1.Increased Phase Angle Reflects Improvement in Activities of Daily Living and Muscle Health in Post-stroke Rehabilitation
Kouki YONEDA ; Yoshihiro YOSHIMURA ; Hidetaka WAKABAYASHI ; Ayaka MATSUMOTO ; Fumihiko NAGANO ; Sayuri SHIMAZU ; Yoshifumi KIDO ; Takahiro BISE ; Takenori HAMADA ; Ai SHIRAISHI
Annals of Geriatric Medicine and Research 2026;30(1):62-69
Background:
Phase angle (PhA) reflects cellular integrity and muscle quality. However, evidence is limited regarding whether an increase in PhA is associated with improvements in activities of daily living (ADL) and skeletal muscle mass. This study aimed to investigate the association between change in PhA and prognosis in terms of ADL and skeletal muscle mass in post-stroke patients undergoing rehabilitation.
Methods:
This retrospective cohort study was conducted at a convalescent rehabilitation hospital in Japan. Patients with a PhA at admission below the cutoff values (4.76° for male and 4.11° for female) were included. Patients were categorized into a PhA-increase group (>0) and a non-increase group (≤0). Outcomes included the Functional Independence Measure (FIM)-motor score and skeletal muscle mass index (SMI) at discharge. Multivariate regression was used to assess associations.
Results:
A total of 253 patients were included (mean age 78.0±10.9 years; 51% females). The median PhA at admission was 3.70° (interquartile range [IQR], 3.20–4.10), and the median change during hospitalization was 0.00° (IQR, -0.20– 0.30). Of these, 119 patients had increased PhA and 134 did not. Change in PhA was independently associated with higher FIM-motor scores (β=0.078, p=0.040) and greater SMI (β=0.454, p<0.001) at discharge.
Conclusions
In post-stroke patients, an increase in PhA during hospitalization was associated with better functional and muscular outcomes. PhA may therefore serve as a valuable biomarker for assessing the efficacy of rehabilitation.
2.Group Chair-Stand Exercise and Cognitive Recovery in Sarcopenic Stroke Patients
Fumihiko NAGANO ; Yoshihiro YOSHIMURA ; Ayaka MATSUMOTO ; Yoichi SATO ; Takafumi ABE ; Sayuri SHIMAZU ; Ai SHIRAISHI ; Takahiro BISE ; Yoshifumi KIDO ; Takenori HAMADA ; Aomi KUZUHARA ; Kouki YONEDA ; Kenichiro MAEKAWA
Annals of Geriatric Medicine and Research 2025;29(4):477-486
Background:
Evidence on the effectiveness of exercise for cognitive recovery in patients with sarcopenia is limited. This study examined the association between group-based chair-stand exercise and cognitive improvement during convalescent rehabilitation.
Methods:
This retrospective cohort study included stroke patients with sarcopenia and impaired cognitive level, defined as a Functional Independence Measure (FIM)-cognitive score ≤23, admitted between 2016 and 2023. All patients received standard rehabilitation and participated in group-based chair-stand exercise twice daily. The frequency of exercise during hospitalization was recorded. The primary outcome was FIM-cognitive score at discharge. Secondary outcomes were handgrip strength (HG) and FIM-motor score. Multivariate linear regression analysis was used to examine associations between exercise frequency and outcomes, adjusting for potential confounders.
Results:
Of the 1,220 patients admitted, 273 sarcopenic stroke patients with reduced cognitive level (mean age 80 years; 48% male) were included in the final analysis dataset; the median frequency of performing chair-stand exercise per day was 43 (interquartile range, 20–71). Higher exercise frequency was independently associated with better FIM-cognitive score at discharge (β=0.217, p<0.001), greater HG (β=0.146, p=0.008), and improved FIM-motor score (β=0.295, p<0.001).
Conclusion
Frequent participation in group-based chair-stand exercise was associated with improvements in cognitive and physical function in sarcopenic stroke patients. Incorporating simple, repetitive resistance exercises into rehabilitation programs may enhance recovery outcomes in this vulnerable population.
3.Improved Systemic Inflammation is Associated with Functional Prognosis in Post-Stroke Patients
Kota HORI ; Yoshihiro YOSHIMURA ; Hidetaka WAKABAYASHI ; Fumihiko NAGANO ; Ayaka MATSUMOTO ; Sayuri SHIMAZU ; Ai SHIRAISHI ; Yoshifumi KIDO ; Takahiro BISE ; Aomi KUZUHARA ; Takenori HAMADA ; Kouki YONEDA ; Kenichiro MAEKAWA
Annals of Geriatric Medicine and Research 2024;28(4):388-394
Background:
Systemic inflammation is associated with poor functional outcomes. However, the effects of improved inflammation on functional indicators remain unclear. This study aimed to clarify the relationship between improvements in systemic inflammation and activities of daily living in patients after stroke.
Methods:
This retrospective cohort study included patients post stroke with systemic inflammation upon admission. Systemic inflammation was defined as a modified Glasgow Prognostic Score (mGPS) score of 1–2. Improvement in systemic inflammation was defined as a reduction in mGPS score or blood C-reactive protein (CRP) levels during hospitalization. The primary outcomes were the motor items of the Functional Independence Measure (FIM-motor) at discharge. We applied multiple linear regression analysis to examine whether reduced systemic inflammation was associated with outcomes after adjusting for confounding factors.
Results:
Of the 1,490 patients recruited, 158 (median age of 79 years; 88 men) had systemic inflammation on admission and were included in the study. Among these patients, 131 (82.9%) and 147 (93.0%) exhibited reduced mGPS and CRP levels, respectively. The median change in CRP was 2.1 mg/dL (interquartile range, 1.1–3.8). Multivariate analysis revealed that improvements in mGPS (β=0.125, p=0.012) and CRP levels (β=0.108, p=0.108) were independently and positively associated with FIM-motor at discharge.
Conclusions
Improvement in systemic inflammation was positively associated with functional outcomes in patients post stroke. Early detection and therapeutic intervention for systemic inflammation may further improve outcomes in these patients.
4.Improved Systemic Inflammation is Associated with Functional Prognosis in Post-Stroke Patients
Kota HORI ; Yoshihiro YOSHIMURA ; Hidetaka WAKABAYASHI ; Fumihiko NAGANO ; Ayaka MATSUMOTO ; Sayuri SHIMAZU ; Ai SHIRAISHI ; Yoshifumi KIDO ; Takahiro BISE ; Aomi KUZUHARA ; Takenori HAMADA ; Kouki YONEDA ; Kenichiro MAEKAWA
Annals of Geriatric Medicine and Research 2024;28(4):388-394
Background:
Systemic inflammation is associated with poor functional outcomes. However, the effects of improved inflammation on functional indicators remain unclear. This study aimed to clarify the relationship between improvements in systemic inflammation and activities of daily living in patients after stroke.
Methods:
This retrospective cohort study included patients post stroke with systemic inflammation upon admission. Systemic inflammation was defined as a modified Glasgow Prognostic Score (mGPS) score of 1–2. Improvement in systemic inflammation was defined as a reduction in mGPS score or blood C-reactive protein (CRP) levels during hospitalization. The primary outcomes were the motor items of the Functional Independence Measure (FIM-motor) at discharge. We applied multiple linear regression analysis to examine whether reduced systemic inflammation was associated with outcomes after adjusting for confounding factors.
Results:
Of the 1,490 patients recruited, 158 (median age of 79 years; 88 men) had systemic inflammation on admission and were included in the study. Among these patients, 131 (82.9%) and 147 (93.0%) exhibited reduced mGPS and CRP levels, respectively. The median change in CRP was 2.1 mg/dL (interquartile range, 1.1–3.8). Multivariate analysis revealed that improvements in mGPS (β=0.125, p=0.012) and CRP levels (β=0.108, p=0.108) were independently and positively associated with FIM-motor at discharge.
Conclusions
Improvement in systemic inflammation was positively associated with functional outcomes in patients post stroke. Early detection and therapeutic intervention for systemic inflammation may further improve outcomes in these patients.
5.Improved Systemic Inflammation is Associated with Functional Prognosis in Post-Stroke Patients
Kota HORI ; Yoshihiro YOSHIMURA ; Hidetaka WAKABAYASHI ; Fumihiko NAGANO ; Ayaka MATSUMOTO ; Sayuri SHIMAZU ; Ai SHIRAISHI ; Yoshifumi KIDO ; Takahiro BISE ; Aomi KUZUHARA ; Takenori HAMADA ; Kouki YONEDA ; Kenichiro MAEKAWA
Annals of Geriatric Medicine and Research 2024;28(4):388-394
Background:
Systemic inflammation is associated with poor functional outcomes. However, the effects of improved inflammation on functional indicators remain unclear. This study aimed to clarify the relationship between improvements in systemic inflammation and activities of daily living in patients after stroke.
Methods:
This retrospective cohort study included patients post stroke with systemic inflammation upon admission. Systemic inflammation was defined as a modified Glasgow Prognostic Score (mGPS) score of 1–2. Improvement in systemic inflammation was defined as a reduction in mGPS score or blood C-reactive protein (CRP) levels during hospitalization. The primary outcomes were the motor items of the Functional Independence Measure (FIM-motor) at discharge. We applied multiple linear regression analysis to examine whether reduced systemic inflammation was associated with outcomes after adjusting for confounding factors.
Results:
Of the 1,490 patients recruited, 158 (median age of 79 years; 88 men) had systemic inflammation on admission and were included in the study. Among these patients, 131 (82.9%) and 147 (93.0%) exhibited reduced mGPS and CRP levels, respectively. The median change in CRP was 2.1 mg/dL (interquartile range, 1.1–3.8). Multivariate analysis revealed that improvements in mGPS (β=0.125, p=0.012) and CRP levels (β=0.108, p=0.108) were independently and positively associated with FIM-motor at discharge.
Conclusions
Improvement in systemic inflammation was positively associated with functional outcomes in patients post stroke. Early detection and therapeutic intervention for systemic inflammation may further improve outcomes in these patients.
6.Analysis of stress proteins ioduced by acupuncture stimulation.
Kazuko KOBAYASHI ; Takahiro SHIMAZU ; Mika OTA ; Masamori IIBOSHI
Journal of the Japan Society of Acupuncture and Moxibustion 1990;40(4):365-368
We show here that stress proteins (Mr 70K, 85K and 100K) were induced by both electroacupuncture and moxibustion.
Rats (Wister strain, male, 250g) were cauterized with moxa on the hip, and the subcutaneous and intramuscular temperatures of the hip were kept at 45°C and at 39-40°C for 15 minutes. While, another group of rats were electrically stimulated for 15min inserting acupuncture needles as electrodes into the muscle of the hips in the depth of 1cm and using current pulse acupuncture system (5Hz, 3-5mA). Both groups of rats were sacrificed under deep anesthesia and the muscular tissues were excised 3 hours after the stimulations. The proteins extracted from the homogenized and centrifuged tissues in the two groups of rats and control rats were analyzed by two-dimensional gel electrophoreses. The heat shock proteins with molecular weight of 70000 (Mr 70K, hsp 70), 85000 (Mr 85K, hsp 85) and 100000 (Mr 100K, hsp 100) were detected in the rats stimulated by moxibustion. The stress proteins of molecular mass 70000, 85000 and 100000 similar to hsps induced by moxibustion were found in the rats stimulated by electroacupuncture.


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