[Purpose] To determine the effect of dual-task training with cognitive tasks on cognitive and walking ability after stroke. [Subjects and Methods] Twenty patients diagnosed with stroke participated in this study. All participants were receiving a traditional rehabilitation program 5 days a week. Dual-task and single-task training were additionally performed for 4 weeks, 3 days a week. The Stroop test, Timed Up and Go (TUG) test, 10-Meter Walk Test (10MWT), and Figure-of-8 Walk Test (F8WT) were used to measure cognitive and walking abilities and were evaluated 3 times (before and after training and at the 2-week follow-up). [Results] Dual-task training improved cognitive and walking abilities, and dual-task training subjects’ performance was better than single-task training subjects’ performance. In addition, these training benefits were maintained for 2 weeks. [Conclusion] Dual-task training improves cognitive and walking abilities of patients with stroke.

[Purpose] The purpose of this study was to examine the effects on stroke patients of trunk stabilization exercise on different support surfaces. [Subjects and Methods] Sixteen stroke patients with onset of stroke six months earlier or longer were randomly and equally assigned to group I (exercise performed on a stable support surface) and group II (exercise performed on an unstable support surface). The two groups conducted the trunk stabilization exercises on the respective support surfaces, in addition to existing rehabilitation exercises five times per week for 12 weeks. Changes in the cross-sectional area (CSA) of the muscles were examined using computed tomography (CT), and changes in the balance ability were assessed using a measuring system and the trunk impairment scale (TIS). [Results] In group I, there was a significant increase in the CSA of the mulifidus muscle on the side contralateral to the brain lesion and in the paravertebral and multifidus muscles on the side ipsilateral to the brain lesion. In group II, there was a significant increase in the CSA of the paravertebral and multifidus muscles on the side contralateral to the brain lesion and on the side ipsilateral to the brain lesion. In terms of changes in balance ability, the sway path (SP) and TIS significantly improved in group I, and the SP, sway area (SA), and TIS significantly improved in group II . [Conclusion] Exercise on the unstable support surface enhanced the size of the cross-sectional area of the trunk muscles and balance ability significantly more than exercise on the stable support surface.

SH.Cannabinoid receptor 1 mediates high glucose-induced apoptosis via endoplasmic reticulum stress in primary cultured rat mesangial cells. Am J Physiol Renal Physiol 301: F179 -F188, 2011. First published February 16, 2011 doi:10.1152/ajprenal.00032.2010.-The endocannabinoid system in animals and humans is involved in the onset of diverse diseases, including obesity and diabetic nephropathy, which is a major end-stage renal disease characterized by high glucose (HG)-induced apoptosis of mesangial cells. Endocannabinoids induce physiological and behavioral effects by activating two specific receptors, cannabinoid receptor 1 (CB 1R) and cannabinoid receptor 2 (CB2R). However, the pathophysiology of CB 1R in diabetic nephropathy has not been elucidated. We investigated the effects of HG on CB 1R expression and its signaling pathways in primary cultured rat mesangial cells. HG significantly increased CB 1R mRNA and protein levels in a time-dependent manner and induced CB 1R internalization. NF-B and cPLA 2 were involved in the HG-induced increase in CB 1R levels. Using a CB1R antagonist (AM251) and CB1 siRNA transfection, we showed that HG-induced CB 1R is linked to apoptosis. Specifically, HG inhibited the expression of GRP78, but induced increases in endoplasmic reticulum (ER) stress proteins, including phosphorylated (p)-protein kinase-like ER-associated kinase, p-eukaryotic initiation factor 2␣, p-activating transcription factor-4, and C/EBP homologous protein. In addition, HG increased the Bax/Bcl-2 ratio and increased the amounts of cleaved poly(ADP-ribose) polymerase and caspase-3. These apoptotic effects were prevented by AM251 and by the downregulation of CB 1R expression by small interfering RNA. We propose a mechanism by which blockade of CB 1R attenuates HG-induced apoptosis in rat mesangial cells. Our findings suggest that blockade of CB 1R may be a potential therapy in diabetic nephropathy. endocannabinoid system DIABETIC NEPHROPATHY IS CHARACTERIZED by hyperglycemia-induced dysfunction of mesangial cells (21). In an environment of high glucose (HG), renal mesangial cells undergo cascades of deleterious reactions, including cell injury and extracellular matrix deposition, which lead to glomeruli dysfunction (1,25,49). Mesangial cell apoptosis promoted by HG contributes to the development of diabetic nephropathy (22,40).Endocannabinoids are endogenous lipid mediators with a wide range of biological effects, similar to those of marijuana. The endocannabinoid system (ECS) regulates synaptic plasticity, emotional responses, energy homeostasis, and glucose metabolism (44). Dysregulation of ECS is involved in the onset of obesity and diabetic nephropathy (12). Barutta et al. (5) have reported that cannabinoid receptor 1 (CB 1 R) was overexpressed within glomeruli in diabetic mice and CB 1 blockade prevented diabetes-induced albuminuria. It has been also reported that the condition of HG increased the endogenous ligands of the ECS, N-arachidonoyl ethanolamine (AEA) and 2-arachidonylglycerol ( 2-AG) in vivo...

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[Purpose] The purpose of this research was to analyze the efficacy of extracorporeal shock wave therapy for the treatment of stroke patients with plantar fasciitis. [Subjects and Methods] This study included 10 stroke patients diagnosed with plantar fasciitis who were administered 3 sessions of extracorporeal shock wave therapy per week. After the last session, they performed stretching exercises for their Achilles tendon and plantar fascia for 30 min/day, 5 times a week for 6 months. The following parameters were measured and compared prior to therapy, 6 weeks after therapy, and 6 months after therapy: thickness of the plantar fascia, using an ultrasonic imaging system; degree of spasticity, using a muscle tension measuring instrument; degree of pain, using the visual analogue scale; and gait ability, using the Functional Gait Assessment. [Results] Decreased plantar fascia thickness, spasticity, and pain and increased gait ability were noted after therapy. These changes were significantly greater at 6 months after therapy than at 6 weeks after therapy. [Conclusion] These results indicated that extracorporeal shock wave therapy reduced tension in the plantar fascia, relieving pain and improving gait ability in stroke patients.