Effects of Language Differences on Inpatient Fall Detection Using Deep Learning.

This study examined the effects of language differences between Korean and English on the performance of natural language processing in the classification task of identifying inpatient falls from unstructured nursing notes.

Usefulness of one-arm motorized gait device for chronic hemiplegic stroke survivors.

BACKGROUND: After stroke, gait training is a key component of rehabilitation, and most individuals use a variety of walking aids depending on their physical condition and environment. OBJECTIVE: This study aimed to investigate the potential effect of a one-arm motorized gait device for gait assist of chronic hemiplegic stroke survivors through comparison with traditional gait devices (parallel bar and hemi-walker). METHODS: This study was conducted on 14 chronic hemiplegic stroke survivors. The participants were asked to walk under three conditions using different gait devices, and their gait parameters during walking were collected and analyzed. The first condition involved walking on parallel bars; second condition, walking using hemi-walkers; and third condition, walking using one-arm motorized gait devices. With the use of a gait analysis system, the spatio-temporal gait parameters in each condition were collected, such as gait velocity, cadence, step length, stride length, single support time, and double support time. RESULTS: In the results by repeated-measures ANOVA or the Friedman test, a significant difference was found in the gait parameters among all three conditions (p< 0.05). The post-hoc test showed a significant change in the spatio-temporal gait parameters (especially, velocity, cadence and affected side single and double support time) when one-arm motorized gait device were used compared with parallel bars and hemi-walkers (p< 0.05). CONCLUSION: The results of this study suggest that one-arm motorized gait devices developed for hemiplegic stroke survivors may be more effective potentially than parallel bars and hemi-walkers in gait assistance of chronic hemiplegic stroke survivors.

Preventive Effects of a Human Hematopoietic Mesenchymal Stem Cell (hHMSC) Therapy in Ovalbumin-Induced Food Allergy.

No effective therapeutic strategies have been developed against food allergies. Immunomodulation during early infant period could prevent the development of food allergies. We investigated the preventive effects of human hematopoietic mesenchymal stem cells (hHMSCs) in mice with ovalbumin (OVA)-induced food allergy. BALB/c mice with OVA-induced food allergy were divided into 3 groups, and each group was treated with hHMSCs or hHMSC culture medium (hHMSC-CM) or saline. Ear thickness, allergy score, rectal temperature, and diarrhea occurrence were checked. Total IgE, OVA-specific IgE, and mucosal mast cell protease-1 (mMCP-1) were measured by ELISA. Other allergic parameters were analyzed using histology specimens, RT-PCR, and flow cytometry. Treatment with hHMSCs or hHMSC-CM significantly suppressed the frequency of anaphylactic response and rectal temperature decline, reduced diarrhea, total IgE, OVA-specific IgE, and mMCP-1. While the treatment decreased the level of Th2 cytokines, it enhanced IL-10 and TGF-ß1 mRNA. Exposure to hHMSC or hHMSC-CM did not generate regulatory T cells, but reduced mast cells. The immunomodulatory effect on the Th2 cytokines was greater in hHMSC-CM than in hHMSCs. hHMSC treatment may be a promising preventive intervention against food allergy. Further studies are needed to elucidate the key substances released from hHMSC to induce immune tolerance.

The relationship between sitting balance, trunk control and mobility with predictive for current mobility level in survivors of sub-acute stroke.

OBJECTIVE: To investigate the relationship between sitting balance, trunk control, and mobility, as well as whether the sitting balance and trunk control can predict mobility level in sub-acute stroke survivors. METHODS: This is a observational and cross-sectional study. Fifty-five hemiplegic stroke survivors were participated in this study. The Timed Up and Go Test (TUG) was used to estimate mobility, and the Sitting Balance Scale (SBS) was used to examining sitting balance. The Trunk Impairment Scale (TIS), Trunk Control Test (TCT), and Postural Assessment Scale for Stroke-trunk control (PASS-TC) were used for examining the trunk control. Spearman's correlation was used to analyze the relationship between TUG, SBS, TIS, TCT, and PASS-TC. RESULTS: The TUG is significantly correlated with SBS (r = -0.78), TIS (r = -0.76), TCT (r = -0.65), and PASS-TC (r = -0.67). In addition, the receiver operation characteristic (ROC) curve showed as cut-off value of SBS as >28.5, TIS > 16.5, TCT >82, and PASS-TC >10.5. The area under the ROC curve in each of the four tests is moderately accurate for predicting the mobility of sub-acute stroke survivors (0.84 ~0.90) (0.7 < AUC ≤ 9 (moderate informative)). IMPLICATIONS: The SBS showed the highest correlation for mobility using TUG in the hemiplegic stroke survivors. Also, SBS was revealed as the most dominant examination tool predicting the mobility by TUG, it can be explained the sitting postural balance is the variable predicting the mobility in survivors of sub-acute stroke.

Effects of Kinect Video Game Training on Lower Extremity Motor Function, Balance, and Gait in Adolescents with Spastic Diplegia Cerebral Palsy: A Pilot Randomized Controlled Trial.

The Kinect video game (KVG) has received attention as an intervention method for cerebral palsy (CP). However, evidence remains limited. PURPOSE: To investigate the effects of training using Xbox Kinect on lower extremity motor function, balance, and gait in adolescents with spastic diplegia CP. METHODS: This study was a pilot randomized controlled trial. Ten participants were randomly allocated to either the KVG training group (n = 5) or the conventional training (CT) group (n = 5). The Selective Control Assessment of the Lower Extremity (SCALE) tool, Pediatric Balance Scale (PBS), and GAITRite were used for the outcome measurements. RESULTS: In the comparison between the groups, the KVG group showed significant improvements in all the items in the SCALE (except for right hip abduction) and PBS score as compared with the CT group. CONCLUSIONS: KVG training might be an effective intervention for the rehabilitation of adolescents with spastic diplegia CP.

Feasibility of training using full immersion virtual reality video game in young stroke survivor: A case report.

BACKGROUND: With the recent developments in science, full-immersion virtual reality devices have been developed, which may have feasibility for stroke rehabilitation. OBJECTIVE: This case report investigated the feasibility of training using a full-immersion virtual reality video game for improving motor function, balance, and gait in a young stroke survivor. METHOD: The case was a 27-year-old woman with stroke. A training using full-immersion virtual reality video game (Sony PlayStation®VR) was performed for 30 minutes per session, 3 sessions per week, for 6 weeks, with a total of 18 sessions. Before training and at each training for 6 weeks, with a total of 19 times, the motor function, balance, and gait were assessed using the Motor Assessment Scale (MAS), Berg Balance Scale (BBS), Timed Up and Go (TUG) Test, and Tinetti Balance Assessment, 10 Meter Walk Test (10MWT), Tinetti Gait Assessment, and Dynamic Gait Index (DGI). RESULTS: During the training, there were no adverse events reported. The case achieved 14 points higher than the pre-assessment with 34 points on the MAS, 16 points higher than the pre-assessment with 48 points on BBS, 6.85 sec lower than the pre-assessment, with 13.58 sec on TUG, 5 points higher than the pre-assessment with 13 points on the Tinetti Balance Assessment, 5.36 sec lower than the pre-assessment, with 8.15 sec on the 10MWT, 4 points higher than the pre-assessment with 10 points on the Tinetti Gait Assessment, and 10 points higher than the pre-assessment with 21 points on the DGI. CONCLUSION: This case report suggests that training using a full-immersion virtual reality video game may be a safe and effective method to improve motor function, balance, and gait in a young stroke survivor.

Gait analysis in hemiplegic stroke survivors who used the one-arm motorized walker.

OBJECTIVE: A high number of stroke survivors experience limitations in balance and gait abilities. Thus, an improvement in gait ability is an important goal in the rehabilitation of hemiplegic stroke survivors. This study aimed to investigate the effect of using the one-arm motorized walker, a hemi-walker developed to assist hemiplegic stroke survivors in gait training and activities of daily living, on the improvement in gait ability in hemiplegic stroke survivors. METHODS: Eleven hemiplegic stroke survivors who met the inclusion criteria were included. The participants were instructed to walk thrice using traditional walking aids on a gait mat and then to walk thrice using the one-arm motorized walker. During each walk, spatiotemporal gait parameters, including velocity, cadence, step length, stride length, single support time, and double support time, were evaluated using a gait analysis system. RESULTS: Velocity and cadence significantly increased when the participants walked using the one-arm motorized walker compared to those who used traditional walking aids (p< 0.05), whereas double support time significantly decreased for both the more affected and less affected sides (p< 0.05). However, no significant difference was observed in terms of step length and single support time. CONCLUSION: The one-arm motorized walker may have a positive effect on the improvement of gait ability in hemiplegic stroke survivors. It can be an effective walking aid for hemiplegic stroke survivors who experience difficulties in independent walking.

Comparison of Gait Ability of a Child with Cerebral Palsy According to the Difference of Dorsiflexion Angle of Hinged Ankle-Foot Orthosis: A Case Report.

BACKGROUND The purpose of this study was to compare gait abilities in a child with spastic diplegia according to different dorsiflexion angles on hinged ankle-foot orthosis (hinged AFO). CASE REPORT This study is a case report of a child who was diagnosed with spastic diplegia and ambulated independently with the use of a hinged AFO. For gait analysis, the GAITRite® was used under 3 different conditions including barefoot, wearing regular of hinged AFO, and wearing a dorsiflexion 10° hinged AFO. The gait velocity and cadence were collected as temporal parameters, while step length, stride length, and single and double leg support time were collected as temporal spatial parameters. As a result, when a regular hinged AFO was worn on the barefoot, the gait velocity and cadence per minute were increased, whereas the step length and stride length, the single and double leg support time decreased. The gait velocity, cadence, step length, and stride length were significantly increased when dorsiflexion 10° hinged AFO was applied compared to barefoot. The gait velocity, cadence, step length, and stride length increased with dorsiflexion 10° hinged AFO compared to regular hinged AFO. CONCLUSIONS The results of this study demonstrated that wearing a dorsiflexion 10° hinged AFO would have a positive effect on improving gait ability of a child with cerebral palsy rather than wearing a bare foot and a general hinged AFO.

The Effects of Viewing Smart Devices on Static Balance, Oculomotor Function, and Dizziness in Healthy Adults.

BACKGROUND The number of people using smart devices such as smartphones (SPs) or virtual reality head-mounted displays (HMDs) is rapidly increasing. This study aimed to investigate the effects of viewing smart devices, including SPs and HMDs, on postural balance and the development of dizziness in healthy individuals. MATERIAL AND METHODS Twenty-six healthy adults underwent static balance measurements at baseline, and after 5, 10, and 20 minutes of viewing the SP and HMD display. Measurements were taken using a force plate and Wii Balance Board (WBB) and included the parameters of postural sway velocity, path length, and postural sway area. A modified Simulator Sickness Questionnaire (SSQ) evaluated oculomotor function and dizziness twice for each device, after 5 and 20 minutes of use. RESULTS Compared with baseline, the use of smart devices for 20 minutes had significantly increased effects on balance, oculomotor function, and dizziness than shorter use for 10 minutes or 5 minutes in healthy adults. Postural sway velocity and path length were significantly increased after 20 minutes of use of the HMD and SP when compared 5-minute use and baseline measurements (p<0.05). Postural sway area after 20-minute use of the HMD was significantly increased compared with the baseline and 5-minute and 10-minute use of the SP and 5-minute use of the HMD (p<0.05). The SSQ showed that dizziness was significantly increased after 20-minute use compared with 5-minute use of the HMD and SP (p<0.05). CONCLUSIONS Longer use of smart devices affected static balance, oculomotor function, and dizziness in healthy adults.

Biological surface electromyographic switch and necklace-type button switch control as an augmentative and alternative communication input device: a feasibility study.

Augmentative and alternative communication (AAC) is an approach used to supplement, improve, and support the communication of those with speech or language impairments. We developed an AAC device for diverse approaches, using an electromyographic (EMG) switch and a necklace-type button switch. The EMG switch comprised an EMG signal processor and a switch interface processor. EMG signals were processed using an electrode through the stages of signal acquisition, amplification, filtering, rectification, and smoothing. In the switch interface processor, the microprocessor determined the switch as ON or OFF in response to an input EMG signal and then converted the EMG signal into a keyboard signal, which was transmitted to a smart device via Bluetooth communication. A similar transmission process was used for the necklace-type button switch, and switch signals were input and processed with general-purpose input/output. The first and second feasibility tests for the EMG switch and button switch were conducted in a total of three test sessions. The result of the feasibility test indicated that the major inconvenience and desired improvement associated with the EMG switch were the intricacy of the AAC device settings. The major inconveniences and desired improvements for the necklace-type button switch involved device shifting, volume and weight, and inconvenience in fixing the switch in various directions. Thus, based on the first and second feasibility tests, we developed an additional device. Finally, the EMG switch and necklace-type button switch developed to remedy the inconveniencies had high feasibility.

Effect of afferent electrical stimulation with mirror therapy on motor function, balance, and gait in chronic stroke survivors: a randomized controlled trial.

BACKGROUND: When solely mirror therapy is applied for a long period of time, spatial perception and attention to the damaged side may decrease, and the effect of mirror therapy may be limited. To overcome this limitation, it has recently been suggested that the combination of mirror therapy with mirror treatment is effective. AIM: The aim of this study was to investigate the effects of afferent electrical stimulation with mirror therapy on motor function, balance, and gait in chronic stroke survivors. DESIGN: A randomized controlled trial. SETTING: Rehabilitation center. POPULATION: Thirty stroke survivors were randomly assigned to two groups: the experimental group (N.=15) and the control group (N.=15). METHODS: Participants of the experimental group received afferent electrical stimulation with mirror therapy, and participants of the control group received sham afferent electrical stimulation with sham mirror therapy for 60 minutes per day, 5 days per week, for 4 weeks. Motor function was measured using a handheld dynamometer and the Modified Ashworth Scale, balance was measured using the Berg Balance Scale, and gait was assessed using the GAITRite® (GAITRite, CIR System Inc., Franklin, NJ, USA) pressure-sensitive walkway at baseline and after 4 weeks. RESULTS: The experimental group showed significant differences in muscle strength, Modified Ashworth Scale, and Berg Balance Scale results, and velocity, cadence, step length, stride length, and double support time of their gait (P<0.05) in the pre-post intervention comparison. Significant differences between the two groups in muscle strength, Berg Balance Scale, gait velocity, step length, and stride length (P<0.05) were found. CONLCUSIONS: Mirror therapy with afferent electrical stimulation may effectively improve muscle strength and gait and balance abilities in hemiplegic stroke survivors. CLINICAL REHABILITATION IMPACT: Afferent electrical stimulation combined with mirror therapy can be used as an effective intervention to improve lower limb motor function, balance, and gait in chronic stroke survivors in clinical settings.

Amide-Functionalized Porous Carbonaceous Anode Materials for Lithium-Ion Batteries.

Porous carbonaceous anode materials have received considerable attention as an alternative anode material, however, there is a critical bottleneck as it suffers from a large irreversible specific capacity loss over several initial cycles owing to undesired surface reactions. In order to suppress undesired surface reactions of porous carbonaceous anode material, here, we suggest a simple and convenient two-step surface modification approach that allows the embedding of an amide functional group on the surface of a porous carbonaceous anode, which effectively improves the surface stability. In this approach, the porous carbonaceous anode material is firstly activated by means of strong acid treatment comprising a combination of H2 SO4 and HNO3 , and it is subjected to further modification by means of an amide coupling reaction. Our additional systematic analyses confirm that the acid functional group effectively transforms into the amide functional group. The resulting amide-functionalized porous carbon exhibits an improved electrochemical performance: the initial discharge specific capacity is greatly reduced to less than 2,620 mA h g-1 and charge specific capacity is well still remained, indicating stabling cycling performance of the cell.

Development of a wheeled walker braking device using the four-bar mechanism.

The elderly population in many countries has been rising rapidly, and falls are a serious event many elderly people experience. Assistive equipment is actively used to reduce falls among elderly people. Popular types of assistive equipment include canes, electric wheelchairs, and wheeled walkers. Wheeled walkers support the body of elderly people, making their gait comfortable as they age or recover from injuries. Wheeled walkers may be equipped with hand brakes; however, frail older people may experience difficulty using such hand brakes, as they require force to operate. Thus, in the present study, a braking method using a wire connected to a user's belt or clothes was designed and implemented; if the tension of the wire connecting the safety device and the user exceeds a critical value, the wheeled walker brakes, which can prevent the rapid motion of walkers. Two feasibility tests of the wheeled walker with the braking device were conducted: one with 10 healthy adults in their 20s and the other with 10 elderly people over 65 years of age; the tests measured the braking time and speed control using a speed measuring device. The results of the first and second feasibility tests demonstrated that the average braking time of participants was 50.3 ms and 50.7 ms, respectively. All participants in the feasibility tests succeeded in the speed control test. Thus, based on the results, the braking device on the wheeled walker worked properly.

Usability of the Thera-Band® to improve foot drop in stroke survivors.

BACKGROUND: Stroke survivors show "foot drop", dragging their toes on the ground in the swing phase of gait. Ineffective ankle dorsiflexion may result in an abnormal gait pattern. OBJECTIVE: The purpose of this study was to investigate the effect of ankle Thera-Band® use on gait patterns in stroke survivors. METHODS: Gait data were collected in eight subjects who had had strokes using gait analysis system, both with and without the Thera-Band®. The following dependent variables of gait parameters were analyzed: velocity, cadence, step length, stride length, single support time, and double support time. RESULTS: There were significant improvements in gait velocity, cadence, stride length, and double support time in those who used the Thera-Band® compared to those who did not (p <  0.05). However, there were no significant differences in step length or single support time (p >  0.05). CONCLUSIONS: The results show that ankle Thera-Band® use may have a positive effect in improving gait parameters by increasing the ankle stability in stroke survivors with foot drop. Its usefulness in the rehabilitation of foot drop in stroke survivors needs to be further investigated.

Comparison of postural sway depending on balance pad type.

[Purpose] The purpose of the present study was to compare the postural sway of healthy adults standing on different types of balance pads. [Subjects and Methods] Nine healthy adults participated in this study. Postural body sway was measured while participants were standing on four different types of balance pads: Balance-pad Elite (BE), Aero-Step XL (AS), Dynair Ballkissen Senso (DBS), and Dynair Ballkissen XXL Meditation and Yoga (DBMY). A Wii Balance Board interfaced with Balancia software was used to measure postural body sway. [Results] In the sway velocity, sway path length, and sway area, no significant differences were found between baseline conditions (participants were standing on the floor with no balance pad) and the use of the BE or AS. However, significant increases in all parameters were found comparing baseline conditions to the use of either Dynair balance pad. Furthermore, the use of either Dynair balance pad significantly increased postural sway compared to both the BE and the AS. [Conclusion] These findings suggest that the DBS and DBMY balance pads may serve as superior tools for providing unstable condition for balance training than the BE and the AS balance pads.

A novel one arm motorized walker for hemiplegic stroke survivors: a feasibility study.

BACKGROUND: A hemiplegic stroke survivor with a moderate to severe gait disturbance may have difficulty walking using a one-arm walker. This study aimed to test the safety and feasibility of a prototype one-arm motorized walker that uses a power-driven device to provide gait assistance to hemiplegic stroke survivors with moderate to severe gait disturbances. METHODS: A one-arm motorized walker with a power-driven device was developed and tested with respect to 10 distinct variables, including weight, degrees of freedom, handle, handle substitution function, two-sided use function, variable handle height, redirecting function, electric moving parts through the handle control, brake function using the handle control, folding chairs, and design stability. Its safety and feasibility were tested in 19 hemiplegic stroke individuals using the Likert scale and a simple interview. RESULTS: The walker consists of a frame platform including a handle, electric motor for driving, one wheel for driving, two wheels for turning, unlocking sensor, driving button, and turning buttons. The walker is programmed so that a touch sensor in the handle can unlock the locking system. Furthermore, it is programmed so that a user can propel it by pushing the handle downward or pressing a button and can control directions for turning right or left by pressing buttons. Safety and performance testing was achieved for 10 separate variables, and a Likert scale score of 3.5 of 5 was recorded. CONCLUSION: This walker's novel design was developed for hemiplegic stroke survivors with moderate to severe gait disturbances. Our findings indicate that the walker is both safe and feasible for providing walking assistance to hemiplegic stroke survivors and establish the potential advantages of the one-arm motorized walker.

A novel hinged ankle foot orthosis for gait performance in chronic hemiplegic stroke survivors: a feasibility study.

Stroke survivors with gait disturbances may use ankle foot orthoses (AFOs). However, most AFOs come in one-piece styles, which make it difficult for spasticity-affected stroke survivors to don. AFOs are also limited since they do not properly prevent ankle joint for foot drop by itself. Therefore, the present study developed a novel hinged AFO by adding a locking device to a hinged joint. We then tested its feasibility in 9 hemiplegic stroke survivors by investigating temporal-spatial gait parameters using the GAITRite in the following 3 conditions: no AFO, traditional AFO, and novel hinged AFO. There was no significant difference in spatiotemporal gait parameters among the different conditions. There were greater decreases in gait velocity, cadence, step length, and stride length in the novel hinged AFO group than in the no AFO and traditional AFO groups. This novel hinged AFO was developed to prevent foot drop. However, the AFO did not show significant differences in gait parameters because it consists of metal with extra weight and volume. Functionally, it prevented foot drop. It also improved convenience by its releasable design. Thus, further studies are needed to develop an AFO that improves gait and is convenient to use for hemiplegic stroke survivors.

Discriminative and predictive validity of the short-form activities-specific balance confidence scale for predicting fall of stroke survivors.

[Purpose] The present study aimed to investigate the discriminative validity of the short-form activities-specific balance confidence scale (ABC scale) in predicting falls, and its validity. [Subjects and Methods] 43 stroke survivors were identified as a group with a history of multiple falls (faller group) and a group without or with a history of one falls (non-faller group). The balance confidence was examined using the ABC scale and the short-form ABC scale. Functional abilities were examined with Fugl-Meyer assessment, sit-to-stand test, and Berg balance scale. [Results] The area under the curve of the ABC scale and the short-form ABC scale in predicting fall was>0.77. This result indicates that both examination tools have discriminative validity in predicting falls. Although both tools showed an identical predictable specificity of 72% in the non-faller and faller groups, the short-form ABC scale exhibited a predictable sensitivity of 86% in the faller group, which is higher than that of the ABC scale (71%). [Conclusion] Results of this study showed that the short-form ABC scale is an efficient clinical tool to evaluate and predict the balance confidence of stroke survivors.

Comparison of trunk electromyographic muscle activity depends on sitting postures.

BACKGROUND: Different postural positions can be characterized by the activation and relative contributions of different postural muscles, and may variously contribute to the recovery from or worsening of chronic lower back pain. OBJECTIVE: The present study aimed to investigates trunk muscle activities in four types of seated postures: cross-legged, long, side, and W-shaped. METHODS: Eight healthy adults participated in the study. Trunk muscle activities of the external oblique (EO), rectus abdominis (RA), latissimus dorsi (LD), and erector spinae (ES) muscles in each of the sitting postures including cross-legged, long, side, and W-shaped were collected utilizing surface electromyography (sEMG). The mean sEMG signals in each of the sitting postures were used for statistical comparisons. RESULTS: There were no significant differences in electromyographic muscle activity of EO, RA, LD, and ES in the four postures (p > 0.05). However, in the W-shape sitting posture, the left LD showed the greatest electromyographic muscle activity, followed by the right LD and left EO, respectively. The right and left LD in the long sitting posture and left ES in the side sitting posture showed greater electromyographic muscle activity than that of other muscles. CONCLUSION: Based on the results, trunk muscle activity did not significantly differ between the four types of sitting postures. However, our study is limited by its experimental method and sample size. Thus, in the Future, further study will be needed.

A comparative study of the electromyographic activities of lower extremity muscles during level walking and Pedalo riding.

[Purpose] To analyze the electromyographic (EMG) activities of several lower extremity muscles during ground walking and pedaling using the Pedalo Reha-Bar device. [Subjects and Methods] Fifteen healthy adults aged 20-29 year participated in this study. The subjects' surface EMG signals while walking and Pedalo Reha-Bar riding were recorded. The subjects performed 20 steps on flat ground and 20 cycles on the Pedalo Reha-Bar. During the tasks, EMG signals of the rectus femoris, biceps femoris, tibialis anterior, soleus, and gastrocnemius within a 20-second period were recorded. The mean EMG signals within the 10 seconds from 6 to 15 seconds were used for the data analysis. [Results] There was a significant increase in the bilateral use of the rectus femoris and a significant decrease in the use of the left tibialis anterior and left soleus in pedaling using the Pedalo Reha-Bar device compared to ground walking. [Conclusion] Level walking and the Pedalo Reha-Bar riding utilize different types of muscles activities. These results suggest that Pedalo Reha-Bar riding may be used for neuromuscular activation, especially of the rectus femoris.