Japanese journal of comprehensive rehabilitation science最新文献

{"title":"Relationship Between the Revised Version of the Ability for Basic Movement Scale and Motor Functional Independence Measure Scores and Gain.","authors":"Kota Takahashi, Shinya Hori, Akira Wada, Shoji Takahashi","doi":"10.11336/jjcrs.17.53","DOIUrl":"10.11336/jjcrs.17.53","url":null,"abstract":"<p><p>Takahashi K, Hori S, Wada A, Takahashi S. Relationship Between the Revised Version of the Ability for Basic Movement Scale and Motor Functional Independence Measure Scores and Gain. Jpn J Compr Rehabil Sci 2026; 17: 53-58.</p><p><strong>Objective: </strong>This study analyzed the relationship between the Revised Version of the Ability for Basic Movement Scale (ABMS II) and the motor Functional Independence Measure (FIM) total score, as well as between ABMS II and motor FIM gain.</p><p><strong>Methods: </strong>In total, 373 patients were admitted to a convalescent rehabilitation ward in Japan. The relationships between admission ABMS II and admission motor FIM, discharge motor FIM, and motor FIM gain (discharge - admission) were examined. Spearman's rank correlation coefficient was used.</p><p><strong>Results: </strong>Admission ABMS II positively correlated with admission motor FIM (rs = 0.75) and discharge motor FIM (rs = 0.69). Admission ABMS II showed a weak negative correlation with motor FIM gain (rs = -0.20), whereas patients with moderate ABMS II scores tended to have higher motor FIM gain.</p><p><strong>Conclusion: </strong>The relationship of admission ABMS II with motor FIM total score was linear, whereas that with motor FIM gain was nonlinear. This pattern may be explained by the limited improvement in FIM scores among patients with low ABMS II scores and the ceiling effect among those with mild ABMS II scores. Patients with moderate ABMS II scores at admission showed higher motor FIM gain. ABMS II may provide a useful clinical indicator for interpreting both the motor FIM total score and motor FIM gain.</p>","PeriodicalId":101309,"journal":{"name":"Japanese journal of comprehensive rehabilitation science","volume":"17 ","pages":"53-58"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between activities of daily living and the introduction of home-visit medical care in patients with stroke discharged from a convalescent rehabilitation ward.","authors":"Tetsuya Takaoka, Fumihito Kasai, Tetsuo Ikai","doi":"10.11336/jjcrs.17.33","DOIUrl":"10.11336/jjcrs.17.33","url":null,"abstract":"<p><p>Takaoka T, Kasai F, Ikai T. Association between activities of daily living and the introduction of home-visit medical care in patients with stroke discharged from a convalescent rehabilitation ward. Jpn J Compr Rehabil Sci 2026; 17: 33-39.</p><p><strong>Objectives: </strong>The Japanese government has implemented a community-based integrated care system, under which some patients with stroke receive home-visit medical care. This study aimed to determine the proportion of patients with stroke discharged from a convalescent rehabilitation ward who received home-visit medical care, and to identify the factors influencing its introduction.</p><p><strong>Methods: </strong>We analyzed 129 patients with stroke (cerebral infarction, n = 83; cerebral hemorrhage, n = 40; subarachnoid hemorrhage, n = 6) discharged from our convalescent rehabilitation ward in 2023. Patients were classified into a home-visit medical care group or an outpatient care group. Data collected included age, sex, hospitalization duration, functional independence measure (FIM) scores at admission and discharge, and the number of family members. Multivariate logistic regression analysis identified independent factors associated with the introduction of home-visit medical care.</p><p><strong>Results: </strong>The home-visit medical care introduction rate was 10.9%. Patients in this group were older and had longer hospital stays. Multivariate logistic regression analysis identified FIM motor scores (FIM-M) at discharge (odds ratio [OR] = 0.933, p = 0.027) and age (OR = 1.095, p = 0.011) as independent factors. Among patients with high FIM-M scores, those of older age and with lower FIM cognitive scores (FIM-C) were more likely to receive home-visit medical care.</p><p><strong>Conclusions: </strong>Older patients with lower FIM-M scores at discharge were more likely to receive home-visit medical care. Additionally, even among those with a high FIM-M score, older age and lower FIM-C scores increased this likelihood. Early discharge planning that includes information on home-visit medical care may facilitate transitions to home care.</p>","PeriodicalId":101309,"journal":{"name":"Japanese journal of comprehensive rehabilitation science","volume":"17 ","pages":"33-39"},"PeriodicalIF":0.0,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Motor FIM at Discharge for Recovery Stroke Patients in a Rehabilitation Ward Using an AI Predictive Analysis Tool.","authors":"Kazuyuki Morita, Senshu Abe, Keisuke Ono, Ryosuke Takahashi, Yosuke Ara, Masayuki Abe, Tomohide Shirasaka","doi":"10.11336/jjcrs.17.40","DOIUrl":"10.11336/jjcrs.17.40","url":null,"abstract":"<p><p>Morita K, Abe S, Ono K, Takahashi R, Ara Y, Abe M, Shirasaka T. Predicting Motor FIM at Discharge for Recovery Stroke Patients in a Rehabilitation Ward Using an AI Predictive Analysis Tool. Jpn J Compr Rehabil Sci 2026; 17: 40-45.</p><p><strong>Objective: </strong>This study aimed to create a prediction model for motor Functional Independence Measure (FIM) at discharge using an artificial intelligence (AI) predictive analysis tool (Prediction One, Sony Network Communications Inc.) and to clarify its accuracy.</p><p><strong>Methods: </strong>This study included 457 stroke patients discharged between April 2020 and March 2022 as the training dataset, and 43 stroke patients discharged between April and October 2022 as the validation dataset. First, an AI prediction model was developed using the training dataset. Next, the prediction accuracy was evaluated using the validation dataset. As part of the accuracy validation, the residuals between the actual motor FIM at discharge and the predicted values of the AI and therapists, as well as the correlation coefficients and coefficients of determination for each prediction result were calculated and statistically compared.</p><p><strong>Results: </strong>The coefficient of determination for the prediction model was 0.799. The residuals from the actual values were 5.43 ± 5.93 points for AI predictions and 6.42 ± 5.52 points for therapist predictions. The correlation coefficients and R² values for the prediction results were 0.939 and 0.881 for AI predictions, and 0.943 and 0.889 for therapist predictions, respectively. No significant difference was observed between the two correlation coefficients (z = -0.295, p = 0.768). The residual distributions indicated that the therapist predictions tended to overestimate the actual values.</p><p><strong>Conclusion: </strong>The model developed in this study demonstrated an accuracy no less than that reported in previous studies. Furthermore, it achieved a predictive performance comparable to that of the therapists. This model could potentially predict motor FIM at discharge with consistent accuracy, regardless of the years of experience. In the future, we plan to expand the range of target conditions and assess their external validity.</p>","PeriodicalId":101309,"journal":{"name":"Japanese journal of comprehensive rehabilitation science","volume":"17 ","pages":"40-45"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction Models for Gait Independence in Patients with Post-Stroke Hemiplegia in a Convalescent Rehabilitation Ward: Comparison of Predictive Performance Between Different Trunk Function Assessments.","authors":"Masakazu Murakami, Ryo Sato, Keita Ogasawara, Yuto Kimura","doi":"10.11336/jjcrs.17.24","DOIUrl":"10.11336/jjcrs.17.24","url":null,"abstract":"<p><p>Murakami M, Sato R, Ogasawara K, Kimura Y. Prediction Models for Gait Independence in Patients with Post-Stroke Hemiplegia in a Convalescent Rehabilitation Ward: Comparison of Predictive Performance Between Different Trunk Function Assessments. Jpn J Compr Rehabil Sci 2026; 17: 24-32.</p><p><strong>Objective: </strong>This study aimed to compare the predictive performance for walking independence at discharge using two trunk function assessments: the Functional Assessment for Control of Trunk (FACT) and the Trunk Control Test (TCT), alongside activities of daily living (ADL) ability and physical function at admission, in patients with post-stroke hemiplegia admitted to a convalescent rehabilitation ward.</p><p><strong>Methods: </strong>A cohort of 196 patients with post-stroke hemiplegia admitted to a convalescent rehabilitation ward between October 2020 and March 2024 was retrospectively analyzed. Patients achieving a walking score of 6 or higher on the Functional Independence Measure (FIM) at discharge were classified as the walking-independent group. Independent variables included motor FIM (m-FIM), cognitive FIM (c-FIM), paretic lower-extremity function on the Stroke Impairment Assessment Set (SIAS), Ueda's 12-Grade Hemiplegic Function Test, non-paretic-side SIAS function, age, sex, and either FACT or TCT. Decision-tree analysis served as the primary analytical method, with logistic regression and receiver operating characteristic (ROC) curve analyses conducted as supplementary approaches to examine discriminative performance.</p><p><strong>Results: </strong>The cohort included 102 men and 94 women, with a mean age of 77.7 ± 11.2 years. The walking-independent group comprised 47 patients (24.0%). Decision-tree analyses indicated that both the FACT and TCT models identified m-FIM and non-paretic-side SIAS function as predictive factors. Additionally, FACT and TCT were each selected as predictive factors in their respective models. ROC analysis demonstrated high discriminative ability for both models (FACT model: area under the curve [AUC] = 0.968; TCT model: AUC = 0.971).</p><p><strong>Conclusion: </strong>Both models utilizing FACT or TCT as trunk function assessments demonstrated high predictive accuracy, suggesting their potential utility for prognostic prediction in clinical practice.</p>","PeriodicalId":101309,"journal":{"name":"Japanese journal of comprehensive rehabilitation science","volume":"17 ","pages":"24-32"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Platypnea-Orthodeoxia Syndrome Following COVID-19 Pneumonia Treated in a Convalescent Rehabilitation Ward.","authors":"Rei Kaizu, Hajime Maruyama, Naofumi Tanaka, Hidetoshi Takahashi, Hiroshi Kigawa","doi":"10.11336/jjcrs.17.46","DOIUrl":"10.11336/jjcrs.17.46","url":null,"abstract":"<p><p>Kaizu R, Maruyama H, Tanaka N, Takahashi H, Kigawa H. A Case of Platypnea-Orthodeoxia Syndrome Following COVID-19 Pneumonia Treated in a Convalescent Rehabilitation Ward. Jpn J Compr Rehabil Sci 2026; 17: 46-52. Platypnea-orthodeoxia syndrome (POS), characterized by worsening hypoxemia associated with postural changes, has been reported as a complication following pneumonia due to coronavirus disease 2019 (COVID-19). In most cases, POS improves during the acute phase. We report a case in which POS was diagnosed in a convalescent rehabilitation ward, with symptoms persisting for more than 100 days, ultimately enabling discharge to home. The patient was a 76-year-old man who, despite receiving acute-phase treatment for COVID-19 pneumonia, continued to exhibit marked oxygen desaturation and dyspnea in the sitting and standing positions, resulting in difficulty with mobilization. Following admission to the convalescent rehabilitation ward, decreases in SpO₂ and arterial partial pressure of oxygen associated with postural changes were confirmed, leading to a diagnosis of POS. Rehabilitation therapy was administered in short, high-frequency sessions, focusing on low-load sitting training and instruction on breathing techniques, while adjusting oxygen supplementation to facilitate mobilization. In addition, activities of daily living (ADL) training were initiated with early consideration of home oxygen therapy. As a result, sitting tolerance and ADL improved, and the patient was successfully discharged home with home oxygen therapy. POS may persist even in patients admitted to a convalescent rehabilitation ward. Even in cases where oxygen desaturation occurs with postural changes, appropriate adjustment of oxygen supplementation combined with short-duration, high-frequency mobilization may contribute to improvements in ADL and facilitate discharge to home.</p>","PeriodicalId":101309,"journal":{"name":"Japanese journal of comprehensive rehabilitation science","volume":"17 ","pages":"46-52"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148458317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of updating discharge FIM prediction at one month after admission using multiple regression analysis.","authors":"Makoto Tokunaga, Katsuhiko Sannomiya, Yoshihiko Imada","doi":"10.11336/jjcrs.17.16","DOIUrl":"10.11336/jjcrs.17.16","url":null,"abstract":"<p><p>Tokunaga M, Sannomiya K, Imada Y. Significance of updating discharge FIM prediction at one month after admission using multiple regression analysis. Jpn J Compr Rehabil Sci 2026; 17: 16-23.</p><p><strong>Objective: </strong>To clarify the significance of updating predictions at one month after admission in multiple regression analyses that predict the motor component of the Functional Independence Measure (mFIM) at discharge in stroke patients.</p><p><strong>Methods: </strong>A total of 849 stroke patients admitted to a convalescent rehabilitation ward were included. The dependent variables were discharge mFIM (S prediction) and mFIM effectiveness (E prediction). Independent variables consisted of either admission data alone or admission data plus mFIM improvement during the first month after admission (plus prediction). Four models were constructed: S prediction, S plus prediction, E prediction, and E plus prediction. Absolute residuals were compared among the four groups using the Kruskal-Wallis test. When significant differences were observed, multiple comparisons were performed using the Steel-Dwass test.</p><p><strong>Results: </strong>The absolute residuals were 9.3 ± 7.2 for S prediction, 6.8 ± 5.3 for S plus prediction, 7.6 ± 7.0 for E prediction, and 6.3 ± 5.7 for E plus prediction. Significant differences were observed among the four models. Multiple comparisons revealed that S plus prediction had significantly smaller residuals than S prediction; E plus prediction was smaller than E prediction; E prediction was smaller than S prediction; and E plus prediction was smaller than S plus prediction.</p><p><strong>Conclusion: </strong>Predicting mFIM effectiveness and converting it to discharge mFIM yielded more accurate predictions than directly predicting discharge mFIM. Updating predictions at one month after admission further improved the accuracy of discharge mFIM prediction.</p>","PeriodicalId":101309,"journal":{"name":"Japanese journal of comprehensive rehabilitation science","volume":"17 ","pages":"16-23"},"PeriodicalIF":0.0,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13271879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of long-term comprehensive rehabilitation culminated in weaning from a ventilator and regaining oral intake for a patient who underwent tracheostomy, mechanical ventilation, and alternative nutritional management because of type II respiratory failure after ascending aortic artificial vascular replacement.","authors":"Tomoya Mizumoto, Kohki Matsubara, Yukie Kambayashi, Tomoyuki Nomura, Akina Fukushima, Yoshino Ueki, Naotaka Aida","doi":"10.11336/jjcrs.17.8","DOIUrl":"10.11336/jjcrs.17.8","url":null,"abstract":"<p><p>Mizumoto T, Matsubara K, Kambayashi Y, Nomura T, Fukushima A, Ueki Y, Aida N. A case of long-term comprehensive rehabilitation culminated in weaning from a ventilator and regaining oral intake for a patient who underwent tracheostomy, mechanical ventilation, and alternative nutritional management because of type II respiratory failure after ascending aortic artificial vascular replacement. Jpn J Compr Rehabil Sci 2026; 17: 8-15. Long-term mechanical ventilation and alternative nutritional management make it difficult to wean patients from the ventilator and to regain oral intake. Furthermore, persistent functional dysfunction also makes it difficult to maintain motivation for rehabilitation training and markedly reduces quality of life (QOL). In this report, we describe a case in which comprehensive rehabilitation achieved favorable results in a patient who underwent long-term mechanical ventilation and alternative nutritional management. The patient was a woman in her eighties. In February of year X, she developed type II respiratory failure due to phrenic nerve injury after artificial vascular replacement of the ascending aorta. She subsequently underwent tracheostomy, mechanical ventilation, and alternative nutritional management for six months. She was transferred to our hospital in August of year X. At the time of intervention, respiratory and swallowing dysfunction and general muscle weakness were observed. She wished to attend her grandchild's wedding scheduled for the following year and began training with the long-term goal of attending the wedding. Multidisciplinary rehabilitation programs incorporating swallowing, respiratory and phonation training, and whole-body exercise were carried out in stages in collaboration with multiple professionals. After approximately one year of training, she achieved weaning from both mechanical ventilation and alternative nutritional management, regained independent ambulation and oral intake of three meals per day, and successfully attended the wedding. This case demonstrates that even in patients with long-term respiratory and swallowing dysfunction, clear goal setting and stepwise comprehensive rehabilitation can lead to meaningful functional recovery and improvements in QOL.</p>","PeriodicalId":101309,"journal":{"name":"Japanese journal of comprehensive rehabilitation science","volume":"17 ","pages":"8-15"},"PeriodicalIF":0.0,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of pharmacist intervention on FIM gain in patients with musculoskeletal disorders in Kaifukuki rehabilitation wards.","authors":"Hisato Fujihara, Makoto Kishimoto, Eiji Kose, Hiroshi Shinonaga, Eriko Tanaka, Mariko Nakamichi, Fumihiro Mizokami","doi":"10.11336/jjcrs.16.53","DOIUrl":"10.11336/jjcrs.16.53","url":null,"abstract":"<p><p>Fujihara H, Kishimoto M, Kose E, Shinonaga H, Tanaka E, Nakamichi M, Mizokami F. The impact of pharmacist intervention on FIM gain in patients with musculoskeletal disorders in Kaifukuki rehabilitation wards. Jpn J Compr Rehabil Sci 2025; 16: 53-59.</p><p><strong>Objective: </strong>Currently, in Kaifukuki (convalescent) rehabilitation wards, pharmacists' services are not reimbursed under the medical fee system, which has hindered the placement of pharmacists in wards and made it difficult to fully clarify their usefulness. In this study, we classified patients with musculoskeletal disorders into groups that received active pharmacist intervention and those that did not, and evaluated the effect of pharmacist intervention on changes in ADL.</p><p><strong>Method: </strong>This was a multicenter retrospective cohort study targeting Kaifukuki rehabilitation wards. Participating hospitals were recruited through the website of the Japanese Society of Hospital Pharmacists. The study included patients with musculoskeletal disorders who were discharged from each participating hospital between October 1 and October 31, 2022. The primary outcome measure was FIM gain, which was compared between the active and non-intensive intervention groups.</p><p><strong>Results: </strong>Responses were received from 140 hospitals, and information was collected from 1,265 patients. After adjusting for propensity scores, 742 patients (371 in the active intervention group and 371 in the non-intensive intervention group) were included in the analysis. When comparing the FIM gains between the two groups, the active intervention group showed significantly higher values than the non-intensive intervention group.</p><p><strong>Discussion: </strong>Pharmacist intervention in patients with musculoskeletal disorders admitted to rehabilitation wards was significantly associated with improvements in ADL. Pharmacists working in Kaifukuki rehabilitation wards should actively participate in ward activities and contribute to the appropriate use of medications for hospitalized patients, including deprescribing.</p>","PeriodicalId":101309,"journal":{"name":"Japanese journal of comprehensive rehabilitation science","volume":"16 ","pages":"53-59"},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12712467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of the Presence of Registered Dietitians and Dental Hygienists on the Body Weight and Activities of Daily Living of Elderly Patients with Low BMI in a Kaifukuki (Convalescent) Rehabilitation Ward.","authors":"Yasuyuki Okamoto, Shinta Nishioka, Takatsugu Okamoto, Ichiro Miyai","doi":"10.11336/jjcrs.16.46","DOIUrl":"10.11336/jjcrs.16.46","url":null,"abstract":"<p><p>Okamoto Y, Nishioka S, Okamoto T, Miyai I. Effect of the Presence of Registered Dietitians and Dental Hygienists on the Body Weight and Activities of Daily Living of Elderly Patients with Low BMI in a Kaifukuki (Convalescent) Rehabilitation Ward. Jpn J Compr Rehabil Sci 2025; 16: 46-52.</p><p><strong>Objective: </strong>This study aimed to examine the association between the presence of registered dietitians (RD) and dental hygienists (DH) and the changes in the activities of daily living and body weight in elderly patients with a low body mass index (BMI) who were admitted to a Kaifukuki (convalescent) rehabilitation ward (KRW) class 1.</p><p><strong>Methods: </strong>Patients aged 70 years or older with a BMI of less than 20.0 kg/m², who were admitted to hospitals with a KRW class 1 as per the 2022 survey data from the Japanese Association of Rehabilitation in Post-acute Care, were included in the study. The patients were divided into two groups based on the presence of DH: the RD+DH+ group and the RD+DH- group. The Functional Independence Measure (FIM) gain, change in BMI, and percentage of patients with improved BMI (an increase of ≥0.7 kg/m²) were compared using univariate and multivariate analyses.</p><p><strong>Results: </strong>A total of 3,329 patients (61.8% female, mean age of 83.3 years) were analyzed. The RD+DH+ group consisted of 431 patients, and the RD+DH- group consisted of 2,834 patients. No significant difference in FIM gain was found between the two groups. However, the RD+DH+ group showed significantly greater change in BMI and a higher percentage of patients with improved BMI than the RD+DH- group. Furthermore, the change in BMI and the percentage of BMI improvement were associated with the presence of RD and DH.</p><p><strong>Conclusion: </strong>The findings of this study suggest that the presence of RD and DH in a KRW may improve the BMI of elderly patients.</p>","PeriodicalId":101309,"journal":{"name":"Japanese journal of comprehensive rehabilitation science","volume":"16 ","pages":"46-52"},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12712466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two cases of hemiplegia at 5 years post-stroke onset showing changes in corticospinal and cortico-reticular pathways after 1 month of intensive rehabilitation including repetitive facilitative exercise.","authors":"Toshiro Kisa, Michio Kato, Yasuo Sakai, Taikou Maguchi, Makiko Uchida, Kumiko Kawasumi, Hirotaka Ishihara, Makoto Ohta","doi":"10.11336/jjcrs.16.60","DOIUrl":"10.11336/jjcrs.16.60","url":null,"abstract":"<p><p>Kisa T, Kato M, Sakai Y, Maguchi T, Uchida M, Kawasumi K, Ishihara H, Ohta M. Two cases of hemiplegia at 5 years post-stroke onset showing changes in corticospinal and cortico-reticular pathways after 1 month of intensive rehabilitation including repetitive facilitative exercise. Jpn J Compr Rehabil Sci 2025; 16: 60-67. Case reports have described the findings of diffusion tensor tractography (DTT) during the recovery phase of stroke hemiplegia but not during the chronic phase. We report here the cases of two patients with hemiplegia due to stroke, at 5 years post-onset, who underwent 1 month of intensive rehabilitation therapy including repetitive facilitative exercises and a phenol block, whose spasticity and paralysis improved. In both cases, significant changes were observed post-versus pre-DTT; the corticospinal tract (CST) was not visualized on the lesion side before treatment, but was visualized originating in M1 and extending downward after treatment. In the first case, over 5 years, transcallosal fibers (TCF) and transpontine fibers (TPF) extended from the contralateral side to the affected hemisphere, and the cortico-reticular pathway (CRP) of the DP descending motor pathways (DP) increased on both the affected and contralateral sides (particularly the former). However, after treatment, the CRP decreased on both sides. In the second case, the affected and contralateral sides. In the second case, the TCF became denser and the CRP on the contralateral side increased significantly. Previous case reports tracking changes in DTT were all within 1 year of hemiplegia onset. The two cases discussed here were 5 years post-stroke, and intensive rehabilitation not only improved upper limb and hand motor function in a short period but also produced imaging changes consistent with functional improvements on DTT. This is the first study to track changes in DTT before versus after intensive rehabilitation in old cases of stroke-induced hemiplegia. Most of the changes, such as the emergence of new CST patterns, increased CRP, and appearance of the TCF, were consistent with the working hypothesis derived from the accumulation of previous cases within 1 year of onset. However, in one case, the CRP decreased after treatment. This finding represents new insights not included in the working hypothesis and is discussed herein.</p>","PeriodicalId":101309,"journal":{"name":"Japanese journal of comprehensive rehabilitation science","volume":"16 ","pages":"60-67"},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12712465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}