NeuroRehabilitation最新文献

{"title":"Effects of a Virtual Reality-Based Balance Training Program on Clinical Outcomes and Cortical Oscillatory Activity: A Combined Behavioral and EEG Study.","authors":"Aastha Arora, Moattar Raza Rizvi, Ankita Sharma, Khalid A Alshamrani, Rayyan A Bukhari, Rana M Alarawi, Shadab Uddin, Mohamed K Seyam, Irshad Ahmad, Fuzail Ahmad, Omar Irshad Ahmad","doi":"10.1177/10538135261473295","DOIUrl":"10.1177/10538135261473295","url":null,"abstract":"<p><p><b>Background:</b> Stroke-related balance and mobility deficits often persist despite conventional rehabilitation. Virtual reality (VR)-based training may improve functional recovery. This study examined whether short-term VR training enhances clinical mobility outcomes and whether accompanying electroencephalography (EEG) changes reflect global cortical adaptations. <b>Methods:</b> In a prospective single-group repeated-measures study, 28 subacute stroke survivors completed 12 VR sessions over 4 weeks. Outcomes included the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, affected and unaffected limb scores on the Lower-Extremity Motor Coordination Test (LEMOCOT), and resting EEG recorded with the Emotiv EPOC + headset. Assessments were performed at baseline, week 2, and week 4. Global EEG band power was averaged across Fz, Cz, C3, and C4 electrodes. Repeated-measures analyses with adjusted pairwise comparisons and standardized effect sizes evaluated longitudinal changes. Partial correlations controlling for baseline EEG and clinical scores assessed associations between EEG and functional improvement. <b>Results:</b> Clinical outcomes improved significantly over 4 weeks. Mean BBS scores increased from 38.3 to 49.7, TUG time decreased from 68.4 to 47.7 seconds, and affected-side LEMOCOT scores increased from 5.0 to 8.7, with large overall effects. Global EEG power increased progressively in beta, alpha, and theta bands. Balance gains correlated with alpha increases (<i>r</i> = 0.38 overall; <i>r</i> = 0.63 during weeks 2-4), while mobility improvements and early affected-limb coordination were associated with beta modulation. <b>Conclusions:</b> Four weeks of VR training produced meaningful functional gains alongside widespread increases in cortical oscillatory activity, supporting a mechanistic relationship between VR-induced neuroplasticity and recovery in subacute stroke survivors undergoing rehabilitation.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"518-531"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living with Parkinson's Disease: Stage-Wise Variations in Quality of Life, Self-Efficacy, and Acceptance of Illness.","authors":"Mishal M Aldaihan, Majed S Albalawi, Hamad T Aldubayan, Asma A Alderaa, Muneera Almurdi, Sami S AlAbdulwahab","doi":"10.1177/10538135261470442","DOIUrl":"10.1177/10538135261470442","url":null,"abstract":"<p><p>ObjectiveThis cross-sectional study assesses the level of HRQoL, self-efficacy, and disease acceptance among patients at different stages of Parkinson's Disease (PD).Methods83 PD patients were stratified by Hoehn-Yahr stages I-V into 5 groups. HRQoL (SF-12), self-efficacy (CD-SES), and acceptance of the disease (AIS) were assessed. Kruskal-Wallis test was used to compare the mean scores for the outcomes of SF-12, SES, and AIS between patients at each of the five stages of PD; chi-square tests analyzed demographics. Statistical significance was defined as p < .05 (95% confidence level).ResultsSelf-efficacy scores significantly declined from 35.95 ± 15.37 in Stage I, to 17.55 ± 9.47 in Stage V (p < 0.05). Acceptance of illness also declined, from a mean score of 28.73 ± 8.62 in Stage I to 18.91 ± 5.77 in Stage V (p < 0.05). Several individual HRQoL domains demonstrated stage-related deterioration in physical functioning, pain interference, emotional well-being, and social participation. However, no statistically significant difference was observed in the overall SF-12 summary score across stages (p > 0.05).ConclusionsThe findings underscore the progressive impact of PD on self-efficacy and illness acceptance, while several HRQoL domains demonstrated stage-related deterioration despite relatively stable global SF-12 summary scores. The results highlighted a need for stage-specific interventions, focusing on strengthening self-efficacy, promoting acceptance of illness, and addressing physical, emotional, and social challenges to enhance HRQoL, particularly in the advanced stages of the disease.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"497-504"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Conventional Therapy in Parkinson's Disease Patients: The Impact of Visual Feedback Training on Balance and Trunk Control - A Prospective Cohort Study.","authors":"Alessandro de Sire, Andrea Demeco, Andrea Parente, Andrea Racinelli, Angela Russo, Chiara Conte, Gianpaolo Ronconi, Marco Invernizzi, Nicola Marotta, Antonio Ammendolia","doi":"10.1177/10538135261473286","DOIUrl":"10.1177/10538135261473286","url":null,"abstract":"<p><p>BackgroundPostural instability and impaired balance are major contributors to disability and fall risk in individuals with Parkinson's disease (PD). Technology-assisted rehabilitation based on visual biofeedback may enhance the effects of conventional physiotherapy. This study aimed to evaluate the effects of a visual feedback training program combined with conventional physiotherapy on balance, mobility, and functional independence in patients with PD.MethodsIn this prospective cohort study, 21 patients with PD (Hoehn and Yahr stages 1-3) underwent a 4-week rehabilitation program consisting of 20 sessions (60 min/session, 5 sessions/week) combining conventional physiotherapy with visual-feedback balance and trunk-control training using the ProKin 252N platform. Outcomes were assessed at baseline (T0), post-treatment (T1), 3 months (T2), and 6 months (T3). Primary outcome was the Berg Balance Scale (BBS). Secondary outcomes included the Performance-Oriented Mobility Assessment (POMA), Timed Up and Go (TUG), and Functional Independence Measure (FIM).ResultsSignificant improvements were observed after treatment in BBS (40.10 ± 8.99 vs. 43.45 ± 7.63; <i>p</i> < 0.001), POMA (19.00 ± 4.85 vs. 22.00 ± 3.37; <i>p</i> < 0.001), TUG (14.73 ± 6.10 vs. 12.84 ± 4.94 s; <i>p</i> = 0.010), and FIM (109.2 ± 10.75 vs. 110.2 ± 9.57; <i>p</i> = 0.002). Improvements were maintained at T2 and remained significantly better than baseline at T3 (BBS: 44.83 ± 7.53; Tinetti: 23.00 ± 3.38; TUG: 12.72 ± 4.47 s; FIM: 111.1 ± 8.81). Repeated-measures ANOVA demonstrated significant improvements over time for all outcomes (<i>p</i> < 0.001).ConclusionsVisual feedback training combined with conventional physiotherapy may improve balance, mobility, and functional independence in individuals with PD, with benefits maintained up to 6 months. Larger controlled studies are warranted to confirm these findings.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"505-517"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Therapeutic Education Delivered by a Community Post-Stroke Rehabilitation Team and Improvement in the Frenchay Activities Index: A Retrospective Cohort Study.","authors":"Fasan Olivia, Guediri Amine, Mandigout Stéphane, Bernikier David, Salle Jean-Yves, Daviet Jean-Christophe, Compagnant Maxence","doi":"10.1177/10538135261473298","DOIUrl":"10.1177/10538135261473298","url":null,"abstract":"<p><p>BackgroundSocial participation is frequently impaired after stroke. Therapeutic patient education (TPE) may promote self-management and community reintegration, but evidence regarding home-based programs delivered by Community Stroke Rehabilitation Teams (CSRTs) remains limited.ObjectiveTo investigate the association between participation in a home-based TPE program, including physical activity (PA) workshops, and changes in social participation after stroke.MethodsThis retrospective comparative cohort study included 163 stroke survivors managed by a CSRT between 2019 and 2020. Among them, 110 participated in a home-based TPE program and 53 received standard CSRT care. Within the TPE group, 52 patients attended PA workshops. Social participation was assessed using the Frenchay Activities Index (FAI) at admission and discharge. Changes in FAI scores were compared using Mann-Whitney tests and adjusted analyses of covariance controlling for baseline FAI score, age, Barthel Index, time since stroke, duration of care, and lockdown status.ResultsPatients receiving TPE showed greater improvement in FAI scores than those receiving standard care (mean change: 6.02 ± 8.22 vs. 1.62 ± 3.98; <i>p</i> < 0.001). Among TPE participants, those attending PA workshops demonstrated greater improvement than those receiving TPE without PA workshops (7.87 ± 8.37 vs. 4.36 ± 7.78; <i>p</i> = 0.006). These associations remained significant after adjustment for potential confounders and were confirmed by bootstrap sensitivity analyses.ConclusionsHome-based TPE delivered by a CSRT was associated with greater improvement in social participation after stroke, particularly when combined with PA workshops. Prospective controlled studies are needed to determine the effectiveness of this approach.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"463-472"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Telerehabilitation Versus Conventional Rehabilitation on Motor Function and Activities of Daily Living After Stroke: A Systematic Review of Randomized Controlled Trials.","authors":"Kainat Shehzadi, Tiberiu Tătaru","doi":"10.1177/10538135261478641","DOIUrl":"10.1177/10538135261478641","url":null,"abstract":"<p><p>BackgroundAlthough telerehabilitation is an increasingly popular method for delivering physiotherapy remotely, its efficacy compared with traditional in person therapy for stroke patients remains uncertain.ObjectiveThis systematic review evaluates the effectiveness of telerehabilitation compared with conventional physiotherapy on motor function (Fugl-Meyer Assessment, FMA) and activities of daily living (Barthel Index) in stroke patients.ResultsFour trials involving 226 randomized participants were included. Cramer et al. showed noninferiority of dose-matched home telerehabilitation for Fugl-Meyer change (adjusted difference 0.06 points, 95% CI -2.14 to 2.26; p = .96). Shamweel and Gupta found no post-treatment FMA-UE difference (p = .337). Saygili et al. reported significant group-by-time interactions for FM-UE (p = .001) and FIM (p = .006), but Tele-CIMT was added to a home-exercise program and was not dose matched. Chen et al. found no differential Modified Barthel Index trajectory (group-by-time p = .897). Two trials were judged low risk of bias and two had some concerns. Certainty was very low for motor and ADL outcomes because of inconsistency, indirectness, and imprecision, with additional risk-of-bias concerns.ConclusionsTelerehabilitation can produce clinically relevant gains, and one adequately powered dose-matched trial supports noninferiority for arm motor recovery. The evidence does not establish general superiority over equivalent in-person rehabilitation. Larger trials should match content and dose, prespecify comparative estimands, and report standardized outcomes.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"473-484"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Classified Gait Pattern Subgroups and Definitions of Abnormal Gait Patterns Following Stroke: A Scoping Review.","authors":"Ryosuke Kitatani, Tomotaka Ito, Masaki Yamamoto, Naoto Mano, Yuta Suzuki, Yusuke Sekiguchi, Naomichi Mizuta","doi":"10.1177/10538135261476708","DOIUrl":"10.1177/10538135261476708","url":null,"abstract":"<p><p>BackgroundHemiplegic gait following stroke has been classified into several gait pattern subgroups; however, characteristics of the classified subgroups and definitions of abnormal gait patterns remain uncertain, despite the emerging importance of individualized gait training tailored to the personalized gait patterns following stroke. Therefore, we aimed to comprehensively explore the existing characteristics of the classified gait pattern subgroups following stroke.MethodsWe conducted this scoping review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and Joanna Briggs Institute Evidence Synthesis guidelines. We comprehensively searched for studies classifying and investigating abnormal gait patterns following stroke using gait analysis instruments (e.g., motion analysis systems, force plates, and electromyography), published from January 1, 1995, to December 31, 2025, in three databases (PubMed, Scopus, and Web of Science). Two reviewers independently screened the articles to include studies investigating abnormal gait pattern classifications following stroke.ResultsFifty-five studies were identified, of which twenty-six studies focused on gait pattern classifications to identify characteristics of classified subgroups, and twenty-nine studies investigated individual abnormal gait patterns. While classified gait pattern subgroups have been reported with a wide variety based on various gait parameters, the knee-related abnormal gait patterns during the stance and swing phases have frequently been reported from early to recent studies. However, few abnormal gait patterns except for the knee joint were defined using clear objective numerical thresholds following stroke.ConclusionGait classifications regarding the knee-related abnormal gait patterns following stroke may warrant particular attention in clinical settings.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"378-404"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Discriminative Validity of a Smartphone-Based Accelerometer Application During the Modified Clinical Test of Sensory Interaction on Balance to Screen Fall Risk in Vestibular Patients.","authors":"Kanokporn Pooranawatthanakul, Nichaporn Khumduang, Nattawan Utoomprurkporn, Akkradate Siriphorn","doi":"10.1177/10538135261470441","DOIUrl":"10.1177/10538135261470441","url":null,"abstract":"<p><p>Background<b>:</b> Objective, accessible tools are needed to screen fall risk in vestibular patients. Smartphone-based accelerometry (ACC) offers a practical, scalable solution.ObjectivesThis study evaluated the preliminary discriminative validity of smartphone ACC application during the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) to differentiate vestibular patients with and without a fall history.MethodsIn this cross-sectional study, 42 vestibular patients were classified as fallers (n = 16) or non-fallers (n = 26) based on a 12-month retrospective self-reported history. Postural sway was quantified via resultant root mean square (RMS) acceleration using a custom Android application during four mCTSIB conditions. Area under the curve (AUC) was calculated using receiver operating characteristic analysis, with DeLong's test comparing AUCs. Spearman's rank correlation assessed associations with Mini-BESTest.ResultsAUCs ranged from 0.681 to 0.798, indicating acceptable-to-good preliminary discriminatory capacity, though wide confidence intervals were present and condition AUCs did not differ statistically. The eyes closed-firm condition demonstrated high specificity (96.1%) and a strong positive likelihood ratio (LR+=14.63), suggesting utility as a highly specific \"rule-in\" screening task, while eyes open-foam yielded the highest AUC (0.798). Significant negative correlations occurred between application RMS metrics and total Mini-BESTest scores across all conditions (ρ = -0.410 to -0.525, p < .05), with eyes closed-foam specifically associating with reactive postural control and dynamic gait subscores.ConclusionsThe application demonstrates preliminary discriminative validity for screening fall risk within vestibular cohorts. Due to modest sensitivity, wide confidence intervals, and the study's cross-sectional nature, this tiered pathway remains strictly exploratory; prospective longitudinal validation is warranted.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"485-496"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomic Dysfunction After Pediatric Concussion: A Scoping Review.","authors":"Scott Ramsay, Hunter Lloyd, Violetta Kobzeva, James Lee","doi":"10.1177/10538135261479313","DOIUrl":"10.1177/10538135261479313","url":null,"abstract":"<p><p>PurposeA concussion is a common injury in children and adolescents. Despite how common these brain injuries are, relatively little is known about the underlying pathophysiology of pediatric concussion. This scoping review aims to collect and synthesize the literature on autonomic dysfunction (AD) in pediatric concussion, with a secondary aim to identify the procedures and measures testing autonomic function (AF).MethodsWe completed a systematic search using six databases of articles pertaining to AD after concussion. The resulting articles were exported, screened, and reviewed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines.ResultsTwenty-two studies met the study criteria and were included in the review. Findings revealed that children and adolescents experience varying degrees of AD after concussion. Fifteen of the 22 studies identified some anomaly related to AD in the concussed pediatric population, though the direction of findings varied across studies and injury phases. The most common autonomic assessment used in studies focused on cardiovascular autonomic reflex testing resulting from orthostatic stressors (n = 10), with other measures including respiratory effects during aerobic exercise and ocular dynamics.ConclusionOverall, there is a gap in our understanding of AD after pediatric concussion. The findings of this study provide mixed results on AD after pediatric concussion. Future research should prioritize prospective studies examining autonomic recovery trajectories across developmental subgroups. Autonomic measures, such as cardioregulatory measures and pupillometry, represent promising emerging markers that require further validation to inform rehabilitation protocols in pediatric concussion.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"343-363"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Diagnosis: An Integrated Perspective on Strategic Dosing in Neurologic Motor Rehabilitation. A Scoping Review and Collaborative Viewpoint.","authors":"Ahmad Rifai Sarraj, Jihan Allaw, Fadi Zein El Abidin, Antonio Pinti","doi":"10.1177/10538135261470437","DOIUrl":"10.1177/10538135261470437","url":null,"abstract":"<p><p>BackgroundCurrent neurorehabilitation often relies on static, diagnosis-driven protocols or generic exercise administration, contributing to suboptimal long-term outcomes. There is a clinical need for a cohesive, mechanism-based framework to guide therapeutic reasoning, dosing, and longitudinal adaptation.MethodsA scoping review of neurorehabilitation literature was conducted according to PRISMA-ScR guidelines to map evidence on dosing, intensity, and longitudinal management. From 9,373 records, 42 studies were synthesized. The literature did not converge on standardized dosing parameters but supported a broad distinction between higher-intensity approaches for non-progressive conditions and more conservative, energy-conserving strategies for progressive conditions. Integrating these findings with author consensus, we developed a collaborative viewpoint proposing a hypothesis-generating clinical framework.Proposed FrameworkWe conceptualize three dynamic clinical pillars: (1) Optimization of Motor Performance, targeting behavioral restitution of activities of daily living through experience-dependent neuroplasticity; (2) Maximization of Motor Performance, promoting active neuroprotection in early degenerative diseases and structural compensation in stable lesions through high physiological effort; and (3) Preservation of Remaining Functions, prioritizing energy conservation and reduction of secondary sequelae in rapidly progressive conditions. The evidence supports the broad progressive versus non-progressive dosing distinction, while the three-pillar structure, FITT-PRO profiles, and transition triggers remain hypotheses requiring validation.Clinical ApplicationA preliminary decision-support structure is proposed around FITT-PRO parameters and longitudinal reassessment. Transition triggers, such as biological plateaus or exacerbations, are not yet operationally defined and require prospective biomarker-based validation.ConclusionThis framework differentiates conditions by functional responsiveness rather than diagnosis, supporting interdisciplinary prognostic reasoning while requiring prospective validation before clinical implementation.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"364-377"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Virtual Reality Versus Whole-Body Vibration on Muscle Strength and Balance in Children with Duchenne Muscular Dystrophy: a Randomized Controlled Trial.","authors":"Mostafa S Ali, Mahmoud Usama","doi":"10.1177/10538135261473293","DOIUrl":"10.1177/10538135261473293","url":null,"abstract":"<p><p>ObjectiveTo compare the effects of virtual reality versus whole-body vibration on quadriceps muscle strength and balance in children with Duchenne muscular dystrophy.MethodsIn this assessor-blinded, parallel-group randomized controlled trial (1:1 allocation), 50 ambulatory boys with DMD (aged 6-10 years; AFCSD levels I-II) were recruited from Cairo University's outpatient clinic. Both groups received a structured physical therapy program (warm-up, stretching, isometric contractions) three times weekly for 12 weeks. VR Group (n = 25) additionally performed 10 min of semi-immersive VR (Nintendo Wii Fit Balance Board). WBV Group (n = 25) additionally performed 10 min of side alternating WBV (30 Hz, 2 mm amplitude). The primary outcome was isometric quadriceps strength (Lafayette manual muscle tester). Secondary outcomes were overall stability index (OSI), anterior-posterior stability index (APSI), and medial-lateral stability index (MLSI) measured by the Biodex Balance System. Assessments were conducted at baseline, 6 weeks, and 12 weeks by assessors blinded to group allocation. A mixed MANOVA with Bonferroni correction was used.ResultsA significant treatment time interaction was observed (F = 22.31, p < 0.001, ηp²=0.85). At 12 weeks, the VR group showed significantly greater improvements than the WBV group in right quadriceps strength (p < 0.001, ηp²=0.742), left quadriceps strength (p < 0.001, ηp²=0.757), OSI (p < 0.001, ηp²=0.346), APSI (p < 0.001, ηp²=0.737), and MLSI (p < 0.001, ηp²=0.335). No adverse events were reported.ConclusionIn ambulatory children with DMD, a 12-week VR-based intervention produced greater improvements in isometric quadriceps strength and dynamic postural stability compared to WBV. These findings support VR as a motivating adjunct to physical therapy, though functional outcomes and longer follow-up are needed.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"405-417"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}