Efficacy of a Novel Recording Method in Facilitating Rapid Documentation of Disaster Rehabilitation Support Activities / The Japanese Journal of Rehabilitation Medicine

Objective：An efficient disaster relief service necessitates the documentation and dissemination of information acquired from disaster response-related activities. However, recording and summarizing information pertaining to rehabilitation support activities is time-consuming and a pressing concern；therefore, mark-sheet forms have been introduced to reduce the time required for this process. Therefore, this study aimed to examine whether mark-sheet forms can facilitate a more accurate and rapid recording of information than conventional descriptive recording forms.Methods：Fifty physical therapists affiliated with the Osaka Physical Therapists Association with no history of performing disaster rehabilitation support activities were recruited. Participants were randomized into descriptive recording form and mark-sheet form groups. Individuals in both groups were instructed to document the information gathered by watching simulated videos of the rehabilitation support activities on their designated recording forms. A statistical analysis compared the accuracy and time required to record the data obtained from the 10 simulation videos between groups.Results：In all 10 scenarios, the recording time was significantly shorter (p＜0.05) for the mark-sheet form than descriptive recording form group. However, no discernible intergroup difference was observed in recorded content accuracy.Conclusion：The use of mark-sheet versus descriptive recording forms facilitated more rapid documentation of disaster rehabilitation support activities.

Experience of Rehabilitation Treatment for Osmotic Demyelination Syndrome with Locked-in Syndrome / The Japanese Journal of Rehabilitation Medicine

Osmotic demyelination syndrome is a pathological condition that leads to electrolyte imbalances and rapid correction, resulting in pseudobulbar palsy, quadriplegia, and altered consciousness. Approximately 33-55％ of affected patients experience residual functional impairment. Herein, we describe a case of a patient with osmotic demyelination syndrome who developed locked-in syndrome during the disease course, underwent rehabilitation treatment, and achieved complete remission without sequelae.The patient was a 47-year-old man who was admitted to hospital A owing to weakness in the lower extremities and dysarthria. He had severe hyponatremia and received sodium correction. However, on hospital day 9, dysarthria redeveloped and involuntary finger movements were noted. Osmotic demyelination syndrome was suspected based on the findings of magnetic resonance imaging of the head and clinical course, leading to his transfer to hospital B. Steroid pulse and rehabilitation therapies were initiated at hospital B. By the 19th day of symptom onset, his limb and facial muscle paralysis progressed, leading to locked-in syndrome. Thereafter, the patient was transferred to hospital C, where he received physiotherapy, occupational therapy, and eating training, markedly improving his physical functions. He was discharged from hospital C, 4 months after the symptom onset, with limited range of motion of the fingers and weakness of the extremities and continued to receive outpatient rehabilitation treatment. His symptoms improved further, and 1 year after the onset of symptoms, he returned to work without any sequelae.

A Case of Response to Keishikajutsubuto for Stump Pain after Both Femoral Amputation / 日本東洋医学雑誌

We have experienced a case of response to keishikajutsubuto for stump pain after both femoral amputations. There are few reports on the use of Kampo medicines for stump pain after amputation. In this case, the critical lower-limb ischemia that led to the amputation was due to severe stenosis and occlusion caused by arteriosclerosis in both limbs. From the perspective of Kampo medicine, ischemia is considered to have cold and blood status as a result of deficiency and stagnation of yang qi due to circulatory failure. In this case, we regarded blood stasis as a secondary product of ischemia, and we mainly considered a prescription to remove cold and bring yang qi to the eliminative organs, which was effective for the pain. For stump pain after amputation that is poorly responded to general analgesics, the combination of keishikajutsubuto is expected to provide rapid analgesic effect, suggesting that it is useful for pain control.

Exercise attenuates oxidative stress in patients with stroke

In stroke patients, excessive oxidative stress impairs brain nerve cells and leads to arteriosclerosis. On the other hand, rehabilitative exercise is necessary for the functional improvement and maintenance after stroke, and exercises themselves increase reactive oxygen species production simultaneously. Therefore, it is essential to elucidate how exercises influence oxidative stress in stroke patients. We assessed the effects of exercises on 29 Japanese subacute-phase stroke patients (exercise group, 20; control group, 9), in terms of oxidative stress by examining changes in reactive oxygen metabolite (ROM) level (i.e., oxidative stress) and biological antioxidant potential (BAP) level (i.e., antioxidant capacity) in blood plasma. The exercise group performed two sets of 1-hour exercises 6 days/week for 56 days. The control group performed the same 1-hour exercises, but only on days 1 and 56. ROM and BAP levels in blood plasma in both groups were measured immediately before and after the exercises and at rest on days 1 and 56. ROM level significantly decreased and BAP level significantly increased at rest from days 1 to 56 in the exercise group. However, no significant change was observed in these levels in the control group. Conclusion: Regular rehabilitative exercise can improve antioxidant capacity and attenuate oxidative stress even in stroke patients.

The Present State and Future Direction of Rehabilitation Medicine in the Treatment of Rheumatoid Arthritis / The Japanese Journal of Rehabilitation Medicine

Protraction of RA induces joint function disorders resulting in a deterioration in the activities of daily living (ADL), which can cause a change in the patient's household role and limit their social participation. As there is not at present a curative treatment for RA, once functional disorders develop, they cannot be recovered easily or completely. However, it was recently reported that disorders progress rapidly within a few years from RA disease onset in terms of the changes wrought by joint damage and the resulting functional disorder inflicted on the patient. Therefore, it is proposed that adequate administration of methotrexate should be started initially and that RA treatment should be based on the recommendations under the regime of Treat to Target (T2T). Rehabilitation for RA patients includes various kinds of exercises and approaches such as physical therapy in the early stage and nursing home service with caregiver insurance in the terminal RA phase. In terms of the principles of T 2 T, the aim of the RA treatment is to improve the patients' long-term QOL as much as possible during their lifetime through the restoration of body functions and their participation in social activities. The ultimate aim of rehabilitation is the same as that of T 2 T because it is to let people with disabilities live normal lives by diminishing the difficulties RA patients face in daily life and improving their QOL. It is therefore very important to keep in mind that RA is a complex condition that includes people with various afflictions and difficulties in meeting their daily living tasks and not just one disease.