著者

Yuya Mawarikado Yusuke Inagaki Tadashi Fujii Hidetaka Imagita Takahiko Fukumoto Takanari Kubo Mimo Shirahase Akira Kido Yasuhito Tanaka

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.20220049, 2022 (Released:2022-09-15)

参考文献数

37

被引用文献数

3

---

Objectives: The aim of this study was to investigate the preoperative factors affecting health-related quality of life (HRQOL) at 3 and 12 months after total knee arthroplasty (TKA).Methods: In total, 156 patients who underwent unilateral TKA for knee osteoarthritis were included in the study. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was used as a measure of HRQOL before surgery and 3 and 12 months post-TKA. The Modified Gait Efficacy Scale (mGES) score, tibiofemoral angle, rest pain, walking pain, knee joint range of motion, knee joint extensor strength, and walking speed were recorded preoperatively. Pearson’s correlation coefficient and the correlation ratio were used to calculate the correlation between KOOS and preoperative factors at 3 and 12 months post-TKA. Multiple regression analysis was performed using the stepwise method with the five postoperative KOOS subscales as dependent variables and the other preoperative factors as independent variables.Results: Preoperative mGES scores were significantly correlated with KOOS Activities of Daily Living, Sport/Rec, and QOL subscores at 3 months post-TKA and with all five KOOS subscales at 12 months post-TKA. Multiple regression analysis identified mGES as an influencing factor for all KOOS subscales except Pain at 3 months post-TKA and all KOOS subscales except Symptoms at 12 months post-TKA.Conclusions: Preoperative walking self-efficacy influenced HRQOL at 3 and 12 months post-TKA. Psychological factors such as self-efficacy should be considered when predicting postoperative outcomes.

著者

Yusuke Yamamoto Eiichiro Iwata Hideki Shigematsu Hiroshi Nakajima Masato Tanaka Akinori Okuda Yasuhiko Morimoto Keisuke Masuda Munehisa Koizumi Yasuhito Tanaka

出版者

The Japanese Society for Spine Surgery and Related Research

雑誌

Spine Surgery and Related Research (ISSN:2432261X)

巻号頁・発行日

pp.2017-0052, (Released:2018-02-28)

被引用文献数

6

---

Introduction To identify the temporal comparison of biochemical markers for early detection of surgical site infection (SSI) following instrumented spinal fusion that are not affected by operative factors.Materials and methods We reviewed data on C-reactive protein level and total white blood cell count and differential count before instrumented spinal fusion and at 1, 4, and 7 days postoperatively. The 141 patients in our sample were divided into an SSI group (patients who developed deep SSI) and a non-SSI group. We investigated the peak or nadir value day and identified those not affected by operative circumstances (operating time, intraoperative blood loss, and number of fusion segments) in the non-SSI group. If there was a significant difference between the peak or nadir value day and the next survey day, we considered the temporal comparison between these unaffected markers as an indicator of SSI and examined the usefulness of these indicators by calculating sensitivity and specificity. Furthermore, we investigated the usefulness of the combination of these markers (if even each one marker was recognized, we considered it positive).Results Four biochemical markers of SSI were selected: neutrophil percentage at postoperative day 4 more than day 1 (sensitivity 36%, specificity 95%), neutrophil count at postoperative day 4 more than day 1 (sensitivity 46%, specificity 93%), lymphocyte percentage at postoperative day 4 less than day 1 (sensitivity 36%, specificity 90%), and lymphocyte count at postoperative day 4 less than day 1 (sensitivity 36%, specificity 90%). The combination of these markers showed sensitivity 100%, specificity 80%, respectively.Conclusions Four markers are reliable indicators for early detection of SSI following spinal instrumented fusion because they are not affected by operative factor. The combination of each indicator had both high sensitivity and specificity. Therefore, it is reliable and much useful for early detection of SSI.

著者

Akihito Kawai Sachiko Kawasaki Tomoko Nishimura Hideki Shigematsu Masato Tanaka Yasuhito Tanaka

出版者

The Japanese Society for Spine Surgery and Related Research

雑誌

Spine Surgery and Related Research (ISSN:2432261X)

巻号頁・発行日

vol.6, no.6, pp.721-724, 2022-11-27 (Released:2022-11-27)

参考文献数

10

著者

YASUHITO TANAKA

出版者

JAPANESE ECONOMIC ASSOCIATION

雑誌

The Economic Studies Quarterly (ISSN:0557109X)

巻号頁・発行日

vol.43, no.3, pp.210-229, 1992-09-18 (Released:2007-10-19)

参考文献数

21

---

In this paper I examine the welfare effects of tariffs in international free-entry oligopolies under integrated markets in a two-country world model. I shall show that a small specific (or ad-variorum) tariff imposed by the home country exercises the same welfare effect as a small specific (or ad-variorum) tariff imposed by the foreign country in a free trade equilibrium. These unilateral specific (or ad-variorum) tariffs and reciprocal specific (or advariorum) tariffs make the home and the foreign countries better off if demand functions of oligopolistic goods are concave (or concave or linear). (JEL No. 411, 611)

著者

Daisuke BAI Mitsunori TOKUDA Taiki IKEMOTO Shingo SUGIMORI Shoki OKAMURA Yuka YAMADA Yuna TOMITA Yuki MORIKAWA Yasuhito TANAKA

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

pp.E10050, (Released:2020-09-28)

参考文献数

20

---

Objectives: This study aimed to assess physical function such as lower limb function and Activities of Daily Living after surgery for proximal femoral fractures ( unstable medial femoral neck fracture and trochanteric fracture). Methods: This study enrolled 68 patients with proximal femoral fractures. Isometric knee extension strength (IKES), the Japanese Orthopedic Association (JOA) hip score, and the number of days required to develop straight leg raising, transfer, and T-caneassisted gait abilities to become independent were assessed. Patients were classified based on the types of proximal femoral fractures, namely unstable medial femoral neck fracture (bipolar hip arthroplasty [BHA] group), stable trochanteric fracture (S group), and unstable trochanteric fracture (US group). Results: IKES and the JOA hip score were significantly better in the BHA group than in the S and US groups. IKES and the JOA hip score were significantly worse in the US group than in the BHA and S groups. Both transfer and T-cane-assisted gait abilities of patients in the BHA and S groups were indifferent. However, all physical functions were significantly worse in the US group. Conclusions: Our study results suggested that physical therapists plan the different rehabilitation program for the patients with proximal femoral fractures who were classified into three types, namely unstable medial femoral neck fracture, stable trochanteric fracture, and unstable trochanteric fracture, instead of two types.

著者

Akira Kido Shozo Yoshida Emiko Shimoda Yukako Ishida Masatoshi Hasegawa Hiroshi Kobayashi Kanya Honoki Hirosei Horikawa Yasuhito Tanaka

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.1, pp.20160009, 2016 (Released:2016-12-21)

参考文献数

15

被引用文献数

1

---

Objective: Radiotherapy is an essential component of curative or palliative therapy for patients with uterine cervical cancer. Although advances in radiotherapy have led to longer survival, survivors may consequently be at risk of pelvic insufficiency fracture (PIF). We retrospectively reviewed medical records and clinical outcomes to assess the impact of PIF on walking disability. Methods: Between January 2002 and December 2009, 145 uterine cancer patients treated with radiotherapy in our hospital were reviewed. Among these, 15 patients (10.3%) were diagnosed with PIF. The types of fractures were identified according to the AO/OTA classification system. Medical records were examined to establish the time to first diagnosis of PIF, the type of fracture, and clinical outcomes. Disability was assessed using Barthel index mobility scores. Results: The median time to PIF detection was 16 months. Of the 15 patients with PIF, 14 had type B fractures (7 cases of B2 and 7 cases of B3) and 1 had a type C fracture. Among 11 patients with pelvic pain, 6 achieved pain control but 5 patients with bilateral lesions in the posterior arch or lateral compression of the sacrum developed pain that finally resulted in walking disability and a lower performance status. Conclusions: PIF causes severe motor disturbance in patients with unstable fracture types. Routine imaging checkups were useful during the 5 years after completion of radiotherapy; in nine patients the fracture progressed for longer than 1 year. In cancer rehabilitation for PIF patients, continuous assessment is essential for predicting walking disability.