研究等業績 - 原著論文 - 工藤 大輔
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Kimura R.
Biomimetics ( Biomimetics ) 9 ( 10 ) 2024年10月
研究論文（学術雑誌）
This study aimed to identify whether the combined use of functional electrical stimulation (FES) reduces the motor torque of a gait exercise rehabilitation robot in spinal cord injury (SCI) and to verify the effectiveness of the developed automatic assist level adjustment in people with paraplegia. Acute and chronic SCI patients (1 case each) performed 10 min of gait exercises with and without FES using a rehabilitation robot. Reinforcement learning was used to adjust the assist level automatically. The maximum torque values and assist levels for each of the ten walking cycles when walking became steady were averaged and compared with and without FES. The motor's output torque and the assist level were measured as outcomes. The assist level adjustment allowed both the motor torque and assist level to decrease gradually to a steady state. The motor torque and the assist levels were significantly lower with the FES than without the FES under steady conditions in both cases. No adverse events were reported. The combined use of FES attenuated the motor torque of a gait exercise rehabilitation robot for SCI. Automatic assistive level adjustment is also useful for spinal cord injuries.
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Clinical Manifestations and Diagnostic Considerations of C7-T1 Single-Level Myelopathy: A Case Series.
Kento Okamoto, Ryota Kimura, Yuji Kasukawa, Michio Hongo, Daisuke Kudo, Hayato Kinoshita, Yuichi Ono, Naohisa Miyakoshi
Cureus 16 ( 5 ) e60306 2024年05月
研究論文（学術雑誌）
Cervical myelopathy is caused by compression of the cervical spinal cord for any reason. Cervical myelopathy most commonly affects the C5-6 level. However, C7-T1 single-level myelopathy is rare, and neurological findings may be atypical, making diagnosis difficult. We report three cases and discuss their clinical manifestations. Unlike other levels of cervical myelopathy, C7-T1 single-level myelopathy may present with gait disturbance without neurological deficits in the upper extremities. In addition, all three of our cases had different levels of spinal cord compression and locations of sensory deficits; at the C7-T1 level, the spinal cord compression may not correspond to the site of the sensory deficit. These features may help clinicians in the diagnosing of myelopathy.
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Comparison of Postoperative Results With Prognostic Nutritional Index for Lumbar Disc Herniation.
Hayato Kinoshita, Michio Hongo, Eiji Abe, Takashi Kobayashi, Yuji Kasukawa, Kazuma Kikuchi, Daisuke Kudo, Ryota Kimura, Yuichi Ono, Naohisa Miyakoshi
Cureus 16 ( 5 ) e60584 2024年05月
研究論文（学術雑誌）
INTRODUCTION: The prognostic nutritional index (PNI) is an immune-nutritional index simply provided by a blood test. We retrospectively compared the postoperative outcomes of patients with lumbar disc herniation divided into two groups according to the PNI. MATERIALS AND METHODS: Seventy-three patients who underwent surgery at our hospital were included in the study. All patients had herniation between one of the L3/4, L4/5, or L5/S intervertebral discs and underwent one posterior lumbar interbody fusion. These patients were divided into two groups: patients with a PNI of <50 (poorly nourished (PN) group) and patients with a PNI of ≥50 (well-nourished (WN) group). Evaluation items included patient background characteristics, operative time, blood loss, postoperative complications, and length of hospital stay. RESULTS: The results showed that the body mass index was significantly higher in the WN group than in the PN group (p=0.0221). The rates of collagen disease, steroid use, and postoperative complications were significantly higher (p=0.0475, p=0.0073, and p=0.0211, respectively) and the length of hospital stay was significantly longer (p=0.021) in the PN group than in the WN group. CONCLUSION: In conclusion, this study indicates that postoperative complications and the length of hospital stay are significantly worse in PN patients than in WN patients.
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Sato H.
Sensors ( Sensors ) 24 ( 7 ) 2024年04月
研究論文（学術雑誌）
The purpose of this study was to investigate the relationship between clinical outcomes and lateral thrust before and after unicompartmental knee arthroplasty (UKA) using inertial measurement sensor units. Eleven knees were evaluated with gait analysis. The varus angular velocity was used to evaluate lateral thrust. The femorotibial angle (FTA) and hip-knee-ankle angle (HKA) were used to evaluate lower-limb alignment, and the Oxford Knee Score (OKS) and Japanese Orthopaedic Association Score (JOA) were used to evaluate clinical outcomes. The mean pre-UKA peak varus velocity was 37.1 ± 9.8°/s, and that for post-UKA was 28.8 ± 9.1°/s (p = 0.00003), such that instabilities clearly improved. Assuming the definition of lateral thrust is when the varus angular velocity is more than 28.1°/s, 81.8% of patients had lateral thrust preoperatively, but this decreased to 55.6% postoperatively, such that the symptoms and objective findings improved. Both OKS and JOA improved after surgery. In addition, HKA was -7.9° preoperatively and -5.8° postoperatively (p = 0.024), and FTA was 181.4° preoperatively and 178.4° postoperatively (p = 0.012). There was a positive correlation between postoperative JOA and FTA, indicating that changes in postoperative alignment affected clinical outcomes. This study quantitatively evaluated the disappearance of lateral thrust by UKA, and it found that the stability can be achieved by UKA for unstable knees with lateral thrust.
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Hatakeyama Y.
Acta Medica Okayama ( Acta Medica Okayama ) 77 ( 5 ) 499 - 509 2023年
研究論文（学術雑誌）
This study aimed to clarify neurological differences among the epiconus, conus medullaris, and cauda equina syndromes. Eighty-seven patients who underwent surgery for acute thoracolumbar spinal injuries were assessed. We defined the epiconus as the region from the terminal end of the spinal cord to the proximal 1.0 to 2.25 vertebral bodies, the conus medullaris as the region proximal to < 1.0 vertebral bodies, and the cauda equina as the distal part of the nerve roots originating from the spinal cord. On the basis of the distance from the terminal end of the spinal cord to the narrowest level of the spinal canal, the narrowest levels were ordered as follows: the epiconus followed by the conus medullaris and cauda equina. The narrowest levels were the epiconus in 22 patients, conus medullaris in 37 patients, and cauda equina in 25 patients. On admission, significantly more patients had a narrowed epiconus of Frankel grades A-C than a narrowed cauda equina. At the final follow-up, there were no significant differences in neurological recovery among those with epiconus, conus medullaris, or cauda equina syndrome. Anatomically classifying the narrowest lesion is useful for clarifying the differences and similarities among these three syndromes.
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Miura T.
International Journal of Environmental Research and Public Health ( International Journal of Environmental Research and Public Health ) 19 ( 24 ) 2022年12月 [査読有り]
研究論文（学術雑誌）
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Shoji R.
Anticancer Research ( Anticancer Research ) 42 ( 11 ) 5357 - 5363 2022年11月 [査読有り]
研究論文（学術雑誌）
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Hirota R.
Spine ( Spine ) 47 ( 19 ) 1391 - 1398 2022年10月 [査読有り]
研究論文（学術雑誌）
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Earlier appearance of Risser sign on ultrasound versus radiograph in adolescent idiopathic scoliosis
Hongo M.
Journal of Clinical Imaging Science ( Journal of Clinical Imaging Science ) 12 2022年07月 [査読有り]
研究論文（学術雑誌）
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Kasukawa Y.
Applied Sciences (Switzerland) ( Applied Sciences (Switzerland) ) 12 ( 9 ) 2022年05月 [査読有り]
研究論文（学術雑誌）
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Shoji R.
In Vivo ( In Vivo ) 36 ( 2 ) 667 - 671 2022年03月 [査読有り]
研究論文（学術雑誌）
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Utility of a wearable robot for the fingers that uses pneumatic artificial muscles for patients with post-stroke spasticity
Mita Motoki, Suzumori Koichi, Kudo Daisuke, Saito Kimio, Chida Satoaki, Hatakeyama Kazutoshi, Shimada Yoichi, Miyakoshi Naohisa
Japanese Journal of Comprehensive Rehabilitation Science ( 一般社団法人 回復期リハビリテーション病棟協会 ) 13 ( 0 ) 12 - 16 2022年 [査読有り]
研究論文（学術雑誌）
<p>Mita M, Suzumori K, Kudo D, Saito K, Chida S, Hatakeyama K, Shimada Y, Miyakoshi N. Utility of a wearable robot for the fingers that uses pneumatic artificial muscles for patients with post-stroke spasticity. Jpn J Compr Rehabil Sci 2022; 13: 12-16.</p><p><b>Objective</b>: We investigated the utility of a wearable robot for the fingers that we developed using pneumatic artificial muscles for rehabilitation of patients with post-stroke spasticity.</p><p><b>Methods</b>: Three patients with post-stroke finger spasticity underwent rehabilitation for 20 minutes a day, 5 days a week, for 3 weeks. Passive range of motion, Modified Ashworth Scale (MAS), and circumference of each finger were measured before and after training and compared.</p><p><b>Results</b>: The range of motion and finger circumference increased when using a wearable robot. The MAS improved partially, and no exacerbation was observed.</p><p><b>Conclusions</b>: The wearable robot we developed is useful for rehabilitation of post-stroke spasticity and may improve venous return.</p>
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Chronic atlantoaxial rotatory fixation with neurofibromatosis type I: A case report
Ono Y.
Surgical Neurology International ( Surgical Neurology International ) 13 2022年 [査読有り]
研究論文（学術雑誌）
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Inoue Junichi, Kimura Ryota, Shimada Yoichi, Saito Kimio, Kudo Daisuke, Hatakeyama Kazutoshi, Watanabe Motoyuki, Maeda Kai, Iwami Takehiro, Matsunaga Toshiki, Miyakoshi Naohisa
Progress in Rehabilitation Medicine ( 公益社団法人 日本リハビリテーション医学会 ) 7 ( 0 ) n/a 2022年 [査読有り]
研究論文（学術雑誌）
<p><b>Objective: </b>We have developed a robot for gait rehabilitation of paraplegics for use in combination with functional electrical stimulation (FES). The purpose of this study was to verify whether the robot-derived torque can be reduced by using FES in a healthy-person pseudo-paraplegic model.</p><p><b>Methods: </b>Nine healthy participants (22–36 years old) participated in this study. The robot exoskeleton was designed based on the hip–knee–ankle–foot orthosis for paraplegia. Participants walked on a treadmill using a rehabilitation lift to support their weight. The bilateral quadriceps femoris and hamstrings were stimulated using FES. The participants walked both with and without FES, and two walking speeds, 0.8 and 1.2 km/h, were used. Participants walked for 1 min in each of the four conditions: (a) 0.8 km/h without FES, (b) 0.8 km/h with FES, (c) 1.2 km/h without FES, and (d) 1.2 km/h with FES. The required robot torques in these conditions were compared for each hip and knee joint. The maximum torque was compared using one-way analysis of variance to determine whether there was a difference in the amount of assist torque for each gait cycle.</p><p><b>Results: </b>Walking with the exoskeleton robot in combination with FES significantly reduced the torque in hip and knee joints, except for the right hip during extension.</p><p><b>Conclusions: </b>In the healthy-participant pseudo-paraplegic model, walking with FES showed a reduction in the robot-derived torque at both the hip and knee joints. Our rehabilitation robot combined with FES has the potential to assist paraplegics with various degrees of muscle weakness and thereby provide effective rehabilitation.</p>
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Contralaterally controlled functional electrical stimulation immediately improves hand function
Murata Shohei, Koike Yasuharu, Kasukawa Yuji, Saito Kimio, Okada Koki, Kudo Daisuke, Shimada Yoichi, Miyakoshi Naohisa
Japanese Journal of Comprehensive Rehabilitation Science ( 一般社団法人 回復期リハビリテーション病棟協会 ) 13 ( 0 ) 26 - 30 2022年 [査読有り]
研究論文（学術雑誌）
<p>Murata S, Koike Y, Kasukawa Y, Saito K, Okada K, Kudo D, Shimada Y, Miyakoshi N. Contralaterally controlled functional electrical stimulation immediately improves hand function. Jpn J Compr Rehabil Sci 2022; 13: 26-30.</p><p><b>Objective</b>: The purpose of this study was to investigate the immediate effects of contralaterally controlled functional electrical stimulation (CCFES) on upper limb function in stroke patients.</p><p><b>Methods</b>: CCFES and mirror therapy (MT) exercises were conducted for 13 stroke patients at least 4 weeks post-onset. A sufficient interval of at least 24 hours was left between the two types of rehabilitation exercises. Before treatment and immediately after each training session, grip strength, Fugl-Meyer Assessment for Upper Extremity (FMA-UE) score and FMA-UE subscores for the shoulder/elbow/forearm, wrist, hand, and coordination were evaluated.</p><p><b>Results</b>: Grip strength, FMA-UE and FMA-UE shoulder/elbow/forearm, wrist, and coordination did not differ significantly after CCFES and MT compared to before therapy. FMA-UE hand did not change significantly after MT compared to before therapy, but it improved significantly after CCFES (<i>p</i> = 0.013).</p><p><b>Conclusion</b>: CCFES for the upper extremities immediately improves hand function and may be effective in maintaining and improving patients' motivation for rehabilitation treatment.</p>
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Impact of a specialized outpatient clinic on bone metastasis and its burden on spine surgeons
Tsuchie H.
In Vivo ( In Vivo ) 35 ( 6 ) 3575 - 3579 2021年12月 [査読有り]
研究論文（学術雑誌）
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Miyakoshi N.
Spinal Cord ( Spinal Cord ) 59 ( 6 ) 626 - 634 2021年06月 [査読有り]
研究論文（学術雑誌）
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Pediatric spinal infection with epidural abscess: A report of two cases
Shoji R.
Surgical Neurology International ( Surgical Neurology International ) 12 2021年04月 [査読有り]
研究論文（学術雑誌）
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Impact of appendicular and trunk skeletal muscle mass and back extensor strength on sagittal spinal alignment in Japanese women without vertebral fracture
Daisuke Kudo, Naohisa Miyakoshi, Michio Hongo, Yuji Kasukawa, Yoshinori Ishikawa, Takashi Mizutani, Yoichi Mizutani, Yoichi Shimada
Osteoporosis and sarcopenia 2021年03月 [査読有り]
研究論文（学術雑誌） 国内共著
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Impact of appendicular and trunk skeletal muscle mass and back extensor strength on sagittal spinal alignment in Japanese women without vertebral fracture.
Daisuke Kudo, Naohisa Miyakoshi, Michio Hongo, Yuji Kasukawa, Yoshinori Ishikawa, Takashi Mizutani, Yoichi Mizutani, Yoichi Shimada
Osteoporosis and sarcopenia 7 ( 1 ) 36 - 41 2021年03月
研究論文（学術雑誌）
OBJECTIVES: Progressive and generalized loss of skeletal muscle mass (SMM) and strength are characteristics of sarcopenia. However, the impact of appendicular and trunk SMM and back extensor strength (BES) on spinal sagittal alignment remains unclear. Herein, we investigate the relationship between these factors and spinal sagittal alignment. METHODS: In total, 202 women without vertebral fractures (median age, 66.9 years; interquartile range, 61.4-71.9 years) were analyzed at an orthopedic outpatient clinic. Pelvic incidence (PI), lumbar lordosis (LL), sagittal vertical axis (SVA), and pelvic tilt (PT) were measured on whole spine radiographs. Body mass index (BMI), appendicular and trunk relative SMM index, and BES were also evaluated. These measurements were compared between spinal sagittal alignment groups using the Mann-Whitney U test. Finally, the factors contributing to abnormal alignment were analyzed using multiple logistic regression analysis. RESULTS: BES was significantly lower in all abnormal sagittal alignment groups, as defined by PI-LL (≥ 10°), SVA (≥4 cm), and PT (≥20°) (all P < 0.001). On multivariate analysis, BES was a contributing factor for abnormal PI-LL (P < 0.001), SVA (P = 0.001), and PT (P < 0.001). Conversely, a decrease in appendicular and trunk relative SMM index did not statistically affect abnormal spinal sagittal alignment. CONCLUSIONS: BES was associated with changes in spinal sagittal alignment; however, SMM, which is often used for diagnosing sarcopenia, did not affect spinal sagittal alignment.