Objective: To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment. Methods: An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors. Results: The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006). Conclusion Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.

Objective: To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment. Methods: An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors. Results: The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006). Conclusion Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.

In recent years, the relationship between healthy life expectancy and exercise has been shown, and the same is also reported for the disabilities. However, we have not yet found any reports on the effects of exercise in children with lower extremity amputations. In this study, we had followed a seven-year-old boy who had undergone right knee rotationplasty for the Ewing's sarcoma, and studied the changes in his athletic abilities, bone density, and body composition with the use of a running-specific prosthesis (RSP). After becoming independent on walking with a daily-use prosthesis, he started using the RSP during exercise such as running. We measured the above parameters before the introduction of RSP, then again after one year use of the RSP. The results showed positive changes in all measurements: increased motor strength around hip, longer time on one leg standing test, increased one leg jump, faster walking speed, wider stride, improved bone density, and improved body compositions. The use of RSP's along with daily-use prostheses for children in their growth period may have favorable effects on their athletic abilities, bone densities, and body compositions.

In recent years, the relationship between healthy life expectancy and exercise has been shown, and the same is also reported for the disabilities. However, we have not yet found any reports on the effects of exercise in children with lower extremity amputations. In this study, we had followed a seven-year-old boy who had undergone right knee rotationplasty for the Ewing's sarcoma, and studied the changes in his athletic abilities, bone density, and body composition with the use of a running-specific prosthesis (RSP). After becoming independent on walking with a daily-use prosthesis, he started using the RSP during exercise such as running. We measured the above parameters before the introduction of RSP, then again after one year use of the RSP. The results showed positive changes in all measurements: increased motor strength around hip, longer time on one leg standing test, increased one leg jump, faster walking speed, wider stride, improved bone density, and improved body compositions. The use of RSP's along with daily-use prostheses for children in their growth period may have favorable effects on their athletic abilities, bone densities, and body compositions.

Since 2019 in our hospital, Rehabilitation Conference (Rehab-CF) with doctors, nurses, and physical therapists has been held for all patients in the intensive care unit (ICU). When Rehab-CF first started, we discussed the contents of rehabilitation only, but over time, began to discuss the management of medical equipment, medicines, and nutrition for rehabilitation, so clinical engineers, pharmacists, and registered dietitians were added as the participants in Rehab-CF. This report is aimed at revealing effects of the expanded Rehab-CF. The analysis involved patients admitted to the ICU between July 2019 and March 2023, and we investigated the effects of the expanded Rehab-CF from the viewpoints of the changing participants, the period of beginning rehabilitation, and changes in patients' general condition. In total, 1155 Rehab-CFs were held for all patients. The period of beginning rehabilitation was ambiguous in 2018, but since we started Rehab-CF, rehabilitation was started on the day after ICU admission for all patients whose general condition was suitable for rehabilitation. The participation of clinical engineers has enabled patients to ambulate under ventilator support and prevented accidental extubation by extending the respiratory circuit. The participation of pharmacists has enabled consideration of the timing for administering sleeping pills, securing nighttime sleep and daytime wakefulness for patients, which contributes to rehabilitation. The participation of registered dietitians has enabled changes in the timing and type of enteral nutrition and a decrease in the backflow of nutrition, facilitating respiratory rehabilitation These changes resulting from the Rehab-CF may have contributed to earlier respirator weaning after ICU admission. By holding Rehab-CF, we could consider patients from multiple perspectives and implement rehabilitation safely, efficiently, and promptly.

Objective: To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment. Methods: An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors. Results: The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006). Conclusion Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.

Methods: This study included 99 men (mean age, 74.9 years; range, 28–93 years) who visited Qiball Clinic for BMD and body composition examinations. The osteoporosis group consisted of 24 patients (mean age, 72.5 years; range, 44–92 years), and the control group consisted of 75 individuals (mean age, 74.9 years; range, 28–93 years). Whole-body skeletal muscle mass was measured using a bioelectrical impedance analyzer. BMD was measured by dual X-ray absorptiometry. Skin autofluorescence (SAF), a marker of dermal AGE accumulation, was measured using a spectroscope. Osteoporosis was defined as a bone density T score of –2.5 or less. Physical findings, skeletal muscle mass, BMD, grip strength, and SAF were compared between the osteoporosis and control groups. Results: The osteoporosis group had significantly lower trunk muscle mass (23.1 kg vs. 24.9 kg), lower leg muscle mass (14.4 kg vs. 13.0 kg), and skeletal mass index (7.1 kg/m2 vs. 6.7 kg/m2) than the control group (all p<0.05). Lower limb muscle mass was identified as a risk factor for osteoporosis in men (odds ratio, 0.64; p=0.03). Conclusions Conservative treatment of osteoporosis in men will require an effective approach that facilitates the maintenance or strengthening of skeletal muscle mass, including exercise therapy with a focus on lower extremities and nutritional supplementation.