Purpose: Maintaining or increasing user adherence to digital healthcare services is of great concern to service providers. This study aims to verify whether the donation model is an effective strategy to increase adherence to physical exercise using a mobile application. Materials and Methods: A total of 5618 users of a motion-detecting mobile exercise coaching application participated in a donation or self-reward exercise challenge with the same exercise protocol. The workout consisted of 50 squats daily for 14 days. The user’s exercise was monitored through a smartphone camera, providing real-time visual and audio feedback. In the donation group, 6 USD was donated to the economically disadvantaged if a participant completed their workout each day. In the self-reward group, three people who completed the program and 20 people who completed ≥12 days of exercise were randomly selected and provided with goods worth 60 USD and 4.3 USD of online currency, respectively. Results: The average daily exercise completion rate (% of participants who completed daily exercise) in the donation group was 1.8 times higher than that of the self-reward group (donation, 41.7%; self-reward, 22.7%; p<0.0001). The donation group completed more days of the program (donation, 5.8; self-reward, 3.2; p<0.0001). The completion rate of both groups decreased with time and decreased most on day two (donation, -9.9%; self-reward, -14.5%). Conclusion The donation model effectively promoted adherence to mobile app-based exercise. This donation model is expected to effectively enhance user adherence to digital healthcare services.

Purpose: Maintaining or increasing user adherence to digital healthcare services is of great concern to service providers. This study aims to verify whether the donation model is an effective strategy to increase adherence to physical exercise using a mobile application. Materials and Methods: A total of 5618 users of a motion-detecting mobile exercise coaching application participated in a donation or self-reward exercise challenge with the same exercise protocol. The workout consisted of 50 squats daily for 14 days. The user’s exercise was monitored through a smartphone camera, providing real-time visual and audio feedback. In the donation group, 6 USD was donated to the economically disadvantaged if a participant completed their workout each day. In the self-reward group, three people who completed the program and 20 people who completed ≥12 days of exercise were randomly selected and provided with goods worth 60 USD and 4.3 USD of online currency, respectively. Results: The average daily exercise completion rate (% of participants who completed daily exercise) in the donation group was 1.8 times higher than that of the self-reward group (donation, 41.7%; self-reward, 22.7%; p<0.0001). The donation group completed more days of the program (donation, 5.8; self-reward, 3.2; p<0.0001). The completion rate of both groups decreased with time and decreased most on day two (donation, -9.9%; self-reward, -14.5%). Conclusion The donation model effectively promoted adherence to mobile app-based exercise. This donation model is expected to effectively enhance user adherence to digital healthcare services.

Ergonovine stress echocardiography might be a feasible, accurate and safe procedure for the noninvasive diagnosis of coronary vasospasm. During ergonovine stress echocardiography, reversal of spasm is usually achieved by administration of nitroglycerin or nifedipine. However, we experienced a 61 year-old male case of cardiac arrest caused by multiple spasms and refractory of these medications during ergonovine stress echocardiography.
Coronary Vasospasm ; Diagnosis ; Echocardiography ; Echocardiography, Stress* ; Ergonovine* ; Heart Arrest* ; Humans ; Male ; Middle Aged ; Nifedipine ; Nitroglycerin ; Spasm

Ergonovine stress echocardiography might be a feasible, accurate and safe procedure for the noninvasive diagnosis of coronary vasospasm. During ergonovine stress echocardiography, reversal of spasm is usually achieved by administration of nitroglycerin or nifedipine. However, we experienced a 61 year-old male case of cardiac arrest caused by multiple spasms and refractory of these medications during ergonovine stress echocardiography.
Coronary Vasospasm ; Diagnosis ; Echocardiography ; Echocardiography, Stress* ; Ergonovine* ; Heart Arrest* ; Humans ; Male ; Middle Aged ; Nifedipine ; Nitroglycerin ; Spasm

There are some cases of myofascial pain syndrome (MPS) with chronic upper back pain that does not respond to dry needling or trigger point injection, well-known treatments for MPS. A 67-year-old female developed a stabbing upper back pain with trigger point at left T7∼8 levels 10 years ago. She complained of the pain with Numeral Rating Scale (NRS) 8 points. Myofascial release technique and trigger point injection had no effect. Under ultrasound guidance 20 ml of 1% lidocaine was injected into thoracic paravertebral space. Immediately, the pain was reduced to NRS 4 points. One week later, the second block was performed in the same way as the first, and the pain was reduced to NRS 2 points. The stabbing pain disappeared, and oral opioids were discontinued. Ultrasound guided thoracic paravertebral space block is an effective and safe treatment for refractory MPS with chronic upper back pain.

Manual therapy has been widely practiced in almost all countries worldwide. With its potential complications, there are contraindications for thrust technique. A 56-year-old woman diagnosed with athetoid cerebral palsy visited a local clinic due to a tingling sensation in right hand that lasted for a year and aggravated to both upper extremities. The patient underwent three sessions of cervical manual therapy including thrust technique. No evaluation was performed. The patient immediately felt weakness in all extremities after performing cervical thrust technique. Magnetic resonance imaging showed atlantoaxial instability and cervical myelopathy. Approximately one-third of adults with cerebral palsy reported chronic musculoskeletal pain and they often experience neck pain. Particularly in athetoid cerebral palsy, malalignment or instability of the cervical spine is prevalent and often results in myelopathy. Therefore, musculoskeletal evaluation is necessary to identify cervical instability in case of cervical thrust technique, and it should be performed by relevant medical professionals.