Neurofeedback has been a powerful method for self-regulating brain activities to elicit potential ability of human mind. GABA is a major inhibitory neurotransmitter in the central nervous system. Transcranial magnetic stimulation (TMS) is a tool that can evaluate the GABAergic system within the primary motor cortex (M1) using paired-pulse stimuli, short intracortical inhibition (SICI). Herein we investigated whether neurofeedback learning using SICI enabled us to control the GABAergic system within the M1 area. Forty-five healthy subjects were randomly divided into two groups: those receiving SICI neurofeedback learning or those receiving no neurofeedback (control) learning. During both learning periods, subjects made attempts to change the size of a circle, which was altered according to the degree of SICI in the SICI neurofeedback learning group, and which was altered independent of the degree of SICI in the control learning group. Results demonstrated that the SICI neurofeedback learning group showed a significant enhancement in SICI. Moreover, this group showed a significant reduction in choice reaction time compared to the control group. Our findings indicate that humans can intrinsically control the intracortical GABAergic system within M1 and can thus improve motor behaviors by SICI neurofeedback learning. SICI neurofeedback learning is a novel and promising approach to control our neural system and potentially represents a new therapy for patients with abnormal motor symptoms caused by CNS disorders.
The objective of the current study was to investigate the kinematic relationships between the rearfoot and hip/knee joint during walking and single-leg landing. Kinematics of the rearfoot relative to the shank, knee and hip joints during walking and single-leg landing were analyzed in 22 healthy university students. Kinematic relationships between two types of angular data were assessed by zero-lag cross-correlation coefficients and coupling angles, and were compared between joints and between tasks. During walking, rearfoot eversion/inversion and external/internal rotation were strongly correlated with hip adduction/abduction (R=0.69 and R=0.84), whereas correlations with knee kinematics were not strong (R≤0.51) and varied between subjects. The correlations with hip adduction/abduction were stronger than those with knee kinematics (P<0.001). Most coefficients during single-leg landing were strong (R≥0.70), and greater than those during walking (P<0.001). Coupling angles indicated that hip motion relative to rearfoot motion was greater than knee motion relative to rearfoot motion during both tasks (P<0.001). Interventions to control rearfoot kinematics may affect hip kinematics during dynamic tasks. The coupling motion between the rearfoot and hip/knee joints, especially in the knee, should be considered individually.
BACKGROUND: Although it is well known that quadriceps force generates anterior tibial force, it has been unclear whether quadriceps force causes great anterior tibial force during the early phase of a landing task. The purpose of the present study was to examine whether the quadriceps force induced great anterior tibial force during the early phase of a landing task. METHODS: Fourteen young, healthy, female subjects performed a single-leg landing task. Muscle force and anterior tibial force were estimated from motion capture data and synchronized force data from the force plate. One-way repeated measures analysis of variance and the post hoc Bonferroni test were conducted to compare the peak time of the vertical ground reaction force, quadriceps force and anterior tibial force during the single-leg landing. In addition, we examined the contribution of vertical and posterior ground reaction force, knee flexion angle and moment to peak quadriceps force using multiple linear regression. RESULTS: The peak times of the estimated quadriceps force (96.0 ± 23.0 ms) and anterior tibial force (111.9 ± 18.9 ms) were significantly later than that of the vertical ground reaction force (63.5 ± 6.8 ms) during the single-leg landing. The peak quadriceps force was positively correlated with the peak anterior tibial force (R = 0.953, P < 0.001). Multiple linear regression analysis showed that the peak knee flexion moment contributed significantly to the peak quadriceps force (R 2 = 0.778, P < 0.001). CONCLUSION: The peak times of the quadriceps force and the anterior tibial force were obviously later than that of the vertical ground reaction force for the female athletes during successful single-leg landings. Studies have reported that the peak time of the vertical ground reaction force was close to the time of anterior cruciate ligament (ACL) disruption in ACL injury cases. It is possible that early contraction of the quadriceps during landing might induce ACL disruption as a result of excessive anterior tibial force in unanticipated situations in ACL injury cases.
CONTEXT: Identifying the foot positions that are vulnerable to lateral ankle sprains is important for injury prevention. The effects of foot position in the transverse plane on ankle biomechanics during landing are unknown. OBJECTIVE: To examine the effects of toe-in or toe-out positioning on ankle inversion motion and moment during single-leg landing. DESIGN: Repeated measures. SETTING: Motion analysis laboratory. PARTICIPANTS: 18 healthy participants (9 men and 9 women). INTERVENTIONS: Participants performed single-leg landing trials from a 30-cm high box under 3 conditions: natural landing, foot internally rotated (toe-in), and foot externally rotated (toe-out). MAIN OUTCOME MEASURES: 4 toe-in or toe-out angles were calculated against 4 reference coordinates (laboratory, pelvis, thigh, and shank) in the transverse plane. Ankle inversion angle, angular velocity, and external moment in the 200 ms after initial foot-to-ground contact were compared between the 3 landing conditions. RESULTS: All toe-in or toe-out angles other than those calculated against the shank were significantly different between each of the 3 landing conditions (P < .001). Ankle inversion angle, angular velocity, and moment were highest during toe-in landings (P < .01), while eversion angle and moment were highest during toe-out landings (P < .001). The effect sizes of these differences were large. Vertical ground reaction forces were not different between the 3 landing conditions (P = .290). CONCLUSIONS: Toe-in or toe-out positioning during single-leg landings impacts on ankle inversion and eversion motion and moment. Athletes could train not to land with the toe-in positioning to prevent lateral ankle sprains.
BACKGROUND: Vestibular rehabilitation is useful to alleviate chronic dizziness in patients with vestibular dysfunction. It aims to induce neuronal plasticity in the central nervous system (especially in the cerebellum) to promote vestibular compensation. Transcranial cerebellar direct current stimulation (tcDCS) reportedly enhances cerebellar function. OBJECTIVE/HYPOTHESIS: We investigated whether vestibular rehabilitation partially combined with tcDCS is superior to the use of rehabilitation alone for the alleviation of dizziness. METHODS: Patients with chronic dizziness due to vestibular dysfunction received rehabilitation concurrently with either 20-min tcDCS or sham stimulation for 5 days. Pre- and post-intervention (at 1 month) dizziness handicap inventory (DHI) scores and psychometric and motor parameters were compared. RESULTS: Sixteen patients completed the study. DHI scores in the tcDCS group showed significant improvement over those in the sham group (Mann-Whitney U test, p = 0.033). CONCLUSION: Vestibular rehabilitation partially combined with tcDCS appears to be a promising approach.
神経学的既往のない健常人37名(男性19名、女性18名、平均21.4±0.62歳)を対象とした。一人称イメージ:右下肢課題群、一人称イメージ:左下肢課題群に分けた。統計処理として多重比較補正によるfamily wise error(FWB)を用いた場合、右下肢課題群、左下肢課題群共に運動イメージ課題では、運動関連領野に有意に賦活する部位を認めなかったが、右下肢課題群、左下肢課題群共に運動実行課題では、運動関連領野が賦活した。統計処理として多重比較補正を行い仮説検定であるuncorrectedを用いた場合、右下肢課題群の運動実行課題は、左下肢課題群の運動実行課題と比較して、左右のBA40と右BA10及び左BA21の活動が有意に高かった。uncorrectedを用いた場合、右下肢課題群と左下肢課題群の比較で、第三者の動く足趾映像を見ながら運動実行課題を行った場合も、被験者自身の動く足趾映像を見ながら運動実行課題を行った場合も、賦活する共通部位があった。一人称イメージを運動イメージに結びつけて想起した場合、運動実行課題では左頭頂間溝前方部、イメージ課題では左腹側運動前野が賦活傾向にあった。
Abstract For clinical application of transcranial static magnetic stimulation (tSMS), it is important to achieve a focal target cortical stimulation. Previous study suggested that the associative stimulation combining non-invasive stimulation of the motor cortex (M1) and the peripheral nerve stimulation (PNS) may be useful to produce cortical excitability change. To test this hypothesis, we measured the M1 excitability and intracortical circuits by using transcranial magnetic stimulation (TMS) before and after the tSMS of short duration (5 min) combined with PNS. Thirty-three normal volunteers were participated; tSMS+PNS (n = 11), sham+PNS (n = 11), and tSMS alone (n = 11). We found the transient suppression of the motor-evoked potential (MEP) of the right abductor pollicis brevis (APB) muscle, but not of the abductor digiti minimi (ADM) muscle, when combining tSMS with PNS over median nerve at the wrist. The lack of suppressive effect on APB in tSMS alone with short duration is in accord with the previous observation. In addition, the tendency of transient enhancement of the short-latency intracortical inhibition was observed immediately after intervention in the tSMS±PNS group. These findings show that the combination of tSMS and PNS can induce the cortical excitability change in target cortical motor area and potentiate the suppression effect.
[Purpose] The purpose of the present study was to investigate the relationship between the external knee adduction moment (KAM) during walking and the biomechanical characteristics of single-leg standing in healthy subjects. [Subjects and Methods] Twenty-eight healthy subjects were recruited for this study. Data were collected while the subjects performed walking and single-leg standing using a motion analysis system with six digital video cameras and two force plates. Pearson's correlation coefficient was used to quantify the relationship between peak KAM during walking and single-leg standing. To determine whether the kinematic behavior of the pelvis and trunk during single-leg standing are associated with peak KAM during walking, Pearson's correlation coefficients were calculated and stepwise linear regression was performed. [Results] The peak KAM during single-leg standing was significantly correlated with that during walking. The peak KAM during walking was significantly correlated with the peak lateral lean of the trunk and the peak lateral tilt of the pelvis during single-leg standing. The results of stepwise linear regression analysis show the peak KAM during walking was partially explained by the peak lateral lean of the trunk during single-leg standing. [Conclusion] Our findings suggest that single-leg standing might be a useful method for predicting the peak KAM during walking.
【目的】通常の核磁気共鳴画像法(magnetic resonance imaging;MRI)では所見が不明瞭であるにもかかわらず,高次脳機能障害を後遺する頭部外傷(traumatic brain injury;TBI)患者の病変を明らかにするため,拡散テンソル画像(diffusion tensor imaging;DTI)のvoxel-based analysisの有用性について検討する.【対象・方法】慢性期のMRI所見が軽微なびまん性軸索損傷(diffuse axonal injury;DAI)による高次脳機能障害患者5例に対して,通常のMRIに加えてDTIを撮影し,fractional anisotropy(FA)値について,健常成人データベースとの間でstatistical parametric mapping(SPM)およびeasy z-score imaging system(eZIS)を使って解析し,Z-score 2以上のvoxelが表示されるFA変化マップを作成した.【結果】3例では急性期に通常のMRIを施行されており,そのうち2例において慢性期のMRIで所見が消失した急性期fluid attenuated IR(FLAIR)高信号領域に一致してFA値低下がみられた.4例で脳梁にFA値低下領域を認めた.4例で微小出血周囲にFA値低下領域を認めた.【結語】DTI voxel-based analysisは慢性期TBIにおいて所見が不明瞭となる軸索損傷の描出に有用である.(著者抄録)
PURPOSE: The purpose of the present study was to evaluate lower limb kinematics and muscular activities during walking, side-turning while walking, and side-cutting movement in athletes with chronic ankle instability and compare the results to those of athletes without chronic ankle instability. METHODS: Lower limb kinematics and muscular activities were evaluated in 10 athletes with chronic ankle instability and 10 healthy control athletes using a three-dimensional motion analysis system and surface electromyography during the 200-ms pre-initial contact (IC) and stance phases while walking, side-turning while walking, and side-cutting. RESULTS: During walking or side-turning while walking, there were no significant differences in kinematics or muscle activities between the subjects with and without chronic ankle instability. For the side-cutting task, however, ankle inversion angles during the 200-ms pre-IC and late stance phases [effect sizes (ESs) = 0.95-1.43], the hip flexion angle (ESs = 0.94-0.96) and muscular activities of the gastrocnemius medialis (ESs = 1.04-1.73) during the early stance phase were significantly greater in the athletes with chronic ankle instability than in the healthy control athletes. CONCLUSIONS: Alterations of kinematics in athletes with chronic ankle instability were found not only at the ankle but also at hip joints during the side-cutting movement. These alterations were not detected during walking or side-turning while walking. The findings of the present study indicate that clinicians should take into account the motion of the hip joint during the side-cutting movement in persons with chronic ankle instability. LEVEL OF EVIDENCE: III.
The objective of this work was to investigate the possibilities of using the wearable sensors-based H-Gait system in an actual clinical trial and proposes new gait parameters for characterizing OA gait. Seven H-Gait sensors, consisting of tri-axial inertial sensors, were attached to seven lower limb body segments (pelvis, both thighs, both shanks and both feet). The acceleration and angular velocity data measured were used to estimate three-dimensional kinematic parameters of patients during level walking. Three new parameters were proposed to assess the severity of OA based on the characteristics of these joint center trajectories in addition to conventional gait spatio-temporal parameters. The experiment was conducted on ten subjects with knee OA. The kinematic results obtained (hip, knee and ankle joint angles, joint trajectory in the horizontal and sagittal planes) were compared with those from a reference healthy (control) group. As a result, the angle between the right and left knee trajectories along with that of the ankle joint trajectories were almost twice as large (21.3° vs. 11.6° and 14.9° vs. 7.8°) compared to those of the healthy subjects. In conclusion, it was found that the ankle joints during stance abduct less to avoid adduction at the knee as the severity of OA increases and lead to more acute angles (less parallel) between the right and left knee/ankle joints in the horizontal plane. This method was capable to provide quantitative information about the gait of OA patients and has the advantage to allow for out-of-laboratory monitoring.
Abstract OBJECTIVES: Transcranial magnetic stimulation (TMS) has been used to measure cortical excitability as a functional measurement of corticomotor pathways. Given its potential application as an assessment tool in stroke, we aimed to analyze the correlation of TMS parameters with clinical features in stroke using data from 10 different centers. METHODS: Data of 341 patients with a clinical diagnosis of stroke were collected from studies assessing cortical excitability using TMS. We used a multivariate regression model in which the baseline cortical excitability parameter "resting Motor Threshold (rMT)" was the main outcome and the demographic, anatomic and clinical characteristics were included as independent variables. RESULTS: The variable "severity of motor deficit" consistently remained significant in predicting rMT in the affected hemisphere, with a positive β coefficient, in the multivariate models after sensitive analyses and adjusting for important confounders such as site center. Additionally, we found that the correlations between "age" or "time since stroke" and the rMT in the affected hemisphere were significant, as well as the interaction between "time since stroke" and "severity of motor deficit". CONCLUSIONS: We have shown that severity of motor deficit is an important predictor for rMT in the affected hemisphere. Additionally, time since stroke seems to be an effect modifier for the correlation between motor deficit and rMT. In the unaffected motor cortex, these correlations were not significant. We discuss these findings in the context of stroke rehabilitation.
女性のdrop vertical jumpにおける膝関節周囲筋の着地前筋活動と膝関節外反角度および外反モーメントとの関係を調査することを目的とした。健常女性18名を対象に、drop vertical jumpを行わせ、表面筋電計と三次元動作解析により膝関節周囲筋の着地前活動と膝関節外反角度および外反モーメントを算出した。結果、大腿二頭筋の着地前筋活動および半腱様筋/大腿二頭筋の着地前筋活動比率と接地後50ms時および最大の膝関節外反角度との間に有意な相関を認めた。本研究結果より、ハムストリングスの着地前筋活動パターンは、着地動作中の膝関節外反運動と関連すると考えられる。(著者抄録)
OBJECTIVE: Although recent studies have shown the suppressive effects of static magnetic fields (SMFs) on the human primary motor cortex (M1) possibly due to the deformed neural membrane channels, the effect of the clinical MRI scanner bore has not been studied in the same way. METHODS: We tested whether the MRI scanner itself and compact magnet can alter the M1 function using single- and paired-pulse transcranial magnetic stimulation (TMS). RESULTS: We found the transient suppression of the corticospinal pathway in both interventions. In addition, the transient enhancement of the short-latency intracortical inhibition (SICI) was observed immediately after compact magnet stimulation. CONCLUSIONS: The present results suggest that not only the inhomogeneous SMFs induced by a compact magnet but also the homogeneous SMF produced by the MRI scanner bore itself can produce the transient cortical functional change. SIGNIFICANCE: Static magnetic stimulation can modulate the intracortical inhibitory circuit of M1, which might be useful for clinical purposes. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
Abstract A number of studies have shown that non-invasive brain stimulation has an additional effect in combination with rehabilitative therapy to enhance functional recovery than either therapy alone. The combination enhances use-dependent plasticity induced by repetitive training. The neurophysiological mechanism of the effects of this combination is based on associative plasticity. However, these effects were not reported in all cases. We propose a list of possible strategies to achieve an effective association between rehabilitative training with brain stimulation for plasticity: (1) control of temporal aspect between stimulation and task execution; (2) the use of a shaped task for the combination; (3) the appropriate stimulation of neuronal circuits where use-dependent plastic changes occur; and (4) phase synchronization between rhythmically patterned brain stimulation and task-related patterned activities of neurons. To better utilize brain stimulation in neuro-rehabilitation, it is important to develop more effective techniques to combine them.
After watching sports, people often feel as if their sports skills might have been improved, even without any actual training. On some occasions, this motor skill learning through observation actually occurs. This phenomenon may be due to the fact that both action and action observation (AO) can activate shared cortical areas. However, the neural basis of performance gain through AO has not yet been fully clarified. In the present study, we used transcranial magnetic stimulation to investigate whether primary motor cortex (M1) plasticity is a physiological substrate of AO-induced performance gain and whether AO itself is sufficient to change motor performance. The excitability of M1, especially that of its intracortical excitatory circuit, was enhanced after and during AO with kinesthetic illusion but not in interventions without this illusion. Moreover, behavioral improvement occurred only after AO with kinesthetic illusion, and a significant correlation existed between the performance gain and the degree of illusion. Our findings indicated that kinesthetic illusion is an essential component of the motor learning and M1 plasticity induced by AO, and this insight may be useful for the strategic rehabilitation of stroke patients.
[Purpose] The purpose of this study was to determine the normal range of the side-to-side difference in three dimensional knee kinematics measured by the point cluster technique (PCT). [Subjects] The subjects were twenty-one healthy normal volunteers without knee pain or an episode of injury to the legs. [Methods] The subjects were tested bilaterally at a self-selected normal walking speed and six degrees of freedom knee kinematics were measured using the PCT, and the 95% confidence intervals of the average side-to-side differences in flexion-extension (FE), adduction-abduction (AA), internal-external (IE) rotation, and anterior-posterior (AP), medial-lateral (ML), superior-inferior (SI) translation in each stage of the gait cycle were determined. [Results] The average side-to-side differences and their 95% confidence intervals in rotation/translation in each stage of the gait cycle were determined. The side-to-side differences in AA rotation and AP translation of the tibia were significantly larger in the swing phase than in the stance phase. [Conclusion] The side-to-side differences in AA rotation and AP translation were highly dependent on the stage of the gait cycle. Therefore, the normal ranges of the side-to-side differences in knee kinematics in each stage of the gait cycle, in particular AA rotation and AP translation of the tibia, is useful information for evaluating knee kinematics during walking.
Recently, we have developed a new hybrid-rehabilitation combining 5Hz repetitive transcranial magnetic stimulation and extensor motor training of the paretic upper-limb for stroke patients with flexor hypertonia. We previously showed that the extensor-specific plastic change in M1 was associated with beneficial effects of our protocol (Koganemaru et al., 2010). Here, we investigated whether extensor-specific multiregional brain reorganization occurred after the hybrid-rehabilitation using functional magnetic resonance imaging. Eleven chronic stroke patients were scanned while performing upper-limb extensor movements. Untrained flexor movements were used as a control condition. The scanning and clinical assessments were done before, immediately and 2 weeks after the hybrid-rehabilitation. As a result, during the trained extensor movements, the imaging analysis showed a significant reduction of brain activity in the ipsilesional sensorimotor cortex, the contralesional cingulate motor cortex and the contralesional premotor cortex in association with functional improvements of the paretic hands. The activation change was not found for the control condition. Our results suggested that use-dependent plasticity induced by repetitive motor training with brain stimulation might be related to task-specific multi-regional brain reorganization. It provides a key to understand why repetitive training of the target action is one of the most powerful rehabilitation strategies to help patients.
[Purpose] The purpose of this study was to compare the upper, middle, and lower trapezius muscles' activity in the different planes of shoulder elevation. [Subjects] Twenty male subjects volunteered for this study. [Methods] Surface electromyographic (EMG) activity for each of the three regions of the trapezius muscles in the three different planes of elevation were collected while the participants maintained 30, 60, and 90 degrees of elevation in each plane. The EMG data were normalized with maximum voluntary isometric contraction (%MVIC), and compared among the planes at each angle of elevation. [Results] There were significantly different muscle activities among the elevation planes at each angle. [Conclusion] This study found that the three regions of the trapezius muscles changed their activity depending on the planes of shoulder elevation. These changes in the trapezius muscles could induce appropriate scapular motion to face the glenoid cavity in the correct directions in different planes of shoulder elevation.
[Purpose] Glenohumeral posterior capsule tightness possibly relates to posterior capsule thickness (PCT). The purpose of the current study was to analyze the relationships between PCT and glenohumeral range of motion (ROM) in horizontal adduction (HAdd) and internal rotation (IR). [Subjects and Methods] This study recruited 39 healthy collegiate baseball players. We measured PCT by using ultrasonography and ROM of the glenohumeral joint of the throwing shoulder by using a digital inclinometer. Pearson's correlation coefficients were calculated between PCT and HAdd or IR ROM. [Results] There was no correlation between PCT and HAdd ROM, but PCT was significantly correlated with IR ROM. [Conclusion] This result indicates that posterior shoulder capsule tightness only relates to IR ROM, and that restricted HAdd ROM might reflect tightness of other tissue, such as the posterior deltoid.
Purpose] The purpose of this study was to compare the intramuscular balance ratios of the upper trapezius muscle (UT) and the lower trapezius muscle (LT), and the intermuscular balance ratios of the UT and the serratus anterior muscle (SA) among prone extension (ProExt), prone horizontal abduction with external rotation (ProHAbd), forward flexion in the side-lying position (SideFlex), side-lying external rotation (SideEr), shoulder flexion with glenohumeral horizontal abduction load (FlexBand), and shoulder flexion with glenohumeral horizontal adduction load (FlexBall) in the standing posture. [Methods] The electromyographic (EMG) activities of the UT, LT and SA were measured during the tasks. The percentage of maximum voluntary isometric contraction (%MVIC) was calculated for each muscle, and the UT/LT ratios and the UT/SA ratios were compared among the tasks. [Results] The UT/LT ratio with the FlexBand was not significantly different from those of the four exercises in the side-lying and prone postures. The UT/SA ratio with the FlexBall demonstrated appropriate balanced activity. [Conclusion] In an anti-gravity posture, we recommend the FlexBand and the FlexBall for inducing balanced UT/LT and UT/SA ratios, respectively.
Accumulated signal noise will cause the integrated values to drift from the true value when measuring orientation angles of wearable sensors. This work proposes a novel method to reduce the effect of this drift to accurately measure human gait using wearable sensors. Firstly, an infinite impulse response (IIR) digital 4th order Butterworth filter was implemented to remove the noise from the raw gyro sensor data. Secondly, the mode value of the static state gyro sensor data was subtracted from the measured data to remove offset values. Thirdly, a robust double derivative and integration method was introduced to remove any remaining drift error from the data. Lastly, sensor attachment errors were minimized by establishing the gravitational acceleration vector from the acceleration data at standing upright and sitting posture. These improvements proposed allowed for removing the drift effect, and showed an average of 2.1°, 33.3°, 15.6° difference for the hip knee and ankle joint flexion/extension angle, when compared to without implementation. Kinematic and spatio-temporal gait parameters were also calculated from the heel-contact and toe-off timing of the foot. The data provided in this work showed potential of using wearable sensors in clinical evaluation of patients with gait-related diseases.
The aim of this study was to evaluate the thickness of the transversus abdominis (TrA) muscle in three basic postures in subjects with and without chronic low back pain. Subjects were classified into a chronic low back pain group (n = 27) and a healthy control group (n = 23). The thickness of the TrA muscle was measured at rest and during the abdominal drawing-in manoeuvre (ADIM) in supine, sitting and standing postures using B-mode ultrasound imaging. Contraction ratio (TrA thickness during the ADIM/TrA thickness at rest) was calculated for each posture. At rest, the TrA thickness in the sitting and standing postures was significantly greater than in the supine posture (p < 0.017) in the control group, but similar in all three postures in the low back pain group. TrA thickness was similar in the low back pain and control group in all three postures. During the ADIM, TrA thickness was significantly greater in the control group than in the chronic low back pain group in all three postures. The contraction ratio was also significantly higher in the control group than in the chronic low back pain group in all three postures. These results indicate that the automatic postural contraction of the TrA observed in the control subjects in the sitting and standing postures was not demonstrated in subjects with chronic low back pain. The present study revealed the one aspect of different response of the TrA muscle to changing posture between two groups.
BACKGROUND: Recently, several animal studies have found that spontaneous hyaline cartilage regeneration can be induced in vivo within a large osteochondral defect by implanting a synthetic double-network (DN) hydrogel, which is composed of poly-(2-acrylamido-2-methylpropanesulfonic acid) (PAMPS) and poly-(N,N'-dimethyl acrylamide) (PDMAAm), at the bottom of the defect. However, the effect of hydrogel on hyaline cartilage regeneration remains unexplained. The purpose of this study was to investigate the chondrogenic differentiation of C3H10T1/2 cells on PAMPS/PDMAAm DN gel. METHODS: C3H10T1/2 cells of 1.0 × 105 were cultured on PAMPS/PDMAAm DN gel in polystyrene tissue culture dishes or directly on polystyrene tissue culture dishes. We compared cultured cells on PAMPS/PDMAAm DN gel with those on polystyrene dishes by morphology using phase-contrast microscopy, mRNA expression of aggrecan, type I collagen, type II collagen, Sox 9 and osteocalcin using real-time RT-PCR, and local expression of type II collagen using immunocytochemistry. RESULTS: C3H10T1/2 cells cultured on the PAMPS/PDMAAm DN gels formed focal adhesions, aggregated rapidly and developed into large nodules within 7 days, while the cells cultured on the polystyrene surface did not. The mRNA levels of aggrecan, type I collagen, type II collagen, Sox 9 and osteocalcin were significantly greater in cells cultured on the PAMPS/PDMAAm DN gel than in those cultured on polystyrene dishes. In addition, C3H10T1/2 cells cultured on PAMPS/PDMAAm DN gel expressed more type II collagen at the protein level when compared with cells cultured on polystyrene dishes. CONCLUSIONS: The present study showed that PAMPS/PDMAAm DN gel enhanced chondrogenesis of C3H10T1/2 cells, which are functionally similar to mesenchymal stem cells. This suggests that mesenchymal stem cells from the bone marrow contribute to spontaneous hyaline cartilage regeneration in vivo in large osteochondral defects after implantation of PAMPS/PDMAAm DN gels.
我々は今回リハビリ特化型デイサービスを利用している高齢者で、運動機能・身体能力などの有効性と生活空間評価(Life space assessment:LSA)の効果を調査するため、30名の利用者に対しトレーニング前及びトレーニング1年後の各種筋群、握力、10m歩行速度、TUG、FES、LSA変化、さらにはトレーニング1年後のLSAに対する独立の影響因子を、前記各因子を用いて多変量解析を用いて検討した。その結果、1年後の前記各因子では、握力を除く全項目で優位な改善が認められた。しかし一方、1年後のLSA全体に対する独立の影響因子は認められなかった。居室から町内までの各レベルに分けてのLSAにおいても、その影響因子は抽出されなかった。したがって、他の何らかの因子が、よりLSAを規定する可能性がある。(著者抄録)
To test whether the right inferior frontal gyrus (IFG) plays role in the endowment effect, we investigated the effects of transcranial direct current stimulation (tDCS) of the right IFG on the willingness to accept/willingness to pay (WTA/WTP) discrepancy. Twelve healthy subjects underwent anodal, cathodal and sham tDCS on separate days. Stimulation was applied over the right IFG for 20min at 2mA. Subjects participated in the pricing task where they evaluated the presented items under WTA and WTP framings during tDCS intervention. The results showed that the WTA/WTP ratio after anodal tDCS was significantly higher than that after cathodal one. In addition, we found that the reaction time during the cathodal tDCS condition was significantly longer compared to those during anodal or sham tDCS conditions. Our findings suggest the functional relevance of the right IFG for producing endowment effect.
BACKGROUND: Several new procedures for medial collateral ligament (MCL) reconstruction using a hamstring tendon graft have been reported in the 2000s. However, the midterm and long-term clinical outcomes of these procedures have not been reported. HYPOTHESIS: Postoperative medial stability of the knee that underwent our MCL reconstruction may not be significantly different from that of the noninjured knee. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A total of 37 patients who sustained multiligamentous knee injuries underwent combined MCL and cruciate ligament reconstruction at our institution between 1994 and 2007. Thirty of the 37 patients were clinically evaluated at least 2 years after surgery. Sixteen had combined MCL and anterior cruciate ligament (ACL) reconstruction, 5 had combined MCL and posterior cruciate ligament (PCL) reconstruction, and 9 had combined MCL, ACL, and PCL reconstruction. The International Knee Documentation Committee (IKDC) evaluation form and Lysholm score were used to evaluate postoperative knee function. Anteroposterior knee laxity was examined with a KT-2000 arthrometer. To assess objective medial instability, we performed a stress radiograph examination under valgus stress with the knee at 20° of flexion. RESULTS: At the final follow-up, 1 patient showed a loss of knee extension of more than 3°. Five patients revealed a loss of knee flexion of 6° to 15° and 2 patients of 16° to 25°. Lysholm scores averaged 94.8 points. In the IKDC evaluation, 9 patients were graded as A, 17 were graded as B, 3 were graded as C, and 1 was graded as D. In the stress radiograph examination, the mean medial joint opening was 8.5 ± 1.6 mm in the reconstructed knee and 8.0 ± 1.2 mm in the healthy opposite knee. There was no significant difference in the medial joint opening between reconstructed and intact knees. CONCLUSION: Medial collateral ligament reconstruction for chronic combined knee instabilities can be safely performed using hamstring tendon autografts, and the clinical outcome with a minimum 2-year follow-up was favorable with satisfactory stability.
我々のリハビリ特化型デイサービスにおいて、要支援・要介護15人(平均年齢72.5歳:男性7人、女性8人)の利用者を対象に、筋力トレーニングマシーン及び集団スリングエクササイズを併用した運動訓練プログラムを週1回-3回まで連続して3ヵ月間施行した。施行前後の評価は握力、10m歩行速度、Time Up & Go Test、Falls Efficacy Scale、筋力テストを用いた。その結果、TUG、FES、レッグプレス(筋力)で有意な改善を示した。高齢者でも筋力、動的平衡機能を両方ともに改善する、利にかなった方法である。(著者抄録)