著者

YUINE Hiroshi KATAOKA Nobuhiro KURAKATA Hiroshi SASAKI Takeshi WAKAYAMA Shuichi YOSHII Yuichi SHIRAISHI Hideki

出版者

Japanese Society for Brain Function and Rehabilitation

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

vol.23, no.1, pp.231201, 2023 (Released:2023-07-28)

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While mirror therapy is used to improve upper limb function after stroke, evidence supporting its use for treating post-stroke complex regional pain syndrome remains inconclusive. We aimed to evaluate the therapeutic effects of mirror therapy for complex regional pain syndrome after stroke. The following databases were searched for relevant literature: MEDLINE, EMCARE, EMBASE, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, Web of Science, OTseeker, and the Physiotherapy Evidence Database, with no restrictions on language, type, or date. Randomized controlled trials comparing mirror therapy with placebo interventions or other treatments for stroke and complex regional pain syndrome type 1 were included. Studies involving multiple trauma cases were excluded. Primary outcomes were pain, assessed using a visual analog scale, and upper limb function, evaluated using the Wolf Motor Function Test and Fugl–Meyer assessment. Risk of bias was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Of 2,977 screened articles, 17 were reviewed. Three studies fulfilling the inclusion criteria with moderate overall risk of bias were considered for data extraction. All three studies assessed pain using the visual analog scale; two assessed upper extremity function via the Wolf Motor Function Test or Fugl–Meyer assessment. Each of the three studies showed significant improvement in the mirror therapy group compared with the control group. This review validated mirror therapy as an effective treatment for complex regional pain syndrome type 1 after stroke; however, the quality of evidence remains very low.

著者

Ito Ayahito Ishioka Toshiyuki

出版者

Japanese Society for Brain Function and Rehabilitation

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

pp.200512, (Released:2020-05-14)

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Coronavirus disease 2019 (COVID-19) has a profound impact on our society, and health care professionals are challenged by the present outbreak. A recent study showed that a significant proportion of second-line workers and frontline workers experienced psychological distress. Although these findings suggest the possibility that rehabilitation therapists, especially those who work at the hospital, experience psychological distress, their mental health state has been largely dismissed and the number of an evidence-based practice is limited. Here, we discuss the importance of focusing on the mental health of therapists by introducing studies that focus on the mental health of health care workers during the COVID-19, SARS, and H1N1 influenza pandemics. We then noted the need to track the dynamic relationship between the mental health of therapists and the COVID-19 pandemic by employing longitudinal data collection with psychological measures that reliably and validly capture the mental health of therapists. This approach would be effective for preparation for future pandemics, as we have learned much from previous pandemics. We hope that our Tutorial Note will help readers who are interested in the mental health of rehabilitation therapists and encourage future studies.

著者

Takayuki WATABE Hisayoshi SUZUKI Shuichi SASAKI Rikitaro SAKO Yoshihumi OZASA Jun NAGASHIMA Nobuyuki KAWATE Hiroo ICHIKAWA

出版者

Japanese Society for Brain Function and Rehabilitation

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

vol.20, no.1, pp.7-12, 2020 (Released:2020-10-09)

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The objectives of this study were to develop an oculomotor rehabilitation program by means of expert discussion, based on the results of a systematic review, that may be easily administered in clinical settings; it also aimed to evaluate the efficacy of the newly developed program in a single case. Four experts with extensive knowledge and experience of brain trauma rehabilitation (mean length of clinical experience 30.5  0.6 years) developed an oculomotor rehabilitation program on the basis of the types, duration, frequency, and timing of exercises previously found to be effective in available literature. In this program, a clinician indicated a target to the patient, who performed exercises to encourage fixation, saccade, pursuit, and vergence in sessions lasting 20 minutes a day, 6 days a week, for a total of 8 weeks. An immediate effect was evident after the first session, with an increase in oculomotor range of motion compared to before the session. The supraduction range of motion of the right eye increased from 1.44 mm before the start of the 8-week program to 4.36 mm after its completion; the patient’s ability to perform activities of daily living also improved. The use of this program improved contraction and weakness of the extraocular muscle, and increased the oculomotor range of motion.

著者

KATO Masaki TAKASUGI Jun ICHIKAWA Takeo OGA Tatsuhide

出版者

Japanese Society for Brain Function and Rehabilitation

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

pp.200508, (Released:2020-05-28)

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There are few case reports of patients with hemiparetic stroke who had previously been diagnosed with poliomyelitis (polio). Herein, we present the case of an 84-year-old male stroke patient with right-sided hemiparesis and polio. He was infected with polio at age 6 and had severe right-leg palsy. He was able to walk independently, performed knee hyperextension, and walked using a cane prior to the stroke at age 84. He was transferred to our hospital 31 days post-stroke. At that time, manual muscle test (MMT) was Poor-to-Good for the right ankle muscles and Trace for the right hip and knee muscles. He required assistance from a therapist to walk even with grasping parallel bars because he could not hyperextend the right knee and the knee had collapsed. For physical therapy, he performed stretching, muscle strengthening, standing, and walking exercises. Consequently, he was able to walk with a walking frame independently at discharge (day 131 after the onset). He regained knee hyperextension and resolved the knee collapse. MMT for the right hip muscles became Poor. This hemiparetic stroke patient with polio had severe right leg palsy and consequently had trouble walking due to knee collapse. It is postulated that regaining the knee hyperextension enabled him to walk safely.

著者

Miho YOSHIOKA Zen KOBAYASHI Keisuke INOUE Mayumi WATANABE Kaori KATO Kazunori TOYODA Yoshiyuki NUMASAWA Shoichiro ISHIHARA Hiroyuki TOMIMITSU Shuzo SHINTANI

出版者

Japanese Society for Brain Function and Rehabilitation

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

vol.19, no.1, pp.33-36, 2019 (Released:2019-10-25)

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The Trail Making Test (TMT) is widely used as a measure of attention impairment. The time needed to complete TMT (TMT score) is prolonged in association with attention impairment in patients with brain diseases. Thus far, however, there have been no reports of serial changes in the TMT score after minor ischemic stroke. We retrospectively investigated serial changes in the TMT score of 19 patients with minor ischemic stroke. We included patients in whom TMT could be performed both 4-11 days after onset (initial evaluation) and 14-47 days after onset (second evaluation). The mean value of the initial TMT-A scores was 58 seconds, and that of the initial TMT-B scores was 144 seconds. The mean value of the second TMT-A scores was 43 seconds, and that of the second TMT-B scores was 119 seconds. The TMT-A and TMT-B scores improved in 89 % and 74 % of patients, respectively. This study demonstrated that most minor ischemic stroke patients showed improvement in the TMT score 14 days or later after onset.

著者

KAJIMURA Shogo ITO Ayahito

出版者

Japanese Society for Brain Function and Rehabilitation

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

vol.23, no.1, pp.231701, 2023 (Released:2023-04-14)

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The relationship quality between therapists and clients is crucial for obtaining a good outcome from long-term therapeutic relationships such as counseling and physical/occupational therapy. Although findings on the relationship between the compatibility of therapists and clients and their self-reported psychological characteristics/behaviors have been accumulated, it has been suggested that the compatibility of interpersonal relationships cannot be predicted by psychological constructs. Recently, using resting-state functional magnetic resonance imaging (fMRI) data and a newly developed similarity index, we overcame the limitations of self-report psychological constructs and succeeded in predicting the compatibility of interpersonal relationships a priori. We propose a procedure to predict therapist-client compatibility for better therapeutic outcomes. We hope that this tutorial note will promote the development of a prediction system and help make it more practical in the near future.

著者

Ito Ayahito Ishioka Toshiyuki

出版者

Japanese Society for Brain Function and Rehabilitation

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

vol.20, no.1, pp.19-23, 2020 (Released:2020-10-09)

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Coronavirus disease 2019 (COVID-19) has a profound impact on our society, and health care professionals are challenged by the present outbreak. A recent study showed that a significant proportion of second-line workers and frontline workers experienced psychological distress. Although these findings suggest the possibility that rehabilitation therapists, especially those who work at the hospital, experience psychological distress, their mental health state has been largely dismissed and the number of an evidence-based practice is limited. Here, we discuss the importance of focusing on the mental health of therapists by introducing studies that focus on the mental health of health care workers during the COVID-19, SARS, and H1N1 influenza pandemics. We then noted the need to track the dynamic relationship between the mental health of therapists and the COVID-19 pandemic by employing longitudinal data collection with psychological measures that reliably and validly capture the mental health of therapists. This approach would be effective for preparation for future pandemics, as we have learned much from previous pandemics. We hope that our Tutorial Note will help readers who are interested in the mental health of rehabilitation therapists and encourage future studies.

著者

KATO Masaki TAKASUGI Jun ICHIKAWA Takeo OGA Tatsuhide

出版者

Japanese Society for Brain Function and Rehabilitation

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

vol.20, no.1, pp.13-18, 2020 (Released:2020-10-09)

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There are few case reports of patients with hemiparetic stroke who had previously been diagnosed with poliomyelitis (polio). Herein, we present the case of an 84-year-old male stroke patient with right-sided hemiparesis and polio. He was infected with polio at age 6 and had severe right-leg palsy. He was able to walk independently, performed knee hyperextension, and walked using a cane prior to the stroke at age 84. He was transferred to our hospital 31 days post-stroke. At that time, manual muscle test (MMT) was Poor-to-Good for the right ankle muscles and Trace for the right hip and knee muscles. He required assistance from a therapist to walk even with grasping parallel bars because he could not hyperextend the right knee and the knee had collapsed. For physical therapy, he performed stretching, muscle strengthening, standing, and walking exercises. Consequently, he was able to walk with a walking frame independently at discharge (day 131 after the onset). He regained knee hyperextension and resolved the knee collapse. MMT for the right hip muscles became Poor. This hemiparetic stroke patient with polio had severe right leg palsy and consequently had trouble walking due to knee collapse. It is postulated that regaining the knee hyperextension enabled him to walk safely.

著者

KATO Kenji NISHIMURA Yukio

出版者

Japanese Society for Brain Function and Rehabilitation

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

vol.20, no.1, pp.1-6, 2020 (Released:2020-10-09)

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Motor impairment following stroke is one of the most important issues to be addressed in clinical care. In this review, we summarize a study in which lost volitional motor control of the hand was regained in a monkey model of stroke using an “artificial cortico-muscular connection” (ACMC) via a neural interface that bypassed the damaged neural pathway after stroke. The ACMC was produced by a computer interface that can detect the high-gamma cortical oscillations and converted in real-time to activity-contingent electrical stimuli delivered to the paralyzed muscles. As a result, within 20 min, the monkeys learned rapidly to use the ACMC and reacquired volitional motor control of the affected hand. Learning to use the ACMC was achieved regardless of whether the input signal was extracted from the primary motor area or the primary somatosensory area, and the activation areas of the input high-gamma signals were changed to concentrate around the arbitrarily-assigned input electrode as learning progressed. This study may have the potential to lead to the development of a clinically effective neural prosthesis to regain lost motor function by bypassing the lesion site and activating paralyzed muscles via an artificial neural connection, even after a limb is paralyzed due to stroke.

著者

KATO Kenji NISHIMURA Yukio

出版者

Japanese Society for Brain Function and Rehabilitation

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

pp.200731, (Released:2020-08-23)

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Motor impairment following stroke is one of the most important issues to be addressed in clinical care. In this review, we summarize a study in which lost volitional motor control of the hand was regained in a monkey model of stroke using an “artificial cortico-muscular connection” (ACMC) via a neural interface that bypassed the damaged neural pathway after stroke. The ACMC was produced by a computer interface that can detect the high-gamma cortical oscillations and converted in real-time to activity-contingent electrical stimuli delivered to the paralyzed muscles. As a result, within 20 min, the monkeys learned rapidly to use the ACMC and reacquired volitional motor control of the affected hand. Learning to use the ACMC was achieved regardless of whether the input signal was extracted from the primary motor area or the primary somatosensory area, and the activation areas of the input high-gamma signals were changed to concentrate around the arbitrarily-assigned input electrode as learning progressed. This study may have the potential to lead to the development of a clinically effective neural prosthesis to regain lost motor function by bypassing the lesion site and activating paralyzed muscles via an artificial neural connection, even after a limb is paralyzed due to stroke.

著者

Isato FUKUSHI Yasumasa OKADA

出版者

Japanese Society for Brain Function and Rehabilitation

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

vol.19, no.1, pp.22-32, 2019 (Released:2019-10-25)

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Dyspnea is defined as “a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity”. In patients especially with pulmonary diseases, dyspnea reduces daily activity, which worsens the physical condition, and thereby further increases dyspnea, forming a vicious cycle. In clinical practice, reduction of dyspnea in patients with diseases is crucial. One of the goals in pulmonary rehabilitation is reduction of dyspnea to break the above-mentioned vicious cycle. However, the mechanism of dyspnea perception has not been fully elucidated because it is complex and is not explained by a single factor such as changes in blood gas. Not all patients with chronic respiratory failure with hypercapnia are dyspneic, or not all patients with COPD with severe hypoxemia perceive dyspnea. To date, sufficiently effective methods to relieve dyspnea have not been established. We integrated the theories which explain the mechanisms of dyspnea perception with our considerations from the viewpoint of respiratory neurophysiology, and propose a model of dyspnea perception mechanism. In our model, dyspnea results from disassociation or mismatch between the neural respiratory motor output from the respiratory neural network in the lower brainstem and the actually accomplished ventilation. The projection modality of neural information on dyspnea to the higher sensory center of the brain, and the brain regions for comparison of the intended respiratory neural output from the brainstem respiratory center and the monitored actual ventilatory output remain unknown. Further clarification of these issues will enlighten understanding of the pathophysiology of dyspnea and contribute to more effective practice of pulmonary rehabilitation.

著者

Toru YAMADA

出版者

Japanese Society for Brain Function and Rehabilitation

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

vol.19, no.1, pp.10-21, 2019 (Released:2019-10-25)

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Continuous wave functional near-infrared spectroscopy (CW-fNIRS) has potential advantages in the detection of cerebral functional activation, such as safety, portability, resistance to electromagnetic noise, time resolution higher than that of functional magnetic resonance imaging (fMRI), spatial resolution higher than that of electroencephalography (EEG), and the lack of need for subject restraint. However, for practical application of the fNIRS technique, a careful study design is required for experiments, practical measurements, and data analysis. Each step should be based on accurate knowledge of both the advantages and drawbacks of the fNIRS technique. This review will describe various signal components in the fNIRS measurement and their appropriate management through critical discussions on the measurement principle and the physiological origin of the signal.

著者

Shinichiro MAESHIMA Aiko OSAWA

出版者

Japanese Society for Brain Function and Rehabilitation

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

vol.19, no.1, pp.3-9, 2019 (Released:2019-10-25)

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A variety of cognitive dysfunctions occur after subcortical damage. Aphasia and unilateral spatial neglect often result from lesions of the putamen and thalamus. They are particularly frequent during the acute stage of cerebral hemorrhage, with approximately 80 % of patients presenting such symptoms. To understand the mechanism by which they appear, we must not only consider causes related to damage to the subcortical white matter fibers, but also secondary functional decline caused by direct damage to the cortex as well as by diaschisis. Infratentorial lesions are known to cause language deficits, visuospatial inattention, executive function disorders, personal change, and other symptoms. Many of these reports pertain to cerebellar lesions; however, there are not a few cases where cognitive dysfunction develops because of brainstem lesions. Impairment of the cortical pontocerebellar tract’s fiber connections and damage to the brainstem reticular regulatory system may be considered as the mechanism by which cognitive dysfunction appears. Because of this, detailed cognitive function assessments must also be performed for patients with infratentorial lesions.

著者

Takayuki WATABE Hisayoshi SUZUKI Shuichi SASAKI Rikitaro SAKO Yoshihumi OZASA Jun NAGASHIMA Nobuyuki KAWATE Hiroo ICHIKAWA

出版者

Japanese Society for Brain Function and Rehabilitation

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

pp.200115, (Released:2020-03-05)

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The objectives of this study were to develop an oculomotor rehabilitation program by means of expert discussion, based on the results of a systematic review, that may be easily administered in clinical settings; it also aimed to evaluate the efficacy of the newly developed program in a single case. Four experts with extensive knowledge and experience of brain trauma rehabilitation (mean length of clinical experience 30.5  0.6 years) developed an oculomotor rehabilitation program on the basis of the types, duration, frequency, and timing of exercises previously found to be effective in available literature. In this program, a clinician indicated a target to the patient, who performed exercises to encourage fixation, saccade, pursuit, and vergence in sessions lasting 20 minutes a day, 6 days a week, for a total of 8 weeks. An immediate effect was evident after the first session, with an increase in oculomotor range of motion compared to before the session. The supraduction range of motion of the right eye increased from 1.44 mm before the start of the 8-week program to 4.36 mm after its completion; the patient’s ability to perform activities of daily living also improved. The use of this program improved contraction and weakness of the extraocular muscle, and increased the oculomotor range of motion.