Li-Chieh Kuo

• PhD
• Professor/Consultant at National Cheng Kung University

INTRODUCTION Satellite glial cells (SGCs) in the dorsal root ganglia (DRG) play a pivotal role in the formation of neuropathic pain (NP). Sciatic nerve stimulation (SNS) neuromodulation was shown to alleviate NP and reduce neuroinflammation. However, the mechanisms underlying SNS in DRG remain unclear. We hypothesized that following nerve injury, a...

Background: Few studies have examined the activity of the accessory inspiratory muscles as well as respiratory function simultaneously in individuals with chronic obstructive pulmonary disease (COPD) while performing activities of daily living (ADLs). This cross-sectional study is aimed at understanding the differences in the demands for respirator...

This study aimed to investigate the effect of hand muscle fatigue on finger control and force efficiency during piano performance, which is crucial for skilled piano playing among professional pianists engaged in prolonged periods of high-intensity practice or concert preparation. Thirty-one professional pianists were recruited as participants. Thi...

Background Satellite glial cells (SGCs) in the dorsal root ganglia (DRG) play a pivotal role in the formation of neuropathic pain (NP). Sciatic nerve stimulation (SNS) neuromodulation was reported to alleviate NP and reduce neuroinflammation. However, the mechanisms underlying SNS in the DRG remain unclear. This study aimed to elucidate the mechani...

Rationale The conventional treatment of giant cell tumors is intralesional curettage with local adjuvant therapy. Because hand tumors have a high local recurrence, the primary goal for treating tumors of the hand is to eradicate the lesion. Patient concerns To preserve the metacarpophalangeal (MCP) joint function as well as avoid further recurrenc...

The Fracture Risk Assessment tool (FRAX®) is a widely utilized country-specific calculator for identifying individuals with high fracture risk; its score is calculated from 12 variables, but its formulation is not publicly disclosed. We aimed to decompose and simplify the FRAX® by utilizing a nationwide community survey database as a reference modu...

Diabetes mellitus and chronic kidney disease represent escalating global epidemics with comorbidities akin to neuropathies, resulting in various neuromuscular symptoms that impede daily performance. Interestingly, previous studies indicated differing sensorimotor functions within these conditions. If assessing sensorimotor features can effectively...

Patients with stroke often use ankle-foot orthoses (AFOs) for gait improvement. 3D printing technology has become a popular tool in recent years for the production of AFOs due to its strengths on customization and rapid manufacturing. However, the porosity of the 3D printed materials affects the kinetic features of these orthoses, leading to its lo...

Background The original version of the Tenodesis-Induced-Grip Exoskeleton Robot (TIGER) significantly improved the motor and functional performance of the affected upper extremity of chronic stroke patients. The assist-as-needed (AAN) technique in robot-involved therapy is widely favored for promoting patient active involvement, thereby fostering m...

Introduction Transition periods are integral parts of a person’s life span, characterized by phases of life and shifts in activity before adapting to new situations. Objectives This study aims to understand the high potential characteristics of students with disabilities and evaluate the roles of school-based occupational therapists (SBOT) in assis...

Background Previous works reported people with schizophrenia experienced inferior hand functions which influence their daily participation and work efficiency. Sensorimotor capability is one of indispensable elements acting in a well-executed feed-forward and feedback control loop to contribute to hand performances. However, rare studies investigat...

Purpose Understanding the pathogenesis of playing-related hand disorders through investigations based on coordination and biomechanical perspectives is indispensable. This study aimed to establish a sensor-embedded kinetic assessment piano system (SeKAPS) and conduct reliability and validity tests for this system. In addition, the differences in di...

This paper presents a cost-effective methodology for automatic segmentation of trapeziometacarpal (TMC) joint morphology from computed tomography (CT) images. We utilize the properties of CT imaging by incorporating multiple views into our approach to enhance segmentation accuracy. Instead of a single model, our pipeline utilizes an ensemble of mul...

This study aimed to investigate the hamstring onset time and recruitment level during jumping tasks in athletes with chronic hamstring strain injuries. Thirteen hamstring injured athletes and thirteen matched healthy athletes were recruited. Activation onset time and muscle recruitment (median frequency of the EMG) of the lateral hamstring (LH) and...

It is unclear how hamstring stiffness influences lower limb muscle activation during jump-landing mechanics. The study aimed to investigate the role of the hamstring stiffness on lower limb muscle recruitment during jumping manoeuvres. Thirty male athletes were recruited and allocated into high- and low-stiffness groups. Hamstring stiffness was det...

The decision support system (DSS) provides systematic data for improving effective decision-making by school-based occupational therapists (SBOTs) in healthcare services. The purposes of this study were to develop the DSS and investigate its usability in providing the occupational therapy (OT) service for students with disabilities during transitio...

PurposeDeveloping effective interventions for relieving the pain and improving the physical function of the knee in Muslim pray movements is of great importance in facilitating religious commitments and improving the general quality of life (QoL). However, the effects of the exercise intervention duration on the functional activity of knee osteoart...

Kinesio taping (KT) is widely used in sports for performance improvement and injury prevention. However, little is known of the behavior of the muscle region beneath the KT with movement, particularly when the muscle is fatigued. Accordingly, this study investigated the changes in the medial gastrocnemius muscle architecture and fascia thickness wh...

Introduction: Regular physical exercise is believed to counteract the adverse physiological consequences of aging. However, smart fitness equipment specifically designed for older adults is quite rare. Here we designed an exergame-integrated internet of things (IoT)-based ergometer system (EIoT-ergo) that delivers personalized exercise prescriptio...

Falls represent an important adverse effect associated with knee osteoarthritis and result in a significant financial burden on the healthcare system. Therefore, identification of fall predictors is essential to minimize fall incidence. However, few studies have investigated falls and fall predictors, particularly focused on the fear of falls and p...

Slow movements and irregular muscle contraction have been reported separately in different studies targeting individuals with psychotic-like experiences (PLEs). To date, it remains unknown whether these two movement abnormalities, possibly associated with hypo- and hyper-dopaminergia, respectively, co-existed in one sample with PLEs and interrelate...

Purpose Reduced physical activity is reported in the elderly, especially in institutional residents. Institutionalized older adults exhibit a high prevalence of frailty. In this work, we developed an artificial intelligence of things (AIoT)-based feedback assistive strengthening ergometer (AIFASE), for the physical strengthening of the elderly with...

Objective : To compare the effects of using an Internet of Things (IoT)-assisted tenodesis-induced-grip exoskeleton robot (TIGER) and task-specific motor training (TSMT) as home programs for the upper-limb (UL) functions of patients with chronic stroke to overturn conventional treatment modes for stroke rehabilitation. Design : A randomized two-pe...

The combination of cross-linked hyaluronate (cHA) and corticosteroid showed more rapid pain or functional improvement in knee osteoarthritis and adhesive capsulitis. However, rare evidence of this combination in treating tendinopathy has been reported. We hypothesized that the specific formulations of cHA and dexamethasone (DEX) conferred ameliorat...

Background: to compare the 52-week effectiveness and safety between HYAJOINT Plus (HJP) and Durolane in knee osteoarthritis (OA) treatment. Methods: consecutive patients received a single injection of 3 mL HJP or Durolane. The primary outcome was a visual analog scale (VAS) pain measurement at 26 weeks post-injection. Secondary outcomes included ot...

Background To better understand biomechanical factors that affect intervertebral alignment throughout active therapeutic exercise, it is necessary to determine spinal kinematics when subjects perform spinal exercises. This study aims to investigate the outcomes of active cervical therapeutic exercise on intervertebral foramen changes in neck pain p...

Introduction Handwriting difficulty (HD) is a widely discussed issue. Previous researchers have revealed many valuable kinematics related to the handwriting performance. However, a clear understanding of the kinetics of handwriting performance in children with HD is still lacking. Therefore, this study investigated the writing performance of childr...

CD44 exerts anti-senescence effects in many disease models. We examined senescence in tendinopathy and the effect of CD44 on senescence-associated secretory phenotypes (SASPs). Senescent markers were determined in human tendinopathic long head of biceps (LHB) and normal hamstring tendons. CD44 gene transfer in rat tendinopathic tenocytes stimulated...

Sarcopenia is a wild chronic disease among elderly people. Although it does not entail a life-threatening risk, it will increase the adverse risk due to the associated unsteady gait, fall, fractures, and functional disability. The import factors in diagnosing sarcopenia are muscle mass and strength. The examination of muscle mass must be carried in...

Background. Embedding mirror therapy within a virtual reality (VR) system may have a superior effect on motor remediation for chronic stroke patients. Objective. The objective is to investigate the differences in the effects of using conventional occupational therapy (COT), mirror therapy (MT), and VR-based MT (VR-MT) training on the sensorimotor f...

Objective: Neovascularization of injured tendons prolongs the proliferative phase of healing, but prolonged neovascularization may cause improper healing and pain. Currently, ultrasound Doppler imaging is used for measuring the neovascularization of injured tendons (e.g., Achilles tendon). However, the resolution of state-of-the-art clinical ultra...

Background: People with type 2 diabetes mellitus (T2DM) tend to be vulnerable to geriatric syndromes such as sarcopenia and frailty. Reduced physical activity also accompanies sarcopenia and frailty, which is generally typical of patients with T2DM. However, a comprehensive assessment of physical fitness in patients with T2DM has seldom been carri...

Carpal tunnel release (CTR) is an effective procedure used in open, endoscopic, or ultrasound-guided methods. The complications are rare but potentially devasting. Most complications come from errors related to intraoperative technique, especially in the minimally invasive approach. An understanding of the "safe zones" is essential to perform percu...

Background Patients with severe carpal tunnel syndrome (CTS) undergo carpal tunnel release (CTR) surgery to alleviate pressure in the carpal tunnel. However, the subsequent lack of the transverse carpal ligament (TCL) causes the bowstring phenomenon of the flexor tendons and increases the potential incidence of trigger finger. Objective This study...

Objective To investigate the digit force control during a five-digit precision grasp in aligned (AG) and unaligned grasping (UG) configurations. Background The effects of various cylindrical handles for tools on power grasp performance have been previously investigated. However, there is little information on force control strategy of precision gr...

Objective: Quantifying muscle tone is often based on a tester's subjective judgment in clinical settings. There is, however, a lack of suitable tools that can be used to objectively assess muscle tone. This study thus introduces a reliable, clinically-feasible device, called the Arm Circumference Motor Evaluation System (ACMES), for quantifying th...

Objective (1) To examine the ultrasound (US) characteristics in patients with hemodialysis-related carpal tunnel syndrome (H-CTS) and (2) to evaluate the accuracy of a proposed US parameter-dynamic ratio of median nerve-to-hamate hook distance (RMHD) in diagnosis of H-CTS. Design A case-control study. Setting In a tertiary medical center and a se...

Abstract Background Music-based interventions (MBI), using music as a therapeutic medium, has been utilized as a promising strategy for motor relearning and shaping. However, currently, MBI with active performance training is restricted to being extensively applied for patients with various levels of defects in fine motor skills and cognitive funct...

Purpose This study was aimed toward developing a lightweight assisting tenodesis-induced-grip exoskeleton robot (TIGER) and to examine the performance of the TIGER in stroke patients with hemiplegia. Methods This was a single-blinded, randomized control trial with pre-treatment, immediate post-treatment, and 12-week follow-up assessments. Thirty-f...

Background: Music-supported therapy (MST), a type of biofeedback therapy with multi-sensory information input, has been proposed as an effective approach to improving motor control in people with sensorimotor deficits. However, currently, MST training is restricted to being extensively applied for patients with various levels of defects in fine mot...

PurposeDynamic anthropometry can be applied in equipment/environment designs related to human motions. Since younger children are prone to accidents due to their less-developed physical control and lack of proper judgment of danger. This study aimed to establish a dynamic anthropometric resource for playground safety for preschoolers in Taiwan.Meth...

Tendon injuries lead to tendon stiffness, which impairs skeletal muscle movement. Most studies have focused on patellar or Achilles tendons by using ultrasound elastography. Only a few studies have measured the stiffness of hand tendons because their thickness is only 1–2 mm, rendering clinical ultrasound elastography unsuitable for mapping hand te...

PurposeThree-dimensional printed ankle-foot orthoses (AFO) have been used in stroke patients recently, but there was little evidence of gait improvement. Here, we designed a novel customized AFO with energy storage, named Energy-Storage 3D Printed Ankle-Foot Orthosis (ESP-AFO), and investigated its effects on gait improvement in stroke patients.Met...

We compared the physical function performances of community-dwelling and day care center older adults with and without regular physical activity (PA). A total of 163 Taiwanese older adults living in rural communities participated. PA habits and physical functional performances were assessed. The participants were divided into community-dwelling (CD...

Background: Comminuted intraarticular fractures of the metacarpophalangeal joint (MPJ) are difficult to treat. We evaluated the clinical outcomes of using a dynamic traction splint to treat comminuted intraarticular fracture of MPJ. Patients and methods: We conducted a retrospective chart review on patients with comminuted intraarticular fractur...

Mirror therapy (MT) has been proposed as an essential component of upper limb neuro-rehabilitation, using mirror illusion of the unaffected hand movement and superimposing it on the affected hand to improve neuroplasticity for improving motor recovery in stroke patients. In this paper, we developed a virtual reality mirror therapy (VRMT) system, an...

Objective: To investigate the effects of perturbation-based pinch task training on the sensorimotor performance of the upper extremities of patients with chronic stroke via a novel vibrotactile therapy system. Design: A single-blinded randomized controlled trial. Setting: A university hospital. Participants: Patients with chronic stroke (N=1...

Context Appropriate training without risk of injury is a critical concern for athletes. Remodeled bicycle pedal training with multi-directional challenges may be effective in improving the balance performance of athletes with functional ankle instability (FAI). Objective To evaluate the effects of 6-week modified bicycle pedal training on the bala...

The motor control of individual fingers is an important part of daily life, but there are many people who have difficulty with it, such as elderly people and stroke patients. While continuous rehabilitation is necessary for functional recovery of finger mobility and suppression of functional deterioration, it usually requires the assistance of occu...

Motor abnormalities have been indicated to be a core manifestation of schizophrenia and not just motor side-effects of antipsychotics. However, little is known about whether all of the complete motor function, including fine motor function, muscle strength, and balance is linked to psychotic symptoms. Therefore, this study was to investigate associ...

Purpose Hand tendon injuries caused by various accidents are common in emergency departments. The assessment of tendon properties is crucial for evaluating the effectiveness of therapy or rehabilitation during recovery after hand injuries. Many recent studies have indicated that the shear wave velocity (SWV) of tendons is related to their stiffness...

Objective: Injuries to the hands, wrists, and fingers often involve damage to the tendons. The ability to measure tendon movements during the rehabilitation process can provide clinicians with important information in the quantification of tendon injuries. Conventionally, the tendon is considered a single spring-like structure during force transmi...

Background: A novel stair-climber called a pinnacle trainer (PT) provides both sagittal and frontal plane exercise, making it different from a step trainer (ST), which provides only sagittal plane exercise. Exercise with different trajectories may produce different biomechanical responses. There are currently no guidelines for choosing between a P...

Apoptosis has emerged as a primary cause of tendinopathy. CD44 signaling pathways exert anti-apoptotic and -inflammatory effects on tumor cells, chondrocytes, and fibroblast-like synoviocytes. The aim of this study was to examine the association among CD44, apoptosis and inflammation in tendinopathy. Expression of CD44 and apoptotic cell numbers in...

This study aims toward an investigation and comparison of the digital force control and the brain activities of older adults and young groups during digital pressing tasks. A total of 15 young and 15 older adults were asked to perform force ramp tasks at different force levels with a custom pressing system. Near-infrared spectroscopy was used to co...

Background: Symptoms of diabetic hands have been gradually elucidated, however the interventions for these hand problems are typically underemphasized. Few studies have discussed intervention effects on sensorimotor problems in hands, which prevent diabetic patients from executing their daily routines and lower their quality of life (QoL). Aim:...

Background: A pinnacle trainer is a stair climber that has a biplane exercise trajectory and an adjustable pedal stance width (PSW). A pinnacle trainer integrated with a body weight support (BWS) system can help overweight individuals or individuals with poor balance exercise safely by reducing excessive or improper joint loads, preventing trainin...

Hand function deterioration brings about inconvenience to the daily lives of the chronic kidney disease patients. However, a full spectrum of hand function examination is absent. Therefore, this study aimed to classify the hand sensorimotor functions of the chronic kidney disease patients using the novel sensorimotor assessment tools, manual tactil...

Background/aim: Task-specific repetitive training, a usual care in occupational therapy practice, and robotic-aided rehabilitation with bilateral practice are used to improve upper limb motor and task performance. The difference in effects of two strategies requires exploration. This study compared the impact of robotic-assisted therapy with bilat...

One major concern for the elderly is the decline in their ability to control their hands, which can significantly affect their ability to perform activities of daily living. One of the important hand functions that deteriorate over time is the ability to control finger force exertion, due to the gradual decrease in finger muscle strength as people...

Background.: Knowledge regarding the relationship between writing kinetics and the difference among writing tasks is limited. Purpose.: This study examined the differences in handwriting performance when doing tasks with different levels of challenge from both temporal and kinetic perspectives among children in four different age groups. Method...

Importance: To develop a practical program in the early phase after nerve repair for more rapid return of function. Objective: To investigate the effects of touch-observation and task-based mirror therapy on the sensorimotor outcomes of patients with nerve repair. Design: An assessor-blinded study with a randomized controlled design. Setting: Unive...

Ankle-foot orthoses (AFO) were well-used for stroke patients. Our study developed a new 3D printed AFO with the function of Energy Storage. It would be expected to improve the gait of the stroke patients. This study made a 3D printed joint part fixed between the foot plate and shank structure of AFO. The joint part was made of Nylon and inserted a...

Objective: To investigate the reliability and validity of a modified pinch apparatus devised with three surface textures and two different weights for clinical application. Design: Case-controlled study. Setting: A university hospital. Participants: The participants included 16 carpal tunnel syndrome (CTS) patients with 20 sensory neuropathy...

Anthropometry is important in product or environment designs based on human factors. Specific anthropometric databases should be established for certain of populations, especially for different genders, ages and races. In this study, 5772 preschool children (from two to six years old) were recruited. An electromagnetic motion analysis system, measu...

Background/Objective Patients with schizophrenia not only have psychiatric symptoms, but also have movement problems, which might also be associated with their reduced quality of life. Little is known about how to improve their movement performance for patients. Manipulating object size and distance is common in occupational therapy practice to eva...

Trigger finger has long been a common disorder in hand orthopedics. To clarify the unknown causative factors regarding the disease, numerous experiments were done on human cadavers, including tendon forces, tendon moment arm, mechanical properties of the pulley, gliding resistance, etc. However, most of these studies were conducted on normal finger...

Introduction.– Emerging evidence indicates that motor abnormalities are associated with progression of psychotic symptoms in individuals at the prodromal stage and can predict onset of full-blown psychosis. It is proposed that because of shared neurological malfunction in basal ganglia, motor abnormalities and psychotic symptoms are connected. To d...

Few studies have described extents of subluxation, applied stresses, and assessing postures during trapeziometacarpal stress-view radiography, which probably has led to unsatisfactory reliability of the Eaton classification for determining arthritis. To address this problem, this study examined the effects of applied forces and thumb position on le...

Few studies discuss kinetic changes in tendinopathy models. We propose a customized corridor to evaluate dynamic weight bearing (DWB) and shearing forces. Sixty rats were randomly given ultrasound-assisted collagenase injections (Collagenase rats) or needle punctures (Control rats) in their left Achilles tendons, and then evaluated 1, 4, and 8 week...

Optical tracking systems have been used in previous studies to capture the motion of the nude breast and breasts in bras, under the assumption that no breast-bra relative movement occurred within the bra. This study compared breast and bra movement through electromagnetic tracking and optical tracking systems to determine the relative breast moveme...

Trigger finger has become a prevalent disease that greatly affects occupational activity and daily life. Ultrasound imaging is commonly used for the clinical diagnosis of trigger finger severity. Due to image property variations, traditional methods cannot effectively segment the finger joint’s tendon structure. In this study, an adaptive texture-b...

Ground truth of Testing images: Each text file contains the ground trurh contour of corresponding image with the same file name. Each row in the file is the point coordinate (X,Y) on the contour. (ZIP)

Tendon images for segmentation. (ZIP)

Tendon image pairs for classification. (ZIP)

The purpose of this study was to investigate the dynamic changes of histopathology, biomechanical properties, echo intensity, and ultrasound features in a collagenase-induced tendinopathy model of rat Achilles tendons, and to examine the associations among biomechanical properties, echo intensity, and ultrasound features. Forty-two rats received an...

Background The presence of subtle losses in hand dexterity after stroke impacts the regaining of independence with regard to activities of daily living. Therefore, awareness of ipsilesional upper extremity (UE) function may be of importance when drafting a comprehensive rehabilitation program. However, current hand function tests seem to be unable...

Background/aim: Numerous tools have been developed to evaluate handwriting performances by analysing written products. However, few studies have directly investigated kinetic performances of digits when holding a pen. This study thus attempts to investigate pen-grip kinetics during writing tasks of school-age children and explore the relationship...

Background Tendon motion, which is commonly observed using ultrasound imaging, is one of the most important features used in tendinopathy diagnosis. However, speckle noise and out-of-plane issues make the tracking process difficult. Manual tracking is usually time consuming and often yields inconsistent results between users. Methods To automatical...