Japanese Journal of Comprehensive Rehabilitation Science
Online ISSN : 2185-5323
ISSN-L : 2185-5323
Volume 7
Displaying 1-18 of 18 articles from this issue
Original Article
  • Yuri Kanayama, Keiko Tsuchiya, Kenichi Ono, Yosuke Yoshimura, Ryuji Ko ...
    Article type: Original Article
    2016 Volume 7 Pages 1-6
    Published: 2016
    Released on J-STAGE: May 13, 2016
    JOURNAL FREE ACCESS
    Supplementary material
    Kanayama Y, Tsuchiya K, Ono K, Yoshimura Y, Kobayashi R. The relationship between satisfaction in activities of daily living and perceived quality of life in recovery rehabilitation inpatients. Jpn J Compr Rehabil Sci 2016; 7: 1-6.
    Purpose: The purpose of this study was to examine the relationship between subjective satisfaction in activities of daily living (ADL) and quality of life (QOL). We also investigated the difference between objective ADL and QOL.
    Method: We recruited 40 participants from the recovery rehabilitation ward. Participants had no difficulty communicating, and scored 24 or more on the Mini Mental State Examination (MMSE). We used the Satisfaction of Selected Activities of Daily Living (SSADL) scale to assess participants’ subjective satisfaction in ADL. We used the Functional Independence Measure (FIM) as our objective measure of ADL, and the World Health Organization’s WHOQOL-BREF to assess QOL.
    Results: Significant positive correlations were found between SSADL and total WHOQOL-BREF (rs = 0.44, p < 0.05), SSADL and WHOQOL-BREF physical domain (rs = 0.41, p < 0.05), and SSADL and WHOQOL-BREF psychological domain (rs = 0.49, p < 0.01). Significant positive correlations were found between FIM and total WHOQOL-BREF (r = 0.41, p < 0.05), and FIM and WHOQOL-BREF physical domain (r = 0.46, p < 0.01).
    Conclusions: Significant relationships were observed between subjective satisfaction in ADL and QOL. We also found differences between objective ADL and QOL.
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  • Makoto Tokunaga, Ayumi Beppu, Yasuki Tamura, Kumiko Oowaki, Yoshimi To ...
    Article type: Original Article
    2016 Volume 7 Pages 7-12
    Published: 2016
    Released on J-STAGE: May 13, 2016
    JOURNAL FREE ACCESS
    Supplementary material
    Tokunaga M, Beppu A, Tamura Y, Oowaki K, Tokunaga Y, Ishihara C, Shibata K, Tanaka K, Takayama M. Relationship between improvement in GNRI, a nutritional index, and improvement in motor FIM in elderly stroke patients hospitalized in a Kaifukuki Rehabilitation Ward. Jpn J Compr Rehabil Sci 2016; 7: 7-12.
    Objective: To clarify the relationship between improvement in the Geriatric Nutritional Risk Index (GNRI) and improvement in the Functional Independence Measure (FIM).
    Methods: The subjects were 155 patients aged 65 years or older selected among stroke patients admitted to a Kaifukuki Rehabilitation Ward. Seven items, including GNRI at hospital admission and degree of GNRI improvement, served as independent variables. For multiple regression analysis, motor FIM score at hospital discharge was the dependent variable. For multiple logistic regression analysis, motor FIM gain (1:13 points or more, 0:12 points or less) was the dependent variable.
    Results: GNRI at admission was a significant positive independent variable in the multiple regression analysis. GNRI at admission and degree of GNRI improvement were both significant independent variables in the multiple logistic regression analysis, with odds ratios of 1.084 and 1.090, respectively.
    Conclusion: Improvements in motor FIM are greater when GNRI at admission and the degree of GNRI improvement are larger.
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  • Makoto Tokunaga, Yoshitaka Mori, Yoshitaka Ogata, Yasunori Tanaka, Kou ...
    Article type: Original Article
    2016 Volume 7 Pages 13-18
    Published: 2016
    Released on J-STAGE: May 13, 2016
    JOURNAL FREE ACCESS
    Supplementary material
    Tokunaga M, Mori Y, Ogata Y, Tanaka Y, Uchino K, Maeda Y, Kamiyoshi M. Predicting FIM gain in stroke patients by adding median FIM gain stratified by FIM score at hospital admission to the explanatory variables in multiple regression analysis —An analysis of the Japan Rehabilitation Database—. Jpn J Compr Rehabil Sci 2016; 7: 13-18.
    Objective: To clarify whether the accuracy of predicting motor Functional Independence Measure (FIM) gain in stroke patients can be improved by calculating median values of motor FIM gain (median mFIM gain) stratified by motor FIM score at hospital admission, then inserting these standard gain values in multiple regression analysis.
    Methods: The subjects were 2,542 stroke patients registered in the Japan Rehabilitation Database. Motor FIM score at admission was stratified into 39 groups at 2-point intervals and “median mFIM gain” was calculated for each group. With motor FIM gain as the objective variable, multiple regression analysis was performed with and without median mFIM gain in the explanatory variables. Then, correlations were examined between measured values and predicted values of motor FIM gain.
    Results: Adding median mFIM gain to the explanatory variables increased the correlation coefficient of measured values and predicted values of motor FIM gain from 0.507 to 0.638.
    Conclusion: Adding median mFIM gain to the explanatory variables can improve the accuracy of multiple regression analyses to predict motor FIM gain.
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  • Shota Suzumura, Aiko Osawa, Taishi Nagahama, Izumi Kondo, Yuko Sano, A ...
    Article type: Original Article
    2016 Volume 7 Pages 19-28
    Published: 2016
    Released on J-STAGE: May 20, 2016
    JOURNAL FREE ACCESS
    Supplementary material
    Suzumura S, Osawa A, Nagahama T, Kondo I, Sano Y, Kandori A. Assessment of finger motor skills in individuals with mild cognitive impairment and patients with Alzheimer's disease: Relationship between finger-to-thumb tapping and cognitive function. Jpn J Compr Rehabil Sci 2016; 7: 19-28.
    Objective: Decreased finger dexterity can impede a person's daily activities. The present study examined finger dexterity in individuals with mild cognitive impairment (MCI) and patients with Alzheimer's disease (AD) compared with healthy older adults using a magnetic sensing finger tapping device (UB-1).
    Methods: Finger-to-thumb tapping tasks were carried out by 23 patients who were diagnosed with AD or MCI at the authors' hospital (AD/MCI group) and 22 members of their families (healthy control group), and measurement parameters were calculated. Mini-Mental State Examination (MMSE) was carried out to assess cognitive function and the association between finger function and the results of MMSE was evaluated. Additionally, the measurement parameters were compared between the AD/MCI group (n = 14) and the healthy control group (n = 13) after adjusting for age.
    Results: A correlation between finger function and MMSE results was observed in five measurement parameters (r ≥ 0.6). Additionally, in the AD/MCI group, the total traveling distance was shorter compared to that in the healthy control group and rhythm perturbations were observed (p < 0.05).
    Discussion: In the present study, the AD/MCI group showed decreased finger dexterity, which was also found to be associated with decline in cognitive function. It is suggested that assessment of finger dexterity can be used as an indicator of cognitive function.
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  • Midori Ihara, Masazumi Mizuma, Nobuyuki Kawate
    Article type: Original Article
    2016 Volume 7 Pages 29-38
    Published: 2016
    Released on J-STAGE: October 21, 2016
    JOURNAL FREE ACCESS
    Supplementary material

    Ihara M, Mizuma M, Kawate N. Voluntary training undertaken by stroke patients during the recovery phase and related factors. Jpn J Compr Rehabil Sci 2016; 7: 29-38.

    Objective: This study assessed factors related to voluntary training undertaken by stroke patients.

    Methods: Patients who had been hospitalized for 1 or more months after stroke completed a questionnaire regarding their background, disease characteristics, voluntary training, outcome expectations, efficacy expectations, and the degree of life satisfaction. The Mann-Whitney U test, Fisher's exact test, and Spearman's rank correlation coefficient were used for analysis.

    Results: There was a significant positive correlation between the number of training days per week and the number of months after stroke. However, there was no significant correlation between the number of training days per week and outcome expectations, efficacy expectations, and the degree of life satisfaction.

    Conclusions: The factor related to the number of voluntary training days per week undertaken by stroke patients during the recovery phase was the number of months after stroke. In this period, outcome expectations, efficacy expectations, the degree of life satisfaction, and voluntary training by stroke patients may not be related. This may be because patients have mental agitation or a low degree of satisfaction during this period.

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Case Report
  • Masahiro Ikeno, Hiromichi Metani, Shinya Fukunaga, Akio Tsubahara
    Article type: Case Report
    2016 Volume 7 Pages 39-44
    Published: 2016
    Released on J-STAGE: July 16, 2016
    JOURNAL FREE ACCESS
    Supplementary material

    Ikeno M, Metani H, Fukunaga S, Tsubahara A. Effectiveness of Dysphagia Rehabilitation in a Post-cardiac Surgery Patient Who Leads a Social Life. Jpn J Compr Rehabil Sci 2016; 7: 39-44.

    Many patients are reported to experience dysphagia following thoracotomy, and there is a high rate of persistence of dysphagia as a result of prolonged endotracheal intubation. The importance of appropriate postoperative evaluation and rehabilitation has also been reported. A patient who had dysphagia following thoracotomy but recovered the ability for oral intake by undergoing long-term dysphagia rehabilitation in the active community-living phase (home care phase) is reported. The patient was a 90-year-old man diagnosed with severe dysphagia on the basis of recurrent laryngeal nerve paralysis following thoracotomy. The patient received a gastrostomy and was placed on home care. The patient visited our hospital 6 months after surgery, during which time his function had worsened due to his lack of oral intake ability. A videofluoroscopic swallowing study was performed after the patient presented at our hospital on the basis of information received from the patient's care manager. This was followed by tongue movement exercises and the chin push-pull maneuver. Directly thereafter, swallowing exercises were initiated with simultaneous introduction of compensatory techniques (postural adjustments, conscious swallowing). Eight months after surgery, the patient was capable of full oral intake. The mechanisms by which dysphagia improved in the present case were likely the spontaneous healing of postoperative recurrent laryngeal nerve paralysis and the efficacy of exercises for recovering from swallowing function disuse that occurred during the period when he was incapable of oral intake. The rehabilitation of the present patient suggested that specialized and continuous evaluation and rehabilitative intervention are needed even at the stage of transition to the active community-living phase.

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Original Article
  • Takahiro Onose, Koichi Ohnaka, Kunihiko Suzuki, Manami Anzai, Narumi S ...
    Article type: Original Article
    2016 Volume 7 Pages 45-50
    Published: 2016
    Released on J-STAGE: October 21, 2016
    JOURNAL FREE ACCESS
    Supplementary material

    Onose T, Ohnaka K, Suzuki K, Anzai M, Sato N, Kimura M, Shimokurosawa A. Effect of self-managed training of the paretic upper limb in stroke patients in the convalescent phase: application of the Transfer Package, an element of CI therapy. Jpn J Compr Rehabil Sci 2016; 7: 45-50.

    Objective: Transfer package (TP) is one of the elements of constraint-induced movement therapy (CI therapy). This study evaluated the effectiveness of implementing TP as self-training in addition to occupational therapy for the upper paretic limb in the convalescent phase after stroke.

    Methods: Twelve patients at 8 to 16 weeks after onset of primary stroke were recruited in the study. A comparative study was conducted by dividing the subjects into two groups: a group that implemented self-training consisting of TP in addition to routine occupational therapy (TP group) and a group that implemented self-training including stretching and self-assisted exercise in addition to routine occupational therapy (non-TP group). In both groups, self-training was conducted for approximately 30 min a day, everyday for three weeks. At the beginning and three weeks after intervention, the patients were evaluated using the manual function test (MFT) and the motor activity log (MAL). Wilcoxon signed rank test was used to evaluate the changes in various evaluation parameters before and after intervention.

    Results: The MFT score improved significantly in both groups. For the MAL evaluation, the Amount of Use and Quality of Movement improved significantly in the TP group compared to the non-TP group.

    Conclusion: The present study indicates that self-training incorporating TP in the convalescent phase of stroke is effective in improving the amount of use and quality of movement of the paretic upper limb at the level of daily life.

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  • Takashi Tanaka, Hitoshi Kagaya, Yasunori Ozeki, Wataru Fujii, Takatosh ...
    Article type: Original Article
    2016 Volume 7 Pages 51-54
    Published: 2016
    Released on J-STAGE: September 09, 2016
    JOURNAL FREE ACCESS
    Supplementary material

    Tanaka T, Kagaya H, Ozeki Y, Fujii W, Iida T, Shibata S, Tomita S, Ishiguro Y, Ota K, Saitoh E. Revised classification of aspiration before, during, and after the swallow and its reliability. Jpn J Compr Rehabil Sci 2016; 7: 51-54.

    Objective: The purpose of this study was to reevaluate the classification of aspiration before, during, and after the swallow, and to verify the reliability of the revised classification.

    Methods: Aspirations occurring during swallowing reflex were classified as during the swallow; aspiration during the first swallowing reflex was subclassified as type D-1, and aspiration during the second or subsequent swallowing reflex as type D-2; aspirations occurring prior to the first swallowing reflex were classified as before swallow (type B); and aspirations other than the above types were classified as after the swallow (type A). In 212 patients (mean age, 66 years) who underwent videofluoroscopic examinations of swallowing (400 examinations), aspiration was classified retrospectively. Inter- and intra-rater reliability was analyzed using the data obtained from the evaluation of 20 patients with aspiration by four observers accredited by the Japanese Society of Dysphagia Rehabilitation.

    Results: The numbers of aspirations were in the order of D-1>D-2>A>B. The frequency showed variability depending on the bolus. The mean inter- and intra-rater kappa coefficients were 0.68 and 0.85, respectively.

    Conclusion: Our revised classification for aspiration before, during, and after the swallow is easy and adequately reliable.

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  • Sayako Shimizu, Kozo Hanayama, Hiromichi Metani, Takefumi Sugiyama, Hi ...
    Article type: Original Article
    2016 Volume 7 Pages 55-60
    Published: 2016
    Released on J-STAGE: September 09, 2016
    JOURNAL FREE ACCESS
    Supplementary material

    Shimizu S, Hanayama K, Metani H, Sugiyama T, Abe H, Seki S, Hiraoka T, Tsubahara A. Retest reliability of ultrasonic geniohyoid muscle measurement. Jpn J Compr Rehabil Sci 2016; 7: 55-60.

    Objective: Ultrasonography can be used to assess both the morphology and movement of the muscles of deglutition. This study investigated the intratester, intertester, and retest reliability of ultrasonic assessments of the suprahyoid muscle group.

    Methods: Three testers performed ultrasonographic measurements of the length and area of the geniohyoid muscle in 10 healthy adults, and the contraction ratio during swallowing. Results were compared using intraclass correlation coefficients (ICCs) to determine intratester, retest, and intertester reliabilities.

    Results: Intratester and retest reliabilities were very good, with ICCs ≥0.8 for all assessment parameters. In intertester reliability, ICCs were ≥0.8 for geniohyoid muscle length and area during swallowing and ≥0.6 for geniohyoid muscle length at rest and contraction ratio.

    Discussion: These results indicate high reliability of this assessment method for assessments made by the same individual, with reliability of the method remaining high for assessments performed at intervals.

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  • Hiroyuki Miyasaka, Wataru Narita, Yuuki Nakagawa, Rieko Kanamori, Maki ...
    Article type: Original Article
    2016 Volume 7 Pages 61-72
    Published: 2016
    Released on J-STAGE: September 09, 2016
    JOURNAL FREE ACCESS
    Supplementary material

    Miyasaka H, Narita W, Nakagawa Y, Kanamori R, Ohshita M, Kawakami S, Shimomura K, Kondo I, Sonoda S. Development and validity of an evaluation of higher cortical dysfunction in the daily life of patients with stroke and traumatic brain injury. Jpn J Compr Rehabil Sci 2016; 7: 61-72.

    Purpose: To develop a valid Cognition-oriented Performance Evaluation (COPE) questionnaire for the evaluation of higher brain function in any environment using the nominal group technique (NGT).

    Method: The NGT participants included nine expert staff members of our hospital. The NGT process was performed twice and involved: 1) enumerating questions regarding the presence or absence of higher cortical dysfunction symptoms, 2) judging each item on a four-point scale and posing additional questions, 3) determining the level of agreement across participants using the NGT, and 4) modifying, removing, and adding questions based on the agreement and comments of the NGT participants. In addition, a correlation analysis between COPE areas and the social cognition items of the Functional Independence Measure (FIM) was performed in 20 patients with higher cortical dysfunction.

    Results and discussion: An initial 126 questions were crafted prior to the NGT. During the first NGT, 12 items failed to achieve adequate agreement, and during the second NGT, three items failed. Furthermore, we coordinated the expressed opinions after the second NGT. The final version contained 96 items. Correlation analysis demonstrated significant correlation between the COPE and FIM in related items such as memory and problem-solving. Thus, the validity of the COPE was verified using a qualitative research technique (consensus method) and by correlation with another scale.

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  • Eriko Mizokoshi, Hitoshi Kagaya, Kazuyo Oguchi, Yoichiro Aoyagi, Seiko ...
    Article type: Original Article
    2016 Volume 7 Pages 73-79
    Published: 2016
    Released on J-STAGE: November 16, 2016
    JOURNAL FREE ACCESS
    Supplementary material

    Mizokoshi E, Kagaya H, Oguchi K, Aoyagi Y, Shibata S, Inamoto Y, Hattori A, Yamamoto A, Ota N, Hota S, Kondo T, Saitoh E. Usefulness of swallowing rounds in acute general hospital. Jpn J Compr Rehabil Sci 2016; 7 : 73-79.

    Objective: To investigate the usefulness of swallowing rounds using videoendoscopic evaluation of swallowing in patients with suspected dysphagia admitted to an acute general hospital.

    Methods: 473 patients (mean age 79 years) in whom swallowing rounds were conducted in 2013 were analyzed retrospectively. The parameters analyzed were disease at admission, eating status scale (ESS) score, dysphagia severity scale (DSS) score, food texture, onset of pneumonia during hospitalization, discharge destination, and nutrition method at discharge.

    Results: The most common diseases at admission were pneumonia (48%) and stroke (20%). Compared to the first swallowing round, significant (p < 0.001) improvements in ESS score, DSS score, and food texture were achieved at discharge or end of intervention in all patients, pneumonia patients, and stroke patients. The incidence of pneumonia onset during hospitalization was 4.9%. The incidence of pneumonia was significantly (p=0.045) higher in patients with respiratory diseases than in stroke patients.

    Conclusion: In this study, significant improvements of ESS score, DSS score and food texture were achieved by conducting swallowing rounds, indicating their usefulness in acute general hospital.

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  • Kannit Pongpipatpaiboon, Masahiko Mukaino, Kazuhiro Tsuchiyama, Kei Oh ...
    Article type: Original Article
    2016 Volume 7 Pages 80-86
    Published: 2016
    Released on J-STAGE: November 16, 2016
    JOURNAL FREE ACCESS

    Pongpipatpaiboon K, Mukaino M, Tsuchiyama K, Ohtsuka K, Matsuda F, Tanikawa H, Yamada J, Saitoh E. The use of a holistic figure in gait analysis: a preliminary study on the effect of ankle-foot orthosis. Jpn J Compr Rehabil Sci 2016; 7: 80-86.

    Objective: To examine the practical usefulness of a simplified three-dimensional treadmill gait analysis with a Lissajous overview picture (LOP), a holistic figure of marker trajectories, to present the effect of ankle-foot orthoses (AFO) on hemiparetic gait.

    Methods: Seven patients with hemiparesis who were able to walk without an orthosis or gait assistive device were included in this study. Patients were measured with a simplified three-dimensional treadmill gait analysis system as they walked with and without an orthosis in a rehabilitation center of a university medical center. Gait was analyzed using the LOP, and quantitative comparisons were made to evaluate the changes in joint angles and joint position displacements during the swing phase.

    Results: Using the orthosis decreased ankle plantar flexion during the swing phase (p = 0.028) and significantly reduced compensatory patterns, including hip elevation, knee elevation, and circumduction (p = 0.028, 0.018, and 0.028, respectively).

    Conclusions: The quantitative assessment by a simplified gait analysis system clarified the effect of AFO on reducing the compensatory movement in a hemiparetic gait. The use of LOP helps to understand the holistic effect of AFO and to analyze the individual patterns of gait disturbance.

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  • Tetsuya Tsunoda, Satoshi Hirano, Eiichi Saitoh, Shigeo Tanabe, Ryuzo Y ...
    Article type: Original Article
    2016 Volume 7 Pages 87-94
    Published: 2016
    Released on J-STAGE: November 16, 2016
    JOURNAL FREE ACCESS
    Supplementary material

    Tsunoda T, Hirano S, Saitoh E, Tanabe S, Yanohara R, Tanahashi M, Kondoh R, Muramatsu N, Fuse I, Kagaya H. The game task level of a balance exercise assist robot achieved by chronic stroke patients with hemiplegia is correlated with balance ability after training. Jpn J Compr Rehabil Sci 2016; 7: 87-94.

    Objective: The balance exercise assist robot (BEAR) is a balance training system that utilizes robot technology. The purpose of this study was to use BEAR on chronic stroke patients with hemiplegia and to elucidate the correlation between balance indices and BEAR game task levels.

    Methods: The subjects were 15 chronic stroke patients with hemiplegia. The Berg Balance Scale (BBS), Timed Up and Go Test (TUG), and other balance indices as well as leg muscle strength and paralysis were assessed before and after the BEAR training period. The relationship between the achieved game task levels (tennis, skiing, and rodeo) and balance indices after training was investigated using Spearman's rank correlation coefficient.

    Results: After training, TUG, Functional Reach Test (FRT) and comfortable walking speed showed a significant improvement. Furthermore, BBS, FRT, and comfortable walking speed showed a significant correlation with the achieved game task levels.

    Conclusions: The results of this study suggest that balance training using BEAR contributes to an improvement in dynamic postural control ability. The levels achieved for all BEAR game tasks are thought to reflect the balance ability of the subjects after training.

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  • Yoshie Omiya, Shota Suzumura, Naoki Itoh, Aiko Osawa, Rie Tateno, Aki ...
    Article type: Original Article
    2016 Volume 7 Pages 95-101
    Published: 2016
    Released on J-STAGE: December 30, 2016
    JOURNAL FREE ACCESS
    Supplementary material

    Omiya Y, Suzumura S, Itoh N, Osawa A, Tateno R, Mizuno A, Kondo I. Effect of adaptations to the living environment on ADL abilities and self-perception of performance/satisfaction—Based on experience from post-discharge home visits—. Jpn J Compr Rehabil Sci 2016; 7: 95-101.

    Objective: We evaluated the change in post-discharge ability in activities of daily living (ADL) and self-perception of performance/satisfaction in patients who were hospitalized at the restoration phase rehabilitation ward and for whom pre-discharge home visits were conducted.

    Methods: The study included 10 patients, for whom post-discharge home visits were conducted approximately 3 months after discharge. In the post-discharge home visit, we ascertained the places where adaptations to the living environment were made before patients were discharged. ADL abilities were assessed by the Functional Independence Measure (FIM) while occupational performance and satisfaction with performance were evaluated by the Canadian Occupational Performance Measure (COPM).

    Results: The patients tended to perceive ADL that were carried out in a well-adapted living environment as important occupations. A comparison made between pre- and post-discharge home visits showed improvement in mean score from 5.5 to 7.3 for performance and from 5.3 to 7.4 for satisfaction, both presenting significant differences, maintaining ADL by and large.

    Conclusion: It was suggested that when implementing hospital-to-home discharge, it is vital to focus on the in-home flow of activity, means for going out, and toilet and bathroom environment, and that adaptations to the living environment have a beneficial effect on self-perception of performance/satisfaction for the occupations selected by patients.

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  • Takayuki Tamura, Yohei Otaka, Jun Nakamoto, Keisuke Kato
    2016 Volume 7 Pages 102-106
    Published: 2016
    Released on J-STAGE: December 14, 2016
    JOURNAL FREE ACCESS
    Supplementary material

    Tamura T, Otaka Y, Nakamoto J, Kato K. Kinematic analysis of slipping when stepping. Jpn J Compr Rehabil Sci 2016; 7 : 102-106.

    Objective: Slipping is a major cause of falls. We investigated body kinematics during slipping when stepping forward.

    Methods: Five healthy adults (mean age, 22.2 ± 2.4 years) participated in the study. When the participants stepped forward with the right leg onto a treadmill, one of three types of slips (forward, lateral, or medial) was induced by rapid movement of the treadmill belt. The relationship between the base of support (BOS) and center of gravity (COG) was investigated using three-dimensional motion analysis.

    Results: The COG was displaced anterolaterally during all three types of slips. On the horizontal plane, the COG often deviated from the BOS with large medial and lateral slips. Participants most often lost their balance with medial slips, when the COG deviated outside an altered BOS.

    Conclusion: Postural control is difficult and is at increased risk of failure during slipping. The risk is greatest in medial slips, followed by lateral slips, and is least in forward slips.

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  • Toshiaki Sato, Tomomi Hayasaka, Kou Arata
    Article type: Original Article
    2016 Volume 7 Pages 107-110
    Published: 2016
    Released on J-STAGE: December 22, 2016
    JOURNAL FREE ACCESS
    Supplementary material

    Sato T, Hayasaka T, Arata K. Sacral skin blood flow rate changes during shoulder and ankle flexion and extension in healthy young adults. Jpn J Compr Rehabil Sci 2016; 7 : 107-110.

    Objective: We investigated the changes in sacral skin blood flow during shoulder and ankle flexion and extension movements.

    Subjects and Methods: The subjects were 18 healthy young adult men. Sacral skin blood flow rates were measured using a laser Doppler flow meter during active and passive movements of the shoulder and ankle. Analysis of variance with Tukey's multiple comparison test was used to compare the sacral skin blood flow rates before, during, and after movements.

    Results: In terms of movement sites, shoulder movement significantly increased the sacral skin blood flow compared with ankle movement (p < 0.01). For movement patterns, active movement (vs. passive movement) significantly increased the sacral skin blood flow compared with passive movement (p < 0.01).

    Conclusion: These results suggested that sacral skin blood flow rates varied according to the movement site and pattern.

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  • Fumihiro Matsuda, Masahiko Mukaino, Kei Ohtsuka, Hiroki Tanikawa, Kazu ...
    Article type: Original Article
    2016 Volume 7 Pages 111-118
    Published: 2016
    Released on J-STAGE: December 30, 2016
    JOURNAL FREE ACCESS
    Supplementary material

    Matsuda F, Mukaino M, Ohtsuka K, Tanikawa H, Tsuchiyama K, Teranishi T, Kanada Y, Kagaya H, Saitoh E. Analysis of strategies used by hemiplegic stroke patients to achieve toe clearance. Jpn J Compr Rehabil Sci 2016; 7: 111-118.

    Objective: The purpose of this study was to analyze the extent to which lower limb shortening and compensatory movements contribute to toe clearance during swing, and to identify the different strategies employed by healthy individuals and hemiplegic stroke patients to achieve toe clearance.

    Methods: The subjects comprised 18 hemiplegic stroke patients and 18 healthy individuals matched for age, gender, and walking speed. We calculated toe clearance and its components for comparison between the two groups. We also calculated the correlations between the components.

    Results: The foot-to-floor distance during mid-swing was smaller in hemiplegic stroke patients than in healthy individuals. Regarding the components, shortening of hip-toe length (SHTL) was smaller in stroke patients, whereas upward movement of the hip due to pelvic obliquity, upward movement of the foot due to abduction, and upward movement of the contralateral hip were all greater. Among hemiplegic stroke patients, there were significant negative correlations between SHTL and the other components.

    Conclusions: Hemiplegic stroke patients achieved smaller upward movement by lower limb shortening compared with healthy individuals. The contribution of hip hiking and other compensatory movements that correlated to SHTL appeared to be important in achieving toe clearance.

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  • Hiroshi Matsuo, Shigeru Sonoda, Shinichiro Maeshima, Makoto Watanabe, ...
    Article type: Original Article
    2016 Volume 7 Pages 119-129
    Published: 2016
    Released on J-STAGE: December 22, 2016
    JOURNAL FREE ACCESS
    Supplementary material

    Matsuo H, Sonoda S, Maeshima S, Watanabe M, Sasaki S, Okuyama Y, Okazaki H, Okamoto S, Kondo I. Contribution of physical impairment or imaging findings in the prediction of ADL outcome in stroke patients with middle cerebral artery infarction. Jpn J Compr Rehabil Sci 2016; 7: 119-129.

    Objective: Effective rehabilitation can be realized through improved prediction accuracy of activities of daily living (ADL) outcomes in stroke patients after cerebral infarction. We investigated whether physical impairment and imaging findings contributed to improved prediction accuracy of ADL outcomes in stroke patients with a first time unilateral infarction in the middle cerebral artery.

    Methods: The study included a total of 331 patients with diffusion-weighted magnetic resonance images from an acute-care hospital, who were admitted to our Kaifukuki Rehabilitation Wards. Admission Functional Independence Measure (FIM) motor (FIM-M) score, admission FIM cognitive score, age, days until admission to our hospital, Stroke Impairment Assessment Set (SIAS) (motor function, trunk function, unilateral spatial neglect, and lower limb position), type of cerebral infarction, and presence of lesions were set as independent variables. Discharge FIM-M score and FIM-M gain were designated as dependent variables. Multiple regression analysis, logistic regression analysis, and decision tree analysis were performed. In addition, independent variables that significantly contributed to improved prediction accuracy of ADL outcomes were clarified by stratifying patients and inserting/deleting independent variables.

    Results: Trunk function and presence of lesions contributed to improved accuracy in predicting FIM-M gain in patients with low admission FIM-M scores.

    Conclusion: Using physical impairment and image findings in addition to the admission ADL in patients with first time unilateral infarctions in the middle cerebral artery after stratification was useful in predicting the discharge ADL.

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