Ono K, Takahashi R, Morita K, Ara Y, Abe S, Ito S, Uno S, Abe M, Shirasaka T. Can AI predict walking independence in patients with stroke upon admission to a recovery-phase rehabilitation ward? Jpn J Compr Rehabil Sci 2024; 15: 1-7.

Objective: This study aimed to develop a prediction model for walking independence in patients with stroke in the recovery phase at the time of hospital discharge using Prediction One, an artificial intelligence (AI)-based predictive analysis tool, and to examine its utility.

Methods: Prediction One was used to develop a prediction model for walking independence for 280 patients with stroke admitted to a rehabilitation ward-based on physical and mental function information at admission. In 134 patients with stroke hospitalized during different periods, accuracy was confirmed by calculating the correct response rate, sensitivity, specificity, and positive and negative predictive values based on the results of AI-based predictions and actual results.

Results: The prediction accuracy (area under the curve, AUC) of the proposed model was 91.7%. The correct response rate was 79.9%, sensitivity was 95.7%, specificity was 62.5%, positive predictive value was 73.6%, and negative predictive value was 93.5%.

Conclusion: The accuracy of the prediction model developed in this study is not inferior to that of previous studies, and the simplicity of the model makes it highly practical.

Hideshima Y, Asami T, Ichiba M, Matsuo K, Murata T. A study on the effectiveness of training in the operation of an electric mobility aid in severely mentally and physically handicapped children. Jpn J Compr Rehabil Sci 2024; 15: 8-16.

Purpose: We examined whether operation training for children with severe mental and physical disabilities using recently developed electric mobility aids improves their skills in operating such aids and their daily activities. By doing so, we aimed to clarify the effectiveness of electric mobility aid operation training for children with severe mental and physical disabilities.

Method: Operation training and normal training using an electric mobility aid were conducted for 42 school-aged children with severe mental and physical disabilities, aged 8-18 years old. The trainee children were randomly assigned to two groups: 21 to the intervention group to receive operation training and 21 to the control group to receive general training. The intervention lasted 20 minutes/training session, with three sessions/week over a period of eight weeks. The Powered Mobility Program (PMP) and Pediatric Evaluation of Disability Inventory (PEDI) were used for pre- and post-intervention assessments, and SPSS was used for two-way analysis of variance (ANOVA).

Results: PMP scaled scores significantly increased (p = 0.001) in both groups, but there was no interaction effect. The PEDI scaled scores did not significantly increase in either of the two groups.

Discussion: The effects of the intervention and use of the electric mobility aid on the operating skills of children with severe mental and physical disabilities were explicitly demonstrated. Future long-term studies are required to clarify the effects of training in the operation of electric mobility aids on the subsequent development of severely physically and mentally handicapped children.

Watanabe N, Kamakura Y, Fukada J. Esophageal speech training system and needs for esophageal speech training in a laryngectomy patient association in Japan. Jpn J Compr Rehabil Sci 2024; 15: 17-26.

Objectives: To study the esophageal speech training system and needs for esophageal speech training in one laryngectomy patient association in Japan.

Methods: The esophageal speech training system of Association X for laryngectomy patients was observed through participation. Needs for esophageal speech training were analyzed qualitatively and inductively by semi-structured interviews with 7 esophageal speech (ES) trainers, 11 ES learners, and 8 family members of the association conducted according to an interview guide.

Results: Association X was organized, and its teaching system was established, by the Japan Federation of Laryngectomy Patient Associations (Nikkoren), and 12 ES trainers were appointed for esophageal speech and electrolarynx speech training. The training was based on the “Speech Practice Manual” published by the association, but the teaching methods and training contents and methods were left to the discretion of the individual ES trainers. The survey by Association X showed that there were needs for “Improvement of the methods and contents of esophageal speech training” and “Organizational reform of the association.” The former category included “Improvements for evidence-based training that ensures vocalization” and “Improving training methods and assigning roles for advanced ES learners”; the latter category included “Development of a system for trainers to continue receiving training from better qualified trainers” and “Reforming the association to allow learners and families to voice their opinions about training.” Each category consisted of three subcategories.

Conclusions: In Association X, substitute vocalizations were taught by 12 ES trainers. “Improvement of the methods and contents of esophageal speech training” and “Organizational reform of the association” were expressed as needs for Association X concerning esophageal speech training.

Kamiue M, Tsubahara A, Ito T. Effects of repetitive peripheral magnetic stimulation on a patient with severe lower limb muscle weakness due to coronavirus disease-2019. Jpn J Compr Rehabil Sci 2024; 15: 27-33.

Introduction: A patient developed severe lower limb muscle weakness and gait disturbance after receiving mechanical ventilation in the intensive care unit (ICU) due to coronavirus disease 2019 (COVID-19). We describe the effect of repetitive peripheral magnetic stimulation (rPMS) to strengthen his lower limb muscles.

Case: A 70-year-old man was mechanically ventilated due to COVID-19-related breathing difficulties. He was weaned off mechanical ventilation after 54 days, and the tracheostomy was closed after 225 days. However, his lower limbs remained significantly weak, and he was wheelchair-bound for daily activities. Despite approximately 6 months of functional training at a day-service center, his physical function and movement abilities did not improve. Therefore, 30-Hz rPMS was applied to both quadriceps for 20 minutes/day, three times a week, for 4 weeks (12 times). Knee extensor torque (KET) during maximum voluntary contraction (MVC) was greater after (right: 42.1 Nm, left: 40.7 Nm) than before the intervention (right: 33.7 Nm, left: 36.2 Nm). Before the intervention, KET induced by rPMS (rPMS-induced torque) was 0 Nm on both sides, the 30-second chair stand test (CS-30) was challenging to perform, and the walking item score of the Functional Independence Measure (FIM) was 2 points (endurance 30 m). Post-intervention, rPMS-induced torque was 6.5 Nm on the right and 4.7 Nm on the left side, CS-30 could be performed once, and the FIM walking score was improved to 6 points (endurance 60 m).

Discussion: The use of rPMS improved lower limb muscle strength in a patient who developed ICU-acquired muscle weakness after COVID-19.