著者

Ryozo Tanaka Hiroaki Fushiki Reiko Tsunoda Tomohiko Kamo Takumi Kato Hirofumi Ogihara Masato Azami Kaoru Honaga Toshiyuki Fujiwara

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.20230002, 2023 (Released:2023-01-14)

参考文献数

35

被引用文献数

2

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Objectives: This study investigated the effects of a supervised home-based vestibular rehabilitation program using a booklet on gait function and dizziness in patients with chronic peripheral vestibular hypofunction.Methods: This was a non-blinded, randomized, controlled trial. Patients (n=42) with chronic peripheral vestibular hypofunction were randomly divided into the vestibular rehabilitation group (VR group; n=20) or the control group (n=22). Patients in the VR group received a supervised home-based vestibular rehabilitation program using a booklet in addition to physician care for 4 weeks. The physical therapist checked the home program when the VR group visited the outpatient clinic once a week. Patients in the control group received physician care only during the trial period. The primary outcome was functional gait assessment (FGA). The secondary outcomes were the dynamic gait index (DGI) and the dizziness handicap inventory (DHI).Results: Two-way repeated measures analysis of variance showed a significant interaction for FGA, DGI, DHI total, and DHI emotional scores (P<0.05) with the VR group improving more than the control group. No significant interactions were found for DHI physical and DHI functional scores (P≥0.05).Conclusions: The home-based vestibular rehabilitation program in this study was effective in improving gait function and dizziness in patients with chronic peripheral vestibular hypofunction. Regular supervision may have improved adherence to home exercise and contributed to the effectiveness of vestibular rehabilitation.

著者

Kozo Hatori Yasuhiro Tagawa Taku Hatano Osamu Akiyama Nana Izawa Akihide Kondo Kazunori Sato Ayami Watanabe Nobutaka Hattori Toshiyuki Fujiwara

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.20230014, 2023 (Released:2023-05-12)

参考文献数

19

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Background: Task-specific dystonia (TSD) confined to the lower extremities (LE) is relatively rare. This report describes dystonia confined to the LE only during forward walking. This case required careful neurological and diagnostic assessment because the patient was taking several neuropsychiatric drugs that cause symptomatic dystonia, such as aripiprazole (ARP).Case: A 53-year-old man visited our university hospital with a complaint of abnormalities in the LE that appeared only during walking. Neurological examinations other than walking were normal. Brain magnetic resonance imaging revealed meningioma in the right sphenoid ridge. The patient had been treated for depression with neuropsychiatric medications for a long time, and his abnormal gait appeared about 2 years after additional administration of ARP. After the meningioma was removed, his symptoms remained. Surface electromyography showed dystonia in both LE during forward walking, although his abnormal gait appeared to be accompanied by spasticity. The patient was tentatively diagnosed with tardive dystonia (TD). Although dystonia did not disappear clinically, it was alleviated after discontinuing ARP. Administration of trihexyphenidyl hydrochloride and concomitant rehabilitation improved his dystonia until return to work, but some residual gait abnormalities remained.Discussion: We report an unusual case of TD with task specificity confined to the LE. The TD was induced by the administration of ARP in combination with multiple psychotropic medications. Careful consideration was required for clinical diagnosis, rehabilitation, and assessment of its relevance to TSD.

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

Kazunori Sato Eku Hirai Tomomi Sukigara Tsukasa Yoshida Noriaki Aita Eriko Kitahara Yoshihide Hokari Toshiyuki Fujiwara

出版者

JAPANESE PHYSICAL THERAPY ASSOCIATION

雑誌

理学療法学Supplement

巻号頁・発行日

pp.E-141_2, 2019 (Released:2019-08-20)

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【Background/Purpose】 The deep brain stimulation of subthalamic nucleus (STN-DBS) is a surgical treatment for Parkinson's disease (PD) to reduce off-state. There have been scarce reports that indicate the effectiveness of postoperative rehabilitation on the axial symptoms. The purpose of this study is to examine the effectiveness of postoperative rehabilitation in PD patients.【Methods or Cases】 The data of 31 postoperative PD patients who received 2 week physical therapy from May 2017 to May 2018 were extracted from a prospectively maintained database, and were analyzed retrospectively. Outcome measures were the Mini-Balance Evaluation Systems Test (Mini-BESTest), Trunk impairment scale (TIS), Leg extension torque, 10 times toe tapping (10TTT) and Treadmill gait analysis. The patients were evaluated at pre-operation, post-operation and discharge period. One-way repeated measures analysis of variance (ANOVA) and post-hoc Paired t-tests with Bonferroni adjustment for multiple comparison were used to analyze the data (P < 0.05).【Results】 The ANOVA showed that all clinical data had the significant differences among three periods. The post hoc test revealed that there were significant differences between pre-operation and discharge periods in the Mini-BESTest (P < 0.0001), TIS (P < 0.0001), Step length on the Treadmill (P=0.004) and 10TTT (P=0.009), but the lower limb extension torque (P=0.11). There was only significantly different between pre-operation and post-operation in the Step length on the Treadmill (P=0.032). 【Discussion/Conclusion】 The results showed that postoperative rehabilitation has a positive effect on the balance ability, trunk function, gait function and limb akinesia of the PD patients. These facts might indicate that STN-DBS and postoperative rehabilitation provide different effects on the PD patients.【Ethical consideration】This study was conducted with the declaration of Helsinki. This study was approved by the institutional ethics review board (JHS 18-007).