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Prolonged hospitalization contributes to a decline in physical function and immobilization. This narrative review aims to explore physical rehabilitation approaches that address the specific characteristics of physical dysfunction in patients with schizophrenia. A literature review was conducted following an electronic search of PubMed for English-language articles published between January 2014 and January 2025. Based on the findings, a framework was constructed to categorize symptoms and physical challenges into three domains: (1) movement disorders and obesity induced by antipsychotic medications, which alter motor performance and lead to compensatory movements; (2) negative symptoms and cognitive impairments, which promote sedentary behavior and result in dysphagia, dynapenia, sarcopenia, and frailty; and (3) accelerated brain aging and disuse syndrome by schizophrenia, which impair neuromotor and cognitive function and increases the risk of physical dependency. These interconnected factors emphasize the need for targeted physical rehabilitation to maintain independence and reduce the risk of hospitalization. This review proposes a multidisciplinary approach involving psychiatrists, physical therapists, and occupational therapists, along with individualized nutritional support, as essential components of comprehensive rehabilitation strategies aimed at improving physical outcomes and reducing early mortality in this population.

The rising prevalence of physical comorbidities among patients with mental illness has increased the relevance of physical rehabilitation within psychiatric care. However, specific physical rehabilitation practices in specialized psychiatric hospitals in Japan remain insufficiently documented. This exploratory and descriptive study aimed to characterize the rehabilitation content provided and to categorize patient characteristics and comorbidities in a single specialized psychiatric hospital using an expert-led consensus approach. Clinical data from 150 patients (median age 71.0 years) who received physical rehabilitation were retrospectively analyzed. Patient categorization was conducted through a multidisciplinary consensus-building process involving an expert panel of physical therapists, occupational therapists, psychiatrists, and nurses, each with over 10 years of clinical experience. Using a hierarchical rule set based on International Classification of Diseases, 10th Revision (ICD-10) codes and clinical referral data, five distinct categories were identified: Disuse Syndrome (41%), Neurologic Disorders (20%), Lower Limb Lesions (18%), Parkinson’s Syndrome (15%), and Upper Limb Lesions (6%). Across all categories, rehabilitation interventions focused on foundational motor therapies, such as range of motion (27%) and strength training (23%). Mobility-oriented interventions were selectively provided to patients with high bedridden status based on clinical potential. Overall, practices in this setting primarily targeted disuse syndrome and maintenance of basic motor function and were delivered with input from multiple professional disciplines; such practices may inform future research on structured multidisciplinary rehabilitative approaches, especially for aging psychiatric populations.

Background/Objectives: Despite the increasing recognition of person-centered care (PCC), existing evaluation tools often have profession-specific limitations, lacking broad applicability across interdisciplinary contexts. This study aimed to develop and validate the Person-Centered Care Instrument (PCCI), designed to assess the competence of healthcare providers from diverse professions. Methods: Using a two-round modified Delphi technique, ten experts validated an initial pool of 63 items. The process assessed both face validity (overall appropriateness) and content validity using a 9-point Likert scale and the Item-level Content Validity Index (I-CVI). Items with a median rating of 6 or higher and an I-CVI of ≥0.70 were retained. Results: The final PCCI consists of 37 items, with a scale-level content validity index of 0.65. Three items achieved universal agreement among the experts (I-CVI = 1.0). For the final 37-item PCCI, the Scale-level Content Validity Index (S-CVI) was 0.65, and the index based on universal agreement was 0.22. Conclusions: The developed PCCI demonstrated good face and content validity, making it a valid and broadly applicable tool for assessing competence in delivering PCC. This instrument can support quality improvement initiatives and help promote a culture of empathy and respect in healthcare.

Background/Objectives: With the increasing need for interprofessional team-based care, a practical framework is necessary to evaluate the caring competencies of healthcare providers. This study aimed to develop a refined, concise version of the Technological Competency as Caring in Healthcare Instrument (TCCHI) by: (1) reducing the items from the original 38-item Delphi-validated pool through confirmatory factor analysis (CFA) and (2) providing a preliminary assessment of its structural validity and reliability. Methods: An online survey was conducted with 528 healthcare professionals across Japan. The CFA process began with the 38 items identified in a previous Delphi study. To optimize model fit and ensure interprofessional applicability, items were systematically refined based on both statistical criteria and theoretical relevance, resulting in a 12-item, three-factor structure. Results: The final 12-item model demonstrated an improved and generally acceptable fit: chi-square to degrees of freedom ratio (χ2/df) = 3.96, comparative fit index (CFI) = 0.947, Tucker–Lewis Index (TLI) = 0.931, and Root Mean Square Error of Approximation (RMSEA) = 0.0749. All factor loadings were statistically significant (p < 0.001) and ranged from 0.437 to 0.83. Composite reliability (CR) for the three factors ranged from 0.700 to 0.827, meeting the threshold for internal consistency. While average variance extracted (AVE) values for some factors were below 0.50, the overall model provided a stable and theoretically consistent structure, albeit as a preliminary psychometric refinement. Conclusions: This study provides preliminary evidence for the structural validity and reliability of a refined 12-item, three-factor TCCHI. By offering a concise measurement tool aligned with caring theory, the TCCHI has the potential to support interprofessional assessment, education, and professional development in technology-mediated healthcare environments. However, further research is required to address issues of discriminant validity and confirm measurement invariance across different professional groups.

Background/Objectives: This study aimed to develop the Technological Competency as Caring in Healthcare Providers Instrument (TCCHI) for multidisciplinary use, based on Locsin’s theory of Technological Competency as Caring in Nursing. Methods: A content validation design employing a modified Delphi technique was conducted with a multidisciplinary panel of 10 healthcare experts (recruited by purposive sampling based on expertise in technology/caring). The preliminary 67-item pool was derived from a literature review and theoretical alignment. Two Delphi rounds were implemented to establish face and content validity. Qualitative feedback from Round 1 guided item refinement for Round 2. The Wilcoxon matched-pairs signed-rank test was used to confirm the response stability between rounds. Results: Among the 67 initial items, 38 were retained after two Delphi rounds, achieving an I-CVI of 0.80–0.90. Response stability was established (p > 0.05). The resulting 38 items were categorized into six refined concepts reflecting the integration of technology and caring. Inter-rater consistency, assessed by the Intraclass Correlation Coefficient (ICC), was moderate (Round 1 ICC = 0.49; Round 2 ICC = 0.50), suggesting initial variability among the multidisciplinary panel. Conclusions: The TCCHI is a comprehensive and theoretically grounded instrument applicable across diverse healthcare disciplines. However, the moderate inter-rater consistency suggests that further empirical validation is required. Further psychometric evaluation, including confirmatory factor analysis and internal consistency reliability testing, is required to establish construct validity and strengthen the instrument’s applicability in diverse healthcare settings.

Background/Objectives: In patients with schizophrenia, gait disturbances (e.g., reduced walking speed and stride length) are linked to neural dysfunction and extrapyramidal symptoms. To inform gait rehabilitation strategies, this study examines the relationships of walking speed with extrapyramidal symptoms, stride length, antipsychotic dosage, ankle joint range of motion, and body composition in patients with chronic schizophrenia. Methods: Sixty-eight patients with chronic schizophrenia were included. All variables were described based on their measurement levels using non-parametric methods. Spearman’s rho was calculated to assess correlations. For multiple linear regression analyses, backward stepwise elimination was used to determine variables associated with walking speed. Statistical significance was set to p < 0.05. Results: Walking speed was positively correlated with stride length, chlorpromazine-equivalent dose, ankle plantar flexion, body mass index, bone mineral content, trunk muscle mass, and skeletal muscle mass index. In contrast, it was negatively correlated with drug-induced extrapyramidal symptoms scale (DIEPSS) scores for gait, bradykinesia, tremor, overall severity, and age. The multiple linear regression indicated that DIEPSS 2 bradykinesia level and ankle plantar flexion angle, adjusted for a 26% variance, best explained the walking speed. Conclusions: A lower bradykinesia severity and a higher ankle plantar flexion are associated with higher walking speeds. Thus, it is critical to assess stride length, bradykinesia, angle/limitation/torque of ankle plantar flexion, trunk and upper and lower limb muscle masses, and walking speed in patients with chronic schizophrenia. Specific strategies for gait rehabilitation should focus on stride training, plantar flexion strengthening exercises, and balance training.

The sensitivity and discrimination capacity of sensory systems can be improved by perceptual training. Most individuals demonstrate tactile perceptual learning, but with marked differences in efficiency. Here, we investigated the neural mechanisms underlying individual differences in tactile learning efficiency at the network level. Electroencephalographic (EEG) signals were recorded from 25 neurologically healthy participants at baseline, after one training session (50 trials) on the tactile grating orientation discrimination task (GOT), and again after four sessions of GOT training (200 training trials in total). Participants were then divided into low- and high-learning groups based on the post-training change in GOT threshold (sensitivity). Cortical alpha-band power, which is associated with sensory processing efficiency, was compared between baseline and post-training in low- and high-learning groups. Coherence analysis was also performed between EEG electrode pairs to reveal functional connectivity (FC) networks associated with low and high learning. In the high-learner group, alpha-band power spectral density (PSD) was significantly stronger post-training at the left central-parietal electrodes. In addition, FC in the alpha band was significantly strengthened within left frontal-parietal regions after training. In the low-learner group, post-training alpha-band PSD was significantly strengthened at the bilateral frontal-central electrodes, while FC in the alpha band did not change significantly compared to baseline. These results suggest that individual differences in tactile learning may result from the utilization of distinct neural networks.

Graft failure (GF) is a life-threatening complication after allogeneic stem cell transplantation (SCT). Although salvage SCTs can be performed with haploidentical donor (HID) or cord blood (CB), no study has compared the performances of these two sources. Using nationwide registration data, we compared the transplant outcomes of patients who developed GF and underwent salvage transplantation from HID (n = 129) and CB (n = 570) from 2007 to 2016. The HID group demonstrated better neutrophil recovery (79.7 vs. 52.5% at 30 days, P < 0.001). With a median follow-up of 3 years, both groups demonstrated similar overall survival (OS) and nonrelapse mortality (NRM; 1-year OS, 33.1 vs. 34.6% and 1-year NRM, 45.1 vs. 49.8% for the HID and CB groups). After adjustments for other covariates, OS did not differ in both groups. However, HID was associated with a lower NRM (hazard ratio, 0.71; P = 0.038) than CB. The incidence of acute graft-versus-host disease (GVHD)-related deaths was significantly higher in the HID group, although infection-related deaths were observed more frequently in the CB group. HID may be a promising salvage SCT option after GF due to its faster engraftment and low NRM.

Post-cardiac arrest brain injury (PCABI) is the leading cause of death and disability following cardiac arrest (CA). Nicotinamide adenine dinucleotide (NAD + ) depletion after CA contributes to neuronal injury, while nicotinamide mononucleotide (NMN) replenishes NAD + and may provide neuroprotection via sirtuin activation. This study aimed to investigate the effects of systemic NMN administration on neurological function, survival, and sirtuin-3 (SIRT3) levels in the brain post-CA. In adult male mice (C57BL/6NCrSlc, 10–15 weeks old), 10-min CA was induced by intravenous potassium chloride injection followed by cardiopulmonary resuscitation. NMN (60 mg/kg body weight) or normal saline (control) was randomly administered by intraperitoneal injection immediately after the return of spontaneous circulation (ROSC) and 24 and 48 h post-CA. Brain NAD + and adenosine triphosphate (ATP) levels, neurological function score (NFS), survival, histological neuronal injury, and brain gene expression and protein levels were measured. Brain NAD + levels decreased at 2 h post-ROSC and NMN significantly increased brain NAD + and ATP levels. At 48 h post-CA, surviving mice in the NMN group exhibited significantly higher NFS (control: 8 [IQR: 4–12] vs. NMN: 12 [IQR: 9–12], p = 0.03) and less severe hippocampal neuronal injury compared with controls. Moreover, the NMN group showed significantly higher 7-day survival rate (control: 22.2% [4/18] vs. NMN: 61.1% [11/18], p = 0.03) and brain SIRT3 levels (control: 17.7 ± 3.6 vs. NMN: 34.5 ± 4.4 pg/mg protein, p = 0.01). In conclusion, systemic NMN administration after ROSC attenuates PCABI. The increased brain ATP levels and SIRT3 upregulation may suggest the usefulness of NMN for improving mitochondrial function and contributing to neuroprotection. NAD + supplementation with NMN is a promising therapeutic approach against PCABI.

Although graft failure (GF) is a fatal complication after allogeneic stem cell transplantation (SCT), no mortality risk assessments after salvage SCT have been reported. We developed a comprehensive prognostic scoring system consisting of patient and comorbidity factors with 470 patients as a training cohort out of 940; these patients underwent salvage SCT for GF. The multivariate analysis demonstrated that older age, poorer performance status, a continuation of antimicrobial treatment, and severe organ dysfunction were independently associated with worse overall survival (OS) and non-relapse mortality (NRM). Based on each factor’s hazard ratio, weighted scores of 1–3 were assigned to these factors. Using the summed scores (0–8), a prognostic scoring system successfully stratified outcomes after salvage SCT in the cohort. For patients in the low (0–2, n = 122), intermediate (3–4, n = 209), and high score (5–8, n = 110) groups, the 1-year OS was 62.8%, 40.8%, and 14.2%, respectively (P < 0.001), whereas the 1-year NRM was 24.1%, 43.9%, and 72.7%, respectively (P < 0.001). The prognostic value of the scoring system was confirmed in the validation cohort (n = 470). Our scoring system is useful for predicting survival after salvage SCT.