Kazutoshi Hatakeyama

The impact of high-frequency magnetic stimulation of peripheral nerves: muscle hardness, venous blood flow, and motor function of upper extremity in healthy subjects

The purpose of this study was to investigate the impact of high-frequency peripheral nerve magnetic stimulation on the upper limb function. Twenty-five healthy adults (16 men and 9 women) participated in this study. The radial nerve of the non-dominant hand was stimulated by high-frequency magnetic stimulation device. A total of 600 impulses were applied at a frequency of 20 Hz and intensity of 1.2 resting motor threshold (rMT). At three time points (before, immediately after, and 15 min after stimulation), muscle hardness of the extensor digitorum muscle on the stimulated side was measured using a mechanical tissue hardness meter and a shear wave imaging device, cephalic venous blood flow on the stimulated side was measured using an ultrasound system, and the Box and Block test (BBT) was performed. Mechanical tissue hardness results did not show any significant differences between before, immediately after, and 15 min after stimulation. Measurements via shear wave imaging showed that muscle hardness significantly decreased both immediately and 15 min after stimulation compared to before stimulation (P < 0.05). Peripheral venous blood flow and BBT score significantly increased both immediately and 15 min after stimulation compared to before stimulation (P < 0.01). High-frequency peripheral nerve magnetic stimulation can achieve effects similar to electrical stimulation in a less invasive manner, and may therefore become an important element in next-generation rehabilitation.

Impact of pulmonary rehabilitation on postoperative complications in patients with lung cancer and chronic obstructive pulmonary disease

Given the extent of the surgical indications for pulmonary lobectomy in breathless patients, preoperative care and evaluation of pulmonary function are increasingly necessary. The aim of this study was to assess the contribution of preoperative pulmonary rehabilitation (PR) for reducing the incidence of postoperative pulmonary complications in non‐small cell lung cancer (NSCLC) patients with chronic obstructive pulmonary disease (COPD).

Postcontraction hyperemia after electrical stimulation: potential utility in rehabilitation of patients with upper extremity paralysis.

The purpose of this study was to compare postcontraction hyperemia after electrical stimulation between patients with upper extremity paralysis caused by upper motor neuron diseases and healthy controls. Thirteen healthy controls and eleven patients with upper extremity paralysis were enrolled. The blood flow in the basilic vein was measured by ultrasound before the electrical stimulation of the biceps brachii muscle and 30 s after the stimulation. The stimulation was performed at 10 mA and at a frequency of 70 Hz for 20 s. The mean blood flow in the healthy control group and in upper extremity paralysis group before the electrical stimulation was 60 ± 20 mL/min (mean ± SD) and 48 ± 25 mL/min, respectively. After the stimulation, blood flow in both groups increased to 117 ± 23 mL/min and 81 ± 41 mL/min, respectively. We show that it is possible to measure postcontraction hyperemia using an ultrasound system. In addition, blood flow in both groups increased after the electrical stimulation because of postcontraction hyperemia. These findings suggest that evaluating post contraction hyperemia in patients with upper extremity paralysis can assess rehabilitation effects.

Optimum Stimulation Frequency of High-Frequency Repetitive TranscranialMagnetic Stimulation for Upper-Limb Function in Healthy Subjects

Objective: Because rTMS requires the subject’s head to be immobilized and the subject to maintain the same posture throughout stimulation, stimulation of long duration may induce discomfort. If changing the stimulation parameters can allow the duration of rTMS to be shortened, physical discomfort may decrease. The purpose of this study was to identify the most beneficial stimulation parameters for high-frequency rTMS in terms of the effect on upper-limb function in healthy subjects. Materials and Methods: Forty right-handed healthy volunteers were divided into four groups: three real rTMS groups (5, 10, and 20 Hz rTMS) and one sham group. In the real rTMS groups, 600 impulses were applied at a frequency of 5, 10, or 20 Hz and an intensity of 90% of resting motor threshold. Performance on a peg-board task, tapping task, and grip strength were measured before stimulation, immediately after stimulation, and 20 min after stimulation. Results: All real rTMS groups showed a significant increase in performance on the peg-board task and tapping task after rTMS. There was no significant increase in grip strength in any group. Conclusions: 10-Hz rTMS may improve upper-limb function with a shorter duration of stimulation than rTMS at 5 or 20 Hz. 10-Hz rTMS had the shortest stimulation time, and is recommended as beneficial setting to use with a little discomfort. These results can be used when deciding rTMS stimulation frequency.