Significance of Stabilometry for Assessing Postoperative Body Sway in Patients with Cervical Myelopathy

Shinji Tanishima,Hideki Nagashima,Hiroyuki Ishii,Satoru Fukata,Toshiyuki Dokai,Taiki Murakami,Yasuo Morio 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.5

Study Design: Prospective study. Purpose: To examine the changes in body sway using stabilometry in patients who underwent cervical laminoplasty for cervical myelopathy. Overview of Literature: Although the patients of cervical myelopathy complain body sway there are few report to examine body sway objectively. Methods: Patients who received treatment for cervical myelopathy between October 2010 and February 2013 were included. Twentyone patients underwent cervical laminoplasty (myelopathy group). Body sway was assessed using stabilometry, wherein patients stood on a stabilometer with their eyes closed for 30 seconds. The Romberg ratio, outer peripheral area (OPA) with eyes closed (cm2), and total locus length per unit area (L/A) with eyes closed (/cm) were examined. Examinations were performed preoperatively (at baseline) and at 8 weeks postoperatively. Examination results of patients in the myelopathy group were compared with those of 17 healthy individuals (control group). Clinical symptoms were evaluated using the Japanese Orthopaedic Association scale score (JOA score) and the timed up and go (TUG) test. Results: In the myelopathy and control groups, the mean baseline Romberg ratio, OPA, and L/A were 2.3±1.2, 8.9±5.5 cm2, and 14.2±5.3/cm and 1.4±1.0, 4.3±2.8 cm2, and 23.7±10.1/cm, respectively. Eight weeks after laminoplasty, only L/A showed significant improvement from baseline in the myelopathy group (23.2±10.1 to 16.8±7.9; p =0.03). The Romberg ratio and OPA showed improvement in the myelopathy group, but the changes were not statistically significant. JOA scores and TUG test results in this group significantly improved from baseline to 8 weeks after laminoplasty (12.7 to 13.4 and 10.8 to 8.0 seconds, respectively; both p <0.05). Conclusions: L/A is a useful parameter for measuring body sway to assess the recovery of body sway after laminoplasty.

Successful Use of the Hybrid Assistive Limb for Care Support to Reduce Lumbar Load in a Simulated Patient Transfer

Miura Kousei,Kadone Hideki,Abe Tetsuya,Koda Masao,Funayama Toru,Noguchi Hiroshi,Kumagai Hiroshi,Nagashima Katsuya,Mataki Kentaro,Shibao Yosuke,Sato Kosuke,Kawamoto Hiroaki,Sankai Yoshiyuki,Yamazaki Ma 대한척추외과학회 2021 Asian Spine Journal Vol.15 No.1

Study Design: Prospective experimental study in humans.Purpose: To determine whether the hybrid assistive limb (HAL) for Care Support can reduce lumbar load during a patient transfer.Overview of Literature: The prevalence of work-related low back pain (LBP) among nurses is high. In particular, transferring patients poses a high risk for LBP due to the large lumbar load. Attempts to reduce the lumbar load are crucial to avoid the risk of LBP. Therefore, we investigated the effects of the HAL for Care Support.Methods: Nineteen volunteers (16 men, three women) lifted a 60-kg doll from a seated position to a standing position. The first transfer was performed without the HAL for Care Support, and the second was performed with the HAL for Care Support assistive robot. We evaluated transfer performance, the visual analog scale (VAS) score for lumbar fatigue, and electromyogram analyses of the trunk and hip.Results: Four participants (two men, two women) succeeded with the HAL for Care Support even though they were unable to perform the task without it. The mean lumbar fatigue VAS score for all participants without the HAL for Care Support was 62 mm, while that with it was 43 mm. With lumbar assistance from the HAL for Care Support, subjective lumbar fatigue during the transfer decreased significantly. A power analysis indicated adequate statistical power to detect a difference in the VAS score for lumbar fatigue (0.99). The activity of the left gluteus maximus alone increased significantly during transfers with the HAL for Care Support. No adverse events occurred during use of the HAL for Care Support for transfers.Conclusions: The HAL for Care Support was able to reduce lumbar load in a simulated patient transfer.

Development of a Plasma Control System for Steady-state Operation on QUEST

Makoto Hasegwa,Kazuo Nakamura,Hideki Zushi,Kazuaki Hanada,Akihide Fujisawa,Keisuke Matsuoka,Hiroshi Idei,Yoshihiko Nagashima,Kazutoshi Tokunaga,Shoji Kawasaki,Hisatoshi Nakashima,Aki Higashijima 한국물리학회 2014 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.65 No.8

A drift error correction technique with machine vision and a real-time equilibrium calculation codehave been developed on the QUEST (Q-shu university experiment with the steady-state sphericaltokamak) for steady-state operation. The drift error caused by the long time-integration of magneticraw signals has to be removed. With a captured image of the plasma’s cross section, the plasma’sposition is identified by use of image filters. The measured magnetic flux values are corrected to thecalculated flux values estimated by using this plasma position. The correction with the capturedimage work as expected in the preliminary result using a flashlight instead of a plasma.

Relationship between sarcopenia and pain catastrophizing in patients with lumbar spinal stenosis: A cross-sectional study

Takashi Wada,Shinji Tanishima,Mari Osaki,Hideki Nagashima,Hiroshi Hagino 대한골다공증학회 2019 Osteoporosis and Sarcopenia Vol.5 No.4

Objectives: The purpose of this study is to clarify the psychological factors related to sarcopenia in patients with lumbar spinal stenosis (LSS). Methods: This cross-sectional study included 72 patients with LSS (38 males and 34 females; mean age, 70.4 ± 6.9 years). Demographic data, lower extremity pain, back pain, Japanese Orthopaedic Association score, Pain Catastrophizing Scale (PCS) score, Hospital Anxiety and Depression Scale (HADS) score, Fear- Avoidance Beliefs Questionnaire score, walking velocity, grip strength, walking distance, and appendicular muscle mass were assessed. Muscle mass was measured using bioelectrical impedance analysis. Patients were grouped based on sarcopenia status according to skeletal muscle mass index. Results: The prevalence of sarcopenia was 13.9% (10 of 72 patients). Sarcopenia was significantly more common in females. The incidence of dyslipidemia and cardiovascular disease were significantly higher in the sarcopenia group. The sarcopenia group had lower body weight, body mass index, grip strength, and walking distance than the control group. The sarcopenia group had higher PCS scores and HADSanxiety scores. Multivariate analysis identified body weight, dyslipidemia, walking distance, and PCS score as significantly related to sarcopenia. Conclusions: Pain catastrophizing might be the most relevant psychological factor in sarcopenia. Evaluation of both physical function and pain catastrophizing is needed when investigating sarcopenia in LSS.

Evaluating the Reproducibility of the Walking Test for Intermittent Claudication Associated with Lumbar Spinal Stenosis

Tanishima Shinji,Weishi Li,Jianzhong Hu,Jie Zhao,Huilin Yang,Nagashima Hideki 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.3

Study Design: This is a multicenter, prospective study.Purpose: This study aimed to evaluate the reproducibility of the walking test for patients with lumbar spinal stenosis (LSS).Overview of Literature: Walking test is one of the useful procedures to investigate cauda equina syndrome with lumbar spinal stenosis. One the other hands, there were few studies to investigate the reproducibility of this test.Methods: In this study, we prospectively examined 70 LSS patients with intermittent claudication symptoms at a multicenter outpatient clinic. A walking test was administered at baseline and week 4 to assess patients’ walking distance and lower limb pain and numbness. Immediately after the walking test, patients were asked to use the Visual Analog Scale (VAS) to rate their pain and numbness in the front, back, outside, inside, and hip of the lower legs. The reproducibility of the walking test was evaluated using Cohen’s κ analysis and intraclass correlation coefficients (ICCs). Meanwhile, the Swiss Spinal Stenosis (SSS) Questionnaire was used to evaluate the severity of the stenosis.Results: The walking distance ICC at baseline and at week 4 remained unchanged at 0.7, with acceptable interobserver reliabilities for lower limb pain and numbness in both legs. The average VAS score for lower leg pain was 23.2±25.2 mm at baseline and 27.4±28.8 mm at week 4, while the corresponding average VAS score for numbness was 23.4±26.7 mm at baseline and 24.8±25.2 mm at week 4. The ICC score was 0.7 for leg pain and 0.7 for numbness. The mean SSS was 30.2±5.5 at baseline and 29.2±5.2 at week 4, and there was no significant difference in the severity.Conclusions: The walking test for LSS has acceptable reproducibility.

Relationship among Osteoporosis, Sarcopenia, Locomotive Syndrome, and Spinal Kyphosis in Older Individuals Living in a Local Mountain Area

Tanishima Shinji,Hagino Hiroshi,Matsumoto Hiromi,Tanimura Chika,Nagashima Hideki 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.6

Study Design: Cross-sectional cohort study.Purpose: This study investigated the relationship among osteoporosis, sarcopenia, locomotive syndrome, and spinal kyphosis in older individuals living in a mountain area.Overview of Literature: Kyphosis greatly reduces the quality of life of older individuals. Osteoporosis and sarcopenia are kyphosiscausing factors.Methods: This cross-sectional study included 361 individuals aged ≥65 years (mean age, 75.0 years) living in a local mountain area and underwent medical check-ups from 2014 to 2018. The survey items included kyphosis index, body mass index, back pain prevalence, back pain Visual Analog Scale score, Oswestry Disability Index, walking speed, grip strength, skeletal mass index, osteoporosis (% young adult mean [YAM]), LOCOMO 5 score, and presence of sarcopenia (Asian Working Group for Sarcopenia). The participants were divided into the N (kyphosis index: <12; n=229, 63.4%), M (kyphosis index: 12–15; n=99, 27.4%), and K (kyphosis index: ≥15; n=33, 9.2%) groups. <i>p</i> -values of <0.05 were considered statistically significant. An association factor of kyphosis (kyphosis index: ≥15) was investigated with logistic regression analysis.Results: Age and LOCOMO 5 scores were significantly higher (<i>p</i> <0.05) and %YAM and walking speed were significantly lower (<i>p</i> <0.05) in the K group than in the M and N groups. Other survey items showed significant differences. Only %YAM (odds ratio, 0.20; 95% confidence interval, 0.04–0.96) was an independent factor associated with a kyphosis index of ≥15.Conclusions: Decreased muscle mass and muscle strength would be related to kyphosis; however, no such relations were noted. Bone loss was significantly related to kyphosis. Osteoporosis-induced decrease in vertebral body height is present in the background. Sarcopenia and locomotive syndrome were not related to kyphosis, whereas decreased bone density was independently associated with kyphosis in older individuals living in a mountain area.