谷野 元一

<p>Teranishi T, Kondo I, Okuyama Y, Tanino G, Miyasaka H, Sonoda S. Investigation of factors involved in patient falls during the early stage of hospitalization in a Kaifukuki rehabilitation ward. Jpn J Compr Rehabil Sci 2017; 8: 10-15. </p><p>Objective: To investigate factors affecting the occurrence of falls during the early stage of hospitalization in a Kaifukuki (convalescence) rehabilitation ward. </p><p>Methods: The subjects were 545 hospitalized patients, divided into a fall group (having experienced a fall within 14 days following admission) and a non-fall group. Differences between the two groups in terms of the Standing Test for Imbalance and Disequilibrium (SIDE) level and in the subscales of the Functional Independence Measure (FIM) were investigated. Logistic regression was carried out on items for which there were significant differences between the groups as dependent variables and the occurrence of falls as the objective variable, and the odds ratios were computed. </p><p>Results: The fall group comprised 36 subjects. Significant differences between groups were found in the SIDE level, lower body dressing, bath transfer, stairs, social interaction, problem solving, and memory. Logistic regression only identified problem solving as associated with the occurrence of falls (odds ratio, 0.288; p=0.035). For the SIDE level, complete separation of non-fall subjects was seen at levels of 2b or higher. </p><p>Conclusion: Falls in the early stage following admission do not occur among individuals with good balance, and problem solving according to the FIM is involved in falls.</p>

歩行再建では社会生活を見据えつつ，歩行の基盤となる機能レベルの底上げを図り，障害の残存を考慮して装具などを用いた新たな動作を学習することになる．その実践には運動学習の理論に基づいた高強度・高密度でのリハビリテーションが不可欠である．われわれが開発したFIT programには365日の訓練を可能とする仕組み，リハビリテーションの質を担保するためのコミュニケーションなどが内包されている．<br> 訓練量の増加は片麻痺の改善，歩行能力の改善をもたらす．装具を用いた訓練難易度の最適化は大切である．さらに効率を高めるためにロボットやトレッドミル，安全懸架などの手段を用いたり，病棟での訓練を調整することも重要となる．

Teranishi T, Kondo I, Sonoda S, Kagaya H, Wada Y, Miyasaka H, Tanino G, Narita W, Sakurai H, Okada M, Saitoh E. A discriminative measure for static postural control ability to prevent in-hospital falls: Reliability and validity of the Standing Test for Imbalance and Disequilibrium (SIDE). Jpn J Compr Rehabil Sci 2010; 1: 11-16<br>Purposes: To determine the reliability, validity, and clinical significance of the Standing Test for Imbalance and Disequilibrium (SIDE), a discriminative measure of standing balance, before using it to prevent falls in clinical settings.<br>Methods: In all, 30 patients (18 men and 12 women) with a mean (standard deviation) age of 57.4 (16.97) years (range, 25-85 years) who were admitted to the &ldquo;Kaifukuki&rdquo; rehabilitation ward voluntarily participated in this study. In the reliability study, 2 physiotherapists independently classified the level of static postural control ability by using SIDE. Functional balance control ability was simultaneously evaluated using the Berg Balance Scale (BBS). Cohen's &kappa; statistic was used to determine the inter-rater reliability, and the Spearman rank-correlation coefficient between the BBS score and SIDE level was used to determine the criterion-related validity.<br> Results: Inter-rater reliability of SIDE showed excellent reproducibility (Cohen's &kappa; statistic = 0.76). Criterion-related validity was very high between SIDE levels and BBS scores (Spearman rank-correlation coefficient = 0.93; p < 0.01).<br>Conclusion: SIDE can be used to efficiently and accurately classify balance control ability across individuals and has remarkable concurrent validity in balance evaluation compared to BBS.