脳卒中者の隙間通過歩行と知覚判断

首都大学東京, 2018-03-25, 博士（健康科学）, 乙第165号首都大学東

Relationships Between Childhood Bullying/Domestic Violence Experience and Insomnia among Employees in Japan [version 1; peer review: 2 approved]

Traumatic childhood experiences such as domestic violence and bullying have been reported to be associated with insomnia in adulthood. However, little evidence is available for the long-term effects of childhood adversity on workers’ insomnia worldwide. Our objective was to examine whether childhood experiences of bullying and domestic violence are associated with insomnia in workers in adulthood. We used survey data from a cross-sectional study of the Tsukuba Science City Network in Tsukuba City, Japan. Workers aged 20 to 65 years (4509 men and 2666 women) were targeted. The Binomial Logistic regression analysis with the Athens Insomnia Scale as the objective variable showed that childhood bullying and domestic violence experience of childhood bullying and domestic violence were associated with insomnia. It may be useful to focus on childhood traumatic experiences regarding insomnia in workers

Obstacle avoidance training for individuals with stroke: a systematic review and meta-analysis

Objectives: To accumulate evidence that obstacle avoidance training alone is effective in improving the locomotor ability of individuals with stroke. Design: Systematic review and meta-analysis. Setting: MEDLINE, EMBASE, CENTRAL, ICTRP and PEDro were searched for related information until December 2018. Two independent reviewers extracted data. Outcome measurement data were subjected to meta-analyses using random-effects models. Data syntheses were conducted using RevMan V.5.3, and the certainty of evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation approach. Participants: Participants with various types and phases of stroke were included. Intervention: The usual gait training including obstacle avoidance training (interventions of any type, intensity, duration and frequency). Results: Two randomised controlled trials with a total of 49 participants were used as data sources for this study. The obstacle avoidance training (training) group had lower gait speed than the control group (mean difference (MD) 0.03, 95% CI −0.11 to 0.16, p=0.51). Further, the certainty of evidence was very low. The subjective balance ability (Activities-specific Balance Confidence scale) was not significantly different between the training and control groups (MD 6.65, 95% CI −7.59 to 20.89, p=0.36), and it showed very low certainty of evidence. Conclusions: Obstacle avoidance training may have little or no effect on individuals with stroke. The failure to find the effectiveness of obstacle avoidance training alone is possibly attributable to the insufficient amount of training in the intervention and the lack of well-designed studies that measured relevant outcomes. PROSPERO registration number: CRD42017060691

Walking through Apertures in Individuals with Stroke

<div><p>Objective</p><p>Walking through a narrow aperture requires unique postural configurations, i.e., body rotation in the yaw dimension. Stroke individuals may have difficulty performing the body rotations due to motor paralysis on one side of their body. The present study was therefore designed to investigate how successfully such individuals walk through apertures and how they perform body rotation behavior.</p><p>Method</p><p>Stroke fallers (n = 10), stroke non-fallers (n = 13), and healthy controls (n = 23) participated. In the main task, participants walked for 4 m and passed through apertures of various widths (0.9–1.3 times the participant’s shoulder width). Accidental contact with the frame of an aperture and kinematic characteristics at the moment of aperture crossing were measured. Participants also performed a perceptual judgment task to measure the accuracy of their perceived aperture passability.</p><p>Results and Discussion</p><p>Stroke fallers made frequent contacts on their paretic side; however, the contacts were not frequent when they penetrated apertures from their paretic side. Stroke fallers and non-fallers rotated their body with multiple steps, rather than a single step, to deal with their motor paralysis. Although the minimum passable width was greater for stroke fallers, the body rotation angle was comparable among groups. This suggests that frequent contact in stroke fallers was due to insufficient body rotation. The fact that there was no significant group difference in the perceived aperture passability suggested that contact occurred mainly due to locomotor factors rather than perceptual factors. Two possible explanations (availability of vision and/or attention) were provided as to why accidental contact on the paretic side did not occur frequently when stroke fallers penetrated the apertures from their paretic side.</p></div

The number of steps necessary to cross the aperture in each group.

<p>The number of steps necessary to cross the aperture in each group.</p