Background: Immersive virtual reality (VR) has emerged as a promising tool to enhance neuroplasticity, motivation, and engagement during post-stroke motor rehabilitation. However, evidence on its feasibility and data-driven integration into clinical practice remains limited. Objective: This pilot study aimed to evaluate the feasibility, usability, and short-term motor outcomes of an immersive VR-assisted rehabilitation program using the Travee-VR system. Methods: Fourteen adults with post-stroke upper-limb paresis completed a 10-day hybrid rehabilitation program combining conventional therapy with immersive VR sessions. Feasibility and tolerability were assessed through adherence, adverse events, the System Usability Scale (SUS), and the Simulator Sickness Questionnaire (SSQ). Motor outcomes included active and passive range of motion (AROM, PROM) and a derived GAP index (PROM–AROM). Correlations between clinical changes and in-game performance metrics were explored to identify potential digital performance metrics of recovery. Results: All participants completed the program without adverse events. Usability was rated as high (mean SUS = 79 ± 11.3), and cybersickness remained mild (SSQ < 40). Significant improvements were observed in shoulder abduction (+7.3°, p < 0.01) and elbow flexion (+5.8°, p < 0.05), with moderate-to-large effect sizes. Performance gains in the Fire and Fruits games correlated with clinical improvement in shoulder AROM (ρ = 0.45, p = 0.041). Cluster analysis identified distinct responder profiles, reflecting individual variability in neuroplastic adaptation. Conclusions: The Travee-VR system proved feasible, well tolerated, and associated with measurable short-term improvements in upper-limb function. By linking clinical outcomes with real-time kinematic data, this study supports the role of immersive, feedback-driven VR as a catalyst for data-informed neuroplastic recovery. These results lay the groundwork for adaptive, clinic-to-home rehabilitation models integrating clinical and exploratory digital performance metrics.

Background. Plantar fasciitis is a degenerative condition that may follow a chronic or recurrent course. Injectable agents are frequently employed to alleviate pain and restore function. Recently, botulinum toxin (BoNT) has gained particular attention for its analgesic properties, positioning it as a promising therapeutic option for the management of plantar fasciitis. Method. We conducted a literature review to evaluate studies on BoNT administration in plantar fasciitis, aiming to define the target tissues, optimal doses, methods of administration, and associated adverse effects. Results. The evidence suggests that BoNT provides significant short- and long-term analgesic benefits when administered either intrafascially or intramuscularly, with outcomes comparable to or exceeding those of corticosteroids. Conclusion. Further high-quality studies are warranted to compare BoNT with other therapeutic modalities, such as PRP and extracorporeal shockwave therapy (ESWT).

Background: Immersive virtual reality (VR) has emerged as a promising tool to enhance neuroplasticity, motivation, and engagement during post-stroke motor rehabilitation. However, evidence on its feasibility and data-driven integration into clinical practice remains limited. Objective: This pilot study aimed to evaluate the feasibility, usability, and short-term motor outcomes of an immersive VR-assisted rehabilitation program using the Travee-VR system. Methods: Fourteen adults with post-stroke upper-limb paresis completed a 10-day hybrid rehabilitation program combining conventional therapy with immersive VR sessions. Feasibility and tolerability were assessed through adherence, adverse events, the System Usability Scale (SUS), and the Simulator Sickness Questionnaire (SSQ). Motor outcomes included active and passive range of motion (AROM, PROM) and a derived GAP index (PROM–AROM). Correlations between clinical changes and in-game performance metrics were explored to identify potential digital biomarkers of recovery. Results: All participants completed the program without adverse events. Usability was rated as high (mean SUS = 79 ± 11.3), and cybersickness remained mild (SSQ < 40). Significant improvements were observed in shoulder abduction (+7.3°, p < 0.01) and elbow flexion (+5.8°, p < 0.05), with moderate-to-large effect sizes. Performance gains in the Fire and Fruits games correlated with clinical improvement in shoulder AROM (ρ = 0.45, p = 0.041). Cluster analysis identified distinct responder profiles, reflecting individual variability in neuroplastic adaptation. Conclusions: The Travee-VR system proved feasible, well tolerated, and associated with measurable short-term improvements in upper-limb function. By linking clinical outcomes with real-time kinematic data, this study supports the role of immersive, feedback-driven VR as a catalyst for data-informed neuroplastic recovery. These results lay the groundwork for adaptive, clinic-to-home rehabilitation models integrating clinical and digital biomarkers.

Background/Objectives: Clinical assessment of post-stroke spasticity may not fully distinguish neural contributions from structural and mechanical muscle changes. This systematic review examined associations between B-mode ultrasonographic and elastography-derived muscle parameters and the presence or severity of post-stroke spasticity. Methods: PubMed, Scopus, and Web of Science Core Collection were searched from inception to 18 July 2026. Eligible studies investigated ultrasound-derived skeletal muscle parameters in adults after stroke in relation to spasticity status or severity. Methodological quality was assessed using the Joanna Briggs Institute checklist, and certainty of evidence was evaluated using the GRADE approach. Findings were synthesized narratively because of substantial heterogeneity. Results: Eighteen studies were included, six contributing B-mode structural data and twelve elastography-derived mechanical data. B-mode findings were inconsistent across muscles and measurement conditions. Elastography more frequently identified increased stiffness-related parameters in paretic or spastic muscles, although associations with clinical spasticity severity were not consistently observed. The certainty of evidence was very low across the assessed outcome domains, reflecting methodological limitations, small sample sizes, and inconsistency in the reported associations. Conclusions: B-mode ultrasound and elastography provide complementary information on muscle changes after stroke, but neither can currently serve as a stand-alone measure of spasticity severity. Elastography may help characterize the mechanical component of post-stroke hypertonia alongside clinical examination. Larger, standardized longitudinal studies are needed to establish the clinical utility of these techniques.

Introduction: Chronic stroke frequently causes structural and functional impairments in the tibialis anterior (TA) muscle, leading to foot-drop and altered gait kinematics. We investigated the relationship between ultrasonographic parameters of the TA muscle and functional gait performance in chronic stroke survivors. Methods: This cross-sectional, observational pilot study evaluated eight consecutive chronic stroke patients (>6 months post-stroke). Structural parameters of TA (rest and contraction thickness, pennation angle) were documented by ultrasound imaging. A dynamic feature calculated was the Contraction Index (CI = effort/resting thickness). Functional metrics included the Medical Research Council (MRC) muscle strength scale and the 10-Meter Walk Test (10MWT) for gait velocity. Results: Statistical analysis revealed a moderate negative correlation trend between resting TA muscle thickness and functional gait speed (r = −0.618, p = 0.102). Conversely, a moderate positive correlation trend was found (r = 0.548, p = 0.160). Ultrasound imaging successfully differentiated three distinct pathological phenotypes: an atrophic phenotype (low pennation angle, flaccid muscle failure), a severely shortened spastic phenotype (increased resting thickness, high pennation angle, pathological CI < 1.0), and a spastic co-contraction loop. Patients with the atrophic phenotype achieved high mechanical efficiency with an ankle–foot orthosis (AFO), whereas the spastic phenotype exhibited resistance against the orthotic device. Conclusions: Musculoskeletal ultrasound provides objective parameters for post-stroke TA muscle remodeling and contributes to completing the assessment and therapy. Identifying specific structural muscle phenotypes allows clinicians to optimize target-specific neurorehabilitation strategies, predict AFO efficiency, and guide antispastic interventions such as botulinum toxin injections.