ABSTRACT
[Purpose] Mental practice (MP) is a method of rehabilitating upper extremity function on the affected side of the body post-stroke, with the aim of improving motor task performance through the sustained repetition of motor imagery (MI). However, most studies thus far have investigated MP for post-stroke paralytic upper limb function in patients in the chronic phase. Therefore, it is necessary to obtain evidence regarding whether MP is an effective intervention modality in the acute phase of stroke. In the present study, we examined the effects of an intervention combining mirror therapy and MP initiated during the acute phase of cerebral infarction. [Participant and Methods] A female patient >80â years of age with a cerebral infarction was studied. Prior to cerebral infarction, the patient was independent in her activities of daily living. [Results] As a result of MP, sufficient improvement was observed in the upper extremity function on the paralyzed side, as assessed using the Fugl-Meyer Assessment (FMA) and Motor Activity Log (MAL). [Conclusion] In patients with MP initiated during the acute stroke phase, a combination of mirror therapy and action observation to enable vivid MI may elicit a more significant intervention effect.
ABSTRACT
AIM: Efforts to improve the treatment of frail elderly patients in acute care hospitals are urgently needed because a low physical activity level due to hospitalization is reported to be associated with a risk of disability. The aim of this study was to clarify the characteristics of frail elderly patients in acute care hospitals. METHODS: We assessed 198 elderly patients who were admitted to acute care hospitals. The factors that were evaluated included the presence of frailty, the age, gender, and nutritional status of the patients, and complications that developed during hospitalization. In this study, frailty was evaluated using the Kihon checklist (KCL), and was defined by a total KCL score of ≥7 points. RESULTS: A total of 87 (43.9%) subjects met the definition of frailty and there was a female predominance (63.2%). The nutritional status of the subjects with frailty was significantly worse than that of the non-frail patients. In comparison to the non-frail subjects, the frail subjects were significantly older and the onset of complications during hospitalization was observed significantly more frequently. Moreover, a large number of frail subjects showed low scores on the KCL items related to their social activity, physical and oral functions, and psychological status. CONCLUSION: These findings suggest that efforts to improve the treatment of frail elderly patients in acute care hospitals are important because of the high incidence of frailty. Multifaceted assessments and the promotion of physical activity to prevent the onset of complications during hospitalization may be needed for frail elderly patients in acute care hospitals.
Subject(s)
Frail Elderly , Aged , Aged, 80 and over , Checklist , Female , Hospitalization , HumansABSTRACT
[Purpose] Diffusion tensor imaging (DTI) has attracted attention as a method for determining prognosis following paralysis after stroke. However, DTI can assess the degree of damage to the corticospinal tract but cannot evaluate other brain regions. In this study, we examined in detail the prognosis of upper-limb function of the paralyzed side following stroke, using DTI and voxel-based morphometry (VBM). [Subjects and Methods] We studied 17 consecutive patients diagnosed with stroke, including hemorrhagic and ischemic types, who exhibited hemiparesis and were treated in our hospital. DTI and VBM were performed 14 days after admission. Outcome measurements that assessed upper limb function were Fugl-Meyer Assessment (FMA) and Motor Activity Log (MAL), which were applied after 3 months. [Results] The fractional anisotropy ratio of the bilateral cerebral peduncles (rFA) was significantly correlated with FMA, amount of use, and quality of movement 3 months after stroke. The precentral gyrus significantly degenerated as compared with the control group for a case with notable motor paralysis, for which rFA was high. [Conclusion] We suggest it may be possible to predict recovery of upper limb function following stroke by combining DTI and VBM visualization methods.
