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写真a

ナカムラ タケシ
中村 健
Takeshi Nakamura
所属
医学研究科 医科学専攻 リハビリテーション科学 主任教授
医学部 医学科
職名
主任教授
プロフィール
リハビリテーション医学を専門としており、障害医学、運動生理学、環境生理学、循環調節、再生医療におけるリハビリテーションなどをテーマとして研究を進めている。
外部リンク

学位

  • 博士(医学) ( 和歌山県立医科大学 )

研究キーワード

  • 周術期リハビリテーション医療

  • 中枢性循環調節

  • 自律神経

  • 急性期リハビリテーション医療

  • リハビリテーション医学

  • 運動生理学

  • パラスポーツ

  • 運動負荷

  • 脊髄損傷

  • 運動療法

研究分野

  • ライフサイエンス / リハビリテーション科学

  • ライフサイエンス / スポーツ科学

論文

  • Effect of long-term rehabilitation on takotsubo syndrome-induced severe intensive care unit-acquired weakness: a case report. 査読

    Yoshitaka Shimizu, Ryoko Someya, Yugo Minamimoto, Akinobu Nemoto, Takeshi Nakamura

    Journal of physical therapy science   36 ( 11 )   750 - 755   2024年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    [Purpose] To examine the effectiveness of acute and outpatient cardiac rehabilitation for severe intensive care unit (ICU)-acquired weakness. [Participant and Methods] A 79-year-old woman, diagnosed with takotsubo syndrome. A percutaneous catheter-based transvalvular left ventricular assist device was used from day 2 to day 8, extracorporeal membrane oxygenation from day 3 to day 9, and inotropic support from day 1 to day 15. The patient was weaned from the ventilator on day 59, transferred to another hospital on day 67, and discharged home on day 152. From days 16 to 65 and 177 to 262, she underwent inpatient rehabilitation and outpatient cardiac rehabilitation, respectively, at our hospital. [Results] After inpatient rehabilitation at our hospital, her Medical Research Council score improved from 16 to 46. In outpatient cardiac rehabilitation, her 6-minute walk distance improved from 385 to 473 m, and her Kansas City Cardiomyopathy Questionnaire score improved from 88.6 to 100. [Conclusion] The results suggest that acute rehabilitation can effectively improve muscle strength, whereas outpatient cardiac rehabilitation can effectively improve exercise tolerance and quality of life in patients with severe ICU-acquired weakness.

    DOI: 10.1589/jpts.36.750

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  • White matter microstructural alterations in patients with neuropathic pain after spinal cord injury: a diffusion tensor imaging study 査読

    Dong Dong, Koichi Hosomi, Nobuhiko Mori, Yoshi-ichiro Kamijo, Yohei Furotani, Daisuke Yamagami, Yu-ichiro Ohnishi, Yoshiyuki Watanabe, Takeshi Nakamura, Fumihiro Tajima, Haruhiko Kishima, Youichi Saitoh

    Frontiers in Neurology   14   2023年8月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Frontiers Media SA  

    Background

    Through contrastive analysis, we aimed to identify the white matter brain regions that show microstructural changes in patients with neuropathic pain (NP) after spinal cord injury (SCI).

    Methods

    We categorized patients with SCI into NP (n = 30) and non-NP (n = 15) groups. We extracted diffusion tensor maps of fractional anisotropy (FA) and mean (MD), axial (AD), and radial (RD) diffusivity. A randomization-based method in tract-based spatial statistics was used to perform voxel-wise group comparisons among the FA, MD, AD, and RD for nonparametric permutation tests.

    Results

    Atlas-based analysis located significantly different regions (p < 0.05) in the appointed brain atlas. Compared to the non-NP group, the NP group showed higher FA in the posterior body and splenium of the corpus callosum and higher AD in the corpus callosum, internal capsule, corona radiata, posterior thalamic radiation, sagittal stratum, external capsule, cingulum, fornix/stria terminalis, superior longitudinal fasciculus, and uncinate fasciculus.

    Conclusion

    The results demonstrated that compared with the non-NP group, NP pathogenesis after SCI was potentially related to higher values in FA that are associated with microstructural changes in the posterior body and splenium of the corpus callosum, which could be regarded as central sensitization or network hyperexcitability.

    DOI: 10.3389/fneur.2023.1241658

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  • Association between sarcopenia and exercise capacity in patients with pulmonary hypertension without left heart disease. 査読 国際誌

    Mina Nakayama, Masaaki Konishi, Teruyasu Sugano, Masatsugu Okamura, Masaomi Gohbara, Kiwamu Iwata, Naoki Nakayama, Eiichi Akiyama, Naohiro Komura, Manabu Nitta, Noriyuki Kawaura, Tomoaki Ishigami, Kiyoshi Hibi, Toshiyuki Ishikawa, Takeshi Nakamura, Kouichi Tamura, Kazuo Kimura

    International journal of cardiology   387   131115 - 131115   2023年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Pulmonary hypertension (PH) has recently been described as a complex clinical syndrome affecting multiple organ systems, including the heart, lungs, and skeletal muscle, each of which plays an important role in exercise capacity. However, the relationship between exercise capacity and skeletal muscle abnormalities in patients with PH has not been fully elucidated. METHODS: We retrospectively analysed the exercise capacity and measures of skeletal muscle of 107 patients with PH without left heart disease (mean age 63 ± 15 years, 32.7% males, n = 30/6/66/5 in the clinical classification Group 1/3/4/5). RESULTS: Sarcopenia, low appendicular skeletal muscle mass index, low grip strength, and slow gait speed, determined by international criteria, were found in 15 (14.0%), 16 (15.0%), 62 (57.9%), and 41 (38.3%) patients, respectively. The mean 6-min walk distance of all patients was 436 ± 134 m and was independently associated with sarcopenia (standardised β = -0.292, p < 0.001). All patients with sarcopenia showed reduced exercise capacity defined as 6-min walk distance < 440 m. Multivariable logistic regression analysis showed that each of the components of sarcopenia was associated with reduced exercise capacity (adjusted odds ratio and 95% confidence interval of appendicular skeletal muscle mass index: 0.39 [0.24-0.63] per 1 kg/m2, p = 0.006, grip strength: 0.83 [0.74-0.94] per 1 kg, p = 0.003, and gait speed: 0.31 [0.18-0.51] per 0.1 m/s, p < 0.001). CONCLUSIONS: Sarcopenia and its components are associated with reduced exercise capacity in patients with PH. A multifaceted evaluation may be important in the management of reduced exercise capacity in patients with PH.

    DOI: 10.1016/j.ijcard.2023.06.006

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  • Impact of grip strength and gait speed on exercise tolerance in patients with pulmonary hypertension without left heart disease. 査読

    Masatsugu Okamura, Masaaki Konishi, Yusuke Saigusa, Shuji Ando, Mina Nakayama, Naohiro Komura, Teruyasu Sugano, Kouichi Tamura, Takeshi Nakamura

    Heart and vessels   37 ( 11 )   1928 - 1936   2022年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Patients with pulmonary hypertension (PH) suffer from poor exercise tolerance due to impaired oxygenation and/or reduced cardiac output. However, the relationship between exercise tolerance and physical function remains unclear. The purpose of this study was to investigate the relationship between exercise tolerance and physical function in patients with PH. A total of 94 patients without left heart disease (61.3 ± 14.7 years old, 69.1% females, 22/8/60/4 patients with Group 1/3/4/5 PH) were retrospectively analysed. Physical function was measured using muscle strength (grip strength, knee extension muscle strength), balance function (one-leg standing time), and gait speed within 7 days of cardiac catheterization. Exercise tolerance was measured using the 6-min walking distance (6-MWD). A total of 194 6-MWD measurements and the corresponding physical function were evaluated in 94 patients. Multivariable linear regression analysis using adaptive-LASSO methods indicated that the World Health Organization functional classification, pulmonary vascular resistance, mixed venous oxygen saturation, grip strength, and gait speed were independently associated with the 6-MWD. Low grip strength (< 28 kg for males and < 18 kg for females; adjusted odds ratio and 95% confidence interval: 2.06 [1.30-3.26], p = 0.002), and slow gait speed (< 1.0 m/s for both sexes; 13.33 [3.61-49.19], p < 0.001) were independent predictors of poor exercise tolerance (6-MWD < 440 m) in a logistic regression analysis. Grip strength and gait speed as measures of physical function, pulmonary vascular resistance, and mixed venous oxygen saturation were associated with exercise tolerance in patients with PH without left heart disease.

    DOI: 10.1007/s00380-022-02091-2

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  • Early mobilization in spinal cord injury promotes changes in microglial dynamics and recovery of motor function. 査読 国際誌

    Kohta Asano, Takeshi Nakamura, Kengo Funakoshi

    IBRO neuroscience reports   12   366 - 376   2022年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    In the acute phase of spinal cord injury, the initial injury triggers secondary damage due to neuroinflammation, leading to the formation of cavities and glial scars that impair nerve regeneration. Following injuries to the central nervous system, early mobilization promotes the recovery of physical function. Therefore, in the present study, we investigated the effects of early mobilization on motor function recovery and neuroinflammation in rats. Early mobilization of rats with complete spinal cord transection resulted in good recovery of hindlimb motor function after 3 weeks. At 1 week after spinal cord injury, the early-mobilized rats expressed fewer inflammatory M1 microglia/macrophages and more anti-inflammatory M2 microglia. In addition, significantly more matrix metalloproteinase 2 (MMP2)-positive cells were observed at the lesion site 1 week after injury in the early-mobilized rats. Multiple labeling studies suggested that many MMP2-positive cells were M2 microglia. MMP9-positive cells that highly co-expressed GFAP were also observed more frequently in the early-mobilized rats. The density of growth-associated protein-positive structures in the lesion center was significantly higher in the early-mobilized rats at 3 weeks after spinal cord injury. The present results suggest that early mobilization after spinal cord injury reduced the production of M1 microglia/macrophages while increasing the production of M2 microglia at the lesion site. Early mobilization might also activate the expression of MMP2 in M2 microglia and MMP9 in astrocytes. These cellular dynamics might suppress neuroinflammation at the lesion site, thereby inhibiting the progression of tissue destruction and promoting nerve regeneration to recover motor function.

    DOI: 10.1016/j.ibneur.2022.04.002

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  • Association between long-term hospitalization for mental illness and locomotive syndrome. 査読

    Yusuke Ishibashi, Hideki Arakawa, Sae Uezono, Sosuke Kitakaze, Munetsugu Kota, Shinichi Daikuya, Junichi Hirakawa, Takeshi Nakamura, Etsuo Chosa

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   27 ( 2 )   473 - 477   2022年3月

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    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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  • An 18-hole round of golf acutely elevates serum interleukin-6 and brain-derived neurotrophic factor concentration - a pilot study 査読

    Yoshinori Yasuoka, Takeshi Nakamura, Yasunori Umemoto, Tokio Kinoshita, Sven P. Hoekstra, Keisuke Hoshiai, Hiroshi Ohko, Masahiro Abo, Fumihiro Tajima

    The Journal of Physical Fitness and Sports Medicine   11 ( 1 )   1 - 7   2022年1月

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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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  • Impact of early mobilization on discharge disposition and functional status in patients with subarachnoid hemorrhage: A retrospective cohort study. 査読 国際誌

    Masatsugu Okamura, Masaaki Konishi, Akiko Sagara, Yasuo Shimizu, Takeshi Nakamura

    Medicine   100 ( 51 )   e28171   2021年12月

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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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  • Long Term Decreased Exercise Capacity of COVID-19 Patients Who Received Mechanical Ventilation in Japan: A Case Series. 査読 国際誌

    Takuya Saeki, Fumihiro Ogawa, Mina Matsumiya, Mei Yamamura, Hideyuki Oritsu, Manabu Nonogaki, Jo Uesugi, Ichiro Takeuchi, Takeshi Nakamura

    American journal of physical medicine & rehabilitation   2021年5月

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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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  • Clinical introduction and benefits of non-invasive ventilation for above C3 cervical spinal cord injury. 査読 国際誌

    Akiko Toki, Takeshi Nakamura, Yukihide Nishimura, Mikio Sumida, Fumihiro Tajima

    The journal of spinal cord medicine   44 ( 1 )   70 - 76   2021年1月

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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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  • Increased serum levels of brain-derived neurotrophic factor following wheelchair half marathon race in individuals with spinal cord injury. 査読 国際誌

    Yukihide Nishimura, Takeshi Nakamura, Yoshi-Ichiro Kamijo, Hideki Arakawa, Yasunori Umemoto, Tokio Kinoshita, Yuta Sakurai, Fumihiro Tajima

    The journal of spinal cord medicine   1 - 6   2020年10月

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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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  • Rehabilitation Therapy for a COVID-19 Patient Who Received Mechanical Ventilation in Japan. 査読 国際誌

    Takuya Saeki, Fumihiro Ogawa, Ryosuke Chiba, Manabu Nonogaki, Jo Uesugi, Ichiro Takeuchi, Takeshi Nakamura

    American journal of physical medicine & rehabilitation   99 ( 10 )   873 - 875   2020年10月

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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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  • Mobilization within 24 hours of new-onset stroke enhances the rate of home discharge at 6-months follow-up: a prospective cohort study. 査読 国際誌

    Tokio Kinoshita, Tatsuya Yoshikawa, Yukihide Nishimura, Yoshi-Ichiro Kamijo, Hideki Arakawa, Takeshi Nakamura, Takamasa Hashizaki, Sven P Hoekstra, Fumihiro Tajima

    The International journal of neuroscience   1 - 10   2020年6月

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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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  • Relationship between ultrasonographically low-echoic lesions under the skin, wheelchair sitting time, and interface pressure on ischial region in individuals with chronic spinal cord injury. 査読 国際誌

    Shinji Kawasaki, Yukihide Nishimura, Yoshi-Ichiro Kamijo, Hiroyasu Uenishi, Taro Nakamura, Ken Kouda, Yumi Koike, Takeshi Nakamura, Fumihiro Tajima

    The journal of spinal cord medicine   44 ( 6 )   1 - 7   2020年5月

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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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  • Childhood Nephrotic Syndrome Complicated by Catastrophic Multiple Arterial Thrombosis Requiring Bilateral Above-Knee Amputation. 査読 国際誌

    Hayato Togashi, Yuko Shimosato, Ken Saida, Noriko Miyake, Takeshi Nakamura, Shuichi Ito

    Frontiers in pediatrics   8   107 - 107   2020年

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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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  • 【障がい者スポーツを知ろう!】障がい者スポーツ選手への医学的サポート

    中村 健, 河崎 敬

    関節外科   37 ( 11 )   1225 - 1229   2018年11月

  • Reply. 国際誌

    Takeshi Nakamura

    PM & R : the journal of injury, function, and rehabilitation   10 ( 9 )   989 - 990   2018年9月

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  • Head-out immersion in hot water increases serum BDNF in healthy males. 査読 国際誌

    Daisuke Kojima, Takeshi Nakamura, Motohiko Banno, Yasunori Umemoto, Tokio Kinoshita, Yuko Ishida, Fumihiro Tajima

    International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group   34 ( 6 )   834 - 839   2018年9月

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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.

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  • Properties of Paraspinal Muscles in Japanese High School Baseball Players With Terminal-Stage Lumbar Spondylolysis. 査読 国際誌

    Hiroyuki Tsuboi, Yukihide Nishimura, Takeshi Sakata, Hideaki Tanina, Hideki Arakawa, Takeshi Nakamura, Yuichi Umezu, Fumihiro Tajima

    PM & R : the journal of injury, function, and rehabilitation   10 ( 2 )   175 - 182   2018年2月

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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.

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  • Effects of physiatrist and registered therapist operating acute rehabilitation (PROr) in patients with stroke 査読

    Tokio Kinoshita, Yukihide Nishimura, Takeshi Nakamura, Takamasa Hashizaki, Daisuke Kojima, Makoto Kawanishi, Hiroyasu Uenishi, Hideki Arakawa, Takahiro Ogawa, Yoshi-ichiro Kamijo, Takashi Kawasaki, Fumihiro Tajima

    PLOS ONE   12 ( 10 )   e0187099   2017年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1371/journal.pone.0187099

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  • 【東京パラリンピックに向けて今、何をすべきか-パラリンピアン育成のために】パラリンピアンの医学的サポート

    河崎 敬, 伊藤 倫之, 指宿 立, 尾川 貴洋, 中村 健, 田島 文博

    Journal of Clinical Rehabilitation   26 ( 6 )   557 - 562   2017年6月

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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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  • Noninvasive positive pressure ventilation enhances the effects of aerobic training on cardiopulmonary function 査読

    Takashi Moriki, Takeshi Nakamura, Yoshi-ichiro Kamijo, Yukihide Nishimura, Motohiko Banno, Tokio Kinoshita, Hiroyasu Uenishi, Fumihiro Tajima

    PLOS ONE   12 ( 5 )   e0178003   2017年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • 【脊椎・脊髄疾患のニューロサイエンス 神経所見の診かたから再生医療まで】脊椎・脊髄疾患の治療法の進歩 理学療法 ニューロリハビリテーション

    荒川 英樹, 中村 健, 尾川 貴洋, 田島 文博

    整形・災害外科   60 ( 5 )   609 - 616   2017年4月

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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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  • Changes in oxidized LDL during a half marathon in athletes with spinal cord injuries. 査読 国際誌

    Toshihito Mitsui, Tomoyuki Ito, Yusuke Sasaki, Takashi Kawasaki, Takeshi Nakamura, Yukihide Nishimura, Tatsuru Ibusuki, Yukiharu Higuchi, Sayoko Hosoe, Fumiaki Ito, Fumihiro Tajima

    Spinal cord series and cases   3   17015 - 17015   2017年

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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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  • Fatigue-related differences in erector spinae between prepubertal children and young adults using surface electromyographic power spectral analysis 査読

    Hideaki Tanina, Yukihide Nishimura, Hiroyuki Tsuboi, Takeshi Sakata, Takeshi Nakamura, Ken-ya Murata, Hideki Arakawa, Yuichi Umezu, Fumihiro Tajima

    JOURNAL OF BACK AND MUSCULOSKELETAL REHABILITATION   30 ( 1 )   1 - 9   2017年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.3233/BMR-160705

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  • Aerobic Exercise Combined With Noninvasive Positive Pressure Ventilation Increases Serum Brain-Derived Neurotrophic Factor in Healthy Males 査読

    Takamitsu Kawazu, Takeshi Nakamura, Takashi Moriki, Yoshi-ichiro Kamijo, Yukihide Nishimura, Tokio Kinoshita, Fumihiro Tajima

    PM&R   8 ( 12 )   1136 - 1141   2016年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.pmrj.2016.05.004

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  • Walking Pattern in COPD Patients 査読

    Yukiko Sakamoto, Keiko Sakamoto, Yoshiaki Minakata, Sumiko Shiba, Takeshi Nakamura, Masakazu Ichinose, Fumihiro Tajima

    REHABILITATION NURSING   41 ( 4 )   211 - 217   2016年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1002/rnj.209

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  • A Pilot Clinical Study of Olfactory Mucosa Autograft for Chronic Complete Spinal Cord Injury. 査読

    Koichi Iwatsuki, Fumihiro Tajima, Yu-Ichiro Ohnishi, Takeshi Nakamura, Masahiro Ishihara, Koichi Hosomi, Koshi Ninomiya, Takashi Moriwaki, Toshiki Yoshimine

    Neurologia medico-chirurgica   56 ( 6 )   285 - 92   2016年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.2176/nmc.oa.2015-0320

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  • Suppression of activation of muscle sympathetic nerve during non-noxious local cooling after the end of local cooling in normal adults. 査読 国際誌

    Kazuya Ishida, Takeshi Nakamura, Kenichi Kimura, Nami Kanno, Noriyo Takahashi, Yoshi-Ichiro Kamijo, Fumihiro Tajima

    European journal of applied physiology   116 ( 4 )   851 - 8   2016年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/s00421-016-3343-9

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  • Rehabilitation of Charcot-Marie-Tooth disease 査読

    Fumihiro Tajima, Takeshi Nakamura, Yukihide Nishimura, Hideki Arakawa, Takashi Kawasaki, Takahiro Ogawa, Kazunari Nishiyama

    Brain and Nerve   68 ( 1 )   59 - 68   2016年1月

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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  

    DOI: 10.11477/mf.1416200347

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  • 【シャルコー・マリー・トゥース病】CMTのリハビリテーション

    田島 文博, 中村 健, 西村 行秀, 荒川 英樹, 河崎 敬, 尾川 貴洋, 西山 一成

    BRAIN and NERVE: 神経研究の進歩   68 ( 1 )   59 - 68   2016年1月

  • Motor evoked potential and voluntary EMG activity after olfactory mucosal autograft transplantation in a case of chronic, complete spinal cord injury: case report. 査読 国際誌

    Koichi Iwatsuki, Fumihiro Tajima, Yoshiyuki Sankai, Yu-Ichiro Ohnishi, Takeshi Nakamura, Masahiro Ishihara, Koichi Hosomi, Koshi Ninomiya, Takashi Moriwaki, Toshiki Yoshimine

    Spinal cord series and cases   2   15018 - 15018   2016年

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    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.

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  • Ehlers-Danlos症候群による重度の関節弛緩に対して装具療法が有効であった一例

    垣田 友里, 垣田 真里, 坂野 元彦, 荒川 英樹, 木下 利喜生, 佐々木 裕介, 西村 行秀, 中村 健, 田島 文博

    リハビリテーション科診療近畿地方会誌   ( 15 )   35 - 38   2015年12月

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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  

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  • Hot water immersion induces an acute cytokine response in cervical spinal cord injury 査読

    C. A. Leicht, K. Kouda, Y. Umemoto, M. Banno, T. Kinoshita, T. Moriki, T. Nakamura, N. C. Bishop, V. L. Goosey-Tolfrey, F. Tajima

    European Journal of Applied Physiology   115 ( 11 )   2243 - 2252   2015年11月

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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  

    DOI: 10.1007/s00421-015-3206-9

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  • The role of cardiac sympathetic innervation and skin thermoreceptors on cardiac responses during heat stress. 査読 国際誌

    Manabu Shibasaki, Yasunori Umemoto, Tokio Kinoshita, Ken Kouda, Tomoyuki Ito, Takeshi Nakamura, Craig G Crandall, Fumihiro Tajima

    American journal of physiology. Heart and circulatory physiology   308 ( 11 )   H1336-42 - H1342   2015年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1152/ajpheart.00911.2014

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  • Elevation of interleukin-6 and attenuation of tumor necrosis factor-α during wheelchair half marathon in athletes with cervical spinal cord injuries. 国際誌

    T Ogawa, T Nakamura, M Banno, Y Sasaki, Y Umemoto, K Kouda, T Kawasaki, F Tajima

    Spinal cord   52 ( 8 )   601 - 5   2014年8月

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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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  • Wheelchair marathon creates a systemic anti-inflammatory environment in persons with spinal cord injury. 査読 国際誌

    Yusuke Sasaki, Kazunari Furusawa, Fumihiro Tajima, Takeshi Nakamura, Ken Kouda, Nami Kanno, Takashi Kawasaki, Yasunori Umemoto, Katuji Shimizu

    Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine   24 ( 4 )   295 - 301   2014年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/JSM.0000000000000015

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  • 【ここまで進んだ リハビリテーション】総論 内科系医師に知っておいてほしいこと

    河崎 敬, 坂野 元彦, 幸田 剣, 中村 健, 田島 文博

    診断と治療   102 ( 3 )   323 - 327   2014年3月

  • Disabled sports and physiological specificity in persons with spinal cord injury

    Takeshi Nakamura, Kazunari Furusawa, Ken Kouda, Yukihide Nishimura, Yusuke Sasaki, Yasunori Umemoto, Motohiko Banno, Takahiro Ogawa, Takashi Kawasaki, Tomoyuki Ito, Toshihito Mitsui, Fumihiro Tajima

    The Journal of Physical Fitness and Sports Medicine   3 ( 3 )   335 - 339   2014年

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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.3.335

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  • Carotid blood flow, cardiovascular and endocrine responses during head-up tilt in patients with acute cerebrovascular diseases. 査読 国際誌

    Takahiro Miyake, Takeshi Nakamura, Ken Kouda, Hiroyasu Uenishi, Yoshio Yamamoto, Shinji Kawasaki, Masami Ueno, Fumihiro Tajima

    SpringerPlus   3   191 - 191   2014年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1186/2193-1801-3-191

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  • Immediate effects of unaffected arm exercise in poststroke patients with spastic upper limb hemiparesis. 査読 国際誌

    Keiko Sakamoto, Takeshi Nakamura, Hiroyasu Uenishi, Yasunori Umemoto, Hideki Arakawa, Masahiro Abo, Ryuichi Saura, Hiroyoshi Fujiwara, Toshikazu Kubo, Fumihiro Tajima

    Cerebrovascular diseases (Basel, Switzerland)   37 ( 2 )   123 - 7   2014年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1159/000357421

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  • 温泉による全身浴(頸下浸水)の身体・脳活性化メカニズム

    田島 文博, 中村 健, 下松 智哉, 児嶋 大介, 山本 洋司, 櫻井 雄太, 木下 利喜生, 尾川 貴洋, 藤原 浩芳, 久保 俊一

    日本生体電気・物理刺激研究会誌   27   19 - 23   2013年12月

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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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  • Age-related sex differences in erector spinae muscle endurance using surface electromyographic power spectral analysis in healthy humans. 査読 国際誌

    Hiroyuki Tsuboi, Yukihide Nishimura, Takeshi Sakata, Hiroshi Ohko, Hideaki Tanina, Ken Kouda, Takeshi Nakamura, Yuichi Umezu, Fumihiro Tajima

    The spine journal : official journal of the North American Spine Society   13 ( 12 )   1928 - 33   2013年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.spinee.2013.06.060

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  • Increase in interleukin-6 immediately after wheelchair basketball games in persons with spinal cord injury: Preliminary report 査読

    T. Kinoshita, T. Nakamura, Y. Umemoto, D. Kojima, T. Moriki, T. Mitsui, M. Goto, Y. Ishida, F. Tajima

    Spinal Cord   51 ( 6 )   508 - 510   2013年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1038/sc.2013.4

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  • 那智勝浦町における被災地支援活動

    西 弘子, 佐藤 泰子, 田島 文博, 芝崎 学, 城本 依穂, 喜田 弘美, 坂口 千恵子, 柳川 敦子, 網野 美佐, 中村 健, 坂野 元彦, 河﨑 敬

    繊維製品消費科学   54 ( 3 )   243 - 246   2013年

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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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  • [Basic strategy of rehabilitation for regeneration of spinal cord nerve]. 査読

    Tajima F, Nakamura T

    Rinsho shinkeigaku = Clinical neurology   53 ( 11 )   1183   2013年

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  • Comparison of the effects of flexion and extension of the thumb and fingers on the position and cross-sectional area of the median nerve. 査読 国際誌

    Yasushi Toge, Yukihide Nishimura, Jeffrey R Basford, Takako Nogawa, Midori Yamanaka, Takeshi Nakamura, Munehito Yoshida, Akira Nagano, Fumihiro Tajima

    PloS one   8 ( 12 )   e83565   2013年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1371/journal.pone.0083565

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  • Wheelchair half-marathon race increases natural killer cell activity in persons with cervical spinal cord injury

    M. Banno, T. Nakamura, K. Furusawa, T. Ogawa, Y. Sasaki, K. Kouda, T. Kawasaki, F. Tajima

    Spinal Cord   50 ( 7 )   533 - 537   2012年7月

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    掲載種別:研究論文(学術雑誌)  

    DOI: 10.1038/sc.2011.188

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  • 内部障害者の運動効果とスポーツ参加基準 内部障害者におけるスポーツ参加に向けての医学・生理学的課題と運動による炎症性サイトカイン上昇の検討

    中村 健, 幸田 剣, 西村 行秀, 後藤 正樹, 佐々木 裕介, 梅本 安則, 河崎 敬, 坂野 元彦, 尾川 貴洋, 田島 文博, 古澤 一成, 井手 睦

    The Japanese Journal of Rehabilitation Medicine   49 ( 7 )   404 - 407   2012年7月

  • Exercise significantly increases plasma adrenaline and oxidized low-density lipoprotein in normal healthy subjects but not in persons with spinal cord injury. 査読 国際誌

    Toshihito Mitsui, Takeshi Nakamura, Tomoyuki Ito, Yasunori Umemoto, Keiko Sakamoto, Tokio Kinoshita, Masafumi Nakagawa, Fumihiro Tajima

    Archives of physical medicine and rehabilitation   93 ( 4 )   725 - 7   2012年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.apmr.2011.08.046

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  • Cardiovascular responses to arm static exercise in men with thoracic spinal cord lesions. 査読 国際誌

    Keiko Sakamoto, Takeshi Nakamura, Yasunori Umemoto, Yumi Koike, Yusuke Sasaki, Fumihiro Tajima

    European journal of applied physiology   112 ( 2 )   661 - 6   2012年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/s00421-011-2017-x

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  • Local heat application to the leg reduces muscle sympathetic nerve activity in human. 査読 国際誌

    Noriyo Takahashi, Takeshi Nakamura, Nami Kanno, Kenichi Kimura, Yasushi Toge, Kyu-Ha Lee, Fumihiro Tajima

    European journal of applied physiology   111 ( 9 )   2203 - 11   2011年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/s00421-011-1852-0

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  • 【脊髄損傷 社会生活上の課題】余暇活動

    坂野 元彦, 尾川 貴洋, 三井 利仁, 中村 健, 田島 文博

    総合リハビリテーション   39 ( 7 )   657 - 660   2011年7月

  • 障害者スポーツ医学の最先端 ―残存骨格筋は内分泌器官である―:—残存骨格筋は内分泌器官である—

    田島 文博, 古澤 一成, 中村 太郎, 大隈 秀信, 梅津 祐一, 井手 睦, 美津島 隆, 上田 まり, 中村 健, 河津 隆三, 荒川 英樹, 伊藤 倫之, 山中 緑, 幸田 剣, 後藤 正樹, 佐々木 裕介, 神埜 奈美, 河崎 敬, 梅本 安則, 下松 智哉, 坂野 元彦, 上西 啓裕, 大川 裕行, 浅山 滉

    The Japanese Journal of Rehabilitation Medicine   47 ( 5 )   304 - 309   2010年

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    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

  • Standing position improves arm and hand performance on un-affected side in hemiplegic patients. 査読 国際誌

    Hidenori Tojo, Nami Kanno, Takeshi Nakamura, Yasuko Mizumoto, Midori Yamanaka, Fumihiro Tajima

    NeuroRehabilitation   27 ( 4 )   359 - 65   2010年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.3233/NRE-2010-0620

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  • Cardiovascular responses to hypothalamic arcuate nucleus stimulation in the rat: role of sympathetic and vagal efferents. 国際誌

    Takeshi Nakamura, Suresh Bhatt, Hreday N Sapru

    Hypertension (Dallas, Tex. : 1979)   54 ( 6 )   1369 - 75   2009年12月

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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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  • Cardiovascular responses to microinjections of urocortins into the NTS: role of inotropic glutamate receptors. 国際誌

    Takeshi Nakamura, Hreday N Sapru

    American journal of physiology. Heart and circulatory physiology   296 ( 6 )   H2022-9   2009年6月

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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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  • Low-echoic lesions underneath the skin in subjects with spinal-cord injury 査読

    N. Kanno, T. Nakamura, M. Yamanaka, K. Kouda, T. Nakamura, F. Tajima

    Spinal Cord   47 ( 3 )   225 - 229   2009年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1038/sc.2008.101

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  • Topical anesthesia blunts the pressor response induced by bowel manipulation in subjects with cervical spinal cord injury 査読

    K. Furusawa, H. Sugiyama, A. Tokuhiro, M. Takahashi, T. Nakamura, F. Tajima

    Spinal Cord   47 ( 2 )   144 - 148   2009年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1038/sc.2008.86

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  • Cardiovascular responses to microinjections of urocortin 3 into the nucleus tractus solitarius of the rat. 国際誌

    Takeshi Nakamura, Kazumi Kawabe, Hreday N Sapru

    American journal of physiology. Heart and circulatory physiology   296 ( 2 )   H325-32   2009年2月

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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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  • Mechanism of heart rate responses elicited by chemical stimulation of the hypothalamic paraventricular nucleus in the rat. 国際誌

    Tetsuya Kawabe, Vineet C Chitravanshi, Takeshi Nakamura, Kazumi Kawabe, Hreday N Sapru

    Brain research   1248   115 - 26   2009年1月

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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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  • Cold pressor test in the rat: medullary and spinal pathways and neurotransmitters. 国際誌

    Takeshi Nakamura, Kazumi Kawabe, Hreday N Sapru

    American journal of physiology. Heart and circulatory physiology   295 ( 4 )   H1780-7   2008年10月

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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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  • Attenuation of natural killer cell activity during 2-h exercise in individuals with spinal cord injuries 査読

    M. Ueta, K. Furusawa, M. Takahashi, Y. Akatsu, T. Nakamura, F. Tajima

    Spinal Cord   46 ( 1 )   26 - 32   2008年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1038/sj.sc.3102054

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  • Muscle sympathetic nerve activity during isometric exercise in patients with cerebrovascular accidents 査読

    Takeshi Nakamura, Takashi Mizushima, Mitsuru Yamamoto, Takamitsu Kawazu, Yuichi Umezu, Fumihiro Tajima

    Archives of Physical Medicine and Rehabilitation   86 ( 3 )   436 - 441   2005年

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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  

    DOI: 10.1016/j.apmr.2004.06.071

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  • Muscle sympathetic nerve activity during cold pressor test in patients with cerebrovascular accidents 査読

    Takashi Mizushima, Fumihiro Tajima, Takeshi Nakamura, Mitsuru Yamamoto, Kyu-Ha Lee, Hajime Ogata

    Stroke   29 ( 3 )   607 - 612   1998年

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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  

    DOI: 10.1161/01.STR.29.3.607

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共同研究・競争的資金等の研究課題

  • 膵頭十二指腸切除術の骨格筋量への影響と術前リハビリテーション治療の効果

    研究課題/領域番号:23K10480  2023年4月 - 2026年3月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    立花 佳枝, 中村 健

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    配分額:4680000円 ( 直接経費:3600000円 、 間接経費:1080000円 )

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  • 心疾患維持期患者におけるデジタルデバイスを利用した運動習慣獲得と医学的効果の検証

    研究課題/領域番号:22K11373  2022年4月 - 2025年3月

    日本学術振興会  科学研究費助成事業 基盤研究(C)  基盤研究(C)

    中村 健, 礒 良崇, 水越 慶

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    配分額:4160000円 ( 直接経費:3200000円 、 間接経費:960000円 )

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  • ICU重症患者における急性期立位・運動負荷の検討

    研究課題/領域番号:15K01384  2015年4月 - 2018年3月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    田島 文博, 幸田 剣, 西村 行秀, 中村 健, 上條 義一郎

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    配分額:4680000円 ( 直接経費:3600000円 、 間接経費:1080000円 )

    研究の目的は、重症患者に対して起立・運動負荷施行の効果を検証することである。まず、研究を遂行するための起立台を地元企業と作成した。疾患別に取り組む必要があり、脳血管障害例を対象とした。ただし、初診時にはリハビリテーション科医が診察し、熟練した療法士が起立・歩行訓練を施行した(PROr)。その結果、24時間以内にPROrを導入すれば、それ以降施行するよりも有意にFIM利得が大きいことが判明した。

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  • 障がい者スポーツにおける陸上競技アスリートのスポーツ傷害実態調査

    研究課題/領域番号:15K01598  2015年4月 - 2018年3月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    三井 利仁, 田島 文博, 幸田 剣, 西村 行秀, 梅本 安則, 河崎 敬, 坂野 元彦, 中村 健, 伊藤 倫之

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    配分額:4680000円 ( 直接経費:3600000円 、 間接経費:1080000円 )

    本研究は、車椅子陸上競技を行っている脊髄損傷者の障害者アスリートを対象として、理学的所見と画像診断等により肩関節スポーツ傷害発症の実態について調査した。さらに、練習内容と量を調査しそれぞれの選手のフォームを解析した。それらの結果を総合的に検証し、肩関節スポーツ傷害発症メカニズムを考察し、予防法を検討した。調査項目としては、車椅子選手の肩関節に影響を与えうる要素を全て抽出した。具体的には、1.練習内容、2.練習量、3.車いす駆動フォーム、4.理学的所見、5.画像所見(エコーおよびMRI)、について調査した。

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  • 非侵襲的陽圧換気を使用した体力・健康増進に有効な運動方法の開発

    研究課題/領域番号:15K01382  2015年 - 2017年

    文部科学省  科学研究費補助金(基盤研究(C))  基盤研究(C)

    中村 健

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    担当区分:研究代表者  資金種別:競争的資金

    配分額:4810000円 ( 直接経費:3700000円 、 間接経費:1110000円 )

    若年健常男性に対し、自転車エルゴメーターにより60%最大酸素摂取量の運動負荷で1日30分間の有酸素運動を非侵襲的陽圧換気(NPPV, 12cmH2O)下および非NPPV下で連続5日間施行した。NPPV下と非NPPV下でのトレーニングは、3週間のウオッシュアウト期間を置いて実施した。それぞれ、5日間のトレーニングの前後で、最大酸素摂取量(体力)と脳由来神経栄養因子(BDNF)の測定を実施した。
    最大酸素摂取量は、NPPV下の方が優位に高く上昇し、BDNFはNPPV下でのみ上昇した。
    NPPV下の有酸素運動トレーニングは、最大酸素摂取量とBDNFの上昇を向上させ、健康に有益な作用がある事が示唆された。

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  • 脊髄損傷者の運動時における酸化LDL動態について

    研究課題/領域番号:24500748  2012年4月 - 2015年3月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    三井 利仁, 田島 文博, 中村 健, 伊藤 倫之, 馬渕 博行

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    配分額:5200000円 ( 直接経費:4000000円 、 間接経費:1200000円 )

    頸髄障害者(CSCI)は副腎髄質への交感神経支配が障害されているために運動時アドレナリン分泌が胸腰髄損傷者(LSCI)より抑制されている。今回の研究で、当初運動による上昇を予想していた酸化LDLがLSCIに比べCSCIで抑制されていた理由として、このアドレナリン分泌の低下が一因であると推察される。
    下部胸髄節交感神経障害があるLSCIには末梢性交感神経障害が存在すると考えられる。結果よりoxLDLがLSCIよりCSCIの方が抑制されていた理由は、このアドレナリン分泌の低下が原因であると推察する。酸化LDLの有意な増加がないことからは、この運動はたとえCSCIにおいても安全であることが示唆された。

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  • 温浴におけるサイトカイン発現に関する研究

    研究課題/領域番号:23590894  2011年 - 2013年

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    田島 文博, 中村 健, 幸田 剣, 幸田 剣

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    配分額:4550000円 ( 直接経費:3500000円 、 間接経費:1050000円 )

    健常成人8名を対象に、30分の安静の後、以下の負荷のいずれかを20分間負荷された、1)室内安静、2)温泉(42℃)全身浴、3)中性温(35℃)全身浴、4)室内運動(最大酸素摂取量の60%)、5)温泉全身浴運動、6)中性温全身浴運動、その後60分の回復期を観察した。全被験者は別の日に上記負荷を全てテストされた。その結果、温泉全身浴と温泉全身浴運動の2つの負荷で負荷60分後に血中IL-6の有意な上昇を認めた。温泉全身浴そのものは運動同様IL-6発現の刺激となる。

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  • 脊髄損傷対麻痺者における運動時Natural Killer Cell活動変動

    研究課題/領域番号:17500368  2005年 - 2006年

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    田島 文博, 中村 健, 峠 康

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    配分額:3600000円 ( 直接経費:3600000円 )

    【目的】健常者における運動時の免疫機能はNatural Killer細胞(NK細胞)活性を指標として、多数の報告がある。しかし、脊髄損傷者においては、我々が車いすフルマラソンではレース直後にNK細胞活性が低下し、ハーフマラソンでは上昇する事が知られているだけである。今回我々は、実験室で運動強度を一定にし、2時間の運動を継続した時の免疫機能の変動を調査した。【方法】対象は男性脊髄損傷者7名(脊損者、年齢34.3±7.1歳、損傷レベルTh11〜L4)と健常男性6名(健常者、年齢28.8±7.7歳)とした。予めハンドエルゴメーターで被験者の最大酸素摂取量(VO2max)を測定した結果、脊損者は27.9±3.0ml/min、健常者は25.7±4.1ml/minであり、両群に有意差を認めなかった。VO2max測定とは別の日に、被験者はそれぞれのVO2maxの60%で2時間ハンドエルゴメーター運動を行った。採血は、運動前、1時間運動後、運動終了直後、終了後2時間の4回行い、白血球数、アドレナリン、NK細胞数、NK細胞活性を測定した。別の日に運動を行わないタイムコントロール実験を行った。【結果】健常者の白血球数と血中アドレナリンは運動直後に有意な上昇を見た。NK細胞数は運動直後の変動は有意ではなかったが、NK細胞活性は運動直後に有意に低下し、2時間後に回復した。【考察】車いすフルマラソンの実験モデルを行い、NK細胞活性は低下した。しかし、NK細胞活性は2時間後には回復した事から、車いすマラソンで選手が感染に留意する時間は数時間で良いと考えられる。

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