著者

Koji Takamoto Yutaka Morizaki Akira Fukuda Takashi Ohe

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.20230030, 2023 (Released:2023-09-21)

参考文献数

33

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Objective: The aim of this study was to investigate the impact of untreated hand diseases on hand grip strength, a value that is commonly used as a diagnostic parameter for sarcopenia and frailty in geriatric populations. We hypothesized that individuals with untreated hand diseases would have lower grip strength than those without hand diseases.Methods: A total of 240 individuals aged at least 65 years were recruited and divided into two groups based on the presence or absence of typical hand diseases. Grip strength was compared between the two groups separately for men and women using a t-test, with each group consisting of 60 women or 60 men.Results: Both women and men in the hand disease group exhibited significantly lower grip strength than those in the control group.Conclusions: These findings suggest that untreated hand diseases have a negative impact on grip strength, and this may introduce bias in the screening or diagnosis of sarcopenia and frailty. It is essential to consider the presence of hand diseases when measuring hand grip strength in older adults.

著者

Takaaki Fujita Ryuichi Kasahara Megumi Kurita Ryohei Jinbo Yuichi Yamamoto Yoko Ohira Koji Otsuki Kazuaki Iokawa

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.20230028, 2023 (Released:2023-09-16)

参考文献数

39

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Objectives: Little attention has been paid to the relationship between balance function and bathing independence. This research aimed to determine the degree of balance function needed by patients with stroke and patients with hip fracture (hereinafter referred to as patients with stroke and hip fracture) to bathe independently.Methods: Retrospective data analysis was performed on 59 patients with hip fracture and 201 patients with stroke. Logistic regression was performed to determine whether bathing independence was associated with the Berg Balance Scale (BBS) in patients with stroke and hip fracture. A receiver operating characteristic curve was generated to calculate cutoff values.Results: The BBS was significantly associated with bathing independence in patients with stroke and hip fracture. The calculated BBS cutoff value was 48 points for those with stroke (sensitivity, 84.7%; specificity, 79.1%) and 43 points for those with hip fracture (sensitivity, 81.3%; specificity, 77.8%).Conclusions: Balance function was independently associated with bathing independence. The level of balance function required for bathing independence may be lower for patients with hip fracture than for those with stroke. This could be a simple and useful indicator for rehabilitation professionals to interpret BBS results when conducting bathing interventions.

著者

Mitsuhiko Ikebuchi Yoichi Ohta Yukihide Minoda Akiko Toki Tamotsu Nakatsuchi Hidetomi Terai Hiroaki Nakamura Ryoichi Kato Sigeyoshi Nakajima

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.20230027, 2023 (Released:2023-09-13)

参考文献数

21

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Objectives: Patients with severe coronavirus disease 2019 (COVID-19) who develop pneumonia face the risk of ventilatory muscle disuse in the acute phase, which can result in persistent respiratory impairments in the subacute phase. Although rehabilitation during the acute phase is considered effective, there are limited reports on this topic. Therefore, this study aimed to investigate the effectiveness of acute-phase rehabilitation in patients with severe COVID-19.Methods: The study included 57 patients (45 men and 12 women; mean age: 63.2±12.1 years) admitted between April and June 2021, all of whom required intubation for respiratory management. Among them, 34 patients underwent acute-phase rehabilitation interventions based on the early goal-directed mobilization protocol. The primary objectives were to assess the occurrence of medical accidents related to acute-phase rehabilitation and evaluate their impact on survival and mobility upon hospital discharge. Statistical techniques and machine learning algorithms were employed for data analysis.Results: Remarkably, no medical accidents occurred during the acute-phase rehabilitation among the patients. Furthermore, our findings indicated that acute-phase rehabilitation did not influence survival outcomes. However, it did have a positive impact on the mobility of patients upon hospital discharge.Conclusions: Acute-phase rehabilitation can be safely administered to patients with severe COVID-19 by following an early goal-directed mobilization protocol. This approach may also contribute to improved activities of daily living after discharge.

著者

Yuka Kurihara Kozo Hanayama Toshiaki Furukawa Yoshihisa Masakado Minoru Toyokura

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.20230025, 2023 (Released:2023-08-24)

参考文献数

23

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Objectives: This study explored the relationship between clinical severity of ulnar neuropathy at the elbow (UNE) and ulnar nerve cross-sectional area (CSA) by ultrasound examination to identify appropriate measurement sites for UNE diagnosis and evaluation.Methods: In this retrospective analysis, we examined the arms of 37 patients diagnosed with UNE and those of 34 individuals as controls. The ulnar nerve CSAs were measured at 2 cm distal to the tip of the medial epicondyle (dME), the tip of the medial epicondyle (ME), 2 cm proximal to the tip of the medial epicondyle (pME), and any site showing the maximum CSA between the dME and pME (largest dpME). The modified McGowan classification (grades I, IIA, IIB, and III) was used to rate the clinical severity of UNE.Results: For all sites, the CSAs were significantly correlated with clinical severity. The sites showing the maximum CSA were inconsistent between controls and grade IIA patients. Grade IIB patients showed the largest CSA at the ME in the majority of patients. In grade III patients, maximum CSA occurred only at the ME.Conclusions: Serial assessment to detect nerve enlargement at multiple sites was beneficial for mild UNE patients with weakness of the ulnar distal muscles with Medical Research Council (MRC) score of 4 or higher (grade IIA). For severe UNE patients with weakness of the ulnar distal muscles classified as MRC3 or less (grades IIB, III), the most efficient method for detecting enlarged nerves was to initially measure the CSA at the ME.

著者

Takayuki Kamimoto Yuichiro Hosoi Kenya Tanamachi Rieko Yamamoto Yuka Yamada Tatsuya Teramae Tomoyuki Noda Fuminari Kaneko Tetsuya Tsuji Michiyuki Kawakami

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.20230024, 2023 (Released:2023-08-17)

参考文献数

44

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Background : Walking disability caused by central nervous system injury often lingers. In the chronic phase, there is great need to improve walking speed and gait, even for patients who walk independently. Robot-assisted gait training (RAGT) has been widely used, but few studies have focused on improving gait patterns, and its effectiveness for motor function has been limited. This report describes the combination of “RAGT to learn the gait pattern” and “ankle robot training to improve motor function” in a patient with chronic stage brain injury.Case : A 34-year-old woman suffered a traumatic brain injury 5 years ago. She had residual right hemiplegia [Fugl-Meyer Assessment-Lower Extremity (FMA-LE): 18 points] and mild sensory impairment, but she walked independently with a short leg brace and a cane. Her comfortable gait speed was 0.57 m/s without an orthosis, and her 6-m walk test distance was 240 m. The Gait Assessment and Intervention Tool (G.A.I.T.) score was 35 points. After hospitalization, ankle robot training was performed daily, with RAGT performed 10 times in total. Post-intervention evaluation performed on Day 28 showed: FMA-LE, 23 points; comfortable walking speed, 0.69 m/s; G.A.I.T., 27 points; and three-dimensional motion analysis showed ankle dorsiflexion improved from 3.22° to 12.59° and knee flexion improved from 1.75° to 16.54° in the swing phase.Discussion : This is one of few studies to have examined the combination of two robots. Combining the features of each robot improved the gait pattern and motor function, even in the chronic phase.

著者

近藤 克則 太田 正

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.34, no.2, pp.129-133, 1997-02-18 (Released:2009-10-28)

参考文献数

18

被引用文献数

14 4

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発症後第14病日以内(中央値第1.5病日)に入院した初発脳卒中患者20人の下肢筋断面積をCTを用いて経時的に計測した.(1)「全介助群」で入院2週後の両側大腿,下腿筋断面積は,入院時の79~86%(両側大腿,下腿各々の平均80%,84%)と有意に減少し,4週時に69~79%,8週時に62~72%まで萎縮した.(2)「早期歩行自立群」では,2週時で96~100%と断面積を維持していた.(3)両群の「中間群」では,2週時に89~95%と有意に減少したが,8週時には入院時の94~99%(入院時と有意差なし)まで回復した.早期リハビリテーション患者でも廃用性筋萎縮は見られ,麻痺側でも十分な訓練により筋肥大をきたすが,回復には歩行訓練開始までの期間の3倍以上の長期間かかることが示唆された.

著者

Makoto Ueno Seiji Miura Rintaro Ohama Megumi Shimodozono

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.20230019, 2023 (Released:2023-06-29)

参考文献数

26

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Background: Carnitine is a vital human nutrient. Although there are many reports on carnitine deficiency, most studies have been conducted on children, patients with severe mental and physical disabilities, epileptic patients, patients with liver cirrhosis, and dialysis patients. To the best of our knowledge, there are no reports on carnitine administration for disorders of consciousness after stroke. We report two such cases in which carnitine administration improved disorders of consciousness.Cases: Case 1 was a woman in her sixties who was admitted to our rehabilitation center 4 months after the onset of subarachnoid hemorrhage. After admission, her disorders of consciousness worsened even though she was actively undergoing rehabilitation. Suspecting carnitine deficiency, we administered 1500 mg/day of L-carnitine, which resulted in improvement of her disorders of consciousness and disappearance of symptoms such as convulsions. Case 2 was a man in his thirties who was admitted to our rehabilitation center 5 months after the onset of cerebral hemorrhage. During active rehabilitation, he suffered worsening disorders of consciousness, convulsions, and cramps. We found carnitine deficiency with a blood carnitine concentration of 21 mg/dL, so we administered 1500 mg/day of L-carnitine; symptoms of disorders of consciousness and convulsions then improved.Discussion: It is possible that carnitine deficiency has been overlooked in some patients in rehabilitation wards, and measurement of ammonia might facilitate its detection. Because carnitine deficiency can interfere with active rehabilitation, nutritional management with attention to carnitine deficiency could be important during rehabilitation.

著者

大熊 るり 植松 海雲 藤島 一郎 向井 愛子

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.4, pp.180-185, 2002-04-18 (Released:2009-10-28)

参考文献数

18

被引用文献数

5 2

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上部消化管造影検査施行中に発生したバリウム誤嚥について調査を行い,誤嚥への対策について検討した.7年半の間に検査を受けた262,888名を対象に,誤嚥発生率の推移や誤嚥が確認された118名のプロフィール等につき調査した.誤嚥者の年齢は30~94(平均65)歳.70歳以上では誤嚥発生率が70歳未満の約10倍となっており,高齢受診者への配慮が必要と思われた.また誤嚥発生率が平成11年度から12年度にかけて上昇しており,これは検査に使用するバリウム製剤の粘性が低下した時期と一致していた.誤嚥対策として,検査前に嚥下障害に関するスクリーニングを行うこと,使用するバリウム製剤の粘性を検討すること等が考えられた.

著者

Kyohei Ichikawa Takashi Baba Hiroka Ogata Kana Fujita Kei Minemura Taichi Hoshino Erina Fujimoto Hidekazu Katori Shiori Otake Taku Numao Kazu Amimoto

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.20230009, 2023 (Released:2023-03-21)

参考文献数

31

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Objectives: This study aimed to clarify the effect of an intervention using a head-mounted display with a web camera set at a modified pitch angle on spatial awareness, sit-to-stand movement, and standing balance in patients with left and right hemisphere damage.Methods: The participants were 12 patients with right hemisphere damage and 12 patients with left hemisphere damage. The line bisection test, a sit-to-stand movement, and balance assessment were performed before and after the intervention. The intervention task involved pointing at targets 48 times in an upward bias condition.Results: Significant upward deviation on the line bisection test was noted in patients with right hemisphere damage. The load on the forefoot during the sit-to-stand movement was significantly increased. The range of anterior–posterior sway during forward movement in the balance assessment was reduced.Conclusions: An adaptation task performed in an upward bias condition may produce an immediate effect on upward localization, sit-to-stand movement, and balance performance in patients with right hemisphere stroke.

著者

Keiichi Osaki Shinichiro Morishita Tetsuhiro Shimokawa Akiho Kamimura Takashi Sekiyama Chisaki Kanehiro Atsushi Shindo Kensuke Shiga Eri Kawata

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.20230007, 2023 (Released:2023-03-11)

参考文献数

20

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Background: This case report describes the successful management of rehabilitation therapy for a hematological malignancy patient who was receiving chemotherapy and had coronavirus disease 2019 (COVID-19).Case: A 76-year-old man receiving chemotherapy for relapsed refractory multiple myeloma (MM) presented to our hospital with fever and dyspnea and was hospitalized with a diagnosis of COVID-19. Physical therapy (20 min/day, 5 days/week) was started on day 6 of hospitalization while the patient was receiving oxygen therapy. Conditioning exercises and movement exercises were performed in an isolation room, and blood counts, fracture susceptibility, and respiratory status were monitored. The patient was severely immunocompromised and required 34 days of isolation due to persistent severe acute respiratory syndrome coronavirus 2 virus (SARS-CoV-2) infection. Physical function was assessed by manual muscle testing of the lower extremities and by the extent of lower extremity fatigue and dyspnea on exertion, as assessed using the Borg scale. Motor capacity was assessed using the de Morton Mobility Index (DEMMI) score and the Barthel Index (BI). Muscle weakness and severe dyspnea developed 4 days after physical therapy was started. However, physical therapy led to improvements in DEMMI score and BI. The patient was discharged home on day 43 with home medical care.Discussion: Careful management of MM and COVID-19 facilitated safe treatment with physical therapy. The patient’s physical function improved with a carefully planned physical therapy program. Moreover, the patient required prolonged isolation due to persistent viral shedding; however, as a result of the treatment, which was coordinated between physicians and nurses, the patient could be discharged home.

著者

三村 將 坂村 雄

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.5, pp.314-322, 2003-05-18 (Released:2009-10-28)

参考文献数

34

被引用文献数

3 1

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Baddeley and Hitch proposed a fundamental framework for working memory in 1974, emphasizing its transiently activated memory aspect for performing various cognitive tasks. This concept of working memory is quite useful in understanding human cognitive processes and has been widely used in the fields of cognitive and developmental psychology and neuropsychology. The idea of working memory has also been introduced to consider cognitive rehabilitation for patients with brain damage. In the present review, we first described a current theoretical framework of working memory and then reported on recent studies on the conceptualization of working memory. We subsequently reviewed neural substrates of working memory subsystems, i. e., the phonological loop, the visuospatial sketch pad and the central executive. We further referred to the contribution of working memory in understanding various language-related symptoms in patients with aphasia, one of the major targets in the field of cognitive rehabilitation. Working memory plays a crucial role in the everyday life of brain damaged patients. Future research is warranted to focus on the improvement of deficient working memory in order to ameliorate clinical problems of brain damaged patients.

著者

竹迫 賢一 川平 和美 日吉 俊紀 川津 学 上土橋 浩 東郷 伸一 田中 信行

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.31, no.3, pp.173-177, 1994-03-18 (Released:2009-10-28)

参考文献数

13

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脳卒中患者の感情失禁に対する新しい治療法として感情失禁を有する脳卒中患者23例に種々のβ-遮断薬を試み,著明改善26.1%,改善26.1%,やや改善13.0%(なんらかの改善65.2%)が得られた.その効果は性,年齢,病巣部位による差はなかった.血液脳関門通過性やβ1,2-受容体選択性の異なるプロプラノロールとアテノロールは同程度の効果を示し,ラベタロール,メトプロロールでも各1例の改善がみられたことから,その効果はβ1-作動系の遮断を介するもので,血液脳関門の破綻も推測された.またβ-遮断薬で改善を認めた6例で薬剤を中止したところ,5例はほぼ1週間以内に感情失禁の悪化を認めた.以上の結果から,β-遮断薬は感情失禁に対し明らかに有用な薬剤と思われた.

著者

Shuntaro Tamura Kazuhiro Miyata Sota Kobayashi Ren Takeda Hiroki Iwamoto

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.20220043, 2022 (Released:2022-08-27)

参考文献数

30

被引用文献数

3

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Objectives: The aim of the current study was to identify a cut-off value for predicting walking independence at discharge in older adults with hip fracture based on their Berg Balance Scale (BBS) score at admission to a convalescent rehabilitation ward.Methods: This was a retrospective, multicenter, observational study of 187 older adults with hip fractures (mean age 83.7, range 66–97 years). Data was collected on the patients’ age, sex, treatment, and physical function evaluation. An ordinal logistic regression analysis was used to identify predictors associated with the degree of independence in walking at discharge. Receiver operating characteristic curves were used to estimate cut-off values to predict independent and supervised walking at discharge based on the BBS score at admission. The accuracy of the classification was assessed using the area under the curve (AUC).Results: The BBS score at admission was a significant factor predicting the degree of walking independence at discharge (odds ratio = 1.09, 95%CI: 1.06–1.11). The cut-off values of the BBS score at admission for predicting independent walking and supervised walking at discharge were 28 points (AUC = 0.76, 95%CI: 0.69–0.83) and 21 points (AUC = 0.84, 95%CI: 0.77–0.91), respectively.Conclusions: The BBS scores of older adults with hip fracture on admission to a rehabilitation ward are useful for predicting the degree of independence in walking at discharge and can help to structure therapy according to the predicted degree of independence.

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.2, pp.91-97, 2000-02-18 (Released:2009-10-28)

著者

Natsuko Kanazawa Norihiko Inoue Takuaki Tani Koichi Naito Hiromasa Horiguchi Kiyohide Fushimi

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.20220031, 2022 (Released:2022-06-24)

参考文献数

36

被引用文献数

1

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Objectives: This study investigated the impact of the initial outbreak of coronavirus disease (COVID-19) on rehabilitation and functional outcomes of patients in Japanese hospitals.Methods: The study subjects were hospitals belonging to Japan’s National Hospital Organization that provided inpatient care for patients with coronavirus COVID-19 during March–May 2020. We specifically focused on patients who were hospitalized for acute diseases, such as stroke, hip fracture, acute myocardial infarction, congestive heart failure, or chronic obstructive pulmonary disease, and received rehabilitation during hospitalization. Data were sourced from Japanese administrative data. The primary outcome was rehabilitation provision time in the target hospitals. The secondary outcomes were patient outcomes: rehabilitation participation time, length of hospital stay, 30-day readmission rate, and improvement of activities of daily living. Interrupted time series analysis was performed to evaluate the trend of rehabilitation provision time. Patient outcomes were compared with those for 2019.Results: The rehabilitation provision time for outpatients declined by 62% during the pandemic, while that for inpatients declined temporarily, and then increased. Compared with 2019 outcomes, rehabilitation participation time was longer and hospital stay length was shorter for stroke and hip-fracture patients, the 30-day readmission rate was increased for hip-fracture patients, and improvement of activities in daily living was less for patients with congestive heart failure who were totally dependent at admission. Other outcomes did not change.Conclusions: The findings suggest that during the initial COVID-19 pandemic, resources for rehabilitation were quickly reallocated to inpatient care, and the impact on inpatient outcomes was minimized.

著者

蜂須賀 研二

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.10, pp.642-647, 2002-10-18 (Released:2009-10-28)

参考文献数

30

被引用文献数

7 5

著者

Tomoko Sakai Chisato Hoshino Megumi Nakano Yu Fujiwara Atsushi Okawa

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.20220015, 2022 (Released:2022-03-31)

参考文献数

20

被引用文献数

2

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Objectives: This study aimed to describe the rehabilitation characteristics of patients with acute stage coronavirus disease managed with extracorporeal membrane oxygenation (ECMO) in the intensive care unit.Methods: This retrospective study enrolled coronavirus disease patients who underwent rehabilitation following ECMO between April 21, 2020, and August 20, 2021. The following patient data were evaluated: age, sex, weaning, peak C-reactive protein, lowest albumin level, white blood cell count, use of steroids and muscle relaxants, duration of respiratory management, ECMO management and rehabilitation, Medical Research Council (MRC) score, and Barthel index after sedation and at discharge.Results: ECMO was performed in 20 patients, and 16 were weaned successfully. The median durations of ECMO and respiratory management in survivors were 14.5 and 38 days, respectively. The median MRC scores after sedation and after rehabilitation therapy were 18 and 45, respectively. The median rehabilitation duration after sedation was 14 days. The MRC score after sedation showed significant correlations with the durations of ECMO and intubation. The median Barthel index values after sedation and at discharge were 0 and 30, respectively.Conclusions: Rehabilitation was important for patients with severe coronavirus disease because muscle weakness advanced in proportion with the durations of ECMO and ventilation management in the intensive care unit.

著者

福田 文雄 植田 尊善

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.38, no.1, pp.29-33, 2001-01-18 (Released:2009-10-28)

参考文献数

10

被引用文献数

11 6

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頸髄損傷の評価法として,我々は当センターで考案した独自の評価法を用いている.横位評価として改良Frankel分類を,高位評価として頸髄損傷高位判定評価法を用い,受傷後7日以内に入院し6ヵ月以上経過観察できた294例を対象に,その神経回復を解析し麻痺の予後予測を試みた.改良Frankel B1,B2,B3からD以上への回復は,それぞれ20,32,80%となり,B3はB1,B2に比して有意な差を認めた.同様に改良Frankel C1,C2からD以上への回復は61%と97%であり有意な差がみられた.Frankel分類を細分化することにより,四肢麻痺の機能障害を一層明瞭に評価できるだけでなく,急性期頸髄損傷の神経学的回復において予後予測として有用である.

著者

吉田 清和

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.9, pp.548-556, 2002-09-18 (Released:2009-10-28)

参考文献数

2

著者

笹沼 澄子 福迫 陽子

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.9, no.2, pp.79-89, 1972-04-18 (Released:2009-10-28)

参考文献数

7

被引用文献数

35 35

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The recovery processes of 72 out of the 269 aphasic patients studied in PART I were investigated longitudinally by means of following up the rate (and direction) of the change of each of the five factors obtained in PART I. Measurement was taken of the increase and decrease of the factor scores estimated for each patient at each of the successive re-testings. The length of the follow-up period ranged from one to 32 months after the initial evaluation.Each factor seemed to have its characteristic mode of change in time. Factor 1 (the general factor of language behavior) had a tendency to exhibit subnormal scores in the majority of subjects at the initial evaluation, but to show a greatest possibility of improvement for a longest period of time (1.5 years since onset). The rest of the factors tended to be more variable in the kinds of subjects exhibiting subnormal scores as well as in the rate and degree of improvement. The clinical types of aphasia appeared to serve as a crutial variable in predicting the overall patterns of improvement of the five factors in individual patients.The findings seemed to give a further support for the neuro-physiological interpretation of the five factors suggested in PART I. The necessity of increased specificity in our diagnostic and therapeutic procedures was emphasized, and the possible use of the factor analysis technique for this purpose was reiterated.