Therapeutic Effects of Metaverse Rehabilitation for Cerebral Palsy: A Randomized Controlled Trial.

Metaverse physical therapy (MPT), an adjuvant technology for the rehabilitation of children with cerebral palsy (CP), has gained notoriety in the clinical field owing to its accessibility and because it provides motivation for rehabilitation. The aim is to compare the gross motor function and cardiopulmonary function, the activities of daily living, quality of life (QOL), and the perceived risk of coronavirus disease (COVID)-19 transmission between MPT and conventional physical therapy (CPT). A convenience sample of 26 children with CP (mean age, 11.23 ± 3.24 years, 14 females) were randomized into either the MPT or CPT group and received therapy three days/week for four weeks. Clinical outcomes included gross-motor-function measure 66 (GMFM-66), heart rate (HR), Borg-rating perceived exertion (BRPE), functional independence measure (FIM), pediatric QOL, and the risk of COVID-19 transmission. An analysis of variance showed that compared with CPT, MPT exerted positive effects on GMFM, HR, and BRPE. An independent t-test showed that compared with CPT, MPT exerted positive effects on the perceived transmission risk of COVID-19 but not on FIM and QOL. Our results provide promising therapeutic evidence that MPT improves gross motor function, cardiopulmonary function, and the risk of COVID-19 in children with CP.

BNT162b2-induced neutralizing and non-neutralizing antibody functions against SARS-CoV-2 diminish with age.

Each severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant renews concerns about decreased vaccine neutralization weakening efficacy. However, while prevention of infection varies, protection from disease remains and implicates immunity beyond neutralization in vaccine efficacy. Polyclonal antibodies function through Fab domains that neutralize virus and Fc domains that induce non-neutralizing responses via engagement of Fc receptors on immune cells. To understand how vaccines promote protection, we leverage sera from 51 SARS-CoV-2 uninfected individuals after two doses of the BNT162b2 mRNA vaccine. We show that neutralizing activities against clinical isolates of wild-type and five SARS-CoV-2 variants, including Omicron BA.2, link to FcγRIIIa/CD16 non-neutralizing effector functions. This is associated with post-translational afucosylation and sialylation of vaccine-specific antibodies. Further, polyfunctional neutralizing and non-neutralizing breadth, magnitude, and coordination diminish with age. Thus, studying Fc functions in addition to Fab-mediated neutralization provides greater insight into vaccine efficacy for vulnerable populations, such as the elderly, against SARS-CoV-2 and novel variants.

Comparative Effectiveness of Artificial Intelligence-Based Interactive Home Exercise Applications in Adolescents with Obesity.

The rate of obesity in adolescents has increased due to social distancing measures and school closures caused by the COVID-19 pandemic. These issues have caused adolescents to change their lifestyles and eating habits. Furthermore, the growth in inactive behavior and computer screen or watching TV time, as well as the reduction in physical activity, could similarly be related with obesity. To overcome this problem, we recently developed an artificial intelligence (AI)-based gesture recognition game application called Super Kids Adventure (SUKIA, Funrehab, Daejeon, Korea), which provides inexpensive and motivational game applications. This research is designed to assess the effects of SUKIA and Nintendo Switch (NINS) on calorie consumption, VO2 max, 6-minute walking test (6MWT) as well as body mass index (BMI), and the Borg rating of perceived exertion scale (RPE) in adolescents with obesity. A convenience sample of 24 adolescents with obesity were randomized into either the NINS or SUKIA groups 5 days/week for 3 weeks. Analysis of variance (ANOVA) and independent t-tests were presented with significant level at p < 0.05, and the analysis indicated that SUKIA showed superior effects on calorie consumption, VO2 max, and RPE compared to NINS. Our results provide evidence that SUKIA can more effectively improve cardiopulmonary function and calorie consumption than NINS in adolescents with obesity during COVID-19.

EFFECTS OF THE COVID-19 PANDEMIC ON CARDIOPULMONARY FUNCTION IN CHILDREN WITH CEREBRAL PALSY: A PRELIMINARY STUDY

The purpose of this study was to examine what effects the coronavirus disease 2019 (COVID-19) pandemic has on the cardiopulmonary endurance, heart rate and oxygen saturation in children with cerebral palsy (CP) during a 6-min walk test (6MWT). This study had a laboratory design and tested a single group pre- and post-COVID-19. A convenience sample of 8 participants with CP (three females;mean age±SD=13±6.4 years) that was recruited from a community-based rehabilitation center was enrolled in the current study. Due to COVID-19, no rehabilitation was provided by a physical therapist for two months as the participants stayed at home. The descriptive statistics and paired t-test were derived by examining the participants’ cardiopulmonary function via the Borg scale, 6MWT, heart rate and oxygen saturation, while they underwent rehabilitation versus the two months without rehabilitation due to COVID-19. The participants’ walking distances, oxygen saturation and heart rates were measured, and the Borg scale was used to assess the participants’ perceptions of their fatigue, breathlessness, and effort and exertion during the 6MWT. The descriptive statistical analysis demonstrated the following effects when comparing the post-COVID-19 results to those before the pandemic: greater distance on the 6 MWT test (0.69%), minimal changes in oxygen saturation (−0.3%) and increased heart rate (8.4%) and Borg scale values (19.4%). Paired t-test suggested that a significant difference was shown on the Borg scale (P=0.04) and heart rate (P=0.01). The results of this study provide clinical, evidence-based insights into the impact of the COVID-19 pandemic on cardiopulmonary function in children with CP. The clinical case series study demonstrated that after the COVID-19 pandemic, the participants with CP experienced increased heart rates and decreased minimal oxygen saturation, cardiopulmonary endurance. Recent advances in communication and information technology allow physical therapists to train and refine individually through remote rehabilitation. Exercise and combining VR remote education can be a way to maintain cardiopulmonary functions that have fallen due to the pandemic. [ FROM AUTHOR] Copyright of Journal of Mechanics in Medicine & Biology is the property of World Scientific Publishing Company and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

BNT162b2 induced neutralizing and non-neutralizing antibody functions against SARS-CoV-2 diminish with age

Each SARS-CoV-2 variant renews concerns about decreased vaccine neutralization weakening efficacy. However, while prevention of infection varies, protection from disease remains and implicates immunity beyond neutralization in vaccine efficacy. Polyclonal antibodies function through Fab domains that neutralize virus, and Fc domains that induce non-neutralizing responses via engagement of Fc receptors on immune cells. To understand how vaccines promote protection, we leverage sera from 51 SARS-CoV-2 uninfected individuals after two doses of the BNT162b2 mRNA vaccine. We show neutralizing activities against clinical isolates of wildtype and five SARS-CoV-2 variants, including Omicron BA.2, link to FcγRIIIa/CD16 non-neutralizing effector functions. This is associated with post-translational afucosylation and sialylation of vaccine specific antibodies. Further, polyfunctional neutralizing and non-neutralizing breadth, magnitude and coordination diminish with age. Thus, studying Fc functions in addition to Fab mediated neutralization provides greater insight into vaccine efficacy for vulnerable populations such as the elderly against SARS-CoV-2 and novel variants. Graphical Bates et al. investigate viral neutralization, antibody glycosylation and Fc-mediated effector functions from BNT162b2. Neutralization and antibody-dependent natural killer cell activation correlate. Vaccine-specific IgG display distinct glycosylation patterns with afucosylation and sialylation associating with natural killer cell activation. These antibody properties collectively diminish in those ≥65 years old.

Minimal Contact Robotic Stroke Rehabilitation on Risk of COVID-19, Work Efficiency and Sensorimotor Function.

Patients with hemiparetic stroke undergo direct, labor-intensive hands-on conventional physical therapy to improve sensorimotor function, spasticity, balance, trunk stability, and activities of daily living (ADLs). Currently, direct, intensive hands-on therapeutic modalities have increased concerns during the coronavirus (COVID-19) global pandemic. We developed an innovative Walkbot to mitigate the issues surrounding conventional hands-on physical therapy. We aimed to compare the effects of minimal-contact robotic rehabilitation (MRR) and full-contact conventional rehabilitation (FCR) on static and dynamic balance, trunk stability, ADLs, spasticity, and cognition changes in patients with hemiparetic stroke. A total of 64 patients with hemiparetic stroke (mean age = 66.38 ± 13.17; 27 women) underwent either MRR or FCR three times/week for 6 weeks. Clinical outcome measurements included the Trunk Impairment Scale (TIS), the Berg Balance Scale (BBS), the modified Ashworth Scale (MAS), the Fugl-Meyer Assessment (FMA), and the modified Barthel Index (MBI) scores. A 2 × 2 repeated analysis of variance (ANOVA) was performed, and an independent t-test was used to determine statistical differences in the physiotherapists' work efficiency and COVID-19 transmission risk. The ANOVA showed that MRR had effects superior to those of FCR on the TIS, the BBS, the FMA, and the MBI (p < 0.05), but not on the MAS (p = 0.230). MRR showed a greater decrease on the physiotherapist's work efficiency and COVID-19 transmission risk (p < 0.05). Our results provide clinical evidence that robot-assisted locomotor training helps maximize the recovery of sensorimotor function, abnormal synergy, balance, ADLs, and trunk stability, and facilitates a safer environment and less labor demand than conventional stroke rehabilitation.

Effects of innovative hip-knee-ankle interlimb coordinated robot training on ambulation, cardiopulmonary function, depression, and fall confidence in acute hemiplegia

BACKGROUND: While Walkbot-assisted locomotor training (WLT) provided ample evidence on balance and gait improvements, the therapeutic effects on cardiopulmonary and psychological elements as well as fall confidence are unknown in stroke survivors. OBJECTIVE: The present study aimed to compare the effects of Walkbot locomotor training (WLT) with conventional locomotor training (CLT) on balance and gait, cardiopulmonary and psychological functions and fall confidence in acute hemiparetic stroke. METHODS: Fourteen patients with acute hemiparetic stroke were randomized into either the WLT (60-minute physical therapy +30-minute Walkbot-assisted gait training) or CLT (60 min physical therapy +30 min gait training) groups, 7 days/week over 2 weeks. Clinical outcomes included the Berg balance scale (BBS), functional ambulation category (FAC), heart rate (HR) and Borg rating of perceived exertion (BRPE), Beck depression inventory-II (BDI-II), and the activities-specific balance confidence (ABC) scale. The analysis of covariance (ANCOVA) was conducted at P < 0.05. RESULTS: ANCOVA showed that WLT showed superior effects, compared to CLT, on FAC, HR, BRPE, BDI-II, and ABC scale (P < 0.05), but not on BBS (P = 0.061). CONCLUSIONS: Our results provide novel, promising clinical evidence that WLT improved balance and gait function as well as cardiopulmonary and psychological functions, and fall confidence in acute stroke survivors who were unable to ambulate independently.