[Background] We have reported on the practical use of the modified-RSMT-method, and suggested that it could be used in a wide range of patients. In this report, we describe a case of occlusion of the main artery of the upper limb due to Behçet’s disease, who presented with difficulty in elevating the left upper limb, for whom we used the method with major improvement obtained as a result of the practice.

[Methods] The patient had been visiting the Vascular Surgery Department of our hospital with a chief complaint of left upper limb fatigue, with no improvement, when he was introduced to the Department of Rehabilitation Medicine in November 2021. We started basic occupational therapy once a week, but his pain repeatedly remitted and flared up. We instructed him to practice the modified-RSMT-method from April 2022 and to do it as a daily home training. Heart rate variability was measured using Check My Heart^TM.

[Results and Discussion] At the start of the modified-RSMT-method, Total Power, an index of overall autonomic nervous system activity, was markedly low, and LF/HF, which represents the overall balance between sympathetic and parasympathetic nerves, showed a state of sympathetic dominance. Total Power showed a trend toward activation from the period of pain reduction (June 2022), and LF/HF became average from the same period. One month after the start of the program (May 2022), the range of motion of the left shoulder joint improved, and by June of the same year, the pain was in remission. The improvement in function remains the same. The patient was able to resume snow shoveling routine this winter, which had been the patient’s goal. This treatment suggests further potential of the use of our modified-RSMT-method.

[Background] Therapists rehabilitating COVID-19 patients can experience mental health problems such as stress, anxiety, and depressive symptoms due to fear of an unknown virus, and it is useful to use quantitative assessment tools to capture changes in mental health over time.

[Methods] The subject was a male physical therapist in his twenties who provided rehabilitation to COVID-19 patients. Heart rate variability analysis using Check My Heart^TM, Profile of Mood States 2nd Edition (POMS2), and Brief Occupational Stress Questionnaire were conducted before and after the rehabilitation for COVID-19. We analyzed the effects that COVID-19 rehabilitation may have on mental health.

[Results and discussion] The anxiety score of the Brief Occupational Stress Questionnaire increased from “slightly high” (Stage 4) to “high” (Stage 5), the vigor-vitality score of the POMS2 decreased from 62 (high) to 43 (average), and respiratory rate increased from 6 breaths/min to 10 breaths/min before and after COVID-19 rehabilitation. Low frequency (LF) component decreased, very low frequency (VLF) and Total Power increased after the rehabilitation for COVID-19. We speculate that the heart rate variability components, mainly VLF, were increased by the high stress that had a negative effect on vigor and vitality.