Progress in rehabilitation medicine最新文献

{"title":"Association of Sarcopenia at Admission with Physical Performance at Discharge in Older Patients with Subacute Stroke: A Prospective Cohort Study.","authors":"Yuto Kameyama, Ryota Ashizawa, Hiroya Honda, Koki Take, Kohei Yoshizawa, Ichiro Fujishima, Tomohisa Ohno, Kenjiro Kunieda, Takashi Shigematsu, Shintaro Iio, Yoshinobu Yoshimoto","doi":"10.2490/prm.20260027","DOIUrl":"10.2490/prm.20260027","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated whether sarcopenia at admission is independently associated with physical performance at discharge in older patients with stroke, after adjusting for stroke severity and other clinical variables.</p><p><strong>Methods: </strong>This prospective cohort study included patients with stroke aged 65 years or older admitted to a rehabilitation hospital between November 2021 and August 2024. Sarcopenia was defined by Asian Working Group for Sarcopenia 2019 criteria (handgrip strength and skeletal muscle mass index). Physical performance was assessed using the Short Physical Performance Battery (SPPB) at admission and discharge. Multiple linear regression examined the association between sarcopenia and SPPB scores at discharge, adjusting for age, sex, body mass index, stroke type, premorbid modified Rankin Scale, Charlson Comorbidity Index, Brunnstrom recovery stage, National Institutes of Health Stroke Scale, and SPPB score at admission.</p><p><strong>Results: </strong>Of 198 patients screened, 145 were included in the final analysis (mean age, 76.9 ± 7.1 years; 74 were male), and 85 participants (58.6%) presented with sarcopenia. After adjustment, sarcopenia at admission was independently associated with lower SPPB scores at discharge (β = -0.123; 95% confidence interval: -1.874 to -0.066; P = 0.036). Age, premorbid modified Rankin Scale score, stroke severity, and admission SPPB score were also significant predictors of physical performance at discharge.</p><p><strong>Conclusions: </strong>Sarcopenia is independently associated with poorer physical performance at discharge among older patients with stroke, even after accounting for stroke-related factors. Early identification and management of sarcopenia may allow optimization of rehabilitation outcomes in this demographic, although the clinical significance of this association warrants further investigation.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"11 ","pages":"20260027"},"PeriodicalIF":1.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152423","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":"Impact of Frailty Risk on Adverse Outcomes after Open Heart Valve Surgery in Older Patients: A Retrospective Cohort Study.","authors":"Issei Kameda, Akio Shimizu, Kenta Ushida, Miho Shimizu, Kohei Ochiai, Yuki Kato, Ryo Momosaki","doi":"10.2490/prm.20260024","DOIUrl":"10.2490/prm.20260024","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the impact of preoperative frailty risk, assessed using the Hospital Frailty Risk Score (HFRS), on hospitalization-associated disability (HAD) and in-hospital complications in patients aged 65 years or older who underwent open heart valve surgery.</p><p><strong>Methods: </strong>This retrospective cohort study included patients in the JMDC database aged 65 years or older with valvular heart disease who underwent open heart valve surgery between April 2017 and December 2022. Patients were categorized into low (HFRS <5) and high frailty risk (HFRS ≥5) groups. The primary outcome was the proportion of patients with HAD. The secondary outcomes included the proportion of patients who developed pneumonia, respiratory failure, and delirium during hospitalization. Mediation analysis was performed to examine whether preoperative frailty risk influenced the risk of HAD through postoperative complications.</p><p><strong>Results: </strong>Among 4658 patients (mean age 75.0 ± 5.5 years), 328 (7.0%) were classified as high frailty risk. The high risk group had a significantly higher proportion of HAD than the low risk group [odds ratio (OR), 3.49; 95% confidence interval (CI), 2.60-4.67; P <0.001]. Mediation analysis showed that high frailty risk was independently associated with HAD (direct effect: OR, 2.75; 95% CI, 2.01-3.76; P <0.001). The indirect effect mediated by postoperative complications was significant (OR, 1.26; 95% CI, 1.11-1.43; P <0.05), accounting for 19% of the total effect.</p><p><strong>Conclusions: </strong>The preoperative frailty risk assessed by the HFRS may serve as a useful predictor of HAD and in-hospital complications in older patients undergoing open heart valve surgery.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"11 ","pages":"20260024"},"PeriodicalIF":1.3,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990468","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":"Skeletal Muscle Mass Estimation from Lower Leg Digital Images Using Machine Learning.","authors":"Tomohiko Nagano, Hiroo Matsuse, Yoshio Takano, Ryuki Hashida, Junichi Kawakami, Osamu Taguchi, Kenta Murotani, Shigeaki Matsuo, Koji Hiraoka","doi":"10.2490/prm.20260025","DOIUrl":"10.2490/prm.20260025","url":null,"abstract":"<p><strong>Objectives: </strong>In the current study, a convolutional neural network (CNN) model for estimating the skeletal muscle index (SMI) from lower leg digital images was developed, and its predictive performance was evaluated.</p><p><strong>Methods: </strong>One hundred healthy adults participated in the study; 50 men and 50 women (median age 37.5 years, interquartile range 28-44 years). Digital images of the non-dominant lower leg were obtained from lateral and posterior views. A CNN model was trained to estimate SMI after applying data augmentation and Canny edge detection. Predictive accuracy was evaluated using fivefold cross-validation (80% training, 20% testing).</p><p><strong>Results: </strong>The mean SMI was 7.0 ± 1.1 kg/m². The mean absolute percentage error ranged from 3.70% to 4.15% for lateral images and from 4.23% to 4.85% for posterior images. The respective concordance correlation coefficients ranged from 0.93 to 0.94 and from 0.90 to 0.91, indicating strong agreement with the reference values.</p><p><strong>Conclusions: </strong>The CNN model accurately estimated SMI from lower leg digital images, with prediction errors below 5%. This simple, noninvasive method could serve as a practical tool for screening skeletal muscle mass.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"11 ","pages":"20260025"},"PeriodicalIF":1.3,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990532","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":"Relationship between Corticosteroid Dose and Physical Performance after HSCT: A Prospective Cohort Study.","authors":"Nobuyoshi Nishikado, Tatsushi Wakasugi, Katsuji Kaida, Atsushi Umeji, Koichiro Sota, Daiki Takemura, Naoki Sasanuma, Kyoko Yoshihara, Satoshi Yoshihara, Yuki Uchiyama, Kazuhisa Domen","doi":"10.2490/prm.20260023","DOIUrl":"10.2490/prm.20260023","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to prospectively investigate the factors affecting the diminished ability of patients to stand up following hematopoietic stem cell transplantation (HSCT).</p><p><strong>Methods: </strong>Fifty patients were enrolled in the study. Pre- and post-HSCT physical performance was assessed using the Short Physical Performance Battery (SPPB). Post-HSCT physical performance decline was defined as a decrease of at least 1 point in the SPPB chair rise score at hospital discharge compared with the pre-HSCT score. Factors associated with this decline were analyzed using multiple logistic regression.</p><p><strong>Results: </strong>A functional decline in the ability to stand up post-HSCT was noted. The total corticosteroid dose (odds ratio, 1.03, 95% confidence interval 1.00-1.05) showed an independent association with physical performance decline post-HSCT.</p><p><strong>Conclusions: </strong>The total corticosteroid dose is a valuable predictor of physical performance decline post-HSCT. Therefore, standing up movements should be evaluated cautiously in patients who are expected to receive high corticosteroid doses for the treatment of acute graft-versus-host disease or HSCT regimens.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"11 ","pages":"20260023"},"PeriodicalIF":1.3,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936111","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":"Feasibility and Short-term Functional Outcomes of Early Gait Training within 14 days after Thoracic Myelopathy Surgery: A Retrospective Case Series.","authors":"Ryo Fukata, Takeo Furuya, Mayuko Kuwata, Ryosuke Tadaki, Keita Takase, Shun Ishii, Satoshi Maki, Atsushi Murata, Seiji Ohtori","doi":"10.2490/prm.20260022","DOIUrl":"10.2490/prm.20260022","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined the feasibility, short-term safety, and changes in objective mobility measures associated with initiating gait training between postoperative day (POD) 2 and POD 4 and completing it by POD 14 following surgery for thoracic myelopathy.</p><p><strong>Methods: </strong>This retrospective, single-arm cohort study included 11 patients with thoracic myelopathy and preoperative gait impairments. Individualized gait training combined recumbent cycling and treadmill walking (~40 min/session, 3-5 times/week) at a \"somewhat hard\" intensity on the modified Borg scale (rating: 6). Primary outcomes were walking speed and step length on the 10-m Walk Test. Secondary outcomes included time and step count from the Timed Up-and-Go Test (TUG), the Japan Orthopaedic Association lower-extremity motor function score (JOA-LE), static balance, muscle strength, and sensory function. Assessments were performed preoperatively and on POD 14.</p><p><strong>Results: </strong>Walking speed (median change 0.25 m/s, P = 0.029) and step length (median change 0.05 m, P = 0.009) improved significantly. TUG results also improved for completion time (median change -3.03 s, P = 0.007) and step count (median change -3 steps, P = 0.046). Standing balance improved, with nine patients achieving independence in the Romberg position with eyes closed (P<i> </i>= 0.029). No notable changes were observed in JOA-LE, muscle strength, or sensory function. No adverse events occurred.</p><p><strong>Conclusions: </strong>Early, device-assisted gait training initiated within POD 4 was feasible and safe, and it was associated with short-term improvements in objective mobility measures. Controlled trials are warranted to confirm these findings.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"11 ","pages":"20260022"},"PeriodicalIF":1.3,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870833","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":"Cyclic Neuromuscular Electrical Stimulation as a Priming Intervention in Acute Stroke: A Narrative Review of Rationale and Clinical Perspectives.","authors":"Yoshinori Yamamoto, Ryo Momosaki","doi":"10.2490/prm.20260021","DOIUrl":"10.2490/prm.20260021","url":null,"abstract":"<p><p>The acute phase of stroke is characterized by heightened neuroplasticity; however, rehabilitation interventions are often limited because of impaired voluntary motor control and systemic instability. Severe cases may miss the opportunity for recovery before adequate physiological readiness is achieved. Cyclic neuromuscular electrical stimulation (NMES) is a noninvasive modality that induces muscle activity and sensory input independently of volitional effort. Besides suppressing muscle atrophy, NMES can potentially activate the central nervous system. This narrative review aimed to investigate the neurophysiological mechanisms and clinical applicability of cyclic NMES in patients with acute stroke, focusing on its strategic value and current challenges. NMES in the acute phase showed modest improvements in muscle strength, spasticity, and walking ability. However, inconsistencies in patient selection, stimulation parameters, and outcome measures remain major barriers to its application. Successful clinical integration requires redefining NMES as a \"priming stimulus,\" with an emphasis on comfort, responsiveness, and continuity. Developing semi-standardized, strategically guided protocols is necessary. Cyclic NMES can be a preparatory intervention during the critical \"window of neuroplasticity\" in acute stroke rehabilitation, offering potential benefits that extend beyond conventional adjunctive therapies. Further studies focusing on stratified patient selection and neurophysiologically informed outcome measures are needed to enhance evidence-based application.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"11 ","pages":"20260021"},"PeriodicalIF":1.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870823","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":"Exploring Usability and User Engagement in Fully Immersive Virtual Reality Systems for Upper Limb Stroke Rehabilitation: A Scoping Review.","authors":"Dimosthenis Lygouras, Avgoustos Tsinakos, Konstantinos Vadikolias, Ioannis Seimenis","doi":"10.2490/prm.20260020","DOIUrl":"10.2490/prm.20260020","url":null,"abstract":"<p><strong>Objectives: </strong>Fully immersive virtual reality (FIVR) systems are emerging as innovative tools for upper limb stroke rehabilitation. These systems provide immersive, interactive environments that foster motivation, engagement, and functional recovery. This scoping review examines the usability of FIVR systems for upper limb rehabilitation among stroke survivors, focusing on evaluation methods, patient and therapist experiences, and barriers to adoption.</p><p><strong>Methods: </strong>The review followed PRISMA-ScR guidelines. A systematic search of PubMed, IEEE Xplore, and Scopus identified 20 eligible studies. Data were extracted on study design, participant demographics, VR system characteristics, software, task type, game/task elements, usability evaluation methods, and key findings.</p><p><strong>Results: </strong>The findings demonstrate generally positive benefits in terms of usability and engagement, with participants indicating both motivation and enjoyment during FIVR interventions. However, there was considerable variability in assessment methods, including both quantitative and qualitative approaches, as well as in hardware, software, interaction methods and no standardized framework. Common challenges included mild side effects (e.g., dizziness), technical complexity, and the need to adapt to patients' varying abilities. Such limitations highlight gaps in the standardization and replicability of usability assessment across studies.</p><p><strong>Conclusions: </strong>FIVR systems offer potential as supplements to conventional therapy, providing engaging and personalized rehabilitation experiences. Improving usability assessment through standardized frameworks, addressing technical and accessibility barriers, and ensuring the adaptability of interventions to individual patient needs are critical to optimizing effectiveness and supporting broader clinical adoption.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"11 ","pages":"20260020"},"PeriodicalIF":1.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847159","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":"Analysis of Bone Mineral Density and Body Composition in Lower and Upper Limbs of Spina Bifida Patients Using DXA Scans.","authors":"Hiroki Fujita, Misa Kaga, Kazuhisa Yoshifuji, Atsushi Teramoto","doi":"10.2490/prm.20260019","DOIUrl":"10.2490/prm.20260019","url":null,"abstract":"<p><strong>Objectives: </strong>Several tools are available for the assessment and classification of lesion level in spina bifida (SB) patients. This study aimed to quantitatively investigate potential relationships that lesion level and mobility style may have with bone mineral density (BMD) and body composition in both lower and upper limbs using dual-energy X-ray absorptiometry (DXA) scans in patients with SB.</p><p><strong>Methods: </strong>We investigated 74 patients (34 boys, 40 girls) with SB (mean age 12.8 years, range 10-18 years) using DXA scans to analyze BMD and body composition. Participants were classified by lesion level (upper lumbar or above, mid lumbar, lower lumbar, and sacral) for analysis of lower and upper limbs. Patients were reclassified by functional mobility scale (FMS) 50-m rating (wheelchair users, assisted ambulators, and independent ambulators) for further analysis of upper limbs.</p><p><strong>Results: </strong>The abovementioned lesion level groups contained 18, 17, 20, and 19 patients, respectively. A one-way analysis of variance (ANOVA) of lower limb outcomes showed significant intragroup homogeneity for BMD and body composition and also revealed a stepwise pattern that was consistent across multiple analyses. The FMS-based upper limb groups contained 19, 15, and 40 patients, respectively. Our analysis of BMD and percent bone mineral content did not reveal statistically significant trends in the upper limbs.</p><p><strong>Conclusions: </strong>Lower limb body composition among children with SB was significantly classified by lesion level using ANOVA. In the upper limbs, our results showed no significant correlation between lesion level and BMD or body composition.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"11 ","pages":"20260019"},"PeriodicalIF":1.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791323","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":"Outpatient Cardiac Rehabilitation before and after Left Ventricular Assist Device Implantation: A Case Report.","authors":"Yutaro Ohnishi, Tsubasa Yokote, Taichi Ogami, Masako Ohbuchi, Takatoshi Nishimura, Michiko Shimomi, Atsushi Tanaka, Jun-Ichiro Nishi, Ryuichi Matsukawa","doi":"10.2490/prm.20260018","DOIUrl":"10.2490/prm.20260018","url":null,"abstract":"","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"11 ","pages":"20260018"},"PeriodicalIF":1.3,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724824","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":"Rehabilitation Management of Upper Limb Segmental Zoster Paresis Following Coronavirus 2019 Vaccination: A Case Report.","authors":"Toshiyuki Suzuki, Katsuhiro Mizuno, Yuki Nakayama, Atsuko Nishimura, Tetsuya Tsuji","doi":"10.2490/prm.20260017","DOIUrl":"10.2490/prm.20260017","url":null,"abstract":"","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"11 ","pages":"20260017"},"PeriodicalIF":1.3,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679322","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}