Objective: This study aimed to clarify the process through which physical therapists develop a sense of self-growth based on their end-of-life care experiences.

Methods: This study included five physical therapists who experienced self-growth through end-of-life care. The trajectory equifinality approach was used, comprising a questionnaire and two semi-structured interviews.

Results: Self-growth development consisted of three stages: (1) acquiring fundamental knowledge and skills related to end-of-life physical therapy, (2) practicing appropriate physical therapy for patients at the end of life, and (3) recognizing personal growth through such practice. During these stages, participants developed core values characterized by “providing physical therapy from a palliative care-based independent living support perspective.”

Conclusion: Support and educational methods, along with suggestions for improving workplace and learning environments derived from this process, may serve as practical guidelines for promoting self-growth of physical therapists involved in end-of-life care.

Objective: Phase angle (PhA) is an indicator associated with muscle quality and is known to improve with regular resistance training. However, for individuals who have difficulty engaging in such training, electrical muscle stimulation (EMS) may serve as an alternative method. Nevertheless, the effects of EMS on PhA have not been fully investigated.

Methods: Twelve healthy adult males participated in this study. PhA of the upper and lower limbs was measured at baseline, after a 4-week control period, after an 8-week EMS intervention, and following a 4-week detraining period. During the intervention period, EMS was applied to both thighs at the maximum tolerable intensity for 30 minutes per day, twice a week, for 8 weeks.

Results: Lower limb PhA significantly increased compared to baseline, after the EMS intervention compared to before the intervention, and after the detraining period compared to before the intervention. No significant changes were observed in upper limb PhA before and after the intervention.

Conclusion: Regular EMS applied to the lower limbs improves lower-limb phase angle in healthy adult males.

Objective: To present and validate a CT-based spatial normalization framework for brain imaging that supports lesion-based outcome prediction and group-level analyses in stroke rehabilitation.

Methods: We retrospectively analyzed data from 25 patients with unilateral supratentorial intracerebral hemorrhage who were admitted to a convalescent rehabilitation ward. The hemorrhagic lesion on each patient’s CT image was segmented and converted to a binary mask. The whole-brain CT image and the lesion mask were spatially normalized onto an age-specific CT template using the Clinical Toolbox for Statistical Parametric Mapping. Voxel-based lesion–symptom mapping (VLSM) was used to relate lesion location to maximal gait speed at discharge.

Results: Spatial normalization was successful in all patients and yielded accurate anatomical alignment despite variability in routine clinical CT acquisition. VLSM identified a cluster in the posterior part of the posterior limb of the internal capsule. Overlay with a white matter atlas indicated that this cluster corresponded to corticospinal tract fibers innervating the lower limb muscles, consistent with previous MRI-based reports.

Conclusion: VLSM using spatially normalized CT images identified brain regions consistent with those reported in previous MRI-based studies, thereby demonstrating the validity of this method. This approach may facilitate wider implementation of quantitative neuroimaging in general hospitals.

Objective: We investigated whether the number of comorbidities at admission is associated with early neurological deterioration (END) in patients with Branch atheromatous disease (BAD).

Methods: We retrospectively analyzed 132 consecutive patients with BAD admitted between April 2014 and November 2022. END was defined as an increase of ≥2 points in the total National Institutes of Health Stroke Scale (NIHSS) score or ≥1 point in the NIHSS motor subscore within 72 hours of admission. Comorbidity count was defined as the number of chronic conditions under active treatment and/or those observed at admission. Associations were assessed using multivariable logistic regression with missing data handled through multiple imputation (m=20). The results were pooled using Rubin’s rules. The primary model was adjusted for the serum uric acid/serum creatinine ratio, neutrophil-to-lymphocyte ratio, female sex, NIHSS score at admission, and low-density lipoprotein cholesterol. A supplementary analysis used an additionally adjusted model including hypertension, argatroban use, and B-type natriuretic peptide.

Results: END occurred in 52 patients (39.4%). The median comorbidity count was higher in the END group than in the non-END group (2.5 [interquartile range (IQR), 2.0–3.25] vs. 2.0 [IQR, 1.0–3.0]; p=0.004). In the primary model, the comorbidity count was independently associated with END (odds ratio [OR], 1.44; 95% confidence interval [95%CI], 1.08–1.93; p=0.013). In the additionally adjusted model, the comorbidity count remained independently associated with END (adjusted OR, 1.58; 95% CI, 1.13–2.20; p=0.007).

Conclusions: In this single-center retrospective cohort of patients with BAD, a higher comorbidity count at admission was associated with END in multivariable analyses. The prognostic value of comorbidity count should be interpreted cautiously and requires further validation.

Objective: In this study, we aimed to examine the intra-rater reliability of the Self-Efficacy for Home Exercise Programs Scale (SEHEPS) among older adults receiving community-based rehabilitation.

Methods: We investigated older adults receiving home-based rehabilitation or day-care services using the SEHEPS. We performed reassessment within two weeks of the initial evaluation. We evaluated intra-rater reliability using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and Bland–Altman analysis to examine systematic error.

Results: The ICC and SEM values were 0.84 (95% CI: 0.78–0.89) and 7.9 (95% CI: 7.0–9.2), respectively. We observed no fixed bias (p=0.23), whereas we detected proportional bias (p<0.05).

Conclusion: SEHEPS demonstrated good intra-rater reliability among older adults receiving community-based rehabilitation, suggesting that it is a useful tool for self-efficacy alteration and intervention effect assessment.

Objective: To identify admission physical function indicators associated with improvement in sarcopenia status at discharge among patients with sarcopenia in a convalescent rehabilitation ward.

Methods: Eighty-seven patients diagnosed with sarcopenia according to the Asian Working Group for Sarcopenia (AWGS) 2019 criteria were included. Patients whose sarcopenia severity improved by one stage at discharge were classified as the improved group, whereas those whose severity was maintained or worsened were classified as the non-improved group. Admission skeletal muscle mass index (SMI), phase angle, muscle strength, and the Functional Independence Measure (FIM) were compared between groups. Bayesian logistic regression was performed with sarcopenia improvement as the dependent variable.

Results: In the regression analysis, admission motor FIM was estimated as an indicator associated with sarcopenia improvement.

Conclusion: In a convalescent rehabilitation ward, admission motor FIM may be associated with improvement in sarcopenia status and may serve as a reference for understanding convalescent rehabilitation outcomes.