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Chien-Lin Lin,1 Ching-Ping Shen,2 Chin-Kai Lin3 1Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taiwan and School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 2National Chung-Shan Institute of Science & Technology Shi-Yuan Polyclinic, Taipei, Taiwan; 3Program of Early Intervention, Department of Early Childhood Education, National Taichung University of Education, Taichung, TaiwanCorrespondence: Chin-Kai Lin, National Taichung University of Education, 140 Min-Shen Road, Taichung, 40306, Taiwan, Tel +886 4-22183007, Fax +886 4-22183380, Email Linchinkai97@gmail.comPurpose: Few studies have tested the cognitive flexibility, specifically auditory and motor flexibility of children with ASD. This study was conducted to understand the relationship between cognitive flexibility and visual, auditory, and motor development in young children with ASD and autistic behaviors.Participants and methods: A purposive sampling approach was used to screen nineteen four- to five-year-old ASD children. Tests included the Autism Behavior Checklist-Taiwan Version and Cognitive Flexibility Test, which included visual, auditory, and motor cognitive flexibility subtests.Results: At the pre-switch and post-switch of three subtests, there were considerable variations in the number of ASD passing. According to the findings, children aged five had more visual cognitive flexibility than children aged four, but the lack of significant differences for the other flexibilities. The negative correlation of the three cognitive flexibilities with autistic behaviors was − 0.57∼-0.64.Conclusion: Children with ASD have significant difficulties in switching rule tasks characterized by visual, auditory, and motor cognitive flexibility. The results suggest that visual cognitive flexibility had an age effect. The negative correlation of the three cognitive flexibilities with autistic behaviors was moderate.Keywords

Chien-Lin Lin1,2 Chin-Kai Lin,3 Jia-Jhen Yu4 1Department of Physical Medicine and Rehabilitation, China Medical University Hospital, 2School of Chinese Medicine, College of Chinese Medicine, China Medical University, 3Program of Early Intervention, Department of Early Childhood Education, National Taichung University of Education, 4Occupation Therapy Unit of Rehabilitation Techniques Section, Lin Shin Medical Corporation Wuri Lin Shin Hospital, Taichung, Taiwan Introduction: This study aims to explore the impact of Parent Participation Program on the development of developmental delay children. Methods: Pretest-posttest equivalent-group experimental design study was used in this paper. A total of 30 pairs of developmental delay children aged 0–72 months and their parents participated into this study. They were divided into two groups, namely control group and experimental group, according to parents’ wishes. The objects of study in control group received 16 courses of direct rehabilitation therapy; those in experimental group received 8 courses of direct rehabilitation therapy and 8 courses of instruction and tracking of Parent Participation Program. The duration of the intervention was 8 weeks. All cases should be evaluated before and after the intervention, to analyze the difference before and after intervention and among groups. The statistical methods in this paper included descriptive analysis, Chi-square test, independent sample t-test, pair-sample t-test. Results and conclusion: The intervention of Parent Participation Occupational Program has positive impact on the development of developmental delay children in various fields. Among all the intervention results, the progress of the experimental group is 1.895 times more than that of the control group. With parent involvement, Parent Participation Occupational Therapy can promote the cognitive ability, language ability, action ability (gross and fine movement), social competence and self-c

Bi-Huei Wang,1,* Chien-Lin Lin,1,2,* Te-Mao Li,2,3 Shih-Din Lin,3 Jaung-Geng Lin,2 Li-Wei Chou1,2,4 1Department of Physical Medicine and Rehabilitation, China Medical University Hospital; 2School of Chinese Medicine, College of Chinese Medicine; 3Graduate Institute of Acupuncture Science, 4Acupuncture Research Center, China Medical University, Taichung, Taiwan *These authors contributed equally to this work Background: This study investigated the clinical efficacy of electroacupuncture (EA) in inhibiting upper-extremity spasticity in chronic stroke patients, and also in mapping a unique preliminary acupoint-selection protocol. Methods: Fifteen patients were divided into two groups: patients in the control group (n=6) received minimal acupuncture (MA), and those in the experimental group (n=9) received EA. Four acupoints, which include Neiguan (PC6), Shaohai (HT3), Zeqian (Ex-UE, A32), and Shounizhu (EX-UE), were treated near the motor points of the muscles for elbow flexion, forearm pronation, and finger flexion. Both groups were treated for twelve sessions, 20 minutes per session, for 6 weeks (two sessions per week). The outcome measures in this study included angle of muscle reaction (R1), passive range of motion (R2), and dynamic component (R2–R1). Results: In the experimental group, the R2–R1 of the elbow joint was significantly decreased at 1 (P=0.0079), 3 (P=0.0013), and 6 weeks (P=0.0149) after treatment compared with pretreatment levels (P<0.05). The between-group difference in the R2–R1 of the elbow joint after the 6-week treatment was statistically significant. Conclusion: Combining the 6-week EA and standard rehabilitation treatment reduced the spasticity of the elbow for chronic stroke survivors. However, no significant effect was observed in the spasticity of the wrist joints. The choice of acupoints and the frequency of EA have to be taken into account to achieve a positive treatment effect. The correlation between

Kuo-Wei Yu,1,* Yu-Hui Huang,2,3 Chien-Lin Lin,1,4,* Chang-Zern Hong,5 Li-Wei Chou1,41Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; 2School of Medicine, Chung Shan Medical University, Taichung, Taiwan; 3Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, Taichung, Taiwan; 4School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 5Department of Physical Therapy, Hungkuang University, Taichung, Taiwan*These authors contributed equally to this workAbstract: Central hyperthermia is characterized by a rapid onset, high temperature, marked temperature fluctuation, and poor response to antipyretics and antibiotics. Although poststroke central hyperthermia is common, prolonged instances are rare. We report a case of prolonged central fever after an intracranial hemorrhage. Before the accurate diagnosis and management of central fever, the patient underwent long-term antibiotic use that led to pseudomembranous colitis. Bromocriptine was used to treat the prolonged central hyperthermia, after which the fever did not exceed 39°C. A week later, the body temperature baseline was reduced to 37°C and a low-grade fever with minor temperature fluctuation occurred only a few times. No fever occurred in the month following the treatment. After the fever subsided, the patient could undergo an aggressive rehabilitation program.Keywords: bromocriptine, central hyperthermia, fever, stroke

Chien-Lin Lin,1,2 Yu-Fan Min,3 Li-Wei Chou,1,2,* Chin-Kai Lin,4,* 1Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; 2School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 3Faith, Hope and Love, Center for Children and Adults With Disabilities, Taichung, Taiwan; 4Program of Early Intervention, Department of Early Childhood Education, National Taichung University of Education, Taichung, Taiwan*These authors contributed equally to this workBackground: The purpose of this study was to investigate the effectiveness of sensory processing strategies in improving the activity level of children with sensory integration dysfunction.Methods: The study used a matching-only pretest–posttest control group design, which requires random matching of sensory integration dysfunction to the corresponding intervention group (n = 18) and control group (n = 18). The intervention group comprised 3–6-year-old children who received an 8-week school-day intervention during implementation of the theme curriculum.Results: The 8-week treatment significantly reduced the activity level and foot-swinging episodes in children with sensory integration dysfunction, and obtained a medium-effect size. However, the level of improvement in the control group did not show any statistically significant change.Conclusion: Sensory processing strategies could improve activity levels in children with sensory integration dysfunction. However, this study was unable to exclude a developmental effect. The social validity results show that sensory processing strategies can be integrated into the theme curriculum and improve activity levels in children.Keywords: activity level, preschool inclusive classroom, sensory integration dysfunction, sensory processing strategy

Kuo-Wei Yu,1,* Chien-Lin Lin,1,2 Chun-Chuang Hung,3 Eric Chieh-Lung Chou,4 Yueh-Ling Hsieh,5 Te-Mao Li,2,3,* Li-Wei Chou1,2,61Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; 2School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 3Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan; 4Department of Urology, China Medical University Hospital, Taichung, Taiwan; 5Department of Physical Therapy, China Medical University, Taichung, Taiwan; 6Acupuncture Research Center, China Medical University, Taichung, Taiwan*These authors contributed equally to this workBackground: Incomplete bladder emptying (IBE) is defined as having a postvoid residual (PVR) urine volume greater than 100 mL for 2 consecutive days. IBE is common in stroke patients and could necessitate indwelling or intermittent catheterization. The condition is correlated with urinary tract infections, which could impede rehabilitation progress and increase medical costs. Treatment for patients with IBE includes bladder retraining, biofeedback, medication, and botulinum toxin injection, but none of these interventions are completely effective.Methods: All patients with acute stroke who were admitted to the rehabilitation ward between August 2010 and April 2011 were included in the study and their PVR urine volume was checked. Electroacupuncture (EA; 1 Hz, 15 minutes) was performed on the acupoints Sanyinjiao (SP6), Ciliao (BL32), and Pangguangshu (BL28) of stroke patients with IBE for a total of ten treatments (five times a week for 2 weeks). Bladder diaries, which included the spontaneous voiding and PVR urine volumes, were recorded during the course of treatment.Results: The presence of IBE was not related to sex, history of diabetes mellitus, stroke type (hemorrhagic or ischemic), or stroke location (P > 0.05). Among the 49 patients in the study, nine (18%) had IBE, and s