Progress in Rehabilitation Medicine
Online ISSN : 2432-1354
ISSN-L : 2432-1354
Volume 4
Showing 1-21 articles out of 21 articles from the selected issue
  • Yoshiteru Akezaki, Ritsuko Tominaga, Masato Kikuuchi, Hideaki Kurokawa ...
    Type: ORIGINAL ARTICLE
    2019 Volume 4 20190021
    Published: 2019
    Released: November 23, 2019
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    Objective: The aim of the current study was to assess the risk factors for developing lymphedema following breast cancer treatment. Methods: The subjects of this study were 238 consecutive patients who underwent axillary lymph node dissection for breast cancer at Shikoku Cancer Center. The study variables were the occurrence of lymphedema, the body mass index, the follow-up period, the drain removal time, the level of lymph node dissection, the presence or absence of co-resident household members, radiation therapy, neoadjuvant chemotherapy, and adjuvant chemotherapy. Results: We observed lymphedema in 23.9% of patients after axillary lymph node dissection for breast cancer. Neoadjuvant chemotherapy and adjuvant chemotherapy using docetaxel and cyclophosphamide increased the risk of developing lymphedema (P <0.05). Conclusions: Those patients treated with neoadjuvant chemotherapy and adjuvant chemotherapy using docetaxel and cyclophosphamide should be observed closely after axillary lymph node dissection, and appropriate intervention should be considered from an early stage.

  • Tomoyuki Matsuba, Yukihiko Hata, Norio Ishigaki, Koichi Nakamura, Hiro ...
    Type: CASE REPORT
    2019 Volume 4 20190020
    Published: 2019
    Released: November 13, 2019
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    Background: We herein report a case of heterotopic ossification (HO) in the subdeltoid space after open resection and rotator cuff repair in a patient with refractory calcific tendinitis. Case: A 56-year-old man was admitted to our hospital because of right shoulder pain and difficulty in raising his arm. The patient was diagnosed with calcific tendinitis with contracture of the right shoulder joint and was scheduled for surgery because of refractory shoulder pain. Calcium removal was performed using a mini-open approach. Postoperative radiographs showed no calcium deposits. There was mild residual pain at 3 months postoperatively, and the range of motion (ROM) had deteriorated when compared to preoperative levels. A massive ossified shadow was observed in the subdeltoid space on radiographs. Etidronate disodium was orally administered, and the patient continued to undergo careful rehabilitation. HO occurred at 3 months postoperatively, matured at 1 year postoperatively, and showed no progression between 1 year and 2 years postoperatively. The clinical symptoms corresponded with the image findings, and restricted ROM and decreased shoulder function scores were observed at 3 months postoperatively. Although the ROM remained restricted and the function score remained low until 1 year postoperatively, a gradual recovery was achieved at 2 years postoperatively, and the patient did not require reoperation. Discussion: Although early diagnosis, evaluation, and resection are recommended for treating HO, the maturation of bone may lead to symptomatic improvement and the prevention of reoperation, provided that careful rehabilitative measures are performed to avoid ankyloses.

  • Takayuki Mitsuishi, Yoshihito Ishihara
    Type: ORIGINAL ARTICLE
    2019 Volume 4 20190019
    Published: 2019
    Released: November 01, 2019
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    Objective: The objectives of this study were to clarify whether prevertebral soft tissue (PVST) thickening increases the risk of dysphagia, to identify at which vertebral level determining PVST thickness is useful, and to determine cutoff values. Methods: A total of 80 patients with traumatic cervical spinal cord injury (TCSCI) treated over a 43-month period at a single regional institution specializing in cervical spinal cord injuries participated in the study. The exclusion criteria were having undergone anterior cervical spine surgery; a history of complicated traumatic brain injury, complicated vertebral artery injury, or brain injury; endotracheal intubation at day 30 after onset; the disappearance of neurological symptoms within 24 hours after onset; and the use of a halo vest. The associations between PVST thicknesses at C1, C2, C3, C6, and C7 measured by CT on the day of onset and the presence of dysphagia (Food Intake LEVEL Scale score <8) at 30 and 60 days after onset of TCSCI were analyzed using ROC curves to calculate the maximum area under the curve and the PVST cutoff values for these vertebrae. Associations between various risk factors, including PVST thickness, and dysphagia at days 30 and 60 after onset were examined using univariate and multivariate analyses. Results: Independent associations with dysphagia were found with the C3 PVST thickness (day 30: ≥8.3 mm, day 60: ≥9.4 mm) and tracheostomy. Conclusion: PVST thickness or injury seems to be an independent risk factor for dysphagia. By measuring PVST, it is possible to estimate the severity of dysphagia even in acute conditions.

  • Hiroaki Teramatsu, Junichiro Shiraishi, Yasuyuki Matsushima, Masaru Ar ...
    Type: ORIGINAL ARTICLE
    2019 Volume 4 20190018
    Published: 2019
    Released: October 19, 2019
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    Objective: The aim of this study was to investigate which method of evaluating physical function could predict 1-year readmission due to worsening of heart failure (HF) in newly diagnosed HF patients. Methods: One hundred sixteen consecutive patients with HF who underwent cardiac rehabilitation at our hospital between May 2012 and September 2015 were retrospectively enrolled. Participants were divided into two groups based on whether they were readmitted for worsening HF within 1 year. Logistic regression analysis was used to evaluate whether physical function at the time of discharge was related to HF readmission within 1 year. Results: After a mean follow-up period of 327 days, 22 patients were readmitted because of worsening HF. In the readmission group, the results of the 6-Minute Walk Test (6MWT), One-Leg Standing Test, and 30-Second Chair-Stand Test at initial discharge were significantly worse than those in the non-readmission group. In a multivariable logistic regression model, after adjusting for age and sex, a lower 6MWT distance was independently associated with increased risk of readmission within 1 year (odds ratio: 0.990, 95% confidence interval: 0.985–0.996). The 6MWT showed better prognostic value (area under the receiver operating characteristic curve: 0.696) than other evaluation methods of physical function. The 1-year non-readmission rates were 90% for 6MWT ≥382.5 m, 68% for 6MWT <382.5 m, and 53% for those unable to walk 200 m independently (P <0.001). Conclusion: Physical function, particularly the 6MWT distance at time of discharge, can be used to predict the likelihood of readmission within 1 year for patients with HF.

  • Mieko Yokozuka, Chie Miki, Hirohiko Kurogo, Takeshi Kobayashi, Mayumi ...
    Type: ORIGINAL ARTICLE
    2019 Volume 4 20190017
    Published: 2019
    Released: October 11, 2019
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    Objective: We examined the toe flexor strength, foot morphology, and falls in community-dwelling elderly women who could walk outdoors independently without aids. Methods: The presence or absence of falls in 1 year, the toe flexor strength, and foot morphology were recorded in 70 women. Hallux valgus was defined as a first phalangeal angle ≥16°. Falls were compared based on the presence or absence of hallux valgus using the chi-squared test. The toe flexor strength, arch height ratio (medial longitudinal arch), and spread ratio (lateral arch) were compared using the Mann-Whitney U-test according to the presence or absence of hallux valgus. Spearman’s correlation coefficient was used to compare toe flexor strength and foot morphology. Results: No difference in the fall rate was noted between those with hallux valgus on at least one foot and those without hallux valgus. No difference in toe flexor strength was noted between feet with and without hallux valgus. Correlations were found between the hallux valgus angle and the arch height (r=–0.228, P<0.01) and spread ratios (r=0.494, P<0.001). Conclusions: Among community-dwelling elderly women who can walk independently outdoors without aids, the presence or absence of hallux valgus does not affect the incidence of falls. The lack of correlation between toe flexor strength and foot morphology may support this conclusion.

  • Minori Imura, Yasuyo Nakashima, Risa Kawaguchi, Mariko Terashima, Sige ...
    Type: CASE REPORT
    2019 Volume 4 20190016
    Published: 2019
    Released: September 20, 2019
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    Background: Effective interaction with orally intubated patients is important for critical care rehabilitation. An electrolarynx (EL) has reportedly proven useful for facilitating verbal communication during oral intubation. The EL allows patients to express their wishes instantly. Nevertheless, this method is not commonly applied, probably because articulation is often unsatisfactory. Here, we report a case of successful EL-based communication during early mobilization and describe the key factors involved in this success. Case: An 82-year-old man, who was intubated and undergoing mechanical ventilation for the treatment of acute respiratory failure caused by severe pneumonia, was referred to the rehabilitation department for early mobilization. The patient tried to speak during the spontaneous awakening trials and breathing trials for weaning off mechanical ventilation. However, he was frustrated by communication difficulties and consequently exhibited negative behavior toward physical therapy. We attempted to use an EL to facilitate communication, but initially the patient failed to achieve intelligible articulation. We eventually established that the intubation tube should be located at the corner of the mouth to minimize the restriction of tongue movement. Intelligible sounds were recognized and successful communication between the patient and staff was subsequently achieved. Discussion: The use of an EL is worthy of consideration during early mobilization of orally intubated patients. To achieve successful communication with an EL, both patient selection (Richmond Agitation-Sedation Scale score of 0 or −1) and the proper placement of the intubation tube are necessary to ensure intelligible articulation.

  • Ena Sato, Takehiko Yamaji, Hideomi Watanabe
    Type: ORIGINAL ARTICLE
    2019 Volume 4 20190015
    Published: 2019
    Released: September 06, 2019
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    Background: The WISH-type S-form hip brace (WISH brace) has been shown to significantly improve hip function, functional mobility, and gait biomechanics in patients with hip osteoarthritis. The aim of the current study was to evaluate the effects of the WISH brace over time on the strength of muscles around the hip and knee joints. Methods: A prospective short-term longitudinal study with a 6-month follow-up was conducted. Muscle strengths were measured using a handheld dynamometer. Results: The muscle strengths of hip flexion, hip abduction, and knee extension were lower in the affected limb than in the unaffected limb, whereas hip adduction muscle strength was reduced to the same extent in both the affected and unaffected limbs. This short-term longitudinal study revealed that only hip adduction and knee extension exhibited significant interaction between legs and time when measurement was performed without the WISH brace. Furthermore, the inherent hip abduction muscle strength of the affected limb was improved by the WISH brace so that the strength became the same as the unaffected limb. Conclusions: Improvement in abduction muscle strength of the affected limb by daily walking exercise with the WISH brace, which occurred with little interaction with the unaffected limb, may improve hip function.

  • Hideyuki Tashiro, Takuya Isho, Takanori Takeda, Takahito Nakamura, Nao ...
    Type: ORIGINAL ARTICLE
    2019 Volume 4 20190014
    Published: 2019
    Released: September 03, 2019
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    Objective: Individuals with stroke frequently experience mobility deficits and limited community reintegration. This study aimed to investigate life-space mobility and relevant factors in community-living individuals with stroke. Methods: This was a cross-sectional study of 46 community-dwelling individuals with chronic stroke in Japan (mean age 72.7 ± 7.4 years; mean time post-stroke 63.6 ± 43.3 months; 26 men/20 women). We measured life-space mobility using a Japanese translation of the Life-Space Assessment. The following factors that might affect life-space mobility were assessed: the ability to perform activities of daily living, physical performance, fear of falling, and cognitive function. Results: A total of 41 participants (89.1%) had restricted life-space mobility (Life-Space Assessment score <60 points). A multiple linear regression analysis showed that limitations in activities of daily living, walking speed, and Falls Efficacy Scale-International scores were independently related to Life-Space Assessment scores. This model explained 51.3% of the variance in Life-Space Assessment scores. Conclusions: Most individuals with stroke had restricted life-space mobility. Life-space mobility was associated with the ability to perform activities of daily living, walking speed, and fear of falling. These findings could contribute to the development of rehabilitation interventions for regaining life-space mobility in individuals with stroke.

  • Tomoko Sakai, Tetsuya Jinno, Chisato Hoshino, Atsushi Okawa
    Type: ORIGINAL ARTICLE
    2019 Volume 4 20190013
    Published: 2019
    Released: June 29, 2019
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    Objective: This study aimed to investigate risk management during acute rehabilitation in cases where rehabilitation was canceled after prescription. Methods: Rehabilitation cases that were judged to be canceled after prescription in our hospital between April 1, 2017, and September 30, 2017, were investigated prospectively. The following parameters were examined: the total number of canceled rehabilitation therapies, the age and sex of the patients, the rehabilitation categories, the reasons for cancellation of rehabilitation, the clinical course after cancellation of rehabilitation, the number of cancellation cases with reasons corresponding to the cancellation criteria from the officially issued guidelines of the Japanese Association of Rehabilitation Medicine, and the applicable elements of the cancellation criteria. Results: Of the 2263 patients prescribed rehabilitation during the investigation period, rehabilitation was canceled in 110 (4.9%). The reasons for discontinuation were changes in vital signs in 53.6% of these 110 patients. Among the 21 patients in whom rehabilitation was stopped because of decreased oxygen saturation, six were found to have symptomatic pulmonary thromboembolism. In 92.8% of canceled cases, the reasons for cancellation corresponded to the cancellation criteria of rehabilitation. No serious adverse events were noted during the study period. Conclusion: The judgments of discontinuation of rehabilitation in this study were similar to the cancellation criteria of rehabilitation. Acute rehabilitation should be performed under the control of the cancellation criteria of rehabilitation.

  • Satoshi Kamada, Etsuji Shiota, Toshiyuki Yamashita, Takahiko Kiyama, K ...
    Type: CASE REPORT
    2019 Volume 4 20190012
    Published: 2019
    Released: June 12, 2019
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    Background: Kabuki syndrome is a rare congenital syndrome. Individuals with Kabuki syndrome have intellectual disabilities, often combined with skeletal anomalies and joint laxity. We herein report the first case of rehabilitation after reconstruction of the medial patellofemoral ligament in a patient with Kabuki syndrome. Case: A 27-year-old woman with Kabuki syndrome and severe intellectual disability fell during an epileptic seizure. The right patella dislocated and then spontaneously reduced; similar episodes occurred repeatedly. Reconstruction of the medial patellofemoral ligament and lateral retinacular release were performed. Despite an intensive rehabilitation protocol, the patient’s activities of daily living (ADL) did not quickly improve postoperatively because of her severe intellectual impairment and unwillingness to participate in rehabilitation exercises. About 3 months postoperatively, staff encouraged the patient to transfer from a wheelchair to a car, and she was able to get into the car with a little assistance. Subsequently, the patient’s ADL gradually improved. By approximately 1 year postoperatively, the patient was able to ambulate independently for a few meters. Discussion: The patient was thought to be interested in cars and in going for drives. Rehabilitation training for ADL improvement in patients with severe developmental disorders should include activities that the patients consider interesting.

  • Kyohei Omon, Masahiko Hara, Hideo Ishikawa
    Type: CASE REPORT
    2019 Volume 4 20190011
    Published: 2019
    Released: May 31, 2019
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    Background: Virtual reality (VR) technology has been recently introduced in a variety of clinical settings, such as physical, occupational, cognitive, and psychological rehabilitation or training. However, the clinical efficacy of VR rehabilitation compared with traditional training techniques remains to be elucidated. Case: A 90-year-old man underwent VR-guided, dual-task, body trunk balance training in the sitting position using a newly developed medical device (mediVR KAGURA, mediVR, Inc., Toyonaka, Japan) after his physical activity level had plateaued. The patient had difficulty in walking outside the hospital even after having undergone traditional physical training. VR-guided training was performed for 40 min every weekday for 2 weeks. Trunk balance training was performed using reaching tasks, and cognitive stimulation was designed to emulate the cognitive processing involved when walking in a city or town. After the VR-guided training, the patient’s 6-min walk distance improved from 430 m to 500 m even though there had been no improvement in muscle strength of the lower extremities. Furthermore, the patient could successfully walk outside the hospital without falling or colliding with obstacles. Discussion: It is noteworthy that the patient’s walking ability improved further by the addition of VR-guided, dual-task, trunk balance training carried out in the sitting position. This finding suggests several possible new approaches to overcoming walking disability. Walking requires lower-extremity muscle strength, postural balance, and dual-task processing. Currently, no effective quantitative methods have been identified for postural balance and dual-task training with the patient in the sitting position. Herein, we discuss the possible advantages of VR-guided rehabilitation over traditional training methods.

  • Masanori Okamoto, Munehisa Kito, Yasuo Yoshimura, Kaoru Aoki, Shuichir ...
    Type: ORIGINAL ARTICLE
    2019 Volume 4 20190010
    Published: 2019
    Released: March 26, 2019
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    Objective: The objective of the current study was to find the factors affecting the activities of daily living, as evaluated by the Barthel Index, at the end of rehabilitation after musculoskeletal tumour surgery. Further, we evaluated whether the Barthel Index correlates with functional scores that are specific to musculoskeletal tumours at final follow-up. Methods: The activities of daily living of 190 patients who underwent postoperative rehabilitation after surgery to treat musculoskeletal tumours were evaluated at the end of the program using the Barthel Index. Functional evaluation at the time of final follow-up observation was evaluated using the Musculoskeletal Tumour Society Score and the Toronto Extremity Salvage Score. Results: The post-rehabilitation Barthel Index was significantly lower in elderly patients aged more than 60 years and in those with malignant tumours and tumours larger than 10 cm. Malignancy and large tumour size were risk factors for a low Barthel Index. There was significant correlation between the Musculoskeletal Tumour Society Score/Toronto Extremity Salvage Score at final functional evaluation and the Barthel Index at the end of rehabilitation. Conclusion: The Barthel Index is a simple method to assess the activities of daily living and can potentially predict disease-specific health-related quality of life at final functional evaluation after musculoskeletal tumour surgery.

  • Machiko Hiramoto, Toru Morihara, Yoshikazu Kida, Tomoyuki Matsui, Yosh ...
    Type: ORIGINAL ARTICLE
    2019 Volume 4 20190009
    Published: 2019
    Released: March 20, 2019
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    Objective: The rotational range of motion (ROM) in the upper extremities, trunk, and lower extremities is important for throwing motion. However, unlike for the shoulders, the differences relating to age and throwing-side in trunk and lower extremity ROMs in baseball pitchers are unknown. This study examined the effects of age and dominance on the ROMs of the trunk and upper and lower extremities. Methods: The study included 356 young baseball pitchers aged 9–17 years who participated in off-season baseball camps. The subjects comprised 155 youth pitchers (aged 9–14 years) and 201 high-school pitchers (aged 15–17 years) who were able to throw at full force without pain. The neck, shoulder, trunk, and hip rotational ROMs on the dominant and non-dominant side were measured by well-trained physical therapists. The differences between throwing sides and between age groups were examined using two-way analysis of variance. Results: Shoulder external rotation on the dominant side was greater than that on the non-dominant side. Shoulder external and internal rotational ROMs were maintained regardless of age, whereas the trunk rotational ROM significantly increased with age. Conclusions: The effects of age and dominance on ROMs of the neck, trunk, and upper and lower extremities in Japanese youth and high-school baseball pitchers were clarified. These data could be used as a specific reference and as target values for the rehabilitation of throwing injuries in young athletes.

  • Taku Numao, Yuri Fujita, Kyohei Ichikawa, Shogo Ide, Hidekazu Katori, ...
    Type: ORIGINAL ARTICLE
    2019 Volume 4 20190008
    Published: 2019
    Released: February 26, 2019
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    Objective: The purpose of this study was to verify the effect on spatial perception in healthy young subjects of an unconscious leftward optical shift created by a head-mounted display (HMD) with an offset camera. Methods: We recruited 40 healthy right-handed adults who were divided into four groups according to the hand used in the tests and the visual direction displayed by the HMD (centered or 10° left). Each of the four groups (n = 10) undertook line bisection tasks across four combinations of variables: using a finger/stick or a mouse to point at a touch panel located 60 or 120 cm away from the subject. Results: According to the results, regardless of the hand used, when the index finger or a stick was used (reaching condition), the line bisection point was displaced significantly to the left of the center. Additionally, a major left-displacement trend was observed in the short-distance reaching task, which did not require the use of a stick. In contrast, the long-distance task required a stick to be used, and the left displacements were all smaller than those for the short-distance tasks that used the index finger. Conclusion: This finding may be explained by the subjects having sufficient experience coordinating hand and eye movements in the condition where they used their dominant hand and reached with their own arms without using a stick.

  • Masahiro Yamane, Mitsuhiro Aoki, Yuji Sasaki, Hayato Kawaji
    Type: ORIGINAL ARTICLE
    2019 Volume 4 20190007
    Published: 2019
    Released: February 16, 2019
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    Objective: The aim of this study was to elucidate the activities of the hip flexor muscles during straight leg raising (SLR) in healthy subjects. We also investigated the activities of these muscles during SLR with deep flexion, abduction, and external rotation. Methods: The ten dominant right legs of ten male volunteers were analyzed in this study. Twelve SLR motion tasks were performed; these comprised combinations of hip flexion at 30°, 45°, and 60°; abduction at 0° and 20°; and external rotation at 0° and 30°. The activities of the psoas major (PM) and iliacus (IL) were measured using fine-wire electrodes, whereas the activities of the rectus femoris, sartorius, adductor longus, and tensor fasciae latae muscles were measured using surface electrodes. The percentage of the maximal voluntary isometric muscle contraction (%MVC) during SLR was calculated for each muscle and used for data analyses. The Friedman test and the Wilcoxon signed-rank test were performed for statistical analyses. The significance level was set at P <0.05. Results: The %MVCs for the PM and IL at 60° flexion were significantly larger than those at 30° or 45° flexion. Moreover, for a constant hip flexion, the %MVC values for the PM and IL showed no significant changes when hip abduction and external rotation were added. For the other muscles, the %MVC values showed no significant change with increasing hip flexion with or without added abduction and external rotation. Conclusion: Our findings suggest that subjects who perform SLR of up to 60° mainly activate the PM and IL at larger hip flexion angles, whereas the other muscles included in the analysis do not contribute greatly to increased flexion angles during SLR.

  • Takaki Imai, Masafumi Gotoh, Keita Hagie, Keiji Fukuda, Misa Ogino, Ka ...
    Type: ORIGINAL ARTICLE
    2019 Volume 4 20190006
    Published: 2019
    Released: February 16, 2019
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    Objective: Although clinical outcomes after arthroscopic rotator cuff repair are generally favorable, postoperative return to work is also an important issue. This study aimed to assess clinical outcomes and clarify the factors affecting return to work in patients who had undergone arthroscopic rotator cuff repair. Methods: In total, 63 patients who had undergone arthroscopic rotator cuff repair were included in this study. Clinical assessment was performed using Japanese Orthopaedic Association (JOA) scores, along with measurements of pain, range of motion, muscle strength, cuff integrity, and fatty infiltration. Depending on their return-to-work status at the final follow-up, subjects were assigned to either the complete return group (the patient returned to work) or the incomplete return group (the patient had quit or had changed their occupation at final follow-up). Various clinical parameters affecting the return to work outcome were examined through univariate and multivariate analyses. Results: Of the 63 subjects, 42 belonged to the complete return group and 21 belonged to the incomplete return group. Therefore, the working capability recovery rate following arthroscopic rotator cuff repair was 66.7%. Both groups showed significant improvement from their preoperative status, but there were statistically significant differences in JOA scores between the groups at 9 and 12 months postoperatively (P <0.01). Multivariate stepwise logistic regression analysis showed that heavy work and female sex were significantly adversely associated with return to work (P <0.05). Conclusion: The working capability recovery rate following arthroscopic rotator cuff repair was 66.7%, and the preoperative factors affecting recovery of working capability were heavy work and female sex.

  • Yasuhisa Fukawa, Wataru Kakuda, Seiya Yoshida, Masashi Zenta, Osamu It ...
    Type: ORIGINAL ARTICLE
    2019 Volume 4 20190005
    Published: 2019
    Released: February 06, 2019
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    Background: The clinical importance of postoperative rehabilitation for cancer patients has recently attracted much attention. However, it remains uncertain whether early rehabilitation can prevent infectious complications in patients undergoing gastrointestinal cancer surgery. Methods: The study group consisted of 259 patients who underwent laparoscopic or open surgery for gastrointestinal cancer at our institution between December 2012 and November 2016. Our department proposed a new early rehabilitation protocol for such patients to encourage physical activity after surgery. The protocol was clinically introduced on July 21, 2015. We divided the study subjects into two groups: those who were admitted before the introduction of the new protocol and those admitted after. The frequency of infectious complications, including respiratory infections, and the length of hospital stay after surgery were compared between the two groups. Results: No adverse cardiovascular event associated with the early rehabilitation protocol was experienced. After the protocol was introduced, more than 80% of patients started exercising on the first day after surgery. For patients undergoing open surgery, the frequency of infectious complications was significantly reduced with the introduction of the protocol (p<0.05). Moreover, when open surgery was performed, the protocol significantly shortened the length of hospital stay (p<0.05). Conclusion: Our proposed early rehabilitation protocol for patients who have undergone gastrointestinal cancer surgery was considered to be safe and feasible. The protocol may prevent infectious complications and shorten the hospital stay after such surgery.

  • Megumi Fukui, Yosuke Yoshida, Kazuo Higaki
    Type: ORIGINAL ARTICLE
    2019 Volume 4 20190004
    Published: 2019
    Released: February 05, 2019
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    Objective: Cardiovascular diseases cause psychological symptoms, such as depression and anxiety. Symptoms of depression have a major effect on patients and worsen prognosis as a result of reduced quality of life and decreased levels of physical activity. Because cardiac rehabilitation (CR) has physical, mental, and secondary preventative effects, it is necessary to evaluate the psychological factors of patients and to provide patients with psychological support based on the results. The management tool for daily life performance (MTDLP) was developed in 2006 by the Japanese Association of Occupational Therapists. Since then, its effectiveness for patients with cerebrovascular diseases and bone fractures has been verified. However, no randomized controlled trial has been conducted on the effectiveness of interventions using MTDLP on patients with cardiovascular diseases. Methods: We examined the effectiveness of intervention using MTDLP on patients undergoing outpatient CR. Thirty-six patients who scored at least 48 on the self-rating depression scale (SDS) were included in the study. Eighteen patients were allocated to both the CR and MTDLP groups. The SDS, Barthel index, Frenchay Activities Index (FAI), and Life-Space Assessment were evaluated as outcome measures. Results: The CR group (n=14) showed significantly improved post-intervention scores on the SDS (P=0.007). Furthermore, the MTDLP group (n=11) showed significantly improved post-intervention scores on the SDS (P=0.010) and FAI (P=0.003). Conclusions: CR improves depression, whereas additional intervention using MTDLP improves not only depression but also various daily activities. Consequently, intervention using MTDLP in CR appears to be effective.

  • Yoko Tsuji, Yoshiteru Akezaki, Hitomi Katsumura, Tomihiro Hara, Yuki S ...
    Type: ORIGINAL ARTICLE
    2019 Volume 4 20190003
    Published: 2019
    Released: January 31, 2019
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    Objective: This study investigated the factors affecting walking speed in schizophrenia patients who were inpatients at a psychiatric hospital. Methods: The study subjects were 37 patients with schizophrenia who were hospitalized in a psychiatric hospital. The measured assessment items included age, duration of hospitalization, duration of disease, muscle strength (30-s chair stand test), balance ability (one-leg standing time with eyes open/closed, Functional Reach Test, and Timed Up & Go Test), flexibility (long sitting position toe-touching distance), walking speed (10-m maximum walking speed), and the antipsychotic drug intake. Results: The walking speed was found to be correlated with the results of the 30-s chair stand test, the one-leg standing time with eyes open, the one-leg standing time with eyes closed, and the Timed Up & Go Test. Stepwise multiple regression analysis revealed that only the Timed Up & Go Test results affected walking speed. Conclusion: In schizophrenia patients, walking speed is influenced by balance and lower-limb muscle force, just as it is for patients without mental diseases. In schizophrenia patients, the dynamic balance ability has a strong influence on the walking speed.

  • Kazutomo Miura, Eiichi Tsuda, Yasuyuki Ishibashi
    Type: ORIGINAL ARTICLE
    2019 Volume 4 20190002
    Published: 2019
    Released: January 12, 2019
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    Objective: Repetitive overhead movements stress the dominant shoulder of volleyball players, potentially causing glenohumeral internal rotation deficit (GIRD) and suprascapular neuropathy. The aim of this study was to determine the prevalence of pathological GIRD and suprascapular neuropathy in male collegiate volleyball players. Methods: We evaluated 22 male collegiate volleyball players and compared the range of motion, the isometric shoulder strength, the thickness of the infraspinatus (ISP) muscle, and the latency and amplitude of the suprascapular nerve [in a nerve conduction study (NCS)] between the hitting and contralateral shoulders. Correlations between the physical findings and each parameter were also determined. Results: The internal rotation angle of the hitting shoulder (55.1±8.7°) was significantly less than that of the contralateral shoulder (64.5±10.2°) (P<0.001); pathological GIRD (≥20°) was found in four players (18.2%). Three players (13.6%) showed abnormal electrophysiological findings of the suprascapular nerve on the ISP muscle in the hitting shoulder. The external-to-internal rotation (ER/IR) torque ratio in the hitting shoulder (99±18%) was significantly lower than that in the contralateral shoulder (106±12%) (P=0.04); no significant differences were observed in ISP muscle thickness or NCS data between the hitting and contralateral shoulders. Conclusion: The prevalence of pathological GIRD in male collegiate volleyball players was consistent with that of previous studies. Meanwhile, the prevalence of suprascapular neuropathy was less than that previously reported in high-level volleyball players. Preventive posterior rotator cuff strengthening programs are recommended to correct imbalances between ER and IR in the hitting shoulder, thereby decreasing the risk of shoulder injury.

  • Yasunori Ikenaga, Ikuko Sakai, Yui Sakurai, Tomoko Takayanagi
    Type: CASE REPORT
    2019 Volume 4 20190001
    Published: 2019
    Released: January 01, 2019
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    Background: We report the changes in the health condition after using a service dog of a person with a complete C5 spinal cord injury (SCI). Case: A 48-year-old married man began using a service dog after suffering a complete C5 SCI. We conducted a semi-structured interview based on the International Classification of Functioning, Disability, and Health (ICF) rehabilitation sets to describe the change in the participant’s experience after using a service dog. The interview was converted into written form, and information regarding the changes in the participant’s health condition was extracted. These data were categorized by similarity and then classified by the ICF conceptual framework. Discussion: The participant experienced multiple changes in his health condition after using a service dog. These included the following factors from the ICF – “Body Function” category: “increased vitality and motivation,” “emergence of self-affirmation,” and “physical improvement.” Health changes form the “Activities and Participation” category included: “emergence of new roles,” “increased resilience,” “expansion of moving area,” “acquisition of activities incorporated with a service dog assist,” “emergence of autonomous health management,” “expansion of relation with other people,” and “expansion of social activity.” The participant experienced “reduction of psychological barriers,” categorized under “Personal Factor,” and “expansion of support environment,” categorized under “Environmental Factor.”

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