Gait Training in Severely Affected Stroke Patients

Review Article | DOI: https://doi.org/10.31579/2639-4162/363

Gait Training in Severely Affected Stroke Patients

  • Jan Van de Rakt 1*
  • Steve McCarthy-Grunwald 2

1 Physical Therapist NDT teacher IBITA, Course Leader and teacher on the Dutch Institute for Allied Health Sciences. Nursing Home “Waelwick” in Ewijk the Netherlands.

2 MSc BSc RMN Lecturer in Mental Health Nursing with Dementia Specialty. University of Cumbria, Bowerham Road, Lancaster, LA1 3JD England.

*Corresponding Author: Jan van de Rakt, Physical Therapist NDT teacher IBITA, Course Leader and teacher on the Dutch Institute for Allied Health Sciences. Nursing Home “Waelwick” in Ewijk the Netherlands.

Citation: Jan Van de Rakt, Steve McCarthy-Grunwald, (2026), Gait Training in Severely Affected Stroke Patients, J. General Medicine and Clinical Practice, 9(7); DOI: 10.31579/2639-4162/363

Copyright: © 2026, Jan van de Rakt. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received: 22 May 2026 | Accepted: 28 May 2026 | Published: 08 June 2026

Keywords: walking after a stroke; training according to training rules; 'relearning' is compensating; diagonal

Abstract

Background.  Many people who have had a stroke find a way to be able to walk again. This recovery is an adaptation/compensation strategy of the individuals and their therapeutic team, searching for a way to bear weight and maintain control, especially of balance. Very quickly, support/aids are used and practiced with, but what are we actually doing? Is this training to build better coordination, or is that not possible? In any case, it is not relearning, because these individuals have to compensate. Aim/Design:  Searching for the reasons why so many, even severely affected individuals, are still able to stand and walk on the affected leg, while, for example, hand/arm and foot/leg selectivity is often very severely impaired. One of these reasons is the innervation of the trunk and the large joints from the hemispheres of the brain. Because the pathways from the cortex partially cross, a connection from both hemispheres remains present, and it appears that this crossing at lower levels even approaches a 70%-30% distribution.

Result: This result therefore means that muscle patterns are also influenced by unaffected areas in the brain and that this therefore plays a role in recovery, but of course also in the control of walking and especially of the stance phase. For example, the posterior diagonal is essential to activate the affected side/hip via the unaffected shoulder, yet we often see that this is not sufficiently successful.

Discussion and conclusion: The search for an adjustment/compensation after a stroke in order to be able to walk in some way often involves providing aids and “grooving in” that walking. That is not training according to training rules, and often no activation occurs in the muscles around the affected hip joint even though this is possible. By including this activation in the training program from the start, it will also be incorporated into the walking pattern. This therefore does not mean first looking for an adjustment/compensation, or “relearning,” but immediately actively training the coordination of the affected lower trunk/hip.

Introduction

Various studies show that many people are still able to learn to walk in one way or another after a stroke [1-6]. The recovery of this ability is much stronger than, for example, that of the arm and certainly the hand function. This is mainly due to the organization of the brain and the pathway of the brain to the systems that are important for walking [7-14]. Due to this organization, reduced control in the damaged hemisphere can be 'compensated' by the contribution of the other hemisphere, but the result will always be at a lower level than before. The damaged hemisphere, together with the other side, still has to ensure the highest form of selectivity, which is often no longer optimally possible, and the system has to make adjustments. These adjustments are often seen in the use of pathological stereotypical synergies and higher tone. In fact, the degrees of freedom [14] (the basis of selectivity) are limited, which means less control is required and some form of standing and walking is still possible. The control of the body to move, and in this case to walk, is then no longer completely monitored by the cortex (figure 1), but also by lower systems (Figure 2).

Figures 1 and 2: The projection of the body onto the cortex (figure 1) and it is striking how large the projections of the extremities are (hand-foot) and how small, precisely, the rest of the leg and torso are. Figure 2 shows the projection deeper in the brain, and here we see a large projection of the leg and torso as a basis for the “coarse execution” of the walking movement.

The pathways that run from the brain to the nerves downwards and vice versa, and when we look at walking, we see that those pathways to the trunk and the shoulders/hips cross 90% at the cortical level, but 10% go directly to the same side. These (cortical) brain nuclei are especially important for finer, more selective work such as balance during walking, but if we remove that balance element, control from lower centres (figure 2) should be sufficient to be able to walk with help/support within a large stable base of support. And here we see that the influence of both hemispheres is important because here the crossing part is lower, namely 70%, and the non-crossing part 30% [16]. This system thus makes it possible to practice a form of walking at a lower level, and that also gives room to train muscle patterns in a task-specific way. The outcome will always be from a lower level if the system is damaged, and often that is in the interpretation of the incoming information and the ability to respond selectively in an optimal way.

Figure 4: This figure shows the progression from the cortex projections distally. At the level of the brainstem, we see that the majority of these cortical pathways cross to the other side to continue their distally. But at that brainstem level, it is clearly visible that a portion remain on the same side and innervate distally. This concerns the motor pathways.

Diagonals

This organization, of course, has a very clear reason, and that is particularly visible in movements like walking. When we walk, we see that the arm swing is opposite to the movement of the leg but in line with the movement of the leg on the other side. [16, 6,7,8,9,10] If we look at motor patterns, then the diagonal system plays the biggest role in walking. We do need to temporarily disregard balance and see where the power comes from. The force needed to move forward over the loaded hip during the stance phase comes from the posterior diagonal running from the gluteus maximus to the opposite shoulder and through their combined effort. At the same time, the anterior diagonal is engaged in the swing phase through a contraction in that muscle chain. The muscle system therefore receives its innervation from both hemispheres.

Photo 1 and 2: Depending on the intensity, we see the contribution of the rear/front diagonal to the swing and swing form of the opposite arm.

These are photos of people without a disruption of the system due to brain damage to make clear which system serves as a basis for walking. But it is clearly visible here that the opposite swing between arm and leg is greater as the speed and/or step increases. 

The posterior diagonal starts in the gluteal musculature with its attachment in the thoraco-lumbar fascia and then directly to the opposite shoulder via the latissimus dorsi and many other muscles that additionally support this whole. A concentric contraction brings the opposite shoulder backward simultaneously with the hip/trunk on the other side. 

So, if there is a fixed point on the ground, the body is moved over that point. The anterior diagonal has a clearly less rigid structure because the tendon sheet at the front depends on the muscle tone in the m. rectus abdominus. We do see the connection between the m. serratus anterior and the oblique abdominal muscles, which seem to continue from one side to the other. Yet the 'connection' with the hip flexor (m. iliopsoas) is indirect and depends on 'core stability [17],' because then a point is fixed and concentric contraction of the anterior diagonal can swing the leg and opposite arm forward. So, if there is a fixed point, then movement over that point is possible and we have a step. A swing depends on the correct tension in the front diagonal, which brings the m. iliospoas to length and swings forward.   And this is often more difficult after a stroke. Heel strike.

Normal walking at a reasonable speed will typically be characterized at the start by means of the heel strike [18]. The fixed point provides the rear diagonal underneath on that side of the fixed point, with the leg positioned well forward and the gluteal muscles nicely at length, and through the tension of the rear diagonal from the opposite shoulder, the other part of the gluteal is also ensured of a fixed point. Thus, a concentric contraction of the gluteal muscle pulls the leg under the hip or, in other words, the torso over the foot. Once again, all balance necessities are disregarded, but it is true that the movement must proceed “precisely” to optimally activate the musculature (Figure 7).

Figure 7: The red line shows the posterior diagonal running from the shoulder joint to the opposite hip joint. The blue line represents the course when someone heavily leans on a cane, and then the diagonal comes out 'in front of the hip joint,' and studies have shown that the EMG activity [19] then decreases so much that muscle loss/coordination occurs. In post-stroke individuals, this will also happen, but at the same time the dominance of the adductors will increase because they can still provide extension in the leg, especially in combination with hip flexion.

The other diagonal (green line) will therefore often also not end in the shoulder joint but end in and around the shoulder blade, which often causes a retraction as a reaction in the upper torso. Standing and walking after a stroke will depend on the fixed point (the affected foot) but also on how well the diagonal can function. Because a heel strike often does not occur, weight is placed on that foot without the concentric contraction of the gluteal muscles, but instead, weight is placed and the gluteal muscles are lengthened (an eccentric contraction) together with the adductors at the back, which are further engaged due to hip flexion.  Here, we thus see the compensation that occurs when people try to walk with support using a cane. 

Figure 8: The swing phase is performed with the torso as the 'fixed point,' and because tension develops on the extended m. iliopsoas, little power is needed to swing the free leg forward. After a stroke, the continuity of the anterior diagonals is disrupted, which is often visible as the navel being pulled more toward the unaffected side. In Figure 8, we see that the diagonal actually loses its stability because the rectus is not stably positioned in the center, and, among other things, the oblique abdominal muscles lose their fixed point. Furthermore, core stability will immediately disappear, making it difficult to provide the hip flexor with a fixed point to swing the leg forward.

The red line indicates the diagonal to the swing leg on the affected side, but the blue line to the non-affected side [20], and then we know that when walking, a lot of forward movement and balance actually comes from that side, and that produces a reaction in the diagonal to the opposite shoulder, which at the front is often incomplete. To get the leg forward, we will see movements initiated by the non-affected side through an extension of the affected trunk with a rotation done by the non-affected hip, the circumduction movement [21].

Pathology after stroke.   We see that the trunk has a very important role for the walking part and can actually almost always perform it in some way, however limited. If there is a stable fixed point that can support the body weight, limited movement over and/or “along” that fixed point leg is possible. Due to the different projections at different levels and double innervation, this is also possible after major brain damage. The system will often have to manage without heel strike, even though the foot is “fixed” in that position by an AFO (Ankle Foot Orthosis), it will often only be a creation of a fixed point. The result is that no concentric action of the gluteal is elicited, but that the leg is loaded by moving the torso over the leg from 'above,' and when that goes well, the other leg is pushed/added. This often means 'hanging' on the gluteal muscles/adductors, so an eccentric reaction and a muscle reaction elicited by a 'stretch' on these muscle groups.[22,23,24] An eccentric contraction is certainly an “economic” solution, but it will not really further improve the walking pattern; for that we need more, and that must be achieved through training of the muscle patterns and the integration of this improved coordination and power into everyday walking. Due to a pes equinus varus, this movement pattern is even more readily invoked because there is no simple alternative. [25,26] The extensive neural network, including the diagonals (front and back), also shows that the arms are now much more involved in activating the diagonals, but that there can also be consequences arising from this. The non-affected arm/shoulder is used by all people who need an aid to maintain balance to improve walking over the affected hip, and you can see that in the placement and holding of a cane.

Photo 3 and 4:  People after a stroke who usually only need a standard cane to control their balance and improve their walking. But now they use the cane to improve movement on the affected side starting from the shoulder, and this activation now begins in the opposite shoulder. We can see this from the way they hold the cane (index finger photo 4) as well as where the cane is placed. Namely at the level of the push-off of the affected leg.

That this is a perfect solution is evident from the concentric contraction of the hip extensors. This means that through the push-off with the pole, the diagonal is optimally activated and that the posterior diagonal still ends well in the hip joint, thereby maintaining and utilizing the concentric contraction.  This means that walking in this way—task-specific—with resistance will lead to training of the muscle pattern responsible for the stance phase and step length. This effect of activating the posterior diagonal from the opposite shoulder also occurs when walking with Nordic Walking poles, which are also positioned backward [27].

However, this will change if the possibilities cannot be solved with a simple stick because the balance requires support surface area and the load on the affected leg may not be optimal. That requires support on the non-affected side and at the same time causes a shift to that side, so the diagonal will no longer run optimally and therefore this results in a loss of muscle coordination and muscle.

Pay attention to the arm position on the affected side because, since the unaffected leg has to work so hard to bear weight, control balance, and facilitate the swing, the posterior diagonal will be very active and place the affected shoulder in retraction, and thus in a flexion synergy with all the consequences thereof. 

Photo 7:Swing phase of the affected leg.  In principle, the leg often remains in the same position as in the stance phase and the weight of that leg is first taken off and controlled by the non-affected leg and arm/cane. The front diagonal is not able to provide an anchor for the hip flexor, so an alternative is sought. Here, the upper torso leans mostly backward on the non-affected side, creating a stretch on the front diagonal and thereby building enough tension in it and the flexor, often in combination with the upper torso leaning sideways to the non-affected side [32] - circumduction movement.  This swing phase is therefore largely performed by the non-affected side, and improvement must come from creating more core stability and thus more cohesion in the front diagonal.

For the people in photos 3 and 4, walking in that way with some load can turn into a training of the muscle patterns and, for example, increase the stride length while walking. But the compensation strategy in photos 5, 6, and 7 will only give the person more confidence, but will not train/improve the system. The danger is even present that the possibilities that still exist due to double innervation will “disappear” due to disuse and that, due to high muscle tone for a long time, the muscle itself shortens through loss of sarcomeres, etc. [34,35,36,37].  Walking in this way is therefore not training at a better and more stable walking pattern!

Training. Very often this is explained as a form of relearning, and the well-known forms of relearning (explicit and implicit) come into play. However, the principle is to regain control of walking from the combination of the extra support that is offered and the remaining capacity that is still present. In the beginning, this will involve searching for the best solution (a form of explicit/implicit learning), but if the combination is correct, it will become automatic. Photos 5, 6, and 7 show such an image, and “strangely” most of the attention goes to the aids on the non-affected hand/arm and affected leg. Furthermore, we see that the distance and speed increase until a ceiling is quickly reached in this group, and the “training” brings minimal change there. And actually, it is simple, because to improve walking the muscle patterns need to be activated and improved in terms of coordination and power. [38,39,40]

So, in order for the training to be successful, it must be targeted (task-specific [41,42,43]) and there must be an increase in coordination and power that is also transferred to the running pattern. To achieve this, training must be done to induce muscle fatigue (the stimulus for coordination/power improvement) and its application with many repetitions with variation in the different forms of running. Therefore, we need to determine what the 1 R.M. is of the muscle pattern (for example, stance phase) and we know that 75% of that with at least 10 repetitions, three times in a row, and at least twice a week should lead to an improvement in coordination and power [44,45,46,47]. 

The integration of this skill is achieved by task-specific training, preferably with resistance so that the energy demand is higher and thus muscle fatigue occurs. In individuals with a stroke, there is always the question of whether the damaged brain system is capable of providing this coordination, and precisely because of the double innervation during walking, it is possible, but it does require targeted training. That which is not used must, if possible, be activated, and that which actually inhibits selectivity (pathological synergies and pathological tone) must be controlled because the activation of the posterior diagonal is at “risk” and therefore inhibited.

Photo 8, 9 and Picture 1: Training form in lying position of the posterior diagonal starts in the leg/foot that is on the bench. Photo 9 shows the 1 R.M. [47] determined and the weight on the free leg ensures activation and concentric contraction in the other leg and posterior diagonal. It is about the reaction-activation of the affected side and in photo 8 we see without resistance that there is no control in the hip and a plantar flexion in the ankle. And Picture 1 shows that the lift of the buttocks cannot be maintained.

No activation means no concentric contraction of the muscles around the hip of the leg on the bench and therefore no control. Often caused by the dominance of a pathological synergy with a pathological tone. We see plantar flexion in the ankle but also sliding of the leg in extension and 'collapsing' of the tentacle (Picture 1) as signs of the dominance of this pathological synergy/tone. Specifically, this means that this training will not work, because there is no activation.

Picture 2:  Start of an activation in the position of the musculature around the hip, as the starting point of the posterior diagonal towards the opposite shoulder. It is very important that the degrees of freedom under the hip, in the knee, and foot are limited. In the knee, this is done with a posterior splint and in the foot, for example, with a bandaging technique, because this now makes it possible to properly put weight on the affected leg. To keep balance completely under control, we use an adjustable height mobile bench, which provides a large support surface.

The support -for- will mainly be on the non-affected elbow, so the activation will be optimized through hands-on technique. The height -picture 2- of the bench is partly determined by that activation, and now it will also occur earlier because the extensors are under stretch. Essential for that activation is a concentric reaction of the hip muscles, especially extensors/abductors, and for that a good alignment of the diagonals is needed and a lift of the other leg. And start by lifting and moving backward against resistance; this will often provide activation but also immediately give a first impression of 1.R.M. of the muscle pattern that ensures good weight-bearing on the affected leg.

Walking backwards is then the next step, important because with a splint a backward swing phase is easier and because it often provides quicker extension of the trunk. But certainly, also sideways along a bench is a perfect activation of the lower part of the posterior diagonal, and keep testing with hands-on to ensure that the activation takes place, but also a test of the 1R.M. by providing resistance to the swinging leg (non-affected), and we can set up training according to the training rules. Walking forward is possible over a long distance with a mobile bench, and the muscle patterns can be trained optimally against resistance. A 1 R.M. can be determined, pushing a bench can be such a load, so a training program can be realized, which improves the coordination and power of the muscle pattern. Pushing provides activation of the anterior and posterior diagonals (core stability [50]) and therefore also affects the swing phase as well as the stance phase, even with proper extension of the calf. It is important that the activation of the hip extensors remains optimal and that a progression is achieved through the task-specific resistance training program. From the beginning, focus must therefore be placed on the activation of the hip extensors, which must always be monitored optimally, because as soon as the compensation / adaptation walking technique is applied daily, it will require much more training to improve it. Stabilization of the knee and foot is necessary and thus directly affects the way/quality of walking; the posterior splint directly affects the swing phase, but an AFO (Ankle Foot Orthosis [48,49]) can also have an influence. Unfortunately, with the standard carbon AFO, where no movement is allowed, we see that in some people this leads from the beginning to walking with an apparent equinus and, with prolonged use, to a shortening of the calf musculature [25,26].

Picture 3 and Photo 9: Picture 3 gives an image of how to secure a foot in the ankle.  Photo 9 gives an image of the effect of a carbon AFO in the shoe and the limitation that arises at the end of the stance phase and the compensations that this causes.

The posture that the person displays gives a signal that they want to move the unaffected foot forward but are being limited. Yet, they try to reach their “old” step length and we see: knee hyperextension, outward rotation of the affected hip, or better, a counter-rotation on the other side, and trunk reaction. This means that a poor walking pattern is being “imposed,” but also that the calf muscle is not, with every step, being brought to length, with the consequence that this can lead to calf muscle shortening due to loss of sarcomeres. [51,52] 

Extra training, besides gait training with hands-on correction, is necessary to improve coordination and power to such an extent that they can be used in that walking pattern. That means the intensity of the training must be optimal, but also that walking throughout the day should not differ too much, because otherwise integration will only become more difficult. This also means that other caregivers must have the knowledge and skills to properly guide this. For example, to be able to use what has been trained, it remains essential that the end of the rear diagonal ends in the correct position in the hip joint, and walking with an aid to the side creates a risk that this will not be achieved. Especially at the beginning of rehabilitation, this can quickly occur due to fatigue, and it is important to include this element in the training.

Photo 10 and 11:  Training of the stance phase through task-specific resistance therapy. By applying resistance against the swinging leg, you can determine 1 R.M. and thus set up training according to the rules, and an improvement in coordination and power can be achieved.

By consistently incorporating this section into the treatment, there will be an improvement in the ability to enhance the stance phase, and the activation of the hip musculature will become easier, but this does require that the training rules are also followed. So per session 3 sets of 10 repetitions at 75% of 1 R.M. [41,42,43], leading to muscle fatigue, and twice in a row. And at least twice a week, but preferably three times a week, with an increase in resistance to consistently reach muscle fatigue. The variation of the resistance is very large because a small change in direction already produces a different muscle response. Important (Photo 12) keep checking whether the activation of the muscles is optimal because leaning on a chair back can always create a diagonal that does not optimally engage the hip joint. Also realize that the front diagonal is involved because resistance is applied against the swinging leg, and it is therefore important that the opposite shoulder moves forward (protraction), which also partially determines the choice of how much percentage of 1 R.M. can be given as resistance and thus also the number of repetitions. This is necessary to achieve the training effect but also to prevent that, due to too high resistance, the person has to rely on pathological synergies with pathological tone, because then the activation of the hip muscles is inhibited.

Picture 4: Training of the hip muscles is essential for the walking pattern after a stroke and certainly has potential. Due to the bilateral innervation from the brain, the trunk and the major joints are controlled “doubly,” and of course, this is reduced after an injury. What applies to starting a standing and/or walking training also applies to training and activation of the main muscle patterns, which means that where there is no control, we must create it. Picture 4 shows these in the form of a posterior splint that secures the knee, a bandage around the ankle, and support on a table to the side and a therapist in front and on the side. Now it is possible to provide resistance and determine 1 R.M. and carry out the training program, whereby the variation can be very large for the entire hip region.

It is remarkable that the activation of the hip region/lower trunk as part of the posterior diagonal works best when someone is optimally standing on the affected leg.

Photo 12: Weight on one leg requires an adjustment in the lower trunk. In other words, the diagonal must fall in or preferably just beyond the hip joint. This requires not only selectivity but also a great perceptual ability, because this is and remains a balance moment, yet still within limits.  Especially in people after a stroke, this perceptual control is often severely impaired, and one of the reasons that a movement is made or dared sideways, which means that the activation of the muscle patterns is lost with all the associated consequences.

At the moment that this activation does not occur due to perceptual and/or motor reasons, it cannot be expected that it will be incorporated despite training. The only solution is to ensure that the situation changes (becomes safe) and that this activation does occur, because then there will also be training/stimulation of the input (perception) alone but also through the muscle contractions. [53,54] And then it is important to create a situation where someone can handle that, and picture 4 provides a fine solution. By stabilizing the knee, many people will dare to stand on the leg and can therefore train their lower trunk muscle patterns but also use them while walking, although the swing phase is less graceful. The opposite, trying to keep all elements under control with too few fixed points, often results in a situation where the activation of the muscle patterns in the affected lower trunk does not come across at all and is therefore never incorporated into the walking pattern. In that case, stabilizing the knee and foot so that this activation can take place and be trained optimally is the best option to further improve walking.

Photo 13, 14, 15 and 16: The search of a man affected by a stroke for a safe way to walk with a cane. This is practiced intensively under supervision, but he does not seem to like to evoke and train an activation of the hip muscle patterns. The placement of the cane and the way he holds it indicate that he is trying everything possible to activate the diagonal towards the affected leg through the upper body. Of course, there is a double problem here: due to perception, there is no optimal control over the affected leg and therefore more stabilization needs to be provided, which must also be 'felt' because then activation can occur.

The red line indicates the sideways movement and the green line the rear diagonal, and then it is fairly far in both compared to normal.

Photo 17, 18, 19, 20 and 21: At the moment the gentleman tries to practice his walking pattern without an extra aid on the unaffected side, it becomes clear that his perception of the affected side is such that he can hardly dare/can hardly fully load the affected side. The consequence on the affected side is that activation of the hip muscles cannot take place, and photo 21 shows an increase in retraction in the affected shoulder, which affects the selectivity of the entire trunk. The photos also show that a lot is being demanded, and that the moment the unaffected foot lifts, this leads to lower activation and higher pathological tone.

Photo 22, 23, 24 and 25: Through an AFO with the ability to move at the ankle, it becomes clear that not only a stabilization of the ankle is achieved, but also of the knee. However, it is still insufficient when he walks to include the activation of the hip extensors and thus to incorporate the training of these muscle patterns into his walking pattern. Training of this muscle patterns should therefore be incorporated into the walking pattern, which means always creating optimal stabilization but also training other ways of walking with support, and not choosing lateral support too quickly as this often 'inhibits' activation.

Other walking training

The additional training of the lower torso to enable optimal movement over the affected hip coordinatively and with sufficient power, but that must be incorporated back into walking.  At the moment when walking with a lot of lateral support, incorporation will be almost impossible, so it is important not to move too quickly to that form. Especially not if this person is increasingly able to walk longer distances and is better off than choosing another 'walking support' and additional stabilization so that the acquired abilities are also used.  Often it is also still possible to provide an extra task-specific resistance.

Photo 26, 27 and 28: Walking behind a high chair backrest. Photo 26 and 27 show that now the diagonal runs perfectly and this can be seen in a clearly improved walking pattern. But in photo 28, the twisting of the hip is still present.

No matter how severe the damage in the brain is, the double innervation provides an opportunity to mainly improve the movement over the affected hip, but that requires training of these muscle patterns and finding a solution to incorporate it into the walking pattern. It is precisely this incorporation that is essential, because if this does not succeed, what has been achieved through training will disappear again.

Conclusion

Recovery of walking after a stroke actually has a reasonably good prognosis due to the double innervation of the trunk and large joints [55]. The process these individuals have to start is a search for the best control and at the same time the best and safest way to get somewhere else. This therefore does not mean 'learning' but searching through adaptation and compensation to find that stabilization, and unfortunately, aids are often used, which increase the support base and stabilize, enable loading, and control balance.  Practicing a lot and regularly is then the therapy strategy to automate this adaptability. This is not training according to the training rules and certainly not an activation of the hip extensors of the affected hip; the opposite will happen because these muscle patterns will deteriorate faster in terms of strength and coordination [19]. It is precisely a treatment aimed at activating the hip muscles by optimally stabilizing the affected leg, and not seeking lateral support base enlargement, that will trigger this activation and, through proper training, lead to a positive change in the walking pattern with possibilities for improving balance as well. This training is actually best done in water [56], both the task-specific resistance training of the muscle patterns and the incorporation of these possibilities into the walking pattern.

References

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Perlat Kapisyzi

Dear Reader: We have published several articles in the Auctores Publishing, LLC, journal, Clinical Medical Reviews and Reports in recent years (CMRR). This is an ‘open access’ journal and the following are our observations. From the initial invitation to submit an article, to the final edits of galley proofs, we have found CMRR personnel to be professional, responsive, rapid and thorough. This entire process begins with Catherine Mitchell, Editorial Coordinator. She is simply outstanding, and, I believe, unparalleled in her capacity. I cannot imagine a more responsive and dedicated Editorial Coordinator. As I read the dates and timing of her correspondence with us, it seems that she never sleeps. I hope Auctores Publishing, LLC, appreciates her efforts as much as these authors do. Thank you to Auctores Publishing, LLC, to the Editorial Staff/Board, and to Catherine Mitchell from a grateful author(s).

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Dr Gary Merrill

Dear Maria Emerson, Editorial Coordinator of - Journal of Clinical Research and Reports. ''I am pleased to provide this testimonial following the publication of our recent case report in this journal. The peer review process was rigorous, constructive, thorough, and conducted in a timely manner. The reviewers’ comments were thoughtful, detailed, and highly constructive, contributing substantially to the refinement, clarity, and scientific robustness of our manuscript. The process was conducted with professionalism and academic integrity throughout. The support provided by the editorial office was exemplary. Communication was consistently prompt, clear, and courteous at all stages of the submission and publication process. The editorial team demonstrated a high level of organization and responsiveness, ensuring that all queries were addressed efficiently and that the process remained transparent and well-coordinated. The overall quality of the journal is reflected in its strong editorial standards, commitment to scientific excellence, and dedication to publishing clinically meaningful research. It has been a privilege to publish our work in this journal, and we would welcome the opportunity to contribute further in the future.'' Best wishes from, Dr. Efstratios Trogkanis, Cardiologist.

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Dr Efstratios Troganis

Dear Grace Pierce, Editorial Coordinator of the journal IJCCR, I had a very positive experience with Auctores - Journal throughout the publication process. The Editorial Team was highly responsive, professional, and supportive at every stage. I would like to extend my sincere thanks to the Editor: Grace Pierce, for her guidance and assistance. The peer-review process was smooth and constructive, helping improve the quality of my work. I would gladly recommend Auctores Journal to fellow researchers and authors. Dr. SABITA SINHA, Medical Oncologist, MD (Electro Homeopathy).

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Dr SABITA SINHA

Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.

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Dr Ted Christopher

International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.

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Joel Yat Seng Wong

Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.

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Dr Mamoun Magzoub

Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.

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Baciulescu Laura

Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal

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Christoph Maurer

Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.

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Dr Elena Salvatore

Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed

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Mahmoud Kamal Moustafa Ahmed

Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.

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Dr Meng-JouLe

Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell

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Dr Andriy Sinelnyk

I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.

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Edouard Kujawski

Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.

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Dr Matteo Bonori

Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti

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Dr Claudio Ligresti

Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.

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Dr Chiara Giuseppina Beccaluva

Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.

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Dr Aline Tollet

Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.

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Dr Ravi Shrivastava

Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora

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Dariusz Ziora

Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.

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Dr Jelle Lettinga

Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.

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Dr Walter F Riesen

Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.

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Dr Rakhi Mishra

Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.

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Hala Al Shaikh

Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD

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Dr Eric S Nussbaum

Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.

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Dr Susan Anne Smith

Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.

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Dr Victor Olagundoye

Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.

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Dr Farahnaz Fallahian

Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.

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Dr Susan Anne Smith

Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.

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Dr Oleg Golyanovski

To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina

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Dr Elvira Farina

My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.

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Gertraud Teuchert-Noodt

We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.

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Dr David Vinyes

Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.

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Dr Anyuta Ivanova

I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.

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Dr Farooq Wandroo

"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".

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Dr Shweta Tiwari

To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.

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Dr Tewodros Kassahun Tarekegn

I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.

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Cristina Berriozabal

Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."

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Thomas Urban

I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.

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Zhao Jia

My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.

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Luiz Sellmann

My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.

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Sonila Qirko

My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.

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Lin-Show Chin

Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner

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Dr Susan Weiner

Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”

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Zsuzsanna Bene

Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.

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Dr Maria Regina Penchyna Nieto

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.

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Dr Maria Dolores Gomez Barriga

Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.

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Maria Dolores Gomez Barriga

The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.

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Lin Shaw Chin

Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.

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Gomez Barriga Maria Dolores

Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.

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Khurram Arshad

Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.

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Rui Tao

“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.

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George Varvatsoulias

Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.

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Tania Munoz

I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.

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S Munshi

I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.

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Husain Taha Radhi

I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.

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Dr Tong Ming Liu

We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.

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Dr Griffith

I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.

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Douglas Miyazaki

"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".

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Jesus Simal-Gandara

I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!

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Baheci Selen

Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.

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Bruno Chauffert

Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.

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Dr Suramya Dhamija

International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.

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Andreas Filippaios

Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.

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Raed Mualem

As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.

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Dr Shiming Tang

Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.

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Hao Jiang

This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.

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Prof Sherif W Mansour

Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.

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Bernard Terkimbi Utoo

Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.

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Pedro Marques Gomes

Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.

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Anthony Kodzo-Grey Venyo

Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.

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Katarzyna Byczkowska

Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.

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Orlando Villarreal

The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.

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Sing-yung Wu

We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.

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Layla Shojaie

Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.

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Mina Sherif Soliman Georgy

Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.

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Ziemlé Clément Méda

Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.

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Delcio G Silva Junior

Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.

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Virginia E. Koenig