脳卒中後の肩関節亜脱臼に対する反復末梢磁気刺激の効果：予備的検討

藤田医科大

The measurement of cough response to bronchoconstriction induced by methacholine inhalation in healthy subjects: An examination using the Astograph method

Background: We demonstrated that heightened cough response to bronchoconstriction is a fundamental feature of cough variant asthma (CVA). To evaluate this physiological feature of CVA in daily clinical practice, it is necessary to clarify the cough response to bronchoconstriction in healthy subjects. We evaluated cough response to methacholine (MCh)-induced bronchoconstriction in healthy subjects. A forced oscillometry technique was used to measure airway resistance changes with Mch. Methods: Healthy never-smokers (21 men, 20 women; mean 22.3 ± 3.7 years) participated. None had a >3-week cough history, clinically significant respiratory or cardiovascular disorders, or disorders that might put subjects at risk or influence the study results or the subjects’ ability to participate. Twofold increasing concentrations of Mch chloride diluted in phosphate-buffered saline (0.039 to 160 mg/mL) were inhaled from nebulizers at 1-minute intervals during subjects’ tidal breathing after the baseline respiratory resistance (Rrs) was recorded. Mch inhalation continued until Rrs reached twice the baseline value and forced expiratory volume in 1 second (FEV1) decreased to <90% of baseline value. Spirometry was measured before Mch inhalation and immediately after Rrs had increased twofold. Coughs were counted during and for 30 minutes after Mch inhalation. The cough reflex sensitivity to capsaicin was also examined. Results: The number of coughs was 11.1 ± 14.3 (median, 7.0; range, 0 to 71; reference range, 0 to 39.7). There was no significant difference in the cough response between the sexes. The reproducibility of the cough response to bronchoconstriction was sufficient. No correlation existed between the bronchoconstriction-induced cough response and capsaicin cough-reflex sensitivity. Conclusions: Using the Astograph method, cough response to bronchoconstriction could be measured easily, safely and highly reproducibly in healthy subjects. © 2017 Taylor & FrancisEmbargo Period 12 month

Acquisition Status of Basic Clinical Skills in Japanese Novice Rehabilitation Therapists: A Preliminary Single-Center Study

The number of post-graduate rehabilitation therapists (novice therapists) is increasing due to the growing demand for rehabilitation services in Japan. This study investigated the acquisition status of Japanese novice therapists&rsquo; basic clinical skills to clarify their quality and characteristics. Eleven participants&rsquo; basic clinical skills (eight physical and three occupational therapists) were assessed using an Objective Structured Clinical Examination. Tasks included exercises of joint range of motion, muscle strengthening, getting up, standing up and sitting down, and transferring between wheelchair and bed. Assessment items were subdivided into categories: attitude, preparation, intervention, safety management, and feedback. One-way ANOVA and Friedman test were used for statistical analysis to compare the data between tasks and categories. The scores for each task&rsquo;s achievement rate were not statistically significant. However, the achievement rate of each category including tasks was 92.6% (SD 4.0%) for attitude, 81.4% (SD 11.1%) for preparation, 77.9% (SD 14.7%) for intervention, 87.6% (SD 17.3%) for safety management, and 64.0% (SD 14.2%) for feedback. There were significant differences between attitude and feedback (p &lt; 0.001), and between safety management and feedback (p = 0.012). Post-graduate training programs should focus on improving the quality of clinical skills, especially in skills related to feedback

Kinematic Analysis for Repetitive Peripheral Magnetic Stimulation of the Intrinsic Muscles of the Hand

The intrinsic muscles of the hand are responsible for finger flexion and extension. The purpose of this study was to investigate the usefulness of stimulating the intrinsic muscles of the hand using repetitive peripheral magnetic stimulation (rPMS). We evaluated angular changes in the finger joints by studying active motion and rPMS. Ten healthy adults were instructed to perform the following tests in random order: (1) maximum active metacarpophalangeal joint flexion; (2) maximum active metacarpophalangeal joint abduction; and (3) repetitive peripheral magnetic stimulation for 2 s at maximum stimulation intensity. A three-dimensional motion analysis system was used to measure angular changes. Pain during stimulation was graded on a numerical rating scale (NRS). The maximum flexion and abduction of the metacarpophalangeal joint were not significantly different between active motion and rPMS. The proximal interphalangeal joint (p = 0.009) and distal interphalangeal joint (p = 0.005) were significantly extended by rPMS. The median NRS score for pain during rPMS was 2. rPMS can produce the same extent of metacarpophalangeal joint flexion and abduction as active movement with less pain. This technique can effectively stimulate the intrinsic muscles of the hand and may be used as a treatment for various diseases that cause immobility of the metacarpophalangeal joints

Analysis of a Serial/Parallel Type of Electromagnetic Actuator

This paper describes the design and analysis of a small-sized and high thrust electromagnetic actuator. The proposed actuator is supposed to be used for application control of the hotmelt adhesive. The hotmelt has different characteristics for each material and the electromagnetic actuator is required variable characteristics. However, the problem seems to lie in the fact that it is necessary to remake another mold again to change the characteristics of the conventional electromagnetic actuator. Therefore, this paper presents small-sized electromagnetic actuator called a basic model that can stack it in the axial direction or in the radial direction. As the analysis comparison at the same size, the characteristics of conventional two serial model which stack two basic models in the axial direction and proposed three serial models have been compared by three-dimensional finite element method. In the proposed model, characteristics have been improved by reducing the core volume and increasing the number of stacks in the basic model from the viewpoint of magnetic flux density. In addition, various electromagnetic actuators that stack basic models in the axial direction or in the radial direction have been analyzed. The analysis results have been clearly shown as characteristics mapping and it has indicated that the proposed electromagnetic actuator can be constructed easily by stacking the basic model