著者

Kazuki OKURA Yusuke TAKAHASHI Kakeru HASEGAWA Kazutoshi HATAKEYAMA Kimio SAITO Chihiro IMAIZUMI Hajime KAGA Naoto TAKAHASHI

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

pp.E10188, (Released:2022-11-09)

参考文献数

21

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Introduction: Early implementation of neuromuscular electrical stimulation (NMES) has been reported to prevent muscle atrophy and physical functional decline in patients requiring mechanical ventilation. However, its effect in patients with acute exacerbation of interstitial lung disease (ILD) remains unclear. We herein report our experience using the NMES combined with mobilization in a patient with an acute exacerbation of rheumatoid arthritis-associated ILD (RA-ILD) requiring mechanical ventilation. Case presentation: A 74-year-old man was admitted to the intensive care unit (ICU) and put on mechanical ventilation due to severe acute exacerbation of RA-ILD. Early mobilization and the NMES using a belt electrode skeletal muscle electrical stimulation system were started on day 7 of hospitalization (day 2 of ICU admission). The NMES duration was 20 min, performed once daily. The patient could perform mobility exercises on day 8 and could walk on day 16. We assessed his rectus femoris and quadriceps muscle thicknesses using ultrasound imaging, and found decreases of 4.5% and 8.4%, respectively, by day 14. On day 27, he could independently visit the lavatory, and the NMES was discontinued. He was instructed to start long-term oxygen therapy on day 49 and was discharged on day 63. His 6-minute walk distance was 308 m and his muscle thickness recovered to levels comparable to those at the initial evaluation at the time of discharge. Conclusion: Combining the NMES and mobilization started in the early phase and continued after ICU discharge was safe and effective in a patient with a severe acute exacerbation of RA-ILD.

著者

Hiroaki Tsukamoto Kimio Saito Toshiki Matsunaga Takehiro Iwami Hidetomo Saito Hiroaki Kijima Manabu Akagawa Akira Komatsu Naohisa Miyakoshi Yoichi Shimada

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.6, pp.20210009, 2021 (Released:2021-02-06)

参考文献数

20

被引用文献数

3

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Objectives: The purpose of this study was to clarify the diagnostic accuracy of the mobile assessment of varus thrust using inertial measurement units (IMUs).Methods: A total of 80 knees in 49 patients were enrolled in this study. On visual analysis of gait to determine the presence or absence of varus thrust, 23 knees were assigned to the Present group, 17 to the Ambiguous group, and 40 to the Absent group. The peak knee varus angular velocities (PVVs), measured by quantitative gait analysis using nine-axis IMUs, were compared between these three groups. A receiver operating characteristic curve for the relationship between the visual assessment of varus thrust (Present and Ambiguous) and the measured PVV was created, and the cut-off PVV for visualized varus thrust was determined as the highest point for both sensitivity and specificity.Results: The mean PVVs were significantly different between the three groups (Present, 47.7 ± 8.2 degree/s, Ambiguous, 34.1 ± 10.5 degree/s, and Absent, 28.1 ± 8.3 degree/s, respectively, ANOVA P=0.000). The PVV cut-off value for visualized varus thrust was 28.1 degree/s, yielding a sensitivity of 0.957 and a specificity of 0.579.Conclusions: A PVV <28.1 degree/s is useful for ruling out varus thrust during gait. This quantitative varus thrust assessment method using IMUs has clinical utility as a screening test.