Progress in rehabilitation medicine最新文献

Objectives: Assessment of quality of life (QOL) is essential in evaluating rehabilitation outcomes for individuals with lower limb amputation (LLA). However, there are few longitudinal studies of QOL over extended periods. This study reports the findings of a third QOL survey conducted in 2021 using the Japanese version of the Prosthetic Evaluation Questionnaire (PEQ-J), following previous surveys in 2003 and 2011.

Methods: The survey targeted 254 individuals with LLA who had received prosthetic limbs from our center. Questionnaires were mailed, and responses were analyzed using the PEQ-J. Results were compared with those from previous surveys. The Mann-Whitney U test was used to assess statistical significance.

Results: Responses were received from 129 participants (response rate: 51%): 101 males and 28 females, with a mean age of 62.8 ± 14.8 years. Causes of amputation were trauma (n=83), disease (n=44), and others (n=2). The present survey had more older participants than the previous surveys. Fifty-seven individuals responded to both the 2011 and 2021 surveys. The most notable changes were observed in psychological domains. Sex-based differences in "Perceived Response" observed in 2011 were not present in 2021. Moreover, differences in "Frustration" and "Social Burden" related to time since amputation were no longer observed.

Conclusions: Our findings suggest that psychological adaptation may evolve over time, reducing disparities previously associated with sex and amputation duration. Advanced prosthetics and the Tokyo 2020 Paralympic Games may have effected improvements in QOL in individuals with LLA.

Objectives: This study investigated the relationship between frailty as assessed using the Kihon checklist (KCL) and rheumatoid arthritis (RA) status.

Methods: In total, 626 consecutive patients with RA were enrolled in this cross-sectional study. We examined the patients' KCL scores, characteristics, and clinical data. The patients were grouped according to their KCL scores as follows: robust (scores of 0-3), pre-frailty (scores of 4-7), and frailty (scores ≥8).

Results: Frailty, pre-frailty, and robust groups accounted for 36.9%, 30.5%, and 32.6% of the patients, respectively. Significant factors comparing frailty and robust groups were age (P < 0.001), Health Assessment Questionnaire Disability Index (HAQ-DI) (P < 0.001), and habitual exercise (P = 0.004). Significant factors comparing the pre-frailty and robust groups were age (P < 0.001) and HAQ-DI (P = 0.041).

Conclusions: In patients with RA, HAQ-DI and exercise should be managed to prevent frailty and avoid the need for long-term care. Our results will help identify those patients who can most benefit from aggressive management of RA.

Objectives: In previous studies, intensive rehabilitation for patients with Parkinson's disease (PD) has been implemented in both outpatient and inpatient settings, with varying durations across studies. Among these, most inpatient intensive rehabilitation programs are conducted for 1 month, with few reports evaluating detailed changes in neuropsychological functions. In this study, we investigated the effect of a short-term intensive inpatient rehabilitation program lasting 2 or 3 weeks on motor and non-motor symptoms, motor ability, and neuropsychological functions in hospitalized patients with PD.

Methods: We enrolled 15 patients with PD (7 men, 8 women; mean age, 75.1±6.5 years; Hoehn and Yahr stages III/IV, 12/3). The rehabilitation program included physical, occupational, and speech-language therapies and was implemented daily for 2 or 3 weeks. Motor and non-motor symptoms as well as motor abilities were assessed using the Movement Disorders Society Unified Parkinson's Disease Rating Scale, Functional Independence Measure, Parkinson's Disease Questionnaire-39, and other assessments. Neuropsychological functions were evaluated using Japanese versions of the Mini-Mental State Examination and Frontal Assessment Battery and using the CogEvo (computerized cognitive function evaluation) tool. Scores were compared before and after intervention.

Results: This short-term inpatient rehabilitation therapy significantly improved motor and non-motor symptoms, motor abilities, reality orientation as assessed by CogEvo, and the overall quality of life.

Conclusions: The results of this study suggest that short-term intensive rehabilitation in patients with PD may achieve favorable outcomes even within a limited timeframe. Further discussion of the appropriate duration of inpatient rehabilitation for patients with PD is warranted.

Objectives: : This study aimed to assess the qualitative effects of locomotion training (LT) on articular cartilage using magnetic resonance imaging T1ρ mapping.

Methods: : Fifteen patients with early knee osteoarthritis participated in the study. They performed a series of exercises, including one-leg stands, squats, heel raises, and front lunges, on a daily basis for 12 weeks. Knee joint function and physical performance were evaluated before and 3 months after completing the LT program. Additionally, a questionnaire was administered to assess patient-reported outcomes. The quality of articular cartilage was evaluated through magnetic resonance imaging using T1ρ mapping. T1ρ values were quantified on sagittal planes with ten regions of interest.

Results: : Regarding physical function, the time required for one-leg stands was significantly increased following LT, and the right functional reach test and the 30-s chair stand test showed improvement. T1ρ values were significantly reduced at 0° relative to the anatomical axis of the femur, whereas other regions of interest showed no significant change after LT.

Conclusions: : LT significantly improved muscle strength and balance in patients with early knee osteoarthritis. LT also improved the T1ρ values of articular cartilage at 0° relative to the anatomical axis of the femur. This change may reflect that LT mitigates cartilage degeneration following the application of moderate mechanical stress to the loading region. We propose that LT represents a safe and effective exercise therapy for early knee osteoarthritis, with the potential to improve both motor function and articular cartilage quality.

Objectives: This study aimed to clarify the relationship between depressive symptoms on admission and improvement in activities of daily living (ADLs) among patients with fractures admitted to a recovery rehabilitation unit.

Methods: This retrospective observational study enrolled patients with fractures who were admitted to a rehabilitation hospital between August 2018 and October 2020 in Okinawa City, Japan. Based on Geriatric Depression Scale scores, patients were divided into two groups: one group with depressive symptoms and another group without depressive symptoms. Associations between depressive symptoms and the motor Functional Independence Measure (FIM) gain were identified using multivariate linear regression analyses.

Results: Out of 127 patients (range, 40.0-83.0 years; male: 27.6%), 71 had depressive symptoms on admission. Multiple linear regression analysis revealed that depressive symptoms on admission were significantly associated with motor FIM gain (β coefficient: -5.022, 95% confidence interval -9.551 to -0.494, P = 0.030). Body Mass Index on admission, motor FIM on admission, Mini-Mental State Examination on admission, and use of antidepressants were also associated with motor FIM gain.

Conclusions: Among patients with fractures admitted to a recovery rehabilitation unit, depressive symptoms on admission were associated with less improvement in ADLs. The use of antidepressants was also an independent factor affecting the improvement of ADLs in these patients.