Tsuji, Tetsuya



School of Medicine, Department of Rehabilitation Medicine (Shinanomachi)



Other Affiliation 【 Display / hide

  • School of Medicine, 腫瘍センター(リハビリテーション部門), 部門長

Career 【 Display / hide

  • 1990.04

    keio University Hospital, Rehabilitation Medicine, resident

  • 1992.04

    Keio University Hospital, Rehabilitation Medicine, senior resident

  • 1996.05

    Saitama Rehabilitation Center, Rehabilitation Medicine, 医員

  • 1998.05

    Keio University School of Medicine, Rehabilitation Medicine, assistant professor

  • 2000.05

    Institue of Neurology, University College of London, Clinical Neurophysiology, research fellow

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Academic Background 【 Display / hide

  • 1990.03

    Keio University, School of Medicine

    University, Graduated

Academic Degrees 【 Display / hide

  • 慶應義塾大学, Keio University, National Institution for Academic Degrees and University Evaluation, 1999.09


Licenses and Qualifications 【 Display / hide

  • 医師免許, 1990.05

  • 日本リハビリテーション医学会認定臨床医, 1994.10

  • 義肢装具等適合判定医, 1995.01

  • 日本リハビリテーション医学会専門医, 1996.03

  • 身体障害者福祉法第15条指定医, 2002.08

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Research Areas 【 Display / hide

  • Rehabilitation science/Welfare engineering

  • Brain biometrics

Research Keywords 【 Display / hide

  • Cancer Rehabilitation

  • Physical Medicine and Rehabilitation

  • Lymphedema

  • Palliative Medicine

  • Clinical Neurophysiology

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Research Themes 【 Display / hide

  • Evaluation of a new fiber-grating vision sensor for assessing swallowing functions, 


  • 3次元Fiber grantingセンサ呼吸診断システムを用いた脳血管障害患者・筋ジストロフィー患者の夜間呼吸解析, 



Papers 【 Display / hide

  • Assessment of the Mini-Balance Evaluation Systems Test, Timed Up and Go test, and body sway test between cancer survivors and healthy participants

    Morishita S., Hirabayashi R., Tsubaki A., Aoki O., Fu J., Onishi H., Tsuji T.

    Clinical Biomechanics (Clinical Biomechanics)  69   28 - 33 2019.10

    ISSN  02680033

     View Summary

    © 2019 Elsevier Ltd Background: Cancer survivors experience late and long-term effects of treatment; also, the disease itself might be responsible for persisting functional impairments. The purpose of this study was to investigate muscle strength, balance function using the Mini-Balance Evaluation Systems Test and Timed Up and Go test with single and cognitive dual tasks and body sway in breast cancer survivors and healthy women and non-breast cancer survivors and healthy participants. Methods: Twenty-six cancer survivors and 19 healthy participants were assessed for grip and knee extension strength with the Mini-Balance Evaluation Systems Test, Timed Up and Go, and body sway test performance. Findings: Breast cancer survivors had significantly lower hand grip strength (p < .05) and Mini-Balance Evaluation Systems Test scores than healthy women (p < .05). Additionally, in breast cancer survivors, hand grip strength had a significant relationship with Mini-Balance Evaluation Systems Test and Timed Up and Go scores (p < .05) but had no relationship with the total center of pressure length. Hand grip strength and Mini-Balance Evaluation Systems Test scores were not significantly different in non-breast cancer survivors and healthy participants. In non-breast cancer survivors, knee extension strength had a significant relationship with the Timed Up and Go scores (p < .05). Interpretation: The relationship between muscle strength and balance function may be characterized by the different diagnoses in cancer survivors. The current findings showed the changes in balance function and muscle strength among cancer survivors.

  • A randomized phase II study of nutritional and exercise treatment for elderly patients with advanced non-small cell lung or pancreatic cancer: The NEXTAC-TWO study protocol

    Miura S., Naito T., Mitsunaga S., Omae K., Mori K., Inano T., Yamaguchi T., Tatematsu N., Okayama T., Morikawa A., Mouri T., Tanaka H., Kimura M., Imai H., Mizukami T., Imoto A., Kondoh C., Shiotsu S., Okuyama H., Ueno M., Takahashi T., Tsuji T., Aragane H., Inui A., Higashiguchi T., Takayama K.

    BMC Cancer (BMC Cancer)  19 ( 1 )  2019.05

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    © 2019 The Author(s). Background: Most advanced elderly cancer patients experience fatigue, anorexia, and declining physical function due to cancer cachexia, for which effective interventions have not been established. We performed a phase I study of a new nonpharmacological multimodal intervention called the nutritional and exercise treatment for advanced cancer (NEXTAC) program and reported the excellent feasibility of and compliance with this program in elderly patients with advanced cancer who were at risk for cancer cachexia. We report here the background, hypothesis, and design of the next-step multicenter, randomized phase II study to evaluate the efficacy of the program, the NEXTAC-TWO study. Methods: Patients with chemo-naïve advanced non-small cell lung cancer or pancreatic cancer, age ≥ 70 years, performance status ≤2, with adequate organ function and without disability according to the modified Katz index will be eligible. In total, 130 participants will be recruited from 15 Japanese institutions and will be randomized into either the intervention group or a control group. Computer-generated random numbers are allocated to each participant. Stratification factors include performance status (0 to 1 vs. 2), site of primary cancer (lung vs. pancreas), stage (III vs. IV), and type of chemotherapy (cytotoxic vs. others). Interventions and assessment will be performed 4 times every 4 ± 2 weeks from the date of randomization. Interventions will consist of nutritional counseling, nutritional supplements (rich in branched-chain amino acids), and a home-based exercise program. The exercise program will include low-intensity daily muscle training and lifestyle education to promote physical activity. The primary endpoint is disability-free survival. It is defined as the period from the date of randomization to the date of developing disability or death due to any cause. This trial also plans to evaluate the improvements in nutritional status, physical condition, quality of life, activities of daily living, overall survival, and safety as secondary endpoints. Enrollment began in August 2017. The study results will demonstrate the efficacy of multimodal interventions for elderly cancer patients and their application for the maintenance of physical and nutritional conditions in patients with cancer cachexia. This work is supported by a grant-in-aid from the Japan Agency for Medical Research and Development. Discussion: This is the first randomized trial to evaluate the efficacy and safety of a multimodal intervention specific for elderly patients with advanced cancer.

  • Factors affecting lower limb muscle strength and cardiopulmonary fitness after allogeneic hematopoietic stem cell transplantation

    Ishikawa A., Otaka Y., Kamisako M., Suzuki T., Miyata C., Tsuji T., Matsumoto H., Kato J., Mori T., Okamoto S., Liu M.

    Supportive Care in Cancer (Supportive Care in Cancer)  27 ( 5 ) 1793 - 1800 2019.05

    ISSN  09414355

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    © 2018, The Author(s). Purpose: The aim of this study is to clarify the factors affecting physical function after allogeneic hematopoietic stem cell transplantation (HSCT). Methods: We retrospectively analyzed 88 patients (median age, 44.5 years) who received allogeneic HSCT. Leg extension torque and peak oxygen consumption (VO 2 ) were evaluated before and after HSCT. Patient factors (age, sex, underlying diseases, hemoglobin, serum albumin, and Karnofsky performance status score before transplant) and transplant factors (conditioning regimen, days to neutrophil engraftment, grades of acute graft-versus-host disease [GVHD], infections, and the interval between pre- and post-evaluation) were collected via chart review, and were used for correlational and comparison analyses in order to identify the variables associated with reduced post-HSCT leg extension torque and peak VO 2 . Stepwise multiple regression analyses for post-HSCT leg extension torque and post-HSCT peak VO 2 were performed using age, sex, and the related variables with a p value < 0.2 in the correlational and comparison analyses. Results: Leg extension torque and peak VO 2 were significantly reduced after HSCT (p < 0.001). Pre-HSCT leg extension torque, grades of acute GVHD, age, and the interval between pre- and post-evaluation were identified as significant factors associated with reduced post-HSCT leg extension torque. However, none of these factors were significantly associated with reduced post-HSCT peak VO 2 , and only its pre-transplant value was identified as a significant factor. Conclusions: These findings suggest that improvements in muscle strength and cardiopulmonary fitness before HSCT are crucial for maintaining post-treatment physical function, especially in elderly individuals with acute GVHD requiring a long-term stay in a protective environment.

  • Feasibility of early multimodal interventions for elderly patients with advanced pancreatic and non-small-cell lung cancer

    Naito T., Mitsunaga S., Miura S., Tatematsu N., Inano T., Mouri T., Tsuji T., Higashiguchi T., Inui A., Okayama T., Yamaguchi T., Morikawa A., Mori N., Takahashi T., Strasser F., Omae K., Mori K., Takayama K.

    Journal of Cachexia, Sarcopenia and Muscle (Journal of Cachexia, Sarcopenia and Muscle)  10 ( 1 ) 73 - 83 2019.02

    ISSN  21905991

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    © 2018 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders Background: Combinations of exercise and nutritional interventions might improve the functional prognosis for cachectic cancer patients. However, high attrition and poor compliance with interventions limit their efficacy. We aimed to test the feasibility of the early induction of new multimodal interventions specific for elderly patients with advanced cancer Nutrition and Exercise Treatment for Advanced Cancer (NEXTAC) programme. Methods: This was a multicentre prospective single-arm study. We recruited 30 of 46 screened patients aged ≥70 years scheduled to receive first-line chemotherapy for newly diagnosed, advanced pancreatic, or non-small-cell lung cancer. Physical activity was measured using pedometers/accelerometer (Lifecorder ® , Suzuken Co., Ltd., Japan). An 8 week educational intervention comprised three exercise and three nutritional sessions. The exercise interventions combined home-based low-intensity resistance training and counselling to promote physical activity. Nutritional interventions included standard nutritional counselling and instruction on how to manage symptoms that interfere with patient's appetite and oral intake. Supplements rich in branched-chain amino acids (Inner Power ® , Otsuka Pharmaceutical Co., Ltd., Japan) were provided. The primary endpoint of the study was feasibility, which was defined as the proportion of patients attending ≥4 of six sessions. Secondary endpoints included compliance and safety. Results: The median patient age was 75 years (range, 70–84). Twelve patients (40%) were cachectic at baseline. Twenty-nine patients attended ≥4 of the six planned sessions (96.7%, 95% confidence interval, 83.3 to 99.4). One patient dropped out due to deteriorating health status. The median proportion of days of compliance with supplement consumption and exercise performance were 99% and 91%, respectively. Adverse events possibly related to the NEXTAC programme were observed in five patients and included muscle pain (Grade 1 in two patients), arthralgia (Grade 1 in one patient), dyspnoea on exertion (Grade 1 in one patient), and plantar aponeurositis (Grade 1 in one patient). Conclusions: The early induction of multimodal interventions showed excellent compliance and safety in elderly patients with newly diagnosed pancreatic and non-small-cell lung cancer receiving concurrent chemotherapy. We are now conducting a randomized phase II study to measure the impact of these interventions on functional prognosis.

  • Differences in Balance Function Between Cancer Survivors and Healthy Subjects: A Pilot Study

    Morishita S., Mitobe Y., Tsubaki A., Aoki O., Fu J., Onishi H., Tsuji T.

    Integrative cancer therapies (Integrative cancer therapies)  17 ( 4 ) 1144 - 1149 2018.12

    ISSN  15347354

     View Summary

    Older adults who have survived cancer experience significantly more falls compared with healthy adults. Adult cancer survivors may also have a lower balance function than healthy adults. We examined muscle strength and balance function among 19 cancer survivors and 14 healthy subjects. The mean age of the cancer survivors was 51.5 ± 11.2 years; 6 men and 13 women. Cancer diagnoses included breast cancer, retroperitoneal sarcoma, acute leukemia, lung cancer, colorectal cancer, thyroid cancer, Ewing's sarcoma, and tongue cancer. The mean age of healthy subjects was 47.4 ± 14 years; 3 men, 11 women. Muscle strength was assessed using hand grip and knee extensor strength tests. Balance function was evaluated using the Timed Up and Go (TUG) test, and body sway was tested using a force platform. No significant differences were found with respect to right and left grip strength or right and left knee extension strength between the 2 groups. A significantly higher TUG time was observed in cancer survivors than in healthy subjects ( P < .05). With eyes open, the area of the center of pressure was significantly larger in cancer survivors than in healthy subjects ( P < .05). Similarly, the length per area was significantly lower both with eyes open and closed for cancer survivors than for healthy subjects ( P < .05). TUG was significantly correlated with muscle strength in both groups ( P < .05). However, no body sway parameters were related to muscle strength in either group. Cancer survivors had lower balance function that might not have been related to muscle strength. Cancer survivors should be evaluated for balance function as there is a potential for impairment. The findings of this study will be relevant for planning the prevention of falls for cancer survivors.

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Papers, etc., Registered in KOARA 【 Display / hide

Research Projects of Competitive Funds, etc. 【 Display / hide

  • Immediate effects of manual lymph drainage (MLD) and active exercise with compression therapy on lower-limb lymphedema: compilation of the treatment guidelines of lymphedema


    MEXT,JSPS, Grant-in-Aid for Scientific Research, 辻 哲也, Grant-in-Aid for Scientific Research (C), Principal Investigator

  • Immediate effects of active exercise with compression therapy and the creation of guidelines for the best type of exercise on lower-limb lymphedema


    MEXT,JSPS, Grant-in-Aid for Scientific Research, 辻 哲也, Grant-in-Aid for Scientific Research (C), Principal Investigator

  • Study on analysis of psychometric property of the comprehensive measurement and the assessment set in patients with lymphedema


    MEXT,JSPS, Grant-in-Aid for Scientific Research, 辻 哲也, Grant-in-Aid for Scientific Research (C), Principal Investigator

     View Summary

    The aim is to evaluate exercise tolerance (Shuttle walking test: SWT), leg power (stair climbing power test: SCPT), lower Limb muscle strength (the ratio of quadriceps muscle strength to body weight on the affected side: QUAD) and clear negative effects of lymphedema on motor function.
    Subjects were 42 patients with lymphedema. In severe edema group, there were significantly shorter in SWT distance, longer in SCPT time, and lower in QUAD than in mild one. Patients below 40% of QUAD in severe edema group, SWT distance was shorter and SCPT time was longer significantly.
    Severer lymphedema and lower muscle strength on the affected side were one of the main factor of decreases in motor function. We showed that evaluation items of our study were useful as the assessment set of motor function in patients with lymphedema.

Awards 【 Display / hide

  • 慶應医学会三四会賞

    1999.10, 慶應医学会

  • 日本リハビリテーション医学会論文賞 優秀賞

    2005.06, 日本リハビリテーション医学会

  • 日本リハビリテーション医学会論文賞 優秀賞

    2006.06, 日本リハビリテーション医学会

  • 日本リハビリテーション医学会論文賞 奨励賞

    2007.06, 日本リハビリテーション医学会

  • 慶應医学会三四会奨励賞

    2011.10, 慶應医学会


Courses Taught 【 Display / hide





Courses Previously Taught 【 Display / hide

  • Rehabilitation Medicine

    Keio University, 2015, Autumn Semester, Major subject, Lecture, Lecturer outside of Keio, 1h, 110people

    Cancer Rehabilitation, Cardiac rehabilitation, Pulmonary rehabilitation

  • Clinical Oncology, Cancer Rehabilitation

    Keio University, 2015, Autumn Semester, Major subject, Lecture, 1h, 10people

    Cancer Rehabilitation