30-Second Takeaway
- Most stroke survivors still cannot stand independently at 1 month; weakness, lateropulsion, and hypoesthesia are key targets.
- cTBS rTMS can meaningfully improve mild–moderate poststroke lateropulsion, though neural correlates remain unclear.
- Technology-enabled and preoperative strength programs around arthroplasty offer small but real functional advantages, with limits after surgery.
- Targeted hip strengthening after revision THR adds little over standard community rehab at 4 months.
- Exercise and novel training (sensorimotor, singing) show broad benefits across oncology, long-COVID, and chronic low back pain populations.
Week ending January 17, 2026
Poststroke standing, neuromodulation, and peri-arthroplasty rehab: what should physiatry change now?
cTBS rTMS improves mild–moderate poststroke lateropulsion in a 3-week inpatient protocol
In this 3-arm sham-controlled RCT, 42 patients with poststroke lateropulsion received cTBS, high-frequency rTMS, or sham for 3 weeks. All groups improved over time on Burke Lateropulsion Scale, contraversive pushing, falls efficacy, mobility, and Fugl-Meyer motor scores. In patients with mild–moderate lateropulsion, cTBS produced significantly better Burke Lateropulsion scores than sham at 3 weeks. Functional near-infrared spectroscopy showed a complex interaction in left dorsolateral prefrontal cortex, but no clear linear relationship with clinical gains. Clinically, cTBS offers a promising adjunct for mild–moderate lateropulsion despite incomplete understanding of cortical mechanisms.
One month after hemispheric stroke, over half of patients cannot stand independently
This DOBRAS cohort study analyzed 221 adults 30 days after a first unilateral hemispheric stroke. At one month, 20% could not stand alone and 33% stood only with difficulty; just 47% stood rather well. Greater motor weakness, lateropulsion, and hypoesthesia were the strongest determinants of inability or difficulty standing, with additional influence of age. The proportion with impaired standing at one month has remained stable for two decades, despite evolving stroke care. Findings emphasize systematically assessing lateropulsion, sensorimotor deficits, and age when prognosticating standing and planning early balance rehab.
Technology-enabled rehab after lower-limb arthroplasty yields small functional gains over usual care
This meta-analysis pooled 15 low-bias RCTs of digital or electromechanical rehab after lower-limb arthroplasty (n=1966). Technology-enabled programs produced a small yet statistically significant improvement in patient-reported function versus usual care (Hedges g≈0.28). Virtual reality showed the largest, though imprecise, effect; web/app telerehab and robotic or sensor-based systems yielded modest, non-significant benefits. Heterogeneity was high, suggesting outcomes depend on specific implementation, feedback quality, and dosing. Overall, tech-enabled rehab appears at least noninferior and may reduce in-person therapist time while maintaining or modestly enhancing outcomes.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.