Coronavirus disease 2019 (COVID‐19) has widely spread all over the world and the numbers of patients and deaths are increasing. According to the epidemiology, virology, and clinical practice, there are varying degrees of changes in patients, involving the human body structure and function and the activity and participation. Based on the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) and its biopsychosocial model of functioning, we use the WHO Family of International Classifications (WHO‐FICs) framework to form an expert consensus on the COVID‐19 rehabilitation program, focusing on the diagnosis and evaluation of disease and functioning, and service delivery of rehabilitation, and to establish a standard rehabilitation framework, terminology system, and evaluation and intervention systems based the WHO‐FICs.
BackgroundSwallowing is a continuous process with substantive interdependencies among different muscles, and it plays a significant role in our daily life. The aim of this study was to propose a novel technique based on high-density surface electromyography (HD sEMG) for the evaluation of normal swallowing functions.MethodsA total of 96 electrodes were placed on the front neck to acquire myoelectric signals from 12 healthy subjects while they were performing different swallowing tasks. HD sEMG energy maps were constructed based on the root mean square values to visualize muscular activities during swallowing. The effects of different volumes, viscosities, and head postures on the normal swallowing process were systemically investigated by using the energy maps.ResultsThe results showed that the HD sEMG energy maps could provide detailed spatial and temporal properties of the muscle electrical activity, and visualize the muscle contractions that closely related to the swallowing function. The energy maps also showed that the swallowing time and effort was also explicitly affected by the volume and viscosity of the bolus. The concentration of the muscular activities shifted to the opposite side when the subjects turned their head to either side.ConclusionsThe proposed method could provide an alternative method to physiologically evaluate the dynamic characteristics of normal swallowing and had the advantage of providing a full picture of how different muscle activities cooperate in time and location. The findings from this study suggested that the HD sEMG technique might be a useful tool for fast screening and objective assessment of swallowing disorders or dysphagia.
BackgroundThe current paradigm for cord blood transplantation is that HLA matching and immune suppression are strictly required to prevent graft versus host disease (GVHD). Immunological arguments and historical examples have been made that the use of cord blood for non-hematopoietic activities such as growth factor production, stimulation of angiogenesis, and immune modulation may not require matching or immune suppression.Methods114 patients suffering from non-hematopoietic degenerative conditions were treated with non-matched, allogeneic cord blood. Doses of 1-3 × 107 cord blood mononuclear cells per treatment, with 4-5 treatments both intrathecal and intravenously were performed. Adverse events and hematological, immunological, and biochemical parameters were analyzed for safety evaluation.ResultsNo serious adverse effects were reported. Hematological, immunological, and biochemical parameters did not deviate from normal ranges as a result of therapy.ConclusionThe current hematology-based paradigm of need for matching and immune suppression needs to be revisited when cord blood is used for non-hematopoietic regenerative purposes in immune competent recipients.
Unilateral peripheral facial paralysis (UPFP) is a form of facial nerve paralysis and clinically classified according to conditions of facial symmetry. Prompt and precise assessment is crucial to neural rehabilitation of UPFP. The prevalent House-Brackmann (HB) grading system relies on subjective judgments with significant interobservation variation. Therefore, to explore an objective method for the UPFP assessment, clinical image sequences are captured using a web camera setup while 5 healthy and 27 UPFP subjects perform a group of predefined actions, including keeping expressionless, raising brows, closing eyes, bulging cheek, and showing teeth in turn. First, facial region is decided using Haar cascade classifier, and then landmark points are acquired by a supervised descent method. Second, these landmark points are used to generate a group of features reflecting the structural parameters of regions of eyebrows, eyes, nose, and mouth, respectively. Third, correlation coefficients are computed between the raw features HB scores. To reduce feature dimensions, only those with correlation coefficients larger than an empirically selected value, 0.35, are input into a support vector machine to generate a classifier. With the classifier, exact match (discrepancy = 0 between result from proposed method and HB scores) rate at 49.9%, and loose match (discrepancy = 1) rate at 87.97% are achieved on the experiment data. After sample augmentation, the final rate is increased to 90.01%, outperformed previous reports. In conclusion, it is demonstrated with an unobtrusive web camera setup, encouraging results have been generated with the proposed framework in this exploratory study.
BackgroundThe differential diagnosis for hereditary ataxia encompasses a variety of diseases characterized by both autosomal dominant and recessive inheritance. There are no curative treatments available for these neurodegenerative conditions. This open label treatment study used human umbilical cord blood-derived mononuclear cells (CBMC) combined with rehabilitation training as potential disease modulators.Methods30 patients suffering from hereditary ataxia were treated with CBMCs administered systemically by intravenous infusion and intrathecally by either cervical or lumbar puncture. Primary endpoint measures were the Berg Balance Scale (BBS), serum markers of immunoglobulin and T-cell subsets, measured at baseline and pre-determined times post-treatment.ResultsA reduction of pathological symptoms and signs was shown following treatment. The BBS scores, IgG, IgA, total T cells and CD3+CD4 T cells all improved significantly compared to pre-treatment values (P < 0.01~0.001). There were no adverse events.ConclusionThe combination of CBMC infusion and rehabilitation training may be a safe and effective treatment for ataxia, which dramatically improves patients' functional symptoms. These data support expanded double blind, placebo-controlled studies for these treatment modalities.
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