Publications by authors named "Ryo Kozu"

Background: The high prevalence of poor sleep quality in patients with chronic respiratory diseases makes it an important clinical topic. However, the prevalence and characteristics of poor sleep quality in those with nontuberculous mycobacterial pulmonary disease and its association with clinical variables remain unclear.

Methods: This retrospective study involved patients with nontuberculous mycobacterial pulmonary disease between June 2017 and May 2022.

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Background: Lung cancer represents a significant global health concern and constitutes the primary cause of cancer-related mortality. Complete surgical resection with curative intent remains the most efficacious treatment modality for improving the survival rate of patients with localized lung cancer. Average life expectancy has increased in many countries, and the number of older patients undergoing surgery has increased.

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  • The study evaluated the feasibility and safety of a problem-solving exercise program for older patients with chronic respiratory diseases, focusing on balance, walking, and chair stands.
  • With 36 participants, the program showed high adherence (100%) and no related adverse events, with significant improvements in daily step count and physical performance scores over four weeks.
  • While results indicate that the exercise program is both feasible and safe, further validation in larger randomized controlled trials is necessary to confirm its effectiveness.
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  • Frailty is common among patients with aortic stenosis (AS), but the study aimed to understand how the severity of AS affects frailty levels in hospitalized patients undergoing transcatheter aortic valve implantation (TAVI).
  • The study included 137 patients and found no significant difference in frailty prevalence, gait speed, or nutritional risk between those with severe and very severe AS; however, NT-proBNP levels were higher in the very severe group.
  • The analysis indicated that AS severity itself didn't correlate with frailty, but low gait speed and poor nutritional status were linked to increased frailty, suggesting that exercise and nutritional support could benefit these patients alongside AS treatment.
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Background: Manual breathing assist technique (MBAT) is a common physical therapy technique used to facilitate airway clearance and improve ventilation and oxygenation. The effects during and immediately after intervention in individuals with chronic obstructive pulmonary disease (COPD) are unknown. This study aimed to investigate the acute effects and potential mechanisms of MBAT on lung volume, dyspnea, and oxygenation in individuals with COPD.

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Introduction: Virtual reality cycling (VRC) is simulated outdoor cycling with changes in scenery in virtual reality (VR) with rotating ergometer pedals. The speed at which the scenery changes, which is the visual flow velocity, can shift according to the same pedal rotation speed.

Objectives: This study investigated the effects of different visual flow velocities on the psychophysiological responses of cyclists using the VRC.

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Background: Recovery of walking independence in critically ill patients is required for safe discharge home. However, the pre-admission predictors affecting this outcome in this patient group are unknown. This study aimed to identify these predictors.

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Objective: To investigate the effect of inspiratory muscle training (IMT) on cough strength in older people with frailty.

Design: Single-blind randomized controlled trial.

Setting: Day health care centers at 2 sites.

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Background: Lung resection is the standard of care for patients with clinical stage I/II non-small cell lung cancer. This surgery reduces both the duration and quality of patients' daily ambulatory activities 1 month after surgery. However, little is known about physical activity after lung resection in patients with lung cancer.

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Background And Objective: Interstitial lung disease (ILD) is characterized by dyspnoea on exertion and exercise-induced hypoxaemia. High-flow nasal cannula (HFNC) therapy reduces the respiratory workload through higher gas flow and oxygen supplementation, which may affect exercise tolerance. This study aimed to examine the effects of oxygen and gas flow rates through HFNC therapy on exercise tolerance in ILD patients.

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This retrospective observational study aimed to assess the clinical characteristics of platypnea-orthodeoxia syndrome in patients with coronavirus disease 2019 (COVID-19) treated using mechanical ventilation or high-flow nasal canula. We analyzed 42 consecutive patients with COVID-19 from January 2020 to March 2022. The primary outcomes were the incidence of platypnea-orthodeoxia syndrome, the time with required long-term oxygen therapy, and short-term prognosis.

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Background And Objective: Reference values of physical activity to interpret longitudinal changes are not available in patients with idiopathic pulmonary fibrosis (IPF). This study aimed to define the minimal clinical important difference (MCID) of longitudinal changes in physical activity in patients with IPF.

Methods: Using accelerometry, physical activity (steps per day) was measured and compared at baseline and 6-months follow-up in patients with IPF.

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Objective: To examine the association between the mobilization level during intensive care unit (ICU) admission and independence in activity of daily living (ADL), defined as Barthel Index (BI)≥70.

Methods: This was a post-hoc analysis of the EMPICS study involving nine hospitals. Consecutive patients who spend >48 hours in the ICU were eligible for inclusion.

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Article Synopsis
  • The study aimed to address the challenges of assessing post-intensive care syndrome (PICS) in ICU survivors by identifying effective assessment instruments through a scoping review and consensus process.
  • A total of 6972 records were reviewed, leading to 20 recommended instruments spanning various domains, including physical health, cognition, and mental health.
  • The findings provide a structured approach to evaluating PICS, highlighting tools like the 6-min walk test and MoCA, ensuring comprehensive assessment for ICU survivors and their families.
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Providing standardized, high-quality rehabilitation for critically ill patients is a crucial issue. In 2017, the Japanese Society of Intensive Care Medicine (JSICM) promulgated the "Evidence-Based Expert Consensus for Early Rehabilitation in the Intensive Care Unit" to advocate for the early initiation of rehabilitations in Japanese intensive care settings. Building upon this seminal work, JSICM has recently conducted a rigorous systematic review utilizing the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology.

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Background And Objective: Interstitial lung disease (ILD) encompasses several diverse pulmonary pathologies that result in abnormal diffuse parenchymal changes. When prescribing rehabilitation, several additional factors need to be considered as a result of aging, polypharmacy, and comorbidities manifested in ILD patients. This review aims to discuss issues related to frailty, skeletal muscle and cognitive function that limit physical activities in ILD patients.

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This study aimed to examine the validity of urinary N-terminal titin fragment/creatinine (urinary N-titin/Cr) reflecting muscle damage biomarker in patients with interstitial lung disease. This retrospective study enrolled patients with interstitial lung disease. We measured urinary N-titin/Cr.

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Purpose: Assessment for frailty is important as it enables timely intervention to prevent or delay poor prognosis in chronic obstructive pulmonary disease (COPD). The aims of this study, in a sample of outpatients with COPD, were to (i) assess the prevalence of physical frailty using the Japanese version of the Cardiovascular Health Study (J-CHS) criteria and the Short Physical Performance Battery (SPPB) and the degree of agreement between the findings of the two assessments and (ii) identify factors associated with the disparity in the results obtained with these instruments.

Patients And Methods: This was a multicenter cross-sectional study of individuals with stable COPD enrolled in four institutions.

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Background: Idiopathic pulmonary fibrosis (IPF) is characterised by worsening dyspnoea and exercise intolerance.

Research Question: Does a long-term pulmonary rehabilitation improve exercise tolerance in patients with IPF treated with standard antifibrotic drugs, which are expected to reduce disease progression?

Methods: This open-label randomised controlled trial was performed at 19 institutions. Stable patients receiving nintedanib were randomised into pulmonary rehabilitation and control groups (1:1).

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Article Synopsis
  • * A study of 135 LDLT patients revealed that those with HAD had higher mortality rates compared to those without HAD, particularly among patients with low skeletal muscle index (SMI).
  • * Results suggest that HAD is an important independent risk factor for post-transplant mortality, highlighting the need for improved perioperative rehabilitation strategies to enhance patient outcomes.
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We defined respiratory sarcopenia as a coexistence of respiratory muscle weakness and decreased respiratory muscle mass. Although respiratory muscle function is indispensable for life support, its evaluation has not been included in the regular assessment of respiratory function or adequately evaluated in clinical practice. Considering this situation, we prepared a position paper outlining basic knowledge, diagnostic and assessment methods, mechanisms, involvement in respiratory diseases, intervention and treatment methods, and future perspectives on respiratory sarcopenia, and summarized the current consensus on respiratory sarcopenia.

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There are various interventions of rehabilitation on the bed, but these are time-consuming and cannot be performed for all patients. The purpose of this study was to identify the patients who require early mobilization based on the level of sedation. We retrospectively evaluated the data of patients who underwent physical therapy, ICU admission of > 48 h, and were discharged alive.

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Background: In the treatment of patients with nontuberculous mycobacterial pulmonary disease (NTM-PD), pulmonary rehabilitation (PR) has been recommended as a non-pharmacological therapy. However, no study has validated the combination of chemotherapy and PR in this context. This study investigated the effect of chemotherapy and supervised PR on health-related quality of life (HRQoL) and physical function in NTM-PD patients.

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Background And Objective: The International Primary Airways Group (IPAG) questionnaire is a useful tool for screening for chronic obstructive pulmonary disease. The cut-off score of the IPAG questionnaire is investigated in Japan. However, its validity has not been examined according to sex, which was the aim of this study.

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This is a prospective multicenter cohort study aiming to investigate the association between early mobilization (EM), defined as a rehabilitation level of sitting at the edge of the bed or higher within 72 h of ICU admission, and psychiatric outcome. Consecutive patients, admitted to the ICU for more than 48 h, were enrolled. The primary outcome was the incidence of psychiatric symptoms at 3 months after hospital discharge defined as the presence of any of three symptoms: depression, anxiety, or post-traumatic stress disorder (PTSD).

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