記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Patients in psychiatric care wards face serious problems in terms of declining physical function due to aging and long-term hospitalization. This study aimed to determine the current status of locomotive syndrome (LS) in long-term inpatients in psychiatric care wards and to clarify the factors associated with LS risk severity. METHODS: The study included 84 patients admitted to psychiatric care wards who underwent the LS stage test. We investigated the participants' age, length of stay, antipsychotic drug use, body mass index, and activities of daily living were assessed and analyzed the correlations between the LS stage test and each assessment item. RESULTS: The participants' mean age was 60.0 ± 13.6 years, with those aged ≥60 years comprising nearly 60% of the sample. The participants' mean length of stay was 10.5 ± 12.0 years, and over half of the patients stayed >5 years: 17.9% stayed between 5 and 10 years, while 36.9% stayed ≥10 years. Nearly 90% of participants stayed for >1 year. The LS stage test showed that 60.7% of the participants were stage 3, 21.4% were stage 2, 14.3% were stage 1, and 3.6% had no risk. The results of the LS stage indicated significant correlations with age, length of stay, and the Barthel Index scores. CONCLUSIONS: Patients who stay in a psychiatric care unit for a long period experience declining physical function, which is associated with aging and long-term hospitalization and might affect their activities of daily living.

DOI： 10.1016/j.jos.2021.01.015

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掲載種別：研究論文（学術雑誌）   出版者・発行元：The Japanese Society of Physical Fitness and Sports Medicine  

DOI： 10.7600/jpfsm.11.1

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Whereas early rehabilitation improves the patients' physical function in patients with cerebral infarction and hemorrhage, complications in the early stage are the main barriers in patients with subarachnoid hemorrhage (SAH). Therefore, the clinical impact of early rehabilitation in patients with SAH is not well documented. We sought to investigate whether early mobilization is associated with favorable discharge disposition and functional status in patients with SAH.Hospitalization data of 35 patients (65.7 ± 13.7 years, 37.1% men) were retrospectively reviewed. The early and delayed mobilization groups were defined as those who had and had not participated in walking rehabilitation on day 14, respectively. We investigated whether patients were discharged or transferred to another hospital and assessed their functional status using the Functional Ambulation Categories, Ambulation Index, Glasgow Outcome Scale, and modified Rankin Scale scores.Nine patients (69.2%) in the early mobilization group and one patient (4.5%) in the delayed mobilization group were discharged home directly (P < .001). In multivariate logistic regression analysis, early mobilization was independently associated with home discharge after adjustment using the World Federation of Neurosurgical Societies grade (adjusted odds ratio = 30.20, 95% CI = 2.77-329.00, P < .01). Early mobilization was associated with favorable functional status at discharge through multivariate linear regression analysis (standardized beta = 0.64 with P < .001 for the Functional Ambulation Category and beta = -0.62 with P < .001 for the modified Rankin Scale, respectively).Early mobilization was associated with home discharge and favorable functional status at discharge. Larger prospective studies are warranted.

DOI： 10.1097/MD.0000000000028171

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

ABSTRACT: The long-term exercise capacity of coronavirus disease 2019 (COVID-19) patients with acute respiratory distress syndrome (ARDS) is not clear. The 6-minute walking distance (6MWD) of four patients with COVID-19-associated ARDS was followed for 6 months after admission to the hospital. These four patients were admitted to the intensive care unit (ICU) of our hospital and received mechanical ventilation. Rehabilitation therapy (positioning, postural drainage, and passive range of motion exercises) was started after ICU admission. Mobilization therapy, including muscle power training, sitting on the edge of the bed, and endurance training, was performed after the end of sedation. The Medical Research Council sum scores and Barthel Indexes for the patients improved after ICU discharge and completely recovered 6 months after admission to the hospital. However, the 6MWD of the four patients remained shorter than those of healthy persons of the same age at 6 months after admission to the hospital. Furthermore, the minimum SpO2 during the 6-minute walking test remained below 96%. It is possible that patients who receive mechanical ventilation due to COVID-19-associated ARDS have decreased long-term exercise capacity, despite muscle power and activities of daily living recovering completely.

DOI： 10.1097/PHM.0000000000001803

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Study design: Retrospective study.Objectives: To determine the best time to introduce non-invasive ventilation (NIV), clinical effectiveness of NIV, and complications of long-term use of NIV in patients with high-level cervical spinal cord injuries (CSCI).Setting: Public Hospital, Japan.Methods: The subjects were 14 tracheostomy ventilator-dependent patients, with above C3 spinal lesions, and American Spinal Cord Injury Association Impairment Scale A (ASIA A). They were referred to our clinic between 2005 and 2010 for switching mechanical ventilation support system from tracheostomy ventilation to NIV. Respiratory function tests were measured before and after NIV. Patients who were successfully switched to NIV were interviewed two years later and asked about their health and social status.Results: Eleven patients were successfully switched to NIV. The success rate of switching to NIV within 1 year was also high (P < 0.05). NIV improved the vital capacity of C2 ASIA A and C1 ASIA A patients with adequate respiratory accessory muscle strength sufficient to expand the chest wall. The time on ventilator-free spontaneous breathing increased or did not deteriorate after NIV. Three C1 ASIA A patients with insufficient muscle strength to expand the thorax mastered glossopharyngeal breathing and enjoyed a short ventilator-free time. All patients who were successfully switched to NIV lived in the community. Two patients developed minor complications after discharge and two died later for unrelated causes.Conclusion: Ventilator-dependent patients should be switched to NIV within 1 year of injury. Long-term NIV can improve respiratory function and clinical outcome.

DOI： 10.1080/10790268.2019.1644474

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Objective: Brain-derived neurotrophic factor (BDNF) has beneficial effects on metabolism as well as the peripheral and central nervous systems. The aim of this study was to assess the response of serum BDNF concentration ([BDNF]s) to wheelchair half marathon race in individuals with spinal cord injury (SCI). Design: Prospective observational study. Setting: The 34th Oita International Wheelchair Marathon Race in Japan. Participants: Nine cervical SCIs (CSCI) and 8 thoracic and lumber SCIs (LSCI) male athletes. Interventions: Wheelchair half-Marathon Race. Outcome measures: [BDNF]s, plasma concentrations of adrenaline ([Ad]p), noradrenaline ([Nor]p), and cortisol ([Cor]p), hematocrit, and platelet count were measured the day before, immediately after, and an hour after the race. Results: [BDNF]s increased significantly immediately after the race in both groups (CSCI; P = 0.0055, LSCI; P = 0.0312) but returned to the baseline levels at one hour after the race. However, [BDNF]s immediately and one hour after the race were significantly higher in LSCI than in CSCI (immediately after the race; P = 0.0037, 1 h after the race; P = 0.0206). Hematocrit and platelet count remained unchanged throughout the study. In LSCI, [Ad]p, [Nor]p and [Cor]p increased significantly immediately after and one hour after the race, compared with the baseline values (P < 0.05). On the other hand, these variables remained unchanged throughout the study in the CSCI. Conclusions: [BDNF]s increased significantly from the baseline in both LCSI and CSCI but was higher in LSCI than in CSCI immediately after and one hour after the race.

DOI： 10.1080/10790268.2020.1816402

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

A 65-yr-old man visited a primary care hospital with a continued fever of 38°C for 3 days. As his fever did not improve until 8 days after, he was admitted into another acute care hospital, where his respiratory condition rapidly worsened. Therefore, the patient was transferred to our hospital. On the day of transfer (day 1), he was started on mechanical ventilation. COVID-19 was diagnosed using a polymerase chain reaction assay 6 days after admission (day 6). The rehabilitation therapy was begun on day 6. The initial rehabilitation programs focused on positioning and postural drainage. The patient was extubated on day 19, and he began standing and stepping on the same day. Gait exercises began on day 22, and endurance training was initiated on day 28. The patient was discharged from our hospital on day 34 as he met the physical function milestones. One month after discharge, the Medical Research Council sum score and Barthel Index had each improved; therefore, muscle strength and daily activities had returned to normal. It was assumed that mobilization should be performed as soon as possible after the end of sedation during the acute phase of severe COVID-19 infection in patients receiving mechanical ventilation.

DOI： 10.1097/PHM.0000000000001545

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background/Objective: Previous research indicates a better improvement of functional independence measure (FIM) at discharge in acute-stroke patients who received physiatrist and registered therapist operating rehabilitation (PROr) within 24 hrs compared with those who received after 24 hrs was reported. The aim of this prospective cohort study was to determine whether PROr provided within 24 hrs for new-onset stroke patients affects home-discharge rate at 6 months later.Methods: Acute new-onset stroke patients admitted to our hospital and received PROr (n = 227) and were conducted into 3 categories based on the time until starting PROr; within 24 hrs (very early mobilization; VEM; n = 47), 24-48 hrs (early mobilization; EM; n = 77) and >48 hrs (later mobilization; LM; n = 103). Home-discharge rates as well as changes in FIM, and rates of recurrence and mortality during the 6-month follow-up were assessed.Results: A total of 139 patients [VEM (n = 32), EM (n = 43), LM (n = 64)] could be followed throughout the 6-month period. The home-discharge rate was ∼80% and significantly higher by ∼20% in VEM than EM. The gains in the motor subscale of FIM at 6 months were significantly higher in VEM than LM, while the mortality and recurrent rates were not significantly different among the categories.Conclusions: Starting PROr within 24 hrs of new-onset stroke may help to increase home-discharge rates at 6-month follow-up, simultaneously with a higher FIM. Very early mobilization in our hospital did not increase the risks of recurrence or death.

DOI： 10.1080/00207454.2020.1774578

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Objective: To determine the relationship between physical findings, wheelchair sitting time, and interface pressure on ischial region in subjects with spinal cord injury (SCI).Design: Cross-sectional study.Setting: Rehabilitation center in Japan.Participants: Manual wheelchair users with chronic SCI (n = 45).Interventions: Pressure ulcers (PU) were diagnosed by inspection, palpation, and ultrasonography. Self-reports were obtained on wheelchair sitting time and pressure mapping was recorded while the subject was seated on the wheelchair.Outcome measures: Subjects were divided into those with ultrasonographically low-echoic lesions (PU-positive group, n = 11) and no such lesions (PU-negative group, n = 34). Outcome measures included wheelchair sitting time and interface pressure at bilateral ischial regions.Results: Using ultrasonography, 13 low-echoic lesions were identified in 11 subjects of the PU-positive group. The pressure duration was longer and interface pressure was significantly higher in subjects of the PU-positive group compared with those of the PU-negative group (P < 0.05 and P < 0.001, respectively).Conclusions: This is the first study to evaluate the interrelationship between physical findings, sitting time, and ultrasonographically measured interface pressure on ischial region area in subjects with spinal cord injury. To prevent pressure ulcers, we recommend avoidance of prolonged wheelchair sitting and measures that can reduce the interface pressure. These variables should be carefully tailored to the needs of the individual subjects with SCI.

DOI： 10.1080/10790268.2020.1746873

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記述言語：英語  

Background: Thromboembolic events are rare but critical complications in childhood nephrotic syndrome. The veins are more commonly affected, while arterial thrombosis is extremely rare but often life-threatening. Herein, we describe the clinical course of a 10-years-old girl with catastrophic multiple arterial thrombosis at the primary onset of nephrotic syndrome who underwent bilateral above-knee amputation. Case diagnosis/treatment: A previous healthy 10-years-old girl contracted the influenza B virus. Five days later, she suddenly developed severe ischemia in both legs. Physical examination showed eyelid and leg edema, and laboratory tests revealed hypoalbuminemia and acute kidney injury. After undergoing contrast-enhanced computed tomography, the patient was diagnosed with multiple arterial thrombosis (including the bilateral iliac arteries) due to nephrotic syndrome. Despite the performance of surgical thrombectomies, fasciotomy, and systematic heparinization, she required bilateral above-knee amputation. The patient achieved spontaneous remission of nephrotic syndrome, and her renal function fully recovered. There were no findings suggestive of secondary nephrotic syndrome and antiphospholipid syndrome. Her protein C and protein S concentrations were slightly decreased at admission. However, whole-exome sequencing revealed a thrombotic risk variant (T630I) in the PROS1 gene encoding protein S. This missense variant is often reported in patients with thrombosis or protein S deficiency, and may result in a thrombotic predisposition in some situations, such as nephrotic syndrome. Conclusions: Arterial thrombosis is a rare complication; however, it must be considered, especially in patients with new-onset nephrotic syndrome. Early recognition is important for early intervention and prevention of serious sequelae.

DOI： 10.3389/fped.2020.00107

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記述言語：日本語   出版者・発行元：(株)メジカルビュー社  

障がい者スポーツ選手に対する医学的サポートには、健常者によるスポーツと同様に、国内・国際大会などに帯同する医療サポート、日常的な健康管理や国際大会などの参加可能を判断するメディカルチェック、アンチ・ドーピングがある。また、障がい者スポーツに特有なものとしてクラス分けがある。さらに、スポーツの安全性の確保や競技力向上のための医学的研究がある。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J00282&link_issn=&doc_id=20181022030005&doc_link_id=10.18885%2FJ00282.2019048109&url=https%3A%2F%2Fdoi.org%2F10.18885%2FJ00282.2019048109&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：英語  

DOI： 10.1016/j.pmrj.2018.03.012

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Brain-derived neurotrophic factor (BDNF) is an important neurotrophin. The present study investigated the effects of head-out water immersion (HOI) on serum BDNF concentrations. METHODS: Eight healthy men performed 20 min head-out water immersion at 42 °C (hot-HOI) and 35 °C (neutral-HOI). These experimental trials were administered in a randomised order separated by at least 7 days. Venous blood samples were withdrawn at rest, immediately after the 20-min HOI, as well as at 15 and 30 min after the end of the HOI. Serum BDNF and S100β, plasma cortisol, platelet and monocyte counts, and core body temperature (Tcb) were measured. RESULTS: Tcb was higher at the end of the hot-HOI and 15 min after hot-HOI (p < 0.01), but recovered to pre-HOI level at 30 min after hot-HOI. No change in Tcb was recorded during neutral-HOI. BDNF level was higher (p < 0.05) at the end of the hot-HOI and at 15 min after the end of hot-HOI, and returned to the baseline at 30 min after hot-HOI. S100β, platelet count and monocyte count remained stable throughout the study. Cortisol level was lower at the end of the hot-HOI and returned to pre-HOI level during the recovery period. BDNF and S100β, cortisol, and platelet and monocyte counts did not change throughout the neutral-HOI study. CONCLUSIONS: The present findings suggested that the increase in BDNF during 20-min hot-HOI was induced by hyperthermia through enhanced production, rather than by changes in permeability of the blood-brain barrier (BBB), platelet clotting mechanisms or secretion from monocytes.

DOI： 10.1080/02656736.2017.1394502

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Lumbar spondylolysis is a defect in the pars interarticularis that is common in young athletes; the stress distribution at the pars interarticularis is the highest in extension and rotation movements. The paraspinal muscles play an important role in stabilization of the lumbar spine; however, no study has assessed the properties of paraspinal muscles in athletes with lumbar spondylolysis. OBJECTIVE: To evaluate the properties of paraspinal muscles in athletes with lumbar spondylolysis. DESIGN: Cross-sectional study. SETTING: Laboratory. PARTICIPANTS: Six high school baseball players with terminal-stage lumbar spondylolysis and 11 high school baseball players without organic lumbar lesions of similar anthropometric characteristics. METHODS: All subjects performed the unsupported trunk holding test combined with surface electromyographic (EMG) power spectral analysis until exhaustion. The results of EMG power spectral analysis were compared between the spondylolysis and control groups. MAIN OUTCOME MEASUREMENTS: The median frequency (MF) was computed from the raw EMG signal of the erector spinae and multifidus during trunk holding test using fast Fourier transform spectrum analysis. The initial MF and MF slope were calculated. RESULTS: No significant differences in endurance time were found between the spondylolysis and control groups. The initial MF and the MF slopes of the erector spinae and multifidus were significantly lower in the spondylolysis group than in the control group. CONCLUSIONS: The results suggest lower fast-twitch motor unit recruitment in the erector spinae and multifidus of high school baseball players with terminal-stage lumbar spondylolysis compared with the control. LEVEL OF EVIDENCE: IV.

DOI： 10.1016/j.pmrj.2017.06.018

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：PUBLIC LIBRARY SCIENCE  

Objective
Clinical evidence suggests that early mobilization of patients with acute stroke improves activity of daily living (ADL). The purpose of this study was to compare the utility of the physiatrist and registered therapist operating acute rehabilitation (PROr) applied early or late after acute stroke.
Subjects and methods
This study was prospective cohort study, assessment design. Patients with acute stroke (n = 227) admitted between June 2014 and April 2015 were divided into three groups based on the time of start of PROr: within 24 hours (VEM, n = 47), 24-48 hours (EM, n = 77), and more than 48 hours (OM, n = 103) from stroke onset. All groups were assessed for the number of deaths during hospitalization, and changes in the Glasgow Coma Scale (GCS), National Institute of Health Stroke Scale (NIHSS), and Functional Independence Measure (FIM) at hospital discharge.
Interventions
All patients were assessed by physiatrists, who evaluated the specific needs for rehabilitation, and then referred them to registered physical therapists and occupational therapists to provide early mobilization (longer than one hour per day per patient).
Results
The number of deaths encountered during the PROr period was 13 (out of 227, 5.7%), including 2 (4.3%) in the VEM group. GCS improved significantly during the hospital stay in all three groups, but the improvement on discharge was significantly better in the VEM group compared with the EM and OM groups. FIM improved significantly in the three groups, and the gains in total FIM and motor subscale were significantly greater in the VEM than the other groups.
Conclusions
PROr seems safe and beneficial rehabilitation to improve ADL in patients with acute stroke.

DOI： 10.1371/journal.pone.0187099

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記述言語：日本語   出版者・発行元：医歯薬出版(株)  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：PUBLIC LIBRARY SCIENCE  

Purpose
The purpose of this study was to determine the effect of aerobic training under noninvasive positive pressure ventilation (NPPV) on maximal oxygen uptake (VO2max).
Methods
Ten healthy young male volunteers participated in the study. Before the training, stroke volume (SV) and cardiac output (CO) were measured in all subjects under 0, 4, 8, and 12 cmH(2)O NPPV at rest. Then, the subjects exercised on a cycle ergometer at 60% of pretraining VO2max for 30 min daily for 5 consecutive days with/without NPPV. The 5-day exercise protocol was repeated after a three-week washout period without/with NPPV. The primary endpoint was changes in VO2max. The secondary endpoints were changes in SV, CO, maximum heart rate (HRmax), maximum respiratory rate (RRmax), maximum expiratory minute volume (VEmax) and the percent change in plasma volume (PV).
Results
NPPV at 12 cmH(2)O significantly reduced SV and CO at rest. VO2max significantly increased after 5 days training with and without NPPV, but the magnitude of increase in VO2max after training under 12 cmH(2)O NPPV was significantly higher than after training without NPPV. VEmax significantly increased after training under NPPV, but not after training without NPPV. HRmax and RRmax did not change during training irrespective of NPPV. The percent change in PV was similar between training with and without NPPV. The 5-day training program with NPPV resulted in greater improvement in VO2max than without NPPV.
Conclusions
Aerobic training under NPPV has add-on effects on VO2max and exercise-related health benefits in healthy young men.

DOI： 10.1371/journal.pone.0178003

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記述言語：日本語   出版者・発行元：金原出版(株)  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: We reported previously that exercise significantly increases plasma adrenaline and oxidized low-density lipoprotein (oxLDL) in healthy subjects but not in persons with spinal cord injury (SCI). Since oxLDL and adrenaline levels are associated with oxidant/antioxidant balance, and exercise training elicits production of reactive oxygen species, we elucidated the effects of exercise on adrenaline, oxidant/antioxidant balance and oxLDL in individuals with SCI. CASE PRESENTATION: Eight subjects with cervical spinal cord injury (CSCI) and nine subjects with lower lesion of SCI (lower SCI (LSCI)) participated in a wheelchair half marathon race, and blood samples were collected before (pre), immediately after (post) and 1 h after the race (post 1 h). The blood samples were used to determine adrenaline, derivatives of reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP), both as markers for oxidant/antioxidant balance. DISCUSSION: Pre-serum oxLDL levels were 147.2±8.1 and 97.0±10.4 U l-1 (mean±s.e.m.) in LCSI and CSCI subjects, respectively, and remained stable throughout the study. Adrenaline levels were higher in LSCI athletes than in CSCI athletes, especially post half marathon. Serum d-ROMs level did not change between pre and post in both groups. The mean BAP was significantly higher in LSCI than in CSCI subjects (2574±94.6 vs 2118±94.6 μmol l-1) at post, whereas the oxidative stress index (d-ROMs/BAP) was similar in the two groups throughout the study. In conclusion, exercise did not increase the d-ROMs or d-ROMs/BAP ratio in CSCI and LSCI subjects. The lack of increase in the plasma oxLDL level in SCI subjects was not due to the lack of response of adrenaline to exercise.

DOI： 10.1038/scsandc.2017.15

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：IOS PRESS  

BACKGROUND: The erector spinae is more resistant to fatigue in adult women than men. However, no study has reported the sex differences in back muscle fatigue in children.
OBJECTIVE: The aim of this study was to evaluate the fatigability of erector spinae in prepubertal children and adults, in both males and females.
METHODS: Fourteen prepubertal boys, 13 prepubertal girls, 14 adult men, and 13 adult women performed the Sorensen back isometric endurance test until exhaustion. The results of electromyographic (EMG) power spectral analysis of erector spinae were compared between both age groups and sexes.
RESULTS: The slopes of EMG power spectral median and mean power frequency were significantly higher in males than in females, in both age groups. Furthermore, the slopes were significantly lower in prepubertal children than in adults, in both males and females.
CONCLUSIONS: Our results showed major differences in the fatigue threshold of the erector spinae between boys and girls and children and adults. The muscle fatigued faster in prepubertal boys and adult men than in prepubertal girls and adult women. In both sexes, a lower slope of EMG power spectrum parameters of the erector spinae was noted during endurance test in prepubertal children compared to adults.

DOI： 10.3233/BMR-160705

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Background: Brain-derived neurotrophic factor (BDNF) has been implicated in enhancing neuronal health. Exercise and noninvasive positive-pressure ventilation (NPPV) are known to independently alter BDNF levels in patients with depression, dementia, type 2 diabetes, chronic obstructive pulmonary disease, and obstructive sleep apnea syndrome. However, the combined effects of exercise and NPPV on serum BDNF in normal subjects are unknown.
Objective: To determine the effects of the combination of acute aerobic exercise under NPPV on serum BDNF in normal adults.
Design: Cross-over design study.
Setting: Wakayama Medical University.
Participants: Ten healthy young men.
Intervention: The subjects exercised on a cycle ergometer at 60% of pretraining maximal oxygen uptake (VO2max) for 30 minutes daily for 5 consecutive days with or without NPPV (12 cmH(2)O). The 5-day exercise protocol was repeated after a 3-week washout period with or without NPPV.
Main Outcome Measurements: Serum BDNF, plasma cortisol, and platelet, lymphocyte, and monocyte counts were measured at 24 hours before the first day exercise with or without NPPV and 24 hour after last day exercise with or without NPPV at resting condition. Measurements were also made on the first day exercise; serum BDNF level was measured immediately before and immediately after exercise, as well as at 1, 2, and 3 hours after exercise with or without NPPV.
Results: The 5-day exercise protocol significantly (P &lt;.05) increased serum BDNF when combined with NPPV, but not without NPPV, and did not change plasma cortisol level, platelet, or lymphocyte counts, with or without NPPV. The 5-day exercise protocol also significantly (P &lt;.05) decreased monocyte count without NPPV, but not with NPPV, relative to baseline. Changes noticed immediately after the first day of exercise included significant (P &lt;.05) increase in serum BDNF compared with immediately before the exercise, with or without NPPV.
Conclusions: The results indicated that a 5-day exercise protocol combined with NPPV increased serum BDNF, suggesting that NPPV synergistically enhances the effect of aerobic exercise on serum BDNF level.

DOI： 10.1016/j.pmrj.2016.05.004

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

PurposeTo compare the activity and walking pattern of individuals with chronic obstructive pulmonary disease (COPD) and control subjects during a 24-hour period.
DesignCross-sectional study in home and community.
MethodsThe average walking velocity, time spent in sitting, standing, and lying, and numbers of steps per 24hours were measured in nine individuals with COPD and eight healthy control subjects.
FindingsThe average walking velocity in individuals with COPD was equivalent to that of the control subjects. Individuals with COPD walked significantly less than the control subjects. The total time spent sitting, standing, and walking was similar in the two groups.
ConclusionsThe results suggested that the walking velocity selected by individuals with COPD serves to minimize energy cost per distance.
Clinical RelevanceThe study findings emphasize the need to maintain walking velocity in any exercise prescription for individuals with COPD.

DOI： 10.1002/rnj.209

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JAPAN NEUROSURGICAL SOC  

Recent studies of spinal cord axon regeneration have reported good long-term results using various types of tissue scaffolds. Olfactory tissue allows autologous transplantation and can easily be obtained by a simple biopsy that is performed through the external nares. We performed a clinical pilot study of olfactory mucosa autograft (OMA) for chronic complete spinal cord injury in eight patients according to the procedure outlined by Lima et al. Our results showed no serious adverse events and improvement in both the American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade and ASIA motor score in five patients. The preoperative post-rehabilitation ASIA motor score improved from 50 in all cases to 52 in case 2, 60 in case 4, 52 in case 6, 55 in case 7, and 58 in case 8 at 96 weeks after OMA. The AIS improved from A to C in four cases and from B to C in one case. Motor evoked potentials (MEPs) were also seen in one patient, reflecting conductivity in the central nervous system, including the corticospinal tract. The MEPs induced with transcranial magnetic stimulation allow objective assessment of the integrity of the motor circuitry comprising both the corticospinal tract and the peripheral motor nerves.We show the feasibility of OMA for chronic complete spinal cord injury.

DOI： 10.2176/nmc.oa.2015-0320

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

PURPOSE: While non-noxious local cooling is widely used in physical medicine, its effect on muscle sympathetic nerve activity (MSNA) and cardiovascular regulation are not clear. The purpose of the present study was to assess the responses of MSNA, blood pressure (BP), heart rate (HR) and local blood flow during non-noxious local cooling. METHODS: The study included two protocols. Both protocols consisted of 10-min rest in supine position, followed by 15-min local cooling (15 °C) of the shin and anterior foot, and 20-min recovery. MSNA of the right common peroneal nerve, BP, HR, and shin skin temperature (TSK) were recorded in eight men in the first protocol, while leg blood flow (LBF) was measured in the same subjects by strain-gauge plethysmography in the second protocol. RESULTS: TSK gradually decreased from 31.5 ± 0.02 to 16.0 ± 1.01 °C (mean ± SEM) during local cooling, and gradually increased after the end of local cooling. No subject complained of pain, and BP and HR remained constant. The MSNA burst rate increased significantly (p < 0.05) to 141.1 ± 12.5 % during local cooling, but decreased significantly (p < 0.05) to 73.6 ± 5.9 % during the recovery period. Total MSNA also increased to 148.0 ± 14.2 % (p < 0.05) during local cooling, and decreased to 74.0 ± 13.9 % (p < 0.05) at recovery. LBF remained constant through the experiment. CONCLUSIONS: The results suggest that MSNA is activated by non-noxious local cooling, and attenuated after the end of local cooling without any changes in HR and BP.

DOI： 10.1007/s00421-016-3343-9

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Igaku-Shoin Ltd  

Charcot-Marie-Tooth disease (CMT) is one of the most commonly inherited neuromuscular diseases causing progressive muscle weakness
contracture
deformity in the feet, legs, and hands
and impairments of ambulation and handgrip. Reduced physical ability can be attributed not only to the disease but also to physical deconditioning. Previously, most physicians in the field of rehabilitation were anxious about the hypothesis of overwork weakness in CMT, and did not conduct intensive exercise programs for patients with CMT. However, recent studies have reported that progressive resistance strengthening programs for lower extremities are feasible, safe, beneficial, and improve exercise intolerance and undue fatigue in patients with CMT. Although the improvement in exercise tolerance may be partly due to the reversal of deconditioning effect of related sedentary lifestyle, progressive resistance training and physical fitness can improve walking function, activities of daily living, and subjective perception of pain and fatigue in patients with CMT. To increase the daily physical function, some studies described the potential benefits of ankle-foot orthoses (AFOs)
however, no control study supported it. So far, the training programs on CMT have been dependent on the exercise programs for able-bodied individuals. To increase the effects of rehabilitation, optimal programs that combine the training protocol and AFO strategies will have to be designed for patients with CMT.

DOI： 10.11477/mf.1416200347

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記述言語：日本語   出版者・発行元：(株)医学書院  

シャルコー・マリー・トゥース病患者における日常生活動作上の問題は歩行・手指機能障害である。特に,足・下腿筋群筋力低下による足・膝関節不安定性が問題である。そのリハビリテーションとして,下肢装具療法と下肢筋力強化のための抵抗運動訓練などの運動療法がある。1980年代,筋力強化訓練により過用性筋力低下が懸念されていたが,近年,漸増抵抗運動は筋力を低下させず,股関節周囲筋などを強化し,歩行能力を維持・改善させる報告が相次いでいる。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J04871&link_issn=&doc_id=20160127370010&doc_link_id=40020711471&url=http%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F40020711471&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

The efficacy of olfactory mucosal autografts (OMAs) for chronic spinal cord injury (SCI) has been reported, but there is no report documenting electrophysiological conductivity via the emergence of motor evoked potentials (MEPs). We report the case of a 39-year-old man with chronic, complete SCI at T8, who exhibited MEPs after OMA transplantation, and, with intensive rehabilitation, was ultimately able to ambulate with short leg braces and Lofstrand crutches. The initial injury occurred in a motor vehicle accident in November 1999 and resulted in a complete loss of sensorimotor function below T8. OMA transplantation to the injury site was performed in March 2010 in combination with intensive pre- and postoperative rehabilitation. The patient exhibited voluntary electromyograph (EMG) activity and MEPs at 96 and 144 weeks after transplantation and he was was ambulatory with short leg braces and Lofstrand crutches at 144 weeks after transplantation. We were able to elicit MEPs after OMA with intensive rehabilitation. To our knowledge, this is the first report of recovery of electrophysiological conductivity in the spinal cord after any type of treatment for chronic, complete SCI.

DOI： 10.1038/scsandc.2015.18

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記述言語：日本語   出版者・発行元：日本リハビリテーション医学会-近畿地方会  

46歳女。両膝関節の不安定性と膝関節痛を主訴とした。頸椎すべり症に対する頸椎前方後方除圧固定術後のリハビリテーション中であった。顔面、手背、肘部の皮膚に軽度過伸展を認めたが、皮膚の脆弱性は認めず、両側の肩関節、肘関節、手指関節、膝関節、足関節で関節可動域の亢進を認め、関節可動域亢進型Ehles-Danlos症候群の診断基準を満たしていた。膝関節痛と反張膝・膝関節の動揺性に対し、下肢筋力増強訓練と装具による歩行訓練を行った。装具は両側支柱付き長下肢装具へ変更してパッドを追加し、炭素繊維素材を用いて軽量化を図った。歩行時に足元を見る必要がなくなって、長時間の装具が可能となり歩容の改善も認めた。積極的なリハビリテーションにより、関節可動域および下肢筋力について大きな変化は認めなかったが、FIM総点は100点→112点へ改善を認め、術後2ヵ月で家庭復帰した。その後も復職に向けて通院リハビリ中である。

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Verlag  

Purpose: The dysfunctional sympathetic nervous system in individuals with cervical spinal cord injury (CSCI) impairs adrenergic responses and may, therefore, contribute to the blunted post-exercise cytokine response. The purpose of this study was to investigate an alternative way to exercise to induce an acute cytokine response by passive core temperature elevation in CSCI. Methods: Seven male participants with a motor complete CSCI and 8 male able-bodied controls were immersed for 60 min in water set at a temperature 2 °C above the individuals’ resting oesophageal temperature. Blood was collected pre, post, and every hour up to 4 h post-immersion. Results: Hot water immersion resulted in an IL-6 plasma concentration mean increase of 133 ± 144 % in both groups (P = 0.001). On a group level, IL-6 plasma concentrations were 68 ± 38 % higher in CSCI (P = 0.06). In both groups, IL-8 increased by 14 ± 11 % (P = 0.02) and IL-1ra by 18 ± 17 % (P = 0.05). Catecholamine plasma concentrations were significantly reduced in CSCI (P &lt
 0.05) and did not increase following immersion. Conclusions: Passive elevation of core temperature acutely elevates IL-6, IL-8 and IL-1ra in CSCI despite a blunted adrenergic response, which is in contrast to earlier exercise interventions in CSCI. The present study lays the foundation for future studies to explore water immersion as an alternative to exercise to induce an acute cytokine response in CSCI.

DOI： 10.1007/s00421-015-3206-9

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER PHYSIOLOGICAL SOC  

The mechanism(s) for the changes in cardiac function during heat stress remain unknown. This study tested two unique hypotheses. First, sympathetic innervation to the heart is required for increases in cardiac systolic function during heat stress. This was accomplished by comparing responses during heat stress between paraplegics versus tetraplegics, with tetraplegics having reduced/absent cardiac sympathetic innervation. Second, stimulation of skin thermoreceptors contributes to cardiovascular adjustments that occur during heat stress in humans. This was accomplished by comparing responses during leg only heating between paraplegic versus able-bodied individuals. Nine healthy able-bodied, nine paraplegics, and eight tetraplegics participated in this study. Lower body (i.e., nonsensed area for para/tetraplegics) was heated until esophageal temperature had increased by ~1.0°C. Echocardiographic indexes of diastolic and systolic function were performed before and at the end of heat stress. The heat stress increased cardiac output in all groups, but the magnitude of this increase was attenuated in the tetraplegics relative to the able-bodied (1.3 ± 0.4 vs. 2.3 ± 1.0 l/min; P < 0.05). Diastolic function was maintained in all groups. Indexes of left atrial and ventricular systolic function were enhanced in the able-bodied, but did not change in tetraplegics, while these changes in paraplegics were attenuated relative to the able-bodied. These data suggest that the cardiac sympathetic innervation is required to achieve normal increases in cardiac systolic function during heat stress but not required to maintain diastolic function during this exposure. Second, elevated systolic function during heat stress primarily occurs as a result of increases in internal temperature, although stimulation of skin thermoreceptors may contribute.

DOI： 10.1152/ajpheart.00911.2014

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

STUDY DESIGN: Nonrandomized study. OBJECTIVES: The purpose of this study was to determine the effects of long and intensive exercise on interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in athletes with cervical spinal cord injuries (CSCI). SETTING: The 30th Oita International Wheelchair Marathon Race. METHODS: Blood samples from six athletes with CSCI and eight athletes with thoracic and lumber spinal cord injuries (SCI) participating in wheelchair half marathon race were collected before the race, immediately after the race and 2 h after the race. IL-6, TNF-α, adrenaline and blood cell counts were measured. RESULTS: Monocyte count remained stable throughout the study in the CSCI group but was significantly high at 2 h after the race in the SCI group. Plasma IL-6 concentrations were significantly elevated immediately after the race in both groups, although the levels in CSCI were significantly lower than in the SCI group. Plasma adrenaline was significantly elevated immediately after the race in the SCI group but recovered at 2 h after the race. In contrast, plasma adrenaline did not change in the CSCI group throughout the study and was significantly lower than in the SCI group. Plasma TNF-α did not change throughout the study in the SCI group compared with a significant decrease at 2 h after the race in the CSCI group. CONCLUSION: Long and intensive exercise increased IL-6 in the CSCI group despite the small muscle mass and lack of sympathetic nervous system. The post-race fall in plasma TNF-α in the CSCI group could be related to the inhibitory effect of rising IL-6 in the presence of normal monocyte count and stable adrenaline level.

DOI： 10.1038/sc.2014.88

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

OBJECTIVE: To investigate interleukin (IL)-6 and other inflammation markers in athletes with spinal cord injury (SCI) during a wheelchair marathon race. DESIGN: Nonrandomized study in an actual race. SETTING: The 28th Oita International Wheelchair Marathon Race, Japan. PARTICIPANTS: Twenty-eight men with SCI between T7 and L2 (16 full-marathon racers, full-group; and 12 half-marathon racers, half-group). MAIN OUTCOME MEASURES: Plasma IL-6, tumor necrosis factor (TNF)-α, and high-sensitivity C-reactive protein (hsCRP) were measured the day before, immediately after the race, and 2 hours after the race. RESULTS: Plasma IL-6 concentrations increased by 18.4-fold and by 9.4-fold (P < 0.05) in the full- and half-groups immediately after the race (P < 0.05), respectively, but returned to baseline at 2 hours of recovery. In contrast, plasma TNF-α and hsCRP did not change throughout the race in both groups. The fold change in plasma IL-6 immediately after the race relative to the prerace was significantly higher in the full-group than the half-group (P < 0.05). In both groups, plasma IL-6 immediately after the race did not correlate with the average wheelchair speed. Interestingly, plasma IL-6 and hsCRP before the race in the full-group, but not in half-group, correlated negatively with the average wheelchair speed (P < 0.05). CONCLUSIONS: The study demonstrated that half- and full-marathon wheelchair races increased plasma IL-6, but not TNF-α and hsCRP. Furthermore, the top athletes of the full-group had low plasma IL-6 and hsCRP at baseline. Wheelchair marathon competition, especially full-marathon, and daily training seem to have beneficial effects on SCI through the plasma IL-6 response.

DOI： 10.1097/JSM.0000000000000015

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記述言語：日本語   出版者・発行元：(株)診断と治療社  

＜Headline＞1.急性期のリハビリテーション(リハ)はあらゆる疾患・障害に対して行うべきである。また、急性期リハの目的は不必要な安静臥床、廃用症候群や合併症を予防し、機能改善を図ることである。2.脳卒中の発症後できるだけ早期に立位・歩行訓練を開始することが予後を改善することが報告されており、頭部外傷でも受傷後早期リハ、多くの訓練量が求められている。3.集中治療室(ICU)では治療のための鎮静および臥床は必要ではあるが、近年、ICUであっても早期離床を行うことは可能であり、安全かつ有効であることが報告されている。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J00697&link_issn=&doc_id=20140312190002&doc_link_id=%2Fae4digta%2F2014%2F010203%2F003%2F0323-0327%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fae4digta%2F2014%2F010203%2F003%2F0323-0327%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

掲載種別：研究論文（学術雑誌）   出版者・発行元：The Japanese Society of Physical Fitness and Sports Medicine  

DOI： 10.7600/jpfsm.3.335

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER INTERNATIONAL PUBLISHING AG  

The purpose of this study was to define common carotid blood flow (CBF), cardiovascular and endocrine responses during head-up tilt (HUT) in patients with acute cerebrovascular diseases (CVD). In 31 male patients with acute CVD (damage of the supratentorial area) and 21 age-matched control male subjects, we measured CBF, mean blood pressure (MBP), heart rate, stroke volume and cardiac output responses before (baseline), during and after HUT. We also measured plasma levels of antidiuretic hormone, adrenaline, noradrenaline, aldosterone and plasma renin activity. After obtaining baseline measurements during 3-minutes horizontal position, HUT was performed for 5 minutes, followed by continuation of recording for 3 more minutes in the horizontal position. During HUT, CBF decreased significantly and equally in both groups. MBP did not change during HUT in both groups. The endocrine responses were also not different between the two groups. The results suggest that damage to the supratentorial area in patients with acute CVD do not alter the CBF, cardiovascular and endocrine responses. In other words, HUT does not predispose patients with acute CVD to serious falls in MBP and CBF at upright posture.

DOI： 10.1186/2193-1801-3-191

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：KARGER  

BACKGROUND: Spasticity is a major disabling symptom in stroke patients. Clinically, one of the goals of management of stroke patients should be to reduce spasticity. Recent evidence suggests that motor recovery after stroke comprises a hierarchical, dynamic framework of interacting mechanisms in brain cortex. We hypothesized that unaffected arm exercise can stimulate the ipsilateral motor cortex and change the affected upper limb function and spasticity in stroke patients. To test the hypothesis, we evaluated the effects of unaffected arm exercise on spasticity of the affected upper limb and motor function in stroke patients. METHODS: The study was performed in 41 chronic stroke patients with upper limb hemiparesis. Affected upper limb spasticity and function were assessed at baseline and after each intervention by the modified Ashworth Scale and Fugl-Meyer Assessment, respectively. Patients were also evaluated clinically by the modified Rankin Scale, Functional Independence Measurement and National Institutes of Health Stroke Scale. Subjects stood for 10 min during the control period, and then cycled an arm crank ergometer at 50% of maximum work load for 10 min by the unaffected arm in standing position. RESULTS: The mean age at study entry was 64.6 ± 1.7 years. The latency between onset of stroke and the study was 109.0 ± 17.0 months (range, 6-495). The cause of hemiparesis was cerebral infarction (n = 21), intracerebral hemorrhage (n = 17) or subarachnoid hemorrhage (n = 3). Exercise significantly improved the modified Ashworth Scale compared with baseline (p < 0.0001). No such change was noted after the control intervention. The Fugl-Meyer Assessment score did not change after exercise compared with baseline (p = 0.95). CONCLUSIONS: We conclude that 10 min of unaffected arm exercise improves the affected upper limb spasticity in stroke patients. Further studies are needed to determine the exact mechanism of such improvement and the long-term effects of unaffected arm exercise on motor performance.

DOI： 10.1159/000357421

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記述言語：日本語   出版者・発行元：日本生体電気・物理刺激研究会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND CONTEXT: Previous studies reported that the erector spinae muscle is more resistant to fatigue in healthy adult women than in men. However, no study has reported changes in back muscle fatigue with aging in healthy men and women. PURPOSE: The aim of this study was to evaluate age-related changes in muscle fatigue of erector spinae muscle in men and women. STUDY DESIGN/SETTING: This cross-sectional study was conducted in a laboratory. PATIENT SAMPLE: Fifty-three healthy subjects (11 elderly men, 11 elderly women, 17 young men, and 14 young women) without low back pain history. OUTCOME MEASURES: The median frequency (MF) and mean power frequency (MPF) during trunk holding test were derived from the raw electromyographic (EMG) signal using Fast Fourier Transform spectrum analysis program. The rates of changes in MF and MPF were calculated. METHODS: Subjects performed the unsupported trunk holding test until exhaustion. The results of power spectral analysis of the EMG activity of the left erector spinae muscle were compared in both age groups and sexes. RESULTS: The endurance time in young men was significantly shorter than in young women. The slopes of MF and MPF in young men were significantly higher than in young women. There were no significant differences in MF and MPF slopes of elderly men and elderly women. Furthermore, the MF and MPF slopes were significantly lower in elderly men than young men but similar in the two women groups. CONCLUSIONS: Age-related changes in the slopes of MF and MPF of erector spinae muscle occur in healthy men but not in healthy women.

DOI： 10.1016/j.spinee.2013.06.060

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Study design:Case series.Objectives:To investigate the effects of wheelchair basketball game on plasma interleukin-6 (IL-6), tumor necrosis factor-(TNF), C-reactive protein (CRP) and blood cell counts in persons with spinal cord injury (SCI).Setting:The 2009 Mei-shin League of Wheelchair Basketball Games held at Wakayama, Japan.Participants:Five wheelchair basketball players with SCI voluntarily participated in this study.Interventions:Blood samples were taken approximately 1 h before the player warm-up for the game and immediately after the game.Main outcome measures:IL-6, TNF CRP and blood cell count were measured.Results:Plasma IL-6 level and number of monocytes were significantly increased after the game, compared with pre-game measurements (P&lt
0.05). No changes were observed in other measurements. There was a significant relationship between increased IL-6 levels and accumulated play duration.Conclusion:The lack of change in TNF and CRP levels suggested that the exercise-induced rise in IL-6 was not related to exercise-induced inflammatory response. Furthermore, the associated increase in the number of monocytes did not correlate with exercise-induced IL-6 changes, negating monocytes as the source of IL-6. © 2013 International Spinal Cord Society All rights reserved.

DOI： 10.1038/sc.2013.4

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記述言語：日本語   出版者・発行元：一般社団法人 日本繊維製品消費科学会  

<p><tt>平成</tt>23<tt>年</tt>9<tt>月</tt>3<tt>日，和歌山県那智勝浦町は台風</tt>12<tt>号により甚大な被害を受けた．台風災害直後より，町立病院と町保健師が協力し被災地支援活動を行った．病院スタッフと町保健師により，被災地に開設した救護所と避難所において医療支援活動を行った．この活動を通して，避難所における環境不備による健康問題が明らかになった．また，衣料支援における問題点も明らかとなり，下着，靴下，男性用のズボンの供給不足などが問題となった．</tt></p>

DOI： 10.11419/senshoshi.54.3_243

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: To assess the separate effects of thumb and finger extension/flexion on median nerve position and cross-sectional area. METHODS: Ultrasonography was used to assess median nerve transverse position and cross-sectional area within the carpal tunnel at rest and its movement during volitional flexion of the individual digits of the hand. Both wrists of 165 normal subjects (11 men, 4 women, mean age, 28.6, range, 22 to 38) were studied. RESULTS: Thumb flexion resulted in transverse movement of the median nerve in radial direction (1.2 ± 0.6 mm), whereas flexion of the fingers produced transverse movement in ulnar direction, which was most pronounced during flexion of the index and middle fingers (3.2 ± 0.9 and 3.1 ± 1.0 mm, respectively). Lesser but still statistically significant movements were noted with flexion of the ring finger (2.0 ± 0.8 mm) and little finger (1.2 ± 0.5 mm). Flexion of the thumb or individual fingers did not change median nerve cross-sectional area (8.5 ± 1.1 mm(2)). CONCLUSIONS: Volitional flexion of the thumb and individual fingers, particularly the index and middle fingers, produced significant transverse movement of the median nerve within the carpal tunnel but did not alter the cross-sectional area of the nerve. The importance of these findings on the understanding of the pathogenesis of the carpal tunnel syndrome and its treatment remains to be investigated.

DOI： 10.1371/journal.pone.0083565

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掲載種別：研究論文（学術雑誌）  

Study design:Non-randomized study.Objective:We reported that individuals with cervical spinal cord injury (CSCI) showed no increase in natural killer cell activity (NKCA) in response to 20-min arm exercise. It could be argued that this lack of response was owing to the short duration and intensity of the exercise.Setting:The 29th Oita International wheelchair marathon race.Methods:The present study compared the effects of wheelchair half-marathon race on natural killer (NK) cell count, NKCA and other hematological and hormonal parameters in six subjects with CSCI and seven control subjects with spinal cord injury between T4 and L1 (SCI), before, immediately after and 2 h after recovery.Results:NK cell counts increased at both time points after the race in SCI, but not in CSCI, compared with before the race. NKCA increased immediately in both groups of subjects after the race, and then returned to the pre-race level at 2 h after the race. Plasma cortisol did not change in both groups throughout the study. Plasma adrenaline increased sharply in SCI after the race, then returned to the pre-race level at 2 h after the race, whereas no change was observed in CSCI throughout the study.Conclusion:The present study demonstrated that wheelchair half-marathon race increases NKCA despite the lack of increase in plasma adrenaline in CSCI, suggesting the activation of NKCA by mechanisms other than circulating adrenaline level. © 2012 International Spinal Cord Society.

DOI： 10.1038/sc.2011.188

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記述言語：日本語   出版者・発行元：(公社)日本リハビリテーション医学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J04897&link_issn=&doc_id=20120725110012&doc_link_id=%2Fch7remed%2F2012%2F004907%2F012%2F0404-0407%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fch7remed%2F2012%2F004907%2F012%2F0404-0407%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: To compare plasma concentrations of oxidized low-density lipoprotein (oxLDL) and adrenaline during exercise between persons with spinal cord injury (SCI) and able-bodied (AB) individuals. DESIGN: Randomized controlled study. SETTING: Human laboratory at a medical university. PARTICIPANTS: Persons with SCI (n=7) and AB individuals (n=9). INTERVENTION: Two-hour arm crank ergometer exercise at 60% maximum oxygen consumption. MAIN OUTCOME MEASURES: Plasma oxLDL and adrenaline levels. RESULTS: Exercise significantly increased plasma adrenaline levels in AB persons (mean ± SD: rest, 45.4±32.2 pg/mL; exercise, 200.9±113.7 pg/mL; P<.05) and persons with SCI; however; the magnitude of the increase in those with SCI was attenuated (mean ± SD: rest, 45.4±14.0 pg/mL; exercise, 83.0±55.8 pg/mL; P<.05). Exercise also significantly increased plasma oxLDL levels in AB persons (mean ± SD: rest, 102.2±30.2 U/L; exercise, 179.7±60.0 U/L; P<.05), but not in persons with SCI (mean ± SD: rest, 124.3±66.0 U/L; exercise, 138.9±59.5 U/L). CONCLUSIONS: The results suggest that increases in plasma adrenaline levels during exercise contribute to the increase in plasma oxLDL levels.

DOI： 10.1016/j.apmr.2011.08.046

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Isometric muscle contraction (static exercise) induces circulatory response. Static exercise in individuals with thoracic spinal cord injury (TSCI) induces cardiovascular response and blood redistribution to the non-exercising muscles. The aim of our study was to determine the circulatory response during arm static exercise in individuals with TSCI and able-bodied (AB) controls. Mean blood pressure (MBP), heart rate (HR), cardiac output (CO), leg skin blood flow (SBF), and leg muscle blood flow (MBF) were recorded noninvasively, total peripheral resistance (TPR) was estimated by dividing MBP by CO, and hormonal changes were measured before, during and after static 35% maximal voluntary contraction (MVC) of the arm flexor muscles in seven male individuals with TSCI (T7-T11) and seven age-comparable AB control (32.2 ± 7.6 and 31.0 ± 4.7 years, respectively). The 35% MVC was similar in TSCI and AB individuals (107.3 ± 28.2 and 101.0 ± 22.5 N, respectively). HR, CO, MBP, TPR, SBF and MBF increased in both groups during arm static exercise. Plasma epinephrine concentration increased during arm static exercise in AB controls only (P < 0.05). Circulation to leg muscles was similar in TSCI and AB individuals and the lack of sympathetic vasoconstriction in the paralyzed leg area did not alter the cardiovascular responses during 35% MVC of arm static exercise. We conclude that sympathetic vasoconstriction in the resting leg area did not contribute to the pressor reflex during 35% MVC of arm static exercise.

DOI： 10.1007/s00421-011-2017-x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

The study was designed to assess the effects of local heat (LH) application on postganglionic muscle sympathetic nerve activity (MSNA) measured by microneurography in healthy men. In the first protocol, MSNA of the left peroneal nerve, blood pressure (BP), heart rate (HR), and skin temperature of the shin (TSK) were recorded in nine men. In the second protocol, leg blood flow (LBF) was measured in the same subjects by strain-gauge plethysmography. In both protocols, after 10 min of rest in the supine position, a heated hydrocollator pack was applied to the shin and anterior foot for 15 min and recovery was monitored over a period of 20 min. TSK gradually increased from 31.7 ± 0.1 to 41.9 ± 0.5°C (mean ± SEM) during LH. No subject complained of pain, and BP and HR remained constant. The MSNA burst rate (16.1 ± 2.1 beats/min) during the control period decreased significantly (P < 0.05) to 72.0 ± 2.3% during LH. Total MSNA also decreased to 59.2 ± 2.6% (P < 0.05) during LH, but both immediately returned to baseline at recovery. In contrast, LBF in the left leg significantly and immediately increased (P < 0.05) after LH application and remained significantly elevated until the end of the recovery period. These results suggest that: (1) LH application significantly attenuates MSNA without any changes in HR and BP. (2) Other factors in addition to MSNA seem to control regional blood flow in the lower extremity during LH.

DOI： 10.1007/s00421-011-1852-0

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記述言語：日本語   出版者・発行元：(株)医学書院  

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2011&ichushi_jid=J00780&link_issn=&doc_id=20110714130010&doc_link_id=10.11477%2Fmf.1552102130&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1552102130&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：日本語   出版者・発行元：公益社団法人 日本リハビリテーション医学会  

DOI： 10.2490/jjrmc.47.304

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その他リンク： https://jlc.jst.go.jp/DN/JALC/00352098304?from=CiNii

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND AND PURPOSE: The main objective of this study was to compare the hand and finger performance of stroke patients in standing and sitting positions. METHODS: The study subjects were 11 males and 3 females with history of stroke (age, 68.6 ± 6.3 years, mean ± SD). Inclusion criteria were right-handedness before stroke, right hemiparesis due to left hemisphere lesion induced by stroke, at least 4 months between stroke and study enrollment, and ability to stand for more than 10 minutes. Tests of dexterity (peg board test), attention, unilateral spatial neglect, and cognition were conducted in comfortable sitting and standing positions. Seven subjects started in standing position, and the other seven subjects were tested first in sitting position. Tests in the first position were performed on one day, and repeated one week later but performed in a different position. RESULTS: The mean performance time on the peg board test in standing position was significantly faster than in sitting position (p=0.022). However, the results of the Trail making test-part A, line cancellation test, line bisection and Mini Mental State conducted in standing position were similar to those of sitting position. There were no differences between the first and second trial tests. CONCLUSIONS: Our results showed that standing position improved the functional performance of hand and arm on the un-affected side in stroke patients, but had no effects on consistent attention, unilateral spatial neglect, or cognition.

DOI： 10.3233/NRE-2010-0620

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Experiments were carried out in urethane-anesthetized, artificially ventilated, adult male Wistar rats. Microinjections (50 nL) of N-methyl-d-aspartic acid (1, 5, and 10 mmol/L), but not artificial cerebrospinal fluid, into the hypothalamic arcuate nucleus (ARCN) elicited increases in mean arterial pressure (5.7+/-0.5, 13.2+/-1.4, and 17.3+/-1.1 mm Hg, respectively) and heart rate (24.3+/-4.3, 49.3+/-5.2, and 75.2+/-8.0 bpm, respectively). ARCN stimulation was accomplished by microinjections of a maximally effective concentration of N-methyl-d-aspartic acid (10 mmol/L). The tachycardic responses to the ARCN stimulation were significantly attenuated after bilateral vagotomy. Intrathecal injections of ionotropic glutamate receptor (iGLUR) antagonists completely blocked pressor responses to the ARCN stimulation, whereas the tachycardic responses were significantly attenuated but not abolished. Intrathecal injections of iGLUR antagonists at T9 to T10, combined with bilateral vagotomy, completely blocked the tachycardic responses to ARCN stimulation. ARCN stimulation with N-methyl-d-aspartic acid elicited increased activities of the greater splanchnic nerve (91.7+/-14.8%) and the renal nerve (109.3+/-13%). Intrathecal injections of iGLURs at T9 to T10 blocked the increase in the greater splanchnic nerve activity in response to ARCN stimulation. These results indicate the following: (1) the chemical stimulation of the ARCN elicits increases in mean arterial pressure, greater splanchnic nerve and renal nerve activity, and heart rate; (2) the increases in mean arterial pressure and sympathetic nerve activity are mediated via the activation of spinal cord iGLURs; and (3) the increases in heart rate are mediated via the activation of spinal cord iGLURs and decreases in vagal input to the heart.

DOI： 10.1161/HYPERTENSIONAHA.109.140715

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Urocortin 1 (Ucn1) and urocortin 3 (Ucn3) are new members of the corticotrophin-releasing factor (CRF) peptide family. Ucn1 is a ligand for both the CRF type 1 receptors (CRF(1)Rs) and the CRF type 2 receptors (CRF(2)Rs), whereas Ucn3 is a high-affinity ligand for the CRF(2)Rs. Recently, we reported that Ucn3 microinjections into the medial nucleus tractus solitarius (mNTS) elicit decreases in mean arterial pressure (MAP) and heart rate (HR) (Nakamura T, Kawabe K, Sapru HN. Am J Physiol Heart Circ Physiol 296: H325-H332, 2009). The presence of CRF(2)Rs on afferent terminals has been reported in the mNTS of the rat. It was hypothesized that activation of CRF(2)Rs on afferent terminals in the mNTS may release glutamate, which, in turn, may elicit decreases in MAP and HR via activation of ionotropic glutamate receptors (iGLURs). This hypothesis was tested in urethane-anesthetized, artificially ventilated, adult male Wistar rats. Microinjections (100 nl) of Ucn1 (0.12 mM) into the mNTS elicited decreases in MAP and HR. The responses were partially blocked by microinjections of iGLUR antagonists into the mNTS. On the other hand, the decreases in MAP and HR elicited by microinjections of Ucn3 (0.06 mM) into the mNTS were completely blocked by microinjections of iGLUR antagonists into the mNTS. These results indicate that activation of CRF(2)Rs in the mNTS, by Ucn1 and Ucn3, releases glutamate, which, in turn, elicits decreases in MAP and HR via activation of iGLURs.

DOI： 10.1152/ajpheart.00191.2009

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Study design: Criterion standard and survey cases. Objectives: To assess the utility of ultrasonography for detecting deep tissue injury or incipient pressure ulcers and to determine the patterns of development of pressure ulcers in subjects with chronic spinal-cord injury (SCI). Setting: Ambulatory setting at public hospital. Methods: The subjects were 43 men with SCI between C5 and L1 (age: 42.6±11.6 years, mean±s.d.). A total of 129 areas (sacral region and bilateral ischial regions in each subject) were examined by inspection, palpation and ultrasonography. Results: Of the 129 areas, 112 were normal by inspection, palpation and ultrasound imaging. Nine areas were abnormal on ultrasonography alone and six were lesion positive by palpation and ultrasonography. Only two areas were abnormal by all three methods. Ultrasonography always detected a heterogeneous pattern and low-echoic areas directly adjacent to the bone. Conclusions: Our results indicated that low-echoic lesions, signaling deep tissue injuries or early pressure ulcers, originated in areas near the bone and extended toward the epidermis. The results suggest that ultrasonography is a useful tool for the early detection of deep tissue injuries or pressure ulcers. © 2009 International Spinal Cord Society All rights reserved.

DOI： 10.1038/sc.2008.101

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Design: Prospective double-blind study. Objective: Manual emptying of rectal contents is necessary for patients with spinal cord injury to prevent bowel obstruction
however, this maneuver induces a rise in blood pressure (BP) and autonomic dysreflexia (AD). The purpose of this prospective double-blind study was to investigate whether topical anorectal anesthesia attenuates the BP rise and AD during bowel manipulation in patients with cervical spinal cord injury (CSCI). Setting: Kibikogen Rehabilitation Center for Employment Injuries. Methods: The study subjects were 25 consecutive clinically stable patients with CSCI. Each subject received a complete bowel program involving manual removal of stool in lateral recumbency, after topical application of lidocaine or placebo jelly to the anorectal area. Systolic and diastolic BP, heart rate and symptoms of AD were recorded before, during and after bowel manipulation. Results: Systolic BP was significantly lower during the lidocaine arm of the study compared with placebo at insertion of rectal medication, digital stimulation, beginning of stool flow, manual removal of stool, end of stool flow and at 5-min after emptying. The mean maximal increase in systolic BP during lidocaine treatment (33.2±14.6 mm Hg) was less than during placebo (50.2±19.5 mm Hg, P&lt
0.001). Conclusion: On the basis of our findings, we recommend induction of lidocaine jelly immediately before rectal manipulation in patients with CSCI to minimize the incidence and severity of AD. © 2009 International Spinal Cord Society All rights reserved.

DOI： 10.1038/sc.2008.86

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Urocortin 3 (Ucn3) is a new member of the corticotropin-releasing factor (CRF) peptide family and is considered to be a specific and endogenous ligand for CRF type 2 receptors (CRF2Rs). The presence of CRF(2)Rs has been reported in the nucleus tractus solitarius (NTS) of the rat. It was hypothesized that the activation of CRF2Rs in the medial NTS (mNTS) may play a role in cardiovascular regulation. This hypothesis was tested in urethane-anesthetized, artificially ventilated, adult male Wistar rats. Microinjections (100 nl) of Ucn3 (0.03, 0.06, 0.12, and 0.25 mM) into the mNTS of anesthetized rats elicited decreases in mean arterial pressure (MAP: 5.0 +/- 1.0, 21.6 +/- 2.6, 20.0 +/- 2.8, and 12.7 +/- 3.4 mmHg, respectively) and heart rate (HR: 7.8 +/- 2.6, 46.2 +/- 9.3, 34.5 +/- 8.4, and 16.6 +/- 4.9 beats/min, respectively). Microinjections of artificial cerebrospinal fluid (100 nl) into the mNTS did not elicit cardiovascular responses. Maximum decreases in MAP and HR were elicited by 0.06 mM concentration of Ucn3. Cardiovascular responses to Ucn3 were similar in unanesthetized midcollicular decerebrate rats. A bilateral vagotomy completely abolished Ucn3-induced bradycardia. The decreases in MAP and HR elicited by Ucn3 (0.06 mM) were completely blocked by astressin (1 mM; nonselective CRFR antagonist) and K41498 (5 mM; selective CRF2R antagonist). Microinjections of Ucn3 (0.06 mM) into the mNTS decreased the efferent greater splanchnic nerve activity. After the blockade of CRF2Rs in the mNTS, a Ucn3-induced decrease in the efferent sympathetic nerve discharge was abolished. These results indicate that Ucn3 microinjections into the mNTS exerted excitatory effects on the mNTS neurons via CRF2Rs, leading to depressor and bradycardic responses.

DOI： 10.1152/ajpheart.01044.2008

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

This study was designed to examine the mechanism of heart rate (HR) responses elicited by the stimulation of hypothalamic paraventricular nucleus (PVN). Experiments were done in urethane-anesthetized, barodenervated, adult, male Wistar rats. Chemical stimulation of the PVN by unilateral microinjections of N-methyl-d-aspartic acid (NMDA) elicited increases in HR which were attenuated by bilateral vagotomy. PVN-induced tachycardia was also attenuated by the blockade of the spinal ionotropic glutamate receptors (iGLURs) which was accomplished by intrathecal injections at T9-T10 or direct application at T1-T4 of iGLUR antagonists. The blockade of spinal iGLURs combined with bilateral vagotomy completely blocked PVN-induced tachycardia. Blockade of GABA receptors in the medial nucleus tractus solitarius (mNTS) also attenuated the PVN-induced tachycardia. Complete blockade of PVN-induced tachycardia was also observed after the blockade of iGLURs in both the spinal cord and mNTS. Combination of the blockade of mNTS GABA receptors and spinal iGLURs also abolished PVN-induced tachycardia. PVN-induced tachycardia was not altered by the blockade of spinal vasopressin or oxytocin receptors at T1-T4. These results suggested that in barodenervated rats: 1) tachycardia elicited by the chemical stimulation of the PVN was mediated via both inhibition of vagal and activation of sympathetic outflows to the heart, 2) the vagal inhibition contributing to the PVN-induced tachycardia was mediated by the iGLURs and GABARs in the mNTS, 3) sympathetic activation contributing to the PVN-induced tachycardia was mediated via spinal iGLURs, and 4) spinal vasopressin and oxytocin receptors were not involved in the mediation of PVN-induced tachycardia.

DOI： 10.1016/j.brainres.2008.10.059

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

This study was designed to delineate the medullary and spinal pathways mediating the cardiovascular responses to cold pressor test (CPT) and to identify neurotransmitters in these pathways. Experiments were done in barodenervated, urethane-anesthetized, male Wistar rats. The CPT was performed by immersing the limbs and ventral half of the body of the rat in ice-cold water (0.5 degrees C) for 2 min. CPT elicited an immediate increase in mean arterial pressure (MAP), heart rate (HR), and greater splanchnic nerve activity (GSNA). Bilateral blockade of ionotropic glutamate receptors (iGLURs) in the rostral ventrolateral medullary pressor area (RVLM) significantly attenuated the CPT-induced responses. Bilateral blockade of gamma-aminobutyric acid (GABA) receptors, but not iGLURs, in the nucleus ambiguus (nAmb) significantly reduced the CPT-induced increases in HR, but not MAP. Blockade of spinal iGLURs caused a significant reduction in CPT-induced increases in MAP and GSNA, whereas the increases in HR were reduced to a lesser extent. Combination of the blockade of spinal iGLURs and bilateral vagotomy or intravenous atropine almost completely blocked CPT-induced tachycardia. Midcollicular decerebration significantly reduced CPT-induced increases in MAP and HR. These results indicated that: 1) CPT-induced increases in MAP, HR, and GSNA were mediated by activation of iGLURs in the RVLM and spinal cord, 2) activation of GABA receptors in the nAmb also contributed to the CPT-induced tachycardic responses, and 3) brain areas rostral to the brain stem also participated in the CPT-induced pressor and tachycardic responses.

DOI： 10.1152/ajpheart.646.2008

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Design: Non-randomized study. Objective: To determine natural killer cell cytotoxic activity (NKCA) to 2-h arm ergometer exercise in persons with spinal cord injuries (SCI) and the underlying mechanism of such response. Setting: University of Occupational and Environmental Health, Japan. Methods: We examined NKCA response to 2-h arm crank ergometer exercise at 60% of maximum oxygen consumption (VO 2max) in SCI and able-bodied persons. NKCA and plasma concentrations of prostaglandin E2 (PGE2), adrenaline and cortisol were measured before, during and immediately after the exercise. The study included seven subjects with SCI between Th11 and L4 and six able-bodied persons. Results: NKCA in able-bodied subjects increased (P&lt
0.05) at 60 min of exercise and immediately after the exercise, and remained elevated up to 2 h after exercise. However, NKCA in SCI decreased (P&lt
0.05) immediately after exercise but recovered at 2 h after exercise. Plasma adrenaline in both groups increased significantly (P&lt
0.05) immediately after exercise and returned to baseline level 2 h after the exercise. Plasma cortisol in both groups remained constant throughout the study. In SCI, PGE2 significantly increased immediately after 2 h exercise and returned to the baseline level 2 h after exercise
however, it remained unchanged during the test in able-bodied subjects. Conclusion: Our results suggested that increase of PGE2 in SCI partially contributes to NKCA. © 2008 International Spinal Cord Society All rights reserved.

DOI： 10.1038/sj.sc.3102054

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：W.B. Saunders  

Objectives: To define isometric exercise-induced pressor responses in patients with cerebrovascular accidents (CVAs) and to assess potential cardiovascular and sympathetic nervous system abnormalities during isometric exercise in CVA. Design: Nonrandomized study. Setting: University laboratory setting. Participants: Eight men with CVA who had documented damage of subcortical structures and 8 sex-matched controls. Interventions: A 2-minute sustained contraction of elbow flexor muscles in the unaffected side at 35% of maximal voluntary contraction (MVC
isometric exercise). Main Outcome Measures: Heart rate, arterial blood pressure, and muscle sympathetic nerve activity (MSNA), recorded from the peroneal nerve on the affected side. Results: The percent changes in total MSNA, heart rate, and mean blood pressure in patients with CVA increased during isometric exercise but were attenuated compared with the controls. Total MSNA (mean burst amplitude per minute times burst rate) increased significantly in CVA and control subjects during isometric exercise by 18.7%±6.3% and 95.8%±25.2%, respectively. Conclusions: The attenuated pressor responses during isometric exercise in subjects with CVA relative to the controls indicated damage to subcortical structures
such damage lowered sympathetic nervous response to isometric exercise. Our findings suggest that isometric exercise at 35% of MVC does not put patients with CVA at risk for serious tachycardia or hypertension. © 2005 by American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.

DOI： 10.1016/j.apmr.2004.06.071

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Lippincott Williams and Wilkins  

Background and Purpose - Autonomic dysfunction is frequently present in patients with cerebrovascular accidents (CVA). However, the pathophysiological mechanisms of these disorders are not clear. The purpose of the study was to assess the effects of CVA on the autonomic nervous system. Methods - In eight male patients with a history of CVA with damage of the cortical or subcortical structures, we measured the cold pressor response during recording of muscle sympathetic nerve activity (MSNA) from the peroneal nerve on the hemiplegic side. We also studied 10 age-matched male control subjects. Tests were performed before, during, and after immersion of the nonhemiplegic hand in ice water for a period of 3 minutes in each phase. We also recorded changes in heart rate (HR), arterial blood pressure, skin temperature of the middle finger, and perception of pain using the Borg's score. Results - During the control period, the mean burst count of MSNA in CVA (57.2±3.9 beats/100 HR) was higher than in control subjects (36.3±3.2 beats/100 HR) (P&lt
.05). Total MSNA (the mean burst amplitude per minute times burst rate) increased significantly in CVA and control during the immersion period by 79.9±18.4% and 133.1±25.6%, respectively. The percent change in total MSNA in CVA was attenuated during immersion compared with control subjects. The HR and skin temperature responses as well as the Borg's score were similar in both groups during control, hand immersion, and recovery periods. Conclusions - The present results suggest that increased MSNA in CVA may be due to damage of cortical or subcortical structures or stroke-related changes in other areas or nonspecific changes that cause continuous increase in basal MSNA.

DOI： 10.1161/01.STR.29.3.607

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記述言語：日本語  

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