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Sato H, Miyata K, Yoshikawa K, Chiba S, Mizukami M. Responsiveness and minimal clinically important differences of the Trunk Assessment Scale for Spinal Cord injury (TASS). J Spinal Cord Med 2022:1-9. [PMID: 35776096 DOI: 10.1080/10790268.2022.2087138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE To confirm the responsiveness and minimal clinically important differences (MCIDs) of the Trunk Assessment Scale for Spinal Cord Injury (TASS). PARTICIPANTS AND METHODS We evaluated 48 Japanese individuals with spinal cord injury (SCI) (age 64.1 ± 10.4 yrs, 28 with tetraplegia) admitted to two institutions at admission, at 1 month of hospitalization, and at discharge with the TASS, the Trunk Control Test in individuals with an SCI (TCT-SCI) motor score, the Functional Independence Measure motor score (mFIM), and the Global Rating of Change Scale (GRCS). We assessed the TASS responsiveness by determining the correlation coefficients for the changes in the TASS' and other assessments' scores. We calculated the MCIDs by five anchor-based methods. RESULTS The changes in the TASS and those in the other assessments were weakly correlated at 1 month and moderately correlated at discharge. The TASS MCIDs were observed at 1 month and at discharge. CONCLUSION Our findings confirmed that the change in TASS scores had weak-to-moderate correlations with the changes in the participants' upper- and lower-limb function and activities of daily living. Using the MCID for the TASS determined by anchor-based methods may lead to a better interpretation of changes in the trunk function of individuals with SCIs.
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Hayashi S, Miyata K, Takeda R, Iizuka T, Igarashi T, Usuda S. Minimal clinically important difference of the Berg Balance Scale and comfortable walking speed in patients with acute stroke: A multicenter, prospective, longitudinal study. Clin Rehabil 2022; 36:1512-1523. [PMID: 35730136 DOI: 10.1177/02692155221108552] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the minimal clinically important difference between the Berg Balance Scale and comfortable walking speed in acute-phase stroke patients. DESIGN Multicenter, prospective, longitudinal study. SETTING Inpatient acute stroke rehabilitation. SUBJECTS Seventy-five patients with acute stroke, mean (SD) age 71.7 (12.2) years. INTERVENTION Inpatients with acute stroke were assessed with the Berg Balance Scale and comfortable walking speed before and after rehabilitation. Physiotherapy was conducted to improve balance and gait over a 2-week period: an average of 40 min/day on weekdays and 20 min/day on weekends and holidays. MAIN MEASURES The patients' Berg Balance Scale, comfortable walking speed, Global Rating of Change scale (patient-rated and physiotherapist-rated), and motor score of the Functional Independence Measure were obtained. Minimal clinically important differences were estimated using both anchor- (receiver operating characteristic curves and change difference) and distribution-based approaches (minimal detectable change and 0.5× the change score [SD]). RESULTS The baseline scores were 31.2 (18.9) for the Berg Balance Scale and 0.79 (0.35) m/s for comfortable walking speed. The minimal clinically important difference in the Berg Balance Scale was 6.5-12.5 points by the anchor-based approach and 2.3-4.9 points by the distribution-based approach. The minimal clinically important difference in comfortable walking speed was 0.18-0.25 m/s by the anchor-based and 0.13-0.15 m/s by the distribution-based approach. CONCLUSIONS A change of 6.5-12.5 points in the Berg Balance Scale and 0.18-0.25 m/s in the comfortable walking speed is required in these measurements' anchor-based minimal clinically important differences to be beyond measurement error, and to be perceptible by both patients and clinicians.
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Miyata K, Hasegawa S, Iwamoto H, Kaizu Y, Otani T, Shinohara T, Usuda S. Rasch Validation and Comparison of the Mini-BESTest and S-BESTest in Individuals With Stroke. Phys Ther 2022; 102:6482024. [PMID: 34972868 DOI: 10.1093/ptj/pzab295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 10/13/2021] [Accepted: 12/03/2021] [Indexed: 02/09/2023]
Abstract
OBJECTIVE The purpose of this study was to compare the psychometric properties of the Mini-Balance Evaluation Systems Test (Mini-BESTest) and S-BESTest and to evaluate which is more suitable for use in clinical settings for individuals with stroke. METHODS This multicenter retrospective cross-sectional study investigated 115 individuals with stroke (mean age, 70.8 y [SD = 11.2 y]) who were able to stand without physical assistance. All individuals were examined with the BESTest and with the Mini-BESTest and S-BESTest scored based on the BESTest results. The data were analyzed using a Rasch analysis (partial credit model). RESULTS The Mini-BESTest results revealed a correctly functioning rating scale, good fit of the data to the model (apart from 1 overfit item), good reliability for both persons and items (6 statistically detectable levels of balance ability), local dependence between 1 item pair, and essential unidimensionality. The S-BESTest results demonstrated disordered rating scale thresholds (1 response option required collapsing), good fit of the data to the model (apart from 1 underfit item), good reliability for both persons and items (5 statistically detectable levels of balance ability), local dependence between 2 item pairs, and essential unidimensionality. CONCLUSION The analyses confirmed that the reliability of the S-BESTest was good and unidimensional and that the test provides several improved points, such as item redundancy and local independence of items. Nevertheless, the Mini-BESTest results supported previous findings as a whole and were better than those from the S-BESTest. IMPACT Rasch analysis demonstrated that the Mini-BESTest was a better balance assessment scale than the S-BESTest for individuals with stroke based on its psychometric properties. The Mini-BESTest may serve as a useful scale for assessing balance in individuals with stroke, and a keyform plot and strata may help clinical decision-making in terms of interpreting scores and goal setting.
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Sato H, Miyata K, Yoshikawa K, Kusano S, Mizukami M. Reliability and minimal detectable change of the Trunk Assessment Scale for Spinal Cord Injury (TASS) and the trunk control test for individuals with spinal cord injury. Spinal Cord Ser Cases 2022; 8:30. [PMID: 35279669 PMCID: PMC8918346 DOI: 10.1038/s41394-022-00502-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 02/28/2022] [Accepted: 02/28/2022] [Indexed: 11/09/2022] Open
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVES To evaluate the reliability and calculate the measurement error of the Trunk Assessment Scale for Spinal Cord Injury (TASS) and trunk control test (TCT-SCI) in individuals with spinal cord injury (SCI). SETTING Rehabilitation Hospital in Japan. METHODS The evaluations of TASS and TCT-SCI for individuals with SCI were video-recorded. The inter-rater reliability (two physiotherapists) was confirmed using the videos. ICC (2,1), kappa coefficient (κ) were used to determine the reliability of the total score and each item. Each minimal detectable change (MDC) was calculated. RESULTS The TASS and TCT-SCI total scores showed excellent inter-rater reliability (ICC = 0.99, and 1.00). The kappa coefficients of TASS were acceptable to excellent for 8 items (κ = 0.76-1.00), below acceptable for 1 item (κ = 0.62). The kappa coefficients of TCT-SCI were excellent for 12 items (κ = 0.83-1.00), below acceptable for 1 item (κ = 0.68). The inter-rater MDC of the TASS total score was 4.07 points, and the MDC of the TCT-SCI total score was 1.13 points. The intra-rater MDC of the TASS total score was 3.86 points. CONCLUSION Both TASS and TCT-SCI showed high reliability. Differences of less than four points in TASS and one point in TCT-SCI were interpreted as measurement errors between the two raters.
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Kaizu Y, Miyata K, Arii H. Predictors of post-hip fracture knee pain in hospitalized older adults with intertrochanteric femoral fracture. PM R 2022; 15:563-569. [PMID: 35238168 DOI: 10.1002/pmrj.12798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 02/20/2022] [Accepted: 02/23/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Post-hip fracture knee pain (PHFKP) is an important issue that contributes to reduced gait speed and prolonged hospitalization. Femoral morphology has been reported to contribute to the development of PHFKP, but an independent association has not been confirmed and clinically applicable cutoffs for predicting the development of PHFKP remain unclear. OBJECTIVE To determine whether femoral morphology and knee extension range of motion limitation are independent factors in PHFKP and to determine cutoffs for predicting the development of PHFKP. DESIGN Retrospective chart review study. SETTING Convalescent inpatient rehabilitation hospital. PARTICIPANTS Patients in a convalescent ward after intertrochanteric femoral fracture surgery. MAIN OUTCOME MEASURES PHFKP development, radiographic femoral morphology (leg length discrepancy and neck-shaft angle), and knee extension range of motion limitation. RESULTS PHFKP developed in 36 (35%) of the 103 patients enrolled. The PHFKP group had a longer hospital stay (p = .029), greater weight (p = .031), greater knee extension range of motion limitation (p = .001), and more varus neck-shaft angle (p < .001) compared to the non-PHFKP group. Varus neck-shaft angle (odds ratio, 0.85; 95% confidence interval [CI], 0.78-0.92; p < .001) and knee extension range of motion limitation (odds ratio, 1.18; 95% CI, 1.07-1.30; p = .001) were significant factors for PHFKP development. Neck-shaft angle discrepancy and knee extension range of motion limitation demonstrated moderate accuracy in discriminating development of PHFKP according to receiver operating characteristic analysis, with cutoffs of 9.6° and 7.5°, respectively. Areas under the receiver operating characteristic curve were 0.77 (95% CI, 0.66-0.88; p < .001) for neck-shaft angle discrepancy and 0.67 (95% CI, 0.56-0.79; p = .004) for knee extension range of motion limitation. CONCLUSIONS Varus neck-shaft angle and knee extension range of motion limitation were identified as independent predictors of PHFKP. The cutoff for neck-shaft angle may be useful for predicting PHFKP development and to define an acceptable angle of fracture reduction to prevent PHFKP.
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Miyata K, Usuda S. On "Insights Into the Mini-BESTest Scoring System: Comparison of 6 Different Structural Models." Godi M, Arcolin I, Leavy B, Giardini M, Corna S, Franzén E. Phys Ther. 2021;101:pzab180. https://doi.org/10.1093/ptj/pzab180. Phys Ther 2022; 102:6519054. [PMID: 35134238 DOI: 10.1093/ptj/pzac009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/26/2022] [Indexed: 11/15/2022]
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Kaizu Y, Tajika K, Miyata K. Measurement of physical activity and prevention of physical inactivity/sedentary behaviors in patients with septic knee arthritis before and after hospital discharge: A case report. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2022; 27:e1943. [PMID: 35148439 DOI: 10.1002/pri.1943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/03/2021] [Accepted: 01/29/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Patients with septic knee arthritis tend to have prolonged pain, which may lead to a decrease in physical activity (PA). Pain catastrophizing, which is associated with chronic pain, is known to be a limiting factor for PA. An objective measurement of PA in patients with septic knee arthritis has not been reported. Here we describe the accelerometry-based measurement of the PA of a patient with septic knee arthritis before and after discharge, and we report the ability of follow-up outpatient physical therapy to increase PA. METHODS A 70-year-old Japanese woman admitted to the hospital with a diagnosis of left septic knee arthritis presented with prolonged pain and pain catastrophizing in the left knee. We investigated her pre- and post-discharge PA by using an accelerometer. We also investigated her physical function, pain, and pain catastrophizing as a possible influence on PA. Follow-up outpatient physical therapy (consisting of PA feedback, counseling, and reassurance) was performed to improve the patient's physical function and increase her PA. RESULTS The patient's PA indicated general inactivity from pre-discharge to 1 month post-discharge, especially immediately post-discharge (sedentary behavior [SB]: 540-571.3 min/daytime, light-intensity PA: 145.8-177.8 min/daytime). The follow-up outpatient physical therapy was effective in increasing her physical function and PA (a 31-min decrease in SB, a 32-min increase in light-intensity PA) but was not effective in reducing her pain or pain catastrophizing. DISCUSSION Contrary to the general trend, this patient showed a decrease in PA after hospital discharge compared to PA during hospitalization. Follow-up outpatient physical therapy had the effect of increasing the patient's PA, which was decreased immediately post-discharge.
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Kobayashi S, Miyata K, Tamura S, Takeda R, Iwamoto H. Cut-off values and sub-items of the Berg Balance Scale for walking-aid use in hospitalized older adults with a hip fracture: a retrospective analysis. Physiother Theory Pract 2022:1-9. [PMID: 35132914 DOI: 10.1080/09593985.2022.2037114] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To identify the Berg Balance Scale (BBS) values that can be used to discriminate the use of a walking aid and the BBS sub-items that reveal the differences in the use of walking aids among hospitalized older adults with a hip fracture. METHODS The cases of 77 older adults (age 80.8 ± 7.5 years) with a hip fracture who were able to walk independently in the hospital were retrospectively analyzed. A receiver operating characteristic curve (AUC) analysis was used to identify BBS scores that optimized the identification of subjects with different levels of aids. The BBS sub-items identifying differing among the walking aids were identified by a classification and regression tree analysis. RESULTS The BBS scores were highest for no aid, a cane, and a walker, in that order. The ability to walk without an aid and the ability to walk without a walker showed moderate AUCs (0.824 and 0.865) with cutoff values of 51.5 and 45.5 points, respectively. The sub-items identified were Turning 360° (4 vs. < 4 points) as the best discriminator for using/not using a cane and Stool Stepping (≥ 2 vs. < 2 points) for using a cane or walker. CONCLUSION The BBS is useful for determining whether to discontinue the use of a walker in individuals with a hip fracture.
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Shinohara T, Saida K, Miyata K, Usuda S. Sections of the Brief-Balance Evaluation Systems Test Relevant for Discriminating Fast Versus Slow Walking Speeds in Community-Dwelling Older Women. J Geriatr Phys Ther 2022; 45:E1-E7. [PMID: 32769810 DOI: 10.1519/jpt.0000000000000280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Walking speed can be used to identify characteristics of frailty in older adults. It has a strong positive correlation with balance abilities. The Brief-Balance Evaluation Systems Test (Brief-BESTest) was developed to assess functions of the 6 balance control systems in a short time. However, for community-dwelling older adults, the relationship between walking speed and the Brief-BESTest needs to be clarified. Even the cutoff scores for each Brief-BESTest section should be indicated for physical therapists to effectively evaluate balance deficits. Our objective was to establish cutoff scores for individual Brief-BESTest sections, determine fast or slow walkers in community-dwelling older adults, and investigate the relationship between balance control systems and walking speed. METHODS In a cross-sectional study involving 55 participants 77 years and older, the Brief-BESTest was evaluated after grouping the participants based on their walking speeds in public community centers. We compared the age, history of falls, handgrip strength, quadriceps strength, appendicular skeletal muscle mass index, comfortable walking speeds, and the Brief-BESTest scores between the fast- and slow-walking groups by using the independent t test, Fisher exact test, or Mann-Whitney U test. We also determined the receiver operating characteristic curves, and calculated the cutoff, area under the curve (AUC), sensitivity, and specificity of each section. RESULTS All sections of the Brief-BESTest, except Section 1 (Biomechanical Constraints) were able to differentiate between fast and slow walkers in community-dwelling older women. Section VI (Stability in Gait) showed the highest AUC (0.83) and the cutoff score for the fast- and slow-walker groups was 3.0 points (sensitivity = 0.85, specificity = 0.81). Sections III, IV, and V (Anticipatory, Reactive, and Sensory Orientation, respectively) had moderate AUC (0.71-0.72). Sections I and II (Stability Limits) showed weak correlations with the walking speed. CONCLUSIONS Three sections (III, anticipatory postural adjustments; IV, reactive postural responses; and VI, stability in gait) could differentiate between fast and slow walkers. Section VI was a particularly important balance function measurement that differentiated the walking speed with the highest accuracy. Therefore, it should be a primary focus when physical therapists treat community-dwelling older adults.
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Tamura S, Miyata K, Kobayashi S, Takeda R, Iwamoto H. Development of Cut-off Values on the Berg Balance Scale for Predicting Walking Independence in Older Adults with Hip Fracture. Prog Rehabil Med 2022; 7:20220043. [PMID: 36118148 PMCID: PMC9411036 DOI: 10.2490/prm.20220043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: The aim of the current study was to identify a cut-off value for predicting walking independence at discharge in older adults with hip fracture based on their Berg Balance Scale (BBS) score at admission to a convalescent rehabilitation ward. Methods: This was a retrospective, multicenter, observational study of 187 older adults with hip fractures (mean age 83.7, range 66–97 years). Data was collected on the patients’ age, sex, treatment, and physical function evaluation. An ordinal logistic regression analysis was used to identify predictors associated with the degree of independence in walking at discharge. Receiver operating characteristic curves were used to estimate cut-off values to predict independent and supervised walking at discharge based on the BBS score at admission. The accuracy of the classification was assessed using the area under the curve (AUC). Results: The BBS score at admission was a significant factor predicting the degree of walking independence at discharge (odds ratio = 1.09, 95%CI: 1.06–1.11). The cut-off values of the BBS score at admission for predicting independent walking and supervised walking at discharge were 28 points (AUC = 0.76, 95%CI: 0.69–0.83) and 21 points (AUC = 0.84, 95%CI: 0.77–0.91), respectively. Conclusions: The BBS scores of older adults with hip fracture on admission to a rehabilitation ward are useful for predicting the degree of independence in walking at discharge and can help to structure therapy according to the predicted degree of independence.
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Miyata K, Matsuda T, Fujita Y, Wakayama S, Sasaki T, Hotta K. Influences of remote exercise training for community-dwelling older adults in Japan during the COVID-19 pandemic. J Phys Ther Sci 2021; 33:828-831. [PMID: 34776617 PMCID: PMC8575474 DOI: 10.1589/jpts.33.828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/02/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The coronavirus disease (COVID-19) pandemic has caused sudden lifestyle
changes. This study aimed to determine the limitations in activity and the influences of
remote exercise training on community-dwelling older adults during a state of emergency in
Japan. [Participants and Methods] In May 2020, during the COVID-19 state of emergency, we
carried out a mail survey of community-dwelling older adults who had previously
participated in a disability prevention program in Ami town, Ibaraki, Japan. The mail
included a brochure on exercises and a DVD. The attached exercise program was comprised of
10 different exercises, which could be conducted in approximately 30 minutes. [Results] Of
the 191 older adults, 73 responded to this survey (38.2%), of which 42 (58.5%)
participants had decreased outdoor exercise activity, and 50 (68.5%) decreased the amount
of time spent on physical activities during the COVID-19 state of emergency. There were
significant reductions (19.2–22.5%) in the perceived exercise load for each posture after
two weeks of remote exercise training with DVD (n=26). [Conclusion] Our results suggested
that the remote exercise training with the brochure and DVD may be effective. Since this
study involved a small number of participants, future studies should involve larger
populations.
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Miyata K, Hasegawa S, Iwamoto H, Otani T, Kaizu Y, Shinohara T, Usuda S. Which Balance Evaluation Systems Test sections best distinguish levels of post-stroke functional walking status? J Rehabil Med 2021; 53:jrm00230. [PMID: 34486068 PMCID: PMC8638744 DOI: 10.2340/16501977-2870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To determine which sections of the Balance Evaluation Systems Test (BESTest) distinguish levels of post-stroke functional walking status and to establish their cut-off scores. Design A retrospective cross-sectional study. Subjects and methods The BESTest was administered to 87 stroke patients who were able to walk without physical assistance upon discharge from the hospital. Subjects were divided into 3 functional walking status groups: namely, household ambulators, limited community ambulators, and unlimited community ambulators. The receiver operating characteristic curve was determined and the cut-off score and area under the receiver operating characteristic curve (AUROC) of each section calculated. Results In the comparison of household and limited community ambulators, the accuracies of all BESTest sections were moderate (AUROC>0.7), and the cut-off scores were 36.1–78.6%. In the comparison of limited and unlimited community ambulators, one section (stability in gait) had high accuracy (AUROC=0.908, cut-off scores=73.8%) and 3 sections (biomechanical constraints, anticipatory postural adjustments, and postural response) had moderate accuracy (AUROC=0.812–0.834, cut-off scores=75.0–83.4%). Conclusion This study demonstrated that different sections of the BESTest had different abilities to discriminate levels of post-stroke functional walking status, and identified cut-off values for targeted improvement.
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Aoyama T, Ae K, Souma H, Miyata K, Kajita K, Kawamura T, Iwai K. Difference in Personality Traits and Symptom Intensity According to the Trigger-Based Classification of Throwing Yips in Baseball Players. Front Sports Act Living 2021; 3:652792. [PMID: 34514382 PMCID: PMC8424038 DOI: 10.3389/fspor.2021.652792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022] Open
Abstract
The triggers of initial onset of yips symptoms can be broadly divided into psychological and non-psychological factors; however, a trigger-based classification of yips has not been established. This study aims to obtain insight into the prevention of yips by clarifying whether there are differences in symptoms and personality traits according to a trigger-based classification of yips in baseball players. A total of 107 college baseball players responded to a questionnaire assessing the presence or absence of yips and its symptoms. They were classified into the psychologically triggered yips group, the non-psychologically triggered yips group, and the non-yips group based on the presence or absence of yips and the triggers of its initial onset. Additionally, we compared whether personality traits examined by the NEO Five-Factor Inventory differed across these three groups. The psychologically triggered yips group had significantly higher agreeableness scores compared with the non-yips group, whereas the non-psychologically triggered yips group had significantly higher neuroticism scores compared with the psychologically triggered yips group. In the non-psychologically triggered yips group, there was a significantly higher frequency of throwing errors than in the psychologically triggered yips group, with a tendency to develop yips symptoms gradually. Since the trigger-based classification of yips is closely related to the strength of the yips symptoms and the players' personality traits, the results of this study contribute to a better understanding of the symptoms of yips and establishment of the prevention of yips. Large prospective studies are necessary to determine the causal relationship between a trigger-based classification of yips and the personality traits and symptoms of athletes with yips.
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Tamura S, Miyata K, Kobayashi S, Takeda R, Iwamoto H. Minimal clinically important difference of the Berg Balance Scale score in older adults with hip fractures. Disabil Rehabil 2021; 44:6432-6437. [PMID: 34410873 DOI: 10.1080/09638288.2021.1962993] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE The minimal clinically important difference (MCID) is the smallest clinically significant difference in treatment identified as crucial to the patient. There is no known MCID for the Berg Balance Scale (BBS), which measures balance function in patients with hip fractures. We aimed to calculate the MCID of the BBS in older adults with hip fractures. MATERIALS AND METHODS This is a retrospective multicenter clinical study that included 187 older adults with hip fractures. MCID was calculated using functional ambulation categories (FACs), which were used as anchors for the change in BBS scores between admission and discharge. MCID was calculated as an improvement for more than one point and as a substantial change for improvement for more than two points in the FAC. RESULTS MCID of the BBS was 11.5 points and that of the substantial change was 18.5 points, with an area under the curve of 0.76 and 0.81, respectively. CONCLUSIONS MCID for the BBS was 11.5 points in older adults with hip fractures. In addition, an improvement of more than 18.5 points in BBS can be considered a substantial change. These values may be useful in determining meaningful balance function improvement.Implications for rehabilitationHip fractures are a common injury for the older adults, and improvement in gait function has a bearing on prognosis.The effectiveness of meaningful rehabilitation is possible to determine by clarifying the minimal clinically important difference in balance function, which is important for the acquisition of gait.An improvement of 11.5 points or more on the Berg Balance Scale in an older adult with a hip fracture is considered a meaningful effect.
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Kaizu Y, Miyata K, Arii H, Yamaji T. Inpatient knee pain after hip fracture surgery affects gait speed in older adults: A retrospective chart-referenced study. Geriatr Gerontol Int 2021; 21:830-835. [PMID: 34342386 DOI: 10.1111/ggi.14255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/28/2021] [Accepted: 07/17/2021] [Indexed: 12/25/2022]
Abstract
AIM Post-hip fracture knee pain (PHFKP) develops in 28-37.4% of patients with hip fracture and contributes to prolonged hospitalization. Although reduced balance and gait speed contribute to falls, the effects of PHFKP remain unclear. This study aimed to clarify whether PHFKP is a factor in balance and gait speed. METHODS We retrospectively reviewed the medical records of patients after hip fracture. Development of PHFKP, basic information, and physical function were examined. Berg balance scale (BBS) and maximum walking speed (MWS) were collected at discharge. These parameters were compared with the presence or absence of PHFKP. In addition, multiple analyses were conducted with BBS and MWS as dependent variables and PHFKP as one of the independent variables. RESULTS Of the 146 patients enrolled, 43 (29.5%) developed PHFKP, and 37.2% of patients with PHFKP showed residual symptoms at discharge. Intensity of PHFKP was mostly mild to moderate. The PHFKP group showed an extended length of stay (+13.3 days) and a tendency toward more discharges to facilities compared with the control group. Knee extension range of motion limitation, knee extensor strength, and BBS did not differ between groups, while MWS was significantly lower in the PHFKP group (0.85 ± 0.32 m/s vs. 1.07 ± 0.39 m/s). Multiple analyses showed that development of PHFKP was not associated with BBS, but was associated with decreased MWS (standardized beta = -0.202, P = 0.005). CONCLUSIONS PHFKP was identified as an independent factor in gait speed decline. PHFKP patients should be monitored for reduced gait speed during rehabilitation. Geriatr Gerontol Int 2021; 21: 830-835.
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Miyata K, Hasegawa S, Iwamoto H, Shinohara T, Usuda S. Section of the Balance Evaluation Systems Test (BESTest) Cutoff Values for Walking Speed Level in Older Women With Hip Fracture. J Geriatr Phys Ther 2021; 44:153-158. [PMID: 32049752 DOI: 10.1519/jpt.0000000000000261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND PURPOSE Hip fracture is a common injury in older adults, with a high proportion of hip fractures affecting women. After a hip fracture, the recovery of the patient's walking speed is very important; one of the key determinants of walking speed is balance. The Balance Evaluation Systems Test (BESTest), a clinical balance measure, categorizes balance into 6 postural control systems. However, the relationship between the walking speed level and the sections of the BESTest has not been explored for older women with hip fracture. Our objective was to establish section scores for the BESTest cutoff values for walking speed in older women with hip fracture. METHODS This was an observational study involving 46 older women 65 years or older with hip fracture. The BESTest was administered to all participants upon their discharge from the hospital. Participants were divided into groups on the basis of their walking speed levels, and receiver operating characteristic curves were determined for each section of the BESTest. We calculated the cutoff value, area under the curve (AUC), sensitivity, and specificity of each. RESULTS Section IV-Stability in Gait showed the highest AUC (0.92) compared with the other sections, and the cutoff value determined for the fast and slow walker groups was 64.3% (sensitivity = 0.82, specificity = 0.83). The sections with moderate AUC (0.7-0.9) were I-Biomechanical Constraints (cutoff = 70.0%), III-Anticipatory Postural Adjustments (cutoff = 66.5%), IV-Postural Responses (cutoff = 69.4%), and V-Sensory Orientation (cutoff = 83.4%). The sections with the highest sensitivity (0.82) were I-Biomechanical Constraints and VI-Stability in Gait, and that with the highest specificity (0.88) was II-Stability Limits and Verticality. CONCLUSIONS Five of the BESTest sections (I-Biomechanical Constraints, III-Anticipatory Postural Adjustments, IV-Postural Responses, V-Sensory Orientation, and IV-Stability in Gait) were able to differentiate between fast and slow walkers among older women with hip fracture. Balance during gait and anticipatory postural adjustments were shown to be important components of balance, and their cutoff values were indicators of the balance required to reach fast walking levels.
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Tamura S, Miyata K, Kobayashi S, Takeda R, Iwamoto H. The minimal clinically important difference in Berg Balance Scale scores among patients with early subacute stroke: a multicenter, retrospective, observational study. Top Stroke Rehabil 2021; 29:423-429. [PMID: 34169808 DOI: 10.1080/10749357.2021.1943800] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Balance dysfunction is common in stroke patients. The Berg Balance Scale (BBS) is useful for evaluating the balance function of stroke patients, and it can estimate the minimal clinically important difference (MCID) in balance. BBS scores differ among stroke patients depending on whether they require walking assistance. The MCID should thus be estimated separately for patients who require assistance and those who do not.Objectives: To estimate the MCID of individuals who have had an early subacute stroke and require a walking aid and those who do not, to assist the clinical determination of the effectiveness of therapy.Methods: This was a retrospective clinical analysis of 80 early subacute stroke patients. We estimated the MCID by using the Functional Ambulation Categories (FAC) as anchors for changes in BBS scores during a 1-month period. The MCID was estimated based on a cutoff score for separating the patients who achieved a FAC change ≥1 point on receiver operator characteristic curves. The area under the curve (AUC) was used to measure the discrimination accuracy. The MCID was estimated for the patients who needed walking assistance and those who did not.Results: The estimated MCID of BBS scores in the assisted-walking group was 5 points and the AUC was 0.84 (p < .01); the corresponding values in the unassisted-walking group were 4 points and 0.62 (p = .26).Conclusions: For early subacute stroke patients who require assistance to walk, a 5-point improvement in the BBS score is a useful indicator for reducing the amount of assistance.
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Shinohara T, Saida K, Tanaka S, Miyata K, Yamagami T. Effects of assessment-oriented group action supported by a health professional on the physical function in community-dwelling older adults: a feasibility study. Physiother Theory Pract 2021; 38:2495-2504. [PMID: 34097565 DOI: 10.1080/09593985.2021.1934927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Assessment-oriented group action (AGA) could be used to empower community-dwelling older adults to maintain their health by groups. AGA can be implemented with the support of a health professional to provide feedback to older adults on physical and cognitive function.Objective: To evaluate the effects of AGA.Methods: For this feasibility study, we enrolled 23 and 20 participants in the intervention and control groups, respectively. Thοse in the intervention group received feedback of their assessments and devised exercise plans with professional support. The participants performed their exercises over 12 weeks; the follow-up examination was conducted at 40 weeks. The control group only received feedback. The change in health-related consciousness and behavior was evaluated. Muscle strength and mass were measured and the timed up and go test, and the Brief-balance evaluation system test (BESTest) were performed.Results: There were no significant differences in consciousness or behavior between the groups. The score was higher in the intervention than in the control group at 40 weeks in Section-I of the Brief-BESTest, indicating that the muscle strength contributed to balance function.Conclusion: AGA did not show positive changes in consciousness or behaviors but demonstrated significant improvements and lasting effects in balance function.
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Kaizu Y, Miyata K, Arii H, Tazawa M, Yamaji T. Femoral morphology is associated with development of knee pain after hip fracture injury among older adults: A nine-year retrospective study. J Orthop 2021; 24:190-193. [PMID: 33737793 DOI: 10.1016/j.jor.2021.02.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 02/14/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction We aimed to clarify differences in femoral morphology associated with post-hip fracture knee pain (PHFKP). Methods Medical records and radiographic examinations were retrospectively reviewed to determine the relationship between PHFKP development and femoral morphology. Leg length discrepancy (LLD) and neck-shaft angle discrepancy (NSAD) were measured from hip radiographs. Results 202 were enrolled, of whom 64 (31.7%) developed PHFKP. The PHFKP group showed more varus NSA. Intertrochanteric femoral fractures (γ-nail or CHS) displayed a more varus NSA. Conclusions Femoral morphology (varus NSA) may be involved in the development of PHFKP.
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Shinohara T, Saida K, Miyata K. Ability of the Brief-Balance Evaluation Systems Test to evaluate balance deficits in community-dwelling older adults: a cross-sectional study. Physiother Theory Pract 2020; 38:1381-1388. [PMID: 33289587 DOI: 10.1080/09593985.2020.1840682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND A method for assessing balance that differentiates between balance deficit can help guide effective interventions for preventing falls in older adults. OBJECTIVE This study aimed to clarify the relationship between balance control systems and falls, and to examine the ability of the Brief-Balance Evaluation Systems Test (BESTest) to evaluate balance deficits in older adults. METHODS Overall, 109 community-dwelling older adults participated in this study. The history of falls in the last year was investigated. Balance deficits were assessed using the Brief-BESTest, the functional reach test, the Timed up and Go Test, and the one leg balance test. We analyzed the difference between the fallers and non-fallers across two different age groups. RESULTS Among younger-older group participants (age < 75 years), there were no significant differences between fallers and non-fallers across all variables. Among older-older group participants (age ≥ 75 years), there were significant differences in the Brief-BESTest total (p= .011; fallers, 13.5 versus non-fallers, 17.0) and section IV scores (postural responses of the Brief-BESTest; p= .026, 2.0 versus 5.0). There was no significant difference in other balance measurements. CONCLUSIONS The postural responses assessed by the Brief-BESTest may serve important functions and may be associated with falls in older adults.
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Miyata K, Usuda S. Response to letter to the editor from Franco Franchignoni and Andrea Giordano. J Rehabil Med 2020; 52:jrm00104. [PMID: 32968817 DOI: 10.2340/16501977-2747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Miyata K, Hasegawa S, Iwamoto H, Otani T, Kaizu Y, Shinohara T, Usuda S. Comparison of the structural validity of three Balance Evaluation Systems Test in older adults with femoral or vertebral fracture. J Rehabil Med 2020; 52:jrm00079. [PMID: 32623475 DOI: 10.2340/16501977-2709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To clarify and compare the structural validity of 3 Balance Evaluation Systems Tests (BESTest, Mini-BESTest, and Brief-BESTest) in older adults with femoral or vertebral fractures. DESIGN Cross-sectional study. SUBJECTS Ninety-four older adults (age ?65 years) with femoral or vertebral fractures, who could walk without physical assistance. METHODS Four BESTest models (BESTest, one-factor Mini-BESTest, four-factor Mini-BESTest, and Brief-BESTest) were examined using confirmatory factor analysis, and the models goodness-of-fit was assessed. Unidimensionality of the best-fitting model was confirmed by Rasch principal component analysis on the residuals. RESULTS Confirmatory factor analysis showed that the four-factor Mini-BESTest model (comparative fit index?=?0.952; Tucker-Lewis index?=?0.937; root-mean square error of approximation?=?0.060; standardized root-mean-square residual?=?0.062) has a better structure than other models. The principal component analysis of standardized residuals showed that the variance attributable to Rasch factor was good, with eigenvalues <2, confirming the factors unidimensionality. CONCLUSION The four-factor Mini-BESTest model shows good structural validity in older adults with femoral or vertebral fracture. Evaluating dynamic balance by focusing on 4 components (anticipatory postural adjustments, postural responses, sensory orientation, and stability in gait) may help therapists in making clinical decisions.
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Ohata Y, Takeyari S, Nakano Y, Kitaoka T, Nakayama H, Bizaoui V, Yamamoto K, Miyata K, Yamamoto K, Fujiwara M, Kubota T, Michigami T, Yamamoto K, Yamamoto T, Namba N, Ebina K, Yoshikawa H, Ozono K. Correction to: Comprehensive genetic analyses using targeted next-generation sequencing and genotype-phenotype correlations in 53 Japanese patients with osteogenesis imperfecta. Osteoporos Int 2020; 31:1185. [PMID: 32246166 PMCID: PMC7237517 DOI: 10.1007/s00198-020-05396-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The original article has been corrected.
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Miyata K, Hasegawa S, Iwamoto H, Otani T, Kaizu Y, Shinohara T, Usuda S. Comparing the measurement properties and relationship to gait speed recovery of the Mini-Balance Evaluation Systems Test and the Berg Balance Scale in ambulatory individuals with subacute stroke. Phys Ther Res 2020; 23:72-78. [PMID: 32850282 DOI: 10.1298/ptr.e10004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 12/09/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Although the Mini-Balance Evaluation Systems Test (Mini-BESTest) is known to be a reliable and valid measure of balance in individuals with stroke, the utility of this tool in relation to subacute stroke walking speed and the recovery of gait ability has not been explored. Here, we compared the measurement properties and their relationship to gait speed on the Mini-BESTest and the Berg Balance Scale (BBS) in middle and older ambulatory individuals with subacute stroke, and we investigated which balance assessment tool is more likely to capture the status of the recovery of gait speed. METHODS We retrospectively analyzed the cases of 88 individuals 50 years or older with stroke who had been evaluated using the Mini-BESTest by using the BBS and by assessing their comfortable walking speed (CWS). The proportion of subjects who showed improvement was calculated for 34 stroke survivors from data obtained at admission to and discharge from the hospital. RESULTS Compared with the BBS, the Mini-BESTest showed a better distribution of total scores without a ceiling effect. The two scales showed correlations with gait speed (Mini-BESTest: r=0.702; BBS: r=0.592) and discrimination between fast and slow walkers. The responsiveness of the Mini-BESTest was excellent, with an area under the curve of 0.894, thus discriminating between gait speed improvement versus non-improvement. CONCLUSIONS These results indicate that the Mini-BESTest is more useful than the BBS in terms of its measurement properties and ability to measure gait recovery in middle and older ambulatory individuals with subacute stroke.
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Yamamoto S, Ishii D, Noguchi A, Tanamachi K, Okamoto Y, Takasaki Y, Miyata K, Fujita Y, Kishimoto H, Hotta K, Iwai K, Kohno Y. A Short-Duration Combined Exercise and Education Program to Improve Physical Function and Social Engagement in Community-Dwelling Elderly Adults. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2019; 40:281-287. [PMID: 31865852 DOI: 10.1177/0272684x19896732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Exercise is a key intervention for improving older adults' physical function and life expectancy. Here, we investigated a short-term intervention program designed to improve the physical functioning of elderly adults in a community-dwelling setting. We examined the effect of a 5-week combined exercise and education program on the physical function, social engagement, mobility performance, and fear of falling in 42 subjects older than 65 years. Eleven subjects dropped out. There was significant improvement in the 30-second chair stand test (p < .001) and timed up-and-go test (p < .001) between the baseline and the last session. At the end of the intervention, the subjects' social engagement was significantly higher than at baseline (p = .022), but this improvement was not maintained in the follow-up assessment. These results suggest that a combined exercise and education program can improve the physical function and social engagement of elderly individuals living in a community dwelling.
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