Randomized comparison trial of balance training by using exergaming and conventional weight-shift therapy in patients with chronic stroke.

OBJECTIVE: To compare the effects of exergaming with conventional weight-shift training on balance function in patients with chronic stroke. DESIGN: Single-blind randomized controlled trial. SETTING: Medical center. PARTICIPANTS: Patients (N=30) with chronic stroke and balance deficits. INTERVENTIONS: Twelve weeks of Wii Fit training or conventional weight-shift training. MAIN OUTCOME MEASURES: Static balance was assessed using posturography. We recorded the stability index and percentage of weight bearing on the affected leg in 8 positions. We also used the timed Up and Go and forward reach tests for dynamic balance evaluation, Falls Efficacy Scale-International for fear of falling assessment, and Physical Activity Enjoyment Scale for estimating the enjoyment of training. RESULTS: The exergaming group showed more improvement in stability index than the control group in head straight with eyes open while standing on a foam surface, eyes closed while standing on a solid surface with head turned 30° to the left, and eyes closed while standing on a solid surface with head turned up positions (time-group interaction P=.02, .04, and .03, respectively); however, the effects were not maintained. At 3-month follow-up, the control group showed more improvement in weight-bearing symmetry in the head straight with eyes open while standing on a solid surface position than the exergaming group (time-group interaction P=.03). Both groups showed improvement in the timed Up and Go test, forward reach test, and fear of falling. The improvement in fear of falling was not maintained. The exergaming group enjoyed training more than the control group (P=.03). CONCLUSIONS: Exergaming is enjoyable and effective for patients with chronic stroke.

The inhibition of inwardly rectifying K+ channels by memantine in macrophages and microglial cells.

BACKGROUND/AIMS: Memantine (MEM) can block N-methyl-D-aspartate receptors non-competitively and is recognized to exert anti-inflammatory action. Whether MEM and other related compounds produce any effects on K(+) currents in macrophages and in microglial cells is largely unknown. In this study, we investigated the effects of MEM and other related compounds on inwardly rectifying K(+) current (IK(IR)) in RAW 264.7 macrophages and in BV2 microglial cells. METHODS: Patch-clamp recordings under whole-cell, cell-attached or inside-out configuration were performed in standard patch-clamp technique. MEM suppressed the IK(IR) amplitude in a concentration-dependent manner with an IC50 value of 12 µM. RESULTS: This agent significantly slowed the inactivation time rate of IK(IR) evoked with membrane hyperpolarization. In cells dialyzed spermine (10 µM), MEM-mediated inhibition of IK(IR) no longer existed. MEM-suppressed activity is associated with a decrease in the slow component of mean open time and an increase in mean closed time, despite no detectable change in single-channel conductance of inwardly rectifying K(+) (Kir) channels. Under current-clamp conditions, the addition of MEM resulted in membrane depolarization of RAW 264.7 cells. Similarly, in BV2 microglial cells, addition of MEM suppressed IK(IR) as well as depolarized the membrane. However, neither C6 astrocytic cells nor Jurkat T-lymphoces were noted to display IK(IR). CONCLUSION: The block by MEM of Kir2.1 channels is thus one of the important mechanisms underlying its actions on the functional activities of either macrophages or microglial cells, if similar findings occur in vivo.