Rhythmic auditory stimulation using a portable smart device: short-term effects on gait in chronic hemiplegic stroke patients.

[Purpose] The effects of various rhythmic auditory stimulation tempos on stroke gait pattern changes when training patients with a smartphone-based rhythmic auditory stimulation application were investigated. [Subjects and Methods] Fifteen patients with chronic stroke were included. Cadence during comfortable walking was measured (baseline). After the baseline findings were recorded, rhythmic auditory stimulation with five different tempos (i.e., -10%, -5%, 0%, +5%, and +10% change from baseline) was randomly applied. Finally, comfortable walking without rhythmic auditory stimulation was initiated to evaluate gait pattern changes. [Results] As the tempo increased, the spatiotemporal gait parameters of the stroke patients changed significantly. Gait speed, cadence, and gait cycle duration showed the greatest improvement in the +10% rhythmic auditory stimulation condition compared to baseline. After gait training with rhythmic auditory stimulation, gait speed, cadence, stride length, gait cycle duration, and step length of the affected and unaffected sides improved significantly compared to baseline. [Conclusion] Significant changes in the gait pattern of stroke patients were noted for various tempos after training with rhythmic auditory stimulation. These findings could be used to customize rehabilitative gait training for patients who experience stroke with hemiplegia.

Kinematic analysis of upper extremity movement during drinking in hemiplegic subjects.

BACKGROUND: It is necessary to analyze the kinematic properties of a paralyzed extremity to quantitatively determine the degree of impairment of hemiplegic people during functional activities of daily living (ADL) such as a drinking task. This study aimed to identify the kinematic differences between 16 hemiplegic and 32 able-bodied participants in relation to the task phases when drinking with a cup and the kinematic strategy used during motion with respect to the gravity direction. METHODS: The subjects performed a drinking task that was divided into five phases according to Murphy's phase definition: reaching, forward transport, drinking, backward transport, and returning. We found that the groups differed in terms of the movement times and the joint angles and angular velocities of the shoulder, elbow, and wrist joints. FINDINGS: Compared to the control group, the hemiplegic participants had a larger shoulder abduction angle of at most 17.1° during all the phases, a larger shoulder flexion angle of 7.6° during the reaching phase, and a smaller shoulder flexion angle of 6.4° during the backward transporting phase. Because of these shoulder joint patterns, a smaller elbow pronation peak angle of at most 13.1° and a larger wrist extension peak angle of 12.0° were found in the motions of the hemiplegic participants, as compensation to complete the drinking task. The movement in the gravity direction during the backward transporting phase resulted in a 15.9% larger peak angular velocity for elbow extension in the hemiplegic participants compared to that of the control group. INTERPRETATION: These quantitative kinematic patterns help provide an understanding of the movements of an affected extremity and can be useful in designing rehabilitation robots to assist hemiplegic people with ADL.

Synthesis of 1,3-azaphosphol-2-ones. Crystal and molecular structures of [SP-4-2]-dichlorobis(3-phenyl-1,3-dihydrobenzo[1,3]azaphosphol-2-one-P)palladium(II) and its chloro(methyl)platinum(II) analogue.

Reaction of secondary phosphine (+/-)-(2-aminophenyl)phenylphosphine, (+/-)-app, with PCl(5) in toluene gives the hydrochloride salt of the expected chlorophosphine (+/-)-(2-aminophenyl)chlorophenylphosphine, (+/-)-acpp.HCl, however, this is not the case with triphosgene. Rather the first example of a 1,3-azaphosphol-2-one is isolated, viz. (+/-)-3-phenyl-1,3-dihydrobenzo[1,3]azaphosphol-2-one, (+/-)-pbap. The hydrochloride salt (+/-)-acpp.HCl readily reacts with excess vinyl-, 2-methylphenyl- or 2-methoxyphenyl magnesium bromide to give the corresponding tertiary phosphines (+/-)-(2-H(2)NC(6)H(4))PPhR (where R = CH=CH(2), 2-C(6)H(4)Me or 2-C(6)H(4)OMe). Hydrophosphination of the vinyl substituted tertiary phosphine with (+/-)-app in the presence of KOBu(t) provides a synthetic route to the elusive P(2)N(2) quadridentate ligand (R(P)*,R(P)*)- and (R(P)*,S(P)*)-(CH(2))(2)(PPhC(6)H(4)NH(2)-2)(2), albeit in low yield. The azaphospholone (+/-)-pbap can be readily deprotonated with KOBu(t) in thf and subsequently alkylated with methyl iodide or benzyl bromide to give the analogous N-methyl or N-benzyl derivatives. Alkylation with 1,3-dibromopropane gives the bis(azaphospholone) (R(P)*,R(P)*)- and (R(P)*,S(P)*)-1,3-bis[1-{3-phenyl-1,3-dihydrobenzo[1,3]azaphosphol-2-one}]propane. The latter and the N-methyl substituted azaphospholone can also be synthesised by the reaction of the corresponding secondary phosphine, viz. (R(P)*,R(P)*)- and (R(P)*,S(P)*)-(CH(2))(3)(NHC(6)H(4)PHPh-2)(2) and (+/-)-(2-methylaminophenyl)phenylphosphine, with triphosgene. All three azaphospholones react with [PtClMe(1,5-cyclooctadiene)] in thf to give complexes of the type cis-[PtClMeL(2)] in which ligand L is coordinated via the P atom of the azaphospholones. The ligand (+/-)-pbap has also been complexed to palladium(II) via the reaction with Li(2)[PdCl(4)] in methanol to give cis-[PdCl(2){(+/-)-pbap}(2)]. The structures of cis-[PtClMe{(+/-)-pbap}(2)] and cis-[PdCl(2){(+/-)-pbap}(2)] have been confirmed by X-ray analysis.