Neurorehabilitation and neural repair最新文献

{"title":"Ten Things I Have Learned From Dr. Steven L. Wolf.","authors":"Steven C Cramer","doi":"10.1177/15459683261416403","DOIUrl":"10.1177/15459683261416403","url":null,"abstract":"<p><p>Dr. Steven L. Wolf has been engaged in neurorehabilitation research for 6 decades. During this time, he has published numerous studies, of great breadth and depth, and of substantial impact. Along the way, he has taught many people a number of key lessons, pertaining to subjects such as leadership, tenacity, creativity, and generosity. This editorial explores 10 of the top lessons from the career of Dr. Wolf.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"815-818"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133733","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":"The Concept of Shaping Applied to Locomotor Interventions: Clinical and Robotic Strategies to Facilitate and Progress Variable Stepping Training at Higher Intensities.","authors":"Kelly P Westlake, Katherine Dudek, Anindo Roy, Christopher E Henderson, T George Hornby","doi":"10.1177/15459683261454948","DOIUrl":"10.1177/15459683261454948","url":null,"abstract":"<p><p>High-intensity training (HIT) focused on stepping practice consistently improves clinical locomotor outcomes in individuals with neurologic injury. However, traditional HIT approaches typically do not target underlying impairments, and gains in non-locomotor tasks (ie, balance and transfers) or daily stepping are limited. One strategy to address these limitations involves providing HIT in variable contexts by progressively increasing locomotor demands across diverse environments while targeting specific biomechanical deficits (ie, limb-swing, propulsion, stance, and postural stability). This approach parallels the concept of \"shaping\" used successfully in constraint-induced movement therapy trials pioneered by Dr. Steven Wolf. The rapid progression of variable, difficult stepping tasks during HIT produces gains in multiple locomotor and non-locomotor outcomes, although, importantly, the accelerated progression of task demands and acceptance of movement variability represent key departures from conventional rehabilitation frameworks emphasizing gait quality. Together, this focus on progression and variability is likely responsible for the observed gains. In this issue honoring Dr. Steven Wolf, we delineate the shaping principles applied to locomotor rehabilitation following neurologic injury. We outline the rationale for HIT in variable contexts, explain how biomechanical targeting guides intervention progression, and present evidence detailing its observed efficacy in improving clinical and community mobility outcomes. We also describe how advanced robotic technology can further enhance locomotor outcomes by applying progressive resistance to target specific locomotor deficits. By integrating principles of biomechanics with long-standing theories in motor learning, we believe HIT in variable contexts can further harness the neural plasticity of the nervous system to maximize locomotor function following neurologic injury.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"784-795"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13271171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148255303","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":"Robotic Technologies for Hand Recovery After Stroke: A Reflection on Research Paths in Honor of Dr. Steven Wolf.","authors":"David J Reinkensmeyer","doi":"10.1177/15459683261448473","DOIUrl":"10.1177/15459683261448473","url":null,"abstract":"<p><p>Over the past 35 years, my work has focused on developing and studying robotic technologies to promote hand and arm recovery after stroke. In this Point-of-View, written for a special issue honoring Steven L. Wolf, I reflect on the personal and theoretical factors that shaped my research path, and how they intersect with Steve's pioneering contributions to stroke rehabilitation. I first provide a brief overview of the personal factors that influenced my research journey. Then, I turn to theoretical factors, highlighting conceptual synergies between Constraint-Induced Movement Therapy (CIMT) and robot-assisted therapy, including the principles of dose, task-specific training, shaping, prevention of slacking, participant selection, and the critical role of proprioception. Finally, I discuss 5 implications for future directions in robotic therapy consistent with Dr. Wolf's vision of intensive, patient-centered, and mechanistically grounded therapy: (1) the use of shared principles from CIMT and robot-assisted therapy to guide the design of advanced rehabilitation technologies; (2) precision rehabilitation that prioritizes proprioception; (3) the design of practical, widely adoptable robotic systems; (4) the development of real-time biomarkers and closed-loop training systems that optimize recovery; and (5) the need for deeper collaboration with people with lived experience of disability to address unsolved challenges. Steve's impactful results, driven by his curiosity, rigor, and openness to diverse approaches, have profoundly influenced my career, the ideas I present here, and the broader field of robotic therapy.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"735-745"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059251","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":"Special Issue: Novel Interventions to Mitigate Risk of and Promote Recovery in Neurological Conditions-Honoring the Contributions of Dr. Steven L. Wolf.","authors":"Michael Borich, Randolph J Nudo","doi":"10.1177/15459683261480781","DOIUrl":"10.1177/15459683261480781","url":null,"abstract":"","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"699-700"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803879","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":"The Impact of Dosing Schedule on the Efficacy of Hand-Arm Bimanual Intensive Therapy Including the Lower Extremities (HABIT-ILE) in Children With Bilateral Cerebral Palsy.","authors":"Susan E Sienko, Cathleen Buckon, Nicole Metelski, Astrid Carton de Tournai, Yannick Bleyenheuft, Marina Brandao, Grace-Anne Herard, Andrew M Gordon","doi":"10.1177/15459683261432091","DOIUrl":"10.1177/15459683261432091","url":null,"abstract":"<p><p>BackgroundRecent studies indicate that 60 to 90 hours of motor learning-based interventions provided over a 2 to 3 weeks period improve upper and lower extremity function, balance, and trunk control in children with bilateral cerebral palsy (BCP). However, this treatment dose and schedule may not be feasible for many families and treatment centers. The present study aimed to determine whether a distributed dosing schedule spread out over a longer period would yield gains and retention of functional motor skills and activity.MethodsFollowing randomization, 21 children age 5 to 17 years with BCP participated in a 90-hour Hand-Arm Bimanual Intensive Therapy Including the Lower Extremities (HABIT-ILE) program provided in either a massed (6 hours/day, 5 days/week for 3 weeks) or distributed (6 hours/day, 1 day/week for 15 weeks) dosing schedule. Primary outcomes included upper extremity dexterity (Box and Blocks Test), gross motor function (Gross Motor Function Measure-66), and trunk control (Trunk Control Measurement Scale).ResultsBoth dosing schedules led to significant gains in upper and lower extremity function, balance, and trunk control (<i>P</i> < .05 on all primary measures). Overall, there was not an advantage of 1 dosing schedule over the other.ConclusionsA distributed model of HABIT-ILE can produce similar gains and retention in gross motor function, manual dexterity, balance, and trunk control in children with BCP. The findings may allow clinicians more flexibility in decision-making with regard to the delivery method to fit the preferences for family routines, potentially increasing the feasibility of implementing intensive therapies into clinical practice.Trial Registration NumberNCT03940989.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"770-783"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793395","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":"Correlation of Motor-Task Related Brain Activation Changes With Motor Performance Changes Induced by Constraint-Induced Therapy After Stroke.","authors":"George F Wittenberg, Xiaoyan Leng, Andrew J Butler, Krishnankutty Sathian","doi":"10.1177/15459683261464076","DOIUrl":"10.1177/15459683261464076","url":null,"abstract":"<p><strong>Background: </strong>Steven Wolf made an exceptional effort to design, organize, and conduct a study of the biology of constraint induced movement therapy (CIMT) but only the transcranial magnetic stimulation results have been published previously.</p><p><strong>Objective: </strong>To evaluate changes in motor-task related brain activation and their relationship to functional recovery in participants with stroke undergoing CIMT during the subacute and chronic periods.</p><p><strong>Methods: </strong>Participants with hemiparetic stroke (n = 42) underwent fMRI of a hand task at baseline, immediately after a 2-week intervention or waiting period, and 4 months later, with effort or rate controlled at each timepoint. Functional outcome was assessed via the Wolf Motor Function Test (WMFT). Functional images were analyzed at the individual and group level.</p><p><strong>Results: </strong>Significant improvement in WMFT occurred in the intervention groups. Group-level changes in task-related activation over time were not significant. However, across all participants, increased WMFT task speed correlated significantly with increased ipsilesional M1 activation. No significant difference between activation changes were noted between any groups.</p><p><strong>Conclusions: </strong>Despite meaningful functional gains, longitudinal changes in cortical activation were limited when controlled for rate or effort, yet individual recovery was significantly associated with preserved or increased activation in the affected primary motor cortex. These results suggest that post-stroke motor recovery may reflect changes in how effort to move activates the stroke-affected motor cortex and more distal changes in response to motor cortical activation. Multi-site fMRI in stroke rehabilitation trials remains challenging, with strong control and monitoring of task performance needed.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"807-814"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551875","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":"Advancing Neurorehabilitation and Recovery Through Human Movement Quantification via Wearable Sensing.","authors":"Catherine E Lang, Allison E Miller, Chelsea E Macpherson, Marghuretta D Bland, Carey L Holleran, Keith R Lohse","doi":"10.1177/15459683251412310","DOIUrl":"10.1177/15459683251412310","url":null,"abstract":"<p><p>Wearable movement sensing has enormous potential to transform the field of neurorehabilitation and neural repair. This perspective paper discusses: (1) the case for wearable sensing as a compelling, scalable measurement tool, (2) moving from first generation to second generation research in wearable movement sensing, (3) the enormity in the potential range of use cases for wearable technology, and (4) challenges that lie ahead for moving from research space into clinical rehabilitation care. Wearable sensors, as a measurement tool, offer a data-rich avenue for measuring numerous dimensions of motor behavior in the clinic and in daily life, complementing other available tools. Second-generation research questions focus on determining <i>how</i> to quantify, <i>for whom, when</i>, and <i>with what</i> variable(s). Answering these second-generation questions requires substantial evidence at the individual use case level; we provide 1 exemplar variable and its evidence within stroke recovery and rehabilitation. Potential use cases for deployment of wearable movement sensors span developmental, acquired, and degenerative neurological conditions and variables extracted can be intended as digital biomarkers and/or digital clinical outcome assessments. As research progresses, we look forward to the translation of this measurement tool into routine clinical care and welcome implementation challenges related to readiness, approach, and presentation in the busy, complex, healthcare arena. Achieving the promise of wearable movement sensing will require extensive collaboration, as exemplified by Dr. Wolf, across research teams, disciplines, institutions, people with lived experience, and other stakeholders.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"746-759"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12834478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042446","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":"Visuospatial Working Memory Predicts Strategic Motor Learning With Visual Feedback During Gait After Stroke.","authors":"Sidra Manzoor, Matthew L Cohen, Susanne M Morton, Ryan T Pohlig, Elizabeth D Thompson, Henry Wright, Tamara Wright, Darcy S Reisman","doi":"10.1177/15459683261448468","DOIUrl":"10.1177/15459683261448468","url":null,"abstract":"<p><strong>Background: </strong>Strategic motor learning, guided by visual feedback (VF), is commonly used in post-stroke gait rehabilitation. While visuospatial working memory (VSWM) has been shown to support VF-guided motor correction in upper limb motor learning tasks, its role in locomotor learning after stroke remains unclear.</p><p><strong>Objective: </strong>We examined whether VSWM is related to strategic learning by examining the overall accuracy and improvement in accuracy over time with VF-guided locomotor learning in individuals with chronic stroke.</p><p><strong>Methods: </strong>Seventy-seven individuals >6 months post-stroke (41 males and 36 females; mean age = 66.3 ± 10.9 years) adapted walking on a split-belt treadmill (2:1 ratio) with real-time VF of step lengths. Feedback was displayed as visual targets on a screen and participants were instructed to use the visual cues to counteract the split-belt perturbation and restore their pre-perturbation step lengths. Strategic learning was assessed using 2 outcomes: overall accuracy and improvement in accuracy over strides during the VF phase. VSWM was assessed with the Spatial Addition subtest of the Wechsler Memory Scale-IV.</p><p><strong>Results: </strong>After adjusting for age, sex, time since stroke, and lower extremity Fugl-Meyer score, VSWM explained a significant proportion of the variance in both outcomes (overall accuracy: Δ<i>R</i>² = .085, <i>P</i> = .013; improvement in accuracy: Δ<i>R</i>² = .153, <i>P</i> < .001).</p><p><strong>Conclusion: </strong>Our findings suggest that VSWM may be important for strategic locomotor learning with VF in people with chronic stroke, highlighting its potential relevance as a key consideration in designing walking rehabilitation strategies for people after stroke.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"796-806"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152824","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":"Neurorehabilitation in the 21st Century: New Science, New Strategies, New Expectations.","authors":"Jonathan R Wolpaw, Aiko K Thompson, Monica A Perez, Sumner L Norman, Martin Oudega, Carolee J Winstein","doi":"10.1177/15459683251412309","DOIUrl":"10.1177/15459683251412309","url":null,"abstract":"<p><p>BackgroundNeurorehabilitation is among the most vibrant areas of biomedical research. Its main strategy has been skill-specific practice, which often fails to produce adequate recovery. Now, new recognition of central nervous system (CNS) plasticity, new understanding of skills, and new technologies provide new strategies that enhance the efficacy of practice.ObjectivesThe substrate of a skill is a network of neurons and synapses that extends from cortex to spinal cord and is now called a heksor. A heksor changes continually to maintain the key features of its skill, the attributes that make the skill satisfactory. Muscle activity and kinematics may change; key features are maintained. Heksors share neurons and synapses. Through their concurrent changes, they keep the CNS in a negotiated equilibrium that enables each to maintain its skill. When CNS damage occurs, the goal is to enable damaged heksors to repair themselves.ResultsTwo new strategies enhance the efficacy of skill-specific practice. One increases plasticity. A damaged heksor shapes the additional plasticity through practice. The other targets beneficial plasticity to a critical site in a damaged heksor. This improves practice, enabling the heksor to achieve wider beneficial plasticity. In animals and humans, protocols that combine these strategies with practice enhance lasting recovery.ConclusionsThe challenge is to develop, optimize, and validate these combined protocols. Computational modeling can accelerate the process. Controlled trials and comprehensive outcome assessments are essential. Pre-morbid factors and physiological measures may identify biomarkers that can predict efficacy or guide patient-specific protocol design. Many combined protocols will be noninvasive and suitable for home use.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"701-734"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12944605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208498","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":"Bridging the Gaps for Functional Restoration After Spinal Cord Injury: Emerging Directions in Clinically Accessible Neuromodulation, Neurorehabilitation, and Biomarkers.","authors":"Edelle C Field-Fote, Anastasia Zarkou, Nicholas H Evans, Evan B Sandler, Jennifer A Iddings","doi":"10.1177/15459683261426349","DOIUrl":"10.1177/15459683261426349","url":null,"abstract":"<p><p>BackgroundSpinal cord injury (SCI) has profound and often lifelong consequences. In the absence of proven cellular or pharmacologic therapies to reverse neural damage, neurorehabilitation strategies that harness neuroplasticity through practice and training remain the most effective means of improving function. Task‑oriented practice drives use‑dependent neuroplasticity and functional gains, and can be augmented by neuromodulatory interventions. To maximize real‑world impact, neuromodulatory strategies must prioritize cost‑effective, clinically accessible tools. Obtaining the best outcomes from rehabilitation also depends on the ability to anticipate future functional potential and tailor interventions accordingly. When expertly and consistently applied, some current clinical measures provide valuable predictive insight, but heterogeneity in clinical presentation and variability in responsiveness continue to challenge individualized treatment planning.ObjectivesThis article will examine how neuromodulatory strategies, predictive measures, and biomarkers can be integrated with intensive, neuroscience-informed rehabiltation to improve functional outcomes, enhance clinical trial design, and advance individualized care for people with SCI.ResultsClinically accessible neuromodulation can influence spinal and cortical circuits to enhance motor output for improved hand and walking function and for managing spasticity. Emerging electrophysiological, imaging, and molecular biomarkers, along with established clinical prediction models offer means to estimate recovery potential, guide intervention selection, and identify likely responders. Novel physiologic measures, such as limb accelerations recorded during sleep, provide noninvasive indicators of neuromotor function that may improve prediction accuracy.ConclusionIncorporating intensive, neuroscience-informed and systematically‑documented rehabilitation into clinical trial protocols is essential for developing the most effective SCI therapies. In addition, stratifying participants using biomarker or prediction model profiles can lead to more robust research evidence. Leveraging predictive tools to reduce variability and enhance statistical power can improve reproducibility and optimize detection of treatment effects. Together, these strategies support more targeted, efficient, and impactful SCI rehabilitation and research, with the potential to deliver advances that have long eluded the field.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"760-769"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694438","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}