著者

Hiroaki Teramatsu Junichiro Shiraishi Yasuyuki Matsushima Masaru Araki Tetsuya Okazaki Satoru Saeki

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.20190018, 2019 (Released:2019-10-19)

参考文献数

50

被引用文献数

7

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Objective: The aim of this study was to investigate which method of evaluating physical function could predict 1-year readmission due to worsening of heart failure (HF) in newly diagnosed HF patients. Methods: One hundred sixteen consecutive patients with HF who underwent cardiac rehabilitation at our hospital between May 2012 and September 2015 were retrospectively enrolled. Participants were divided into two groups based on whether they were readmitted for worsening HF within 1 year. Logistic regression analysis was used to evaluate whether physical function at the time of discharge was related to HF readmission within 1 year. Results: After a mean follow-up period of 327 days, 22 patients were readmitted because of worsening HF. In the readmission group, the results of the 6-Minute Walk Test (6MWT), One-Leg Standing Test, and 30-Second Chair-Stand Test at initial discharge were significantly worse than those in the non-readmission group. In a multivariable logistic regression model, after adjusting for age and sex, a lower 6MWT distance was independently associated with increased risk of readmission within 1 year (odds ratio: 0.990, 95% confidence interval: 0.985–0.996). The 6MWT showed better prognostic value (area under the receiver operating characteristic curve: 0.696) than other evaluation methods of physical function. The 1-year non-readmission rates were 90% for 6MWT ≥382.5 m, 68% for 6MWT <382.5 m, and 53% for those unable to walk 200 m independently (P <0.001). Conclusion: Physical function, particularly the 6MWT distance at time of discharge, can be used to predict the likelihood of readmission within 1 year for patients with HF.

著者

Takashi Ariie Masami Nakahara Masaharu Morita

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.20210005, 2021 (Released:2021-01-27)

参考文献数

24

被引用文献数

1

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Objectives : The aim of the study was to understand the physical therapist’s experience and perception of the support they give to their older patients or clients to continue exercising.Methods : Using purposive sampling, we recruited fifteen physical therapists with more than 5 years of clinical experience and conducted semi-structured interviews. We analyzed the transcribed data using thematic analysis.Results : Three main themes emerged: (1) the expected results as healthcare professionals, (2) clinical experience and continuing professional development, and (3) limited educational opportunities. Physical therapists struggled to achieve a certain level of exercise adherence in their patients, and the low success rate decreased their confidence. We found that physical therapists needed not only to rely on clinical experience but also to integrate scientific evidence to implement better behavioral change techniques; they would also appreciate receiving appropriate educational opportunities.Conclusions : This study revealed a possibility of educational insufficiency for physical therapist to support of behavior change to improve exercise adherence in the older population.

著者

村岡 慶裕 正門 由久 富田 豊 藤原 俊之

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.7, pp.453-458, 2000-07-18 (Released:2009-10-28)

参考文献数

11

被引用文献数

6 6

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治療的電気刺激(TES)の作用機序を解明する目的で,脳卒中患者15名の前脛骨筋にTESを行い,その前後で,ヒラメ筋H波と前脛骨筋H波を指標とし,前脛骨筋とヒラメ筋間の2シナプス性Ia相反抑制を観測した.前脛骨筋Ia線維からヒラメ筋へのIa相反抑制は15名中6名が有意に増加し,一方,ヒラメ筋Iaから前脛骨筋へのIa相反抑制は,前脛骨筋にH波の誘発可能であった3名全ての患者が有意に減少した.TESは,電気刺激した筋肉の抑制介在ニューロンからその拮抗筋の運動ニューロンと抑制介在ニューロンへのシナプスの伝達効率を増強させ,それが,主動筋の随意性の向上,拮抗筋の痙縮の抑制に関与している可能性が示唆された.

著者

原 行弘

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.1, pp.43-52, 2000-01-18 (Released:2009-10-28)

参考文献数

48

被引用文献数

1

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Several authors have reported that disuse might not be a major factor of muscle wasting in hemiplegic patients with stroke. A number of published investigations have shown that pathological spontaneous activity can occur in electromyographic studies in upper motor neuron lesions. There have been some reports that the decrease of hemiplegic side M-potential reflects the drop of motor unit numbers. Most of them have estimated that pathological spontaneous activity in hemiplegic muscles might due to transsynaptic degeneration. The submaximal stimuli can evoke a sample of motor unit action potentials of S-MUAPs in the F-response entirely representative of the relative numbers of surface detected S-MUAPs of different sizes. The motor unit number estimation (MUNE) was investigated among the bilateral abductor pollicis brevis (APB) muscles in seven healthy normal controls and fifteen stroke patients with moderate-to-severe hemiplegia. The needle EMG was examined in hemiplegic side APB. The average S-MUAP on each APB muscle was calculated from a selected population of F-wave responses. The MUNE was calculated by dividing the negative peak amplitude measured from the average S-MUAP waveform into corresponding values measured from a maximum M-potential. There was no statistically difference between the both sides motor units number among normal subjects and this MUNE method also revealed the good reproducibility in them. The needle EMG revealed the spontaneous activity in hemiplegic APB muscles at 3-4 months after the onset. The motor unit number on the hemiplegic side was significantly lower than on the unaffected side (p<0.05, Mann-Whitney test) among stroke patients. About one year later, most stroke patients revealed no spontaneous activity by needle EMG but the motor unit decrement in hemiplegic side was also recognized by the MUNE method among them. The motor unit could decrease in the moderate-to-severe hemiplegic muscle due to the trans-synaptic degeneration secondary to the upper motor neuron lesion. Some investigations, however, reported that there was no significant difference in morphometrical anterior horn cell number between the affected and unaffected sides in strokes. The transsectional areas of anterior horn cells associated with the hemispheric lesional side were reported to be significantly decreased compared with those of the unaffected sides in patients and normal subjects. The motor units may remain morphometrically unchanged in their number but the functional motor units number in the hemiplegic side might decrease because the loss of trophic effect from the upper motor neurons could alter the functional state of anterior horn cell in the affected side. The investigation and therapy for the muscle wasting should be proceeded more for the rehabilitation in upper motor neuron lesions.

著者

Ariie Takashi Iwasaki Daichi

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.20200005, 2020 (Released:2020-02-29)

参考文献数

48

被引用文献数

2

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Objectives: The purpose of this study was to evaluate the quality of reporting of systematic reviews published in Japanese in the field of physical therapy. Methods: The study design was a bibliometric analysis of systematic reviews. Two Japanese physical therapy journals (Physical Therapy Japan and Rigakuryoho Kagaku) were analysed using J-STAGE. The inclusion criterion was that articles were systematic reviews. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was used to score the reporting quality of eligible systematic reviews. The quality assessment was performed by two reviewers independently. Results: Of the 1578 articles identified, thirteen articles were included in this study. The median score of checklist items adequately adhered to across the included studies was 12 (range, 7–17). None of the studies adhered to the structured summary or additional analysis PRISMA items. The intention of bias assessment across studies was reported in only three studies (23%), and only two of these three reported the results. Conclusions: The reporting quality of systematic reviews published in Japanese physical therapy journals was suboptimal. Therefore, readers should critically appraise the contents of systematic reviews. It is recommended that journals should strictly require their authors to adhere to reporting guidelines.

著者

佐直 信彦 中村 隆一 細川 徹

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.28, no.7, pp.541-548, 1991-07-18 (Released:2009-10-28)

参考文献数

16

被引用文献数

21 9

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退院後1年以上経った歩行可能な在宅脳卒中患者54例を対象として,10m最大歩行速度(MWS)と75項目の日常生活活動遂行の関係を検討した.性別,年齢,麻痺側,罹病期間,家庭内地位,MWSを説明変数とし,各項目の遂行頻度を目的変数として,数量化I類を用いて分析した.MWSが第一義の決定因として選出された活動は27項目であった.身辺処理や新聞を読むなどの静的活動はMWSの速度とは無関係であった.20m/分以上で掃除,買物などの家事,趣味や旅行などの余暇活動,40m/分以上で政治,文化講演会参加,80m/分以上では老人などの世話を行っていた.MWSは在宅脳卒中患者の日常生活活動の予知に有用である.

著者

久保田 一雄 町田 泉 田村 耕成 倉林 均 白倉 卓夫

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.34, no.1, pp.40-45, 1997-01-18 (Released:2009-10-28)

参考文献数

23

被引用文献数

2

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平成2年6月からの5年間に46例のアトピー性皮膚炎患者(男性31例,女性15例,25±11歳)に対して,草津温泉療法(40~42℃,1回10分,1日1~2回)を3~28週行った.その泉質は酸性(pH2.0)-アルミニウム-硫酸塩・塩化物温泉である.32例(70%)で皮膚症状が改善し,さらにそのうち18例で掻痒も改善した.皮膚症状の改善は血清LDHの有意な低下でも裏付けられた.皮膚症状改善例のうち,温泉療法前に皮膚表面に多数の黄色ぶどう球菌が検出された15例では,温泉療法後に13例で消失,2例で減少した.この草津温泉療法による皮膚症状の改善機序として,皮膚病変の増悪因子である黄色ぶどう球菌に対する酸性温泉水の殺菌作用が推定される.

著者

矢形 幸久

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.35, no.8, pp.556-562, 1998-08-18 (Released:2009-10-28)

参考文献数

27

被引用文献数

5 3

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本研究は,内側広筋優位の強化を目的とした大腿四頭筋等尺性収縮訓練について調べたものである.5種類の大腿四頭筋等尺性収縮訓練について,健常者群15名(15肢),廃用性筋萎縮がある患者群11名(15肢)における内側広筋,外側広筋,大腿直筋の筋活動を表面筋電図積分波形の最大波高で評価した.その結果,従来的な開運動鎖での四頭筋セッティングに比べ,足部回外位の足底接地で股内転等尺性収縮と同期して行うセッティングにおいて,外側広筋に対する内側広筋の比(VM/VL)は高値を示した.膝伸展等尺性収縮訓練では,股内転等尺性収縮との共同運動を足部回外位の閉運動鎖で行うことにより,内側広筋の収縮が外側広筋より優位となる.

著者

Yukari Ogawa Futoshi Nibe Ryuichi Ogawa Masaharu Sakoh

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.20200010, 2020 (Released:2020-05-16)

参考文献数

39

被引用文献数

3

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Objectives: Medications with anticholinergic or sedative effects induce impaired cognitive and physical performances. The aim of this study was to evaluate the associations of anticholinergic and sedative drug burden with recovery of physical function and activities of daily living in patients admitted to a Japanese rehabilitation hospital after cerebrovascular accidents. Methods: We retrospectively reviewed the medical records of patients aged 18 years or older who had undergone the inpatient rehabilitation program for cerebrovascular disease in Nerima Ken-ikukai Hospital. Patients who did not complete the rehabilitation program because of acute unexpected changes of physical or psychological condition or the need for surgical procedures were excluded. The primary outcome was recovery of activities of daily living as measured by the motor and cognitive subscores of the Functional Independence Measure. The secondary outcome was recovery of physical function as assessed by the 10-m walk test and the Berg balance scale. Multiple Cox proportional hazard regression analyses were conducted to calculate hazard ratios with 95% confidence intervals for the outcome measures. Results: Of 122 patients included in the study, 81 (66%) were exposed to anticholinergics and sedatives. Patients’ age, body mass index, and average daily drug burden during hospitalization were independently associated with achieving the cutoff Functional Independence Measure–motor subscore. Patients’ age and average daily drug burden during hospitalization were independently associated with achieving the Berg balance scale cut-off score. Conclusions: Our study of Japanese patients who were transferred from acute stroke care hospitals to a rehabilitation facility identified the drug burden of anticholinergics and sedatives as an independent factor associated with the time to recovery of activities of daily living and postural balance.

著者

大川 弥生 上田 敏

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.25, no.5, pp.377-381, 1988-09-18 (Released:2009-10-28)

参考文献数

7

被引用文献数

7 2

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脳卒中後片麻痺患者125名に対し32項目の全身動作テストを施行し,片麻痺の理学療法プログラムの再検討に役立つ以下の結果を得た.(1)動作の難易度は必ずしも「正常運動発達」の順序をとらない.(2)ある姿勢をとる動作のほうがその姿勢を保持することよりも困難である.(3)片膝立ちの健側前と患側前との差は,物につかまるか否かで達成率に大きな差がある.(4)全身動作テストと片麻痺機能テストとの相関は高い.

著者

岡本 五十雄

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.8, pp.531-536, 2003-08-18 (Released:2009-10-28)

参考文献数

13

著者

近藤 克則 戸倉 直実 二木 立

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.1, pp.46-53, 1994-01-18 (Released:2009-10-28)

参考文献数

17

被引用文献数

1 1

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発症早期の座位で脳卒中の再発・進行頻度が増えるか否かを検討した.対象は発症後第7病日以内入院の全脳卒中患者384人.入院第14日以内の意識障害,片麻痺などの悪化を再発・進行とした.座位耐性訓練以外に,来院時・診察時・看護上の座位なども座位に含めた.その結果,入院後14日以内の死亡を含めた再発・進行は,(1)早期座位の対象となる入院第1病日の意識障害清明,または1桁の患者281人のうち42人(14.9%)でみられ,(2)入院第1日に座位にした群で21/200人(10.5%)と座位にしなかった群の21/81人(25.9%)よりむしろ低かった.(3)重症度・病型・病巣部位・全身状態の安定度などで層別化しても結果は同様で,早期座位を施行しても再発・進行は増えていなかった.

著者

森谷 敏夫

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.40, no.7, pp.430-435, 2003-07-18 (Released:2009-10-28)

参考文献数

10

被引用文献数

3 1

著者

沢崎 博次 古賀 良平

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.5, no.1, pp.17-23, 1968-01-18 (Released:2009-10-28)

参考文献数

6

著者

Shigeya Tanaka Tetsuya Yamagami

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.20180001, 2018 (Released:2018-02-03)

参考文献数

33

被引用文献数

2

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Objective: To investigate (1) the concurrent validity of the Nursing Home Life-Space Diameter (NHLSD) and the Home-based Life-Space Assessment (Hb-LSA), (2) the correlated factors of life-space, and (3) the factors that affected the NHLSD score for the elderly in a geriatric health service facility, or Roken. Methods: This cross-sectional study included 32 participants in a Roken. Staff members, who had received essential guidance for assessment, examined the cognitive function, physical function, mood, communication ability, objective quality of life, vitality, and daily behavior of the participants. Correlation analysis between NHLSD and other measurements and multiple regression analysis with NHLSD as a dependent variable were conducted. Results: NHLSD and Hb-LSA were significantly correlated (r=0.710, P<0.01). NHLSD was significantly correlated with more measurements than Hb-LSA was; i.e., NHLSD was significantly correlated with communication ability, independence of daily living (Barthel Index; BI), maximum knee extension strength, grip strength, function in daily living, and three QOL measurements: positive affects, ability to communicate, and spontaneity and activity. A stepwise multiple regression analysis indicated that the BI total score, the maximum knee extension strength, and spontaneity and activity (one of the QOL items) were significantly correlated with the NHLSD score. Conclusions: NHLSD can measure the mobility levels of elderly persons in Roken. In addition to physical conditions and dependence of ADLs, spontaneity (or low levels of apathy) may be an important factor for promoting physical activity in Roken.

著者

Ayumi Nobematsu Hidetaka Wakabayashi Takuya Hanada Naoko Watanabe Kae Tachibana

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.20180010, 2018 (Released:2018-05-16)

参考文献数

8

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Background: Acute lithium intoxication is associated with neurological manifestations such as tremor, ataxia, dysarthria, seizures, and in more severe cases encephalopathy and coma; patients experiencing such manifestations require rehabilitation. The authors present a patient who received post-acute rehabilitation for lithium toxicity-associated ataxia. Case: The patient was a man aged 30 years who had been diagnosed with bipolar disorder more than 10 years ago and had been prescribed lithium carbonate by a psychiatrist. The patient was admitted to the hospital with disturbance of consciousness, and physical therapy began on day 6 of hospitalization. Occupational therapy and speech therapy began on day 15. Physical therapy interventions focused on improving balance and coordination, and occupational therapy focused on improving stability while sitting, upper extremity control, and activities of daily living to improve the Functional Independence Measure motor subscale score. Speech therapy focused on dysarthria. On day 27 of hospitalization, the patient was able to walk 5 m with two Lofstrand crutches and could feed himself without assistance. From day 15 to day 30 of hospitalization, the Scale for the Assessment and Rating of Ataxia score improved from 28 to 19, and the Functional Independence Measure score increased from 25 to 77. On day 31, the patient was discharged to a convalescent rehabilitation hospital. Discussion: Post-acute rehabilitation for ataxia caused by acute lithium toxicity may improve ataxia and the ability to perform activities of daily living, and therefore may be of benefit.

著者

Ryo Shiraishi Keisuke Sato Nobumasa Chijiiwa Takahiro Ogawa

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.20230036, 2023 (Released:2023-10-17)

参考文献数

33

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Objectives: This study aimed to investigate the relationship between trunk muscle mass index (TMI), appendicular skeletal muscle mass index (ASMI), and walking independence in patients aged 65 years and older undergoing rehabilitation for hip fracture.Methods: This retrospective, observational study was conducted in a convalescent rehabilitation ward and included 314 patients (aged ≥65 years) with hip fracture. The patients were classified into the independence group [functional independence measure (FIM)-walk score ≥6] or the non-independence group (FIM-walk score ≤5) according to the mobility item score among the motor FIM items at the time of discharge. Age, sex, TMI, ASMI, and Mini Nutritional Assessment-Short Form (MNA-SF) data were also extracted. Between-group and multivariate analyses were performed to evaluate the factors associated with walking independence.Results: The independence group had higher TMI (males: 6.6±0.9 vs. 5.6±1.0 kg/m2, P <0.001; females: 6.1±0.8 vs. 5.7±1.0 kg/m2, P <0.001), ASMI (males: 6.7±1.1 vs. 5.9±1.3 kg/m2, P=0.004; females: 5.3±0.9 vs. 4.7±0.8 kg/m2, P <0.001), MMSE-J (21.5±4.9 vs. 16.4±4.5 points, P <0.001), and MNA-SF [median (interquartile range): 8 (6–9) vs. 7 (5–8) points, P <0.001] than the non-independence group. Multivariate analysis showed that TMI at admission was significantly associated with walking independence (odds ratio: 1.86, 95% confidence interval: 1.28–2.72, P <0.001).Conclusions: This study suggests that a higher TMI at admission was important for acquiring walking independence in patients with hip fracture and shows the importance of early evaluation of TMI during hospitalization of patients with hip fracture.

著者

Tomoko Sakai Chisato Hoshino Masanobu Hirao Megumi Nakano Yusuke Takashina 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.8, pp.20230017, 2023 (Released:2023-06-14)

参考文献数

39

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Objectives : We aimed to review the most recent articles on the rehabilitation of patients after coronavirus disease 2019 (COVID-19) and to identify the methods and effects of rehabilitation on such patients.Methods : A literature search was conducted using PubMed and Web of Science from study inception to October 2022 using the following search terms to identify meta-analyses and randomized controlled studies with abstracts written in English: [“COVID-19” or “COVID 19” or “2019-nCoV” or “SARS-CoV” or “novel coronavirus” or “SARS-CoV-2”] and [“rehabilitation”]. Publications investigating the effects of pulmonary and physical rehabilitation on patients with COVID-19 were extracted.Results: The extraction process selected four meta-analyses, two systematic reviews, two literature reviews, and two randomized controlled trials. Pulmonary rehabilitation recovered forced vital capacity (FVC), 6-min walk distance (6MWD), health-related quality of life (HRQOL), and dyspnea. Pulmonary rehabilitation increased predicted FVC, distance in the 6MWD test, and HRQOL score compared with baseline values. Physical rehabilitation, comprising aerobic exercises and resistance training, effectively improved fatigue, functional capacity, and quality of life with no adverse events. Telerehabilitation was an effective tool to provide rehabilitation for patients with COVID-19.Conclusions: Our study suggests that rehabilitation after COVID-19 should be considered an effective therapeutic strategy to improve the functional capacity and quality of life of patients with COVID-19.

著者

下堂薗 恵 川平 和美

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.41, no.6, pp.387-389, 2004-06-18 (Released:2009-10-28)

参考文献数

9

被引用文献数

1 1

著者

清野 良文 橋爪 長三 赤津 昇

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.33, no.7, pp.476-483, 1996-07-18 (Released:2009-10-28)

参考文献数

18

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当センターに入院した頸髄損傷完全麻痺患者35例67手に対しFQテストを施行し,麻痺レベルとFQとの関係を調べるとともに,上肢機能再建手術による改善を評価した.最低機能髄節が下がり有効な筋が増えるに従ってFQは高値を示し,さらに同じ麻痺レベルでも高齢者は低値を示す傾向を認めた.手機能再建手術によってFQは平均で約14点の改善が得られた.ADLがやっと自立可能と考えられるFQのレベル(20~30点)はZancolliの2-B:II,2-B:IIIに相当していたが,手機能再建手術によって1-Bから2-B:Iの症例もこのレベルに到達していた.総合的な手機能の評価法としてFQテストは有用であったが,評点と因子得点率を詳細に分析するにあたっては注意を要した.