Effects of two different intensities of transcutaneous electrical nerve stimulation on pain thresholds of contralateral muscles in healthy subjects.

[Purpose] This study aimed to investigate the differential effects of high-intensity and low-intensity transcutaneous electrical nerve stimulation on the contralateral side on the pain threshold in healthy subjects. [Subjects and Methods] Twenty-five healthy adults, volunteers received two intensity levels (motor-level, 1.5 times the muscle motor threshold; sensory-level, sensory threshold of the common peroneal nerve), for 30 s on separate days. Pressure pain threshold was recorded on the contralateral tibialis anterior and deltoid muscle before, during, and after stimulation. [Results] Motor-level stimulation significantly increased the pressure pain threshold at both muscle sites, while effects of sensory-level stimulation on pressure pain thresholds were significant only at the deltoid site. The percent change in pressure pain thresholds at both sites was significantly higher during motor-level stimulation. [Conclusion] Motor-level stimulation, applied unilaterally to one leg, produced immediate contralateral diffuse and segmental analgesic effects. This may be of therapeutic benefit in patients for whom transcutaneous electrical nerve stimulation cannot be directly used at the painful site.

Foot Tapping Test as Part of Routine Neurologic Examination in Degenerative Compression Myelopathies: A Significant Correlation between 10-sec Foot-tapping Speed and 30-m Walking Speed.

INTRODUCTION: Leg spasticity in degenerative compression myelopathy causes impairment of fast and rapid repetitive movements, which tends to appear despite the disproportionate paucity of clinical weakness. As clinically useful measures used to quantify the slowness of voluntary leg movements in this pathological condition, we compared the foot tapping test (FTT) with the simple walking test, which is now considered the gold standard in this field. METHODS: We compared the FTT with the simple walking test, the grip-and-release test, and the functional scales of Nurick and the Japanese Orthopedic Association (JOA) in 77 patients with cervical compression myelopathy and 56 age-matched healthy subjects. The FTT was conducted on both sides separately, and the subject, while being seated on a chair, moved his/her toes up and down repeatedly to tap the floor as fast and as vigorously as possible for 10 sec with his/her heels planted on the floor. RESULTS: The number of 10-sec foot tapping in the patient group significantly correlated with the Nurick grades (r = -0.566; P < 0.0001), the JOA scores (r = 0.520; P < 0.0001), and the grip-and-release rates (r = 0.609; P < 0.0001). It also significantly correlated with the 30-m walking time (r = -0.507; P < 0.0001) and the number of steps taken (r = -0.494; P < 0.0001). Assessments of wheelchair-dependent patients and side-to-side comparison, in which the simple walking test plays no role, revealed significantly fewer FTT taps in wheelchair-bound patients than in the ambulatory patients and a significant trend for cervical compression myelopathy to dominantly affect the upper and lower limbs on the same side. CONCLUSIONS: This study contributes to the reassessment of the currently underutilized FTT as part of a routine neurologic examination of degenerative compression myelopathy.

[Promoting daily physical activity by encouraging stair using banners].

OBJECTIVE: To test the effectiveness of stair-use banners in encouraging the use of stairs instead of escalators. DESIGN: Observational survey with prompted banners. PARTICIPANTS: Shoppers and a few employees. METHODS: The use of the escalator and adjacent stair was monitored in a department store in Kochi City, Japan. Participants were coded for gender, age, and presence of hand bags. A 2 week baseline period was followed by a 4-week intervention using motivating messages on the stair-use banners. Follow-up data were also collected for 1 week after the removal of the banners 2 weeks later. The details of the study were published in the Kochi newspaper (booster) on the last day of intervention in the third week. RESULTS: A total of 9,834 escalator/stair-choice observations were made. The percentage of people who used the stair increased significantly from 46.0% to 51.1% during the intervention of 3-4 weeks (p < 0.001). When the banners were removed, the percentage remained higher than the baseline. The booster had no effect on the stair use. CONCLUSION: This intervention method is effective in encouraging physical activity among the general public. As one method for encouraging exercise action for unspecified number of the general public, it was concluded that this intervention method was successful.

A subclinical impairment of ventilatory function in cervical spondylotic myelopathy.

OBJECTIVE: To evaluate the ventilatory function in patients with cervical spondylotic myelopathy (CSM). DESIGN: Prospective cohort study. SETTING: Medical school in Japan. PARTICIPANTS: Thirty-seven consecutive patients with CSM. INTERVENTIONS: All the patients had surgical intervention for mild to moderate spastic limb paresis. MAIN OUTCOME MEASURES: Analysis of the maximum voluntary ventilation (MVV) in addition to routine spirometry before and after surgical decompression. Functional assessment was made by using the Japanese Orthopaedic Association (JOA) Scale. RESULTS: The MVV (% predicted) increased significantly (P<.002) from 77%+/-19% preoperatively to 84%+/-20% postoperatively. None of the other routine spirometric data (ie, vital capacity, forced vital capacity, forced expired volume in 1 second, peak expiratory flow rate) increased significantly. According to the JOA score, tetraparesis improved significantly (P<.0001) from 8.3+/-3.2 preoperatively to 11.4+/-3.0 postoperatively. The ratio of postoperative to preoperative MVV showed a significant correlation (r=.538, P<.002) with that of the JOA score. CONCLUSIONS: MVV provides a useful measure for monitoring ventilatory impairment in patients with myelopathy.