Objectives: This review aimed to examine the characteristics of patients with spinal cord injury (SCI) who experience in-hospital cardiac arrest (IHCA), as well as the timing, circumstances, and interventions associated with these events. Methods: A comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, Cochrane Library, and Igaku Chuo Zasshi Web (in Japanese), for studies published up to 2024. Two independent reviewers screened the literature. Data were extracted from the selected studies regarding the characteristics of patients with SCI who experienced IHCA, the timing of IHCA, the circumstances under which it occurred, and the interventions provided. Results: A total of 56 studies met the inclusion criteria. IHCA most commonly occurs in patients with complete cervical SCI. The time frame for IHCA occurrence ranged from 1 day and 2.5 months post-injury. IHCA frequently occurs during endotracheal suctioning or postural changes. The most commonly reported intervention for IHCA was the use of a pacemaker. Conclusions: In patients with SCI, IHCA is more prevalent among those with severe cervical injuries and is often triggered by procedures such as suctioning or postural adjustments. Physical therapist needs to implement robust risk management strategies. These findings are crucial for both clinical practice and future research.

Objective: The movement of the diaphragm plays an important role in respiration. In this study, we proposed and validated a new method for estimating the volume of a single ventilation (representing the tidal volume [VT]) from the vertical distance of diaphragmatic movement and thoracic circumference. Method: Diaphragm excursion (DE) was measured in healthy adult subjects via ultrasound, and the thoracic cavity volume change was estimated based on DE and thoracic circumference. Moreover, we measured the VT obtained by an expiratory gas analyzer and examined the relationships between DE and thoracic volume change (TVC) and between DE and VT. Results: The results showed that a correlation (ρ = 0.609) existed between DE and VT, and an even higher correlation existed between TVC and VT. TVC correlated better with the product of thoracic circumference squared and DE (ρ = 0.839) than with the product of thoracic circumference and DE as an alternative index (ρ = 0.746). Conclusion: Our findings demonstrate that, taking into account body size in addition to DE, changes in thoracic cavity volume are useful predictors of VT and provide an alternative measure for assessing the respiratory function, which will improve clinical and research practice in respiratory care.

Objective: This study aimed to clarify the association between frailty and the self-reported inability to immediately open a polyethylene terephthalate (PET) bottle cap. Methods: This cross-sectional study included 427 participants aged 73 and 78 years in City A, Japan. Frailty was assessed using the Kihon Checklist (KCL), and PET bottle cap opening ability was surveyed using a mailed questionnaire. The participants were divided into Immediately Open and Cannot-Immediately Open groups. The frailty status and KCL scores were compared between the groups. Multivariate analysis was used to investigate the association between frailty and the PET bottle cap-opening pattern. The possibility of screening frailty based on the Immediately/Cannot-Immediately Open classification was analyzed using a receiver operating characteristic (ROC) curve. Results: The number of frailty in the Cannot-Immediately Open group was significantly greater than the expected count compared to the robust and pre-frailty groups (P <0.001). Total KCL scores differed significantly between the Immediately Open group (3.2 ± 3.1) and the Cannot-Immediately Open group (5.7 ± 4.1) (P <0.001). The Cannot-Immediately Open group showed significantly higher scores in 5 of the 7 domains and a higher proportion of 1-point scores in 15 of the 25 KCL items. Individuals in the Cannot-Immediately Open group were associated with frailty (β = 2.03; odds ratio = 7.62; P <0.001). The ROC analysis revealed a sensitivity and specificity of 50.0% and 81.0%, respectively (area under the curve = 0.65; P <0.001). Conclusions: The self-reported inability to open a PET bottle cap immediately may be a moderate screening tool for frailty and is associated with many frailty factors.

Objectives: The study provided a comprehensive analysis exploring the association between athletes’ injury characteristics and the choice of physiotherapy treatments applied at the Polyclinic Tokyo 2020. Methods: Data from all physiotherapy treatments offered in the Polyclinic Olympic Village in Tokyo between 13 July and 10 August were recorded electronically. The physiotherapy team consisted of approximately 150 Japanese physiotherapists. Physiotherapy modalities analyzed were cryotherapy, electrotherapy, exercise therapy, laser therapy, manual therapy, shockwave therapy, taping, and ultrasound therapy. Logistic regression assessed the association between athletes’ injury characteristics and the physiotherapy treatment the Polyclinic Physiotherapy Services offered at the Tokyo 2020 Olympic Games using odds ratio. Results: This study analyzed 808 athletes who received physiotherapy, of which 66.6% (n = 1023) were for lower limb chronic injuries affecting muscles and tendons (72.8%, n = 1209) and were the most prevalent ones treated. Chronic injuries accounted for 56.7% (n = 942). Manual therapy was associated with trunk injuries (odds ratio 1.8, 95% confidence interval 1.4–2.3) and chronic injuries (1.5, 1.2–1.9). Ultrasound therapy was associated with injuries of the upper limbs (3.6, 1.9–6.7) and lower limbs (3.0, 1.7–5.2). Taping was associated with bone/joint/ligament injuries (2.1, 1.4–3.0). Shockwave was associated with muscle/tendon injuries (2.0, 1.2–3.4). Cryotherapy was related to acute injuries (1.8, 1.1–3.0) and lower limbs (3.6, 1.4–9.4). Laser was associated with bone/joint/ligament injuries (14.4, 4.5–45.8). Conclusions: Chronic injuries affecting lower limb muscles and tendons were the most prevalent musculoskeletal injuries treated at the Tokyo 2020 Polyclinic. Overall, Japanese physiotherapists used manual therapy, taping, exercise, and ultrasound therapy to treat athlete injuries.

Sensory afferent inputs play a crucial role in neuromuscular control. Enhancing sensory input through electrical or mechanical stimulation of the limbs may improve motor function and facilitate motor learning. This scoping review synthesizes literature investigating the effects of sensory electrical stimulation (SES) and local vibration (LV) on motor function and learning in both healthy individuals and those with musculoskeletal or neurological disorders. The findings suggest that SES can enhance motor learning and improve motor function. Furthermore, its efficacy is maximized when combined with rehabilitation programs and motor training rather than being used as a stand-alone intervention. Similarly, LV applied to muscle or tendon regions enhances proprioceptive input, thereby improving motor control and learning. The clinical benefits of LV, like those of SES, can be augmented by incorporating it into motor training regimens. Future research should focus on optimizing stimulation parameters and determining the most effective integration strategies for rehabilitation programs to maximize therapeutic outcomes.

Objectives: This study aimed to determine whether neuromuscular electrical stimulation (NMES) of the quadriceps muscle early after total knee arthroplasty (TKA) is effective in improving muscle strength. Methods: This was a single-center, non-blinded, randomized controlled trial involving 37 patients (60 knees) who underwent TKA. Patients were randomly assigned to either the intervention group (19 patients, 30 knees) or the control group (18 patients, 30 knees). Both groups received standard rehabilitation starting on postoperative day 1. Additionally, the intervention group received NMES therapy starting on postoperative day 2. NMES was administered at the highest tolerable intensity for 15 min per session (10-s stimulation and 10-s rest) twice daily for 4 weeks. Outcome measures included voluntary isometric quadriceps strength, knee joint range of motion (ROM), visual analog scale (VAS), and the Timed Up and Go (TUG) test, which were assessed preoperatively and at 4, 8, and 12 weeks postoperatively. The outcomes were compared between the two groups. Results: Both groups showed improvements in all outcomes over time. However, no significant differences were observed between the two groups (muscle strength: p = 0.412, flexion ROM: p = 0.668, extension ROM: p = 1.000, VAS score: p = 0.192, TUG test score: p = 0.296) (p-values are main effects of group factors in the split-plot analysis of variance). Conclusions: NMES in the early postoperative period after TKA did not provide significant additional functional recovery benefits compared with standard rehabilitation.

Objectives: In recent years, the number of elderly heart failure patients with multiorgan failure has been increasing. Furthermore, the combination of heart failure and decreased hepatic reserve can cause severe skeletal muscle impairment and decreased survival rates. This study investigated whether the degree of improvement in the five repetitions of sit-to-stand (5STS) and walking speed (WS) differs depending on hepatic reserve in elderly heart failure patients. Methods: The patients were divided into the following two groups: good hepatic reserve (albumin–bilirubin score [ALBI score] ≤−2.25) and poor hepatic reserve (ALBI score >−2.25). Propensity score matching was performed using the brain natriuretic peptide level. A two-way analysis of variance (ANOVA) was performed to examine the main effects of the hepatic reserve and time points (admission or discharge). Results: After propensity score matching, 28 out of the 33 (84.8%) patients in the good hepatic reserve (age, 83.74 ± 9.25 years and ALBI score, −2.55 ± 0.19 points) and 27 out of 40 (67.5%)patients in the poor hepatic reserve (age, 85.85 ± 7.53 years and ALBI score, −1.93 ± 0.26 points) were analyzed. Two-way ANOVA showed that the 5STS (p = 0.04) and WS (p = 0.01) in poor hepatic reserve tended to be worse than in good hepatic reserve. Furthermore, the 5STS (p = 0.04) and WS tended to improve at discharge in both groups. However, the improvement in WS was not significant (p = 0.15). Conclusions: Our study suggests that the hepatic reserve in elderly heart failure patients may be an important factor in the assessment of physical functions.

Advancements in brain imaging and analytical methods have demonstrated that behavior arises from the coordinated activity of multiple brain regions within cortico-cortical networks. Transcranial alternating current stimulation (tACS), a noninvasive brain stimulation (NIBS) technique, applies weak sinusoidal alternating currents to specific brain regions using scalp-mounted electrodes. Traditionally, tACS has been used to target single brain regions to enhance functions such as motor, sensory, and cognitive abilities. However, recent findings indicate its potential for simultaneously stimulating 2 brain regions, thereby modulating cortico-cortical network strength through neural entrainment—where brain oscillations synchronize with external rhythmic stimuli. Despite this potential, tACS applications remain primarily focused on individual brain regions. Given that behavior stems from dynamic interactions within cortico-cortical networks rather than isolated regions, this minireview explores the role of these networks in shaping behavior through functional connectivity as identified by neuroimaging. It also provides an in-depth analysis of tACS as a tool for modifying cortico-cortical networks via neural entrainment, offering promising applications in neurorehabilitation for brain disorders linked to network dysfunction. This highlights tACS as a novel approach for targeted modulation of cortico-cortical networks, distinguishing it from traditional NIBS techniques.

Objectives: Chronic fracture pain (CFP) is a significant issue in patients with osteoporotic fractures (OFs) in convalescent rehabilitation wards (CRWs). This study aimed to examine the association between CFP and the Japanese short-form Central Sensitization Inventory (CSI-9) and verify the predictive validity of CSI-9 in patients with OF admitted to a CRW. Methods: This single-center retrospective study included 71 patients with OF (median age: 85.3 years, 54 females). CFP was defined as pain of Numerical Rating Scale (NRS) score ≥4 persisting at discharge, despite >3 months post-fracture. Multiple logistic regression and receiver operating characteristic curve analyses were performed to assess the association and predictive validity of the CSI-9 for CFP. Results: The incidence of CFP was 38.0%. CSI-9 was independently associated with CFP at admission (odds ratio = 1.12, 95% confidence interval [CI]: 1.01–1.24) and discharge (odds ratio = 1.15, 95% CI: 1.03–1.29). The area under the curve for the CSI-9 was 0.727 (95% CI: 0.605–0.850) at admission and 0.752 (95% CI: 0.637–0.867) at discharge, indicating fair predictive accuracy. The optimal cutoff values for the CSI-9 were 8 points at admission and 6 points at discharge. Conclusions: CSI-9 was independently associated with CFP and demonstrated moderate predictive accuracy in patients with OF in CRWs. Assessing central sensitization-related symptoms using the CSI-9 may be useful for evaluating and preventing CFP in this population. Further validation using large-scale prospective studies is required.

Objective: In this study, we aimed to identify factors associated with the likelihood of early discharge to home by the 7th-day assessment in patients with ischemic stroke who underwent endovascular therapy (EVT). Methods: Among the 128 patients with ischemic stroke who underwent EVT, 2 groups were identified: an early discharge to the home group and the transfer group, with patients included in the latter group needing to be transferred to rehabilitation hospitals. Variables from the 7th day were used as explanatory variables to determine the outcome. Multiple logistic regression analysis was conducted using these variables. Receiver operating characteristic (ROC) curves for the significant factors were obtained, and cutoff values were calculated. Results: There were 19 patients (14.8%) in the early discharge to the home group and 109 patients (85.2%) in the transfer group. The Stroke Impairment Assessment Set (SIAS) (odds ratio [OR]: 1.16, 95% confidence interval [CI]: 1.02–1.32, p = 0.03) and the presence of dysphagia (OR: 8.75, 95% CI: 1.55–49.45, p = 0.01) were significant factors associated with early discharge home. The area under the ROC curve of the SIAS was 0.90, with a cutoff value of 63.5 points. Conclusion: Our results suggest that SIAS scores and the presence of dysphagia within the 1st week post-onset are significant predictors of whether patients with ischemic stroke who undergo EVT can be early discharged home.