研究等業績 - その他 - 工藤　大輔

Surgical Treatment for Severe Scoliosis in Patients with Reduced Cardiorespiratory Function after Surgery for Congenital Heart Disease: A Report of Two Cases.

Hayato Kinoshita, Naohisa Miyakoshi, Michio Hongo, Akiko Misawa, Daisuke Kudo, Yoichi Shimada

Case reports in orthopedics   2018   4610796 - 4610796   2018年

PURPOSE: Congenital heart disease (CHD) is associated with an increased risk of scoliosis. The prognosis of scoliosis patients with CHD has improved because of advances in cardiac care. As a result, the frequency of surgery for scoliosis in this population has increased, although the risk of perioperative complications remains high. We treated two patients with CHD who underwent surgery for severe scoliosis. To avoid perioperative complications, we evaluated the preoperative cardiac status and anesthetic risks before posterior correction and fixation in both patients. METHODS: An expert anesthesiologist evaluated the anesthetic risk in each case, and an adequate reservoir of autologous blood was collected preoperatively. The patient in case 1 was at risk of significant blood loss and required extremely careful operative technique. The patient in case 2 had low cardiac output preoperatively. We therefore performed a thorough preoperative cardiac evaluation. Both patients were admitted to the intensive care unit postoperatively. RESULTS: Neither patient suffered serious complications, and both achieved favorable outcomes. CONCLUSIONS: Appropriate surgical technique and teamwork among experts are the keys to success in patients with severe scoliosis and CHD.

DOI PubMed

1.Development of a Rehabilitation Robot Combined with Functional Electrical Stimulation Controlled by Non-disabled Lower Extremity in Hemiplegic Gait

Kimura Ryota, Matsunaga Toshiki, Iwami Takehiro, Kudo Daisuke, Saitoh Kimio, Hatakeyama Kazutoshi, Watanabe Motoyuki, Takahashi Yusuke, Miyakoshi Naohisa, Shimada Yoichi

Progress in Rehabilitation Medicine ( 公益社団法人 日本リハビリテーション医学会 )  3 ( 0 ) n/a   2018年

<p><b>Objective:</b> We developed a rehabilitation robot to assist hemiplegics with gait exercises. The robot was combined with functional electrical stimulation (FES) of the affected side and was controlled by a real-time-feedback system that attempted to replicate the lower extremity movements of the non-affected limb on the affected side. We measured the reproducibility of the non-affected limb movements on the affected side using FES in non-disabled individuals and evaluated the smoothness of the resulting motion. <b>Method:</b> Ten healthy men participated in this study. The left side was defined as the non-affected side. The measured hip and knee joint angles of the non-affected side were reproduced on the pseudo-paralytic side using the robot’s motors. The right quadriceps was stimulated with FES. Joint angles were measured with a motion capture system. We assessed the reproducibility of the amplitude from the maximum angle of flexion to extension during the walking cycle. The smoothness of the motion was evaluated using the angular jerk cost (AJC). <b>Results:</b> The amplitude reproduction (%) was 87.9 ± 6.2 (mean ± standard deviation) and 71.5 ± 10.7 for the hip and knee joints, respectively. The walking cycle reproduction rate was 99.9 ± 0.1 and 99.8 ± 0.2 for the hip and knee joints, respectively. There were no statistically significant differences between results with FES versus those without FES. The AJC of the robot side was significantly smaller than that of the non-affected side. <b>Conclusions:</b> A master–slave gait rehabilitation system has not previously been attempted in hemiplegic patients. Our rehabilitation robot showed high reproducibility of motion on the affected side.</p>

DOI CiNii Research

mRNA expressions of peroxisome proliferator-activated receptor gamma coactivator 1α, tumor necrosis factor-α, and interleukin-6 in paraspinal muscles of patients with lumbar kyphosis: A preliminary study

Kudo D.

Clinical Interventions in Aging ( Clinical Interventions in Aging )  13   1633 - 1638   2018年

DOI

Relationship between preoperative serum rapid turnover proteins and early-stage surgical wound infection after spine surgery

Kudo D.

European Spine Journal ( European Spine Journal )  26 ( 12 ) 3156 - 3161   2017年12月

DOI

Indications for Drug Holiday among Japanese Patients after Long-term Bisphosphonate Treatment.

Yuji Kasukawa, Naohisa Miyakoshi, Michio Hongo, Koji Nozaka, Yoshinori Ishikawa, Hiroyuki Tsuchie, Daisuke Kudo, Yoichi Shimada

JOURNAL OF BONE AND MINERAL RESEARCH ( WILEY )  32   S269 - S269   2017年12月

Comparison of spinal alignment, muscular strength, and quality of life between women with postmenopausal osteoporosis and healthy volunteers

Miyakoshi N.

Osteoporosis International ( Osteoporosis International )  28 ( 11 ) 3153 - 3160   2017年11月

DOI

特集 運動器リハビリテーションに必須の評価法と活用法 3 腰痛症のリハビリテーションに必須の評価法と活用法

工藤 大輔, 島田 洋一

リハビリテーション医学 ( 株式会社医学書院 )  54 ( 11 ) 835 - 840   2017年11月

DOI CiNii Research

脊椎・脊髄疾患のニューロサイエンス 神経所見の診かたから再生医療まで 4.脊椎・脊髄疾患の治療法の進歩　B　理学療法 機能的電気刺激(FES)

島田 洋一, 松永 俊樹, 工藤 大輔, 斉藤 公男, 巌見 武裕

整形・災害外科 ( 金原出版 )  60 ( 5 ) 617 - 621   2017年04月

DOI CiNii Research

Relationships among spinal mobility and sagittal alignment of spine and lower extremity to quality of life and risk of falls

Ishikawa Y.

Gait and Posture ( Gait and Posture )  53   98 - 103   2017年03月

DOI

Age-related changes in muscle strength and spinal kyphosis angles in an elderly Japanese population

Kasukawa Y.

Clinical Interventions in Aging ( Clinical Interventions in Aging )  12   413 - 420   2017年02月

DOI

機能的電気刺激装置の最近の動向

島田 洋一, 松永 俊樹, 工藤 大輔, 斉藤 公男

リハビリテーション医学 ( 公益社団法人 日本リハビリテーション医学会 )  54 ( 8 ) 564 - 569   2017年

<p>機能的電気刺激（FES）は，中枢神経障害による運動麻痺に対し，プログラムされた刺激による機能再建を行う治療法である．適応として，脳卒中・脳外傷，脊髄損傷，脳性麻痺，多発性硬化症などがあり，治療効果のエビデンスも豊富になりつつある．FESは，上肢用では手指把持動作再建，下肢用では麻痺性内反尖足・下垂足の歩行再建などが可能であり，表面電極システムを中心に臨床的に十分利用可能な実用的な製品がある．今後は費用面での患者家族負担が軽減されるよう，公的支援の拡充に期待したい．</p>

DOI CiNii Research

腰痛症のリハビリテーションに必須の評価法と活用法

工藤 大輔, 島田 洋一

リハビリテーション医学 ( 公益社団法人 日本リハビリテーション医学会 )  54 ( 11 ) 835 - 840   2017年

<p>腰痛症のリハビリテーションでは，red flags（危険信号）を有する重篤な脊椎疾患（腫瘍，炎症，骨折など）に伴う腰痛，神経症状を伴う腰痛，非特異的腰痛のトリアージを最初に行う．</p><p>腰椎疾患の評価ツールは痛み，機能，心理的な評価に大別される．これらを効果的に用いることでリハビリテーションを含めた治療の計画，治療効果の判定に役立てることができる．特に非特異的慢性腰痛における心理面の評価は必須で，近年報告されたSTarT（Subgrouping for Targeted Treatment）Backスクリーニングツールは，リスクに応じた層別化，治療介入に有用である．</p>

DOI CiNii Research