辻 哲也 (ツジ テツヤ)

Tsuji, Tetsuya

写真a

所属(所属キャンパス)

医学部 リハビリテーション医学教室 (信濃町)

職名

准教授

その他の所属・職名 【 表示 / 非表示

  • 医学部, 腫瘍センター(リハビリテーション部門), 部門長

経歴 【 表示 / 非表示

  • 1990年04月
    -
    1992年03月

    慶應義塾大学病院, リハビリテーション科, 研修医

  • 1992年04月
    -
    1996年04月

    慶應義塾大学病院, リハビリテーション科, 専修医

  • 1996年05月
    -
    1998年04月

    埼玉県総合リハビリテーションセンター, リハビリテーション科, 医員

  • 1998年05月
    -
    2000年04月

    慶應義塾大学医学部, リハビリテーション医学, 助教

  • 2000年05月
    -
    2001年04月

    ロンドン大学附属神経研究所, 臨床神経生理学, リサーチフェロー

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学歴 【 表示 / 非表示

  • 1990年03月

    慶應義塾, 医学部

    大学, 卒業

学位 【 表示 / 非表示

  • 慶應義塾大学, 慶應義塾, 大学評価・学位授与機構, 1999年09月

    脳卒中片麻痺患者のフィジカルフィットネスに関する運動生理学的研究

免許・資格 【 表示 / 非表示

  • 医師免許, 1990年05月

  • 日本リハビリテーション医学会認定臨床医, 1994年10月

  • 義肢装具等適合判定医, 1995年01月

  • 日本リハビリテーション医学会専門医, 1996年03月

  • 身体障害者福祉法第15条指定医, 2002年08月

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研究分野 【 表示 / 非表示

  • リハビリテーション科学・福祉工学

  • 脳計測科学

研究キーワード 【 表示 / 非表示

  • がんリハビリテーション

  • リハビリテーション医学

  • リンパ浮腫

  • 緩和ケア

  • 臨床神経生理学

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研究テーマ 【 表示 / 非表示

  • 3次元Fiber grantingセンサ摂食嚥下機能解析・診断装置を用いた摂食嚥下機能の定量評価に関する研究, 

    2014年09月
    -
    継続中

  • 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, 

    2013年11月
    -
    継続中

 

論文 【 表示 / 非表示

  • 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年10月

    ISSN  02680033

     概要を見る

    © 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年05月

     概要を見る

    © 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年05月

    ISSN  09414355

     概要を見る

    © 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年02月

    ISSN  21905991

     概要を見る

    © 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年12月

    ISSN  15347354

     概要を見る

    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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KOARA(リポジトリ)収録論文等 【 表示 / 非表示

競争的資金等の研究課題 【 表示 / 非表示

  • リンパ浮腫の圧迫下での運動療法の効果と最適な運動様式の指針の作成に関する研究

    2017年04月
    -
    2020年03月

    文部科学省・日本学術振興会, 科学研究費助成事業, 辻 哲也, 基盤研究(C), 補助金,  代表

  • リンパ浮腫の包括的評価法の計量心理学的分析と評価セットの作成に関する研究

    2014年04月
    -
    2017年03月

    文部科学省・日本学術振興会, 科学研究費助成事業, 辻 哲也, 基盤研究(C), 補助金,  代表

     研究概要を見る

    目的は下肢リンパ浮腫患者を対象に運動耐容能(シャトルウォーキングテスト:SWT)、脚パワー(階段昇降テスト:SCPT)、下肢筋力(患側大腿四頭筋筋力体重比:QUAD)を評価しリンパ浮腫が運動機能への影響を明らかにすることである。
    対象は下肢リンパ浮腫患者42名。浮腫重度群では有意にSWT歩行距離が短く、SCPT時間が長く、QUADが低かった。浮腫重度群でQUAD 40%未満の患者では、有意にSWT歩行距離が短く、SCPT時間が長かった。
    リンパ浮腫の重症化と浮腫側下肢筋力の低下が運動機能低下の主要因の一つであった。本研究で使用した評価項目のリンパ浮腫の運動機能の評価セットとしての有用性が示された。

受賞 【 表示 / 非表示

  • 慶應医学会三四会賞

    1999年10月, 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年06月, 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年06月, 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年06月, 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年10月, 慶應医学会

 

担当授業科目 【 表示 / 非表示

  • リハビリテーション医学講義

    2019年度

担当経験のある授業科目 【 表示 / 非表示

  • リハビリテーション医学

    慶應義塾, 2015年度, 秋学期, 専門科目, 講義, 兼担, 1時間, 110人

    がんリハビリテーション、心臓リハビリテーション、呼吸リハビリテーション

  • 臨床腫瘍学、がんリハビリテーション

    慶應義塾, 2015年度, 秋学期, 専門科目, 講義, 1時間, 10人

    がんリハビリテーション