研究者詳細 - 工藤　大輔

研究等業績 - 原著論文 - 工藤　大輔

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Automatic Assist Level Adjustment Function of a Gait Exercise Rehabilitation Robot with Functional Electrical Stimulation for Spinal Cord Injury: Insights from Clinical Trials

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.

DOI PubMed

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.

DOI PubMed

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.

DOI PubMed

Unicompartmental Knee Arthroplasty for Osteoarthritis Eliminates Lateral Thrust: Associations between Lateral Thrust Detected by Inertial Measurement Units and Clinical Outcomes

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.

DOI PubMed

Neurological Analysis Based on the Terminal End of the Spinal Cord and the Narrowest Level of Injured Spine in Thoracolumbar Spinal Injuries

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.

DOI PubMed

Relationship between Intervertebral Disc Compression Force and Sagittal Spinopelvic Lower Limb Alignment in Elderly Women in Standing Position with Patient-Specific Whole Body Musculoskeletal Model

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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研究等業績 - 原著論文 - 工藤 大輔

<工藤　大輔>

研究等業績 - 原著論文 - 工藤　大輔