Background: Shoulder subluxation occurs in 17–64% of hemiplegic patients after stroke and develops mostly during the first three weeks of hemiplegia. A range of shoulder orthoses has been used in rehabilitation to prevent subluxation. However, there is little evidence of their efficacy. AIM: This study aimed to investigate whether there is a difference in the subluxation distance, pain, and functional level of the hemiplegic upper extremity among patients with two different shoulder orthoses. Design: This is a prospective, randomized controlled trial with intention-to-treat analysis. SETTING: Multicenter, rehabilitation medicine department of two university hospitals in South Korea. Population: Forty-one patients with subacute stroke with shoulder subluxation with greater than 0.5 finger width within 4 weeks of stroke were recruited between January 2016 and October 2021. Methods: The experimental group used an elastic dynamic sling while sitting and standing to support the affected arm for eight weeks. The control group used a Bobath sling while sitting and standing. The primary outcome was to assess the distance of the shoulder subluxation on radiography. The secondary outcomes were upper-extremity function, muscle power, activities of daily living, pain and spasticity. Result: The horizontal distance showed significant improvement in the elastic dynamic sling group, but there were no significant differences in the vertical distance between the elastic dynamic and Bobath sling groups. Both groups showed improvements in upper-extremity movements and independence in daily living after 4 and 8 weeks of using shoulder orthoses, and the differences within the groups were significant (p < 0.05). However, there were no significant differences in upper-extremity movements and independence in daily living between the two groups. Conclusions: The subluxation distance showed better results in the elastic dynamic sling, which has both proximal and distal parts, than in the Bobath sling, which holds only the proximal part. Both shoulder orthoses showed improvements in the modified Barthel index, upper-extremity function, and manual muscle testing.

Malnutrition and autonomic dysfunction are associated with poor outcomes, mortality, and psychological problems after stroke. Relevant laboratory biomarkers include serum albumin, prealbumin, and transferrin. Heart rate variability (HRV), a noninvasive measurement, can objectively measure autonomic nervous system (ANS) function. The relationship between HRV and nutritional biomarkers in stroke patients has not been studied. This study aimed to examine the relationship between nutritional biomarkers and HRV parameters in stroke patients. We retrospectively recruited 426 patients with subacute stroke who were examined for nutritional biomarkers, such as serum albumin, prealbumin, and transferrin, and underwent 24 h ambulatory Holter electrocardiography. Patients were divided into groups according to their nutritional biomarker status. Differences in HRV parameters between nutritional biomarker-deficient and normal groups were assessed. Pearson’s correlation and multiple regression analyses were used to verify the relationship between HRV parameters and nutritional biomarkers. HRV parameters were significantly lower in the nutritional biomarker-deficient groups. In addition, there was a significant association between HRV parameters and nutritional biomarkers. Serum albumin, prealbumin, and transferrin levels were associated with ANS function, as measured by HRV, and their deficiency may be a predictive factor for the severity of ANS dysfunction in stroke patients.

Background and Objectives: Acute kidney injury (AKI) affects the survival rate of kidney transplant organs and patients. Acute rejection (AR) due to AKI may lead to kidney transplantation failure. It is known that there is a relationship between human leukocyte antigen-G (HLA-G), which is involved in immune regulation, and AR in transplant patients. Moreover, 14-bp insertion/deletion polymorphism in the 3′ untranslated region (UTR) region of the HLA-G gene is known to affect HLA-G expression. However, its relationship to AR is still controversial. The aim of this study was to investigate whether HLA-G 14-bp insertion/deletion polymorphism contributed to the development of AR in kidney transplant patients using a meta-analysis. Materials and Methods: To perform our meta-analysis, eligible studies about HLA-G 14-bp insertion/deletion polymorphism and AR were searched in electronic databases until 1 June 2021. Finally, a total of 336 patients with AR and 952 patients without AR in relation to kidney transplantation were analyzed from a total of nine studies. Results: In our results, the Del allele and Ins/Del+Del/Del and Del/Del genotypes significantly increased susceptibility of AR in Asian populations [odds ratio (OR) = 2.359, 95% confidence interval (CI) = 1.568–3.550, p = 3.8 × 10⁻⁵; OR = 3.357, 95% CI = 1.769–6.370, p = 0.002; OR = 2.750, 95% CI = 1.354–5.587, p = 0.0052 in each model, respectively]. Conclusions: Evidence of the present results indicate that HLA-G 14-bp insertion/deletion polymorphism is associated with susceptibility to AR in the Asian population.

Dysphonia and malnutrition are major problems in patients who have suffered an ischemic stroke. Tools to assess dysphonia severity include the dysphonia severity index (DSI) and maximum phonation time (MPT). This study aimed to investigate whether the nutritional biomarkers transferrin, albumin, and prealbumin could be predictors of dysphonia severity. A retrospective analysis was conducted between January 2018 and October 2022. A total of 180 patients who had suffered an ischemic stroke were included. Serum transferrin, albumin, and prealbumin levels were significantly correlated with DSI and MPT levels. In a multiple regression analysis, prealbumin and transferrin were significant predictors of DSI, whereas only prealbumin was a significant predictor of MPT. Serum transferrin, albumin, and prealbumin levels in patients who have suffered an ischemic stroke may correlate with dysphonia severity as assessed using DSI and MPT. These results may provide objective evidence that nutritional biomarkers affect dysphonia severity.

Background/Objectives: Abnormal muscle tone and impaired motor control commonly limit gait recovery after stroke. Robot-assisted gait training has been introduced to augment conventional rehabilitation; however, its effects on stage-based motor recovery, functional ambulation, and muscle tone during the subacute phase remain unclear. Methods: This prospective, single-center, randomized controlled trial enrolled 30 patients with subacute stroke who received robot-assisted gait training plus conventional rehabilitation (R-BoT Plus group, n = 15) or conventional rehabilitation alone (control group, n = 15) over 4 weeks. The primary outcome was the change in Brunnstrom recovery stage of the lower extremities (BRS-LE). Secondary outcomes included Functional Ambulation Category (FAC), Fugl–Meyer Assessment for the Lower Extremity (FMA-LE), clinical spasticity measures (Modified Ashworth Scale and Modified Tardieu Scale), and muscle mechanical properties (MyotonPRO). Exploratory analyses were conducted to examine the associations between changes in stage-based motor recovery (ΔBRS-LE), functional ambulation (ΔFAC), and MyotonPRO parameters. Within-group changes were assessed using the Wilcoxon signed-rank test. Between-group effects were primarily evaluated using baseline-adjusted ANCOVA with HC3 robust standard errors, with Wilcoxon rank-sum tests on change scores as sensitivity analyses. Associations between changes in clinical outcomes and MyotonPRO parameters were evaluated using Spearman’s rank correlation coefficient (ρ). Results: BRS-LE (p = 0.014) and functional ambulation (p = 0.041) were significantly improved in the R-BoT Plus group. Changes in FMA-LE and clinical spasticity measures did not differ significantly between groups. Quantitative myotonometry revealed selective muscle- and parameter-specific changes. No robust correlations were observed between MyotonPRO parameters and changes in BRS-LE. Conclusions: The addition of robot-assisted gait training to conventional rehabilitation was associated with greater improvements in stage-based lower-limb motor recovery and functional ambulation in patients with subacute stroke. In contrast, cumulative impairment scores and conventional clinical spasticity measures demonstrated limited changes between groups. Quantitative muscle mechanical assessment revealed selective muscle-specific adaptations, supporting its role as a complementary tool for mechanistic characterization rather than as a surrogate marker of motor recovery. Future studies incorporating dose-matched designs and longer follow-up periods are warranted to clarify the independent and long-term effects of robot-assisted gait training.

Articulation disorder is associated with impaired control of respiration and speech organ movement. There are many cases of dysarthria and dysphonia in stroke patients. Dysphonia adversely affects communication and social activities, and it can interfere with everyday life. The purpose of this study is to assess the association between phonation abilities and the vowel quadrilateral in stroke patients. The subjects were stroke patients with pronunciation and phonation disorders. The resonance frequency was measured for the 4 corner vowels to measure the vowel space area (VSA) and formant centralization ratio (FCR). Phonation ability was evaluated by the Dysphonia Severity Index (DSI) and maximal phonation time (MPT) through acoustic evaluation for each vowel. Pearsons correlation analysis was performed to confirm the association, and multiple linear regression analysis was performed between variables. The correlation coefficients of VSA and MPT/u/ were 0.420, VSA and MPT/i/ were 0.536, VSA and DSI/u/ were 0.392, VSA and DSI /i/ were 0.364, and FCR and DSI /i/ were −0.448. Multiple linear regression analysis showed that VSA was a factor significantly influencing MPT/u/ (β = 0.420, P = .021, R ² = 0.147), MPT/i/ (β = 0.536, P = .002, R ² = 0.262), DSI/u/ (β = 0.564, P = .045, R ² = 0.256), and DSI/i/ (β = 0.600, P = .03, R ² = 0.302). The vowel quadrilateral can be a useful tool for evaluating the phonation function of stroke patients.