A Molecular Biological Approach to Muscle Strengthening…Satoshi IKEDA 242

Basic Research in Bone and Cartilage Diseases (or Locomotive Syndromes)…Shinjiro TAKATA 245

Basic Research and Clinical Applications of Electrical Stimulation for Cardiovascular Diseases…Makoto NAGASAKA 248

A Brain-injury Model and Analysis…Masahiro ABO, Hideki YAMAUCHI 256

Basic Research in Micturition Disturbances…Akira YOSHIDA 259

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It has been pointed out that a biased perception of the subjective visual vertical (SVV) in stroke patients might be related to balance deficits and impaired activities of daily living (ADL). The relationship between SVV and static balance in stroke patients, however, still remains unclear. Thus we examined the relationship between SVV and standing balance in 29 hemiparetic patients with a first-ever supratentorial stroke. We measured the rotation angle formed by a subjective vertical and the gravitational vertical (rotation to the non-paretic side was set as positive) 8 times, and employed the mean value as the SVV value. We also calculated the absolute rotation angle for each time and employed the mean value as the absolute SVV value. Then we evaluated postural balance using four stabilometer parameters : length of center of pressure per time (LNG/T), envelopment area (ENV), root mean square (RMS) and weight-bearing asymmetry (WBA) during standing. The relationship between the SVV values or the absolute SVV values and the four stabilometer parameters were analyzed using the Spearman's rank correlation coefficient. The mean values for SVV and absolute SVV of all participants were -0.3±2.3° and 2.0±1.5°, respectively. The absolute SVV value and each of the four parameters were positively correlated with statistical significance (LNG/T ; r=0.44, ENV ; r=0.41, RMS ; r=0.46, WBA ; r=0.40), while there was no statistically significant correlation between the SVV value and each of them. These results suggest that the SVV bias size is possibly related to standing balance in stroke patients.

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Malnutrition often occurs in patients with disabilities. The prevalence of malnutrition in geriatric rehabilitation was higher than in hospital (50.5% vs 38.7%) according to MNA classification. Nutrition care management of patients with disabilities is often inappropriate. As nutritional status is associated with rehabilitation outcome, a combination of both rehabilitation and nutrition care management may be associated with a better outcome. This concept is defined as rehabilitation nutrition. Rehabilitation nutrition aims to assess patients according to the International Classification of Functioning, Disability and Health including nutrition status and to practice a rehabilitation nutrition care plan under adequate prognosis prediction. It is not enough for patients with disabilities to coordinate only their rehabilitation or clinical nutrition. Rehabilitation nutrition care management is important to improve their activities of daily living and quality of life. Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength. Primary sarcopenia is considered to be age-related when no other cause is evident, other than ageing itself. Secondary sarcopenia should be considered when one or more other causes are evident, such as activity-related sarcopenia, disease-related sarcopenia, or nutrition-related sarcopenia. Activity-related sarcopenia can result from bed rest, deconditioning, or zero-gravity conditions. Disease-related sarcopenia is associated with invasion (acute inflammatory diseases), cachexia (cancer, advanced organ failure, collagen diseases, etc.), and neuromuscular disease. Nutrition-related sarcopenia results from inadequate dietary intake of energy and/or protein. Treatment, including rehabilitation and nutrition care management, differs according to the causes of sarcopenia. No nutrition care, no rehabilitation. Nutrition is a vital sign for rehabilitation.

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