Objective
To systematically translate the Duchenne muscular dystrophy Functional Ability Self-Assessment Tool (DMDSAT) into Korean and verify the reliability and validity of the Korean version (K-DMDSAT).
Methods
The original DMDSAT was translated into Korean by two translators and two pediatric physiatrists. A total of 88 patients with genetically confirmed Duchenne muscular dystrophy (DMD) participated in the study. They were evaluated using the K-DMDSAT once as a self-assessment and once by an interviewer. The interviewer evaluated the K-DMDSAT again 1 week later using a test-retest approach. The intraclass correlation coefficient (ICC) was used to verify the interrater and test-retest reliabilities. Pearson correlation analysis between the K-DMDSAT and the Brooke or Vignos scales were used to assess validity.
Results
The total score and all domains of the K-DMDSAT showed excellent interrater and test-retest reliability, with an ICC for total scores of 0.985 and 0.987, respectively. All domains had an ICC >0.90. From the Pearson correlation analysis, the total K-DMDSAT score was significantly correlated with the Vignos and Brooke scales (r=0.918 and 0.825, respectively; p<0.001), and each domain of K-DMDSAT showed significant correlation with either the Vignos or Brooke scales.
Conclusion
DMDSAT was systematically translated into Korean, and K-DMDSAT was verified to have excellent reliability and validity. K-DMDSAT can help clinicians easily describe and categorize various functional aspects of patients with DMD through the entire disease progression.

Citations

• Muscle Pathology Associated With Cardiac Function in Duchenne Muscular Dystrophy
  Jin A Yoon, Heirim Lee, In Sook Lee, You Seon Song, Byeong-Ju Lee, Soo-Yeon Kim, Yong Beom Shin
  Annals of Rehabilitation Medicine.2024; 48(6): 405.     CrossRef

Objective
To evaluate treadmill backward walking training (BWT) effects on walking speed, balance, mobility, and walking endurance in children with cerebral palsy (CP).
Methods
The study evaluated 41 children with CP (age, 6–18; Gross Motor Function Classification System levels I and II). They were randomly allocated into control and BWT groups. BWT was applied (two sessions/week, 15 min/session for 8-week) to BWT group after the neurodevelopmental-based physiotherapy program routinely followed by all participants while the control group did not receive BWT. 10-Meter Walk Test (10MWT), Pediatric Balance Scale (PBS), Timed Up and Go Test (TUG), and Two-Minute Walk Test (2MWT) were selected as outcome measures for assessing walking speed, balance, mobility and endurance respectively.
Results
In BWG, 2MWT distance (3.5%), PBS (3.5%) increased significantly, and TUG decreased by 5.1% (all p<0.001) after training, 10MWT was shorter by 6.1% for BWG, corresponding to 7.4% faster walking speed (p<0.01). Control group assessment variations were stationary and not statistically significant.
Conclusion
Backward treadmill walking training induces small but statistically significant motor capacity improvements in children with CP.

Citations

• Quiet standing and anteroposterior limits of stability in adolescents and young adults with bilateral spastic cerebral palsy
  Hidehito Tomita, Daisuke Kawaguchi, Shuhei Takahashi, Hitoshi Asai
  Human Movement Science.2024; 95: 103215.     CrossRef

Objective
To investigate the relationship between Trunk Impairment Scale (TIS) and lumbar spine bone mineral density (BMD) in subacute stroke patients.
Methods
Twenty-three subacute male stroke patients under the age of 65 were prospectively enrolled to exclude both postmenopausal and senile effects on BMD. The TIS, Berg Balance Scale, the Korean version of the Modified Barthel Index, and manual muscle test were measured at admission and 3 months after stroke onset. BMD of the bilateral lower extremities and lumbar vertebrae was measured by dual-energy X-ray absorptiometry 3 months after stroke onset.
Results
TIS at baseline (TIS_B) and TIS at 3 months after stroke (TIS_3m) showed significant correlations with lumbar BMD (TIS_B, r=0.522; TIS_3m, r=0.517). Through multiple regression analysis, the TIS_B was associated with lumbar BMD (adjusted R2=0.474). However, BMD of the bilateral lower extremities was not correlated with any clinical measurements except body mass index.
Conclusion
We found a relationship between TIS_B and lumbar BMD in subacute young male stroke patients. Stroke patients with poor trunk control in the early subacute stage would have low BMD of vertebral bones at 3 months. The TIS can be useful for estimating bone fragility in the lumbar vertebrae of subacute stroke patients.

Citations

• Effects of shoulder brace usage on postural stability in stroke survivors: A pilot randomized controlled trial
  Giovanni Morone, Alessandro Antonio Princi, Marco Iosa, Rebecca Montemurro, Irene Ciancarelli, Paola Coiro, Danilo Lisi, Riccardo Savo, Matteo Notturno Granieri, Domenico De Angelis, Marco Tramontano
  NeuroRehabilitation.2024; 54(3): 449.     CrossRef

Objective
To evaluate the feasibility and usability of cost-effective complex upper and lower limb robot-assisted gait training in patients with stroke using the GTR-A, a foot-plate based end-effector type robotic device.
Methods
Patients with subacute stroke (n=9) were included in this study. The enrolled patients received 30-minute robot-assisted gait training thrice a week for 2 weeks (6 sessions). The hand grip strength, functional ambulation categories, modified Barthel index, muscle strength test sum score, Berg Balance Scale, Timed Up and Go Test, and Short Physical Performance Battery were used as functional assessments. The heart rate was measured to evaluate cardiorespiratory fitness. A structured questionnaire was used to evaluate the usability of robot-assisted gait training. All the parameters were evaluated before and after the robot-assisted gait training program.
Results
Eight patients completed robot-assisted gait training, and all parameters of functional assessment significantly improved between baseline and posttraining, except for hand grip strength and muscle strength test score. The mean scores for each domain of the questionnaire were as follows: safety, 4.40±0.35; effects, 4.23±0.31; efficiency, 4.22±0.77; and satisfaction, 4.41±0.25.
Conclusion
Thus, the GTR-A is a feasible and safe robotic device for patients with gait impairment after stroke, resulting in improvement of ambulatory function and performance of activities of daily living with endurance training. Further research including various diseases and larger sample groups is necessary to verify the utility of this device.

Citations

• Changes in body composition, physical fitness and quality of life on robotic gait assisted training in patients with Guillain-Barré Syndrome: a case report
  Moon Jin Lee, Sung Jin Yoon
  Physical Activity and Nutrition.2024; 28(4): 009.     CrossRef
• Smart Devices for Health and Wellness Applied to Tele-Exercise: An Overview of New Trends and Technologies Such as IoT and AI
  Antonio Fabbrizio, Alberto Fucarino, Manuela Cantoia, Andrea De Giorgio, Nuno D. Garrido, Enzo Iuliano, Victor Machado Reis, Martina Sausa, José Vilaça-Alves, Giovanna Zimatore, Carlo Baldari, Filippo Macaluso
  Healthcare.2023; 11(12): 1805.     CrossRef

Objective
To define the effect of the inspiratory method and cough timing on peak cough flow (PCF).
Methods
We investigated the effect of measurement conditions on PCF in healthy subjects (n=10). We then compared obstructive and restrictive pulmonary diseases (n=20) to assess for similar results in respiratory diseases. The PCF was measured under four conditions: before coughing, without maneuver 1 or with maneuver 2 a temporary respiratory pause (4–6 seconds) after rapid inspiration, and without maneuver 3 or with maneuver 4 a temporary respiratory pause after slow inspiration. After the measurements were completed, the PCF between the four conditions was compared for each subject group, and the effect size was calculated.
Results
PCF of maneuvers 1 and 3 were significantly higher than maneuver 4 in healthy subjects (476.34±102.05 L/min and 463.44±107.14 L/min vs. 429.54±116.83 L/min, p<0.01 and p<0.05, respectively) and patients with restrictive pulmonary disease (381.96±145.31 L/min, 354.60±157.36 L/min vs. 296.94±137.49 L/min, p<0.01 and p<0.05, respectively). In obstructive pulmonary disease, maneuver 1 was significantly higher than maneuver 4 (327.42±154.73 L/min vs. 279.48±141.10 L/min, p<0.05). The largest effect sizes were shown by maneuvers 4 and 1.
Conclusion
PCF depends on changes in inspiratory speed before coughing and on temporary respiratory pauses after maximal inspiration. It will become necessary to unify the measurement methods for coughing strength and present appropriate coughing methods.

Citations

• Factors related to pre-operative cough strength in cardiac surgical patients: a cross-sectional study
  Yan Zhang, Zheng Lin, Yuhong Chen, Liang Hong, Xiao Shen
  Heart & Lung.2024; 63: 128.     CrossRef

Objective
To assess the relationships between phase angle and muscle mass, strength, and physical function in patients with heart failure.
Methods
This study used a cross-sectional design. The analysis included 51 patients with heart failure. The Short Physical Performance Battery, one-leg standing time, handgrip strength, phase angle, and skeletal muscle index were measured. To identify explanatory variables of phase angle, hierarchical multiple regression analysis was performed.
Results
Handgrip strength was found to be an explanatory variable of phase angle independent of age, sex, and body mass index. This model was able to explain 30.4% of the model variance for phase angle.
Conclusion
In patients with heart failure, improving muscle strength rather than muscle mass or physical function might be more important for improving phase angle. Handgrip strength is an important outcome for improving prognosis in patients with heart failure.

Citations

• Phase Angle and Impedance Ratio as Indicators of Physical Function and Fear of Falling in Older Adult Women: Cross-Sectional Analysis
  Danielle A Sterner, Jeffrey R Stout, Kworweinski Lafontant, Joon-Hyuk Park, David H Fukuda, Ladda Thiamwong
  JMIR Aging.2024; 7: e53975.     CrossRef
• Prevalence and clinical characteristics of Sarcopenia in older adult patients with stable chronic obstructive pulmonary disease: a cross-sectional and follow-up study
  Sang Hun Kim, Cho Hui Hong, Myung-Jun Shin, Ki Uk Kim, Tae Sung Park, Jun Yong Park, Yong Beom Shin
  BMC Pulmonary Medicine.2024;[Epub]     CrossRef
• Malnutrition in Amyotrophic Lateral Sclerosis: Insights from Morphofunctional Assessment and Global Leadership Initiative on Malnutrition Criteria
  María Teresa Zarco-Martín, Carmen Freire, María Carmen Andreo-López, Socorro Leyva-Martínez, María Luisa Fernández-Soto
  Nutrients.2024; 16(16): 2625.     CrossRef

Objective
To investigate the clinical and swallowing characteristics related to respiratory infection in patients with parkinsonism.
Methods
One hundred and forty-two patients with parkinsonism who underwent videofluoroscopic swallowing studies (VFSS) were enrolled in this study. The initial clinical and VFSS characteristics were compared between patients with and without a history of respiratory infection in the past year. A multivariate logistic regression model was applied to identify clinical and swallowing characteristics related to respiratory infections.
Results
Patients with respiratory infections were older (74.75±10.20 years vs. 70.70±8.83 years, p=0.037), had a higher Hoehn and Yahr (H&Y) stage (stage IV–V, 67.9% vs. 49.1%; p=0.047), and were more likely to have a diagnosis of idiopathic Parkinson’s disease (IPD) (67.9% vs. 41.2%, p=0.011) than those without respiratory infections. Among VFSS findings, bolus formation, premature bolus loss, oral transit time, pyriform sinus residues, pharyngeal wall coatings, and penetration/aspiration were significantly worse in patients with respiratory infections (p<0.05). Regarding clinical characteristics, higher H&Y stage (odds ratio [OR], 3.174; 95% confidence interval [CI], 1.226–8.216; p=0.017) and diagnosis of IPD (OR, 0.280, 95% CI, 0.111–0.706; p=0.007) were significantly related to respiratory infections in the multivariate analysis. Among VFSS findings, pyriform sinus residue (OR, 14.615; 95% CI, 2.257–94.623; p=0.005) and premature bolus loss (OR, 5.151; 95% CI, 1.047–25.338; p=0.044) were also significantly associated with respiratory infection.
Conclusion
This study suggests that disease severity, diagnosis, pyriform sinus residue, and premature bolus loss observed in VFSS are associated with respiratory infection in patients with parkinsonism.