Neurological Rehabilitation Research Articles

Hormonal Dysfunction in Paediatric Patients Admitted to Rehabilitation for Severe Traumatic Brain Injury: Analysis of the Associations with Rehabilitation Outcomes.

Traumatic brain injury is often accompanied by defects in hormone levels, caused by either peripheral gland dysfunctions or by an insufficient central stimulation of hormone production. The epidemiology of endocrinological defects after traumatic brain injury is quite well described, but the consequences of hormone defects are largely unknown, especially in paediatric patients undergoing neurological rehabilitation. Only one previous study reported on a cohort of 20 children with traumatic brain injury and found a low incidence of hormone defects and a correlation between some hormone levels and neurological recovery. In this study, we performed a retrospective chart review on patients affected by severe subacute traumatic brain injury. Their levels of cortisol, ACTH, IGF-1, TSH, free T4, free T3, and prolactin were collected and compared with reference ranges; we then used regression models to highlight any correlation among them and with clinical variables; last, we probed with regression models whether hormone levels could have any correlation with clinical and rehabilitation outcomes. We found eligible data from the records of 52 paediatric patients with markedly severe traumatic brain injury, as shown by an average GCS of 4.7; their age was 10.3 years, on average. The key results of our study are that 32% patients had low IGF-1 levels and in multiple regression models, IGF-1 levels were correlated with neurological recovery, indicating a possible role as a biomarker. Moreover, 69% of patients had high prolactin levels, possibly due to physical pain and high stress levels. This study is limited by the variable timing of the IGF-1 sampling, between 1 and 2 months after injury. Further studies are required to confirm our exploratory findings.

Factors Determining the Functional Efficiency of Patients After Ischemic Stroke After Neurological Rehabilitation.

The factors determining the level of functional efficiency in patients after ischemic stroke are: age, sex, physical condition, mental activity before stroke, previous neurological deficits, comorbidities, nutritional status and the course of the stroke. Assessment of the functional efficiency of patients before and after rehabilitation due to ischemic stroke and determination of the influence of selected factors on the effects of rehabilitation measured by functional efficiency. The study was conducted in neurological rehabilitation centers among 82 people diagnosed with ischemic stroke. The examination was performed twice: on admission to the ward and after a month of neurological rehabilitation. The diagnostic survey method, the Barthel scale, the NRS 2002 scale were used, and the BMI was calculated. The functional efficiency level of the patients was varied, higher after one month of rehabilitation (p <0.05). Among the patients who achieved a lower level of functional efficiency, the following factors had a significant influence: underweight and overweight (p = 0.002), risk of malnutrition (p = 0.002), right-sided paresis (p = 0.016), limited physical activity before stroke (p = 0.01) and the later rehabilitation period (p = 0.01). There was no correlation between sociodemographic data and the level of efficiency of patients after a stroke after one month of rehabilitation. The level of functional efficiency after rehabilitation improved in all patients, however, to a different extent depending on the nutritional status and physical activity. Therefore, it is important to to undertake rehabilitation in the shortest possible time.

Neurodevelopmental Disorders Caused by Genetic Defects in Structure of Glutamatergic Receptors

Background: the role of glutamate receptor dysfunction in mental disorders, neurological, autoimmune, and oncological pathology has been intensively investigated in the past decade. The development of drugs that target glutamatergic receptors has also been a focus of research.The aim was to describe modern concepts of neurodevelopmental disorders (according to the International Classification of Diseases 11th revision, L1-6A0) that are associated with genetically induced alterations of the structure of glutamatergic receptors.Material and method: a search for descriptions of cases with impaired neuropsychiatric development associated with genetic defects of ionotropic and metabotropic glutamate receptor subunits was performed in the MEDLINE/Gene database, MEDLINE/PubMed scientific library, Online Mendelian Inheritance in Man (OMIM), UniProt, ClinGen and eLibrary. Genetically induced structural abnormalities of most known ionotropic (GluA, GluN, GluK, GluD) and a number of metabotropic glutamate receptors (mGluR1, 5, 7) are associated with severe variants of neuropsychiatric disorders that manifest in infancy and early childhood.Conclusion: the considerable variation in the clinical presentation of these cases demands a transnosological approach to diagnosis and management of patients, under cooperation of specialists in pediatrics, child psychiatry, neurology, genetics, and medical and social rehabilitation.

Effectiveness of Proprioceptive Neuromuscular Facilitation Technique on Balance and Mobility in Chronic Stroke Patient

This comprehensive review explores the multifaceted impact of stroke, a cerebrovascular disorder, on individuals, emphasizing the physical, emotional, and cognitive dimensions of its aftermath. Stroke is a major global health concern, contributing significantly to mortality and disability. The immediate consequences involve neurological impairments such as paralysis, speech difficulties, and impaired vision, while the emotional toll includes coping with loss and adjusting to new realities. Long-term cognitive implications affect memory, attention, and executive function, adding complexity to the recovery journey. Communication challenges, physical limitations, and the risk of secondary complications are discussed, highlighting the importance of a continuum of care. The role of caregivers is explored, emphasizing the emotional, physical, and financial burdens they face. Technological innovations, such as virtual reality and robotics, are introduced as promising tools in stroke rehabilitation. The focus then shifts to balance and mobility issues in stroke survivors, particularly the impact of proprioceptive neuromuscular facilitation (PNF) techniques. Proprioceptive neuromuscular facilitation emerges as a dynamic and versatile therapeutic approach, offering promise for improved functional outcomes and enhanced quality of life in the evolving landscape of stroke care and rehabilitation. The review delves into the neurophysiological ballet of PNF, emphasizing neuromuscular stimulation, neuroplasticity, and motor learning. Clinical applications of PNF in orthopaedic, neurological, geriatric, and paediatric rehabilitation are discussed, highlighting its versatility.

Neural rehabilitation based on brain computer interface

BCI is a newly developed technology that can be used for neurological rehabilitation of brain injuries and paralysis. This article first reviews the history of BCI, and then introduces two major neurorehabilitation BCI technologies for neurorecording and neuromodulation, invasive and non-invasive. For each technology, we describe the challenges of each technology, analyzing the current state and future development trends. In terms of non-invasive technology, the most mature and extensive EEG brain signal analysis methods and two brain regulation technologies, transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (tES), as well as the application of brain signal analysis techniques such as functional magnetic resonance imaging (fMRI) and functional near-infrared spectroscopy fNIRS) were also discussed. In terms of invasive technology, the implantable neural interface technology focuses on implantable neural interface technology, which collects cortical electrical brain signals (ECoG), which can obtain more original neural information and has high temporal and spatial resolution characteristics. In recent years, with the development of microelectronics technology and material technology, invasive BCI technology has made a lot of cutting-edge progress, which is an important future development direction of neurorehabilitation technology.

Effects and Mechanisms of Exercise on Brain-Derived Neurotrophic Factor (BDNF) Levels and Clinical Outcomes in People with Parkinson's Disease: A Systematic Review and Meta-Analysis.

Exercise therapy may increase brain-derived neurotrophic factor (BDNF) levels and improve clinical outcomes in people living with Parkinson's disease (PD). This systematic review was performed to investigate the effect of exercise therapy on BDNF levels and clinical outcomes in human PD and to discuss mechanisms proposed by authors. A search on the literature was performed on PubMed up to December 2023 using the following key words: Parkinson's disease AND exercise, exercise therapy, neurological rehabilitation AND brain-derived neurotrophic factor, brain-derived neurotrophic factor/blood, brain-derived neurotrophic factor/cerebrospinal fluid AND randomized clinical trial, intervention study. Only randomized clinical trials comparing an exercise intervention to treatment as usual, usual care (UC), sham intervention, or no intervention were included. A meta-analysis of BDNF outcomes with pooled data from five trials (N = 216 participants) resulted in a significant standardized mean difference (SMD) of 1.20 [95% CI 0.53 to 1.87; Z = 3.52, p = 0.0004, I2 = 77%], favoring exercise using motorized treadmill, Speedflex machine, rowing machine, and non-specified exercise. Significant improvements were found in Unified Parkinson's Disease Rating Scale (UPDRS), UPDRS-III, 6 Minute Walk Test (6MWT), and Berg Balance Scale (BBS). Methodological quality of trials was categorized as "good" in three trials, "fair" in one trial, and "poor" in one trial. Key results of this systematic review are that exercise therapy is effective in raising serum BDNF levels and seems effective in alleviating PD motor symptoms. Exercise therapy confers neuroplastic effects on Parkinson brain, mediated, in part, by BDNF.

Innovative Insights into Traumatic Brain Injuries: Biomarkers and New Pharmacological Targets.

A traumatic brain injury (TBI) is a major health issue affecting many people across the world, causing significant morbidity and mortality. TBIs often have long-lasting effects, disrupting daily life and functionality. They cause two types of damage to the brain: primary and secondary. Secondary damage is particularly critical as it involves complex processes unfolding after the initial injury. These processes can lead to cell damage and death in the brain. Understanding how these processes damage the brain is crucial for finding new treatments. This review examines a wide range of literature from 2021 to 2023, focusing on biomarkers and molecular mechanisms in TBIs to pinpoint therapeutic advancements. Baseline levels of biomarkers, including neurofilament light chain (NF-L), ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1), Tau, and glial fibrillary acidic protein (GFAP) in TBI, have demonstrated prognostic value for cognitive outcomes, laying the groundwork for personalized treatment strategies. In terms of pharmacological progress, the most promising approaches currently target neuroinflammation, oxidative stress, and apoptotic mechanisms. Agents that can modulate these pathways offer the potential to reduce a TBI's impact and aid in neurological rehabilitation. Future research is poised to refine these therapeutic approaches, potentially revolutionizing TBI treatment.

The significance of early neurological rehabilitation intervention in patients with severe stroke.

The significance of early neurological rehabilitation intervention in patients with severe stroke.

Acupuncture for ischemic stroke: Where are we now?

Acupuncture is an effective treatment for ischemic stroke (IS) and plays a key role in neurological rehabilitation after IS. Acupuncture can improve the clinical symptoms of various complications after IS, including motor dysfunction, swallowing disorders, speech disorders, cognitive impairment, depression, insomnia, and fatigue. However, the mechanisms underlying the effects of acupuncture in IS remain unclear. Available evidence suggests that acupuncture may exert neuroprotective effects through neuroplasticity (neurogenesis and synaptogenesis), angiogenesis, cell proliferation and apoptosis, and regulation of oxidative stress, inflammation, and immunity. Further studies should be conducted to improve the high-quality evidence-based system of acupuncture intervention for IS, by focusing on the clinical and basic research design, increasing the sample size, standardizing and quantifying the standards of acupuncture operations, using multidisciplinary techniques and methods to systematically explore the key targets of acupuncture intervention for IS, and reveal the efficacy and mechanism of acupuncture in the treatment of IS.

Post-stroke rehabilitation in the peri-pandemic COVID-19 era.

The coronavirus disease 2019 (COVID-19), which arosein late 2019, caused extensive destruction, impacting a substantial proportion of the worldwide population and leading to millions of deaths. Although COVID-19 is mainly linked to respiratory and pulmonary complications, it has the potential to affect neurologic structures as well. Neurological involvement may manifest as minimal and reversible; however, a notable proportion of cases have exhibited pronounced neurological consequences, such as strokes. Endothelial inflammation, hypercoagulation, renin-angiotensin-aldosterone system alterations, and cardiogenic embolism are the pathophysiological mechanismsof stroke under COVID-19 circumstances. Physical activity and exercise have improved several aspects of post-stroke recovery, including cardiovascular health, walking capacity, and upper limb strength. They are commonly used to assist stroke survivors in overcomingtheir motor restrictions. Furthermore, stroke rehabilitation can incorporate a range of specific techniques, including body-weight-supported treadmill applications, constraint-induced movement therapy, robotic rehabilitation interventions, transcranial direct current stimulation, transcranial magnetic stimulation, and prism adaptation training. Under pandemic conditions, there were several barriers to neurological rehabilitation. The most significant of these were individual's fear of infection, which caused them to postpone their rehabilitation applicationsand rehabilitation areas being converted into COVID-19 units. The primary emphasis had turned to COVID-19 treatment. Several valuable data and views were gained in reorganizing rehabilitation during the pandemic, contributing to establishing future views in this regard.

Neurobehavioural rehabilitation of dysexecutive syndrome following traumatic brain injury - a narrative review of management

Background: &#x0D; Traumatic brain injury (TBI) leads to &gt;200,000 hospital admissions in the UK annually. Frontal lobes are frequently affected, leading to a sequela of symptoms affecting behaviour, emotions, and cognition; a cluster of symptoms referred to as dysexecutive syndrome (also known as frontal lobe syndrome). People who survive this, experience long-term sequelae and require long-term support through neurological rehabilitation. The UK has robust guidelines on the medical/physical aspects of rehabilitation following brain injury. However, these guidelines mention little information on the management of neurobehavioural problems following TBI. The aim of this review is to determine what the evidence-based neurobehavioural management of patients with dysexecutive syndrome following TBI is in the UK.&#x0D; &#x0D; Methods: &#x0D; A systematic review of articles using MEDLINE, EMBASE (1974 – present) and Web of Science was conducted. Search terms included frontal lobe syndrome, dysexecutive syndrome, traumatic brain injury, neurorehabilitation, neurological rehabilitation, neurological management, behaviour therapy and behavioural management. Additional references were sourced from the search results and author NH, a medical director within a hospital catering to people with brain injury.&#x0D; &#x0D; Results: &#x0D; 168 results were obtained. 21 articles remained following exclusions: 19 original articles and 2 reviews. Interventions mentioned included: behavioural psychotherapy, memory training, feedback, awareness interventions, goal management training, social skills training, work placements, problem solving training, metacognitive skills, token economy and response cost. Interventions were utilised using a person-centred approach, however, generally there was a lack of consensus as the most effective one. Only 2 studies considered the long-term outcomes of rehabilitation.&#x0D; &#x0D; Discussion:&#x0D; Successful rehabilitation of dysexecutive syndrome post-TBI involves using a person-centred approach, to determine which intervention will target the problem of concern to the patient. Few papers address behavioural rehabilitation of dysexecutive syndrome post-TBI. Further research is required to determine the most effective and beneficial interventions for patients in both the short- and long-term.

Feasibility of high-frequency percussions in people with severe acquired brain injury and tracheostomy: an observational study.

People with severe acquired brain injury (pwSABI) frequently experience pulmonary complications. Among these, atelectasis can occur as a result of pneumonia, thus increasing the chance of developing acute respiratory failure. Respiratory physiotherapy contribution to the management of atelectasis in pwSABI is yet poorly understood. We conducted a retrospective analysis on 15 non-cooperative pwSABI with tracheostomy and spontaneously breathing, hospitalized and treated with high-frequency percussion physiotherapy between September 2018 and February 2021 at the Neurological Rehabilitation Unit of the IRCCS "S.Maria Nascente - Fondazione Don Gnocchi", Milan. Our primary aim was to investigate the feasibility of such a physiotherapy intervention method. Then, we assessed changes in respiratory measures (arterial blood gas analysis and peripheral night-time oxygen saturation) and high-resolution computed tomography lung images, evaluated before and after the physiotherapy treatment. The radiological measures were a modified radiological atelectasis score (mRAS) assigned by two radiologists, and an opacity score automatically provided by the software CT Pneumonia Analysis® that identifies the regions of abnormal lung patterns. Treatment diaries showed that all treatments were completed, and no adverse events during treatment were registered. Among the 15 pwSABI analyzed, 8 were treated with IPV® and 7 with MetaNeb®. After a median of 14 (I-III quartile=12.5-14.5) days of treatment, we observed a statistical improvement in various arterial blood gas measures and peripheral night-time oxygen saturation measures. We also found radiological improvement or stability in more than 80% of pwSABI. In conclusion, our physiotherapy approach was feasible, and we observed respiratory parameters and radiological improvements. Using technology to assess abnormal tomographic patterns could be of interest to disentangle the short-term effects of respiratory physiotherapy on non-collaborating people.

Currents of Change: Galvanic Vestibular Stimulation

Galvanic vestibular stimulation (GVS) is an electrode-mediated method of non-invasive electrical stimulation. Its ability to modulate vestibular neuronal activity through electrical currents makes it a coveted diagnostic and therapeutic tool for vestibular and neurodegenerative disorders. Although more robust clinical research is needed before wide-spread implementation, GVS shows promise as a safe, cost-effective, and accessible therapeutic tool for neurological rehabilitation.

Can the Initial Parameters of Functional Scales Predict Recovery in Patients with Complete Spinal Cord Injury? A Retrospective Cohort Study.

Regaining greater independence in performing daily activities constitutes a priority for people with tetraplegia following spinal cord injury (SCI). The highest expectations are connected with the improvement of hand function. Therefore, it is so important for the clinician to identify reliable and commonly applicable prognostic factors for functional improvement. The aim of this study was to conduct an analysis to assess the impact of initial functional factors on the clinical improvement in patients during early neurological rehabilitation (ENR). This study assessed 38 patients with complete SCI aged 17-78 who underwent ENR in 2012-2022. The analysis included the motor score from the AIS (MS), the Barthel Index (BI) and the SCIM scale values at the beginning of the ENR program and after its completion. During ENR, patients achieved a statistically significant improvement in MS, BI and SCIM. The initial MS and the level of neurological injury constituted the predictors of functional improvement during ENR. Significant statistical relationships were observed primarily in the correlations between the initial MS and BI, and the increase in the analyzed functional scales of SCI patients. Higher initial MS may increase the chances of a greater and faster functional improvement during ENR.

Post Stroke Visual Impairment: Interdisciplinary Collaborative Program – Canadian Perspective

ABSTRACT Post-stroke visual impairment (PSVI) affects more than 60% of the people who have a stroke but visual function is not routinely assessed in most stroke units. Recent high-quality research in this field has produced evidence-based assessment and management practices for PSVI. Orthoptists have integrated into the stroke care team in the United Kingdom (UK) to provide this valuable service. This paper outlines the development and implementation of the first known orthoptic PSVI service in North America. A pilot program was developed between the Ophthalmology, Neurology, and Physical Medicine and Rehabilitation Departments in Saskatoon, Saskatchewan, Canada. A new referral pathway was established to refer stroke patients with PSVI directly to an orthoptist with specialization in PSVI. Clinical findings from the first year of operation are reported. One hundred and seven visual deficits were suspected by the referring service. Visual field deficits were the most commonly reported PSVI. Diplopia was the most commonly reported oculomotor deficit in this cohort, and visual neglect/inattention was the most common visual perceptual deficit reported. Reading issues were the most commonly reported functional issues. Following assessment by an orthoptist, 45 additional visual deficits were identified and addressed. Stroke patients require assessment and treatment for PSVI. Orthoptists are perfectly suited to PSVI assessment and management. There is an opportunity to increase orthoptists’ scope of practice in North America to ensure stroke patients receive specialized vision assessment and treatment.

Understanding the Barriers and Facilitators of Digital Health Technology (DHT) Implementation in Neurological Rehabilitation: An Integrative Systematic Review.

Digital Health technologies (DHT) have potential to deliver intensive, novel and engaging rehabilitation for people with neurological conditions, yet health services lack a strong track record in embedding DHT into practice. The aim of this review was to synthesise factors that have been shown to influence implementation of DHT into neurological rehabilitation. An integrative review was undertaken. An extensive search of MEDLINE, CINAHL, AMED, EMBASE was undertaken. The title and abstract of all retrieved sources were screened against pre-defined criteria. Retained sources underwent full text review. The quality of all included sources was assessed. A meta-ethnographic synthesis explored commonalities and contradictions of the included studies. Fourteen studies (1 quantitative, 8 qualitative and 5 mixed methods) were included. Eleven implementation theories/models/frameworks were used across the 14 studies. Five themes were identified: (i) individual factors; (ii) user experience of the technology; (iii) the content of the intervention; (iv) access to the technology and (v) supporting use. Key factors which appear to influence the implementation of DHT into clinical settings are highlighted. Implementation theories, models and frameworks are under-utilised in DHT rehabilitation research. This needs to be addressed if DHT are to realise their potential in neurological rehabilitation. The protocol was registered and is available from PROSPERO (CRD42021268984).

The Effect of Riboflavin on Neurological Rehabilitation after Traumatic Brain Injury in Children.

Traumatic brain injury (TBI), which is the brain impairment and lesion caused by the external force injuring the head and the underlying brain, can cause pediatric death, disability, neurological disorders, and even lifelong disability. This study was to explore the effect of riboflavin (RF) on neurological rehabilitation and functional recovery after TBI. The rat models of TBI were constructed by treating rats with controlled cortical impact (CCI). By treating TBI rats with RF, we investigated whether the administration of RF would affect the sensorimotor function and cognitive ability recovery through adhesive removal test, modified neurological severity score (mNSS), corner test, wire-grip test and the Morris water maze. The effects of RF on lesion volume and water content were investigated using hematoxylin and eosin (H&E) staining and wet-dry method. The Nissl staining and terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) staining were used to demonstrate the effect of RF on neural apoptosis. Inflammation-related cytokines of interleukin (IL)-6, IL-1β, tumor necrosis factor (TNF)-α, and transforming growth factor (TGF)-β1 were measured by enzyme-linked immunosorbent assay (ELISA) to evaluate the effect of RF on neuroinflammation. The impact of RF on oxidative stress was assessed by measuring malondialdehyde (MDA) content and superoxide dismutase (SOD) activity, and the platelet endothelial cell adhesion molecule-1 (CD31) staining for observing vessel density, the reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) for measuring vascular endothelial growth factor (VEGF) mRNA expression and western blot for VEGF protein expression were used for evaluated angiogenesis. The administration of RF could facilitate the recovery of neurological function by promoting the recovery of sensorimotor function and cognitive ability (p < 0.05). Furthermore, RF could reduce the lesion volume and water content after TBI and ameliorate neural apoptosis, neuroinflammation, and oxidative stress (p < 0.05). Finally, RF increased vessel density (p < 0.01) and VEGF levels (p < 0.01) in brain tissues after TBI, promoting angiogenesis. RF benefits neurological rehabilitation after TBI by promoting neurological function recovery, ameliorating the pathogenesis after TBI, and facilitating brain vascular remodeling. These findings provide a novel mechanism for RF treating pediatric TBI.

Challenges and Suggestions of Ethical Review on Clinical Research Involving Brain-Computer Interfaces

Brain-computer interface (BCI) technology is rapidly advancing in medical research and application. As an emerging biomedical engineering technology, it has garnered significant attention in the clinical research of brain disease diagnosis and treatment, neurological rehabilitation, and mental health. However, BCI also raises several challenges and ethical concerns in clinical research. In this article, the authors investigate and discuss three aspects of BCI in medicine and healthcare: the state of international ethical governance, multidimensional ethical challenges pertaining to BCI in clinical research, and suggestive concerns for ethical review. Despite the great potential of frontier BCI research and development in the field of medical care, the ethical challenges induced by itself and the complexities of clinical research and brain function have put forward new special fields for ethics in BCI. To ensure “responsible innovation” in BCI research in healthcare and medicine, the creation of an ethical global governance framework and system, along with special guidelines for cutting-edge BCI research in medicine, is suggested.

A Review on Biomaterials for Neural Interfaces: Enhancing Brain-Machine Interfaces

Biomaterials are essential to the development of neural interfaces, including brainmachine interfaces. Biomaterial methods improve neural interface functionality, compatibility, and longevity, enabling brain-device communication. An extensive investigation of biomaterials utilized in brain electrode arrays, neural probes, &amp; implantable devices rely on how materials affect neural signals recording, stimulation, &amp; tissue contact. It also investigates how biomaterials, bioelectronics and 3D printing could improve neural interfaces. Biomaterials modulate neuroinflammatory responses, enhance brain tissue regeneration, and promote neural interface longevity. This study shows the potential for change of biomaterial-based neural interfaces in neuroprosthetics, neurological rehabilitation, and fundamental neuroscience research, addressing the need for brain-machine relationship and neurotechnology innovation. These findings suggest expanding biomaterials research and development to advance and sustain neural interface technologies for future use.

Outcomes of early neurorehabilitation with a 6-month follow-up

Neurological early rehabilitation aims to improve body function in individuals with severe neurological conditions and facilitate the best possible return to their previous lives. However, the rehabilitation potential varies depending on the initial neurological diagnosis and other factors. Here we present a cohort study on the clinical course during inpatient rehabilitation and the outcomes at a 6 month follow-up. All patients were treated at the Schoen Clinic Bad Aibling. A follow-up telephone interview was conducted six months after discharge from Phase B rehabilitation. Among the 229 individuals included in the study, significant improvements in basic daily living skills (Barthel-Index) were observed after an average of 3.5 months of inpatient rehabilitation. Individuals with critical illness polyneuropathy/myopathy (CIP/CIM) exhibited the best recovery, achieving the highest scores on the Barthel-Index, the modified Rankin Scale (mRS), and health-related quality of life (EQ-5D-3L). In contrast, individuals with stroke showed significantly worse outcomes at discharge from rehabilitation and in the followup assessment. Only 12 % of stroke patients achieved a favorable outcome (mRS &lt; 3), compared to 30 % of the patients with CIP/CIM. Patients with subarachnoid hemorrhage and intracranial bleeding also tended to have worse outcomes, whereas those with traumatic brain injury did better. At follow-up, only 15 % of the entire cohort were able to lead an independent life; the majority required assistance from family members or caregivers. Overall, despite good improvement during rehabilitation, individuals across all diagnoses frequently exhibited significant long-term impairments that limited their independence in activities of daily living. Keywords: neurologic rehabilitation, long-term outcome, stroke, critical illness polyneuropathy