The purpose of this study was to investigate body composition focusing on motor functional capacity and to correlate body composition with functional outcomes with subacute stroke patients. The subjects of this study were 34 inpatients with hemiparetic stroke who could walk. Motor functional capacity of patients was assessed on the basis of the Brunnstrom recovery stage (BRS), and functional status was measured using the Functional Independence Measure (FIM) instrument scores and gait velocity. Body composition was assessed by bioelectrical impedance analysis. Significant correlations were observed between FIM scores and the BRS of the lower extremity or lean body mass. The correlations for body water in affected and unaffected legs with the FIM subscores were statistically significant (p<0.05). The correlations for the FIM scores with BRS and body water were higher in the lower extremity than in the upper extremity. Differences in body composition were calculated between the affected and unaffected sides. There was no significant difference in body water between the affected leg and the unaffected leg, but body water in the affected arm was lower than that in the unaffected arm (p<0.01). These results suggest that motor function capacity and body composition are generally related with functional status rather than the lower extremity or upper extremity.
To clarify the characteristics of the recovery process of gait disturbances after ventriculo-peritoneal shunt (VP shunt) surgery in patients with idiopathic normal pressure hydrocephalus (iNPH), we investigated three areas in two severely disabled patients: longitudinal changes of the severity of postural instability of motor aspects of the Unified Parkinson's disease Rating Scale (UPDRS); time taken in the "timed up and go (TUG)" test; and the prevalence of freezing episodes and the severity of bradykinesia. We also compared the computed tomography findings before and after VP shunt. Gait disturbances in the early stage after VP shunt fall under the frontal gait disorder of Nutt's classification or the mixed gait apraxia of Liston's classification. Disequilibrium clearly improved gradually after VP shunt, however, gait ignition failure and hypokinesia showed no significant improvement in our study. In the early stage after VP shunt, complementing disequilibrium using high-heeled shoes was highly effective at improving the time taken in TUG. The improvements in radiographic findings were reported after VP shunt.
The purposes of this study were to evaluate the gender difference in exercise tolerance. We analyzed the relationship between the double product (DP) at the double product break-point (DPBP) and the systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MAP), pulse pressure (PP), heart rate (HR) at DPBP. The subjects were 18 healthy men and 15 healthy women. Exercise tests were performed on a cycle ergometer. The DP at DPBP increased more in women than in men (p<0.05). There were no significant differences in DBP, MAP, PP or HR at DPBP between the groups. At DPBP of men, DP was significantly correlated with SBP, MAP, PP and HR (p<0.05). In women, the only significant correlation was between HR and DP at DPBP (p<0.05). This suggests that the configuration factors of exercise tolerance differ between men and women, although men have a blood pressure dominant response at DPBP, women have a heart rate dominant response.
The objective of the present study was to investigate the effects of expiratory muscle training (EMT) on pulmonary function, including peak cough flow (PCF), by administering EMT at a natural or fast flow rate to healthy volunteers. Subjects comprised 33 healthy volunteers randomly divided into 3 groups: EMT at a natural expiratory flow rate (NFR group); EMT at a fast expiratory flow rate (FFR group); and no EMT (Control group). For the NFR and FFR groups, subjects trained using a device for expiratory muscle training at 30% maximal expiratory muscle pressure (PEmax) for 15 min twice daily, 7 days a week for 4 weeks. Before and after training, PEmax and pulmonary function were measured. For the NFR and FFR groups, PEmax significantly increased but pulmonary function, including PCF, was unchanged. Moreover, no significant correlation was seen between changes in PEmax and changes in pulmonary function parameters in the NFR and FFR groups. In conclusion, natural or fast flow rate EMT increases PEmax, but neither technique improves pulmonary function, including PCF. Thus, velocity-specific muscle strengthening by EMT does not contribute to changes in pulmonary function related to expiratory flow.
We investigated postural sway in young subjects who were asked to rotate the head in the direction of visual targets. Thirteen subjects wore a helmet and stood on a force plate. They were asked to look at the targets quickly by directing the laser spot attached to the helmet on the target. Every subject showed consistent changes in the ground reaction force (Fx, Fy, Fz) and in the center of pressure (COP) associated with head movements. In 31% of all trials, force changes in Fx, Fy and Fz preceded head movements. During downward head movements, the anterior-posterior component of COP (COPx) exhibited the largest changes and the shortest latency. Ground reaction force in the anterior-posterior direction (Fx) also showed changes before the onset of downward head movements in 85% of the subjects (mean latency=-20 ms). However, the mean latency in other movements lagged behind the head movement onset. Electromyographic activities (EMGs) of the biceps femoris preceded the initiation of downward head movements by 22-54 ms in 2 subjects. These results indicate that goal-directed rotational head movements elicit COP changes. In addition, the COP changes preceding downward head movement suggest preparatory reactions related to anticipatory postural adjustments (APAs).