著者

Tomohiro OKA Osamu WADA Shingo NITTA 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

vol.23, no.1, pp.66-71, 2020-06-20 (Released:2020-06-20)

参考文献数

20

被引用文献数

5

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Objective: Deep vein thrombosis (DVT) is a severe complication after total knee arthroplasty (TKA). Performing self-calf massage may decrease the incidence of DVT. The purpose of this study was to investigate whether self-calf massage is effective for preventing DVT after TKA. Method: In all, 165 patients participated in the present study. Patients were randomized to one of two groups: the self-calf massage group or the control group. In the control group, patients started regular physical therapy. In the self-calf massage group, in addition to regular physical therapy, patients were instructed to massage their calf muscles 30 times from the distal to proximal side. This procedure was repeated three times and was completed in 2 mins during the 2 days following TKA. All patients were evaluated for DVT on postoperative day 3 using lower limb vein ultrasonography. Results: The incidence of DVT was significantly lower in the self-calf massage group than in the control group. Self-calf massage was associated with a lower incidence of DVT, whereas age and female sex were risk factors for DVT. Conclusion: This study showed that the self-calf massage may be beneficial for the prevention of DVT after TKA.

著者

Tetsuya TAKAHASHI Michitaka KATO Kengo OBATA Ryo KOZU Toru FUJIMOTO Koji YAMASHITA Morihide ANDO Yusuke KAWAI Noriaki KOJIMA Hiroshi KOMATSU Kensuke NAKAMURA Yuhei YAMASHITA Shane PATMAN Akemi UTSUNOMIYA Osamu NISHIDA

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

pp.E10060, (Released:2020-11-25)

参考文献数

22

被引用文献数

7

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Objective: Early mobilization and rehabilitation has become common and expectations for physical therapists working in intensive care units have increased in Japan. The objective of this study was to establish consensus-based minimum clinical practice standards for physical therapists working in intensive care units in Japan. It also aimed to make an international comparison of minimum clinical practice standards in this area. Methods: In total, 54 experienced physical therapists gave informed consent and participated in this study. A modified Delphi method with questionnaires was used over three rounds. Participants rated 272 items as "essential/unknown/non-essential". Consensus was considered to be reached on items that over 70% of physical therapists rated as "essential" to clinical practice in the intensive care unit. Results: Of the 272 items in the first round, 188 were deemed essential. In round 2, 11 of the 62 items that failed to reach consensus in round 1 were additionally deemed essential. No item was added to the "essential" consensus in round 3. In total, 199 items were therefore deemed essential as a minimum standard of clinical practice. Participants agreed that 42 items were not essential and failed to reach agreement on 31 others. Identified 199 items were different from those in the UK and Australia due to national laws, cultural and historical backgrounds. Conclusions: This is the first study to develop a consensus-based minimum clinical practice standard for physical therapists working in intensive care units in Japan.

著者

Hiroki KUBO Tsuyoshi ASAI Yoshihiro FUKUMOTO Kensuke OSHIMA Shota KOYAMA Hiroki MONJO Hirotsugu TAJITSU Tomohiro OKA

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

pp.E10007, (Released:2020-02-25)

参考文献数

31

被引用文献数

3

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Objective: To compare the association of cough peak flow (CPF) with aging in community-dwelling older adults and to investigate the relationship between physical fitness and CPF in these individuals. Method: Two hundred twenty two community-dwelling older adults were enrolled. CPF was assessed as a cough function parameter. Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1.0) were assessed as respiratory function. Maximal expiratory pressure (MEP) and inspiratory pressure (MIP) were assessed as respiratory muscle strength. The 3-minute walk test (3MWT) performance was assessed as a physical fitness. Participants were divided into the following age groups: 60-64, 65-69, 70-74, 75-79 and 80-89 years. One way analysis of variance were computed for comparison between age group, sex and CPF. Multivariate regression analyses were used to investigate the association of CPF with 3MWT. Results: The value of CPF significantly decreased in the 75-79 and 80-89 years group than 60-64 years group in men and in the 80-89 years group than 65-69 years group in women. The value of CPF were 545.5, 497.2, 403.3, 354.8 and 325.4 L/min in the 60-64, 65-69, 70-74, 75-79 and 80-89-year group in men and 263.4, 278.8, 264.5, 214.0, and 193.6 L/min in the corresponding age groups in women, respectively. 3MWT (p = 0.041) was significantly associated with CPF. Conclusions: Cough function tends to decrease with aging in community-dwelling elderly. Physical fitness is associated with cough function.

著者

Ferran CUENCA-MARTÍNEZ Sara CORTÉS-AMADOR Gemma Victoria ESPÍ-LÓPEZ

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

vol.21, no.1, pp.16-22, 2018-06-20 (Released:2018-06-20)

参考文献数

42

被引用文献数

22 24

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Introduction: Chronic low back pain is a pathological process that compromises the functionality and quality of life worldwide. The objective of the study was to evaluate the effectiveness of classical physiotherapy in the management of non-specific chronic low back pain. Methods: A literature search in English electronic databases was performed from November to December of 2015. Only those studies addressing chronic non-specific low back pain by manual therapy and different types of exercises methods were included, and those, which combined acute or subacute pain with systematic reviews and clinical practice guidelines, were excluded. Studies involving cognitive-behavioral approaches were also excluded. Results: 487 studies were identified, 16 were analyzed and 10 were excluded. Of the 6 studies reviewed, 5 of them achieved a moderate quality and 1 of them was of a low quality. Back School exercises and McKenzie's method were all ineffective. Osteopathic spinal manipulation proved effective when performed on the lower back and the thoracic area but only immediately after it was received, and not in the medium or long term. Massages proved effective in the short term too, as well as the global postural reeducation although ultimately this study can be considered of a low methodological quality. Conclusions: Based on the data obtained, classical physiotherapy proposals show ineffectiveness in the treatment of chronic non-specific low back pain. More multidimensional studies are needed in order to achieve a better treatment of this condition, including the biopsychosocial paradigm.

著者

Yuki NONAKA Takayuki OIKE Shinichiro TANAKA Kazuyuki TABIRA

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

vol.26, no.1, pp.17-23, 2023-04-20 (Released:2023-04-20)

参考文献数

38

被引用文献数

1

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Objective: We aimed to examine the relationship between physical performance and readmission among older patients with heart failure (HF) over the past year. Methods: This retrospective cohort study included 325 patients with HF who were aged ≥65 years and were hospitalized for acute exacerbation between November 2017 and December 2021. We investigated age, sex, body mass index, length of hospital stay, initiation of rehabilitation, New York Heart Association (NYHA) class, Charlson comorbidity index (CCI) score, medications, cardiac/renal function, nutrition, maximal quadriceps isometric strength, grip strength, and Short Physical Performance Battery (SPPB) score. Data were analyzed using the χ2 test, Mann–Whitney U test, and logistic regression analysis. Results: Altogether, 108 patients met the inclusion criteria and were divided into the non-readmission (n = 76) and readmission (n = 32) groups. The readmission group exhibited longer hospital stay, more severe NYHA class, higher CCI score, higher brain natriuretic peptide (BNP) levels, lower muscle strength, and lower SPPB score compared to the non-readmission group. In the logistic regression model, BNP level and SPPB score were independent factors associated with readmission. Conclusion: BNP level and SPPB score were associated with readmission in patients with HF within the past year.

著者

Shinichiro MORISHITA Katsuyoshi SUZUKI Taro OKAYAMA Junichiro INOUE Takashi TANAKA Jiro NAKANO Takuya FUKUSHIMA

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

pp.R0023, (Released:2023-03-22)

参考文献数

54

被引用文献数

1

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In recent years, the number of cancer survivors has been increasing each year due to advances in the early diagnosis and treatment of cancer. Cancer survivors present a variety of physical and psychological complications due to cancer and its treatment. Physical exercise is an effective nonpharmacological treatment for complications in cancer survivors. Furthermore, recent evidence has shown that physical exercise improves the prognosis of cancer survivors. The benefits of physical exercise have been widely reported, and guidelines for physical exercise for cancer survivors have been published. These guidelines recommend that cancer survivors engage in moderate- or vigorous-intensity aerobic exercises and/or resistance training. However, many cancer survivors have a poor commitment to physical exercise. In the future, it is necessary to promote physical exercise among cancer survivors through outpatient rehabilitation and community support.

著者

Yuki NONAKA Takayuki OIKE Shinichiro TANAKA Kazuyuki TABIRA

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

pp.E10187, (Released:2022-12-28)

参考文献数

38

被引用文献数

1

---

Objective: We aimed to examine the relationship between physical performance and readmission among older patients with heart failure (HF) over the past year. Methods: This retrospective cohort study included 325 patients with HF who were aged ≥65 years and were hospitalized for acute exacerbation between November 2017 and December 2021. We investigated age, sex, body mass index, length of hospital stay, initiation of rehabilitation, New York Heart Association (NYHA) class, Charlson comorbidity index (CCI) score, medications, cardiac/renal function, nutrition, maximal quadriceps isometric strength, grip strength, and Short Physical Performance Battery (SPPB) score. Data were analyzed using the χ2 test, Mann–Whitney U test, and logistic regression analysis. Results: Altogether, 108 patients met the inclusion criteria and were divided into the non-readmission (n = 76) and readmission (n = 32) groups. The readmission group exhibited longer hospital stay, more severe NYHA class, higher CCI score, higher brain natriuretic peptide (BNP) levels, lower muscle strength, and lower SPPB score compared to the non-readmission group. In the logistic regression model, BNP level and SPPB score were independent factors associated with readmission. Conclusion: BNP level and SPPB score were associated with readmission in patients with HF within the past year.

著者

Kazufumi KITAGAKI Rei ONO Harumi KONISHI Michio NAKANISHI Hiroyuki MIURA Tatsuo AOKI Teruo NOGUCHI

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

pp.E10199, (Released:2022-09-14)

参考文献数

22

被引用文献数

1

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Objective: This study aimed to investigate whether longitudinal changes in exercise capacity in patients with acute myocardial infarction (AMI) differ by sex and clarified what contributed to these differences. Methods: We retrospectively examined the differences in each variable between men and women in 156 patients with AMI (mean age: 65 ± 12 years; 82.0% male) who participated in a 3-month cardiac rehabilitation (CR) program and could be followed-up for exercise capacity 12-months after AMI onset. Sex-related differences in the change in peak oxygen uptake (peak VO2) at baseline, 3-months, and 12-months after AMI were analyzed. Results: Male patients with AMI were younger and had higher body mass index and employment rate than women. The attendance of the CR program was higher in women (men vs. women; 10 [3–15] vs. 14 [11–24] sessions, p = 0.0002). Women showed a significant lower %change in peak VO2 after 12 months (men vs. women; 7.8% [–0.49% to 14.6%] vs. 1.3% [–5.7% to 7.5%], p = 0.013). In multiple linear regression analysis, age (β = –0.76, 95% confidence interval [CI] = –1.0 to –0.50, p <0.0001) and female sex (β = –6.3, 95% CI = –9.1 to –3.5, p <0.0001) were negative independent predictors of change in peak VO2 over 12 months, while CR attendance (β = 0.21, 95% CI = 0.0032–0.42, p = 0.047) and recommended exercise habit after the CR program (β = 2.1, 95% CI = 0.095–4.1, p = 0.040) were positive independent predictors of change in peak VO2 over 12 months. Conclusion: In female patients, exercise capacity improved during the CR program but decreased to AMI onset levels after 12 months.

著者

Miki SAKAMOTO

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

vol.24, no.1, pp.1-8, 2021-04-20 (Released:2021-04-20)

参考文献数

66

被引用文献数

5

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Skeletal muscle injury is caused by a variety of events, such as muscle laceration, contusions, or strain. Muscle fibers respond to minor damage with immediate repair mechanisms that reseal the cell membrane. On the other hand, repair of irreversibly damaged fibers is achieved by activation of muscle precursor cells. Muscle repair is not always perfect, especially after severe damage, and can lead to excessive fibroblast proliferation that results in the formation of scar tissue within muscle fibers. Remaining scar tissue can impair joint movement, reduce muscular strength, and inhibit exercise ability; therefore, to restore muscle function, minimizing the extent of injury and promoting muscle regeneration are necessary. Various physical agents, such as cold, thermal, electrical stimulation, and low-intensity pulsed ultrasound therapy, have been reported as treatments for muscle healing. Although approaches based on the muscle regeneration process have been under development, the most efficacious physiological treatment for muscle injury remains unclear. In this review, the influence of these physical agents on muscle injury is described with a focus on research using animal models.

著者

Kenichi SUGAWARA

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

pp.R0010, (Released:2020-12-04)

参考文献数

57

被引用文献数

2

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For central nervous system disorders' rehabilitation, it is important to accurately understand motor control and implement an appropriate motor learning process to induce neuroplastic changes. The neurophysiological studies have revealed that neural control mechanisms are crucial during both the onset of muscular activities and muscle release after contraction. When performing various movements during daily activities, muscle relaxation control enables precise force output and timing control. Moreover, surround inhibition is a functional mechanism in the motor system. Surround inhibition of the motor system may be involved in the selective execution of desired movements. This review demonstrates cortical excitability resulting from motor learning, movement control mechanisms including muscle relaxation and the suppression of nontarget muscle groups, and the voluntary drive's importance that is required for movement.

著者

Kazuya HIRAYAMA Eiki TSUSHIMA Hiroki ARIHARA Yoichi OMI

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.9-16, 2019-06-20 (Released:2019-06-20)

参考文献数

34

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Objective: To develop a clinical prediction rule (CPR) that predicts treatment responses to mechanical lumbar traction (MLT) among patients with lumbar disc herniation (LDH). Method: This study was an uncontrolled prospective cohort study. The subjects included 103 patients diagnosed with LDH for which they underwent conservative therapy. The subjects received MLT for 2 weeks, and the application of any other medication was left at the discretion of the attending physician. The initial evaluation was performed prior to the initiation of treatment. The independent variables from the initial evaluation were imaging diagnosis, Oswestry Disability Index (ODI), Fear-Avoidance Beliefs Questionnaire score, visual analog scale, medical interview, physical examination. The patients whose ODI after 2 weeks of treatment improved by ≥50% of that at the initial evaluation were defined as responders. Results: Of the 103 subjects, 24 were responders, and the five predictors selected for the CPR were limited lumbar extension range of motion, low-level fear-avoidance beliefs regarding work, no segmental hypomobility in the lumbar spine, short duration of symptoms, and sudden onset of symptoms. For the patients with at least three of the five predictors, the probability of their ODI greatly improving increased from 23.3% to 48.7% compared with the patients without these predictors (positive likelihood ratio, 3.13). Conclusion: Five factors were selected for the CPR to predict whether patients with LDH would demonstrate short-term improvement following conservative therapy with MLT.

著者

Aoi MATSUMURA Hiroshige TATEUCHI Masatoshi NAKAMURA Noriaki ICHIHASHI

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

vol.26, no.2, pp.58-64, 2023 (Released:2023-08-20)

参考文献数

29

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Objective: Generally, low-intensity training is recommended as selective training of the infraspinatus muscle. This study aimed to investigate whether an 8-week intervention of low-intensity, slow-movement, external rotation exercise of the shoulder led to an increase in muscle strength with shoulder external rotation and cross-sectional area (CSA) infraspinatus muscle. Methods: Sixteen healthy male volunteers were randomly assigned to the low-intensity and slow-movement (LS) group (N = 8) or the normal-intensity and normal-speed (NN) group (N = 8). The LS and NN groups performed shoulder external rotation exercises with low intensity and slow movement, and normal intensity and normal speed, respectively. The exercise session consisted of three sets of 10 repetitions, which were performed three times per week for 8 weeks. We measured the CSA of the infraspinatus and muscle strength of the shoulder external rotation before and after the 8-week intervention. Results: A significant increase in infraspinatus CSA from baseline to 8 weeks was found in the LS group (7.3% of baseline) but not in the NN group. No significant differences were found in the muscle strength of shoulder external rotation. Conclusion: Our results suggest that low-intensity exercise of the infraspinatus is effective for muscle hypertrophy when performed with slow movement. This finding may help patients who should avoid excessive stress in the early phase of rehabilitation.

著者

Tatsuro KITAYAMA Taishi TSUJI Kenta MIKAMI Naoto USUI Ryo EMORI Yasuyuki MARUYAMA Tadanori HARADA

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

pp.E10232, (Released:2023-04-27)

参考文献数

21

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Objective: This study aimed to understand the long-term transition of exercise tolerance in patients on phase III cardiac rehabilitation (CR) and clarify the characteristics of patients with a high risk of declined exercise tolerance during the first emergency declaration. Methods: Patients who participated in phase III outpatient CR before the first emergency declaration and those who performed cardiopulmonary exercise testing were at ≥2-time points: before and at 3 or 12 months post-emergency declaration. Exercise tolerance transition at 3-time points was analyzed, and whether different social background factors affected the peak oxygen uptake (VO2) transition method remains to be examined. Results: A total of 101 (median age 74.0 years, 69% men), and both peak VO2 and anaerobic threshold (AT) significantly declined from pre-declaration to 3 months post-declaration but recovered to levels likely similar from pre-declaration at 12 months (peak VO2: from 17.3 to 16.7 to 18.7 mL/min/kg; AT: from 11.8 to 11.2 to 11.6 mL/min/kg). Further, patients with multiple comorbidities at pre-declaration had a significantly lower peak VO2 at 3 months (−1.0 mL/min/kg, p = 0.025) and it remained significantly low in those with a slower gait speed at 12 months after lifting the emergency declaration (−2.5 mL/min/kg, p = 0.009). Conclusion: The emergency declaration declined the exercise tolerance in patients on phase III CR but improved to pre-declaration levels over time, but more likely declined in patients with multiple comorbidities during pre-declaration and those with low-gait speeds were less likely to improve their declined exercise tolerance.

著者

Aoi MATSUMURA Hiroshige TATEUCHI Masatoshi NAKAMURA Noriaki ICHIHASHI

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

pp.E10227, (Released:2023-04-22)

参考文献数

29

---

Objective: Generally, low-intensity training is recommended as selective training of the infraspinatus muscle. This study aimed to investigate whether an 8-week intervention of low-intensity, slow-movement, external rotation exercise of the shoulder led to an increase in muscle strength with shoulder external rotation and cross-sectional area (CSA) infraspinatus muscle. Methods: Sixteen healthy male volunteers were randomly assigned to the low-intensity and slow-movement (LS) group (N = 8) or the normal-intensity and normal-speed (NN) group (N = 8). The LS and NN groups performed shoulder external rotation exercises with low intensity and slow movement, and normal intensity and normal speed, respectively. The exercise session consisted of three sets of 10 repetitions, which were performed three times per week for 8 weeks. We measured the CSA of the infraspinatus and muscle strength of the shoulder external rotation before and after the 8-week intervention. Results: A significant increase in infraspinatus CSA from baseline to 8 weeks was found in the LS group (7.3% of baseline) but not in the NN group. No significant differences were found in the muscle strength of shoulder external rotation. Conclusion: Our results suggest that low-intensity exercise of the infraspinatus is effective for muscle hypertrophy when performed with slow movement. This finding may help patients who should avoid excessive stress in the early phase of rehabilitation.

著者

Tetsuya AMANO Ryo TANAKA Shigeharu TANAKA

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

vol.23, no.2, pp.202-208, 2020-12-20 (Released:2020-12-20)

参考文献数

30

被引用文献数

2

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Objective: To derive a clinical prediction rule for early recovery of knee range of motion after total knee arthroplasty. Methods: This prospective cohort study evaluated the data of 273 individuals undergoing primary total knee arthroplasty. The individual factors, the physical and motor function data were assessed preoperatively upon admission as a baseline survey. The knee joint extension angle and knee joint flexion angle were re-evaluated on postoperative day 14 as a follow-up. The recovery group comprised individuals with a knee joint extension angle of more than -5 degrees and knee joint flexion angle of more than 110 degrees on postoperative day 14. The other patients constituted the non-recovery group. Multivariate logistic regression analysis was used for deriving a clinical prediction rule. Results: The results indicated that the use of a cane, knee joint extension and flexion angles, and Timed Up and Go test time were significant factors for predicting early recovery of knee range of motion after total knee arthroplasty. Furthermore, a clinical prediction rule was derived and included the use of a cane, knee joint extension angle ≥ -15 degrees, knee joint flexion angle ≥ 125 degrees, and a Timed Up and Go test time < 11.2 s. A total clinical prediction rule score ≥ 8 indicated a positive likelihood ratio of more than 10 for a successful outcome and the post-test probability was approximately 95%. Conclusions: The derived clinical prediction rule might be a useful screening tool for proper postoperative goal setting and the establishment of individualized physical therapy programs.

著者

Satomi ISHIGE Sawako WAKUI Yumi MIYAZAWA Hisashi NAITO

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

pp.E9982, (Released:2019-10-10)

参考文献数

43

被引用文献数

4 6

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Objective: In Japan, there were 1.17 million people with stroke in 2014; however, studies on community rehabilitation among stroke survivors are lacking. The Activities-specific Balance Confidence (ABC) scale is used in many languages to evaluate patients undergoing stroke rehabilitation. This study aimed to investigate the reliability and validity of the Japanese ABC scale (ABC-J) version among patients ≥6 months after stroke. Methods: This cross-sectional study was conducted with 88 post-stroke patients (mean age 66.5±9.5 years). The ABC-J was administered with the 10-meter walk test (10MWT), Timed Up and Go Test (TUG-T), Berg Balance Scale (BBS), Geriatric Depression Scale-Short version-Japanese (GDS-S-J), and the Falls Efficacy Scale-International (FES-I). After a 1-2-week interval, the ABC-J was completed again by 69 of the patients. Reliability was investigated for reproducibility (intra-class correlation coefficient [ICC], standard error of measurement [SEM], and minimal detectable change [MDC]) and internal consistency (Cronbach's α). Concurrent and convergent validities were assessed using Spearman's rank correlation coefficients. Results: The ABC-J showed excellent internal consistency (Cronbach's α = 0.95) and substantial test-retest reliability (ICC = 0.92, 95% confidence interval: 0.87-0.95), with SEM and MDC of 7.14 and 19.79, respectively. The total ABC-J score was significantly correlated with 10MWT (r = −0.51, p < 0.001), TUG-T (r = −0.55, p < 0.001), BBS (r = 0.61, p < 0.001), GDS-S-J (r = −0.27, p = 0.012), and FES-I (r = −0.77, p < 0.001). Conclusion: ABC-J is a valid and reliable measurement tool for investigating balance confidence among patients ≥6 months after stroke.

著者

Kosho OHTA Kazuaki UDA Asumu FUJII Shingo MURANAGA So NAKAJI Koichi MIYAKOSHI

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

vol.25, no.2, pp.75-83, 2022-08-20 (Released:2022-08-20)

参考文献数

43

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Objective: The study aimed to examine the effect of dedicated physical therapy (PT) staffing on the outcomes of patients admitted to a general medical ward with acute cholangitis. Methods: This retrospective observational study was conducted in an 865-bed tertiary-care hospital in Japan. Patients with acute cholangitis between September 2015 and August 2017 were enrolled. Patients admitted to a ward with dedicated PT staffing were included in the dedicated group, while those admitted to a ward without dedicated PT staffing were included in the non-dedicated group. Each group was further divided into pre-dedicated and post-dedicated period based on September 1, 2016, at which PT staffing was implemented. The primary outcome was absolute functional gain (AFG), which was defined as the difference between Barthel index at discharge and that at admission. A difference-in-difference analysis was conducted to examine the changes in AFG associated with ward-dedicated PT staffing. Results: We identified 456 patients with acute cholangitis. Complete case analysis was applied, resulting in 252 patients in the final analysis. Patients were assigned to the dedicated group in the pre-dedicated period (n = 66) and post-dedicated period (n = 52), and to the non-dedicated group in the pre-dedicated period (n = 60) and post-dedicated period (n = 74). The adjusted difference-in-difference estimator was 17.1 (95% confidence interval: 5.6 to 28.5, p = 0.003) for AFG. Conclusion: Ward-dedicated PT staffing may improve the AFG of general medical patients in an acute hospital. Ward-dedicated PT staffing should be among the strategies utilized in the acute care process.

著者

Hiroaki ABE Kei KADOWAKI Naohide TSUJIMOTO Toru OKANUKA

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

vol.24, no.3, pp.195-203, 2021-12-20 (Released:2021-12-20)

参考文献数

41

被引用文献数

7

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Impairments resulting from stroke lead to persistent difficulties with walking. Subsequently, an improved walking ability is one of the highest priorities for people living with stroke. The degree to which gait can be restored after a stroke is related to both the initial impairment in walking ability and the severity of paresis of the lower extremities. However, there are some patients with severe motor paralysis and a markedly disrupted corticospinal tract who regain their gait function. Recently, several case reports have described the recovery of gait function in stroke patients with severe hemiplegia by providing alternate gait training. Multiple studies have demonstrated that gait training can induce "locomotor-like" coordinated muscle activity of paralyzed lower limbs in people with spinal cord injury. In the present review, we discuss the neural mechanisms of gait, and then we review case reports on the restoration of gait function in stroke patients with severe hemiplegia.

著者

Satoshi YAMAMOTO Daisuke ISHII Kyoko KANAE Yusuke ENDO Kenichi YOSHIKAWA Kazunori KOSEKI Ryo NAKAZAWA Hanako TAKANO Masahiko MONMA Arito YOZU Akira MATSUSHITA Yutaka KOHNO

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

pp.E10032, (Released:2021-02-24)

参考文献数

22

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Objective: We explore the effects of body weight-supported (BWS) treadmill training, including the change of cortical activation, on a patient with post-stroke hemidystonia. Patient: The patient was a 71-year-old man with left thalamus hemorrhage. His motor symptoms indicated slight impairment. There was no overactive muscle contraction in the supine, sitting, or standing positions. During his gait, the right initial contact was the forefoot, and his right knee showed an extension thrust pattern. These symptoms suggested that he had post-stroke hemidystonia. Methods: The patient performed BWS treadmill training 14 times over 3 weeks. The effects of the BWS training were assessed by a step-length analysis, electromyography and functional magnetic resonance imaging (fMRI). Results: The patient's nonparetic step length was extended significantly in the Inter-BWS (p<0.001) and Post-BWS (p=0.025) periods compared to the Pre-BWS session. The excessive muscle activity of the right gastrocnemius medialis in the swing phase was decreased at the Inter-BWS, Post-BWS, and follow-up compared to the Pre-BWS session. The peak timing difference of the bilateral tibialis anterior muscle became significant (p<0.05) on the first day of the intervention. The fMRI revealed that the cortical areas activated by the motor task converged through the intervention (p<0.05, family-wise error corrected). Conclusion: These results suggest that there was improvement of the patient's symptoms of post-stroke hemidystonia due to changes in the brain activity during voluntary movement after BWS intervention. Body weight-supported treadmill training may thus be an effective treatment for patients with poststroke hemidystonia.

著者

Kenichi SUGAWARA

出版者

Japanese Society of Physical Therapy

雑誌

Physical Therapy Research (ISSN:21898448)

巻号頁・発行日

vol.23, no.2, pp.106-112, 2020-12-20 (Released:2020-12-20)

参考文献数

57

被引用文献数

2

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For central nervous system disorders' rehabilitation, it is important to accurately understand motor control and implement an appropriate motor learning process to induce neuroplastic changes. The neurophysiological studies have revealed that neural control mechanisms are crucial during both the onset of muscular activities and muscle release after contraction. When performing various movements during daily activities, muscle relaxation control enables precise force output and timing control. Moreover, surround inhibition is a functional mechanism in the motor system. Surround inhibition of the motor system may be involved in the selective execution of desired movements. This review demonstrates cortical excitability resulting from motor learning, movement control mechanisms including muscle relaxation and the suppression of nontarget muscle groups, and the voluntary drive's importance that is required for movement.