Szilvia Kóra
59459797800
Publications - 7
Effects of walking training with and without a robot and standard care on clinical and mobility outcomes: A randomized clinical trial in acute ischemic stroke patients
Publication Name: Experimental Gerontology
Publication Date: 2025-10-15
Volume: 210
Issue: Unknown
Page Range: Unknown
Description:
Background: Stroke incidence rises with age. A stroke can severely affect walking ability, requiring therapy. Robot-assisted walking therapy (ROB) has been advocated as one form of walking rehabilitation in stroke patients. However, its comparative efficacy remains controversial and three-group comparisons are scant. We compared the effects of ROB, walking training therapy without a robot (WTT) and standard treatment therapy (STT) on clinical and mobility outcomes in acute ischemic stroke patients. Methods: Individuals (n = 45, 71 % males, age 64.4y ±6.34), who have recently experienced an ischemic stroke, were randomized to ROB, WTT or STT. Clinical and mobility outcomes were assessed before and after each intervention (3 weeks, 5 sessions/week) and after 5 weeks of no-intervention follow-up. Results: Outcomes did not differ between groups at baseline (p > 0.05). Modified Rankin Scale (primary outcome), improved (p < 0.05) after ROB and WTT vs. STT. These improvements were retained relative to baseline (p < 0.05) after follow-up. Barthel index, Berg Balance Scale, 10-m walking speed, the distance while walking with and without the robot for six minutes, and center pressure velocity in standing improved most after ROB (all p < 0.001), exceeding the changes after WTT which in turn were greater than the changes after STT (p ≤ 0.040). Conclusion: Older adults shortly after an ischemic stroke can quickly learn to walk with a soft robot and retain substantial clinical and mobility improvements at follow-up.
Open Access: Yes
Effectiveness of High-Intensity Therapy in Rehabilitation of Parkinson’s Disease Patients
Publication Name: Applied Sciences Switzerland
Publication Date: 2025-06-01
Volume: 15
Issue: 11
Page Range: Unknown
Description:
Parkinson’s disease (PD) is a progressive movement disorder with no cure. In this randomized controlled study, 100 patients with PD were assigned to four intervention groups (Exergame, Cycling, Agility, and Robot) for 14 weeks. This study evaluates the effectiveness of high-intensity therapy in a randomized clinical trial. Exergaming, cycling, agility, and robot therapies improved motor function, postural stability, and cardiovascular health. Heart rate monitoring and Borg Scale ratings confirmed the safety and adaptability of high-intensity training, with patients sustaining moderate-to-high exertion without adverse effects. Significant improvements were observed in gait speed (+0.30–0.50 m/s), Functional Independence Measure (FIM) (+25–30 points), and Berg Balance Scale scores. Integrating high-intensity, functional movement-based therapies into PD rehabilitation may offer superior motor, gait, and cardiovascular benefits compared to conventional methods.
Open Access: Yes
DOI: 10.3390/app15115890
Brain Structural Abnormalities in Patients with Post-COVID-19 Headache
Publication Name: Neurology International
Publication Date: 2025-04-01
Volume: 17
Issue: 4
Page Range: Unknown
Description:
Background/Objectives: Headache is one of the most common neurological symptoms associated with COVID-19, affecting approximately 25% of patients. While most headaches resolve within weeks, some persist for months, suggesting underlying structural brain changes. This study aimed to identify brain MRI abnormalities associated with chronic headaches in patients with a history of COVID-19 infection. Methods: This retrospective study included 30 patients with post-COVID-19 headaches and 30 control patients with no history of COVID-19. Demographic characteristics were analyzed using t-tests and chi-square tests. MRI findings were categorized into six types: cortical atrophy, white matter lesions, vascular lesions, lacunar lesions, vascular encephalopathy, and sinusitis. Differences in MRI findings between the two groups were evaluated using chi-square tests. Secondary outcomes included the analysis of symptoms accompanying headaches, diagnoses following MRI, and treatments applied. Results: White matter lesions were significantly more frequent in the post-COVID-19 group (50%) compared to controls (20%) (p = 0.015). Conversely, sinusitis was more prevalent in the control group (36.7%) than in the post-COVID-19 group (6.7%) (p = 0.005). Other MRI abnormalities showed no significant differences. Cognitive dysfunction (30%) and dizziness (33.3%) were the most common associated symptoms. The most frequent diagnoses after MRI in the post-COVID-19 group were headaches/migraines (23.3%), post-COVID-19 headache (20%), and vestibular syndrome (13.3%). Conclusions: Persistent post-COVID-19 headaches may be linked to structural white matter changes observed in MRI. Further research, ideally including pre-infection imaging data, is needed to determine the causal relationship between these lesions and chronic headache symptoms. Trial Registration: This study was registered in ClinicalTrials with the trial registration number NCT06825741 on 13 February 2025.
Open Access: Yes
Comparison of Five Rehabilitation Interventions for Acute Ischemic Stroke: A Randomized Trial
Publication Name: Journal of Clinical Medicine
Publication Date: 2025-03-01
Volume: 14
Issue: 5
Page Range: Unknown
Description:
Background: Comparative efficacy of rehabilitation interventions in persons with acute ischemic stroke (PwS) is limited. This randomized trial assessed the immediate and lasting effects of five interventions on clinical and mobility outcomes in 75 PwS. Methods: Five days after stroke, 75 PwS were randomized into five groups: physical therapy (CON, standard care, once daily); walking with a soft robotic exoskeleton (ROB, once daily); agility exergaming once (EXE1, once daily) or twice daily (EXE2, twice daily); and combined EXE1+ROB in two daily sessions. Interventions were performed 5 days per week for 3 weeks. Outcomes were assessed at baseline, post-intervention, and after 5 weeks of detraining. Results: Modified Rankin Scale (primary outcome) and Barthel Index showed no changes. EXE1, EXE2, ROB, and EXE1+ROB outperformed standard care (CON) in five secondary outcomes (Berg balance scale, 10m walking speed, 6-min walk test with/without robot, standing balance), with effects sustained after 5 weeks. Dose effects (EXE1 vs. EXE2) were minimal, while EXE1+ROB showed additive effects in 6-min walk tests. Conclusions: These novel comparative data expand evidence-based options for therapists to design individualized rehabilitation plans for PwS. Further confirmation is needed.
Open Access: Yes
DOI: 10.3390/jcm14051648
Telerehabilitation After Brain Injuries: Its Efficacy and Role in Reducing Healthcare Burdens
Publication Name: Acta Polytechnica Hungarica
Publication Date: 2023-01-01
Volume: 20
Issue: 8
Page Range: 305-320
Description:
Rehabilitation following brain injuries, such as stroke and other traumatic injuries, presents significant challenges for both patients and healthcare systems. Traditional in-person rehabilitation often requires regular visits to specialized facilities, which can be difficult for patients in remote areas or those with mobility and financial constraints. Telerehabilitation offers a promising solution by enabling patients to continue essential therapy at home, ensuring continuity of care while reducing the burden on healthcare providers. It can be effectively applied across various patient groups, including children, adults, the elderly, amputees, individuals with traumatic neurological injuries, and those with neurocognitive impairments such as dementia. Our telemedicine platform integrates advanced technologies, i.e., 3D motion analysis and Virtual Reality (VR) to enhance home-based physiotherapy. These tools enable precise monitoring, real-time feedback, and immersive therapy sessions, in order to improve coordination, fine motor skills, hand-eye coordination, and the vestibular system, which is crucial for balance. This platform also performs detailed offline data analysis, allowing healthcare professionals to adjust therapy plans based on individual needs. As the demand for rehabilitation services continues to grow, adopting these technologies will be crucial for sustainable, effective healthcare, ultimately improving patient outcomes and shaping a more efficient and equitable future for healthcare systems.
Open Access: Yes
Virtual Reality in Cerebrovascular Rehabilitation: A Mini Review on Clinical Efficacy and Neurological Impacts
Publication Name: Acta Polytechnica Hungarica
Publication Date: 2023-01-01
Volume: 20
Issue: 8
Page Range: 321-336
Description:
The application of virtual reality (VR) technology in both upper and lower limb rehabilitation represents a significant advancement in the field of medicine. VR-based therapies provide patients with the opportunity to engage in intensive, repetitive, and targeted exercises that promote neuroplasticity and improve the motor skills necessary for daily life. VR has long been recommended for the rehabilitation of conditions such as in case of ischemic stroke, Parkinson’s disease, and multiple sclerosis, further underscoring its versatility and therapeutic potential. In our study, we evaluated the effectiveness of VR therapy focusing on stroke rehabilitation. The reviewed VR systems provided motion analysis, tracking, feedback reinforcement, and realistic environments to facilitate the restoration of motor functions. Furthermore, we developed a VR-based therapy aimed at both upper and lower limb motor functions, combined with traditional rehabilitation. The application of VR technology not only promotes the improvement of motor functions but also offers economic advantages by reducing the burden on healthcare workers and increasing rehabilitation capacity. Further research is needed to determine the optimal conditions for applying VR therapy in clinical practice.
Open Access: Yes
Structural Brain Abnormalities, Diagnostic Approaches, and Treatment Strategies in Vertigo: A Case-Control Study
Publication Name: Neurology International
Publication Date: 2025-09-01
Volume: 17
Issue: 9
Page Range: Unknown
Description:
Background/Objectives: Dizziness is a frequent medical complaint with neurological, otolaryngological, and psychological origins. Imaging studies such as CT (Computer Tomography), cervical X-rays, and ultrasound aid diagnosis, while MRI (Magnetic Resonance Imaging) is crucial for detecting brain abnormalities. Our purpose is to identify structural brain changes associated with vertigo, assess pre-MRI diagnostic approaches, and evaluate treatment strategies. Methods: A case-control study of 232 vertigo patients and 232 controls analyzed MRI findings, pre-MRI examinations, symptoms, and treatments. Statistical comparisons were performed using chi-square and t-tests (p < 0.05). Results: White matter lesions, lacunar infarcts, Circle of Willis variations, and sinusitis were significantly more frequent in vertigo patients (p < 0.05). Pre-MRI diagnostics frequently identified atherosclerosis (ultrasound) and spondylosis (X-ray). Common symptoms included headache, imbalance, and visual disturbances. The most frequent post-MRI diagnosis was Benign Paroxysmal Positional Vertigo (BPPV). Treatments included lifestyle modifications, physical therapy (e.g., Epley maneuver), and pharmacological therapies such as betahistine. Conclusions: MRI revealed structural brain changes linked to vertigo. Pre-MRI assessments are essential for ruling out vascular and musculoskeletal causes. A multidisciplinary treatment approach is recommended. Trial Registration: This study was registered in ClinicalTrials.gov with the trial registration number NCT06848712 on 22 February 2025.
Open Access: Yes
