4.Quantitative Measurement of Blood Glucose Disposition Rate by Intravenous Glucose Infusion and the Effects of Warm Water Bathing
Nobuyuki TANAKA ; Mitsuru KOKUSHO ; Yousuke OHKATSU ; Megumi SHIMODOZONO ; Kazumi KAWAHIRA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2010;73(2):122-128
Blood glucose disposition rate after intravenous glucose infusion is considered to reflect mainly the rate of cellular glucose uptake, the rate of glucose degradation process and gluconeogenesis. excluding the influense of glucose absorption.
When it is hypothesized that the elevated blood glucose is disposed by constant rate (one-compartment theory), the following formula will be realized.
Ct = A (1— k)t Ct = blood glucose level at t-minutes after infusion
A = initial glucose level after infusion
k = constant glucose disposition index / min
log Ct = log A (1—k) t= log A + t log (1 — k)
This formula demonstrates that logarithm of blood glucose concentration (Ct) is a one-dimensional (linear) function of time t with a slope log (1 — k), and blood glucose disposition index k can be calculated from this slope.
To examine the validity of this hypothesis, 1.5 ml / kg of 20% glucose (0.3g / kg) was infused at rest within 3 minutes into an antecubital vein and plasma glucose was determinned at 1, 3, 5, 10, 15, 20, 30 and 40 min after the cessation of infusion.
In 10 healthy subjects, linear regression coefficient between logarithm of plasma glucose and time t was significantly higher (r= 0.992 ± 0.006, p<0.001) during 5 to 40 min. Calculated k index ranged from 0.78 to 4.54% / min and the correlation between the 1st and the 2nd measurements (n=5) within a week was also significantly high (0.92±0.06, p<0.01). These results highly support the validity of basic formula (one-compartment theory) and practical procedure to measure k index.
The effects of warm water bathing (42 C, 10min) was examined in 7 subjects keeping warmth by blankets. After bathing, k value remained in nearly the same in 4 subjects, decreased in 2 and increased in 1. Although more detailed studies are needed, the effect of single bathing on glucose disposition seems to be not so significant.
5.Effects of Repetitive Facilitation Exercise Combined with Continuous Low-frequency Electrical Stimulation on Upper-limb Motor Impairment and Hand Edema during an Acute Phase of Cerebral Infarction
Atsushi MAESAKO ; Manami NAGASE ; Tatsui NAGADOU ; Megumi SHIMODOZONO ; Kazumi KAWAHIRA
The Japanese Journal of Rehabilitation Medicine 2014;51(3):219-227
Purpose : To study the effect of repetitive facilitation exercise combined with continuous low-frequency electrical stimulation on upper-extremity motor impairment or hand edema during the acute phase of cerebral infarction. Subjects : Thirty inpatients with both hemiplegia and hand swelling, who were admitted to a hospital from April 2011 to March 2012. Methods : In this randomized, controlled, observer-blinded trial, we randomized the subjects into two groups and provided treatment on a 2-week, 30 minutes/day schedule. Subjects in the intervention group received repetitive facilitation exercise concurrent with continuous low-frequency electrical stimulation, while subjects in the control group were provided passive range-of-motion (ROM) exercise. Upper Limb Fugl-Meyer Assessment (FMA), edema and passive ROM were evaluated at baseline and at two weeks. Results : At two weeks, the intervention group showed significant improvements on all measurements. However, the control group showed significant improvement only in their FMA. The intervention group had significantly greater improvements than the control group on all three measurements. Conclusion : Repetitive facilitation exercise concurrent with continuous low-frequency electrical stimulation therapy is effective not only for recovery from motor impairment but also for reducing swelling of the hand during the acute phase of cerebral infarction.
6.Improvement of Exercise Torelance after Hot Water Bathing in Aged Men.
Yutaka HORIKIRI ; Megumi SHIMODOZONO ; Xiao Jun WANG ; Nobuyuki TANAKA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2000;63(3):138-142
Treadmill exercise tolerance test(Modified Bruce Method) was performed with and without warm water bathing (WWB, 41°C, 10min) in 14 healthy aged men and women over 65y. o. (68.6±6.0y.o).
Increase in HR, BP and PRP during exercise was reduced after WWB. Duration of exercise and ST depression and occurrence of arrythmia during treadmill exerecise were significantly improved after WWB. Fatigability of the legs and Borg's index were also decreased aftr WWB. These results indicated the improvement of exercise tolerance after WWB was probably due to the increase in cardiac functions and collagenous viscosity (extensivility) of the musculoskeletal system.
7.Quadranopsia improved by Repetitive Visual Stimulation using a Computerized Visual Field Training Machine in a Stroke Patient: A Case Report
Yurika SHIMOZONO ; Michiko ARIMA ; Yuiko KAI ; Megumi SHIMODOZONO ; Kazumi KAWAHIRA
The Japanese Journal of Rehabilitation Medicine 2007;44(10):613-619
Although visual field defects are common disorders in stroke patients, rehabilitation treatments have developed slowly. In this study, we report a case of a 35-year-old man with quadranopsia and visual agnosia due to right occipital hemorrhage. He had no upper limb motor impairments and began to work as a dental mechanic one month after the stroke, but had to retire because of difficulty in making dental implants. He failed to find things in his lower left visual field, and could not perceive fine differences in slope and depth. He was admitted 2 months after the onset and received occupational therapy for visual agnosia, and treatment for quadranopsia one month after admission. The treatment for quadranopsia was performed using a newly designed computerized visual field training machine consisting of a personal computer system which displayed a fixing point for the eyes at the center of the computer display, and a visual stimulation point at areas between residual vision and quadranopsia on the computer display accompanied by a response warning sound after the patient indicated using a switch when he found the visual stimulation. The visual stimulations contained 20% placebo (no visual stimulation). The computer also calculated the percent of correct responses. After one month of continuous occupational therapy only, his visual agnosia improved but his quadranopsia did not. However, his quadranopsia did improve after repetitive visual stimulation using the computerized visual field training machine. In conclusion, quadranopsia might be improved by repetitive visual stimulation.
8.Effects of Forearm Bathing on Function and Spasticity of Hemiplegic Hands
Seiji ETOH ; Ayako SUNANAGA ; Ryota HAYASHI ; Yuto ONITSUKA ; Shuji MATSUMOTO ; Megumi SHIMODOZONO ; Kazumi KAWAHIRA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2010;73(4):248-254
Purpose
Forearm bathing is considered beneficial for the hands of patients with spastic hemiplegia, but the effect has not been investigated comprehensively. This study investigated the effectiveness of forearm bathing for patients with hemiplegic hands.
Subjects and Methods
In total, nine hemiplegic patients participated in the study (mean±standard deviation age=56.9±16.6 years; mean±standard deviation period from onset=21.1±21.2 months). Participants sat in a relaxed position on a chair, and dipped the affected forearms into 40°C warm water for 15 mins. The Simple Test for Evaluating Hand Function (STEF) score was evaluated before and after forearm bathing as an indicator of hemiplegic hand function. The Modified Ashworth Scale (MAS) score for the biceps brachii muscle, and both the resistance power of elbow extension and the F/M ratio (F-wave amplitudes/ M wave amplitudes) for the abductor pollicis brevis muscle, were evaluated as indicators of hemiplegic hand spasticity. The device used to measure the resistance power of elbow extension comprised a motor, cuffs to fix the hemiplegic arm and forearm in place, and a control system. The axis of rotation of the device was positioned over the axis of rotation of the elbow joint. The device induced passive elbow flexion and extension movements at an angular velocity of 60°/sec or 90°/sec.
Results
After forearm bathing, the STEF score increased significantly (p<0.05) from 42.9±28.0 to 47.8±28.4 (n=9), the resistance power of elbow extension at 90°/min decreased significantly (p<0.01) from 4.0±1.8 N to 3.0±1.9 N, and the MAS score and F/M ratio were unchanged (n=6).
Conclusions
Forearm bathing appeared to improve function and decrease spasticity in hemiplegic hands. This treatment might facilitate hand rehabilitation.