Topics in Stroke Rehabilitation最新文献

{"title":"Development and validation of a protective factor-based rehabilitation resilience nursing intervention for stroke survivors.","authors":"Lian-Huan Cai, Xiao-Fang Wang, Hui Chen, Yang-Yang Mei, Min-Fang Ding, Yan Zhuo, Li-Qun Yao","doi":"10.1080/10749357.2026.2677636","DOIUrl":"https://doi.org/10.1080/10749357.2026.2677636","url":null,"abstract":"<p><strong>Objective: </strong>To develop and content-validate a protective factor - based nursing intervention aimed at enhancing rehabilitation resilience in stroke survivors.</p><p><strong>Materials and methods: </strong>This study was guided by the Medical Research Council Framework for Developing and Evaluating Complex Interventions (the MRC framework). Focusing on the development phase (Phase I), we systematically integrated existing evidence, theoretical models, and clinical guidelines to construct a structured intervention protocol targeting rehabilitation resilience. A two-round Delphi process was conducted to evaluate content validity, with the Content Validity Index (CVI), coefficient of variation (CV), and Kendall's coefficient of concordance (W) used to assess expert consensus and reliability.</p><p><strong>Results: </strong>Sixteen experts participated in the Delphi process, demonstrating high engagement and authority (authority coefficient = 0.875). Consensus improved across rounds, with CV values decreasing (0-0.29 to 0-0.20) and Kendall's W increasing (0.276 to 0.519). All intervention items achieved excellent content validity (I-CVI = 1.00; S-CVI = 1.00). The finalized intervention protocol is structured across four rehabilitation phases: early rehabilitation, mid-stage rehabilitation, late rehabilitation, and discharge planning, with each phase targeting key protective factors to enhance resilience.Conclusion: A theoretically grounded and evidence-informed rehabilitation resilience nursing intervention was successfully developed and validated. The protocol demonstrates strong content validity, clinical relevance, and feasibility, providing a robust foundation for subsequent feasibility testing and randomized controlled trials. This work addresses a critical gap in the literature by offering a transparent and systematic description of intervention development for resilience-based stroke rehabilitation.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-12"},"PeriodicalIF":2.5,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989079","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":"Differences in standing balance by level of upper extremity motor impairment after stroke.","authors":"Ana Mallo-López, Francisco Molina-Rueda, Teresa E Fernández-Pardo, Ángela Aguilera-Rubio, Alicia Cuesta-Gómez","doi":"10.1080/10749357.2026.2674870","DOIUrl":"https://doi.org/10.1080/10749357.2026.2674870","url":null,"abstract":"<p><strong>Background: </strong>Postural instability is a common and disabling consequence of stroke. Emerging evidence suggests that the upper extremities may also contribute to postural control - even during quiet stance.</p><p><strong>Objectives: </strong>To investigate whether varying levels of UE motor impairment are associated with distinct postural control profiles in individuals with chronic stroke.</p><p><strong>Methods: </strong>A cross-sectional observational study was conducted in outpatient neurorehabilitation centers. Sixty-five individuals with chronic stroke (mean age 56.77 ± 12.86 years; 56.92% male), all able to stand and walk independently, were included. Participants were stratified by upper extremity motor impairment severity using the Fugl-Meyer Assessment for the Upper Extremity (FMA-UE). Postural sway was evaluated with instrumented posturography employing a Wii Balance Board and open-source software. Center of pressure displacement and mean sway velocity were recorded under four sensory conditions. Clinical balance scales complemented the instrumented assessment.</p><p><strong>Results: </strong>Significant differences in mediolateral sway were found across severity groups in three of the four sensory conditions (<i>p</i> < 0.01), with the severe group showing greater sway than the mild group - particularly under the most challenging condition (eyes closed on foam: 3.05 cm, 95% CI: 1.40-4.70; <i>p</i> < 0.001). Regarding sway velocity, the severe group exhibited higher values than the severe-moderate group under reduced sensory input (e.g. eyes closed: mean difference = 1.11 cm/s; <i>p</i> = 0.016).</p><p><strong>Conclusions: </strong>Upper extremity motor impairment was associated with greater mediolateral instability during quiet standing in chronic stroke, supporting the clinical relevance of considering upper extremity function in balance-focused rehabilitation.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-10"},"PeriodicalIF":2.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975656","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 decreased paretic quadriceps muscle thickness in the acute phase of stroke and functional outcomes at 3 months.","authors":"Shota Tanaka, Kota Yamauchi, Yuri Hayashi, Eisei Harayama, Tokuaki Shinya, Shuji Arakawa","doi":"10.1080/10749357.2026.2675413","DOIUrl":"https://doi.org/10.1080/10749357.2026.2675413","url":null,"abstract":"<p><strong>Background: </strong>Skeletal muscle mass is important for functional recovery after stroke. The association between acute-phase longitudinal muscle loss and subsequent functional outcomes has not been fully elucidated.</p><p><strong>Objective: </strong>We examined whether early changes in paretic quadriceps muscle thickness are associated with functional outcomes at 3 months after acute stroke.</p><p><strong>Methods: </strong>This post-hoc analysis used data from a randomized controlled trial in patients with acute stroke. Forty-nine patients with acute stroke (National Institutes of Health Stroke Scale [NIHSS] ≥4) were included. Quadriceps muscle thickness was measured using ultrasound at admission and 2 weeks later. The percentage change in paretic quadriceps muscle thickness was used as the primary independent variable. Functional outcome at 3 months was assessed using the modified Rankin Scale and dichotomized as favorable (0-3) or poor (4-6). Modified Poisson regression analyses were performed, adjusting for age and admission NIHSS.</p><p><strong>Results: </strong>At 3 months, 23 (46.9%) and 26 patients (53.1%) had favorable and poor outcomes, respectively. Baseline paretic quadriceps muscle thickness did not differ between groups; however, the poor outcome group showed a greater reduction in muscle thickness over 2 weeks (-19.6% vs. -5.4%, <i>p</i> = 0.001). A greater reduction in paretic quadriceps muscle thickness was independently associated with poor functional outcomes (risk ratio, 0.977; 95% confidence interval, 0.961-0.994; <i>p</i> = 0.010). No significant association was observed for changes in non-paretic muscle thickness.</p><p><strong>Conclusions: </strong>Greater acute-phase reduction in paretic quadriceps muscle thickness was independently associated with poor functional outcomes at 3 months after stroke and may provide clinically useful information for early prognostic prediction.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-10"},"PeriodicalIF":2.5,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147960270","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":"Dynamic evaluation of claw toe using three-dimensional motion analysis.","authors":"Keita Aimoto, Daiki Shimotori, Jun Matsumura, Hirotaka Katayama, Kenichi Ozaki, Hitoshi Kagaya","doi":"10.1080/10749357.2026.2669755","DOIUrl":"https://doi.org/10.1080/10749357.2026.2669755","url":null,"abstract":"<p><strong>Background: </strong>Claw toe is a common spastic deformity of the lower limbs, but no objective analysis has been reported to date.</p><p><strong>Objectives: </strong>To establish a three-dimensional motion analysis method for toe movement in healthy individuals and in a patient with claw toe.</p><p><strong>Methods: </strong>Twenty healthy individuals and one patient with claw toe were included in this cross-sectional study. Infrared reflective markers were attached to II toe of each participant. In the standing position and using a handrail, participants performed four elevations of the lower limb. The proximal interphalangeal (PIP) joint and metacarpophalangeal (MTP) joint angles were measured during the elevations using five cameras. The patient with hemiplegia underwent botulinum toxin therapy three times, with joint angles assessed before and at 1 month after each injection.</p><p><strong>Results: </strong>No marker detachment occurred due to contact or other external factors, and all assessments were completed successfully. In healthy individuals, PIP and MTP joint angles showed no change during repeated lower limb elevations. In contrast, the patient with claw toe showed increased flexion at the PIP and MTP joints, with progressive PIP joint flexion with increasing number of repetitions, but the MTP joint angle was unchanged.</p><p><strong>Conclusion: </strong>Three-dimensional motion analysis enabled evaluation of toe motion and distinguished joint behavior between healthy individuals and a patient with claw toe, before and after botulinum toxin therapy.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-8"},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843231","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":"Caring beyond recovery: a phenomenological study of nursing roles and working conditions in stroke rehabilitation.","authors":"Nilgün Aras, Nurcan Çalışkan, Eda Gürçay, Emre Adıgüzel","doi":"10.1080/10749357.2026.2669756","DOIUrl":"https://doi.org/10.1080/10749357.2026.2669756","url":null,"abstract":"<p><strong>Background: </strong>Stroke rehabilitation requires a multidisciplinary approach, in which nurses contribute to the continuity and coordination of care. While their role is integral within the rehabilitation team, the experiential and contextual dimensions of nursing practice in stroke rehabilitation remain insufficiently explored.</p><p><strong>Objective: </strong>This study aimed to explore the lived experiences of nurses in stroke rehabilitation and to identify factors influencing their roles and working conditions.</p><p><strong>Methods: </strong>A qualitative study with a phenomenological orientation was conducted in two rehabilitation hospitals. Data were collected through face-to-face semi-structured interviews with 14 nurses. Data collection continued until sufficient depth and richness of the data were achieved. Interviews were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis supported by MAXQDA Analytics Pro 2024.</p><p><strong>Results: </strong>Three main themes were identified: (1) the integrative role, (2) everyday challenges, and (3) working conditions. Nursing practice was experienced as requiring continuous vigilance, emotional regulation, and ongoing negotiation between patient needs, safety, and organizational constraints.</p><p><strong>Conclusions: </strong>This study reconceptualizes nursing roles in stroke rehabilitation as integrative practices rather than task-based functions. The findings highlight the need for organizational strategies that better support nurses in managing complex clinical and emotional demands, which may enhance nurses' well-being and improve the quality of rehabilitation care.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-9"},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843160","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":"Amantadine use during acute hospitalization for neurological recovery after stroke: a systematic review.","authors":"Andrea Loggini, Faddi G Saleh Velez, Jonatan Hornik, Shawn S Wallery, Alejandro Hornik, Awni D Shahait","doi":"10.1080/10749357.2026.2670716","DOIUrl":"https://doi.org/10.1080/10749357.2026.2670716","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Disorders of consciousness and impaired neurological recovery are common during acute hospitalization for stroke, yet evidence-based pharmacologic strategies to enhance neurorecovery remain limited. Amantadine is frequently used off-label in this setting based on data from traumatic brain injury; however, evidence supporting its use in stroke is unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To systematically review the available literature evaluating the use of amantadine during acute hospitalization in adult patients with stroke.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420251273897). PubMed/MEDLINE, Embase, and Cochrane CENTRAL were searched for studies that included adults with stroke who received amantadine during acute hospitalization compared to standard care without amantadine, placebo, or within-cohort comparisons among amantadine-treated patients. Outcomes of interest included recovery of consciousness, neurological and functional outcomes, in-hospital mortality, and adverse events. Due to heterogeneity in study design, patient populations, and outcome measures, a quantitative meta-analysis was not performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seven studies involving a total of 929 patients were included, the majority with stroke, although one mixed non-traumatic brain injury cohort also included patients with status epilepticus (&lt;i&gt;n&lt;/i&gt; = 29) and bacterial meningitis (&lt;i&gt;n&lt;/i&gt; = 11). Amantadine was initiated during acute hospitalization, mostly in the intensive care unit, at doses of 100-200 mg twice daily. Across observational cohorts, 50-65% of patients responded to amantadine, defined as improvement in arousal or recovery of consciousness, with higher response rates observed in smaller cohorts. Amantadine exposure was also associated with earlier improvement in consciousness compared with no treatment. However, no consistent long-term functional effect or reduction in mortality was reported. Amantadine was generally well tolerated; reported adverse events included seizures (5-13%), agitation (6-14%), QTc prolongation (up to 8%), and sleep disruption (16%). No consistent safety signal attributable to amantadine was identified, although comparative safety data were limited. Risk of bias ranged from low to moderate across the included studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The evidence supporting amantadine use during acute hospitalization for stroke is limited and heterogeneous. While amantadine is commonly used to promote arousal in patients with impaired consciousness after stroke, available data do not allow firm conclusions regarding efficacy for functional recovery or mortality, and safety conclusions remain limited by inconsistent adverse-event reporting. Prospective, stroke-specific studies conducted in the acute hospital setting are needed to clarify the efficacy, optimal timing, and safety of amantad","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-10"},"PeriodicalIF":2.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843208","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 whole-body vibration exercise on lower limb spasticity for stroke survivors: a single-blind randomized controlled trial.","authors":"Yulin Dong, Ruirui Xing, Jiajia Yao, Yinhu Hu, Yan Qi, Wenxin Niu","doi":"10.1080/10749357.2026.2664222","DOIUrl":"https://doi.org/10.1080/10749357.2026.2664222","url":null,"abstract":"<p><strong>Background: </strong>Spasticity is a common condition among stroke survivors, and previous studies have explored the effects of whole-body vibration therapy for its benefits. However, the findings regarding lower limb spasticity remain inconsistent. Thus, the aim of this study was to determine the effect of eight-week whole-body vibration exercise on lower limb spasticity for stroke survivors.</p><p><strong>Methods: </strong>This is a single-blind randomized controlled trial. The 40 participants were eligible to participate the study and were allocated randomly to either an intervention group or control group. The intervention group implemented as 40 min of conventional therapy sessions and whole-body vibration training daily, five times a week for eight weeks; the control group implemented the same movements on a vibration platform without vibration with daily habitual living styles. The measurements were assessed at baseline, week four, and week eight. Primary outcomes were measured using the Modified Ashworth Scale and surface electromyography to measure spasticity. The Fugl-Meyer assessment was measured as a secondary outcome.</p><p><strong>Results: </strong>In the intervention group, spasticity of the triceps surae decreased by a mean of 0.45 points on the Modified Ashworth Scale from baseline to mid-intervention, and the same mean reduction was maintained at post-intervention. However, the statistical between-group differences were not observed at either mid-intervention or post-intervention. No significant between-group or within-group differences were observed in surface electromyography outcomes or Fugl-Meyer Assessment scores in either the intervention or control group.</p><p><strong>Conclusion: </strong>Whole-body vibration therapy may contribute to improvements in lower-limb spasticity in stroke survivors and demonstrates some moderate effect sizes. These findings suggest that whole-body vibration may have potential benefits as a long-term adjunct therapy in stroke rehabilitation.Trial registrationThe registration number is ChiCTR1900026439.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-11"},"PeriodicalIF":2.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821133","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 repetitive transcranial magnetic stimulation for post-stroke shoulder pain: a systematic review and meta-analysis.","authors":"Jiayang Qu, Hui Zhou, Qiaoqiao Wang, Jinkuo Pang, Suqin Zheng, Sijia Zhao, Jiangsu Zhang, Honghao Wei, Tianxiao Yang, Guohao Lin, Xuekang Niu","doi":"10.1080/10749357.2025.2571564","DOIUrl":"10.1080/10749357.2025.2571564","url":null,"abstract":"<p><strong>Background: </strong>Post-stroke shoulder pain (PSSP) is a common complication of stroke survivors, substantially impeding upper-limb functional recovery and diminishing quality of life. Conventional treatments usually target peripheral symptoms and only yield limited or transient benefits. Repetitive transcranial magnetic stimulation (rTMS) has shown analgesic potential in various neuropathic pain conditions, yet its efficacy in PSSP lacks systematic evaluation.</p><p><strong>Methods: </strong>Eight databases were systematically searched to identify randomized controlled trials evaluating rTMS interventions for PSSP. The primary outcome was pain intensity measured by the visual analog scale or numeric rating scale. Secondary outcomes included Fugl-Meyer Assessment, Modified Barthel Index, and shoulder range of motion. Risk assessment and data analysis were performed using Review Manager 5.4.1, with heterogeneity quantified by the I² statistic and subgroup analyses conducted to explore its potential sources.</p><p><strong>Results: </strong>12 RCTs involving over 500 participants met the inclusion criteria. Results revealed that rTMS significantly reduced pain intensity compared to control (WMD: -1.62; 95% CI: -2.00, -1.24; <i>p</i> < 0.00001). Additionally, rTMS significantly improved the FMA, MBI scores and shoulder ROM.</p><p><strong>Conclusion: </strong>rTMS appears to be a promising intervention for reducing PSSP and enhancing upper-limb motor function. These findings support incorporating rTMS into stroke rehabilitation protocols. In the future, high-quality, multi-center RCTs with extended follow-up are warranted to optimize stimulation parameters and validate long-term benefits.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"391-405"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252758","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":"Comparative effects of dynamic and static stretching on spasticity reduction in stroke patients using a robotic hand-wrist stretching device.","authors":"Shih-Chen Fan, Hsiao-Ping Chiu","doi":"10.1080/10749357.2025.2566134","DOIUrl":"10.1080/10749357.2025.2566134","url":null,"abstract":"<p><strong>Background: </strong>Spasticity is a common consequence of upper motor neuron syndrome, affecting approximately 42.6% of stroke patients and impairing quality of life. Although stretching is widely used, the optimal type and parameters remain unclear.</p><p><strong>Objective: </strong>This study investigates the immediate effects of dynamic and static stretching on spasticity reduction and motor function improvement in stroke patients using a robotic hand-wrist stretching device (RHWSD).</p><p><strong>Methods: </strong>This study was a randomized crossover trial with double-blind design. Thirty-one stroke patients with wrist flexor spasticity were randomly assigned to three RHWSD stretching protocols: 30° dynamic stretching (30° DS), 60° static stretching (60° SS), and 60° dynamic stretching (60° DS). Each protocol involved a 3-minute session with 20-minute rest intervals. Wrist flexor spasticity was assessed with the Modified Ashworth Scale (MAS). Active range of motion (AROM) and passive range of motion (PROM) of wrist extension and finger metacarpophalangeal (MP) extension, were measured at baseline and after each session.</p><p><strong>Results: </strong>Significant reductions in MAS scores were observed with both dynamic stretching protocols (30° DS: 2.45 ± 0.72; 60° DS: 2.48 ± 0.63) compared to static stretching (60° SS: 2.94 ± 0.51; <i>p</i> < .000). Both dynamic protocols yielded significantly greater gains in AROM and PROM for wrist and finger MP extension than static stretching (all <i>p</i> < .001).</p><p><strong>Conclusions: </strong>Dynamic stretching is more effective at reducing spasticity in stroke patients. A stretching angle of 80% of the normal range (60°) is sufficient to achieve significant improvements in ROM. The RHWSD was effective in providing consistent stretching.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"428-439"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138944","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":"Role of tDCS plus virtual reality in enhancing cognitive function in patients with chronic stroke: a quasi-randomized clinical trial.","authors":"R De Luca, A Gangemi, R A Fabio, M G Maggio, M Bonanno, C Rifici, D Di Ciuccio, F Corallo, C Mento, M R A Muscatello, A Quartarone, R S Calabro'","doi":"10.1080/10749357.2025.2563227","DOIUrl":"10.1080/10749357.2025.2563227","url":null,"abstract":"<p><strong>Background: </strong>Alone or combined with other advanced rehabilitative treatments , non-invasive transcranial direct current stimulation (tDCS) is a promising tool to augment neuroplasticity as well as improve cognitive function post stroke.</p><p><strong>Objective: </strong>To investigate the psychological and neurophysiological effects of tDCS application combined with cognitive virtual reality training (VRT) in patients with chronic ischemic stroke.</p><p><strong>Material and methods: </strong>Twenty subjects were enrolled in this quasi-randomized pilot study and assigned to the experimental (EG) or control groups (CG). The EG received VRT combined with tDCS, while the CG received the VRT with sham-tDCS, five times a week for 4 weeks. Each patient was evaluated using a psychometric battery, including Mini Mental State Examination (MMSE), Hamilton Rating Scale (HRS-D), and Frontal Assessment Battery (FAB), at the beginning (T0) and the end (T1) of the study. Additionally, a neurophysiology technician measured the brain electrical activity through event-related potential P300.</p><p><strong>Results: </strong>A significant improvement in MMSE scores from T0 to T1 was observed in the EG. A significant improvement in FAB scores was observed over time (i.e. at the intragroup analysis), with greater gains in the group receiving active tDCS. On the contrary, both groups showed a significant reduction in depressive symptoms scores over time. A key finding of the study was the enhancement of cognitive processing speed, as indicated by reduced P300 latency, in the EG.</p><p><strong>Conclusions: </strong>This study suggests that tDCS may potentiate the effects of VR by promoting neuroplasticity and improving the efficiency of cognitive networks, ultimately contributing to better recovery outcomes in patients with stroke.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"351-363"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233429","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}