<Original Paper>A Study of Hemiplegic Patients at an Outpatient Clinic

Thisu survey was designed to study hemiplegic patients visiting an outpatient clinic.The subjects were 38 hemiplegics utilizing the outpatient clinic at Kawasaki Medical School Hospital.The items in the survey included : 1)the length and frequency of visits, 2)FIM(functional independence measure), 3)the purpose of the visit, and 4)activities outside the home.The mean length of treatments was 65.2±40.6 months, and the mean FIM score was 108±18.9.Nineteen patients visited the clinic to maintain motor function.Twenty-two patients did not leave their homes except to visit the hospital.The results showed that visiting the outpatient clinic was a long-term habit and many of the patients showed a high degree of independence concerning their ADL

Somatosensory Evoked Potentials in Cerebral Infarction Model Rats Induced by Microsphere Injection to Cerebral Artery

Microspheres, monodisperse polystyrene beads, are used for the study of cerebral infarction by injection into the cerebral artery. Cerebral infarction model rats were made by injecting 2,600 microspheres into the right internal carotid artery in this study. Motor ability was assessed by the rotarod test in which cling duration on the accelerating rotating rod was measured. Significant decrease in the motor ability was recognized on 3 and 15 days after the embolization compared with before surgery (p<0.05). However, sham-operated rats did not show significant change of motor ability. Each rat was reanaesthetized 15 days after surgery, and somatosensory evoked potentials (SEPs) induced by stimulation of the sciatic nerve of the contralateral hind limb were averaged. Latencies of N_1 and N_2 waves in SEPs were compared between sham-operated rats and embolized rats 15 days after surgery. No significant differences in N_1 and N_2 latencies were recognized between the two groups. These results suggest that motor ability was impaired at chronic periods of the embolization, while SEPs recovered, although latencies of N_1 and N_2 in SEPs were reported to increase at acute periods in embolized rats

Changes in the lactate threshold during treadmill exercise after microsphere-induced infarction in rats.

The aim of this study was to clarify changes in the lactate threshold (LT) in the acute period after cerebral infarction. Cerebral infarction was induced by the injection of microspheres (MS) into the right internal carotid artery. To estimate the degree of neurologic deficit caused by surgery, the behaviors of all rats were evaluated in terms of typical symptoms of stroke in rats. The rotarod test was used to evaluate equilibrium function. Rats were forced to perform stepwise treadmill exercises, and serial changes in blood lactate concentration were measured for determination of the LT. The average treadmill speed at the LT and the rotarod test performance in MS rats was significantly lower than those in sham-operated rats on postsurgery day 2. However, although neurologic deficits disappeared on postsurgery day 7 in MS rats, LT level and rotarod test performance were significantly lower than in sham-operated rats. These results suggest that the decrease in LT in the acute period after cerebral infarction might be induced by impaired equilibrium function. Other possibilities are discussed as well

Effectiveness of impedance parameters for muscle quality evaluation in healthy men

We investigated the relationship between impedance parameters and skeletal muscle function in the lower extremities, as well as the effectiveness of impedance parameters in evaluating muscle quality. Lower extremity impedance of 19 healthy men (aged 23–31 years) measured using the direct segmental multi-frequency bioelectrical impedance analysis were arc-optimized using the Cole–Cole model, following which phase angle (PA), Ri/Re, and β were estimated. Skeletal muscle function was assessed by muscle thickness, muscle intensity, and isometric knee extension force (IKEF). IKEF was positively correlated with PA (r = 0.58, p < 0.01) and β (r = 0.34, p < 0.05) was negatively correlated with Ri/Re (r = − 0.43, p < 0.01). Stepwise multiple regression analysis results revealed that PA, β, and Ri/Re were correlated with IKEF independently of muscle thickness. This study suggests that arc-optimized impedance parameters are effective for evaluating muscle quality and prediction of muscle strength

<Original Paper>Gait Endurance Index for Patients with Hemiplegia due to Cerebrovascular Accidents

The purpose of this study was to investigate the validity of the gait endurance index ( GEI ) for easily evaluating the physical fitness of hemiplegic patients. The subjects were 52 hemiplegic patients( 39 men and 13 women, 55.1�}11.3 years old) and 11 healthy subjects ( 7 men and 4 women, 64.0�}6.1 years old) as a control group. All patients were able to walk indoors without aids or with a brace or cane or both. All subjects were tested using the GEI, which was defined as the gait distance for 5 min. / recovery heart rate. The recovery heart rate was defined as the total number of heart beats during the 1-1.5 min., 2-2.5 min. and 3-3.5 min. intervals just after gait. Oxygen uptake and heart rate were measured with portable equipment during gait in 13 hemiplegics who volunteered to participate and the 11 healthy subjects. The gait distance for 5 min., recovery heart rate and GEI were measured twice in 23 patients during a two week period. The gait distance of the patients was significantly shorter than that of the healthy subjects, but there was no significant difference in the recovery heart rate between the two groups. The GEI of the patients was significantly smaller than that of the healthy subjects. A significant correlation was found between the gait distance for 5 mm. and oxygen uptake in the volunteer group, and between the recovery heart rate and the steady state heart rate during gait. No correlation between the recovery heart rate and the gait distance for 5 min. was found, in either the patients or the control group. These results indicate that the GEI is a valid and simple measure of physical fitness for hemiplegic patients after strokes