Ryohei Goto

Effects of gait training using the Hybrid Assistive Limb ® in recovery-phase stroke patients: A 2-month follow-up, randomized, controlled study

BACKGROUND Gait training using the Hybrid Assistive Limb® (HAL®) may have beneficial effects on post-stroke gait function and independent walking. However, the long-term and medium-term efficacies of gait training using HAL® in stroke patients remain unclear. OBJECTIVE To compare the medium-term efficacy of gait training using a single-leg version of the Hybrid Assistive Limb® (HAL®) on the paretic side with conventional gait training (CGT) in recovery-phase stroke patients. METHODS Twenty-four post-stroke participants (HAL® group: n = 12, CGT group: n = 12) completed the trial. Over 4 weeks, all participants received twelve 20-min sessions of either HAL® (using the single-leg version of HAL® on the paretic side) or conventional (performed by skilled and experienced physical therapists) gait training. Outcome measures were evaluated prior to training, after 12 sessions, and at 8 and 12 weeks after intervention initiation. Functional Ambulation Category (FAC) was the primary outcome measure. RESULTS The HAL® group showed significant improvement in FAC after 12 sessions, and at 8 and 12 weeks compared to the conventional group (P = 0.02). CONCLUSIONS The results suggested that a gait training program based on HAL® may improve independent walking more efficiently than CGT at 1 and 2 months after intervention.

Identification of prognostic factors for activities of daily living in elderly patients after hospitalization for acute infectious disease in Japan: A 6-month follow-up study: Prognostic factors for ADL in elderly

We investigated factors that predict the prognosis of activities of daily living (ADL) in elderly patients who had undergone rehabilitation during hospitalization for acute infectious disease.

Association between Excessive Alcohol Use and Alcohol-Related Injuries in College Students: A Multi-Center Cross-Sectional Study in Japan.

Alcohol-related injuries in college students are a major public health problem worldwide. We clarified the association between excessive drinking and alcohol-related injuries in Japanese college students. This was a cross-sectional study with a self-administered questionnaire. From January to March 2013, we sampled all college students and graduate students aged 20 years or older during annual health examinations at three colleges in Mie Prefecture in Japan. The questionnaire assessed the frequency of alcohol drinking, amount of alcohol consumed per day, binge drinking during the past year, alcohol-related injuries during the past year, and demographic data. Logistic regression analysis was conducted on the association between excessive alcohol use and alcohol-related injuries. A total of 2,842 students underwent health examinations, of whom 2,177 (76.6%) completed the questionnaire. Subjects included 1,219 men (56.0%) and 958 women (44.0%). Eighty-eight men (7.2%) and 93 women (9.7%) were classified as excessive weekly drinkers, while 693 men (56.8%) and 458 women (47.8%) were determined to be binge drinkers. Eighty-one men (6.6%) and 26 women (2.7%) had experienced alcohol-related injuries during the past year. In the logistic regression analysis, binge drinkers (odds ratio 25.6 [8.05-81.4]) and excessive weekly drinkers (odds ratio 3.83 [2.41-6.09]) had a history of significantly more alcohol-related injuries, even after adjusting for age and sex. In conclusion, alcohol-related injuries in college students in Japan were strongly associated with excessive drinking. As a strategy for preventing such injuries in this population, an interventional study is required to identify effective methods for reducing excessive alcohol use.

Factors associated with the recovery of activities of daily living after hospitalization for acute medical illness: a prospective cohort study

[Purpose] This study investigated the factors associated with the recovery rate of activities of daily living of elderly patients hospitalized for acute medical illness. [Subjects and Methods] A total of 238 elderly patients were enrolled in this study. The main outcome measure was the functional independence measure score which was used as an assessment of activities of daily living. The participants were divided into 2 groups based on their activities of daily living before onset: the independent group and the partially dependent group. The participants of each group were further divided into 2 subgroups based on recovery rates of activities of daily living: the high-recovery group (80%) and the low-recovery group (<80%). The factors associated with the recovery rate were examined using multivariate logistic regression analysis. [Results] The factors associated with the recovery rate were: days of inactivity and cognitive status at the start of rehabilitation for the independent group, and days of inactivity and nutritional status at the start of rehabilitation for the partially dependent group. [Conclusion] The results of this study suggest that the important factors for return to normal activities of daily living are: days of inactivity and cognitive status for the independent group; and days of inactivity and management of nutrition for the partially dependent group.

The Use of All-You-Can-Drink System, Nomihodai, Is Associated with the Increased Alcohol Consumption among College Students: A Cross-Sectional Study in Japan

Excessive drinking by college students is a major public health problem in Japan. However, data on heavy episodic drinking (HED) and nomihodai, a several-hour all-you-can-drink system, are scarce. We surveyed the drinking behavior of undergraduate and graduate students at 35 colleges, and examined the association between HED and use of nomihodai. The study used a cross-sectional design conducted by a self-administered questionnaire. From December 2016 to March 2017, we sampled undergraduate and graduate students aged 20 or older at 35 colleges in the Kanto area, including Tokyo. The following items were measured: 1) frequency of drinking; 2) frequency of binge drinking in the past year; 3) nomihodai use; 4) the number of drinks consumed when using or not using nomihodai; and 5) sex and age for demographic data. Paired t-test was used to compare means between use and non-use state of nomihodai. The Fishers exact test was used to evaluate the significance of the distribution difference between the two types of states. A total of 511 subjects completed the questionnaire, including 274 men and 237 women. The amount of drinking was increased 1.8-fold (85.9 ± 49.7 g vs. 48.2 ± 29.5 g) among men and 1.7-fold (63.7 ± 39.3 g vs. 36.5 ± 26.7 g) among women during nomihodai use, comapred with non-use states. Among them, 109 (39.8%) men and 71 (30.3%) women reported HED only at nomihodai states. These data suggest that the use of nomihodai system may lead to excessive drinking among college students.

Internet Survey Regarding Knowledge About the Common Cold in Japan

Background: Our aim was to assess people’s knowledge about the common cold and to identify factors leading to medical consultation for intravenous infusion or injection. We expect that this knowledge will be used to develop educational interventions that facilitate appropriate self-care and decision-making regarding whether or not to seek medical consultation. Methods: This study was conducted among people aged 20 to 79, excluding healthcare professionals. A national Internet survey administered in 2012 asked 17 questions about the prevention of, general knowledge about, and behaviors for coping with the common cold. Factors associated with the belief that early symptom relief could be achieved by infusion or injection were evaluated by multivariate analysis. Results: Three hundred and forty-eight (348) people (mean age: 48.6 ± 16.9 years) were included in the analysis. Nearly 80% of participants endorsed questionnaire items stating that “taking cold medicines earlier” and “receiving an infusion or injection” were appropriate actions for recovering from a cold, and more than 60% reported that “you should see a doctor when you catch a cold”. Factors affecting the expectation that infusion or injection would provide early symptom relief included younger age and inaccurate knowledge about treatment of the common cold, for instance the idea that “you can recover from a cold earlier if you take cold medicines”. Conclusions: We found that people’s knowledge about prevention of the common cold was relatively sufficient, but their understanding of the clinical issues and treatment related to the common cold was not. Since the expectation that infusion or injection would provide early symptom relief was associated with inaccurate knowledge about treatment of the common cold, it is considered that people require further health literacy education.

Relationship between psychophysiological factors and prognosis for activities of daily living in patients with stroke in a recovery rehabilitation unit: a preliminary study

[Purpose] The objective of the present study was to examine the factors, including physical and mental functions, that are associated with the prognosis for activities of daily living in patients with stroke in a recovery rehabilitation unit. [Subjects and Methods] The subjects were 13 patients with stroke who were admitted to the recovery rehabilitation unit of Tokai Memorial Hospital between March and October 2014 and followed up for 2 months. Their physical and mental functions were evaluated at the time of admission and the relationship between these functions and activities of daily living was assessed 2 months later. [Results] The activities of daily living at 2 months after admission showed a significant correlation not only with the severity of motor paralysis (R=−0.80) but mental function (R=−0.69) at the time of admission. No significant correlation was noted between the severity of motor paralysis and the mental function. [Conclusion] It is important to evaluate both mental function and severity of motor paralysis immediately after patients’ admission to the recovery rehabilitation unit. Mental health intervention should be considered in the future to effectively improve subsequent activities of daily living.