Background and Purpose-Obvious cardiac dysfunction, including ECG abnormalities and left ventricular asynergy, is known to develop after subarachnoid hemorrhage (SAH). To clarify the close relationship between myocardial damage and sympathetic nervous activity immediately after SAH, a novel experimental animal model was used. Methods-SAH was provoked by perforation of the basilar artery with the use of a microcatheter inserted through the femoral artery in 18 beagle dogs. Hemodynamic changes were recorded, and plasma concentrations of noradrenaline, adrenaline, and 3-methoxy-4-hydroxy-phenylethylene glycol (MHPG) and serum levels of creatine kinase-MB (CK-MB) and troponin T were measured at 0, 5, 15, 30, 60, 120, and 180 minutes after SAH. Results-Noradrenaline (pg/mL), adrenaline (pg/mL), and MHPG (ng/mL) increased abruptly from 120Ϯ70, 130Ϯ70, and 1.3Ϯ0.5 before SAH to 1700Ϯ1200, 5600Ϯ3500, and 3.2Ϯ1.2 at 5 minutes after SAH, respectively. Aortic pressure, left ventricular wall motion, and cardiac output increased by 60%, 40%, and 30%, respectively (PϽ0.001) at 5 minutes and then decreased by 50%, 55%, and 40%, respectively (PϽ0.001) Ͼ60 minutes after SAH compared with baseline values. The peak value of CK-MB correlated positively with the peak values of noradrenaline and adrenaline (rϭ0.730 and rϭ0.611, respectively). The peak value of troponin T also correlated positively with the peak values of noradrenaline and adrenaline (rϭ0.828 and rϭ0.792, respectively). Conclusions-These results suggest that the elevated activity of the sympathetic nervous system observed in the acute phase of SAH induced myocardial damage and contributed to the development of cardiac dysfunction.

The aim of the present study was to investigate the effects of home-based exercise without home visits on physical function, falls, and bone mineral density in community-dwelling elderly women. Sixty community-dwelling, elderly (> or =65 years of age) women were recruited from a Japanese community. Subjects were randomly assigned to a home-based exercise group or a control group. The subjects assigned to the home-based exercise group performed home-based exercise without home visits 3 times per week for 6 months in their homes. Assessments of physical function and bone mineral density were carried out before and after intervention in both groups. Muscle strength, gait velocity, the timed up and go test (TUGT), single leg stance time, the bend reach performance test, and reaction time were measured to assess physical function. The patients' history of falls was also assessed before and after the 12-month follow-up. To determine bone mineral density, the speed of sound (SOS) at the right calcaneus was measured using a quantitative ultrasound device. There were no significant differences between the two groups in baseline characteristics. 82.6% of subjects completed the prescribed exercise program in the home-based exercise group. Compared to the control group, TUGT improved significantly (p<0.05) in the home-based exercise group. Home-based exercise without home visits can be adopted for community-dwelling elderly women, particularly since no specific place or instructor is needed.

Strength training has been reported as a potentially useful exercise to improve psychological aspects in the elderly, but its effects remain controversial. This study investigated the effectiveness of strength training conducted twice a week for 12 weeks for improving health-related quality of life (HRQOL) and executive cognitive function. The study was a single-blind randomized controlled trial with assessments before and after intervention. HRQOL and executive function were assessed using the SF-36 Health Status Survey and a computerized neuro-cognitive assessment using task-switch reaction time trials, respectively. Subjects comprised 119 participants Ն65 years old, randomized to either strength training (nϭ65) or health education classes (controls, nϭ54). The strength training program was designed to strengthen the large muscle groups most important for functional activities and to improve balance. The effects of the intervention on the eight dimensions of the SF-36 in the control and training groups were analyzed. Only the mental health scale of the SF-36 was significantly improved for the training group compared with controls after 12 weeks. Task-switch reaction time and correct response rate remained unchanged. Short-term strength training might have modest positive effects on HRQOL, although this training period may not be sufficient to affect executive function in relatively healthy older people.

Most falls experienced by elderly people are caused by tripping or slipping during walking. The fact that walking balance function did not correlate with standing balance function indicates that multifaceted evaluation is important to comprehend dynamic balance function while standing and walking.

The reference values of TUG in Japanese healthy elderly people calculated in this study are certainly shorter than in African-Americans and Caucasians. The reference values of TUG estimated by our study appear to be specific for healthy, elderly, Japanese people.