It is our great pleasure to take charge of organized session of International forum under cooperation of your China Rehabilitation Research Centre. We started a researchers association as "An academic meeting for the 21st century" in 1993, and renewed in 2001 to"Biophilia Rehabilitation Academy", with international section. International section has been concerning following states and territory, US, Saipan, Philippine, Australia, Canada, Cuba and Poland. We participated and could change a lot of information in every countries. We hope success the fifth Beijing International Rehabilitation Forum.
Rehabilitation cause will not get developed without international cooperation and communication. To promote the development of global rehabilitation cause, the 5th Beijing International Forum on Rehabilitation is to be held during Oct. 29-Nov. 1, 2010 in Beijing, jointly sponsored by China Rehabilitation Research Center (CRRC) and Norway Health & Rehabilitation Association. During that period, CRRC will jointly hold a sub-forum titled "Value Life" with International Biophilia Rehabilitation Academy for the first time. As the technical resource center and demonstrating window in the rehabilitation field in China, CRRC has annually held Beijing International Forum on Rehabilitation successfully for 4 years, setting up a platform of learning and communicating for the rehabilitation field in China, Asia, even the world. The theme of this forum is "Create, Integrate, and Share". There will be sub-forums in the following fields : value life, central nervous system injury and repair, SCI and new technique in spine surgery, uro-rehabilitation, nervous system rehabilitation nursing, management of rehabilitation organization, psychological & rehabilitation evaluation and therapy of the disabled, rehabilitation engineering and aids etc. We believe that this sub-forum will bring new conception to China, enhance the popularization of "Value Life" conception worldly, improve the human beings' welfare and expand the rehabilitation field. We have confidence that this forum will be another significant and successful international rehabilitation conference!
In facing an increasingly aged society, it is important for the disabled elderly not to slip into "acceptance of remaining disabilities" by the previous rehabilitation medicine but focus on "regaining physical functions as much as possible and enabling an independent living" by the Biophilia Rehabilitation. Our research, with official support, shows the fact that 30% of the bedridden elderly re-acquired walking from 1993. The results combined with other studies means that disabled elderly can gain some improvements over their disabled physical function even after being diagnosed as impairment.
As a member, I highly value the International Biophilia Rehabilitation Academy's(IBRA) short but valuable achievements in propagating rehabilitation medicine and techniques. The Academy has a rather unique multi focus on the scientific, clinical, and practical aspects of rehabilitation and, in particular, on antiaging strategies. As a medical scientist and a clinician, my interest focuses on respiratory rather than physical rehabilitation. Respiratory rehabilitation seems currently underestimated as a means of increasing longevity through increased delivery of oxygen to tissues and counteracting hypoxia creeping up on, due to old age and disease. Respiratory health also includes specific physical respiratory exercise which requires continued emphasis in old patients' care and in public health policy.
Thank you truly for staff that organized such a fulfilling meeting in China. In Japan the rate of the elderly exceeded 23% in 2010. In the near future China will reach to the aged society as well as Japan, the problem of nursing becomes serious. The research of this field becomes more important because the more the number of senior citizens increases, the more senior citizens who need nurser increases, I have been involved in rehabilitation from the field of mechanical engineering, too. In Yokohama National University, an exchange program with China is planned by the keyword of "Health". I expect China and Japan to lead the world in this field at the end.
"Biophilia Rehabilitation Academy" was developed from "the 21st Century Rehabilitation Study Group" which reviewed future rehabilitation and was formed in 1993 including the International Academy. Research of community rehabilitation was an important element within it. Ten years have passed since then. It has existed as an omnibus study group which has studied problems across all boundaries effecting rehabilitation regardless of socio-economic background from the beginning. Moreover, many problems (including medical cooperation, the medical treatment and welfare cooperation) which are reporting by mass communications today have also been reviewed since the beginning of the study.
The society of population pyramid inverted due to human beings' longevity by progress of science and technology. The 21st century of China and Japan will rush into the super-aged society which human beings have never before experienced worldwide. Japan runs the tip at top speed to the super-aged society, but a Chinese elderly population is increasing in speed. If elderly people's absolute number is seen, China is already the world's largest aging state. Chinese aged 60 and over population were 132 million people in 2000. It is a number which is already equal to the overall population of Japan. The Chinese elderly population aged 65 and over broke through 90 million people by the end of 2009. It turned out that 9.6 million of them could not provide for themselves through single support. According to the newest data in 2009 of mainland China, population aged 60 and over occupies 12.5% of population by 167 million people. It increases at 3% or more every year. The elderly population aged 80 and over amounts to 18 million people, it increases at 5% every year. The supply and demand seems not to be balanced for elderly-people welfare in China as the officials said. The problem of aging for both countries should resolve immediately that all the elderly people are able to receive nursing services and medical treatment. Although the author is a generation who does not know the war, the influence to the people, especially for the next generation is so serious that it can compare with the disaster of the war. If disabled soldiers and/or disabled veteran's care is considered, the disabled elderly requiring care are synonymous. The increasing number of disabled elderly in both countries is exceeding that it of the previous war for the next generation. It may be called "the aging crisis" as the author used for these 20 years.
Recently, the number of stroke patient has been increasing in many countries including Japan according to aging of population. Besides the number of physical therapist (PT) has not increased despite of the aging of society and the absence of PT is one of the social problem. Therefore an own forcing training is required on behalf of externally forcing training by PT. Biophilia institute made some devices for rehabilitation, which device called "Pata-Koro", and it is reported that the devices are valid for own forcing training. In this study the purpose is to measure brain activity by fMRI and NIRS at the rehabilitation training. First, we perform image processing MRI image and NIRS image at the rehabilitation training. Next, the correspondence relation of fMRI image and NIRS image is discussed and the feature of rehabilitation score of fMRI and NIRS. Since fMRI is ill-suited for fMRI inspection because we cannot bring the devices of rehabilitation at the inspection, and we decide the use of NIRS for measurement at rehabilitation. Final goal of this study is to analyze the time-dependent change of brain function by rehabilitation effect using NIRS.
The rehabilitation service for the outpatients under the nursing-care insurance seems to keep up their physical function due to mainly servicing the chronic case patients. The result of national statistics shows a heavy burden being placed on the nursing care degree for that service. The rehabilitation facilities which introduced the Takizawa program into the basic individual rehabilitation programs for the neuromuscular re-educating and basic motion training have shown improvement of physical function and abilities of daily living. The 18 outpatients' medical records on the nursing care degree, independence degree and rehabilitation process from their beginning to March 2010 were examined and summarized following the national records summary. The functional brain evaluation by the near-infrared optical topography device (fNIRS) was enforced in order to research the mechanism of the improvement.
The main objective of this health care facility, which focuses on the care of elderly people, is to enable the disabled elderly to return home. To achieve this, we are rehabilitating in and out patients to assist them in acquiring the ability to do so. Our main method is the rehabilitation with self-action or assistive exercises. At the introduction of the motivative exercise, we made two groups, one with the motivative exercise and the other without, to evaluate the effect. The motivative exercise we are introducing at this time is a kind of rehabilitation by self-exercise. The subject performs these exercises using devices which make bilateral movement for both legs in order to make the affected side leg active by the movement of the unaffected side. Since the bilateral movement exercise was reported to affect brain function, we report the evaluation of brain function (fNIRS) with optical topography system with function of legs.
PET imaging studies using radioactive marker allows the examination of neurotransmitters or transporter ligands, regional cerebral blood flow(rCBF), regional metabolic rate of glucose (rCMRglc), and regional metabolic rate of oxygen (rCMRO2), thus can indicate the signaling viability of nerve cells in a given brain region.
It is necessary to evaluate elderly's walking ability correctly to execute rehabilitation effectively, and to do appropriate training. However, a walking ability is usually judged qualitatively by physical therapists. Moreover, a manpower shortage and an increase of senior citizen is an issue. In this paper, it aims at the construction of the system that can quantitatively judge a walking ability by choosing the evaluation item with a high correlation between the walking ability and parameters obtained from measurement results.
We have been dealing with a measuring device to improve. The points of the improvement are divided into two devices, indoor wireless communications for devise and use the internet to get the users' data. As a result below, we report that the device which is able to collect and analyze biological data have been developed, and we started a registered clinical test by collecting the data.
Few patients can survive after severe crushing pelvic traumas which is an indication of hemicorporectomy (HCP, also called translumbar amputation). Prosthesis is essential for such patient to regain standing and walking ability. This article aimed to describe the rehabilitation of a Chinese HCP amputee and evaluate his mobility devices from a prosthetist's view. Case study method was used. A 46-year-old male patient came to our hospital 3 years after accidental emergency amputation from pelvis. Team workers included orthopaedists, prosthetists, physiotherapists, engineers and social workers. It took over 5 months for the patient to attain most of activities of daily living independent. Four mobility devices were designed and provided to him: a self-suspending socket, a modified wheelchair, a custom cart and a reciprocating gait prosthesis. Socket/stump interface pressure tests showed that the main weight bearing area was at the lower thorax. Pulmonary function tests revealed that the sockets limited thoracic movements so that vital capacity was reduced by 7%~13%. Energy expenditure tests indicated that walking with prosthesis consumed more oxygen than hand walking with socket, followed by wheelchair and custom cart which cost the least. All the results suggest that thorax can bear human weight. Although sockets limited the patient's thoracic movement, it is the basis to help him stand up and use other three mobility devices.
As one of the rehabilitation methods for disabled elderly to be independent, the exercise devices, this can perform motivative exercises that an unaffected side extremity leads the exercise of the affected side extremity, has been developed and used. In order to quantify the motivative exercise, it was necessary to develop the device to evaluate it, so our developing section members have been developing and practicing engineering and medical tests. The developed device is not used by any physical therapist in the rehabilitation scene. We carried out the test to use by the physical therapists at a rehabilitation center for outpatients in Oita Prefecture for the safety use. The reliability, durability, and practicality of the device for ankle flexion and dorsiflexion and knee extension exercises were evaluated for three months. We evaluated the effect for out patients by body temperature changes. The results of the examination for three months, which was carried out safely and outcome of body temperature were collected are reported.
The lecture focuses on age-changes in the lungs, their clinical consequences, and the physical rehabilitation strategies which could potentially slow down the process of respiratory health deterioration in old age. Lung aging is a complex process involving genetic, environmental, and life style factors. Structural age-changes in lung parenchyma consist of declines in lung surface area, supporting lung tissue, and consequently in the amount of air in terminal bronchioles. Pulmonary surfactant is essential for maintaining lung function. In an ultrastructural study we found that that the surfactant-producing lamellar bodies of type II pneumocytes and tubular myelin unfolding from the lamellar bodies degenerate in the lungs of senescent, but otherwise healthy, rats. There are gaps and blebs inside the lamellar bodies and cellular debris protruding into the airspace. The extracellular epithelial lining layer is made up of membranous entities chaotically strewn about, instead of regularly shaped tubular myelin mesh forming a solid layer integrated with the plasma membrane of type II cells, so characteristic of young lungs. Surfactant dysfunction in senescence may have an impact on gas exchange and susceptibility for infection in old age.
Nerve plastic theory is the important neurophysiological basis in clinical treatment and rehabilitation therapy of CNS disease, it has been learned and researched for long time. But there is few articals reported ahout how to use this theory in clinical treatment and rehabilitation therapy of CNS disease systematically in China. Here we attempts to use the theory, combining clinical with rehabilitation treatment experience, to discuss how to recognize the onset, clinical treatment and rehabilitation training, (part) recovery process of CNS disease systematically, in order to combine the theory with practice in a better way and provide guidance and advice to clinical treatment and rehabilitation therapy from the perspective of neurophysiology.
1. Analysis the application of the elements and components of the normal postural movement in stroke sequela and other central nervous disease patients' treatment. 2. Through the analysis of common factors of human movement, we try to find out the elements to promote hemiplegia patients' future movement and the components of pattern. 3. Normal movement is the action due to normal reciprocalinnervation ultimately in the spinal level. It is possible to repair reciprocal innervation in stroke patients through normal movement.
It is a great pleasure to extend this greeting in holding of "The 8th International Biophilia Rehabilitation Conference" on behalf of the Embassy of Japan in China. The needs for rehabilitation are growing with the increase in elderly people and services of them in both of our great countries. It is very meaningful that the experiences within this field in Japan and China are introduced mutually through the presentations of the research results and opinion exchanges about the functional recovery of advanced-age disabled persons, such as bedridden elderly, are performed in this conference. It encourages and activates the exchange of people who are engaged in the functional recovery of elderly and disabled individuals in both countries. It is my sincerest desire to increase a cooperative and productive relationship in this field between our two great nations in the future starting with the success of this conference.