Physical therapy research最新文献

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.

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.

Objectives: Anaerobic threshold (AT) assessment using cardiopulmonary exercise testing (CPX) during hospitalization is considered ideal for prescribing exercise regimens in patients with acute myocardial infarction (AMI). However, practical limitations often hinder its implementation. This study evaluated strategies for prescribing exercise based on resting heart rate (RHR).

Methods: A total of 194 consecutive male patients with AMI who underwent CPX within 13 days of hospitalization were enrolled. Bland-Altman analysis was performed to assess the agreement between the heart rate (HR) at AT (ATHR) and RHR +20, +25, and +30 beats. Multiple regression analysis was conducted to identify factors influencing ΔHR (ATHR-RHR). Decision-tree analysis was used to establish thresholds for appropriate exercise prescriptions based on RHR.

Results: Regardless of β-blocker use, the RHR + 25 formula most closely approximated the ATHR in patients who underwent early CPX after AMI. Multivariate analysis identified RHR and hemoglobin (Hb) as significant predictors of ΔHR. Decision-tree analysis indicated that RHR + 25 was appropriate when RHR <91 bpm and Hb ≥12.0 g/dL.

Conclusions: RHR + 25 is a practical alternative for determining the target HR in post-AMI rehabilitation among male patients, particularly in those with RHR <91 bpm and Hb ≥12.0 g/dL, when CPX is not feasible.

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: The need for early postoperative rehabilitation in patients with congenital heart disease (CHD) is increasing. However, rehabilitation settings in the pediatric intensive care unit (PICU) are usually determined subjectively by therapists. To address the lack of objective measurements, we sought to determine the effectiveness of near-infrared spectroscopy (NIRS) in evaluating skeletal muscles during rehabilitation of patients in the PICU. This case series aimed to clarify the characteristics of skeletal muscle oxygenation during exercise in 2 postoperative patients with CHD.

Methods: The participants were two 6-month-female infant: one had undergone the Yasui operation (Case 1), and the other had undergone a bidirectional Glenn anastomosis (Case 2). Vital signs and tissue oxygen saturation (StO₂) were measured during each exercise task, and the muscle oxygen extraction ratio (MOER), an index of the intramuscular oxygen extraction rate, was calculated. The results were compared between the two cases.

Results: Case 1 showed no significant changes in vital signs, StO₂, or MOER, whereas Case 2 had low oxygen saturation at rest and low StO₂ during the exercise tasks. MOER increased during the exercise tasks.

Conclusions: The results showed that sitting did not impose a strong cardiopulmonary load on postoperative patients. However, in children with cyanotic cardiac disease, such as in Case 2, skeletal muscle oxygenation should be considered, and NIRS monitoring may be useful for safely performing rehabilitation.

Fatigue is one of the most common symptoms encountered in rehabilitation and during physical therapy interventions. Although this phenomenon is known and experienced by everyone, its assessment is not straightforward. The lack of consensus on its definition, complex etiology, and multidimensional nature means that a large number of outcomes exist and continue to be reviewed. However, it seems essential that its assessment be better defined and standardized to understand the effects of physical therapy. To provide an initial exploratory overview, we conducted a rapid scoping review of the various fatigue assessments used in physiotherapy interventions or performed by physical therapists. A total of 139 articles published between 2020 and July 31, 2025 were included and explored. We found 43 different outcomes used across 46 population groups. While the most well-known chronic conditions such as cancer, multiple sclerosis (MS), and coronavirus disease 2019 (COVID-19) are representative, their assessment methods do not appear to be harmonized. These findings from the study support the idea that fatigue remains a complex phenomenon to assess. However, it appears that the lack of justification for the choice of an outcome prevents a better understanding of the reproducible effects on fatigue in physiotherapy interventions.

Objectives: Inpatient cardiac rehabilitation (CR) and pharmacotherapy are important for better in-hospital outcomes in elderly heart failure (HF) patients. We aimed to examine whether conventional CR combined with Waon therapy (Waon-CR) improves exercise capacity compared to CR alone in elderly HF patients.

Methods: Decompensated and hospitalized HF patients who could not walk independently over 200 m were recruited. Patients admitted from May 2020 to March 2021 and from April 2021 to March 2024 were included in the CR and Waon-CR groups, respectively. Participants underwent a 5-session program during hospitalization. The main outcome measure was a 6-minute walk distance (6MWD) at the completion of the program. We also investigated exercise-related adverse events.

Results: A total of 34 patients (mean age 79.5 years, 13 males) were enrolled, including 18 patients in the CR group and 16 patients in the Waon-CR group. The 6MWD after the 5-session program was longer in the Waon-CR group than in the CR group (362.2 ± 103.7 vs. 286.3 ± 100.6 m, p = 0.038). Significant improvement of the 6MWD was demonstrated in the Waon-CR group after adjusting for confounding factors (adjusted B, 147.0 m; 95% confidence interval, 41.3-252.8 m, p = 0.012). There were no adverse events during the hospital stay.

Conclusions: Inpatient Waon-CR was feasible and led to improved 6MWD in elderly HF patients at the completion of the 5-session program.

Objectives: The reliability of observational gait analyses is generally considered poor or moderate. This is considered due to the drawbacks in the experimental designs and measurement methods used in related studies. This study examined the reliability and validity of physical therapists' (PTs) visual joint angle estimation in gait analysis with a rigorous design.

Methods: Twenty PTs were divided into 2 groups of 10 each based on their experience: <10 years and >10 years. They observed videos and still images of patients with gait disorders and visually estimated the joint angles at specific points during the gait cycle. Reliability was assessed using the intraclass correlation coefficient, and validity was assessed by a correlation analysis, which compared their estimates with reference values obtained from the digital video analysis.

Results: Intra-rater reliability for visual estimation using video tended to exceed 0.6 for most indicators, whereas inter-rater reliability ranged from 0.04 to 0.59. For validity, correlation coefficients indicated an accuracy of 0.06-0.62 for video and 0.08-0.68 for still images.

Conclusions: Although intra-rater reliability tended to be higher than inter-rater reliability, neither reached levels considered sufficiently reliable, and validity showed only limited agreement with reference values. These results highlight the limitations of visual estimation in joint angle assessment. Future efforts should focus not only on improving observational consistency but also on improving agreement with reference values through corrective training using still images.

Objectives: The aim of this study was to investigate the relationship between fall frequency and progressive supranuclear palsy (PSP) severity, walking ability, balance function, cognitive function, and frontal lobe function in patients with PSP.

Methods: The study included 54 patients with PSP. Multiple logistic regression analysis was conducted to examine whether PSP severity, walking ability, balance function, cognitive function, and frontal lobe function after discharge were associated with fall frequency (falling two or more times per month). Balance function was assessed using the Berg Balance Scale and Mini-Balance Evaluation Systems Test (Mini-BESTest), with each used as an independent variable in separate models for association analysis. The Mini-BESTest showed a significant association, and its subitems were further analyzed using multiple logistic regression analysis.

Results: A significant association was observed between the Mini-BESTest and fall frequency, and among its subitems, anticipatory postural adjustments were significantly associated with fall frequency.

Conclusions: In patients with PSP characterized by impaired postural reflexes, the anticipatory postural adjustment ability may be associated with fall frequency.

Objectives: This study examined the relationship between phase angle (PhA), an indicator of muscle quality, and independent walking in stroke patients. The objective was to determine the predictive value of a PhA at admission for walking independence at discharge.

Methods: This study included 220 stroke patients (121 males, 99 females), categorized based on their functional independence measure (FIM) mobility scores at discharge: independent (FIM ≥6; n = 100) and dependent (FIM ≤5; n = 120). Logistic regression analysis assessed whether PhA at admission predicted ambulatory independence at discharge. Additionally, receiver-operating characteristic curve analysis determined optimal cutoff values.

Results: Logistic regression analysis showed that PhA at admission and the National Institutes of Health Stroke Scale (NIHSS) were significant predictors of independent walking. The optimal cutoff values for PhA were determined to be 4.35° for men and 4.1° for women. Similarly, the cutoff scores for the NIHSS were 7.5 points for men and 5.5 points for women.

Conclusions: In stroke patients, PhA and NIHSS at admission were significantly associated with ambulatory independence at discharge. Evaluation of PhA and NIHSS at admission may be useful for more accurate prediction of gait outcomes.