Rehabilitation Model in a Community ; What Physiatrist can Show and Manage?…Kazuyo OGUCHI 522

The Only Convalescence Rehabilitation Ward alone Hospital Managed by a Local Government directly in Japan and Resident Education…Kazuto AKABOSHI 526

Form of our Recovery Phase Rehabilitation Ward : As a Branch Hospital of Kagoshima University Hospital…Atsuko OGATA 529

Training Rehabilitation Doctors in a Kaifukuki Rehabilitation Ward…Hidekazu SUGAWARA 533

The Appropriate Way of the Medical Doctor in Recovery Rehabilitation : A Personal Opinion…Ataru FUKUDA, Isao KITAHARA, Yoshinori TESHIMA, Tomohiro MORITO, Ryou TANAKA, Takashi SOTA 537

View full abstract

Rehabilitation for TBI on Sub-acute Phase : Cognitive Problems as Obstacles to Social Participation…Minoru TOYOKURA 542

Rehabilitation of Traumatic Head Injured Patients in the Chronic Life Stage…Mitsuo TAKEI 547

View full abstract

Objective : Serum albumin is important marker in all aspects of stroke care including rehabilitation. We examined the serum albumin level of stroke patients, and investigated the relation between their serum albumin level and their prognosis. Methods : The serum albumin levels of 295 patients enrolled from 2008 to 2014 were sequentially checked in our hospital and in subsequent rehabilitation hospitals. Functional outcome was measured by functional independence measure (FIM) at the time of discharge from the rehabilitation hospital. Results : In all types (cerebral infarction, cerebral hemorrhage and subarachnoid hemorrhage (SAH)) of apoplexy, serum albumin levels were the highest at the time of admission, temporarily declined after admission, and almost recovered at the time of discharge. In SAH, the serum albumin levels deteriorated at a greater rate than in other types of stroke. In cerebral infarction and cerebral hemorrhage, the lowest serum albumin level was positively correlated with FIM at the time of discharge from the rehabilitation hospital (p<0.001). But, in SAH, there was no significant correlation between the lowest serum albumin level and FIM at the time of discharge (p=0.844). Conclusion : Our data suggest that serum albumin level is associated with the outcome of stroke patients, except for SAH patients. Serum albumin level should be one of the prognostic factors used in stroke patients, but we should consider that SAH patients are exceptional because of other neurological complications.

View full abstract

A sixteen-year-old girl with neuropsychological dysfunction after cerebral encephalopathy came to our hospital for evaluation of her cognitive impairment and ability to acquire compensatory skills for communicative dysfunction. Neuropsychological examinations revealed low scores on FSIQ, VCI, WMI and PSI by WISC-Ⅳ. We intervened using a process-orientated speech-language-hearing therapy to improve her cognitive, language and communicative skills for a year. After that, we evaluated her cognitive ability by WISC-Ⅳ and LCSA. As a result of our intervention, her word knowledge, idiom and mental expression, sentence expression and reading social condition and expression scores in LCSA performance were improved but each IQ by WISC-Ⅳ was preserved. In ST intervention for pediatric neuropsychological dysfunction, the patient evaluation should be made not only using IQ by WISC-IV but also by measuring other communicative skills such as by LCSA.

View full abstract