So JI, et al. Ann Rehabil Med. 2017 Feb;41(1):51-57. https://doi.org/10.5535/arm.2017.41.1.51

Yim SY, et al. Ann Rehabil Med. 2017 Aug;41(4):638-649. https://doi.org/10.5535/arm.2017.41.4.638

Background: Stroke often leads to disability, and poststroke survivors often have limited accessibility to medical facilities. Introduction: For such patients, mobile videoconferencing technology offers an opportunity to perform follow-up assessment and appropriate management of cognitive impairment. We aimed to determine the validity of the Korean version of the Mini-Mental State Examination (MMSE-K) when administered using a smartphone. Materials and Methods: Thirty patients with ischemic or hemorrhagic stroke were included in this study (20 males, 10 females; mean age, 69.8 ± 12.9 years). Both face-to-face and remote assessments of cognitive function through MMSE-K were performed for each patient at an interval of at least 3 days. Additionally, an in-person collaborator evaluated the MMSE-K score during the remote assessment. A smartphone and a tablet were used by the patient and the examiner, respectively, and remote connection was mediated using a dedicated videoconferencing application. The MMSE-K scores obtained through face-to-face, remote, and in-person assessments were compared using the Wilcoxon signed rank test and the Spearman correlation analysis. Results: There was good agreement between face-to-face and remote assessments, as well as between remote assessment and in-person collaborator's evaluation regarding total MMSE-K score and subscores for each MMSE-K domain (orientation, memory, attention/calculation, language, and visuospatial function). Discussion: Remote assessment can be a useful clinical evaluation method, and this study confirmed the validity. Conclusions: The smartphone represents a promising tool for the assessment of cognitive function in clinical practice, but further research into the intra- and inter-rater reliability of observations is warranted.

Botulinum toxin A is considered an important tool to control spasticity in children with cerebral palsy. Several factors are known to affect the efficacy of botulinum toxin, such as dosage, appropriate muscle selection and application, age, and accompanying therapy. A multicenter, double-blind, randomized, prospective phase III clinical trial of botulinum toxin A for the treatment of dynamic equinus in 144 children with cerebral palsy was performed to compare the efficacies of letibotulinumtoxin A and onabotulinumtoxin A. Secondary analyses were performed to evaluate factors that affected the outcome, focusing on the number of times injections were repeated. Effectiveness was defined as a change of 2 or more in the physician’s rating scale. Multivariate regression analyses were performed with multiple variables. The first injection of botulinum toxin A significantly improved D subscale of Gross Motor Function Measure-88 scores at 3 months compared to repeated injections (p < 0.05). After 6 months, patients who had one injection or none before the study showed significantly better outcomes than those who had more than one injection in terms of observational gait scores.

Increased survival in the very preterm population results in a higher risk of developing neurodevelopmental and behavioral disabilities among survivors. We examined the outcomes of very preterm infants and parents after a preventive intervention program of four home visits by a specialized nurse, 5 days, 2 weeks, and 1 month after discharge, respectively, and at CA 2 months, followed by up to 12 times of group sessions between CA 3 and 6 months. Our multicenter randomized controlled trial assessed 138 preterm infants (gestational age ≤30 weeks or birth weight ≤1500 g) enrolled from the three participating hospitals. We randomly allocated the preterm babies to either the intervention or the control group. The primary outcome was the neurodevelopmental outcomes of Bayley-III scores at CA 10 and 24 months. At CA 10 months and 24 months, there were no significant differences between the intervention and control groups in the cognitive, motor, and language domains of Bayley-III scores. In addition, there were no significant differences in the mother’s depression scale, mother–child attachment, and the modified Infant and Toddler Social and Emotional Assessment.