Search Results (1,676)

Background: When a small design-of-experiments dataset is used to optimize a machining process with particle swarm optimization (PSO), the regression model chosen as the fitness function is rarely validated against more than one candidate response, checked against alternative model families, or checked for the optimization that follows from using the same cross-validation score to both tune and report a model. Methods: We revisit 24 end-milling trials on AISI 1045 steel (fifteen one-factor-at-a-time runs plus a Taguchi L9 array; every value was independently verified against the underlying thesis records) in which cutting force, cutting-zone temperature, and X-ray diffraction residual stress were measured. A multiple linear regression (MLR), a quadratic response-surface model (RSM), a support vector regression (SVR), and a Gaussian process regression (GPR) were each cross-validated by nested leave-one-out cross-validation against every response, with bootstrap 95% confidence intervals and paired bootstrap significance tests on the resulting R² values, as well as a variance-inflation-factor check on the combined design matrix. The best-validated model per response was then used inside an identical constricted-PSO routine, which was run across 30 random seeds per fitness function to assess the convergence stability. Results: Design collinearity was not a concern (all VIF ≤ 1.28). Under the nested validation, the response-specific pattern held for temperature and residual stress but not for cutting force: the SVR was the only model to beat the MLR by a margin that survived a paired bootstrap test (residual stress, P (SVR not better) = 0.02); for force, a quadratic RSM model outperformed all three other families (R² = 0.72 vs. 0.39 for MLR and 0.28 for GPR), and the GPR’s earlier apparent advantage for force did not survive the leakage-free hyperparameter selection. The residual-stress PSO result was stable across seeds: 27 of 30 of the SVR-fitness runs converged to the same interior optimum (579.8 rpm, 40 mm/min, 0.413 mm; mean −472.5 MPa, SD 3.4 MPa), against a boundary optimum found deterministically by every MLR-fitness run (355 rpm, 40 mm/min, 0.5 mm, −434.6 MPa). The validated interior optimum also predicted a 55% lower cutting force and a slightly lower temperature at the same operating point. Conclusions: Whether a nonlinear surrogate should replace a linear one is response-specific and must be checked with a leakage-free validation scheme rather than assumed; for this dataset, that check overturns the original force-model recommendation while confirming the residual-stress result under both cross-model and multi-seed checks. The residual-stress optimum remains a model prediction pending physical confirmation. Full article

Receptor-mediated endocytosis requires a particle to approach the cell membrane to within a few nanometers before ligand–receptor binding can occur. Existing continuum models often start from an already established contact and do not explicitly describe how crowding particles on the extracellular side influence the distribution of the particle near the membrane. We examine entropic depletion forces as one possible nonspecific contribution to this initial approach. For ideal depletants, the Asakura–Oosawa excluded-volume construction gives an exact depletion potential for the planar geometry before contact. The potential and force vanish continuously at the onset of excluded-volume overlap. This interaction provides a possible contribution to membrane proximity before specific binding, while its extension to curved wrapping geometries requires additional approximation. Within a reduced continuum model, we combine depletion attraction, ligand–receptor binding, membrane deformation, and cytoskeletal viscoelastic dissipation. The viscoelastic contact is formulated through a hereditary integral and a standard linear solid. The kinetic model gives a conditional minimum ligand density for complete engulfment, a finite particle-size window, and a stiffness-dependent upper limit. When the stationary radius lies inside the domain of finite positive wrapping times, the estimated wrapping time has a minimum at a radius that decreases with increasing binding energy density. At fixed viscosity and other independent parameters, the same time approximation predicts slower wrapping as cell stiffness increases. The two positive roots defining the size window merge at a limiting parameter value, which characterizes closure of the admissible size interval. Depletion attraction is interpreted as one possible contribution to particle-membrane association, alongside electrostatic interactions, steric effects, and membrane fluctuations. The present analysis identifies how nonspecific attraction, specific adhesion, and mechanical resistance can contribute to different stages of membrane wrapping. Full article

Cavitation bubble collapse generates impact loads that can initiate surface damage and accelerate material degradation in hydraulic and fluid-handling systems. Predicting these loads remains challenging because the collapse response depends on nonlinear interactions among bubble dynamics, stand-off distance, and polymer mechanical, acoustic, and viscoelastic properties. This study developed machine-learning regression models to predict impact loads from laser-induced single-bubble collapse on polyethylene, polytetrafluoroethylene (PTFE), polyamide, and antistatic polyethylene terephthalate (antistatic PET). Experiments were performed using a pulsed Nd:YAG laser at energies of $12.5$, 25, and $50\mathrm{mJ}$ and normalized stand-off distances of $\gamma =1$–5, producing 180 measurements. Impact loads were measured using a force-calibrated PVDF sensor with material-specific calibration equations. Bubble radius was obtained from high-speed imaging, whereas collapse time was determined from the PVDF voltage-time response. Thirteen input variables were used to train linear, ridge, LASSO, multilayer perceptron, and random forest regressors with Bayesian optimization and grouped five-fold cross-validation. Random forest regression achieved the best performance, with $\mathrm{RMSE}=0.6820\mathrm{N}$, $\mathrm{MAE}=0.5339\mathrm{N}$, $R^2=0.9168$, and $\mathrm{MAPE}=12.44\%$. SHAP analysis identified collapse time, acoustic impedance, and loss modulus as dominant predictors. The model is therefore suitable for trend prediction within the tested experimental domain. Full article

Full-waveform inversion (FWI) typically employs finite-difference time-domain (FDTD) methods to solve the wave equation under the point-source assumption. For computational efficiency, the coarsest grid that satisfies dispersion and stability requirements is generally preferred. However, this grid may not resolve the finite aperture and spatial phase characteristics of a transducer, thereby introducing imaging artifacts and errors. This paper proposes an Operator-consistent reduced source that maps a local fine-grid radiation field to node-specific forcing histories for a prescribed coarse-grid operator. These histories are reused in repeated simulations without online fine-grid computation. On a 0.50 mm grid, the method reduced root-mean-square (RMS) field relative error by 96.4% compared with the Direct coarse-grid aperture source. In controlled FWI with independent observations, the sound-speed root-mean-square error was 2.14 m/s, compared with 4.94 and 5.17 m/s for the Point source and the Direct coarse-grid aperture source, respectively. Hydrophone measurements, blind ring-water validation, and three repeated phantom acquisitions further assessed field reproduction and reconstruction performance. The method enables coarse-grid FDTD simulations to represent the radiated fields of finite-aperture transducers whose device-scale features are not directly resolved by the target grid. Full article

Reliable structural monitoring for smart buildings and construction sites requires more than sensor acquisition; it requires sensing and communication paths that remain traceable, recoverable, and compatible with platform-side data processing under heterogeneous field constraints. This study presents a dual-path IoT sensing and communication framework that deliberately separates high-data-rate vibration monitoring from low-data-rate inclination-status monitoring while maintaining common requirements for preservation of available time information, data-source identification, and backend interpretability. The smart-building path integrates an ADXL355 triaxial accelerometer, ESP32-S3, Power over Ethernet (PoE), and Message Queuing Telemetry Transport (MQTT) for 200 Hz vibration acquisition, together with a second-order 10 Hz low-pass filter, 40-record batching, and a Flash LittleFS-based store-and-recovery mechanism that interleaves live and replayed records after reconnection. The construction-site path combines an SCL3300-D01 inclinometer with LoRaWAN, baseline-referenced relative-angle estimation, and a hysteresis state machine with distinct alarm and recovery thresholds. In a 24 h validation, four vibration nodes delivered all 69,120,000 expected records, and four forced-outage trials recovered all offline records while live transmission continued. Frequency-domain analysis confirmed attenuation of high-frequency components while retaining the dominant low-frequency response. The inclination path demonstrated quantifiable angle accuracy, correct alarm/recovery transitions, continuous LoRaWAN frame delivery over the observed interval, and correct backend decoding. The results show that path-specific communication design, combined with a common traceability concept, supports prototype functionality under the reported test conditions, not immediate construction-site deployment. Full 3D visual synchronization, BIM/GIS asset mapping, and digital-twin platform interfacing were not implemented and remain future development tasks. Full article

Despite major advances in exercise physiology, biomechanics, and mechanobiology, exercise science still lacks a clear conceptual definition of the mechanical stimulus experienced by skeletal muscle during resistance training. Current approaches rely on diverse external, internal, and biomechanical variables (e.g., volume-load, force, power, velocity, time under tension, or muscle architecture), yet none individually captures the muscle-specific mechanical exposure relevant to muscular adaptation. This conceptual inconsistency limits comparisons across studies, complicates training prescription, and hinders the development of individualized monitoring strategies. This integrative review critically synthesizes current evidence from mechanobiology, skeletal muscle physiology, biomechanics, and resistance training to examine how mechanical stimuli are currently conceptualized, quantified, and interpreted. Based on this synthesis, we propose a working definition of Mechanical Dose as the cumulative, muscle-specific mechanical exposure experienced over a defined time window, characterized by loading magnitude, rate, duration, frequency, and spatial distribution, and conditioned by contraction mode and muscle–tendon geometry. Rather than representing a directly measurable variable, mechanical dose is presented as a latent conceptual construct that can only be estimated through combinations of biomechanical, physiological, and morphological indicators. Building upon this definition, we introduce an integrative conceptual framework linking external load, movement biomechanics, mechanical dose, mechanotransduction, and tissue adaptation. We further discuss how this framework may guide future research on the interpretation of field-based monitoring, resistance training prescription, recovery management, and future explainable artificial intelligence approaches in sport science. By reframing mechanical dose as the central construct connecting biomechanics and biological adaptation, this review provides a unified conceptual basis for future research and contributes toward a more biologically informed paradigm of exercise prescription and monitoring. Full article

Digital technology has been recognized as a pivotal force in optimizing land use patterns, particularly in enhancing the green utilization efficiency of urban land. In this study, panel data from 219 cities across China covering the 2013–2023 period are used to investigate the impact of urban digital transformation (UDT) on land green use efficiency (LGUE) and the underlying mechanisms involved. The spatiotemporal evolution of LGUE demonstrates a clear upward trend over time and hot spots of LGUE are mainly concentrated in coastal cities. The findings reveal that UDT significantly enhances LGUE, a conclusion that remains robust across multiple checks and an instrumental variable approach. Mechanism analyses indicate that a market-oriented allocation of data elements, green technological innovation, and optimization of the labor skill structure serve as plausible channels driving this improvement. Importantly, spatial Durbin model analysis confirms a significant positive spatial spillover effect, indicating that local digital transformation also radiates to benefit the green land utilization of neighboring cities. Finally, heterogeneity analyses reveal that the positive effects of digital transformation on LGUE are notably more pronounced in larger cities and those with advanced internet development. Furthermore, the impacts exhibit structural divergence across specific digital dimensions, with economic digitalization significantly driving LGUE, whereas social digitalization exerts a negative effect. Full article

Background/Objectives: Change-of-direction (COD) movements represent a fundamental component of performance in multidirectional sports and constitute one of the primary mechanisms of knee injury. The biomechanical assessment of such movements has traditionally relied on optoelectronic systems and force platforms, tools characterized by high accuracy but limited applicability in field settings. Inertial measurement units (IMUs) represent a promising alternative; however, operational doubts and uncertainties frequently persist. Therefore, the purpose of this systematic review was to critically evaluate the concurrent validity and practical utility of IMU sensors for detecting the biomechanical characteristics of COD maneuvers in sport. Methods: The bibliographic search was conducted in March 2024 across the PubMed MEDLINE, Scopus, and Web of Science databases, using Boolean combinations of the following keywords: IMU, “inertial measurement unit”, CoD, “change of direction”, “cutting maneuvers”, sport, and soccer. Study selection and analysis were performed, and methodological quality was assessed using the QUADAS-2 tool. Results: In the original search (March 2024), ten studies were included, involving 208 participants; a formal update of the search (through August 2026), conducted with the same protocol, identified two additional candidate studies (14 and 30 participants), bringing the total to twelve studies and 252 participants; both supplementary studies underwent the same four-reviewer independent screening, full-text data extraction and QUADAS-2 appraisal applied to the original ten studies. The findings indicate that IMUs demonstrate good concurrent validity for kinematic variables in the sagittal plane, particularly at the hip and knee joints, with ICC values up to 0.99 and a mean RMSE below 2°. Performance decreases substantially in the frontal and transverse planes. Regarding ground reaction forces, IMUs provide acceptable estimates of mean values, but not of instantaneous forces. For temporal variables, IMUs proved comparable to timing gates in the assessment of explosive actions. Conclusions: Based on a limited and heterogeneous evidence base of twelve studies, IMUs appear to be a promising and accessible technology for specific field-based applications, particularly for the assessment of CODs at 0°, 45°, and 90° in the sagittal plane, for monitoring right-left asymmetries, and for counting explosive actions. Given the small number of included studies and their methodological heterogeneity, these findings should be interpreted with caution. IMUs cannot yet be recommended as a complete replacement for gold-standard systems in applications requiring high precision or detailed analysis of instantaneous forces. Full article

Background/Objectives: Contemporary health systems continue to face persistent challenges in financing, equity, and governance, particularly under conditions of limited resources, workforce shortages, and demographic pressures. While the World Health Organization calls for strengthening social participation to achieve universal health coverage, evidence suggests that such participation often remains largely symbolic. Existing global examples of social participation in health are limited either by their short duration of implementation or by their limited scope. In contrast, the experience of former Yugoslavia (1945–1991) represents a distinctive case. In the early post-war period, health reforms were directed towards the development of a decentralised, self-managed health system that emphasised universal coverage, participatory governance, social solidarity, and local autonomy. The trajectory of these reforms was further shaped by global economic and political pressures, including neoliberal trends, international debt, and the oil crises, which constrained resources and exposed systemic vulnerabilities. The so-called Yugoslav Experiment may offer an alternative to existing market-oriented and, at times, inefficient health systems. This review aims to synthesise evidence on the governance, financing, organisation, and outcomes of Yugoslavia’s self-managed health system and to evaluate its relevance to contemporary debates on health system resilience, decentralisation, participatory governance, equity, and sustainability. It examines power relations, stakeholder interests, and resource allocation, and assesses the lessons that the Yugoslav experience offers for contemporary debates on participatory governance and the sustainability of healthcare systems, while identifying areas of convergence, debate, and gaps in the existing scholarship. Methods: We conducted a systematic narrative review of peer-reviewed articles, book chapters, conference papers, and commentaries published in English or Bosnian–Croatian–Montenegrin–Serbian that covered the period 1945–1991. Scopus, PubMed, and EBSCOhost (including CINAHL Plus with full text, Medline and PsychInfo) were searched on 19 January 2026. Studies were included if they addressed health system reform, self-management, governance, financing, or institutional continuity. Contextual studies of selected services—primary care, mental health, reproductive health, and vaccination—were included only if they illuminated reform trajectories. Data synthesis focused on reform phases, institutional transformations, financing arrangements, governance mechanisms, and power relations, with particular attention to continuity, path dependence, and critical junctures. Given the heterogeneous and predominantly historical, analytical, and policy-oriented nature of the literature, we did not apply conventional study-design-specific risk-of-bias tools. Instead, we used an overarching framework to classify and contextualise the included evidence according to five dimensions: source type, nature of contribution, evidentiary role, temporal context, and health-system domain. The protocol was not registered. The study was financed by the Provincial Secretariat for Higher Education and Scientific Research, Autonomous Province of Vojvodina, Republic of Serbia. Results: The database searches yielded 265 records, of which 193 were selected for title and abstract screening after removing 72 duplicates. At this stage, 133 publications were excluded because they did not meet the eligibility criteria and 60 publications were selected for full-text review. Application of the predefined inclusion and exclusion criteria resulted in 22 eligible publications. An additional 18 studies were identified through citation chaining and targeted Google Scholar searches. Twenty-two publications were coded as primary studies, directly examining health system reform, governance, or self-management, while 18 were classified as contextual studies addressing specialty areas. The analysis identified key reforms that followed the social participation, i.e., ‘self-management’, approach, which expanded primary care, preventive services, and local participation. It revealed institutional changes, as well as the role of power and health financing in health reforms aimed at strengthening social participation. Nonetheless, challenges—including bureaucratic and managerial elitism, unequal professional authority, resource scarcity, and tensions between market-oriented policies and social solidarity—were amplified by global economic forces and neoliberal trends, ultimately contributing to the system’s collapse by the late 1980s. This review was limited by its search strategy, the exclusion of grey literature, the potential omission or inaccessibility of relevant studies, and its focus on selected aspects of health reform, namely post-war recovery and self-management. Conclusions: The Yugoslav experience illustrates both the promise and the fragility of socially oriented, participatory health systems, demonstrating how international political alignments and global economic pressures can profoundly shape domestic health reform trajectories. Lessons from this case remain relevant to contemporary efforts to strengthen social participation for universal health coverage through designing sustainable, resilient, equitable, and socially accountable health systems under complex global conditions. Full article

Pension funds and insurers in emerging markets size long-horizon capital with economic scenario generators (ESGs)—econometrically, simulators of a multivariate predictive density. The production benchmark draws its innovations by Gaussian Cholesky factorization, forcing thin marginal tails and zero joint tail dependence, so it cannot generate the simultaneous yield and currency shocks that dominate emerging-market stress; as supervisors move market-risk capital to expected shortfall, a density blind to joint extremes understates the number they now act on. We retain the three-layer liability-driven-investment cascade but replace its innovation engine with a Student-t copula over Student-t marginals, a more general specification of which the Gaussian benchmark is a special case, and validate it on Indonesian data from February 2010 to May 2026. A boundary-corrected bootstrap test rejects the Gaussian dependence structure; the heavy-tailed engine is the better-calibrated joint density forecast both in sample and in real-time rolling evaluation, with a scoring advantage that is clear in sample and small in real time; and the Gaussian default understates 99% expected-shortfall capital by about 11%, a direction that is robust across bootstrap resamples and across truncation and tail-heaviness settings, though imprecise in magnitude. Framed as a density forecast and judged by calibration and proper scores, the copula engine is better calibrated and more prudent, pricing the joint extremes the Gaussian default omits. Full article

Depression and stress-related disorders remain important targets for the development of new neuroactive compounds. We evaluated three imidazo[1,2-a]pyridine–[1,2,5]oxadiazolo[3,4-b]pyrazine derivatives, selected by a SERT-oriented computational screen, using chemical characterization, zebrafish embryo toxicity, larval and adult zebrafish behavioural assays, mouse behavioural HPLC, and qPCR experiments. AD19/UtIA-0167 had the highest computational consensus but showed greater embryo toxicity and no consistent advantage in adult zebrafish. AD20/UtIA-0108 showed a distinct larval locomotor profile, increased middle-zone occupancy after chronic exposure in stressed adult zebrafish, and was therefore examined in mice. Chronic AD20 increased latency to enter the dark compartment; whereas, time in the light compartment, open-field measures and forced-swim immobility were unchanged. HPLC and qPCR changes were region-specific and did not demonstrate direct SERT engagement. AD20 should therefore be regarded as an early neuroactive candidate from a SERT-oriented screen, not as a confirmed SERT inhibitor or antidepressant. Interpretation across species is limited by the duplicated zebrafish serotonin-transporter system, waterborne exposure and the limited scope of the mouse behavioural effect. Direct transporter assays, pharmacokinetic studies and independent behavioural replication are required. Full article

Urban flood control basins without forced drainage operate as one-shot systems: they must perform within a single event and cannot empty themselves until it ends. The timing of gate closure is therefore decisive—closing early wastes storage, whereas closing late lets stored water drain back to the falling channel—yet the recovery-based Reliability–Resiliency–Vulnerability (RRV) framework does not capture this trade-off. We reformulated the RRV indices for non-drainable basins and applied them to a full-scale experimental channel reproduced with high-resolution Structure-from-Motion terrain and simulated with the two-dimensional Nays2D Flood model. The three indices provide complementary performance dimensions: Reliability describes temporal threshold attainment, Resiliency describes event-integrated retention, and Vulnerability describes the maximum instantaneous deficit. Five gate-closing scenarios were compared with the no-gate reference. For this single-site, single-hydrograph event on the calibrated 211 × 111 grid, the net inflow at the inlet reversed at about t = 2611 s, and closures made before this instant avoided backflow. Closing just before reversal (t = 2574 s) gave the highest Resiliency (0.995), the lowest Vulnerability (0.074), and the largest net inflow (1487 m³) among the tested scenarios; delaying closure reduced Resiliency to 0.809 and raised Vulnerability to 0.255. The exact values are specific to the adopted grid and event, whereas the principal result is the reversal-based closure window. The method identifies this window using observed or forecast water level or flow direction information, without requiring new forced-drainage or pumping infrastructure. Full article

Musculoskeletal injuries are the leading cause of time loss in professional football, yet machine learning models integrating multi-protocol force-plate data for injury-risk classification are absent from the Latin American professional football literature. Purpose: This study aims to develop and internally cross-validate a supervised Random Forest model for injury risk classification using full-season VALD ForceDecks data from a professional Costa Rican club, with thresholds derived from receiver operating characteristic (ROC) analyses. Methods: We utilized an observational longitudinal study (September 2024 to April 2026). One hundred and twenty-six male footballers from five competitive categories underwent 518 dual-force-plate assessments across four protocols (Nordic Hamstring, isometric mid-thigh pull, isometric adductor squeeze, countermovement jump), yielding 21 variables; one assessment per player entered the model. Record linkage against 262 surveillance-documented time-loss events identified 53 players with pre-injury assessments as the positive class (42.1%; ratio 1:1.4). SMOTE (k = 5) was applied within each training fold only. A Random Forest model (500 trees; depth 4) used 5-fold stratified cross-validation. The HIGH boundary was set at the Youden index, and the LOW boundary was set as the first score quartile. Results: The mean AUC-ROC across folds was 0.683 +/− 0.050, the only estimate of generalisation reported. Refitted on the complete dataset and applied back to the same players, the model gave at the Youden cut-point (score ≥ 45.2) an apparent sensitivity of 100% and specificity of 95.9%; these resubstitution values are optimistically biased. The leading predictors were Pull RFD (10.0%), CMJ power per body mass (7.2%) and eccentric CMJ peak force (6.6%). The risk tiers were HIGH 56 (44.4%), MEDIUM 39 (31.0%), and LOW 31 (24.6%). Conclusions: Multi-protocol force-plate data yield moderate internally cross-validated discrimination of injury risk. The near-perfect threshold metrics are apparent values, not generalisation performance. Rate of force development and eccentric force capacity outranked asymmetry indices. Prospective external validation is required before clinical use. Full article

Rapid post-earthquake assessment of urban rail viaducts requires nonlinear pier models that capture cyclic deterioration at manageable computational costs. This study calibrates and evaluates the established Ibarra–Medina–Krawinkler (IMK) formulation for reinforced-concrete solid piers rather than proposing a new hysteretic law or experimental database. Seven previously reported quarter-scale tests are reused for direction-specific parameter identification and calibration-set assessment. The new contribution is a multilevel accuracy–efficiency evaluation covering cyclic metrics, a scaled 12 m Fiber benchmark, nonlinear dynamics, incremental dynamic analysis (IDA), computational cost, and fragility. For the specimens, final secant stiffness achieved R² = 0.891 and a 9.93% mean absolute percentage error; cumulative energy achieved R² = 0.893 but a 27.79% error. For the prototype, the intermediate-backbone force difference was 3.83%. Under eight representative records, mean differences were 2.64% for peak base shear and 4.15% for peak displacement. Across 60 records scaled from PGA = 0.1 to 1.5 g, peak–displacement and peak–base–shear comparisons yielded R² values of 0.854 and 0.931. The corresponding mean absolute percentage errors were 15.95% and 11.32%. The IMK model reduced wall-clock time by 96.37%, a 27.55-fold speed-up. Paired fragility curves differed by 3.14 percentage points on average, and median PGA capacities differed by 11.23%; Sa(T1) and capacity-dispersion checks preserved the main comparison. Because the record groups were not matched in spectral amplitude or velocity, their ranking is interpreted as an association rather than a causal pulse-period effect. The calibrated IMK model is therefore suitable for rapid global demand and fragility assessment within its calibration domain, whereas Fiber models remain preferable for local damage, residual deformation, and detailed energy dissipation. Full article

Background: Spinal cord injury (SCI) is associated with persistent motor impairment, neuropathic pain, and reduced quality of life. While spinal cord stimulation (SCS) is an established therapy for neuropathic pain, motor effects have largely been demonstrated in experimental settings with activity-based training protocols. Whether such effects can be achieved within routine clinical care remains unclear. Case Presentation: We report on motor effects after the clinical implementation of percutaneous SCS using a commercially available system in a patient with chronic, posttraumatic, incomplete thoracic SCI. Following a standard inpatient trial and implantation of two percutaneous leads for neuropathic pain, all subsequent management, programming, and rehabilitation were conducted in an outpatient setting. Task-specific stimulation programs were iteratively developed to support functional activities during routine rehabilitation. Lower-extremity muscle strength was assessed using standardized handheld dynamometry at baseline and at monthly intervals over six months under stimulation-ON and stimulation-OFF conditions. Results: Serial dynamometry showed early stimulation-associated increases in force generation, with higher values under stimulation-ON than stimulation-OFF conditions. Over time, absolute strength values under OFF conditions also increased across individual muscle measurements, while stimulation-associated ON–OFF differences became less pronounced during intermediate follow-up but remained evident at month six. These observations included both acute stimulation-associated differences in force generation and longitudinal improvements in OFF-state motor performance. Stimulation was well tolerated during daily use and successfully integrated into outpatient rehabilitation. Functional outcomes showed concordant improvements in ambulatory performance and patient-reported domains. No stimulation-related adverse effects were observed during follow-up. Conclusions: This case illustrates how clinically indicated percutaneous SCS can be combined with motor-oriented programming within routine outpatient rehabilitation. The observed stimulation-associated motor effects and longitudinal changes in stimulation-OFF strength are limited to this individual patient and cannot establish efficacy or causality. Prospective controlled studies are needed to determine the reproducibility and clinical relevance of these observations in chronic incomplete SCI. Full article