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The antifracture efficacy of vitamin D in osteoporosis is due to its direct action on bones and indirect extraskeletal effects to prevent falls. Eldecalcitol is an analog of active vitamin D3 that improves bone mineral density and reduces the risk of osteoporotic fractures. However, the effects of eldecalcitol on muscle strength and static and dynamic postural balance are unclear. In this open-label randomized controlled study, we assessed the effects of eldecalcitol on muscle strength and static and dynamic postural balance in 50 postmenopausal women (mean age 74 years) with osteoporosis treated with bisphosphonate. Participants were randomly divided into a bisphosphonate group (alendronate at 35 mg/week; n = 25) or an eldecalcitol group (eldecalcitol at 0.75 μg/day and alendronate at 35 mg/week; n = 25) and were followed up for 6 months. Trunk muscle strength, including back extensor strength and iliopsoas muscle strength, was measured. Static standing balance was evaluated and the one leg standing test was performed to assess static postural balance. Dynamic sitting balance was evaluated and the 10-m walk test, functional reach test, and timed up and go test were performed to assess dynamic postural balance. At 6 months, there were no significant changes in any measure of muscle strength or balance in the bisphosphonate group, whereas eldecalcitol significantly increased back extensor strength (p = 0.012) and iliopsoas muscle strength (p = 0.035). Eldecalcitol also significantly improved findings on the timed up and go test (p = 0.001) and dynamic sitting balance (p = 0.015) at 6 months. These results with eldecalcitol may have an impact on prevention of falls.

BackgroundGiven the extent of the surgical indications for pulmonary lobectomy in breathless patients, preoperative care and evaluation of pulmonary function are increasingly necessary. The aim of this study was to assess the contribution of preoperative pulmonary rehabilitation (PR) for reducing the incidence of postoperative pulmonary complications in non‐small cell lung cancer (NSCLC) patients with chronic obstructive pulmonary disease (COPD).MethodsThe records of 116 patients with COPD, including 51 patients who received PR, were retrospectively analyzed. Pulmonary function testing, including slow vital capacity (VC) and forced expiratory volume in one second (FEV 1), was obtained preoperatively, after PR, and at one and six months postoperatively. The recovery rate of postoperative pulmonary function was standardized for functional loss associated with the different resected lung volumes. Propensity score analysis generated matched pairs of 31 patients divided into PR and non‐PR groups.ResultsThe PR period was 18.7 ± 12.7 days in COPD patients. Preoperative pulmonary function was significantly improved after PR (VC 5.3%, FEV 1 5.5%; P < 0.05). The FEV 1 recovery rate one month after surgery was significantly better in the PR (101.6%; P < 0.001) than in the non‐PR group (93.9%). In logistic regression analysis, predicted postoperative FEV 1, predicted postoperative %FEV 1, and PR were independent factors related to postoperative pulmonary complications after pulmonary lobectomy (odds ratio 18.9, 16.1, and 13.9, respectively; P < 0.05).Conclusions PR improved the recovery rate of pulmonary function after lobectomy in the early period, and may decrease postoperative pulmonary complications.

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Hemiplegia is a common sequel of stroke and assisted living care is needed in many cases. The purpose of this study was to evaluate the effect of using surface electrode stimulation device in rehabilitation, in terms of functional improvement in upper limb and the changes in brain activation related to central nervous system reconstruction. Five patients with chronic hemiplegia received electrical stimulation therapy using the orthosis-type surface electrode stimulation device for 12 weeks. Training time was 30 min/day for the first weeks, and increased 30 min/day in every 4 weeks. Upper limb outcome measures included Brunnstrom stage, range of motion, Fugl-Meyer assessment and manual function test. Brain activation was measured using functional MRI. After therapy with therapeutic electrical stimulation (TES) for 12 weeks upper limb function improved in all cases. The results of brain activation showed two patterns. In the first, the stimulation produced an activity in the bilateral somatosensory cortices (SMC), which was seen to continue over time. The second, activation was bilateral and extensive before stimulation, but localized to the SMC after intervention. Treatment with TES using an orthosis-type electrode stimulation device improves upper limb function in chronic hemiplegia patients. The present findings suggest that there are not only efferent but also afferent effects that may promote central nervous system remodeling.Stroke is the main cause of disability in industrialized countries, with a significant impact on individual, family, and societal healthcare. Although many hemiplegic survivors after stroke achieve independent ambulatory functions with orthotic devices, half of them are unable to use their upper extremity in their activities of daily living (ADL) after months of standard stroke rehabilitation (31). A common approach in rehabilitation for upper limb hemiplegia in chronic stage has been training the healthy side, especially if it contains the nondominant hand, and learning to perform tasks with only one arm. In recent years, it has been recognized that the phenomenon of "learned non-use" (30, 33), which results from use of the healthy side only, invites a state of further inability to use the affected side. Because this can lead to exacerbation of secondary disorders such as edema, pain, decreased range of motion, and shoulder subluxation, attention has focused on approaches for rehabilitating the affected upper limb based on the plasticity of the central nervous system. Reports that rehabilitation for the affected upper limb produces reconstruction of the central nervous system as upper limb function improves (27) have also attracted attention. One of the most promising alternate interventions to help hemiplegic survivors recover upper limb function is functional electrical stimulation (FES). FES is a method of restoring functionality to upper or lower extremities by electrically stimulating the lower motor neurons of hemiplegic survivors after stroke (26). FES training involves t...