Virtual reality (VR) therapy has many benefits to promote neurological and functional recovery in the field of neurorehabilitation after brain injury. VR-assisted neurorehabilitation can be applied in motor, sensori-motor, cognitive, activities of daily living (ADL), and telerehabilitation. Recent reports found that VR therapy appears to be a safe intervention that is effective at improving arm function and ADL function following stroke. Greater improvements were seen at a higher VR therapeutic dose. There has been insufficient evidence that VR therapy improved lower extremity gait speed, balance, and cognitive function after brain injury. As a result, the number of commercially available devices have increased and large-scale controlled trials have reported positive effects recently. Interface devices, various feedback methods, and the advancement of augmented reality technology are quickly developing, therefore, the potential value of VR therapy in neurorehabilitation will be high and its clinical application will be diversified.
Activities of Daily Living ; Arm ; Brain Injuries ; Cognition ; Gait ; Lower Extremity ; Neurological Rehabilitation* ; Rehabilitation ; Stroke ; Telerehabilitation

OBJECTIVETo evaluate the feasibility and safety of CO2 laser supraglottoplasty for severe laryngomalacia in infants.

METHODSFrom January 2009 to December 2011, 32 infants with severe laryngomalacia were confirmed by electronic laryngoscope and clinical assessment in Shenzhen Children's Hospital. According to the choice made by the parents, 16 children accepted CO2 laser supraglottoplasty (group 1), the others were treated conservatively (group 2). The beginning observation point T0 was defined as the age on the first medicine taking day or the age of surgery. T1, T3, T6 were defined as 1, 3, 6 months following T0. Clinical symptoms included stridor, dyspnea, aspiration, and respiratory infections. The body weight, PSG reports, laryngoscope findings, cure rates of the two groups were compared.

RESULTSThe anatomical abnormalities were corrected surgically, and the symptoms ,such as stridor, dyspnea, and aspiration improved rapidly after the operation. The cure rates was higher in group 1 than in group 2 on T1, T3, T6 stage. There were statistically significant differences(χ(2) were 13.9, 28.1, 24.6 respectively; all P < 0.01). Children in group 1 gained weight better than in group 2. There was a statistically significant difference in Z scores median on T1, T3, T6 stage (z score were -0.848, -2.940, -4.110; P < 0.05, or P < 0.01 respectively). The lowest oxygen saturation in group 1 improved one month after the surgery (from average 0.686 ± 0.106 to 0.901 ± 0.041). There was a statistically significant difference (t = -7.876, P = 0.001). Complications included adhesion (1 case) and temporary new-onset aspiration (1 case).

CONCLUSIONSThe CO2 laser supraglottoplasty can resolve severe laryngomalacia symptoms including stridor, dyspnea and aspiration. It can reduce the frequency of respiratory infections, and contribute to weight gaining. The CO2 laser supraglottoplasty is effective, of high security and with rare complications.

Carbon Dioxide ; Glottis ; Humans ; Infant ; Infant, Newborn ; Laryngomalacia ; radiotherapy ; Laryngoscopes ; Lasers, Gas ; therapeutic use ; Low-Level Light Therapy ; Retrospective Studies

OBJECTIVE: To evaluate the effectiveness of intensive rehabilitation to support recovery of neurological function after brain tumor surgery and assess long-term satisfaction. METHODS: This retrospective study included patients with neurological impairment after brain tumor surgery who underwent intensive rehabilitation therapy between December 2013 and May 2017. To assess effectiveness of rehabilitation, functional outcomes (motor, cognition, and activities of daily living [ADL]) were compared between brain tumor group and a control group enrolling stroke patients who received equivalent rehabilitation during the study period. Long-term satisfaction with rehabilitation was evaluated by surveying family caregivers. RESULTS: This study included 21 patients with benign brain tumor, 14 with malignant brain tumor, and 108 with stroke. Significant and similar improvement in motor, cognition, and ADL function were noted in both the brain tumor group and the stroke group. Malignancy status did not influence the extent of functional improvement. According to medical records and surveys, 9 (69.2%) patients with malignant tumor and 2 (11.8%) with benign tumor had expired by the time of the survey. Most family caregivers confirmed that rehabilitation was effective for functional improvement (>60%), expressing overall satisfaction and stating they would recommend such therapy to patients with similar conditions (approximately 70%). CONCLUSION: Intensive rehabilitation may help promote functional improvement following brain tumor surgery regardless of malignancy compared with stroke patients. Family caregivers expressed overall satisfaction with rehabilitation at long-term follow-up. These findings support the provision of intensive rehabilitation therapy for neurologic function recovery following brain tumor surgery.
Activities of Daily Living ; Brain Neoplasms ; Brain ; Caregivers ; Cognition ; Follow-Up Studies ; Humans ; Medical Records ; Neurological Rehabilitation ; Pilot Projects ; Recovery of Function ; Rehabilitation ; Retrospective Studies ; Stroke ; Treatment Outcome

This study identified the explanatory power of the Korean rehabilitation patient group (KRPG) v1.1 for acquired brain injury (ABI) on medical expenses in the rehabilitation hospitals and the correlation of functional outcomes with the expenses. Here, the design is a retrospective analysis from the claim data of the designated rehabilitation hospitals. Data including KRPG information with functional status and medical expenses were collected from 1 January and 31 August 2018. Reduction of variance (R2) was statistically analyzed for the explanation power of the KRPG. Association between functional status and the medical expenses was carried out using the Spearman's rank order correlation (rho). From the claim data of 365 patients with ABI, the KRPG v1.1 explained 8.6% of variance for the total medical expenses and also explained 9.8% of variance for the rehabilitation therapy costs. Cognitive function and spasticity showed very weak correlation with the total medical expenses (rho = −0.17 and −0.14, respectively). Motor power and performance of activities of daily living were associated weakly (rho = −0.27 and −0.30, respectively). The KRPG and related functional status in ABI reflects the total medical expenses and rehabilitation therapy costs insufficiently in the designated rehabilitation hospitals. Thus, the current KRPG algorithm and variables for ABI may need to be ameliorated in the future.
Activities of Daily Living ; Brain Diseases ; Brain Injuries ; Brain ; Cognition ; Diagnosis-Related Groups ; Fee-for-Service Plans ; Humans ; Muscle Spasticity ; Neurological Rehabilitation ; Rehabilitation ; Retrospective Studies

OBJECTIVETo assess the efficacy and safety of low-energy QS Nd : YAG and QS alexandrite laser for melsasma.

METHODSWe treated 32 patients with melasma using the low-energy QS Nd : YAG and QS alexandrite laser. Pigment subsided by > or = 90% was regarded as "cured", by 60% -89% as "remarkably improved", by 30% -59% as "effective", and by < 30% as "ineffective" .

RESULTSAmong the 32 patients, 21 patients (65.6%) were cured after (10.2 +/- 3.5) times (range: 4-15 times) of treatments, 11 patients (34.4%) were remarkably improved after (11.4 +/- 2.5) times (range: 10-14 times) of treatment. The rates of "cured" and "remarkably improved" were 81.3% and 18.7% among patients with light brown melasma and 50.0% and 50.0% among patients with dark brown melasma (P < 0.05). In patients with a disease history of less than 2 years, the rates of " cured" and "remarkably improved" were 87.5% and 12.5%, which was significantly better than the treatment results of patients with a disease history of more than 2 years (the rates of "cured" and "remarkably improved" were 58.3% and 41.7%) (P < 0.05). No hyperpigment and scarring was observed and only one patient experienced a transient pigment loss.

CONCLUSIONSLower-energy QS Nd : YAG and QS Alexandrite Laser can be used to treat patients with melasma safely and effectively. The color and disease course of melasma were factors that may affect the treatment results.

Adult ; Female ; Humans ; Lasers, Solid-State ; therapeutic use ; Low-Level Light Therapy ; methods ; Male ; Melanosis ; radiotherapy ; Middle Aged ; Risk Assessment ; Treatment Outcome

OBJECTIVETo assess the efficacy and safety of the 308 nm excimer laser for the treatment of vitiligo.

METHODSWe treated 170 patients with stable vitiligo by using the 308 nm excimer laser. The lesions of vitiligo were treated one to two times per week for 10-30 times. Efficacies were evaluated every 7 days and 3 days after the treatments were completed. Patients were followed up for two months.

RESULTSThe rates of "remarkably improved" and "cured" were 67.97% and 32.03% in faces, 54.55% and 27.27% in necks, 63.26% and 26.53% in trunks, 38.84% and 15.70% in limbs, and 0 and 0 in hands and feet. The areas of faces had a better response than those of necks, trunks, or limbs (P < 0.01), and the areas of trunks or limbs had better response than that of hands and feet (P < 0.01).

CONCLUSIONThe 308 nm excimer laser is safe and effective in treating stable vitiligo and the efficacy varies in different lesion sites.

Adolescent ; Adult ; Child ; Female ; Humans ; Lasers, Excimer ; therapeutic use ; Low-Level Light Therapy ; instrumentation ; methods ; Male ; Middle Aged ; Risk Assessment ; Treatment Outcome ; Vitiligo ; radiotherapy ; Young Adult

No abstract available.
Brain* ; Neurological Rehabilitation*

Recently, various modalities for noninvasive reduction of adipose tissue, including cryolipolysis, radiofrequency, low-level laser therapy, and high-intensity focused ultrasound, have become available. Among these modalities, cryolipolysisis can selectively target certain tissues rich in lipids. Many preclinical and clinical studies have established the safety and efficacy of cryolipolysis for noninvasive body contouring. However, it can lead to serious adverse effects when performed by untrained clinicians. Thus, to promote the proper and safe use of cyolipolysis, we have summarized the history, basic principles, and adverse effects of cyolipolysis.
Adipose Tissue ; Low-Level Light Therapy ; Ultrasonography

OBJECTIVE: To investigate the effect of a conservative treatment regime in Parkinson's disease patients with camptocormia. METHODS: Nine patients with Parkinson's disease were included in a retrospective pilot study of the value of back extensor strengthening exercise. Six inpatients received a 30-minute treatment, twice daily for 5 weeks, being treated on average for 34 days; while three outpatients visited the clinic and were educated for home exercise and backpack wearing treatment. Outpatients should be scheduled to visit the outpatient department to check physical status every 2–4 weeks for an average of 3 months. RESULTS: All patients except one showed statistically significant improvements in activities of daily living (ADL) and motor symptoms, as measured by flexion angle at standing posture, Unified Parkinson's Disease Rating Scale (UPDRS) II and III, and modified Hoehn-Yahr staging. CONCLUSION: Conservative treatment is effective in postural correction of camptocormia in Parkinson's disease, as well as improvement in ADL and motor symptoms.
Activities of Daily Living ; Humans ; Inpatients ; Outpatients ; Parkinson Disease* ; Physical Therapy Modalities ; Pilot Projects* ; Posture ; Rehabilitation ; Retrospective Studies*

OBJECTIVETo evaluate the efficacy of semiconductor low level laser irradiation for the treatment of postoperative exposure of hydroxyapatite orbital implants.

METHODS22 cases with postoperative exposure of hydroxyapatite orbital implants were divided into three groups according to the size of implants exposure. The exposure wound in the 3 groups was irradated with semiconductor low level laser 5 min per day for 5-15 days. The follow-up period ranged from 2 to 24 months.

RESULTSIn the group with less then 3 mm of exposure, the wound healed in 1 week after 5-10 days irradiation; in the group with implant exposure of 4-7 mm, the would healed in 1-2 weeks after 10-15 days irradiation; in the group with implant exposure of 8-10 mm, the would healed in 2-3 weeks after 10-15 days irradiation. Compared with the treatments of drugs and/or surgical repair, which was used for another 20 cases of exposure of hydroxyapatite orbital implants, semiconductor low level laser increased healing rate obviously in the groups with implant exposure of 4-7 mm and 8-10 mm (P = 0.019, 0.018).

CONCLUSIONSemiconductor low level laser has better effects than drugs and/or surgical repair for exposure of hydroxyapatite orbital implants.

Adolescent ; Adult ; Aged ; Child ; Durapatite ; therapeutic use ; Eye ; pathology ; radiation effects ; Female ; Follow-Up Studies ; Humans ; Low-Level Light Therapy ; methods ; Male ; Middle Aged ; Orbital Implants ; adverse effects ; Postoperative Complications ; etiology ; radiotherapy ; Semiconductors ; Treatment Outcome