研究者詳細 - 里宇　明元

論文 - 里宇　明元

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Correlation between changes in functional connectivity in the dorsal attention network and the after-effects induced by prism adaptation in healthy humans: A dataset of resting-state fMRI and pointing after prism adaptation

Tsujimoto K., Mizuno K., Nishida D., Tahara M., Yamada E., Shindo S., Watanabe Y., Kasuga S., Liu M.

Data in Brief （Data in Brief） 22 583 - 589 2019年02月

© 2019 The Authors It has been reported that it is possible to observe transient changes in resting-state functional connectivity (FC) in the attention networks of healthy adults during treatment with prism adaptation. by using functional magnetic resonance imaging (fMRI) (see “Prism adaptation changes resting-state functional connectivity in the dorsal stream of visual attention networks in healthy adults: A fMRI study” (Tsujimoto et al., 2018) [1]. Recent neuroimaging and neurophysiological studies support the idea that prism adaptation (PA) affects the visual attention and sensorimotor networks, which include the parietal cortex and cerebellum. These data demonstrate the effect of PA on resting-state functional connectivity between the primary motor cortex and cerebellum. Additionally, it evaluates changes of resting-state FC before and after PA in healthy individuals using fMRI. Analyses focus on FC between the primary motor cortex and cerebellum, and the correlation between changes in FC and its after-effects following a single PA session. Here, we show data that demonstrate the change in resting-state FC between the primary motor cortex and cerebellum, as well as a correlation between the change ratio of FC and the amplitude of the after-effect.

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Development of Rehabilitation System with Brain-Computer Interface for Subacute Stroke Patients

Hashimoto Y., Kakui T., Ushiba J., Liu M., Kamada K., Ota T.

Proceedings - 2018 IEEE International Conference on Systems, Man, and Cybernetics, SMC 2018 （Proceedings - 2018 IEEE International Conference on Systems, Man, and Cybernetics, SMC 2018） 51 - 56 2019年01月

ISSN 9781538666500

© 2018 IEEE. There have been recent advances in brain-computer interfaces for post-stroke rehabilitation. In particular, compact and embedded brain-computer interface systems with neuromuscular electrical stimulation have been developed by industry and academia, and some of them can potentially be used at the bedside. However, limited studies have demonstrated their safety and feasibility for treatment in subacute stroke patients. The aim of this pilot study was to first develop a brain-computer interface system for subacute stroke inpatients that is usable at the bedside and to show the safety and feasibility using a small cohort of inpatients. Four hemiplegic stroke inpatients in the very early phase (7-24 days from stroke onset) participated in this study. The portable brain-computer interface system shows the amplitude of sensorimotor rhythms extracted from scalp electroencephalograms in real time. Patients attempted to extend the wrist on their affected side, and neuromuscular electrical stimulation was applied only when the brain-computer interface system detected significant movement intention-related electroencephalogram changes. Each brain-computer interface training lasted 40 minutes. On average, 120-200 training trials of the wrist extension task were successfully and safely conducted over 3.3 days (range 2-4 days) with the bedside brain-computer interface system. Furthermore, electroencephalogram results showed a new significant event-related desynchronization in the damaged hemisphere after training. These results clearly show the proposed bedside brain-computer interface system's safety and feasibility and also demonstrated electrophysiological plasticity in the damaged hemisphere in subacute patients with post-stroke hemiplegia. Larger clinical studies are needed to identify the brain-computer interface system's clinical efficacy and its effect size in the subacute post-stroke patient population.

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Development of Shoulder Exoskeleton Toward BMI Triggered Rehabilitation Robot Therapy

Ogura M., Furukawa J., Teramae T., Noda T., Okuyama K., Kawakami M., Liu M., Morimoto J.

ISSN 9781538666500

© 2018 IEEE. Since exoskeletons show potential for rehabilitation therapy, many scientists have been designing upper extremity exoskeletons. Unfortunately, few have successfully provided a shoulder exoskeleton for severe impairment. Toward Brain-Machine-Interface (BMI) rehabilitation robot therapies for severe upper extremity impairment, this paper introduces a shoulder exoskeleton robot with a modular joint and an off-board modular actuator. We applied a Modular Exoskeletal Joint (MEJ) to a shoulder exoskeleton that was driven by Pneumatic Artificial Muscles (PAMs) transmitted by a Bowden cable. Our objective is generating passive movements triggered by BMI. Since large torque has to be generated for assist a whole arm, we newly designed a more powerful Nested-cylinder PAMs (NcPAMs) than our previous work. As a proof of the concept of the mechatronics design, we show the tracking performance of the periodic trajectory of a joint angle with both human and mannequin arms as simulated impairments. Our result shows that the tracking error is sufficiently small in all of the conditions and that our developed shoulder exoskeleton is an adequate substitute for flexion/extension movements.

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The Amelioration of Pain-Related Behavior in Mice with Chronic Spinal Cord Injury Treated with Neural Stem/Progenitor Cell Transplantation Combined with Treadmill Training

Tashiro S., Nishimura S., Shinozaki M., Takano M., Konomi T., Tsuji O., Nagoshi N., Toyama Y., Liu M., Okano H., Nakamura M.

Journal of Neurotrauma （Journal of Neurotrauma） 35 （ 21 ） 2561 - 2571 2018年11月

ISSN 08977151

© Copyright 2018, Mary Ann Liebert, Inc., publishers 2018. Progress in regenerative medicine is realizing the possibility of neural regeneration and functional recovery in spinal cord injury (SCI). Recently, rehabilitation has attracted much attention with respect to the synergistic promotion of functional recovery in combination with neural stem/progenitor cell (NS/PC) transplantation, even in the chronic refractory phase of SCI. Nevertheless, sensory disturbance is one of the most prominent sequelae, even though the effects of combination or single therapies have been investigated mostly in the context of motor recovery. To determine how combination therapy with treadmill training (TMT) and NS/PC transplantation affects the manifestation of thermal allodynia and tactile hyperalgesia in chronic phase SCI, four groups of SCI mice were used to assess pain-related behavior and histological changes: combined transplantation and TMT therapy, transplantation only, TMT only, and control groups. Thermal allodynia and coarse touch-pressure hyperalgesia exhibited significant recovery in the combined therapy group in comparison with controls, whereas there were no significant differences with fine touch-pressure hyperalgesia and motor function. Further investigation revealed fewer fibers remaining in the posterior funiculus, which contained the tracts associated with the two modalities showing less recovery; that is, touch-pressure hyperalgesia and motor function. A significant correlation was only observed between these two modalities. Although no remarkable histological recovery was found within the lesion epicenter, changes indicating amelioration of pain were observed in the lumbar enlargement of the combination therapy group. Our results suggest that amelioration of thermal allodynia and tactile hyperalgesia can be brought about by the additive effect of NS/PC transplantation and TMT. The degree of recovery seems dependent on the distribution of damage.

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Predictors for achieving oral intake in older patients with aspiration pneumonia: Videofluoroscopic evaluation of swallowing function

Ito M., Kawakami M., Ohara E., Muraoka K., Liu M.

Geriatrics and Gerontology International （Geriatrics and Gerontology International） 18 （ 10 ） 1469 - 1473 2018年10月

ISSN 14441586

© 2018 Japan Geriatrics Society Aim: Pneumonia is a common disease that is often fatal, particularly in older persons. Dysphagia is known to be closely associated with aspiration pneumonia, and hospitalized patients with aspiration pneumonia often have difficulty with oral intake. However, the relationship between acquisition of oral intake and detailed swallowing data has not been explored. The purpose of the present study was to examine the predictors, including videofluoroscopic swallowing evaluation, for achieving oral intake in older patients with aspiration pneumonia. Methods: This study included older patients, aged ≥65 years, who were admitted to Kawasaki Municipal Hospital (Kawasaki, Japan) from April 2012 through March 2014 as a result of aspiration pneumonia. Factors likely related to oral intake, including swallowing, nutritional, metabolic, and functional status, pneumonia severity and comorbidities were extracted from the medical records. Multiple logistic regression analysis was carried out to identify independent predictors for acquisition of oral intake. Results: A total of 160 patients were assigned to either the “oral intake” group (n = 104) or the “non-oral intake” group (n = 56). Multiple regression analysis showed that a low penetration aspiration scale on videofluoroscopy using 3 mL of moderately thick liquid water with tilting 30–60°, high albumin values, short duration of non-oral intake and a high Food Intake Level Scale score before admission were significantly associated with achievement of oral intake. Conclusions: Aspiration on videofluoroscopy, swallowing status before admission, nutritional status and duration of non-oral intake are important factors for acquiring oral intake. These results might be helpful for the management of older patients with aspiration pneumonia. Geriatr Gerontol Int 2018; 18: 1469–1473.

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Long-term follow-up of dysphagia in adult patients with Duchenne muscular dystrophy

Yamada Y., Kawakami M., Wada A., Fukui S., Haruyama K., Otsuka T., Liu M.

European Journal of Paediatric Neurology （European Journal of Paediatric Neurology） 22 （ 5 ） 786 - 790 2018年09月

ISSN 10903798

© 2018 European Paediatric Neurology Society Background: Dysphagia is a well-known dysfunction in patients with Duchenne muscular dystrophy (DMD), but long-term follow-up of this symptom has not been reported. The aims of this study were to investigate swallowing status, prospectively study the prognosis of swallowing function in adult patients with DMD over the course of 6 years, and to identify clinical factors related to prognosis. Methods: Participants were 81 patients with DMD. Swallowing status was assessed using the Neuromuscular Disease Swallowing Status Scale (NdSSS) every 2 years for 6 years. Results: NdSSS was related to age, functional ability assessed using the Swinyard staging and the status of ventilator dependence. Median NdSSS changed from 6 to 4, 4 and 3 over the 4 time points. Number of patients with tube feeding increased by 5–10% every 2 years. Initial NdSSS was a predictor of future swallowing status. Conclusion: Swallowing status declined over time in patients with adult DMD, with initial NdSSS as a predictor.

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Priming With intermittent theta burst transcranial magnetic stimulation promotes spinal plasticity induced by peripheral patterned electrical stimulation

Yamaguchi T., Fujiwara T., Lin S., Takahashi Y., Hatori K., Liu M., Huang Y.

Frontiers in Neuroscience （Frontiers in Neuroscience） 12 （ JUL ） 2018年07月

ISSN 16624548

© 2018 Yamaguchi, Fujiwara, Lin, Takahashi, Hatori, Liu and Huang. This study explored the effect of corticospinal activity on spinal plasticity by examining the interactions between intermittent theta burst transcranial magnetic stimulation (iTBS) of the motor cortex and peripheral patterned electrical stimulation (PES) of the common peroneal nerve (CPN). Healthy volunteers (n = 10) received iTBS to the tibialis anterior (TA) muscle zone of the motor cortex and PES of the CPN in three separate sessions: (1) iTBS-before-PES, (2) iTBS-after-PES, and (3) sham iTBS-before-PES. The PES protocol used 10 100-Hz pulses every 2 s for 20 min. Reciprocal inhibition (RI) from the TA to soleus muscle and motor cortical excitability of the TA and soleus muscles were assessed at baseline, before PES, and 0, 15, 30, and 45 min after PES. When compared to the other protocols, iTBS-before-PES significantly increased changes in disynaptic RI for 15 min and altered long-loop presynaptic inhibition immediately after PES. Moreover, the iTBS-induced cortical excitability changes in the TA before PES were correlated with the enhancement of disynaptic RI immediately after PES. These results demonstrate that spinal plasticity can be modified by altering cortical excitability. This study provides insight into the interactions between modulation of corticospinal excitability and spinal RI, which may help in developing new rehabilitation strategies.

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Structural Gray Matter Changes in the Hippocampus and the Primary Motor Cortex on An-Hour-to-One- Day Scale Can Predict Arm-Reaching Performance Improvement

Kodama M., Ono T., Yamashita F., Ebata H., Liu M., Kasuga S., Ushiba J.

Frontiers in Human Neuroscience （Frontiers in Human Neuroscience） 12 2018年06月

© 2018 Kodama, Ono, Yamashita, Ebata, Liu, Kasuga and Ushiba. Recent studies have revealed rapid (e.g., hours to days) training-induced cortical structural changes using magnetic resonance imaging (MRI). Currently, there is great interest in studying how such a rapid brain structural change affects behavioral improvement. Structural reorganization contributes to memory or enhanced information processing in the brain and may increase its capability of skill learning. If the gray matter (GM) is capable of such rapid structural reorganization upon training, the extent of volume increase may characterize the learning process. To shed light on this issue, we conducted a case series study of 5-day visuomotor learning using neuroanatomical imaging, and analyzed the effect of rapid brain structural change on motor performance improvement via regression analysis. Participants performed an upper-arm reaching task under left-right mirror-reversal for five consecutive days; T1-weighted MR imaging was performed before training, after the first and fifth days, and 1 week and 1 month after training. We detected increase in GM volume on the first day (i.e., a few hours after the first training session) in the primary motor cortex (M1), primary sensory cortex (S1), and in the hippocampal areas. Notably, regression analysis revealed that individual differences in such short-term increases were associated with the learning levels after 5 days of training. These results suggest that GM structural changes are not simply a footprint of previous motor learning but have some relationship with future motor learning. In conclusion, the present study provides new insight into the role of structural changes in causing functional changes during motor learning.

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Brain-computer interfaces for post-stroke motor rehabilitation: a meta-analysis

Cervera M., Soekadar S., Ushiba J., Millán J., Liu M., Birbaumer N., Garipelli G.

Annals of Clinical and Translational Neurology （Annals of Clinical and Translational Neurology） 5 （ 5 ） 651 - 663 2018年05月

© 2018 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals, Inc on behalf of American Neurological Association. Brain-computer interfaces (BCIs) can provide sensory feedback of ongoing brain oscillations, enabling stroke survivors to modulate their sensorimotor rhythms purposefully. A number of recent clinical studies indicate that repeated use of such BCIs might trigger neurological recovery and hence improvement in motor function. Here, we provide a first meta-analysis evaluating the clinical effectiveness of BCI-based post-stroke motor rehabilitation. Trials were identified using MEDLINE, CENTRAL, PEDro and by inspection of references in several review articles. We selected randomized controlled trials that used BCIs for post-stroke motor rehabilitation and provided motor impairment scores before and after the intervention. A random-effects inverse variance method was used to calculate the summary effect size. We initially identified 524 articles and, after removing duplicates, we screened titles and abstracts of 473 articles. We found 26 articles corresponding to BCI clinical trials, of these, there were nine studies that involved a total of 235 post-stroke survivors that fulfilled the inclusion criterion (randomized controlled trials that examined motor performance as an outcome measure) for the meta-analysis. Motor improvements, mostly quantified by the upper limb Fugl-Meyer Assessment (FMA-UE), exceeded the minimal clinically important difference (MCID=5.25) in six BCI studies, while such improvement was reached only in three control groups. Overall, the BCI training was associated with a standardized mean difference of 0.79 (95% CI: 0.37 to 1.20) in FMA-UE compared to control conditions, which is in the range of medium to large summary effect size. In addition, several studies indicated BCI-induced functional and structural neuroplasticity at a subclinical level. This suggests that BCI technology could be an effective intervention for post-stroke upper limb rehabilitation. However, more studies with larger sample size are required to increase the reliability of these results.

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Effect of the combination of motor imagery and electrical stimulation on upper extremity motor function in patients with chronic stroke: preliminary results

Okuyama K., Ogura M., Kawakami M., Tsujimoto K., Okada K., Miwa K., Takahashi Y., Abe K., Tanabe S., Yamaguchi T., Liu M.

Therapeutic Advances in Neurological Disorders （Therapeutic Advances in Neurological Disorders） 11 2018年01月

ISSN 17562856

© The Author(s), 2018. Background: The combination of motor imagery (MI) and afferent input with electrical stimulation (ES) enhances the excitability of the corticospinal tract compared with motor imagery alone or electrical stimulation alone. However, its therapeutic effect is unknown in patients with hemiparetic stroke. We performed a preliminary examination of the therapeutic effects of MI + ES on upper extremity (UE) motor function in patients with chronic stroke. Methods: A total of 10 patients with chronic stroke demonstrating severe hemiparesis participated. The imagined task was extension of the affected finger. Peripheral nerve electrical stimulation was applied to the radial nerve at the spiral groove. MI + ES intervention was conducted for 10 days. UE motor function as assessed with the Fugl–Meyer assessment UE motor score (FMA-UE), the amount of the affected UE use in daily life as assessed with a Motor Activity Log (MAL-AOU), and the degree of hypertonia in flexor muscles as assessed with the Modified Ashworth Scale (MAS) were evaluated before and after intervention. To assess the change in spinal neural circuits, reciprocal inhibition between forearm extensor and flexor muscles with the H reflex conditioning-test paradigm at interstimulus intervals (ISIs) of 0, 20, and 100 ms were measured before and after intervention. Results: UE motor function, the amount of the affected UE use, and muscle hypertonia in flexor muscles were significantly improved after MI + ES intervention (FMA-UE: p < 0.01, MAL-AOU: p < 0.01, MAS: p = 0.02). Neurophysiologically, the intervention induced restoration of reciprocal inhibition from the forearm extensor to the flexor muscles (ISI at 0 ms: p = 0.03, ISI at 20 ms: p = 0.03, ISI at 100 ms: p = 0.01). Conclusion: MI + ES intervention was effective for improving UE motor function in patients with severe paralysis.

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Relationship between spasticity and spinal neural circuits in patients with chronic hemiparetic stroke

Okuyama K., Kawakami M., Hiramoto M., Muraoka K., Fujiwara T., Liu M.

Experimental Brain Research （Experimental Brain Research） 236 （ 1 ） 207 - 213 2018年01月

ISSN 00144819

© 2017, Springer-Verlag GmbH Germany, part of Springer Nature. Spasticity is a common problem in patients with stroke that contributes to motor dysfunction. However, the pathophysiological mechanisms underlying spasticity are not fully understood. The purpose of the present study was to explain the relationship between features of spinal neural circuits assessed using electrophysiological techniques and the clinical manifestations of stroke. The participants were 71 patients with chronic hemiparetic stroke. To assess spinal neural circuits, Hmax/Mmax of the forearm flexor muscles and reciprocal inhibition (RI) between forearm extensor and flexor muscles with the H reflex conditioning-test paradigm were measured. The relationships between electrophysiological parameters and clinical variables (age, time from stroke onset, upper extremity functional scores, and spasticity) were then analyzed. It was found that the third phase of RI (RI-3) correlated with the modified Ashworth scores of the wrist and finger flexors. No other correlations were found between electrophysiological and clinical measures. These results suggest that RI-3 is associated with spasticity and may be helpful to understand the basis of post-stroke spasticity.

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Voluntary contraction enhances spinal reciprocal inhibition induced by patterned electrical stimulation in patients with stroke

Takahashi Y., Fujiwara T., Yamaguchi T., Matsunaga H., Kawakami M., Honaga K., Mizuno K., Liu M.

Restorative Neurology and Neuroscience （Restorative Neurology and Neuroscience） 36 （ 1 ） 99 - 105 2018年

ISSN 09226028

© 2016-IOS Press and the authors. All rights reserved. Background: Reciprocal inhibition (RI) may be important for recovering locomotion after stroke. Patterned electrical stimulation (PES) can modulate RI in a manner that could be enhanced by voluntary muscle contraction (VC). Objective: To investigate whether VC enhances the PES-induced spinal RI in patients with stroke. Methods: Twelve patients with chronic stroke underwent three 20 min tasks, each on different days: (1) PES (10 pulses, 100 Hz every 2 s) applied to the common peroneal nerve; (2) VC consisting of isometric contraction of the affected-side tibialis anterior muscle; (3) PES combined with VC (PES + VC). RI from the tibialis anterior to the soleus muscle was assessed before, immediately after, and 10, 20, and 30 min after the task. Results: Compared to the baseline, PES + VC significantly increased the changes in reciprocal inhibition at immediately after and 10 min after the task. PES alone significantly increased this change immediately after the task, while VC alone showed no significant increase. Conclusion: VC enhanced the PES-induced plastic changes in RI in patients with stroke. This effect can potentially increase the success rate of newer neurorehabilitative approaches in achieving functional recovery after stroke.

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Rehabilitation outcomes of stroke patients with low left ventricular ejection fraction in the subacute rehabilitation phase

Tsujikawa M., Otaka Y., Hasegawa R., Kondo K., Muraoka K., Liu M.

Journal of Rehabilitation Medicine （Journal of Rehabilitation Medicine） 50 （ 6 ） 499 - 504 2018年

ISSN 16501977

© 2018 Foundation of Rehabilitation Information. Objective: To examine the left ventricular ejection fraction in patients with subacute stroke and compare rehabilitation outcomes between those with decreased left ventricular ejection fraction and those without. Design: Retrospective chart review. Subjects: A total of 482 consecutive patients with stroke admitted to a convalescent rehabilitation hospital. Methods: Patients were assessed using transthoracic echocardiography within 7 days of admission. The patients were divided into a group with low left ventricular ejection fraction and a group with preserved left ventricular ejection fraction. Functional Independence Measure (FIM) scores at admission and discharge, FIM gain, FIM efficiency, and discharge disposition were compared between groups. Results: The low left ventricular ejection fraction group had significantly lower cognitive and total FIM scores on admission than the preserved left ventricular ejection fraction group. The patients in the low left ventricular ejection fraction group tended to be transferred to acute hospitals more frequently. However, the total score of discharge FIM, FIM gain, and FIM efficiency did not differ significantly between the groups when rehabilitation was continued until discharge. Conclusion: Stroke patients with low left ventricular ejection fraction in the subacute phase could achieve almost the same functional outcomes as those of patients with preserved left ventricular ejection fraction. Although the general medical condition should be considered, the finding of low left ventricular ejection fraction did not pose a barrier to successful rehabilitation after stroke.

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Feasibility of task-specific brain-machine interface training for upper-extremity paralysis in patients with chronic hemiparetic stroke

Nishimoto A., Kawakami M., Fujiwara T., Hiramoto M., Honaga K., Abe K., Mizuno K., Ushiba J., Liu M.

Journal of Rehabilitation Medicine （Journal of Rehabilitation Medicine） 50 （ 1 ） 52 - 58 2018年

ISSN 16501977

© 2018 Foundation of Rehabilitation Information. Objective: Brain-machine interface training was developed for upper-extremity rehabilitation for patients with severe hemiparesis. Its clinical application, however, has been limited because of its lack of feasibility in real-world rehabilitation settings. We developed a new compact task-specific brain-machine interface system that enables task-specific training, including reach-and-grasp tasks, and studied its clinical feasibility and effectiveness for upper-extremity motor paralysis in patients with stroke. Design: Prospective before-after study. Subjects: Twenty-six patients with severe chronic hemiparetic stroke. Methods: Participants were trained with the brainmachine interface system to pick up and release pegs during 40-min sessions and 40 min of standard occupational therapy per day for 10 days. Fugl-Meyer upper-extremity motor (FMA) and Motor Activity Log-14 amount of use (MAL-AOU) scores were assessed before and after the intervention. To test its feasibility, 4 occupational therapists who operated the system for the first time assessed it with the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST) 2.0. Results: FMA and MAL-AOU scores improved significantly after brain-machine interface training, with the effect sizes being medium and large, respectively (p < 0.01, d = 0.55; p < 0.01, d = 0.88). QUEST effectiveness and safety scores showed feasibility and satisfaction in the clinical setting. Conclusion: Our newly developed compact brainmachine interface system is feasible for use in realworld clinical settings.

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Change in Reciprocal Inhibition of the Forearm with Motor Imagery among Patients with Chronic Stroke

Kawakami M., Okuyama K., Takahashi Y., Hiramoto M., Nishimura A., Ushiba J., Fujiwara T., Liu M.

Neural Plasticity （Neural Plasticity） 2018 2018年

ISSN 20905904

© 2018 Michiyuki Kawakami et al. We investigated cortically mediated changes in reciprocal inhibition (RI) following motor imagery (MI) in short- and long(er)-term periods. The goals of this study were (1) to describe RI during MI in patients with chronic stroke and (2) to examine the change in RI after MI-based brain-machine interface (BMI) training. Twenty-four chronic stroke patients participated in study 1. All patients imagined wrist extension on the affected side. RI from the extensor carpi radialis to the flexor carpi radialis (FCR) was assessed using a FCR H reflex conditioning-test paradigm. We calculated the "MI effect score on RI" (RI value during MI divided by that at rest) and compared that score according to lesion location. RI during MI showed a significant enhancement compared with RI at rest. The MI effect score on RI in the subcortical lesion group was significantly greater than that in the cortical lesion group. Eleven stroke patients participated in study 2. All patients performed BMI training for 10 days. The MI effect score on RI at a 20 ms interstimulus interval was significantly increased after BMI compared with baseline. In conclusion, mental practice with MI may induce plastic change in spinal reciprocal inhibitory circuits in patients with stroke.

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Resting-state fluctuations of EEG Sensorimotor Rhythm reflect BOLD activities in the pericentral areas: A simultaneous EEG-fMRI study.

里宇明元

Frontiers in Human Neuroscience 2017年

After-effects of pedaling exercise on spinal excitability and spinal reciprocal inhibition in patients with chronic stroke.

里宇明元

Int J Neurosci 21 1 - 7 2017年

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Establishment of an appropriate fall prevention program

里宇明元

a community-based study Geriatrics & Gerontology International 17 （ 7 ） 1081 - 1089 2017年

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Transcracial direct current stimulation improves audioverbal memory in stroke patients.

里宇明元

Am J Phys Med Rehabil 96 （ 8 ） 565 - 571 2017年

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Feasibility of respiratory movement evaluation tool to quantify thoracoabdominal movement for neuromuscular diseases.

里宇明元

Respiratory Care 62 （ 4 ） 423 - 431 2017年

Individual difference in b-band corticomuscular coherence and its relation to force steadiness during isometric voluntary ankle dorsiflexion in healthy humans.

里宇明元

Clinical Neurophysiology 128 303 - 311 2017年

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Transcranial direct current stimulation improves audioverbal memory in stroke patients.

里宇明元

Am J Phys Med Rehabil 96 （ 8 ） 565 - 571 2017年

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Nitrogen balance in patients with hemiparetic stroke during the subacute rehabilitation phase.

里宇明元

J Human Nutrition and Dietetics 30 （ 3 ） 302 - 308 2017年

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A comparison of swallowing dysfunction in Becker muscular dystrophy and Duchenne muscular dystrophy

里宇明元

Disability and Rehabilitation （Disability and Rehabilitation） 40 （ 12 ） 1421 - 1425 2017年

共著, ISSN 09638288

© 2017 Informa UK Limited, trading as Taylor & Francis Group. Purpose: Swallowing dysfunction has been reported in Duchenne muscular dystrophy (DMD), but has not been studied in Becker muscular dystrophy (BMD). The aims of this study were to report the characteristics of swallowing dysfunction in BMD compared with DMD. Materials and methods: The study participants were 18 patients with BMD and 18 patients with DMD. All the patients were examined using videofluorography during swallowing of 5 mL of fluid. The penetration–aspiration scale (P–A scale) and the videofluorographic dysphagia scale (VDS) were used to evaluate dysphagia. Results: Swinyard functional ability stage was not significantly different between the BMD and DMD groups. Rate of aspiration, P–A scale score, and total VDS score did not differ across groups, but the VDS item score for laryngeal elevation was lower in the BMD group than in the DMD group (median scores 4.5 and 9, respectively; p < 0.001). In the BMD group, total VDS score significantly correlated with Swinyard stage (r = 0.78, p < 0.001), but not with age or lung function. Conclusion: Patients with BMD have swallowing problems similar to those observed in patients with DMD when matched according to physical functional status. These patients should be evaluated and followed-up for the duration of their disease. Implications for rehabiliation Dysphagia is one of the most critical problems in patients with progressive neuromuscular disease but dysphagia in patients with Becker muscular dystrophy (BMD) was not well known. Eighteen patients with BMD and 18 patients with Duchenne muscular dystrophy were examined with videofluorography. Patients with BMD have swallowing problems similar to those observed in patients with DMD.

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Contribution of propriospinal neurons to recovery of hand dexterity after corticospinal tract lesions in monkeys.

里宇明元

Proceedings of the National Academy of Sciences 114 （ 3 ） 604 - 609 2017年

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Swallowing dysfunction and postoperative pneumonia in elderly patients undergoing transcatheter aortic valve implantation: a preliminary prospective cohort study.

里宇明元

Top in Geriat Rehabil 32 （ 2 ） 114 - 118 2016年

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The effects of anodal transcranial direct current stimulation and patterned electrical stimulation on spinal inhibitory interneurons and motor function in patients with spinal cord injury.

里宇明元

Exp Brain Res 120 1 - 10 2016年

A new therapeutic application of brain-machine interface (BMI) training followed by hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy for patients with severe hemiparetic stroke

里宇明元

Restor Neurol Neurosci 34 （ 5 ） 789 - 797 2016年

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Investigating the course and predictors of desire to void after stroke with the new desire to void scale: A prospective cohort study.

里宇明元

Brain Impairment 17 （ 2 ） 162 - 170 2016年

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BDNF Induced by Treadmill Training Contributes to the Suppression of Spasticity and Allodynia After Spinal Cord Injury via Upregulation of KCC2

Tashiro Syoichi, Shinozaki Munehisa, Mukaino Masahiko, Renault-Mihara François, Toyama Yoshiaki, Liu Meigen, Nakamura Masaya, Okano Hideyuki

Neurorehabilitation and Neural Repair 29 （ 7 ） 677 - 689 2015年08月

ISSN 1545-9683

Background. Spasticity and allodynia are major sequelae that affect the quality of life and daily activities of spinal cord injury (SCI) patients. Although rehabilitation ameliorates spasticity and allodynia, the molecular mechanisms involved in these processes remain elusive. Objective. To investigate the molecular mechanisms by which rehabilitation ameliorates spasticity and allodynia after SCI in rats. Methods. The expression levels of brain-derived neurotrophic factor (BDNF) and potassium-chloride cotransporter-2 (KCC2), as well as the localization of KCC2, were examined in the lumbar enlargements of untrained and treadmill-trained thoracic SCI model rats. Spasticity and allodynia were determined via behavioral and electrophysiological analyses. The effects of BDNF on spasticity, allodynia, and KCC2 activation were determined by inhibition of BDNF signaling via intrathecal administration of TrkB-IgG. The effects of SCI and training on the expression levels of functional phospholipase C-γ in the lumbar enlargement were also examined. Results. Treadmill training after SCI upregulated endogenous BDNF expression and posttranslational modification of KCC2 in the lumbar enlargement significantly. There were also significant correlations between increased KCC2 expression and ameliorated spasticity and allodynia. Administration of TrkB-IgG abrogated the training-induced upregulation of KCC2 and beneficial effects on spasticity and allodynia. The expression level of functional phospholipase C-γ was reduced significantly after SCI, which may have contributed to the change in the function of BDNF, whereby it did not trigger short-term downregulation or induce long-term upregulation of KCC2 expression secondary to training. Conclusions. BDNF-mediated restoration of KCC2 expression underlies the suppression of spasticity and allodynia caused by rehabilitation.

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Clinical usefulness and validity of robotic measures of reaching movement in hemiparetic stroke patients

Otaka Eri, Otaka Yohei, Kasuga Shoko, Nishimoto Atsuko, Yamazaki Kotaro, Kawakami Michiyuki, Ushiba Junichi, Liu Meigen

Journal of NeuroEngineering and Rehabilitation 12 （ 1 ） 1 - 10 2015年08月

Abstract Background: Various robotic technologies have been developed recently for objective and quantitative assessment of movement. Among them, robotic measures derived from a reaching task in the KINARM Exoskeleton device are characterized by their potential to reveal underlying motor control in reaching movements. The aim of this study was to examine the clinical usefulness and validity of these robot-derived measures in hemiparetic stroke patients. Methods: Fifty-six participants with a hemiparetic arm due to chronic stroke were enrolled. The robotic assessment was performed using the Visually Guided Reaching (VGR) task in the KINARM Exoskeleton, which allows free arm movements in the horizontal plane. Twelve parameters were derived based on motor control theory. The following clinical assessments were also administered: the proximal upper limb section in the Fugl-Meyer Assessment (FMA-UE(A)), the proximal upper limb part in the Stroke Impairment Assessment Set (SIAS-KM), the Modified Ashworth Scale for the affected elbow flexor muscles (MAS elbow), and seven proximal upper limb tasks in the Wolf Motor Function Test (WMFT). To explore which robotic measures represent deficits of motor control in the affected arm, the VGR parameters in the paretic arm were compared with those in the non-paretic arm using the Wilcoxon signed rank test. Then, to explore which VGR parameters were related to overall motor control regardless of the paresis, correlations between the paretic and non-paretic arms were examined. Finally, to investigate the relationships between the robotic measures and the clinical scales, correlations between the VGR parameters and clinical scales were investigated. Spearman's rank correlation coefficients were used for all correlational analyses. Results: Eleven VGR parameters on the paretic side were significantly different from those on the non-paretic side with large effect sizes (|effect size| = 0.76-0.87). Ten VGR parameters correlated significantly with FMA-UE(A) (|r| = 0.32-0.60). Eight VGR parameters also showed significant correlations with SIAS-KM (|r| = 0.42-0.49), MAS elbow (|r| = 0.44-0.48), and the Functional Ability Scale of the WMFT (|r| = 0.52-0.64). Conclusions: The robot-derived measures could successfully differentiate between the paretic arm and the non-paretic arm and were valid in comparison to the well-established clinical scales.

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Transcranial direct current stimulation enhances mu rhythm desynchronization during motor imagery that depends on handedness

Kasuga Shoko, Matsushika Yayoi, Kasashima-Shindo Yuko, Kamatani Daiki, Fujiwara Toshiyuki, Liu Meigen, Ushiba Junichi

Laterality 20 （ 4 ） 453 - 468 2015年07月

ISSN 1357-650X

Transcranial direct current stimulation (tDCS) can modulate the amplitude of event-related desynchronization (ERD) that appears on the electroencephalogram (EEG) during motor imagery. To study the effect of handedness on the modulating effect of tDCS, we compared the difference in tDCS-boosted ERD during dominant and non-dominant hand motor imagery. EEGs were recorded over the left sensorimotor cortex of seven healthy right-handed volunteers, and we measured ERD induced either by dominant or non-dominant hand motor imagery. Ten minutes of anodal tDCS was then used to increase the cortical excitability of the contralateral primary motor cortex (M1), and ERD was measured again. With anodal tDCS, we observed only a small increase in ERD during non-dominant hand motor imagery, whereas the same stimulation induced a prominent increase in ERD during dominant hand motor imagery. This trend was most obvious in the participants who used their dominant hand more frequently. Although our study is preliminary because of a small sample size, these results suggest that the increase in ERD by applying anodal tDCS was stronger on the dominant side than on the non-dominant side. The background excitability of M1 may determine the strength of the effect of anodal tDCS on ERD by hand motor imagery.

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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 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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Sensorimotor event-related desynchronization represents the excitability of human spinal motoneurons

Takemi M., Masakado Y., Liu M., Ushiba J.

Neuroscience 297 58 - 67 2015年06月

ISSN 0306-4522

Amplitudes of mu and beta (7-26. Hz) oscillations measured by electroencephalography over the sensorimotor areas are suppressed during motor imagery as well as during voluntary movements. This phenomenon is referred to as event-related desynchronization (ERD) and is known to reflect motor cortical excitability. The increased motor cortical excitability associated with ERD during hand motor imagery would induce a descending cortical volley to spinal motoneurons, resulting in facilitation of spinal motoneuronal excitability. Therefore, in the present study, we tested the association of ERD during motor imagery with the excitability of spinal motoneurons in 15 healthy participants. Spinal excitability was tested using the F-wave recorded from the right abductor pollicis brevis muscle. The F-wave results from antidromic activation of spinal motoneurons and is induced by peripheral nerve stimulation. Participants performed 5. s of motor imagery of right thumb abduction following 7. s of rest. The right median nerve was stimulated at wrist level when the ERD magnitude of the contralateral hand sensorimotor area exceeded predetermined thresholds during motor imagery. The results showed ERD magnitude during hand motor imagery was associated with an increase in F-wave persistence, but not with the response average of F-wave amplitude or F-wave latency. These findings suggest that the ERD magnitude may be a biomarker representing increases in the excitability of both cortical and spinal levels.

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Psychometric properties of the simple test for evaluating hand function in patients with stroke

Shindo Keiichiro, Oba Hideki, Hara Joji, Ito Mari, Hotta Fujiko, Liu Meigen

Brain Injury 29 （ 6 ） 772 - 776 2015年06月

ISSN 0269-9052

Objective: The simple test for evaluating hand function (STEF) is widely used for clinical evaluation of upper extremity function in Japan. However, except for test-re-test reliability, its psychometric properties have not been investigated. The aim of this study is to explore its internal consistency, concurrent validity and responsiveness in patients with sub-acute stroke. Design: This was a prospective longitudinal study. Patients: Thirty-four inpatients who had suffered hemiparetic stroke within 60 days of participation were enrolled. Methods: To investigate its internal consistency and responsiveness, they were assessed with the STEF and Action Research Arm Test (ARAT) at admission and 3 weeks later. To explore its concurrent validity, the Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL) and Functional Independence Measure (FIM™) were also evaluated at admission. Results: The Cronbach's alpha for the STEF was 0.98-0.99, indicating excellent internal consistency. The STEF score strongly correlated with the ARAT, FMA and MAL scores and moderately with the FIM™ score. Effect sizes and the standardized response mean were 0.27 and 0.52 for the STEF and 0.30 and 0.95 for the ARAT, respectively. Conclusion: This study indicates that the STEF is reliable, valid and sensitive to changes when applied to patients with sub-acute stroke.

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Resting energy expenditure in patients with stroke during the subacute phases - Relationships with stroke types, location, severity of paresis, and activities of daily living

Kawakami Michiyuki, Liu Meigen, Wada Ayako, Otsuka Tomoyoshi, Nishimura Atsuko

Cerebrovascular Diseases 39 （ 3-4 ） 170 - 175 2015年05月

ISSN 1015-9770

Background: The energy demands in patients with stroke during the subacute phases are unclear. However, this information is essential for appropriate clinical and nutritional management. The aims of this study were to determine the resting energy expenditure (REE) during the subacute phases, examine its relationships with stroke types, location, severity of hemiparesis, and activities of daily living (ADL), and evaluate whether estimation of REE from the Harris-Benedict equation (HB) requires the addition of a 'stress factor' to capture possible additional REE imposed by stroke. Methods: We measured REE in 95 patients with subacute stroke (53.5 ± 16.6 days post-stroke) with indirect calorimetry, and compared it with predicted values of energy expenditure estimated from the HB (expressed as percentage). Patients were admitted for rehabilitation of their first ischemic or nonsurgical hemorrhagic stroke. The severity of hemiparesis was assessed with the motor items of the Stroke Impairment Assessment Set (SIAS). The ADL was assessed with the Functional Independence Measure (FIM). We compared REE and %HB of the two groups divided by hemiparesis severity and ADL limitation using the Student's t-test, and those of the five groups divided by stroke location. The correlations between REE and the motor items of the SIAS and the FIM score were assessed with the Spearman rank correlation test. A multiple regression analysis for REE was conducted. Results: The average body weight (BW) was 57.1 ± 11.3 kg. The average body mass index (BMI) was 22.5 ± 4.0. The mean REE (%HB) was 1,271 ± 284 kcal/day (106.0 ± 17.3%). REE and %HB of the low ADL group was less than that of the high ADL group (p < 0.05). The REE had a positive correlation with the FIM score (rs = 0.51, p < 0.01). The motor items of the SIAS were not significantly correlated with REE. BW, FIM, and stroke location were independent predictors of REE. Conclusions: Analysis of energy expenditure suggests that stroke patients are not hypermetabolic during the subacute phase. The 'stress factor' in stroke patients during the subacute phase was 1.0-1.1. This finding provides important information for improving nutritional management during the subacute phase in patients with stroke.

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Alteration of a motor learning rule under mirror-reversal transformation does not depend on the amplitude of visual error

Kasuga Shoko, Kurata Makiko, Liu Meigen, Ushiba Junichi

Neuroscience Research 94 62 - 69 2015年05月

ISSN 0168-0102

Human's sophisticated motor learning system paradoxically interferes with motor performance when visual information is mirror-reversed (MR), because normal movement error correction further aggravates the error. This error-increasing mechanism makes performing even a simple reaching task difficult, but is overcome by alterations in the error correction rule during the trials. To isolate factors that trigger learners to change the error correction rule, we manipulated the gain of visual angular errors when participants made arm-reaching movements with mirror-reversed visual feedback, and compared the rule alteration timing between groups with normal or reduced gain. Trial-by-trial changes in the visual angular error was tracked to explain the timing of the change in the error correction rule. Under both gain conditions, visual angular errors increased under the MR transformation, and suddenly decreased after 3-5 trials with increase. The increase became degressive at different amplitude between the two groups, nearly proportional to the visual gain. The findings suggest that the alteration of the error-correction rule is not dependent on the amplitude of visual angular errors, and possibly determined by the number of trials over which the errors increased or statistical property of the environment. The current results encourage future intensive studies focusing on the exact rule-change mechanism.

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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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Echocardiographic abnormalities in patients with stroke during the subacute rehabilitation phase

Tsujikawa Masahiro, Otaka Yohei, Hasegawa Rei, Kondo Kunitsugu, Liu Meigen

Journal of Rehabilitation Medicine 47 （ 1 ） 38 - 44 2015年01月

ISSN 1650-1977

OBJECTIVE: To evaluate cardiac function using echocardiography in patients with stroke admitted to subacute rehabilitation units.DESIGN: Retrospective, cross-sectional study.PARTICIPANTS: A total of 750 consecutive patients with stroke who were admitted to a suburban rehabilitation hospital. Mean age 67.5 years (standard deviation (SD) 12.3 years). Mean time since stroke 36.7 days (SD 13.2 days).METHODS: Patients were assessed using transthoracic echocardiography within 7 days of admission. The prevalence of echocardiographic abnormalities was analysed and compared between cerebral infarction and haemorrhage using the Mantel-Haenszel method controlled for age.RESULTS: Arrhythmias were found in 13.7% of the patients, 94.2% of whom had atrial fibrillation. Left atrial enlargement and left ventricular hypertrophy were found in 20.4% and 19.5% of all patients, respectively. Left ventricular asynergy was detected in 6.1% of all patients, but 47.8% of them had no history of myocardial infarction. Left ventricular ejection fraction was low in 12.2% of all patients. Abnormal rhythms and left atrial enlargement were significantly more frequent in patients with cerebral infarction than in those with cerebral haemorrhage (p < 0.01).CONCLUSION: The prevalence of cardiac problems is high among patients with subacute stroke regardless of a history of heart disease, and this should be taken into account when planning rehabilitation programmes.

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【脳と循環の20年】脳卒中とリハビリテーション

里宇明元大高洋平，里宇明元

脳と循環 20 45 - 49 2015年

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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

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.

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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

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.

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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

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.

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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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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

単著

【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

単著

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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Erratum to

Sakamoto Keizo, Endo Naoto, Harada Atsushi, Sakada Takenori, Tsushita Kazuyo, Kita Kiyoshi, Hagino Hiroshi, Sakai Akinori, Yamamoto Noriaki, Okamoto Tetsunori, Liu Meigen, Kokaze Akatsuki, Suzuki Hiromichi

Journal of Orthopaedic Science 19 （ 2 ） 373 - 374 2014年

ISSN 0949-2658

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Efficacy of brain-computer interface-driven neuromuscular electrical stimulation for chronic paresis after stroke.

Mukaino Masahiko, Ono Takashi, Shindo Keiichiro, Fujiwara Toshiyuki, Ota Tetsuo, Kimura Akio, Liu Meigen, Ushiba Junichi

Journal of rehabilitation medicine 46 （ 4 ） 378 - 382 2014年

Brain computer interface technology is of great interest to researchers as a potential therapeutic measure for people with severe neurological disorders. The aim of this study was to examine the efficacy of brain computer interface, by comparing conventional neuromuscular electrical stimulation and brain computer interface-driven neuromuscular electrical stimulation, using an A-B-A-B withdrawal single-subject design. A 38-year-old male with severe hemiplegia due to a putaminal haemorrhage participated in this study. The design involved 2 epochs. In epoch A, the patient attempted to open his fingers during the application of neuromuscular electrical stimulation, irrespective of his actual brain activity. In epoch B, neuromuscular electrical stimulation was applied only when a significant motor-related cortical potential was observed in the electroencephalogram. The subject initially showed diffuse functional magnetic resonance imaging activation and small electro-encephalogram responses while attempting finger movement. Epoch A was associated with few neurological or clinical signs of improvement. Epoch B, with a brain computer interface, was associated with marked lateralization of electroencephalogram (EEG) and blood oxygenation level dependent responses. Voluntary electromyogram (EMG) activity, with significant EEG-EMG coherence, was also prompted. Clinical improvement in upper-extremity function and muscle tone was observed. These results indicate that self-directed training with a brain computer interface may induce activity- dependent cortical plasticity and promote functional recovery. This preliminary clinical investigation encourages further research using a controlled design.

Cancer Functional Assessment Set: 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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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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Multimodal Sensory Feedback Associated with Motor Attempts Alters BOLD Responses to Paralyzed Hand Movement in Chronic Stroke Patients

Ono Takashi, Tomita Yutaka, Inose Manabu, Ota Tetsuo, Kimura Akio, Liu Meigen, Ushiba Junichi

Brain Topography 28 （ 2 ） 340 - 351 2014年

ISSN 0896-0267

Electroencephalogram-based brain–computer interfaces (BCI) have been used as a potential tool for training volitional regulation of corticomuscular drive in patients who have severe hemiplegia due to stroke. However, it is unclear whether ERD observed while attempting motor execution can be regarded as a neural marker that represents M1 excitability in survivors of severe stroke. Therefore we investigated the association between ERD and the blood-oxygen-level-dependent (BOLD) fMRI signal during attempted movement of a paralyzed finger in stroke patients. Nine chronic stroke patients received BCI training for finger extension movement 1 h daily for a duration of 1 month. The sensorimotor rhythm was recorded from the sensorimotor area of the damaged hemisphere, and ongoing amplitude variations were monitored using a BCI system. Either a visual alert or the action of a motor-driven orthosis was triggered in response to ERD of the sensorimotor rhythm while patients attempted extension movements of the paralyzed fingers. Inter-subject covariance between ERD and the BOLD response in the sensorimotor areas was calculated. After BCI training, an increased ERD over the damaged hemisphere was confirmed in all participants while they attempted extension of the affected finger and this increase was associated with a BOLD response in primary sensorimotor area. Whole-brain MRI revealed that the primary sensorimotor area and supplementary motor area were activated in the damaged hemisphere after 1 month of BCI training. ERD reflects the BOLD responses of the primary motor areas in either hemisphere while patients who have severe chronic hemiplegia due to a stroke attempt an extension movement of the paralyzed fingers. One month of BCI can alter motor-related brain area activation. Combining BCI with other methods to facilitate such changes may help to implement BCI for motor rehabilitation after stroke.

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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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Event-related desynchronization reflects downregulation of intracortical inhibition in human primary motor cortex

Takemi Mitsuaki, Masakado Yoshihisa, Liu Meigen, Ushiba Junichi

Journal of Neurophysiology 110 （ 5 ） 1158 - 1166 2013年09月

ISSN 0022-3077

There is increasing interest in electroencephalogram (EEG)-based brain-computer interface (BCI) as a tool for rehabilitation of upper limb motor functions in hemiplegic stroke patients. This type of BCI often exploits mu and beta oscillations in EEG recorded over the sensorimotor areas, and their event-related desynchronization (ERD) following motor imagery is believed to represent increased sensorimotor cortex excitability. However, it remains unclear whether the sensorimotor cortex excitability is actually correlated with ERD. Thus we assessed the association of ERD with primary motor cortex (M1) excitability during motor imagery of right wrist movement. M1 excitability was tested by motor evoked potentials (MEPs), short-interval intracortical inhibition (SICI), and intracortical facilitation (ICF) with transcranial magnetic stimulation (TMS). Twenty healthy participants were recruited. The participants performed 7 s of rest followed by 5 s of motor imagery and received online visual feedback of the ERD magnitude of the contralateral hand M1 while performing the motor imagery task. TMS was applied to the right hand M1 when ERD exceeded predetermined thresholds during motor imagery. MEP amplitudes, SICI, and ICF were recorded from the agonist muscle of the imagined hand movement. Results showed that the large ERD during wrist motor imagery was associated with significantly increased MEP amplitudes and reduced SICI but no significant changes in ICF. Thus ERD magnitude during wrist motor imagery represents M1 excitability. This study provides electrophysiological evidence that a motor imagery task involving ERD may induce changes in corticospinal excitability similar to changes accompanying actual movements. © 2013 the American Physiological Society.

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Early visual processing is affected by clinical subtype in patients with unilateral spatial neglect

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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Rate of complications among the recipients of intrathecal baclofen pump in Japan

Taira Takaomi, Ueta Takayoshi, Katayama Yoichi, Kimizuka Mamori, Nemoto Akinobu, Mizusawa Hidehiro, Liu Meigen, Koito Motonao, Hiro Yuko, Tanabe Hirokazu

Neuromodulation 16 （ 3 ） 266 - 272 2013年05月

ISSN 1094-7159

Objective To evaluate the incidence of complications of intrathecal baclofen (ITB) therapy for spasticity in Japan, where a unique training course and nationwide registration are required. Materials and Methods An analysis of complications was performed in all patients who underwent ITB in Japan from 2005 to 2011. Prior to surgery, all the doctors involved took a one-day training course, which included hands-on training. Surgical techniques that avoided complications were emphasized. Results A total of 406 pumps were implanted in 400 patients (277 men, 123 women) having severe spasticity. Because this study is currently in progress, among the 400 patients, 78.3% (313/400) had finished a one-year observation follow-up. There were 369 adult and 31 juvenile (under 17 years old) patients, including 12 patients under nine years old. All-cause adverse events were seen in 148 patients (37%), and 93 (23.3%) of these were regarded as severe. Catheter problems were observed in 34 (8.5%) patients: catheter migration in 25 (6.3%), breakage in 6 (1.5%), obstruction in 2 (0.5%), kinking in 1 (0.3%), and dislodgement in 1 (0.3%). Pump trouble was observed in seven (1.8%) patients: alarm abnormality in one (0.3%), memory error in one (0.3%), delayed recovery in one (0.3%), rotation in one (0.3%), malfunction in one (0.3%), and abnormal infusion rate in two (0.6%). Device-related and surgical wound infection occurred in 12 patients (3%), and nine were regarded as severe. Leakage or subcutaneous accumulation of the cerebrospinal fluid was seen in 13 patients (3.3%). Conclusion The requirement of taking of a training course before starting ITB seemed to reduce complications. Although there were surgery-related complications, the rate of complications in Japan appeared to be lower than those reported in larger series of ITB. However, whether the reported rates can be primarily ascribed to a mandatory training course requires further investigations. © 2012 International Neuromodulation Society.

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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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Why not use your own body weight to prevent falls? A randomized, controlled trial of balance therapy to prevent falls and fractures for elderly people who can stand on one leg for ≤15 s

Journal of Orthopaedic Science 18 （ 1 ） 110 - 120 2013年01月

ISSN 0949-2658

Background: Maintaining or improving motor (balance) ability is essential to extending the healthy lifespan of elderly people, and developing effective and efficient strategies to prevent falls of elderly people is an urgent. The purpose of this study was to determine the effects of balance exercise on fall and fracture prevention for elderly people with poor balance. Methods: A 6-month, randomized controlled trial was conducted to verify whether one-leg standing with eyes open for a total of 1 min, three times a day (dynamic flamingo exercise) prevents falls and fractures. Setting and participants were elderly people ≥75 years of age and one-leg standing time ≤15.0 s living in their own home. They were visiting orthopaedic clinics for orthopaedic handicaps. Subjects with poor balance were allowed to hold on to something. If a subject's lifted leg touched the ground during the exercise, they were allowed to lift it again and continue so that they stood on one leg for a total of 60 s. Results: The dynamic flamingo exercise group (410 people; 86 men, 324 women) and the no exercise group (455 people; 78 men, 377 women) were compared. After dynamic flamingo exercise for 6 months, significant differences were seen in the increase in one-leg standing time with eyes open (men right/left, women right/left), in the improvement in independence in daily living (women), number of people who fell during the 6 months (women), and adverse events (women). The number of fractures was not significantly different for men or women. Conclusions: Dynamic flamingo exercise prevents falls but no significant difference was demonstrated in fracture prevention in elderly women with poor balance. © 2012 The Japanese Orthopaedic Association.

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【到来二人に一人脳卒中時代】　脳卒中の医療連携・介護・制度障害を抱えた脳卒中患者の生活は?

里宇明元川上途行，里宇明元

内科 111 911 - 915 2013年

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Is event-related desynchronization a biomarker representing corticospinal excitability?

Takemi Mitsuaki, Masakado Yoshihisa, Liu Meigen, Ushiba Junichi

281 - 284 2013年

Brain computer interfaces (BCIs) using event-related desynchronization (ERD) of the electroencephalogram (EEG), which is believed to represent increased activation of the sensorimotor cortex, have attracted attention as tools for rehabilitation of upper limb motor functions in hemiplegic stroke patients. However, it remains unclear whether the corticospinal excitability is actually correlated with ERD. The purpose of this study was to assess the association between the ERD magnitude and the excitability of primary motor cortex (M1) and spinal motoneurons. M1 excitability was tested by motor evoked potentials (MEPs), short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) using transcranial magnetic stimulation, and spinal motoneuronal excitability was tested by F-waves using peripheral nerve stimulation. Results showed that large ERD during motor imagery was associated with significantly increased F-wave persistence and reduced SICI, but no significant changes in ICF and the response average of F-wave amplitudes. Our findings suggest that ERD magnitude during motor imagery represents the instantaneous excitability of both M1 and spinal motoneurons. This study provides electrophysiological evidence that ERD-based BCI with motor imagery task increases corticospinal excitability as changes accompanying actual movements. © 2013 IEEE.

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Asymmetrical skull deformity in children with cerebral palsy

Kawakami Michiyuki, Liu Meigen, Otsuka Tomoyoshi, Wada Ayako, Uchikawa Ken, Aoki Asako, Otaka Yohei

Journal of Rehabilitation Medicine 45 （ 2 ） 149 - 153 2013年

ISSN 1650-1977

Objective: Asymmetrical skull deformity is frequently seen in children with cerebral palsy, and may contribute to postural abnormalities and deformities. The aim of this cross-sectionalsurvey was to determine the frequency of asymmetrical skull deformity and its correlation with clinical parameters. Methods: A 10-item checklist for asymmetrical skull deformity, postural abnormalities, and deformities was developed, and its inter-rater reliability was tested. A total of 110 participants aged 1-18 years (mean age 9.3 years (standard deviation 4.7)) was assessed using the checklist. The frequency of asymmetrical skull deformity was analysed and related to the Gross Motor Function Classification System (GMFCS), postural abnormalities, and deformities. Results: The reliability of the checklist was satisfactory (κ > 0.8). Asymmetrical skull deformity was observed in 44 children, 24 showing right and 20 showing left flat occipital deformity. Its frequency was significantly related to GMFCS and with the patterns of asymmetrical posture and deformities (p < 0.05). Children with right flat occipital asymmetrical skull deformity showed predominantly rightward facial direction and right-side-dominant asymmetrical tonic neck reflex, left convex scoliosis, right-side-elevated pelvic obliquity, and left-sided hip dislocation. Those with left flat occipital asymmetrical skull deformity demonstrated the reverse tendency. Conclusion: Asymmetrical skull deformity is frequent in cerebral palsy and closely related to asymmetrical posture and deformities. This information will be useful to manage these problems. © 2013 The Authors.

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A pilot study of sensory feedback by transcutaneous electrical nerve stimulation to improve manipulation deficit caused by severe sensory loss after stroke

Kita Kahori, Otaka Yohei, Takeda Kotaro, Sakata Sachiko, Ushiba Junichi, Kondo Kunitsugu, Liu Meigen, Osu Rieko

Journal of NeuroEngineering and Rehabilitation 10 （ 1 ） 2013年

Background: Sensory disturbance is common following stroke and can exacerbate functional deficits, even in patients with relatively good motor function. In particular, loss of appropriate sensory feedback in severe sensory loss impairs manipulation capability. We hypothesized that task-oriented training with sensory feedback assistance would improve manipulation capability even without sensory pathway recovery. Methods. We developed a system that provides sensory feedback by transcutaneous electrical nerve stimulation (SENS) for patients with sensory loss, and investigated the feasibility of the system in a stroke patient with severe sensory impairment and mild motor deficit. The electrical current was modulated by the force exerted by the fingertips so as to allow the patient to identify the intensity. The patient had severe sensory loss due to a right thalamic hemorrhage suffered 27 months prior to participation in the study. The patient first practiced a cylindrical grasp task with SENS for 1 hour daily over 29 days. Pressure information from the affected thumb was fed back to the unaffected shoulder. The same patient practiced a tip pinch task with SENS for 1 hour daily over 4 days. Pressure information from the affected thumb and index finger was fed back to the unaffected and affected shoulders, respectively. We assessed the feasibility of SENS and examined the improvement of manipulation capability after training with SENS. Results: The fluctuation in fingertip force during the cylindrical grasp task gradually decreased as the training progressed. The patient was able to maintain a stable grip force after training, even without SENS. Pressure exerted by the tip pinch of the affected hand was unstable before intervention with SENS compared with that of the unaffected hand. However, they were similar to each other immediately after SENS was initiated, suggesting that the somatosensory information improved tip pinch performance. The patient's manipulation capability assessed by the Box and Block Test score improved through SENS intervention and was partly maintained after SENS was removed, until at least 7 months after the intervention. The sensory test score, however, showed no recovery after intervention. Conclusions: We conclude that the proposed system would be useful in the rehabilitation of patients with sensory loss. © 2013 Kita et al.; licensee BioMed Central Ltd.

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ペダリング運動と治療的電気刺激の併用が回復期脳卒中片麻痺患者の歩行能力へ及ぼす影響　シングルケースデザインによる検討

里宇明元

理学療法学 40 371 - 377 2013年

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スモン患者の咳嗽力に関する検討

里宇明元

The Japanese Journal of Rehabilitation Medicine 50 654 - 657 2013年

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東日本大震災を経験した私たちがなすべきこと

里宇明元

The Japanese Journal of Rehabilitation Medicine 50 947 - 950 2013年

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【脳から疾患をみる-神経科学最前線!-】機能障害　脳卒中後の機能障害に対するリハビリテーションの進歩

里宇明元水野勝広, 里宇明元

治療 95 2079 - 2086 2013年

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【続　他科医に聞きたいちょっとしたこと】廃用症候群について

里宇明元

クリニシアン 60 961 - 963 2013年

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【もう悩まない!100症例から学ぶリハビリテーション評価のコツ】評価のポイント

里宇明元

MEDICAL REHABILITATION 163 1 - 3 2013年

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入門講座　英文論文作成法原著

里宇明元

総合リハビリテーション 41 937 - 942 2013年

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ニューロリハビリテーションの最近のトピックス

里宇明元藤原俊之, 里宇明元

Neurological Surgery 41 663 - 668 2013年

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【神経回路の可塑性とbrain-machine interface】片麻痺上肢に対する新たなリハビリテーション手法の開発

里宇明元

神経内科 79 519 - 525 2013年

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【脳卒中診療の最新情報】脳卒中のリハビリテーション

里宇明元松浦大輔, 里宇明元

臨牀と研究 90 780 - 784 2013年

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【神経障害性疼痛のマネジメント】病態別疼痛マネジメント　帯状疱疹後神経痛のマネジメントとリハビリテーション・アプローチ

里宇明元田代祥一, 里宇明元

Journal of Clinical Rehabilitation 22 660 - 665 2013年

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Brain-Machine Interface(BMI)の現状と展望(Vol.6)　BMIニューロリハビリテーション　片麻痺上肢に対するあらたな治療戦略

里宇明元

医学のあゆみ 245 962 - 968 2013年

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【脳血管障害-予防・診断・治療法の進歩-】ニューロリハビリテーションの現状と未来

里宇明元藤原俊之, 里宇明元

最新医学 68 988 - 994 2013年

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【周術期リハビリテーション】術前・術後のリハビリテーション評価　開胸・開腹術を中心に

里宇明元石川愛子, 里宇明元, 木村彰男

総合リハビリテーション 41 417 - 423 2013年

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Newer challenges to restore hemiparetic upper extremity after stroke

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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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.

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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Real-Time Changes in Corticospinal Excitability during Voluntary Contraction with Concurrent Electrical Stimulation

Yamaguchi Tomofumi, Sugawara Kenichi, Tanaka Satoshi, Yoshida Naoshin, Saito Kei, Tanabe Shigeo, Muraoka Yoshihiro, Liu Meigen

PLoS ONE 7 （ 9 ） 2012年09月

While previous studies have assessed changes in corticospinal excitability following voluntary contraction coupled with electrical stimulation (ES), we sought to examine, for the first time in the field, real-time changes in corticospinal excitability. We monitored motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation and recorded the MEPs using a mechanomyogram, which is less susceptible to electrical artifacts. We assessed the MEPs at each level of muscle contraction of wrist flexion (0%, 5%, or 20% of maximum voluntary contraction) during voluntary wrist flexion (flexor carpi radialis (FCR) voluntary contraction), either with or without simultaneous low-frequency (10 Hz) ES of the median nerve that innervates the FCR. The stimulus intensity corresponded to 1.2× perception threshold. In the FCR, voluntary contraction with median nerve stimulation significantly increased corticospinal excitability compared with FCR voluntary contraction without median nerve stimulation (p<0.01). In addition, corticospinal excitability was significantly modulated by the level of FCR voluntary contraction. In contrast, in the extensor carpi radialis (ECR), FCR voluntary contraction with median nerve stimulation significantly decreased corticospinal excitability compared with FCR voluntary contraction without median nerve stimulation (p<0.05). Thus, median nerve stimulation during FCR voluntary contraction induces reciprocal changes in cortical excitability in agonist and antagonist muscles. Finally we also showed that even mental imagery of FCR voluntary contraction with median nerve stimulation induced the same reciprocal changes in cortical excitability in agonist and antagonist muscles. Our results support the use of voluntary contraction coupled with ES in neurorehabilitation therapy for patients. © 2012 Yamaguchi et al.

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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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A pilot study of contralateral homonymous muscle activity simulated electrical stimulation in chronic hemiplegia

Osu Rieko, Otaka Yohei, Ushiba Junichi, Sakata Sachiko, Yamaguchi Tomofumi, Fujiwara Toshiyuki, Kondo Kunitsugu, Liu Meigen

Brain Injury 26 （ 9 ） 1105 - 1112 2012年08月

ISSN 0269-9052

Objective: For the recovery of hemiparetic hand function, a therapy was developed called contralateral homonymous muscle activity stimulated electrical stimulation (CHASE), which combines electrical stimulation and bilateral movements, and its feasibility was studued in three chronic stroke patients with severe hand hemiparesis. Methods: Patients with a subcortical lesion were asked to extend their wrist and fingers bilaterally while an electromyogram (EMG) was recorded from the extensor carpi radialis (ECR) muscle in the unaffected hand. Electric stimulation was applied to the homonymous wrist and finger extensors of the affected side. The intensity of the electrical stimulation was computed based on the EMG and scaled so that the movements of the paretic hand looked similar to those of the unaffected side. The patients received 30-minutes of therapy per day for 2 weeks. Results: Improvement in the active range of motion of wrist extension was observed for all patients. There was a decrease in the scores of modified Ashworth scale in the flexors. Fugl-Meyer assessment scores of motor function of the upper extremities improved in two of the patients. Conclusions: The results suggest a positive outcome can be obtained using the CHASE system for upper extremity rehabilitation of patients with severe hemiplegia. © 2012 Informa UK Ltd.

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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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Effects of pedaling exercise on the intracortical inhibition of cortical leg area

Yamaguchi Tomofumi, Fujiwara Toshiyuki, Liu William, Liu Meigen

Experimental Brain Research 218 （ 3 ） 401 - 406 2012年05月

ISSN 0014-4819

Pedaling is widely used for rehabilitation of locomotion because it induces similar muscle activity to that observed during locomotion. However, no study has examined the effects of pedaling exercise on intracortical inhibition. The aim of the present study was to investigate the effect of pedaling exercise on short-interval intracortical inhibition (SICI) in the cortical area controlling the tibialis anterior (TA) and soleus (SOL) muscles. Ten healthy adults participated in this study and were instructed to perform 7 min of active and passive pedaling. Paired pulse transcranial magnetic stimulation (TMS) was used to investigate the SICI. Using interstimulus intervals of 2-3 ms, the SICI of TA and SOL muscles was recorded at rest before and after the pedaling and repetitive ankle dorsiflexion tasks. SICI in both TA and SOL muscles decreased immediately after active pedaling. There were no significant changes in SICI after the passive pedaling and repetitive ankle dorsiflexion. A short-term, low-intensity active pedaling exercise decreases the intracortical inhibition of the leg area of the motor cortex. Our results suggest that pedaling has the potential to restore ambulation-inducing cortical reorganization among patients with central nervous system lesions. © Springer-Verlag 2012.

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How did rehabilitation professionals act when faced with the Great East Japan Earth quake and Disaster? Descriptive epidemiology of disability and an interim report of the relief activities of the TEN Rehabilitation -related Organizations

Liu Meigen, Kohzuki Masahiro, Hamamura Akinori, Ishikawa Makoto, Saitoh Masami, Kurihara Masaki, Handa Kazuto, Nakamura Haruki, Fukaura Junichi, Kimura Ryuji, Ito Takao, Matsuzaka Nobuou

Journal of Rehabilitation Medicine 44 （ 5 ） 421 - 428 2012年05月

ISSN 1650-1977

Objective: Inter-organizational coordination is important for rehabilitation disaster relief. The 2011 Great East Japan Earthquake and Disaster was unprecedented, being geographically widespread and multifaceted. Faced with the crisis, rehabilitation professionals established the 10 Rehabilitation- Related Organizations of Rehabilitation Support Service (10-RRO). The objectives of this paper are to provide descriptive epidemiology and assess the activities of 10- RRO. Design: Descriptive. Methods: Epidemiological data on disability were collected, mainly from official sources. Relief activities were reviewed from daily reports, and the preparedness, initial response and functioning of 10-RRO were assessed with a questionnaire directed at 36 executives of individual organizations. Results: The disaster was characterized by a very low ratio of injuries to death of 0.372, and an odds ratio of deaths among disabled persons of 2.32. 10-RRO provided relief activities at 3 shelters. The total number of dispatch days ranged from 107 to 146, and the cumulative number of professionals and evacuees served was 1,202 and 7,300, respectively. Support activities included prevention of immobilization, daily life support, environmental improvement and transition to temporary housing. The questionnaire survey revealed poor preparedness, satisfactory initial response and support activities, and problems of data collection and advocacy. Conclusion: The disaster was characterized by minimal trauma and a great need for preventing immobilization. This first collaborative endeavour was successful. © 2012 Foundation of Rehabilitation Information.

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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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Cortical current source estimation from electroencephalography in combination with near-infrared spectroscopy as a hierarchical prior

Aihara Takatsugu, Takeda Yusuke, Takeda Kotaro, Yasuda Wataru, Sato Takanori, Otaka Yohei, Hanakawa Takashi, Honda Manabu, Liu Meigen, Kawato Mitsuo, Sato Masa aki, Osu Rieko

NeuroImage 59 （ 4 ） 4006 - 4021 2012年02月

ISSN 1053-8119

Previous simulation and experimental studies have demonstrated that the application of Variational Bayesian Multimodal EncephaloGraphy (VBMEG) to magnetoencephalography (MEG) data can be used to estimate cortical currents with high spatio-temporal resolution, by incorporating functional magnetic resonance imaging (fMRI) activity as a hierarchical prior. However, the use of combined MEG and fMRI is restricted by the high costs involved, a lack of portability and high sensitivity to body-motion artifacts. One possible solution for overcoming these limitations is to use a combination of electroencephalography (EEG) and near-infrared spectroscopy (NIRS). This study therefore aimed to extend the possible applications of VBMEG to include EEG data with NIRS activity as a hierarchical prior. Using computer simulations and real experimental data, we evaluated the performance of VBMEG applied to EEG data under different conditions, including different numbers of EEG sensors and different prior information. The results suggest that VBMEG with NIRS prior performs well, even with as few as 19 EEG sensors. These findings indicate the potential value of clinically applying VBMEG using a combination of EEG and NIRS. © 2011 Elsevier Inc..

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Development of gravity compensator for analysis of walking characteristics under the reduced gravity (verification of its effectiveness with rimless wheel)

Ikeda Tatsuhiko, Matsumoto Yusuke, Narukawa Terumasa, Takahashi Masaki, Yamada Shin, Ohshima Hiroshi, Liu Meigen

Nihon Kikai Gakkai Ronbunshu, C Hen/Transactions of the Japan Society of Mechanical Engineers, Part C 78 （ 790 ） 2022 - 2033 2012年

ISSN 0387-5024

For the future manned exploration mission to the other planet, the change of motion characteristics due to the reduced gravity must be studied. Walking, especially, is the basic action of human life, and the efficient walking enables the exploration mission under the limited life-sustaining time and resources. To minimize the risk of injury and damaging of the life-supporting system, the safety of the walking must be studied. To simulate the micro-gravity on the earth, gravity compensation is required, and the wire suspension system is often used for gait analysis. In this system, a subject wears harness and will be suspended by the wire to apply an upward force to the center of mass of the subject. However, pulleys for many systems are fixed at a point and this will lead to inappropriate compensation. While the subject is underneath the pulley, the complete compensation can be achieved with suspension force parallel to the gravity. However, once the subject moved away from the initial position, the unloading force is no longer equal to the suspension force but fluctuate as the subject move. Considering this problem, this paper first represents the effect of force fluctuation to the gait property using the planar rimless wheel, one of the simplest models of locomotion. Gait under lunar gravity and under fixed point suspension is compared, and the effect of restoring force is analyzed. Then, a new gravity compensator with horizontal follower is proposed and its effectiveness is verified through rimless wheel experiment. © 2012 The Japan Society of Mechanical Engineers.

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Development of newer rehabilitative measures for hemiparetic upper limb after stroke

Liu Meigen

Clinical Neurology 52 （ 11 ） 1178 - 1181 2012年

ISSN 0009-918X

Because recovery of upper extremity (UE) function to a practical level has been difficult in many stroke patients, compensatory approaches have been emphasized. Based on researches indicating greater potential for brain plasticity, newer approaches targeting at functional restoration have been attempted. However, no intervention has been shown to be effective to improve hand function. We therefore devised a therapeutic approach to facilitate the use of the hemiparetic hand in daily life by combining EMG triggered electrical stimulation with a wrist splint, called hybrid assistive neuromuscular dynamic stimulation (HANDS). With HANDS, we demonstrated improved motor function, spasticity, functional scores and neurophysiological parameters in chronic stroke. With a RCT, we also demonstrated its effectiveness in subacute stroke. However, to be its candidates, electromyogram must be recorded from finger extensors, and it cannot be applied to patients with complete paralysis. For them, we recently developed a Brain Machine Interface (BMI) neurorehabilitation system. Based on analysis of volitionally decreased amplitudes of sensory motor rhythm during motor imagery involving extending the affected fingers, real-time visual feedback is provided. In patients with severe hemiparesis, we demonstrated its effectiveness with clinical scales, neuroimaging and electrophysiological studies. These newer interventions might offer useful neurorehabilitative tools for hemiparetic UE.

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Modulation of event-related desynchronization during motor imagery with transcranial direct current stimulation in a patient with severe hemiparetic stroke

Tohyama Takamichi, Fujiwara Toshiyuki, Matsumoto Jun, Honaga Kaoru, Ushiba Junichi, Tsuji Tetsuya, Hase Kimitaka, Liu Meigen

Keio Journal of Medicine 60 （ 4 ） 114 - 118 2011年12月

ISSN 0022-9717

Recently, surface electroencephalogram (EEG)-based brain-machine interfaces (BMI) have been used for people with disabilities. As a BMI signal source, event-related desynchronization of alpha-band EEG (8-13 Hz) during motor imagery (mu ERD), which is interpreted as desynchronized activities of the activated neurons, is commonly used. However, it is often difficult for patients with severe hemiparesis to produce mu ERD of sufficient strength to activate BMI. Therefore, whether it is possible to modulate mu ERD during motor imagery with anodal transcranial direct-current stimulation (tDCS) was assessed in a severe left hemiparetic stroke patient. EEG was recorded over the primary motor cortex (M1), and mu ERD during finger flexion imagery was measured before and after a 5-day course of tDCS applied to M1. The ERD recorded over the affected M1 increased significantly after tDCS intervention. Anodal tDCS may increase motor cortex excitability and potentiate ERD during motor imagery in patients with severe hemiparetic stroke. © 2011 by The Keio Journal of Medicine.

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Effects of therapeutic gait training using a prosthesis and a treadmill for ambulatory patients with hemiparesis

Hase Kimitaka, Suzuki Etsuko, Matsumoto Maiko, Fujiwara Toshiyuki, Liu Meigen

Archives of Physical Medicine and Rehabilitation 92 （ 12 ） 1961 - 1966 2011年12月

ISSN 0003-9993

Objective: To examine the short-term effects of a newly developed hemiparetic gait training in which patients walk with a prosthesis applied to the nonparetic leg in the flexed knee position. Design: Pre-post nonrandomized controlled trial. Setting: Rehabilitation center and gait laboratory of a university hospital. Participants: Community-dwelling ambulatory volunteers (N=22) with chronic hemiparesis caused by a unilateral stroke. Intervention: Study subjects participated in a gait training program using either a below-knee prosthesis or a treadmill. Treadmill gait training was performed at a speed approximating the maximum gait velocity for each patient. The 3-week program consisted of a 5-minute gait training session 2 to 3 times a day. Main Outcome Measures: The ground reaction forces, stance time, step length and cadence during walking at a comfortable speed, and maximum gait speed, as well as the Berg Balance Score, were estimated before and after each training program. Results: In comparison with changes after the treadmill gait training, analyses of covariance demonstrated a significant increase of the fore-aft ground reaction forces during the paretic propulsion phase and a significant increase in the relative durations of the paretic and nonparetic single stance involved in a gait cycle after the prosthetic gait training (P<.05). Conclusions: Prosthetic gait training would have different effects on a hemiparetic gait than treadmill gait training. The gait-related task inducing the dominant use of the paretic leg to support the body may be useful as a rehabilitative treatment to improve the kinetic abilities in the paretic stance period. © 2011 American Congress of Rehabilitation Medicine.

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Effectiveness of hybrid assistive neuromuscular dynamic stimulation therapy in patients with subacute stroke

Shindo Keiichiro, Fujiwara Toshiyuki, Hara Joji, Oba Hideki, Hotta Fujiko, Tsuji Tetsuya, Hase Kimitaka, Liu Meigen

Neurorehabilitation and Neural Repair 25 （ 9 ） 830 - 837 2011年11月

ISSN 1545-9683

Background and objective. Hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy was devised to facilitate the use of the hemiparetic upper extremity in daily life by combining assistive neuromuscular electrical stimulation, referred to as the integrated volitional electrical stimulator (IVES), with a splint. The aim of this study is to assess the effectiveness of HANDS therapy for patients with subacute stroke. Methods. The participants were 24 inpatients receiving rehabilitation for hemiparetic stroke within 60 days of onset. Entry criteria included inability to individuate finger extension. Patients were randomly assigned to 2 groups. The HANDS group (n = 12) used the IVES combined with a wrist splint for 8 hours a day for 3 weeks, and the control group (n = 12) wore a wrist splint alone. All patients received the same daily dose and length of standard poststroke multidisciplinary rehabilitation. Outcome measures were the upper extremity portion of the Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT), and Motor Activity Log-14 (MAL). Results. In all, 10 patients in each group completed the interventions. Compared with the control group, the HANDS group showed significantly greater gains in distal (wrist/hand) portion of the FMA (P <.01) and improvement of the ARAT (P <.05). The gains in the MAL did not differ. No adverse effects occurred and the HANDS therapy was well accepted. Conclusion. HANDS therapy in addition to conventional therapy may improve hand function in patients with moderate to severe hand impairment during early rehabilitation. © 2011 American Society of Neurorehabilitation.

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Prism adaptation therapy enhances rehabilitation of stroke patients with unilateral spatial neglect

Mizuno Katsuhiro, Tsuji Tetsuya, Takebayashi Toru, Fujiwara Toshiyuki, Hase Kimitaka, Liu Meigen

Neurorehabilitation and Neural Repair 25 （ 8 ） 711 - 720 2011年10月

ISSN 1545-9683

Background and objective. Unilateral spatial neglect (USN) can interfere with rehabilitation processes and lead to poor functional outcome. The purpose of this study was to determine whether prism adaptation (PA) therapy improves USN and functional outcomes in stroke patients in the subacute stage. Methods. A multicenter, double-masked, randomized, controlled trial was conducted to evaluate the effects of a 2-week PA therapy on USN assessed with the Behavioral Inattention Test (BIT), the Catherine Bergego Scale (CBS), and activities of daily living (ADL) as evaluated with the Functional Independence Measure (FIM). A total of 38 USN patients with right-brain damage were divided into prism (n = 20) and control (n = 18) groups. Patients were divided into mild and severe USN groups according to BIT behavioral test (mild 55 and severe<55). The prism group performed repetitive pointing with prism glasses that induce rightward optical shift twice daily, 5 days per week, for 2 weeks, whereas the control group performed similar pointing training with neutral glasses. Results. The FIM improved significantly more in the prism group. In mild USN patients, there was significantly greater improvement of BIT and FIM in the prism group. Conclusions. PA therapy can significantly improve ADL in patients with subacute stroke. © 2011 American Society of Neurorehabilitation.

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Effects of neurofeedback training with an electroencephalogram-based brain-computer interface for hand paralysis in patients with chronic stroke

Shindo Keiichiro, Kawashima Kimiko, Ushiba Junichi, Ota Naoki, Ito Mari, Ota Tetsuo, Kimura Akio, Liu Meigen

Journal of Rehabilitation Medicine 43 （ 10 ） 951 - 957 2011年10月

ISSN 1650-1977

To explore the effectiveness of neurorehabilitative training using an electroencephalogram-based brain-computer interface for hand paralysis following stroke. Design: A case series study. Subjects: Eight outpatients with chronic stroke demonstrating moderate to severe hemiparesis. Methods: Based on analysis of volitionally decreased amplitudes of sensory motor rhythm during motor imagery involving extending the affected fingers, real-time visual feedback was provided. After successful motor imagery, a mechanical orthosis partially extended the fingers. Brain-computer interface interventions were carried out once or twice a week for a period of 4-7 months, and clinical and neurophysiological examinations pre- and post-intervention were compared. Results: New voluntary electromyographic activity was measured in the affected finger extensors in 4 cases who had little or no muscle activity before the training, and the other participants exhibited improvement in finger function. Significantly greater suppression of the sensory motor rhythm over both hemispheres was observed during motor imagery. Transcranial magnetic stimulation showed increased cortical excitability in the damaged hemisphere. Success rates of brain-computer interface training tended to increase as the session progressed in 4 cases. Conclusion: Brain-computer interface training appears to have yielded some improvement in motor function and brain plasticity. Further controlled research is needed to clarify the role of the brain-computer interface system. © 2011 The Authors.

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Between-subject variance in the magnitude of corticomuscular coherence during tonic isometric contraction of the tibialis anterior muscle in healthy young adults

Ushiyama Junichi, Suzuki Tatsuya, Masakado Yoshihisa, Hase Kimitaka, Kimura Akio, Liu Meigen, Ushiba Junichi

Journal of Neurophysiology 106 （ 3 ） 1379 - 1388 2011年09月

ISSN 0022-3077

Oscillatory activity of the sensorimotor cortex has been reported to show coherence with muscle activity in the 15- to 35-Hz frequency band (β-band) during weak to moderate intensity of isometric contraction. The present study examined the variance of the magnitude of the corticomuscular coherence across a large number of subjects. We quantified the coherence between EEG over the sensorimotor cortex and rectified electromyogram (EMG) from the tibialis anterior muscle during tonic isometric contraction at 30% of maximal effort in 100 healthy young individuals. We estimated the maximal peak of EEG-EMG coherence (Cohmax) and the ratio of the sum of the autopower spectral density function within the β -band to that of all frequency ranges for both EEG (EEG β -PSD) and EMG (EMG β -PSD) signals. The frequency histogram of Cohmax across all subjects showed a broad bell-shaped continuous distribution (range, 0.048-0.816). When the coherence was thresholded at the estimated significance level of P < 0.05 (0.114), 46 out of 100 subjects showed significant EEG-EMG coherence. Cohmax occurred within the β -band in the majority of subjects who showed significant EEG-EMG coherence (n = 43). Furthermore, Cohmax showed significant positive correlations with both EEG β - PSD (r = 0.575, P < 0.001) and EMG β -PSD (r = 0.606, P < 0.001). These data suggest that even during simple tonic isometric contraction, the strength of oscillatory coupling between the sensorimotor cortex and spinal motoneurons varies among individuals and is a contributory factor determining muscle activation patterns such as the degree of grouped discharge in muscle activity within the β -band for each subject. © 2011 the American Physiological Society.

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Transcranial direct current stimulation modulates the spinal plasticity induced with patterned electrical stimulation

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

Clinical Neurophysiology 122 （ 9 ） 1834 - 1837 2011年09月

ISSN 1388-2457

Objective: Patterned sensory electrical stimulation (PES) has been shown to induce plasticity in spinal reciprocal Ia inhibition of the calf muscles. To study the cortical modulation of spinal plasticity, we examined the effects of giving transcranial direct current stimulation (tDCS) to the motor cortex before PES. Methods: Seven healthy volunteers participated in this study. PES involved stimulating the left common peroneal nerve at the fibular head with a train of 10 pulses at 100. Hz every 1.5. s for 20. min using an intensity equal to the motor threshold of the tibialis anterior. tDCS was applied for 10. min before PES. For anodal stimulation, the electrode was placed over the motor cortex, and the cathodal electrode over the contralateral supraorbital area. For cathodal stimulation, the electrodes were reversed. Reciprocal inhibition was assessed using a soleus H reflex conditioning-test paradigm. Results: PES increased disynaptic reciprocal inhibition from the peroneal nerve to the soleus H reflex. When cathodal tDCS was applied before PES, PES no longer increased reciprocal inhibition. Conclusions: Applying tDCS before PES modulated the effects of PES on spinal reciprocal inhibition in a polarity specific manner. Significance: We suggest that the motor cortex may play a role in spinal plasticity. © 2011 International Federation of Clinical Neurophysiology.

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Effects of integrated volitional control electrical stimulation (IVES) on upper extremity function in chronic stroke

Yamaguchi Tomofumi, Tanabe Shigeo, Muraoka Yoshihiro, Imai Syuji, Masakado Yoshihisa, Hase Kimitaka, Kimura Akio, Liu Meigen

Keio Journal of Medicine 60 （ 3 ） 90 - 95 2011年06月

ISSN 0022-9717

We evaluated the efficacy of a novel electromyogram (EMG)-controlled electrical stimulation system, called the integrated volitional control electrical stimulator (IVES), on the recovery of upper extremity motor functions in patients with chronic hemiparetic stroke. Ten participants in the chronic stage (more than 12 months post-stroke with partial paralysis of their wrist and fingers) received treatment with IVES to the extensor carpi radialis and extensor digitorum communis 6 h/day for 5 days. Before and after the intervention, participants were assessed using upper-extremity Fugl-Meyer motor assessment (FMA), the active range of motion (A-ROM), the nine-hole peg test (NHPT), and surface EMG recordings. The upper extremity FMA showed a statistically significant increase from 50.8 ± 5.8 to 56.8 ± 6.2 after the intervention (P < 0.01). The A-ROM of wrist extension was also significantly improved from 36.0° ± 15.4° to 45.0° ± 15.5° (P < 0.01). The NHPT significantly decreased from 85.3 ± 52.0 to 63.3 ± 29.7 (P = 0.04). EMG measurements demonstrated statistically significant improvements in the coactivation ratios for the wrist flexor and extensor muscles after the intervention. This study suggested that 5 days of IVES treatment yields a noticeable improvement in upper extremity motor functions in patients with chronic hemiparetic stroke. © 2011 by The Keio Journal of Medicine.

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Muscle fatigue-induced enhancement of corticomuscular coherence following sustained submaximal isometric contraction of the tibialis anterior muscle

Ushiyama Junichi, Katsu Masanori, Masakado Yoshihisa, Kimura Akio, Liu Meigen, Ushiba Junichi

Journal of Applied Physiology 110 （ 5 ） 1233 - 1240 2011年05月

ISSN 8750-7587

Oscillatory activity of the sensorimotor cortex shows coherence with muscle activity within the 15-to 35-Hz frequency band (β-band) during weak to moderate sustained isometric contraction. We aimed to examine the acute changes in this corticomuscular coupling due to muscle fatigue and its effect on the steadiness of the exerted force. We quantified the coherence between the electroencephalogram (EEG) recorded over the sensorimotor cortex and the rectified surface electromyogram (EMG) of the tibialis anterior muscle as well as the coefficient of variance of the dorsiflexion force (Force_CV) and sum of the autopower spectral density function of the force within the β-band (Force_{β -PSD}) during 30% of maximal voluntary contraction (MVC) for 60 s before (prefatiguing task) and after (postfatiguing task) muscle fatigue induced by sustained isometric contraction at 50% of MVC until exhaustion in seven healthy male subjects. The magnitude of the EEG-EMG coherence increased in the postfatiguing task in six of seven subjects. The maximal peak of EEG-EMG coherence stayed within the β-band in both pre-and postfatiguing tasks. Interestingly, two subjects, who had no significant EEG-EMG coherence in the prefatiguing task, showed significant coherence in the postfatiguing task. Additionally, Force_CV and Force _β-PSD significantly increased after muscle fatigue. These data suggest that when muscle fatigue develops, the central nervous system enhances oscillatory muscular activity in the β-band stronger coupled with the sensorimotor cortex activity accomplishing the sustained isometric contraction at lower performance levels. © 2011 the American Physiological Society.

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Adaptation process for standing postural control in individuals with hemiparesis

Kiyota Yasuhiro, Hase Kimitaka, Nagashima Hayato, Obara Tomoko, Liu Meigen

Disability and Rehabilitation 33 （ 25-26 ） 2567 - 2573 2011年

ISSN 0963-8288

Purpose.To study the adaptation process for standing postural control in patients with hemiparesis after stroke. Methods.The changes of a standing posture developed in nine hemiparetic patients who had never maintained an upright stance alone (aged 4862 years; 619 days after stroke) was evaluated by recording ground reaction forces and surface electromyographic (EMG) from lower limbs. A 60-s standing trial without any instruction about body alignment was repeated five times, and the experience-related changes of centre of pressure (COP) and integrated EMG data were estimated. Results.In the early standing trials, patients balanced themselves by managing the average COP position around the midline of both feet, accompanied by increased muscular activity of the non-paretic leg. COP displacement gradually decreased in the later standing trials (P<0.05). Postural adaptations were achieved by shifting the centre of body sway to the side of the non-paretic foot (P<0.05) while reducing biceps femoris muscular activity (P<0.01) in the non-paretic leg. Conclusions.This study revealed that weight-bearing asymmetry might contribute to improving increased body sway and muscular over-activity of the non-paretic leg. When planning rehabilitative treatment for hemiparetic patients, we should consider that weight-bearing asymmetry may be a result of systematic postural control. © 2011 Informa UK, Ltd.

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Quantifying the quality of hand movement in stroke patients through three-dimensional curvature

Osu Rieko, Ota Kazuko, Fujiwara Toshiyuki, Otaka Yohei, Kawato Mitsuo, Liu Meigen

Journal of NeuroEngineering and Rehabilitation 8 （ 1 ） 2011年

Background: To more accurately evaluate rehabilitation outcomes in stroke patients, movement irregularities should be quantified. Previous work in stroke patients has revealed a reduction in the trajectory smoothness and segmentation of continuous movements. Clinically, the Stroke Impairment Assessment Set (SIAS) evaluates the clumsiness of arm movements using an ordinal scale based on the examiner's observations. In this study, we focused on three-dimensional curvature of hand trajectory to quantify movement, and aimed to establish a novel measurement that is independent of movement duration. We compared the proposed measurement with the SIAS score and the jerk measure representing temporal smoothness. Methods. Sixteen stroke patients with SIAS upper limb proximal motor function (Knee-Mouth test) scores ranging from 2 (incomplete performance) to 4 (mild clumsiness) were recruited. Nine healthy participant with a SIAS score of 5 (normal) also participated. Participants were asked to grasp a plastic glass and repetitively move it from the lap to the mouth and back at a conformable speed for 30 s, during which the hand movement was measured using OPTOTRAK. The position data was numerically differentiated and the three-dimensional curvature was computed. To compare against a previously proposed measure, the mean squared jerk normalized by its minimum value was computed. Age-matched healthy participants were instructed to move the glass at three different movement speeds. Results: There was an inverse relationship between the curvature of the movement trajectory and the patient's SIAS score. The median of the -log of curvature (MedianLC) correlated well with the SIAS score, upper extremity subsection of Fugl-Meyer Assessment, and the jerk measure in the paretic arm. When the healthy participants moved slowly, the increase in the jerk measure was comparable to the paretic movements with a SIAS score of 2 to 4, while the MedianLC was distinguishable from paretic movements. Conclusions: Measurement based on curvature was able to quantify movement irregularities and matched well with the examiner's observations. The results suggest that the quality of paretic movements is well characterized using spatial smoothness represented by curvature. The smaller computational costs associated with this measurement suggest that this method has potential clinical utility. © 2011 Osu et al; licensee BioMed Central Ltd.

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Change in brain activity through virtual reality-based brain-machine communication in a chronic tetraplegic subject with muscular dystrophy

Hashimoto Yasunari, Ushiba Junichi, Kimura Akio, Liu Meigen, Tomita Yutaka

BMC Neuroscience 11 2010年09月

Background: For severely paralyzed people, a brain-computer interface (BCI) provides a way of re-establishing communication. Although subjects with muscular dystrophy (MD) appear to be potential BCI users, the actual long-term effects of BCI use on brain activities in MD subjects have yet to be clarified. To investigate these effects, we followed BCI use by a chronic tetraplegic subject with MD over 5 months. The topographic changes in an electroencephalogram (EEG) after long-term use of the virtual reality (VR)-based BCI were also assessed. Our originally developed BCI system was used to classify an EEG recorded over the sensorimotor cortex in real time and estimate the user's motor intention (MI) in 3 different limb movements: feet, left hand, and right hand. An avatar in the internet-based VR was controlled in accordance with the results of the EEG classification by the BCI. The subject was trained to control his avatar via the BCI by strolling in the VR for 1 hour a day and then continued the same training twice a month at his home.Results: After the training, the error rate of the EEG classification decreased from 40% to 28%. The subject successfully walked around in the VR using only his MI and chatted with other users through a voice-chat function embedded in the internet-based VR. With this improvement in BCI control, event-related desynchronization (ERD) following MI was significantly enhanced (p < 0.01) for feet MI (from -29% to -55%), left-hand MI (from -23% to -42%), and right-hand MI (from -22% to -51%).Conclusions: These results show that our subject with severe MD was able to learn to control his EEG signal and communicate with other users through use of VR navigation and suggest that an internet-based VR has the potential to provide paralyzed people with the opportunity for easy communication. © 2010 Hashimoto et al; licensee BioMed Central Ltd.

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Anti-IL-6-receptor antibody promotes repair of spinal cord injury by inducing microglia-dominant inflammation

Mukaino Masahiko, Nakamura Masaya, Yamada Osamu, Okada Seiji, Morikawa Satoru, Renault-Mihara Francois, Iwanami Akio, Ikegami Takeshi, Ohsugi Yoshiyuki, Tsuji Osahiko, Katoh Hiroyuki, Matsuzaki Yumi, Toyama Yoshiaki, Liu Meigen, Okano Hideyuki

Experimental Neurology 224 （ 2 ） 403 - 414 2010年08月

ISSN 0014-4886

We previously reported the beneficial effect of administering an anti-mouse IL-6 receptor antibody (MR16-1) immediately after spinal cord injury (SCI). The purpose of our present study was to clarify the mechanism underlying how MR16-1 improves motor function after SCI. Quantitative analyses of inflammatory cells using flow cytometry, and immunohistochemistry with bone marrow-chimeric mice generated by transplanting genetically marked purified hematopoietic stem cells, revealed that MR16-1 dramatically switched the central player in the post-traumatic inflammation, from hematogenous macrophages to resident microglia. This change was accompanied by alterations in the expression of relevant cytokines within the injured spinal cord; the expression of recruiting chemokines including CCL2, CCL5, and CXCL10 was decreased, while that of Granulocyte/Macrophage-Colony Stimulating Factor (GM-CSF), a known mitogen for microglia, was increased. We also showed that the resident microglia expressed higher levels of phagocytic markers than the hematogenous macrophages. Consistent with these findings, we observed significantly decreased tissue damage and reduced levels of myelin debris and Nogo-A, the axonal growth inhibitor, by MR16-1 treatment. Moreover, we observed increased axonal regeneration and/or sprouting in the MR16-1-treated mice. Our findings indicate that the functional improvement elicited by MR16-1 involves microglial functions, and provide new insights into the role of IL-6 signaling in the pathology of SCI. © 2010 Elsevier Inc.

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Modulation of mu rhythm desynchronization during motor imagery by transcranial direct current stimulation

里宇明元

J NeuroEng Rehabil 2010年07月

研究論文（学術雑誌）, 共著

Herpes Zoster-Induced Trunk Muscle Paresis Presenting With Abdominal Wall Pseudohernia, Scoliosis, and Gait Disturbance and Its Rehabilitation

Tashiro Syoichi, Akaboshi Kazuto, Kobayashi Yukiko, Mori Toshiki, Nagata Masaaki, Liu Meigen

Archives of Physical Medicine and Rehabilitation 91 （ 2 ） 321 - 325 2010年02月

ISSN 0003-9993

Tashiro S, Akaboshi K, Kobayashi Y, Mori T, Nagata M, Liu M. Herpes zoster-induced trunk muscle paresis presenting with abdominal wall pseudohernia, scoliosis, and gait disturbance and its rehabilitation: a case report. Herpes zoster (HZ)-induced abdominal wall pseudohernia has been frequently reported, but there has been no report describing HZ-induced trunk muscle paresis leading to functional problems. We describe a 73-year-old man with T12 and L1 segmental paresis caused by HZ presenting with abdominal wall pseudohernia, scoliosis, and standing and gait disturbance who responded well to a systematic rehabilitation approach. He first noticed a right abdominal bulge in the 6th postherpetic week, which was gradually accompanied by right convex thoracolumbar scoliosis, pain, and standing and gait disturbance in the 12th week. Needle electromyography revealed abnormal spontaneous activities at rest in the right T12 myotomal muscles, and motor unit recruitment was markedly decreased. We arranged an outpatient rehabilitation program consisting of using a soft thoracolumbosacral orthosis for pain relief and trunk stability, muscle reeducation of the paretic abdominal muscles, strengthening of the disused trunk and extremity muscles, and gait exercise. Based on electromyographic findings, we instructed him in an effective method of muscle reeducation. After 4 months of rehabilitation, he showed marked improvement and became an outdoor ambulator. We suggest that electromyography is a useful tool to evaluate clinical status and devise an effective rehabilitation program in patients with HZ trunk paresis. © 2010 American Congress of Rehabilitation Medicine.

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Herpes zoster induced trunk muscle paralysis presenting with abdominal wall pseudohernia, scoliosis and gait disturbance: a case report

里宇明元

Arch Phys Med Rehabil 91 321 - 325 2010年

研究論文（学術雑誌）, 共著

Correlation between EEG-EMG coherence during isometric contraction and its imaginary execution

Hashimoto Yasunari, Ushiba Junichi, Kimura Akio, Liu Meigen, Tomita Yutaka

Acta Neurobiologiae Experimentalis 70 （ 1 ） 76 - 85 2010年

ISSN 0065-1400

To assess the similarity between cortical activities observed during actual and imaginary motor tasks, we evaluated electroencephalography-electromyography (EEG-EMG) coherence during motor task execution (ME) and the same task-related EEG power increase (TRPI) during kinesthetic motor imagery (MI). EEGs recorded at the vertex and EMGs recorded at the right tibialis anterior muscle (TA) were analyzed in 13 healthy subjects. Subjects were requested to perform: (1) isometric TA contraction, (2) imagery of the same movement without overt motor behavior, and (3) rest without MI. The results show significant EEG-EMG coherence during ME, as well as TRPI during both ME and MI tasks within a similar 14-30 Hz band. The magnitude of EEG-EMG coherence and TRPI varied among the subjects. Intersubject analysis revealed a significant correlation between EEG-EMG coherence and TRPI. These results support the hypothesis that ME and MI tasks involve overlapping neural networks in the perirolandic cortical areas. © 2010 by Polish Neuroscience Society - PTBUN.

Modulation of mu rhythm desynchronization during motor imagery by transcranial direct current stimulation

Matsumoto Jun, Fujiwara Toshiyuki, Takahashi Osamu, Liu Meigen, Kimura Akio, Ushiba Junichi

Journal of NeuroEngineering and Rehabilitation 7 （ 1 ） 2010年

Background. The mu event-related desynchronization (ERD) is supposed to reflect motor preparation and appear during motor imagery. The aim of this study is to examine the modulation of ERD with transcranial direct current stimulation (tDCS). Methods. Six healthy subjects were asked to imagine their right hand grasping something after receiving a visual cue. Electroencephalograms (EEGs) were recorded near the left M1. ERD of the mu rhythm (mu ERD) by right hand motor imagery was measured. tDCS (10 min, 1 mA) was used to modulate the cortical excitability of M1. Anodal, cathodal, and sham tDCS were tested in each subject with a randomized sequence on different days. Each condition was separated from the preceding one by more than 1 week in the same subject. Before and after tDCS, mu ERD was assessed. The motor thresholds (MT) of the left M1 were also measured with transcranial magnetic stimulation. Results. Mu ERD significantly increased after anodal stimulation, whereas it significantly decreased after cathodal stimulation. There was a significant correlation between mu ERD and MT. Conclusions. Opposing effects on mu ERD based on the orientation of the stimulation suggest that mu ERD is affected by cortical excitability. © 2010 Matsumoto et al; licensee BioMed Central Ltd.

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Anti-IL-6-receptor antibody promotes repair of spinal cord injury by inducing microglia-dominant inflammation.

里宇明元

Experimental Neurology 224 （ 2 ） 403 - 414 2010年

研究論文（学術雑誌）, 共著

Correlation between EEG-EMG coherence during isometric contraction and its imaginary execution.

里宇明元

Acta Neurobiol Exp 70 76 - 85 2010年

研究論文（学術雑誌）, 共著

Activities of Daily Living(ADL) Structure of Patients with Duchenne Muscular Dystrophy, Including Adults

里宇明元

The Keio Journal of Medicine 58 （ 4 ） 223-226 2009年12月

研究論文（学術雑誌）, 共著

Development of rehabilitation medicine in Japan

Liu Meigen

Japan Medical Association Journal 52 （ 4 ） 259 - 262 2009年07月

ISSN 1346-8650

Identification of quasi-in-need-of-care state (QUINOCS) among community dwelling elderly people using a seven-item subset of the Functional Independence Measure (FIMTM)

里宇明元

Disabil Rehabil 31 381 - 386 2009年

研究論文（学術雑誌）, 共著

Motor improvement and orticospinal mudulation induced by Hybrid Assistive Neuromuscular Dynamic Stimulation (HANDS) therapy in patients with chronic stroke

里宇明元

Neurorehabilitation Neural Repair 23 （ 2 ） 125-132 2009年

研究論文（学術雑誌）, 共著

Identification of quasi-in-need-of-care state (QUINOCS) among community dwelling elderly people using a seven-item subset of the Functional Independence Measure (FIM?)

里宇明元

Disability & Rehabilitation 31 （ 5 ） 381-386 2009年

研究論文（学術雑誌）, 共著

Subscapularis motor point block for spastic shoulders in patients with cervical cord injury

里宇明元

Spinal Cord 47 （ 3 ） 249–251 2009年

研究論文（学術雑誌）, 共著

嚥下障害を主訴に受診し、嚥下造影検査にて食道気管支瘻が疑われた3例

里宇明元川上途行, 松本真以子, 里宇明元, 黒川真希子, 藤原俊之, 辻哲也, 長谷公隆

Journal of Clinical Rehabilitation 18 1141 - 1143 2009年

研究論文（学術雑誌）, 共著

クロススペクトル解析を用いた視覚誘発電位型ブレイン・マシン・インタフェースの開発

里宇明元小川雄喜(慶応義塾大学大学院理工学研究科), 富田豊, 牛場潤一, 正門由久, 木村彰男, 里宇明元

総合リハビリテーション 37 1063 - 1066 2009年

研究論文（学術雑誌）, 共著

熱傷瘢痕癌による下腿切断にTSB式義足を処方した1例

里宇明元森俊樹(市川市リハビリテーション病院リハビリテーション科), 赤星和人, 小林由紀子, 高尾祐子, 永田雅章, 里宇明元

The Japanese Journal of Rehabilitation Medicine 46 583 - 587 2009年

研究論文（学術雑誌）

片側下腿感覚入力遮断後の立位姿勢制御　Stabilogram-diffusion解析による検討

里宇明元今井覚志, 長谷公隆, 牛場潤一, 東海林淳一, 堤則允, 里宇明元

理学療法学 36 101 - 108 2009年

研究論文（学術雑誌）, 共著

Subscapularis motor point block for spastic shoulders in patients with cervical cord injury

里宇明元

Spinal Cord 47 249 - 251 2009年

研究論文（学術雑誌）, 共著

Activities of daily living (ADL) structure of patients with Duchenne muscular dystrophy, including adults.

里宇明元

Keio J Med. 58 223 - 226 2009年

研究論文（学術雑誌）, 共著

高齢者における筋肉の加齢変化

大高洋平、近藤国嗣、里宇明元

関節外科 27 130-135 2008年

研究論文（学術雑誌）, 共著

Dysphagia in patients with Duchenne muscular dystrophy evaluated with a questionnaire and videofluorography

里宇明元

Disabil Rehabil 30 （ 7 ） 517-522 2008年

研究論文（学術雑誌）, 共著

Effects of prosthetic gait training for stroke patients to induce use of the paretic leg: a report of three cases

里宇明元

The Keio Journal of Medicine 57 （ 3 ） 162-167 2008年

研究論文（学術雑誌）, 共著

The origin of the premotor potential recorded from the second lumbrical

里宇明元

Electromyography and clinical neurophysiology 48 （ 1 ） 9-11 2008年

研究論文（学術雑誌）, 共著

EEG-EMG coherence changes in postural tasks

里宇明元

Electromyography and clinical neurophysiology 48 （ 1 ） 27-33 2008年

研究論文（学術雑誌）, 共著

Strenous exercise-induced alterations of muscle fiber Cross-Secctional area and fiber-type distribution in steroid myopathy rats

里宇明元

American Journal of Physical Medicine& Rehabilitation 87 （ 2 ） 126-133 2008年

研究論文（学術雑誌）, 共著

Strenuous Exercise-Induced alterations of muscle fiber cross-sectional area and fiber-type distribution in teroid myopathy rats

里宇明元

Am J Phys Med Rehabil 87 （ 2 ） 126-133 2008年

研究論文（学術雑誌）, 共著

Dysphagia in patients with Duchenne muscular dystrophy evaluated with a questionnaire and videofluorography

里宇明元

Disabil Rehabil 30 （ 7 ） 517-522 2008年

研究論文（学術雑誌）, 共著

高齢者における立位時姿勢とバランス能力に関する検討

三村聡男 , 大高洋平 , 藤原俊之 , 宇沢充圭 , 里宇明元

Osteoporosis Japan 16 （ 3 ） 560-561 2008年

研究論文（学術雑誌）, 共著

転倒恐怖は何番目の恐怖か

森田光生, 大高洋平, 市川可奈子, 三村聡男 , 宇沢充圭 , 里宇明元

Osteoporosis Japan 16 （ 3 ） 553-554 2008年

研究論文（学術雑誌）, 共著

上肢局所性ジストニアに対する経頭蓋直流電気刺激 (transcranial direct current stimulation:tDCS) と指節関節固定スプリント併用の試み

宮田知恵子 , 藤原俊之, 補永薫 ,辻哲也 , 正門由久 , 長谷公隆 , 里宇明元

The Japanese Journal of Rehabilitation Medicine 45 （ 5 ） 301-307 2008年

研究論文（学術雑誌）, 共著

日本リハビリテーション医学会社会保険等委員会平成 20 年度リハビリテーション医学に関連する社会保険診療報酬等の改定について

里宇明元 ,水間正澄 ,田中宏太佳, 江端広樹, 染屋政幸, 尾花正義 , 長谷公隆, 古市照人, 古閑博明 , 高橋博達, 原寛美, 近藤克則, 赤星和人, 梅津祐一, 畑野栄治 , 川手信行, 藤谷順子, 森英二

The Japanese Journal of Rehabilitation Medicine 45 （ 5 ） 264-270 2008年

研究論文（学術雑誌）, 共著

【診療科の壁を越える共通語 -IL-6 を例として】抗 IL-6 受容体抗体による神経修復・炎症制御と神経再生

向野雅彦 , 中村雅也 , 岡田誠司 , 戸山芳昭 , 里宇明元 , 岡野栄之

日本臨床免疫学会会誌 31 （ 2 ） 93-98 2008年

研究論文（学術雑誌）, 単著

四肢のリンパ浮腫の治療微少循環装置を用いた下肢リンパ浮腫の血行動態解析と手術予後判定

永竿智久、中島龍夫、辻哲也、里宇明元

PEPARS 36 （ 7 ） 90-97 2008年

研究論文（学術雑誌）, 単著

【脳卒中の臨床　最新の実地治療・予防戦略】脳卒中の臨床・セミナー / ベッドサイドの問題点と臨床,脳卒中急性期リハビリテーションの意義と実際

補永薫 , 里宇明元

Medical Practice 25 2207-2209 2008年

研究論文（学術雑誌）, 共著

【リハビリテーション医学2007　最近10年の動向とエビデンス】　リハビリテーション・アプローチうつ病　脳卒中・脳外傷・脊髄損傷後のうつ病と一般的なうつ病に対する運動療法

先崎章, 長田麻衣子, 村岡香織, 里宇明元

総合リハビリテーション 35 1161-1169 2007年

研究論文（学術雑誌）, 共著

＜特集：最近の脳卒中リハビリテーション技術＞半側空間無視に対するプリズム適応療法

水野勝弘,　辻　哲也,　木村彰男,　里宇明元

総合リハビリテーション 35 1409-1418 2007年

研究論文（学術雑誌）, 共著

脳卒中早期リハビリテーションの効

川上途行, 正門由久,里宇明元

EB NURSING 8 60-66 2007年

研究論文（学術雑誌）, 共著

実践講座疾患特有の評価法慢性閉塞性肺疾患

牛場直子、新藤恵一郎、里宇明元

総合リハ 35 583-588 2007年

研究論文（学術雑誌）, 共著

神経筋疾患患者の運動のすすめかた

森俊樹、里宇明元

臨床スポーツ医学 24 244-250 2007年

研究論文（学術雑誌）, 共著

脳卒中患者における連合反応と半球間抑制の電気生理学的検討

補永薫 , 藤原俊之 , 里宇明元

臨床脳波 49 621-627 2007年

研究論文（学術雑誌）, 共著

脊髄障害自立度評価法（SCIM)の信頼性と妥当性に関する検討

黒川真希子、問川博之、鈴木幹次郎、内川　研、田中尚文、里宇明元

リハビリテーション医学 44 230-236 2007年

研究論文（学術雑誌）, 共著

Associated reaction and spasticity among patients with stroke

里宇明元

American Journal of Physical Medicine & Rehabilitation 86 （ 8 ） 656-661. 2007年

研究論文（学術雑誌）, 共著

Electromyographic findings after different selective neck dissections

里宇明元

Laryngoscope 117 （ 2 ） 319-322 2007年

研究論文（学術雑誌）, 共著

A washing toilet seat with a CCD camera monitor to stimulate bowel movement in patients with spinal cord injury.

里宇明元

Am J Phys Med Rehabil 86 （ 3 ） 200-204 2007年

研究論文（学術雑誌）, 共著

脊髄障害自立度評価法（SCIM）の信頼性と妥当性に関する検討

黒川真希子，問川博之，鈴木幹次郎，内川　研，田中尚文，里宇明元

リハビリテーション医学（35in press） 35 2007年

研究論文（学術雑誌）, 共著

Effect of exercise intensity and duration on muscle fibers in steroid myopathy rat

里宇明元

Am J Phys Med Rehabil 87 125-133 2007年

研究論文（学術雑誌）, 共著

Identification of quasi-in-need-of-care state (QUINOCS) among community dwelling elderly people using a seven-item subset of the Functional Independence Measure (FIM)

里宇明元

Disability and Rehabilitation in press 2007年

研究論文（学術雑誌）, 共著

脊髄障害自立度評価法（SCIM）の信頼性と妥当性に関する検討

黒川真希子、問川博之、鈴木幹次郎、内川研、田中尚文、里宇明元

日本リハビリテーション医学 44 230－236 2007年

研究論文（学術雑誌）, 共著

非麻痺側下肢にシミュレーション用義足を適用した片麻痺歩行訓練の有用性

鈴木悦子, 八並光信, 上迫道代, 長谷公隆, 里宇明元

運動療法と物理療法 18 37-43 2007年

研究論文（学術雑誌）, 共著

肝肺症候群に対する生体部分肝移植術後の運動療法に関する検討

佐野由布子, 八並光信, 深井和良, 上迫道代, 長谷公隆, 里宇明元

日本私立医科大学理学療法学会誌 24 56-58 2007年

研究論文（学術雑誌）, 共著

臨床実習学生に対する活動理論を用いた検討

市川雅彦, 今井覚志, 小林賢, 三森由香子, 玉置広香, 長谷公隆, 里宇明元

日本私立医科大学理学療法学会誌 24 36-39 2007年

研究論文（学術雑誌）, 共著

左半側空間無視患者のプリズム適応ー健常者との比較－

中野奈古美 , 倉澤友子 , 前田陽子 , 阿部薫 , 水野勝広 , 辻哲也 , 里宇明元

総合リハビリテーション 35 501-505 2007年

研究論文（学術雑誌）, 共著

Duchenne型筋ジストロフィー(DMD)患者における車椅子の種類と機能障害との関係

田邊亜矢, 藤原俊之, 田沼明, 里宇明元

リハビリテーション医学 44 685-689 2007年

研究論文（学術雑誌）, 共著

The effect of zaltoprofen on physiotherapy for limited shoulder movement in breast cancer patients: a single-blinded before-after trial

里宇明元

Archives of Physical Medicine and Rehabilitation 87 （ 12 ） 1618-1622 2006年11月

研究論文（学術雑誌）, 共著

Development of a short version of the motor FIM for use in long-term care settings

里宇明元

Journal of Rehabilitation Medicine 38 （ 1 ） 50-56 2006年01月

研究論文（学術雑誌）, 共著

オーバービュー　脳卒中におけるフィットネスの重要性

里宇明元

臨床スポーツ医学 23 1149-1152 2006年

研究論文（学術雑誌）, 単著

FIMオンライン採点支援プログラム「iFIM」の開発

山田深, 大田哲生, 里宇明元, 木村彰男, 長谷公隆, 田中尚文, 藤原俊之

総合リハビリテーション 34 69-76 2006年

研究論文（学術雑誌）, 共著

EBMは臨床現場を変えることができたかリハビリテーション科領域

里宇明元

EBMジャーナル 7 168-173 2006年

研究論文（学術雑誌）, 単著

リハビリテーションにおけるリスクマネージメント.リハビリテーション医の立場から

里宇明元

リハビリテーション医学 43 149-155 2006年

研究論文（学術雑誌）, 単著

脳卒中治療ガイドラインの概要と展望

正門由久、里宇明元、木村彰男

PTジャーナル 40 253-258 2006年

研究論文（学術雑誌）, 共著

エビデンスに基づいた転倒予防

大高洋平、里宇明元

リハビリテーション医学 43 96-104 2006年

研究論文（学術雑誌）, 共著

慢性期片麻痺患者の上肢機能に対する随意運動介助型電気刺激(Integrated Volitional control Electrical Stimulator:IVES)と手関節固定装具併用療法の試み

笠島悠子, 藤原俊之, 村岡慶裕, 辻哲也, 長谷公隆, 里宇明元

リハビリテーション医学 43 （ 6 ） 353-357 2006年

研究論文（学術雑誌）, 共著

脊髄損傷患者のための新しいADL評価尺度ーSCIM

問川博之、黒川真希子、出田良輔、里宇明元

臨床リハ 15 952－957 2006年

研究論文（学術雑誌）, 共著

高齢障害者の健康関連QOL（HRQOL)調査―スモン患者におけるSF-8TMの利用―

補永薫, 山田深, 里宇明元

リハビリテーション医学 43 762‐766 2006年

研究論文（学術雑誌）, 共著

平成18年度診療報酬改定に関するアンケート調査の結果について

里宇明元、水間正澄、田中宏太佳, 赤星和人, 梅津祐一, 江端広樹, 岡川敏郎, 尾花正義, 古閑博明, 園田茂, 高橋博達, 畑野栄治, 原寛美, 古市照人

リハビリテーション医学 43 714-718 2006年

研究論文（学術雑誌）, 共著

退院援助の視点から見たアプローチ　脳卒中を例に

青木朝子、里宇明元

臨床看護 32 2124-2130 2006年

研究論文（学術雑誌）, 共著

造血幹細胞移植におけるリハビリテーション

石川愛子, 里宇明元

看護技術 52 （ 11 ） 62-65 2006年

研究論文（学術雑誌）, 共著

転倒　その予防と対策　エビデンスに基づいた転倒予防.

大高洋平、里宇明元

リハビリテーション医学 43 96-104 2006年

研究論文（学術雑誌）, 共著

施設入居者を対象とした転倒予防の取り組みおよび病院主催の転倒予防教室他　病院と地域それぞれにおける転倒予防

大高洋平, 岩本潤, 倉上光市, 森田光生, 亀田充子, 工藤一彦, 平林　洌, 里宇明元, 宇沢充圭

Osteoporosis Japan 14 108-109 2006年

研究論文（学術雑誌）, 共著

診断の指針　治療の指針　転倒の原因と対策

大高洋平,里宇明元

綜合臨床 55 1937-1938 2006年

研究論文（学術雑誌）, 共著

脳卒中後うつ病（Poststroke depression）―その診断と治療

長田麻衣子,村岡香織, 里宇明元

リハビリテーション医学 65 119‐126 2006年

研究論文（学術雑誌）, 共著

脊髄損傷者のための新しいADL評価尺度-SCIM

問川博之、黒川真希子, 出田良輔, 里宇明元

臨床リハ 15 952-957 2006年

研究論文（学術雑誌）, 共著

小児リハビリテーションの最新情報 ADL評価

問川博之、里宇明元, 高橋秀寿

総合リハ 34 523-532 2006年

研究論文（学術雑誌）, 共著

脳卒中片麻痺上肢機能障害の治療

藤原俊之, 里宇明元, 笠島悠子, 植村　修

リハビリテーション医学 43 542-553 2006年

研究論文（学術雑誌）, 共著

治療ガイドラインの策定によって、何が変わったか？

正門由久、里宇明元、木村彰男

リハビリテーション医学 43 729-32 2006年

研究論文（学術雑誌）, 共著

脳卒中リハビリテーションの新たな展開

里宇明元

日本臨床 64 744-748 2006年

研究論文（学術雑誌）, 単著

脳性麻痺のリハビリテーション EBMの実践に向けて

里宇明元

理学療法学 33 414-422 2005年

研究論文（学術雑誌）, 単著

Clinical electromyography and electrodiagnosis course at Keio University Hospital - a-7-year experience

里宇明元

The Keio Journal of Medicine 54 （ 4 ） 193-196 2005年

研究論文（学術雑誌）, 共著

Motor strategies responsible for maintaining standing posture after deafferentation of the unilateral leg.

里宇明元

Arch Phys Med Rehabil 86 （ 10 ） 2027-33 2005年

研究論文（学術雑誌）, 共著

Identification of a simple assessment tool of dysphagia in patients with stroke with factor analysis of multiple dysphagia variables

里宇明元

Journal of Rehabilitation Medicine 37 （ 4 ） 247- 251 2005年

研究論文（学術雑誌）, 共著

Pedaling exercise for neuromuscular re-education: a review.

里宇明元

Crit Rev Phys Rehabil Med 17 163-178 2005年

研究論文（学術雑誌）, 共著

母趾過伸展に対しモーターポイントブロック療法を行った脳卒中の1例

川上途行, 山田深, 里宇明元, 田中尚文, 高橋宣成, 長谷公隆

リハビリテーション医学 42 418-422 2005年

研究論文（学術雑誌）, 共著

脳卒中片麻痺患者における運動イメージ時の運動誘発電位の検討

鈴木幹次郎、辻哲也、村岡慶裕、大田哲生、正門由久、木村彰男、里宇明元

リハビリテーション医学 42 457-462 2005年

研究論文（学術雑誌）, 共著

脳卒中特異的QOLスケールに関する検討

問川博之、新藤恵一郎、和田勇治、内川研、里宇明元

Journal of Clinical Rehabilitation 14 684-689 2005年

研究論文（学術雑誌）, 共著

造血幹細胞移植患者の廃用症候群に対する理学療法効果について

八並光信、上迫道代、小宮山一樹、高橋友理子、遠藤敏、石川愛子、里宇明元、正門由久、森毅彦、近藤咲子、渡辺進

理学療法科学 20 133-138 2005年

研究論文（学術雑誌）, 共著

無菌室内での理学療法頻度による効果の違い‐成人造血幹細胞移植患者を対象として‐

八並光信，渡辺進，上迫道代，小宮山一樹，高橋友理子，石川愛子，里宇明元

川崎医療福祉学会誌 15 227-235 2005年

研究論文（学術雑誌）, 共著

脳卒中のリハビリテーションにおける性差

藤原俊之, 里宇明元

性差と医療 2 1419-1423 2005年

研究論文（学術雑誌）, 共著

脳卒中治療ガイドラインとリハビリテーション　ガイドラインの国際比較

正門由久、里宇明元、木村彰男

総合リハビリテーション 33 1101-1106 2005年

研究論文（学術雑誌）, 共著

【高齢者・認知症高齢者の転倒予防】高齢者の姿勢と歩行

大高洋平、里宇明元

老年精神医学雑誌 16 922-928 2005年

研究論文（学術雑誌）, 共著

脳性麻痺児の運動療法に関する理論的考察

問川博之、里宇明元

小児科 46 1468-1474 2005年

研究論文（学術雑誌）, 共著

廃用症候群のリハビリテーション　仮の要介護状態とその対策

山田深, 里宇明元

リハビリテーション医学 42 690-696 2005年

研究論文（学術雑誌）, 共著

【廃用症候群の診療の実際】　循環器系機能低下

里宇明元

日本医師会雑誌 132 （ 11 ） 1409-1413 2004年12月

研究論文（学術雑誌）, 単著

慢性呼吸器疾患患者の日常生活動作(ADL)　Pulmonary Functional Status and Dyspnea Questionnaire Modified(PFSDQ-M)による予備的検討

牛場直子,里宇明元, 藤原俊之, 花山耕三, 田沼明, 辻哲也, 川城丈夫, 千野直一

日本呼吸管理学会誌 14 （ 2 ） 240-245 2004年12月

研究論文（学術雑誌）, 共著

体重免荷がトレッドミル歩行時の下腿筋活動に及ぼす影響

東海林淳一, 小林賢, 田中直次郎, 長谷公隆, 正門由久, 里宇明元, 木村彰男, 千野直一

総合リハビリテーション 32 （ 12 ） 1175-1179 2004年12月

研究論文（学術雑誌）, 共著

入門講座　リハビリテーション医学における神経生理学検査(2)

藤原俊之, 里宇明元, 千野直一

臨床脳波巻号 46 （ 11 ） 743-750 2004年11月

研究論文（学術雑誌）, 共著

【筋炎最新臨床のすべて】筋炎の治療　筋炎患者のリハビリテーション

田沼明, 藤原俊之, 里宇明元

Clinical Neuroscience 22 （ 10 ） 1187-1189 2004年10月

研究論文（学術雑誌）, 共著

Electrophysiological and clinical assessment of a simple wrist-hand splint for patients with chronic spastic hemiparesis secondary to stroke

里宇明元

Electromyogr Clin Neurophysiol 44 （ 7 ） 423-429 2004年10月

研究論文（学術雑誌）, 共著

Twenty-seven years of complication-free life with clean intermittent self-catheterization in a patient with spinal cord injury: A case report

里宇明元

Archives of Physical Medicine and Rehabilitation 85 （ 10 ） 1705-1707 2004年10月

研究論文（学術雑誌）, 共著

入門講座　リハビリテーション医学における神経生理学検査(1)

藤原俊之, 里宇明元, 千野直一

臨床脳波 46 （ 10 ） 674-680 2004年10月

研究論文（学術雑誌）, 共著

【エビデンスに基づく脳卒中リハビリテーション医療】　脳卒中リハビリテーション医療　脳卒中リハビリテーションの新たな展開

里宇明元,千野直一

Modern Physician 24 （ 9 ） 1429-1433 2004年09月

研究論文（学術雑誌）, 共著

Development of a New Measure to Assess Trunk Impairment Arter Stroke

里宇明元

American Journal of Physical Medecine and Rehabilitation 83 （ 9 ） 681-688 2004年09月

研究論文（学術雑誌）, 共著

【ADL・IADL・QOL】　ADL・IADL・QOLとは

里宇明元

リハビリテーションMOOK9号 1-14 2004年09月

研究論文（学術雑誌）, 単著

褥瘡に対して閉鎖陰圧療法を行った頸髄損傷患者の一例

山田深, 長谷公隆, 川上途行, 田中尚文, 里宇明元, 千野直一, 小菅治彦

Journal of Clinical Rehabilitation 13 （ 9 ） 862-865 2004年09月

研究論文（学術雑誌）, 共著

書痙患者に対する低頻度反復経頭蓋磁気刺激の効果　ペン型簡易筆圧計を用いた筆圧分析による検討

新藤恵一郎, 辻哲也, 正門由久, 長谷公隆, 里宇明元, 木村彰男, 千野直一

リハビリテーション医学 41 （ 9 ） 619-624 2004年09月

研究論文（学術雑誌）, 共著

小児における能力低下の評価　WeeFIMとPEDI

里宇明元

リハビリテーション医学 41 （ 8 ） 531-539( 2004年08月

研究論文（学術雑誌）, 単著

【エビデンスからみた脳性麻痺児への治療効果】　治療効果尺度と研究デザイン

高橋秀寿, 里宇明元

Journal of Clinical Rehabilitation 13 （ 6 ） 500-507 2004年06月

研究論文（学術雑誌）, 共著

Physical fitness in persons with hemiparetic stroke: its structure and longitudinal changes during an inpatient rehabilitation programme

里宇明元

Clinical Rehabilitation 18 （ 4 ） 450-460 2004年06月

研究論文（学術雑誌）, 共著

【EBOT時代の評価法25】　こどものための機能的自立度評価法(WeeFIM)

阿部薫, 中野奈古美, 倉澤友子, 里宇明元, 高橋秀寿

作業療法ジャーナル 38 （ 7 ） 693-699 2004年06月

研究論文（学術雑誌）, 共著

【リハビリテーション医学とEBM】　リハビリテーションガイドラインの作成とEBM

里宇明元

EBMジャーナル 5 （ 4 ） 384-390 2004年06月

研究論文（学術雑誌）, 単著

筋線維の増生と再生

里宇明元近藤国嗣　新藤恵一郎

リハビリテーション医学 41 （ 5 ） 313-323 2004年05月

研究論文（学術雑誌）, 共著

【脳卒中後の大腿骨頸部骨折】　退院後の在宅リハビリテーション　再転倒予防を目指して

大高洋平, 森田光生, 里宇明元

Journal of Clinical Rehabilitation 13 （ 4 ） 323-328 2004年04月

研究論文（学術雑誌）, 共著

造血幹細胞移植患者の筋力と重心動揺

小宮山一樹, 八並光信, 上迫道代, 遠藤敏, 里宇明元, 千野直一, 正門由久, 森毅彦, 近藤咲子, 渡辺進

日本私立医科大学理学療法学会誌（ 21 ） 70-72 2004年04月

研究論文（学術雑誌）, 共著

【医療改革時代におけるリハビリテーション】　医師の卒前・卒後教育の改革

長谷公隆, 里宇明元, 木村彰男

総合リハビリテーション 32 （ 4 ） 329-335 2004年04月

研究論文（学術雑誌）, 共著

【ケーススタディとQ&Aで学ぶ脳梗塞の治療】　Q&A　脳梗塞急性期におけるリハビリテーション

松本真以子, 里宇明元

今月の治療 12 （ 5 ） 511-516 2004年04月

研究論文（学術雑誌）, 共著

呼吸リハビリテーションの臨床展開の追求　新たな運動療法マニュアルの作成と将来像　リハビリテーション科医としての立場から

里宇明元

日本呼吸管理学会誌 13 （ 3 ） 433-438 2004年03月

研究論文（学術雑誌）, 単著

Functional status and muscle strength in people with Duchenne muscular dystrophy living in the community

里宇明元

Physical and Rehabilitation Medicine 36 （ 3 ） 124-129 2004年03月

研究論文（学術雑誌）, 共著

【小児のリハビリテーション　病態とライフステージへの対応】　関連知識の整理　小児筋疾患　筋ジストロフィー歩行障害の治療

里宇明元

リハビリテーションMOOK8号 113-123 2004年03月

研究論文（学術雑誌）, 単著

脳卒中リハビリテーションガイドラインの動向　脳卒中リハビリテーション・ガイドライン　策定経過と概要

里宇明元

リハビリテーション医学 41 （ 2 ） 86-89 2004年02月

研究論文（学術雑誌）, 単著

【呼吸リハビリテーション】　呼吸リハビリテーションにおけるADLとQOLの評価

里宇明元, 新藤恵一郎, 小林直子, 松本真以子

総合リハビリテーション 32 （ 2 ） 133-141 2004年02月

研究論文（学術雑誌）, 共著

Rehabilitation research in China and Japan

里宇明元

Journal of Rehabilitation Medicine 36 （ 4 ） 145-152 2004年01月

研究論文（学術雑誌）, 共著

筋ジストロフィーのリハビリテーション

里宇明元

小児科 44 （ 1 ） 38-47 2003年01月

研究論文（学術雑誌）, 単著

Trunk muscles in persons with hemiparetic stroke evaluated with a computed tomographic method.

里宇明元

Journal of Rehabilitation Medicine 35 （ 4 ） 184-188 2003年

研究論文（学術雑誌）, 共著

エビデンスからみた転倒予防プログラムの効果ム2.転倒にまつわる諸問題と転倒研究における今後の課題-.

大高洋平、　里宇明元、　宇沢充圭、　千野直一

リハビリテーション医学 40 389-397 2003年

研究論文（学術雑誌）, 共著

Practical problems and management of seating through the clinical stages of Duchenne muscular dystrophy.

里宇明元

Archives of Physical Medicine and Rehabilitation 84 （ 6 ） 818-824 2003年

研究論文（学術雑誌）, 単著

Rehabilitation research from Japan published in peer-reviewed English Journals.

里宇明元

Disability and Rehabilitation 25 （ 23 ） 1304-1311 2003年

研究論文（学術雑誌）, 共著

ストレングスエルゴ　各種ペダリング肢位での筋活動の比較

'田中直次郎、東海林淳一, 小林賢, 牛場潤一, 八並光信, 遠藤敏, 正門由久, 里宇明元, 千野直一'

日本私立医科大学理学療法学会誌 20 20-22 2003年

研究論文（学術雑誌）, 共著

筋ジストロフィーのリハビリテーション

里宇明元

小児科 44 433-440 2003年

研究論文（学術雑誌）, 単著

プログラムの立て方とその評価の基本

辻　哲也、里宇明元

治療 85 1625-1633 2003年

研究論文（学術雑誌）, 共著

呼吸器疾患における筋力トレーニング

山田　深、里宇明元

臨床リハビリテーション 12 593-598 2003年

研究論文（学術雑誌）, 共著

エルゴメータ運動と歩行におけるH反射の変化（第2報）

田中直次郎、東海林淳一、小林　賢、牛場潤一、長谷公隆、正門由久、里宇明元、千野直一

臨床脳波 45 433-440 2003年

研究論文（学術雑誌）, 共著

エビデンスからみた転倒予防プログラムの効果ム1.狭義の転倒予防-.

大高洋平、里宇明元、宇沢充圭、千野直一

リハビリテーション医学 40 374-388 2003年

研究論文（学術雑誌）, 共著

Physical fitness in persons with hemiparetic stroke. review-.

里宇明元

Keio Journal of Medicine 52 （ 4 ） 211-219 2003年

研究論文（学術雑誌）, 単著

The effect of pedaling exercise on the hemiplegic lower limb.

里宇明元

American Journal of Physical Medicine and Rehabilitation 82 （ 5 ） 357-363 2003年

研究論文（学術雑誌）, 共著

Psychometric properties of the stroke impairment assessment set(SIAS)

Liu Meigen, Chino Naoichi, Tuji Tetsuya, Msakado Yoshihisa, Hase Kimitaka, Kimura Akio

Neurorehabilitation and neural repair 16 （ 4 ） 339-351 2002年12月

研究論文（学術雑誌）, 共著

Psychometric properties of the Stroke Impairment Assessment Set (SIAS)

Liu Meigen, Chino Naoichi, Tsuji Testuya, Masakado Yoshihisa, Hase Kimitaka, Kimura Akio

Neurorehabilitation and neural repair 16 （ 4 ） 339-351 2002年12月

研究論文（学術雑誌）, 共著

Brain attack時代の脳卒中リハビリテーション

里宇明元

綜合臨床 51 （ 12 ） 3131-3133 2002年12月

研究論文（学術雑誌）, 単著

Psychometric properties of the stroke impairment assessment set(SIAS)

Liu Meigen, Chino Naoichi, Tuji Tetsuya, Msakado Yoshihisa, Hase Kimitaka, Kimura Akio

Neurorehabilitation and neural repair 16 （ 4 ） 339-351 2002年12月

研究論文（学術雑誌）, 共著

リハビリテーション医学とEBM

里宇明元

医学のあゆみ 203 （ 9 ） 590-595 2002年11月

研究論文（学術雑誌）, 単著

脳性麻痺　機能評価　GMFM,WeeFIM,PEDI

里宇明元

総合リハビリテーション 30 （ 11 ） 1168-1180 2002年11月

研究論文（学術雑誌）, 単著

脳卒中片麻痺患者の運動負荷試験 ―新しく考案した骨盤挙上動作による運動負荷試験を中心に―

辻哲也，里宇明元

リハビリテーション医学 39 （ 1 ） 565-571 2002年09月

研究論文（学術雑誌）, 共著

脳卒中早期リハビリテーションの効果

里宇明元

治療学 36 （ 8 ） 797-802 2002年08月

研究論文（学術雑誌）, 単著

Electrophysiological assessment of wrist orthosis

Fujiwara Toshiyuki, Liu Meigen, Arita Motohide, Chino Naoichi

Clinical neurophysiology 113 （ 6 ） 975-975 2002年06月

研究論文（学術雑誌）, 共著

日本呼吸管理学会/日本呼吸器学会　呼吸リハビリテーションに関するステートメント

福地義之助，江藤文夫，木田厚瑞，木村謙太郎，土居洋子，宮川哲夫，宮城征四郎，安藤守秀，植木純，桂秀樹，千住秀明，谷口博之，野村浩一郎，宮本顕二，里宇明元，白日高歩，中田紘一郎，三嶋理晃

日本呼吸器学会雑誌 40 （ 6 ） 536-544 2002年06月

研究論文（学術雑誌）, 共著

末梢神経損傷後の神経再生とリハビリテーション

西脇香織，近藤国嗣，里宇明元，千野直一

リハビリテーション医学 39 （ 5 ） 257-266 2002年05月

研究論文（学術雑誌）, 共著

FRG―機能に基づく患者分類法

里宇明元

医学のあゆみ 200 （ 13 ） 1015 2002年03月

研究論文（学術雑誌）, 単著

Current status of rehabilitation medicine in Asia. A report from New Millennium Asian Symposium on Rehabilitation Medicine

Chino Naoichi, Ishigami Shigenobu, Akai Masami, Liu Meigen, Okajima Yasutomo, Koike Junko, Kobayashi Kazuyuki

Journal of Rehabilitation Medicine 34 （ 1 ） 1-4 2002年01月

研究論文（学術雑誌）, 共著

Current status of rehabilitation medicine in Asia: a report from New Millennium Asian Symposium on Rehabilitation Medicine

里宇明元

Journal of Rehabilitation Medicine 34 （ 1 ） 1-4 2002年

研究論文（学術雑誌）, 共著

介護負担感の概念と研究の動向

里宇明元

臨床リハビリテーション 10 （ 10 ） 659-667 2001年10月

研究論文（学術雑誌）, 単著

リハビリテーション医学へのEvidence-based Medicine (EBM)の導入

里宇明元

リハビリテーション医学 38 （ 7 ） 558-561 2001年07月

研究論文（学術雑誌）, 単著

脳血管障害患者の介護

里宇明元

日本医師会雑誌特別号（脳血管障害の臨床） 125 （ 12 ） S306-S315 2001年06月

研究論文（学術雑誌）, 単著

介護保険におけるリハの問題点と課題

里宇明元

社会保険旬報 2087 12-16 2001年02月

研究論文（学術雑誌）, 単著

脳卒中のリハビリテーションとは

里宇明元

からだの科学（ 216 ） 77-82 2000年12月

研究論文（学術雑誌）, 単著

Current status of rehabilitation, especially in patients with stroke, in Japan

Liu Meigen, Chino Naoichi, Takahasi Hidetoshi

Scandinavian Journal of Rehabilitation Medicine 32 （ 4 ） 148-158 2000年12月

研究論文（学術雑誌）, 共著

小児リハビリテーションの評価尺度　ADLの評価尺度（1）─WeeFIM─

里宇明元

Journal of Clinical Rehabilitetion 9 （ 11 ） 1075-1086 2000年11月

研究論文（学術雑誌）, 単著

ADLの評価尺度(2)―PEDI―

問川博之，里宇明元

Journal of Clinical Rehabilitation 9 （ 11 ） 1087-1094 2000年11月

研究論文（学術雑誌）, 共著

介護家族の立場からみた摂食・嚥下リハの問題点

里宇明元

Journal of Clinical Rehabilitetion 9 （ 9 ） 890-894 2000年09月

研究論文（学術雑誌）, 単著

小児のリハビリテーション

里宇明元

からだの科学（ 213 ） 56-59 2000年07月

研究論文（学術雑誌）, 単著

The stroke impairment assessment set: its internal consistency and predictive validity

Tsuji Tetsuya, Liu Meigen, Sonoda Shigeru, Domen Kazuhisa, Chino Naoichi

Archives of Physical Medicine and Rehabilitation 81 （ 7 ） 863-868 2000年07月

研究論文（学術雑誌）, 共著

工学的観点からみたサイクルエルゴメーターの負荷制御とリハビリテーション領域への応用

堤俊彦，鈴木浩徳，加藤守匠，里宇明元

リハビリテーション医学 37 （ 6 ） 398-406 2000年06月

研究論文（学術雑誌）, 共著

中枢神経の障害　（5）姿勢保持の障害

花山耕三，里宇明元

日本義肢装具学会誌 16 （ 2 ） 127-133 2000年04月

研究論文（学術雑誌）, 共著

The internal consistencyand predictive validity of the stroke impairment assessment set(SIAS)

Tsuji Tetsuya, Liu Meigen, Sonoda Shigeru, Domen Kazuhisa, Chino Naoichi

Journal of Stroke and Cerebrovascular Disease 9 （ 2 (Suppl1) ） 229-230 2000年03月

研究論文（学術雑誌）, 共著

座位保持の効果

里宇明元

臨床リハビリテーション 8 （ 12 ） 1135-1145 1999年12月

研究論文（学術雑誌）, 単著

処方の実際：成功例・失敗例　・高齢者

清宮清美，里宇明元

臨床リハビリテーション 8 （ 12 ） 1172-1176 1999年12月

研究論文（学術雑誌）, 共著

リハビリテーション医学におけるEBM

里宇明元

日本醫事新報（ 3948 ） 89-90 1999年12月

研究論文（学術雑誌）, 単著

呼吸リハビリテーションに必要な臨床評価

辻哲也，里宇明元

臨床リハビリテーション別冊 36-47 1999年11月

研究論文（学術雑誌）, 共著

リハビリテーションkey word. EBM（Evidence-based Medicine）

里宇明元

臨床リハビリテーション 8 （ 11 ） 1100-1101 1999年11月

研究論文（学術雑誌）, 単著

Osteoporosis in hemiplegic stroke patients as studied with dual energy X-ray absorptiometry.

Liu Meigen, Tsuji Tetsuya, Higuchi Yoshiko, Domen Kazuhisa, Tsujiuchi Kazuhito, Chino Naoichi

Archives of Physical Medicine and Rehabilitation 80 （ 10 ） 1219-1226 1999年10月

研究論文（学術雑誌）, 共著

嚥下リハビリテーションの問題点

里宇明元

臨床リハビリテーション 8 （ 9 ） 689-696 1999年09月

研究論文（学術雑誌）, 単著

Comorbidities in stroke patients as assessed with a newly developed comorbidity scale.

Liu Meigen, Tsuji Tetsuya, Tsujiuchi Kazuhito, Chino Naoichi

American Journal of Physical Medicine and Rehabilitation 78 （ 5 ） 416-424 1999年09月

研究論文（学術雑誌）, 共著

Bridging activity as a mode of stress testing for persons with hemiplegia.

Tsuji Tetsuya, Liu Meigen, Tsujiuchi Kazuhito, Chino Naoichi

Archives of Physical Medicine and Rehabilitation 80 （ 9 ） 1060-1064 1999年09月

研究論文（学術雑誌）, 共著

脊髄損傷患者の社会的不利に影響を与える要因─Craig Handicap Assessment and Reporting Technique（CHART）による予備的検討─

青柳紀代，高橋秀寿，原行弘，柴崎啓一，里宇明元，千野直一

リハビリテーション医学 36 （ 9 ） 599-606 1999年09月

研究論文（学術雑誌）, 共著

脳卒中片麻痺患者の骨密度─多領域測定による検討

樋口佳子，道免和久，里宇明元，辻哲也，安藤久恵，千野直一

総合リハビリテーション 27 （ 9 ） 865-871 1999年09月

研究論文（学術雑誌）, 共著

頚髄損傷残存高位下限における筋肥大─筋線維伝導速度による検討─

近藤国嗣，岡島康友，里宇明元，千野直一

リハビリテーション医学 36 （ 9 ） 607-611 1999年09月

研究論文（学術雑誌）, 共著

水中運動の生理学─水中走行を中心に─

里宇明元，進藤順哉

総合リハビリテーション 27 （ 8 ） 729-740 1999年08月

研究論文（学術雑誌）, 共著

ADL structure for nondisabled Japanese children based on the functional independence measure for children (WeeFIM^TM)

Tsuji Tetsuya, Liu Meigen, Toikawa Hiroyuki, Hanayama Kozo, Sonoda Shigeru, Chino Naoichi

American Journal of Physical Medicine and Rehabilitaion 78 （ 3 ） 208-212 1999年05月

研究論文（学術雑誌）, 共著

特集小児のリハビリテーション：脊髄性筋萎縮症

里宇明元

総合リハビリテーション 27 （ 5 ） 431-441 1999年05月

研究論文（学術雑誌）, 単著

運動障害者における心疾患への対応　虚血性心疾患が問題となる場合　I 急性期

辻哲也，里宇明元

臨床リハビリテーション 8 （ 4 ） 315-323 1999年04月

研究論文（学術雑誌）, 共著

リハビリテーションとEvidence-based medicine (EBM)

里宇明元

臨床リハビリテーション 8 （ 1 ） 53-62 1999年01月

研究論文（学術雑誌）, 単著

リハビリテーションとスポーツ医学―最近の話題―

辻哲也，里宇明元，木村彰男

総合リハビリテーション 27 （ 1 ） 21-29 1999年01月

研究論文（学術雑誌）, 共著

Newly developed short behavior scale for use in stroke outcome research

Tsuji T, Liu M, Sonoda S, Domen K, Tsujiuchi K, Chino N

American Journal of Physical Medicine and Rehabilitation 77 （ 5 ） 376-381 1998年10月

研究論文（学術雑誌）, 共著

CHARTによる脳卒中患者の社会的不利の測定

問川博之，高橋秀寿，里宇明元，千野直一

総合リハビリテーション 26 （ 10 ） 985-989 1998年10月

研究論文（学術雑誌）, 共著

リハビリテーション臨床と高脂血症

里宇明元

臨床リハビリテーション 7 （ 10 ） 971-973 1998年10月

研究論文（学術雑誌）, 単著

リハビリテーションkey word DRG

里宇明元

臨床リハビリテーション 7 （ 10 ） 1061-1061 1998年10月

研究論文（学術雑誌）, 単著

専門医レポート　研修施設紹介　埼玉県総合リハビリテーションセンター

里宇明元

臨床リハビリテーション 7 （ 10 ） 1055-1060 1998年10月

研究論文（学術雑誌）, 単著

リハビリテーションkey word FRG

里宇明元

臨床リハビリテーション 7 （ 10 ） 1126-1127 1998年10月

研究論文（学術雑誌）, 単著

座位保持装置の現状と問題点　進行性疾患（筋ジストロフィー症）の座位保持の問題点とアプローチ

里宇明元

日本義肢装具学会誌 14 （ 3 ） 277-284 1998年09月

研究論文（学術雑誌）, 単著

呼吸器のリハビリテーション

里宇明元

カレントテラピー 16 （ 8 ） 84-89 1998年08月

研究論文（学術雑誌）, 単著

レビュー：呼吸リハビリテーションの効果

里宇明元

臨床リハビリテーション 7 （ 8 ） 801-814 1998年08月

研究論文（学術雑誌）, 単著

地域リハビリテーションにおけるマルチメディアの活用

里宇明元，辻内和人，塚野信，奥田澄江，金森晶

バイオメカニズム学会誌 22 （ 2 ） 67-73 1998年05月

研究論文（学術雑誌）, 共著

リハビリテーションと呼吸循環系モニタリング；呼吸循環系モニタリングの方法

辻哲也，里宇明元

臨床リハ 6 （ 11 ） 1057-1063 1997年11月

研究論文（学術雑誌）, 共著

Gerstmann症候群様の症状を呈した1例のリハビリテーションの経験

青柳陽一郎，里宇明元，辻哲也，辻内和人，先崎章，水野雅文，千野直一

臨床リハ 6 （ 10 ） 1040-1044 1997年10月

研究論文（学術雑誌）, 共著

Gerstmann症候群様の症状を呈した1例のリハビリテーションの経験--アプローチのための評価スケールの工夫--

青柳陽一郎，里宇明元，辻哲也，辻内和人，先崎章，水野雅文，千野直一

臨床リハ 6 1040-1044 1997年10月

研究論文（学術雑誌）, 共著

こどものための機能的自立度評価法(WeeFIM)による小児のADL評価―発達検査法との比較―

問川博之，里宇明元，関勝，道免和久，千野直一

総合リハ 25 （ 6 ） 549-555 1997年06月

研究論文（学術雑誌）, 共著

リハで見逃しやすい合併症とチェックポイント─小児編─小児の特殊性─陥りやすいピットフォール

里宇明元

臨床リハ 6 （ 6 ） 529-534 1997年06月

研究論文（学術雑誌）, 単著

問題となる併存疾患をもつ症例

辻哲也，里宇明元

臨床リハ（別冊） 77-83 1997年05月

研究論文（学術雑誌）, 共著

併存疾患のとらえかた

里宇明元

臨床リハ（別冊） 45-49 1997年05月

研究論文（学術雑誌）, 単著

リハ外来の目標とリハ医の役割

里宇明元

臨床リハ（別冊） 196-204 1997年05月

研究論文（学術雑誌）, 単著

質問紙によるFIM(Functional Independence Measure)評価の試み

大田哲生，道免和久，里宇明元，千野直一

総合リハ 25 （ 5 ） 449-454 1997年05月

研究論文（学術雑誌）, 共著

パーソナルコンピューターを制御および表示装置とした環境制御装置の開発

辻内和人，園田茂，有田元英，倉持昇，大旗慎一，南浩一，里宇明元，千野直一

臨床リハ 6 （ 4 ） 376-378 1997年04月

研究論文（学術雑誌）, 共著

Comorbidity measures for stroke outcome research. A preliminary study

Liu Meigen, Domen Kazuhisa, Chino Naoichi

Arch Phys Med Rehabil 78 （ 2 ） 166-172 1997年02月

研究論文（学術雑誌）, 共著

急性増悪を繰り返す慢性呼吸器疾患患者の外来ケア　在宅酸素療法（HOT）

里宇明元

JIM 7 （ 2 ） 128-131 1997年02月

研究論文（学術雑誌）, 単著

筋ジストロフィーのリハビリテーション

里宇明元

診断と治療 85 （ 8 ） 1272-1275 1997年

研究論文（学術雑誌）, 単著

社会啓発とシステム形成--リハビリテーションにおけるマルティメディアの活用--

里宇明元

総合リハ 24 （ 10 ） 981-986 1996年10月

研究論文（学術雑誌）, 単著

疾患別リハ処方　筋ジストロフィー症（Duchenne型）

里宇明元

臨床リハ別冊　実践リハ処方 120-126 1996年05月

研究論文（学術雑誌）, 単著

歯科用磁性材料が頭部MRIに及ぼす影響とその対策

江面陽子，植松宏，梅崎伸子，石幡伸雄，道免和久，里宇明元

総合リハ 24 （ 5 ） 461-464 1996年05月

研究論文（学術雑誌）, 共著

膝関節屈曲筋力測定における体位の影響

有田元英，里宇明元，千野直一

リハ医学 33 （ 4 ） 237-241 1996年04月

研究論文（学術雑誌）, 共著

地域活動訪問シリーズ　国立療養所東埼玉病院の地域活動・・医療と密接に結びついたデイケア

里宇明元

臨床リハビリテーション 5 （ 2 ） 206-211 1996年02月

研究論文（学術雑誌）, 単著

ADL structure for stroke patients in Japan based on the functional independence measure

Tsuji T, Sonoda S, Doumen K, Saitoh E, Liu M, Chino N

Am J Phys Med Rehabil 74 （ 6 ） 432-438 1995年11月

研究論文（学術雑誌）, 共著

脊髄損傷患者の性に関する意識調査

萩原美和，道免和久，堀房子，里宇明元，上小鶴正弘

総合リハビリテーション 23 （ 10 ） 847-853 1995年10月

研究論文（学術雑誌）, 共著

小児の補装具に関する問題点・・利用者，処方者，制作者に対するアンケート調査より

里宇明元，千野直一，君塚葵，木佐俊郎，正門由久，長谷公隆

総合リハビリテーション 23 （ 10 ） 885-894 1995年10月

研究論文（学術雑誌）, 共著

リハ相談室　困った症例へのアドバイス　私ならこうする

里宇明元

臨床リハビリテーション 4 （ 10 ） 971-973 1995年10月

研究論文（学術雑誌）, 単著

リハビリテーションの基礎と臨床

里宇明元

日本医師会雑誌 113 782-784 1995年09月

研究論文（学術雑誌）, 単著

デュシェンヌ型筋ジストロフィー症（DMD）の在宅リハビリテーション

里宇明元，浅野賢

総合リハビリテーション 23 （ 7 ） 569-579 1995年07月

研究論文（学術雑誌）, 共著

運動障害：麻痺および歩行障害

里宇明元

エキスパートナース 11（臨時増刊号　脳卒中マニュアル) 42-50 1995年

研究論文（学術雑誌）, 単著

Muscle damage progression in Duchenne muscular dystrophy evaluated by a new quantitative computed tomography method

里宇明元

Archives of physical medicine and rehabilitation 74 （ 5 ） 507-514 1993年

研究論文（学術雑誌）, 共著

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