Standing Posture Analysis…Kimitaka HASE 591

Gait Analysis in Hemiplegia…Masahiro OHASHI, Masatoshi BEPPU 597

Motion Analysis in Spinal Cord Injured Individuals…Toshiki MATSUNAGA, Yoichi SHIMADA, Mineyoshi SATO, Satoaki CHIDA, Kazutoshi HATAKEYAMA 603

Orthotic Gait Analysis…Sumiko YAMAMOTO 607

Simple Motion Analysis for Ataxia Patients…Hitoshi KAGAYA, Akiyoshi WATANABE, Fumihiro MATSUDA, Yohei KATO 612

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Design : A pilot, comparative study was conducted. Background : Heat wraps using bentonite (HWb) are commonly used in thermotherapy. In the Okayama University Misasa Medical Center, heat wraps using mud (HWm) produced by mixing soil with boiling water have also been used. The subjective thermal effects of HWm on patients with osteoarthritis of the knee have been reported. However, the objective thermal effects of HWm have not been examined. As such, the physicochemical thermal effects of HWm were analyzed and compared with those of HMb. Methods : The thermal effects of HWm and HWb were investigated regarding heat radiation, conduction, capacity and moisture content. Heat radiation and conduction were measured by changes in temperature of the heat wraps, in addition heat conduction was also assessed by blood flow in body surfaces (N=7). Heat capacity and moisture content were measured with a Differential Scanning Calorimeter. Results: Heat radiation and heat conduction of HWm were significantly greater than those of HWb (p<0.001). The specific heat capacity of HWm was 2.0 J/g/°C, and was 1.7 J/g/°C for HWb. Moisture content of HWm and HWb were 0.6 mg/g and 0.3 mg/g, respectively. Conclusion : Heat radiation, conduction and capacity of HWm are superior to those of HWb. Moreover, the moisture content in HWm is greater than that of HWb. These results indicate that the thermal effects of HWm would have more be physicochemical usefulness.

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Objective : To evaluate the efficacy and safety of botulinum toxin type A (BTXA) in Japanese patients with post-stroke lower limb spasticity in a multicenter, randomized, double-blind, single dose, placebo-controlled study (double-blind phase) followed by an open-label, multiple dose extension (open-label phase). Methods : One hundred and twenty patients with lower limb spasticity were randomized to receive a single treatment with BTXA 300 Units (U) or placebo into lower limb muscles in the double-blind phase. Patients who met the re-injection criteria received up to 3 repeated treatments of BTXA into lower limb muscles with at least 12 weeks between treatments in the open-label phase through 48 weeks. Results : In the double-blind phase there was significant improvement from baseline spasticity in the Modified Ashworth Scale (MAS) ankle score between the BTXA 300U and placebo groups, with a mean difference in the area under the curve (AUC) of -3.428 (p=0.006, t test). The MAS ankle score further decreased from baseline in all repeat treatment cycles of BTXA in the open-label phase. No clinically relevant difference was noted in the frequency of treatment-related adverse events between BTXA-treated and placebo-treated patients during the study period. Conclusions : BTXA reduced spasticity in lower limb muscles from the first treatment with continued long-term efficacy. BTXA is safe and effective for the long-term treatment of post-stroke lower limb spasticity.

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The worldwide population of elderly people suffering dementia is considerable. In 2005, 1.69 million persons in Japan suffered from Alzheimer's disease (AD) and other forms of dementia. Considering the ageing of the population, the number of elderly adults with dementia should rise to 3.78 million in 2045. The physical and mental benefits of exercise are universally recognized. Exercise training promotes extensive cardiovascular changes and adaptive mechanisms in both the peripheral and cerebral vasculature, such as improved organ blood flow, induction of antioxidant pathways, and enhanced angiogenesis and vascular regeneration. Clinical studies have demonstrated a reduction of morbidity and mortality from cardiovascular disease among exercising individuals. Exercise also regulates the brain function, but the mechanism by which it does so is unknown. In this article, I summarize current knowledge about the potential benefits of physical exercise in elderly adults with AD and other dementia, and then describe the development of a moderate-intensity aerobic exercise program for this population. Evidence from some longitudinal studies and randomized trials suggests that physical exercise enhances cognitive function in older adults with dementia. Accumulating evidence from human studies suggests that physical activity may reduce the risk of poor cognition and early cognitive decline. In conclusion, recent studies suggest that regular physical exercise can enhance cognitive function and functional activities (activities daily living, exercise capacity, muscle strength, flexibility, balance, cardiopulmonary function) in elderly adults with dementia and that engaging in physical exercise may, along with other health benefits, delay or prevent the onset and progression of dementia.

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