Jun Iwamoto

Bio: Jun Iwamoto is an academic researcher from Keio University. The author has contributed to research in topics: Osteoporosis & Bone remodeling. The author has an hindex of 39, co-authored 223 publications receiving 6210 citations. Previous affiliations of Jun Iwamoto include Winthrop-University Hospital.

Low-dose vitamin D prevents muscular atrophy and reduces falls and hip fractures in women after stroke: a randomized controlled trial.

Abstract: Objective: Vitamin D supplementation is suggested to reduce the risk of falls among ambulatory or institutionalized elderly subjects. The present study was undertaken to address the

Effect of Folate and Mecobalamin on Hip Fractures in Patients With Stroke: A Randomized Controlled Trial

Abstract: Context Stroke increases the risk of subsequent hip fracture by 2 to 4 times. Hyperhomocysteinemia is a risk factor for both ischemic stroke and osteoporotic fractures in elderly men and women. Treatment with folate and mecobalamin (vitamin B 12 ) may improve hyperhomocysteinemia. Objective To investigate whether treatment with folate and vitamin B 12 reduces the incidence of hip fractures in patients with hemiplegia following stroke. Design, Setting, and Patients A double-blind, randomized controlled study of 628 consecutive patients aged 65 years or older with residual hemiplegia at least 1 year following first ischemic stroke, who were recruited from a single Japanese hospital from April 1, 2000, to May 31, 2001. Patients were assigned to daily oral treatment with 5 mg of folate and 1500 μg of mecobalamin, or double placebo; 559 completed the 2-year follow-up. Main Outcome Measure Incidence of hip fractures in the 2 patient groups during the 2-year follow-up. Results At baseline, patients in both groups had high levels of plasma homocysteine and low levels of serum cobalamin and serum folate. After 2 years, plasma homocysteine levels decreased by 38% in the treatment group and increased by 31% in the placebo group ( P P Conclusion In this Japanese population with a high baseline fracture risk, combined treatment with folate and vitamin B 12 is safe and effective in reducing the risk of a hip fracture in elderly patients following stroke.

Effect of whole-body vibration exercise and muscle strengthening, balance, and walking exercises on walking ability in the elderly.

Abstract: The present study was conducted to determine the beneficial effect of whole-body vibration (WBV) exercise in addition to muscle strengthening, balance, and walking exercises on the walking ability in the elderly Sixty-seven elderly participants were divided into two groups; the WBV exercise plus routine exercises group (n=40) and the routine exercises alone group (n=27) WBV exercise was performed on a Galileo machine (Novotec, Pforzheim, Germany) at an intensity of 12-20 Hz, for a duration of 4 minutes, once every week All the participants in both the groups were similarly instructed to undergo routine exercises such as balance and muscle strengthening training, and take walking exercise twice a week The period of this study was 2 months to evaluate the acute effects of WBV exercise The mean age of the participants was 720 years (range, 59-86 years) At baseline, there were significant negative correlations between age and the walking speed, step length, and maximum standing time on one leg After the 2-month exercise program, the walking speed, step length, and the maximum standing time on one leg were significantly improved in the WBV exercise plus routine exercises group, while no significant changes in these parameters were observed in the routine exercises alone group Thus, the present study showed the beneficial effect of WBV exercise in addition to muscle strengthening, balance, and walking exercises in improving the walking ability in the elderly WBV exercise was safe and well tolerated in the elderly

Vitamin D Deficiency

Abstract: Once foods in the United States were fortified with vitamin D, rickets appeared to have been conquered, and many considered major health problems from vitamin D deficiency resolved. But vitamin D deficiency is common. This review considers the role of vitamin D in skeletal and nonskeletal health and suggests strategies for the prevention and treatment of vitamin D deficiency.

Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association

Abstract: The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage secondary prevention for these patients. Evidence-based recommendations are provided for control of risk factors, intervention for vascular obstruction, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke. Recommendations are also provided for the prevention of recurrent stroke in a variety of specific circumstances, including aortic arch atherosclerosis, arterial dissection, patent foramen ovale, hyperhomocysteinemia, hypercoagulable states, antiphospholipid antibody syndrome, sickle cell disease, cerebral venous sinus thrombosis, and pregnancy. Special sections address use of antithrombotic and anticoagulation therapy after an intracranial hemorrhage and implementation of guidelines.

Interventions for preventing falls in older people living in the community

Abstract: As people get older, they may fall more often for a variety of reasons including problems with balance, poor vision, and dementia. Up to 30% may fall in a year. Although one in five falls may require medical attention, less than one in 10 results in a fracture. This review looked at the healthcare literature to establish which fall prevention interventions are effective for older people living in the community, and included 159 randomised controlled trials with 79,193 participants. Group and home-based exercise programmes, usually containing some balance and strength training exercises, effectively reduced falls, as did Tai Chi. Overall, exercise programmes aimed at reducing falls appear to reduce fractures. Multifactorial interventions assess an individual's risk of falling, and then carry out treatment or arrange referrals to reduce the identified risks. Overall, current evidence shows that this type of intervention reduces the number of falls in older people living in the community but not the number of people falling during follow-up. These are complex interventions, and their effectiveness may be dependent on factors yet to be determined. Interventions to improve home safety appear to be effective, especially in people at higher risk of falling and when carried out by occupational therapists. An anti-slip shoe device worn in icy conditions can also reduce falls. Taking vitamin D supplements does not appear to reduce falls in most community-dwelling older people, but may do so in those who have lower vitamin D levels in the blood before treatment. Some medications increase the risk of falling. Three trials in this review failed to reduce the number of falls by reviewing and adjusting medications. A fourth trial involving family physicians and their patients in medication review was effective in reducing falls. Gradual withdrawal of a particular type of drug for improving sleep, reducing anxiety, and treating depression (psychotropic medication) has been shown to reduce falls. Cataract surgery reduces falls in women having the operation on the first affected eye. Insertion of a pacemaker can reduce falls in people with frequent falls associated with carotid sinus hypersensitivity, a condition which causes sudden changes in heart rate and blood pressure. In people with disabling foot pain, the addition of footwear assessment, customised insoles, and foot and ankle exercises to regular podiatry reduced the number of falls but not the number of people falling. The evidence relating to the provision of educational materials alone for preventing falls is inconclusive.