著者

Yoshitaka Wada Satoshi Hirano Ayaka Kumagai Kaori Takeuchi Ryosuke Inagaki Hiroshi Hosokawa Hirofumi Maeda Seiko Shibata Yohei Otaka

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.20220052, 2022 (Released:2022-09-24)

参考文献数

13

被引用文献数

1

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Background: Coronavirus disease 2019 (COVID-19) is associated with an increased risk of thrombotic complications. Nonetheless, there is a paucity of clinical knowledge regarding rehabilitation of patients with COVID-19 after lower-limb amputation.Case: A 74-year-old woman with COVID-19 was admitted to a university hospital. During hospitalization, she underwent right transfemoral amputation due to acute limb ischemia. Three months after admission, the patient was transferred to a convalescent rehabilitation ward in the same hospital. A femoral prosthesis was prescribed 2 weeks after her transfer to the rehabilitation ward. It featured ischial-ramal containment with a soft liner and belt suspension, 668-g multiple linkage-type safety knee joint (Imasen Engineering; M0781 SwanS), and a solid-ankle cushioned-heel foot. The total rehabilitation time during the patient’s stay in the acute-care and rehabilitation wards was 65.5 h (0.99 h/day, 66 days) and 275.0 h (3.02 h/day, 91 days), respectively. In the rehabilitation ward, the patient underwent 54.4 h (19.8%) of muscle strength training, 48.1 h (17.5%) of comprehensive assessments, and 47.1 h (17.1%) of gait training. The patient was discharged home 6 months after admission, with a total Functional Independence Measure score of 120. The patient could walk slowly [44.2 s (0.23 m/s) in the 10 m-walk test] with a femoral prosthesis and a quad cane but exhibited limited endurance (75.0 m in the 6-min walk test).Discussion: Following appropriate rehabilitation, a patient was able to walk independently after lower-limb amputation despite the complication of COVID-19, although her walking ability was limited.

著者

Yoshitaka Wada Seiko Shibata Ayato Shinohara Koji Mizutani Masahiko Mukaino Yohei Otaka

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2023-015, (Released:2023-11-29)

参考文献数

29

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Objectives: To examine the functional outcomes of patients with coronavirus disease 2019 (COVID-19) who underwent a new protocol-based rehabilitation program.Methods: In this retrospective cohort study, we enrolled patients who were hospitalised in a university hospital in Japan because of COVID-19 from 1st September, 2020–5th July, 2021. The primary outcome was the Functional Independence Measure (FIM) subtotal score for motor items at discharge. The secondary outcomes included the FIM cognitive subtotal score, length of hospital stay, rehabilitation period, total rehabilitation time, final rehabilitation protocol level, and discharge destination.Results: Of the 78 enrolled patients (49 men; mean age [standard deviation], 70.3 [13.9] years), 24 died (30.8%) during hospitalisation. Disease severity was classified as mild, moderate I, moderate II, and severe in 1, 6, 41, and 30 patients, respectively. The FIM motor subtotal score differed significantly among groups for all participants (p=0.027). Post hoc analysis revealed that the FIM motor subtotal score in the severe group was significantly lower than that in the moderate II group (p=0.030).Conclusions: Disease severity significantly affected patients’ functional outcome for COVID-19 at discharge. Our protocol-based program provides a benchmark for COVID-19 rehabilitation in an acute care setting.

著者

Megumi Ozeki Hitoshi Kagaya Yoko Inamoto Tomoko Iizumi Seiko Shibata Keiko Onogi Eiichi Saitoh

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2019-018, (Released:2020-03-25)

参考文献数

15

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Objective: The “chin-down” posture involves tucking the chin to the neck. However, clinicians and researchers have their own forms of the chin-down posture: some consider it to be head and neck flexion, whereas others consider it to be head flexion alone. The purpose of this study was to evaluate the effects of head, neck and combined head-and-neck flexion postures separately.Methods: Ten healthy volunteers participated in the study. The head and neck were set in neutral (N), head flexion (HF), neck flexion (NF) or combined head-and-neck flexion (HFNF) positions. Participants were instructed to swallow 4 ml of thick barium liquid in an upright sitting position. Head and neck angles at rest, distances in the pharynx and larynx at rest, and duration of swallowing were measured. Statistical analysis was performed with a paired t-test with Bonferroni correction.Results: Head angles in HF, NF and HFNF positions were significantly greater than in the N position. Neck angles were significantly greater in the NF position than in the N position. The distance between the tongue base and the posterior pharyngeal wall, the vallecular space and the airway entrance were smaller in the HF position than in the N position. The tongue base was in contact with the posterior pharyngeal wall longer in the HF position than in the N position.Conclusion: Because HF, NF and HFNF positions have different effects, we recommend the use of these terms instead of “chin-down position.”

著者

Hidetaka Tsuzuki Yoko Inamoto Eiichi Saitoh Keiko Aihara Seiko Shibata Hitoshi Kagaya Keiko Onogi Enri Nakayama Mitsuyasu Sato Koichiro Ueda

出版者

Nihon University School of Dentistry

雑誌

Journal of Oral Science (ISSN:13434934)

巻号頁・発行日

vol.62, no.1, pp.18-22, 2020 (Released:2020-01-29)

参考文献数

19

被引用文献数

7

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This study used 320-row area detector computed tomography (320-ADCT) to determine whether kinematic swallowing events and bolus movement through the oropharynx are affected by bolus consistency and angle of recline. Fourteen healthy adults (4 men, 10 women; age, 22-90 years) underwent 320-ADCT assessment during three 10-mL barium swallow tests, with honey-thick liquid at 60° recline (60°thick), thin liquid at 60° recline (60°thin), and thin liquid at 45° recline (45°thin). The times of swallowing events were measured and compared among the different tests. Bolus propulsion, onset time of true vocal cord (TVC) closure, and upper esophageal sphincter opening were significantly earlier for 60°thin than for 60°thick. Onset time did not significantly differ between 60°thin and 45°thin; however, greater variability was noted for onset of TVC closure with 45°thin, as the TVC started to close before onset of swallowing in 30% of participants. Modulation of TVC closure depends on bolus transport in different reclining positions. The 45° reclining position elicited pre-swallow TVC closure in some participants, which suggests that excessive recline can increase perceived risk of airway invasion during swallowing.