NeuroRehabilitation最新文献

{"title":"Intensive Therapy in Adults with Cerebral Palsy? Yes, They Can! A Retrospective Study on Short-Term Functional Outcomes of an Intensive Goal-Oriented Strengthening Program.","authors":"Laure Mathevon, Soline Bellaiche, Marianne Bagnol, Cristian Preda, Rachel Bard-Pondarré, Emmanuelle Chaléat-Valayer","doi":"10.1177/10538135261470440","DOIUrl":"10.1177/10538135261470440","url":null,"abstract":"<p><p>ObjectiveTo evaluate the effects of a 4-week intensive, goal-oriented muscle strengthening program on functional goal attainment, physical performance, fatigue, and self-esteem in ambulatory adults with cerebral palsy (CP).DesignRetrospective monocentric uncontrolled observational study.ParticipantsSixty-six ambulatory adults with hemiplegic, diplegic or quadriplegic CP, classified as Gross Motor Function Classification System (GMFCS) levels I-III.MethodsThe intervention consisted in a 4-week intensive group program (48 h total) focused on individualized, goal-directed muscle strengthening. Functional goals were assessed with the Canadian Occupational Performance Measure. Physical performance included the 6-Minute Walk Test, Gross Motor Function Measure, and muscle strength testing. Fatigue was measured using the Fatigue Impact Scale, and self-esteem with the Rosenberg Self-Esteem Scale.ResultsMost goals concerned mobility (32%), domestic activities (25%), and leisure (19%). Significant improvements were observed in COPM performance (+1.8) and satisfaction (+2.4), walking distance (+49.4 m), GMFM dimensions D and E (+2.9 and +3), and muscle strength (all p<0.001). Fatigue decreased across all FIS domains, and self-esteem improved modestly. No correlation was found between fatigue reduction and motor gains.ConclusionThis first study of intensive group therapy in adults with CP shows that participation in the program was associated in improvements in short-term functional outcomes without increasing fatigue, aligns with patient priorities, and may support active and healthy aging. These findings should be interpreted with caution due to the study design.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"418-430"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620997","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":"Effect of Visual Modification by Video See-Through Augmented Reality with REHA-Glasses on Postural Verticality in Individuals with Post-Stroke Lateropulsion.","authors":"Chiaki Yokota, Masatoshi Kamada, Hailong Liu, Katsuhiro Omae, Daishi Doda, Kanta Shioiri, Katsuaki Shimano, Takahiro Wada, Koichi Ito","doi":"10.1177/10538135261472484","DOIUrl":"10.1177/10538135261472484","url":null,"abstract":"<p><p>ObjectivesTo examine whether post-stroke lateropulsion can be corrected to the upright position by wearing REHA-glasses, which provide the wearer with front-view images rotated based on body tilt.MethodsA prospective, open-label, single-arm, exploratory, interventional study for individuals with first-ever acute stroke and spontaneous body posture rated ≥ 0.75 on the Scale for Contraversive Pushing (SCP) was conducted in a single center in Japan. The intervention was performed by three physical therapists who understood the study protocol. When the participants wore REHA-glasses, the therapist rotated the visual field of view with the intent of moving the participants' position to an upright stance. Differences in assessment between therapists were resolved by mutual agreement. The primary outcome was the change in the total SCP score between the pre-wearing and wearing periods. Adverse events included falling, cybersickness symptoms, deterioration of neurological symptoms, and mechanical problems.ResultsTwenty-four participants (mean 67.6 years) were enrolled. The total SCP score was lower during wearing than during pre-wearing: mean 0.62 (standard deviation: 0.96) vs. 2.26 (1.13); median 0.1 (interquartile range: 0-0.9) vs. 2.0 (1.3-2.5); mean difference 1.64 (95% confidence interval: 1.29-1.97), respectively, <i>p</i> < 0.001, Cohen's <i>dz</i> = 2.04. Mechanical problems, due to damage to the connection port of the headset, was the only adverse event, which did not endanger the participants' safety.ConclusionsPost-stroke lateropulsion was improved by modulating visual input using REHA-glasses.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"453-462"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621046","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 Wii Fit on Functional Balance and Elbow Flexion in Children with Unilateral Spastic Cerebral Palsy: A Pilot Study.","authors":"Mahshad Maleki, Mahsa Mohammadi, Shirin Modarresi, Saeid Fatorehchy","doi":"10.1177/10538135261478260","DOIUrl":"10.1177/10538135261478260","url":null,"abstract":"<p><p>BackgroundChildren with unilateral spastic cerebral palsy often present with impaired dynamic balance, which can negatively affect functional activities and contribute to compensatory upper-limb movement patterns. Although balance-focused interventions have been shown to improve functional balance, their potential influence on upper-limb outcomes has not been well explored. This pilot study explored the effects of balance training using the Wii Fit balance board on functional balance and elbow range of motion (ROM) in children with unilateral spastic cerebral palsy.MethodsA single-subject A-B-A (withdrawal) design was implemented across three phases: baseline (4 weeks), intervention (12 weeks), and follow-up (4 weeks). Outcome measures included the Pediatric Balance Scale (PBS), Timed Up and Go (TUG), and elbow ROM. Data were analyzed using visual inspection, Hedges' g, and the percentage of nonoverlapping data (PND).ResultsNine children (mean age = 7.33 ± 2.00 years) participated. Pediatric Balance Scale and Timed Up and Go scores demonstrated notable improvements during the intervention phase (PND ≈ 75%; Hedges' g > 0.8 for most participants), with gains largely maintained at follow-up. Elbow outcomes also improved, with consistent increases in active elbow range of motion and reductions in passive elbow flexion during the intervention phase (PND = 100% for most participants; Hedges' g > 0.8), although maintenance of gains varied across participants.ConclusionBalance training with the Wii Fit balance board resulted in improvements in functional balance and elbow range of motion in children with unilateral spastic cerebral palsy. Although balance gains were generally maintained, elbow gains were more variable among subjects at follow-up, suggesting that balance-focused interventions may positively influence upper-limb movement patterns but require additional or sustained intervention to optimize long-term elbow outcomes.Approval codeIR.USWR.REC.1399.149.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"431-444"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796360","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":"Manifestations of Oral Muscle Mass, Tongue Strength, and Endurance in Patients with Stroke Across Varying Degrees of Swallowing Function: A Pilot Study.","authors":"Sung-Ling Tsai, Yu-Chi Huang, Chung-Hui Cheng","doi":"10.1177/10538135261470434","DOIUrl":"10.1177/10538135261470434","url":null,"abstract":"<p><p>BackgroundPost-stroke dysphagia (PSD) is associated with swallowing muscle atrophy and impaired tongue performance.ObjectivesThis study aimed to compare oral muscle mass, muscle elasticity, and tongue performance in stroke patients with different swallowing function levels.MethodsIn this cross-sectional pilot study, 41 stroke patients from Kaohsiung Chang Gung Memorial Hospital, Taiwan, were stratified into three groups based on the Functional Oral Intake Scale (FOIS): severe dysphagia (levels 1-3), mild-to-moderate dysphagia (levels 4-6), and no dysphagia (level 7). Tongue and bilateral masseter muscle thickness and elasticity, expressed as shear wave velocity (SWV), were assessed using ultrasonography and sonoelastography. Tongue strength and endurance were evaluated using Iowa Oral Performance Instrument (IOPI). Group differences were analyzed using the Kruskal-Wallis test followed by Mann-Whitney U post hoc comparisons. Associations between FOIS scores and IOPI or sonographic measurements were evaluated using Spearman's rank correlation.ResultsTwenty-seven men and fourteen women were included. Unaffected-side masseter muscle thickness differed significantly among groups (<i>p</i> < 0.05), increasing with better swallowing function. Tongue SWV was highest in the severe dysphagia group (median 1.98 [IQR 0.83] m/s), with significant differences among groups (<i>p</i> < 0.05). Higher FOIS levels were associated with greater tongue strength and endurance, although endurance did not differ between the mild-to-moderate dysphagia and non-dysphagic groups.ConclusionsOral muscle mass measurements alone may not adequately reflect PSD severity. Integrating sonoelastography and IOPI assessments identifies increased tongue stiffness and reduced tongue performance in severe PSD, supporting severity-specific rehabilitation strategies.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"445-452"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761083","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 Sensory Electrical Stimulation Versus Alternating Electromyography-Guided Electrical Stimulation on Functional Recovery of the Hand in Chronic Stroke: A Randomized Controlled Trial.","authors":"Dany Alphonse Anwar Habib, Mohamed Emam, Ahmed Elsayed, Abd El-Hamied Ibrahim El-Sayed Mohammad El-Sherbini, Reham Ali Mohamed Ali Ahmed","doi":"10.1177/10538135261496135","DOIUrl":"https://doi.org/10.1177/10538135261496135","url":null,"abstract":"<p><p>BackgroundImpaired hand function can limit independence. Sensory electrical stimulation (SES) and alternating electromyography-guided electrical stimulation (Alt-EMG) differ in stimulation characteristics and voluntary effort requirements, but comparative evidence is limited.ObjectiveTo compare SES and Alt-EMG, each combined with conventional physical therapy, on upper-limb motor function, spasticity, and muscle strength in chronic stroke.MethodsThis three-arm, assessor-blinded randomized controlled trial included 60 adults aged 45-65 years, 6-18 months post-stroke, allocated equally to SES, Alt-EMG, or control groups (n = 20 each). The primary outcome was the Action Research Arm Test (ARAT); Modified Ashworth Scale (MAS) and Medical Research Council (MRC) scores were secondary outcomes. ARAT was analyzed using ANCOVA adjusted for baseline score and age; ordinal outcomes were analyzed nonparametrically. Benjamini-Hochberg and Holm corrections addressed multiplicity.ResultsAll participants completed the 12-week intervention. Treatment group significantly predicted adjusted post-intervention ARAT scores (F (2,55) = 23.19, P < .001, partial η²=.46). Adjusted mean gains versus control were 12.05 points for SES and 12.44 points for Alt-EMG (both P < .001), with no significant difference between active groups. Significant between-group differences were observed for shoulder, elbow, and wrist spasticity and most muscle-strength measures, except finger extensors.ConclusionsSES and Alt-EMG combined with conventional physical therapy produced greater improvement in upper-limb motor function than conventional physical therapy alone over 12 weeks. No difference was observed between SES and Alt-EMG for the primary outcome.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"10538135261496135"},"PeriodicalIF":2.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183372","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":"Transcutaneous Vagus Nerve Stimulation Improves Motor Function of Upper Extremity in Adults with Chronic Ischemic Stroke: A Randomized Controlled Trial.","authors":"Moshera H Darwish, Mohamed S El-Tamawy, Marwa Mostafa, Nehad A Abo-Zaid, Sheemah Alenezi, Heba A Khalifa","doi":"10.1177/10538135261490939","DOIUrl":"https://doi.org/10.1177/10538135261490939","url":null,"abstract":"<p><p>BackgroundUpper limb motor dysfunctions are common after stroke affecting daily activities. About 60% of survivors still have impairment despite rehabilitation.ObjectiveTo assess the effect of transcutaneous auricular vagal nerve stimulation (taVNS) on upper limb motor function in chronic stroke patients.MethodsForty patients with chronic ischemic stroke in the middle cerebral artery territory were randomly assigned equally to; real group received 30 min of real taVNS followed by 30 min of upper limb exercises and sham group received identical program with sham taVNS. Intervention was conducted three sessions / week for four weeks. Upper extremity motor functions; Isometric (shoulder abductor, elbow flexors) and isokinetic (elbow flexors, extensors) muscle strength; and hand grip were evaluated through Fugl-Meyer Assessment for upper extremity (FMA- UE), Biodex system, and electronic hand dynamometer, respectively pre and post intervention.ResultsPost-intervention between-group comparisons favored real taVNS for FMA-UE (MD = 3.95, 95% CI 0.21-7.69), IMSA (MD = 4.78, 95% CI 1.89-7.66), IMEF (MD = 4.16, 95% CI 1.02-7.30), IKEE (MD = 5.34, 95% CI 3.23-7.61), and IKEF (MD = 4.72, 95% CI 2.71-6.72, p < 0.05). The HG improved significantly within the real taVNS group; however, the between-group difference was not significant (MD = 1.33, 95% CI -1.21 -3.85, p = 0.297).ConclusionstaVNS was associated with significant between-group improvements in upper-limb motor function and shoulder and elbow muscle strength. Clinical relevance of FMA-UE should be interpreted cautiously because its 95% CI was below the reported minimal clinically important difference.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"10538135261490939"},"PeriodicalIF":2.0,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168177","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":"Early Changes in Post-Stroke Quality of Life and Associated Factors: A Prospective Study.","authors":"Senay Demir Yazici, Murat Birtane, Nurettin Tastekin, Galip Ekuklu, Ufuk Utku, Nilda Turgut, Talip Asil","doi":"10.1177/10538135261494069","DOIUrl":"https://doi.org/10.1177/10538135261494069","url":null,"abstract":"<p><p>BackgroundStroke affects physical, psychological, and social functioning. Early changes in health-related quality of life (HRQoL) remain incompletely characterized.ObjectivesTo assess early HRQoL changes after stroke and identify associated factors.MethodsWe assessed 111 patients with first-ever stroke at baseline, 1 month, and 3 months. Functional status, cognition, depressive symptoms, and HRQoL were evaluated using the Barthel Index, Functional Ambulation Scale, Mini-Mental State Examination, Beck Depression Inventory, Form-36 (SF-36) and the Stroke Impact Scale 3.0 (SIS 3.0). Paired tests, correlations with false discovery rate correction, and multivariable linear regression were used.ResultsNinety-seven patients completed follow-up. Physical and psychosocial HRQoL showed divergent recovery trajectories. SF-36 physical component scores progressively improved across both intervals (baseline to 1 month, <i>p</i>  =  0.006; 1 to 3 months, <i>p</i> = 0.033), whereas mental component scores improved only during the first month (<i>p</i> = 0.021) and showed no further significant improvement thereafter (<i>p</i> = 0.342). Similarly, SIS 3.0 emotion scores showed no significant change between 1 and 3 months (<i>p</i> = 0.831) and no significant net change over 3 months (<i>q</i> = 0.103), unlike the other domains, which continued to improve. In multivariable regression, functional ambulation at 3 months was independently associated with physical HRQoL change (β = 0.483, <i>p</i> < 0.001; adjusted R² = 0.450), whereas depressive symptom severity was independently associated with mental HRQoL change (β = -0.692, <i>p</i> < 0.001; adjusted R² = 0.667).ConclusionPhysical and psychosocial HRQoL did not recover in parallel during the first 3 months after stroke. Ambulation and depressive symptoms warrant separate attention during early rehabilitation planning.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"10538135261494069"},"PeriodicalIF":2.0,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171972","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":"Quran Memorization as a Naturalistic Neurocognitive Training Paradigm: A Quality-Weighted Evidence Synthesis in Student Populations.","authors":"Amine Souissi, Mahmoud Al Sayed, Hamdah Abdullah Alghamdi, Hager Ahmed Abdelsattar, Bahia Zemni, Helmi Ben Saad","doi":"10.1177/10538135261494193","DOIUrl":"https://doi.org/10.1177/10538135261494193","url":null,"abstract":"<p><p>AimWe aimed to quantitatively synthesize observational evidence on the association between memorization (<i>Hifz</i>) and cognitive and mental health outcomes in students, using a quality-weighted evidence synthesis approach.MethodFor observational studies published between 2005 and 2026, a systematic multi-database search was carried out using <i>PubMed/Medline</i>, <i>Scopus</i>, <i>ScienceDirect</i>, and <i>Google Scholar</i>. The direction, strength, and consistency of the evidence across predetermined outcome domains were measured using a quality-weighted vote-counting synthesis. Seven observational studies involving 690 students were included.ResultsA statistically significant positive association between <i>Hifz</i> and at least one cognitive or psychological outcome was identified in 5 of 7 studies (71.4%). One study identified a neutral result, and one study (Magnetic Resonance Imaging morphology outcome) was reclassified as uncertain. No study reported a significant negative association. The quality-weighted evidence score was <i>W</i> = 71.5%, corresponding to moderate evidence. Memory performance, intelligence quotient, and quality of life showed the most consistent positive associations. Several studies reported more favourable cognitive or psychosocial outcomes among participants with higher levels of <i>Quran</i> memorization, although the observational design precludes causal interpretation.ConclusionQuality-weighted synthesis (<i>W</i> = 71.5%) indicates generally favourable associations between <i>Hifz</i> and cognitive and psychological outcomes in students. Although all studies included were conducted in students rather than clinical rehabilitation samples, emerging neurophysiological and clinical research on <i>Quranic</i> engagement provides a preliminary rationale for investigating its cognitive-linguistic and neurorehabilitation potential. Accordingly, <i>Hifz</i> is considered as a promising, culturally sensitive, hypothesis-generating model of intensive cognitive-linguistic practice that warrants rigorous prospective evaluation in neurological populations.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"10538135261494193"},"PeriodicalIF":2.0,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167588","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":"Physical Activity and Sedentary Time in Chronic Stroke: An Agreement Study Between the IPAQ-SF and ActiGraph Measures.","authors":"Teresa L Dias, Fernando Ribeiro, Carla M Pereira","doi":"10.1177/10538135261491937","DOIUrl":"https://doi.org/10.1177/10538135261491937","url":null,"abstract":"<p><p>BackgroundThe International Physical Activity Questionnaire - Short Form (IPAQ-SF) and ActiGraph accelerometers are widely used and internationally recommended to assess physical activity (PA) and sedentary time (ST). However, their agreement in individuals with chronic stroke remains unclear.ObjectivesTo quantify the magnitude of agreement between IPAQ-SF and ActiGraph-derived weekly moderate-to-vigorous PA (MVPA), total PA, and ST in chronic stroke survivors.MethodsFifty community-dwelling adults with chronic stroke who walked independently were enrolled in this cross-sectional study. Participants wore an accelerometer (ActiGraph GT3X+) on the non-paretic side of the waist for seven consecutive days. The IPAQ-SF was completed via interview on the following day.ResultsIPAQ-SF and ActiGraph-derived estimates showed substantial individual-level discrepancies, with wide limits of agreement (LoA) across outcomes. For MVPA, the mean ratio was 1.02 (95%CI: 0.49 to 2.11; ratio LoA: 0.01 to 154.62). For total PA, the median ratio was 0.08 (95% CI: 0.06 to 0.14; non-parametric ratio LoA: 0.00 to 1.33). For ST, the mean ratio was 0.85 (95%CI: 0.78 to 0.92; ratio LoA: 0.47 to 1.53).ConclusionFindings indicate poor individual-level agreement between the IPAQ-SF and ActiGraph-derived estimates, with wide LoA and evidence of heteroscedasticity. At the group level, the IPAQ-SF underestimated total PA and ST, whereas MVPA showed no evidence of fixed bias. Although the IPAQ-SF may provide a broad descriptive assessment of PA and ST at the group level, it should not be used interchangeably with ActiGraph for individual-level estimation in individuals with chronic stroke.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"10538135261491937"},"PeriodicalIF":2.0,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172102","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":"Prognostication in Amyotrophic Lateral Sclerosis: A Narrative Review of Pre-Diagnosis and Functional Outcomes.","authors":"Amber Vocelle, Erik Ensrud, Ileana M Howard","doi":"10.1177/10538135261490936","DOIUrl":"https://doi.org/10.1177/10538135261490936","url":null,"abstract":"<p><p>Amyotrophic Lateral Sclerosis (ALS) is a very heterogeneous disease, yet some of the most common questions received by physicians in the ALS clinic are \"how much time do I have?\" and \"what can I expect to happen next?\" This line of inquiry is not strictly limited to patients; clinicians also need an idea of prognosis to appropriately plan for treatment decisions and prepare the patient and caregiver for future care needs. This narrative review synthesizes current evidence on prognostic indicators in ALS, organized across three temporal phases: factors preceding diagnosis, factors present at diagnosis, and factors emerging after diagnosis. Pre-diagnosis predictors include age at onset, sex, socioeconomic status, genetic background, premorbid Body Mass Index (BMI) and nutritional status, and comorbid disease. At diagnosis, clinical phenotype and site of onset, diagnostic delay, baseline Amyotrophic Lateral Sclerosis Functional Rating Score-Revised (ALSFRS-R) and forced vital capacity, cognitive involvement, fluid biomarkers, and electrophysiologic measures carry prognostic weight. Post-diagnosis, the trajectory is refined by the rate of ALSFRS-R decline, serial respiratory measures, and weight loss, and is actively modified by clinical interventions including noninvasive ventilation, enteral nutrition, disease-modifying therapy, and multidisciplinary care. Notably, quality of life does not track with physical decline, consistent with the disability paradox described in other severe neurological conditions. For neurorehabilitation, these indicators support a shift from reactive to anticipatory practice: timing equipment provision, communication support, respiratory intervention, and goals-of-care discussions to the predicted trajectory rather than to established deficit. Refinement of prognostic models may also improve stratification in ALS clinical trials.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"10538135261490936"},"PeriodicalIF":2.0,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168418","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}