Low-Cost Tele-assessment System for Home-Based Evaluation of Reaching Ability Following Stroke

Objective:Tele-assessment techniques can provide healthcare professionals with easily accessible information regarding patients' clinical progress. Recently, kinematic analysis systems have been used to assess rehabilitative outcomes in stroke patients. Kinematic systems, however, are not compatible with tele-assessment. The objective of our study was to develop a tele-assessment system for acquiring kinematic data of forward reaching movements in stroke patients, with an emphasis on cost-effectiveness, portability, and ease of use.Materials and Methods:We selected four healthy control participants and eight hemiplegic stroke patients for our study. The stroke patients were classified as Brunnstrom stage III, stage IV, or stage V. Our tele-assessment system used two three-axes accelerometers, a potentiometer, a multifunctional data acquisition card, and two computers. A standardized kinematic system was applied simultaneously to validate the measurements recorded by our tele-assessment system during five repetitions of forward reaching movements.Results:The correlation coefficients of the reaching displacement, velocity, and acceleration measurements obtained using our tele-assessment system and the standardized kinematic system were 0.956, 0.896, and 0.727, respectively. Differences in the maximum reaching distance and the maximum reaching velocity of forward reaching movements were observed among the study groups. There were no significant differences in the time required to complete the testing session among the study groups.Conclusions:Our tele-assessment system is valid for the evaluation of upper-extremity reaching ability in stroke patients. Further research is needed to investigate the feasibility of the use of the tele-assessment system in patients' homes

An Interactive Wireless Communication System for Visually Impaired People Using City Bus Transport

Visually impaired people have difficulty accessing information about public transportation systems. Several systems have been developed for assisting visually impaired and blind people to use the city bus. Most systems provide only one-way communication and require high-cost and complex equipment. The purpose of this study is to reduce the difficulties faced by visually impaired people when taking city buses, using an interactive wireless communication system. The system comprised a user module and a bus module to establish a direct one-to-one connection. When the user inputs 4-digit numbers, the user module immediately sends out the information. If the bus module receives the matched bus number, it buzzes and the warning LED flashes to notify the bus driver that someone is waiting to board on the bus. User tests were conducted by two visually impaired people in a simulated vehicle and a city bus. The success rate of interactive wireless communication, recognizing the arrival of the bus and boarding the correct bus reached 100% in all of the tests. The interactive wireless communication aid system is a valid and low-cost device for assisting visually impaired people to use city buses

Pain quality descriptors and sex-related differences in patients with shoulder pain

[[abstract]]Background: Pain quality assessment is applicable to pain evaluation and treatment. However, shoulder pain quality descriptors mostly remain unknown. Furthermore, sex-related differences considerably affect clinical pain experience. The aim of this study was to investigate pain quality descriptors and to compare sex-related differences in using pain descriptors among patients with shoulder pain. Materials and methods: A sample of 120 patients (41 males and 79 females) with shoulder pain was recruited from Department of Physical Medicine and Rehabilitation. Shoulder pain quality descriptors were investigated using a 36-item pain quality list. Sex-related differences in the number and frequency of pain quality descriptors were compared using independent t-test and X2 test, respectively. Results: Fifteen commonly used shoulder pain quality descriptors were identified. Among them, “sore” was the most frequently used, followed by “pulled”. Deep pain sensations (eg, sore, pulled, torsion, and taut) were relatively more predominant than superficial pain sensations (eg, pricking and lacerating). In terms of sex-related differences, female patients used more pain quality descriptors than the male patients (5.5 vs 3.7, P<0.001). The frequency of paroxysmal, dullness, and constriction-related pain quality descriptors, such as “shooting”, “faint”, “clicking”, and “squeezing”, were higher in females than in males (all P<0.05). Conclusion: The results provide commonly used shoulder pain quality descriptors that are useful for assessing shoulder pain and for developing a new shoulder pain assessment tool. Because the shoulder pain quality profiles differed between male and female participants, clinicians an

Efficacy of Noninvasive Stellate Ganglion Blockade Performed Using Physical Agent Modalities in Patients with Sympathetic Hyperactivity-Associated Disorders: A Systematic Review and Meta-Analysis

<div><p>Background</p><p>Stellate ganglion blockade (SGB) is mainly used to relieve symptoms of neuropathic pain in conditions such as complex regional pain syndrome and has several potential complications. Noninvasive SGB performed using physical agent modalities (PAMs), such as light irradiation and electrical stimulation, can be clinically used as an alternative to conventional invasive SGB. However, its application protocols vary and its clinical efficacy remains controversial. This study investigated the use of noninvasive SGB for managing neuropathic pain or other disorders associated with sympathetic hyperactivity.</p><p>Materials and Methods</p><p>We performed a comprehensive search of the following online databases: Medline, PubMed, Excerpta Medica Database, Cochrane Library Database, Ovid MEDLINE, Europe PubMed Central, EBSCOhost Research Databases, CINAHL, ProQuest Research Library, Physiotherapy Evidence Database, WorldWideScience, BIOSIS, and Google Scholar. We identified and included quasi-randomized or randomized controlled trials reporting the efficacy of SGB performed using therapeutic ultrasound, transcutaneous electrical nerve stimulation, light irradiation using low-level laser therapy, or xenon light or linearly polarized near-infrared light irradiation near or over the stellate ganglion region in treating complex regional pain syndrome or disorders requiring sympatholytic management. The included articles were subjected to a meta-analysis and risk of bias assessment.</p><p>Results</p><p>Nine randomized and four quasi-randomized controlled trials were included. Eleven trials had good methodological quality with a Physiotherapy Evidence Database (PEDro) score of ≥6, whereas the remaining two trials had a PEDro score of <6. The meta-analysis results revealed that the efficacy of noninvasive SGB on 100-mm visual analog pain score is higher than that of a placebo or active control (weighted mean difference, −21.59 mm; 95% CI, −34.25, −8.94; <i>p</i> = 0.0008).</p><p>Conclusions</p><p>Noninvasive SGB performed using PAMs effectively relieves pain of various etiologies, making it a valuable addition to the contemporary pain management armamentarium. However, this evidence is limited by the potential risk of bias.</p></div

Publication bias plot.

<p>Effect size plot for trials with ultrasound (US, circle), transcutaneous electrical nerve stimulation (TENS, diamond), and linear polarized infrared light (square). The effect relative to the placebo is shown on the x-axis, and the standard error is shown on the y-axis. Substantial asymmetry was not observed in the funnel plot of pain reduction through visual inspection. Egger’s linear regression test results indicated no evidence of reporting bias among the studies (<i>t</i> = −0.376; <i>p</i> = 0.732).</p

Effect of noninvasive stellate ganglion blockade (SGB) on sympatholytic response compared with that of placebos in four controlled trials grouped according to the type of electrophysical modality used.

<p>Trial results plotted on the right-hand side indicate effects favoring noninvasive SGB, and the combined effects are plotted using black diamonds. US = ultrasound; TENS = transcutaneous electrical nerve stimulation.</p

Forest plot of comparisons of outcomes between noninvasive stellate ganglion blockade and placebo groups: (A) short- and (B) medium-term effects on functional mobility and disability outcomes.

<p>Trial results plotted on the right-hand side indicate effects favoring noninvasive SGB, and the combined effects are plotted using black diamonds. US = ultrasound; TENS = transcutaneous electrical nerve stimulation.</p

Flow chart of study selection.

<p>Flow chart of study selection.</p

Source of stimulation, wavelength, power, power density, and energy.

<p>Source of stimulation, wavelength, power, power density, and energy.</p

Effect of noninvasive stellate ganglion blockade (SGB) on hemodynamic changes compared with that of placebos.

<p>Trial results plotted on the right-hand side indicate effects favoring noninvasive SGB, and the combined effects are plotted using black diamonds.</p