著者

Mayumi Matsuda Kuroda Nobuaki Iwasaki Kenichi Yoshikawa Ryoko Takeuchi Yuki Mataki Tomohiro Nakayama Junko Nakayama Haruka Ohguro Kayo Tokeji Hirotaka Mutsuzaki

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.7, pp.20220050, 2022 (Released:2022-09-15)

参考文献数

29

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Background: Constraint-induced movement therapy (CIMT) improves the motor function of paralyzed upper limbs of adults after stroke. However, in patients with severe spastic cerebral palsy (CP), the use of CIMT is not warranted. Our aim was to investigate the feasibility and effectiveness of repetitive voluntary-assisted upper limb training (VAUT) for three patients with severe CP using a combination of robotics [Hybrid Assistive Limb (HAL)] and functional electrical stimulation [Integrated Volitional Control Electrical Stimulation (IVES)].Case: Three patients with CP were enrolled. Patients 1, 2, and 3 were 8-, 19-, and 18-year-old males, respectively. Patient 1 had spastic hemiplegia, while patients 2 and 3 had spastic quadriplegia. VAUT using single-joint HAL was performed for 1 or 2 sessions/month for 50 min/session over an 8-month period for 9–13 sessions in total. One patient’s voluntary hand movement was insufficient, affecting his upper limb exercise performance; therefore, IVES was required in addition to HAL. Outcome measures included motor function of the upper limbs and use of paralyzed hands, which were measured before and after intervention. No adverse events were observed during VAUT. After intervention, the Action Research Arm Test scores showed improvements in all three patients. The Children’s Hand-use Experience Questionnaire showed improvements in two patients.Discussion: The use of VAUT, together with new systems such as HAL and IVES, for severe CP is safe and may be effective. Our study suggested that upper limb function can be improved for patients with severe CP.

著者

Kunihiko Araki Ryoko Takeuchi Fumiaki Katada Toshio Fukutake

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.5112-20, (Released:2020-08-04)

参考文献数

20

被引用文献数

2

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Rotatory vertigo is known to have not only peripheral causes, e.g., Meniere's disease, vestibular neuritis, and benign paroxysmal positional vertigo, but also central causes, e.g., stroke, hemorrhage, and tumor. In most cases, central rotatory vertigo is caused by a lesion in the brainstem or cerebellum, but rare cases with a cerebral lesion have also been reported. We herin describe a unique case with acute rotatory vertigo following a small hemorrhage in the left superior temporal gyrus, which probably led to a dysfunction of the visual-vestibular system.

著者

Yohei Tomaru Hiroshi Kamada Yuta Tsukagoshi Shogo Nakagawa Mio Onishi Kenta Tanaka Ryoko Takeuchi Yuki Mataki Shumpei Miyakawa Masashi Yamazaki

出版者

THE JAPANESE ASSOCIATION OF RURAL MEDICINE

雑誌

Journal of Rural Medicine (ISSN:1880487X)

巻号頁・発行日

vol.14, no.2, pp.176-180, 2019 (Released:2019-11-20)

参考文献数

10

被引用文献数

2

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Objectives: The purpose of this study was to evaluate the relationship between exercise time and musculoskeletal problems and to determine the appropriate amount of exercise for children in both lower- and higher-grade levels of elementary and junior high schools.Materials and Methods: Mark-sheet-type questionnaires were distributed to and collected from all elementary and junior high schools in two cities. We collected 22,494 questionnaires in total. The relationship between exercise time and musculoskeletal problems was analyzed. The χ2 test and multivariate logistic regression analysis were used for statistical analyses.Results: The mean exercise time in school, in addition to physical education time, was 3.1 hours per week. In 56% of the children, the exercise time was less than 2 hours per week, and in 13% of the children, the exercise time was more than 10 hours per week. Although the rate of sports injury increased with an increase in exercise time, the duration of one-leg stand (a test of balance and muscle strength) also increased with an increase in exercise time. The cut-off values for sports injuries in boys/girls were 2.9/2.9 hours, 4.0/2.9 hours, and 7.5/4.2 hours in lower grade elementary school, higher grade elementary school, and junior high school, respectively.Conclusions: Although an appropriate amount of exercise improves one’s physical health and ability, excessive exercise leads to musculoskeletal problems. Approximately 7 hours/week of exercise is recommended for junior high school students. In elementary school, the exercise time should be carefully decided as the musculoskeletal system of the students is still immature.

著者

Hirotaka Mutsuzaki Ryoko Takeuchi Yuki Mataki Yasuyoshi Wadano

出版者

THE JAPANESE ASSOCIATION OF RURAL MEDICINE

雑誌

Journal of Rural Medicine (ISSN:1880487X)

巻号頁・発行日

vol.12, no.1, pp.33-37, 2017 (Released:2017-05-24)

参考文献数

24

被引用文献数

23 33

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Objective: Postoperative knee range of motion (ROM) is among the most important factors influencing patient satisfaction after total knee arthroplasty (TKA). The purpose of this study was to clarify the time course of improvement in knee ROM up to 12 months after TKA, including intraoperative knee ROM after implantation, and to clarify a target ROM for rehabilitation after TKA.Patients and Methods: In total, 39 knee joints in 26 patients with osteoarthritis who underwent TKA (retaining the posterior cruciate ligament) were evaluated. Goniometry was used to measure the knee range of extension and flexion preoperatively; intraoperatively; at 1 and 2 weeks after TKA; and then at 1, 3, 6, and 12 months after TKA.Results: The postoperative extension range gradually improved up to a maximum at 6 months after TKA; there were no significant differences in the extension range between intraoperative and 6 months after TKA, intraoperative and 12 months after TKA, or 6 and 12 months after TKA. The postoperative flexion range gradually improved, with the maximum improvement observed at 3 months after TKA; there were no significant differences in the flexion range before TKA and 3, 6, and 12 months after TKA. There were no significant differences between flexion ROM measured at 3, 6, and 12 months after TKA.Conclusions: The changes in the knee range of extension plateaued 6 months after TKA, and those in the knee range of flexion plateaued 3 months after TKA. The target range of extension for rehabilitation from 6 months to 12 months after TKA was the intraoperative range, and the target range of flexion for rehabilitation from 3 months to 12 months after TKA was the preoperative range.

著者

Ryoko Takeuchi Hirotaka Mutsuzaki Yuki Mataki Hiroshi Kamada

出版者

THE JAPANESE ASSOCIATION OF RURAL MEDICINE

雑誌

Journal of Rural Medicine (ISSN:1880487X)

巻号頁・発行日

vol.15, no.4, pp.164-169, 2020 (Released:2020-10-01)

参考文献数

18

被引用文献数

4

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Objective: This study aimed to investigate the age at which scoliosis progresses to a severe condition and identify the factors related to severe scoliosis in patients with cerebral palsy.Patients and Methods: This retrospective study included 51 patients aged ≥15 years. The Cobb angle was measured over time using radiographs. Patients were divided into the following groups according to their final Cobb angle: <60°, 60°–100°, and ≥100°. The age at which the Cobb angle was ≥20° in the patients was compared among the groups. Moreover, the age at which a significant difference in the Cobb angle occurred in the groups was considered the age at which the scoliosis worsened. Association of the final Cobb angle with factors such as the location of curve, Gross Motor Functional Classification System (GMFCS), capability of turning over, orthosis use, hip dislocation, tracheotomy, and gastric fistula was examined.Results: The mean age at which the Cobb angle was ≥20° was significantly lower in the ≥100° group. From 9 years of age, a significant difference was noted in the Cobb angle between the <60° group and ≥100° group. Between 13–19 years, a significant difference in the Cobb angle was observed among the three groups. Furthermore, GMFCS, capability of turning over, hip dislocation, and gastric fistula were the factors showing a significant difference among the three groups.Conclusion: Scoliosis progressed to the severe form (Cobb angle ≥100°) at 9 years of age. Moreover, scoliosis is aggravated during the growth period. Severe cerebral palsy with low motor function levels and problems with internal functions was considered the cause of scoliosis deterioration.