Neurorehabilitation and neural repair最新文献

{"title":"Minimal Impact of Low Vision on Explicit Sensorimotor Adaptation.","authors":"Mihai Cipleu, Sritej Padmanabhan, Emily A Cooper, Jonathan S Tsay","doi":"10.1177/15459683261445439","DOIUrl":"https://doi.org/10.1177/15459683261445439","url":null,"abstract":"<p><strong>Objective: </strong>Rehabilitation from motor system dysfunction relies on learning deliberate motor corrections through practice and feedback. This is called explicit motor adaptation. One key source of feedback for this adaptation is the visual error signal between the intended movement and the achieved movement. As people age, both motor dysfunction and visual impairment become more common, potentially compromising the visual feedback signal. Previous work has shown that visual impairment can disrupt the implicit, automatic adjustments made by the sensorimotor system. But how visual impairment influences explicit motor adaptation, a cornerstone of rehabilitation, remains unknown.</p><p><strong>Methods: </strong>To address this gap, we recruited individuals with low vision (LV), defined as uncorrectable visual impairment resulting in functional vision loss, and age-matched controls to complete a visuomotor task designed to isolate 2 components of explicit motor adaptation: discovering a new deliberate sensorimotor strategy and recalling a previously learned one.</p><p><strong>Results: </strong>Surprisingly, LV was not associated with a measurable impact on either component. Individuals with LV were as effective as controls in both discovering and retrieving successful explicit sensorimotor strategies.</p><p><strong>Conclusion: </strong>Together, these findings identify explicit strategies as a resilient learning mechanism that can be potentially leveraged in motor rehabilitation, even when visual input is degraded.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261445439"},"PeriodicalIF":3.7,"publicationDate":"2026-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical Dual-Task Cost and Reduced Attentional Neural Modulation in Parkinson's Disease With Freezing of Gait.","authors":"Ing-Shiou Hwang, Yu-An Chen, Ruey-Meei Wu, Cheng-Ya Huang","doi":"10.1177/15459683261448466","DOIUrl":"https://doi.org/10.1177/15459683261448466","url":null,"abstract":"<p><strong>Background: </strong>Dual-task walking poses substantial challenges for individuals with Parkinson's disease (PD), particularly those with freezing of gait (FOG), as dual-task interference increases fall risk and limits functional mobility.</p><p><strong>Objective: </strong>To investigate dual-task interference at both the behavioral and neural levels in PD individuals with FOG (PDFOG+) and those without FOG (PDFOG-) during dual-task walking involving a demanding manual task.</p><p><strong>Methods: </strong>Seventeen PDFOG- and 17 PDFOG+ participated in this study. Gait performance, manual-task performance, and scalp electroencephalograph (EEG) were recorded in single-task condition and dual-task walking while performing a high attentional-load manual task (an interlocking ring task). The primary behavioral outcomes were dual-task costs (DTC) of gait velocity and ring performance, representing locomotor interference and manual-task interference, respectively. The primary neural outcomes focused on theta-band EEG measures, including regional theta power and inter-regional theta connectivity, given their established role in attentional control during dual-task walking in PDFOG+.</p><p><strong>Results: </strong>Compared with PDFOG-, PDFOG+ exhibited significantly less DTC of gait velocity and greater DTC of ring performance. At the neural level, PDFOG+ demonstrated attenuated task-dependent modulations of increased theta-band power and decreased theta-band connectivity relative to PDFOG-.</p><p><strong>Conclusions: </strong>PDFOG+ exhibited an atypical pattern of dual-task interference characterized by preserved gait velocity at the expense of concurrent manual-task performance, together with diminished theta-band attentional modulation. These findings suggest limited flexibility in attentional resource allocation in PDFOG+ and highlight theta-band neural dynamics as a key mechanism underlying maladaptive task-task regulation during walking.</p><p><strong>Trial registration: </strong>National Taiwan University Hospital Research Ethics Committee: No. NCT03298503.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261448466"},"PeriodicalIF":3.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Accessible and Multimodal Diagnosis of Disorders of Consciousness: Integrating Clinical and Autonomic Markers.","authors":"Lucia Francesca Lucca, Maria Daniela Cortese, Maria Ursino, Francesco Riganello","doi":"10.1177/15459683261442142","DOIUrl":"https://doi.org/10.1177/15459683261442142","url":null,"abstract":"<p><strong>Background: </strong>Disorders of consciousness (DoC) remain among the most challenging conditions in neurorehabilitation, with misdiagnosis rates approaching 40% and major implications for treatment planning, prognosis, and ethical decision-making. Current European and American guidelines recommend standardized behavioral assessments and, where available, advanced neuroimaging and neurophysiology. However, cost, limited access, and patient instability constrain implementation, leaving advanced assessments largely restricted to specialized centers. This diagnostic gap underscores the need for complementary approaches beyond behavioral scales or advanced imaging alone. Bedside behavioral tools, although indispensable, may fail to capture covert awareness or cognitive-motor dissociation. Conversely, reliance on high-technology investigations risks exacerbating inequities in structurally constrained healthcare systems.</p><p><strong>Objective: </strong>We propose a hybrid clinical-physiological assessment model combining standard behavioral assessments, including the Coma Recovery Scale-Revised, Motor Behavior Tool-Revised, and Nociception Coma Scale, with autonomic and neurophysiological markers of central autonomic network function.</p><p><strong>Methods: </strong>The structured workflow, consolidated in clinical practice, includes baseline autonomic recordings before and during standardized behavioral testing, repeated weekly during the first month and biweekly thereafter. Family involvement at scheduled intervals contextualizes behavioral responses and informs communication strategies.</p><p><strong>Results: </strong>By fostering cross-modal convergence, this complementary framework enhances diagnostic certainty, supports tailored rehabilitation, and strengthens ethical transparency.</p><p><strong>Conclusions: </strong>While not yet validated as a formal protocol, it offers a scalable, cost-effective strategy adaptable across healthcare settings. Multicenter validation is recommended to confirm its generalizability and promote equitable integration of bedside physiological assessment into DoC care.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261442142"},"PeriodicalIF":3.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuromechanics of Nonuse and Compensation: Implications for Rehabilitation After Stroke.","authors":"Germain Faity, Denis Mottet, Jérôme Froger, Marion Delorme","doi":"10.1177/15459683261445442","DOIUrl":"https://doi.org/10.1177/15459683261445442","url":null,"abstract":"<p><strong>Background: </strong>Stroke often results in compensatory movement strategies that combine use of trunk movements with nonuse of the affected upper extremity, which is considered detrimental to recovery.</p><p><strong>Objective: </strong>In this study, we investigate whether compensation and nonuse can be more than a suboptimal counterpart to recovery. We explore the influence of neuromechanics on nonuse and compensation in 22 individuals with stroke and 22 controls.</p><p><strong>Methods: </strong>We asked seated participants to reach a target under 2 nonuse conditions (spontaneous or with minimized trunk compensation) and under 3 arm weight conditions (control, lightened, and weighted).</p><p><strong>Results: </strong>We replicated the findings that stroke induces more trunk compensation, more anterior deltoid activation and greater effort. We found that, in stroke patients, reduced arm weight decreased nonuse, while in controls, increased arm weight induced trunk compensation similar to what is observed after stroke. Furthermore, reaching with nonuse after stroke required less effort and preserved a force reserve at the shoulder.</p><p><strong>Conclusion: </strong>Our results show that both poststroke and healthy individuals engage in similar nonuse and compensation in the face of their neuromechanical limitations, as predicted by an optimal control policy aiming to succeed at the task while keeping a force reserve at each joint. We derive 2 theoretical predictions for future clinical research. First, patients whose nonuse yields few functional gains should benefit most from interventions to reduce compensation. Second, improving shoulder strength after stroke should reduce relative muscle activation, thereby decreasing trunk compensation and upper extremity nonuse.<i>Clinical Trial</i>. NCT04747587.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261445442"},"PeriodicalIF":3.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmented Reality and Artificial Intelligence for the Assessment and Rehabilitation of Spatial Neglect: A Systematic Review.","authors":"Shaojun Li, Benjamin Chong, Ghazal Mehri-Kakavand, Catherine Shi, Denise Taylor, Allan Fowler, Mark Billinghurst, Monika Harvey, Alan Wang","doi":"10.1177/15459683261445440","DOIUrl":"https://doi.org/10.1177/15459683261445440","url":null,"abstract":"<p><strong>Background and purpose: </strong>Augmented reality (AR) and artificial intelligence (AI) have been applied to the assessment and rehabilitation of post-stroke spatial neglect (SN). This study aims to evaluate the feasibility, effectiveness, degree of personalization, and ecological validity of AR, AI, and hybrid methods for SN assessment and rehabilitation.</p><p><strong>Methods: </strong>PubMed, Scopus, Web of Science, Embase, CINAHL, IEEE Xplore, and the ACM Digital Library were searched up to August 2025. Two reviewers independently screened articles, extracted data, and assessed risk of bias and outcome-level certainty.</p><p><strong>Results: </strong>Of 268 screened studies published between 2000 and 2025, 15 met the inclusion criteria, including 11 assessment studies (8 AI, 1 AR, and 2 hybrid) and 4 AR rehabilitation studies, involving 567 participants. AI assessment methods demonstrated high diagnostic accuracy (area under the curve (AUC) up to 0.95), and 1 AR assessment showed strong diagnostic accuracy (AUC = 0.89). Four AR rehabilitation studies reported acceptable feasibility, with 1 randomized controlled trial (RCT) showing improvements in several neglect outcomes. Ecological validity and personalization were generally very low, and the overall certainty of evidence ranged from low to very low.</p><p><strong>Conclusion: </strong>Current evidence for AR and AI SN assessment and rehabilitation methods remains insufficient to determine their feasibility, effectiveness, ecological validity, and degree of personalization, largely due to small sample sizes, methodological heterogeneity, and the limited number of RCTs. Future research should focus on developing standardized, scalable frameworks that integrate AR with adaptive AI models, and multicenter RCTs are required to confirm clinical efficacy and long-term functional outcomes.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261445440"},"PeriodicalIF":3.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Blinded, Controlled Randomized Clinical Trial on the Efficacy of Neck Muscle Vibration in Patients with Post-Stroke Spatial Neglect.","authors":"Britta Stammler, Carina Thiel, Anne Lieb, Heike Meißner, Hans-Otto Karnath","doi":"10.1177/15459683251412287","DOIUrl":"10.1177/15459683251412287","url":null,"abstract":"<p><strong>Background and aim: </strong>Unilateral spatial neglect (UN) impairs patients' ability to detect and respond to stimuli on the contralesional side, severely limiting functional recovery after right-hemispheric stroke. Neck muscle vibration (NMV) has been shown to be a bottom-up, proprioceptive intervention to modulate spatial neglect. Although preliminary studies found promising effects, the isolated efficacy of NMV for neglect rehabilitation has not yet been tested in a randomized, blinded controlled trial. This study aimed to evaluate whether NMV alone improves neglect symptoms and activities of daily living (ADL).</p><p><strong>Methods: </strong>Twenty patients with right-hemispheric stroke and UN were randomly assigned to receive either active or placebo NMV (combined, but not simultaneously with computer-based training) over 2 weeks (5 sessions/week, 20 minutes/day). In the computer training, the placebo NMV group completed neglect-specific modules (standard neglect therapy [SNT], e.g., visual exploration training), while the active NMV group performed only general cognitive tasks unrelated to neglect. This allowed the isolated effect of NMV to be examined. Assessments included standard neglect diagnostics (e.g., Letter Cancellation), the Free Exploration Test (FET), and 2 ADL-based measures (NET, CBS), conducted before, immediately after, and (NMV group only) 1 month post-treatment.</p><p><strong>Results: </strong>The active NMV group showed significant improvements in 3 of 4 standard neglect tests, exploration behavior (FET), and ADL performance, with effects remaining stable at 1-month follow-up. The SNT group with placebo NMV showed comparable gains in ADL outcomes but improved in 1 standard neglect test only. Between-group analyses revealed no statistically significant differences, suggesting similar efficacy of both interventions.</p><p><strong>Conclusion: </strong>NMV alone yields clinically meaningful and lasting improvements in neglect symptoms and ADL, comparable to SNT. Its passive nature makes it a promising tool, particularly for early rehabilitation.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"347-356"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13087163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055728","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":"Trajectories of Objective Sleep Quality and Their Association With Neurological Functional Recovery After Stroke: A Prospective Longitudinal Study.","authors":"Fan-Jiayi Yang, Jia-Ning Wei, Chen-Shuang Li, Chang-Qing Sun, Yan-Jin Liu, Xiao-Fang Dong","doi":"10.1177/15459683261416417","DOIUrl":"10.1177/15459683261416417","url":null,"abstract":"<p><p>ObjectiveTo explore the latent trajectory classes of objective sleep quality in stroke patients and their impact on neurological functional recovery.MethodsA multicenter cluster sampling method was used to recruit 362 stroke patients from the neurology departments of 5 tertiary hospitals in China between November 2023 and July 2024. Baseline data were collected using a general information questionnaire and related scales. Objective sleep data were obtained using ActiGraph GT3X triaxial accelerometers during the acute (T0), recovery (T1), and chronic (T2) phases of stroke. Neurological recovery was assessed at 12 months post-onset (T3) using the modified Rankin Scale. Parallel-process latent class growth modeling was used to identify trajectory classes. Binary logistic regression examined the association between sleep trajectories and neurological recovery.ResultsA total of 306 patients were followed up. Four distinct trajectory classes were identified: Consistently good sleep quality group (34.31%), Short sleep-increased efficiency-improved fragmentation group (49.02%), Long sleep-reduced efficiency-deteriorated fragmentation group (7.84%), and Consistently poor sleep quality group (8.82%). Compared to the consistently good sleep quality group, patients in the Long sleep-reduced efficiency-deteriorated fragmentation group and Consistently poor sleep quality group had 5.728 (95% confidence interval [CI]: 2.124-15.444) and 6.769 (95% CI: 2.580-17.758) times higher risks of poor neurological recovery, respectively.ConclusionStroke patients exhibit heterogeneous sleep quality trajectories, with differential impacts on neurological recovery. Healthcare providers should implement personalized sleep management strategies to optimize both sleep quality and functional outcomes.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"368-378"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Pressure Increases in Spinal Stimulation: Reviewing Autonomic Dysreflexia and the Necessity for its Redefinition.","authors":"Einat Engel-Haber, Ryan Solinsky, Steven Kirshblum, Gail F Forrest","doi":"10.1177/15459683261417269","DOIUrl":"10.1177/15459683261417269","url":null,"abstract":"<p><p>The expanding application of spinal stimulation therapies in spinal cord injury (SCI) rehabilitation necessitates a critical reexamination of cardiovascular (CV) responses to these interventions. A key question arises: How should blood pressure (BP) responses to stimulation be interpreted, and does the conventional definition of autonomic dysreflexia (AD) adequately capture these phenomena? Researchers remain divided-some classify BP elevations during stimulation as AD, while others attribute them to intentional neuromodulation targeting sympathetic preganglionic neurons. This review scrutinizes the various AD definitions in the literature, including the conventional threshold (systolic BP increase >20 mmHg), revealing substantial limitations in research contexts. While symptomatic AD occurs in only 4-7% of stimulation study participants, asymptomatic BP increases are considerably more frequent. This established threshold lacks robust physiological rationale and creates significant interpretive challenges, particularly when evaluating interventions designed to modulate BP responses. The current limitations of guideline-based definitions of AD challenge research interpretation and clinical translation. Although several publications describe AD as \"unregulated\" or \"uncontrolled,\" it has not yet been incorporated into formal guideline definitions. This review underscores the need for a collaborative effort to refine AD definitions in research, particularly in the context of spinal stimulation. Future consensus development should address whether uniform thresholds should apply across different contexts, how to integrate heart rate dynamics and absolute BP values alongside symptomatic status, and how to meaningfully distinguish therapeutic BP modulation from adverse autonomic responses. This is essential for standardizing research approaches, optimizing stimulation parameters, and ensuring efficacy and safety as spinal stimulation technologies advance clinically.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"414-427"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reactive Balance Deficits Differ in People After Mild Traumatic Brain Injury Based on Chronicity of Self-Reported Symptoms.","authors":"Cecilia Monoli, Paula K Johnson, Amanda J Morris, Ryan M Pelo, Leland E Dibble, Peter C Fino","doi":"10.1177/15459683251412303","DOIUrl":"10.1177/15459683251412303","url":null,"abstract":"<p><strong>Background: </strong>Mild traumatic brain injury (mTBI) can lead to persistent balance impairments, affecting daily functioning. While mTBI deficits in static and dynamic balance are well-documented, reactive balance-essential for recovering from perturbations-remains understudied, and the relationship with symptom severity and quality of life remains unclear.</p><p><strong>Objective: </strong>Examine reactive balance across different stages of mTBI recovery and its association with self-reported symptoms and quality of life.</p><p><strong>Methods: </strong>This cross-sectional study included 82 participants: 19 with acute (4-14 days post-injury), 11 with sub-acute (3-12 weeks post-injury), 11 with chronic (>12 weeks post-injury) mTBI, and 41 healthy controls. Reactive balance was assessed using the Instrumented-modified Push and Release under both single and cognitive dual-task conditions, measuring time to stability and step latency.</p><p><strong>Results: </strong>Participants with acute mTBI had longer step latencies (<i>P</i> = .004 single-task; <i>P</i> = .016 dual-task) but no differences in time to stability compared to controls, while people with chronic mTBI exhibited longer time to stability (<i>P</i> = .004 single-task; <i>P</i> = .017 dual-task) but no difference in step latencies compared to controls. Dizziness and total symptom severity were moderately associated with single- and dual-task time to stability and dual-task step latency acutely, and with single-task time to stability and dual-task step latency in the sub-acute phase.</p><p><strong>Conclusions: </strong>Reactive balance deficits persist chronically after mTBI and differ between people with acute, sub-acute, and chronic symptoms. These differences suggest people with chronic symptoms may prioritize different aspects of balance control compared to the people in the acute stage of recovery related to functional adaptations to self-reported symptoms.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"357-367"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12851506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055720","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":"Centrality of Pain in Post-Stroke Shoulder Pain: A Case-Control Study.","authors":"Hasan Hüseyin Gökpınar, Büşra Arı, Dilan Bulut Özkaya, İsmail Saraçoğlu","doi":"10.1177/15459683261416418","DOIUrl":"10.1177/15459683261416418","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine whether centrality of pain behavior differs between individuals with post-stroke shoulder pain (PSSP) and those with non-hemiplegic chronic shoulder pain.</p><p><strong>Methods: </strong>Participants with a history of cerebrovascular accident (CVA) were assigned to the PSSP group, whereas those without a history of CVA were classified as the non-hemiplegic shoulder pain group. Pain intensity was measured with the numeric pain scale. The Centrality of Pain Scale (COPS) assessed pain centralizing behavior. Shoulder pain and functional status were evaluated using the Shoulder Pain and Disability Index (SPADI).</p><p><strong>Results: </strong>A total of 130 participants were included: 65 individuals with PSSP (mean age = 61.84 ± 11.47) and 65 with non-hemiplegic shoulder pain (mean age = 57.09 ± 11.80). The PSSP group demonstrated significantly higher COPS scores (MD = -3.21; 95% confidence interval [CI] = -5.78 to -0.65; <i>P</i> = .014) and higher SPADI disability (MD = -28.01; 95% CI = -54.77 to -1.24; <i>P</i> = .040) and total scores (MD = -10.09; 95% CI = -16.85 to -3.33; <i>P</i> = .004) compared with the non-hemiplegic shoulder pain group. Pain intensity and duration showed no clinically meaningful differences. COPS further explained 54% of the variance in SPADI pain scores and 51.1% of the variance in SPADI total scores.</p><p><strong>Conclusion: </strong>Individuals with PSSP demonstrated significantly higher pain centralizing behavior despite similar pain intensity and shorter pain duration compared with non-hemiplegic shoulder pain. Moreover, COPS scores explained a meaningful portion of pain and disability, highlighting the role of central mechanisms in PSSP.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"379-386"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}