Search Results (513)

Background and Objectives: Dual-task training (DTT) is an innovative therapeutic approach that involves the simultaneous application of two tasks, which can be motor, cognitive, or a combination of both. Children with cerebral palsy (CP) often exhibit impairments in balance, motor skills, and gait, conditions that may be amenable to improvement through DTT. The aim of this study was to determine the effectiveness of DTT in enhancing balance, walking speed, and gross motor function-related balance in children with CP. Materials and Methods: In accordance with PRISMA guidelines, a comprehensive systematic review with meta-analysis (SRMA) was conducted. Electronic databases like PubMed Medline, Scopus, Web of Science, CINAHL, and PEDro were searched up to March 2025, with no language or publication date restrictions. Only randomized controlled trials (RCTs) examining the effectiveness of DTT on balance, gross motor function, and walking speed in children with CP were included. The methodological quality and risk of bias of the included RCTs were assessed using the PEDro scale. Pooled effects were calculated using Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95% CI) within random-effects models. Results: Eight RCTs, providing data from 216 children, were included. Meta-analyses suggested that DTT was more effective than conventional therapies for increasing functional (SMD = 0.65; 95% CI 0.18 to 1.13), dynamic (SMD = 0.61; 95% CI 0.15 to 1.1), and static balance (SMD = 0.46; 95% CI 0.02 to 0.9), as well as standing (SMD = 0.75; 95% CI 0.31 to 1.18; p = 0.001) and locomotion dimensions (SMD = 0.65; 95% CI 0.22 to 1.08) of the Gross Motor Function Measure (GMFM) and walking speed (SMD = 0.46; 95% CI 0.06 to 0.87). Subgroup analyses revealed that a motor–cognitive dual task is better than a motor single task for functional, dynamic, and static balance and standing and locomotion dimensions for the GMFM. Conclusions: This SRMA, including the major number of RCTs to date, suggests that DTT is effective in increasing balance, walking and gross motor function-related balance in children with CP. Full article

Cervical cancer represents a significant global health challenge. Photodynamic therapy (PDT) appears to be a promising, minimally invasive alternative to standard treatments. However, the clinical efficacy of PDT is sometimes limited by the low solubility and aggregation of photosensitizers, their non-selective distribution in the body, hypoxia in the tumor microenvironment, and limited light penetration. Recent advances in nanoparticle and nanocomposite platforms have addressed these challenges by integrating multiple functional components into a single delivery system. By encapsulating or conjugating photosensitizers in biodegradable matrices, such as mesoporous silica, organometallic structures and core–shell construct nanocarriers increase stability in water and extend circulation time, enabling both passive and active targeting through ligand decoration. Up-conversion and dual-wavelength responsive cores facilitate deep light conversion in tissues, while simultaneous delivery of hypoxia-modulating agents alleviates oxygen deprivation to sustain reactive oxygen species generation. Controllable “motor-cargo” constructs and surface modifications improve intratumoral diffusion, while aggregation-induced emission dyes and plasmonic elements support real-time imaging and quantitative monitoring of therapeutic response. Together, these multifunctional nanosystems have demonstrated potent cytotoxicity in vitro and significant tumor suppression in vivo in mouse models of cervical cancer. Combining targeted delivery, controlled release, hypoxia mitigation, and image guidance, engineered nanoparticles provide a versatile and powerful platform to overcome the current limitations of PDT and pave the way toward more effective, patient-specific treatments for cervical malignancies. Our review of the literature summarizes studies on nanoparticles and nanocomposites used in PDT monotherapy for cervical cancer, published between 2023 and July 2025. Full article

Background/Objectives: Obesity in adolescence is associated with a deterioration in cognitive functions, with significant implications for psychophysical well-being and academic performance. Recent studies highlight the importance of integrated interventions that combine nutrition education and physical activity to promote the overall health of students. The present study aims to evaluate the efficacy of an integrated intervention based on nutritional education and conscious body movement in improving cognitive functions, perceived well-being and nutritional knowledge in lower secondary school students with indicators of overweight and obesity. Methods: A quasi-experimental design with randomization at the class level was adopted, involving 60 students divided into an experimental group and control group. The intervention was divided into twelve weeks of activities, divided between nutritional education modules and physical activity courses. Standardized tests for the assessment of cognitive functions (Digit Span Forward, Digit Span Backward, Stroop Test, Trail Making Test B), motor tests (6-Minute Walk Test, Sit and Reach Test) and a food knowledge questionnaire were administered before and after the intervention. Results: The experimental group showed significant improvements compared to the control group in all cognitive, motor, and nutritional knowledge measures, indicating the effectiveness of the integrated intervention in promoting cognitive and physical well-being. Conclusions: The findings support the role of school as a generative environment of integrated well-being, suggesting the need to develop and implement curricular programs that integrate nutrition education and physical activity to counteract the negative effects of obesity on cognitive function in adolescents. Full article

The growing popularity of Personal Light Electric Vehicles (PLEVs), such as e-scooters, has revolutionized urban mobility by offering compact, cost-effective, and environmentally friendly transportation solutions. However, safety concerns, including inadequate infrastructure, poor protective measures, and high accident rates, remain critical challenges. This paper presents the design and development of an innovative self-balancing microvehicle under the H2020 LEONARDO project, which aims to address these challenges through advanced engineering and user-centric design. The vehicle combines features of monowheels and e-scooters, integrating cutting-edge technologies to enhance safety, stability, and usability. The design adheres to European regulations, including Germany’s eKFV standards, and incorporates user preferences identified through representative online surveys of 1500 PLEV users. These preferences include improved handling on uneven surfaces, enhanced signaling capabilities, and reduced instability during maneuvers. The prototype features a lightweight composite structure reinforced with carbon fibers, a high-torque motorized front wheel, and multiple speed modes tailored to different conditions, such as travel in pedestrian areas, use by novice riders, and advanced users. Braking tests demonstrate deceleration values of up to 3.5 m/s², comparable to PLEV market standards and exceeding regulatory minimums, while smooth acceleration ramps ensure rider stability and safety. Additional features, such as identification plates and weight-dependent motor control, enhance compliance with local traffic rules and prevent misuse. The vehicle’s design also addresses common safety concerns, such as curb navigation and signaling, by incorporating large-diameter wheels, increased ground clearance, and electrically operated direction indicators. Future upgrades include the addition of a second rear wheel for enhanced stability, skateboard-like rear axle modifications for improved maneuverability, and hybrid supercapacitors to minimize fire risks and extend battery life. With its focus on safety, regulatory compliance, and rider-friendly innovations, this microvehicle represents a significant advancement in promoting safe and sustainable urban mobility. Full article

To improve commutation accuracy and effectively suppress torque ripple in brushless DC motors (BLDCMs), this paper presents a novel commutation correction strategy integrated into an enhanced direct torque control (DTC) framework. The proposed method estimates the commutation angle error in real time by analyzing the integral difference in phase currents across adjacent 30° conduction intervals, enabling dynamic and accurate commutation correction. This correction mechanism is seamlessly embedded into a modified DTC algorithm that employs a three-level torque hysteresis comparator and introduces a novel zero-voltage vector selection strategy to minimize torque ripple. Compared with conventional DTC approaches employing dual-loop control and standard zero vectors, the proposed method achieves up to a 58% reduction in torque ripple along with improved commutation precision, as demonstrated through both simulation and experimental validation. These results confirm the method’s effectiveness and its potential for application in high-performance BLDCMs drive systems. Full article

Background: Epidemiological studies have reported an inverse association between smoking and Parkinson’s disease (PD) risk, prompting interest in nicotine as a potential therapeutic agent. The present meta-analysis evaluated the efficacy of nicotine therapy in improving motor symptoms and activities of daily living in patients with PD. Methods: PubMed, Embase, and Cochrane Library were systematically searched to identify randomized controlled trials (RCTs) assessing nicotine therapy in PD. Clinical RCTs administering interventions extending beyond 1 week and reporting motor or nonmotor outcomes were included. Random-effects models were used to analyze short-term (<6 months) and long-term (≥6 months) outcomes by using standardized mean differences (SMDs). Results: This meta-analysis included five RCTs (346 participants). Nicotine therapy led to no significant improvement in motor outcomes in the short term (pooled SMD: −0.452, 95% confidence interval: −1.612 to 0.708) or long term (pooled SMD: 0.174, 95% confidence interval: −0.438 to 0.787). Considerable interstudy heterogeneity was noted. Furthermore, short-term nicotine therapy resulted in no significant improvement in daily functioning, cognition, or quality of life. Conclusions: This meta-analysis revealed a lack of compelling evidence suggesting that nicotine-based therapies improve motor or nonmotor outcomes in PD. The findings highlight a disconnect between epidemiological associations and clinical efficacy. Given the prodromal nature of PD pathology and the challenges of early diagnosis, future preventive strategies should be implemented before symptom onset in high-risk individuals identified using advanced biomarker panels. Full article

Background and Objectives: Cerebral palsy (CP) is a non-progressive neurological disorder characterized by motor impairments such as spasticity and poor postural control. Among these, trunk control plays a critical role in maintaining balance and enabling functional mobility. Since spasticity is known to interfere with motor coordination and posture, evaluating its response to trunk-focused interventions may offer additional clinical insights. This systematic review and meta-analysis evaluated the effectiveness of trunk-focused interventions on trunk control, gross motor function, balance, and spasticity. Materials and Methods: A systematic search was conducted in PubMed, Embase, Web of Science, MEDLINE, and CINAHL for randomized controlled trials (RCTs) published in the last 10 years up to 11 April 2023. Studies targeting trunk-specific interventions in children with CP were included. Meta-analyses were performed using RevMan 5.3, calculating standardized mean differences (SMDs) with 95% confidence intervals (CIs). Study quality was assessed using the PEDro scale. Results: Fifteen RCTs involving 454 children were included. Trunk control improved significantly (SMD = 3.67; 95% CI: 3.10–4.25; I² = 0%). Gross motor function showed a small but significant improvement (SMD = 0.49; 95% CI: 0.06–0.92; I² = 44%). Balance exhibited a large, though not statistically significant, effect (SMD = 0.90; 95% CI: −0.00 to 1.79; I² = 81%). Subgroup analysis indicated that interventions performed more than four times per week produced a significant effect on balance (SMD = 0.54; 95% CI: 0.08–1.01). Only one study assessed spasticity and found no group difference. Conclusions: Trunk-based interventions significantly improve trunk control and gross motor function in children with CP. While improvements in balance were inconsistent, higher-frequency interventions yielded more favorable results. Further research is warranted to clarify effects on spasticity and optimize intervention protocols for clinical application. Full article

Digital Twins (DTs) are transforming manufacturing by bridging the physical and digital worlds, enabling real-time insights, predictive analytics, and enhanced decision making. In Industry 4.0, DTs facilitate automation and data integration, while Industry 5.0 emphasizes human-centric, resilient, and sustainable production. However, implementing DTs in robotic metal additive manufacturing (AM) remains challenging because of the complexity of the wire-based laser metal deposition (LMD) process, the need for real-time monitoring, and the demand for advanced defect detection to ensure high-quality prints. This work proposes a structured DT architecture for a robotic wire-based LMD cell, following a standard framework. Three DT implementations were developed. First, a real-time 3D simulation in RoboDK, integrated with a 2D Node-RED dashboard, enabled motion validation and live process monitoring via MQTT (message queuing telemetry transport) telemetry, minimizing toolpath errors and collisions. Second, an Industrial IoT-based system using KUKA iiQoT (Industrial Internet of Things Quality of Things) facilitated predictive maintenance by analyzing motor loads, joint temperatures, and energy consumption, allowing early anomaly detection and reducing unplanned downtime. Third, the Meltio dashboard provided real-time insights into the laser temperature, wire tension, and deposition accuracy, ensuring adaptive control based on live telemetry. Additionally, a prescriptive analytics layer leveraging historical data in FireStore was integrated to optimize the process performance, enabling data-driven decision making. Full article

Background: Digital technologies offer innovative opportunities for recovering and maintaining intellectual and mental health. The use of a multitask approach that combines motor component with various cognitive tasks in a virtual environment can optimize cognitive and physical functions and improve the quality of life of cardiac surgery patients. This study aimed to localize current sources of theta and alpha power in patients who have undergone virtual multitask training (VMT) and a control group in the early postoperative period of coronary artery bypass grafting (CABG). Methods: A total of 100 male CABG patients (mean age, 62.7 ± 7.62 years) were allocated to the VMT group (n = 50) or to the control group (n = 50). EEG was recorded in the eyes-closed resting state at baseline (2–3 days before CABG) and after VMT course or approximately 11–12 days after CABG (the control group). Power EEG analysis was conducted and frequency-domain standardized low-resolution tomography (sLORETA) was used to assess the effect of VMT on brain activity. Results: After VMT, patients demonstrated a significantly higher density of alpha-rhythm (7–9 Hz) current sources (t > −4.18; p < 0.026) in Brodmann area 30, parahippocampal, and limbic system structures compared to preoperative data. In contrast, the control group had a marked elevation in the density of theta-rhythm (3–5 Hz) current sources (t > −3.98; p < 0.017) in parieto-occipital areas in comparison to preoperative values. Conclusions: Virtual reality-based multitask training stimulated brain regions associated with spatial orientation and memory encoding. The findings of this study highlight the importance of neural mechanisms underlying the effectiveness of multitask interventions and will be useful for designing and conducting future studies involving VR multitask training. Full article

Transparency is a key requirement for some classes of robots, exoskeletons, and assistive devices (READs), where safe and efficient human–robot interaction is crucial. Typical fields that require transparency are rehabilitation and industrial contexts. However, the definitions of transparency adopted in the literature are heterogeneous. It follows that there is a need to clarify, summarize, and assess how transparency is commonly defined and measured. Thus, the goal of this review is to systematically examine how transparency is conceptualized and evaluated across studies. To this end, we performed a structured search across three major scientific databases. After a thorough screening process, 20 out of 400 identified articles were further examined and included in this review. Despite being recognized as a desirable and essential characteristic of READs in many domains of application, our findings reveal that transparency is still inconsistently defined and evaluated, which limits comparability across studies and hinders the development of standardized evaluation frameworks. Indeed, our screening found significant heterogeneity in both terminology and evaluation methods. The majority of the studies used either a mechanical or a kinematic definition, mostly focusing on the intrinsic behavior of the device and frequently giving little attention to the device impact of the user and on the user’s perception. Furthermore, user-centered or physiological assessments could be examined further, since evaluation metrics are usually based on kinematic and robot mechanical metrics. Only a few studies have examined the underlying motor control strategies, using more in-depth methods such as muscle synergy analysis. These findings highlight the need for a shared taxonomy and a standardized framework for transparency evaluation. Such efforts would enable more reliable comparisons between studies and support the development of more effective and user-centered READs. Full article

Background and Objectives: Recent technological advances have introduced new interventions in the field of stroke rehabilitation. Among them, visual feedback (VF) and non-invasive brain stimulation (NIBS) have gained considerable attention, with growing evidence supporting their efficacy. However, their combined application in lower limb recovery remains to be established. This systematic review aims to evaluate the current evidence on the therapeutic effect of combining VF and NIBS for lower limb motor rehabilitation in stroke patients. Methods: Following PRISMA guidelines, PubMed, Embase, Scopus, and Cochrane databases were searched for randomized controlled trials and observational studies comparing VF and NIBS interventions with either their monotherapy, placebo, or standard treatment. The outcomes evaluated for lower limb function included balance, gait, and motor performance. Results: From 997 studies screened, 5 studies (3 RCTs and 2 cohort studies) were included. Despite heterogeneity in the immersion level, NIBS protocols, and outcome measures, evidence emerged supporting the efficacy of combined VF and NIBS across multiple outcomes. However, the degree to which these interventions outperform standard therapies remains uncertain, primarily due to a limited number of comparator studies and the quality of the existing data. Conclusions: This review provides preliminary insights into the potential of combining VF and NIBS in stroke patients affected by lower limb motor impairments. Future research should focus on standardizing protocols and addressing demographic variability to enhance the reliability and comparability of findings. Full article

In recent years, the traditional orchard sprayer has had problems, such as waste of liquid agrochemicals, low target coverage, high manual dependence, and environmental pollution. In this study, an automatic swing-arm sprayer for orchards was developed based on the standardized pear orchard in Pinggu, Beijing. Firstly, the structural principles of a crawler-type traveling system and swing-arm sprayer were simulated using finite element software design. The combination of a diffuse reflection photoelectric sensor and Arduino single-chip microcomputer was used to realize real-time detection and dynamic spray control in the pear canopy, and the sensor delay compensation algorithm was used to optimize target recognition accuracy and improve the utilization rate of liquid agrochemicals. Through the integration of innovative structural design and intelligent control technology, a vertical droplet distribution test was carried out, and the optimal working distance of the spray was determined to be 1 m; the nozzle angle for the upper layer was 45°, that for the lower layer was 15°, and the optimal speed of the swing-arm motor was 75 r/min. Finally, a particle size test and field test of the orchard sprayer were completed, and it was concluded that the swing-arm mode increased the pear tree canopy droplet coverage by 74%, the overall droplet density by 21.4%, and the deposition amount by 23% compared with the non-swing-arm mode, which verified the practicability and reliability of the swing-arm spray and achieved the goal of on-demand pesticide application in pear orchards. Full article

This paper presents a simulation framework for evaluating power flow, energy efficiency, thermal behavior, and energy consumption in electric vehicles (EVs) under standardized driving conditions. A detailed Simulink model is developed, integrating a lithium-ion battery, inverter, permanent magnet synchronous motor (PMSM), gearbox, and a field-oriented control strategy with PI-based speed and current regulation. The framework is applied to four standard driving cycles—UDDS, HWFET, WLTP, and NEDC—to assess system performance under varied load conditions. The UDDS cycle imposes the highest thermal loads, with temperature rises of 76.5 °C (motor) and 52.0 °C (inverter). The HWFET cycle yields the highest energy efficiency, with PMSM efficiency reaching 92% and minimal SOC depletion (15%) due to its steady-speed profile. The WLTP cycle shows wide power fluctuations (−30–19.3 kW), and a motor temperature rise of 73.6 °C. The NEDC results indicate a thermal increase of 75.1 °C. Model results show good agreement with published benchmarks, with deviations generally below 5%, validating the framework’s accuracy. These findings underscore the importance of cycle-sensitive analysis in optimizing energy use and thermal management in EV powertrain design. Full article

Spinal muscular atrophy (SMA) is a genetic neuromuscular disorder primarily affecting motor neurons. Emerging evidence suggests it also involves multiple organs, including potential cardiac manifestations. This study aimed to evaluate cardiac abnormalities in pediatric SMA patients compared to age-matched healthy controls, providing insight into underlying cardiomyopathy in this population. A total of 126 children were included in the study, with 63 SMA patients and 63 age-matched controls. We conducted clinical examinations, standard electrocardiography (ECG), and cardiac ultrasound (CUS) in all patients. Electrocardiographic analysis revealed a higher prevalence of sinus tachycardia in the SMA group and significantly deeper Q waves, indicating possible myocardial involvement. Echocardiographic findings demonstrated a significant reduction in left ventricular mass and left ventricular mass index in SMA patients compared to controls, despite normal systolic function. Statistical analysis confirmed that SMA diagnosis was an independent predictor of reduced myocardial mass, suggesting a distinct cardiac phenotype in SMA patients. This study provides new evidence of subclinical cardiac involvement in SMA, characterized by reduced myocardial mass, altered electrocardiographic parameters, and increased sinus tachycardia. These findings suggest a previously unrecognized form of cardiomyopathy in SMA that differs from cardiac manifestations typically seen in other neuromuscular disorders. Full article

Background: Charcot-Marie-Tooth (CMT) disease is a hereditary motor and sensory neuropathy that affects foot morphology and gait patterns, potentially leading to abnormal plantar pressure distribution. This systematic review synthesizes the existing literature examining plantar pressure characteristics in CMT patients. Methods: A comprehensive search was conducted across PubMed, Scopus, and Web of Science databases. Risk of bias was assessed using the Newcastle–Ottawa Scale. Results: Six studies comprising 146 patients were included. Four studies employed dynamic baropodometry, and two used in-shoe pressure sensors to evaluate the main plantar pressure parameters. The findings were consistent across different populations and devices, with a characteristic plantar-pressure profile of marked midfoot off-loading with peripheral overload at the forefoot and rearfoot, often accompanied by a lateralized center-of-pressure path and a prolonged pressure–time exposure. These alterations reflect both structural deformities and impaired neuromuscular control. Interventional studies demonstrated a load redistribution of pressure after corrective surgery, though residual lateral overload often persists. Conclusions: Plantar pressure mapping seems to be a valuable tool to identify high-pressure zones of the foot in order to personalize orthotic treatment planning, to objectively monitor disease progression, and to evaluate therapeutic efficacy. Further longitudinal studies with standardized protocols are needed to confirm these results. Full article