COPD prescription patterns after the 2018 Japan floods: analysis of national data.

Proprioceptive deficits in the upper extremities impair activity of the daily living ability such as skillful movement of hands and manipulation of objects. Proprioceptive deficits following stroke occur in 27 to 54% of patients and are consistently correlated with length of hospitalization and mortality. The severity of impaired proprioception can also predict poor motor ability, functional ability, and dexterity of the affected upper extremity (UE) during the chronic phase of stroke. This is particularly true for sensory ataxic hemiparesis (proprioceptive deficits accompanied by motor paresis), a condition specifically associated with a poorer prognosis for motor recovery compared to pure motor deficits. Consequently, achieving substantial motor recovery in acute stroke survivors with sensory ataxic hemiparesis is exceptionally challenging. It is well established that the first month after stroke onset offers the highest recovery rate, defining a critical period for maximizing treatment effectiveness. Given this narrow window, here is an urgent need to establish effective strategies to augment post-stroke recovery. This necessity is compounded by external factors, particularly in settings like Japan. The medical service circumstances of stroke survivors are unfavorable for investigating the advantages of early intervention in the acute phase. Rehabilitation intervention in acute care hospitals is often suspended within 2–4 weeks of onset, and patients are subsequently followed at restorative rehabilitation care units in other hospitals or nursing homes. The transfer timing mainly depended upon bed control, indicating that the patient might abruptly suspended. It would therefore be difficult to design clinical studies or follow-up motor recovery over a longer period. In situations where patients are receiving a limited amount of conventional intervention during the critical period, we need to strive to establish an effective strategy to augment post-stroke recovery. Neuromodulators are promising candidates expected to enhance post-stroke motor recovery. The efficacy of top-down neuromodulators (e.g., repetitive transcranial magnetic stimulation, rTMS) follow a phase-dependent hierarchy (acute > subacute > chronic). Similarly, bottom-up neuromodulators, such as neuromuscular electrical stimulation (NMES) and repetitive peripheral magnetic stimulation (rPMS) are expected to become intervention devices that facilitate motor recovery after stroke, are expected to facilitate recovery, with NMES showing faster motor recovery when applied in the acute phase.