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Objective: Many stroke survivors still present with upper-limb paresis six months post-stroke, impacting their autonomy and quality of life (QoL). We designed an enriched Music-supported Therapy (eMST) program to reduce disability in this population. We evaluated the eMST's effectiveness in improving functional abilities and QoL in chronic stroke individuals compared to the conventional motor program Graded Repetitive Arm Supplementary Program (GRASP). Methods: We conducted a pragmatic two-arm parallel-group randomized controlled trial with a 3-month follow-up and masked assessment. The eMST involved playing instruments during individual self-administered and group music therapy sessions. The GRASP consisted of self-administered motor exercises using daily objects. Both interventions were completed at home with telemonitoring and involved four one-hour weekly sessions for 10 weeks. The primary outcome was upper-limb motor function measured with the Action Research Arm Test. Secondary outcomes included motor impairment, daily life motor performance, cognitive functions, emotional well-being, QoL, self-regulation, and self-efficacy. Intention-to-treat (ITT) and per-protocol (PP) analyses were conducted including participants who discontinued the intervention and those who completed it entirely, respectively. Results: Fifty-eight chronic stroke patients were randomized to the eMST-group (n = 26; age: 64.2 ± 12.5; 6 [23.1%] females; 2.8 ± 2.9 years post-stroke), and the control group (n = 32; age: 62.2 ± 12; 8 [25%] females; 1.8 ± 6.2 years post-stroke). The eMST-group had more participants achieving a clinically relevant improvement in motor impairment post-intervention than the control group for the ITT (55% vs 21.6%; OR = 4.5 (95% CI 1.4–14); p =.019) and PP analyses (60% vs 20%; OR = 6 (95% CI 1.5–24.7); p =.024), sustained at follow-up. The eMST-group reported greater improvements in emotion (difference = 11.1 (95% CI 0.8–21.5; p = 0.36) and participation (difference = 10.3 (95% CI 0.6–25.9); p = 0.41) subscales of QoL, and higher enjoyment during the sessions (difference = 1 (95% CI 0.3–1.5); p = 0.12). No changes were found in other outcomes. Conclusion: eMST demonstrated superiority over conventional motor rehabilitation program in enhancing upper-limb functions and QoL in chronic stroke individuals. Trial Registration: ClinicalTrials.gov (ID: NCT04507542). [ABSTRACT FROM AUTHOR]

Technology-based approaches for upper limb (UL) motor rehabilitation after stroke are mostly designed for severely affected patients to increase their recovery chances. However, the available randomized controlled trials (RCTs) focused on the efficacy of technology-based interventions often include patients with a wide range of motor impairment. This scoping review aims at overviewing the actual severity of stroke patients enrolled in RCTs that claim to specifically address UL severe motor impairment. The literature search was conducted on the Scopus and PubMed databases and included articles from 2008 to May 2024, specifically RCTs investigating the impact of technology-based interventions on UL motor functional recovery after stroke. Forty-eight studies were selected. They showed that, upon patients' enrollment, the values of the UL Fugl-Meyer Assessment and Action Research Arm Test covered the whole range of both scales, thus revealing the non-selective inclusion of severely impaired patients. Heterogeneity in terms of numerosity, characteristics of enrolled patients, trial design, implementation, and reporting was present across the studies. No clear difference in the severity of the included patients according to the intervention type was found. Patient stratification upon enrollment is crucial to best direct resources to those patients who will benefit the most from a given technology-assisted approach (personalized rehabilitation). [ABSTRACT FROM AUTHOR]

As the global prevalence of motor disabilities continues to rise, there is a pressing need for advanced solutions in physical rehabilitation. This systematic review examines the progress and challenges of implementing robotic technologies in the motor rehabilitation of patients with physical disabilities. The integration of robotic technologies such as exoskeletons, assistive training devices, and brain–computer interface systems holds significant promise for enhancing functional recovery and patient autonomy. The review synthesizes findings from the most important studies, focusing on the clinical effectiveness of robotic interventions in comparison to traditional rehabilitation methods. The analysis reveals that robotic therapies can significantly improve motor function, strength, co-ordination, and dexterity. Robotic systems also support neuroplasticity, enabling patients to relearn lost motor skills through precise, controlled, and repetitive exercises. However, the adoption of these technologies is hindered by high costs, the need for specialized training, and limited accessibility. Key insights from the review highlight the necessity of personalizing robotic therapies to meet individual patient needs, alongside addressing technical, economic, social, and cultural barriers. The review also underscores the importance of continued research to optimize these technologies and develop effective implementation strategies. By overcoming these challenges, robotic technologies can revolutionize motor rehabilitation, improving quality of life and social integration for individuals with motor disabilities. [ABSTRACT FROM AUTHOR]

Abstract Background The increase in cases of mild cognitive impairment (MCI) underlines the urgency of finding effective methods to slow its progression. Given the limited effectiveness of current pharmacological options to prevent or treat the early stages of this deterioration, non-pharmacological alternatives are especially relevant. Objective To assess the effectiveness of a cognitive-motor intervention based on immersive virtual reality (VR) that simulates an activity of daily living (ADL) on cognitive functions and its impact on depression and the ability to perform such activities in patients with MCI. Methods Thirty-four older adults (men, women) with MCI were randomized to the experimental group (n = 17; 75.41 ± 5.76) or control (n = 17; 77.35 ± 6.75) group. Both groups received motor training, through aerobic, balance and resistance activities in group. Subsequently, the experimental group received cognitive training based on VR, while the control group received traditional cognitive training. Cognitive functions, depression, and the ability to perform activities of daily living (ADLs) were assessed using the Spanish versions of the Montreal Cognitive Assessment (MoCA-S), the Short Geriatric Depression Scale (SGDS-S), and the of Instrumental Activities of Daily Living (IADL-S) before and after 6-week intervention (a total of twelve 40-minutes sessions). Results Between groups comparison did not reveal significant differences in either cognitive function or geriatric depression. The intragroup effect of cognitive function and geriatric depression was significant in both groups (p

This study evaluates the R3THA™ assessment protocol (R3THA-AP™), a technology-supported testing module for personalized rehabilitation in children with cerebral palsy (CP). It focuses on the reliability and validity of the R3THA-AP in assessing hand and arm function, by comparing kinematic assessments with standard clinical assessments. Conducted during a 4-week summer camp, the study assessed the functional and impairment levels of children with CP aged 3–18. The findings suggest that R3THA is more reliable for children aged 8 and older, indicating that age significantly influences the protocol's effectiveness. The results also showed that the R3THA-AP's kinematic measurements of hand and wrist movements are positively correlated with the Box and Blocks Test Index (BBTI), reflecting hand function and dexterity. Additionally, the R3THA-AP's accuracy metrics for hand and wrist activities align with the Melbourne Assessment 2's Range of Motion (MA2-ROM) scores, suggesting a meaningful relationship between R3THA-AP data and clinical assessments of motor skills. However, no significant correlations were observed between the R3THA-AP and MA2's accuracy and dexterity measurements, indicating areas for further research. These findings validate the R3THA-AP's utility in assessing motor abilities in CP patients, supporting its integration into clinical practice. [ABSTRACT FROM AUTHOR]

Background: The increase in cases of mild cognitive impairment (MCI) underlines the urgency of finding effective methods to slow its progression. Given the limited effectiveness of current pharmacological options to prevent or treat the early stages of this deterioration, non-pharmacological alternatives are especially relevant. Objective: To assess the effectiveness of a cognitive-motor intervention based on immersive virtual reality (VR) that simulates an activity of daily living (ADL) on cognitive functions and its impact on depression and the ability to perform such activities in patients with MCI. Methods: Thirty-four older adults (men, women) with MCI were randomized to the experimental group (n = 17; 75.41 ± 5.76) or control (n = 17; 77.35 ± 6.75) group. Both groups received motor training, through aerobic, balance and resistance activities in group. Subsequently, the experimental group received cognitive training based on VR, while the control group received traditional cognitive training. Cognitive functions, depression, and the ability to perform activities of daily living (ADLs) were assessed using the Spanish versions of the Montreal Cognitive Assessment (MoCA-S), the Short Geriatric Depression Scale (SGDS-S), and the of Instrumental Activities of Daily Living (IADL-S) before and after 6-week intervention (a total of twelve 40-minutes sessions). Results: Between groups comparison did not reveal significant differences in either cognitive function or geriatric depression. The intragroup effect of cognitive function and geriatric depression was significant in both groups (p < 0.001), with large effect sizes. There was no statistically significant improvement in any of the groups when evaluating their performance in ADLs (control, p = 0.28; experimental, p = 0.46) as expected. The completion rate in the experimental group was higher (82.35%) compared to the control group (70.59%). Likewise, participants in the experimental group reached a higher level of difficulty in the application and needed less time to complete the task at each level. Conclusions: The application of a dual intervention, through motor training prior to a cognitive task based on Immersive VR was shown to be a beneficial non-pharmacological strategy to improve cognitive functions and reduce depression in patients with MCI. Similarly, the control group benefited from such dual intervention with statistically significant improvements. Trial registration: ClinicalTrials.gov NCT06313931; https://clinicaltrials.gov/study/NCT06313931. [ABSTRACT FROM AUTHOR]

Upper limb impairment is common after stroke, with a significant impact on the stroke survivor's function, social participation and quality of life. Clinical guidelines are needed to inform clinical practise, tailor interventions to improve outcomes and address unresolved research questions. This review contributes to the evidence guiding clinical practise for upper limb motor recovery after stroke by summarising the recommendations from the UK rehabilitation guidelines (National Institute for Health and Care Excellence (NICE) and the Intercollegiate Stroke Working Party (ISWP)) and the European Stroke Organisation (ESO) guidelines, all published in 2023. All three guidelines target researchers, clinical practitioners, stroke survivors and their social networks. An important feature in all three guidelines was therapeutic intensity, with all guidelines recommending increased therapeutic intensity. Unlike the ESO, the NICE and ISWP additionally include specific research recommendations. While the NICE guidelines seem more holistic and target a wider audience, the three guidelines are complimentary. We recommend that a future consensus statement should be developed in partnership between all three organisations, agreeing on scope and using the same terminology, on recommendations to improve stroke rehabilitation in the UK and Europe. [ABSTRACT FROM AUTHOR]

The persistence of symptoms following COVID-19 infection represents a significant challenge in healthcare management. During the outbreak, tele-rehabilitation emerged as a new tool to support healthcare structures in providing rehabilitation services. This study assessed the effectiveness and the feasibility of a 3-week home-based motor and respiratory rehabilitation program for individuals with long COVID-19 after traditional rehabilitation. Twenty-three patients completed the program and underwent functional tests at different time points (i.e., baseline, at discharge from in-hospital rehabilitation and after tele-rehabilitation). Motor function was evaluated using the instrumented Six-Minutes Walking Test (i6MWT), with monitored heart rate and oxygen saturation. Additionally, respiratory function was measured via forced vital capacity (FVC) and maximal voluntary ventilation (MVV) tests. Significant improvements (p < 0.05) in motor and respiratory function were observed throughout the intervention, including an 18.3% increase in walked distance from the baseline. The findings suggest that the proposed home-based tele-rehabilitation shows potential in enhancing motor and respiratory function in patients with long COVID. Despite limitations such as the small sample size, lack of control group and the preliminary nature of the outcomes observed, the overall findings seem to support the feasibility of the proposed tele-rehabilitation program in managing long COVID symptoms and promoting functional recovery. Nevertheless, further research is needed to validate these findings and explore tele-rehabilitation's potential in broader and different patient populations [ABSTRACT FROM AUTHOR]

Peripheral facial paralysis (PFP) causes deficits in muscle and sensory functions of the face due to damage to the facial nerve. In this study, we evaluated the effectiveness of the "Fisiobem" app in rehabilitating patients with PFP through facial mimicry exercises. The app uses the device's camera to identify the user and measure the range of motion during the exercises, applying the ARKit framework to quantify the intensity of the movements. We conducted a usability study with 34 participants unaffected by PFP, performing mimics with different amplitudes. Results show that glasses did not affect recognition accuracy in exercises such as raising eyebrows, frowning, and closing the eyes tightly. As for wrinkling the nose exercise, glasses impacted higher intensities. As for the beard or mustache, lower lip protrusion, compressing the lips, smiling, showing teeth and blowing out filling cheeks were not affected. However, when smiling with lips together, beard and mustache influenced intensities above 75%. It is important to highlight that this study has limitations, such as the sample size and lack of consideration for ethnic diversity among participants. Future research with larger and more diverse samples is needed to validate and generalize these findings and explore the nuances of interactions between facial features and facial recognition algorithms. Despite these limitations, the approach facilitated by the "Fisiobem" application offers significant benefits, especially for patients with PFP who face challenges in accessing specialized therapists. It allows patients to complement their treatment by performing guided facial mimicry exercises at home. The application helps individuals accurately perform the exercises and effectively track the progress of their rehabilitation. [ABSTRACT FROM AUTHOR]

Background: The use of immersive Virtual Reality (VR) in stroke rehabilitation appears to be promising for the improvement of motor and cognitive functions. Methods: The purpose of this pilot study was to investigate the suitability, usability and safety of VR applications that combine motor and cognitive training. Patients suffering from stroke in a subacute phase, and with Mini Mental State Examination (MMSE) ≥18/30, participated in the study. In the context of the REACT project, two IVR applications were designed and created, combining the use of motor and cognitive skills. Full immersion was achieved using the Head Mounted Display (HMD) Oculus Rift S. The intervention lasted for 4 weeks. The Suitability Evaluation Questionnaire (SEQ) was used for measurements. Values are expressed in the median (25th75th percentile). Results: Four patients [age: 64.5(61.0-69.5) years, gender:1 female / 3 male] in the 3rd -14th week of rehabilitation were finally included. Overall, the patient's SEQ score was 61(55-63). No adverse effects were reported, only one patient reported mild confusion 5.0(4.8-5.0) in one assessment. No differences were found in the comparison between first and second evaluation [61(58-62) vs 61(48- 64), p>0.05]. Conclusions: The primary results of this study show that the equipment is usable, safe, and suitable for use in the rehabilitation of patients with stroke in the early stages of rehabilitation. However, more large-scale studies are needed to investigate the validity and effects of VR applications in the neurorehabilitation of various disorders. [ABSTRACT FROM AUTHOR]

Background: Transcutaneous auricular vagus nerve stimulation (taVNS) has garnered attention for stroke rehabilitation, with studies demonstrating its benefits when combined with motor rehabilitative training or delivered before motor training. The necessity of concurrently applying taVNS with motor training for post-stroke motor rehabilitation remains unclear. We aimed to investigate the necessity and advantages of applying the taVNS concurrently with motor training by an electromyography (EMG)-triggered closed-loop system for poststroke rehabilitation. Methods: We propose a double-blinded, randomized clinical trial involving 150 stroke patients assigned to one of three groups: concurrent taVNS, sequential taVNS, or sham control condition. In the concurrent group, taVNS bursts will synchronize with upper extremity motor movements with EMG-triggered closed-loop system during the rehabilitative training, while in the sequential group, a taVNS session will precede the motor rehabilitative training. TaVNS intensity will be set below the pain threshold for both concurrent and sequential conditions and at zero for the control condition. The primary outcome measure is the Fugl-Meyer Assessment of Upper Extremity (FMA-UE). Secondary measures include standard upper limb function assessments, as well as EMG and electrocardiogram (ECG) features. Ethics and dissemination: Ethical approval has been granted by the Medical Ethics Committee, affiliated with Zhujiang Hospital of Southern Medical University for Clinical Studies (2023-QX-012-01). This study has been registered on ClinicalTrials (NCT05943431). Signed informed consent will be obtained from all included participants. The findings will be published in peer-reviewed journals and presented at relevant stakeholder conferences and meetings. Discussion: This study represents a pioneering effort in directly comparing the impact of concurrent taVNS with motor training to that of sequential taVNS with motor training on stroke rehabilitation. Secondly, the incorporation of an EMG-triggered closed-loop taVNS system has enabled the automation and individualization of both taVNS and diverse motor training tasks--a novel approach not explored in previous research. This technological advancement holds promise for delivering more precise and tailored training interventions for stroke patients. However, it is essential to acknowledge a limitation of this study, as it does not delve into examining the neural mechanisms underlying taVNS in the context of post-stroke rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: Hand and upper limb functional impairments following stroke lead to limitations in performing activities of daily living. We aimed to investigate feasibility and efficacy of an early sensory-motor rehabilitation program on hand and upper limb function in patients with acute stroke. Design: A pilot, single-subject experimental, A-B-A study. Setting: Stroke unit of an educational hospital and an outpatient occupational therapy clinic. Participants: A convenience sample including five people with acute stroke. Procedures: Participants received 3 h of an intensive hand and upper limb sensory and motor rehabilitation program, 5 days per week for 3 months (15-min mental imagery, 15-min action observation, 30-min mirror therapy, 1.5-h constraint-induced movement therapy, and 30-min bilateral arm training). Activities were chosen based on the task-oriented occupational therapy approach. Outcome measures: An assessor blinded to intervention program measured sensory and motor functions using action research arm test, box and block test, Semmes–Weinstein monofilaments, and upper extremity section of Fugl-Meyer assessment. Results: Assessment data points in intervention and follow-up phases compared to baseline were in higher levels, sloped upwardly, and increased significantly for all participants in all outcome measures. Conclusions: The present pilot study showed that a package of nowadays evidence-based rehabilitation methods including mental imagery, action observation, mirror therapy, modified constraint-induced movement therapy, bilateral arm training, and task-oriented occupational therapy approach is able to improve sensory and motor functions of the hand and upper limb in patients with acute stroke. [ABSTRACT FROM AUTHOR]

Copyright of Critical Hermeneutics: Biannual Journal of Philosophy is the property of Universita degli Studi di Cagliari and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Stroke is a highly disabling condition, for which music therapy is regularly used in rehabilitation. One possible mechanism for the effects of music therapy is the motivational aspect of music, for example regarding treatment adherence based on improved mood. In this study, changes in motivation related to Neurologic Music Therapy (NMT) techniques during rehabilitation in the subacute phase after stroke will be investigated. Using a randomised within-subjects cross-over design, the effects of two NMT techniques and related motivational indices will be investigated. Data will be collected at three timepoints: baseline (TP1), after being randomised into groups and receiving NMT or standard care (TP2), and then at a third time point after the cross-over and having received both conditions (TP3). This design allows to counteract order effects, time effects due to spontaneous and/or nonlinear recovery, as well as single-subject comparisons in a relatively heterogeneous sample. Twenty adult participants who have experienced a supratentorial ischaemic or haemorrhagic stroke and are experiencing upper-limb impairments and/or cognitive deficits will be included. Behavioural measures of motor function, cognition, and quality of life will be collected, along with self-reported indices of overall motivation. The study outcomes will have implications for the understanding of the underlying mechanisms of music therapy in stroke recovery, more specifically regarding the relevance of motivational states in neurorehabilitation.

A reserve in the motor domain may underlie the capacity exhibited by some patients to maintain motor functionality in the face of a certain level of disease. This form of "motor reserve" (MR) could include cortical, cerebellar, and muscular processes. However, a systematic definition has not been provided yet. Clarifying this concept in healthy individuals and patients would be crucial for implementing prevention strategies and rehabilitation protocols. Due to its wide application in the assessment of motor system functioning, non-invasive brain stimulation (NIBS) may support such definition. Here, studies focusing on reserve in the motor domain and studies using NIBS were revised. Current literature highlights the ability of the motor system to create a reserve and a possible role for NIBS. MR could include several mechanisms occurring in the brain, cerebellum, and muscles, and NIBS may support the understanding of such mechanisms. [ABSTRACT FROM AUTHOR]

Aim: Stroke represents a significant cause of long‐term disability in adults. Repetitive transcranial magnetic stimulation (rTMS) is a non‐invasive brain stimulation method known for its potential to enhance motor recovery. Intermittent theta burst stimulation (iTBS), a standardised rTMS protocol initially utilised in patients with depression, has garnered attention in the realm of stroke rehabilitation. This study seeks to establish the efficacy profile of iTBS in motor rehabilitation for patients with subacute or chronic stroke. Patients and methods: This study is a prospective cohort trial in which eligible patients with stroke were recruited into the iTBS group. Ten sessions of iTBS were conducted, followed by physiotherapy. An equal number of matched controls were recruited into the conventional physiotherapy group. The differences in various scoring systems related to motor performance at 6 months were analysed using independent two‐sample t test. Results: Forty patients were enrolled in the study. At 6 months, iTBS demonstrated a statistically significant improvement compared with conventional physiotherapy across various scoring systems, including motor power grading (47.4% vs 0%, P <.0001), Upper Extremity Fugl–Meyer Assessment (19.8% vs 0.7%, P <.0001), Box and Block Test (25.6% vs 1.7%, P =.007) and Barthel Index (17.8% vs 0.1%, P =.0002). No major adverse events were reported in the iTBS group at 6 months. Conclusion: iTBS resulted in significant improvement in motor performance across various domains at 6 months compared with conventional physiotherapy alone. This method proves to be a safe approach for motor rehabilitation. [ABSTRACT FROM AUTHOR]

This research aims to design a rehabilitation program to reduce the deviation of the neck of the text and identify its effect through the range of motion (neck) and flexibility of the spine. Then the researchers used the experimental method and used the pre- and post-measurement method on one group to suit the nature of the research. The research population included 405 male and female students in the Cairo administration. The new students at the Fifth Settlement School (General Omar Suleiman School) range in age from 12 to 14 years in the preparatory stage. The sample was chosen intentionally from students afflicted with textural syndrome. They numbered 30 male and female students, aged between (12-14) years, 20 afflicted from the basic sample and 10 exploratory samples from outside the basic research sample. The results of the research that the researcher arrived at in light of the research sample resulted in the researcher concluding what The following are statistical differences in the averages of the pre- and post-measurements in improving the degree of neck deviations among middle school students in Cairo Governorate, in favor of the post-measurement averages. The most important recommendations were the necessity of spreading awareness among teachers and parents regarding proper national customs, how to deal with mobile devices, and avoiding wrong habits while using electronic devices when dealing with students through organized campaigns targeting all sectors . [ABSTRACT FROM AUTHOR]

Background: Balance and mobility impairments are prevalent post-stroke and a large number of survivors require walking assistance at 6 months post-stroke which diminishes their overall quality of life. Personalized interventions for gait and balance rehabilitation are crucial. Recent evidence indicates that stroke lesions in primary motor pathways, such as corticoreticular pathways (CRP) and corticospinal tract (CST), may lead to reliance on alternate motor pathways as compensation, but the current evidence lacks comprehensive knowledge about the underlying neural mechanisms. Methods: In this study, we investigate the functional connectivity (FC) changes within the motor network derived from an individualized cortical parcellation approach in 33 participants with chronic stroke compared to 17 healthy controls. The correlations between altered motor FC and gait deficits (i.e., walking speed and walking balance) were then estimated in the stroke population to understand the compensation mechanism of the motor network in motor function rehabilitation post-stroke. Results: Our results demonstrated significant FC increases between ipsilesional medial supplementary motor area (SMA) and premotor in stroke compared to healthy controls. Furthermore, we also revealed a negative correlation between ipsilesional SMA-premotor FC and self-selected walking speed, as well as the Functional Gait Assessment (FGA) scores. Conclusion: The increased FC between the ipsilesional SMA and premotor regions could be a compensatory mechanism within the motor network following a stroke when the individual can presumably no longer rely on the more precise CST modulation of movements to produce a healthy walking pattern. These findings enhance our understanding of individualized motor network FC changes and their connection to gait and walking balance impairments post-stroke, improving stroke rehabilitation interventions. [ABSTRACT FROM AUTHOR]

Introduction: Virtual Reality applications for rehabilitation are increasing in popularity. In traditional as well as virtual rehabilitation, the guidance of an occupational therapist through physical and verbal interaction is often required. Several studies have attempted to implement a virtual therapist or assistant in immersive virtual environments for rehabilitation. Objective: This research aims to systematically review these studies, understanding the therapist's role and how they are represented in the virtual environment, how the virtual therapist and patient interact and the experience of users. Our goal is to provide guidance for virtual therapist implementations into fully immersive virtual reality environments. Method: The researchers systematically reviewed the literature on virtual therapists in immersive virtual environments for motor rehabilitation (protocol prospectively registered with PROSPERO ID: CRD42022357369). Results and Conclusion: Seven studies were identified, with findings showing that virtual therapists are often human-like avatars that guide patients, requiring them to mimic the therapist's movements. Visual, haptic, or one-direction audio feedback from the therapist to the patient was provided in five studies. The selected studies were all newly developed custom-made systems, with five systems developed using the same game engine. Studies carrying out user testing utilised several methods to understand user experience, evidencing a positive attitude from therapists and motivated and satisfied patients. Future Research: The roles of virtual therapists for motor rehabilitation needs to be explored further in rigorous empirical studies to gather data on patient and therapist user experience. Considerable potential was identified in the development of virtual therapists and therapeutic alliance in the virtual environment. Future systems should reduce manual input from therapists and include personalisation and individualised patient feedback. [ABSTRACT FROM AUTHOR]

Introduction: Acquired brain injuries pose significant societal and individual challenges worldwide. The adoption of XR technologies presents an opportunity to enhance current rehabilitation procedures. However, a comprehensive understanding of the specific requirements of different user groups in XR-based rehabilitation remains incomplete. Our objective was to identify design recommendations for designers and researchers of XR-based exergames for motor rehabilitation for lower-limb motor recovery at home. Methods: After initially conducting a mini-literature review and brief market analysis, we used a human-centered design process, interviewing central stakeholders to understand their perspectives and using thematic analysis to identify recurring themes and insights related to XR-based rehabilitation. Results: The resulting eight key themes for integrating XR-based exergames into acquired brain injuries (ABI) rehabilitation were safety, flexibility, efficacy, usability, technology, motivation, ownership, and social factors. Conclusion: By addressing technical and user-oriented demands, our resulting design recommendations aid designers in developing meaningful XR-based rehabilitation exercises. [ABSTRACT FROM AUTHOR]

Background: Motor learning is essential for performing specific tasks and progresses through distinct stages, including the rapid learning phase (initial skill acquisition), the consolidation phase (skill refinement), and the stable performance phase (skill mastery and maintenance). Understanding the cortical activation dynamics during these stages can guide targeted rehabilitation interventions. Methods: In this longitudinal randomized controlled trial, functional near‐infrared spectroscopy was used to explore the temporal dynamics of cortical activation in hand‐related motor learning. Thirty‐one healthy right‐handed individuals were randomly assigned to perform either easy or intricate motor tasks with their non‐dominant hand over 10 days. We conducted 10 monitoring sessions to track cortical activation in the right hemisphere (according to lateralization principles, the primary hemisphere for motor control) and evaluated motor proficiency concurrently. Results: The study delineated three stages of nondominant hand motor learning: rapid learning (days 1 and 2), consolidation (days 3–7), and stable performance (days 8–10). There was a power‐law enhancement of motor skills correlated with learning progression. Sustained activation was observed in the supplementary motor area (SMA) and parietal lobe (PL), whereas activation in the right primary motor cortex (M1R) and dorsolateral prefrontal cortex (PFCR) decreased. These cortical activation patterns exhibited a high correlation with the augmentation of motor proficiency. Conclusions: The findings suggest that early rehabilitation interventions, such as transcranial magnetic stimulation and transcranial direct current stimulation (tDCS), could be optimally directed at M1 and PFC in the initial stages. In contrast, SMA and PL can be targeted throughout the motor learning process. This research illuminates the path for developing tailored motor rehabilitation interventions based on specific stages of motor learning. NEW and NOTEWORTHY: In an innovative approach, our study uniquely combines a longitudinal design with the robustness of generalized estimating equations (GEEs). With the synergy of functional near‐infrared spectroscopy (fNIRS) and the Minnesota Manual Dexterity Test (MMDT) paradigm, we precisely trace the evolution of neural resources during complex, real‐world fine‐motor task learning. Centering on right‐handed participants using their nondominant hand magnifies the intricacies of right hemisphere spatial motor processing. We unravel the brain's dynamic response throughout motor learning stages and its potent link to motor skill enhancement. Significantly, our data point toward the early‐phase rehabilitation potential of TMS and transcranial direct current stimulation on the M1 and PFC regions. Concurrently, SMA and PL appear poised to benefit from ongoing interventions during the entire learning curve. Our findings carve a path for refined motor rehabilitation strategies, underscoring the importance of timely noninvasive brain stimulation treatments. [ABSTRACT FROM AUTHOR]

Copyright of GeSec: Revista de Gestao e Secretariado is the property of Sindicato das Secretarias e Secretarios do Estado de Sao Paulo (SINSESP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Physical therapy is crucial to rehabilitating hand function needed for activities of daily living after neurological traumas such as traumatic brain injury (TBI). Virtual reality (VR) can motivate participation in motor rehabilitation therapies. This study examines how multimodal feedback in VR to train grasp-and-place function will impact the neurological and motor responses in TBI participants (n = 7) compared to neurotypicals (n = 13). Methods: We newly incorporated VR with our existing intelligent glove system to seamlessly enhance the augmented visual and audio feedback to inform participants about grasp security. We then assessed how multimodal feedback (audio plus visual cues) impacted electroencephalography (EEG) power, grasp-and-place task performance (motion pathlength, completion time), and electromyography (EMG) measures. Results: After training with multimodal feedback, electroencephalography (EEG) alpha power significantly increased for TBI and neurotypical groups. However, only the TBI group demonstrated significantly improved performance or significant shifts in EMG activity. Discussion: These results suggest that the effectiveness of motor training with augmented sensory feedback will depend on the nature of the feedback and the presence of neurological dysfunction. Specifically, adding sensory cues may better consolidate early motor learning when neurological dysfunction is present. Computerized interfaces such as virtual reality offer a powerful platform to personalize rehabilitative training and improve functional outcomes based on neuropathology. [ABSTRACT FROM AUTHOR]

Motor impairment has a profound impact on a significant number of individuals, leading to a substantial demand for rehabilitation services. Through brain–computer interfaces (BCIs), people with severe motor disabilities could have improved communication with others and control appropriately designed robotic prosthetics, so as to (at least partially) restore their motor abilities. BCI plays a pivotal role in promoting smoother communication and interactions between individuals with motor impairments and others. Moreover, they enable the direct control of assistive devices through brain signals. In particular, their most significant potential lies in the realm of motor rehabilitation, where BCIs can offer real-time feedback to assist users in their training and continuously monitor the brain's state throughout the entire rehabilitation process. Hybridization of different brain-sensing modalities, especially functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG), has shown great potential in the creation of BCIs for rehabilitating the motor-impaired populations. EEG, as a well-established methodology, can be combined with fNIRS to compensate for the inherent disadvantages and achieve higher temporal and spatial resolution. This paper reviews the recent works in hybrid fNIRS-EEG BCIs for motor rehabilitation, emphasizing the methodologies that utilized motor imagery. An overview of the BCI system and its key components was introduced, followed by an introduction to various devices, strengths and weaknesses of different signal processing techniques, and applications in neuroscience and clinical contexts. The review concludes by discussing the possible challenges and opportunities for future development. [ABSTRACT FROM AUTHOR]

A reserve in the motor domain may underlie the capacity exhibited by some patients to maintain motor functionality in the face of a certain level of disease. This form of “motor reserve” (MR) could include cortical, cerebellar, and muscular processes. However, a systematic definition has not been provided yet. Clarifying this concept in healthy individuals and patients would be crucial for implementing prevention strategies and rehabilitation protocols. Due to its wide application in the assessment of motor system functioning, non-invasive brain stimulation (NIBS) may support such definition. Here, studies focusing on reserve in the motor domain and studies using NIBS were revised. Current literature highlights the ability of the motor system to create a reserve and a possible role for NIBS. MR could include several mechanisms occurring in the brain, cerebellum, and muscles, and NIBS may support the understanding of such mechanisms.

Effective upper-limb rehabilitation for severely impaired stroke survivors is still missing. Recent studies endorse novel motor rehabilitation approaches such as robotic exoskeletons and virtual reality systems to restore the function of the paretic limb of stroke survivors. However, the optimal way to promote the functional reorganization of the central nervous system after a stroke has yet to be uncovered. Electromyographic (EMG) signals have been employed for prosthetic control, but their application to rehabilitation has been limited. Here we propose a novel approach to promote the reorganization of pathological muscle activation patterns and enhance upper-limb motor recovery in stroke survivors by using an EMG-controlled interface to provide personalized assistance while performing movements in virtual reality (VR). We suggest that altering the visual feedback to improve motor performance in VR, thereby reducing the effect of deviations of the actual, dysfunctional muscle patterns from the functional ones, will actively engage patients in motor learning and facilitate the restoration of functional muscle patterns. An EMG-controlled VR interface may facilitate effective rehabilitation by targeting specific changes in the structure of muscle synergies and in their activations that emerged after a stroke—offering the possibility to provide rehabilitation therapies addressing specific individual impairments.

The article highlights the innovative way of development of adaptive student sports at the NRU “MEI” in general, and motor rehabilitation of students of a special medical group, in particular. The proposed strategy is a unique realisable project being implemented, integrally combining a technological scientifically grounded approach to the problem under study, and the practical effective implementation of a multi-component motor rehabilitation model operating in its basic basis with an instrumental component of student sports.

This study examined the effects of different modes of augmented visual feedback of joint kinematics on the emerging joint moment patterns during the two-legged squat maneuver. Training with augmented visual feedback supports improved kinematic performance of maneuvers related to sports or daily activities. Despite being representative of intrinsic motor actions, joint moments are not traditionally evaluated with kinematic feedback training. Furthermore, stabilizing joint moment patterns with physical training is beneficial to rehabilitating joint-level function (e.g., targeted strengthening and conditioning of muscles articulating that joint). Participants were presented with different modes of augmented visual feedback to track a target squat-motion trajectory. The feedback modes varied along features of complexity (i.e., number of segment trajectories shown) and body representation (i.e., trajectories shown as sinusoids versus dynamic stick-figure avatars). Our results indicated that mean values and variability (trial-to-trial standard deviations) of joint moments are significantly (p < 0.05) altered depending on the visual feedback features being applied, the specific joint (ankle, knee, hip), and the squat movement phase (early, middle, or late time window). This study should incentivize more optimal delivery of visual guidance during rehabilitative training with computerized interfaces (e.g., virtual reality).

This study evaluates the R3THA™ assessment protocol (R3THA-AP™), a technology-supported testing module for personalized rehabilitation in children with cerebral palsy (CP). It focuses on the reliability and validity of the R3THA-AP in assessing hand and arm function, by comparing kinematic assessments with standard clinical assessments. Conducted during a 4-week summer camp, the study assessed the functional and impairment levels of children with CP aged 3–18. The findings suggest that R3THA is more reliable for children aged 8 and older, indicating that age significantly influences the protocol’s effectiveness. The results also showed that the R3THA-AP’s kinematic measurements of hand and wrist movements are positively correlated with the Box and Blocks Test Index (BBTI), reflecting hand function and dexterity. Additionally, the R3THA-AP’s accuracy metrics for hand and wrist activities align with the Melbourne Assessment 2’s Range of Motion (MA2-ROM) scores, suggesting a meaningful relationship between R3THA-AP data and clinical assessments of motor skills. However, no significant correlations were observed between the R3THA-AP and MA2’s accuracy and dexterity measurements, indicating areas for further research. These findings validate the R3THA-AP’s utility in assessing motor abilities in CP patients, supporting its integration into clinical practice.

The persistence of symptoms following COVID-19 infection represents a significant challenge in healthcare management. During the outbreak, tele-rehabilitation emerged as a new tool to support healthcare structures in providing rehabilitation services. This study assessed the effectiveness and the feasibility of a 3-week home-based motor and respiratory rehabilitation program for individuals with long COVID-19 after traditional rehabilitation. Twenty-three patients completed the program and underwent functional tests at different time points (i.e., baseline, at discharge from in-hospital rehabilitation and after tele-rehabilitation). Motor function was evaluated using the instrumented Six-Minutes Walking Test (i6MWT), with monitored heart rate and oxygen saturation. Additionally, respiratory function was measured via forced vital capacity (FVC) and maximal voluntary ventilation (MVV) tests. Significant improvements (p < 0.05) in motor and respiratory function were observed throughout the intervention, including an 18.3% increase in walked distance from the baseline. The findings suggest that the proposed home-based tele-rehabilitation shows potential in enhancing motor and respiratory function in patients with long COVID. Despite limitations such as the small sample size, lack of control group and the preliminary nature of the outcomes observed, the overall findings seem to support the feasibility of the proposed tele-rehabilitation program in managing long COVID symptoms and promoting functional recovery. Nevertheless, further research is needed to validate these findings and explore tele-rehabilitation’s potential in broader and different patient populations

In this study we combined non-invasive transcutaneous auricular vagal nerve stimulation (taVNS) with 40 h of constraint induced movement therapy (CIMT) in infants. All infants completed the full intervention with no adverse events. Therapists were able to maintain high treatment fidelity and reported high ratings for ease of use and child tolerance. Preliminary results show promising gains on motor outcomes: Mean QUEST increase 19.17 (minimal clinically important difference, MCID 4.89); Mean GMFM increase 13.33 (MCID 1%–3%). Infants also exceeded expectations on Goal Attainment Scores (+1). Early data is promising that taVNS paired with intensive motor CIMT is feasible, reliable, and safe in young infants with hemiplegia, and may help harness activity-dependent plasticity to enhance functional movement.

Introduction: Virtual Reality applications for rehabilitation are increasing in popularity. In traditional as well as virtual rehabilitation, the guidance of an occupational therapist through physical and verbal interaction is often required. Several studies have attempted to implement a virtual therapist or assistant in immersive virtual environments for rehabilitation.Objective: This research aims to systematically review these studies, understanding the therapist’s role and how they are represented in the virtual environment, how the virtual therapist and patient interact and the experience of users. Our goal is to provide guidance for virtual therapist implementations into fully immersive virtual reality environments.Method: The researchers systematically reviewed the literature on virtual therapists in immersive virtual environments for motor rehabilitation (protocol prospectively registered with PROSPERO ID: CRD42022357369).Results and Conclusion: Seven studies were identified, with findings showing that virtual therapists are often human-like avatars that guide patients, requiring them to mimic the therapist’s movements. Visual, haptic, or one-direction audio feedback from the therapist to the patient was provided in five studies. The selected studies were all newly developed custom-made systems, with five systems developed using the same game engine. Studies carrying out user testing utilised several methods to understand user experience, evidencing a positive attitude from therapists and motivated and satisfied patients.Future Research: The roles of virtual therapists for motor rehabilitation needs to be explored further in rigorous empirical studies to gather data on patient and therapist user experience. Considerable potential was identified in the development of virtual therapists and therapeutic alliance in the virtual environment. Future systems should reduce manual input from therapists and include personalisation and individualised patient feedback.Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=357369], PROSPERO ID [CRD42022357369].

Abstract Background Motor learning is essential for performing specific tasks and progresses through distinct stages, including the rapid learning phase (initial skill acquisition), the consolidation phase (skill refinement), and the stable performance phase (skill mastery and maintenance). Understanding the cortical activation dynamics during these stages can guide targeted rehabilitation interventions. Methods In this longitudinal randomized controlled trial, functional near‐infrared spectroscopy was used to explore the temporal dynamics of cortical activation in hand‐related motor learning. Thirty‐one healthy right‐handed individuals were randomly assigned to perform either easy or intricate motor tasks with their non‐dominant hand over 10 days. We conducted 10 monitoring sessions to track cortical activation in the right hemisphere (according to lateralization principles, the primary hemisphere for motor control) and evaluated motor proficiency concurrently. Results The study delineated three stages of nondominant hand motor learning: rapid learning (days 1 and 2), consolidation (days 3–7), and stable performance (days 8–10). There was a power‐law enhancement of motor skills correlated with learning progression. Sustained activation was observed in the supplementary motor area (SMA) and parietal lobe (PL), whereas activation in the right primary motor cortex (M1R) and dorsolateral prefrontal cortex (PFCR) decreased. These cortical activation patterns exhibited a high correlation with the augmentation of motor proficiency. Conclusions The findings suggest that early rehabilitation interventions, such as transcranial magnetic stimulation and transcranial direct current stimulation (tDCS), could be optimally directed at M1 and PFC in the initial stages. In contrast, SMA and PL can be targeted throughout the motor learning process. This research illuminates the path for developing tailored motor rehabilitation interventions based on specific stages of motor learning. NEW and NOTEWORTHY In an innovative approach, our study uniquely combines a longitudinal design with the robustness of generalized estimating equations (GEEs). With the synergy of functional near‐infrared spectroscopy (fNIRS) and the Minnesota Manual Dexterity Test (MMDT) paradigm, we precisely trace the evolution of neural resources during complex, real‐world fine‐motor task learning. Centering on right‐handed participants using their nondominant hand magnifies the intricacies of right hemisphere spatial motor processing. We unravel the brain's dynamic response throughout motor learning stages and its potent link to motor skill enhancement. Significantly, our data point toward the early‐phase rehabilitation potential of TMS and transcranial direct current stimulation on the M1 and PFC regions. Concurrently, SMA and PL appear poised to benefit from ongoing interventions during the entire learning curve. Our findings carve a path for refined motor rehabilitation strategies, underscoring the importance of timely noninvasive brain stimulation treatments.

This work present the TeamBridge 2.0, a middleware able to perform the communication between digital games and hardware devices, like joysticks, mice and cameras (both rgbd and monocular). That communication does not require any modification to the game source code, allowing an old game to be adapted to work with a new hardware device. To prove this, tests were carried out with several games, including one of them being a commercial game. This middleware also allows the use of more than one device at the same time, so we can obtain more accurate information, one device can supply the deficiencies of the other. Finally, we performed tests to make sure that the middleware would not interfere with the user experience. Tests have shown that TeamBridge 2.0 can receive, interpret and send information quickly, the time varies according to the device used, getting 33ms when used with Kinect, 40ms with Leap Motion and 255ms with a DIY Data-Glove.

Introduction: Acquired brain injuries pose significant societal and individual challenges worldwide. The adoption of XR technologies presents an opportunity to enhance current rehabilitation procedures. However, a comprehensive understanding of the specific requirements of different user groups in XR-based rehabilitation remains incomplete. Our objective was to identify design recommendations for designers and researchers of XR-based exergames for motor rehabilitation for lower-limb motor recovery at home.Methods: After initially conducting a mini-literature review and brief market analysis, we used a human-centered design process, interviewing central stakeholders to understand their perspectives and using thematic analysis to identify recurring themes and insights related to XR-based rehabilitation.Results: The resulting eight key themes for integrating XR-based exergames into acquired brain injuries (ABI) rehabilitation were safety, flexibility, efficacy, usability, technology, motivation, ownership, and social factors.Conclusion: By addressing technical and user-oriented demands, our resulting design recommendations aid designers in developing meaningful XR-based rehabilitation exercises.

Hand rehabilitation in chronic stroke remains challenging, and finding markers that could reflect motor function would help to understand and evaluate the therapy and recovery. The present study explored whether brain oscillations in different electroencephalogram (EEG) bands could indicate the motor status and recovery induced by action observation-driven brain–computer interface (AO-BCI) robotic therapy in chronic stroke. The neurophysiological data of 16 chronic stroke patients who received 20-session BCI hand training is the basis of the study presented here. Resting-state EEG was recorded during the observation of non-biological movements, while task-stage EEG was recorded during the observation of biological movements in training. The motor performance was evaluated using the Action Research Arm Test (ARAT) and upper extremity Fugl–Meyer Assessment (FMA), and significant improvements (p 0.01) were found both in the pre-training and post-training stages. After comparing the variation of oscillations over training, we found patients with good and poor recovery presented different trends in delta, low-beta, and high-beta variations, and only patients with good recovery presented significant changes in EEG band power after training (delta band, p

This article reviews data on changes in indicators obtained from multichannel EEG, MRI, fMRI, and diffusion tensor tractography in poststroke patients during motor recovery. The main indicators most commonly analyzed in the literature on changes in the brain occurring both during traditional motor rehabilitation and during rehabilitation procedures using brain–computer interface technology are considered. Changes in the indicators discussed here reflect the dynamics of the involvement of the hemispheres, individual areas of the brain, and connections between them in solving motor tasks and constitute a manifestation of both instant functional rearrangements of the network and genuine neuroplastic (structural) changes in the brain. The functional roles of the hemispheres, individual areas, and connections between areas in the process of motor rehabilitation after stroke are discussed. [ABSTRACT FROM AUTHOR]

More than 85% of stroke survivors suffer from different degrees of disability for the rest of their lives. They will require support that can vary from occasional to full time assistance. These conditions are also associated to an enormous economic impact for their families and health care systems. Current rehabilitation treatments have limited efficacy and their long-term effect is controversial. Here we review different challenges related to the design and development of neural interfaces for rehabilitative purposes. We analyze current bibliographic evidence of the effect of neuro-feedback in functional motor rehabilitation of stroke patients. We highlight the potential of these systems to reconnect brain and muscles. We also describe all aspects that should be taken into account to restore motor control. Our aim with this work is to help researchers designing interfaces that demonstrate and validate neuromodulation strategies to enforce a contingent and functional neural linkage between the central and the peripheral nervous system. We thus give clues to design systems that can improve or/and re-activate neuroplastic mechanisms and open a new recovery window for stroke patients. [ABSTRACT FROM AUTHOR]

This study examined the effects of different modes of augmented visual feedback of joint kinematics on the emerging joint moment patterns during the two-legged squat maneuver. Training with augmented visual feedback supports improved kinematic performance of maneuvers related to sports or daily activities. Despite being representative of intrinsic motor actions, joint moments are not traditionally evaluated with kinematic feedback training. Furthermore, stabilizing joint moment patterns with physical training is beneficial to rehabilitating joint-level function (e.g., targeted strengthening and conditioning of muscles articulating that joint). Participants were presented with different modes of augmented visual feedback to track a target squat-motion trajectory. The feedback modes varied along features of complexity (i.e., number of segment trajectories shown) and body representation (i.e., trajectories shown as sinusoids versus dynamic stick-figure avatars). Our results indicated that mean values and variability (trial-to-trial standard deviations) of joint moments are significantly (p < 0.05) altered depending on the visual feedback features being applied, the specific joint (ankle, knee, hip), and the squat movement phase (early, middle, or late time window). This study should incentivize more optimal delivery of visual guidance during rehabilitative training with computerized interfaces (e.g., virtual reality). [ABSTRACT FROM AUTHOR]

We present and discuss a runtime architecture that integrates sensorial data and classifiers with a logic-based decision-making system in the context of an e-Health system for the rehabilitation of children with neuromotor disorders. In this application, children perform a rehabilitation task in the form of games. The main aim of the system is to derive a set of parameters the child's current level of cognitive and behavioral performance (e.g., engagement, attention, task accuracy) from the available sensors and classifiers (e.g., eye trackers, motion sensors, emotion recognition techniques) and take decisions accordingly. These decisions are typically aimed at improving the child's performance by triggering appropriate re-engagement stimuli when their attention is low, by changing the game or making it more difficult when the child is losing interest in the task as it is too easy. Alongside state-of-the-art techniques for emotion recognition and head pose estimation, we use a runtime variant of a probabilistic and epistemic logic programming dialect of the Event Calculus, known as the Epistemic Probabilistic Event Calculus. In particular, the probabilistic component of this symbolic framework allows for a natural interface with the machine learning techniques. We overview the architecture and its components, and show some of its characteristics through a discussion of a running example and experiments. [ABSTRACT FROM AUTHOR]

Stroke is the leading cause of motor impairments and generates distortion of body representation. Hence, stroke can modulate the sense of embodiment, namely the feeling of being inside the body (ownership), in the place where the body is located (location), and moving the body according to its own intentions (agency). A growing number of studies have adopted virtual reality (VR) to train motor abilities. However, the impact of the body illusion on the rehabilitation outcome is not fully understood. The present systematic review investigates the modulating role of the body illusion elicited by VR on motor rehabilitation in post-stroke patients after embodying a virtual avatar. The research was led in the main databases—PubMed, Scopus, PsychINFO, and Web of Science—and four studies matched the inclusion criteria (e.g., to have a sample of adult post-stroke patients, to use VR as an instrument for motor rehabilitation, to adopt the paradigm of the body illusion as a modulator for motor rehabilitation, to test the sense of body illusion outcome). Research outcomes demonstrated that two studies adopted the immersive and two the non-immersive embodied VR; three studies focused on the upper limb, and one on lower limb rehabilitation. Two studies compare VR training with traditional therapy, and two are pilot studies with only one experimental group. The studies demonstrated the feasibility of the body illusion as an accelerator for motor rehabilitation compared to the non-embodied condition, and as a positive correlator of the rehabilitation outcome. The finding should be taken with caution due to the limited studies included; however, they are encouraging to justify further research efforts in this area. [ABSTRACT FROM AUTHOR]

Introduction: Physical therapy is crucial to rehabilitating hand function needed for activities of daily living after neurological traumas such as traumatic brain injury (TBI). Virtual reality (VR) can motivate participation in motor rehabilitation therapies. This study examines how multimodal feedback in VR to train grasp-and-place function will impact the neurological and motor responses in TBI participants (n = 7) compared to neurotypicals (n = 13).Methods: We newly incorporated VR with our existing intelligent glove system to seamlessly enhance the augmented visual and audio feedback to inform participants about grasp security. We then assessed how multimodal feedback (audio plus visual cues) impacted electroencephalography (EEG) power, grasp-and-place task performance (motion pathlength, completion time), and electromyography (EMG) measures.Results: After training with multimodal feedback, electroencephalography (EEG) alpha power significantly increased for TBI and neurotypical groups. However, only the TBI group demonstrated significantly improved performance or significant shifts in EMG activity.Discussion: These results suggest that the effectiveness of motor training with augmented sensory feedback will depend on the nature of the feedback and the presence of neurological dysfunction. Specifically, adding sensory cues may better consolidate early motor learning when neurological dysfunction is present. Computerized interfaces such as virtual reality offer a powerful platform to personalize rehabilitative training and improve functional outcomes based on neuropathology.

More than 85% of stroke survivors suffer from different degrees of disability for the rest of their lives. They will require support that can vary from occasional to full time assistance. These conditions are also associated to an enormous economic impact for their families and health care systems. Current rehabilitation treatments have limited efficacy and their long-term effect is controversial. Here we review different challenges related to the design and development of neural interfaces for rehabilitative purposes. We analyze current bibliographic evidence of the effect of neuro-feedback in functional motor rehabilitation of stroke patients. We highlight the potential of these systems to reconnect brain and muscles. We also describe all aspects that should be taken into account to restore motor control. Our aim with this work is to help researchers designing interfaces that demonstrate and validate neuromodulation strategies to enforce a contingent and functional neural linkage between the central and the peripheral nervous system. We thus give clues to design systems that can improve or/and re-activate neuroplastic mechanisms and open a new recovery window for stroke patients.

Abstract Applying sensors in biomedical institutions and home‐based stroke rehabilitation is now a global research focus. In this review paper, the relationship between stroke diseases’ physiology mechanism and diverse sensors’ functionalities is detailed explained. The review starts by interpreting how stroke influences motion abilities and then introduces broadly adopted physical training methods. After, the working principles of sensors and their use to objectively provide patients’ body information for stroke rehabilitation status are discussed. The content of the paper aims to not only review the state‐of‐the‐art works of developing sensors for assisting in evaluating stroke patients’ status but also bridging the gap between medical staff and engineers.