Tomofumi Yamaguchi

• PT, Ph.D.
• Professor at Kyoto University

Objectives Physical therapy education depends on hands-on training. However, the COVID-19 pandemic limited face-to-face demonstrations. This study considers the use of smart glasses, devices that allow real-time information sharing from remote locations. We investigated the efficacy of teachers’ use of smart glasses during a class on students’ subj...

Reciprocal inhibition (RI) between leg muscles is crucial for smooth movement. Pedaling is a rhythmic movement that can increase RI in healthy individuals. Transcutaneous spinal cord stimulation (tSCS) stimulates spinal neural circuits by targeting the afferent fibers. Pedaling with simultaneous tSCS may modulate the plasticity of the spinal neural...

Introduction The conventional method of placing transcranial direct current stimulation (tDCS) electrodes is just above the target brain area. However, this strategy for electrode placement often fails to improve motor function and modulate cortical excitability. We investigated the effects of optimized electrode placement to induce maximum electri...

Introduction A knee-ankle-foot orthosis (KAFO) prevents knee buckling during walking and enables gait training for acute hemiplegic stroke patients with severe gait disturbances. Although the goal of gait training with a KAFO is to improve gait ability, that is, to acquire walking with an ankle-foot orthosis (AFO), it is not clear how gait training...

Using theta burst stimulation (TBS) to induce neural plasticity has played an important role in improving the treatment of neurological disorders. However, the variability of TBS-induced synaptic plasticity in the primary motor cortex prevents its clinical application. Thus, factors associated with this variability should be explored to enable the...

Objectives To investigate the construct validity of the Trunk Impairment Scale (TIS), which was developed to assess trunk impairment in patients with stroke, in patients with Parkinson’s disease (PD). Design This retrospective, cross-sectional study enrolled consecutive PD inpatients. Correlation analysis was performed to clarify whether the TIS a...

Background:Transcranial direct current stimulation (tDCS) has recently drawn attention as an inexpensive, painless, safe, and effective technique to improve motor performance and cognitive function in older adults. This study examined the effects of a selected balance exercise combined with anodal tDCS on balance performance in older adults. Method...

Background: An artificial intelligence (AI)-integrated electromyography (EMG)-driven robot hand was devised for upper extremity (UE) rehabilitation. This robot detects patients' intentions to perform finger extension and flexion based on the EMG activities of 3 forearm muscles. Objective: This study aimed to assess the effect of this robot in pa...

Introduction Neuromuscular electrical stimulation (NMES) induces neural plasticity of the central nervous system (CNS) and improves motor function in patients with CNS lesions. However, the extended stimulus duration of NMES reduces its clinical applicability. Transcutaneous spinal direct current stimulation (tsDCS), which increases afferent input,...

Background Transcranial direct current stimulation (tDCS) has recently drawn attention as an inexpensive, painless, safe, and effective technique to improve motor performance and cognitive function in older adults. This quasi-experimentstudy examined the effects of a selected balance exercise combined with anodal tDCS on balance performance in olde...

Cerebellar transcranial direct current stimulation (ctDCS) modulates the primary motor cortex (M1) via cerebellar brain inhibition (CBI), which affects motor control in humans. However, the effects of ctDCS on motor control are inconsistent because of an incomplete understanding of the real-time changes in the M1 excitability that occur during ctDC...

Objective To assess the relationship between spinal reflexes and motor function in sub-acute (SAS) and chronic stroke (CS) patients. Methods Twelve SAS and 16 CS patients underwent electrophysiological assessment of heteronymous facilitation (HF), heteronymous inhibition (HI), disynaptic reciprocal inhibition (DRI), and D1 inhibition (D1). The Fug...

Spinal DC stimulation (tsDCS) shows promise as a technique for the facilitation of functional recovery of motor function following central nervous system (CNS) lesion. However, the network mechanisms that are responsible for the effects of tsDCS are still uncertain. Here, in a series of experiments, we tested the hypothesis that tsDCS increases the...

Background Simultaneously modulating individual neural oscillation and cortical excitability may be important for enhancing communication between the primary motor cortex and spinal motor neurons, which plays a key role in motor control. However, it is unknown whether individualized beta-band oscillatory transcranial direct current stimulation (otD...

Background Sensory input via neuromuscular electrical stimulation (NMES) may contribute to synchronization between motor cortex and spinal motor neurons and motor performance improvement in healthy adults and stroke patients. However, the optimal NMES parameters used to enhance physiological activity and motor performance remain unclear. In this st...

Background: Shortening of tensor fasciae latae is one factor that causes a functional leg length discrepancy. A shoe lift has been used to correct the compensatory posture resulting from the discrepancy. Despite the potential therapeutic benefit of a shoe lift, the mechanism by which it exerts its effect is unclear. Objective: To investigate the...

Cerebellar transcranial direct current stimulation (ctDCS) modulates cerebellar activity and postural control. However, the effects of ctDCS on postural control learning and the mechanisms associated with these effects remain unclear. To examine the effects of single-session ctDCS on postural control learning and cerebellar brain inhibition (CBI) o...

Repetitive peripheral magnetic stimulation (rPMS) may improve motor function following central nervous system lesions, but the optimal parameters of rPMS to induce neural plasticity and mechanisms underlying its action remain unclear. We examined the effects of rPMS over wrist extensor muscles on neural plasticity and motor performance in 26 health...

Background: Sensory input via neuromuscular electrical stimulation (NMES) may contribute to synchronization between motor cortex and spinal motor neurons and motor performance improvement in healthy adults and stroke patients. However, the optimal NMES parameters used to enhance physiological activity and motor performance remain unclear. In this s...

Theta burst stimulation (TBS) has been used as a tool to induce synaptic plasticity and improve neurological disorders. However, there is high interindividual variability in the magnitude of the plastic changes observed after TBS, which hinders its clinical applications. The electric field induced by transcranial magnetic stimulation (TMS) is stron...

Optimization of motor performance is of importance in daily life, in relation to recovery following injury as well as for elite sports performance. The present study investigated whether transcutaneous spinal direct current stimulation (tsDCS) may enhance voluntary ballistic activation of ankle muscles and descending activation of spinal motor neur...

Consolidation leading to retention of motor memory following motor practice involves activity-dependent plastic processes in the corticospinal system. To investigate whether beta band transcranial alternating current stimulation (tACS) applied immediately following skill acquisition can enhance ongoing consolidation processes and thereby motor skil...

Background: Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that has the potential to induce motor cortical plasticity in humans. It is well known that motor cortical plasticity plays an essential role in motor learning and recovery in patients with stroke and neurodegenerative disorders. However, it re...

The primary objective of this study was to clarify whether balance evaluation during walking in elderly people was related to fall risk assessment; the second objective was to clarify the difference in balance strategy between young and elderly people based on the balance evaluation through a gait cycle. Thirty healthy young adults and 25 healthy e...

Cycling exercise is commonly used in rehabilitation to improve lower extremity (LE) motor function and gait performance after stroke. Motor learning is important for regaining motor skills, suggesting that training of motor skills influences cortical plasticity. However, the effects of motor skill learning in dynamic alternating movements of both l...

While previous studies assessed corticospinal excitability changes during and after motor imagery (MI) or action observation (AO) combined with peripheral nerve electrical stimulation (ES), we examined, for the first time, the time course of corticospinal excitability changes for MI during AO combined with ES (AO–MI + ES) using transcranial magneti...

Motor imagery (MI) combined with electrical stimulation (ES) enhances upper-limb corticospinal excitability. However, its after-effects on both lower limb corticospinal excitability and spinal reciprocal inhibition remain unknown. We aimed to investigate the effects of MI combined with peripheral nerve ES (MI + ES) on the plasticity of lower limb c...

The aim of the present study was to investigate whether anodal transcranial direct-current stimulation (tDCS) combined with attention to the paretic hand can improve hand performance in stoke patients. Eight chronic stroke patients participated in the double-blind, crossover, sham-controlled study. There were three intervention conditions: (1) anod...

Background: The combination of motor imagery (MI) and afferent input with electrical stimulation (ES) enhances the excitability of the corticospinal tract compared with motor imagery alone or electrical stimulation alone. However, its therapeutic effect is unknown in patients with hemiparetic stroke. We performed a preliminary examination of the t...

Objective The present study evaluated ankle stiffness in adults with and without neurological disorders and investigated the accuracy and reproducibility of a clinically applicable method using a dynamometer. Methods Measurements were obtained from 8 healthy subjects (age 39.3), 9 subjects with spastic cerebral palsy (CP) (age 39.8) and 8 subjects...

This study explored the effect of corticospinal activity on spinal plasticity by examining the interactions between intermittent theta burst transcranial magnetic stimulation (iTBS) of the motor cortex and peripheral patterned electrical stimulation (PES) of the common peroneal nerve (CPN). Healthy volunteers (n = 10) received iTBS to the tibialis...

Introduction/Background Upper extremity (UE) dysfunction is a common problem in patients with stroke. Recently, several neurorehabilitation approaches have been developed to improve the UE motor function (Langphorene P. Lancet Neurol, 2009). However, most approaches target either proximal or distal UE motor function, although interventions targetin...

Purpose: The study aimed to develop a toileting performance assessment test to measure the toileting performance ability of patients in the early phase after stroke. Methods: In this study, 214 stroke patients were enrolled. Cronbach's α, Spearman's rank correlations (ρ values) with the toileting-related items of the functional independence meas...

Transcranial direct current stimulation (TDCS) can modulate motor cortical excitability. However, its after-effects are highly variable between individuals. Individual cranial and brain anatomy may contribute to this variability by producing varying electric fields in each subject's brain. Here we show that these fields are related to excitability...

Background: Reciprocal inhibition (RI) may be important for recovering locomotion after stroke. Patterned electrical stimulation (PES) can modulate RI in a manner that could be enhanced by voluntary muscle contraction (VC). Objective: To investigate whether VC enhances the PES-induced spinal RI in patients with stroke. Methods: Twelve patients...

Cardiorespiratory fitness assessment with leg cycle exercise testing may be influenced by motor impairments in the paretic lower extremity. Hence, this study examined the usefulness of a unilateral arm crank exercise test to assess cardiorespiratory fitness in individuals with stroke, including sixteen individuals with hemiparetic stroke (mean ± SD...

The parietal operculum (PO) often shows ipsilateral activation during tactile object perception in neuroimaging experiments. However, the relative contribution of the PO to tactile judgment remains unclear. Here, we examined the effect of transcranial direct current stimulation (tDCS) over bilateral PO to test the relative contributions of the ipsi...

Anodal transcranial direct current stimulation (tDCS) combined with patterned electrical stimulation (PES) modulates spinal reciprocal inhibition and improves the ankle movement in patients with incomplete spinal cord injury (Yamaguchi et al., 2016). This study aimed to examine the immediate effects of anodal tDCS combined with PES on gait performa...

Objective: To investigate real-time excitability changes in corticospinal pathways related to motor imagery in a changing force control task, using transcranial magnetic stimulation (TMS). Methods: Ten healthy volunteers learnt to control the contractile force of isometric right wrist dorsiflexion in order to track an on-screen sine wave form. P...

The aim of this study was to examine the effects of voluntary contraction (VC) on the modulation of reciprocal inhibition induced by patterned electrical stimulation (PES) in healthy individuals. Twelve healthy volunteers participated in this study. PES was applied to the common peroneal nerve with a train of 10 pulses at 100 Hz every 2 s for 20 mi...

The present study investigated the effects of anodal transcranial direct current stimulation (tDCS) on lower extremity muscle strength training in 24 healthy participants. In this triple-blind, sham-controlled study, participants were randomly allocated to the anodal tDCS plus muscle strength training (anodal tDCS) group or sham tDCS plus muscle st...

Introduction Peripheral patterned electrical stimulation (PES) to the common peroneal nerve modulates the spinal reciprocal inhibition from the tibialis anterior muscle (TA) to the soleus muscle (SOL) through spinal plasticity mechanisms, which have essential roles in functional recovery of the lower limb after spinal cord injury or stroke. Further...

Introduction Transcutaneous spinal cord stimulation (tSCS) is a non-invasive method to stimulate afferent structures of the spinal neural circuits related with lower limb motor control. Its application is known to improve lower limb motor function in individuals with spinal cord injury. However, it remains unknown whether tSCS induces spinal plasti...

Purpose: To examine the relationship between walking speed and lower limb extension strength in people with moderate and severe post-stroke hemiparesis. Method: Twenty-nine ambulatory stroke survivors (mean age, 64 years; mean time after stroke onset, 183 days) with a score of ≤2 on the knee-extension test of the Stroke Impairment Assessment Set pa...

[Purpose] The purpose of this study was to evaluate the validity of estimating step time and length asymmetries, using an accelerometer against force plate measurements in individuals with hemiparetic stroke. [Subjects and Methods] Twenty-four individuals who previously had experienced a stroke were asked to walk without using a cane or manual assi...

Purpose: To investigate changes in gait performance and lower limb muscle strength in stroke survivors who continuously attended an adult daycare facility for 2 years. Method: 126 stroke survivors (mean age, 63.7 years; mean time after stroke onset, 1.3 years) were enrolled in this study. Based on their gait speed at baseline, the participants were...

Supraspinal excitability and sensory input may play an important role for the modulation of spinal inhibitory interneurons and functional recovery among patients with incomplete spinal cord injury (SCI). Here, we investigated the effects of anodal transcranial direct current stimulation (tDCS) combined with patterned electrical stimulation (PES) on...

In healthy subjects, dual hemisphere transcranial direct current stimulation (tDCS) over the primary (S1) and secondary somatosensory cortices (S2) has been found to transiently enhance tactile performance. However, the effect of dual hemisphere tDCS on tactile performance in stroke patients with sensory deficits remains unknown. The purpose of thi...

Purpose of the study: To evaluate the after-effects of pedaling on spinal excitability and spinal reciprocal inhibition in patients with post-stroke spastic hemiparesis. Materials and methods: Twenty stroke patients with severe hemiparesis participated in this study and were instructed to perform 7 minutes of active pedaling and 7 minutes of pas...

Purpose: We investigated skin extensibility around surgical wounds in patients after total knee arthroplasty (TKA) to determine the relationship between skin extensibility and knee range of motion. Methods: Twenty patients treated with TKA (mean age: 78.1 ± 7.4 years) and ten age-matched healthy subjects (mean age, 71.8 ± 8.7 years) participated in...

The present study aimed to investigate corticospinal excitability changes during muscle relaxation with a tracking task. The motor-evoked potential, which was elicited from the flexor carpi radialis (agonist) and extensor carpi radialis (antagonist) muscles, was analyzed in terms of both the relaxation velocity and phase. Our results suggest that i...

Purpose: We evaluated the combined effects of pedaling exercise and therapeutic electrical stimulation on gait performance in subacute stroke patients. Methods: Six patients were randomly allocated to one of the following three groups: (1) pedaling exercise combined with therapeutic electrical stimulation, (2) pedaling exercise alone, and (3) thera...

[Purpose] Using canonical correlation analysis, physical functions related to gait ability were evaluated in subacute stroke patients. [Subjects] Seventy-two stroke patients in convalescent rehabilitation wards were enrolled. [Methods] For gait ability, we evaluated gait velocity and gait variability. For physical function, we evaluated both motor...

The aim of this study was to test the hypothesis that dual-hemisphere transcranial direct current stimulation (tDCS) over the primary somatosensory cortex (S1) could improve performance in a tactile spatial discriminative task, compared with uni-hemisphere or sham tDCS. Nine healthy adults participated in this double-blind, sham-controlled, and cro...

Prolonged changes in primary motor cortex excitability in response to combined neuromuscular electrical stimulation (NMES) and voluntary contraction with motor evoked potentials (MEPs) were investigated by transcranial magnetic stimulation and recorded by mechanomyography. Participants included 22 healthy individuals. NMES was applied to the extens...

The aim of this exploratory study was to investigate the effects of transcutaneous spinal direct current stimulation (tsDCS) on the plasticity of spinal circuits and corticospinal tracts in humans. Ten healthy volunteers participated in this single-blind, sham-controlled cross-over study. Reciprocal inhibition and D1 inhibition of the soleus H-refl...

Supraspinal modulation and phase-related sensory input play an important role for the functional recovery of locomotion among patients with central nervous system (CNS) lesions. Reciprocal inhibition (RI) modulates reciprocating lower extremity movements such as locomotion and pedaling. The effects of therapeutic electrical stimulation (TES) on rec...

[Purpose] The aim of this study was to investigate whether exploratory factor analysis could classify the patterns of joint motions during a task of lateral dynamic sitting balance. [Subjects] Forty-eight healthy adults (29 males and 19 females) were recruited for this study. [Method] We measured the center of pressure (COP) and joint motions durin...

An electromyogram (EMG)-driven neuromuscular stimulator for upper limb functional recovery (Muraoka et al., 1998) can stimulate target muscles in proportion to the amount of voluntary EMG of the identical target muscles. Furthermore, it can facilitate the contraction of paralyzed muscles by electrical stimulation at subthreshold intensity level. Al...

Although motor imagery enhances the excitability of the corticospinal tract, there are no peripheral afferent inputs during motor imagery. In contrast, peripheral nerve electrical stimulation (ES) can induce peripheral afferent inputs; thus, a combination of motor imagery and ES may enhance the excitability of the corticospinal tract compared with...

Objective The aim of this study was to test the hypothesis that dual-hemisphere transcranial direct current stimulation (tDCS) over the primary somatosensory cortex (S1) could improve performance in a tactile spatial discriminative task, compared with uni-hemisphere or sham tDCS. Methods Nine healthy adults participated in this double-blind, sham-...

While previous studies have assessed changes in corticospinal excitability following voluntary contraction coupled with electrical stimulation (ES), we sought to examine, for the first time in the field, real-time changes in corticospinal excitability. We monitored motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation and rec...

Real-time changes in corticospinal excitability during the antagonist voluntary contraction effort with/without median nerve stimulation. (DOC)

Changes in MMG-MEPs during rest or during antagonist voluntary contraction (ECR voluntary contraction), with and without median nerve stimulation. (TIF)

In order to walk upright on the Moon or Mars without falling, a specific walking strategy to account for altered gravitational conditions must be verified. We have therefore been studying changes in the kinematics of walking at different gravitational loads using a body weight suspension system. Our simulation consisted of three gravitational condi...

For the recovery of hemiparetic hand function, a therapy was developed called contralateral homonymous muscle activity stimulated electrical stimulation (CHASE), which combines electrical stimulation and bilateral movements, and its feasibility was studied in three chronic stroke patients with severe hand hemiparesis. Patients with a subcortical le...

Pedaling is widely used for rehabilitation of locomotion because it induces similar muscle activity to that observed during locomotion. However, no study has examined the effects of pedaling exercise on intracortical inhibition. The aim of the present study was to investigate the effect of pedaling exercise on short-interval intracortical inhibitio...

The aim of the present study was to investigate whether anodal transcranial direct-current stimulation (tDCS) of lower-limb primary motor cortex (M1) could increase cortical excitability when reference electrodes were placed at extracephalic positions. Ten healthy volunteers participated in this study. Anodal electrodes were placed over the left lo...

Objective: Research to examine the immediate effects of electrical stimulation combined with passive locomotion-like movement on gait velocity and spasticity. Design: A single-masked, randomized controlled trial design. Subjects: Twenty-seven stroke inpatients in subacute phase (ischemic n=16, hemorrhagic n=11). Interventions: A novel approach usin...

We evaluated the efficacy of a novel electromyogram (EMG)-controlled electrical stimulation system, called the integrated volitional control electrical stimulator (IVES), on the recovery of upper extremity motor functions in patients with chronic hemiparetic stroke. Ten participants in the chronic stage (more than 12 months post-stroke with partial...

: [Purpose] We investigated the efficacy of constraint-induced (CI) movement therapy for stroke patientsliving at home and attending a day-care center. [Subjects] The subjects were 6 post-stroke patients fulfilling a suitablestandard who received rehabilitation for upper extremity hemiparesis at our hospital’s day-care center. [Method] Withthe uppe...

This study was designed to examine the effects of electrical stimulation combined with locomotion-like movement (ES/LM) for improving gait disorder in a stroke patient. A four-phase ABAB single-subject design with five therapy sessions per phase was employed. In the intervention phases, transcutaneous electrical stimulation was applied to the tibia...

Hybrid exercise (HE) was designed to use the force generated by an electrically stimulated antagonist to provide resistance to a volitionally contracting agonist. The purpose of this study was to measure and compare the soleus H-reflex before and after HE or conventional resistance exercise (CRE). The experiments were carried out in 18 healthy subj...