Bimanual cooperation plays a vital role in functions of the upper extremity and daily activities. Based on the principle of bilateral movement, mirror therapy could provide bimanual cooperation training. However, conventional mirror therapy could not achieve the isolation of the mirror. A novel paradigm mirror therapy called associated mirror therapy (AMT) was proposed to achieve bimanual cooperation task-based mirror visual feedback isolating from the mirror. The study was aimed at exploring the feasibility and effectiveness of AMT on stroke patients. We conducted a single-blind, randomized controlled trial. Thirty-six eligible patients were equally assigned into the experimental group (EG) receiving AMT and the control group (CG) receiving bimanual training without mirroring for five days/week, lasting four weeks. The Fugl-Meyer Assessment Upper Limb subscale (FMA-UL) for upper extremity motor impairment was used as the primary outcome. The secondary outcomes were the Box and Block Test (BBT) and Functional Independence Measure (FIM) for motor and daily function. All patients participated in trials throughout without adverse events or side effects. The scores of FMA-UL and FIM improved significantly in both groups following the intervention. Compared to CG, the scores of FMA-UL and FIM were improved more significantly in EG after the intervention. The BBT scores were improved significantly for EG following the intervention, but no differences were found in the BBT scores of CG after the intervention. However, no differences in BBT scores were observed between the two groups. In summary, our study suggested that AMT was a feasible and practical approach to enhance the motor recovery of paretic arms and daily function in stroke patients. Furthermore, AMT may improve manual dexterity for poststroke rehabilitation.

Food intake monitoring can play an important role in the prevention of malnutrition in the aging population, but traditional tools may not be adequate for use in this target group. Traditional tools typically involve the use of questionnaires or food diaries that require manual data entry. Due to their time consuming nature, they are often incomplete, contain mistakes or not used at all. An alternative to self-reporting tools, in the form of a plate system that automatically measures the consumed food during the meal, is presented in this work. Furthermore, the system can estimate the location where each bite was taken on the plate. The system is compatible with an off-the-shelf plate that is mounted on top of a base station. Weight sensors need not be integrated in the plate itself. Localization of the bites is done by looking at the movement of the center of mass during eating. When used with a compartmentalized plate, the amount of consumed food per compartment can be estimated. With prior knowledge of the type of food in each compartment, this can give an indication of the amount of calories and nutritional intake. We present a bite detection algorithm using a random forest decision tree classifier. Data from 24 aging adults (ages 52-95) eating a single meal with chopsticks was used to train and evaluate the model. Out of a total of 836 true annotated bites, the algorithm detected 602 with a precision and recall of 0.78 and 0.76, respectively. By summing the weights of detected bites from each compartment, the algorithm was able to estimate the amount of food taken per compartment with an average error of (8 $\pm$ 8)% of the portion size.

Mirror therapy (MT) is an effective approach in stroke recovery, but its impact on subcortical neural reorganization remains unclear. Thus, we aimed to investigate the neuroplastic effects on white matter due to MT. In this study, thirty-three participants with stroke were recruited and randomly assigned into the MT group (n=16) or the control group (n=17) for a 4-week intervention. Before and after the intervention, motor recovery was evaluated using the Fugl-Meyer Assessment upper limb subscale (FMA-UL), and the white matter structure and function were investigated using DTI and resting-state fMRI, focusing on the corticospinal tract and the corpus callosum. Significant correlations between the improvements of the FMA-UL and the baseline fractional anisotropy of ipsilesional corticospinal tract (p < 0.001) and corpus callosum (p = 0.009) were observed only in the MT group. Additionally, no significant structural alterations were found between the two groups after the intervention. The fractional amplitude of low-frequency fluctuation of ipsilesional corticospinal tract (p = 0.003) and corpus callosum (p = 0.005) were significantly enhanced only in the MT group, which were correlated with the improvements of the FMA-UL (p < 0.001). Furthermore, partial correlation analysis and subsequent mediation model analysis suggested that the changes of fractional amplitude of low-frequency fluctuation in corpus callosum partially mediated the effect of the baseline fractional anisotropy of ipsilesional corticospinal tract on the FMA-UL improvements in the MT group. This study provided neuroimaging evidence on white matter reorganization after MT, specifically the corpus callosum, suggesting a potential interhemispheric transcallosal neuroplastic mechanism of MT.

Obesity and malnutrition have psychological and physiological impacts on the health of older adults. Automated eating gesture detection has the potential to advance the assessment of their dietary intake activity. However, detecting eating gestures in older adults poses heightened challenges due to the variability in their eating behaviors. Some individuals exhibit slower eating habits, while others experience limitations in using one hand. Conversely, certain individuals conform to typical eating patterns observed in the adult population. To address this issue, we propose an automated eating gesture detection system using wrist and head mounted inertial measurement unit (IMU) sensors. An end-to-end approach is developed to detect and segment the time interval of eating gestures by employing a multi-stage temporal convolutional network (MS-TCN). Compared to existing eating gesture detection approaches, the present method is able to segment intervals of detected eating gestures more efficiently. We assess our methodology using one self-collected dataset containing 24 older adults, along with three publicly available datasets: FIC, OREBA, and Clemson. The leave-one-subject-out (LOSO) evaluation shows that our method achieves a segmental F1-score of 0.944 on our dataset. Furthermore, results on the FIC, OREBA, and Clemson datasets consistently indicate that our detection approach outperforms existing sliding window-based algorithms that combine convolutional neural networks and recurrent neural networks (CNN-RNNs).

Facial palsy would lead to a series of physical and mental problems, as facial function plays an important role in various aspects of daily life. However, the current strategies for evaluating facial function relied heavily on raters and the results varied from the experience of raters. Thus, an objective and accurate facial evaluation system is always claimed. In this study, a customized automatical facial evaluation system (AFES) was proposed, which might have the potential to be employed as an adjunctive and efficient assessing method in clinic. In order to investigate the feasibility of AFES, ninety-two participants with facial palsy were recruited and received scale-based subjective manual evaluation (including mHBGS and mSFGS) and objective automatical evaluation of AFES (including aHBGS, aSFGS and indicators of facial regional features) at enrollment and after two weeks. The correlations between the results of the two methods were analyzed and the participants were stratified according to the severity of facial function for further analyses. Strong positive correlations between manual and automatical HBGS and SFGS were observed and higher correlations were reported in the participants with normal-mild and moderate facial palsy. Significant improvements in clinical scales and indicator of eye synkinesis were found in forty-two participants in two weeks. Furthermore, some of the indicators were correlated with scale scores (I4, I7) and one of them presented a significant change between the baseline evaluation and follow-up evaluation (I7). According to the results, AFES could be considered as a viable method to perform objective and reliable evaluation for patients with facial palsy and provide clarified results for prognosis.

Introduction: Non-invasive brain stimulation has been combined with mirror visual feedback (MVF) as a priming strategy to enhance therapeutic efficacy. However, a superior combined effect is hindered by the lack of emphasis on MVF-relevant embodiment perception.Objective: This study assessed the priming effect of repeated transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) and dorsolateral prefrontal cortex (dlPFC) on embodiment perception during MVF.Methods: In the experiment, 15 healthy participants were required to complete tasks using their left hand while keeping their right hand static behind a mirror. They first received excitatory TMS over the left M1 or dlPFC, or sham-TMS in random order during three trial rounds and then performed three subsequent motor tasks and two task-oriented evaluations during MVF in each trial. Latency time (LT), number of embodiment occurrences, embodiment questionnaire (EQ) score, and time required to complete the task-oriented activities were recorded.Results: The results showed that the LT of forearm rotation in the dlPFC-TMS round was shorter than that in the sham-TMS round, although a greater number of occurrences were obtained in both the M1-TMS and dlPFC-TMS rounds compared to the sham-TMS round within the three motor tasks, which suggested that TMS priming facilitated the elicitation of embodiment perception. The EQ results indicated strengthened embodiment perception after TMS priming, especially in the dlPFC-TMS round.Conclusion: This study provides evidence that TMS priming over motor process-related regions, specifically the dlPFC, contributes to eliciting and intensifying embodiment perception during MVF, which benefited from a superior MVF paradigm for improving rehabilitation outcomes.Clinical Trial Registration: Identifier ChiCTR2400089499 https://www.chictr.org.cn/showproj.html?proj=240385.