著者

忽那 龍雄 渡辺 英夫

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

リハビリテーション医学 (ISSN:0034351X)

巻号頁・発行日

vol.21, no.4, pp.215-219, 1984-07-18 (Released:2009-10-28)

参考文献数

6

被引用文献数

3 1

---

健康成人,男性946名,女性842名の両下肢の下肢伸展挙上角度(SLR角度)を調査し,SLRテストを評価する上に参考となる事項について述べた.即ち,1.日本人成人におけるSLR角度の正常値は,男性が右下肢78.7度±9.70度,左下肢79.0度±9.94度であり,女性が右下肢85.7度±8.48度,左下肢87.3度±8.38度であった.これらSLR角度の臨界値は男性65度,女性75度と考えられた.2.SLRテストを評価するにあたっては,正常者のSLR角度には男女差があり女性の角度が大きいこと,並びに左右差はなく左下肢と右下肢との間に高い相関があることに配慮する必要がある.3.また正常者におけるtight hamstringsの頻度は,男性が12.5%,女性が13.2%であった.

著者

Kyohei Omon Masahiko Hara Hideo Ishikawa

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.4, pp.20190011, 2019 (Released:2019-05-31)

参考文献数

18

被引用文献数

13

---

Background: Virtual reality (VR) technology has been recently introduced in a variety of clinical settings, such as physical, occupational, cognitive, and psychological rehabilitation or training. However, the clinical efficacy of VR rehabilitation compared with traditional training techniques remains to be elucidated. Case: A 90-year-old man underwent VR-guided, dual-task, body trunk balance training in the sitting position using a newly developed medical device (mediVR KAGURA, mediVR, Inc., Toyonaka, Japan) after his physical activity level had plateaued. The patient had difficulty in walking outside the hospital even after having undergone traditional physical training. VR-guided training was performed for 40 min every weekday for 2 weeks. Trunk balance training was performed using reaching tasks, and cognitive stimulation was designed to emulate the cognitive processing involved when walking in a city or town. After the VR-guided training, the patient’s 6-min walk distance improved from 430 m to 500 m even though there had been no improvement in muscle strength of the lower extremities. Furthermore, the patient could successfully walk outside the hospital without falling or colliding with obstacles. Discussion: It is noteworthy that the patient’s walking ability improved further by the addition of VR-guided, dual-task, trunk balance training carried out in the sitting position. This finding suggests several possible new approaches to overcoming walking disability. Walking requires lower-extremity muscle strength, postural balance, and dual-task processing. Currently, no effective quantitative methods have been identified for postural balance and dual-task training with the patient in the sitting position. Herein, we discuss the possible advantages of VR-guided rehabilitation over traditional training methods.

著者

Yuki Choji Ryuji Kobayashi

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.20200001, 2020 (Released:2020-01-30)

参考文献数

35

被引用文献数

1

---

Objective: The success of a client-centred practice depends on the relationship between the client and therapist and on their ability to make constructive decisions together, particularly in the field of occupational therapy. The aim of this study was to develop a Occupational Therapy Collaborative Relationship Scale (OTCRS) to measure the quality of such interaction. Methods: This work included constructing a draft questionnaire and testing its validity and reliability. A Rasch analysis was applied to determine its validity, and several tests were used to confirm its internal consistency. Results: After reviewing more than 130 scientific papers and books, we built explicit selection criteria for issues to be addressed in this instrument, and we developed 40 questions to be included. These were analysed using a standard content validation process and a Rasch analysis to examine confirmation validity. A nine-item scale was finalised for testing (OTCRS-9). This review process revealed the validity, high internal consistency, and item/person separation reliability of OTCRS-9. Conclusion: This study presents only the initial phase of scale development. As suggested by the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN), the OTCRS-9 score should be tested further for validity and reliability and should also be conducted in subjects of other ethnicities to improve its generalizability.

著者

Masako Kishima Hidetaka Wakabayashi Hideaki Kanazawa Masataka Itoda Toshio Nishikimi

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.3, pp.20180020, 2018 (Released:2018-12-11)

参考文献数

12

---

Background: Dysphagia occurs often after oral cancer surgery. However, no case of dysphagia in combination with cerebral hemorrhage, tongue defect, and sarcopenia has been reported. We describe the case of a 70-year-old man with dysphagia associated with a cerebral hemorrhage, tongue defect, and sarcopenia who received rehabilitation nutrition and underwent glottal closure. Case: At age 48 years, the patient had the left part of his tongue removed because of cancer. Twenty-two years later, he developed dysphagia and right hemiplegia after a cerebral hemorrhage. The patient was diagnosed with sarcopenia based on a low left handgrip strength (10 kg) and reduced calf circumference (26.5 cm). The patient’s Functional Oral Intake Scale (FOIS) score was 1, and his tongue muscle mass indicated atrophy, making the maximum tongue pressure difficult to measure. Palatal augmentation prostheses (PAP) were made to increase swallowing and tongue pressures, and nutritional intake was changed from nasal tube feeding to a gastric fistula. Nutritional intake was increased to 2400 kcal/day and protein intake to 96 g/day. Although rehabilitation nutrition using PAP improved the patient’s nutritional status, the dysphagia did not improve, and therefore he underwent glottal closure. This resulted in a weight gain of 13.7 kg and increased tongue muscle strength and volume. The patient’s FOIS score increased to 7 (i.e., total oral diet with no restrictions) at 5 months after discharge. Discussion: Glottic closure surgery may be useful for improving oral ingestion, nutritional status, and activities of daily living.Background: Dysphagia occurs often after oral cancer surgery. However, no case of dysphagia in combination with cerebral hemorrhage, tongue defect, and sarcopenia has been reported. We describe the case of a 70-year-old man with dysphagia associated with a cerebral hemorrhage, tongue defect, and sarcopenia who received rehabilitation nutrition and underwent glottal closure. Case: At age 48 years, the patient had the left part of his tongue removed because of cancer. Twenty-two years later, he developed dysphagia and right hemiplegia after a cerebral hemorrhage. The patient was diagnosed with sarcopenia based on a low left handgrip strength (10 kg) and reduced calf circumference (26.5 cm). The patient’s Functional Oral Intake Scale (FOIS) score was 1, and his tongue muscle mass indicated atrophy, making the maximum tongue pressure difficult to measure. Palatal augmentation prostheses (PAP) were made to increase swallowing and tongue pressures, and nutritional intake was changed from nasal tube feeding to a gastric fistula. Nutritional intake was increased to 2400 kcal/day and protein intake to 96 g/day. Although rehabilitation nutrition using PAP improved the patient’s nutritional status, the dysphagia did not improve, and therefore he underwent glottal closure. This resulted in a weight gain of 13.7 kg and increased tongue muscle strength and volume. The patient’s FOIS score increased to 7 (i.e., total oral diet with no restrictions) at 5 months after discharge. Discussion: Glottic closure surgery may be useful for improving oral ingestion, nutritional status, and activities of daily living.

著者

Yusuke Ito Yoshihiro Yoshimura Fumihiko Nagano Ayaka Matsumoto Shin Nomura

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.20230044, 2023 (Released:2023-12-09)

参考文献数

48

---

Objectives: This study aimed to determine whether the phase angle is associated with physical function at discharge and discharge destination in patients with osteoporotic fragile fractures.Methods: This retrospective cohort study included patients with fragile osteoporotic fractures who were admitted to a convalescent rehabilitation ward. The phase angle was calculated using a body composition meter and bioelectrical impedance analysis. The primary outcome was the Functional Independence Measure motor (FIM-motor) score at discharge, and the secondary outcome was discharge to home. Multivariate analysis was used to determine the association between phase angle and FIM-motor scores at discharge and discharge to home.Results: The study included 127 patients (108 women, age 81.2 ± 9.7 years). The median phase angle on admission was 4.1° for men and 3.6° for women. The median FIM-motor score at discharge was 83, with 92 (72.4%) patients discharged home and 35 (27.6%) discharged to a destination other than home. Multiple regression analysis adjusted for confounders revealed a significant independent association between the phase angle and FIM-motor score at discharge (β=0.262, P=0.019). However, no significant association was found between phase angle and discharge destination (odds ratio, 1.350; 95% confidence interval: 0.680–2.670, P=0.391).Conclusions: Phase angle was independently associated with physical function at discharge in patients with fragile osteoporotic fractures. For patients with a reduced phase angle on admission, a multidisciplinary approach, including exercise, nutrition, oral health, and medication, should be implemented to maximize improvement in physical function.

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.20220058, 2022 (Released:2022-11-17)

参考文献数

11

---

Background: We previously reported that swallowing in the bridge position (bridge swallowing) strengthened esophageal contractions and increased the lower esophageal sphincter pressure against gravity. Furthermore, bridge swallowing exercise improved the symptoms of gastroesophageal reflux disease (GERD) in subjects with GERD. Bridge swallowing may have the potential to strengthen esophageal peristalsis and improve GERD. In this case series, we evaluated the effect of bridge swallowing on GERD symptoms and esophageal residue observed by videofluoroscopic examination of swallowing (VF) in patients with dysphagia after stroke.Cases: We reviewed the cases of five patients hospitalized with stroke and concurrent GERD symptoms. Dry swallowing exercises in the bridge (hip lift) position were performed ten times per day for 4 weeks. Frequency Scale for Symptoms of GERD (FSSG) questionnaire scores and esophageal residue on VF were compared before and after exercise. All patients completed the bridge swallowing exercise without adverse events and all showed improved FSSG scores after the exercise. Three patients showed improvements in esophageal residue on VF after exercise.Discussion: Our findings indicated that the bridge swallowing exercise can improve FSSG scores. Some patients showed improved esophageal residue on VF. This exercise was performed easily and safely without adverse events. Further studies are needed to validate the effectiveness of the bridge swallowing exercise in improving GERD.

著者

Masato Ogawa Tsuyoshi Matsumoto Risa Harada Ryo Yoshikawa Yuya Ueda Daiki Takamiya Yoshitada Sakai

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.20230008, 2023 (Released:2023-03-11)

参考文献数

26

被引用文献数

3

---

Objectives: Measurement of skeletal muscle using ultrasonography (US) has received considerable attention as an alternative method of muscle assessment. However, intra- and inter-rater reliability remains controversial. Furthermore, there is no consensus regarding the relationship between muscle assessment using US and muscle mass or physical assessment. We aimed to verify the validity and reliability of muscle measurements using US and its relationships with muscle strength and physical assessment.Methods: The 22 participants were all healthy men. Quadriceps muscle thickness was measured by US by three different raters. Intraclass correlation coefficient (ICC) was used to assess inter- and intra-rater reliability. The maximum isokinetic strength of the quadriceps and handgrip strength were used as measures of lower and upper muscle strength, respectively. Leg muscle mass was assessed using the leg skeletal muscle index (SMI), measured by body impedance analysis, and calf circumference.Results: The intra-rater reliability was excellent which the ICC(1,1) ranges 0.957-0.993, and ICC(1,3) ranges 0.985-0.998. For inter-rater reliability, the values of 0.904 for ICC(2,1) and 0.966 for ICC(2,3) indicated excellent reliability. Leg SMI was significantly correlated with quadriceps thickness (r=0.36). Maximum isokinetic strength and handgrip strength showed weak but statistically significant correlations with quadriceps thickness (r=0.20, r=0.30, respectively). The correlation between quadriceps thickness and calf circumference was not statistically significant.Conclusions: Quadriceps muscle assessment using US is a valid and reliable technique for healthy individuals. Quadriceps muscle thickness was significantly positively correlated with upper and lower muscle strength and leg SMI. Muscle thickness assessment could replace full body muscle assessment in clinical settings.

著者

Narumi Watanabe Yohei Otaka Masashi Kumagai Kunitsugu Kondo Eiji Shimizu

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.20220046, 2022 (Released:2022-09-09)

参考文献数

21

被引用文献数

1

---

Objectives: This study examined whether the reliability of the Nine Hole Peg Test (NHPT) is improved by a modification (mNHPT) that confines the peg insertion/removal order to one way to reduce the degree of freedom of spatial strategies.Methods: Participants performed the NHPT and mNHPT three times each in two sessions with an interval of 3–5 days. Healthy adults used their non-dominant hand (n=40), while those with hemiparetic stroke used their affected (n=40) or unaffected hand (n=40). The mean value of three trials from each session was used for analyses. The reliabilities of the NHPT and mNHPT during the two sessions were assessed via intraclass correlation coefficients (ICCs) and Bland–Altman analysis.Results: The ICCs of the NHPT and mNHPT were 0.49 and 0.66, respectively, in healthy participants, and 0.91 and 0.94, respectively, in participants with stroke, regardless of the hand used. A significant fixed bias between the sessions was observed in both tests, except for participants with stroke who used their affected hand. Proportional biases were noted in the mNHPT results of healthy participants and in the NHPT and mNHPT results of participants with stroke who used their affected hand. The limits of agreement (lower, upper) in the affected hand were −11.0 and 9.5 for the NHPT and −8.0 and 6.2 for the mNHPT.Conclusions: Reduced degrees of freedom in the spatial strategy improved the relative reliability and reduced measurement errors in the NHPT. However, fixed and proportional biases were still evident.

著者

G. Shankar Ganesh

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.20220056, 2022 (Released:2022-11-02)

参考文献数

17

著者

Megumi Takato Tomoki Nanto Masaru Kanamori Yuta Nakao Kohei Horikawa Kazuki Eimoto Kaho Toyota Kohei Marumoto Satoshi Kaku Yuki Uchiyama Kazuhisa Domen

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.20220060, 2022 (Released:2022-11-23)

参考文献数

24

---

Background: Constraint-induced aphasia therapy (CIAT) has been reported as a short-term, intensive language training program for improving language function in patients with chronic aphasia. We report the recovery of language function in a patient with chronic aphasia who was evaluated in the baseline assessment as having reached a plateau.Case: The patient with subcortical aphasia was a 62-year-old, right-handed man. At 192 days after left putamen hemorrhage, he visited our hospital to begin CIAT. The patient’s language and speech abilities were evaluated 1 month before and immediately before the start of CIAT. To evaluate the training effect, language function was assessed immediately after, 1 month after, 3 months after, and 6 months after the end of CIAT. The Western Aphasia Battery (WAB), the single-word-naming task in the Test of Lexical Processing in Aphasia (TLPA), and the Verbal Activity Log (VAL) were used to assess his language function and the amount of spoken language. From 1 month before CIAT to 6 months after CIAT, the WAB Aphasia Quotient increased by 6.1 points. Compared with before therapy, the errors of apraxia of speech in the TLPA disappeared from immediately after to 6 months after CIAT. Although the VAL score at 3 months after CIAT was higher than that before the start of CIAT, the score decreased after 6 months because of reduced opportunities for communication with friends.Discussion: CIAT improved the word-naming ability and amount of spontaneous, real-world spoken language in a patient with chronic aphasia.

著者

Walter R. Frontera

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.20220044, 2022 (Released:2022-09-03)

参考文献数

84

被引用文献数

4

---

The 20th and 21st centuries have witnessed a substantial increase in human life expectancy and in the number of men and women aged 60 years and older. Aging is associated with a large number of health conditions, including sarcopenia, which has been the subject of important research in the past 30 years. Sarcopenia is characterized by an age-related loss of muscle mass, weakness, and impaired physical performance. The condition can be diagnosed with a combination of measurements of these three elements. The precise definition of sarcopenia and the selection of optimal assessment methods have changed significantly in the past 20 years; nonetheless, the prevalence of sarcopenia in the general older population is in the range of 5–15%. Molecular and cellular events at the muscle cell level impact the size and quality of muscles (force adjusted for size). The active and passive mechanical properties of single muscle fibers are altered by changes in the structure and function of various cellular elements. Systemic factors such as inflammation, loss of hormonal influence, and deleterious lifestyle choices also contribute to sarcopenia. The consequences of sarcopenia include many adverse effects such as impairments in activities of daily living, falls, loss of independence, and increased mortality. Several rehabilitative interventions have been tested, and the safest and most effective is the use of progressive resistance exercise. An increase in dietary protein intake has synergistic effects. Future research should focus on a consensus definition of sarcopenia, identification of the best assessment methods, understanding of biological mechanisms, and testing of innovative interventions.

著者

Hideki Arai Naoya Ikegawa Masafumi Nozoe Kuniyasu Kamiya Satoru Matsumoto

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.20220003, 2022 (Released:2022-01-29)

参考文献数

24

被引用文献数

3

---

Objective: The aim of the current study was to investigate the association between the skeletal muscle mass index (SMI) and the convalescent rehabilitation ward achievement index (CRWAI) in older patients with functional impairment.Methods: We conducted a retrospective cohort study at a single rehabilitation center in Japan to include patients admitted to the convalescent rehabilitation ward because of neurological disease, motor disorder, or disuse syndrome. Patients with missing SMI data, those who died or were transferred to other hospitals due to comorbidities, those aged less than 65 years, and those hospitalized for <7 days were excluded from the study. We divided patients into two groups based on their SMI – the high SMI group (SMI ≥7.0 kg/m2 in men and SMI ≥5.7 kg/m2 in women) and the low SMI group (SMI <7.0 kg/m2 in men and SMI <5.7 kg/m2 in women); we then evaluated the association between SMI and the CRWAI score.Results: Of the 319 recruited patients, 84 (26%) were in the high SMI group. The medians and interquartile ranges of the CRWAI scores in the high SMI and low SMI groups were 38.6 (23.1–61) and 31.8 (10.1–57.5), respectively (P=0.029). A high SMI was independently and negatively associated with the CRWAI score (β=− 0.16, P=0.014).Conclusions: Our study showed that a high SMI was an independent factor negatively influencing the CRWAI score in older patients in a convalescent rehabilitation ward.

著者

Masahiko Hara Tetsuhisa Kitamura Yuichiro Murakawa Kyosuke Shimba Shimpei Yamaguchi Masatake Tamaki

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.3, pp.20180016, 2018 (Released:2018-10-24)

参考文献数

27

被引用文献数

12

---

Objective: The ability to walk is one of the most important basic functional activities of daily living, and the number of patients with walking disability who need rehabilitation is increasing worldwide. The purpose of this first-in-man study was to evaluate the safety and feasibility of an off-label, tailor-made, dual-task rehabilitation program for body trunk balance using the mediVR01 system (mediVR, Inc. Osaka, Japan), which incorporates virtual reality (VR) and three-dimensional tracking technologies. Methods: We prospectively enrolled 31 healthy volunteers to take part in the trial (Trial Registration UMIN000029659). After an assessment of body trunk balance, a tailor-made, dual-task, rehabilitation training program lasting 10–15 min was provided. The primary endpoint was the postprocedural number of simulator sickness questionnaire (SSQ) symptoms. The secondary endpoints were adverse events and satisfaction with the program. Results: The median age of participants was 68 years, with 67.7% being elderly (>65 years) and 54.8% being male. The number of SSQ symptoms immediately after the rehabilitation programs significantly increased from 0 (interquartile range 0–0) to 0 (0–1.5) (P=0.009), with a significant difference between the young and elderly participants (P-interaction<0.001). The most frequent symptom was sweating (22.6%), followed by fatigue (19.4%). All participants successfully completed the rehabilitation programs without significant adverse events such as fall or injuries. Moreover, all participants considered the VR rehabilitation programs to be enjoyable, and 93.5% of participants reported a sense of achievement. Group attendance was associated with higher levels of satisfaction (P=0.049). Conclusion: The tailor-made, dual-task rehabilitation training programs for body trunk balance using VR and three-dimensional tracking technologies were safe and feasible even for elderly participants.

著者

Midori Mochizuki Yuki Uchiyama Kazuhisa Domen Tetsuo Koyama

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.20230041, 2023 (Released:2023-11-22)

参考文献数

34

被引用文献数

1

---

Background: Aphasia is a common disorder among stroke patients. Assessment of aphasia is essential for scheduling appropriate rehabilitative treatment. Although this is conventionally accomplished using neuropsychological test batteries, these tests are not always accessible because of attention and/or consciousness disturbances during acute care. To overcome this issue, we have introduced a newly developed automated tractography known as XTRACT.Cases: Diffusion-tensor images were acquired from three patients on days 10–14. Brain images were processed by XTRACT, which automatically extracts neural tracts using standardized protocols. Fractional anisotropy (FA) values were then bilaterally evaluated in the following neural tracts associated with aphasia: arcuate fasciculus, inferior fronto-occipital fasciculus, middle longitudinal fasciculus, inferior longitudinal fasciculus, and uncinate fasciculus. Case 1 had word-finding difficulty on admission. FA values in the lesioned left hemisphere were not decreased in all tracts and this patient fully recovered during acute care. Case 2 had reduced spontaneous speech and a low FA value in the left arcuate fasciculus. Rehabilitative treatment was scheduled to improve the verbal output of sentences and word recall. Case 3 could not complete the conventional aphasia test battery because of attention disturbance. He had low FA values in all tracts in the left hemisphere. Rehabilitative treatment was designed to focus on both speaking and auditory comprehension.Discussion: Automated tractography enables quantitative assessment of the neural damage associated with aphasia, even in patients with attention and/or consciousness disturbances. This modality can aid in the assessment of aphasia and allows the planning of appropriate rehabilitative treatment.

著者

Takaaki Ikeda Tomoto Suzuki Michiaki Takagi Masayasu Murakami

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.20210049, 2021 (Released:2021-12-09)

参考文献数

36

被引用文献数

3

---

Objectives : Vertebral compression fractures are common among older people. Currently, knowledge of the effects of early rehabilitation treatment on the recovery of activities of daily living (ADL) in older patients who receive conservative treatment for these fractures is limited. Using the instrumental variable (IV) method, we examined the effects on ADL at discharge of a delay in initiating rehabilitation treatment.Methods: In this retrospective cohort study, data from the Japanese Diagnosis Procedure Combination database were analyzed. The subjects were patients with vertebral compression fracture who had undergone rehabilitation treatment during their hospitalization between 2014 and 2019 in one of the 29 acute-care hospitals in Yamagata Prefecture. We analyzed data from 1706 patients (mean age, 82.1 years). The independent variable was the number of days between hospital admission and the start of rehabilitation treatment, and the outcome was the Barthel index (BI) score at discharge. An IV method was applied, with adjustments for covariates, including demographics and functional status at admission.Results: Most patients started rehabilitation treatment within 3 days of hospital admission. Our IV method showed that the interval between hospital admission and the start of rehabilitation treatment was significantly associated with the BI score at discharge. The coefficient was −2.71 (95% confidence interval [CI]: −5.06 to −0.35).Conclusions: A delay in initiating rehabilitation treatment had a negative effect on ADL at discharge. This result emphasizes the importance of including early rehabilitation treatment in acute care, as recommended by several existing guidelines for the treatment of orthopedic diseases.

著者

Sumiya Shibata Satoko Koganemaru Tatsuya Mima

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.20230015, 2023 (Released:2023-05-25)

参考文献数

50

---

Objectives: This study aimed to update the current knowledge on non-invasive brain stimulation (NIBS) effects, such as repetitive transcranial brain stimulation and transcranial direct current stimulation, in patients with post-stroke dysphagia (PSD).Methods: We summarized the basic principles and therapeutic strategies of NIBS. We then reviewed nine meta-analyses from 2022 that investigated the efficacy of NIBS in PSD rehabilitation.Results: Although dysphagia is a common and devastating sequela of stroke, the efficacy of conventional swallowing therapies remains controversial. NIBS techniques have been proposed as promising approaches for managing PSD via neuromodulation. Recent meta-analyses have shown that NIBS techniques are beneficial for the recovery of patients with PSD.Conclusions: NIBS has the potential to become a novel alternative treatment for PSD rehabilitation.

著者

Toshifumi Chino Shoji Kinoshita Masahiro Abo

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.20230005, 2023 (Released:2023-03-01)

参考文献数

83

被引用文献数

2

---

Recent technological advances in non-invasive brain stimulation (NIBS) have led to the development of therapies for post-stroke upper extremity paralysis. Repetitive transcranial magnetic stimulation (rTMS), a NIBS technique, controls regional activity by non-invasively stimulating selected areas of the cerebral cortex. The therapeutic principle by which rTMS is thought to work is the correction of interhemispheric inhibition imbalances. The guidelines for rTMS for post-stroke upper limb paralysis have graded it as a highly effective treatment, and, based on functional brain imaging and neurophysiological testing, it has been shown to result in progress toward normalization. Our research group has published many reports showing improvement in upper limb function after administration of the NovEl Intervention Using Repetitive TMS and intensive one-to-one therapy (NEURO), demonstrating its safety and efficacy. Based on the findings to date, rTMS should be considered as a treatment strategy based on a functional assessment of the severity of upper extremity paralysis (Fugl-Meyer Assessment), and NEURO should be combined with pharmacotherapy, botulinum treatment, and extracorporeal shockwave therapy to maximize therapeutic effects. In the future, it will be important to establish tailormade treatments in which stimulation frequency and sites are adjusted according to the pathological conditions of interhemispheric imbalance, as revealed by functional brain imaging.

著者

Koichiro Sota Yuki Uchiyama Katsuji Kaida Tatsushi Wakasugi Daiki Takemura Naoki Sasanuma Kazuhiro Ikegame Kazuhisa Domen

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.20230003, 2023 (Released:2023-02-08)

参考文献数

47

---

Objectives: This study compared the balance function in patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT) with their balance function after subsequent training sessions with a Balance Exercise Assist Robot (BEAR).Methods: In this prospective observational study, inpatients who underwent allo-HSCT from human leukocyte antigen-mismatched relatives were enrolled from December 2015 to October 2017. Patients were allowed to leave their clean room after allo-HSCT and underwent balance exercise training using the BEAR. Sessions (20–40 min) were performed 5 days per week and consisted of three games that were performed four times each. A total of 15 sessions were performed by each patient. Patient balance function was assessed before BEAR therapy according to the mini-balance evaluation systems test (mini-BESTest), and patients were divided into two groups (Low and High) based on a 70% cut-off value for the total mini-BESTest score. Patient balance was also assessed after BEAR therapy.Results: Fourteen patients providing written informed consent fulfilled the protocol: six patients in the Low group, and eight patients in the High group. In the Low group, there was a statistically significant difference between pre- and post-evaluations in postural response, which a sub-item of the mini-BESTest. In the High group, there was no significant difference between pre- and post-evaluations in the mini-BESTest.Conclusions: BEAR sessions improve balance function in patients undergoing allo-HSCT.

著者

Yuki Kato Shinsuke Hori Ryo Momosaki

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.20220041, 2022 (Released:2022-08-20)

参考文献数

23

被引用文献数

2

---

Objectives: This study reviewed the effect of vocal exercise on patients with cervical spinal cord injury (SCI).Methods: An electronic search of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase databases was conducted for relevant studies published between 1980 and 2022. The review included studies that used randomized controlled trials to examine the effects of vocal exercise on people with cervical SCI.Results: We screened 1351 articles, of which 4 studies were eligible for inclusion. Vocal exercises were conducted two or three times a week for 12–24 weeks. Random sequences were adequately generated in all studies. All studies used respiratory function as the main outcome, and three studies used vocal quality as an outcome. In all studies, there were no dropouts other than those caused by unexpected illness. Vocal exercises were reported to have a positive effect on respiratory function in all studies and on voice quality in three studies. Meta-analysis was not possible because of the heterogeneity of the studies.Conclusions: Vocal exercise for SCI is a sustainable method that does not require special equipment or skills. More studies with large sample sizes are needed to confirm the effects of vocal exercises in patients with cervical SCI.

著者

Yuki Kawami Yasutaka Nikaido Shoma Nose Maya Unekawa Kohei Marumoto Mika Kawami So Matsugashita Tsuyoshi Kozuki Toshihiro Akisue

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.20220048, 2022 (Released:2022-09-09)

参考文献数

28

---

Objectives: Balance in the mediolateral direction is usually maintained in patients with early-stage Parkinson’s disease (PD), but not in moderate-stage PD as revealed by the Tandem Gait Test. Although mediolateral postural control in PD patients remains controversial, previous studies have shown that the Tandem Gait Test may predict the risk of future falls in patients with PD. This study aimed to clarify postural control differences among PD patients with and without mediolateral balance impairments (MLBI: mediolateral balance impairments, nMLBI: non-mediolateral balance impairments, respectively) and healthy controls (HCs).Methods: We recruited 40 PD patients and 20 HCs. According to the Tandem Gait Test score, PD patients were divided into MLBI and nMLBI groups. Primary outcome measures were the ambulatory movement trajectory amplitude of the center of mass and its coefficient of variation (CV) during gait.Results: Mediolateral movement trajectory amplitudes and CV were not significantly different between the nMLBI group and HCs, whereas the mediolateral movement trajectory amplitude in the MLBI group was significantly higher than that in the nMLBI group. Moreover, the CV of the mediolateral movement trajectory amplitude in the MLBI group was significantly lower than that in the nMLBI group. The mediolateral movement trajectory amplitude was significantly correlated with the fall score.Conclusions: The current results suggest that PD patients with mediolateral balance impairments showed mediolateral postural sway during gait compared with PD patients without mediolateral balance impairments. It is necessary to focus on the instabilities in the mediolateral direction to avoid falls in PD patients.