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Background/Aims@#Gastric acid secretion is suspected to be a pivotal contributor to the pathogenesis of functional dyspepsia. The present study investigates the potential association of the gastric acid secretion estimated by measuring serum pepsinogen with therapeutic responsiveness to the prokinetic drug acotiamide. @*Methods@#Dyspeptic patients consulting participating clinics from October 2017 to March 2019 were prospectively enrolled in the study. The dyspeptic symptoms were classified into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). Gastric acid secretion levels were estimated by the Helicobacter pylori infection status and serum pepsinogen using established criteria and classified into hypo-, normo-, and hyper-secretion. Each patient was then administered 100 mg acotiamide thrice daily for 4 weeks, and the response rate to the treatment was evaluated using the overall treatment efficacy scale. @*Results@#Of the 86 enrolled patients, 56 (65.1%) and 26 (30.2%) were classified into PDS and EPS, respectively. The estimated gastric acid secretion was not significantly different between PDS and EPS. The response rates were 66.0% for PDS and 73.1% for EPS, showing no significant difference. While the response rates were stable, ranging from 61.0% to 75.0% regardless of the estimated gastric acid secretion level among subjects with PDF, the rates were significantly lower in hyper-secretors than in non-hyper-secretors among subjects with EPS (42.0% vs 83.0%, P = 0.046). @*Conclusion@#Although acotiamide is effective for treating EPS as well as PDS overall, the efficacy is somewhat limited in EPS with gastric acid hypersecretion, with gastric acid suppressants, such as proton pump inhibitors, being more suitable.
ABSTRACT
Objective：To investigate the effects of being instructed to use a squat method on posture and the joints involved in the pelvic position.Methods：The subjects were 15 healthy men (mean age, 23.8 ± 1.0 years)．We set free and squat conditions as the measurement tasks and instructed the subjects to lift an object from the floor. Differences in joint angles between the two conditions at the time the object left the floor were examined using a corresponding t test. To assess the joints that affect the pelvic anterior tilt angle, lumbar and limb joint angles and the correlation coefficient between them were calculated.Results：In the squat condition, the extension angles of the thoracic vertebrae, upper and lower thoracolumbar transitional vertebrae, and upper lumbar vertebrae；the pelvic posterior tilt angle；flexion angles of the hip and knee joints；and dorsiflexion angle of the ankle joint increased. The pelvic anterior tilt angle was related to the knee and ankle joint angles in both conditions.Conclusion：Instructions to use a squat method increased the trunk extension and leg flexion angles. In both conditions, the knee and ankle joints affect the pelvic anterior tilt angle.
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Objective：The belt-tying movement is of two types. One uses an abduction method in which the scapular on the same side as the upper limb to be moved is touched. The other type uses an adduction method in which the scapular on the opposite side is touched. The purpose of this study was to determine the scapular movement and muscle activity of the periscapular muscle in each method.Methods：Ten healthy men performed abduction and adduction belt-tying movements. The scapular upward rotation, anterior tilt, and internal rotation angles were measured using a three-dimensional operation analysis device. The joint angles were compared between the abduction and adduction methods by using a multiple comparison procedure. In addition, the muscle activities of the trapezius upper, middle, lower, and serratus anterior muscles were measured and analyzed using surface electromyography.Results：The abduction method involved an anterior tilt and upward rotation of the scapular muscle. By contrast, the adduction method involved an upper limb descent at the L5/T12 level, a scapular anterior tilt and upward rotation, and a scapular downward rotation at a level higher than L5/T12. The muscle activity of the upper trapezius muscle fiber was always increased between the ptosis and T7 by the abduction method but was attenuated at a higher level than T12 by the abduction method.Conclusion：Rehabilitation therapy that focuses on scapular anterior tilt and downward rotation, and the muscle activity of the upper trapezius muscle fiber is important for acquiring the belt-tying movement ability using the adduction method.
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Objective：The belt-tying movement is of two types. One uses an abduction method in which the scapular on the same side as the upper limb to be moved is touched. The other type uses an adduction method in which the scapular on the opposite side is touched. The purpose of this study was to determine the scapular movement and muscle activity of the periscapular muscle in each method.Methods：Ten healthy men performed abduction and adduction belt-tying movements. The scapular upward rotation, anterior tilt, and internal rotation angles were measured using a three-dimensional operation analysis device. The joint angles were compared between the abduction and adduction methods by using a multiple comparison procedure. In addition, the muscle activities of the trapezius upper, middle, lower, and serratus anterior muscles were measured and analyzed using surface electromyography.Results：The abduction method involved an anterior tilt and upward rotation of the scapular muscle. By contrast, the adduction method involved an upper limb descent at the L5/T12 level, a scapular anterior tilt and upward rotation, and a scapular downward rotation at a level higher than L5/T12. The muscle activity of the upper trapezius muscle fiber was always increased between the ptosis and T7 by the abduction method but was attenuated at a higher level than T12 by the abduction method.Conclusion：Rehabilitation therapy that focuses on scapular anterior tilt and downward rotation, and the muscle activity of the upper trapezius muscle fiber is important for acquiring the belt-tying movement ability using the adduction method.
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Objective：To investigate the effects of being instructed to use a squat method on posture and the joints involved in the pelvic position.Methods：The subjects were 15 healthy men (mean age, 23.8 ± 1.0 years)．We set free and squat conditions as the measurement tasks and instructed the subjects to lift an object from the floor. Differences in joint angles between the two conditions at the time the object left the floor were examined using a corresponding t test. To assess the joints that affect the pelvic anterior tilt angle, lumbar and limb joint angles and the correlation coefficient between them were calculated.Results：In the squat condition, the extension angles of the thoracic vertebrae, upper and lower thoracolumbar transitional vertebrae, and upper lumbar vertebrae；the pelvic posterior tilt angle；flexion angles of the hip and knee joints；and dorsiflexion angle of the ankle joint increased. The pelvic anterior tilt angle was related to the knee and ankle joint angles in both conditions.Conclusion：Instructions to use a squat method increased the trunk extension and leg flexion angles. In both conditions, the knee and ankle joints affect the pelvic anterior tilt angle.
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<p>【Objective】</p><p>To investigate the role of the back and foot muscles during lateral weight-shifting in the standing position by examining the corresponding muscle activity patterns associated with a postural change.</p><p>【Methods】</p><p>The subjects were 24 healthy men (age 24.3 ± 2.6 [mean ± SD] years). The following parameters were recorded : center of pressure (COP) ; surface electromyograms of the multifidus, iliocostalis, longissimus (bilateral), peroneus, and foot supinator (on the moving side) muscles ; and video imaging during lateral weight-shifting after 2 seconds in the standing position.</p><p>【Results】</p><p>Horizontal movement of the pelvis resulted in elevation of the non-moving side from the middle of the COP, with moving side displacement. In the lower limbs, lateral weight shifting resulted in an outward tilt due to foot pronation. Activity of the multifidus, iliocostalis, and longissimus muscles on the non-moving side, and the peroneus and foot supinator muscles on the moving side, tended to increase with displacement of the COP on the moving side.</p><p>【Conclusion】</p><p>The multifidus, iliocostalis, and longissimus muscles were involved in lateral flexion of the thoracolumbar area and elevation of the pelvis on the non-moving side. Simultaneously, the foot supinator and peroneus muscles were involved in pronation of the grounded foot.</p>
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<p>The aim of this study was to investigate the effects of acupuncture to SP 3 on the quadriceps femoris during knee extension in patients with musculoskeletal diseases by applying the meridian concept.<br>The subjects included 10 healthy individuals with a mean age of 23.1 years, and all of whom provided informed consent for participation. During knee extension, each subject underwent three different types of acupuncture stimuli : 1) stimulation to SP 3, 2) stimulation to SP 4, and 3) no stimulation. For each stimulation,the subjects performed isometric contraction with 40% of maximum voluntary contraction with knee flexion to 60°. Surface electromyography (EMG) of the vastus medialis obliquus, vastus medialis longus, rectus femoris,and the four sites within the vastus lateralis was performed during knee extension before acupuncture stimulation ; immediately after starting stimulation ; and 5, 10, and 15 min after starting stimulation. Relative-integrated EMG data was recorded during and after acupuncture stimulation and compared to data that were recorded before acupuncture as reference values.<br>The results showed that after 15 min of acupuncture stimulation to SP 3, the relative-integrated EMG data on the vastus medialis obliquus was significantly increased compared to the data obtained without stimulation (p < 0.05).<br>Therefore, in conclusion, after 15 min of acupuncture stimulation to SP 3, the relative-integrated EMG data on the vastus medialis obliquus exhibited suppressed muscle function.</p>
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<b>[Background]</b> Although we have demonstrated the clinical effect of acupuncture therapy with epidermal stimulation by needle penetration, its neurophysiological mechanisms are unclear. To investigate the clinical effects of epidermal stimulation by needle penetration on muscle tone, we tested the Hoffmann's reflex (Hreflex) of the soleus muscle during epidermal needle stimulation. <br><b>[Methods]</b> Eighteen healthy participants were recruited. We tested the soleus H-reflex elicited by tibial nerve stimulation before and after epidermal stimulation by needle penetration. Epidermal stimulation was performed at several points on the Achilles tendon by needle penetration. We analyzed the amplitude ratio of H/M obtained from the waveforms of the soleus muscle before and after epidermal stimulation. <br><b>[Results]</b> The amplitude ratio of H/M was significantly decreased during stimulation when compared with ratio during rest (p < 0.05). Each participant demonstrated a decrease in soleus muscle amplitude ratio of H/M during epidermal stimulation by needle penetration as compared with the ratio during rest. <br><b>[Discussion]</b> Epidermal stimulation of the muscle by needle penetration activated the inhibitory interneurons of the dermatome at the stimulation site. Therefore, epidermal stimulation by needle penetration was considered as a possible method to induce muscle relaxation. <br><b>[Conclusion]</b> It is suggested that epidermal stimulation by needle penetration for 2 minutes for the insertion of the Achilles tendon results in an inhibitory effect by stimulating the spinal cord neural mechanisms that correspond to the soleus muscle.
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To clarify the function of the vastus medialis obliquus (VMO) and longus (VML), we investigated the electromyographic properties of superficial quadriceps femoris during fatiguing knee extension task.Ten healthy male and 10 female volunteers participated in this study. The subjects performed fatiguing knee extension task at maximal effort (10 times×10 set at 60 deg/sec). Surface electromyography (EMG) was recorded from the VMO, VML, vastus lateralis(VL) and rectus femoris(RF) during isometric knee extension (knee bent at 60 deg and 30% of the maximal voluntary contraction level) with a 90-sec interval between each set. Knee extension peak torque, integrated EMG (IEMG) and median power frequency (MDF) of four muscles during each set were compared using Dunnett's test.Knee extension peak torque decreased gradually and peak torque decreased significantly starting from set 9 in male subjects, while there was no significant decrease in female subjects. IEMG from VMO and VL increased linearly. IEMG increased significantly from set 7 in VMO and set 6 in VL for both male and female subjects. Then, IEMG from both VML and RF increased significantly starting from set 9 in VML and set 8 in RF in male subjects, while there was no significant change in female subjects.MDF of VMO, VL and RF also increased significantly at timepoints similar to those showing increases in IEMG in male subjects. However, MDF of VML increased significantly from set 4 in male subjects. On the other hand, MDF did not change significantly in female subjects.As a result of this study, it was suggested that VMO and VL were facilitated to maintain target knee extension torque during fatigue. Therefore, it was considered that VML and RF facilitated the maintenance of target torque under fatiguing conditions.
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In this seminar, the effects of acupuncture and moxibustion on muscle diseases and muscular functions/metabolism were reported, and the status of these techniques were summarized.<BR>In the clinical study section, it was reported that the effects of treatment on muscle diseases and muscular functions were evaluated using objective criteria, such as electromyograms. In the review of the methods for the evaluation of muscular functions using surface electromyograms, the static electromyograms, dynamic electromyograms, and power-spectrum analysis were presented, and the effects of acupuncture and manual treatment on diseases mainly in locomotor organs and their problems were discussed. For example, 72.9% of the 48 patients with cervical dystonia were found to show improvement by 10 courses of acupuncture treatment, and effects were observed in all patients by electromyography. Similar effects were obtained with patients with drug-induced dystonia. In many of the patients with writer's cramp who underwent 10 courses of acupuncture treatment, improvement in writing tests, subjective evaluation, and the strength of pen stokes were observed.<BR>In the review of the basic studies, the effects of acupuncture, electroacupuncture, and transcutaneous electrical nerve stimulation (TENS) on muscular tension, muscular metabolism (energy metabolism, intracellular pH, lactate metabolism), muscular circulation, and noxious and non-noxious motor reflex were surveyed, and their mechanisms and problems were discussed.
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To investigate the effects of Kampo and a rehabilitation approach on patients with spinocerebellar degeneration (SCD), a 65-year-old female patient with SCD was treated with Ogi-kenchu-to and therapeutic exercise based on the Bobath concept.<br>She had a gait disturbance (unable to walk) with slightly increased muscle tonus and deep sensory disturbance in the left leg before therapy. In Kampo confirmations, there was a generalized cold feeling and fatigue due to decreased physical fitness. In the electrophysiological study, the amplitude of Auditory Brainstem Responses (ABR) and Somatosensory Evoked Potentials (SEP) in the left side showed a greater decrease than those in the right side. The amplitude of the F-wave in the left side showed a greater increase than that of the right side.<br>After two months of this therapy, the patient was able to walk unassisted. Improvement in the neurological and general findings, along with normalization of the ABR, SEP and F-wave were also observed.<br>It was suggested that Kampo therapy using Ogi-kenchu-to and therapeutic exercise based on the Bobath concept were effective in the treatment of this patient with SCD.