It is my honor that I can write a foreword as the chief editor of the BIOPHILIA journal, in which I emphasizes that the restructuring of the rehabilitation medicine is indispensable. Although this special issue is re-printing papers, there is a big meaning for the advanced age disabled person keeping lives independently in the world, and I share it with you, readers. I hope that PubMed application is permitted with the special number publication, and also that the registration will be permitted. The permission leads also to apply not only to PubMed publishing but also an application to the Web of Science. That is, the BIOPHILAI journal which we started develops as human beings' property, and becomes an opportunity to contribute greatly. I indicate the following matters in this foreword in order to clarify the importance of this special number and the next; i) How do advanced doctors and us consider rehabilitation medicine? ii) What reactions have been shown by some persons concerned about the Rehabilitation Medicine restructuring? iii) How is the social situation changing in relation to reactions? and iv) How is the recognition of the society related to our presentation? There is a limitation of the space in a foreword, therefore please read our printed articles for detail. I express profound gratitude to the committees of The Japanese Biophilia Rehabilitation Academy and the member of The Editorial Board of the BIOPHILIA journal which gave me this opportunity to republish.

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I have cooperated with the International Biophilia Rehabilitation Academy in order to be of help for this Academy development. The Academy’s activities have been steadily growing in importance. Recently, the Academy’s main journal has been introduced with 8 volume issued since 2011. The greeting note for a previous issue remains actual, so let it be published again. “Those who are involved in medical treatment and rehabilitation often see someone who moves an arm, diagnosed as being impaired or paralyzed, with the other healthy hand. That is tantamount to a kind of PASSIVE EXERCISE by a physiotherapist, except that the beneficial effect of such movement would be enhanced. However, it is rather impossible to move a paralyzed leg by one’s healthy hand due to inconveniency and the sheer weight of a leg, i.e., the load would be too much. The question arises of what effect is to be expected when the patient would be able to move his own paralyzed leg. That question has been the starting point of my cooperative research in medicine and engineering devoted to medical rehabilitation. A simple device has been designed in Japan to perform such moving of a paralyzed leg by the other healthy one. Since then, I have participated in this research and have been searching for the underlying physiological mechanisms of the beneficial effects. The effects of such self-training apparently consist of a boost to cerebral function due to enhancement in cortical blood flow. Rehabilitation of a paralyzed patient with PASSIVE EXERCISE performed by a physiotherapist has been done for years. However, the nature of impairment basically persists basically unchanged. To improve the present state of rehabilitation by seeking the physiological underpinnings of a handicap we propose that molecular genetics could contribute to the diagnosis or judgment of medical results obtained. That could be achieved by cooperative research efforts in the field of medical engineering in rehabilitation.” I reviewed a number of articles which were published by Japanese researchers in a Japanese journal, read by the international research community. I am sure that these articles will contribute to the improvement of human welfare.

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I served as the first president at the time of Biophilia Rehabilitation Academy establishment, which had been called the 21st century rehabilitation study group till then. The assumption of the president greeting at the time of Academy establishment, I expressed “I expected much more research efforts of member in order to realize from “care and dependence to independence” and “elderly requiring nursing care generating to be a little less than 10% from 16% in 2025 assumed”. I am pleased with the situation and activity where the Academy is continuing the activity which turned its eyes not only to domestic but also to the world as the same in expectation.
It was the center for me taking office as the president of this Academy that "I watch efforts of Prof. Takizawa and his associates to abolish bedridden and the result to be obtained by their efforts.” He was a youth lawmaker of Fujisawa expected much to attain greatness as a politician. He had been a person of great insight of the aged society and had had a broad outlook. Therefore He noticed the peculiarity of the result of kinetic training and the technique that nobody had noticed and the rationality that enabled it to methodize. He relinquished a city lawmaker position to successors and didn’t accept the candidacy request of the outgoing prefectural assembly chairman that had meant to be a lawmaker of the House of Representatives and dealt with the study.

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I was asked to submit the congratulatory address in publishing a memorial edition in order to apply the PubMed registration in USA.
The aging of a human being which he has foreseen is clear. Prof. Takizawa knew the inevitability of that and has continued the challenge to prevent the social disruption. Nobody would have expected that the endeavor of preventing the social disruption by the aging process of societies, which was named the Aging crisis, can be achieved by cooperation of doctors in the world.

This memorial edition can contribute to the improvement in the welfare of human beings greatly, and also I am sure that people who collaborate with him can prevent the Aging crisis.

Now, I write recollections to a congratulatory address. Prof. Takizawa who is a chief editor of the BIOPHILIA journal and his daughter have been my patients. It seemed that my soliloquy as "Why did he run as a candidate for a mayor? (Success in an election was not expectable)" was transmitted to him from her at the time of his defeated mayoral election. At the situation that she attended my hospital regularly, I got his letter. I remember that I was very much surprised at receiving his letter despite the twenty years that have elapsed from that time.
The letter was related the meaning of the election campaign as follows; “Anxiety to an aged society arriving” and “It is possible to remove the anxiety since elderly people independence can be attained by the rehabilitation medicine innovation. And the campaign should enable the innovation as a seed.",
"It can be predicted that laboriousness and the length in order to reach the purpose." and “There is a necessity to deal with it from the viewpoint of philanthropy without fearing a result although it is very difficult for him to return to "politician." and “As a conclusion, he explained that he had committed himself to live with a social contribution in his school days.”
Although there wasn’t any doctor in the study group till then, it was a weakness of an implementation of the study. I heard that doctors who had looked at this election participated in the study. It seems that his challenge which doesn’t fear his failure result induced the supposition result.
It was my pleasure to know the progress of studies by the report of the Japan wire agency “Jiji Press” that were offered by him from time to time after that.
I send sincere praise to the members of the research team of medicine, engineering, and social science which cooperated closely like the "family" who consists of a volunteer with him in the world, and expect progress of the future research from now on.

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The cushion, the upper extremity function training device, the simple ankle plantar flexion and knee extension and flexion training devices, the flexible leg brace, the RAKU walker and the shower chair combination Raku walker with stoppers to get over a step with the slides were developed and used. By using these devices, the movement of the functioning extremity accompanies the movement of the impaired extremity. The painless motivative exercise improves the impaired extremity with extension of the range of motion or ROM instead of the passive exercise. Disabled bedridden patients who were adapted for ROM exercise depending on own general conditions were taken out to the training room by using the wheelchair. Passive exercise on mats as ROM exercise in the training room has been never done for them. The motivative exercise reinforces the muscle force of trunk and extremities and extends gradually ROM of the knee and foot by one’s own pace without pain. 59 people in 193 inpatients have acquired walking from bedridden by the rehabilitation that was based on the motivative exercise.

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We propose to downsize the occurrence of the disabled geriatric population from 16% to 10% or less in Japan and show how to realize it by showing past studies. The Takizawa rehabilitation method has been effective to reinforce the muscle force of the trunk and extremities for bedridden patients with a stroke, osteoarthrosis and other medical problems can be extended gradually by pacing without pain in the sitting position and by using the devices developed. One therapist can perform this process for many patients at the same time by the Takizawa method with the Motivative exercise. Both nurses and caregivers can rehabilitate them with appropriate guidance. We show the characteristics of the motivative exercise comparing to passive exercise and the possibility to substitute for passive exercise . The Takizawa method with the Motivative exercise contributed to the disabled elderly achieving care-independence. Therefore, we insist that the Takizawa method with the Motivative exercise enables budget cuts and will realize our proposition. The method contributes to the resolution for the aging crisis.

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Most of all the patients with double-hemiplegia due multiple infarctions who become bedridden cannot reacquire walking. We have rehabilitated a bedridden inpatient with double-hemiplegia, mainly with the motivative exercise according to the instructions of the Takizawa method rehabilitation in a hospital. A woman, 91 years old at the time of hospital admission had improved ADL, reacquired walking after being bedridden, became independent of toilet activities and maintained independence of the activities of daily living (ADL) for 3 years. We report the feasibility of the rehabilitation process of the Takizawa method and the progress of ADL.

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Elderly cases offered Takizawa method as one of the rehabilitation techniques were evaluated statistically. Initially we clarified the characteristics of the total FIM (Functional Independent Measure) score and the relation between the number of improved items and of worsened ones. Furthermore, we investigated the multidimensional relevance of 18 FIM items to explain the characteristics of improvement or aggravation clear, and obtained four factors by factor analysis and classified into six groups by cluster analysis, and then extracted some specific cases. Finally, we statistically verified the effect about the 18 FIM evaluation items using the t-test, a sign test and the Wilcoxon signed rank sum test, and several items in the FIM were turned out to be significantly effective.

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We enforced the construction of a community rehabilitation network for the autonomous rehabilitation of the disabled elderly by the official grant. We distributed the prepared manual and devices developed for subjects in order to perform the rehabilitation exercises. 47 disabled elderly 13 Aftereffect of cerebrovascular accident,（9 hemiplegia left, 3 hemiplegia left and one another）, 8 knee osteoarthritis, 7 lumbar spinal stenosis and 19 others were involved as subjects. The change of a body situation depended on the Long-Term Care Insurance Survey (LTCIS) including the Degree of Independent Living for the Disabled Elderly (DILDE) was analyzed with changes in the level of care. As a result, the sitting ability with both feet on Ground has improved significantly (P<0.05). From these research findings, it is thought that the possibility of enforcement of the autonomous rehabilitation and home implementation of it has been specified for the disabled elderly.

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We have researched the reality and the future of the consumer education to the elderly as well as elderly with slight dementia supported by the Grant of Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT). We executed the questionnaire investigation and the evaluation for the experiments. We report in this paper about those contents, the results of the mail survey and the future way of advancing our plan. The mail survey shows that (a) social welfare facilities will be short, therefore a consumption education for the elderly will be needed, and also (b) we should enrich the nursing care of the society and increase the number of people talented for welfare and nursing care.

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We assessed a new type of walker with a seat and fore sleds for use in both faculties and at home. This walker has been named “RAKU walker”, with 4 casters and a pair of sleds besides the front casters. 47 patients were evaluated for this study. Quite an improvement was observed in FIM items (bathing, toilet use, self grooming, transfer and locomotion) in the initial interval. Patients above 75 years and below showed similar improvements. Clinical success of this walker depends on both the analysis of patient needs and proper selection of the patients.

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The elderly population of Japan of 65 years old or more increased rapidly, and reached 19% in 2003. Various strategies are necessary so that the aged may maintain healthy life. It appears to a physical function as a good influence if a mental function is activated for the aged. This time, the relation between a result and body various functions to practice the consumption behavior for a weak senior citizen and the slight dementia senior citizen were assumed and the relation to the state of mental was assumed to be an examination. Subjects were divided randomly into two groups, with one group (Cons-G) actually taking place in consumption activity, and with other group (W-G) only having a watching activity in the shopping center. Depression scale and face scale showed the improvement tendency in C-Group. It has been understood to cause the influence on a mental function with a physical change through this consumption behavior. It is necessary to grope for an effective technique achieving relations and these that achieve such senior citizen individual's needs.

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The priority of Proprioceptive Neuromuscular Facilitation (PNF) to hemiplegic patients on the affected side must be reconsidered due to a lack of effect in its procedure. By the improvement of the theory and techniques of PNF, the improvement of therapeutic effects on hemiplegia patients could be expected in connection with their progress, however the outcome of medical examination has hardly been changed on hemiplegia patients at the clinical aspect over the last 40 years. Although PNF is thought to be more suitable for the normalization of a movement pattern to perform synthetic coordinated movements by affected side priority, it takes too long to lead to the active contraction of the peripheral muscles. Sometimes, even the atrophy of an unaffected side and the trunk can be seen. In considering the PNF of unaffected side priority the effect of facilitation is larger than that of affected side priority. Therefore, if the unaffected priority is used a smaller number of patients will be bedridden by atrophy and contracture. From the recent research on new born power of a neural stem cell (NSC), the elucidation of the mechanism for the effectiveness of the kinetic rehabilitation by the unaffected side priority enables us to expect the functional recovery of a damaged area. The NSC would also affect to the rehabilitation in the realm of the nervous system. It's recommended to try to use and get the evidence of PNF by unaffected side priority.

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Various social problems in an elderly society are global issues in today’s society. Aging proceeds globally in the world while Japan is expected to become a super-aged society in an unprecedented short term. An increase in the elderly population, including the disabled, demands the expansion of social security-related expenditures, which confers an unbearable burden to the following generation. These “Aging Crises” would give rise to the collapse of the social system. We are here to emphasize the importance of the integration of the elderly population toward the productive society and in the reform of the life cycle that is currently refined by education, labor, and retirement. In order to establish a sustainable society, in which the elderly can be independent, we need to explore the occupations that are suitable for the elderly and reduce social security-related expenditures. In our research scheme, we conjugated the related research fields including medical science, engineering, and social science in order to integrate the various aspects of a complex aged society. The recent progress in our research project is reported.

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It is important to go ahead with the plan which combines local communities with concerned individuals and to work together in an effort to accomplish community-based positive health. In this article, the health education program maintains an objective of positive health of women of middle or advanced-age. Planning, operation and evaluation were used to develop an empowerment technique. Women of positive health class were admitted based on body composition, energy and blood lipid item. They appeared to be most interested in the motivation of thinking and continuing the execution of improvement of their lifestyles. It has been determined that the academic board which employed epidemiologic method bringing long term continuing positive effect and QOL into view is important, in order to carry on better estimate and remediation of education.

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The purpose of the present study was to determine the response of glucose (G), insulin (In) and insulin like growth factor (IGF)-I to eccentric (ECC) vs. concentric (CON) resistance exercise in healthy trained and untrained subjects. Venous blood samples were drawn before and immediately after the test, and during 1-hour recovery for the determinations of hormonal and somatomedin concentrations. As compared to resting values, the maximal eccentric (ECC) resistance exercise test caused a significant decrease in G level (p<0.05). Significant differences were observed in post-exercise G level during ECC exercise (p<0.05). Different types of muscle contractions (ECC vs. CON) and resistance training had a significant effect on serum IGF-I concentration at maximal exercise intensity. A significant increase in IGF-I concentration was observed in response to eccentric muscle contraction in trained subjects compared to the control. Conclusions: These results seem to have demonstrated that in healthy subjects increased serum IGF-I concentration might be responsible for better glucose transport during resistance exercise, and this predominantly in eccentric muscle contraction.

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TAKIZAWA, Taki Shigeo
Mieczyslaw Pokorski
GELU ONOSE
Yoshiyasu Takefuji
Takuji Shirasawa
Hajime Takada
Toshiyuki Tanaka
Hiroshi Nagasawa
Camillo Di Giulio
Raoul Saggini
Jose Leon-Carrion
Yoshiko Morita

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