Background: Early mobilization and rehabilitation interventions should be provided to patients who survived severe COVID-19 to improve their physical function and activities of daily living (ADL). However, their physical and mental status at discharge has not been well described in Japan. We report the intervention provided for a survivor of severe COVID-19 and his physical and mental status at discharge from an acute care hospital.
Case report: A 62-year-old man was admitted to our emergency department with a diagnosis of COVID-19 with severe acute respiratory dysfunction. He had complicated intensive care unit-acquired weakness (ICU-AW) and delirium during mechanical ventilation therapy. Rehabilitation intervention was initiated on the seventh day post-admission and was gradually performed according to his respiratory and hemodynamic status. As a result of the rehabilitation intervention, ICU-AW and cognitive function gradually improved. On hospital day 37, he independently performed basic ADL and was discharged. However, he lost approximately 9% of his body weight at discharge. In addition, his hand grip strength and six-minute walking distance were lower and shorter than the reference values, respectively. His mental component summary of the Short Form-8™ was lower than the national standard deviation for the Japanese population.
Conclusion: Although survivors of severe COVID-19 who undergo early rehabilitation can be discharged from an acute care hospital, they may have several impairments in their physical and mental status, including muscle function, diffusion capacity, exercise tolerance, and health-related quality of life.
{"title":"Impairment in Physical Function and Mental Status in a Survivor of Severe COVID-19 at Discharge from an Acute Care a Hospital: A Case Report.","authors":"Shinya Matsushima, Yusuke Kasahara, Shun Aikawa, Takeru Fuzimura, Hitoshi Yokoyama, Hironobu Katata","doi":"10.1298/ptr.E10083","DOIUrl":"https://doi.org/10.1298/ptr.E10083","url":null,"abstract":"<p><strong>Background: </strong>Early mobilization and rehabilitation interventions should be provided to patients who survived severe COVID-19 to improve their physical function and activities of daily living (ADL). However, their physical and mental status at discharge has not been well described in Japan. We report the intervention provided for a survivor of severe COVID-19 and his physical and mental status at discharge from an acute care hospital.</p><p><strong>Case report: </strong>A 62-year-old man was admitted to our emergency department with a diagnosis of COVID-19 with severe acute respiratory dysfunction. He had complicated intensive care unit-acquired weakness (ICU-AW) and delirium during mechanical ventilation therapy. Rehabilitation intervention was initiated on the seventh day post-admission and was gradually performed according to his respiratory and hemodynamic status. As a result of the rehabilitation intervention, ICU-AW and cognitive function gradually improved. On hospital day 37, he independently performed basic ADL and was discharged. However, he lost approximately 9% of his body weight at discharge. In addition, his hand grip strength and six-minute walking distance were lower and shorter than the reference values, respectively. His mental component summary of the Short Form-8™ was lower than the national standard deviation for the Japanese population.</p><p><strong>Conclusion: </strong>Although survivors of severe COVID-19 who undergo early rehabilitation can be discharged from an acute care hospital, they may have several impairments in their physical and mental status, including muscle function, diffusion capacity, exercise tolerance, and health-related quality of life.</p>","PeriodicalId":74445,"journal":{"name":"Physical therapy research","volume":"24 3","pages":"285-290"},"PeriodicalIF":0.0,"publicationDate":"2021-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8752843/pdf/ptr-24-03-0285.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39916016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Several strategies have been designed to improve balance after stroke. Although recent studies have suggested that the balance training in stroke should include exercises that are performed in different sensory conflict conditions, little attention has been paid to manipulation of visual input. This study aimed to compare effects of balance training on an unstable surface with balance training under visual deprivation conditions in persons with stroke.
Method: Forty-five stroke patients were randomized into three groups: the visual deprivation- stable based training (VD-SBT); unstable based training (UBT); and control (C) groups. Subjects of the VD-SBT group performed balance training on a stable surface with closed eyes. The UBT group performed balance training on an unstable surface with open eyes. Patients were assessed before and after interventions for Timed Up and Go (TUG), Four Square Step (FSS) and Five Times Sit to Stand (FTSS) tests.
Result: There was a significant difference in pre- post intervention time of TUG, FSS and FTSS tests in all three groups. In a comparison of three groups, the UBT and VD-SBT groups had a significant improvement in time of all tests but significant improvement in time of all tests was observed in the VD-SBT group in comparison with the UBT group. In the field of balance training, the manipulation of visual input was more effective than the manipulation of standing surface to reweighting the sensory information.
Conclusion: We recommended balance rehabilitation programs after stroke performed under conditions to stimulate the use of underused sensory input.
{"title":"Stroke Patients Showed Improvements in Balance in Response to Visual Restriction Exercise.","authors":"Shima Jandaghi, Nahid Tahan, Alireza Akbarzadeh Baghban, Maryam Zoghi","doi":"10.1298/ptr.E10081","DOIUrl":"https://doi.org/10.1298/ptr.E10081","url":null,"abstract":"<p><strong>Objective: </strong>Several strategies have been designed to improve balance after stroke. Although recent studies have suggested that the balance training in stroke should include exercises that are performed in different sensory conflict conditions, little attention has been paid to manipulation of visual input. This study aimed to compare effects of balance training on an unstable surface with balance training under visual deprivation conditions in persons with stroke.</p><p><strong>Method: </strong>Forty-five stroke patients were randomized into three groups: the visual deprivation- stable based training (VD-SBT); unstable based training (UBT); and control (C) groups. Subjects of the VD-SBT group performed balance training on a stable surface with closed eyes. The UBT group performed balance training on an unstable surface with open eyes. Patients were assessed before and after interventions for Timed Up and Go (TUG), Four Square Step (FSS) and Five Times Sit to Stand (FTSS) tests.</p><p><strong>Result: </strong>There was a significant difference in pre- post intervention time of TUG, FSS and FTSS tests in all three groups. In a comparison of three groups, the UBT and VD-SBT groups had a significant improvement in time of all tests but significant improvement in time of all tests was observed in the VD-SBT group in comparison with the UBT group. In the field of balance training, the manipulation of visual input was more effective than the manipulation of standing surface to reweighting the sensory information.</p><p><strong>Conclusion: </strong>We recommended balance rehabilitation programs after stroke performed under conditions to stimulate the use of underused sensory input.</p>","PeriodicalId":74445,"journal":{"name":"Physical therapy research","volume":"24 3","pages":"211-217"},"PeriodicalIF":0.0,"publicationDate":"2021-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8752821/pdf/ptr-24-03-0211.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39826109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To clarify the corrected age of walking attainment in very low birth weight infants by birth weight and gestational age, and determine perinatal factors affecting the delay in walking attainment.
Method: This was a longitudinal study. We investigated walking attainment and perinatal factors in 145 very low birth weight infants without neurological abnormalities (mean birth weight 1019.3 ± 299.7 g, gestational age 29.0 ± 2.9 weeks). The study infants were stratified by birth weight (group A: <1,000 g, group B: 1,000 g≤, <1,500 g) and gestational age (group I: <28 weeks, group II: 28 weeks≤, <37 weeks) and were compared using unpaired t-tests. Furthermore, we examined the perinatal factors that affect the delay in walking attainment using multiple regression analysis.
Results: Of the walking attainment, infants in Group A were older than those in Group B (50th percentile, 15.8 vs. 14.7 months). Infants in Group I were older than those in Group II (50th percentile, 16.0 vs. 14.8 months). Using multiple regression analysis with walking attainment age as the dependent variable, the duration of mechanical ventilation was found to be significantly related.
Conclusion: Very low birth weight infants with light weight and short gestational age have delayed walking attainment, and longer duration of mechanical ventilation increases the risk of delay.
{"title":"Walking Attainment in Very Low Birth Weight Infants in Japan.","authors":"Yuu Uchio, Naoko Shima, Kaho Nakamura, Osamu Nitta, Tetsuo Ikai","doi":"10.1298/ptr.E10087","DOIUrl":"https://doi.org/10.1298/ptr.E10087","url":null,"abstract":"<p><strong>Objective: </strong>To clarify the corrected age of walking attainment in very low birth weight infants by birth weight and gestational age, and determine perinatal factors affecting the delay in walking attainment.</p><p><strong>Method: </strong>This was a longitudinal study. We investigated walking attainment and perinatal factors in 145 very low birth weight infants without neurological abnormalities (mean birth weight 1019.3 ± 299.7 g, gestational age 29.0 ± 2.9 weeks). The study infants were stratified by birth weight (group A: <1,000 g, group B: 1,000 g≤, <1,500 g) and gestational age (group I: <28 weeks, group II: 28 weeks≤, <37 weeks) and were compared using unpaired t-tests. Furthermore, we examined the perinatal factors that affect the delay in walking attainment using multiple regression analysis.</p><p><strong>Results: </strong>Of the walking attainment, infants in Group A were older than those in Group B (50th percentile, 15.8 vs. 14.7 months). Infants in Group I were older than those in Group II (50th percentile, 16.0 vs. 14.8 months). Using multiple regression analysis with walking attainment age as the dependent variable, the duration of mechanical ventilation was found to be significantly related.</p><p><strong>Conclusion: </strong>Very low birth weight infants with light weight and short gestational age have delayed walking attainment, and longer duration of mechanical ventilation increases the risk of delay.</p>","PeriodicalId":74445,"journal":{"name":"Physical therapy research","volume":"24 3","pages":"204-210"},"PeriodicalIF":0.0,"publicationDate":"2021-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8752867/pdf/ptr-24-03-0204.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39826108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: This study aimed to investigate anatomical changes in the brain following chronic complete traumatic thoracic spinal cord injury (ThSCI) using voxel-based morphometry (VBM). That is, it attempted to examine dynamic physical change following thoracic injury and the presence or absence of regions with decreased and increased changes in whole brain volume associated with change in the manner of how activities of daily living are performed.
Methods: Twelve individuals with chronic traumatic complete ThSCI (age; 21-63 years, American Spinal Injury Association Impairment Scale; grade C-D) participated in this study. VBM was used to investigate the regions with increased volume and decreased volume in the brain in comparison with healthy control individuals.
Results: Decreases in volume were noted in areas associated with motor and somatosensory functions, including the right paracentral lobule (PCL)-the primary motor sensory area for lower limbs, left dorsal premotor cortex, and left superior parietal lobule (SPL). Furthermore, increased gray matter volume was noted in the primary sensorimotor area for fingers and arms, as well as in higher sensory areas.
Conclusions: Following SCI both regions with increased volume and regions with decreased volume were present in the brain in accordance with changes in physical function. Using longitudinal observation, anatomical changes in the brain may be used to determine the rehabilitation effect by comparing present cases with cases with cervical SCI or cases with incomplete palsy.
{"title":"Anatomical Increased/Decreased Changes in the Brain Area Following Individuals with Chronic Traumatic Complete Thoracic Spinal Cord Injury.","authors":"Takashi Murayama, Kousuke Takahama, Kazumasa Jinbo, Tomoyoshi Kobari","doi":"10.1298/ptr.E10076","DOIUrl":"https://doi.org/10.1298/ptr.E10076","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate anatomical changes in the brain following chronic complete traumatic thoracic spinal cord injury (ThSCI) using voxel-based morphometry (VBM). That is, it attempted to examine dynamic physical change following thoracic injury and the presence or absence of regions with decreased and increased changes in whole brain volume associated with change in the manner of how activities of daily living are performed.</p><p><strong>Methods: </strong>Twelve individuals with chronic traumatic complete ThSCI (age; 21-63 years, American Spinal Injury Association Impairment Scale; grade C-D) participated in this study. VBM was used to investigate the regions with increased volume and decreased volume in the brain in comparison with healthy control individuals.</p><p><strong>Results: </strong>Decreases in volume were noted in areas associated with motor and somatosensory functions, including the right paracentral lobule (PCL)-the primary motor sensory area for lower limbs, left dorsal premotor cortex, and left superior parietal lobule (SPL). Furthermore, increased gray matter volume was noted in the primary sensorimotor area for fingers and arms, as well as in higher sensory areas.</p><p><strong>Conclusions: </strong>Following SCI both regions with increased volume and regions with decreased volume were present in the brain in accordance with changes in physical function. Using longitudinal observation, anatomical changes in the brain may be used to determine the rehabilitation effect by comparing present cases with cases with cervical SCI or cases with incomplete palsy.</p>","PeriodicalId":74445,"journal":{"name":"Physical therapy research","volume":"24 2","pages":"163-169"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8419593/pdf/ptr-24-02-0163.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39424115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: We examined the association between social frailty and subjective sleep quality among community-dwelling adults.
Methods: This cross-sectional study recruited Japanese adults over the age of 60 years from health check-ups held in a public townhall in a suburban area between 2018 and 2019. Social frailty was evaluated using five criteria (living alone, not visiting friends sometimes, going out less frequently than the last year, not feeling helpful to friends or family, and not talking to someone every day) and categorized into three groups: non-frailty, pre-frailty, and frailty. Sleep quality was assessed according to the Pittsburgh Sleep Quality Index (PSQI) by giving participants a self-reported questionnaire. We performed multivariable linear regression analysis, denoting social frailty as an independent variable, and the global PSQI score as a dependent variable.
Results: Data from 300 older adults were analyzed, 51.0% of whom were female. The participants' mean age was 73.0 years (standard deviation = 5.8). Multivariable analysis revealed the notable association between social frailty and a high global PSQI score (compared with non-frailty, frailty: β = 0.94, 95% CI = 0.08 to 1.80, p = 0.033). Of the five determiners of social frailty, not talking with someone every day was especially associated with a high global PSQI score (β = 1.57, 95% CI = 0.49 to 2.66, p = 0.005).
Conclusion: The present study suggests that social frailty is associated with poor sleep quality among community-dwelling older adults. Our findings indicate the importance of social frailty on sleep quality among older adults.
目的:探讨社区居民的社会脆弱与主观睡眠质量之间的关系。方法:这项横断面研究招募了2018年至2019年期间在郊区一个公共市政厅进行健康检查的60岁以上的日本成年人。社会脆弱是用五个标准来评估的(独自生活,有时不拜访朋友,比去年更少外出,对朋友或家人没有帮助,每天不与某人交谈),并分为三组:非脆弱,脆弱前和脆弱。根据匹兹堡睡眠质量指数(PSQI),通过给参与者一份自我报告的问卷来评估睡眠质量。我们进行了多变量线性回归分析,将社会脆弱性作为自变量,将整体PSQI评分作为因变量。结果:分析了300名老年人的数据,其中51.0%为女性。参与者的平均年龄为73.0岁(标准差= 5.8)。多变量分析显示,社会脆弱与高整体PSQI评分之间存在显著关联(与非脆弱相比,脆弱:β = 0.94, 95% CI = 0.08至1.80,p = 0.033)。在社会脆弱的五个决定因素中,不每天与某人交谈与高整体PSQI评分特别相关(β = 1.57, 95% CI = 0.49至2.66,p = 0.005)。结论:目前的研究表明,在社区居住的老年人中,社会脆弱性与睡眠质量差有关。我们的研究结果表明,社会脆弱性对老年人睡眠质量的重要性。
{"title":"Association between Social Frailty and Sleep Quality among Community-dwelling Older Adults: A Cross-sectional Study.","authors":"Taiji Noguchi, Ippei Nojima, Tomoe Inoue-Hirakawa, Hideshi Sugiura","doi":"10.1298/ptr.E10085","DOIUrl":"https://doi.org/10.1298/ptr.E10085","url":null,"abstract":"<p><strong>Objective: </strong>We examined the association between social frailty and subjective sleep quality among community-dwelling adults.</p><p><strong>Methods: </strong>This cross-sectional study recruited Japanese adults over the age of 60 years from health check-ups held in a public townhall in a suburban area between 2018 and 2019. Social frailty was evaluated using five criteria (living alone, not visiting friends sometimes, going out less frequently than the last year, not feeling helpful to friends or family, and not talking to someone every day) and categorized into three groups: non-frailty, pre-frailty, and frailty. Sleep quality was assessed according to the Pittsburgh Sleep Quality Index (PSQI) by giving participants a self-reported questionnaire. We performed multivariable linear regression analysis, denoting social frailty as an independent variable, and the global PSQI score as a dependent variable.</p><p><strong>Results: </strong>Data from 300 older adults were analyzed, 51.0% of whom were female. The participants' mean age was 73.0 years (standard deviation = 5.8). Multivariable analysis revealed the notable association between social frailty and a high global PSQI score (compared with non-frailty, frailty: β = 0.94, 95% CI = 0.08 to 1.80, p = 0.033). Of the five determiners of social frailty, not talking with someone every day was especially associated with a high global PSQI score (β = 1.57, 95% CI = 0.49 to 2.66, p = 0.005).</p><p><strong>Conclusion: </strong>The present study suggests that social frailty is associated with poor sleep quality among community-dwelling older adults. Our findings indicate the importance of social frailty on sleep quality among older adults.</p>","PeriodicalId":74445,"journal":{"name":"Physical therapy research","volume":"24 2","pages":"153-162"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8419475/pdf/ptr-24-02-0153.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39424114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Interstitial lung disease (ILD) is a diverse group of chronic lung conditions characterized by dyspnea, exercise-induced hypoxemia (EIH), and exercise intolerance. Since activity limitations and impaired health-related quality of life (HRQoL) in ILD are similar to those in other chronic respiratory diseases, including chronic obstructive pulmonary disease (COPD), pulmonary rehabilitation is also indicated for patients with ILD. This rehabilitation program mainly comprises exercise training and self-management education. Exercise training is the most important component of pulmonary rehabilitation. It significantly improves dyspnea and enhances exercise capacity and HRQoL in patients with ILD. The standard exercise prescription used for COPD is also effective for ILD. However, considering that disease progression and exercise-limiting factors are different in patients with COPD is necessary. Severe EIH, the adverse effects of corticosteroid administration, and comorbidities often lead to difficulty in employing a sufficient exercise intensity. Some modifications in the exercise prescription for individual patients or strategies to minimize EIH and dyspnea are required to optimize training intensity. Since EIH is common and severe in patients with ILD, supplemental oxygen should be provided. In advanced and more severe patients, who have difficulty in performing exercises, energy conservation techniques and the use of energy-saving devices to improve and maintain the patients' activities of daily living may be effective..
{"title":"Respiratory Impairment, Limited Activity, and Pulmonary Rehabilitation in Patients with Interstitial Lung Disease.","authors":"Ryo Kozu, Kazuya Shingai, Masatoshi Hanada, Masato Oikawa, Hiroki Nagura, Hiroshi Ito, Chika Kitagawa, Takako Tanaka","doi":"10.1298/ptr.R0012","DOIUrl":"https://doi.org/10.1298/ptr.R0012","url":null,"abstract":"<p><p>Interstitial lung disease (ILD) is a diverse group of chronic lung conditions characterized by dyspnea, exercise-induced hypoxemia (EIH), and exercise intolerance. Since activity limitations and impaired health-related quality of life (HRQoL) in ILD are similar to those in other chronic respiratory diseases, including chronic obstructive pulmonary disease (COPD), pulmonary rehabilitation is also indicated for patients with ILD. This rehabilitation program mainly comprises exercise training and self-management education. Exercise training is the most important component of pulmonary rehabilitation. It significantly improves dyspnea and enhances exercise capacity and HRQoL in patients with ILD. The standard exercise prescription used for COPD is also effective for ILD. However, considering that disease progression and exercise-limiting factors are different in patients with COPD is necessary. Severe EIH, the adverse effects of corticosteroid administration, and comorbidities often lead to difficulty in employing a sufficient exercise intensity. Some modifications in the exercise prescription for individual patients or strategies to minimize EIH and dyspnea are required to optimize training intensity. Since EIH is common and severe in patients with ILD, supplemental oxygen should be provided. In advanced and more severe patients, who have difficulty in performing exercises, energy conservation techniques and the use of energy-saving devices to improve and maintain the patients' activities of daily living may be effective..</p>","PeriodicalId":74445,"journal":{"name":"Physical therapy research","volume":"24 1","pages":"9-16"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111423/pdf/ptr-24-01-0009.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38975766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-01eCollection Date: 2021-01-01DOI: 10.1298/ptr.E10089
Takazumi Ono, Mieko Kashima, Yasuyoshi Asakawa
Objectives: To reveal self-rated changes of health status during stay-at-home orders among older adults and to verify whether decrease in frequency of going outdoors during these orders was related to self-rated changes in health status.
Method: A self-completed questionnaire for older adults was provided in 2 dayservice facilities and a nursing station. We operationally defined health status with 4 domains (motor function, oral and swallowing function, depression, and social networks) and designed the questionnaire to determine self-rated changes in health status using factor analysis. After factor analysis, regression analyses were conducted. Dependent variable was each factor score (self-rated changes of health status), and independent variable was decrease in frequency of going outdoors.
Results: Approximately 80% of participants answered that their health status had "worsened" in motor function (75.0%-87.2%). Moreover, more than 70% of participants answered "worsened" in "Feeling energy" and "Getting together and speaking with friends" (72.3% and 75.7%, respectively). Regression analyses demonstrated that, after adjusting for covariates, the decrease in frequency of going outdoors was related to self-rated changes of motor function and friend network.
Conclusion: During stay-at-home orders, older adults felt deterioration in their motor function, in feeling energy, and in their friend network, especially people who had decreased their frequency of going outdoors felt more deterioration in their motor function and in their friend network.
{"title":"Self-rated Changes of Health Status during Stay-at-home Orders among Older Adults Using the Long-term Care Insurance System of Japan: A Cross-sectional Study.","authors":"Takazumi Ono, Mieko Kashima, Yasuyoshi Asakawa","doi":"10.1298/ptr.E10089","DOIUrl":"https://doi.org/10.1298/ptr.E10089","url":null,"abstract":"<p><strong>Objectives: </strong>To reveal self-rated changes of health status during stay-at-home orders among older adults and to verify whether decrease in frequency of going outdoors during these orders was related to self-rated changes in health status.</p><p><strong>Method: </strong>A self-completed questionnaire for older adults was provided in 2 dayservice facilities and a nursing station. We operationally defined health status with 4 domains (motor function, oral and swallowing function, depression, and social networks) and designed the questionnaire to determine self-rated changes in health status using factor analysis. After factor analysis, regression analyses were conducted. Dependent variable was each factor score (self-rated changes of health status), and independent variable was decrease in frequency of going outdoors.</p><p><strong>Results: </strong>Approximately 80% of participants answered that their health status had \"worsened\" in motor function (75.0%-87.2%). Moreover, more than 70% of participants answered \"worsened\" in \"Feeling energy\" and \"Getting together and speaking with friends\" (72.3% and 75.7%, respectively). Regression analyses demonstrated that, after adjusting for covariates, the decrease in frequency of going outdoors was related to self-rated changes of motor function and friend network.</p><p><strong>Conclusion: </strong>During stay-at-home orders, older adults felt deterioration in their motor function, in feeling energy, and in their friend network, especially people who had decreased their frequency of going outdoors felt more deterioration in their motor function and in their friend network.</p>","PeriodicalId":74445,"journal":{"name":"Physical therapy research","volume":"24 2","pages":"170-175"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8419481/pdf/ptr-24-02-0170.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39424116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Many clinical trials have shown the therapeutic effects of electrical stimulation (ES) in various conditions. Our previous studies showed that ES (200 μA and 2 Hz) promotes migration and proliferation of human dermal fibroblasts (HDFs). However, the effective duty cycle and the effect of ES on myofibroblast differentiation are unclear. This study aimed to investigate the relationship between duty cycle and myofibroblast differentiation.
Methods: HDFs were subjected to ES (200 μA and 2 Hz) for 24 h with the duty cycle adapted at 0% (control), 10%, 50%, or 90%. α-smooth muscle actin (SMA) and transforming growth factor (TGF)-β1 mRNA and α-SMA protein expressions were assessed. Collagen gel contraction was observed for 48 h after ES initiation and the gel area was measured. Cell viability and pH of culture medium were analyzed for cytotoxicity of the ES.
Results: Cell viabilities were decreased in the 50% and the 90% groups but ES did not influence on pH of culture media. ES with a duty cycle of 10% significantly promoted the mRNA expression of α-SMA and TGF-β1. α-SMA protein expression in the 10% group was also significantly higher than that of the control group. Collagen gel subjected to ES with a duty cycle of 10% was contracted.
Conclusion: Duty cycle can influence on myofibroblast differentiation and ES with a duty cycle 10% is the effective for wound healing.
目的:许多临床试验表明,电刺激(ES)对各种疾病都有治疗作用。我们之前的研究表明,电刺激(200 μA 和 2 Hz)可促进人真皮成纤维细胞(HDFs)的迁移和增殖。然而,ES的有效占空比和对肌成纤维细胞分化的影响尚不清楚。本研究旨在探讨占空比与肌成纤维细胞分化之间的关系。方法:将 HDFs 放在 ES(200 μA 和 2 Hz)中 24 小时,占空比调整为 0%(对照组)、10%、50% 或 90%。在 ES 启动后的 48 小时内观察胶原凝胶收缩并测量凝胶面积。对细胞活力和培养基 pH 值进行分析,以确定 ES 的细胞毒性:结果:50% 和 90% 组的细胞活力下降,但 ES 对培养基的 pH 值没有影响。占空比为 10%的 ES 能明显促进 α-SMA 和 TGF-β1 的 mRNA 表达,10% 组的α-SMA 蛋白表达也明显高于对照组。在占空比为 10%的 ES 条件下,胶原凝胶发生收缩:占空比可影响肌成纤维细胞的分化,占空比为 10%的 ES 对伤口愈合有效。
{"title":"Monophasic Pulsed Current Stimulation of Duty Cycle 10% Promotes Differentiation of Human Dermal Fibroblasts into Myofibroblasts.","authors":"Mikiko Uemura, Masaharu Sugimoto, Yoshiyuki Yoshikawa, Terutaka Hiramatsu, Taketo Inoue","doi":"10.1298/ptr.E10064","DOIUrl":"10.1298/ptr.E10064","url":null,"abstract":"<p><strong>Objective: </strong>Many clinical trials have shown the therapeutic effects of electrical stimulation (ES) in various conditions. Our previous studies showed that ES (200 μA and 2 Hz) promotes migration and proliferation of human dermal fibroblasts (HDFs). However, the effective duty cycle and the effect of ES on myofibroblast differentiation are unclear. This study aimed to investigate the relationship between duty cycle and myofibroblast differentiation.</p><p><strong>Methods: </strong>HDFs were subjected to ES (200 μA and 2 Hz) for 24 h with the duty cycle adapted at 0% (control), 10%, 50%, or 90%. α-smooth muscle actin (SMA) and transforming growth factor (TGF)-β1 mRNA and α-SMA protein expressions were assessed. Collagen gel contraction was observed for 48 h after ES initiation and the gel area was measured. Cell viability and pH of culture medium were analyzed for cytotoxicity of the ES.</p><p><strong>Results: </strong>Cell viabilities were decreased in the 50% and the 90% groups but ES did not influence on pH of culture media. ES with a duty cycle of 10% significantly promoted the mRNA expression of α-SMA and TGF-β1. α-SMA protein expression in the 10% group was also significantly higher than that of the control group. Collagen gel subjected to ES with a duty cycle of 10% was contracted.</p><p><strong>Conclusion: </strong>Duty cycle can influence on myofibroblast differentiation and ES with a duty cycle 10% is the effective for wound healing.</p>","PeriodicalId":74445,"journal":{"name":"Physical therapy research","volume":"24 2","pages":"145-152"},"PeriodicalIF":0.0,"publicationDate":"2021-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8419484/pdf/ptr-24-02-0145.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39424113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: We explore the effects of body weight-supported (BWS) treadmill training, including the change of cortical activation, on a patient with post-stroke hemidystonia.
Patient: The patient was a 71-year-old man with left thalamus hemorrhage. His motor symptoms indicated slight impairment. There was no overactive muscle contraction in the supine, sitting, or standing positions. During his gait, the right initial contact was the forefoot, and his right knee showed an extension thrust pattern. These symptoms suggested that he had post-stroke hemidystonia.
Methods: The patient performed BWS treadmill training 14 times over 3 weeks. The effects of the BWS training were assessed by a step-length analysis, electromyography and functional magnetic resonance imaging (fMRI).
Results: The patient's nonparetic step length was extended significantly in the Inter-BWS (p<0.001) and Post-BWS (p=0.025) periods compared to the Pre-BWS session. The excessive muscle activity of the right gastrocnemius medialis in the swing phase was decreased at the Inter-BWS, Post-BWS, and follow-up compared to the Pre-BWS session. The peak timing difference of the bilateral tibialis anterior muscle became significant (p<0.05) on the first day of the intervention. The fMRI revealed that the cortical areas activated by the motor task converged through the intervention (p<0.05, family-wise error corrected).
Conclusion: These results suggest that there was improvement of the patient's symptoms of post-stroke hemidystonia due to changes in the brain activity during voluntary movement after BWS intervention. Body weight-supported treadmill training may thus be an effective treatment for patients with poststroke hemidystonia.
{"title":"The Progress of the Gait Impairment and Brain Activation in a Patient with Post-stroke Hemidystonia.","authors":"Satoshi Yamamoto, Daisuke Ishii, Kyoko Kanae, Yusuke Endo, Kenichi Yoshikawa, Kazunori Koseki, Ryo Nakazawa, Hanako Takano, Masahiko Monma, Arito Yozu, Akira Matsushita, Yutaka Kohno","doi":"10.1298/ptr.E10032","DOIUrl":"https://doi.org/10.1298/ptr.E10032","url":null,"abstract":"<p><strong>Objective: </strong>We explore the effects of body weight-supported (BWS) treadmill training, including the change of cortical activation, on a patient with post-stroke hemidystonia.</p><p><strong>Patient: </strong>The patient was a 71-year-old man with left thalamus hemorrhage. His motor symptoms indicated slight impairment. There was no overactive muscle contraction in the supine, sitting, or standing positions. During his gait, the right initial contact was the forefoot, and his right knee showed an extension thrust pattern. These symptoms suggested that he had post-stroke hemidystonia.</p><p><strong>Methods: </strong>The patient performed BWS treadmill training 14 times over 3 weeks. The effects of the BWS training were assessed by a step-length analysis, electromyography and functional magnetic resonance imaging (fMRI).</p><p><strong>Results: </strong>The patient's nonparetic step length was extended significantly in the Inter-BWS (p<0.001) and Post-BWS (p=0.025) periods compared to the Pre-BWS session. The excessive muscle activity of the right gastrocnemius medialis in the swing phase was decreased at the Inter-BWS, Post-BWS, and follow-up compared to the Pre-BWS session. The peak timing difference of the bilateral tibialis anterior muscle became significant (p<0.05) on the first day of the intervention. The fMRI revealed that the cortical areas activated by the motor task converged through the intervention (p<0.05, family-wise error corrected).</p><p><strong>Conclusion: </strong>These results suggest that there was improvement of the patient's symptoms of post-stroke hemidystonia due to changes in the brain activity during voluntary movement after BWS intervention. Body weight-supported treadmill training may thus be an effective treatment for patients with poststroke hemidystonia.</p>","PeriodicalId":74445,"journal":{"name":"Physical therapy research","volume":"24 2","pages":"176-186"},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8419483/pdf/ptr-24-02-0176.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39424117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aimed to clarify the effect of home-based exercise therapy on physical activity in peripheral arterial disease (PAD) patients after EVT.
Methods: Study design was controlled clinical design. The subjects were 30 patients (76.6% men) who underwent EVT in the Sakakibara Heart Institute of Okayama. Patients with EVT meeting the inclusion criteria were divided into two groups, intervention group (Home-based exercise) and control group. Patients' basic characteristics, the number of steps walked and QOL questionnaire (WIQ, SEPA, Vascu QOL) were assessed before surgery and, at the 3 month after discharge. A two-way analysis of variance (ANOVA) was performed to compare number of steps walked and QOL questionnaire.
Results: Interaction effect were observed in the number of steps walked (F (1,28) =13.89, p<0.01). A multiple comparison test confirmed a significant increase between results of before surgery and at three months after surgery in the intervention group (p<0.01). An interaction between the presence and absence of intervention was found for the WIQ pain score (F(1,28) = 5.86, p=0.01), speed score (F(1,28) = 3.80, p=0.04) and SEPA (F(1,28) = 4.99, p=0.03). In a multiple comparison study, there was a significant increase in WIQ pain and speed scores in both groups before and 3 months after discharge from the hospital.
Conclusion: Home-based exercise therapy using physical activity indices has the potential to improve number of steps and quality of life in patients with PAD after EVT.
研究目的本研究旨在阐明家庭运动疗法对 EVT 后外周动脉疾病(PAD)患者体力活动的影响:研究设计为临床对照设计。研究对象为在冈山榊原心脏研究所接受 EVT 的 30 名患者(76.6% 为男性)。符合纳入标准的 EVT 患者被分为两组,即干预组(家庭锻炼)和对照组。在手术前和出院后 3 个月对患者的基本特征、行走步数和 QOL 问卷(WIQ、SEPA、Vascu QOL)进行评估。对步行步数和 QOL 问卷进行了双向方差分析(ANOVA):结果:步行步数存在交互效应(F(1,28)=13.89,p):采用体力活动指数的家庭运动疗法有可能改善 EVT 后 PAD 患者的行走步数和生活质量。
{"title":"Effect of Home-based Exercise Therapy for Peripheral Arterial Disease Patients Underwent Endovascular Treatment: A Clinical Controlled Design.","authors":"Shota Otsuka, Tomoyuki Morisawa, Yu Hojo, Atsuhisa Ishida, Akira Tamaki","doi":"10.1298/ptr.E10056","DOIUrl":"10.1298/ptr.E10056","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to clarify the effect of home-based exercise therapy on physical activity in peripheral arterial disease (PAD) patients after EVT.</p><p><strong>Methods: </strong>Study design was controlled clinical design. The subjects were 30 patients (76.6% men) who underwent EVT in the Sakakibara Heart Institute of Okayama. Patients with EVT meeting the inclusion criteria were divided into two groups, intervention group (Home-based exercise) and control group. Patients' basic characteristics, the number of steps walked and QOL questionnaire (WIQ, SEPA, Vascu QOL) were assessed before surgery and, at the 3 month after discharge. A two-way analysis of variance (ANOVA) was performed to compare number of steps walked and QOL questionnaire.</p><p><strong>Results: </strong>Interaction effect were observed in the number of steps walked (F (1,28) =13.89, p<0.01). A multiple comparison test confirmed a significant increase between results of before surgery and at three months after surgery in the intervention group (p<0.01). An interaction between the presence and absence of intervention was found for the WIQ pain score (F(1,28) = 5.86, p=0.01), speed score (F(1,28) = 3.80, p=0.04) and SEPA (F(1,28) = 4.99, p=0.03). In a multiple comparison study, there was a significant increase in WIQ pain and speed scores in both groups before and 3 months after discharge from the hospital.</p><p><strong>Conclusion: </strong>Home-based exercise therapy using physical activity indices has the potential to improve number of steps and quality of life in patients with PAD after EVT.</p>","PeriodicalId":74445,"journal":{"name":"Physical therapy research","volume":"24 2","pages":"120-127"},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8419477/pdf/ptr-24-02-0120.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39424669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}