We investigated the changes in exercise tolerance before and after cardiac surgery in patients with mitral regurgitation (MR), and also evaluated the factors influencing postoperative status of exercise tolerance. Subjects were 25 patients with MR who underwent cardiopulmonary exercise testing, echocardiography, and blood examination.
AT VO₂, Peak VO₂, VE/VCO₂ and minimal VD/VT were calculated from cardiopulmonary exercise testing. LVEF from echocardiography, and Hb value was obtained from blood examination. Exercise tolerance was significantly impaired after cardiac surgery (AT VO₂ p<0.05, peak VO₂ p<0.001). After cardiac surgery, AT VO₂ showed significant negative correlation with VE/VCO₂, and negative correlation with minimal VD/VT. These results suggest that the negative change in VE/VCO₂ may impair the status of postoperative exercise tolerance (r = -0.45, r = -0.64; p<0.05, p<0.001). Changes in AT VO₂ showed significant correlation with changes in LVEF. This result suggests that the negative change in LVEF may impair the status of postoperative exercise tolerance.

View full abstract

The somatosensory evoked potentials (SSEP) was examined in cervical myelopathic patients to determine the clinical usefulness. Subjects were 21 patients (mean age: 63.2 years old) and 7 normal subjects (mean age: 68.0 years old). In normal subjects, all components (N9, N11, N13, N20) appeared clearly, and high interrelationship between height and each component was obtained. In cervical patients N9 component was recognized in all patients, but N11 and N13 component tended to disappear or become late in latency. Especially, N11 component was most low percentage of appearance. Clinically, abnormal SSEP was most reflected by deep sensory disturbance, but there is no relationship between SSEP and stenosis of cervical cord in myelography. These results confirmed the clinical usefulness of SSEP.

View full abstract

The purpose of this study is to clarify 1) process and 2) prerequisite of dependence on activities parallel to daily living or self care activities in the elderly with dementia.
Subjects were 31 home-bound elderly people with dementia. Information on difficulties in performance as well as assistance to them were collected from their caregivers.
・Feeding : Early stage, some elderly people with dementia were not able to ascertain the term for relish, and separate the uneatable part of foods. Afterward, they were careless in table manners. Last stage, they needed the assistances of “feeding” by reasons of hardly recognizing foods as something to eat.
・Toileting : They needed “leading to toilet or diaper” by reasons of hardly using the flushing equipment, stool, and so on. Last stage, they had difficulty in recognizing toilet as the space for excreting.
・Locomotion : Early stage, they were not able to go to the nearby hospital or store. Afterward, they needed observation of “locomotion in their home” by reasons of high risk of falls, disorientation in their home, and so on.
・Dressing : Early stage, they were not able to select their clothes by season, and differentiate the soiled clothes. Afterward, they needed the assistances of “dressing” by reasons of hardly buttoning their shirt, distinguishing right or left side of clothes, and so on.
・Washing/bathing : They needed the assistances of “washing their face/washing themselves” by reasons of hardly using the washbowl and so on.
・Others : Early stage, they were not able to use telephone, stove, washing machine, and so on.

View full abstract

The purpose of this study was to find some differences in activities among four hamstring muscles by integrated EMG, and to analyze the relationship among EMG, torque and muscle length during maximum isometric knee flexion. Ten healthy male volunteers participated in this study. The subject was fixed in prone position on a bed, and the knee joint was fixed at 60- or 90-degree in flexion with neutral, external and internal knee rotation. They performed maximum isometric knee flexion with these six knee positions. Then, the knee flexion torque was measured and the EMG data were detected by bipolar fine wire electrode from semitendinosus, semimembranosus and long and short head of biceps femoris muscle, simultaneously. The EMG data were full-wave rectified and integrated (IEMG). The knee flexion torque and the detected IEMGs from each hamstring muscle at 60-degree were compared with the values at 90-degree in each knee rotated position. As a result, the knee flexion torque at 60-degrees was higher than that at 90-degree regardless of knee rotation. The IEMG values of the semitendinosus and semimembranosus muscle at 60-degree in knee flexion with neutral and external knee rotation position were lower than those at 90-degree. On the other hand, the IEMG value of the long head of biceps femoris at 60-degree with neutral, external and internal knee rotation were significantly higher than those at 90-degree. There were no significant differences in IEMG values of short head of biceps femoris between 60-degree and 90-degree with any rotational angles. These results indicate next two insights. First, there are obvious differences in activities among four hamstring muscles during maximum isometric knee flexion. Second, the agonist muscles are not always fully active even if the isometric movement is performed with the maximum efforts.

View full abstract

We, this time, designed a method of bathing for an extremely-low-birth-weight (ELBW) infant in an incubator who had no major difficulty in stabilizing his/her posture in it during a bathing care, and examined its physical and psychological safety.
The subjects were 3 ELBW infants who were born as triplets after a 24 weeks + 3 days-gestation. We provided them with a bathing care or a washing care in an incubator for several days, and investigated the changes of their skin temparature, pulse, blood pressure and facial expression. A unique positioner, a high-density urethane pad, was placed in a stainless vat for bathing.
The results were as follows. 1. The values of their skin temparature were relatively stable during a bathing, although they declined significantly during a washing. 2. The changes of their pulse and blood pressure during a bathing or a washing were within the range of their daily activities. 3. All the infants tended to show calm facial expression during a bathing and to cry easily during a washing.
These results suggested the availability of the bathing in an incubator to an infant whose current weight is even less then 1,000 g, without the medical or psychological distress, provided that the posture of infants is maintained properly.

View full abstract