There is some information about the Functional Independence Measure (FIM) score of patients with spinal cord injury (SCI), but there are a few publications dealing with the relationship between the FIM score and the motor score of the American Spinal Injury Association (ASIA). We have studied the relationship of all FIM items with the motor score, and reviewed the disability of patients with spinal cord injury in greater detail. The purpose of this study was to describe the characteristics of impairment and disability in patients with SCI, using the FIM and motor score of the ASIA. The subjects were 100 inpatients with SCI (Frankel A, B). Neurological level, days from the onset, and the FIM were examined. In addition to these items, the ASIA motor scores were calculated for 22 tetraplegic patients. We investigated the relationships among these various respects. We also examined the changes of the physical items of the FIM score (physical FIM) over time for 18 patients. The mean FIM scores of those with tetraplegia with C4, CS, C6, C7, C8 lesions, and those with paraplegia with above TS levels, and those below T6 were 3S, 61, 82, 90, 116, 114 and 114 respectively. The FIM score reached the plateau in approximately 10 months, 6 months and 3 months post injury, in tetraplegia, paraplegia above TS and that below T6 respectively. The FIM scores in C6 patients were widely distributed from S6 to 104. On the other hand, the ASIA motor score could subdivide C6 patients and related well to the FIM score. The mean FIM scores for each neurological level were similar to those previously reported, thus they appeared to be plateau scores. With regard to the motor score, we feel that it could reflect the disability of the patients better than considering the neurological levels alone. Also considering the changes in the physical FIM score over time within a year from the onset of the injury, there were differences in the ADL improvement patterns among patients with different neurological levels. It appears that timing of the highest physical FIM improvement for each neurological level can exist. Thus it is important not to delay the start of the rehabilitation of patients with spinal cord injury in proper time.
The Functional Independence Measure for Children (WeeFIM) was developed based on the FIMSM instrument to assess disability in children aged six months to seven years. Its reliability and validity have been studied, and normative data are available for American children. The WeeFIM instrument is potentially an internationally useful instrument, but data from other countries are lacking. The objectives of this study are to examine whether the WeeFIM instrument is applicable to Japanese children and to describe preliminary normative data. To study interrater reliability, we had two examiners assess 20 nondisabled children and calculated weighted kappas for individual item scores and intraclass correlation coefficients for total scores and motor and cognitive subscores. We then assessed 110 nondisabled children ages six months to seven years to obtain normative data and compared them with the American data. In 51 of these healthy children, we compared total WeeFIM scores with developmental ages as obtained with the Tsumori test, a standardized developmental test widely used in Japan to assess its concurrent validity. The weighted kappas were greater than 0.8, and the intraclass correlation coefficients were greater than 0.98. Total scores and motor and cognitive subscores increased with age, reaching a plateau at 60 to 72 months, which is similar to the American data. There were three patterns of chronologic changes in individual item scores: items showing high correlations with age (Spearman's rho > 0.8; grooming, dressing, memory, etc.), moderate correlations (0.8 > rho > 0.7; eating, bladder, comprehension, etc.), and lower correlations (0.7 > rho > 0.6; locomotion and chair transfer). Total scores correlated significantly with developmental ages (Spearman's rho = 0.938), but there was a discrepancy between each item score and the pass-or-fail patterns of the Tsumori test. This study demonstrated the applicability of the WeeFIM instrument to Japanese children with satisfactory reliability and validity and provided preliminary normative data for future studies.
Our results indicate that for an accurate diagnosis and assessment, biopsies should be taken from the following four sites: the lesser curvatures of the mid-antrum (site 1) and middle body (site 3), and the greater curvatures of the mid-antrum (site 4) and middle body (site 6) of the stomach.
The LCM1 regimen consisting of 30 mg lansoprazole once daily, 200 mg clarithromycin twice daily, and 250 mg metronidazole twice daily (the regular doses in ordinary use in Japan) is a highly effective and safe regimen for Japanese patients. LCM1 as a new triple therapy is a promising regimen for the first-line treatment of H. pylori infection in Japanese patients.
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