Objective To examine the long-term effects of the low-frequency repetitive transcranial magnetic stimulation (LFrTMS) combined with task-specific training on paretic hand function following subacute stroke.
Methods Sixteen participants were randomly selected and grouped into two: the experimental group (real LFrTMS) and the control group (sham LF-rTMS). All the 16 participants were then taken through a 1-hour taskspecific training of the paretic hand. The corticospinal excitability (motor evoke potential [MEP] amplitude) of the non-lesioned hemisphere, and the paretic hand performance (Wolf Motor Function Test total movement time [WMFT-TMT]) were evaluated at baseline, after the LF-rTMS, immediately after task-specific training, 1 and 2 weeks after the training.
Results Groups comparisons showed a significant difference in the MEP after LF-rTMS and after the training. Compared to the baseline, the MEP of the experimental group significantly decreased after LF-rTMS and after the training and that effect was maintained for 2 weeks. Group comparisons showed significant difference in WMFT-TMT after the training. Only in the experimental group, the WMFT-TMT of the can lifting item significantly reduced compared to the baseline and the effect was sustained for 2 weeks.
Conclusion The results of this study established that the improvement in paretic hand after task-specific training was enhanced by LF-rTMS and it persisted for at least 2 weeks.
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Objective To investigate the effect of upper limb rehabilitation combining robot with low-frequency repetitive transcranial magnetic stimulation (rTMS) on unilateral spatial neglect in stroke patients.
Methods Patients who had hemispatial neglect after right hemisphere stroke were randomly divided into rTMS only group, robot only group, and combined group. All groups received conventional neglect therapy and additional treatment for each group. rTMS group received rTMS therapy. Robot group received robot therapy, while combined group received both therapies. The effect of therapy was assessed with Motor-Free Visual Perception Test-3 (MVPT-3), line bisection test, star cancellation test, Catherine Bergego Scale (CBS), Mini-Mental State Examination (MMSE), and the Korean version of Modified Barthel Index (K-MBI). These measurements were evaluated before and after treatment.
Results For each group, 10 patients were recruited. There were no significant differences in baseline characteristics or initial values among the three groups. Two weeks after the therapy, all groups showed significant improvement in MVPT-3, line bisection test, star cancellation test, CBS, MMSE, and K-MBI. However, changes in measurements showed no significant differences among groups.
Conclusion Treatment effect of the combined therapy of robotic therapy and low-frequency rTMS therapy for hemispatial neglect was not statistically different from that of each single treatment. Results of this study did not prove the superiority of any of the three treatments. Further study with large number of patients is needed to evaluate the superiority of these treatments.
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Objective To investigate the relationship between peak cough flow (PCF), pulmonary function tests (PFT), and severity of dysphagia in patients with ischemic stroke.
Methods This study included patients diagnosed with ischemic stroke, who underwent videofluoroscopic swallowing study (VFSS), PCF and PFT from March 2016 to February 2017. The dysphagia severity was assessed using the videofluoroscopic dysphagia scale (VDS). Correlation analysis of VDS, PFT and PCF was performed. Patients were divided into three groups based on VDS score. One-way ANOVA of VDS was performed to analyze PCF, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and age among the different groups.
Results The correlation coefficients of VDS and PCF, VDS and FVC, and VDS and FEV1 were -0.836, -0.508, and -0.430, respectively, all of which were statistically significant at the level of p<0.001. The one-way ANOVA indicated statistically significant differences in PCF, FVC, FEV1, and age among the VDS groups. Statistically significant differences in VDS and age were observed between aspiration pneumoia and non-aspiration pneumonia groups.
Conclusion Coughing is a useful factor in evaluating the risk of aspiration in dysphagia patients. Evaluation of respiratory and coughing function should be conducted during the swallowing assessment of patients with ischemic stroke.
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Objective To elucidate the effect of a 12-week horizontal vibration exercise (HVE) in chronic low back pain (CLBP) patients as compared to vertical vibration exercise (VVE).
Methods Twenty-eight CLBP patients were randomly assigned to either the HVE or VVE group. All participants performed the exercise for 30 minutes each day, three times a week, for a total of 12 weeks. Altered pain and functional ability were evaluated using the visual analog scale (VAS) and Oswestry Disability Index (ODI), respectively. Changes in lumbar muscle strength, transverse abdominis (TrA) and multifidus muscle thicknesses, and standing balance were measured using an isokinetic dynamometer, ultrasonography, and balance parameters, respectively. These assessments were evaluated prior to treatment, 6 weeks and 12 weeks after the first treatment, and 4 weeks after the end of treatment (that is, 16 weeks after the first treatment).
Results According to the repeated-measures analysis of variance, there were significant improvements with time on VAS, ODI, standing balance score, lumbar flexor, and extensor muscle strength (all p<0.001 in both groups) without any significant changes in TrA (p=0.153 in HVE, p=0.561 in VVE group) or multifidus (p=0.737 in HVE, p=0.380 in VVE group) muscle thickness. Further, there were no significant differences between groups according to time in any of the assessments. No adverse events were noticed during treatment in either group.
Conclusion HVE is as effective as VVE in reducing pain, strengthening the lumbar muscle, and improving the balance and functional abilities of CLBP patients. Vibrational exercise increases muscle strength without inducing muscle hypertrophy.
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Objective To suggest rotation angles of fluoroscopy that can bypass the carotid sheath according to vertebral levels for cervical transforaminal epidural steroid injection (TFESI).
Methods Patients who underwent cervical spine magnetic resonance imaging (MRI) from January 2009 to October 2017 were analyzed. In axial sections of cervical spine MRI, three angles to the vertical line (α, angle not to insult carotid sheath; β, angle for the conventional TFESI; γ, angle not to penetrate carotid artery) were measured.
Results Alpha (α) angles tended to increase for upper cervical levels (53.3° in C6-7, 65.2° in C5-6, 75.3° in C4-5, 82.3° in C3-4). Beta (β) angles for conventional TFESI showed a constant value of 45° to 47° (47.5° in C6-7, 47.4° in C5-6, 45.7° in C4-5, 45.0° in C3-4). Gamma (γ) angles increased at higher cervical levels as did α angles (25.2° in C6-7, 33.6° in C5-6, 43.0° in C4-5, 56.2° in C3-4).
Conclusion The risk of causing injury by penetrating major vessels in the carotid sheath tends to increase at upper cervical levels. Therefore, prior to cervical TFESI, measuring the angle is necessary to avoid carotid vessels in the axial section of CT or MRI, thus contributing to a safer procedure.
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Objective To determine the socio-demographic, psychologic, hematologic, or other relevant factors associated with hand grip strength in Korean farmers.
Methods A total of 528 healthy Korean farmers were enrolled. Hand grip strength was measured in both hands using a hydraulic dynamometer. Socio-demographic characteristics were assessed and anthropometric measurements were obtained. Psycho-cognitive measurements such as sleep quality (Pittsburgh Sleep Quality Index) and Go/No-Go test response time were conducted. In addition to physical measurements, serologic parameters including insulin-like growth factor 1 were measured. The factors associated with hand grip strength were analyzed using multiple linear regression analysis after adjusting for age, height, and weight.
Results The mean hand grip strength was associated with the Pittsburgh Sleep Quality Index total score (β=-0.12, p=0.01), the Go/No-Go test response time (β=-0.18, p=0.001), vitamin D (β=0.12, p=0.02), and insulin-like growth factor 1 levels (β=0.1, p=0.045). In female farmers, hand grip strength was only associated with the Pittsburgh Sleep Quality Index total score (β=-0.32, p<0.001).
Conclusion The results of this study demonstrate that hand grip strength was associated with sleep quality and attention in Korean farmers.
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Objective To investigate and demonstrate persistent increase of peak cough flow after mechanical in-exsufflator application, in patients with neuromuscular diseases and pneumonia.
Methods A mechanical in-exsufflator was applied with patients in an upright or semi-upright sitting position (pressure setting, +40 and −40 cmH2O; in-exsufflation times, 2–3 and 1–2 seconds, respectively). Patients underwent five cycles, with 20–30 second intervals to prevent hyperventilation. Peak cough flow without and with assistive maneuvers, was evaluated before, and 15 and 45 minutes after mechanical in-exsufflator application.
Results Peak cough flow was 92.6 L/min at baseline, and 100.4 and 100.7 L/min at 15 and 45 minutes after mechanical in-exsufflator application, respectively. Assisted peak cough flow at baseline, 15 minutes, and 45 minutes after mechanical in-exsufflator application was 170.7, 179.3, and 184.1 L/min, respectively. While peak cough flow and assisted peak cough flow increased significantly at 15 minutes after mechanical in-exsufflator application compared with baseline (p=0.030 and p=0.016), no statistical difference was observed between 15 and 45 minutes.
Conclusion Increased peak cough flow after mechanical in-exsufflator application persists for at least 45 minutes.
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Methods Hematologic cancer patients admitted for chemotherapy were reviewed. They received a rehabilitation program during their hospital stay. DEMMI score measurement was performed, before and after rehabilitation. Demographics, diagnosis, chemotherapy information, rehabilitation program duration, mortality, body mass index (BMI), and laboratory test results were collected. For analysis, patients were classified according to diagnosis (multiple myeloma, leukemia, and others), mortality, and additional chemotherapy.
Results There was statistically significant improvement in DEMMI score of 10.1 points (95% confidence interval, 5.9–14.3) after rehabilitation. It was more evident in the multiple myeloma group, and they revealed less mortality. When patients were divided according to mortality, survivors received the program earlier, and in a shorter period than in mortality cases. Although survivors revealed higher initial DEMMI score, improvement after rehabilitation did not differ significantly.
Conclusion In hematologic cancer patients, rehabilitation program was effective for recovery from deconditioning, revealing significant increase in DEMMI score. Multiple myeloma patients may be good candidates for rehabilitation. Rehabilitation could be sustained during chemotherapy and for high-risk patients.
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Objective To compare the effects of low intensity ultrasound (LIUS), traditional exercise therapy (TET), low level laser therapy (LLLT) and TET on temporomandibular joint (TMJ) pain and trismus following recovery from head and neck cancer (HNC).
Methods Sixty participants following, who had experienced HNC, were randomly allocated to three groups of 20 people each. Each group received different therapy. Group A received LIUS and TET; group B received LLLT and TET; while group C received TET. All 60 participants were evaluated under the visual analog scale (VAS), the University of Washington Quality of Life questionnaire (UW-QOL) and the Vernier caliper scale (VCS) at the beginning of the therapies and after 4 weeks.
Results ANOVA test revealed significant improvements across all three groups with outcomes of p<0.05. The results of the UW-QOL questionnaire showed a significant difference between groups A, B and C in favor of group A (p<0.05). The VAS results showed a more improvement in group A as compared to group B (p<0.05), while there was no statistical difference between groups B and C (p>0.05). The VCS results showed more improvement for the individuals in group B as compared to those in group C (p<0.05), while there was minimal difference between groups A and B (p>0.05).
Conclusion The LIUS and TET are more effective than LLLT and/or TET in reducing TMJ pain and trismus following HNC.
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Objective To investigate the effect of treadmill training with eyes open (TEO) and closed (TEC) on the knee joint position sense (JPS), functional balance and mobility in children with spastic diplegia.
Methods Forty-five children with spastic diplegia aged 11–13 years participated in this study. They were randomly assigned to three groups of equal number. The control group (CON) underwent designed physical therapy program whereas, the study groups (TEO and TEC) underwent the same program, in addition to treadmill gait training with eyes open and closed, respectively. Outcome measures were the degree of knee joint position error, functional balance and mobility. Measurements were taken before and after 12 weeks of intervention.
Results After training, the three groups showed statistically significant improvement in all measured outcomes, compared to the baseline with non-significant change in the knee JPS in the CON group. When comparing posttreatment results, the TEC group showed greater significant improvement in all measured outcomes, than the TEO and CON groups.
Conclusion Treadmill training with eyes open and closed is effective in rehabilitation of children with diplegia, but blocked vision treadmill training has more beneficial effect.
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Objective To evaluate the association between progression of curvature of scoliosis, and correction for functional component in patients with juvenile idiopathic scoliosis (JIS).
Methods We retrospectively reviewed medical data of patients prescribed custom molded foot orthosis (FO) to correct inequality of RCSPA (resting calcaneal stance position angle), and chose 52 patients (26 females, 26 males) with Cobb angle ≥10° in radiology and uneven pelvic level at iliac crest by different RCSPA (≥3°) as a factor of functional scoliosis. They had different hump angle ≥5° in forward bending test, for idiopathic scoliosis component. Their mean age and mean period of wearing FO were 79.5±10.6 months and 18.6±0.70 months.
Results Cobb angle was reduced from 22.03°±4.39° initially to 18.86°±7.53° after wearing FO. Pelvis height difference and RCSPA difference, were reduced from 1.07±0.25 cm initially to 0.60±0.36, and from 4.25°±0.71° initially to 1.71°±0.75° (p<0.01). Cobb angle improved most in 9 months. However, there was no significant improvement for those with more than 25° of Cobb angle initially. Mean Cobb angle improved in all age groups, but patients less than 6 years had clinically significant improvement of more than 5°.
Conclusion JIS can have functional components, which should be identified and managed. Foot orthosis is useful in correcting functional factors, in the case of pelvic inequality caused by different RCSPA, for patients with juvenile idiopathic scoliosis.
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Methods The investigation was conducted in three separate hospitals with three healthy participants. IMUs were attached to the abdomen as well as the thigh, shank, and foot of both legs of each participant. Each participant then completed a 10-m gait course 10 times. During each gait cycle, the hips, knees, and ankle joints were observed from the sagittal, frontal, and transverse planes. The experiments were conducted with both a camerabased system and an IMU-based system. The measured gait analysis data were evaluated for validity and reliability using root mean square error (RMSE) and intraclass correlation coefficient (ICC) analyses.
Results The differences between the RMSE values of the two systems determined through kinematic parameters ranged from a minimum of 1.83 to a maximum of 3.98 with a tolerance close to 1%. The results of this study also confirmed the reliability of the IMU-based system, and all of the variables showed a statistically high ICC.
Conclusion These results confirmed that IMU-based systems can reliably replace camera-based systems for clinical body motion and gait analyses.
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Evaluating the difference in walk patterns among normal-weight and overweight/obese individuals in real-world surfaces using statistical analysis and deep learning methods with inertial measurement unit data Tasriva Sikandar, Mohammad Fazle Rabbi, Kamarul Hawari Ghazali, Omar Altwijri, Mohammed Almijalli, Nizam Uddin Ahamed Physical and Engineering Sciences in Medicine.2022; 45(4): 1289. CrossRef
Validity of an instrumented knee brace compared to 3D motion navigation: A cadaveric investigation Reneaud Nicolas, Pierre Emma, Zory Raphaël, Chorin Frédéric, Thomas Luc, Chavet Pascale, Coyle Thelma, Truchet Eric, Puech Stephane, Ollivier Matthieu, Chabrand Patrick, Gerus Pauline Measurement.2021; 173: 108590. CrossRef
Reliability and Validity of a Mobile Device for Assessing Head Control Ability Mohammad Nikkhoo, Chi-Chien Niu, Chen-Ju Fu, Meng-Ling Lu, Wen-Chien Chen, Yang-Hua Lin, Chih-Hsiu Cheng Journal of Medical and Biological Engineering.2021; 41(1): 45. CrossRef
IMU-Based Gait Normalcy Index Calculation for Clinical Evaluation of Impaired Gait Lei Wang, Yun Sun, Qingguo Li, Tao Liu, Jingang Yi IEEE Journal of Biomedical and Health Informatics.2021; 25(1): 3. CrossRef
Effects of vestibular neurectomy and neural compensation on head movements in patients undergoing vestibular schwannoma resection Omid A. Zobeiri, Gavin M. Mischler, Susan A. King, Richard F. Lewis, Kathleen E. Cullen Scientific Reports.2021;[Epub] CrossRef
Effects of knee osteoarthritis severity on inter-joint coordination and gait variability as measured by hip-knee cyclograms Jae Hyeon Park, Hyojin Lee, Jae-sung Cho, Inyoung Kim, Jongshill Lee, Seong Ho Jang Scientific Reports.2021;[Epub] CrossRef
Identification of Patients with Sarcopenia Using Gait Parameters Based on Inertial Sensors Jeong-Kyun Kim, Myung-Nam Bae, Kang Bok Lee, Sang Gi Hong Sensors.2021; 21(5): 1786. CrossRef
Assessing Stability of Crutch Users by Non-Contact Methods Achilles Vairis, Suzana Brown, Maurice Bess, Kyu Hyun Bae, Jonathan Boyack International Journal of Environmental Research and Public Health.2021; 18(6): 3001. CrossRef
An Approach to Acquire Path-Following Skills by Industrial Robots From Human Demonstration Angel Rodriguez-Linan, Ismael Lopez-Juarez, Alan Maldonado-Ramirez, Antonio Zalapa-Elias, Luis Torres-Trevino, Jose Luis Navarro-Gonzalez, Pamela Chinas-Sanchez IEEE Access.2021; 9: 82351. CrossRef
Measurement of Ankle Joint Movements Using IMUs during Running Byong Hun Kim, Sung Hyun Hong, In Wook Oh, Yang Woo Lee, In Ho Kee, Sae Yong Lee Sensors.2021; 21(12): 4240. CrossRef
Immediate Effect of Restricted Knee Extension on Ground Reaction Force and Trunk Acceleration during Walking Hiroshi Osaka, Daisuke Fujita, Kenichi Kobara, Tadanobu Suehiro, Jae-Young Lim Rehabilitation Research and Practice.2021; 2021: 1. CrossRef
Investigating the validity of a single tri-axial accelerometer mounted on the head for monitoring the activities of daily living and the timed-up and go test Vahid Abdollah, Tarek N. Dief, John Ralston, Chester Ho, Hossein Rouhani Gait & Posture.2021; 90: 137. CrossRef
Discriminative Mobility Characteristics between Neurotypical Young, Middle-Aged, and Older Adults Using Wireless Inertial Sensors Clayton W. Swanson, Brett W. Fling Sensors.2021; 21(19): 6644. CrossRef
Development of a Lower Limb Finite Element Musculoskeletal Gait Simulation Framework Driven Solely by Inertial Measurement Unit Sensors Sentong Wang, Kazunori Hase, Susumu Ota Biomechanics.2021; 1(3): 293. CrossRef
JTrack: A Digital Biomarker Platform for Remote Monitoring of Daily-Life Behaviour in Health and Disease Mehran Sahandi Far, Michael Stolz, Jona M. Fischer, Simon B. Eickhoff, Juergen Dukart Frontiers in Public Health.2021;[Epub] CrossRef
Analysis of Gait Characteristics Using Hip-Knee Cyclograms in Patients with Hemiplegic Stroke Ho Seok Lee, Hokyoung Ryu, Shi-Uk Lee, Jae-sung Cho, Sungmin You, Jae Hyeon Park, Seong-Ho Jang Sensors.2021; 21(22): 7685. CrossRef
Feasibility Validation on Healthy Adults of a Novel Active Vibrational Sensing Based Ankle Band for Ankle Flexion Angle Estimation Peiqi Kang, Shuo Jiang, Peter B. Shull, Benny Lo IEEE Open Journal of Engineering in Medicine and Biology.2021; 2: 314. CrossRef
Motion quality in rotator cuff tear using an inertial measurement unit: new parameters for dynamic motion assessment Jae-Man Kwak, Tae-Hyun Ha, Yucheng Sun, Erica Kholinne, Kyoung-Hwan Koh, In-Ho Jeon Journal of Shoulder and Elbow Surgery.2020; 29(3): 593. CrossRef
Age-Related Changes in Smoothness of Gait of Healthy Children and Early Adolescents Bruno Leban, Veronica Cimolin, Micaela Porta, Federico Arippa, Giuseppina Pilloni, Manuela Galli, Massimiliano Pau Journal of Motor Behavior.2020; 52(6): 694. CrossRef
Concurrent validity and inter trial reliability of a single inertial measurement unit for spatial-temporal gait parameter analysis in patients with recent total hip or total knee arthroplasty Marco Bravi, Emilio Gallotta, Michelangelo Morrone, Mirella Maselli, Fabio Santacaterina, Rossana Toglia, Calogero Foti, Silvia Sterzi, Federica Bressi, Sandra Miccinilli Gait & Posture.2020; 76: 175. CrossRef
Determining the Most Appropriate Assistive Walking Device Using the Inertial Measurement Unit-Based Gait Analysis System in Disabled Patients Junhee Lee, Chang Hoon Bae, Aeri Jang, Seoyon Yang, Hasuk Bae Annals of Rehabilitation Medicine.2020; 44(1): 48. CrossRef
Accuracy and repeatability of smartphone sensors for measuring shank-to-vertical angle Brandon T Nguyen, Nick A Baicoianu, Darrin B Howell, Keshia M Peters, Katherine M Steele Prosthetics & Orthotics International.2020; 44(3): 172. CrossRef
3D motion tracking of the shoulder joint with respect to the thorax using MARG sensors and data fusion algorithm José Antonio Barraza Madrigal, Jessica Cantillo Negrete, Roberto Muñoz Guerrero, Lauro Armando Contreras Rodríguez, Humberto Sossa Biocybernetics and Biomedical Engineering.2020; 40(3): 1205. CrossRef
Changes in symmetry during gait in adults with Prader-Willi syndrome Veronica Cimolin, Massimiliano Pau, Nicola Cau, Bruno Leban, Micaela Porta, Paolo Capodaglio, Alessandro Sartorio, Graziano Grugni, Manuela Galli Computer Methods in Biomechanics and Biomedical Engineering.2020; 23(14): 1094. CrossRef
Kinematics and temporospatial parameters during gait from inertial motion capture in adults with and without HIV: a validity and reliability study Karina Berner, John Cockcroft, Quinette Louw BioMedical Engineering OnLine.2020;[Epub] CrossRef
Quantitative Modeling of Spasticity for Clinical Assessment, Treatment and Rehabilitation Yesung Cha, Arash Arami Sensors.2020; 20(18): 5046. CrossRef
Inertial Sensors as a Tool for Diagnosing Discopathy Lumbosacral Pathologic Gait: A Preliminary Research Sebastian Glowinski, Karol Łosiński, Przemysław Kowiański, Monika Waśkow, Aleksandra Bryndal, Agnieszka Grochulska Diagnostics.2020; 10(6): 342. CrossRef
Estimating Walking Speed in the Wild Loubna Baroudi, Mark W. Newman, Elizabeth A. Jackson, Kira Barton, K. Alex Shorter, Stephen M. Cain Frontiers in Sports and Active Living.2020;[Epub] CrossRef
Novel Method of Classification in Knee Osteoarthritis: Machine Learning Application Versus Logistic Regression Model Jung Ho Yang, Jae Hyeon Park, Seong-Ho Jang, Jaesung Cho Annals of Rehabilitation Medicine.2020; 44(6): 415. CrossRef
Validity of Measurement for Trailing Limb Angle and Propulsion Force during Gait Using a Magnetic Inertial Measurement Unit Takasuke Miyazaki, Masayuki Kawada, Yuki Nakai, Ryoji Kiyama, Kazunori Yone BioMed Research International.2019; 2019: 1. CrossRef
We report a female proband carrying a de novo 5q34-q35.2 deletion breakpoint, and review the unique skeletal phenotype and possible genotype related to this mutation. The patient presented with a persistent head tilt and limited head rotation. Non-contrast-enhanced three-dimensional computed tomography of the cervical spine revealed several malformations including a bone cleft in the right pars interarticularis, a bone defect in both C5 lamina and the transverse foramen at C2–C3, agenesis of the right articular process of C5, bony fusion of C4–C5, and subluxation of the craniocervical joints. Several deformities of the cervical spine seen in this patient have not been associated with the 5q deletion. A review of 5q-related mutations suggests that abnormalities associated with MSX2 gene might cause cervical spine abnormalities.
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