Background: The purpose of this study was to confirm whether fully-immersive virtual reality instrumental activities of daily living training is safe and feasible for people with mild dementia. Methods:The virtual reality program contents include simulation of instrumental activities of daily living training. Feasibility was assessed by means of responses to a self-report satisfaction questionnaire and the Simulator Sickness Questionnaire; and by analyzing the level of participants' immersion. Researchers assessed the instrumental activities of daily living scores, cognitive functioning, and mood changes pre-and post-intervention.Results: A total of seven participants with mild dementia were recruited. The mean immersion score was 50.42±7.89 points, and the mean adherence was 83.71±6.10 points. Overall, the participants found the activities satisfying. Six participants experienced negligible side effects and one exhibited moderate side effects. After the training, the instrumental activities of daily living scores improved significantly (P=0.042).Performance on the Word List Delayed Recall test and Trail Making Test B showed improvements in all participants.Conclusions: Fully-immersive, virtual reality-based, instrumental activities of daily living training is feasible for people with mild dementia and provides them with a high level of satisfaction and immersion. This program can help improve their capacities to carry out activities of daily living, their cognitive functioning, and mood. However, further research is needed for fully-immersive virtual reality instrumental activities of daily living training before it can be considered as a treatment option in people with mild dementia.

Background: The purpose of this study was to confirm that fully-immersive virtual reality (VR) instrumental activities of daily living (I-ADL) training is (1) safe and feasible for patients with mild cognitive impairment (MCI) and (2) helpful for patients’ cognitive function and ADL performanceMethods: The VR system included simulation of I-ADL. The feasibility was assessed by using self-report satisfaction questionnaire, the level of the participants’ immersion, and a Simulator Sickness Questionnaire (SSQ). Before after VR training, the researchers assesse I-ADL scores, cognitive function, mood.Results: A total of 7 patients with MCI and mild dementia were recruited. Overall, the patients were highly satisfied. The mean immersion score was 50.42±7.89 points and the mean adherence was 83.71±6.10 points. Six patients experienced negligible side effects. After VR training, I-ADL scores improved significantly (P<0.05). Wordlist delayed recall (p=0.023) and Trail making test-B (TMT-B) (p=0.042) showed a statistically significant improvement.Conclusion: The fully-immersive VR I-ADL training was feasible for patients with MCI and provided them with a high level of satisfaction and immersion.This program can help improve patients’ ADL, cognition, and mood. These findings suggest that VR I-ADL training programs can be used as a treatment tool for patients with MCI.

In dysphagia, food or water cannot be delivered safely through the oral cavity to the stomach; both are treated using texture-modified food and thickened fluid. Before, each country had its own diet modifications and texture measurement standards. In 2012, the International Dysphagia Diet Standardisation Initiative (IDDSI) was developed by several countries. Owing to cultural differences, it was necessary to determine whether the IDDSI could well be applied to clinicians and patients without difficulties in East Asia countries. To evaluate the IDDSI scale to find out the difficulties applying this scale in East Asia countries to educate the clinicians and patients. In May 2021, we enrolled physicians, nurses, nutritionists, and swallowing therapists involved in dysphagia treatment at a single center in Seoul. To evaluate the degree of understanding and difficulties of adapting IDDSI to clinicians in East Asia countries, we used the 17-item questionnaire with IDDSI sample foods and foods in Asian countries. In first 7 items, we compared IDDSI with the previously used scale based on the National Dysphagia Diet (NDD). In the next 10 questions, only the IDDSI levels were answered, and the absolute values of the answer–response differences were calculated. The IDDSI showed a significantly high intraclass correlation with the previously used NDD-based scale; the coefficient was higher for the nutritionists (0.988) and swallowing therapists (0.991). When evaluating whether the IDDSI could applied well in East Asia countries, the absolute values of the answer–response differences were lower than 0.5 in majority of levels, except for Level 4. Because the IDDSI framework might successfully be applied universally regardless of food culture, a worldwide standard for food rheology in dysphagia treatment might be possible.

Purpose This study aimed to identify predictors of the occurrence and severity of neurological symptoms in patients with metastatic spinal tumor who still had no neurological symptoms. Methods We retrospectively examined patients with metastatic spinal tumor (regardless of tumor type) who visited the Department of Rehabilitation Medicine between 2017 and 2021. Using the patients’ magnetic resonance imaging and clinical data, we investigated whether epidural spinal cord compression (ESCC) scale, spinal instability neoplastic score (SINS), and pain character were related to the occurrence and severity of neurological symptoms within 1 year. Results Of the 70 included patients, 40 showed neurological symptoms, and 30 did not. Multivariable analysis showed that ESCC (2 or 3) (P = 0.002), SINS (P = 0.007), and radiating pain (P = 0.015) were associated with neurological complications. None of the factors was associated with neurological symptom severity. Notably, neurological symptoms progressed rapidly in patients with high ESCC (P = 0.003). Conclusion ESCC, SINS, and radiating pain were related to the occurrence of neurological symptoms, but not to severity. Only ESCC was associated with the rapid progression of neurological symptoms. This retrospective study provides useful insights in predicting a patient's functional prognosis and determining management using radiology and clinical data.

Lamin A (<i>LMNA</i>)-related congenital muscular dystrophy usually presents with hypotonia and severe axial muscle weakness in early infancy. We report a patient who initially presented with torticollis but was finally diagnosed with <i>LMNA</i>-related congenital muscular dystrophy. A 7-month-old infant presented to the outpatient clinic with a chief complaint of torticollis. During a thorough physical examination, axial muscle weakness and gross motor delay were noted, and she was admitted to the pediatric rehabilitation department for further evaluation. The serum creatine kinase level was elevated, and electromyography demonstrated the possibility of hereditary myopathy or a motor neuron disorder. A gene study was conducted, and it showed a c.745C>T (p.Arg249Trp) mutation in the <i>LMNA</i> gene, which is known to cause congenital muscular dystrophy in rare cases. Since there are few reports describing nerve conduction and electromyography studies in patients with <i>LMNA</i>-related congenital muscular dystrophy, this case is meaningful.

Purpose: Thisstudy aimed to identify predictors of the occurrence and severity of neurological symptoms in patients with metastatic spinal tumor who still had noneurological symptoms. Methods: We retrospectively examined patients with metastatic spinal tumor (regardless of tumor type) who visited the Department of Rehabilitation Medicine between 2017 and 2021. Using the patients’ magnetic resonance imaging and clinical data, weinvestigated whether epidural spinal cord compression (ESCC) scale, spinal instability neoplastic score (SINS), and pain character were related to the occurrence and severity of neurological symptoms within 1 year. Results: Of the 70 included patients, 40 showedneurological symptoms, and 30 did not. Multivariable analysis showed that ESCC (2 or 3) (P = 0.002), SINS (P = 0.007), and radiating pain (P = 0.015) were associated with neurological complications. None of the factors was associated with neurological symptom severity. Notably, neurological symptoms progressed rapidly in patients with high ESCC (P = 0.003). Conclusion: ESCC, SINS, and radiating pain were related to the occurrence of neurological symptoms, but not to severity. Only ESCC was associated with the rapid progression of neurological symptoms. This retrospective study provides useful insights in predicting a patient's functional prognosis and determining management using radiology and clinical data.

Intraoperative neurophysiologic monitoring (IONM) has been widely used to prevent nerve damage during spinal tumor surgery. However, when the tumor is located in the thoracic vertebrae, it is impossible to monitor lower motor neurons such as nerve roots by conventional methods. To solve this problem, the rectus abdominis muscle, which is innervated by the thoracic nerve root, can be used. We report a case using the rectus abdominis motor evoked potentials (MEP) and free-running electromyography in a patient with schwannoma located at the T12 thoracic vertebrae. During surgery, a reduction in MEP was seen upon removal of the tumor, but not less than 50%. Neurotonic discharge was seen upon removal of the tumor, but was not sustained. After the operation, the patient did not report any neurological symptoms. This case supports that MEP and free-running electromyography of the rectus abdominis muscle can be feasible for monitoring in thoracic spine surgery.