Body weight-supported treadmill training with the voluntary driven exoskeleton(VDE-BWSTT) has been shown to improve the gait function of patients with chronic spinal cord injury. However, little is known whether VDE-B...Body weight-supported treadmill training with the voluntary driven exoskeleton(VDE-BWSTT) has been shown to improve the gait function of patients with chronic spinal cord injury. However, little is known whether VDE-BWSTT can effectively improve the trunk function of patients with chronic spinal cord injury. In this open-label, single-arm study, nine patients with chronic spinal cord injury at the cervical or thoracic level(six males and three females, aged 37.8 ± 15.6 years, and time since injury 51.1 ± 31.8 months) who underwent outpatient VDE-BWSTT training program at Keio University Hospital, Japan from September 2017 to March 2019 were included. All patients underwent twenty 60-minute gait training sessions using VDE. Trunk muscular strength, i.e., the maximum force against which patient could maintain a sitting posture without any support, was evaluated in four directions: anterior, posterior, and lateral(right and left) after 10 and 20 training sessions. After intervention, lateral muscular strength significantly improved. In addition, a significant positive correlation was detected between the change in lateral trunk muscular strength after 20 training sessions relative to baseline and gait speed. The change in trunk muscular strength after 20 training sessions relative to baseline was greatly correlated with patient age. This suggests that older adult patients with chronic spinal cord injury achieved a greater improvement in trunk muscle strength following VDE-BWSTT. All these findings suggest that VDE-BWSTT can improve the trunk function of patients with chronic spinal cord injury and the effect might be greater in older adult patients. The study was approved by the Keio University of Medicine Ethics Committee(IRB No. 20150355-3) on September 26, 2017.展开更多
The mass of very small vehicles is often comparable to that of their drivers,and thus there is a greater degree of coupling between the vehicle and the driver,compared with a case for traditional vehicles.When develop...The mass of very small vehicles is often comparable to that of their drivers,and thus there is a greater degree of coupling between the vehicle and the driver,compared with a case for traditional vehicles.When developing small vehicles,it is necessary to give ample consideration to the dynamics of the person who ride them.Here,a model of a human body riding a small personal vehicle was constructed to investigate the dynamics of the person inside such a vehicle.Moreover,an experiment on posture maintenance by acceleration of direction of travel was conducted and the parameters for posture control were identified using agenetic algorithm.Results shows that body behavior could be successfully simulated using the proposed model,and the control parameters were effective in determining the posture maintenance characteristics of the vehicle occupant.展开更多
BACKGROUND Impalement of the body is a rare injury and comes with varied presentation.There is no set classification or defined protocols for managing this injury.This case report aims to create awareness among trauma...BACKGROUND Impalement of the body is a rare injury and comes with varied presentation.There is no set classification or defined protocols for managing this injury.This case report aims to create awareness among trauma surgeons about unusual presentation and management of such case.CASE SUMMARY A 45-year-old man presented to the emergency department with a sharp penetrating wooden plank at right clavicular region between the neck and shoulder following a road traffic accident.The vehicle had crashed into a roadside wooden hut,thus causing an impalement injury.He was meticulously worked up and taken to emergency theatre.The wooden plank was removed and the wound healed uneventfully.Postoperatively,he had fairly good shoulder function and was able to return back to work successfully.CONCLUSION Each impalement injury brings in challenges in management as no two cases are the same.The varied presentation and risks involved should be known to medical professionals handling the emergency.Coordinated multidisciplinary team approach is needed for successful outcome.展开更多
Objective To discuss the principle of treatment for scoliosis associated Marfan’ s syndrome in children. Methods Thirty cases of scoliosis associated Marfan’ s syndrome were corrected and followed-up. Thirteen patie...Objective To discuss the principle of treatment for scoliosis associated Marfan’ s syndrome in children. Methods Thirty cases of scoliosis associated Marfan’ s syndrome were corrected and followed-up. Thirteen patients underwent posterior fusion whereas 17 cases received anterior release and posterior correction. Among the 30 patients,20 were previously treated with brace and other conservative methods. The results were analyzed using apex vertebral translation (AVT), apex vertebral rotation (AYR),Cobb’s angle,trunk shift (TS).and pre-and post-operative body heights. Results Posterior approach resulted in more complications. Wider range anterior fusion combined with posterior correction improved the result. Conclusion Anterior release combined with posterior correction is the perferred treatment of scoliosis associated Marfan’ s syndrome. 11 refs,1 tab.展开更多
基金supported by the Uehara Memorial foundation,Japan Science and Technology Agency,No.05-001-0002Japan Agency for Medical Research and Development,No.19bk0104017h00029(both to MN)。
文摘Body weight-supported treadmill training with the voluntary driven exoskeleton(VDE-BWSTT) has been shown to improve the gait function of patients with chronic spinal cord injury. However, little is known whether VDE-BWSTT can effectively improve the trunk function of patients with chronic spinal cord injury. In this open-label, single-arm study, nine patients with chronic spinal cord injury at the cervical or thoracic level(six males and three females, aged 37.8 ± 15.6 years, and time since injury 51.1 ± 31.8 months) who underwent outpatient VDE-BWSTT training program at Keio University Hospital, Japan from September 2017 to March 2019 were included. All patients underwent twenty 60-minute gait training sessions using VDE. Trunk muscular strength, i.e., the maximum force against which patient could maintain a sitting posture without any support, was evaluated in four directions: anterior, posterior, and lateral(right and left) after 10 and 20 training sessions. After intervention, lateral muscular strength significantly improved. In addition, a significant positive correlation was detected between the change in lateral trunk muscular strength after 20 training sessions relative to baseline and gait speed. The change in trunk muscular strength after 20 training sessions relative to baseline was greatly correlated with patient age. This suggests that older adult patients with chronic spinal cord injury achieved a greater improvement in trunk muscle strength following VDE-BWSTT. All these findings suggest that VDE-BWSTT can improve the trunk function of patients with chronic spinal cord injury and the effect might be greater in older adult patients. The study was approved by the Keio University of Medicine Ethics Committee(IRB No. 20150355-3) on September 26, 2017.
文摘The mass of very small vehicles is often comparable to that of their drivers,and thus there is a greater degree of coupling between the vehicle and the driver,compared with a case for traditional vehicles.When developing small vehicles,it is necessary to give ample consideration to the dynamics of the person who ride them.Here,a model of a human body riding a small personal vehicle was constructed to investigate the dynamics of the person inside such a vehicle.Moreover,an experiment on posture maintenance by acceleration of direction of travel was conducted and the parameters for posture control were identified using agenetic algorithm.Results shows that body behavior could be successfully simulated using the proposed model,and the control parameters were effective in determining the posture maintenance characteristics of the vehicle occupant.
文摘BACKGROUND Impalement of the body is a rare injury and comes with varied presentation.There is no set classification or defined protocols for managing this injury.This case report aims to create awareness among trauma surgeons about unusual presentation and management of such case.CASE SUMMARY A 45-year-old man presented to the emergency department with a sharp penetrating wooden plank at right clavicular region between the neck and shoulder following a road traffic accident.The vehicle had crashed into a roadside wooden hut,thus causing an impalement injury.He was meticulously worked up and taken to emergency theatre.The wooden plank was removed and the wound healed uneventfully.Postoperatively,he had fairly good shoulder function and was able to return back to work successfully.CONCLUSION Each impalement injury brings in challenges in management as no two cases are the same.The varied presentation and risks involved should be known to medical professionals handling the emergency.Coordinated multidisciplinary team approach is needed for successful outcome.
文摘Objective To discuss the principle of treatment for scoliosis associated Marfan’ s syndrome in children. Methods Thirty cases of scoliosis associated Marfan’ s syndrome were corrected and followed-up. Thirteen patients underwent posterior fusion whereas 17 cases received anterior release and posterior correction. Among the 30 patients,20 were previously treated with brace and other conservative methods. The results were analyzed using apex vertebral translation (AVT), apex vertebral rotation (AYR),Cobb’s angle,trunk shift (TS).and pre-and post-operative body heights. Results Posterior approach resulted in more complications. Wider range anterior fusion combined with posterior correction improved the result. Conclusion Anterior release combined with posterior correction is the perferred treatment of scoliosis associated Marfan’ s syndrome. 11 refs,1 tab.
