論文 - 辻　哲也

Effect of Postoperative Oral Intake Status on Sarcopenia Six Months After Esophageal Cancer Surgery

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 ） 340 - 350 2022年06月

ISSN  0179-051X

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PURPOSE: In patients with esophageal cancer, skeletal muscle mass has been reported to decrease progressively after surgery and be independently associated with a poor prognosis. The purpose of this study was to investigate perioperative changes in dysphagia, oral intake status, and nutritional status and identify factors related to sarcopenia 6 months after esophagectomy. METHODS: A total of 134 patients who underwent radical resection for thoracic esophageal cancer between March 2016 and July 2019 were analyzed retrospectively. The diagnosis of sarcopenia was made by CT taken 6 months postoperatively using the cut-off criteria of skeletal muscle index (SMI) < 52.4 cm2/m2 for male and SMI < 38.5 cm2/m2 for female patients. As factors related to postoperative sarcopenia, dysphagia, oral intake status, nutritional status, and physical function were extracted from the medical records. Multivariate logistic regression analysis was performed to identify perioperative risk factors related to sarcopenia 6 months after surgery. RESULTS: Of the 134 patients, 34.3% were judged to be unable to start oral intake on swallowing assessment. At discharge, 30.6% received tube feeding with or without oral intake. In the non-oral intake group on swallowing assessment, a significantly higher proportion of patients received tube feeding at discharge (p = 0.014). Preoperative BMI, postoperative handgrip strength, and tube feeding at discharge were independent risk factors for sarcopenia 6 months after esophagectomy in male patients. CONCLUSION: Tube feeding at discharge is significantly related to postoperative sarcopenia in patients with esophageal cancer. Identifying high-risk groups might allow early detection of malnutrition and provision of appropriate care.

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

Ito, D; Kawakami, M; Ishii, R; Tsujikawa, M; Honaga, K; Kondo, K; Tsuji, T

BMC NEUROLOGY 22 （ 1 ）  2022年06月

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

Ito D, Kawakami M, Ishii R, Tsujikawa M, Honaga K, Kondo K, Tsuji T

BMC neurology 22 （ 1 ） 219 2022年06月

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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 22 （ 1 ） 219 - 219 2022年06月

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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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Effects of Galvanic Vestibular Stimulation on Subjective Visual Vertical and Sitting Balance in Patients with Stroke

Tomioka, Y; Tohyama, T; Honaga, K; Kawakami, M; Kondo, K; Tsuji, T

JOURNAL OF STROKE & CEREBROVASCULAR DISEASES 31 （ 5 ） 106430 - 106430 2022年05月

ISSN  1052-3057

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OBJECTIVE: This study aimed to examine the effects of galvanic vestibular stimulation (GVS) on visual vertical cognition and sitting balance in stroke patients. MATERIALS AND METHODS: Patients with unilateral supratentorial infarction and hemorrhagic lesions and healthy controls were recruited. Bipolar GVS was performed through the bilateral mastoid processes with an 1.5-mA electric current. Each participant received three stimulation patterns: right anode-left cathode, left anode-right cathode, and sham. The subjective visual vertical (SVV) and center of gravity positions in the sitting posture were measured in three groups of participants: patients with right hemisphere lesions, patients with left hemisphere lesions, and in healthy controls. Changes in the SVV and center of gravity positions before and during galvanic vestibular stimulation were assessed. RESULTS: In each group, eight individuals were recruited for SVV measurements and nine individuals for center of gravity measurements. We found changes due to polarity of stimulation on the SVV and mediolateral changes in the center of gravity in the sitting position of patients with stroke, while there was no significant difference between groups or interaction of the two factors (polarity vs. group). CONCLUSION: Changes in the visual vertical cognition and sitting balance occur during GVS in patients with stroke. GVS is a potential tool for ameliorating balance dysfunction in patients with stroke.

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Differences in the Relationships Between Muscle Strength, Muscle Mass, Balance Function, and Quality of Life for Middle-Aged and Older Breast Cancer Survivors

Morishita, S; Kasahara, R; Yamamoto, Y; Jinbo, R; Takano, A; Yasuda, M; Tsubaki, A; Aoki, O; Fu, JB; Tsuji, T

INTEGRATIVE CANCER THERAPIES 21   15347354221138574 - 15347354221138574 2022年

ISSN  1534-7354

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PURPOSE: The purpose of this study was to investigate the differences in muscle strength, muscle mass, balance function, and quality of life (QOL) among middle-aged breast cancer survivors (BCSs) and older BCSs. METHODS: The study included 53 middle-aged (<65 years old) BCSs and 49 older (≥65 years old) BCSs. Muscle strength was evaluated via handgrip and knee extensor strength, and muscle mass was assessed using a body composition test. Balance function was assessed using the Timed Up and Go test and the body sway test. QOL was assessed using the Medical Outcome Study 36-item Short-Form Health Survey. RESULTS: The older BCSs had significantly lower right grip strength, right knee extension strength, and muscle mass (P < .05) than the middle-aged BCSs. In addition, the body sway test showed that older BCSs had a significant increase in the length of center of pressure compared to middle-aged BCSs (P < .05). Older BCSs showed significantly lower physical functioning subscales in QOL compared to middle-aged BCSs (P < .05). The associations among muscle strength, muscle mass and QOL were more significantly observed in the older BCSs (P < .05). Furthermore, a significant correlation between QOL and balance function was observed in the older BCSs, but not in the middle-aged BCSs (P < .05). CONCLUSION: There may be associations among muscle strength, muscle mass, balance and QOL in older BCSs, but not in middle-aged BCSs. We believe that the findings of this study will be relevant in the context of planning rehabilitation for older BCSs.

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Cancer Rehabilitation Provided by Designated Cancer Hospitals in Japan: The Current State of Outpatient Setting and Coordination after Discharge

Fukushima, T; Tsuji, T; Watanabe, N; Sakurai, T; Matsuoka, A; Kojima, K; Yahiro, S; Oki, M; Okita, Y; Yokota, S; Nakano, J; Sugihara, S; Sato, H; Kawakami, J; Kagaya, H; Tanuma, A; Sekine, R; Mori, K; Zenda, S; Kawai, A

Progress in Rehabilitation Medicine （公益社団法人 日本リハビリテーション医学会）  7 （ 0 ） n/a - n/a 2022年

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<p><b>Objectives: </b>The aim of the present study was to clarify the current state of outpatient cancer rehabilitation and coordination systems provided by designated cancer hospitals in Japan.</p><p><b>Methods: </b>A questionnaire was sent to 427 designated cancer hospitals in Japan to investigate the status of outpatient cancer rehabilitation and whether it was sufficiently conducted. The status of regional coordination with post-discharge rehabilitation facilities was surveyed.</p><p><b>Results: </b>Responses were received from 235/427 facilities (55.0%). Outpatient cancer rehabilitation was implemented in 92 (39.1% of responding facilities), and of these facilities, 83.7% answered that the provision of rehabilitation was insufficient. The reasons were ineligibility for reimbursement of medical fees, a lack of human resources, a lack of awareness of the need, and a lack of education. Regional coordination was conducted by 39.1% of responding facilities, yet a regional alliance path had been established in only 9.8% of centers. The absence of coordination was associated with large facility size, the absence of physiatrists, and few rehabilitation professionals who had completed the training program; an insufficient framework for regional coordination was also given as a reason.</p><p><b>Conclusions: </b>To provide adequate outpatient cancer rehabilitation, sufficient human resources, the reimbursement of medical fees in the outpatient setting, and education and a framework to promote regional coordination are necessary.</p>

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Current progress of rehabilitative strategies in stem cell therapy for spinal cord injury: a review

Tashiro, S; Tsuji, O; Shinozaki, M; Shibata, T; Yoshida, T; Tomioka, Y; Unai, K; Kondo, T; Itakura, G; Kobayashi, Y; Yasuda, A; Nori, S; Fujiyoshi, K; Nagoshi, N; Kawakami, M; Uemura, O; Yamada, S; Tsuji, T; Okano, H; Nakamura, M

NPJ REGENERATIVE MEDICINE 6 （ 1 ） 81 - 81 2021年11月

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Stem cell-based regenerative therapy has opened an avenue for functional recovery of patients with spinal cord injury (SCI). Regenerative rehabilitation is attracting wide attention owing to its synergistic effects, feasibility, non-invasiveness, and diverse and systemic properties. In this review article, we summarize the features of rehabilitation, describe the mechanism of combinatorial treatment, and discuss regenerative rehabilitation in the context of SCI. Although conventional rehabilitative methods have commonly been implemented alone, especially in studies of acute-to-subacute SCI, the combinatorial effects of intensive and advanced methods, including various neurorehabilitative approaches, have also been reported. Separating the concept of combined rehabilitation from regenerative rehabilitation, we suggest that the main roles of regenerative rehabilitation can be categorized as conditioning/reconditioning, functional training, and physical exercise, all of which are indispensable for enhancing functional recovery achieved using stem cell therapies.

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FACTORS ASSOCIATED WITH COGNITIVE IMPROVEMENT IN SUBACUTE STROKE SURVIVORS

Mori, N; Otaka, Y; Honaga, K; Matsuura, D; Kondo, K; Liu, M; Tsuji, T

JOURNAL OF REHABILITATION MEDICINE 53 （ 8 ） jrm00220 2021年08月

ISSN  1650-1977

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OBJECTIVE: To elucidate the characteristics of subacute stroke survivors with post-stroke cognitive impairment, and examine the factors associated with cognitive recovery. DESIGN: Retrospective cohort study. PARTICIPANTS: A total of 218 consecutive stroke survivors, who were admitted to a rehabilitation hospital between April 2014 and March 2015, were included. METHODS: The prevalence of post-stroke cognitive impairment, defined as having a Mini-Mental State Examination (MMSE) score < 24 was investigated. Among those with post-stroke cognitive impairment, the characteristics of patients with clinically significant improvement in MMSE scores (change ≥ 4) were explored. Univariable and multivariable regression analyses were performed to examine the relationship between Functional Independence Measure (FIM) items and improvement in post-stroke cognitive impairment. RESULTS: Post-stroke cognitive impairment occurred in 47.7% of participants. The mean improvement in their MMSE scores was 3.43. Participants who showed improvement had significantly higher FIM scores at discharge than those who did not show improvement. Regarding FIM items, eating (odds ratio 1.3; 95% confidence interval 1.0-1.7; p = 0.041) and social interaction (odds ratio 1.5, 95% CI 1.1-2.1, p = 0.010) were associated with cognitive improvement. CONCLUSION: Approximately half of subacute stroke survivors have post-stroke cognitive impairment. Eating and social interaction are significantly associated with cognitive improvement.

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Development of home-based resistance training for older patients with advanced cancer: The exercise component of the nutrition and exercise treatment for advanced cancer program

Tatematsu, N; Naito, T; Okayama, T; Tsuji, T; Iwamura, A; Tanuma, A; Mitsunaga, S; Miura, S; Omae, K; Mori, K; Takayama, K

JOURNAL OF GERIATRIC ONCOLOGY 12 （ 6 ） 952 - 955 2021年07月

ISSN  1879-4068

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Conservative rehabilitation for a patient presenting with severe orthostatic hypotension after surgical management of brainstem tumor: illustrative case

Nagumo, M; Tashiro, S; Hijikata, N; Ishikawa, A; Akiyama, T; Tsuji, T

JOURNAL OF NEUROSURGERY-CASE LESSONS 1 （ 25 ） CASE2136 2021年06月

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BACKGROUND: Blood pressure (BP) dysregulation is frequently observed in patients after surgical management of brainstem lesions; however, there has been no standard rehabilitation. Considering the conflicting risks for hypoperfusion and disuse syndrome in these patients, a safe and effective rehabilitative strategy is warranted. OBSERVATIONS: A 50-year-old man who had undergone craniotomy for resection of a recurrent dorsal medullary epidermoid cyst developed persistent orthostatic hypotension. It was resistant to physical exercise, pharmacological therapy, abdominal binders, and compression stockings; therefore, it inhibited postoperative rehabilitation. Although the responsible lesion was not clearly visible on the postoperative image, accompanying symptoms, including segmental sensory impairment, implied an improvement in BP control. Although there was a trade-off between the risk of developing disuse syndrome and a delay in functional recovery, the authors decided to continue a conservative rehabilitation strategy rather than increasing the workload. The patient's BP control was gradually restored by the seventh postoperative week, and the authors proceeded with basic activity training. LESSONS: A conservative prognostic prediction-based rehabilitation strategy was applied in this case. The precise evaluation of the accompanying neurological symptoms was helpful in deciding the treatment regimen. The conflicting risks for hypoperfusion and disuse syndrome in such cases must be considered.

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Correlation between the brain activity with gait imagery and gait performance in adults with Parkinson's disease: A data set

Nishida, D; Mizuno, K; Yamada, E; Tsuji, T; Hanakawa, T; Liu, MG

DATA IN BRIEF 36   106993 - 106993 2021年06月

ISSN  2352-3409

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This article describes data related to the research study entitled "The neural correlate of gait improvement by rhythmic sound stimulation in adults with Parkinson's disease - A functional magnetic resonance imaging study" [1]. We evaluated gait performance using the 10-meter walk test (10MWT) in adults with Parkinson's disease (PD) and age-matched healthy controls (HC). Gait speed (GS) and step length (SL) were calculated from the results of the 10MWT. We also evaluated neural activities in regions that were significantly activated by gait imagery in adults with PD using functional magnetic resonance imaging (fMRI). The correlation among GS, SL, and activation of blood oxygenation level-dependent (BOLD) signals by gait imagery in adults with PD. Both GS and SL were smaller in adults with PD than in HCs. The left parietal operculum (PO), left supplementary motor area (SMA), and right cerebellum were activated by gait imagery in adults with PD. No significant correlation was found in any pair of gait performance and neural activation of such regions. This data set could be reused for studies to investigate the relationship between gait performance and neural activities in adults with PD.

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Fugl-Meyer Assessment上肢運動項目の難易度-回復期脳卒中患者での検討

新藤 恵一郎, 森 直樹, 辻川 将弘, 紙本 貴之, 下村 忠賛, 秋本 知則, 中尾 桂子, 川上 途行, 辻 哲也, 近藤 国嗣

The Japanese Journal of Rehabilitation Medicine （(公社)日本リハビリテーション医学会）  58 （ 特別号 ） 2 - 3 2021年05月

ISSN  1881-3526

Fugl-Meyer Assessment上肢運動項目の難易度-回復期脳卒中患者での検討

新藤 恵一郎, 森 直樹, 辻川 将弘, 紙本 貴之, 下村 忠賛, 秋本 知則, 中尾 桂子, 川上 途行, 辻 哲也, 近藤 国嗣

The Japanese Journal of Rehabilitation Medicine （(公社)日本リハビリテーション医学会）  58 （ 特別号 ） 2 - 3 2021年05月

ISSN  1881-3526

COVID-19感染拡大下におけるエアロゾル発生を伴う診療への非対面リハビリテーション診療の試み

田島 浩之, 和田 彩子, 川上 途行, 山田 祐歌, 森 直樹, 石川 愛子, 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）  58 （ 特別号 ） 2 - 2 2021年05月

ISSN  1881-3526

COVID-19感染拡大下におけるエアロゾル発生を伴う診療への非対面リハビリテーション診療の試み

田島 浩之, 和田 彩子, 川上 途行, 山田 祐歌, 森 直樹, 石川 愛子, 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）  58 （ 特別号 ） 2 - 2 2021年05月

ISSN  1881-3526

COVID-19感染拡大下におけるエアロゾル発生を伴う診療への非対面リハビリテーション診療の試み

田島 浩之, 和田 彩子, 川上 途行, 山田 祐歌, 森 直樹, 石川 愛子, 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）  58 （ 特別号 ） 2 - 15 2021年05月

ISSN  1881-3526

COVID-19の感染拡大による、通所リハビリテーションの利用自粛に伴う身体機能低下

紙本 貴之, 川上 途行, 平部 顕子, 宮崎 裕大, 土方 奈奈子, 山田 健, 秋本 知則, 辻川 将弘, 鈴木 幹次郎, 忽那 岳志, 平松 和嗣久, 近藤 国嗣, 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）  58 （ 特別号 ） 1 - 2 2021年05月

ISSN  1881-3526

COVID-19の感染拡大による、通所リハビリテーションの利用自粛に伴う身体機能低下

紙本 貴之, 川上 途行, 平部 顕子, 宮崎 裕大, 土方 奈奈子, 山田 健, 秋本 知則, 辻川 将弘, 鈴木 幹次郎, 忽那 岳志, 平松 和嗣久, 近藤 国嗣, 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）  58 （ 特別号 ） 1 - 2 2021年05月

ISSN  1881-3526

Functional Status and Instrumental Activities of Daily Living After Transcatheter Aortic Valve Replacement

Fukui, S; Kawakami, M; Hayashida, K; Ishikawa, A; Mori, N; Oguma, Y; Fukuda, K; Tsuji, T

TOPICS IN GERIATRIC REHABILITATION （Ovid Technologies (Wolters Kluwer Health)）  37 （ 2 ） 128 - 131 2021年04月

ISSN  0882-7524

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