Design: Non-randomized study. Objective: To determine natural killer cell cytotoxic activity (NKCA) to 2-h arm ergometer exercise in persons with spinal cord injuries (SCI) and the underlying mechanism of such response. Setting: University of Occupational and Environmental Health, Japan. Methods: We examined NKCA response to 2-h arm crank ergometer exercise at 60% of maximum oxygen consumption (VO 2max ) in SCI and able-bodied persons. NKCA and plasma concentrations of prostaglandin E 2 (PGE 2 ), adrenaline and cortisol were measured before, during and immediately after the exercise. The study included seven subjects with SCI between Th11 and L4 and six able-bodied persons.Results: NKCA in able-bodied subjects increased (Po0.05) at 60 min of exercise and immediately after the exercise, and remained elevated up to 2 h after exercise. However, NKCA in SCI decreased (Po0.05) immediately after exercise but recovered at 2 h after exercise. Plasma adrenaline in both groups increased significantly (Po0.05) immediately after exercise and returned to baseline level 2 h after the exercise. Plasma cortisol in both groups remained constant throughout the study. In SCI, PGE 2 significantly increased immediately after 2 h exercise and returned to the baseline level 2 h after exercise; however, it remained unchanged during the test in able-bodied subjects. Conclusion: Our results suggested that increase of PGE 2 in SCI partially contributes to NKCA.

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A plastic ankle foot orthosis (AFO) was developed, referred to as functional ankle foot orthosis Type 2 (FAFO (11)), which can deal with genu recurvatum and the severe spastic foot in walking. Clinical trials were successful for all varus and drop feet, and for most cases of genu recurvatum. Electromyogram studies showed that the FAFO (11) reduced the spasticity of gastrocnemius and hamstring muscles and activated the quadricep muscles. Gait analysis revealed a reduction of the knee angles in the stance phase on the affected side when using the FAFO (11). Mechanical stress tests showed excellent durability of the orthosis and demonstrated its effectiveness for controlling spasticity in comparison with other types of plastic AFOs.

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