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
The patient, a 72-year-old man, was admitted for disuse syndrome after left lower thigh cellulites, who originally developed left hemiparesis at age 60. At the time of admission, he was alert, his Body Mass Index was 18.5 and his FIM (Functional Independence Measure) score was 49. We thought this was a case of post stroke disuse syndrome manifesting after long-term bedridden inactivity. He underwent a hospital rehabilitation program; however, he gained only poor functional recovery after one month. He complained about nighttime snoring and awakening from sleep. So he was evaluated with a portable device for SAS (Sleep Apnea Syndrome). His ESS (Epworth Sleepiness Scale) was 21, his Apnea-Hypnea Index was 58.2 and his lowest SpO<sub>2</sub> level was 75%. With a diagnosis of severe SAS, he was treated with nighttime nCPAP (nasal Continuous Positive Airway Pressure). After treatment, his lowest SpO<sub>2</sub> level rose to 90%, and the patient's excessive daytime sleepiness (ESS=15) and ADL (FIM=85) improved. When patients exhibit poor recovery after training, the possibility of SAS should be taken into consideration and they should be tested accordingly.