while the anteroposterior (AP) MoS remained unchanged.</p><p><strong>Conclusions: </strong>These results indicate that the current passive assistance can reduce cumulative tibiofemoral loading during downhill walking. Concurrently, the increased lateral margin of stability reflects a more cautious, wide-based gait strategy. These outcomes demonstrate that the device reduced joint loading through an intertwined combination of direct mechanical resistance and the induction of a joint-protective, shorter-step gait strategy. Consequently, passive wearable devices represent a promising approach for joint load management during downhill walking.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148226010","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":"Mixed reality assisted target localization for transcranial magnetic stimulation navigation: a feasibility study.","authors":"Zhongjie Shi, Zhengbo Yuan, Lu Gao, Yahui Hu, Guoxin Ni, Wenhui Liao, Yuting Xie, Jiawei He, Deyong Xiao, Xueqin Chen, Zhanxiang Wang","doi":"10.1186/s12984-026-02045-z","DOIUrl":"10.1186/s12984-026-02045-z","url":null,"abstract":"<p><strong>Background: </strong>Transcranial magnetic stimulation (TMS), as a non-invasive neurostimulation technique, modulates neural activity by applying electromagnetic fields to specific areas of the brain. It is clinically used for several approved indications, including major depressive disorder, obsessive‑compulsive disorder, and migraine with aura, and is under active investigation for other neurological and psychiatric conditions. Accurate stimulation targeting is crucial for the effectiveness of TMS. Existing targeting methods, such as generic brain localization caps and the international 10-20 electroencephalogram (EEG) system, generally provide only rough localization, leading to significant targeting errors. In recent years, significant progress has been made in the application of mixed reality (MR) technology in medicine, particularly in surgical navigation, offering new ideas and possibilities for developing a simple, low-cost, and efficient TMS navigation system.</p><p><strong>Objective: </strong>This study proposes, for the first time, a portable MR navigation system for non-invasive neural modulation target localization. The aim is to evaluate its localization accuracy and operational efficiency in TMS through preclinical validation. This system seeks to provide a simple and high-precision localization solution for other non-invasive technologies, with the goal of improving localization accuracy and simplifying the operational workflow in clinical applications.</p><p><strong>Methods: </strong>The system is based on Microsoft HoloLens 2 and features three specifically designed interaction tools. Five different types of simulation head models were selected, and ten target points were set on each head model. CT scanning was used to obtain imaging data for each head model. Three researchers used the system to perform target localization and repeated the verification process by adjusting the head model posture (from standing to lying) to assess localization accuracy and efficiency.</p><p><strong>Results: </strong>The validation conducted by the three researchers showed the following results: In the standing position of the simulated head model, the measurement errors were 2.4 (IQR: 1.4-2.7) mm, 2.3 (IQR: 1.7-2.7) mm, and 2.6 (IQR: 1.9-3.0) mm, respectively. In the lying position of the simulated head model, the measurement errors were 1.9 (IQR: 1.6-2.4) mm, 2.0 (IQR: 1.4-3.0) mm, and 2.5 (IQR: 1.9-2.9) mm, respectively. There was a significant difference between researchers (p < 0.05), but no significant difference within the same researcher (p > 0.05).</p><p><strong>Conclusion: </strong>The TMS-Guide, based on mixed reality technology, is a portable and simple navigation solution that provides higher localization accuracy than traditional manual targeting. It shows promising potential for broader applications in non-invasive neural modulation and brain-computer interface fields.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148218082","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 of the Meta Quest 3 for upper limb kinematic analysis: accuracy, consistency, agreement and reliability.","authors":"Gloria Campos, Gabriela Calvo, Adrián Borrego, Luis Millán, Álvaro Page, Roberto Llorens","doi":"10.1186/s12984-026-02038-y","DOIUrl":"10.1186/s12984-026-02038-y","url":null,"abstract":"<p><strong>Background: </strong>Upper limb motor impairment is a frequent long-term consequence of a wide range of neurological and musculoskeletal conditions. Accurate assessment of motor function is essential to determine patient's condition and plan adequate interventions. While clinical scales are easy to administer and not time-consuming, they could have limited accuracy and be biased. Kinematic analysis can provide detailed, quantitative information but usually depends on expensive, complex, and non-portable systems. Recent virtual reality head-mounted displays, with integrated hand-tracking, offer a promising, low-cost, and portable alternative to conduct upper limb kinematic assessment. However, the accuracy, consistency, agreement and reliability of kinematic variables derived from the hand tracking feature of these devices, as well as the impact of signal preprocessing on feature extraction, remain largely unexplored.</p><p><strong>Methods: </strong>Thirty-nine healthy subjects performed five upper-limb tasks including tracking, point-reaching, and reach-and-grasp, while their movements were simultaneously recorded using a laboratory-grade motion capture system and the Meta Quest 3 headset. Multiple kinematic variables were extracted from the hand trajectories of both systems and analysed to evaluate accuracy, consistency, agreement and reliability. Additionally, the impact of signal smoothing on the extracted kinematic values was examined.</p><p><strong>Results: </strong>Minimal absolute and relative errors were estimated between systems, showing high concordance and consistency across most kinematic variables and tasks. Importantly, the differences observed remained below the minimal detectable change of the motion capture system. Test-retest reliability of kinematic measures estimated by the Meta Quest 3 was moderate to good for nearly all variables with the only exception of the number of movement units, which consistently showed poor reliability across all tasks, indicating limited robustness of this metric. The signal smoothing was found to influence the magnitude of the estimated errors, highlighting the importance of optimizing the preprocessing to maximize the accuracy of the Meta Quest 3.</p><p><strong>Conclusions: </strong>Our findings support the feasibility of using the Meta Quest 3 as a cost-effective and portable alternative to laboratory-grade motion capture systems for kinematic evaluation of upper-limb motor function. However, caution is warranted regarding the selection of variables and tasks, particularly for metrics with limited robustness.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148218090","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":"Multidimensional evaluation of a two-level-of-compliance quasi-passive prosthetic wrist: functional, biomechanical, cognitive and user-experience outcomes in trans-radial limb loss.","authors":"Eleonora Braccili, Denise Anastasi, Eva Zimei, Marco Notarantonio, Marta Gherardini, Aldo Lazich, Ugo Della Croce, Lorenzo Rum","doi":"10.1186/s12984-026-02007-5","DOIUrl":"10.1186/s12984-026-02007-5","url":null,"abstract":"<p><strong>Background: </strong>Advances in upper limb prosthetics have expanded functional capabilities for individuals with trans-radial limb loss, yet compensatory movements remain common due to mobility limitations of current prosthetic devices. This study evaluated the functional performance of a quasi-passive prosthetic wrist with two degrees of freedom and adjustable compliance operating according to the Synchronous Hand-Wrist Operation principle (compliant during reaching and automatically stiffening at grasp onset), focusing on clinical function, compensatory strategies, cognitive workload and user experience.</p><p><strong>Methods: </strong>Six male prosthetic users (53 ± 13 years) completed two experimental sessions on consecutive days. Session one included familiarization and clinical evaluation using the Southampton Hand Assessment Procedure (SHAP). In session two, compensatory strategies were assessed during six standardized manual tasks using motion capture (Vicon, UK) and compared against age- and sex-matched healthy controls. Prosthetic users performed all procedures with the device in compliant-while-reaching (ON) and full-stiff modes (OFF) in randomized order. Clinical, spatio-temporal and kinematic outcomes were analyzed using linear mixed-effect models. Subjective evaluation included the NASA-Task Load Index (NASA-TLX), System Usability Scale (SUS) and a custom questionnaire, assessing the overall experience with the device in its intended compliant operating mode.</p><p><strong>Results: </strong>In the SHAP, the ON condition yielded significantly lower mean hand functionality scores than OFF (55.0 vs. 58.3, ~ 5% decrease; p = 0.034) and longer completion times in 4/26 items (+ 1.4 s on average, + 18-44%; p < 0.05). Biomechanical analysis showed increased reaching phase duration in ON across all tasks, with minimal increases in total hand trajectory. Task-specific kinematic adaptations were evident: when wrist deviation during grasping occurred in ON, reduced compensations were observed at more proximal joints, bringing joint ranges of motion closer to healthy controls. Additional motor strategies were required, particularly in tasks involving surface interaction or complex hand-object alignment. Subjective evaluations indicated moderate cognitive workload (NASA-TLX: 48/100), above-average usability (SUS: 74/100) and overall positive acceptance.</p><p><strong>Conclusions: </strong>A multi-DoF quasi-passive prosthetic wrist can reduce proximal compensations, although introducing longer execution times and novel motor demands. Functional benefits are strongly task-dependent. These findings stress the importance of balancing added mechanical complexity with usability to optimize clinical outcomes and user satisfaction.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163349","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":"Altered temporal variability-based functional reorganization of brain networks predicts motor outcome after stroke.","authors":"Guojun Xu, Ling Li, Qinyang Li, Hewei Wang, Mingxia Fan, Limin Sun, Zhiyong Zhao, Hongxing Wang","doi":"10.1186/s12984-026-02037-z","DOIUrl":"10.1186/s12984-026-02037-z","url":null,"abstract":"<p><strong>Background: </strong>Dynamic functional connectivity (FC) studies have shown that motor recovery after stroke was associated with functional reorganization of brain networks. However, most previous studies have focused on interregional variability rather than the temporal variability (TV) of specific regions or networks. TV quantifies the dynamic reconfiguration of a region's or network's functional connectivity profile over time and reflects neural flexibility.</p><p><strong>Purpose: </strong>This study investigated functional reorganization in chronic subcortical stroke using TV of brain networks derived from resting-state fMRI.</p><p><strong>Methods: </strong>Thirty-three patients with left subcortical stroke (LSS), thirty with right subcortical stroke (RSS), and fifty-six age- and sex-matched healthy controls (HCs) were enrolled. Stroke patients underwent resting-state fMRI and Upper Extremity Fugl-Meyer Assessment (UE-FMA) at two time points. TV was computed to characterize dynamic functional connectivity at regional, intra-network, and inter-network levels. Group differences were assessed using one-way ANCOVA with post hoc tests. Linear regression was used to examine associations between TV and motor outcomes. The false discovery rate was used to multiple comparisons correction.</p><p><strong>Results: </strong>Compared with HCs, both LSS and RSS showed significantly reduced TV in the right frontal-cingulate regions, the somatomotor hand network (SSH), and the connections between SSH and higher-order cognitive networks (all p < 0.05, |Cohen's d| > 0.49). Increased TV was observed in the left postcentral gyrus, inferior frontal gyrus, cerebellar network (CEN), and somatomotor mouth network (all p < 0.05, |Cohen's d| > 0.48). Relative to LSS, RSS exhibited additional TV reductions in the right middle occipital gyrus, orbital middle frontal gyrus, default mode network (DMN), and interactions among higher-order cognitive networks (all p < 0.05, |Cohen's d| > 0.65). Notably, TV in the right opercular inferior frontal gyrus (IFGoperc) (β = 102.69, adjusted p = 6.4 × 10^- 5) and CEN (β = 27.87, adjusted p = 0.011) at the first observation positively correlated with UE-FMA scores at follow-up, with effects modulated by lesion laterality.</p><p><strong>Conclusion: </strong>TV captures multiscale functional reorganization in chronic subcortical stroke involving motor, cognitive, and sensory networks. TV of the right IFGoperc showed potential as a neuroimaging biomarker for predicting post-stroke motor recovery.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13465671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176011","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}