ABSTRACT
Objective：We aimed to determine the impact of the COVID-19 pandemic on the “body function”, “activity”, and “participation” domains of functioning as defined in the International Classification of Functioning (ICF) for individuals with spinocerebellar degeneration (SCD) and multiple system atrophy (MSA).Methods：A questionnaire survey was administered to 1,000 members of the SCD/MSA patient association in Japan between November and December 2020. Questions related to COVID-19 were extracted from the multipurpose data, and the degree of COVID-19-related effects on each life function was assessed using a 7-point scale. Results were stratified into two groups based on age, care needs based on long-term care insurance coverage, and limited opportunities for rehabilitation. The χ2 test was used to examine differences between pairs of groups regarding impacts on functioning.Results：Data from 460 participants with SCD and MSA were analyzed. Participation restriction was reported in 54％ of participants with SCD and 46％ of participants with MSA, and impairment and activity limitation in approximately 20％ of participants with both conditions resulting from the COVID-19 pandemic. Participants with low care needs reported more impairment in SCD and more participation restriction in MSA. About 24％ of subjects reported limited opportunities for rehabilitation. MSA participants with these limitations reported greater impairment.Conclusion：The COVID-19 pandemic has had a particular impact on the participation domain of functioning in participants with SCD and MSA. The domains of body function and participation were found to be affected in participants with low care needs or limited opportunities for rehabilitation.
ABSTRACT
Objective：This study aimed to identify the characteristics of daily rehabilitation in patients with spinocerebellar degeneration (SCD), including those with multiple system atrophy, with a focus on physical status and social background.Methods：We analyzed questionnaire responses from 914 patients in Japan and conducted inter-group comparisons of backgrounds and rehabilitation-related information by dividing patients into a rehabilitation group, a self-directed exercise group, and a non-rehabilitation group.Results：Among all subjects, the rehabilitation group accounted for 67.9％, the self-directed exercise group for 17.7％, and the non-rehabilitation group for 14.3％．In the rehabilitation group, the percentage receiving services increased with a decline in the level of independent living and increase in coverage by long-term care insurance. The frequency and duration of rehabilitation showed a maximum distribution of 2-3 sessions/week for 40 minutes per session in the rehabilitation group and 7 sessions/week for 20 minutes per session in the self-directed exercise group. The intent to continue in the rehabilitation group was significantly greater than in the self-directed exercise group (p＝0.018), although subjective changes with rehabilitation showed no difference between groups.Conclusion：The percentage of SCD patients who participated in rehabilitation programs including self-directed exercise was high. However, the subjective effect was not clear. We consider it necessary to develop an environment in which experts can provide rehabilitation to all SCD patients, irrespective of the disease stage.
ABSTRACT
Objective：This study aimed to identify the characteristics of daily rehabilitation in patients with spinocerebellar degeneration (SCD), including those with multiple system atrophy, with a focus on physical status and social background.Methods：We analyzed questionnaire responses from 914 patients in Japan and conducted inter-group comparisons of backgrounds and rehabilitation-related information by dividing patients into a rehabilitation group, a self-directed exercise group, and a non-rehabilitation group.Results：Among all subjects, the rehabilitation group accounted for 67.9％, the self-directed exercise group for 17.7％, and the non-rehabilitation group for 14.3％．In the rehabilitation group, the percentage receiving services increased with a decline in the level of independent living and increase in coverage by long-term care insurance. The frequency and duration of rehabilitation showed a maximum distribution of 2-3 sessions/week for 40 minutes per session in the rehabilitation group and 7 sessions/week for 20 minutes per session in the self-directed exercise group. The intent to continue in the rehabilitation group was significantly greater than in the self-directed exercise group (p＝0.018), although subjective changes with rehabilitation showed no difference between groups.Conclusion：The percentage of SCD patients who participated in rehabilitation programs including self-directed exercise was high. However, the subjective effect was not clear. We consider it necessary to develop an environment in which experts can provide rehabilitation to all SCD patients, irrespective of the disease stage.
ABSTRACT
Objective : To determine whether or not the time difference index of the Timed Up and Go test (TUG) and the imagined TUG (iTUG), which reflects motor imagery capacity, has utility in predicting falls in patients with stroke. Method : A follow-up study of falls occurring over the 6-month period after discharge was performed in 47 patients with stroke. Baseline values were evaluated at discharge for subject age, sex, disease name, paralysis side, disease duration, fall history, whether a gait assistive device was used, mini-mental state examination (MMSE), TUG, and the time difference (delta time) between TUG and iTUG. A logistic regression analysis was performed using the number of falls and evaluation results, and the predictive factors for falls were extracted. Results : Thirty-three patients were followed for the entire 6-month period, and the fall rate was 48.5%. According to the results of the analysis, only delta time was a significant fall factor (<i>p</i><0.01), and the cutoff value for fall prediction was 0.88%. Conclusion : Our results show that delta time could be used to identify the likelihood of a fall occurrence over the 6-month period after discharge in patients with stroke.