Relationship between musical and linguistic abilities in patients with aphasia

This retrospective study aimed to investigate the relationship between musical and linguistic abilities in patients with aphasia. We reviewed the clinical records of 32 stroke patients with aphasia admitted to subacute rehabilitation units between May 2014 and August 2018. We analyzed the results of melody and rhythm reproduction tests and subtests of auditory comprehension and speech sections in the Standard Language Test of Aphasia （SLTA） collected upon admission and discharge. The Spearman rank correlation coefficient （rs） was used to analyze the correlation between 1）the increase in melody reproduction test scores and SLTA auditory comprehension subtest scores, 2）the increase in melody reproduction test scores and SLTA speech subtest scores, 3）the increase in rhythm reproduction test scores and SLTA auditory comprehension subtest scores, and 4）the increase in rhythm reproduction test scores and SLTA speech subtest scores. There were significant positive correlations between melody reproduction and auditory comprehension subtest scores on the SLTA: “word comprehension” （n＝14, rs＝0.57, p＜0.05） and “following verbal instructions” （n＝31, rs＝0.42, p＜0.05）. An SLTA speech subtest score—action naming—was positively correlated with rhythm reproduction （n＝31, rs＝0.44, p＜0.05）. This study implies that melody reproduction ability is related to auditory comprehension and that rhythm reproduction ability is related to speech production in patients with aphasia after experiencing a stroke

Comparison of Plantar Pressure and Plantar Contact Area before and after Botulinum Toxin Type A(BoNT-A)Therapy in Stroke Patients with Lower Limb Spasticity

The effectiveness of botulinum toxin type A(BoNT-A)therapy for reducing muscle spasticity has been reported. We examined changes in the plantar contact area and plantar pressure after BoNT-A injection therapy in stroke patients with spastic hemiparesis. The study participants were 12 male hemiparetic stroke patients treated in our outpatient clinic(right hemiparesis, 7; left, 5), who were able to walk without orthoses. They were requested to walk barefoot at their normal walking speed on a sheet with pressure measurement sensors, before, and at one and three months after BoNT-A therapy. Simultaneously the maximum plantar pressures and maximum plantar contact areas of both feet during the standing phase of walking were analyzed using a pressure distribution measuring system. The ratios of the measured values for the affected side to that of the unaffected side were calculated. The mean ratio of the maximum plantar pressure of the affected/unaffected limb on standing changed from 61.5%±12.4% to 75.0%±9.5% at one month, and 61.2%±7.3% at three months after BoNT-A therapy. The mean maximum plantar contact area ratios also changed from 75.3%±11.7% to 87.9%±8.7% at one month and 77.8%±8.8% at three months. For both parameters, the ratios were significantly increased at one month after BoNT-A, compared to the other time points(P<0.01). These results suggest that BoNT-A therapy reduces muscle spasticity of the lower limbs, which improves the range of motion of the ankle joints, leading to improved plantar contact during the standing phase of walking. This pressure measurement system may be useful for assessing the effectiveness of BoNT-A therapy

Effects of Gentle Cutaneous Stimulation Using Contact and Sham Acupuncture on the H/M Ratio in Patients with Chronic Hemiparesis

This study aimed to evaluate the neurophysiological effects of gentle cutaneous stimulation by acupuncture on muscle tone in patients with chronic spastic paresis. We conducted a randomized, double-blind, crossover trial comparing the effects of contact acupuncture on the H/M ratios of soleus muscles between 8 patients with spastic paresis and 17 healthy volunteers. The study subjects were randomly assigned to two groups, and then they received gentle stimulations to their lower limb (affected side) using skin attachment-type contact acupuncture and sham acupuncture in different order. Fourteen acupuncture points were selected according to the Meridian-Test (M-Test). The soleus muscle in both stimulated and unstimulated limbs was analyzed by electromyography following tibial electrical stimulation at the popliteal fossa, and the H/M ratios were then calculated. Paretic subjects showed a significant decrease in H/M ratio after both contact and sham acupunctures in the stimulated limbs, but not in the unstimulated limbs (unaffected side), and this result was not affected by the order of stimulation. Healthy subjects showed a significant decrease in the H/M ratio after both contact and sham acupunctures in both stimulated and unstimulated limbs. The H/M ratio decrease indicates a decreased overall percentage of activated α-motor neurons. Our results therefore suggest that gentle cutaneous stimulation could reduce α-motor neuron excitability at rest under some conditions

Relationship between sacral‐abdominal wall distance and grip strength in postmenopausal osteoporotic patients

Abstract Background An increase in waist circumference (WC) is a factor in lifestyle‐related diseases. The rectus abdominis muscle is a skeletal muscle that attaches to the pelvis from the xiphoid process and is thought to be affected by kyphosis deformity and posterior pelvic tilt. The purpose of this study is to examine differences between sacral‐abdominal wall distance (SAD) and WC and to determine whether they are associated with fall risk, frailty, markers of sarcopenia (grip strength and lean body mass), and spinal alignment. A secondary objective is to examine these differences by stratification by grip strength. Methods This retrospective study included 239 women aged 65 years or older (mean age 76.5 ± 6.7 years) attending an outpatient osteoporosis clinic. Bone mineral density and skeletal body composition (muscle mass index and trunk lean mass) were measured using dual‐energy X‐ray absorptiometry. SAD, pelvic tilt, and sagittal longitudinal axis were measured from simple X‐ray images of the spine sides. WC, grip strength, frailty, and fall risk score were investigated. Statistics were performed using Stat Flex, with two‐sided P < 0.05 being significantly different. Results WC was correlated with SAD (R = 0.68, P < 0.001). The SAD cut‐off value for a WC of 90 cm was 167 mm. The relationship between grip strength, SAD, and WC, weaker grip strength was associated with greater SAD; however, no significant difference was noted in WC. WC was not correlated with pelvic alignment but was correlated with body mass index (P < 0.01). Meanwhile, SAD was correlated with body mass index, pelvic tilt, sagittal longitudinal axis (P < 0.01), spinal alignment, and WC. Logistic regression analysis was performed with a grip strength of less than 18 kg as the objective variable. We found that the conditions for a grip strength of less than 18 kg were older age (P < 0.001), increased SAD (P = 0.02), and decreased trunk lean body mass. There was a decrease in grip strength (P < 0.05) and an increase in frailty (P < 0.05) and falls (P < 0.01) score in patients with SAD of 167 mm or greater. Conclusions SAD and WC were found to be correlated; SAD was associated with body weight, posterior pelvic tilt, and anterior spinal tilt deformity, while WC was related to body weight. Increased SAD was found to be linked with decreased grip strength and increased risk of falls. This study was the first to examine a new measurement, SAD, for its utility in assessing grip strength, spinal alignment, frailty, and fall risk