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Kitamura S, Otaka Y, Uehara S, Murayama Y, Ushizawa K, Narita Y, Nakatsukasa N, Matsuura D, Osu R, Kondo K, Sakata S. Time-course for acquiring transfer independence in patients with subacute stroke: a prospective cohort study. J Rehabil Med 2024; 56:jrm40055. [PMID: 39382396 PMCID: PMC11481307 DOI: 10.2340/jrm.v56.40055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 09/17/2024] [Indexed: 10/10/2024] Open
Abstract
OBJECTIVE To clarify the time-course of longitudinal changes in the independence level of subtasks composing bed-wheelchair transfer among patients with stroke. DESIGN Single-institution prospective cohort study. PATIENTS A total of 137 consecutive post-stroke patients using wheelchair on admission to the subacute rehabilitation wards. METHODS The independence degree in each of the 25 transfer-related subtasks was assessed using the Bed-Wheelchair Transfer Tasks Assessment Form on a three-level scale every two weeks, from admission to the endpoint (either discharge or when achieving independent transfer). Patients were classified based on admission and endpoint assessment form scores using two-step cluster analysis. RESULTS Patients were classified into three clusters. The first cluster included 50 patients who exhibited a greater independence level in all subtasks on admission (52.0-100% of patients performed each subtask independently) and at the endpoint (64.0-100%). The second included 30 patients who showed less independence on admission (0-27.8%) but achieved greater independence levels at the endpoint (44.4-97.2%). The third included 51 patients whose independence level remained low in many subtasks from admission (0-5.8%) until the endpoint (0-29.4%). CONCLUSION The independence level and its changing process during transfer were categorized into three time-courses, each requiring different intervention strategies.
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Affiliation(s)
- Shin Kitamura
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan; Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, Aichi, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, Aichi, Japan.
| | - Shintaro Uehara
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan
| | - Yudai Murayama
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Kazuki Ushizawa
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, Aichi, Japan
| | - Yuya Narita
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Faculty of Rehabilitation, School of Health Sciences, Chiba Prefectural University of Health Sciences, Chiba, Japan
| | - Naho Nakatsukasa
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Daisuke Matsuura
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, Aichi, Japan
| | - Rieko Osu
- Faculty of Human Sciences, Waseda University, Saitama, Japan
| | - Kunitsugu Kondo
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Faculty of Rehabilitation, School of Health Sciences, Chiba Prefectural University of Health Sciences, Chiba, Japan
| | - Sachiko Sakata
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
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Kondo H, Koyama S, Otaka Y, Kumazawa N, Furuzawa S, Kanada Y, Tanabe S. Kinematic analysis of preparation for transferring from wheelchair to bed. Assist Technol 2024; 36:309-318. [PMID: 38446111 DOI: 10.1080/10400435.2024.2315410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 03/07/2024] Open
Abstract
This study aimed to clarify the kinematics, particularly of the shoulder and hip joints, during preparation for manual wheelchair-to-bed transfer (i.e. when flipping up the arm and foot supports). This cross-sectional study included 32 able-bodied individuals. The kinematics of the shoulder and hip joints when the arm and foot supports were flipped up of manual wheelchair, were evaluated using a markerless inertial sensor-based motion capture system. We found that flipping the arm support upwards involved a large amount of abduction, internal and external rotation, flexion, and extension at the shoulder joint, whereas flipping the foot support upwards involved a large amount of flexion at the hip joint. The findings suggest that it is necessary to consider the range of motion required to flip up the arm and foot supports of manual wheelchairs, particularly in those with limited shoulder and hip range of motion such as older people, neuromuscular disorders, and orthopedic disorders.
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Affiliation(s)
- Hikaru Kondo
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
- Graduate School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Soichiro Koyama
- Graduate School of Health Sciences, Fujita Health University, Toyoake, Japan
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Nobuhiro Kumazawa
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Shotaro Furuzawa
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Yoshikiyo Kanada
- Graduate School of Health Sciences, Fujita Health University, Toyoake, Japan
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Shigeo Tanabe
- Graduate School of Health Sciences, Fujita Health University, Toyoake, Japan
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
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Nakagawa K, Kanai S, Kitakaze S, Okamura H. Interventions focusing on learning pre-transfer wheelchair manipulation in a patient with severe Alzheimer's disease: a case report. Physiother Theory Pract 2024; 40:1091-1099. [PMID: 36412000 DOI: 10.1080/09593985.2022.2149287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 11/14/2022] [Accepted: 11/14/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Independence of transfer is important for the daily activities of wheelchair users. A critical step in performing this transfer includes a pre-transfer wheelchair manipulation, and patients with Alzheimer's disease (AD) experience difficulties in learning these tasks. In this report, we present the results of a treatment focused on learning pre-transfer wheelchair manipulation and its learning course in a patient with severe AD. CASE DESCRIPTION The patient was a 92-year-old woman with severe AD during hospitalization in a long-term care ward. Since her cognitive function was highly compromised, she required assistance for pre-transfer wheelchair manipulation. Physiotherapists implemented a treatment plan that incorporated post-behavioral praise into a practice combining errorless learning and spaced retrieval training for pre-transfer wheelchair manipulation. OUTCOMES The patient was able to accurately perform pre-transfer wheelchair manipulation in the seventh treatment session and achieved transfer independence after 12 physiotherapy sessions. CONCLUSION This case report suggests that practicing combined errorless learning, spaced retrieval training, and post-behavioral praise was helpful as a treatment modality for an individual with severe AD for wheelchair manipulation learning before transfer.
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Affiliation(s)
- Keita Nakagawa
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Department of Rehabilitation, Faculty of Health Sciences, Hiroshima Cosmopolitan University, Hiroshima, Japan
| | - Shusaku Kanai
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Sosuke Kitakaze
- Department of Rehabilitation, Maple-Hill Hospital, Hiroshima, Japan
| | - Hitoshi Okamura
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Ushizawa K, Otaka Y, Kitamura S, Inoue S, Sakata S, Kondo K, Mukaino M, Shimizu E. Development of an assessment form for the performance of public transportation use in individuals with stroke. Disabil Rehabil 2023; 45:2336-2345. [PMID: 35764527 DOI: 10.1080/09638288.2022.2089919] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/06/2022] [Accepted: 06/10/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To develop a new assessment form that is assessed by therapists for the performance of public transportation use for stroke survivors through content validation. MATERIALS AND METHODS The items for the tentative assessment form were selected using hierarchical clustering analysis on previous records of 76 field-based training sessions for public transportation use for stroke survivors. After the modification of the tentative form based on 6 months of clinical use, the final form was developed through content validation using the Delphi method by 71 therapists who had been working at the hospital for more than 2 years and had experience with training for public transportation use. RESULTS The Public Transportation use Assessment Form (PTAF) for stroke was successfully developed through three validation processes. It consists of four categories (plan for going out, mobility, using trains, and using buses) including 15 items that cover various tasks of public transportation use. The scoring for each was as follows: 3, independent; 2, requires supervision of verbal assistance; 1, requires assistance; and N, not applicable. CONCLUSION The PTAF, developed through content validation, could assess the ability of public transportation use, and identify specific problems for each stroke survivor in clinical setting.IMPLICATIONS FOR REHABILITATIONWe developed the Public Transportation use Assessment Form (PTAF) to assess the ability of stroke survivors to use public transportation.The PTAF could identify specific problems related to public transportation use for stroke survivors and aid in planning rehabilitation programs based on the results.The PTAF could share information about which task need support in public transportation use and could augment the hospital discharge plan.
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Affiliation(s)
- Kazuki Ushizawa
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
- Department of Rehabilitation Medicine I, Fujita Health University School of Medicine, Aichi, Japan
- Department of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
- Department of Rehabilitation Medicine I, Fujita Health University School of Medicine, Aichi, Japan
| | - Shin Kitamura
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
- Faculty of Rehabilitation, Fujita Health University School of Health Sciences, Aichi, Japan
| | - Seigo Inoue
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Sachiko Sakata
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Kunitsugu Kondo
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, Fujita Health University School of Medicine, Aichi, Japan
| | - Eiji Shimizu
- Department of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, Chiba, Japan
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Kitamura S, Otaka Y, Murayama Y, Ushizawa K, Narita Y, Nakatsukasa N, Matsuura D, Kondo K, Sakata S. Differences in the difficulty of subtasks comprising the toileting task among patients with subacute stroke: A cohort study. J Stroke Cerebrovasc Dis 2023; 32:107030. [PMID: 36709731 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107030] [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: 08/19/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION Toileting comprises multiple subtasks, and the difficulty of each is critical to determining the target and priority of intervention. The study aimed to examine the difficulty of subtasks that comprise toileting upon admission and the reacquisition of skills of subtasks during hospitalization. MATERIALS AND METHODS This was a single-center prospective cohort study. We enrolled 101 consecutive stroke patients (mean age: 69.3 years) admitted to subacute rehabilitation wards. The independence in each of the 24 toileting subtasks was assessed using the Toileting Tasks Assessment Form (TTAF) every two or four weeks. The number of patients who were independent upon admission, as well as those who were not independent upon admission but became independent during hospitalization, was examined in each subtask. RESULTS The most difficult subtask upon admission was "Lock the wheelchair brakes" (16.8% of patients were independent), followed by "Turn while standing (before urination/defecation)" (17.8%), "Pull the lower garments down" (18.0%), "Turn while standing (after urination/defecation)" (18.8%), "Pull the lower garments up and adjust them" (18.8%), and "Maintain a standing position (before urination/defecation)" (18.8%). The most difficult subtask for those who were not independent but became independent was "Dispose of incontinence pad/sanitary items" (19.3%), followed by "Press the nurse call button (after urination/defecation)" (28.3%), "Take the foot off the footrest and place it on the ground" (28.6%), and "Clean up after urination/defecation" (29.0%). CONCLUSIONS The difficult subtasks upon admission and those for reacquired skills were different. The most difficult subtasks upon admission were main tasks, and the difficult subtasks in reacquiring skills were preparatory tasks.
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Affiliation(s)
- Shin Kitamura
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Aichi, Japan; Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan.
| | - Yudai Murayama
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Kazuki Ushizawa
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan
| | - Yuya Narita
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Faculty of Rehabilitation, School of Health Sciences, Chiba Prefectural University of Health Sciences, Chiba, Japan
| | - Naho Nakatsukasa
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Daisuke Matsuura
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, Brain Attack Center Ota Memorial Hospital, Hiroshima, Japan
| | - Kunitsugu Kondo
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Sachiko Sakata
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
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Difficulty of the subtasks comprising bed-wheelchair transfer in patients with subacute strokes: A cohort study. J Stroke Cerebrovasc Dis 2022; 31:106740. [PMID: 36054975 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106740] [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] [Received: 04/19/2022] [Revised: 07/31/2022] [Accepted: 08/16/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Bed-wheelchair transfer comprises multiple subtasks; hence, it is important to know the difficulty of each subtask to identify and prioritize subtasks that must be practiced. This study aimed to investigate the difficulty of the subtasks that comprise bed-wheelchair transfer upon admission and reacquiring subtask skills during hospitalization. MATERIALS AND METHODS This was a single-center prospective cohort study. We enrolled 137 consecutive stroke patients (mean age: 69.8 years) admitted to subacute rehabilitation wards who used wheelchairs upon admission. The degree of independence in each of the 25 subtasks that comprised transferring was assessed using the Bed-wheelchair transfer Tasks Assessment Form every 2 weeks. The number of patients who were independent in the subtasks upon admission and those who were not but became independent during hospitalization were examined. RESULTS The most difficult subtask for independent patients upon admission was "Manipulate the handrail for the bed" (18.3%), followed by "Ready the wheelchair for transfer" (19.3%), "Maneuver the wheelchair toward the appropriate place for transfer to the bed" (20.6%), "Wear shoes/brace" (24.8%), and "Turn while standing" (25.5%). The most difficult subtask for those who were not independent but became independent was "Ready the wheelchair for transfer" (32.1%), followed by "Manipulate the handrail for the bed" (32.9%), "Press the nurse call button" (36.4%), "Press the nurse call button (wheelchair-to-bed)" (36.7%), and "Lock the wheelchair brakes" (37.3%). CONCLUSIONS Subtasks related to preparation for transfer were difficult upon admission, and this tendency became more pronounced during the skill acquisition process.
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