著者

Norikazu Hishikawa Shogo Toyama Koshiro Sawada Takashi Kawasaki Suzuyo Ohashi Kazuya Ikoma Daisaku Tokunaga Yasuo Mikami

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.20220047, 2022 (Released:2022-09-09)

参考文献数

44

被引用文献数

1

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Objectives: Patients with rheumatoid arthritis (RA)-related foot impairment have a high rate of sarcopenia. Treatment using a foot orthosis (FO) enables not only a reduction in pain while walking but also an increase in physical activity, helping to prevent further loss of muscle mass. However, the primary goal of treating RA is to maximize patients’ long-term quality of life (QOL). We investigated whether FO treatment both increases physical activity and improves QOL.Methods: Among 31 patients with RA-related foot impairment, 15 with sarcopenia were treated with an FO for 6 months. Foot-specific QOL (measuring using the Self-Administered Foot Evaluation Questionnaire), foot pain, activities of daily living, and physical activity (walking-intensity activity and moderate- to vigorous-intensity activity) were compared before treatment and after 6 months of treatment.Results: Ten patients who completed 6 months of follow-up were analyzed. Significant QOL improvements were found in the Pain and Pain-Related category and the Physical Functioning and Daily Living category (P = 0.02–0.04); however, no significant changes were found in the Social Functioning, General Health and Well-Being, or Shoe-Related categories (P = 0.09–0.21). Foot pain and activities of daily living significantly improved (P = 0.01–0.04). Physical activity significantly increased for walking-intensity activity (P = 0.04) but did not change for moderate- to vigorous-intensity activity (P = 1.00).Conclusions: FO treatment in patients with RA-related foot impairment and sarcopenia increased light-intensity physical activity such as walking and improved physical QOL.

著者

Yuta Minoshima Yukihide Nishimura Hiroyuki Tsuboi Hideyuki Sato Takahiro Ogawa Yoshi-ichiro Kamijo Yuichi Umezu Fumihiro Tajima

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.20220051, 2022 (Released:2022-09-17)

参考文献数

47

被引用文献数

1

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Objectives: With a relatively high percentage of type I fibers in the vastus medialis (VM), its fatigability may be more sensitive to the effects of muscle activity in the quadriceps. However, sex-related differences in the muscle fatigability of the VM remain unknown. The purpose of the present study was to assess the differences in fatigability of the VM between healthy adult men and women.Methods: Surface electromyographic (EMG) activities of VM oblique (VMO) and VM long (VML) were recorded during sustained isometric contraction on a leg press machine. The results of EMG power spectral analysis were compared between healthy adult men and women. The decline in the median frequency (MF), defined as MF slope, was calculated using spectrum analysis after fast Fourier transform of the raw EMG signals of VMO and VML.Results: The endurance time and the MF slopes of the VMO and VML were significantly longer and lower, respectively, in women than in men. The present results demonstrated that both VMO and VML are more fatigue-resistant in women than in men.Conclusions: Understanding the sex differences in fatigability could help to design more effective exercise regimens for VMO and VML in healthy individuals. A similar approach should be considered when prescribing practical exercise regimens for patients with muscle atrophy.

著者

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

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.7, pp.20220052, 2022 (Released:2022-09-24)

参考文献数

13

被引用文献数

1

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

著者

Ryozo Tanaka Yusuke Okita Takashi Nakamura Kennosuke Kawama

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.7, pp.20220053, 2022 (Released:2022-09-29)

参考文献数

26

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

著者

Kei Aoyama Kenjiro Kunieda Takashi Shigematsu Tomohisa Ohno Emiko Wada Ichiro Fujishima

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.7, pp.20220054, 2022 (Released:2022-10-08)

参考文献数

21

被引用文献数

1

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Objectives: We previously reported that swallowing in the bridge position (bridge swallowing) increased distal esophageal contractions and lower esophageal sphincter pressure against gravity. Moreover, bridge swallowing had the potential to strengthen esophageal peristalsis. In this study, we sought to evaluate whether the bridge swallowing exercise could improve gastroesophageal reflux disease (GERD) symptoms and gastroscopy findings.Methods: Seventeen subjects with scores of 8 points or higher on the Frequency Scale for Symptoms of GERD (FSSG) questionnaire participated in the study. The exercise of dry swallowing in the bridge posture lasted 4 weeks and was performed ten times per day. FSSG scores were compared before and after exercise. Three of the 17 participants underwent upper gastrointestinal endoscopy. The modified Los Angeles classification of reflux esophagitis was used for objective assessment before and after exercise.Results: No participants dropped out of this study. FSSG scores improved significantly after exercise (from median [range] 16 [13–21] points before exercise to 5 [4–10] points after exercise, P <0.001). Upper gastrointestinal endoscopy showed improvement in the modified Los Angeles classification grade in one participant.Conclusions: The bridge swallowing exercise significantly improves FSSG scores. This exercise can be performed easily and safely without adverse events. Further multicenter prospective studies are needed to validate that the bridge swallowing exercise is effective in improving GERD.

著者

Ena Sato Takehiko Yamaji Takahisa Sato Kosuke Saida Hideomi Watanabe

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.7, pp.20220055, 2022 (Released:2022-10-21)

参考文献数

26

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

著者

Naoki Sasa Shuji Matsumoto Go Kamata Takashi Hoei Yoichiro Aoyagi

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.7, pp.20220059, 2022 (Released:2022-11-18)

参考文献数

31

被引用文献数

1

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

著者

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

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.7, pp.20220061, 2022 (Released:2022-12-01)

参考文献数

31

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

著者

Ippei Kitade Akihiro Kawabata Yoshimasa Yonemura Ai Takahashi

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.7, pp.20220062, 2022 (Released:2022-12-11)

参考文献数

20

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

著者

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

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

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

参考文献数

19

被引用文献数

5

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

著者

小口 和代 才藤 栄一 水野 雅康 馬場 尊 奥井 美枝 鈴木 美保

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.37, no.6, pp.375-382, 2000-06-18 (Released:2009-10-28)

参考文献数

19

被引用文献数

67 117

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機能的嚥下障害スクリーニング法として,「反復唾液嚥下テスト」(the Repetitive Saliva Swallowing Test: RSST)を考案した.30秒間の平均空嚥下回数は若年者(N=30)で7.4回,高齢者(N=30)で5.9回,30秒間の平均人工唾液嚥下回数は若年者で7.7回,高齢者で6.2回であった.空嚥下,人工唾液嚥下ともに高齢者は若年者より有意に嚥下回数が少なかった.一方,若年者,高齢者それぞれの空嚥下と人工唾液嚥下の嚥下回数には有意差を認めなかった.嚥下運動の確認は喉頭挙上の触診で可能であった.高齢者の積算嚥下時間(検査開始から嚥下完了時点までの時間)上限より,RSST 2回/30秒間以下が嚥下障害のスクリーニング値として設定できた.

著者

Tomoko Sakai Chisato Hoshino Atsushi Okawa Kenji Wakabayashi Hidenobu Shigemitsu

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.5, pp.20200016, 2020 (Released:2020-07-29)

参考文献数

26

被引用文献数

2

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

著者

大高 洋平 里宇 明元 宇沢 充圭 千野 直一

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.40, no.6, pp.374-388, 2003-06-18 (Released:2009-10-28)

参考文献数

72

被引用文献数

9 8

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Fall prevention is one of the major issues in health care in our aging society. The aim of this review is to provide useful information for researchers and practitioners who plan to start fall prevention programs for elderly persons with various risk levels and in different settings. Fifty-three randomized controlled trials (RCTs) and several meta-analyses retrieved with extensive literature search formed the basis for this review. Available evidence suggests that several preventive strategies have been proven beneficial in fall prevention. For the community-dwelling elderly, two RCTs and one meta-analysis demonstrated that an individually tailored home exercise program provided by nurses or physical therapists could reduce the rate of falls and injuries. One RCT suggested that Tai Chi Chuan might have a high potential to reduce falls. Two large RCTs indicated that programs including group exercise classes could also reduce the number of fallers. For people with known risk factors living in the community, three RCTs showed that home visits to address multiple risk factor modification were an effective way to reduce falls. One RCT with a relatively small sample showed that psychotropic withdrawal reduced falls in elderly persons taking psychotropic medication. A subgroup analysis of one RCT showed that home hazard reduction at hospital discharge reduced subsequent falls in patients with a past history of falls. However, more evidence is needed to prove its effectiveness, because this effect was also observed outside of homes. Dual chamber pacemaker for elderly persons with hypersensitive carotid sinus, who were detected when investigated for undiagnosed falls, markedly reduced subsequent falls with or without syncope. In institutional settings, two RCTs showed that comprehensive risk assessment and modification reduced the rate of falls and fractures or the number of recurrent fallers. Three RCTs performed in hospital settings failed to show any effectiveness. However, a meta-analysis of 3 controlled trials and 7 cohort studies with a historical control suggested that fall prevention program in hospitals could be promising. There are some methodological problems in fall prevention research such as the definition, measures, and monitoring method of falls, inadequate sample size and a short follow-up period. In the future, we need research based on strong and comprehensive methodological designs.

著者

Hiroki Fujita Atsushi Teramoto Hiroyori Fusagawa Toshihiko Yamashita and Paulo Selber

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.8, pp.20230029, 2023 (Released:2023-09-20)

参考文献数

16

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

著者

Toru Yasuda Sirinda Jaotawipart Hironobu Kuruma

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.8, pp.20230022, 2023 (Released:2023-07-22)

参考文献数

33

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

著者

Kozo Hatori Yasuhiro Tagawa Taku Hatano Osamu Akiyama Nana Izawa Akihide Kondo Kazunori Sato Ayami Watanabe Nobutaka Hattori Toshiyuki Fujiwara

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.8, pp.20230014, 2023 (Released:2023-05-12)

参考文献数

19

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Background: Task-specific dystonia (TSD) confined to the lower extremities (LE) is relatively rare. This report describes dystonia confined to the LE only during forward walking. This case required careful neurological and diagnostic assessment because the patient was taking several neuropsychiatric drugs that cause symptomatic dystonia, such as aripiprazole (ARP).Case: A 53-year-old man visited our university hospital with a complaint of abnormalities in the LE that appeared only during walking. Neurological examinations other than walking were normal. Brain magnetic resonance imaging revealed meningioma in the right sphenoid ridge. The patient had been treated for depression with neuropsychiatric medications for a long time, and his abnormal gait appeared about 2 years after additional administration of ARP. After the meningioma was removed, his symptoms remained. Surface electromyography showed dystonia in both LE during forward walking, although his abnormal gait appeared to be accompanied by spasticity. The patient was tentatively diagnosed with tardive dystonia (TD). Although dystonia did not disappear clinically, it was alleviated after discontinuing ARP. Administration of trihexyphenidyl hydrochloride and concomitant rehabilitation improved his dystonia until return to work, but some residual gait abnormalities remained.Discussion: We report an unusual case of TD with task specificity confined to the LE. The TD was induced by the administration of ARP in combination with multiple psychotropic medications. Careful consideration was required for clinical diagnosis, rehabilitation, and assessment of its relevance to TSD.

著者

植松 海雲 猪飼 哲夫

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.39, no.7, pp.396-402, 2002-07-18 (Released:2009-10-28)

参考文献数

23

被引用文献数

28 19

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リハビリテーション専門病院に入院した高齢脳卒中患者374症例を対象に,自宅退院のための能力的・社会的因子条件について,classification and regression trees (CART)を用いて分析した.対象患者の自宅退院率は82.6%.単変量の解析では退院時家族構成人数,配偶者の同居の有無,functional independence measure (FIM)18項目各得点において転帰先間で有意差を認めた.CARTによる解析の結果,FIMトイレ移乗,家族構成人数からなる決定木が得られ,トイレ移乗が要介助でかつ家族構成人数が2人以下の場合は自宅退院が困難(自宅退院率21.7%)などのルールが得られた.CARTは,連続変数,カテゴリー変数のいずれをも扱うことが可能であり,結果は直感的に理解しやすく分類や予測などの研究に有効な手法と考えられた.

著者

Issei Miyagi Mizuho Ohta Makoto Tamari

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.8, pp.20230013, 2023 (Released:2023-04-21)

参考文献数

29

被引用文献数

2

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

著者

Mami Hirasaki Daisuke Takagi Yoshiko Umeda Motoki Moriwaki Norimasa Katagiri Akiko Nomoto Tomohisa Ohno Ichiro Fujishima

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.8, pp.20230006, 2023 (Released:2023-03-01)

参考文献数

20

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

著者

Tomohiro Oba Hiroaki Iwase Yoshitake Oshima Junya Miyazaki Kojiro Ishii

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

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

参考文献数

26

被引用文献数

1 1

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