Ken Nishihara

Investigation of Optimum Electrode Locations by Using an Automatized Surface Electromyography Analysis Technique

Identification of the innervation zone is widely used to optimize the accuracy and precision of noninvasive surface electromyography (EMG) signals because the EMG signal is strongly influenced by innervation zones. However, simply structured fusiform muscle, such as biceps brachii muscle, has been employed mainly due to the simplicity with which the propagation from raw EMG signals can be observed. In this study, the optimum electrode location (OEL), free from innervational influence, was investigated by the propagation pattern of action potentials for brachii muscles and more complicated deltoid muscle structures using an automatized signal analysis technique. The technique employed newly developed computer software with additional clinical uses and minimized subjective differences. EMG signals were recorded using surface array electrodes during voluntary isometric contractions obtained from 12 healthy male subjects. Peaks in EMG signals were detected and averaged for each muscle. The propagation patterns and OEL were examined from biceps brachii muscles for all subjects and from deltoid muscles for seven subjects. The estimated locations were partially confirmed by comparing the root mean squares of the EMG signals. These results show that propagation patterns and OEL could be estimated simply and automatically even from the surface EMG signals of deltoid muscles.

Effect of position of electrodes relative to the innervation zone onsurface EMG

We investigated the effect of the position of electrodes relative to the innervation zone (IZ) of the biceps brachii muscle during isometric elbow flexion using eight-channel surface array electrodes. We estimated the location of the IZ near the centre of the muscle in 20 male subjects. The pulse peaks from electromyogram (EMG) waveforms were detected for each channel and averaged, the triphasic pulse was determined, and the peak values of the first and third phases were compared. The results showed significantly greater pulse values for the first phase when the electrode placement was proximal to the estimated IZ, and for the third phase when the electrode placement was distal to the estimated IZ. Using this method, the positional relationship between electrodes and IZ can be determined using a surface EMG waveform recorded with a pair of bipolar electrodes. This method may be clinically useful in confirming the reliability of a recorded surface EMG.

Investigation of Innervation Zone Shift with Continuous Dynamic Muscle Contraction

Innervation zone (IZ) has been identified as the origin of action potential propagation in isometric contraction. However, IZ shifts with changes in muscle length during muscle activity. The IZ shift has been estimated using raw EMG signals. This study aimed to investigate the movement of IZ location during continuous dynamic muscle contraction, using a computer program. Subjects flexed their elbow joint as repetitive dynamic muscle contractions. EMG signals were recorded from the biceps brachii muscle using an eight-channel surface electrode array. Approximately 100 peaks from EMG signals were detected for each channel and summed to estimate the IZ location. For each subject, the estimated IZ locations were subtracted from the IZ location during isometric contractions with the elbow flexed at 90°. The results showed that the IZ moved significantly with elbow joint movement from 45° to 135°. However, IZ movement was biased with only a 3.9 mm IZ shift on average when the elbow angle was acute but a 16 mm IZ shift on average when it was obtuse. The movement of IZ location during continuous dynamic muscle contraction can be investigated using this signal processing procedure without subjective judgment.

The prevalence and risk factor control associated with noncommunicable diseases in China, Japan, and Korea

Background Noncommunicable disease (NCD) has become the leading cause of mortality and disease burden worldwide. Methods A cross-sectional survey was carried out to investigate the prevalence of NCDs and risk factor control on dietary behaviors and dietary intake in China, Japan, and Korea. Results There were significant differences among the three countries on the prevalence of hypertension (24.5% in China, 17.6% in Korea, and 15.2% in Japan), diabetes (8.9% in China, 5.7% in Korea, and 4.8% in Japan), hyperlipidemia (13.1% in China, 9.2% in Korea, and 6.9% in Japan), and angina pectoris (3.6% in China, 1.7% in Korea, and 1.5% in Japan). The prevalence rate of hypertension, diabetes, hyperlipidemia, and angina pectoris was highest in China and lowest in Japan. However, 82.2%, 48.4%, and 64.4% of Chinese, Koreans, and Japanese presented good dietary behavior, respectively. Multivariable logistic regression analysis found that sex, age, and marital status were predictors of good dietary behavior. In addition, in comparison with subjects without hypertension, diabetes, or hyperlipidemia, subjects with hypertension, diabetes, or hyperlipidemia significantly improved their dietary behaviors and controlled their intake of salt, sugar, and oil. Conclusions The prevalence of NCDs and trends in major modifiable risk factor control in China, Korea, and Japan remain troubling. Public efforts to introduce healthy lifestyle changes and systematic NCDs prevention programs are necessary to reduce the epidemic of NCDs in these three Asian countries.

A novel approach for evaluating nerve function in healthy elderly persons: A pilot study

Background Motor nerve function decreases with age and can cause abnormalities in motor function. Using newly designed methods, we used evoked electromyograms to evaluate change in motor nerve function. Material/Methods Motor function was assessed by grip strength, timed up-and-go test, 5-m normal walk, and 5-m fastest walk. In addition, motor nerve conduction velocity was calculated by measuring latency differences (NCV) in elderly and young subjects. We also investigated motor nerve conduction velocity by correlation coefficient (NCVCC) and the difference between NCV and NCVCC (DNCV). Results Significant differences were observed in the motor function of elderly and young persons in grip strength, the timed up-and-go test, and the 5-m fastest walk; however, no difference was observed in the 5-m normal walk test. NCVCC was lower than NCV in both elderly and young. The correlation coefficient peak of the NCVCC calculation was lower in elderly than in young. A negative correlation was observed between correlation coefficient peak and DNCV in elderly subjects. Conclusions NCVCC compares the overall shape of compound muscle action potential and reflects not only the fastest motor unit, but also the motor nerve conduction velocity of other motor unit components. A significant negative correlation between DNCV and the correlation coefficient peak was observed only in elderly subjects, suggesting that older individuals, including those that maintain a high level of physical strength, experience a loss of motor nerve function. Thus, changes in motor nerve function among elderly persons can potentially be further examined for clinical use.

Evaluating visual bias and effect of proprioceptive feedback in unilateral neglect

We propose modified versions of the line-bisection task for assessing visual bias and effect of proprioceptive feedback in unilateral neglect; that is, the verbal line-bisection (VLB) task and the VLB plus pointing task. The VLB task requires only a verbal response to assess pure visual bias. Conversely, the VLB plus pointing task requires both a verbal response and pointing to assess visual and proprioceptive bias. Ten patients with unilateral neglect were administered these tasks on a computer using presentation software. Eight participants showed obvious rightward deviation in the VLB task, and were thus classified as patients with visual neglect. Four participants showed significantly greater deviation in the VLB plus pointing task than in the VLB task, and were thus classified as patients with proprioceptive bias. Visual bias and effect of proprioceptive feedback in unilateral neglect were successfully assessed by these tasks.

Relationship Between the Oxygen Uptake During Cardiopulmonary Exercise Testing and Left Ventricular Function in Patients with Acute Myocardial Infarction

The relationship between exercise capacity and left ventricular function has been evaluated in 35 patients with acute myocardial infarction (34 males and 1 female; mean age 55.5 ± 7.1 years). Single photon emission computed tomography (SPECT) was used to measure left ventricular function in the acute phase (4.9 ± 2.2 days after onset) and the chronic phase (188.5 ± 22.9 days after onset). More than 10% left ventricular dilatation from the acute phase to the chronic phase was defined as remodeling (RM) and the subjects were divided into 2 groups: RM and non-RM. Cardiopulmonary exercise testing was performed at 1 month (1M), 3 months (3M) and 6 months (6M) after onset. In the RM group, anaerobic threshold (AT) and peak oxygen uptake (Peak ) did not change significantly. In the non-RM group, AT was 15 ± 1 (ml/min/Kg) at 1M, 16 ± 2 at 3M and 18 ± 4 at 6M. Peak was 26 ± 3 (ml/min/Kg) at 1M, 30 ± 2 at 3M and 32 ± 3 at 6M. Both parameters in the chronic phase increased significantly compared with those at 1M (p<0.002 and p<0.0001). Thus, change in exercise capacity would correlate with change in left ventricular function.

Community-Based Interprofessional Education at Saitama Prefectural University

Saitama Prefectural University (SPU) aims to turn its students into high-quality health and social care professionals who understand the need for working in cooperation with professionals in other disciplines and are competent working with them. SPU offers interprofessional experiences to students to accomplish its stated aims. Based on the principle of interprofessional education, SPU has created an educational framework for achieving collaborative and integrated health and social services. The university provides opportunities from which students can learn, with and about each other beyond the boundaries of their departments and disciplines. In 2005, SPU was selected as one of the universities to be provided with a national government grant in the Support Program for Contemporary Education Needs. In the study presented, signifi cant differences in learning effects were observed in an interprofessional (IP) study, particularly for the aspects of understanding patients, extracting issues, considering resolutions, understanding other professions’ roles, developing perspectives on a team, understanding cooperation and collaboration, and identifying professional roles. The IP study seemed to enable the learning of interprofessional work, which allows students to share objectives in health and social services.