Search Results (69)

The assessment of upper limb (UL) movement patterns plays a critical role in the rehabilitation of individuals with motor impairments resulting from neuromotor disorders, which significantly affect essential activities of daily living (ADLs) such as drinking and eating. However, conventional clinical evaluation methods often lack objective and quantitative insights into the biomechanics of movement. To enable accurate identification of pathological patterns, it is first necessary to establish normative biomechanical and electrophysiological benchmarks in healthy individuals. In this study, a previously developed, low-cost, wearable, and portable prototype device was employed to objectively assess UL movement. The system, specifically designed for clinical applicability, integrates surface electromyography (EMG) sensors and an inertial measurement unit (IMU) to capture muscle activity and kinematic data, respectively. Thirty healthy participants were recruited to perform standardized drinking and eating tasks. The analysis focused on characterizing muscle activation patterns and joint range of motion during different task phases. Results revealed consistent variations in muscle contraction and joint kinematics, allowing the identification of distinct activation profiles for key shoulder muscles. The findings contribute to the establishment of a normative dataset that can serve as a reference for the assessment of clinical populations. Such data are essential for informing rehabilitation strategies and developing predictive models of UL function during ADLs in individuals with neuromotor disorders. Full article

Background and Objectives: Arthrogenic muscle inhibition (AMI) is a key neurophysiological barrier to effective rehabilitation in individuals with chronic ankle instability (CAI). The primary objective of this narrative review is to explore the role of arthrogenic muscle inhibition (AMI) in chronic ankle instability (CAI) and to critically appraise neurophysiological and rehabilitative strategies targeting its resolution. Although peripheral strengthening remains a cornerstone of treatment, the roles of spinal and cortical modulation are increasingly recognised. Materials and Methods: A narrative review was conducted to examine recent clinical trials targeting AMI in CAI populations. A structured search of MEDLINE, Web of Science, Scopus, Cochrane Central, and PEDro was performed. Five studies were included, encompassing peripheral, spinal, and cortical interventions. The outcomes were grouped and analysed according to neurophysiological and functional domains. Results: Manual therapy combined with exercise improved pain, strength, and functional mobility. Fibular reposition taping transiently enhanced spinal reflex excitability, while transcranial direct current stimulation (tDCS) over the primary motor cortex significantly modulated corticospinal excitability and voluntary muscle activation. Improvements in subjective stability, dynamic balance, and neuromuscular responsiveness were observed in the majority of the five included studies, although methodological heterogeneity and short-term follow-ups limit generalisability. Conclusions: Multimodal interventions targeting different levels of the neuromotor system appear to be more effective than isolated approaches. Integrating manual therapy, sensorimotor training, and neuromodulation may optimise outcomes in CAI rehabilitation. Future trials should focus on standardised outcome measures and long-term efficacy. Full article

Millimeter-wave (mmWave) sensing has emerged as a promising technology for non-contact health monitoring, offering high spatial resolution, material sensitivity, and integration potential with wireless platforms. While prior work has focused on specific applications or signal processing methods, a unified understanding of how mmWave signals map to clinically relevant biomarkers remains lacking. This survey presents a full-stack review of mmWave-based medical sensing systems, encompassing signal acquisition, physical feature extraction, modeling strategies, and potential medical and healthcare uses. We introduce a taxonomy that decouples low-level mmWave signal features—such as motion, material property, and structure—from high-level biomedical biomarkers, including respiration pattern, heart rate, tissue hydration, and gait. We then classify and contrast the modeling approaches—ranging from physics-driven analytical models to machine learning techniques—that enable this mapping. Furthermore, we analyze representative studies across vital signs monitoring, cardiovascular assessment, wound evaluation, and neuro-motor disorders. By bridging wireless sensing and medical interpretation, this work offers a structured reference for designing next-generation mmWave health monitoring systems. We conclude by discussing open challenges, including model interpretability, clinical validation, and multimodal integration. Full article

Neurological diseases leading to motor deficits constitute significant challenges to healthcare systems. Despite technological advancements in data acquisition, sensor development, data processing, and virtual reality (VR), a suitable framework for patient-centered neuromotor robot-assisted rehabilitation using collective sensor information does not exist. An extensive literature review was achieved based on 124 scientific publications regarding different types of sensors and the usage of the bio-signals they measure for neuromotor robot-assisted rehabilitation. A comprehensive classification of sensors was proposed, distinguishing between specific and non-specific parameters. The classification criteria address essential factors such as the type of sensors, the data they measure, their usability, ergonomics, and their overall impact on personalized treatment. In addition, a framework designed to collect and utilize relevant data for the optimal rehabilitation process efficiently is proposed. The proposed classifications aim to identify a set of key variables that can be used as a building block for a dynamic framework tailored for personalized treatments, thereby enhancing the effectiveness of patient-centered procedures in rehabilitation. Full article

Background: Democratized access to safe and effective robotic neurorehabilitation for stroke survivors requires innovative, affordable solutions that can be used not only in clinics but also at home. This requires the high usability of the devices involved to minimize costs associated with support from physical therapists or technicians. Methods: This paper describes the early findings of the NeuroExo brain–machine interface (BMI) with an upper-limb robotic exoskeleton for stroke neurorehabilitation. This early feasibility study consisted of a six-week protocol, with an initial training and BMI calibration phase at the clinic followed by 60 sessions of neuromotor therapy at the homes of the participants. Pre- and post-assessments were used to assess users’ compliance and system performance. Results: Participants achieved a compliance rate between $21\%$ and $100\%$, with an average of $69\%$, while maintaining adequate signal quality and a positive perceived BMI performance during home usage with an average Likert scale score of four out of five. Moreover, adequate signal quality was maintained for four out of five participants throughout the protocol. These findings provide valuable insights into essential components for comprehensive rehabilitation therapy for stroke survivors. Furthermore, linear mixed-effects statistical models showed a significant reduction in trial duration (p-value < 0.02) and concomitant changes in brain patterns (p-value < 0.02). Conclusions: the analysis of these findings suggests that a low-cost, safe, simple-to-use BMI system for at-home stroke rehabilitation is feasible. Full article

Cerebral palsy (CP) is a neuromotor disorder affecting movement, muscle tone, and posture, leading to difficulties in motor coordination, balance, and strength. Virtual reality (VR) games offer an interactive method to engage children in a non-real environment, potentially improving balance and motor function. This study aimed to explore the impact of a VR-based balance system on gross motor function and balance in children with CP. Four participants (two boys and two girls, mean age 9.75 ± 3.41) were assessed at three time points: pre-treatment, six weeks post-initial assessment, and two weeks after intervention. Using tools like the Gross Motor Function Measure Scale (GMFMS), Pediatric Balance Scale (PBS), and Gross Motor Performance Measure (GMPM), the study found significant improvements in gross motor skills, balance, and motor performance with the use of the Nintendo Wii Balance Board within conventional physiotherapy. Further research is recommended to refine intervention parameters, incorporate additional outcome measures, and assess broader applicability, including for children with conditions like ADHD. Full article

Stroke, amyotrophic lateral sclerosis (ALS), and Parkinson’s disease are some of the conditions that can lead to neuromotor disabilities requiring rehabilitation. To address the socio-economic burden that is amplified by the rapidly increasing elderly population, traditional rehabilitation techniques have recently been complemented by technological advancements, particularly Robot-Assisted Therapy (RAT). RAT enhances motor learning by improving both accuracy and consistency. This study proposes an innovative rehabilitation system that combines serious gaming and augmented reality (AR) with the LegUp parallel robot, developed for the spatial rehabilitation of the hip, knee, and ankle in bed-ridden patients. The system aims to improve patient outcomes and actively involve patients in their therapy. Electro-goniometers and a HoloLens 2 device are used to provide immediate feedback about the position of the patient’s joints, forming the basis of an interactive game in which the patient moves their leg to reach various targets. Two game modes were developed, each targeting different aspects of neuromotor rehabilitation, such as coordination, strength, and flexibility. Preliminary findings suggest that combining RAT with augmented reality-based serious gaming can increase patient motivation and engagement. Furthermore, the personalized and interactive nature of the therapy holds the potential to improve rehabilitation outcomes by fostering sustained engagement and effort. Full article

The paper presents an innovative virtual reality (VR)-based environment for personalized telerehabilitation programs. This environment integrates a parallel robotic structure designed for the lower limb rehabilitation of patients with neuromotor disabilities and a virtual patient. The robotic structure is controlled via a user interface (UI) that communicates with the VR environment via the TCP/IP protocol. The robotic structure can also be operated using two controllers that communicate with a VR headset via the Bluetooth protocol. Through these two controllers, the therapist demonstrates to the patient various exercises that the robotic system can perform. With the right-hand controller, the therapist guides exercises for the hip and knee, while the left-hand controller manages ankle exercises. The therapist remotely designs a rehabilitation plan for patients at home, defining exercises, interacting with the rehabilitation robot in real-time via the VR headset and the two controllers, and initiating therapy sessions. The user interface allows monitoring of patient progress through video feedback, electromyography (EMG) sensors, and session recording. Full article

In recent years, extended reality (XR) and telerehabilitation (TR) technologies have increasingly been used in the neurorehabilitation of motor dysfunctions in patients with cerebral palsy (CP). The Khymeia Virtual Reality Rehabilitation System (K-VRRS) is a medical device specifically designed for neuromotor rehabilitation, and it can also be used in TR mode. This pilot study aims to evaluate the effectiveness and adherence to a “two-step neuromotor program” (TS-NP) approach using K-VRRS to enhance upper limb motor functions in children with CP. The TS-NP protocol consists of two phases. In the first phase, patients undergo intensive motor training with K-VRRS during a period of hospitalization. In the second phase, initiated after discharge, patients continue K-VRRS treatment at home through TR, building upon the progress made during their hospital stay. A total of seven children with unilateral spastic CP (ages 4–10 years) were assessed at three time points: baseline (T0), after the first phase of in-person hospital treatment (T1), and following the second phase of TR treatment at home (T2). Standardized outcome measures were used, with the primary measure being the Melbourne Assessment 2. Preliminary data support the hypothesis that intensive K-VRRS treatment during hospitalization enhances motor function in the affected upper limb of children with CP. Furthermore, continuing K-VRRS treatment at home through TR appears crucial for maintaining the motor gains achieved during the hospital phase. Full article

Background and Purpose: activities-based locomotor training (AB-LT) is a restorative therapeutic approach to the treatment of movement deficits in people with non-progressive neurological conditions, including cerebral palsy (CP). Transcutaneous spinal stimulation (TSS) is an emerging tool in the rehabilitation of individuals with sensorimotor deficits caused by neurological dysfunction. This non-invasive technique delivers electrical stimulation over the spinal cord, leading to the modulation of spinal sensorimotor networks. TSS has been used in combination with AB-LT and has been shown to improve muscle activation patterns and enhance motor recovery. However, there are no published studies comparing AB-LT + TSS to AB-LT alone in children with CP. The purpose of this case study was to compare the impact of AB-LT alone versus AB-LT combined with TSS on functional movement and quality of life in a child with CP. Methods: A 13-year-old male with quadriplegic CP participated in this pilot study. He was classified in the Gross Motor Function Classification System (GMFCS) at Level III. He completed 20 sessions of AB-LT (5x/week), then a 2-week washout period, followed by 20 sessions of body-AB-LT + TSS. Treatment sessions consisted of 1 h of locomotor training with body weight support and manual facilitation and 30 min of overground play-based activities. TSS was applied using the RTI Xcite^®, with stimulation at the T11 and L1 vertebral levels. Assessments including the Gross Motor Function Measure (GMFM), 10-m walk test (10 MWT), and Pediatric Balance Scale (PBS) were performed, while spatiotemporal gait parameters were assessed using the Zeno Walkway^®. All assessments were performed at three time points: before and after AB-LT, as well as after AB-LT + TSS. OUTCOMES: After 19/20 sessions of AB-LT alone, the participant showed modest improvements in the GMFM scores (from 86.32 to 88), 10 MWT speed (from 1.05 m/s to 1.1 m/s), and PBS scores (from 40 to 42). Following the AB-LT combined with TSS, scores improved to an even greater extent compared with AB-LT alone, with the GMFM increasing to 93.7, 10 MWT speed to 1.43 m/s, and PBS to 44. The most significant gains were observed in the GMFM and 10 MWT. Additionally, improvements were noted across all spatiotemporal gait parameters, particularly at faster walking speeds. Perhaps most notably, the child transitioned from the GMFCS level III to level II by the end of the study. Discussion: Higher frequency and intensity interventions aimed at promoting neuroplasticity to improve movement quality in children with CP are emerging as a promising alternative to traditional physical therapy approaches. This case study highlights the potential of TSS to augment neuroplasticity-driven treatment approaches, leading to improvements in neuromotor function in children with CP. These findings suggest that TSS could be a valuable addition to rehabilitation strategies, warranting further research to explore its efficacy in larger populations. Full article

Background: Stroke is the third leading cause of disability. Virtual reality (VR) has shown promising results in post-stroke rehabilitation. The VR TRAVEE system was designed for the neuromotor rehabilitation of the upper limb after a stroke and offers the ability to track limb movements by providing auditory feedback and visual augmentation. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), aligned with the International Classification of Functioning, Disability, and Health (ICF) principles, is a valid tool for measuring disability regardless of its cause. This study aimed to investigate the feasibility of the VR TRAVEE system in upper limb rehabilitation for stroke patients. Methods: A total of 14 stroke patients with residual hemiparesis were enrolled in the study. They underwent a 10-day program combining conventional therapy (CnvT) with VR rehabilitation. At baseline (T0), the upper limb was assessed using the Modified Ashworth Scale (MAS), active range of motion (AROM), and the Numeric Rating Scale (NRS) for pain. These assessments were repeated after the 10-day rehabilitation program (T1). Additionally, disability was measured using WHODAS 2.0 at T0 and again 30 days after completing the program. Results: Significant improvements were observed in AROM and MAS scores for the shoulder, elbow, wrist, and metacarpophalangeal joints, as well as in the reduction in shoulder pain (p ˂ 0.001). WHODAS scores decreased across all six domains, with a statistically significant improvement in the Cognition domain (p = 0.011). Conclusions: Combining CnvT with VR as a rehabilitation approach enhances motor function in the upper limb. This method has the potential to reduce disability scores and promote neuroplasticity. Full article

The worldwide increase in the number of disorders requiring rehabilitation is weighing more and more on healthcare systems, seriously affecting the quality of life of patients. Emergent technologies and techniques should be used more and more in both physical and psychological rehabilitation, after a thorough study of their potential and effects. Our paper presents an original virtual reality-based system including gamified immersive physio-psychological exercises, which was tested in a clinical setting with 25 patients suffering from various musculoskeletal, neuromotor, or mental disorders. A thorough testing protocol was followed during a two-week period, including repeated trials, progress tracking, and objective and subjective instruments used for data collection. A statistical analysis helped us identify interesting correlations between complex virtual reality games and people’s performance, and the high level of relaxation and stress relief (4.57 out of 5 across all games) which can be offered by VR-based psychotherapy exercises, as well as the increased ease of use (4.26 out of 5 perceived across all games) of properly designed training exercises regardless of patients’ level of VR experience (84% of patients with no or low experience and no patient with high experience). Full article

Parkinson’s disease (PD) is a prevalent neurodegenerative disease in which treatment often includes an exercise regimen. Exercise is neuroprotective in animal models of PD, and, more recently, human clinical studies have verified exercise’s disease-modifying effect. Aerobic exercise and resistance training improve many of PD’s motor and non-motor symptoms, while neuromotor therapy and stretching/flexibility exercises positively contribute to the quality of life in people with PD. Therefore, understanding the role of exercise in managing this complex disorder is crucial. Exerkines are bioactive substances that are synthesized and released during exercise and have been implicated in several positive health outcomes, including neuroprotection. Exerkines protect neuronal cells in vitro and rodent PD models in vivo. Aerobic exercise and resistance training both increase exerkine levels in the blood, suggesting a role for exerkines in the neuroprotective theory. Many exerkines demonstrate the potential for protecting the brain against pathological missteps caused by PD. Every person (people) with Parkinson’s (PwP) needs a comprehensive exercise plan tailored to their unique needs and abilities. Here, we provide an exercise template to help PwP understand the importance of exercise for treating PD, describe barriers confronting many PwP in their attempt to exercise, provide suggestions for overcoming these barriers, and explore the role of exerkines in managing PD. In conclusion, exercise and exerkines together create a powerful neuroprotective system that should contribute to slowing the chronic progression of PD. Full article

Structured follow-up visits should be accessible for children at risk for developmental delay. Follow-up visits should include a serial neuromotor assessment in the first two years of life (e.g., 3–6, 12, 24 months corrected age), which are repeated during the transition to school. The diagnosis of neuromotor development may be prognostic for important skills later in life. The early diagnosis of a child’s general movements can be helpful in planning appropriately for proper treatment and intervention. These diagnostic assessments should be conducted by qualified healthcare professionals. The evaluation of neuromotor developmental health is specified in the national guidelines and funded by either a national government or public or private healthcare insurance and based on standardized assessment scales. The aim of this study is to show what elements of follow-up visits are recommended. Objectives: The group of patients for whom the structured follow-up systems are intended were children born very preterm (<32 weeks gestation) or full-term born children with severe neonatal complications. Material and methods: The methods for monitoring neurodevelopment include the following: The General Movements Assessment (GMA), the Ages and Stages Questionnaire (ASQ-3), the Bayley Scales of Infant and Toddler Development (BSID-4), and the Parent Report of Children’s Abilities-Revised (PARCA-R). Results: The results of follow-up visits should be registered. Conclusions: The benefits of follow-up neuromotor development assessments can be observed at school age and even in adulthood. Full article

The aquatic ecotoxicity of three α-amino acid-derived polyamidoamines (PAAs) was studied using zebrafish embryos as a viable vertebrate model organism. The PAAs examined were water-soluble amphoteric polyelectrolytes with a primarily negative charge, which were efficient flame retardants for cotton. The fish embryo acute toxicity test performed with PAA water solutions using 1.5–500 mg L⁻¹ concentrations showed that toxicity did not statistically differ from the control. The survival rates were indeed >90%, even at the highest concentration; the hatching rates were >80%; and the numbers of morphological defects were comparable to those of the control. Tests using transgenic zebrafish lines indicated that the numbers of microscopic vascular and musculoskeletal defects were comparable to the control, with one random concentration showing doubled alterations. Sensory–motor tests in response to visual and tactile stimuli were also performed. In the presence of PAAs, embryos exposed to alternating light/dark cycles showed an insignificant mobility reduction during the dark phase. Touch-evoked response tests revealed a mild effect of PAAs on the neuromotor system at concentrations > 10 mg L⁻¹. The cystine/glycine copolymer at 100 mg L⁻¹ exhibited the greatest effect. Overall, the studied PAAs showed a minimal impact on aquatic systems and should be further considered as promising ecofriendly materials. Full article