Rehabilitation for ocular motility disorder and diplopia after acute cerebral infarction has not been established. In the present case, we describe the course of oculomotor rehabilitation in a patient with left-sided gaze palsy and diplopia due to a stroke in the paramedian part of the left pontine tegmentum. The patient was a right-handed man in his 40s. Cerebral infarction occurred after coil embolization with stenting for an unruptured dissecting aneurysm. He presented with eye movement difficulty resulting from conjugate deviation of the eyes to the right at onset. No other motor-sensory abnormalities were present. Processing speed of Wechsler Adult Intelligence Scale-Fourth Edition was decreased. We performed oculomotor rehabilitation from the acute phase, including fixation, smooth pursuit, saccadic and convergent movements. Visual attention tasks such as visual search and cancellation tasks were applied from 10 days after onset. The oculomotor disorders gradually improved and disappeared by 65 days after onset. The responsible lesion was localized in left paramedian pontine reticular formation and abducens nucleus. Medial longitudinal fasciculus was not involved, which was consistent with the clinical oculomotor findings. The neuropsychological assessments showed that processing speed was improved. Based on the neuropsychological assessments and actual vehicle evaluation, our multidisciplinary team determined that the patient should not refrain from automobile driving. The patient returned to work and resumed driving 86 days after onset. The results suggest that visual attention tasks together with basic oculomotor trainings for ocular motility disorder and diplopia are useful for early return to automobile driving and society.

Objective: To develop a nomogram-based model for predicting the time required to reestablish independent walking on level ground in stroke patients with hemiplegia admitted to a convalescent rehabilitation ward, based on available information at admission.

Methods: This retrospective study included 228 patients with stroke-induced hemiplegia who were admitted to the convalescent rehabilitation ward of our hospital. The assessed outcome was the proportion of patients who achieved independent walking at 30, 60, 90, and 120 days after stroke onset. Candidate predictors at admission included age, sex, stroke type, side of paresis, number of days from onset to admission, ability to get up, lower extremity Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS) score, and total motor and cognitive Functional Independence Measure (FIM) scores. Cox proportional hazards analysis was used to identify significant predictors, and a nomogram was developed.

Results: The multivariate analysis identified age, number of days from onset, ability to get up, BBS score, and total FIM motor and cognitive scores as significant predictors. The nomogram demonstrated high predictive performance (C-index: 0.858; bootstrap: 0.851) with good calibration.

Conclusion: This model may assist clinicians in estimating the probability of achieving independent walking on level ground at 30, 60, 90, and 120 days after stroke onset, supporting early goal setting and individualized rehabilitation planning.

Objective: This study aims to statistically clarify the association between disability characteristics and school refusal in school-aged children with Autism Spectrum Disorder (ASD).

Methods: The subjects were 158 school-aged children with ASD who were prescribed rehabilitation at Narita Hospital of International University of Health and Welfare. The following information was collected from medical records: presence or absence of school refusal, age, gender, the Autism Screening Questionnaire (ASQ) scores, result of the Wechsler Intelligence Test 4th version, the Sensory Profile (SP) scores, the Liebowitz Social Anxiety Scale for Children and Adolescents scores, decline in family functions, bullying, and enrolled class. Poisson regression analysis was conducted using both crude and adjusted models. School refusal was the dependent variable, while ASQ and SP subcategories were the independent variables. Age and other factors were used as covariates in the adjusted model.

Results: The “sensory avoidance” of the SP subcategory was significantly associated with school refusal in both the crude and adjusted models (odds ratio, 95% confidence interval: 1.03, 1.01-1.05, 1.03, 1.00-1.05, respectively).

Conclusion: Analysis of the association between disability characteristics and school refusal in school-aged children with ASD suggests that sensory processing deficits are associated with school refusal.

Objective: This study aimed to identify the clinical characteristics of patients achieving independent gait through Robot-Assisted Gait Training, based on their condition at the onset of the training.

Methods: The subjects were patients after stroke who underwent 4 weeks of gait training using the Hybrid Assistive Limb^® (HAL, Cyberdyne, Inc.). The assessment items were Functional Ambulation Categories (FAC), Stroke Impairment Assessment Set (SIAS), Fugl-Meyer Assessment (FMA) for lower extremity, Berg Balance Scale (BBS), Functional Independence Measure (FIM), and Hasegawa Dementia Scale-Revised (HDS-R). Patients with a FAC score of 3 or higher were classified as the independent group, while those with a FAC score of 2 or lower were classified as the assistance group. A univariate analysis was conducted with a significance level set at 5%.

Results: Ten patients were in the independent group (mean age 73.2±13.8 years), while 7 patients were in the assistance group (mean age 83.6±6.1 years). The independent group demonstrated significantly higher scores in SIAS total score, BBS, FIM, and HDS-R (p<0.05). Additionally, the SIAS subscales assessing knee joint function, lower limb range of motion, abdominal muscle strength, verticality, and quadriceps muscle strength on the non-paralyzed side were all significantly higher in the independent group (p<0.05).

Conclusion: Patients achieving independent gait through training with HAL were younger, exhibited lower levels of functional disability, demonstrated better balance, and showed a greater capacity to perform activities of daily living and cognitive function.