This study sought to elucidate the relationship between units of rehabilitative training time and Functional Independence Measure (FIM) at time of discharge in femoral neck fracture patients. The subjects were 795 patients with femoral neck fracture from 19 hospitals registered in the Japan Rehabilitation Database who satisfied the inclusion criteria. Separating these into 15 hospitals (371 cases) where surgery was performed at outside institutions and 14 hospitals (424 cases) where surgery was performed in-house, multiple regression analysis was performed using six explanatory variables including hospital dummy and training time units, and motor FIM score at discharge as an objective variable. In the outside surgery group, whose training time units ranged from 0.8 to 8.6, the coefficient was not significant. However, it became significant when narrowed to two hospitals comprising more than 50 cases (B=2.187). The in-house surgery group's training time units represented a significantly positive coefficient (1.427). It is thought that if the number of training time units used for patients with femoral neck fractures increases by one unit, then the patient's motor FIM score at discharge will rise about 1.4 to 2 points.

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Regenerative medicine, which aims to restore, replace or regenerate cells and tissues using novel approaches such as iPS therapy, is currently a big issue in the field of rehabilitation medicine. Neurological recovery has been proved using marmoset monkeys with spinal cord lesions and Hematoxylin-Eosin and Luxol fast blue staining were adopted to identify the increased number of neurons at the spinal cord level. In regenerative medicine, pathophysiological findings demonstrating the recovery of motor units can provide direct evidence of neuromuscular function. In the field of rehabilitation medicine, the final common pathway, e.g. intramuscular nerve fibers and neuromuscular junctions, will be the target used to identify the recovery of motor function. Present physiatric modalities such as electrical or magnetic stimulations and therapeutic exercises will serve as the strategic applications used in neuromuscular regeneration treatments. The methylene blue vital staining method is a classical technique that when combined with the recently developed functional fluorescent protein staining along with transgenic procedures and confocal endomicroscopy examinations will illuminate our investigations into the degree of regenerative success obtained. These neuromuscular pathologies at the spinal cord level as well as the lower motor neuron level will allow us to more clearly determine the efficacy of various physical modalities used in rehabilitation medicine. The regenerative medicine era will require rehab efforts not only for treating spinal cord lesions but also for treating brain damaged patients in the future.

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