The Fugl-Meyer assessment (FMA) is the most popular instrument for evaluating upper extremity motor function in stroke patients. However, it is a labor-intensive and time-consuming method. This paper proposes a novel automated FMA system to overcome these limitations of the FMA. For automation, we used Kinect v2 and force sensing resistor sensors owing to their convenient installation as compared with body-worn sensors. Based on the linguistic guideline of the FMA, a rule-based binary logic classification algorithm was developed to assign FMA scores using the extracted features obtained from the sensors. The algorithm is appropriate for clinical use, because it is not based on machine learning, which requires additional learning processes with a large amount of clinical data. The proposed system was able to automate 79% of the FMA tests because of optimized sensor selection and the classification algorithm. In clinical trials conducted with nine stroke patients, the proposed system exhibited high scoring accuracy (92%) and time efficiency (85% reduction in clinicians' required time).
Background: Mixed reality (MR) technology, which combines the best features of augmented reality and virtual reality, has recently emerged as a promising tool in cognitive rehabilitation therapy. Objective: To investigate the effectiveness of an MR-based cognitive training system for individuals with mild cognitive impairment (MCI). Methods: Twenty-one individuals aged 65 years and older who had been diagnosed with MCI were recruited for this study and were divided into two groups. Participants in the MR group (n=10, aged 70.5±4.2 years) received 30 minutes of training 3 times a week for 6 weeks using a newly developed MR-based cognitive training system. Participants in the control group (n=11, aged 72.6±5.3 years) received the same amount of training using a conventional computer-assisted cognitive training system. Both groups took the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD-K) both before and after intervention. To determine the effect of the intervention on cognitive function, we compared the difference in each group’s CERAD-K scores. Results: There was a statistically significant interaction between intervention (MR group vs control group) and time (before vs after intervention) as assessed by the Constructional Recall Test. The individuals with MCI who participated in the MR training showed significantly improved performance in visuospatial working memory compared with the individuals with MCI who participated in the conventional training. Conclusion: An MR-based cognitive training system can be used as a cognitive training tool to improve visuospatial working memory in individuals with MCI.
Zero-dimensional–two-dimensional (0D–2D) hybrid optoelectronic devices have demonstrated high sensitivity and high performance due to the high absorption coefficient of 0D materials with a tunable detection range and a high carrier transport property of 2D materials. However, the reported 0D–2D hybrid devices employ toxic nanomaterials as sensitizing layers, which can limit the practical applications. In this study, we first fabricated the 0D–2D hybrid photodetector using nontoxic InP quantum dots (QDs) as a light-absorbing layer and black phosphorus (BP) as a transport layer. The surface treatment using 1,2-ethanedithiol and thermal treatment were carried out to remove the surface long ligands of colloidal QDs, which can accelerate the charge injection of the photogenerated carriers through the interfaces between InP QDs and BP. The InP QDs/BP hybrid photodetector demonstrates a high responsivity of 1 × 109 A/W and detectivity of 4.5 × 1016 Jones at 0.05 μW cm–2 under 405 nm illumination. The results show that 0D–2D hybrid photodetectors based on III–V semiconducting QD materials can be optimized for high-performance photodetectors.
Predicting functional outcome and quality of life (QOL) is critical to the treatment of patients with stroke. The purpose of this study was to analyze the factors influencing functional status and QOL of stroke patients 6 months after a first-ever stroke. This study was an interim analysis of the Korean Stroke Cohort for Functioning and Rehabilitation Study, designed to include 10 years of follow-up for first-ever stroke patients. This study analyzed data from 2857 patients who completed face-to-face assessments with the functional independence measurement (FIM) and Euro Quality of Life-5D (EQ-5D) at 6 months after stroke onset. A multivariate regression analysis was used to analyze factors that potentially influenced FIM and EQ-5D results at 6 months after stroke. Of the patients in this study, 80.1 % suffered from ischemic stroke and 19.9 % experienced hemorrhagic stroke. The independent predictors of functional independency measured by FIM at 6 months after stroke were age, initial stroke severity, duration of hospitalization, and functional level at discharge in terms of motor, ambulation, and language. For QOL measured by EQ-5D at 6 months after stroke, age, duration of hospitalization, and motor function at discharge were significant predictors. In conclusion, proper treatment to achieve maximal functional gain at discharge may be an important factor in improving functional independency and QOL in chronic stage stroke survivors. These results provide useful information for establishing comprehensive and systematic care for stroke patients.
Motor and sensory deficits after spinal cord injury (SCI) result in functional reorganization of the sensorimotor network. While several task-evoked functional magnetic resonance imaging (fMRI) studies demonstrated functional alteration of the sensorimotor network in SCI, there has been no study of the possible alteration of resting-state functional connectivity using resting-state fMRI. The aim of this study was to investigate the changes of brain functional connectivity in the sensorimotor cortex of patients with SCI. We evaluated the functional connectivity scores between brain areas within the sensorimotor network in 18 patients with SCI and 18 controls. Our findings demonstrated that, compared with control subjects, patients with SCI showed increased functional connectivity between primary motor cortex and other motor areas, such as the supplementary motor area and basal ganglia. However, decreased functional connectivity between primary somatosensory cortex and secondary somatosensory cortex also was found in patients with SCI, compared with controls. These findings therefore demonstrated alteration of the resting-state sensorimotor network in patients with SCI, who showed increased connectivity between motor components, and decreased connectivity between sensory components, within the sensorimotor network, suggesting that motor components within the motor network increased in functional connectivity in order to compensate for motor deficits, whereas the sensory network did not show any such increases or compensation for sensory deficits.
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