NeuroRehabilitation最新文献

{"title":"Multidisciplinary Management of Post-Stroke Depression: A Survey of Therapists' Observations.","authors":"Diletta Maria Pisaniello, Ingela Kerstin Johnson, Sara Anello, Pier Carlo Battain","doi":"10.1177/10538135261420363","DOIUrl":"10.1177/10538135261420363","url":null,"abstract":"<p><p>BackgroundPost-stroke depression is common yet frequently underdiagnosed, substantially hindering rehabilitation engagement and functional recovery. Understanding its impact from the clinician's perspective is critical to optimizing care.ObjectiveThis study aimed to explore how post-stroke depression affects patient autonomy and rehabilitation processes from the viewpoint of occupational, physical, and speech therapists.MethodsAn observational mixed-methods study was conducted via an online survey of 111 neurorehabilitation therapists. Quantitative data were analyzed descriptively; qualitative responses from open-ended questions underwent thematic analysis.ResultsTherapists reported that post-stroke depression profoundly influences rehabilitation through: (1) reduced patient motivation and collaboration; (2) the consequent need for adapted therapeutic strategies (e.g., modified goal-setting and relational approaches); (3) significant professional challenges in patient engagement; and (4) an increased emotional burden on therapists. Consequently, interventions are routinely modified, requiring more time, interdisciplinary coordination, and psychological support.ConclusionsThis study underscores that post-stroke depression necessitates a fundamentally adapted, team-based rehabilitation approach tailored to motivational deficits. The findings highlight the importance of early screening, therapist training in motivational and relational skills, and structured support for clinicians to improve both patient outcomes and therapist well-being.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"463-473"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227932","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":"Modeling Long-Term Depression Trajectories After Spinal Cord Injury Using Irregularly Sampled Assessments and Rehabilitation Baseline Predictors.","authors":"Alejandro García-Rudolph, Maria Dolors Soler, Anna Gilabert, Eloy Opisso, Joan Saurí","doi":"10.1177/10538135261433166","DOIUrl":"10.1177/10538135261433166","url":null,"abstract":"<p><p>PurposeTo identify and characterize latent trajectories of depression using growth mixture modeling (GMM) applied to irregularly timed assessments spanning up to 20 years post-injury, examine baseline rehabilitation variables significantly associated with trajectory membership, and determine predictors of sustained depressive burden.MethodsThis retrospective observational cohort study included adults with traumatic or non-traumatic spinal cord injury admitted for inpatient rehabilitation within 3 months post-injury (2005-2023), with follow-up extending until May 2025. Depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS-D) at admission, discharge, and follow-up, totaling 3,258 assessments (n = 679 patients). GMM identified latent trajectories while accommodating irregularly spaced assessments. Predictors of trajectory membership were analyzed through multivariable regression with quantified model discrimination.ResultsA 3-class GMM solution provided optimal fit (entropy=0.75). Most participants (81.6%) followed a stable low-depression trajectory (Class 1). A borderline depression trajectory (Class 2; 8.4%) remained persistently elevated, while a probable depression trajectory (Class 3; 10.0%) displayed delayed worsening peaking at 5-7 years post-injury. Class 3 included a significantly higher proportion of non-traumatic injuries (63%) and females (44.1%), with most patients (85.3%) showing no depressive symptoms during rehabilitation, but later exhibiting a marked increase in depressive burden. Logistic regression predicting Class 2 achieved good discrimination (AUC=0.81; 95% CI, 0.65-0.97), identifying baseline depressive symptoms, tetraplegia, female sex, and primary level of education as significant predictors.ConclusionsIrregularly sampled follow-ups revealed distinct depression trajectories, including delayed-onset risk. Findings emphasize early rehabilitation-based screening and long-term monitoring to target follow-up and psychological support.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"486-499"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513836","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":"Strategies for Exoskeletal Upper Limb Robot with Bio-Sensors in Stroke Rehabilitation: A Scoping Review.","authors":"Yuji Iwamoto, Junpei Tanabe, Takeshi Imura, Tsubasa Mitsutake, Shingo Taki, Kazuya Saita, Ryo Tanaka","doi":"10.1177/10538135261426530","DOIUrl":"10.1177/10538135261426530","url":null,"abstract":"<p><p><b>Background:</b> Upper extremity motor impairment is common after stroke. The Hybrid Assistive Limb single-joint type (HAL-SJ), an exoskeletal robot with biosensors, assists voluntary movement by detecting biopotential signals. While there are reports of positive effects, optimal strategies and patient selection criteria remain unclear. <b>Objective:</b> To map the evidence on HAL-SJ use for upper extremity recovery after stroke. <b>Methods:</b> A scoping review was conducted using five databases (search date: September 20, 2025). The studies included stroke patients treated with HAL-SJ and reported motor function outcomes. Reviews, abstracts, and commentaries were excluded. <b>Results:</b> Eight studies met the inclusion criteria. HAL-SJ improved upper limb motor function across recovery phases, with several studies reporting clinically meaningful improvements assessed by measures such as the Fugl-Meyer Assessment and Action Research Arm Test. Effective strategies included combining HAL-SJ with therapies such as botulinum toxin A and occupational therapy, and high-frequency training. Patients with moderate impairment benefited most; early intervention showed potential in severe cases. <b>Conclusion:</b> HAL-SJ shows potential as a rehabilitation tool for stroke-related upper extremity motor impairment. However, all included studies were conducted in Japan, which may limit the generalizability of these findings. Large-scale, multicenter studies are needed to establish optimal intervention protocols.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"396-405"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317672","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":"Efficacy of Robot-Assisted Training Plus Acupuncture Therapy on Lower Limb Functional Recovery in Stroke Patients: A Systematic Review and Meta-Analysis.","authors":"Weihao Ke, Xiaoxuan Ren, Hongxin Cheng, Liang Yang, Xiaomin Lai, Zhenyu Wang","doi":"10.1177/10538135261420364","DOIUrl":"10.1177/10538135261420364","url":null,"abstract":"<p><p>PurposeTo assess the effectiveness of robot-assisted training (RAT) plus acupuncture therapy (AT) on lower limb functional recovery in stroke patients.MethodsThe study protocol was registered with INPLASY (INPLASY2024120107). We searched CNKI, Wanfang, VIP, CBM, PubMed, Embase, Web of Science, and Cochrane Library for RCTs comparing RAT plus AT versus conventional rehabilitation, RAT alone, or AT alone. The risk of bias was assessed using the Cochrane risk-of-bias tool 2.0.ResultsTwenty-one studies (n = 1821) were included. Meta-analyses showed RAT plus AT yielded superior improvements in FMA-LE (MD = 4.02, 95% CI [3.12, 4.93], I² = 89%), FAC (MD = 0.66, 95% CI [0.43, 0.89], I² = 86%), MBI (MD = 9.88, 95% CI [6.43, 13.33], I² = 83%), and BBS (MD = 6.79, 95% CI [5.43, 8.16], I² = 90%). Significant improvements were also observed in gait parameters: step length (MD = 7.42, 95% CI [6.48, 8.36], I² = 12%), step speed (MD = 0.16, 95% CI [0.12, 0.21], I² = 90%), and step width (MD = -2.22, 95% CI [3.96, -0.48], I² = 90%). Sensitivity analyses verified the robustness of these findings.ConclusionRAT plus AT effectively ameliorates post-stroke lower limb dysfunction, demonstrating superior improvements in motor function, gait parameters, and daily living activities compared to monotherapies.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"381-395"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317719","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 Virtual Reality on Hand Function for Patients with Hemiplegia After Stroke: A Meta-Analysis of Randomized Controlled Trials.","authors":"Syeda Faiqa Rehman, Yanan Liang, Jie Wang, Likai Wang, Meiling Luo, Shuangyang Niu, Xiangxin Xing, Siqi Zhang, Yonghui Wang","doi":"10.1177/10538135261418720","DOIUrl":"10.1177/10538135261418720","url":null,"abstract":"<p><p>BackgroundHemiplegia resulting from a stroke frequently causes considerable difficulties in hand function. Virtual reality (VR) therapy has evolved as an innovative and engaging method to facilitate sensorimotor rehabilitation.ObjectiveThis meta-analysis assessed the efficacy of VR-based therapies on hand function in post-stroke hemiplegic patients. The study evaluated the impact of treatment duration, type of VR (immersive, semi-immersive, non-immersive), and stroke stage (subacute versus chronic) on outcomes.MethodsA comprehensive search of six databases until September 2024 identified randomized controlled trials (RCTs) that compared VR therapy with conventional rehabilitation or sham control. The primary outcomes consisted of validated, hand-specific performance metrics, including the Fugl-Meyer upper extremity subscale, Action Research Arm Test, Box and Block Test, Jebsen-Taylor Hand Function Test and Box and Block Test.ResultsTwenty-five RCTs involving 844 participants were evaluated. VR therapy significantly enhanced hand function (SMD = 0.68; 95% CI: 0.41-0.95; p < 0.00001), while there was considerable heterogeneity (I² = 71%). Subgroup analysis indicated that semi-immersive VR had the most significant benefit (SMD = 1.03), whereas interventions with a cumulative training duration beyond 12 h, along with those administered to subacute patients, demonstrated greater effect size in hand function relative to shorter interventions (pooled SMD for >12 h = 0.94; 95% CI: 0.66-1.23).ConclusionThis meta-analysis suggests that semi-immersive VR therapy improves hand function in post-stroke patients, especially when the total cumulative treatment duration exceeds 12 h. Future research should determine the principal treatment elements, establish uniform dosing methods, and evaluate long-term results, including activities of daily living and quality of life.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"331-345"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284654","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":"Interpretable Machine Learning for Stroke Recovery: Predicting Discharge and 3-Month Functional Outcomes.","authors":"Inês Carvalho Martins Augusto, Nuno Antonio, Ana Marreiros, Sara Ventura Ramalhete, Hipólito Nzwalo","doi":"10.1177/10538135261420819","DOIUrl":"10.1177/10538135261420819","url":null,"abstract":"<p><p>IntroductionStroke is a leading cause of disability worldwide. This study uses Machine Learning models to investigate factors influencing modified Rankin Scale scores at discharge and three months post-discharge.MethodsData from 116 stroke patients were analyzed using four predictive models: Logistic Regression, Support Vector Machine, Random Forest, and Extreme Gradient Boosting (XGB). Shapley Additive Explanations (SHAP) were also employed to interpret factor significance.Results and discussionThe XGB model achieved an Area Under the Curve of 79% at discharge and 87% three months post-discharge. SHAP analysis revealed changing factor significance over time. The National Institutes of Health Stroke Scale was most critical at discharge, while post-discharge destination became more significant at three months. Age, time metrics, thrombolysis therapy, and management of long-term health issues also proved influential.ConclusionsFindings highlight the complex, evolving nature of stroke recovery. The shift in factor importance from clinical interventions to broader health management issues emphasizes the need for time-sensitive, multifaceted approaches to stroke care. This study contributes to understanding stroke recovery by identifying key influencing factors and demonstrating the value of SHAP for model interpretation. The insights gained have practical implications for rehabilitation practices. By identifying evolving predictors of recovery, the proposed framework may support early stratification of rehabilitation needs, assist clinicians in tailoring rehabilitation intensity and modality, and inform discharge destination decisions.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"453-462"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Predictors of Speaking Valve Use in Neurological Patients: A Retrospective Cohort Study.","authors":"Matías Otto-Yáñez, Gonzalo Monge-Martínez, Rodrigo Torres-Castro, Tamara Muñoz, Erico Segovia, Diana C Sánchez-Ramírez, Roberto Vera-Uribe, Luis Vasconcello-Castillo, Vanessa Resqueti, Guilherme Fregonezi","doi":"10.1177/10538135261423945","DOIUrl":"10.1177/10538135261423945","url":null,"abstract":"<p><p>IntroductionSpeaking valves (SVs) restore phonation and may support airway protection in people with a tracheostomy, yet tolerance varies widely in neurological rehabilitation. We aimed to identify clinical factors associated with SV use and duration in a neurological rehabilitation setting.MethodsWe retrospectively analyzed 117 adults with neurological conditions and tracheostomy admitted to a rehabilitation center. Two internally validated multivariable models were developed: logistic regression for SV use (yes/no) and a quasi-Poisson regression for target daytime SV duration (hours/day), using routinely available bedside clinical variables.ResultsOf 117 patients, 64 (54.7%) used an SV during hospitalization. In the multivariable logistic model, higher level of consciousness (eMCS vs VS/MCS; OR 6.26, 95% CI 1.53-23.14), a positive blue dye test (OR 0.05, 95% CI 0.01-0.30), and endotracheal suction requirement (vs spontaneous cough; OR 0.07, 95% CI 0.003-0.879) were independently associated with SV use. Model performance was strong (AUC 0.856; accuracy 79.5%). Among SV users, longer daytime duration for SV use was associated with younger age, greater inspiratory and expiratory muscle strength, higher consciousness level, mild dysphagia, spontaneous cough, and neuromuscular or spinal cord injury diagnoses. In contrast, moderate-to-abundant secretions were associated with fewer hours.ConclusionIn a single-center neurological rehabilitation cohort, SV adoption and sustained tolerance were associated with bedside indicators of neurological responsiveness, secretion management, swallowing safety, and respiratory muscle strength. Findings should be interpreted as predictive associations and warrant external validation in contemporary multicenter cohorts.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"474-485"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284633","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":"Clinical Balance Recovery Profiles Based on the Berg Balance Scale and Associated Lesion Characteristics in Patients with Subacute Stroke.","authors":"Hiroaki Abe, Yuka Hashimoto, Ryo Sato","doi":"10.1177/10538135261444037","DOIUrl":"https://doi.org/10.1177/10538135261444037","url":null,"abstract":"<p><p>BackgroundStroke frequently impairs balance, which critically affects mobility, independence, and fall risk during rehabilitation. However, heterogeneous patterns of balance recovery and their neural substrates remain poorly understood.ObjectiveTo identify inpatient balance recovery profiles using initial performance and subsequent improvement across the 14 Berg Balance Scale items, and to examine associations with lesion characteristics to inform prognostic stratification during neurorehabilitationMethodsWe used data from a retrospective cohort of 115 patients with a first-ever stroke. Berg Balance Scale item-level scores at admission and discharge were standardized, and principal component analysis was applied to identify three underlying components. Recovery patterns were then derived from initial scores and rates of improvement, followed by clustering analysis and lesion overlap analyses to characterize the neuroanatomical features of each profile.ResultsCluster analysis based on principal component scores identified five distinct recovery profiles. The profile with severe balance impairment at admission and minimal improvement showed extensive lesions extending from the peri-Rolandic region into the parietal area, whereas no consistent parietal involvement was observed in other profiles.ConclusionsItem-level Berg Balance Scale data revealed heterogeneous inpatient balance recovery profiles after stroke. The poorest recovery profile was characterized by extensive peri-rolandic and parietal lesions, suggesting the involvement of sensorimotor regions in severe balance dysfunction. These findings may improve our understanding of heterogeneity in post-stroke balance recovery and may help inform rehabilitation planning and risk management; however, their direct implications for treatment selection remain exploratory and require prospective validation.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"10538135261444037"},"PeriodicalIF":1.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777970","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":"Task-State EEG Reveals Fine Hand Motor Impairment in Acute Ischemic Stroke: A Multidimensional Analysis of Cortical Dynamics.","authors":"Ke Deng, Jie Zhao, Yuqi Liu, Chune Tian, Xiaofei Lin, Xiaoqing Wei, Rui Li, Weiping Liu","doi":"10.1177/10538135261441843","DOIUrl":"https://doi.org/10.1177/10538135261441843","url":null,"abstract":"<p><p>PurposeTo systematically characterize the cortical dynamics underlying fine hand motor impairment in patients with acute ischemic stroke (AIS) using a multidimensional task-state electroencephalography (EEG) analysis framework.Materials and MethodsFifteen patients with AIS and sixteen age- and sex-matched healthy controls were enrolled. EEG signals were recorded while participants performed three standardized fine motor tasks, including fist clenching, index finger pointing, and thumb-finger opposition. Source localization, time-frequency analysis, and brain network topology analysis were jointly applied to extract multidimensional electrophysiological features. Correlation analyses were further conducted to examine the relationships between EEG-derived metrics and clinical measures, including muscle strength grading, National Institutes of Health Stroke Scale (NIHSS) scores, and Activities of Daily Living (ADL) scores.ResultsCompared with healthy controls, patients with AIS showed abnormal spatiotemporal cortical dynamics during fine hand movements. These abnormalities included delayed movement-related potentials, a shift of alpha- and beta-band event-related desynchronization from contralateral dominance toward more bilateral and diffuse activation, and altered brain network organization characterized by reduced network efficiency and changes in nodal centrality. In addition, EEG-derived features were significantly associated with clinical measures. Specifically, several event-related desynchronization/event-related synchronization (ERD/ERS)-related amplitudes and small-world properties were significantly correlated with muscle strength grading, NIHSS scores, and ADL scores after false discovery rate correction.ConclusionMultidimensional task-state EEG analysis can characterize cortical activation abnormalities and network reorganization associated with fine hand motor impairment in patients with AIS. The identified EEG-derived metrics may serve as objective markers for post-stroke motor function assessment and recovery monitoring, and may help support individualized rehabilitation evaluation and planning.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"10538135261441843"},"PeriodicalIF":1.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777977","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 an 8-Week Combined Aerobic-Resistance Training on Motor Function, Functional Mobility, and Metabolic Parameters in Patients with Parkinson's Disease: A Controlled Study.","authors":"Šimon Janovič, Erik Szabo, Martin Gábor, Igor Straka, Zita Majerníková, Alice Kušnírová, Veronika Boleková, Zuzana Košutzká","doi":"10.1177/10538135261434253","DOIUrl":"https://doi.org/10.1177/10538135261434253","url":null,"abstract":"<p><p>Exercise is increasingly recognized as a key component of Parkinson's disease (PD) management, but data on short-term combined aerobic-resistance training (ART) on motor and metabolic parameters remain limited. In this controlled study, 28 patients with PD (median Hoehn & Yahr stage= 2, IQR 1.75-2.0) were allocated to an 8-week supervised ART group (n= 19) or a stretching-only control group (n = 9). Training consisted of two 45-minute sessions weekly. Primary outcomes were MDS-UPDRS-III, Sit-to-Stand Test (STS), and Six-Minute Walk Test (6MWT). Fasting laboratory parameters were exploratory given the small sample size and absence of an a priori power analysis. Between-group post-intervention differences were analyzed using ANCOVA (baseline as covariate); exploratory biochemical outcomes were controlled for multiple comparisons using Benjamini-Hochberg false discovery rate (FDR). ART improved the MDS-UPDRS-III tremor subscore (p = 0.004) and6MWT distance (p = 0.003), with no significant effects on other motor or functional outcomes. In exploratory laboratory analyses, unadjusted between-group differences were observed for HDL cholesterol (p =0.014), vitamin D₃ (p = 0.003), TSH (p = 0.042), and homocysteine (p =0.019); after FDR correction, only vitamin D₃ remained significant (qFDR= 0.039). Total cholesterol, LDL, and VLDL showed non-significant decreases. An eight-week ART program improved tremor and walking endurance inpatients with PD, while other motor outcomes remained unchanged. Exploratory changes in selected biochemical markers were detected (including a decrease in vitamin D₃); their clinical relevance remains unclear and should be evaluated in larger, well-powered randomized studies.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"10538135261434253"},"PeriodicalIF":1.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646142","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}