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Masahiro Abo
Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo

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Observational study
Published: 18 June 2021 in Medicine
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The clinical presentation of stroke is usually more severe in patients with intracerebral hemorrhage (ICH) than in those with cerebral infarction (CI); recovery of stroke-related muscle paralysis is influenced and limited by the type of stroke. To date, many patients have been treated by neurorehabilitation; however, the changes in the recovery of motor paralysis depending on the type of stroke, ICH or CI, have not been established. This study aimed to determine this difference in improvement of upper extremity paralysis using 2-week in-hospital NovEl intervention Using Repetitive transcranial magnetic stimulation combined with Occupational therapy (NEURO). We scrutinized the medical records of all patients with poststroke (ICH or CI) upper extremity muscle paralysis using Fugl-Meyer assessments (FMAs) who had been admitted to 6 hospitals between March 2010 and December 2018 for rehabilitation treatment. This was a multiinstitutional, open-label, retrospective cohort study without control patients. We evaluated the effects of NEURO on patients with CI and ICH by dividing them into 2 groups according to the type of stroke, after adjustment for age, sex, dominant hand, affected hand side, time since stroke, and prediction of recovery capacity in the upper extremity. The study included 1716 (CI [n = 876] and ICH [n = 840]) patients who had undergone at least 2 FMAs and had experienced stroke at least 6 months before. The type of stroke had no effect on the outcomes (changes in the FMA-upper extremity score, F[4,14.0] = 2.05, P = .09, partial η2 = 0.01). Patients from all 5 groups equally benefited from the treatment (improvement in FMA scores) according to the sensitivity analysis-stratified analysis (F = 0.08 to 1.94, P > .16, partial η2 < 0.001). We conclude that NEURO can be recommended for chronic stroke patients irrespective of the type of stroke.

ACS Style

Hisashi Tatsuno; Toyohiro Hamaguchi; Jinichi Sasanuma; Kiyohito Kakita; Takatsugu Okamoto; Masato Shimizu; Naoki Nakaya; Masahiro Abo. Does a combination treatment of repetitive transcranial magnetic stimulation and occupational therapy improve upper limb muscle paralysis equally in patients with chronic stroke caused by cerebral hemorrhage and infarction? Medicine 2021, 100, e26339 .

AMA Style

Hisashi Tatsuno, Toyohiro Hamaguchi, Jinichi Sasanuma, Kiyohito Kakita, Takatsugu Okamoto, Masato Shimizu, Naoki Nakaya, Masahiro Abo. Does a combination treatment of repetitive transcranial magnetic stimulation and occupational therapy improve upper limb muscle paralysis equally in patients with chronic stroke caused by cerebral hemorrhage and infarction? Medicine. 2021; 100 (24):e26339.

Chicago/Turabian Style

Hisashi Tatsuno; Toyohiro Hamaguchi; Jinichi Sasanuma; Kiyohito Kakita; Takatsugu Okamoto; Masato Shimizu; Naoki Nakaya; Masahiro Abo. 2021. "Does a combination treatment of repetitive transcranial magnetic stimulation and occupational therapy improve upper limb muscle paralysis equally in patients with chronic stroke caused by cerebral hemorrhage and infarction?" Medicine 100, no. 24: e26339.

Original research article
Published: 20 October 2020 in Frontiers in Neurology
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Recovery from motor paralysis is facilitated by affected patients' recognition of the need for and practice of their own exercise goals. Neurorehabilitation has been proposed and used for the treatment of motor paralysis in stroke, and its effect has been verified. If an expected score for the neurorehabilitation effect can be calculated using the Fugl-Meyer Motor Assessment (FMA), a global assessment index, before neurorehabilitation, such a score will be useful for optimizing the treatment application criteria and for setting a goal to enhance the treatment effect. Therefore, this study verified whether the responsiveness to a treatment method, the NovEl intervention using repetitive transcranial magnetic stimulation and occupational therapy (NEURO), in patients with post-stroke upper extremity (UE) motor paralysis could be predicted by the pretreatment FMA score. No control group was established in this study for NEURO treatment. To analyze the recovery of the motor function in the UE, delta-FMA was calculated from the pre- and post-FMA scores obtained during NEURO treatment. The probability of three levels of treatment responsiveness was evaluated in association with delta-FMA score (<5, 5 ≤ delta-FMA <10, and ≥10 as non-responders; responders; and hyper-responders, respectively) according to the reported minimal clinically important difference (MCID). The association of the initial FMA scores with post-FMA scores, from the status of the treatment responsiveness, was determined by multinomial logistic regression analysis. Finally, 1,254 patients with stroke, stratified by FMA scores were analyzed. About 45% of the patients who had FMA scores ranging from 30 to 40 before treatment showed improvement over the MCID by NEURO treatment (odds ratio = 0.93, 95% CI = 0.92–0.95). Furthermore, more than 25% of the patients with more severe initial values, ranging from 26 to 30, improved beyond the MCID calculated in the acute phase (odds ratio = 0.87, 95% CI = 0.85–0.89). These results suggest that the evaluated motor function score of the UE before NEURO treatment can be used to estimate the possibility of a patient recovering beyond MCID in the chronic phase. This study provided clinical data to estimate the effect of NEURO treatment by the pretreatment FMA-UE score.

ACS Style

Toyohiro Hamaguchi; Naoki Yamada; Takuya Hada; Masahiro Abo. Prediction of Motor Recovery in the Upper Extremity for Repetitive Transcranial Magnetic Stimulation and Occupational Therapy Goal Setting in Patients With Chronic Stroke: A Retrospective Analysis of Prospectively Collected Data. Frontiers in Neurology 2020, 11, 581186 .

AMA Style

Toyohiro Hamaguchi, Naoki Yamada, Takuya Hada, Masahiro Abo. Prediction of Motor Recovery in the Upper Extremity for Repetitive Transcranial Magnetic Stimulation and Occupational Therapy Goal Setting in Patients With Chronic Stroke: A Retrospective Analysis of Prospectively Collected Data. Frontiers in Neurology. 2020; 11 ():581186.

Chicago/Turabian Style

Toyohiro Hamaguchi; Naoki Yamada; Takuya Hada; Masahiro Abo. 2020. "Prediction of Motor Recovery in the Upper Extremity for Repetitive Transcranial Magnetic Stimulation and Occupational Therapy Goal Setting in Patients With Chronic Stroke: A Retrospective Analysis of Prospectively Collected Data." Frontiers in Neurology 11, no. : 581186.

Journal article
Published: 26 July 2020 in Journal of Clinical Medicine
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Osteosarcopenia and frailty have a negative health impact on an aging society. This cross-sectional study aimed to investigate the clinical characteristics and relationship of osteosarcopenia and frailty in 291 patients with chronic liver disease (CLD), who comprised 137 males and 154 females, with a median age of 70.0 years. Sarcopenia was diagnosed according to the Japan Society of Hepatology criteria. Bone mineral density was measured using dual-energy X-ray absorptiometry. Frailty was defined by five parameters (exhaustion, slowness, weakness, low physical activity, and weight loss). Among the 291 patients, 49 (16.8%) and 81 (27.8%) had osteosarcopenia and frailty, respectively. Frailty and vertebral fracture were more frequently noted in patients with osteosarcopenia than in those without osteosarcopenia (79.6% vs. 17.4% and 59.2% vs. 20.2%, respectively; p < 0.001 for both). Meanwhile, osteosarcopenia and vertebral fracture were more frequently observed in patients with frailty than in those without frailty (48.1% vs. 4.8% and 49.4% vs. 18.1%, respectively; p < 0.001 for both). On multivariate analysis, frailty was an independent factor associated with osteosarcopenia (odds ratio (OR), 9.837; p < 0.001), and vice versa (OR, 10.069; p < 0.001). Osteosarcopenia and frailty were prevalent, closely interrelated, and increased the risk of vertebral fracture in patients with CLD.

ACS Style

Chisato Saeki; Tomoya Kanai; Masanori Nakano; Tsunekazu Oikawa; Yuichi Torisu; Masahiro Abo; Masayuki Saruta; Akihito Tsubota. Relationship between Osteosarcopenia and Frailty in Patients with Chronic Liver Disease. Journal of Clinical Medicine 2020, 9, 2381 .

AMA Style

Chisato Saeki, Tomoya Kanai, Masanori Nakano, Tsunekazu Oikawa, Yuichi Torisu, Masahiro Abo, Masayuki Saruta, Akihito Tsubota. Relationship between Osteosarcopenia and Frailty in Patients with Chronic Liver Disease. Journal of Clinical Medicine. 2020; 9 (8):2381.

Chicago/Turabian Style

Chisato Saeki; Tomoya Kanai; Masanori Nakano; Tsunekazu Oikawa; Yuichi Torisu; Masahiro Abo; Masayuki Saruta; Akihito Tsubota. 2020. "Relationship between Osteosarcopenia and Frailty in Patients with Chronic Liver Disease." Journal of Clinical Medicine 9, no. 8: 2381.

Neurology
Published: 23 March 2020 in Current Medical Research and Opinion
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Introduction: The safety and tolerability of incobotulinumtoxinA 400 U for upper- and lower-limb post-stroke spasticity was assessed in a small cohort of Japanese patients during the open-label lead-in tolerability periods (LITP) of two phase 3 studies (CTI-153029 and CTI-153030; Japan Pharmaceutical Information Centre).Methods: Adult patients received a single incobotulinumtoxinA injection session (total dose of 400 U) in the upper (J-PURE) or lower limb (J-PLUS). Adverse events (AEs) were assessed at 1, 4, 8, and 12 weeks post-injection during the 12-week follow-up.Results: The LITP of J-PURE and J-PLUS included 11 patients each. Mild/moderate AEs were reported by 5/11 (45.5%) and 8/11 (72.7%) patients in J-PURE and J-PLUS, respectively. No serious AEs were reported. Non-serious, transient AEs of special interest reported by 2 patients in J-PURE comprised muscular weakness and eyelid ptosis. No patient discontinued due to AEs.Conclusion: Preliminary results in this small population suggest that incobotulinumtoxinA 400 U is well tolerated for treating upper- or lower-limb post-stroke spasticity in Japanese patients.

ACS Style

Hitoshi Kagaya; Yoshihisa Masakado; Eiichi Saitoh; Toshiyuki Fujiwara; Masahiro Abo; Shin-Ichi Izumi; Hiroyuki Nodera; Andrzej Dekundy; Reinhard Hiersemenzel; Christiane Martina Nalaskowski; Angelika Hanschmann; Ryuji Kaji. IncobotulinumtoxinA for upper- and lower-limb spasticity in Japanese patients. Current Medical Research and Opinion 2020, 36, 827 -834.

AMA Style

Hitoshi Kagaya, Yoshihisa Masakado, Eiichi Saitoh, Toshiyuki Fujiwara, Masahiro Abo, Shin-Ichi Izumi, Hiroyuki Nodera, Andrzej Dekundy, Reinhard Hiersemenzel, Christiane Martina Nalaskowski, Angelika Hanschmann, Ryuji Kaji. IncobotulinumtoxinA for upper- and lower-limb spasticity in Japanese patients. Current Medical Research and Opinion. 2020; 36 (5):827-834.

Chicago/Turabian Style

Hitoshi Kagaya; Yoshihisa Masakado; Eiichi Saitoh; Toshiyuki Fujiwara; Masahiro Abo; Shin-Ichi Izumi; Hiroyuki Nodera; Andrzej Dekundy; Reinhard Hiersemenzel; Christiane Martina Nalaskowski; Angelika Hanschmann; Ryuji Kaji. 2020. "IncobotulinumtoxinA for upper- and lower-limb spasticity in Japanese patients." Current Medical Research and Opinion 36, no. 5: 827-834.

Journal article
Published: 18 February 2020 in Toxins
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In many countries, 400 units (U) is the maximum dose of onabotulinumtoxinA available to treat upper limb spasticity, but few studies have demonstrated the optimal use of this dose. In the double-blind phase of this randomized, controlled trial, we compared the efficacy and safety of 400 vs. 240 U onabotulinumtoxinA in patients with post-stroke upper limb spasticity. Both groups received 240 U onabotulinumtoxinA injected in the forearm. An additional 160 U onabotulinumtoxinA (400 U group) or placebo (240 U group) was injected in the elbow flexors. Both groups showed similar muscle tone reduction in the wrist, fingers, and thumb; muscle tone reduction in the elbow flexors was greater in the group treated with onabotulinumtoxinA (400 U group) compared to placebo (240 U group). Functional disabilities improved in both groups. No substantial difference was found in safety profiles. In the subsequent open-label phase, all participants received repeat injections of 400 U onabotulinumtoxinA (target muscles and doses per muscle determined by the physician). Similar efficacy and safety outcomes, as with the 400 U group in the double-blind phase, were confirmed. This final report demonstrates that injection of onabotulinumtoxinA 400 U relieves muscle tone in a wide range of areas and improves functional disabilities; generally, it was well-tolerated, and no new safety concerns were identified. The dosing data in the open-label phase will inform optimal use of onabotulinumtoxinA in clinical practice (ClinicalTrials.gov: NCT03261167).

ACS Style

Masahiro Abo; Takashi Shigematsu; Hiroyoshi Hara; Yasuko Matsuda; Akinori Nimura; Yoshiyuki Yamashita; Kaoru Takahashi. Efficacy and Safety of OnabotulinumtoxinA 400 Units in Patients with Post-Stroke Upper Limb Spasticity: Final Report of a Randomized, Double-Blind, Placebo-Controlled Trial with an Open-Label Extension Phase. Toxins 2020, 12, 127 .

AMA Style

Masahiro Abo, Takashi Shigematsu, Hiroyoshi Hara, Yasuko Matsuda, Akinori Nimura, Yoshiyuki Yamashita, Kaoru Takahashi. Efficacy and Safety of OnabotulinumtoxinA 400 Units in Patients with Post-Stroke Upper Limb Spasticity: Final Report of a Randomized, Double-Blind, Placebo-Controlled Trial with an Open-Label Extension Phase. Toxins. 2020; 12 (2):127.

Chicago/Turabian Style

Masahiro Abo; Takashi Shigematsu; Hiroyoshi Hara; Yasuko Matsuda; Akinori Nimura; Yoshiyuki Yamashita; Kaoru Takahashi. 2020. "Efficacy and Safety of OnabotulinumtoxinA 400 Units in Patients with Post-Stroke Upper Limb Spasticity: Final Report of a Randomized, Double-Blind, Placebo-Controlled Trial with an Open-Label Extension Phase." Toxins 12, no. 2: 127.

Review
Published: 05 December 2019 in Toxins
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Aim: The purpose of this study was to examine the effectiveness of botulinum toxin A (BoNT-A) therapy combined with rehabilitation on motor function in post-stroke patients. Methods: The following sources up to December 31, 2018, were searched from inception for articles in English: Pubmed, Scopus, CINAHL, Embase, PsycINFO, and CENTRAL. Trials using injections of BoNT-A for upper and lower limb rehabilitation were examined. We excluded studies that were not performed for rehabilitation or were not evaluated for motor function. Results: Twenty-six studies were included. In addition to rehabilitation, nine studies used adjuvant treatment to improve spasticity or improve motor function. In the upper limbs, two of 14 articles indicated that significant improvement in upper limb motor function was observed compared to the control group. In the lower limbs, seven of 14 articles indicated that significant improvement in lower limb motor function was observed compared to the control group. Conclusions: The effect of combined with rehabilitation is limited after stroke, and there is not sufficient evidence, but results suggest that BoNT-A may help to improve motor function. In future studies, the establishment of optimal rehabilitation and evaluation times of BoNT-A treatment will be necessary for improving motor function and spasticity.

ACS Style

Takatoshi Hara; Ryo Momosaki; Masachika Niimi; Naoki Yamada; Hiroyoshi Hara; Masahiro Abo. Botulinum Toxin Therapy Combined with Rehabilitation for Stroke: A Systematic Review of Effect on Motor Function. Toxins 2019, 11, 707 .

AMA Style

Takatoshi Hara, Ryo Momosaki, Masachika Niimi, Naoki Yamada, Hiroyoshi Hara, Masahiro Abo. Botulinum Toxin Therapy Combined with Rehabilitation for Stroke: A Systematic Review of Effect on Motor Function. Toxins. 2019; 11 (12):707.

Chicago/Turabian Style

Takatoshi Hara; Ryo Momosaki; Masachika Niimi; Naoki Yamada; Hiroyoshi Hara; Masahiro Abo. 2019. "Botulinum Toxin Therapy Combined with Rehabilitation for Stroke: A Systematic Review of Effect on Motor Function." Toxins 11, no. 12: 707.

Clinical trial
Published: 07 November 2019 in BioMed Research International
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Aim. This study evaluated whether specific actual performance could accurately predict body function levels and upper limb use in the real-life functioning of poststroke hemiparesis patients to aid in choosing the most appropriate rehabilitation exercises. Methods. We measured the time taken for poststroke patients to move small objects with the paralyzed hand and investigated how the measurement could estimate upper extremity motor impairment and hand usage during activities of daily living (ADL). We examined 86 stroke patients (age 66 ± 16 years) whose upper extremity motor paralysis was measured using the Fugl-Meyer assessment (FMA) and Southampton Hand Assessment Procedure (SHAP), and patient-reported ADL was investigated using the Jikei Assessment Scale for Motor Impairment in Daily Living (JASMID). To identify the time required to perform each SHAP item, we employed a linear regression analysis. The prediction formula was used in the linear regression analysis, and the coefficient of determination (R 2) was applied to compare each component item score that was obtained with the predicted values derived from the linear regression analysis. Results. The most easily accomplished task was Heavy Power in the SHAP. The R 2 between the SHAP Heavy Power item score and the FMA scores was moderate (R 2 = 0.344, P < 0.0001 ), whereas the R 2 with the JASMID score was low (R 2 = 0.126, P < 0.001 ). Conclusions. By measuring the time it takes for poststroke hemiparesis patients to hold and move an object, we developed a prediction formula for upper extremity motor function and hand dexterity.

ACS Style

Tomoko Tanaka; Toyohiro Hamaguchi; Makoto Suzuki; Daigo Sakamoto; Junpei Shikano; Naoki Nakaya; Masahiro Abo. Estimation of Motor Impairment and Usage of Upper Extremities during Daily Living Activities in Poststroke Hemiparesis Patients by Observation of Time Required to Accomplish Hand Dexterity Tasks. BioMed Research International 2019, 2019, 1 -8.

AMA Style

Tomoko Tanaka, Toyohiro Hamaguchi, Makoto Suzuki, Daigo Sakamoto, Junpei Shikano, Naoki Nakaya, Masahiro Abo. Estimation of Motor Impairment and Usage of Upper Extremities during Daily Living Activities in Poststroke Hemiparesis Patients by Observation of Time Required to Accomplish Hand Dexterity Tasks. BioMed Research International. 2019; 2019 ():1-8.

Chicago/Turabian Style

Tomoko Tanaka; Toyohiro Hamaguchi; Makoto Suzuki; Daigo Sakamoto; Junpei Shikano; Naoki Nakaya; Masahiro Abo. 2019. "Estimation of Motor Impairment and Usage of Upper Extremities during Daily Living Activities in Poststroke Hemiparesis Patients by Observation of Time Required to Accomplish Hand Dexterity Tasks." BioMed Research International 2019, no. : 1-8.

Articles
Published: 22 October 2019 in International Journal of Neuroscience
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Purpose/aim: An intervention that combines low-frequency repetitive transcranial magnetic stimulation and intensive occupational therapy can improve brain function in post-stroke patients with motor paralysis. The purpose of the present study is examined motor function recovery by repetitive transcranial magnetic stimulation and intensive occupational therapy and changes in the activity of motor cortex based on magnetic resonance imaging data. Materials and methods: In total, we assessed 30 patients with post-stroke upper extremity paralysis who were hospitalized for 12 sessions of low-frequency repetitive transcranial magnetic stimulation over the lesion-free hemisphere plus daily occupational therapy for 15 days. Imaging analysis was performed using 3-dimensional T1-weighted image and functional magnetic resonance imaging. Hemispheric dominance was assessed by functional magnetic resonance imaging using the laterality index. In addition, Seed-based functional connectivity analysis was used to evaluate functional connectivity between the precentral gyrus of the affected side and other areas. Results: A positive correlation was found between laterality index before intervention and the Brunnstrom recovery stage for hand/fingers (p < 0.05). The intervention resulted in significantly higher functional connectivity between the precentral gyrus of the affected side and that of the healthy side (false discovery rate corrected p < 0.05). Conclusions: We clarified that the recovery of motor function by intervention with low-frequency repetitive transcranial magnetic stimulation and occupational therapy and the increase of functional connectivity between the precentral gyrus on the affected side and the healthy side are related. These results facilitate prognostic predictions and evidence-based medical care.

ACS Style

Ryo Ueda; Naoki Yamada; Masahiro Abo; Pradeepa Wanniarachchi Ruwan; Atsushi Senoo; Wanni Arachchi Pradeepa Ruwan. MRI evaluation of motor function recovery by rTMS and intensive occupational therapy and changes in the activity of motor cortex. International Journal of Neuroscience 2019, 130, 309 -317.

AMA Style

Ryo Ueda, Naoki Yamada, Masahiro Abo, Pradeepa Wanniarachchi Ruwan, Atsushi Senoo, Wanni Arachchi Pradeepa Ruwan. MRI evaluation of motor function recovery by rTMS and intensive occupational therapy and changes in the activity of motor cortex. International Journal of Neuroscience. 2019; 130 (3):309-317.

Chicago/Turabian Style

Ryo Ueda; Naoki Yamada; Masahiro Abo; Pradeepa Wanniarachchi Ruwan; Atsushi Senoo; Wanni Arachchi Pradeepa Ruwan. 2019. "MRI evaluation of motor function recovery by rTMS and intensive occupational therapy and changes in the activity of motor cortex." International Journal of Neuroscience 130, no. 3: 309-317.

Journal article
Published: 02 August 2019 in Toxins
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The short-term effects of botulinum toxin type A (BoNT-A) treatment in stroke patients with upper limb extremity are well established. This study examined the association between the recovery of motor function of the upper extremity with subjective physical symptoms in outpatients receiving long-term BoNT-A and occupational therapy following stroke. We also investigated the expectations of patients who elected to continue treatment. Forty-seven patients (23 men and 24 women) aged 61 years received BoNT-A treatment more than 20 times. The subjective physical status was analyzed by using the visual analogue scale score through an eight-item questionnaire. Recovery of motor function in the upper extremity was detected by calculating the change (delta) in Fugl-Mayer Assessment (FMA), and ordinal logistic modeling analysis was used to determine the association between the delta-FMA score and the subjective level of agreement for each item. When the ordinal logistic modeling fit was statistically significant, results were interpreted as having logistic probability. The logistic curves discriminating one point (strongly disagree) from five points (strongly agree) were fit in a stepwise fashion. This study suggests that patients receiving long-term BoNT-A treatment and occupational therapy experienced an increased upper extremity mitigation and decreased insomnia after injection, regardless of the recovery of motor function.

ACS Style

Toyohiro Hamaguchi; Masahiro Abo; Kai Murata; Mari Kenmoku; Izumi Yoshizawa; Atsushi Ishikawa; Makoto Suzuki; Naoki Nakaya; Kensuke Taguchi. Association of Long-Term Treatment by Botulinum Neurotoxins and Occupational Therapy with Subjective Physical Status in Patients with Post-Stroke Hemiplegia. Toxins 2019, 11, 453 .

AMA Style

Toyohiro Hamaguchi, Masahiro Abo, Kai Murata, Mari Kenmoku, Izumi Yoshizawa, Atsushi Ishikawa, Makoto Suzuki, Naoki Nakaya, Kensuke Taguchi. Association of Long-Term Treatment by Botulinum Neurotoxins and Occupational Therapy with Subjective Physical Status in Patients with Post-Stroke Hemiplegia. Toxins. 2019; 11 (8):453.

Chicago/Turabian Style

Toyohiro Hamaguchi; Masahiro Abo; Kai Murata; Mari Kenmoku; Izumi Yoshizawa; Atsushi Ishikawa; Makoto Suzuki; Naoki Nakaya; Kensuke Taguchi. 2019. "Association of Long-Term Treatment by Botulinum Neurotoxins and Occupational Therapy with Subjective Physical Status in Patients with Post-Stroke Hemiplegia." Toxins 11, no. 8: 453.

Multicenter study
Published: 07 June 2019 in Nutrients
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Low vitamin D levels are associated with poorer outcomes after stroke. However, it is not clear whether post-stroke vitamin D supplementation can improve these outcomes. In this study, we investigated the effects of vitamin D supplementation on outcomes in hospitalized patients undergoing rehabilitation after acute stroke. A multicenter, randomized, controlled, double-blind, parallel-group trial was conducted from January 2012 through July 2017. One hundred patients admitted to a convalescent rehabilitation ward after having an acute stroke were randomized, and each one received either vitamin D3 (2000 IU/day) or a placebo. The primary outcome was a gain in the Barthel Index scores at week 8. Secondary outcomes were seen in Barthel Index efficiency, hand grip strength, and calf circumference at week 8. Ninety-seven patients completed the study. There were no significant differences in the demographic characteristics between the groups. The mean (±standard deviation) gain in the Barthel Index score was 19.0 ± 14.8 in the supplementation group and 19.5 ± 13.1 in the placebo group (p = 0.88). The Barthel Index efficiency was 0.32 ± 0.31 in the supplementation group and 0.28 ± 0.21 in the placebo group (p = 0.38). There were no between-group differences in the other secondary outcomes. Our findings suggest that oral vitamin D3 supplementation does not improve rehabilitation outcomes after acute stroke.

ACS Style

Ryo Momosaki; Masahiro Abo; Mitsuyoshi Urashima. Vitamin D Supplementation and Post-Stroke Rehabilitation: A Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients 2019, 11, 1295 .

AMA Style

Ryo Momosaki, Masahiro Abo, Mitsuyoshi Urashima. Vitamin D Supplementation and Post-Stroke Rehabilitation: A Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients. 2019; 11 (6):1295.

Chicago/Turabian Style

Ryo Momosaki; Masahiro Abo; Mitsuyoshi Urashima. 2019. "Vitamin D Supplementation and Post-Stroke Rehabilitation: A Randomized, Double-Blind, Placebo-Controlled Trial." Nutrients 11, no. 6: 1295.

Original article
Published: 21 May 2019 in Acta Neurologica Belgica
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Intervention that combines low-frequency repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy (OT) may improve brain function in post-stroke patients with motor paralysis. We aimed to clarify the brain region involved in motor function improvement following chronic stroke. We recruited 25 patients hospitalized for 15 days with post-stroke upper extremity paralysis to receive 12 sessions of low-frequency rTMS over the non-lesioned hemisphere and occupational therapy. In this study, 72% of the patients had suffered from intracranial haemorrhage. Imaging analysis was performed using diffusion tensor imaging (DTI) to assess changes in white matter after intervention. We investigated white matter change before and after intervention and the relationship between white matter structure and motor function recovery using tract-based spatial statistics. The intra-voxel directional coherence was significantly increased in the anterior limb of the internal capsule and anterior thalamic radiation on the lesional side following intervention. Mean diffusivity and radial diffusivity values of clusters in the superior corona radiata on the lesional side were negatively correlated with motor function recovery. White matter nerve fibre structures are involved in motor function improvement following rTMS and OT interventions. Our results show novel findings regarding the relationship between stroke neurorehabilitation and cerebral nerve structure.

ACS Style

Ryo Ueda; Naoki Yamada; Masahiro Abo; Atsushi Senoo. White matter changes follow low-frequency repetitive transcranial magnetic stimulation plus intensive occupational therapy for motor paralysis after stroke: a DTI study using TBSS. Acta Neurologica Belgica 2019, 121, 387 -396.

AMA Style

Ryo Ueda, Naoki Yamada, Masahiro Abo, Atsushi Senoo. White matter changes follow low-frequency repetitive transcranial magnetic stimulation plus intensive occupational therapy for motor paralysis after stroke: a DTI study using TBSS. Acta Neurologica Belgica. 2019; 121 (2):387-396.

Chicago/Turabian Style

Ryo Ueda; Naoki Yamada; Masahiro Abo; Atsushi Senoo. 2019. "White matter changes follow low-frequency repetitive transcranial magnetic stimulation plus intensive occupational therapy for motor paralysis after stroke: a DTI study using TBSS." Acta Neurologica Belgica 121, no. 2: 387-396.

Articles
Published: 26 November 2018 in International Journal of Neuroscience
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Background: The beneficial effects of the combination therapy of low-frequency repetitive transcranial magnetic stimulation of non-lesional hemisphere and intensive occupational therapy (LF-rTMS/OT) on upper limb hemiparesis have been well established in poststroke patients. However, there is no information on the effect of brain activity on LF-rTMS/OT treatment outcome. Method: A total of 59 poststroke patients with upper limb hemiparesis received 15-day LF-rTMS/OT. Motor function of the affected upper limb was evaluated before and after the treatment. We also conducted functional near-infrared spectroscopy (fNIRS) before the treatment and calculated the laterality index (LI) based on the change in oxy-hemoglobin in the primary sensorimotor cortex and supplementary motor cortex. The correlation between LI before LF-rTMS/OT and observed improvement in upper limb motor function was analyzed. Results: Motor recovery was significantly more pronounced in patients with unaffected hemisphere dominance in both hemispheres (LI of -1 to 0) than in those with affected hemisphere dominance in the lesional hemisphere (LI of 0 to 1). There was a significant negative correlation between LI and improvement in upper limb motor function. Discussion: The results demonstrated that patients with a shift in brain activity to the non-injured cerebral cortex exhibited better motor recovery following LF-rTMS/OT. The findings suggest that evaluation of brain asymmetry before LF-rTMS/OT with fNIRS can help predict the response to LF-rTMS/OT.

ACS Style

Hiroaki Tamashiro; Shoji Kinoshita; Takatsugu Okamoto; Naoki Urushidani; Masahiro Abo. Effect of baseline brain activity on response to low-frequency rTMS/intensive occupational therapy in poststroke patients with upper limb hemiparesis: a near-infrared spectroscopy study. International Journal of Neuroscience 2018, 129, 337 -343.

AMA Style

Hiroaki Tamashiro, Shoji Kinoshita, Takatsugu Okamoto, Naoki Urushidani, Masahiro Abo. Effect of baseline brain activity on response to low-frequency rTMS/intensive occupational therapy in poststroke patients with upper limb hemiparesis: a near-infrared spectroscopy study. International Journal of Neuroscience. 2018; 129 (4):337-343.

Chicago/Turabian Style

Hiroaki Tamashiro; Shoji Kinoshita; Takatsugu Okamoto; Naoki Urushidani; Masahiro Abo. 2018. "Effect of baseline brain activity on response to low-frequency rTMS/intensive occupational therapy in poststroke patients with upper limb hemiparesis: a near-infrared spectroscopy study." International Journal of Neuroscience 129, no. 4: 337-343.

Controlled clinical trial
Published: 31 August 2018 in Toxins
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Objectives: This study is a retrospective investigation of the effects of repetitive botulinum toxin A therapy (BoNT-A) and intensive rehabilitation (IR) on lower limb spasticity in post-stroke patients. Methods: Thirty-five post-stroke patients was included in this study and received BoNT-A for the first time. A 12-day inpatient protocol was with 4 cycles of the treatment protocol. The severity of spasticity, motor function and brace status were evaluated. Results: The modified Ashworth Scale (MAS) score of ankle dorsiflexors, range of motion, walking speed and balancing ability were significantly improved after cycle 1. The improvement of spasticity and motor function was persistent through cycles 2–4. One-third of brace users were able to discontinue the use of a brace. All of these brace users showed a forward gait pattern prior to therapy. Conclusions: Repeated BoNT-A combined with IR improved lower limb spasticity in post-stroke patients. Our results suggest that patients who show the forward gait pattern prior to therapy may be able to discontinue the use of their brace after therapy.

ACS Style

Takatoshi Hara; Masahiro Abo; Hiroyoshi Hara; Nobuyuki Sasaki; Naoki Yamada; Masachika Niimi; Yusuke Shimamoto. The Effect of Repeated Botulinum Toxin A Therapy Combined with Intensive Rehabilitation on Lower Limb Spasticity in Post-Stroke Patients. Toxins 2018, 10, 349 .

AMA Style

Takatoshi Hara, Masahiro Abo, Hiroyoshi Hara, Nobuyuki Sasaki, Naoki Yamada, Masachika Niimi, Yusuke Shimamoto. The Effect of Repeated Botulinum Toxin A Therapy Combined with Intensive Rehabilitation on Lower Limb Spasticity in Post-Stroke Patients. Toxins. 2018; 10 (9):349.

Chicago/Turabian Style

Takatoshi Hara; Masahiro Abo; Hiroyoshi Hara; Nobuyuki Sasaki; Naoki Yamada; Masachika Niimi; Yusuke Shimamoto. 2018. "The Effect of Repeated Botulinum Toxin A Therapy Combined with Intensive Rehabilitation on Lower Limb Spasticity in Post-Stroke Patients." Toxins 10, no. 9: 349.

Journal article
Published: 18 July 2018 in The Japanese Journal of Rehabilitation Medicine
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目的:本研究の目的は日本におけるリハビリテーション医学領域の研究登録状況を調査し,今後のリハビリテーション医学研究のあり方について検討することである. 方法:UMIN-CTR(2005年以降)の登録データを用い,リハビリテーション医学領域の介入研究を網羅的に検索した.研究デザインや結果公開状況,登録時期などのデータを収集し,検討を行った. 結果:21,410件のデータより,529件の研究が抽出された.研究デザインは並行群間比較が54%と最も多く,有効性の検討を目的とした研究が65%と多かった.比較試験の86%はランダム化がなされており,53%はブラインド化がなされていた.研究開始前の事前登録は50%あり,事後登録研究に比べ,結果の公開割合が少なかった. 結論:研究登録数は経年的に増加していたが,研究の透明性を確保するためにも事前登録を心がける必要があると考えられた.リハビリテーション医学領域においても臨床研究を適切に計画・登録できる医療者のさらなる育成が重要だと考えられた.

ACS Style

Ryo Momosaki; Masafumi Okada; Tsuyoshi Okuhara; Takahiro Kiuchi; Naoshi Ogata; Masahiro Abo. Clinical Trials Registry in the Field of Rehabilitation Medicine. The Japanese Journal of Rehabilitation Medicine 2018, 55, 606 -613.

AMA Style

Ryo Momosaki, Masafumi Okada, Tsuyoshi Okuhara, Takahiro Kiuchi, Naoshi Ogata, Masahiro Abo. Clinical Trials Registry in the Field of Rehabilitation Medicine. The Japanese Journal of Rehabilitation Medicine. 2018; 55 (7):606-613.

Chicago/Turabian Style

Ryo Momosaki; Masafumi Okada; Tsuyoshi Okuhara; Takahiro Kiuchi; Naoshi Ogata; Masahiro Abo. 2018. "Clinical Trials Registry in the Field of Rehabilitation Medicine." The Japanese Journal of Rehabilitation Medicine 55, no. 7: 606-613.

Journal article
Published: 22 May 2018 in Journal of Stroke and Cerebrovascular Diseases
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Rehabilitation characteristics in high-performance hospitals after acute stroke are not clarified. This retrospective observational study aimed to clarify the characteristics of high-performance hospitals in acute stroke rehabilitation. Patients with stroke discharged from participating acute hospitals were extracted from the Japan Rehabilitation Database for the period 2006-2015. We found 6855 patients from 14 acute hospitals who were eligible for analysis in this study after applying exclusion criteria. We divided facilities into high-performance hospitals and low-performance hospitals using the median of the Functional Independent Measure efficiency for each hospital. We compared rehabilitation characteristics between high- and low-performance hospitals. High-performance hospitals had significantly shorter length of stay. More patients were discharged to home in the high-performance hospitals compared with low-performance hospitals. Patients in high-performance hospitals received greater amounts of physical, occupational, and speech therapy. Patients in high-performance hospitals engaged in more self-exercise, weekend exercise, and exercise in wards. There was more participation of board-certified physiatrists and social workers in high-performance hospitals. Our data suggested that amount, timing, and type of rehabilitation, and participation of multidisciplinary staff are essential for high performance in acute stroke rehabilitation.

ACS Style

Masashi Sawabe; Ryo Momosaki; Kiyotaka Hasebe; Akira Sawaguchi; Seiji Kasuga; Daichi Asanuma; Shoya Suzuki; Narimi Miyauchi; Masahiro Abo. Rehabilitation Characteristics in High-Performance Hospitals after Acute Stroke. Journal of Stroke and Cerebrovascular Diseases 2018, 27, 2431 -2435.

AMA Style

Masashi Sawabe, Ryo Momosaki, Kiyotaka Hasebe, Akira Sawaguchi, Seiji Kasuga, Daichi Asanuma, Shoya Suzuki, Narimi Miyauchi, Masahiro Abo. Rehabilitation Characteristics in High-Performance Hospitals after Acute Stroke. Journal of Stroke and Cerebrovascular Diseases. 2018; 27 (9):2431-2435.

Chicago/Turabian Style

Masashi Sawabe; Ryo Momosaki; Kiyotaka Hasebe; Akira Sawaguchi; Seiji Kasuga; Daichi Asanuma; Shoya Suzuki; Narimi Miyauchi; Masahiro Abo. 2018. "Rehabilitation Characteristics in High-Performance Hospitals after Acute Stroke." Journal of Stroke and Cerebrovascular Diseases 27, no. 9: 2431-2435.

Journal article
Published: 18 April 2018 in The Japanese Journal of Rehabilitation Medicine
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ACS Style

Ryo Momosaki; Shoji Kinoshita; Masahiro Abo. Significance of Board Certified Physiatrist in Convalescent Rehabilitation Medicine. The Japanese Journal of Rehabilitation Medicine 2018, 55, 323 -326.

AMA Style

Ryo Momosaki, Shoji Kinoshita, Masahiro Abo. Significance of Board Certified Physiatrist in Convalescent Rehabilitation Medicine. The Japanese Journal of Rehabilitation Medicine. 2018; 55 (4):323-326.

Chicago/Turabian Style

Ryo Momosaki; Shoji Kinoshita; Masahiro Abo. 2018. "Significance of Board Certified Physiatrist in Convalescent Rehabilitation Medicine." The Japanese Journal of Rehabilitation Medicine 55, no. 4: 323-326.

Comparative study
Published: 06 April 2018 in Geriatrics & Gerontology International
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To test the hypothesis that the functional outcome of hip fracture patients who receive weekend rehabilitation is better than that of similar patients who undergo non-weekend rehabilitation. The present retrospective observational study used data from the Japan Rehabilitation Database spanning 2005-2015. We identified in-hospital hip fracture patients admitted to acute hospitals. After applying exclusion criteria, 469 patients were eligible. The primary outcome was motor Functional Independence Measure (FIM) efficiency. Of the patients with hip fracture, 68.0% received weekend rehabilitation. The patients who received weekend rehabilitation had significantly higher scores in motor FIM efficiency (mean 1.08 vs 0.73, P < 0.001), FIM efficiency (mean 1.12 vs 0.79, P = 0.001) and shorter length of stay (mean 32 vs 54, P < 0.001) than the patients without weekend rehabilitation. Multivariate linear regression analysis identified the weekend rehabilitation as a significant factor in motor FIM efficiency (coefficient 0.237, 95% confidence interval 0.074-0.400, P = 0.004), FIM efficiency (coefficient 0.235, 95% confidence interval 0.079-0.391, P = 0.003) and length of stay (coefficient -9.649, 95% confidence interval -18.194 to -1.104, P = 0.027). The present cohort analysis showed that weekend rehabilitation for hip fracture patients can lead to functional recovery and reduce the length of stay. Geriatr Gerontol Int 2018; 18: 1143-1146.

ACS Style

Kiyotaka Hasebe; Ryo Momosaki; Masashi Sawabe; Masayuki Chono; Akira Sawaguchi; Seiji Kasuga; Daichi Asanuma; Shoya Suzuki; Narimi Miyauchi; Masahiro Abo. Effectiveness of weekend physical rehabilitation for functional recovery in geriatric patients with hip fracture. Geriatrics & Gerontology International 2018, 18, 1143 -1146.

AMA Style

Kiyotaka Hasebe, Ryo Momosaki, Masashi Sawabe, Masayuki Chono, Akira Sawaguchi, Seiji Kasuga, Daichi Asanuma, Shoya Suzuki, Narimi Miyauchi, Masahiro Abo. Effectiveness of weekend physical rehabilitation for functional recovery in geriatric patients with hip fracture. Geriatrics & Gerontology International. 2018; 18 (8):1143-1146.

Chicago/Turabian Style

Kiyotaka Hasebe; Ryo Momosaki; Masashi Sawabe; Masayuki Chono; Akira Sawaguchi; Seiji Kasuga; Daichi Asanuma; Shoya Suzuki; Narimi Miyauchi; Masahiro Abo. 2018. "Effectiveness of weekend physical rehabilitation for functional recovery in geriatric patients with hip fracture." Geriatrics & Gerontology International 18, no. 8: 1143-1146.

Research article
Published: 13 March 2018 in Neural Plasticity
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We aimed to investigate plastic changes in cerebral white matter structures using diffusion tensor imaging following a 15-day stroke rehabilitation program. We compared the detection of cerebral plasticity between generalized fractional anisotropy (GFA), a novel tool for investigating white matter structures, and fractional anisotropy (FA). Low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) of 2400 pulses applied to the nonlesional hemisphere and 240 min intensive occupation therapy (OT) daily over 15 days. Motor function was evaluated using the Fugl-Meyer assessment (FMA) and Wolf Motor Function Test (WMFT). Patients underwent diffusion tensor magnetic resonance imaging (MRI) on admission and discharge, from which bilateral FA and GFA values in Brodmann area (BA) 4 and BA6 were calculated. Motor function improved following treatment (p<0.001). Treatment increased GFA values for both the lesioned and nonlesioned BA4 (p<0.05, p<0.001, resp.). Changes in GFA value for BA4 of the lesioned hemisphere were significantly inversely correlated with changes in WMFT scores (R2=0.363, p<0.05). Our findings indicate that the GFA may have a potentially more useful ability than FA to detect changes in white matter structures in areas of fiber intersection for any such future investigations.

ACS Style

Naoki Yamada; Ryo Ueda; Wataru Kakuda; Ryo Momosaki; Takahiro Kondo; Takuya Hada; Nobuyuki Sasaki; Takatoshi Hara; Atsushi Senoo; Masahiro Abo. Diffusion Tensor Imaging Evaluation of Neural Network Development in Patients Undergoing Therapeutic Repetitive Transcranial Magnetic Stimulation following Stroke. Neural Plasticity 2018, 2018, 1 -8.

AMA Style

Naoki Yamada, Ryo Ueda, Wataru Kakuda, Ryo Momosaki, Takahiro Kondo, Takuya Hada, Nobuyuki Sasaki, Takatoshi Hara, Atsushi Senoo, Masahiro Abo. Diffusion Tensor Imaging Evaluation of Neural Network Development in Patients Undergoing Therapeutic Repetitive Transcranial Magnetic Stimulation following Stroke. Neural Plasticity. 2018; 2018 ():1-8.

Chicago/Turabian Style

Naoki Yamada; Ryo Ueda; Wataru Kakuda; Ryo Momosaki; Takahiro Kondo; Takuya Hada; Nobuyuki Sasaki; Takatoshi Hara; Atsushi Senoo; Masahiro Abo. 2018. "Diffusion Tensor Imaging Evaluation of Neural Network Development in Patients Undergoing Therapeutic Repetitive Transcranial Magnetic Stimulation following Stroke." Neural Plasticity 2018, no. : 1-8.

Multicenter study
Published: 07 March 2018 in Spinal Cord
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Retrospective cohort study. To determine the impact of leg orthotic therapy for improving activities of daily living after spinal cord injury. Participating acute care and rehabilitation hospitals across Japan. We retrospectively identified individuals with spinal cord injury admitted to eight participating hospitals in 2015–2016 from the Japan Rehabilitation Database. Data for 293 individuals were analyzed. Propensity score analysis by inverse probability weighting (IPW) was applied to adjust for potential bias and create two comparable groups. Outcomes were compared between the leg orthotic group and the non-leg orthotic group, using IPW. The primary outcome was motor Functional Independence Measure® (FIM) effectiveness score and the secondary outcome was motor FIM score at discharge. FIM was measured on hospital admission and discharge. Leg orthoses were prescribed for 26% of the 293 individuals. Those prescribed leg orthoses had significantly higher motor FIM effectiveness scores than those who were not, before and after IPW (motor FIM effectiveness: 0.54 vs. 0.35, p < 0.01 and 0.45 vs. 0.36, p = 0.02). Discharge motor FIM was significantly higher in individuals who were prescribed leg orthoses than in those who were not, before and after IPW (discharge motor FIM: 64.5 vs. 52.2, p < 0.01 and 58.9 vs. 53.5, p = 0.02). Leg orthoses may improve activities of daily living in individuals with spinal cord injury after the acute phase.

ACS Style

Takuya Hada; Ryo Momosaki; Masahiro Abo. Impact of orthotic therapy for improving activities of daily living in individuals with spinal cord injury: a retrospective cohort study. Spinal Cord 2018, 56, 790 -795.

AMA Style

Takuya Hada, Ryo Momosaki, Masahiro Abo. Impact of orthotic therapy for improving activities of daily living in individuals with spinal cord injury: a retrospective cohort study. Spinal Cord. 2018; 56 (8):790-795.

Chicago/Turabian Style

Takuya Hada; Ryo Momosaki; Masahiro Abo. 2018. "Impact of orthotic therapy for improving activities of daily living in individuals with spinal cord injury: a retrospective cohort study." Spinal Cord 56, no. 8: 790-795.

Observational study
Published: 02 March 2018 in Geriatrics & Gerontology International
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To clarify the effectiveness of preoperative physical therapy for older patients after hip fracture in an acute care hospital. In the present retrospective observational study, data from the Japan Rehabilitation Database were analyzed for patients admitted to an acute care hospital with hip fracture between 2005 and 2015. In this study, all eligible patients received surgery within 10 days of admission. Propensity score analysis was used to compare outcomes between patients who underwent preoperative rehabilitation and those who did not. The primary outcome was motor Functional Independence Measure (FIM) gain. Of the 681 patients eligible after applying exclusion criteria, 50% underwent preoperative rehabilitation after hip fracture. Both before and after adjustment by inverse probability weighting, motor FIM gain was significantly higher in patients who underwent preoperative rehabilitation (motor FIM gain 31.1 ± 18.2 before weighting, 31.1 ± 18.2 after weighting) than in those who did not (motor FIM gain 24.6 ± 18.1 before weighting, P < 0.01; 26.2 ± 17.6 after weighting, P < 0.02). In addition, motor FIM effectiveness and motor FIM at discharge were significantly higher among patients who underwent preoperative rehabilitation. Our data suggest that preoperative rehabilitation after hip fracture is associated with better rehabilitation outcomes than no preoperative rehabilitation. Geriatr Gerontol Int 2018; ••: ••–••.

ACS Style

Akira Sawaguchi; Ryo Momosaki; Kiyotaka Hasebe; Masayuki Chono; Seiji Kasuga; Masahiro Abo. Effectiveness of preoperative physical therapy for older patients with hip fracture. Geriatrics & Gerontology International 2018, 18, 1003 -1008.

AMA Style

Akira Sawaguchi, Ryo Momosaki, Kiyotaka Hasebe, Masayuki Chono, Seiji Kasuga, Masahiro Abo. Effectiveness of preoperative physical therapy for older patients with hip fracture. Geriatrics & Gerontology International. 2018; 18 (7):1003-1008.

Chicago/Turabian Style

Akira Sawaguchi; Ryo Momosaki; Kiyotaka Hasebe; Masayuki Chono; Seiji Kasuga; Masahiro Abo. 2018. "Effectiveness of preoperative physical therapy for older patients with hip fracture." Geriatrics & Gerontology International 18, no. 7: 1003-1008.