Freezing of gait (FoG) is a prevalent symptom among individuals with Parkinson’s disease and related disorders. FoG detection from videos has been developed recently; however, the process requires using videos filmed within a controlled environment. We attempted to establish an automatic FoG detection method from videos taken in uncontrolled environments such as in daily clinical practices. Motion features of 16 patients were extracted from timed-up-and-go test in 109 video data points, through object tracking and three-dimension pose estimation. These motion features were utilized to form the FoG detection model, which combined rule-based and machine learning-based models. The rule-based model distinguished the frames in which the patient was walking from those when the patient has stopped, using the pelvic position coordinates; the machine learning-based model distinguished between FoG and stop using a combined one-dimensional convolutional neural network and long short-term memory (1dCNN-LSTM). The model achieved a high intraclass correlation coefficient of 0.75–0.94 with a manually-annotated duration of FoG and %FoG. This method is novel as it combines object tracking, 3D pose estimation, and expert-guided feature selection in the preprocessing and modeling phases, enabling FoG detection even from videos captured in uncontrolled environments.

The Kessler Foundation Neglect Assessment Process (KF-NAP) is an assessment tool for unilateral spatial neglect (USN), which is the scoring method for the Catherine Bergego Scale (CBS) based on detailed instructions. This study is aimed at determining the reliability and validity of the Japanese version of the KF-NAP (KF-NAP-J), evaluating the improvement of neglect assessment with KF-NAP-J, and comparing it with the original CBS for subacute stroke patients. We assessed subacute stroke patients admitted to our intensive rehabilitation hospital. Two KF-NAP-trained occupational therapists (OTs) assessed 22 patients. Before implementing the KF-NAP at the hospital, two other OTs assessed the other 23 patients using the CBS. We evaluated the interrater reliability of the KF-NAP and CBS using intraclass correlation coefficients (ICC) for the total scores, weighted kappa statistics for each subscale, and internal consistency using Cronbach’s alpha. We assessed the validity of the KF-NAP against the Behavioral Inattention Test (BIT) and Functional Independence Measure (FIM) using Spearman’s correlation coefficient. The reliability of both the KF-NAP and CBS was excellent. The weighted kappa results demonstrated that each subscale was in better agreement with the KF-NAP than with the CBS. In the KF-NAP, all eight subscales in which weighted kappa could be calculated were in significant agreement, and two were almost in perfect agreement. The KF-NAP moderately correlated with the subscales of BIT and FIM representing USN and activities of daily living. The USN detection rates of KF-NAP and BIT in the KF-NAP group were 63.6% and 22.7%, respectively. These results suggest that the KF-NAP, as well as the CBS, is useful to assess USN, which strongly impacts the rehabilitation outcomes in subacute stroke patients.

Although prism adaptation (PA) has been applied in spatial neglect (SN) for 27 years, its efficacy remains controversial and lacks consistency. The first aim was to assess the immediate and long-term effects of PA on SN via meta-analysis of randomized controlled trials (RCTs). The second aim was to identify potential effect modifiers of PA efficacy. We searched four databases up to March 2025 for RCTs comparing PA, or PA+conventional vs. shamPA, or shamPA+conventional, or only conventional in participants with SN, and assessing behavioral or neuropsychological tests (such as Catherine Bergego scale (CBS) and behavioral inattention test (BIT)). Cochrane risk-of-bias assessment tool and random-effects meta-analysis were used, and effect size was reported as Weighted Mean Difference (WMD) with 95 % CI. Only 10 RCTs (356 participants) could be included, eight of them reporting CBS data and six for BIT. Immediate PA effects on SN showed a significant improvement for CBS between the PA group (PA/PA+conventional) and control group (shamPA/ shamPA+conventional/only conventional), all studies with prism shift ≥10°, (WMD = -2.13, 95% CI -3.93 to 0.33; P = 0.020), but non-significance for conventional BIT (BIT-C). Long-term benefit was not significant for CBS, while it was significant for BIT-C when the prism shift was ≥10° (n = 2; WMD = 12.37, 95% CI 0.53 to 24.21; P = 0.041). Linear regressions showed non-significant effect modifiers among the participant characteristics or PA intervention parameters. Subgroup analyses for CBS showed a significant immediate improvement in the larger total quantity of prism exposure (number of total trials × prism shift) subgroup (WMD = -2.73, 95% CI -5.01 to -0.44; P = 0.019), whereas the subgroup with smaller total exposure showed no significant difference. Even with stringent inclusion criteria, significant effects of PA on SN were observed in the short-term CBS (all studies with prism shift ≥10°), mainly derived from studies with total exposure ≥11250°·trials. The total quantity of prism exposure (°·trials) may be an applicable effect modifier of PA efficacy. PROSPERO database (registration number: CRD420250650402).

A sensory trick is a specific maneuver that temporarily improves focal dystonia. We describe a case of musician’s dystonia in the right-hand fingers of a patient, who showed good and immediate improvement after using an electrical stimulation-mimicking sensory trick. A 49-year-old professional guitarist presented with chronic involuntary flexion of the right-hand third and fourth fingers that occurred during guitar performances. Electrical stimulation with a frequency of 40 Hz and an intensity of 1.5 times the sensory threshold was administered on the third and fourth fingernails of the right hand, which facilitated fluent guitar playing. While he played guitar with and without electrical stimulation, we measured the surface electromyograms (sEMG) of the right extensor digitorum and flexor digitorum superficialis muscles to evaluate the sensory-trick-like effects of electrical stimulation. This phenomenon can offer clues for developing electrical stimulation-based treatment devices for focal dystonia. Electrical stimulation has the advantage that it can be turned off to avoid habituation. Moreover, the device is easy to use and portable. These findings warrant further investigation into the use of sensory stimulation for treating focal dystonia.

Augmentative and alternative communication (AAC) enables digital access for individuals with severe motor impairment. Conventional contact-based switches rely on residual voluntary movement, limiting efficiency. We report the clinical application of a novel, researcher-developed noncontact assistive switch, the Augmentative Alternative Gesture Interface (AAGI), in a 39-year-old male with late-stage Duchenne Muscular Dystrophy (DMD) retaining minimal motion. The AAGI converts subtle, noncontact gestures into digital inputs, enabling efficient computer operations. Before intervention, the participant used a conventional mechanical switch, achieving 12 characters per minute (CPM) in a 2 min text entry task and was unable to perform high-speed ICT tasks such as gaming or video editing. After 3 months of AAGI use, the input speed increased to 30 CPM (+2.5-fold), and previously inaccessible tasks became feasible. The System Usability Scale (SUS) improved from 82.5 to 90.0, indicating enhanced usability, whereas the Short Form 36 (SF-36) Social Functioning (+13) and Mental Health (+4) demonstrated meaningful gains. Daily living activities remained stable. This case demonstrates that the AAGI system, developed by our group can substantially enhance communication efficiency, usability, and social engagement in advanced DMD, highlighting its potential as a practical, patient-centered AAC solution that extends digital accessibility to individuals with severe motor disabilities.

脳障害における脳可塑性変化に注目した歩行再建が注目されている．脳活動と動作解析手法を組み合わせ，歩行動作と脳の神経活動の関係性が少しずつ明らかになっている．本稿では歩行動作と脳機能の解析手法とその知見について概観し，脳障害の病態でニューロモデュレーションの臨床応用，研究が比較的進んでいるパーキンソン病を例に外部刺激，薬剤，電気刺激，磁気刺激による歩行再建について検討する．また，ロボットリハビリテーション訓練ではさまざまな疾患の歩行再建について脳可塑性変化をめざして研究開発，利用の拡大が行われている．現時点で脳可塑性に基づいた歩行再建リハビリテーションは発展途上であり今後の展開が期待される．