The purpose of this study was to test the hypothesis that a home-based rehabilitation program following anterior cruciate ligament (ACL) reconstruction is equally effective to a clinic-based program. Thirty-eight patients (23 male, 15 female, 24.4 years) completed the study. Seventeen patients received home-based rehabilitation, and 21 patients received clinic-based rehabilitation. Knee range of motion, thigh atrophy, Lachman test, pivot shift test, KT-2000, isokinetic extension and flexion strength, International Knee Documentation Committee (IKDC) objective and subjective score, and Lysholm score were evaluated at 3, 6 and 12 months postoperatively. There was no significant difference for all outcomes except for isokinetic extension and flexion strength at 6 months between both groups. Isokinetic extension and flexion strength at 6 months postoperatively was significantly greater in the home-based group compared with the clinic-based group. Results indicated that patients undergoing ACL reconstruction can successfully reach acceptable outcomes with a home-based rehabilitation program.

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A minimally invasive technique for esophagostomy called percutaneous transesophageal gastrotubing (PTEG) was recently developed. We performed PTEG in 3 patients with dysphagia who were also difficult cases of percutaneous endoscopic gastrostomy (PEG). The first case was a 69-year-old woman with a subarachnoid hemorrhage and a ventricle-peritoneal shunt. The second case was an 81-year-old man with cerebral infarction and post subtotal gastrectomy. The third case was a 64-year-old man with cerebral infarction after aortic arch replacement and coronary artery bypass graft, where the position of the stomach had shifted in the thorax. We established PTEG in the first and the second cases, and it was effective for enteral nutrition in these cases. However, the tips of the gastrotube were sometimes cut off by degradation and the procedure was carried out with endoscopy in the second case. We could not perform PTEG in the third case due to adhesion of cervical lesions and treated the patient with a nasogastric tube. PTEG is as safe and effective for enteral nutrition as PEG, and should be considered a good option when choosing an approach for delivering enteral nutrition.

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We report two patients with acquired immunodeficiency syndrome (AIDS) who are under rehabilitation treatment at our hospital. They are undergoing a highly active antiretroviral therapy. Case 1, a male in his forties, came down with toxoplasmic encephalitis and later developed right hemiplegia, truncal ataxia and higher brain dysfunction. He received antibiotic therapy and medical rehabilitation. As a result, his impairment improved. He has been trained to acquire the means of coping with his frontal lobe dysfunction so as to have access to a job once again. Case 2, a male in his fifties, has muscle weakness, sensory disturbance in his lower extremities and easy fatigability. His illness was diagnosed as AIDS ten years ago. AIDS wasting syndrome and distal symmetrical polyneuropathy caused his symptoms. He has performed therapeutic exercises. The muscular weakness has lasted, but he can continue to live alone by making good use of an electric wheelchair and receiving on-visit nursing and home help services. In many ways, AIDS can cause functional impairments and disabilities. When we employ rehabilitation strategies to manage impairments associated with AIDS, we must discuss the condition of the patient and the cause of their impairments one by one. The serious problem of AIDS rehabilitation is that social participation is difficult for patients with AIDS. With AIDS turning into a chronic condition, the rehabilitation strategies play an expanded role for people living with AIDS. Even though there are only a few AIDS patients in our rural district, we will strive to provide adequate rehabilitation services to them.

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