著者

Yuta Tauchi Tomoyuki Ogino Tomoyuki Morisawa Yosuke Wada Rie Sakamoto Yoshihiro Kanata Kazuhisa Domen

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

pp.CR-22-0102, (Released:2023-03-11)

参考文献数

29

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Background: The purpose of this study was to investigate the actual conditions of cardiac rehabilitation (CR) for elderly patients with heart failure (HF) in outpatient rehabilitation (OR) facilities using long-term care insurance systems.Methods and Results: This was a cross-sectional web-based questionnaire survey conducted at 1,258 facilities in the Kansai region (6 prefectures) of Japan from October to December 2021. In all, 184 facilities responded to the web-based questionnaire (response rate 14.8%). Of these facilities, 159 (86.4%) accepted patients with HF. Among the patients with HF, 94.3% were aged ≥75 years and 66.7% were classified as New York Heart Association functional class I/II. Facilities treating patients with HF generally provided exercise therapy, patient education, and disease management, which were components of CR. Many facilities not currently treating patients with HF responded positively stating they will accept HF patients in the future. However, a few facilities responded by stating that they are waiting for clearer evidence demonstrating the beneficial effect of OR on patients with HF.Conclusions: The present results show the possibility that outpatient CR can be performed for elderly patients with HF in other than medical insurance.

著者

Ryosuke Matsuki Noriaki Kojima Koki Watanabe Akira Hotta Yohei Kubori Keisuke Oura Tomoyuki Morisawa Hidehiko Koyama Toshihiko Ebisu Takuya Hashino

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.5, pp.20200027, 2020 (Released:2020-11-06)

参考文献数

22

被引用文献数

2

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Objectives: The goal of this study was to determine the effects of an intensive care unit (ICU) rehabilitation protocol with dedicated therapists on the physical function and activities of daily living (ADL) of patients on discharge from the ICU.Methods: This retrospective study included patients who started rehabilitation during their ICU stay. Patients were divided into three groups: the Usual Care group (before the introduction of the rehabilitation protocol), the Protocol group (after the introduction of the rehabilitation protocol), and the PT + Protocol group (with a dedicated therapist in addition to the rehabilitation protocol). The standard interventions in the Protocol group and the PT + Protocol group were set according to the protocol based on the level of consciousness and strength of each individual patient. Patients’ age, APACHE II score, length of ICU stay, length of hospital stay, and the Functional Status Score for the ICU (FSS-ICU) and Medical Research Council score (MRC score) on discharge from the ICU were compared among the three groups.Results: There were no significant differences among the three groups in age and APACHE II score. The MRC and FSS-ICU scores were significantly higher in the PT + Protocol and Protocol groups than in the Usual Care group. Furthermore, the lengths of ICU stay and hospital stay were lower in the PT + Protocol group than in the Usual Care group.Conclusions: Introduction of the rehabilitation protocol improved the limb strength and ADL of patients. Moreover, the presence of dedicated therapists in addition to the protocol reduced the lengths of ICU and hospital stays.

著者

Tomoyuki Morisawa Tetsuya Takahashi Shinichi Nishi

出版者

The Society of Physical Therapy Science

雑誌

Journal of Physical Therapy Science (ISSN:09155287)

巻号頁・発行日

vol.27, no.1, pp.165-168, 2015 (Released:2015-01-09)

参考文献数

14

被引用文献数

6 6

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[Purpose] It is important to facilitate intestinal motility in patients with reduced bowel movement through physiotherapy. The purpose of the present study was to compare the effects of passive exercise of the lower limbs and trunk (PELT) and combination therapies (COM) with those of conventional thermotherapy (TT) on bowel sounds (BSs) in healthy adult subjects. Since autonomic activity (AA) significantly influences intestinal motility, we also investigated the relation between intestinal motility and AA by measurement of BSs. [Subjects] The subjects were 16 healthy adult males. [Methods] The subjects were randomly assigned to 3 different physiotherapies, and BSs and sympathetic nerve activity were measured before and after the physiotherapies. [Results] While BSs significantly increased following all physiotherapies, the temporal changes in BSs were different among the physiotherapies. AA measurement showed that PELT and TT significantly decreased the heart rate. While the high-frequency (HF) component was increased in all physiotherapy groups, the increases in HF did not reach statistical significance. There were no significant correlations between BSs and AA. [Conclusion] We found that all of the tested physiotherapies increased BSs, suggesting that they are clinically useful for treatment of patients with reduced intestinal motility due to limited spontaneous movement or inability to rise up from bed.

著者

Michitaka KATO Masakazu SAITOH Tomonori KAWAMURA Kentaro IWATA Koji SAKURADA Daisuke OKAMURA Masayuki TAHARA Satoshi YUGUCHI Kenta KAMISAKA Keisuke OURA Yuji MORI Tomoyuki MORISAWA Tetsuya TAKAHASHI

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

vol.22, no.1, pp.1-8, 2019-06-20 (Released:2019-06-20)

参考文献数

31

被引用文献数

1 13

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Objective: Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery. The aim of this multicenter study was to determine the relationship between POAF and patients' progress in early rehabilitation after heart valve surgery. Methods: We enrolled 302 patients (mean age, 69±10 years) who had undergone heart valve surgery. POAF was monitored using continuous electrocardiogram telemetry, and the Short Physical Performance Battery (SPPB) was used to assess lower-extremity function before surgery and at the time of discharge. Progress in early rehabilitation was evaluated by the duration from the surgery to independent walking. We determined factors associated delayed early rehabilitation and evaluated the interplay of POAF and delayed early rehabilitation in increasing the risk of decline in lower-extremity function from preoperatively to hospital discharge. Results: Multivariate analysis determined POAF to be independent predictors of delayed early rehabilitation after heart valve surgery (OR: 3.906, P =.01). The association between delayed early rehabilitation and decline in lower extremity function was stronger in patients with POAF (OR: 2.73, P =.041) than in those without (OR: 2.22, P =.052). Conclusions: POAF was clinical predictors of delayed early rehabilitation in patients undergoing heart valve surgery. The combination of POAF with delayed early rehabilitation conferred a high risk of decline in lower-extremity function during hospitalization.

著者

Tetsuya TAKAHASHI Tomoyuki MORISAWA Masakazu SAITOH Miho YOKOYAMA Kasunori SHIMADA Toshiyuki FUJIWARA Hiroyuki DAIDA

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

vol.23, no.1, pp.1-7, 2020-06-20 (Released:2020-06-20)

参考文献数

20

被引用文献数

9

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In recent years, the importance of early physiotherapy for rapid mental and physical functional recovery is increasing with the increasing number of older patients and high-risk patients with duplicate disorders. Increasing the effectiveness of acute physiotherapy within a shorter hospital stay is a great challenge. We published the first expert consensus of early rehabilitation in Asia in 2017. Our expert consensus will contribute to the establishment of physiotherapy in intensive care for Asian populations. The minimum standard of clinical practice for physiotherapists working in critical care settings is important to showcase physiotherapists' knowledge and abilities as medical professionals working in the intensive care unit. We are planning to release the minimum standard of clinical practice for Japanese physiotherapists working in critical care settings in 2020. Being in the forefront among nations of aging populations, Japan has a rapidly increasing number of older frail patients with heart failure. Further studies are necessary to confirm the effectiveness of task-specific exercise training considering the characteristics of frailty.

著者

Tetsuya Takahashi Tatsunori Shitara Megumi Kumamaru Masanobu Taya Hiroko Kazama Jun-ichi Nishikawa Harue Nakano Masami Inokuma Tomoyuki Morisawa Simio Yamada Hikaru Matsuda

出版者

The Society of Physical Therapy Science

雑誌

Journal of Physical Therapy Science (ISSN:09155287)

巻号頁・発行日

vol.23, no.1, pp.21-23, 2011 (Released:2011-04-28)

参考文献数

9

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[Purpose] The aim of this study was to determine the lower-limb muscle activities during muscle exercise using an on-the-bed muscle training device that utilizes the intermittent inflation of an oval rubber balloon placed against the sole. [Subjects and Methods] Ten healthy subjects were asked to adopt a semi-recumbent position with a flat oval chloridized polyvinyl balloon placed against the sole. The subjects were asked to extend both their legs when they felt the inflation of the balloon on their plantar surface. This exercise was defined as leg exercise against intermittent sole pressure stimulation (ExISPS). [Results] The root-mean-square (RMS)-EMG values of the vastus medialis during ExISPS in the semi-recumbent position were similar to those when standing up from 45-degree knee flexion and calf-raising. The RMS-EMG values of the biceps femoris showed no significant difference among these exercises. The RMS-EMG values of gastrocnemius medialis during ExISPS in the semi-recumbent position were higher than those when standing up from 45-degree knee flexion and standing up from a chair. [Conclusion] The findings of this study suggest that the muscle activities during ExISPS mimic or are greater than those required of the leg in daily life.