Publications by authors named "Wei-Ting Wu"

183 Publications

A multicenter study to compare the effectiveness of the inpatient post acute care program versus traditional rehabilitation for stroke survivors.

Sci Rep 2022 Jul 27;12(1):12811. Epub 2022 Jul 27.

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung Shan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan.

There is insufficient evidence to prove the effect of the Post-acute Care (PAC) program on post-stroke recovery. This study aimed to determine the effectiveness of the PAC versus traditional inpatient rehabilitation (non-PAC) for middle- and old-aged stroke survivors. This multicenter cohort study enrolled 334 stroke patients admitted for post-stroke rehabilitation. The outcome variables included the Barthel Index (BI), Functional Oral Intake Scale (FOIS), Mini Nutritional Assessment-Short Form (MNA-SF), EuroQoL-5D (EQ-5D), Lawton-Brody Instrumental Activities of Daily Living (ADL) Scale, and Mini-Mental State Examination (MMSE). The inverse-probability-of-treatment-weighting method was used to analyze the differences in outcomes between the PAC and non-PAC groups. The PAC group showed better improvements in BI, MNA-SF, EQ-5D, Instrumental ADL, and MMSE compared to the non-PAC group, with differences in effect sizes of 0.54 (95% confidence interval [CI] 0.38-0.71), 0.26 (95% CI 0.10-0.42), 0.50 (95% CI 0.33-0.66), 0.44 (95% CI 0.28-0.60) and 0.34 (95% CI 0.17-0.50), respectively. The PAC project showed more improvement in basic and instrumental ADL and status of swallowing, nutrition, and cognition than those of non-PAC, which had less length of stay restricted by the National Health Insurance. More studies are warranted to investigate the influence of hospital stay and duration from stroke onset on the PAC's effectiveness.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-022-16984-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9329354PMC
July 2022

Ultrasound Imaging of Facial Vascular Neural Structures and Relevance to Aesthetic Injections: A Pictorial Essay.

Diagnostics (Basel) 2022 Jul 21;12(7). Epub 2022 Jul 21.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara 06100, Turkey.

The facial and submental regions are supplied by complicated neurovascular networks; therefore, facial aesthetic injections may be associated with serious adverse events such as skin necrosis and blindness. Pre-injection localization of neurovascular structures using high-resolution ultrasound can theoretically prevent unexpected complications. Therefore, a systematic protocol that focuses on these facial neurovascular structures is warranted. In this pictorial essay, we discuss the sonoanatomy of facial and submental neurovascular structures and its relevance to aesthetic injections. Moreover, we have highlighted the mechanisms underlying potential neurovascular injuries during aesthetic injections.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/diagnostics12071766DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317469PMC
July 2022

Ultrasound Examination Facilitated the Diagnosis of an Intercostal Schwannoma.

Cureus 2022 Jun 19;14(6):e26079. Epub 2022 Jun 19.

Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, TUR.

Ultrasound imaging is known for its capability in scrutinizing superficial soft tissue disorders. We report a rare case of a 71-year-old male who presented with a history of rectal cancer with lymph node metastasis and had complete remission after surgery and chemotherapy. He had a palpable mass over the right anterior lower chest, which became gradually painful in the recent six months. Ultrasound facilitated the diagnosis of an intercostal schwannoma, which was also evident on magnetic resonance imaging and was confirmed by the histopathological study. Following the tumor excision, the patient had complete pain relief at the second-month follow-up. The case report highlighted the usefulness of ultrasound in clarification of the exact location of a chest wall tumor in relation to ribs, pleura, adjacent muscles, and intercostal neurovascular bundles as well as delineation of its echotexture and internal vascularity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.26079DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9293252PMC
June 2022

Diverging Artifact in a Subcutaneous Abscess.

J Med Ultrasound 2022 Apr-Jun;30(2):163. Epub 2021 Jun 16.

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/JMU.JMU_12_21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9272705PMC
June 2021

Ultrasound Imaging in Predicting the Autograft Size in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis.

J Clin Med 2022 Jul 4;11(13). Epub 2022 Jul 4.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara 06230, Turkey.

Anterior cruciate ligament (ACL) reconstruction is widely used to restore knee stability after injury, but the risk of revision surgery increases when the autograft size is inadequate. Ultrasound (US) measurements of preoperative target tendons have been applied to predict the intraoperative autograft size, with various outcomes across different studies. This systematic review and meta-analysis aimed to summarize the evidence and investigate the usefulness of US in predicting autograft size. Electronic databases were searched for relevant studies from inception to 19 January 2022. The primary outcome was the correlation between the preoperative US measurements of donor tendons and intraoperative autograft size. The secondary outcomes encompassed the predictive performance of US for autograft size and the comparison between US and magnetic resonance imaging (MRI) for preoperative tendon measurements. Nine studies, comprising 249 patients, were enrolled. The preoperative US measurements of the donor tendons demonstrated a significant positive correlation with their intraoperative autograft diameter, with a pooled correlation coefficient of 0.443 (95% confidence interval [CI], 0.266-0.591, < 0.001) for the gracilis and semitendinosus autograft, 0.525 (95% CI, 0.114-0.783, = 0.015) for the semitendinosus autograft, and 0.475 (95% CI, 0.187-0.687, = 0.002) for the gracilis autograft. The pooled sensitivity and specificity of US imaging in predicting the autograft diameter were 0.83 (95% CI 0.57-0.95) and 0.70 (95% CI, 0.36-0.91), respectively. Moreover, no significant differences were observed between US and MRI measurements in predicting the sizes of the gracilis and semitendinosus autografts. Preoperative US measurements of the target tendons were moderately correlated with the intraoperative autograft size. US imaging has a discriminative performance similar to that of MRI in predicting the autograft size. A standardized US scanning protocol is needed for future studies to minimize the variations in tendon measurements across different investigators and increase the comparability of US imaging with intraoperative findings.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/jcm11133876DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267791PMC
July 2022

Ultrasonographic Imaging and Guided Intervention for the Superior Cluneal Nerve: A Narrative Pictorial Review.

Pain Physician 2022 07;25(4):E657-E667

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

Background: Ultrasound (US) has been widely used for the diagnosis and guided interventions of peripheral nerve disorders. Although superior cluneal nerve (SCN) entrapment is an important cause of lower back pain, a relevant review as to how US can be used for imaging and guided intervention for cases of SCN entrapment is still lacking.

Objectives: This review aims to revisit the anatomy and pertinent clinical issues of SCN entrapment, as well as the role of US regarding the diagnosis and subsequent management of relevant clinical scenarios.

Study Design: A narrative review.

Methods: Although the present article is a narrative review, we used a systematic approach to search the relevant literature. The combinations of key words, including SCN, ultrasound, and sonography, were used to search PubMed and Medline without restriction of languages or article types. The search period was from the earliest record through November 2021.

Results: Our included studies showed that high-resolution US and knowledge of sonoanatomy facilitated the visualization of individual branches of the SCN after emerging from the erector spinae muscles. However, the diagnostic block was needed for confirmation of SCN entrapment. Perineural US-guided injection was helpful in relieving the complaints of SCN entrapment; whereas, hydrodissection underneath the thoracolumbar fascia over the iliac crest seems to be a feasible approach for postsurgical analgesia.

Limitations: There was no clinical trial comparing the efficacy of different injection techniques and regimens.

Conclusions: US imaging is helpful for guiding injections of SCN entrapment and related clinical conditions. The evidence of US imaging in diagnosing SCN disorders remains insufficient, which requires more prospective studies to validate.
View Article and Find Full Text PDF

Download full-text PDF

Source
July 2022

Does Suprascapular Nerve Release Provide Additional Benefits for Rotator Cuff Repair: a Systematic Review and Meta-Analysis.

J Shoulder Elbow Surg 2022 Jun 20. Epub 2022 Jun 20.

Department of Physical Medicine and Rehabilitation, National Taiwan University, College of Medicine, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University, Hospital, Bei-Hu Branch, Taipei, Taiwan; Center for Regional Anesthesia and Pain Medicine, Wang-Fang Hospital, Taipei Medical University, Taipei, Taiwan. Electronic address:

Background: There is still a lack of consensus regarding whether suprascapular nerve decompression should be routinely performed with rotator cuff repair. Therefore, this meta-analysis aimed to evaluate whether additional suprascapular nerve release (SSNR) could improve shoulder functional outcomes and pain relief more than rotator cuff repair alone.

Material And Methods: We performed a literature review of electronic databases for non-comparative and comparative studies investigating the effect of SSNR in patients undergoing rotator cuff repair. The primary outcome was the change in shoulder function scores from the preoperative status, and the secondary outcome was the change in the visual analog scale (VAS) score of pain after surgery. A subgroup analysis was conducted based on the study design (non-comparative studies vs. comparative studies).

Results: Nine studies comprising 279 participants were included. Our analysis demonstrated that the group that underwent SSNR had a better shoulder functional score after surgery than at preoperative assessment [standardized mean difference (SMD), 1.333, 95% confidence interval (CI), 0.708-1.959)]. No significant differences were identified in shoulder function improvement between those with and without SSNR, with an SMD of 0.163 (95% CI, -0.091-0.418). Likewise, the group with SSNR showed a decreased VAS score after surgery compared to their preoperative status (SMD, 0.910; 95% CI, 0.560-1.260). However, there was no significant difference in VAS change between those with and without SSNR, with an SMD of 0.431 (95% CI, -0.095-0.956).

Conclusion: The present meta-analysis revealed that SSNR might not be routinely needed in rotator cuff tendon repair as no additional benefits in functional improvement or pain relief were identified compared to rotator cuff tendon repair alone.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jse.2022.05.015DOI Listing
June 2022

Ultrasonography for the diagnosis of carpal tunnel syndrome: an umbrella review.

J Neurol 2022 Sep 31;269(9):4663-4675. Epub 2022 May 31.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, 06100, Ankara, Turkey.

Background: Numerous sonographic modalities and parameters have been used to diagnose carpal tunnel syndrome (CTS), with varying accuracy. Our umbrella review aimed to summarize the evidence from systematic reviews and meta-analyses regarding the use of ultrasound imaging to diagnose CTS.

Methods: Systematic reviews and meta-analyses meeting the inclusion criteria were searched in PubMed, Embase, Medline, Web of Science, and Cochrane databases from inception to March 2022. Critical appraisal, data extraction, and synthesis were performed in accordance with the criteria for conducting an umbrella review.

Results: Sixteen reviews were included. Three reviews were classified as high quality, one as moderate, four as low, and eight as critically low. The cross-sectional area (CSA) of the median nerve at the carpal tunnel inlet demonstrated the best reliability and diagnostic accuracy among multiple parameters. A cutoff CSA value of 9-10.5 mm gave the highest diagnostic performance in the general population. The degree of CSA enlargement was correlated with CTS severity. Sonoelastography and Doppler ultrasound might provide additional insights into CTS evaluation as median nerve stiffness and vascularity at the wrist were increased in these patients.

Conclusions: Sonography is a reliable tool to diagnose CTS, with inlet CSA being the most robust parameter. Sonoelastography and Doppler ultrasound can serve as auxiliary tools to confirm CTS diagnoses. Further studies are needed to expand the use of sonography for diagnosing CTS, especially in the presence of concomitant neuromuscular disease(s).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00415-022-11201-zDOI Listing
September 2022

Ultrasound imaging for congenital bilateral absence of extensor pollicis brevis tendons.

Med Ultrason 2022 May;24(2):257-258

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11152/mu-3637DOI Listing
May 2022

Peritendinous effusion of the flexor hallucis longus tendon as a sign of ankle joint capsule injury.

Med Ultrason 2022 May;24(2):253

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan.

.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11152/mu-3519DOI Listing
May 2022

Ultrasound imaging for inguinal hernia: a pictorial review.

Ultrasonography 2022 Jul 24;41(3):610-623. Epub 2022 Feb 24.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

Inguinal hernia is the most prevalent type of abdominal wall hernia. Indirect inguinal hernia is twice as common as direct inguinal hernia. Computed tomography and magnetic resonance imaging can be used to evaluate inguinal hernia, but these modalities are greatly limited by their cost and availability. Ultrasonography has emerged as the most convenient imaging tool for diagnosing inguinal hernia due to its advantages, such as portability and absence of radiation. The present pictorial review presents an overview on the use of ultrasonography in the evaluation of inguinal hernia with a particular emphasis on the regional anatomy, relevant scanning tips, identification of subtypes, postoperative follow-up, and diagnosis of pathologies mimicking inguinal hernia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14366/usg.21192DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9262670PMC
July 2022

EURO-MUSCULUS/USPRM Dynamic Ultrasound Protocols for Wrist and Hand.

Am J Phys Med Rehabil 2022 Apr 20. Epub 2022 Apr 20.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

Abstract: In this dynamic protocol, ultrasound evaluation of the wrist and hand is described using various maneuvers for relevant conditions. Scanning videos are coupled with real-time patient examination videos. The authors believe that this practical guide - prepared by the international consensus of several experts - will help musculoskeletal physicians perform a better and uniform/standard examination approach.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/PHM.0000000000002005DOI Listing
April 2022

Lower Back Pain Heralding Cauda Equina Syndrome in a Patient With Achondroplasia.

Cureus 2022 Feb 19;14(2):e22380. Epub 2022 Feb 19.

Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, TUR.

Achondroplasia is the most common cause of congenital dwarfism and is associated with multiple complications due to impaired skeletal development. Herein, we report a 21-year-old woman with achondroplasia experiencing lower back pain which progressed to lower limb weakness and urinary retention. Magnetic resonance imaging revealed decreased interpedicular distance and severe stenosis of the lumbosacral spinal canal. Cauda equina syndrome was diagnosed and she underwent laminectomy. After decompression, pain, muscle strength and bladder function improved significantly. This case highlights the importance of early recognition of spinal compression in patients with achondroplasia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.22380DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938231PMC
February 2022

Clinical Validation of Cardiac Arrest Hospital Prognosis (CAHP) Score and MIRACLE2 Score to Predict Neurologic Outcomes after Out-of-Hospital Cardiac Arrest.

Healthcare (Basel) 2022 Mar 20;10(3). Epub 2022 Mar 20.

Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City 833, Taiwan.

Background: Out-of-hospital cardiac arrest (OHCA) remains a challenge for emergency physicians, given the poor prognosis. In 2020, MIRACLE2, a new and easier to apply score, was established to predict the neurological outcome of OHCA.

Objective: The aim of this study is to compare the discrimination of MIRACLE2 score with cardiac arrest hospital prognosis (CAHP) score for OHCA neurologic outcomes.

Methods: This retrospective cohort study was conducted between January 2015 and December 2019. Adult patients (>17 years) with cardiac arrest who were brought to the hospital by an emergency medical service crew were included. Deaths due to trauma, burn, drowning, resuscitation not initiated due to pre-ordered "do not resuscitate" orders, and patients who did not achieve return of spontaneous circulation were excluded. Receiver operating characteristic curve analysis with Youden Index was performed to calculate optimal cut-off values for both scores.

Results: Overall, 200 adult OHCA cases were analyzed. The threshold of the MIRACLE2 score for favorable neurologic outcomes was 5.5, with an area under the curve (AUC) value of 0.70 (0.61-0.80, < 0.001); the threshold of the CAHP score was 223.4, with an AUC of 0.77 (0.68-0.86, < 0.001). On setting the MIRACLE2 score cut-off value, we documented 64.7% sensitivity (95% confidence interval [CI], 56.9-71.9%), 66.7.0% specificity (95% CI, 48.2-82.0%), 90.8% positive predictive value (PPV; 95% CI, 85.6-94.2%), and 27.2% negative predictive value (NPV; 95% CI, 21.4-33.9%). On establishing a CAHP cut-off value, we observed 68.2% sensitivity (95% CI, 60.2-75.5%), 80.6% specificity (95% CI, 62.5-92.6%), 94.6% PPV (95% CI, 88.6%-98.0%), and 33.8% NPV (95% CI, 23.2-45.7%) for unfavorable neurologic outcomes.

Conclusions: The CAHP score demonstrated better discrimination than the MIRACLE2 score, affording superior sensitivity, specificity, PPV, and NPV; however, the CAHP score remains relatively difficult to apply. Further studies are warranted to establish scores with better discrimination and ease of application.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/healthcare10030578DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8950818PMC
March 2022

Quantitative Analysis of Dynamic Subacromial Ultrasonography: Reliability and Influencing Factors.

Front Bioeng Biotechnol 2022 15;10:830508. Epub 2022 Feb 15.

Department of Physical Medicine and Rehabilitation and Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan.

Current imaging methods used to examine patients with subacromial impingement syndrome (SIS) are limited by their semi-quantitative nature and their capability of capturing dynamic movements. This study aimed to develop a quantitative analytic model to assess subacromial motions using dynamic ultrasound and to examine their reliability and potential influencing factors. We included 48 healthy volunteers and examined their subacromial motions with dynamic ultrasound imaging. The parameters were the minimal vertical acromiohumeral distance, rotation radius, and degrees of the humeral head. The generalized estimating equation (GEE) was used to investigate the impact of different shoulder laterality, postures, and motion phases on the outcome. Using the data of the minimal vertical acromiohumeral distance, the intra-rater and inter-rater reliabilities (intra-class correlation coefficient) were determined as 0.94 and 0.88, respectively. In the GEE analysis, a decrease in the minimal vertical acromiohumeral distance was associated with the abduction phase and full-can posture, with a beta coefficient of -0.02 cm [95% confidence interval (CI), -0.03 to -0.01] and -0.07 cm (95% CI, -0.11 to -0.02), respectively. The abduction phase led to a decrease in the radius of humeral rotation and an increase in the angle of humeral rotation, with a beta coefficient of -1.28 cm (95% CI, -2.16 to -0.40) and 6.60° (95% CI, 3.54-9.67), respectively. A significant negative correlation was observed between the rotation angle and radius of the humeral head and between the rotation angle and the minimal vertical acromiohumeral distance. Quantitative analysis of dynamic ultrasound imaging enables the delineation of subacromial motion with good reliability. The vertical acromiohumeral distance is the lowest in the abduction phase and full-can posture, and the rotation angle of the humeral head has the potential to serve as a new parameter for the evaluation of SIS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fbioe.2022.830508DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8886165PMC
February 2022

Ultrasound Imaging and Ultrasound-Guided Injection of the Coccygeal Nerve for Coccydynia.

Am J Phys Med Rehabil 2022 07 23;101(7):e108-e109. Epub 2022 Feb 23.

From the Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan (W-TW, Y-CH, K-VC); Center for Regional Anesthesia and Pain Medicine, Wang-Fang Hospital, Taipei Medical University, Taipei, Taiwan (KV-C); and Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey (LÖ).

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/PHM.0000000000001987DOI Listing
July 2022

Ultrasound Imaging of the Facial Muscles and Relevance with Botulinum Toxin Injections: A Pictorial Essay and Narrative Review.

Toxins (Basel) 2022 01 27;14(2). Epub 2022 Jan 27.

Department of Physical and Rehabilitation Medicine, Medical School, Hacettepe University, Ankara 06100, Turkey.

High-resolution ultrasound is preferred as the first-line imaging modality for evaluation of superficial soft tissues, such as the facial muscles. In contrast to magnetic resonance imaging and computed tomography, which require specifically designated planes (axial, coronal and sagittal) for imaging, the ultrasound transducer can be navigated based on the alignment of facial muscles. Botulinum toxin injections are widely used in facial cosmetic procedures in recent times. Ultrasonography is recognized as a useful tool for pre-procedure localization of target muscles. In this pictorial review, we discuss the detailed sonoanatomy of facial muscles and their clinical relevance, particularly with regard to botulinum toxin injections. Furthermore, we have summarized the findings of clinical studies that report ultrasonographic imaging of facial muscles.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/toxins14020101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878462PMC
January 2022

Ultrasound Imaging for the Diagnosis and Evaluation of Sarcopenia: An Umbrella Review.

Life (Basel) 2021 Dec 22;12(1). Epub 2021 Dec 22.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara 06100, Turkey.

There is an increasing number of reviews investigating the value of ultrasound (US) in the assessment of aging-related muscle loss. The present umbrella review aimed to systematically investigate the evidence of US imaging in the diagnosis and evaluation of sarcopenia. PubMed, Medline, Embase and Web of Science were searched from their inceptions to 31 October 2021. Systematic reviews and reviews using a systematic strategy for literature search were enrolled. The extracted data were narrated at the level of systematic reviews and meta-analyses. This umbrella review included four articles pertaining to 125 original studies and yielded several important findings. First, US is a reliable and valid imaging tool for the assessment of skeletal muscle mass. Second, among all the US parameters in B-mode, muscle thickness is the most commonly used one, which has good correlation with other standard measurements. Third, although sonoelastography and contrast-enhanced US are promising imaging modalities, their clinical utility is still limited at the current stage. Finally, a future systematic review is warranted to analyze how different ultrasonographic diagnostic criteria influence the prevalence of sarcopenia as well as its adverse health outcomes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/life12010009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8781401PMC
December 2021

Standardized Mean Difference Versus Weighted Mean Difference for Summarizing the Effect of Ultrasound Therapy for Patients with Osteoarthritis.

J Ultrasound Med 2022 Jan 4. Epub 2022 Jan 4.

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch and National Taiwan University College of Medicine, Taipei, Taiwan.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/jum.15938DOI Listing
January 2022

Ultrasound Imaging of the Anterior Cruciate Ligament: A Pictorial Essay and Narrative Review.

Ultrasound Med Biol 2022 03 21;48(3):377-396. Epub 2021 Dec 21.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

Ultrasound has been extensively applied to the diagnosis of and guided interventions for knee disorders. However, although it is commonly affected during sports injuries, the anterior cruciate ligament (ACL) is not usually incorporated in the majority of ultrasound scanning protocols. In the past, because of its oblique trajectory and deeper location, the ACL was considered to be a challenging structure for ultrasound imaging. Owing to advances in ultrasound technology and knowledge of knee sono-anatomy, an increasing number of studies are investigating the clinical value of ultrasound in the diagnosis and management of ACL injuries. In this regard, the present review aims to elaborate on the sono-anatomy of the ACL, to summarize the evidence for ultrasound imaging for ACL lesions and to investigate whether it is useful in the pre-operative preparation and post-operative follow-up of ACL reconstruction.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ultrasmedbio.2021.11.004DOI Listing
March 2022

EURO-MUSCULUS/USPRM Dynamic Ultrasound Protocols for Elbow.

Am J Phys Med Rehabil 2022 06 29;101(6):e83-e92. Epub 2021 Dec 29.

From the Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy (VR); Department of Physical and Rehabilitation Medicine, Mersin University Medical School, Mersin, Turkey (OG); Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan (K-VC, W-TW); National Taiwan University College of Medicine, Taipei, Taiwan (K-VC); Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic (KM); Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey (MK, LÖ); The Hand Clinic, Ankara, Turkey (GL); Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy (CP, CS); Ankara City Hospital, Physical Medicine and Rehabilitation Hospital, Ankara, Turkey (AMA); Physical Medicine and Rehabilitation Hospital, Ministry of Health, Kuwait City, Kuwait (MD); and Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Population and Data Sciences, University of Texas Southwestern, Dallas, Texas (NBJ).

Abstract: In this dynamic protocol, ultrasound examination of the elbow using different maneuvers is described for several/relevant elbow problems. Scanning videos are coupled with real-time patient examination videos for better understanding. The authors believe that this practical guide-prepared by an international consensus of several experts (EURO-MUSCULUS: European Musculoskeletal Ultrasound Study Group and USPRM: Ultrasound Study Group of ISPRM [International Society of Physical and Rehabilitation Medicine])-will help musculoskeletal physicians perform a better and uniform/standard approach.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/PHM.0000000000001915DOI Listing
June 2022

Comparative Effectiveness of Botulinum Toxin Injections and Extracorporeal Shockwave Therapy for Post-Stroke Spasticity: A Systematic Review and Network Meta-Analysis.

EClinicalMedicine 2022 Jan 4;43:101222. Epub 2021 Dec 4.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

Background: The anti-spasticity efficacy of botulinum toxin (BoNT) injection has been well established for patients with chronic stroke; however, extracorporeal shock wave therapy (ESWT), i.e. focused shockwave (FSW) and radial shockwave (RSW), has recently been applied. We aimed to investigate the comparative effectiveness of BoNT vs. ESWT in the reduction of spasticity among stroke survivors.

Methods: PubMed, EMBASE, MEDLINE and Cochrane CENTRAL were searched from the earliest record to September 2021 for randomized controlled trials. Weighted mean differences (WMDs) on the reduction of the Modified Ashworth Scale before or at the 6th post-treatment week (short-term) and between the 7th and 12th weeks (mid-term) after the intervention were calculated. Ranking probabilities of the WMD were simulated to determine which treatment had the potential to possess the best effectiveness. inplasy.com registration: INPLASY202170018.

Findings: A total of 33 studies comprising 1,930 patients were enrolled. The network meta-analysis revealed that BoNT injections, FSW and RSW were better in spasticity reduction than the control treatment(s) at the short term, with WMDs of -0.69 (95% CI, -0.87 to -0.50), -0.36 (95% CI, -0.69 to -0.03) and -0.62 (95% CI, -0.84 to -0.40), respectively. Likewise, mid-term effects of BoNT injections, FSW and RSW also revealed superiority, with WMDs of -0.44 (95% CI, -0.62 to -0.26), -0.74 (95% CI, -1.26 to -0.23) and -0.79 (95% CI, -1.07 to -0.51), respectively. Ranking probability analysis revealed that RSW had the highest probability of being the best treatment for spasticity reduction at the short-term (62.2%) and mid-term (72.3%) periods during the follow up.

Interpretation: BoNT injections and ESWT are effective in alleviating post-stroke spasticity at the mid-term. The effectiveness of ESWT was comparable to BoNT injections, and RSW had the potential to be the best treatment for spasticity reduction among the three treatment options. More prospective trials incorporating head-to-head comparisons of BoNT injections vs. ESWT are needed to validate the role of ESWT in reducing post-stroke spasticity.

Funding: The current research project was supported by (1) National Taiwan University Hospital, Bei-Hu Branch; (2) Ministry of Science and Technology (MOST 106-2314-B-002-180-MY3 and 109-2314-B-002-114-MY3); 3) Taiwan Society of Ultrasound in Medicine.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.eclinm.2021.101222DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649216PMC
January 2022

Sarcopenic Dysphagia: A Narrative Review from Diagnosis to Intervention.

Nutrients 2021 Nov 12;13(11). Epub 2021 Nov 12.

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10048, Taiwan.

Sarcopenia, defined as a decline in muscle mass and function related to aging, affects both limb and swallowing-related muscles. Sarcopenic dysphagia is characterized by decreased swallowing function; therefore, early detection of subclinical dysphagia and subsequent intervention appear to be crucial in the elderly. Numerous tools have been employed to measure the function, strength, and mass of swallowing-related muscles in sarcopenic elderly. The swallowing function can be evaluated by questionnaires like Eating Assessment Tool, Functional Oral Intake Scale, and Food Intake Level Scale, and tests such as the modified water swallowing test and videofluoroscopic swallowing study. Surface electromyography and high-resolution manometry can be applied for quantifying swallowing-related muscle strength. Modalities such as ultrasonography and magnetic resonance imaging are capable of estimating the swallowing muscle mass. In patients with sarcopenic dysphagia, a thorough assessment should be given followed by an integrated intervention combining swallowing muscle strengthening, nutrition support, food texture modification, physical, and occupational therapies. This article aimed to comprehensively summarize the diagnostic criteria/tools as well as their associations/performance in sarcopenic dysphagia. The intervention strategy will also be narrated in this review.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/nu13114043DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8621579PMC
November 2021

Ultrasound imaging for bladder hernia: a rare cause of female inguinal hernia.

Med Ultrason 2021 Nov;23(4):493-494

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11152/mu-3385DOI Listing
November 2021

Pre-hospital Prognostic Factors of Out-of-Hospital Cardiac Arrest: The Difference Between Pediatric and Adult.

Front Pediatr 2021 21;9:723327. Epub 2021 Oct 21.

Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City, Taiwan.

The prognosis of out-of-hospital cardiac arrest (OHCA) is very poor. Although several pre-hospital factors are associated with survival, the different association of pre-hospital factors with OHCA outcomes in pediatric and adult groups remain unclear. To assess the association of pre-hospital factors with OHCA outcomes among pediatric and adult groups, a retrospective observational study was conducted using the emergency medical service (EMS) database in Kaohsiung from January 2015 to December 2019. Pre-hospital factors, underlying diseases, and OHCA outcomes were collected for the pediatric (Age ≤ 20) and adult groups. Kaplan-Meier type plots and multivariable logistic regression were used to analyze the association between pre-hospital factors and outcomes. In total, 7,461 OHCAs were analyzed. After adjusting for EMS response time, bystander CPR, attended by EMT-P, witness, and pre-hospital defibrillation, we found that age [odds ratio (OR) = 0.877, 95% confidence interval (CI): 0.764-0.990, = 0.033], public location (OR = 7.681, 95% CI: 1.975-33.428, = 0.003), and advanced airway management (AAM) (OR = 8.952; 95% CI, 1.414-66.081; = 0.02) were significantly associated with survival till hospital discharge in pediatric OHCAs. The results of Kaplan-Meier type plots with log-rank test showed a significant difference between the pediatric and adult groups in survival for 2 h ( < 0.001), 24 h ( < 0.001), hospital discharge ( < 0.001), and favorable neurologic outcome ( < 0.001). AAM was associated with improved survival for 2 h ( = 0.015), 24 h ( = 0.023), and neurologic outcome ( = 0.018) only in the pediatric group. There were variations in prognostic factors between pediatric and adult patients with OHCA. The prognosis of the pediatric group was better than that of the adult group. Furthermore, AAM was independently associated with outcomes in pediatric patients, but not in adult patients. Age and public location of OHCA were independently associated with survival till hospital discharge in both pediatric and adult patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fped.2021.723327DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8567010PMC
October 2021

Sonoanatomy and Stepwise/Systematic Ultrasound Examination of the Extrinsic/Intrinsic Wrist Ligaments.

Diagnostics (Basel) 2021 Oct 4;11(10). Epub 2021 Oct 4.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara 06100, Turkey.

Ultrasound has emerged as the most useful imaging tool for investigating wrist and hand disorders, with several published ultrasound protocols having demonstrated their practicality in scanning the wrist tendons and nerves. However, ligaments of the wrist are networked in a complex manner, deterring sonographers from examining them with an organized strategy. Furthermore, because of the non-parallel alignment between the radiocarpal, mid-carpal, and carpal-metacarpal joints, precise recognition of the carpal bones is challenging, although ultrasound is paramount for visualizing the wrist ligaments. In this regard, the current article for point of view aims to elaborate sonoanatomy of the carpal bones and to present a stepwise systematic approach for navigating the extrinsic and intrinsic wrist ligaments.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/diagnostics11101834DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8534780PMC
October 2021

Authors' Response to the Letter to the Editor on "Ultrasonography in Pronator Teres Syndrome: Dynamic Examination and Guided Hydrodissection".

Pain Med 2022 01;23(1):223-224

Department of Physical Medicine and Rehabilitation, National Taiwan University  Hospital, Bei-Hu Branch and National Taiwan University College of Medicine, Taipei, Taiwan.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/pm/pnab309DOI Listing
January 2022

Constraint-Induced Movement Therapy Combined With Botulinum Toxin for Post-stroke Spasticity: A Systematic Review and Meta-Analysis.

Cureus 2021 Sep 1;13(9):e17645. Epub 2021 Sep 1.

Research, Paolo Procacci Foundation, Roma, ITA.

Stroke is considered one of the main causes of adult disability and the second most serious cause of death worldwide. The combination of botulinum toxin type A (BTX) with rehabilitation techniques such as modified constraint-induced movement therapy (mCIMT) has emerged as a highly efficient intervention for stroke patients to start synchronized motor function along with spasticity reduction. The current systematic review and meta-analysis were conducted in order to evaluate the available literature about the safety and efficacy of constraint-induced movement therapy (CIMT) combined with BTX in stroke patients with upper limb spasticity. Searches were conducted on WoS (Web of Science), Ovid, EBSCO-ASC&BSC, and PubMed for identifying relevant literature published from 2000-2020. Randomized Controlled Trials (RCTs) and Quasi-experimental studies were considered for inclusion. Rayyan (systematic review tool) QCRI (Qatar Computing Research Institute) was used for independent screening of the studies by two reviewers. For risk of bias and study quality assessment, Cochrane risk of bias tool (RoB 2) and Physiotherapy Evidence Database (PEDro) scales were used. Cochrane review manager was used to carry out the meta-analyses of the included studies. The search resulted in a total of 13065 references, of which 4967 were duplicates. After the title, abstract and full-text screening, two RCTs were deemed eligible for inclusion. Both the RCTs scored 8 on PEDro and were level evidence. The studies were heterogeneous. The findings of this meta-analysis in all the three joints post-stroke spasticity assessed on modified Ashworth scale (MAS) at four weeks post-injection aren't statistically significant (elbow P-value 0.74, wrist P-value 0.57, fingers P-value 0.42), however, according to one of the included studies the therapeutic efficacy of the combination of BTX-mCIMT injection assessed at four weeks post-injection in wrist and finger flexors was promising.  The effectiveness of BTX-CIMT combination over conventional therapy (CT) for improving post-stroke spasticity still needs to be explored with long-term, multicenter rigorously designed RCTs having a good sample size. However, the BTX-CIMT combination is promising for enhancing motor function recovery and improving activities of daily living (ADLs).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.17645DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8486367PMC
September 2021

Comparative Effectiveness of Injection Therapies for Hemiplegic Shoulder Pain in Stroke: A Systematic Review and Network Meta-Analysis.

Pharmaceuticals (Basel) 2021 Aug 10;14(8). Epub 2021 Aug 10.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, 06100 Ankara, Turkey.

Hemiplegic shoulder pain (HSP) hampers post-stroke functional recovery and is not well managed with conservative treatments. This systematic review aimed to examine the various injection therapies for HSP and investigate their effectiveness at different time points. The protocol of this meta-analysis was registered on INPLASY with a registration number of INPLASY202180010. PubMed, EMBASE, and Scopus were searched from their inception to 4 August 2021 for the clinical studies investigating comparative effectiveness of different injection regimens for treating hemiplegic shoulder pain in patients with stroke. The primary outcome was the weighted mean difference (WMD) on the visual analog scale (VAS) of pain reduction in the fourth-week and between the fourth and twenty-fourth weeks. Ranking probabilities of the WMD for each treatment were obtained using simulations. Seventeen studies with 595 participants were included. The network meta-analysis showed that at the fourth-week, intra-muscular botulinum toxin (BoNT) injections and suprascapular nerve blocks (SSNB) were superior to a placebo, with WMDs of 1.55 (95% CI, 0.09 to 3.01) and 1.44 (95% CI, 0.07 to 2.80), respectively. SSNB possessed the highest probability (53.3%) and appeared to be the best treatment in the fourth-week, followed by intra-muscular BoNT injections (42.6%). Intramuscular BoNT injections were better than the placebo, with a WMD of 1.57 (95% CI, 0.30 to 2.84) between the 4th and 24th weeks. Intramuscular BoNT injections had the highest probability (79.8%) as the best treatment between the 4th and 24th weeks. SSNB was likely to rank first in relieving HSP at the fourth post-treatment week, whereas intra-muscular BoNT injections had the highest probability to achieve the best treatment effectiveness in the post-injection period between the fourth and twenty-fourth weeks. However, as some of the included studies used a non-randomized controlled design, more randomized controlled trials are needed in the future to validate and better understand the short- and long-term efficacy of different injection therapies for management of HSP.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ph14080788DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8401803PMC
August 2021
-->