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INTRODUCTION: Gait asymmetry can become very pronounced in patients who have suffered a stroke. The impairment of trunk function in some stroke patients can restrict thorax mobility and cause respiratory muscle weakness. Trunk and neck dysfunction are believed to affect the gait in stroke patients. OBJECTIVE: This study aimed to investigate the relationship between gait asymmetry and respiratory function in stroke patients by measuring the step time and trunk acceleration. METHODS: This study employed a cross-sec- tional design. Thirty stroke patients participated in this study. The symmetry index (SI) and Lissajous index (LI) were used to evaluate asymmetry during walking. The respiratory function and respiratory muscle strength were evaluated by spirometry. We examined the relation between SI or LI and the respiratory function/respiratory muscle strength in patients with stroke. RE- SULTS: The results of our analysis demonstrated that the SI was significantly correlated with the inspiratory and expiratory muscle strength and the LI was significantly correlated with the percentage of the predicted vital capacity (respectively, r = ﹣0.386, r = ﹣0.392, r = ﹣0.446; p CONCLUSION: The present study is the first to indicate a relationship between gait asymmetry and respiratory function in stroke patients.

Purpose: Mechanically assisted coughing (MAC) is an airway clearance method in which the thorax/abdomen is compressed in synchronization with mechanical insufflation-exsufflation (MI-E). MAC can be performed with manual assistance at the upper thorax (MAC-UT), lower thorax (MAC-LT), and upper thorax + abdomen (MAC-UT/A). This study aimed to determine the most effective approach under different conditions (air stacking or tracheostomy) in patients with neuromuscular disorders (NMDs). Methods: The study included 34 patients with NMDs. The patients were categorized into air stacking group (n=15), no air stacking group (n=9), and tracheostomy/tracheostomy positive-pressure ventilation (TPPV) group (n=10). Results: In each group, the cough peak flow (CPF) at 75% of the forced vital capacity (V̇75), V̇50, V̇25, and V̇10 were investigated during the approaches. In the air stacking group, the CPF was higher with MAC-UT, MAC-LT, and MAC-UT/A than with MI-E (p < 0.05). Additionally, V̇75 was higher with MAC-LT and MAC-UT/A than with MI-E (p < 0.05 and p < 0.01, respectively). In the no air stacking group, V̇75 was higher with MAC-UT/A than with MI-E (p < 0.05). In the tracheotomy/TPPV group, there were no significant differences. Conclusions: MAC approaches, especially MAC-LT and MAC-UT/A, are preferred in air stacking patients. However, in tracheostomy/TPPV patients, the CPF might not increase with MAC.

Abnormal body composition in myotonic dystrophy type 1 (DM1) are affected by energy intake above resting energy expenditure (REE). We aim to investigate the characteristics and relationship between body composition, REE, and pulmonary function in patients with DM1, and to examine their changes in 1 year. The study design was a single-center, cross-sectional, and longitudinal study of body composition, REE characteristics, and pulmonary function. Twenty-one male patients with DM1 and 16 healthy volunteers were registered in the study. Body composition was measured using dual-energy X-ray absorptiometry (DEXA). Fat mass (FM) index (kg/m2), fat-FM index (kg/m2), and skeletal mass index (kg/m2) were calculated. The measurements were taken breath by breath with a portable indirect calorimeter. The REE was calculated using the oxygen intake (VO2) and carbon dioxide output (VCO2) in the Weir equation. Basal energy expenditure (BEE) was calculated by substituting height, weight, and age into the Harris-Benedict equation. The study enrolled male patients with DM1 (n = 12) and healthy male volunteers (n = 16). Patients with DM1 (n = 7) and healthy volunteers (n = 14) could be followed in 1 year. The body composition of patients with DM1 was significantly higher in the FM index and significantly lower in the fat-FM index and skeletal mass index. The REE of patients with DM1 was significantly lower and was not associated with body composition. Patients with DM1 had poor metabolism that was not related to body composition. FM was high and lean body mass was low.

Dietary inhibitors of fats and carbohydrates degrading digestive enzymes can reduce obesity and type 2 diabetes. In this study, we investigated and compared polyphenol content, DPPH radical scavenging activity, and inhibitory activity on digestive enzymes, including α-glucosidase, α-amylase and lipase in flesh, peel, core and seed from mini apple (Malu domestica cv. ‘Alps Otome’). Polyphenol content was significantly higher in peel and seed extracts than in flesh and core extracts. As comparing with flesh, peel polyphenols exhibited stronger DPPH radical scavenging activity, and α-amylase and lipase inhibitory activity. Oligomeric polyphenols (Fra.II) were the main polyphenols in seed extracts, which exhibited significantly strong DPPH radical scavenging activity and inhibitory activity on digestive enzymes. However, monomeric polyphenols (Fra.I) were the main polyphenols in core extracts, which exhibited weak inhibitory activity on digestive enzymes than the other parts. Moreover, Fra.III of seed and peel extracts had the highest inhibitory activity on α-glucosidase, followed by Fra.II and Fra.I, respectively. It indicated that more highly polymerized polyphenols from peel and seed of mini apple showed more potent inhibitory activities on α-glucosidase. All of the observations suggested that mini apples possess useful properties. Particularly, it has potential applications for the treatment of diabetes and obesity.

BACKGROUND: Manually-assisted coughing and mechanical insufflation-exsufflation (MI-E) are commonly used in patients with Duchenne muscular dystrophy (DMD). Few studies have compared cough peak flow (CPF) with manually-assisted coughing to other methods, such as MI-E + manually-assisted coughing. In addition, few studies have reported the reliability of the measured CPF values. This study aimed to compare CPF with different cough-assistance methods and to examine the reliability of CPF data. METHODS: The study included 12 subjects with DMD (mean age, 34 ± 8 y). CPF, CPF + manually-assisted coughing (assisted CPF), maximum insufflation capacity (MIC) + CPF (MIC-CPF), MIC + manually-assisted coughing (MIC+assisted CPF), MI-E (MI-E–CPF), and MI-E + assisted CPF were measured. A spirometer was used to compare CPF measurements obtained with each of the cough-assist techniques. The reliability of the measured CPF values was analyzed using Bland-Altman analysis. RESULTS: CPF was 59 ± 34 L/min, assisted CPF was 113 ± 32 L/min, MIC-CPF was 170 ± 30 L/min, MIC+assisted CPF was 224 ± 62 L/min, MI-E–CPF was 199 ± 40 L/min, and MI-E + assisted CPF was 240 ± 38 L/min. A fixed and proportional bias was found in the CPF measurements made with the peak flow meter and the spirometer. The average 95% CI in the difference between peak flow meter, MI-E, and CPF obtained using the spirometer were −7.45 to −1.95 and −1.45 to 4.95, respectively. Test for correlation was r = 0.54 (P CONCLUSION: MI-E + assisted CPF was the highest. The CPF measured with the peak flow meter suggested underestimation.

Introduction: Mechanically assisted coughing (MAC) is an airway clearance method in which the thorax and/or the abdomen are compressed in synchronization with mechanical insufflation-exsufflation (MI-E). Aims: The purpose of this study was to examine the effects of four MAC procedures on pulmonary function in different conditions of patients with neuromuscular disease (NMD). Methods: Twenty-seven patients (mean age, 54.3 ± 18.8 years) with NMD (PMD=15, ALS=6, other=6) who underwent MI-E were divided into an air stacking group, a no air stacking group, and a tracheostomy positive pressure ventilation(TPPV) group. MAC procedures were divided into the following four groups according to the position of manual assistance: MI-E alone, upper thoracic MAC (UT-MAC), lower thoracic MAC (LT-MAC), and upper thoracic/abdominal MAC (UT/A-MAC). Pulmonary function was evaluated by cough peak flow (CPF) and the value at 75% of the forced vital capacity (V75). Results: In the air stacking group, CPF with MI-E alone was significantly lower than CPF with UT-MAC, LT-MAC, and UT/A-MAC (p Conclusions: In the air stacking group, a higher CPF was achieved with MAC compared with MI-E. However, the effect of MAC was influenced by the position of manual assistance and the presence of scoliosis. MAC did not increase CPF in NMD patients with TPPV.

In the present study, we sysnthesize two types of MR fluids with different particle shapes and sizes. The magnetic functions are evaluated circulatingly by the analysis of cluster formation, rheological properties in the applied magnetic field and damping characteristics in the MR damper, comparing with those of commercial MR fluids. Final objective is to provide the fundamental data for the development of newly advanced MR fluids. The main topics consist of geographycal cluster formation depending on particle shapes and sizes, relating to the apparent viscosity and yield stress with magnetic flux density and further equivalent damping coefficient of two newly sysnthesised MR fluids comparing with those of LORD MR fluid.