One-year changes in activities of daily living and social life in elderly patients undergoing home-based rehabilitation within 1 year of stroke onset.

[Purpose] In this study, we investigated changes in activities of daily living and social participation over 1 year in elderly patients with stroke, who underwent home-based rehabilitation. [Participants and Methods] This 1 year, multicenter cohort study included patients aged ≥65 years with diagnosis of the first onset of stroke within 1 year. Variables recorded included the functional independence measure and performance qualifiers for "d6 domestic life" and "d9 community, social, and civic life" (social life) based on the International Classification of Functioning, Disability and Health framework. [Results] Of the 44 partients recruited at baseline, 19 completed the study over 1 year. We observed significant improvements in the functional independence measure-motor, functional independence measure-cognitive, and functional independence measure-total and in the performance qualifiers ("domestic life" and "social life") of the International Classification of Functioning, Disability and Health tool. We also observed that the functional independence measure-total scores improved over 3 months and "domestic life" and "social life" scores gradually improved over 1 year. [Conclusion] Our results showed that activities of daily living improved earlier than other variables, including social participation, which gradually improved over 1 year and that home-based rehabilitation may effectively improve activities of daily living and social participation.

A Randomized, Single-Blind, Placebo-Controlled Study on the Efficacy of the Arthrokinematic Approach-Hakata Method in Patients with Chronic Nonspecific Low Back Pain.

STUDY DESIGN: Cized, single-blind, controlled trial. OBJECTIVE: To investigate the efficacy of the Arthrokinematic approach (AKA)-Hakata (H) method for chronic low back pain. SUMMARY OF BACKGROUND DATA: The AKA-H method is used to manually treat abnormalities of intra-articular movement. METHODS: One hundred eighty-six patients with chronic nonspecific low back pain randomly received either the AKA-H method (AKA-H group) or the sham technique (S group) monthly for 6 months. Data were collected at baseline and once a month. Outcome measures were pain intensity (visual analogue scale [VAS]) and quality of life (the Roland-Morris Disability Questionnaire [RDQ] and Short Form SF-36 questionnaire [SF-36]). RESULTS: At baseline, the VAS, RDQ, and SF-36 scores showed similar levels between the groups. After 6 months, the AKA-H group had more improvement in the VAS (42.8% improvement) and RDQ score (31.1% improvement) than the sham group (VAS: 10.4% improvement; RDQ: 9.8% improvement; both, P < 0.001). The respective scores for the SF-36 subscales (physical functioning, role physical, bodily pain, social functioning, general health perception, role emotional, and mental health) were also significantly more improved in the AKA-H group than in the sham group (all, P < 0.001). The scores for the physical, psychological, and social aspects of the SF-36 subscales showed similar improvement in the AKA-H group. CONCLUSION: The AKA-H method can be effective in managing chronic low back pain. TRIAL REGISTRATION: UMIN Clinical Trials Registry (UMIN-CTR) UMIN000006250.

General endurance in hemiplegic patients: comparison between healthy subjects and hemiplegics using the incremental stand-up exercise-load method.

OBJECTIVES: To evaluate the utility of our newly devised method (incremental stand-up exercise-load) to determine features of general endurance in hemiplegic patients. SUBJECTS/PATIENTS: Participants were 15 healthy adults and 15 hemiplegics, with 13 men and 2 women in each group. METHODS: To evaluate endurance, the subjects were required to assume a sitting position on a bed for 3 minutes and thereafter repeat standing-sitting (SS) movements. Successively increasing loads were imposed by increasing the frequency of repetition of the SS movements. An expired gas analyzer measured the magnitude of general endurance. Results were compared between the two groups using the anaerobic threshold (AT) as an indicator. RESULTS: The AT value was determinable in 80% of subjects in both groups. The AT values in hemiplegics (10.4 +/- 2.0 ml/min/kg) were significantly (p<0.01) less than those (17.3 +/- 3.0 ml/min/kg) in controls. Time of imposition of the load in hemiplegics (11 min 7 s +/- 13 min 45 s) were significantly (p<0.01) less than those (27 min 0 s +/- 7 min 36 s) in controls. CONCLUSION: This newly devised method that does not require special equipment is suitable to examine general endurance in hemiplegic patients.

[A follow-up study on mental and physical function function among stroke patients: comparisons between admission and discharge status in a rehabilitation-specialized hospital].

PURPOSE: To assess results of a 5 year-follow-up, in terms of disability, depression, quality of life, and social network in cases of stroke patients. This report deal with results at admission and discharge (in average, from 2.5 to 6 months of the onset) in a rehabilitation-specialzed hospital. OBJECT AND METHOD: The subjects were 87 stroke patients hospitalized in the Ibaraki Prefectural University Hospital. They were 64 men and 23 women, and their age were between 42 and 79 with an average of 59 years. Systematic evaluation for mental and physical functions was conducted at admission and discharge, and it is intended that the evaluation will be repeated 1, 2, 3 and 5 years from the stroke onset. RESULTS: There were substantial improvements in motor functions, general intelligence, and the status of dementia during the hospitalization. Activities of daily living and degrees of job execution and satisfactory were also improved. The prevalence of depression remained 40%, and the acceptance of limb paralysis or reduced quality of life did not change. Social network scores declined. DISCUSSION: Lack of improvement of depressive status and quality of life, and deterioration social network may increase the rist of major difficulties after discharge of stoke patients. Prevention programs at hospital may be necessary to cope with these potential problems.