1
|
Hirano S, Saitoh E, Imoto D, Ii T, Tsunoda T, Otaka Y. Effects of robot-assisted gait training using the Welwalk on gait independence for individuals with hemiparetic stroke: an assessor-blinded, multicenter randomized controlled trial. J Neuroeng Rehabil 2024; 21:76. [PMID: 38745235 PMCID: PMC11092154 DOI: 10.1186/s12984-024-01370-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 05/02/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Gait disorder remains a major challenge for individuals with stroke, affecting their quality of life and increasing the risk of secondary complications. Robot-assisted gait training (RAGT) has emerged as a promising approach for improving gait independence in individuals with stroke. This study aimed to evaluate the effect of RAGT in individuals with subacute hemiparetic stroke using a one-leg assisted gait robot called Welwalk WW-1000. METHODS An assessor-blinded, multicenter randomized controlled trial was conducted in the convalescent rehabilitation wards of eight hospitals in Japan. Participants with first-ever hemiparetic stroke who could not walk at pre-intervention assessment were randomized to either the Welwalk group, which underwent RAGT with conventional physical therapy, or the control group, which underwent conventional physical therapy alone. Both groups received 80 min of physical therapy per day, 7 days per week, while the Welwalk group received 40 min of RAGT per day, 6 days per week, as part of their physical therapy. The primary outcome was gait independence, as assessed using the Functional Independence Measure Walk Score. RESULTS A total of 91 participants were enrolled, 85 of whom completed the intervention. As a result, 91 participants, as a full analysis set, and 85, as a per-protocol set, were analyzed. The primary outcome, the cumulative incidence of gait-independent events, was not significantly different between the groups. Subgroup analysis revealed that the interaction between the intervention group and stroke type did not yield significant differences in either the full analysis or per-protocol set. However, although not statistically significant, a discernible trend toward improvement with Welwalk was observed in cases of cerebral infarction for the full analysis and per-protocol sets (HR 4.167 [95%CI 0.914-18.995], p = 0.065, HR 4.443 [95%CI 0.973-20.279], p = 0.054, respectively). CONCLUSIONS The combination of RAGT using Welwalk and conventional physical therapy was not significantly more effective than conventional physical therapy alone in promoting gait independence in individuals with subacute hemiparetic stroke, although a trend toward earlier gait independence was observed in individuals with cerebral infarction. TRIAL REGISTRATION This study was registered with the Japan Registry of Clinical Trials ( https://jrct.niph.go.jp ; jRCT 042180078) on March 3, 2019.
Collapse
Affiliation(s)
- Satoshi Hirano
- Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Daisuke Imoto
- Department of Rehabilitation, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Takuma Ii
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Tetsuya Tsunoda
- Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| |
Collapse
|
2
|
Makiuchi T, Hioki T, Shimizu H, Hoshi K, Elyasi M, Yamamoto K, Yokoi N, Serga AA, Hillebrands B, Bauer GEW, Saitoh E. Persistent magnetic coherence in magnets. Nat Mater 2024; 23:627-632. [PMID: 38321239 DOI: 10.1038/s41563-024-01798-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 01/05/2024] [Indexed: 02/08/2024]
Abstract
When excited, the magnetization in a magnet precesses around the field in an anticlockwise manner on a timescale governed by viscous magnetization damping, after which any information carried by the initial actuation seems to be lost. This damping appears to be a fundamental bottleneck for the use of magnets in information processing. However, here we demonstrate the recall of the magnetization-precession phase after times that exceed the damping timescale by two orders of magnitude using dedicated two-colour microwave pump-probe experiments for a Y3Fe5O12 microstructured film. Time-resolved magnetization state tomography confirms the persistent magnetic coherence by revealing a double-exponential decay of magnetization correlation. We attribute persistent magnetic coherence to a feedback effect, that is, coherent coupling of the uniform precession with long-lived excitations at the minima of the spin-wave dispersion relation. Our finding liberates magnetic systems from the strong damping in nanostructures that has limited their use in coherent information storage and processing.
Collapse
Affiliation(s)
- T Makiuchi
- Department of Applied Physics, University of Tokyo, Tokyo, Japan
- Quantum-Phase Electronics Center, University of Tokyo, Tokyo, Japan
| | - T Hioki
- Department of Applied Physics, University of Tokyo, Tokyo, Japan
- WPI Advanced Institute for Materials Research, Tohoku University, Sendai, Japan
| | - H Shimizu
- Department of Applied Physics, University of Tokyo, Tokyo, Japan
| | - K Hoshi
- Department of Applied Physics, University of Tokyo, Tokyo, Japan
- Institute for AI and Beyond, University of Tokyo, Tokyo, Japan
| | - M Elyasi
- WPI Advanced Institute for Materials Research, Tohoku University, Sendai, Japan
| | - K Yamamoto
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai, Japan
| | - N Yokoi
- Department of Applied Physics, University of Tokyo, Tokyo, Japan
- Institute for AI and Beyond, University of Tokyo, Tokyo, Japan
| | - A A Serga
- Department of Physics and Research Center OPTIMAS, RPTU Kaiserslautern-Landau, Kaiserslautern, Germany
| | - B Hillebrands
- Department of Physics and Research Center OPTIMAS, RPTU Kaiserslautern-Landau, Kaiserslautern, Germany
| | - G E W Bauer
- WPI Advanced Institute for Materials Research, Tohoku University, Sendai, Japan
- Kavli Institute for Theoretical Sciences, University of the Chinese Academy of Sciences, Beijing, China
| | - E Saitoh
- Department of Applied Physics, University of Tokyo, Tokyo, Japan.
- Quantum-Phase Electronics Center, University of Tokyo, Tokyo, Japan.
- WPI Advanced Institute for Materials Research, Tohoku University, Sendai, Japan.
- Institute for AI and Beyond, University of Tokyo, Tokyo, Japan.
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai, Japan.
- RIKEN Center for Emergent Matter Science, Wako, Japan.
| |
Collapse
|
3
|
Gao M, Inamoto Y, Saitoh E, Aihara K, Shibata S, Gonzalez-Fernandez M, Otaka Y. Location of the upper oesophageal sphincter during swallowing: Analysis using swallowing CT. J Oral Rehabil 2024. [PMID: 38570928 DOI: 10.1111/joor.13686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 12/21/2023] [Accepted: 03/09/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Upper oesophageal sphincter (UES) serves as an important anatomical and functional landmark during swallowing. However, the precise UES location before and during swallowing has not been well established. OBJECTIVE This study aimed to determine upper oesophageal sphincter (UES) location and displacement during swallowing accounting for sex, age, and height in healthy adults using 320-row area detector computed tomography (320-ADCT). METHODS Ninety-four healthy adults (43 males; 22-90 years) underwent 320-ADCT scanning while swallowing one trial of 10 mL honey thick barium. UES location at bolus hold and at maximum displacement and vertical displacement during swallowing were identified using the coordinates and the section classification of vertebrae (VERT scale). The differences and correlations of UES location and distance in terms of sex, age, and height were analysed using Mann-Whitney U test and Spearman's correlation coefficient. RESULTS UES locations at bolus hold and at maximum displacement were significantly lower and UES vertical displacement was significantly larger in males than in females (p < .001). UES location at bolus hold became lower with increasing age (r = -.312, p = .002), but the negative correlation was low at maximum displacement (r = -.230, p = .026), resulting in larger vertical distance with ageing. UES locations showed high negative correlation at bolus hold with height (r = -.715, p < .001), and showed moderate negative correlation at maximum displacement with height (r = -.555, p < .001), although this effect was unclear when analysed by sex. CONCLUSION Males showed lower UES location and larger displacement than females. The impact of age was evident with lower location before swallowing and larger displacement during swallowing. Differences observed by sex were not completely explained by using the VERT scale to adjust for height.
Collapse
Affiliation(s)
- Minxing Gao
- Graduate School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yoko Inamoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Keiko Aihara
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Marlis Gonzalez-Fernandez
- Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| |
Collapse
|
4
|
Suzuki M, Wu YJ, Ota K, von Wild KRH, Naito M, Maeda A, Hirano A, Yamada M, Saitoh E, Kondo I, Zeldovich M, von Steinbüchel N. Quality of life after brain injury-overall scale, Japanese version: assessment of reliability and validity. Brain Inj 2024; 38:260-266. [PMID: 38297434 DOI: 10.1080/02699052.2024.2309652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 01/21/2024] [Indexed: 02/02/2024]
Abstract
This study analyzed the linguistic and psychometric validation of the Japanese version of the Quality of Life after Brain Injury-Overall Scale (QOLIBRI-OS) consisting of six items which cover several TBI-relevant domains. We hypothesized that the Japanese version has good reliability, convergent validity, and divergent validity, compared with its long version, the 37-item QOLIBRI. The QOLIBRI-OS Japanese version was forward and back-translated from the English version. In total, 129 individuals participated in this study after experiencing a traumatic brain injury and attending clinics, rehabilitation centers, and support centers in Japan. The structure of the QOLIBRI-OS was investigated by confirmatory factor analyses and compared with the QOLIBRI. Only one factor was extracted, and a model with one underlying factor had a good fit. The QOLIBRI-OS showed good-to-excellent internal consistency and test-retest reliability. The QOLIBRI-OS was positively correlated with the QOLIBRI, Short Form Health Survey-36 version 2, and Glasgow Outcome Scale Extended, and negatively correlated with the Hospital Anxiety and Depression Scale. The results suggest that the QOLIBRI-OS Japanese version is a reliable and valid tool for assessing disease-specific health-related QOL in individuals after traumatic brain injury in Japan.
Collapse
Affiliation(s)
- Megumi Suzuki
- Graduate School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Yi-Jhen Wu
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Georg-August-University, Göttingen, Germany
| | - Kikuo Ota
- School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | | | - Mariko Naito
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima-city, Hiroshima, Japan
| | - Akiko Maeda
- School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Asuka Hirano
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Masayuki Yamada
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima-city, Hiroshima, Japan
| | - Eiichi Saitoh
- School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Izumi Kondo
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Marina Zeldovich
- Institute for Psychology, University of Innsbruck, Wien, Austria
| | - Nicole von Steinbüchel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Georg-August-University, Göttingen, Germany
- Institute for Psychology, University of Innsbruck, Wien, Austria
| |
Collapse
|
5
|
Iizuka K, Kobae K, Yanagi K, Yamada Y, Deguchi K, Ushiroda C, Seino Y, Suzuki A, Saitoh E, Naruse H. Differing Effects of Body Size on Circulating Lipid Concentrations and Hemoglobin A1c Levels in Young and Middle-Aged Japanese Women. Healthcare (Basel) 2024; 12:465. [PMID: 38391840 PMCID: PMC10887960 DOI: 10.3390/healthcare12040465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/08/2024] [Accepted: 02/10/2024] [Indexed: 02/24/2024] Open
Abstract
The condition of being underweight is a social problem in Japan among women. However, there is a lack of evidence for dietary guidance for underweight women because there has been no comparison of lipids or HbA1c among underweight, normal weight, and overweight women in different age groups. We analyzed the effect of body size and age on the serum lipid and hemoglobin A1c levels in Japanese women in a cross-sectional study. A total of 26,118 women aged >20-65 years underwent physical examinations between 2012 and 2022. Seventeen percent of women aged >20-29 years were underweight, and 8% of those aged 50-65 years were underweight. Total cholesterol and non-HDL-C concentrations increased with age, but the difference between underweight and overweight individuals was lowest among women aged 50-65 years. On the other hand, the differences in HDL-C, TG, and HbA1c levels between underweight and overweight subjects were greatest in the 50-65 age group, but the differences between underweight and normal weight subjects were much smaller. Considering that, unlike HDL-C, TG, and HbA1c, TC and non-HDL-C increase to levels comparable to overweight levels in underweight women in aged 50-65 years, educating people about a diet that lowers non-HDL-C is necessary even in young underweight women.
Collapse
Affiliation(s)
- Katsumi Iizuka
- Department of Clinical Nutrition, Fujita Health University, Toyoake 470-1192, Japan
- Food and Nutrition Service Department, Fujita Health University Hospital, Toyoake 470-1192, Japan
| | - Kazuko Kobae
- Health Management Center, Fujita Health University, Toyoake 470-1192, Japan
| | - Kotone Yanagi
- Health Management Center, Fujita Health University, Toyoake 470-1192, Japan
| | - Yoshiko Yamada
- Health Management Center, Fujita Health University, Toyoake 470-1192, Japan
| | - Kanako Deguchi
- Department of Clinical Nutrition, Fujita Health University, Toyoake 470-1192, Japan
| | - Chihiro Ushiroda
- Department of Clinical Nutrition, Fujita Health University, Toyoake 470-1192, Japan
| | - Yusuke Seino
- Department of Endocrinology, Diabetes, Metabolism, Fujita Health University, Toyoake 470-1192, Japan
| | - Atsushi Suzuki
- Department of Endocrinology, Diabetes, Metabolism, Fujita Health University, Toyoake 470-1192, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake 470-1192, Japan
| | - Hiroyuki Naruse
- Health Management Center, Fujita Health University, Toyoake 470-1192, Japan
- Department of Medical Laboratory Science, Fujita Health University Graduate School of Health Sciences, Toyoake 470-1192, Japan
| |
Collapse
|
6
|
Ritsuno Y, Morita M, Mukaino M, Otsuka K, Kanaji A, Yamada J, Saitoh E, Matsumoto M, Nakamura M, Otaka Y, Fujita N. Determinants of Gait Parameters in Patients With Severe Hip Osteoarthritis. Arch Phys Med Rehabil 2024; 105:343-351. [PMID: 37683907 DOI: 10.1016/j.apmr.2023.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE To investigate the characteristics and symptoms of patients with hip osteoarthritis that are associated with spatiotemporal gait parameters, including their variability and asymmetry. DESIGN A retrospective, cross-sectional study. SETTING University hospital. PARTICIPANTS The study analyzed the gait analysis data of 155 patients (N=155) with hip osteoarthritis who were admitted to a university hospital for total hip replacement and were able to walk on a treadmill without a handrail. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The dependent variables were gait parameters during treadmill walking. These included gait speed, stride length, cadence, coefficient of variation of stride length and stride time, swing time symmetry index, and step symmetry index. Single and multiple regression analyses were conducted using independent variables of the characteristics and symptoms of the patients, including age, sex, height, pain, leg-length discrepancy, and muscle strength of the affected and normal sides measured with a hand-held dynamometer (iliopsoas, gluteus medius, and quadriceps). RESULTS In the analysis, gait speed and stride were the dependent variables, whereas age, height, and muscle strength on the affected side were the significant independent variables (P<.05). Additionally, pain demonstrated a marginal association with gait speed (P=.053). Only the leg-length discrepancy correlated with cadence. When the coefficient of variation of the stride length was the dependent variable, age and muscle strength on the affected side were significant. For the swing time symmetry index, only the muscle strength on the affected side was significant. Furthermore, the step symmetry index only correlated with leg-length discrepancy. The muscle strength on the affected side was the only significant independent variable for the coefficient of variation of the stride time. CONCLUSIONS The results revealed that each of the frequent clinical symptoms of hip osteoarthritis, such as pain, muscle weakness, and leg-length discrepancy, can explain different aspects of gait performance.
Collapse
Affiliation(s)
- Yoshihiro Ritsuno
- Department of Orthopaedic Surgery, Fujita Health University School of Medicine, Aichi, Japan; Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Mitsuhiro Morita
- Department of Orthopaedic Surgery, Fujita Health University School of Medicine, Aichi, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine, Fujita Health University School of Medicine, Aichi, Japan; Department of Rehabilitation Medicine, Hokkaido University Hospital, Hokkaido, Japan.
| | - Kei Otsuka
- Faculty of Rehabilitation, Fujita Health University School of Health Sciences, Aichi, Japan
| | - Arihiko Kanaji
- Department of Orthopedic Surgery, Restorative Medicine of Neuro-Musculoskeletal System, Fujita Health University Bantane Hospital, Aichi, Japan
| | - Junya Yamada
- Department of Rehabilitation, Fujita Health University Hospital, Aichi, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine, Fujita Health University School of Medicine, Aichi, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine, Fujita Health University School of Medicine, Aichi, Japan
| | - Nobuyuki Fujita
- Department of Orthopaedic Surgery, Fujita Health University School of Medicine, Aichi, Japan
| |
Collapse
|
7
|
Ogasawara T, Mukaino M, Matsunaga K, Wada Y, Suzuki T, Aoshima Y, Furuzawa S, Kono Y, Saitoh E, Yamaguchi M, Otaka Y, Tsukada S. Prediction of stroke patients' bedroom-stay duration: machine-learning approach using wearable sensor data. Front Bioeng Biotechnol 2024; 11:1285945. [PMID: 38234303 PMCID: PMC10791943 DOI: 10.3389/fbioe.2023.1285945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/11/2023] [Indexed: 01/19/2024] Open
Abstract
Background: The importance of being physically active and avoiding staying in bed has been recognized in stroke rehabilitation. However, studies have pointed out that stroke patients admitted to rehabilitation units often spend most of their day immobile and inactive, with limited opportunities for activity outside their bedrooms. To address this issue, it is necessary to record the duration of stroke patients staying in their bedrooms, but it is impractical for medical providers to do this manually during their daily work of providing care. Although an automated approach using wearable devices and access points is more practical, implementing these access points into medical facilities is costly. However, when combined with machine learning, predicting the duration of stroke patients staying in their bedrooms is possible with reduced cost. We assessed using machine learning to estimate bedroom-stay duration using activity data recorded with wearable devices. Method: We recruited 99 stroke hemiparesis inpatients and conducted 343 measurements. Data on electrocardiograms and chest acceleration were measured using a wearable device, and the location name of the access point that detected the signal of the device was recorded. We first investigated the correlation between bedroom-stay duration measured from the access point as the objective variable and activity data measured with a wearable device and demographic information as explanatory variables. To evaluate the duration predictability, we then compared machine-learning models commonly used in medical studies. Results: We conducted 228 measurements that surpassed a 90% data-acquisition rate using Bluetooth Low Energy. Among the explanatory variables, the period spent reclining and sitting/standing were correlated with bedroom-stay duration (Spearman's rank correlation coefficient (R) of 0.56 and -0.52, p < 0.001). Interestingly, the sum of the motor and cognitive categories of the functional independence measure, clinical indicators of the abilities of stroke patients, lacked correlation. The correlation between the actual bedroom-stay duration and predicted one using machine-learning models resulted in an R of 0.72 and p < 0.001, suggesting the possibility of predicting bedroom-stay duration from activity data and demographics. Conclusion: Wearable devices, coupled with machine learning, can predict the duration of patients staying in their bedrooms. Once trained, the machine-learning model can predict without continuously tracking the actual location, enabling more cost-effective and privacy-centric future measurements.
Collapse
Affiliation(s)
- Takayuki Ogasawara
- NTT Basic Research Laboratories and Bio-Medical Informatics Research Center, NTT Corporation, Atsugi, Japan
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
- Department of Rehabilitation Medicine, Hokkaido University Hospital, Sapporo, Japan
| | | | - Yoshitaka Wada
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Takuya Suzuki
- Department of Rehabilitation Medicine, Fujita Health University Hospital, Toyoake, Japan
| | - Yasushi Aoshima
- Department of Rehabilitation Medicine, Fujita Health University Hospital, Toyoake, Japan
| | - Shotaro Furuzawa
- Department of Rehabilitation Medicine, Fujita Health University Hospital, Toyoake, Japan
| | - Yuji Kono
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
- Department of Rehabilitation Medicine, Fujita Health University Hospital, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Masumi Yamaguchi
- NTT Basic Research Laboratories and Bio-Medical Informatics Research Center, NTT Corporation, Atsugi, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Shingo Tsukada
- NTT Basic Research Laboratories and Bio-Medical Informatics Research Center, NTT Corporation, Atsugi, Japan
| |
Collapse
|
8
|
Ota H, Mukaino M, Inoue Y, Matsuura S, Yagi S, Kanada Y, Saitoh E, Otaka Y. Movement Component Analysis of Reaching Strategies in Individuals With Stroke: Preliminary Study. JMIR Rehabil Assist Technol 2023; 10:e50571. [PMID: 38051570 PMCID: PMC10731574 DOI: 10.2196/50571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/29/2023] [Accepted: 09/21/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Upper limb motor paresis is a major symptom of stroke, which limits activities of daily living and compromises the quality of life. Kinematic analysis offers an in-depth and objective means to evaluate poststroke upper limb paresis, with anticipation for its effective application in clinical settings. OBJECTIVE This study aims to compare the movement strategies of patients with hemiparesis due to stroke and healthy individuals in forward reach and hand-to-mouth reach, using a simple methodology designed to quantify the contribution of various movement components to the reaching action. METHODS A 3D motion analysis was conducted, using a simplified marker set (placed at the mandible, the seventh cervical vertebra, acromion, lateral epicondyle of the humerus, metacarpophalangeal [MP] joint of the index finger, and greater trochanter of the femur). For the forward reach task, we measured the distance the index finger's MP joint traveled from its starting position to the forward target location on the anterior-posterior axis. For the hand-to-mouth reach task, the shortening of the vertical distance between the index finger MP joint and the position of the chin at the start of the measurement was measured. For both measurements, the contributions of relevant upper limb and trunk movements were calculated. RESULTS A total of 20 healthy individuals and 10 patients with stroke participated in this study. In the forward reach task, the contribution of shoulder or elbow flexion was significantly smaller in participants with stroke than in healthy participants (mean 52.5%, SD 24.5% vs mean 85.2%, SD 4.5%; P<.001), whereas the contribution of trunk flexion was significantly larger in stroke participants than in healthy participants (mean 34.0%, SD 28.5% vs mean 3.0%, SD 2.8%; P<.001). In the hand-to-mouth reach task, the contribution of shoulder or elbow flexion was significantly smaller in participants with stroke than in healthy participants (mean 71.8%, SD 23.7% vs mean 90.7%, SD 11.8%; P=.009), whereas shoulder girdle elevation and shoulder abduction were significantly larger in participants with stroke than in healthy participants (mean 10.5%, SD 5.7% vs mean 6.5%, SD 3.0%; P=.02 and mean 16.5%, SD 18.7% vs mean 3.0%, SD 10.4%; P=.02, respectively). CONCLUSIONS Compared with healthy participants, participants with stroke achieved a significantly greater distance via trunk flexion in the forward reach task and shoulder abduction and shoulder girdle elevation in the hand-to-mouth reach task, both of these differences are regarded as compensatory movements. Understanding the characteristics of individual motor strategies, such as dependence on compensatory movements, may contribute to tailored goal setting in stroke rehabilitation.
Collapse
Affiliation(s)
- Hirofumi Ota
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine, Hokkaido University Hospital, Sapporo, Japan
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yukari Inoue
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Shoh Matsuura
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Senju Yagi
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Yoshikiyo Kanada
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| |
Collapse
|
9
|
Ohtsuka K, Mukaino M, Yamada J, Fumihiro M, Tanikawa H, Tsuchiyama K, Teranishi T, Saitoh E, Otaka Y. Effects of ankle-foot orthosis on gait pattern and spatiotemporal indices during treadmill walking in hemiparetic stroke. Int J Rehabil Res 2023; 46:316-324. [PMID: 37755385 PMCID: PMC10619636 DOI: 10.1097/mrr.0000000000000602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/26/2023] [Indexed: 09/28/2023]
Abstract
Ankle-foot orthosis (AFO) is known to correct abnormal gait patterns and improve walking stability and speed in patients with hemiparesis. To quantify these benefits in post-stroke gait, a three-dimensional motion analysis of gait pattern was conducted. Forty patients with hemiparesis were enrolled. A three-dimensional motion analysis system was used to analyze patients' treadmill walking with/without an AFO. Outcome measures were 12 abnormal gait indices (forefoot contact, knee extensor thrust, retropulsion of the hip, flexed-knee gait, medial whip in the stance phase, circumduction gait, hip hiking, insufficient knee flexion during the swing phase, excessive lateral shifting of the trunk, contralateral vaulting, excessive hip external rotation, and posterior pelvic tilt), calculated using kinematic data and spatiotemporal indices, and the symmetry index of double-stance and single-stance time and step length. Forefoot contact (without AFO vs. with AFO: 71.0 vs. 65.8, P < 0.001), circumduction gait (65.0 vs. 57.9, P < 0.001), and contralateral vaulting (78.2 vs. 72.2, P = 0.003) were significantly reduced, whereas excessive hip external rotation (53.7 vs. 62.8, P = 0.003) significantly increased during walking with an AFO. Hip hiking (77.1 vs. 71.7) showed marginal reduction with the use of AFO ( P = 0.096). The absolute symmetry index of double-stance time (21.9 vs. 16.1, P = 0.014) significantly decreased during walking with an AFO. AFO effectively mitigates abnormal gait patterns typical of hemiparetic gait. A 3D motion analysis system with clinically oriented indices can help assess intervention efficacy for gait abnormalities.
Collapse
Affiliation(s)
- Kei Ohtsuka
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine, Hokkaido University Hospital, Sapporo, Hokkaido
| | - Junya Yamada
- Department of Rehabilitation, Fujita Health University Hospital
| | - Matsuda Fumihiro
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi
| | - Hiroki Tanikawa
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi
| | - Kazuhiro Tsuchiyama
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi
| | - Toshio Teranishi
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi
| | | | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| |
Collapse
|
10
|
Aihara K, Inamoto Y, Saitoh E, Shibata S, Sato Y, Harada M, Otaka Y. Development and validation of a device for monitoring laryngeal motion during swallowing. Front Robot AI 2023; 10:1259257. [PMID: 38023590 PMCID: PMC10652282 DOI: 10.3389/frobt.2023.1259257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives: Hyolaryngeal movement during swallowing is essential to airway protection and bolus clearance. Although palpation is widely used to evaluate hyolaryngeal motion, insufficient accuracy has been reported. The Bando Stretchable Strain Sensor for Swallowing (B4S™) was developed to capture hyolaryngeal elevation and display it as waveforms. This study compared laryngeal movement time detected by the B4S™ with laryngeal movement time measured by videofluoroscopy (VF). Methods: Participants were 20 patients without swallowing difficulty (10 men, 10 women; age 30.6 ± 7.1 years). The B4S™ was attached to the anterior neck and two saliva swallows were measured on VF images to determine the relative and absolute reliability of laryngeal elevation time measured on VF and that measured by the B4S™. Results: The intra-class correlation coefficient of the VF and B4S™ times was very high [ICC (1.1) = 0.980]. A Bland-Altman plot showed a strong positive correlation with a 95% confidence interval of 0.00-3.01 for the mean VF time and mean B4S™ time, with a fixed error detected in the positive direction but with no proportional error detected. Thus, the VF and B4S™ time measurements showed high consistency. Conclusion: The strong relative and absolute reliability suggest that the B4S™ can accurately detect the duration of superior-inferior laryngeal motion during swallowing. Further study is needed to develop a method for measuring the distance of laryngeal elevation. It is also necessary to investigate the usefulness of this device for evaluation and treatment in clinical settings.
Collapse
Affiliation(s)
- Keiko Aihara
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Yoko Inamoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yuriko Sato
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Maki Harada
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| |
Collapse
|
11
|
Inamoto Y, González-Fernández M, Saitoh E. Timing of True Vocal Cords Closure for Safe Swallowing: A Review of 5 Studies Using 3D Analysis Using Computerized Tomography (CT). Dysphagia 2023:10.1007/s00455-023-10620-y. [PMID: 37804445 DOI: 10.1007/s00455-023-10620-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/28/2023] [Indexed: 10/09/2023]
Abstract
Timely and complete laryngeal closure is critical for a successful swallow. Researchers have studied laryngeal closure, including true vocal cords (TVC) closure, closure of the arytenoids to the epiglottis base (laryngeal vestibule closure), and epiglottic inversion, but the most commonly available imaging tools have limitations that do not allow the study of these components individually. Swallowing computerized tomography (CT) has enabled three-dimensional dynamic visualization and quantitative evaluation of swallowing events providing a unique view of swallowing-related structures and their motion. Using CT, TVC closure can be visualized and evaluated on any plane or cross-section without being obscured by of laryngeal vestibule closure or epiglottis inversion. The current review summarizes the results of five papers evaluating the effects of bolus consistency and volume, posture, and age on TVC closure. The combined results of these studies suggest that TVC closure is responsive to oral sensory input based on bolus consistency and size and can be modulated in response to conditions perceived to increase the risk of airway invasion. These results are meaningful for dysphagia rehabilitation as it suggests that interventions to improve TVC closure are likely to enhance airway protection.
Collapse
Affiliation(s)
- Yoko Inamoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan.
| | - Marlís González-Fernández
- Department of Physical Medicine and Rehabilitation and Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| |
Collapse
|
12
|
Iizuka K, Sato H, Kobae K, Yanagi K, Yamada Y, Ushiroda C, Hirano K, Ichimaru S, Seino Y, Ito A, Suzuki A, Saitoh E, Naruse H. Young Japanese Underweight Women with "Cinderella Weight" Are Prone to Malnutrition, including Vitamin Deficiencies. Nutrients 2023; 15:2216. [PMID: 37409654 DOI: 10.3390/nu15092216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 04/25/2023] [Accepted: 05/05/2023] [Indexed: 07/07/2023] Open
Abstract
Undernutrition among young women at "Cinderella weight" is socially important in Japan. To determine the nutritional status of Cinderella-weight women, we conducted an exploratory cross-sectional study on the health examination results of employees aged 20 to 39 (n = 1457 and 643 for women and men, respectively). The percentage of underweight women was found to be much higher than that of men (16.8% vs. 4.5%, respectively). In underweight women (n = 245), handgrip strength (22.82 ± 5.55 vs. 25.73 ± 5.81 kg, p < 0.001), cholesterol level (177.8 ± 25.2 vs. 194.7 ± 31.2 mg/dL, p < 0.05), and lymphocyte count (1883 ± 503 vs. 2148 ± 765/μL, p < 0.001) were significantly lower than in overweight women (n = 116). Then, the BMI < 17.5 group (n = 44) was referred to the outpatient nutrition evaluation clinic. Lower prealbumin, cholesterol, and lymphocyte levels were also observed in 34%, 59%, and 32% of the patients, respectively. Regarding dietary characteristics, 32% of the underweight women in this study skipped breakfast, and 50% had low dietary diversity scores. Lower total energy intake, carbohydrate and fiber intake, and Ca and Fe intake were also observed in 90% of the patients. Deficiencies in vitamin B1, B12, D, and folate were diagnosed in 4.6%, 25%, 14%, and 98% of the patients, respectively. Thus, young underweight women may be prone to malnutrition.
Collapse
Affiliation(s)
- Katsumi Iizuka
- Department of Clinical Nutrition, Fujita Health University, Toyoake 470-1192, Japan
- Food and Nutrition Service Department, Fujita Health University Hospital, Toyoake 470-1192, Japan
| | - Hiroko Sato
- Health Management Center, Fujita Health University, Toyoake 470-1192, Japan
| | - Kazuko Kobae
- Health Management Center, Fujita Health University, Toyoake 470-1192, Japan
| | - Kotone Yanagi
- Health Management Center, Fujita Health University, Toyoake 470-1192, Japan
| | - Yoshiko Yamada
- Health Management Center, Fujita Health University, Toyoake 470-1192, Japan
| | - Chihiro Ushiroda
- Department of Clinical Nutrition, Fujita Health University, Toyoake 470-1192, Japan
| | - Konomi Hirano
- Food and Nutrition Service Department, Fujita Health University Hospital, Toyoake 470-1192, Japan
| | - Satomi Ichimaru
- Food and Nutrition Service Department, Fujita Health University Hospital, Toyoake 470-1192, Japan
| | - Yusuke Seino
- Department of Endocrinology, Diabetes, Metabolism, Fujita Health University, Toyoake 470-1192, Japan
| | - Akemi Ito
- Food and Nutrition Service Department, Fujita Health University Hospital, Toyoake 470-1192, Japan
| | - Atsushi Suzuki
- Department of Endocrinology, Diabetes, Metabolism, Fujita Health University, Toyoake 470-1192, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake 470-1192, Japan
| | - Hiroyuki Naruse
- Health Management Center, Fujita Health University, Toyoake 470-1192, Japan
- Department of Medical Laboratory Science, Fujita Health University Graduate School of Health Sciences, Toyoake 470-1192, Aichi, Japan
| |
Collapse
|
13
|
Rongione E, Gueckstock O, Mattern M, Gomonay O, Meer H, Schmitt C, Ramos R, Kikkawa T, Mičica M, Saitoh E, Sinova J, Jaffrès H, Mangeney J, Goennenwein STB, Geprägs S, Kampfrath T, Kläui M, Bargheer M, Seifert TS, Dhillon S, Lebrun R. Emission of coherent THz magnons in an antiferromagnetic insulator triggered by ultrafast spin-phonon interactions. Nat Commun 2023; 14:1818. [PMID: 37002246 PMCID: PMC10066367 DOI: 10.1038/s41467-023-37509-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 03/20/2023] [Indexed: 04/03/2023] Open
Abstract
Antiferromagnetic materials have been proposed as new types of narrowband THz spintronic devices owing to their ultrafast spin dynamics. Manipulating coherently their spin dynamics, however, remains a key challenge that is envisioned to be accomplished by spin-orbit torques or direct optical excitations. Here, we demonstrate the combined generation of broadband THz (incoherent) magnons and narrowband (coherent) magnons at 1 THz in low damping thin films of NiO/Pt. We evidence, experimentally and through modeling, two excitation processes of spin dynamics in NiO: an off-resonant instantaneous optical spin torque in (111) oriented films and a strain-wave-induced THz torque induced by ultrafast Pt excitation in (001) oriented films. Both phenomena lead to the emission of a THz signal through the inverse spin Hall effect in the adjacent heavy metal layer. We unravel the characteristic timescales of the two excitation processes found to be < 50 fs and > 300 fs, respectively, and thus open new routes towards the development of fast opto-spintronic devices based on antiferromagnetic materials.
Collapse
Affiliation(s)
- E Rongione
- Unité Mixte de Physique, CNRS, Thales, Université Paris-Saclay, F-91767, Palaiseau, France
- Laboratoire de Physique de l'Ecole Normale Supérieure, ENS, Université PSL, CNRS, Sorbonne Université, Université Paris Cité, F-75005, Paris, France
| | - O Gueckstock
- Institute of Physics, Freie Universität Berlin, D-14195, Berlin, Germany
| | - M Mattern
- Institut für Physik und Astronomie, Universität Potsdam, D-14476, Potsdam, Germany
| | - O Gomonay
- Institute of Physics, Johannes Gutenberg-University Mainz, D-55099, Mainz, Germany
| | - H Meer
- Institute of Physics, Johannes Gutenberg-University Mainz, D-55099, Mainz, Germany
| | - C Schmitt
- Institute of Physics, Johannes Gutenberg-University Mainz, D-55099, Mainz, Germany
| | - R Ramos
- WPI-Advanced Institute for Materials Research, Tohoku University, Sendai, J-980-8577, Japan
- Centro Singular de Investigación en Química Bilóxica e Materiais Moleculares (CIQUS), Departamento de Química-Física, Universidade de Santiago de Compostela, Santiago de Compostela, 15782, Spain
| | - T Kikkawa
- Department of Applied Physics, The University of Tokyo, Tokyo, J-113-8656, Japan
| | - M Mičica
- Laboratoire de Physique de l'Ecole Normale Supérieure, ENS, Université PSL, CNRS, Sorbonne Université, Université Paris Cité, F-75005, Paris, France
| | - E Saitoh
- WPI-Advanced Institute for Materials Research, Tohoku University, Sendai, J-980-8577, Japan
- Department of Applied Physics, The University of Tokyo, Tokyo, J-113-8656, Japan
- Institute for AI and Beyond, The University of Tokyo, Tokyo, J-113-8656, Japan
| | - J Sinova
- Institute of Physics, Johannes Gutenberg-University Mainz, D-55099, Mainz, Germany
| | - H Jaffrès
- Unité Mixte de Physique, CNRS, Thales, Université Paris-Saclay, F-91767, Palaiseau, France
| | - J Mangeney
- Laboratoire de Physique de l'Ecole Normale Supérieure, ENS, Université PSL, CNRS, Sorbonne Université, Université Paris Cité, F-75005, Paris, France
| | - S T B Goennenwein
- Department of Physics, University of Konstanz, D-78457, Konstanz, Germany
| | - S Geprägs
- Walther-Meißner-Institut, Bayerische Akademie der Wissenschaften, D-85748, Garching, Germany
| | - T Kampfrath
- Institute of Physics, Freie Universität Berlin, D-14195, Berlin, Germany
| | - M Kläui
- Institute of Physics, Johannes Gutenberg-University Mainz, D-55099, Mainz, Germany
- Graduate School of Excellence Materials Science in Mainz (MAINZ), Staudingerweg 9, D-55128, Mainz, Germany
- Center for Quantum Spintronics, Department of Physics, Norwegian University of Science and Technology, N-7034, Trondheim, Norway
| | - M Bargheer
- Institut für Physik und Astronomie, Universität Potsdam, D-14476, Potsdam, Germany
- Helmholtz-Zentrum Berlin für Materialien und Energie, Wilhelm-Conrad-Röntgen Campus, BESSY II, Albert-Einstein-Strasse 15, D-12489, Berlin, Germany
| | - T S Seifert
- Institute of Physics, Freie Universität Berlin, D-14195, Berlin, Germany.
| | - S Dhillon
- Laboratoire de Physique de l'Ecole Normale Supérieure, ENS, Université PSL, CNRS, Sorbonne Université, Université Paris Cité, F-75005, Paris, France
| | - R Lebrun
- Unité Mixte de Physique, CNRS, Thales, Université Paris-Saclay, F-91767, Palaiseau, France.
| |
Collapse
|
14
|
Inamoto Y, Saitoh E, Aihara K, Ito Y, Kagaya H, Shibata S, Mukaino M, Kobayashi M, Gonzalez MF. Correction to: Effect of the Effortful Swallow on Pharyngeal Cavity Volume: Kinematic Analysis in Three Dimensions Using 320‑Row Area Detector Computed Tomography. Dysphagia 2023:10.1007/s00455-023-10563-4. [PMID: 36780032 DOI: 10.1007/s00455-023-10563-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- Yoko Inamoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan. .,Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan. .,Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA.
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Keiko Aihara
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Yuriko Ito
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Masanao Kobayashi
- Faculty of Radiological Technologies, School of Heath Sciences, Fujita Health University, Toyoake, Japan
| | - Marlis F Gonzalez
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
15
|
Mavragani A, Mukaino M, Imaeda S, Sawada M, Satoji K, Nagai A, Hirano S, Okazaki H, Saitoh E, Sonoda S, Otaka Y. A Tablet-Based Aphasia Assessment System "STELA": Feasibility and Validation Study. JMIR Form Res 2023; 7:e42219. [PMID: 36753308 PMCID: PMC9947769 DOI: 10.2196/42219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 01/01/2023] [Accepted: 01/03/2023] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND There is an extensive library of language tests, each with excellent psychometric properties; however, many of the tests available take considerable administration time, possibly bearing psychological strain on patients. The Short and Tailored Evaluation of Language Ability (STELA) is a simplified, tablet-based language ability assessment system developed to address this issue, with a reduced number of items and automated testing process. OBJECTIVE The aim of this paper is to assess the administration time, internal consistency, and validity of the STELA. METHODS The STELA consists of a tablet app, a microphone, and an input keypad for clinician's use. The system is designed to assess language ability with 52 questions grouped into 2 comprehension modalities (auditory comprehension and reading comprehension) and 3 expression modalities (naming and sentence formation, repetition, and reading aloud). Performance in each modality was scored as the correct answer rate (0-100), and overall performance expressed as the sum of modality scores (out of 500 points). RESULTS The time taken to complete the STELA was significantly less than the time for the WAB (mean 16.2, SD 9.4 vs mean 149.3, SD 64.1 minutes; P<.001). The STELA's total score was strongly correlated with the WAB Aphasia Quotient (r=0.93, P<.001), supporting the former's concurrent validity concerning the WAB, which is a gold-standard aphasia assessment. Strong correlations were also observed at the subscale level; STELA auditory comprehension versus WAB auditory comprehension (r=0.75, P<.001), STELA repetition versus WAB repetition (r=0.96, P<.001), STELA naming and sentence formation versus WAB naming and word finding (r=0.81, P<.001), and the sum of STELA reading comprehension or reading aloud versus WAB reading (r=0.82, P<.001). Cronbach α obtained for each modality was .862 for auditory comprehension, .872 for reading comprehension, .902 for naming and sentence formation, .787 for repetition, and .892 for reading aloud. Global Cronbach α was .961. The average of the values of item-total correlation to each subscale was 0.61 (SD 0.17). CONCLUSIONS Our study confirmed significant time reduction in the assessment of language ability and provided evidence for good internal consistency and validity of the STELA tablet-based aphasia assessment system.
Collapse
Affiliation(s)
| | - Masahiko Mukaino
- Deparment of Rehabilitation Medicine, Hokkaido University Hospital, Sapporo, Japan.,Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Sayuri Imaeda
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Manami Sawada
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Kumi Satoji
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Ayako Nagai
- Department of Rehabilitation, Fujita Health University Nanakuri Memorial Hospital, Tsu, Japan
| | - Satoshi Hirano
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Hideto Okazaki
- Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Shigeru Sonoda
- Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| |
Collapse
|
16
|
Ogasawara T, Mukaino M, Matsuura H, Aoshima Y, Suzuki T, Togo H, Nakashima H, Saitoh E, Yamaguchi M, Otaka Y, Tsukada S. Ensemble averaging for categorical variables: Validation study of imputing lost data in 24-h recorded postures of inpatients. Front Physiol 2023; 14:1094946. [PMID: 36776969 PMCID: PMC9910696 DOI: 10.3389/fphys.2023.1094946] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/06/2023] [Indexed: 01/27/2023] Open
Abstract
Acceleration sensors are widely used in consumer wearable devices and smartphones. Postures estimated from recorded accelerations are commonly used as features indicating the activities of patients in medical studies. However, recording for over 24 h is more likely to result in data losses than recording for a few hours, especially when consumer-grade wearable devices are used. Here, to impute postures over a period of 24 h, we propose an imputation method that uses ensemble averaging. This method outputs a time series of postures over 24 h with less lost data by calculating the ratios of postures taken at the same time of day during several measurement-session days. Whereas conventional imputation methods are based on approaches with groups of subjects having multiple variables, the proposed method imputes the lost data variables individually and does not require other variables except posture. We validated the method on 306 measurement data from 99 stroke inpatients in a hospital rehabilitation ward. First, to classify postures from acceleration data measured by a wearable sensor placed on the patient's trunk, we preliminary estimated possible thresholds for classifying postures as 'reclining' and 'sitting or standing' by investigating the valleys in the histogram of occurrences of trunk angles during a long-term recording. Next, the imputations of the proposed method were validated. The proposed method significantly reduced the missing data rate from 5.76% to 0.21%, outperforming a conventional method.
Collapse
Affiliation(s)
- Takayuki Ogasawara
- NTT Basic Research Laboratories and Bio-Medical Informatics Research Center, NTT Corporation, Atsugi, Japan,*Correspondence: Takayuki Ogasawara,
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan,Department of Rehabilitation Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Hirotaka Matsuura
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yasushi Aoshima
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Takuya Suzuki
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Hiroyoshi Togo
- NTT Device Innovation Center, NTT Corporation, Atsugi, Japan
| | - Hiroshi Nakashima
- NTT Basic Research Laboratories and Bio-Medical Informatics Research Center, NTT Corporation, Atsugi, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Masumi Yamaguchi
- NTT Basic Research Laboratories and Bio-Medical Informatics Research Center, NTT Corporation, Atsugi, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Shingo Tsukada
- NTT Basic Research Laboratories and Bio-Medical Informatics Research Center, NTT Corporation, Atsugi, Japan
| |
Collapse
|
17
|
Inamoto Y, Saitoh E, Aihara K, Ito Y, Kagaya H, Shibata S, Mukaino M, Kobayashi M, Gonzalez MF. Effect of the Effortful Swallow on Pharyngeal Cavity Volume: Kinematic Analysis in Three Dimensions Using 320-Row Area Detector Computed Tomography. Dysphagia 2023:10.1007/s00455-022-10539-w. [PMID: 36609563 DOI: 10.1007/s00455-022-10539-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 10/27/2022] [Indexed: 01/09/2023]
Abstract
This study evaluated the effects of the effortful swallow (ES) on pharyngeal cavity volume using three-dimensional kinematic analyses. Nine healthy volunteers (30.7 ± 7.8 years old) underwent a CT scan while swallowing 10 ml of honey thick liquid using no maneuvers (control) and during an ES. Upper and lower volumes (bordered by valleculae) of the pharyngeal air column and the bolus were measured at every frame and were compared between ES and control swallows. Duration of pharyngeal obliteration and the timing of swallowing events were also measured. Maximum volume and volume at the onset of hyoid anterosuperior movement using ES were significantly smaller than those in control swallows (p = 0.012, p = 0.015) in the upper pharynx but not significantly different in lower pharynx. Minimum pharyngeal volume was sustained for a longer time when ES was used compared to control swallows in both upper and lower pharynx (upper p = 0.016, lower p = 0.027). Onset of velopharyngeal closure was earlier when comparing ES and control swallows (p = 0.04). Termination of all events was significantly delayed when the ES was used (p < 0.05). Changes in the upper pharyngeal volume and in the onset of velopharyngeal closure suggest earlier pharyngeal constriction when using the ES. Longer pharyngeal obliteration and prolonged termination of velopharyngeal closure and epiglottis inversion suggest the prolonged pharyngeal constriction during the ES. These findings suggest the ES can be useful for improving the efficiency of swallowing.
Collapse
Affiliation(s)
- Yoko Inamoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan. .,Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan. .,Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA.
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Keiko Aihara
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Yuriko Ito
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Masanao Kobayashi
- Faculty of Radiological Technologies, School of Heath Sciences, Fujita Health University, Toyoake, Japan
| | - Marlis F Gonzalez
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
18
|
Mizutani K, Otaka Y, Kato M, Hayakawa M, Ozeki M, Maeda H, Hirano S, Mukaino M, Shibata S, Kagaya H, Sakurai H, Saitoh E. Functional outcomes in acute care settings vary by disease categories but show a consistent pattern of disability. Ann Phys Rehabil Med 2022; 66:101648. [PMID: 35219896 DOI: 10.1016/j.rehab.2022.101648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 12/03/2022]
Affiliation(s)
- Koji Mizutani
- Department of Rehabilitation, Fujita Health University Hospital, Aichi, Japan; Graduate School of Health Sciences, Fujita Health University, Aichi, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan.
| | - Masaki Kato
- Department of Rehabilitation, Fujita Health University Hospital, Aichi, Japan
| | - Miwako Hayakawa
- Department of Rehabilitation, Fujita Health University Hospital, Aichi, Japan
| | - Megumi Ozeki
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan
| | - Hirofumi Maeda
- Department of Rehabilitation Medicine I, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Satoshi Hirano
- Department of Rehabilitation Medicine I, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation Medicine I, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Hiroaki Sakurai
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| |
Collapse
|
19
|
Imoto D, Hirano S, Mukaino M, Saitoh E, Otaka Y. A novel gait analysis system for detecting abnormal hemiparetic gait patterns during robot-assisted gait training: A criterion validity study among healthy adults. Front Neurorobot 2022; 16:1047376. [PMID: 36531918 PMCID: PMC9751383 DOI: 10.3389/fnbot.2022.1047376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 11/10/2022] [Indexed: 07/30/2023] Open
Abstract
INTRODUCTION Robot-assisted gait training has been reported to improve gait in individuals with hemiparetic stroke. Ideally, the gait training program should be customized based on individuals' gait characteristics and longitudinal changes. However, a gait robot that uses gait characteristics to provide individually tailored gait training has not been proposed. The new gait training robot, "Welwalk WW-2000," permits modification of various parameters, such as time and load of mechanical assistance for a patient's paralyzed leg. The robot is equipped with sensors and a markerless motion capture system to detect abnormal hemiparetic gait patterns during robot-assisted gait training. Thus, it can provide individually tailored gait training. This study aimed to investigate the criterion validity of the gait analysis system in the Welwalk WW-2000 in healthy adults. MATERIALS AND METHODS Twelve healthy participants simulated nine abnormal gait patterns that were often manifested in individuals with hemiparetic stroke while wearing the robot. Each participant was instructed to perform a total of 36 gait trials, with four levels of severity for each abnormal gait pattern. Fifteen strides for each gait trial were recorded using the markerless motion capture system in the Welwalk WW-2000 and a marker-based three-dimensional (3D) motion analysis system. The abnormal gait pattern index was then calculated for each stride from both systems. The correlation of the index values between the two methods was evaluated using Spearman's rank correlation coefficients for each gait pattern in each participant. RESULTS Using the participants' index values for each abnormal gait pattern obtained using the two motion analysis methods, the median Spearman's rank correlation coefficients ranged from 0.68 to 0.93, which corresponded to moderate to very high correlation. CONCLUSION The gait analysis system in the Welwalk WW-2000 for real-time detection of abnormal gait patterns during robot-assisted gait training was suggested to be a valid method for assessing gait characteristics in individuals with hemiparetic stroke. CLINICAL TRIAL REGISTRATION [https://jrct.niph.go.jp], identifier [jRCT 042190109].
Collapse
Affiliation(s)
- Daisuke Imoto
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Satoshi Hirano
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| |
Collapse
|
20
|
Pongpipatpaiboon K, Inamoto Y, Aihara K, Kagaya H, Shibata S, Mukaino M, Saitoh E, Gonzalez-Fernandez M. Thin Liquid Bolus Volume Alters Pharyngeal Swallowing: Kinematic Analysis Using 3D Dynamic CT. Dysphagia 2022; 37:1423-1430. [PMID: 34981256 DOI: 10.1007/s00455-021-10397-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 12/06/2021] [Indexed: 12/16/2022]
Abstract
The previous studies reported that different volumes of thick liquid had an impact on spatiotemporal characteristics and pharyngeal response of swallowing. However, the bolus flow and swallowing motion pattern were different between thick and thin liquids. The effects of thin bolus volume on pharyngeal swallowing, especially true vocal cord (TVC) closure is still unclear. This study assessed the temporal characteristics when swallowing different volumes of thin liquid to determine the mechanical adaptation using 320-row area detector computed tomography (320-ADCT) and investigated a change of swallowing physiology including laryngeal closure, particularly TVC closure. Fourteen healthy women (28-45 years) underwent 320-ADCT while swallowing of 3, 10, and 20 ml of thin liquid barium in 45° semi-reclining position. Kinematic analysis was performed for each swallow including temporal characteristic, structural movements while swallowing, and maximal cross-sectional area of the upper esophageal sphincter (UES) opening. Bolus head reached to pharynx and esophagus earlier in larger volume significantly, indicating faster bolus transport as volume increased. There were significant effects on swallowing mechanism revealing earlier TVC closure and UES opening with increasing volume. Maximum cross-sectional area of the UES opening was increased to accommodate a larger bolus. Differences in mechanical adaptation through bolus transit and motion of swallowing structures were detected across increasing volumes. These volume-dependent adaptations potentially reduce the risk of aspiration. Understanding the swallowing physiological changes as volume increased is helpful for diagnosis and treatment of dysphagia patients as well as outcomes of swallowing rehabilitation in clinical practice.
Collapse
Affiliation(s)
- Kannit Pongpipatpaiboon
- Department of Rehabilitation Medicine, Samitivej Srinakarin Hospital, Bangkok, Thailand.,Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Yoko Inamoto
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan. .,Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan.
| | - Keiko Aihara
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.,Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | | |
Collapse
|
21
|
Kumazawa N, Koyama S, Mukaino M, Tsuchiyama K, Tatemoto T, Tanikawa H, Ohtsuka K, Katoh M, Otaka Y, Saitoh E, Tanabe S. Development and preliminary evaluation of a tele-rehabilitation exercise system using computer-generated animation. Fujita Med J 2022; 8:114-120. [PMID: 36415828 PMCID: PMC9673083 DOI: 10.20407/fmj.2021-020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/08/2021] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To evaluate the safety and acceptability of a newly developed tele-rehabilitation exercise system using computer-generated animation. METHODS The participants comprised a convenience sample of 38 diverse individuals in Experiment 1 (15 healthy young people, 16 healthy older people, 5 patients with stroke, and 2 patients with respiratory disease) and 18 healthy older individuals in Experiment 2. Experiment 1 assessed safety in terms of cardiopulmonary vascular aspects and risk of fall, and Experiment 2 assessed treatment acceptability via a subjective evaluation. All participants completed the same exercise program. The safety assessment was conducted using heart rate (HR) and saturation of percutaneous oxygen (SpO2), measured before and after exercise. In addition, the occurrence of falls was assessed. For the acceptability assessment, the participants answered five questions (three-point Likert scale) after the exercise program. RESULTS The safety assessment indicated that HR and SpO2 changed from 70.5±10.2 beats per minute and 97.8±1.3% before exercise to 87.6±13.6 beats per minute and 98.2±0.9% after exercise, respectively. In addition, all participants completed the exercises without experiencing any falls. In the acceptability assessment, the score reflecting continuation desire was the highest of the five items examined (2.71±0.46). In contrast, the adequacy of exercise intensity had the lowest score (1.29±0.57). CONCLUSIONS The present system was confirmed to be safe, and the participants were motivated to continue the exercises. Future developments should incorporate a function to enable participants and medical staff to adjust exercise intensity according to individual physical function.
Collapse
Affiliation(s)
- Nobuhiro Kumazawa
- Graduate School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Soichiro Koyama
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Kazuhiro Tsuchiyama
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Tsuyoshi Tatemoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
- Tokyo Bay Rehabilitation Hospital, Narashino, Chiba, Japan
| | - Hiroki Tanikawa
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Kei Ohtsuka
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Masaki Katoh
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Shigeo Tanabe
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| |
Collapse
|
22
|
Tanikawa H, Mukaino M, Itoh S, Kondoh H, Fujimura K, Teranishi T, Ohtsuka K, Hirano S, Kagaya H, Saitoh E, Otaka Y. Development of a simple mechanical measurement method to measure spasticity based on an analysis of a clinical maneuver and its concurrent validity with the modified Ashworth scale. Front Bioeng Biotechnol 2022; 10:911249. [PMID: 36046668 PMCID: PMC9420860 DOI: 10.3389/fbioe.2022.911249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/18/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Despite recent developments in the methodology for measuring spasticity, the discriminative capacity of clinically diagnosed spasticity has not been well established. This study aimed to develop a simple device for measuring velocity-dependent spasticity with improved discriminative capacity based on an analysis of clinical maneuver and to examine its reliability and validity. Methods: This study consisted of three experiments. First, to determine the appropriate motion of a mechanical device for the measurement of velocity-dependent spasticity, the movement pattern and the angular velocity used by clinicians to evaluate velocity-dependent spasticity were investigated. Analysis of the procedures performed by six physical therapists to evaluate spasticity were conducted using an electrogoniometer. Second, a device for measuring the resistance force against ankle dorsiflexion was developed based on the results of the first experiment. Additionally, preliminary testing of validity, as compared to that of the Modified Ashworth Scale (MAS), was conducted on 17 healthy participants and 10 patients who had stroke with spasticity. Third, the reliability of the measurement and the concurrent validity of mechanical measurement in the best ankle velocity setting were further tested in a larger sample comprising 24 healthy participants and 32 patients with stroke. Results: The average angular velocity used by physical therapists to assess spasticity was 268 ± 77°/s. A device that enabled the measurement of resistance force at velocities of 300°/s, 150°/s, 100°/s, and 5°/s was developed. In the measurement, an angular velocity of 300°/s was found to best distinguish patients with spasticity (MAS of 1+ and 2) from healthy individuals. A measurement of 300°/s in the larger sample differentiated the control group from the MAS 1, 1+, and 2 subgroups (p < 0.01), as well as the MAS 1 and 2 subgroups (p < 0.05). No fixed or proportional bias was observed in repeated measurements. Conclusion: A simple mechanical measurement methodology was developed based on the analysis of the clinical maneuver for measuring spasticity and was shown to be valid in differentiating the existence and extent of spasticity. This study suggest possible requirements to improve the quality of the mechanical measurement of spasticity.
Collapse
Affiliation(s)
- Hiroki Tanikawa
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
- *Correspondence: Masahiko Mukaino,
| | - Shota Itoh
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Hikaru Kondoh
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Kenta Fujimura
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Toshio Teranishi
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Kei Ohtsuka
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Satoshi Hirano
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| |
Collapse
|
23
|
Sugama J, Ishibasi M, Ota E, Kamakura Y, Saitoh E, Sanada H, Nakayama T, Nomura T, Yamada M, Nakagami G, Sato N, Shibata S, Hase T, Fukada J, Miki T, Arita M, Urai T, Okawa Y, Kitamura A, Dai M, Takahashi T, Tamai N, Tobita I, Noguchi H, Matsumoto M, Miura Y, Mukai K, Mugita Y, Yoshida M, Kurachi M, Shirasaka T, Yamane Y. Japanese clinical practice guidelines for aspiration and pharyngeal residual assessment during eating and swallowing for nursing care. Jpn J Nurs Sci 2022; 19:e12496. [PMID: 35715990 DOI: 10.1111/jjns.12496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/15/2022] [Accepted: 04/11/2022] [Indexed: 11/30/2022]
Abstract
AIM This clinical practice guideline aims to provide and recommend methods of assessing aspiration and pharyngeal residue during eating and swallowing and methods of selecting and implementing nursing care for adults to prevent the development of aspiration pneumonia through early and appropriate management of oropharyngeal dysphagia. METHODS In April 2018, the Japan Academy of Nursing Science established the Supervisory Committee in Nursing Care Development/Standardization Committee to develop clinical practice guidelines for aspiration and pharyngeal residual assessment during eating and swallowing for nursing care. This clinical practice guideline was developed according to the Minds Manual for Guideline Development 2017, with the aim of providing a specific pathway for nurses to determine the policy for selecting management for oropharyngeal dysphagia based on research evidence and multifaceted factors including the balance of benefits and harms and patients' values. RESULTS Based on the 10 clinical questions related to assessment by physical assessment, the Repetitive Saliva Swallowing Test, Modified Water Swallowing Test, Food Test, cervical auscultation, observation using an ultrasound diagnostic device, and an endoscope, 10 recommendations have been developed. Eight recommendations have been evaluated as the Grading of Recommendations Assessment, Development and Evaluation (GRADE) 2C, and the other two have been evaluated as no GRADE. CONCLUSION The first reliable clinical practice guideline has been produced from an academic nursing organization that focuses on assessment for nursing care and incorporates the latest findings.
Collapse
Affiliation(s)
- Junko Sugama
- Research Center for Implementation Nursing Science Initiative, Fujita Health University, Toyoake, Japan
| | - Miyuki Ishibasi
- Department of Frontier Practice Nursing, Division of Modern Gerontological Nursing, Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Erika Ota
- Graduate School of Nursing Science, St.Luke's International University, Tokyo, Japan.,The Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Yayoi Kamakura
- Japanese Red Cross Toyota College of Nursing, Toyota, Japan
| | | | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Takeshi Nomura
- Department of Intensive Care Unit, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Masako Yamada
- Graduate School of Nursing Science, St.Luke's International University, Tokyo, Japan
| | - Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naoko Sato
- Tokyo Hikari Nursing Station, Tokyo, Japan
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Takashi Hase
- Department of Oral and Maxillofacial Surgery, Noto General Hospital, Nanao, Japan
| | - Junko Fukada
- School of Nursing & Health, Aichi Prefectural University, Nagoya, Japan
| | - Tatsuto Miki
- Department of Nursing, Fujita Health University Hospital, Toyoake, Japan
| | - Mikiko Arita
- Department of Nursing, Osaka Shin-ai College, Ibaraki, Japan
| | - Tamae Urai
- Faculty of Nursing, Toyama Prefectural University, Toyama, Japan
| | - Yohei Okawa
- Department of Psychosomatic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Aya Kitamura
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Misako Dai
- Research Center for Implementation Nursing Science Initiative, Fujita Health University, Toyoake, Japan
| | - Toshiaki Takahashi
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nao Tamai
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Itoko Tobita
- Faculty of Nursing, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Hiroshi Noguchi
- Graduate School of Engineering, Osaka Metropolitan University, Osaka, Japan
| | - Masaru Matsumoto
- School of Nursing, Ishikawa Prefectural Nursing University, Kahoku, Japan
| | - Yuka Miura
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kanae Mukai
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Yuko Mugita
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mikako Yoshida
- Department of Women's Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masako Kurachi
- Department of Speech and Hearing Sciences, International University of Health and Welfare, Narita, Japan
| | | | - Yukiko Yamane
- Graduate School of Nursing Science, Asahikawa Medical University, Asahikawa, Japan
| |
Collapse
|
24
|
Mukaino M, Ogasawara T, Matsuura H, Aoshima Y, Suzuki T, Furuzawa S, Yamaguchi M, Nakashima H, Saitoh E, Tsukada S, Otaka Y. Validity of trunk acceleration measurement with a chest-worn monitor for assessment of physical activity intensity. BMC Sports Sci Med Rehabil 2022; 14:104. [PMID: 35689292 PMCID: PMC9185863 DOI: 10.1186/s13102-022-00492-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 05/27/2022] [Indexed: 11/30/2022]
Abstract
Background Recent advancements in wearable technology have enabled easy measurement of daily activities, potentially applicable in rehabilitation practice for various purposes such as maintaining and increasing patients’ activity levels. In this study, we aimed to examine the validity of trunk acceleration measurement using a chest monitor embedded in a smart clothing system (‘hitoe’ system), an emerging wearable system, in assessing the physical activity in an experimental setting with healthy subjects (Study 1) and in a clinical setting with post-stroke patients (Study 2). Methods Study 1 involved the participation of 14 healthy individuals. The trunk acceleration, heart rate (HR), and oxygen consumption were simultaneously measured during treadmill testing with a Bruce protocol. Trunk acceleration and HR were measured using the "hitoe" system, a smart clothing system with embedded chest sensors. Expiratory gas analysis was performed to measure oxygen consumption. Three parameters, moving average (MA), moving standard deviation (MSD), and moving root mean square (RMS), were calculated from the norm of the trunk acceleration. The relationships between these accelerometer-based parameters and oxygen consumption-based physical activity intensity measured with the percent VO2 reserve (%VO2R) were examined. In Study 2, 48 h of simultaneous measurement of trunk acceleration and heart rate-based physical activity intensity in terms of percent heart rate reserve (%HRR) was conducted with the "hitoe" system in 136 post-stroke patients. Results The values of MA, MSD, RMS, and %VO2R were significantly different between levels 1, 2, 3, and 4 in the Bruce protocol (P < 0.01). The average coefficients of determination for individual regression for %VO2R versus MA, %VO2R versus MSD, and %VO2R versus RMS were 0.89 ± 0.05, 0.96 ± 0.03, and 0.91 ± 0.05, respectively. Among the parameters examined, MSD showed the best correlation with %VO2R, indicating high validity of the parameter for assessing physical activity intensity. The 48-h measurement of MSD and %HRR in post-stroke patients showed significant within-individual correlation (P < 0.05) in 131 out of 136 patients (correlation coefficient: 0.60 ± 0.16). Conclusions The results support the validity of the MSD calculated from the trunk acceleration measured with a smart clothing system in assessing the physical activity intensity. Trial registration: UMIN000034967. Registered 21 November 2018 (retrospectively registered). Supplementary Information The online version contains supplementary material available at 10.1186/s13102-022-00492-4.
Collapse
Affiliation(s)
- Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.
| | - Takayuki Ogasawara
- NTT Basic Research Laboratories and Bio-Medical Informatics Research Center, NTT Corporation, Atsugi, Kanagawa, Japan
| | - Hirotaka Matsuura
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.,Department of Rehabilitation Medicine, Nippon Medical School Chiba Hokuso Hospital, Inzai, Chiba, Japan
| | - Yasushi Aoshima
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Takuya Suzuki
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Shotaro Furuzawa
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Masumi Yamaguchi
- NTT Basic Research Laboratories and Bio-Medical Informatics Research Center, NTT Corporation, Atsugi, Kanagawa, Japan
| | - Hiroshi Nakashima
- NTT Basic Research Laboratories and Bio-Medical Informatics Research Center, NTT Corporation, Atsugi, Kanagawa, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Shingo Tsukada
- NTT Basic Research Laboratories and Bio-Medical Informatics Research Center, NTT Corporation, Atsugi, Kanagawa, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| |
Collapse
|
25
|
Tsuchiyama K, Mukaino M, Ohtsuka K, Matsuda F, Tanikawa H, Yamada J, Pongpipatpaiboon K, Kanada Y, Saitoh E, Otaka Y. Effects of ankle-foot orthoses on the stability of post-stroke hemiparetic gait. Eur J Phys Rehabil Med 2022; 58:352-362. [PMID: 34498833 PMCID: PMC9980585 DOI: 10.23736/s1973-9087.21.07048-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Ankle-foot orthoses are used to improve gait stability in patients with post-stroke gait; however, there is not enough evidence to support their beneficial impact on gait stability. AIM To investigate the effects of ankle-foot orthoses on post-stroke gait stability. DESIGN An experimental study with repeated measurements of gait parameters with and without orthosis. SETTING Inpatients and outpatients in the Fujita Health University Hospital, Toyoake, Japan. POPULATION Thirty-two patients (22 males; mean age 48.3±20.0 years) with post-stroke hemiparesis participated in the study. METHODS Three-dimensional treadmill gait analysis was performed with and without ankle-foot orthosis for each participant. Spatiotemporal parameters, their coefficient of variation, and margin of stability were evaluated. Toe clearance, another major target of orthosis, was also examined. The effect of orthosis in the patients with severe (not able to move within the full range of motion, defying gravity) and mild ankle impairment (able to move within the full range but have problem with speed and/or smoothness of the ankle movement) was compared. RESULTS In the total group comparison, the decrease in the coefficient of variation of step width (P=0.012), and margin of stability on the paretic side (P=0.023) were observed. In the severe ankle impairment groups, the decreased in the coefficient of variation of the non-paretic step length (P=0.007), stride length (P=0.037), and step width (P=0.033) and margin of stability on the paretic side (P=0.006) were observed. No significant effects were observed in the mild ankle impairment group; rather, the coefficient of variation of non-paretic step length increased with the use of orthosis in this group (P=0.043); however, toe clearance increased with the use of ankle-foot orthosis (P=0.041). CONCLUSIONS Ankle-foot orthoses improved gait stability indices; however, the effect was either not significant or showed possible worsening in the patients with mild ankle impairment, while the effect on toe clearance was significant. These results suggest that the effects of using orthoses in patients with mild impairment should be carefully evaluated. CLINICAL REHABILITATION IMPACT Understanding the effects of ankle-foot orthoses on the stability of post-stroke gait and their relationship with ankle impairment severity may support clinical decision-making while prescribing orthosis for post-stroke hemiparesis.
Collapse
Affiliation(s)
- Kazuhiro Tsuchiyama
- School of Health Sciences, Faculty of Rehabilitation, Fujita Health University, Toyoake, Japan
| | - Masahiko Mukaino
- School of Medicine, Department of Rehabilitation Medicine I, Fujita Health University, Toyoake, Japan -
| | - Kei Ohtsuka
- School of Health Sciences, Faculty of Rehabilitation, Fujita Health University, Toyoake, Japan
| | - Fumihiro Matsuda
- School of Health Sciences, Faculty of Rehabilitation, Fujita Health University, Toyoake, Japan
| | - Hiroki Tanikawa
- School of Health Sciences, Faculty of Rehabilitation, Fujita Health University, Toyoake, Japan
| | - Junya Yamada
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | | | - Yoshikiyo Kanada
- School of Health Sciences, Faculty of Rehabilitation, Fujita Health University, Toyoake, Japan
| | - Eiichi Saitoh
- School of Medicine, Department of Rehabilitation Medicine I, Fujita Health University, Toyoake, Japan
| | - Yohei Otaka
- School of Medicine, Department of Rehabilitation Medicine I, Fujita Health University, Toyoake, Japan
| |
Collapse
|
26
|
Fujimura K, Mukaino M, Itoh S, Miwa H, Itoh R, Narukawa D, Tanikawa H, Kanada Y, Saitoh E, Otaka Y. Requirements for Eliciting a Spastic Response With Passive Joint Movements and the Influence of Velocity on Response Patterns: An Experimental Study of Velocity-Response Relationships in Mild Spasticity With Repeated-Measures Analysis. Front Neurol 2022; 13:854125. [PMID: 35432169 PMCID: PMC9007406 DOI: 10.3389/fneur.2022.854125] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background Spasticity is defined as a velocity-dependent increase in tonic stretch reflexes and is manually assessed in clinical practice. However, the best method for the clinical assessment of spasticity has not been objectively described. This study analyzed the clinical procedure to assess spasticity of the elbow joint using an electrogoniometer and investigated the appropriate velocity required to elicit a spastic response and the influence of velocity on the kinematic response pattern. Methods This study included eight healthy individuals and 15 patients with spasticity who scored 1 or 1+ on the modified Ashworth Scale (MAS). Examiners were instructed to manually assess spasticity twice at two different velocities (slow and fast velocity conditions). During the assessment, velocity, deceleration value, and angle [described as the % range of motion (%ROM)] at the moment of resistance were measured using an electrogoniometer. Differences between the slow and fast conditions were evaluated. In addition, variations among the fast condition such as the responses against passive elbow extension at <200, 200–300, 300–400, 400°/s velocities were compared between the MAS 1+, MAS 1, and control groups. Results Significant differences were observed in the angular deceleration value and %ROM in the fast velocity condition (417 ± 80°/s) between patients and healthy individuals, but there was no difference in the slow velocity condition (103 ± 29°/s). In addition, the deceleration values were significantly different between the MAS 1 and MAS 1+ groups in velocity conditions faster than 300°/s. In contrast, the value of %ROM plateaued when the velocity was faster than 200°/s. Conclusion The velocity of the passive motion had a significant effect on the response pattern of the elbow joint. The velocity-response pattern differed between deceleration and the angle at which the catch occurred; the value of deceleration value for passive motion was highly dependent on the velocity, while the %ROM was relatively stable above a certain velocity threshold. These results provide clues for accurate assessment of spasticity in clinical practice.
Collapse
Affiliation(s)
- Kenta Fujimura
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
- *Correspondence: Masahiko Mukaino
| | - Shota Itoh
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Haruna Miwa
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Ryoka Itoh
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Daisuke Narukawa
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Hiroki Tanikawa
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Yoshikiyo Kanada
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| |
Collapse
|
27
|
Koyama S, Tanabe S, Gotoh T, Taguchi Y, Katoh M, Saitoh E, Otaka Y, Hirano S. Wearable Power-Assist Locomotor for Gait Reconstruction in Patients With Spinal Cord Injury: A Retrospective Study. Front Neurorobot 2022; 16:775724. [PMID: 35250528 PMCID: PMC8894852 DOI: 10.3389/fnbot.2022.775724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/11/2022] [Indexed: 11/16/2022] Open
Abstract
Wearable robotic exoskeletons (WREs) have been developed from orthoses as assistive devices for gait reconstruction in patients with spinal cord injury. They can solve some problems encountered with orthoses, such as difficulty in independent walking and standing up and high energy consumption during walking. The Wearable Power-Assist Locomotor (WPAL), a WRE, was developed based on a knee–ankle–foot orthosis with a single medial hip joint. The WPAL has been updated seven times during the period from the beginning of its development, in 2005, to 2020. The latest version, launched as a commercialized model in 2016, is available for medical facilities. In this retrospective study, which included updated results from previous reports, all data were extracted from development research records from July 2007 to December 2020. The records were as follows: patient characteristics [the number of participants, injury level, and the American Spinal Injury Association Impairment Scale (AIS) score], the total number of WPAL trials when aggregating the cases with all the versions or only the latest version of the WPAL, and maximum walking performance (functional ambulation category [FAC], distance, and time of continuous walking). Thirty-one patients participated in the development research. The levels of spinal cord injury were cervical (C5–C8), upper thoracic (T3–T6), lower thoracic (T7–T12), and lumbar (L1) in 10, 5, 15, and 1 of the patients, respectively. The numbers of patients with AIS scores of A, B, C, and D were 20, 7, 4, and 0, respectively. The total number of WPAL trials was 1,785, of which 1,009 were used the latest version of the WPAL. Twenty of the patients achieved an FAC score of 4 after an average of 9 (median 8, range 2–22) WPAL trials. The continuous walking distance and time improved with the WPAL were compared to the orthosis. We confirmed that the WPAL improves walking independence in people with a wide range of spinal cord injuries, such as cervical spinal cord injuries. Further refinement of the WPAL will enable its long-term use at home.
Collapse
Affiliation(s)
- Soichiro Koyama
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Shigeo Tanabe
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Takeshi Gotoh
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Yuta Taguchi
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Masaki Katoh
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Satoshi Hirano
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
- *Correspondence: Satoshi Hirano
| |
Collapse
|
28
|
Thimabut N, Yotnuengnit P, Charoenlimprasert J, Sillapachai T, Hirano S, Saitoh E, Piravej K. Effects of the robot-assisted gait training device plus physiotherapy in improving ambulatory functions in subacute stroke patients with hemiplegia: An assessor-blinded, randomized controlled trial. Arch Phys Med Rehabil 2022; 103:843-850. [PMID: 35143747 DOI: 10.1016/j.apmr.2022.01.146] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 01/05/2022] [Accepted: 01/08/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To investigate the effects of the robot-assisted gait training device (RAGTD) plus physiotherapy versus physiotherapy alone, in improving ambulatory functions in subacute stroke patients with hemiplegia. DESIGN A prospective, assessor-blinded, randomized controlled trial. SETTING Subacute stroke patients with hemiplegia admitted at the Rehabilitation Center. PARTICIPANTS Twenty-six subacute stroke patients with hemiplegia. INTERVENTION All patients received 30 training sessions (five days/week for six weeks) which included conventional physiotherapy training (60 min) and ambulation training (60 min). In the ambulation training session, the RAGTD group received robotic training (40 min) and ground ambulation training (20 min). The control group received only ground ambulation training (60 min). The outcomes were assessed at the initial session, the end of the 15th and the 30th sessions. Comparisons within group and between the groups were conducted. MAIN OUTCOME MEASURES Primary outcome variables were the Functional Independence Measure (FIM)-walk score and the efficacy of FIM-walk. RESULTS The RAGTD group showed greater improvements from baseline than control in: (1) the FIM-walk score, at the end of the 15th session (p = 0.012), (2) the efficacy of FIM-walk, at the end of the 15th session (p = 0.008), (3) walking distance in the 6-minute walk test (6MWT), at the end of the 15th session (p = 0.018), (4) the Barthel Index for Activities of Daily Living (ADL), at the end of the 30th session (p < 0.001), and (5) gait symmetry ratio, at the end of the 30th session (p = 0.044). Other gait parameters showed tendencies of improvement in the RAGTD group, but there were no significant differences. CONCLUSION RAGTD plus physiotherapy showed early improvements in walking ability and Barthel ADL index compared to the ground level training plus physiotherapy in subacute stroke patients with hemiplegia.
Collapse
Affiliation(s)
- Natapatchakrid Thimabut
- Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, THAILAND
| | - Pattarapol Yotnuengnit
- Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, THAILAND
| | | | | | - Satoshi Hirano
- Department of Rehabilitation Medicine Ι, School of Medicine, Fujita Health University, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine Ι, School of Medicine, Fujita Health University, Japan
| | - Krisna Piravej
- Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, THAILAND.
| |
Collapse
|
29
|
Tatemoto T, Mukaino M, Kumazawa N, Tanabe S, Mizutani K, Katoh M, Saitoh E, Otaka Y. Overcoming language barriers to provide telerehabilitation for COVID-19 patients: a two-case report. Disabil Rehabil Assist Technol 2021; 17:275-282. [PMID: 34958627 DOI: 10.1080/17483107.2021.2013962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE This report presents two cases of successful telerehabilitation delivery for patients quarantined due to COVID-19. One of the patients did not speak the therapists' language, whereas the other presented complete deafness. MATERIALS AND METHODS We assembled a telerehabilitation system using commercial applications, including a remote-control application that minimizes the need for patient's input. The telerehabilitation comprised a combination of video calls with a physical therapist and a 20-minute exercise video. The first case was of a 72-year-old man who could only speak Cantonese, a language that none of the service providers could speak, making communication difficult. Therefore, telerehabilitation was provided using Google Translate to simultaneously translate the therapist's instructions in Japanese to Cantonese. The second case involved a 49-year-old man with neurofibromatosis and complete deafness. In this case, communication during the exercise programme was achieved using 25 cue cards that were prepared in advance and used to convey instructions. The patients' satisfaction was assessed using either of a simple three-item questionnaire (Case 1) or the Telemedicine Satisfaction Questionnaire with five additional items (Case 2). RESULTS In both cases, the exercise programme was successfully conducted, and the patients reported being highly satisfied with the programme. CONCLUSIONS Communication barriers can impede telerehabilitation therapy; this problem is aggravated when the recipients cannot receive on-site education for device operation and exercise performance in advance due to COVID-19 restrictions. However, the use of supplementary methodologies may contribute to solving these issues, further expanding the coverage and applicability of telerehabilitation.IMPLICATIONS FOR REHABILITATIONWe provided telerehabilitation for two patients with communication difficulties who were quarantined due to COVID-19.Telerehabilitation was carried out using a system with a remote-control mechanism to minimise patient input and avoid problems caused by their unfamiliarity in operating the devices.In addition, an online translation mechanism was used to overcome language differences, while cue cards were used for a patient with a hearing impairment.Telerehabilitation was performed without any technical issues. Both patients reported being highly satisfied with the intervention.This experience of providing telerehabilitation and overcoming communication difficulties may help develop a strategy to expand the coverage of telerehabilitation in the treatment of patients in isolation due to highly transmissible diseases, such as COVID-19.
Collapse
Affiliation(s)
- Tsuyoshi Tatemoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Nobuhiro Kumazawa
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Shigeo Tanabe
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Koji Mizutani
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Masaki Katoh
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| |
Collapse
|
30
|
Nagashima Y, Kagaya H, Toda F, Aoyagi Y, Shibata S, Saitoh E, Abe K, Nakayama E, Ueda K. Effect of electromyography-triggered peripheral magnetic stimulation on voluntary swallow in healthy humans. J Oral Rehabil 2021; 48:1354-1362. [PMID: 34499762 DOI: 10.1111/joor.13256] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 07/24/2021] [Accepted: 09/01/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Electrical stimulation therapy is effective for patients with dysphagia. However, because of the pain, strong stimulation cannot be applied. Although magnetic stimulation induces less pain, there are no reports on magnetic stimulation being synchronised with a swallowing reflex. OBJECTIVE This study aimed to determine whether it is possible to induce magnetic stimulation during a voluntary swallowing using electromyography (EMG)-triggered peripheral magnetic stimulation and to evaluate its effect on healthy individuals. METHODS A total of 20 healthy adults in seated position were instructed to swallow saliva and 10 ml of barium under videofluoroscopy. For concomitant use of magnetic stimulation, a magnetic stimulus for suprahyoid muscles at 30 Hz frequency was applied for 2 s when the EMG level in the sternohyoid muscle exceeded the threshold. During the voluntary swallowing, the movement of the hyoid bone and opening width of the upper oesophageal sphincter (UES) were measured. Furthermore, pressure topography was evaluated in 6 subjects using high-resolution manometry. RESULTS The magnetic stimulation significantly extended the movement time of the hyoid bone (p < 0.001). During liquid deglutition, significant increases were observed in the anterior maximum movement distance of the hyoid bone (p < 0.05), opening width of the UES (p < 0.001) and anterior movement distance of the hyoid bone at the maximum UES opening (p < 0.01). In the pressure topography, the maximum pressure immediately after UES closure significantly decreased with magnetic stimulation (p < 0.05). CONCLUSION EMG-triggered peripheral magnetic stimulation made it possible to apply magnetic stimulation during a voluntary swallowing.
Collapse
Affiliation(s)
- Yuki Nagashima
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan.,Department of Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Fumi Toda
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yoichiro Aoyagi
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Kimiko Abe
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo, Japan
| | - Enri Nakayama
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo, Japan
| | - Koichiro Ueda
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo, Japan
| |
Collapse
|
31
|
Aihara K, Inamoto Y, Kanamori D, González-Fernández M, Shibata S, Kagaya H, Hirano S, Kobayashi H, Fujii N, Saitoh E. Effect of tongue-hold swallow on posterior pharyngeal wall using dynamic area detector computed tomography. J Oral Rehabil 2021; 48:1235-1242. [PMID: 34407238 PMCID: PMC9291453 DOI: 10.1111/joor.13246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 07/15/2021] [Accepted: 08/12/2021] [Indexed: 11/28/2022]
Abstract
Purpose The purpose of this study was to elucidate the effects of the tongue‐hold swallow (THS) on the pharyngeal wall by quantifying posterior pharyngeal wall (PPW) anterior bulge during the THS. In addition, the effect of tongue protrusion length on the extent of pharyngeal wall anterior bulge was analysed. Methods Thirteen healthy subjects (6 males and 7 females, 23–43 years) underwent 320‐row area detector CT during saliva swallow (SS) and THS at two tongue protrusion lengths (THS1 protrude the tongue as much as 1/3 of premeasured maximum tongue protrusion length (MTP‐L) and THS2 protrude the tongue as much as 2/3 of MTP‐L). To acquire images of the pharynx at rest, single‐phase volume scanning was performed three times during usual breathing with no tongue protrusion (rest), protrusion of the tongue at 1/3 of MTP‐L (rTHS1) and protrusion of the tongue at 2/3 of MTP‐L (rTHS2). Length from cervical spine to PPW (PPW‐AP) and the volume of pharyngeal cavity was measured and was compared between rest, rTHS1 and rTHS2 and between SS, THS1 and THS2. Correlation between MTP‐L and PPW‐AP was calculated in three conditions, SS, THS1 and THS2. Results PPW‐AP at rest, rTHS1 and rTHS2 was 2.9 ± 0.6 mm, 3.0 ± 0.5 mm and 3.0 ± 0.5 mm, respectively, showing no significant differences across swallows. PPW‐AP at the maximum pharyngeal constriction was 8.1 ± 2.0 mm, 9.1 ± 2.4 mm and 8.7 ± 2.0 mm in SS, THS1 and THS2, respectively. Compared to SS, PPW‐AP in THS1 was significantly larger (p = 0.04) and PPW‐AP in THS2 was not significantly different (p = 0.09). Pharyngeal volume at rest, rTHS1 and rTHS2 was 16.4 ± 5.2 mm3, 18.4 ± 4.5 mm3 and 21.3 ± 6.2 mm3, respectively. It was significantly larger during rTHS2 compared with rest or rTHS1 (rTHS2‐rest p = 0.007, rTHS2‐rTHS1 p = 0.007). Pharyngeal volume was completely obliterated (zero volume) at maximum pharyngeal contraction in all except one subject. There was no correlation between MTP‐L and PPW‐AP in any of the three conditions (SS, THS1 and THS2). Discussion This study demonstrated that the expanded pharyngeal cavity due to the tongue protrusion was completely obliterated by the increase in anterior motion of pharyngeal wall during THS. It also became clear that the degree of tongue protrusion did not linearly correlate with the movement of PPW during THS. There was no relationship between PPW motion and the MTP‐L, suggesting that the effect of tongue protrusion is better determined in each subject by analysing the motion of PPW using imaging tools.
Collapse
Affiliation(s)
- Keiko Aihara
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Yoko Inamoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan.,Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Daisuke Kanamori
- Department of Density and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Marlís González-Fernández
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Satoshi Hirano
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Hiroko Kobayashi
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Naoko Fujii
- Department of Radiology, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| |
Collapse
|
32
|
Hota S, Inamoto Y, Oguchi K, Kondo T, Otaka E, Mukaino M, Gonzalez-Fernandez M, Saitoh E. Outcomes of Dysphagia Following Stroke: Factors Influencing Oral Intake at 6 Months After Onset. J Stroke Cerebrovasc Dis 2021; 30:105971. [PMID: 34280690 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105971] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 06/10/2021] [Accepted: 06/23/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE This study aimed to describe recovery of dysphagia after stroke. We determined the proportion of stroke survivors with dysphagia on admission, discharge, and 6 months after stroke. Additionally, the factors affecting oral feeding 6 months after stroke were explored. METHODS A total of 427 acute stroke patients were recruited prospectively. Presence of dysphagia was evaluated on admission, weekly until recovery was achieved, and at discharge. We compared stroke survivors with dysphagia who had complete recovery, who had dysphagia but achieved oral feeding, and who required tube feeding. Patient-reported eating ability was evaluated at 6 months. Patients who achieved oral feeding by 6 months were compared to those who had persistent tube feeding need. RESULTS Fifty-five percent of stroke survivors had dysphagia on initial evaluation (3.1 ± 1.4 days after admission) and 37% at discharge (21.1 ± 12.4 days). At 6 months, 5% of patients required tube feeding. Among those who had dysphagia at initial evaluation, 32% had resolution of dysphagia within two weeks, 44% had dysphagia but started oral feeding before discharge, and 23% required alternative means of alimentation (nasogastric tube feeding, percutaneous endoscopic gastrostomy, parental nutrition) throughout hospitalization. At 6 months, 90% of stroke survivors who achieved oral feeding by discharge continued with oral feeding. Patients who achieved oral feeding after discharge had less cognitive impairments on admission and a higher speech therapist intervention rate after discharge. CONCLUSIONS More than half of stroke survivors had dysphagia but the vast majority were able to return to oral feeding by 6 months. Cognitive function and dysphagia rehabilitation interventions were associated with return to oral feeding after hospital discharge.
Collapse
Affiliation(s)
- Sachiyo Hota
- Department of Rehabilitation, Kariya Toyota General Hospital, Kariya, Japan
| | - Yoko Inamoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan; Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan.
| | - Kazuyo Oguchi
- Department of Rehabilitation, Kariya Toyota General Hospital, Kariya, Japan
| | - Tomoko Kondo
- Department of Rehabilitation, Kariya Toyota General Hospital, Kariya, Japan
| | - Eri Otaka
- Department of Rehabilitation, Kariya Toyota General Hospital, Kariya, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | | | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| |
Collapse
|
33
|
Senju Y, Mukaino M, Prodinger B, Selb M, Okouchi Y, Mizutani K, Suzuki M, Yamada S, Izumi SI, Sonoda S, Otaka Y, Saitoh E, Stucki G. Development of a clinical tool for rating the body function categories of the ICF generic-30/rehabilitation set in Japanese rehabilitation practice and examination of its interrater reliability. BMC Med Res Methodol 2021; 21:121. [PMID: 34126940 PMCID: PMC8204586 DOI: 10.1186/s12874-021-01302-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 04/27/2021] [Indexed: 11/24/2022] Open
Abstract
Background The International Classification of Functioning, Disability, and Health (ICF) Generic-30 (Rehabilitation) Set is a tool used to assess the functioning of a clinical population in rehabilitation. The ICF Generic-30 consists of nine ICF categories from the component “body functions” and 21 from the component “activities and participation”. This study aimed to develop a rating reference guide for the nine body function categories of the ICF Generic-30 Set using a predefined, structured process and to examine the interrater reliability of the ratings using the rating reference guide. Methods The development of the first version of the rating reference guide involved the following steps: (1) a trial of rating patients by several raters; (2) cognitive interviews with each rater to analyze the thought process involved in each rating; (3) the drafting of the rating reference guide by a multidisciplinary panel; and (4) a review by ICF specialists to confirm consistency with the ICF. Subsequently, we conducted a first field test to gain insight into the use of the guide in practice. The reference guide was modified based on the raters’ feedback in the field test, and an inter-rater reliability test was conducted thereafter. Interrater agreement was evaluated using weighted kappa statistics with linear weights. Results The first version of the rating reference guide was successfully developed and tested. The weighted kappa coefficient in the field testing ranged from 0.25 to 0.92. The interrater reliability testing of the rating reference guide modified based on the field test results yielded an improved weighted kappa coefficient ranging from 0.53 to 0.78. Relative improvements in the weighted kappa coefficients were observed in seven out of the nine categories. Consequently, seven out of nine categories were found to have a weighted kappa coefficient of 0.61 or higher. Conclusions In this study, we developed and modified a rating reference guide for the body function categories of the ICF Generic-30 Set. The interrater reliability test using the final version of the rating reference guide showed moderate to substantial interrater agreement, which encouraged the use of the ICF in rehabilitation practice.
Collapse
Affiliation(s)
- Yuki Senju
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
| | - Birgit Prodinger
- Faculty of Applied Health and Social Sciences, Technical University of Applied Sciences Rosenheim, Rosenheim, Germany.,Swiss Paraplegic Research, Nottwil, Switzerland.,ICF Research Branch, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Melissa Selb
- Swiss Paraplegic Research, Nottwil, Switzerland.,ICF Research Branch, Nottwil, Switzerland
| | - Yuki Okouchi
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Kouji Mizutani
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Megumi Suzuki
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Shin Yamada
- Department of Rehabilitation Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Shin-Ichi Izumi
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Shigeru Sonoda
- Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Mie, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Gerold Stucki
- Swiss Paraplegic Research, Nottwil, Switzerland.,ICF Research Branch, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| |
Collapse
|
34
|
Ogasawara T, Mukaino M, Otaka Y, Matsuura H, Aoshima Y, Suzuki T, Togo H, Nakashima H, Yamaguchi M, Tsukada S, Saitoh E. Validation of Data Imputation by Ensemble Averaging to Quantify 24-h Behavior Using Heart Rate of Stroke Rehabilitation Inpatients. J Med Biol Eng 2021. [DOI: 10.1007/s40846-021-00622-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
35
|
Aoyagi Y, Inamoto Y, Shibata S, Kagaya H, Otaka Y, Saitoh E. Clinical Manifestation, Evaluation, and Rehabilitative Strategy of Dysphagia Associated With COVID-19. Am J Phys Med Rehabil 2021; 100:424-431. [PMID: 33657028 PMCID: PMC8032217 DOI: 10.1097/phm.0000000000001735] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
ABSTRACT Dysphagia is the difficulty in swallowing because of the presence of certain diseases; it particularly compromises the oral and/or pharyngeal stages. In severe acute respiratory syndrome coronavirus 2 infection, neuromuscular complications, prolonged bed rest, and endotracheal intubation target different levels of the swallowing network. Thus, critically ill patients are prone to dysphagia and aspiration pneumonia. In this review, we first discuss the possible cause and pathophysiology underlying dysphagia associated with coronavirus disease 2019, including cerebrovascular events, such as stroke, encephalomyelitis, encephalopathy, peripheral neuropathy, and myositis, that may lead to the dysphagia reported as a complication associated with the coronavirus disease 2019. Next, we present some recommendations for dysphagia evaluation with modifications that would allow a safe and comprehensive assessment based on available evidence to date, including critical considerations of the appropriate use of personal protective equipment and optimization individual's noninstrumental swallowing tasks evaluation, while preserving instrumental assessments for urgent cases only. Finally, we discuss a practical managing strategy for dysphagia rehabilitation to ensure safe and efficient practice in the risks of severe acute respiratory syndrome coronavirus 2 exposure, in which swallowing therapy using newer technology, such as telerehabilitation system or wearable device, would be considered as a useful option.
Collapse
|
36
|
Jiang N, Nii Y, Arisawa H, Saitoh E, Ohe J, Onose Y. Chirality Memory Stored in Magnetic Domain Walls in the Ferromagnetic State of MnP. Phys Rev Lett 2021; 126:177205. [PMID: 33988392 DOI: 10.1103/physrevlett.126.177205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 04/08/2021] [Indexed: 06/12/2023]
Abstract
Chirality in a helimagnetic structure is determined by the sense of magnetic moment rotation. We found that the chiral information did not disappear even after the phase transition to the high-temperature ferromagnetic phase in a helimagnet MnP. The 2nd harmonic resistivity ρ^{2f}, which reflects the breaking down of mirror symmetry, was found to be almost unchanged after heating the sample above the ferromagnetic transition temperature and cooling it back to the helimagnetic state. The application of a magnetic field along the easy axis in the ferromagnetic state quenched the chirality-induced ρ^{2f}. This indicates that the chirality memory effect originated from the ferromagnetic domain walls.
Collapse
Affiliation(s)
- N Jiang
- Department of Basic Science, The University of Tokyo, Tokyo 153-8902, Japan
| | - Y Nii
- Institute for Materials Research, Tohoku University, Sendai 980-8577, Japan
- PRESTO, Japan Science and Technology Agency (JST), Kawaguchi 332-0012, Japan
| | - H Arisawa
- Institute for Materials Research, Tohoku University, Sendai 980-8577, Japan
| | - E Saitoh
- Institute for Materials Research, Tohoku University, Sendai 980-8577, Japan
- Department of Applied Physics, The University of Tokyo, Tokyo 113-8656, Japan
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
- Advanced Institute for Materials Research, Tohoku University, Sendai 980-8577, Japan
| | - J Ohe
- Department of Physics, Toho University, 2-2-1 Miyama, Funabashi 274-8510, Japan
| | - Y Onose
- Institute for Materials Research, Tohoku University, Sendai 980-8577, Japan
| |
Collapse
|
37
|
Mori S, Osawa A, Maeshima S, Sakurai T, Ozaki K, Kondo I, Saitoh E. Possibility of Using Quantitative Assessment with the Cube Copying Test for Evaluation of Visuo-spatial Function in Patients with Alzheimer's Disease. Prog Rehabil Med 2021; 6:20210021. [PMID: 33937549 PMCID: PMC8080165 DOI: 10.2490/prm.20210021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 04/15/2021] [Indexed: 11/10/2022] Open
Abstract
Objectives: The aim of this study was to investigate the clinical usefulness of the Cube Copying
Test (CCT) for quantitative assessment of visuo-spatial function in patients with
Alzheimer’s disease (AD). Methods: The CCT, Raven’s Colored Progressive Matrices (RCPM), and other neuropsychological
tests were administered to 152 AD outpatients. For the quantitative assessment of CCT,
we scored the points of connection (POC) and the number of plane-drawing errors (PDE)
and categorized the pattern classification (PAC). We also measured Functional Assessment
Staging (FAST) to assess the severity of AD. The relationships among CCT, RCPM, and FAST
were then analyzed. Results: The mean POC and PDE scores were 2.7 and 3.6, respectively, and the median PAC score
was 6.0. PDE and PAC showed a linear relationship, but POC and PDE, and POC and PAC did
not. Each component of CCT showed a significant correlation with RCPM scores. PDE and
PAC had closer correlations with RCPM scores than POC did. The PDE and PAC results were
significantly different among most of the FAST stages. Conclusions: Quantitative assessment using CCT may be effective for the quick determination of the
visuo-spatial function in AD patients.
Collapse
Affiliation(s)
- Shino Mori
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Aiko Osawa
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Japan.,Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | | | - Takashi Sakurai
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenichi Ozaki
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Izumi Kondo
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| |
Collapse
|
38
|
Tomida K, Tanino G, Sonoda S, Hirano S, Itoh N, Saitoh E, Kagaya H, Suzuki A, Kawakami K, Miyajima T, Takai M. Development of Gait Ability Assessment for hemiplegics (GAA) and verification of inter-rater reliability and validity. Jpn J Compr Rehabil Sci 2021; 12:19-26. [PMID: 37860214 PMCID: PMC10545035 DOI: 10.11336/jjcrs.12.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 10/21/2023]
Abstract
Tomida K, Tanino G, Sonoda S, Hirano S, Itoh N, Saitoh E, Kagaya H, Suzuki A, Kawakami K, Miyajima T, Takai M. Development of Gait Ability Assessment for hemiplegics (GAA) and verification of inter-rater reliability and validity. Jpn J Compr Rehabil Sci 2021; 12: 19-26. Objective To develop the Gait Ability Assessment for hemiplegics (GAA), and to verify its validity and inter-rater reliability. Methods We developed the GAA, a new method for the assessment of gait ability. Next, we examined the inter-rater reliability of GAA by assessing gait ability of post-stroke patients by two physical therapists. Then, we verified the validity of GAA by comparing with the existing assessments methods comprising Functional Ambulation Categories (FAC), Functional Independence Measure (FIM)-walk, maximum walking speed, motor subscore of the FIM (FIM-M), and total score of affected-side motor function of the Stroke Impairment Assessment Set (SIAS-L/E). Results Regarding the inter-rater reliability of GAA, κ coefficient was 0.76 and weighted κ coefficient was 0.96. The correlation coefficients between GAA scores and existing assessment methods were: 0.95 for FAC scores, 0.95 for FIM-walk scores, 0.82 for maximum walking speed, 0.89 for FIM-M, and 0.61 for SIAS-L/E, all of which showed a significant correlation (p<0.01). Conclusion GAA has high inter-rater reliability as well as high validity as a gait ability assessment method, suggesting that it can be applied to research and clinical settings.
Collapse
Affiliation(s)
- Ken Tomida
- Fujita Health University Nanakuri Memorial Hospital, Tsu, Mie, Japan
| | - Genichi Tanino
- Fujita Health University Okazaki Medical Center, Okazaki, Aichi, Japan
| | - Shigeru Sonoda
- Fujita Health University Nanakuri Memorial Hospital, Tsu, Mie, Japan
- Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Mie, Japan
| | - Satoshi Hirano
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Norihide Itoh
- Faculty of Rehabilitation, School of Health Science, Fujita Health University, Toyoake, Aichi, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Akira Suzuki
- Fujita Health University Nanakuri Memorial Hospital, Tsu, Mie, Japan
| | - Kenji Kawakami
- Fujita Health University Nanakuri Memorial Hospital, Tsu, Mie, Japan
| | - Takumi Miyajima
- Fujita Health University Comprehensive Community Care Center, Toyoake, Aichi, Japan
| | - Misaki Takai
- Fujita Health University Nanakuri Memorial Hospital, Tsu, Mie, Japan
| |
Collapse
|
39
|
Inamoto Y, Saitoh E, Palmer JB. Correction to: Annular Flow in the Upper Esophageal Sphincter Demonstrated with Dynamic 320-row Area Detector Computed Tomography. Dysphagia 2021; 36:1095. [PMID: 33721081 PMCID: PMC8578090 DOI: 10.1007/s00455-021-10282-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yoko Inamoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1‑98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470‑1192, Japan. .,Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Jefrey B Palmer
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
40
|
Kishi T, Okuya M, Sakuma K, Otaka Y, Saitoh E, Iwata N. Body composition in Japanese patients with psychiatric disorders: A cross-sectional study. Neuropsychopharmacol Rep 2021; 41:117-121. [PMID: 33506653 PMCID: PMC8182961 DOI: 10.1002/npr2.12160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 01/27/2023] Open
Abstract
AIM This study aimed to investigate body composition in Japanese patients with psychiatric disorders. METHODS A cross-sectional study was conducted to assess the body composition in Japanese patients with psychiatric disorders and healthy controls. InBody470 was used to measure the body composition of the participants. For the primary analysis, measures of body composition between patients and healthy controls were compared. Moreover, the following patient subgroups were also compared with the healthy controls: (a) patients with psychotic disorders only, (b) patients with mood disorders only, (c) patients receiving antipsychotics, (d) patients receiving conventional mood stabilizers, (e) patients receiving antidepressants only but not any antipsychotics and/or mood stabilizers, and (f) patients receiving hypnotics/anxiolytics. RESULTS This study included 205 individuals (105 patients and 100 healthy controls). It was found that patients had a significantly higher body mass index, waist-hip ratio, body fat mass, and percent body fat compared with the healthy controls. Moreover, significant differences were noted in the waist-hip ratio, body fat mass, and percent body fat between all patient subgroups other than patients receiving conventional mood stabilizers subgroup and healthy controls. CONCLUSION This is the first cross-sectional study to examine body composition in Japanese patients with psychiatric disorders. No difference in the skeletal muscle volume was noted although patients had higher body fat than healthy controls. A longitudinal and large cohort study in the future, controlling for medication and diagnosis, will need to determine why body fat is increased in Japanese patients with psychiatric disorders.
Collapse
Affiliation(s)
- Taro Kishi
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Makoto Okuya
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kenji Sakuma
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, Fujita Health University School of Medicine, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, Fujita Health University School of Medicine, Toyoake, Japan
| | - Nakao Iwata
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| |
Collapse
|
41
|
Inamoto Y, Saitoh E, Palmer JB. Annular Flow in the Upper Esophageal Sphincter Demonstrated with Dynamic 320-row Area Detector Computed Tomography. Dysphagia 2021; 36:1088-1094. [PMID: 33507395 PMCID: PMC8578160 DOI: 10.1007/s00455-020-10241-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 12/30/2020] [Indexed: 11/30/2022]
Abstract
Understanding bolus flow patterns in swallowing (rheology, the study of flow) is fundamental to assessment and treatment of dysphagia. These patterns are complex and poorly understood. A liquid swallow is typically biphasic, including air, so the actual bolus has both liquid and gas phases. We report a novel observation of annular two-phase flow (a ring of liquid around a core of air) as thin liquids passed through the upper esophageal sphincter (UES). Dynamic CT was performed on 27 healthy asymptomatic volunteers swallowing liquid barium in a semi-reclining position. Each subject swallowed 3, 10, and 20 ml of either thin (14 subjects) or thick liquid (13 subjects). Sagittal and axial images were analyzed. Flow patterns in the UES were assessed on cross-sectional images. Annular flow was seen in the majority of subjects with thin liquid but few with thick liquid swallows. The percentage of Annular flow during UES opening was 3 ml 58%, 10 ml 58%, 20 ml 56% in thin and 3 ml 0%, 10 ml 4%, 20 ml 1% in thick. Annular flow was usually observed from the second or third frames after onset of UES opening. The other pattern, Plug flow was seldom seen with thin but was typical with thick liquid swallows. Annular flow was the most common pattern for thin liquids (but not thick liquids) passing through the UES. Annular flow has been defined as a liquid continuum adjacent to the channel wall with a gas continuum (core) in the center of the channel. The two regions are demarcated by a gas–liquid interface. Annular flow is typical for two-phase gas–liquid flow in a vertical or inclined channel. It results from the interaction of viscosity with cohesive and adhesive forces in the two phases. We infer that the difference in flow pattern between thin liquid–air and thick liquid–air boluses resulted from the differing magnitudes of viscous forces.
Collapse
Affiliation(s)
- Yoko Inamoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan. .,Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Jeffrey B Palmer
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
42
|
Aoyagi Y, Ohashi M, Ando S, Inamoto Y, Aihara K, Matsuura Y, Imaeda S, Saitoh E. Effect of Tongue-Hold Swallow on Pharyngeal Contractile Properties in Healthy Individuals. Dysphagia 2021; 36:936-943. [PMID: 33386483 PMCID: PMC8464565 DOI: 10.1007/s00455-020-10217-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 11/17/2020] [Indexed: 01/19/2023]
Abstract
Tongue-hold swallow (THS) is a swallow exercise in which an individual swallows saliva while holding the anterior portion of the tongue between the front teeth. The effect of THS on pharyngeal contractile vigor is still unclear. The purpose of this study was to quantify THS using high-resolution manometry with a contractile integral analysis. Twenty-two healthy participants performed three different saliva swallow tasks: normal swallow, weak THS (in which the tongue was protruded 1 cm outside the upper incisors), and strong THS (in which the tongue was protruded 2 cm outside the upper incisors). The participants repeated each task twice randomly. Pharyngeal and upper esophageal sphincter metrics, including the pharyngeal contractile integral, were analyzed. Both weak and strong THS enhanced the velopharyngeal contractile integral and peak pressure compared with normal swallow (P < 0.01). THS also prolonged mesopharyngeal contraction (P < 0.01). Holding the tongue anteriorly during swallow requires significant biomechanical changes to pharyngeal contractile properties at the superior and middle pharyngeal constrictor levels; thus, it may serve as a resistance exercise for the muscles that are involved in bolus propulsion.
Collapse
Affiliation(s)
- Yoichiro Aoyagi
- Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
| | - Miho Ohashi
- Department of Rehabilitation, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Shiori Ando
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Yoko Inamoto
- Faculty of Rehabilitation, Fujita Health University, Toyoake, Japan
| | - Keiko Aihara
- Faculty of Rehabilitation, Fujita Health University, Toyoake, Japan
| | - Yoko Matsuura
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Sayuri Imaeda
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| |
Collapse
|
43
|
Yamada R, Okumura S, Kono Y, Miyazaki A, Niwa Y, Ito T, Ueda S, Ishiguro T, Yoshinaga M, Fujiwara W, Hayashi M, Ozaki Y, Saitoh E, Izawa H. Effect of cardiac rehabilitation on circulating microRNA expression in heart failure: a preliminary study. Fujita Med J 2021; 7:76-82. [PMID: 35111549 PMCID: PMC8749499 DOI: 10.20407/fmj.2020-010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/02/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES There are benefits of exercise-based cardiac rehabilitation (CR) in patients with heart failure (HF), but their underlying molecular mechanisms remain elusive. The effect of CR on the expression profile of circulating microRNAs (miRNAs), which are short noncoding RNAs that regulate posttranscriptional expression of target genes, is unknown. If miRNAs respond to changes following CR for HF, then serum profiling of miRNAs may reveal cardioprotective mechanisms of CR. METHODS This study enrolled three hospitalized patients with progressed systolic HF and three normal volunteer controls. In patients, CR was initiated after improvement of HF, which included 2 weeks of bicycle ergometer and resistance exercises. Genome-wide expression profiling of circulating miRNAs was performed using microarrays for the patients (mean±SD age, 60.0±12.2 years) and controls (58.7±0.58 years). Circulating miRNA expression profiles were compared between patients with HF before and after CR and the controls. RESULTS Expression levels of two miRNAs were significantly different in patients before CR compared with controls and patients after CR. The expression of hsa-miR-125b-1-3p was significantly downregulated and that of hsa-miR-1290 was significantly upregulated in patients before CR. CONCLUSIONS When performing CR, expression of certain circulating miRNAs in patients with HF is restored to nonpathological levels. The benefits of CR for HF may result from regulation of miRNAs through multiple effects of gene expression.
Collapse
Affiliation(s)
- Ryo Yamada
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Satoshi Okumura
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Yuji Kono
- Department of Rehabilitation, Fujita Health University Bantane
Hospital, Nagoya, Aichi, Japan
| | - Akane Miyazaki
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Yudai Niwa
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Takehiro Ito
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Sayano Ueda
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Tomoya Ishiguro
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Masataka Yoshinaga
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Wakaya Fujiwara
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Mutsuharu Hayashi
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Yukio Ozaki
- Department of Cardiology, Fujita Health University, School of
Medicine, Toyoake, Aichi, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, Fujita Health University, School of
Medicine, Toyoake, Aichi, Japan
| | - Hideo Izawa
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| |
Collapse
|
44
|
Ueda S, Kono Y, Yamada R, Ishiguro T, Yoshinaga M, Okumura S, Fujiwara W, Hayashi M, Aoyagi Y, Saitoh E, Otaka Y, Izawa H. Impact of physical function on indeterminable anaerobic threshold in patients with heart failure. Fujita Med J 2021; 7:65-69. [PMID: 35111547 PMCID: PMC8749534 DOI: 10.20407/fmj.2020-015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/01/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Anaerobic threshold (AT) during cardiopulmonary exercise testing (CPET) is not always determinable in patients with heart failure (HF). However, little is known about the clinical features of patients with HF who have indeterminable AT. Therefore, the present study aimed to clarify the clinical features of such patients. METHODS A total of 70 patients with HF (58 males; age: 68±12 years) who underwent CPET during hospitalization were divided into two groups: determinable AT (n=50) and indeterminable AT (n=20). Physical function, echocardiographic results, and laboratory findings were subsequently determined. RESULTS Univariate analyses showed that the indeterminable AT group had significantly higher age and left ventricular ejection fraction, and significantly lower body mass index, calf circumference, handgrip strength, walking speed, serum hemoglobin, and serum albumin than the determinable AT group. Multiple logistic regression analysis identified handgrip strength and walking speed as independent predictive factors for indeterminable AT. Receiver-operating characteristic analyses revealed that handgrip strength of 21.2 kg and walking speed of 0.97 m/s were optimal cutoff values for differentiating patients who were likely to experience indeterminable AT. CONCLUSIONS The present study identified handgrip strength and walking speed as powerful predictors for indeterminable AT with HF.
Collapse
Affiliation(s)
- Sayano Ueda
- Department of Cardiology, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Yuji Kono
- Department of Rehabilitation, Fujita Health University Hospital,
Toyoake, Aichi, Japan
| | - Ryo Yamada
- Department of Cardiology, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Tomoya Ishiguro
- Department of Cardiology, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Masataka Yoshinaga
- Department of Cardiology, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Satoshi Okumura
- Department of Cardiology, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Wakaya Fujiwara
- Department of Cardiology, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Mutsuharu Hayashi
- Department of Cardiology, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Yoichiro Aoyagi
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Hideo Izawa
- Department of Cardiology, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| |
Collapse
|
45
|
Maeda A, Suzuki M, Teranishi T, Ito M, Hokimoto N, Fujimura K, Ota H, Saitoh E. Do therapists with fewer years of clinical experience encounter more accidents? The relationship between number of years of clinical experience and number of accidents in a year. Fujita Med J 2021; 7:8-11. [PMID: 35111537 PMCID: PMC8749488 DOI: 10.20407/fmj.2019-015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 03/04/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study sought to determine whether therapists experience more accidents annually with increased clinical experience, and whether experiencing an accident in the first year of practice is associated with accidents in the second year of practice. METHODS We categorized 642 therapists into five groups based on years of clinical experience (first, second, third, fourth, and 5-20 years; n=138, 112, 117, 58, and 217, respectively) and tallied the accidents they reported over an 8-year period. The difference between the five groups in the number of accidents per person per year was subjected to multiple comparisons testing using Kruskal-Wallis tests. RESULTS Significant differences were revealed between the first year group and the 5-20 years group (p<0.01), between the second year group and the 5-20 years group (p<0.05), and between the third year group and the 5-20 years group (p<0.05). Specifically, participants in the 5-20 years group encountered fewer accidents than those in the other groups. Therapists who encountered an accident in their first year, compared with those who had not, had significantly more accidents in their second year. CONCLUSIONS Therapists with 1-3 years of clinical experience are more likely to encounter an accident than therapists with >5 years of clinical experience. We conclude that young therapists who have experienced accidents are prone to future accidents. These findings inform the optimal allocation of educational resources to reduce the number of accidents encountered by therapists.
Collapse
Affiliation(s)
- Akiko Maeda
- Faculty of Rehabilitation, Fujita Health University, School of Health
Sciences, Toyoake, Aichi, Japan
| | - Megumi Suzuki
- Faculty of Rehabilitation, Fujita Health University, School of Health
Sciences, Toyoake, Aichi, Japan
| | - Toshio Teranishi
- Faculty of Rehabilitation, Fujita Health University, School of Health
Sciences, Toyoake, Aichi, Japan
| | - Mihoko Ito
- Faculty of Rehabilitation, Fujita Health University, School of Health
Sciences, Toyoake, Aichi, Japan
| | - Nozomi Hokimoto
- Faculty of Rehabilitation, Fujita Health University, School of Health
Sciences, Toyoake, Aichi, Japan
| | - Kenta Fujimura
- Faculty of Rehabilitation, Fujita Health University, School of Health
Sciences, Toyoake, Aichi, Japan
| | - Hirofumi Ota
- Faculty of Rehabilitation, Fujita Health University, School of Health
Sciences, Toyoake, Aichi, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, Fujita Health University, School of
Medicine, Toyoake, Aichi, Japan
| |
Collapse
|
46
|
Mukaino M, Tatemoto T, Kumazawa N, Tanabe S, Katoh M, Saitoh E, Otaka Y. An Affordable, User-friendly Telerehabilitation System Assembled Using Existing Technologies for Individuals Isolated With COVID-19: Development and Feasibility Study. JMIR Rehabil Assist Technol 2020; 7:e24960. [PMID: 33279877 PMCID: PMC7732353 DOI: 10.2196/24960] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/17/2020] [Accepted: 12/05/2020] [Indexed: 12/14/2022] Open
Abstract
Background Isolation due to a COVID-19 infection can limit activities and cause physical and mental decline, especially in older adults and people with disabilities. However, due to limited contact, adequate rehabilitation is difficult to provide for quarantined patients. Telerehabilitation technology could be a solution; however, issues specific to COVID-19 should be taken into consideration, such as strict quarantine and respiratory symptoms, as well as accessibility to deal with rapid increases in need due to the pandemic. Objective This study aims to develop and to investigate the feasibility of a telerehabilitation system for patients who are quarantined due to COVID-19 by combining existing commercial devices and computer applications. Methods A multidisciplinary team has identified the requirements for a telerehabilitation system for COVID-19 and developed the system to satisfy those requirements. In the subsequent feasibility study, patients diagnosed with COVID-19 (N=10; mean age 60 years, SD 18 years) were included. A single session of telerehabilitation consisted of stretching exercises, a 15-minute exercise program, and a video exercise program conducted under real-time guidance by a physical therapist through a video call. The system included a tablet computer, a pulse oximeter, videoconferencing software, and remote control software. The feasibility of the system was evaluated using the Telemedicine Satisfaction Questionnaire (TSQ; 14 items) and an additional questionnaire on the telerehabilitation system (5 items). Each item was rated from “1 = strongly disagree” to “5 = strongly agree.” Results The telerehabilitation system was developed by combining existing devices and applications, including a pulse oximeter and remote control mechanism, to achieve user-friendliness, affordability, and safety, which were determined as the system requirements. In the feasibility study, 9 out of 10 patients were able to use the telerehabilitation system without any on-site help. On the TSQ, the mean score for each item was 4.7 (SD 0.7), and in the additional items regarding telerehabilitation, the mean score for each item was 4.3 (SD 1.0). Conclusions These findings support the feasibility of this simple telerehabilitation system in quarantined patients with COVID-19, encouraging further investigation on the merit of the system’s use in clinical practice.
Collapse
Affiliation(s)
- Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Tsuyoshi Tatemoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Nobuhiro Kumazawa
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Shigeo Tanabe
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Masaki Katoh
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| |
Collapse
|
47
|
Post MW, Reinhardt JD, Avellanet M, Escorpizo R, Engkasan JP, Schwegler U, Leiulfsrud AS, Engkasan JP, Middleton JW, Stucki G, Brach M, Bickenbach J, Fekete C, Thyrian C, Battistella L, Li J, Perrouin-Verbe B, Gutenbrunner C, Rapidi CA, Wahyuni LK, Zampolini M, Saitoh E, Lee BS, Juocevicius A, Hasnan N, Hajjioui A, Post MW, Stanghelle JK, Tederko P, Popa D, Joseph C, Avellanet M, Baumberger M, Kovindha A, Escorpizo R. Employment Among People With Spinal Cord Injury in 22 Countries Across the World: Results From the International Spinal Cord Injury Community Survey. Arch Phys Med Rehabil 2020; 101:2157-2166. [DOI: 10.1016/j.apmr.2020.05.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 05/14/2020] [Accepted: 05/28/2020] [Indexed: 10/23/2022]
|
48
|
Koyama S, Tanabe S, Otaka Y, Kato T, Furuzawa S, Tatemoto T, Kumazawa N, Yoshimuta H, Torii K, Tsukada S, Saitoh E. Novel lateral transfer assist robot decreases the difficulty of transfer in post-stroke hemiparesis patients: a pilot study. Disabil Rehabil Assist Technol 2020; 17:828-832. [PMID: 32927997 DOI: 10.1080/17483107.2020.1818136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of this study was to clarify whether the novel lateral transfer assist robot facilitates easier transfers compared with a wheelchair in post-stroke hemiparesis patients. METHODS This cross-sectional study enrolled 20 post-stroke hemiparesis patients, and the task difficulty of transfers was compared between a wheelchair and lateral transfer assist robot. All participants were asked to transfer from either wheelchair or lateral transfer assist robot to a platform table and back. The primary outcome was the transfer score of the Functional Independence Measure. The secondary outcome was the time required for transfer. RESULTS The transfer score of the Functional Independence Measure was significantly higher with lateral transfer assist robot than with wheelchair (p < .001). The transfer times from these devices to a platform table and back showed no significant differences (to device from platform table: 7.8 s, lateral transfer assist robot vs 7.6 s, wheelchair, p > .05: device to platform table: 7.1 s, lateral transfer assist robot vs 8.0 s, wheelchair, p > .05). CONCLUSIONS Transfer with a lateral transfer assist robot is easier than with wheelchair and facilitates independence in post-stroke hemiparesis patients.IMPLICATIONS FOR REHABILITATIONTransfer skill influences the functional independence and quality of life of a wheelchair userA novel structural mobility device-the lateral transfer assist robot (LTAR)-can facilitate transfersThe LTAR could improve the degree of independence for transfers than the wheelchair, without any time loss, in post-stroke hemiparesis patientsThe LTAR could potentially reduce the risk for falls in various medical and care facilities.
Collapse
Affiliation(s)
- Soichiro Koyama
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Shigeo Tanabe
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Tomoya Kato
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Shotaro Furuzawa
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Tsuyoshi Tatemoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Nobuhiro Kumazawa
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | | | | | - Shingo Tsukada
- NTT Basic Research Laboratories, NTT Corporation, Atsugi, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| |
Collapse
|
49
|
Wang Y, Mukaino M, Hirano S, Tanikawa H, Yamada J, Ohtsuka K, Ii T, Saitoh E, Otaka Y. Persistent Effect of Gait Exercise Assist Robot Training on Gait Ability and Lower Limb Function of Patients With Subacute Stroke: A Matched Case-Control Study With Three-Dimensional Gait Analysis. Front Neurorobot 2020; 14:42. [PMID: 32848691 PMCID: PMC7396555 DOI: 10.3389/fnbot.2020.00042] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 05/27/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Gait exercise assist robot (GEAR), a gait rehabilitation robot developed for poststroke gait disorder, has been shown to improve walking speed and to improve the poststroke gait pattern. However, the persistence of its beneficial effect has not been clarified. In this matched case–control study, we assessed the durability of the effectiveness of GEAR training in patients with subacute stroke on the basis of clinical evaluation and three-dimensional (3D) gait analysis. Methods Gait data of 10 patients who underwent GEAR intervention program and 10 patients matched for age, height, sex, affected side, type of stroke, and initial gait ability who underwent conventional therapy were extracted from database. The outcome measures were walk score of Functional Independence Measure (FIM-walk), Stroke Impairment Assessment Set total lower limb motor function score (SIAS-L/E), and 3D gait analysis data (spatiotemporal factors and abnormal gait patter indices) at three time points: baseline, at the end of intervention, and within 1 week before discharge. Results In the GEAR group, the FIM-walk score, SIAS-L/E score, cadence, and single stance time of paretic side at discharge were significantly higher than those at post-training (p < 0.05), whereas the stance time and double support time of the unaffected side, knee extensor thrust, insufficient knee flexion, and external rotated hip of the affected side were significantly lower (p < 005). However, no significant differences in these respects were observed in the control group between the corresponding evaluation time points. Conclusion The results indicated significant improvement in the GEAR group after the training period, with respect to both clinical parameters and the gait pattern indices. This improvement was not evident in the control group after the training period. The results possibly support the effectiveness of GEAR training in conferring persistently efficient gait patterns in patients with poststroke gait disorder. Further studies should investigate the long-term effects of GEAR training in a larger sample.
Collapse
Affiliation(s)
- Yiji Wang
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan.,Department of Spinal Cord Injury Rehabilitation, China Rehabilitation Research Center, Capital Medical University, Beijing, China.,School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Satoshi Hirano
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Hiroki Tanikawa
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Junya Yamada
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Kei Ohtsuka
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Takuma Ii
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| |
Collapse
|
50
|
Ito Y, Inamoto Y, Saitoh E, Aihara K, Shibata S, Aoyagi Y, Kagaya H, Palmer JB, Gonzalez-Fernandez M. The effect of bolus consistency on pharyngeal volume during swallowing: Kinematic analysis in three dimensions using dynamic Area Detector CT. J Oral Rehabil 2020; 47:1287-1296. [PMID: 32738063 DOI: 10.1111/joor.13062] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 07/10/2020] [Accepted: 07/16/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study investigated the effects of bolus consistency on pharyngeal volume during swallowing using three-dimensional kinematic analysis. METHODS Eight subjects (2 males and 6 females, mean ± SD 44 ± 10 years old) underwent a 320-row area detector scan during swallows of 10 mL of honey-thick liquid and thin liquid. Critical event timing (hyoid, soft palate, UES) and volume of pharyngeal cavity and bolus were measured and compared between two swallows. RESULTS The pharynx is almost completely obliterated by pharyngeal constriction against the tongue base for both consistencies. There were no significant differences in maximum volume, minimum volume and pharyngeal volume constriction ratio values between thick and thin liquids. However, the pattern of pharyngeal volume change (decrease) was different. For thick liquids, the air volume started to decrease before the onset of hyoid anterosuperior movement and decreased rapidly after onset of hyoid anterosuperior movement. During thin liquid swallowing, air volume remained relatively large throughout the swallow and started to decrease later when compared to swallowing thick liquids. At onset of UES opening, the bolus volume was not significantly different between thin and thick liquids; however, air volume was significantly larger when swallowing thin liquids, which made the total volume of the pharyngeal cavity larger. CONCLUSION This difference between the two consistencies is associated with differences in tongue motion to propel the bolus and clear the pharynx from possible residue.
Collapse
Affiliation(s)
- Yuriko Ito
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yoko Inamoto
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Keiko Aihara
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yoichiro Aoyagi
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Jeffrey B Palmer
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, USA
| | | |
Collapse
|