Physical therapy research最新文献

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.

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: By using a single-case design, we aimed to assess the impact of postoperative somatosensory foot training on walking balance and speed compared with conventional physical therapy interventions in 3 patients with proximal femoral fractures.

Methods: This study included 3 patients in their 70s who sustained left proximal femoral fractures due to falls and underwent open reduction and internal fixation or hemiarthroplasty. An AB-type single-case design was employed, with phase A consisting of conventional physical therapy interventions and phase B involving additional somatosensory training. Each phase lasted for 6 days. The outcome measures included the Timed Up-and-Go (TUG) test and 10-m maximum walking speed. To determine interventional effects, effect sizes were calculated using the percentage of nonoverlapping data (PND) and the Tau-U coefficient.

Results: Our PND analysis indicated a large effect size for the TUG and 10-m maximum walking speed outcome measures in all cases. Additionally, the Tau-U analysis showed that all patients exhibited significantly shorter TUG times and higher 10-m maximum walking speeds in phase B compared with phase A (p <0.05).

Conclusions: Postoperative somatosensory foot training may be effective in improving walking balance and speed in patients with proximal femoral fractures.

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.

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.

Objective: Sleeve gastrectomy (SG) effectively reduces food intake and enhances health and longevity, although weight loss often involves reductions in body fat and skeletal muscle. Hence, we examined how changes in skeletal muscle density relate to muscle strength and physical activity before and after SG.

Methods: This pilot observational study included 173 patients (mean age: 46 ± 11 years) who attended the hospital before and 1 year after undergoing SG between December 2018 and July 2022. Muscle cross-sectional area (cm²), skeletal muscle density, and fat cross-sectional area (cm²) at the 3rd lumbar vertebra were measured on computed tomography (CT) images. The psoas muscle index (PMI) was calculated as the cross-sectional area of both psoas muscles (cm²) divided by height squared (m²), and CT values for skeletal muscle density of the psoas and multifidus muscles, visceral fat area (VFA), and subcutaneous fat area (SFA) were obtained. Relative and absolute muscle strengths, sitting time, and total physical activity from the International Physical Activity Questionnaire were also assessed.

Results: Although VFA, SFA, PMI, and absolute muscle strength decreased significantly after SG compared to those before SG (p <0.001), skeletal muscle density, relative muscle strength, and total physical activity increased significantly after SG, with a significant reduction in sitting time (p <0.001). There were significant positive correlations between changes in skeletal muscle density and changes in relative muscle strength and total physical activity.

Conclusions: Improving skeletal muscle density with SG may be associated with increased relative muscle strength and improved physical activity.

Objectives: The effect of the co-occurrence of whole-body muscle wasting and respiratory muscle weakness on the clinical characteristics of patients with chronic obstructive pulmonary disease (COPD) is unclear. We investigated this association in patients with chronic respiratory diseases.

Methods: 47 outpatients with mild to very severe COPD were classified into four groups according to their fat-free mass index and respiratory muscle strength: 19 without muscle wasting and respiratory muscle weakness (normal), 6 with muscle wasting only (MW), 11 with respiratory weakness only (RW), and 11 with muscle wasting and respiratory weakness (MW + RW). We measured their body composition, pulmonary function, lower muscle strength, submaximal exercise capacity, physical activity in daily life, nutritional status, frailty status, and health-related quality of life (QOL). Multiple linear regression analyses examined the association of muscle wasting and/or respiratory muscle weakness with participant characteristics, using each participant's characteristics as an explained variable adjusted for confounding variables (Normal as the reference).

Results: The regression analysis revealed that the percentage of vital capacity, lower muscle strength, submaximal exercise capacity, nutritional status, and frailty status were worse in the MW + RW group than in the Normal group. The MR + RW group had the largest number of variables with significant differences compared to the Normal group.

Conclusions: These data suggest that the co-occurrence of whole-body muscle wasting and respiratory muscle weakness was significantly associated with deteriorating clinical characteristics in patients with COPD.

Objectives: Recently, rehabilitation professionals in Japan have become increasingly involved in Kayoi-no-ba for long-term care prevention. However, there are significant differences in the quality and content of professional rehabilitation support. This study aimed to develop a competency scale for rehabilitation professionals who support Kayoi-no-ba.

Methods: A survey was mailed to rehabilitation supervisors at 440 facilities selected from a nationwide Internet search of facilities that implement the "community-based rehabilitation activity support project," and rehabilitation professionals involved in supporting Kayoi-no-ba were asked to respond to the survey. The questionnaire was self-administered, and responses were sought via a 6-point scale for the 50 proposed competency items. For statistical analysis, exploratory factor analysis was conducted to examine the factor structure of the scale. Covariance structure analysis was used to assess model fit and to evaluate the reliability and internal consistency of the scale.

Results: Among the 260 facilities that responded (59.1%), 607 participants provided valid responses. The final competency scale had a 3-factor structure (knowledge and attitude, ability to coordinate groups, and clinical practice skills) comprising 20 items. Model fit and internal consistency were good.

Conclusions: Our findings indicate that rehabilitation professionals who support Kayoi-no-ba should have the attitude and knowledge of supporters, the ability to coordinate groups, and the clinical practice skills of rehabilitation therapists. This competency scale could be used as a guideline to improve the quality of support.

Objectives: This study aimed to investigate the effect of the number of days from surgery to ambulation on activities of daily living (ADL) at discharge in postoperative patients with type A aortic dissection (TAAD).

Methods: It included patients with a diagnosis of TAAD who were independent in ADL before the onset of symptoms. ADL was assessed using the Katz Index (KI), with a KI score of 6 points at discharge defining independence and less than 6 points classified as dependence. Patients were divided into 2 groups based on independence in ADL at discharge. Logistic regression analysis was performed with independence in ADL at discharge as the object variable and the number of days from surgery to ambulation as the explanatory variable. A receiver operating characteristic curve was constructed to calculate the cutoff value.

Results: A total of 100 patients were included in the analysis. There was a significant difference in the number of days to ambulation between the 2 groups. Multiple logistic regression analysis revealed that the probability of being independent in ADL at discharge was significantly lower with more days to ambulation (odds ratio: 0.93, 95% confidence interval: 0.86-0.99, P < 0.035). The cutoff value for the number of days from surgery to ambulation for independence in ADL at discharge was 8 days (area under the curve: 0.64).

Conclusions: In postoperative patients with TAAD, the longer the postoperative days to start ambulation, the more difficult ADL recovery may be, but the cutoff values need further validation.

Objectives: This study aimed to clarify the impact of cachexia on physical function recovery during hospitalization among patients with heart failure using the new Asian Working Group for Cachexia criteria and to identify the characteristics of heart failure patients with cachexia.

Methods: Cachexia at discharge was defined by low body mass index combined with one or more of the following: low handgrip strength, elevated C-reactive protein, or anorexia. Physical function was assessed at admission and discharge. Two-way analysis of variance (ANOVA) was performed to examine the interaction and main effects of the presence of cachexia and duration factors (admission and discharge) on physical function. Hierarchical logistic regression analysis was performed to explore factors associated with the presence of cachexia.

Results: Of the 96 patients analyzed, 26 were heart failure patients with cachexia, and 70 were heart failure patients without cachexia. The results of the 2-way ANOVA indicated that heart failure patients without cachexia exhibited improved physical function at discharge compared to that at admission. In contrast, heart failure patients with cachexia showed no improvement in physical function during hospitalization. Hierarchical logistic regression analysis revealed that a low geriatric nutritional risk index (GNRI) and low muscle power were associated with the presence of cachexia in patients with heart failure.

Conclusions: Our results suggest that heart failure patients with cachexia experience poor recovery of physical function during hospitalization, and that reduced muscle power and deterioration in nutritional status, as indicated by a low GNRI, were associated with the presence of cachexia.