Clinical trials

This study aims to develop and evaluate a smart nursing AI agent to support health self-management among middle-aged and older patients, and further to examine its effectiveness in home care and health self-management. The goal is to propose innovative strategies for middle-aged and older care that enhance the quality of home care and strengthen patients' health self-management abilities. A randomized controlled trial design will be adopted, with a planned enrollment of 102 participants. Participants will be randomly assigned to either the experimental group or the control group. Regardless of group assignment, their routine medical care will remain unchanged. Both groups will participate in the study for 12 weeks (8 weeks of intervention and 4 weeks of follow-up), with identical frequency and number of follow-ups, interviews, and evaluations. The experimental group will receive an 8 week intervention using the smart nursing AI agent care model, which provides daily interaction, reminder systems, personalized recommendations, activity monitoring, goal setting, motivational support, and health self-management education. The control group will continue with the existing standard health education approach. Data collection will include demographic information, medical history, physiological indicators, functional activity measures (e.g., steps, distance, exercise duration), sarcopenia screening, nutritional assessment, physical activity levels, health self-management ability, health literacy, quality of life, and digital usage behaviors. Statistical analyses will be conducted to evaluate the effectiveness, feasibility, and acceptability of the intervention.

This study is being done to better understand how vestibular problems and thinking abilities (such as attention and mental flexibility) are related in older adults, and how doing a balance task and a thinking task at the same time affects their performance. Older adults will first complete questionnaires and simple paper-and-pencil tests of attention, memory, and mental rotation while seated. They will then perform standing balance tasks on a portable force platform under different conditions (eyes open, eyes closed, standing on a foam surface) and will repeat some of the thinking tasks at the same time. Next, participants will walk on a treadmill while wearing small motion sensors, both with and without added thinking tasks such as serial subtraction and digit reordering. The total testing time is about 90 minutes. Two groups will be included: healthy older adults and older adults who have had dizziness or falls in the past two years. By comparing these groups, the study aims to provide a basis for designing future dual-task assessment and training programs to reduce balance problems and falls in older adults.

Participants will participate in a 5-day facial exercise program and will be assessed at baseline, immediately after completion of the intervention, and 1 month after completion of the intervention. Older adults aged 60 years and above who are able to communicate in Mandarin or Taiwanese and who participate in activities at adult day-care centers or community care centers will be eligible for inclusion. Individuals with severe visual or hearing impairment, moderate to severe dementia, inability to communicate verbally, obvious facial wounds or lesions, or medical conditions affecting swallowing function (e.g., stroke) will be excluded from participation. A total of approximately 130 participants will be recruited and assigned to one of two groups: Intervention Group (n ≈ 65): Participants will perform facial exercises using the Smart Facial Coaching System. Control Group (n ≈ 65): Participants will perform facial exercises by following a video-based facial exercise program. After providing informed consent and meeting the eligibility criteria, participants will complete baseline assessments, including structured questionnaires and the Repetitive Saliva Swallowing Test (RSST). Participants in both groups will then perform facial exercises for five consecutive days, with each session lasting approximately 10-15 minutes. Upon completion of the 5-day facial exercise program, participants will complete post-intervention assessments, including structured questionnaires and the Repetitive Saliva Swallowing Test (RSST). One month after completion of the intervention, participants will complete follow-up questionnaires assessing facial exercise behavior and psychosocial outcomes, which will take approximately 15-20 minutes.

This study is the first phase of the research project. The purpose of this phase is to develop and refine a narrative-based intervention designed to reduce self-stigma among people with schizophrenia. A small pilot study will be conducted with 24 participants recruited from halfway houses in northern Taiwan. Eligible participants will receive the intervention, which consists of four group sessions and four individual sessions, held once a week for a total of eight weeks. The program uses narrative therapy techniques to help participants explore their personal experiences and reduce self-stigma. Participants will complete a workbook during the program, and the written content will be analyzed to better understand their experiences with stigma. Any personal information will be removed to protect participants' privacy. Before and after the intervention, participants will complete questionnaires on self-stigma, depression, social functioning, well-being, hope, and recovery. Information on medication use will also be collected. Group and individual sessions will be audio-recorded for research purposes. The questionnaire data and recordings will be used to evaluate the feasibility and preliminary effects of the intervention.

This study aims (1)to investigate the effects of repetitive functional overhead movements targeting shoulder and scapular muscles on glenohumeral and scapular kinematics and muscle activation during the arm cocking and acceleration of spiking, and changes in subacromial structures in healthy recreational volleyball players; (2) to compare these fatigue-related changes between athletes with good and poor shoulder motor control.

The research aims to compare the differences between stable and unstable load conditions during shoulder pressing in overhead athletes with SAPS and to compare the differences between SAPS and healthy athletes with stable and unstable load conditions.

Background: Temporomandibular disorders (TMDs) are the leading cause of non-odontogenic orofacial pain interfering with daily activities. TMDs consist of a group of conditions affecting the masticatory muscles, the temporomandibular joint (TMJ), or the associated structures. Previous studies showed alterations in TMJ kinematics, cortical excitability, electromyographic (EMG) activity of the masticatory muscles, and tongue pressure in individuals with TMDs compared to healthy controls. Furthermore, several studies have demonstrated that manual therapy applied to the cervical joint could reduce pain and improve jaw function in individuals with TMDs. However, the effects of upper cervical mobilization on TMJ kinematics, cortical excitability, tongue pressure, and EMG of masticatory muscles during mouth opening in individuals with myogenous TMDs remain unknown. Purpose: This study aims to investigate the immediate effects of upper cervical mobilization on TMJ kinematics, EMG of masticatory system muscles, cortical excitability, and tongue pressure in individuals with myogenous TMDs. Methods: A randomized controlled trial will be conducted with a total sample size of 48 participants. Individuals diagnosed with myogenous TMDs, defined as chronic myalgia (lasting \>3 months continuously or \> 6 months intermittently) according to the Diagnostic Criteria for Temporomandibular Disorders, will be recruited for this study. Participants will be randomly assigned to either the experimental or the control group, stratified by age and sex. The experimental group will receive a single session of upper cervical mobilization, while the control group will receive a placebo maneuver. The primary outcomes will include TMJ kinematics and EMG activity of the masseter and suprahyoid muscles, while the secondary outcomes will include cortical excitability, tongue pressure, pain intensity, and upper cervical mobility. All measurements will be taken before and immediately after the intervention. Statistical analysis: The continuous and categorical variables of clinical and demographic characteristics will be analyzed by an independent t test/Mann-Whitney U test and a Chi-square test, respectively. A 2×2 mixed-model analysis of variance (ANOVA) will be used to analyze the outcome measures and to test the main effects and interactions between time and group. If there is a significant interaction effect, post hoc pairwise comparisons with Bonferroni correction will be used. The alpha level is set at 0.05.

This study will analyze and compare scapular kinematics and muscle activation patterns between upper string musicians with and without neck pain during arm elevation and playing tasks (open strings, scales, musical pieces), providing insights for performance training and rehabilitation programs to reduce playing-related musculoskeletal disorders.

Tennis players often suffer from shoulder pain due to the repetitive high-loaded overhead movements during serving, and subacromial pain syndrome is one of the main types of shoulder pain. Previous shoulder injury has been identified as one of the risk factors for shoulder overuse injuries in overhead sports. No research has explored differences in trunk kinematics and shoulder muscle activities among tennis players with and without subacromial pain syndrome or a history of shoulder pain. Furthermore, limited studies have examined shoulder kinematics during tennis serve and musculoskeletal characteristics in tennis players with subacromial pain syndrome or a history of shoulder pain. Therefore, this study aims to investigate shoulder and trunk kinematics and shoulder muscle activity during the tennis serve and musculoskeletal characteristics in tennis players with subacromial pain syndrome or a history of shoulder pain. This study will recruit sixty tennis players with subacromial pain syndrome, a history of shoulder pain, and healthy players. The electromagnetic tracking system will be applied to collect shoulder and trunk kinematics during the tennis serve, and surface electromyography will be simultaneously used for recording shoulder muscle activities. Moreover, we will collect shoulder and trunk rotational joint range of motion, isometric strength and rate of force development of shoulder internal and external rotation, scapulothoracic and glenohumeral joint control capability, upper quarter Y-balance test performance, and posterior shoulder endurance. This study will compare the difference of these measures in tennis players with subacromial pain syndrome or a history of shoulder pain to healthy players.

Background: Cardio-renal metabolic syndrome (CRMS) is a vicious cycle of cardiac, renal, and metabolic disease, representing a high-risk for atherosclerosis. Laser acupuncture modulates vascular inflammation and improves endothelial function via low-level laser therapy (LLLT, \<500mW) at acupoints or musculoskeletal pain sites. Few studies have focused on CRMS populations. This study evaluates laser acupuncture effects on arterial stiffness in CRMS. Purpose: To assess the effects of improvement of laser acupuncture in patients with CRMS, and to evaluate its feasibility as supportive therapy. Methods: A single-group pre-post design is used. Participants are patients with CRMS receiving laser acupuncture at a Chinese medicine clinic in Taiwan. CRMS is interrelated by cardiac, renal, and metabolic disease. Inclusion criteria require diagnosis in ≥2 of 3 systems (cardiovascular, renal, or metabolic; n = 35). Laser acupuncture will be applied to bilateral BL40 for 12 weeks (1-3 sessions/week, 60mins/session). Pulse wave velocity(PWV) measured by Omron HBP- 8000 as the primary outcome for arterial stiffness. Paired t-tests and GEE will be used for analysis. Expected Results: PWV is expected to show significant improvement after intervention.

Prior research has explored factors influencing muscle activation, including muscle thickness, fear avoidance beliefs (kinesiophobia), and somatosensory integration. In individuals with chronic shoulder pain, various characteristics impacting symptoms and treatment outcomes have been identified, such as psychosocial factors, fear avoidance, central sensitization, somatosensory impairments, and brain morphology changes. These shared characteristics affecting both muscle activation and chronic shoulder pain may potentially modulate upper trapezius muscle activation during functional movements in patients with chronic shoulder pain. Notably, there remains a gap in the literature concerning investigations into the upper trapezius muscle's morphology and quality, fear avoidance, central sensitization, somatosensory impairments, and their interplay with upper trapezius muscle activation in chronic shoulder pain patients. To address these gaps, this study aims to: this study aims to: 1) compare different methods of measuring clavicular kinematics using an electromagnetic tracking system; 2) establish the reliability and validity of measuring muscle thickness and fat infiltration through ultrasound and magnetic resonance imaging; 3) compare shoulder kinematics, muscle activation, muscle morphology, and muscle fat infiltration in individuals with chronic shoulder pain with matched healthy controls; 4) explore the correlation between the factors that may influence upper trapezius muscle activation, including basic data of the subjects, muscle morphology, and muscle fat infiltration.

The goal of this randomized controlled trial is to evaluate the effectiveness of a multi-modal digital intervention, based on the Theory of Planned Behavior (TPB), in promoting healthy weight control behaviors among overweight and obese adolescents. This study also aims to reduce the risk of unhealthy weight control behaviors by leveraging artificial intelligence-driven coaching, interactive platforms, gamified applications, and real-time feedback mechanisms. The main questions this study aims to answer are: 1. Can a multi-modal digital intervention effectively modify adolescents' primary beliefs underlying TPB constructs (attitude, subjective norms, and perceived behavioral control)? 2. How do TPB constructs influence weight control intentions, and how do these intentions translate into either healthy or unhealthy weight control behaviors? What role do adolescents' body image, body satisfaction, and mental health play in moderating the relationship between weight control intention and behavior? Participants will: 1. Be adolescents aged 12-18 years with a BMI ≥ 85th percentile. 2. Be randomly assigned to either the intervention group (multi-modal digital intervention) or the control group (general health education). 3. Engage in AI-driven coaching, interactive digital sessions, and gamified experiences tailored to TPB constructs. 4. Complete biweekly sessions over a period of three months (each session lasting two hours). 5. Receive personalized feedback and real-time monitoring through the Virti platform. 6. Participate in follow-up assessments at one month and three months post-intervention. Researchers will compare the intervention group to the control group to determine whether the multi-modal digital intervention leads to a higher adoption of healthy weight control behaviors and a lower prevalence of unhealthy weight control behaviors.

This research will analyze and compare the muscle activation levels, muscle recruitment timing, trunk kinematics, and shoulder joint kinematics between the four forehand strokes and between elite table tennis players with and without shoulder injuries, providing insights for daily training and rehabilitation programs to reduce the occurrence of sports injuries.

Nearly half of individuals with stroke experience limitations in community ambulation, and 35.7% of community-dwelling stroke survivors experienced falls while walking, indicating that falls are common during routine daily activities in community settings. Sensory reweighting refers to the ability to appropriately prioritize and integrate sensory inputs to maintain postural stability. Stroke survivors often demonstrate impaired sensory reweighting, characterized by excessive reliance on visual and proprioceptive cues and insufficient integration of vestibular information. This deficit adversely affects postural control and subsequently compromises gait performance and fall risk .In addition, many individuals with stroke exhibit reduced gaze stability during walking and turning, suggesting potential impairments in the vestibulo-ocular reflex (VOR), a key mechanism for maintaining stable vision during head movement. Insufficient gaze stability has been associated with gait disturbances; therefore, deficits in sensory reweighting and VOR function may contrib-ute to limited community ambulation and increased fall risk. Although previous studies have primarily focused on general balance training, few have directly targeted vestibular input. Thus, the effectiveness of vestibular-specific training for improving community ambulation and reducing fall risk in chronic stroke remains unclear. This study aims to investigate the effects of vestibular training on community ambulation and fall risk in individuals with chronic stroke.

Nearly half of individuals with stroke experience limitations in community ambulation, and 35.7% of community-dwelling stroke survivors experienced falls while walking, indicating that falls are common during routine daily activities in community settings. Patla (1999) proposed that community mobility is influenced by eight factors: ambient conditions, terrain characteristics, external physical load, attentional demands, postural transitions, traffic level, time constraints, and walking distance. This framework suggests that community ambulation requires consideration of multiple physiological domains as well as environmental factors. However, current assessments of community ambulation primarily rely on indoor walking speed as an indicator, which may be insufficient to fully evaluate patients' community ambulation ability. Previous studies have not yet established the reliability of community ambulation assessments such as the Walking Ability Questionnaire, community walking speed, and the Falls Efficacy Scale (Taiwan Chinese version)-in individuals with chronic stroke. Additionally, stroke survivors often demonstrate insufficient integration of vestibular information, which may affect gait performance through impaired dynamic visual acuity. Therefore, this study aims to investigate the reliability of community ambulation assessments and dynamic visual acuity testing in individuals with chronic stroke.

People with Parkinson's disease (PD) may have difficulty stopping or changing their movements, especially when walking around obstacles. The goal of this observational study is to learn if a specific cognitive function, called inhibitory control (the ability to stop or control actions) is associated with gait adaptability in people with Parkinson's disease. Gait adaptability means the ability to adjust how a person walks in response to changes in the environment, such as stepping over obstacles. The main questions the study aims to answer are: * If brain activation related to inhibitory control, measured by EEG, is associated with gait adaptability during obstacle crossing in people with Parkinson's disease? * If behavioral inhibitory control is associated with gait adaptability during obstacle crossing in people with Parkinson's disease? Participants take part in one study visit. During this visit, participants complete simple thinking tests, have their brain activity recorded using EEG, and perform walking tasks that include stepping over obstacles.

The dual-task automated walking performance in people with Parkinson\&#39;s disease (PD) is affected by their gait disturbances and impaired executive functions. Currently, the relationship between brain activity related to inhibitory control, executive functions, and dual-task walking performance in people with PD is not well understood. Therefore, this study aims to investigate the significance of different executive function domains on gait stability in healthy older adults and people with PD; whether brain activation related to inhibitory control is associated with gait stability in healthy older adults and people with PD.

Chronic non-specific low back pain is commonly associated with impaired movement control. Movement control training is often used in rehabilitation, and different cueing methods may influence how patients perform and learn movements. The purpose of this randomized controlled trial is to compare the immediate effects of manual cueing and verbal cueing during movement control training in individuals with chronic non-specific low back pain. Participants will be randomly assigned to receive either manual cueing or verbal cueing during a standardized movement training session. The study will examine immediate changes in movement control performance, perceived difficulty, and related clinical outcomes following the intervention. The results of this study may help clinicians better understand how different cueing strategies influence movement performance in people with chronic non-specific low back pain.

This study aims to investigate the interactive effects of two core stability training strategies-abdominal drawing-in manoeuvre (ADIM) and Dynamic Neuromusculoskeletal Stabilization abdominal expansion (DNS-AE)-and two instructional approaches (verbal cueing and manual facilitation) on training outcomes in individuals with chronic non-specific low back pain. A 2×2 factorial randomized controlled trial design will be employed. Ninety-six participants with chronic non-specific low back pain will be randomly allocated, using block randomization, to one of four intervention groups in equal proportions. All groups will receive a 4-week intervention program, with training conducted twice per week. Outcome measures will be assessed at four time points: before the intervention (baseline), immediately after the first training session, at the completion of the 4-week intervention, and at a 3-month follow-up, to evaluate short-term and mid-term effects as well as the sustainability of training outcomes.

The goal of this clinical trial is to learn if two common physical therapy approaches, used alone or together, can help reduce pain and improve daily function in adults with nonspecific low back pain. Nonspecific low back pain means low back pain without a clear medical cause. The main questions this study aims to answer are: 1. Does hands-on pressure to painful muscle spots (called myofascial trigger point therapy) help lower low back pain? 2. Does a guided exercise program that focuses on how muscles work together help lower low back pain? 3. Does combining hands-on therapy with exercise work better than using either approach alone? Researchers will compare three groups to see which approach leads to greater improvement. One group will receive hands-on trigger point therapy, one group will do a specific exercise program, and one group will receive both treatments. Participants will: * Be assigned to one of the three treatment groups by chance * Receive treatment twice a week for four weeks * Complete simple assessments before treatment starts, after the first treatment session, and after the final session The results of this study may help physical therapists choose better noninvasive treatment options for people with nonspecific low back pain.

Overview This study evaluates the effectiveness of a dedicated mobile health (mHealth) application in supporting home exercise programs for patients with musculoskeletal disorders, such as neck, shoulder, back, or knee pain. The research aims to address the widespread challenge of low patient adherence to unsupervised home-based exercises. Study Design The project employs a dual-methodology approach: Clinical Trial: 30 participants presenting with neck, shoulder, back, or knee pain will be randomly assigned to either an app-assisted group or a traditional home exercise group. Both groups will undergo 4 weeks of physiotherapy. The study will compare pain intensity, physical function, and exercise adherence between the two cohorts. Retrospective Analysis: To complement the trial, the study will analyze a large-scale database containing approximately 700,000 anonymized real-world data entries. This analysis aims to observe real-time pain fluctuations before and after exercise sessions within routine clinical settings. Goal The primary objective is to determine if integrating mHealth technology into traditional rehabilitation can enhance clinical outcomes and improve patient adherence to home-based exercise routines.

This study investigates the effects of a parent-child picture book reading intervention on the cardiopulmonary stability of preterm infants, parental anxiety, and parent-child attachment. A randomized controlled trial will be conducted in a neonatal intensive care unit (NICU) and neonatal intermediate care unit in northern Taiwan. A total of 88 preterm infants and their parents will be randomly assigned to an intervention or control group. Parents in the intervention group will read picture books to their infants from a corrected gestational age of 28 weeks to 36 weeks and 6 days. Physiological data (heart rate, respiratory rate, oxygen saturation, and heart rate variability) and parental anxiety levels will be assessed at multiple time points. The study aims to determine whether this intervention improves infant stability, reduces parental anxiety, and enhances parent-child attachment, contributing to improved neonatal care practices.

The purpose of this study is: (a) to examine the changes in anxiety, depression symptoms, and positive/negative emotions before and after the intervention, as well as before discharge from the intensive care unit (ICU) in the experimental group (using the therapeutic robot PARO), the control group (using a stuffed seal), and the comparison group (receiving standard care). (b) To compare the effectiveness in relieving anxiety, depression symptoms, and positive/negative emotions among the experimental group, control group, and comparison group for ICU pediatric and adolescent patients in the school-age period. The research questions addressed in this study are: 1. What are the changes in anxiety, depression symptoms, and negative emotions before and after the intervention in the experimental group? 2. What are the changes in anxiety, depression symptoms, and negative emotions before and after the intervention in the control group? 3. What are the changes in anxiety, depression symptoms, and negative emotions before and after the intervention in the comparison group? 4. What is the effectiveness in reducing anxiety after the intervention among the experimental group, control group, and comparison group? 5. What is the effectiveness in alleviating depression symptoms after the intervention among the experimental group, control group, and comparison group? 6. What is the effectiveness in reducing negative emotions and increasing positive emotions after the intervention among the experimental group, control group, and comparison group?

Background: Muscle power, defined as the rate at which muscular force is generated to produce movement, declines more rapidly with age than muscle strength. The decline in lower extremity muscle power is associated with reduced functional independence, impaired mobility, and an increased risk of falls among older adults. While power training has been shown to improve muscle power, balance, and functional abilities, the feasibility and effectiveness of home-based interventions have not been thoroughly investigated. Purpose: The aim of this study is to investigate the effects of home-based lower extremity muscle power training program on functional muscle and balance performance in older adults. Methods: This is a single-blind, randomized controlled trial. Forty community-dwelling older adults will be recruited and randomly assigned to the experimental group (n=20) and control group (n=20). Participants in the experimental group will complete 24 sessions of home-based lower extremity muscle power training targeting the lower limb muscle groups in 8 weeks. The training intensity will be progressively adjusted according to participants' performance. Participants in the control group will maintain their daily activities. In addition, both groups will receive health education. Primary outcomes include functional muscle power measured by the Four-Step Stair Climb Power Test, functional muscle strength measured by Five Times Sit-to-Stand Test, and the functional balance performance measured by the Mini-BESTest, and Timed Up and Go Test. The fall confidence, as the secondary outcome, will be measured by Falls Efficacy Scale International. Statistical analysis: The SPSS® version 29 will be used for statistical analysis. Independent-t-test or chi-square test will be conducted to compare the baseline demographic characteristics between groups. Two-way repeated measure ANOVA will be used to compare the differences between groups and times, post-hoc analyses will be performed using Tukey's test. The significance level is set at 0.05.

A cross-sectional study (part 1) aims to investigate the influence of fatigue on the MI ability in PD compared to healthy controls. A randomized controlled trial (part 2) aims to compare the effect of fNIRS-based NFB-MI on balance and gait performance versus MI only in people with PD.