Objective: To examine the inter- and intra-rater reliability of the pull test in patients with Parkinson’s disease (PD) using the extracted pull force. Methods: In this inter- and intra-rater reliability study, two raters performed a pull test on 30 patients with PD. The pull force was quantified using inertial sensors attached to the rater’s right hand and the patient’s lower trunk. In this study, the pull force was calculated as an extracted three-dimensional vector quantity, the resultant acceleration, and was expressed in m/s2. Inter- and intra-rater reliabilities were analyzed using the interclass correlation coefficient (ICC) for the pull force and Cohen’s weighted kappa (κw) for the pull test score. Furthermore, Bland–Altman analysis was used to investigate systematic errors. Results: The inter- and intra-rater reliability of the pull force was very poor (ICC = 0.033–0.214). Bland–Altman analysis revealed no systematic errors in the pull forces between the two test points. Conversely, κw for the pull test scores ranged from 0.763 to 0.920, indicating substantial to almost perfect agreement. Conclusion The pull test score was reliable despite variations in the quantified pull force for inter- and intra-rater reliability. Our findings suggest that the pull test is a robust tool for evaluating postural instability in patients with PD and that the pull force probably does not affect scoring performance.

OBJECTIVES: Sarcopenia and osteoporosis affects activities of daily living and quality of elderly people. However, little is known about its impact on elderly locomotor diseases, such as osteoporotic vertebral fracture (OVF). There is no report investigating the influence of both sarcopenia and osteoporosis on outcomes of OVF. This study aimed to evaluate the clinical outcomes of OVF in elderly patients from sarcopenic perspectives. METHODS: This prospective study was conducted with 396 patients, aged 65 years or more, hospitalized for the treatment of OVF (mean age, 81.9 ± 7.1 years; 111 males, 285 females). The primary outcome was the Japanese Orthopaedic Association (JOA) score for lumbar disease (at first visit, hospital discharge, and 1 year after treatment) and Barthel index (at the same time and before hospitalization). The second outcome was living place after discharge. Susceptibility to sarcopenia and osteoporosis were evaluated and clinical results of conservative treatment were compared. RESULTS: Sarcopenia significantly affected Barthel index at first visit and discharge. Sarcopenia patients had significantly higher rate for discharge to nursing home and living in nursing home after 1 year than patients without sarcopenia. Osteoporosis significantly affected the JOA score at the first visit and the Barthel index before hospitalization, at the first visit, discharge, and after 1 year. Osteoporosis did not affect the living place at discharge and after 1 year. CONCLUSIONS: Sarcopenia and osteoporosis affected outcomes of conservative treatment for OVF; moreover, sarcopenia affected the living place of OVF patients at discharge and after 1 year.
Activities of Daily Living ; Aged ; Asian Continental Ancestry Group ; Hospitalization ; Humans ; Male ; Nursing Homes ; Osteoporosis ; Prospective Studies ; Sarcopenia

Objective：This study investigated whether the day of initial ambulation during rehabilitation affects postoperative outcomes in patients with colorectal cancer.Methods：This retrospective observational study was conducted at the Urasoe General Hospital. Patients who underwent scheduled surgery and requested preoperative rehabilitation between June 2019 and December 2021 were included in this study. Patient characteristics and surgery- and rehabilitation-related data were retrieved from the medical records. The patients were divided into early- and late-discharge groups according to their median postoperative hospital stay. The cut-off value of initial ambulation during the postoperative hospital stay was calculated, and logistic regression analysis was performed to determine the impact of initial ambulation on delayed postoperative hospital stay.Results：This study included 184 patients. The cutoff value for initial ambulation during the postoperative hospital stay was three days. In the univariate analysis, rectal cancer, operation time, blood loss, postoperative complications of Clavien-Dindo classification grade II or higher, and the initial ambulation day were identified as potentially significant factors. In the multivariate analysis, which included these potentially significant factors as input variables, postoperative complications, operation time, and the initial ambulation day were determined to be significant independent factors affecting postoperative hospital stay.Conclusion：The initial ambulation day can affect postoperative hospital stay in patients with colorectal cancer. It is important that the rehabilitation interventions undertaken after colorectal cancer surgery facilitate ambulation within the third postoperative day.

Objective：This study investigated whether the day of initial ambulation during rehabilitation affects postoperative outcomes in patients with colorectal cancer.Methods：This retrospective observational study was conducted at the Urasoe General Hospital. Patients who underwent scheduled surgery and requested preoperative rehabilitation between June 2019 and December 2021 were included in this study. Patient characteristics and surgery- and rehabilitation-related data were retrieved from the medical records. The patients were divided into early- and late-discharge groups according to their median postoperative hospital stay. The cut-off value of initial ambulation during the postoperative hospital stay was calculated, and logistic regression analysis was performed to determine the impact of initial ambulation on delayed postoperative hospital stay.Results：This study included 184 patients. The cutoff value for initial ambulation during the postoperative hospital stay was three days. In the univariate analysis, rectal cancer, operation time, blood loss, postoperative complications of Clavien-Dindo classification grade II or higher, and the initial ambulation day were identified as potentially significant factors. In the multivariate analysis, which included these potentially significant factors as input variables, postoperative complications, operation time, and the initial ambulation day were determined to be significant independent factors affecting postoperative hospital stay.Conclusion：The initial ambulation day can affect postoperative hospital stay in patients with colorectal cancer. It is important that the rehabilitation interventions undertaken after colorectal cancer surgery facilitate ambulation within the third postoperative day.

Oculomotor disorder and diplopia cause a decline in quality of life and activities of daily living. The usefulness of orthoptic exercise for oculomotor disorder has been proven. However, there are few reports about orthoptic therapy with diplopia after a cerebrovascular accident in a convalescent rehabilitation ward which usually has no certified orthoptist. A previous study reported that diplopia caused by traumatic subarachnoid hemorrhage was improved after binocular gaze training. On the other hand, it was also reported that binocular training alone did not lead to complete recovery of diplopia, as no improvement was seen after the sixth day. We experienced a case of abducens nerve palsy and diplopia due to subarachnoid hemorrhage. Orthoptic treatment without special equipment restores disordered eye movement and improves double vision. Notably, binocular gazing training, devised to move the gazing target farther away or to the side, improved over a long period, unlike in a previous report. We report this case because it showed the availability of our attempted treatment for oculomotor disorder in a convalescent rehabilitation ward.

Oculomotor disorder and diplopia cause a decline in quality of life and activities of daily living. The usefulness of orthoptic exercise for oculomotor disorder has been proven. However, there are few reports about orthoptic therapy with diplopia after a cerebrovascular accident in a convalescent rehabilitation ward which usually has no certified orthoptist. A previous study reported that diplopia caused by traumatic subarachnoid hemorrhage was improved after binocular gaze training. On the other hand, it was also reported that binocular training alone did not lead to complete recovery of diplopia, as no improvement was seen after the sixth day. We experienced a case of abducens nerve palsy and diplopia due to subarachnoid hemorrhage. Orthoptic treatment without special equipment restores disordered eye movement and improves double vision. Notably, binocular gazing training, devised to move the gazing target farther away or to the side, improved over a long period, unlike in a previous report. We report this case because it showed the availability of our attempted treatment for oculomotor disorder in a convalescent rehabilitation ward.