Background: Stroke often results in impaired postural control and asymmetric weight distribution, which negatively affect balance and functional mobility. Previous research has demonstrated that balance training interventions incorporating proprioceptive stimulation and visual feedback can enhance postural stability in stroke survivors. However, there remains debate regarding the relative effectiveness of these two approaches. While proprioception-based training emphasizes sensory input from mechanoreceptors to improve postural control, visual feedback-based training leverages external cues to facilitate balance adjustments. Objectives: To investigation the effects of proprioception-based trunk exercise and visual-auditory feedback-based trunk exercise on sitting balance in patients with chronic stroke. Design: Randomized controlled trial. Methods: A total of 24 participants diagnosed with chronic stroke were randomly assigned to two groups: the proprioception-based trunk exercise group (PTG, n=10) and the visual-auditory feedback-based trunk exercise group (VTG, n=11). Both groups participated in a 6-week intervention program, five sessions per week, lasting 25 minutes per session. Outcome measures included the Limitation of Stability (LOS), the Korean version of the Trunk Impairment Scale (K-TIS), and the Postural Assessment Scale for Stroke (PASS). Pre- and post-intervention assessments were analyzed using paired t-tests and independent t-tests to evaluate within-group and between-group differences. Results: Both PTG and VTG groups demonstrated significant improvements in LOS, K-TIS, and PASS scores following the intervention (P<.05). However, there were no statistically significant differences between the two groups in the amount of change observed. Conclusion: The findings suggest that both proprioception-based and visualauditory feedback-based trunk exercises are effective in improving sitting balance in chronic stroke patients. The lack of a significant difference between the groups indicates that both approaches provide comparable benefits. Future research should explore long-term effects and investigate potential differences in various functional domains beyond sitting balance.

Background: Functional sarcopenia, a subcategory of sarcopenia, has recently been introduced. It is defined by muscle weakness and reduced physical performance, regardless of muscle mass reduction, and may potentially affect overall rehabilitation outcomes in patients. Objectives: This study aimed to classify stroke patients into two groups based on the presence or absence of functional sarcopenia and to compare changes in balance and gait ability after receiving the same rehabilitation intervention. Design: A quasi-experimental design. Methods: A total of 44 stroke patients participated in this study and were classified into functional sarcopenia (n=22) and non-functional sarcopenia groups. Physical function tests were used to assess balance (Timed Up and Go, Berg Balance Scale) and gait (10-Meter Walk Test, Functional Ambulation Category). All participants underwent a four-week convalescent rehabilitation program, receiving five sessions per week, with each session lasting four hours per day. Results: After four weeks of convalescent rehabilitation, both groups showed significant improvements in all outcome measures (P<.05). However, when comparing the pre-post changes, no significant differences were found between the two groups in the changes of balance and gait outcomes (P>.05). Conclusion: These findings suggest that stroke patients with functional sarcopenia can achieve a similar level of functional recovery as those without functional sarcopenia when provided with appropriate rehabilitation interventions.

Background: As the length of stay for rehabilitation and medical care services for occupational injury patients continues to increase, this study aims to explore alternative solutions that can support the corporation's efforts to develop rehabilitation treatment programs in response. Objectives: By analyzing the most frequent diseases among occupational injury patients over the past five years and comparing the average length of stay (LOS) for each disease by disease type, occupation, gender, and type of accident, it is expected that the necessity for developing rehabilitation treatment programs for occupational injury patients can be identified. Furthermore, when applying the developed treatment programs, a reasonable LOS can be derived. Design: Patient clinical data lab. Methods: From January 2017 to December 2021, data from 292,423 occupational injury patients who submitted their initial medical treatment applications to the Korea Workers' Compensation & Welfare Service (KWCWS) and received approval for their occupational injuries were de-identified. After data preprocessing, the cases were categorized by diagnosis, and statistical analysis was conducted using Excel ver. 21.0. Results: In the intensive rehabilitation treatment process, inpatient and outpatient care show a very strong correlation with r=0.8817, followed by the total number of treatment days (r=0.6431) and the number of treatment sessions (r=0.6441). Conclusion: It is necessary to establish application criteria for injury groups that significantly impact the average medical care days and medical care benefits of industrial accident patients. These criteria should consider factors such as exceeding the average length of medical care for specific injury groups (orthopedic/neurological), gender differences (female patient group), discrepancies in inpatient and outpatient medical care benefits, the proportion of high disability grades (Grade 1-3), common injury (accident) types, and the top 1/2/3 associated injury groups by occupation type. Based on these criteria, simultaneous management of the provision timing of rehabilitation service programs and the average medical care days for the 50 most common injury groups is required.

Background: Subacromial impingement syndrome (SAIS) is a prevalent cause of shoulder pain, often linked to abnormal scapular positioning and movement. Prior research suggests that scapular stabilization exercises (SSE) may improve SAIS symptoms, but there's a lack of research on the specific quantitative effects of SSE on scapular position and function. Objectives: To investigated the effects of SSE on scapular position and shoulder function in patients with SAIS. Design: A randomized controlled trial. Methods: Thirty participants with SAIS, diagnosed using the Scapular Dyskinesis Test (SDT), were randomly assigned to either a scapular stabilization exercise group (SSEG, n=15) or a traditional rehabilitation training group (TRTG, n=15). Both groups received eight weeks of intervention. Outcome measures included the scapular index (SI), measured using digital vernier calipers, and the Shoulder Pain and Disability Index (SPADI). Results: The SSE group showed statistically significant increases in scapular index (SI) and significant decreases in Shoulder Pain and Disability Index (SPADI) pain and disability scores. The TRTG showed no statistically significant changes in these measures. The SSE group demonstrated statistically significant improvements in SI and SPADI scores compared to the TRTG. Conclusion: These findings suggest that SSE may be a valuable treatment option for improving shoulder function and reducing pain in patients with SAIS. Further research is needed to validate these findings and explore the longterm effects of SSE.

이 논문의 목적은 치매를 초고령사회에 나타날 중차대한 복합적 사회문제로 보고, 치매 치료와 극복을 위한 세계공통(WHO, 네덜란드 호그벡 마을, 일본 등) 방향과 결을 같이 하면서 현재 한국 상황에도 맞는 교회적 접근과 돌봄 전략을 제시하는 것이다. 이에 본고는 치매에 대한 세계공통방향이 기술중심케어보다 인간중심케어라는 것과 함께 우리나라 치매정책과 한계점을 살피면서 개선점에 대해 논한다. 분명한 것은 국제적 입장에서 WHO도 치매가 장기적이면서 고비용의 초국가 적 질병임을 알아 각 회원국의 치매 대응능력 강화와 치매 관련 사회·보 건 시스템 전반의 역량 증진을 목표한다는 점이다. 이에 각국도 국가 차원의 민관 협력을 유도하는 중이다. 따라서 본고는 치매 문제를 실제적이고 효과적이면서 기독교적인 치료와 극복을 위해 프로스트와 허쉬가 말하는 성육신적 접근의 주요 특징에 기반한 네 가지, 곧 전인적, 환경적, 활동적, 자생적인 성육신적 접근과 돌봄 전략을 제시한다.

Background/Aim: This study investigated the relationship between albumin-bilirubin (ALBI) grade and advanced liver fibrosis in patients with a history of gallstone disease and cholecystectomy, focusing on those diagnosed with metabolic dysfunctionassociated steatohepatitis (MASH) using the acMASH algorithm. Methods: Data from 566 subjects in the National Health and Nutrition Examination Survey 2017-2020 dataset were analyzed. MASH and advanced fibrosis (AF) were determined using acMASH and acFibroMASH algorithms, respectively. Liver stiffness measurement (LSM), ALBI grade, and other fibrosis indices were evaluated. Results: Of 566 subjects, 13 (2.3%) were diagnosed with MASH, and 65 (11.48%) had AF. MASH subjects showed significantly higher LSM values compared to non-MASH subjects (p=0.032). ALBI grade demonstrated weak positive correlations with LSM, FIB- 4, and acFibroMASH in non-MASH subjects. The AUROC for ALBI grade in identifying AF was 0.631 (95% CI 0.590-0.671). Multivariate analysis confirmed ALBI grade as an independent predictor of AF (odds ratio 0.193, 95% CI 0.1025-0.2837, p<0.001). Conclusions: ALBI grade shows potential as a non-invasive marker for advanced liver fibrosis in patients with a history of gallstone disease and cholecystectomy, particularly in those with MASH. Further studies with larger MASH cohorts are needed to validate these findings.

Background: For patients with neck pain, a taping method has been used to promote thoracic spine extension. To induce thoracic spine extension without back pain, a neutral lumbo-pelvic position must be established. The spiral trunk taping method can induce a neutral lumbo-pelvic position and thoracic spine extension. Objectives: To determine the effectiveness of spiral trunk taping in inducing thoracic spine extension and neutral lumbo-pelvic position in patients with neck pain. Design: A randomized controlled trial. Methods: Thirty patients with neck pain were randomly assigned to groups. The experimental group received spiral trunk taping and the control group received sham taping. The resting position visual analogue scale (VAS) and VAS during painful movement were measured and compared pre and post treatment. Results: Significant within-subjects changes were resting position VAS (F=59.823, P=0.001) and VAS during painful movement (F=76.128, P=0.001). Significant between-subject changes were resting position VAS (F=10.402, P=0.003) and VAS during painful movement (F=7.657, P=0.01). Conclusion: Spiral trunk taping, which can induce thoracic spine extension and a neutral lumbo-pelvic position, was effective for neck pain. This study demonstrates the potential of a systemic taping approach in the management of neck pain, and provides important clues for future clinical applications.

Background: This study aims to analyze the trends in research related to the application of whole-body vibration exercise in stroke patients, the methods used, and the effects of such applications. Additionally, it seeks to propose future directions for research on whole-body vibration exercise in stroke patients and provide foundational data for future studies. Objectives: The purpose of this study was to analyze the trends in research on the application of whole-body vibration exercise in stroke patients, focusing on the methods used and the resulting effects. Design: A scoping review. Methods: This is a literature review aimed at identifying trends in whole-body vibration exercise research for stroke patients published in Korea between 2000 and March 2024. The study followed the five stages of the scoping review procedure proposed by Arksey and O’Malley. Results: The remaining one was a comparative study of the effects between vibration frequencies. The main findings from the literature showed statistical significance in 15 studies, excluding 3 articles. Additionally, 13 studies reported that the whole-body vibration exercise group demonstrated more significant improvements than the control group, while 1 study found the control group had more significant effects than the whole-body vibration exercise group. The remaining study compared the effects between different vibration frequencies. Conclusion: Based on the findings of this study, there is a need for more systematic reviews and meta-analyses to evaluate the effectiveness and quality of interventions. These should focus on systematically analyzing the outcomes of vibration exercise programs applied to stroke patients and the relevant dependent variables.

Background: Recent cases of spinal cord infarction combined with cerebral infarction have demonstrated improved walking ability through pharmacological treatment and rehabilitation. However, studies on the efficacy of multidisciplinary approaches remain limited. Objectives: This study aimed to investigate rehabilitation strategies and establish a foundation for clinical practice, focusing on physical and occupational therapy for patients with spinal cord and cerebral infarctions. Design: A case study. Methods: A 70-year-old woman with combined spinal cord and cerebral infarction underwent 20 weeks of rehabilitation. Functional outcomes were assessed using Grip Strength, Manual Muscle Test (MMT), Trunk Impairment Scale (TIS), Manual Function Test (MFT), Berg Balance Scale (BBS), 10-Meter Walking Test (10MWT), and Korean Modified Barthel Index (K-MBI). Results: Over 20 weeks, Grip Strength improved to 6 kg (left) and 13 kg (right), MMT increased from 97 to 103 points, and TIS improved from 2 to 10 points. MFT scores increased to 18 (left) and 25 (right). BBS improved from 1 to 23 points, and the 10MWT time decreased to 19.84 seconds. K-MBI scores rose from 12 to 39 points. Conclusion: A multidisciplinary approach, including robotic therapy, significantly improved functional recovery, facilitating reintegration into daily life.

Background: Stroke patients often exhibit excessive kyphosis of the spine and a forward head posture (FHP), which negatively impacts their daily activities. These postural abnormalities not only negatively affect functional movement but also exacerbate musculoskeletal problems. Objectives: This study was conducted to determine the effect of backward walking on FHP in stroke patients. Design: Single-case experimental design (A-B-A’ design). Methods: The study was conducted over a total of 8 weeks, comprising 24 sessions: 3 baseline sessions (A), 18 intervention sessions (B), and 3 regression baseline sessions (A'). No backward walking intervention was performed during baseline (A) and regression baseline (A’). To determine changes in FHP, the craniovertebral angle (CVA) was measured at all sessions. Results: The CVA increased in the intervention (B) and regression baseline (A’) compared to the baseline (A). Conclusion: Backward walking was effective in improving FHP, and the effect was maintained after intervention (B) in patients with stroke. Therefore, backward walking was effective in improving the postural alignment of stroke patients.

본 연구는 양안 완전 교정 굴절력 차이가 3.75 D인 24세 여성 부등시 환자를 대상으로 시기능 훈련의 효과를 분 석하였다. 환자는 원거리 흐림, 안정 피로 및 근거리 작업 시 불편함을 호소하였으며, 기존 안경은 저교정 상태였 다. 초기 검사에서 양성융합버전스와 폭주 근점 등 주요 시기능 지표가 기댓값보다 낮게 나타났다. 완전 교정과 사 이즈 렌즈 처방을 통해 부등상시 증상을 완화하고 시각적 선명도를 개선한 후, 약 1개월간 안경원 및 가정에서 병 행하여 시기능 훈련을 실시하였다. 훈련 결과, 원거리와 근거리에서 양성융합버전스가 정상 범위로 회복되었으며, 조절 근점과 폭주 근점 또한 유의미한 개선을 보였다. 특히 근거리 작업 시 집중력 향상과 작업 시간 증가가 관찰 되었다. 본 사례는 부등시 환자 관리에서 굴절 이상 교정과 체계적 시기능 훈련의 효과적 결합이 임상적으로 유의 미한 결과를 도출할 수 있음을 보여준다.

Background: Stroke patients commonly experience functional declines in balance and gait due to decreased muscle strength and coordination issues caused by brain damage. Through repetitive training, robot-assisted gait training (RAGT) can aid in promoting neuroplasticity in stroke patients and help them acquire effective gait patterns. Additionally, convalescent rehabilitation hospitals help to ensure rapid recovery through intensive rehabilitation training. Objects: This study investigated the effects of RAGT frequency on gait and balance recovery in stroke patients in convalescent rehabilitation hospitals, providing data to optimize rehabilitation efficiency, enhance functional recovery, and support the development of personalized strategies to ensure safer and more rapid returns to daily life. Methods: This study compared the frequency of RAGT by analyzing a group receiving two units of RAGT per day for 5 days per week with a group receiving two units of RAGT per week as part of a comprehensive rehabilitation program, totaling 16 units daily, in a convalescent rehabilitation hospital. Results: In the 10-minute walking test, statistical significance was observed both within and between groups, whereas the Functional Ambulation Category, Fugl-Meyer Assessment–lower extremities, Berg Balance Scale, and timed up-and-go tests showed significance only within groups. Conclusion: End-effector RAGT and traditional gait training significantly improve gait ability, balance, and lower limb function in stroke patients.

Background: Limited ankle dorsiflexion (DF) range of motion (ROM) is associated with mechanical dysfunctions and chronic ankle instability. Uphill treadmill walking exercise (UTWE) has the potential to improve ankle mobility and function. Objects: This study aimed to examine the immediate effects of a 15° UTWE on DF ROM and torque generation in patients with limited DF. Methods: The study included 20 adults, comprising 10 males and 10 females, with a mean age 28 years and a passive DF range of 5°–12°. After baseline assessments, participants completed 30 minutes of UTWE on a 15° incline treadmill, followed by post-assessments. DF ROM was evaluated during the stance phase of gait, and in both open-kinematic-chain (OKC) and closed-kinematic-chain (CKC) conditions using a goniometer and Image J software. DF and plantar flexion (PF) peak torque were measured with a Biodex Dynamometer. Results: Post intervention, maximum DF ROM during the stance phase of gait increased significantly from a mean of 8.54° ± 3.97° to 11.03° ± 4.41°. The DF ROM in the OKC and CKC conditions increased significantly from a mean of 8.90° ± 0.62° and 21.55° ± 0.72° to 18.00° ± 1.13° and 28.20° ± 1.00°, respectively (p < 0.0001). DF peak torque increased from 16.20 ± 1.28 N/m to 21.52 ± 1.39 N/m, and PF peak torque increased from 25.26 ± 2.51 N/m to 44.22 ± 4.20 N/m (p < 0.0002). Conclusion: UTWE significantly enhanced DF ROM and ankle torque, indicating that it may be an effective intervention for improving ankle function and preventing injury in clinical and rehabilitation settings.

Background: Rotator cuff tears often cause shoulder pain and functional limitations that may require conservative treatment or surgical intervention. Identifying preoperative differences in muscle strength and function can aid in treatment decisions. Objects: This study aimed to compare the preoperative shoulder muscle strength and functional outcomes between patients undergoing arthroscopic rotator cuff repair and those receiving conservative treatment. Methods: A retrospective review was conducted of 315 patients with rotator cuff tears, including 145 who underwent surgery and 170 who received conservative treatment. Shoulder isokinetic muscle strength (external rotator, internal rotators, abductor, and adductors) and functional scores (American Shoulder and Elbow Surgeons [ASES] and Constant-Murley shoulder scores) were measured. The conservative treatment group was assessed during a hospital visit, whereas the surgery group was tested on the morning of the surgery. An independent t-test was used to evaluate the preoperative shoulder strength and functional scores. Results: The conservative treatment group showed lower deficits in external (11.3 ± 23.9) and internal (11.7 ± 15.5) rotators compared to the surgery group (26.3 ± 33.8 and 17.1 ± 26.1, respectively; p = 0.001). Abductor and adductor deficits (18.2 ± 25.3 and 9.8 ± 16.8) were also lower in the conservative treatment group (30.7 ± 31.6 and 21.9 ± 28.4, respectively; p = 0.036 and p = 0.001). The external per internal rotator ratio (50.9 ± 16.8; p = 0.003) and ASES scores were higher (74.5 ± 14.8; p = 0.047) was higher in the conservative treatment group. Conclusion: The conservative treatment group had lower shoulder strength deficits, better muscle balance, and higher ASES scores than the surgery group, indicating superior functional outcomes. These findings suggest that assessing preoperative muscle strength and function might provide valuable insights into treatment planning for patients with rotator cuff tears.

본 연구는 K-공간 기반 노이즈 제거 딥러닝(DL)을 이용한 확산강조영상(DWI)의 유용성을 평가하고자 하였다. 연구 를 위해 간세포암으로 확진된 환자 30명을 대상으로 DL 기법 적용 전후의 DWI에 각각 확산경사자계(b-value) 50 과 800을 적용하여 영상화하였다. 획득한 영상에서 간세포암 조직과 정상 간 조직에 관심 영역을 설정하여 b50, b800에서의 신호대잡음비(SNR)와 대조대잡음비(CNR)를 측정하였고 두 명의 관찰자가 각 영상에서 간세포암 조직 을 측정하여 겉보기확산계수(ADC) 값을 계산하였다. 모든 측정값의 평가는 T-검정(T-test)을 사용하여 상관관계 를 평가하였으며 급내상관계수(ICC)를 이용하여 두 관찰자 간 ADC 측정값의 일치도와 신뢰도를 평가하였다. 연구 결과, DL 적용 후 영상에서 SNR과 CNR이 모두 높아졌으며 통계적으로 유의한 것으로(p<0.05) 나타났다. 또한, 간세포암의 ADC 값은 통계적으로 유의하지 않은 것으로(p<0.05) 나타났지만 두 관찰자 간 ADC 측정값의 일치에 대한 신뢰도는 상관계수가 0.75 이상으로 우수하였고, 간세포암의 고유한 성질로 인해 ADC 값의 변화가 적은 점을 고려한다면 충분히 유의한 결과라고 볼 수 있다. 결론적으로 DL DWI은 영상 획득 시간을 단축하면서도 기존 DWI 보다 질적으로 더 나은 영상을 획득했다. 향후 다양한 MRI 검사에 DL이 적용된다면 더욱 유용하게 사용될 것으로 사료 된다.

급성 뇌경색 진단에는 환자에 따라 관류강조영상과 조영증강 자기공명혈관영상이 동시에 촬영되는 경우가 있으며, 이 과정에서 MRI 조영제인 가돌리늄의 T1 단축 효과가 발생하여 동맥과 정맥의 신호 겹침이 빈번히 발생한다. 특 히, 3D T1 경사에코 기법을 사용한 CE-MRA에서 첫 번째 조영제 주입(PWI) 후 연속적으로 발생하는 T1 감소 효과로 인해 혈관의 정확한 묘사에 한계가 있었다. 본 연구에서는 이러한 문제를 해결하기 위해 마스크 영상의 획득 시점을 조정하여 새로운 방법(B)을 제안하였다. 기존 방법(A)에서는 관류강조영상 이전에 마스크 영상을 획득했지 만, 새로운 방법(B)에서는 관류강조영상 이후 마스크 영상을 획득하여 동맥과 정맥 신호 겹침을 효과적으로 줄였다. 연구 결과, S상 정맥동과 내경정맥에서 새로운 방법이 기존 방법보다 유의미하게 낮은 대조대잡음비를 보였으며, 신호 겹침이 줄어들어 정맥 신호의 억제 효과가 극대화되었다(p<0.05). 본 연구의 새로운 방법은 기술적으로 추가적 인 복잡성 없이 효율적으로 정맥 신호를 제거하여 CE-MRA 영상의 진단적 정확성을 향상하는 유용한 기법으로 평 가된다. 향후 연구에서는 더 다양한 환자군을 대상으로 본 방법의 유용성을 검증하고, 최적의 방안 모색을 할 필요가 있다.

Purpose: This study aimed to integrate and synthesize the recovery experiences of stroke patients through a qualitative meta-synthesis methodology. Methods: By searching through Korean databases(RISS, DBpia, KISS, NDSL), we compared 12 qualitative studies on recovery experiences of stroke patients. The meta-synthesis process was primarily guided by Noblit and Hare’s approach. Results: The common central experience of stroke patients was “reaching the world again”. Findings from the literature reviewed were synthesized into four themes: ‘earnest desire for recovery’, ‘rediscovery of family’, ‘duet of hope and despair’, ‘designing a new life’. Conclusion: The findings of this study provides a deeper understanding of recovery experiences of stroke patients. And this finding will serve as the basis for educational programs for health care personnel and families caring for stroke patients, development of programs to promote recovery of stroke patients, and self-help groups.

Background: Sarcopenia, characterized by a decrease in physical performance, muscle mass, and strength, is a common complication in patients with stroke, significantly impacting their rehabilitation and quality of life. Objectives: This study aimed to analyze the clinical characteristics associated with sarcopenia in patients with stroke and to identify factors that influence its occurrence. Design: A cross-sectional study. Methods: Data were collected using electronic medical records and assessments, including Korean version of mini-mental state examination (MMSE-K), manual muscle testing, berg balance scale (BBS), functional ambulation category (FAC), and modified barthel index. Sarcopenia was diagnosed based on the Asian working group for sarcopenia 2019 guidelines. Descriptive statistics, chi-square tests, independent t-tests, and logistic regression analyses were used. Results: Of the 82 patients with stroke included in this study, 46 were found to have sarcopenia. Sarcopenic patients had significantly lower body weight, cognitive function (MMSE-K), balance (BBS), walking ability (FAC), and daily living activities (MBI) scores compared to non-sarcopenic patients (P<.05). Logistic regression identified body weight (OR=.852, P=<.001) and cognitive function (OR=.897, P=.035) as significant predictors of sarcopenia. Conclusion: Body weight and cognitive function are crucial in predicting sarcopenia in patients with stroke. These findings suggest the importance of managing body weight and cognitive function to prevent sarcopenia and improve rehabilitation outcomes.

Coronavirus disease 2019 (COVID-19) is a highly contagious illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This disease is characterized by a wide spectrum of symptoms, ranging from mild to severe, including fatal outcomes. This study aims to review gustatory and salivary secretion dysfunctions and determine their potential pathogenic mechanisms. Gustatory impairment and salivary dysfunction are prevalent among patients with acute COVID-19 and those recovering from the disease. The mouth serves as a critical entry route for SARS-CoV-2. The cells within the oral epithelium, taste buds, and minor and major salivary glands express key entry factors for SARS-CoV-2, including angiotensin-converting enzyme 2, transmembrane serine protease 2, and furin. The co-occurrence of gustatory and salivary secretion dysfunctions possibly has pathogenetic association with the following factors: the expression of SARS-CoV-2 cellular entry receptors in the taste buds and salivary glands and SARS-CoV-2–induced zinc deficiency, which is crucial for normal taste perception and saliva secretion. Furthermore, the cytokine storm triggered by COVID-19 contributes to secondary damage affecting gustatory and salivary functions.