Journal of Neurologic Physical Therapy最新文献

{"title":"Therapeutic Benefits of Robot-Assisted Gait Training in Individuals With Spinal Cord Injury: A Systematic Review and Meta-Analysis.","authors":"Yi-Ting Sun, Xiao-Na Xiang, Jia-Lei Peng, Yan Liu, Jiang-Yin Zhang, Hong-Chen He","doi":"10.1097/NPT.0000000000000570","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000570","url":null,"abstract":"<p><strong>Background and purpose: </strong>To assess the efficacy of robot-assisted gait training (RAGT) in individuals with spinal cord injury, with a focus on motor function, quality of life (QoL), activities of daily living (ADL), cardiopulmonary function, psychological function, and bowel function.</p><p><strong>Methods: </strong>Seven databases were searched from inception to March 26, 2025. The risk of bias and evidence certainty (The Grading of Recommendations Assessment, Development and Evaluation) were assessed. Effect sizes were reported as mean differences (MDs) or standardized mean differences (SMDs). Subgroup analyses were performed based on injury severity (The American Spinal Injury Association), exoskeleton type, intervention duration, and duration of injury (DOI).</p><p><strong>Results: </strong>In total, 37 studies met eligibility criteria, with 30 included in the meta-analysis. The results demonstrated that RAGT significantly improved walking ability (SMD, 0.58; 95 % confidence interval [CI], 0.28-0.87; moderate certainty), muscle strength (MD, 1.81; 95% CI, 0.48-3.14; moderate certainty), QoL (SMD, 0.43; 95% CI, 0.02-0.85; low certainty), and ADL (SMD, 0.28; 95% CI, 0.11-0.45; moderate certainty) compared with control interventions. However, control interventions were superior in reducing muscle tone (MD, 0.23; 95% CI, 0.01-0.46; low certainty). No significant differences were observed in balance, psychological function, or cardiopulmonary function. Subgroup analysis revealed that both intervention duration and DOI moderated effects.</p><p><strong>Discussion and conclusions: </strong>RAGT may effectively enhance walking ability, muscle strength, QoL, and ADL for spinal cord injury, while its benefits may be influenced by intervention duration and DOI. RAGT suggests potential superiority for muscle strength gains in protocols exceeding 8 weeks and balance recovery in subacute stages, whereas control interventions may be more effective for reducing muscle tone.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Movement Through Time: The Evolution of Treatment for People with Parkinson Disease.","authors":"Terry Ellis","doi":"10.1097/NPT.0000000000000566","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000566","url":null,"abstract":"<p><p>Parkinson disease (PD) is the fastest-growing neurological disorder worldwide, projected to affect approximately 25 million people by 2050. Despite effective pharmacologic management of motor symptoms, patients consistently identify walking, mobility, and balance as their greatest challenges. This Special Interest paper, based on the 2026 Anne Shumway-Cook Lectureship, summarizes a program of research aimed at building the evidence base for rehabilitation in PD and translating that evidence into improved real-world outcomes. Four interrelated themes are addressed: (1) the historical development of the evidence base, from 11 randomized controlled trials in 2001 to more than 240 today; (2) the capacity-performance gap and the importance of targeting real-world walking, not only clinic-based function; (3) complementary intervention approaches, including cognitive-behavioral strategies, closed-loop rhythmic auditory stimulation, and soft-robotic assistance for freezing of gait, that address psychological, neural, and biomechanical barriers to everyday mobility; and (4) a proposed secondary-prevention model of care that initiates rehabilitation at diagnosis and sustains it longitudinally. Taken together, this body of work argues for a fundamental restructuring of physical therapy for people with PD: from a reactive, late-stage response to a proactive, lifelong strategy that reduces disability, preserves independence, and improves healthspan.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ongoing Revision of Balance Dysfunction Diagnoses: Pilot Survey of Clinical Physical Therapists.","authors":"Lois D Hedman, Kathleen M Gill-Body, Laura Plummer, Leslie Wolf, Laura Doyle, Lina Kleinschmidt","doi":"10.1097/NPT.0000000000000540","DOIUrl":"10.1097/NPT.0000000000000540","url":null,"abstract":"<p><strong>Background and purpose: </strong>The American Physical Therapy Association's (APTA) vision of transforming society by optimizing movement to improve the human experience must include a reduction in the unwarranted variation in physical therapist practice. The APTA proposed that the profession adopt the movement system as a basis for developing diagnoses to classify movement dysfunction so that treatment is more consistent and specific. In 2021, the Academy of Neurologic Physical Therapy Movement System Diagnosis Task Force developed 10 movement system diagnoses for balance dysfunction, a diagnostic process, and recommended intervention strategies. The purpose of this special interest paper is to report on the ongoing refinement of the balance diagnoses and the diagnostic process based on a pilot survey of practicing clinicians and colleagues' informal feedback.</p><p><strong>Summary of key points: </strong>Pilot survey participants largely agreed on the clarity of the definitions, the accuracy of the key movement observations, and appropriateness of the key findings from tests and measures, but not the mutual exclusivity of the balance diagnoses. Using an iterative process, the authors considered the feedback to arrive at a consensus to address these concerns. The result is an updated set of 12 balance diagnoses, revision of some key definitions, a refined diagnostic process, and an updated summary of the evidence for task-specific balance-related interventions. These updated diagnoses and diagnostic processes must be examined for mutual exclusivity, validity, and reliability prior to clinical adoption.</p><p><strong>Recommendations for clinical practice: </strong>Until the balance diagnoses are shown to be mutually exclusive, valid, and reliable, we recommend that clinicians conceptualize balance control dysfunction using the well-established postural control strategies and apply well-supported principles of task-specific interventions when managing individuals with balance dysfunction.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"108-118"},"PeriodicalIF":4.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Trans-spinal Direct Current Stimulation on Gait Function in People With Multiple Sclerosis.","authors":"Gülser Cinbaz, Zübeyir Sarı, Semra Oğuz, Lütfü Hanoğlu, Juan Jose Fernández-Pérez, Julio Gómez-Soriano","doi":"10.1097/NPT.0000000000000534","DOIUrl":"10.1097/NPT.0000000000000534","url":null,"abstract":"<p><strong>Background and purpose: </strong>Multiple sclerosis (MS) presents significant challenges due to its inflammatory and degenerative nature, often manifesting in debilitating symptoms such as gait disturbances. Non-invasive stimulation techniques, such as trans-spinal direct current stimulation (tsDCS), offer promising avenues for enhancing functional recovery, but evidence on tsDCS effectiveness in neurological disorders remains sparse. This study aimed to investigate the effects of cathodal tsDCS on gait function and fatigue in people with MS (pwMS) compared to sham tsDCS.</p><p><strong>Methods: </strong>Twenty-two pwMS received 6 sessions of 20-minute cathodal tsDCS (n = 11) or sham tsDCS (n = 11) in addition to a physiotherapy program. The primary outcomes were the Timed 25-Foot Walk (T25-FW), Timed Up and Go test (TUG), gait speed, and the Multiple Sclerosis Walking Scale-12 (MSWS-12) evaluated before and after treatment. The secondary outcome was fatigue, measured with the Fatigue Severity Scale (FSS) and Fatigue Impact Scale (FIS).</p><p><strong>Results: </strong>Intergroup comparisons showed a significant improvement in the cathodal tsDCS group compared to the sham tsDCS group. Specifically, there was a greater reduction in pre-post values for T25-FW (Median: -4.43; Range: -12.1 to -1.0), MSWS-12 (-16.70; -31.7 to -5.0), TUG (-6.03; -20.8 to -0.7), FSS (-0.30; -2.2 to 0.1), and FIS-Physical (-4.00; -13.0 to 0.0). Additionally, walking speed increased significantly (0.15; 0.02 to 0.24) in the cathodal tsDCS group. Moreover, all gait-related outcomes and FSS showed large effect sizes ( r > 0.5), indicating a strong intervention effect.</p><p><strong>Discussion and conclusions: </strong>Incorporating cathodal tsDCS into a physiotherapy program improved walking function and fatigue in pwMS. Although replication is warranted, these results hold promise for clinical applications, highlighting tsDCS as a potential tool for enhancing motor function and reducing fatigue in pwMS.</p><p><strong>Video abstract available: </strong>for more insights from the authors (see Supplemental Digital Content available at http://links.lww.com/JNPT/A542 ).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"70-78"},"PeriodicalIF":4.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Neurological Physiotherapy Association, World Physiotherapy Congress Top Abstracts 2025.","authors":"","doi":"10.1097/NPT.0000000000000552","DOIUrl":"10.1097/NPT.0000000000000552","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"119-120"},"PeriodicalIF":4.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining Loneliness in People With Parkinson Disease Participating in Community-based Exercise.","authors":"L A Swink, D Diprinzio, J Brown, D Novak, C L Christiansen, M M Mañago","doi":"10.1097/NPT.0000000000000532","DOIUrl":"10.1097/NPT.0000000000000532","url":null,"abstract":"<p><strong>Background and purpose: </strong>This study determined the prevalence of loneliness in a regional community-based exercise class program for people with Parkinson disease (PwPD) and examined relationships with demographic characteristics, functional independence, functional mobility, and quality of life (QOL).</p><p><strong>Methods: </strong>This study was a cross-sectional analysis of 231 PwPD, all of whom were participating in community-based exercise class programs. Participants completed questionnaires on loneliness (UCLA 3-Item Loneliness Scale [UTILS]), functional independence (Schwab & England Scale), performance-based measures of functional mobility (Timed Up & Go, 10 Meter Walk Test, 30 Second Sit-to-Stand), and QOL (Parkinson's Disease Questionnaire-8). UTILS scores of ≤ 4 were classified as \"non-lonely,\" and scores > 4 were classified as \"lonely.\"</p><p><strong>Results: </strong>Participants were, on average, 71.9 (±7.5) years old, 5.4 (±5.4) years since their Parkinson disease diagnosis, had been participating in group exercise classes for 2.3 (±2.4) years, and almost one-third of participants ( n = 76/231, 32.9%) scored in the \"lonely\" range on the UTILS. There were significant differences between the lonely and non-lonely groups in sex distribution, functional independence, Timed Up & Go, and QOL. Age, functional independence, and loneliness scores accounted for 55.8% of the variance in QOL scores.</p><p><strong>Discussion and conclusion: </strong>In this study, loneliness was present even in PwPD actively engaged with an exercise community. Loneliness among PwPD was also related to functional independence, functional mobility, and QOL. While further study is needed, having rehabilitation clinicians and exercise class instructors screen for loneliness in PwPD may help inform plans of care and recommendations to address loneliness.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"88-95"},"PeriodicalIF":4.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Predictive Validity of Fall-Risk Screening Assessments in Subacute Stroke.","authors":"Prudence Plummer, Megan E Schliep, Ehsan Sinaei, Lina Jallad, Meaghan Costello, Vicki S Mercer, Jody A Feld, Liraz Arie","doi":"10.1097/NPT.0000000000000544","DOIUrl":"10.1097/NPT.0000000000000544","url":null,"abstract":"<p><strong>Background and purpose: </strong>Poststroke fall prevention is hindered by inaccurate prediction of imminent fallers. We compared the predictive validity of the Berg Balance Scale (BBS), Functional Gait Assessment (FGA), 10-m gait speed, and a novel, step test + obstacle test (STOB) in subacute stroke.</p><p><strong>Methods: </strong>A total of 64 ambulatory stroke survivors discharging home from inpatient rehabilitation completed all tests before discharge. Falls were tracked prospectively for 3 months. Logistic regression estimated the odds of being a faller with a failed test. Sensitivity, specificity, likelihood ratios, area under the curve, accuracy, and posttest probabilities for classifying fall status for each test were calculated using existing and optimized cutoffs.</p><p><strong>Results: </strong>Twenty participants (31.3%) were fallers at 3 months. STOB had the best overall model fit with odds ratio 8.0 (95% CI 2.4-26.8). FGA ≤13 had the highest sensitivity of all tests (0.85), and gait speed ≤0.47 m/s had the highest specificity (0.89). A combination of positive tests for 10-m gait speed (≤0.47 m/s), STOB (≥3), FGA (≤13), and BBS (≤43) generated a cumulative diagnostic posttest probability of future falls of 94.5%.</p><p><strong>Discussion and conclusions: </strong>No single test emerged with strong discriminative power for predicting future falls at discharge from inpatient rehabilitation for stroke, but a combination of gait speed, STOB, and FGA may enhance prognostic decision-making accuracy.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":"50 2","pages":"63-69"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural and Functional Changes With 8 Weeks of Backward Walking Training in Multiple Sclerosis: A Case Series: Erratum.","authors":"Maryam M Abbawi, Michael VanNostrand, Patrick G Monaghan, Taylor N Takla, Biaohua Yu, Ana M Daugherty, Jeffrey A Stanley, Nora E Fritz","doi":"10.1097/NPT.0000000000000549","DOIUrl":"10.1097/NPT.0000000000000549","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"120"},"PeriodicalIF":4.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognizing the Most Outstanding 2025 Article Published in JNPT.","authors":"","doi":"10.1097/NPT.0000000000000548","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000548","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":"50 2","pages":"95"},"PeriodicalIF":4.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving the Movement System Forward in Neurologic Physical Therapy.","authors":"Nora E Fritz, Jill C Stewart","doi":"10.1097/NPT.0000000000000551","DOIUrl":"10.1097/NPT.0000000000000551","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"61-62"},"PeriodicalIF":4.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}