Objective：The purpose of this study was to determine the reliability and predictive validity of the Judgement checklist for beneficial falls (hereafter called“Judgement checklist”) in stroke patients.Methods：Five raters evaluated the Judgement checklist for 20 fallers with stroke, and two raters reevaluated the same patients. Fleiss' Kappa and Cohen's Kappa for examination of inter-rater and intra-rater reliability were calculated. For predictive validity, beneficial fallers were identified from among 123 fallers with stroke, using the Judgement checklist. We compared the incidence rate of recurrent falls and motor Functional Independence Measure (FIM) in beneficial fallers and other fallers.Results：Fleiss' Kappa for Judgement was 0.838, and Cohen's Kappa was 1.000. Inter-rater and intra-rater reliability for the Judgement checklist was high. The rate of recurrent falls in beneficial fallers was significantly lower than that in other fallers. The motor FIM in beneficial fallers was significantly higher than that in other fallers, and beneficial fallers tended to have above average ability to recover.Conclusion：The reliability and predictive validity of the Judgement checklist were shown to be high. The Judgment checklist was effective in evaluating the quality of falls and was useful for patient instruction after a fall.

Objective：The purpose of this study was to determine the reliability and predictive validity of the Judgement checklist for beneficial falls (hereafter called “Judgement checklist”) in stroke patients.Methods：Five raters evaluated the Judgement checklist for 20 fallers with stroke, and two raters reevaluated the same patients. Fleiss' Kappa and Cohen's Kappa for examination of inter-rater and intra-rater reliability were calculated. For predictive validity, beneficial fallers were identified from among 123 fallers with stroke, using the Judgement checklist. We compared the incidence rate of recurrent falls and motor Functional Independence Measure (FIM) in beneficial fallers and other fallers.Results：Fleiss' Kappa for Judgement was 0.838, and Cohen's Kappa was 1.000. Inter-rater and intra-rater reliability for the Judgement checklist was high. The rate of recurrent falls in beneficial fallers was significantly lower than that in other fallers. The motor FIM in beneficial fallers was significantly higher than that in other fallers, and beneficial fallers tended to have above average ability to recover.Conclusion：The reliability and predictive validity of the Judgement checklist were shown to be high. The Judgment checklist was effective in evaluating the quality of falls and was useful for patient instruction after a fall.

We report the case of a 20-year-old woman with hypertrophic cardiomyopathy and severe brain dysfunction caused by post-resuscitation encephalopathy. Transferred to our hospital's convalescent rehabilitation ward, she aimed to regain independence in daily living and return to college. Upon admission, she was diagnosed with moderate attention impairment and intellectual disability. She underwent a 4-month intensive inpatient rehabilitation program, including occupational therapy (OT). Despite modest improvements in day-to-day activities and brain function by discharge, these were insufficient for her to resume university childcare classes. Further improvement in behavioral control, physical activity management, and exercise tolerance was necessary post-discharge.OT is pivotal in supporting patient self-management of day-to-day activities, is included within the cardiac rehabilitation (CR) program covered by health insurance. Thus, we introduced her to the CR program for aerobic exercise training and OT. Counseling for physical activity based on the aerobic threshold was performed at each visit, using a chart to record daily activities and heart rate to prevent overactivity, which could lead to fatal arrhythmia.Eventually, she resumed her classes and engaged in childcare training. For patients with brain and heart conditions, a combination of rehabilitation in the convalescent ward and outpatient CR seems to be beneficial for secondary prevention and long-term self-management.

We report the case of a 20-year-old woman with hypertrophic cardiomyopathy and severe brain dysfunction caused by post-resuscitation encephalopathy. Transferred to our hospital's convalescent rehabilitation ward, she aimed to regain independence in daily living and return to college. Upon admission, she was diagnosed with moderate attention impairment and intellectual disability. She underwent a 4-month intensive inpatient rehabilitation program, including occupational therapy (OT). Despite modest improvements in day-to-day activities and brain function by discharge, these were insufficient for her to resume university childcare classes. Further improvement in behavioral control, physical activity management, and exercise tolerance was necessary post-discharge.OT is pivotal in supporting patient self-management of day-to-day activities, is included within the cardiac rehabilitation (CR) program covered by health insurance. Thus, we introduced her to the CR program for aerobic exercise training and OT. Counseling for physical activity based on the aerobic threshold was performed at each visit, using a chart to record daily activities and heart rate to prevent overactivity, which could lead to fatal arrhythmia.Eventually, she resumed her classes and engaged in childcare training. For patients with brain and heart conditions, a combination of rehabilitation in the convalescent ward and outpatient CR seems to be beneficial for secondary prevention and long-term self-management.