Toru Nagao

Clinical Evaluation of Training System for Recovery of Motor Function after Stroke in Patients with Hemiplegia

We developed a training system (URSystem: Useful and Ultimate Rehabilitation System) for recovery of motor function of the upper limb after stroke in patients with hemiplegia. Clinical evaluation of the therapeutic effect of the URSystem was performed in eight patients. Active ranges of motion (A-ROMs) of elbow extension and supination of the forearm were improved after training with the URSystem within two weeks. Moreover, the modified Ashworth scale scores for elbow extension and supination of the forearm were increased. This means that spastic paralysis was reduced. These effects persisted for one month after the training. These results show the effectiveness of training with the URSystem for recovery of motor function of the upper limb.

A Preliminary Investigation to Explore the Effects of Daytime Physical Activity Patterns on Health-Related QOL in Healthy Community-Dwelling Elderly Subjects

The purpose of this study was to determine if different lifestyles of healthy elderly subjects would exert some influence on their daytime physical activity patterns and health-related QOL. Sixty-nine elders were categorized into age-gender, marital status, and body mass index (BMI)-matched groups by lifestyle; 12 males living alone (MA), 20 males living with spouse (MS), 16 females living alone (FA), and 21 females living with spouse (FS). Daytime physical activity (DPA) was recorded with the actigraph: a wrist-worn device. Health-related QOL scales consisted of Zung Self-Rating Depression Scale (SDS), Life Satisfaction Index-Z (LSI), and Visual Analogue Scale of Happiness.Among the four lifestyles, statistical analysis revealed a significant difference in SDS and LSI (both, p < 0.05), and DPA (p < 0.01). Trends in these parameters characteristically indicated that (1) the greatest SDS and the lowest others were observed in MA, compared with FA and (2) greater SDS and DPA, and lower LSI, were shown in FS than MS. The current findings demonstrate that lifestyle of the elderly subjects residing in urban wards might appreciably exercise influences on QOL and physical activity. The preliminary study suggests that more attention to daily physical activity and lifestyle of healthy community-dwelling elderly subjects may not be less efficacious than conventional care in rehabilitative intervention, but the characteristics of elderly handicapped subjects remain unclear.

The Role of Physical Therapists in Living Environment Maintenance of the Home-bound Elderly Disabled

[Purpose] This study explored the roles of physical therapists (PTs) in living environment maintenance, which is essential for living securely and stably at home, and examines how physical therapists can fulfill these roles more efficiently and effectively. [Subjects and Methods] A questionnaire on living environment maintenance was given to PTs working at randomly selected hospitals, health care facilities for the elderly requiring long-term care, home-visit nursing stations, and other such facilities and directly providing physical therapy to the home-bound elderly disabled. The subjects of the study were 77 PTs who returned valid responses. [Results] For awareness of systems for living environment maintenance, PTs were more aware of the system based on the Long-Term Care (LTC) Insurance Act than the system based on the Act on Welfare for the Home-Bound Elderly Disabled. PTs who have worked at two or more types of medical, welfare, and intermediate institutions were more aware of such systems than PTs who have worked at only one type. For PTs handling living environment maintenance for the home-bound elderly disabled, approximately 80% of respondents answered that they have handled some living environment maintenance, and PTs with longer clinical experience have handled more living environment maintenance cases. [Conclusion] The results demonstrated that PTs understand their living environment maintenance work well and handle the work. The results, however, also suggested that educational and operational improvements are urgently required for PTs handling living environment maintenance essential for the lives of the home-bound elderly disabled.