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Brain Sciences Special Issue: Insight in the Application of Rehabilitation Devices in Neurological Disease

by Maria Cristina De Cola

Brain Sci. 2025, 15(1), 39; https://doi.org/10.3390/brainsci15010039 - 2 Jan 2025

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Abstract

It was a great pleasure to be the guest editor for the Brain Sciences Special Issue on understanding the use of rehabilitation devices in neurological diseases [...] Full article

(This article belongs to the Special Issue Insight in the Application of Rehabilitation Devices in Neurological Disease)

Research

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16 pages, 1561 KiB

Open AccessArticle

Impact of Serial Casting on Autonomic Nervous System Responses during Virtual Reality Tasks in Children with Cerebral Palsy: A Pilot Study Comparing Orthoses and Barefoot Conditions

by Marisa de Paula Paro, Raísa Marques de Sousa, Juliana Perez Martinez, Amanda Orasmo Simcsik, Marina Junqueira Airoldi, Rodrigo Martins Dias, Íbis Ariana Peña de Moraes, Fernando Henrique Magalhães, Carlos Bandeira de Mello Monteiro and Talita Dias da Silva-Magalhães

Brain Sci. 2024, 14(10), 1000; https://doi.org/10.3390/brainsci14101000 - 30 Sep 2024

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Abstract

Cerebral palsy (CP) is a group of movement disorders that impair posture and mobility, often leading to spasticity and joint contractures. Interventions like serial casting are commonly used to improve joint mobility and manage spasticity in children with CP. However, its effects on [...] Read more.

Cerebral palsy (CP) is a group of movement disorders that impair posture and mobility, often leading to spasticity and joint contractures. Interventions like serial casting are commonly used to improve joint mobility and manage spasticity in children with CP. However, its effects on the autonomic nervous system (ANS) remain unclear. This study aimed to evaluate the effects of serial casting and ankle–foot orthoses (AFOs) on ANS responses during a virtual reality (VR) standing task, comparing these interventions with a barefoot condition. Thirty children with CP were randomized into three groups (n = 10 per group): serial casting, AFOs, and barefoot. Heart rate variability (HRV) was used to assess ANS responses across three phases: seated rest, VR task, and recovery. The results showed that the serial casting group exhibited higher sympathetic activity during rest compared to the other groups, but had a reduced sympathetic response during the VR task. Additionally, the serial casting group displayed a more pronounced parasympathetic rebound during recovery, similar to the orthoses and barefoot groups. While serial casting provides essential joint stability, it alters ANS response patterns, leading to heightened sympathetic activation at rest, without providing significant improvements in ANS behavior during physical activity. Full article

(This article belongs to the Special Issue Insight in the Application of Rehabilitation Devices in Neurological Disease)

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16 pages, 1554 KiB

Open AccessArticle

Effectiveness of Transcranial Direct Current Stimulation (tDCS) during a Virtual Reality Task in Women with Fibromyalgia—A Randomized Clinical Study

by Thaís Nogueira da Silva, Vivian Finotti Ribeiro, Margot Carol Condori Apaza, Lívia Gallerani Romana, Íbis Ariana Peña de Moraes, Eduardo Dati Dias, Suely Steinschreiber Roizenblatt, Juliana Perez Martinez, Fernando Henrique Magalhães, Marcelo Massa, Alessandro Hervaldo Nicolai Ré, Luciano Vieira de Araújo, Talita Dias da Silva-Magalhães and Carlos Bandeira de Mello Monteiro

Brain Sci. 2024, 14(9), 928; https://doi.org/10.3390/brainsci14090928 - 18 Sep 2024

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Abstract

Background/Objectives: Fibromyalgia (FM) is a chronic condition characterized by widespread musculoskeletal pain, fatigue, and impaired motor performance. This study aimed to investigate the effects of transcranial direct current stimulation (tDCS) during virtual reality (VR) tasks on the motor performance of women with FM. [...] Read more.

Background/Objectives: Fibromyalgia (FM) is a chronic condition characterized by widespread musculoskeletal pain, fatigue, and impaired motor performance. This study aimed to investigate the effects of transcranial direct current stimulation (tDCS) during virtual reality (VR) tasks on the motor performance of women with FM. Methods: Participants were divided into two groups: Group A received active tDCS for 10 days followed by sham tDCS for 10 days, while Group B received the opposite sequence. Both groups performed VR tasks using MoveHero software (v. 2.4) during the tDCS sessions. Motor performance was assessed by the number of hits (movement with correct timing to reach the targets) and absolute (accuracy measure) and variable (precision measure) errors during VR tasks. Participants were 21 women, aged 30–50 years, and diagnosed with FM. Results: Group A, which received active tDCS first, presented significant improvements in motor performance (number of hits and absolute and variable errors). The benefits of active tDCS persisted into the sham phase, suggesting a lasting neuroplastic effect. Conclusions: tDCS during VR tasks significantly improved motor performance in women with FM, particularly in complex, extensive movements. These findings indicate that tDCS enhances neuroplasticity, leading to sustained motor improvements, making it a promising therapeutic tool in FM rehabilitation. Full article

(This article belongs to the Special Issue Insight in the Application of Rehabilitation Devices in Neurological Disease)

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11 pages, 1077 KiB

Open AccessArticle

Efficacy of a Virtual Reality Rehabilitation Protocol Based on Art Therapy in Patients with Stroke: A Single-Blind Randomized Controlled Trial

by Gaetano Tieri, Marco Iosa, Antonio Fortini, Federica Aghilarre, Federico Gentili, Cristiano Rubeca, Tommaso Mastropietro, Gabriella Antonucci and Roberto De Giorgi

Brain Sci. 2024, 14(9), 863; https://doi.org/10.3390/brainsci14090863 - 27 Aug 2024

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Abstract

Background: Art therapy has a long history of applications in cognitive and motor rehabilitation. More recently, a growing body of scientific literature has highlighted the potential of virtual reality in neurorehabilitation, though it has focused more on the technology itself than on the [...] Read more.

Background: Art therapy has a long history of applications in cognitive and motor rehabilitation. More recently, a growing body of scientific literature has highlighted the potential of virtual reality in neurorehabilitation, though it has focused more on the technology itself than on the principles adopted in digital scenarios. Methods: This study is a single-blind randomized controlled trial conducted on 40 patients with stroke, comparing conventional therapy (physical therapy for the upper and lower limbs, for posture and balance, cognitive therapy, occupational therapy, speech therapy, and specific therapy for swallowing, bowel, and bladder dysfunctions) to a protocol in which the upper limb physical therapy was substituted with art therapy administered by means of virtual reality exploiting the so-called Michelangelo effect. Results: After 12 sessions, patients in the virtual art therapy group showed a significantly greater improvement in independence in activities of daily living, as assessed by the Barthel Index (interaction of time and group: p = 0.001). Significant differences were also found in terms of upper limb muscle strength (Manual Muscle Test, p < 0.01) and reduction in spasticity (Ashworth scale, p = 0.007) in favor of the experimental group. In the virtual art therapy group, the effectiveness of the intervention was significantly correlated with patient participation (Pittsburgh Rehabilitation Participation Scale: R = 0.41), patient satisfaction (R = 0.60), and the perceived utility of the intervention by the therapist (R = 0.43). Conclusions: These findings support the efficacy of virtual art therapy leveraging the Michelangelo effect. Further studies should also focus on cognitive domains that could benefit from this type of approach. Full article

(This article belongs to the Special Issue Insight in the Application of Rehabilitation Devices in Neurological Disease)

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11 pages, 2196 KiB

Open AccessArticle

Effectiveness of the Use of Virtual Reality Rehabilitation in Children with Dyslexia: Follow-Up after One Year

by Giuseppa Maresca, Francesco Corallo, Maria Cristina De Cola, Caterina Formica, Silvia Giliberto, Giuseppe Rao, Maria Felicita Crupi, Angelo Quartarone and Alessandra Pidalà

Brain Sci. 2024, 14(7), 655; https://doi.org/10.3390/brainsci14070655 - 27 Jun 2024

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Abstract

Dyslexia is a common learning disorder that hinders reading fluency and comprehension. Traditional treatments can be tedious for children, limiting their effectiveness. This study investigated the one-year effects of rehabilitation treatment with a virtual reality rehabilitation system (VRRS) on children with dyslexia. Twenty-four [...] Read more.

Dyslexia is a common learning disorder that hinders reading fluency and comprehension. Traditional treatments can be tedious for children, limiting their effectiveness. This study investigated the one-year effects of rehabilitation treatment with a virtual reality rehabilitation system (VRRS) on children with dyslexia. Twenty-four children were divided into control (CG) and experimental (EG) groups. The CG underwent conventional neuropsychological treatment (CNT), while the EG underwent VR neurorehabilitation training (VRNT) using the VRRS. Neuropsychological evaluation was conducted before treatment, after six months, and again after one year for both groups. Compared to the control group, children who received VR training showed significant improvement in reading skills, especially in non-word reading and reading speed, even after one year without further VR intervention. VRRS can improve treatment adherence and minimize symptoms by offering engaging activities for children. These findings suggest VRRS may be a valuable tool for dyslexia rehabilitation with long-lasting effects. Full article

(This article belongs to the Special Issue Insight in the Application of Rehabilitation Devices in Neurological Disease)

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13 pages, 1239 KiB

Open AccessArticle

Motor Intentions Decoded from fMRI Signals

by Sergio Ruiz, Sangkyun Lee, Josue Luiz Dalboni da Rocha, Ander Ramos-Murguialday, Emanuele Pasqualotto, Ernesto Soares, Eliana García, Eberhard Fetz, Niels Birbaumer and Ranganatha Sitaram

Brain Sci. 2024, 14(7), 643; https://doi.org/10.3390/brainsci14070643 - 26 Jun 2024

Cited by 2 | Viewed by 1867

Abstract

Motor intention is a high-level brain function related to planning for movement. Although studies have shown that motor intentions can be decoded from brain signals before movement execution, it is unclear whether intentions relating to mental imagery of movement can be decoded. Here, [...] Read more.

Motor intention is a high-level brain function related to planning for movement. Although studies have shown that motor intentions can be decoded from brain signals before movement execution, it is unclear whether intentions relating to mental imagery of movement can be decoded. Here, we investigated whether differences in spatial and temporal patterns of brain activation were elicited by intentions to perform different types of motor imagery and whether the patterns could be used by a multivariate pattern classifier to detect such differential intentions. The results showed that it is possible to decode intentions before the onset of different types of motor imagery from functional MR signals obtained from fronto-parietal brain regions, such as the premotor cortex and posterior parietal cortex, while controlling for eye movements and for muscular activity of the hands. These results highlight the critical role played by the aforementioned brain regions in covert motor intentions. Moreover, they have substantial implications for rehabilitating patients with motor disabilities. Full article

(This article belongs to the Special Issue Insight in the Application of Rehabilitation Devices in Neurological Disease)

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15 pages, 2106 KiB

Open AccessArticle

Reliability and Construct Validity of a Mobile Application for the Finger Tapping Test Evaluation in People with Multiple Sclerosis

by Víctor Navarro-López, Roberto Cano-de-la-Cuerda, Pilar Fernández-González, Selena Marcos-Antón, Aitor Blázquez-Fernández, María Fernández-Cañas and Diego Fernández-Vázquez

Brain Sci. 2024, 14(4), 407; https://doi.org/10.3390/brainsci14040407 - 21 Apr 2024

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Abstract

The finger tapping test (FTT) is a tool to evaluate the motor performance of the hand and fingers and eye-hand coordination with applicability in people with multiple sclerosis (pwMS). The aim of this study was to evaluate the intra- and inter-rater reliability of [...] Read more.

The finger tapping test (FTT) is a tool to evaluate the motor performance of the hand and fingers and eye-hand coordination with applicability in people with multiple sclerosis (pwMS). The aim of this study was to evaluate the intra- and inter-rater reliability of the TappingPro^® mobile app and the construct validity between this app and validated clinical scales for motor performance in healthy subjects and pwMS. 42 healthy subjects (mean age 25.05) and 13 pwMS (mean age 51.69, EDSS between 3 and 7.5E) participated. FTT was performed with the TappingPro^® mobile app. All participants were examined twice, with a one-week interval between the two appointments. For the analysis of construct validity, the Jamar^® hydraulic hand dynamometer, Box and Blocks Test (BBT), and Nine Hole Peg Test (NHPT) were used. The intra-rater reliability showed a good correlation (Intraclass Correlation Coefficient, ICC > 0.787) for both upper limbs and both times of FTT for healthy subjects, and an excellent correlation (ICC > 0.956) for upper limbs and both times of FTT for pwMS. The ICC for the inter-rater reliability was good (ICC = 0.869) for the non-dominant upper limb in the FTT 10 s of the healthy subjects, and excellent (ICC > 0.904) for all the other measurements of the healthy subjects and pwMS. However, the Bland–Altman plots showed disagreement between observers and measurements that should be considered in the interpretation of clinical evaluations. The correlation analysis for healthy subjects showed poor associations between all variables, except for the association between hand grip strength and the FTT 60 s in the non-dominant upper limb, which had a moderate coefficient. For pwMS, there were moderate to excellent associations between BBT and the NHPT and FTT for both upper limbs. The correlations between hand grip strength and FFT were poor. This mobile app could be a useful and low-cost assessment tool in pwMS, allowing a simple evaluation and follow-up that has excellent correlation with clinical scales validated in this pathology. Full article

(This article belongs to the Special Issue Insight in the Application of Rehabilitation Devices in Neurological Disease)

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12 pages, 729 KiB

Open AccessArticle

Assessing the Impact of Electrosuit Therapy on Cerebral Palsy: A Study on the Users’ Satisfaction and Potential Efficacy

by David Perpetuini, Emanuele Francesco Russo, Daniela Cardone, Roberta Palmieri, Andrea De Giacomo, Domenico Intiso, Federica Pellicano, Raffaello Pellegrino, Arcangelo Merla, Rocco Salvatore Calabrò and Serena Filoni

Brain Sci. 2023, 13(10), 1491; https://doi.org/10.3390/brainsci13101491 - 22 Oct 2023

Cited by 1 | Viewed by 2396

Abstract

The aim of this study is to evaluate the effectiveness of electrosuit therapy in the clinical treatment of children with Cerebral Palsy, focusing on the effect of the therapy on spasticity and trunk control. Moreover, the compliance of caregivers with respect to the [...] Read more.

The aim of this study is to evaluate the effectiveness of electrosuit therapy in the clinical treatment of children with Cerebral Palsy, focusing on the effect of the therapy on spasticity and trunk control. Moreover, the compliance of caregivers with respect to the use of the tool was investigated. During the period ranging from 2019 to 2022, a total of 26 children (18 M and 8 F), clinically stable and affected by CP and attending the Neurorehabilitation Unit of the “Padre Pio Foundation and Rehabilitation Centers”, were enrolled in this study. A subset of 12 patients bought or rented the device; thus, they received the administration of the EMS-based therapy for one month, whereas the others received only one-hour training to evaluate the feasibility (by the caregivers) and short-term effects. The Gross Motor Function Classification System was utilized to evaluate gross motor functions and to classify the study sample, while the MAS and the LSS were employed to assess the outcomes of the EMS-based therapy. Moreover, between 80% and 90% of the study sample were satisfied with the safety, ease of use, comfort, adjustment, and after-sales service. Following a single session of electrical stimulation with EMS, patients exhibited a statistically significant enhancement in trunk control. For those who continued this study, the subscale of the QUEST with the best score was adaptability (0.74 ± 0.85), followed by competence (0.67 ± 0.70) and self-esteem (0.59 ± 0.60). This study investigates the impact of the employment of the EMS on CP children’s ability to maintain trunk control. Specifically, after undergoing a single EMS session, LSS showed a discernible improvement in children’s trunk control. In addition, the QUEST and the PIADS questionnaires demonstrated a good acceptability and satisfaction of the garment by the patients and the caregivers. Full article

(This article belongs to the Special Issue Insight in the Application of Rehabilitation Devices in Neurological Disease)

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