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Background: Based on the understanding of the muscle activation relationship between the infraspinatus and posterior deltoid muscles to according to the angle of motion during external rotation on glenohumeral joint, effective shoulder joint strengthening exercise for the prevention and rehabilitation of shoulder injury due to muscle strength imbalance can be performed by achieving the ideal muscle activity ratio during exercise. Objectives: To compare and analyze the muscle activation changes and activity ratio of the infraspinatus and posterior deltoid muscles according to the glenohumeral external rotation angle. Design: Quasi-randomized trial. Methods: The study included 48 healthy male and female adults who provided informed consent for participation in the study. All the subjects performed isometric glenohumeral external rotation by setting the angle of motion to 30°, 45°, and 60° using a 5 kg resistance weight pulley. On surface electromyography, the differences in muscle activation and activity ratio between the infraspinatus and posterior deltoid muscles were investigated. Results: A significant difference in muscle activation was found in the comparison between the infraspinatus and posterior deltoid muscles according to the glenohumeral external rotation angle (P

This study aimed to compare gait analysis and balance function measurements, such as the Berg balance scale (BBS) score to seek specific measurements that can represent the balance functions of patients with brain lesions. Additionally, we also compared other different gait function scale scores with gait analysis measurements. This study included 77 patients with brain lesions admitted to our institution between January 2017 and August 2020. Their gait analysis parameters and clinical data, including personal data; clinical diagnosis; duration of the disease; cognition, ambulation, and stair-climbing sub-scores of the modified Barthel index (MBI); manual muscle test (MMT) findings of both lower extremities; functional ambulation category (FAC); and BBS score, were retrospectively analyzed. A multiple linear regression analysis was performed to identify the gait analysis parameters that would significantly correlate with the balance function and other physical performances. In the results, the BBS scores were significantly correlated with the gait speed and step width/height2. However, the other gait function measurements, such as the FAC and ambulation and stair-climbing sub-scores of the MBI, were correlated only with the gait speed. Additionally, both the summations of the lower extremity MMT findings and anti-gravity lower extremity MMT findings were correlated with the average swing phase time. Therefore, in the gait analysis, the gait speed may be an important factor in determining the balance and gait functions of the patients with brain lesions. Moreover, the step width/height2 may be a significant factor in determining their balance function. However, further studies with larger sample sizes should be performed to confirm this relationship.

Background Cognitive training using virtual reality (VR) may result in motivational and playful training for patients with mild cognitive impairment and mild dementia. Fully immersive VR sets patients free from external interference and thus encourages patients with cognitive impairment to maintain selective attention. The enriched environment, which refers to a rich and stimulating environment, has a positive effect on cognitive function and mood. Objective The aim of this study was to investigate the feasibility and usability of cognitive training using fully immersive VR programs in enriched environments with physiatrists, occupational therapists (OTs), and patients with mild cognitive impairment and mild dementia. Methods The VR interface system consisted of a commercialized head-mounted display and a custom-made hand motion tracking module. We developed the virtual harvest and cook programs in enriched environments representing rural scenery. Physiatrists, OTs, and patients with mild cognitive impairment and mild dementia received 30 minutes of VR training to evaluate the feasibility and usability of the test for cognitive training. At the end of the test, the usability and feasibility were assessed by a self-report questionnaire based on a 7-point Likert-type scale. Response time and finger tapping were measured in patients before and after the test. Results Participants included 10 physiatrists, 6 OTs, and 11 patients with mild cognitive impairment and mild dementia. The mean scores for overall satisfaction with the program were 5.75 (SD 1.00) for rehabilitation specialists and 5.64 (SD 1.43) for patients. The response time of the dominant hand in patients decreased after the single session of cognitive training using VR, but this was not statistically significant (P=.25). There was no significant change in finger tapping in either the right or left hand (P=.48 and P=.42, respectively). None of the participants reported headaches, dizziness, or any other motion sickness after the test. Conclusions A fully immersive VR cognitive training program may be feasible and usable in patients with mild cognitive impairment and mild dementia based on the positive satisfaction and willingness to use the program reported by physiatrists, OTs, and patients. Although not statistically significant, decreased response time without a change in finger tapping rate may reflect a temporary increase in attention after the test. Additional clinical trials are needed to investigate the effect on cognitive function, mood, and physical outcomes.

Objectives: To evaluate the clinical efficacy of smartphone-assisted self-rehabilitation in patients with frozen shoulder. Design: A single-center, randomized controlled trial. Setting: Orthopedic department of a university hospital. Subjects: A total of 84 patients with frozen shoulder were recruited. Intervention: Patients were randomly divided into two groups: a smartphone-assisted exercise group ( n = 42) and a conventional self-exercise group ( n = 42). The study was performed over three months, during which each group performed home-based rehabilitation. Main measures: Visual analogue scale for pain and passive shoulder range of motion were assessed at baseline and after 4, 8, and 12 weeks of treatment. Technology Acceptance Model–2 and Usefulness, Satisfaction, and Ease of Use scores were evaluated in the smartphone group. Results: Initial visual analogue scale for pain of the smartphone group was 6.0 ± 2.2 and ended up with 1.8 ± 2.5 after 12 weeks, whereas the self-exercise group showed 5.8 ± 2.3 for the baseline visual analogue scale for pain and 2.2 ± 1.7 at the end. Significant time-dependent improvements in all measured values were observed in both groups (all Ps Conclusion: There was no difference between home-based exercise using a smartphone application and a conventional self-exercise program for the treatment of frozen shoulder in terms of visual analogue scale for pain and range of motions.

Injury to the thalamocortical tract (one in the Papez circuit) that leads to memory impairment following brain injury is very rare. In this study, we present a case of partial injury to the thalamocortical tract that causes memory impairment after concurrent thalamic and hippocampal infarct. A 20-year-old male complained of memory impairment 1 month after partial injury to the thalamocortical tract. Using a probabilistic diffusing tensor tractography, it was found that the right thalamocortical tract was thinner than the left thalamocortical tract. However, all other neural tracts including the fornix, cingulum, and mammillothalamic tract were intact on both hemispheres. Therefore, the memory impairment in this patient was considered as being due to thalamic infarct based on the observation that the fornix from hippocampal infarct was intact. This case suggests that the assessment of lesions in the neural tracts of the Papez circuit might be useful for understanding the mechanism of memory impairment following cerebral infarction.

For effective water management in the downstream area of a dam, it is necessary to estimate the amount of discharge from the dam to quantify the flow downstream of the dam. In this study, a machine learning model was constructed to predict the amount of discharge from Soyang River Dam using precipitation and dam inflow/discharge data from 1980 to 2020. Decision tree, multilayer perceptron, random forest, gradient boosting, RNN-LSTM, and CNN-LSTM were used as algorithms. The RNN-LSTM model achieved a Nash–Sutcliffe efficiency (NSE) of 0.796, root-mean-squared error (RMSE) of 48.996 m3/s, mean absolute error (MAE) of 10.024 m3/s, R of 0.898, and R2 of 0.807, showing the best results in dam discharge prediction. The prediction of dam discharge using machine learning algorithms showed that it is possible to predict the amount of discharge, addressing limitations of physical models, such as the difficulty in applying human activity schedules and the need for various input data.

We conducted a focus group discussion with bus workers to evaluate their experiences and perceptions, as well as their reasons for participating in a program for vulnerable workers. The study also sought to identify the strengths and weaknesses of the program. A total of nine bus workers participated in the focus group discussion. The focus group discussion was conducted based on a semi-structured guide, which was developed from discussions among the researchers and a review of major preliminary studies. The verbatim transcriptions were analyzed using content analysis. The sole existence of a health promotion program for vulnerable workers in Ulsan was sufficient to attract participants who had not been involved in other health management programs. Participants reported that participation in the program mitigated some of their musculoskeletal symptoms, which are often faced by bus workers. The findings of this study may contribute to the expansion of the health promotion program targeting workers in vulnerable working environments in Ulsan and other places. In order to increase users&rsquo, satisfaction and the sustainability of the program, it is necessary to develop a strategy to increase the accessibility of the program and enhance the self-efficacy of participants.

BACKGROUND Cognitive training using virtual reality (VR) may result in motivational and playful training for patients with mild cognitive impairment and mild dementia. Fully immersive VR sets patients free from external interference and thus encourages patients with cognitive impairment to maintain selective attention. The enriched environment, which refers to a rich and stimulating environment, has a positive effect on cognitive function and mood. OBJECTIVE The aim of this study was to investigate the feasibility and usability of cognitive training using fully immersive VR programs in enriched environments with physiatrists, occupational therapists (OTs), and patients with mild cognitive impairment and mild dementia. METHODS The VR interface system consisted of a commercialized head-mounted display and a custom-made hand motion tracking module. We developed the virtual harvest and cook programs in enriched environments representing rural scenery. Physiatrists, OTs, and patients with mild cognitive impairment and mild dementia received 30 minutes of VR training to evaluate the feasibility and usability of the test for cognitive training. At the end of the test, the usability and feasibility were assessed by a self-report questionnaire based on a 7-point Likert-type scale. Response time and finger tapping were measured in patients before and after the test. RESULTS Participants included 10 physiatrists, 6 OTs, and 11 patients with mild cognitive impairment and mild dementia. The mean scores for overall satisfaction with the program were 5.75 (SD 1.00) for rehabilitation specialists and 5.64 (SD 1.43) for patients. The response time of the dominant hand in patients decreased after the single session of cognitive training using VR, but this was not statistically significant (P=.25). There was no significant change in finger tapping in either the right or left hand (P=.48 and P=.42, respectively). None of the participants reported headaches, dizziness, or any other motion sickness after the test. CONCLUSIONS A fully immersive VR cognitive training program may be feasible and usable in patients with mild cognitive impairment and mild dementia based on the positive satisfaction and willingness to use the program reported by physiatrists, OTs, and patients. Although not statistically significant, decreased response time without a change in finger tapping rate may reflect a temporary increase in attention after the test. Additional clinical trials are needed to investigate the effect on cognitive function, mood, and physical outcomes.

Supplemental material, Supplemental_Material for Effect of smartphone application-supported self-rehabilitation for frozen shoulder: a prospective randomized control study by Younggeun Choi, Jihoon Nam, Dongseok Yang, Whanik Jung, Hwa-Ryeong Lee and Sae Hoon Kim in Clinical Rehabilitation

Background context Subdural spinal hematoma (SDH) is a very rare entity; however, it can lead to serious complications resulting from injuries to the spinal cord and roots. Although acupuncture has been a popular method for the management of pain control, we encountered the first case of SDH after acupuncture. Purpose The purpose of this case report was to present the first case of subdural hematoma after acupuncture and the reasons for the risks of blind cervical acupuncture. Study design A case report and review of the previous literature are presented. Methods A 69-year-old man complained of progressive weakness in the right upper and lower extremities 2 hours after acupuncture on the cervical spine and back. The diagnosis was delayed because of unilateral weakness, and the symptom was initially misinterpreted as a transient ischemic attack because of no sensory change and pain and normal findings of two brain magnetic resonance imaging (MRI). Results Cervical MRI 36 hours after onset revealed acute hematoma from the C3–C5 level; hematoma showed an isointensity on T1-weighted image (WI) with the preservation of epidural fat and a hypointensity on T2WI. A decompressive surgery was scheduled to perform within 2 days after the cervical MRI scan because of a previous anticoagulation therapy, but the patient refused it. Finally, 9 days after the onset, surgical decompression and removal of hematoma were performed. Three months postoperatively, the patient had fully recovered demonstrating fine hand movement and good ability to walk up and down the stairs. Conclusions Our study indicates that it is essential to perform cervical MRI when a patient does not show an improvement in the neurologic deficit and has a negative brain MRI after acupuncture. In addition, blind acupuncture if not correctly practiced may be harmful to the cervical structures.

A couple of the most common complications after anterior cervical spine surgery are dysphagia and hoarseness. This is often related to recurrent laryngeal nerve palsy and it can also be caused by injury to the branches of the lower cranial nerves. In general, Tapia syndrome is combined injuries of the recurrent laryngeal nerve of the vagus and the hypoglossal nerves. There has been no reported case until now of Tapia syndrome after a patient underwent anterior cervical spine surgery. We present here the case of a 42-yr-old man who complained of hoarseness, dysphagia, and right deviation of the tongue with an atrophic change for 2 mos after he underwent C3-4 discectomy and anterior fusion body. We found that he has a diagnosis of a variant of Tapia syndrome, although recurrent laryngeal nerve injury did not seem to be involved according to a videofluoroscopic swallowing study and electromyography. Our case report demonstrates that the combined diagnostic tools of videofluoroscopic swallowing study, electromyography, and laryngoscopy can be very useful in localizing and evaluating the level of lesions in patients with Tapia syndrome.

It is not clear whether the fornix and cingulum are involved in cognition after putaminal hemorrhage (PH). We investigated structural changes and differences of the neural tracts, and the relationship between the integrity of the neural tracts and cognition not only at the affected but also at the unaffected side. Sixteen patients with left chronic putaminal hemorrhage and 20 healthy volunteers were enrolled. Using diffusion tensor tractography (DTT), we compared fiber number (FN), fractional anisotropy (FA), and apparent diffusion coefficient (ADC) of the neural tracts between patient and control groups. The relationship between the neural tract parameters and neuropsychological results was also analyzed. The left fornix FN was significantly lower than the right fornix FN in the patient group. Except for the cingulum FA, the neural tracts parameters for both the affected and unaffected hemispheres differed significantly between the groups. The fornix FA and ADC at the affected side were significantly correlated with intelligence quotient (IQ), mini-mental status examination (MMSE), and short-term memory. Interestingly, the fornix ADC at the unaffected side was significantly correlated with MMSE. However, none of the cingulum parameters was correlated with neuropsychological results. The fornix integrity is critical for cognitive impairment after putaminal hemorrhage.

Detection of facial feature is fundamental for applications such as security, biometrics, 3D modeling, and facial expression recognition. Active Shape Model (ASM) is one of the most popular local texture models for face detection. This paper addresses issues related to face detection and implements an efficient extraction algorithm for facial landmarks suitable for use on mobile devices. The original ASM was modified to enhance its performance (1) improving the initialization model using the center of the eyes by utilizing a feature ma of RGB color information, (2) building a modified model definition and fitting more landmarks than the classical ASM, and (3) extending and building a 2-D profile model for detecting faces in input images. The new scheme was evaluated on experimental test set containing over 500 images of faces and found to successfully extract facial features, clearly outperforming the original ASM.

Active shape model (ASM) is one of the most popular local texture models for face detection. This paper addresses issues related to face detection and implements an efficient extraction of facial point features which is more suitable for using on mobile devices. The proposed and implemented algorithm in this paper is modified to enhance its performance (1) improving the initialization model using center of the eyes by using a feature map of RGB color information, and (2) building and extending a 2-D profile model for detecting faces in an image. To evaluate the performance of our work, we assess the ratio of success with common face image database. The obtained result shows that our algorithm described in this paper is enough to applicable to mobile environments.

In this paper, we propose a new efficient photo image retrieval method that automatically indexed for searching relevant photo images using a combination of geo-referenced attributes and low-level visual features. Photo image is labeled with its GPS (Global Positioning System) coordinates at the moment of capture, and a flat layer index is generated with the pair of latitude and longitude. These are then utilized to create a hierarchical layer indexes for spatial information after uploaded to media server. Then, low-level visual features such as color histogram and edge histogram are extracted and combined with geo-spatial information for indexing and searching photo images. For user's querying process, the proposed method adopts two different steps as progressive approach, filtering and/or selecting the relevant subset prior to content-based retrieval. To evaluate the performance of the proposed descriptor, we assess the simulation performance in terms of average precision and F-score using digital photo collections. Comparing the proposed approach to search using visual content alone, an improvement of around 20% was observed in experimental trials. These results reveal that combination of context and content analysis is markedly more effective and meaningful than using only visual content for this task.