著者

Kei Aoyama Kenjiro Kunieda Takashi Shigematsu Tomohisa Ohno Emiko Wada Ichiro Fujishima

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.20220058, 2022 (Released:2022-11-17)

参考文献数

11

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Background: We previously reported that swallowing in the bridge position (bridge swallowing) strengthened esophageal contractions and increased the lower esophageal sphincter pressure against gravity. Furthermore, bridge swallowing exercise improved the symptoms of gastroesophageal reflux disease (GERD) in subjects with GERD. Bridge swallowing may have the potential to strengthen esophageal peristalsis and improve GERD. In this case series, we evaluated the effect of bridge swallowing on GERD symptoms and esophageal residue observed by videofluoroscopic examination of swallowing (VF) in patients with dysphagia after stroke.Cases: We reviewed the cases of five patients hospitalized with stroke and concurrent GERD symptoms. Dry swallowing exercises in the bridge (hip lift) position were performed ten times per day for 4 weeks. Frequency Scale for Symptoms of GERD (FSSG) questionnaire scores and esophageal residue on VF were compared before and after exercise. All patients completed the bridge swallowing exercise without adverse events and all showed improved FSSG scores after the exercise. Three patients showed improvements in esophageal residue on VF after exercise.Discussion: Our findings indicated that the bridge swallowing exercise can improve FSSG scores. Some patients showed improved esophageal residue on VF. This exercise was performed easily and safely without adverse events. Further studies are needed to validate the effectiveness of the bridge swallowing exercise in improving GERD.

著者

Kei Aoyama Kenjiro Kunieda Takashi Shigematsu Tomohisa Ohno Emiko Wada Ichiro Fujishima

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.20220054, 2022 (Released:2022-10-08)

参考文献数

21

被引用文献数

1

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Objectives: We previously reported that swallowing in the bridge position (bridge swallowing) increased distal esophageal contractions and lower esophageal sphincter pressure against gravity. Moreover, bridge swallowing had the potential to strengthen esophageal peristalsis. In this study, we sought to evaluate whether the bridge swallowing exercise could improve gastroesophageal reflux disease (GERD) symptoms and gastroscopy findings.Methods: Seventeen subjects with scores of 8 points or higher on the Frequency Scale for Symptoms of GERD (FSSG) questionnaire participated in the study. The exercise of dry swallowing in the bridge posture lasted 4 weeks and was performed ten times per day. FSSG scores were compared before and after exercise. Three of the 17 participants underwent upper gastrointestinal endoscopy. The modified Los Angeles classification of reflux esophagitis was used for objective assessment before and after exercise.Results: No participants dropped out of this study. FSSG scores improved significantly after exercise (from median [range] 16 [13–21] points before exercise to 5 [4–10] points after exercise, P <0.001). Upper gastrointestinal endoscopy showed improvement in the modified Los Angeles classification grade in one participant.Conclusions: The bridge swallowing exercise significantly improves FSSG scores. This exercise can be performed easily and safely without adverse events. Further multicenter prospective studies are needed to validate that the bridge swallowing exercise is effective in improving GERD.

著者

Masaki Ohya Yuko Iwashita Satoko Kunimoto Shuto Yamamoto Toru Mima Shigeo Negi Takashi Shigematsu

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.58, no.18, pp.2595-2603, 2019-09-15 (Released:2019-09-15)

参考文献数

28

被引用文献数

7

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Objective This follow-up survey report describes medication adherence and patient preferences, beliefs, and expectations of maintenance hemodialysis treatment in Japan. Methods This patient-reported questionnaire-based survey was conducted in six regions in Japan from September 2016 to November 2016. Patients The questionnaire was provided to 700 patients (50-79 years old) on maintenance hemodialysis for >3 years who were members of the Japan Association of Kidney Disease Patients. Patients were randomly selected by a stratified sampling method based on patient distribution observed from the Japanese Society for Dialysis Therapy Renal Data Registry. Results A total of 524 (74.9%) complete patient questionnaires were evaluated; the mean (SD) age was 66.6 (7.2) years (men, 63.4%) with a dialysis vintage of 16.9 (9.1) years. Adherence was high for all types of medications: between 76.7% for phosphate binders and 95.7% for antidiabetic medications. The most common reason for a missed dose was forgetting to take medication [52.5% (117/223)]. Patient preference for oral medication was as low as 0.9% (1/110), 9% (31/345), and 2.9% (2/69) for patients who felt mental burden, felt no mental burden, and neither, respectively, with their current treatment regimen. In addition, 37.8% (198/524) of patients responded that the elimination of 1 medication (1 tablet) would reduce their mental burden. Conclusion The results of this survey show that overall medication adherence is high in Japanese patients on maintenance hemodialysis. While many patients perceive an absence of mental burden, they still prefer to avoid oral medication when possible.

著者

Osamu EZAKI Mayumi TAKAHASHI Takashi SHIGEMATSU Kyoko SHIMAMURA Junji KIMURA Haruo EZAKI Takahiko GOTOH

出版者

Center for Academic Publications Japan

雑誌

Journal of Nutritional Science and Vitaminology (ISSN:03014800)

巻号頁・発行日

vol.45, no.6, pp.759-772, 1999 (Released:2009-04-28)

参考文献数

30

被引用文献数

48 61

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Although important roles of dietary n-3 fatty acids in the prevention of coronary heart disease (CHD) have been suggested, long-term effects of dietary α-linolenic acid (ALA, 18:3n-3) have not yet been established under controlled conditions. We tested whether a moderate increase of dietary ALA affects fatty acids composition in serum and the risk factors of CHD. Oxidized LDL (OxLDL) was directly measured by ELISA using antibody specific to OxLDL. By merely replacing soybean cooking oil (SO) with perilla oil (PO) (i.e., increasing 3g/d of ALA), the n-6/n-3 ratio in the diet was changed from 4:1 to 1:1. Twenty Japanese elderly subjects were initially given a SO diet for at least 6 mo (baseline period), a PO diet for 10 mo (intervention period), and then returned to the previous SO diet (washout period). ALA in the total serum lipid increased from 0.8 to 1.6% after 3 mo on the PO diet, but EPA and DHA increased in a later time, at 10 mo after the PO diet, from 2.5 to 3.6% and 5.3 to 6.4%, respectively (p<0.05), and then returned to baseline in the washout period. In spite of increases of serum n-3 fatty acids, the OxLDL concentration did not change significantly when given the PO diet. Body weight, total serum cholesterol, triacylglycerol, glucose, insulin and HbA1c concentrations, platelet count and aggregation function, prothrombin time, partial thromboplastin time, fibrinogen and PAT-1 concentration, and other routine blood analysis did not change significantly when given the PO diet. These data indicate that, even in elderly subjects, a 3g/d increase of dietary ALA could increase serum EPA and DHA in 10 mo without any major adverse effects.

著者

Yuko Iwashita Masaki Ohya Satoko Kunimoto Yu Iwashita Toru Mima Shigeo Negi Takashi Shigematsu

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0108-17, (Released:2018-05-18)

参考文献数

25

被引用文献数

11

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Objective This report presents a part of a survey pertaining to drug burden in maintenance hemodialysis patients in Japan. Methods A patient-reported questionnaire-based survey was conducted from September to November 2016 in six regions in Japan. Patients or Materials A total of 700 patients (50-79 years old) on maintenance hemodialysis for >3 years and members of the Japan Association of Kidney Disease Patients (JAKDP) were provided with the questionnaire. They were randomly selected using stratified sampling according to patient distribution observed from the Japanese Society for Dialysis Therapy Renal Data Registry (JSDT JRDR). Results A total of 524 (74.9%) patient questionnaires were evaluated (mean [standard deviation; SD] age, 66.6 [7.2] years; males, 63.4%; dialysis vintage, 16.9 [9.1] years). Patients' age, gender, and regional distribution were similar to the JSDT JRDR. They were taking an average (SD) of 16.4 (8.34) and 16.3 (8.55) oral medications/day on dialysis and nondialysis days, respectively. A majority of the patients were taking ≥10 oral medications/day on dialysis (75.1%) and nondialysis (74.4%) days, with phosphate binders being the most taken (7.0 tablets/day). A similar proportion (74.4%, 72.9%, respectively) was taking ≥6 different types of oral medications/day. Most patients were taking oral medications 3 (31%, 33%), 4 (24%, 22%), and ≥5 times (31%, 30%) a day, respectively. The drug burden was similar on dialysis and nondialysis days and did not vary with dialysis vintage. Conclusion The number, type, and frequency of oral medications in maintenance hemodialysis patients are high in Japan. The proportion of phosphate binders was highest among the prescription medications.