Search Results (31)

Background: Upper-limb performance in handball depends on accurate shoulder sensorimotor control under high loads and fatigue. This study examined between-cohort differences associated with concentric versus eccentric exercise-induced fatigue in shoulder proprioception, kinesthesia, functional stability, and isometric force output in professional male handball players. Methods: This was a retrospective, quasi-experimental (non-randomized) between-cohort comparison of two previously collected cohorts who completed either a concentric (n = 46) or eccentric (n = 33) fatigue protocol, with pre- and post-fatigue assessments of joint repositioning sense (absolute angular error, AAE), threshold to detection of passive movement (TTDPM), Y Balance Test Upper Quarter (YBT-UQ), and the Athletic Shoulder (ASH) test. Results: Fatigue significantly increased AAE across all tested angles (Time: all p < 0.001), with a contraction-specific effect at end-range internal rotation (IR45°), where AAE increased more after concentric than eccentric fatigue (Time × Fatigue Type: p = 0.017; Δ = +1.34° (+61.8%) vs. +0.20° (+7.4%)). TTDPM increased after fatigue (p = 0.001) with no interaction (p = 0.968). YBT-UQ performance decreased after fatigue for all dominant-limb outcomes and for non-dominant inferolateral, superolateral, and composite scores (all p ≤ 0.018), but not for non-dominant anteromedial reach (p = 0.986); no Time × Fatigue Type interactions were detected for YBT-UQ outcomes (all p > 0.05). ASH force output decreased across all positions and both limbs (all p ≤ 0.002), with the dominant-limb Y position showing a greater decline following eccentric fatigue (Time × Fatigue Type: p = 0.030; e.g., ASH Y dominant Δ = −0.49 (−4.6%) vs. −1.43 N·kg⁻¹ (−13.3%)). Conclusions: Exercise-induced fatigue impairs shoulder sensorimotor function and upper-limb performance in handball. Contraction-mode differences were small and task-specific in this between-cohort comparison, emerging primarily at end-range proprioception and selected isometric strength positions. These findings may inform the design of training programs that emphasize fatigue-resistant sensorimotor control and end-range strength, while causal inferences regarding contraction mode are not warranted given the non-randomized design. Full article

Parkinson’s disease (PD) is a heterogeneous clinical syndrome representing the final stage of a complex and long-lasting neurodegenerative process that involves not only dysfunction of the dopaminergic system but also impairments in other neurotransmitter systems. The diversity of the clinical presentation of PD, together with the existence of Parkinsonian syndromes and atypical Parkinsonism—such as multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and dementia with Lewy bodies (DLB)—has important implications for rehabilitation outcomes and underscores the need for individualized, stage-dependent therapeutic approaches. Juggling is a complex motor activity that integrates cognitive, visuomotor, and balance processes, requiring a high level of concentration, precision, and motor adaptation. In recent years, there has been growing interest in this form of activity as a potential tool for supporting neuroplasticity, cognitive functions, and neurological rehabilitation. The aim of this review was to summarize current scientific evidence on the effects of juggling training on cognitive functions, visuomotor coordination, and balance, as well as to discuss the potential benefits of combining it with controlled hypoxia in patients with Parkinson’s disease (PD). This narrative review additionally considers how disease heterogeneity and stage of progression may influence the effectiveness of such multimodal interventions. This paper reviews the literature concerning the neurophysiological basis of learning to juggle and the mechanisms of brain plasticity, including increases in gray matter volume, improvements in white matter integrity, and reorganization of neuronal networks in motor and associative regions. Attention is drawn to the synergistic potential of combining juggling training with exposure to moderate, controlled hypoxia, which may induce an adaptive response involving the transcription factor HIF-1α, enhance the expression of brain-derived neurotrophic factor (BDNF), and promote angiogenesis and mitochondrial biogenesis. Although juggling and hypoxia are not directly related to training stimuli, both interventions activate overlapping and complementary neuroplastic pathways, providing a conceptual rationale for their parallel consideration and potential integration within future rehabilitation protocols. Juggling delivers task-specific motor–cognitive learning, whereas hypoxia may amplify molecular plasticity signaling, potentially enhancing responsiveness to motor interventions, particularly in patients at early stages of PD when compensatory mechanisms and neuroplastic capacity are relatively preserved. Findings from existing studies suggest that juggling under controlled hypoxic conditions may represent an innovative, safe, and multimodal form of training that supports both cognitive and motor components. Such effects may be particularly relevant in patients at early stages of PD, when compensatory mechanisms and neuroplastic potential are relatively preserved. Such an intervention may contribute to improvements in balance, attention, executive functions, and cognitive flexibility, which is particularly relevant in the context of rehabilitation for patients with neurodegenerative diseases. Importantly, to date, no randomized clinical trials have directly examined juggling performed under controlled hypoxic conditions in PD. Therefore, the present concept should be regarded as translational and exploratory, integrating evidence from juggling-induced neuroplasticity and hypoxia-related physiological adaptations. In this context, the proposed approach represents a proof-of-concept framework for future multimodal interventions rather than an established therapeutic strategy. Available evidence suggests that combining complex sensorimotor skill training with physiological modulation of the internal environment may constitute a novel direction in PD rehabilitation, extending beyond conventional exercise-based models. Despite promising reports, further well-designed clinical studies are needed to determine the optimal training parameters (frequency, intensity, duration, and degree of hypoxia), to evaluate the long-term sustainability of therapeutic effects, and to account for the heterogeneity of PD and related Parkinsonian disorders. Full article

Background: Osteoarthritis (OA) is a common degenerative joint disease that often leads to impaired postural control, pain, and reduced physical function. Exercise is considered a first-line treatment, with sensorimotor training being an effective approach for managing OA. However, the optimal method of sensorimotor training for individuals with OA has not yet been established. Thus, the aim of this study was to compare the effects of a 24-week Gyrokinesis method (GK) versus Pilates (PL) intervention on balance control, function, pain and kinesiophobia in women with knee OA. Methods: Twenty women (aged 60 ± 7 years) with grade 2 or 3 knee OA were assigned to either GK (n = 12) or PL (n = 8). Both groups trained twice weekly for 24 weeks. Pre- and post-intervention assessments included postural sway parameters (RMS, velocity, frequency), physical function tests (e.g., TUG, Sit-to-Stand), flexibility, pain (Brief Pain Inventory), kinesiophobia (Tampa Scale), and quality of life (SF-36). Results: GK resulted in significantly greater improvements than PL in postural sway mean velocity AP right (GK −53.85% vs. PL −20.17%), AP left (GK −43.48% vs. PL +13.45%), and ML left (GK −40.18% vs. PL +37.95), pain reduction (GK −82.5% vs. PL −33.3%), and physical function (Sit-to-Stand: GK +75.9% vs. PL +3.7%; TUG: GK −16.4% vs. PL −13.8%; Step Test right: GK +34.2% vs. PL +19.9%; Step Test left: GK +41.4% vs. PL +18.1%) (all, p < 0.05). No significant between-group differences were observed for kinesiophobia or SF-36 scores (both, p > 0.05). Conclusions: Gyrokinesis method may be more effective than Pilates in enhancing balance, reducing pain, and improving physical function in women with knee OA. These findings support the use of the Gyrokinesis method in rehabilitation programs for individuals with OA. Full article

Objectives: Language is one of the core attributes of human development. Impaired or delayed language development (i.e., developmental language disorder: DLD) is a highly prevalent condition; however, its underlying etiopathogenetic causes are not fully elucidated. The possible role of multisensory integration (MSI) may be proposed. The aim of this pilot interventional study was to assess the effect of an individualized vestibular exercise training program regarding the processes that rely on multisensory integration in DLD. Methods: Children aged between 5 and 12 years with DLD and their age-matched neurotypical controls were included. Following informed consent, a baseline assessment (primitive reflexes, postural control, receptive language performance) was conducted. Next, a 26 week-long exercise program rich in vestibular stimuli was implemented in the DLD group. At 26-week follow-up, both groups were reassessed. Results: Compared to baseline, the primitive reflex profile significantly improved in the DLD group. Scores for dynamic postural control also improved (score of 0.25 IQR 0–1 at baseline vs. 2 IQR 1–2 at follow-up; p < 0.001). Age-standardized scores for receptive grammar (score of 79.5 IQR 71.5–89.5 at baseline, 87 IQR 66–103 at follow-up; p = 0.03) were also improved. When two-way comparisons using the mixed-effects models were made, improvement in the DLD group was evident when compared to baseline levels and to the control group at follow-up. Conclusions: Based on these results, the possible interplay between multisensory and sensorimotor integration and integration of primitive reflexes is proposed, with vestibular stimulation contributing to the cortical input that may underlie the maturation of the areas dedicated to multisensory processes. Full article

(1) Background: Recent decades have seen growing interest in neuroplasticity and the activity-dependent mechanisms that allow Brain Networks to adapt functionally. Among the various stimuli, physical exercise has emerged as a key modulator of brain plasticity. This narrative review aims to synthesize evidence on the structural and functional effects of physical exercise on the brain in healthy individuals aged 18–80 years. Exercise modalities were categorized into Cardiovascular, Strength, and Mixed Training. Each was further classified by intensity (Light-to-Moderate vs. Vigorous) and duration (Short- vs. Long-Term). A total of 25 interventions were analyzed to evaluate how these variables influence Brain Networks. Findings indicate that exercise type, intensity, and duration collectively modulate neuroplastic responses. Notably, physical training induces structural and functional changes in major Brain Networks, including the Default Mode Network, Salience Network, Central Executive Network, Visuospatial Network, Sensorimotor Network, and Language and Auditory Networks. These results underscore the potential of physical exercise as an effective non-pharmacological strategy to enhance brain health and plasticity across the adult lifespan. This narrative review aims to highlight the effects of physical exercise in changing the brain either functionally or structurally. Moreover, the most relevant exercise training modalities that may improve/change neural networks in healthy populations (18–80 years) were discussed. (2) Methods: Three different types of exercise were considered: (i) Cardiovascular, (ii) Strength, and (iii) Mixed Exercise. For each of them, two levels of intensity (Light-to-Moderate and Vigorous) and two durations (Short-Term and Long-Term Effects) were included. By analyzing 25 interventions, indications about the effects on the brain considering the three factors (type of exercises, intensities, and durations) were provided. (3) Results: The findings suggest that the type of exercises, intensities, and durations could to lead neural modification over time. Specifically, exercise intervention contributes to both structural and functional changes in brain regions located in key Brain Networks, including the Default Mode Network, Salience Network, Central Executive Network, Visuospatial Network, Sensorimotor Network, and Language and Auditory Networks. (4) Conclusions: In conclusion, the evidence presented herein underscores the beneficial effects of physical exercise on the structural and functional integrity of the brain, highlighting its importance as a non-pharmacological intervention to improve brain plasticity. 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

The ability to walk is often lost after neural injury, leading to multiple secondary complications that reduce quality of life and increase healthcare costs. The current rehabilitation interventions primarily focus on restoring leg movements through intensive training on a treadmill or using robotic devices, but ignore engaging the arms. Several groups have recently shown that simultaneous arm and leg (A&L) cycling improves walking function and interlimb connectivity. These findings highlight the importance of neuronal pathways between the arm (cervical) and leg (lumbar) control regions in the spinal cord during locomotion, and emphasize the need for activating these pathways to improve walking after neural injury or disease. While the findings to date provide important evidence about actively including the arms in walking rehabilitation, these strategies have yet to be optimized. Moreover, improvements beyond A&L cycling alone may be possible with conjunctive targeted strategies to enhance spinal interlimb connectivity. The aim of this review is to highlight the current evidence for improvements in walking function and neural interlimb connectivity after neural injury or disease with cycling-based rehabilitation paradigms. Furthermore, strategies to enhance the outcomes of A&L cycling as a rehabilitation strategy are explored. These include the use of functional electrical stimulation-assisted cycling in acute care settings, utilizing non-invasive transcutaneous spinal cord stimulation to activate previously inaccessible circuitry in the spinal cord, and the use of paired arm and leg rehabilitation robotics. This review aims to consolidate the effects of exercise interventions that incorporate the arms on improved outcomes for walking, functional mobility, and neurological integrity, underscoring the importance of integrating the arms into the rehabilitation of walking after neurological conditions affecting sensorimotor function. Full article

This narrative review explores the significant evolution of sports rehabilitation, tracing its trajectory from basic exercise therapies of the early 20th century to the advanced, neuroplasticity-driven approaches of the 21st century, with a specific focus on anterior cruciate ligament reconstruction (ACLR). The primary aim is to understand how neuroplasticity, motor control, and sensorimotor retraining can optimize recovery, reduce reinjury risk, and enhance long-term athletic performance, and to synthesize current rehabilitation strategies that integrate innovative technologies, such as robotics, virtual reality (VR), and biofeedback systems, to address the neurocognitive deficits that contribute to the alarmingly high reinjury rates (9–29%) observed in young athletes post-ACLR. These deficits include impaired proprioception, motor control, and psychological factors like fear of reinjury. The methodology employed involves a narrative review of peer-reviewed literature from databases including PubMed, Scopus, and Web of Science. The synthesis of findings underscores the importance of holistic rehabilitation approaches, including targeted proprioceptive exercises, dual-task drills, and immersive VR training, in enhancing sensorimotor integration, decision-making, and athlete confidence. Furthermore, this review highlights the critical need for long-term monitoring and interdisciplinary collaboration between neuroscientists, physiotherapists, and engineers to refine rehabilitation protocols and ensure sustained recovery. By leveraging neuroplasticity and advanced technologies, the field can shift from a focus on purely physical restoration to comprehensive recovery models that significantly reduce reinjury risks and optimize athletic performance. Full article

Sensorimotor training on an unstable base of support is considered to lead to improvements in balance and coordination tasks. Here, we intend to lay the groundwork for generating cost-effective real-time kinematic feedback for coordination training on devices with an unstable base of support, such as Sensopros or slacklines, by establishing a model for estimating relevant tape kinematic data from angle measurements alone. To assess the accuracy of the model in a real-world setting, we record a convenience sample of three people performing ten exercises on the Sensopro Luna and compare the model predictions to motion capture data of the tape. The measured accuracy is reported for each target measure separately, namely the roll angle and $XYZ$-position of the tape segment directly below the foot. After the initial assessment of the model in its general form, we also propose how to adjust the model parameters based on preliminary measurements to adapt it to a specific setting and further improve its accuracy. The results show that the proposed method is viable for recording tape kinematic data in real-world settings, and may therefore serve as a performance indicator directly or form the basis for estimating posture and other measures related to human motor control in a more intricate training feedback system. Full article

Developmental central hypotonia describes children with decreased muscle tone due to non-progressive central damage, and includes many genetic conditions (e.g., Down, Prader–Willi or Joubert syndromes etc.), cerebral palsy with hypotonia as the main motor type, developmental delays and congenital hypotonia with favorable outcome. This umbrella review aims to systematically describe the best available evidence for interventions that may be used by early intervention therapists in home and community settings. We conducted electronic searches in PubMed, Medline, CINAHL, EMBASE, EBM Reviews and PEDro during August 2024. Methodological quality and risk-of-bias were rated by all authors, and included reviews were compared and contrasted. Eight systematic reviews (SRs) and two overviews of interventions for children with developmental central hypotonia under 6 years of age were identified through databases and other search methods. Four SRs and one overview evaluated treadmill training, one SR evaluated use of orthotics, another evaluated therapeutic exercise, and two SRs and one overview evaluated a range of occupational and physical therapy interventions. Methodological quality and risk-of-bias of included reviews were variable. Most evidence is related to children with Down syndrome, with few studies addressing children with central hypotonia from other causes. Low-quality (GRADE) evidence supports treadmill training to promote walking onset in children with Down syndrome. Motor, sensorimotor, orthotics, positioning, mobility and infant massage interventions are supported by positive but low- or very-low-quality evidence, and recommendations in favor are all conditional. Primary research on effectiveness of all occupational and physical therapy early interventions for children with developmental central hypotonia from all causes is warranted. Full article

Breast cancer (BC)-related sequelae drastically impact the psychophysical functioning and quality of life of affected women. Adapted physical activity (APA) has proved to effectively counteract these impairments in a non-medicalized framework. In particular, dragon boats are able to promote body functionality, social interaction, and quality of life in BC survivors, but the literature on specific motor gestures is scarce and practice is still based more on a re-educative perspective than a performative one. In this context, the present longitudinal study investigated the benefits of an adapted biofeedback-based sensorimotor training intervention on upper body functionality in a team of dragon ladies. The 8-week intervention was conceived as integrated dry workout sessions led by an APA kinesiologist and applied a novel sensorized proprioceptive device, such as a Libra board. Post-protocol evaluation revealed a significant improvement in bilateral upper limb mobility, core endurance, and trunk stability along with a distress decrease and quality of life enhancement through validated assessment tools. Our findings suggest that integrating biofeedback-based workout sessions can effectively promote upper body functionality in BC survivors practicing dragon boating. Furthermore, our innovative approach could help spread methodological hints able to boost exercise adherence in this target population, thus counteracting cancer recurrence while promoting overall well-being. Full article

Researchers commonly use the ‘free-fall’ paradigm to investigate motor control during landing impacts, particularly in drop landings and depth jumps (DJ). While recent studies have focused on the impact of vision on landing motor control, previous research fully removed continuous visual input, limiting ecological validity. The aim of this investigation was to evaluate the effects of stroboscopic vision on depth jump (DJ) motor control. Ground reaction forces (GRF) and lower-extremity surface electromyography (EMG) were collected for 20 young adults (11 male; 9 female) performing six depth jumps (0.51 m drop height) in each of two visual conditions (full vision vs. 3 Hz stroboscopic vision). Muscle activation magnitude was estimated from EMG signals using root-mean-square amplitudes (RMS) over specific time intervals (150 ms pre-impact; 30–60 ms, 60–85 ms, and 85–120 ms post-impact). The main effects of and interactions between vision and trial number were assessed using two-way within-subjects repeated measures analyses of variance. Peak GRF was 6.4% greater, on average, for DJs performed with stroboscopic vision compared to full vision (p = 0.042). Tibialis anterior RMS EMG during the 60–85 ms post-impact time interval was 14.1% lower for DJs performed with stroboscopic vision (p = 0.020). Vastus lateralis RMS EMG during the 85–120 ms post-impact time interval was 11.8% lower for DJs performed with stroboscopic vision (p = 0.017). Stroboscopic vision altered DJ landing mechanics and lower-extremity muscle activation. The observed increase in peak GRF and reduction in RMS EMG of the tibialis anterior and vastus lateralis post-landing may signify a higher magnitude of lower-extremity musculotendinous stiffness developed pre-landing. The results indicate measurable sensorimotor disruption for DJs performed with stroboscopic vision, warranting further research and supporting the potential use of stroboscopic vision as a sensorimotor training aid in exercise and rehabilitation. Stroboscopic vision could induce beneficial adaptations in multisensory integration, applicable to restoring sensorimotor function after injury and preventing injuries in populations experiencing landing impacts at night (e.g., military personnel). Full article

Visual input significantly affects kinesthesis skills and, hence, visually impaired individuals show less developed sensorimotor control, especially in an unfamiliar outdoor environment. Regular blind baseball practice can counteract such a deficit but, given the complex kinetic chain model required, a targeted workout proposal is needed to improve the main athletic gesture performance. On these premises, we investigated, for the first time, the running and pitching performance of a competitive Italian blind baseball team through quantitative tools and parameters such as Libra Easytech sensorized proprioceptive board, goniometric active range of motion, chronometric speed, and pitching linear length. Moreover, the perceived physical exertion was assessed by the Borg CR10 scale. Consequently, an adapted athletic training protocol was designed and tested on the field during the competitive season, with the aim to strengthen sport specific-gesture coordination and efficacy as well as to prevent injuries. Quantitative assessments showed an improvement in ankle stability index, bilateral upper limb and hip mobility, reactive agility, running braking phase control during second base approaching, and auditory target-related pitching accuracy along with a decrease in perceived physical exertion. This protocol might therefore represent an effective and easily reproducible training and evaluation approach to tailor management of visually impaired baseball players, and safely improve their athletic performance under the supervision of an adapted exercise specialist. Full article

Background: Many stroke survivors suffer from sensorimotor deficits, especially balance impairments. The purpose of this trial is to investigate whether the designed Immersive Virtual Reality training program is better in the short term (15 sessions) and in the medium term (30 sessions) than physiotherapy training with Bayouk, Boucher and Leroux exercises, with respect to static balance in sitting and standing, dynamic balance and quality of life in patients with balance impairment in stroke survivors. Methods: This study is a randomized controlled trial with two treatment arms and evaluators blinded, and a functionality treatment group in combination with specific balance exercise training according to Bayouk, Boucher and Leroux (control group) or a balanced treatment using Immersive VR. The primary outcome will be static, Dynamic balance and gait measured by Bestest Assessment Score (BESTest), Berg Scale (BBS), Pass Scale (PASS) and Time Up and Go test (TUG). The secondary outcome will be the stroke-associated quality of life using the Stroke Quality of Life Scale (ECVI-38). Conclusions: The results of this study may add new insights into how to address balance using Immersive Virtual Reality after a stroke. If the new training approach proves effective, the results may provide insight into how to design more comprehensive protocols in the future for people with balance impairments after stroke. Full article

It is well-known that sensorimotor training aims to increase the performance of the sensorimotor system to maintain an upright position. Through the use of a randomized placebo-controlled trial, the specific aim of this study was to investigate the short-term effects of a specific session of sensorimotor training on postural balance, stability and coordination in healthy, recreationally active participants. Ninety subjects were randomly allocated into three groups: experimental (n = 30), placebo (n = 32) and control (n = 28). The experimental group performed a 5 min warm-up, with the sensorimotor training consisting of 60-min specific sensorimotor exercises; the control group was not allowed to perform any sensorimotor training; the placebo group observed a video clip of an individual belonging to the experimental group performing the sensorimotor training accurately. All participants were seen three times per week for 4 weeks. Before and after the entire training, all groups of participants undertook stabilometric parameter assessment. The intervention-mediated sensorimotor training confirmed significant enhancement in the proprioceptive system. Significant improvement in the motor and/or sensory function was observed in the experimental and placebo groups. In conclusion, our findings suggest that specific sensorimotor training performed 3 days per week for 4 weeks could improve postural balance, stability and coordination in healthy individuals. Full article