Search Results (132)

Background/Objectives: Chronic ankle instability (CAI) is a common sequela of lateral ankle sprain and is characterized by recurrent episodes of giving way, sensorimotor deficits, impaired postural control, and diminished functional performance. While exercise-based rehabilitation, including neuromuscular training and proprioceptive exercises, remains the gold standard for managing CAI, patients often require additional support during daily activities. Orthotic interventions predominantly address mechanical instability, yet there is a clinical gap in providing integrated solutions that simultaneously offer mechanical support and sensory feedback to enhance postural control. This study aimed to investigate the effects of a semi-rigid ankle brace combined with vibro-stimulation on tactile sensation and center of pressure excursion in individuals with CAI. Methods: A randomized clinical trial was designed with two parallel groups and repeated measurements over time. Thirty adults (n = 15 per group) aged 18–35 years, who met the International Ankle Consortium criteria for CAI, were recruited. Participants in the experimental group received a semi-rigid ankle brace integrated with a wearable vibro-stimulation system, whereas those in the comparison group used the ankle brace alone. Outcome measures were collected at baseline, after 10 min, and after 2 and 4 weeks. Primary outcomes included Vibration Detection Rate and phase plane portraits assessed using a 128 Hz tuning fork and a force plate. Results: The ankle bracing plus vibration band group demonstrated significantly greater improvement at 4 weeks than the orthosis group in Vibration Detection Rate (F (3,26) = 31.93, p < 0.001, η² = 0.78). Also, the largest effect was observed for the anteroposterior phase plane portrait at 4 weeks (MD = −2.10 ± 0.42, 95% CI: −2.96 to −1.23, p < 0.001, d = −1.79). Conclusions: The findings suggest that combining a semi-rigid ankle bracing with vibro-stimulation provides additional benefits over the use of bracing alone in individuals with CAI. Full article

Background: This study sought to evaluate overall survival (OS) following palliative radiotherapy in glioblastoma and to identify clinically applicable predictors supporting patient-centred treatment decisions, with exploration of early mortality. Methods: This retrospective single-centre study analysed 169 glioblastoma patients treated with palliative radiotherapy between 2010 and 2025. Baseline clinical and treatment variables were assessed. OS calculated from the last day of radiotherapy was estimated using Kaplan–Meier analysis; predictors were analysed using Cox regression. Early mortality (≤30 and ≤60 days) was evaluated using logistic regression. Results: Median age at diagnosis was 75 years, median Karnofsky Performance Status (KPS) was 60%, with 63% of patients < 70%. Impaired mental status, sensorimotor deficits, and steroid use were observed in 47%, 68%, and 86% of patients, respectively. Median OS was 3.5 months. Impaired mental status (HR 2.25), sensorimotor deficits (HR 1.77), steroid use (HR 1.39), multilobar involvement (HR 1.44), and age (HR 1.03) were independently associated with OS, whereas KPS was not. The rate of early mortality at 30 and 60 days was 18% and 31%. Early mortality analysis indicated impaired mental status and steroid use as indicators of very limited survival. Conclusions: Impaired mental status and steroid use identify patients with limited survival, whereas KPS lacks independent prognostic value in this setting. Full article

Background: Patellar tendinopathy is a common musculoskeletal condition that may impair functional performance and limit physical activity. While structural and mechanical factors have been widely investigated, the role of proprioceptive function and its interaction with behavioral and central pain-related mechanisms remain unclear. This study aimed to investigate the relationship between knee joint position sense, kinesiophobia, and central sensitization in individuals with chronic patellar tendinopathy. Methods: A total of 42 recreational athletes with clinically diagnosed chronic patellar tendinopathy were included in this cross-sectional study. Knee joint proprioception was assessed using joint position sense testing at multiple knee flexion angles with a continuous passive motion device. Kinesiophobia and central sensitization were evaluated using the Tampa Scale of Kinesiophobia and the Central Sensitization Inventory, respectively. Joint position sense values of the involved and contralateral extremities were compared, and correlation analyses were performed to examine associations between joint position sense and psychosocial variables. Results: The involved extremity demonstrated significantly greater absolute angular error compared to the contralateral side at higher knee flexion angles (≥60°, p < 0.01), whereas no significant differences were observed at lower angles. A moderate positive correlation was found between joint position sense error and kinesiophobia at higher flexion angles (≥30°, p < 0.01). No significant association was identified between joint position sense error and central sensitization across any of the tested angles (p > 0.05). Conclusions: Proprioceptive function is impaired in individuals with chronic patellar tendinopathy, particularly under increased mechanical demand. The association between joint position sense deficits and kinesiophobia, but not central sensitization, suggests a potential relationship between movement-related fear and sensorimotor alterations. These findings highlight the importance of incorporating proprioceptive assessment and addressing kinesiophobia in the clinical management of patellar 36 tendinopathy. Full article

Cerebrovascular and neurodegenerative diseases are often linked to dysregulated cerebral blood flow, which results in oxidative stress and alterations in energy metabolism. Targeting the underlying initiators and exacerbating factors could offer protective benefits. Among the proposed therapeutic agents, the steroid hormone progesterone (P4) has shown considerable potential. This study evaluates the protective effects of P4 (1.7 mg/kg, administered subcutaneously once daily for a week) in a rat model of chronic cerebral hypoperfusion (CCH), provoked by the permanent bilateral ligation of the common carotid arteries. Redox and metabolic imbalances, specifically lipid and adenine nucleotide metabolism, were examined in serum and striatal crude synaptosomal fractions. Additionally, sensorimotor functions were assessed using non-invasive neurological tests. Biochemical analyses showed that P4 in CCH conditions contributed to the normalization of redox and metabolic homeostasis in both the serum and striatum. In the serum, this was accompanied by increased adenine nucleotide turnover, likely favoring protective adenosine signaling. In parallel, P4 alleviated the striatal oxidative burden while augmenting antioxidant response and promoting nucleotide catabolism. Our findings demonstrate that P4-mediated protection is accomplished through coordinated biochemical serum–striatum responses, linking systemic and synaptic metabolic regulation with improved sensorimotor function and recovery from CCH-induced deficits. Full article

Spinal cord injury (SCI) is an acute, devastating neurologic condition that results in permanent progressive motor deficits, sensory disturbances, and autonomic dysfunctions, which limit function, participation, and quality of life. Although substantial progress has been made during the last several decades for both early trauma care and rehabilitation protocols following SCI, long-term neurological recovery remains unpredictable and often incomplete. This manuscript summarizes mechanistic and clinical evidence regarding robotic-assisted rehabilitation (RAR) and spinal neuromodulation (SN), which have been published since 2010 until the present time in a structured narrative review of the literature on these two emerging areas for neurorehabilitation after SCI. RAR provides high-intensity, task-specific training that consistently results in improvements in functional outcomes such as balance, coordination, and independence; however, its impact is limited when it comes to walking speed or voluntary motor control. SN (particularly epidural stimulation) can activate the residual neural pathways to standing up and stepping even after a complete injury but effects are typically stimulus dependent, with heterogeneous clinical results that often lack strong long-term evidence due in part to variability in patient selection, stimulation parameters and rehabilitation protocols. However, there is emerging mechanistic data supporting combining modulation of excitability through SN approaches along with structured sensorimotor training as an approach for enhancing recovery. Collectively, these findings support a shift toward more physiology-driven neurorehabilitation strategies and the need for future research to improve clinical translation and outcome predictability by patient stratification using standardized intervention protocols that include longitudinal evaluation. Full article

SARS-CoV-2 infection is associated with not only acute respiratory symptoms but is also characterized by strong neurotropism which may contribute to the development of the multisystem post-COVID syndrome (PASC). Patients frequently report chronic neurocognitive disorders such as brain fog, significant attention deficits and increased susceptibility to epileptiform discharges. The aim of this review is to systematize the knowledge regarding deviations in quantitative electroencephalography (QEEG) recordings in convalescents and to evaluate the utility of this method as an objective biomarker. This work constitutes a comprehensive literature review integrating the latest data on neuroinflammation, blood-brain barrier damage and changes in cortical oscillatory dynamics induced by the infection. The literature analysis indicates that the virus may induce a pathological excitation and inhibition imbalance (E/I imbalance) in neuronal networks. In QEEG studies this manifests as excessive activity of slow bands (Theta, Delta), a deficit of rhythms responsible for attention and sensorimotor integration (SMR) and a pathologically elevated Theta to Beta ratio (TBR). In conclusion, QEEG can serve as an objective and highly sensitive tool supporting the diagnosis and stratification of patients with neurocognitive complications of Long COVID. The integration of precise electrophysiological phenotyping with targeted behavioral neuromodulation (e.g., EEG-Biofeedback) fits into the paradigm of personalized medicine and offers a prospective strategy for mitigating long-term neurological burdens. Full article

Background: Guillain–Barré syndrome (GBS) is a rare, immune-mediated disorder affecting the peripheral nerves, often presenting with ascending muscle weakness and possible respiratory failure, usually following an infection. Borrelia burgdorferi, the causative agent of Lyme neuroborreliosis, is an uncommon trigger of GBS. Case presentation: We report the case of a 13-year-old girl with Lyme neuroborreliosis who developed sensorimotor GBS. She presented with progressive, symmetrical weakness, initially in the lower limbs and subsequently in the upper limbs, accompanied by absent deep tendon reflexes. Peripheral demyelination, confirmed in this case, is exceptionally rare. Results: Prompt diagnosis and appropriate treatment, together with rehabilitation measures, prevented further nerve damage. Seven months after onset, she was able to walk with support and had no sensory or cognitive deficits. Conclusions: Lyme neuroborreliosis can rarely trigger GBS with peripheral demyelination. Early recognition, timely intervention, and effective interprofessional collaboration limited the extent of nerve damage and promoted neurological recovery. Full article

Background: Traditional functional mobility assessments often fail to detect subclinical postural decline in active aging populations. This study introduces the Head–Sternum Dissociation Index as a novel digital biomarker to identify latent sensorimotor deficits before macroscopic balance failure occurs. Methods: Ninety-four participants (Young, Middle-Aged Civil, Middle-Aged Dancers, and Older Adults) performed instrumented limits of stability tasks, specifically functional and lateral reach tests, utilizing a three-sensor inertial measurement unit configuration. Postural strategies were quantified via the Head–Sternum Dissociation Index and the peak ratio of corrective micro-movements, validating the sensor output against a gold-standard force platform. Results: A significant kinematic breakpoint in postural control was identified at age 55 (p < 0.001). However, Middle-Aged Civilians exhibited early kinematic divergence despite maintaining normal Timed Up and Go test performance. Receiver operating characteristic analysis revealed distinct, sex-specific physiological limits: aging males predominantly adopted a rigid “Stiffness” strategy (peak ratio ≤ 1.15, head–sternum dissociation threshold > 0.63°), while females utilized a broader, more permissive “Continuous” strategy (head–sternum dissociation threshold > 0.31°). Notably, recreational rhythmic training (dance) completely neutralized this age-related decay, with middle-aged dancers maintaining highly efficient, youthful stabilization profiles (Cohen’s d = 2.20). Conclusions: The Head–Sternum Dissociation Index, combined with relative corrective frequency, successfully phenotypes early sensorimotor erosion. These findings advocate for the integration of sex-specific kinematic screening into primary care, allowing clinicians to prescribe targeted interventions well before clinical fall risk manifests. Full article

Background: Sensorimotor differences have frequently been reported in children with developmental dyslexia, but are often considered secondary or comorbid to phonological deficits. Within an embodied cognition perspective, reading acquisition emerges from dynamic interactions between bodily regulation, multisensory integration, and learning-related neural plasticity. Proprioception contributes to spatial orientation, motor coordination, and perceptual stabilization, while sleep-dependent processes play a critical role in the consolidation and automatization of cognitive and motor skills. Objectives: Building on early clinical observations, including the hypothesis proposed by Martins da Cunha, this review explores whether variations in proprioceptive processing and sensorimotor regulation may influence multisensory stability and the conditions under which reading skills develop in some individuals with dyslexia. Methods: This narrative synthesis integrates clinical observations and experimental paradigms examining proprioceptive function in children with dyslexia, including studies conducted in our laboratory over the past two decades. These investigations address postural regulation under varying attentional demands, laboratory measures of proprioceptive acuity, visuospatial localization tasks, multisensory interactions, and exploratory observations concerning sleep–wake regulation. Results: Across studies, children with dyslexia often show differences in proprioceptive processing associated with variations in postural regulation, visuospatial stability, and multisensory tasks. Laboratory measurements suggest reduced proprioceptive acuity in some individuals, with moderate correlations observed between proprioceptive sensitivity and reading-related measures. Additional observations suggest that nocturnal physiological regulation—including respiratory dynamics and sleep architecture—may interact with daytime sensorimotor stability and attentional functioning. Conclusions: Taken together, these findings support the hypothesis that variations in sensorimotor regulation across the sleep–wake cycle may influence the stability of multisensory processing and attentional conditions relevant for reading acquisition. Within this perspective, proprioception is not proposed as an alternative explanation for dyslexia but as a complementary dimension that may contribute to the heterogeneity of dyslexic profiles. Further longitudinal and controlled studies are required to clarify the relationships between sensorimotor regulation, sleep-dependent plasticity, and learning processes. Full article

Background: Adolescent idiopathic scoliosis (AIS) is often associated with central nervous system disorders and deficits in sensorimotor function. While the Schroth method is a common clinical intervention, research evidence regarding its effectiveness in enhancing sensorimotor control remains limited. This study aimed to evaluate the impact of the Schroth method on sensorimotor control and quality of life (QoL) in AIS patients. Methods: Sixty female participants (mean age 13.4 years) with Cobb angles between 10° and 45° were divided into an intervention group (n = 30), receiving Schroth exercises and bracing for 10 weeks, and a control group (n = 30), receiving bracing alone. Outcome measures included static and dynamic balance, spine lateral flexion joint position sense (JPS), upper-limb functional proprioception, and the GR-BSSQ Brace questionnaire. Results: Statistical analysis using two-way mixed ANOVA revealed significant Group × Time interactions across several parameters. The Schroth group showed significant improvements in static and dynamic balance, with ellipse area reduction (p = 0.005) and reduced Fukuda test distance (p = 0.007), respectively. Significant enhancements were noted in spine lateral flexion JPS (Bilateral p = 0.008) and upper-limb proprioception (Bilateral p = 0.000). Furthermore, the intervention group reported a significant improvement in QoL scores compared to the control (p = 0.000). Conclusions: The findings demonstrate that the Schroth method was associated with enhanced sensorimotor control, supporting its use as a targeted approach to improve functional outcomes in individuals with AIS. These results highlight the clinical value of the method, beyond spinal curve correction. Full article

Attention-Deficit/Hyperactivity Disorder (ADHD) may be associated with alterations in eye movements, which in turn may reflect dysfunctions in executive functions and sensorimotor integration processes. This review analyzed the pattern of oculomotor findings of pediatric populations diagnosed with ADHD with or without methylphenidate (MPH) treatment, with the aim of systematically describing the oculomotor abnormalities observed in affected children. A total of 24 studies were analyzed. The results showed that children with ADHD exhibit increased latency, a higher number of directional errors in prosaccade and antisaccade tasks, as well as intrusions during fixation and a higher frequency of microsaccades and involuntary blinks. Furthermore, studies involving the administration of MPH showed an improvement in oculomotor control, with a reduction in errors and a modulation of latency and oculomotor inhibition. These findings confirmed the potential role of oculomotor parameters as objective and non-invasive biomarkers for exploring the neurofunctional correlates of ADHD and for evaluating the effects of pharmacological treatment. Full article

Background: Stroke is a major global risk to human health due to its high incidence, mortality, and prevalence of associated long-term disabilities. Recent studies have highlighted a significant impact of the gut–brain axis and metabolites derived from intestinal microbiota on modulating neurological disorders, including stroke. Methods: In this study, we investigated the effects of pre- and post-treatment with D-lactate, a lactate stereoisomer mainly produced by certain gut bacteria, on stroke outcome using a transient middle cerebral artery occlusion (MCAO) mouse model. For this purpose, male C57BL/6J mice received a single administration of D-lactate or vehicle (PBS) via the tail vein either before the MCAO surgery, as a preventive approach, or upon reperfusion, as a therapeutic paradigm. Functional outcome was assessed daily using a standard neuroscore and the adhesive removal test until day three post-surgery, when mice were sacrificed. Results: Our results indicated no significant difference in infarct size, measured using cresyl violet staining, between the D-lactate and PBS groups in both pre- and post-treatment experiments. In addition, evaluation of neurological deficits and sensorimotor function showed no statistically significant differences between the interventions throughout the experiment. Conclusions: The present data suggest that treatment with D-lactate does not show a beneficial effect in our C57BL/6J mouse MCAO model. Full article

Background/Objectives: Stroke frequently leads to balance deficits. Vestibular physical therapy (VPT) may enhance postural control through neuroplastic mechanisms. Virtual reality (VR) can provide ecologically valid environments for rehabilitation, increasing patient engagement. Methods: In this randomized feasibility study, nine individuals with chronic stroke were randomized to either a Real visuo–vestibular rehabilitation group (n = 6) or a Sham VR group (n = 3) to explore the feasibility of the protocol and randomization procedures rather than to compare clinical efficacy. Both groups were trained in immersive VR environments for 12 sessions. The Real group experienced visuo–vestibular stimuli requiring sensorimotor integration; the Sham group trained in the same environments without such stimuli. Feasibility was assessed through attendance, participation (Pittsburgh Rehabilitation Participation Scale, PRPS), and user satisfaction (USEQ). Safety and acceptability were monitored through adverse event reporting. Secondary exploratory outcomes included measures of balance—the Mini Balance Evaluation Systems Test (MiniBESTest), the Berg Balance Scale (BBS), and the Performance-Oriented Mobility Assessment (POMA)—as well as functional independence (Barthel Index), health-related quality of life (Stroke-Specific Quality of Life Scale, SSQoL), and a set of spatiotemporal and gait quality parameters derived from inertial measurement unit (IMU) data collected during the 10-Meter Walk Test and the Figure of 8 Walk Test. Results: All participants completed the protocol without adverse events. Participation, as measured by the PRPS, remained consistently high across sessions (mean ≥5.7/6), while USEQ scores indicated excellent user satisfaction (mean ≥28/30). Exploratory analyses revealed improvements in MiniBESTest and BBS scores for the Real group. Instrumental measures derived from IMUs demonstrated improvements across groups. Conclusions: Exploratory outcomes suggested positive trends in balance improvements, and the integration of clinical scales with wearable sensors proved feasible and informative. Full article

Background: Proprioceptive deficits, commonly quantified as joint position sense error (JPSE), are frequently reported in musculoskeletal conditions. Articular manual therapy may influence afferent input and sensorimotor integration. This review synthesised the effects of joint mobilization and/or high-velocity low-amplitude (HVLA) thrust manipulation on quantitative proprioception outcomes in humans. Methods: PubMed, Scopus, CINAHL, and MEDLINE Complete were searched (from inception to November 2025) for randomized or sham-controlled trials assessing proprioception after eligible articular manual therapy. Searches were limited to English-language publications. Risk of bias was assessed using Risk of Bias 2 (RoB 2). Random-effects meta-analysis (Hedges’ g) was conducted when outcomes and time points were comparable; pooling was possible for only one outcome/time-point comparison. Certainty of evidence was assessed using GRADE. Results: Database searches yielded 483 records; after duplicate removal, 371 records were screened. Eighteen full-text articles were assessed for eligibility, of which 11 were excluded, resulting in seven randomized clinical trials (2018–2025; total n = 350) evaluating spinal or peripheral mobilization/manipulation. No eligible randomized or sham-controlled trials meeting the prespecified criteria were identified before 2018. In chronic mechanical neck pain, cervical thrust manipulation improved cervical JPSE versus sham with large partial eta-squared effects (η²p = 0.23–0.36). Cervical mobilization improved left rotation JPSE (4.15 → 1.65° vs. 4.01→3.74°). In patellofemoral pain, lumbopelvic manipulation produced immediate reductions in knee JPSE at 60° (6.58 → 4.48° vs. 5.91 → 6.05°). Only one outcome/time-point was suitable for meta-analysis (knee JPSE at 60° flexion in patellofemoral pain; two trials), showing no statistically significant pooled effect (Hedges’ g = −0.21, 95% CI −1.36 to 0.94; I² ≈ 83%). Remaining outcomes could not be pooled due to heterogeneity and incompatible reporting. Conclusions: Evidence from seven randomized trials indicates that articular manual therapy (mobilization and/or HVLA thrust manipulation) can improve quantitative proprioceptive outcomes immediately post-intervention, particularly JPSE in neck and patellofemoral pain; however, effects are condition- and outcome-specific, and confidence is limited by heterogeneity and the predominance of narrative synthesis with sparse poolable data. Future adequately powered trials should standardize proprioception protocols, include longer follow-up, and report data to enable robust meta-analysis. Full article

Objectives: Frozen shoulder (FS) leads to pain, reduced shoulder function, and deficits in postural stability and sensorimotor control during upper-limb weight-bearing and activities of daily living tasks. This study investigated how an eight-week Dynamic Neuromuscular Stabilization (DNS) program affected Center of Pressure (COP) control and pain in midlife women with FS. Methods: Twenty-two midlife women with FS were randomly assigned to a DNS group (DNSG, n = 11) or a control group (CG, n = 11). The DNSG performed DNS exercises twice weekly for eight weeks, while the CG performed a dynamic stretching–based active control program. COP variables (distance, velocity, and root mean square (RMS) in the anterior–posterior (AP) and medial–lateral (ML) directions) were measured using a force platform under affected-side single-hand support with visual input and bilateral hand support with and without visual input. Pain was assessed using the Visual Analog Scale (VAS). All variables were analyzed using a two-way mixed ANOVA. Results: Under the affected-side single-hand support condition, a significant group × time interaction was observed for the prespecified primary outcome, ML-RMS (p < 0.05). Other COP variables under this condition were not significant after Holm–Bonferroni correction. Under bilateral hand-support conditions, ML-RMS remained significant after multiplicity adjustment in both visual conditions (p < 0.05). Pain (VAS) decreased over time in both groups, with no significant group × time interaction observed. Conclusions: The DNS intervention was associated with positive changes in COP-based postural control during upper-limb weight-bearing tasks in midlife women with FS. Pain decreased over time in both groups, with no significant group-by-time interaction. These findings suggest that DNS may be a potentially useful intervention for improving postural stability during upper-limb support tasks in patients with FS. Full article