Effectiveness of rehabilitation based on recreational activities:A systematic review

AIM: To summarize the evidence from randomized controlled trials(RCTs) on the rehabilitation effects of recreational activities.METHODS: Studies were eligible if they were RCTs. Studies included one treatment group in which recreational activity was applied. We searched the following databases from 1990 to May 31, 2012: MEDLINE via Pub Med, CINAHL, Web of Science, and Ichushi-Web. We also searched all Cochrane Databases and Campbell Systematic Reviews up to May 31, 2012. RESULTS: Eleven RCTs were identified, which included many kinds of target diseases and/or symptoms such as stroke, dementia, Parkinson's disease, acquired brain injury,chronic non-malignant pain, adolescent obesity, high-risk pregnancy, and the frail elderly. Various intervention methods included gaming technology, music, dance, easy rider wheelchair biking, leisure education programs, and leisure tasks. The RCTs conducted have been of relatively low quality. A meta-analysis(pooled sample; n = 44, two RCTs) for balance ability using tests such as "Berg Balance Scale" and "Timed Up and Go Test" based on game intervention revealed no significant difference between interventions and controls. In all other interventions, there were one or more effects on psychological status, balance or motor function, and adherence as primary or secondary outcomes.CONCLUSION: There is a potential for recreational activities to improve rehabilitation-related outcomes, particularly in psychological status, balance or motor function, and adherence.

Establishment of induced pluripotent stem cells from aged mice using bone marrow-derived myeloid cells

If induced pluripotent stem(iPS)cells are to be used to treat damaged tissues or repair organs in elderly patients,it will be necessary to establish iPS cells from their tissues.To determine the feasibility of using this technology with elderly patients,we asked if it was indeed possible to establish iPS cells from the bone marrow(BM)of aged mice.BM cells from aged C57BL/6 mice carrying the green fluorescence protein(GFP)gene were cultured with granulocyte macrophage-colony stimulating factor(GM-CSF)for 4 days.Four factors(Oct3/4,Sox2,Klf4 and c-Myc)were introduced into the BM-derived myeloid(BM-M)cells.The efficiency of generating iPS cells from aged BM cultured in GM-CSF was low.However,we succeeded in obtaining BM-M-iPS cells from aged C57BL/6 mice,which carried GFP.Our BM-M-iPS cells expressed SSEA-1 and Pou5f1 and were positive for alkaline phosphatase staining.The iPS cells did make teratoma with three germ layers following injection into syngeneic C57BL/6 mice,and can be differentiated to three germ layers in vitro.By co-culturing with OP9,the BM-M-iPS cells can be differentiated to the myeloid lineage.The differentiated BM-M-iPS cells proliferated well in the presence of GM-CSF,and lost expression of Nanog and Pou5f1,at least in part,due to methylation of their promoters.On the contrary,Tnf and Il1b gene expression was upregulated and their promoters were hypomethylated.