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Introduction: The purposes of this study were to investigate the effects of raising the heel to the forefoot plantar pressure (PP) in diabetic patients with or without limited ankle dorsiflexion due to tight tendon Achilles (TA).  Materials and methods:  Plantar pressure recordings and gait tests were performed in the two groups of subjects with diabetes (tight TA, n=17; normal TA, n=13) with the heel raised from 1 cm to 3 cm. Results: There were no significant forefoot pressure difference between both intervention groups (p < 0.05).  Plantar pressure reduction was seen in the medial (10-30%) and lateral metatarsal heads (20-50%) as well as the heel (2-38%) when heel raise was increased from 1 to 3 cm. However, reciprocal pressure increase was seen at hallux (11-76%), toes (1-200%) and midfoot (22-100%) with increased heel height.  Conclusion:  Heel elevation up to 2 cm is recommended for footwear prescription for to diabetic patients. A higher heel raise may may cause plantar pressure elevation to the hallux which is one of the high risk regions for plantar ulceration in diabetics.

Currently, fully automated rehabilitation robots can assist therapists in providing rehabilitation therapy, hence the patients could get hurt. On the other hand, manual treatment may cause less patient injury but it is tiresome, and there are not enough therapists in most countries. Power assist rehabilitation robots can support the therapists in conducting the treatment and may help to alleviate this problem. The goal of this study is to develop a control strategy for the robot to assist the therapist’s movement in a power assist upper limb rehabilitation treatment. The system combines the advantages of robotic and manual rehabilitation therapy. Torque and position sensors fitted on the power assist upper limb rehabilitation robot arm are used for motion intention estimation. The amount of angular velocity necessary to be delivered to the feedback controller will be determined by predicting the therapist‘s motion intention using the impedance control method. The resulting velocity from the motion intention estimator is incorporated into the Sliding Mode Control - Function Approximation Technique (SMC-FAT) based adaptive controller. The SMC-FAT based adaptive controller in the feedback loop, overcomes the uncertain parameters in the combination of the robot and the human arm. The motion intention estimator forecasts the movement of therapists. The proposed controller is used to regulate elbow flexion and extension motion on a power assist upper limb rehabilitation robot with one degree of freedom (DOF). The proposed control system has been tested using MATLAB simulation and hardware experimental tests. The outcomes demonstrate the effectiveness of the proposed controller in directing the rehabilitation robot to follow the desired trajectory based on the therapist's motion intention, with maximum errors of 0.002rad/sec, 0.005rad/sec and 0.02rad/sec for sinusoidal, constant torque values, and hardware experiment respectively. ABSTRAK: Pada masa ini, robot rehabilitasi automatik sepenuhnya dapat membantu ahli terapi dalam menyediakan terapi pemulihan, tetapi pesakit berkemungkinan tercedera. Sebaliknya, rawatan manual berkemungkinan mengurangkan kecederaan pesakit tetapi ia memenatkan, dan terdapat kurang ahli terapi yang mencukupi di kebanyakan negara. Robot pembantu rehabilitasi dapat membantu ahli terapi dalam menjalankan pemulihan dan mengurangkan masalah ini. Sistem ini menggabungkan kelebihan terapi pemulihan robotik dan manual. Alat pengesan tork dan kedudukan diletakkan pada anggota atas lengan robot rahabilitasi yang digunakan bagi mengesan anggaran jarak pergerakan ahli terapi. Anggaran halaju sudut diperlukan bagi kawalan gerak balas dan dapat diketahui melalui anggaran niat gerakan ahli terapi menggunakan kaedah kawalan impedans. Halaju yang terhasil daripada anggaran niat gerakan diadaptasi ke dalam pengawal adaptif berasaskan Kawalan Mod Gelongsor - Teknik Anggaran Fungsi (SMC-FAT). Pengawal penyesuaian berasaskan SMC-FAT dalam gelung maklum balas, mengatasi parameter yang tidak pasti dalam gabungan robot dan lengan manusia. Penganggar niat gerakan meramalkan gerakan ahli terapi. Pengawal yang dicadangkan digunakan bagi mengawal lenturan siku dan gerakan lanjutan pada robot rehabilitasi dengan satu darjah kebebasan (DOF). Sistem kawalan yang dicadangkan telah diuji menggunakan simulasi MATLAB dan ujian eksperimen perkakasan. Dapatan kajian menunjukkan keberkesanan pengawal yang dicadangkan dalam mengarahkan robot rehabilitasi mengikut trajektori yang dikehendaki berdasarkan niat gerakan ahli terapi, dengan ralat maksimum masing-masing 0.002rad/s dan 0.005rad/s bagi sinusoidal, nilai tork malar, dan eksperimen perkakasan masing-masing.

Introduction: The electronic cigarette (e-cigarette) is an electronic device containing a cartridge filled with liquid nicotine and other chemicals, producing inhalable smoke. Malaysia is known to be one of the biggest markets for e-cigarettes due to the highest recorded number of young consumers. E-cigarette cause multiple pulmonary complications or direct injury secondary to the device explosion. Little is known about its effects on cognitive performance, and its potential hazard to the brain. Given a different sociodemographic background and e-cigarette profile compared to the other country, it is paramount to explore its potential effect on cognitive function among the young population in Malaysia. Method: This is a case-controlled study to explore the cognitive performance differences between e-cigarette users and non-users among university students in Malaysia. We performed a face-to-face cognitive evaluation using WHO Auditory Verbal Learning Tests (WHO-AVLT), Trail Making test (TMT), and Digit Span Test (DST). We assessed the knowledge and attitude towards e-cigarettes using a self-reported questionnaire and explored their association with the behaviour. Results: DST has shown a significant difference, with the e-cigarette users demonstrated a higher score compared to non-cigarette users with scores of 21.75 and 20.17, p < 0.05, respectively. There were no significant differences between the e-cigarette users and non-users for WHO-AVLT and TMT. E-cigarette users demonstrate a lower level of knowledge and attitude than users, showing a significant association with e-cigarette behavior. Conclusion: E-cigarette does not cause a cognitive performance decline among university students. This study provides the initial evidence of whether there is any potential for e-cigarette effect on cognitive function among our local young population. The finding may serve as a reference for a more robust related study in the future.

Review question / Objective: Review Questions: 1. What are the publicly available databases that can identified in Complementary and Integrative Medicine (CIM) studies? 2. What are the main characteristics of these studies? 3. Which of the CIM studies identified are associated with rehabilitation? Objectives 1. To create a tool for future research approaches based on lessons from the studies identified - hence promoting robust scientific protocols in its pursuit – for better acceptance by scientists, practitioners, and end-users. 2. To map and review open access databases that include CIM related data as defined by the National Institute of Health in 2012. 3. To highlight a subset of CIM studies that are associated with rehabilitation; to be identified as CIRM and promote it as an inclusive rehabilitative modality. 4. To guide future research on Complementary and Integrative Medicine. 5. To stimulate future research in Complementary and Integrative Medicine. 6. To promote evidence-based practice in Complementary and Integrative Medicine.