Rehabilitation Methods Research Articles

Analysis of electroencephalography characteristics during walking in stroke patients under different conditions: a cross-sectional study.

Aims/Background Backward walking is gaining traction in rehabilitation therapy, showing promise as an intervention for stroke patients with walking difficulties. However, the brain activity patterns (neurophysiological mechanisms) underlying backward walking in these patients remain unclear. This study investigated the neurophysiological mechanism in stroke patients within 1 year of their stroke. Methods Twenty-four subjects walked forward and backward for 5 min on an 8-m track while their electroencephalographic signals were collected. The power values of each frequency band were compared during forward and backward walking, and the delta to alpha power ratio (DAR) was calculated. Results The results showed a significant increase in α-band activity within the frontal cortex during backward walking (p < 0.05). This increase correlated positively with scores on the Fugl-Meyer lower extremity motor function assessment scale. Similarly, α-band activity showed significant enhancement within the right parietal cortex during backward walking (p < 0.05). There were no significant differences between forward and backward walking states in δ, θ, and β wavebands across the entire brain region (p > 0.05). Additionally, the DAR was significantly lower during backward walking than during forward walking (p < 0.05). Conclusion This study suggests that backward walking may more effectively activate neural activity in the prefrontal and right posterior parietal cortices. This finding supports the potential of backward walking to enhance motor execution and walking function in stroke patients, thereby supporting its application as a rehabilitation method.

Relationship between postoperative rehabilitation style, gastrointestinal function, and inflammatory factor levels in children with intussusception.

Intussusception occurs in children and progresses rapidly. If not treated in time, it may lead to secondary complications such as intestinal perforation, which affect the quality of life and health of children. Surgery is the most common clinical treatment and has a good effect. However, the postoperative prognosis of children with intussusception has a correlation with the postoperative rehabilitation method. Therefore, in this study, we explored the relationship between postoperative rehabilitation, gastrointestinal function, and the expression of inflammatory factors in children with intussusception. To explore the relationship between postoperative rehabilitation, gastrointestinal function, and inflammatory factor levels in children with intussusception. The medical records of 18 children who were admitted to our hospital for intussusception surgery between October 2022 and May 2024 were retrospectively reviewed. The patients were divided into the routine nursing group (n = 6) and rehabilitation training group (n = 12) according to the postoperative rehabilitation method. The general data, gastrointestinal function, and inflammatory factor levels of the two groups were statistically analyzed. Pearson correlation analysis of gastrointestinal function, inflammatory factors, and postoperative rehabilitation was performed. We found no significant intergroup differences in sex, age, or disease course (P > 0.05). The times to first defecation, bowel sound recovery, and anal exhaust were shorter and inflammatory factor levels were lower in the rehabilitation training group than in the routine nursing group (P < 0.05). Pearson correlation analysis showed that gastrin and motilin levels were positively correlated with postoperative rehabilitation (P < 0.05). Interleukin (IL)-2, IL-4, IL-6, IL-10, high-sensitivity C-reactive protein, and tumor necrosis factor-α levels were negatively correlated with postoperative rehabilitation (P < 0.05). Gastrointestinal function was positively correlated (P < 0.05), and levels of inflammatory factors were negatively correlated with postoperative recovery time (P < 0.05). We found a positive correlation between gastrointestinal function and postoperative rehabilitation training, and a negative correlation between inflammatory factor levels and rehabilitation training in children with intussusception.

Reconnecting Anisometropic Amblyopic Eyes to the Cortex: VEP-Based Auditory Biofeedback.

This study aimed to evaluate the effectiveness of a visual rehabilitation method for anisometropic amblyopia that uses visual evoked potential (VEP) parameters and sound biofeedback to increase objectiveness. an observational, case-controlled trial. Ophthalmology Clinic, Emergency County Hospital, Cluj-Napoca, Romania. Sixteen subjects with amblyopic anisometropia, aged 15-57, and sixteen controls, aged 24-33, were included. Subjects were divided into two groups. The control group, composed of normal-vision subjects, and the amblyopic group received 10 training sessions. The rehabilitation program lasted 10 min, took place twice a week, and ran over five consecutive weeks. During each session, the subjects were asked to fixate on a target on the computer screen and were instructed to keep the fixation and maintain the sound of the biofeedback at high frequency. The study assessed the main visual parameters at baseline, after 10 sessions, and 1, 3, 6, and 12 months after treatment. Performance was evaluated by measuring visual acuity, contrast sensitivity, and reading velocity (words/minute). In the experimental group, mean BCVA improved with two rows, which means an improvement in the LogMARLogMAR scale with an average of nine letters. These values tended to be maintained over time. Both groups showed better reading velocities after training, but this parameter has undergone large variability during follow-ups. Contrast sensitivity was also improved and stable. Visual rehabilitation with the Retimax Vision Trainer can improve visual performance in patients with amblyopia after the critical period, an improvement that is maintained in most cases for at least one year after treatment.

A review of functional electrical stimulation based on brain-computer interface

Individuals with motor dysfunction caused by damage to the central nervous system are unable to transmit voluntary movement commands to their muscles, resulting in a reduced ability to control their limbs. However, traditional rehabilitation methods have problems such as long treatment cycles and high labor costs. Functional electrical stimulation (FES) based on brain-computer interface (BCI) connects the patient's intentions with muscle contraction, and helps to promote the reconstruction of nerve function by recognizing nerve signals and stimulating the moving muscle group with electrical impulses to produce muscle convulsions or limb movements. It is an effective treatment for sequelae of neurological diseases such as stroke and spinal cord injury. This article reviewed the current research status of BCI-based FES from three aspects: BCI paradigms, FES parameters and rehabilitation efficacy, and looked forward to the future development trend of this technology, in order to improve the understanding of BCI-based FES.

Behavior of self-sensing masonry structures exposed to high temperatures and rehydration

High temperatures can compromise the structural integrity of structural masonry. Therefore, assessing the post-fire mechanical behavior is crucial for selecting suitable rehabilitation methods. Recent research has proposed the application of self-sensing cementitious composites for monitoring strains, stresses, and damage of structural masonry in room temperature. No previous research has been found on the self-sensing performance of fire-damaged masonry prisms exposed to elevated temperatures, with or without subsequent rehydration. Masonry prisms with integrated self-sensing joints and blocks were produced and exposed to different maximum temperature levels, followed or not by rehydration. Then, experimental tests for determination of compressive strength, modulus of elasticity, gauge factor (GF) and damage-detection performance were carried out. The exposure to 300 ºC caused a 7.4 % decrease in compressive strength and a 44.5 % reduction in elastic modulus. Rehydration methods had negligible effects in this case. After 600 ºC, substantial reductions of 42.2 % in compressive strength and 81.5 % in elastic modulus occurred. In this case, rehydration led to a 15.9 % increase in compressive strength and a 117.4 % increase in elastic modulus. Regardless of the exposure temperature, the predominant rupture mode initiated by vertical cracks originating at the block-mortar interfaces. After 300 ºC, slight GF increases occurred due to the thermal decomposition of hydrates of the cementitious matrix, while exposure to 600 ºC resulted in high GF increases due to partial oxidation of nanomaterials and substantial microcracking propagation. Post-fire curing improved the GF by sealing microcracks with nonconductive rehydration products and enhancing tunneling conduction mechanisms. The self-sensing prisms also demonstrated the ability for real-time damage detection and quantification, providing valuable predictive insights into the propagation of damage.

MRehab: A Mixed Reality Rehabilitation System Supporting Integrated Speech and Hand Training

Integrated speech and hand-motor training is an effective post-stroke rehabilitation method. However, few interactive systems and assistive technologies were developed in this field. Driven by this challenge, we leverage Mixed Reality technology, which merges immersive virtual scenarios with physical hands-on tools in the real world, to provide patients with multi-modal interactions and engaging training experiences. Following a user-centered design approach, we first interviewed seven therapists to identify user requirements and design considerations. We further designed MRehab, an interactive rehabilitation system that allows patients to regain speech and hand skills through MR scenarios that depict daily living activities. We conducted a preliminary user test with 12 patients and 5 therapists to validate the feasibility and understand the user experience with MRehab. The results confirmed its feasibility for hand-motor training. Additionally, the patients expressed high motivation, engagement, and a positive attitude toward using MRehab. Our findings demonstrate the potential of MR technology in integrated speech and hand function rehabilitation training.

Dual PGPR-AMF Inoculation Offsets Salinity Stress Impact on the Fodder Halophyte Sulla carnosa by Concomitantly Modulating Plant ABA Content and Leaf Antioxidant Response

AbstractSalt-tolerant microbes are known to mitigate various biotic and abiotic stresses in plants. However, the intimate mechanisms involved, as well as their effects on the production of signaling molecules associated with the host plant–microbe interaction remain largely unknown. The present work aimed to investigate the role and potential uses of arbuscular mycorrhizal fungi (AMF) Rhizophagus intraradices and/or halotolerant plant growth-promoting rhizobacteria (PGPR) Bacillus subtilis in improving plant growth, functional biochemical synthesis and signaling of endogenous abscisic acid during plant response to short- and long-term salt stress in the forage halophyte Sulla carnosa. Plant growth attributes and biochemical traits were determined at 2 different time intervals (45 and 60 d after transplanting time) when salinity was raised from 100 to 200 mM NaCl. S. carnosa showed significant reduction in dry biomass in response to NaCl stress at the second harvest (200 mM NaCl); however inoculating plants with B. subtilis alone or associated with R. intraradices offset salt impact. Leaf electrolyte leakage was significantly increased by salinity but was significantly reduced following dual microbial inoculation. The applied bacterial inoculants also mitigated oxidative stress as reflected by the higher activities of catalase (APX) and superoxide dismutase (SOD) antioxidant enzymes and reduced H2O2 level. Inoculation with B. subtilis and R. intraradices upregulated 9-cisepoxycarotenoid dioxygenase 1 (NCED1) and SOD genes expression in S. carnosa plants upon salinity treatment. Furthermore, dual AMF-PGPR -inoculated plants accumulated significantly higher levels of abscisic acid (ABA) in both leaves and roots than non-inoculated and single inoculated plants under salinity stress at both harvest times, thereby accounting for their higher salt tolerance of salt-challenged S. carnosa plants. As a whole, the use of halophytic plants associated with beneficial soil microorganisms could improve the effectiveness of biological methods for saline soil rehabilitation. At the mechanistic level, ABA might represent a key player in the attenuation of salt impact in inoculated plants.

Review of Baduanjin and resistance exercise for the mental health of patients with hematologic malignancies.

Patients with hematological tumors experience physical and psychological stress, and negative psychological states. Baduanjin, an emerging psychological rehabilitation method combined with resistance exercise, has received widespread attention. This study reviews the current status of the application of Baduanjin combined with resistance exercise in improving the negative psychological state of patients with hematological tumors and discusses its problems and prospects. Through a literature review and comprehensive analysis, the application of Baduanjin and resistance exercise in the psychological rehabilitation of patients with hematological tumors was identified and evaluated. The results showed that Baduanjin with resistance exercise had a positive effect on improving negative psychological states of patients with hematological tumors, which can alleviate anxiety, depression, and other adverse emotions, and improve quality of life. However, there is a lack of unified and standardized exercise intervention programs for practical application, and patient participation and compliance must be improved. Baduanjin combined with resistance exercise can potentially improve the negative psychological status of patients with hematological tumors; however, it is still necessary to further standardize and improve the exercise program improving patient participation and compliance. Future studies should strengthen theoretical exploration and empirical research, providing more effective psychological rehabilitation strategies for patients with hematological tumors.

Walking representation and simulation based on multi-source image fusion and multi-agent reinforcement learning for gait rehabilitation

In the formulation of strategies for walking rehabilitation, achieving precise identification of the current state and making rational predictions about the future state are crucial but often unrealized. To tackle this challenge, our study introduces a unified framework that integrates a novel 3D walking motion capture method using multi-source image fusion and a walking rehabilitation simulation approach based on multi-agent reinforcement learning. We found that, (i) the proposal achieved an accurate 3D walking motion capture and outperforms other advanced methods. Experimental evidence indicates that, compared to similar visual skeleton tracking methods, the proposed approach yields results with higher Pearson correlation (r=0.93), intra-class correlation coefficient (ICC(2,1)=0.91), and narrower confidence intervals ([0.90,0.95] for r, [0.88,0.94] for ICC(2,1)) when compared to standard results. The outcomes of the proposed approach also exhibit commendable correlation and concurrence with those obtained through the IMU-based skeleton tracking method in the assessment of gait parameters ([0.85,0.89] for r, [0.75,0.81] for ICC(2,1)); (ii) multi-agent reinforcement learning has the potential to be used to solve the simulation task of gait rehabilitation. In mimicry experiment, our proposed simulation method for gait rehabilitation not only enables the intelligent agent to converge from the initial state to the target state, but also observes evolutionary patterns similar to those observed in clinical practice through motor state resolution. This study offers valuable contributions to walking rehabilitation, enabling precise assessment and simulation-based interventions, with potential implications for clinical practice and patient outcomes.

Clinical application research of intelligent monitoring system for knee rehabilitation: a randomized controlled trial

BackgroundThis study investigates the effectiveness of a self-developed intelligent monitoring system for home-based knee rehabilitation following total knee arthroplasty (TKA).MethodsIn this randomized controlled trial, 120 patients undergoing TKA were divided using random digit allocation. Preoperative and one-month postoperative assessments of knee function, quality of life, and isometric knee extension strength were conducted with the Intelligent Monitoring System. Patients received group-specific rehabilitation instructions pre-discharge and performed exercises for one month.ResultsChanges in isometric knee extensor strength on the affected side within one month post-surgery for the brace-monitored rehabilitation group showed a significant decrease three days after surgery compared to one day before surgery. Subsequent measurements taken at postoperative days 5, 7, 14, and 21 indicated a gradual increase in strength, although these increases did not reach statistical significance when compared with previous measurements. One month post-surgery, all groups demonstrated significant improvements in knee joint function and mobility compared to pre-surgery levels. Notably, the brace-monitored group showed statistically significant improvements in 36-Item Short-Form Health Survey (SF-36) scores over the conventional rehabilitation group.ConclusionsThe Intelligent Monitoring System provides effective real-time monitoring and guidance for home-based knee rehabilitation post-TKA. It significantly enhances knee joint function, isometric knee extension strength, and quality of life shortly after surgery compared to traditional rehabilitation methods. This system offers a promising approach for improving postoperative recovery in TKA patients.Trial registrationThis study was approved by the Medical Ethics Committee of Xiangya Hospital, Central South University (Ethics Approval Number 202209008-2). It was registered with the China Clinical Trial Registry, a primary registry of the World Health Organization’s International Clinical Trials Registry Platform (Registration Number ChiCTR2300068852).

Neurodevelopmental technologies in the medical rehabilitation of children with the consequences of perinatal damage to the central nervous system

Abstract. Modern medicine focuses on the development of effective methods of medical rehabilitation of children with perinatal damage to the central nervous system, which is due to the high risk of the formation of persistent motor disorders and disability of such patients. A promising area of physical rehabilitation of children with the consequences of perinatal CNS damage is the development and scientific substantiation of neurodevelopmental technologies. The purpose. Analyze scientific publications on the use of neurodevelopmental technologies in the medical rehabilitation of children with perinatal central nervous system damage. Material and methods. The selection of publications for the literature review was carried out using the main databases eLibrary, PubMed, Cochrane Library with a search depth of 10 years. Results. Based on the analysis, data on the beneficial effect of neurodevelopmental technologies on muscle tone, motor development indicators, postural balance are presented, and their contribution to the formation of age-related motor skills in children with the consequences of perinatal central nervous system damage is established. In comparative studies, the advantage of Bobat therapy in initial hypertension and Voita therapy in patients with hypotension has been revealed.

Long COVID Brain Fog Treatment: Findings from a Pilot Randomized Controlled Trial of Constraint-Induced Cognitive Therapy.

Long COVID brain fog is often disabling. Yet, no empirically-supported treatments exist. This study's objectives were to evaluate feasibility and efficacy, provisionally, of a new rehabilitation approach, Constraint-Induced Cognitive Therapy (CICT), for post-COVID-19 cognitive sequelae. Sixteen community-residents ≥ 3-months post-COVID-19 infection with mild cognitive impairment and dysfunction in instrumental activities of daily living (IADL) were enrolled. Participants were randomized to Immediate-CICT or treatment-as-usual (TAU) with crossover to CICT. CICT combined behavior change techniques modified from Constraint-Induced Movement Therapy with Speed of Processing Training, a computerized cognitive-training program. CICT was deemed feasible if (a) ≥80% of participants completed treatment, (b) the same found treatment highly satisfying and at most moderately difficult, and (c) <2 study-related, serious adverse-events occurred. The primary outcome was IADL performance in daily life (Canadian Occupational Performance Measure). Employment status and brain fog (Mental Clutter Scale) were also assessed. Fourteen completed Immediate-CICT (n=7) or TAU (n=7); two withdrew from TAU before their second testing session. Completers were [M (SD)]: 10 (7) months post-COVID; 51 (13) years old; 10 females, 4 males; 1 African American, 13 European American. All the feasibility benchmarks were met. Immediate-CICT, relative to TAU, produced very large improvements in IADL performance (M=3.7 points, p<.001, d=2.6) and brain fog (M=-4 points, p<.001, d=-2.9). Four of five non-retired Immediate-CICT participants returned-to-work post-treatment; no TAU participants did, p=.048. CICT has promise for reducing brain fog, improving IADL, and promoting returning-to-work in adults with Long COVID. Findings warrant a large-scale RCT with an active-comparison group.

Seismic rehabilitation of RC frames with innovative precast U-shaped UHPC jackets: Experimental evaluation and computational simulation

The rehabilitation of post-earthquake reinforced concrete (RC) frames is crucial for both restoring structural integrity and enhancing seismic resilience against future seismic events. Ultra-high-performance concrete (UHPC) is distinguished by its exceptional strength, crack-control capabilities, ductility, and durability. Despite numerous studies on its use for structural retrofitting, its application in rehabilitating damaged RC frames remains limited. This study introduced a novel precast U-shaped UHPC jacket designed for the post-earthquake rehabilitation of RC frames. The jacketing method promotes composite action in rehabilitated members through lap splicing and dowel bars, complemented by cast-in-place connections using UHPC to minimize splice length and strengthen potential weak areas under external loads. The efficacy of this jacketing approach was rigorously evaluated through cyclic loading experiments on two RC frame specimens. Results indicated that the UHPC rehabilitation method not only recovered but significantly enhanced the seismic performance of the previously damaged frame, improving initial stiffness, yield strength, peak strength, displacement ductility, and energy dissipation capacity. However, the rehabilitated frame showed a reduced yield drift and increased residual displacement compared to the as-built frame. The experimental results also revealed the necessity of accounting for bond slip in structural rehabilitation analysis and design to prevent overestimating lateral stiffness. Furthermore, the study developed a computational model that incorporates flexure, bond slip, and shear responses, aiming to effectively simulate the load-displacement behavior of rehabilitated RC frames with reasonable accuracy.

Factors influencing limb movements in post-stroke patients

BackgroundStroke is the leading cause of long-term disability impacting patients’ daily lives. Adequate and ongoing rehabilitation is a necessity. Due to disability problems, rehabilitation in the health care system is limited. Traditional medicine has been promoted in Thailand for stroke rehabilitation, with physical therapy as the primary treatment plan. However, despite more options, many patients still receive inadequate rehabilitation. The development of an appropriate rehabilitation model is still necessary. This study aims to study factors influencing limb movements in post-stroke patients.MethodsThis cross-sectional study comprised 120 ischemic stroke patients obtained by multi-stage sampling in Muang district, Phitsanulok province. The data were collected using questionnaires with Cronbach’s alpha coefficient of 0.89. The ability to move the muscles of the limbs of the patients was assessed using the motor power assessment form, and binary logistic regression statistics analyzed the factors influencing limb movements.ResultData analysis shows that 76% of the stroke patients were female, 39.3% aged 61–70 years had a mean of 62 years and a standard deviation (S.D.) of 8.9, 4.6% of stroke patients had a duration of illness of 6–12 months, and 94.2% had a caregiver. 53.1% received rehabilitation once a week, and 92.5% received Thai massage. Thai traditional medicine utilization methods consist of Thai massage, herbal compresses, herbal steam, and taking herbal medicines. There are two factors influencing the ability to move the limb muscles of stroke patients as follows: (1) the massage with the Thai traditional medicine rehabilitation method (Adj OR = 28.917, p-value = 0.006) and (2) the number of rehabilitation sessions per week (Adj OR = 2.465, p-value < 0.001). These two variables explain the variance of regaining limb movement among post-stroke patients of 42.5% at a significance level of 0.05. In this analysis, the predictive accuracy was 70%.ConclusionRehabilitation using Thai massage, together with the number of rehabilitation sessions per week, influenced the ability of limb movement in post-stroke patients. In other words, increasing the number of rehabilitation times per week and using Thai massage in rehabilitation will help stroke patients move their limbs better.

Effects of modified oropharyngeal exercises on individuals with simple snoring: An online randomized controlled trial.

Individuals who suffer from simple snoring rarely go to a doctor due to a lack of medical knowledge, but simple snoring can reduce the individual's quality of life and may cause social problems to the bed partner/family members. The aims of the present study are to explore the effects of online modified oropharyngeal exercises on the individuals with simple snoring and to provide a rehabilitation method for individuals with simple snoring. This study is a double-blinded, two-arm, randomized controlled trial. Participants were enrolled and randomly assigned to the intervention group (n = 33) or the control group (n = 33). The participants in the control group received health education on snoring, while the participants in the intervention group received the modified oropharyngeal exercise besides health education on snoring. The intervention duration was 4 weeks. The primary outcomes included snoring index, snoring loudness, and snoring quantity. The secondary outcomes included self-reported snoring, sleep quality, daytime sleepiness, anxiety symptoms, depression symptoms, and quality of life. All outcomes were measured at baseline, 4 weeks, and 8 weeks. Generalized estimating equations (GEE) analyses showed significant differences between the intervention group and the control group on snoring index, loudness, and quantity (p < .001). Moreover, modified oropharyngeal exercise had effects on sleep quality, daytime sleepiness, anxiety symptoms, depression symptoms, and quality of life in individuals with simple snoring (p < .001). Self-reported snoring also improved at 8 weeks. The modified oropharyngeal exercises were effective in improving simple snoring. It could also improve sleep quality, daytime sleepiness, anxiety symptoms, depression symptoms, and quality of life.

The efficacy of virtual reality-based rehabilitation in improving motor function in patients with stroke: a systematic review and meta-analysis.

Stroke is a major cause of adult disability, prompting the exploration of innovative rehabilitation methods. Virtual rehabilitation (VR), leveraging technological advances, has gained popularity as a treatment for stroke recovery. The authors conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) published in English within the last decade, adhering to the PRISMA guidelines. The authors searched databases such as Medline/PubMed, and the Cochrane Library using specific search keywords and Medical Subject Headings (MeSH). The methodological quality was assessed using the PEDro scale, focusing on RCTs involving adult stroke patients undergoing VR rehabilitation, with outcomes related to motor function and quality of life. The authors included 15 studies in our meta-analysis. VR rehabilitation offers several advantages over traditional therapy, such as enhanced feedback and increased patient motivation. Engaging VR environments helps improve focus during treatment, potentially boosting recovery from post-stroke impairments. VR therapies significantly benefit motor function, which can improve activities of daily living and overall quality of life. VR has demonstrated efficacy in improving motor function and quality of life for stroke survivors. Future research should explore patient variability and refine intervention methods. Incorporating VR into rehabilitation programs could optimize stroke recovery outcomes.

Effective and ineffective strategies for successful rehabilitation: A comparison of activities in juvenile and adult facilities

This article discusses social rehabilitation among adults and minors, comparing methods used in penitentiary units and facilities for adolescents in conflict with the law. The research underlying this article was conducted in two stages: first, through study visits by the Criminological Scientific Club of the University of Warsaw, followed by a series of structured interviews. This approach enabled the authors to determine what works and what does not in the social rehabilitation system. The research revealed that in prisons, the most beneficial factors for convicts are work opportunities and family contact. In turn, for units housing minors, measurable benefits come from education tailored to the child’s learning level and educational outreach beyond the facility walls. However, the authors attributed the failures to the slow work of the courts, which prolongs the time needed to send adolescents to the facility, and to the lack of proper supervision over the situation of the charges. In the case of adults, problems include poor treatment of convicts by the Prison Service, insufficient therapeutic and educational system, and improper selection of management staff. The authors concluded from their research analysis that there are no universal social rehabilitation methods that can be effectively applied to both adults and minors.

Alaryngeal Speech Enhancement for Noisy Environments Using a Pareto Denoising Gated LSTM

Loss of the larynx significantly alters natural voice production, requiring alternative communication modalities and rehabilitation methods to restore speech intelligibility and improve the quality of life of affected individuals. This paper explores advances in alaryngeal speech enhancement to improve signal quality and reduce background noise, focusing on individuals who have undergone laryngectomy. In this study, speech samples were obtained from 23 Lithuanian males who had undergone laryngectomy with secondary implantation of the tracheoesophageal prosthesis (TEP). Pareto optimized gated LSTM was trained on tracheoesophageal speech data to recognize complex temporal connections and contextual information in speech signals. The system was able to distinguish between actual speech and various forms of noise and artifacts, resulting in a 25% drop in the mean signal-to-noise ratio (SNR) compared to other approaches. According to acoustic analysis, the system significantly decreased the number of unvoiced frames (PVF) from 40% to 10% while maintaining stable proportions of voiced frames (PVS) and average voicing evidence (AVE), indicating the accuracy of the approach in selectively attenuating noise and undesired speech artifacts while preserving important speech information.

The Technology to Enhance Patient Motivation in Virtual Reality Rehabilitation: A Review.

Virtual reality (VR) technology has experienced a steady rise and has been widely applied in the field of rehabilitation. The integration of VR technology in rehabilitation has shown promising results in enhancing their motivation for treatment, thereby enabling patients to actively engage in rehab training. Despite the advancement, there is a dearth of comprehensive summary and analysis on the use of VR technology to enhance patient motivation in rehabilitation. Thus, this narrative review aims to evaluate the potential of VR technology in enhancing patient motivation during motor rehabilitation training. This review commences with an explanation of how enhancing motivation through the VR rehabilitation system could improve the efficiency and effectiveness of rehabilitation training. Then, the technology was analyzed to improve patient motivation in the present VR rehabilitation system in detail. Furthermore, these technologies are classified and summarized to provide a comprehensive overview of the state-of-the-art approaches for enhancing patient motivation in VR rehabilitation. Findings showed VR rehabilitation training utilizes game-like exercises to enhance the engagement and enjoyment of rehabilitation training. By immersing patients in a simulated environment with multisensory feedback, VR systems offer a unique approach to rehabilitation that can lead to improved patient motivation. Both ultimately lead to improved patient outcomes, which is not typically achievable with traditional rehabilitation methods. The review concludes that VR rehabilitation presents an opportunity to improve patient motivation and adherence to long-term rehabilitation training. However, to further enhance patient self-efficacy, VR rehabilitation should integrate psychology and incorporate methods. Moreover, it is necessary to build a game design theory for rehabilitation games, and the latest VR feedback technology should also be introduced.

Quality of Life of Patients Using Esophageal Speech after Total Laryngectomy: A Systematic Review Study.

(1) Background: The present systematic study aimed to assess whether using esophageal speech (ES) as a method of vocal rehabilitation in patients after total laryngectomy enhances their quality of life (QoL) and vocal functionality based on patients' reports. (2) Methods: Data collection was conducted from PubMed, Google Scholar, and Speech Bite, and the PRISMA Flow Diagram tool was used to record different stages of the literature search process. In the review, nine studies were included, while a bias check was carried out using the Critical Appraisal Skills Programme (CASP) checklists. Survey analysis incorporated quantitative and qualitative data, including standardized questionnaires and audio analyses. (3) Results: A technique's effectiveness depends on the method's functionality and the patient's abilities. Furthermore, the findings revealed that ES use unexpectedly affects quality of life regarding patients. While statistical analysis of the studies showed that some patients reported improvement in quality of life and vocal functionality, others faced challenges such as difficulty in learning the technique, long-term intervention, and unsatisfactory phonetic performance. Some studies observed quantitative measures, such as improved Voice Impairment Index (VHI) scores and Voice-Related Quality of Life (V-RQOL) scores. However, results were not uniformly positive across studies, with a subset of patients reporting minimal improvement. (4) Conclusions: The limited literature on the effect of ES on patients' QoL appears to influence the results in different ways. However, research data support that patients' communication and psychological state seem to improve significantly compared to patients who have not been rehabilitated. The final assessment of the technique's effectiveness on quality of life must depend on many factors.