Medicine and Health Sciences Commons^™

Management Of Dysphagia In Tracheostomized Patients: A Narrative Review, Chih-En Liu, Shu-Mei Yang, Ming-Yen Hsiao

Rehabilitation Practice and Science

Swallowing disorders are prevalent in tracheostomized patients and are associated with a high incidence of aspiration. This narrative review discusses the primary causes and subsequent management strategies for dysphagia in this population. Factors such as reduced laryngeal elevation, compromised hypopharyngeal and laryngeal sensations, impaired vocal cord function, loss of glottic airflow and subglottic pressure, weakened cough reflex, increased respiratory secretions, and disuse muscle atrophy have been identified as major contributors. These challenges can lead to severe complications, including aspiration pneumonia and respiratory failure. Comprehensive evaluations that combine clinical assessments with a thorough review of a patient’s medical history are crucial. …

Application Of Intravenous Laser Irradiation Of Blood (Ilib) In Physical Medicine: A Narrative Review, Ya-Chi Chuang, Yuan-Yang Cheng

Rehabilitation Practice and Science

Intravenous laser irradiation of blood (ILIB) involves a type of intravascular treatment which applies a helium-neon laser possessing a wavelength of 632.8nm. Since its first use in 1981 by Russian scientists, it is now widely applied in the treatment of various diseases, including chronic musculoskeletal pain, wound healing, spinal cord injury, stroke, traumatic brain injury, coronary artery disease, type 2 diabetes mellitus, rheumatoid arthritis and acute kidney injury. The underlying mechanism for ILIB may be associated with its anti-oxidative (through regulating the reactive oxygen species systems) and anti-inflammatory effects (by reducing the production of inflammatory cytokines). Moreover, positive effects on …

Clinical Application Of Intraoperative Neurophysiological Monitoring During Resection Of A Spinal Tumor: A Case Report, Chia-Hung Hou, Sanford P C Hsu, Pang-Wei Chang, Chen-Liang Chou, Tsui-Fen Yang

Rehabilitation Practice and Science

Surgical resection of a spinal tumor is the first choice of treatment in clinical practice, however it carries a significant risk of creating new postoperative neurological deficits. It is believed that the concomitant use of intraoperative neurophysiological monitoring (IONM) during tumor resection can not only increase safety of the procedure, but also improve surgical outcomes.

Case description:

A 52-year-old female who was in good health and neurologically intact presented with intermittent claudication, numbness and weakness of bilateral lower extremities, and bowel and urinary incontinence in June 2021. L-spine MRI revealed an intradural extramedullary tumor at T8 level. She received T7-9 …

Early Intervention In A Child With Aymé-Gripp Syndrome: A Case Report, Liang-Jun Ou-Yang, Pei-Hsuan Huang, Hsiang-Ning Chang, Chih-Chi Chen, Chia-Ling Chen, Chia-Ying Chung

Rehabilitation Practice and Science

Aymé-Gripp syndrome is an autosomal dominant inherited disease. The de novo pathogenic variant of the MAF gene, located at 16q23.2, is considered the primary common cause of this disease. The pathogenic variant causes interference with lens and eye development and embryonic development. Patients with Aymé-Gripp syndrome typically present with bilateral cataracts, bilateral congenital sensorineural hearing loss, and Down syndrome-like facial features. Dual sensory impairment is observed in these patients. Delayed developmental milestones in the aspect of gross motor, fine motor, speech, and language, cognitive function, and social interaction can be detected early in life. Here we presented a 4-year-old male …

Pseudomeningocele Following Traumatic Brachial Plexus Injury: A Case Report, Shih-Ting Huang, Ming-Hsun Lee, Simon-Fuk Tan Tang, Ching-Yu Wang, Yu-Ting Hsieh

Rehabilitation Practice and Science

An injury to the brachial plexus can lead to the development of a pseudomeningocele, a buildup of cerebrospinal fluid (CSF) in the subarachnoid space caused by tears in the affected root sleeves. External forces acting on the brachial plexus represent the main mechanism of injury. The resulting stretching and tearing of the meninges outside the nerve root led to the pseudomeningocele. Although often initially asymptomatic, a pseudomeningocele can eventually cause pain, paresthesia, muscle weakness, and paralysis. The nerve conduction studies (NCS), electromyography (EMG), and magnetic resonance imaging (MRI) can be used to identify the injury, and treatment can involve either …

Evaluations Of Exercise Intolerance With Cardiopulmonary Exercise Tests In A 24-Year-Old Young Male With Obesity With Tetrahydrobiopterin Deficiency: A Case Report, Chun-Yu Chen, Shin-Tsu Chang, Ko-Long Lin, Mu-Hsun Wu

Rehabilitation Practice and Science

Phenylketonuria (PKU) is a rare amino acid metabolism genetic disorder. Tetrahydrobiopterin (BH4) metabolism defects cause variant PKU. BH4 coenzyme deficiency disables phenylalanine metabolism into tyrosine, causing brain damage and intellectual impairment. Patients follow a low-phenylalanine diet for life, increasing the risk of obesity, hypertension, and metabolic syndrome. A 24-year-old male patient with BH4 deficiency underwent a pulmonary function test and cardiopulmonary exercise test (CPET). Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were within normal values, with an 80.68% ratio. The 20-watt bicycle exercise test indicated moderate functional impairment (27.3 ml/kg/min of peak oxygen intake). The …

Clinical Multimedia: Ultrasound Examination Of Medial Meniscus Posterior Root Tear, Yu-Xuan Wu, Chien-Ping Chen, Hung-Jui Chuang

Rehabilitation Practice and Science

This report outlines the case of a 52-year-old woman with continuous left knee pain. An initial assessment, suggesting a meniscal tear based on joint line tenderness and a positive McMurray test, led to an ultrasonographic investigation. The ultrasound revealed left medial meniscus extrusion without positional change from full extension to 90° flexion, a hypoechoic cleft in the medial meniscus posterior root (MMPR) area, and the notable absence of the MMPR anterior to the posterior cruciate ligament (PCL), identified as the ultrasonographic ghost sign. A subsequent MRI confirmed a medial meniscus posterior root tear (MMPRT). MMPRT is known to cause biomechanical …

Evaluating Dysphagia In Patients With Cervical Spinal Cord Injury Using The Modified Barium Swallow Impairment Profile, Ting-Huan Chen, Bai-Hong Chen, Shih-Chung Chang

Rehabilitation Practice and Science

Background/Purpose: To clarify the characteristics of dysphagia in patients with cervical spinal cord injury (CSCI) by using modified barium swallow impairment profile (MBSImP) scoring in a videofluoroscopic swallowing study (VFSS). Methods: This retrospective study included the data of 10 patients with CSCI (9 men and 1 woman) with dysphagia admitted to the rehabilitation ward of a university medical hospital who had undergone VFSS. The patients’ oral, pharyngeal, and esophageal impairments were evaluated using the MBSImP. Results: Comprising the MBSImP overall score, the median oral impairment total score (OT) was 10.5 (interquartile range [IQR]: 9–11), the median pharyngeal impairment total score …

Effect Of Robotic Training On The Mobility Of Children With Cerebral Palsy: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Fu-An Yang, Ya-Chu Shih, Li-Fong Lin, Chih-Wei Peng, Chien-Hung Lai, Tsan-Hon Liou, Reuben Escorpizo, Hung-Chou Chen

Rehabilitation Practice and Science

In this study, we conducted a systematic review and meta-analysis to investigate the effect of robotic training on the mobility of children with cerebral palsy. The PubMed, Cochrane Library, PEDro, and Embase databases were searched for relevant studies from their inception to June 17, 2023. We selected studies that (1) were randomized controlled trials (RCTs), (2) included patients with cerebral palsy aged years, (3) compared robotic training with conventional rehabilitation alone, and (4) reported mobility outcomes. Continuous variables are expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). The analysis was performed using RevMan 5.4 software. We included …

Effectiveness Of Specialized Oral Care For Post-Acute Stroke Patients, Hui-Chuan Chen, Hsiao-Han Wei, Yi-Hsuan Yang, Hsial-Lun To, Hsiao-Fan Wang, Ying-Han Hong

Rehabilitation Practice and Science

(1) Background: Poor oral health is a common problem in stroke patients. In Taiwan, there are professional oral care processes for patients with special needs such as stroke patients, which are guided by dental hygienists. This study sought to investigate the effectiveness of specialized oral care for hospitalized stroke patients; (2) Methods: This prospective study was conducted in the Rehabilitation ward at the Taipei City Hospital. Sixty-six patients were randomly divided into two groups. The specialized oral care group (n=34) was guided by dental hygienists. The control group (n=32) received only routine oral care. The oral health outcome measure was …