Investigation of inspiratory intercostal muscle activity in patients with spinal cord injury: a pilot study using electromyography, ultrasonography, and respiratory inductance plethysmography.

[Purpose] The respiratory function in patients with cervical spinal cord injury is influenced by inspiratory intercostal muscle function. However, inspiratory intercostal muscle activity has not been conclusively evaluated. We evaluated the inspiratory intercostal muscle activity in patients with cervical spinal cord injury by using inspiratory intercostal electromyography, respiratory inductance plethysmography, and ultrasonography. [Participants and Methods] Three patients with cervical spinal cord injury were assessed. The change in mean amplitude (rest vs. maximum inspiration) was calculated by using intercostal muscle electromyography. Changes in intercostal muscle thickness (resting expiration and maximum inspiration) were also evaluated on ultrasonography. The waveform was converted to spirometry ventilation with respiratory inductance plethysmography, and the waveform at the xiphoid was considered to determine the rib cage volume. Each index was compared with the inspiratory capacities in each case. [Results] Intercostal muscle electromyography failed to measure the notable myoelectric potential in all the patients. The rib cage volume was higher at higher inspiratory capacities. The changes in muscle thickness were not significantly different between the patients. [Conclusion] The rib cage volume (measured with inductance plethysmography) was greater in the patients with cervical spinal cord injury when inspiratory intercostal muscle activity was high. Respiratory inductance plethysmography can capture inspiratory intercostal muscle function in patients with cervical spinal cord injury.

Reliability of voluntary cough assessments using respiratory flow waveform.

[Purpose] Voluntary cough can be assessed by recording flow waves. The purpose of this study was to examine the reliability of the measurements of respiratory flow waveforms, using equipment that recorded flow waves during cough. [Participants and Methods] Twenty healthy participants were recruited for this study. They underwent spirometry on them and, subsequently, their flow waves during single and consecutive voluntary cough tasks in the sitting position were recorded. The intra-class correlation coefficient was used to assess the intra-rater and inter-rater reliabilities for the voluntary cough data. [Results] The intra-class correlation coefficients were 0.6 to 0.8 for 'intra-rater reliability' and higher than 0.9 for 'inter-rater reliability', for single and consecutive cough tasks. The first assessment of cough peak flow was significantly higher than the second, during consecutive cough tasks. Similarly, the first assessment of cough volume acceleration was significantly higher than the second. [Conclusion] Our results demonstrated high intra-rater and inter-rater reliabilities for single and consecutive cough tasks. Following additional procedures and valuations, including the storage of data and standard range decisions, this method of cough assessment will be applied to patients with reduced cough function.

Measurement of intercostal muscle thickness with ultrasound imaging during maximal breathing.

[Purpose] Determining the thickness of the intercostal muscle with ultrasound imaging would be a useful parameter in evaluating respiratory muscle activity in patients with tetraplegia and neuromuscular weakness. However, it has not been clarified whether ultrasound imaging can measure changes in intercostal muscle thickness during breathing. This study aimed to measure contractions of the human intercostal muscle in the anterior, lateral, and posterior parts with ultrasound imaging during maximal breathing. [Participants and Methods] The participants were 12 healthy males. Intercostal muscle thickness was measured using ultrasound at rest and at maximal breathing. The measurement sites were the anterior, lateral, and posterior portions of the right intercostal spaces. Statistical analysis was performed using a paired t-test comparing intercostal muscle thickness at rest and maximal breathing. [Results] The thickness of the intercostal muscle showed significant increases in the first, second, third, fourth, and sixth intercostal spaces of the anterior portions. There were no significant differences in the lateral or posterior portions between rest and maximal breathing. [Conclusion] Human intercostal muscle thickness can be measured with ultrasound and increases only in the anterior portions during maximal breathing.

Oxygen cost of thoracic and diaphragmatic breathing during hyperventilation in healthy males.

[Purpose] It is unclear whether diaphragmatic breathing (DB) results in lower respiratory muscle oxygen consumption during dynamic exercise. The purpose of this study was to compare oxygen consumption in the respiratory muscles (VO2rm) with thoracic breathing (TB) and with DB, in healthy males during hyperventilation. [Subjects and Methods] Ten healthy men participated in this study. The subjects sat on a chair with the backrest reclined at an angle of 60 degrees. Respiratory parameters were measured breath by breath, using an expired gas analyzer. Oxygen consumption was measured for three minutes during quiet breathing. Measurements during TB and DB were performed for one minute each, after connecting a rebreather loading device. The breathing pattern was analyzed by inductance plethysmography, using transducer bands placed over the chest and abdomen that recorded thoracoabdominal movements. [Results] Both ΔVO2/body weight and VO2rm decreased significantly with DB when compared to that with TB, during hyperventilation. [Conclusion] DB results in less respiratory muscle oxygen consumption, even during dynamic exercise.

Immediate effects of a single session of robot-assisted gait training using Hybrid Assistive Limb (HAL) for cerebral palsy.

[Purpose] Robot-assisted gait training (RAGT) using Hybrid Assistive Limb (HAL, CYBERDYNE) was previously reported beneficial for stroke and spinal cord injury patients. Here, we investigate the immediate effect of a single session of RAGT using HAL on gait function for cerebral palsy (CP) patients. [Subjects and Methods] Twelve patients (average age: 16.2 ± 7.3 years) with CP received a single session of RAGT using HAL. Gait speed, step length, cadence, single-leg support per gait cycle, hip and knee joint angle in stance, and swing phase per gait cycle were assessed before, during, and immediately after HAL intervention. [Results] Compared to baseline values, single-leg support per gait cycle (64.5 ± 15.8% to 69.3 ± 12.1%), hip extension angle in mid-stance (149.2 ± 19.0° to 155.5 ± 20.1°), and knee extension angle in mid-stance (137.6 ± 20.2° to 143.1 ± 19.5°) were significantly increased immediately after intervention. Further, the knee flexion angle in mid-swing was significantly decreased immediately after treatment (112.0 ± 15.5° to 105.2 ± 17.1°). Hip flexion angle in mid-swing also decreased following intervention (137.2 ± 14.6° to 129.7 ± 16.6°), but not significantly. Conversely, gait speed, step length, and cadence were unchanged after intervention. [Conclusion] A single-time RAGT with HAL improved single-leg support per gait cycle and hip and knee joint angle during gait, therapeutically improving gait function in CP patients.

Functional electrical stimulation to the abdominal wall muscles synchronized with the expiratory flow does not induce muscle fatigue.

[Purpose] Continuous electrical stimulation of abdominal wall muscles is known to induce mild muscle fatigue. However, it is not clear whether this is also true for functional electrical stimulation delivered only during the expiratory phase of breathing. This study aimed to examine whether or not intermittent electrical stimulation delivered to abdominal wall muscles induces muscle fatigue. [Subjects and Methods] The subjects were nine healthy adults. Abdominal electrical stimulation was applied for 1.5 seconds from the start of expiration and then turned off during inspiration. The electrodes were attached to both sides of the abdomen at the lower margin of the 12th rib. Abdominal electrical stimulation was delivered for 15 minutes with the subject in a seated position. Expiratory flow was measured during stimulus. Trunk flexor torque and electromyography activity were measured to evaluate abdominal muscle fatigue. [Results] The mean stimulation on/off ratio was 1:2.3. The declining rate of abdominal muscle torque was 61.1 ± 19.1% before stimulus and 56.5 ± 20.9% after stimulus, not significantly different. The declining rate of mean power frequency was 47.8 ± 11.7% before stimulus and 47.9 ± 10.2% after stimulus, not significantly different. [Conclusion] It was found that intermittent electrical stimulation to abdominal muscles synchronized with the expiratory would not induce muscle fatigue.

Maximal respiratory pressure in healthy Japanese children.

[Purpose] Normal values for respiratory muscle pressures during development in Japanese children have not been reported. The purpose of this study was to investigate respiratory muscle pressures in Japanese children aged 3-12 years. [Subjects and Methods] We measured respiratory muscle pressure values using a manovacuometer without a nose clip, with subjects in a sitting position. Data were collected for ages 3-6 (Group I: 68 subjects), 7-9 (Group II: 86 subjects), and 10-12 (Group III: 64 subjects) years. [Results] The values for respiratory muscle pressures in children were significantly higher with age in both sexes, and were higher in boys than in girls. Correlation coefficients were significant at values of 0.279 to 0.471 for each gender relationship between maximal respiratory pressure and age, height, and weight, respectively. [Conclusion] In this study, we showed pediatric respiratory muscle pressure reference value for each age. In the present study, values for respiratory muscle pressures were lower than Brazilian studies. This suggests that differences in respiratory muscle pressures vary with ethnicity.

Respiratory flow and vital signs associated with the intensity of functional electrical stimulation delivered to human abdominal muscles during quiet breathing.

[Purpose] The purpose of this study was to examine the effects of increasing the intensity of functional electrical stimulation delivered to abdominal muscles during quiet breathing on respiratory flow, vital signs and pain in healthy subjects. [Subjects and Methods] Electrical stimulation was delivered bilaterally using one pair of high-conductivity gel-skin plate electrodes, placed on both sides of the abdomen, to nine healthy males. Subjects were required to breathe normally through a face mask for 2 minutes while in a supine position. The stimulation intensity was incrementally increased by 10 mA until reaching 100 mA. Respiratory parameters, vital signs and pain based on the visual analog scale were measured for each intensity of electrical stimulation. [Results] Transcutaneous oxygen saturation showed a slight upward trend in association with increasing stimulation intensity, but there were no significant changes in pulse or blood pressure. Respiratory flow, tidal volume, and minute ventilation increased significantly as the stimulation intensity rose. [Conclusion] This study revealed that functional electrical stimulation can be safely delivered to human abdominal muscles without causing vital sign abnormalities. It was also found that the appropriate intensity level of electrical stimulation for achieving effects on respiratory flow while also minimizing pain is 60-80 mA.

Regional lung volume differences between the side-lying and semi-prone positions.

[Purpose] This study aimed to clarify the differences in regional lung volume between the semi-prone (Sim's position) and side-lying position, and the optimal position for increasing lung volume. [Methods] Measurements were performed in both positions on both sides. Sim's position was inclined 45° forward from the side-lying position. A 1.5-T system with a fast advanced spin-echo sequence in the coronal plane was used for magnetic resonance imaging. [Results] The two positions did not significantly differ in total lung capacity and its subdivisions on both sides, except the left lung in the right side-lying position and right Sim's position. In the nondependent lung, the percentage lung volume of the dorsal segment was significantly higher in the right Sim's position than in the right side-lying position. However, no significant difference was observed between the left side-lying and left Sim's position. [Conclusion] The heart was displaced ventrally by gravity in Sim's position and leaned on the ventral parapet. The spaces for the expansion of the ventral and dorsal segments of the lung were decreased and increased in Sim's position, respectively. With a nondependent left lung, the increase in the percentage lung volume of the dorsal segment was greater in Sim's position than in the side-lying position.

Compression of the lungs by the heart in supine, side-lying, semi-prone positions.

[Purpose] Clarification of the differences in the compression volume of the lungs by the heart (CVLH) between postures may facilitate the selection of optimal postures in respiratory care. Determining CVLH in the supine, semi-prone (Sim's position), and side-lying positions was the aim of this study. [Subjects and Methods] Eight healthy volunteers (six males, two females; mean age, 29.0 ± 9.2 years) were enrolled in the study. Measurements were performed in the supine, right and left semi-prone, and right and left side-lying positions. semi-prone position was inclined 45° ventrally from the side-lying position. A 1.5-T system with a fast advanced spin-echo sequence in the coronal plane was used for magnetic resonance imaging. [Results] CVLH and heart compression ratio were significantly lower in the semi-prone position on both sides than the other positions. The heart was displaced ventrally when semi-prone and a larger area of the heart leaned on the ventral chest wall, localizing compression to part of the ventral region of the dependent lung. [Conclusion] The region of lungs compressed by the heart is reduced in the semi-prone position due to ventral displacement of the heart. These results suggest that maintaining expansion of the dependent lung is easier in the semi-prone position.

Axonal projection of the medullary expiratory neurons in the feline thoracic spinal cord.

Expiratory neurons in the caudal ventral respiratory group extend descending axons to the lumbar and sacral spinal cord, and they possess axon collaterals, the distribution of which has been well-documented. Likewise, these expiratory neurons extend axons to the thoracic spinal cord and innervate thoracic expiratory motoneurons. These axons also give rise to collaterals, and their distribution may influence the strength of synaptic connectivity between the axons and the thoracic expiratory motoneurons. We investigated the distribution of axon collaterals in the thoracic spinal cord using a microstimulation technique. This study was performed on cats; one cat was used to make an anatomical atlas and six were used in the experiment. Extracellular spikes of expiratory neurons were recorded in artificially ventilated cats. The thoracic spinal gray matter was microstimulated from dorsal to ventral sites at 100-µm intervals using a glass-insulated tungsten microelectrode with a current of 150-250 µA. The stimulation tracks were made at 1 mm intervals along the spinal cord in segments Th9 to Th13, and the effective stimulating sites of antidromic activation in axon collaterals were systematically mapped. The effective stimulating sites in the contralateral thoracic spinal cord with expiratory neurons in the caudal ventral respiratory group (cVRG) occupied 14.4% of the total length of the thoracic spinal cord examined. The mean percentage of effective stimulating tracks per unit was 18.6 ± 4.4%. The distribution of axon collaterals of expiratory neurons in the feline thoracic spinal cord indeed resembled that reported in the upper lumbar spinal cord. We propose that a single medullary expiratory neuron exerts excitatory effects across multiple segments of the thoracic spinal cord via its collaterals.

Correlation of cervical-inspiratory-muscle electromyography and oxygen uptake during treadmill walking.

For measurements of exercise intensity, an individual's oxygen uptake (V̇O2) is measured with an exhaled gas analyzer that involves a mask, but exercise coaching would benefit if an individual's V̇O2 could be estimated with more easily obtained predictors. We investigated the predictability of V̇O2 by electromyography (EMG) of the neck inspiratory muscles. We analyzed the EMG results of the sternocleidomastoid (EMGst) and scalene (EMGsc) muscles of 14 healthy adults who performed a treadmill exercise load test. Their V̇O2, inspiratory flow rate, and heart rate were simultaneously recorded during the exercise. The exercise load test was performed twice at a ≥2-day interval. The first visit was an incremental exercise test, and the second was a repeated two-load exercise test at levels below and above the participant's ventilatory threshold (VT) as determined in the first test. We observed that the integrated EMG values for each exercise load showed partially significant positive correlations with the EMGst and EMGsc. However, the cervical inspiratory muscle EMGs did not show as high a correlation as the minute ventilation. These results indicate that (i) EMG of the cervical inspiratory muscles could be used to estimate V̇O2, but (ii) these EMG parameters alone should be considered insufficient for estimating V̇O2.

Rib cage contributions to inspiratory capacity in patients with cervical spinal cord injury.

Background: Cervical spinal cord injury (CSI) often leads to impaired respiratory function, affecting the overall well-being of patients. This study aimed to investigate the influence of rib cage motion on inspiratory capacity in CSI patients. Methods: We conducted a study with 11 CSI patients, utilising respiratory inductance plethysmography (RIP). We measured ventilatory volume by spirometry concurrently with RIP. Participants were instructed to perform maximal inspiratory efforts. Inspiratory capacity (IC) was calculated from spirometry waveforms. We converted the respiratory waveforms of the chest and abdomen into inspiratory volume measured by a spirometer. The inspiratory volume measured by the chest sensor was defined as VRIP-rib cage (VRIP-rc), and the inspiratory volume measured by the abdominal sensor was defined as VRIP-abdomen (VRIP-ab). Subsequently, the relationships of IC with VRIP-rc and VRIPab were assessed. Results: The mean IC was 1.828 ± 0.459 L, with the mean VRIP-rc at 1.343 ± 0.568 L and the mean VRIP-ab at 0.485 ± 0.427 L. A significant correlation was observed between IC and VRIP-rc (r = 0.67, p = 0.02), indicating that rib cage motion significantly influences IC in CSI patients. Conclusion: This study highlights the importance of rib cage motion in assessing inspiratory capacity in patients with CSI.

Routine hypercapnic challenge after cervical spinal hemisection affects the size of phrenic motoneurons.

After an individual experiences a cervical cord injury, the cell body's adaptation to the smaller size of phrenic motoneurons occurs within several weeks. It is not known whether a routine hypercapnic load can alter this adaptation of phrenic motoneurons. We investigated this question by using rats with high cervical cord hemisection. The rats were divided into four groups: control, hypercapnia, sham, and sham hypercapnia. Within 72 h post-hemisection, the hypercapnia groups began a hypercapnic challenge (20 min/day, 4 times/week for 3 weeks) with 7% CO2 under awake conditions. After the 3-week challenge, the phrenic motoneurons in all of the rats were retrogradely labeled with horseradish peroxidase, and the motoneuron sizes in each group were compared. The average diameter, cross-sectional area, and somal surface area of stained phrenic motoneurons as analyzed by software were significantly smaller in only the control group compared to the other groups. The histogram distribution was unimodal, with larger between-group size differences for motoneurons in the horizontal plane than in the transverse plane. Our findings indicate that a routine hypercapnic challenge may increase the input to phrenic motoneurons and alter the propensity for motoneuron adaptations.

Factors associated with spinal instability in low back lumbar diseases with leg pain: Analysis of sagittal translation and segmental angulation.

BACKGROUND: Determining the association between radiographic spinal instability assessment and lower back lumbar diseases with lower limb symptoms can contribute to evidence-based assessment and treatment in clinical practice and rehabilitation. Therefore, radiological evidence of lumbar spine instability assessment, such as sagittal translation (ST) and segmental angulation (SA), is clinically important. OBJECTIVE: To identify factors associated with the assessment of spinal instability in lumbar disc herniation with leg pain and discogenic low back pain using ST and SA. METHODS: We examined 112 patients with lumbar disc herniation with leg pain and 116 with discogenic low back pain at our clinic from 2016 to 2021. Data on age, gender, sports activities, and occupation were collected from medical records. Additionally, ST and SA of L4 and L5 during maximum trunk flexion and extension were measured using radiography. Simple and multiple logistic regression analyses were used for statistical analysis. RESULTS: Simple logistic regression analysis showed that ST and SA (odds ratio [OR]: 1.11; 95% confidence interval [CI]: 1.03-1.19) were associated with lumbar disc herniation. Multiple logistic regression analysis showed that only ST was associated with lumbar disc herniation (OR: 2.29; 95% CI: 1.78-3.00). CONCLUSION: Multiple logistic regression analysis showed that ST was associated with lumbar disc herniation with leg pain and had a stronger association than SA.

Benefits of a Wearable Cyborg HAL (Hybrid Assistive Limb) in Patients with Childhood-Onset Motor Disabilities: A 1-Year Follow-Up Study.

Rehabilitation robots have shown promise in improving the gait of children with childhood-onset motor disabilities. This study aimed to investigate the long-term benefits of training using a wearable Hybrid Assistive Limb (HAL) in these patients. Training using a HAL was performed for 20 min a day, two to four times a week, over four weeks (12 sessions in total). The Gross Motor Function Measure (GMFM) was the primary outcome measure, and the secondary outcome measures were gait speed, step length, cadence, 6-min walking distance (6MD), Pediatric Evaluation of Disability Inventory, and Canadian Occupational Performance Measure (COPM). Patients underwent assessments before the intervention, immediately after the intervention, and at 1-, 2-, 3-month and 1-year follow-ups. Nine participants (five males, four females; mean age: 18.9 years) with cerebral palsy (n = 7), critical illness polyneuropathy (n = 1), and encephalitis (n = 1) were enrolled. After training using HAL, GMFM, gait speed, cadence, 6MD, and COPM significantly improved (all p < 0.05). Improvements in GMFM were maintained one year after the intervention (p < 0.001) and in self-selected gait speed and 6MD three months after the intervention (p < 0.05). Training using HAL may be safe and feasible for childhood-onset motor disabilities and may maintain long-term improvements in motor function and walking ability.

Features of electromyography threshold of the respiratory muscles during incremental exercise test.

In this study, we aimed to examine the electromyography threshold (EMGT) of the respiratory muscle and accessory respiratory muscles. Sixteen healthy men underwent an incremental exercise test at 15 W/minute to the end point. Expired gases and electromyograms of the respiratory and lower limb muscles were measured. The breakpoints for the EMG and expired gas data were analyzed using a segmented regression model. EMGT of the sternocleidomastoid and diaphragm was significantly more delayed than the ventilation threshold (VT) (287.94 s, 288.15 s vs. 185.5 s, p = 0.028 and 0.044, respectively). The EMGT of respiratory muscles and VT were not related, though EMGT of rectus femoris and vastus lateralis correlated with VT (r = 0.854, p < 0.001; r = 0.657, p = 0.011, respectively). EMGT of respiratory muscles may be influenced by multiple factors, such as central command and afferent input of mechanical stimulation from muscles, in addition to VT-induced changes in metabolic dynamics.

Incidence of cervical kyphosis and cervical posterior translation in neck pain associated with radiological evidence of degenerative disc disease.

BACKGROUND: Cervical kyphosis mechanically influences the intervertebral discs, which may lead to neck, shoulder, and scapular pain. OBJECTIVES: To investigate the incidence of cervical kyphosis and posterior displacement of cervical vertebrae (cervical posterior translation index) in patients with radiologically evident degenerative disc disease. DESIGN: Retrospective-cohort study. METHODS: Ninety-five patients with radiologically evident degenerative disc disease were recruited at our clinic from 2015 to 2019. Radiography images were used to analyze the straight-line index in each patient in the upright posture. The straight-line index was calculated by drawing a reference line connecting the posterior inferior edges of C2 to C7 and normalizing the addition of the distances from the posterior inferior edges of C3, C4, C5, and C6 to the reference line, respectively. Straight-line index <0 was defined as cervical kyphosis and ≥0 as cervical lordosis, the cervical kyphosis. In cervical kyphosis group, the distance from the posterior inferior edges of C3, C4, C5, and C6 to the reference line was normalized by the reference line distance to determine posterior displacement. Multiple comparison tests aside from simple and multiple linear regression analysis were performed. RESULTS: The incidence of cervical kyphosis in patients with radiologically evident degenerative disc disease was 60% (57/95 patients). Multiple comparison tests revealed that the cervical posterior translation indexes of C4 and C5 were significantly higher than those of C3, C4, and C6, in cervical kyphosis group. CONCLUSIONS: Cervical kyphosis was present in 60% of patients with radiologically evident degenerative disc disease, with C5 showing the most posterior displacement.

Effects of breathing control using visual feedback of thoracoabdominal movement on aerobic exercise.

PURPOSE: To clarify whether voluntary respiratory movement control strategy is sustainable during exercise and to determine its effect on aerobic exercise. MATERIAL AND METHODS: Ten healthy men were enrolled in this study. We developed a device that can convert information on thoracoabdominal changes from an inductance plethysmograph and display the Konno-Mead diagram on the monitor in real time for each breath. On the first day, an incremental load test (ILT) was performed under two conditions. On the second day, a constant load test (CLT) was performed under two conditions using the load 1 min before the anaerobic threshold (AT). RESULTS: In the ILT, a significant prolongation of AT time was observed with voluntary respiratory movement control. In the CLT, carbon dioxide excretion showed no significant interaction, but the gas exchange ratio did. CONCLUSION: Voluntary respiratory movement control using a combination of chest band and visual feedback of thoracoabdominal movements may be a respiratory strategy to enhance aerobic exercise.

Effectiveness of a case-based digital learning interprofessional workshop involving undergraduates in medical technology, radiological science, and physical therapy: A pre-post intervention study.

All healthcare professionals must understand information on a patient's biophysical functions, and it is important to educate professionals on how to use this information in an interprofessional team for diagnosis. However, there is little interprofessional education for students of medical technology and radiological science involved in biophysical function diagnosis. In the present study, we developed a case-based interprofessional learning tool for using biophysical information for diagnosis. The study examined the effects of a collaborative exercise workshop for healthcare professional students using the tool. Participants were 234 students from three healthcare professions (medical technology, radiological science, and physical therapy). They completed the Japanese version of the Readiness for Interprofessional Learning Scale before and after the workshops. The workshops incorporated digital materials that allowed students to examine the test results of a virtual patient, answer questions, and discuss their diagnoses and prognoses. For analysis, a two-way analysis of variance was performed on the total score on the Readiness for Interprofessional Learning Scale of the three departments, and the effectiveness of the workshop for the three departments was compared. Statistical analyses showed no interaction between time and department (p = 0.283). After the workshop, students from all three departments showed significant improvements in total scores on the Readiness for Interprofessional Learning Scale (p < 0.01) with medium to large effect sizes (r = 0.33-0.52). In the comparison between departments, there was a significant difference in the awareness levels of only medical technology and radiological science students before the workshop (p = 0.015). This study conducted case-based learning workshops with students from three departments, in which a patient's biophysical information was conveyed between occupational practices. The workshops improved the awareness of interprofessional education in students from all departments and revealed that interprofessional education is important for healthcare professions involved in biophysical function diagnosis.