研究者詳細 - 辻　哲也

論文 - 辻　哲也

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APPLICATION OF TRANSCRANIAL ALTERNATING CURRENT STIMULATION TO HAND REHABILITATION FOR CHRONIC STROKE PATIENTS WITH SEVERE UPPER LIMB PARESIS - A PHASE I CLINICAL TRIAL

Tashiro, S; Takemi, M; Yamada, S; Tsuji, T

INTERNATIONAL JOURNAL OF STROKE 18 （ 3 ） 430 - 430 2023年10月

ISSN 1747-4930

DMD患者における上肢運動機能障害度分類の併存的妥当性の検討

宮崎裕大, 原貴敏, 上村亜希子, 山野真弓, 萩原和樹, 西田大輔, 竹下絵里, 小牧宏文, 水野勝広, 辻哲也, 安保雅博

国立病院総合医学会講演抄録集（国立病院総合医学会） 77回 643 - 643 2023年10月

DMD患者における上肢運動機能障害度分類の併存的妥当性の検討

宮崎裕大, 原貴敏, 上村亜希子, 山野真弓, 萩原和樹, 西田大輔, 竹下絵里, 小牧宏文, 水野勝広, 辻哲也, 安保雅博

国立病院総合医学会講演抄録集（国立病院総合医学会） 77回 643 - 643 2023年10月

Charcot-Marie-Tooth病における短下肢装具療法の治療効果を定量的に評価した1例

宮崎裕大, 原貴敏, 加藤太郎, 西田大輔, 萩原和樹, 安保雅博, 辻哲也

臨床神経生理学（(一社)日本臨床神経生理学会） 51 （ 5 ） 577 - 577 2023年10月

ISSN 1345-7101

Charcot-Marie-Tooth病における短下肢装具療法の治療効果を定量的に評価した1例

宮崎裕大, 原貴敏, 加藤太郎, 西田大輔, 萩原和樹, 安保雅博, 辻哲也

臨床神経生理学（(一社)日本臨床神経生理学会） 51 （ 5 ） 577 - 577 2023年10月

ISSN 1345-7101

Charcot-Marie-Tooth病における短下肢装具療法の治療効果を定量的に評価した1例

宮崎裕大, 原貴敏, 加藤太郎, 西田大輔, 萩原和樹, 安保雅博, 辻哲也

臨床神経生理学（(一社)日本臨床神経生理学会） 51 （ 5 ） 577 - 577 2023年10月

ISSN 1345-7101

Association of sarcopenia with relative dose intensity of neoadjuvant chemotherapy in older patients with locally advanced esophageal cancer: A retrospective cohort study

Harada, T; Tsuji, T; Ueno, J; Hijikata, N; Ishikawa, A; Kotani, D; Kojima, T; Fujita, T

JOURNAL OF GERIATRIC ONCOLOGY （Elsevier BV） 14 （ 7 ） 101580 - 101580 2023年09月

ISSN 1879-4068

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Comparing the contribution of each clinical indicator in predictive models trained on 980 subacute stroke patients: a retrospective study

Miyazaki, Y; Kawakami, M; Kondo, K; Tsujikawa, M; Honaga, K; Suzuki, K; Tsuji, T

SCIENTIFIC REPORTS （Springer Science and Business Media LLC） 13 （ 1 ） 12324 2023年07月

ISSN 2045-2322

Abstract

Post-stroke disability affects patients’ lifestyles after discharge, and it is essential to predict functional recovery early in hospitalization to allow time for appropriate decisions. Previous studies reported important clinical indicators, but only a few clinical indicators were analyzed due to insufficient numbers of cases. Although review articles can exhaustively identify many prognostic factors, it remains impossible to compare the contribution of each predictor. This study aimed to determine which clinical indicators contribute more to predicting the functional independence measure (FIM) at discharge by comparing standardized coefficients. In this study, 980 participants were enrolled to build predictive models with 32 clinical indicators, including the stroke impairment assessment set (SIAS). Trunk function had the most significant standardized coefficient of 0.221. The predictive models also identified easy FIM sub-items, SIAS, and grip strength on the unaffected side as having positive standardized coefficients. As for the predictive accuracy of this model, R2 was 0.741. This is the first report that included FIM sub-items separately in post-stroke predictive models with other clinical indicators. Trunk function and easy FIM sub-items were included in the predictive model with larger positive standardized coefficients. This predictive model may predict prognosis with high accuracy, fewer clinical indicators, and less effort to predict.

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COVID-19と誤嚥性肺炎による嚥下障害悪化にリハビリテーション治療が有効であったレット症候群の一例

堀川ゆい子, 大森まいこ, 中井咲貴子, 久保悠, 益田結子, 岡亜沙子, 朝倉めぐみ, 櫛田幸, 杉山遥, 辻哲也

The Japanese Journal of Rehabilitation Medicine （(公社)日本リハビリテーション医学会） 60 （特別号） 3 - 8 2023年05月

ISSN 1881-3526

Electrically Induced Sensory Trick in a Patient with Musician's Dystonia: A Case Report

Nishida, D; Mizuno, K; Takahashi, O; Liu, MG; Tsuji, T

BRAIN SCIENCES 13 （ 2 ） 2023年01月

ISSN 2076-3425

A sensory trick is a specific maneuver that temporarily improves focal dystonia. We describe a case of musician's dystonia in the right-hand fingers of a patient, who showed good and immediate improvement after using an electrical stimulation-mimicking sensory trick. A 49-year-old professional guitarist presented with chronic involuntary flexion of the right-hand third and fourth fingers that occurred during guitar performances. Electrical stimulation with a frequency of 40 Hz and an intensity of 1.5 times the sensory threshold was administered on the third and fourth fingernails of the right hand, which facilitated fluent guitar playing. While he played guitar with and without electrical stimulation, we measured the surface electromyograms (sEMG) of the right extensor digitorum and flexor digitorum superficialis muscles to evaluate the sensory-trick-like effects of electrical stimulation. This phenomenon can offer clues for developing electrical stimulation-based treatment devices for focal dystonia. Electrical stimulation has the advantage that it can be turned off to avoid habituation. Moreover, the device is easy to use and portable. These findings warrant further investigation into the use of sensory stimulation for treating focal dystonia.

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Early Phase Functional Recovery after Spinal Intramedullary Tumor Resection Could Predict Ambulatory Capacity at 1 Year after Surgery

Suzuki, T; Tsuji, O; Ichikawa, M; Ishii, R; Nagoshi, N; Kawakami, M; Watanabe, K; Matsumoto, M; Tsuji, T; Fujiwara, T; Nakamura, M

ASIAN SPINE JOURNAL 17 （ 2 ） 355 - 364 2023年01月

ISSN 1976-1902

STUDY DESIGN: This is a single-center retrospective cohort study with a university hospital setting. PURPOSE: This study aims to evaluate the short-term course of physical function and walking ability after intramedullary spinal cord tumor (ISCT) resection and predict walking independence 1 year after surgery. OVERVIEW OF LITERATURE: Although several reports have shown the postoperative functional prognosis of spinal intramedullary tumors with long-term follow-up, no reports have identified the predictors associated with the functional outcome at an early stage. METHODS: A total of 79 individuals who underwent ISCT resection at our institute between 2014 and 2019 were enrolled in the study, whose preoperative walking state was independent ambulator regardless of cane support with the Functional Independence Measure Locomotor Scale (FIM-L) score of ≥6. The FIM-L, the American Spinal Injury Association (ASIA) motor and sensory scores in the lower extremities, and the Walking Index for Spinal Cord Injury II (WISCI II) were assessed for walking independence, lower-limb function, and walking ability, respectively. These evaluations were performed at 4 time points: preoperatively, 1 week (1W), 2 weeks (2W), and 1 year after surgery. RESULTS: In the early phase after surgery, 71% and 43% of the participants were nonindependent ambulators at 1W and 2W, respectively. Histopathology indicated that patients with solid tumors (ependymoma, astrocytoma, or lipoma) showed significantly lower indices at 1W and 2W than those with vascular tumors (hemangioblastoma or cavernous hemangioma). Regarding tumor location, thoracic cases exhibited poorer lower-limb function at 1W and 2W and poorer walking ability at 2W than cervical cases. According to the receiver operating characteristic (ROC) analysis, 2 WISCI II points at 2W had the highest sensitivity (100%) and specificity (92.2%) in predicting the level of walking independence at 1 year postoperatively (the area under the ROC curve was 0.99 (95% confidence interval, 0.93-1.00). CONCLUSIONS: The higher the lower-limb function scores in the early phase, the better the improvement in walking ability is predicted 1 year after ISCT resection.

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Combined Ankle Robot Training and Robot-assisted Gait Training Improved the Gait Pattern of a Patient with Chronic Traumatic Brain Injury

Kamimoto, T; Hosoi, Y; Tanamachi, K; Yamamoto, R; Yamada, Y; Teramae, T; Noda, T; Kaneko, F; Tsuji, T; Kawakami, M

Progress in Rehabilitation Medicine （公益社団法人日本リハビリテーション医学会） 8 （ 0 ） n/a - n/a 2023年

Background : Walking disability caused by central nervous system injury often lingers. In the chronic phase, there is great need to improve walking speed and gait, even for patients who walk independently. Robot-assisted gait training (RAGT) has been widely used, but few studies have focused on improving gait patterns, and its effectiveness for motor function has been limited. This report describes the combination of “RAGT to learn the gait pattern” and “ankle robot training to improve motor function” in a patient with chronic stage brain injury.Case : A 34-year-old woman suffered a traumatic brain injury 5 years ago. She had residual right hemiplegia [Fugl-Meyer Assessment-Lower Extremity (FMA-LE): 18 points] and mild sensory impairment, but she walked independently with a short leg brace and a cane. Her comfortable gait speed was 0.57 m/s without an orthosis, and her 6-m walk test distance was 240 m. The Gait Assessment and Intervention Tool (G.A.I.T.) score was 35 points. After hospitalization, ankle robot training was performed daily, with RAGT performed 10 times in total. Post-intervention evaluation performed on Day 28 showed: FMA-LE, 23 points; comfortable walking speed, 0.69 m/s; G.A.I.T., 27 points; and three-dimensional motion analysis showed ankle dorsiflexion improved from 3.22° to 12.59° and knee flexion improved from 1.75° to 16.54° in the swing phase.Discussion : This is one of few studies to have examined the combination of two robots. Combining the features of each robot improved the gait pattern and motor function, even in the chronic phase.

Effect of Postoperative Oral Intake Status on Sarcopenia Six Months After Esophageal Cancer Surgery (Jun, 10.1007/s00455-022-10471-z, 2022)

Hijikata, N; Ishikawa, A; Matsuda, S; Kawakami, M; Muraoka, K; Ando, M; Mayanagi, S; Irino, T; Kawakubo, H; Kitagawa, Y; Tsuji, T

DYSPHAGIA 38 （ 1 ） 351 - 352 2022年12月

ISSN 0179-051X

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ASO Author Reflections: Significance of Loss of Skeletal Muscle Mass During Neoadjuvant Chemotherapy in Older Patients with Esophageal Cancer

Harada, T; Tsuji, T; Fujita, T

ANNALS OF SURGICAL ONCOLOGY 29 （ 13 ） 8140 - 8141 2022年12月

ISSN 1068-9265

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Cognitive function is associated with home discharge in subacute stroke patients: a retrospective cohort study

Daisuke Ito, Michiyuki Kawakami, Ryota Ishii, Masahiro Tsujikawa, Kaoru Honaga, Kunitsugu Kondo, Tetsuya Tsuji

BMC Neurology （Springer Science and Business Media LLC） 22 （ 1 ） 2022年12月

Abstract

Aim

To investigate the cognitive function and its relation to the home discharge of patients following subacute stroke.

Methods

This retrospective cohort study included 1,229 convalescent patients experiencing their first subacute stroke. We determined discharge destination and demographic and clinical information. We recorded the following measurement scores: Mini-Mental State Examination (MMSE) score, Stroke Impairment Assessment Set score, grip strength, and Functional Independence Measure (FIM). We performed a multivariable logistic regression analysis with the forced-entry method to identify factors related to home discharge.

Results

Of the 1,229 participants (mean age: 68.7 ± 13.5 years), 501 (40.8%), 735 (59.8%), and 1,011 (82.3%) were female, had cerebral infarction, and were home discharged, respectively. Multivariable logistic regression analysis revealed that age (odds ratio [OR], 0.93; 95% confidence interval [CI], 0.91 – 0.96; P < 0.001), duration from stroke onset to admission (OR, 0.98; 95% CI, 0.96 – 0.99; P = 0.003), living situation (OR, 4.40; 95% CI, 2.69 – 7.20; P < 0.001), MMSE score at admission (OR, 1.05; 95% CI, 1.00 – 1.09; P = 0.035), FIM motor score at admission (OR, 1.04; 95% CI, 1.01 – 1.06; P = 0.001), and FIM cognitive score at admission (OR, 1.08; 95% CI, 1.04 – 1.13; P < 0.001) were significantly associated with home discharge.

Conclusions

MMSE at admission is significantly associated with home discharge in patients with subacute stroke.

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ASO Visual Abstract: Prognostic Impact of the Loss of Skeletal Muscle Mass during Neoadjuvant Chemotherapy on Older Patients with Esophageal Cancer

Harada, T; Tsuji, T; Ueno, J; Koishihara, Y; Konishi, N; Hijikata, N; Ishikawa, A; Kotani, D; Kojima, T; Fujiwara, H; Fujita, T

ANNALS OF SURGICAL ONCOLOGY 29 （ 13 ） 8142 - 8143 2022年12月

ISSN 1068-9265

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Effects of the COVID-19 Pandemic on Physical Function of Community-Dwelling People with Disabilities in Japan

Kamimoto, T; Kawakami, M; Morita, T; Miyazaki, Y; Hijikata, N; Akimoto, T; Tsujikawa, M; Honaga, K; Suzuki, K; Kondo, K; Tsuji, T

INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 19 （ 19 ） 2022年10月

ISSN 1661-7827

In 2020, COVID-19 spread throughout the world, and international measures such as travel bans, quarantines, and increased social distancing were implemented. In Japan, the number of infected people increased, and a state of emergency was declared from 16 April to 25 May 2020. Such a change in physical activity could lead to a decline in physical function in people with disabilities. A retrospective study was conducted to determine the impact of the pandemic on the physical function of disabled persons living in the community. Data were collected at four points in time: two points before the declaration of the state of emergency was issued and two points after the declaration period had ended. Time series data of physical function at four points in time were compared for 241 people with disabilities. The mean age was 72.39 years; 157 had stroke, 59 musculoskeletal disease, and 26 other diseases. Overall, there was a long-term decrease in walking speed (p < 0.001) and a worsening of the Timed Up-and-Go (TUG) score (p < 0.001) after the period of the state of emergency. The TUG score worsened only in the group with a walking speed of 1.0 m/s or less before the state of emergency (p = 0.064), suggesting that this group was more susceptible.