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.

出版者

千鐘房須原屋茂兵衛

巻号頁・発行日

vol.[4], 1856

出版者

千鐘房須原屋茂兵衛

巻号頁・発行日

vol.[3], 1856

出版者

千鐘房須原屋茂兵衛

巻号頁・発行日

vol.[1], 1856

出版者

近代将棋

巻号頁・発行日

vol.42(2), no.491, 1991-02

著者

西山 瑛利

出版者

山梨大学大学院総合研究部教育人間科学域障害児教育学系(山梨大学教育学部障害児教育講座)

雑誌

山梨障害児教育学研究紀要 (ISSN:24329096)

巻号頁・発行日

no.15, pp.45-58, 2021-02-01

出版者

写

巻号頁・発行日

vol.25,

出版者

[出版者不明]

巻号頁・発行日

1770

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歌舞伎「倭花小野五文字(くにのはなおののいつもじ)」の絵本番付下冊(端本1冊)と村田版の「曽我一代記」第1冊・第4冊(第16丁欠)を合綴したもの。

著者

大蔵省印刷局 [編]

出版者

日本マイクロ写真

巻号頁・発行日

vol.1934年12月28日, 1934-12-28

著者

藤井彰民 著

巻号頁・発行日

vol.[1], 1800

著者

佐野, 山陰

出版者

写

巻号頁・発行日

vol.[9],

著者

佐野, 山陰

出版者

写

巻号頁・発行日

vol.[8],

著者

佐野, 山陰

出版者

写

巻号頁・発行日

vol.[6],

著者

二藤 拓人

出版者

日本独文学会

雑誌

ドイツ文学 (ISSN:24331511)

巻号頁・発行日

vol.160, pp.45-61, 2020 (Released:2021-06-04)

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Die von Friedrich Schlegel konzipierte Gattung „Fragment“ gehört zu einem modernen Kulturphänomen, dem im Prozess der medienhistorischen Leserevolution seit Mitte des 18. Jahrhunderts (Polenz 1994) die literaturprogrammatische Funktion der Mitteilung zugewiesen wurde. Sie wandte sich ausschließlich an das in eine „geniale“ Intelligenz eingeweihte Lesepublikum. Aus dieser medialen Intention der neuartigen Gattung ergab sich die Trennung zwischen einem kleinen intimen Kreis genialer Künstler und dem allgemeinen Publikum. Dies obwohl das frühromantische Konzept der „neuen Mythologie“ auf die Vereinheitlichung von Esoterik und Exoterik abzielte, die in einem breiteren Kreis die Zugänglichkeit der „Poesie“ ermöglichen sollte. Diese Ambivalenz kennzeichnet nicht nur die Romantik, sondern sie gehört vielmehr zur allgemeinen Tendenz des Zeitalters im Zerfall der Einheit der in Habermas’ Strukturwandel der Öffentlichkeit (1962) herausgearbeiteten bürgerlich-literarischen Öffentlichkeit, deren kritische Betrachtung aus sozialgeschichtlicher Perspektive auch im von Christa und Peter Bürger sowie Jochen Schulte-Sasse herausgegebenen Sammelband Aufklärung und literarischen Öffentlichkeit (1980) zusammengestellt ist. Im Blick auf diese nicht nur in sozial-, sondern auch in mediengeschichtlicher Hinsicht zu betrachtende Problematik soll beim vorliegenden Beitrag die Situation der Schreib- und Lesepraxis der zeitgenössischen Publikationskultur anhand von frühesten Texten (1792–1797) Friedrich Schlegels genauer unter die Lupe genommen werden. Erst auf diesem Weg können die bisher kaum beachteten Entstehungsprozesse und -bedingungen des „Fragments“ in Bezug auf den Wandel der literarischen Öffentlichkeit erläutert werden. Der komplexe Gebrauch des Wortes „Fragment“ lässt sich in drei verschiedenen Erscheinungsformen feststellen: als in Briefen mitgeschickten Aufzeichnungen, die im Kreis der Frühromantik zirkulierten, als Formulierungen in Überschriften bzw. Titeln und als antike Quellenmaterialien der von Schlegel durchgeführten Forschung. Im Briefwechsel zwischen Friedrich Schlegel und seinem älteren Bruder August Wilhelm werden „Fragmente aus Hamlet und Romeo“ (KA 23, 138) oder „Fragmente aus Sh[akespeare]“ (ebd., 266) erwähnt, die sich beide offensichtlich auf August Wilhelms Übersetzungsarbeit beziehen. Da diese fragmentarischen Manuskripte durchaus nicht in die Brieftexte eingebettet, sondern ihnen beigefügt wurden, ist jeder Briefleser bzw. -empfänger berechtigt, dieses Fragment ohne Rücksicht auf die Intention des Autors bzw. Absenders frei und sachlich zu kritisieren. Diese Abtrennung des dem Brief beigefügten Fragments vom Brieftext selbst läuft der im 18. Jahrhundert zu beobachtenden Tendenz des bürgerlichen Lesepublikums zuwider, auf die Habermas (1962) bereits hinweist. Er konstatiert dabei, dass sowohl der intime Briefwechsel als auch die Lektüre einer daraus entwickelten Romanliteratur auf der bürgerlichen Basis der „literaturfähigen und publizitätsbezogenen Subjektivität“ zustande komme. Diese Feststellung unterstreicht im Grunde selbst der Habermas kritisierende Kittler (1980), mit dessen Begriff „Phantasma der Autorschaft“ die Einbildung des Lesers bezeichnet wird, der ein Buch allein und still liest, als wäre es ein an ihn persönlich adressierter Brief. Ein Paradebeispiel dafür ist Goethes Werther-Roman, in dessen Protagonisten sich nicht wenige Leser damals einfühlten. (View PDF for the rest of the abstract.)