The Journal BIOPHILIA 2017 (2)

The Proceedings of IBRC 2017

"Rehabilitation in XXI Century - Aging and Life Couse" and

the Proceedings of workshop Biophilia 2017

"Brain Activity" and "Overcome Disability"

6-7 Oct. 2017 In Ustron, Poland

Hosted by;

International Biophilia Rehabilitation Academy

The Academy of Physical Education, Poland Medical University of Silesia, Poland

Co-Hosted by;

Medical University of Silesia,

University "G.d'Annunzio"-Chieti-Pescara, Italy

Biophilia Rehabilitation Academy of Japan

Supported by:

Embassy of Japan in Poland

Japanese Society for Rehabilitation of Persons with Disabilities

Japanese National Foundation, Association for Technical Aids

Prof. Aleksandra Zebrowska, PhD.. Academy of Physical EducationProf.

Dariusz Jastrzebski MD.PhD. Medical University of Silesia

Prof. (Taki) Takizawa, Shigeo, (Founder / Inventor) Biophilia Institute, The Designated and Registered Institute by the Japanese Ministry of Education, Culture, Sports, Science and Technology

President, International Biophilia Rehabilitation Academy

Greetings from chairperson of organizing committee of the the 14th International Conference on International Biophilia Rehabilitation Academy (IBRC 2017)

Dr hab. Aleksandra Zebrowska, Professor of Department of Physiological and Medical Sciences, Academy of Physical Education, Katowice, Poland

On behalf of the organizing committee, it is my great pleasure to welcome you to The 14th International Conference on International Biophilia Rehabilitation Academy. IBRC 2017 will be held from the 6th to 7th October, 2017 in Ustron, Poland.

The IBRC 2017, which is held every year, follows the successful tradition of the previous meetings in Warsaw, Poland, Seville, Spain, Chieti, Italy, Tokyo, Japan, and the last year in Geneva. IBRC provides an ideal academic platform for researchers to present the latest research findings and describe rehabilitation methods as well as directions in Rehabilitation and Physiotherapy Sciences issues. The conference seeks to contribute to presenting novel research results in all aspects of Rehabilitation of the aging, Neuro-, and Cardiopulmonary Rehabilitation.

The conference aims to bring together leading academic scientists, researchers and research scholars from around the world to exchange and share their experiences and research results about all aspects of Rehabilitation in the XXI Century.

The scientific program will focus on current advances in the research, methods, and use of rehabilitation equipment. The conference's goal is to provide a scientific forum for all international prestige scholars around the world and enable the interactive exchange of knowledge. The conference will focus on evidence-based benefits proven in clinical trials and scientific experiments.

I hope you will join us at the conference and have a great time in our mountains resort of Ustron, located in the south of Poland, where the unique mountain climate and picturesque location in the Beskidy mountain range promote both relaxation and physical activity. Along with the members of organizing committee, I look forward to meet you in the Ustron Health Resort, coming October.

With very kind regards,

Dear Friends;

It’s a great honor and big pleasure for me to invite you to Ustron to take part in the International Conference “Rehabilitation in XXI Century - Aging and Life Course”. Thanks of Uzdrowisko Ustron Health Resort which host the conference this year we have the opportunity to meet together in the beautiful Beskid Mountains.

I am sure that amazing views and clean air will be inspiration to fruitful deliberations. This year, first time in the history of Biophilia Academy Conferences separate session was dedicated to cardiopulmonary rehabilitation. While the cardiac rehabilitation is well-founded in everyday practice, the pulmonary rehabilitation is still ‘terra incognita” in many fields. Despite the fact, that we start our life and end it with the first and last breath. Dyspnea, cough is common not only in the lung diseases. Especially in the elderly those symptoms become across - the board and substantially worsen the quality of life. I am grateful for Biophilia Academy that this year Pulmonary Rehabilitation gains a chance to become crucial element of that Congress.

I am sure that your scientific enthusiasm will be inspiration for new goals of rehabilitation in the 21st century and happy that “International Conference “Rehabilitation in XXI Century - Aging and Life Course” could be helpful to achieve them. I wish you a pleasant stay in Ustron With very kind regards,

Dear colleagues,

On behalf of International Biophilia Rehabilitation Academy, I am pleased to extend my heartfelt greetings to my friends all over the world in holding IBRC 2017.

It is my honor to be one of the chairpersons of IBRC2017 with Prof. Aleksandra Zebrowska and Prof. Dariusz Jastrzebski.

There were eventful conferences to look back on and the most memorable one was in Fujisawa in 2005 which was entitled "The retrospect and regret on the proprioceptive neuromuscular facilitation techniques" chaired by Dr. Fukui who is a famous rehabilitation doctor in Japan. Since then we have proposed the innovation of rehabilitation medicine.

I was afraid to become "EI ingenioso hidalgo Don Quixote de Ia Mancha" in high probability because of my decision in my mind to restructure the rehabilitation medicine in 1987. We have been studying the innovation of Rehab. Medicine by studying integrated study subjects such as Rehab. Medicine, Engineering, Social science and Public Administration.

I have no doubt whatsoever that I am not 'Don Quixote'. Because the World Health Organization sent us the presenter last year. And we could show the result of our studies of Motivative exercise on the brain.

We hold IBRC 2017 with the Health resort Ustron, Academy of Physical Education and Medical University of Silesia under such progress of research in Ustron, Poland this year.

I wish that IBRC 2017 is useful for the progress of the related studies and becomes a fruitful meeting for participants.

In closing, I express my gratitude as a president of International Biophilia Rehabilitation Academy to all persons who work hard for holding IBRC 2017.

Thank you!!

I welcome with pleasure the opportunity to attend the 14th International Biophilia Rehabilitation Conference (IBRC) to be held in a small mountainous resort of Ustron in southwestern Poland on 6-7 October 2017. The venue of the conference is a rehabilitation sanitarium. It is not an accidental choice as the conference is devoted to modern rehabilitation approaches. Rehabilitation is the field of many virtues, which focuses on the care of individuals and communities. It provides therapy, often combined with a diet or exercise regimen, for rest and recuperation so that convalescents attain and maintain optimal health and quality of life. Although rehabilitation is often understood as reestablishing bodily functions damaged after major external traumatic or diseased neurological events, it notably concerns the physical and mental spheres of the chronically ill and the aged.The IBRC is a scientifically focused conference that would lay a forum for the expert exchanges and discussions on the ways to revolutionize the rehabilitation field to be able to cope with a sharply increasing population of the elderly worldwide, and thus increasing morbidity requiring post-treatment physical and mental rehabilitation on the one side, and a deepening shortage of certified rehabilitators, which causes a dissonance between demand and need, on the other side.

The IBRC covers a wide range of critically important issues, from basic research to innovations, in the field of rehabilitation. The conference advocates a change in the rehabilitation paradigm consisting of so-called motivated rehabilitative exercise that involves the patient’s own psychosomatic skills to reacquire lost functions. Motivated rehabilitation activates the brain’s dormant reserves and appears conducive to patient satisfaction and well-being and also lowers the rehabilitation burden and costs. The conference aims to drive policy changes that would meet the health needs of patients and the expectations of society. This is a remarkable event that brings together a mix of academicians, clinical practitioners, and allied professionals interested in discussing novel research, innovative ideas, and models of best rehabilitation practice.

The 2017 IBRC is posed to restructure the rehabilitation field to help avoid becoming frail and disabled.

It is a great pleasure to held the 14th International Biophilia Rehabilitation Conference (14th IBRC) in Ustron, Poland, on October 6-7, 2017.

I am Toshiyuki Tanaka, chairperson of Biophilia Rehabilitation Academy in Japan. I am part of the Faculty of Science and Technology at Keio University, which is a long-established private institution founded in Japan in 1858 by Yukichi Fukuzawa. Keio University is well known to researchers worldwide for the students and professors who produce high-quality research. My research field is pattern measurement, including medical image processing and computer-aided diagnosis. In recent years, hospitals have seen increases in the number of patients, in step with the aging of the population. Following advances in medical devices using techniques such as fMRI, fNIRS, and X-ray CT to support the work of doctors, the precision of diagnosis has risen markedly. However, it seems that the burdens on doctors have not lessened. To reduce these burdens, we are developing a diagnosis support system using medical image processing. We have promoted the construction of new rehabilitation system that one physical therapist treats several patients with easy devices, which was called “Takizawa method”.

The international Biophilia Rehabilitation Academy (IBRA), which is a sisterhood institute of BRA in Japan, has worldwide revolved the promotion of new rehabilitation system. In consequence, IBRA has achieved a harmonious relationship with Poland, Italy, Romania and so on. In this year, we have an international conference in cooperation with the Health Resort, where is in a wonderful atmosphere of Ustron. We appreciate the chair of organized committee in Ustron.

The BRA in Japan shall be glad to serve IBRC 2017 in any way in our power. Through a workshop and research exchange, we hope that the 14th IBRC will provide the opportunity to introduce important innovations in the field of the rehabilitation.

The experience matured during the collaboration with IBRA (International Biophilia Rehabilitation Academy) every year enables us to deepening the area of neurological disorders in the advanced rehabilitative contexts related to it.

This partnership allows all the participants to discuss in the light of the inherent international literature and of every own experience matured during time and also to speak in a context debated at international level but also in scientific literature.

We can implement, enhance and potentiate the particular fields of Physical And Rehabilitative Medicine which is actually projected to the recovery of illnesses related to the psyco-bio-socio aspects of the person only through the collaboration and the exchange of knowledge.

The Man, considered as a complex biomotor biosystem, needs, when afflicted by a neurological illness, to recover his residual potential so he can adapt the corporeal system to the different condition to which it is subjected: that is how he can realize a continuous dynamic interaction in and with the environment around, even if afflicted by the supervening disability.

A multidisciplinary and multispecialistic medical equipe that is able to act on every aspect of the body system, in a coordinated and synergc way it is necessary In order to obtain those rehabilitative outcome.

This important scientific appointment, IBRC 2016 will allow us to focalize and discuss on the state of art of these problems, in a view of multispecialistic international collaboration pointing on the innovation in the rehabilitative field, inspired by the principles of the evidence based medicine.

I wish for every organizer, participants and for everyone of us that this will be a productive conference in every aspect: the result of this cultural exchange will be just the apex of all the positive predictions announced.

Dear colleagues,

It gives me a great pleasure to know that Aleksandra Zebrowska and Dariusz Jastrzebski are organizing the “14th International Biophilia Rehabilitation Conference” in Ustron (Poland) with an important topic that has become crucial today,

“Aging and Life Course”. The program includes a number of advanced topics regarding new approach to the Rehabilitation Medicine and the Physiological correlates.The meeting would be a great opportunity to share experiences bringing together old friends and the leading scientists in the field of rehabilitation to discuss the practical challenges, concerns and strategies, as well as promote collaborations and share the new findings. It offers a great opportunity for scientists and clinicians at any stage in their career to present and develop their own research, and connect with each other.

We are aware these days that the researches will be required to elucidate the correlations among physiology of aging with rehabilitation program, but we have to find new ideas that could improve our quality of life in the short period of time that is left for us to live in this beautiful world, expressing our “love for living” in terms of Biophilia.

I wish you all a fruitful meeting with excellent science and culture in Ustron.

The author states Pulmonary Rehabilitation in following order in this paper; 1. Overview of Pulmonary Rehabilitation, 2. Knowledge and Awareness of Pulmonary Rehabilitation, 3. Payer Awareness, 4. Pulmonary Rehabilitation in other diseases than COPD, 5. Comorbidities and physical activity, 6. Technology-assisted exercise training. 7. Cost-effectiveness of pulmonary rehabilitation programs.

I will present how to the Society of the Demographic Transition Era Sustainable. Preparation of our study started in 1987, and then our systematic research started in 1998 as the society for the study of the Rehabilitation in XXI Century.

From the beginning, I stood the prediction about the mechanism of the high effect and advanced research.

The procedure of research is as follows; we reported the effect first as our research¹⁾²⁾, verified the effect of the Takizawa Method³⁾⁴⁾⁵⁾, developed devices⁶⁾⁷⁾⁸⁾, changed the name of the meeting into the Biophilia Rehabilitation Academy and organized the international organization towards spread⁹⁾, and measured the encephalic function about the mechanism of the effect¹⁰⁾¹¹⁾. We show the grants that made the study possible¹²⁾.

And we announced the paper, which the existing rehabilitation medicine is not helpful for the elderly¹³⁾.

We confirmed that the motivative exercise activated the encephalic function compared with a physiotherapist's passive exercise¹⁰⁾¹¹⁾.

The time of demographic transition has come globally and the people have agreed with our enforcement is increasing.

The continuation to hold the IBRC 14 times shows it.

The holding IBRC 2017, which was named the Rehabilitation in XXI Century is the best thing, and we are deeply moved, and the name of it touches my heart.

I give a keynote lecture about the matter mentioned above.

I would like to talk to you using the slides in the presentation. Firstly, I will introduce our university, and then I would like to explain to you the vision I proposed when I was inaugurated as the president of the university. I will then explain our motivation and objective for coming to this place at this time, and finally present our university as a global university proposal that we would like to make to you.

To maximize the performance of an athlete, a team of experts work together to ensure each athlete achieves the maximal benefit from their prescribed exercise conditioning programs. In addition to the exercise specialists, the athlete’s team frequently includes psychologists (who address performance anxiety, stress, and depression), counselors (who address smoking cessation, reduction or elimination of alcohol consumption if necessary, weight optimization, and optimal sleep), and nutritionists (who address optimal nutrition and body mass attributes). Such a collaborative approach has become standard practice for athletes aiming to excel in their sports. Despite unequivocal and compelling evidence, this paradigm has only weakly been transferred to the needs of patients participating in rehabilitation programs. These individuals, like the athlete, also need to achieve their highest level of functional performance and recovery for carrying out their activities of daily living, managing the needs of their families, and often returning to work. This presentation reviews the evidence-based literature and the implications of this multifaceted approach in rehabilitation programs.

The augmented benefits to exercise training and conditioning (prescriptive activity/exercise and less sitting) along with their ‘effect sizes’ are described in the rehabilitation context, in conjunction with smoking cessation, moderate or elimination of alcohol consumption, optimal nutrition, optimal body mass, manageable stress, and optimal sleep. These factors can be viewed as physical performance enhancers both in individuals participating in rehabilitation whose aim is maximal performance and recovery and in athletes aiming for maximal performance in their sports. Thus, without targeted attention to these lifestyle factors, rehabilitation outcomes cannot be maximized.

The evidence presented in this presentation has implications for health professionals including physical therapists and others who are practicing in rehabilitation settings and those working with individuals in need in the community.

Aging is typically associated with multi-morbidity and complex health problems, including geriatric syndromes such as dementia, delirium, depression as well as visual and hearing impairment, falls, urinary and fecal incontinence and pressure ulcers. Problems are often underreported by the patient and unrecognized by the physician. Special attention is focused on frailty - a syndrome of decreased functional capacity and resistance to stressors, resulting from cumulative declines across multiple physiologic systems, causing vulnerability to adverse outcomes: disability, falls, multi-morbidity, hospitalization, institutionalization and mortality. Diagnostic information omitting analysis of functional relevance of the underlying conditions is of limited value. Social and environmental factors are also important, especially in older persons with functional impairment and dependency. Comprehensive geriatric assessment (CGA) is a method of complex examination of elderly patients and care planning. CGA involves the systematic evaluation of medical conditions, psychological parameters, functional status and socio-environmental networks. Our study demonstrated the rationale for including frailty examination in the CGA of geriatric inpatients. This diagnostic approach is realized by an interdisciplinary team consisting of a clinician (usually geriatrician), nurse, psychologist, physical/occupational therapist, social worker and other professionals according to the setting of the geriatric assessment. Validated measures are used to assess patient functional status. Studies comparing care based on the concept of the CGA with usual care showed benefits in terms of better patient outcomes and more efficient healthcare use.

Dementia is an increasing problem in aging society. Elderly people with dementia do not only require a multi-morbidity therapy but also they need special, professional care in their daily living. It is possible to improve the quality of life and efficiency of these people and the comfort of their caregivers through the implementation of properly specialized rehabilitation. Dementia includes several symptoms, which are usually chronic and progressive. They result from some degenerative changes in the brain, leading to an impairment of higher cortical memory functions, disorders of thought, understanding, orientation, counting, learning abilities, language functions and critical thinking as well as behavioural disorders and personality changes. Consciousness remains undisturbed. Dementia is not a normal process of aging. The six main groups of factors leading to dementia are degenerative changes, vascular, infectious, toxic, metabolic factors as well as CNS injuries.

There is no effective treatment to prevent the development of dementia. In the early stages of the disease, drugs temporarily slow down the development of symptoms. The treatment also includes symptomatic treatment of depression, sleep disorders, anxiety disorders, agitation, hallucinations and delusions. In advanced forms of the disease, care procedures are used in accordance with medical standards.

The purpose of rehabilitation in people with dementia is to stay home (as long as possible), with security and self-service. The basis for comprehensive rehabilitation is to create of a safe environment adapted to disability. It is necessary to avoid hurriedness and urges in the patient’s daily living, to avoid all kinds of changes by imposing an orderly routine of the day and stable order around the patient. The proper way of communicating is essential (short, simple sentences, closed questions, reminders, repetitions). Other facilities include signed items, labeled doors and removal of hazardous objects. The ability to remain as independent as possible is the most important for the patient. Physiotherapeutic methods include: passive exercises, respiratory exercises, strength training exercises, balance exercises including biofeedback exercises, stretching, swimming, yoga, tai chi, massage, individual motor training, magnetostimulation, magnetotherapy, TMS (Transcranial Magnetic Stimulation) or general cryotherapy. Providing cognitive rehabilitation helps to attain the highest individual level of mental function and functional independence. These goals may be achieved by memory training, relaxation, meditation therapy, validation strategies, reminiscence therapy, validation therapy, re-training methods to restore life skills, learning compensation skills.

The cognitive rehabilitation program is also based on the use of computer programs combined with neurofeedback. By using all the possibilities of rehabilitation, a person with dementia is able to maintain his or her identity and dignity.

We examined the effects and feasibility of a twice-weekly combined therapy of branched-chain amino acids (BCAAs) and exercise on physical function improvement in frail and pre-frail elderly people requiring long-term care. We used a crossover design in which the combination of exercise and nutritional interventions was carried out twice a week during cycles A (3 months) and B (3 months) and the exercise intervention alone. The exercise intervention entailed the following 5 training sets: 3 sets of muscle training at 30% of maximum voluntary contraction, 1 set of aerobic exercise, and 1 set of balance training. For the nutritional intervention, 6 g of BCAAs or 6 g of maltodextrin was consumed 10 min before starting the exercise. We determined grip strength and quadriceps muscle isometric strength, performance on the Functional Reach Test (FRT) and the Timed Up and Go test, and activity level. In the comparison between the BCAA group and the control group after crossover, the improvement rates in quadriceps muscle strength and FRT performance were significantly greater (by approximately 10%) in the BCAA group. In the comparison between different orders of BCAA administration, significant effects were shown for the quadriceps muscle in both groups only when BCAAs were given. The combination of BCAA intake and exercise therapy yielded significant improvements in quadriceps muscle strength and dynamic balance ability.

Pulmonary rehabilitation has been established as the standard of care for patients with symptomatic COPD. Benefits include improvements in exercise tolerance, dyspnea and quality of life; magnitude of benefit is generally greater than for any other COPD therapy. A wide range of professional organizations and standards documents have recommended pulmonary rehabilitation; benefits accrue across the spectrum of disease severity.

However, pulmonary rehabilitation is provided to only a tiny fraction of those COPD patients who would benefit. International estimates posit that only 1-2% of COPD patients receive pulmonary rehabilitation. In contrast, other COPD therapies, bronchodilators and oxygen therapy in particular, are much more widely available. The costs of pulmonary rehabilitation should not be a major barrier, as costs are comparable to other therapies.

In seeking strategies to increase pulmonary rehabilitation availability, it can be argued that a demonstration of a life prolongation benefit would be of great help. Therapies that improve survival have a high priority for patients, for their health care providers and for payers. A well-designed survival study has never been performed. A group of investigators in the United States is attempting to get such a study underway; design features of such a study will be discussed.

Aging as a physiological part of life is the cumulative result of oxidative damage to cells which derives from aerobic metabolism. Insufficient tissue oxygenation occurs in a wide range of physiological and pathological conditions and reactive oxygen species are physiological products of aerobic life and their accumulation affects aging. Aging is characterized by a decrease in oxygen supply to tissues, in reduction of tissue PO2 and in the activity of several enzymes and metabolic factors. The ventilatory response to hypoxia is attenuated with aging, related to the age-dependent structure modifications including the basal reduction of oxygen requirements. Weather life span could be correlated with oxygen supply remains to be elucidated. However, an increased metabolic rate, intense exercise and stress induce release of several substances that can influence aging velocity. Rehabilitative processes would improve the aging effects with increase in oxygen supply through several factor that would induce vasodilatation in damaged tissues. Moreover rehabilitation and exercise training programs would prevent diseases improving the quality of life. For this reason, we would argue if rehabilitation would modify the oxygen supply to tissue and if Rehabilitation works through the modification of the oxygen to tissues would improve the aging processes. The main issue concerning the correlations between hypoxia and life span remains open until we solve the question of how and why do cells sense oxygen? In other words, to better understand aging and rehabilitative processes we need to know what is the O2 species that is being sensed by cells and would clarify how rehabilitation could delay or reduce the effects of the ageing.

Oxygen belongs to therapeutic pharmacological tools. It is a life-safer in a host of clinical conditions, notably in emergency treatment when it is supplemented on the acute basis, and in chronic hypoxic lung pathologies when it is often used in home-based self-treatment. Emergency supplementation of oxygen is often shunned due to the possibility of dampening of lung ventilation mediated by carotid body inhibition. That rekindles an old and still unclear issue of whether oxygen is actually inhibitory or stimulatory for ventilation. To this end, I would like to present some of our results on the application of high oxygen concentration to breathing in healthy humans. The ventilatory inhibition appeared short-lived during 1-2 min after the commencement of oxygen bleed into the airway pipe, mediated by carotid body inhibition, and was followed by a gradual increase in ventilation over the baseline level, likely of central origin. Thus, a passing oxygen-related ventilatory inhibition in healthy persons does not seem of clinical significance.

Posture, balance and dynamic movement as during gait need continuous integration of signals coming from visual, vestibular, and proprioceptive apparatus, which are part of the sensory-motor system. All these informations travels along myelinated long nervous fibers belonging to the central nervous system (CNS). So the mechanism underlines impairments balance strategy during functional movements and gait may be correlate to abnormal integration of sensorimotor stimuli.Body weight supported treadmill training (BWSTT) is a task-oriented technique for gait restoration. BWSTT has the advantage over conventional therapy as it offers higher intensity, more repetitive and task-oriented practice over the same period of time when compared to conventional therapy.The SPAD® (Dynamic Antigravity Postural System) is a BWS training that has a pneumatic system with electronic pressure regulators that are able to self-regulate, through an electronic central control unit, the reduction of body weight.This system allows to set the pressure, to follow the center of gravity of the subject in its vertical excursions due to the opening of the compass of the lower limbs, allows to maintain stable, during the therapy, Body

This study, underwent in the Chair of Physical Medicine and Rehabilitation of “G. d’Annunzio” University of Chieti-Pescara, have the purpose to evaluate the immediate effects on spasticity of lower limbs of two different therapeutic approaches on a single session in patients affected by cerebral palsy. 30 patients has been recruited and divided in 3 groups: Group A has been treated with neuromuscular manual therapy in acquatic environment.

Group B has been treated with interactive electro neuromodulation. Group C has underwent sham approach respecting the operative procedure of Group B treatment. The whole sample has been recruited following these inclusion criteria:

Diagnosis of cerebral palsy

Age between and 10-20 years

Presence of spastic para/tetra paresis

Ashworth Scale result between 1 and 3

The whole sample has been evaluated using a myometric system, MyotonPro, before (T0) and after (T1) the single session of treatment, in the same environmental conditions. The statistical analysis underline that both Interactive Electro Neuromodulation and Manual Therapy in Water Environment results effective in reduction of muscular tone, while in Group C no significant results has been shown. In conclusion, we can affirm that Interactive Electro Neuromodulation approach could be a good alternative for the treatment of spasticity in patients affected by cerebral palsy, regarding costs and benefits.

There exist new technologies as Robotics and Prosthetics, Functional Electrical Stimulations, Brain Computer Interfaces and Virtual Reality with the problems associated with cost reduction for diffusion in medical hospitals and home daily use and neuropsychological negative side effects in connection with new using technologies.Motivation exercise and feedback, virtual reality and robotics must be applied in PM & RM in concordance with the status of the patient and in relation with functional capabilities.

We study the motivative exercise with easy devices, that is calle Takizawa method as the future rehabilitation system. In this paper, we show another motivative exercise with mirror box. The subject performs a training that the subject writes the diagram as training. The subject writes the several Chinese character, and the writing time and the number of mistakes are measured before and after training. We show the effectiveness of training with mirror box.

After I Joined the Biophilia Rehabilitation Academy, I studied the following matters; we can serve the homogeneous rehabilitation service to a lot of people by the simplified program, even the chronic term bedridden inpatients with a diagnosis of disuse syndrome could stand and re-acquire walk¹⁾, the self-kinetic rehabilitation which led to unaffected side extremity and exercise affected side in one direction with a device (the motivative exercise) can expect a kind of effect of Proprioceptive Neuromuscular Facilitation²⁾, Due to Making muscle activity and range of motion excise by the motivative exercise, we can expect to inhibit the disuse syndrome³⁾, and although a super-aged society is imminent close at hand and baby boomers will be oldest old elderly in 2025, which will not be become a negative inheritance if elderly people are fine and live independent⁴⁾.

I learned and carried out the Takizawa method and got the opportunity to participate in many types of research. I can say from the research which participated and presented until now; It is easy to introduce by the visiting at home rehabilitation medicine (it is cheap, and it is possible to perform it with a narrow place comparatively). There are the patients who could revivify nerves, such as BRS at the chronic term day care service facility. The simultaneous exercise by both sided is expectable for activating brain activity. There is little change of the vital signs before and after the motivative exercise, and it is expectable to make fatal elderly exercise safely. The effect by correlation being also regarded as a motivative exercise using Pata-Koro correlate with a motor function, and the functional improvement is expectable by becoming skilled. It is useful to prevent disuse syndrome on of muscles required for a standup, and study of movement.

I present these my experience.

We have commonly known that DVT is not so often but sudden onset after operation of abdomen or lower extremities, long stay in sitting position (so called economy syndrome), or with severe leg palsy. Once DVT expands to lung organ, pulmonary thrombosis (PE) occurs. This condition should be vital situation to death. We might happen to experience a few PE cases during our long clinical intervals.　

In our recovery ward after treatments in the emergency hospitals, almost all of our patients are suffered from stoke, operated femoral neck fracture, head or spinal injury. All of these diseases have just same risk factor of DVT, post operation or sever lower extremity motor palsy.

We’ve noticed PATA and/or KORO might be useful to prevent DVT soon after beginning of this research plan.

We will show you interdisciplinary team in this ward that every staff recommends active self-motivate exercise with PATA/KORO to sitting still patients in wheel chair.

Even in the case of severe dementia patients, PATA/KORO is so easy equipment that they can move these tools very well followed by volar guidance or clap hands of staffs.You can notice the venous flow by eco video during PATA/KORO exercise.

These findings prove triceps muscle works pumping action to return venous blood back to heart. This is the reason this muscle called the 2nd heart.

INTRODUCTIONLiterature data provide evidence of significant age-related decline in circulating levels of insulin like growth factor-1 (IGF-1) [1, 2]. The paracrine IGF-1 system confers vasoprotection and cardioprotection effects and contributes to maintenance of the functional integrity of the neuromuscular system [3, 4]. The aim of the present study was to identify the association between the age-related decline in IGF-1 secretion with the occurrence of cardiometabolic risk factors (CMRFs) in a population-based sample of Polish older adults.

METHODS:Anthropometric and biochemical parameters were assessed in 982 participants (aged 55-104 years), a population-based sample of Polish older adults. The presented data were collected from a nationwide, multicentre PolSenior Study conducted from 2007 to 2011. In all subjects serum contents of glucose, insulin, total and HDL cholesterol (TC and HDL-C), triglycerides (TG), IGF-1, and IGFBP-3 were measured. To determine IGF-1 bioavailability, the IGF-1/IGFBP-3 molar ratio was calculated. In order to evaluate the risk for cardiometabolic disease, lipid ratios (TC/HDL-C, LDL-C/HDL-C, TG/HDL-C), atherogenic index of plasma (AIP) and insulin resistance index (HOMA-IR) were calculated. Variables of lipid profile, HOMA-IR and somatic variables were used to identify individuals with any CMRF. The Statistica package v. 12 (StatSoft Poland, 12.0) was used for data processing and analyses.

RESULTS:The results of the study have demonstrated differences in selected cardiometabolic risk factors levels in response to age and gender. Serum IGF-1 concentrations significantly decrease with age (F = 5.7 p < 0.001). Higher serum IGF-1 and lower IGFBP-3 levels were found in male compared to female subjects and significant associations were observed between HOMA-IR and IGF-1 levels (F = 7.0 p < 0.01). Individuals with higher IGF-1/IGFBP-3 ratio (p < 0.05) and higher serum IGF-1 contents were characterized by lower HOMA-IR levels. A significantly higher serum IGF-1 and IGF-1 bioavailability were associated with lower level of insulin resistance, a favorable changes in lipid profile, and higher prevalence of normal blood pressure.

CONCLUSIONS: These findings suggest that low IGF-1 levels have been associated with an increased risk of developing cardiovascular disease and diabetes in older adults.

The process of ageing is highly dynamic both in Europe and in the whole world. It poses new challenges to policy makers. The increasing insufficiency of family care leads to a growing need for care, rehabilitation as well as care and social benefits in the society. Rehabilitation is becoming an indispensable part of treating senior citizens. It helps to achieve the maximum level of independence and life quality. However, participation in formal rehabilitation, particularly among the oldest citizens and rural inhabitants is scarce. It stems from their being unaware of its existence and from its limited availability. Financial resources for disabled persons are spread across a lot of institutions and their management is not coordinated. Furthermore, the effectiveness of activities that are carried out is not evaluated. Therefore, it is essential to implement intensive activities aimed at introducing systemic changes in organizing rehabilitation. Currently, the Agency for Health Technology Assessment and Tariff System, with the substantial assistance of experts in the field of medical rehabilitation, is preparing new standards in medical rehabilitation. Changes in the organization of the rehabilitation system are broadly endorsed by the Parliamentary Committee for Senior Policy. The Committee put forward the desideratum with postulates of changes to the Minister of Health. In 2013, the Council of Ministers adopted Assumptions of the Long-term Senior Policy in Poland for the years 2014-2020. Their goal is to ensure aging in good health and living an independent and satisfying life. The ASOS program (Social Participation of Senior Citizens) for 2014-2020 was implemented. The objective of the project is to improve the quality and level of life of elderly people. Another action taken by the state is the implementation of the SENIOR PLUS program. Its aim is to create day care centers for senior citizens where rehabilitation plays a crucial therapeutic role. Other programs to be introduced, with broadly understood rehabilitation as an important component, include ‘Prevention of unfavorable demographic and epidemiological trends. Health prophylaxis’, ‘Community in action’ and ‘Program of activation of senior citizens.'

The demographic situation in Belarus shows as in many countries an overall aging of the population. The proportion of persons aged 60 years and older is almost 20,6%; above 14% of population is older than 65 years; there is 5,8% of disabled people among the population of Belarus. Number of older people who suffer from some chronic, non-communicable disease is constantly increasing as well as depression, social isolation, feeling of uselessness. Due to their illness, older people often experience limited mobility.Belarus Red Cross (BRC) has been implementing a Healthy Ageing program in communities of Belarus with support of Swiss Red Cross in line with Strategy and action plan for healthy ageing in Europe, 2012–2020. BRC contributes to development People centred long-term care and Healthy ageing over the life-course. BRC Visiting Nursing Service provides integrated long-term home based care including Kinaesthetic for older people. More over BRC promotes physical activity, falls prevention, prevention of social isolation and social exclusion with focus on people over 50 implementing participatory community approach and Healthy Ageing toolkit of the International Federation of Red Cross and Red Crescent Societies.

In the field of the motivated exercise that deals with neurological rehabilitation, nowadays more and more techniques and instruments has been developed that features characteristic of fine neuro-sensorial and peripheral stimulation.

Aim of this workshop expressed by an international work group will be to demonstrate how the integration in scientific and technological knowledge could porta to a shared rehabilitative protocol with specific effects on spinal cord, sub cortex and cortex measurable trough the international measurement scale and the variation of the tonic postural system.

The experience of this work group wants to show how multidisciplinary integration and the correct use of new rehabilitative methods could be a useful supplement to the traditional rehabilitative programs in the post stroke patients.

The application of rehabilitative techniques and specific devices becomes for each rehabilitation specialist an important moment in the therapeutic choice.The first step of each therapeutic moment should be the awareness of the behaviours and responses perceived by the patient mediated by each specific stimulation.

The experience of this work group full shows all the response capabilities of the body system toward specific rehabilitative gestures founded on scientific literature and on the correct integration of different rehabilitative techniques that uses in the best way possible the manual specific characteristic of the physiotherapist and the most modern methods that are based on the use of new devices.

To Whom It May Concern:

Following the decisions taken during the last IBRC Conference in Genevea it has been established that:

1)The next lBRC Conference will be organized thank to the disposability Of Professor Zebrowska in Poland (Ustron);

2)The Biophilia workshop will be organized (always thank to the disposability of Professor Zebrowska) in Ustron by the working team of the University of Chieti (Professor Saggini, Professor Bellomo, Professor Barassi and Professor DiGiulio) in collaboration with Professor Zebrowska and Professor Dunnala;

3)One of the aim of this meeting will be to discuss and analize the results of the multicentric study that will be made by the working team of the Chair of Physical and Rehabilitative Medicine of the University of Chieti, directed by Professor Saggini.

The presidence of the Biophilia Institute is therefore pleased to use these collaborations for the organization of these events, with the aim to create the basis for a focused study of the best methods and approaches regarding the neurological rehabilitation, to decrease the recovery time of the patient and the social costs of the therapy, defining more and more efficient and effective approaches.

Regards,

I introduce the meaning and the contents of the Ustron workshop as the greeting from the president of the IBRA. There may be some persons who have a strange sense that the Italian professor is chairperson in the workshop which we hold in Poland. The agreement between our academy and the university in Italy, which is shown in the PDF file is the foundation for it. I expect that we can progress the joint research which enables change of the medical rehabilitation concept to "Overcome disabilities" from "Acceptance of disabilities" with obtaining the participation of many enterprising professors and doctors in this workshop.

We intend for Stroke a focal or generalized neurological deficit, which signs and symptoms are showed for at least 24 hours.

It is a high incidence and mortality illness, which involve a large number of people, especially the elderly population. Following a stroke, patients are commonly left with debilitating motor and cognitive impairments. This work reviews state of the art in neurological repair for stroke and proposes a new model for the future. Inside the Physical and Rehabilitative Chair of “G. d'Annunzio” University of Chieti - director Raoul Saggini, in collaboration with the BIOPHILIA Institute of Tokyo - director Shigeo Takizawa, the goal of this research is to design a rehabilitation protocol for the neurological problems connected to Ictus that uses devices of easy application and minimum waste of time.

We suggest that stroke treatment--from the time of the ictus itself to living with the consequences-- must be fundamentally neurological, from limiting the extent of the injury at the outset to repairing the consequent damage. Survivors usually show relevant physical, cognitive and psychological problems.

The protocol that we formulated consisted in 3 phases, executed on both the superior quadrant and the inferior one, divided in the first stage of passive mobilization of the interested limb, the second stage of active-assisted functional sensory re-education exercises and the third stage of neuromuscular stretching techniques to release the treated limb.

Our proposal of the therapeutical protocol can be considered a landmark in the field of neurological rehabilitation regarding strokes.

This is due to the fact that it is simple and widely reliable, because of the usage of intuitive, efficient and effective.

Preliminary data are relevant in each aspect of pathology analyzed and show how our protocol results effectively in the treatment of these patients.

Since we gained a new research grant from the Ministry of Internal Affairs and Communications, we reported the details of research last year. The name is as the notation, and the purpose of research and development is systems development which is based on the local ICT organization in Kanagawa prefecture. We researched and are developing the system which can manage autonomous rehabilitation in the whole region and an institution at remoteness by information and communications technology (ICT) due to the device development for the motivative exercise of the leg.In this argument, we would like to discuss the international field study of the developing device.

The number of stroke patients has increased in step with the aging of the population in many countries. We proposed a new rehabilitation system with easy devices that is so-called "Takizawa method". Although the Takizawa method is estimated as a method that reduces the burden of physical therapists (PT), the assessment is not sufficiently performed. Tanaka laboratory has some topics of analysis for the Takizawa method, such as an inverse problem analysis and a multiple classification analysis. We discuss what we can do for Takizawa method rehabilitation in the next step.

In our laboratory, we have measured the brain function by fNIRS, in order to check activation site in the brain. Although the fNIRS can measure the activation site near the cephalic surface, it cannot precisely obtain the activation site in the deep of brain. We have tried to obtain the position of activation site in the deep part of brain by using the mathematical method of inverse problem. As the matter of course, we will carry on the approach of measuring the precise activation site.

Here, we consider corroboration of the study for neurorehabilitation with the other universities. We can discuss using the other device such as the electroencephalograph.