The gait speed was significantly correlated with the physical domains of the QOL in stroke patients. The community ambulators had the highest QOL among the three groups.

BACKGROUND: Dry needling (DN) is commonly used to treat myofascial trigger points (MTrPs). OBJECTIVE: To compare the effect between DN with and without needle retention in the treatment of MTrPs in the upper trapezius muscle. METHODS: Fifty-four patients who had active MTrPs in the upper trapezius muscle were randomly allocated into the DN group or the DN with retention group. The DN group received DN only, while the DN with retention group received DN with needle retention for 30 minutes. The visual analogue scale (VAS) and pressure pain threshold (PPT) were recorded both before and after 7 and 14 days of the treatment sessions. RESULTS: Both groups showed a significant decrease of the VAS at 7 and 14 days (mean difference DN group -53.0, DN with retention group -57.0, p< 0.001). The PPT was also significantly improved in both groups (mean difference DN group 109.8 kPa, DN with retention group 132.3 kPa, p< 0.001). However, there were no significant differences in the VAS or PPT between the groups. CONCLUSIONS: Both DN and DN with retention had significant improvement of pain intensity in the treatment of MTrPs in the upper trapezius muscle at 14 days. However, pain reduction was not significantly different between the interventions.

Background The flipped classroom (FC) is a well-known active learning module that activates the prior knowledge of students and promotes their cognitive skills during in-class activities. However, most on-site teaching during the COVID-19 pandemic had to be conducted online. The FC in our rehabilitation medicine clerkship curriculum was also shifted to online asynchronous lectures (OLs), without real-time interactions. There is no previous comparison of effectiveness between these two methods. Therefore, this study aimed to compare learning outcomes and student satisfaction in both FC and OL models. Methods The study design was a historically controlled study. A physical modality was chosen for the content. The FC group (n = 233), in the academic years 2018 and 2019, was assigned to perform a pre-class activity consisting of reading study materials. Thereafter, the in-class activity comprised a small-group case-based discussion. The OL group (n = 240) in the academic years 2020 and 2021 followed an online model during the COVID-19 lockdown. They were also asked to read the online materials and then watch a self-paced recorded lecture video on Learning Management Systems. The learning outcomes, including their multiple-choice questions (MCQs) scores, final exam scores, grade points, and letter grades, were evaluated. Their overall course satisfaction ratings were also collected. Results The OL group had an overall higher MCQ score for the physical modality portion than the FC group (p = 0.047). The median (lower quartile, upper quartile) of the total 50-MCQ scores were 34 (31, 37) in the OL group and 33 (29, 36) in the FC group (p = 0.007). The median final exam scores of the OL and FC groups were 69.5 and 68.3, respectively (p = 0.026). The median grade points and the letter grades were not significantly different between the groups. The proportions of satisfaction were significantly higher in the FC group than in the OL group. Conclusions The OL group revealed significantly higher learning outcomes than the FC group. However, the FC group showed more satisfaction with interactivity than the OL group. The authors are of the view that a combination of both FC and OL methods will likely result in better outcomes.

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Objective: This study aims to describe the clinical, laboratory and electrophysiological findings of the prisoners who developed acute reversible motor predominant polyradiculoneuropathy after the outbreak of H3N2 influenza. Material and Methods: Among H3N2 infected Thai prisoners, all patients with acute flaccid weakness were included in this retrospective case series. We analyzed the results of electromyography (EMG), cerebrospinal fluid analysis, and serum levels of antiganglioside antibodies, folate, thiamine, and vitamin B12.Results: Among 262 H3N2 influenza patients, motor predominant polyradiculoneuropathy predominantly affecting the lower limbs developed in 10 patients. EMG revealed significantly decreased compound muscle action potentials with preserved distal latencies and conduction velocities in the peroneal nerves. Early fibrillation potentials were demonstrated on EMG performed 12-14 days post-onset of symptoms. The cerebrospinal fluid study showed normal profiles. All laboratory results appeared normal except for the significantly low mean±standard deviation serum folate level of 1.80± 0.78 [reference value 3.89–26.80 nanograms per milliliter (ng/mL)] as compared to the mean serum folate level in the normal Thai population of 10.80 ng/mL (p-value<0.001, 95% confidential interval -9.55 to -8.45). All patients were treated with 15 milligram per day of folic acid and all patients improved clinically. Conclusion: Although the relationship between low plasma folate level and polyradiculoneuropathy is unclear, a superimposed folate deficiency contributing to the pathophysiology is possible.