This study investigates whether Augmented Reality (AR)-based interventions can be as effective as physical therapists (PT) regarding balance, positioning sensation, and flexibility. A sample of 39 regular people who voluntarily participated in this study were randomly distributed into two groups. Then AR was applied in the experimental group and PT was applied in the control group. Variables were measured by Tetrax (static balance), Y-balance test (dynamic balance), CSMI (proprioception), and sit and reach test (flexibility). All measurements were analyzed using paired t-test and independent t-test. The exercise program of this study improved the stability index (ST) of the static balance in both groups after the intervention, and there was a significant difference (p < 0.05) at normal eye close (NC) and Pillow with eye close (PC) positions. Moreover, regarding the case of dynamic balance, there were significant differences in AR and PT groups to reach in all directions (p < 0.05). In the case of positioning sensation, there was no significant difference in both groups (p > 0.05), and there was a significant difference in flexibility (p < 0.05). When comparing the two groups, there was no significant difference in all categories (p > 0.05). As a result, AR can be considered an effective form of therapy and can be selected according to individual conditions.

[Purpose] The purpose of this study was to evaluate the functioning, extent of activity, and participation of school-aged children with cerebral palsy (CP) using the Manual Ability Classification System (MACS). [Subjects and Methods] The Subjects were 57 school-aged children (7-12 years old) with CP. The MACS, Gross Motor Function Measure (GMFM), International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) Checklist, and a questionnaire were used to measure children's functioning, activity, and participation. [Results] GMFM scores differed significantly across the MACS levels. The following differed significantly according to MACS level when assessed with the ICF-CY function section: mental functions; sensory function and pain; voice and speech functions; functions of the digestive, metabolic, and endocrine systems; genitourinary and reproductive function; and neuromusculoskeletal and movement related function. The data from the activities and participation section of the ICF-CY also showed statistically significant differences across MACS levels. [Conclusion] These results suggest that the functioning, activity, and participation of school-aged children with CP depend on their MACS level and that the functioning of children with CP affects their activities and participation.

Background: Speech sound disorders are common in children and are associated with an increased risk of academic reading difficulties. The COVID-19 pandemic further highlighted the need for remote and digitalized assessment tools. In South Korea, standardized instruments such as the Urimal Test of Articulation and Phonation and Assessment of Phonology and Articulation for children are widely used but have limitations, including reliance on face-to-face evaluation, and the absence of automated scoring. Objective: This study aimed to develop and establish the content validity of an articulation assessment tool that can overcome these limitations and be integrated into digital therapeutics (DTx). Methods: A 3-round modified Delphi survey was conducted between July and September 2025 with 92% (23/25) of the invited experts, including 52.2% (12/23) physiatrists and 47.8% (11/23) speech-language pathologists, with a mean professional experience of 10.69 (SD 5.09) years. All participants (23/23, 100%) completed all rounds. Panelists evaluated the appropriateness of word lists, phonological environments, and scoring criteria. Quantitative analyses, including calculations of content validity ratio (CVR), content validity index (CVI), and median and IQR, were performed. Consensus thresholds were set at a CVR of ≥0.39, a CVI of ≥0.78, a median of ≥3.5, and an IQR of ≤1.0. Items were retained only when all 4 criteria were satisfied. While formal qualitative analysis was not performed, the research team internally reviewed and synthesized core keywords and themes from the experts’ open-ended responses to guide the refinement of items. Results: These findings were summarized into four key areas: (1) modernization of word stimuli, (2) expansion of phonological coverage, (3) refinement of scoring criteria to reduce ambiguity, and (4) enhancement of result interpretability through visualization. In round 2, a revised 35-word list was evaluated across 25 items, of which 20 (80%) met all consensus criteria. In total, 20% (5/25) of the items failed to meet at least one threshold, including phonological environment adequacy (CVR=0.48; CVI=0.74), scoring redundancy (CVR=0.13; CVI=0.57), usefulness of proportion of whole-word correctness or percentage of word proximity (CVR=0.39; CVI=0.70), contribution of mean phonological length (CVR=0.22; CVI=0.61), and usefulness of feature-based indexes (CVR=0.30; CVI=0.65; IQR 2). Items that reached consensus showed CVR values of 0.57 to 0.91, CVI values of 0.78 to 0.96, a median score of 4, and IQR values of 0 to 1. In round 3, all remaining items achieved consensus. Conclusions: This Delphi study developed a novel articulation assessment tool with robust content validity. This tool includes updated word stimuli, diverse analysis indexes, and visualization features, thereby enhancing its clinical utility and suitability for integration into artificial intelligence–based DTx. By standardizing and digitalizing articulation assessments, this tool has the potential to support personalized and accessible interventions for children with speech sound disorders.

Rationale: Dysphagia is a frequent complication after stroke, often resulting in aspiration, malnutrition, and diminished quality of life. Conventional swallowing rehabilitation, including 2-channel neuromuscular electrical stimulation (NMES), may have limited benefits in chronic cases. A newly developed 4-channel NMES delivers sequential stimulation to mimic physiological swallowing. Patient concerns: A 63-year-old man experienced persistent dysphagia 25 months after a left hemispheric infarction. Despite prolonged conventional swallowing rehabilitation combined with 2-channel NMES, he remained restricted to pureed foods (International Dysphagia Diet Standardisation Initiative level 4), required frequent suctioning, and showed severe aspiration on videofluoroscopic swallowing study (penetration-aspiration scale score up to 8). Diagnoses: The patient was diagnosed with chronic poststroke dysphagia with severe aspiration confirmed by videofluoroscopic swallowing study. Interventions: The patient underwent an 8-week course of 4-channel NMES applied twice daily in combination with conventional swallowing rehabilitation. Outcomes: Following the intervention, the patient’s diet advanced to International Dysphagia Diet Standardisation Initiative level 6, penetration-aspiration scale scores improved to 1 to 3, suctioning was no longer required, and both the Eating Assessment Tool-10 and Swallowing Quality of Life Questionnaire scores markedly improved. Lessons: This case suggests that 4-channel NMES may be a promising treatment option for chronic poststroke dysphagia refractory to conventional swallowing rehabilitation and warrants further validation in larger studies.

Background: Augmented reality (AR)-based exercise offers a low-cost option for home training, but the lack of supervision increases the risk of incorrect performance. Therefore, AR systems must demonstrate accuracy and effectiveness comparable to therapist-led training. To address this need, this study examined whether an AR-supported multi-component exercise program improves six key components of physical fitness. Methods: Twenty-eight healthy adults from South Korea were recruited and randomly assigned to either the AR group or the physical therapist (PT) group. Participants were assessed for six components of physical fitness: muscular strength, muscular endurance, balance, cardiorespiratory endurance, flexibility, and coordination. Each group performed the exercise program three times per week for four weeks, with each session lasting at least 30 min. Statistical analyses were conducted using paired t-tests to evaluate pre- and post-intervention effects within each group and independent t-tests to compare differences between the two groups. The level of statistical significance was set at p < 0.05. Results: Exploratory analyses showed that both groups demonstrated post-intervention improvements in muscular endurance, balance, flexibility, and coordination, while cardiorespiratory endurance and grip strength showed no notable changes. Between-group comparisons revealed significant differences only in right-hand relative grip strength at both baseline and post-intervention, with no other domains differing between groups. Conclusions: First, the AR-based intervention significantly improved muscular endurance, balance, flexibility, and coordination. Second, there were no significant differences between the AR-based and therapist-led interventions. Consequently, AR-based exercise programs may enhance specific components of physical fitness and could be effectively utilized to complement and extend therapist-led training sessions.

Hip deformities, including subluxation, dislocation, and coxa valga, are common in nonambulatory children with spastic cerebral palsy (CP), especially those classified as Gross Motor Function Classification System IV and V. These deformities impact daily activities and quality of life. This study aimed to identify factors associated with hip deformity and explore rehabilitation strategies to prevent complications. A cross-sectional study (August 2018–May 2020) included 46 children with spastic CP (Gross Motor Function Classification System IV-V, aged 2–10 years). Radiographic and physical measurements, including range of motion, spasticity, muscle strength, and surface electromyography, were analyzed using multiple regression and Pearson correlation. Hip deformities were assessed via Reimer’s migration index, femoral neck-shaft angle, acetabular index, and pelvic obliquity. Migration index was negatively correlated with hip abduction range of motion (ROM) at 90-degree flexion. The femoral neck-shaft angle showed a negative correlation with the abductor-to-adductor muscle strength ratio. These findings suggest that reduced hip abduction ROM and muscle strength imbalance are associated with hip deformities in nonambulatory children with spastic CP. Hip abduction ROM and muscle strength balance are crucial for preventing hip deformities in nonambulatory children with spastic CP. While strengthening hip abductors and improving ROM may be potentially beneficial, interventional studies are needed to confirm whether these strategies reduce subluxation risk. Early identification using noninvasive methods like ROM and surface electromyography can help minimize radiation exposure from frequent radiographic evaluations.