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Technological advances in neonatology led to the improvement of the survival rate in preterm babies with very low birth weights. However, intraventricular hemorrhage (IVH) has been one of the major complications of prematurity. IVH is relevant to neurodevelopmental disorders, such as cerebral palsy, language and cognitive impairments, and neurosensory and psychiatric problems, especially when combined with brain parenchymal injuries. Additionally, severe IVH requiring shunt insertion is associated with a higher risk of adverse neurodevelopmental outcomes. Multidisciplinary and longitudinal rehabilitation should be provided for these children based on the patients’ life cycles. During the infantile period, it is essential to detect high-risk infants based on neuromotor examinations and provide early intervention as soon as possible. As babies grow up, close monitoring of language and cognitive development is needed. Moreover, providing continuous rehabilitation with task-specific and intensive repetitive training could improve functional outcomes in children with mild-to-moderate disabilities. After school age, maintaining the level of physical activity and managing complications are also needed.

Various neurological and musculoskeletal disorders can induce pathologic toe walking and lead to changes in foot kinematics. In this study, we analyzed the differences in foot kinematics between toe walking and heel-toe walking (HW) in able-bodied individuals. Twenty young healthy adults performed three gaits: HW, comfortable-height toe walking (CTW), and maximum-height toe walking (MTW). Oxford Foot Model was used for gait analysis. Toe walking showed increase of forefoot plantarflexion and hindfoot internal rotation compared to HW. Thus, our results may help distinguish the pathologic mechanism of the equinus gait in various disorders from the kinematic change of toe walking itself.

BACKGROUND Shoulder subluxation is a frequent complication after stroke causing joint instability, shoulder pain, decreased activities of daily living, and impedance to rehabilitation progress. Electrical stimulation (ES) is considered an effective modality to reduce shoulder subluxation in acute stroke. However, few studies have investigated the effect of position-triggered ES, which induces active muscle contraction though accurate motion detection. AIM The aim of this study was to investigate whether position-triggered ES was more effective in reducing acute hemiplegic shoulder subluxation after stroke than passive ES. DESIGN Single-blind, randomized controlled trial. SETTING The study setting was the university hospital rehabilitation center. POPULATION Fifty poststroke subacute hemiparetic patients with shoulder subluxation. METHODS Patients were randomly assigned into two groups. The position-triggered ES group received 30-minute ES sessions, 5 days per week for 3 weeks with specially modified Novastim® CU-FS1 (CU Medical Systems, Inc., Gangwon-do, South Korea) for motion triggering. The passive ES group received the same protocol without motion triggering. The vertical distance (VD) and the joint distance (JD), relative VD and JD (rVD, rJD), upper extremity component of Fugl-Meyer Motor Assessment (FMA upper ), Motricity Index (MI), Manual Function Test (MFT), and peak torque of affected shoulder abductor (PT) were assessed at baseline (T0), end of electrical stimulation session (T1), and 3 weeks (T2) after treatment. RESULTS Repeated-measures analysis of variance revealed significant interaction between time and intervention on JD and rJD, indicating that shoulder subluxation was significantly more reduced in position-triggered ES than in passive ES (P upper , MI, MFT, and PT did not show this significance. The change of (∆)JD, ∆rVD, and ∆rJD in the motion-triggered ES group improved significantly more at T1 than in the passive ES group (P

Center-of-pressure (CoP) measurements have been studied for assessing balance control. While CoP measurements using force plates have been used to assess standing balance in children with cerebral palsy (CP), it has not been assessed in a sitting position, which specifically reflects trunk postural control.The purpose of this study was to compare CoP measurements using force plates during both standing and sitting trials with the Pediatric Balance Scale (PBS) in children with spastic CP.We recruited 26 children with spastic CP (7.8 ± 3.4 years, 4-13 years) and used the PBS, a validated evaluation tool that measures static and dynamic balance control. We took CoP measurements using force plates during sitting and standing. For both trials, subjects stayed still for 10 s with their eyes open or closed. We calculated the CoP velocity, mediolateral (ML) and anteroposterior (AP) velocity, and ML and AP displacements of CoP.During standing trials, static PBS standing scores negatively correlated with more AP displacement and velocity than ML displacement and velocity (p 0.05). During sitting trials, dynamic PBS sitting scores negatively correlated with ML displacement and velocity (p 0.05). CoP parameters in the ML direction of the sitting position and CoP parameters in the AP direction of the standing position may better reflect the balance control in children with spastic CP.

Objective To verify the suitability and reliability of YouTube videos pertaining to the 5 most commonly used knee stability tests for educational purposes. Design Cross-sectional observational study. Setting YouTube videos were categorized into 2 groups according to their sources: professional and nonprofessional groups. Only videos that satisfied the purpose and procedure parts among comprehensiveness scores were defined as suitable for educational purposes. For evaluating the reliability, the modified DISCERN was used. One-way analysis of variance and Kruskal-Wallis test were used to compare continuous and categorical variables, respectively. Participants Research on YouTube videos (N=218) from November 13, 2019, to November 17, 2019, was done using the following keywords: “anterior drawer test knee,” “Lachman test knee,” “posterior drawer test,” “valgus knee test,” and “varus knee test.” Interventions Not applicable. Main Outcome Measures Comprehensiveness score that focused on the purpose, procedure, interpretation, and limitations or precautions of the test were developed by the authors, and modified DISCERN score. Results In terms of the suitability for educational purposes, 126 videos (58%) were classified into the suitable group, and 92 (42%) were classified into the unsuitable group. Neither group had significantly more views, views per posting days, likes, dislikes, or posting days. When comparing the comprehensiveness and reliability scores of each group, significant differences between groups were identified. Only 47 videos met the limitations/precautions category. A total of 155 videos (71%) were from the professional group and 63 videos (29%) were from the nonprofessional group. Significant differences were found in views, views per posting days, likes, and dislikes between the professional group and nonprofessional group. Conclusions YouTube should not be used for learning about knee stability tests. Professionals, especially those in rehabilitation medicine, should pay more attention to uploading high-quality videos with reliable content.

Background and Aims: Robotic rehabilitation therapy has been tried as a novel technology in field of upper extremity rehabilitation of stroke patients. However, the previous trial revealed the additional effect of robotic therapy compared to conservative therapy. We aimed to investigate whether the same intensity robot-assisted arm training(RAT) was more effective on the recovery of motor and improvement of upper limb function than conventional occupational therapy(COT) in subacute first-ever hemiplegic stroke patients (Fig.1). Methods: The clinical assessment included Fugl-Meyer Assessment(FMA), Motricity Index(MI), Functional Independence Measure(FIM), Motor Function Test(MFT), Wolf Motor Function Test(WMFT), Trunk Control Test(TCT), Maximal Voluntary Torques(MVT), Visual Analogue Scale(VAS) for pain, and Active Range of Motion(AROM). The repeated measures ANOVA was used to compare the results of longitudinal analyses between two groups (SPSS Inc., Chicago, IL, USA). Results: The all parameters measured at baseline did not differ between two groups. Both groups showed significant improvements in FMA, MI, FIM, MFT, WMFT, TCT, MVT, and AROM after treatment (P Conclusions: This study did not agree that robot-assisted arm training combined with conventional occupational therapy in subacute post-stroke hemiplegic patients may be superior to the same intensity conventional occupational therapy.

ObjectivesThe gait disturbance in spastic paraplegic patients lowers the gait speed, increases fall risk and eventually lower the quality of life. This study aims to investigate the effect of electrical twitch obtaining intramuscular stimulation (ETOIMS) on spastic paraplegic patients’ gait speed and pattern.MethodsA prospective short-term cohort study was designed in the outpatient clinic of the department of rehabilitation in a tertiary hospital. Patients with spastic paraplegia (N=5) were participated, including spinal cord tumour (N=2), cervical myelitis (N=1), hereditary spastic paraplegia (NIPA1 mutation; N=1) and spinal cord injury (N=1). The participants underwent ETOIMS. The target muscles were the bilateral quadratus lumborum, multifidus inserting to the L4 and L5 spinous process, and gluteus medius. Gait speed, gait pattern and subjective symptoms, including pain scores (measured by visual analogue scale), were compared before and immediately after the intervention.ResultsAll patients subjectively reported reduced stiffness during walking and alleviated muscular pain in the lower back and gluteal area. After one session of ETOIMS, patient 1–4 showed 57%, 29%, 33% and 6 % improvement in gait speed, respectively, and all patients showed increased pelvic dissociation.ConclusionsThe ETOIMS can be effective in improving gait speed and stability by relaxing the muscles or alleviating the pain in the lower back and gluteal area in spastic paraplegic patients.