Purpose: Incorporating social determinants of health (SDH) into medical education is crucial. However, there are limited data on standard education models and comprehensive SDH curricula in Taiwan are insufficient. This study presents a systematic SDH curriculum instructed primarily by social workers for postgraduate doctors and aims to examine the training outcomes of the innovative curriculum.
View Article and Find Full Text PDFThis study introduces a novel paradigm for achieving widely tunable many-body Fano quantum interference in low-dimensional semiconducting nanostructures, beyond the conventional requirement of closely matched energy levels between discrete and continuum states observed in atomic Fano systems. Leveraging Floquet engineering, the remarkable tunability of Fano lineshapes is demonstrated, even when the original discrete and continuum states are separated by over 1 eV. Specifically, by controlling the quantum pathways of discrete phonon Raman scattering using femtosecond laser pulses, the Raman intermediate states across the excitonic Floquet band are tuned.
View Article and Find Full Text PDFHome exercise programs are beneficial in managing frozen shoulder (FS), yet adherence remains challenging. This pilot study introduces the remote app, Defrozen, designed for home exercises and assesses its feasibility and clinical outcomes in FS patients undergoing intra-articular and sub-acromial corticosteroid treatment. Over a four-week period, patients used the Defrozen-app, engaging in guided exercises.
View Article and Find Full Text PDFBackground: Multidomain intervention may delay or ameliorate cognitive decline in older adults at risk of Alzheimer's disease, particularly in the memory and inhibitory functions. However, no study systematically investigates the changes of brain function in cognitively-normal elderly with subjective cognitive decline (SCD) when they receive multidomain intervention.
Objective: We aimed to examine whether a multidomain intervention could improve neuropsychological function and neurophysiological activities related to memory and inhibitory function in SCD subjects.
Objective: Technologically adapted mirror therapy shows promising results in improving motor function for stroke survivors. The treatment effects of a newly developed multi-mode stroke rehabilitation system offering multiple training modes in digital mirror therapy remain unknown. This study aimed to examine the effects of unilateral mirror visual feedback (MVF) with unimanual training (UM-UT), unilateral MVF with bimanual training (UM-BT), and bilateral MVF with bimanual training (BM-BT) on clinical outcomes in stroke survivors, compared to classical mirror therapy (CMT).
View Article and Find Full Text PDFEur J Phys Rehabil Med
June 2023
Background: How the natural deterioration of aging, sex difference, and pathological effect of stroke affect the prediction of hand strength is still unknown.
Aim: This study aimed to compare and predict grip strength in both hands between normal controls (NCs) and stroke patients.
Design: Observational, cross-sectional study.
Health related quality of life (HRQOL) reflects individuals perceived of wellness in health domains and is often deteriorated after stroke. Precise prediction of HRQOL changes after rehabilitation interventions is critical for optimizing stroke rehabilitation efficiency and efficacy. Machine learning (ML) has become a promising outcome prediction approach because of its high accuracy and easiness to use.
View Article and Find Full Text PDFWhether muscle properties gradually change with age and how muscle properties are affected by sex remain unclear. In this study, we investigated the influence of age and sex on the biomechanical and viscoelastic properties of arm muscles in middle-aged and older adults. In this cross-sectional study, 80 healthy participants were divided by sex (male and female), and each sex group, by 10-year age ranges (40-49, 50-59, 60-69, and 70-79 years).
View Article and Find Full Text PDFMany individuals with stroke experience upper-limb motor deficits, and a recent trend is to develop novel devices for enhancing their motor function. This study aimed to develop a new upper-limb rehabilitation system with the integration of two rehabilitation therapies into one system, digital mirror therapy (MT) and action observation therapy (AOT), and to test the usability of this system. In the part I study, the new system was designed to operate in multiple training modes of digital MT (i.
View Article and Find Full Text PDF(1) Background: Road traffic accidents (RTAs) are the leading cause of pediatric traumatic brain injury (TBI) and are associated with high mortality. Few studies have focused on RTA-related pediatric TBI. We conducted this study to analyze the clinical characteristics of RTA-related TBI in children and to identify early predictors of in-hospital mortality in children with severe TBI.
View Article and Find Full Text PDFBackground: Several brain regions are activated in response to mirror visual feedback (MVF). However, less is known about how these brain areas and their connectivity are modulated in stroke patients. This study aimed to explore the effects of MVF on brain functional connectivity in stroke patients.
View Article and Find Full Text PDFMirror visual feedback (MVF) has been shown to increase the excitability of the primary motor cortex (M1) during asynchronous bimanual movement. However, the functional networks underlying this process remain unclear. We recruited 16 healthy volunteers to perform asynchronous bimanual movement, that is, their left hand performed partial range of movement while their right hand performed normal full range of movement.
View Article and Find Full Text PDFTraumatic brain injury (TBI) is the leading cause of mortality in children. There are few studies focused on school-aged children with TBI. We conducted this study to identify the early predictors of in-hospital mortality in school-aged children with severe TBI.
View Article and Find Full Text PDFBoth action observation (AO) and virtual reality (VR) provide visual stimuli to trigger brain activations during the observation of actions. However, the mechanism of observing video movements performed by a person's real hand versus that performed by a computer graphic hand remains uncertain. We aimed to investigate the differences in observing the video of real versus computer graphic hand movements on primary motor cortex (M1) activation by magnetoencephalography.
View Article and Find Full Text PDFBackground: Accurate prediction of motor recovery after stroke is critical for treatment decisions and planning. Machine learning has been proposed to be a promising technique for outcome prediction because of its high accuracy and ability to process large volumes of data. It has been used to predict acute stroke recovery; however, whether machine learning would be effective for predicting rehabilitation outcomes in chronic stroke patients for common contemporary task-oriented interventions remains largely unexplored.
View Article and Find Full Text PDFObjective: This study aimed to investigate the differential effects of bilateral and unilateral mirror therapy (MT) on motor cortical activations in stroke patients by magnetoencephalography (MEG).
Methods: Sixteen stroke patients and 16 right-handed healthy volunteers were recruited. All participants were required to perform 4 conditions: resting, no mirror with bilateral hand movements (Bilateral-No mirror), mirror with bilateral hand movements (Bilateral-Mirror) and mirror with unilateral hand movements (Unilateral-Mirror).
Background: The timing of transcranial direct current stimulation (tDCS) with neurorehabilitation interventions may affect its modulatory effects. Motor function has been reported to be modulated by the timing of tDCS; however, whether the timing of tDCS would also affect restoration of daily function and upper extremity motor control with neurorehabilitation in stroke patients remains largely unexplored. Mirror therapy (MT) is a potentially effective neurorehabilitation approach for improving paretic arm function in stroke patients.
View Article and Find Full Text PDFBackground: Action observation therapy and mirror therapy, two promising rehabilitation strategies, are aimed at enhancing the motor learning and functional improvement of stroke patients through different patterns of visual feedback and observation.
Objective: This study investigated and compared the treatment effects of the action observation therapy, mirror therapy, and active control intervention on motor and functional outcomes of stroke patients.
Methods: Twenty-one patients with subacute stroke were recruited in this study.
Patients with amnestic mild cognitive impairment (aMCI) demonstrate significant cognitive deficits, especially in the memory aspect. The memory deficiency might be attributed to the difficulties in the inhibitory function to suppress redundant stimuli. Sensory gating (SG) refers to the attenuation of neural responses to the second identical stimulus in a paired-click paradigm, in which auditory stimuli are delivered in pairs with inter-stimulus intervals (ISI) of 500 ms and inter-pair intervals of 6-8 s.
View Article and Find Full Text PDFWe differentiated the influence of mirror-induced visual conflicts on the perceptual-attention-motor control process by examining the variation of primary motor cortex (M1) activities and the functional connectivity among five brain regions associated with perceptual, motor, and attentional processes. Magnetoencephalography (MEG) was recorded under three conditions: both hands kept stationary with the forearms supinated (resting condition), in-phase bimanual movements with congruent visual feedback [symmetry (Sym) condition], and out-of-phase bimanual movements with incongruent visual feedback [asymmetry (Asy) condition]. We found that compared with the resting state, the decrease in beta oscillation was greater in the Sym than in the Asy condition, suggesting a greater activation of M1 when implementing hand movement without visual conflict.
View Article and Find Full Text PDFThe priming effect of mirror visual feedback can be simply provided by inexpensive mirror therapy (MT), which exhibits beneficial effects on sensorimotor recovery in stroke. The present study was a single-blind pretest-posttest study that examined whether the priming effect of mirror visual feedback on bilateral task practice would render better outcomes. Twenty-three patients with chronic stroke were randomized to receive hospital-based task-oriented MT or bilateral arm training (BAT) for 4 weeks at 90 minutes/day, 3 days/week and a home practice for 30-40 minutes/day, 5 days/week.
View Article and Find Full Text PDFAction observation therapy has recently attracted increasing attention; however, the mechanisms through which action observation and execution (AOE) modulate neural activity in stroke patients remain unclear. This study was aimed at investigating the effects of action observation and two types of AOE on motor cortical activations after stroke using magnetoencephalography. Twenty patients with stroke and 20 healthy controls were recruited for the collection of data on the beta oscillatory activity in the primary motor cortex (M1).
View Article and Find Full Text PDFObjective: To identify the predictors of minimal clinically important changes in actual and perceived functional arm use of the affected upper limb after rehabilitative therapy.
Design: Retrospective, observational cohort study.
Setting: Outpatient rehabilitation settings.
[Purpose] Limited literature has investigated the relationships between acceleration-based gait characteristics and kinematic information from motion analysis systems in gait analysis. The purpose of this study is to determine whether acceleration-based gait characteristics were associated with gait characteristics by motion analysis systems in patients with stroke. [Participants and Methods] Seventeen patients with stroke walked along a 10-m-long walkway at their comfortable speed.
View Article and Find Full Text PDFObjective: This study was to investigate the effectiveness of action observation therapy on arm and hand motor function, walking ability, gait performance, and activities of daily living in stroke patients.
Design: Systematic review and meta-analysis of randomized controlled trials.
Data Sources: Searches were completed in January 2019 from electronic databases, including PubMed, Scopus, the Cochrane Library, and OTseeker.