Journal of Physical Therapy Science最新文献

[Purpose] To examine the association between intensive care unit-acquired weakness and functional disability, specifically hospitalization-associated disability. [Participants and Methods] This post-hoc analysis of an investigation of the physical activity of mechanical ventilated patients in intensive care units involved nine hospitals. Consecutive patients, intubated in the intensive care unit for >48 h, were eligible. The exposure variable was intensive-care-unit-acquired weakness. The primary outcomes were the Barthel Index and incidence of hospitalization-associated disability. Multiple logistic regression analysis was used to analyze the association between intensive-care-unit-acquired weakness and both outcomes. [Results] Of the 121 patients, 46 were assigned to the intensive-care-unit-acquired weakness group and 75 to the non-intensive-care-unit-acquired weakness group. The Barthel Index scores were consistently different between intensive care unit discharge and hospital discharge. No significant difference in the incidence of hospitalization-associated disability was found from intensive care unit discharge to 28 days post-ICU discharge. A significant difference between the two groups was observed only at the time of hospital discharge. The Medical Research Council score correlated linearly with the Barthel Index at 7, 14, and 28 days and with hospital discharge. [Conclusion] Intensive-care-unit-acquired weakness is significantly associated with functional disability and hospitalization-associated disability in critically ill patients admitted with acute illness.

[Purpose] To verify and compare the effects of different training methods on balance retention during early motor learning in unstable standing environments. [Participants and Methods] Twenty-six healthy adults were randomly assigned to three groups for a balance maintenance task involving holding a tandem standing position on a slackline. The active assistance (AA) group held a cane in each hand, the passive assistance (PA) group had the participant manually assisted by a therapist, and the no assistance (NA) group had no canes or assistance. Tandem standing time (TST) was measured before, immediately after, and one week after the three weeks training period. [Results] Intra-group comparisons revealed that the AA and PA groups showed significant improvements in TST immediately after practice, with the PA group maintaining this significant improvement one week later. No significant differences were observed between groups at any time point. [Conclusion] Our findings suggest, that in the early stages of motor learning for balance in an unstable standing environment, practicing with manual assistance may be more effective for developing an accurate perception of optimal balance.

[This corrects the article on p. 564 in vol. 36 PMC11374172.].

[Purpose] Osteoarthritis is the most common form of arthritis worldwide and has detrimental effects on an individual's quality of life. We compared two interventions-an exercise program alone and an exercise program combined with the intra-articular platelet-rich plasma (PRP) injection-focusing on pain and functionality in patients with mild knee osteoarthritis. [Participants and Methods] A total of 76 patients (41 men and 35 women) participated in the study. They were divided equally into the control and intervention groups. To assess knee functionality in both groups, we used state-of-the-art assessment tools, namely the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Injury and Osteoarthritis Outcome Score (KOOS). [Results] The results revealed that following the eight-week exercise program, the intervention group showed significantly better values in the WOMAC scale and in three of the four components of the KOOS scale (pain, symptoms, and activities of daily living). Additionally, we observed that the improvement in WOMAC and KOOS scores was significantly better in the intervention group than in the control group. [Conclusion] Combining PRP and exercise therapy can help improve patients' quality of life. However, PRP preparation protocols and exercise prescriptions must be optimized and tailored to individual patient needs.

[Purpose] To determine sex-based differences in body composition, based on discharge destination of patients admitted to a convalescent rehabilitation unit. [Participants and Methods] A total of 135 patients admitted to a convalescent rehabilitation unit were included. Body composition, motor function subscale of the Functional Independence Measure (mFIM) score, length of stay, and mean number of rehabilitation sessions per day were measured and compared between home and non-home discharge groups. [Results] The home and non-home discharge groups comprised 112 (45 males and 67 females) and 23 (nine males and 14 females) participants, respectively. Differences were observed in phase angle (PhA), skeletal muscle mass index (SMI), extracellular water to total body water ratio, and mFIM score for both sexes, based on discharge destination. Binomial logistic regression analysis with discharge destination as the dependent variable showed that the mFIM score and length of stay were influencing factors for males and females, respectively. [Conclusion] PhA and SMI are promising new tools for assessing common discharge destinations in both sexes, suggesting an impact of recovery in the mFIM score and on length of stay in male and female patients, respectively.

[Purpose] To investigate the relationship between footwear characteristics and motor development in toddlers walking independently. [Participants and Methods] A total of 13 toddlers (mean age: 26.5 ± 4.5 months) were included. Footwear characteristics, including size, presence of a heel counter, and flex point alignment, were assessed. Motor development was evaluated using the Enjoji Analytical Developmental Test. [Results] Improperly fitted footwear was frequently observed. A significant positive correlation was identified between appropriately sized footwear and locomotor development. [Conclusion] These findings underscore the importance of correctly fitted footwear to support optimal motor development in toddlers.

[Purpose] To identify factors immediately post surgical treatment of proximal femoral fractures that can predict walking ability at discharge from an acute care hospital within one month. [Participants and Methods] A total of 122 patients >50 years, admitted to our institution with a fractured proximal femur, were able to walk independently or with a cane or walker prior to admission, and were prescribed physical therapy, post-surgery, were evaluated. Each patient was assigned to one of two groups: those who could walk with a cane or independently at discharge (walking group; n=35) and those who could not walk with the assistance of a cane at discharge (non-walking group; n=87). Multivariate regression analysis was performed to identify predictors of walking ability at discharge. [Results] Age, sex, pre-injury Functional Independence Measure motor (FIMm) score, and pre-injury Functional Independence Measure cognitive (FIMc) score were significantly related to walking ability. In the multivariate regression analysis, the FIMc score was a significant predictor of walking ability. [Conclusion] A detailed assessment of cognitive function on admission may enable predictions regarding the feasibility of direct discharge and the provision of appropriate rehabilitation.

[Purpose] This study aimed to investigate the effect of cognitive behavioral therapy (CBT) combined with physical therapy on improving outcomes in chronic low back pain (CLBP). [Participants and Methods] Participants were divided into two groups: Group A (31 participants) received CBT combined with physical therapy, and Group B (32 participants) received only physical therapy. Outcome measures at baseline and post-treatment were assessed using the Numeric Pain Rating Scale (NPRS), Oswestry Disability Index, Tampa Scale for Kinesiophobia, Pain Self-Efficacy Questionnaire, and Depression Anxiety Stress Scale-21. [Results] After 12 weeks of intervention, the pain relief effect, as measured using the NPRS, indicated that Group A experienced a reduction of 79.0% compared with the pretreatment period, whereas Group B showed a decrease of 58.0% during the same timeframe. However, Group A demonstrated a more significant improvement than did Group B. Additionally, enhancements in self-confidence during daily activities, reduction in motor avoidance, and overall psychological well-being were all more pronounced in Group A than in Group B. [Conclusion] Both groups demonstrated improvement following treatment; however, CBT combined with physical therapy resulted in greater enhancements in pain relief, psychological status, kinesiophobia, and daily functioning in patients with CLBP compared with that via physical therapy alone after 12 weeks of intervention.

[Purpose] Effective nutritional management is essential for inpatient rehabilitation. This study aimed to examine changes in body composition in relation to weight gain or loss between admission and discharge from convalescent rehabilitation wards. [Participants and Methods] A total of 91 patients (39 men and 52 women) admitted to convalescent rehabilitation wards were included. Body composition, height, and weight were measured during admission and discharge using a device which allows measurements in seated or supine positions (InBody S10). Patients were classified into three groups based on whether they gained, maintained, or lost at least 3% of their body weight. [Results] Thirteen participants (six men and seven women) were categorized into the weight gain group, 58 (24 men and 34 women) into the unchanged group, and 20 (nine men and 11 women) into the weight loss group. Significant differences in the percentage change in the amount of body fat in men and change in the skeletal muscle mass index in women were observed. [Conclusion] In men, changes in body fat mass were observed, while in women, skeletal muscle mass changes were observed, which were linked to weight variations. These findings underscore the gender-specific differences in body composition changes during inpatient rehabilitation.

[Purpose] We report a case of stroke hemiplegia in which two types of step training affected gait parameters. [Participant and Methods] A 50-year-old man presented with right-sided hemiplegia caused by a left putaminal hemorrhage. Four months after the onset of asymmetric gait, he practiced stepping in the anterior-posterior directions on a 20-cm platform. Step training was conducted over three 5-day periods. Gait parameters were evaluated on the day following the completion of each training period. Data on the maximum walking speed, single- and double-leg support phases, and step length were collected. Furthermore, the symmetry ratio and trailing limb angle were calculated. [Results] Post-training improvements were noted in gait symmetry, and the trailing limb angle on the affected side improved after anterior-posterior step training. [Conclusion] Anterior-posterior step training may improve gait parameters following a hemiplegic stroke.