Background: This randomized controlled trial aimed to investigate the effects of dance therapy using telerehabilitation on trunk control and balance training in patients with stroke and compare them with the effects of conventional treatment. Methods: We enrolled 17 patients with subacute or chronic stroke who were randomly assigned to either an experimental or a control group. In addition to conventional physical therapy, the experimental group (n = 9) participated in 40-minute, non-face-to-face, dance-therapy sessions and the control group (n = 8) received conventional physical therapy. The primary outcome measures were the Trunk Impairment Scale (TIS) scores to assess trunk control and balance function between the 2 groups as a measure of change from baseline to after the intervention. Results: We found that the TIS scores of the patients in the experimental group significantly improved (P = .017). The TIS results indicated non-inferiority within a predefined margin for dance therapy using telerehabilitation (difference = -0.86, 95% confidence interval [CI] = -2.21 to 0.50). Conclusion: Dance therapy using telerehabilitation significantly improved the TIS scores in the experimental group and was not inferior to conventional rehabilitation treatment when compared in a non-inferiority test. The remote dance program may therefore have similar effects to those of conventional treatment regarding trunk-control improvement in patients with stroke.

Objective To utilize pulmonary function parameters as predictive factors for dysphagia in individuals with cervical spinal cord injuries (CSCIs).Methods Medical records of 78 individuals with CSCIs were retrospectively reviewed. The pulmonary function was evaluated using spirometry and peak flow meter, whereas the swallowing function was assessed using a videofluoroscopic swallowing study. Participants were divided into the non-penetration-aspiration group (score 1 on the Penetration-Aspiration Scale [PAS]) and penetration-aspiration group (scores 2–8 on the PAS). Individuals with pharyngeal residue grade scores >1 were included in the pharyngeal residue group.Results The mean age was significantly higher in the penetration-aspiration and pharyngeal residue groups. In this study, individuals with clinical features, such as advanced age, history of tracheostomy, anterior surgical approach, and higher neurological level of injury, had significantly more penetration-aspiration or pharyngeal residue. Individuals in the penetration-aspiration group had significantly lower peak cough flow (PCF) levels. Individuals in the pharyngeal residue group had a significantly lower forced expiratory volume in 1 second (FEV1). According to the receiver operating characteristic curve analysis of PCF and FEV1 on the PAS, the cutoff value was 140 L/min and 37.5% of the predicted value, respectively.Conclusion Low PCF and FEV1 values may predict the risk of dysphagia in individuals with CSCIs. In these individuals, active evaluation of swallowing is recommended to confirm dysphagia.

Autonomic dysfunction is a common complication of acute stroke, which impairs functional outcomes and increases mortality. There is a lack of well-established knowledge regarding the influence of autonomic dysfunction in patients with acute stroke. This study aims to investigate the impact of the severity of autonomic dysfunction on functional outcomes in patients with acute stroke. A retrospective analysis was conducted at a single center, involving 22 patients diagnosed with acute stroke. The severity of autonomic dysfunction was evaluated based on the Composite Autonomic Scoring Scale (CASS). The modified Barthel Index, Berg Balance Scale, Functional Ambulatory Category, and modified Rankin Scale were designated as functional outcome measures. The impact of the severity of autonomic dysfunction on functional outcomes was analyzed using one-way analysis of covariance (ANCOVA). A statistically significant difference was observed between the initial and follow-up functional outcomes based on the severity of autonomic dysfunction. This study presents evidence that the severity of autonomic dysfunction influences functional prognosis in patients with acute stroke. The findings will serve as additional considerations for the rehabilitation of patients with acute stroke.

Tracheostomy is a typical surgical procedure that has been widely practiced to address airway-related difficulties, such as airway obstruction or chronic conditions, that require long-term supportive ventilation. However, it may result in symptoms that detrimental to respiratory system. Computational fluid dynamics (CFD) is a noninvasive and efficient approach for observing the effects of tracheostomy. In this study, we introduced a CFD framework that can reveal the effects of tracheostomy tube insertion based on a comparison with the airflow of a normal airways. An automatic transformation method was developed using a patient's anatomical information to combine subject-specific airways with an artificial tracheostomy tube geometry and an idealized upper airway geometry for later comparison of characteristics of airflow and particle transport. The CFD scheme used for flow simulation in lungs was employed to achieve the behaviors of airflow. The tracheostomy tube generates a jet flow, resulting in twice greater wall shear stress (WSS) and 30 times greater viscous dissipation in the trachea compared to normal airway. The tracheostomized airway induces an intense turbulent jet, which enhances chaotic motion of the particles therein and allows particles to deposit more frequently on the surface. Subsequently, an increase in particle deposition is observed on the central airway's surface. The variation of pressure between inspiration and expiration phase was twice greater and the airflow resistance was also significantly higher compared to normal airway, implying the greater work of breathing. The novel framework could evaluate the efficiency and potential complications in performing tracheostomy beforehand by observing airflow behaviors.

Although noninvasive ventilation (NIV) is administered to manage respiratory failure due to various causes, safety and effectiveness issues associated with the use of NIV masks have been reported. The present article aims to provide health professionals with a comprehensive review of the ergonomic considerations of NIV masks in terms of design, evaluation, and personalization. Based on a review of 93 papers, we provide guidelines for mask selection and troubleshooting during mask use as well as ergonomic approaches including face anthropometry, sizing systems, mask design, evaluation, and personalization. The comprehensive information presented in this review provides ergonomic perspectives to identify and prevent safety and usability problems associated with the use of NIV masks. Ergonomic improvement and personalization are important goals in order to facilitate the success of NIV treatment.