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Background/objectives: There is a notable lack of evidence regarding the long-term effects of rehabilitation services, particularly concerning functional recovery and daily living activities of patients following discharge from convalescent rehabilitation wards. This study aimed to clarify the longitudinal changes in activities of daily living and instrumental activities of daily living of patients after discharge from a convalescent rehabilitation ward and the association between the use of rehabilitation services and clinical outcomes., Methods:  Patients discharged from Japanese convalescent rehabilitation wards in August 2021 were included. They were classified into two groups (rehabilitation and nonrehabilitation services use) based on whether they used rehabilitation services (outpatient rehabilitation, older adult day care, or home-based rehabilitation) after discharge. The primary outcomes, including the Barthel Index, functional independence measure, Frenchay Activities Index, and life-space assessment scores at 6 months after discharge, were analyzed by multivariate analysis., Results:  A total of 293 patients (median age: 75 years; 148 females) were included in the analysis. The use of rehabilitation services was independently associated with the Barthel Index (partial regression coefficient [B]: 7.224; 95% confidence interval [CI]: [1.760, 12.688]), functional independence measure (B: 2.659; 95% CI: [0.194, 5.125]), Frenchay Activities Index (B: 2.351; 95% CI: [0.5088, 4.192]), and life-space assessment at 6 months after discharge (B: 8.226, 95% CI: [3.902, 12.550])., Conclusions:  The use of rehabilitation services was independently associated with patients' Barthel Index, functional independence measure, Frenchay Activities Index, and life-space assessment after discharge from a convalescent rehabilitation ward. This study emphasizes crucial role of postdischarge interventions for improved patient outcomes.

Tumor-induced osteomalacia (TIO) is an acquired fibroblast growth factor 23 (FGF23)-related hypophosphatemic osteomalacia caused by phosphaturic mesenchymal tumors (PMTs) developed in the bone or soft tissue. Diagnostic delay should be addressed, and ideal techniques to localize PMTs and efficient treatment options should be explored to improve the outcomes of this rare disease. To clarify the detailed clinical course and outcomes of TIO patients, retrospective questionnaire surveys were conducted among physicians from the Japanese Society for Bone and Mineral Research (JSBMR) and the Japan Endocrine Society (JES). The primary survey collected the number of TIO patients between January 2007 and December 2018. The secondary survey aimed to obtain the detailed characteristics, laboratory data, and outcomes. Eighty-eight patients (52 males, mean: 52 years old) were included, and 24 patients were clinically diagnosed with TIO without localized PMTs. The median duration from the onset to detection of high FGF23 levels was 3.4 years, with 77 patients being initially misdiagnosed. Among the methods used to detect small, localized PMTs (≤10 mm), fluorine-18-fluorodeoxyglucose-positron emission tomography/computed tomography and somatostatin receptor scintigraphy were less sensitive than somatostatin receptor positron emission tomography/computed tomography (SRPET/CT). Systemic venous sampling (SVS) of FGF23 was performed in 53 patients; among them, SVS was considered useful for detecting localized PMTs in 45 patients with diverse tumor sizes. Finally, 45 patients achieved biochemical remission by surgery, 39 patients continued pharmaceutical treatment, including burosumab (11 patients), and four patients died. These results encouraged us to further increase the awareness of TIO and to improve the accessibility of SRPET/CT and SVS. Further evidence about the efficacy of new pharmaceutical treatments is awaited. © 2022 American Society for Bone and Mineral Research (ASBMR)., (© 2022 American Society for Bone and Mineral Research (ASBMR).)

Aim: To evaluate the effects of an intensity display type accelerometer on diabetic patients' physical activity., Methods: This was a two-arm, non-randomized controlled study. Both groups received information about the recommendation of 150 min/week moderate-to-vigorous physical activity (MVPA). The intervention group used an intensity display type accelerometer to monitor their physical activity intensity for 10 days at baseline and 3 months later. We compared intervention and control groups after 3 and 6 months. Primary outcomes were MVPA and number of steps over 7 days. Secondary outcomes were glycosylated hemoglobin (HbA1c), body mass index, and self-management., Results: Of 62 participants, 30 and 32 were included in the intervention and control groups, respectively. Mean age in each group was 59.7 ± 10.8 and 58.8 ± 10.2 years, and mean HbA1c was 6.9 ± 0.9% and 6.9 ± 0.8%, respectively. There were no significant differences between the intervention and control groups at either time point, and no outcomes showed significant changes. In a subgroup analysis by physical activity intensity, MVPA of active individuals in the control group significantly decreased at 6 months from baseline. MVPA and number of steps among inactive individuals in the intervention group significantly increased at 6 months from baseline. Self-management of the intervention group showed a trend toward improvement, but HbA1c and body mass index showed no significant change., Conclusions: Monitoring physical activity intensity led to increased MVPA of inactive patients and maintained MVPA of active patients with diabetes mellitus. This straightforward intervention could be applied in clinical practice., (© 2021 Japan Academy of Nursing Science.)