Progress in rehabilitation medicine最新文献

{"title":"Outpatient Rehabilitation of a Patient with Functional Neurological Disorder Receiving Workers' Compensation Benefits: A Case Report.","authors":"Risa Tamura, Mari Kuinose, Rika Kurahashi, Mari Furuya, Masatoshi Amako","doi":"10.2490/prm.20230043","DOIUrl":"10.2490/prm.20230043","url":null,"abstract":"<p><strong>Background: </strong>Functional neurological disorder (FND) is a clinical syndrome characterized by abnormal involuntary movements and specific clinical features that are incongruent with known neurologic diseases. Clinical information is lacking on outpatient rehabilitation for patients with FND.</p><p><strong>Case: </strong>A 28-year-old woman visited our hospital for gait disturbance. She had experienced an occupational accident 20 months earlier. Her injuries were relatively minor, but subsequently, she was unable to move her ankle voluntarily and began receiving workers' compensation benefits. The patient had persistent gait disturbance and preferred to walk with an ankle-foot orthosis. However, at her first visit, her ankle could move while walking without her ankle brace. Nerve conduction studies showed no abnormalities. Shortly after receiving an explanation regarding the diagnosis of FND, the patient was able to move her ankle voluntarily; however, her gait disturbance was partially persistent. After outpatient rehabilitation, she was able to walk in different types of footwear without an ankle brace. Satisfied with the result, she agreed to end rehabilitation and her access to workers' compensation.</p><p><strong>Discussion: </strong>After diagnosis and rehabilitation for FND following an occupational injury, our patient was eventually able to walk without an ankle brace. In this case, providing the patient with information regarding a diagnosis of FND and obtaining her informed consent for subsequent rehabilitation may have helped to improve the symptoms of FND.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"8 ","pages":"20230043"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479764","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":"Age of Adolescent Female Soccer Players at First Ankle Sprain and Menarche.","authors":"Yuri Inoue, Akihiro Tamura, Shogo Misu","doi":"10.2490/prm.20230042","DOIUrl":"10.2490/prm.20230042","url":null,"abstract":"<p><strong>Objectives: </strong>: To provide targeted interventions for the prevention of first ankle sprains, this study determined the prevalence of ankle sprains in female adolescent soccer players and analyzed the correlation between the age at the first occurrence of ankle sprain and the age at menarche.</p><p><strong>Methods: </strong>: The study included 131 female participants from three club teams. The mean age was 13.37 ± 0.96 years. A survey was conducted using a questionnaire that requested information regarding the age at which the first ankle sprain occurred, age at menarche, status of ankle problems, extent to which the ankle joint problem affected playing ability, use of medical facilities or other healthcare facilities for the first or recurrent ankle sprains, and methods used to care for their ankle.</p><p><strong>Results: </strong>Ankle sprains most commonly occurred for the first time at 12 years, followed by the ages of 13, 10, and 11 years. About 25% of participants experienced their first ankle sprain at the age of menarche, 20% at 1 year after menarche, and 16% a year before menarche. The incidence of the first ankle sprain was high in the second and fifth years after starting to play soccer. Medical treatment was rarely received for the second or subsequent injury, although 36% had some sequelae.</p><p><strong>Conclusions: </strong>Adolescent female soccer players were not injured early in their soccer careers. Most players experienced their first ankle sprain at the age of 12 years, which was at or close to the age of menarche.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"8 ","pages":"20230042"},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10682156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464951","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":"Automated Tractography for the Assessment of Aphasia in Acute Care Stroke Rehabilitation: A Case Series.","authors":"Midori Mochizuki, Yuki Uchiyama, Kazuhisa Domen, Tetsuo Koyama","doi":"10.2490/prm.20230041","DOIUrl":"https://doi.org/10.2490/prm.20230041","url":null,"abstract":"<p><strong>Background: </strong>Aphasia is a common disorder among stroke patients. Assessment of aphasia is essential for scheduling appropriate rehabilitative treatment. Although this is conventionally accomplished using neuropsychological test batteries, these tests are not always accessible because of attention and/or consciousness disturbances during acute care. To overcome this issue, we have introduced a newly developed automated tractography known as XTRACT.</p><p><strong>Cases: </strong>Diffusion-tensor images were acquired from three patients on days 10-14. Brain images were processed by XTRACT, which automatically extracts neural tracts using standardized protocols. Fractional anisotropy (FA) values were then bilaterally evaluated in the following neural tracts associated with aphasia: arcuate fasciculus, inferior fronto-occipital fasciculus, middle longitudinal fasciculus, inferior longitudinal fasciculus, and uncinate fasciculus. Case 1 had word-finding difficulty on admission. FA values in the lesioned left hemisphere were not decreased in all tracts and this patient fully recovered during acute care. Case 2 had reduced spontaneous speech and a low FA value in the left arcuate fasciculus. Rehabilitative treatment was scheduled to improve the verbal output of sentences and word recall. Case 3 could not complete the conventional aphasia test battery because of attention disturbance. He had low FA values in all tracts in the left hemisphere. Rehabilitative treatment was designed to focus on both speaking and auditory comprehension.</p><p><strong>Discussion: </strong>Automated tractography enables quantitative assessment of the neural damage associated with aphasia, even in patients with attention and/or consciousness disturbances. This modality can aid in the assessment of aphasia and allows the planning of appropriate rehabilitative treatment.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"8 ","pages":"20230041"},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464952","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":"Transitions of Activities of Daily Living Status among Inpatients with Subacute Stroke: A Latent Class Approach.","authors":"Hiroaki Furuta, Katsuhiro Mizuno, Kei Unai, Hiroki Ebata, Keita Yamauchi, Michiko Watanabe","doi":"10.2490/prm.20230039","DOIUrl":"10.2490/prm.20230039","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the transition patterns of activities of daily living (ADL) status based on the Functional Independence Measure (FIM) motor and cognitive items in patients who experienced subacute stroke.</p><p><strong>Methods: </strong>In this single-site, retrospective investigation, 1592 FIM samples were collected during the hospitalization of 373 stroke patients who were admitted between April 2018 and March 2020. FIM item levels were transformed from seven to three (FIM1-2, Complete Dependence; FIM3-5, Modified Dependence; FIM6-7, Independence). FIM samples were classified by latent class modeling into six latent ADL states based on the independence levels of FIM motor and cognitive items. We created an ADL status transition diagram based on the FIM sample's probability of belonging to each status at different hospitalization timepoints.</p><p><strong>Results: </strong>Transition diagrams for each ADL status at admission revealed distinct patterns. In two ADL statuses for which patients required full assistance in FIM motor items, the patients remained motor-dependent without achieving independence on discharge. In contrast, patients in transition from the other four ADL statuses largely achieved independence in motor items by the time of discharge. The time required to reach higher ADL status varied according to the initial ADL status at admission; the slowest improvement was observed in statuses initially classified as needing the most assistance, whereas many patients achieved transition within 3 months from admission.</p><p><strong>Conclusions: </strong>Based on the characteristics of patient ADL status and timing of its changes, the classification of ADL status and visualization of ADL transition can contribute to improved treatment.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"8 ","pages":"20230039"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489787","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":"Long-term Observation in Patients with Duchenne Muscular Dystrophy with Early Introduction of a Standing Program Using Knee-ankle-foot Orthoses.","authors":"Akiko Fujimoto,&nbsp;Katsuhiro Mizuno,&nbsp;Yasuyuki Iwata,&nbsp;Hiroyuki Yajima,&nbsp;Daisuke Nishida,&nbsp;Hirofumi Komaki,&nbsp;Akihiko Ishiyama,&nbsp;Madoka Mori-Yoshimura,&nbsp;Hisateru Tachimori,&nbsp;Yoko Kobayashi","doi":"10.2490/prm.20230038","DOIUrl":"https://doi.org/10.2490/prm.20230038","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the outcomes of the early introduction of a standing program for patients with Duchenne muscular dystrophy (DMD).</p><p><strong>Methods: </strong>This was a retrospective observational study of 41 outpatients with DMD aged 15-20 years. We introduced the standing program using knee-ankle-foot orthoses (KAFO) to slow the progression of scoliosis when ankle dorsiflexion became less than 0° in the ambulatory period.</p><p><strong>Results: </strong>Thirty-two patients with DMD were offered the standing program with KAFO; 12 continued the program until the age of 15 years (complete group) and 20 discontinued the program before the age of 15 years (incomplete group). The non-standing program group included 9 patients. The standing program with KAFO was significantly associated with the Cobb angle at the age of 15 years after adjustment for the duration of corticosteroid use and DMD mutation type (P=0.0004). At the age of 15 years, significant correlations were found between the ankle dorsiflexion range of motion (ROM) and non-ambulatory period (P=0.0010), non-ambulatory period and Cobb angle (P<0.0001), Cobb angle and percent predicted forced vital capacity (P=0.0004), and ankle dorsiflexion ROM and Cobb angle (P=0.0066). In the complete group, the age at ambulation loss (log-rank P=0.0015), scoliosis progression (log-rank P=0.0032), and pulmonary dysfunction (log-rank P=0.0006) were significantly higher than in the non-standing program group.</p><p><strong>Conclusions: </strong>The early introduction of a standing program for DMD patients may prolong the ambulation period and slow the progression of scoliosis and pulmonary dysfunction.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"8 ","pages":"20230038"},"PeriodicalIF":0.0,"publicationDate":"2023-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10602754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415840","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":"Effects of Task-related Trunk Training with Sensory Electrical Stimulation on Sitting Balance in Stroke Survivors: A Randomized Controlled Trial.","authors":"Takuya Yada,&nbsp;Kazu Amimoto","doi":"10.2490/prm.20230037","DOIUrl":"10.2490/prm.20230037","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to investigate the immediate effect of sensory electrical stimulation (SES) and task-related trunk training (TRTT) interventions on sitting postural control in stroke survivors.</p><p><strong>Methods: </strong>Acute to subacute stroke survivors were screened and recruited for this study. Patients were randomly assigned to the SES group, receiving TRTT combined with simultaneous SES of the neck and lumbar muscles, or to the sham group, receiving TRTT combined with sham stimulation. The primary outcome of the sitting task assessment was the joint angles of the neck and trunk. The outcome was measured at three time points (baseline; online effect: 10 min after the intervention started while the intervention continued; and after-effect: immediately after the intervention).</p><p><strong>Results: </strong>In total, 26 patients were divided into the SES (n=13) and sham (n=13) groups. The SES group showed a significant increase in the trunk joint angle for the online effect (P=0.03) and the after-effect (P=0.01) when compared with those measured at baseline.</p><p><strong>Conclusions: </strong>TRTT combined with simultaneous SES of the neck and lumbar muscles can immediately change the trunk angle during a sitting balancing task.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"8 ","pages":"20230037"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d2/4f/prm-8-20230037.PMC10593609.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50164033","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 Trunk Muscle Mass Index at Admission and Walking Independence in Patients with Hip Fracture.","authors":"Ryo Shiraishi,&nbsp;Keisuke Sato,&nbsp;Nobumasa Chijiiwa,&nbsp;Takahiro Ogawa","doi":"10.2490/prm.20230036","DOIUrl":"https://doi.org/10.2490/prm.20230036","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the relationship between trunk muscle mass index (TMI), appendicular skeletal muscle mass index (ASMI), and walking independence in patients aged 65 years and older undergoing rehabilitation for hip fracture.</p><p><strong>Methods: </strong>This retrospective, observational study was conducted in a convalescent rehabilitation ward and included 314 patients (aged ≥65 years) with hip fracture. The patients were classified into the independence group [functional independence measure (FIM)-walk score ≥6] or the non-independence group (FIM-walk score ≤5) according to the mobility item score among the motor FIM items at the time of discharge. Age, sex, TMI, ASMI, and Mini Nutritional Assessment-Short Form (MNA-SF) data were also extracted. Between-group and multivariate analyses were performed to evaluate the factors associated with walking independence.</p><p><strong>Results: </strong>The independence group had higher TMI (males: 6.6±0.9 vs. 5.6±1.0 kg/m², P <0.001; females: 6.1±0.8 vs. 5.7±1.0 kg/m², P <0.001), ASMI (males: 6.7±1.1 vs. 5.9±1.3 kg/m², P=0.004; females: 5.3±0.9 vs. 4.7±0.8 kg/m², P <0.001), MMSE-J (21.5±4.9 vs. 16.4±4.5 points, P <0.001), and MNA-SF [median (interquartile range): 8 (6-9) vs. 7 (5-8) points, P <0.001] than the non-independence group. Multivariate analysis showed that TMI at admission was significantly associated with walking independence (odds ratio: 1.86, 95% confidence interval: 1.28-2.72, P <0.001).</p><p><strong>Conclusions: </strong>This study suggests that a higher TMI at admission was important for acquiring walking independence in patients with hip fracture and shows the importance of early evaluation of TMI during hospitalization of patients with hip fracture.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"8 ","pages":"20230036"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b7/46/prm-8-20230036.PMC10579811.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49686024","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":"Effects of Rehabilitative Intervention for Augmenting Cough Function in Patients with Multiple System Atrophy.","authors":"Takashi Asakawa,&nbsp;Mieko Ogino,&nbsp;Naomi Tominaga,&nbsp;Naoto Ozaki,&nbsp;Jin Kubo,&nbsp;Wataru Kakuda","doi":"10.2490/prm.20230035","DOIUrl":"https://doi.org/10.2490/prm.20230035","url":null,"abstract":"<p><strong>Objectives: </strong>One of the causes of death in patients with multiple system atrophy (MSA) is aspiration pneumonia caused by cough dysfunction. This study aimed to identify an effective approach to improve coughing and to explore the establishment of criteria for the use of gastrostomy based on cough and respiratory dysfunctions.</p><p><strong>Methods: </strong>Eighteen probable MSA patients participated in the study. They were categorized into air stacking and non-air stacking groups. First, we investigated how the inspiration volume changes by applying maximum insufflation capacity (MIC). Second, peak cough flow (PCF) was measured by different cough augmentation methods: 1) spontaneous coughing (SpC); 2) SpC with MIC (SpC + MIC); 3) SpC with manually assisted cough (MAC) (SpC + MAC); and 4) SpC with MIC and MAC (SpC + MIC + MAC). Among these four conditions, PCF values were compared to determine the most effective approach for cough augmentation. Receiver operating characteristic analysis was performed on percent forced vital capacity (%FVC) to determine an index for discriminating PCF below160 L/min, which indicates a high risk of suffocation, involving SpC and SpC + MIC.</p><p><strong>Results: </strong>Inspiration volume increased significantly with MIC in both groups (P < 0.05), and PCF increased significantly with MIC in the air stacking group (P < 0.01). PCF could not be maintained at 160 L/min when %FVC fell below 59%, even when MIC was applied.</p><p><strong>Conclusions: </strong>PCF increases with MIC in patients with MSA. It may be meaningful to consider the timing of gastrostomy introduction based on the severity of cough and respiratory dysfunction.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"8 ","pages":"20230035"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/cb/prm-8-20230035.PMC10542584.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41123864","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 6-Month Follow-up Study on Adherence and Satisfaction with Lower Limb Prostheses and Orthoses Delivered to Community-Dwelling People in Japan.","authors":"Tomoko Yamaguchi,&nbsp;Masafumi Kubota,&nbsp;Hiroaki Naruse,&nbsp;Akihiko Matsumine,&nbsp;Osamu Yamamura,&nbsp;Hiroyuki Tsuchiya","doi":"10.2490/prm.20230034","DOIUrl":"https://doi.org/10.2490/prm.20230034","url":null,"abstract":"<p><strong>Abstract: </strong></p><p><strong>Introduction: </strong>We aimed to evaluate adherence and satisfaction with prostheses and orthoses (POs) of the lower extremities delivered to community-dwelling patients and to assess the relationship of adherence and satisfaction with patient background factors, including medical status, physical findings, and level of participation.</p><p><strong>Methods: </strong>: We conducted a descriptive cohort study. Consecutive patients with disability who applied for lower extremity POs were invited to enroll. The patients' background information was collected at enrolment, and they were asked at 6 months after PO delivery whether they were using their PO as expected prior to its delivery, and, on a numerical rating scale (NRS, 0 - 10), if they were satisfied with their POs. Furthermore, the relationship between usage/satisfaction and the participants' backgrounds was evaluated and the participants' comments regarding their POs were summarized.</p><p><strong>Results: </strong>: This study analyzed the data of 51 participants (mean age, 56.5 ± 19 years). At the 6-month follow-up, 45 participants used POs as much as they had expected before delivery; this group was younger than their counterparts (52.7 versus 69.2 years). The median satisfaction score using the NRS was 8.5. Older participants (r = - 0.33), participants who were able to attach and remove their POs, and those who were independent in locomotion scored lower on satisfaction. Other background factors were not different regarding adherence or satisfaction.</p><p><strong>Conclusions: </strong>: This study demonstrated the difficulty in predicting the usage and satisfaction with lower limb POs from users' backgrounds. Producer-user communication, particularly with patients of older age and/or a higher level of participation, may improve adherence and satisfaction.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"8 ","pages":"20230034"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/62/prm-8-20230034.PMC10520559.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41167621","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 Optimizing Medical Rehabilitation System for Patients with Coronavirus Disease 2019 Using the Functional Resonance Analysis Method.","authors":"Naoki Sasanuma,&nbsp;Keiko Takahashi,&nbsp;Ai Yanagida,&nbsp;Yohei Miyagi,&nbsp;Seiya Yamakawa,&nbsp;Tetsu Seo,&nbsp;Yuki Uchiyama,&nbsp;Norihiko Kodama,&nbsp;Kazuhisa Domen","doi":"10.2490/prm.20230032","DOIUrl":"https://doi.org/10.2490/prm.20230032","url":null,"abstract":"<p><strong>Objectives: </strong>Coronavirus infection 2019 (COVID-19) is an indication for rehabilitation medicine, especially in severe cases. However, there has been no system analysis of safe and continuous provision of medical rehabilitation for COVID-19 patients. The aim of this study was to confirm the effectiveness of rehabilitation for severe COVID-19 and to analyze the optimization of the medical rehabilitation system using the Functional Resonance Analysis Method (FRAM).</p><p><strong>Methods: </strong>The subject of the analysis was the medical rehabilitation system itself, which had been implemented by the Rehabilitation Center of our hospital in response to the increased number of COVID-19 patients. In the FRAM analysis, Functions were identified, and their relationships were examined. Functions were established using a hierarchical cross-check by the authors. Patient outcomes resulting from optimization of the rehabilitation system were length of hospital stay, patient independence in daily living, and rehabilitation-related medical costs, and these were statistically validated.</p><p><strong>Results: </strong>In repeated optimizations of the rehabilitation system, the main issues were \"handling of infected patients and isolation of usual clinical practice,\" \"staff rotation,\" and \"remote consultation\". The modification of the medical rehabilitation system was associated with shorter hospital stays, shorter periods of time without prescription, faster improvement in independence of daily living, and lower rehabilitation-related medical costs.</p><p><strong>Conclusions: </strong>Optimization at each stage of medical rehabilitation resulted in positive effects on patient outcomes. FRAM is useful for identifying and the optimization of key functions.</p>","PeriodicalId":74584,"journal":{"name":"Progress in rehabilitation medicine","volume":"8 ","pages":"20230032"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a6/45/prm-8-20230032.PMC10518249.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41180655","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}