著者

Yoshitaka Wada Satoshi Hirano Ayaka Kumagai Kaori Takeuchi Ryosuke Inagaki Hiroshi Hosokawa Hirofumi Maeda Seiko Shibata Yohei Otaka

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.20220052, 2022 (Released:2022-09-24)

参考文献数

13

被引用文献数

1

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Background: Coronavirus disease 2019 (COVID-19) is associated with an increased risk of thrombotic complications. Nonetheless, there is a paucity of clinical knowledge regarding rehabilitation of patients with COVID-19 after lower-limb amputation.Case: A 74-year-old woman with COVID-19 was admitted to a university hospital. During hospitalization, she underwent right transfemoral amputation due to acute limb ischemia. Three months after admission, the patient was transferred to a convalescent rehabilitation ward in the same hospital. A femoral prosthesis was prescribed 2 weeks after her transfer to the rehabilitation ward. It featured ischial-ramal containment with a soft liner and belt suspension, 668-g multiple linkage-type safety knee joint (Imasen Engineering; M0781 SwanS), and a solid-ankle cushioned-heel foot. The total rehabilitation time during the patient’s stay in the acute-care and rehabilitation wards was 65.5 h (0.99 h/day, 66 days) and 275.0 h (3.02 h/day, 91 days), respectively. In the rehabilitation ward, the patient underwent 54.4 h (19.8%) of muscle strength training, 48.1 h (17.5%) of comprehensive assessments, and 47.1 h (17.1%) of gait training. The patient was discharged home 6 months after admission, with a total Functional Independence Measure score of 120. The patient could walk slowly [44.2 s (0.23 m/s) in the 10 m-walk test] with a femoral prosthesis and a quad cane but exhibited limited endurance (75.0 m in the 6-min walk test).Discussion: Following appropriate rehabilitation, a patient was able to walk independently after lower-limb amputation despite the complication of COVID-19, although her walking ability was limited.

著者

Ryozo Tanaka Yusuke Okita Takashi Nakamura Kennosuke Kawama

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.20220053, 2022 (Released:2022-09-29)

参考文献数

26

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Objectives: The gait characteristics of people with bilateral transtibial amputation are not well understood. This study aimed to clarify changes in trunk lateral bending and the trunk flexion angle during walking in people with bilateral transtibial amputation.Methods: In this cross-sectional study, four participants with bilateral transtibial amputation who could walk without assistance (BTTA group) and ten able-bodied participants (control group) were recruited. The range of motion of trunk lateral bending, the trunk flexion angle, and other gait parameters during comfortable-speed and maximum-speed walking were measured using a three-dimensional motion analysis system and force plates. These parameters were compared between the amputees and the controls.Results: During maximum-speed walking, the BTTA group walked slower with a smaller trunk flexion angle (median, 1.75° vs. 4.79°, P=0.036) and greater double leg support time (0.18 vs. 0.12, P=0.008) when compared with the control group. The other parameters during maximum-speed walking were not significantly different between the two groups. During comfortable-speed walking, none of the parameters were significantly different between the two groups.Conclusions: Compensatory trunk flexion angle decreases markedly during maximum-speed walking in people with bilateral transtibial amputation. People with bilateral transtibial amputation may be changing the trunk flexion angle to walk faster. When evaluating gait compensation for people with bilateral transtibial amputation, trunk flexion angle may be an important index and maximum-speed walking is needed to detect the change in trunk flexion angle.

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

Ena Sato Takehiko Yamaji Takahisa Sato Kosuke Saida Hideomi Watanabe

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.20220055, 2022 (Released:2022-10-21)

参考文献数

26

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Objectives: The WISH-type S-form hip brace (WISH brace) has significantly improved hip function and functional mobility in patients with hip osteoarthritis (OA). However, most patients later undergo surgery. The main purpose of this study was to evaluate how long the orthosis can be effectively used by patients with hip OA, and to reveal the associated prognostic factors.Methods: This prospective study examined the survival curve of the equipment by using surgery as an endpoint and investigated how the duration of use affects patients. Harris Hip Score, muscle strength, and the Timed Up and Go test (TUG) were evaluated as prognostic factors.Results: By drawing the survival curves of 26 patients, approximately one third were expected to be still using the brace after 7 years. A rapid decrease in use was observed at around 1 year. A significant difference between patients with and without bracing at 1 year was found for the TUG result with the unaffected leg inside (ULI) at the start of bracing. A cut-off value of 9.5 s for the TUG with ULI significantly differentiated patients with and without bracing at 1 year, suggesting a possible predictor of brace survivorship in the early phase.Conclusions: The TUG with ULI with a cut-off value of 9.5 s, or at most 10 s, may be a possible predictor of persistence of brace use in the early phase.

著者

Naoki Sasa Shuji Matsumoto Go Kamata Takashi Hoei Yoichiro Aoyagi

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.20220059, 2022 (Released:2022-11-18)

参考文献数

31

被引用文献数

1

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Objectives: To provide a safe and appropriate out-of-bed program for stroke patients, screening for stroke-related functional impairments and disabilities should be performed in advance. However, few tools are available for clinical assessment of out-of-bed mobility while patients are still on bed. We sought to establish the validity and reliability of a newly developed Functional Bridge Test (FBT) for hemiplegic patients with acute stroke.Methods: This repeated-measures, observational study was conducted at a stroke care unit at an acute hospital. We assessed the validity of the FBT score, intra-rater and inter-rater reliabilities of the FBT, and concurrent validity of the FBT in stroke patients with hemiplegia. In addition to the original qualitative assessment, the FBT was also assessed quantitatively to evaluate the validity of the FBT score. Outcome measures included stroke severity, lower limb muscle strength, and basic mobility.Results: We enrolled 32 patients with acute stroke. The newly developed FBT score had high validity. Intra-rater and inter-rater reliabilities (weighted kappa coefficient, 95% confidence interval) showed almost perfect agreement (0.95, 0.88–1.00; 0.98, 0.94–1.00, respectively). The FBT score was significantly associated with stroke severity, physical function, and basic mobility.Conclusions: The FBT has sufficient validity and reliability for acute stroke patients with hemiplegia. The advantages of the FBT in a clinical setting are based on its ability to be quickly administered on a bed without the need for specialized equipment. The FBT may help in screening functional impairment and disability in hemiplegic patients with acute stroke before they resume out-of-bed activities.

著者

Yoshiaki Tsuboi Akira Ito Takanobu Otsuka Hideki Murakami Masato Sawada Kazunobu Sawamoto

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.20220061, 2022 (Released:2022-12-01)

参考文献数

31

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Objectives: Neonatal brain injury during gait development disrupts neural circuits and causes permanent gait dysfunction. Rehabilitation as an intervention to improve impaired gait function has been used in adults as a treatment for stroke and spinal cord injury. However, although neonates have greater neuroplasticity and regenerative capacity than adults, normal gait development and the effects of habilitation on gait function following neonatal brain injury are largely unknown.Methods: In this study, we generated cryogenic injury in mice at postnatal day 2 and subsequently performed habilitative training to promote autonomous limb movement for 4 weeks. We also quantitatively analyzed the gait acquisition process in developing mice using the Catwalk XT system.Results: Using quantitative gait analyses, we showed that during normal gait development in mice, stance phase function matures later than swing phase function. We also demonstrated that habilitation in which active limb movements were enhanced by suspending mice with a rubber band with no floor grounding promotes motor learning, including gait function, in mice with impaired acquisition of gait function resulting from neonatal brain injury.Conclusions: Our findings provide a basis for research on gait development in mice and suggest new habilitation strategies for patients with impaired gait development caused by perinatal brain diseases such as hypoxic–ischemic encephalopathy and periventricular leukomalacia.

著者

Ippei Kitade Akihiro Kawabata Yoshimasa Yonemura Ai Takahashi

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.20220062, 2022 (Released:2022-12-11)

参考文献数

20

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Background: Auto-mobilization (AM) is a treatment method that patients can use by themselves for pain relief. We report the case of a patient diagnosed with cervical disk herniation (CDH), with frequent recurrences of upper limb numbness and neck pain. The patient experienced a favorable outcome after cervical spine AM, as evidenced by the immediate and long-term relief of his symptoms as well as changes observed through imaging.Case: A 33-year-old-man diagnosed with CDH presented with frequent recurrences of upper limb numbness and neck pain. Radiographic and T2-weighted magnetic resonance imaging scans revealed cervical spine kyphosis and a left paracentral to intraforaminal lesion with disk herniation of protrusion type at C4–5. He was started on AM to elicit physiological lordosis of the cervical spine. This treatment was painless and did not cause withdrawal on discontinuation. AM improved the mobility of his cervical lower facet joints, reduced dysesthesia, and eliminated pain. Improvement in neck pain and cervical kyphosis and reduction of disk herniation were observed 2 years after initiating the intervention.Discussion: Appropriate physical therapy evaluation and cervical AM for this patient resulted in symptomatic relief and indirect disk herniation regression. By adding imaging findings to clinical findings, the effect of AM could be visualized, and the reliability of the therapeutic effect was further enhanced.

著者

Hiroshi Takasaki Kazuki Kikkawa Hiroki Chiba Yusuke Handa Albert Sesé-abad Juan Carlos Fernández-domínguez

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.6, pp.20210034, 2021 (Released:2021-08-27)

参考文献数

19

被引用文献数

5

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Objectives: The Health Sciences Evidence-Based Practice (HS-EBP) questionnaire was recently developed for measuring five constructs of evidence-based clinical practice among Spanish health professionals by applying content and construct validity investigation. The current study aims to undertake a cross-cultural adaptation of the HS-EBP into Japanese and to investigate the internal consistency and test–retest reliability of the Japanese HS-EBP among undergraduate students of nursing and physical and occupational therapies.Methods: Cross-cultural adaptation was undertaken by following Beaton’s five-step process. Subsequently, the Japanese HS-EBP test–retest reliability was assessed with a 2-week interval. Participants were recruited from among third and fourth grade undergraduate students of nursing and physical and occupational therapies with clinical training experience.Results: Pilot testing included 30 participants (11 nursing students, 11 physical therapy students, 8 occupational therapy students). Consequently, we developed the Japanese HS-EBP to be understandable for undergraduate students of nursing and physical and occupational therapies. Data from 52 participants who completed test–retest reliability questionnaires demonstrated adequate test–retest reliability in the total scores of Domains 1, 3, 4, and 5 [intraclass correlation coefficients were (ICC)=0.74, 0.70, 0.75, and 0.74, respectively]; the exception was Domain 2, which had an ICC of 0.66. Internal consistency (Cronbach’s α) was adequate for Domains 1–5, for which α was 0.87, 0.94, 0.86, 0.93, and 0.95, respectively.Conclusions: This study developed the Japanese version of HS-EBP and provided preliminary evidence of adequate internal consistency and test–retest reliability in most domains for undergraduate students of nursing and physical and occupational therapies.

著者

Tomoko Sakai Chisato Hoshino Atsushi Okawa Kenji Wakabayashi Hidenobu Shigemitsu

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.20200016, 2020 (Released:2020-07-29)

参考文献数

26

被引用文献数

2

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Objective: The aim of this study was to investigate the effect and risk management of early mobilization in the intensive care unit (ICU) with multidisciplinary collaboration and daily goal planning.Methods: Rehabilitation of ICU patients in our hospital between April 1, 2019, and September 30, 2019, was investigated retrospectively. The following factors were evaluated: age and sex of the subjects; diseases; the total number of early mobilization therapy sessions done at a lowered goal level; the clinical course of the step-down sessions; reasons for lowering goal levels that corresponded to the cancellation criteria from the officially issued guidelines of the Japanese Association of Rehabilitation Medicine, the expert consensus on ICU, or other reasons for step down; and the rate of planned goals that were achieved.Results: Of the 1908 overall rehabilitation sessions carried out during the period of investigation, 9.6% had the planned level lowered; changes in vital signs accounted for 54.6% of the reasons for lowering the level. Of the step-down sessions, 92.3% corresponded with the cancellation criteria of rehabilitation. Early mobilization in the ICU in accordance with daily goal planning via collaboration within the multidisciplinary team during rounds was accomplished in 90.4% of sessions. No serious mobilization-related adverse events were noted during the study period.Conclusion: Early mobilization should be performed with daily goal planning by a multidisciplinary team during rounds and should be governed by the cancellation criteria of rehabilitation.

著者

Hiroki Fujita Atsushi Teramoto Hiroyori Fusagawa Toshihiko Yamashita and Paulo Selber

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.20230029, 2023 (Released:2023-09-20)

参考文献数

16

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Background: There are numerous etiologies relating to physeal arrest. The clinical manifestations of physeal arrest may include limb length discrepancy (LLD) and bone malalignment, especially in younger children with more growth ahead of them.Case: We performed three-dimensional gait analysis (3DGA) four times over a 13-year period in a boy aged from 9 to 22 years who was suffering from LLD and genu valgum. At the final follow-up, the patient’s LLD and coronal malalignment had been ameliorated on radiographic findings after multiple corrective surgeries, including the use of external fixation. In 3DGA, the patient’s Gait Profile Score (GPS) at age 12.5 years was poorest at 12.4°, improving to 8.4° at age 22.3, a change of 2.5 times the minimal clinically important difference. Assessment of kinetics showed a mean knee coronal moment during the stance phase of 0.17 (varus) and 0.20 (valgus) Nm/kg at the ages of 18.6 and 22.3 years, respectively. Importantly, this revealed significant improvement from the perspective of knee coronal moment (P <0.001).Discussion: This is the first report of long-term follow-up 3DGA using GPS in a patient undergoing multiple corrective surgeries for LLD and genu valgum. Although both LLD and genu valgum improved, gait function did not normalize. This shows that focusing on radiographic findings alone may not lead to improved patient outcomes and indicates the value of gait function assessment.

著者

Toru Yasuda Sirinda Jaotawipart Hironobu Kuruma

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.20230022, 2023 (Released:2023-07-22)

参考文献数

33

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Objectives: This study used magnetic resonance imaging (MRI) to investigate the effects of thoracic spine self-mobilization on patients with low back pain (LBP) and lumbar hypermobility.Methods: Twenty-four patients (15 men, 9 women) with LBP were randomly allocated to a thoracic spine self-mobilization group or sham group. The thoracic spine self-mobilization group performed thoracic spine active flexion and extension activities using two tennis balls fixed with athletic tape. Outcome measures were collected pre-intervention and after 4 weeks and included the Visual Analog Scale (VAS) for pain, the Oswestry Disability Index, lumbar rotation angle measured using MRI taken in the lateral position with 45° of trunk rotation, thoracolumbar rotation range of motion (ROM) in the sitting position, and stiffness of the erector spinae muscles. The effects of the intervention were analyzed using two-way repeated-measures analysis of variance (ANOVA), followed by multiple comparisons. The significance level was set at 5%.Results: The results of the two-way repeated measures ANOVA indicated that the main effect of the group was significant (P<0.05) for VAS, the sum of the lumbar rotation angle, and the thoracolumbar rotation ROM. A significant group-by-time interaction was found for the sum of lumbar rotation angles. The results of the multiple comparison tests for VAS, sum of the lumbar rotation angle from L1 to S1, and thoracolumbar rotation ROM were significantly different after 4 weeks.Conclusions: This study revealed a decrease in lumbar segmentation after thoracic spine mobilization. Thoracic spine mobilization may be effective in patients with LBP and hypermobility.

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

Issei Miyagi Mizuho Ohta Makoto Tamari

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.20230013, 2023 (Released:2023-04-21)

参考文献数

29

被引用文献数

2

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Objectives : It is unclear whether the increased center of mass lateral shift during gait induced by leg length difference induces lateral instability. The purpose of this study was to investigate the effect of leg length discrepancy (LLD) on dynamic gait stability and the compensatory kinematic and dynamic strategies for this effect by using the extrapolated center of mass and margin of stability.Methods : Nineteen healthy male participants walked without insoles (no LLD condition; 0 cm) and with added insoles (LLD condition; 3 cm). Kinematic and kinetic data were analyzed using a three-dimensional motion analyzer and force plates; the values were compared between the two conditions. Correlation analysis was performed on the parameters and the margin of stability and significant changes were identified.Results: Compared with the no-LLD condition, in the LLD condition, lateral stability was maintained on both the short leg side and the long leg side. Nonetheless, changes in joint angles and muscle activity on the frontal plane were observed on the short leg side, although the correlations were not significant. On the long leg side, a moderate negative correlation was found between the lateral flexion angle of the trunk and the margin of stability (r=–0.56, P=0.011).Conclusions: The short leg side may compensate for lateral stability by complex changes in joint angles and muscle activity, and the long leg side may compensate for lateral stability by actively adjusting the trunk lateral flexion angle.

著者

Mami Hirasaki Daisuke Takagi Yoshiko Umeda Motoki Moriwaki Norimasa Katagiri Akiko Nomoto Tomohisa Ohno 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.8, pp.20230006, 2023 (Released:2023-03-01)

参考文献数

20

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Background: Palatal augmentation prosthesis (PAP) and palatal lift prosthesis (PLP) have been used to improve dysphagia and dysarthria. However, to date, there are few reports on their combined use. We report a quantitative evaluation of the effectiveness of a flexible-palatal lift/augmentation combination prosthesis (fPL/ACP) based on videofluoroscopic swallowing study (VFSS) and speech intelligibility testing.Case: An 83-year-old woman was admitted to our hospital with a hip fracture. She developed aspiration pneumonia at 1 month after partial hip replacement. Oral motor function tests revealed a motor deficit of the tongue and soft palate. VFSS showed delayed oral transit, nasopharyngeal reflux, and excessive pharyngeal residue. The cause of her dysphagia was assumed to be pre-existing diffuse large B-cell lymphoma and sarcopenia. To improve the dysphagia, an fPL/ACP was fabricated and applied. It improved the patient’s oral and pharyngeal swallowing and speech intelligibility. In addition to prosthetic treatment, rehabilitation and nutritional support allowed her to be discharged.Discussion: The effects of fPL/ACP in the present case were similar to those of flexible-PLP and PAP. f-PLP assists in elevation of the soft palate and improved the nasopharyngeal reflux and hypernasal speech. PAP promotes tongue movement and results in improved oral transit and speech intelligibility. Therefore, fPL/ACP may be effective in patients with motor deficits in both the tongue and soft palate. To maximize the effect of the intraoral prosthesis, a transdisciplinary approach with concurrent swallowing rehabilitation, nutritional support, and physical and occupational therapy is necessary.

著者

Tomohiro Oba Hiroaki Iwase Yoshitake Oshima Junya Miyazaki Kojiro Ishii

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.2, pp.20170016, 2017 (Released:2017-12-27)

参考文献数

26

被引用文献数

1 1

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Objective: This study investigated the optimum conditions for obtaining valid step-count measurements for patients with abnormal gait. Methods: Subjects comprised 61 hospitalized patients with abnormal gait. Four different devices were tested: Active Style Pro (AS), Walking Style (WS), Lifecorder PLUS, and Steps. The same device type was attached to the waist on both the affected and the unaffected side. Patients then walked 25 m at a comfortable speed. This test was repeated four times, once for each device. The measurement error (ME) and walking parameters (gait velocity, step length, and cadence) were calculated from the test data. ME scores smaller than 3% and 10% were classified as valid: scores above these standards were classified as invalid. Walking parameter values that identified the invalid group with a specificity of 0.95 were set as the cut-off velocity (COV), the cut-off step length (COS), and the cut-off cadence. Sensitivity values >0.40 and positive predictive values >80% were then set as necessary conditions. Results: COV values were 0.90 m/s (AS on the unaffected side at 3% ME and AS on the affected side or the unaffected side at 10% ME), 0.92 m/s (WS on the unaffected side at 10% ME), and 0.98 m/s (WS on the affected side at 3% ME). COS values were 0.50 m (AS on the affected side at 10% ME) and 0.52 m (AS on the unaffected side at 3% ME). Conclusion: The most accurate measurements were obtained using AS attached to the unaffected side with a gait velocity of >0.90 m/s.

著者

Takahisa Ogawa Hiroto Hayashi Toshiki Kishimoto Shota Mashimo Yasuaki Kusumoto Keisuke Nakamura Takuya Aoki Janelle Moross Morten Tange Kristensen Hideaki Ishibashi

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.20200030, 2020 (Released:2020-12-02)

参考文献数

36

被引用文献数

1 2

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Objectives: The aim of this study was to translate the Cumulated Ambulation Score (CAS) from English into Japanese in cooperation with different types of healthcare providers and to investigate its inter-rater reliability and internal consistency.Methods: Two physical therapists at each of three general hospitals in Japan measured the mobility of 50 consecutive post-operative hip fracture patients on two occasions between 2 and 6 days after surgery using the Japanese version of the CAS (CAS-JP). We analyzed the inter-rater reliability and agreement using both the linear weighted kappa and the interclass correlation coefficient; we also analyzed the internal consistency using Cronbach’s alpha coefficient.Results: The mean age of patients was 81 (SD: 11.6) years and 82% were women. Approximately half of the patients had severe cognitive impairment. Kappa was ≥ 0.93 for the three mobility activities and for the total CAS-JP score, the percentage agreement was ≥ 0.98, the ICC was ≥ 0.95, and Cronbach’s alpha coefficient was 0.85.Conclusions: We found that the CAS-JP possessed good inter-rater reliability, agreement, and internal consistency. The CAS-JP is a reliable and easy-to-use evaluation tool suitable for daily clinical practice across different healthcare providers to monitor mobility in older hip fracture patients in Japan. We suggest that CAS-JP be evaluated in future studies for use in younger patients and in other patient groups with mobility problems.

著者

Ceri Houldsworth Krishnan Padmakumari Sivaraman Nair Ram Pankajam Hariharan

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.20230001, 2023 (Released:2023-01-14)

参考文献数

23

被引用文献数

1

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Objectives: The aim of this study was to assess the cognitive abilities of people with spinal cord injury (SCI) using the Edinburgh Cognitive and Behavior Amyotrophic Lateral Sclerosis Screen (ECAS), a tool designed for testing cognition in individuals with limited hand motor function. The impact of cognitive dysfunction on quality of life was also assessed.Methods: Forty-one patients with SCI were assessed using ECAS, the brief version of the World Health Organisation Quality of Life questionnaire (WHOQOL-BREF), and the Spinal Cord Independence Measure.Results: Overall, 28 of the 41 participants scored below the cut-off threshold for normal population in ECAS. The domains affected were language, 63%; memory, 51%; executive function, 44%; verbal fluency, 44%; and visuospatial skills, 24%. On multiple regression analysis, the ECAS total score moderately strongly explained the variance in the WHOQOL-BREF psychological (β = 0.428, t = 2.958, P = 0.005) and environmental (β = 0.411, t = 2.819, P = 0.008) domains. ECAS memory scores independently influenced WHOQOL-BREF physical (β = 0.398, t = 2.67, P = 0.011) and environmental (β = 0.37, t = 2.697, P = 0.010) domains. WHOQOL-BREF psychological scores were significantly influenced by ECAS executive scores (β = 0.415, t = 2.85, P = 0.007), whereas the social domain was not significantly influenced by ECAS scores.Conclusions: It was feasible to use ECAS in individuals with SCI. Cognitive ability influenced the quality of life of people with SCI.

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

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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

Shinichi Watanabe Keibun Liu Yasunari Morita Takahiro Kanaya Yuji Naito Shuichi Suzuki Yoshinori Hasegawa

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.20220013, 2022 (Released:2022-03-23)

参考文献数

48

被引用文献数

6

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Objectives: This study investigated the effect of early mobilization [EM; physical rehabilitation with the intensity needed to sit on the edge of the bed started within 5 days of intensive care unit (ICU) admission] in relation to improvements in gait independence and other clinical outcomes.Methods: This retrospective single-center study evaluated patients aged at least 18 years who stayed in the ICU for at least 48 h and were categorized into EM and late mobilization (LM; physical rehabilitation started more than 5 days after ICU admission) groups. Outcomes were compared after adjusting for 20 background factors by propensity score matching and inverse probability of treatment weighting. The primary outcome was independent gait at discharge. The secondary outcomes were medical costs, 90-day survival, and durations of ICU and hospital stays.Results: Of 177 patients, 85 and 92 were enrolled in the EM and LM groups, respectively. Propensity score matching created 37 patient pairs. There was no significant difference in the 90-day survival rate (P=0.308) or medical costs (P=0.054), whereas independent gait at discharge (P=0.025) and duration of hospital stay (P=0.013) differed significantly. Multivariate logistic regression analysis showed that EM was independently associated with independent gait at discharge (P=0.011) and duration of hospital stay (P=0.010) but was not associated with 90-day survival (odds ratio: 2.64, 95% confidence interval: 0.67–13.12, P=0.169).Conclusions: Early mobilization in the ICU did not affect 90-day survival and did not lower medical costs but was associated with independent gait at discharge and shorter hospital stays.

著者

Noritaka Hamano Hitoshi Shitara Tsuyoshi Tajika Tsuyoshi Ichinose Tsuyoshi Sasaki Takuro Kuboi Daisuke Shimoyama Masataka Kamiyama Ryosuke Miyamoto Fumitaka Endo Kurumi Nakase Tsutomu Kobayashi Atsushi Yamamoto Kenji Takagishi Hirotaka Chikuda

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.6, pp.20210015, 2021 (Released:2021-03-10)

参考文献数

32

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Objectives: We aimed to examine the relationship between the hip range of motion (ROM) and ankle ROM and throwing-related shoulder and elbow injuries in elementary school baseball pitchers.Methods: This retrospective comparative study (Level of evidence: Level III) included 195 baseball pitchers (mean age 10.8±1.0 years, range 8–12 years). All pitchers underwent physical function measurements, including height, weight, shoulder strength, and hip and ankle ROM. Shoulder and elbow injury was defined as shoulder and elbow pain that the pitchers had been aware of in the past or at the time of medical checkups. The results for the injured and non-injured groups were then compared.Results: The shoulder ROM and strength in the injured and non-injured groups did not differ to a statistically significant extent. The hip external rotation on the dominant side (injured vs. non-injured: 48.9±11.1° vs. 53.3±9.7°, P<0.01), the hip internal rotation on the non-dominant side (injured vs. non-injured: 36.6±12.0° vs. 40.9±11.0°, P=0.01), and ankle plantar flexion on the non-dominant side (injured vs. non-injured: 52.0±6.8° vs. 54.3±6.7°, P=0.02) were significantly smaller in the injured group than in the non-injured group.Conclusions: The hip external rotation ROM on the dominant side and the hip internal rotation and ankle plantar flexion on the non-dominant side were significantly lower in the injured group than in the non-injured group. These results may suggest measures to reduce the incidence of elbow and shoulder injuries in elementary school baseball pitchers.