研究者詳細 - 辻　哲也

論文 - 辻　哲也

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リハビリテーション医学・医療のすべて支持・緩和医療主体の時期のがんリハビリテーション医療

辻哲也

医学のあゆみ 2018年03月

研究論文（学術雑誌）, 単著

Anamorelin (ONO-7643) for the treatment of patients with non–small cell lung cancer and cachexia: Results from a randomized, double-blind, placebo-controlled, multicenter study of Japanese patients (ONO-7643-04)

Katakami N., Uchino J., Yokoyama T., Naito T., Kondo M., Yamada K., Kitajima H., Yoshimori K., Sato K., Saito H., Aoe K., Tsuji T., Takiguchi Y., Takayama K., Komura N., Takiguchi T., Eguchi K.

Cancer （Cancer） 124 （ 3 ） 606 - 616 2018年02月

ISSN 0008543X

© 2017 American Cancer Society BACKGROUND: Cachexia, described as weight loss (mainly in lean body mass [LBM]) and anorexia, is common in patients with advanced cancer. This study examined the efficacy and safety of anamorelin (ONO-7643), a novel selective ghrelin receptor agonist, in Japanese cancer patients with cachexia. METHODS: This double-blind clinical trial (ONO-7643-04) enrolled 174 patients with unresectable stage III/IV non–small cell lung cancer (NSCLC) and cachexia in Japan. Patients were randomized to daily oral anamorelin (100 mg) or a placebo for 12 weeks. The primary endpoint was the change from the baseline LBM (measured with dual-energy x-ray absorptiometry) over 12 weeks. The secondary endpoints were changes in appetite, body weight, quality of life, handgrip strength (HGS), and 6-minute walk test (6MWT) results. RESULTS: The least squares mean change (plus or minus the standard error) in LBM from the baseline over 12 weeks was 1.38 ± 0.18 and −0.17 ± 0.17 kg in the anamorelin and placebo groups, respectively (P <.0001). Changes from the baseline in LBM, body weight, and anorexia symptoms showed significant differences between the 2 treatment groups at all time points. Anamorelin increased prealbumin at weeks 3 and 9. No changes in HGS or 6MWT were detected between the groups. Twelve weeks' treatment with anamorelin was safe and well tolerated in NSCLC patients. CONCLUSIONS: Anamorelin significantly increased LBM and improved anorexia symptoms and the nutritional state, but not motor function, in Japanese patients with advanced NSCLC. Because no effective treatment for cancer cachexia is currently available, anamorelin can be a beneficial treatment option. Cancer 2018;124:606-16. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Anamorelin (ONO-7643) for the Treatment of Patients with Non-small Cell Lung Cancer and Cachexia: Results from a Randomized, Double-Blind, Placebo-Controlled, Multicenter, Study on Japanese Patients (ONO-7643-04)

Katakami N, Uchino J, Yokoyama T, Naito T, Kondo M, Yamada K, Kitajima H, Yoshimori K, Sato K, Saito H, Aoe K, Tsuji T, Takiguchi Y, Takayama K, Komura N, Takiguchi T, Eguchi K

Cancer 2018年02月

研究論文（学術雑誌）, 共著, 査読有り

悪液質高リスクの高齢進行がん患者に対する在宅ベースの下肢筋力トレーニングプログラムの開発─NEXTAC-ONE試験の運動介入の詳細─

立松典篤, 盛啓太, 高山浩一, 岡山太郎, 辻哲也, 岩村明, 田沼明, 内藤立暁, 光永修一, 三浦理, 大前勝弘

Palliative Care Research （日本緩和医療学会） 13 （ 4 ） 373 - 381 2018年

【目的】悪液質リスクの高い高齢進行がん患者に対して，初回化学療法導入時より栄養と運動を組み合わせたマルチモーダルな介入プログラムを開発した．本研究の目的は，その中の下肢筋力トレーニングの詳細と安全性および忍容性を報告することである．【方法】対象は，初回化学療法導入予定の70歳以上の進行非小細胞肺がんおよび進行膵がん患者30例とした．下肢筋力トレーニングは約8週間の在宅ベースプログラムとし，対象者別にトレーニング内容および負荷量を設定した．【結果】介入期間中の下肢筋力トレーニングの実施割合は91（69〜95）％であった．治療継続や日常生活に影響を及ぼすような有害事象発生はなく，介入前後で身体機能や活動量の有意な低下は認められなかった．【結論】悪液質リスクの高い高齢進行がん患者において，われわれが開発した下肢筋力トレーニングは高い実施割合を有し，身体機能や身体活動量の維持に寄与した可能性が示唆された．

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Immediate effects of active exercise with compression therapy on lower-limb lymphedema

Fukushima T, Tsuji T, Sano Y, Miyata C, Kamisako M, Hohri H, Yoshimura C, Asakura M, Okitsu T, Muraoka K, Liu M

Supportive Care in cancer 25 （ 8 ） 2603 - 2610 2017年

研究論文（学術雑誌）, 共著, 査読有り

Feasibility of a Respiratory Movement Evaluation Tool to Quantify Thoracoabdominal Movement for Neuromuscular Diseases

Liu F, Kawakami M, Tamura K, Taki Y, Shimizu K, Otsuka T, Tsuji T, Miyata C, Tashiro S, Wada A, Mizuno K, Aoki Y, Liu M

Respiratory Care 62 （ 4 ） 423 - 431 2017年

研究論文（学術雑誌）, 共著, 査読有り

Physical frailty in older people with severe aortic stenosis

Fukui S, Kawakami M, Otaka Y, Ishikawa A, Mizuno K, Tsuji T, Hayashida K, Inohara T, Yashima F, Liu M

Aging Clinical and Experimental Research 28 （ 6 ） 1081 - 1087 2016年

研究論文（学術雑誌）, 共著, 査読有り

Spatial and temporal dynamics of visual search tasks distinguish subtypes of unilateral spatial neglect

Mizuno Katsuhiro, Kato Kenji, Tsuji Tetsuya, Shindo Keiichiro, Kobayashi Yukiko, Liu Meigen

Neuropsychological Rehabilitation 1 - 25 2015年06月

ISSN 0960-2011

We developed a computerised test to evaluate unilateral spatial neglect (USN) using a touchscreen display, and estimated the spatial and temporal patterns of visual search in USN patients. The results between a viewer-centered USN patient and a stimulus-centered USN patient were compared. Two right-brain-damaged patients with USN, a patient without USN, and 16 healthy subjects performed a simple cancellation test, the circle test, a visuomotor search test, and a visual search test. According to the results of the circle test, one USN patient had stimulus-centered neglect and a one had viewer-centered neglect. The spatial and temporal patterns of these two USN patients were compared. The spatial and temporal patterns of cancellation were different in the stimulus-centered USN patient and the viewer-centered USN patient. The viewer-centered USN patient completed the simple cancellation task, but paused when transferring from the right side to the left side of the display. Unexpectedly, this patient did not exhibit rightward attention bias on the visuomotor and visual search tests, but the stimulus-centered USN patient did. The computer-based assessment system provided information on the dynamic visual search strategy of patients with USN. The spatial and temporal pattern of cancellation and visual search were different across the two patients with different subtypes of neglect.

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Brain-computer interface training combined with transcranial direct current stimulation in patients with chronic severe hemiparesis

Kasashima-Shindo Yuko, Fujiwara Toshiyuki, Ushiba Junichi, Matsushika Yayoi, Kamatani Daiki, Oto Misa, Ono Takashi, Nishimoto Atsuko, Shindo Keiichiro, Kawakami Michiyuki, Tsuji Tetsuya, Liu Meigen

Journal of Rehabilitation Medicine 47 （ 4 ） 318 - 324 2015年04月

ISSN 1650-1977

Objective: Brain-computer interface technology has been applied to stroke patients to improve their motor function. Event-related desynchronization during motor imagery, which is used as a brain-computer interface trigger, is sometimes difficult to detect in stroke patients. Anodal transcranial direct current stimulation (tDCS) is known to increase event-related desynchronization. This study investigated the adjunctive effect of anodal tDCS for brain-computer interface training in patients with severe hemiparesis. Subjects: Eighteen patients with chronic stroke. Design: A non-randomized controlled study. Methods: Subjects were divided between a brain-computer interface group and a tDCS-brain-computer interface group and participated in a 10-day brain-computer interface training. Event-related desynchronization was detected in the affected hemisphere during motor imagery of the affected fingers. The tDCS-brain-computer interface group received anodal tDCS before brain-computer interface training. Event-related desynchronization was evaluated before and after the intervention. The Fugl-Meyer Assessment upper extremity motor score (FM-U) was assessed before, immediately after, and 3 months after, the intervention. Results: Event-related desynchronization was significantly increased in the tDCS-brain-computer interface group. The FM-U was significantly increased in both groups. The FM-U improvement was maintained at 3 months in the tDCS brain-computer interface group. Conclusion: Anodal tDCS can be a conditioning tool for brain-computer interface training in patients with severe hemiparetic stroke.

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Executive dysfunction is related with decreased frontal lobe blood flow in patients with subarachnoid haemorrhage

Uchikawa Ken, Inaba Makoto, Kagami Hiroshi, Ichimura Shinya, Fujiwara Toshiyuki, Tsuji Tetsuya, Otaka Yohei, Liu Meigen

Brain Injury 28 （ 1 ） 15 - 19 2014年

ISSN 0269-9052

Objective: This study evaluated executive dysfunction in patients with subarachnoid haemorrhage (SAH) using the Behavioural Assessment of the Dysexecutive Syndrome (BADS) and correlated the occurrence of executive dysfunction with cerebral blood flow (CBF) reduction in the frontal lobe as assessed by single photon emission computed tomography (SPECT). Design: Correlational study. Subjects: Twenty-Two patients who underwent microsurgical clipping at least 3 months after SAH. Methods: This study evaluated the BADS and the Wechsler Adult Intelligence Scale-III (WAIS-III). In addition, it assessed activities of daily living (ADL). CBF was evaluated using SPECT. The patients were divided into the following groups according to the results of SPECT: (1) those with reduced CBF in the frontal lobe (reduced CBF group, n = 8) and (2) those with intact CBF (intact CBF group, n = 14). Results: The BADS score was significantly lower in the reduced CBF group compared with that of the intact CBF group, while there was no significant difference in the WAIS-III scores and ADL scale between the two groups. Conclusion: Although this result was conducted with a small sample size, executive dysfunction correlates with reduced CBF in the frontal lobes of SAH patients. A detailed evaluation of executive function is suggested in SAH patients, even if the patient's intelligence test and ADL scale reveal no abnormalities. © 2014 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted.

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Cancer Functional Assessment Set (cFAS): A New Tool for Functional Evaluation in Cancer

Miyata Chieko, Tsuji Tetsuya, Tanuma Akira, Ishikawa Aiko, Honaga Kaoru, Liu Meigen

American Journal of Physical Medicine and Rehabilitation 93 （ 8 ） 656 - 664 2014年

ISSN 0894-9115

OBJECTIVE: The aim of this study was to develop and evaluate the psychometric properties of a new measurement tool, the Cancer Functional Assessment Set (cFAS). DESIGN: A total of 119 inpatients with cancer participated in this prospective cohort study. This study took place in three phases: (1) item generation, literature search, and a round-table discussion by 32 rehabilitation specialists; (2) item reduction and selection of appropriate items from the first item pool; and (3) evaluation of psychometric properties. Concurrent validity (Spearman correlation coefficients with existing scales), internal reliability (Cronbach coefficient alpha), interrater reliability (weighted kappa statistics and intraclass correlation coefficient), cross-validation, and responsiveness (standardized response mean values) were examined. RESULTS: The cFAS consisted of 24 items. Significant correlations were found between the cFAS and existing scales. Cronbach α for the total score was 0.92. Weighted κ values for each item ranged from 0.74 to 1.00. The intraclass correlation for the total score was 0.97. Concurrent validity and internal consistency were similar at two different hospitals. The cFAS was more responsive to changes than the other tools. CONCLUSIONS: The cFAS has acceptable psychometric properties, supporting its broad generalizability. It can be a useful tool in clinical trials and can contribute to the development of cancer rehabilitation. Copyright © 2014 Lippincott Williams & Wilkins.

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Early Visual Processing is Affected by Clinical Subtype in Patients with Unilateral Spatial Neglect: A Magnetoencephalography Study

Mizuno Katsuhiro, Tsuji Tetsuya, Rossetti Yves, Pisella Laure, Ohde Hisao, Liu Meigen

Frontiers in Human Neuroscience （ JUL ） 2013年07月

ISSN 1662-5161

Objective: To determine whether visual evoked fields (VEFs) elicited by right and left hemifield stimulation differ in patients with unilateral spatial neglect that results from cerebrovascular accident. Methods: Pattern-reversal stimulation of the right and left hemifield was performed in three patients with left unilateral spatial neglect. Magnetoencephalography was recorded using a 160-channel system, and VEFs were quantified in the 400 ms after each stimulus. The presence or absence of VEF components at around 100 ms (P100m component) and 145 ms (N145m component) after stimulus onset was determined. The source of the VEF was determined using a single equivalent current dipole model for spherical volume conduction. All patients were evaluated using the behavioral inattention test (BIT). Results: In response to right hemifield stimulation, the P100m and N145m components of the VEF were evident in all three patients. In response to left hemifield stimulation, both components were evident in Patient 3, whereas only the P100m component was evident in Patient 1 and only the N145m component was evident in Patient 2. Patient 1 exhibited impairments on the line bisection and cancellation tasks of the BIT, Patient 2 exhibited impairments on the copying, drawing and cancellation tasks of the BIT, and Patient 3 exhibited impairments on the cancellation task of the BIT. Conclusions: These results demonstrate that early VEFs are disrupted in patients with unilateral spatial neglect and support the concept that deficits in visual processing differ according to the clinical subtype of unilateral spatial neglect and the lesion location. This study also demonstrates the feasibility of using magnetoencephalography to explore subtypes of neglect. © 2013 Mizuno, Tsuji, Rossetti, Pisella, Ohde and Liu.

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The effect of active pedaling combined with electrical stimulation on spinal reciprocal inhibition

Yamaguchi Tomofumi, Fujiwara Toshiyuki, Saito Kei, Tanabe Shigeo, Muraoka Yoshihiro, Otaka Yohei, Osu Rieko, Tsuji Tetsuya, Hase Kimitaka, Liu Meigen

Journal of Electromyography and Kinesiology 23 （ 1 ） 190 - 194 2013年02月

ISSN 1050-6411

Objective: Pedaling is widely used for rehabilitation of locomotion because it induces muscle activity very similar to locomotion. Afferent stimulation is important for the modulation of spinal reflexes. Furthermore, supraspinal modulation plays an important role in spinal plasticity induced by electrical stimulation. We, therefore, expected that active pedaling combined with electrical stimulation could induce strong after-effects on spinal reflexes. Design: Twelve healthy adults participated in this study. They were instructed to perform 7. min of pedaling. We applied electrical stimulation to the common peroneal nerve during the extension phase of the pedaling cycle. We assessed reciprocal inhibition using a soleus H-reflex conditioning-test paradigm. The magnitude of reciprocal inhibition was measured before, immediately after, 15 and 30. min after active pedaling alone, electrical stimulation alone and active pedaling combined with electrical stimulation (pedaling. +. ES). Results: The amount of reciprocal inhibition was significantly increased after pedaling. +. ES. The after-effect of pedaling. +. ES on reciprocal inhibition was more prominent and longer lasting compared with pedaling or electrical stimulation alone. Conclusions: Pedaling. +. ES could induce stronger after-effects on spinal reciprocal inhibitory neurons compared with either intervention alone. Pedaling. +. ES might be used as a tool to improve locomotion and functional abnormalities in the patient with central nervous lesion. © 2012 Elsevier Ltd.

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State of intracortical inhibitory interneuron activity in patients with chronic stroke

Honaga Kaoru, Fujiwara Toshiyuki, Tsuji Tetsuya, Hase Kimitaka, Ushiba Junichi, Liu Meigen

Clinical Neurophysiology 124 （ 2 ） 364 - 370 2013年02月

ISSN 1388-2457

Objectives: Few studies have assessed short intracortical inhibition (SICI) in the affected hemisphere (AH) in a large number of patients with chronic stroke. In this study, SICI was assessed in chronic stroke patients with severe hemiparesis, and its relationship to clinical parameters was examined. Methods: The participants were 72 patients with chronic hemiparetic stroke. SICI of both the AH and the unaffected hemisphere (UH) was assessed. The relationships between SICI and the location of lesion, time from onset, and finger function were studied. Motor function of the paretic finger was assessed with the Stroke Impairment Assessment Set (SIAS) and the Fugl-Meyer test upper extremity motor score. To compare the results with those of healthy subjects, SICI was assessed in seven age-matched control subjects. Results: MEPs of the UH were evoked in all 72 subjects, and MEPs of the AH were evoked in 24 subjects. SICI of the AH was inversely correlated with paretic finger motor function and time from stroke onset. SICI of the UH was not correlated with either one. SICI of the UH was higher in the cortical lesion group than in the control group. Conclusions: The state of intracortical inhibitory neuron activity depends on the state of motor function and lesion site even in chronic stroke patients with severe hemiparesis. Significance: The inhibitory system of the AH is involved in functional recovery of the paretic hand even in the chronic stage of stroke. © 2012 International Federation of Clinical Neurophysiology.

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Natural history of lymph pumping pressure after pelvic lymphadenectomy

Okitsu T., Tsuji Tetsuya, Fujii T., Mihara M., Hara H., Kisu I., Aoki D., Miyata C., Otaka Y., Liu M.

Lymphology 45 （ 4 ） 165 - 176 2012年12月

ISSN 0024-7766

Lower limb lymphedema is difficult to prevent and diagnose early because its natural history is unclear. Therefore, the aim of this study was to clarify its pathogenesis and to identify risk factors that may lead to early diagnosis. In 29 patients, aged 25 to 74 years with cervical, uterine, or ovarian cancer who underwent pelvic lymphadenectomy, indocyanine green fluorescence lymphangiography was performed with an infrared camera system, and lymph pumping pressure was measured indirectly preoperatively, and one, two, three, and six months postoperatively. Of these 29 patients, 22 (75.9%) completed the examinations. In the non-lymphedema group, the average lymph pumping pressure did not change significantly at postoperative follow-up compared with preoperative values. On the other hand, lymph pumping pressure increased at various time points in five patients who developed early lymphatic changes with dermal diffusion at the level of the proximal femur. An increase in lymph flow path resistance due to pelvic lymphadenectomy resulted in an initial increase in lymph pumping pressure, followed by a subsequent decrease, in the early lymphatic changes group. This trend in the pressure change signifies that the lymph vessels became dysfunctional as they were overwhelmed by the overload condition and this feature may be a clinically useful signal for the early diagnosis of developing lymphedema.

Newer challenges to restore hemiparetic upper extremity after stroke: HANDS therapy and BMI neurorehabilitation

Liu Meigen, Fujiwara Toshiyuki, Shindo Keiichiro, Kasashima Yuko, Otaka Yohei, Tsuji Tetsuya, Ushiba Junichi

Hong Kong Physiotherapy Journal 30 （ 2 ） 83 - 92 2012年12月

Because recovery of upper extremity (UE) functions to a practical level has been considered difficult in many patients with stroke, compensatory approaches have been emphasised. Recently, based on basic and clinical research indicating a greater potential for plastic changes in the brain, approaches directed toward functional restoration are becoming increasingly popular. Meta-analysis has indicated the effectiveness of constraint-induced movement therapy, electromyography biofeedback, electrostimulation, mental practice, and robot exercise to improve UE functions, but not hand functions. Therefore, we devised two new interventions to improve the paretic hand. One is hybrid assistive neuromuscular dynamic stimulation therapy, designed to facilitate daily use of the hemiparetic UE by combining electromyography (EMG)-triggered electrical stimulation with a wrist splint. We demonstrated improvement of motor function, spasticity, functional scores, and neurophysiologic parameters in chronic hemiparetic stroke. With a randomised controlled trial, we also demonstrated its effectiveness in subacute stroke. The other is brain-machine interface neurofeedback training, which provides real-time feedback based on analysis of volitionally decreased amplitudes of sensory motor rhythm during motor imagery involving extension of the affected fingers. This elicited new voluntary EMG activities, and improved finger functions and neurophysiological parameters. These interventions may offer powerful neurorehabilitative tools for improving hemiparetic UE function after stroke. © 2012 Hong Kong Physiotherapy Association Ltd.

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Comparison of the after-effects of transcranial direct current stimulation over the motor cortex in patients with stroke and healthy volunteers

Suzuki Kanjiro, Fujiwara Toshiyuki, Tanaka Naofumi, Tsuji Tetsuya, Masakado Yoshihisa, Hase Kimitaka, Kimura Akio, Liu Meigen

International Journal of Neuroscience 122 （ 11 ） 675 - 681 2012年11月

ISSN 0020-7454

It is known that weak transcranial direct current stimulation (tDCS) induces persistent excitability changes in the cerebral cortex. There are, however, few studies that compare the after-effects of anodal versus cathodal tDCS in patients with stroke. This study assessed the after-effects of tDCS over the motor cortex in patients with hemiparetic stroke and healthy volunteers. Seven stroke patients and nine healthy volunteers were recruited. Ten minutes of anodal and cathodal tDCS (1 mA) and sham stimulation were applied to the affected primary motor cortex (M1) on different days. In healthy subjects, tDCS was applied to the right M1. Before and after tDCS, motor-evoked potentials (MEPs) in the first dorsal interosseous (FDI) muscle and silent period were measured. Anodal tDCS increased the MEPs of the affected FDI in patients with stroke as well as in healthy subjects. Cathodal tDCS increased the MEPs of the affected FDI in patients with stroke. In healthy subjects, however, cathodal tDCS decreased the MEPs. We found no significant change in the duration of the silent period after anodal or cathodal tDCS. We found that both anodal and cathodal tDCS increased the affected M1 excitability in patients with stroke. It is thought that the after-effects of tDCS are different in patients with stroke compared with healthy subjects. © 2012 Informa Healthcare USA, Inc.

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Modulation of event-related desynchronization during motor imagery with transcranial direct current stimulation (tDCS) in patients with chronic hemiparetic stroke

Kasashima Yuko, Fujiwara Toshiyuki, Matsushika Yayoi, Tsuji Tetsuya, Hase Kimitaka, Ushiyama Junichi, Ushiba Junichi, Liu Meigen

Experimental Brain Research 221 （ 3 ） 263 - 268 2012年09月

ISSN 0014-4819

Electroencephalogram-based brain-computer interface (BCI) has been developed as a new neurorehabilitative tool for patients with severe hemiparesis. However, its application has been limited because of difficulty detecting stable brain signals from the affected hemisphere. It has been reported that transcranial direct current stimulation (tDCS) can modulate event-related desynchronization (ERD) in healthy persons. The objective of this study was to test the hypothesis that anodal tDCS could modulate ERD in patients with severe hemiparetic stroke. The participants were six patients with chronic hemiparetic stroke (mean age, 56.8 ± 9.5 years; mean time from the onset, 70.0 ± 19.6 months; Fugl-Meyer Assessment upper extremity motor score, 30.8 ± 16.5). We applied anodal tDCS (10 min, 1 mA) and sham stimulation over the affected primary motor cortex in a random order. ERD of the mu rhythm (mu ERD) with motor imagery of extension of the affected finger was assessed before and after anodal tDCS and sham stimulation. Mu ERD of the affected hemisphere increased significantly after anodal tDCS, whereas it did not change after sham stimulation. Our results show that anodal tDCS can increase mu ERD in patients with hemiparetic stroke, indicating that anodal tDCS could be used as a conditioning tool for BCI in stroke patients. © Springer-Verlag 2012.

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Immediate effects of electrical stimulation combined with passive locomotion-like movement on gait velocity and spasticity in persons with hemiparetic stroke

Yamaguchi Tomofumi, Tanabe Shigeo, Muraoka Yoshihiro, Masakado Yoshihisa, Kimura Akio, Tsuji Tetsuya, Liu Meigen

Clinical Rehabilitation 26 （ 7 ） 619 - 628 2012年07月

ISSN 0269-2155

Objective: Research to examine the immediate effects of electrical stimulation combined with passive locomotion-like movement on gait velocity and spasticity.Design: A single-masked, randomized controlled trial design.Subjects: Twenty-seven stroke inpatients in subacute phase (ischemic n=16, hemorrhagic n=11).Interventions: A novel approach using electrical stimulation combined with passive locomotion-like movement.Main measures: We assessed the maximum gait speed and modified Ashworth scale before and 20 minutes after the interventions.Results: The gait velocity of the electrical stimulation combined with passive locomotion-like movement group showed the increase form 0.68±0.28 (mean±SD, unit: m) to 0.76±0.32 after the intervention. Both the electrical stimulation group and passive locomotion-like movement group also showed increases after the interventions (from 0.76±0.37 to 0.79±0.40, from 0.74±0.35 to 0.77±0.36, respectively). The gait velocity of the electrical stimulation combined with passive locomotion-like movement group differed significantly from those of the other groups (electrical stimulation combined with passive locomotion-like movement versus electrical stimulation: P=0.049, electrical stimulation combined with passive locomotion-like movement versus passive locomotion-like movement: P=0.025). Although there was no statistically significant difference in the modified Ashworth scale among the three groups, six of the nine subjects (66.6%) in the electrical stimulation combined with passive locomotion-like movement group showed improvement in the modified Ashworth scale score, while only three of the nine subjects (33.3%) in the electrical stimulation group and two of the nine subjects (22.2%) improved in the passive locomotion-like movement group.Conclusion: These findings suggest electrical stimulation combined with passive locomotion-like movement could improve gait velocity in stroke patients. © The Author(s) 2011.

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Contraction level-related modulation of corticomuscular coherence differs between the tibialis anterior and soleus muscles in humans

Ushiyama Junichi, Masakado Yoshihisa, Fujiwara Toshiyuki, Tsuji Tetsuya, Hase Kimitaka, Kimura Akio, Liu Meigen, Ushiba Junichi

Journal of Applied Physiology 112 （ 8 ） 1258 - 1267 2012年04月

ISSN 8750-7587

The sensorimotor cortex activity measured by scalp EEG shows coherence with electromyogram (EMG) activity within the 15- to 35-Hz frequency band (β-band) during weak to moderate intensity of isometric voluntary contraction. This coupling is known to change its frequency band to the 35- to 60-Hz band (γ-band) during strong contraction. This study aimed to examine whether such contraction level-related modulation of corticomuscular coupling differs between muscles with different muscle compositions and functions. In 11 healthy young adults, we quantified the coherence between EEG over the sensorimotor cortex and rectified EMG during tonic isometric voluntary contraction at 10-70% of maximal voluntary contraction of the tibialis anterior (TA) and soleus (SOL) muscles, respectively. In the TA, the EEG-EMG coherence shifted from the β-band to the γ-band with increasing contraction level. Indeed, the magnitude of β-band EEG-EMG coherence was significantly decreased, whereas that of γ-band coherence was significantly increased, when the contraction level was above 60% of maximal voluntary contraction. In contrast to the TA, the SOL showed no such frequency changes of EEG-EMG coherence with alterations in the contraction levels. In other words, the maximal peak of EEG-EMG coherence in the SOL existed within the β-band, irrespective of the contraction levels. These findings suggest that the central nervous system regulates the frequency of corticomuscular coupling to exert the desired levels of muscle force and, notably, that the applicable rhythmicity of the coupling for performing strong contractions differs between muscles, depending on the physiological muscle compositions and functions of the contracting muscle. Copyright © 2012 the American Physiological Society.

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