著者

Tatsu FUJIURA Hiroshi NAGASAWA Hidetaka WAKABAYASHI

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.39-46, 2020-06-20 (Released:2020-06-20)

参考文献数

26

被引用文献数

5

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Objective: To assess the effect of manual lymph drainage (MLD) on pain in Japanese patients up to 10 days after a total knee arthroplasty (TKA).Methods: This study was a randomized controlled trial performed at a University Medical Center. Patients who underwent unilateral TKA and received once daily MLD for 20 minutes prior to standard physical therapy up to 10 days after TKA were investigated. Pain at rest, knee extension muscle contraction, and maximum load were assessed using the visual analog scale (mm) before surgery, after drain removal, and after the fifth MLD. As secondary outcomes, the circumference, range of motion, muscle strength, walking speed, and walking rate were evaluated.Result: Forty-one patients aged 45-85 participated in this study, 21 of whom were assigned to the intervention (MLD group) and 20 who were not (control group). Ten days after TKA, no significant difference was evident between the MLD and control groups for resting pain [4.5 mm (1.6-10.8) vs 7.0 mm (1.8-25.5), respectively, p=0.17], pain during knee extension muscle contraction [12.3 mm (4.5-24.8) vs 20.8 mm (6.4-31.8), p=0.41], and pain at maximum load [13.0 mm (8.3-39.8) vs 16.0 mm (4.6-32.5), p=0.73]. There were no significant differences between groups in terms of secondary outcomes.Conclusion: This study shows that MLD up to 10 days after TKA does not affect pain.

著者

Masahiro IWAKURA Kazuki OKURA Mika KUBOTA Keiyu SUGAWARA Atsuyoshi KAWAGOSHI Hitomi TAKAHASHI Takanobu SHIOYA

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

pp.E10049, (Released:2020-10-12)

参考文献数

33

被引用文献数

23

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Objective: To estimate the minimal clinically important difference (MCID) of quadriceps and inspiratory muscle strength after a home-based pulmonary rehabilitation program (PRP) in chronic obstructive pulmonary disease (COPD). Method: Eighty-five COPD patients were included. Quadriceps maximal voluntary contraction (QMVC) was measured. We measured maximal inspiratory mouth pressure (PImax), the 6-minute walk distance (6MWD), the chronic respiratory questionnaire (CRQ) and the modified Medical Research Council dyspnoea score (mMRC). All measurements were conducted at baseline and at the end of the PRP. The MCID was calculated using anchor-based (using 6MWD, CRQ, and mMRC as possible anchor variables) and distribution-based (half standard deviation and 1.96 standard error of measurement) approaches. Changes in the five variables were compared in patients with and without changes in QMVC or PImax >MCID for each variable. Results: Sixty-nine COPD patients (age 75±6 years) were analysed. QMVC improved by 2.4 (95%CI 1.1-3.7) kgf, PImax by 5.8 (2.7-8.8) cmH2O, 6MWD by 21 (11-32) meters and CRQ by 3.9 (1.6-6.3) points. The MCID of QMVC and PImax was 3.3-7.5 kgf and 17.2-17.6 cmH2O, respectively. The MCID of QMVC (3.3 kgf) could differentiate individuals with significant improvement in 6MWD and PImax from those without. Conclusion: The MCID of QMVC (3.3 kgf) can identify a meaningful change in quadriceps muscle strength after a PRP. The MCID of PImax (17.2 cmH2O) should be used with careful consideration, because the value is estimated using distributionbased method.

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

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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

Tomohiro OKA Osamu WADA Tsuyoshi ASAI Hideto MARUNO Kiyonori MIZUNO

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

pp.E9996, (Released:2020-08-05)

参考文献数

31

被引用文献数

16

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Background: We investigate the association with knee flexion range of motion (ROM) during the acute phases and that at 12 months after total knee arthroplasty (TKA). We also clarified the cut-off ROM during the acute phases in predicting the goal of knee flexion ROM at 12 months. Methods: In this retrospective study, 193 patients with knee osteoarthritis (female:144 patients, age:73.2 ± 7.7 years) who underwent unilateral TKA at an orthopedic clinic were recruited. They underwent assessments of knee flexion ROM at 5 days, 1 month, and 12 months after TKA. The goal of knee flexion ROM at 12 months after TKA was set at 120°. Single and logistic-regression analyses were performed with the dependent variables including the outcome of the goal of knee flexion ROM at 12 months, and the independent variables included knee flexion ROM at 5 days and 1 month, separately. We calculated the cut-off ROM at 5 days and 1 month for predicting the goal of knee flexion ROM at 12 months with receiver operating curve analysis. Results: Knee flexion ROM at 5 days and 1 month were significantly associated with the goal of that at 12 months (p < 0.01). The cut-off ROM were 85° at 5 days and 105° at 1 month separately. Conclusions: Our results suggest the importance of early improvement in knee flexion ROM after TKA, and that at 1 month postoperatively indicates the likelihood of achievement of the goal of knee flexion ROM at 12 months after TKA.

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

Munetsugu KOTA Sae UEZONO Yusuke ISHIBASHI Sousuke KITAKAZE Hideki ARAKAWA

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

pp.E10016, (Released:2020-08-20)

参考文献数

26

被引用文献数

4

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Objective: We focused on locomotive syndrome as a low physical function factor that may prevent patients with psychiatric disease from being discharged. The purpose of this study is to clarify the factors, including locomotive syndrome, that prevent discharge from psychiatric long-term care wards. Method: We enrolled 74 patients who were admitted to psychiatric long-term care wards at three different hospitals in Japan. Nurses or medical social workers in the ward were asked whether the planned discharge destination had been decided, and patients were categorized into a decided group and an undecided group. Outcome measures were age, sex, F code in the ICD-10 Classification of Mental and Behavioral Disorders, length of stay, chlorpromazine equivalent dose of antipsychotics, locomotive syndrome test scores (25-question GLFS, two-step test, stand-up test), and Barthel Index. Results: Based on the multivariate logistic regression analysis results, the length of stay and the two-step test score significantly explained the difference between the two groups. The odds ratio of a length of stay greater than 10 years was 8.42 times that of a length of stay less than 2 years (P=0.012, 95% CI=1.59, 44.53). Regarding the twostep test, the odds ratio for obtaining stage 2 was 10.62 times that for obtaining stage 0 (P=0.013, 95% CI=1.65, 68.23). Conclusion: Those who with longer length of stays and lower two-step test scores tended not to be decided the planned discharge destination.

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

Naohito MORISHIMA Takeshi KAMIYA Yoshinori NAITO Ayako MORISAKA Tomoji ISHIKAWA Keita TACHIBANA Shingo MURAKAMI

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.59-65, 2020-06-20 (Released:2020-06-20)

参考文献数

16

被引用文献数

3

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Objective: To evaluate the effect of muscle strengthening intervention in peripheral facial palsy (PFP). Methods: A randomized controlled trial was conducted at five hospitals. Fifty-one subjects with PFP who showed a response of less than 20% on electroneurography (ENoG) were enrolled. Subjects in a muscle-strengthening-intervention group (MS Group) underwent a selective muscle contraction intervention (SMCI). Subjects in another group not receiving muscle strengthening intervention (Non-MS Group). Both groups underwent three interventions: Prohibition of maximum effort movements, Stretching of the affected facial muscles, and Mirror biofeedback therapy. The outcomes were measured by the Sunnybrook Facial Grading System (FGS) at 6 months after onset (primary endpoint) and at 12 months after onset (secondary endpoint). The subjects in the MS Group and Non-MS Group were further divided into subgroups showing ENoG responses of 10% or less and ENoG responses of over 10%, as a sub-analysis. Results: No significant differences between the MS Group and Non-MS Group at either the primary endpoint or secondary endpoint. Among the subjects in the treatment group with an ENoG response of over 10% at the primary endpoint, the FGS Composite Score and FGS Voluntary Movement score were both significantly higher in the MS Group than in Non-MS Group. Although the MS Group had a significantly lower FGS Resting Symmetry Score, there was no significant difference between the two groups in the FGS Synkinesis Score. Conclusions: SMCI improved paralysis in subjects exhibiting an ENoG response of over 10% within the 6 months from onset without any deterioration of synkinesis.

著者

Tatsu FUJIURA Hiroshi NAGASAWA Hidetaka WAKABAYASHI

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

pp.E9992, (Released:2020-03-25)

参考文献数

26

被引用文献数

5

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Objective: To assess the effect of manual lymph drainage (MLD) on pain in Japanese patients up to 10 days after a total knee arthroplasty (TKA).Methods: This study was a randomized controlled trial performed at a University Medical Center. Patients who underwent unilateral TKA and received once daily MLD for 20 minutes prior to standard physical therapy up to 10 days after TKA were investigated. Pain at rest, knee extension muscle contraction, and maximum load were assessed using the visual analog scale (mm) before surgery, after drain removal, and after the fifth MLD. As secondary outcomes, the circumference, range of motion, muscle strength, walking speed, and walking rate were evaluated.Result: Forty-one patients aged 45-85 participated in this study, 21 of whom were assigned to the intervention (MLD group) and 20 who were not (control group). Ten days after TKA, no significant difference was evident between the MLD and control groups for resting pain [4.5 mm (1.6-10.8) vs 7.0 mm (1.8-25.5), respectively, p=0.17], pain during knee extension muscle contraction [12.3 mm (4.5-24.8) vs 20.8 mm (6.4-31.8), p=0.41], and pain at maximum load [13.0 mm (8.3-39.8) vs 16.0 mm (4.6-32.5), p=0.73]. There were no significant differences between groups in terms of secondary outcomes.Conclusion: This study shows that MLD up to 10 days after TKA does not affect pain.

著者

Satoshi SHIBATA Masahiro TAKEMURA Shumpei MIYAKAWA

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

vol.21, no.2, pp.44-52, 2018-12-20 (Released:2018-12-20)

参考文献数

44

被引用文献数

14

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Background: Neurocognitive function may be a risk factor for anterior cruciate ligament (ACL) injury by changing neuromuscular control such as muscle activities. However, the effect of differences in neurocognitive function on biomechanics and neuromuscular control related to ACL injury risk is not clear. The purpose of this study was to examine the effect of differences in neurocognitive function on biomechanics and neuromuscular control during an unanticipated side-step cutting motion. Method: The subjects were 15 collegiate female athletes who were divided into two groups using the Symbol Digit Modalities Test (SDMT). The experimental task was an unanticipated side-step cutting motion from a 30 cm high box. We calculated joint angles and moments using a 3-dimensional motion analysis system from the dominant leg, and measured muscle activities using a surface electromyography. We calculated the co-contraction ratio (CCR) as relative muscle activity of the quadriceps to the hamstring. Results: As a result, subjects with a lower SDMT score had significantly increased quadriceps activity before and after ground contact and decreased CCR only after ground contact. Conclusion: In the lower SDMT score group, the quadriceps showed stronger muscle activity than the hamstring during an unanticipated side-step cutting motion. This dominant quadriceps muscle activity has been reported to increase the load on the ACL, and there was a possibility of increasing the risk of the ACL injury. Considering these factors, subjects with lower neurocognitive function could have a high risk of ACL injury due to alterations in muscle activities surrounding the knee.