Ryotokuji University

[Purpose] One-leg standing motion was measured in patients with Parkinson’s disease (PD)to evaluate the association between freezing of gait (FOG) and anticipatory posturaladjustments (APA). [Participants and Methods] The participants included10 healthy olderindividuals, seven patients with PD without FOG (PD-FOG group), and seven patients with PDand FOG (PD+FOG group). An accelerometer that was built into a smartphone was attached tothe lower back of each participant, and acceleration in the mediolateral direction wasmeasured during one-leg standing. For the mediolateral component of acceleration, the timeto the maximum value in the stance direction (peak latency, PL) and the amount ofdisplacement of the maximum value (peak magnitude, PM) were analyzed as APA features. Aone-way analysis of variance (ANOVA) was used to compare PL and PM among the three groups.In addition, the APA ratio (APAr), which is the ratio of PL to PM, was compared betweenstudy cohorts. [Results] Delayed PL and decreased PM were observed in the PD+FOG group,compared with the older and PD-FOG groups. In addition, APAr levels were significantlylower in the PD+FOG group. [Conclusion] Patients with PD with FOG had greater APAimpairment than those with PD without FOG.

[Purpose] The purpose of this study was to clarify the relationship between the learning effects of distance learning in a physical therapist training school and information and communication technology (ICT) literacy and course environment. [Participants and Methods] Sixty-two students among the third year students of the Department of Physical Therapy at a four-year university who took the distance learning course were analyzed. A questionnaire survey was conducted of the upper and lower Grade Point Average (GPA) groups to investigate ICT literacy and the environment for taking remote classes. [Results] The upper GPA group showed significantly higher values for expression and collection skills in ICT literacy. There was no significant difference in the course environment. [Conclusion] It was clarified that ICT literacy has an impact on the learning effect of distance learning. In particular, collection and expression skills are deeply involved. It is thought that the acquisition of these skills may improve the learning effect of distance learning.

ObjectiveTo investigate the factors predicting oral feeding ability following acute stroke.MethodsThis retrospective study compared patients admitted to a stroke care unit in 2 groups: an oral intake group and a tube feeding group. The groups were evaluated for 28 items and initial blood investigation tests, and the results compared. Logistic regression analysis was used to identify the clinical variables significantly associated with oral feeding ability.ResultsA total of 255 stroke patients (162 in the oral intake group and 93 in the tube feeding group) were admitted to the stroke care unit. Significant differences were observed between the 2 groups for 20 items. Logistic analysis found that the following variables were significant in the prediction model: age, date of initiation of oral feeding, stroke recurrence/patient deterioration during hospitalization, and date of initiation of occupational therapy.ConclusionFactors associated with achieving oral intake among stroke care unit patients were: young age at time of admission; starting oral intake early; no stroke recurrence/patient deterioration during hospitalization; and achieving rehabilitation of daily activities early during the physical function recovery stage.LAY ABSTRACTA stroke care unit is a hospital ward specializing in acutestage stroke. Length of stay in the SCU is short. While some SCU patients achieve oral feeding ability by the time of hospital discharge or transfer to another hospital, others do not. In the acute phase of stroke, swallowing status must be confirmed early in order to enable optimum nutritional management. Therefore, this study investigated and clarified factors predicting oral intake ability/incapacity in stroke patients admitted to the SCU. Stroke patients were divided into 2 groups: those who were able to achieve nutrition by oral intake only and those who could not achieve oral intake. Information was obtained from electronic medical records, and several items and data from the initial blood test were compared, and significant differences were found. Of the 255 patients included in the study, 162 had achieved nutrition by oral intake. This study found 4 factors associated with achieving oral intake in SCU patients. It was suggested that if the age of onset of stroke is young, the nutritional status at the time of onset is good, the condition does not worsen during hospitalization, and rehabilitation for daily living can be started early, oral intake may be possible before hospital discharge.

Shoulder subluxation, a risk factor for hemiplegic shoulder pain, is an important target to treat during stroke rehabilitation. Calcific tendinitis is an idiopathic condition characterized by calcium deposition over fibrocartilaginous tenocyte metaplasia that inhibits the efficacy of occupational therapy for the treatment of stroke. To provide comprehensive occupational therapy, we provided repetitive facilitative exercise under continuous neuromuscular electrical stimulation and robot-assisted training, while controlling pain, for fourteen weeks in a case of convalescent post-stroke hemiplegia with rotator cuff calcific tendinopathy and shoulder subluxation. As a result, this comprehensive occupational therapy not only improved upper-extremity function and the ability to manipulate objects, but also reduced calcified deposits. Shoulder subluxation with calcifying tendinitis is rare. There is a possibility that calcified deposits below the acromion may push down the humeral head. Sufficient rest and non-steroidal anti-inflammatory drugs during the acute inflammatory stage may be helpful for the melting and resorption of calcified deposits. In addition, the appropriate and comprehensive occupational therapy may contribute to the effects of upper-extremity hemiplegia with calcific tendinitis and shoulder subluxation.

ABSTRACT Background Understanding the degree of motor paralysis in stroke patients is important for assessing the severity of functional impairment and predicting functional prognosis. Fugl-MeyerAssessment for the lower extremities (FMA-LE)is a commonly used measure with high reliability and validity, but there is no official translated Japanese version of FMA-LE. Objectives This study aimed to develop Japanese FMA-LE and verify its reliability and validity in patients with acute stroke. Methods The Japanese FMA-LE was developed following a standardized translation process. The reliability and validity were evaluated in 50 stroke patients at an acute care hospital. Validity was examined by determining the correlation between FMA-LEand Brunnstrom Recovery Stage (BRS), as well as Short Physical Performance Battery (SPPB). Intra-raterand inter-raterrelative reliabilities were evaluated by calculating intra-classcorrelation coefficients (ICCs). Absolute reliability was assessed by determining the standard error of the measurement and minimum detectible change (MDC). Systematic error was also assessed. Results FMA-LEtotal score was high correlated with BRS (ρ = 0.73,p < .01) and moderately correlated with SPPB (ρ = 0.69,p < .01). For intra-raterreliability, ICC was 0.98 (p < .01), only fixed systematic error was observed (p < .01), and MDC of the FMA-LEtotal score was 1.24. For inter-raterreliability, ICC was 0.98 (p < .01), no systematic error was observed, and MDC of the FMA-LEtotal score was 3.23. Conclusions The Japanese FMA-LE was reliable, valid, and useful for evaluating lower extremity function of acute stroke patients.

〔目的〕小学校高学年児童におけるmodified Star Excursion Balance Test（mSEBT）の信頼性を検討することを目的とした．〔対象と方法〕健常な小学校高学年児童9名にmSEBT を2回連続で実施し，その際の検者内信頼性およびBland-Altman分析（BAA），誤差範囲を算出した．〔結果〕3つの方向の級内相関係数（ICC）（1,1）は0.797–0.875であった．BAAの結果，前方リーチ，同側後方リーチに固定誤差が認められた．測定の誤差は最大で16 cmであった．〔結語〕小学校高学年児童においてmSEBTのICCは高値を示したが，測定の誤差は測定値から比較して許容できないほど高値となったため，小学校高学年児童に対するmSEBTは慎重に利用すべきである．

There are various types of elderly in the community, ranging from healthy to frail and those who need nursing care. We have conducted researches on “gait,” “foot,” and “the elderly” in the community from the viewpoint of medical engineering and medical information. I have found that foot care is important for the continuation of positive activities. We would like to utilize this research to improve the effectiveness of rehabilitation of paralyzed patients with sequelae of cerebrovascular diseases.

〔目的〕立位保持が困難な重症片麻痺者における立位保持時間を平行棒把持条件と垂直棒把持条件において比較した．〔対象と方法〕対象は，平行棒内立位保持が困難な脳卒中片麻痺患者9症例とした．平行棒片手把持での立位条件（条件A）と，垂直棒片手把持での立位条件（条件B）における立位保持時間を5日間にわたって計測し，比較した．〔結果〕5日間とも条件Aに比較して条件Bにおいて立位保持時間は有意に長かった（p＜0.05）．6例は，5日目の条件Bにおいて60秒の立位保持が可能となったが，条件Aでは不可能であった．〔結語〕平行棒での立位保持が困難な重症片麻痺者に対しては，垂直棒の利用を検討すべきである．

〔目的〕子どもの運動不足により，運動器疾患を罹患しやすい子どもが増加している．千葉県内スポーツフェアで現状を把握することを目的とした．〔対象と方法〕子ども336名に運動項目7項目の測定とアンケートを実施した．〔結果〕運動項目で不可の割合が多かったのは腹筋運動，からだ挙げ，四つ這いバランス，体前屈であった．運動習慣は69.6％が毎日～ほぼ毎日運動していた．現在または過去の運動器の疼痛は16.4％，37.2％，日常的によく転倒する子が26.1％であった．過去の運動器の疼痛はしゃがみ込み，腹筋運動，転倒との間に，転倒のしやすさはからだ挙げ，つま先立ち，片脚立ちの間に有意差があった．〔結語〕基本的な運動機能が低下している子どもが多く，その運動項目と運動器の疼痛や転倒のしやすさが関連していることが考えられる．