Kio University

This case report details an incident of acute hypothermia following the administration of valproic acid in a patient presenting with seizures. We describe the clinical presentation, diagnostic workup, treatment plan, and potential mechanisms underlying this rare adverse effect.

ABSTRACTObjectives:Non-older adults are at risk of developing sarcopenia, and exercise and increased physical activity are effective preventive interventions. Digital interventions, including gamification, may enhance the effects of exercise interventions. This systematic review and meta-analysis examined the effects of digital health interventions on muscle strength, muscle mass, and physical function in non-older adults at risk of sarcopenia.Methods:We conducted a systematic review of randomized controlled trials that evaluated the effects of digital health interventions on outcomes related to sarcopenia. Literature searches were performed in MEDLINE (Ovid), Web of Science Core Collection, and CENTRAL databases. Risk of bias was assessed according to established guidelines, and meta-analyses were conducted. The certainty of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.Results:In total, 28 studies were analyzed. The pooled results indicated that digital health interventions led to improvements in grip strength, performance in the chair-stand test, walking speed, Dynamic Gait Index, and Timed Up-and-Go test. In contrast, lower limb muscle strength and lean body mass did not show meaningful improvements. Although no major risks of bias were identified, the strength of the evidence remained limited because of the small number of studies and participants included.Conclusions:This systematic review suggests that digital health interventions may lead to modest improvements in muscle strength, muscle mass, and physical function in non-older adults at risk of sarcopenia, although the current evidence remains inconclusive. Further studies are needed to establish their effect.

Abstract The sense of agency—namely, the feeling that one’s actions are self-initiated and controllable—is fundamental to how individuals understand themselves and engage with the world. Although often taken for granted, this experience may be altered by physical disability. The present study examined differences in the sense of agency between healthy adults and individuals with physical impairments using a movement-based dot trajectory task. Two indices—sensitivity (slope) and decision criterion (point of subjective equality)—were derived from logistic regression modeling. The results showed that individuals with physical disabilities not only had blurred between self-other distinction, but also attributed actions to themselves without justification, indicating blurred self-other boundaries. Notably, the observed alteration was not attributable to age or physical activity levels, and no significant associations were observed with psychological state or caregiving needs. These findings suggest that physical limitations themselves, irrespective of mental health or daily activity, may reshape how individuals perceive control over their own actions. Understanding such shifts in self-perception could have important implications for rehabilitation strategies and for improving quality of life in populations with physical impairments.

ObjectiveThis study aimed to compare the impact of sarcopenia on gait recovery using the Sarcopenia Special Interest Group of the International Society of Physical and Rehabilitation Medicine (ISarcoPRM) and the Asian Working Group for Sarcopenia 2019 (AWGS2019) algorithms in older orthopaedic patients.DesignA prospective observational study.PatientsA total of 153 orthopaedic patients (78.4% women; average age 79.3 ± 6.7 years) were included during hospitalization.MethodsSarcopenia was defined using the ISarcoPRM and AWGS2019 algorithms on admission. Functional ambulation categories assessed gait independence before admission and on discharge. The impact of sarcopenia on worsened gait independence on discharge was evaluated using multivariate logistic regression analysis.ResultsSarcopenia based on the ISarcoPRM algorithm (prevalence=56.2%) was significantly associated with worsened gait independence (odds ratio: 3.94, 95% confidence interval: 1.51–10.25, p = 0.005), unlike sarcopenia based on AWGS2019 (prevalence=36.6%).ConclusionSarcopenia assessed using the ISarcoPRM algorithm was associated with worsened gait independence on discharge in older orthopaedic patients.

Central post-stroke pain (CPSP) is one of the sequelae that significantly impacts the quality of life for stroke patients. This case report examines the effects of a combined intervention, which included thermotherapy using warm water and transcranial direct current stimulation (tDCS) in a woman in her 50s who experienced severe left hemiplegia and CPSP following stroke. After thermotherapy aimed at reducing pain, tDCS was applied to the primary motor cortex for two weeks. In addition, robotic therapy targeting shoulder and elbow joint movements was introduced as a form of self-training to complement the intervention.Post-intervention assessments revealed improvements in upper limb motor function and a reduction in pain intensity, as indicated by a decrease in the numerical rating scale scores from a pre-intervention range of 4 to 10 to a post-intervention range of 4.5 to 6. These results suggestthat a combined approach centered on tDCS may promote pain management and functional recovery in patients with CPSP.