Objective : It is not known whether residents in geriatric facilities are satisfied with the rehabilitation they receive. The purpose of this study was to investigate the relationship between their satisfaction with facility services and their satisfaction with the rehabilitation they receive in geriatric facilities. An additional aim was to identify the factors related to customer satisfaction with rehabilitation.
Methods : One hundred residents in 19 geriatric facilities participated in this study. After obtaining informed consent from the residents, we conducted semi-structured interviews which included scales for facility services satisfaction, customer satisfaction with rehabilitation, and the Geriatric Depression Scale (GDS). The characteristics and conditions of the residents were investigated by interviewing the facilities' staff. For statistical analysis, we used Spearman's, rank correlation test, and multiple regression analysis.
Results : Sixty-seven percent of the subjects were women, and the mean age (±SD) was 78.2±10.4 years. Multiple regression analysis revealed that the total customer satisfaction with rehabilitation score was associated with facility service satisfaction (β=0.232, p<0.05). Significant associations were also observed with “female”(β=0.198, p<0.05), “support counselors” (β=0.269, p<0.01), and “GDS” score (β=-0.291, P< 0.01). Customer satisfaction with rehabilitation was associated with “age” (β=-0.296, p<0.01), “BI” (β=0.261, p<0.01), “satisfaction with rehabilitation time” (β=0.254, p<0.01), “satisfaction with the training environment” (β=0.206, p<0.05), “toilet training” (β=0.210, p<0.05), “bathing training” (β=-0.252, p<0.01), and “GDS” score (β=-0.258, p<0.01).
Conclusion : Customer satisfaction with rehabilitation was significantly associated with facility service satisfaction in geriatric facilities.
These data suggest that rehabilitation is an important service in geriatric facilities, and supplying a sufficient number of hours of rehabilitation and having adequate facilities for rehabilitation were important for improving satisfaction with rehabilitation services in geriatric facilities.

Objective : With clinical application in mind, we developed a method to measure the movement of a selected joint three-dimensionally as a conic domain (joint sinus cone). The method was applied to shoulder joint motion during daily living activities exercises in a group of hemiparetic poststroke patients. The results were compared to the exercise range of physically unimpaired persons. Methods : The subjects dressed in jackets and performed certain other tasks in a sitting position and the range of motion of the shoulder joint in three dimensions was measured using a 6-dimensional electromagnetic tracking system. Measurement results were analyzed with a plane display using a Lambert Azimuthal equal area. Results : This method was able to determine findings difficult to see with the naked eye, such as the narrow range of motion in a paralyzed shoulder joint and poor functionality also in the contralateral shoulder. Conclusion : The dressing measurement was achieved using magnetic measurement equipment. By displaying the results through a map projection it was possible to appreciate the whole range of the motion. Because this method facilitates the expression of complex joint exercise ranges, it will be useful in the analysis of daily behavior restrictions due to impairment.

We report two cases of patients with intractable upper abdominal pain and histories of injury or surgery. The patients' pains were successfully treated with tokishigyakukagoshuyushokyoto (TSG). Case 1 involved a 59-year-old woman with left upper abdominal and thoracodorsal pain lasting 5 years. Kampo drugs such as tokito or prescriptions containing saiko were ineffective. Two years after her first visit, we noticed an injury scar from childhood that passed near the left hikon (pi-gen, ExB4) and induration and tenderness of the left hikon. TSG was administered, and the pain promptly improved. Case 2 involved a 66-year-old woman. She complained of epigastric, right­-upper-­quadrant abdominal and back pain lasting 7 years. Two years before presentation, the pain had worsened, but the cause was unclear. Although keishibukuryogan or Kampo drugs containing saiko were ineffective, her pain improved when TSG plus bushi was administered. A wound from a cholecystectomy was observed on her right abdomen. Induration and tenderness of the right hikon were demonstrated. The combination of past history of injury or surgery of the upper abdomen or back and induration of hikon can be associated with development of indications for TSG.

Although cardiac rehabilitation (CR) has been shown to improve exercise tolerance and prognosis in patients with cardiovascular diseases, there remains low participation in outpatient CR. This may be attributed to the patients’ busy schedules and difficulty in visiting the hospital due to distance, cost, avoidance of exercise, and severity of coronary disease. To overcome these challenges, many countries are exploring the possibility of remote CR. Specifically, there is increasing attention on the development of remote CR devices, which allow transmission of vital information to the hospital via a remote CR application linked to a wearable device for telemonitoring by dedicated hospital staff. In addition, remote CR programs can support return to work after hospitalization. Previous studies have demonstrated the effects of remote CR on exercise tolerance. However, the preventive effects of remote CR on cardiac events and mortality remain controversial. Thus, safe and effective remote CR requires exercise risk stratification for each patient, telenursing by skilled staff, and multidisciplinary interventions. Therefore, quality assurance of telenursing and multi-disciplinary interventions will be essential for remote CR. Remote CR may become an important part of cardiac management in the future. However, issues such as costeffectiveness and insurance coverage still persist.