Kawakami, Michiyuki

写真a

Affiliation

School of Medicine, Department of Rehabilitation Medicine (Shinanomachi)

Position

Associate Professor
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Academic Degrees 【 Display / hide 】

  • 医学博士, 慶應義塾大学

    Asymmetric skull deformity in children with cerebral palsy: frequency and correlation with postural abnormalities and deformities.

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Licenses and Qualifications 【 Display / hide 】

  • 日本摂食・嚥下リハビリテーション学会　認定士

  • 日本障害者スポーツ協会公認障害者スポーツ医

  • 日本体育協会公認スポーツドクター

  • 日本臨床神経生理学会　認定医

  • 日本脳卒中学会認定脳卒中専門医

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Research Areas 【 Display / hide 】

  • Life Science / General internal medicine

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Books 【 Display / hide 】

  • 自信がもてる!リハビリテーション臨床実習

    Kawakami Michiyuki, 医歯薬出版株式会社, 2015

  • 神経科学の最前線とリハビリテーション 脳の可塑性と運動

    Kawakami Michiyuki, 医歯薬出版株式会社, 2015

    Scope: ボツリヌス療法

  • 脊髄小脳変性症・多系統萎縮症のリハビリテーション

    Kawakami Michiyuki, 2014

  • Handbook on Cerebral Palsy: Risk Factors, Therapeutic Management and Long-Term Prognosis Chapters Books

    Kawakami Michiyuki, 2014

    Scope: Management of Postural Abnormalities in Children with Cerebral Palsy.

  • 脳卒中上下肢痙縮　Expertボツリヌス治療　―私はこう治療している―

    Kawakami Michiyuki, 診断と治療社, 2013

    Scope: 上下肢複数筋の治療の工夫・考え方

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Papers 【 Display / hide 】

  • Effects of Galvanic Vestibular Stimulation on Subjective Visual Vertical and Sitting Balance in Patients with Stroke

    Tomioka Y., Tohyama T., Honaga K., Kawakami M., Kondo K., Tsuji T.

    Journal of Stroke and Cerebrovascular Diseases (Journal of Stroke and Cerebrovascular Diseases)  31 ( 5 )  2022.05

    ISSN  10523057

    　View Summary

    Objective: This study aimed to examine the effects of galvanic vestibular stimulation (GVS) on visual vertical cognition and sitting balance in stroke patients. Materials and Methods: Patients with unilateral supratentorial infarction and hemorrhagic lesions and healthy controls were recruited. Bipolar GVS was performed through the bilateral mastoid processes with an 1.5-mA electric current. Each participant received three stimulation patterns: right anode-left cathode, left anode-right cathode, and sham. The subjective visual vertical (SVV) and center of gravity positions in the sitting posture were measured in three groups of participants: patients with right hemisphere lesions, patients with left hemisphere lesions, and in healthy controls. Changes in the SVV and center of gravity positions before and during galvanic vestibular stimulation were assessed. Results: In each group, eight individuals were recruited for SVV measurements and nine individuals for center of gravity measurements. We found changes due to polarity of stimulation on the SVV and mediolateral changes in the center of gravity in the sitting position of patients with stroke, while there was no significant difference between groups or interaction of the two factors (polarity vs. group). Conclusion: Changes in the visual vertical cognition and sitting balance occur during GVS in patients with stroke. GVS is a potential tool for ameliorating balance dysfunction in patients with stroke.

  • Investigation of the Effect of Nutritional Supplementation with Whey Protein and Vitamin D on Muscle Mass and Muscle Quality in Subacute Post-Stroke Rehabilitation Patients: A Randomized, Single-Blinded, Placebo-Controlled Trial

    Honaga K., Mori N., Akimoto T., Tsujikawa M., Kawakami M., Okamoto T., Sakata Y., Hamano H., Takeda Y., Kondo K.

    Nutrients (Nutrients)  14 ( 3 )  2022.02

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    In post-stroke hemiparesis patients, the skeletal muscle mass decrease rapidly with the histological degradation. We investigated the effect of nutritional supplementation with whey protein and vitamin D on the muscle mass and muscle quality, in post-stroke convalescent rehabilitation patients in a randomized, single-blinded, placebo-controlled trial. Fifty patients were randomly assigned to two groups; HP group received supplemental jelly (100 kcal; whey protein 10 g; vitamin D 20 µg) twice a day throughout up to 16-week period, the control group received placebo jelly. Cross-sectional area (CSA) of thigh muscle, skeletal muscle index (SMI), muscle strength, activity of daily living (ADL), and some nutritional indicators in blood were measured. Although no significant difference was observed in CSA and SMI between the groups, fat infiltration into the thighs muscle was singnificantly lower in the HP group. There were no significant difference in muscle strength and ADL between the groups. Blood urea nitrogen and serum 25(OH)D at endpoint were significantly higher in the HP group but physiological normal ranges. Supplementation with whey protein and vitamin D in post-stroke patients led to suppression of fat infiltration into the muscle. Long-term follow-up studies are needed to verify whether this nutritional intervention provides substantial benefits for the prognosis of stroke survivors.

  • Neurorehabilitation using a voluntary driven exoskeletal robot improves trunk function in patients with chronic spinal cord injury: A single-Arm study

    Okawara H., Tashiro S., Sawada T., Sugai K., Matsubayashi K., Kawakami M., Nori S., Tsuji O., Nagoshi N., Matsumoto M., Nakamura M.

    Neural Regeneration Research (Neural Regeneration Research)  17 ( 2 ) 427 - 432 2022.02

    ISSN  16735374

    　View Summary

    Body weight-supported treadmill training with the voluntary driven exoskeleton (VDE-BWSTT) has been shown to improve the gait function of patients with chronic spinal cord injury. However, little is known whether VDE-BWSTT can effectively improve the trunk function of patients with chronic spinal cord injury. In this open-label, single-Arm study, nine patients with chronic spinal cord injury at the cervical or thoracic level (six males and three females, aged 37.8 ± 15.6 years, and time since injury 51.1 ± 31.8 months) who underwent outpatient VDE-BWSTT training program at Keio University Hospital, Japan from September 2017 to March 2019 were included. All patients underwent twenty 60-minute gait training sessions using VDE. Trunk muscular strength, i.e., the maximum force against which patient could maintain a sitting posture without any support, was evaluated in four directions: Anterior, posterior, and lateral (right and left) after 10 and 20 training sessions. After intervention, lateral muscular strength significantly improved. In addition, a significant positive correlation was detected between the change in lateral trunk muscular strength after 20 training sessions relative to baseline and gait speed. The change in trunk muscular strength after 20 training sessions relative to baseline was greatly correlated with patient age. This suggests that older adult patients with chronic spinal cord injury achieved a greater improvement in trunk muscle strength following VDE-BWSTT. All these findings suggest that VDE-BWSTT can improve the trunk function of patients with chronic spinal cord injury and the effect might be greater in older adult patients. The study was approved by the Keio University of Medicine Ethics Committee (IRB No. 20150355-3) on September 26, 2017.

  • Model-Based Analyses for the Causal Relationship Between Post-stroke Impairments and Functional Brain Connectivity Regarding the Effects of Kinesthetic Illusion Therapy Combined With Conventional Exercise

    Miyawaki Y., Yoneta M., Okawada M., Kawakami M., Liu M., Kaneko F.

    Frontiers in Systems Neuroscience (Frontiers in Systems Neuroscience)  15 2022.01

    ISSN  16625137

    　View Summary

    Aims: Therapy with kinesthetic illusion of segmental body part induced by visual stimulation (KINVIS) may allow the treatment of severe upper limb motor deficits in post-stroke patients. Herein, we investigated: (1) whether the effects of KINVIS therapy with therapeutic exercise (TherEx) on motor functions were induced through improved spasticity, (2) the relationship between resting-state functional connectivity (rs-FC) and motor functions before therapy, and (3) the baseline characteristics of rs-FC in patients with the possibility of improving their motor functions. Methods: Using data from a previous clinical trial, three path analyses in structural equation modeling were performed: (1) a mediation model in which the indirect effects of the KINVIS therapy with TherEx on motor functions through spasticity were drawn, (2) a multiple regression model with pre-test data in which spurious correlations between rs-FC and motor functions were controlled, and (3) a multiple regression model with motor function score improvements between pre- and post-test in which the pre-test rs-FC associated with motor function improvements was explored. Results: The mediation model illustrated that although KINVIS therapy with TherEx did not directly improve motor function, it improved spasticity, which led to ameliorated motor functions. The multiple regression model with pre-test data suggested that rs-FC of bilateral parietal regions is associated with finger motor functions, and that rs-FC of unaffected parietal and premotor areas is involved in shoulder/elbow motor functions. Moreover, the multiple regression model with motor function score improvements suggested that the weaker the rs-FC of bilateral parietal regions or that of the supramarginal gyrus in an affected hemisphere and the cerebellar vermis, the greater the improvement in finger motor function. Conclusion: The effects of KINVIS therapy with TherEx on upper limb motor function may be mediated by spasticity. The rs-FC, especially that of bilateral parietal regions, might reflect potentials to improve post-stroke impairments in using KINVIS therapy with TherEx.

  • Impact of additional selexipag on prostacyclin infusion analogs in patients with pulmonary arterial hypertension

    Momoi M., Hiraide T., Shinya Y., Momota H., Fukui S., Kawakami M., Fukuda K., Kataoka M.

    Respiratory Medicine Case Reports (Respiratory Medicine Case Reports)  36 2022.01

    　View Summary

    The effective therapy for pulmonary arterial hypertension (PAH) with inadequate clinical response is scarce except for lung transplantation when prostacyclin infusion is ineffective. The purpose of this study is to investigate the efficacy and safety of selexipag in addition to the infusion of prostacyclin. Nine patients [median 38 (36–49) years of age; 78% female] with PAH whose clinical response was inadequate despite the use of prostacyclin infusion analogs, were evaluated. Addition of selexipag significantly improved hemodynamics and no serious adverse events were observed. Selexipag with prostacyclin infusion analogs can be an effective therapeutic strategy for the PAH patients with inadequate clinical response.

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Papers, etc., Registered in KOARA 【 Display / hide 】

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Research Projects of Competitive Funds, etc. 【 Display / hide 】

  • 下肢複数関節の分離運動を促進し正常歩行を獲得するためのロボットリハビリ手法の確立

    2023.04
    -
    2026.03

    基盤研究(B), Principal investigator

  • 運動麻痺回復を促進する適切な筋出力導出を行うロボットリハビリテーションの構築

    2019.04
    -
    2021.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Early-Career Scientists , Principal investigator

  • Effect of combination of motor imagery and electrical stimulation on upper motor function in patients with stroke.

    2016.04
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    2018.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Young Scientists (B), Principal investigator

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Awards 【 Display / hide 】

  • JSPEN クリニコ YOUNG DOCTORS AWARD

    2014

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Courses Taught 【 Display / hide 】

  • LECTURE SERIES, REHABILITATION MEDICINE

    2024

  • LECTURE SERIES, REHABILITATION MEDICINE

    2023

  • LECTURE SERIES, REHABILITATION MEDICINE

    2022

  • LECTURE SERIES, REHABILITATION MEDICINE

    2021

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Memberships in Academic Societies 【 Display / hide 】

  • 日本リハビリテーション医学会

    　

  • 日本脳卒中学会

    　

  • 日本臨床神経生理学会

    　

  • 日本摂食・嚥下リハビリテーション学会

    　

  • 日本静脈経腸栄養学会

    　
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