- 著者
- Shogo Fukui Michiyuki Kawakami Yohei Otaka Aiko Ishikawa Fumiaki Yashima Kentaro Hayashida Yuko Oguma Keiichi Fukuda Meigen Liu
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Reports (ISSN:24340790)
- 巻号頁・発行日
- vol.2, no.2, pp.83-88, 2020-02-10 (Released:2020-02-10)
- 参考文献数
- 32
- 被引用文献数
- 1 4
Background:This aim of this study was to clarify prognosis after transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis (AS) and to identify baseline factors associated with mortality.Methods and Results:We prospectively enrolled 257 consecutive elderly persons with AS who were referred to Keio University Hospital and who underwent assessment of cardiac, physical (walking speed), cognitive, and renal functions, nutritional status, activities of daily living (ADL), instrumental ADL (IADL) assessed with the Frenchay activities index (FAI), and comorbidities. The primary outcome was postoperative death. Differences in basic characteristics were compared between a group that survived for a median of 661 days (IQR, 0–1,289 days) after TAVI and a group that did not. Multivariate hazard ratios (HR) were calculated for independent factors selected in Cox proportional hazard models. Thirty-one individuals died during follow-up. Walking speed was significantly faster (0.87±0.25 vs. 0.70±0.24 m/s, P<0.001) and FAI was significantly higher (21.2±8.0 vs. 15.7±8.0, P=0.026) in the survival group compared with those who died. Multivariate HR for mortality according to walking speed was 0.05 (95% CI: 0.028–0.091) in model 1 and 0.04 (95% CI: 0.020–0.081) in model 2, and those for FAI were 0.94 (95% CI: 0.92–0.95) and 0.92 (95% CI: 0.90–0.92), respectively.Conclusions:Preoperative walking speed and IADL are crucial factors associated with prognosis after TAVI even after adjustment.
- 著者
- Takayuki Kamimoto Yuichiro Hosoi Kenya Tanamachi Rieko Yamamoto Yuka Yamada Tatsuya Teramae Tomoyuki Noda Fuminari Kaneko Tetsuya Tsuji Michiyuki Kawakami
- 出版者
- The Japanese Association of Rehabilitation Medicine
- 雑誌
- Progress in Rehabilitation Medicine (ISSN:24321354)
- 巻号頁・発行日
- vol.8, pp.20230024, 2023 (Released:2023-08-17)
- 参考文献数
- 44
Background : Walking disability caused by central nervous system injury often lingers. In the chronic phase, there is great need to improve walking speed and gait, even for patients who walk independently. Robot-assisted gait training (RAGT) has been widely used, but few studies have focused on improving gait patterns, and its effectiveness for motor function has been limited. This report describes the combination of “RAGT to learn the gait pattern” and “ankle robot training to improve motor function” in a patient with chronic stage brain injury.Case : A 34-year-old woman suffered a traumatic brain injury 5 years ago. She had residual right hemiplegia [Fugl-Meyer Assessment-Lower Extremity (FMA-LE): 18 points] and mild sensory impairment, but she walked independently with a short leg brace and a cane. Her comfortable gait speed was 0.57 m/s without an orthosis, and her 6-m walk test distance was 240 m. The Gait Assessment and Intervention Tool (G.A.I.T.) score was 35 points. After hospitalization, ankle robot training was performed daily, with RAGT performed 10 times in total. Post-intervention evaluation performed on Day 28 showed: FMA-LE, 23 points; comfortable walking speed, 0.69 m/s; G.A.I.T., 27 points; and three-dimensional motion analysis showed ankle dorsiflexion improved from 3.22° to 12.59° and knee flexion improved from 1.75° to 16.54° in the swing phase.Discussion : This is one of few studies to have examined the combination of two robots. Combining the features of each robot improved the gait pattern and motor function, even in the chronic phase.