Quadruple amputation, defined as the loss of all four limbs, is an exceptionally rare condition. Conventional gait training is particularly challenging in this population because the absence of upper limbs limits the ability to grasp assistive devices that are essential for maintaining balance and stability during walking. End-effector robot-assisted gait training offers an alternative rehabilitation strategy that enables upright mobility and task-specific gait training for patients who experience substantial difficulty performing conventional gait training. This approach provides safe, repetitive, and hands-free gait training for individuals with quadruple amputation, resulting in measurable improvements in balance, ground reaction force, and functional mobility. We report two cases of successful amputee gait rehabilitation using an end-effector–type gait robot in two females (aged 72 and 51 years) with quadruple amputation.

Objective
This cross-sectional pilot study aimed to translate, culturally adapt, and validate the Korean version of the Pediatric Eating Assessment Tool-10 (K-Pedi-EAT-10).
Methods
To translate, culturally adapt, and validate the Korean version of the Pediatric Eating Assessment Tool-10 (K-Pedi-EAT-10).
Results
The K-Pedi-EAT-10 demonstrated excellent internal consistency (Cronbach’s α=0.956) and strong test–retest reliability (ICC=0.988; 95% CI, 0.971–0.995). Content validity indices were high (I-CVI>0.80 for all items; S-CVI/Ave=0.92 for relevance, 0.88 for clarity). Children with dysphagia showed markedly higher K-Pedi-EAT-10 total scores (16.15±9.24) than controls (0.31±0.72; U=9.5, Z=-4.053, p<0.001), confirming discriminative validity. Higher K-Pedi-EAT-10 scores were observed in children with aspiration (Penetration-Aspiration Scale [PAS]≥6) than in those without (p<0.05). Significant correlations were found between K-Pedi-EAT-10 total and PAS scores (r=0.705, p=0.007), confirming its potential utility as a screening tool that reflects aspiration severity without radiation exposure from videofluoroscopic swallowing study. Receiver operating characteristic analysis yielded an area under the curve of 0.98 (95% CI, 0.95–1.00) and identified a cut-off score of 19 for predicting aspiration, with 100% sensitivity and 85.7% specificity.
Conclusion
The K-Pedi-EAT-10 is a reliable, valid, and non-invasive tool for screening pediatric dysphagia. Its strong psychometric performance supports its potential use for the early identification and timely intervention of children at risk for dysphagia in clinical practice.

Objective
To investigate the effects of small group speech therapy consisting of two children in aspects of language and social development and identify powerful predictors for maximal therapeutic gains of two-person small-group speech therapy (2-SST).
Methods
We retrospectively reviewed the medical records of 51 children, who had participated in 2-SST. Language and social abilities of children were assessed using multiple scales at initial and follow-up visits after participating in 2-SST program. Receptive and expressive language were measured using the Preschool Receptive-Expressive Language Scale and the Receptive-Expressive Vocabulary Test, while social abilities were assessed with the Social Maturity Scale.
Results
Participants in the 2-SST showed significant improvements in all categories of receptive/ expressive language and social abilities. Multivariable linear regression analysis revealed that the same diagnosis and baseline receptive language ability difference and intellectual ability difference from paired-child were powerful predictors of improvement in receptive language ability. Younger age (≤5 years) was a powerful predictor of improvement in expressive language ability. Older age (>5 years) was an independent predictor of improvement in social ability.
Conclusion
The 2-SST can be an appropriate delivery model to improve language and social skills with advantages of both individual and group speech therapy. For maximal therapeutic gains of 2-SST, same diagnosis, similar language and cognitive level with paired-child, and age should be considered depending on the more specific goals of treatment.

Upper limb amputation leads to significant physical and psychosocial burden; however, it remains underrepresented in global epidemiological and rehabilitation studies. This study aimed to systematically review the global epidemiological data on upper limb amputation, focusing on its prevalence, incidence, anatomical levels, and etiology. According to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a comprehensive literature search was conducted using PubMed, Embase, Cochrane Library, and Regional Information Sharing Systems (up to May 2023). Two authors independently selected the studies, assessed their methodological quality, and summarized the evidence. Nineteen studies were finally included in this study. The prevalence of major upper limb amputation was higher in individuals with disabilities than in the general population. The prevalence in general population was 11.6 per 100,000 adults between 2006 and 2008 in Norway, whereas the prevalence in individuals with disabilities was 6.9 per 1,000 individuals in 2011 and increased to 11.3 per 1,000 individuals in 2020 in South Korea. The incidence rates were generally higher in the occupational population than in the general population. Below-elbow amputation was consistently the most common major amputation level reported. Although traumatic causes were predominant, medical conditions substantially contributed to upper limb impairment among individuals with disabilities. Upper limb amputation presents significant global variations in prevalence, incidence, anatomical level, and cause. The scarcity of standardized, disaggregated data limits effective planning for prosthetic services and rehabilitation. Future studies should prioritize comprehensive data collection to support equitable healthcare delivery and inform prosthetic innovation.

Objective
To compare the immediate recovery effects of cold compression (CC) and ischemic preconditioning with ice (IPCice) on muscle recovery, this study was conducted.
Methods
Athletes were randomly assigned to CC (n=12), IPCice (n=12), or control (n=12) groups. All participants completed a fatigue-inducing jump rope protocol targeting the gastrocnemius prior to recovery interventions. CC involved 20 minutes of alternating pressure (25–75 mmHg) on the gastrocnemius muscles. IPCice involved thigh cuffs inflated to 200 mmHg (2 minutes on/off cycles for 20 minutes) with manual ice application. Thirty-six amateur mixed martial arts (MMA) athletes. Muscle pain, congestion, strength, creatine kinase, muscle stiffness, perfusion, pressure pain threshold, reactive strength index, and total quality recovery were assessed at rest, post-exercise, post-treatment, and 48 hours later.
Results
Post-treatment, CC significantly improved perfusion (p<0.001) and reduced muscle soreness in both legs compared to IPCice and control (p≤0.02). CC also resulted in significantly higher PPT values (p≤0.006). Benefits on some variables remained at 48 hours.
Conclusion
Both modalities enhanced recovery following fatiguing exercise; however, CC demonstrated superior effectiveness in attenuating fatigue-related impairments, particularly in perfusion, soreness, and muscle function, highlighting its practical advantage over IPCice for MMA athletes.

Objective
To investigate the psychometric properties of the balance self-efficacy (BSE) scale in people with stroke.
Methods
This is a cross-sectional study held in a university-based rehabilitation center. Sixty- three people with stroke and 30 healthy older adults were included from the community dwelling. The people with stroke underwent the following assessments in a random order: the BSE, Fugl-Meyer Assessment of Lower Extremity (FMA-LE), muscle strength of plantar flexors and dorsiflexors, Montreal Cognitive Assessment, Berg Balance Scale, Limit of Stability (LOS), Foot and Ankle Ability Measure (FAAM), 12-Item Short Form Survey (SF-12) version 2, and Oxford Participation and Activities Questionnaire (Ox-PAQ). The healthy older adults were assessed with BSE.
Results
The BSE scale demonstrated good test-retest reliability (intraclass correlation coefficient= 0.796) with minimal detectable change at a 95% confidence interval of 433.74 and cut-off score of 1,225, which best differentiated between people with stroke and healthy older adults. The BSE score was significantly correlated with the FMA-LE score, muscle strength of the affected side ankle dorsiflexor and plantar flexor, LOS parameter, FAAM, SF- 12, and Ox-PAQ scores.
Conclusion
The BSE scale is a reliable clinical tool with good test-retest reliability. The BSE scores were significantly correlated with other outcome measures that assess motor functions, balance, and quality of life. It is a simple and easy-to-administer outcome measure for assessing BSE in people with stroke.

Objective
To compare the walking ability, mobility, and satisfaction among 24 ambulatory participants with stroke while walking under four conditions: without an ankle support device (ASD), with a plastic ankle-foot orthosis (AFO), and with two types of elastic ASDs— namely, a long ankle sling made from a 3- to 4-inch bandage, and elastic ankle support equipment (EASE) made from elastic bands with buttonholes and rivet buttons.
Methods
This crossover design study assessed spatiotemporal gait variables and mobility using the Timed Up and Go test (TUG) while participants walked under the four conditions in random order. They then completed a self-report questionnaire regarding satisfaction with the three ASDs. The findings were compared using the Friedman and Wilcoxon signed rank test.
Results
The participants’ spatiotemporal and TUG data improved significantly when walking with a long ankle sling and EASE compared to the other two conditions (p<0.05). Participants satisfied with the dimensions, weight, safety, security, and effectiveness of the long ankle sling and EASE (p<0.001). The EASE was also comfortable and easy to adjust, whereas the AFO was noted for its durability (p<0.01).
Conclusion
With the design to promote mobility during both the swing and stance phases, the present findings support the clinical benefits of elastic ASDs, specifically a long ankle sling and EASE. The EASE is also user-friendly; thus, it can be applied in various clinical and community settings, particularly in those with limited budget.

Objective
To test the feasibility and usability of an artificial intelligence (AI)-guided mobile cognitive telerehabilitation program for patients with stroke or older adults with mild cognitive impairment (MCI).
Methods
Thirteen participants with cognitive impairment (Mini-Mental State Examination [MMSE] score≤26; nine with stroke and four with MCI) were enrolled in the study. Each participant was provided with an AI-guided mobile cognitive rehabilitation program (Zenicog®). Participants were instructed to complete 24 sessions within 6 weeks, and those with sufficient adherence (≥70%, 17 sessions) were included in the analysis. Cognitive assessments included the MMSE, digit span, and Trail Making Tests A & B. The usability questionnaire investigated equitable use and flexibility in use, simple and intuitive use, perceptible information, tolerance for error, low physical effort, size and space for use, overall product quality, overall satisfaction.
Results
Eleven participants completed the study, and 10 participants met adherence criteria. The MMSE score increased significantly from 24.00 [21.00, 25.75] at baseline to 27.50 [26.00, 28.75] after intervention. The overall product quality (Likert scale: 1–5) score was 4.00±0.87. The lowest score in the usability questionnaire was for tolerance for error. Female participants and participants with <12 years’ education gave lower scores for tolerance for error and equitable/ flexibility in use, respectively.
Conclusion
The AI-guided mobile cognitive telerehabilitation program is feasible and potentially beneficial for improving cognitive function in patients with stroke or older adults with MCI. Individuals who are less familiar with electronic devices require special consideration to improve their usability.

Objective
To compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on cardiovascular function, gait ability, and hematological variables in chronic stroke survivors.
Methods
Twenty-nine higher-functioning, ambulatory chronic stroke survivors were randomized to HIIT (n=15) or MICT (n=14). Participants underwent supervised training three times weekly for six weeks, consisting of 30 minutes conventional therapy followed by 40 minutes aerobic exercise (HIIT: six 1-minute high-intensity intervals at 80%–100% maximum heart rate (HRmax) with 4-minute active recovery; MICT: continuous exercise at 60%–80% HRmax). Outcomes included cardiovascular function (maximal oxygen uptake [VO2max], HRmax, walking heart rate), gait (10-Meter Walk Test, Timed Up and Go test, 6-Minute Walk Test), and lipid profiles (low-density lipoprotein, high-density lipoprotein, triglycerides).
Results
In this higher-functioning cohort (n=29), HIIT showed significantly greater improvements than MICT in VO2max (F=40.574, p=0.001), HR_max (F=24.661, p=0.001), walking heart rate (F=11.277, p=0.002), 10-Meter Walk Test (F=20.865, p=0.001), Timed Up and Go test (F=12.317, p=0.002), and 6-Minute Walk Test (F=9.742, p=0.004). Lipid profiles improved significantly within the HIIT group only (p<0.05), no between-group differences were observed.
Conclusion
In higher-functioning chronic stroke survivors, HIIT was superior to MICT for cardiovascular fitness and functional mobility under a matched exposure; lipid changes occurred within HIIT only without between-group effects. These findings support incorporating HIIT into stroke rehabilitation programs to enhance recovery outcomes.

Adolescent idiopathic scoliosis (AIS) is the most encountered spinal deformity in growing children, which may bring significant impacts on patients’ physical function, appearance, and overall quality of life. A physiatrist plays a crucial role in the early diagnosis of AIS and longitudinal management through continuous care. Contemporary management for AIS is according to the skeletal maturity, the magnitude of the spinal curves, and the risk of progression. For mild curves, therapeutic exercises, particularly physiotherapeutic scoliosis-specific exercises (PSSE), are employed as a conservative approach to improve postural symmetry and reduce the risk of curve progression. Bracing is required for moderate curves from 25 to 45 degrees in skeletally immature cases. Strict compliance with bracing is critical for therapeutic success. In cases that are rapidly progressive or in severe curves exceeding 40 to 45 degrees, spinal fusion surgery is considered the definitive treatment. Recent advancements in non-fusion and motion-preserving techniques provide alternative options to traditional fusion surgery. To protect maximal neurological function, intraoperative neurophysiological monitoring (IONM) is currently the trend for spinal deformity correction surgery. The care for AIS patients is an individualized, multidisciplinary, patient-centered, growth-sensitive approach, aiming to optimize outcomes and minimize long-term complications. This review outlines a comprehensive rehabilitation-oriented strategy for AIS patients from the perspective of a physiatrist, encompassing clinical assessment, conservative management with observation, therapeutic exercises, bracing, and further considerations in referral to spinal surgery.

Objective
To compare the efficacy, safety, and patient compliance of tele-cardiac rehabilitation (T-CR) versus center-based cardiac rehabilitation (C-CR) in patients with coronary artery disease (CAD). A secondary aim was to assess the effects of both interventions on quality of life (QoL) and kinesiophobia.
Methods
This nonrandomized, patient-preference controlled trial included 40 CAD patients (83% post-myocardial infarction) at a university hospital. Participants selected either C-CR or T-CR. The four-week intervention included supervised in-hospital exercise (C-CR) or telemonitored exercise with heart rate feedback (T-CR). The primary outcome was peak oxygen uptake (VO2 peak). Secondary outcomes included VO2 at ventilatory anaerobic threshold (VO2 at VAT), time to VAT, oxygen pulse, QoL, Fear of Activity in Patients with Coronary Artery Disease (Fact-CAD) scores, and exercise adherence.
Results
Baseline VO2 peak was higher in the T-CR group (23.2±3.5 vs. 19.4±4.2, p=0.004). Rehabilitation improved VO2 peak (p<0.001), VO2 at VAT (p=0.004), and time to VAT (p<0.001) in both groups. Fact-CAD scores decreased (p=0.004), and QoL improved (p<0.001). However, C-CR led to greater kinesiophobia reduction (p=0.038) and slightly higher QoL improvements (p=0.05). T-CR participants completed more exercise sessions (14.9±2.9 vs. 12.0±0, p<0.001), with no serious adverse events reported.
Conclusion
T-CR is a safe and effective alternative to C-CR, providing similar physiological benefits. However, C-CR may be superior in reducing kinesiophobia. Future studies should assess long-term adherence and psychological outcomes in diverse populations.

Objective
To explore subjective vitality and mental health among individuals with spinal cord injury (SCI) in South Korea; specifically the relationship between subjective vitality and mental health and their associations with SCI-related factors, including health conditions, activity, environmental, and personal factors.
Methods
This cross-sectional study utilized data from the International Spinal Cord Injury Community Survey conducted in South Korea between March and October 2017. Data from 688 community-dwelling individuals with SCI were included in this study. Correlation and multiple regression analyses were conducted to investigate the relationships between vitality, mental health, and their associated factors.
Results
A strong positive correlation was identified between subjective vitality and mental health (r=0.78, p<0.001). In multiple regression analyses, common factors significantly associated with both domains included sleep problems, healthcare-related activities, financial burden, self-efficacy, and belongingness. Bowel problems were associated only with subjective vitality, while pressure injury and perceived social attitudes were associated only with mental health.
Conclusion
These findings highlight the importance of comprehensive approaches that address secondary health complications, promote healthcare education, and alleviate financial burdens to enhance both subjective vitality and mental health in individuals with SCI. Additionally, psychological interventions that foster belongingness and strengthen self-efficacy may further contribute to psychological well-being following SCI. Further research is needed to validate these associations and evaluate the long-term effects of such multidimensional strategies on subjective vitality and overall quality of life following SCI.

Objective
To assess patient gait ability by capturing both trend and scale aspects, this study proposes a method using the Pearson correlation coefficient and symmetric mean absolute percentage error (SMAPE).
Methods
Gait patterns from three patients with hip osteoarthritis (OA) were analyzed using kinematic and kinetic data. In each case, using MAPE or Pearson correlation alone failed to provide a reliable assessment, revealing limitations in capturing the full characteristics of gait patterns.
Results
The combined use of Pearson and SMAPE effectively identified gait abnormalities across all cases. This integrated approach offered a more accurate and comprehensive evaluation than single-metric methods.
Conclusion
The findings highlight the importance of considering both trend and scale in gait analysis. The proposed dual-metric methodology overcomes the limitations of conventional and single-metric approaches, enabling a clearer understanding of gait characteristics in patients with hip OA.

Objective
To examine the effect of the telerehabilitation program on sleep quality and fatigue level in patients with multiple sclerosis (MS) was aimed in this study. MS is a demyelinating disease defined by various signs and symptoms that affects physical, emotional, social, and cognitive functioning. Fatigue, depression, sleep disturbance and cognitive impairment are the among common symptoms of MS.
Methods
The study implemented an individual exercise program for twice a week for 12 weeks via telerehabilitation. In the home-based video exercise group, the same exercises were given as video recordings and the patients were asked to do the exercises twice a week for 12 weeks. Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Multiple Sclerosis Quality of Life Scale-54 and Timed 25 Foot Walk Test were used in the evaluation. The trial is registered with the number of NCT04979845 on ClinicalTrials.gov.
Results
PSQI scores changed from 5.6 (2.1) to 3.66 (2.09) in telerehabilitation group (p=0.03) while no significant change were seen in the video exercise group. Similarly FSS scores decreased from 4.37 (1.42) to 3.67 (1.68) in telerehabilitation group (p=0.04) while no significant changes were seen in the video based exercise group.
Conclusion
The telerehabilitation program is thought to be an effective and accessible non-pharmacological application that can be used in the treatment of sleep quality and fatigue in individuals with MS.

Citations

• FATIGUE IN MULTIPLE SCLEROSIS – MECHANISMS, DIAGNOSIS, AND TREATMENT OPTIONS
  Kornelia Kaźmierkiewicz-Makanga, Weronika Spychalska, Emilia Piotrowicz, Filip Witowicz, Julia Glińska, Aleksandra Krawczyk, Wiktoria Waldon, Paulina Sumlet, Maria Gofron, Michał Duliński
  International Journal of Innovative Technologies in Social Science.2025;[Epub]     CrossRef

Management of upper limb deformities in patients with cerebral palsy is crucial, given its impact on activities of daily living, social interaction, and self-esteem. While medical management and rehabilitative therapy—including the use of assistive devices—remain the foundation of treatment, significant advancements have been made in surgical reconstruction techniques aimed at enhancing functional outcomes. Despite this, many eligible patients may miss the opportunity for surgical intervention due to limited awareness of appropriate indications, candidate selection criteria, and the availability of specialized expertise. This article provides an overview intended to guide pediatric rehabilitation physicians in recognizing common upper limb presentations in cerebral palsy, conducting appropriate assessments, selecting candidates, and understanding available surgical reconstructive options.

Objective
To compare the Hong (GH) and sustained insertion (GS) dry needling methods in patients with myofascial neck pain, this experimental study was conducted.
Methods
A randomized controlled trial included 30 participants, assigned to either the GH (n=15) or GS (n=15) group. Each group received treatment on either the right or left side, with one side receiving experimental DN and the other receiving control (sham) DN. The GS method involved a single needle insertion per myofascial trigger point for one minute, while the GH method used multiple rapid needle insertions over two minutes without needle retention. Measurements were taken before therapy, 5 minutes post-DN session (post-5min), 24 hours post-session (post-24h), and 7 days post-session (post-7d). Muscle tension (MT) and muscle stiffness (MS) were measured with a myotonometer, pressure pain threshold (PPT) with an algometer, maximum isometric strength (Fmax) with a handheld dynamometer, and transcutaneous perfusion (PU) with laser Doppler flowmetry. Power Doppler Score (PDS) and minor adverse events were also recorded.
Results
Results showed that GH led to significantly higher MT and MS values at post-24h and post-7d (p<0.001). In contrast, GS showed greater PPT and Fmax at post-5min, post-24h, and post-7d (p<0.001). Additionally, GH exhibited higher PU values at post-5min and post-7d (p<0.001), while GS showed higher PDS values at post-5min and post-24h (p<0.001).
Conclusion
The GH method resulted in less favorable outcomes in terms of MT and MS, while the GS method showed superior improvements in pain relief and functional recovery.

Citations

• Clinical impact and relevance of dry needling site location in the management of chronic neck pain: a randomized controlled trial
  Fernando Piña-Pozo, Hermann Fricke-Comellas, Ángel Oliva Pascual-Vaca, Félix Paredes-López, Ana Isabel Hueso-Pérez, Alberto Marcos Heredia-Rizo
  Journal of Manual & Manipulative Therapy.2025; : 1.     CrossRef

Objective
To increase participation in cardiac rehabilitation among outpatients with heart disease in Thailand. Factors contributing to low participation are poorly understood. A scale is needed to identify barriers to participation in cardiac rehabilitation. This study aimed to evaluate the psychometric properties of the newly translated Cardiac Rehabilitation Barriers Scale Thai version to justify its use in the Thai population with cardiovascular diseases.
Methods
Psychometric testing was conducted using a cross-sectional survey of 200 outpatients at a Bangkok hospital eligible for the cardiac rehabilitation program from April 2023 to mid-April 2024. Construct validity was evaluated using principal axis factor analysis and first- and second-order confirmatory factor analysis. Cronbach’s alpha assessed the scale’s internal consistency.
Results
The average age of the total sample was 62.60±12.37 years. Principal axis factoring with Oblimin rotation and Kaiser normalization extracted four components (subscales) that explained 61.8% of the cumulative percentage of variance. These were labeled work and time conflicts, lack of perceived need factors, comorbidities, and logistical barriers. Values for the confirmatory factor analysis goodness of fit indices exceeded recommended minimum thresholds. The internal consistencies for the total scale and the four components were entirely acceptable.
Conclusion
The Cardiac Rehabilitation Barriers Scale Thai version has acceptable psychometric properties for Thai outpatients with cardiovascular diseases. It may be used to identify barriers to participating in cardiac rehabilitation, promote rehabilitation attendance, and improve patient care.

Objective
To investigate the temporal and kinematic parameters of hyoid bone excursion (HBE) in head and neck cancer (HNC) patients with and without aspiration.
Methods
Videofluoroscopic swallowing study images from 28 HNC patients were divided into aspiration and non-aspiration groups. The kinematic parameters of HBE, including displacement, instantaneous velocity, and instantaneous acceleration, as well as the timing of reaching maximal values in these parameters, were analyzed.
Results
The timings of reaching maximal horizontal (2.37±1.10 seconds vs. 1.09±1.58 seconds, p=0.010; 0.68±0.28 vs. 0.37±0.26, p=0.010 for percentage of time), vertical (1.83±2.06 seconds vs. 0.86±1.42 seconds, p=0.020) and hypotenuse instantaneous velocities (2.36±1.96 seconds vs. 0.79±1.20 seconds, p=0.006; 0.60±0.33 vs. 0.33±0.24, p=0.028 for percentage of time), as well as the timings of reaching maximal horizontal (2.22±1.50 seconds vs. 0.90±1.26 seconds, p=0.009; 0.60±0.32 vs. 0.37±0.29, p=0.041 for percentage of time), vertical (2.09±1.94 seconds vs. 0.83±1.19 seconds, p=0.003), and hypotenuse instantaneous accelerations (2.49±1.93 seconds vs. 0.81±1.24 seconds, p=0.004; 0.65±0.34 vs. 0.34±0.28, p=0.026 for percentage of time) were significantly prolonged in the aspiration group. After signal smoothing, the aspiration group exhibited delayed timing in reaching maximal horizontal instantaneous velocity (2.07±1.09 seconds vs. 0.74±1.10 seconds, p=0.004; 0.58±0.29 vs. 0.32±0.24, p=0.017 for percentage of time), as well as maximal horizontal (2.18±1.16 seconds vs. 1.12±1.46 seconds, p=0.008) and hypotenuse accelerations (2.21±2.50 seconds vs. 0.81±1.21 seconds, p=0.011). There were no significant between-group differences in other kinematic parameters, except for horizontal displacement (7.66±6.26 mm vs. 12.14±5.82 mm, p=0.042).
Conclusion
The timings of reaching maximal instantaneous velocities and accelerations of HBE, rather than the maximum values of these kinematic parameters, may be critical parameters related to aspiration in HNC patients.

Objective
To examine the short-term and long-term effects of computer-based cognitive training on postural stability, locomotion, and cognitive performance in Parkinson’s disease (PD) patients.
Methods
Sixty-eight PD participated in this randomized-controlled trial, were randomly allocated into two groups; control group (GA) received a designed physiotherapy program for 60 minutes, and an experimental group (GB) got 30 minutes physiotherapy program as GA, along with 30 minutes of computerized cognitive training. Treatment sessions were three times/week for eight weeks. Primary outcomes were balance and spatiotemporal gait parameters; cognition was a secondary outcome. Primary and secondary measures were examined at baseline, immediately post-treatment, and three months post-treatment.
Results
From baseline to post-treatment, GB showed greater reductions in postural sway compared to GA. The mean differences in stability indices were 1.461±1.240, 0.982±1.185, and 1.006±0.982 in GB, vs. 0.581±1.503, 0.426±1.459, and 0.374±1.072 in GA. For gait parameters (gait velocity, stride length, and cadence), GB demonstrated larger improvements, with mean differences of -0.361±0.245, -0.242±0.158, and -11.606±12.628, compared to -0.155±0.254, -0.191±0.248, and -4.516±10.773 in GA. PD-Cognitive Rating Scale improved more substantially in GB (-16.091±6.978) than in GA (-1.129±4.552). These gains in postural stability, gait, and cognition were statistically significant (p<0.001) and sustained at the 3-month follow-up.
Conclusion
Computerized cognitive training as an add-on in the rehabilitation of PD is efficient in improving postural stability and locomotion, as well as the cognitive performance. The consistency of these findings for 3 months is an imperative point in the clinical course of PD patients.

Objective
To investigate muscle tone changes over time in contralateral homonymous muscles when unilateral muscles are stimulated, using F-wave measurements, we examined whether vibratory stimulation on the contralateral homonymous muscle of the affected side may reduce spasticity, whose optimal duration remains unclear.
Methods
Vibratory stimulation was applied to the right hand of healthy adults, using parameters of 80 Hz frequency, 0.4 mm amplitude, 400 g load, and 195 seconds of duration on the abductor digiti minimi muscle. F-wave was measured in the left hand before stimulation, at seven intervals during stimulation, and immediately after.
Results
The F/M amplitude ratio decreased immediately at stimulation onset, at 30 seconds, and at 60 seconds compared to baseline. A least-squares analysis revealed a negative slope from baseline to 60 seconds (f(x)=-0.11x+1.12), while the slope became positive after 90 seconds, continuing after stimulation ended (f(x)=0.04x+0.82).
Conclusion
Unilateral vibratory stimulation may decrease excitability in the spinal anterior horn cells of the contralateral homonymous muscle for up to 75 seconds post-stimulation, suggesting a potential mechanism for spasticity management.

Wearable robotic exoskeletons have emerged as promising technologies for enhancing gait rehabilitation and providing mobility assistance in individuals with neurological and musculoskeletal disorders. This narrative review summarizes recent advances in wearable robots—including both rigid exoskeletons and soft exosuits—and evaluates their clinical application across diverse conditions such as stroke, spinal cord injury, cerebral palsy, and Parkinson’s disease. For rehabilitation purposes, these devices enable repetitive, task-specific gait training that promotes motor learning, reduces therapist burden, and facilitates improvements in walking speed, balance, and endurance. Rigid exoskeletons provide substantial joint support and are particularly effective for patients with severe gait impairments, whereas soft exosuits offer lightweight assistance suited to individuals with milder deficits or fatigue, albeit with limited capacity to deliver high-torque support. Beyond rehabilitation, wearable robots are increasingly used as assistive devices to compensate for permanent gait limitations and restore mobility in daily life. However, widespread clinical adoption remains constrained by several challenges, including a lack of standardized protocols; limited evidence from large-scale, multicenter studies; and practical issues such as device weight, comfort, and ease of use in community settings. Recent developments—such as adaptive control algorithms, volition-adaptive assistance, and artificial intelligence integration—are addressing these barriers by enabling more personalized and responsive support. With continued research investment, user-centered design, and supportive policies, wearable exoskeletons hold considerable potential to improve independence, participation, and quality of life for individuals across a broad spectrum of mobility impairments.

Citations

• The potential of robotics: A systematic review of neuroplastic changes following advanced lower limb rehabilitation in neurological disorders
  Rocco Salvatore Calabrò, Andrea Calderone, Laura Simoncini, Antonino Naro, Lorenzo Octavio Small Haughton, Angelo Quartarone, Carl Froilan D. Leochico
  Neuroscience & Biobehavioral Reviews.2026; 180: 106459.     CrossRef
• A review of treatment methods for movement disorders
  Mahdi Khezri, Shakiba Afsar
  Behavioural Brain Research.2026; 500: 115979.     CrossRef
• Influence of Rehabilitation Aid Use on Obstacle Height During Gait in Patients with Foot Drop: A Case Series Study
  Joonsung Park, Himchan Shim, Changho Jang, Hanyang Yin, Jongbin Kim
  Healthcare.2025; 13(22): 2984.     CrossRef
• A Wearable System for Knee Osteoarthritis: Based on Multimodal Physiological Signal Assessment and Intelligent Rehabilitation
  Jingyi Hu, Shuyi Wang, Yichun Shen, Xinrong Miao
  Sensors.2025; 25(23): 7334.     CrossRef
• Ethical Horizons in Robotic Rehabilitation: Ensuring Safe AI Use Under the EU AI Act
  Rocco Salvatore Calabrò
  Medical Sciences.2025; 13(4): 317.     CrossRef

Objective
Primary frozen shoulder causes significant pain and progressively restricts shoulder movements. Diagnosis is primarily clinically based on patient history and physical examination. Management is mainly non-invasive owing to its self-limiting clinical course. However, clinical practice guidelines for frozen shoulder have not yet been developed in Korea. The developed guidelines aim to provide evidence-based recommendations for the diagnosis and treatment of frozen shoulder.
Methods
A guideline development committee reviewed the literature from four databases (PubMed, Embase, Cochrane Library, and KMbase). Using the PICO (Population, Intervention, Comparator, and Outcome) framework, the committee formulated two backgrounds and 16 key questions to address common clinical concerns. Recommendations were made using the Grading of Recommendations, Assessment, Development, and Evaluation framework.
Results
Diabetes, thyroid disease, and dyslipidemia significantly increase the risk of developing a frozen shoulder. Although frozen shoulder is often self-limiting, some patients may experience long-term disabilities. Ultrasound and magnetic resonance imaging should be used as adjunctive tools alongside clinical diagnosis, and not as independent diagnostic methods. Noninvasive approaches, such as medications, physical modalities, exercises, electrical stimulation, and manual therapy, may reduce pain and improve shoulder function. Other noninvasive interventions have limited evidence, and their application should be based on clinical judgment. Intra-articular steroid injections are recommended for treatment, and physiotherapy or hydrodilatation with steroid injections can also be beneficial.
Conclusion
These guidelines provide evidence-based recommendations for diagnosing and treating primary frozen shoulder.

Citations

• Comparison of efficacy of intra-articular injection of platelet-rich plasma with bupivacaine and steroid combination in chronic shoulder pain
  Naveen Malhotra, Neha Sinha, Amit Kumar, Ritu, Disha Gupta, Naman Malhotra
  Journal of Anaesthesiology Clinical Pharmacology.2026; 42(1): 120.     CrossRef

Objective
To investigate the effects of a home-based rehabilitation program on physical capacity, lung function, and health-related quality of life (QOL) in patients with advanced lung cancer undergoing platinum-based chemotherapy.
Methods
Between December 2021 and December 2023, participants were randomly assigned to exercise and control groups. The exercise group engaged in a home-based exercise program, including respiratory, aerobic, and resistance training, for 60 minutes per session, three times per week, before the first tumor response evaluation. Outcome evaluations included the 6-minute walk test, spirometry to measure lung function (specifically assessing forced expiratory volume in 1 second [FEV1] and forced vital capacity, hand grip strength, and QOL assessments using the Short Form 36-Item Health Survey and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Lung Cancer Module 29. Participants were assessed at baseline, post-intervention, and followed up for 1 year.
Results
Twenty-one of the 26 participants completed the study. The control group showed a significant decrease in FEV1 (p=0.011). Delays in chemotherapy occurred in 40.0% of participants in the control group but none in the exercise group (p=0.019). Mental health showed improvement in the exercise group (p=0.041), whereas adverse effects were more common in the control group (p=0.007), according to QOL questionnaire results.
Conclusion
Home-based rehabilitation during chemotherapy may help maintain lung function, improve mental health, and reduce side effects in patients with lung cancer, warranting further research.

Citations

• Construction of the central symptom cluster management program for patients with lung cancer undergoing chemotherapy: a Delphi study
  Le Zhang, Yuanyuan Luo, Dongmei Mao, Benxiang Zhu, Zhihui Yang, Cui Cui, Jingxia Miao, Lili Zhang
  BMC Nursing.2025;[Epub]     CrossRef

Diabetic peripheral neuropathy (DPN), a common complication of type 2 diabetes mellitus, leads to sensory and motor impairments that significantly affect fine motor skills, grip strength, and dexterity, limiting daily functioning. Understanding the impact of DPN on hand-related activities of daily living (ADLs) is crucial for improving patient care and outcomes. This review employed the International Classification of Functioning, Disability, and Health (ICF) framework to assess hand function issues. A systematic search of peer-reviewed studies was conducted across multiple databases to identify research examining the impact of DPN on hand-related ADLs. The findings were categorised using relevant ICF codes linked to hand function issues. The analysis identified four major themes: (1) the impact of DPN on daily activities and participation; (2) sensory impairments affecting hand function; (3) muscle weakness and functional limitations; and (4) unaddressed areas, such as structural changes, driving, assisting others, and preparing meals. DPN was found to significantly hinder hand function, reducing independence in ADLs and overall quality of life. This review highlights the need for comprehensive assessments that address not only impairments, but also activity limitations and participation restrictions, to capture the multifaceted challenges of DPN. Developing targeted assessments tailored to the specific needs of individuals with DPN is essential for improving intervention strategies and overall quality of care.

Citations

• Hand function in immune-mediated inflammatory rheumatic diseases: assessment and rehabilitation approaches
  Umida Khojakulova, Olena Zimba, Mariusz Korkosz, Burhan Fatih Kocyigit
  Rheumatology International.2025;[Epub]     CrossRef

The effect of inspiratory muscle training (IMT) on cervical spinal cord injury (SCI) remains controversial. This study aimed to assess the efficacy of IMT in enhancing breathing muscle strength, pulmonary function, and quality of life (QoL) among patients with cervical SCI. A search was performed using the PubMed, Cochrane Library, Scopus, Embase, and Web of Science databases through December 2023. This review was conducted according to PRISMA guidelines and the Cochrane Library Handbook. The meta-analysis used mean differences (MDs) or standardized mean differences to pool the results. The Risk of Bias 2 and the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) were used to assess the methodological quality of the included studies. This systematic review included five randomized controlled trials (202 participants). The results of the meta-analysis showed that IMT significantly improved maximal inspiratory pressure (MIP) with MD 12.13 cmH2O (95% confidence interval [CI] 4.22 to 20.03), maximal expiratory pressure (MEP) with MD 8.98 cmH2O (95% CI 6.96 to 11.00), and vital capacity (VC) with MD 0.25 L (95% CI 0.21 to 0.28). There were no significant improvements in forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and QoL. The quality of the evidence ranged from very low to moderate, owing to bias and heterogeneity. Our results showed that IMT may improve MIP, MEP, and VC, but not FEV1, FVC, or QoL, in patients with cervical SCI. Further large-scale studies are required to determine this effect’s optimal dosage and duration.

Citations

• Rewiring the Lung–CNS Axis After Spinal Cord Injury
  HaiRong Wu, Xiaolong Li, Wenjun Zhao, Yihan Li, Hang Zhang, Heng Yin, Xiaofeng Gu
  Journal of Inflammation Research.2026; Volume 19: 1.     CrossRef

Objective
To examine the contribution of perceived upper limb function to participation and activity among community-dwelling people with chronic stroke.
Methods
A cross-sectional study was conducted with eighty-one people with stroke aged ≥50 years. The outcome measures included the Oxford Participation and Activities Questionnaire (Ox-PAQ), Arm Activity Measure (ArmA), Wolf Motor Function Test (WMFT), Timed Up and Go Test (TUG), and Geriatric Depression Scale (GDS).
Results
Correlation analyses revealed that perceived upper limb function, as measured using the ArmA, had the strongest and most significant correlations with the levels of participation and activity, as measured using the Ox-PAQ, among all of the tested variables (rs=0.35–0.59, p<0.01). Multiple linear regression analyses also showed that perceived upper limb function significantly associated the levels of participation and activity, accounting for 2.0% to 9.0% of the variance in the Ox-PAQ scores. The final model, which included TUG time, the GDS score, the WMFT score, and the ArmA score, could explain 54% and 28% of the variance in the routine activities and social engagement subscales of the Ox-PAQ, respectively. The model including the GDS score, the WMFT score, and the ArmA score explains 32% of the variance in the emotional well-being subscale of the Ox-PAQ.
Conclusion
Perceived upper limb function is a crucial determinant of participation and activity among community-dwelling people with chronic stroke. It could thus be a target component of stroke rehabilitation interventions to facilitate participation and activity after stroke.

Citations

• Upper Limb Capacity, Performance, and Leisure Participation in Children with Unilateral Cerebral Palsy
  Manel Abid, Isabelle Poitras, Léandre Gagné-Pelletier, Carole Rigourd, Charles Sèbiyo Batcho, Catherine Mercier
  Sensors.2025; 25(23): 7120.     CrossRef

Objective
To investigate the effectiveness of radial extracorporeal shock wave therapy (rESWT) on pain, lumbar range of motion (ROM) and F-wave minimal latency and F-chronodispersion in patients with post laminectomy epidural fibrosis.
Methods
Sixty patients complaining of low back pain and sciatica secondary to lumbar post laminectomy epidural fibrosis were allocated to one of the two equal groups (study and control groups). Pain intensity, lumbar ROM, and F-wave latency and F-chronodispersion were assessed pre- and posttreatment using visual analogue scale (VAS), Back ROM II device, and Neuro-MEP-Micro electromyography device, respectively.
Results
Posttreatment mean values showed statistically significant decrease in VAS mean scores in both groups, with more significant decrease posttreatment in favor of the study group. There was statistically significant increase in all lumbar ROM mean scores and statistically significant decrease in F-minimal latency and F-chronodispersion for both peroneal and tibial nerves in the study group only posttreatment. Also, the results showed that significant positive moderate correlation between VAS scores and F-chronodispersion for peroneal nerve, strong negative correlation between right side bending scores and F-wave minimal latency for peroneal nerve and moderate negative correlation between left side bending scores and F-wave minimal latency for peroneal nerve after treatment.
Conclusion
It was concluded that rESWT is a new and convenient modality, that would be beneficial if added to the conventional physical therapy protocols in managing patients with lumbar post-laminectomy epidural fibrosis.

Objective
To assess mobility in prosthetic limb users, the Prosthetic Limb Users Survey of Mobility (PLUS-M) was developed as a brief item bank. The PLUS-M exhibits good reliability and has been translated into more than 15 languages; however, a Korean translation is not yet available. Therefore, this study translated the 44 items of PLUS-M into the Korean language and analysed the psychometric properties of the PLUS-M/Short Form 12 (PLUS-M/SF- 12) instrument through official procedures.
Methods
The process of Korean translation began with a consultation with the developer of the PLUS-M and included the first and second compatibility verification, back-translation, back-translation verification by the developer, and the final approval of the Korean version. This study tested validity using different instruments such as Activities-specific Balance Confidence scale, 2-Minute Walk Test, Timed Up and Go Test to assess various characteristics related to mobility. The translated version PLUS-M was then sent to two physical therapists working at Incheon Hospital and one prosthetist working at a Rehabilitation Engineering Center for them to assess the appropriateness of term use and understanding of the instrument.
Results
The study found excellent internal consistency and test-retest reliability of the PLUS-M/SF-12 Korean version questionnaire, indicating its reliability and predictability across repeated measurements.
Conclusion
This study provided a tool to assess the mobility of individuals with lower limb amputations.

Objective
To investigate the impact of self-efficacy in using one’s upper limbs on the overall wellbeing of stroke patients, we developed the Korean version of the Confidence of Arm and Hand Movement (K-CAHM) scale by modifying the original CAHM to suit Korean cultural conditions.
Methods
This study was conducted from May 2022 to June 2023 at a rehabilitation hospital with 54 stroke patients. Participants with sufficient cognitive and verbal abilities were included, while those with severe comorbidities were excluded. For the translation and cultural adaptation of CAHM into Korean, permission was obtained from the original author. Two translators independently translated the questionnaire, followed by a consensus discussion and expert review to create K-CAHM version 1.0. After back-translation and further review, the final Korean version was completed. Reliability and validity were assessed using Cronbach’s alpha, intraclass correlation coefficient (ICC), exploratory factor analysis, Bland–Altman analysis, and Pearson correlation.
Results
The K-CAHM showed good reliability (Cronbach’s alpha=0.97; ICC=0.895). Bland–Altman plot analysis showed good agreement, indicating test-retest reliability. Moreover, K-CAHM showed good concurrent validity, demonstrated by its correlation with three domains of the International Classification of Functioning, Disability and Health: Fugl-Meyer assessment, the Jebsen-Taylor Hand Function Test, personal hygiene and bathing in the modified Barthel Index, and hand and stroke recovery domain in the Stroke Impact Scale.
Conclusion
The newly developed K-CAHM could complement other outcome measures, facilitating patient-centered rehabilitation in the Korean context.

Objective
To investigate the effects of modified stepping exercises over six weeks on functional mobility and individual lower extremity muscle strength in community-dwelling older individuals.
Methods
This prospective randomized controlled trial design was conducted in thirty-two older adults who completed a modified stepping exercises program (n=16 for soft-surface stepping exercise; n=16 for firm-surface stepping exercise). These exercises were practiced for 50 minutes/day, three days/week, over six weeks. They were assessed for their functional mobility relating to levels of independence at baseline, after 4 weeks, after 6 weeks of intervention, and at 1 month after the last intervention sessions.
Results
Both groups showed significant improvements in functional mobility, lower extremity muscle strength, and walking speed after 4 and 6 weeks of intervention, as well as at the one-month follow-up. However, the soft-surface stepping exercise group exhibited significantly greater improvements in dynamic balance (p=0.035) and lower extremity muscle strength (p=0.015) compared to the firm-surface stepping exercise group after 6 weeks of intervention. Additionally, the soft-surface group demonstrated superior gains in hip flexor (p=0.041), hip extensor (p=0.047), hip adductor (p=0.026), and hip abductor strength (p=0.046), with these enhancements maintained at the one-month follow-up.
Conclusion
Soft-surface stepping exercise that involves whole-body movements offers a promising alternative to promote independence and safety among community-dwelling older adults. This study underscores the need for future research to evaluate the sustained impact of these benefits post-intervention, particularly during a retention period following the intervention.

Objective
To evaluate the effectiveness of a squatting posture grading system established to screen for limited ankle dorsiflexion.
Methods
The squat posture grading system categorizes subjects’ squat posture into three grades. Grade 1 is defined as being able to maintain a squatting posture with heels on the ground in full ankle dorsiflexion without effort. Grade 2 is defined as being able to perform the same position, but unable to maintain the position for more than 5 seconds or requiring trunk and leg muscle efforts to maintain the position. Grade 3 is defined as being unable to maintain the same position and falling backwards immediately if attempted to touch the ground with heels. Next, subjects’ ankle dorsiflexion angles were directly measured in knee flexed and extended position by goniometer.
Results
Out of the 92 total subjects, 35 were in grade 1, 18 were in grade 2, and 39 were in grade 3. The average ankle dorsiflexion angle with knee flexed position were 23.13° for grade 1, 16.03° for grade 2, and 9.31° for grade 3. The average ankle dorsiflexion angle with knee extended position were 15.16° for grade 1, 7.92° for grade 2, and 3.40° for grade 3. Ankle dorsiflexion angles showed a significant decrease from grade 1 to 3 (p<0.05).
Conclusion
The squatting posture grading system defined in this study effectively graded the subjects based on the difference in their average ankle dorsiflexion angle. This system could be used as a quick screening method for limited ankle dorsiflexion.

Objective
To determine the effectiveness of adding inspiratory muscle training (IMT) alongside a pulmonary rehabilitation protocol in terms of inspiratory muscle strength, lung function, and exercise capacity in burned adults.
Methods
A randomized, double-blinded, sham-controlled study. Fifty-two adult patients with burn injuries, more than 20 years old and at least 20% total body surface area, were assigned randomly either to the experimental or the conventional group. The participants in the experimental group were given IMT plus a pulmonary rehabilitation program; the conventional group received only a pulmonary rehabilitation program. The interventions were performed for 8 weeks. At the beginning and after 8 weeks of training, the respiratory muscles’ strength, lung function and exercise capacity were all examined.
Results
After 2 months of training, the experimental group demonstrated statistically significant improvements than conventional group in maximum inspiratory pressure, maximum expiratory pressure, 6-minute walk test, forced vital capacity, and forced expiratory volume in 1 second (p<0.05).
Conclusion
An 8-week IMT program coupled with pulmonary rehabilitation increases respiratory muscle strength, pulmonary functions, and functional capacity in burn patients. IMT is a beneficial and efficient therapy that can be easily implemented for burn patients.

Objective
To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment.
Methods
An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors.
Results
The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006).
Conclusion
Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.

Objective
To prove 5-time sit-to-stand (5-STS) and 30-second sit-to-stand (30sSTS) tests in assessing cardiorespiratory fitness in chronic heart failure (HF) patients with systolic dysfunction. Alternative tests, such as 5-STS and 30sSTS, may be used to assess cardiorespiratory fitness in patients with HF but have not been thoroughly evaluated. Thus, this study aimed to prove 5-STS and 30sSTS tests in assessing cardiorespiratory fitness in chronic HF patients with systolic dysfunction.
Methods
A cross-sectional study was done, evaluating chronic HF patients with systolic dysfunction that have received optimal guideline directed medical treatment for at least 3 months. All patients underwent the same intervention on the same day, starting with an initial 5-STS test, followed by a 30sSTS, and a 6-minute walk test (6MWT).
Results
A total of 34 patients were enrolled in this study. The median left ventricular ejection fraction was 44% (interquartile range=34%–48%). Mean values of 5-STS, 30sSTS, and 6MWT were 13.90±4.72, 13.29±3.38, and 463.65±87.04, respectively. 5-STS showed moderate correlation with 6MWT (r=-0.436, p=0.01). However, the 30sSTS revealed strong correlation with 6MWT (r=0.629, p<0.001).
Conclusion
The 30sSTS test had strong correlation with 6MWT. It could be used to illustrate cardiorespiratory fitness in chronic HF patients with systolic dysfunction.

Citations

• A Cross-Sectional Pilot Study on the Impact of Socioeconomic Status on Fall Risk in Older Adults Based on Multiple Outcome Measures: 10MWT, 5TSIS, CTSIB-M, and 6MWT
  Mary Bayer, Halle Krisinski, Nikita Sak, Rob Sillevis
  Journal of Rehabilitation Practices and Research.2025;[Epub]     CrossRef
• Reliability and interchangeability of 1-minute sit-to-stand, 3-minute chair rise, and 3-minute walk tests in assessing functional capacity
  Meredith T Yeung, Xian Cong Goh, Ray Han Lian, Anne C. Ting, Mingxing Yang
  Journal of Sports Sciences.2025; 43(21): 2538.     CrossRef

Objective
To establish and evaluate the validity of the recently developed Korean version of the Oxford Cognitive Screen (K-OCS), this study verified its reliability, validity, and diagnostic accuracy.
Methods
Between November 2021 and December 2023, we recruited 72 patients with stroke from our hospital who agreed to participate in the study. The patients were repeatedly tested using K-OCS by the same or different assessors to estimate inter- and intra-rater reliability. To demonstrate the validity and usability of K-OCS, the test results of screening tools currently used in clinical practice, including the Korean-Mini Mental State Examination and the Korean version of the Montreal Cognitive Assessment, were used in comparison analyses.
Results
The subtests of K-OCS demonstrated excellent inter-rater reliability (intra-class correlation coefficient [ICC]=0.914–0.998) and test–retest reliability (ICC=0.913–0.994). We found moderate-to-strong correlations for convergent validity for the subsets (r=0.378– 0.979, p<0.01), and low-to-moderate discriminant validity correlations. The optimal cut-offs estimated for the subtests of the K-OCS showed a good-to-high range of specificity (94.8%– 100%). The positive predictive value was 58.2%–100% and negative predictive value was 65.6%–98.4%. Sensitivity was estimated at 25.6%–86.9%.
Conclusion
The results of this study indicate that K-OCS is a reliable and valid tool for screening cognitive impairment in patients post-stroke.

Citations

• Intra- and Inter-Rater Reliability Analysis of MMSE-K and Tablet PC-Based MMSE-K Kit in Patients with Neurologic Disease
  Seung-Ho Choun, Sang-Woo Lee, Yu-Sun Min, Eunhee Park, Jee-Hyun Kim, Tae-Du Jung
  Healthcare.2025; 13(23): 3015.     CrossRef

Objective
To evaluate the association between outcomes, including affected extremity functions and activities of daily living (ADL), and fractional anisotropy (FA) derived from automated tractography incorporating age among patients after stroke.
Methods
This study enrolled stroke patients, and diffusion-tensor imaging was conducted during the second week. Standardized automated tractography was utilized to compute FA values in the corticospinal tract (CST), the inferior fronto-occipital fasciculus (IFOF), and the superior longitudinal fasciculus (SLF). Outcome evaluations were performed at discharge from our affiliated rehabilitation facility. Extremity functions were assessed using the total scores of the motor component of the Stroke Impairment Assessment Set (SIAS-motor). Independence levels in ADL were appraised through the motor and cognition components of the Functional Independence Measure (FIM). For each outcome measure, multivariate regression analysis incorporated the FA values of the CST, the IFOF, and the SLF, along with age.
Results
Forty-two patients were enrolled in the final analytical database. Among the four explanatory variables, the CST emerged as the most influential factor for SIAS-motor scores. Conversely, age proved to be the primary determinant for both the motor and cognition components of FIM, surpassing the impact of FA metrics, including the CST and the IFOF.
Conclusion
The key influencing factors exhibited significant variations based on the targeted outcome assessments. Clinicians should be aware of these differences when utilizing neuroimaging techniques to predict stroke outcomes.

Objective
To comprehensively assess the relationship between nerve conduction study (NCS), sympathetic skin response (SSR), and demographic factors in patients with diabetic neuropathy, exploring potential risk factors and mechanisms.
Methods
A retrospective study (N=184) included patients diagnosed with type 2 diabetes mellitus undergoing NCS and SSR. Demographic, clinical, and laboratory data were analyzed. Patients were categorized by diabetic peripheral neuropathy (DPN) and SSR stages for comparative analysis.
Results
HbA1c levels correlated with DPN progression. SSR stages exhibited age-related differences. Height correlated with DPN but not SSR stages. Body mass index showed no significant differences.
Conclusion
While DPN progression correlated with glycemic control and duration of diabetes, SSR was influenced by age. Unexpectedly, cholesterol levels remained within the normal range, challenging established concepts. Understanding these relationships is crucial for interpreting test results and developing targeted interventions for diabetic neuropathy.

Cerebral palsy (CP) is the most common motor disability in children, characterized by diverse clinical manifestations and often uncertain etiology, which has spurred increasing interest in genetic diagnostics. This review synthesizes findings from various studies to enhance understanding of CP’s genetic underpinnings. The discussion is structured around five key areas: monogenic causes and copy number variants directly linked to CP, differential genetic disorders including atypical CP and mimics, ambiguous genetic influences, co-occurrence with other neurodevelopmental disorders, and polygenic risk factors. Case studies illustrate the clinical application of these genetic insights, underscoring the complexity of diagnosing CP due to the phenotypic overlap with other conditions and the potential for misdiagnosis. The review highlights the significant role of advanced genetic testing in distinguishing CP from similar neurodevelopmental disorders and assessing cases with unclear clinical presentations. Furthermore, it addresses the ongoing challenges in establishing a consensus on genetic contributors to CP, the need for comprehensive patient phenotyping, and the integration of rigorous genetic and functional studies to validate findings. This comprehensive examination of CP genetics aims to pave the way for more precise diagnostics and personalized treatment plans, urging continued research to overcome the current limitations and refine diagnostic criteria within this field.

Citations

• Advances in Genetic Discoveries in Cerebral Palsy: Implications for Diagnosis, Prognosis, and Counseling
  Juan Darío Ortigoza-Escobar
  Current Neurology and Neuroscience Reports.2026;[Epub]     CrossRef
• The placenta as a window into neonatal brain injury
  Elmira Bachinsky, Lauren Guyer, Riddhi Patel, Stephen K. Amoah, Diana Ortega, Shenandoah Robinson, Hawley Helmbrecht, Lauren L. Jantzie
  Seminars in Perinatology.2025; 49(8): 152143.     CrossRef
• Thoracic Spinal Arachnoid Cyst in a Patient With Cerebral Palsy: Clinical Evaluation and Technical Note
  Jordan M Rasmussen, Patrick Opperman, Afshin Salehi
  Cureus.2025;[Epub]     CrossRef
• Наследственные атаксии, протекающие под маской детского церебрального паралича
  Daria S. Razheva, Gareguin Sh. Khondkarian, Nikolay N. Zavadenko
  L.O. Badalyan Neurological Journal.2025; 6(3): 140.     CrossRef

Objective
To identify the prevalence and factors associated with T-score discordance between the spine and hip, as well as between the paretic and non-paretic hips in hemiplegic stroke patients, this study investigated bone mineral density (BMD) patterns. Bone loss predominantly affects the paretic hip after a stroke, and typical clinical assessments using dual-energy X-ray absorptiometry (DXA) that scan the lumbar spine (LS) and a single hip may overlook an osteoporosis diagnosis. This oversight could potentially lead to suboptimal treatment for stroke patients.
Methods
This study was a multicenter retrospective analysis of 540 patients admitted for stroke rehabilitation between October 2014 and February 2022, who underwent DXA of LS and bilateral hips.
Results
The prevalence rates of concordance, low LS discordance, and low hip discordance between the LS and hips were 48.2%, 12.2%, and 39.6%, respectively. The discordance rate between bilateral hips was 17.0%. The paretic side had significantly lower total hip T-scores than the non-paretic side (p<0.001). Notably low paretic hip discordance was more prevalent during the chronic phase. DXA scans of the LS and both hips revealed a 0.7%–0.9% higher major discordance compared to LS and single hip DXA scans. The multivariate analysis revealed a significant correlation between a low paretic hip discordance and cognitive impairment (adjusted odds ratio 0.071, 95% confidence interval 0.931–1.003, p<0.05).
Conclusion
Since stroke survivors are at high risk for hip fractures, comprehensive BMD assessments, which include LS and bilateral hips, should be considered for post-stroke osteoporosis care to enhance diagnostic accuracy and timely treatment.

Citations

• Association between bone mineral density and stroke: a meta-analysis
  Peng Zhao, Huaxia Sun
  Frontiers in Neurology.2025;[Epub]     CrossRef

Objective
Tremors are caused by contractions of reciprocally innervated muscles. The role of ultrasound in diagnosing tremors has not yet been investigated, although it appears to be promising because it can visualize muscle movements. In the present study, we report four cases of tremor (Holmes’ tremor, extremity tremor associated with palatal myoclonus, dystonic tremor, and tremor associated with dystonia), which were evaluated using ultrasound and treated with botulinum toxin injections.
Methods
The muscles of patients with tremors were examined using B- or M-mode ultrasound while they were in the supine position. Tremor was determined by involuntary muscular contraction (B-mode) or fasciculation (M-mode) from recorded sonography clips. Thereafter, tremors were measured as frequency and amplitude of specific muscles. Ultrasound-guided botulinum toxin type A injection was administered, and follow-up ultrasonography was used to assess tremors.
Results
Tremors, which manifest as a specific set of muscle contractions, were measured using ultrasonography and treated with botulinum toxin injection. Follow-up ultrasonography revealed improved tremors as seen with decreased frequency and amplitude of specific muscle after the intervention, which included medication and botulinum toxin injections.
Conclusion
Ultrasonography is an effective assessment tool for tremors, allowing further information regarding tremor characteristics with high sensitivity, playing a role in detecting specific muscles that are affected by tremors, and guiding an exact intervention with botulinum toxin.

Citations

• Botulinum Toxin for the Treatment of Tremors
  Steven Bellows, Joseph Jankovic
  Toxins.2025; 17(8): 401.     CrossRef

Objective
To compare the progression of muscle fibrosis of various site and its relation between cardiac deterioration in Duchenne muscular dystrophy (DMD). In this study aimed to examine the associations between echocardiogram-based cardiac function indices and fibrosis of the abdominal and lower extremity muscles in patients with DMD to facilitate early detection of cardiac dysfunction and identify its predictors.
Methods
Twenty-one patients with DMD patients were enrolled in the study. The association between cardiac dysfunction and fibrosis of the abdominal and lower extremity muscles was determined by analyzing the echocardiography and elastography. Non-parametric Spearman rank correlation coefficients were used to examine the pairwise relationships between cardiac function and muscle elasticity.
Results
All patients were male and non-ambulant. Their mean age was 18.45±4.28 years. The strain ratios of the abdominal muscle and quadriceps muscles were significantly higher than those of the medial gastrocnemius. The strain ratio of the rectus abdominis muscle has a significant negative correlation with left ventricular ejection fraction. Cardiac function and valvular insufficiency were not significantly correlated with muscle strain ratio. According to the result of our study, the only skeletal muscle which showed significant correlation with cardiac dysfunction was degree abdominal muscle fibrosis.
Conclusion
The degree of fibrosis of respiratory muscles was also significantly associated with cardiac dysfunction; therefore, it can be used as a predictor of cardiac dysfunction in patients with DMD in clinical practice.

Citations

• Impact of functional status in patients with muscular dystrophy-associated cardiomyopathy on survival after heart transplantation
  Sanath Patil, Nayeem Nasher, T. Reese Macmillan, Daler Rahimov, Eugene Storozynsky, J. Eduardo Rame, Keshava Rajagopal, John W. Entwistle, Charles W. Hoopes, Vakhtang Tchantchaleishvili
  Expert Review of Cardiovascular Therapy.2025; 23(10): 625.     CrossRef

Objective
To evaluate muscle strength and cardiorespiratory parameters, this study uses simple tests in older adults, including those who have and have not recovered from mild coronavirus disease 2019 (COVID-19).
Methods
Eighty older adults (age≥60 years old) were divided into two groups: those without previous COVID-19 (control group, n=40) and those with recovery from mild COVID-19 (recovered group, n=40). Muscle strength was assessed using a handgrip strength test and the sit-to-stand test (STS10). Cardiorespiratory parameters were evaluated with a 1-minute sitto- stand (1-min STS) test and a 6-minute walk test (6MWT).
Results
Both groups had normal values for body mass index, blood pressure, heart rate, and pulse oxygen saturation. The recovered group showed significant differences in handgrip strength test (24.73±6.99 vs. 22.03±4.36, p=0.041) and duration for the STS10 (25.15±6.11 vs. 33.40±7.56, p<0.001) when compared to the control group. Furthermore, the recovered group had significantly decreased repetitions of a 1-min STS (31.38±4.89 vs. 21.25±3.64, p<0.001) and increased the rate of perceived exertion (RPE) (7.43±1.20 vs. 8.95±1.01, p=0.01) and leg fatigue (1.49±1.13 vs. 3.00±1.04, p=0.03) after performing a 1-min STS when compared with the control group. Moreover, the recovered group had also significantly decreased distances for the 6MWT (421.68±8.28 vs. 384.35±6.17, p<0.001) and increased the post-test RPE (7.63±1.37 vs. 12.05±1.63, p<0.001) and the post-test leg fatigue (1.71±0.88 vs. 5.28±0.91, p<0.001) compared with the control group.
Conclusion
Older adults with recovery from mild COVID-19 reported reduced muscle strength and exercise tolerance when compared with older adults without COVID-19.

Objective
To determine the factors influencing the life satisfaction of people with physical disabilities during the COVID-19 pandemic, considering demographics, disability-related characteristics, health behaviors, and psychosocial characteristics.
Methods
We used cross-sectional data from 301 respondents of the 2021/2022 survey of the Korean Health Cohort Study for People with Physical Disabilities. Descriptive statistics were used to analyze the research subjects’ characteristics, and chi-square tests and multiple logistic regression were used to identify the determinants of life satisfaction.
Results
Among socio demographic variables, occupation had a strong association with life satisfaction. Significant health behavior variables included daily regular meals, weight control effort, and chronic pain. All psychosocial characteristics (perceived stress, depression, suicidal ideation, cognitive function assessment, subjective health status, family satisfaction, income satisfaction) were strongly associated with life satisfaction. Results of the analysis of factors affecting life satisfaction showed that unemployment, lack of regular exercise, elevated stress, suicidal thoughts, and dissatisfaction with family contributed to increased life dissatisfaction.
Conclusion
Economic support through job creation that considers the specific characteristics of people with disabilities, and social access through community integration services that encourage participation in social activities, should be prioritized.

Citations

• Impact of Disability Acceptance on Life Satisfaction among Older Adults with Disabilities: A Longitudinal Comparative Study of the Pre-pandemic (2018–2019) and Pandemic Periods (2020–2022)
  Heesoo Kim, Sung Rae Shin
  Korean Journal of Adult Nursing.2025; 37(4): 515.     CrossRef

This systematic review aims to determine the effectiveness of non-pharmacological interventions for the management of spasticity in people with multiple sclerosis (pwMS). A comprehensive literature search in health science databases (MEDLINE, Embase, CENTRAL, CINHAL) was performed to identify randomized controlled trials (RCTs) (up to April 2024). Manual searching in journals and screening of the reference lists of identified studies were conducted. Two authors independently selected the studies, assessed the methodological quality, and summarized the evidence. A meta-analysis was not feasible due to the methodological, clinical, and statistical diversity of the included studies. Overall, 32 RCTs (n=1,481 participants) investigated various types of non-pharmacological interventions including: physical activity, transcranial magnetic stimulation (intermittent theta burst stimulation [iTBS], repetitive transcranial magnetic stimulation [rTMS]), electromagnetic therapy, transcutaneous electrical nerve stimulation, vibration therapy, shock wave therapy, self-management educational programs, and acupuncture. All studies scored ‘low’ on the methodological quality assessment, implying a high risk of bias. The findings suggest ‘moderate to low certainty’ evidence for physical activity programs used in isolation or combination with other interventions (pharmacological or non-pharmacological), and for iTBS/rTMS with or without adjuvant exercise therapy in improving spasticity in adults with MS. There is ‘very low certainty’ evidence supporting the use of other modalities for treating spasticity in this population. Despite a wide range of non-pharmacological interventions used for the management of spasticity in pwMS, there is a lack of conclusive evidence for many. More robust trials with larger sample sizes and longer-term follow-ups are needed to build evidence for these interventions.

Citations

• The effect of the EXOPULSE Mollii suit on motor functions in patients with multiple sclerosis – a randomized sham-controlled crossover trial
  Samar S Ayache, Joseph G Mattar, Alain Créange, Mohamed Abdellaoui, Mickael Zedet, Jean-Pascal Lefaucheur, Hana Megherbi, Hayfa Khaled, Georges Naïm Abi Lahoud, Moussa A Chalah
  Multiple Sclerosis Journal – Experimental, Translational and Clinical.2025;[Epub]     CrossRef
• Efeito agudo do ultrassom no padrão espástico do bíceps braquial em indivíduos com distúrbios neurológicos
  João Sávio Carneiro Silva, Letícia Costa Mengoni, Gabriel Pádua da Silva, Wellington Marcelo Queixas Moreira, Oswaldo Luiz Stamato Taube, Bruno Ferreira
  RCMOS - Revista Científica Multidisciplinar O Saber.2025;[Epub]     CrossRef
• Balancing innovation and affordability in relapsing-remitting multiple sclerosis: a budget impact analysis from Saudi Arabia
  Ahmed Al-Jedai, Hajer Almudaiheem, Faisal Al-Suweidan, Mohamed al Jumah, Ahmed al-Thobaiti, Fahad Alzureiqan, Wejdan Abu Ras, Fahad M. Al-Dosari, Yaser Al Malik, Pratik Dhopte, Rita Ojeil
  Frontiers in Public Health.2025;[Epub]     CrossRef

Objective
To culturally adapt the original English Scale for the Assessment and Rating of Ataxia to Thai (SARA-TH) and to evaluate the reliability and validity of the SARA-TH in assessing ataxia in acute ischemic stroke or transient ischemic attack (TIA) patients, as assessed by three healthcare professionals.
Methods
The SARA underwent translation and cross-cultural adaptation to Thai according to established guidelines. Reliability (e.g., internal consistency, intrarater reliability, interrater reliability) and validity (e.g., content validity, convergent validity) were assessed in a sample of 50 participants with ataxia after acute ischemic stroke or TIA. Spearman correlation analysis was used to examine the relationships between the SARA-TH and the Barthel Index (BI-TH), the National Institutes of Health Stroke Scale (NIHSS-TH), and the International Cooperative Ataxia Rating Scale (ICARS) to assess convergent validity. Interrater and intrarater reliability among experienced and novice neurologists, physiotherapists, and occupational therapists were assessed using weighted kappa.
Results
The SARA-TH demonstrated good comprehension and exhibited no significant floor or ceiling effects. It showed excellent internal consistency (Cronbach’s α≥0.776). Significant correlations were found between the SARA-TH score and the BI-TH score (rs=-0.743 to -0.665), NIHSS- TH score (rs=0.404–0.513), and ICARS score (rs=0.859–0.917). The intrarater reliability for each rater ranged from 0.724 to 1.000 (p<0.01), and the interrater reliability varied from 0.281 to 0.927 (p<0.01).
Conclusion
The SARA-TH has excellent internal consistency, validity, and intrarater reliability, as well as acceptable interrater reliability among health professionals with varying levels of experience. It is recommended for assessing ataxia severity in individuals following acute ischemic stroke or TIA.

Objective
To investigate longitudinal changes in plantar pressure examinations and plain radiographs and to assess the correlations between these two modalities in pediatric patients with flexible flatfoot (FFF).
Methods
Pediatric patients diagnosed with FFF were analyzed in this retrospective cohort study. Medical records were reviewed to collect data on plain radiographs and plantar pressure examinations. Changes in radiographic angles and plantar pressure parameters were analyzed over a follow-up period exceeding 1 year. Statistical analyses included paired t-test, Wilcoxon signed rank test, and Spearman’s correlation analysis.
Results
A total of 52 subjects was included in the plantar pressure analysis, with a mean age of 9.9 years at the first visit and a median follow-up duration of 52 months. The lateral tarso-first metatarsal angle decreased by 1.3° (p<0.001) and calcaneal inclination angle increased by 2.5° (p<0.001) in these patients. The percentage value of midfoot width (WMF) divided by forefoot width (WFF) decreased by an average of 9.8% p (p<0.001), and the maximal pressure on the medial midfoot (MMF) decreased by 1.6 N/cm2 (p<0.001). However, no correlations were found between plantar pressure and radiographic changes.
Conclusion
During follow-up of patients with FFF, the maximal pressure on the MMF and the ratio of WMF to WFF decreased in successive plantar pressure examinations. Changes observed in plantar pressure and plain radiographs were not consistent, indicating that these two testing modalities can complement each other.

Objective
To investigate the impact of body mass index (BMI) and exercise habits on readmission rates among older patients with heart failure.
Methods
Ninety-seven older patients admitted for heart failure (median age: 81 years; 57.7% male) were included in the study. Patients were categorized into four groups based on the presence or absence of lower BMI and/or the absence of exercise habits. Lower BMI was defined as BMI<20.3 kg/m2 at discharge and exercise habits were defined as engaging in 30 or more minutes of moderate or vigorous exercise at least once a week. The primary outcome was all-cause readmission during the 1-year follow-up period.
Results
The patients were distributed across four groups: lower BMI/non-exerciser (n=24, 24.7%), lower BMI/exerciser (n=22, 22.7%), non-lower BMI/non-exerciser (n=21, 21.6%), and non-lower BMI/exerciser (n=30, 30.9%). Forty-six patients (47.4%) experienced readmission during the 1-year follow-up period. In a cox proportional hazard analysis, non-lower BMI/exerciser remained an independent prognostic factor even after adjusting for confounding factors (non-lower BMI/exerciser vs. lower BMI/non-exerciser: hazard ratio, 0.26; 95% confidence interval, 0.08–0.83; p=0.022).
Conclusion
The coexistence of non-lower BMI and regular exercise habits may reduce readmission during the 1-year in older patients with heart failure. Therefore, it is imperative to conduct appropriate nutritional assessments for patients with lower BMI at discharge. Additionally, promoting and monitoring sustained physical activity after discharge is crucial for older patients with heart failure.

The impact of disease-modifying therapy ranges from cure to no impact with a wide range of intermediates. In cases where the intermediate group reaches a plateau after the acquisition of some muscle strength, it is necessary to set a functional level appropriate for increased motor power and establish a long-term exercise plan to maintain it. As the disease status stabilizes and the life span increases, early nonsurgical interventions are required, such as using a standing frame to prevent joint contracture, applying a spinal brace at the early stage of scoliosis, and maintaining sitting postures that exaggerate lumbar lordosis. In cases where scoliosis and hip displacement occur and progress even after conservative managements are implemented, early referral to surgery should be considered. Oromotor activity and swallowing function are influenced not only by the effects of disease-modifying drugs, but also by post-birth experience and training. Therefore, although the feeding tube cannot be removed, it is necessary to make efforts to simulate the infant feeding development while maintaining partial oral feeding. Since the application period of non-invasive ventilators has increased, it has become more important to prevent long-term complications such as facial abrasion, skin allergy, orthodontic deformities, and maxillary flattening caused by the interface. Dual ventilator mode or interface can also be utilized.

Citations

• Physical and Respiratory Rehabilitation in Spinal Muscular Atrophy: A Critical Narrative Review
  Serena Cammarano, Vincenzo Alessio Chirico, Benedetto Giardulli, Giovanna Mazzuoccolo, Carlo Ruosi, Bruno Corrado
  Applied Sciences.2025; 15(8): 4398.     CrossRef
• Treatment Guidelines and Rehabilitation in Spinal Muscular Atrophy and Duchenne’s Muscular Dystrophy
  Eleni Drakou, Sarah Wright, Leslie D. Delfiner, David Cancel
  Physical Medicine and Rehabilitation Clinics of North America.2025; 36(3): 531.     CrossRef
• Management of Hip and Spine in Neuromuscular Disorders
  Unwana Abasi, Abigail Allen, Coral Candelario-Velazquez, Sheena Ranade, David Cancel
  Physical Medicine and Rehabilitation Clinics of North America.2025; 36(3): 429.     CrossRef
• Multimodal Analysis of Biomarkers for SMA - Data from the First Six-Month Nusinersen Follow-Up
  Corina Sporea, Mihaela Axente, Gabriel Cristian Bejan, Andrada Mirea, Mihaela Badina
  Balneo and PRM Research Journal.2025; 16(Vol 16 No.): 883.     CrossRef
• The effect of thoracolumbosacral orthosis on scoliosis progression and chest deformity in children with type 1 spinal muscular atrophy: A randomized controlled trial
  Emre Dansuk, Ayşe Nur Tunalı Van Den Berg, Görkem Ata, Seval Kutluturk Yıkılmaz, Sedat Oktem, Taher Babaee
  PLOS One.2025; 20(9): e0323341.     CrossRef
• Immediate and Sustained Effects of Intensive Equine-Assisted Physiotherapy Based on Neuroproprioceptive “Facilitation and Inhibition” on Psychomotor Development, Clinical Functions, Quality of Life, and Molecular Biological Indicators in Children with Spi
  Katerina Marikova, Jindra Reissigová, Miloslav Vilimek, Marie Cerna, Marketa Pokorna, Kamila Rasova
  JMIR Research Protocols.2025;[Epub]     CrossRef

Objective
To establish the reference standard of the median nerve conduction study (NCS) in Korea.
Methods
A total of 648 median motor and 602 median sensory NCSs from 349 Korean healthy volunteers were tested and analyzed prospectively. Equipment calibration, assessment of intraand inter-rater reliability, and the NCSs per se were conducted according to a predetermined protocol. A reference standard was established from uncertainty components for the following parameters: the onset and peak latencies; the baseline-to-peak and peak-to-peak amplitudes; the area and duration of the negative wave; and the nerve conduction velocity. The effects of sex, age and stimulation intensity were analyzed.
Results
Each measured value of 648 median motor and 602 median sensory nerves were obtained and presented with both mean and expanded uncertainties, as well as mean and standard deviations. The cut-off values with expanded uncertainty were determined for different age and sex groups. After adjusting for anthropometric covariates, all parameters except duration were affected by age, and sex appeared to influence both duration and area. While stimulation intensity significantly affected some parameters including latencies, the effect sizes were negligible.
Conclusion
We propose the median NCS reference standard using the largest Korean dataset ever available. The use of the traceable and reliable reference standard is anticipated to promote more accurate and dependable diagnosis and appropriate management of median neuropathies in Korea.

Objective
To assess whether performing exercises during hemodialysis reduces the risk of developing intradialytic hypotension and enhances exercise capacity in patients with chronic kidney disease.
Methods
This study included patients aged ≥18 years undergoing hemodialysis. Participants performed exercises using a portable lower extremity ergometer during hemodialysis sessions for 3 weeks. Data regarding walking distance, knee strength, quality of life, fat-free mass, arterial pressure, blood pressure, heart rate, frequency of intradialytic hypotension, fatigue, and duration of hemodialysis were collected and analyzed.
Results
Significant improvements in walking distance and knee strength were observed following the implementation of exercise training during hemodialysis. Although there was no significant reduction in the frequency of intradialytic hypotension, a decreasing trend was noted. Other parameters such as quality of life and fatigue did not show significant changes.
Conclusion
Using a portable ergometer during hemodialysis improved exercise capacity and knee strength in patients with chronic kidney disease. There was a trend toward reduced intradialytic hypotension, suggesting potential cardiovascular benefits. Further research with larger sample sizes is needed to confirm these findings.

Citations

• Can exercise reduce fatigue in people living with kidney disease?
  Thomas J. Wilkinson, Lisa Ancliffe, Jamie H. Macdonald
  Current Opinion in Clinical Nutrition & Metabolic Care.2025; 28(3): 200.     CrossRef
• Effect of intra-dialytic exercise on hemodialysis session adequacy and solutes clearance and rebound in prevalent hemodialysis patients
  Howaida Elshinnawy, Hisham Elsayed, Hayam Hebah, Waleed Abdelmohsen, Dina Farrag, Mostafa Abdelnasier
  Egyptian Rheumatology and Rehabilitation.2025;[Epub]     CrossRef