論文 - 里宇　明元

脳脳梗塞後の嚥下障害とされた重症筋無力症の一例

里宇 明元

Journal of Clinical Rehabilitation 24   310 - 314 2015年

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【電気信号を用いた神経機能再建】 Brain-machine interface(BMI)によるリハビリ支援

里宇 明元新藤 恵一郎，里宇 明元

脳21 18   89 - 93 2015年

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Comparison of three instruments to assess changes of motor impairment in acute hemispheric stroke

Seki Masaru, Hase Kimitaka, Takahashi Hidetoshi, Liu Meigen

Disability and Rehabilitation 36 （ 18 ） 1549 - 1554 2014年08月

ISSN  0963-8288

　概要を見る

<p>Purpose: The purpose was to compare the performance of three representative instruments to measure changes of motor recovery with acute hemispheric stroke. Method: In 41 consecutive patients with acute hemispheric infarction, motor recovery was assessed within 3 days of onset and then every 2 weeks until the 12th week with the Stroke Impairment Assessment Set (SIAS), the National Institutes of Health stroke scale (NIHSS) and the Canadian Neurological Scale (CNS). We analyzed the relationships among the corresponding subscales of the three instruments with the Spearman's rank correlation method, and compared their responsiveness by plotting the temporal profiles of scores of each instrument and by testing the significance of changes over time with the Friedman test. Results: High correlations were observed among the three instruments at each examination point. However, the SIAS scores were more widely dispersed at the same NIHSS and CNS scores. Friedman test revealed that the scores changed significantly during the observation period with the SIAS and the CNS but not with the NIHSS. The changes were detected later with the CNS than with the SIAS. Conclusions: Although the assessment results with the three instruments were highly inter-correlated, the SIAS performed better with respect to responsiveness to changes.Implication for RehabilitationWhen providing rehabilitation services to patients with stroke, it is important to document objectively the level of their impairment from the acute stage and during the entire course of rehabilitation with standardized instrument, and to predict their functional outcomes as early and accurately as possible.This study therefore compared three representative instruments with established psychometric properties, the SIAS, the NIHSS and the CNS, with respect to their ability to document motor impairment and their responsiveness to recovery in patients with acute hemispheric stroke.</p>

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Rewiring of regenerated axons by combining treadmill training with semaphorin3A inhibition

Zhang Liang, Kaneko Shinjiro, Kikuchi Kaoru, Sano Akihiko, Maeda Miho, Kishino Akiyoshi, Shibata Shinsuke, Mukaino Masahiko, Toyama Yoshiaki, Liu Meigen, Kimura Toru, Okano Hideyuki, Nakamura Masaya

Molecular Brain 7 （ 1 ）  2014年03月

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<p>Background: Rats exhibit extremely limited motor function recovery after total transection of the spinal cord (SCT). We previously reported that SM-216289, a semaphorin3A inhibitor, enhanced axon regeneration and motor function recovery in SCT adult rats. However, these effects were limited because most regenerated axons likely do not connect to the right targets. Thus, rebuilding the appropriate connections for regenerated axons may enhance recovery. In this study, we combined semaphorin3A inhibitor treatment with extensive treadmill training to determine whether combined treatment would further enhance the "rewiring" of regenerated axons. In this study, which aimed for clinical applicability, we administered a newly developed, potent semaphorin3A inhibitor, SM-345431 (Vinaxanthone), using a novel drug delivery system that enables continuous drug delivery over the period of the experiment. Results: Treatment with SM-345431 using this delivery system enhanced axon regeneration and produced significant, but limited, hindlimb motor function recovery. Although extensive treadmill training combined with SM-345431 administration did not further improve axon regeneration, hindlimb motor performance was restored, as evidenced by the significant improvement in the execution of plantar steps on a treadmill. In contrast, control SCT rats could not execute plantar steps at any point during the experimental period. Further analyses suggested that this strategy reinforced the wiring of central pattern generators in lumbar spinal circuits, which, in turn, led to enhanced motor function recovery (especially in extensor muscles). Conclusions: This study highlights the importance of combining treatments that promote axon regeneration with specific and appropriate rehabilitations that promote rewiring for the treatment of spinal cord injury. © 2014 Zhang et al.; licensee BioMed Central Ltd.</p>

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Different strategy of hand choice after learning of constant and incremental dynamical perturbation in arm reaching

Habagishi Chie, Kasuga Shoko, Otaka Yohei, Liu Meigen, Ushiba Junichi

Frontiers in Human Neuroscience 8 （ 1 FEB ）  2014年02月

ISSN  1662-5161

　概要を見る

<p>In daily life, we encounter situations where we must quickly decide which hand to use for a motor action. Here, we investigated whether the hand chosen for a motor action varied over a short timescale (i.e., hours) with changes in arm dynamics. Participants performed a reaching task in which they moved a specified hand to reach a target on a virtual reality display. During the task, a resistive viscous force field was abruptly applied to only the dominant hand (DH). To evaluate changes in hand choice caused by this perturbation, participants performed an interleaved choice test in which they could freely choose either hand for reaching. Furthermore, to investigate the effect of temporal changes on arm dynamics and hand choice, we exposed the same participants to another condition in which the force field was introduced gradually. When the abrupt force was applied, use of the perturbed hand significantly decreased and not changed during the training. In contrast, when the incremental force was applied, use of the perturbed hand gradually decreased as force increased. Surprisingly, even though the final amount of force was identical between the two conditions, hand choice was significantly biased toward the unperturbed hand in the gradual condition. These results suggest that time-varying changes in arm dynamics may have a greater influence on hand choice than the amplitude of the resistant force itself. © 2014 Habagishi, Kasuga, Otaka, Liu and Ushiba.</p>

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歩行不可能な患者への理学的鑑別診断法

里宇 明元川上 途行，里宇 明元

日本医事新報 4686   76 - 78 2014年

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日本語版Mini-Balance Evaluation Systems Test(Mini-BESTest)の妥当性の検討

里宇 明元

The Japanese Journal of Rehabilitation Medicine 51   673 - 681 2014年

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食道がんに対する食道摘出術施行前後の筋肉量の変化について

里宇 明元

運動器リハビリテーション 25   279 - 283 2014年

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片麻痺患者の歩行機能に対する5%フェノール筋内神経ブロックの効果

里宇 明元

The Japanese Journal of Rehabilitation Medicine 51   4 - 5 2014年

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日本語版Balance Evaluation Systems Test(BESTest)の妥当性の検討

里宇 明元

The Japanese Journal of Rehabilitation Medicine 51   8 - 9 2014年

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亜急性期脳卒中片麻痺患者における基本動作時の酸素摂取量とmetabolic equivalentsに関する予備的研究

里宇 明元

運動器リハビリテーション 25   63 - 67 2014年

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Rewiring of regenerated axons by combining treadmill training with semaphorin3A inhibition.

里宇 明元Zhang L, Kaneko S, Kikuchi K, et al.

Mol Brain 7   14 2014年

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Functional recovery from chronic writer’s cramp by brain-computer interface rehabilitation: a case report .

里宇 明元

BMC Neurosic 15   103 2014年

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【脳血管疾患最前線】 脳血管疾患の最新のリハビリテーション

里宇 明元水野 勝広, 里宇 明元

公衆衛生 78   763 - 770 2014年

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宇宙医学からみたロコモティブシンドローム

里宇 明元

東京都医師会雑誌 67   676 - 681 2014年

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【脳のfunctional connectivity network:update】 脳のfunctional connectivity network　リハビリテーションの立場から

里宇 明元新藤 恵一郎，里宇 明元

神経内科 81   196 - 203 2014年

【最新臨床脳卒中学[上]-最新の診断と治療-】 リハビリテーション　脳卒中リハビリテーションの新たな展開

里宇 明元川上 途行，里宇 明元

日本臨床 72 （ 増刊5 ） 663 - 667 2014年

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日本のリハビリテーション医学・医療　これまでの50年、これからの50年

里宇 明元

北海道リハビリテーション学会雑誌 39   13 - 20 2014年

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【神経診察-そのポイントと次の一手】　その他 廃用症候群　臨床医に必要な知識とは?

里宇 明元川上 途行，里宇 明元

Medicina 51   1308 - 1311 2014年

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【ここまで進んだリハビリテーション】 脳科学研究と新しい治療法　脳卒中片麻痺上肢の機能回復に向けて

里宇 明元

診断と治療 102   361 - 366 2014年

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