Neurorehabilitation and neural repair最新文献

{"title":"Creating a Roadmap for Pediatric Implanted Brain-Computer Interfaces.","authors":"Mariana P Branco, Eli Kinney-Lang, Nicole Ruest, Helen L Carlson, Adam Kirton, Mariska J Vansteensel","doi":"10.1177/15459683261481764","DOIUrl":"https://doi.org/10.1177/15459683261481764","url":null,"abstract":"<p><strong>Background: </strong>Implanted brain-computer interfaces (iBCIs) can record signals directly from the brain and translate them into computer commands continuously, at high speed and fidelity. Over 150 people worldwide have been implanted with an iBCI, and this number is expected to increase rapidly as iBCIs become commercially available. Despite the progress that is being made in the development of safe, wireless, and highly effective iBCIs, none of these have been implemented in youth or adults with pediatric-onset conditions.</p><p><strong>Objective: </strong>Pediatric-onset conditions, such as Cerebral Palsy (CP), represent a large proportion of the global burden of complex and severe disability. Since affected individuals, particularly youth, will likely benefit significantly from iBCIs, they should not be left behind in technological progress that would be life-changing. We outlined the evidence gaps, steps required, and arguments for greater focus on this population in iBCI research and development.</p><p><strong>Methods: </strong>Here, we present the result of two years of cumulative effort, combining expert opinions and findings from multiple transdisciplinary engagement sessions, including the first International Virtual Summit on Implanted BCIs for Children with Complex Needs, follow-up themed workgroup sessions, and a final in-person workshop held at the 11th International BCI Society Meeting.</p><p><strong>Results: </strong>We established a world-first visionary, community-and-partner-engaged roadmap for the design, development, and implementation of iBCIs for youth with CP to meaningfully interact with the world.</p><p><strong>Conclusions: </strong>Developing iBCI systems for youth with CP requires a fundamental shift toward child‑centric neuroscience, engineering, and user‑driven design rather than adapting adult‑oriented technologies.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261481764"},"PeriodicalIF":3.7,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868560","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":"External Validation of the Time to Walking Independently After Stroke (TWIST) Prediction Algorithm within 72 Hours Poststroke.","authors":"Lara Anka Rajkovic, Silke Veerbeek-Preuss, Sandrine Bärtschi, Beatrice Ottiger, Thomas Nyffeler, Janne Marieke Veerbeek","doi":"10.1177/15459683261477077","DOIUrl":"https://doi.org/10.1177/15459683261477077","url":null,"abstract":"<p><strong>Background: </strong>The TWIST algorithm was developed to predict the time to walk independently after stroke based on clinical assessments performed 1 week poststroke. The objective of this study was to externally validate this algorithm within 72 hours after stroke in a heterogeneous sample as a next step towards clinical implementation in an acute stroke unit setting.</p><p><strong>Methods: </strong>This prospective longitudinal observational cohort study included adult stroke patients unable to walk independently (Functional Ambulation Categories [FAC] <4) within 72 hours poststroke. Within this timeframe, the predictors Trunk Control Test (TCT) and paretic hip extensor strength were assessed. Patients were categorized into 'independent 6 weeks', 'independent 12 weeks', or 'dependent 12 weeks' based on the algorithm's prediction. After 6 and 12 weeks, walking ability was evaluated with the FAC. The algorithm's performance was assessed by area under the curve (AUC), classification measures, and accuracy. In case of insufficient performance for an outcome category, differences in patients' characteristics were explored.</p><p><strong>Results: </strong>146 participants were analyzed. Multiclass AUC was 0.73, the sensitivity for 'independent 6 weeks' was 0.83 (95% CI 0.74, 0.90) and for 'independent 12 weeks' 0.23 (95% CI 0.09, 0.44). The specificity for 'dependent 12 weeks' was 0.80 (95% CI 0.72, 0.87).</p><p><strong>Conclusion: </strong>Application of the TWIST algorithm within 72 hours poststroke can inform on who will regain independent gait at 6 weeks but not about who will regain independent gait between 6 and 12 weeks. Before initiating clinical implementation, the impact of predictor assessment timing and the optimization of predictions for 'independent 12 weeks' should be investigated.</p><p><strong>Clinical trial registration: </strong>ClinicalTrails.gov (Identifier: NCT05039047).</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261477077"},"PeriodicalIF":3.7,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835151","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":"White Matter Diffusion Anisotropy and the Effects of Inpatient Multidisciplinary Rehabilitation in Parkinson's Disease: A Diffusion Tensor Imaging Analysis.","authors":"Kohei Marumoto, Tetsuo Koyama, Ryuichi Takahashi, Shinji Yamamoto, Yuki Kawami, So Matsugashita, Ayumi Nakatani, Hiroshi Yamamoto, Michiko Inoue, Eiji Mizuta, Norihiko Kodama, Yuki Uchiyama","doi":"10.1177/15459683261477083","DOIUrl":"https://doi.org/10.1177/15459683261477083","url":null,"abstract":"<p><strong>Background: </strong>In Parkinson's disease (PD), compensatory increases in corticospinal tract (CST) fractional anisotropy (FA) occur early; whether pretreatment white matter integrity predicts rehabilitation responsiveness is unknown.</p><p><strong>Objective: </strong>To determine whether pretreatment CST FA predicts inpatient rehabilitation response in PD.</p><p><strong>Methods: </strong>Ninety-four PD patients and 13 age-matched healthy controls underwent DTI before an 8-week inpatient multidisciplinary rehabilitation program. Patients were classified as responders (UPDRS Part III improvement ≥2.5 points; n = 61) or non-responders (n = 33). FA across 20 white matter ROIs was compared (Kruskal-Wallis; Mann-Whitney U post-hoc) and voxel-wise TBSS performed. Logistic regression adjusted for age, disease duration, H-Y stage, and levodopa dose.</p><p><strong>Results: </strong>Responders had higher bilateral CST FA than non-responders (right: <i>P</i> < .001, d = 0.99; left: <i>P</i> < .001, d = 1.14; both FDR-corrected) and maintained CST FA comparable to healthy controls, whereas non-responders showed significantly lower CST FA. TBSS confirmed bilateral CST clusters of higher FA in responders (<i>P</i> < .05, TFCE-corrected). CST FA correlated inversely with H-Y stage (ρ = -0.307, <i>P</i> = .003) and motor improvement (ρ = -0.417, <i>P</i> < .001). Logistic regression identified CST FA as an independent predictor (OR = 5.51 per SD; 95% CI 2.50-12.06; Nagelkerke R² = 0.408; <i>P</i> < .001).</p><p><strong>Conclusions: </strong>Pretreatment CST FA independently predicts rehabilitation responsiveness in PD, with responder integrity comparable to healthy controls. With good internal discrimination (AUC 0.79), DTI-derived CST FA is a promising marker for stratifying rehabilitation potential, though external validation is required before clinical use.</p><p><strong>Trial registration: </strong>UMIN Clinical Trials Registry, https://www.umin.ac.jp/, UMIN000023641.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261477083"},"PeriodicalIF":3.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815431","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":"Effects of Prism Adaptation on Left and Right Spatial Neglect in Patients with Subacute Stroke: A Multi-Centred Randomized Controlled Trial.","authors":"Danling Feng, Kenneth N K Fong, Han Zhang, Yue Chen, Bo Chen, Lun Luo","doi":"10.1177/15459683261477085","DOIUrl":"https://doi.org/10.1177/15459683261477085","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of prism adaptation (PA), using a left or right visual shift prism, in terms of improving left spatial neglect (LSN) or right spatial neglect (RSN) in patients after subacute stroke.</p><p><strong>Methods: </strong>This was a randomized controlled trial with 3 inpatient sites. Forty-eight participants (PA: 25; control: 23) completed the interventions, they were further stratified into LSN and RSN according to the neglect sides. Participants in the 2 intervention arms - PA and control, received the same pointing tasks, with the only difference being participants in the PA group wore a pair of prisms inducing a 5.7° optical shift to the right or left, while participants in the control group wore plain (sham) glasses, in the exposure stage. The training lasted for 20 to 30 minutes per session, for 10 sessions across 2 weeks. Main measures were Behavioural Inattention Test, Catherine Bergego Scale, and Modified Barthel Index were rated at 4 timepoints.</p><p><strong>Results: </strong>Both the PA and control groups improved over time. The gain scores for all outcomes in the PA group were significantly higher than that in the control group. Subgroup analyses showed that the gain scores in the PA-LSN and PA-RSN groups were significantly higher than in the sham-LSN and sham-RSN groups, respectively.</p><p><strong>Conclusion: </strong>PA is effective for poststroke spatial neglect recovery and performs better than a sham adaptation in terms of the amelioration of symptoms of neglect and daily functioning improvement in patients with LSN and RSN, but more benefits can be seen for LSN.</p><p><strong>Clinical trial registry: </strong>(Ref. no.: ChiCTR2100052573).</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261477085"},"PeriodicalIF":3.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815394","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":"Effect of DLPFC Targeted rTMS on Phantom Limb Pain and Associated Psychological Comorbidities: A Pilot Randomized Controlled Trial.","authors":"Deepanshu Vats, Renu Bhatia, Sushma Sagar, Aasheesh Kumar, Raj Kumar Yadav, Maroof Ahmad Khan, Sheffali Gulati, Akanksha Singh","doi":"10.1177/15459683261477087","DOIUrl":"https://doi.org/10.1177/15459683261477087","url":null,"abstract":"<p><strong>Background & aim: </strong>Maladaptive cortical plasticity is central to the pathophysiology of phantom limb pain (PLP), a condition often accompanied by sleep disturbances, anxiety, and depression states affecting quality of life. Repetitive transcranial magnetic stimulation (rTMS) has potential for relieving chronic neuropathic pain. Dorsolateral prefrontal cortex (DLPFC) is a critical component of neural circuitry subserving pain processing and associated affective aspects of pain. rTMS induced neuromodulation of DLPFC could be a potential therapeutic strategy in PLP management. Present study explored the role of rTMS of DLPFC on pain, anxiety, depression, and quality of life in PLP patients.</p><p><strong>Methods: </strong>Twenty-seven traumatic amputees with PLP were randomized into real or sham rTMS group. Real rTMS therapy included 10 sessions over 2 weeks, with 1Hz stimulation at 90% resting motor threshold applied to DLPFC contralateral to amputation site. For sham rTMS therapy, same protocol was used, except coil was placed perpendicular to the scalp, preventing actual stimulation. The primary outcome was pain intensity assessed using Visual Analogue Scale. Secondary outcomes included pain assessment using Short-Form McGill Pain Questionnaire, anxiety using Hamilton Anxiety Rating Scale, depression using Hamilton Depression Rating Scale, and quality of life using WHO quality of life-BREF questionnaire. Assessments were performed at baseline, after 10^th session, and during follow-up on days 15, 30, and 60 post-therapy.</p><p><strong>Results and conclusion: </strong>rTMS on DLPFC was associated with improvement in PLP, anxiety, depression, and quality of life. The findings suggest the potential of DLPFC-rTMS as an adjunctive modality in the management of PLP.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261477087"},"PeriodicalIF":3.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815399","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":"Analysis of Home-Based Rehabilitation Robotics: Lessons Learned from Nationwide Direct-to-Consumer Deployment.","authors":"Russell Jeter, Steven L Wolf, Stephen N Housley","doi":"10.1177/15459683261464105","DOIUrl":"https://doi.org/10.1177/15459683261464105","url":null,"abstract":"<p><strong>Introduction: </strong>Millions of stroke survivors in the US have sensory-motor impairments that significantly impact quality of life and place a long-term burden on families, communities, and the healthcare system. Neurorehabilitation aims to improve function, typically through repetitive practice of movements and task-related activities where doses are regularly titrated by skilled clinicians. Unfortunately, these highly intensive, skilled interventions are challenging to implement at the scale needed to serve the needs of stroke survivors. Rehabilitation technologies have long promised to be the workforce multiplier to normalize this large supply-demand mismatch in the U.S. healthcare system. Extensive investigations into rehabilitation devices have revealed myriad benefits. While rehab technologies have the potential to improve function, these inferences are largely derived from academic clinical studies which, while useful for exploring efficacy, do not represent marketplace (ie, commercial) conditions where interventions must operate to serve the larger population.</p><p><strong>Methods: </strong>Here, we present data from the first nationwide direct-to-consumer deployment of 2 home-based rehabilitation robotic systems.</p><p><strong>Results: </strong>Analysis of 3182 device deployments from August 2019 to June 2024 reveal surprising patterns in usage and compliance. We investigate the effects of socio-economic status, sex, rural-urban classification, and engagement on long-term utilization. Finally, we provide preliminary dose-response insights.</p><p><strong>Discussion and conclusions: </strong>We discuss the influence of market forces on commercial delivery of care to inform stakeholders of the challenges faced translating interventions to the consumer. Overall, we aim to derive lessons that can guide future implementations and improve the inclusivity and effectiveness of rehabilitation technologies deployed at scale.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261464105"},"PeriodicalIF":3.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803888","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":"Efficacy of Integrating the Interactive Virtual Device (REAtouch®) into HABIT-ILE for Children with Bilateral Cerebral Palsy: A Randomized Controlled Non-Inferiority Trial.","authors":"Seyma Kilcioglu, Benoît Schiltz, Astrid Carton de Tournai, Enimie Herman, Zélie Rosselli, Merlin Somville, Edouard Ducoffre, Célia De Clerck, Daniela Ebner-Karestinos, Rodrigo Araneda, Geoffroy Saussez, Yannick Bleyenheuft","doi":"10.1177/15459683261469065","DOIUrl":"https://doi.org/10.1177/15459683261469065","url":null,"abstract":"<p><strong>Background: </strong>Implementing intensive motor skill learning interventions like Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) in clinical practice faces accessibility challenges. Integrating the interactive virtual device (REAtouch®) into HABIT-ILE may help overcome these barriers, with potential for remote use.</p><p><strong>Objective: </strong>This study aimed to investigate whether HABIT-ILE with REAtouch® has non-inferior results compared to usual HABIT-ILE in children with bilateral cerebral palsy (BCP).</p><p><strong>Methods: </strong>Thirty children with BCP were randomized into the REAtouch® group (using the device for half of the one-to-one intervention time) or the HABIT-ILE group. Both groups completed a 65-hour intervention over 2 weeks. Assessments were conducted at baseline, post-intervention, and follow-up using primary (Gross Motor Function Measure [GMFM-66] and ABILHAND-Kids) and secondary measures. Analyses included one-way RM ANOVA, Friedman Test, and non-inferiority statistics.</p><p><strong>Results: </strong>Non-inferiority analysis indicated that the REAtouch® group did not achieve non-inferior changes compared with usual HABIT-ILE for most primary and secondary outcomes at post-intervention and follow-up (p > 0.025). Although both groups demonstrated statistically significant improvements in primary and most secondary outcomes, non-inferiority was confirmed only for ABILHAND-Kids (<i>P</i> = .022) and JTTHF-MA (<i>P</i> = 0.021) at post-intervention.</p><p><strong>Conclusion: </strong>While both groups improved in motor functions and daily life abilities, integrating REAtouch® into HABIT-ILE may not allow achieving non-inferior changes compared to usual HABIT-ILE in children with BCP. This highlights the role of virtual devices like REAtouch® as complementary tools rather than replacements for evidence-based therapy, with potential to enhance accessibility through carefully implemented remote use.</p><p><strong>Clinical trial registration number: </strong>NCT04403464.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261469065"},"PeriodicalIF":3.7,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763055","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 Unified Framework of Functional Clinical Outcomes for Implantable Motor Brain-Computer Interfaces: From Digital Motor Outputs to Critical Digital Activities.","authors":"Sawyer A, Burkhart I, Willis M, Ramsey N, Vansteensel M J, Putrino D","doi":"10.1177/15459683261477076","DOIUrl":"https://doi.org/10.1177/15459683261477076","url":null,"abstract":"<p><p>Implantable brain-computer interfaces (iBCIs) are at a pivotal inflection point. Multiple commercial ventures are advancing toward regulatory approval, and the challenge facing the field is transitioning from demonstrating safety and feasibility to achieving regulatory approval, reimbursement by payors, and sustainable clinical integration. Central to this challenge is the urgent need for robust, valid, and reliable clinical outcome assessments (COAs) that satisfy both regulatory and payor requirements and meaningfully reflect the lived experiences of people with severe motor impairment. Without such measures, iBCIs risk stalling in the transition from early feasibility to reimbursable therapy.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261477076"},"PeriodicalIF":3.7,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761042","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":"Time-Domain HRV Metrics as Predictors of Concussion Recovery in Adolescents: A Boosted Tree Approach.","authors":"Francesco Riganello, Christopher S Balestrini, Douglas D Fraser, M Erin Moir, Kolten C Abbott, Stephen A Klassen, Andrea Soddu, J Kevin Shoemaker","doi":"10.1177/15459683261469102","DOIUrl":"https://doi.org/10.1177/15459683261469102","url":null,"abstract":"<p><strong>Background: </strong>Concussions in adolescents, especially in sports, represent a major public health issue due to prolonged recovery and diagnostic challenges compared to adults. Current clinical assessments often underestimate the true burden and recovery course, highlighting the need for objective physiological biomarkers.</p><p><strong>Objective: </strong>To investigate heart rate variability (HRV) as a potential biomarker for monitoring concussion recovery in adolescents through both traditional statistics and machine learning approaches.</p><p><strong>Methods: </strong>Thirty-seven concussed adolescents (23 females, 14 males; mean age 15 ± 2 years) and 37 age-matched healthy controls (14 females, 23 males; mean age 16 ± 2 years) were enrolled. Concussed participants were evaluated within 1 month post-injury and at clinical discharge (mean interval = 9 ± 4 days). Each session included a 5-minute electrocardiogram and Post-Concussion Symptom Scale (PCSS). Time-domain HRV metrics-standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive differences (RMSSD), were severity-adjusted to PCSS severity (SDNNidx, RMSSDidx). A Boosted Tree algorithm predicted clinical outcomes (Good/Bad) based on raw and severity-adjusted HRV features.</p><p><strong>Results: </strong>Conventional statistics revealed no significant group differences in raw HRV metrics. However, severity-adjusted indices increased with lower symptom severity. The optimized Boosted Tree model achieved promising discriminative performance (AUC = .88), with 82% to 83% sensitivity, 75% to 79% specificity, and 82% to 84% F1 scores, accurately classifying all controls.</p><p><strong>Conclusions: </strong>Machine learning uncovered nonlinear HRV patterns predictive of clinical recovery where standard analyses failed. HRV-based predictive modeling may provide a noninvasive approach for individualized autonomic monitoring and evidence-based concussion management in adolescents.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261469102"},"PeriodicalIF":3.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709177","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":"Applying the International Classification of Functioning, Disability and Health to Classify Upper Limb Outcome Measures in Stroke Rehabilitation: A Construct-Driven Perspective.","authors":"Canan Yuksel-Haji, Nicola Hancock, Allan Clark, Valerie M Pomeroy","doi":"10.1177/15459683261469063","DOIUrl":"https://doi.org/10.1177/15459683261469063","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate evaluation of upper limb recovery after stroke is essential for guiding rehabilitation targeting specific impairments and activity limitations. To achieve this, outcome measures must clearly reflect what they assess, whether neuromuscular impairments or activity limitations. However, classification of measures is not always clear-cut, which can lead to misinterpretation of recovery progress and reduce rehabilitation planning effectiveness.</p><p><strong>Problem: </strong>Current classification practices often prioritize item content over the scoring criteria that define what is being quantified. This becomes particularly problematic when task-based items are scored using impairment-oriented criteria (e.g., range of motion), blurring whether change reflects impairment recovery or activity-level improvement. This ambiguity can mislead clinical decision-making and the interpretation of research findings.</p><p><strong>Solution: </strong>We propose a construct-driven application of the International Classification of Functioning, Disability and Health (ICF) in which component-level attribution is determined by the construct operationalized through scoring rather than inferred from item content. As scoring structures differ, three strategies are suggested based on item-level scoring attribution where feasible: (1) proportional classification for measures in which one ICF component predominates (with a pragmatic, provisional ≥60% dominance guideline for near-boundary cases), otherwise (2) dual-component reporting for mixed measures; and (3) non-proportional interpretation for measures exhibiting construct shifting across score levels or using dominant-construct scoring with embedded grading criteria.</p><p><strong>Conclusion: </strong>Grounding classification in the construct operationalized by scoring criteria provides a more defensible basis for outcome selection and interpretation. This supports clearer interpretation of intervention effects, more targeted rehabilitation, and stronger comparability across trials and evidence synthesis.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683261469063"},"PeriodicalIF":3.7,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703186","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}