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Brain Sciences
Special Issues
Outcome Measures in Rehabilitation
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Outcome Measures in Rehabilitation

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurorehabilitation".

Deadline for manuscript submissions: 31 August 2026 | Viewed by 7959

Special Issue Editors

Prof. Dr. Antonio Nardone

E-Mail Website
Guest Editor
1. Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
2. Istituti Clinici Scientifici Maugeri IRCCS, Centro Studi Attività Motorie and Neurorehabilitation and Spinal Units of Pavia Institute, 27100 Pavia, Italy
Interests: rehabilitation medicine; Parkinson's disease; chronic disease; neurodegenerative disease
Dr. Irene Aprile

E-Mail Website
Guest Editor
IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269, 50143 Firenze, Italy
Interests: robotic rehabilitation; movement analysis; gait analysis; neurorehabilitation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

An outcome measure is a measure of the initial, intermediate or final outcome of a rehabilitation intervention, whether inpatient or outpatient, most commonly in the musculoskeletal, neurological or cardiopulmonary field. Depending on the patient, the type of treatment and its expected effects, one or more outcome measures may be chosen. An outcome measure can be qualitative or quantitative. On the one hand, qualitative measures are subject to intra- and inter-rater variability; on the other hand, quantitative measures are precise but sometimes time-consuming and rely on expensive equipment. For example, muscle strength can be measured qualitatively using the manual muscle test or quantitatively using a handheld dynamometer.

The aim of this Special Issue is to provide researchers and clinicians with examples of using rehabilitation outcome measures from real-world experience.

Successful rehabilitation requires a clear definition of goals and measurable objectives to evaluate and guide interventions.

Authors are invited to submit original papers, reviews and case reports dealing with the use of qualitative and quantitative outcome measures in rehabilitation of people with musculoskeletal, neurological or cardiopulmonary disorders.

Prof. Dr. Antonio Nardone
Dr. Irene Aprile
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • outcome measures
  • qualitative measures
  • quantitative measures
  • neurologic rehabilitation
  • musculoskeletal rehabilitation
  • cardiopulmonary rehabilitation
  • robotic rehabilitation
  • movement analysis
  • gait analysis

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Published Papers (6 papers)

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9 pages, 205 KB  
Article
Variety of Neuropsychological Deficits and Clinical Rehabilitation Course After Surgical Removal of Cerebral Meningioma Under Neuropsychological Therapy
by Stefanie Auer, Peter Gugel, Natalie Gdynia, Andreas Gratzer, Ingo Haase and Hans-Jürgen Gdynia
Brain Sci. 2026, 16(4), 416; https://doi.org/10.3390/brainsci16040416 - 15 Apr 2026
Viewed by 241
Abstract
Background: Meningiomas (MG) are the most common form of benign intracranial tumors. Neuropsychological deficits are often noticed preoperatively. After surgical removal, both improvements and persistent neuropsychological deficits have been reported. Here we present the neuropsychological characteristics of a larger patient group following acute [...] Read more.
Background: Meningiomas (MG) are the most common form of benign intracranial tumors. Neuropsychological deficits are often noticed preoperatively. After surgical removal, both improvements and persistent neuropsychological deficits have been reported. Here we present the neuropsychological characteristics of a larger patient group following acute treatment for meningioma. Methods: This retrospective study is part of an overall project investigating the postoperative characteristics and rehabilitation outcomes of 151 patients following surgical removal of MG. Patients were recruited at the neurological department of m&i-Fachklinik Enzensberg between 2019 and 2024. In addition to demographic data and tumor characteristics, the neuropsychological reports were evaluated by two experienced (neuro)psychologists. Results: 69 patients underwent standardized testing in the neuropsychology department and were thus included in the analysis. Upon admission, 52.2% of these patients exhibited attention deficits, 48% showed executive deficits, and 44% had memory impairments. No correlation was found between the extent of resection or the occurrence of complications during surgery and cognitive deficits. However, there was a trend showing that higher-grade tumors were more likely to cause cognitive impairment. The location of the tumor did not correlate with the impaired cognitive domains. At discharge, fewer patients exhibited attention deficits, and those that did had less severe symptoms. Conclusions: Meningiomas are considered to be easily treatable. However, our data show that neuropsychological impairments frequently occur after acute treatment, which may not be given sufficient attention in practice. Even mild cognitive impairments can lead to problems in everyday life or at work. We therefore recommend detailed neuropsychological diagnosis and, if necessary, therapy for all patients after acute treatment. Full article
(This article belongs to the Special Issue Outcome Measures in Rehabilitation)
24 pages, 2029 KB  
Article
Multimodal Rehabilitative Outcome Measures of Fatigue in Patients with Diabetic Neuropathy
by Cira Fundarò, Dibo Mesembe Mosah, Fabio Plano, Roberto Maestri, Stefania Ghilotti, Pierluigi Chimento, Marina Maffoni, Monica Panigazzi, Guido Magistrali, Stefano Bruciamonti, Manuela Ravasio and Chiara Ferretti
Brain Sci. 2026, 16(3), 298; https://doi.org/10.3390/brainsci16030298 - 7 Mar 2026
Viewed by 505
Abstract
Background/Objectives: Diabetic neuropathy (DN), a common complication of type 2 diabetes mellitus, manifests as peripheral nerve dysfunction with symptoms such as fatigue. Although exercise effectively reduces fatigue in neuropathy patients, precise detection methods are crucial to elucidate the role of rehabilitation. Accordingly, [...] Read more.
Background/Objectives: Diabetic neuropathy (DN), a common complication of type 2 diabetes mellitus, manifests as peripheral nerve dysfunction with symptoms such as fatigue. Although exercise effectively reduces fatigue in neuropathy patients, precise detection methods are crucial to elucidate the role of rehabilitation. Accordingly, this study aimed to evaluate fatigue in DN patients using a multimodal approach (clinical and instrumental) and to compare the efficacy of aerobic versus resistance training on fatigue parameters. Methods: Eligible DN inpatients admitted for rehabilitation at the Neuromotor Rehabilitation Unit of the IRCCS ICS Maugeri Institute of Montescano (PV) were enrolled. Inclusion criteria included age between 65 and 85 years and confirmation via the Michigan Neuropathy Screening Instrument (anamnestic section: ≥7; clinical section: ≥2.5). Patients with confounding orthopedic, neurologic, or unstable cardiopulmonary/diabetic conditions were excluded. Overall, 36 participants were randomized into two groups: 17 underwent aerobic training (treadmill), while 19 received resistance training (elastic bands), both as supplements to a standard rehabilitation program. Assessments at baseline and post-training comprised clinical measures (Borg CR10 scale, Functional Independence Measure (FIM) total and subitems, Six-Minute Walk Test (6MWT), fasting blood glucose) and instrumental evaluations (sEMG of the tibialis anterior muscle to analyze conduction velocity intercept, slope, and changes). Results: All patients completed the protocol without dropout or adverse events. Both groups demonstrated significant improvements in FIM scores and post-exercise perceived exertion over time. Instrumental sEMG analysis confirmed a physiological fatigue trend manifested as conduction velocity reduction, yet revealed no significant differences between groups. Conclusions: Multimodal assessment provides an effective means to characterize fatigue in DN patients. Both aerobic and resistance modalities enhance functional independence and fatigue perception. Its early identification enables clinicians to tailor rehabilitation strategies to overcome exercise barriers. Full article
(This article belongs to the Special Issue Outcome Measures in Rehabilitation)
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9 pages, 267 KB  
Article
Team-Based Long-Term Multidisciplinary Inpatient Neurological Rehabilitation After Surgery of Cerebral Meningioma—Outcome and Confounding Factors
by Natalie Gdynia, Ingo Haase, Andreas Gratzer, Stefanie Auer and Hans-Jürgen Gdynia
Brain Sci. 2026, 16(3), 263; https://doi.org/10.3390/brainsci16030263 - 26 Feb 2026
Cited by 1 | Viewed by 510
Abstract
Objective: Cerebral meningiomas are the most common primary intracranial tumors in adults. Treatment of symptomatic tumors is normally surgical; tumors not suitable for surgery can be irradiated. While there is good data on the effectiveness of acute therapy, little is known about the [...] Read more.
Objective: Cerebral meningiomas are the most common primary intracranial tumors in adults. Treatment of symptomatic tumors is normally surgical; tumors not suitable for surgery can be irradiated. While there is good data on the effectiveness of acute therapy, little is known about the effects of long-term team-based multidisciplinary inpatient neurological rehabilitation. We analyzed the outcome of these patients undergoing neurological rehabilitation. Methods: We performed a retrospective analysis of patients with cerebral meningioma who underwent specialized rehabilitation. We analyzed routine demographic and clinical data; the outcome was measured with the Barthel Index (BI) in patients with a BI of ≤90 on admission. Results: We analyzed 151 patients. Neuropsychological deficits were evident in 93 patients, and 9% had speech disorders. BI increased from 66.8 to 75.2%. Examination of factors influencing treatment success revealed that the number of secondary diagnoses had an influence on the average increase in the BI. No correlation was found for the other independent variables, including age, sex, tumor localization, stage, resection (complete or incomplete), complications, and length of stay. Conclusions: Even given the limitations of our analysis, rehabilitation appears to be effective in these patients. However, further investigations with a matched control group would be desirable to verify our hypothesis. Furthermore, studies regarding optimal intensity, timing, long-term outcome, and modality of rehabilitation are necessary. Full article
(This article belongs to the Special Issue Outcome Measures in Rehabilitation)
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17 pages, 651 KB  
Article
Evaluation of Relationship Between Neuromuscular Fatigue and Manual Dexterity in Physiotherapists: An Observational Study
by Gianluca Libiani, Francesco Sartorio, Ilaria Arcolin, Stefano Corna, Marco Godi and Marica Giardini
Brain Sci. 2026, 16(2), 193; https://doi.org/10.3390/brainsci16020193 - 6 Feb 2026
Viewed by 656
Abstract
Background/Objectives: Neuromuscular fatigue (NMF) can impair manual dexterity and strength in healthcare professionals. Due to their high physical and cognitive workloads, physiotherapists (PTs) are particularly susceptible to NMF. This study investigated whether NMF, expressed as changes in manual dexterity and grip strength, occurs [...] Read more.
Background/Objectives: Neuromuscular fatigue (NMF) can impair manual dexterity and strength in healthcare professionals. Due to their high physical and cognitive workloads, physiotherapists (PTs) are particularly susceptible to NMF. This study investigated whether NMF, expressed as changes in manual dexterity and grip strength, occurs over a workday and across a workweek in PTs, and explored its relationship with stress and sleep quality. Methods: A total of 43 full-time PTs (25 female, mean age 37.72 ± 11.94 years) were recruited. Manual dexterity was assessed using the Functional Dexterity Test (FDT), while maximal grip strength (MGS) was measured by a hand dynamometer. Reliability was evaluated on a subgroup using Intraclass Correlation Coefficients (ICC3,1) and Standard Error of Measurement (SEM). Evaluations were conducted at the beginning and at the end of the work shift, on Monday and Friday. Subjective fatigue, perceived stress, and sleep quality were also recorded. Results: The FDT showed excellent intra-rater reliability (ICC > 0.93; SEM < 0.94 s). FDT performance was significantly slower on Friday evening compared to all other time points (p < 0.01), exceeding the minimal detectable change thresholds. No significant changes were observed in MGS across the week. Perceived stress was strongly correlated with fatigue levels on Monday (ρ = 0.731) and Friday (ρ = 0.612) evenings. Sleep quality and professional experience did not correlate with performance changes. Conclusions: PTs experience a significant decline in manual dexterity by the end of the workweek, suggesting an accumulation of NMF. While MGS remains stable, fine motor control is more sensitive to fatigue. Psychosocial stress appears to be a major driver of perceived fatigue in this population. Full article
(This article belongs to the Special Issue Outcome Measures in Rehabilitation)
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15 pages, 533 KB  
Article
Effects of Exergame with Biofeedback Training on Functional Status, Cognition, and Quality of Life in Outpatients with Polyneuropathies: A Longitudinal Pilot Study
by Francesco Zanatta, Daniela Mancini, Patrizia Steca, Monica Panigazzi, Elena Prestifilippo, Cesare Grilli, Marco D’Addario, Antonia Pierobon and Marina Maffoni
Brain Sci. 2026, 16(1), 45; https://doi.org/10.3390/brainsci16010045 - 29 Dec 2025
Viewed by 613
Abstract
Background: Polyneuropathies impair sensory, motor, and autonomic functions, affecting functional status, cognition, and quality of life. This pilot study investigated the effects of exergame with biofeedback training (Riablo system) versus standard rehabilitation on these outcomes in outpatients with mixed-etiology polyneuropathies. Methods: Seventeen outpatients [...] Read more.
Background: Polyneuropathies impair sensory, motor, and autonomic functions, affecting functional status, cognition, and quality of life. This pilot study investigated the effects of exergame with biofeedback training (Riablo system) versus standard rehabilitation on these outcomes in outpatients with mixed-etiology polyneuropathies. Methods: Seventeen outpatients were assigned to standard rehabilitation (Group 1, n = 9) or combined standard plus Riablo training (Group 2, n = 8) over three weeks. Functional status, pain, cognition, quality of life, and psychological well-being were assessed pre- and post-intervention, with a 6-month follow-up. Outcome measures included the Morse Fall Scale, Visual Analogue Scales for pain and autonomy, Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), Stroop Test, Frontal Assessment Battery (FAB), Verbal fluency test, the Short-Form Health Survey-12 (SF-12), and the Patient Health Questionnaire-4 (PHQ-4). Longitudinal changes and between-group differences were analyzed using nonparametric statistics. Results: Both groups showed significant improvements in functional status and global cognition at post-intervention. Group 2 demonstrated greater improvements in executive functions and attention, with significant reductions in pain and fall risk. At 6-month follow-up, Group 2 maintained post-intervention gains in QoL and psychological outcomes, while Group 1 showed a significant decline. Technology evaluation revealed high usability and positive psychosocial impact in Group 2, with strong correlations between executive function improvements and device usability. Conclusions: Integrating exergames with biofeedback into standard rehabilitation may provide broader and longer-lasting benefits for polyneuropathy patients. These findings support further large-scale trials to confirm efficacy and optimize technology-assisted rehabilitation protocols. Full article
(This article belongs to the Special Issue Outcome Measures in Rehabilitation)
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15 pages, 1796 KB  
Systematic Review
Treadmill Training in Patients with Parkinson’s Disease: A Systematic Review and Meta-Analysis on Rehabilitation Outcomes
by Elisa Boccali, Carla Simonelli, Beatrice Salvi, Mara Paneroni, Michele Vitacca and Davide Antonio Di Pietro
Brain Sci. 2025, 15(8), 788; https://doi.org/10.3390/brainsci15080788 - 24 Jul 2025
Cited by 1 | Viewed by 4659
Abstract
Background/Objectives: Parkinson’s disease (PD) is a neurodegenerative disorder that impairs mobility. Treadmill training (TT) is a common rehabilitation strategy for improving gait parameters in individuals with PD. This systematic review evaluated the effectiveness of TT in improving motor function, walking ability, and [...] Read more.
Background/Objectives: Parkinson’s disease (PD) is a neurodegenerative disorder that impairs mobility. Treadmill training (TT) is a common rehabilitation strategy for improving gait parameters in individuals with PD. This systematic review evaluated the effectiveness of TT in improving motor function, walking ability, and overall functional mobility in PD patients. Methods: We compared TT to other forms of gait and motor rehabilitation, including conventional and robotic gait training. Trials that compared a treadmill training group with a non-intervention group were excluded from this review. We searched multiple databases for RCTs involving Parkinson’s patients until January 2025. The primary outcomes were motor function (UPDRS-III) and walking ability (6 MWT and TUG test). Results: We identified 285 articles; 199 were excluded after screening. We assessed the full text of 86 articles for eligibility, and 13 RCTs met the inclusion criteria. Some of them were included in the meta-analysis. The TT group showed a significant improvement in UPDRS-III scores [mean difference (MD): −1.36 (95% CI: −2.60 to −0.11)] and greater improvement in TUG performance [MD, −1.75 (95% CI: −2.69 to −0.81)]. No significant difference in walking capacity as assessed through the 6 MWT was observed [MD: 26.03 (95% CI: −6.72 to 58.77). Conclusions: The current study suggests that TT is effective in improving the motor symptoms and functional mobility associated with PD. Further studies are needed to develop protocols that consider the patients’ clinical characteristics, disease stage, exercise tolerance, and respiratory function. Full article
(This article belongs to the Special Issue Outcome Measures in Rehabilitation)
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