The Japanese Journal of Rehabilitation Medicine
Online ISSN : 1880-778X
Print ISSN : 0034-351X
ISSN-L : 0034-351X
Volume 42, Issue 8
Displaying 1-5 of 5 articles from this issue
President's Proposal
Case Reports
  • Akiyoshi NAGATOMI, Kazuto AKABOSHI, Reon ABE, Shinji OGAWA, Kaori MURA ...
    2005 Volume 42 Issue 8 Pages 553-557
    Published: 2005
    Released on J-STAGE: September 22, 2006
    JOURNAL FREE ACCESS
    We report a 40-year-old female patient with Spinal Muscular Atrophy (SMA) type III, a slow progressive motor neuron disease, who also had an ADL disorder caused by a bilateral severe pes equinus deformity since she was an infant and newly occurring brachial plexus palsy. Her pes equinus deformity occurred in childhood and was gradually aggravated afterwards, but appropriate guidance was not taken due to her mother's distrust of medical intervention. By the time she was 25, it was impossible for her to walk, and she retired from her job and lived afterward at several homes. Her left upper extremity was inconvenient, but she utilized her right upper extremity, and her independent life indoors was managed by crawling. At 39 years of age, she became unconsciousness in a diabetic coma for four days. When her consciousness returned, right brachial plexus paralysis occurred. All of her ADL needs except meal movement required assistance, so she was transferred to our hospital for the purpose of rehabilitation 11 months after the onset of her paralysis. Finally, she was able to dress herself, roll over and gain locomotion with an electric wheelchair and she became independent, but she still needed assistance for transfer activities. With her improved ADL, her mother's distrust of medical assistance was overcome and a good doctor patient relationship was formed.
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  • Yuusuke ABE, Tetsurou WATANABE, Satoru SAEKI, Kenji HACHISUKA
    2005 Volume 42 Issue 8 Pages 558-563
    Published: 2005
    Released on J-STAGE: September 22, 2006
    JOURNAL FREE ACCESS
    We report a 59-year-old man with X-linked Charcot-Marie-Tooth disease. Although the patient had already been diagnosed with polyneuropathy at a hospital, he was admitted to our department for further rehabilitative treatments because he began to notice that he needed assistance while walking. On admission, he had muscle atrophy and weakness in the distal part of his extremities, sensory loss of touch and pain in the fingers, feet and toes, and loss of deep tendon reflexes, and pes equino-cavus. Conduction velocities of the bilateral median, ulnar, and tibial nerves were lower than the standard values, and evoked potentials of the bilateral sural nerves were not detected. Needle electromyography showed polyphasic motor unit action potentials in the left tibialis anterior and right first dorsal interosseus muscles. Gene analysis disclosed a mutation (Trp77→stop codon) in the connexin 32. Therefore, we diagnosed him as having X-linked Charcot-Marie-Tooth disease. For rehabilitative treatments, we prescribed resistive exercises for the upper and lower extremities, prolonged stretching of the ankle joints on a standing board, and gait training with bilateral Lofstrand's crutches and shoe-horn type plastic ankle-foot orthosis. A standard wheelchair was also made available for going outside.
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Review Article
  • Effects of Muscle Strength and Muscle Tone
    Masaharu MARUISHI, Yasuo KUROSE, Shotaro KATAYAMA
    2005 Volume 42 Issue 8 Pages 564-572
    Published: 2005
    Released on J-STAGE: September 22, 2006
    JOURNAL FREE ACCESS
    Cerebral palsy (CP) is a motor disorder that results from a nonprogressive brain lesion that occurs during prenatal or perinatal development. As motor function in patients with CP changes with brain development, it may be more suitable to make a quantitative evaluation during adulthood than childhood. But until now there has been little information available about adult CP. In this review, we investigate the clinical characteristics and ADL scores in adult CP patients from our series of clinical experience. From our previous study that assessed the clinical characteristics of adult CP using uniform scale, a population of adult CP patients showed markedly increased muscle tone and moderate muscle weakness. These two factors did not correlate with each other, and were independently responsible for worse ADL scores. Decreased functional ability and secondary muscloskeletal problems such as cervical spondylosis are common in adult CP patients. We therefore added a review of them such reports from the literatures.
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