A study of the effect of visual depth information on upper limb movement by use of measurement of smoothness.

[Purpose] This study verified that the smoothness of reaching movements is able to quantitatively evaluate the effects of two- and three-dimensional images on movement in healthy people. In addition, clinical data of cerebrovascular accident patients were also analyzed by the same method. [Subjects] Ten healthy adult volunteers and two male patients with previous cerebrovascular accidents participated. [Methods] The subjects were tasked with reaching for objects shown on a display. The target and virtual limb, rendered with computer graphics, were shown on the display. Movements of the virtual limb were synchronized with those of the subject. Healthy subjects reached for targets with their dominant arm, and cerebrovascular accident patients used their paretic arm. A polarized display and polarized glasses were used when the subjects were shown three-dimensional images. In the present study, jerk cost was used to quantify the smoothness of movement. [Results] Six of the 10 healthy subjects had significantly smoother reaching movements when viewing the three-dimensional images. The two cerebrovascular accident patients tended to have smoother movements in response to the three-dimensional images. [Conclusion] Analysis of the smoothness of movement was able to detect the influence of the depth cue in vision on movement quantitatively for the healthy subjects and cerebrovascular accident patients.

Development and evaluation of a new telerehabilitation system based on VR technology using multisensory feedback for patients with stroke.

[Purpose] The purpose of this study was to develop a new telerehabilitation system based on VR technology for training of paralyzed upper and lower extremities and poor balance in patients with stroke. Moreover, the effectiveness of the system was verified by analysis of the recovery of these patients. [Subjects] Five healthy persons and five people with motor paralysis, caused by cerebrovascular disease, participated. [Methods] The features of our system are as follows: (1) Our system can train upper and lower limbs and balancing with 3D images. (2) A Kinect(®) is used for user posture detection. (3) A vibrator is used for feedback to a sensory receptor in order to promote the learning effect of motion. Upper limb and balance training were conducted in this study. [Results] The time necessary for the upper limb and balance training tasks was shortened for the participants with disabilities. The joint angle for the participants with disabilities tended to equate to that of the healthy participants over time. Moreover, our system had no side effects. [Conclusion] These points suggest that our system is effective and safe. The user interface and assessment of the conditions of patients from a distance should be studied in the future.

A study of upper extremity training for patients with stroke using a virtual environment system.

[Purpose] A virtual environment (VE) system was designed to facilitate the retraining of motor control by feedback of movement trajectory to patients with neurological impairments, such as stroke victims or those with an acquired brain injury. In this study, we quantitatively assessed motion trajectory of the upper extremity during VE in order to further understand the effect of paralyzed upper extremity movement in VE for each patient as well as the functional clinical evaluations. [Subjects and Methods] Six patients with stroke were participated in this study. The VE system consisted of a computer, an electromagnetic motion tracking device, which monitored and displayed patient movement on the computer, and the VE software, which provided the tools for creating training scenes. This system was used to facilitate motor relearning of the upper extremity for six patients with stroke. [Results] The results showed there were improvements in variability and accuracy of the arm movement in motion trajectory. In addition, the scores of clinical evaluations improved, and VE did not hinder motor relearning of the upper extremity, which is necessary for activities of daily living. [Conclusion] This VE system might be effective at facilitating motor relearning of the upper extremity for stroke patients.

[A patient with peritoneal metastasis from gastric cancer who responded to weekly chemotherapy with paclitaxel on the third line and could take meal].

We report a patient with peritoneal metastasis from gastric cancer who responded to weekly chemotherapy with paclitaxel (TXL) as the third line treatment and could take meals for half a year. The patient was a 64-year-old man who underwent total gastrectomy for advanced gastric cancer with peritoneal metastasis. He was first treated with TS-1 as an outpatient treatment; however, tumor markers rose. He could not take meals and had to be hospitalized. CPT-11 was infused on the second line, but due to disease progress, the patient was administered weekly TXL. TXL (70 mg/m2) was infused over 1 hour after short premedication. Administration was continued for 3 weeks followed by 1 week rest. The tumor markers decreased, and he could take meals and was discharged from hospital. The toxic events were leukopenia (grade 2), alopecia (grade 2) and pneumonia (grade 3).