Neurorehabilitation and neural repair最新文献

{"title":"Key Influencers of Community Ambulation Post-Stroke: Insights from a Mapping Review.","authors":"Kanika Bansal, Jane Morgan-Daniel, Sudeshna A Chatterjee, Dorian K Rose","doi":"10.1177/15459683261442195","DOIUrl":"10.1177/15459683261442195","url":null,"abstract":"<p><strong>Background: </strong>Interventions to enhance community ambulation post-stroke have traditionally focused on improving gait-related impairments, but recent evidence indicates that biopsychosocial and environmental factors also significantly influence community ambulation.</p><p><strong>Objective: </strong>To map the existing evidence on physical, biopsychosocial, and environmental factors associated with community ambulation based on the assessment tools commonly used to determine limitations in community ambulation.</p><p><strong>Methods: </strong>Nine databases were searched for studies examining factors affecting community ambulation in adults at least 6 months post-stroke. Studies assessing general physical activity or community mobility through transportation modes other than walking were excluded. Identified records were de-duplicated, screened, and reviewed by 2 independent reviewers.</p><p><strong>Results: </strong>From 1824 titles/abstracts screened and 99 full texts reviewed, 40 studies were included, representing 3915 stroke survivors. Participation in community ambulation was most commonly quantified by daily walking performance using accelerometers or predicted based on clinical gait speed. Other assessments included questionnaires, direct observation, and travel logs. Key physical factors consistently reported to be positively associated with community ambulation were gait-related endurance, balance, and walking performance. Biopsychosocial factors like falls-efficacy and depression showed mixed evidence of association, while age, gender, stroke type, and marital status were not associated with community ambulation. Environmental factors like neighborhood walkability, work status, and driving independence also produced mixed evidence of association.</p><p><strong>Conclusions: </strong>Multiple factors were identified as key influencers of community ambulation, with gait-related endurance, balance, and walking performance most consistently reported. Severe limitations in community ambulation were reported across all studies, but assessment approaches varied widely and lacked standardization.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"885-899"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990398","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":"Low-Frequency STN-DBS for Standing and Gait Initiation in Parkinson's Disease: A Double-Blinded Randomised Cross-Over Feasibility Trial.","authors":"Zachary J Conway, Peter A Silburn, Thushara Perera, Karen O'Maley, Liam Johnson, Michael H Cole","doi":"10.1177/15459683261448483","DOIUrl":"10.1177/15459683261448483","url":null,"abstract":"<p><strong>Background: </strong>Following high-frequency (>100 Hz) deep brain stimulation of the subthalamic nucleus (STN-DBS), some people with Parkinson's disease (PD) report poorer balance which may contribute to an increased falls risk. However, low-frequency (60 Hz) STN-DBS may improve balance. To better understand the effect of low-frequency STN-DBS, this double-blind randomised crossover study evaluated the acute effects of this therapy on objective measures of balance during standing and gait initiation in people with PD.</p><p><strong>Methods: </strong>Sixteen post-operative PD patients completed standing, walking and clinical assessments while off medication and receiving high- and low-frequency STN-DBS therapy. Changes in balance were measured using a force plate to provide insight into the effect of stimulation strategy on balance during standing and gait initiation.</p><p><strong>Results: </strong>Linear mixed model analyses indicated that balance during both standing and the locomotion phase of gait initiation was improved with low-frequency STN-DBS, while no difference in the postural phase of gait initiation. These effects were independent of electrode location and total electrical energy delivered. No differences were noted between stimulation conditions for clinical measures of mobility, motor symptom severity, or gait retropulsion.</p><p><strong>Conclusions: </strong>This study provides evidence for the acute benefits of low-frequency stimulation for improving objective measures of balance during standing and gait initiation in STN-DBS PD patients, independent of DBS electrode contact location. However, the benefits of this alternate therapy may be reduced for patients who experienced significant pre-operative tremor, as low frequency was less effective for managing tremor.</p><p><strong>Trial registry: </strong>Australian New ZealandClinical Trials RegistryURL: www.anzctr.org.au.</p><p><strong>Registration number: </strong>ACTRN12618000944235.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"874-884"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148159712","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":"Efficacy of Aerobic Exercise on Brain MRI Measures in Parkinson's Disease.","authors":"Martin Langeskov-Christensen, Mikkel Karl Emil Nygaard, Simon Fristed Eskildsen, Steffen Ringgaard, Jacob Geday, Erik H Danielsen, Erik L Johnsen, Cecilie Thrue, Frederik Bonde-Jensen, Lars G Hvid, Ulrik Dalgas","doi":"10.1177/15459683261448458","DOIUrl":"10.1177/15459683261448458","url":null,"abstract":"<p><strong>Objectives: </strong>Medical disease-modifying treatments are lacking in Parkinson's disease (PD). Physical exercise is potentially an inexpensive and easily accessible disease-modifying therapy, but this remains to be studied using recent promising magnetic resonance imaging (MRI) markers of disease progression. The objective was to determine whether 24 weeks of moderate to high-intensity progressive aerobic exercise affects brain MRI measures in people with PD (pwPD).</p><p><strong>Methods: </strong>A 24-week randomized controlled multicenter trial (with a 24-week follow-up) was conducted, including an exercise group (supervised aerobic exercise followed by self-guided physical activity) and a control group (habitual lifestyle). Patients older than 40 years with mild to moderate impairments (Hoehn & Yahr score ≤3) were randomized (1:1). The primary outcome was R2* (effective transverse relaxation rate) after 24 weeks, which was analyzed using the intention-to-treat principle. Additional outcomes included free water and neuromelanin levels in the substantia nigra, cardiorespiratory fitness, the Movement Disorder Society-sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), and levodopa equivalent daily dose (LEDD).</p><p><strong>Results: </strong>Seventy participants were randomized to exercise (n = 36) or control (n = 34). R2* did not change over the intervention period (between-group difference: -1.14 [-5.14; 2.87], mean [95%CI]). Similarly, no significant effects were seen in cardiorespiratory fitness (+1.64 mL O2/min/kg [-0.23; 3.51]) and MDS-UPDRS III (-0.7 [-5.3; 4.0]), whereas LEDD increased less following exercise (-78.4 [-154.6; -2.1]).</p><p><strong>Conclusion: </strong>These findings do not support a neuroprotective effect of progressive aerobic exercise on R2* in pwPD, whereas the intervention appears to benefit the efficacy of levodopa.</p><p><strong>Clinical trial registration: </strong>Clinicaltrials.gov identifier: NCT04379778.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"862-873"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990428","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 Relationship Between Age, Brain Structure, and Cognition in Chronic Traumatic Brain Injury.","authors":"Amber Ayton, Jennie Ponsford, Amelia J Hicks, Rachael Knott, Gavin Gan, Gershon Spitz","doi":"10.1177/15459683261442198","DOIUrl":"10.1177/15459683261442198","url":null,"abstract":"<p><p>BackgroundThe long-term impact of traumatic brain injury (TBI) on ageing remains poorly understood without controlled studies.ObjectiveCross-sectionally examine how chronic moderate-severe TBI and advancing age interact to affect brain structure and related cognition in adults aged 40 to 90 years who received compensated inpatient rehabilitation in Australia.MethodsCross-sectional magnetic resonance imaging (MRI) and neuropsychological data were collected from 123 individuals with chronic moderate-severe TBI (6-33 years post-injury; M_age = 59.64) and age- and gender-matched to 74 non-TBI controls (M_age = 62.10). Analyses examined cortical thickness, subcortical volume, and white matter microstructural integrity using tract-based analysis.ResultsAgeing and TBI were independently associated with reduced structural integrity in multiple regions. However, age moderated the effect of TBI on both fornix integrity and left thalamic volume, such that TBI-related reductions were present in adults in their 40s to 70s and 40s to 60s, respectively, but attenuated in the oldest age groups (80+ and 70+, respectively) relative to controls. Fornix and thalamic reductions correlated with poorer cognitive function, with the largest effects in verbal memory and processing speed.ConclusionsWhile TBI and ageing were independently associated with changes in brain structure, their interaction manifested distinctly in the bilateral fornix and left thalamus, with TBI-related structural losses in middle-age that diminished in later life as controls experienced typical age-related declines. In adults who received inpatient rehabilitation, moderate-severe TBI may result in initial structural alterations that do not accelerate age-related declines or compound with ageing processes long-term. Age-dependent fornix and thalamic structural changes were strongly associated with cognitive performance, particularly in verbal memory and processing speed.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"848-861"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950544","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 Motor Outcome in Patients With Severe Upper Limb Impairment After Stroke Using Motor Evoked Potentials.","authors":"Rikke Møller Feldbæk, Iris Charlotte Brunner, Camilla Biering Lundquist","doi":"10.1177/15459683261442196","DOIUrl":"10.1177/15459683261442196","url":null,"abstract":"<p><p>IntroductionIdentifying the individuals who may achieve a favorable upper limb function after severe stroke-related upper limb impairment remains challenging. Incorporating a biomarker, motor-evoked potential (MEP), may improve prediction accuracy.ObjectivesTo evaluate the prediction accuracy of baseline MEP status for upper limb motor outcome at 3 months post-stroke and to determine the predictive association between MEP status and upper limb motor outcome.MethodsThis prospective longitudinal cohort study included patients ≥18 years of age with severe upper limb impairment within 4 weeks post-stroke. MEP status was examined with transcranial magnetic stimulation at baseline. The primary outcome was the Fugl-Meyer Assessment upper extremity score (FMA) at follow-up 3 months post-stroke. The accuracy was determined by comparing MEP status (MEP present or absent) with 2 FMA outcome categories (FMA ≤ or >17) including calculation of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The predictive association between MEP status and 3 FMA outcome categories (FMA: 0-4; 5-17; and 18-66) was examined using ordinal logistic regression.ResultsOf 80 included patients, 74 completed follow-up. Overall accuracy was 75.7% (95% confidence interval [CI]: 64.3%-84.9%). Specificity was 80.3% (95% CI: 68.2%-89.4%), sensitivity 53.8% (95% CI: 25.1%-80.8%), PPV 36.8% (95% CI: 16.3%-61.6%), and NPV 89.1% (CI 95% 77.8%-95.9%). MEP presence was strongly associated with a higher motor outcome category at follow-up (odds ratio: 6.6; 95% CI: 2.1-21.9; <i>P</i> = .001).ConclusionsAssessing MEP status is a clinically relevant approach for predicting upper limb motor outcomes in patients with severe upper limb impairment after stroke.Trial Registry NameiTMS-Implementing Transcranial Magnetic Stimulation to Assess Cortico-spinal Tract Integrity. https://clinicaltrials.gov/study/NCT06153017. Registration number: NCT06153017.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"836-847"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950535","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":"Cerebellar Theta-Burst Stimulation Induces Distinct Functional Connectivity Patterns in Post-Stroke Aphasia: A Randomized Controlled Trial.","authors":"Xin Wang, Xinlei Xu, Daoran Wang, Guilan Huang, Kai Zheng, Chengchen Chen, Dongdong Jiang, Fanglan Gao, Caili Ren, Zhiyong Zhao","doi":"10.1177/15459683261479722","DOIUrl":"https://doi.org/10.1177/15459683261479722","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have identified the right cerebellar Crus I (rCrus I) as a promising target for rTMS in improving language rehabilitation. However, it remains unclear whether continuous theta burst stimulation (cTBS) over the rCrus I improves language outcomes in patients with subacute post-stroke aphasia (PSA).</p><p><strong>Objective: </strong>To determine whether inhibitory cTBS over rCrus I improves language recovery in PSA and to explore underlying functional connectivity (FC) mechanisms.</p><p><strong>Methods: </strong>Fifty-one PSA patients were randomized to receive either real cTBS (n = 25) or sham stimulation (n = 26) over rCrus I (10 sessions, 2 weeks) combined with speech-language therapy (SLT). Language assessments (WAB-AQ, BNT, BDAE) and resting-state fMRI were conducted before and after the intervention.</p><p><strong>Results: </strong>Both groups showed significant language improvement post-intervention. No significant interaction was found for WAB-AQ (<i>P</i> = .058), but a significant interaction was observed for repetition (<i>P</i> = .034), favoring cTBS. Resting-state fMRI showed altered connectivity between rCrus I and right temporo-occipital regions, with FC changes negatively correlated with language gains in the cTBS group. Exploratory subgroup analyses identified 2 distinct FC response patterns (FC-increase and FC-decrease), indicating heterogeneous cerebello-cortical and intra-cerebellar connectivity modulation across participants.</p><p><strong>Conclusions: </strong>Cerebellar cTBS did not confer a significant overall benefit on language recovery in PSA, but selectively improved repetition performance, suggesting domain-specific effects. Functional imaging indicated that rCrus I-centered connectivity changes were associated with behavioral outcomes, with marked inter-individual variability. These findings support a modulatory role of cerebellar cTBS on language networks, warranting further validation in larger, well-powered studies.</p><p><strong>Trial registration: </strong>This trial was registered under the China Clinical Trial Registry (Registration No. ChiCTR2100049828).</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261479722"},"PeriodicalIF":3.7,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077333","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":"Oculomotor and Cognitive Correlates of White Matter Organization in Military Personnel with Chronic Mild, Moderate, and Severe Traumatic Brain Injury.","authors":"Sarah I Gimbel, Mark L Ettenhofer, Rujvi Kamat, Jenna K Trotta, Angelica D Aguirre","doi":"10.1177/15459683261469081","DOIUrl":"https://doi.org/10.1177/15459683261469081","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic Brain Injury (TBI) often involves diffuse axonal injury that is difficult to detect with clinical neuroimaging and may not be fully captured by standard cognitive tests. This study investigated the link between white matter microstructure, assessed by Diffusion Tensor Imaging (DTI), and performance on a multimodal neurocognitive eye tracking assessment.</p><p><strong>Methods: </strong>Participants included n = 60 active duty military personnel, including n = 23 with chronic mild TBI (mTBI), n = 16 with chronic moderate-to-severe TBI (msTBI), and n = 21 TBI-negative controls. Cognitive and oculomotor functions were measured by the Fusion Multimodal Assessment, which records saccadic and manual responses under cognitive load, along with conventional neuropsychological tests and self-reported neurobehavioral symptoms and post-traumatic stress. White matter integrity was analyzed using regional Fractional Anisotropy (FA) and \"pothole\" analysis, which identifies clusters of abnormally low FA.</p><p><strong>Results: </strong>Results demonstrated that oculomotor and cognitive performance from the Fusion Multimodal Assessment, including intra-individual variability of saccadic response speed, visual working memory performance, and difficulty ratings from this task, were associated with DTI FA and FA potholes in widespread white matter regions throughout the brain. In comparison, global performance on conventional cognitive measures showed limited/inconsistent associations with regional DTI FA or FA potholes, and severity of self-reported symptoms was associated with DTI FA potholes primarily in brainstem and sensorimotor pathways.</p><p><strong>Discussion: </strong>These findings suggest that neurocognitive eye tracking may provide unique value for detecting impairments linked to white matter pathology in chronic TBI.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261469081"},"PeriodicalIF":3.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972865","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":"Sex-Specific Differences in Response to Non-Invasive Brain Stimulation for Recovery From Post-Stroke Aphasia: A Retrospective Analysis of the NORTHSTAR Trial.","authors":"Donguk Jo, Franziska E Hildesheim, Numa Dancause, Alexander Thiel, Jodi D Edwards","doi":"10.1177/15459683261477086","DOIUrl":"https://doi.org/10.1177/15459683261477086","url":null,"abstract":"<p><strong>Background and aim: </strong>There are limited clinical trial data examining sex differences in response to non-invasive brain stimulation interventions for language recovery in individuals with post-stroke aphasia. The primary aim of this analysis was to retrospectively assess sex differences in longitudinal language recovery and neuromodulation in a subset of the international NORTHSTAR clinical trial cohort.</p><p><strong>Methods: </strong>A cohort of 76 adults with post-stroke aphasia (31 females and 45 males) was ascertained from the NORTHSTAR trial data for the present analysis. In NORTHSTAR, patients were randomly allocated to receive 15-minute repetitive transcranial magnetic stimulation, cathodal transcranial direct current stimulation, or sham stimulation, paired with 45-minute speech-language therapy for 10 sessions. In the present analysis, random coefficient mixed-effects models were used to estimate sex differences in longitudinal language recovery (naming, verbal fluency, and comprehension) over the 30-day follow-up both overall and in subacute patients only. Secondary analyses examined change in contralesional resting motor threshold over the 10 sessions in subacute patients only. All models were adjusted for variables that differed by sex at baseline (Montreal Cognitive Assessment (MoCA) scores, stroke severity, age, and education).</p><p><strong>Results: </strong>Females had a significantly greater increases in the ability of naming compared to males over the follow-up period in the overall cohort, with significant contributions from MoCA-visuospatial and language to sex-specific naming recovery. In contrast, no sex differences were observed in changes in verbal fluency or language comprehension during the recovery period.</p><p><strong>Conclusions: </strong>The greater recovery of the naming function in females compared to males may be mainly associated with sex differences in visuospatial cognitive function, given the characteristics of MoCA-language that heavily weight on aphasia-related language deficits. However, this should be interpreted cautiously, given the lack of sex differences in comprehension and semantic fluency.<i>NORTHSTAR trial registration</i> (#NCT02020421): https://clinicaltrials.gov/ct2/show/NCT02020421.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261477086"},"PeriodicalIF":3.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901754","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":"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":"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}