Joshua (Sung) Hyun You

Background: To compare the effects of conventional cardiopulmonary physical therapy (CCPT) and specialized core mobilization exercise (SCME) on cardiopulmonary function and functional difficulties in patients after open-heart surgery. Methods: This randomized controlled, single-blind study used repeated-measures analysis of variance to examine time and group interaction effects across multiple postoperative assessment points. A post hoc Tukey test was performed when significant effects were identified. The study was conducted at the Myongji Hospital Cardiac Rehabilitation Center from June 2022 to July 2023 and included 37 patients (mean age = 66.1   ±   11.4 years) who were randomly assigned to the CCPT or SCME group. Results: Compared with CCPT, SCME resulted in greater improvements in peak oxygen consumption, metabolic equivalents, forced vital capacity, forced expiratory volume in 1 second, maximal voluntary ventilation ( P   <   .05), and Functional Difficulties Questionnaire scores ( P   <   .01). Conclusion: SCME demonstrated superior effects on peak oxygen consumption, selected pulmonary function parameters, and functional thoracic mobility compared with CCPT in patients after open-heart surgery.

While “passive” hip–knee–ankle–foot orthoses (HKAFOs) have been developed to enhance walking mobility for individuals with complete spinal cord injury, self-balancing robotic assisted hip–knee–ankle–foot orthoses (SRA-HKAFOs) have not been compared. The aim of this study was to compare therapeutic differences in kinematics and temporal–spatial parameters between “powered” HKAFOs and SRA-HKAFOs in individuals with complete spinal cord injury under both slow and fast walking conditions. A patient with a complete T11 spinal cord injury underwent the “powered” HKAFOs and SRA-HKAFOs under slow and fast walking conditions. Outcome measures included the functional ambulation category (FAC), perceived rate of exertion, walking speed, and hip and knee joint kinematics during a 10[ ]m walking test (10[ ]MWT). SRA-HKAFOs showed substantial improvements compared to “powered” HKAFOs in the FAC (from level 0 to 3), perceived rate of exertion, walking speed, and hip and knee joint kinematics during the 10[ ]MWT. The SRA-HKAFO system may provide promising clinical evidence as an alternative, powerful robotic gait-assisted vehicle to maximize independence in ambulation by enhancing hip and knee joint kinematics. The temporal–spatial gait parameters in patients with complete spinal cord injury were also improved.

The pelvis and trochanteric soft tissue stiffness influence hip impact force during falls. We examined potential relationships between the stiffness values acquired from different methodologies. Twenty-six individuals simulated sideways falls. During trials, force-deformation data of the trochanteric soft tissue were recorded, then fitted to polynomial and exponential functions. Stiffness was determined as a slope of the tangent line at maximum deformation ( K _{s_1st} , K _{s_2nd} , and K _{s_exp} ) and at 0.4 N ( K _{s_2nd_0.4 N} , K _{s_exp_0.4 N} ). Similarly, force-deformation data of the pelvis were fitted exponentially to determine the pelvis stiffness at peak impact force ( K _b ). We also used a clinical device to measure the trochanteric soft tissue stiffness ( K _{s_myoton} ). Correlation and regression analyses were performed. The K _b was correlated with K _{s_1st} and K _{s_2nd} ( P < .05) and decreased 1.7 and 0.7 kN/m for every 1 kN/m increase in K _{s_1st} and K _{s_2nd} , respectively ( R ² = .23 and R ² = .21), but no variables were correlated with the K _{s_myoton} ( P > .05). When normalized, however, both K _b and K _{s_myoton} were correlated with K _{s_1st} and K _{s_2nd} ( P < .05). These findings provide insights into hip impact dynamics, suggesting that trochanteric soft tissue stiffness measured with a clinical device may serve as a predictor of pelvis stiffness during falls.

This study aimed to investigate the efficacy of the novel “MIRACLE” smart shoes in improving gait performance, particularly toe-walking and foot clearance, in a child with cerebral palsy (CP) demonstrating limited ankle dorsiflexion during gait. This single-case study conducted observational gait assessments and joint kinematic analysis to compare the effects of the MIRACLE smart shoes with those of the regular shoes during overground walking. One child with CP who exhibited abnormal toe-walking and limited foot clearance participated in the study. The MIRACLE smart shoes were developed to increase tibialis anterior activation and decrease excessive gastrocnemius activation during gait by applying a customized talus strap and BOA ^® closure system to promote ankle dorsiflexion. Gait performance was evaluated with the dynamic gait index (DGI), the physician rating scale (PRS), and ankle joint kinematic analysis via ImageJ software. The DGI score improved from 16 (with regular shoes) to 20 (with MIRACLE shoes), an 18.4% increase, with significant improvements observed in the “gait level surface” and “step over obstacle” tasks. Additionally, the PRS demonstrated improvements in overall gait mechanics, specifically in ankle dorsiflexion control. ImageJ analysis confirmed improved dorsiflexion kinematics during the swing phase of gait. The MIRACLE smart shoes effectively enhanced gait performance by resolving toe-walking and poor foot clearance in a child with CP. These results indicate that the MIRACLE shoes provide a promising alternative to conventional interventions, offering immediate improvements in functional mobility and reducing fall risk.

The use of rehabilitation robots is critical for fostering social integration among individuals with gait limitations. This study aimed to explore three main areas: first, the current status of rehabilitation robot usage among individuals with gait limitations across different life stages; second, whether personal, psychological, and social integration outcomes differ based on past experience with rehabilitation robots; and third, identifying factors that influence social integration in this population. Participants were recruited from clinical sites and community welfare centers, with approval from the Yonsei University IRB and informed consent obtained. A survey of 192 individuals with gait limitations found that 59.3% had used rehabilitation robots, primarily for indoor walking training (86.1%). Participants with prior experience using rehabilitation robots showed higher scores in social integration measures compared to those without such experience. Key factors for rehabilitation robot use included safety (44.1%), cost (30.5%), and convenience (23.7%), with an overall satisfaction rate of 68.6%. Multiple regression analysis identified rehabilitation robot experience as a significant positive predictor of social integration. These findings underscore the potential of rehabilitation robots to enhance social integration and quality of life for individuals with gait limitations, providing a foundation for future advancements in social rehabilitation.

Although mechanical diagnosis and therapy (MDT) is generally used for its accurate “hands-on manual or face-to-face diagnostic” classification and therapeutic efficacy in treating low back pain (LBP), the validity and test–retest reliability of an AI-based MDT platform (“Dr. AI”) for chronic LBP diagnosis remain unestablished. This research aimed to assess the validity and reliability of Dr. AI compared to the conventional face-to-face diagnosis by physical therapists (“Dr. PT”). Fifty participants ([ ] years, eight females) with chronic LBP were classified into postural, derangement, and other syndromes using MDT guidelines based on the signs, posture, and repeated movement tests. Convolutional neural networks (CNNs) were employed to compare the classification accuracies of Dr. PT and Dr. AI. The significance value for linear regression and intraclass correlation coefficient (ICC) analyses was set at [ ]. Linear regression analysis demonstrated excellent validity ([ ], [ ]), indicating the outstanding accuracy of Dr. AI. The test–retest reliability data demonstrated good-to-excellent ICC (0.82–0.94; [ ]), indicating consistent measurements by Dr. AI. These findings highlight the important clinical application of the Dr. AI MDT system, which accurately and consistently identifies and classifies syndromes in chronic LBP in a remote or ecological environment. Our novel study has demonstrated more than 10% higher reliability and validity than previous studies.