The Japanese Journal of Rehabilitation Medicine
Online ISSN : 1881-8560
Print ISSN : 1881-3526
ISSN-L : 1881-3526
Volume 57 , Issue 8
Showing 1-13 articles out of 13 articles from the selected issue
  • Junya Hirata, Masaru Umeda, Kyoko Tanaka, Makoto Zukeran, Masaki Goto, ...
    2020 Volume 57 Issue 8 Pages 749-756
    Published: August 18, 2020
    Released: September 25, 2020
    [Advance publication] Released: July 15, 2020
    JOURNALS RESTRICTED ACCESS

    It remains unclear how much rehabilitation training is suitable for stroke patients aged ≥ 75 years. To investigate this, especially in convalescent rehabilitation wards, we studied 65 patients (28, ≦ 74 years;37 ≧ 75 years) with cerebral infarction hospitalized in the acute care ward and then in a convalescent rehabilitation ward. From their medical records, we collected data regarding the length of their hospital stay, total amount of rehabilitation training, and activities of daily living evaluated using the total scores of the functional independent measure (FIM) measured on admission to the acute care and convalescent rehabilitation wards, respectively. From these data, we calculated the absolute functional gain, relative functional gain, and average amount of rehabilitation training per day. The correlation of each item and age was analyzed. Items that significantly correlated with age were compared between ≦ 74 and ≧ 75 years age groups. As a result, the absolute functional gain and average amount of rehabilitation training per day were not significantly different between groups. The relative functional gain was significantly lower in the ≧ 75 years group than in the ≦ 74 years group. The total FIM scores at discharge showed a positive correlation with the amount of rehabilitation training in patients aged ≧ 75 years. We believe that a large amount of rehabilitation training is beneficial for patients aged ≧ 75 years with cerebral infarction.

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  • Utako Miyamoto, Etsuko Mizutamari, Makoto Tokunaga, Kaoru Matsunaga, R ...
    2020 Volume 57 Issue 8 Pages 757-765
    Published: August 18, 2020
    Released: September 25, 2020
    [Advance publication] Released: July 15, 2020
    JOURNALS RESTRICTED ACCESS

    Paraparesis is a rare and serious complication following epidural anesthesia. Abnormal findings on magnetic resonance imaging (MRI) help with the diagnosis;however, diagnosis is challenging in the absence of MRI abnormalities.

    We present the case of a 26-year-old pregnant woman who received combined spinal-epidural anesthesia for cesarean delivery. The following day, she developed muscle weakness and sensory disturbances in the right lower extremity, which were attributable to the continuous epidural analgesia with ropivacaine that was used during the cesarean delivery. MRI revealed no spinal canal abnormalities;however, skeletal muscle MRI performed in the subacute phase revealed abnormally high signals on T2 and fat suppression T2-weighted imaging in the right paraspinal muscle below the L3 level. Nerve conduction studies revealed reduced amplitude of compound muscle action potentials and sensory nerve action potentials recorded in the lower extremities. After a 4-month period of rehabilitation, the patient could walk independently with a right ankle-foot orthosis and crutch;however, her right leg palsy and sensory disturbances persisted. Here, we report the clinical course of a patient who developed lumbosacral radiculopathy attributable to ropivacaine-induced neurotoxicity. Additionally, we present a review of the literature.

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