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The number of elderly individuals in need of care is increasing with the growing elderly population in Japan, resulting in the increased production of disposable diapers. Several warning detectors for urinary incontinence have been developed to provide high-quality care, several of which have been marketed. Most of these detectors use disposable sensors. These sensors must be attached to a new diaper at the time of diaper changing. To reduce both the effort and the cost required to replace the sensor, we developed a warning system to detect urinary incontinence using a reusable sensor on the outside of a diaper. The newly developed system is essentially divided into a sensor unit and an alarm unit. The sensor unit consists of a pair of electrodes; a timer; a signal generator; bridge, rectifier, and smoother circuits; and a transmitter. The alarm unit consists of a receiver and LEDs. The alarm unit delivers a warning about incontinence to care staff via LED lighting. When 500 mL of tap water was absorbed into a diaper, on the outside of which the system was attached by its electrodes, the capacitance and conductance increased 2.5 times and 50 times, respectively, compared with those of a dry diaper. When 50 mL of saline was poured into a diaper that was attached to the crotch region of a torso mannequin to model incontinence, the incontinence warning functioned as intended. The impedance of the pad-type diaper, which was measured by an impedance analyzer, decreased from 270 kΩ to 86 kΩ. The electrodes remained dry after the saline was poured into the diaper. The novel warning system was evaluated in a special nursing home for the aged. Twelve elderly people participated in this trial. The system operated correctly in 49 of 65 trials.

Positron emission tomography (PET) with fluorodeoxyglucose-F18 was used to examine glucose metabolism in patients with late-onset major depression, all hospitalized non-responders to antidepressant medication. The three-dimensional stereotactic surface projection (3D-SSP) method provided 3D-SSP images and relative metabolic values with minimal partial volume effects. The 3D-SSP score map showed decreased relative metabolism in the prefontal, cingulate and parietal regions in both hemispheres, and in the temporal region on the right, and increased relative metabolism in the occipital pole, vermis, cerebellum, dorsal-frontal, central convexity areas and basal ganglia in both hemispheres in patients compared with controls. The ratio of the parietal to occipital values in right plus left hemispheres was significantly decreased. Correlation coefficients of the anterior cingulate-primary sensorimotor, posterior cingulate-primary sensorimotor and occipital-media frontal in both hemispheres, of the frontal-primary sensorimotor, occipital-parahippocampal, primary visual-medial frontal and parahippocampal-amygdala in the right, and the frontal-vermis, parietal-thalamus, temporal-vermis, occipital-putamen, primary visual-putamen, thalamus-vermis and thalamus-cerebellum in the left were significantly different in patients compared with controls. Patients with late-onset depression who were treatment non-responders showed alterations not only in limbic-cortical circuits, but also in a wider network of thalamo-cortical circuits.

藤元早鈴病院, 金沢大学理工研究域機械工学系

山越, 憲一, 金沢大学ベンチャー・ビジネス・ラボラトリー, 金沢大学大学院自然科学研究科知的システム創成, Monitoring of posture change in sagittal plane and walking speed is important for evaluate the effectiveness of rehabilitation program or brace. We have developed a wearable device for monitoring human activity. However, in the previous system, there still remain several drawbacks for practical use such as accuracy in angle measurement, cumbersome cable arrangements, and so on. In order to improve these practical drawbacks, a new sensor system was designed, and its availability was evaluated. The results demonstrated that the accuracy of this system showed superior to that of the previous, and this system appears to be a significant means for quantitative assessment of the patient's motion. ©2006 IEEE.

This study described a niche telemedicine framework for home healthcare. The framework aims to transmit small but sufficient amounts of data for daily monitoring of residential subjects' basic health status. As a proof of concept, an unconstrained monitoring system of heart/respiration rates using wireless telecommunication as an application for home-visit rehabilitation therapists was developed. The system allows a nomadic home-visit therapist to acquire the health information of a patient remotely - from anywhere at any time. It consists of a sensory system for the patient and a viewer system for the therapist. A TCP/IP network connects the subsystems using a physical communication infrastructure. The proposed system showed its usefulness for both the therapist and the patient in planning and evaluating daily rehabilitation training.

We developed a gas-spring-powered device for assisting activities of sit-to-stand and stand-to-sit for the elderly andpersons with disability. The assistive device is fitted to both normal chair and wheelchairs, and is comprised of three mainparts; a seat, two support frames and two gas-springs. The assistive device was evaluated in comparison experimentswith or without this assistive device and commercially available assistive chair. Ten young healthy subjects aged from 21 to 24 yr-old had measurements of joint torque of knee and elbow using a force plate, load-cell attached on an armrest andposition of joint marker in video. In addition electromyography of upper arm and thigh were also measured. From theresults, maximum values of joint torque decreased by 29%-78%in both activities of sit-to-stand and stand-to-sit by usingthe assistive device. In addition, maximum and integrated values of electromyography output of upper arm and thighdecreased by50%-74%in both activities of sit-to-stand and stand-to-sit. In contrast, percentage decrease of commerciallyavailable device(joint torque: -7%-40%, EMG: -24-43%)was lower than the present device. We suggest that thenewly developed device could be a useful means for assisting sit-to-stand and stand-to-sit activities.

In this paper, we quantify the complexity of body motion during walking in post-stroke hemiplegic patients. The body motion of patients and healthy elderly subjects was measured by using the accelerometry technique. The complexity of body motion was quantified using the maximum likelihood estimator (MLE-) based fractal analysis methods. Our results suggest that the fractal dimensions of the body motion in post-stroke hemiplegic patients at several Brunnstrom stages were significantly higher than those of healthy elderly subjects (p < 0.05). However, in the hemiplegic patients, the fractal dimensions were more related to Brunnstrom stages.

Several recent studies have quantified abnormalities in Parkinsonian gait. However, few studies have attempted to quantify the regularity of body motion during walking in patients with Parkinson's disease. The aim of the paper was to characterise body motion patterns in healthy, elderly subjects and patients with Parkinson's disease during walking. Body motion was recorded during walking for 16 patients with Parkinson's disease and ten healthy, elderly subjects using a tri-axial accelerometer device. To characterise the body motion patterns, time-frequency patterns of the body acceleration signal were estimated using a matching pursuit algorithm. Data from the study showed that the healthy, elderly subjects and patients with Parkinson's disease had different time-frequency patterns. The time-frequency patterns were classified into four distinct patterns based on their time durations: vertical (0.15 s), circular (0.15-0.5 s), short horizontal (0.5-2.0 s) and long horizontal (2.0 s). The data showed that the energy of the long horizontal patterns, representing long-term smooth and regular (rhythmic) activities, significantly decreased, but the energy of the circular patterns, representing irregular activities, increased in the patients with mild Parkinson's disease, compared with those of the healthy, elderly subjects (p0.01). Futhermore, these features were seen more clearly in the body motions of severe case patients than is that of mild case patients. It was concluded that these differences are probably due to a lack of ability to control normal and smooth movement is Parkinson's disease.

Objective An entertainment robot was used as occupational therapy instead of animal-assisted therapy to avoid any danger or injury to the patient and maintain cleanliness. This study compared the effectiveness of a robot animal, AIBO, with a toy. Method AIBO is made of metal and responds to spoken commands. We demonstrated AIBO to severely demented elderly people living in a geriatric home and observed their reactions. Results The most frequent reactions to AIBO consisted of looking at, communicating with, and caring for AIBO. The patients recognized that AIBO was a robot. However, once we dressed AIBO, the patients perceived AIBO as either a dog or a baby. Nevertheless, the presentation of AIBO resulted in positive outcomes for the severe dementia patients, including increased communication between the patients and AIBO. Conclusion AIBO was clearly an effective rehabilitation tool in the treatment of severely demented patients.

New Zealand kaolin compacts and laminated kaolin/Si-Ti-C-O woven fabric (16–17 vol%) compacts were formed by filtration and the doctor blade method using aqueous kaolin suspensions containing polyacrylic ammonium and methyl cellulose. The kaolin suspensions, with 10–37 vol% solids at pH 6–8, showing non-Newtonian flow expressed by a power law equation of S = Kγn1 (S) is the shear stress, γ the shear rate, and K and n (0 < n < 1) are constants), were formed into green compacts of 51–54% of the theoretical density (TD). The kaolin compacts and laminated composites were hot pressed to 96–98% TD at 1350–1500 °C under a pressure of 39 MPa in N2 atmosphere. The flexural strengths of hot-pressed kaolin and composites were 210 and 180 MPa, respectively. The composite fractured via delamination in the Si-Ti-C-O fabric layers.

Background: We studied the imaginary coherence (IC) of gamma frequency oscillations between brain regions of male schizophrenia patients during an auditory oddball task using magnetoencephalography (MEG) and electroencephalography (EEG). Methods: Subjects were 10 right-handed male schizophrenia patients, evaluated by the positive and negative symptom scale (PANSS), and 10 healthy controls. Functional connectivity during the auditory oddball task was reconstructed in low (30-50 Hz) and high (50-100 Hz) gamma bands, and represented by imaginary coherence (IC) based on significant oscillatory power changes. We calculated correlations between PANSS scores and IC. Results: In the high gamma band, IC between left occipital and right prefrontal lobe areas during the time window 750- 1000 ms from stimulus onset showed negative correlations with total negative scores, total positive scores, the sum of positive and negative scores in PANSS, conceptual disorganization, and social avoidance scores. In the low gamma band, IC between the same areas from 250-500 ms also showed a negative correlation with the conceptual disorganization score. In the same time window, IC between left occipital and right frontoparietal lobe areas in the low gamma band showed a positive correlation with hallucinatory behavior; IC between right temporal pole and left prefrontal lobe areas showed a positive correlation with delusion scores, although these ICs were decreased relative to controls. Conclusions: Functional disconnection of high and low gamma bands in auditory oddball task may play an important role in the auditory processing in schizophrenia patients.

Objective: We studied differences in the spatiotemporal dynamics of cortical oscillation across brain regions of patients with schizophrenia and normal subjects during the auditory oddball task using magnetoencephalography (MEG) and electroencephalography (EEG). Methods: Ten right-handed male schizophrenia patients were studied. We used a newly developed adaptive spatial filtering algorithm optimized for robust source time-frequency reconstruction of MEG and EEG data, and obtained consecutive images in functional maps of event-related desynchronization (ERD) and synchronization (ERS) in theta, lower alpha (8-10 Hz), upper alpha (10-13 Hz), and beta bands. Results: Beta ERD power at 750-1000 ms in patients was significantly increased in large right upper temporal and parietal regions and small upper portions of bilateral dorsal frontal and dorsal-medial parietal regions. Theta ERS power in schizophrenic patients during the oddball task was significantly increased in the left temporal pole at 250-500 ms, and was significantly increased in dorsal, medial frontal, and anterior portions of the anterior cingulate cortex in both hemispheres, and the left portion of lateral temporal regions at 500-750 ms, compared to the control group (family-wise error correction p

Daily monitoring of health condition at home is important for an effective scheme for early diagnosis, treatment and prevention of lifestyle-related diseases such as adiposis, diabetes and cardiovascular diseases. While a number of commercially available devices for home healthcare monitoring are widely used, those are actually cumbersome in terms of self-attachment of biological sensors and self-operation of them. From this viewpoint, we have been developing a non-conscious physiological monitoring system without attachment of any sensors to the human body as well as any operations for the measurement. We developed some devices installed in a toilet, a bath, and a bed and showed their high measurement precision by comparison with simultaneous recordings of ordinary biological sensors directly attached to the body. In order to investigate those applicability to the health condition monitoring, we developed a monitoring system in combination with all of the monitoring devices at hospital rooms and previously carried out the measurements of patients' health condition. Further in this study, the health conditions were measured in 10 patients with cardiovascular disease or sleep disorder. From these results, the patients' health conditions such as the body and excretion weight in the toilet, the ECG during taking the bath and the pulse and respiration rate during sleeping were successfully monitored in the hospital room, demonstrating its usefulness for monitoring the health condition of the subjects with cardiovascular disease or sleep disorder.

金沢大学理工研究域機械工学系, Daily monitoring of health condition is important for an effective scheme for early diagnosis, treatment and prevention of lifestyle-related diseases such as adiposis, diabetes, cardiovascular diseases and other diseases. Commercially available devices for health care monitoring at home are cumbersome in terms of self-attachment of biological sensors and self-operation of the devices. From this viewpoint, we have been developing a non-conscious physiological monitor installed in a bath, a lavatory, and a bed for home health care and evaluated its measurement accuracy by simultaneous recordings of a biological sensors directly attached to the body surface. In order to investigate its applicability to health condition monitoring, we have further developed a new monitoring system which can automatically monitor and store the health condition data. In this study, by evaluation on 3 patients with cardiac infarct or sleep apnea syndrome, patients' health condition such as body and excretion weight in the toilet and apnea and hypopnea during sleeping were successfully monitored, indicating that the system appears useful for monitoring the health condition during daily living.

In order to evaluate the efficacy of rehabilitation for persons with hemiplegia, a therapist usually makes judgment by directly observing posture changes, walking speed, activities not only in hospital, but also during daily living. Therefore, quantitative assessment of activities is most desirable. From this viewpoint, we have developed a device for ambulatory monitoring of posture changes, walking speed and activity scenario and evaluated its measurement accuracy by simultaneous recordings of a digital video camera. In order to investigate its applicability to a patient’s activity monitoring, we have further developed a new monitoring system which can display static and dynamic motion pictures as well as detailed angle changes of the trunk, thigh and calf. This system makes a therapist to easily understand the patient’s motion during training in rehabilitation center and activities during daily living. By evaluation on 6 patients with hemiplegia, the patients’ motions were successfully monitored during walking in the rehabilitation center and daily living at their own home. The results clearly demonstrated that the system could detect detailed motion characteristics, indicating that the system appears useful for evaluating quantitatively the efficacy of rehabilitation.

The elderly can sometimes find rehabilitation training to be very boring, but if the participants are motivated or having fun, they will continue to exercise. Prevention is the most important issue for health care insurance in Japan, and since suitable training will improve the quality of life, we developed personal computer (PC)-based rehabilitation tools to help the elderly maintain balance and muscle strength. After using the balance-training device, the subjects were able to keep better balance, and the muscle-training device resulted in an energy expenditure of around 2 METs fewer than walking. The results indicate that PC-based rehabilitation tools are effective for maintaining physical exercise.

Cerebral nerve activity estimated by means of magnetoencephalography (MEG) is usually evaluated by fusion with anatomical images such as MRI, X-ray CT. Therefore, in order to diagnose using MEG measurement results, it is very important to consider not only accuracy of MEG source estimation but also total accuracy including fusion with these anatomical images. In this report, we introduce a phantom which is capable of detecting the source location from these anatomical images as well as MEG measurement, and show this phantom can be used for the evaluation of MEG source estimation including fusion with anatomical images.

We developed a modified trail-making test using a PC and touch panel and compared it with the Mini Mental State Examination (MMSE). Methods and Patients: The test consisted of a series of numbers from 1 to 36, randomly arranged across the display. The object of the test was for the subject to touch the numbers in order, beginning with 1 and ending with 36, in as little time as possible. The system consisted of a PC and a liquid crystal display (LCD) touch-panel screen. One hundred and thirty-four patients with dementia performed the test. Sixty of the 134 patients (15 male, 45 female; average age, 81.1 r 7 years) were diagnosed as having Alzheimer's disease and the others had cerebrovascular dementia. Results: Sixty-two of 134 patients (23 male, 39 female; average age, 77.6 r 8 years; MMSE score, 21.5 r 5.6 points) completed the test. The correlation coefficient between test performance time and MMSE score was -0.534. Discussion: This test may also be a useful indicator of focal frontal lesions and can be used as an early screening test for Alzheimer's disease. I. INTRODUCTION n an aging society, the number of dementia patients is increasing. A major problem of dementia, especially of the Alzheimer's type, is that it is fatal, and early diagnosis is necessary for both patient and caregiver. There are several treatments available, either with or without medication. Early diagnosis is essential to initiate early treatment. Computed tomography, magnetic resonance imaging, single photon emission computed tomography, and positron emission tomography are all used as diagnostic tools. Qualitative tests, such as the Mini Mental State Examination (MMSE), are commonly used to screen for the disease. A computer-based MMSE has been developed in which questionnaire results are converted to a digital format. MMSE is a widely used method for assessing cognitive mental status. The evaluation of cognitive functioning is important in a clinical setting because of the recognized high prevalence of cognitive impairment. As a clinical instrument, the MMSE has been used to detect impairment, follow the course of an illness, and monitor response to treatment. The MMSE has also been used as a research tool to screen for cognitive disorders in epidemiological studies and follow cognitive changes in

Ubiquitous healthcare is very important subject not only as an effective scheme for early diagnosis of cardiovascular and other diseases, but also for prevention and control of such diseases. For this purpose, we have developed two kinds of non-invasive physiological monitoring systems. One is the systems utilizing furniture and furnishings in home to detect biosignals under daily life, and the other is portable systems for ambulatory monitoring of physiological valuables including blood pressure, cardiac output, posture change, walking speed, and so on.. In this paper, structure and performance of these systems are briefly described.

We have developed a wearable system for monitoring static and dynamic posture in sagittal plane together with walking speed, and reported its usefulness in the rehabilitation field. However, in the previous system, there still remain several drawbacks for practical use such as accuracy in angle measurement, cumbersome cable arrangements, and so on. In order to improve these practical drawbacks, a new sensor system was designed, and its availability was evaluated. Using 11 healthy subjects (21 to 75 yrs) and 14 patients with hemiplegia (61 to 87 yrs) under their informed consent, the measuring accuracy of the improved system was evaluated by simultaneous recordings of a digital video. The results demostrated that the accuracy of this system (angle change; r=0.997, walking speed; r=0.992) showed superior to that of the previous system (angle change; r=0.986, walking speed; r=0.960). It is clearly shown through the practical monitoring that this system appears to be a useful and significant means for quantitative assessment of the human motion during rehabilitation programs.

In rehabilitating stroke patients, many therapists use range of motion exercise (ROM-ex) at early post onset. There are three general types of ROM-ex: passive, active, and active-assistive ROM-ex is used to prevent joint contracture in paralyzed limbs and to assist in recovery of the central nervous system (CNS). However, its effect on CNS recovery is unclear. Therefore, this study compared the influence of different tasks, including passive and active ROM-ex and imagined extension/flexion at the elbow, on the cerebral cortex. The subjects were six healthy volunteers. We used a magnetoencephalogram (MEG) to measure cerebral cortex activity. In the active ROM-ex task, we confirmed a dipole in the motor area in all subjects. It has been suggested that this dipole is activity of the motor-related field (MRF). By contrast, in the passive ROM-ex experiment, we did not confirm a dipole in the cortex. In addition, in the experiment with no joint motion, in which the subject only imagined moving the elbow joint from flexion to extension, it was possible to estimate a dipole in the motor area. Therefore, an imaginary task might be a possible method of activation when voluntary movement is impossible.

In rehabilitation training for hemiplegic patients, bed-to-wheelchair transfer is most important and allows a patient's early independence. We developed a monitoring system for transfer training that is quantitative and uses accelerometry. Two tri-axial accelerometers were attached to the subjects, at the head and waist. Subjects were trained in moving from a sitting position to standing, then turning through, about 90 degrees, and then sitting on the bed. The acceleration signals at the two sites were recorded via a multi-telemeter system, converted to a digital signal, and stored in a computer. Data were analysed by LabView and displayed on the computer screen as real time motion. The system can be operated by one staff member, and the patients did not feel restricted. We were able to evaluate the time course of the signals, and phase-plane locus of the vertical, lateral and horizontal directions of the signals. The transfer of hemiplegic patients occurred in two motions: a standing-up motion, and a sitting-down motion. Accordingly, we observed twin peaks in the plot of the original signal. In contrast, healthy volunteers moved smoothly and twin peaks were not present.

In this paper, we assess the complexity (fractal measure) of body motion during walking in patients with Parkinson's disease. The body motion of 11 patients with Parkinson's disease and 10 healthy elderly subjects was recorded using a triaxial accelerometry technique. A triaxial accelerometer was attached to the lumbar region. An assessment of the complexity of body motion was made using a maximum-likelihood-estimator-based fractal analysis method. Our data suggest that the fractal measures of the body motion of patients with Parkinson's disease are higher than those of healthy elderly subjects. These results were statistically different in the X (anteroposterior), Y (lateral) and Z (vertical) directions of body motion between patients with Parkinson's disease and the healthy elderly subjects (p < 0.01 in X and Z directions and p < 0.05 in Y direction). The complexity (fractal measure) of body motion can be useful to assess and monitor the output from the motor system during walking in clinical practice.

To investigate sequential changes in magnetoencephalograms (MEGs) during photic stimulation (PS), we performed a quantitative MEG analysis of the alpha band (related to stimulus frequency) in 19 schizophrenic patients and 18 gender- and age-matched control subjects. Photic stimulation was at an interval of 0.5 Hz, and the frequency band was from 8 to 10.5 Hz. In each session, the interval lasted ten seconds and was repeated ten times for each frequency. In the topographic study, we assessed the differences between the two groups under two conditions (i.e., during PS and inter-PS). During the stimulus, the absolute 8-10.5 Hz band energy of the patient group was higher at the posterior sites throughout the ten-second periods. We compared the energy intensity of each site based on international 10/20 derivation. The energy intensity in the schizophrenic patients was smaller than in the control subjects at each site. We observed a gender difference in the control subjects, but not in the schizophrenic ones. These results suggest that schizophrenic patients show fewer changes in alpha activity during the stimulus, and this continuity of posterior dominance may reflect hyperarousal, which counteracts any decrease in vigilance throughout the PS