The purpose of this study was to clarify the factors involving psychological quality of life (QOL)in people after stroke, with structural equation modeling.
The subjects were 134 survivors after stroke, who had adequate cognitive function and lived in their community. Firstly, the measurement model of instrumental activities of daily living (IADL)was validated by confirmatory factor analysis. The measurement model of social activities was tested in elderly samples with respect to the content validity, and then validated across stroke samples by simultaneous factor analysis. Next, a structural equation model was constructed with latent variables of “IADL”, “social activities”, and “psychological QOL”. The analytic model incorporating a priori hypotheses was examined.
The model fitted well to the data. The path coefficients between the latent variables showed the “social activities” had a strong direct effect to the “psychological QOL”, and the “IADL” had an indirect effect through the “social activities”.
These results supported that the both constructs involved psychological QOL, and suggested that variables of social relationship are set as the primary factor influencing QOL and functional ability as the secondary factor.

View full abstract

The appearance order of muscle activation at lower extremities was examined in response to a perturbation applied to a standing person from behind. The purpose of this study was to find the condition occurring a characteristic order of muscle activation when the part of body applied and the strength of the perturbation were changed.
The subjects were twelve healthy women with the mean age of 20.5 ± 0.8 (19 to 22) years. A pendulum made of a weight hit a standing subject from behind. The perturbation was applied to the shoulder or hip, and weight of the pendulum was 1, 3, or 5 kg. In each condition, EMG in both sides of rectus femoris, biceps femoris (long head), and gastrocnemius (lateral head and medial head) were measured.
As a result, a fixed and characteristic order of muscle activation was observed in two conditions; to the shoulder with 5 kg pendulum and to the hip with 5 kg pendulum. Between these two conditions, the order of muscle activation was clearly different. The result suggests that preprogrammed patterns of muscle activation in response to perturbation may exist correspondingly to each part of body, and they could not help but occur in the condition applied by the strongest perturbation such as 5 kg.

View full abstract

This study aimed to identify the effect of rehabilitation in the home and the professional characteristics of physical therapists. The subjects were 51 elderly persons with disabilities (mean age 79 years) who had received regular rehabilitation visits by a physical therapist from our clinic and nursing visits. The proportion of time spent for each service item during the rehabilitation visits and the change in the Barthel Index (BI) of activities of daily living (ADL) were investigated. The average time of the rehabilitation visits was 43.8 minutes. Therapeutic exercise accounted for 61.3% of this time, and the practice in mobility for an additional 26.0%. Next, 67% of the subjects showed an improvement in BI between initial and personal scores. 25% no change, and 8% a decrease. The change in BI between initial (45.8 ± 31.3 points) and final (54.0 ± 34.3 points) average scores was statistically significant (p < 0.005). In addition, BI examined for each item showed a statistically significant difference in personal transfer (p < 0.005), mobility (p < 0.005), stairs climbing (p < 0.005), toileting (p < 0.005) and bathing (p < 0.05), which were influenced by standing and gait. Regular physical therapy service centered on mobility exercise influences the improvement and maintenance of ADL in elderly persons with disabilities.

View full abstract

To reevaluate at 3 years corrected age children who had participated in an early intervention program (EIP) designed to promote the neonatal behavioral organization and developmental progress in infants born prematurely. The study subjects consisted of 47 very low birthweight infants (≦ 1500 gms). During 1993-1996, the experimental group (n=29) received the EIP for 44 weeks starting from 38 weeks of postmenstrual age. The control group (historical control, n=18) received the standard medical-nursing care without EIP during 1990-1992. Developmental outcome was assessed in both groups using the McCarthy Scale. Multivariate analyses were performed to adjust baseline variables that might be associated with the developmental outcome: sex, appropriate or light for dates infant, birthweight, gestational age, Apgar score at 1 minute and duration of intubation. In the McCarthy Scale, none of the outcome measures were significantly different between the two groups. Furthermore, there were no significant differences between two groups in the distribution of the adjusted IQ scores. EIP provided during the first 1 month of life exerted no effects on VLBW infants' cognitive development at 3 years corrected age. These results indicated a need to develop additional intervention strategies for very low birthweight infants that can provide sustained benefits.

View full abstract

[in Japanese]

View full abstract