Annals of Rehabilitation Medicine

Dysphagia

Ultrasonographic Measurements of Tongue Thickness and Swallowing Dysfunction in Amyotrophic Lateral Sclerosis: A Feasibility Study: Min Soo Kim, Yunah Nam, Kyoung Tae Kim; Ann Rehabil Med 2026;50(1):71-79. Published online February 13, 2026; DOI: https://doi.org/10.5535/arm.250135

Abstract
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Objective
To explore whether ultrasonographic measurements of tongue thickness are associated with swallowing function and related clinical domains in patients with amyotrophic lateral sclerosis (ALS), this feasibility study was conducted. Few studies have examined the usefulness of ultrasonographic tongue thickness measurement in patients with ALS, but its association with physiological measures remains unclear.
Methods
Ten patients with ALS underwent tongue thickness measurement using ultrasonography. Clinical assessments including the Korean version of the ALS Functional Rating Scale-Revised (K-ALSFRS-R), Functional Oral Intake Scale (FOIS), Eating Assessment Tool-10 (EAT-10), Dysphagia Handicap Index, Korean version of the Swallowing Quality of Life Questionnaire, Mini Nutritional Assessment–Short Form (MNA-SF), handgrip strength, and bioelectrical impedance analysis for skeletal muscle index (SMI) were performed. Swallowing physiology was evaluated using the Modified Barium Swallow Impairment Profile (MBSImP), Penetration-Aspiration Scale. Simple and partial Pearson’s correlation analyses as well as univariate regression were performed with adjustments for age, sex, and body mass index (BMI).
Results
Tongue thickness showed significant associations with multiple functional and systemic measures in the unadjusted analyses, including FOIS, EAT-10, MNA-SF, BMI, SMI, K-ALSFRS-R. After adjustment, the most consistent associations were observed with the MBSImP oral, pharyngeal, and combined phase scores.
Conclusion
Tongue ultrasonography may serve as a radiation-free method to preliminarily assess bulbar involvement in ALS. Tongue thickness was most specifically associated with dysphagia outcomes, particularly MBSImP. Given the feasibility design and small sample size, larger longitudinal studies are warranted to confirm its clinical utility in monitoring the progression of dysphagia in patients with ALS.

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Brain disorders

Feasibility of Computerized Visuomotor Integration System for Visual Field Defects and Spatial Neglect in Poststroke Patients: Hyeon-Taek Hong, Myeong Geun Jeong, Kyoung Tae Kim; Ann Rehabil Med 2024;48(2):146-154. Published online April 25, 2024; DOI: https://doi.org/10.5535/arm.230028

Objective
To develop a computerized visuomotor integration system for assessment and training of visual perception impairments and evaluate its safety and feasibility in patients with a stroke. Visual field defects and spatial neglect lead to substantial poststroke impairment. Most diagnostic assessments are anchored in traditional methods, and clinical effects of rehabilitation treatments are limited.
Methods
The CoTras Vision system included two evaluations and four training modules. The evaluation modules were based on the Albert’s test and Star cancellation test, and training modules were based on visual tracking, central-peripheral integration, and visuomotor perception techniques. Bland–Altman plots for agreement with the traditional paper-and-pencil test were performed, and the modified Intrinsic Motivation Inventory, Patient Satisfaction Questionnaire, and Simulator Sickness Questionnaire were conducted.
Results
Ten patients with acute stroke completed the study. Bland–Altman plots revealed good agreements for Albert’s test (mean difference, -0.3±4.5) and Star cancellation test (mean difference, 0.3±0.7). The mean±standard deviation scores of the modified Intrinsic Motivation Inventory, Patient Satisfaction Survey, and Simulator Sickness Questionnaire were 84.7±30.6, 40.5±7.9, and 34.0±34.5 respectively.
Conclusion
The CoTras Vision system is feasible and safe in patients with stroke. Most patients had a high degree of motivation to use the system and did not experience severe adverse events. Further studies are needed to confirm its usefulness in stroke patients with visual field defects and hemineglect symptoms. Furthermore, a large, well-designed, randomized controlled trial will be needed to confirm the treatment effect of the CoTras Vision system.

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Tablet computer-based cognitive training for visuomotor integration in children with developmental delay: a pilot study
Jee Hyun Suh, Soo Jeong Han, Sun Ah Choi, Hyesung Yang, Sihyun Park
BMC Pediatrics.2024;[Epub] CrossRef

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Brain disorders

Feasibility and Usability of a Robot-Assisted Complex Upper and Lower Limb Rehabilitation System in Patients with Stroke: A Pilot Study: Kyoung Tae Kim, Yongmin Choi, Jang Hyuk Cho, Soyoung Lee; Ann Rehabil Med 2023;47(2):108-117. Published online April 30, 2023; DOI: https://doi.org/10.5535/arm.23017

Objective
To evaluate the feasibility and usability of cost-effective complex upper and lower limb robot-assisted gait training in patients with stroke using the GTR-A, a foot-plate based end-effector type robotic device.
Methods
Patients with subacute stroke (n=9) were included in this study. The enrolled patients received 30-minute robot-assisted gait training thrice a week for 2 weeks (6 sessions). The hand grip strength, functional ambulation categories, modified Barthel index, muscle strength test sum score, Berg Balance Scale, Timed Up and Go Test, and Short Physical Performance Battery were used as functional assessments. The heart rate was measured to evaluate cardiorespiratory fitness. A structured questionnaire was used to evaluate the usability of robot-assisted gait training. All the parameters were evaluated before and after the robot-assisted gait training program.
Results
Eight patients completed robot-assisted gait training, and all parameters of functional assessment significantly improved between baseline and posttraining, except for hand grip strength and muscle strength test score. The mean scores for each domain of the questionnaire were as follows: safety, 4.40±0.35; effects, 4.23±0.31; efficiency, 4.22±0.77; and satisfaction, 4.41±0.25.
Conclusion
Thus, the GTR-A is a feasible and safe robotic device for patients with gait impairment after stroke, resulting in improvement of ambulatory function and performance of activities of daily living with endurance training. Further research including various diseases and larger sample groups is necessary to verify the utility of this device.

Citations

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Effect of Progressive Speed Increase Versus Constant Speed in Robot-Assisted Gait Training on Balance and Gait Ability in Chronic Stroke: A Randomized Controlled Trial
Dong-Yun Bae, Soo-Yong Kim, Jong-Chul Jung, Min-Chull Park
NeuroRehabilitation.2026; 58(1): 135. CrossRef
Changes in body composition, physical fitness and quality of life on robotic gait assisted training in patients with Guillain-Barré Syndrome: a case report
Moon Jin Lee, Sung Jin Yoon
Physical Activity and Nutrition.2024; 28(4): 009. CrossRef
Smart Devices for Health and Wellness Applied to Tele-Exercise: An Overview of New Trends and Technologies Such as IoT and AI
Antonio Fabbrizio, Alberto Fucarino, Manuela Cantoia, Andrea De Giorgio, Nuno D. Garrido, Enzo Iuliano, Victor Machado Reis, Martina Sausa, José Vilaça-Alves, Giovanna Zimatore, Carlo Baldari, Filippo Macaluso
Healthcare.2023; 11(12): 1805. CrossRef

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Ultrasonographic Measurement of the Thickness of Axillary Recess Capsule in Healthy Volunteers: Kyoung Tae Kim, Dong Gyu Lee, Soyoung Lee, Du Hwan Kim; Ann Rehabil Med 2016;40(3):502-508. Published online June 29, 2016; DOI: https://doi.org/10.5535/arm.2016.40.3.502

Abstract
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Objective

To evaluate the inter-rater and intra-rater reliability of ultrasonographic measurements of axillary recess (AR) thickness in healthy individuals, and to analyze the factors affecting the thickness of the AR capsule.

Methods

We recruited 20 healthy individuals (10 male, 10 female) with a mean age of 37 years (standard deviation ±10). Two physiatrists (an experienced and a novice rater) independently investigated the AR thickness in three rounds. The AR thickness was measured for each individual at three shoulder abduction angles (50°, 70°, and 90°). Intra-class correlation (ICC) coefficients were used to assess the reproducibility of each measurement.

Results

Excellent intra-rater reliability coefficients were observed at the three shoulder abduction angles, in the analysis of both raters. The inter-rater reliability coefficient was also was excellent in both studies. There were significant differences in the AR thickness, according to the angle of shoulder abduction. The AR was thicker at 50° than at 70° and 90° (all p<0.001), and the AR was thicker at 70° than at 90° (p<0.001). Height (r=0.62, p=0.003) and body mass index (r=0.52, p=0.019) were positively correlated with AR thickness. Males had a thicker AR capsule than females at all three angles (all p<0.001).

Conclusion

Ultrasonographic measurements of AR thickness in healthy individuals demonstrate excellent intra-rater and inter-rater reliability. AR thickness may depend on anthropometric variables and position of the shoulder.

Citations

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Diagnostic value of high-frequency ultrasound combined with magnetic resonance in different clinical stages of frozen shoulder: A retrospective cohort study
Lei Zhang, Hua Chen, Qi Yang, Zhichao Ding, Laizhi Zhang, Yifeng Gu
Journal of Back and Musculoskeletal Rehabilitation.2025; 38(2): 253. CrossRef
Ultrasound Technique for the Assessment of the Inferior Glenohumeral Capsule for Frozen Shoulder
Sumi Shrestha‐Taylor
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Inferior glenohumeral joint capsule thickness in frozen shoulder via ultrasonography
Toru Inada, Masahiro Tsutsumi, Masahiro Ikezu, Yasuhiko Iizuka, Tatsuo Nagano, Shintarou Kudo
JSES International.2024; 8(5): 1033. CrossRef
Diagnostic Ultrasound in the Evaluation of Stiff Shoulder
Buwen Yao, Yanyan Yang, Shawn C. Roll, Zhuohua Lin, Yuanmingfei Zhang, Jie Jiang, Mouwang Zhou
American Journal of Physical Medicine & Rehabilitation.2024; 103(12): 1117. CrossRef
Ultrasound assessment of the inferior glenohumeral capsule in normal shoulders—a study of measurement variables and reliability
Sumi Shrestha-Taylor, Karen Ginn, Ann Poulos, Jillian L Clarke
The British Journal of Radiology.2023;[Epub] CrossRef
Ultrasound Features for the Diagnosis of Adhesive Capsulitis/Frozen Shoulder: A Systematic Review
Sumi Shrestha-Taylor, Jillian L. Clarke, Ann Poulos, Karen Ginn
Ultrasound in Medicine & Biology.2022; 48(12): 2379. CrossRef
Comparison of Shoulder Ultrasonographic Assessments between Polymyalgia Rheumatica and Frozen Shoulder in Patients with Bilateral Shoulder Pain: A Comparative Retrospective Study
Eun-Woo Park, Jang-Hyuk Cho, Chul-Hyun Cho, Duk-Hyun Sung, Du-Hwan Kim
Journal of Personalized Medicine.2021; 11(5): 372. CrossRef
Correlation of Ultrasound Findings With Clinical Stages and Impairment in Adhesive Capsulitis of the Shoulder
Jong Geol Do, Jin Tae Hwang, Kyung Jae Yoon, Yong-Taek Lee
Orthopaedic Journal of Sports Medicine.2021;[Epub] CrossRef
Dynamic Ultrasonographic Measurement of Inferior Joint Capsule Thickness in Patients with Unilateral Frozen Shoulder
Jun-Gyu Lee, Hyungsun Peo, Jang-Hyuk Cho, Chul-Hyun Cho, Don-Kyu Kim, Du-Hwan Kim
Diagnostics.2021; 11(5): 898. CrossRef
Adhesive Capsulitis of the Shoulder
Soo-Jung Choi
Journal of the Korean Society of Radiology.2021; 82(6): 1355. CrossRef
Ultrasound measurements of axillary recess capsule thickness in unilateral frozen shoulder: study of correlation with MRI measurements
Du Hwan Kim, Chul-Hyun Cho, Duk Hyun Sung
Skeletal Radiology.2018; 47(11): 1491. CrossRef