Background: The clinical importance of postoperative rehabilitation for cancer patients has recently attracted much attention. However, it remains uncertain whether early rehabilitation can prevent infectious complications in patients undergoing gastrointestinal cancer surgery. Methods: The study group consisted of 259 patients who underwent laparoscopic or open surgery for gastrointestinal cancer at our institution between December 2012 and November 2016. Our department proposed a new early rehabilitation protocol for such patients to encourage physical activity after surgery. The protocol was clinically introduced on July 21, 2015. We divided the study subjects into two groups: those who were admitted before the introduction of the new protocol and those admitted after. The frequency of infectious complications, including respiratory infections, and the length of hospital stay after surgery were compared between the two groups. Results: No adverse cardiovascular event associated with the early rehabilitation protocol was experienced. After the protocol was introduced, more than 80% of patients started exercising on the first day after surgery. For patients undergoing open surgery, the frequency of infectious complications was significantly reduced with the introduction of the protocol (p<0.05). Moreover, when open surgery was performed, the protocol significantly shortened the length of hospital stay (p<0.05). Conclusion: Our proposed early rehabilitation protocol for patients who have undergone gastrointestinal cancer surgery was considered to be safe and feasible. The protocol may prevent infectious complications and shorten the hospital stay after such surgery.
It is thought that quadriceps muscle strength of patients with respiratory diseases is related to their daily living activities (ADL). However, quadriceps force (QF) requires patient effort and often cannot be measured. This study examined the relationship between quadriceps muscle thickness and ADL. [Participants and Methods] The study included 39 patients with chronic respiratory failure. The muscle thicknesses of the rectus femoris and the vastus medialis were measured. The Nagasaki University Respiratory ADL Questionnaire (NRADL) was used for ADL evaluation. In addition, lung function tests, echocardiography tests, and biochemical tests were conducted. For the analysis, Spearman's correlation coefficient was calculated and multiple regression analysis was performed. [Results] Body mass index (BMI), quadriceps muscle thickness (Qt), %DLco, serum albumin (ALB) and FiO2 showed significant correlations with total NRADL. In addition, Qt and %DLco were identified by multiple regression analysis as being related to total NRADL. [Conclusion] The results of this study show that Qt is related to NRADL. Therefore, it should be possible to estimate ADL from the Qt of patients with chronic respiratory failure.
Patients with interstitial lung disease (ILD) tend to be bedridden due to dyspnea, and consequently muscle atrophy becomes a concern. For the treatment of such patients, there has been interest in neuromuscular electrical stimulation (NMES). Since the effect of NMES on ILD patients has not been established, we examined the effect of NMES in combination with voluntary muscular contraction. [Participants and Methods] The participants were 58 ILD patients. The intervention group (n=25) received NMES, while the control group (n=33) received no intervention. In addition, a Nagasaki University ADL evaluation table (NRADL) total of 56 points or less was used to determine the NRADL low value group (n=36), and sub-analysis of the intervention and control groups was performed. Knee extension strength (QF), endurance (6MWD), NRADL, quality of life (QOL) were measured before and after the intervention. [Results] QF and 6MWD significantly improved in the intervention group compared to the control group. Whereas, ADL and QOL showed no significant differences between the groups. In the subanalysis, QF, 6MWD, NRADL and QOL significantly improved in the intervention group. [Conclusion] NMES for ILD was effective in improving muscle strength and endurance during hospitalization. Moreover, the effect of NMES was higher when the NRADL was 56 points or less.
This study aimed to identify evaluation items that can be used to create an index to evaluate caregivers’ fear of care recipient falls. A three-round Delphi method was conducted with medical professionals engaged in discharge support for patients with fall-related fractures. In the first round, a working group brainstormed evaluation items. In the second and third rounds, opinions of medical professionals were quantified and evaluation items were refined. The Delphi method showed convergence of opinion with Kendall’s W of 0.561 in the third round. Of the 109 evaluation items pooled in the first round, the consensus was reached on the importance of 19 items and one more item was additionally included. The 20 items may be useful for creating an index that sensitively measures caregivers’ fear of care recipient falls.
Objective: To evaluate the reliability and validity of this new measure, called the caregivers’ fear of falling index (CFFI).Methods: The study surveyed home-based rehabilitation patients with fall-related fracture, and their primary caregivers. The characteristics of these patients were evaluated, and the caregivers were surveyed using the CFFI and Falls Efficacy Scale-International (FES-I). The reliability of the CFFI was assessed using item-total correlation, while the validity of the CFFI was evaluated through correlation coefficients calculated between the CFFI and the FES-I.Results: The participants were 51 patient-caregiver pairs. The internal consistency of the CFFI showed an alpha coefficient of 0.904. No items were excluded in the corrected item-total correlations. The CFFI showed a moderate correlation with FES-I (r=0.432, p=0.002).Conclusion: This study found the CFFI to be a reliable and valid tool for measuring the primary caregivers’ fear. The CFFI may be a useful tool for healthcare professionals to identify and supporting these primary caregivers.
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