Rehabilitation and Therapy Commons^™

Referred Pain: A Case Report On Shoulder Pain Caused By A Mediastinal Tumor, Cheng-I Chen, Yao-Jen Chen

Rehabilitation Practice and Science

Shoulder pain has many etiologies, with the most common causes being the shoulder joint itself and the surrounding soft tissues, such as tendons, bursae, or ligaments. However, rare pathologies can occur. This report presents a case of chronic right shoulder pain eventually diagnosed as a rare case of extra-skeletal osteosarcoma. The referred right shoulder pain was likely caused by tumor invasion of the pericardium, whose sensory innervation is provided by the phrenic nerve. The purpose of this case report is to highlight the fact that, although rare, neoplasm can be a cause of shoulder pain. Rather than just relieving symptoms, …

Ultrasonography Can Be Early Diagnostic Modality For Pediatric Calcaneus Fractures: A Case Report, Ying-Chu Chen, Szu-En Chen

Rehabilitation Practice and Science

Although calcaneus fractures may be the most common pediatric tarsal bone fracture, most occult calcaneus fractures are not visible on plain radiography, resulting in delayed diagnosis. However, ultrasonography can aid early diagnosis of this fracture with an unspecified mechanism of injury and unremarkable radiographic findings. In a pediatric patient with progressive ankle swelling and pain, initial plain radiography was unremarkable, and antibiotics were administered for suspected infective arthritis. After limping developed, ultrasonography showed symmetric growth plates of bilateral distal tibia, fibula, and tarsal bone; a step-off calcaneus cortex with periosteal reaction; increased power Doppler flow; and probe tenderness, indicating a …

Entrapment Of The Deep Branch Of The Radial Nerve By An Intramuscular Lipoma: A Case Report, Yann-Rong Chen, Ying-Chen Kuo, Yu-Hsien Lin, Yu-Ting Lin

Rehabilitation Practice and Science

Lipomas are benign tumors that are common in subcutaneous tissue and are usually asymptomatic. However, intramuscular lipomas, which are less common, can cause nerve compression in rare cases. Herein, we report the case of a 61-year-old man with an intramuscular lipoma on his right forearm. The lipoma entrapped the deep branch of the radial nerve and caused wrist drop and finger drop. A nerve conduction examination and electromyography were conducted to quantify the degree of and localize the nerve injury. Sonography provided the initial diagnosis of a lipoma, which was verified with magnetic resonance imaging. The lipoma was resected, and …

Efficacy Of A Compound Swallowing Training Program Incorporating Neuromuscular Electrical Stimulation On Postoperative Chronic Dysphagia In Patients With Tongue Cancer, U-Hin Lai, Yu-Chi Huang, Ching-Yi Liao, Xiao-Rou Ding, Chau-Peng Leong

Rehabilitation Practice and Science

Objective: To investigate therapeutic effects of a compound swallowing training program(CSTP) that includes neuromuscular electrical stimulation, swallowing muscle strengthening, posture training, food texture modification, and the use of adaptive feeding devices on chronic dysphagia after surgical treatment of tongue cancer(TC), and review the long-term swallowing outcomes and possible adverse effects.

Materials and methods: In this retrospective longitudinal study, we included patients with chronic dysphagia after surgical treatment of TC, who received a total of 10 CSTPs three times weekly, for one hour each time. Penetration-Aspiration Scale (PAS), Functional Dysphagia Scale (FDS), and Swallowing Performance Rating Scale (SPS) scores were compared …

Delayed Localized Hypersensitivity Reactions To An Adenoviral Vector Vaccine—A Literature Review And A Case Report With Serial Ultrasonography Follow-Up, Chih-Ying Wu, Chien-Min Chen, Szu-Han Wang, Chia-Hung Lin

Rehabilitation Practice and Science

Severe acute respiratory syndrome coronavirus 2 has changed our life worldwide. Vaccination plays an important role in this pandemic to reduce virus transmission and lower the mortality risk. However, as vaccination rates increase, so do the reported adverse effects. This report describes a case of 28-year-old female with severe subcutaneous swelling persisting almost 1 month after receiving the recombinant adenoviral vector vaccine (ChAdOx1 nCov-19, AZD1222), despite paracetamol prophylaxis. The ultrasonography showed a hyperechoic swelling in the subcutaneous layer and a diffuse hypoechoic muscle layer. The phenomenon results from delayed hypersensitivity, however, its clinical picture is often confused with cellulitis and …

Effect Of Repetitive Transcranial Magnetic Stimulation On Gait Function And Strength Among Patients With Spinal Cord Injury: A Meta-Analysis, Yen-Ting Chen, Yu-Chi Su, Yu-Ching Lin

Rehabilitation Practice and Science

Purpose: This meta-anaylysis investigated the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the context of spinal cord injury (SCI). The study focused on assessing its impact on muscle strength and gait speed, measured through the lower extremities motor score of the American Spinal Injury Association (ASIA) and 10-Meter Walk Test scores(10MWT). Methods: The PubMed, Cochrane Library, and Embase databases were searched for articles published through Oct 2023. We enrolled only randomized controlled trials. The Cochrane Collaboration risk of bias tool was used for quality assessment. Outcomes were analyzed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). We …

The Application Of Echo-Guided Injection Of Steroid And Botulinum Toxin Type A For Ankle Contracture In Traumatic Trans-Metatarsal Amputation: A Casereport, Ching Yu Wang, Simon F Tang, Yu Ting Hsieh

Rehabilitation Practice and Science

In this report we share 21 year-old young man with traumatic transmetatarsal amputation treated with multiple operations after few weeks of surgery. Foot equinovarus deformity was noted which leads to walking disability and affects daily activities. Patient was referred to us from orthopedic doctor because he hesitated to have another operation for Achilles tendon lengthening. During the physical examination, equinovarus foot with hip contracture were observed which may be caused by muscle imbalance or nerve injury. Nerve conduction velocity and electromyography tests (NCV/EMG) was arranged for differentiating between neurogenic contraction and myogenic contracture. Peroneal nerve injury was ruled outafter the …

Effectiveness And Predictors Of Home-Based Postacute Stroke Care, Yuan-Ting Lo, Wen-Chih Lin, Lin-Fu Lee, Willy Chou

Rehabilitation Practice and Science

Introduction: Stroke is the leading cause of disability in adults. In 2014, Taiwan's National Health Insurance Administration started to provide inpatient postacute care, and the results indicated that this model improves the overall functional status of patients with stroke. In 2017, home-based postacute stroke care was initiated; however, no study has evaluated its effectiveness. Therefore, we explored the functional recovery of patients with stroke after 6 weeks of postacute care at home and the factors that influenced their functional improvement. Method: We recruited patients with stroke who received a score of 3 or 4 on the modified Rankin Scale between …

Effects Of Supervised Exercise Training On Health-Related Physical Fitness In Community Dwellers Aged Over 50 Years, Chun-Yi Lee, Tieh-Cheng Fu, Jong-Shyan Wang, Chih-Chin Hsu

Rehabilitation Practice and Science

Effects of supervised aerobic exercise training on physical fitness in aging community residents were highlighted in the study. 76 community-dwellers aged ＞ 50 years who completed an 8-week cohort study were included. All participants were instructed to walk ≥ 8000 steps per day (stp/d) and wore a smart watch to record the every-day step amount. The average number of everyday step amount in a week was used as the mean walking steps per day in a week. Among them, 39 participants were randomized to the supervised exercise training (SET) and 37 were allocated to the home exercise training (HET) groups. …

Age-Related Sonoanatomical Change Of The Knee In Children, Shu-Mei Yang, Chia-Wei Lin, Wen-Shiang Chen

Rehabilitation Practice and Science

Ultrasound has been thoroughly studied and become a well-established tool for assessment of adult patients' musculoskeletal system both in research and clinical practice. However, the use of musculoskeletal ultrasound in pediatric populations is still limited. The age-dependent variability of normal sonoanatomy dueto bone maturation and ossification in children is the main limitation to establishing its validity as an imaging tool. Also, standardized definitions of gray-scale and power Doppler ultrasonography findings in different age groups of children is still lacking. Nonetheless, ultrasound is a readily accessible imaging modality that is well tolerated by children. It also allows physicians to perform a …

The Use Of Ultrasonography In Suspected Tibia Plateau Fracture With Lipohemarthrosis: A Casereport, Wei-Nung Hsu, Pon-An Chen, Sen-Wei Tsai

Rehabilitation Practice and Science

Knee pain is a common complaint in rehabilitation outpatient clinics. Plain radiography is typically used to detect knee pain and trauma. However, a slight depression plateau fracture could be easily overlooked on plain radiography. This is a casereport of a 57-year-old woman with left knee pain who visited the outpatient clinic for help. Ultrasonography showed fat-fluid level, but plain radiography did not reveal any fracture. Magnetic resonance examination confirmed the depression fracture of the tibial plateau and the lipohemarthrosis. Lipohemarthrosis is a highly sensitive predictor of intra-articular surface fractures. Ultrasound is a convenient and reliable tool to detect lipohemarthrosisof the …

Application Of Ultrasonography In The Diagnosis And Treatment (5% Dextrose Hydrodissection) For Entrapment Of Spinal Accessory Nerve: A Casereport, Tien-Lee Hsieh, Wei-Ting Wu, Chun-Ping Wang, Liang-Chun Chien, Lin-Fen Hsieh

Rehabilitation Practice and Science

The anatomical structure of the neck area is exceedingly complex; thus, cervical nerve damage during surgical procedures is not uncommon. A 25-year-old woman underwent excisional biopsy for neck lymphadenopathy. The patient reported left upper back pain and left shoulder weakness 1 day after the surgery. Physical examination revealed weakness of the left upper trapezius muscle and winging of the left scapula. A nerve conduction study indicated decreased compound muscle action potential amplitude on stimulation of the left spinal accessory nerve (SAN); electromyography also revealed denervation changes with the presence of voluntary motor unit action potentials in the left upper trapezius …

Viscosity Of Commercial Thickeners In Combination With Different Beverages Of Honey- And Nectar-Like Consistency And Their Change Over Time, Wei-Chun Che, Yuan-Ching Tsai, Meng-I Kuo, Tsan-Hon Liou

Rehabilitation Practice and Science

Objective: This study investigated the viscosity of four beverages (green tea, grape juice, sugar-free soy milk, and Ensure®) thickened to a nectar- and honey-like consistency with five thickening products (Resource® Thickenup® Clear, Toromeal, Toromi-up, eNutrition, and Sentosa) marketed in Taiwan. The sample viscosity over time was compared. Furthermore, the results were compared with the guidelines of National Dysphagia Diet (NDD) established by the American Dietetic Association. Methods: The viscosity was measured using the Brookfield RVDV-II+ Pro viscometer with small sample adaptor, shear rate set at 50 s-1, temperature at 25℃. Results: The results showed that almost all thickening products in …

An Investigation Of The Relationship Between Oral Sucking Habits And Types Of Articulation Errors In Preschool Children With Phonological Impairment, Hsiang-Chan Yen, Ching-Fei Lee, Su-Fen Liao

Rehabilitation Practice and Science

Background: Phonological impairment (PI) is the most common impairment in preschool children with speech sound disorder (SSD). In preschool children with phonological disorders, the most common process is substitution, including fronting, backing, and devoicing. The parents of children with PI always complain that it is difficult for them to abstain from pacifier use or thumb sucking. The purpose of this study was to investigate the oral sucking habits of preschool children with PI, and to explore whether different sucking habits affect different types of PI. Methods: Children aged from 36 months to 72 months, who visited the Physical Medicine and …

Swallowing Function In Parkinson's Disease: Correlation With Disease Duration And Hoehn And Yahr Stage, Yi-Ya Pan, Hsueh-Pei Wang, Ruey-Meei Wu, Tyng-Guey Wang

Rehabilitation Practice and Science

Oropharyngeal dysphagia is a common complication of Parkinson's disease (PD). Swallowing assessment scales, videofluoroscopics wallowing study (VFSS), and fiberoptic endoscopic evaluation of swallowing (FEES) are used to evaluate the swallowing function of patients with dysphagia. However, few studies have been conducted that assessed tongue muscle strength and hyoid bone movement in patients with PD. To better understand the correlation between disease duration, Hoehn and Yahr (H&Y) stage and swallowing function in patients with PD, this study evaluated the swallowing function in patients with PD using ultrasonography and Iowa Oral Performance Instrument (IOPI). Ultrasonography was performed to evaluate hyoid movement, and …

Ganglion Cyst Of Lumbrical Muscles: A Casereport, Pao-Sheng Wu, Chun-Te Lu, Valeria Chiu

Rehabilitation Practice and Science

Ganglion cysts arising from joints or tendons are commonly seen in our daily work as physiatrists, but those originating from muscles have been infrequently reported. In this casereport, we present a patient with a ganglion cyst arising from the fascia of the fourth lumbrical muscle in an occupational therapist, which has never been reported before. The lumbrical muscles of the hand vary greatly from other intrinsic muscles, because of their distinctive structure and function. A ganglion cyst that arises from the lumbrical muscle is supposed to affect the precise movement of the occupational therapist's hand. As a result, the early …

Herpes Zoster And Resultant Segmental Zoster Paresis: A Casereport And Literature Reviewarticle, Yen-Jou Ho, Hong-Yi Lin, Yao-Jen Chen

Rehabilitation Practice and Science

Herpes zoster (HZV) is ascribed to the reactivation of the dormant varicella-zoster virus (VZV) in the dorsal root ganglia. The most commonly seen manifestation is a painful skin rash. However, several additional complications have been documented in the literature. A less-mentioned yet severe complication is segmental zoster paresis (SZP), which can cause limb paralysis. SZP's mechanism is still under debate, and a direct invasion of motor fibers due to anatomical adjacency has been proposed. Here we report a patient who had sudden onset of left upper limb paresis and gradually developed a skin rash afterward, which a dermatologist confirmed as …

Swallowing Dysfunction Following The Covid-19 Infection: A Literature Reviewarticle, I-Chun Liu, Yi-Hsiang Chiu, Tyng-Guey Wang

Rehabilitation Practice and Science

Coronavirus disease 2019 (COVID-19), named by the World Health Organization in 2020, is a novel infectious disease, causing by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Most symptoms, such as cough and fever, will be resolved following supportive management. However, a small number of patients will progress to respiratory distress or suffer other neurological problems that affect their swallowing function. Potential dysphagia mechanisms associated with COVID-19 include neurological complications, muscular disorder, and intensive care unit-acquired swallowing dysfunctions. As dysphagia results in a declined quality of life and increased risk of respiratory complications, early swallowing interventions are imperative after the acute …

The Influence Of Upper Limb Motor Function On The Activity Of Life And Quality Of Life In Stroke Patients, Wan-Ling Hsu, Chi-Tzu Feng, I-Shiang Tzeng

Rehabilitation Practice and Science

Objective: This study attempted to investigate the influence of upper limb motor function on activities of daily living(ADLs) and quality of life(QoL) in stroke patients. We also wanted to reveal whether a disparity exists in ADLs and QoL for patients with different upper limbs impairment. Methods: A total of 57 stroke patients (mean age=55.55±13.11 years old, onset time= 1.57±1.87 years) were analyzed in the study. Methods used to evaluate outcomes included Fugl-Meyer assessment (FMA) for assessing the motor function of upper limbs; functional independence measure (FIM) for assessing the independent of ADLs, and stoke impact scale (SIS) for evaluating the …

Symptomatic Os Supranaviculare Incidentally Found In A Professional Baseball Player: A Casereport, Xuan-Er Shen, Hao-Hong Cai, Chuan-Chao Lin

Rehabilitation Practice and Science

Background: Os supranaviculare is a rare skeletal anatomical variation with a prevalence of approximately 1%. Most patients are asymptomatic. Typically, os supranaviculare is discovered incidentally after an ankle injury or when os supranaviculare causes symptoms such as pain during activities or swelling of the ankle,. Os supranaviculare is often misdiagnosed as a stress fracture of the navicular bone or talus. Careful differential diagnosis should be considered to avoid mistreatment. casereport: A 24-year-old male athlete, who is an active Chinese Major League Baseball player, complained of swelling and pain on the dorsomedial side of his left ankle for about six months. …

Insulin Autoimmune Syndrome In A Patient With Hemorrhagic Stroke: A Rare Casereport And Literature Reviewarticle, Kuan-Yu Kung, Chu-Hsu Lin, Yen-Liang Ke

Rehabilitation Practice and Science

Introduction: Insulin Autoimmune Syndrome (IAS), also known as Hirata's disease, is a rare cause of hyperinsulinemia hypoglycemia, with an overall incidence of one over one billion. Only three hundred and eightycases of IAS were reported world-wide during 1970 to 2009. Such disease was easily underestimated and misdiagnosed. Thus, we sincerely introduce a case newly diagnosed as IAS possibly induced by Angiotensin-Converting Enzyme inhibitor (ACEI) after cerebral vascular accident (CVA).The literature of insulin autoimmune syndrome was also reviewarticleed. Case presentation: This 34-year-old male with past history of hypertension and hyperlipidemia hadsudden onset of mental drowsiness and weakness on left side limbs …

Hypertonic Dextrose Injections For Osteoarthritis, Tai-Yung Yi, Ta-Wei Wu, Kuen-Huei Lin

Rehabilitation Practice and Science

Among the elderly, an increase in the prevalence of certain diseases, such as osteoarthritis, has been observed. Patients with osteoarthritis not only experience discomfort and pain but also have limited range of motion in the joints, which lowers their quality of life. At present, non-drug, drug, and surgical treatment options are available for patients with osteoarthritis; these approaches mainly focus on relieving symptoms and reducing the impact of joint disability. Initially, non-drug therapies, such as those focusing on changing the habits of patients, are usually administered. If the disease remains uncontrolled following non-drug therapy, drugs are administered and/or surgery is …

Diagnosis And Treatment Of Stroke-Related Sarcopenia: A Narrative Reviewarticle, Szu-Han Chen, Tieh-Cheng Fu

Rehabilitation Practice and Science

Stroke patients have a high prevalence of sarcopenia due to the presence of several risk factors, including immobilization, impaired feeding, sympathetic activation, inflammation, and denervation. The occurrence of sarcopenia further exacerbates the disability caused by the stroke. Thus, appropriate diagnosis and intervention for sarcopenia is an important health issue for the stroke population. The article discusses the dilemma in diagnostic tests and potential treatment for stroke-related sarcopenia based on the currently available literature evidence.

Effect Of Playstation® Vr Sessions On Health-Related Quality Of Life And Motor Function In Stroke Patients Undergoing Inpatient Rehabilitation, Chien-Min Chen, Yi-Ching Huang, Kuan-Yu Kung, Yun-Chien Li, I-Lin Yen, Shih-Che Lin, Chu-Hsu Lin, Chia-Hung Lin

Rehabilitation Practice and Science

Background: Virtual Reality (VR) systems have been introduced for rehabilitation of stroke patients. Existing evidence regarding the effects of fully-immersive commercial games on health-related quality of life (HRQOL) and motor function in stroke patients is limited. Objective: To evaluate the efficacy of seven supplemental PlayStation® VR sessions on the HRQOL and motor function of stroke patients undergoing inpatient rehabilitation during a 16-day study period within the first year after stroke. Methods: A randomized, single-blind clinical trial with parallel groups (VR plus conventional therapy vs. conventional therapy) was carried out. For the assessment of outcome measures, the Stroke Impact Scale (SIS) …

A Casereport Of Speech Therapy Combined With Repetitive Transcranial Magnetic Stimulation In Patients With Global Aphasia, Shih-Chen Lai, Yan-Ting Lin, Long-Wei Dai

Rehabilitation Practice and Science

For patients with stroke-induced aphasia, speech therapy is the most common speech rehabilitation program. In recent years, increasing empirical discussions have been conducted on the application of repetitive transcranial magnetic stimulation in treating stroke-related comorbidities; however, such discussions are lacking in Chinese. The present casereport investigated a patient with global aphasia who received frequent sessions of conventional speech therapy (2.5 hours per week) in conjunction with repetitive transcranial magnetic stimulation (5 sessions per week). The total intervention period was 6 months. The Concise Chinese Aphasia Test was used to conduct a pretest and posttest before and after the intervention. This …

Compartment Syndrome With Severe Neurovascular Complications After Trans-Radial Approach Of Percutaneous Coronary Intervention: A Casereport And Literature Reviewarticle, Pei-Yi Chen, Hong-Yi Lin

Rehabilitation Practice and Science

The gold standard for the acute coronary syndrome is percutaneous coronary intervention. Access site practice has shifted from transfemoral to transradialaccess (TRA), with the latter being more popular in Europe and Asia due to higher success rates, fewer site-related vascular complications, mortality, and shorter hospital stay. Significant complications following TRA of percutaneous coronary intervention have been reported, including spasm, occlusion, perforation, pseudoaneurysm formation, arteriovenous fistula, and rarely, compartment syndrome and complex regional pain syndrome (CRPS). Here, we report the case of a 66-y-old male who had persistent right-hand painful swelling, clawed hand, and sensory disturbance for 2 months following TRA …

Poststroke Swallowing Rehabilitation And Recent Development, Shu-Fen Sun, Ping-Hsin Chang, Chien-Wei Hsu, I-Hsiu Liou

Rehabilitation Practice and Science

Dysphagia is a common poststroke complication. It is associated with aspiration, malnutrition, dehydration, and disability, and it may increase the risk of pneumonia, and even death. Early diagnosis and treatment of patients with dysphagia reduces not only the aforementioned risks, but also the length of hospitalization and overall healthcare expenditures. Patients with poststroke oropharyngeal dysphagia exhibit highly variable patterns of swallowing abnormalities, and the related symptoms remain challenging to identify clinically. Patients who have experienced stroke should be screened for dysphagia as early as possible on admission and prior to any form of oral intake. Those who fail dysphagia screening …

Reversal Of Left Ventricular Remodeling Associated With High-Intensity Interval Training Promoting Cardiorespiratory Fitness In Heart Failure Patients, Hsien-Te Chu, Tieh-Cheng Fu, Jong-Shyan Wang, Chih-Chin Hsu

Rehabilitation Practice and Science

This study was designed to explore the high-intensity interval training (HIIT) effects on cardiorespiratory fitness as well as the reversal of left ventricle (LV) remodeling, and association between them in heart failure (HF) patients. We included HF patients under our HF care program between 2009 and 2018. The 17 HF patients enrolled in the study were further divided into in-hospital supervised HIIT (n=8) or medical care (control) (n=9) groups according to their preference. All participants underwent cardiovascular magnetic resonance imaging (CMR) examination and a cardiopulmonary exercise test (CPET) before the exercise intervention or medical care. The HIIT participants had 36 …

Swallowing Exercisesin Enforcing And Augmenting Suprahyoid Muscles To Improve Dysphagia And Upper Esophageal Sphincter Dysfunction For Stroke Patients: A Systematic Reviewarticle, Heng-An Yeh, Yu-Jen Chen

Rehabilitation Practice and Science

Dysphagia often occurs in stroke patients, who may present oral, pharynx, and upper esophageal sphincter dysfunction, including insufficient chewing and stirring bolus ability, poor pharyngeal contraction, pharynx to upper esophageal sphincter incoordination, and relaxation of the upper esophageal sphincter. Insufficient opening of the upper esophageal sphincter is an obstacle for moving a bolus from the pharynx to the esophagus. In addition to provide swallowing training, most of the treatments for upper esophageal sphincter dysfunction are invasive. However, several non-invasive swallowing exercises have been published with the aim of treating upper esophageal sphincter dysfunction. The purpose of this article is to …

Therapeutic Efficacy Of Dynamic Hand Splints In Spastic Hemiparetic Hands: A Randomized Controlled Single-Blind Trial, Yi-Ching Huang, Shih-Che Lin, Kai-Hua Chen, Chien-Min Chen, Chia-Hao Chang, Chu-Hsu Lin

Rehabilitation Practice and Science

Background: It is usually challenging to treat patients following stroke or brain injury with spastic hemiparetic upper limbs. Dynamic hand splints have been used to manage this issue for years, but evidence of their efficacy is still lacking. Objective: To investigate the treatment efficacy of dynamic hand splinting in spastic hemiparetic patients. Methods: In this randomized controlled single-blind clinical trial, patients with spastic hemiparesis lasting more than half a year after a stroke or brain injury were enrolled. They were randomly divided into a splint group and a control group, and received 1 month of task-oriented training with or without …