sonoda shigeru

<p>In humans, body sway is observed in ataxic gait disorder. As gait ataxia develops due to degeneration and loss of cerebellar Purkinje cells in B6-wob/t mice (Wob/t), we measured body sway in these mice. The trajectory length (TL) per unit time in the horizontal direction and the weight variance (WV) in the vertical direction were compared with wild-type C57BL/6J (B6) mice as evaluation parameters. First, a rotarod test was performed to observe the coordinated movement of the four limbs with gait ataxia. The duration of walking on the rotating rod was significantly shorter in Wob/t than in B6 (p<0.001), demonstrating ataxia. In addition, TL and WV in the resting state were measured in an open field. The amplitudes of both body sway parameters were significantly greater in Wob/t than in B6 (p<0.001). Wob/t mice were divided into two groups consisting of training (Ex) and no training (NEx). The Wob/t (Ex) group was subjected to forced gait training to investigate the effect on trunk tremors compared to the Wob/t(NEx) group. The amplitudes of TL and WV were significantly reduced in the Ex compared to the NEx (p<0.05). TL remained significantly different between the Ex and B6 groups (p<0.05), but the difference in WV became insignificant. In contrast, in the standstill state, no difference was noted in either TL or WV among the three groups. Based on these findings, the amplitudes of TL and WV of body sway were greater in Wob/t than in B6. However, the body sway tremors were reduced in Ex after forced gait training compared with NEx. These findings clarified that the cause of gait ataxia in Wob/t was the impact of trunk tremors induced by cerebellar Purkinje cell loss, and that forced gait training reduced the tremors. Regarding the reason for the absence of a significant difference in the TL and WV of body sway in the resting state among the B6, Wob/t(NEx), and Wob/t(Ex) groups, the mice may have been somnolent in the resting state and the cerebellar tremors of Wob/t may have been postural tremors that appear during exercise, similarly to those in humans.</p>

[Purpose] The motor paralysis-improving effect on the hemiplegic lower limb was compared among mirror therapy, integrated volitional-control electrical stimulation, therapeutic electrical stimulation, repetitive facilitative exercises, and the standard training method in post-stroke hemiplegia patients. [Subjects and Methods] Eighty one stroke patients admitted to a convalescent rehabilitation ward were randomly allocated to the above 5 treatment groups. Each patient performed functional training of the paralytic lower limb for 20 minutes a day for 4 weeks, and changes in the lower limb function were investigated using the Stroke Impairment Assessment Set. [Results] The hip and knee joint functions did not significantly improve in the standard training control group, but significant improvements were observed after 4 weeks in the other intervention groups. Significant improvement was noted in the ankle joint function in all groups. [Conclusion] Although the results were influenced by spontaneous recovery and the standard training in the control group, the hip and knee joints were more markedly improved by the interventions in the other 4 groups of patients with moderate paralysis, compared to the control group.

Background: We investigated differences in factors affecting judgments regarding the creation of new adjustable posterior strut knee-ankle-foot orthoses (APS-KAFO) and knee-ankle-foot orthoses with metal struts (traditional KAFO) for hemiplegic stroke patients for whom KAFO were created in rehabilitation wards. Methods: Subjects were 50 patients with hemiplegia due to new-onset stroke (cerebral infarction: n = 25, cerebral hemorrhage: n = 25) who were prescribed KAFO. Patient ages ranged from 36 to 90 years, and the mean duration from stroke onset to hospitalization was 28.8 +/- 13.8 days. Neurologic symptoms, cognitive function, activities of daily living, duration from hospitalization to orthosis creation, hospitalization duration, walking ability at discharge, outcome after discharge, and so forth were compared. Results: Fourteen patients were prescribed APS-KAFO, and 36 were prescribed traditional KAFO. Those prescribed APS-KAFO had somewhat milder neurologic symptoms and cognitive dysfunction and a shorter hospitalization duration than those prescribed traditional KAFO. Patients prescribed APS-KAFO also had a higher score and efficiency on functional independence measure at admission and discharge. Walking independence at discharge was seen in 8 of the 14 patients for whom APS-KAFO were created and 8 of the 36 patients for whom traditional KAFO were created. Conclusions: APS-KAFO was chosen for patients with a high level of activity in the ward and with a higher likelihood of acquiring walking ability using APS-AFO at discharge, whereas traditional KAFO tended to be chosen for patients with relatively severe symptoms who were not expected to acquire practical walking ability.

[Purpose] To develop a device for measuring the torque of an ankle joint during walking in order to quantify the characteristics of spasticity of the ankle and to verify the functionality of the device by testing it on the gait of an able-bodied individual and an equinovarus patient. [Subjects and Methods] An adjustable posterior strut (APS) ankle-foot orthosis (AFO) was used in which two torque sensors were mounted on the aluminum strut for measuring the anterior-posterior (AP) and medial-lateral (ML) directions. Two switches were also mounted at the heel and toe in order to detect the gait phase. An able-bodied individual and a left hemiplegic patient with equinovarus participated. They wore the device and walked on a treadmill to investigate the device's functionality. [Results] Linear relationships between the torques and the corresponding output of the torque sensors were observed. Upon the analyses of gait of an able-body subject and a hemiplegic patient, we observed toque matrices in both AP and ML directions during the gait of the both subjects. [Conclusion] We developed a device capable of measuring the torque in the AP and ML directions of ankle joints during gait.

[Purpose] The purpose of this study was to find whether a fast treadmill gait training speed is effective for the gait training of stroke patients in the early rehabilitation stage. [Subjects and Methods] Thirty-nine stroke patients were the subjects of our investigation. They walked on a treadmill with handrail supports at a fast speed (130% of their comfortable gait speed in the 2nd week). The treadmill gaits of the patients were recorded using a 3-dimensional analysis system at two and six weeks after their admissions. Intraclass Correlation Coefficients (ICC) of the temporal and spatial parameters of the two periods were statistically analyzed. [Results] For all of the patients, the ICCs of the measured parameters were greater than 0.58. In the case of patients whose gait speeds of the two periods were close, the ICC units were greater than 0.7. [Conclusion] The fast gait speed training allowed us to expose the patients to a gait speed that they were expected to acquire at a later stage of their rehabilitation. This training method was found to be beneficial for the mildly paralyzed patients.

Background and Purpose: The purpose of this study was to clarify the distinct influence of verbal and non-verbal cognitive functions on ADL improvement in stroke patients. Methods: RCPM and the MMSE were administered to examine the factors affecting improvement in ADL in 146 stroke patients who underwent convalescent rehabilitation. Results: Most patients with a decrease in MMSE scores alone (M group) had a language disorder caused by left hemisphere damage, while most patients with a decrease in RCPM scores alone (R group) had visuospatial cognitive impairment caused by right hemisphere damage. No difference in improvement in ADL was seen between the M group and those who had no decrease in scores on both assessments (N group). The R group had a longer hospital stay and lower ADL at discharge than the N group. The group of patients with decrease in scores on both assessments (MR group) had lower ADL at discharge and a lower rate of improvement in ADL than the other groups. Furthermore, the MR group had a longer hospital stay than the N group. Conclusion: The MMSE reflects verbal intelligence while the RCPM reflects non-verbal intelligence. Cognitive function as assessed by RCPM and MMSE may differentially affect ADL at discharge and improvements in ADL.

【目的】三次元動作解析装置を用いた片麻痺運動障害の定量的評価法Quantified Paralysis Performance Assessment(QPPA)を開発し,臨床場面で使用する前段階として,再現性と,最小可検変化量を検証することである.【方法】初発脳卒中患者66名(男性39名,女性27名,年齢60±12歳(平均±標準偏差))を対象として,QPPAでの計測を2回1セットで行った.計測は上肢機能(腕=QPPA-UE),下肢機能(股関節=QPPAHip,膝関節=QPPA-Knee,足関節=QPPA-Ankle)の4種類を行い,各指標マーカの挙上距離と最大速度を代表値とした.1セットの計測の各代表値から,級内相関係数(Intraclass correlation coefficient;ICC),および,最小可検変化量(minimal detectable change)の95%信頼区間(以下,MDC95)を算出した.【結果】急性期の同一症例から2週間以上の間隔を空けて,2セットの計測値が得られた場合は,別のデータとして分析を行い,総計91セットの計測値からQPPA指標におけるICC0.956〜0.989およびMDC95 4.56〜6.79%を得た.【結論】QPPAの代表値は高い再現性を示した.また,最小可検変化量は小さく,順序尺度の評価法より臨床的変化を鋭敏に捉えられると推測された.(著者抄録)

Aloe vera gel exhibits protective effects against insulin resistance as well as lipid-lowering and anti-diabetic effects. The anti-diabetic compounds in this gel were identified as Aloe-sterols. Aloe vera gel extract (AVGE) containing Aloe-sterols has recently been produced using a new procedure. We previously reported that AVGE reduced large-sized intestinal polyps in Apc-deficient Min mice fed a high fat diet (HFD), suggesting that Aloe vera gel may protect against colorectal cancer. In the present study, we examined the effects of Aloe vera gel powder (AVGP) and AVGE on azoxymethane-induced colorectal preneoplastic aberrant crypt foci (ACF) in mice fed a HFD. Male C57BL/6J mice were given a normal diet (ND), HFD, HFD containing 0.5% carboxymethyl cellulose solution, which was used as a solvent for AVGE (HFDC), HFD containing 3% or 1% AVGP, and HFDC containing 0.0125% (H-) or 0.00375% (L-) AVGE. The number of ACF was significantly lower in mice given 3% AVGP and H-AVGE than in those given HFD or HFDC alone. Moreover, 3% AVGP, H-AVGE and L-AVGE significantly decreased the mean Ki-67 labeling index, assessed as a measure of cell proliferation in the colonic mucosa. In addition, hepatic phase II enzyme glutathione S-transferase mRNA levels were higher in the H-AVGE group than in the HFDC group. These results suggest that both AVGP and AVGE may have chemopreventive effects on colorectal carcinogenesis under the HFD condition. Furthermore, the concentration of Aloe-sterols was similar between 3% AVGP and H-AVGE, suggesting that Aloe-sterols were the main active ingredients in this experiment.

Obesity markedly increases the risk of colorectal cancer. Recently, the preventive effects of edible mushrooms on triglyceride elevation and visceral fat accumulation have been reported. Here, the effects of Pleurotus eryngii (Eringi) and Hypsizygus marmoreus (Bunashimeji) on azoxymethane (AOM)-induced aberrant crypt foci (ACF precancerous lesions) in the colorectums of mice fed a high-fat diet were examined. Eringi (ER) and Bunashimeji (BU) mushroom powder samples were used. Six-week-old male C57BL/6J mice received an intraperitoneal injection of AOM (10 mg/kg) once a week for two weeks, and were sacrificed and dissected at 6 weeks after the start of the experiment. After the initiation of the experiment, they received a normal diet (ND), high-fat diet (HFD), HFD + ER (1 or 5% of diet), or HFD + BU (1 or 5% of diet). As a result, body and fat weights were significantly lower in the 5% ER and BU groups than in the HFD group. Liver triglyceride levels were also significantly lower in the 5% ER and BU groups. Total liver cholesterol levels were significantly lower in the 5% ER group. The numbers of ACF (especially large ACF) showed strong inhibitory effects in both ER and BU groups. Measurement of the cell proliferation marker Ki-67 labeling index in the colonic mucosa demonstrated more significant suppression in both ER and BU groups than in the HFD group. These results suggest that the simultaneous intake of ER and BU may inhibit colorectal tumorigenesis in HFD-fed mice.

Patients with pontine hemorrhage usually experience severe disturbances of consciousness, pupillary abnormalities, quadriparesis, and respiratory failure. However, little is known regarding cognitive dysfunction in patients with pontine hemorrhage. We report the case of a rehabilitation patient presenting with hemiplegia, ataxia, and cognitive dysfunction caused by a pontine hemorrhage. A 55-year-old, right-handed male suffered sudden onset of vertigo, dysarthria, and hemiplegia on the right side. He was diagnosed with brain stem hemorrhage, and conservative treatment was administered. The vertigo improved, but dysarthria, ataxia, hemiplegia, and gait disorder persisted. He was disoriented with respect to time and place and showed a poor attention span, impaired executive function, and reduced volition. A computed tomography revealed hematomas across the pons on both sides, but no lesions were obvious in the cerebellum and cerebrum. Single-photon emission tomography showed decreased perfusion in the brain stem, bilateral basal ganglia, and frontal and parietal lobes in the left hemisphere. The patient received exercise therapy and cognitive rehabilitation, and home modifications were performed to allow him to continue living at home under the supervision of his family. His symptoms improved, along with enhanced regional cerebral blood flow to the frontal and temporal lobes. These findings suggest that the pontine hemorrhage caused diaschisis resulting in secondary reduction of activity in the cerebral hemisphere and the occurrence of cortical symptoms. Therefore, rehabilitation is necessary, along with active instructions for the family members of patients with severe neurological deficits. This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

[Purpose] The aim of this study was to investigate the recovery process of standing postural control in hemiplegia after stroke. [Subjects and Methods] Thirty-four inpatients with hemiparesis after first-onset stroke were included in this study. We measured the center of pressure fluctuations during quiet standing using a force platform at 2, 4, and 6 weeks after admission. We assessed weight-bearing asymmetry, and velocity and amplitude of body sway. [Results] Weight-bearing asymmetry diminished in the first 2 weeks of observation. Velocity of body sway also decreased significantly in the first 2 weeks, though its amplitude only decreased significantly after 4 weeks of observation. [Conclusion] Amplitude of body sway requires a longer time for significant improvement than weight-bearing asymmetry and velocity of body sway. Although the loading function of the paretic lower limb improved at an early stage, attainment of optimum postural control, including management of the affected paretic lower limb, requires much time.

Predicting recovery from hemiparesis after stroke is important for rehabilitation. A few recent studies reported that the levels of some growth factors shortly after stroke were positively correlated with the clinical outcomes during the chronic phase. The aim of this study was to examine the relationships between the serum levels of growth factors (vascular endothelial growth factor [VEGF], insulin-like growth factor-I [IGF-I], and hepatocyte growth factor [HGF]) and improvement in hemiparesis in stroke patients who received rehabilitation in a postacute rehabilitation hospital. Subjects were 32 stroke patients (cerebral infarction: 21 and intracerebral hemorrhage [ICH]: 11). We measured serum levels of VEGF, IGF-I, and HGF and 5 items of the Stroke Impairment Assessment Set (SIAS) for hemiparesis on admission and at discharge. Age-matched healthy subjects (n 5 15) served as controls. Serum levels of VEGF and HGF in cerebral infarct patients on admission were higher than those in control subjects, and the serum levels of IGF-I in stroke patients were lower than those in controls. The level of HGF in ICH patients on admission was negatively correlated with gains in SIAS, and higher outliers in HGF concentration were correlated with lower gains in SIAS. Focusing on the extremely high levels of these factors may be a predictor of the low recovery from hemiparesis after stroke.

Purpose: The purpose of this study was to identify major risk factors of the falls of the patients with stroke whom live at home by analyzing patients' information and functional evaluation tools data such as FIM (Functional Independence Measure) instrument and SIAS (Stroke Impairment Assessment Set). Methods: Sixty-four stroke outpatients who had earlier discharged from Fujita Health University Nanakuri Sanatorium were participated in our study. We evaluated the following baseline characteristics for all patients: age, sex, stroke type, affected side of the body, number of stroke suffered, maximum walking speed, use of ankle foot orthosis, use of cane, use of medicine that may increase the risk of falling, and frequency of the falls of the patient during their rehabilitation period in the hospital, FIM, SIAS, and Mini-Mental State Examination scoring were also done before their discharge from the hospital. We first carried out bivariate analysis to determine which variables differed significantly between the non-fallers and fallers. Those variables of significant statistical values were then included in a multivariate logistic regression analysis. The model was simplified in a Forward Selection Method (Likelihood Ratio) by removing variables. Results: Those patients with a falling experience comprised 25 patients out of the total 64 patients (39.1% ). The logistic model was refined until it excluded all the predictors except two. These two predictors were maximum walking speed, and use of ankle foot orthosis. Conclusions: Those patients with a slow speed of walking and/or the patients who required the use of ankle foot orthosis were at a higher risk of falling.

Purpose: The purpose of this study was to identify major risk factors of the falls of the patients with stroke whom live at home by analyzing patients' information and functional evaluation tools data such as FIM (Functional Independence Measure) instrument and SIAS (Stroke Impairment Assessment Set). Methods: Sixty-four stroke outpatients who had earlier discharged from Fujita Health University Nanakuri Sanatorium were participated in our study. We evaluated the following baseline characteristics for all patients: age, sex, stroke type, affected side of the body, number of stroke suffered, maximum walking speed, use of ankle foot orthosis, use of cane, use of medicine that may increase the risk of falling, and frequency of the falls of the patient during their rehabilitation period in the hospital, FIM, SIAS, and Mini-Mental State Examination scoring were also done before their discharge from the hospital. We first carried out bivariate analysis to determine which variables differed significantly between the non-fallers and fallers. Those variables of significant statistical values were then included in a multivariate logistic regression analysis. The model was simplified in a Forward Selection Method (Likelihood Ratio) by removing variables. Results: Those patients with a falling experience comprised 25 patients out of the total 64 patients (39.1%). The logistic model was refined until it excluded all the predictors except two. These two predictors were maximum walking speed, and use of ankle foot orthosis. Conclusions: Those patients with a slow speed of walking and/or the patients who required the use of ankle foot orthosis were at a higher risk of falling.

We examined the effects of high temperature- and pressure-treated garlic (HITPG), which has enhanced anti-oxidative activity, on 1, 2-dimethylhydrazine (DMH)-induced mucin-depleted foci (MDF), as premalignant lesions, in the rat colorectum at the post-initiation stage. Male F344 rats (5 weeks old) were injected s.c. with DMH (40 mg/kg, once weekly for 2 weeks). Rats were fed basal diet or experimental diets containing 1% or 3% HTPG for 6 weeks, starting 1 week after the last injection of DMH. At sacrifice, the number of MDF in the 3% HTPG diet group was significantly lower than that in the basal diet group. In addition, we also studied the influence of 3% HTPG diet ingestion. Rats were fed basal diet or 3% HTPG diet under the above conditions without DMH treatment. The 3% HTPG diet did not affect most hematological and plasma biochemical parameters. These results, combined with our previous work (APJCP, 2009), suggest that HTPG may be useful as a health supplement.