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Tani Y.,Tokyo Bay Rehabilitation Hospital | Otaka Y.,Tokyo Bay Rehabilitation Hospital | Otaka Y.,Keio University | Kudo M.,Tokyo Bay Rehabilitation Hospital | And 2 more authors.
Journal of Stroke and Cerebrovascular Diseases | Year: 2016

Background Although genu recurvatum during walking is a well-known issue in stroke rehabilitation, there are no reliable epidemiological data on its prevalence. The aim of the study was to investigate the prevalence of genu recurvatum during walking and associated knee pain among ambulatory community-dwelling patients with chronic hemiplegic stroke. Methods Questionnaires were sent to physical therapists working at 223 adult day care facilities in Chiba Prefecture, Japan. The number of all chronic stroke patients attending the day care who could walk without human assistance, including those who used a walking aid and/or an orthosis; the number of patients with genu recurvatum in the paretic limb during walking; and the number of patients with genu recurvatum who had experienced any knee pain in the last month were investigated. Physical therapists were also asked whether they considered genu recurvatum in stroke patients to be problematic. Results Sixty-four facilities (28.7%) responded, providing data on 1110 ambulatory stroke patients, of whom 217 (19.5%) showed genu recurvatum. Of the patients with genu recurvatum, 25 (11.5%) experienced knee pain in the paretic limb. Of 45 physical therapists who gave an opinion on whether genu recurvatum was problematic, 26 (57.8%) thought it was problematic whereas 19 thought it was not problematic. Conclusion Rates of genu recurvatum and associated knee pain were relatively low among ambulatory community-dwelling stroke survivors attending adult day care. © 2016 National Stroke Association. Source

Yamaguchi T.,Keio University | Yamaguchi T.,Japan Society for the Promotion of Science | Fujiwara T.,Keio University | Saito K.,Tokyo Bay Rehabilitation Hospital | And 7 more authors.
Journal of Electromyography and Kinesiology | Year: 2013

Objective: Pedaling is widely used for rehabilitation of locomotion because it induces muscle activity very similar to locomotion. Afferent stimulation is important for the modulation of spinal reflexes. Furthermore, supraspinal modulation plays an important role in spinal plasticity induced by electrical stimulation. We, therefore, expected that active pedaling combined with electrical stimulation could induce strong after-effects on spinal reflexes. Design: Twelve healthy adults participated in this study. They were instructed to perform 7. min of pedaling. We applied electrical stimulation to the common peroneal nerve during the extension phase of the pedaling cycle. We assessed reciprocal inhibition using a soleus H-reflex conditioning-test paradigm. The magnitude of reciprocal inhibition was measured before, immediately after, 15 and 30. min after active pedaling alone, electrical stimulation alone and active pedaling combined with electrical stimulation (pedaling. +. ES). Results: The amount of reciprocal inhibition was significantly increased after pedaling. +. ES. The after-effect of pedaling. +. ES on reciprocal inhibition was more prominent and longer lasting compared with pedaling or electrical stimulation alone. Conclusions: Pedaling. +. ES could induce stronger after-effects on spinal reciprocal inhibitory neurons compared with either intervention alone. Pedaling. +. ES might be used as a tool to improve locomotion and functional abnormalities in the patient with central nervous lesion. © 2012 Elsevier Ltd. Source

Otaka Y.,Tokyo Bay Rehabilitation Hospital
Clinical calcium | Year: 2010

Fall-related fracture in elderly is one of the big issues in our aging society. A major cause of fractures in elderly is fall. Therefore, the prevention of falls is essential for the prevention of fractures in elderly. Various risk factors of falls such as physical fragility, cognitive decline and visual problem have been reported. The effective way for prevention of falls is the modification of the risk factors for falls. Especially, exercise has been known effective. In addition to prevention of falls, we should explore the appropriate approach to modify fall direction, defensive reaction, local shock absorption, which are closely related to fall-related fracture risk. Source

Sato H.,Kitasato University | Ikura D.,Tokyo Bay Rehabilitation Hospital | Tsunoda M.,Shimada Ryoiku Center Hachioji
Disability and Rehabilitation: Assistive Technology | Year: 2015

Using two types of small, lightweight tri-axial accelerometers, we obtained evidence for the effectiveness of an approach for assessing head-trunk symmetrical or asymmetrical positions during sleep. First, we assessed the accuracy of our monitoring system in five healthy young adults (age range, 22-24 years). The participants wore acceleration monitors on the sternum and forehead; then spent 5 min in six different positions. Once accuracy was confirmed, we assessed head-trunk symmetry during night-time sleep in 10 healthy children (age range, 3-13 years) and 10 young adults (age range, 21-26 years) in their home environments. All participants wore the monitors during one night's sleep in their homes. After computing head-trunk positions using the orientation data obtained by the accelerometers, head and trunk symmetry were evaluated. The head and trunk positions were correctly detected: the positional data from the trunk had 99% agreement, and the data from the head had 96% agreement. Both the young adults and children were observed to spend time with the head-trunk in asymmetric positions; however, the subjects changed position frequently so the asymmetrical postures were mobile. We concluded that the proposed monitoring system is a reliable and valid approach for assessing head-trunk symmetry during sleep at home. © 2015 Informa UK Ltd. Source

Yamaguchi T.,Keio University | Yamaguchi T.,Japan Society for the Promotion of Science | Sugawara K.,Kanagawa University of Human Services | Tanaka S.,Nagoya Institute of Technology | And 5 more authors.
PLoS ONE | Year: 2012

While previous studies have assessed changes in corticospinal excitability following voluntary contraction coupled with electrical stimulation (ES), we sought to examine, for the first time in the field, real-time changes in corticospinal excitability. We monitored motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation and recorded the MEPs using a mechanomyogram, which is less susceptible to electrical artifacts. We assessed the MEPs at each level of muscle contraction of wrist flexion (0%, 5%, or 20% of maximum voluntary contraction) during voluntary wrist flexion (flexor carpi radialis (FCR) voluntary contraction), either with or without simultaneous low-frequency (10 Hz) ES of the median nerve that innervates the FCR. The stimulus intensity corresponded to 1.2× perception threshold. In the FCR, voluntary contraction with median nerve stimulation significantly increased corticospinal excitability compared with FCR voluntary contraction without median nerve stimulation (p<0.01). In addition, corticospinal excitability was significantly modulated by the level of FCR voluntary contraction. In contrast, in the extensor carpi radialis (ECR), FCR voluntary contraction with median nerve stimulation significantly decreased corticospinal excitability compared with FCR voluntary contraction without median nerve stimulation (p<0.05). Thus, median nerve stimulation during FCR voluntary contraction induces reciprocal changes in cortical excitability in agonist and antagonist muscles. Finally we also showed that even mental imagery of FCR voluntary contraction with median nerve stimulation induced the same reciprocal changes in cortical excitability in agonist and antagonist muscles. Our results support the use of voluntary contraction coupled with ES in neurorehabilitation therapy for patients. © 2012 Yamaguchi et al. Source

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