Nervous System Control Mechanism of Resolution Shrinkage: An Interventional Test Using Kinesthetic Illusion for Stroke Hemiplegia and Analysis of the Nervous System

2022 Fiscal Year Final Research Report

• Project/Area Number: 19H01088
• Research Category: Grant-in-Aid for Scientific Research (A)
• Allocation Type: Single-year Grants
• Section: 一般
• Review Section: Medium-sized Section 59:Sports sciences, physical education, health sciences, and related fields
• Research Institution: Tokyo Metropolitan University (2021-2022); Keio University (2019-2020)
• Principal Investigator: Kaneko Fuminari 東京都立大学, 人間健康科学研究科, 准教授 (00344200)
• Co-Investigator(Kenkyū-buntansha): 川上 途行 慶應義塾大学, 医学部(信濃町), 准教授 (80424133) ; 新藤 恵一郎 慶應義塾大学, 政策・メディア研究科(藤沢), 特任准教授 (70338177)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 運動錯覚 / 痙縮 / リハビリテーション / 理学療法 / 脳

Outline of Final Research Achievements

This study suggests that: (1) improvement of motor function by kinesthetic illusion therapy (KINVIS therapy) in patients with severe paralysis after stroke in chronic phase occurs through reduction of spasticity; (2) The relationship between residual corticospinal tract function and spasticity, and the functional equilibrium between corticoreticular and corticospinal tracts strongly influence motor paralysis and spasticity in patients with severe paralysis; (3) Reciprocal inhibition and presynaptic inhibition were enhanced during kinesthetic illusion, and the presynaptic inhibitory effect is enhanced in the stretch reflex arch. (4) The original device was shown to be able to detect velocity-dependent changes in muscle tone that are characteristic of spasticity; (5) The combination of KINVIS therapy and repetitive transcranial magnetic stimulation for the supplementary motor cortex may be effective　in improving spasticity in patients after stroke.

Free Research Field

神経生理学

Academic Significance and Societal Importance of the Research Achievements

痙縮は運動麻痺に伴う主要な症状で，脳卒中，脳性麻痺，脊髄損傷など疾患横断的に発生し。痙縮が起因して運動機能障害を来している方々は全国で少なくとも100万人以上と想定できる。本研究では，これまで課題であった痙縮の定量的評価法について取り組み，表面筋電図データ，トルクデータを基に定量化できる方法を確立した。ヒトを対象とし，痙縮の神経生理学的メカニズムを実証するための研究を行い，皮質網様体路と皮質脊髄路の機能的平衡が関わる可能性を見出した。その結果を基に，臨床神経生理学に基づくニューロリハビリテーション手法の開発・介入試験を継続して行い，臨床現場で活用可能なデバイスを提供する状態にまで至った。