koyama soichiro

Abstract Purpose To evaluate factors influencing the range of motion (ROM) in shoulder flexion and abduction, which are often compromised by postoperative conditions, including pain, soft tissue damage, and muscle weakness, 1 month after breast cancer surgery in patients undergoing inpatient rehabilitation. Methods In this retrospective study, the electronic medical database of a university hospital was searched for patients who underwent inpatient rehabilitation following breast cancer surgery between May 2014 and April 2020. The extracted data included age, sex, affected side, body mass index, number of nodes removed, levels of axillary lymph nodes, type of mastectomy, chemotherapy, radiation therapy, duration of postoperative drain placement, and length of hospital stay after the surgery. Passive shoulder joint ROM was examined before and 1 month after surgery. Multivariable logistic regression was performed to explore the prevalence of and factors associated with the presence of shoulder joint ROM limitations 1 month after surgery. Results This study enrolled 258 patients. A total of 210 participants (81.4%) had shoulder ROM limitation after the surgery. Shoulder flexion and abduction ROM decreased after surgery by an average of 31.3° and 35.9°, respectively. Age, number of nodes removed, and total mastectomy were significantly associated with shoulder joint ROM limitation after surgery. Conclusion Over 80% of participants had reduced shoulder ROM 1 month after surgery, even after inpatient rehabilitation. We identified age, number of nodes removed, and total mastectomy as risk factors for reduced shoulder ROM, providing useful prognostic information regarding the restriction of passive shoulder ROM after breast cancer surgery.

In individuals with Parkinson’s disease (PD), bradykinesia severity is related to physical activity (PA) inside homes. We aimed to investigate the effectiveness of the Lee Silverman Voice Treatment (LSVT)® BIG intervention in increasing at-home PA in individuals with PD. To evaluate the effect of the intervention, we compared pre- and post-intervention scores on the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Parts 3 and 2, as well as the time spent at home in three categories of PA intensity. For statistical testing, paired t-tests were used when the data met the assumptions of normality, and the Wilcoxon signed-rank test was applied otherwise. Differences were considered statistically significant at p < 0.05. This preliminary retrospective observational study included 10 eligible individuals with PD (4 males). The participants’ mean age was 71.0 ± 10.8 years, with median Hoehn and Yahr stage 3 [interquartile range: 1 to 4]. The MDS-UPDRS Part 3 score, bradykinesia score calculated from a part of that score, and the MDS-UPDRS Part 2 score significantly improved after the intervention (Wilcoxon signed-rank test, p < 0.05). The time spent in sedentary behavior (SB) significantly decreased from 516.4 ± 72.6 to 484.0 ± 70.0 min, whereas that spent in light PA (LPA) significantly increased from 137.8 ± 46.2 to 169.5 ± 32.1 min (paired t-test, p < 0.05). The time spent on moderate-to-vigorous PA (MVPA) did not change significantly (paired t-test, p = 0.533). The results suggested that LSVT® BIG is an effective intervention for increasing at-home PA in individuals with PD. In addition, regarding the specific details of the increase, the time spent on MVPA may not change, and the increase may be mainly attributed to increased LPA and reduced sedentary time.

This study aimed to investigate the timing of foot-off and initial contact at the end of the first walking training session with a Wearable Power-Assist Locomotor (WPAL) in novice healthy users. Eight healthy volunteers with no walking experience with the WPAL participated in this study. The participants walked back and forth on a straight 5 m path for 60 min with the WPAL. We calculated the differences between the participant’s foot-off and initial contact timing, as well as the start and end timing of the pre-programmed WPAL lower-limb swing time. Data were divided into four segments of 100 data points. We calculated the median of the last 100 data points and examined whether it falls within an appropriate time range. The foot-off timing tended to be within the appropriate time range (median, −0.44 s); however, the initial contact timing was earlier than the appropriate time range (median, −0.17 s). Although some participants performed foot-off within the appropriate time range, all performed initial contact earlier than the appropriate time range. These findings may contribute to establishing practice protocols for stable walking with wearable robotic exoskeletons in patients with spinal cord injury.

Background/Objectives: Individuals with Parkinson’s disease (PD) often experience four major motor symptoms—tremor, rigidity, bradykinesia, and postural instability/gait disorder. Although these symptoms have been shown to affect activities of daily living, their impact on the level of at-home physical activity (PA) in this population remains unexplored. We aimed to investigate the relationship between the four major motor symptoms of PD and at-home PA in these individuals. Methods: This retrospective cross-sectional study included 17 individuals with PD. We examined the relationship between the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale Part 3 score and the time spent in three PA intensities (sedentary behavior, light PA [LPA], and moderate-to-vigorous PA) within the home. Pearson’s correlation coefficient was used for statistical analysis. Results: In the initial step analysis, a significant negative correlation was observed between the overall motor symptom score and the time spent in LPA inside the home (rs [95% confidence interval]: −0.72 [−0.93 to −0.25]; p < 0.01). In the second step analysis, a significant negative correlation was observed between the bradykinesia score and the time spent in LPA inside the home (rs: −0.74 [−0.92 to −0.30]; p < 0.01). Conclusions: Among the four major motor symptoms, only the severity of bradykinesia influenced the time spent in LPA inside the home. Thus, rehabilitation treatment focusing on bradykinesia may be beneficial for increasing the time spent in LPA inside the home for individuals with PD.