To examine the inter-rater reliability of Autism Diagnostic Interview-Revised, Japanese Version (ADI-R-JV), the authors recruited 51 individuals aged 3-19 years, interviewed by two independent raters. Subsequently, to assess the discriminant and diagnostic validity of ADI-R-JV, the authors investigated 317 individuals aged 2-19 years, who were divided into three diagnostic groups as follows: autistic disorder (AD), pervasive developmental disorder not otherwise specified, and other psychiatric diagnosis or no diagnosis, according to the consensus clinical diagnosis. As regards inter-rater reliability, intraclass correlation coefficients of greater than 0.80 were obtained for all three domains of ADI-R-JV. As regards discriminant validity, the mean scores of the three domains was significantly higher in individuals with AD than in those of other diagnostic groups. As regards diagnostic validity, sensitivity and specificity for correctly diagnosing AD were 0.92 and 0.89, respectively, but sensitivity was 0.55 for individuals younger than 5 years. Specificity was consistently high regardless of age and intelligence. ADI-R-JV was shown to be a reliable tool, and has sufficient discriminant validity and satisfactory diagnostic validity for correctly diagnosing AD, although the diagnostic validity appeared to be compromised with respect to the diagnosis of younger individuals.

ABSTRACT:The purposes of this study were to categorize the functional recovery process of stroke patients, to examine factors relating to the category, and to elucidate the characteristics of each categorized group. Subjects were 131 hemiplegic patients after stroke. The factors affecting the duration of recovery were the initial value of Motor Age (MOA), the duration from the onset to admission, and intellectual deterioration. Subjects who required long time for recovery of MOA were characterized by the low initial value of MOA, short duration from the onset to admission, and no intellectual deterioration. The factors affecting Manual Function Score (MFS) were the initial value of MFS and age. Subjects who required long time for recovery of MFS were featured by the low initial value of MFS and ages of their fifties and seventies. The factors affecting Barthel Index (BI) were the initial value of BI, age and duration from the onset to admission. Subjects who required long time for recovery of BI were characterized by the low initial value of BI, long duration from the onset to admission, and age under 60.

ABSTRACT:The purpose of this study was to clarify the changes in the Activity of Daily Living (ADL) of patients with Cerebral Vascular Accidents (CVA) before and after the establishment of the convalescence rehabilitation ward at the Jiseikai Tokumaru Rehabilitation Hospital. The subjects were 316 patients (pre-establishment group, 158; postestablishment group, 158) who had been hospitalized for rehabilitation purposes at the hospital. There was no significant difference between the two groups in basic characteristics. The period from on-set to admission (POA) has shortened and the execution time of rehabilitation has significantly increased in the post-establishment group. In addition, gain of Barthel Index (BI) in the month after hospitalization has increased significantly in this group. These findings suggest that the effects of concentrated rehabilitation in the convalescent rehabilitation ward at the early stage of stroke appear in the increase of the BI in the month after therapeutic intervention and contribute to early discharge from hospital.

The purpose of this study was to clarify empirically that incontinence after cerebrovascular disease has validity for prognosis or prediction of ADL. We classified 116 hemiplegia patients into 2 groups, incontinence and continence, then stratified the incontinence group into a resolved group and a continuing group, and compared Barthel index scores on admission to hospital, and three months and six months after admission for each group. Since the Barthel index contains an item for incontinence, we made the full score 80 points to exclude the influence of this item. The incontinence group comprised 64% of the patients and had a significantly lower score than the continence group 6 months after hospital admission. It was revealed that incontinence has the validity for prognosis or prediction of ADL between incontinent and continent patients. Since, incontinence on entering hospital is a changing factor in the subsequent treatment process, by stratifying the incontinence group into a resolved group and continuing group, it became clear that the prognosis of the resolved group was good. Incontinence as a single factor alone on entering hospital is not enough to predict the prognosis of incontinence being resolved, it is suggested that consideration is needed to take account of patients' changing condition after entering hospital.

With the objective of clarifying the relationship between unilateral spatial neglect (USN) and practical independence of hemiplegic gait following stroke, we investigated the relationship between independence of hemiplegic gait and the presence or absence of USN, and its severity, among 42 inpatient subjects of our subacute rehabilitation unit who could walk independently in the rehabilitation room. No relationship was found between the degree of severity of USN on admission and independence of hemiplegic gait 3 months later, but a relationship was found between degree of severity of USN at 3 months after admission and independence of hemiplegic gait at the same time. However, the discriminant contribution ratio of the degree of severity of USN in independence of hemiplegic gait was only 14.4%, so we conjecture that a factor other than USN has a greater influence on independence of hemiplegic gait.