Search

BACKGROUND: Impaired upper limb function in stroke survivors is characterized by muscle weakness, increased muscle tone, contracture, or impaired motor control. OBJECTIVE: We aimed to evaluate the effectiveness of Kinesio-taping application for functional recovery on the affected arm and forearm during rehabilitation. METHODS: Forty-one patients eligible for this study were randomly assigned to either the Kinesio-taping group (n = 21), receiving Kinesio-taping intervention and conventional therapy, or control group (n = 20), receiving sham Kinesio-taping intervention and conventional therapy. The whole intervention lasted for 3 weeks. Fugl-Meyer assessment of the upper extremity, Barthel Index, the Stroke Impact Scale, and modified Ashworth scale were measured at 3 time points: baseline, post-treatment (3rd week), and follow-up (6th week). RESULTS: In the Kinesio-taping group, there were significant differences in the upper extremity (p = 0.003), wrist (p = 0.000) and hand (p = 0.000) parts of the Fugl-Meyer assessment of the upper extremity between the three assessment times. On the other hand, the Barthel Index showed significant differences in both groups after therapy. CONCLUSION: Combining conventional rehabilitation with Kinesio-taping intervention may improve functional motor performance of both the proximal and distal parts of the affected upper extremity in stroke survivors, with potential benefits for activity of daily living. [ABSTRACT FROM AUTHOR]

The prevalence of obstructive sleep apnea (OSA) after stroke is variable, likely due to the time of examination and patient population. Although risk factors for OSA are well established, those for OSA in patients with ischemic stroke have not yet been fully identified. Therefore, we examined the prevalence of OSA and identified risk factors for OSA in the acute stage of ischemic stroke in the Taiwanese population. A total of 103 patients with acute ischemic stroke were screened for OSA by performing polysomnography. The demographic and clinical data, Epworth Sleepiness Scale score, and other stroke risk factors were recorded. Sleep parameters, namely sleep efficiency, sleep stages, apnea-hypopnea index, and oxygen desaturation index were recorded. Logistic regression analysis was conducted to determine clinical and demographic risk factors for moderate to severe OSA in patients with stroke. We determined that 91.2% of the patients had OSA in the acute stage of ischemic stroke, and 70% of the patients had moderate to severe OSA. Multivariate logistic regression analysis revealed that patients aged ≥65 years had a significantly higher risk of moderate to severe OSA (adjusted OR: 3.04, 95% CI: 1.20–7.69, p < 0.05) compared with patients with ischemic stroke aged <50 years. OSA is highly prevalent among patients with ischemic stroke in the acute stage, and those aged ≥65 years had a significantly increased risk of moderate to severe OSA. In clinical practice, routine PSG screening of OSA may be necessary among older patients with stroke. [ABSTRACT FROM AUTHOR]

Objectives. This study is aimed at exploring the feasibility of sonoelastography on muscle stiffness of spastic forearm and evaluating the improvement of functional performance in patients with poststroke spasticity (PSS) after receiving kinesiotaping (KT) and rehabilitation. Methods. According to the spastic levels (using modified Ashworth scale (MAS)) of the affected upper extremity, 59 patients with stroke were allocated into two groups, group A (MAS 0–1): 31 patients (14 men and 17 women; mean age: 60 years) and group B (MAS 1+–2): 28 patients (22 men and 6 women; mean age: 51 years). The Brunnstrom motor recovery stage at the wrist/distal parts in groups A and B was stage 3/3.5 and stage 2.75/3. We evaluated the Brunnstrom stage, spastic levels by MAS and modified Tardieu scale (MTS), and Fugl-Meyer Assessment for upper extremity (FMA-UE). We also evaluated the muscle spasticity of flexor carpi radialis (FCR), flexor carpi ulnaris (FCU), and flexor digitorum superficialis (FDS) muscles using sonoelastography with shear wave velocity (SWV). We applied KT for 20 patients in group B, comparing the changes in sonoelastography and functional outcomes between KT and without KT interventions. Results. Both the MAS and MTS scales were moderately correlated with the SWV in forearm muscles on hemiplegic side (r = 0.336 – 0.554) After KT intervention, the SWV in FCR decreased (p = 0.028). Muscle spasticity was reduced (p < 0.01), and distal part of the Brunnstrom stage and FMA-UE were increased (p = 0.045 and p = 0.001). In patients without KT intervention, only the MTS degree reduced (p = 0.026). Conclusions. The SWV of sonoelastography could objectively assess the reduction of muscle stiffness of the affected forearms in patients with PSS after KT intervention. Advances in Knowledge. Sonoelastography could be a quantitative method to follow up for therapeutic effect of the spastic forearm. [ABSTRACT FROM AUTHOR]

Purpose: Only few studies have investigated medial epicondyle (MEC) lesions, particularly in the 12-18 age group. To the best of our knowledge, no study has compared ultrasonography (US), radiography and magnetic resonance imaging (MRI) in detecting MEC lesions. The aims of this study were to examine the value of US for detecting MEC lesions and to investigate correlations among diagnostic tools.Methods: A prospective, comparative study was performed. Young baseball players from southern Taiwan were recruited, and basic characteristics, as well as passive range of motion (pROM) of the upper extremities, were recorded. Screening US was performed to identify MEC lesions, and players with MEC lesions received follow-up plain radiography and MRI.Results: A total of 299 young baseball players were screened using US, and 28 of 299 players with possible MEC lesions were identified with a positive predictive value (PPV) of 88% according to MRI findings. The MEC lesions were primarily comprised of unfused ossicles and bony fragmentation. Other diagnoses, including UCL strain and medial epicondylitis, were also found by MRI in players with abnormal US screening results. The pROM of shoulder external rotation (ER) of the throwing hand was significantly reduced in players with MEC lesions (p = 0.006).Conclusions: Bony cortical discontinuity or fragmentation over the MEC warrants further research, and US provides good PPV for types of MEC lesions. Decreased shoulder ER may relate to MEC lesions and should be taken into consideration. The use of US may facilitate early detection and intervention.Level Of Evidence: IV, Cross-sectional study. [ABSTRACT FROM AUTHOR]

Aim and objectives: To predict the risk factors related to newly diagnosed psychiatric disorders resulting from spinal cord injuries (SCIs). Background: SCIs are a common result of devastating accidents; they can have an essential negative impact on the psychological health of those so afflicted. Psychiatric disorders commonly occur worldwide and are often associated with pain and disability; however, few studies have investigated the risk factors of psychiatric disorders among persons with SCIs. Design: A retrospective cohort study design with data obtained from the Taiwan Health Insurance Research Database (THIRD). THIRD involves the claims data on recipients recorded in the Taiwan National Health Insurance (TNHI), which was set up in 1995 and covers about 99% of the 23 million persons in Taiwan. Methods: We used THIRD to predict the risk factors related to newly diagnosed psychiatric disorders among victims of spinal cord injury. Results: The majority of persons with SCI were men (51.2%), and their average age was 52.8 years. All 5,828 newly diagnosed psychiatric disorders were included from 1997–2009 in 64,907 SCI in the THIRD data set. These results demonstrated notable differences in hazard risk (HR); the injured persons were inspected for the level of SCI, age, hypertension and chronic obstructive pulmonary disease (HR: 1.637, 95% CI: 1.452–1.844, p < .0001; HR: 1.005, 95% CI: 1.002–1.009, p = .0019; HR: 0.724, 95% CI: 0.642–0.816; HR: 1.267, 95% CI: 1.105–1.454, p = .0007; HR: 1.368, 95% CI: 1.183–1.582, p < .0001, respectively); the persons with SCI exhibited significant independent associations with psychiatric disorders. Conclusions: The results revealed that the level of SCI, female gender and age, respectively, affects the incidence of newly diagnosed psychiatric disorder related to SCI. Relevance to clinical practice: This study showed that psychiatric disorders may be associated with the development of SCI, and that this risk was more predominant in females with SCI. Our results are of direct clinical relevance as they are meant to assist clinical assessment, counselling, guidance of symptomatic monitoring and early clinical intervention. [ABSTRACT FROM AUTHOR]

The oriental river prawn (Macrobrachium nipponense) is a non-obligatory amphidromous prawn, and it has a wide distribution covering almost the entire Taiwan. Mitochondrial DNA fragment sequences of the cytochrome oxidase subunit I (COI) and 16S rRNA were combined and used to elucidate the population structure and historical demography of oriental river prawn in Taiwan. A total of 202 individuals from six reservoirs and three estuaries were separately collected. Nucleotide diversity (π) of all populations was 0.01217, with values ranging from 0.00188 (Shihmen Reservoir, SMR, northern Taiwan) to 0.01425 (Mingte Reservoir, MTR, west-central Taiwan). All 76 haplotypes were divided into 2 lineages: lineage A included individuals from all sampling areas except SMR, and lineage B included specimens from all sampling locations except Chengching Lake Reservoir (CLR) and Liyu Lake Reservoir (LLR). All FST values among nine populations were significantly different except the one between Jhonggang River Estuary (JGE, west-central Taiwan) and Kaoping River Estuary (KPE, southern Taiwan). UPGMA tree of nine populations showed two main groups: the first group included the SMR and Tamsui River Estuary (TSE) (both located northern Taiwan), and the second one included the other seven populations (west-central, southern and eastern Taiwan). Demographic analyses implied a population expansion occurred during the recent history of the species. The dispersal route of this species might be from China to west-central and west-southern Taiwan, and then the part individuals belonging to lineage A and B dispersed southerly and northerly, respectively. And then part individuals in west-central Taiwan fell back to and stay at estuaries as the sea level rose about 18,000 years ago. [ABSTRACT FROM AUTHOR]

Morphometric differences were used to elucidate the stock geographic variations and phylogeography of Macrobrachium nipponense in Taiwan. Eight samples were collected from three estuaries (Tamsui River Estuary [TSE], Kaoping River Estuary [KPE], and Houlung River Estuary [HLE]) and five reservoirs (Shimen Reservoir [SMR], Mingde Reservoir [MDR], Deji Reservoir [DJR], Tsengwen Reservoir [TWR], and Chengqing Lake Reservoir [CLR]). Twelve morphometric measurements were size-standardized by the allometric method and via Cluster Analysis and Canonical Variate Analysis (CVA). Randomisation tests were used to verify the morphometric variation between groups. The results clustered the eight samples into a minimum of three groups. The first group included four reservoir samples (i.e. DJR, MDR, CLR, and TWR); the second included the SMR sample, and the third comprised the remaining estuarine samples (i.e. TSE, HLE, and KPE). Morphometric variation among the three groups was significant for each sex. Significant differences between these three groups may be derived from evolutionary origins, geographic events or environmental adaption which was discussed in the paper. The difference between multivariate allometric coefficients in both sexes and sites were also tested based on the eight group data sets, and the result showed that the difference between sexes was significant. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between poststroke depression (PSD) and psychological crisis in patients who have experienced a stroke within 6 months., Methods: This was a retrospective cross-sectional study that enrolled patients within 6 months after stroke onset. The investigators reviewed medical charts to obtain patients' baseline characteristics, and a psychologist evaluated each patient for depression using the Taiwanese Depression Questionnaire (TDQ) and for psychological crisis using the Triage Assessment System (TAS). A generalized linear model (GLM) was used to analyze the association between the results of the TDQ and TAS., Results: Ninety-seven patients with stroke were included. Age ( p = 0.003), time since onset of stroke ( p = 0.041), diabetes mellitus ( p = 0.004), hypertension ( p = 0.016), heart disease ( p = 0.005), and TDQ score were significantly different between the hemorrhagic stroke group and the ischemic stroke group. The TDQ score was significantly lower in the hemorrhagic stroke group ( p = 0.012). The TDQ score was associated with the TAS total score and each domain score, and the presence of heart disease was associated with poorer TAS score in the behavioral domain ( p = 0.016)., Conclusion: PSD is likely an important component of psychological crisis in stroke patients. For clinicians, a comprehensive psychologic evaluation is necessary to optimize treatment., Competing Interests: There are no conflicts of interest to declare. The authors report no actual or potential conflicts of interest, including any financial, personal, or other relationships with other people or organizations, within three years of beginning the submitted work that could inappropriately influence, or be perceived to influence, the work., (Copyright © 2021 Han-Chin Hsieh et al.)

Background: Capitellar osteochondritis dissecans (COCD) is a common elbow injury in young baseball athletes. It may be asymptomatic at the early stage and may progress if left untreated. This study investigated the effectiveness of ultrasonography (US) screening for COCD in adolescent baseball players and identified risk factors of COCD., Methods: A cross-sectional analysis study was conducted among baseball athletes aged 12 to 18 years. US screening of the throwing elbow was performed in all participants, and additional magnetic resonance imaging (MRI) was arranged for those with abnormal screening results. The prevalence of COCD was calculated according to MRI results. The US findings were compared with MRI findings. Data for characteristics, joint range of motion, and quality of pain were collected and analyzed using a logistic regression model to identify the risk factors of COCD., Results: A total of 299 adolescent baseball players were screened, and 17 were found to have COCD according to US findings. MRI was performed in 15 of these 17 players, and the MRI findings further confirmed COCD in 10 players (66.7%). The presence of elbow pain while at rest, body height, and age at introduction to baseball were predictors of COCD., Conclusions: Although the effectiveness of diagnosing stage 1 COCD is satisfactory, US is a helpful tool for detecting stage 2 and higher-stage COCD. Elbow resting pain, lower body height, and introduction to baseball at a younger age are risk factors for COCD., (Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)