Objective：We aimed to examine the effects of a transcranial direct current stimulation (tDCS) performed prior to occupational therapy and combined with an Integrated Volitional control Electrical Stimulation (IVES) therapy on the upper extremity function for patients with chronic stroke. We also aimed to detect the longitudinal changes of hemodynamic responses in the sensorimotor cortex area (SMC) following successive tDCS prior to IVES therapy.
Methods：Seven subjects with moderate upper extremity (UE) paresis in chronic stroke were enrolled in this study. The patients received coupled tDCS and IVES therapy five times a week. UE function was estimated by Simple Test for Evaluating Hand Function (STEF). Functional near-infrared spectroscopy (fNIRS) was used to detect the long-term changes of hemodynamic responses in bilateral SMC during opening and closing of the affected fingers, assisted by IVES. Lastly, the SMC responses after the first tDCS were compared with those obtained after the fifth tDCS.
Results：Coupled tDCS and IVES therapy was effective for improving the UE paresis. fNIRS demonstrated a significantly increased hemodynamic responses in bilateral SMC, following IVES therapy with the fifth tDCS relative to those with the first tDCS.
Conclusion：The findings suggested that tDCS prior to IVES therapy might improve UE function of the patients with chronic stroke, presumably by augmenting hemodynamic responses in bilateral SMC.
Objective：The English version of the Characterizing Freezing of Gait questionnaire (C-FOGQ) that is used to assess detailed information of freezing of gait was developed by Ehgoetz Martens et al. This study aims to develop the Japanese version of the C-FOGQ using guidelines for cross-cultural adaptation and to conduct the pretesting study.
Methods：The C-FOGQ was translated with permission into Japanese according to the following guidelines for cross-cultural adaptation： (1) translation (English to Japanese), (2) back-translation (Japanese to English), and (3) pretesting. Thirty-nine patients with parkinsonism-related disorders participated in the pretesting study.
Results：There was no significant linguistic problem in the process of translation and back-translation. In pretesting, the average response time of the Japanese version of the C-FOGQ was 526.8 seconds. The error/no-response rate was less than 1%. The average score for section II of the Japanese version of the C-FOGQ was 20.0 points.
Conclusion：A linguistically-validated Japanese version of the FOGQ was developed according to the guidelines of cross-cultural adaptation. It seems to be possible to use this questionnaire for detailed evaluation of gait freezing in Japan as well as in the West.
Objective：This study aimed to clarify the actual functions and issues associated with the work of a full-time prosthetist and orthotist while treating patients and users at a rehabilitation hospital.
Methods：Using a database that recorded the work performed by the full-time prosthetist and orthotist, the details of the work performed over the course of a year were classified into eight categories and tabulated by stage and item.
Results：A total of 1,300 responses were collected for the one-year study period, of which participation in replacement of consumables and damage repair, adjustment of conformity, and brace clinic conferences accounted for 54.0%. Ankle-foot orthosis was the most common response (59.2%), and was more frequently associated with the living phase (76.3%) than the recovery phase (46.5%). The response numbers for all items per prescription in the recovery phase were as follows：prosthetic legs, 11.1 times；ankle-foot orthoses, 3.7 times；and knee ankle-foot orthoses, 2.2 times. Thus, the responses for knee ankle-foot orthoses were less frequent than those for the other two.
Conclusion：The maintenance of ankle-foot orthoses in the living phase and prosthetic legs in the recovery phase was well supported by a full-time prosthetist and orthotist. On the other hand, users of knee ankle-foot orthoses may have received less support.