Neurorehabilitation and neural repair最新文献

{"title":"Corrigendum for Senesh MR, Barragan K, Reinkensmeyer DJ (2020), Rudimentary Dexterity Corresponds With Reduced Ability to Move in Synergy After Stroke: Evidence of Competition Between Corticoreticulospinal and Corticospinal Tracts? Neurorehabil Neural Repair 34(10):904-914.","authors":"","doi":"10.1177/15459683241274954","DOIUrl":"10.1177/15459683241274954","url":null,"abstract":"","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"887-888"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057647","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":"Disability Moderates Dual Task Walking Performance and Neural Efficiency in Older Adults With Multiple Sclerosis.","authors":"Manuel E Hernandez, Robert W Motl, Frederick W Foley, Mary Ann Picone, Meltem Izzetoglu, Michael L Lipton, Mark Wagshul, Roee Holtzer","doi":"10.1177/15459683241273411","DOIUrl":"10.1177/15459683241273411","url":null,"abstract":"<p><strong>Background: </strong>Mobility and cognitive impairment are prevalent and co-occurring in older adults with multiple sclerosis (OAMS), yet there is limited research concerning the role of disability status in the cognitive control of gait among OAMS.</p><p><strong>Objective: </strong>We investigated the levels of prefrontal cortex (PFC) activation, using oxygenated hemoglobin (HbO₂), during cognitively-demanding tasks in OAMS with lower and higher disability using functional near-infrared spectroscopy (fNIRS) to: (1) identify PFC activation differences in single task walk and cognitively-demanding tasks in OAMS with different levels of disability; and (2) evaluate if disability may moderate practice-related changes in neural efficiency in OAMS.</p><p><strong>Methods: </strong>We gathered data from OAMS with lower (n = 51, age = 65 ± 4 years) or higher disability (n = 48, age = 65 ± 5 years), using a cutoff of 3 or more, in the Patient Determined Disease Steps, for higher disability, under 3 different conditions (single-task walk, Single-Task-Alpha, and Dual-Task-Walk [DTW]) administered over 3 counterbalanced, repeated trials.</p><p><strong>Results: </strong>OAMS who had a lower disability level exhibited decreased PFC activation levels during Single-Task-Walk (STW) and larger increases in PFC activation levels, when going from STW to a cognitively-demanding task, such as a DTW, than those with higher disability. OAMS with a lower disability level exhibited greater declines in PFC activation levels with additional within session practice than those with a higher disability level.</p><p><strong>Conclusions: </strong>These findings suggest that disability moderates brain adaptability to cognitively-demanding tasks and demonstrate the potential for fNIRS-derived outcome measures to complement neurorehabilitation outcomes.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"795-807"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038135","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":"Carry-Over Effect of Deep Cerebellar Stimulation-Mediated Motor Recovery in a Rodent Model of Traumatic Brain Injury.","authors":"Hugh H Chan, Brittany M Fisher, Margaret A Oimoen, Latavya Chintada, Hemen Khanna, Claire A Sonneborn, Olivia Hogue, André G Machado, Kenneth B Baker","doi":"10.1177/15459683241277194","DOIUrl":"10.1177/15459683241277194","url":null,"abstract":"<p><strong>Background: </strong>We previously demonstrated that deep brain stimulation (DBS) of lateral cerebellar nucleus (LCN) can enhance motor recovery and functional reorganization of perilesional cortex in rodent models of stroke or TBI.</p><p><strong>Objective: </strong>Considering the treatment-related neuroplasticity observed at the perilesional cortex, we hypothesize that chronic LCN DBS-enhanced motor recovery observed will carry-over even after DBS has been deactivated.</p><p><strong>Methods: </strong>Here, we directly tested the enduring effects of LCN DBS in male Long Evans rats that underwent controlled cortical impact (CCI) injury targeting sensorimotor cortex opposite their dominant forepaw followed by unilateral implantation of a macroelectrode into the LCN opposite the lesion. Animals were randomized to DBS or sham treatment for 4 weeks during which the motor performance were characterize by behavioral metrics. After 4 weeks, stimulation was turned off, with assessments continuing for an additional 2 weeks. Afterward, all animals were euthanized, and tissue was harvested for further analyses.</p><p><strong>Results: </strong>Treated animals showed significantly greater motor improvement across all behavioral metrics relative to untreated animals during the 4-week treatment, with functional gains persisting across 2-week post-treatment. This motor recovery was associated with the increase in CaMKIIα and BDNF positive cell density across perilesional cortex in treated animals.</p><p><strong>Conclusions: </strong>LCN DBS enhanced post-TBI motor recovery, the effect of which was persisted up to 2 weeks beyond stimulation offset. Such evidence should be considered in relation to future translational efforts as, unlike typical DBS applications, treatment may only need to be provided until such time as a new function plateau is achieved.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"808-819"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116630","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":"Meeting the Needs of People With Severe Quadriplegia in the 21st Century: The Case for Implanted Brain-Computer Interfaces.","authors":"Abbey Sawyer, Lily Cooke, Erica Breyman, Steve Spohn, Sandy Edelman, Krisha Saravanan, David Putrino","doi":"10.1177/15459683241282783","DOIUrl":"10.1177/15459683241282783","url":null,"abstract":"<p><strong>Background: </strong>In recent decades, there has been a widespread adoption of digital devices among the non-disabled population. The pervasive integration of digital devices has revolutionized how the majority of the population manages daily activities. Most of us now depend on digital platforms and services to conduct activities across the domains of communication, finance, healthcare, and work. However, a clear disparity exists for people who live with severe quadriplegia, who largely lack access to tools that would enable them to perform daily tasks digitally and communicate effectively with their environment.</p><p><strong>Objectives: </strong>The purpose of this piece is to (i) highlight the unmet needs of people with severe quadriplegia (including cases for medical necessity and perspectives from the community), (ii) present the current landscape of assistive technology for people with severe quadriplegia, (iii) make the case for implantable BCIs (how they address needs and why they are a good solution relative to other assistive technologies), and (iv) present future directions.</p><p><strong>Results: </strong>There are technologies that are currently available to this population, but these technologies are certainly not usable with the same level of ease, efficiency, or autonomy as what has been designed for the non-disabled community. This hinders the ability of people with severe quadriplegia to achieve digital autonomy, perpetuating social isolation and limiting the expression of needs, opinions, and preferences.</p><p><strong>Conclusion: </strong>Most importantly, the gap in digital equality fundamentally undermines the basic human rights of people with severe quadriplegia.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"877-886"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335374","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":"Treating Traumatic Brain Injury with Exercise: Onset Delay and Previous Training as Key Factors Determining its Efficacy.","authors":"Tanit Sánchez-Martín, David Costa-Miserachs, Margalida Coll-Andreu, Isabel Portell-Cortés, Soleil García-Brito, Meritxell Torras-Garcia","doi":"10.1177/15459683241270023","DOIUrl":"10.1177/15459683241270023","url":null,"abstract":"<p><strong>Purpose: </strong>Exercise reduces cognitive deficits in traumatic brain injury (TBI), but early post-trauma exercise is often discouraged due to potential harm. The purpose was to evaluate the interaction between pre- and post-injury physical exercise on cognition, neuronal survival and inflammation.</p><p><strong>Methods: </strong>Rats were either sham-operated and kept sedentary (Sham) or subjected to controlled cortical impact injury and then distributed into sedentary (Tbi), pre-injury exercise (Pre-Tbi), post-injury exercise with early (24 hours, Tbi-early) or late (6 days, Tbi-late) onset, and a combination of pre- and post-injury exercise with early (Pre-Tbi-early) or late (Pre-Tbi-late) onset. Object recognition memory, hippocampal volume, neuronal survival (NeuN⁺) in the hippocampus and perirhinal cortex, and microglial activity (Iba-1) in the hippocampus were evaluated.</p><p><strong>Results: </strong>All exercise conditions, except TBI-early, attenuated the significant memory impairment at 24-hour retention caused by TBI. Additionally, Pre-TBI-early treatment led to memory improvement at 3-hour retention. Pre-TBI reduced neuronal death and microglial activation in the hippocampus. TBI-late, but not TBI-early, mitigated hippocampal volume loss, loss of mature neurons in the hippocampus, and inflammation. Combining pre-injury and early-onset exercise reduced memory deficits but did not affect neuronal death or microglial activation. Combining pre-injury and late-onset exercise had a similar memory-enhancing effect than late post-injury treatment alone, albeit with reduced effects on neuronal density and neuroinflammation.</p><p><strong>Conclusions: </strong>Pre-TBI physical exercise reduces the necessary onset delay of post-TBI exercise to obtain cognitive benefits, yet the exact mechanisms underlying this reduction require further research.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"715-728"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984223","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":"Accuracy of Physiotherapist Predictions for Independent Walking After Stroke.","authors":"Marie-Claire Smith, Benjamin J Scrivener, Luke Skinner, Cathy M Stinear","doi":"10.1177/15459683241270055","DOIUrl":"10.1177/15459683241270055","url":null,"abstract":"<p><strong>Background: </strong>The use of prediction tools in stroke rehabilitation research and clinical practice is increasing, but it is not clear whether these prediction tools out-perform clinician predictions.</p><p><strong>Objective: </strong>This study aimed to compare physiotherapist predictions for independent walking with the Time to Walking Independently after STroke (TWIST) prediction tool.</p><p><strong>Methods: </strong>Adults with new lower limb weakness and unable to walk independently (Functional Ambulation Category [FAC] < 4) were recruited. At 1 week post-stroke, the treating physiotherapist was asked to predict whether their patient would achieve independent walking by 4, 6, 9, 12, 16, or 26 weeks, or remain dependent. Predictions were also made using the TWIST prediction tool, but not shared. Binary logistic regressions were conducted with the time independent walking was achieved as the dependent variable and independent variables were the physiotherapist and TWIST predictions.</p><p><strong>Results: </strong>Ninety-one participants were included (median age 71 years, 36 [40%] female). Most participants (67 [74%]) were non-ambulatory (FAC = 0) at 1-week post-stroke. Thirty-seven physiotherapists were recruited. Physiotherapists made accurate predictions for time taken to achieve independent walking for 39 participants (43%). Prediction accuracy was not related to physiotherapist confidence or years of stroke-specific experience. TWIST out-performed physiotherapist predictions (Physiotherapists 76%-77%, TWIST 86%-88% accurate) for participants who achieved independent walking by 4, 6, and 9 weeks post-stroke. Accuracy of physiotherapist and TWIST predictions was similar for 16 and 26 weeks post-stroke.</p><p><strong>Conclusions: </strong>The TWIST prediction tool is more accurate than physiotherapists at predicting whether a patient will achieve independent walking by 4, 6, or 9 weeks post-stroke, but not for 16 or 26 weeks post-stroke. TWIST may be useful to inform early rehabilitation and discharge planning. Clinical Trial Registration-URL: www.anzctr.org.au Unique Identifier: ACTRN12617001434381.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"742-751"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006221","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":"Brain-Hand Function Relationships Based on Level of Grasp Function in Chronic Left-Hemisphere Stroke.","authors":"Elizabeth Rizor, Julius Fridriksson, Denise M Peters, Chris Rorden, Leonardo Bonilha, Grigori Yourganov, Stacy L Fritz, Jill Campbell Stewart","doi":"10.1177/15459683241270080","DOIUrl":"10.1177/15459683241270080","url":null,"abstract":"<p><strong>Background and objective: </strong>The biomarkers of hand function may differ based on level of motor impairment after stroke. The objective of this study was to determine the relationship between resting state functional connectivity (RsFC) and unimanual contralesional hand function after stroke and whether brain-behavior relationships differ based on level of grasp function.</p><p><strong>Methods: </strong>Sixty-two individuals with chronic, left-hemisphere stroke were separated into three functional levels based on Box and Blocks Test performance with the contralesional hand: Low (moved 0 blocks), Moderate (moved >0% but <90% of blocks relative to the ipsilesional hand), and High (moved ≥90% of blocks relative to the ipsilesional hand).</p><p><strong>Results: </strong>RsFC in the ipsilesional and interhemispheric motor networks was reduced in the Low group compared to the Moderate and High groups. While interhemispheric RsFC correlated with hand function (grip strength and Stroke Impact Scale Hand) across the sample, contralesional RsFC correlated with hand function in the Low group and no measures of connectivity correlated with hand function in the Moderate and High groups. Linear regression modeling found that contralesional RsFC significantly predicted hand function in the Low group, while no measure correlated with hand function in the High group. Corticospinal tract integrity was the only predictor of hand function for the Moderate group and in an analysis across the entire sample.</p><p><strong>Conclusions: </strong>Differences in brain-hand function relationships based on level of motor impairment may have implications for predictive models of treatment response and the development of intervention protocols aimed at improving hand function after stroke.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"752-763"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11486587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006222","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":"Prediction of Upper Limb Motor Recovery by the PREP2 Algorithm in a Nonselected Population: External Validation and Influence of Cognitive Syndromes.","authors":"Sarah Millot, Lina Daghsen, Thomas Checkouri, Aymeric Wittwer, Romain Valabregue, Damien Galanaud, Jean Charles Lamy, Charlotte Rosso","doi":"10.1177/15459683241270056","DOIUrl":"10.1177/15459683241270056","url":null,"abstract":"<p><strong>Background: </strong>Early prediction of poststroke motor recovery is challenging in clinical settings. The Prediction recovery potential (PREP2) algorithm is the most accurate approach for prediction of Upper Limb function available to date but lacks external validation.</p><p><strong>Objectives: </strong>(i) To externally validate the PREP2 algorithm in a prospective cohort, (ii) to study the characteristics of patients misclassified by the algorithm, and (iii) to compare the performance according to the presence of cognitive syndromes (aphasia, neglect, cognitive disorders).</p><p><strong>Methods: </strong>We enrolled 143 patients with stroke and upper extremity weakness persistent at Day 3. Evaluation to predict the recovery status according to the PREP2 algorithm included age, SAFE and NIHSS scores at Day 3 and transcranial magnetic stimulation to determine the presence of the motor-evoked potential before day seven. Actual recovery (excellent, good, limited, or poor) was defined based on the Action Research Arm test score at 3 months. Accuracy was computed by comparing the predictions of the PREP2 and the actual category of the patient. Additionally, to investigate misclassifications and the impact of cognitive syndromes, we recorded SAFE and NIHSS scores at Day 7, the Montreal Cognitive Assessment (MoCA) score, the presence of aphasia and neglect and Magnetic Resonance Imaging was used to evaluate the corticospinal tract lesion load.</p><p><strong>Results: </strong>The PREP2 algorithm showed a very good predictive value with 78% accuracy [95% CI: 71.2%-86.1%], especially for the extreme categories of recovery (EXCELLENT 87.5% [95% CI: 78.9%-96.2%] and POOR 94.9% [95% CI: 87.9%-100%]), and only 46.5% [95% CI: 19.05%-73.25%] for the GOOD category and even worse than chance for the LIMITED category 0%. Pessimistic predictions (false-negative cases) had a drastic improvement in the SAFE score acutely compared to that of well-predicted patients with unfavorable recovery (<i>P</i> < 001). The predictive value of PREP2 decreased significantly when patients had cognitive disorders (MoCA score <24) versus not (69.4% [95% CI: 52.8%-86.1%] vs 93.1% [95% CI: 83.9%-100%], <i>P</i> = .01).</p><p><strong>Conclusion: </strong>Our study provides an external validation of the PREP2 algorithm in a prospective population and underlines the importance of taking into account cognitive syndromes in motor recovery prediction.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"764-774"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006225","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":"High-Frequency rTMS Broadly Ameliorates Working Memory and Cognitive Symptoms in Stroke Patients: A Randomized Controlled Trial.","authors":"Yuanwen Liu, Yinan Ai, Jie Cao, Qilin Cheng, Hongwu Hu, Jing Luo, Lei Zeng, Shuxian Zhang, Jie Fang, Li Huang, Haiqing Zheng, Xiquan Hu","doi":"10.1177/15459683241270022","DOIUrl":"10.1177/15459683241270022","url":null,"abstract":"<p><strong>Objective: </strong>To explore the efficacy and tolerability of high-frequency repetitive transcranial magnetic stimulation (rTMS) in the treatment of post-stroke working memory (WM) impairment and its changes in brain function.</p><p><strong>Methods: </strong>In the present randomized, double-blinded, sham-controlled design, 10 Hz rTMS was administered to the left dorsolateral prefrontal cortex (DLPFC) of patients with post-stroke WM impairment for 14 days. Measures included WM (primary outcome), comprehensive neuropsychological tests, and the functional near-infrared spectroscopy test. Patients were assessed at baseline, after the intervention (week 2), and 4 weeks after treatment cessation (week 6).</p><p><strong>Results: </strong>Of 123 stroke patients, 82 finished the trial. The rTMS group showed more WM improvement at week 2 (<i>t</i> = 5.55, <i>P</i> < .001) and week 6 (<i>t</i> = 2.11, <i>P</i> = .045) than the sham group. Most of the neuropsychological test scores were markedly improved in the rTMS group. In particular, the rTMS group exhibited significantly higher oxygenated hemoglobin content and significantly stronger functional connectivity in the left DLPFC, right pre-motor cortex (PMC), and right superior parietal lobule (SPL) at weeks 2 and 6. Dropout rates were equal (18% [9/50 cases] in each group), and headaches were the most common side effect (rTMS: 36% [18/50 cases]; sham: 30% [15/50 cases]).</p><p><strong>Conclusions: </strong>High-frequency rTMS was effective in improving post-stroke WM impairment, with good tolerability, and the efficacy lasted up to 4 weeks, which may be due to the activation of the left DLPFC, right PMC, and right SPL brain regions and their synergistic enhancement of neural remodeling.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"729-741"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006224","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 Balance Exercise Interventions on Balance-Related Performance in People With Multiple Sclerosis: A Systematic Review and a Meta-Analysis of Randomized Controlled Trials.","authors":"Andreas Wallin, Sverker Johansson, John Brincks, Ulrik Dalgas, Erika Franzén, Jacob Callesen","doi":"10.1177/15459683241273402","DOIUrl":"10.1177/15459683241273402","url":null,"abstract":"<p><strong>Background: </strong>Balance training covers a range of different modalities and complexity levels for people with multiple sclerosis (MS). When evaluating the effects of balance training across different kinds of interventions, determination of the specific intervention content that predict effects are needed.</p><p><strong>Objective: </strong>To investigate the effects of balance training on gait and dynamic balance outcomes.</p><p><strong>Methods: </strong>Four databases were systematically searched. Randomized controlled trials involving people with MS (Expanded Disability Status Scale [EDSS] score ≤7.5) where at least 50% of the intervention targeted balance control were included. Interventions were categorized based on training types. Risk-of-bias was assessed using the Tool for the Assessment of Study Quality and Reporting in Exercise (TESTEX).</p><p><strong>Results: </strong>A total of 18 included studies involved 902 people with MS (EDSS range from 0 to 7.5). Interventions evaluated with a balance composite score or a mobility test showed a moderate effect size (ES = 0.46 [95% confidence interval (CI) = 0.18 to 0.74]; <i>p</i> < .01) and a small overall ES (ES = 0.19 [95% CI = 0.01-0.36]; <i>p</i> = .04), respectively, across different training types. Stepping and gait speed outcomes showed no effect. Cognitive dual-task training showed a significant effect (ES = 0.81 [95% CI = 0.24 to 1.37]) on subgroup level, when evaluated with a mobility outcome measure. The median TESTEX score on study quality and reporting was 11 (maximum score = 15).</p><p><strong>Conclusions: </strong>Improvements of balance were found across interventions when measured by balance composite scores and mobility tests, but not when measured by stepping or gait speed outcomes. Large training volume was positively associated with effect on balance. A definition of intensity in balance training is needed for evaluation of its impact on the effect of balance interventions.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"775-790"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11490070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006223","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}