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We systematically reviewed the short-term effects of hippotherapy and therapeutic horseback riding (THR) on lower-limb muscle spasticity in children with cerebral palsy (CP).PubMed, EMBASE, Cochrane Library, and Google Scholar databases were searched for relevant quantitative studies. Treatment effects were coded using the Ashworth scale (AS) or modified Ashworth scale (MAS) in pre- and posttreatment evaluations. Of the 73 studies identified initially, 7 met the inclusion criteria.Treatment was associated with positive effects on lower-limb muscle spasticity, as supported by the AS or MAS scores. However, repeated trials did not show a statistically significant difference from a single trial (Q = 2.95, P = .086).Hippotherapy and THR can be used to treat lower-limb muscle spasticity in children with CP. However, repeated sessions did not show a better effect in reducing spasticity.This is the first meta-analysis to confirm that hippotherapy or THR can reduce lower-limb muscle spasticity in children with CP in the short term, but long-term effects on function still require further studies.

Multiple geochemical analyses may help us better constrain the ice-wedge formation and in-situ greenhouse gas (GHG) production mechanisms. Here we present new results from ice-wedge ice sampled at Zyryanka, Northeastern Siberia (65°93’N, 150°89’E). The plant remains and CO2 gas were analyzed for 14C dating, and we obtained from 810 to 1750 years before 1950 CE for the Zyryanka ice wedge. δ(N2/Ar) of the ice wedges ranges from -17.51 to -3.53 % with regard to modern air, indicating that the Zyryanka ice wedge was formed by both liquid water and dry snow. On the other hand, the δ(O2/Ar) value of the Zyryanka ice wedges ranges from -72.88 to -37.58 % with regard to modern air, implying oxygen gas was consumed considerably by respiration of microorganisms in the ice-wedge ice. We also observed correlations among the three greenhouse gas species and oxygen gas concentrations. N2O and CO2 concentrations show a strong positive correlation (r = 0.94, p=0.01). We also found that the melting fraction (estimated from N2/Ar) is positively correlated with CO2 (r=0.81, p=0.01) and CH4 (r=0.87, p2 concentration is negatively correlated with the CH4 concentrations (r = -0.41, p4 production is associated with biological oxygen consumption. The δ18O of ice melt ranges from -28.6 to -19.1 ‰ for the ice wedge and adjacent soil samples, showing a symmetric structure with low δ18O values in the ice wedge parts and high in the adjacent soils. Comparing with the δ18O value of modern precipitation in the Zyryanka region, it can be inferred that the ice wedge was mainly formed by filling with cold seasonal precipitation. Our study shows that the gas mixing ratios in ice wedges and water stable isotope analysis may help better understanding the biogeochemical environments during and after the formation of ice wedges.

The purpose of this study was to demonstrate the reliability and validity of the Korean version of the Caregiver Burden Inventory (CBI). The study was conducted as a multicenter cross-sectional survey for caregivers caring for patients with disabilities in outpatient or inpatient rehabilitation clinics. Sociodemographic characteristics and health-related quality of life were collected via questionnaires. The CBI and Burden Interview (BI) were administered, after which internal consistency and factor analysis of the CBI and correlation between the CBI and BI were explored. A total of 151 caregivers participated. The mean age of caregivers was 53.7 ± 12.4 years, and 80.8 % were women. The majority of caregivers were the main caregivers of stroke, spinal cord injury or traumatic brain injury. The factor analysis confirmed its five factorial structure. The time-dependence and physical burden scores of CBI were higher than those of other factors. All five-dimensional and total scores of CBI showed high internal consistency and were well correlated with BI. In conclusion, the CBI has proven its reliability, construct validity and concurrent validity for caregivers of disabled people and has shown its advantage as a multidimensional measure.

Global warming is drawing keen attention to people all over the people. Especially, the history of climate in permafrost area is of great interest to better understand greenhouse gas emission due to the thaw of permafrost in the future. In this context, formation of ice wedges and greenhouse gas was studied based on gas chemistry in permafrost ice wedges. The study areas are Batagay and Zyryanka in northeastern Siberia, and North Slope in Alaska. The gas was extracted using a dry extraction method that physically breaks down ice, and cryogenically collects gas in a stainless steel tube. The gas mixing ratios were analyzed by gas chromatography. N2 and Ar occluded in the air bubbles in the ice are relatively unaffected by microbial activity, but if liquid water contacted atmospheric air and froze, the N2/Ar ratio in the ice will differ from the atmospheric value due to difference in the gas solubility in water. On the other hand, if O2 was consumed by microorganisms in the ice, the concentration of O2 will decrease and consequently the O2/Ar ratio will also decrease. Our results show that the δ(O2/Ar) and δ(N2/Ar) of the ice wedges in Zyryanka and North Slope areas range from -86.5% to -12.2% and from -16.0% to 5.5%, respectively with regard to modern air. The 14C ages of Zyryanka and North Slope samples are 810±30 BP and 1920±30 BP, respectively, corresponding to the late Holocene. Because the late Holocene was a relatively warm period, it may be interpreted that the ice wedges formed predominantly from snow melt water, resulting in the negative values of δ(N2/Ar). This is in contrast with our earlier study on ice wedges in Central Yakutia region (Syrdakh, Cyuie, and Churapcha) (Kim et al., 2019). The Central Yakutian ice wedges formed during the Last Glacial Maximum (LGM) and the δ(N2/Ar) values of ~0% indicates that the ice did not form from snow melting. The δ(O2/Ar) of the Zyryanka and North Slope is much less depleted than that of Central Yakutian (close to -100%). Oxygen consumption by microorganisms in the Central Yakutian ice is more completed probably by the longer time period for the biogeochemical reaction compared to the Zyranka and North Slope ice (>20,000 years vs. < 2,000 years). The ages of Batagay ice wedges range to earlier part of the Late Pleistocene, and may allow us to study longer biogeochemical reactions in ice. The concentrations of CO2, N2O and CH4 in the Batagay ice range 260-71,000 ppm, 0.11-68 ppm and 4.7-130 ppm, respectively. Further geochemical analyses are in progress. Future study will include scrutinizing correlations among the three greenhouse gas concentrations. Our study shows that the gas mixing ratios in ice wedges may hlep us better understand the biogeochemical reactions in the ice and climate conditions when the permafrost formed.

Objective To identify the incidence of dysphagia after ischemic stroke and determine factors affecting the presence of dysphagia. Design Retrospective case-control study. This was an interim analysis of a prospective multicenter Korean stroke cohort. Setting Acute care university hospitals. Participants Patients (N=6000) with first-ever acute ischemic stroke. Patients were divided into 2 groups according to the presence or absence of dysphagia confirmed at 7 days after onset using the American Speech-Language-Hearing Association National Outcomes Measurement System (ASHA-NOMS) scale, which was determined after conducting screening or standardized tests. Interventions Not applicable. Main Outcome Measures Age at stroke onset, body mass index (BMI), premorbid modified Rankin Scale (mRS), brainstem lesions, National Institutes of Health Stroke Scale (NIHSS), poststroke mRS, and ASHA-NOMS swallowing level at poststroke day 7 were evaluated. Results Among patients with ischemic stroke, 32.3% (n=1940) had dysphagia at 7 days after stroke onset. At discharge, 80.5% (n=1561) still had dysphagia. The prediction model for the presence of dysphagia identified age at onset, underweight (BMI Conclusions The incidence of dysphagia after ischemic stroke was 32.3%. The prediction model for the presence of dysphagia identified age, low BMI, premorbid disabilities, brainstem lesions, and NIHSS as predictive factors.

Objective To assess the effects of an unsupervised virtual reality (VR)-based exercise program on hip muscle strength and balance control in older adults. Design Controlled cohort repeated-measures experimental design, a pilot study. Setting University research laboratory. Participants Ambulatory older adults (N=32) from a local community. Intervention The VR group (n=18; mean ± SD, 68.28±3.74y; 4 men) completed the VR-based exercise program, whereas the remaining subjects in the control group (n=14; mean ± SD, 66.21±3.87y, 1 man) were asked to continue their daily routine for 8 weeks. Main Outcome Measures Hip muscle strength was measured using a multimodal dynamometer, and ground reaction force using the backward stepping test and the results of the crossover stepping test were recorded using a force platform. Results The VR group showed significant improvement in hip muscle strength of the extensors, flexors, adductors, and abductors after 8 weeks (all P ≤.001). However, no significant improvement was observed in the control group. The VR group had significantly greater ground reaction force on the backward stepping test (with eyes opened and closed) (all P P ≤.001) compared with those at baseline. However, no significant improvement was observed in the control group. Conclusions The VR-based exercise program includes the role of supervisor and feedback, which is important for older adults. Therefore, a VR-based exercise program may be a useful tool to improve decreased physical function in older adults as a home-based exercise.