Life | Special Issue : Neurological Diseases: Prevention, Diagnostics, Treatment and Rehabilitation

Research

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19 pages, 3479 KB

Open AccessArticle

Effects of Dexmedetomidine Treatment After Cerebral Ischemia/Reperfusion on Apoptosis and Oxidative Stress: A Rat Model

by Mahir Kuyumcu and Eda Yıldızhan

Life 2026, 16(2), 325; https://doi.org/10.3390/life16020325 - 13 Feb 2026

Viewed by 442

Abstract

Objectives: Cerebral ischemia/reperfusion (IR) injury is characterized by excessive oxidative stress and activation of apoptotic pathways, which play a central role in neuronal loss and poor neurological outcomes. Modulation of these mechanisms represents a clinically relevant strategy for neuroprotection. This study aimed to [...] Read more.

Objectives: Cerebral ischemia/reperfusion (IR) injury is characterized by excessive oxidative stress and activation of apoptotic pathways, which play a central role in neuronal loss and poor neurological outcomes. Modulation of these mechanisms represents a clinically relevant strategy for neuroprotection. This study aimed to investigate the neuroprotective effects of dexmedetomidine (Dex) on oxidative stress, apoptotic signaling, and neuronal integrity in an experimental rat model of cerebral IR injury. Materials and Methods: Female Wistar rats were assigned to control, IR, and IR+Dex groups. Transient cerebral ischemia was induced for 45 min followed by 2 h of reperfusion. Oxidative stress was evaluated using serum antioxidant enzyme activities (superoxide dismutase [SOD], catalase [CAT], glutathione peroxidase [GSH-Px]), total oxidant and antioxidant status (TOS, TAS), and lipid peroxidation levels (malondialdehyde [MDA]). Apoptotic signaling was assessed by histopathological examination, transmission electron microscopy, and immunohistochemical analysis of B-cell lymphoma 2 (Bcl-2), Bcl-2-associated X protein (Bax) and apoptotic peptidase activating factor-1 (APAF-1) expression, quantitatively evaluated using QuPath with statistical comparison between groups. Bioinformatic network analysis and molecular docking were performed to explore predicted interactions between Dex and apoptosis-related proteins. Results: Cerebral IR induced a marked oxidative imbalance, characterized by reduced antioxidant enzyme activities and increased lipid peroxidation. Dex treatment partially improved antioxidant capacity and reduced oxidative stress parameters. Histopathological and ultrastructural analyses demonstrated severe neuronal degeneration following IR, whereas Dex-treated rats exhibited attenuated neuronal damage and improved ultrastructural preservation. Immunohistochemical analysis showed increased Bax and APAF-1 expression and reduced Bcl-2 expression after IR; these alterations were significantly modulated toward control levels in the IR+Dex group. Bioinformatic analysis identified apoptosis-related pathways, including apoptosis, p53 signaling, and necroptosis, as significantly enriched, while molecular docking suggested stable predicted interactions between Dex and key apoptotic regulators. Conclusions: In this experimental rat cerebral IR model, Dex exerted partial but significant neuroprotective effects by attenuating oxidative stress, modulating apoptotic marker expression, and preserving neuronal morphology. These findings support the potential role of Dex as a neuroprotective agent in ischemia-related brain injury, warranting further translational investigation. Full article

(This article belongs to the Special Issue Neurological Diseases: Prevention, Diagnostics, Treatment and Rehabilitation)

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12 pages, 1713 KB

Open AccessArticle

Relationship Between Clinical Factors and the Risk of Cerebral Vasospasm Following Aneurysmal Subarachnoid Hemorrhage: An Exploratory Analysis

by Máté Czabajszki, Attila Garami, Péter Csécsei, Béla Viskolcz, Csaba Oláh and Csaba Váradi

Life 2026, 16(1), 59; https://doi.org/10.3390/life16010059 - 30 Dec 2025

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Abstract

Background/Objectives: Cerebral subarachnoid hemorrhage (SAH) from ruptured aneurysms poses significant morbidity and mortality risks. Among survivors, cerebral vasospasm can develop, increasing complications. This study investigates the relationship between blood parameters and the risk of vasospasm. Methods: We analyzed clinical data from patients with [...] Read more.

Background/Objectives: Cerebral subarachnoid hemorrhage (SAH) from ruptured aneurysms poses significant morbidity and mortality risks. Among survivors, cerebral vasospasm can develop, increasing complications. This study investigates the relationship between blood parameters and the risk of vasospasm. Methods: We analyzed clinical data from patients with SAH—both with and without vasospasm—and healthy controls. Statistical analyses, including Spearman’s rank correlation and univariate analysis, were conducted. Results: Significant differences were observed between patients with and without vasospasm. Elevated white blood cell counts, a higher neutrophil-to-lymphocyte ratio, and lower platelet counts showed a significant association with symptomatic vasospasm. Younger age and female gender were associated with a higher risk. Conclusions: These preliminary findings highlight the importance of specific blood parameters and demographic factors in assessing the risk of cerebral vasospasm in SAH patients, supporting early risk stratification and monitoring to improve outcomes; however, these results require validation in larger cohorts. Full article

(This article belongs to the Special Issue Neurological Diseases: Prevention, Diagnostics, Treatment and Rehabilitation)

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21 pages, 1715 KB

Open AccessArticle

The Integrated Approach in Patients with Spinal Muscular Atrophy in the Era of Early Diagnosis, Etiopathogenic Therapies and Multidisciplinary Standards of Care and Rehabilitation Interventions Leads to New Phenotypes

by Madalina Cristina Leanca, Andrada Mirea, Georgiana Nicolae, Andrei Capitanescu, Constantin Munteanu and Gelu Onose

Life 2025, 15(11), 1731; https://doi.org/10.3390/life15111731 - 10 Nov 2025

Cited by 1 | Viewed by 1313

Abstract

Novel targeted therapies have transformed spinal muscular atrophy from a condition with a predictable, severe course into a more heterogeneous disorder with a range of new clinical phenotypes and outcomes. The emergence of new phenotypes in spinal muscular atrophy is a recent development [...] Read more.

Novel targeted therapies have transformed spinal muscular atrophy from a condition with a predictable, severe course into a more heterogeneous disorder with a range of new clinical phenotypes and outcomes. The emergence of new phenotypes in spinal muscular atrophy is a recent development in the field. The introduction of new etiopathogenic pharmacological treatments have significantly altered the natural history of the disease, leading to previously unseen clinical presentations and outcomes. Materials and Methods: We observed a cohort of 104 patients (children and adolescents), considering the number of SMN2 gene copies, the use of respiratory ventilation support devices and gastrointestinal support, and finally, their evolution on clinical-functional scales with physical therapy and rehabilitation interventions. With the increasing availability of effective therapies for spinal muscular atrophy, outcome measurement in clinical practice and research requires highly sensitive and reliable tools. In this study, motor function was systematically evaluated using two validated scales—the Children’s Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP INTEND) and the Hammersmith Functional Motor Scale Expanded (HFMSE)—which are specifically designed to capture incremental changes in motor skills across the spectrum of SMA severity and age groups. Results: The median scores on the validated tools steadily increased over the 24 months of follow-up. Starting from 29 at baseline, the scores rose to 36 at 6 months, then to 39 at 12 months, 43 at 18 months, and 44.5 at 24 months. The Friedman test showed that these changes were statistically significant (p < 0.01). Moreover, each follow-up score was significantly higher than both the baseline and the previous time point (all p < 0.01), showing continuous improvement over time. Conclusions: These findings reveal that the development of new SMA phenotypes is closely linked to the stage of disease at which treatment is initiated. Earlier intervention consistently enables patients to acquire previously unattainable motor skills. Consequently, enhancing diagnostic precision and expediting therapy initiation is crucial for maximizing clinical benefits and facilitating optimal functional outcomes. Full article

(This article belongs to the Special Issue Neurological Diseases: Prevention, Diagnostics, Treatment and Rehabilitation)

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14 pages, 3109 KB

Open AccessArticle

Obstacle Circumvention and Motor Daily Dual Task During a Simulation of Street Crossing by Individuals with Parkinson’s Disease

by Carolina Favarin Soares, Aline Prieto Silveira-Ciola, Lucas Simieli, Patrícia de Aguiar Yamada, Fábio Augusto Barbieri and Flávia Roberta Faganello-Navega

Life 2025, 15(6), 900; https://doi.org/10.3390/life15060900 - 31 May 2025

Viewed by 1127

Abstract

Parkinson’s disease (PD) causes attentional deficits and worse dual-task (DT) performance, which increases the risk of being run over. In addition to motor deficits, the decision-making ability and the response to external stimuli are impaired. The aim of this study was to evaluate [...] Read more.

Parkinson’s disease (PD) causes attentional deficits and worse dual-task (DT) performance, which increases the risk of being run over. In addition to motor deficits, the decision-making ability and the response to external stimuli are impaired. The aim of this study was to evaluate the spatiotemporal parameters of gait during everyday tasks of individuals with PD, specifically during street crossing simulation, obstacle circumvention, and motor DT. People with PD (PG) and matched controls (CG) were distributed into two groups and were evaluated under six different gait and randomized conditions: without a concomitant task (NW); with obstacle circumvention (OC); and four other conditions under simulation of street crossing (without concomitant task (SC); with obstacle circumvention (SC_OC); carrying bags (SC_B); and carrying bags concomitant to obstacle circumvention (SC_OC+B)). The CG group had greater values for all parameters compared to PG, except for double support time. This study’s results found that individuals with PD took smaller, narrower, slower, and shorter steps when compared to neurologically healthy older people and that there was a change in the spatiotemporal gait parameters of all individuals, except for the step-duration parameter under the most difficult crossing conditions. Full article

(This article belongs to the Special Issue Neurological Diseases: Prevention, Diagnostics, Treatment and Rehabilitation)

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13 pages, 697 KB

Open AccessArticle

Enhancing Global Cognition and Executive Functions Through Water-Based Exercise in Mild Cognitive Impairment: A Randomized Controlled Trial

by Sutaya Meekum, Kornanong Yuenyongchaiwat, Nongnuch Luangpon, Piyapa Keawutan and Patcharee Kooncumchoo

Life 2025, 15(3), 420; https://doi.org/10.3390/life15030420 - 7 Mar 2025

Cited by 2 | Viewed by 4295

Abstract

Mild cognitive impairment (MCI) is a slight cognitive decline with the ability to perform normal activities in daily life and an increased risk of dementia. Land-based exercise enhances cognitive abilities, but combining cognitive and physical interventions offers greater benefits in MCI. Water-based exercise [...] Read more.

Mild cognitive impairment (MCI) is a slight cognitive decline with the ability to perform normal activities in daily life and an increased risk of dementia. Land-based exercise enhances cognitive abilities, but combining cognitive and physical interventions offers greater benefits in MCI. Water-based exercise is a low-impact activity that minimizes joint strain and reduces injury risk. This study investigated the effects of water-based exercise with or without cognitive training on cognition in older adults with MCI. Thirty-seven participants aged 65 years or older with MCI were randomly assigned to two groups: water-based exercise (W; n = 18) and water-based exercise combined with cognitive training (W-COG; n = 19). Both groups performed 60 min water-based aerobic sessions 3 days per week for 12 weeks. Cognitive assessments were conducted at baseline and after 12 weeks. Post-intervention, 77.77% of the W group and 89% of the W-COG group had improved their cognitive ability. Both groups showed significant improvements in their global cognition (p < 0.001, p < 0.001) and visuospatial ability (p < 0.01 for W, p < 0.05 for W-COG), respectively. In addition, cognitive flexibility and shifting abilities improved only in the W-COG group (p < 0.05). These findings suggest that water-based exercise combined with cognitive training enhances cognitive functions more effectively than exercise alone in older adults with MCI. Full article

(This article belongs to the Special Issue Neurological Diseases: Prevention, Diagnostics, Treatment and Rehabilitation)

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14 pages, 1719 KB

Open AccessArticle

The Role of IL-6 and TNF-Alpha Biomarkers in Predicting Disability Outcomes in Acute Ischemic Stroke Patients

by Ciprian-Ionuț Băcilă, Maria-Gabriela Vlădoiu, Mădălina Văleanu, Doru-Florian-Cornel Moga and Pia-Manuela Pumnea

Life 2025, 15(1), 47; https://doi.org/10.3390/life15010047 - 2 Jan 2025

Cited by 18 | Viewed by 5282

Abstract

Introduction: Inflammatory biomarkers, including Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNF-alpha), play a significant role in influencing stroke outcomes, particularly in the progression of post-stroke disability. While numerous studies have suggested a correlation between elevated levels of these cytokines and poor functional recovery, [...] Read more.

Introduction: Inflammatory biomarkers, including Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNF-alpha), play a significant role in influencing stroke outcomes, particularly in the progression of post-stroke disability. While numerous studies have suggested a correlation between elevated levels of these cytokines and poor functional recovery, further investigation is needed to understand their prognostic value in acute ischemic stroke. Materials and Methods: We conducted a prospective study on 56 patients diagnosed with acute ischemic stroke, evaluating IL-6 and TNF-alpha levels on days 1 and 7 post symptom onset. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) and functional outcomes were measured with the modified Rankin Scale (mRS). Statistical analyses were performed to evaluate the association between biomarker levels and stroke severity and recovery. Results: Our study demonstrated that elevated levels of IL-6 and TNF-alpha on both days 1 and 7 were significantly correlated with greater stroke severity and poorer functional outcomes, as indicated by higher NIHSS and mRS scores. These findings are consistent with broader research indicating strong associations between inflammatory cytokines and post-stroke disability, further reinforcing their relevance as prognostic indicators. Conclusions: IL-6 and TNF-alpha are promising biomarkers for predicting stroke severity and functional recovery in acute ischemic stroke. Monitoring these cytokines in the early stages of stroke could aid in identifying patients at higher risk for long-term disability, potentially guiding personalized therapeutic strategies. Further research into anti-inflammatory therapies targeting these cytokines may improve stroke rehabilitation and outcomes. Full article

(This article belongs to the Special Issue Neurological Diseases: Prevention, Diagnostics, Treatment and Rehabilitation)

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12 pages, 249 KB

Open AccessArticle

Operative Factors Associated with Severe Hypotension in the Postoperative Setting in Patients with Carotid Artery Endarterectomy

by Mircea Robu, Irina-Maria Margarint, Ovidiu Stiru, Andreea Raluca Hanganu, Bogdan Radulescu, Vlad Ichim, Gabriel-Petre Gorecki, Miruna Guzu, Claudia Mazilu, Vlad Anton Iliescu and Horatiu Moldovan

Life 2024, 14(11), 1435; https://doi.org/10.3390/life14111435 - 6 Nov 2024

Cited by 1 | Viewed by 1880

Abstract

Background: Carotid endarterectomy is a recognized method for preventing stroke for both symptomatic and asymptomatic hemodynamically carotid artery stenosis. Hemodynamic depression is more frequently associated with carotid artery stenting, while postoperative hypertension and cerebral hyperperfusion syndrome are known frequent complications after carotid endarterectomy. [...] Read more.

Background: Carotid endarterectomy is a recognized method for preventing stroke for both symptomatic and asymptomatic hemodynamically carotid artery stenosis. Hemodynamic depression is more frequently associated with carotid artery stenting, while postoperative hypertension and cerebral hyperperfusion syndrome are known frequent complications after carotid endarterectomy. Severe hypotension after carotid revascularization is associated with a higher risk of perioperative stroke, myocardial infarction, and death, with limited data existing regarding risk factors. This study aims to investigate intraoperative risk factors for severe hypotension after carotid endarterectomy. Methods: A total of 160 patients who underwent carotid endarterectomy were included in this study. Patients with other cardiac conditions that required concomitant cardiac surgery, patients with incomplete medical records, and patients considered high risk for surgery were excluded. Results: The incidence of severe hypotension was 30.6%. Patients with severe hypotension after carotid endarterectomy had a higher incidence of diabetes, moderate mitral valve regurgitation, a history of percutaneous coronary intervention, and higher operative times. Using logistic regression, temporary shunt insertion was independently associated with severe postoperative hypotension (OR = 2.26, 95% CI = 1.09–4.71, p = 0.029). Conclusions: This result favors the selective shunting strategy when performing carotid endarterectomies, especially for those patients with comorbidities predisposing to postoperative complications. Full article

(This article belongs to the Special Issue Neurological Diseases: Prevention, Diagnostics, Treatment and Rehabilitation)

Review

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18 pages, 1242 KB

Open AccessReview

Chronic Insomnia and Stroke Risk—A Real Bidirectional Issue

by Brindusa Ilinca Mitoiu, Maria Delia Alexe, Gavril Lucian Gheorghievici and Roxana Nartea

Life 2025, 15(10), 1602; https://doi.org/10.3390/life15101602 - 14 Oct 2025

Cited by 1 | Viewed by 2801

Abstract

Chronic insomnia is a prevalent and disabling sleep disorder with growing evidence linking it to cardiovascular and cerebrovascular morbidity. Stroke, a leading cause of mortality and a long-term disability worldwide, may be influenced by sleep disturbances through multiple physiological mechanisms. While traditional risk [...] Read more.

Chronic insomnia is a prevalent and disabling sleep disorder with growing evidence linking it to cardiovascular and cerebrovascular morbidity. Stroke, a leading cause of mortality and a long-term disability worldwide, may be influenced by sleep disturbances through multiple physiological mechanisms. While traditional risk factors such as hypertension, atrial fibrillation, diabetes, obesity, smoking, and sedentary lifestyle remain dominant drivers of stroke burden, accumulating evidence suggests that sleep disturbances, particularly chronic insomnia, may act as both independent risk factors for incident stroke and as outcomes of cerebrovascular injury. Chronic insomnia, affecting approximately 10% of the global population, is characterized by persistent difficulties with sleep initiation, maintenance, or quality, accompanied by daytime dysfunction. Beyond its impact on quality of life and mental health, insomnia has been linked to cardiometabolic dysregulation, inflammation, and vascular dysfunction. Importantly, sleep disturbances after stroke can impair recovery and functional outcomes, underscoring a bidirectional relationship between stroke and sleep. Several recent reviews have examined the connection between insomnia and stroke. Our review differs by focusing specifically on (1) the stroke-specific epidemiological evidence for chronic insomnia as a risk factor, (2) the bidirectional interplay between insomnia and post-stroke sleep disturbances, and (3) the role of emerging technologies in monitoring and prognosis. By addressing these gaps, we aim to refine the current understanding and highlight priorities for future research and clinical translation. Full article

(This article belongs to the Special Issue Neurological Diseases: Prevention, Diagnostics, Treatment and Rehabilitation)

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27 pages, 540 KB

Open AccessReview

Efficacy of Neurorehabilitation Approaches in Traumatic Brain Injury Patients: A Comprehensive Review

by Diana Andrei, Alexandra Laura Mederle, Laura Andreea Ghenciu, Claudia Borza and Alexandra Corina Faur

Life 2025, 15(3), 503; https://doi.org/10.3390/life15030503 - 20 Mar 2025

Cited by 3 | Viewed by 9634

Abstract

Traumatic brain injury (TBI) represents a significant public health issue, causing long-term disabilities and imposing considerable socioeconomic and healthcare challenges. While advancements in acute care have improved survival rates, the demand for effective neurorehabilitation is increasing. This narrative review explores the evidence on [...] Read more.

Traumatic brain injury (TBI) represents a significant public health issue, causing long-term disabilities and imposing considerable socioeconomic and healthcare challenges. While advancements in acute care have improved survival rates, the demand for effective neurorehabilitation is increasing. This narrative review explores the evidence on neurorehabilitation strategies for TBI, focusing on interventions targeting cognitive, motor, and psychological recovery. A total of 32 studies were included and categorized into six approaches: non-invasive brain stimulation, virtual reality (VR), computer-based training, telerehabilitation, robot-assisted therapy (RAT), and mixed approaches. Non-invasive brain stimulation techniques, such as transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), showed variable effectiveness in improving cognitive outcomes. VR-based therapies enhanced attention and executive functions, while RAT, such as Lokomat and exoskeletons, improved gait symmetry and functional mobility. Computer-assisted programs demonstrated benefits in rehabilitating social cognition and executive functions. Telerehabilitation and telephone-based treatments provided short-term gains but lacked sustained effects. Overall, cognitive improvements were better described and represented, while several motor improvements lacked consistency. Despite the promising results, significant gaps remain, including heterogeneity in methodologies, small sample sizes, and limited long-term outcome data. Full article

(This article belongs to the Special Issue Neurological Diseases: Prevention, Diagnostics, Treatment and Rehabilitation)

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Other

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36 pages, 3049 KB

Open AccessSystematic Review

Sarcopenia as a Multisystem Disorder—Connections with Neural and Cardiovascular Systems—A Related PRISMA Systematic Literature Review

by Cristina Popescu, Sorina-Maria Aurelian, Andrada Mirea, Constantin Munteanu, Andreea-Iulia Vlădulescu-Trandafir, Aurelian Anghelescu, Corina Oancea, Ioana Andone, Aura Spînu, Andreea-Valentina Suciu, Simona-Isabelle Stoica, Sandra-Monica Gîdei, Valeria-Mădălina Alecu, Costina-Daniela Gîță, Nadina-Liana Pop, Vlad Ciobanu and Gelu Onose

Life 2026, 16(1), 68; https://doi.org/10.3390/life16010068 - 1 Jan 2026

Cited by 1 | Viewed by 1869

Abstract

Background: Sarcopenia, which has traditionally been considered to be an exclusively geriatric syndrome, has an increased frequency within the general population and fosters interest in its complex neuromuscular, cardiovascular, and metabolic basis. The current systematic review, adopting the recognized Preferred Reporting Items for [...] Read more.

Background: Sarcopenia, which has traditionally been considered to be an exclusively geriatric syndrome, has an increased frequency within the general population and fosters interest in its complex neuromuscular, cardiovascular, and metabolic basis. The current systematic review, adopting the recognized Preferred Reporting Items for Systematic Reviews (PRISMA) methodology, seeks to highlight current evidence on the underlying mechanisms as well as approaches to sarcopenia diagnosis and management. Methods: A comprehensive search of major international databases identified studies published between January 2023 and December 2024, from which 42 articles were retained according to prespecified criteria. To further enrich the present work, eleven additional studies of high relevance were included. Results: The selected literature describes sarcopenia’s multifactorial pathophysiology, including mitochondrial dysfunction, neuromuscular junction (NMJ) degeneration, chronic inflammation, anabolic resistance, endocrine and metabolic dysregulation, altered motor-unit remodeling, and molecular alterations. Diagnostic methods focus on functional assessments, especially muscle strength and physical performance. In addition, imaging techniques and new circulating biomarkers enhance precision in specific situations. Over the years, rehabilitation has proven to be one of the most effective therapeutic approaches. Complementary strategies, ranging from nutritional optimization to pharmacologic modulation of the renin–angiotensin system, show promise in specific patient subsets. Discussion and Conclusions: As supported by the works collected within the current study, future approaches will need to consider sarcopenia as a multifactorial disease that goes beyond aging. Full article

(This article belongs to the Special Issue Neurological Diseases: Prevention, Diagnostics, Treatment and Rehabilitation)

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16 pages, 1179 KB

Open AccessStudy Protocol

Effectiveness of Telerehabilitation-Based Therapeutic Exercise on Functional Capacity in Chronic Stroke: Study Protocol for a Multicenter Randomized Controlled Trial

by Yaiza Casas-Rodríguez, Carlos López-de-Celis, Gala Inglés-Martínez, Lidia González-Tova, María Benilde Martínez-González, Izaskun Barayazarra-López and Anna Escribà-Salvans

Life 2025, 15(12), 1905; https://doi.org/10.3390/life15121905 - 12 Dec 2025

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Abstract

Background: Stroke is the leading cause of physical disability in adults in Catalonia. Despite this, there is a lack of evidence of physiotherapy interventions on functional capacity during the chronic phase of the pathology. This multicenter clinical trial will be conducted with [...] Read more.

Background: Stroke is the leading cause of physical disability in adults in Catalonia. Despite this, there is a lack of evidence of physiotherapy interventions on functional capacity during the chronic phase of the pathology. This multicenter clinical trial will be conducted with a sample size of 75 participants. Objectives: The objective of the study is to evaluate the effectiveness of a therapeutic exercise program in physiotherapy using telerehabilitation to optimize functional recovery and quality of life in people with chronic stroke, and to determine its impact on adherence to the exercise program. Methods: This is a multicenter randomized controlled trial. Three parallel groups will be compared, and two will undergo the same type of therapy. A control group (CG) will perform conventional intervention in primary care. There will be two experimental groups; (EG1) will perform document-guided therapeutic exercises at home and (EG2) will perform therapeutic exercises at home guided by a telerehabilitation program. The outcomes to be measured are degree of independence of a person in their activities of daily living, assessed by the Barthel Index, motor function, muscle tone of the affected limbs, muscle strength of the affected limbs, balance, gait efficiency, perception of musculoskeletal pain, perception of fatigue, risk of falls, perception of quality of life, and the perception of perceived subjective change after treatment. These outcomes will be evaluated at baseline (T0), at ten weeks (T1) (end of the intervention), and at 18 weeks (T2). The study duration per patient will be 18 weeks (a ten-week intervention, followed by an eight-week intervention follow-up). The analysis will be performed using a mixed linear model (ANOVA 3X3) and significance level p < 0.05. Full article

(This article belongs to the Special Issue Neurological Diseases: Prevention, Diagnostics, Treatment and Rehabilitation)

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13 pages, 310 KB

Open AccessStudy Protocol

Myotonometric and Postural Analysis in Patients with Post-Stroke Hemiparesis Included in a Rehabilitation Program: A Study Protocol

by Constantin Ioan Covasala, Elena Constanta Amaricai, Sorana Sacui (Teaha), Anca Valentina Onciulenco, Alexandru Ianculescu, Cosmin Liviu Chifane, Nicoleta Flavia Roman and Catalin Nicolae Hreniuc

Life 2025, 15(12), 1791; https://doi.org/10.3390/life15121791 - 21 Nov 2025

Viewed by 1032

Abstract

This observational study aims to assess both the posture and muscle tone characteristics of the upper and lower limbs in patients with hemiparesis following a cerebrovascular accident. Measurements will be taken comparatively between the affected and non-affected sides. The study will include patients [...] Read more.

This observational study aims to assess both the posture and muscle tone characteristics of the upper and lower limbs in patients with hemiparesis following a cerebrovascular accident. Measurements will be taken comparatively between the affected and non-affected sides. The study will include patients with both ischemic and hemorrhagic strokes. Assessments will be conducted at months 1, 3, and 6 after the stroke event. In order to ensure the homogeneity of the study group, all patients will follow a physical exercise program tailored to their clinical stage of recovery. Myotonometric evaluation will be performed using the Myoton PRO Digital Palpation Device, which allows the assessment of muscle tone, elasticity, dynamic stiffness, tension state, relaxation time, and deformation ratio during muscle relaxation. Postural assessment will be conducted using the GaitON device by Auptimo. In addition to these instrumental evaluations, the following clinical scales will be applied: the Modified Ashworth Scale, Barthel Index, Instrumental Activities of Daily Living and the Modified Rankin Scale. Based on the three successive evaluations (at one, three, and six months after stroke event) we expect that with the spasticity decrease and the improvement of the posture of patients participating in the physical exercise program, both the objectively assessed parameters and the scores obtained from clinical scales will evolve in favor of better functioning. Full article

(This article belongs to the Special Issue Neurological Diseases: Prevention, Diagnostics, Treatment and Rehabilitation)

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