Physiotherapy Commons^™

A Narrative Review Of The Central Neural Control Of Swallowing And Its Implications For Dysphagia Rehabilitation, Kuo-Chang Wei, Tyng-Guey Wang, Ming-Yen Hsiao

Rehabilitation Practice and Science

Swallowing is controlled by a distributed neural network spanning the brainstem central pattern generator, subcortical modulatory circuits, and cortical regions responsible for volitional planning and sensorimotor integration. Evidence from lesion studies, neuroimaging, and neurophysiology demonstrates that dysphagia arises from disruptions at different nodes of this network, producing lesion-specific impairment profiles rather than a uniform swallowing deficit. This network-based perspective has shifted rehabilitation from predominantly compensatory management toward mechanism-driven interventions aimed at restoring physiological function. Behavioral skill-training and resistance-based exercises harness motor learning and cortical plasticity, whereas neuromodulatory approaches—including repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), pharyngeal electrical …

Effect Of Active Music-Based Intervention Conducted By Music Therapists Or Medical Professionals On Reducing Agitation In Patients With Dementia: A Systematic Review And Meta-Analysis, Jian-Jia Huang, Yu-Hsuan Chen, Yun-Chen Chung, Yu-Peng Huang, Yu-Cheng Pei

Rehabilitation Practice and Science

Music-based interventions (MI), including music therapy and music medicine, have been proposed to reduce agitation in patients with dementia, yet evidence from randomized controlled trials (RCTs) and systematic reviews remains inconsistent. Moreover, the efficacy of MI may vary by method and professional involvement, which has not been fully examined. This study aimed to evaluate the effects of active MI conducted by music therapists or medical professionals on agitation in patients with dementia compared with those of general therapy (GT). RCTs published between January 1, 2010, and July 31, 2021, were identified from MEDLINE, PubMed, and the Cochrane Library. Study quality …

Application Of The World Health Organization Disability Assessment Schedule 2.0 In Older Adults: A Narrative Review Of Current Evidence And Future Direction, Yuan-Chen Chang, Tsan-Hon Liou, Lien-Chieh Lin, Reuben Escorpizo, Shih-Wei Huang

Rehabilitation Practice and Science

The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is increasingly valued in geriatric care and rehabilitation for its patient-centered approach and sensitivity to cognitive and social dimensions of disability. It has demonstrated utility in assessing disability prevalence, predicting functional outcomes after dementia, and monitoring rehabilitation effectiveness in older adults. This review evaluated WHODAS 2.0’s application in older populations, identifying research gaps and clinical implications. A comprehensive literature search was conducted in PubMed/Medline, Scopus, Web of Science, Cochrane, and Embase in April 2025 by using the keywords “WHODAS,” “Elderly,” “Geriatric,” and “Disability” without time restrictions. Studies evaluating disability in …

Spontaneous Vertebral Osteomyelitis Mimicking Spinal Tumor: A Rare Cause Of Complete Paraplegia And Rehabilitation Challenges, Yu-Ting Su, Hung-Hsi Lin, Ying-Chun Chen

Rehabilitation Practice and Science

Spontaneous vertebral osteomyelitis (SVO) is a rare but severe spinal infection that often presents with non-specific back pain, leading to misdiagnosis as a neoplastic disease. A 53-year-old female presented with progressive lower back pain, rapidly developing sudden complete paraplegia and neurogenic bowel/bladder. Initial MRI revealed T4–T6 vertebral lesions mimicking a spinal tumor. Emergent surgery and cultures confirmed Escherichia coli vertebral osteomyelitis.

Following decompression and targeted antibiotic therapy, a cautious, phase-specific rehabilitation program was initiated. Given the persistent infection and spinal instability, all weight-bearing activities were deferred until infection control and structural stability were confirmed following a spinal fixation surgery. The …

L3 Extraforaminal Herniated Intervertebral Disc Masquerading As Knee Disorder, Ming-Yen Hsiao, Chueh-Hung Wu, Tyng-Guey Wang

Rehabilitation Practice and Science

No Abstract

Experience And Barriers In Pediatric Dysphagia Rehabilitation: A Quantitative Survey Study, François-Xavier Brajot, Ai-Ju Wu, Pao-Chuan Torng

Rehabilitation Practice and Science

Purpose: Despite an important need for health care services targeting pediatric dysphagia, there exist a number of barriers to doing so, including workforce competence. The current study surveyed practicing Speech-Language Pathologists to determine (1) the importance of pediatric dysphagia in their caseload, (2) the adequacy of existing educational resources, and (3) perceived barriers to providing quality care in Taiwan.

Methods: An anonymous survey was completed by Speech-Language Pathologists working in Taiwan. Responses were analyzed with respect to current work setting, experience, preparation, and perceived barriers.

Results: Survey results from 122 respondents indicated that the pediatric dysphagia caseload is unexpectedly low …

Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease Incidentally Diagnosed During Post-Stroke Rehabilitation: A Case Report, Ching-Yun Liao, Chung-Hao Chao, Chih-Chin Hsu

Rehabilitation Practice and Science

背景

髓鞘少突膠質細胞糖蛋白抗體相關疾病（MOGAD）是一種罕見的自體免疫發炎性疾病，主要涉及中樞神經系統（CNS），其主要特徵是視神經、腦部和脊髓脫髓鞘。我們報告一例最初疑似復發性中風的病例，該病例在住院中風復健期間最終確診為MOGAD。

病例概要

49歲女性，左側大腦半球梗塞，在中風後復健期間出現多次右側肢體肌力下降伴隨失語症。這些神經功能波動偏離了典型卒中的預期復健軌跡。卒中發作兩個月後行腦部磁振造影（MRI）檢查，結果顯示右側內囊後肢、腦橋及C1脊髓出現多處新發病灶。後續血清學檢查顯示抗髓鞘少突膠質細胞糖蛋白（MOG）IgG抗體陽性，而水通道蛋白4（AQP4）抗體陰性，確診為MOGAD。患者接受了甲潑尼龍治療及充分的復健治療，追蹤期間肌力顯著改善，未見脫髓鞘病灶復發。

結論

本案例凸顯了復健科醫師在早期發現類似中風的神經發炎性疾病的關鍵作用。復健科醫師處於獨特的領先地位，能夠透過持續的功能監測識別「危險信號」；任何偏離預期復健路徑或無法解釋的神經功能波動都應促使醫生進行進一步檢查。早期識別此類非典型模式，並及時進行免疫治療和多學科康復，可以預防永久性功能衰退，並優化長期預後。

Ultrasound-Guided Injection In Meralgia Paresthetica: A Narrative Review, Jia-Chi Ko, Tyng-Guey Wang, Shaw-Gang Shyu

Rehabilitation Practice and Science

Meralgia paresthetica (MP) is a neuropathic pain syndrome resulting from compression or irritation of the lateral femoral cutaneous nerve (LFCN). Traditional diagnostic approaches rely on clinical assessments and electrodiagnostic testing. Ultrasound has emerged as a non-invasive, cost-effective modality for detailed visualization of the LFCN and guiding treatment interventions.

This review explores the anatomical considerations of the LFCN, its common etiological factors, clinical presentation, current management strategies, and ultrasound-guided injection techniques. While LFCN exhibits notable anatomical variability, and it is susceptible to external compression near the inguinal ligament. Some potential causes reveal as obesity, diabetes mellitus, or surgical interventions. Patients typically …

Developing A Gpt-Based Virtual Training System For Medical Undergraduates' History Taking In Stroke Rehabilitation, Chao-Yu Hsu, Ching-Lin Hsieh, Jeng-Cheng Wu, Wen-Hsuan Hou

Rehabilitation Practice and Science

Background: Effective history taking in stroke rehabilitation requires comprehensive assessment skills, yet opportunities for medical undergraduates to practice such skills remain limited. Virtual patients (VPs), especially those powered by large language models (LLMs), offer a promising solution. This study aimed to develop and evaluate a GPT-based virtual training system for functional assessments in stroke rehabilitation history taking.

Methods: A mixed-methods design was employed in which VPs were modeled on a clinical stroke case and 10 core domains of functional assessments in stroke rehabilitation were integrated. A virtual examiner (VE) module provided automated scoring and feedback. Phase 1 evaluated the reliability …

Hemiplegic Shoulder Pain: A Narrative Review, Yeh-Kai Liao, Chueh-Hung Wu, Levent Özçakar

Rehabilitation Practice and Science

Hemiplegic shoulder pain is a common post-stroke complication that negatively affects functional recovery. It is caused by both mechanical and neurological factors. Prevention focuses on proper positioning, patient education, and maintenance of motion. Treatment remains largely conservative; with increasing research surrounding injection therapies, including intra-articular corticosteroid injection, subacromial hyaluronic acid injection, suprascapular nerve blocks, and botulinum toxin injection, all of which have demonstrated improved pain control. Functional electrical stimulation appears to be beneficial, and adjunct therapies such as supportive devices and robotic training may further enhance conventional treatment. Herewith, evidence regarding medications and acupuncture remains limited. Emerging treatments including high-intensity …

Ambulation Challenges Post High-Voltage Electrical Burn Involving Three Extremities, Complicated With Osteomyelitis: A Case Report, Chiang-Hui Huang, Katie Pei-Hsuan Wu

Rehabilitation Practice and Science

High-voltage electrical burns in occupational settings can leave detrimental injuries with immediate impact and long-term sequel. Despite extensive literature on the injury mechanism, comprehensive long-term rehabilitation descriptions for such devastating cases remain scarce. This report presents a significant traumatized high-voltage electrical injury involved three out of four extremities. A late complication with extensive tibial osteomyelitis affecting two-thirds of the bone severely compromised the patient’s ambulation potential, emphasizing the importance of segmental rehabilitation with progressive tolerance in ambulatory weight-bearing. We evaluated the patient’s physical, mental, and social component using Barthel Index, Veterans RAND 12-Item Health Survey (VR-12), and Patient-Reported Outcomes Measurement …

Immersive Computer-Assisted And Traditional Balance Training Methods On Balance Performance In Young Athletes: A Randomized Comparative Study, Hsien-I Lai, Yun-Hsin Huang, Chen-Yu Chien, Chung-Lan Kao

Rehabilitation Practice and Science

Introduction: Balance is essential for athletic performance. This study compared immersive computer-assisted balance training using the Bertec Balance Advantage CDP/IVR system with traditional soft mat training in young athletes.

Methods: Twenty-two young athletes were randomly assigned to a soft mat group (n = 10) or a Bertec group (n = 12). Both groups completed four training sessions over two weeks. Balance was assessed pre- and post-training using the Sensory Organization Test (SOT), Limits of Stability (LOS) test, and Dynamic Visual Acuity (DVA) test. Two-way mixed ANOVA and Bonferroni-corrected post-hoc analyses were performed.

Results: Both groups improved in postural stability and …

Assessing How Patients With Spinal Cord Injury Are Affected By Climate Change And Extreme Weather: A Scoping Review, Lien-Chieh Lin, Hung-Chou Chen, Tsan-Hon Liou

Rehabilitation Practice and Science

Climate change and the rising frequency of extreme weather events (EWEs) pose significant challenges to vulnerable populations, particularly individuals with spinal cord injury (SCI). These patients are at greater risk due to impaired thermoregulation, limited mobility, poor sensation, and dependence on caregivers or adaptive equipment, increasing their exposure to climate-related hazards and disrupting healthcare access during disasters. Although climate change impacts on the general population are well-documented, research on specific disability groups like SCI patients remains limited. This scoping review investigates how SCI patients perceive and experience health risks from climate change and EWEs, as well as factors influencing their …

Current Injection Treatment For Adhesive Capsulitis, A Narrative Review, Laurence Roy-Bélanger, Tian Yue Ding, Édouard Marcoux, Mathieu Boudier-Revéret

Rehabilitation Practice and Science

This narrative review outlines the current practices related to ultrasound-guided (USG) injection treatments for adhesive capsulitis (AC), including injection sites, approaches, medications, and doses.

USG procedures are increasingly accessible for AC, offering diverse injection approaches and medication dosing. Given the methodological variations in existing studies, a summary of current practices is essential. We conducted a narrative review of recent literature retrieved from computerized databases.

Glenohumeral (GH) and coracohumeral ligament (CHL) injections may improve outcomes for AC, with some evidence suggesting potential benefits of targeting the CHL. Subacromial bursa injections alone appear to be less effective. Multi-site injection techniques show promising …

Unveiling The Role Of The Suprascapular Nerve In Painful Shoulder: A Narrative Review With A Focus On Ultrasound-Guided Diagnosis And Intervention, Hong Hong, Wei-Ting Wu, Ke-Vin Chang

Rehabilitation Practice and Science

Suprascapular nerve disorders are a significant yet often underdiagnosed cause of shoulder pain and dysfunction, stemming from the nerve's critical role in shoulder stability and mobility through its innervation of the supraspinatus and infraspinatus muscles. This review explores the anatomy and clinical relevance of the suprascapular nerve, highlighting the need for accurate diagnosis in cases of pain, weakness, or functional impairment that mimic other shoulder conditions. Among diagnostic modalities, ultrasound has become a vital tool, providing real-time imaging to precisely assess nerve compression or damage. Its utility extends to therapy, with recent advancements in ultrasound-guided interventions—such as nerve blocks, corticosteroid …

Axillary Web Syndrome Following Breast Cancer Surgery: A Review Of Current Literature, Christina Soong, Tyng-Guey Wang, Shaw-Gang Shyu

Rehabilitation Practice and Science

Axillary web syndrome (AWS), a complication primarily following breast cancer surgeries involving axillary lymph node dissection (ALND), presents as painful cords extending from the axilla, impairing shoulder mobility and potentially delaying cancer treatment. This review consolidates existing knowledge on AWS, covering its clinical presentation, risk factors, pathophysiology, and management strategies. AWS typically arises within weeks post-surgery but may develop later, manifesting as fibrous cords that hinder arm movement. Diagnosis relies primarily on clinical examination, and the reported incidence varies significantly across different populations and study designs. Risk factors include ALND, younger age, low body mass index, and adjuvant therapies. The …

Multidisciplinary Approach To Managing Hypotonia And Developmental Delays Due To A Novel Gtpbp3 Mutation, Fan Mei, Ru-Lan Hsieh

Rehabilitation Practice and Science

Introduction: Hypotonia in early life is often challenging to diagnose due to its diverse etiologies, with genetic disorders accounting for about one-third of cases. A precise diagnosis using a comprehensive, multidisciplinary approach is crucial for determining prognosis, guiding treatment, and providing genetic counseling.

Case Presentation: We report the first case in Taiwan involving compound heterozygous mutations in the GTPBP3 gene. A 13-month-old girl presented with developmental delays and hypotonia despite normal prenatal screenings and a year of rehabilitation therapy. Next-generation sequencing revealed two novel mutations: c.785A>C (p.Gln262Pro), a missense mutation in Exon 5, and c.1175_1181dup (p.Ser395GlufsTer4) …

Principles And Practices Of Selecting Screening Tools For Oropharyngeal Dysphagia: A Narrative Review, Yu-Hsuan Lai, Tyng-Guey Wang, Nai-Hsin Meng

Rehabilitation Practice and Science

Oropharyngeal dysphagia is a potentially life-threatening condition, particularly affecting individuals with neurological diseases, head and neck cancers, and age-related issues. Its prevalence in the general population ranges from 2.3% to 16%, with much higher rates among patients with stroke, Parkinson’s disease, and traumatic brain injury. Dysphagia is prevalent in geriatric and long-term care settings, where over 50% of elderly residents may experience swallowing difficulties. Given its high prevalence and serious consequences, early detection through dysphagia screening in at-risk populations is essential. Since the 1990s, numerous screening tools for dysphagia have been developed, with over 160 non-instrumental tools identified in review …

Dysphagia In Becker Muscular Dystrophy: A Case Report And Literature Review, Chien-Ping Chen, Hung-Jui Chuang, Yi-Chi Li, Ming-Yen Hsiao, Tyng-Guey Wang

Rehabilitation Practice and Science

Dysphagia is a recognized complication in patients with muscular dystrophies, but its characteristics in Becker muscular dystrophy (BMD) remain underexplored. This case report describes a man with BMD who developed dysphagia, initially presenting with mild symptoms but later experiencing aspiration pneumonia with respiratory failure. He regained safe oral intake after swallowing training. Three years later, he suffered worsening dysphagia following a severe coronavirus disease-2019 (COVID-19) infection, ultimately losing the ability to resume oral feeding despite months of rehabilitation. Literature on swallowing disorder in BMD reported poor mastication, reduced laryngeal elevation, and increased pharyngeal residue; however, silent aspiration, as observed in …

Effectiveness Of Fu's Subcutaneous Needling In Pain Management And Rehabilitation: A Narrative Review, Po-En Chiu, Chun-Chang Wu, De-Jian Lu, Zhonghua Fu, Li-Wei Chou

Rehabilitation Practice and Science

Fu’s Subcutaneous Needling (FSN) is a modern needling technique distinct from traditional acupuncture, primarily used for musculoskeletal pain, neuropathic conditions, and emerging applications in rehabilitation. FSN is also designated as a kind of dry needling focusing on deactivating myofascial trigger points. This review categorizes FSN-related studies into case reports, clinical trials, and animal studies, evaluating its therapeutic efficacy, safety, and mechanisms. Case reports suggest that FSN provides rapid pain relief and functional improvement, while clinical trials, including randomized controlled trials (RCTs), support its role in reducing pain and enhancing neuromuscular function despite limitations in sample size and protocol consistency. Animal …

Safety In Dry Needling: The Role And Contributions Of The International Dry Needling Education & Training Advisory Group (Idnetag), W Mahmoud, J. Dommerholt

Rehabilitation Practice and Science

Dry needling is an intervention that physical therapists use to address various neuromusculoskeletal pain syndromes, primarily through targeting myofascial trigger points (TrPs) in muscle tissue. This technique involves inserting thin filiform needles into specific areas to relieve pain and improve movement. Despite its therapeutic potential, concerns regarding adverse events (AEs) necessitate stringent safety protocols and guidelines. In response, the International Dry Needling Education & Training Advisory Group (IDNETAG) was established in 2023 with members from diverse professions across eight countries. IDNETAG's mission is to enhance global standards of practice, focusing on safety, education, and consistency in treatment protocols. Research indicates …

A Rare Case Of Bilateral Supraspinatus Tendon Tears With Unilateral Musculotendinous Junction Involvement In An Elderly Patient, Kanyamas Poompreecha, Patsaree Pattanasuwanna, Ya-Chu Hsu

Rehabilitation Practice and Science

Rotator cuff (RC) tears are a common cause of shoulder pain in the elderly, though tears at the musculotendinous junction (MTJ) are uncommonly observed. We present a rare case of bilateral supraspinatus tendon tears in a 68-year-old male, with unilateral involvement of the MTJ. Symptoms developed three months after resuming resistance training following left acromioclavicular dislocation surgery. Ultrasound revealed a full-thickness insertional tear on the left and a partial MTJ tear on the right. Conservative treatment led to symptom resolution without surgery. This case highlights the diagnostic value of dynamic ultrasound for subtle rotator cuff and MTJ lesions in elderly …

The Effects Of 10-Ml Versus 40-Ml Capsular Dilatation Under Ultrasound Guidance In Patients With Adhesive Capsulitis: A Randomized Controlled Trial, Kollatee Buranarach, Rawipa Khunnarong, Chanasak Hathaiareerug

Rehabilitation Practice and Science

Background: Adhesive capsulitis causes pain and limited mobility. Hydrodilatation is an effective, minimally invasive treatment, but the optimal volume is unclear. This study compares the pain and function improvement from large-volume (40 mL) versus small-volume (10 mL) ultrasound-guided hydrodilatation in patients with adhesive capsulitis.

Methods: This study was conducted at Phramongkutklao Hospital in Bangkok, Thailand, with Thai adults aged 20 and older who had adhesive capsulitis. Participants had a pain score of 4 or higher on the Visual Analogue Scale (VAS) and limited movement in at least two directions. They were divided into two groups. One group received ultrasound-guided hydrodilatation …

Bridging Clinical Capacity And Real-World Performance: Upper And Lower Limb Accelerometry In Pediatric Cerebral Palsy Rehabilitation, Youngsub Hwang, Jeong-Yi Kwon

Rehabilitation Practice and Science

The rehabilitation of children with cerebral palsy (CP) has progressively evolved from therapist-centered, impairment-focused models to child- and family-centered approaches that emphasize real-world participation. This narrative review summarizes conceptual and practical shifts in CP rehabilitation, highlighting the distinction between motor capacity and real-world performance. Accelerometry is a critical objective tool for assessing lower and upper limb physical activity. Devices such as StepWatch and ActiGraph provide ecologically valid data on lower limb activity levels, step counts, and energy expenditure. Studies have shown reduced physical activity in children with CP compared to their typically developing peers, with variations in age and GMFCS …

Novel Sarcopenia Screening Using 1dcnn And Lidar-Enhanced Timed Up And Go Test, Yu-Ming Zhang, Cheng-Yu Tsai, Jiunn Horng Kang

Rehabilitation Practice and Science

Introduction

Sarcopenia is a systemic condition characterized by the loss of muscle mass, decreased strength and physical performance, leading to increased morbidity and mortality. To address this issue, we developed a rapid, cost-effective, and accurate screening model that integrated basic patient characteristics with a one-dimensional Convolutional Neural Network (1DCNN) analyzing Timed Up and Go (TUG) test data, captured using a simple light detection and ranging (LiDAR) device.

Methods

This study included 145 participants (38 diagnosed with sarcopenia and 107 without). During the TUG test, a LiDAR sensor semi-automatically recorded distance-time data, which was processed using a 1DCNN and combined with …

Leveraging Deep Learning For The Automated Detection Of Hemophilic Arthropathy In Knee Radiographs, En-Wei Lin, Edzer Wu, Ming-Ching Shen, Shao-Li Han

Rehabilitation Practice and Science

Background/Purpose:

Hemophilic arthropathy (HA) is a progressive joint disease caused by recurrent hemarthroses in patients with hemophilia. Early radiographic identification of HA is critical for timely intervention and long-term joint preservation. This study aimed to develop and evaluate deep learning models for automated detection of HA in knee radiographs.

Methods:

A retrospective dataset of 849 knee radiographs (AP and lateral views) was used to train three convolutional neural networks: ResNet-34, DenseNet-121, and EfficientNet-B0. Model performance was assessed using standard classification metrics, including accuracy, precision, recall, F1-score, and AUC. Interpretability was evaluated using Grad-CAM heatmaps.

Results:

DenseNet-121 achieved balanced performance on …

Influence Of Local Application Of Lidocaine Patch On Peripheral Nerve Conduction – A Pilot Study, Thanh-Nhan Doan, Fang-Yin Liao, Yueh-Ling Hsieh, Li-Wei Chou

Rehabilitation Practice and Science

Background: This study aimed to investigate the effects of a lidocaine patch on peripheral nerve conduction.

Methods: Fifteen healthy volunteers with no symptoms or signs of neuropathy in either upper limb were recruited for this double-blind, placebo-controlled study over a 10-month period. A lidocaine patch or a placebo patch was applied to the volar aspect of the wrist during sleep. The treatment procedure was repeated for 14 consecutive nights. Nerve conduction studies were performed and analyzed at each assessment point. All participants were re-evaluated, with electrophysiological studies of the median and ulnar nerves repeated at 1 week and 2 weeks …

Long-Term Benefits Of An Integrative Scoliosis-Specific Rehabilitation Program For High-Risk Adolescent Idiopathic Scoliosis: A Retrospective Cohort Study, Yu-Shan Fu, Lin-Fen Hsieh, Julian Wang, Wei-Chen Chang, Ya-Fang Liu, Hsuan-Han Lin

Rehabilitation Practice and Science

Background/Purpose: Adolescent idiopathic scoliosis (AIS) is a common spinal deformity in adolescents, but the optimal combination therapy remains to be established. Therefore, our purpose is to investigate the long-term benefits of a scoliosis-specific rehabilitation program integrating pattern-specific manual therapy, Schroth Best Practice exercises, and Gensingen brace application for patients with AIS.

Methods: The retrospective cohort study was conducted in an outpatient clinic, including 54 patients with AIS at a high risk of progression who participated in the aforementioned program. The primary outcomes were the angle of trunk rotation (ATR) and Cobb angle, whereas the secondary outcome was the lateral …

Persistent Oropharyngeal Dysphagia Caused By Systemic Light Chain Amyloidosis Despite Hematologic Response: A Case Report, Haw-Wen Jeng, Tyng-Guey Wang, Kuo-Chang Wei

Rehabilitation Practice and Science

We report a case of a 44-year-old woman who developed progressive dysphagia and shoulder stiffness, ultimately leading to a diagnosis of multiple myeloma (MM) with systemic light-chain (AL) amyloidosis. Despite intensive systemic therapy for MM with good serological response and nine months of comprehensive swallowing rehabilitation, her tongue mobility remained severely restricted, with only minimal improvement in laryngeal elevation. Videofluoroscopic swallowing study (VFSS) confirmed poor tongue control, reduced laryngeal elevation, and penetration of thin liquids. She ultimately passed away despite hematologic control. This case underscores the profound impact of amyloid deposition on swallowing function, even in the context of medically …

Clinical Application Of Intraoperative Neurophysiological Monitoring During Detethering Surgery Of A Newborn: A Case Report, Mu-Yun Lin, Hsin-Hung Chen, Tsui-Fen Yang

Rehabilitation Practice and Science

Background:

Tethered cord syndrome (TCS) is a rare congenital condition that causes abnormal tension on the spinal cord and often requires early surgical intervention to prevent progressive neurological and orthopedic deficits. However, performing detethering surgery in neonates presents unique challenges due to their immature neural pathways, which complicate intraoperative neuromonitoring (IONM).

Case Description:

We report the case of a 13-day-old neonate with TCS who underwent successful detethering surgery under advanced IONM. Double-train stimulation with a linked quadripolar montage was employed to elicit motor evoked potentials (MEPs), overcoming the challenge of monitoring immature corticospinal tracts. Additionally, subdural strip electrodes were used …