The Efficacy of Early Rehabilitation Combined with Virtual Reality Training in Patients with First-Time Acute Stroke: A Randomized Controlled Trial.

Early rehabilitation has beneficial impacts on functional outcomes for patients with acute stroke. However, whether the addition of virtual reality (VR) training could further improve these patients' muscle strength, functional recovery, and psychological health is unknown. A randomized controlled trial was conducted on 33 patients with first-time acute ischemic stroke. The patients were randomly assigned using a 1:1 randomization ratio to either the experimental group (EG) or the comparison group (CG). Both groups received early rehabilitation, and the EG received extra VR training during their stay in the hospital. Muscle strength, functional status, and psychological health were assessed before the intervention and at discharge. Generalized estimating equations were used to examine the intervention effects via the interaction of time and group. After adjusting for potential covariates, the EG showed a more significant decrease in depression at discharge than the CG (ß = 3.77, p = 0.011). There were no differences in muscle strength and functional recovery between groups after intervention. Adding VR training into early rehabilitation facilitates substantial positive effects on psychological health, specifically depression, but not muscle strength and functional recovery, compared to receiving early rehabilitation alone in patients with first-time acute stroke during their hospitalized period.

Effectiveness of a 12-week telerehabilitation training in people with long COVID: A randomized controlled trial.

BACKGROUND: Telerehabilitation has been developed and applied for years for cardiac and pulmonary diseases with good clinical outcomes. However, its application to participants with long COVID remains limited. OBJECTIVES: To investigate the effectiveness of a 12-week telerehabilitation training program in participants with long COVID. The primary outcome was cardiorespiratory fitness (CRF), and secondary outcomes were physical activity (PA) amounts, exercise self-efficacy, sleep quality, and health-related quality of life (HRQOL). METHODS: A parallel-group, randomized controlled trial was conducted. Eligible participants with long COVID (n = 182) were randomly assigned in a 1:1 ratio to either the experimental group (EG) or the control group (CG). The EG received 12 weeks of telerehabilitation training with weekly remote monitoring for exercise maintenance and support. The CG received PA counseling only. CRF, PA amounts, exercise self-efficacy, sleep quality, and HRQOL were assessed at baseline and 12 weeks. Generalized estimating equations were used to analyze the intervention effects by examining the interaction between time and group. RESULTS: One hundred twenty-two participants (67 %) completed the study, and 182 were included in the intention-to-treat analysis. The EG had greater walking behavior (ß = -763.3, p < 0.001), total amount of PA (ß= -711, p = 0.003), exercise self-efficacy (ß = -1.19, p < 0.001), and better sleep quality (ß = 1.69, p = 0.012) after the 12-weeks of telerehabilitation training than the CG. However, there were no significant differences in any CRF parameters or HRQOL at 12 weeks between the EG and CG. CONCLUSION: Telerehabilitation training offers a personalized and convenient approach that can increase exercise willingness and PA amounts and improve sleep quality. These findings underscore the potential benefits of telerehabilitation training for promoting healthier lifestyles and improving overall health outcomes. CLINICAL TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov (NCT05205460) on January 25, 2022.

Association Between Physical Activity Amount and Cardiorespiratory Fitness, Sleep Quality, and Health-Related Quality of Life in Patients With Long COVID: A Cross-sectional Study.

OBJECTIVE: To investigate the association between physical activity (PA) amount and gender differences on cardiorespiratory fitness (CRF), sleep quality, and health-related quality of life (HRQoL) in individuals with long COVID. DESIGN: Cross-sectional study. SETTING: An integrated outpatient clinic for post-COVID-19 at a medical center. PARTICIPANTS: Convenience sample of patients (N=264) diagnosed with long COVID. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: PA amounts, sleep quality, and HRQoL were measured by the International Physical Activity Questionnaire, Pittsburgh Sleep Quality Index, and the World Health Organization Questionnaire on Quality of Life: Short Form, respectively. CRF was evaluated through graded exercise testing. RESULTS: The participants had a mean age of 42.5±13.5 years and a mean duration of post-COVID-19 symptoms of 12.7±6.8 weeks. More than half (n=149, 56.5%) were female patients. Female participants had significantly lower CRF than male participants (P<.05). Older age and higher body mass index were associated with worse CRF and HRQoL (P<.05). Less sitting behavior and greater amounts of vigorous-intensity PA (VPA) or total PA were associated with better CRF (P<.05). In addition, greater total PA and moderate-intensity PA (MPA) were associated with better sleep quality and HRQoL (P<.05), respectively. CONCLUSIONS: Gender differences were found in CRF among patients with long COVID. Greater self-reported VPA or total PA was associated with better CRF, whereas greater total PA and MPA were associated with better sleep quality and HRQoL, respectively, in patients with long COVID. Further research is needed to explore these associations in longitudinal studies.

Volume Effect of Nerve Hydrodissection for Carpal Tunnel Syndrome: A Prospective, Randomized, and Single-Blind Study.

OBJECTIVES: This study compared ultrasound-guided nerve hydrodissection (HD) outcomes using two commonly used injectate volumes (10 and 5 mL) of normal saline to explore if there is a volume effect of HD for patients with moderate carpal tunnel syndrome (CTS). METHODS: Twenty-four participants were randomly assigned to treatment with HD using ultrasound-guidance and either 10 mL or 5 mL of normal saline (HD-10 and HD-5 groups respectively). Our primary outcome measures were the change scores of the two subscales of the Boston Carpal Tunnel Syndrome Questionnaire: The Symptom Severity Scale (SSS) and Functional Status Scale (FSS). We conducted a one-way repeated analysis of variance for 3 time points (4, 12, and 24 weeks) for both SSS and FSS, respectively, for change scores from time 0, and percentage change from time 0. RESULTS: All participants (n = 12 per group) completed the study. From 0 to 24 weeks the HD-10 group outperformed the HD-5 group for improvement in SSS (median ± IQR; -0.8 ± 0.4 versus -0.5 ± 0.5; P = .024) and FSS scores (mean ± SD; -0.8 ± 0.2 versus -0.5 ± 0.5; P = .011). The HD-10 group improvement in FSS subtest significantly exceeded the MCID percentage-change-based threshold of 27% (34%; P = .039). CONCLUSIONS: Despite the limitations of small study size, a largely inert injectate, and a single injection approach, these findings in favor of the 10 mL group suggest that the volume used for ultrasound-guided HD in moderate CTS matters, and a higher volume is more effective.

Wettability and Surface Roughness of Parylene C on Three-Dimensional-Printed Photopolymers.

The use of poly-(para-chloro-xylylene) (Parylene C) in microelectromechanical systems and medical devices has increased rapidly. However, little research has been conducted on the wettability and surface roughness of Parylene C after being soaked in solutions. In this study, the contact angle and surface roughness (arithmetic average of roughness) of Parylene C on three-dimensional (3D)-printed photopolymer in 10% sodium hydroxide, 10% ammonium hydroxide, and 100% phosphate-buffered saline (PBS) solutions were investigated using a commercial contact angle measurement system and laser confocal microscope, respectively. The collected data indicated that 10% ammonium hydroxide had no major effect on the contact angle of Parylene C on a substrate, with a Shore A hardness of 50. However, 10% sodium hydroxide, 10% ammonium hydroxide, and 100% PBS considerably affected the contact angle of Parylene C on a substrate with a Shore A hardness of 85. Substrates with Parylene C coating exhibited lower surface roughness than uncoated substrates. The substrates coated with Parylene C that were soaked in 10% ammonium hydroxide exhibited high surface roughness. The aforementioned results indicate that 3D-printed photopolymers coated with Parylene C can offer potential benefits when used in biocompatible devices.

Mechanical properties of Pt-Ir and Ni-Ir binary alloys for glass-molding dies coating.

In this study, the different compositions of Pt-Ir and Ni-Ir alloys were deposited by utilizing ion source assisted magnetron sputtering system (ISAMSS). The surface roughness and crystallite size of the Pt-Ir and Ni-Ir coatings were analyzed by atomic force microscopy (AFM) and X-ray diffraction (XRD), respectively. In addition, coatings were soaked at 700 degrees and maintained 10 min under N2 atmosphere using a glass-molding machine. The annealed coatings for oxidation test were examined by energy dispersive X-ray spectrometry (EDS) and for microhardness and reduced modulus test were evaluated by nanoindentation instrucment. The cross-sectional structures between the Pt-Ir and Ni-Ir coating layer and substrates were also examined by field emission scanning electron microscope (FESEM). The results show that surface roughness Ra from 1.25 nm to 3.426 nm was observed with increasing the Ni elements. However, the Ra is less than 2 nm measured in Ir-based coatings doped with Pt concentrations under this study. With increasing Pt and Ni doping, the microhardness of both coatings decreased significantly and the values of reduced modulus of Pt-Ir alloys are larger than that of Ni-Ir alloys. After oxidation process, the oxygen concentration of Pt-Ir coatings is less than that of Ni-Ir coatings and the Pt-Ir coatings exhibit superior properties including oxidation resistance, low surface roughness and high reduced modulus over Ni-Ir coatings, especially for the high Pt concentration coatings such as Pt-Ir 2 (55.25 at.% Pt) and Pt-Ir 3 (79.42 at.% Pt) coatings. The surface roughnesses of all specimens annealed at 700 degrees C were slightly larger than as-deposited coatings. Moreover, due to the serious oxidation occurred in Ni-Ir 3 (73.45 at.% Ni) coatings, the value of reduced modulus of this specimen coating is the lowest and the corrsponding Ra value is the largest compared with the rest of Ir-based coatings in the oxidation testing.