<p>Association Between Active Gait Training for Severely Disabled Patients with Nasogastric Tube Feeding or Gastrostoma and Recovery of Oral Feeding: A Retrospective Cohort Study</p>

Abstract

This study evaluates the effect of introducing active gait training (AGT) to patients who are severely disabled with nasogastric tube feeding or gastrostoma on the recovery of oral feeding. Patients and Methods: We conducted a historical cohort study at a single rehabilitation center in Japan between January 2013 and December 2019. In this study, 154 severely disabled patients with nasogastric tube feeding or gastrostoma due to neurological diseases or disuse syndrome admitted in a rehabilitation ward were included, and their median age was 84 years. AGT was systematically implemented in August 2016, which consisted of using orthosis or assistance from physical therapists. We compared the recovery of oral feeding between periods before (Pre-AGT) and after (Post-AGT) the introduction of AGT. Results: Among the 154 severely disabled patients included, 59 (38%) were admitted in the Post-AGT period. Twenty-eight (30%) and 54 patients (92%) started gait training in the Pre-AGT and Post-AGT periods, respectively (p < 0.001). Significantly more patients recovered oral feeding in the Post-AGT than in the Pre-AGT periods (49% vs 19%, respectively; p < 0.001). After the introduction of AGT, the adjusted hazard ratio for the recovery of oral feeding was 4.0 (95% confidence interval, 1.9-8.3; p < 0.001). Conclusion: After the introduction of AGT to patients, increased recovery of oral feeding was observed in this retrospective evaluation. AGT should be considered for patients with tube feeding to help them recover oral feeding even if patients were severely disabled and required full assistance during gait training.

Exercise Training for Patients With Severe Aortic Stenosis in a Convalescent Rehabilitation Ward ― A Retrospective Cohort Study ―

“…The FIM is a tool for the collection and comparison of rehabilitation outcomes, measurement of patients' progress, and planning treatment protocols. 13 ADLs include self-care, eating, grooming, bathing, dressing, toileting, swallowing, sphincter control, mobility, transfer, and locomotion. 13 The FIM contains 18 items, 13 of which are in the physical domains and 5 of which are related to cognition.…”

“…13 ADLs include self-care, eating, grooming, bathing, dressing, toileting, swallowing, sphincter control, mobility, transfer, and locomotion. 13 The FIM contains 18 items, 13 of which are in the physical domains and 5 of which are related to cognition. 13 Motor items measure self-care, sphincter control, locomotion, and transfer.…”

“…13 The FIM contains 18 items, 13 of which are in the physical domains and 5 of which are related to cognition. 13 Motor items measure self-care, sphincter control, locomotion, and transfer. 13 Cognitive items evaluate a subject's communication and social cognition.…”

“…13 Motor items measure self-care, sphincter control, locomotion, and transfer. 13 Cognitive items evaluate a subject's communication and social cognition. 13 Based on the level of independence, each item is scored on a scale from 1 (total dependence) to 7 (complete independence).…”

“…13 Cognitive items evaluate a subject's communication and social cognition. 13 Based on the level of independence, each item is scored on a scale from 1 (total dependence) to 7 (complete independence). 13 Possible total scores range from 18 to 126, with higher scores meaning more independence in performing ADLs.…”