Posterior YAG capsulotomy choice of the applying pattern

Augmentative and alternative communication (AAC) devices are crucial for amyotrophic lateral sclerosis (ALS) patients because disease progression impairs verbal speech. Although the introduction of AAC devices must be appropriately timed, no guidelines currently exist. In this study, we examined the usefulness of the ALS functional rating scale-revised (ALSFRS-R) for predicting the timing of device introduction.
This study was a retrospective cross-sectional study with consecutive sampling of patients diagnosed with ALS who underwent rehabilitation at Kitasato University East Hospital between 2011 and 2018. Patients were introduced to AAC devices (writing, communication boards, switch control, and/or eye control) and underwent assessment at three timepoints the start of rehabilitation, as each communication device was introduced, and at the end of rehabilitation. ALSFRS-R multiple comparisons were analyzed using the Kruskal-Wallis test and, as a post-test, the Steel-Dwass test was used. click here Receiver operatingvide AAC for patients with ALS.
The aim of the study was to analyze the demographics of rehabilitation physicians and their retention trends, identify factors related to physician retention, and consider the policy implications.
The individual data from 1996 to 2016 from a national census survey administered every two years by the national government of Japan were analyzed. The physician retention trends were then evaluated. Finally, a multivariable logistic regression analysis was performed to identify the factors related to the retention of rehabilitation physicians.
The total numbers of rehabilitation physicians in 1996 and 2016 were 902 (0.4% of all physicians) and 2484 (0.8% of all physicians), respectively, an increase of 175%. It should be noted that between 1996 and 2016 the number of physicians aged ≤39 years decreased, whereas the number of physicians aged ≥40 years greatly increased to 2118, accounting for 85.3% of all rehabilitation physicians in 2016. The overall annual retention rate of full-time rehabilitation physicianf specialist rehabilitation physicians in Japan.
The aim of this study was to validate the usefulness of the measurement of lung insufflation capacity (LIC) using the LIC TRAINER (LT) in patients with amyotrophic lateral sclerosis (ALS).
This retrospective study was conducted in the rehabilitation departments of the Japanese National Center of Neurology and Psychiatry and involved 20 ALS patients who underwent respiratory therapy between April 1, 2014, and December 2017. The vital capacity (VC), maximum insufflation capacity (MIC), and LIC measurements at the start of respiratory therapy were extracted from the medical records, and patients were divided into three groups group A, VC could not be measured; group B, VC could be measured, but MIC was less than VC; and group C, MIC was larger than VC. LIC could be measured in all groups. In group C, paired
-tests were used to analyze whether there was a significant difference in the volumes measured using different methods.
LIC was 950, 1863±595, and 2980±1176 ml in groups A (n=1), B (n=10), and C (n=9), respectively. In groups A and B, LIC could be measured in all patients, even when VC or MIC could not be measured. In group C, the measured LIC value was significantly greater than MIC (p=0.003).
LIC could be successfully measured using the LT. By using the LT, it was feasible to conveniently perform LIC measurements, suggesting that it could be a useful device for performing respiratory therapy in ALS patients.
LIC could be successfully measured using the LT. By using the LT, it was feasible to conveniently perform LIC measurements, suggesting that it could be a useful device for performing respiratory therapy in ALS patients.
Medications with anticholinergic or sedative effects induce impaired cognitive and physical performances. The aim of this study was to evaluate the associations of anticholinergic and sedative drug burden with recovery of physical function and activities of daily living in patients admitted to a Japanese rehabilitation hospital after cerebrovascular accidents.
We retrospectively reviewed the medical records of patients aged 18 years or older who had undergone the inpatient rehabilitation program for cerebrovascular disease in Nerima Ken-ikukai Hospital. Patients who did not complete the rehabilitation program because of acute unexpected changes of physical or psychological condition or the need for surgical procedures were excluded. The primary outcome was recovery of activities of daily living as measured by the motor and cognitive subscores of the Functional Independence Measure. The secondary outcome was recovery of physical function as assessed by the 10-m walk test and the Berg balance scale. Multiplinergics and sedatives as an independent factor associated with the time to recovery of activities of daily living and postural balance.
This study aimed to characterize reaching movements of the paretic arm in different directions within the reachable workspace in post-stroke patients.
A total of 12 post-stroke patients participated in this study. Each held a ball with a tracking marker and performed back-and-forth reaching movements from near the middle of the body to one of two targets in front of them located on the ipsilateral and contralateral sides of the arm performing the movement. We recorded and analyzed the trajectories of the tracking marker. The stability of arm movements was evaluated using areas and minimum Feret diameters to assess the trajectories of both the paretic and non-paretic arms. The speed of the arm movement was also calculated.
For the paretic arm, contralateral movement was more impaired than ipsilateral movement, whereas for the non-paretic arm, no difference was observed between the directions. The maximum speed of the contralateral movement was significantly slower than that of the ipsilateral movement in both the paretic and non-paretic arms.
The paretic arm shows direction-specific instability in movement toward the contralateral side of the arm.
The paretic arm shows direction-specific instability in movement toward the contralateral side of the arm.
The aim of this study was to investigate the effect of repetitive peripheral magnetic stimulation (rPMS) on muscle atrophy prevention in the rectus femoris muscle (RF) of the paretic limb in acute stroke patients.
Twelve acute stroke patients with a National Institute of Health Stroke Scale score >5 and a motor score of the paretic lower limb >2 at admission were divided into an intervention group (rPMS mean age, 75±6.4 years) and a conventional care group (non-rPMS mean age, 62±11.8 years). Baseline measurements were performed within 4 days of stroke onset. In the rPMS group, treatment was applied to the paretic thigh only for 2 weeks, 5 days a week, in addition to conventional care. The cross-sectional area (CSA) of the RF was assessed in both limbs using ultrasound at baseline and 2 weeks later. Data on patient characteristics were collected from the clinical records to assess correlations with the CSA rate of change.
Patients in the rPMS group were significantly older. Although the CSA of the RF did not change significantly on either side in the rPMS group, there was a significant decrease in the CSA on the paretic side in the non-rPMS group. However, no significant difference was observed in the CSA rate of change in the rPMS and non-rPMS groups. The CSA rate of change on the paretic side correlated negatively with age in the rPMS group.
Our results suggest that rPMS prevents muscle atrophy more effectively in patients in their 60s than in patients more than 70 years old.
Our results suggest that rPMS prevents muscle atrophy more effectively in patients in their 60s than in patients more than 70 years old.
Increasing numbers of reports have described atypical femoral fracture (AFF) in patients being treated with oral bone resorption inhibitors, such as bisphosphonates. Most AFF patients undergo surgical treatment. However, there is little information about post-operative rehabilitation and patient activity levels after surgery for such fractures. Here we report the outcome of surgical treatment and postoperative rehabilitation for AFF at a single center in Japan.
We retrospectively reviewed 13 patients (14 AFFs) who underwent surgery at Nagano Matsushiro General Hospital between January 2013 and December 2016. The clinical backgrounds of the patients were evaluated.
The patients comprised 1 man (1 AFF) and 12 women (13 AFFs). The mean age at surgery was 77.7±7.1 years (mean±SD). Before AFF occurred, 12 of the 13 patients had used bisphosphonates for osteoporosis. An intramedullary nail was inserted in all patients. Partial weight bearing was started on average 2 weeks after surgery, and full weight-bearing gait was permitted on average 3 weeks after surgery. The average time to bone union was 9.9±6.1 months, ranging from 3 to 23 months. None of the patients required additional surgical procedures, including revision surgery for pseudoarthrosis (nonunion) or delayed union. Before AFF, 12 patients walked independently, and 1 patient walked with a single cane. At the final follow-up (mean duration 34.5±15.7 months), 8 patients could walk independently and 5 patients walked with a single cane.
We recognized that rigid fixation for AFF supported early weight-bearing gait after surgery.
We recognized that rigid fixation for AFF supported early weight-bearing gait after surgery.
Diffusion tensor fractional anisotropy (FA) in the corticospinal tracts has been used to assess the long-term outcome in stroke patients. Patient age and the type of stroke may also affect outcomes. In this study, we investigated the associations of age, type of stroke, and FA in the ipsilesional and contralesional cerebral peduncles with stroke outcomes.
This study involved 80 patients with stroke (40 hemorrhagic, 40 ischemic) that we had investigated previously. Diffusion tensor FA images were obtained between 14 and 21 days post-stroke. FA values in the ipsilesional and contralesional cerebral peduncles were extracted and their ratio (rFA) was calculated. Outcome was assessed using the Brunnstrom stage, the motor component of the Functional Independence Measure (FIM-motor) at discharge, and the length of stay until discharge from rehabilitation. Using forward stepwise multivariate regression, we assessed the associations of rFA, contralesional FA, age, and type of stroke with outcome measures.
rFA and contralesional FA were included in the final model for the Brunnstrom stage in the upper limbs. There was a strong association between hemorrhagic stroke and poorer lower extremity function. rFA, contralesional FA, and age were included in the final model for FIM-motor and length of stay. The effect of rFA on all outcome measures was stronger than that of contralesional FA. The effect of age on FIM-motor was as strong as that of rFA.
Neural damage in the corticospinal tracts (indicated by rFA) had the strongest effect on outcome measures, whereas the level of disability (measured by FIM-motor) was associated with a broader range of factors, including age.
Neural damage in the corticospinal tracts (indicated by rFA) had the strongest effect on outcome measures, whereas the level of disability (measured by FIM-motor) was associated with a broader range of factors, including age.