We hope this study would lead to protecting independent living for aged people in the aging society progressing in the world. Japanese life expectancy is 83.7 years old and the longest in the world. An aging rate is the highest at 26.0% in the world in 2014. The elderly ratio which was 12.1% in 1990 and increased to 26% in 2014. It is also the earliest pace of expansion in the world. There is the Long-Term Care Insurance System (Care Insurance) under the Long-Term Care Insurance Act (Insurance Act) to support this aged society. We investigated the situation of the English translation of the Care Insurance under the Insurance Act of Japan. We try to translate the untranslated part of it, “Care Degree” and introduced. We examined the Care Degree and the result of enforcement of the knee motivative exercise, which the outpatients are performing by themselves. We performed an evaluation of exercise with setting 15 subjects with their consent subjects at the medical facility by the therapist and rehabilitation collaborators. We analyzed the exercise value when they performed the motivative exercise individually. There was a big difference in the maximum range, the minimum range, time, and the average speed per second of the exercise under exercise for 300 seconds for every individual. We examined the correlation between exercise range and average speed, and the digitalized care degree. There were significant correlation as the maximum movement range (r = .702, p < .01), the minimum movement range (r = .608, p < .05), an average movement range (r = .745, p < .01), and average speed (r = .664, p < .01). We showed that the autonomous knee motivative exercise is an accommodated kinetic rehabilitation to the patient’s physical strength due to correlating with the exercise value of the degree of care. We showed that they could implement under the therapist direction to do for 300 seconds without touching.

View full abstract

We can implement motivative exercise anywhere even if there is no special tutor. The therapist and rehabilitation collaborators at the Tachibana Orthopedic Outpatients Rehabilitation Facility performed the evaluation of the effectiveness of 21 outpatients who gave informed consent. We carried out the measurement of blood pressure, body temperature, pulse rate, and blood oxygen saturation with measuring the quantity of exercise twice. The subjects implemented 300 seconds motivative exercises with 60 seconds rest, but we couldn’t find a significant change of the items by the change measurement before and after implementation of two kinds of motivative exercises. The quantity of exercise is arbitrary, and we did not decide it for every object without specifying the number of times and speed. The result of analyzing the exercise for everyone from the measurement result, the exercise speed, and range differed for every subject. The correlation coefficient of the measurement for numbers of the exercise for 300 seconds to the degree of care is a significant (both sides) at the 1% level. But we couldn’t find the correlation coefficient of the average number of hours, an average angle, and the maximum angle of the degree of care.

View full abstract

Multiple Sclerosis (MS) is a chronic immune-mediated disease of the central nervous system, most often diagnosed in young and middle-aged subjects (two-third of which are women). Walking disturbances and fatigue are key symptoms in patients with MS, and major causes of discomfort, even in patients with mild disability since the early stages of the disease. Controversy exists about the association between fatigue and physical disability, between elevated fatigue, impaired balance and a higher risk of falls, between perceived fatigue and gait performance. We enrolled 16 patients with relapsing-remitting MS at early stage and low or mild disability, 11 females and 5 males, aged 27.1 (range 23-34 years), randomly divided into two groups: patients in g_® roup A underwent a robotic gait rehabilitation treatment which involved the use of SPAD (Sistema Posturale Antigravitario Dinamico, Dynamic Antigravity Postural System), patients in group B underwent a cycle of sensory-motor physical activity in our laboratory of performance enhancement; patients in both groups were subjected to neuromuscular manual therapy. All treatment were provided with 3 sessions per week for 6 weeks (for a total of 18 sess_Ti_M ons). Patients were evaluated by administration of the Functional Independence Measure (FIM ), Expanded Disability Status Scale (EDSS), the Fatigue S_® everity Scale (FSS) and the Modified Fatigue Impact Scale (MFIS), and gait analysis with MTX7 (_TD_M iagnostic Support, Rome, Italy). Results show statistically significant improvement of the FIM average score in all patients, reduction of the EDSS average score in all patients (but in a statistically significant manner only in group A), reduction in average scores obtained in both evaluation questionnaires of fatigue (non-significant improvement of the FSS average score in the overall sample and in both groups, statistically significant reduction of the MFIS average scores), improvement in temporal (but not spatial) gait parameters. So body weight supported gait training is feasible and could be safely used as additional therapeutic option in MS patients with mild walking disability.

View full abstract

This study generated data on the levels of health literacy of doctors and older patients (60+ years old) concerning the functional decline and frailty related to aging in Romania and Latvia. The study tackles the lack of data on the topic and provides insight from two EU member states that struggle with a fall in fertility coupled with a high percentage of outward migration predominantly in the young age working population. 300 doctors responded to the questionnaire. Another 301 responses were received from 60+ older patients living in Romania and Latvia. The study adapted the conceptual HLS-EU general model that defines the health literacy as basically referring to the following personal competencies: access, understand, appraise, and apply specific information. The self-declared awareness concerning the functional decline and frailty was high for both patients and doctors (over 70%). However, the overall level of health literacy on both items were determined by a degree of access, understanding, appraisal, and the application of the knowledge about the functional decline and frailty. These health literacy components are much lower in patients, with over 20% of respondents finding it difficult to access and understand the relevant information. In the case of doctors, there appears a discrepancy between the claim of a problem with health literacy and the actual responses sometimes pointing not to having a full knowledge of the issue.

View full abstract

The interaction between the body system and a microgravity environment influences the biomechanical behaviors allowing the reorganization of sensorimotor relations through “unique” stimulation of the functional hierarchies of the central nervous system, thus changing the motor gesture as a whole. The physical characteristics of the aquatic environment can be exploited by the rehabilitative operator to achieve specific muscle, neurological and sensory recovery with different modality and times compared to the techniques used in a dry environment, stimulating the re-acquisition of neuromotor-sensory skills impaired or even lost. The purpose of the study is to evaluate the effectiveness of a rehabilitation protocol in the thermal aquatic environment, on postural parameters, gait, balance, and autonomy on the disabled patient. 50 subjects (mean age 48.5 years) were evaluated and treated because of the suffering of neuromotor cognitive and/or mental disabilities. Subjects underwent two evaluations, before and after a rehabilitation protocol in aquatic environment, consisting of 20 therapy sessions in thermal water, made of a physiatric specialistic examination, administration of FIM and Tinetti SCALE and Computerized Postural assessment without markers (Sa.BB Imaging), in order to assess the effects of the protocol on the health status of the patient, evaluating the ADL, balance and postural parameters and if these three data show a correlation in clinical practice. Considering the scores of the FIM scale, neurological patients went from a score of 84,323 to 97,29 after 20 sessions of treatment (p=0.0487). Patients with mental disabilities increased from a score of 76,895 to 94,63 (p = 0.0383). In all patients the FIM scale score increased from 82,692 to 95,75 (p = 0.0107). Gait and balance, evaluated through the Tinetti scale, improved from 20,105 to 24,474 (p=0.04) for patients with mental disabilities and from 11,774 to 13,742 (p = 0.4688) for patients with neuromotor disabilities. In all patients the Tinetti score rose from 13,385 to 17,885 (p = 0.4688). These data were validated by the improvements achieved at the postural level, particularly in the values concerning the anteposition of the head, important for the distribution of the load in the polygon of support; also supported by the reduction of the lateral side oscillations of the pelvis. We can conclude that the technique used resulted in a great increase of postural and functional parameters of the subjects of the study.

View full abstract

Introduction: cerebral palsy (CP) is a condition determined by a damage occurred in the developing brain of children during the first year of life, resulting in cognitive alterations and motor disorders like spasticity. It is known in Literature the efficacy of integrated rehabilitative treatment for CP. The aim of this study, conducted in the Chair of Physical Medicine and Rehabilitation at University “G. D’Annunzio” of Chieti - Pescara, was to demonstrate the importance of an early integrated rehabilitative treatment as affirmed in Literature for patients affected by CP. Materials and Methods: 20 patients with CP were recruited, aged between 2 and 7 years old, of both sexes. Data were collected at the beginning of the treatment (T0), at 3 months (T1), at 6 months (T2) and 12 months (T3) using the Gross Motor Function Measure, the WeeFIM and the Barthel Index. Patients performed 3 weekly therapeutic sessions, each one lasting 1 hour, for a total of 6 months and 1 weekly session for the remaining 6 months. Each session consisted of a set of proprioceptive and stretching exercises. Conclusions: at time T2, patients showed an increase in their motor and cognitive abilities. All patients maintained their improvements at the end of the follow-up (T3). These improvements resulted in a greater independence of patients from caregivers and in an overall better quality of life.

View full abstract

In the field of medical rehabilitation, our patients are often in a vulnerable state and are unable to process the real dimension of their illness, so the way that disability is discussed with the patient and his/her family is crucial in the process of understanding their condition and the realistic rehabilitation outcomes. In Romania, these aspects developed later after the ending of the communist period, after we became part of different groupings such as EU and we started to establish good social networks. After a traumatic condition that changes the patient’s and his family’s life the medical decision concerns not only the short-term outcome, but also long-term disability management for daily-life activities.

View full abstract