2.Functional Electrical Stimulation for Pharyngeal Dysphagia : A Feasibility Study
Hiroaki KUNO ; Toshiyasu YAMAMOTO ; Yoichiro AOYAGI ; Akio TSUBAHARA
The Japanese Journal of Rehabilitation Medicine 2010;47(12):867-873
In this study, we investigated a surface electrode stimulation method to support laryngeal elevation in patients with pharyngeal dysphagia, from the viewpoint of functional electric stimulation (FES). Informed consent was obtained from 15 healthy men and 4 patients with pharyngeal dysphagia. Digastric and stylohyoid muscles were stimulated by silver-textile surface electrodes covering the muscle belly. Laryngeal elevation by the electrical stimulation (ES) during liquid (water, 3ml) swallowing movement was measured by digital video camera. The laryngeal elevation trajectory demonstrated a hysteresis loop. The elevation distance of the larynx increased with a rise of stimulus strength. Laryngeal elevation by ES was 76.0% in the normal subjects and 86.6% in patients when measured during liquid swallowing. Applying FES for laryngeal elevation may assist in improving the swallowing reflex.
3.Paraneoplastic Syndrome with Sensory Polyneuropathy : A Report on Rehabilitation in Two Cases
Rieko KAWADA ; Yoichiro AOYAGI ; Takashi HIRAOKA ; Takashi YAMANAKA ; Katsushi KUNIYASU ; Akio TSUBAHARA
The Japanese Journal of Rehabilitation Medicine 2009;46(9):572-576
We report two cases of paraneoplastic syndrome with sensory polyneuropathy. Case one showed numbness of the upper and lower extremities before a diagnosis of small cell carcinoma was made. Case two showed the same symptoms coincidentally with a recurrence of ovarian cancer. In both cases, Romberg's sign was positive, ataxic gait was noted, and the patient's skill movement was disturbed. Sensory nerve action potentials were not evoked in any of the nerves. Compound muscle action potential and motor conduction velocity were at the lower limits of normal. The neurological abnormalities did not resolve in spite of medical treatments. In these two cases, the loss of sensory neurons due to a lesion of the dorsal root ganglia was suggested. The loss of sensory feedback might lead to muscle weakness and fatigue, so they tend to be disused. For long-term rehabilitation management in these two cases, we suggested a regular exercise program to prevent muscle weakness.
4.Relationship between the lifestyle and cognitive functions in elderly individuals
Aiko Osawa ; Shinichiro Maeshima ; Jun Tanemura ; Akio Tsubahara ; Takako Yoshimura ; Fuminori Ozaki ; Hiroshi Moriwaki
Neurology Asia 2012;17(1):31-37
We investigated the relationship between lifestyle and cognitive function in elderly subjects who had
their checkups at a memory clinic. The 136 elderly study subjects included 51 with Alzheimer’s disease,
22 with vascular dementia, 23 with frontotemporal dementia, 25 with mild cognitive impairment, and
15 healthy control. The patients’ lifestyles were assessed using the Frenchay activities index (FAI),
and their cognitive functions were assessed by neuropsychological tests, such as the mini-mental status
examination and the frontal assessment battery (FAB). The FAI score was lower in the demented
patients than in the control subjects. Strong correlations were observed between the FAI scores and
the scores in the neuropsychological tests. The FAI scores did not correlate with the educational level
or the duration of disease. The fi ndings from the stepwise regression analysis indicated that the FAB
score, the number of family members, gender, and age were factors independently affecting the FAI
score. The results indicated that the lifestyles of the elderly people might be affected by not only their
age and family organization but also their cognitive function. We concluded that cognitive function
could play a role in the lifestyle of elderly people.
5.Measurement of Knee Extensor Torque During Repetitive Peripheral Magnetic Stimulation: Comparison of the Forces Induced by Different Stimulators
Masanori KAMIUE ; Akio TSUBAHARA ; Tomotaka ITO ; Yasuhiro KOIKE
Annals of Rehabilitation Medicine 2024;48(3):203-210
Objective:
To investigate the factors that induce strong contractions during repetitive peripheral magnetic stimulation (rPMS) and compare the muscle torque induced by two stimulators (Stim A and Stim B) with different coil properties.
Methods:
rPMS was applied to the right vastus lateralis of 30 healthy young adults. Stim A contained a 10.1 cm2 rectangular iron core coil, while Stim B contained a 191 cm2 round coil. The knee extensor torque (KET) induced by rPMS at 30 Hz was measured isometrically and divided by the maximum voluntary contraction (MVC) to obtain a relative value of MVC (%MVC). KET at 100% intensity of Stim A (A100%, 1.08 T) was compared to those at 100% or 70% intensity of Stim B (B100%, 1.47 T vs. B70%, 1.07 T). Additionally, we conducted a comprehensive literature search for studies that measured the KET during rPMS.
Results:
Both the mean values of %MVC using B100% and B70% were significantly greater than that using A100%. Furthermore, the KET induced by Stim B was found to be larger than that described in previous reports, unless booster units were used to directly stimulate the main trunk of the femoral nerve.
Conclusion
Stim B induced a stronger muscle contraction force than Stim A did. This may be because the larger the coil area, the wider the area that can be stimulated. Additionally, a circular coil allows for deeper stimulation.