Neurorehabilitation and neural repair最新文献

{"title":"Exploring Non-invasive Brain Stimulation Effects on Physical Outcomes in People With Parkinson's Disease: An Umbrella Evidence Mapping Review With Meta-analyses.","authors":"Dale M Harris, Christopher Latella, Nicholas Tripodi, Steven J O'Bryan","doi":"10.1177/15459683241310984","DOIUrl":"https://doi.org/10.1177/15459683241310984","url":null,"abstract":"<p><p><i>Background.</i> Non-invasive brain stimulation (NIBS) is sometimes used alongside medication to alleviate motor symptoms in people with Parkinson's disease (PD). However, the evidence supporting NIBS's effectiveness for improving motor function in PD patients is uncertain. <i>Objective</i>. This umbrella review aims to synthesize recent systematic reviews and meta-analyses that have evaluated the effectiveness of NIBS in improving motor function in people with PD, with a key focus being to examine the quality of the evidence presented. <i>Methods.</i> The review protocol was registered in PROSPERO (CRD42022380544) and conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search strategy was guided by the Population, Intervention, Comparison, and Outcome framework, focusing on individuals with idiopathic PD (Hoehn and Yahr stages 1-4). The review included studies comparing various NIBS techniques (eg, repetitive transcranial magnetic stimulation and transcranial direct current stimulation) to sham or alternative treatments, targeting motor and cognitive regions. Six databases were searched up to June 2024. Methodological quality was assessed using Assessment of Multiple Systematic Reviews 2 (AMSTAR2), and random-effects meta-analyses were performed to pool standardized mean differences (SMDs). <i>Results</i>. The final analysis included 31 meta-analyses and 10 systematic reviews. Overall, the reviews were rated as moderate quality (54% average for AMSTAR2). NIBS showed a small-to-moderate effect on motor function (Unified Parkinson's Disease Rating Scale-Section III scores; SMD = -0.80), functional mobility (gait speed and timed-up-and-go; SMD = -0.39), and freezing of gait (SMD = -0.58), but no significant effect on balance. <i>Conclusion</i>. NIBS offers small-to-moderate benefits for motor symptoms and functional movement in PD, though it does not significantly impact balance. Practitioners should consider the variety of techniques and treatment parameters before application.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683241310984"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960813","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":"Targeting Nerve Fiber Outgrowth Inhibition After Experimental Spinal Cord Injury: A Systematic Review and Meta-analysis of Chondroitinase ABC.","authors":"Alireza Khanteymoori, Clayton Peterson, Roza Atamny, Marc Hohenhaus, Jürgen Beck, David W Howells, Jan M Schwab, Ralf Watzlawick","doi":"10.1177/15459683241311337","DOIUrl":"10.1177/15459683241311337","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury (SCI) can impair motor, sensory, and autonomic function. The formation of the glial scar comprises protective as well as inhibitory neurite outgrowth properties operated by the deposition of chondroitin sulfate proteoglycans (CSPG). Chondroitinase ABC (ChABC) can degrade CSPG and foster neuroaxonal plasticity as a therapeutic approach to restore locomotor function after SCI.</p><p><strong>Objectives: </strong>To systematically review experimental ChABC treatments after SCI and assess their efficacy for locomotor function a comprehensive literature search was conducted following pre-registered Prospero Study protocol, selecting animal studies evaluating neurobehavioral outcomes after traumatic SCI followed by the calculation of normalized effect sizes applying meta-analysis and meta-regression methodology. Additional analyses were performed to investigate the impact of animal type, strain, sex, sample size, injury models, level of injury, and treatment duration.</p><p><strong>Results: </strong>Within the overall analysis of 1066 animals, a considerable amount of heterogeneity was observed. A subgroup analysis comprising experiments applying the same neurobehavioral measurement (blood-brain barrier/Basso-Mouse-Scale [BMS]-subgroup) demonstrated a 15.9% (95% CI = 11.3%-20.6%) improvement in locomotor outcomes. Different experimental characteristics influenced neurological recovery, including sex, level of injury, used anesthetic, reported dosage of ChABC treatment, the timepoint of assessment and perioperative temperature control. Sensitivity analysis applying Trim and Fill identified 19 hypothetical missing experiments suggestive of reporting bias.</p><p><strong>Conclusion: </strong>Reporting bias in experimental SCI research is prevalent and not limited to a specific intervention. ChABC treatment can exert beneficial effects on locomotor recovery after SCI.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683241311337"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960814","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":"Acute and Longitudinal Effects of Concussion on Reactive Balance in Collegiate Athletes.","authors":"Cecilia Monoli, Amanda J Morris, Regan Crofts, Nora F Fino, Tessa L Petersell, Trevor Jameson, Leland E Dibble, Peter C Fino","doi":"10.1177/15459683241309569","DOIUrl":"10.1177/15459683241309569","url":null,"abstract":"<p><strong>Background: </strong>Postural instability is a common observation after concussions, with balance assessments playing a crucial role in clinical evaluations. Widely used post-concussion balance tests focus primarily on static and dynamic balance, excluding the critical aspect of reactive balance.</p><p><strong>Objectives: </strong>This study investigated the acute and longitudinal effects of concussion on reactive balance in collegiate athletes.</p><p><strong>Methods: </strong>Concussed and healthy matched controls NCAA division I athletes were assessed at pre-season baseline and 4 post-concussion timepoints: acute, pre-return-to-play (RTP), post-RTP, and 6 months post-concussion. The instrumented-modified Push and Release test measured reactive balance during single- and dual-task conditions. Longitudinal effects of concussions on time to stability and step latency metrics were investigated applying Generalized Estimating Equations.</p><p><strong>Results: </strong>Acutely after concussion, athletes demonstrated impaired reactive balance, indicated by longer times to stability, in dual-task conditions (<i>P</i> = .004). These acute impairments were transient and recovered over time. Exploratory analyses revealed that athletes who sustained their first lifetime concussion exhibited both acute (<i>P</i> = .037) and longitudinal (<i>P</i> = .004 at post-RTP) impairments in single- and dual-task compared to controls with no lifetime concussion.</p><p><strong>Conclusions: </strong>This comprehensive evaluation provides insights into the multifaceted nature of post-concussion impairments and emphasizes the importance of considering cognitive demand and history of concussions in assessing athletes' balance.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683241309569"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960799","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 a Wearable-Based Intervention on the Hemiparetic Upper Limb in Persons With Stroke: A Randomized Controlled Trial.","authors":"Fong Mei Toh, Winnie W T Lam, Pablo Cruz Gonzalez, Kenneth N K Fong","doi":"10.1177/15459683241283412","DOIUrl":"10.1177/15459683241283412","url":null,"abstract":"<p><strong>Introduction: </strong>Wearables have emerged as a transformative rehabilitation tool to provide self-directed training in the home. <i>Objective.</i> In this study, we examined the efficacy of a novel wearable device, \"Smart Reminder\" (SR), to provide home-based telerehabilitation for hemiparetic upper limb (UL) training in persons with stroke.</p><p><strong>Methods: </strong>Forty stroke survivors from community support groups were randomized (stratified by the period after stroke onset and impairment severity) to either the SR group or the sham device group. Participants received either 20 hours of telerehabilitation using the SR device or training with pictorial handouts and a sham device over 4 weeks. In addition, all participants wore a standard accelerometer for 3 hours each day, 5 times a week, outside the prescribed training. Participants were assessed by a masked assessor at baseline, post-intervention (week 4), and follow-up (week 8). The outcome measures included Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Action Research Arm Test, Motor Activity Log, muscle strength, active range of motion and amount of movement of the UL, and compliance rate of training.</p><p><strong>Results: </strong>The SR group improved substantially in their FMA-UE scores after treatment (mean difference = 2.05, <i>P</i> <i>=</i> <i>.036</i>) compared to the sham group. Also, adherence to the training using the SR device was significantly higher, 97%, than the sham group, 82.3% (<i>P</i> <i>=</i> <i>.038).</i></p><p><strong>Conclusion: </strong>The 4-week telerehabilitation program using a \"SR\" device demonstrated potential efficacy in improving FMA-UE scores of the hemiparetic upper limb. However, it did not significantly enhance the performance of the affected limb in daily activities. The trial was registered on ClinicalTrial.gov (URL: http://www.clinicaltrials.gov) with the identifier NCT05877183.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"31-46"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335371","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":"Impairments in Proprioceptively-Referenced Limb and Eye Movements in Chronic Stroke.","authors":"Duncan T Tulimieri, Amelia Decarie, Tarkeshwar Singh, Jennifer A Semrau","doi":"10.1177/15459683241289123","DOIUrl":"10.1177/15459683241289123","url":null,"abstract":"<p><strong>Background: </strong>Upper limb proprioceptive impairments are common after stroke and affect daily function. Recent work has shown that stroke survivors have difficulty using visual information to improve proprioception. It is unclear how eye movements are impacted to guide action of the arm after stroke. Here, we aimed to understand how upper limb proprioceptive impairments impact eye movements in individuals with stroke.</p><p><strong>Methods: </strong>Control (N = 20) and stroke participants (N = 20) performed a proprioceptive matching task with upper limb and eye movements. A KINARM exoskeleton with eye tracking was used to assess limb and eye kinematics. The upper limb was passively moved by the robot and participants matched the location with either an arm or eye movement. Accuracy was measured as the difference between passive robot movement location and active limb matching (Hand-End Point Error) or active eye movement matching (Eye-End Point Error).</p><p><strong>Results: </strong>We found that individuals with stroke had significantly larger Hand (2.1×) and Eye-End Point (1.5×) Errors compared to controls. Further, we found that proprioceptive errors of the hand and eye were highly correlated in stroke participants (<i>r</i> = .67, <i>P</i> = .001), a relationship not observed for controls.</p><p><strong>Conclusions: </strong>Eye movement accuracy declined as a function of proprioceptive impairment of the more-affected limb, which was used as a proprioceptive reference. The inability to use proprioceptive information of the arm to coordinate eye movements suggests that disordered proprioception impacts integration of sensory information across different modalities. These results have important implications for how vision is used to actively guide limb movement during rehabilitation.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"47-57"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484511","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":"IpsiHand Brain-Computer Interface Therapy Induces Broad Upper Extremity Motor Rehabilitation in Chronic Stroke.","authors":"Nabi Rustamov, Lauren Souders, Lauren Sheehan, Alexandre Carter, Eric C Leuthardt","doi":"10.1177/15459683241287731","DOIUrl":"10.1177/15459683241287731","url":null,"abstract":"<p><strong>Background: </strong>Chronic hemiparetic stroke patients have very limited benefits from current therapies. Brain-computer interface (BCI) engaging the unaffected hemisphere has emerged as a promising novel therapeutic approach for chronic stroke rehabilitation.</p><p><strong>Objectives: </strong>This study investigated the effectiveness of contralesionally-controlled BCI therapy in chronic stroke patients with impaired upper extremity motor function. We further explored neurophysiological features of motor recovery driven by BCI. We hypothesized that BCI therapy would induce a broad motor recovery in the upper extremity, and there would be corresponding changes in baseline theta and gamma oscillations, which have been shown to be associated with motor recovery.</p><p><strong>Methods: </strong>Twenty-six prospectively enrolled chronic hemiparetic stroke patients performed a therapeutic BCI task for 12 weeks. Motor function assessment data and resting state electroencephalogram signals were acquired before initiating BCI therapy and across BCI therapy sessions. The Upper Extremity Fugl-Meyer assessment served as a primary motor outcome assessment tool. Theta-gamma cross-frequency coupling (CFC) was computed and correlated with motor recovery.</p><p><strong>Results: </strong>Chronic stroke patients achieved significant motor improvement in both proximal and distal upper extremity with BCI therapy. Motor function improvement was independent of Botox application. Theta-gamma CFC enhanced bilaterally over the C3/C4 motor electrodes and positively correlated with motor recovery across BCI therapy sessions.</p><p><strong>Conclusions: </strong>BCI therapy resulted in significant motor function improvement across the proximal and distal upper extremities of patients, which significantly correlated with theta-gamma CFC increases in the motor regions. This may represent rhythm-specific cortical oscillatory mechanism for BCI-driven rehabilitation in chronic stroke patients.</p><p><strong>Trial registration: </strong>Advarra Study: https://classic.clinicaltrials.gov/ct2/show/NCT04338971 and Washington University Study: https://classic.clinicaltrials.gov/ct2/show/NCT03611855.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"74-86"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335373","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":"Intensity-Dependent Effects of Low-Frequency Subthreshold rTMS on Primary Motor Cortex Excitability and Interhemispheric Inhibition in Elderly Participants: A Randomized Trial.","authors":"Miles Wischnewski, Lauren Edwards, Kate P Revill, Daniel Drake, Gerald Hobbs, Cathrin M Buetefisch","doi":"10.1177/15459683241292615","DOIUrl":"10.1177/15459683241292615","url":null,"abstract":"<p><strong>Background: </strong>Low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) protocols targeting primary motor cortex (M1) are used in rehabilitation of neurological diseases for their therapeutic potential, safety, and tolerability. Although lower intensity LF-rTMS can modulate M1 neurophysiology, results are variable, and a systematic assessment of its dose effect is lacking.</p><p><strong>Objectives: </strong>To determine the dose-response of LF-rTMS on stimulated and non-stimulated M1.</p><p><strong>Methods: </strong>In a sham-controlled randomized double-blind crossover study the effect of LF-TMS protocols were determined in 20 right-handed older healthy participants. In 3 sessions, 1 Hz rTMS at 80% (rTMS₈₀), 90% (rTMS₉₀) of motor threshold or sham stimulation were applied to left upper extremity M1. Outcome measures were curve parameters of the stimulus-response curve (maximum motor evoked potential [MEP_MAX], slope and the intensity to evoke 50% MEP_MAX), short-interval intracortical inhibition (SICI), and interhemispheric inhibition (IHI).</p><p><strong>Results: </strong>Within LF-rTMS sessions, rTMS₉₀, increased MEP_MAX in the stimulated M1. Furthermore, rTMS₉₀, increased the slope in the non-stimulated M1. LF-rTMS effects on SICI were dependent on the participants' baseline SICI, hemisphere, and intensity of conditioning pulse. Finally, rTMS₉₀ increased whereas rTMS₈₀ decreased IHI, for both IHI directions. These changes were dependent on baseline IHI and hemisphere and were no longer significant when baseline IHI was accounted for.</p><p><strong>Conclusions: </strong>Intensity of subthreshold LF-rTMS has differential effects on excitation and inhibition of stimulated and non-stimulated M1. The effects were small and were only demonstrated within the LF-rTMS sessions but were not different when compared to sham. rTMS related changes in SICI and IHI were dependent on baseline level.</p><p><strong>Clinicaltrials.gov identifier: </strong>NCT02544503, NCT01726218.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"58-73"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515560","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":"Delayed Cortical Responses During Reactive Balance After Stroke Associated With Slower Kinetics and Clinical Balance Dysfunction.","authors":"Jacqueline A Palmer, Aiden M Payne, Jasmine L Mirdamadi, Lena H Ting, Michael R Borich","doi":"10.1177/15459683241282786","DOIUrl":"10.1177/15459683241282786","url":null,"abstract":"<p><strong>Background: </strong>Slowed balance and mobility after stroke have been well-characterized. Yet the effects of unilateral cortical lesions on whole-body neuromechanical control is poorly understood, despite increased reliance on cortical resources for balance and mobility with aging. <i>Objective.</i> We tested whether individuals post stroke show impaired cortical responses evoked during reactive balance, and the effect of asymmetrical interlimb contributions to balance recovery and the evoked cortical response.</p><p><strong>Methods: </strong>Using electroencephalography, we assessed cortical N1 responses evoked over fronto-midline regions (Cz) during backward support-surface perturbations loading both legs and posterior-lateral directions that preferentially load the paretic or nonparetic leg in individuals' post-stroke and age-matched controls. We tested relationships between cortical responses and clinical balance/mobility function, as well as to center of pressure (CoP) rate of rise (RoR) during balance recovery.</p><p><strong>Results: </strong>Cortical N1 responses were smaller and delayed after stroke (<i>P</i> < .047), regardless of perturbation condition. In contrast to controls, slower cortical response latencies associated with lower clinical function in stroke (Mini Balance Evaluation Systems Test: <i>r</i> = -.61, <i>P</i> = .007; Timed-Up-and-Go: <i>r</i> = .53, <i>P</i> = .024; walking speed: <i>r</i> = -.46, <i>P</i> = .055). Paretic-loaded balance recovery revealed slower CoP RoR (<i>P</i> = .012) that was associated with delayed cortical response latencies (<i>r</i> = -.70, <i>P</i> = .003); these relationships were not present during bilateral and nonparetic-loaded conditions, nor in the older adults control group.</p><p><strong>Conclusions: </strong>Individuals after stroke may be limited in their balance ability by the slowed speed of their cortical responses to destabilization. In particular, paretic leg loading may reveal cortical response impairments that reflect reduced paretic motor capacity.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"16-30"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335370","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":"Complex Exercises Improve Cognition in People With Parkinson's Disease and Freezing of Gait.","authors":"Carla Silva-Batista, Filipe Oliveira de Almeida, Alana Batista, Egberto Reis Barbosa, Fay B Horak, Carlos Ugrinowitsch","doi":"10.1177/15459683241290793","DOIUrl":"10.1177/15459683241290793","url":null,"abstract":"<p><strong>Background: </strong>Evidence has suggested that cognitive decline may be a risk factor for freezing of gait (FOG) in Parkinson's disease (PD). Complex and challenging exercises have been suggested as potential rehabilitation strategies to decrease FOG severity and improve cognition; however, it is unknown whether improvement in cognition would explain decreased FOG severity following exercise.</p><p><strong>Objective: </strong>In this secondary analysis, we evaluated the effects of the adapted resistance training with instability (ARTI-complex and challenging exercises) compared with traditional motor rehabilitation (TMR-without challenging exercises) on cognitive function in people with FOG of PD. We also verified whether cognitive improvement explains the decrease in FOG previously published.</p><p><strong>Methods: </strong>Participants were randomized to either the experimental group (ARTI, n = 17) or the active control group (TMR, n = 15). Both training groups exercised 3 times a week for 12 weeks (80-90 minute each session). FOG severity (FOG ratio from inertial sensors during a 360° turning-in-place task), frontal lobe function (Frontal Assessment Battery [FAB]), global cognition (Montreal Cognitive Assessment [MoCA]), and attention and psychomotor speed (Digit Symbol Substitution Test [DSST]) were evaluated before and after interventions.</p><p><strong>Results: </strong>Only the ARTI group improved FAB, MoCA, and DSST scores at posttraining. In addition, ARTI was more effective than TMR in improving FAB scores at posttraining. The changes in FAB scores explained the changes in FOG ratio following ARTI (<i>R</i>² = .43, <i>P</i> < .01).</p><p><strong>Conclusions: </strong>This pilot study suggests that ARTI, a complex and challenging training, improves cognition in people with FOG of PD. Improvements in frontal lobe function with ARTI help explain decreased FOG severity.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"3-15"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484510","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":"Beyond Arm Capacity in Chronic Stroke: Evaluating Paretic Arm Non-Use Through Arm Efficiency-A Cross-Sectional Study.","authors":"Gaël Le Perf, Germain Faity, Denis Mottet, Makii Muthalib, Isabelle Laffont, Karima Bakhti","doi":"10.1177/15459683241303691","DOIUrl":"https://doi.org/10.1177/15459683241303691","url":null,"abstract":"<p><strong>Background: </strong>After a stroke, the use of the paretic arm is determined by its capacity (what it can or cannot do). When both arms have capacity to perform a task, the choice of which arm to use must be based on another criterion, probably by comparing the efficiency of each arm. Two numerical models account for this: the capacity model (the paretic arm is chosen in preference) and the efficiency model (the most efficient arm is chosen).</p><p><strong>Objective: </strong>To numerically determine whether capacity or efficiency best predict the use of the paretic arm in activities of daily living.</p><p><strong>Methods: </strong>We performed numerical simulations to predict paretic arm use with either the capacity model or the efficiency model. We used the Bayesian Information Criterion (BIC) to compare the adequacy of the 2 models in predicting clinical and accelerometric data collected from 30 patients with chronic stroke.</p><p><strong>Results: </strong>The efficiency model predicted arm use in activities of daily living better than the capacity model (BIC = -66.95 vs -5.89; root mean square error = 0.26 vs 0.72).</p><p><strong>Conclusions: </strong>The study highlights the importance of considering efficiency when assessing paretic arm non-use. Assessing individuals' arm efficiency should help personalize rehabilitation strategies after stroke.</p>","PeriodicalId":94158,"journal":{"name":"Neurorehabilitation and neural repair","volume":" ","pages":"15459683241303691"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143495122","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}