Search Results (18)

Background/Objectives: We present a case documenting the successful treatment for a patient with chronic low back pain (CLBP), chronic neck pain (CNP), and decreased quality of life improving after conservative therapy. CLBP has been the leading cause of disability globally for the past few decades, resulting in decreased quality of life physically and emotionally. This case is important in the medical literature to add to studies reporting successful conservative treatment of CLBP and CNP. Triage, diagnosis, and understanding of economical and conservative therapeutics can benefit patients; providers as well as institutions and third party payors benefit from improved outcomes. Methods: A 39-year old male presented with severe CLBP who had experienced no long-term success with prior chiropractic spinal manipulative therapy (SMT). After symptoms began to worsen in spite of receiving SMT, the patient sought treatment for his pain, abnormal spine alignment, and poor sagittal alignment at a local spine facility. History and physical examination demonstrated altered spine and postural alignment including significant forward head posture and reduced cervical and lumbar lordosis and coronal plane abnormalities. Treatment consisted of a multi-modal regimen focused on strengthening postural muscles, specific spine manipulation directed toward abnormal full-spine alignment, and specific Mirror Image® traction aiming to improve spine integrity by realigning the spine toward a more normal position. The treatment consisted of 36 treatments over three months. All original tests and outcome measures were repeated following care. Results: Objective and subjective outcome measures, patient-reported outcomes, and radiographic mensuration demonstrated improvement at the conclusion of treatment and maintained at 1-year follow-up re-examination. Conclusions: This case demonstrates that the CBP^® orthopedic chiropractic treatment approach may represent an effective method to treat abnormal spinal alignment and posture. This study adds to the literature regarding conservative methods of treating spine pain and spinal disorders. Full article

The apparent sizes of horizontal and vertical lines show an anisotropy known as the horizontal vertical illusion (HVI) wherein vertical lines appear to be longer than their horizontal counterparts. Whereas a typical HVI comparing vertical and horizontal lines in a plane produces a 5–10% illusion, a much larger-scale illusion (15–25%) is often found for large objects in the real world, and this has been related to differential angular exaggerations in perceived elevation (vertical) and azimuthal (horizontal) direction. Recently supine observers in virtual environments were found to show larger exaggerations in perceived azimuth than upright observers. Here, 48 participants were tested in both supine and upright postures in an outdoor environment while matching fairly small physical extents in the real world. They adjusted the magnitude of the horizontal extent to perceptually match fairly small vertical poles (0.7–1.3 m tall) that were either presented at the same viewing distance as the matching extent or in a different depth plane, so that size at a distance had to be compared. Supine observers viewed the scene, as though upright, through a large mirror mounted overhead at 45° that was adjusted to approximate their normal eye height. When the matcher extent was at a different distance than the pole, horizontal extent matches typically exceeded the actual pole height by about 15% or more, whether the viewer was upright or supine. The average overestimation was only about 10% when the matching extent was at the same distance. Despite the similarity in performance across different postures for spatial matching, supine observers gave much higher explicit estimates of azimuthal direction than upright observers. However, although the observation of exaggeration in perceived azimuth for supine observers was replicated in a second study with 24 additional participants using a mirror with a smaller (more normal) aspect ratio, the magnitude of the exaggeration seemed to be greatly reduced when the field of view of the apparatus had a more typical aspect ratio. This suggests that the unusually large exaggeration of azimuth found in a previous report with supine observers may have been caused by the unusually large aspect ratio of the viewing apparatus used. Full article

This study proposes a novel optical wireless communication system for high-speed, large-capacity data transmission, supporting underwater IoT devices in shallow seas. The system employs a mirror-equipped aerial drone as a relay between underwater drones and a terrestrial station, using 850 nm optical signals for low atmospheric loss and enhanced confidentiality. Adaptive modulation optimizes transmission capacity based on SNR, accounting for air and underwater channel characteristics. Experiments confirmed an exponential SNR decrease with distance (0.6–1.8 m) and demonstrated successful 4K UHD video streaming in shallow seawater (turbidity: 2.2 NTU) without quality loss. The design ensures cost-effectiveness and stable optical alignment using advanced posture control. Full article

The restoration of fine motor function in the hand is crucial for stroke survivors with hemiplegia to reintegrate into daily life and presents a significant challenge in post-stroke rehabilitation. Current mirror rehabilitation systems based on wearable devices require medical professionals or caregivers to assist patients in donning sensor gloves on the healthy side, thus hindering autonomous training, increasing labor costs, and imposing psychological burdens on patients. This study developed a low-load wearable hand function mirror rehabilitation robotic system based on visual gesture recognition. The system incorporates an active visual apparatus capable of adjusting its position and viewpoint autonomously, enabling the subtle monitoring of the healthy side’s gesture throughout the rehabilitation process. Consequently, patients only need to wear the device on their impaired hand to complete the mirror training, facilitating independent rehabilitation exercises. An algorithm based on hand key point gesture recognition was developed, which is capable of automatically identifying eight distinct gestures. Additionally, the system supports remote audio–video interaction during training sessions, addressing the lack of professional guidance in independent rehabilitation. A prototype of the system was constructed, a dataset for hand gesture recognition was collected, and the system’s performance as well as functionality were rigorously tested. The results indicate that the gesture recognition accuracy exceeds 90% under ten-fold cross-validation. The system enables operators to independently complete hand rehabilitation training, while the active visual system accommodates a patient’s rehabilitation needs across different postures. This study explores methods for autonomous hand function rehabilitation training, thereby offering valuable insights for future research on hand function recovery. Full article

Aimed at the problem of human–machine interaction between patients and robots in the process of using rehabilitation robots for rehabilitation training, this paper proposes a human–machine interactive control method based on an independently developed upper limb rehabilitation robot. In this method, the camera is used as a sensor, the human skeleton model is used to analyse the moving image, and the key points of the human body are extracted. Then, the three-dimensional coordinates of the key points of the human arm are extracted by depth estimation and spatial geometry, and then the real-time motion data are obtained, and the control instructions of the robot are generated from it to realise the real-time interactive control of the robot. This method can not only improve the adaptability of the system to individual patient differences, but also improve the robustness of the system, which is less affected by environmental changes. The experimental results show that this method can realise real-time control of the rehabilitation robot, and that the robot assists the patient to complete the action with high accuracy. The results show that this control method is effective and can be applied to the fields of robot control and robot-assisted rehabilitation training. Full article

This article presents a case that former President of the United States Donald Trump was a tyrant-like leader in the mold of the tyrant in Plato’s Republic. While he does not perfectly embody the tyrant as presented in the Republic, he captures its core feature. Like the tyrant, Trump is driven by unregulated desires that reflect what Plato describes as an extreme freedom that underlies and threatens democratic regimes. Extreme freedom is manifested in Trump’s disregard for social and legal norms, which mirrors the lawlessness of the tyrant. The people, in turn, interpret that posture as a mark of authenticity. Understanding Trump’s appeal in the United States helps alert friends of democracy to the possible rise of tyrant-like figures. In closing, and as a way of remedying the harm done by the tyrannical soul, the article recommends that society help temper tyrant-like passions in the people through a rededication to civic equality. Full article

Background/Objectives: Pathogenic variants in the deleted in colorectal cancer gene (DCC), encoding the Netrin-1 receptor, may lead to mirror movements (MMs) associated with agenesis/dysgenesis of the corpus callosum (ACC) and cognitive and/or neuropsychiatric issues. The clinical phenotype is related to the biological function of DCC in the corpus callosum and corticospinal tract development as Netrin-1 is implicated in the guidance of developing axons toward the midline. We report on a child with a novel inherited, monoallelic, pathogenic variant in the DCC gene. Methods: Standardized measures and clinical scales were used to assess psychomotor development, communication and social skills, emotional and behavioural difficulties. MMs were measured via the Woods and Teuber classification. Exome sequencing was performed on affected and healthy family members. Results: The patient’s clinical presentation during infancy consisted of paroxysmal dystonic posturing when asleep, mimicking nocturnal leg cramps. A brain magnetic resonance imaging (MRI) showed complete ACC. He developed typical upper limb MMs during childhood and a progressively evolving neuro-phenotype with global development delay and behavioural problems. We found an intrafamilial clinical variability associated with DCC mutations: the proband’s father and uncle shared the same DCC variant, with a milder clinical phenotype. The atypical early clinical presentation of the present patient expands the clinical spectrum associated with DCC variants, especially those in the paediatric age. Conclusions: This study underlines the importance of in-depth genetic investigations in young children with ACC and highlights the need for further detailed analyses of early motor symptoms in infants with DCC mutations. Full article

Falling is a major cause of morbidity, and is often caused by a decrease in postural stability. A key component of postural stability is whole-body centroidal angular momentum, which can be influenced by control moment gyroscopes. In this proof-of-concept study, we explore the influence of our wearable robotic gyroscopic actuator “GyroPack” on the balance performance and gait characteristics of non-impaired individuals (seven female/eight male, 30 ± 7 years, 68.8 ± 8.4 kg). Participants performed a series of balance and walking tasks with and without wearing the GyroPack. The device displayed various control modes, which were hypothesised to positively, negatively, or neutrally impact postural control. When configured as a damper, the GyroPack increased mediolateral standing time and walking distance, on a balance beam, and decreased trunk angular velocity variability, while walking on a treadmill. When configured as a negative damper, both peak trunk angular rate and trunk angular velocity variability increased during treadmill walking. This exploratory study shows that gyroscopic actuators can influence balance and gait kinematics. Our results mirror the findings of our earlier studies; though, with more than 50% mass reduction of the device, practical and clinical applicability now appears within reach. Full article

Forward head posture (FHP) is a common postural displacement that is significantly associated with neck pain, with higher risks of having neck pain in female and older populations. This study investigated the effect of two different forward head posture (FHP) interventions in elderly participants with poor posture and non-specific neck pain. Sixty-six elderly participants with a craniovertebral angle (CVA) < 50° were randomized into either a Chiropractic Biophyics^® (CBP^®) or a standardized exercise based FHP correction group (Standard Group). Both groups were treated for 18 sessions over a 6-week period. A 3-month post-treatment follow-up was also assessed with no further interventions. The CBP group received a mirror image^® exercise and a Denneroll™ cervical traction orthotic (DCTO); the standard group performed a protocol of commonly used stretching and strengthening exercises for the neck. Both groups received 30 min of their respective interventions per session. The primary outcome was the CVA, with secondary outcomes including pain intensity, Berg balance score (BBS), head repositioning accuracy (HRA), and cervical range of motion (CROM). After 18 sessions (6 weeks later), the CBP group had statistically significant improvement in the CVA (p < 0.001), whereas the standard group did not. In contrast, both groups showed improved functional measurements on the BBS and HRA as well as improved pain intensity. However, at the 3-month follow-up (with no further treatment), there were statistically significant differences favoring the CBP group for all outcomes (p < 0.001). The differences in the between group outcomes at the 3-month follow-up indicated that the improved outcomes were maintained in the CBP group, while the standard group experienced regression of the initially improved outcomes at 6 weeks. It is suggested that the improvement in the postural CVA (in the CBP group but not in the standard group) is the driver of superior and maintained pain and functional outcomes. Full article

The aim of this study was to investigate the feasibility and effect of a multimodal program for the management of chronic nonspecific neck pain CNSNP with the addition of a 3D adjustable posture corrective orthotic (PCO), with a focus on patient recruitment and retention. This report describes a prospective, randomized controlled pilot study with twenty-four participants with CNSNP and definite 3D postural deviations who were randomly assigned to control and study groups. Both groups received the same multimodal program; additionally, the study group received a 3D PCO to perform mirror image^® therapy for 20–30 min while the patient was walking on a treadmill 2–3 times per week for 10 weeks. Primary outcomes included feasibility, recruitment, adherence, safety, and sample size calculation. Secondary outcomes included neck pain intensity by numeric pain rating scale (NPRS), neck disability index (NDI), active cervical ROM, and 3D posture parameters of the head in relation to the thoracic region. Measures were assessed at baseline and after 10 weeks of intervention. Overall, 54 participants were screened for eligibility, and 24 (100%) were enrolled for study participation. Three participants (12.5%) were lost to reassessment before finishing 10 weeks of treatment. The between-group mean differences in change scores indicated greater improvements in the study group receiving the new PCO intervention. Using an effect size of 0.797, α > 0.05, β = 80% between-group improvements for NDI identified that 42 participants were required for a full-scale RCT. This pilot study demonstrated the feasibility of recruitment, compliance, and safety for the treatment of CNSNP using a 3D PCO to a multimodal program to positively affect CNSNP management. Full article

Dystonia diagnosis is based on clinical examination performed by a neurologist with expertise in movement disorders. Clues that indicate the diagnosis of a movement disorder such as dystonia are dystonic movements, dystonic postures, and three additional physical signs (mirror dystonia, overflow dystonia, and geste antagonists/sensory tricks). Despite advances in research, there is no diagnostic test with a high level of accuracy for the dystonia diagnosis. Clinical neurophysiology and genetics might support the clinician in the diagnostic process. Neurophysiology played a role in untangling dystonia pathophysiology, demonstrating characteristic reduction in inhibition of central motor circuits and alterations in the somatosensory system. The neurophysiologic measure with the greatest evidence in identifying patients affected by dystonia is the somatosensory temporal discrimination threshold (STDT). Other parameters need further confirmations and more solid evidence to be considered as support for the dystonia diagnosis. Genetic testing should be guided by characteristics such as age at onset, body distribution, associated features, and coexistence of other movement disorders (parkinsonism, myoclonus, and other hyperkinesia). The aim of the present review is to summarize the state of the art regarding dystonia diagnosis focusing on the role of neurophysiology and genetic testing. Full article

(1) Background: Mirror therapy is one of the promising interventions for the upper limb rehabilitation of stroke patients. Postural asymmetry during mirror therapy was pointed out as a possibility to influence stroke patients’ rehabilitation negatively. However, it is still difficult to find studies on the postural changes in mirror therapy concept interventions. This study compared three methods of postural differences as follows: traditional mirror therapy (mirror); displaying the real-time movement of the unaffected side on the screen above the affected side (screen); and playing a pre-recorded movement of the unaffected side on a tablet placed on a movable box where the affected hand is put inside (movable). (2) Methods: to observe a kinematic difference, we recruited 16 healthy volunteers to go through three different interventions (mirror, screen, movable). The motion capture system made observations on the postures before and during interventions, then compared and analyzed. (3) Results: while using the mirror, the sitting posture was observed to become asymmetric, and the following unique posture was observed where the target hand went further from the trunk while performing tasks. In addition, the shoulder of the target side came forward, and the difference between both elbow flexion angles was also observed. On the other hand, the screen or movable device did not cause a significant change in the sitting posture, and no additional postural differences were observed either. (4) Conclusions: mirror therapy showed a tendency to cause lateral flexion opposite the target hand, thus, creating additional postural change. However, developed methods controlled spine tilt, and enabled the keeping of the midline while sitting during the intervention. Full article

More innovative technologies are used worldwide in patient’s rehabilitation after stroke, as it represents a significant cause of disability. The majority of the studies use a single type of therapy in therapeutic protocols. We aimed to identify if the association of virtual reality (VR) therapy and mirror therapy (MT) exercises have better outcomes in lower extremity rehabilitation in post-stroke patients compared to standard physiotherapy. Fifty-nine inpatients from 76 initially identified were included in the research. One experimental group (n = 31) received VR therapy and MT, while the control group (n = 28) received standard physiotherapy. Each group performed seventy minutes of therapy per day for ten days. Statistical analysis was performed with nonparametric tests. Wilcoxon Signed-Rank test showed that both groups registered significant differences between pre-and post-therapy clinical status for the range of motion and muscle strength (p < 0.001 and Cohen’s d between 0.324 and 0.645). Motor Fugl Meyer Lower Extremity Assessment also suggested significant differences pre-and post-therapy for both groups (p < 0.05 and Cohen’s d 0.254 for the control group and 0.685 for the experimental group). Mann-Whitney results suggested that VR and MT as a therapeutic intervention have better outcomes than standard physiotherapy in range of motion (p < 0.05, Cohen’s d 0.693), muscle strength (p < 0.05, Cohen’s d 0.924), lower extremity functionality (p < 0.05, Cohen’s d 0.984) and postural balance (p < 0.05, Cohen’s d 0.936). Our research suggests that VR therapy associated with MT may successfully substitute classic physiotherapy in lower extremity rehabilitation after stroke. Full article

We propose a new secondary mirror support structure assisted by multi-robotics to improve the observation performance of vehicle-mobile telescope systems. A mathematical model of the displacement at the end of the robotic and the variation of telescope pitch angle is established, then the posture of the robotic is optimized by the Jacobian matrix iteration inverse kinematic problem method. Based on the new support structure, a high-order sensitivity matrix is proposed to establish the mapping relationship between the robotic misalignment and the Zernike coefficient, with the accuracy verified via the Monte Carlo method. The method of adjusting the secondary mirror to compensate the aberration caused by the primary mirror is proposed, and the relationship between the primary mirror surface error and the system error is established under different pitch angles before and after compensation. The experiment and simulation results showed that the adjustment calculated by the high-order sensitivity matrix method can effectively compensate for the misalignment caused by the robotics and the primary mirror surface error to a certain degree. After multiple iterations, the root mean square of the wavefront aberration was better than $\lambda /15$. This conclusion provides an engineering application reference value for the secondary mirror support and aberration correction technology of the vehicle telescope system. Full article

In humans, physiological systems involved in maintaining stable conditions for health and well-being are complex, encompassing multiple interactions within and between system components. This complexity is mirrored in the temporal structure of the variability of output signals. Entropy has been recognized as a good marker of systems complexity, notably when calculated from heart rate and postural dynamics. A degraded entropy is generally associated with frailty, aging, impairments or diseases. In contrast, high entropy has been associated with the elevated capacity to adjust to an ever-changing environment, but the link is unknown between entropy and the capacity to cope with cognitive tasks in a healthy young to middle-aged population. Here, we addressed classic markers (time and frequency domains) and refined composite multiscale entropy (MSE) markers (after pre-processing) of heart rate and postural sway time series in 34 participants during quiet versus cognitive task conditions. Recordings lasted 10 min for heart rate and 51.2 s for upright standing, providing time series lengths of 500–600 and 2048 samples, respectively. The main finding was that entropy increased during cognitive tasks. This highlights the possible links between our entropy measures and the systems complexity that probably facilitates a control remodeling and a flexible adaptability in our healthy participants. We conclude that entropy is a reliable marker of neurophysiological complexity and adaptability in autonomic and somatic systems. Full article