F-4-02-07
PREVENTION OF SHOULDER HAND SYNDROME AFTER STROKE EFFECT OF PASSIVE MOVEMENT RESTRICTION
Izumi Kondo, Michitaka Fukuda, Manabu Iwata, Masashi Souma (Hirosaki University, Hirosaki, Japan), Masayuki Kudo (Aomori Rosai Hospital, Hachinohe, Japan), Desiree Maltais (McMaster University, Hamilton, Canada)
Purpose: Repeated microtrauma through passive movement is assumed to be one of the major factors causing shoulder hand syndrome (SHS). The purpose of this study was to determine the effect of passive movement restriction on incidence of SHS after stroke.
Methods: Subject group consisted of 81 patients who were referred to the rehabilitation department of Aomori Rosai Hospital and followed for at least 4 months from the onset of stroke. Control group comprised 71 patients who were the subjects in a previous epidemiological study of SHS after stroke. The protocol which included instruction for patient and therapist was used for subject group to restrict passive movement to the involved upper extremity. Control group had no limitations to passive movement. There were no significant differences of demographic data between subject and control group. Same criteria were used to diagnose SHS for both groups. Result was analyzed by χ2 test.
Results: The incidence of SHS in subject group was 18.5% (n=l5) while the incidence of SHS in control group was 32.4% (n=23). The difference between these two groups was statistically significant (χ2=3.885, p<0.05).
Conclusion: These results suggested that passive movement restriction of patient after stroke had preventive effect on SHS.
F-4-02-O8
THE AUTONOMIC NERVE RESPONSE IN LOWER LIMBS BY ELECTORICAL STIMULATION ON TIBIAL NERVE. Shunzo Aramaki, Yasuhiko Kira, Taku Ogura, Yasusuke Hirasawa.
(Kyoto Prefectural Rehabilitation Hospital for the Disabled and Kyoto Prefectural Univ. of Medicine, Kyoto, Japan)
The purpose of this study is to examine the autonomic nerve function by assessing skin temperature change and sympathetic skin response (SSR) obtained from lower limbs after the tibial nerve stimulation.
(Methods) Ten healthy males were subjected and the study was done as the following, 1) 20Hz electrical stimulation(ES) on the fight tibial nerve(TN) for 5 minutes, 2) 5 minutes rests3) 40Hs ES on the right TN for 5 minutes, 4) 20Hs ES on the left TN for 5 minutes, 5) 5 minutes rest, 6) 40Hz ES on the left TN for 5 minutes. As the measurement of the autonomic nerve function, thermography (INFRA-EYE160: Fujitsu) for the skin temperature and SSR by respiratory and electrical stimulation were utilized.
(Results) 1) there was a correlation between the skin temperature and the amplitude of the SSR by respiratory stimulation. 2) the skin temperature showed tendency to become higher by stimulation.
(Discussion and Conclusion) The reason why the temperature may rise by the ES should be considered that the blood flow in the lower limbs could be increased by the ES. From the point of view that the stimulation on the one limb equally effects on the both limbs and rises the skin temperature, it is considered that the ES would enhance the autonomic nerve function.
