kenta fujimura

Objective To determine the effects of repetitive peripheral magnetic stimulation in a patient with chronic stroke. Design Case report. Patients A man in his 70s presented with left hemiplegia secondary to cerebral hemorrhage. Methods An AB design was used: phase A (sham stimulation) and phase B (active stimulation). Magnetic stimulation was applied using a peripheral magnetic stimulator (Pathleader™, IFG, Sendai, Japan). Outcomes were assessed at four points: before the intervention, after phase A, after phase B, and at follow-up (3 weeks after phase B) using the Modified Ashworth Scale, range of motion, Fugl-Meyer Assessment, Simple Test for Evaluating Hand Function, and Canadian Occupational Performance Measures. Results The Modified Ashworth Scale score for the wrist extensor remained unchanged in phase A but improved after phase B and was sustained at follow-up. The range of motion showed no change. The Fugl-Meyer Assessment scores were 40, 41, 44, and 45, respectively, and the Simple Test for Evaluating Hand Function scores were 1, 4, 3, and 5, respectively, at the four time points. One Canadian Occupational Performance Measure item improved after phase B and remained stable. Conclusion In patients with chronic stroke and severe hemiplegia, repetitive peripheral magnetic stimulation may be effective in reducing spasticity and improving motor function.

Objectives This study aimed to evaluate the effect of repetitive peripheral magnetic stimulation on edema of the hemiparetic hand in patients with stroke. Methods This single-center, open-label, crossover, randomized controlled trial was registered with the Japan Registry of Clinical Trials, included 18 post-stroke patients in the convalescent rehabilitation ward. Patients were randomly assigned to two groups and received either conventional rehabilitation (control) or conventional rehabilitation plus repetitive peripheral magnetic stimulation (intervention) for 2 weeks, followed by 2 weeks of the other treatment. The repetitive peripheral magnetic stimulation intervention consisted of 6,000 pulses per day at a frequency of 30 Hz, 5 days per week. The primary outcome was changes in hand edema. The secondary outcomes were circumference of the hand, passive range of motion of flexion and extension of the metacarpophalangeal joint, hand pain and numbness, and grip strength. The outcomes were analyzed using mixed-effects models for repeated measures. Results Sixteen patients who completed the whole phase were included in the analysis. The changes in hand edema showed significant differences between the groups ( p < .01). Metacarpophalangeal joint flexion also had significant differences between the groups ( p < .01). The left-right difference in hand volume increased from 48.8 ± 27.6 mL to 59.1 ± 26.3 mL after the control but significantly decreased from 56.3 ± 31.6 mL to 39.7 ± 30.2 mL after the intervention ( p < .01). Conclusions Repetitive peripheral magnetic stimulation is effective in reducing hemiparetic hand edema and increasing metacarpophalangeal joint flexion after stroke.

Objective: To identify factors associated with earlier independence in “real-life walking” during hospitalization in subacute stroke patients.Design: Retrospective cohort study.Subjects/Patients: Two hundred and six hemiplegic patients.Methods: Functional Independence Measure (FIM) walking items were measured biweekly from admission to discharge. Patients were grouped by achieving independent “real-life walking” (FIM-walking score ≥6). Time to independence, stratified by age, FIM motor score (FIM-M), FIM cognitive score (FIM-C), and Functional Ambulation Categories (FAC) scores were compared using Kaplan–Meier plots and log-rank tests. Hazard ratios were calculated via multivariable Cox proportional hazard models.Results: The median time to independence was 4 weeks, with significant differences (p < 0.05) by age, FIM-M, FIM-C, and FAC stratification. Age ≤64 years (hazard ratio 1.92, 95% confidence interval 1.21–3.06), FIM-C ≥25 (hazard ratio 2.42, 95% confidence interval 1.52–3.86), and FAC ≥3 (hazard ratio 1.98, 95% confidence interval 1.22–3.21) significantly affected earlier walking independence (all p < 0.01). Impeding factors were FIM-M ≤38 (hazard ratio 0.23, 95% confidence interval 0.13–0.40; p < 0.01) and FAC = 0 (hazard ratio 0.184, 95% confidence interval 0.06–0.62; p < 0.01).Conclusion: Early improvement in “real-life walking” was associated with younger age, greater cognitive function, and greater “test-setting walking” ability on admission. Low activities of daily living independence and “test-setting walking” ability hindered early progress.