著者

Kyohei Omon Masahiko Hara Hideo Ishikawa

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.4, pp.20190011, 2019 (Released:2019-05-31)

参考文献数

18

被引用文献数

13

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Background: Virtual reality (VR) technology has been recently introduced in a variety of clinical settings, such as physical, occupational, cognitive, and psychological rehabilitation or training. However, the clinical efficacy of VR rehabilitation compared with traditional training techniques remains to be elucidated. Case: A 90-year-old man underwent VR-guided, dual-task, body trunk balance training in the sitting position using a newly developed medical device (mediVR KAGURA, mediVR, Inc., Toyonaka, Japan) after his physical activity level had plateaued. The patient had difficulty in walking outside the hospital even after having undergone traditional physical training. VR-guided training was performed for 40 min every weekday for 2 weeks. Trunk balance training was performed using reaching tasks, and cognitive stimulation was designed to emulate the cognitive processing involved when walking in a city or town. After the VR-guided training, the patient’s 6-min walk distance improved from 430 m to 500 m even though there had been no improvement in muscle strength of the lower extremities. Furthermore, the patient could successfully walk outside the hospital without falling or colliding with obstacles. Discussion: It is noteworthy that the patient’s walking ability improved further by the addition of VR-guided, dual-task, trunk balance training carried out in the sitting position. This finding suggests several possible new approaches to overcoming walking disability. Walking requires lower-extremity muscle strength, postural balance, and dual-task processing. Currently, no effective quantitative methods have been identified for postural balance and dual-task training with the patient in the sitting position. Herein, we discuss the possible advantages of VR-guided rehabilitation over traditional training methods.

著者

Hideo Ishikawa Yu Yamaguchi Takashi Nishihara Naoki Omachi Misaki Ryuge Kazushi Kitaguchi Tomoaki Hattori

出版者

The Japan Society for Respiratory Endoscopy

雑誌

Respiratory Endoscopy (ISSN:27583813)

巻号頁・発行日

vol.1, no.2, pp.28-41, 2023-11-29 (Released:2023-11-29)

参考文献数

44

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Hemoptysis is a symptom with a high mortality rate. The in-hospital mortality rate of hospitalized patients with hemoptysis is 5%-9%. Bronchial artery embolization was formerly positioned as an emergency treatment for massive hemoptysis. Nowadays, it has become a standard treatment for elective treatment for chronic recurrent hemoptysis. Despite the high mortality rate, only 2%-8% of hospitalized patients with hemoptysis underwent Bronchial Artery Embolization (BAE). One possible reason is the concern about spinal cord infarction, followed by the shortage of operators specializing in BAE.The incidence rate of spinal cord infarction was 0.18%, 0.71%, and 0.06% for gelatin sponge, n-butyl-2-cyanoacrylate (NBCA), and coil, respectively, in a nationwide observational study in JAPAN. CIRSE (Cardiovascular and Interventional Radiological Society of Europe) guideline states that BAE by the coil is relatively safe and spinal-protective based on this study.BAE is primarily performed by radiologists and is a unique intervention targeting various arteries throughout the thorax, often smaller than 2 mm and, in some cases, less than 1 mm. The authors believe that it is essential to increase the number of pulmonologists subspecializing in BAE, like cardiologists and neurosurgeons who perform catheter treatment in their field.This paper aims to provide a technical and practical Expert Review of BAE by coil for pulmonologists based on our experience at a high-volume center managed by pulmonologists. The authors will also discuss a general narrative review on classifications of hemoptysis and BAE because we are concerned about the extreme international inconsistency in classifying and defining hemoptysis-related matters and will propose some challenging suggestions depending on our experience to rectify this situation.