Cervical motion analysis using wearable inertial sensors to patients with cervical ossification of posterior longitudinal ligament.
Satoshi Osuka, Masahiko Takahata, Ryo Takeda, Takeshi Chiba, Hiroaki Hori, Yoshiaki Kataoka, Norimasa Iwasaki, Masahiko Mukaino, Harukazu Tohyama
Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 2024年09月29日, ［国際誌］
英語, 研究論文（学術雑誌）, This study aimed to clarify cervical kinematics during daily activities, including level walking and stair ascending, in patients with cervical ossification of the posterior longitudinal ligament (C-OPLL). Eighteen patients with myelopathy caused by C-OPLL and 18 healthy controls were recruited to participate in the study. The sagittal cervical kinematics during level walking and stair ascent were quantitatively assessed using a motion analysis system based on wearable inertial sensors. The Japanese Orthopaedic Association score, Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire, Neck Disability Index, and deep sensation in the lower extremities were assessed in all participants. Nine of 18 patients with C-OPLL presented with deep sensory disturbances. Patients with C-OPLL with deep sensory disturbances exhibited different sagittal plane cervical motion patterns than healthy controls during level walking and stair ascent. During the first phase of stair ascent, both patients with C-OPLL and healthy controls flexed their necks to the same degree; however, during the middle and final phases of stair ascent and all phases of level walking, the mean cervical flexion angle of patients with C-OPLL with deep sensory disturbances was significantly higher than that of patients with C-OPLL without deep sensory disturbance and healthy controls. Our data suggest that patients with C-OPLL presenting with deep sensory disturbances are likely to walk with their necks flexed and gaze downward to observe their steps throughout their daily lives. This habitual neck posture may lead to a vicious cycle of cervical kyphosis and worsening of compressive myelopathy.

Response to the letter to the editor: clinical impact of non-lying time on hospital-associated functional decline in older patients undergoing transcatheter aortic valve implantation.
Yuji Kono, Masahiko Mukaino, Yushi Ozawa, Koji Mizutani, Yuki Senju, Takayuki Ogasawara, Masumi Yamaguchi, Takashi Muramatu, Hideo Izawa, Yohei Otaka
Heart and vessels, 2024年06月03日, ［国内誌］
英語

Highlighting Unseen Activity Through 48-Hour Continuous Measurement in Subacute Stroke Rehabilitation: Preliminary Cohort Study.
Emi Mizuno, Takayuki Ogasawara, Masahiko Mukaino, Masumi Yamaguchi, Shingo Tsukada, Shigeru Sonoda, Yohei Otaka
JMIR formative research, 8, e51546, 2024年05月29日, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Motor impairments not only lead to a significant reduction in patient activity levels but also trigger a further deterioration in motor function due to deconditioning, which is an issue that is particularly pronounced during hospitalization. This deconditioning can be countered by sustaining appropriate activity levels. Activities that occur outside of scheduled programs, often overlooked, are critical in this context. Wearable technology, such as smart clothing, provides a means to monitor these activities. OBJECTIVE: This study aimed to observe activity levels in patients who had strokes during the subacute phase, focusing on both scheduled training sessions and other nontraining times in an inpatient rehabilitation environment. A smart clothing system is used to simultaneously measure heart rate and acceleration, offering insights into both the amount and intensity of the physical activity. METHODS: In this preliminary cohort study, 11 individuals undergoing subacute stroke rehabilitation were enrolled. The 48-hour continuous measurement system, deployed at admission and reassessed 4 weeks later, monitored accelerometry data for physical activity (quantified with a moving SD of acceleration [MSDA]) and heart rate for intensity (quantified with percent heart rate reserve). The measurements were performed using a wearable activity monitoring system, the hitoe (NTT Corporation and Toray Industries, Inc) system comprising a measuring garment (wear or strap) with integrated electrodes, a data transmitter, and a smartphone. The Functional Independence Measure was used to assess the patients' daily activity levels. This study explored factors such as differences in activity during training and nontraining periods, correlations with activities of daily living (ADLs) and age, and changes observed after 4 weeks. RESULTS: A significant increase was found in the daily total MSDA after the 4-week program, with the average percent heart rate reserve remaining consistent. Physical activity during training positively correlated with ADL levels both at admission (ρ=0.86, P<.001) and 4 weeks post admission (ρ=0.96, P<.001), whereas the correlation between age and MSDA was not significant during training periods at admission (ρ=-0.41, P=.21) or 4 weeks post admission (ρ=-0.25, P=.45). Conversely, nontraining activity showed a negative correlation with age, with significant negative correlations with age at admission (ρ=-0.82, P=.002) and 4 weeks post admission (ρ=-0.73, P=.01). CONCLUSIONS: Inpatient rehabilitation activity levels were positively correlated with ADL levels. Further analysis revealed a strong positive correlation between scheduled training activities and ADL levels, whereas nontraining activities showed no such correlation. Instead, a negative correlation between nontraining activities and age was observed. These observations suggest the importance of providing activity opportunities for older patients, while it may also suggest the need for adjusting the activity amount to accommodate the potentially limited fitness levels of this demographic. Future studies with larger patient groups are warranted to validate and further elucidate these findings.

Functional outcomes of protocol-based rehabilitation for patients with coronavirus disease 2019 in an acute care setting.
Yoshitaka Wada, Seiko Shibata, Ayato Shinohara, Koji Mizutani, Masahiko Mukaino, Yohei Otaka
Fujita medical journal, 10, 1, 35, 42, 2024年02月, ［国内誌］
英語, 研究論文（学術雑誌）, OBJECTIVES: To examine the functional outcomes of patients with coronavirus disease 2019 (COVID-19) who underwent a new protocol-based rehabilitation program. METHODS: In this retrospective cohort study, we enrolled patients who were hospitalised in a university hospital in Japan because of COVID-19 from 1st September, 2020-5th July, 2021. The primary outcome was the Functional Independence Measure (FIM) subtotal score for motor items at discharge. The secondary outcomes included the FIM cognitive subtotal score, length of hospital stay, rehabilitation period, total rehabilitation time, final rehabilitation protocol level, and discharge destination. RESULTS: Of the 78 enrolled patients (49 men; mean age [standard deviation], 70.3 [13.9] years), 24 died (30.8%) during hospitalisation. Disease severity was classified as mild, moderate I, moderate II, and severe in 1, 6, 41, and 30 patients, respectively. The FIM motor subtotal score differed significantly among groups for all participants (p=0.027). Post hoc analysis revealed that the FIM motor subtotal score in the severe group was significantly lower than that in the moderate II group (p=0.030). CONCLUSIONS: Disease severity significantly affected patients' functional outcome for COVID-19 at discharge. Our protocol-based program provides a benchmark for COVID-19 rehabilitation in an acute care setting.

Prediction of stroke patients’ bedroom-stay duration: machine-learning approach using wearable sensor data
Takayuki Ogasawara, Masahiko Mukaino, Kenichi Matsunaga, Yoshitaka Wada, Takuya Suzuki, Yasushi Aoshima, Shotaro Furuzawa, Yuji Kono, Eiichi Saitoh, Masumi Yamaguchi, Yohei Otaka, Shingo Tsukada
Frontiers in Bioengineering and Biotechnology, 11, Frontiers Media SA, 2024年01月03日
研究論文（学術雑誌）, Background: The importance of being physically active and avoiding staying in bed has been recognized in stroke rehabilitation. However, studies have pointed out that stroke patients admitted to rehabilitation units often spend most of their day immobile and inactive, with limited opportunities for activity outside their bedrooms. To address this issue, it is necessary to record the duration of stroke patients staying in their bedrooms, but it is impractical for medical providers to do this manually during their daily work of providing care. Although an automated approach using wearable devices and access points is more practical, implementing these access points into medical facilities is costly. However, when combined with machine learning, predicting the duration of stroke patients staying in their bedrooms is possible with reduced cost. We assessed using machine learning to estimate bedroom-stay duration using activity data recorded with wearable devices.

Method: We recruited 99 stroke hemiparesis inpatients and conducted 343 measurements. Data on electrocardiograms and chest acceleration were measured using a wearable device, and the location name of the access point that detected the signal of the device was recorded. We first investigated the correlation between bedroom-stay duration measured from the access point as the objective variable and activity data measured with a wearable device and demographic information as explanatory variables. To evaluate the duration predictability, we then compared machine-learning models commonly used in medical studies.

Results: We conducted 228 measurements that surpassed a 90% data-acquisition rate using Bluetooth Low Energy. Among the explanatory variables, the period spent reclining and sitting/standing were correlated with bedroom-stay duration (Spearman’s rank correlation coefficient (R) of 0.56 and −0.52, p &lt; 0.001). Interestingly, the sum of the motor and cognitive categories of the functional independence measure, clinical indicators of the abilities of stroke patients, lacked correlation. The correlation between the actual bedroom-stay duration and predicted one using machine-learning models resulted in an R of 0.72 and p &lt; 0.001, suggesting the possibility of predicting bedroom-stay duration from activity data and demographics.

Conclusion: Wearable devices, coupled with machine learning, can predict the duration of patients staying in their bedrooms. Once trained, the machine-learning model can predict without continuously tracking the actual location, enabling more cost-effective and privacy-centric future measurements.

Movement Component Analysis of Reaching Strategies in Individuals With Stroke: Preliminary Study
Hirofumi Ota, Masahiko Mukaino, Yukari Inoue, Shoh Matsuura, Senju Yagi, Yoshikiyo Kanada, Eiichi Saitoh, Yohei Otaka
JMIR Rehabilitation and Assistive Technologies, 10, e50571, e50571, JMIR Publications Inc., 2023年12月05日
研究論文（学術雑誌）, Background

Upper limb motor paresis is a major symptom of stroke, which limits activities of daily living and compromises the quality of life. Kinematic analysis offers an in-depth and objective means to evaluate poststroke upper limb paresis, with anticipation for its effective application in clinical settings.

Objective

This study aims to compare the movement strategies of patients with hemiparesis due to stroke and healthy individuals in forward reach and hand-to-mouth reach, using a simple methodology designed to quantify the contribution of various movement components to the reaching action.

Methods

A 3D motion analysis was conducted, using a simplified marker set (placed at the mandible, the seventh cervical vertebra, acromion, lateral epicondyle of the humerus, metacarpophalangeal [MP] joint of the index finger, and greater trochanter of the femur). For the forward reach task, we measured the distance the index finger’s MP joint traveled from its starting position to the forward target location on the anterior-posterior axis. For the hand-to-mouth reach task, the shortening of the vertical distance between the index finger MP joint and the position of the chin at the start of the measurement was measured. For both measurements, the contributions of relevant upper limb and trunk movements were calculated.

Results

A total of 20 healthy individuals and 10 patients with stroke participated in this study. In the forward reach task, the contribution of shoulder or elbow flexion was significantly smaller in participants with stroke than in healthy participants (mean 52.5%, SD 24.5% vs mean 85.2%, SD 4.5%; P<.001), whereas the contribution of trunk flexion was significantly larger in stroke participants than in healthy participants (mean 34.0%, SD 28.5% vs mean 3.0%, SD 2.8%; P<.001). In the hand-to-mouth reach task, the contribution of shoulder or elbow flexion was significantly smaller in participants with stroke than in healthy participants (mean 71.8%, SD 23.7% vs mean 90.7%, SD 11.8%; P=.009), whereas shoulder girdle elevation and shoulder abduction were significantly larger in participants with stroke than in healthy participants (mean 10.5%, SD 5.7% vs mean 6.5%, SD 3.0%; P=.02 and mean 16.5%, SD 18.7% vs mean 3.0%, SD 10.4%; P=.02, respectively).

Conclusions

Compared with healthy participants, participants with stroke achieved a significantly greater distance via trunk flexion in the forward reach task and shoulder abduction and shoulder girdle elevation in the hand-to-mouth reach task, both of these differences are regarded as compensatory movements. Understanding the characteristics of individual motor strategies, such as dependence on compensatory movements, may contribute to tailored goal setting in stroke rehabilitation.

Effects of ankle-foot orthosis on gait pattern and spatiotemporal indices during treadmill walking in hemiparetic stroke
Kei Ohtsuka, Masahiko Mukaino, Junya Yamada, Matsuda Fumihiro, Hiroki Tanikawa, Kazuhiro Tsuchiyama, Toshio Teranishi, Eiichi Saitoh, Yohei Otaka
International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation, 46, 4, 316, 324, 2023年12月01日
研究論文（学術雑誌）, Ankle-foot orthosis (AFO) is known to correct abnormal gait patterns and improve walking stability and speed in patients with hemiparesis. To quantify these benefits in post-stroke gait, a three-dimensional motion analysis of gait pattern was conducted. Forty patients with hemiparesis were enrolled. A three-dimensional motion analysis system was used to analyze patients' treadmill walking with/without an AFO. Outcome measures were 12 abnormal gait indices (forefoot contact, knee extensor thrust, retropulsion of the hip, flexed-knee gait, medial whip in the stance phase, circumduction gait, hip hiking, insufficient knee flexion during the swing phase, excessive lateral shifting of the trunk, contralateral vaulting, excessive hip external rotation, and posterior pelvic tilt), calculated using kinematic data and spatiotemporal indices, and the symmetry index of double-stance and single-stance time and step length. Forefoot contact (without AFO vs. with AFO: 71.0 vs. 65.8, P < 0.001), circumduction gait (65.0 vs. 57.9, P < 0.001), and contralateral vaulting (78.2 vs. 72.2, P = 0.003) were significantly reduced, whereas excessive hip external rotation (53.7 vs. 62.8, P = 0.003) significantly increased during walking with an AFO. Hip hiking (77.1 vs. 71.7) showed marginal reduction with the use of AFO ( P = 0.096). The absolute symmetry index of double-stance time (21.9 vs. 16.1, P = 0.014) significantly decreased during walking with an AFO. AFO effectively mitigates abnormal gait patterns typical of hemiparetic gait. A 3D motion analysis system with clinically oriented indices can help assess intervention efficacy for gait abnormalities.

Clinical impact of non-lying time on hospital-associated functional decline in older patients undergoing transcatheter aortic valve implantation.
Yuji Kono, Masahiko Mukaino, Yushi Ozawa, Koji Mizutani, Yuki Senju, Takayuki Ogasawara, Masumi Yamaguchi, Takashi Muramatsu, Hideo Izawa, Yohei Otaka
Heart and vessels, 2023年10月16日, ［国内誌］
英語, 研究論文（学術雑誌）, The purposes of the present study were: (1) to investigate the relationship between hospital-associated functional decline (HAFD) and non-lying time and (2) to clarify the optimal cut-off value for non-lying time associated with HAFD in older patients undergoing transcatheter aortic valve implantation (TAVI). From January 2021 to December 2022, patients admitted to a university hospital who underwent trans-femoral TAVI were consecutively recruited. We measured short physical performance battery (SPPB) pre and post-TAVI, and non-lying time from post-operative days 3-5. HAFD was defined as at least 1 point decrease in SPPB during pre and post-TAVI. Among 75 patients (47 female, mean age of 84.5 years) enrolled, 14 patients were classified as having HAFD. Non-lying time was significantly shorter in the HAFD group than in the non-HAFD group (371 min vs. 539 min, P < 0.001). Receiver-operating characteristic analysis determined an optimal cut-off value of 477 min for differentiating the patients more likely to experience HAFD (sensitivity, 75%; specificity, 92%; area under the curve, 0.798). The non-lying time could be one of the associated factors of HAFD in older patients with TAVI. Non-lying time of about 480 min (8 h) during hospitalization may be an initial target for preventing HAFD.

脳出血後の易怒性に対して反復経頭蓋磁気刺激を実施した1例　　　　　　　　　　　　　　　
若林 央樹, 小川 真央, 梅森 秀, 遠山 晴一, 小金丸 聡子, 向野 雅彦
The Japanese Journal of Rehabilitation Medicine, 60, 秋季特別号, S390, S390, (公社)日本リハビリテーション医学会, 2023年10月
日本語

Determinants of Gait Parameters in Patients With Severe Hip Osteoarthritis.
Yoshihiro Ritsuno, Mitsuhiro Morita, Masahiko Mukaino, Kei Otsuka, Arihiko Kanaji, Junya Yamada, Eiichi Saitoh, Morio Matsumoto, Masaya Nakamura, Yohei Otaka, Nobuyuki Fujita
Archives of physical medicine and rehabilitation, 2023年09月07日, ［国際誌］
英語, 研究論文（学術雑誌）, OBJECTIVE: To investigate the characteristics and symptoms of patients with hip osteoarthritis that are associated with spatiotemporal gait parameters, including their variability and asymmetry. DESIGN: A retrospective, cross-sectional study. SETTING: University hospital. PARTICIPANTS: The study analyzed the gait analysis data of 155 patients (N=155) with hip osteoarthritis who were admitted to a university hospital for total hip replacement and were able to walk on a treadmill without a handrail. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The dependent variables were gait parameters during treadmill walking. These included gait speed, stride length, cadence, coefficient of variation of stride length and stride time, swing time symmetry index, and step symmetry index. Single and multiple regression analyses were conducted using independent variables of the characteristics and symptoms of the patients, including age, sex, height, pain, leg-length discrepancy, and muscle strength of the affected and normal sides measured with a hand-held dynamometer (iliopsoas, gluteus medius, and quadriceps). RESULTS: In the analysis, gait speed and stride were the dependent variables, whereas age, height, and muscle strength on the affected side were the significant independent variables (P<.05). Additionally, pain demonstrated a marginal association with gait speed (P=.053). Only the leg-length discrepancy correlated with cadence. When the coefficient of variation of the stride length was the dependent variable, age and muscle strength on the affected side were significant. For the swing time symmetry index, only the muscle strength on the affected side was significant. Furthermore, the step symmetry index only correlated with leg-length discrepancy. The muscle strength on the affected side was the only significant independent variable for the coefficient of variation of the stride time. CONCLUSIONS: The results revealed that each of the frequent clinical symptoms of hip osteoarthritis, such as pain, muscle weakness, and leg-length discrepancy, can explain different aspects of gait performance.

変形性股関節症患者におけるDuchenne歩行の定量的分析　　　　　　　　　　　　　　　
小桑 隆, 大塚 圭, 向野 雅彦, 土山 和大, 山田 純也, 松田 文浩, 谷川 広樹, 寺西 利生, 大高 洋平
運動器理学療法学, 3, Suppl., O, 97, (一社)日本運動器理学療法学会, 2023年06月
日本語

ICD-11V章を用いた横断的生活機能調査　　　　　　　　　　　　　　　
向野 雅彦, 山田 深, 大夛賀 政昭, 出江 紳一
The Japanese Journal of Rehabilitation Medicine, 60, 特別号, 4, 2, (公社)日本リハビリテーション医学会, 2023年05月
日本語

歩行能力改善遷延例の退院時歩行能力自立予測 hitoeシステムを用いた活動モニタリングに基づく検討　　　　　　　　　　　　　　　
松浦 広昂, 向野 雅彦, 小笠原 隆行, 青嶋 保志, 鈴木 卓弥, 古澤 章太郎, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 60, 特別号, 3, 1, (公社)日本リハビリテーション医学会, 2023年05月
日本語

歩行能力改善遷延例の退院時歩行能力自立予測 hitoeシステムを用いた活動モニタリングに基づく検討　　　　　　　　　　　　　　　
松浦 広昂, 向野 雅彦, 小笠原 隆行, 青嶋 保志, 鈴木 卓弥, 古澤 章太郎, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 60, 特別号, 3, 1, (公社)日本リハビリテーション医学会, 2023年05月
日本語

【超高齢者への心臓リハビリテーションの挑戦】心臓リハビリテーションを軸とした高齢心不全患者に対する急性期診療
河野 裕治, 船戸 優佑, 小澤 祐士, 水谷 公司, 千手 佑樹, 向野 雅彦, 簗瀬 正伸, 井澤 英夫, 大高 洋平
心臓リハビリテーション, 29, 1, 33, 36, (NPO)日本心臓リハビリテーション学会, 2023年03月
日本語

A Tablet-Based Aphasia Assessment System "STELA": Feasibility and Validation Study.
Yoko Inamoto, Masahiko Mukaino, Sayuri Imaeda, Manami Sawada, Kumi Satoji, Ayako Nagai, Satoshi Hirano, Hideto Okazaki, Eiichi Saitoh, Shigeru Sonoda, Yohei Otaka
JMIR formative research, 7, e42219, 2023年02月08日, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: There is an extensive library of language tests, each with excellent psychometric properties; however, many of the tests available take considerable administration time, possibly bearing psychological strain on patients. The Short and Tailored Evaluation of Language Ability (STELA) is a simplified, tablet-based language ability assessment system developed to address this issue, with a reduced number of items and automated testing process. OBJECTIVE: The aim of this paper is to assess the administration time, internal consistency, and validity of the STELA. METHODS: The STELA consists of a tablet app, a microphone, and an input keypad for clinician's use. The system is designed to assess language ability with 52 questions grouped into 2 comprehension modalities (auditory comprehension and reading comprehension) and 3 expression modalities (naming and sentence formation, repetition, and reading aloud). Performance in each modality was scored as the correct answer rate (0-100), and overall performance expressed as the sum of modality scores (out of 500 points). RESULTS: The time taken to complete the STELA was significantly less than the time for the WAB (mean 16.2, SD 9.4 vs mean 149.3, SD 64.1 minutes; P<.001). The STELA's total score was strongly correlated with the WAB Aphasia Quotient (r=0.93, P<.001), supporting the former's concurrent validity concerning the WAB, which is a gold-standard aphasia assessment. Strong correlations were also observed at the subscale level; STELA auditory comprehension versus WAB auditory comprehension (r=0.75, P<.001), STELA repetition versus WAB repetition (r=0.96, P<.001), STELA naming and sentence formation versus WAB naming and word finding (r=0.81, P<.001), and the sum of STELA reading comprehension or reading aloud versus WAB reading (r=0.82, P<.001). Cronbach α obtained for each modality was .862 for auditory comprehension, .872 for reading comprehension, .902 for naming and sentence formation, .787 for repetition, and .892 for reading aloud. Global Cronbach α was .961. The average of the values of item-total correlation to each subscale was 0.61 (SD 0.17). CONCLUSIONS: Our study confirmed significant time reduction in the assessment of language ability and provided evidence for good internal consistency and validity of the STELA tablet-based aphasia assessment system.

Effect of the Effortful Swallow on Pharyngeal Cavity Volume: Kinematic Analysis in Three Dimensions Using 320-Row Area Detector Computed Tomography
Yoko Inamoto, Eiichi Saitoh, Keiko Aihara, Yuriko Ito, Hitoshi Kagaya, Seiko Shibata, Masahiko Mukaino, Masanao Kobayashi, Marlis F. Gonzalez
Dysphagia, Springer Science and Business Media LLC, 2023年01月07日
研究論文（学術雑誌）

Ensemble averaging for categorical variables: Validation study of imputing lost data in 24-h recorded postures of inpatients.
Takayuki Ogasawara, Masahiko Mukaino, Hirotaka Matsuura, Yasushi Aoshima, Takuya Suzuki, Hiroyoshi Togo, Hiroshi Nakashima, Eiichi Saitoh, Masumi Yamaguchi, Yohei Otaka, Shingo Tsukada
Frontiers in physiology, 14, 1094946, 1094946, 2023年, ［国際誌］
英語, 研究論文（学術雑誌）, Acceleration sensors are widely used in consumer wearable devices and smartphones. Postures estimated from recorded accelerations are commonly used as features indicating the activities of patients in medical studies. However, recording for over 24 h is more likely to result in data losses than recording for a few hours, especially when consumer-grade wearable devices are used. Here, to impute postures over a period of 24 h, we propose an imputation method that uses ensemble averaging. This method outputs a time series of postures over 24 h with less lost data by calculating the ratios of postures taken at the same time of day during several measurement-session days. Whereas conventional imputation methods are based on approaches with groups of subjects having multiple variables, the proposed method imputes the lost data variables individually and does not require other variables except posture. We validated the method on 306 measurement data from 99 stroke inpatients in a hospital rehabilitation ward. First, to classify postures from acceleration data measured by a wearable sensor placed on the patient's trunk, we preliminary estimated possible thresholds for classifying postures as 'reclining' and 'sitting or standing' by investigating the valleys in the histogram of occurrences of trunk angles during a long-term recording. Next, the imputations of the proposed method were validated. The proposed method significantly reduced the missing data rate from 5.76% to 0.21%, outperforming a conventional method.

Effects of Posterior Spinal Correction and Fusion on Postural Stability in Patients with Adolescent Idiopathic Scoliosis.
Satoshi Osuka, Hideki Sudo, Katsuhisa Yamada, Hiroyuki Tachi, Kentaro Watanabe, Fuma Sentoku, Takeshi Chiba, Norimasa Iwasaki, Masahiko Mukaino, Harukazu Tohyama
Journal of clinical medicine, 12, 1, 2022年12月29日, ［国際誌］
英語, 研究論文（学術雑誌）, The present study aimed to assess the effects of posterior spinal correction and fusion on postural stability in patients with adolescent idiopathic scoliosis (AIS). The study included 41 female patients with AIS at our institution. All patients performed three 10 s single-leg standing trials on a force plate. The center of pressure (COP) was measured preoperatively, and at 1 week and 6 months postoperatively. The postural stability parameters were absolute minimum time-to-boundary (TTB), mean of the minimum TTB, mean COP velocity, standard deviation, range, and 95% confidence ellipse area. One-way repeated analysis of variance or Friedman test was applied to the postural stability parameters. Multiple comparisons were performed using the Bonferroni correction. The absolute minimum TTB and the mean minimum TTB showed a significant increase 6 months post-operation as compared to preoperatively and 1 week postoperatively. The COP velocity significantly decreased at 6 months post-operation compared to preoperatively and 1 week postoperatively. These changes in postural stability indicate that spinal correction and fusion can be considered to improve postural stability during single-leg standing tests in the postoperative period.

Characterization of Postural Control in Post-Stroke Patients by Musculoskeletal Simulation
Kohei Kaminishi, Dongdong Li, Ryosuke Chiba, Kaoru Takakusaki, Masahiko Mukaino, Jun Ota
Journal of Robotics and Mechatronics, 34, 6, 1451, 1462, Fuji Technology Press Ltd., 2022年12月20日
研究論文（学術雑誌）, An association is observed between the standing sway posture and falls in patients with stroke; hence, it is important to study their standing balance. Although there are studies on the standing balance in stroke patients, differences in control have not been adequately investigated. This study aims to propose a method to characterize the postural sway in standing stroke patients using a mathematical model. A musculoskeletal model and neural controller model were used to simulate ten stroke patients (five patients with cerebral hemorrhages and five patients with cerebral infarctions) and eight young healthy participants, and their data were monitored during quiet standing. The model parameters were adjusted by focusing on the maximum-minimum difference in sway, which was considered important in a previous study, and sway speed, which is frequently used in the analysis. The adjusted model parameters were subjected to dimension reduction using non-negative matrix factorization. Consequently, the sway characteristics of stroke patients were expressed as the magnitude of gain parameters related to the extension of the entire body. The results of this study demonstrated the possibility of representing the characteristics of postural sway as model parameters in stroke patients using a mathematical model. This characterization could lead to the design of individualized rehabilitation systems in the future.

Validity of trunk acceleration measurement with a chest-worn monitor for assessment of physical activity intensity
Masahiko Mukaino, Takayuki Ogasawara, Hirotaka Matsuura, Yasushi Aoshima, Takuya Suzuki, Shotaro Furuzawa, Masumi Yamaguchi, Hiroshi Nakashima, Eiichi Saitoh, Shingo Tsukada, Yohei Otaka
BMC Sports Science, Medicine and Rehabilitation, 14, 1, Springer Science and Business Media LLC, 2022年12月
研究論文（学術雑誌）, Abstract

Background

Recent advancements in wearable technology have enabled easy measurement of daily activities, potentially applicable in rehabilitation practice for various purposes such as maintaining and increasing patients’ activity levels. In this study, we aimed to examine the validity of trunk acceleration measurement using a chest monitor embedded in a smart clothing system (‘hitoe’ system), an emerging wearable system, in assessing the physical activity in an experimental setting with healthy subjects (Study 1) and in a clinical setting with post-stroke patients (Study 2).

Methods

Study 1 involved the participation of 14 healthy individuals. The trunk acceleration, heart rate (HR), and oxygen consumption were simultaneously measured during treadmill testing with a Bruce protocol. Trunk acceleration and HR were measured using the "hitoe" system, a smart clothing system with embedded chest sensors. Expiratory gas analysis was performed to measure oxygen consumption. Three parameters, moving average (MA), moving standard deviation (MSD), and moving root mean square (RMS), were calculated from the norm of the trunk acceleration. The relationships between these accelerometer-based parameters and oxygen consumption-based physical activity intensity measured with the percent VO2 reserve (%VO₂R) were examined. In Study 2, 48 h of simultaneous measurement of trunk acceleration and heart rate-based physical activity intensity in terms of percent heart rate reserve (%HRR) was conducted with the "hitoe" system in 136 post-stroke patients.

Results

The values of MA, MSD, RMS, and %VO₂R were significantly different between levels 1, 2, 3, and 4 in the Bruce protocol (P < 0.01). The average coefficients of determination for individual regression for %VO₂R versus MA, %VO₂R versus MSD, and %VO₂R versus RMS were 0.89 ± 0.05, 0.96 ± 0.03, and 0.91 ± 0.05, respectively. Among the parameters examined, MSD showed the best correlation with %VO₂R, indicating high validity of the parameter for assessing physical activity intensity. The 48-h measurement of MSD and %HRR in post-stroke patients showed significant within-individual correlation (P < 0.05) in 131 out of 136 patients (correlation coefficient: 0.60 ± 0.16).

Conclusions

The results support the validity of the MSD calculated from the trunk acceleration measured with a smart clothing system in assessing the physical activity intensity.

Trial registration: UMIN000034967. Registered 21 November 2018 (retrospectively registered).

Rehabilitation outcomes in patients with lower limb amputation receiving haemodialysis: A retrospective cohort study
Yoshitaka Wada, Yohei Otaka, Yuki Senju, Hiroshi Hosokawa, Takamichi Tohyama, Hirofumi Maeda, Masahiko Mukaino, Seiko Shibata, Satoshi Hirano
Journal of Rehabilitation Medicine - Clinical Communications, 5, jrmcc00088, jrmcc00088, Medical Journals Sweden AB, 2022年11月24日
研究論文（学術雑誌）, Objective: To compare the functional outcomes of patients with lower limb amputations receiving haemodialysis and those not receiving haemodialysis.Design: A retrospective cohort study. Patients: Patients with lower limb amputation who were admitted to a convalescent rehabilitation ward between January 2018 and December 2021.Methods: The primary outcome was the effectiveness of the Functional Independence Measure (FIM) during hospitalisation in the ward. Secondary outcomes included the total and subtotal (motor/cognitive) FIM scores at discharge, gain in the total and subtotal (motor/cognitive) FIM scores, K-level at discharge, length of hospital stay in the ward, rehabilitation time, and discharge destination. Outcomes were compared between the non-haemodialysis and haemodialysis groups.Results: A total of 28 patients (mean [standard deviation] age, 67.0 [11.9] years; men, 20) were enrolled in this study. Among them, 11 patients underwent haemodialysis. The FIM effectiveness was significantly higher in the non-haemodialysis group than in the haemodialysis group (median [interquartile range], 0.78 [0.72 – 0.81] vs 0.65 [0.28 – 0.75], p = 0.038). The amount of rehabilitation and all secondary outcomes were not significantly different between the groups (p > 0.05).Conclusion: Patients with lower limb amputation who were receiving haemodialysis had poorer FIM effectiveness than those not receiving haemodialysis.LAY ABSTRACTChronic kidney disease is a risk factor for foot ulcers and lower limb amputation. Thus, patients with lower limb amputation often require maintenance dialysis. However, there is a lack of knowledge on whether patients with lower limb amputation receiving haemodialysis can achieve functional outcomes comparable to those not receiving haemodialysis. This study aimed to compare functional outcomes between patients with lower limb amputations receiving haemodialysis and those not receiving haemodialysis. This retrospective cohort study enrolled 28 patients who underwent amputation surgery and were admitted to a rehabilitation ward, including 11 patients undergoing haemodialysis (8 with diabetic nephropathy, 1 with chronic glomerulonephritis, 1 with rapidly progressive glomerulonephritis, and 1 with acute kidney injury). Although the amount of rehabilitation did not differ between groups, the improvement in the activities of daily living was significantly better in the non-haemodialysis group than in the haemodialysis group. Thus, even the same amount of rehabilitation for patients with lower limb amputations receiving haemodialysis may not lead to functional outcomes comparable to those without haemodialysis.

Reliability and validity of the public transportation use assessment form for individuals after stroke
Shin Kitamura, Yohei Otaka, Kazuki Ushizawa, Seigo Inoue, Sachiko Sakata, Kunitsugu Kondo, Masahiko Mukaino, Eiji Shimizu
Disability and Rehabilitation, 45, 14, 1, 8, Informa UK Limited, 2022年10月14日
研究論文（学術雑誌）

Development of a simple mechanical measurement method to measure spasticity based on an analysis of a clinical maneuver and its concurrent validity with the modified Ashworth scale
Hiroki Tanikawa, Masahiko Mukaino, Shota Itoh, Hikaru Kondoh, Kenta Fujimura, Toshio Teranishi, Kei Ohtsuka, Satoshi Hirano, Hitoshi Kagaya, Eiichi Saitoh, Yohei Otaka
Frontiers in Bioengineering and Biotechnology, 10, Frontiers Media SA, 2022年08月15日
研究論文（学術雑誌）, Background: Despite recent developments in the methodology for measuring spasticity, the discriminative capacity of clinically diagnosed spasticity has not been well established. This study aimed to develop a simple device for measuring velocity-dependent spasticity with improved discriminative capacity based on an analysis of clinical maneuver and to examine its reliability and validity.

Methods: This study consisted of three experiments. First, to determine the appropriate motion of a mechanical device for the measurement of velocity-dependent spasticity, the movement pattern and the angular velocity used by clinicians to evaluate velocity-dependent spasticity were investigated. Analysis of the procedures performed by six physical therapists to evaluate spasticity were conducted using an electrogoniometer. Second, a device for measuring the resistance force against ankle dorsiflexion was developed based on the results of the first experiment. Additionally, preliminary testing of validity, as compared to that of the Modified Ashworth Scale (MAS), was conducted on 17 healthy participants and 10 patients who had stroke with spasticity. Third, the reliability of the measurement and the concurrent validity of mechanical measurement in the best ankle velocity setting were further tested in a larger sample comprising 24 healthy participants and 32 patients with stroke.

Results: The average angular velocity used by physical therapists to assess spasticity was 268 ± 77°/s. A device that enabled the measurement of resistance force at velocities of 300°/s, 150°/s, 100°/s, and 5°/s was developed. In the measurement, an angular velocity of 300°/s was found to best distinguish patients with spasticity (MAS of 1+ and 2) from healthy individuals. A measurement of 300°/s in the larger sample differentiated the control group from the MAS 1, 1+, and 2 subgroups (p &lt; 0.01), as well as the MAS 1 and 2 subgroups (p &lt; 0.05). No fixed or proportional bias was observed in repeated measurements.

Conclusion: A simple mechanical measurement methodology was developed based on the analysis of the clinical maneuver for measuring spasticity and was shown to be valid in differentiating the existence and extent of spasticity. This study suggest possible requirements to improve the quality of the mechanical measurement of spasticity.

Development of an assessment form for the performance of public transportation use in individuals with stroke.
Kazuki Ushizawa, Yohei Otaka, Shin Kitamura, Seigo Inoue, Sachiko Sakata, Kunitsugu Kondo, Masahiko Mukaino, Eiji Shimizu
Disability and rehabilitation, 1, 10, 2022年06月28日, ［国際誌］
英語, 研究論文（学術雑誌）, PURPOSE: To develop a new assessment form that is assessed by therapists for the performance of public transportation use for stroke survivors through content validation. MATERIALS AND METHODS: The items for the tentative assessment form were selected using hierarchical clustering analysis on previous records of 76 field-based training sessions for public transportation use for stroke survivors. After the modification of the tentative form based on 6 months of clinical use, the final form was developed through content validation using the Delphi method by 71 therapists who had been working at the hospital for more than 2 years and had experience with training for public transportation use. RESULTS: The Public Transportation use Assessment Form (PTAF) for stroke was successfully developed through three validation processes. It consists of four categories (plan for going out, mobility, using trains, and using buses) including 15 items that cover various tasks of public transportation use. The scoring for each was as follows: 3, independent; 2, requires supervision of verbal assistance; 1, requires assistance; and N, not applicable. CONCLUSION: The PTAF, developed through content validation, could assess the ability of public transportation use, and identify specific problems for each stroke survivor in clinical setting.IMPLICATIONS FOR REHABILITATIONWe developed the Public Transportation use Assessment Form (PTAF) to assess the ability of stroke survivors to use public transportation.The PTAF could identify specific problems related to public transportation use for stroke survivors and aid in planning rehabilitation programs based on the results.The PTAF could share information about which task need support in public transportation use and could augment the hospital discharge plan.

簡易的リアルタイム歩行分析システムの信頼性　　　　　　　　　　　　　　　
稲森 遥, 大塚 圭, 向野 雅彦, 山田 純也, 林 弘規, 松田 文浩, 谷川 広樹, 土山 和大, 村上 涼, 才藤 栄一, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 59, 特別号, S110, S110, (公社)日本リハビリテーション医学会, 2022年05月
日本語

日中離床時間は経カテーテル大動脈弁埋め込み術患者の入院関連身体機能低下の関連因子となる
河野 裕治, 小澤 祐士, 水谷 公司, 千手 佑樹, 船戸 優佑, 向野 雅彦, 村松 崇, 簗瀬 正伸, 井澤 英夫, 大高 洋平
日本循環器病予防学会誌, 57, 2, 132, 132, (一社)日本循環器病予防学会, 2022年05月
日本語

脳卒中患者における日常の活動量に影響を与える因子の検討　　　　　　　　　　　　　　　
和田 義敬, 向野 雅彦, 小笠原 隆行, 鈴木 卓弥, 青嶋 保志, 古澤 章太郎, 松田 文浩, 大高 洋平, 才藤 栄一
The Japanese Journal of Rehabilitation Medicine, 特別号, S439, S439, (公社)日本リハビリテーション医学会, 2022年05月
日本語

簡易的リアルタイム歩行分析システムの信頼性　　　　　　　　　　　　　　　
稲森 遥, 大塚 圭, 向野 雅彦, 山田 純也, 林 弘規, 松田 文浩, 谷川 広樹, 土山 和大, 村上 涼, 才藤 栄一, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 特別号, S110, S110, (公社)日本リハビリテーション医学会, 2022年05月
日本語

Functional outcomes in acute care settings vary by disease categories but show a consistent pattern of disability.
Koji Mizutani, Yohei Otaka, Masaki Kato, Miwako Hayakawa, Megumi Ozeki, Hirofumi Maeda, Satoshi Hirano, Masahiko Mukaino, Seiko Shibata, Hitoshi Kagaya, Hiroaki Sakurai, Eiichi Saitoh
Annals of physical and rehabilitation medicine, 101648, 101648, 2022年02月24日, ［国際誌］
英語

Thin Liquid Bolus Volume Alters Pharyngeal Swallowing: Kinematic Analysis Using 3D Dynamic CT.
Kannit Pongpipatpaiboon, Yoko Inamoto, Keiko Aihara, Hitoshi Kagaya, Seiko Shibata, Masahiko Mukaino, Eiichi Saitoh, Marlis Gonzalez-Fernandez
Dysphagia, 2022年01月03日, ［国際誌］
英語, 研究論文（学術雑誌）, The previous studies reported that different volumes of thick liquid had an impact on spatiotemporal characteristics and pharyngeal response of swallowing. However, the bolus flow and swallowing motion pattern were different between thick and thin liquids. The effects of thin bolus volume on pharyngeal swallowing, especially true vocal cord (TVC) closure is still unclear. This study assessed the temporal characteristics when swallowing different volumes of thin liquid to determine the mechanical adaptation using 320-row area detector computed tomography (320-ADCT) and investigated a change of swallowing physiology including laryngeal closure, particularly TVC closure. Fourteen healthy women (28-45 years) underwent 320-ADCT while swallowing of 3, 10, and 20 ml of thin liquid barium in 45° semi-reclining position. Kinematic analysis was performed for each swallow including temporal characteristic, structural movements while swallowing, and maximal cross-sectional area of the upper esophageal sphincter (UES) opening. Bolus head reached to pharynx and esophagus earlier in larger volume significantly, indicating faster bolus transport as volume increased. There were significant effects on swallowing mechanism revealing earlier TVC closure and UES opening with increasing volume. Maximum cross-sectional area of the UES opening was increased to accommodate a larger bolus. Differences in mechanical adaptation through bolus transit and motion of swallowing structures were detected across increasing volumes. These volume-dependent adaptations potentially reduce the risk of aspiration. Understanding the swallowing physiological changes as volume increased is helpful for diagnosis and treatment of dysphagia patients as well as outcomes of swallowing rehabilitation in clinical practice.

A novel gait analysis system for detecting abnormal hemiparetic gait patterns during robot-assisted gait training: A criterion validity study among healthy adults.
Daisuke Imoto, Satoshi Hirano, Masahiko Mukaino, Eiichi Saitoh, Yohei Otaka
Frontiers in neurorobotics, 16, 1047376, 1047376, 2022年, ［国際誌］
英語, 研究論文（学術雑誌）, INTRODUCTION: Robot-assisted gait training has been reported to improve gait in individuals with hemiparetic stroke. Ideally, the gait training program should be customized based on individuals' gait characteristics and longitudinal changes. However, a gait robot that uses gait characteristics to provide individually tailored gait training has not been proposed. The new gait training robot, "Welwalk WW-2000," permits modification of various parameters, such as time and load of mechanical assistance for a patient's paralyzed leg. The robot is equipped with sensors and a markerless motion capture system to detect abnormal hemiparetic gait patterns during robot-assisted gait training. Thus, it can provide individually tailored gait training. This study aimed to investigate the criterion validity of the gait analysis system in the Welwalk WW-2000 in healthy adults. MATERIALS AND METHODS: Twelve healthy participants simulated nine abnormal gait patterns that were often manifested in individuals with hemiparetic stroke while wearing the robot. Each participant was instructed to perform a total of 36 gait trials, with four levels of severity for each abnormal gait pattern. Fifteen strides for each gait trial were recorded using the markerless motion capture system in the Welwalk WW-2000 and a marker-based three-dimensional (3D) motion analysis system. The abnormal gait pattern index was then calculated for each stride from both systems. The correlation of the index values between the two methods was evaluated using Spearman's rank correlation coefficients for each gait pattern in each participant. RESULTS: Using the participants' index values for each abnormal gait pattern obtained using the two motion analysis methods, the median Spearman's rank correlation coefficients ranged from 0.68 to 0.93, which corresponded to moderate to very high correlation. CONCLUSION: The gait analysis system in the Welwalk WW-2000 for real-time detection of abnormal gait patterns during robot-assisted gait training was suggested to be a valid method for assessing gait characteristics in individuals with hemiparetic stroke. CLINICAL TRIAL REGISTRATION: [https://jrct.niph.go.jp], identifier [jRCT 042190109].

Development and preliminary evaluation of a tele-rehabilitation exercise system using computer-generated animation
Kumazawa Nobuhiro, Koyama Soichiro, Mukaino Masahiko, Tsuchiyama Kazuhiro, Tatemoto Tsuyoshi, Tanikawa Hiroki, Ohtsuka Kei, Katoh Masaki, Otaka Yohei, Saitoh Eiichi, Tanabe Shigeo
Fujita Medical Journal, advpub, Fujita Medical Society, 2022年
英語, Objectives: To evaluate the safety and acceptability of a newly developed tele-rehabilitation exercise system using computer-generated animation.

Methods: The participants comprised a convenience sample of 38 diverse individuals in Experiment 1 (15 healthy young people, 16 healthy older people, 5 patients with stroke, and 2 patients with respiratory disease) and 18 healthy older individuals in Experiment 2. Experiment 1 assessed safety in terms of cardiopulmonary vascular aspects and risk of fall, and Experiment 2 assessed treatment acceptability via a subjective evaluation. All participants completed the same exercise program. The safety assessment was conducted using heart rate (HR) and saturation of percutaneous oxygen (SpO2), measured before and after exercise. In addition, the occurrence of falls was assessed. For the acceptability assessment, the participants answered five questions (three-point Likert scale) after the exercise program.

Results: The safety assessment indicated that HR and SpO2 changed from 70.5±10.2 beats per minute and 97.8±1.3% before exercise to 87.6±13.6 beats per minute and 98.2±0.9% after exercise, respectively. In addition, all participants completed the exercises without experiencing any falls. In the acceptability assessment, the score reflecting continuation desire was the highest of the five items examined (2.71±0.46). In contrast, the adequacy of exercise intensity had the lowest score (1.29±0.57).

Conclusions: The present system was confirmed to be safe, and the participants were motivated to continue the exercises. Future developments should incorporate a function to enable participants and medical staff to adjust exercise intensity according to individual physical function.

Requirements for Eliciting a Spastic Response With Passive Joint Movements and the Influence of Velocity on Response Patterns: An Experimental Study of Velocity-Response Relationships in Mild Spasticity With Repeated-Measures Analysis.
Kenta Fujimura, Masahiko Mukaino, Shota Itoh, Haruna Miwa, Ryoka Itoh, Daisuke Narukawa, Hiroki Tanikawa, Yoshikiyo Kanada, Eiichi Saitoh, Yohei Otaka
Frontiers in neurology, 13, 854125, 854125, 2022年, ［国際誌］
英語, 研究論文（学術雑誌）, Background: Spasticity is defined as a velocity-dependent increase in tonic stretch reflexes and is manually assessed in clinical practice. However, the best method for the clinical assessment of spasticity has not been objectively described. This study analyzed the clinical procedure to assess spasticity of the elbow joint using an electrogoniometer and investigated the appropriate velocity required to elicit a spastic response and the influence of velocity on the kinematic response pattern. Methods: This study included eight healthy individuals and 15 patients with spasticity who scored 1 or 1+ on the modified Ashworth Scale (MAS). Examiners were instructed to manually assess spasticity twice at two different velocities (slow and fast velocity conditions). During the assessment, velocity, deceleration value, and angle [described as the % range of motion (%ROM)] at the moment of resistance were measured using an electrogoniometer. Differences between the slow and fast conditions were evaluated. In addition, variations among the fast condition such as the responses against passive elbow extension at <200, 200-300, 300-400, 400°/s velocities were compared between the MAS 1+, MAS 1, and control groups. Results: Significant differences were observed in the angular deceleration value and %ROM in the fast velocity condition (417 ± 80°/s) between patients and healthy individuals, but there was no difference in the slow velocity condition (103 ± 29°/s). In addition, the deceleration values were significantly different between the MAS 1 and MAS 1+ groups in velocity conditions faster than 300°/s. In contrast, the value of %ROM plateaued when the velocity was faster than 200°/s. Conclusion: The velocity of the passive motion had a significant effect on the response pattern of the elbow joint. The velocity-response pattern differed between deceleration and the angle at which the catch occurred; the value of deceleration value for passive motion was highly dependent on the velocity, while the %ROM was relatively stable above a certain velocity threshold. These results provide clues for accurate assessment of spasticity in clinical practice.

Stroke Patients with Nearly Independent Transfer Ability are at High Risk of Falling.
Yoshitaka Kato, Shin Kitamura, Masaki Katoh, Asuka Hirano, Yuki Senjyu, Mao Ogawa, Hirofumi Maeda, Masahiko Mukaino, Satoshi Hirano, Hiroaki Sakurai, Seiko Shibata, Yohei Otaka
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 31, 1, 106169, 106169, 2022年01月, ［国際誌］
英語, 研究論文（学術雑誌）, OBJECTIVES: To examine the relationship between patients' transfer ability and fall risk in stroke patients during hospitalization. MATERIALS AND METHODS: We retrospectively enrolled 237 stroke patients who were transferred to a convalescent rehabilitation ward from acute wards in the same hospital. Using incident reports, we investigated their fall rates and activity status at the falls according to their transfer abilities, which were assessed with Functional Independence Measure (FIM) transfer scores. The bi-weekly time trend of fall rates in all patients and in three subgroups based on FIM transfer scores of 1-3, 4-5, and 6-7, and activity status at the falls, were investigated. In addition, changes of patients' transfer ability on admission, at the first fall, and at discharge were investigated among falling patients. RESULTS: The fall rate was the greatest in patients with a FIM transfer score of 4 (14.3 times/1000 person-days). The majority of falls for patients with a FIM transfer score of 1 occurred at the activity status of "on the bed" and "sitting", while three quarters of patients with a FIM score of 7 had falls during "standing" and "walking". No longitudinal trend in fall rates was found overall; however, the fall rate trends differed depending on the FIM transfer score. The majority of the patients who fell required full assistance for transfers upon admission but required no assistance at discharge. CONCLUSIONS: Fall risk differed among patients with various transfer abilities; the greatest risk was in those who needed minimal assistance for transfers.

Overcoming language barriers to provide telerehabilitation for COVID-19 patients: a two-case report.
Tsuyoshi Tatemoto, Masahiko Mukaino, Nobuhiro Kumazawa, Shigeo Tanabe, Koji Mizutani, Masaki Katoh, Eiichi Saitoh, Yohei Otaka
Disability and rehabilitation. Assistive technology, 1, 8, 2021年12月27日, ［国際誌］
英語, 研究論文（学術雑誌）, PURPOSE: This report presents two cases of successful telerehabilitation delivery for patients quarantined due to COVID-19. One of the patients did not speak the therapists' language, whereas the other presented complete deafness. MATERIALS AND METHODS: We assembled a telerehabilitation system using commercial applications, including a remote-control application that minimizes the need for patient's input. The telerehabilitation comprised a combination of video calls with a physical therapist and a 20-minute exercise video. The first case was of a 72-year-old man who could only speak Cantonese, a language that none of the service providers could speak, making communication difficult. Therefore, telerehabilitation was provided using Google Translate to simultaneously translate the therapist's instructions in Japanese to Cantonese. The second case involved a 49-year-old man with neurofibromatosis and complete deafness. In this case, communication during the exercise programme was achieved using 25 cue cards that were prepared in advance and used to convey instructions. The patients' satisfaction was assessed using either of a simple three-item questionnaire (Case 1) or the Telemedicine Satisfaction Questionnaire with five additional items (Case 2). RESULTS: In both cases, the exercise programme was successfully conducted, and the patients reported being highly satisfied with the programme. CONCLUSIONS: Communication barriers can impede telerehabilitation therapy; this problem is aggravated when the recipients cannot receive on-site education for device operation and exercise performance in advance due to COVID-19 restrictions. However, the use of supplementary methodologies may contribute to solving these issues, further expanding the coverage and applicability of telerehabilitation.IMPLICATIONS FOR REHABILITATIONWe provided telerehabilitation for two patients with communication difficulties who were quarantined due to COVID-19.Telerehabilitation was carried out using a system with a remote-control mechanism to minimise patient input and avoid problems caused by their unfamiliarity in operating the devices.In addition, an online translation mechanism was used to overcome language differences, while cue cards were used for a patient with a hearing impairment.Telerehabilitation was performed without any technical issues. Both patients reported being highly satisfied with the intervention.This experience of providing telerehabilitation and overcoming communication difficulties may help develop a strategy to expand the coverage of telerehabilitation in the treatment of patients in isolation due to highly transmissible diseases, such as COVID-19.

ICFに基づく生活機能評価の臨床導入に向けて　　　　　　　　　　　　　　　
向野 雅彦, 山田 深, 出江 紳一
医療情報学連合大会論文集, 41回, 252, 254, (一社)日本医療情報学会, 2021年11月
日本語

高齢心不全患者における経カテーテル大動脈弁置換術前後の身体機能の推移に関する実態調査(第1報)　　　　　　　　　　　　　　　
小澤 祐士, 河野 裕治, 水谷 公司, 千手 佑樹, 前田 寛文, 向野 雅彦, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 58, 秋季特別号, S455, S455, (公社)日本リハビリテーション医学会, 2021年10月
日本語

脳卒中患者に対する上肢ロボット練習が上肢・体幹運動へ与える影響 動作分析を用いて予備的検討をした1例　　　　　　　　　　　　　　　
太田 皓文, 向野 雅彦, 井上 由加里, 才藤 栄一, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 58, 秋季特別号, S461, S461, (公社)日本リハビリテーション医学会, 2021年10月
日本語

回復期リハ病棟入院患者の24時間活動モニタリングに基づく消費エネルギーの推定と体重推移の比較　　　　　　　　　　　　　　　
新家 翼, 向野 雅彦, 三鬼 達人, 稲垣 喜信, 松田 文浩, 青嶋 保志, 鈴木 卓弥, 小笠原 隆行, 大高 洋平, 才藤 栄一
学会誌JSPEN, 3, Suppl.1, 680, 680, (一社)日本臨床栄養代謝学会, 2021年10月
日本語

Effects of ankle-foot orthoses on the stability of post-stroke hemiparetic gait.
Kazuhiro Tsuchiyama, Masahiko Mukaino, Kei Ohtsuka, Fumihiro Matsuda, Hiroki Tanikawa, Junya Yamada, Kannit Pongpipatpaiboon, Yoshikiyo Kanada, Eiichi Saitoh, Yohei Otaka
European journal of physical and rehabilitation medicine, 2021年09月09日, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Ankle-foot orthoses are used to improve gait stability in patients with post-stroke gait; however, there is not enough evidence to support their beneficial impact on gait stability. AIM: To investigate the effects of ankle-foot orthoses on post-stroke gait stability. DESIGN: An experimental study with repeated measurements of gait parameters with and without orthosis. SETTING: Inpatients and outpatients in the Fujita Health University Hospital. POPULATION: Thirty-two patients (22 males; mean age 48.3±20.0 years) with poststroke hemiparesis participated in the study. METHODS: Three-dimensional treadmill gait analysis was performed with and without ankle-foot orthosis for each participant. Spatiotemporal parameters, their coefficient of variation, and margin of stability were evaluated. Toe clearance, another major target of orthosis, was also examined. The effect of orthosis in the patients with severe (not able to move within the full range of motion, defying gravity) and mild ankle impairment (able to move within the full range but have problem with speed and/or smoothness of the ankle movement) was compared. RESULTS: In the total group comparison, the decrease in the coefficient of variation of step width (P=0.012), and margin of stability on the paretic side (P=0.023) were observed. In the severe ankle impairment groups, the decreased in the coefficient of variation of the non-paretic step length (P=0.007), stride length (P=0.037), and step width (P=0.033) and margin of stability on the paretic side (P=0.006) were observed. No significant effects were observed in the mild ankle impairment group; rather, the coefficient of variation of non-paretic step length increased with the use of orthosis in this group (P=0.043); however, toe clearance increased with the use of ankle-foot orthosis (P=0.041). CONCLUSIONS: Ankle-foot orthoses improved gait stability indices; however, the effect was either not significant or showed possible worsening in the patients with mild ankle impairment, while the effect on toe clearance was significant. These results suggest that the effects of using orthoses in patients with mild impairment should be carefully evaluated. CLINICAL REHABILITATION IMPACT: Understanding the effects of ankle-foot orthoses on the stability of post-stroke gait and their relationship with ankle impairment severity may support clinical decision-making while prescribing orthosis for post-stroke hemiparesis.

Outcomes of Dysphagia Following Stroke: Factors Influencing Oral Intake at 6 Months After Onset.
Sachiyo Hota, Yoko Inamoto, Kazuyo Oguchi, Tomoko Kondo, Eri Otaka, Masahiko Mukaino, Marlis Gonzalez-Fernandez, Eiichi Saitoh
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 30, 9, 105971, 105971, 2021年09月, ［国際誌］
英語, 研究論文（学術雑誌）, PURPOSE: This study aimed to describe recovery of dysphagia after stroke. We determined the proportion of stroke survivors with dysphagia on admission, discharge, and 6 months after stroke. Additionally, the factors affecting oral feeding 6 months after stroke were explored. METHODS: A total of 427 acute stroke patients were recruited prospectively. Presence of dysphagia was evaluated on admission, weekly until recovery was achieved, and at discharge. We compared stroke survivors with dysphagia who had complete recovery, who had dysphagia but achieved oral feeding, and who required tube feeding. Patient-reported eating ability was evaluated at 6 months. Patients who achieved oral feeding by 6 months were compared to those who had persistent tube feeding need. RESULTS: Fifty-five percent of stroke survivors had dysphagia on initial evaluation (3.1 ± 1.4 days after admission) and 37% at discharge (21.1 ± 12.4 days). At 6 months, 5% of patients required tube feeding. Among those who had dysphagia at initial evaluation, 32% had resolution of dysphagia within two weeks, 44% had dysphagia but started oral feeding before discharge, and 23% required alternative means of alimentation (nasogastric tube feeding, percutaneous endoscopic gastrostomy, parental nutrition) throughout hospitalization. At 6 months, 90% of stroke survivors who achieved oral feeding by discharge continued with oral feeding. Patients who achieved oral feeding after discharge had less cognitive impairments on admission and a higher speech therapist intervention rate after discharge. CONCLUSIONS: More than half of stroke survivors had dysphagia but the vast majority were able to return to oral feeding by 6 months. Cognitive function and dysphagia rehabilitation interventions were associated with return to oral feeding after hospital discharge.

外傷性転倒を経験した脳卒中片麻痺患者の重心の動きのばらつきの特徴
土山 和大, 向野 雅彦, 山田 純也, 大高 洋平
日本転倒予防学会誌, 8, 2, 138, 138, 日本転倒予防学会, 2021年09月
日本語

脳卒中片麻痺者の歩行練習における転倒要因の検討
加藤 洋平, 大塚 圭, 松田 文浩, 山田 純也, 谷川 広樹, 土山 和大, 本間 友己, 加藤 正樹, 向野 雅彦, 才藤 栄一, 大高 洋平
日本転倒予防学会誌, 8, 2, 139, 139, 日本転倒予防学会, 2021年09月
日本語

外傷性転倒を経験した脳卒中片麻痺患者の重心の動きのばらつきの特徴
土山 和大, 向野 雅彦, 山田 純也, 大高 洋平
日本転倒予防学会誌, 8, 2, 138, 138, 日本転倒予防学会, 2021年09月
日本語

脳卒中片麻痺者の歩行練習における転倒要因の検討
加藤 洋平, 大塚 圭, 松田 文浩, 山田 純也, 谷川 広樹, 土山 和大, 本間 友己, 加藤 正樹, 向野 雅彦, 才藤 栄一, 大高 洋平
日本転倒予防学会誌, 8, 2, 139, 139, 日本転倒予防学会, 2021年09月
日本語

The effect of ankle-foot orthosis on ankle kinematics in individuals after stroke: A systematic review and meta-analysis.
Yoshitaka Wada, Yohei Otaka, Masahiko Mukaino, Yasushi Tsujimoto, Akihiro Shiroshita, Nobuyuki Kawate, Shunsuke Taito
PM & R : the journal of injury, function, and rehabilitation, 2021年08月09日, ［国際誌］
英語, 研究論文（学術雑誌）, OBJECTIVE: To evaluate whether ankle-foot orthosis (AFO) has a beneficial effect on dorsiflexion angle increase during the swing phase among individuals with stroke and patient-important outcomes in individuals with stroke. LITERATURE SURVEY: Randomized controlled trials (RCTs), randomized crossover trials, and cluster RCTs until May 2020 were researched through CENTRAL, MEDLINE, EMBASE, PEDro, CINAHL, and REHABDATA databases. Studies reporting on AFO use to improve walking, functional mobility, quality of life, and activity limitations and reports of adverse events in individuals with stroke were included. METHODOLOGY: Two independent reviewers extracted the data and assessed the risk of bias. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations approach. SYNTHESIS: Fourteen trials that enrolled 282 individuals with stroke and compared AFO with no AFO were included. Compared with no AFO, AFO could increase the dorsiflexion angle of ankle joints during walking (mean difference [MD, 3.7°]; 95% confidence interval [CI], 2.0-5.3; low certainty of evidence). Furthermore, AFO could improve walking ability (walking speed) (MD, 0.09 [m/s]; 95% CI, 0.06-0.12; low certainty of evidence). No study had reported the effects of AFO on quality of life, adverse events, fall frequency, and activities of daily life. CONCLUSIONS: Our findings suggest that AFO improved ankle kinematics and walking ability in the short term; nonetheless, the evidence was characterized by a low degree of certainty.

Development of a clinical tool for rating the body function categories of the ICF generic-30/rehabilitation set in Japanese rehabilitation practice and examination of its interrater reliability.
Yuki Senju, Masahiko Mukaino, Birgit Prodinger, Melissa Selb, Yuki Okouchi, Kouji Mizutani, Megumi Suzuki, Shin Yamada, Shin-Ichi Izumi, Shigeru Sonoda, Yohei Otaka, Eiichi Saitoh, Gerold Stucki
BMC medical research methodology, 21, 1, 121, 121, 2021年06月14日, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: The International Classification of Functioning, Disability, and Health (ICF) Generic-30 (Rehabilitation) Set is a tool used to assess the functioning of a clinical population in rehabilitation. The ICF Generic-30 consists of nine ICF categories from the component "body functions" and 21 from the component "activities and participation". This study aimed to develop a rating reference guide for the nine body function categories of the ICF Generic-30 Set using a predefined, structured process and to examine the interrater reliability of the ratings using the rating reference guide. METHODS: The development of the first version of the rating reference guide involved the following steps: (1) a trial of rating patients by several raters; (2) cognitive interviews with each rater to analyze the thought process involved in each rating; (3) the drafting of the rating reference guide by a multidisciplinary panel; and (4) a review by ICF specialists to confirm consistency with the ICF. Subsequently, we conducted a first field test to gain insight into the use of the guide in practice. The reference guide was modified based on the raters' feedback in the field test, and an inter-rater reliability test was conducted thereafter. Interrater agreement was evaluated using weighted kappa statistics with linear weights. RESULTS: The first version of the rating reference guide was successfully developed and tested. The weighted kappa coefficient in the field testing ranged from 0.25 to 0.92. The interrater reliability testing of the rating reference guide modified based on the field test results yielded an improved weighted kappa coefficient ranging from 0.53 to 0.78. Relative improvements in the weighted kappa coefficients were observed in seven out of the nine categories. Consequently, seven out of nine categories were found to have a weighted kappa coefficient of 0.61 or higher. CONCLUSIONS: In this study, we developed and modified a rating reference guide for the body function categories of the ICF Generic-30 Set. The interrater reliability test using the final version of the rating reference guide showed moderate to substantial interrater agreement, which encouraged the use of the ICF in rehabilitation practice.

Validation of Data Imputation by Ensemble Averaging to Quantify 24-h Behavior Using Heart Rate of Stroke Rehabilitation Inpatients
Takayuki Ogasawara, Masahiko Mukaino, Yohei Otaka, Hirotaka Matsuura, Yasushi Aoshima, Takuya Suzuki, Hiroyoshi Togo, Hiroshi Nakashima, Masumi Yamaguchi, Shingo Tsukada, Eiichi Saitoh
Journal of Medical and Biological Engineering, 41, 3, 322, 330, Springer Science and Business Media LLC, 2021年06月
研究論文（学術雑誌）

脳卒中後の回復期リハビリテーションにおける活動量の改善 hitoeシステムを用いた検討　　　　　　　　　　　　　　　
水野 江美, 向野 雅彦, 小笠原 隆行, 鈴木 卓弥, 古澤 章太郎, 山田 ゆりえ, 松田 文浩, 松浦 広昴, 才藤 栄一, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 58, 特別号, 1, 6, (公社)日本リハビリテーション医学会, 2021年05月
日本語

脳卒中患者に対する短下肢装具の足関節背屈の効果 システマティックレビュー・メタアナリシス　　　　　　　　　　　　　　　
和田 義敬, 大高 洋平, 向野 雅彦, 川手 信行
The Japanese Journal of Rehabilitation Medicine, 58, 特別号, 1, 1, (公社)日本リハビリテーション医学会, 2021年05月
日本語

回復期リハビリテーション病棟入院中の状態悪化により死亡に至った症例の検討　　　　　　　　　　　　　　　
前田 寛文, 柴田 斉子, 向野 雅彦, 平野 哲, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 58, 特別号, 1, 1, (公社)日本リハビリテーション医学会, 2021年05月
日本語

COVID-19肺炎後肺線維症患者に対するリハビリテーション治療に難渋した一例　　　　　　　　　　　　　　　
千手 佑樹, 向野 雅彦, 細川 浩, 木曽 昭史, 前田 寛文, 柴田 斉子, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 58, 特別号, 2, 6, (公社)日本リハビリテーション医学会, 2021年05月
日本語

回復期脳卒中片麻痺患者における定量的評価機器を用いた痙縮の経時変化 症例報告　　　　　　　　　　　　　　　
近藤 輝, 谷川 広樹, 向野 雅彦, 伊藤 翔太, 加藤 正樹, 寺西 利生, 才藤 栄一, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 58, 特別号, 1, 6, (公社)日本リハビリテーション医学会, 2021年05月
日本語

hitoe?システムを利用した回復期病棟入院患者の夜間安静時心拍数と1回拍出量の関係　　　　　　　　　　　　　　　
鈴木 卓弥, 向野 雅彦, 山田 ゆりえ, 古澤 章太郎, 犬飼 絢香, 松田 文浩, 松浦 広昂, 小笠原 隆行, 才藤 栄一, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 58, 特別号, 1, 9, (公社)日本リハビリテーション医学会, 2021年05月
日本語

短下肢装具が片麻痺者の歩行に及ぼす影響 足関節運動機能障害の重症度による違い　　　　　　　　　　　　　　　
土山 和大, 向野 雅彦, 大塚 圭, 松田 文浩, 谷川 広樹, 山田 純也, Kannit Pongpipatpaiboon, 金田 嘉清, 才藤 栄一, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 58, 特別号, 1, 7, (公社)日本リハビリテーション医学会, 2021年05月
日本語

立位課題による脳卒中片麻痺者の麻痺側下肢機能の定量的評価　　　　　　　　　　　　　　　
松田 文浩, 向野 雅彦, 加藤 洋平, 山田 純也, 大塚 圭, 才藤 栄一, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 58, 特別号, 1, 4, (公社)日本リハビリテーション医学会, 2021年05月
日本語

hitoeシステムを利用した入院患者の活動量と自立度の関係性　　　　　　　　　　　　　　　
古澤 章太郎, 向野 雅彦, 小笠原 隆行, 鈴木 卓弥, 犬飼 絢香, 山田 ゆりえ, 松田 文浩, 加藤 正樹, 松浦 広昴, 才藤 栄一, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 58, 特別号, 1, 10, (公社)日本リハビリテーション医学会, 2021年05月
日本語

Evaluating quiet standing posture of post-stroke patients by classifying cerebral infarction and cerebral hemorrhage patients
Dongdong Li, Kohei Kaminishi, Ryosuke Chiba, Kaoru Takakusaki, Masahiko Mukaino, Jun Ota
Advanced Robotics, 35, 13-14, 1, 11, Informa UK Limited, 2021年03月02日, ［査読有り］
研究論文（学術雑誌）, Strokes are the third leading cause of disability worldwide. Currently, several types of performance assessment, such as the Fugl–Meyer index, are used to explore the overall difference between cerebral infarction (CI) and cerebral hemorrhage (CH) post-stroke patients. However, these performance assessments ignore subtle differences in the limbs of patients, which could be helpful for rehabilitation training. This study was designed to determine and evaluate the differences between the limbs of CI and CH patients. First, we collected the kinematic data of patients and extracted the spatio-temporal features. Then, we developed four different models to classify the CI and CH patients, in which a linear support vector machine (LSVM) classifier method achieved an 80.1% classification accuracy. Finally, we calculated the decision boundary of the shoulder and ankle marker position features separately based on the LSVM model. From the decision boundary, we determined that the CI patients' shoulder position appeared to be anterior to that of the CH patients, and the CH patients had a wider stance width compared to the CI patients. Such findings can serve as guidance for doctors and help provide professional rehabilitation courses for post-stroke patients.

Effect of ankle joint fixation on tibialis anterior muscle activity during split-belt treadmill walking in healthy subjects: A pilot study.
Etsuko Mori, Shigeo Tanabe, Yoichiro Aoyagi, Natsuki Yamakami, Masahiko Mukaino, Wataru Kikuchi, Tomoya Kato, Soichiro Koyama, Tomoko Kayukawa
Turkish journal of physical medicine and rehabilitation, 67, 1, 11, 16, 2021年03月, ［国際誌］
英語, 研究論文（学術雑誌）, OBJECTIVES: This study aims to examine the characteristics of muscle activity change of the tibialis anterior (TA) muscle in healthy adults while they walked on a split-belt treadmill with one fixed ankle. PATIENTS AND METHODS: This randomized controlled trial was conducted between November 2017 and July 2018. Fourteen healthy male individuals (mean age 31.4 years; range, 23 to 50 years) were divided into two groups: right ankle joint fixed by ankle-foot orthosis (fixation group) and no orthosis (control group). Both groups were asked to walk on a treadmill with the same belt speed. After familiarizing with walking on both belts at 5.0 km/h, they walked for 6 min with the right belt slower (2.5 km/h) and the left faster (5.0 km/h). For analysis, the 6 min were divided equally among three time periods. The TA muscle activity was calculated at first and last time periods. We compared muscle activities in time periods (early and late phase) and in groups (fixation and control) using two-way mixed analysis of variance. RESULTS: The TA muscle activity decreased in the late phase regardless of ankle joint fixation, and also decreased in the fixation group regardless of the time periods. There was an interaction between these factors. CONCLUSION: These data show that changes in the TA muscle activity were smaller in the fixation group, suggesting that the ankle joint fixation reduces the adaptation.

人工股関節全置換術後の早期歩行改善に関与する因子の検討
立之 芳裕, 小桑 隆, 山田 純也, 木村 稚佳子, 道川 武紘, 向野 雅彦, 大高 洋平, 藤田 順之, 森田 充浩
日本整形外科学会雑誌, 95, 3, S627, S627, (公社)日本整形外科学会, 2021年03月
日本語

Validity of quantitative assessment of posterior pelvic tilt and contralateral vaulting in hemiplegia using 3D treadmill gait analysis.
Hiroki Tanikawa, Keisuke Inagaki, Kei Ohtsuka, Fumihiro Matsuda, Masahiko Mukaino, Junya Yamada, Yoshikiyo Kanada, Hitoshi Kagaya, Eiichi Saitoh
Topics in stroke rehabilitation, 28, 2, 96, 103, 2021年03月, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Assessing abnormal gait patterns could indicate compensatory movements, which could be an index for recovery and a process of motor learning. To quantify the degree of posterior pelvic tilt, contralateral vaulting is necessary. OBJECTIVES: This study aimed to develop and evaluate the validity of quantitative indices for posterior pelvic tilt and contralateral vaulting in hemiplegic patients. METHODS: Forty-six healthy control subjects and 112 hemiplegic patients participated in this study. Of the 112 patients, 50 were selected into each abnormal gait pattern group, with some overlap. Three experienced physical therapists observed their walking and graded the severity of the two abnormalities in five levels. An index to quantify each of the two abnormal gait patterns was calculated from the three-dimensional treadmill gait analysis. The index values of patients were compared with those of healthy subjects and with the results of observational gait assessment done by three physical therapists with expertise in gait analysis. RESULTS: The index values were significantly higher in hemiplegic patients than in healthy subjects (28.0% and 44.7% for the posterior pelvic tilt in healthy subjects and patients, respectively and 0.9 and 4.7 for the contralateral vaulting, respectively). A strong correlation was observed between the index value and the median observational rating for two abnormal gait patterns (r = -0.68 and -0.72). CONCLUSIONS: The proposed indices for posterior pelvic tilt and contralateral vaulting are useful for clinical gait analysis, and thus encouraging a more detailed analysis of hemiplegic gait using a motion analysis system.

人工股関節全置換術後の早期歩行改善に関与する因子の検討
立之 芳裕, 小桑 隆, 山田 純也, 木村 稚佳子, 道川 武紘, 向野 雅彦, 大高 洋平, 藤田 順之, 森田 充浩
日本整形外科学会雑誌, 95, 3, S627, S627, (公社)日本整形外科学会, 2021年03月
日本語

臨床歩行分析の可能性　　　　　　　　　　　　　　　
大塚 圭, 向野 雅彦, 松田 文浩, 山田 純也, 谷川 広樹, 土山 和大, 大高 洋平, 才藤 栄一
臨床歩行分析研究会誌, 8, 2, 1, 6, 臨床歩行分析研究会, 2021年
日本語

Evaluation of Postural Sway in Post-stroke Patients by Dynamic Time Warping Clustering.
Dongdong Li, Kohei Kaminishi, Ryosuke Chiba, Kaoru Takakusaki, Masahiko Mukaino, Jun Ota
Frontiers in human neuroscience, 15, 731677, 731677, 2021年, ［国際誌］
英語, 研究論文（学術雑誌）, Post-stroke complications are the second most frequent cause of death and the third leading cause of disability worldwide. The motor function of post-stroke patients is often assessed by measuring the postural sway in the patients during quiet standing, based on sway measures, such as sway area and velocity, which are obtained from temporal variations of the center of pressure. However, such approaches to establish a relationship between the sway measures and patients' demographic factors have hardly been successful (e.g., days after onset). This study instead evaluates the postural sway features of post-stroke patients using the clustering method of machine learning. First, we collected the stroke patients' multi-variable motion-capture standing-posture data and processed them into t s long data slots. Then, we clustered the t-s data slots into K cluster groups using the dynamic-time-warping partition-around-medoid (DTW-PAM) method. The DTW measures the similarity between two temporal sequences that may vary in speed, whereas PAM identifies the centroids for the DTW clustering method. Finally, we used a post-hoc test and found that the sway amplitudes of markers in the shoulder, hip, knee, and center-of-mass are more important than their sway frequencies. We separately plotted the marker amplitudes and frequencies in the medial-lateral direction during a 5-s data slot and found that the post-stroke patients' postural sway frequency lay within the bandwidth of 0.5-1.5 Hz. Additionally, with an increase in the onset days, the cluster index of cerebral hemorrhage patients gradually transits in a four-cluster solution. However, the cerebral infarction patients did not exhibit such pronounced transitions over time. Moreover, we found that the postural-sway amplitude increased in clusters 1, 3, and 4. However, the amplitude of cluster 2 did not follow this pattern, owing to age effects related to the postural sway changes with age. A rehabilitation doctor can utilize these findings as guidelines to direct the post-stroke patient training.

An Affordable, User-friendly Telerehabilitation System Assembled Using Existing Technologies for Individuals Isolated With COVID-19: Development and Feasibility Study.
Masahiko Mukaino, Tsuyoshi Tatemoto, Nobuhiro Kumazawa, Shigeo Tanabe, Masaki Katoh, Eiichi Saitoh, Yohei Otaka
JMIR rehabilitation and assistive technologies, 7, 2, e24960, 2020年12月10日, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Isolation due to a COVID-19 infection can limit activities and cause physical and mental decline, especially in older adults and people with disabilities. However, due to limited contact, adequate rehabilitation is difficult to provide for quarantined patients. Telerehabilitation technology could be a solution; however, issues specific to COVID-19 should be taken into consideration, such as strict quarantine and respiratory symptoms, as well as accessibility to deal with rapid increases in need due to the pandemic. OBJECTIVE: This study aims to develop and to investigate the feasibility of a telerehabilitation system for patients who are quarantined due to COVID-19 by combining existing commercial devices and computer applications. METHODS: A multidisciplinary team has identified the requirements for a telerehabilitation system for COVID-19 and developed the system to satisfy those requirements. In the subsequent feasibility study, patients diagnosed with COVID-19 (N=10; mean age 60 years, SD 18 years) were included. A single session of telerehabilitation consisted of stretching exercises, a 15-minute exercise program, and a video exercise program conducted under real-time guidance by a physical therapist through a video call. The system included a tablet computer, a pulse oximeter, videoconferencing software, and remote control software. The feasibility of the system was evaluated using the Telemedicine Satisfaction Questionnaire (TSQ; 14 items) and an additional questionnaire on the telerehabilitation system (5 items). Each item was rated from "1 = strongly disagree" to "5 = strongly agree." RESULTS: The telerehabilitation system was developed by combining existing devices and applications, including a pulse oximeter and remote control mechanism, to achieve user-friendliness, affordability, and safety, which were determined as the system requirements. In the feasibility study, 9 out of 10 patients were able to use the telerehabilitation system without any on-site help. On the TSQ, the mean score for each item was 4.7 (SD 0.7), and in the additional items regarding telerehabilitation, the mean score for each item was 4.3 (SD 1.0). CONCLUSIONS: These findings support the feasibility of this simple telerehabilitation system in quarantined patients with COVID-19, encouraging further investigation on the merit of the system's use in clinical practice.

Robot-assisted Gait Training Using Welwalk in Hemiparetic Stroke Patients: An Effectiveness Study with Matched Control.
Takuma Ii, Satoshi Hirano, Shigeo Tanabe, Eiichi Saitoh, Junya Yamada, Masahiko Mukaino, Makoto Watanabe, Shigeru Sonoda, Yohei Otaka
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 29, 12, 105377, 105377, 2020年12月, ［国際誌］
英語, 研究論文（学術雑誌）, OBJECTIVE: Although studies on the efficacy of the rehabilitation robot are increasing, there are few reports using the robot for gait training in the actual clinical setting. This study aimed to investigate the effectiveness of gait training using Welwalk in hemiparetic stroke patients in a real clinical setting. MATERIALS AND METHODS: This prospective study included 36 hemiparetic stroke patients who underwent gait training using Welwalk. We examined the walking ability improvement efficiency using Functional Independence Measure (FIM)-walk as the primary outcome, which was compared with that of 36 patients (matched control group) who underwent conventional rehabilitation. Other outcomes were the actual gait training period using Welwalk, raw FIM-walk score, lower extremity motor functions score in Stroke Impairment Assessment Set at discharge, and duration from stroke onset until discharge. RESULTS: The improvement efficiency of the FIM-walk was significantly higher in the Welwalk group than in the matched control group (control 0.48 ± 0.31, Welwalk 0.80 ± 0.38, p-value < 0.001). The mean gait training period using Welwalk was 5 weeks. No significant differences were found in other outcomes between the Welwalk group and the matched control group. CONCLUSION: This study demonstrated the effectiveness of gait training using Welwalk on the improvement efficiency of the FIM-walk in hemiparetic stroke patients in an actual clinical setting.

振動刺激の介入肢位の違いが下腿三頭筋の痙縮に及ぼす影響 立位と長座位の比較検討　　　　　　　　　　　　　　　
近藤 輝, 谷川 広樹, 向野 雅彦, 桂林 佑太, 伊藤 翔太, 加藤 正樹, 寺西 利生, 大高 洋平, 才藤 栄一
The Japanese Journal of Rehabilitation Medicine, 57, 秋季特別号, S458, S458, (公社)日本リハビリテーション医学会, 2020年11月
日本語

ボツリヌス療法により歩容の改善を得た慢性期脳卒中患者の1例　　　　　　　　　　　　　　　
小関 秀宙, 谷川 広樹, 加賀谷 斉, 近藤 輝, 伊藤 翔太, 寺西 利生, 向野 雅彦, 大高 洋平, 才藤 栄一
The Japanese Journal of Rehabilitation Medicine, 57, 秋季特別号, S460, S460, (公社)日本リハビリテーション医学会, 2020年11月
日本語

振動刺激の介入肢位の違いが下腿三頭筋の痙縮に及ぼす影響 立位と長座位の比較検討　　　　　　　　　　　　　　　
近藤 輝, 谷川 広樹, 向野 雅彦, 桂林 佑太, 伊藤 翔太, 加藤 正樹, 寺西 利生, 大高 洋平, 才藤 栄一
The Japanese Journal of Rehabilitation Medicine, 57, 秋季特別号, S458, S458, (公社)日本リハビリテーション医学会, 2020年11月
日本語

ボツリヌス療法により歩容の改善を得た慢性期脳卒中患者の1例　　　　　　　　　　　　　　　
小関 秀宙, 谷川 広樹, 加賀谷 斉, 近藤 輝, 伊藤 翔太, 寺西 利生, 向野 雅彦, 大高 洋平, 才藤 栄一
The Japanese Journal of Rehabilitation Medicine, 57, 秋季特別号, S460, S460, (公社)日本リハビリテーション医学会, 2020年11月
日本語

Development of an abnormal gait analysis system in gait exercise assist robot 'Welwalk' for hemiplegic stroke patients
Issei Nakashima, Daisuke Imoto, Satoshi Hirano, Masahiko Mukaino, Masayuki Imaida, Eiichi Saitoh, Yohei Otaka
Proceedings of the IEEE RAS and EMBS International Conference on Biomedical Robotics and Biomechatronics, 2020-November, 1030, 1035, 2020年11月
研究論文（国際会議プロシーディングス）, © 2020 IEEE. Welwalk WW-1000 is a gait exercise robotic assist system that allows subjects to walk on treadmill by attaching a knee-ankle-foot robot to a paralyzed limb. Abnormal gait patterns during exercise using Welwalk WW-1000 are evaluated by gait observation or marker-based motion analysis systems. However, gait observation is a subjective and ordinal measure, and marker-based motion analysis systems are challenging to implement due to the complexity of preparing equipment and attaching markers to subjects. In this study, we propose the Welwalk WW-2000 system, which incorporated a marker-less motion analysis system that detects abnormal gait patterns during exercise using the robotic system. Using this system, it is expected that a gait exercise program can be planned from easily obtainable, objective information. This system detects the features of abnormal gait patterns using the body position coordinates of the subject obtained from three-dimensional, inertial, knee angle, and load sensors. The purpose of this study was to validate the marker-less motion analysis system against marker-based motion analysis systems. One healthy male simulated the seven abnormal gait patterns which occur frequently in stroke patients, with four grades of severity. Spearman's rank correlation coefficients were calculated for the relationship between the abnormal gait pattern parameters calculated by each motion analysis system. The correlations between the two systems ranged from 0.81 to 0.95. Therefore, it was confirmed that the marker-less motion analysis system of the Welwalk WW-2000 was valid.

三次元トレッドミル歩行分析装置を用いた人工股関節置換術患者の歩行解析
立之 芳裕, 武田 太樹, 小桑 隆, 山田 純也, 木村 稚佳子, 道川 武紘, 向野 雅彦, 大高 洋平, 藤田 順之, 森田 充浩
日本整形外科学会雑誌, 94, 8, S1912, S1912, (公社)日本整形外科学会, 2020年09月
日本語

COVID-19(第2回) COVID-19現場リポート 藤田医科大学病院の経験と今後の対応
向野 雅彦, 柴田 斉子, 加藤 正樹, 加賀谷 斉, 大高 洋平
Journal of Clinical Rehabilitation, 29, 9, 856, 862, 医歯薬出版(株), 2020年08月
日本語

【リハビリテーションにおけるロボット技術の最近の進歩】片麻痺患者の歩行練習支援ロボット「ウェルウォーク」の現在と未来
平野 哲, 大高 洋平, 向野 雅彦, 才藤 栄一
脊椎脊髄ジャーナル, 33, 8, 793, 798, (株)三輪書店, 2020年08月
日本語, ＜文献概要＞はじめに 脳卒中は要介護の主要な原因であり,要介護者全体では認知症に次ぐ第2位(18.4%)を占める.要介護度が重いほど脳卒中の割合は増え,要介護5では第1位(30.8%)である.少子高齢化により介護人材が不足する社会においては,患者の日常生活活動を向上させ,自立度を高める必要があり,リハビリテーション(以下,リハビリ)が果たすべき役割は大きい.脳卒中患者のリハビリにおいて,歩行再獲得は重要な目標の1つである.脳卒中発症後の歩行能力が,その後の患者の人生に大きな影響を与えるからである.回復期リハビリ病棟退院時の移動能力が歩行自立の患者は約7割が在宅復帰するのに対し,車いす自立・車いす監視・全介助の患者の在宅復帰率は約3割であったとする報告がある.また,歩行を獲得して退院することで,活動量が維持され,廃用予防につながることも考えられる.高齢者医療費が保険財政を圧迫する状況においては,リハビリの高効率化も求められている.平成30年度診療報酬改定では,回復期リハビリ病棟入院料の評価体系に実績指数が組み込まれ,短期間に日常生活活動を大きく改善させることが診療報酬において評価されることとなった.歩行リハビリにおいても,より短期間で,より高い歩行自立度を獲得する工夫が必要であり,歩行練習支援ロボットの貢献が期待されている.

Persistent Effect of Gait Exercise Assist Robot Training on Gait Ability and Lower Limb Function of Patients With Subacute Stroke: A Matched Case–Control Study With Three-Dimensional Gait Analysis
Yiji Wang, Masahiko Mukaino, Satoshi Hirano, Hiroki Tanikawa, Junya Yamada, Kei Ohtsuka, Takuma Ii, Eiichi Saitoh, Yohei Otaka
Frontiers in Neurorobotics, 14, Frontiers Media SA, 2020年07月24日, ［査読有り］
研究論文（学術雑誌）

Development and assessment of a home environment checklist to evaluate mismatch between patients' ability and home environment.
Masahiko Mukaino, Birgit Prodinger, Yuki Okouchi, Kouji Mizutani, Yuki Senju, Megumi Suzuki, Eiichi Saitoh
Annals of physical and rehabilitation medicine, 63, 4, 288, 295, 2020年07月, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Modification of the home environment, together with rehabilitative interventions, is important for maximizing the level of functioning after an individual with disability undergoes rehabilitation in the hospital. OBJECTIVES: We developed a simple screening scale - the home environment checklist (HEC) - to identify any mismatch between an individual's abilities and their home environment to help clinicians monitor the appropriateness of the home environment to which individuals with disability will be discharged. We also examined the psychometric properties of the HEC. METHODS: The HEC was developed by a multidisciplinary panel of rehabilitation experts using information routinely collected in rehabilitation clinics before discharge. The reliability of the checklist was assessed in 60 individuals undergoing rehabilitation. The inter-rater agreement and internal consistency of the scale were assessed by weighted kappa statistics and Cronbach's alpha, respectively. Rasch analysis was performed with 244 rehabilitation individuals to evaluate the internal construct validity, and the known-groups validity was confirmed by a comparison of the daily activity levels of 30 individuals with disabilities under rehabilitation to the HEC score. RESULTS: The HEC was developed as a simple, 10-item checklist. The weighted kappa statistics ranged from 0.73 to 0.93, indicating excellent inter-rater reliability. Cronbach's alpha was 0.92, indicating high internal consistency. Rasch analysis with a testlet approach on 3 subscales demonstrated a good fit with the Rasch model (χ2=13.2, P=0.153), and the demonstrated unidimensionality and absence of differential item functioning supported the internal construct validity of the HEC. HEC scores were significantly different (P<.01) among individuals with disability and 3 levels of restrictions in their activities (no limitation, home-bound, and bed-bound), which demonstrates the known-groups validity of the HEC. CONCLUSIONS: The HEC has good reliability and validity, which supports its utility in rehabilitation clinics.

回復期リハビリテーション病棟におけるリハビリテーション科医師の役割 大学病院における先進リハビリテーション病棟　　　　　　　　　　　　　　　
大高 洋平, 向野 雅彦
The Japanese Journal of Rehabilitation Medicine, 57, 特別号, S340, S340, (公社)日本リハビリテーション医学会, 2020年07月
日本語

低侵襲人工股関節全置換術(MIS-THA)術後の長期的な回復過程の検討　　　　　　　　　　　　　　　
小桑 隆, 向野 雅彦, 大塚 圭, 山田 純也, 近藤 環, 加賀谷 斉, 才藤 栄一, 森田 充浩, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 57, 特別号, 2, 3, (公社)日本リハビリテーション医学会, 2020年07月
日本語

片麻痺患者の回復期リハビリテーションにおける歩行機能の変化 三次元歩行分析を用いた予備的検討　　　　　　　　　　　　　　　
牧野 稜, 向野 雅彦, 大塚 圭, 前田 寛文, 谷川 広樹, 松田 文浩, 山田 純也, 柴田 斉子, 才藤 栄一, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 57, 特別号, 2, 3, (公社)日本リハビリテーション医学会, 2020年07月
日本語

状態悪化により回復期リハビリテーション病棟から退棟した患者の転帰　　　　　　　　　　　　　　　
前田 寛文, 向野 雅彦, 柴田 斉子, 角田 哲也, 八木橋 恵, 名倉 高広, 牧野 稜, 才藤 栄一, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 57, 特別号, 2, 5, (公社)日本リハビリテーション医学会, 2020年07月
日本語

装具が片麻痺患者の歩行安定性に及ぼす効果　　　　　　　　　　　　　　　
土山 和大, 向野 雅彦, 大塚 圭, 谷川 広樹, 松田 文浩, 山田 純也, 大高 洋平, 才藤 栄一
The Japanese Journal of Rehabilitation Medicine, 57, 特別号, 2, 4, (公社)日本リハビリテーション医学会, 2020年07月
日本語

脳卒中後の回復期リハビリテーションにおける活動量の変化　　　　　　　　　　　　　　　
向野 雅彦, 青嶋 保志, 小笠原 隆行, 鈴木 卓弥, 松田 文浩, 松浦 広昂, 大高 洋平, 才藤 栄一
The Japanese Journal of Rehabilitation Medicine, 57, 特別号, 3, 3, (公社)日本リハビリテーション医学会, 2020年07月
日本語

ICFリハビリテーションセットを用いた生活機能評価 Rasch分析を用いた標準化指標作成の取り組み　　　　　　　　　　　　　　　
舟橋 怜佑, 向野 雅彦, 大高 洋平, 千手 佑樹, 才藤 栄一
The Japanese Journal of Rehabilitation Medicine, 57, 特別号, 3, 4, (公社)日本リハビリテーション医学会, 2020年07月
日本語

ICFリハビリテーションセットの臨床使用における評点の検者間信頼性に関わる検討　　　　　　　　　　　　　　　
千手 佑樹, 向野 雅彦, 才藤 栄一, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 57, 特別号, 3, 6, (公社)日本リハビリテーション医学会, 2020年07月
日本語

活動量計測システムを利用し算出した活動コスト指数とADLの関係性の検討　　　　　　　　　　　　　　　
水野 江美, 角田 哲也, 平野 哲, 向野 雅彦, 大高 洋平, 青嶋 保志, 鈴木 卓弥, 小笠原 隆行
The Japanese Journal of Rehabilitation Medicine, 57, 特別号, 3, 3, (公社)日本リハビリテーション医学会, 2020年07月
日本語

食事動作において頻用される上肢関節運動の組み合わせと運動範囲の検討　　　　　　　　　　　　　　　
太田 皓文, 向野 雅彦, 大河内 由紀, 佐々 裕果, 井上 由加里, 芝草 愛, 松浦 翔, 大高 洋平, 才藤 栄一
The Japanese Journal of Rehabilitation Medicine, 57, 特別号, 3, 4, (公社)日本リハビリテーション医学会, 2020年07月
日本語

脳卒中後の回復期リハビリテーションにおける歩行機能の変化 一症例における検討　　　　　　　　　　　　　　　
名倉 宏高, 向野 雅彦, 大塚 圭, 前田 寛文, 谷川 広樹, 松田 文浩, 山田 純也, 柴田 斉子, 才藤 栄一, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 57, 特別号, 4, 4, (公社)日本リハビリテーション医学会, 2020年07月
日本語

Staying Active in Isolation: Telerehabilitation for Individuals With the Severe Acute Respiratory Syndrome Coronavirus 2 Infection.
Masahiko Mukaino, Tsuyoshi Tatemoto, Nobuhiro Kumazawa, Shigeo Tanabe, Masaki Katoh, Eiichi Saitoh, Yohei Otaka
American journal of physical medicine & rehabilitation, 99, 6, 478, 479, 2020年06月, ［査読有り］, ［国際誌］
英語

リハの現場で役立つ!目で見る動作・歩行分析 脳卒中 三次元トレッドミル歩行分析と臨床指向的分析
大塚 圭, 向野 雅彦, 松田 文浩, 山田 純也, 谷川 広樹, 大高 洋平, 才藤 栄一
Journal of Clinical Rehabilitation, 29, 3, 213, 221, 医歯薬出版(株), 2020年03月
日本語

The effect of using Gait Exercise Assist Robot (GEAR) on gait pattern in stroke patients: a cross-sectional pilot study.
Katoh D, Tanikawa H, Hirano S, Mukaino M, Yamada J, Sasaki S, Ohtsuka K, Katoh M, Saitoh E
Topics in stroke rehabilitation, 27, 2, 103, 109, 2020年03月, ［査読有り］, ［国際誌］
英語, Background: The Gait Exercise Assist Robot (GEAR) has been developed to support gait training for stroke patients. The GEAR can assist paretic lower limb swing and stance stability, which make it possible to practice walking without excessive compensation movements. However, there are no studies to-date that investigate the effect of the GEAR on gait pattern.Objectives: The purpose of this study was to clarify the effect of gait training on gait pattern using the GEAR for rehabilitation in stroke patients.Methods: Fifteen hemiplegic patients who received gait training using the GEAR were recruited (GEAR group). As a control group, hemiplegic patients who did not receive gait training using the GEAR were selected for each patient in the GEAR group from 114 cases in our hospital database. Primary outcomes were index values indicating the degree of 10 abnormal gait patterns. Secondary outcomes were spatiotemporal factors and comfortable overground gait velocity.Results: Index values for abnormal gait patterns were significantly lower in the GEAR group compared to the control group for insufficient knee flexion during the swing phase, hip hiking, and excessive lateral shift of the trunk over the unaffected-side (p < .05). The comfortable overground gait velocity, stride length, and unaffected-step length in the GEAR group were significantly better than in the control group (p < .05).Conclusions: Gait training using the GEAR had effects on reducing abnormal gait patterns and improving gait velocity, stride, and unaffected-side step length compared to conventional gait training alone in individuals recovering from stroke-induced hemiplegia.

ICFリハビリテーションセットの心身機能項目における患者-医療者間の評価の一致性(Interrater agreement between clinician ratings and patient self-assessments for body function categories of ICF Rehabilitation Set)
千手 佑樹, 向野 雅彦, 尾関 恩, 渡邉 誠, 大河内 由紀, 水谷 公司, 才藤 栄一, 園田 茂
Japanese Journal of Comprehensive Rehabilitation Science, 11(2020), 9, 16, (一社)回復期リハビリテーション病棟協会, 2020年02月
英語, 【目的】ICFリハビリテーションセットの心身機能項目について,患者自身による評価と採点用リファレンスガイドを用いた医療者による評価とを実施し,患者-医療者間の評価の一致について検討する.【方法】入院もしくは外来リハビリテーション施行中の88名を対象とした.9つの心身機能項目について対象患者が自己評価,医療者が採点用リファレンスガイドを用いた評価をそれぞれ行った.各項目についての患者-医療者間の評価の一致を重み付けκ係数,合計点の一致を,級内相関係数を用いて検討した.【結果】重み付きκ係数は,0.58-0.87の範囲に分布し,9項目中8項目で0.61以上の値をとった.全項目の合計値は患者医療者間に有意な差を認めず,合計値の級内相関係数は0.85であった.【結論】採点用リファレンスガイドを用いた医療者による心身機能の評価は患者の主観評価との間に大きな乖離はなく,生活機能を記述する手段として有用であると考えられた.(著者抄録)

ICFリハビリテーションセットの入院リハビリテーションにおける適用可能性:回復期リハビリテーション病棟入院患者に適用可能な項目セットの作成とその妥当性の検討(Feasibility of the International Classification of Functioning, Disability and Health Rehabilitation Set for inpatient rehabilitation: Selection and validity of a set of categories for inpatients in a convalescent rehabilitation ward)
舟橋 怜佑, 向野 雅彦, 大高 洋平, 千手 祐樹, 米田 千賀子, 尾関 保則, 清水 康裕, 小池 知治, 才藤 栄一
Japanese Journal of Comprehensive Rehabilitation Science, 11(2020), 1, 8, (一社)回復期リハビリテーション病棟協会, 2020年02月
英語, 【目的】回復期リハビリテーション病棟入院中の患者に対するICFリハビリテーションセットの適用可能性について評価を実施する.【方法】回復期リハビリテーション病棟入院患者295例を対象に,ICFリハビリテーションセットを用いた採点を行い,欠測値の割合を調査した.さらに欠測値が10%未満の項目を選択し,Rasch分析を用いて内的構成概念妥当性を検討した.【結果】欠測値は25の項目で検出され,そのうち7つの項目で欠測値が10%以上であった.天井効果および床効果は観察されなかった.欠測値が10%未満であった23項目の評価点を用いて行ったRasch分析ではモデルへの良好な適合が得られ,ICFリハビリテーションセットの内的構成概念妥当性を支持する結果となった.【結論】本研究の結果により,ICFリハビリテーションセットのうち入院リハビリテーション患者において適用可能な項目とその評価としての妥当性が示された.(著者抄録)

Supporting the clinical use of the ICF in Japan - development of the Japanese version of the simple, intuitive descriptions for the ICF Generic-30 set, its operationalization through a rating reference guide, and interrater reliability study.
Masahiko Mukaino, Birgit Prodinger, Shin Yamada, Yuki Senju, Shin-Ichi Izumi, Shigeru Sonoda, Melissa Selb, Eiichi Saitoh, Gerold Stucki
BMC health services research, 20, 1, 66, 66, 2020年01月30日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: The World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) in 2001 and has been in the process of implementing it in clinics since then. Current international efforts to implement ICF in rehabilitation clinics include the implementation of ICF Core Sets and the development of simple, intuitive descriptions for the ICF Generic-30 Set (also called Rehabilitation Set). The present study was designed to operationalize these ICF tools for clinical practice in Japan. This work included 1) the development of the Japanese version of the simple, intuitive descriptions for the ICF Generic-30 Set, 2) the development of a rating reference guide for Activity and Participation categories, and 3) the examination of the interrater reliability of rating Activity and Participation categories. METHODS: The Japanese version of the simple, intuitive descriptions for the ICF Generic-30 Set was developed following the process employed to develop the Chinese and Italian versions. For further operationalization of this ICF Set in practice, a rating reference guide was developed. The development of the rating reference guide involved the following steps: 1) a trial of rating patients by several raters, 2) cognitive interviewing of the raters to analyse the thinking process involved in rating, 3) drafting of the rating reference guide, and 4) review by ICF specialists to confirm consistency with the original ICF concepts. After the rating reference guide was developed, interrater reliability of the rating with the reference guide was determined. Interrater reliability was examined using weighted kappa statistics with linear weight. RESULTS: Through the pre-defined process, the Japanese version of the simple, intuitive descriptions for 30 categories of the ICF Generic-30 Set and the rating reference guides for 21 Activity and Participation categories were successfully developed. The weighted kappa statistics ranged from 0.61 to 0.85, showing substantial to excellent agreement of the ratings between raters. CONCLUSIONS: The present study demonstrates that ICF categories can be translated into clinical practice. Collaboration between clinicians and researchers would further enhance the implementation of the ICF in Japan.

Gait characteristics of post-stroke hemiparetic patients with different walking speeds
Wang, Y., Mukaino, M., Ohtsuka, K., Otaka, Y., Tanikawa, H., Matsuda, F., Tsuchiyama, K., Yamada, J., Saitoh, E.
International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation, 43, 1, 69, 75, 2020年, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, Hemiparesis resulting from stroke presents characteristic spatiotemporal gait patterns. This study aimed to clarify the spatiotemporal gait characteristics of hemiparetic patients by comparing them with height-, speed-, and age-matched controls while walking at various speeds. The data on spatiotemporal gait parameters of stroke patients and that of matched controls were extracted from a hospital gait analysis database. In total, 130 pairs of data were selected for analysis. Patients and controls were compared for spatiotemporal gait parameters and the raw value (RSI) and absolute value (ASI) of symmetry index and coefficient of variation (CV) of these parameters. Stroke patients presented with prolonged nonparetic stance (patients vs. controls: 1.01 ± 0.41 vs. 0.83 ± 0.25) and paretic swing time (0.45 ± 0.12 vs. 0.39 ± 0.07), shortened nonparetic swing phase (0.35 ± 0.07 vs. 0.39 ± 0.07), and prolonged paretic and nonparetic double stance phases [0.27 ± 0.13 (paretic)/0.27 ± 0.17 (nonparetic) vs. 0.22 ± 0.10]. These changes are especially seen in low-gait speed groups (<3.4 km/h). High RSIs of stance and swing times were also observed (-9.62 ± 10.32 vs. -0.79 ± 2.93, 24.24 ± 25.75 vs. 1.76 ± 6.43, respectively). High ASIs and CVs were more generally observed, including the groups with gait speed of ≥3.5 km/h. ASI increase of the swing phase (25.79 ± 22.69 vs. 4.83 ± 4.88) and CV of the step length [7.7 ± 4.9 (paretic)/7.6 ± 5.0 (nonparetic) vs. 5.3 ± 3.0] were observed in all gait speed groups. Our data suggest that abnormalities in the spatiotemporal parameters of hemiparetic gait should be interpreted in relation to gait speed. ASIs and CVs could be highly sensitive indices for detecting gait abnormalities.

日常生活活動で頻回に用いられる上肢動作パターンと運動範囲の検討　　　　　　　　　　　　　　　
芝草 愛, 向野 雅彦, 太田 皓文, 大河内 由紀, 才藤 栄一
日本作業療法学会抄録集, 53回, PA, 1G05, (一社)日本作業療法士協会, 2019年09月, ［査読有り］
日本語

On-site Evaluation of Rehabilitation Patients Monitoring System Using Distributed Wireless Gateways
Kenichi Matsunaga, Takayuki Ogasawara, Junichi Kodate, Masahiko Mukaino, Eiichi Saitoh
Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS, 2019, 3195, 3198, 2019年07月, ［国際誌］
英語, 研究論文（国際会議プロシーディングス）, This paper presents a hands-free monitoring system for rehabilitation patients that uses wireless gateways to fully cover the floor of an inpatient ward. For stroke rehabilitation, 24-hour monitoring is recommended. Low-power wireless such as Bluetooth Low Energy (BLE) is suitable for this purpose because of its long battery life. However, most systems require smartphones or tablet computers to acquire patient data due to BLE's short communication range. Instead of using smartphones, we installed around fifty BLE gateways to implement a hands-free data acquisition system. The system was evaluated both quantitatively and qualitatively. The data acquisition rate of the system was found to be over 90% through 24-hour patient monitoring, which is almost the same as that for systems using smartphones. Questionnaires about usability administered to both medical staff and patients suggested that they felt the smartphone-less system was more comfortable than the smartphone system. These results suggest the possibility of using such a distributed data acquisition system in real medical wards and its benefits.

関節抵抗トルク測定装置による速度依存的な痙縮評価　　　　　　　　　　　　　　　
伊藤 翔太, 谷川 広樹, 向野 雅彦, 近藤 輝, 藤村 健太, 寺西 利生, 大塚 圭, 加藤 正樹, 加賀谷 斉, 才藤 栄一
The Japanese Journal of Rehabilitation Medicine, 56, 特別号, 2, 1, (公社)日本リハビリテーション医学会, 2019年05月
日本語

加齢が健常者歩行のToe clearanceとばらつきに与える影響
村上 涼, 大塚 圭, 向野 雅彦, 山田 純也, 松田 文浩, 土山 和大, 才藤 栄一
愛知県理学療法学会誌, 31, 特別号, 38, 38, (NPO)愛知県理学療法学会, 2019年03月
日本語

回復期脳卒中患者の24時間超継続的活動モニタリングに関する予備的検討(Preliminary study on activity monitoring for over 24 hours among stroke patients in a rehabilitation ward)
Matsuura Hirotaka, Mukaino Masahiko, Ogasawara Takayuki, Aoshima Yasushi, Suzuki Takuya, Inukai Ayaka, Hattori Emi, Saitoh Eiichi
Japanese Journal of Comprehensive Rehabilitation Science, 10(2019), 37, 41, (一社)回復期リハビリテーション病棟協会, 2019年
英語, 【目的】リ八ビリテーションの効果を理解する上で、それが患者の日常の活動量に与える影響を知ることは重要である。本研究では着衣を用いた心拍測定システムを用い、リ八ビリテーションに伴う活動量の変化が検出できるかどうか、回復期の脳卒中患者を対象に予備的な検討を実施した。【方法】回復期病棟に入棟した脳卒中患者6名(男性4名、女性2名、年齢63.5±11.22歳)を対象とした。測定は着衣による心拍モニタリングシステム(hitoeシステム)により行い、回復期病棟入棟時および入棟6週間後に3日間の計測を実施した。【結果】回復期入棟6週間後の1日あたり臥位時間は入棟時に比較して減少傾向が得られた(11.9±3.52 vs 10.3±1.89(平均±SD)時間;p=0.06)。一方、運動強度を示す%予備心拍数(%HRR)が30%以上の時間は有意に増加を認めた(0.9±226% vs 5.1±6.56%;p=0.03)。【結論】着衣を用いた心拍測定による脳卒中片麻痺患者の活動モニタリングを試行し、入院中の活動量の増加傾向が観察された。(著者抄録)

Validity of simplified, calibration-less exercise intensity measurement using resting heart rate during sleep: A method-comparison study with respiratory gas analysis
Matsuura, H., Mukaino, M., Otaka, Y., Kagaya, H., Aoshima, Y., Suzuki, T., Inukai, A., Hattori, E., Ogasawara, T., Saitoh, E.
BMC Sports Science, Medicine and Rehabilitation, 11, 1, 27, 27, 2019年, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, Background: The recent development of wearable devices has enabled easy and continuous measurement of heart rate (HR). Exercise intensity can be calculated from HR with indices such as percent HR reserve (%HRR); however, this requires an accurate measurement of resting HR, which can be time-consuming. The use of HR during sleep may be a substitute that considers the calibration-less measurement of %HRR. This study examined the validity of %HRR on resting HR during sleep in comparison to percent oxygen consumption reserve (%VO2R) as a gold standard. Additionally, a 24/7%HRR measurement using this method is demonstrated. Methods: Twelve healthy adults aged 29 ± 5 years underwent treadmill testing using the Bruce protocol and a 6-min walk test (6MWT). The %VO2R during each test was calculated according to a standard protocol. The %HRR during each exercise test was calculated either from resting HR in a sitting position (%HRRsitting), when lying awake (%HRRlying), or during sleep (%HRRsleeping). Differences between %VO2R and %HRR values were examined using Bland-Altman plots. A 180-day, 24/7%HRR measurement with three healthy adults was also conducted. The %HRR values during working days and holidays were compared. Results: In the treadmill testing, the mean difference between %VO2R and %HRRsleeping was 1.7% (95% confidence interval [CI], - 0.2 to 3.6%). The %HRRsitting and %HRRlying values were 10.8% (95% CI, 8.8 to 12.7%) and 7.7% (95% CI, 5.4 to 9.9%), respectively. In the 6MWT, mean differences between %VO2R and %HRRsitting, %HRRlying and %HRRsleeping were 12.7% (95% CI, 10.0 to 15.5%), 7.0% (95% CI, 4.0 to 10.0%) and - 2.9% (95% CI, - 5.0% to - 0.7%), respectively. The 180-day, 24/7%HRR measurement presented significant differences in %HRR patterns between working days and holidays in all three participants. Conclusions: The results suggest %HRRsleeping is valid in comparison to %VO2R. The results may encourage a calibration-less, 24/7 measurement model of exercise intensity using wearable devices. Trial registration: UMIN000034967.Registered 21 November 2018 (retrospectively registered).

Influence of clinical experience and instruction on typical cases on the inter-rater reliability of observational gait analysis　　　　　　　　　　　　　　　
Tanikawa H, Ohtsuka K, Yamada J, Mukaino M, Matsuda F, Kagaya H, Saitoh E, Kanada Y, Hashimoto S
Jpn J Compr Rehabil Sci, 10, 14, 20, 2019年, ［査読有り］

Designing a robotic smart home for everyone, especially the elderly and people with disabilities
Tanabe S, Saitoh E, Koyama S, Kiyono K, Tatemoto T, Kumazawa N, Kagaya H, Otaka Y, Mukaino M, Tsuzuki A, Ota H, Hirano S, Kanada Y
Fujita Med J, 5, 2, 31, 35, 藤田学園医学会, 2019年, ［査読有り］
英語,

We initiated the Robotic Smart Home (RSH) project to develop a comfortable, safe home environment for all people, including the elderly and individuals with disabilities. An important consideration when introducing robots into a home environment is the confined living space, the so-called space problem. The RSH project plans to simultaneously develop robots and an architectural design for living spaces to create an optimal home environment that will help elderly people live independently at home for longer periods. The RSH accommodates the following three robotics and assistive systems: mobility and transfer assist system, operational assist system, and information assist system. The mobility and transfer assist system includes three types of devices (lifting type, lateral-transfer type, and suspension type), which can be available to users as appropriate according to the severity of their disability. The operational assist system combines a hand robot with an environmental control system for the convenience of users. An information assist system connects the RSH with remote locations for communication. Inside the RSH, a home automation and monitoring system connected to the Internet of Things provides residents with comfort and security. As part of this project, two RSH centers have been established for effective facility adoption.

Development and verification of a cane for treadmill gait training
Tanikawa H, Hirano S, Tanabe S, Fuse I, Ohtsuka K, Mukaino M, Watanabe I, Katoh D, Uno A, Kagaya H, Saitoh E
Jpn J Compr Rehabil Sci, 10, 21, 28, 2019年, ［査読有り］

Application for rehabilitation medicine using wearable textile “hitoe”
Takayuki Ogasawara, Kenichi Matsunaga, Hiroki Ito, Masahiko Mukaino
NTT Technical Review, 16, 9, 6, 12, 2018年09月01日
研究論文（学術雑誌）, © 2018 Nippon Telegraph and Telephone Corp. All Rights Reserved. NTT, Toray Industries, Inc., Fujita Health University, and NTT DOCOMO have begun trials on patient rehabilitation support using the functional material called “hitoe,” which can take continuous measurements of biological data simply by having patients wear it. As innovation progresses in medical and nursing care, it is necessary to improve the quality of rehabilitation, especially for elderly patients, in the recovery progress and return to daily life, and in preventing the recurrence of debilitation. This article introduces new initiatives to develop wearable technology in light of these social issues.

Intra- and inter-rater reliability and validity of the tandem gait test for the assessment of dynamic gait balance
Soichiro Koyama, Shigeo Tanabe, Norihide Itoh, Norihide Itoh, Eiichi Saitoh, Kazuya Takeda, Satoshi Hirano, Kei Ohtsuka, Masahiko Mukaino, Ryuzo Yanohara, Hiroaki Sakurai, Yoshikiyo Kanada
European Journal of Physiotherapy, 20, 3, 135, 140, 2018年07月03日, ［査読有り］
研究論文（学術雑誌）, © 2017, © 2017 Informa UK Limited, trading as Taylor & Francis Group. Purpose: To establish the within-day and between-day intra-rater reliability, inter-rater reliability, validity and systematic errors of the tandem gait test (TGT). Materials and methods: Thirty participants performed the TGT and the timed up and go test (TUG) twice on the first day. Three independent raters measured these tests. After two weeks, the protocol was repeated by one tester to assess between-day reliability. The within-day and between-day intra-rater reliability was estimated by intraclass correlation coefficient (ICC) and Bland–Altman plots to assess systematic errors associated with the learning effect. Inter-rater reliability was estimated by ICC and minimum detectable change at 95% confidence. Concurrent validity was assessed by examination of the correlation between TGT and TUG using Pearson’s correlation coefficient. Results: Within-day and between-day intra-rater reliability were good (ICC > 0.9 and ICC > 0.7). The Bland–Altman plots showed systematic error in the between-day measurements. Inter-rater reliability was supported by strong values for ICC (ICC > 0.9). The Pearson’s correlation coefficient between the TGT and TUG showed a significant positive correlation (r > 0.67, p <.001). Conclusions: These results show that the learning effect of the TGT might be a considerable factor when interpreting follow-up measurements after a few days.

【片麻痺の課題指向型リハビリテーションの潮流】 ロボットを使用した課題指向型リハビリテーション医療　　　　　　　　　　　　　　　
近藤 和泉, 橋爪 美春, 加藤 健治, 向野 雅彦
Journal of Clinical Rehabilitation, 27, 6, 538, 542, 医歯薬出版(株), 2018年06月
日本語

The impact of ankle-foot orthoses on toe clearance strategy in hemiparetic gait: A cross-sectional study
Kannit Pongpipatpaiboon, Masahiko Mukaino, Fumihiro Matsuda, Kei Ohtsuka, Hiroki Tanikawa, Junya Yamada, Kazuhiro Tsuchiyama, Eiichi Saitoh
Journal of NeuroEngineering and Rehabilitation, 15, 1, 41, BioMed Central Ltd., 2018年05月23日, ［査読有り］
英語, 研究論文（学術雑誌）, Background: Ankle-foot orthoses (AFOs) are frequently used to improve gait stability, toe clearance, and gait efficiency in individuals with hemiparesis. During the swing phase, AFOs enhance lower limb advancement by facilitating the improvement of toe clearance and the reduction of compensatory movements. Clinical monitoring via kinematic analysis would further clarify the changes in biomechanical factors that lead to the beneficial effects of AFOs. The purpose of this study was to investigate the actual impact of AFOs on toe clearance, and determine the best strategy to achieve toe clearance (including compensatory movements) during the swing phase. Methods: This study included 24 patients with hemiparesis due to stroke. The gait performance of these patients with and without AFOs was compared using three-dimensional treadmill gait analysis. A kinematic analysis of the paretic limb was performed to quantify the contribution of the extent of lower limb shortening and compensatory movements (such as hip elevation and circumduction) to toe clearance. The impact of each movement related to toe clearance was assessed by analyzing the change in the vertical direction. Results: Using AFOs significantly increased toe clearance (p = 0.038). The quantified limb shortening and pelvic obliquity significantly differed between gaits performed with versus without AFOs. Among the movement indices related to toe clearance, limb shortening was increased by the use of AFOs (p <
0.0001), while hip elevation due to pelvic obliquity (representing compensatory strategies) was diminished by the use of AFOs (p = 0.003). The toe clearance strategy was not significantly affected by the stage of the hemiparetic condition (acute versus chronic) or the type of AFO (thermoplastic AFOs versus adjustable posterior strut AFOs). Conclusions: Simplified three-dimensional gait analysis was successfully used to quantify and visualize the impact of AFOs on the toe clearance strategy of hemiparetic patients. AFO use increased the extent of toe clearance and limb shortening during the swing phase, while reducing compensatory movements. This approach to visualization of the gait strategy possibly contributes to clinical decision-making in the real clinical settings. Trial registration: UMIN000028946. Registered 31 August 2017 (retrospectively registered).

Quantitative assessment for flexed-elbow deformity during gait following botulinum toxin A treatment
Hiroki Tanikawa, Hitoshi Kagaya, Keisuke Inagaki, Yusuke Kotsuji, Keita Suzuki, Kenta Fujimura, Masahiko Mukaino, Satoshi Hirano, Eiichi Saitoh, Yoshikiyo Kanada
Gait and Posture, 62, 409, 414, Elsevier B.V., 2018年05月01日, ［査読有り］
英語, 研究論文（学術雑誌）, Background: The effect of botulinum toxin A (BoNTA) injection on flexed-elbow deformity is usually evaluated using the Modified Ashworth Scale (MAS), but only with the muscle tone at rest. Some patients show the flexed-elbow deformity during gait despite low muscle tone at rest. Objective: This study aimed to evaluate the effect of BoNTA injection on flexed-elbow deformity during gait using a three-dimensional motion analysis system. Methods: Twenty stroke patients with spastic flexed-elbow deformity during gait received BoNTA injections into the upper limb muscles. The MAS score of the elbow flexors, passive elbow range of motion, comfortable overground gait velocity, and elbow flexion angle during treadmill gait were evaluated just before and 2, 6, and 12 weeks after the injection. Twenty-five healthy subjects were also recruited to provide a normal reference of the elbow flexion angle. Results: The MAS scores at 2, 6 and 12 weeks after the injection were significantly lower than that before the injection. Some patients showed no spasticity at rest but an obviously flexed elbow during gait. The elbow flexion angles during gait at 2 and 6 weeks after the injection were significantly lower than that before the injection. Conclusions: BoNTA injections to the upper limb muscles reduced muscle tone at rest and flexed-elbow deformity during gait. However, the elbow flexion angle during gait returned to its pre-injection level sooner than the muscle tone at rest. We strongly recommend evaluating muscle tone during motion and at rest, preferably using three-dimensional motion analysis since it can objectively detect small changes.

ICFリハビリテーションセットb項目における患者アンケート調査と医療者評価の比較　　　　　　　　　　　　　　　
千手 佑樹, 向野 雅彦, 渡邉 誠, 大河内 由紀, 水谷 公司, 才藤 栄一, 園田 茂
The Japanese Journal of Rehabilitation Medicine, 55, 特別号, 4, 8, (公社)日本リハビリテーション医学会, 2018年05月
日本語

脳卒中片麻痺者における平地歩行とトレッドミル歩行の運動学的因子の比較　　　　　　　　　　　　　　　
山田 純也, 向野 雅彦, 大塚 圭, 松田 文浩, 谷川 広樹, 土山 和大, 日高 雅大, 伊東 慶, 安藤 大智, 王 裕香, 才藤 栄一
The Japanese Journal of Rehabilitation Medicine, 55, 特別号, 4, 3, (公社)日本リハビリテーション医学会, 2018年05月
日本語

国際生活機能分類を用いた生活機能の標準化指標作成の取り組み　　　　　　　　　　　　　　　
向野 雅彦, 才藤 栄一, 園田 茂, 岡崎 英人, 河村 美穂, 米田 千賀子, 尾関 保則, 小口 和代, 清水 康裕, 小池 知治, 戸田 芙美, 近藤 和泉
The Japanese Journal of Rehabilitation Medicine, 55, 特別号, 4, 7, (公社)日本リハビリテーション医学会, 2018年05月
日本語

Clinical-oriented three-dimensional gait analysis method for evaluating gait disorder
Masahiko Mukaino, Kei Ohtsuka, Hiroki Tanikawa, Fumihiro Matsuda, Junya Yamada, Norihide Itoh, Eiichi Saitoh
Journal of Visualized Experiments, 2018, 133, Journal of Visualized Experiments, 2018年03月04日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, Three-dimensional gait analysis (3DGA) is shown to be a useful clinical tool for the evaluation of gait abnormality due to movement disorders. However, the use of 3DGA in actual clinics remains uncommon. Possible reasons could include the time-consuming measurement process and difficulties in understanding measurement results, which are often presented using a large number of graphs. Here we present a clinician-friendly 3DGA method developed to facilitate the clinical use of 3DGA. This method consists of simplified preparation and measurement processes that can be performed in a short time period in clinical settings and intuitive results presentation to facilitate clinicians' understanding of results. The quick, simplified measurement procedure is achieved by the use of minimum markers and measurement of patients on a treadmill. To facilitate clinician understanding, results are presented in figures based on the clinicians' perspective. A Lissajous overview picture (LOP), which shows the trajectories of all markers from a holistic viewpoint, is used to facilitate intuitive understanding of gait patterns. Abnormal gait pattern indices, which are based on clinicians' perspectives in gait evaluation and standardized using the data of healthy subjects, are used to evaluate the extent of typical abnormal gait patterns in stroke patients. A graph depicting the analysis of the toe clearance strategy, which depicts how patients rely on normal and compensatory strategies to achieve toe clearance, is also presented. These methods could facilitate implementation of 3DGA in clinical settings and further encourage development of measurement strategies from the clinician's point of view.

【歩行と理学療法I:臨床歩行分析の基礎と実際】 中枢神経疾患患者の理学療法における臨床歩行分析の実際　　　　　　　　　　　　　　　
大塚 圭, 向野 雅彦, 谷川 広樹, 才藤 栄一
理学療法, 35, 2, 156, 168, (株)メディカルプレス, 2018年02月
日本語, 1.中枢神経疾患患者の歩行障害では、歩行速度低下、バランス機能低下、再現性低下などの特徴を認めるとともに、典型的な異常歩行を呈することが多い。2.時間距離因子の分析は、歩行速度の低下を探る第一歩となるとともに、運動学習の指標や対称性の指標になり得る。3.中枢神経疾患患者の歩行障害で高い頻度で認められる足部の過度な内反は、三次元動作分析装置によるトレッドミル歩行分析で評価でき、ボツリヌス療法の治療効果の判定にも有用となる。4.異常歩行の同定は、歩行障害の原因となる病態理解、重症度の判定、介入方針の決定、歩行練習の効果判定の手段としても有用であり、定量的に分析されることが望ましい。5.機能障害を有する中枢神経疾患患者の歩行再建において代償運動の活用は不可欠である一方、過度な代償運動は安定性や耐久性を低下させる要因にもなり得るため、機能障害と代償運動の関係を的確に評価する必要がある。(著者抄録)

【リハビリテーションにおけるICFの活用】 ICFに基づく全般評価システムの作成と臨床活用
向野 雅彦
総合リハビリテーション, 46, 1, 19, 22, (株)医学書院, 2018年01月
日本語

Quantitative assessment of knee extensor thrust, flexed-knee gait, insufficient knee flexion during the swing phase, and medial whip in hemiplegia using three-dimensional treadmill gait analysis
Norikazu Hishikawa, Hiroki Tanikawa, Kei Ohtsuka, Masahiko Mukaino, Keisuke Inagaki, Fumihiro Matsuda, Toshio Teranishi, Yoshikiyo Kanada, Hitoshi Kagaya, Eiichi Saitoh
Topics in Stroke Rehabilitation, 25, 8, 548, 553, 2018年01月01日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group. Background: Most people with hemiplegia experience gait changes after a stroke. Abnormal gait patterns in stroke patients vary across subjects and this make it difficult to assess the cause of gait abnormalities. Therefore, it is necessary to quantitatively evaluate abnormal gait patterns through gait analysis for stroke patients. Objective: To develop and evaluate the validity of quantitative assessments of the degree of knee extensor thrust, flexed-knee gait, insufficient knee flexion during the swing phase, and medial whip. Methods: Forty-six healthy control subjects and 112 people with hemiplegia participated. From the 112 patients, 50 patients were selected into each abnormal gait pattern (knee extensor thrust, flexed-knee gait, insufficient knee flexion during the swing phase, and medial whip) with some overlap. Participants were instructed to walk on a treadmill and were recorded using a three-dimensional motion analysis system. An index to quantify each of the four abnormal gait patterns exhibited by the patients was calculated from the three-dimensional coordinate data. The indices were developed based on the definition of the abnormal gait patterns. The index values for the patients were compared with those of healthy subjects as well as with the results of observational gait assessment by three physical therapists with expertise in gait analysis. Results: Strong correlation was observed between the index value and the median observational rating for all four abnormal gait patterns (−0.64 to −0.86). Most of the patients with an abnormal gait pattern had a higher index value than the healthy subjects. Conclusions: The use of these indices in gait analysis of people with hemiplegia can help to diagnose severity of gait disorder, determine the appropriate treatment, and evaluate the effectiveness of the treatment.

Welwalk facilitate early improvement in walking independence of stroke patients with hemiplegia
S. Hirano, E. Saitoh, H. Kagaya, S. Sonoda, M. Mukaino, T. Tsunoda, S. Tanabe, J. Yamada, A. Suzuki, H. Konosu
Annals of Physical and Rehabilitation Medicine, 61, e93, Elsevier Masson SAS, 2018年, ［査読有り］
英語, 研究論文（学術雑誌）, Introduction/Background: For stroke patients with hemiplegia, walking exercise are conventionally practiced using orthoses. For severe hemiplegic patients, knee-ankle-foot orthoses (KAFO) are frequently used to prevent giving way in the stance phase. However, it is very difficult to swing paralytic leg with KAFO. As a result, walking exercise with KAFO requires a high level of assistance and raise low exercise intensity. To solve these problems, we developed Welwalk, which has a motor on the knee joint with KAFO-like framework. Welwalk can extend and flex the knee in appropriate timing. This time, we examined whether subacute stroke patients with hemiplegia using Welwalk show early improvement in walking independence compared to patients using KAFO. Material and method: Fourteen patients who satisfied the following criteria were included: patients with hemiplegia caused by primary supratentorial intracerebral hemorrhage or cerebral infarction, within 60 days after onset, aged 20 to 75 years, Functional Independence Measure (FIM) walking score ≤ 3, Stroke Impairment Assessment Set (SIAS) lower extremity total score ≤ 6, and use of KAFO. Rehabilitation was conducted for a maximum of 3 hours a day, including 40 minutes of walking exercise using Welwalk. A historical control group was selected from among patients admitted to the ward for intensive inpatient rehabilitation at Nanakuri Memorial Hospital. One control patient matching the criteria of each subject was selected, with a total of fourteen in the control group. The primary outcome measure was the improvement in efficiency of FIM-walk, defined as the gain in FIM walking score from the baseline to supervised walking divided by the number of weeks required. Results: The mean improvement in efficiency of FIM- walk was 0.9 in the Welwalk group and 0.5 in the control group, and was significantly higher in the GEAR group (P <
0.01). Conclusion: Walking exercise using Welwalk may facilitate early improvement in walking independence.

ウェルウォークが片麻痺患者の歩行自立度回復に与える影響　　　　　　　　　　　　　　　
平野 哲, 才藤 栄一, 園田 茂, 加賀谷 斉, 角田 哲也, 布施 郁子, 波多野 和樹, 舟橋 怜佑, 向野 雅彦, 尾関 恩, 田辺 茂雄, 大塚 圭
The Japanese Journal of Rehabilitation Medicine, 54, 秋季特別号, S270, S270, (公社)日本リハビリテーション医学会, 2017年09月
日本語

Regulation of RhoA by STAT3 coordinates glial scar formation
Francois Renault-Mihara, Masahiko Mukaino, Munehisa Shinozaki, Hiromi Kumamaru, Satoshi Kawase, Matthieu Baudoux, Toshiki Ishibashi, Soya Kawabata, Yuichiro Nishiyama, Keiko Sugai, Kaori Yasutake, Seiji Okada, Masaya Nakamura, Hideyuki Okano
JOURNAL OF CELL BIOLOGY, 216, 8, 2533, 2550, ROCKEFELLER UNIV PRESS, 2017年08月, ［査読有り］
英語, 研究論文（学術雑誌）, Understanding how the transcription factor signal transducer and activator of transcription-3 (STAT3) controls glial scar formation may have important clinical implications. We show that astrocytic STAT3 is associated with greater amounts of secreted MMP2, a crucial protease in scar formation. Moreover, we report that STAT3 inhibits the small GTPase RhoA and thereby controls actomyosin tonus, adhesion turnover, and migration of reactive astrocytes, as well as corralling of leukocytes in vitro. The inhibition of RhoA by STAT3 involves ezrin, the phosphorylation of which is reduced in STAT3-CKO astrocytes. Reduction of phosphatase and tensin homologue (PTEN) levels in STAT3-CKO rescues reactive astrocytes dynamics in vitro. By specific targeting of lesion-proximal, reactive astrocytes in Nestin-Cre mice, we show that reduction of PTEN rescues glial scar formation in Nestin-Stat3(+/-) mice. These findings reveal novel intracellular signaling mechanisms underlying the contribution of reactive astrocyte dynamics to glial scar formation.

Reliability and validity of a force-instrumented treadmill for evaluating balance: A preliminary study of feasibility in healthy young adults
Zhou Yuntao, Zhou Yuntao, Izumi Kondo, Masahiko Mukaino, Shigeo Tanabe, Toshio Teranishi, Takuma Ii, Kensuke Oono, Soichiro Koyama, Yoshikiyo Kanada, Eiichi Saitoh
Hong Kong Physiotherapy Journal, 36, 49, 56, Elsevier B.V., 2017年06月01日, ［査読有り］
英語, 研究論文（学術雑誌）, © 2017 Background With the development of computer technology, computerized dynamic posturography provides objective assessments of balance and posture control under static and dynamic conditions. Although a force-instrumented treadmill-based balance assessment is feasible for balance evaluations, currently no data exists. Objective This study was undertaken to assess the reliability and validity of balance evaluations using a force-instrumented treadmill. Methods Ten healthy adults participated in evaluations using both the treadmill and the EquiTest. Four balance evaluations were conducted: Modified Clinical Test of Sensory Interaction on Balance, Unilateral Stance, Weight Bearing Squat, and Motor Control Test. Results All balance evaluations using the force-instrumented treadmill method shared good reliability (intraclass correlation coefficient ≥0.6). The Modified Clinical Test of Sensory Interaction on Balance, Unilateral Stance, and Weight Bearing Squat evaluations had a correlation of r < 0.5 with EquiTest, whereas the Motor Control Test balance evaluation had moderate correlations (r > 0.5) with the EquiTest. Conclusion The results demonstrated that all balance evaluations using the force-instrumented treadmill were reliable, and that the Motor Control Test evaluation was moderately correlated with the EquiTest. Therefore, the use of a force-instrumented treadmill in balance evaluations might provide a certain level of value to clinical practice.

脳卒中片麻痺者におけるToe clearance獲得戦略の分析(Analysis of strategies used by hemiplegic stroke patients to achieve toe clearance)
松田 文浩, 向野 雅彦, 大塚 圭, 谷川 広樹, 土山 和大, 寺西 利生, 金田 嘉清, 加賀谷 斉, 才藤 栄一
Japanese Journal of Comprehensive Rehabilitation Science, 7(2016), 111, 118, (一社)回復期リハビリテーション病棟協会, 2017年01月
英語, 【目的】本研究の目的は,遊脚時のToe clearanceを構成する下肢の短縮と代償運動が実質的にどの程度Toe clearanceに貢献しているかを分析し,健常者と脳卒中片麻痺者における戦略の違いを明らかにすることである.【方法】脳卒中片麻痺者と,年齢・性別・歩行速度をマッチさせた健常者各18名を対象とした.Toe clearanceおよびその構成要素を算出し,2群間で比較した.また,構成要素間の相関を検討した.【結果】片麻痺者の足部-床面距離は,健常者と比べ低い値を示した.構成要素として,Shortening of hiptoe length(SHTL)は健常者より小さく,骨盤傾斜による股関節上方移動距離,外転による足部上方移動距離,対側股関節上方移動距離は大きい値を示した.片麻痺者において,SHTLとその他の構成要素に有意な負の相関を認めた.【結論】片麻痺者では,健常者に比べ下肢短縮によって得られる足部の上方移動は小さく,骨盤挙上をはじめとした代償運動のToe clearanceへの関与が大きいことが示された.(著者抄録)

Objective Measurement of Dynamic Balance Function by the Simultaneous Measurement of the Center of Gravity (COG) and Center of Pressure (COP)
Masahiko Mukaino, Fumihiro Matsuda, Ryoma Sassa, Kei Ohtsuka, Nobuhiro Kumazawa, Kazuhiro Tsuchiyama, Shigeo Tanabe, Eiichi Saitoh
INTELLIGENT AUTONOMOUS SYSTEMS 14, 531, 69, 75, SPRINGER INTERNATIONAL PUBLISHING AG, 2017年, ［査読有り］
英語, 研究論文（国際会議プロシーディングス）, Although a posturography is commonly used for objective evaluation of static balance function, dynamic balance function is usually evaluated only with clinical scales. Simplified objective measurement systems for the evaluation of dynamic balance function need to be developed. In this preliminary study, we attempted to develop an index for the objective measurement of dynamic balance function from COP-COG data. The subjects comprised nine hemiparetic post-stroke patients and five healthy subjects. The simultaneous measurements of COG and COP were performed using a three-dimensional motion analysis system (Kinematracer, KisseiComtec, Japan) combined with force plate analysis. As indices for evaluating dynamic balance function, the latency of COP passing COG after heel contact (LCP) and the averaged |COP| -|COG| subtraction value during stance phase (ASV) were calculated. For evaluating validity of the measurement, the Berg Balance Scale, a frequently used clinical balance scale, was used. The results showed significant differences (0.13 +/- 0.02 vs. 0.29 +/- 0.23 s) between the healthy subjects and patients in LCP, and large, yet insignificant, differences (4.3 +/- 0.5 vs. 2.7 +/- 2.0 cm) in ASV. The ASV was strongly correlated with BBS. A strong correlation was observed between COG acceleration and ASV, except in one patient, who had a severe balance disorder. These results may encourage further investigation into the feasibility of COP-COG measurements for balance measurement.

Biomechanical factors behind toe clearance during the swing phase in hemiparetic patients
Fumihiro Matsuda, Masahiko Mukaino, Kei Ohtsuka, Hiroki Tanikawa, Kazuhiro Tsuchiyama, Toshio Teranishi, Yoshikiyo Kanada, Hitoshi Kagaya, Eiichi Saitoh
TOPICS IN STROKE REHABILITATION, 24, 3, 177, 182, TAYLOR & FRANCIS LTD, 2017年, ［査読有り］
英語, 研究論文（学術雑誌）, Background: The toe clearance of a paretic limb in the swing phase of gait is related to tripping, which is considered a major cause of falls. The biomechanical factors for obtaining toe clearance are more complicated in hemiparetic gait than that in normal gait because of the compensatory movements during swing phase. Understanding the biomechanical factors should help in targeting the point for rehabilitative interventions.
Objective: To clarify the biomechanical factors behind toe clearance during swing phase in hemiparetic gait.
Methods: Fifty patients with hemiparesis after a stroke participated in this study. Three-dimensional motion analysis was used for the kinematic analysis of the hemiparetic gait. The correlation coefficients between limb shortening and angle changes and between limb shortening and hip elevation and foot lateral shift were calculated. Limb shortening was defined as the shortening of the hip-toe distance. The significant factors that determine toe clearance were examined by multiple regression analysis. Independent variables were limb shortening, hip elevation, and foot lateral shift.
Results: Limb shortening was negatively correlated with hip elevation (r = -0.75) and foot lateral shift (r = -0.41). Multiple regression analysis showed a significant contribution of limb shortening and hip elevation to toe clearance. The coefficient of determination was 0.95.
Conclusions: Toe clearance was mainly determined by limb shortening and hip elevation, which were found to be in a trade-off relationship. These results warrant further investigation into the use of three-dimensional motion analysis in the rehabilitation clinic to facilitate targeted rehabilitative training to restore gait ability.

After-effects of pedaling exercise on spinal excitability and spinal reciprocal inhibition in patients with chronic stroke
Akira Tanuma, Toshiyuki Fujiwara, Tomofumi Yamaguchi, Takanori Ro, Hirotaka Arano, Shintaro Uehara, Kaoru Honaga, Masahiko Mukaino, Akio Kimura, Meigen Liu
INTERNATIONAL JOURNAL OF NEUROSCIENCE, 127, 1, 73, 79, TAYLOR & FRANCIS LTD, 2017年, ［査読有り］
英語, 研究論文（学術雑誌）, Purpose of the study: To evaluate the after-effects of pedaling on spinal excitability and spinal reciprocal inhibition in patients with post-stroke spastic hemiparesis. Materials and methods: Twenty stroke patients with severe hemiparesis participated in this study and were instructed to perform 7 min of active pedaling and 7 min of passive pedaling with a recumbent ergometer at a comfortable speed. H reflexes and M waves of paretic soleus muscles were recorded at rest before, immediately after and 30 min after active and passive pedaling. The Hmax/Mmax ratio and H recruitment curve were measured. Reciprocal inhibition was assessed using the soleus H reflex conditioning test paradigm. Results: The Hmax/Mmax ratio was significantly decreased after active and passive pedaling exercise. The decreased Hmax/Mmax ratio after active pedaling lasted at least for 30 min. The H recruitment curve and reciprocal inhibition did not change significantly after active or passive pedaling exercise. Conclusions: Pedaling exercise decreased spinal excitability in patients with severe hemiparesis. Pedaling may be effective in rehabilitation following stroke.

日常生活における上肢頻用動作に基づく客観的上肢機能評価法の検討　　　　　　　　　　　　　　　
太田 皓文, 向野 雅彦, 大河内 由紀, 保木本 のぞみ, 才藤 栄一
日本作業療法学会抄録集, 50回, OA, 2, (一社)日本作業療法士協会, 2016年09月, ［査読有り］
日本語

Feasibility of a Simplified, Clinically Oriented, Three-dimensional Gait Analysis System for the Gait Evaluation of Stroke Patients
Mukaino Masahiko, Ohtsuka Kei, Tsuchiyama Kazuhiro, Matsuda Fumihiro, Inagaki Keisuke, Yamada Junya, Tanikawa Hiroki, Saitoh Eiichi
Progress in Rehabilitation Medicine, 1, 1, 1, 8, 公益社団法人 日本リハビリテーション医学会, 2016年07月, ［査読有り］, ［国内誌］
英語, <p>Objective: Although previous studies have evidenced the value ofthree-dimensional gait analysis (3DGA) for evaluating gait disorder, the time-consumingmeasurement process and space requirement has hampered its use in the clinical setting.The aim of this study was to examine the feasibility of a simplified 3DGA system forstroke patients. Methods: Thirteen pairs of stroke patients and age- (± 1year), gender-, and gait speed- (± 0.5 m/s) matched controls were drawn from the FujitaHealth University gait analysis database. 3DGA was performed using theKinemaTracer® treadmill gait analysis system. Comparisons of thespatiotemporal and kinematic parameters were performed between stroke patients and matchedcontrols. The correlations between items from the Wisconsin Gait Scale (WGS) and 3DGA datain stroke patients were also investigated. Results: 3DGA measurements clearlyshowed reduced toe clearance, hip flexion, and knee flexion in stroke patients comparedwith the matched controls. In contrast, significant increases were observed in hipelevation, shoulder elevation, shoulder lateral shift, and step width in stroke patients.For the four items drawn from the WGS, a significant correlation with three 3DGAparameters was observed: stance time on the impaired side, stance width, and knee flexionfrom toe off to midswing. Conclusions: In this study, significant differencesin gait parameters of stroke patients and age-, gender-, and speed-matched controls werefound using a simplified 3DGA system. A significant correlation with WGS was alsoobserved. These results support the validity of the clinical measurement of gaitparameters using a simplified 3DGA system.</p>

回復期リハビリテーション病棟における脳卒中患者の作業療法内容調査　　　　　　　　　　　　　　　
宮坂 裕之, 國分 実伸, 川上 健司, 奥山 夕子, 向野 雅彦, 沢田 光思郎, 加藤 正樹, 寺西 利生, 園田 茂, 才藤 栄一
The Japanese Journal of Rehabilitation Medicine, JARM2016, I181, I181, (公社)日本リハビリテーション医学会, 2016年06月
日本語

急性期病院におけるリハビリテーション専門職配置の効果 呼吸器内科病棟でのADL維持向上等体制加算算定の取り組み
平野 明日香, 加藤 正樹, 藤村 健太, 早川 美和子, 加賀谷 斉, 向野 雅彦, 才藤 栄一
理学療法学, 43, 3, 255, 262, (公社)日本理学療法士協会, 2016年06月
日本語, 【目的】急性期病院では高齢障害者が増加し、リハビリテーションの重要性が高まっている。当院急性期病棟に理学療法士を病棟配置した効果を検討した。【方法】疾患別リハビリテーション実施者を対象とし、病棟配置前の44例を対照群、病棟に専任配置後の79例を専任群、専従配置(ADL維持向上等体制加算算定)後の83例を専従群とし、当院患者データベースより後方視的に調査した。【結果】専従群は他2群よりリハビリテーション実施割合が有意に増加、リハビリテーション開始までの日数、在院日数は有意に短縮した。アンケート調査より、病棟医師・看護師は情報共有がしやすい、リハビリテーション専門職は病棟とのパイプ役として期待との回答が多かった。【結論】理学療法士の専従配置は病棟医師・看護師と情報共有を密に行え、治療の効率化が図れると示唆された。(著者抄録)

急性期病院におけるリハビリテーション専門職配置の効果 呼吸器内科病棟でのADL維持向上等体制加算算定の取り組み
平野 明日香, 加藤 正樹, 藤村 健太, 早川 美和子, 加賀谷 斉, 向野 雅彦, 才藤 栄一
理学療法学, 43, 3, 255, 262, (公社)日本理学療法士協会, 2016年06月, ［査読有り］
日本語, 【目的】急性期病院では高齢障害者が増加し、リハビリテーションの重要性が高まっている。当院急性期病棟に理学療法士を病棟配置した効果を検討した。【方法】疾患別リハビリテーション実施者を対象とし、病棟配置前の44例を対照群、病棟に専任配置後の79例を専任群、専従配置(ADL維持向上等体制加算算定)後の83例を専従群とし、当院患者データベースより後方視的に調査した。【結果】専従群は他2群よりリハビリテーション実施割合が有意に増加、リハビリテーション開始までの日数、在院日数は有意に短縮した。アンケート調査より、病棟医師・看護師は情報共有がしやすい、リハビリテーション専門職は病棟とのパイプ役として期待との回答が多かった。【結論】理学療法士の専従配置は病棟医師・看護師と情報共有を密に行え、治療の効率化が図れると示唆された。(著者抄録)

The use of a holistic figure in gait analysis: a preliminary study on the effect of ankle-foot orthosis
Kannit Pongpipatpaiboon, Masahiko Mukaino, Kazuhiro Tsuchiyama, Kei Ohtsuka, Fumihiro Matsuda, Hiroki Tanikawa, Junya Yamada, Eiichi Saitoh
Jpn J Compr Rehabil Sci, 7, 80, 86, 一般社団法人 回復期リハビリテーション病棟協会, 2016年, ［査読有り］
英語, 研究論文（学術雑誌）,

Pongpipatpaiboon K, Mukaino M, Tsuchiyama K, Ohtsuka K, Matsuda F, Tanikawa H, Yamada J, Saitoh E. The use of a holistic figure in gait analysis: a preliminary study on the effect of ankle-foot orthosis. Jpn J Compr Rehabil Sci 2016; 7: 80-86.

Objective: To examine the practical usefulness of a simplified three-dimensional treadmill gait analysis with a Lissajous overview picture (LOP), a holistic figure of marker trajectories, to present the effect of ankle-foot orthoses (AFO) on hemiparetic gait.

Methods: Seven patients with hemiparesis who were able to walk without an orthosis or gait assistive device were included in this study. Patients were measured with a simplified three-dimensional treadmill gait analysis system as they walked with and without an orthosis in a rehabilitation center of a university medical center. Gait was analyzed using the LOP, and quantitative comparisons were made to evaluate the changes in joint angles and joint position displacements during the swing phase.

Results: Using the orthosis decreased ankle plantar flexion during the swing phase (p = 0.028) and significantly reduced compensatory patterns, including hip elevation, knee elevation, and circumduction (p = 0.028, 0.018, and 0.028, respectively).

Conclusions: The quantitative assessment by a simplified gait analysis system clarified the effect of AFO on reducing the compensatory movement in a hemiparetic gait. The use of LOP helps to understand the holistic effect of AFO and to analyze the individual patterns of gait disturbance.

非測定下肢の固定がHand-Held Dynamometerによる股関節外転筋力測定値に及ぼす影響　　　　　　　　　　　　　　　
谷川 広樹, 向野 雅彦, 松田 文浩, 稲垣 圭亮, 大塚 圭, 加賀谷 斉, 才藤 栄一, 金田 嘉清
Japanese Journal of Comprehensive Rehabilitation Science, 6(2015), 137, 142, (一社)回復期リハビリテーション病棟協会, 2016年01月
英語, 【目的】Hand-held dynamometerによる股関節外転筋力測定において,非測定下肢機能が測定値に与える影響を明らかにすること.【方法】健常者30名と片麻痺患者59名を対象とし,背臥位で両側股関節外転筋力を,非測定下肢を固定する方法(固定法)としない方法(非固定法)で測定した.同一法における左右および麻痺側・非麻痺側,固定法と非固定法での測定値を比較し,片麻痺患者では麻痺側筋力を従属変数,非麻痺側筋力と麻痺の程度を独立変数として重回帰分析を行った.【結果】非固定法の計測値が固定法よりも有意に小さかった.健常者では非測定下肢の固定によらず左右の相関が高かったが,片麻痺患者では非固定法において相関が低かった.重回帰分析の結果,固定法における麻痺側筋力は非麻痺側下肢機能の影響を強く受けていた.【考察】固定法では非測定下肢機能の影響を受け,測定下肢の筋力を正確に反映していないと考えられた.(著者抄録)

Quantitative assessment of retropulsion of the hip, excessive hip external rotation, and excessive lateral shift of the trunk over the unaffected side in hemiplegia using three-dimensional treadmill gait analysis
Hiroki Tanikawa, Kei Ohtsuka, Masahiko Mukaino, Keisuke Inagaki, Fumihiro Matsuda, Toshio Teranishi, Yoshikiyo Kanada, Hitoshi Kagaya, Eiichi Saitoh
TOPICS IN STROKE REHABILITATION, 23, 5, 311, 317, TAYLOR & FRANCIS LTD, 2016年, ［査読有り］
英語, 研究論文（学術雑誌）, Background: Gait assessment is important to determine the most effective strategy to regain gait function during stroke rehabilitation. To understand the mechanisms that cause abnormal gait patterns, it is useful to objectively identify and quantify the abnormal gait patterns. Objective assessment also helps evaluate the efficacy of treatments and can be used to provide suggestions for treatment.
Objective: To evaluate the validity of quantitative indices for retropulsion of the hip, excessive hip external rotation, and excessive lateral shift of the trunk over the unaffected side in hemiplegic patients.
Methods: Forty-six healthy control subjects and 112 hemiplegic patients participated. From the 112 patients, 50 patients were selected into each abnormal gait pattern with some overlap. Participants were instructed to walk on a treadmill and were recorded using a three-dimensional motion analysis system. An index to quantify each of the three abnormal gait patterns was calculated from the three-dimensional coordinate data. The index values of patients were compared with those of healthy subjects and with the results of observational gait assessment by three physical therapists with expertise in gait analysis.
Results: Strong correlation was observed between the index value and the median observational rating for all three abnormal gait patterns (-0.56 to -0.74). Most of the patients with an abnormal gait pattern had a higher index value than the healthy subjects.
Conclusions: The proposed indices are useful for clinical gait analysis. Our results encourage a more detailed analysis of hemiplegic gait using a motion analysis system.

当科におけるリンパ浮腫の治療成績
田矢理子, 加賀谷斉, 森志乃, 山田薫, 平野哲, 向野雅彦, 柴田斉子, 才藤栄一, 尾関恩, 小野木啓子
Jpn J Rehabil Med, 52, 12, 772, 773, (公社)日本リハビリテーション医学会, 2015年12月18日
日本語

3次元トレッドミル歩行分析を用いた装具の効果判定
布施郁子, 柴田斉子, 赤堀遼子, 平野哲, 向野雅彦, 青柳陽一郎, 加賀谷斉, 才藤栄一, 尾関恩
Jpn J Rehabil Med, 52, 12, 769, 769, (公社)日本リハビリテーション医学会, 2015年12月18日
日本語

Gait Exercise Assist Robot(GEAR) for hemiplegic gait reconstruction(和訳中)　　　　　　　　　　　　　　　
Saitoh Eiichi, Hirano Satoshi, Mukaino Masahiko, Ohtsuka Kei
臨床神経学, 55, Suppl., S60, S60, (一社)日本神経学会, 2015年12月
英語

片麻痺者の歩行における短下肢装具の効果 麻痺側遊脚時の機能障害と代償運動に着目して　　　　　　　　　　　　　　　
土山 和大, 松田 文浩, 向野 雅彦, 大塚 圭, 加賀谷 斉, 才藤 栄一
臨床歩行分析研究会定例会抄録集, 37回, 50, 51, 臨床歩行分析研究会, 2015年10月
日本語

BDNF Induced by Treadmill Training Contributes to the Suppression of Spasticity and Allodynia After Spinal Cord Injury via Upregulation of KCC2
Syoichi Tashiro, Munehisa Shinozaki, Masahiko Mukaino, Francois Renault-Mihara, Yoshiaki Toyama, Meigen Liu, Masaya Nakamura, Hideyuki Okano
NEUROREHABILITATION AND NEURAL REPAIR, 29, 7, 677, 689, SAGE PUBLICATIONS INC, 2015年08月, ［査読有り］
英語, 研究論文（学術雑誌）, Background. Spasticity and allodynia are major sequelae that affect the quality of life and daily activities of spinal cord injury (SCI) patients. Although rehabilitation ameliorates spasticity and allodynia, the molecular mechanisms involved in these processes remain elusive. Objective. To investigate the molecular mechanisms by which rehabilitation ameliorates spasticity and allodynia after SCI in rats. Methods. The expression levels of brain-derived neurotrophic factor (BDNF) and potassium-chloride cotransporter-2 (KCC2), as well as the localization of KCC2, were examined in the lumbar enlargements of untrained and treadmill-trained thoracic SCI model rats. Spasticity and allodynia were determined via behavioral and electrophysiological analyses. The effects of BDNF on spasticity, allodynia, and KCC2 activation were determined by inhibition of BDNF signaling via intrathecal administration of TrkB-IgG. The effects of SCI and training on the expression levels of functional phospholipase C- in the lumbar enlargement were also examined. Results. Treadmill training after SCI upregulated endogenous BDNF expression and posttranslational modification of KCC2 in the lumbar enlargement significantly. There were also significant correlations between increased KCC2 expression and ameliorated spasticity and allodynia. Administration of TrkB-IgG abrogated the training-induced upregulation of KCC2 and beneficial effects on spasticity and allodynia. The expression level of functional phospholipase C- was reduced significantly after SCI, which may have contributed to the change in the function of BDNF, whereby it did not trigger short-term downregulation or induce long-term upregulation of KCC2 expression secondary to training. Conclusions. BDNF-mediated restoration of KCC2 expression underlies the suppression of spasticity and allodynia caused by rehabilitation.

嚥下造影検査施行後に嚥下内視鏡検査を用いてフォローアップした症例の検討
山田 薫, 小野木 啓子, 加賀谷 斉, 柴田 斉子, 青柳 陽一郎, 向野 雅彦, 布施 郁子, 山岸 宏江, 陳 輝, 才藤 栄一, 尾関 恩
The Japanese Journal of Rehabilitation Medicine, 52, 7, 439, 439, (公社)日本リハビリテーション医学会, 2015年07月
日本語

【進歩した神経内科疾患の実地診療●一般実地医家の活用と実践のために】 解明著しい神経内科疾患と手法の進歩 神経リハビリテーション　　　　　　　　　　　　　　　
向野 雅彦, 才藤 栄一
Medical Practice, 32, 6, 1009, 1011, (株)文光堂, 2015年06月
日本語

歩行分析の指標としての機能的脚長
向野雅彦, 松田文浩, 大塚圭, 加賀谷斉, 米田千賀子, 今井幸恵, 山村怜子, 田中ともみ, 河村美穂, 八谷カナン, 才藤栄一
Jpn J Rehabil Med, 52, S402, 2015年05月18日
日本語

バランス練習アシストを用いた前後外乱に対する運動学的検討　　　　　　　　　　　　　　　
石原 健, 才藤 栄一, 平野 哲, 向野 雅彦, 伊藤 慎英, 田辺 茂雄, 矢箆原 隆造, 加藤 翼, 布施 郁子, 前田 博士, 山中 学
The Japanese Journal of Rehabilitation Medicine, 52, Suppl., S403, S403, (公社)日本リハビリテーション医学会, 2015年05月
日本語

脳卒中片麻痺患者に対する歩行練習アシスト(GEAR)の効果　　　　　　　　　　　　　　　
平野 哲, 才藤 栄一, 園田 茂, 向野 雅彦, 田辺 茂雄, 大塚 圭, 加藤 正樹, 伊藤 慎英, 谷野 元一, 山田 純也, 井元 大介
The Japanese Journal of Rehabilitation Medicine, 52, Suppl., S402, S402, (公社)日本リハビリテーション医学会, 2015年05月
日本語

耳朶式脈拍計を用いた脈拍測定の信頼性　　　　　　　　　　　　　　　
向野 雅彦, 山田 純也, 加藤 正樹, 大塚 圭, 尾関 恩, 小野木 啓子, 才藤 栄一
The Japanese Journal of Rehabilitation Medicine, 52, Suppl., S313, S313, (公社)日本リハビリテーション医学会, 2015年05月
日本語

歩行分析機器の臨床活用 トレッドミル歩行分析
大塚 圭, 才藤 栄一, 向野 雅彦, 松田 文浩, 谷川 広樹
臨床歩行分析研究会誌, 2, 1, 11, 15, 臨床歩行分析研究会, 2015年05月
日本語

練習支援リハビリテーションロボット
才藤栄一, 平野哲, 田辺茂雄, 向野雅彦, 加賀谷斉
日本医学会総会総会会誌, 29th, 91, 2015年
日本語

脳卒中片麻痺患者の足部のクリアランスは機能的脚長の短縮量と股関節挙上量によって規定される
土山和大, 松田文浩, 向野雅彦, 大塚圭, 貝沼啓昭, 日高雅大, 加賀谷斉, 才藤栄一
日本臨床医療福祉学会プログラム・抄録集, 13th, 98, 2015年
日本語

超高齢社会の幕開けと今後の日本 臨床に役立つQ&A 1.超高齢社会における医療・福祉ロボットの動向について教えてください
向野雅彦, 才藤栄一, 平野哲
Geriatr Med, 53, 1, 63, 65, 2015年01月01日
日本語

Influence of contralateral lower limb stabilization on hip abductor muscle strength measured by Hand-Held Dynamometer
Tanikawa Hiroki, Mukaino Masahiko, Matsuda Fumihiro, Inagaki Keisuke, Ohtsuka Kei, Kagaya Hitoshi, Saitoh Eiichi, Kanada Yoshikiyo
Japanese Journal of Comprehensive Rehabilitation Science, 6, 0, 137, 142, 一般社団法人 回復期リハビリテーション病棟協会, 2015年, ［査読有り］
英語, Tanikawa H, Mukaino M, Matsuda F, Inagaki K, Ohtsuka K, Kagaya H, Saitoh E, Kanada Y. Influence of contralateral lower limb stabilization on hip abductor muscle strength measured by Hand-Held Dynamometer. Jpn J Compr Rehabil Sci 2015; 6: 137-142.Objective: To investigate the influence of contralateral lower limb function on hip abductor muscle strength using a hand-held dynamometer.Method: Thirty healthy subjects and fifty-nine hemiplegic patients participated in this study. Hip abductor muscle strength was measured in the supine position with or without stabilization of the contralateral lower limb (stabilizing vs. nonstabilizing method, respectively). Strength as measured using both methods was compared on each side for the lower limb and correlation coefficients for the two methods were calculated. In addition, correlation coefficients between measurements of strength using the two methods on both sides were calculated. In the hemiplegic patients, multiple regression analysis was performed using the strength on the affected side as the dependent variable, and the strength on the unaffected side and the degree of paralysis as independent variables.Results: Strength measured using the stabilizing method was significantly lower than when using the nonstabilizing method. The correlation between the strength on both sides was high in the healthy subjects despite contralateral lower limb stabilization, but low in the hemiplegic patients when using the nonstabilizing method. The strength on the affected side was strongly influenced by the unaffected lower limb function in measurements using the stabilizing method.Discussion: Measurements of hip abduction strength when using the stabilizing method are not an accurate reflection of the strength due to the influence of contralateral lower limb function.

左下四分盲に対するコンピュータ化視野訓練装置による短期効果
山岸 宏江, 平野 哲, 加賀谷 斉, 小野木 啓子, 柴田 斉子, 向野 雅彦, 石原 健, 才藤 栄一, 太田 喜久夫, 尾関 恩
The Japanese Journal of Rehabilitation Medicine, 51, 12, 811, 811, (公社)日本リハビリテーション医学会, 2014年12月
日本語

Functional recovery from chronic writer's cramp by brain-computer interface rehabilitation: a case report
Yasunari Hashimoto, Tetsuo Ota, Masahiko Mukaino, Meigen Liu, Junichi Ushiba
BMC NEUROSCIENCE, 15, 103, BIOMED CENTRAL LTD, 2014年09月, ［査読有り］
英語, 研究論文（学術雑誌）, Background: Dystonia is often currently treated with botulinum toxin injections to spastic muscles, or deep brain stimulation to the basal ganglia. In addition to these pharmacological or neurosurgical measures, a new noninvasive treatment concept, functional modulation using a brain-computer interface, was tested for feasibility. We recorded electroencephalograms (EEGs) over the bilateral sensorimotor cortex from a patient suffering from chronic writer's cramp. The patient was asked to suppress an exaggerated beta frequency component in the EEG during hand extension.
Results: The patient completed biweekly one-hour training for 5 months without any adverse effects. Significant decrease of the beta frequency component during handwriting was confirmed, and was associated with clear functional improvement.
Conclusion: The current pilot study suggests that a brain-computer Interface can give explicit feedback of ongoing cortical excitability to patients with dystonia and allow them to suppress exaggerated neural activity, resulting in functional recovery.

EFFICACY OF BRAIN-COMPUTER INTERFACE-DRIVEN NEUROMUSCULAR ELECTRICAL STIMULATION FOR CHRONIC PARESIS AFTER STROKE
Masahiko Mukaino, Takashi Ono, Keiichiro Shindo, Toshiyuki Fujiwara, Tetsuo Ota, Akio Kimura, Meigen Liu, Junichi Ushiba
JOURNAL OF REHABILITATION MEDICINE, 46, 4, 378, 382, FOUNDATION REHABILITATION INFORMATION, 2014年04月, ［査読有り］
英語, 研究論文（学術雑誌）, Objective: Brain computer interface technology is of great interest to researchers as a potential therapeutic measure for people with severe neurological disorders. The aim of this study was to examine the efficacy of brain computer interface, by comparing conventional neuromuscular electrical stimulation and brain computer interface-driven neuromuscular electrical stimulation, using an A-B-A-B withdrawal single-subject design.
Methods: A 38-year-old male with severe hemiplegia due to a putaminal haemorrhage participated in this study. The design involved 2 epochs. In epoch A, the patient attempted to open his fingers during the application of neuromuscular electrical stimulation, irrespective of his actual brain activity. In epoch B, neuromuscular electrical stimulation was applied only when a significant motor-related cortical potential was observed in the electroencephalogram.
Results: The subject initially showed diffuse functional magnetic resonance imaging activation and small electroencephalogram responses while attempting finger movement. Epoch A was associated with few neurological or clinical signs of improvement. Epoch B, with a brain computer interface, was associated with marked lateralization of electroencephalogram (EEG) and blood oxygenation level dependent responses. Voluntary electromyogram (EMG) activity, with significant EEG EMG coherence, was also prompted. Clinical improvement in upper-extremity function and muscle tone was observed.
Conclusion: These results indicate that self-directed training with a brain computer interface may induce activity-dependent cortical plasticity and promotefunctional recovery. This preliminary clinical investigation encourages further research using a controlled design.

Rewiring of regenerated axons by combining treadmill training with semaphorin3A inhibition
Liang Zhang, Shinjiro Kaneko, Kaoru Kikuchi, Akihiko Sano, Miho Maeda, Akiyoshi Kishino, Shinsuke Shibata, Masahiko Mukaino, Yoshiaki Toyama, Meigen Liu, Toru Kimura, Hideyuki Okano, Masaya Nakamura
MOLECULAR BRAIN, 7, 14, BIOMED CENTRAL LTD, 2014年03月, ［査読有り］
英語, 研究論文（学術雑誌）, Background: Rats exhibit extremely limited motor function recovery after total transection of the spinal cord (SCT). We previously reported that SM-216289, a semaphorin3A inhibitor, enhanced axon regeneration and motor function recovery in SCT adult rats. However, these effects were limited because most regenerated axons likely do not connect to the right targets. Thus, rebuilding the appropriate connections for regenerated axons may enhance recovery. In this study, we combined semaphorin3A inhibitor treatment with extensive treadmill training to determine whether combined treatment would further enhance the "rewiring" of regenerated axons. In this study, which aimed for clinical applicability, we administered a newly developed, potent semaphorin3A inhibitor, SM-345431 (Vinaxanthone), using a novel drug delivery system that enables continuous drug delivery over the period of the experiment.
Results: Treatment with SM-345431 using this delivery system enhanced axon regeneration and produced significant, but limited, hindlimb motor function recovery. Although extensive treadmill training combined with SM-345431 administration did not further improve axon regeneration, hindlimb motor performance was restored, as evidenced by the significant improvement in the execution of plantar steps on a treadmill. In contrast, control SCT rats could not execute plantar steps at any point during the experimental period. Further analyses suggested that this strategy reinforced the wiring of central pattern generators in lumbar spinal circuits, which, in turn, led to enhanced motor function recovery (especially in extensor muscles).
Conclusions: This study highlights the importance of combining treatments that promote axon regeneration with specific and appropriate rehabilitations that promote rewiring for the treatment of spinal cord injury.

Brain-computer interface with somatosensory feedback improves functional recovery from severe hemiplegia due to chronic stroke.
Ono T, Shindo K, Kawashima K, Ota N, Ito M, Ota T, Mukaino M, Fujiwara T, Kimura A, Liu M, Ushiba J
Frontiers in neuroengineering, 7, 19, Frontiers Media SA, 2014年, ［査読有り］
研究論文（学術雑誌）

アトピー性脊髄炎による運動障害に対するリハビリテーション
吉田 直樹, 福岡 哲男, 今西 幸仁, 藤井 良憲, 向野 雅彦, 大田 哲生
The Japanese Journal of Rehabilitation Medicine, 50, 5, 339, 344, 2013年
日本語, 雑誌掲載版http://scpj.tulips.tsukuba.ac.jp/info/nii.html症例は35歳女性で、幼少期よりアトピー性皮膚炎があった。歩行時のふらつきが出現し、徐々に運動障害が進行して複数の病院を受診したが諸検査で異常は指摘されず、廃用症候群の診断で紹介受診した。両下肢はMMT 2で筋緊張は亢進し、ADL重介助の状態であり、精査のため神経内科紹介とした。頸部MRIで異常所見を認めなかったが、著明な血中IgE値の上昇と中枢運動伝導速度の低下よりアトピー性脊髄炎と診断された。ステロイドパルス療法と血漿交換療法を行い、リハビリテーション後に再来院した。基本動作およびADL向上を目的に訓練を開始し、歩行は右足部の内反傾向が強かったため右金属支柱付き短下肢装具を製作して立位・歩行練習を行った。両松葉杖で歩行可能となり5ヵ月後に自宅退院した。外来リハを継続し、A型ボツリヌス毒素製剤注射、バクロフェン内服で筋緊張は軽減したが、動揺性変化に備えて左金属支柱付き短下肢装具を製作し、使用を指導した。

Functional recovery in upper limb function in stroke survivors by using brain-computer interface A single case A-B-A-B design
Takashi Ono, Masahiko Mukaino, Junichi Ushiba
2013 35TH ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY (EMBC), 2013, 265, 268, IEEE, 2013年, ［査読有り］
英語, 研究論文（国際会議プロシーディングス）, Resent studies suggest that brain-computer interface (BCI) training for chronic stroke patient is useful to improve their motor function of paretic hand. However, these studies does not show the extent of the contribution of the BCI clearly because they prescribed BCI with other rehabilitation systems, e. g. an orthosis itself, a robotic intervention, or electrical stimulation. We therefore compared neurological effects between interventions with neuromuscular electrical stimulation (NMES) with motor imagery and BCI-driven NMES, employing an ABAB experimental design. In epoch A, the subject received NMES on paretic extensor digitorum communis (EDC). The subject was asked to attempt finger extension simultaneously. In epoch B, the subject received NMES when BCI system detected motor-related electroencephalogram change while attempting motor imagery. Both epochs were carried out for 60 min per day, 5 days per week. As a result, EMG activity of EDC was enhanced by BCI-driven NMES and significant cortico-muscular coherence was observed at the final evaluation. These results indicate that the training by BCI-driven NMES is effective even compared to motor imagery combined with NMES, suggesting the superiority of closed-loop training with BCI-driven NMES to open-loop NMES for chronic stroke patients.
T. Ono and M. Mukaino contributed equally to this work.

Treatment effectiveness of brain-computer interface training for patients with focal hand dystonia: a double-case study
Yasunari Hashimoto, Tetsuo Ota, Masahiko Mukaino, Junichi Ushiba
2013 35TH ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY (EMBC), 2013, 273, 276, IEEE, 2013年, ［査読有り］
英語, 研究論文（国際会議プロシーディングス）, Neuronal mechanism underlying dystonia is poorly understood. Dystonia can be treated with botulinum toxin injections or deep brain stimulation but these methods are not available for every patient therefore we need to consider other methods Our study aimed to develop a novel rehabilitation training using brain-computer interface system that decreases neural overexcitation in the sensorimotor cortex by bypassing brain and external world without the normal neuromuscular pathway. To achieve this purpose, we recorded electroencephalograms (10 channels) and forearm electromyograms (3 channels) from 2 patients with the diagnosis of writer's cramp and healthy control participants as a preliminary experiment. The patients were trained to control amplitude of their electroencephalographic signal using feedback from the brain-computer interface for 1 hour a day and then continued the training twice a month. After the 5-month training, a patient clearly showed reduction of dystonic movement during writing.

脳卒中回復期患者における尿意回復の予測因子
川上 途行, 向野 雅彦, 里宇 明元, 和田 彩子, 堀江 温子, 片平 真佐子, 安西 敦子, 大塚 友吉, 藤原 俊之, 辻 哲也, 長谷 公隆, 木村 彰男
The Japanese Journal of Rehabilitation Medicine, 49, Suppl., S197, S197, (公社)日本リハビリテーション医学会, 2012年05月
日本語

ニューロリハビリテーションとアンチエイジング　　　　　　　　　　　　　　　
向野 雅彦, 里宇明元
分子脳血管病, 11, 2, 169, 173, 2012年

Beneficial compaction of spinal cord lesion by migrating astrocytes through glycogen synthase kinase-3 inhibition
Francois Renault-Mihara, Hiroyuki Katoh, Takeshi Ikegami, Akio Iwanami, Masahiko Mukaino, Akimasa Yasuda, Satoshi Nori, Yo Mabuchi, Hirobumi Tada, Shinsuke Shibata, Ken Saito, Masayuki Matsushita, Kozo Kaibuchi, Seiji Okada, Yoshiaki Toyama, Masaya Nakamura, Hideyuki Okano
EMBO MOLECULAR MEDICINE, 3, 11, 682, 696, WILEY-BLACKWELL, 2011年11月
英語, 研究論文（学術雑誌）, The migratory response of astrocytes is essential for restricting inflammation and preserving tissue function after spinal cord injury (SCI), but the mechanisms involved are poorly understood. Here, we observed stimulation of in vitro astrocyte migration by the new potent glycogen synthase kinase-3 (GSK-3) inhibitor Ro3303544 and investigated the effect of Ro3303544 administration for 5 days following SCI in mice. This treatment resulted in accelerated migration of reactive astrocytes to sequester inflammatory cells that spared myelinated fibres and significantly promoted functional recovery. Moreover, the decreased extent of chondroitin sulphate proteoglycans and collagen IV demonstrated that scarring was reduced in Ro3303544-treated mice. A variety of in vitro and in vivo experiments further suggested that GSK-3 inhibition stimulated astrocyte migration by decreasing adhesive activity via reduced surface expression of beta 1-integrin. Our results reveal a novel benefit of GSK-3 inhibition for SCI and suggest that the stimulation of astrocyte migration is a feasible therapeutic strategy for traumatic injury in the central nervous system.

水中環境が歩行に及ぼす影響
宇内 景, 向野 雅彦, 田代 祥一, 當山 峰道, 新藤 恵一郎, 大田 哲生, 木村 彰男, 里宇 明元
The Japanese Journal of Rehabilitation Medicine, 48, Suppl., S235, S235, (公社)日本リハビリテーション医学会, 2011年10月
日本語

再生医療 臨床応用へ向けての現状と課題 リハビリテーションの果たす役割
向野 雅彦, 里宇明元, 木村 彰男
総合リハビリテーション, 39, 1, 7, 11, 医学書院, 2011年
日本語

各種難病の最新治療情報 脳卒中の後遺症の治療 リハビリテーションの現状と今後の展望
向野 雅彦, 木村 彰男
難病と在宅ケア, 17, 7, 49, 52, 日本プランニングセンター, 2011年
日本語

Novel Concept of Motor Functional Analysis for Spinal Cord Injury in Adult Mice
Munehisa Shinozaki, Yuichiro Takahashi, Masahiko Mukaino, Nobuhito Saito, Yoshiaki Toyama, Hideyuki Okano, Masaya Nakamura
JOURNAL OF BIOMEDICINE AND BIOTECHNOLOGY, 2011, HINDAWI PUBLISHING CORPORATION, 2011年
英語, 研究論文（学術雑誌）, In basic research on spinal cord injury (SCI), behavioral evaluation of the SCI animal model is critical. However, it is difficult to accurately evaluate function in the mouse SCI model due to the small size of mice. Although the open-field scoring scale is an outstanding appraisal method, supplementary objective tests are required. Using a compact SCANET system, in which a mouse carries out free movement for 5 min, we developed a novel method to detect locomotor ability. A SCANET system samples the horizontal coordinates of a mouse every 0.1 s, and both the speed and acceleration of its motion are calculated at each moment. It was found that the maximum speed and acceleration of motion over 5 min varied by injury severity. Moreover, these values were significantly correlated with open-field scores. The maximum speed and acceleration of SCI model mice using a SCANET system are objective, easy to obtain, and reproducible for evaluating locomotive function.

Beneficial compaction of spinal cord lesion by migrating astrocytes through glycogen synthase kinase-3 inhibition.
Renault-Mihara F, Katoh H, Ikegami T, Iwanami A, Mukaino M, Yasuda A, Nori S, Mabuchi Y, Tada H, Shibata S, Saito K, Matsushita M, Kaibuchi K, Okada S, Toyama Y, Nakamura M, Okano H
EMBO. Mol. Med., 2011年, ［査読有り］
英語, 研究論文（学術雑誌）

損傷脊髄の再生医療　　　　　　　　　　　　　　　
向野雅彦, 中村雅也
Journal of Clinical Rehabilitation, 20, 5, 456, 459, 2011年

Anti-IL-6-receptor antibody promotes repair of spinal cord injury by inducing microglia-dominant inflammation
Masahiko Mukaino, Masaya Nakamura, Osamu Yamada, Seiji Okada, Satoru Morikawa, Francois Renault-Mihara, Akio Iwanami, Takeshi Ikegami, Yoshiyuki Ohsugi, Osahiko Tsuji, Hiroyuki Katoh, Yumi Matsuzaki, Yoshiaki Toyama, Meigen Liu, Hideyuki Okano
EXPERIMENTAL NEUROLOGY, 224, 2, 403, 414, ACADEMIC PRESS INC ELSEVIER SCIENCE, 2010年08月
英語, 研究論文（学術雑誌）, We previously reported the beneficial effect of administering an anti-mouse IL-6 receptor antibody (MR16-1) immediately after spinal cord injury (SCI). The purpose of our present study was to clarify the mechanism underlying how MR16-1 improves motor function after SCI. Quantitative analyses of inflammatory cells using flow cytometry, and immunohistochemistry with bone marrow-chimeric mice generated by transplanting genetically marked purified hematopoietic stem cells, revealed that MR16-1 dramatically switched the central player in the post-traumatic inflammation, from hematogenous macrophages to resident microglia. This change was accompanied by alterations in the expression of relevant cytokines within the injured spinal cord; the expression of recruiting chemokines including CCL2, CCL5, and CXCL10 was decreased, while that of Granulocyte/Macrophage-Colony Stimulating Factor (GM-CSF), a known mitogen for microglia, was increased. We also showed that the resident microglia expressed higher levels of phagocytic markers than the hematogenous macrophages. Consistent with these findings, we observed significantly decreased tissue damage and reduced levels of myelin debris and Nogo-A, the axonal growth inhibitor, by MR16-1 treatment. Moreover, we observed increased axonal regeneration and/or sprouting in the MR16-1-treated mice. Our findings indicate that the functional improvement elicited by MR16-1 involves microglial functions, and provide new insights into the role of IL-6 signaling in the pathology of SCI. (C) 2010 Elsevier Inc. All rights reserved.

Anti-IL-6-receptor antibody promotes repair of spinal cord injury by inducing microglia-dominant inflammation
Mukaino, M, Nakamura, M, Yamada, O, Okada, S, Morikawa, S, Renault-Mihara, F, Iwanami, A, Ikegami, T, Ohsugi, Y, Tsuji, O, Katoh, H, Matsuzaki, Y, Toyama, Y, Liu, M, Okano, H
Exp Neurol, 224, 2, 403, 14, 2010年08月, ［国際誌］
英語, 研究論文（学術雑誌）, We previously reported the beneficial effect of administering an anti-mouse IL-6 receptor antibody (MR16-1) immediately after spinal cord injury (SCI). The purpose of our present study was to clarify the mechanism underlying how MR16-1 improves motor function after SCI. Quantitative analyses of inflammatory cells using flow cytometry, and immunohistochemistry with bone marrow-chimeric mice generated by transplanting genetically marked purified hematopoietic stem cells, revealed that MR16-1 dramatically switched the central player in the post-traumatic inflammation, from hematogenous macrophages to resident microglia. This change was accompanied by alterations in the expression of relevant cytokines within the injured spinal cord; the expression of recruiting chemokines including CCL2, CCL5, and CXCL10 was decreased, while that of Granulocyte/Macrophage-Colony Stimulating Factor (GM-CSF), a known mitogen for microglia, was increased. We also showed that the resident microglia expressed higher levels of phagocytic markers than the hematogenous macrophages. Consistent with these findings, we observed significantly decreased tissue damage and reduced levels of myelin debris and Nogo-A,

Therapeutic potential of appropriately evaluated safe-induced pluripotent stem cells for spinal cord injury
Osahiko Tsuji, Kyoko Miura, Yohei Okada, Kanehiro Fujiyoshi, Masahiko Mukaino, Narihito Nagoshi, Kazuya Kitamura, Gentaro Kumagai, Makoto Nishino, Shuta Tomisato, Hisanobu Higashi, Toshihiro Nagai, Hiroyuki Katoh, Kazuhisa Kohda, Yumi Matsuzaki, Michisuke Yuzaki, Eiji Ikeda, Yoshiaki Toyama, Masaya Nakamura, Shinya Yamanaka, Hideyuki Okano
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 107, 28, 12704, 12709, NATL ACAD SCIENCES, 2010年07月
英語, 研究論文（学術雑誌）, Various types of induced pluripotent stem (iPS) cells have been established by different methods, and each type exhibits different biological properties. Before iPS cell-based clinical applications can be initiated, detailed evaluations of the cells, including their differentiation potentials and tumorigenic activities in different contexts, should be investigated to establish their safety and effectiveness for cell transplantation therapies. Here we show the directed neural differentiation of murine iPS cells and examine their therapeutic potential in a mouse spinal cord injury (SCI) model. "Safe" iPS-derived neurospheres, which had been pre-evaluated as nontumorigenic by their transplantation into nonobese diabetic/severe combined immunodeficiency (NOD/SCID) mouse brain, produced electrophysiologically functional neurons, astrocytes, and oligodendrocytes in vitro. Furthermore, when the safe iPS-derived neurospheres were transplanted into the spinal cord 9 d after contusive injury, they differentiated into all three neural lineages without forming teratomas or other tumors. They also participated in remyelination and induced the axonal regrowth of host 5HT(+) serotonergic fibers, promoting locomotor function recovery. However, the transplantation of iPS-derived neurospheres pre-evaluated as "unsafe" showed robust teratoma formation and sudden locomotor functional loss after functional recovery in the SCI model. These findings suggest that pre-evaluated safe iPS clone-derived neural stem/progenitor cells may be a promising cell source for transplantation therapy for SCI.

脳卒中の転帰に影響する機能障害所見の検討
向野 雅彦, 赤星 和人, 小林 由紀子, 森 俊樹, 永田 雅章, 里宇 明元
The Japanese Journal of Rehabilitation Medicine, 47, Suppl., S278, S278, (公社)日本リハビリテーション医学会, 2010年04月
日本語

帯状疱疹による多発脳神経障害で嚥下障害を来たした症例のリハビリテーション
小林 由紀子, 赤星 和人, 田代 祥一, 向野 雅彦, 森 俊樹, 永田 雅章, 里宇 明元
The Japanese Journal of Rehabilitation Medicine, 47, Suppl., S283, S283, (公社)日本リハビリテーション医学会, 2010年04月
日本語

Roles of ES Cell-Derived Gliogenic Neural Stem/Progenitor Cells in Functional Recovery after Spinal Cord Injury
Gentaro Kumagai, Yohei Okada, Junichi Yamane, Narihito Nagoshi, Kazuya Kitamura, Masahiko Mukaino, Osahiko Tsuji, Kanehiro Fujiyoshi, Hiroyuki Katoh, Seiji Okada, Shinsuke Shibata, Yumi Matsuzaki, Satoshi Toh, Yoshiaki Toyama, Masaya Nakamura, Hideyuki Okano
PLOS ONE, 4, 11, e7706, e7706, PUBLIC LIBRARY SCIENCE, 2009年11月
英語, 研究論文（学術雑誌）, Transplantation of neural stem/progenitor cells (NS/PCs) following the sub-acute phase of spinal cord injury (SCI) has been shown to promote functional recovery in rodent models. However, the types of cells most effective for treating SCI have not been clarified. Taking advantage of our recently established neurosphere-based culture system of ES cell-derived NS/PCs, in which primary neurospheres (PNS) and passaged secondary neurospheres (SNS) exhibit neurogenic and gliogenic potentials, respectively, here we examined the distinct effects of transplanting neurogenic and gliogenic NS/PCs on the functional recovery of a mouse model of SCI. ES cell-derived PNS and SNS transplanted 9 days after contusive injury at the Th10 level exhibited neurogenic and gliogenic differentiation tendencies, respectively, similar to those seen in vitro. Interestingly, transplantation of the gliogenic SNS, but not the neurogenic PNS, promoted axonal growth, remyelination, and angiogenesis, and resulted in significant locomotor functional recovery after SCI. These findings suggest that gliogenic NS/PCs are effective for promoting the recovery from SCI, and provide essential insight into the mechanisms through which cellular transplantation leads to functional improvement after SCI.

脊髄損傷に対するES細胞由来神経幹細胞移植効果の違い
熊谷 玄太郎, 岡田 洋平, 山根 淳一, 名越 慈人, 北村 和也, 向野 雅彦, 辻 収彦, 藤 哲, 岡野 栄之, 戸山 芳昭, 中村 雅也
日本整形外科学会雑誌, 82, 8, S913, S913, (公社)日本整形外科学会, 2008年08月
日本語

Role of IL-6 in regulation of inflammation and stem cell differentiation in CNS trauma
Masahiko Mukaino, Masaya Nakamura, Seiji Okada, Yoshiaki Toyama, Meigen Liu, Hideyuki Okano
Nihon Rinshō Men'eki Gakkai kaishi = Japanese journal of clinical immunology, 31, 2, 93, 98, 2008年04月, ［査読有り］
Interleukin-6 (IL-6) has been demonstrated to play a pivotal role in CNS trauma as a proinflammatory cytokine which regulates inflammatory response. Not only being a mediator of inflammation, but IL-6 induces neural stem/progenitor cells to undergo astrocytic differentiation selectively in the injured CNS. These effects are considered to coordinate to prevent the CNS repair after traumatic injury. Consistently, we previously reported that the administration of anti-IL-6 receptor antibody (MR16-1) immediately after spinal cord injury in mice decreased the number of invading inflammatory cells and the severity of connective tissue scar formation, and led to improved functional recovery. These findings suggest that neutralization of IL-6 signaling in the acute phase of SCI will be beneficial for CNS repair. A critical merit of this anti-IL-6 receptor antibody is that humanized antibody to human IL-6 receptor (MRA; Atlizumab) has already been reshaped. However, there are several studies which show beneficial aspects of IL-6 signaling in the pathology of CNS trauma. Further investigation of the mechanisms how MR16-1 reduces tissue damage should be required for clinical application.

Anti IL-6 antibody treatment reduces the infiltration of hematogenous macrophages into the injured spinal cord
Masahiko Mukaino, Masaya Nakamura, Osama Yamada, Seiji Okada, Satoru Morikawa, Yoshiyuki Osugi, Yumi Matsuzaki, Yoshiaki Toyama, Hideyuki Okano
NEUROSCIENCE RESEARCH, 61, S275, S275, ELSEVIER IRELAND LTD, 2008年
英語, 研究論文（学術雑誌）

脊髄損傷に対する抗IL-6受容体抗体の有効性の検討 損傷脊髄内の免疫反応に注目して　　　　　　　　　　　　　　　
向野 雅彦, 中村 雅也, 山田 理, 岡田 誠司, 山根 淳一, 大杉 義征, 松崎 有未, 戸山 芳昭, 里宇 明元, 岡野 栄之
Inflammation and Regeneration, 27, 4, 376, 376, (一社)日本炎症・再生医学会, 2007年07月
日本語

褥瘡に対して持続吸引療法を行った頸髄損傷患者の1例
山田 深, 川上 途行, 向野 雅彦, 田中 尚文, 長谷 公隆, 高橋 宣成, 鈴木 幹次郎, 松本 真以子, 里宇 明元, 千野 直一
リハビリテーション医学, 41, 2, 119, 120, (公社)日本リハビリテーション医学会, 2004年02月
日本語

脳出血後の易怒性に対して反復経頭蓋磁気刺激を実施した1例　　　　　　　　　　　　　　　
若林 央樹, 小川 真央, 梅森 秀, 遠山 晴一, 小金丸 聡子, 向野 雅彦, The Japanese Journal of Rehabilitation Medicine, 60, 秋季特別号, S390, S390, 2023年10月
(公社)日本リハビリテーション医学会, 日本語

リハビリテーション病棟脳卒中患者を対象としたウェアラブルデバイスを用いたFIMの将来予測
小笠原隆行, 和田義敬, 向野雅彦, 才藤栄一, 塚田信吾, 大高洋平, 山口真澄, 人工知能学会全国大会論文集(Web), 37th, 2023年

足内反に対するボツリヌス療法は歩容を変えるか?三次元トレッドミル歩行分析を用いた検討
伊藤翔太, 伊藤翔太, 谷川広樹, 加賀谷斉, 寺西利生, 向野雅彦, 藤村健太, 近藤輝, 近藤輝, 小関秀宙, 平野哲, 才藤栄一, 臨床歩行分析研究会定例会抄録集, 42nd (CD-ROM), 2021年

三次元動作解析を用いてボツリヌス療法の治療効果判定を行った1症例
蟹井貴也, 伊藤翔太, 伊藤翔太, 谷川広樹, 近藤輝, 小関秀宙, 向野雅彦, 加賀谷斉, 臨床歩行分析研究会定例会抄録集, 42nd (CD-ROM), 2021年

ICD-11に新たに導入された生活機能評価に関する補助セクション「V章」の活用及び普及に向けた研究 ICFの評点の採点用ガイドの作成,検証およびフィールドテストの実施
向野雅彦, 山田深, 大夛賀政昭, 出江紳一, ICD-11に新たに導入された生活機能評価に関する補助セレクション「V章」の活用及び普及に向けた研究 令和2年度 総括・分担研究報告書(Web), 2021年

脳卒中入院患者のリハビリテーション活動量向上のためのウェアラブルデバイスを用いた行動変容
小笠原隆行, 向野雅彦, 大高洋平, 山口真澄, 才藤栄一, 塚田信吾, 情報処理学会シンポジウムシリーズ(CD-ROM), 2021, 1, 2021年

脳卒中患者における日常の活動量と血清アルブミン値およびヘモグロビン値との相関の検討
和田義敬, 向野雅彦, 小笠原隆行, 松田文浩, 才藤栄一, 大高洋平, Japanese Journal of Rehabilitation Medicine, 58, Autumn, 2021年

脳血管疾患患者の退院時の歩行自立に関連する活動量関連パラメータの検討
松浦広昂, 松浦広昂, 向野雅彦, 鈴木卓弥, 小笠原隆行, 和田勇治, 青柳陽一郎, 青柳陽一郎, 大高洋平, Japanese Journal of Rehabilitation Medicine, 58, Autumn, 2021年

ウェアラブルデータと機械学習を用いた回復期リハビリ病棟脳卒中患者の機能指標(FIM)予測
小笠原隆行, 田中健太郎, 向野雅彦, 大高洋平, 山口真澄, 才藤栄一, 塚田信吾, 人工知能学会全国大会(Web), 35th, 2021年

ボツリヌス治療により歩行中の過度な肘屈曲と足内反が改善した1例
小関秀宙, 小関秀宙, 小関秀宙, 谷川広樹, 加賀谷斉, 近藤輝, 伊藤翔太, 寺西利生, 向野雅彦, 大高洋平, 才藤栄一, 日本ニューロリハビリテーション学会学術集会プログラム・抄録集, 11th, 2020年

介入肢位の違いが下腿三頭筋の痙縮に対する振動刺激効果に及ぼす影響
近藤輝, 谷川広樹, 向野雅彦, 伊藤翔太, 加藤正樹, 寺西利生, 大高洋平, 才藤栄一, 日本ニューロリハビリテーション学会学術集会プログラム・抄録集, 11th, 2020年

Smart clothingシステムを用いた加速度測定による活動量の定量
古澤章太郎, 向野雅彦, 小笠原隆行, 鈴木卓弥, 山田ゆりえ, 犬飼絢香, 松田文浩, 塚田信吾, 中島寛, 加藤正樹, 松浦広昂, 才藤栄一, 大高洋平, Japanese Journal of Rehabilitation Medicine, 57, Autumn, 2020年

リハビリテーション病棟における脳卒中リハビリ患者の運動機能と日常における運動強度との関連性
小笠原隆行, 松永賢一, 都甲浩芳, 向野雅彦, 電子情報通信学会大会講演論文集(CD-ROM), 2020, 2020年

hitoeシステムによる運動強度測定の妥当性の検証　　　　　　　　　　　　　　　
松浦 広昂, 向野 雅彦, 大高 洋平, 小笠原 隆行, 青嶋 保志, 鈴木 卓弥, 藤野 宏紀, 楠戸 正子, 才藤 栄一, The Japanese Journal of Rehabilitation Medicine, 56, 特別号, 2, 1, 2019年05月
(公社)日本リハビリテーション医学会, 日本語

関節抵抗トルク測定装置による速度依存的な痙縮評価
伊藤 翔太, 谷川 広樹, 向野 雅彦, 近藤 輝, 藤村 健太, 寺西 利生, 大塚 圭, 加藤 正樹, 加賀谷 斉, 才藤 栄一, The Japanese Journal of Rehabilitation Medicine, 56, 特別号, 2, P1K, 2019年05月
(公社)日本リハビリテーション医学会, 日本語

加齢が健常者歩行のToe clearanceとばらつきに与える影響　　　　　　　　　　　　　　　
村上 涼, 大塚 圭, 向野 雅彦, 山田 純也, 松田 文浩, 土山 和大, 才藤 栄一, 愛知県理学療法学会誌, 31, 特別号, 38, 38, 2019年03月
(NPO)愛知県理学療法学会, 日本語

Basic Neuroscience 神経生理 動物での脊髄障害と歩行　　　　　　　　　　　　　　　
向野 雅彦, Annual Review神経, 2019, 8, 14, 2019年03月
(株)中外医学社, 日本語

手すりの使用が片麻痺者のトレッドミル歩行に及ぼす影響
松田文浩, 大塚圭, 向野雅彦, 山田純也, 谷川広樹, 土山和大, 才藤栄一, 日本ニューロリハビリテーション学会学術集会プログラム・抄録集, 10th, 2019年

hitoeシステムを利用した回復期病棟入院患者の活動量の横断的調査
鈴木卓弥, 向野雅彦, 松浦広昂, 青嶋保志, 大河内由紀, 犬飼絢香, 服部恵実, 山田ゆりえ, 加藤正樹, 小笠原隆行, 才藤栄一, Japanese Journal of Rehabilitation Medicine, 56, Supplement, 2019年

回復期リハビリテーション病棟入院患者における運動強度とADL自立度の関係
青嶋保志, 向野雅彦, 松浦広昴, 松田文浩, 大河内由紀, 鈴木卓弥, 山田ゆりえ, 加藤正樹, 小笠原隆行, 才藤栄一, 東海北陸理学療法学術大会誌, 35th, 2019年

リハビリテーション患者のADL評価と入院中の生活活動の関連性
豊田新, 小笠原隆行, 佐藤里江子, 松永賢一, 向野雅彦, 電子情報通信学会大会講演論文集(CD-ROM), 2019, 2019年

リハビリテーション病棟における脳卒中リハビリ患者の運動機能と日常における活動状態との関連性
小笠原隆行, 佐藤里江子, 松永賢一, 向野雅彦, 電子情報通信学会大会講演論文集(CD-ROM), 2019, 2019年

リハビリ患者の活動状態モニタリング結果のフィードバック
佐藤里江子, 小笠原隆行, 豊田新, 松永賢一, 向野雅彦, 電子情報通信学会大会講演論文集(CD-ROM), 2019, 2019年

片麻痺患者に対する治療指向的トレッドミル歩行分析　　　　　　　　　　　　　　　
才藤 栄一, 向野 雅彦, 大塚 圭, The Japanese Journal of Rehabilitation Medicine, 55, 秋季特別号, S123, S123, 2018年10月
(公社)日本リハビリテーション医学会, 日本語

「心身機能・構造」「活動・参加」についての医師と作業療法士の連携 ICFの概論および臨床応用に向けた取り組み　　　　　　　　　　　　　　　
向野 雅彦, The Japanese Journal of Rehabilitation Medicine, 55, 秋季特別号, S235, S235, 2018年10月
(公社)日本リハビリテーション医学会, 日本語

ICF generic-30 setを用いた生活機能及び環境依存性の評価　　　　　　　　　　　　　　　
向野 雅彦, 千手 佑樹, 清水 康裕, 小池 知治, 米田 千賀子, 尾関 保則, 園田 茂, 才藤 栄一, The Japanese Journal of Rehabilitation Medicine, 55, 秋季特別号, S293, S293, 2018年10月
(公社)日本リハビリテーション医学会, 日本語

ELFプロジェクト Project of Exercise Log in FHUR当施設急性期病院と回復期病院における言語聴覚療法の比較と分析　　　　　　　　　　　　　　　
桑原 亜矢子, 稲本 陽子, 佐藤 百合子, 山路 千明, 加藤 正樹, 寺西 利生, 山田 将之, 向野 雅彦, 才藤 栄一, 言語聴覚研究, 15, 3, 240, 240, 2018年09月
(一社)日本言語聴覚士協会, 日本語

ロボットを使用した課題指向型リハビリテーション医療
近藤 和泉, 橋爪 美春, 加藤 健治, 向野 雅彦, Journal of Clinical Rehabilitation, 27, 6, 538, 542, 2018年06月
医歯薬出版(株), 日本語

リハビリテーション医療の臨床における歩行分析　　　　　　　　　　　　　　　
向野 雅彦, The Japanese Journal of Rehabilitation Medicine, 55, 特別号, S365, S365, 2018年05月
(公社)日本リハビリテーション医学会, 日本語

リハビリテーション医療における活動モニタリング　　　　　　　　　　　　　　　
向野 雅彦, The Japanese Journal of Rehabilitation Medicine, 55, 特別号, S467, S467, 2018年05月
(公社)日本リハビリテーション医学会, 日本語

国際生活機能分類を用いた生活機能の標準化指標作成の取り組み　　　　　　　　　　　　　　　
向野 雅彦, 才藤 栄一, 園田 茂, 岡崎 英人, 河村 美穂, 米田 千賀子, 尾関 保則, 小口 和代, 清水 康裕, 小池 知治, 戸田 芙美, 近藤 和泉, The Japanese Journal of Rehabilitation Medicine, 55, 特別号, 4, 4, 2018年05月
(公社)日本リハビリテーション医学会, 日本語

ICFリハビリテーションセットb項目における患者アンケート調査と医療者評価の比較　　　　　　　　　　　　　　　
千手 佑樹, 向野 雅彦, 渡邉 誠, 大河内 由紀, 水谷 公司, 才藤 栄一, 園田 茂, The Japanese Journal of Rehabilitation Medicine, 55, 特別号, 4, 4, 2018年05月
(公社)日本リハビリテーション医学会, 日本語

脳卒中片麻痺者における平地歩行とトレッドミル歩行の運動学的因子の比較　　　　　　　　　　　　　　　
山田 純也, 向野 雅彦, 大塚 圭, 松田 文浩, 谷川 広樹, 土山 和大, 日高 雅大, 伊東 慶, 安藤 大智, 王 裕香, 才藤 栄一, The Japanese Journal of Rehabilitation Medicine, 55, 特別号, 4, KP, 2018年05月
(公社)日本リハビリテーション医学会, 日本語

IoTの進展に向けた研究開発の取り組み ウェアラブル素材hitoeを応用したリハビリ支援の取り組み
小笠原隆行, 小笠原隆行, 松永賢一, 伊藤広樹, 大嶋尚一, 向野雅彦, NTT技術ジャーナル, 30, 7, 2018年

入院中の生活活動に着目したリハビリテーションアプローチの提案
豊田新, 小笠原隆行, 小笠原隆行, 松永賢一, 向野雅彦, 電子情報通信学会大会講演論文集(CD-ROM), 2018, 2018年

術前運動機能評価に基づく低侵襲人工股関節置換術(MIS‐THA)後の帰結予測
向野雅彦, 山田純也, 小桑隆, 大塚圭, 谷川広樹, 近藤環, 才藤栄一, 加賀谷斉, 森田充浩, 山田治基, 日本股関節学会学術集会プログラム・抄録集, 45th, 620, 2018年
日本語

3次元動作解析による低侵襲人工股関節全置換術(MIS‐THA)前後の運動学的因子の比較
小桑隆, 向野雅彦, 大塚圭, 谷川広樹, 山田純也, 近藤環, 才藤栄一, 加賀谷斉, 山田治基, 森田充浩, 日本股関節学会学術集会プログラム・抄録集, 45th, 618, 2018年
日本語

3次元動作解析による低侵襲人工股関節全置換術における術後早期の運動学的因子の比較
近藤環, 向野雅彦, 大塚圭, 谷川広樹, 山田純也, 小桑隆, 才藤栄一, 加賀谷斉, 山田治基, 森田充浩, 日本股関節学会学術集会プログラム・抄録集, 45th, 618, 2018年
日本語

医療の質の評価指標としてのICF評価セット(日本版)およびデータ収集ツールの作成 簡潔かつ直感的な説明文の日本語版作成
出江紳一, 才藤栄一, 向野雅彦, 医療の質の評価指標としてのICF評価セット(日本版)およびデータ収集ツールの作成 平成29年度 総括・分担研究報告書(Web), 201702004A0004 (WEB ONLY), 2018年
日本語

リハビリ、介護領域におけるロボット技術の応用の可能性 ロボティックスマートホーム開発の試み　　　　　　　　　　　　　　　
平野 哲, 才藤 栄一, 田辺 茂雄, 向野 雅彦, 加賀谷 斉, 大高 洋平, The Japanese Journal of Rehabilitation Medicine, 54, 秋季特別号, S83, S83, 2017年09月
(公社)日本リハビリテーション医学会, 日本語

ウェルウォークが片麻痺患者の歩行自立度回復に与える影響　　　　　　　　　　　　　　　
平野 哲, 才藤 栄一, 園田 茂, 加賀谷 斉, 角田 哲也, 布施 郁子, 波多野 和樹, 舟橋 怜佑, 向野 雅彦, 尾関 恩, 田辺 茂雄, 大塚 圭, The Japanese Journal of Rehabilitation Medicine, 54, 秋季特別号, S270, S270, 2017年09月
(公社)日本リハビリテーション医学会, 日本語

リハビリ、介護領域におけるロボット技術の応用の可能性 ロボティックスマートホーム開発の試み　　　　　　　　　　　　　　　
平野 哲, 才藤 栄一, 田辺 茂雄, 向野 雅彦, 加賀谷 斉, 大高 洋平, The Japanese Journal of Rehabilitation Medicine, 54, 秋季特別号, S83, S83, 2017年09月
(公社)日本リハビリテーション医学会, 日本語

国際生活機能分類を用いた生活機能の標準化指標作成の取り組み　　　　　　　　　　　　　　　
向野 雅彦, 才藤 栄一, 山田 深, 園田 茂, 水間 正澄, 出江 紳一, The Japanese Journal of Rehabilitation Medicine, 54, 秋季特別号, S265, S265, 2017年09月
(公社)日本リハビリテーション医学会, 日本語

国際生活機能分類を用いた生活機能の標準化指標作成の取り組み　　　　　　　　　　　　　　　
向野 雅彦, 才藤 栄一, 山田 深, 園田 茂, 水間 正澄, 出江 紳一, The Japanese Journal of Rehabilitation Medicine, 54, 秋季特別号, S265, S265, 2017年09月
(公社)日本リハビリテーション医学会, 日本語

【脳血管障害 診療のエッセンス】 リハビリテーション ロボット支援練習　　　　　　　　　　　　　　　
才藤 栄一, 平野 哲, 向野 雅彦, 日本医師会雑誌, 146, 特別1, S315, S316, 2017年06月
日本医師会, 日本語

【ニューロリハビリテーションの進歩】 療法と実際 バランス・歩行練習ロボット　　　　　　　　　　　　　　　
才藤 栄一, 平野 哲, 向野 雅彦, 加賀谷 斉, 園田 茂, Clinical Neuroscience, 35, 5, 576, 579, 2017年05月
(株)中外医学社, 日本語

リハビリテーション中の継時的な脈拍測定に基づく運動効率の評価　　　　　　　　　　　　　　　
松浦 広昂, 向野 雅彦, 平野 哲, 才藤 栄一, 加賀谷 斉, 角田 哲也, 大塚 圭, 加藤 正樹, 山田 純也, 青嶋 保志, The Japanese Journal of Rehabilitation Medicine, 54, 特別号, 1, 12, 2017年05月
(公社)日本リハビリテーション医学会, 日本語

ICFリハビリテーションセットの臨床使用における評点の信頼性に関わる検討
千手 佑樹, 向野 雅彦, 尾関 恩, 大河内 由紀, 水谷 公司, 才藤 栄一, 山田 深, 園田 茂, 出江 紳一, The Japanese Journal of Rehabilitation Medicine, 54, 特別号, 1, 5, 2017年05月
(公社)日本リハビリテーション医学会, 日本語

人工股関節全置換術前後の簡易な三次元歩行分析による歩容の比較
王裕香, 向野雅彦, 才藤栄一, 加賀谷斉, 加藤正樹, 森田充浩, 山田治基, 日本股関節学会学術集会プログラム・抄録集, 44th, 572, 2017年
日本語

大腿骨頸部骨折患者に対するバランス練習アシストの活用
井伊卓真, 平野哲, 才藤栄一, 園田茂, 加賀谷斉, 向野雅彦, 日本股関節学会学術集会プログラム・抄録集, 44th, 576, 2017年
日本語

簡易な三次元歩行分析を用いた日常臨床における歩容評価の実施可能性
向野雅彦, 王裕香, 加賀谷斉, 森田充浩, 加藤正樹, 山田治基, 才藤栄一, 日本股関節学会学術集会プログラム・抄録集, 44th, 604, 2017年
日本語

【医工、産学連携によるリハビリテーション】 ロボットを用いた歩行練習　　　　　　　　　　　　　　　
向野 雅彦, 平野 哲, 加賀谷 斉, MEDICAL REHABILITATION, 205, 29, 33, 2017年01月
リハビリテーション分野において、ロボットによる練習は現在広く関心を集めているトピックの1つである。特に歩行練習用のロボットについては、多くの報告でその有用性が報告されている。ロボットを使用した歩行練習のメリットは、アシストによって歩行が困難な患者の練習量を飛躍的に増加させることができ、多様な客観的なフィードバックの提供や練習中の計測による効果の検討ができるといった点にある。一方、ロボットを使用した練習は疾患、病態によっても効果が異なることが示唆されており、臨床導入における課題も明らかとなってきている。臨床へのさらなる普及にあたっては、効果メカニズムの理解に基づき、適応を十分に考慮して導入を進めていくことが、今後重要となっていくものと考えられる。(著者抄録), (株)全日本病院出版会, 日本語

上肢ロボット
向野雅彦, 才藤栄一, 平野哲, 田辺茂雄, The Japanese Journal of Rehabilitation Medicine, 54, 2, 167, 168, 2017年, ［査読有り］

電気刺激に対するサイトカイン応答と唾液試料によるサイトカイン計測 がん悪液質患者への介入を想定した事前研究　　　　　　　　　　　　　　　
百田 貴洋, 加賀谷 斉, 山田 晃司, 向野 雅彦, 日本物理療法学会学術大会抄録集, 24回, 52, 52, 2016年10月
日本物理療法学会, 日本語

日常生活における上肢頻用動作に基づく客観的上肢機能評価法の検討　　　　　　　　　　　　　　　
太田 皓文, 向野 雅彦, 大河内 由紀, 保木本 のぞみ, 才藤 栄一, 日本作業療法学会抄録集, 50回, OA, 22, 2016年09月
(一社)日本作業療法士協会, 日本語

ICFの活用と研究に関する国際動向と展望 (特集 ICFコアセット)
向野 雅彦, 才藤 栄一, The Japanese journal of rehabilitation medicine = リハビリテーション医学, 53, 9, 690, 693, 2016年09月
日本リハビリテーション医学会 ; 2007-, 日本語

【ICFコアセット】 脳卒中リハビリテーションにおけるコアセットの活用
近藤 和泉, 伊藤 直樹, 向野 雅彦, The Japanese Journal of Rehabilitation Medicine, 53, 9, 681, 685, 2016年09月
臨床的な活用の観点からは,ICF脳卒中コアセットを使って,どのような問題点が脳卒中患者にあるかという,いわゆる判別的な形での応用が考えられる.問題点がわかれば,それに対する標準的な対応の設定も可能である.一方,個々の項目につけられている評価点はアウトカム尺度として利用できる可能性をもっている.ただし,臨床でアウトカム尺度を標準的に用いていくためには,その尺度の信頼性および妥当性が証明されている必要があり,また詳しいマニュアルの作成を前提とした使用法の標準化がなされていることが望ましい.将来,臨床的に活用していくのであれば,これらの条件が整備される必要があると考えられる.(著者抄録), (公社)日本リハビリテーション医学会, 日本語

脊髄障害性疼痛の治療とリハビリテーション 脊髄損傷に対する歩行訓練が,異常痛覚や痙縮に及ぼす影響とその分子的背景の解析,治療応用
田代祥一, 篠崎宗久, 向野雅彦, FRANCOIS Renault-Mihara, 戸山芳昭, 里宇明元, 中村雅也, 岡野栄之, Journal of Clinical Rehabilitation, 25, 6, 2016年

移動を支援するロボット
平野哲, 才藤栄一, 向野雅彦, 田辺茂雄, The Japanese Journal of Rehabilitation Medicine, 53, 12, 952, 954, 2016年
公益社団法人 日本リハビリテーション医学会, 日本語

リハビリテーションにおける活動機能構造連関 (第51回日本リハビリテーション医学会学術集会) -- (シンポジウム 活動機能構造連関 : 活動が変える)
向野 雅彦, The Japanese journal of rehabilitation medicine, 52, 2, 96, 100, 2015年02月
日本リハビリテーション医学会 ; 2007-, 日本語

ラット脊髄完全切断モデルに対するtreadmill訓練手法の検討と解析
張亮, 向野雅彦, 田代祥一, 中村雅也, 里宇明元, Japanese Journal of Rehabilitation Medicine, 52, 2015年

ラット脊髄完全損傷に対するsemaphorin3A阻害剤とtreadmill訓練の併用療法の検討
張亮, 向野雅彦, 田代祥一, 中村雅也, 里宇明元, Japanese Journal of Rehabilitation Medicine, 52, 2015年

脳卒中片麻痺患者の麻痺側遊脚相における足部のクリアランスを規定する因子の検討
松田文浩, 向野雅彦, 大塚圭, 土山和大, 貝沼啓昭, 日高雅大, 加賀谷斉, 才藤栄一, 日本ニューロリハビリテーション学会学術集会プログラム・抄録集, 6th, 43, 2015年
日本語

急性期病棟における療法士病棟専従の効果
平野 明日香, 加藤 正樹, 藤村 健太, 向野 雅彦, 加賀谷 斉, 才藤 栄一, 理学療法学Supplement, 2014, 0, 2015年
【はじめに，目的】当院は，高度な医療を開発・提供する特定機能病院であり，急性期のリハビリテーション（以下，リハ）に取り組んできたが，必要な患者全てにリハの提供が浸透していなかった。そこで2013年度から療法士を病棟に配置し，病棟医師，看護師と情報共有を密にすることで早期離床，早期ADL獲得など治療の効率化を図った。そして，疾患別リハ実施者においてリハ開始までの期間短縮，在院日数短縮，自宅復帰率向上など効果を得た。また，2014年度の診療報酬改定により急性期病棟におけるリハ専門職の配置に対する評価としてADL維持向上等体制加算が新設され，疾患別リハ算定者以外にも病棟療法士による病棟マネジメント業務を実践し，その効果が期待されるようになった。そこで今回，病棟に療法士を配置し，その前後で療法士病棟専従の効果を明確にするため比較検討したので報告する。【方法】当院呼吸器内科病棟（60床）において疾患別リハ実施者を対象とし，ADL維持向上等体制加算算定後の2014年4月1日より9月30日の間に当該病棟へ入棟した患者83例を専従群とした。また，療法士を病棟配置する前の2012年4月1日から9月30日の間に当該病棟へ入棟した患者44例を対照群とした。疾患分類は肺がん，COPD，肺炎，気胸等が多かった。療法士の病棟配置は理学療法士1名（臨床経験10年以上，認定理学療法士）を専従配置し，疾患別リハ実施者においてリハ部の患者データベースより後方視的に調査した。調査項目は在院日数，入院からリハ開始までの日数，リハ実施日数，FIM，転帰先とした。対照群と専従群で比較検討した。統計学的検討は有意水準5%とし，χ²検定，Mann-Whitney U検定，unpaired-t検定を用いた。また，疾患別リハ実施者に限らず，療法士病棟専従の効果を検証するために病棟医師，看護師にアンケート調査も行なった。取り組み内容として，入院患者に対する定期的なADL評価（入棟・退棟時を含む），ADL維持向上等を目的とした指導，転倒・転落の防止対策，患者・家族との情報共有，定期的なカンファレンスの参加などを通じて多職種恊働による治療の効率化に努めた。定期的なカンファレンスとして病棟看護師と朝・昼のカンファレンス，病棟医師・リハ科医師との週1回のカンファレンスなどを通じて治療方針の統一，早期退院支援，廃用予防，ADL向上を多職種で行なった。カンファレンス以外にも適宜必要な情報共有を行なった。【結果】病棟全体の患者のうちリハ実施している患者の割合は対照群20.3%，専従群50.4%と有意に増加した。疾患別リハ実施者において，在院日数は対照群44.8±34.8日，専従群28.6±18.7日，入院からリハ開始までの日数は対照群14.3±15.5日，専従群5.0±4.3日と有意に短縮した。自宅復帰率は対照群77.3%，専従群80.7%であった。リハ実施日数は対照群30.5±24.2日，専従群23.6±16.2日であった。リハ開始時FIM総合計は対照群83.5±27.8点，専従群80.3±30.4点，リハ終了時FIM総合計は対照群96.7±26.4点，専従群96.0±29.4点，FIM効率は対照群0.49±0.66，専従群0.63±0.83であった。また，病棟全体の患者において，ADL維持向上等体制加算算定後はADL低下率が2.1%，褥創発生率0%であった。そして，病棟医師，看護師対象のアンケート調査から，療法士の病棟専従によって情報共有がし易くなった，在宅へ向けた指導がし易くなった，廃用による体力低下の防止ができた，ADL能力の回復が早くなった，リハ内容が把握し易くなったなどの意見が多数みられた。【考察】取り組みによって新規入院患者の把握による早期リハの開始，ADL維持向上の実施，状態変化者の把握による患者の安全管理の実施，状態にあわせて早期離床，早期退院，自宅復帰推進等ができたと考えられた。以上から療法士の病棟専従により，病棟医師，看護師との効率的連携が生まれ，疾患別リハ実施割合の向上，在院日数短縮，自宅復帰率の向上などに繋がったと考えられた。【理学療法学研究としての意義】2014年度の診療報酬改定によりADL維持向上等体制加算が新設され，今までの疾患別リハのみならず，病棟マネジメント業務まで幅広く行なうようになった。今回の取り組みを通じて，リハに対する認知度が向上し，入院早期からリハ開始，在院日数短縮などの効果がみられた。さらに，現時点ではADL維持向上等体制加算を実施するための取り組みに対する細かな規定はないため，今回の研究で一つの指標を示すことができたと考えられる。引き続き急性期リハの効果，実際の取り組み内容の指標が明確になるように検討していく。, 公益社団法人 日本理学療法士協会, 日本語

脊髄損傷後の運動負荷が誘導するBDNFによるKCC2発現制御とその分子的背景
田代祥一, 篠崎宗久, 向野雅彦, 岡野栄之, 戸山芳昭, 里宇明元, 中村雅也, Journal of Spine Research, 5, 3, 2014年

脊髄損傷後の運動負荷が誘導するBDNFによるKCC2発現制御とその分子的背景
田代祥一, 篠崎宗久, 向野雅彦, 中村雅也, 里宇明元, Japanese Journal of Rehabilitation Medicine, 51, 2014年

症例から学ぶ臨床神経生理学(第3回)末梢神経障害 : 下肢
大田 哲生, 向野 雅彦, 総合リハビリテーション, 41, 3, 263, 268, 2013年03月
医学書院, 日本語

損傷後早期の運動負荷によるBDNFの上昇は,KCC2発現増加を介して長期的な疼痛と痙性の抑制に寄与する
田代祥一, 田代祥一, 篠崎宗久, 向野雅彦, 里宇明元, 中村雅也, Japanese Journal of Rehabilitation Medicine, 50, 2013年

再生医学と理学療法の展望
向野 雅彦, 理学療法学 = The Journal of Japanese Physical Therapy Association, 39, 8, 499, 502, 2012年12月20日
公益社団法人日本理学療法士協会, 日本語

K-067 再生医学と理学療法の展望(先端科学と理学療法,特別講演II,プロフェッション!新たなるステージへ,第47回日本理学療法学術大会)
向野 雅彦, 理学療法学, 39, 1, 208, 208, 2012年05月25日
公益社団法人日本理学療法士協会, 日本語

初発脳梗塞患者の離床時期 Branch Atheromatous Disease症例に着目して
渡邉 恵莉, 川上 途行, 藤原 俊之, 小原 朋子, 笠島 悠子, 富岡 曜平, 前島 早代, 宮田 知恵子, 向野 雅彦, 石川 愛子, 松本 真以子, 大高 洋平, 興津 太郎, 辻 哲也, 長谷 公隆, 木村 彰男, 里宇 明元, The Japanese Journal of Rehabilitation Medicine, 49, Suppl., S168, S168, 2012年05月
(公社)日本リハビリテーション医学会, 日本語

油圧制動足継手付き短下肢装具による底屈制動の違いが片麻痺歩行に及ぼす影響
富岡 曜平, 長谷 公隆, 渡邉 恵莉, 前島 早代, 小原 朋子, 向野 雅彦, 川上 途行, 笠島 悠子, 松本 真以子, 大高 洋平, 藤原 俊之, 辻 哲也, 木村 彰男, 里宇 明元, The Japanese Journal of Rehabilitation Medicine, 49, Suppl., S262, S262, 2012年05月
(公社)日本リハビリテーション医学会, 日本語

胸部食道癌根治術後の嚥下障害 背景因子、術式、(声帯麻痺反回神経麻痺)と嚥下評価、術後経過との関係
小原 朋子, 松本 真以子, 辻 哲也, 長田 麻衣子, 富岡 曜平, 渡邉 恵莉, 前島 早代, 川上 途行, 宮田 知恵子, 向野 雅彦, 笠島 悠子, 石川 愛子, 大高 洋平, 興津 太郎, 藤原 俊之, 長谷 公隆, 木村 彰男, 里宇 明元, The Japanese Journal of Rehabilitation Medicine, 49, Suppl., S302, S302, 2012年05月
(公社)日本リハビリテーション医学会, 日本語

誤嚥性肺炎の発生率と咳嗽力との関係 Peak cough flowと嚥下機能評価
前島 早代, 川上 途行, 小原 朋子, 渡邉 恵莉, 富岡 曜平, 宮田 知恵子, 向野 雅彦, 笠島 悠子, 石川 愛子, 松本 真以子, 大高 洋平, 藤原 俊之, 辻 哲也, 長谷 公隆, 木村 彰男, 里宇 明元, The Japanese Journal of Rehabilitation Medicine, 49, Suppl., S410, S410, 2012年05月
(公社)日本リハビリテーション医学会, 日本語

トイレ関連動作の自立をゴールとした機能障害チェックリストの作成
向野雅彦, 伊海友雪, 吉田亜友美, 田代祥一, 宇内景, 當山峰道, 新藤恵一郎, 大田哲生, 木村彰男, 里宇明元, Japanese Journal of Rehabilitation Medicine, 48, 2011年

脳卒中における高次脳機能障害への白質損傷の関わり
向野雅彦, 猪瀬学, 小野峻史, 宇内景, 田代祥一, 當山峰道, 新藤恵一郎, 大田哲生, 木村彰男, 里宇明元, Japanese Journal of Rehabilitation Medicine, 48, 2011年

Beneficial compaction of spinal cord lesion by migrating astrocytes through Glycogen Synthase Kinase-3 inhibition
Francois Renault-Mihara, Hiroyuki Katoh, Takeshi Ikegami, Akio Iwanami, Masahiko Mukaino, Hirobumi Tada, Akimasa Yasuda, Satoshi Nori, Shinsuke Shibata, Ken Saito, Masayuki Matsushita, Kozo Kaibuchi, Seiji Okada, Yoshiaki Toyama, Masaya Nakamura, Hideyuki Okano, NEUROSCIENCE RESEARCH, 71, E59, E59, 2011年
ELSEVIER IRELAND LTD, 英語, 研究発表ペーパー・要旨（国際会議）

Role and mechanisms of reactive astrocytes? Migration after spinal cord injury
Francois Renault-Mihara, Masahiko Mukaino, Munehisa Shinozaki, Yoshiaki Toyama, Masaya Nakamura, Hideyuki Okano, NEUROSCIENCE RESEARCH, 68, E242, E243, 2010年
ELSEVIER IRELAND LTD, 英語, 研究発表ペーパー・要旨（国際会議）

Combining extensive treadmill training with a selective semaphorin3A inhibitor treatment enhances locomotor functional recovery by wiring regenerated axons in adult spinal cord-transected rats
Liang Zhang, Shinjiro Kaneko, Akihiko Sano, Miho Maeda, Akiyoshi Kishino, Masahiko Mukaino, Yoshiaki Toyama, Meigen Liu, Masaya Nakamura, Hideyuki Okano, NEUROSCIENCE RESEARCH, 68, E259, E260, 2010年
ELSEVIER IRELAND LTD, 英語, 研究発表ペーパー・要旨（国際会議）

ラット脊髄損傷モデルに対する荷重下歩行訓練の効果の検討
向野 雅彦, 中村 雅也, 戸山 芳昭, 岡野 栄之, 里宇 明元, 末梢神経 = Peripheral nerve, 20, 2, 266, 267, 2009年12月01日
日本語

c-Mycを除いたマウス3因子iPS細胞由来神経幹細胞を用いた脊髄損傷治療
辻 収彦, 三浦 恭子, 藤吉 兼浩, 向野 雅彦, 名越 慈人, 熊谷 玄太郎, 山中 伸弥, 岡野 栄之, 戸山 芳昭, 中村 雅也, 日本整形外科学会雑誌, 83, 8, S1068, S1068, 2009年08月
(公社)日本整形外科学会, 日本語

脊髄損傷に対するiPS細胞由来神経幹細胞移植 機能回復メカニズムの解析
辻 収彦, 三浦 恭子, 藤吉 兼浩, 名越 慈人, 北村 和也, 向野 雅彦, 熊谷 玄太郎, 千葉 一裕, 山中 伸弥, 岡野 栄之, 戸山 芳昭, 中村 雅也, 日本脊椎脊髄病学会雑誌, 20, 2, 461, 461, 2009年03月
(一社)日本脊椎脊髄病学会, 日本語

再生医学 (特集 脊髄損傷リハビリテーション--現状・課題・展望)
向野 雅彦, 総合リハビリテ-ション, 36, 10, 929, 932, 2008年10月
医学書院, 日本語

The role of cytokine signaling in pathophysiology for spinal cord injury
Okada Seiji, Nakamura Masaya, Renault-Mihara Francois, MUKAINO Masahiko, SAIWAI Hirokazu, TOYAMA Yoshiaki, IWAMOTO Yukihide, OKANO Hideyuki, 炎症・再生 : 日本炎症・再生医学会雑誌 = Inflammation and regeneration, 28, 5, 440, 446, 2008年09月25日
日本炎症・再生医学会, 英語

顕微鏡的MRIによるコモンマーモセット脊髄損傷の病態解析—q‐space MR imagingを用いて—
藤吉兼浩, 疋島啓吾, 北村和也, 岩波明生, 辻収彦, 向野雅彦, 加藤裕幸, 百島祐貴, 岡野栄之, 戸山芳昭, 中村雅也, 日本整形外科学会雑誌, 82, 8, S936, S936, 2008年08月25日
(公社)日本整形外科学会, 日本語

脊髄損傷に対する人工多能性幹細胞由来神経幹細胞移植の検討
辻 収彦, 三浦 恭子, 藤吉 兼弘, 北村 和也, 名越 慈人, 向野 雅彦, 熊谷 玄太郎, 山中 伸弥, 岡野 栄之, 戸山 芳昭, 中村 雅也, 日本整形外科学会雑誌, 82, 8, S912, S912, 2008年08月
(公社)日本整形外科学会, 日本語

Lecture 拡散テンソルトラクトグラフィー
藤吉兼浩, 中村雅也, 山田雅之, 山田雅之, 疋島啓吾, 疋島啓吾, 北村和也, 辻収彦, 名越慈人, 向野雅彦, 百島祐貴, 加藤裕幸, 石井賢, 松本守雄, 千葉一裕, 岡野栄之, 戸山芳昭, 臨床整形外科, 43, 7, 692-699, 699, 2008年07月25日
(株)医学書院, 日本語

1-4-11 ラット脊髄損傷モデルにおける運動負荷訓練が機能回復及び痙性に与える効果(脊髄損傷(症例(2)),口演,一般演題,リハビリテーション医学の進歩"評価から治療介入へ",第45回日本リハビリテーション医学会学術集会)
向野 雅彦, 中村 雅也, 戸山 芳昭, 岡野 栄之, 里宇 明元, リハビリテーション医学 : 日本リハビリテーション医学会誌, 45, 0, S153, 2008年05月18日
社団法人日本リハビリテーション医学会, 日本語

拡散テンソルtractographyによる損傷末梢神経の描出—組織変化と拡散異方性—
高木岳彦, 中村雅也, 山田雅之, 疋島啓吾, 藤吉兼浩, 向野雅彦, 岡野James洋尚, 百島祐貴, 戸山芳昭, 岡野栄之, 日本磁気共鳴医学会雑誌, 28, 1, 45, 45, 2008年01月15日
8週齢ラットの圧挫損傷直後〜12週(各n=8〜10)の坐骨神経について、拡散テンソル法を用いてtractographyを行い、組織像と比較検討した。画像解析ソフトはVolumeOneとdTVIISRを使用した。圧挫部、圧挫遠位部におけるfractional anisotropy(FA)値の経時的変化を評価し、結果として、圧挫部においてFA値は損傷直後より低下、その後徐々に増加し、圧挫遠位部においてFA値は損傷4〜14日後に低下、その後徐々に回復し、6週後には損傷前と同様の値に回復した。またFA値と軸索面積、髄鞘面積、軸索総線維比、髄鞘厚組の相関関係を検討したところ、FA値の変化は軸索面積、髄鞘面積、軸索総線維比とは正の相関を、髄鞘厚とは不の相関を示した。, (一社)日本磁気共鳴医学会, 日本語

Comparison between ES cell-derived neurogenic and gliogenic neurospheres as a source of transplantation for spinal cord injury
Gentaro Kumagai, Masaya Nakamura, Yohei Okada, Junichi Yamane, Narihito Nagoshi, Kazuya Kitamura, Osahiko Tsuji, Masahiko Mukaino, Satoshi Toh, Yoshiaki Toyama, Hideyuki Okano, NEUROSCIENCE RESEARCH, 61, S43, S43, 2008年
ELSEVIER IRELAND LTD, 英語, 研究発表ペーパー・要旨（国際会議）

Cell therapy for spinal cord injury by neural stem/progenitor cells derived from induced pluripotent stem cells
Osahiko Tsuji, Kyoko Miura, Masaya Nakamura, Narihito Nagoshi, Kazuya Kitamura, Kanehiro Fujiyoshi, Masahiko Mukaino, Gentaro Kumagai, Hiroyuki Katoh, Okada Yohei, Shinya Yamanaka, Yoshiaki Toyama, Hideyuki Okano, NEUROSCIENCE RESEARCH, 61, S69, S69, 2008年
ELSEVIER IRELAND LTD, 英語, 研究発表ペーパー・要旨（国際会議）

拡散テンソル法を用いた末梢神経線維のtractography—ex vivoモデルでの検討—
高木岳彦, 中村雅也, 山田雅之, 疋島啓吾, 藤吉兼浩, 向野雅彦, 岡野James洋尚, 百島祐貴, 岡野栄之, 戸山芳昭, 日本末梢神経学会学術集会プログラム・抄録, 18th, 2, 60, 240, 2007年12月
水分子の拡散の異方性を利用し、拡散係数の最大方向を追跡する画像解析法の1つである拡散テンソル法を用いて、末梢神経線維のtractographyを行い、末梢神経軸索再生の新たな画像評価法としての可能性を検討した。ラットの坐骨神経に対し、圧挫損傷を作成した。圧挫部のfractional anisotropy値は損傷直後より低下し、損傷21日後には損傷前と同様の状態にまで回復した。圧挫遠位部のFA値は損傷4〜14日後に低下し、28日後には損傷前と同様の状態にまで回復した。FA値に適当な閾値を設定することでこれらの変化をtractographyとして視覚化することが可能であった。これらのFA値の時間的経過は特に軸索密度、G-ratioの変化と特に相関を示した。さらに、下肢筋力テスト、rotor-rod test、von Frey filament testいずれも損傷部のFA値と強い相関を示した。, 日本末梢神経学会, 日本語

拡散テンソル法を用いた末梢神経線維の tractography : ex vivo モデルでの検討
高木 岳彦, 中村 雅也, 山田 雅之, 疋島 啓吾, 百島 祐貴, 藤吉 兼浩, 向野 雅彦, 岡野 James 洋尚, 岡野 栄之, 戸山 芳昭, 末梢神経 = Peripheral nerve, 18, 2, 239, 240, 2007年12月01日
日本語

脊髄損傷
向野雅彦, IL-6 Bench to Bedside, 83, 88, 2007年
メディカルレビュー社

講座 再生医学とリハビリテーション(3)再生医学とリハビリテーション
植村 修, 向野 雅彦, 里宇 明元, 総合リハビリテ-ション, 33, 12, 1125, 1131, 2005年12月
医学書院, 日本語

再生医学とリハビリテーション(第42回 日本リハビリテーション医学会 学術集会)
向野 雅彦, 里宇 明元, 岡野 栄之, リハビリテーション医学 : 日本リハビリテーション医学会誌, 42, 10, 702, 707, 2005年10月18日
社団法人日本リハビリテーション医学会, 日本語

運動単位の同期発射 前脛骨筋とヒラメ筋の違い　　　　　　　　　　　　　　　
正門 由久, 山田 理絵, 牛場 潤一, 大田 哲生, 水野 勝広, 補永 薫, 向野 雅彦, 木村 彰男, 富田 豊, リハビリテーション医学, 41, Suppl., S222, S222, 2004年05月
(公社)日本リハビリテーション医学会, 日本語

健常者における運動イメージ時の運動誘発電位の検討 異なる種類の運動イメージが及ぼす影響　　　　　　　　　　　　　　　
大田 哲生, 村岡 慶裕, 辻 哲也, 水野 勝広, 補永 薫, 向野 雅彦, 正門 由久, 木村 彰男, リハビリテーション医学, 41, Suppl., S215, S215, 2004年05月
(公社)日本リハビリテーション医学会, 日本語

マスター脳卒中学 : 最前線医療の現場からリハビリテーションまで
田川, 皓一, 橋本, 洋一郎, 稲富, 雄一郎, 脳卒中リハビリテーションの基本的な考え方
西村書店, 2019年02月, 9784890134939, xx, 587p, 日本語

現代リハビリテーション医学
椿原, 彰夫, 才藤, 栄一, 出江, 紳一, 道免, 和久, 千野, 直一, 再生医療とリハビリテーション医学
金原出版, 2017年07月, 9784307750523, xvi, 459p, 日本語

義肢装具のチェックポイント第８版　　　　　　　　　　　　　　　
伊藤 利之, 赤居 正美, 車椅子
医学書院, 2014年

炎症・再生医学事典　　　　　　　　　　　　　　　
松島綱治, 西脇徹, Ⅱ再生医学・B体性幹細胞と組織修復・1脳神経
朝倉書店, 2009年

IL-6 Bench to Bedside
西本, 憲弘, 平野, 俊夫, 脊髄損傷
メディカルレビュー社, 2007年04月, 9784779200984, 145p, 日本語

リハビリテーション医学における活動モニタリングの意義　　　　　　　　　　　　　　　
向野 雅彦
第58回日本リハビリテーション医学会学術集会, 口頭発表（招待・特別）
2021年06月10日 - 2021年06月13日, ［招待講演］

三次元歩行分析によるリハビリテーション効果の理解と臨床における意思決定への活用　　　　　　　　　　　　　　　
向野 雅彦
第57回日本リハビリテーション医学会学術集会, 口頭発表（招待・特別）
2020年08月19日 - 2020年08月22日

ICFの基本と臨床応用の取り組み　　　　　　　　　　　　　　　
向野 雅彦
第56回日本リハビリテーション医学会学術集会, 口頭発表（招待・特別）
2019年06月12日 - 2019年06月16日, ［招待講演］

ICDとICFの一体としての統計への導入の可能性　　　　　　　　　　　　　　　
向野 雅彦
日・WHOフォーラム2018, 2018年11月18日, 口頭発表（招待・特別）
2018年11月18日 - 2018年11月18日, ［招待講演］

三次元歩行分析による義肢装具の効果の理解　　　　　　　　　　　　　　　
向野 雅彦
第34回日本義肢装具学会学術大会, 口頭発表（招待・特別）
2018年11月10日 - 2018年11月11日, ［招待講演］

リハビリテーション医療における活動モニタリング　　　　　　　　　　　　　　　
向野 雅彦
第55回日本リハビリテーション医学会学術集会, 公開講演，セミナー，チュートリアル，講習，講義等
2018年06月28日 - 2018年07月01日, ［招待講演］

リハビリテーション医療の臨床における歩行分析　　　　　　　　　　　　　　　
向野 雅彦
第55回日本リハビリテーション医学会学術集会, 口頭発表（招待・特別）
2018年06月28日 - 2018年07月01日, ［招待講演］

ウェルウォークが片麻痺患者の歩行自立度回復に与える影響　　　　　　　　　　　　　　　
平野 哲, 才藤 栄一, 園田 茂, 加賀谷 斉, 角田 哲也, 布施 郁子, 波多野 和樹, 舟橋 怜佑, 向野 雅彦, 尾関 恩, 田辺 茂雄, 大塚 圭
The Japanese Journal of Rehabilitation Medicine, 2017年09月, 日本語

国際生活機能分類を用いた生活機能の標準化指標作成の取り組み　　　　　　　　　　　　　　　
向野 雅彦, 才藤 栄一, 山田 深, 園田 茂, 水間 正澄, 出江 紳一
The Japanese Journal of Rehabilitation Medicine, 2017年09月, 日本語

リハビリ、介護領域におけるロボット技術の応用の可能性 ロボティックスマートホーム開発の試み　　　　　　　　　　　　　　　
平野 哲, 才藤 栄一, 田辺 茂雄, 向野 雅彦, 加賀谷 斉, 大高 洋平
The Japanese Journal of Rehabilitation Medicine, 2017年09月, 日本語

リハビリテーション中の継時的な脈拍測定に基づく運動効率の評価　　　　　　　　　　　　　　　
松浦 広昂, 向野 雅彦, 平野 哲, 才藤 栄一, 加賀谷 斉, 角田 哲也, 大塚 圭, 加藤 正樹, 山田 純也, 青嶋 保志
The Japanese Journal of Rehabilitation Medicine, 2017年05月, 日本語

ICFリハビリテーションセットの臨床使用における評点の信頼性に関わる検討　　　　　　　　　　　　　　　
千手 佑樹, 向野 雅彦, 尾関 恩, 大河内 由紀, 水谷 公司, 才藤 栄一, 山田 深, 園田 茂, 出江 紳一
The Japanese Journal of Rehabilitation Medicine, 2017年05月, 日本語

Japanese experience in the development of national rehabilitation quality management systems　　　　　　　　　　　　　　　
Masahiko Mukaino
10th International Society of Physical and Rehabilitation Medicine World Congress, 2016年06月, 英語
Kuala lumpur, Malaysia, ［招待講演］

Development of a clinical tool for measuring dynamic balance function: A proof-of-concept study　　　　　　　　　　　　　　　
Masahiko Mukaino
5th Asia-Oceanian Conference of Physical and Rehabilitation Medicine, 2016年02月, 英語
Cebu, Philippines

ICFの概念と実際　　　　　　　　　　　　　　　
向野雅彦
第53回日本リハビリテーション医学会, 2016年
京都府京都市

The effect of instruction focusing on single versus multi movement parameters on upper limb exercise training,　　　　　　　　　　　　　　　
Masahiko Mukaino
9th International Society of Physical and Rehabilitation Medicine World Congress, 2015年05月, 英語
Berlin, Germany, ［招待講演］

急性期病棟における療法士病棟専従の効果 ADL維持向上等体制加算の開始前後の比較　　　　　　　　　　　　　　　
平野 明日香, 加藤 正樹, 藤村 健太, 向野 雅彦, 加賀谷 斉, 才藤 栄一
理学療法学, 2015年04月, 日本語

耳朶式脈拍計を用いた脈拍測定の信頼性.　　　　　　　　　　　　　　　
向野雅彦, 山田純也, 加藤正樹, 大塚 圭, 尾関, 恩, 小野木啓子, 才藤栄一
第52回日本リハビリテーション医学会, 2015年
新潟県新潟市

歩行分析の指標としての機能的脚長　　　　　　　　　　　　　　　
向野雅彦, 松田文浩, 大塚 圭, 加賀谷斉, 米田千賀子, 今井幸恵, 山村怜子, 田中ともみ, 河村美穂, 八谷カナン 才藤栄一
第52回日本リハビリテーション医学会, 2015年
新潟県新潟市

歩行の神経生理と治療戦略 歩行訓練と脊髄内の構造変化　　　　　　　　　　　　　　　
向野 雅彦
第42回日本臨床神経生理学会学術大会, 2012年
東京

The benefits of early intervention of training for functional recovery after spinal cord injury　　　　　　　　　　　　　　　
Masahiko Mukaino, Osahiko Tsuji, Kanehiro Fujiyoshi, Tetsuo Ota, Meigen Liu, Yoshiaki Toyama, Hideyuki Okano, Masaya Nakamura
Neuroscience 2012, 2012年
New Orleans

脳卒中における高次脳機能障害への白質損傷の関わり　　　　　　　　　　　　　　　
向野 雅彦, 猪瀬 学, 小野 峻史, 宇内 景, 田代 祥一, 當山 峰道, 新藤 恵一郎, 大田 哲生, 木村 彰男, 里宇 明元
第48回日本リハビリテーション医学会学術集会, 2011年
千葉

トイレ関連動作の自立をゴールとした機能障害チェックリストの作成　　　　　　　　　　　　　　　
向野 雅彦, 伊海 友雪, 吉田 亜友美, 田代 祥一, 宇内 景, 當山 峰道, 新藤 恵一郎, 大田 哲生, 木村 彰男, 里宇 明元
第48回日本リハビリテーション医学会学術集会, 2011年
千葉

ブレイン・マシーン・インターフェースを用いた神経筋電気刺激(BMI-NMES)の有効性の検討　　　　　　　　　　　　　　　
向野 雅彦, 小野 峻史, 新藤 恵一郎, 當山 峰道, 宇内 景, 大田 哲生, 牛場 潤一, 木村 彰男, 里宇 明元
第41回日本臨床神経生理学会学術大会, 2011年
静岡

脳卒中の転帰に影響する機能障害所見の検討　　　　　　　　　　　　　　　
向野 雅彦, 赤星 和人, 小林 由紀子, 森 俊樹, 永田 雅章, 里宇 明元
第47回日本リハビリテーション医学会学術集会, 2010年
鹿児島

ラット脊髄損傷モデルに対する荷重下歩行訓練の効果の検討　　　　　　　　　　　　　　　
向野 雅彦, 中村 雅也, 戸山 芳昭, 岡野 栄之, 里宇 明元
第20回日本末梢神経学会学術集会, 2009年
埼玉

ICFによる難病・小慢患者の生活機能の実態把握と経時的変化の対応評価
科学研究費助成事業 挑戦的研究(開拓)
2021年07月09日 - 2025年03月31日
小松 雅代, 祖父江 友孝, 野田 龍也, 盛一 享徳, 向野 雅彦
1.目的
国際生活機能分類(International Classification of Functioning, Disability and Health ：ICF)は、世界保健機関(WHO)が人間の生活機能と障害の分類を、健康状態、心身機能、障害の状態について分類した国際統計分類の一つであり、世界的に活用が推進されている。しかし、我が国においてICFの利活用による疾患別の生活機能に関するデータベースは、ICFコードの多さと認知不足により未だ確立されておらず、疾患別の生活機能分析が進んでいない現状である。本研究の第1目的は、難病・小児慢性特定疾病(小慢)患者の疾患と生活機能をICFを用いてコード化し、共通した生活機能尺度としてICFコードを普及するための基礎資料を得ることである。第2目的は、ICFの生活機能コードを用いて難病・小慢患者の生活機能の全体像を明らかにし、療養生活における生活機能全般と経時的な変化に対する評価を具体的に提示することにより、社会参加への支援を行うことである。
2.実施計画および実績
R3年度～R6年度の4年間で実施予定。R3年度～R4年度は、難病法指定難病のうち神経・筋疾患群、小慢のうち慢性心疾患についてICFコードのコーディングを行い、疾患別の生活機能の現状と課題の整理を実施予定としている。該当疾患のICFコーディングは終了したが、生活機能等を評価する際に対象疾患を追加する必要性が出てきたため、現在、追加疾患のコーディングを実施中である。さらに、指定難病患者データベース及び小児慢性特定疾病児童等データベースの利用申請(厚労省)は済ませており、データ取得の準備も進めている。
日本学術振興会, 挑戦的研究(開拓), 大阪大学, 21K18290

脊髄損傷者における歩行練習支援ロボットWPAL使用時の歩容と筋活動の評価
科学研究費助成事業 基盤研究(C)
2020年04月01日 - 2023年03月31日
平野 哲, 大高 洋平, 向野 雅彦, 才藤 栄一, 田辺 茂雄, 角田 哲也, 小山 総市朗
本研究の目的は，対麻痺者および四肢麻痺者において，歩行支援ロボットWPAL（Werable Power-Assist Locomotor）を用いた歩行練習を行い，運動学習の課程を歩行分析及び表面筋電図解析によって評価することである．歩行分析の方法として，慣性センサ式三次元動作解析装置Xsense(R)を用いる計画であったが，この装置は歩行分析前のキャリブレーションとして健常者に近い歩行速度で歩行を行う必要があり，対麻痺者・四肢麻痺者のロボット歩行では歩行速度が低いため， 正確な計測が困難であることが判明した．そこで，2020年度は低歩行能力者に対しても簡単に実施可能な歩行分析方法の再検討を行い，キャリブレーションが不要で，低方向能力者の身体的負担が少ない方法として，二次元歩行分析であるダートフィッシュ(R)を用いることとした．健常者での予備実験では，第7頚椎，第5腰椎，両側肩峰，両側腸骨稜頂点，両側歩行器にカラーマーカを貼付し，矢状面および前額面（後方より）の撮影を行うことで，体幹の矢状面・前額面の角度の推移が計測できることが分かった．2021年度は，実際の実際の患者での計測に移行した．患者の歩容によっては両側腸骨稜頂点のマーカーが隠れることがあることが判明したため，補正方法を検討・立案した．この補正方法を用いて対麻痺者・四肢麻痺者の歩行分析を行い，計測が可能であることを確認した．2021年度は3名の患者の計測を行うことができた．今後，患者がWPALを用いた歩行に習熟するのを待って再度計測を行い，運動学習課程の評価を行う予定である．
日本学術振興会, 基盤研究(C), 藤田医科大学, 20K11223

地域包括ケアシステムにおいて活用可能な国際生活機能分類（ICF）による多領域にまたがる評価手法の確立に資する研究　　　　　　　　　　　　　　　
厚生労働科学研究費
2021年04月
厚生労働省, 藤田医科大学, 研究代表者

ICD-11に新たに導入された生活機能評価に関する補助セレクション「Ⅴ章」の活用及び普及に向けた研究　　　　　　　　　　　　　　　
厚生労働科学研究費
2020年04月 - 2021年03月
厚生労働省, 藤田医科大学, 研究代表者

医療・介護連携を促進するための国際生活機能分類を用いた評価と情報共有の仕組みの構築　　　　　　　　　　　　　　　
厚生労働科学研究費
2018年04月 - 2020年03月
厚生労働省, 藤田医科大学, 研究代表者

包括的なバランス機能障害評価および介入効果のモニタリングシステムの開発
科学研究費助成事業 新学術領域研究(研究領域提案型)
2017年04月01日 - 2019年03月31日
向野 雅彦
本研究の目的は、これまでに作成してきたバランス機能の指標間の相互関係の理解に基づき、歩行時に重心が足圧により制御される仕組みについて検討を行うことである。対象者は、手すりなしでトレッドミル上で歩行可能なパーキンソン病患者10名、小脳失調患者18名、健常者8名。歩行中の足圧と三次元計測を同期的に行うことで、側方の重心位置と足圧位置の関係性からCOGの速度にCOPの挙動がどのように影響しているか評価することを試みた。
検討の結果、小脳失調群ではCOP-COG距離は健常に比較して有意な上昇を認めた。また、有意水準には至らなかったが、COPの振幅は小脳失調群で拡大の傾向を認めた。パーキンソン病群では単脚支持時間の有意な短縮を認めた。 COP速度、COG速度はパーキンソン病群では低下傾向を認めた。全体の傾向としては、失調患者では時間因子は変わらないものの、COPが健常人よりも比較して大きく動くことでCOGの制御を行っており、失調患者において一般的にみられるwide-basedの歩行パターンを反映しているものと考えられた。一方、パーキンソン病患者では、COPの動く範囲はやや大きい傾向があるものの、小刻み歩行パターンを反映して単脚支持時間は短く、COGの速度は低く保たれている傾向がみられた。
さらにCOG速度を従属変数、上記5変数を独立変数とした重回帰分析を実施した。ステップワイズ法（増減法）による変数選択を実施したところ、COP-COG距離、単脚支持時間、COP-COG方向一致率が選択された。このモデルの決定係数は0.76と比較的良好な当てはまりが得られた。歩行中において、重心速度はCOPとCOGの関係性に強く影響されることが明らかとなとなった。
日本学術振興会, 新学術領域研究(研究領域提案型), 藤田医科大学, 17H05913

Ｂｒａｉｎ Ｍａｃｈｉｎｅ Ｉｎｔｅｒｆａｃｅを用いた急性期脳卒中リハビリの効果
科学研究費助成事業
2012年04月01日 - 2015年03月31日
大田 哲生, 橋本 泰成, 鎌田 恭輔, 向野 雅彦
急性期脳卒中患者の上肢重度麻痺に対してBrain machine interface(BMI)の技術を応用したリハビリ訓練を施行した。訓練には麻痺肢に対する電気刺激も併用した。運動野における事象関連脱同期の出現を確認することはできなかったが、訓練後、脳波による運動と安静を識別する識別率の向上を認めるとともに、10～40hzの周波数帯で、損傷脳におけるパワースペクトルの減少を認めた。麻痺側上肢の運動イメージでリハビリ開始当初から脳の賦活化が行える可能性が示唆された。
日本学術振興会, 基盤研究(C), 旭川医科大学, 24500568