Improve Rehabilitation Outcomes Research Articles

Hand functioning in progressive multiple sclerosis improves with tDCS added to daily exercises: A home-based randomized, double-blinded, sham-controlled clinical trial.

Many individuals with progressive multiple sclerosis (PMS) are challenged by reduced manual dexterity and limited rehabilitation options. Transcranial direct current stimulation (tDCS) during motor training can improve rehabilitation outcomes. We developed a protocol for remotely supervising tDCS to deliver sessions of stimulation paired with training at home. This study evaluated the effectiveness of at-home tDCS paired with manual dexterity training for individuals with PMS. Sixty-five right-hand dominant participants with PMS and hand impairment were randomized to receive either active or sham M1-SO tDCS paired with manual dexterity training over 4 weeks. Clinical outcomes were measured by the changes in Nine-Hole Peg Test (9-HPT) and Dellon-Modified-Moberg-Pick-Up Test (DMMPUT). The intervention had high rates of adherence and completion (98% of participants completed at least 18 of 20 sessions). The active tDCS group demonstrated significant improvement for the left hand compared with baseline in 9-HPT (-5.85 ± 6.19 vs -4.23 ± 4.34, p = 0.049) and DMMPUT (-10.62 ± 8.46 vs -8.97 ± 6.18, p = 0.049). The active tDCS group reported improvements in multiple sclerosis (MS)-related quality of life (mean increase: 5.93 ± 13.04 vs -0.05 ± -8.27; p = 0.04). At-home tDCS paired with manual dexterity training is effective for individuals with PMS, with M1-SO tDCS enhancing training outcomes and offering a promising intervention for improving and preserving hand dexterity.

Research on enhancing human-machine interaction in medical exoskeleton devices through the integration of artificial intelligence

This paper explores the integration of Artificial Intelligence (AI) to enhance human-machine interaction in medical exoskeleton devices. AI technologies such as machine learning, natural language processing (NLP), and predictive analytics can significantly improve the efficiency and comfort of these devices. Machine learning algorithms analyze sensor data in real-time, optimizing control strategies to adapt to user movements. NLP enables intuitive control through voice commands, reducing the cognitive and physical burden on users. Predictive analytics anticipates user needs, enhancing responsiveness and reducing the risk of errors. Case studies of AI-integrated exoskeletons, like the EksoGT and ReWalk, demonstrate improved rehabilitation outcomes and user satisfaction. Despite challenges such as data privacy and the need for significant investment, the benefits of AI integration are substantial. This paper provides insights into the potential of AI to transform medical exoskeletons, offering new levels of independence and quality of life for individuals with mobility impairments. Future research should focus on developing advanced AI algorithms and exploring new applications to further enhance user experience and device performance.

The Use of Platelet-Rich Plasma (PRP) in Surgery: Antibiotic Effects and PostSurgical Rehabilitation Benefits

Platelet-Rich Plasma (PRP) therapy has emerged as a promising adjunct in various surgical disciplines. This paper explores the multifaceted applications of PRP in surgery, focusing on its antibiotic effects and benefits during post-surgical rehabilitation. Comprehensive review and analysis of peer-reviewed studies reveal PRP’s potential in enhancing wound healing, reducing infection rates, and improving rehabilitation outcomes. The paper consolidates current evidence, addressing both the advantages and limitations of PRP therapy.

Finger-Individuating Exoskeleton System with Non-Contact Leader-Follower Control Strategy.

This paper proposes a novel finger-individuating exoskeleton system with a non-contact leader-follower control strategy that effectively combines motion functionality and individual adaptability. Our solution comprises the following two interactive components: the leader side and the follower side. The leader side processes joint angle information from the healthy hand during motion via a Leap Motion Controller as the system input, providing more flexible and active operations owing to the non-contact manner. Then, as the follower side, the exoskeleton is driven to assist the user's hand for rehabilitation training according to the input. The exoskeleton mechanism is designed as a universal module that can adapt to various digit sizes and weighs only 40 g. Additionally, the current motion of the exoskeleton is fed back to the system in real time, forming a closed loop to ensure control accuracy. Finally, four experiments validate the design effectiveness and motion performance of the proposed exoskeleton system. The experimental results indicate that our prototype can provide an average force of about 16.5 N for the whole hand during flexing, and the success rate reaches 82.03% in grasping tasks. Importantly, the proposed prototype holds promise for improving rehabilitation outcomes, offering diverse options for different stroke stages or application scenarios.

Comparison of Six-Week, Three-Month, and One-Year Postoperative Clinical Results of Kinematic and Mechanical Alignment in Primary Medial Pivot Total Knee Arthroplasty.

Total knee replacement (TKR) is a common surgical solution for severe osteoarthritis. Kinematic alignment (KA) and mechanical alignment (MA) are two popular techniques. There is ongoing debate over the optimal method, influenced by varying long-term results and a scarcity of data on short-term postoperative outcomes. Early evaluation of these techniques is vital for improving rehabilitation outcomes and ensuring patient satisfaction. Methods: This study retrospectively analyzed outcomes from 71 KA-TKRs and 85 MA-TKRs performed between 2019 and 2021. Knee flexion, visual analog scale (VAS) scores, EuroQol-5d (EQ-5d) quality of life measures, and dependence on walking aids were evaluated. Evaluations were conducted at baseline, six-weeks, three-months, and 12-months postoperatively using two-sample t-tests for continuous data and Pearson's chi-squared test for categorical data. At six-weeks and three-months postoperatively, the KA group exhibited significantly better outcomes in knee flexion (98.6° vs. 90.2° at six-weeks; 114.7° vs. 94.2° at three-months), pain management, and reduced walking aids compared to the MA group. By 12-months, these differences were no longer significant, with both groups showing comparable results in knee flexion, pain scores, and patient-reported outcomes. Conclusion: KA offers substantial short-term advantages over MA for pain relief, increased knee flexion, and independence from walking aids. However, these benefits do not persist at one-year post-surgery, indicating a convergence of outcomes between the two techniques. Larger studies with extended follow-ups are required to determine the long-term implications of these alignment strategies.

Identifying biomarkers related to motor function in chronic stroke: A fNIRS and TMS study.

Upper limb motor impairment commonly occurs after stroke, impairing quality of life. Brain network reorganization likely differs between subgroups with differing impairment severity. This study explored differences in functional connectivity (FC) and corticospinal tract (CST) integrity between patients with mild/moderate versus severe hemiplegia poststroke to clarify the neural correlates underlying motor deficits. Sixty chronic stroke patients with upper limb motor impairment were categorized into mild/moderate and severe groups based on Fugl-Meyer scores. Resting-state FC was assessed using functional near-infrared spectroscopy (fNIRS) to compare connectivity patterns between groups across motor regions. CST integrity was evaluated by inducing motor evoked potentials (MEP) via transcranial magnetic stimulation. Compared to the mild/moderate group, the severe group exhibited heightened premotor cortex-primary motor cortex (PMC-M1) connectivity (t = 4.56, p < 0.01). Absence of MEP was also more frequent in the severe group (χ2 = 12.31, p = 0.01). Bayesian models effectively distinguished subgroups and identified the PMC-M1 connection as highly contributory (accuracy = 91.30%, area under the receiver operating characteristic curve [AUC] = 0.86). Distinct patterns of connectivity and corticospinal integrity exist between stroke subgroups with differing impairments. Strengthened connectivity potentially indicates recruitment of additional motor resources to compensate for damage. These findings elucidate the neural correlates underlying motor deficits poststroke and could guide personalized, network-based therapies targeting predictive biomarkers to improve rehabilitation outcomes.

Investigating cognitive impairment, biopsychosocial barriers, and predictors of return to daily life among older stroke survivors.

The aim was to investigate the associations between cognitive impairment and biopsychosocial factors among older stroke survivors and predictors of poststroke return to daily life. This cross-sectional study involved 117 stroke survivors (61% men) with an average age of 77 years (range 65-91). The participants completed two questionnaires (Riksstroke and Short Form 36 questionnaires). The Montreal Cognitive Assessment (MoCA) was used to assess cognitive abilities. The International Classification of Functioning, Disability, and Health (ICF) framework guided the selection of biopsychosocial variables. We used Spearman's correlation coefficient and multiple logistic regression in the analyses. The average MoCA score was 21.7 points (range: 4-30, SD 5.6). The need for assistance from relatives and professionals, need for help with dressing and household chores, reliance on others for mobility, and reading and balance problems were correlated with more severe cognitive impairment (r = 0.20-0.33). Cognitive impairment, fatigue, and balance issues predicted an unfavorable return to daily life (odds ratio: 6.2-6.8). The study indicated that cognitive impairment is associated with difficulties in all ICF domains. Cognitive impairment, fatigue, and balance issues are associated with an unsuccessful return to daily life. Prioritizing these factors and screening for cognitive impairment with objective assessment tools may improve rehabilitation outcomes and enhance overall quality of life poststroke.

Expanding Integrated Physiatric Care: A Method to Building Capacity in Physical Medicine and Rehabilitation.

Siloed and episodic care delivery is often not equitable, high-quality, or sustainable. Transitioning from separate care settings, with potentially divergent care models, to an integrated care model is not always straightforward. Some experiences in expanding collaborative care between physiatrists and other healthcare providers for a variety of patient populations and care settings within a university physical medicine and rehabilitation (PM&R) division are shared as a means to inspire the uptake of care integration initiatives more broadly within the specialty. After an initial survey of care integration across multiple clinical sites, the university division: highlighted successful integrated care models; discussed integrated care models at every divisional retreat; reached out to clinicians in other specialties to collaboratively explore expansion; developed a "one-pager" on what physiatrists do; and invited collaborative specialists from integrated clinics to PM&R national and/or international meetings. Since 2019, divisional activity in integrated care has grown and evolved substantially. Future work will focus on: further expansion of integrated clinical care; scholarly evaluation of integrated care models; expansion of academic activity resulting from integration; and advocacy to healthcare providers, hospital administrators, and health system funders about the potential value of care integration in improving rehabilitation outcomes.

Adaptive Functional Electrical Stimulation Delivers Stimulation Amplitudes Based on Real-Time Gait Biomechanics.

Functional electrical stimulation (FES) is often used in poststroke gait rehabilitation to decrease foot drop and increase forward propulsion. However, not all stroke survivors experience clinically meaningful improvements in gait function following training with FES. The purpose of this work was to develop and validate a novel adaptive FES (AFES) system to improve dorsiflexor (DF) and plantarflexor (PF) stimulation timing and iteratively adjust the stimulation amplitude at each stride based on measured gait biomechanics. Stimulation timing was determined by a series of bilateral footswitches. Stimulation amplitude was calculated based on measured dorsiflexion angle and peak propulsive force, where increased foot drop and decreased paretic propulsion resulted in increased stimulation amplitudes. Ten individuals with chronic poststroke hemiparesis walked on an adaptive treadmill with adaptive FES for three 2-min trials. Stimulation was delivered at the correct time to the dorsiflexor muscles during 95% of strides while stimulation was delivered to the plantarflexor muscles at the correct time during 84% of strides. Stimulation amplitudes were correctly calculated and delivered for all except two strides out of nearly 3000. The adaptive FES system responds to real-time gait biomechanics as intended, and further individualization to subject-specific impairments and rehabilitation goals may lead to improved rehabilitation outcomes.

A Review of Wrist Rehabilitation Robots and Highlights Needed for New Devices

Various conditions, including traffic accidents, sports injuries, and neurological disorders, can impair human wrist movements, underscoring the importance of effective rehabilitation methods. Robotic devices play a crucial role in this regard, particularly in wrist rehabilitation, given the complexity of the human wrist joint, which encompasses three degrees of freedom: flexion/extension, pronation/supination, and radial/ulnar deviation. This paper provides a comprehensive review of wrist rehabilitation devices, employing a methodological approach based on primary articles sourced from PubMed, ScienceDirect, Scopus, and IEEE, using the keywords “wrist rehabilitation robot” from 2007 onwards. The findings highlight a diverse array of wrist rehabilitation devices, systematically organized in a tabular format for enhanced comprehension. Serving as a valuable resource for researchers, this paper enables comparative analyses of robotic wrist rehabilitation devices across various attributes, offering insights into future advancements. Particularly noteworthy is the integration of serious games with simplified wrist rehabilitation devices, signaling a promising avenue for enhancing rehabilitation outcomes. These insights lay the groundwork for the development of new robotic wrist rehabilitation devices or to make improvements to existing prototypes incorporating a forward-looking approach to improve rehabilitation outcomes.

The Functional-Cognitive and Sensory Treatment (F-CaST) to improve rehabilitation outcomes of individuals with substance use disorder: a study protocol for a mixed-method randomized controlled trial

BackgroundSubstance use disorder (SUD) is associated with executive function (EF) deficits and sensory modulation dysfunction (SMD). Yet, these deficits are not addressed therapeutically. This study aims to examine the effectiveness of the Functional-Cognitive and Sensory Treatment (F-CaST) compared to standard care to improve everyday performance and behavior and length of stay at the therapeutic community (TC) in individuals with SUD. In addition, to assess the improvement in EF, sensory modulation, participation, self-efficacy, life satisfaction, and use of strategies within and between groups. Satisfaction with F-CaST will also be assessed.MethodsForty-eight participants from a community of men in a TC, aged 18–45 years will be randomly allocated to (i) F-CaST—(experimental group) providing sensory and EF strategies for improving daily function; (ii) standard care (control group) as provided in the TC. Assessments will be conducted by assessors blind to group allocation at 4 time points: T1- pre-intervention; T2- post-intervention; T3- 1-month follow-up; and T4- 3-month follow-up. Primary outcome measures will be everyday performance, assessed by the Canadian Occupational Performance Measure (COPM), behavior and length of stay in the TC; secondary outcome measures will assess EF, SMD. Semi-structured in-depth qualitative interviews will be conducted at T1, T2 and T4.DiscussionWe hypothesize that F-CaST will lead to improved everyday performance and longer length of stay in the TC, compared to the control group. If F-CaST will prove to be effective, cognitive and sensory strategies may be incorporated as an adjunctive intervention in SUD rehabilitation.Trial registration: ClinicalTrials.gov NCT05647863 Registered on 13 December 2022, https://classic.clinicaltrials.gov/ct2/show/NCT05647863.

The impact of reminiscent music therapy and robot-assisted rehabilitation on older stroke patients: a protocol for a randomized controlled trial.

Stroke is the main disease that causes the burden of neurological disease, leading to upper limb dysfunction and affecting their self-care abilities. Robot-assisted rehabilitation therapy has been gradually used in the rehabilitation of upper limb function after stroke. However, it would be beneficial to explore auxiliary interventions such as reminiscent music therapy, a combination of music and reminiscent, to relieve negative emotions and post-stroke fatigue and improve rehabilitation outcomes. This protocol aims to evaluate the effectiveness of reminiscent music therapy combined with robot-assisted rehabilitation in older stroke patients. This trial is a single-blind, three-arm randomized controlled trial. Older stroke patients with upper limb dysfunction will be recruited. Participants will be randomly assigned to receive usual rehabilitation treatment and care, usual rehabilitation treatment and care plus robot-assisted rehabilitation and reminiscent music therapy, or usual rehabilitation treatment and care plus robot-assisted rehabilitation. Robot-assisted rehabilitation will be conducted by rehabilitation doctors five times per week for 3 weeks. In experimental group 1, a reminiscent song list will be played for patients. The primary outcome is activities of daily living. All outcomes will be evaluated at baseline and in the week immediately post-intervention. We are conducting the first randomized controlled trial on the effects of reminiscent music therapy combined with robot-assisted rehabilitation in older stroke patients. It is expected that this study, if proven effective in improving the activities of daily living in older stroke patients with upper limb dysfunction, will provide evidence-based rehabilitation strategies for medical staff.Clinical Trial Registration: ChiCTR2200063738.

Development of an Elderly Care Rehabilitation System Utilizing Machine Learning for Energy Monitoring and Transmission using Wireless Sensor Networks

The combination of robotic exoskeleton systems and machine learning (ML) techniques present great potential for significantly improving rehabilitation outcomes in patients with mobility impairments. This particular study examines whether ML algorithms can predict torque and angular inputs required for joint rotation using electromyography (EMG) data obtained during patient lower-limb rehabilitation. A new exoskeleton was designed for personalized and adaptable assistance in rehabilitation of walking. The predictive power of four different ML models, Artificial Neural Network (ANN), k-Nearest Neighbors (KNN), Decision Trees (DT), and Support Vector Machines (SVM), is evaluated. Of these, the ANN model is the most effective with an accuracy rate of 98.87%, followed by KNN (94.55%), DT (91.2%) and SVM (89.45%). Subsequent patient tests confirm significant improvements in flexion and extension angles of the knee, suggesting improved mobility and restored natural gait mechanics. These results stress the potential uses of ML-enhanced exoskeleton systems in personalised rehabilitation therapy. Proposals for further work include improving model performance, tackling challenges for real-time processing, and evaluating ML performance over the long term as it affects the quality of life in individuals with mobility impairments or changes in their condition over time. This investigation into rehabilitation aims at applying technology-driven solutions to help people regain their freedom and ability to move in a way that pleases them.

Apply Tribal Critical Race Theory to Improve Rehabilitation Outcomes for American Indians with Traumatic Brain Injury

Apply Tribal Critical Race Theory to Improve Rehabilitation Outcomes for American Indians with Traumatic Brain Injury

PERCEIVED AND BIOMECHANICAL EFFECTS OF RUNNING SHOE CENTER OF GRAVITY SHIFTING IN AMATEUR MALE RUNNERS

This study examined the influence of running shoe center of gravity relative position shifting forward and backward in sagittal axis on male amateur runners. Twenty-three adult male runners were recruited through social media with paid to participate in this study. The experimental shoe used was the Li Ning Feidian Challenger 3. Forward center of gravity (FCG), defined as the shoe center of gravity located at 10.8[Formula: see text]cm (15% before midpoint) from shoe toe to heel. Intermediate center of gravity (ICG), defined as the shoe center of gravity, is located at 14.8[Formula: see text]cm (midpoint) from shoe toe to heel. Backward center of gravity (BCG), defined as the shoe center of gravity, is located at 23.1[Formula: see text]cm (15% after midpoint) from shoe toe to heel. Questionnaire collection was used to assess the perception of the center of gravity shifting. Ground contact temporal, peak force/pressure of plantar and kinetics indicators data were simultaneously captured by motion capture system and force platform. Three participants (13.04%) correctly perceived the shoe center of gravity shifting forward and backward simultaneously. Shoes ICG peak force underneath Meta 1 increased significantly than BCG by 7.59% ([Formula: see text]). Shoes FCG peak force underneath Meta 2 decreased significantly compared to ICG and BCG by 13.62% and 8.96% ([Formula: see text]). Shoes BCG peak force underneath Meta 5 decreased significantly compared to ICG and FCG by 18.18% and 23.78% ([Formula: see text]). Shoes FCG peak pressure underneath Meta 2 decreased significantly compared to ICG and BCG by 13.02% and 9.19% ([Formula: see text]). Shoes FCG peak pressure underneath Meta 2 decreased significantly compared to ICG and BCG by 11.18% and 9.16% ([Formula: see text]). However, there are no significant differences in kinetic indicators. The findings suggest that a fraction of participants can correct perceived shoe center of gravity shifting. Shoes’ FCG reduces force and pressure in the middle metatarsal regions. Shoes’ BCG reduces force in the lateral and medial metatarsal region. Healthcare professionals can optimize the design of footwear accordingly to improve rehabilitation outcomes and reduce injury risks in runners.

Analysis of Traditional Chinese Medicine Symptoms in Children with Spastic Cerebral Palsy: A Data Mining Study.

Cerebral palsy (CP) ranks as a major cause of motor disabilities in children, with spastic CP making up roughly 70-80% of all CP cases. The primary objective of our study is to identify characteristics of Traditional Chinese Medicine(TCM) symptom of spastic CP, thereby establishing correlations between the TCM symptom and the disease, providing a more scientific theoretical foundation for TCM treatments on spastic CP, enabling a deeper comprehension of clinical interventions, ultimately, improving rehabilitation outcomes in TCM treatment for spastic CP. We conducted a data mining study on TCM symptom of spastic CP children aged 4-14 years old treated at Xi'an Encephalopathy Hospital Affiliated to Shaanxi University of Chinese Medicine, from October 2021 to March 2023. The medical records of all eligible and complete spastic CP patients were extracted, processed for data cleansing, transformed, and subsequently analyzed to discern distinctive TCM symptom. K-Means Clustering Analysis and Association Rule Analysis were used for data mining. Core symptoms identified for spastic CP encompassed "Motor Dysfunction", "Impaired Speech", "Delayed Development", "Limb Stiffness", "Rigidity in the limbs", "Intellectual Impairment", "Timidity and susceptibility to startle responses", "Muscle Wasting", and "Pale or Dull Complexion". Among the top-ranking associations of symptom, patterns emerge wherein "Motor dysfunction" intertwine with "Impaired speech", "Motor dysfunction" coexist with "Delayed development", and "Impaired speech" are accompanied by "Delayed development". This study identified the core symptom of spastic CP and tentatively suggests that the clinical manifestations of spastic CP are essentially consistent with the TCM pattern "liver exuberance and spleen weakness". This finding has facilitated the preliminary establishment of correlations between TCM pattern differentiation and the disease in medicine. It is anticipated that this correlation will bring tangible benefits to a larger number of children with spastic CP.

Barriers and Facilitators of Vestibular Rehabilitation: Patients and Physiotherapists' Perspectives.

Poor adherence to vestibular rehabilitation protocols is a known barrier to optimal care. Vestibular clinicians' comprehensive understanding of the barriers and facilitators to vestibular home exercise programs (VHEP) is a key element to achieving optimal care in the context of vestibular rehabilitation. The aims of this study are as follows: (1) to identify primary barriers and facilitators to VHEP from the perspective of patients with vestibular dysfunction and vestibular physical therapists (PTs); and (2) to provide strategies for clinicians to improve adherence and outcomes of VHEP. A qualitative research with single-session focus groups conducted separately for: (1) patients with vestibular disorders and (2) vestibular PTs. Six focus groups were conducted, 3 for each population, with a total of 39 participants. An online survey was conducted to evaluate the estimates of adherence rates, followed by a structured discussion over barriers and facilitators to VHEP as perceived by patients and PTs. Thematic data analyses were performed using a mixed deductive-inductive approach. Eighteen patients with vestibular disorders and 21 experienced vestibular PTs participated in this study. Six barrier categories and 5 facilitator categories were identified. Barriers included motivation aspects, provocation of symptoms, time management, associated impairments, missing guidance and feedback, and psychosocial factors. Facilitators included motivation aspects, time management, patient education and exercise instructions, exercise setting, and associated symptom management. Clinicians who prescribe home exercise to patients with vestibular disorders can use this information about common barriers and facilitators for patient education and to provide optimal care and improve rehabilitation outcomes. for more insights from the authors (see the video, Supplemental Digital Content, available at: http://links.lww.com/JNPT/A467 ).

The impact of energy and protein intake on rehabilitation efficiency in convalescent patients.

It is well known that more than 40% of patients in the convalescent rehabilitation settings suffer from malnutrition, and that appropriate nutrition management can improve rehabilitation outcomes. In this study, we used a change in motor score of Functional Independent Measure (FIM-M) of convalescent rehabilitation to investigate whether daily energy intake could influence the rehabilitation outcomes. Of the 217 patients hospitalized in our convalescent rehabilitation ward (CRW) between September 2016 and February 2017, 162 met the eligibility criteria for this study. For a 25 kcal/ ideal body weight (IBW)/day cutoff point, 76 patients consumed more than 25 kcal/IBW/day of energy (H-E group), and 86 patients consumed up to 25 kcal/IBW/day of energy (L-E group). Patients in the L-E group had poorer nutritional status than those in the H-E group at CRW admission. Moreover, patients in the L-E group lost some body weight (BW) during hospitalization, whereas patients in the H-E group gained some BW. Furthermore, the FIM-M efficiency in the L-E group was significantly lower than that in the H-E group. We concluded that appropriate nutritional management given to rehabilitation patients for adequate energy intake to maintain or gain their BW could maximize the outcome of convalescent rehabilitation.

An Optimized Stimulation Control System for Upper Limb Exoskeleton Robot-Assisted Rehabilitation Using a Fuzzy Logic-Based Pain Detection Approach.

The utilization of robotic systems in upper limb rehabilitation has shown promising results in aiding individuals with motor impairments. This research introduces an innovative approach to enhance the efficiency and adaptability of upper limb exoskeleton robot-assisted rehabilitation through the development of an optimized stimulation control system (OSCS). The proposed OSCS integrates a fuzzy logic-based pain detection approach designed to accurately assess and respond to the patient's pain threshold during rehabilitation sessions. By employing fuzzy logic algorithms, the system dynamically adjusts the stimulation levels and control parameters of the exoskeleton, ensuring personalized and optimized rehabilitation protocols. This research conducts comprehensive evaluations, including simulation studies and clinical trials, to validate the OSCS's efficacy in improving rehabilitation outcomes while prioritizing patient comfort and safety. The findings demonstrate the potential of the OSCS to revolutionize upper limb exoskeleton-assisted rehabilitation by offering a customizable and adaptive framework tailored to individual patient needs, thereby advancing the field of robotic-assisted rehabilitation.

Virtual reality immerses you in your mind: the experience and stress-reduction benefits of VR mindfulness modules in persons with TBI

ABSTRACT Objective This pilot study tested the feasibility and stress reduction effectiveness of a one-time virtual reality mindfulness module (VRMM) in individuals with mild-to-moderate traumatic brain injury (TBI). Methods Thirty-eight participants participated in a pilot study utilizing a mixed methods convergent parallel design. Pretest and posttest stress levels were collected; participants engaged in a brief 4-question qualitative interview. Mann Whitney U and Wilcoxon Signed Rank Tests were used. Qualitative analysis utilized grounded theory. Results Post-VRMM, two-thirds (24) of participants had a statistically significant decrease in stress levels. A key qualitative finding indicated that participants found the immersiveness and realism of the VR environments helpful in compensating for cognitive deficits resulting from TBI. There were no adverse side effects reported, indicating that well-designed VRMMs that minimize motion-induced adverse effects are well tolerated in persons with TBI. Conclusion A guided mindfulness activity in a VR environment was well tolerated, and participants overall found VRMM effective in reducing stress levels. VR-based environments have potential to harness guided mindfulness practice and may support persons with TBI to enhance concentration. Further application of this technology in TBI rehabilitation is promising and warrants future research to explore the benefit of VR in improving rehabilitation outcomes.