Biomedical subjects

Manabu Iwata

Publications and source records attributed to Manabu Iwata.

4 recordsLinked to original sources

PubMed2004

Effectiveness of selective muscle-release surgery for children with cerebral palsy: longitudinal and stratified analysis.

The purpose of this study was to determine the effectiveness of muscle-release surgery for children with cerebral palsy (CP) using longitudinal and stratified analysis. Twenty-five children with CP (15 females, 10 males; age range 4 to 16 years; mean age 8 years 2 months, SD 3 years 2 months) were selected from five treatment centres in Japan. Twenty-two children had spastic diplegia, two had spastic quadriplegia, and one had athetospastic quadriplegia. Motor function for each child was assessed using the Gross Motor Function Measure (GMFM). Assessment was conducted on eight separate occasions: 1 month and 1 week before surgery, and 1, 2, 4, 6, 9, and 12 months after surgery. Participants' motor function before surgery was classified using the Gross Motor Function Classification System (GMFCS). Six children were classified at level I, three at level II, six at level III, and 10 at level IV. A significant difference was found after surgery in the GMFCS levels III and IV groups (p<0.05). Improvement in GMFM scores between 1 week before surgery and 12 months after surgery were 1, 5, 8.5, and 8.5 for GMFCS levels I to IV respectively. Results indicate that this treatment is advantageous for improving motor function in children within GMFCS levels III and IV.

Adult↗

PubMed2003

An ankle-foot orthosis with inhibitor bar: effect on hemiplegic gait.

OBJECTIVE: To test whether an inhibitor bar attached to an ankle-foot orthosis (AFO) improves walking ability in hemiplegic stroke patients with tonic toe flexion reflex (TTFR). DESIGN: Before-after trial. SETTING: Rehabilitation hospital in Japan. PARTICIPANTS: Nine patients with TTFR were assigned to the TTFR group, and 8 patients without TTFR were assigned to the control group. INTERVENTION: Inhibitor bar attached to an AFO. MAIN OUTCOME MEASURE: Gait was analyzed by measuring the number of steps and the time required to walk 10m at a maximal walking speed. RESULTS: In the TTFR group, use of an inhibitor bar for 2 weeks significantly increased the maximal walking speed, stride length, and cadence by 13.8% (P=.0045), 8.0% (P=.0398), and 6.1% (P=.0056), respectively. There were no significant changes in the control group. CONCLUSION: An inhibitor bar improved walking ability of hemiplegic patients with TTFR, and its use with an AFO is recommended.

Ankle↗

PubMed2003

Gross motor function classification system: preliminary study for Japanese children.

OBJECTIVE: The purpose of the study was to produce a version of the Gross Motor Function Classification System with the same construct as the original one that would be applicable to Japanese children with cerebral palsy. DESIGN: The reliability studies were performed twice with a convenience sample (first study, 76 children with cerebral palsy; second study, 225 children with cerebral palsy). The first version of the translated Gross Motor Function Classification System was used in the first reliability study. It was revised based on the findings of the study and used in the second reliability study. Two examiners classified each child's level of gross motor function independently. We calculated kappas for individual levels and across all levels to study interrater reliability. RESULTS: The individual kappa for level V changed from 0.59 in the first reliability study to 0.87 in the second reliability study, whereas the overall kappa changed from 0.64 to 0.66. In the second reliability study, the factors that seemed to affect the reproducibility were the unfamiliar words used in the system, partial agreement of the children's status, and thinking of future levels. CONCLUSIONS: Explanation of words and a note stressing the importance of the introduction part should be added to the system for Japanese clinicians.

Age Factors↗

PubMed2002

Prediction of reflex sympathetic dystrophy in hemiplegia by evaluation of hand edema.

OBJECTIVE: To determine the predictive value of measurements of hand edema for the development of reflex sympathetic dystrophy (RSD). DESIGN: Cohort study. SETTING: Departments of rehabilitation medicine in 3 general hospitals and 1 rehabilitation hospital in Japan. PARTICIPANTS: Thirty-four stroke patients. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Measurement of the circumference of the middle finger was used to evaluate hand edema. The degree of hand edema was expressed by the ratio of circumference of the middle finger (RCMF) in the affected side to that in the uninvolved extremity. RESULTS: Eight of 34 patients developed clinical RSD from 2 to 4 months after stroke. Hand edema showed a significant relationship to the development of RSD (ie, the patients who had an RCMF of above 1.06 at 4 weeks poststroke had significantly higher incidence of RSD than those with a lower RCMF; P=.0127). CONCLUSION: It is possible to predict the development of RSD in hemiplegia by measuring hand edema 4 weeks poststroke.

Adult↗