Interleukin-6 (IL-6) is produced by contracting skeletal muscles and then released into the circulation and considered to mediate the health benefits of exercise against chronic diseases. Individuals with spinal cord injury (SCI) are reported to be at higher risk of developing metabolic diseases. We investigated the IL-6 responses to 20-min arm crank ergometer exercise at 60% of maximum oxygen consumption in eight trained individuals with cervical SCI (CSCI) between C6 and C7, and eight able-bodied trained healthy subjects. The plasma concentrations of IL-6, adrenaline, prostaglandin E(2) and cortisol were measured before, immediately after the exercise, 1 and 2 h after exercise. At rest, the plasma adrenaline concentration was significantly lower in individuals with CSCI than in able-bodied subjects (P < 0.01). On the other hand, the concentration of IL-6 was significantly higher at rest in individuals with CSCI (2.18 ± 0.44 pg/ml, mean ± SEM) than the control (1.02 ± 0.22 pg/ml, P < 0.05). In able-bodied subjects, the plasma adrenaline concentration increased significantly immediately after the exercise (P < 0.01) and returned to the baseline level at 1 h after exercise, and the plasma IL-6 level increased significantly at 1 h after exercise (1.91 ± 0.28 pg/ml, P < 0.05) and returned to the baseline level at 2 h after exercise. In contrast, adrenaline and IL-6 levels were steady throughout the study in individuals with CSCI. The lack of exercise-related IL-6 response in individuals with CSCI could be due to muscle atrophy and sympathetic nervous system dysfunction.

No abstract

A cross-sectional survey was done to clarify the incidence of pressure sores in 218 selfsupported Japanese paraplegic patients and to determine e ective measures for prevention. The majority of patients (85.7%) had previous pressure sores, and 46.3% had undergone multiple surgeries. Some patients (17.9%) were still su ering from persistent sores which commonly developed at the ischial tuberosities, suggesting insu ciency of self-care practice during wheelchair activities. Sensory disturbance over the seating surface, urinary incontinence, and general complications were seen in 85.8%, 49.5%, and 18.8% of total subjects, respectively. They were seen as risk factors for pressure sores, but only urinary incontinence clearly increased the current pressure sore prevalence. Nevertheless, both self-care practice and sports activities, seen in 85.3% and 36.2% of total subjects, respectively, contributed to greatly reduce the incidence. A patient education system including acquisition of basic knowledge and proper technique should be established to promote e ective prevention of pressure sores in Japan.

The hingeless plastic ankle-foot orthosis (AFO) changes stiffness largely depending on how much plastic is trimmed around the ankle. To support proper selection of the orthosis and final adjustment of the orthotic stiffness, the correlation between the posterior upright width and the resistance to dorsi- and plantar flexion movements was measured in 30 posterior-type plastic AFOs. The posterior upright width was varied by regularly trimming around the ankle in nine stages. The resistance to dorsi- and plantar flexion movements was measured by bending the plastic AFOs 15d` with the measuring device described in Part 1. All the plastic AFOs decreased in their resistance to both movements in proportion to the reduction of the posterior upright width. The maximum resistance to plantar flexion movement was about 28 Nm, which was strong enough to assist dorsiflexion in patients with severe spasticity. On the other hand, the maximum resistance to dorsiflexion movement measured was about 10 Nm, which was insufficient to stabilise the ankle in patients who lacked in plantar flexion strength. These findings suggested that this type of plastic AFO should be prescribed for patients who predominantly require dorsiflexion assist, and that the orthotic stiffness could be finally adjusted by trimming to exactly meet individual requirements.