Relationship between sleep disturbance and developmental status in preschool-aged children with developmental disorder.

BACKGROUND: Sleep has been known to affect childhood development. Sleep disturbance is likely more common in children with developmental delay (DD) than in typical development. There are few studies on the correlation between sleep disturbance and developmental features in children with DD. Therefore, this study aimed to evaluate the associations between the two in children with DD. METHODS: A total of 45 children (age range 27.0 ± 11.1) with DD were recruited and evaluated using the Sleep Disturbance Scale for Children (SDSC) and Bayley Scales of Infant and Toddler Development (BSID-III). The outcomes are expressed as means and standard deviations. The correlation between SDSC and BSID-III was assessed using Spearman's rank correlation test. Multiple regression analysis was performed to investigate the relationship between BSID-III domains and SDSC questionnaire subscales. Statistical significance was set at p < 0.05. RESULTS: Based on the correlation analysis and subsequent hierarchical regression analysis, cognition and socio-emotional domains of BSID-III were significantly associated with the DOES subscale of the SDSC questionnaire. In addition, the expressive language domain of the BSID-III was found to be associated with the DA subscale of the SDSC questionnaire. It seems that excessive daytime sleepiness might negatively affect emotional and behavioral problems and cognitive function. Also, arousal disorders seem to be related to memory consolidation process, which is thought to affect language expression. CONCLUSION: This study demonstrated that DA and DOES subscales of the SDSC questionnaire were correlated with developmental aspects in preschool-aged children with DD. Sleep problems in children with DD can negatively affect their development, thereby interfering with the effectiveness of rehabilitation. Identifying and properly managing the modifiable factors of sleep problems is also crucial as a part of comprehensive rehabilitation treatment. Therefore, we should pay more attention to sleep problems, even in preschool-aged children with DD.

Feasibility of Mobile Health App-Based Home Aerobic Exercise for Physical Performance in Healthy Young Adults.

OBJECTIVE: To investigate the feasibility and effects of a mobile app-based home cycling exercise program compared to home cycling exercise without additional monitoring system. Compared with fitness facilities or outdoor exercise, home-based exercise programs effectively improve physical performance in an indwelling community. However, a flexible, informal environment may decrease motivation and impair adherence to physical exercise. Mobile devices for aerobic exercise and mobile applications provide real-time monitoring, immediate feedback, and encouragement to increase motivation and promote physical performance. We investigated the feasibility and effects of a mobile app-based home exercise program on body composition, muscular strength, and cardiopulmonary function. METHODS: Between February and May 2023, 20 participants were randomly allocated to the intervention (mobile application with a tablet) and control groups, and they performed aerobic exercise using a stationary bicycle for ≥150 minutes per week for 6 weeks (≤30-minute exercise session, with 3-minute warm-up and 3-minute cool-down). Karvonen formula-based heartrate defined the weekly increase in exercise intensity. Outcome measures included body-composition parameters, isokinetic knee flexor and extensor strength tests, cardiopulmonary exercise test results, and rate of target heart rate (HR) achievement. Participants were assessed at baseline and after the intervention. RESULTS: Unrelated personal events led two participants to drop out. The intervention and control groups had similar baseline characteristics. Compared with the control group, in the post-intervention isokinetic strength test, bilateral knee flexor and extensor power, and time to target HR achievement significantly increased each week in the intervention group. CONCLUSION: Home-based exercise to achieve long-term cardiovascular fitness with portable electronic/mobile devices facilitates individualized exercise using real-time feedback to improve motivation and adherence.

Hip Fracture in Patients with Parkinson's Disease and Related Mortality: A Population-Based Study in Korea.

INTRODUCTION: Patients with Parkinson's disease (PD) are prone to falls, thereby increasing the risk of fractures and mortality. This population-based study investigated the risk of hip fractures and their effect on mortality in patients with PD in Korea. METHODS: National Health Insurance Service-National Sample Cohort data were used. Patients newly diagnosed with PD between 2006 and 2015 and age- and sex-matched individuals were classified into the PD group and the comparison group, respectively, with a 1:9 ratio. The Cox proportional hazards model was used to calculate hazard ratios (HRs), and the Kaplan-Meier method to identify survivorship. RESULTS: In total, 26,570 individuals were enrolled in the study: 2,657 in the PD cohort and 23,913 in the matched comparison cohort. The PD group had about a 2 times higher risk of hip fracture than the comparison group (3.95 vs. 1.94%, p < 0.001). According to sex, the difference between the PD and comparison groups for the risk of hip fracture was greater in males than in females. The highest difference in HR for hip fracture between the PD and comparison groups was found in individuals aged between 60 and 69 years. Regarding post-fracture mortality in patients with PD, the mortality risk was twice as high in the patients with hip fracture than in those without. The effect of hip fracture on mortality between these 2 groups was also the highest in individuals aged between 60 and 69 years. CONCLUSION: The PD group showed an approximately 2 times higher risk of hip fracture compared with the comparison group, and the post-fracture mortality rate was 2 times higher in the patients with PD with hip fracture than in those without. Those aged 60-69 years were associated with the highest risk of hip fracture and post-hip fracture mortality among patients with PD.

Effects of adjuvant mental practice using inverse video of the unaffected upper limb in subacute stroke: a pilot randomized controlled study.

Mental practice has shown some positive effects on arm and hand ability and mobility after stroke. This study's objective was to investigate the adjuvant effects of mental practice using an inverse video of the unaffected limb in subacute stroke patients with severe motor impairment on motor improvement, functional outcomes, and activities of daily living. Participants (n = 20) with severe hemiplegia after a unilateral first-ever stroke within 6 months were divided into two groups. The intervention group performed additional mental practice using an inverse video of the unaffected limb for 20 minutes before every session of their rehabilitation program. The primary outcomes were the Fugl-Meyer assessment for the upper extremity (FMA-UE) and manual function test (MFT). Assessments were performed at baseline and after 4 weeks of rehabilitation intervention. Significant differences were found from baseline to postintervention assessments within both groups on FMA-UE and FIM scores, whereas there were no statistically significant differences in mean FMA-UE, MFT, and FIM scores between groups. We cannot draw conclusions about the superiority of adjuvant mental practice training using inverse video compared with conventional occupation therapy alone in subacute poststroke patients.

Lesions Responsible for Impaired Visual Perception in Poststroke Patients Using Voxel-Based Lesion Symptom Mapping.

We aimed to clarify the clinical characteristics that affect visual perception (VP) and elucidate lesion locations correlated with impaired VP. We reviewed 61 patients with stroke. Clinical assessments of a motor-free VP test were used to evaluate VP after stroke. Regression analyses were performed to examine predictors of impaired VP. We generated statistical maps of lesions related to impaired VP using voxel-based lesion symptom mapping (VLSM). The group of patients who had right hemispheric lesions had significantly low VP function. In a regression model, impaired VP was predicted by cognitive function, age, lesion volume, and right hemispheric lesion. Using VLSM, we found lesion location associated with impaired VP after adjusting for age, lesion volume, and Korean version of mini mental status exam. The results showed a lesion pattern with predominant distribution in the right parietal lobe and deep white matter. Age, lesion volume, and cognitive impairment affected the results of VP tests. Even after adjustments, we found that lesions responsible for impaired VP were located in the right parietal lobe and deep white matter. This result confirmed right hemispheric dominance for VP using VLSM. Clin. Anat. 32:689-696, 2019. © 2019 Wiley Periodicals, Inc.

Periventricular White Matter Lesions as a Prognostic Factor of Swallowing Function in Older Patients with Mild Stroke.

Older patients with stroke have poor functional prognosis compared to younger patients. Patients with stroke who have severe white matter (WM) lesions have been reported to have poor functional prognosis such as cognitive dysfunction, increased propensity for falling, and gait and balance problems. The aim of this study was to determine whether WM lesions exert negative effects on swallowing function in older patients with mild stroke. We conducted a retrospective analysis of 63 patients aged >65 years who had a National Institutes of Health Stroke Scale score ≤5 and who underwent videofluoroscopic swallowing examination after their first stroke. Linear regression analysis showed that oral transit time tended to increase as Fazekas grade increased (p = 0.003). In addition, inadequate mastication was related to the presence of lesions in the left hemisphere (p = 0.039). The presence of penetration could also be predicted by Fazekas grade (p = 0.015). Our findings suggest that WM lesions observed in brain magnetic resonance imaging scans can impact swallowing problems in older patients with mild stroke, regardless of initial stroke severity or other factors associated with lesion location. Accordingly, our data indicate that WM lesions are a predictive factor by which patients can be stratified into favorable or unfavorable outcomes with respect to dysphagia.

Dilemmas of Korean Athletes With a Spinal Cord Injury to Participate in Sports: A Survey Based on the ICF Core Set for Spinal Cord Injury.

OBJECTIVE: To explore the experiences of athletes with spinal cord injury (SCI) in Korea with respect to dilemmas of participating in sports with regards to the facilitators and barriers, using the International Classification of Functioning, Disability and Health (ICF). METHODS: The facilitators and barriers to sports participation of individuals with SCI were examined using 112 ICF categories. A questionnaire in dichotomous scale was answered, which covered the subjects 'Body functions', 'Body structures', 'Activity and participation' and 'Environmental factors'. Data analysis included the use of descriptive statistics to examine the frequency and magnitude of reported issues. RESULTS: Sixty-two community-dwelling participants were recruited. Frequently addressed barriers in 'Body functions' were mobility related problems such as muscle and joint problems, bladder and bowel functions, pressure ulcers, and pain. In 'Activity and participation', most frequently reported were mobility and self-care problems. Highly addressed barriers in 'Environmental factors' were sports facilities, financial cost, transportation problems and lack of information. Relationships such as peer, family and friends were the most important facilitators. CONCLUSION: Numerous barriers still exist for SCI survivors to participate in sports, especially in the area of health care needs and environmental factors. Our results support the need for a multidisciplinary approach to promote sports participation.