Posttraumatic growth, health-related quality of life and subjective happiness among Great East Japan Earthquake survivors attending a community knitting program to perform acts of kindness

Yarn Alive (YA) is a non-profit organization that was started after the 2011 Great East JapanEarthquake to support women through a knitting group that provided social support, creativeexpression, and opportunities to practice acts of kindness. In this study, we examined whetherYA changed the level of posttraumatic growth (PTG), health-related quality of life (HRQOL),and subjective happiness as measured by the subjective happiness scale (SHS). We conducteda retrospective correlational study through administering a cross-sectional survey to 98 YAparticipants and 97 YA non-participants in May-July 2017. Questionnaires were received from72 YA participants (response rate=73.5%) and 63 non-participants (response rate=64.9%).Data was analyzed by conducting descriptive, correlational, and multiple linear regressionanalyses. Participation in the YA program was shown to have a positive impact on HRQOL(R2=.18, adjusted R2=.15, p<.0001) and SHS (R2=.07, adjusted R2=.05, p=.013), which ispositively correlated with time. Participants with a high school education or less seemed tobenefit more from the program than those with at least a college or university degree (R2=.18,adjusted R2=.15, p<.0001). We also found the spiritual domain of PTG to be higher amongYA participants (t=2.9, p=.004) and overall PTG to be positively associated with incrementalimpact experienced during the disaster (R2=.12, adjusted R2=.11, p<.0001). This study showsthat formal academia-led evaluation of grassroots community programs can yield informationthat may help direct resources to the most appropriate and acceptable programs by thecommunity and strengthen their implementation

Case report: A novel approach of closed-loop brain stimulation combined with robot gait training in post-stroke gait disturbance

Most post-stroke patients have long-lasting gait disturbances that reduce their daily activities. They often show impaired hip and knee joint flexion and ankle dorsiflexion of the lower limbs during the swing phase of gait, which is controlled by the corticospinal tract from the primary motor cortex (M1). Recently, we reported that gait-synchronized closed-loop brain stimulation targeting swing phase-related activity in the affected M1 can improve gait function in post-stroke patients. Subsequently, a gait-training robot (Orthobot®) was developed that could assist lower-limb joint movements during the swing phase of gait. Therefore, we investigated whether gait-synchronized closed-loop brain stimulation combined with robot-assisted training targeting the swing phase could enhance the recovery of post-stroke gait disturbance. A 57-year-old female patient with chronic post-stroke hemiparesis underwent closed-loop brain stimulation combined with robot-assisted training for 10 min 2 years after left pons infarction. For closed-loop brain stimulation, we used transcranial oscillatory electrical current stimulation over the lesioned M1 foot area with 1.5 mA of DC offset and 0–3 mA of sine-wave formed currents triggered by the paretic heel contact to set the maximum current just before the swing phase (intervention A; two times repeated, A1 and A2). According to the N-of-1 study design, we also performed sham stimulation (intervention B) and control stimulation not targeting the swing phase (intervention C) combined with robot-assisted training in the order of A1-B-A2-C interventions. As a result, we found larger improvements in gait speed, the Timed Up and Go test result, and muscle strength after the A1 and A2 interventions than after the B and C interventions. After confirming the short-term effects, we performed an additional long-term intervention twice a week for 5 weeks, for a total of 10 sessions. Gait parameters also largely improved after long-term intervention. Gait-synchronized closed-loop brain stimulation combined with robot-assisted training targeting the swing phase of gait may promote the recovery of gait function in post-stroke patients. Further studies with a larger number of patients are necessary