Frontiers in rehabilitation sciences最新文献

{"title":"Persistent refractory hypercapnia following tracheostomy decannulation in a patient with brainstem hemorrhage: a case report.","authors":"Yunhong Deng, Fuqiang Wang, Yaojiang Li, Dongzhen Xue, Jinfeng Liang, Hanbo Chen, Wenying Xie, Bizhou Fu, Man Hao","doi":"10.3389/fresc.2026.1874164","DOIUrl":"10.3389/fresc.2026.1874164","url":null,"abstract":"<p><strong>Background: </strong>In tracheostomy decannulation decisions for patients with brainstem injury, clinicians typically focus on airway patency, swallowing, and overall respiratory status. However, some patients may remain at risk of chronic hypoventilation after decannulation because of impaired central ventilatory drive and other concomitant factors, even when anatomical airway patency has been restored.</p><p><strong>Case presentation: </strong>An elderly male with brainstem hemorrhage underwent decannulation after excision of granulation tissue in January 2024, with no immediate complications. During follow-up, he developed persistent carbon dioxide (CO₂) retention and was readmitted nine times for hypercapnic respiratory failure over the subsequent 19 months, with a peak arterial partial pressure of carbon dioxide of 172 mmHg. Despite repeated medical therapy and noninvasive ventilation, long-term ventilatory stability was not achieved, and a repeat tracheostomy was performed in August 2025.</p><p><strong>Conclusions: </strong>This case suggests that decannulation in brainstem-injury patients can be followed by a prolonged compensated phase-chronic compensated hypercapnia was clinically well tolerated for 19 months in this patient-before late, event-triggered decompensation. FEES performed during follow-up confirmed bilateral vocal cord paralysis with severe (penetration-aspiration scale level 7) aspiration, identifying a more direct mechanism for recurrent pneumonia and progressive ventilatory load than central drive impairment alone. The pre-decannulation PaCO₂ was normal, confirming that central ventilatory drive was sufficient at the time of decannulation; chronic compensated hypercapnia is not, in itself, an indication for recannulation. Longitudinal assessment of ventilatory stability is warranted, and the clinical course was likely multifactorial. Pre-decannulation FEES or flexible laryngoscopy should be considered in every brainstem-injury patient-not only those with documented dysphagia-and post-decannulation CO₂ monitoring should be targeted to selected high-risk patients in whom the results would alter management.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1874164"},"PeriodicalIF":2.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of transcutaneous electrical nerve stimulation based on wrist-ankle acupuncture theory on the skeletal muscle repair and gut microbiota modulation in rats with gastrocnemius muscle injury.","authors":"Haobin Cheng, Tingting Mai, Kai Chen, Mengcheng Cai, Fanfu Fang","doi":"10.3389/fresc.2026.1742110","DOIUrl":"10.3389/fresc.2026.1742110","url":null,"abstract":"<p><strong>Background: </strong>In recent years, the gut microbiota has attracted considerable attention as a critical regulator of inflammation and metabolism, particularly due to its involvement in muscle repair via the \"gut-muscle axis.\" This study aims to evaluate the therapeutic efficacy of transcutaneous electrical nerve stimulation based on wrist-ankle acupuncture theory (WAA-TENS) in a rat model of gastrocnemius muscle injury, and subsequently to explore whether its effects are associated with alterations in the gut microbiota.</p><p><strong>Methods: </strong>Twenty-four 8-week-old rats were randomly allocated to three groups (<i>n</i> = 8 per group): a control group (CON), a model group (MOD), and a WAA-TENS group. The CON group received intramuscular saline, whereas gastrocnemius injury induced by complete Freund's adjuvant (CFA) was established in the MOD and WAA-TENS groups; the latter received WAA-TENS. Mechanical pain threshold, local cytokines, and histological outcomes were assessed, and fecal samples were analyzed by 16S rRNA gene sequencing.</p><p><strong>Results: </strong>Behavioral studies indicated that WAA-TENS significantly increased the pain threshold of model rats (<i>p</i> < 0.001). Histological analysis revealed that the degree of inflammatory cell infiltration in the WAA-TENS group was less than that in the MOD group, and the degree of fibrosis was significantly lower than that in the MOD group. Bacterial diversity analysis indicated that the microbiota structure in the MOD group did not differ significantly from that in the CON group, suggesting that CFA-induced local muscle injury alone may be insufficient to induce systemic gut dysbiosis under the present experimental conditions. Notably, WAA-TENS significantly altered the microbiota structure (characterized by a significant decrease in evenness and an increase in the abundance of Lactobacillus), suggesting that WAA-TENS may exert distinct modulatory effects on the intestinal microenvironment independent of the injury-induced response.</p><p><strong>Conclusion: </strong>WAA-TENS effectively alleviated mechanical allodynia, attenuated local inflammation, and promoted muscle repair in a rat model of CFA-induced gastrocnemius injury. Concurrently, WAA-TENS was associated with significant alterations in gut microbiota composition, including the enrichment of Lactobacillus reuteri. These parallel findings suggest a potential association between WAA-TENS-induced microbiota modulation and its therapeutic effects on skeletal muscle, providing a hypothesis-generating foundation for future mechanistic investigations into the gut-muscle axis. The causal contribution of specific microbial taxa to muscle repair, however, remains to be established.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1742110"},"PeriodicalIF":2.5,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and safety of multi-field functional electrical stimulation for distal upper-limb rehabilitation after subacute stroke: a randomised controlled feasibility trial.","authors":"Silvia Guillén-Climent, Pablo Casado-Adam, Manuela Mejías-Ruiz, Aitor Martín-Odriozola, Cristina Rodríguez-de-Pablo, Inmaculada Salcedo-Leal, Esmeralda Sillero-Ruz, María Dolores Morente-Navajas, Manuel Flores-Lara, José Peña-Amaro, Fernando Jesús Mayordomo-Riera","doi":"10.3389/fresc.2026.1920617","DOIUrl":"10.3389/fresc.2026.1920617","url":null,"abstract":"<p><strong>Background: </strong>Functional electrical stimulation (FES) is recommended for upper-limb rehabilitation after stroke but remains underused in routine clinical practice. Multi-field FES may simplify clinical application and improve selective muscle activation, although evidence generated under real-world rehabilitation conditions remains limited.</p><p><strong>Objective: </strong>To assess the feasibility, usability, and safety of multi-field FES for distal upper-limb rehabilitation after subacute stroke and to generate preliminary effect estimates to inform a future definitive trial.</p><p><strong>Methods: </strong>We conducted a single-centre, parallel-group, randomised controlled feasibility trial with blinded outcome assessment. Sixteen adults with subacute stroke (≤6 months) and unilateral upper-limb impairment were randomised 1:1 to FES-assisted therapy or conventional rehabilitation (<i>n</i> = 8 per group). Both groups received two 40-minute upper-limb therapy sessions per week for 6 weeks (12 sessions); the experimental group received treatment using the Fesia Grasp multi-field stimulation device. Primary outcomes were retention, adherence, usability, motivation, and safety. Secondary exploratory outcomes included the Fugl-Meyer Assessment for Upper Extremity, modified Medical Research Council scale, grip strength, and Box and Block Test, assessed at baseline and post-intervention by blinded evaluators.</p><p><strong>Results: </strong>Of 20 participants screened between April 2022 and August 2023, 16 were recruited and randomised (8 per group) and received 12 sessions of 40 minutes over 6 weeks. All participants completed the study, resulting in 100% retention and adherence (16/16; 95% CI 79.4-100% for both outcomes). In the FES group, usability and motivation scores were high, indicating good acceptability of the intervention. Two FES participants experienced minor, transient skin erythema after electrode application; no serious adverse events were observed. Exploratory analyses yielded point estimates that favoured the FES group for distal upper-limb motor outcomes; however, confidence intervals were wide and findings should not be interpreted as evidence of clinical efficacy.</p><p><strong>Conclusion: </strong>Multi-field FES for distal upper-limb rehabilitation after subacute stroke was feasible and well accepted in routine clinical practice, with no serious adverse events observed. These findings provide preliminary data to support the design of future adequately powered efficacy trials.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/study/NCT04992910, identifier: NCT04992910.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1920617"},"PeriodicalIF":2.5,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of performance-based tests in the assessment of patients with fibromyalgia: a construct validity and comprehensiveness analysis of a standardized test battery.","authors":"José Luis Socorro-Cumplido, Joaquim Chaler, Miriam Almirall, Judith Sánchez-Raya, Josep Blanch-Rubió, Maria José Castro, Maria Giné-Garriga, Patricia Launois, Tamara Rodríguez-Araya, Anna Arias Gassol, Geert Crombez, Raimon Milà Villarroel, Blanca Roman-Viñas","doi":"10.3389/fresc.2026.1947752","DOIUrl":"https://doi.org/10.3389/fresc.2026.1947752","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Comprehensive assessment of functioning in fibromyalgia (FM) requires the integration of objective and subjective outcome measures. Although performance-based tests (PBTs) are increasingly recommended for evaluating physical function, evidence supporting their construct validity within a standardized multidimensional assessment framework remains limited. Furthermore, the complementary contribution of accelerometer-derived physical activity measures has not been fully established.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the construct validity and comprehensiveness of a standardized assessment battery integrating PBTs, patient-reported outcome measures (PROMs), and accelerometer-derived physical activity measures in women with FM within an International Classification of Functioning, Disability and Health (ICF)-based framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cross-sectional study included 87 women with FM recruited from four tertiary hospitals. Participants completed four PBTs (6-minute walk test, handgrip strength test, 8 foot up and go test, and Berg Balance Scale), accelerometer-based physical activity assessment, and validated Spanish PROMs assessing physical functioning, emotional distress, and pain impact and symptom burden. Construct validity was evaluated by testing predefined hypotheses for convergent and discriminant validity using Spearman correlations. Exploratory factor analysis (EFA) was conducted to examine the latent multidimensional structure of the proposed assessment framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The EFA identified four latent constructs corresponding to physical functioning, activity behavior, emotional distress, and pain impact and symptom burden, explaining 67.1% of the total variance. The physical functioning construct accounted for the largest proportion of explained variance (22.6%), followed by activity behavior (18.6%), emotional distress (13.3%), and pain impact and symptom burden (12.7%). Correlation analyses supported the predefined hypotheses, demonstrating moderate to strong within domain associations and generally weak to moderate between domain correlations, confirming both convergent and discriminant validity. ICF mapping showed that the proposed battery provided broad coverage of key body functions and activity domains, while accelerometer-derived variables emerged as an independent construct, supporting their complementary value beyond PBTs and PROMs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The proposed standardized assessment battery demonstrates strong construct validity and provides a comprehensive ICF-based evaluation of functioning in women with FM. The combination of PBTs, accelerometry, and PROMs offers a multidimensional characterization of functioning that may improve functional assessment, individualized rehabilitation planning, and treatment monitoring.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical trial registration: &lt;/strong&gt;https://clinicaltrials.gov/study/NCT06819930, ide","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1947752"},"PeriodicalIF":2.5,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-cost pulmonary rehabilitation for chronic respiratory diseases: a narrative review.","authors":"Else Saliés Fonseca, Marcelo Velloso, Marcelo Couto Jorge Rodrigues, Karla Medeiros Costa, Claudio Andre Barbosa de Lira, Ana Luiza Lima Sousa, Natasha Yumi Matsunaga Spicacci, Gustavo De Conti Teixeira Costa","doi":"10.3389/fresc.2026.1706188","DOIUrl":"10.3389/fresc.2026.1706188","url":null,"abstract":"<p><p>Pulmonary rehabilitation (PR) is a cornerstone in the management of chronic respiratory diseases (CRD), but access remains severely limited in low- and middle-income countries (LMICs) because of cost, infrastructure, and workforce barriers. This mini narrative review synthesized evidence on the effectiveness, feasibility, and implementation of low-cost PR strategies designed with minimal equipment and simplified delivery models. Low-cost PR was considered not only as exercise training using minimal or improvised equipment, but as a context-adapted rehabilitation model that preserves essential PR components while adapting to local health-system, workforce, cultural, and socioeconomic constraints. Searches were conducted in PubMed, Scopus, Web of Science, and SciELO (2014-2024); twenty publications were included, comprising randomized controlled trials, quasi-experimental studies, systematic reviews, clinical guidelines, and implementation research. Across studies, low-cost PR consistently improved exercise capacity, symptoms, and health-related quality of life, measured by 6MWT, ISWT, SGRQ, and CAT. Home-based and community programs demonstrated feasibility and safety, often comparable to conventional PR; supervision and structured education enhanced adherence, while properly instructed unsupervised programs also showed non-inferior outcomes. Tai Chi and Nordic walking emerged as culturally adaptable, low-cost alternatives. However, evidence remains heterogeneous and predominantly COPD-focused, with limited data for other CRD and few studies in primary healthcare, restricting generalizability to the broader CRD burden in LMICs. Effective scale-up requires attention to workforce availability, primary healthcare integration, contextual barriers to home-based rehabilitation, digital accessibility, education, equity, and long-term sustainability. Further high-quality trials and implementation studies are needed to consolidate evidence and inform policies that integrate context-adapted, affordable PR into healthcare systems.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1706188"},"PeriodicalIF":2.5,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline PTSD and depressive symptoms predict multidimensional recovery after combat-related transtibial amputation: a prospective cohort study.","authors":"Iryna Halabitska, Iryna Kamyshna, Mykhailo Buchynskyi, Pavlo Petakh, Oleksandr Kamyshnyi","doi":"10.3389/fresc.2026.1891994","DOIUrl":"10.3389/fresc.2026.1891994","url":null,"abstract":"<p><strong>Introduction: </strong>Posttraumatic stress disorder (PTSD) is common among combat-injured service members. To date, there is insufficient evidence to determine whether the initial severity of psychiatric disorders is associated with the dynamics of motor recovery after lower limb amputation. The aim of the study was to assess whether the severity of PTSD and depressive symptoms at the time of hospitalization affect the outcomes of intensive robotic neurorehabilitation after combat-related unilateral transtibial amputation.</p><p><strong>Methods: </strong>A prospective cohort study included 45 male service members with unilateral transtibial amputations who underwent a standardized robotic neurorehabilitation program for the lower limbs. The examinations were performed at four time points: on days 0, 14, 30, and 120. 46 indicators were evaluated, including stabilometric posturography (Stabiloplatforma Alfa), instrumental gait analysis (OMEGO, STRIDE ONE, BALO), clinical functional tests (BBS, TUG, FRT, AMPPRO, FSST, 10MWT, 2MWT, 6MWT, ABC), pain intensity (VAS), as well as psychiatric scales PCL-5 and PHQ-9. Statistical analyses included longitudinal mixed-effects modeling, multivariable regression, and exploratory machine-learning approaches.</p><p><strong>Results: </strong>The study found that the level of PTSD and depression at the beginning of rehabilitation was associated with functional recovery after combat transtibial amputation. 37.8% of participants recorded a clinically significant improvement according to the combined criterion. Psychiatric scales (PCL-5 and PHQ-9) showed moderate predictive ability for rehabilitation response (AUC = 0.80). The PCL-5, PHQ-9, VAS, and baseline functional indicators (BBS and TUG) had the greatest contribution to prediction. The probability of a positive response to treatment decreased with higher PCL-5 values. Cluster analysis identified two types of patients: with high psychiatric burden and worse recovery and with lower burden and better outcomes.</p><p><strong>Conclusions: </strong>The results suggest that psychiatric status at the beginning of rehabilitation may be an important factor associated with functional recovery after amputation. Screening for PTSD and depression may help predict rehabilitation outcomes. However, these findings need to be confirmed in larger studies. It is also worthwhile to examine whether early psychiatric intervention can improve rehabilitation outcomes.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1891994"},"PeriodicalIF":2.5,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel assessment of self-perceptions of recovery from illness and injury in U.S. Navy service members.","authors":"Lisa M Hernández, Nikita R Tovey, Anu Venkatesh, Kristin J Heaton, Justin S Campbell, Jessica M Hru, Marcus K Taylor","doi":"10.3389/fresc.2026.1846239","DOIUrl":"https://doi.org/10.3389/fresc.2026.1846239","url":null,"abstract":"<p><strong>Objective: </strong>There is no measure that assesses self-perceptions of recovery in service members. This report describes the development and validation of the Military Illness and Injury Recovery Scale-17 (MIIRS-17) in a sample of active duty personnel.</p><p><strong>Methods and measures: </strong>Participants (<i>N</i> = 182) were U.S. Navy aircrew who responded to a survey including 19 candidate scale items and measures of theoretically relevant correlates (e.g., pain). Factor structure of the scale was explored with principal components analysis. Convergent validity was established with bivariate associations between selected correlates, total recovery, and subscales. A multiple linear regression model was used to explore the contributions of each predictor (e.g., fatigue) for total recovery. Models were age-adjusted, as applicable.</p><p><strong>Results: </strong>The final 17-item scale was highly consistent with four subscales, which we termed immune recovery, musculoskeletal injury recovery, physical recovery, and rehabilitation response. Total recovery and relevant correlates were related in the expected directions. In the combined model, eight predictors and age explained 39.6% of variance in total recovery. Sleep disruption, resilience, and age, independently contributed to total recovery.</p><p><strong>Conclusion: </strong>Our preliminary results indicate that the MIIRS-17 is a valid and reliable instrument for assessing self-perceptions of recovery in military members.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1846239"},"PeriodicalIF":2.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Institutionalization of assistive health technology in India: establishment of a national centre within the IIT-AIIMS ecosystem.","authors":"Sunanda Deb, Rinila Das, Ravinder Singh","doi":"10.3389/fresc.2026.1879168","DOIUrl":"10.3389/fresc.2026.1879168","url":null,"abstract":"<p><strong>Background: </strong>Assistive technology (AT) is now recognised as a major element of universal health coverage and rehabilitation systems. Over 2.5 billion individuals around the world need at least one assistive product and this number is expected to increase significantly by 2050. Despite international guidance through the World Health Organization Global Cooperation on Assistive Technology (GATE) and Rehabilitation 2030 initiatives, many low- and middle-income countries (LMICs) lack institutional mechanisms to integrate AT into mainstream public health systems. In India AT provision has historically been fragmented and welfare-orientated.</p><p><strong>Objective: </strong>This paper provides a detail of the development of AT systems in India which subsequently led to the institutional development, governance architecture, and functional design of the National Centre of Assistive Health Technology (NCAHT) in India and discusses its potential implications for strengthening AT systems and policy implementation.</p><p><strong>Methods: </strong>This paper employs a process-based institutional case study design. It explains the original institutional process undertaken by ICMR to establish NCAHT between 2017 and 2023. Primary data comprised ICMR concept notes, expert committee minutes, inter-ministerial consultation records, and formal institutional proposals generated during the establishment process.</p><p><strong>Evolution of ncaht: </strong>India participation in WHO-GATE initiative and international rehabilitation system alignment offered a preparatory strategy that resulted in the NCAHT, 2022 in India. NCAHT is a project funded by the ICMR, and operates as a collaboration between the AlIMS Delhi & IIT Delhi. The Centre operates at the national and international levels in line with WHO 5P framework, ICMR-NLEAP, BIS-ICMR-Standards, WHO Rehabilitation-2030, integrated care for older people (ICOPE), Ear & Hearing Care (EHC), SPECS-2030 ecosystem. NCAHT has established institutional functions across twelve domains, collectively aimed at operationalizing AT as an integral component of health and rehabilitation systems rather than a welfare-driven intervention as discussed in this paper.</p><p><strong>Conclusions: </strong>NCAHT provides a systems-level framework which can be used to enhance access to AT within health and rehabilitation services. Its development presents lessons applicable to the development of AT systems in the low- and middle-income countries based on the coordinated governance, evidence-based validation, and multi-sector cooperation.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1879168"},"PeriodicalIF":2.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergy-based Functional Electrical Stimulation for gait rehabilitation in chronic stroke: a pilot study.","authors":"Jackson Taylor Levine, Xin S Yu, Rebecca Muñoz, Alaina Fiorenza, Irina Djuraskovic, J D Peiffer, Emilia Ambrosini, Simona Ferrante, Elliot J Roth, Jozsef Laczko, Ronald James Cotton, Alessandra Pedrocchi, Jose L Pons","doi":"10.3389/fresc.2026.1847719","DOIUrl":"10.3389/fresc.2026.1847719","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic stroke gait disorders involve impaired motor coordination. While high-intensity gait training (HIGT) is supported by current clinical practice guidelines, and Functional Electrical Stimulation (FES) to tibialis anterior addresses foot drop, extending FES to multiple muscles may improve functional outcomes.</p><p><strong>Methods: </strong>Using a FES neural sleeve capable of recording muscle activity and joint angles, we tested preliminary efficacy and feasibility of a personalized multichannel FES (MFES) intervention based on the individual's motor coordination impairment paired with HIGT. Fourteen individuals with chronic stroke were randomly assigned to either HIGT or MFES + HIGT for six weeks. Gait speed, endurance, gait biomechanics, and muscle synergies were assessed at baseline, midpoint, post-training, and one-month follow-up.</p><p><strong>Results: </strong>Despite the small sample, only the MFES + HIGT group demonstrated significant endurance gains from baseline to post-training and follow-up, while both groups improved walking speed, impaired limb step length, and muscle synergy similarity to normative data. Feasibility was evaluated by measuring setup time (therapist putting device on participant and setting stimulation parameters) and collecting feedback from participants and four therapists. System setup time plateaued at 4.53 min by the ninth session. Both participants and therapists rated the intervention highly feasible, acceptable, and usable. Adherence was high in both groups, with only one dropout in the HIGT group due to preexisting medical conditions.</p><p><strong>Discussion: </strong>This pilot study demonstrates the preliminary effectiveness of synergy-based MFES in improving walking endurance and confirms its feasibility for integration into chronic stroke gait rehabilitation, supporting the need for larger-scale trials to validate clinical efficacy and identify responders.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/study/NCT06099444, identifier NCT0609944.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1847719"},"PeriodicalIF":2.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical implementation of virtual reality in neurorehabilitation: a scoping review of barriers, facilitators, and motivational factors.","authors":"Ahmed S Alanazi, Mohammed M Alrashidi, Reem Aljohani, Taif Aljohani, Hams Madkhali, Alhanouf Almutairi, Alaa M Alqurafi, Saad Z Alqahtani","doi":"10.3389/fresc.2026.1912363","DOIUrl":"10.3389/fresc.2026.1912363","url":null,"abstract":"<p><p>Virtual reality is increasingly used in neurorehabilitation because it provides interactive therapeutic experiences that can enhance patient engagement and support rehabilitation goals. Despite growing evidence supporting its potential benefits, the extent of its integration into routine clinical practice remains unclear. This scoping review aimed to examine the current clinical use of virtual reality in neurorehabilitation and identify barriers, facilitators, and motivational factors influencing its implementation.‏ Searches of seven electronic databases [PubMed, MEDLINE, Embase, Scopus, IEEE Xplore, the Physiotherapy Evidence Database (PEDro), and the Cochrane Central Register of Controlled Trials (CENTRAL)] were conducted to identify relevant studies published between 2010 and 2025. Eligible studies were screened according to predefined inclusion and exclusion criteria, and data were extracted and synthesised descriptively. Eleven studies met the inclusion criteria. Clinical use of virtual reality varied considerably across settings, with only a limited proportion of therapists reporting regular use. Stroke rehabilitation was the most common area of application. Increased patient engagement and positive patient feedback were identified as motivational factors, while improved infrastructure and therapist training were reported facilitators of implementation. Common barriers included limited technical support, insufficient time, inadequate training, and resistance to change. These findings indicate that although interest in virtual reality for neurorehabilitation is increasing, its adoption in clinical practice remains inconsistent and is influenced by organisational, technical, and human factors. Addressing these barriers may facilitate wider implementation and support the integration of virtual reality into routine neurorehabilitation services.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1912363"},"PeriodicalIF":2.5,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}