President's Proposal : With a Harmony of Science and Heart…Masazumi MIZUMA 881

New Steps Taken by the Japanese Association of Rehabilitation Medicine in the Past 10 Years…Kyozo YONEMOTO 886

The Fifty-Year History of the Japanese Association of Rehabilitation Medicine : In Retrospect, Our Road seems to have been Straight and Easy…Fumio ETO 892

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Rehabilitation medicine focuses on the diagnosis, treatment and management of people with disabling medical conditions and dysmobility. Physiatrists work with people with disabilities to reduce the impact of their disease or disability on their daily life activities. On the other hand, clinical neurophysiology is a medical specialty that studies the central and peripheral nervous systems through the recording of bioelectrical activity, whether spontaneous or stimulated. Tests conducted are concerned with measuring the electrical functions of the brain, spinal cord, and nerves in the limbs and muscles. It can give the precise definition of site, the type and degree of the lesion, along with revealing the abnormalities that are in question. Due to these abilities, clinical neurophysiology is used to mainly help diagnose diseases. However, because it records bioelectrical activity, clinical neurophysiology is also useful as a treatment method i.e. electroencephalogram (EEG) biofeedback and electromyography (EMG). Recently, EEG-based brainmachine interfaces (BMI) have been used for people with disabilities. As a BMI signal source, event-related desynchronization of alpha-band EEG during motor imagery (mu ERD), which is interpreted as desynchronized activity of the activated neurons, is commonly used. The ERD represents motor cortex excitability in normal people. ERD is also recorded over the affected side in M 1 and represents motor cortex excitability in stroke patients. BCI EEG feedback is thought to induce some improvement in motor function and brain plasticity. BCI technology therefore will be useful for restoring brain function in patients with stroke. So, owing to these treatment capabilities, clinical neurophysiology is also a medical subspecialty in Rehabilitation Medicine.

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Selecting the Suitable Meal Form for Dysphagia Patients Based on Videofluorographic Results…Seiko SHIBATA, Fumi TODA, Keiko ONOGI, Yoko INAMOTO, Kikuo OTA, Hitoshi KAGAYA, Eiichi SAITOH 900

Dysphagia in Parkinson’s Disease : Conventional Knowledge and Recent Topics <Review Article>…Sonoko NOZAKI 905

Transcranial Direct Current Stimulation Improves Swallowing Function…Takashi SHIGEMATSU, Ichiro FUJISHIMA, Hideaki KANAZAWA 913

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Objective : To understand how test foods used in videofluoroscopic swallowing examinations (VF) are prepared and used. Methods : A survey was conducted using participants in a workshop organized by the Japanese Association of Rehabilitation Medicine (October 27, 2012). Results : Among 129 participants, the survey collection rate was 48.8 %. The percentage who had conducted VF was 66.7 %. The test foods used were thickened liquid 97.6 %, jelly 92.9 %, and test foods other than liquid, thickened liquid or jelly were used by 64.3 %. A little less than 20 % answered that the test foods did not always or possibly did not always have the same physical property and texture. The contrast agents used in test foods were barium sulfate 50.0 %, amidotrizoic acid (Gastrografin^®) 33.3 % and iodinated contrast agent for angiography 7.1 %. Conclusions : In addition to thickened liquid and jelly, many solid test foods were also used. The uniformity and safety of these test foods and their properties need to be examined and considered in their preparation.

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Crow-Fukase syndrome is diagnosed by the presence of polyneuropathy in conjunction with several other characteristic generalized symptoms, including organomegaly, endocrinopathy, M protein, and skin changes (POEMS syndrome). Rehabilitation is very important for patients with Crow-Fukase syndrome because progressive polyneuropathy reduces a patient's muscle strength. We report a case of long-term rehabilitation after high-dose chemotherapy with autologous peripheral blood stem cell transplantation. After transplantation, neurologic improvement began, and following rehabilitation therapy, the patient's proximal lower extremity muscle strength recovered to an almost normal level. At 2 months after transplantation, the patient could walk again using a cane and an ankle-foot orthosis. At six and a half years after transplantation, the neuropathy was still improving and there was no recurrence of other symptoms. We suggest that rehabilitation combined with autologous peripheral blood stem cell transplantation for Crow-Fukase syndrome is very useful for improving the disuse condition and for recovering muscle strength.

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