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Igawa T, Ishii K, Katsuhira J, Suzuki A, Ui H, Urata R, Isogai N, Sasao Y, Matsudaira K, Funao H. Trunk orthosis with joints providing resistive force improves dynamic sagittal alignment in postoperative patients with lumbar spinal stenosis. Sci Rep 2023; 13:20636. [PMID: 38001133 PMCID: PMC10673938 DOI: 10.1038/s41598-023-46209-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 10/29/2023] [Indexed: 11/26/2023] Open
Abstract
This study aimed to determine whether a trunk orthosis with joints providing resistive force (TORF) modifies sagittal malalignment during level walking in patients with lumbar spinal stenosis (LSS). Fifteen patients, 6 months after undergoing surgery for LSS, performed level walking at a self-selected speed while wearing a TORF. Dynamic sagittal alignment, including sagittal vertical axis, lumbar lordosis, and pelvic tilt, and spatiotemporal data as well as lower limb kinematic and kinetic data were recorded using a three-dimensional motion analysis system and six force plates. Statistical analysis was performed to compare these data with and without the TORF, respectively. Compared to the condition without the TORF, the use of the TORF significantly decreased positive sagittal vertical axis (p < 0.05) and increased the lumbar lordosis and pelvic tilt (p < 0.05). Peak hip flexion angle and extension moment during loading response (LR) significantly increased (p < 0.05), and peak hip extension angle and flexion moment during PS statistically decreased (p < 0.05). There was no difference in spatiotemporal data between the two conditions. Our findings suggest that TORF may modify the dynamic sagittal global alignment and lower limb kinematic and kinetics in postoperative LSS patients during level walking.
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Affiliation(s)
- Tatsuya Igawa
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 852 Hatakeda, Narita, Chiba, 286-8520, Japan.
- Department of Rehabilitation, International University of Health and Welfare Mita Hospital, 1-4-3, Mita, Minato-ku, Tokyo, 108-8329, Japan.
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, 2600-1, Kitakanemaru, Ohtawara, Tochigi, 323-8501, Japan.
| | - Ken Ishii
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Junji Katsuhira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
- Department of Human Environment Design, Toyo University, 1-7-11, Akabanedai, Kitaku, Tokyo, 115-053, Japan
| | - Akifumi Suzuki
- Department of Rehabilitation, International University of Health and Welfare Mita Hospital, 1-4-3, Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - Hideto Ui
- Department of Rehabilitation, International University of Health and Welfare Mita Hospital, 1-4-3, Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - Ryunosuke Urata
- Department of Rehabilitation, International University of Health and Welfare Mita Hospital, 1-4-3, Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - Norihiro Isogai
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 852 Hatakeda, Narita, Chiba, 286-8520, Japan
| | - Yutaka Sasao
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 852 Hatakeda, Narita, Chiba, 286-8520, Japan
| | - Ko Matsudaira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
- Department of Pain Medicine, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan
| | - Haruki Funao
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 852 Hatakeda, Narita, Chiba, 286-8520, Japan
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Ikeda H, Miyamori T, Katsuhira J, Sawa R, Shimasaki Y, Takazawa Y, Yoshimura M. Effects of a wearable device and functional wear on spinal alignment and jump performance. J Exerc Sci Fit 2020; 19:91-97. [PMID: 33343670 PMCID: PMC7736979 DOI: 10.1016/j.jesf.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/03/2020] [Accepted: 10/03/2020] [Indexed: 11/25/2022] Open
Abstract
Background/objective To elucidate the effects of walking exercise using a wearable device and functional wear on spinal alignment and jump performance. Methods In total, 27 female college soccer players were randomly divided into two groups: trunk solution (TS) and compression garments (CGs). Spinal alignment, jump performance, and electromyography activity during the jump performance of the two groups were measured after a 20-min walking exercise. The values for each group were compared t pre- and post-intervention. Results The flexibility of the lower thoracic vertebrae in spinal alignment was increased during extension in the TS group. However, the post-value of the abdominal external oblique muscle during a countermovement jump (CMJ) was significantly lower than its pre-value (p < 0.05). In addition, even though spinal alignment was not affected in the CG group, post-values of the jump height during squat jump and CMJ were significantly higher than their pre-values (p < 0.05). Furthermore, the post-value of the biceps femoris during the countermovement jump with arm was significantly lower than its pre-value (p < 0.05). Conclusion Our study suggested that walking exercise using TS may increase the range of motion of the lower thoracic vertebrae in athletes and reduce the muscular activity of the vastus lateralis during CMJ. Additionally, although spinal aliment is not affected, the jump height may increase using CGs.
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Affiliation(s)
- Hayato Ikeda
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Japan
| | - Takayuki Miyamori
- Faculty of Health and Sports Science, Juntendo University, Japan.,Department of Health Science, School of Physiotherapy, Juntendo University, Japan
| | | | - Ryuichi Sawa
- Department of Health Science, School of Physiotherapy, Juntendo University, Japan
| | - Yu Shimasaki
- Faculty of Health and Sports Science, Juntendo University, Japan
| | - Yuji Takazawa
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Japan.,Faculty of Health and Sports Science, Juntendo University, Japan
| | - Masafumi Yoshimura
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Japan.,Faculty of Health and Sports Science, Juntendo University, Japan
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Mahmood MN, Peeters LHC, Paalman M, Verkerke GJ, Kingma I, van Dieën JH. Development and evaluation of a passive trunk support system for Duchenne muscular dystrophy patients. J Neuroeng Rehabil 2018. [PMID: 29540235 PMCID: PMC5853074 DOI: 10.1186/s12984-018-0353-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Patients with Duchenne muscular dystrophy gradually lose the ability to use different muscles of their body. Consequently, they lose the ability to stabilize their trunk against gravity. This hinders them to effectively perform different daily activities. In this paper, we describe the design, realization and evaluation of a trunk orthosis for these patients that should allow them to move their trunk and maintain stability. Method This study aimed to primarily assess the effectiveness of the trunk support system in terms of unloading of trunk muscles, so only healthy participants were recruited for this phase of the study. Measurements were done on 10 healthy participants (23.4±2.07 [M±SD] years old, average body weight 68.42±24.22 [M±SD] kg). The experiment comprised maintaining a constant trunk posture in three different device conditions (control without orthosis and two conditions with different configurations of the orthosis), at four different flexion angles (10°, 20°, 30°, 40°) for each device condition and for two load conditions (with and without stretching the arms). Electromyography (EMG) signals from the trunk muscles were measured to estimate activation levels of the trunk muscles (iliocostalis, longissimus, external oblique and rectus abdominis) and a motion capture system was used to record the movement of the participants during the experiment. Results Wearing the orthosis caused reductions in longissimus and iliocostalis activity. The average muscle activity level was 5%–10% of maximum voluntary contraction in the unsupported conditions for those particular muscles. This level was reduced to 3%–9% of maximal voluntary contraction for the supported conditions. No effect on external oblique and rectus abdominis activity was observed. Moreover, no pain or discomfort was reported by any of the participants during the experiment. The results from the current experiment also suggests the necessity of lumber stabilizing systems while using trunk orthosis. Conclusion The developed orthosis reduces trunk muscle activation level and provides a solid step for further development of support systems for Duchenne muscular dystrophy patients. Trial registration The current study was approved by the medical ethics committee Arnhem-Nijmegen (study number: NL53143.091.15), The Netherlands.
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Affiliation(s)
| | - Laura H C Peeters
- Dept of Rahabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Micha Paalman
- Dept of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands
| | - Gijsbertus J Verkerke
- Dept of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,dept of Biomechanical Engineering, University of Twente, Enschede, The Netherlands
| | - Idsart Kingma
- Dept of Human Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands.
| | - Jaap H van Dieën
- Dept of Human Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
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Katsuhira J, Yamamoto S, Machida N, Ohmura Y, Fuchi M, Ohta M, Ibayashi S, Yozu A, Matsudaira K. Immediate synergistic effect of a trunk orthosis with joints providing resistive force and an ankle-foot orthosis on hemiplegic gait. Clin Interv Aging 2018; 13:211-220. [PMID: 29440881 PMCID: PMC5804285 DOI: 10.2147/cia.s146881] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The synergistic effects of a trunk orthosis and an ankle-foot orthosis (AFO) in stroke patients with a hemiplegic gait are unclear. We previously developed a trunk orthosis with joints providing resistive force (TORF) to modify malalignment of the trunk and pelvis and confirmed its positive effects in stroke patients during level walking without an AFO. The aim of the present study was to determine if this trunk orthosis and an AFO have synergistic effects during level walking in community-dwelling patients with chronic stroke. Methods Twenty-eight community-dwelling stroke patients performed level walking at a self-selected speed with an AFO and again while wearing a TORF (TORF group) or a corset (control group). Spatiotemporal, kinematic, and kinetic data were recorded using a three-dimensional motion analysis system. Results When compared with the control group, the TORF group showed significant increases in walking speed, number of steps on the paretic leg per minute, and peak ankle plantar flexion moment during the single stance phase. Conclusion The TORF increased the ankle joint plantar flexion moment at the end of the single stance phase during level walking in stroke patients, leading to an increase in their gait speed because of the modified trunk and pelvis alignment.
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Affiliation(s)
- Junji Katsuhira
- Department of Prosthetics and Orthotics and Assistive Technology, Faculty of Medical Technology, Niigata University of Health and Welfare, Niigata.,Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo
| | - Sumiko Yamamoto
- Graduate School of International University of Health and Welfare, Tokyo
| | - Nodoka Machida
- International University of Health and Welfare, School of Health Sciences at Narita, Department of Physical Therapy, Chiba
| | - Yuji Ohmura
- International University of Health and Welfare, School of Health Sciences at Odawara, Department of Physical Therapy, Kanagawa
| | - Masako Fuchi
- Department of Occupational Therapy, Kyusyu Nutrition Welfare University, Fukuoka
| | | | | | - Arito Yozu
- Center for Medical Sciences, Ibaraki Prefectural University of Health Science, Ibaraki, Japan
| | - Ko Matsudaira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo
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Katsuhira J, Matsudaira K, Oka H, Iijima S, Ito A, Yasui T, Yozu A. Efficacy of a trunk orthosis with joints providing resistive force on low back load during level walking in elderly persons. Clin Interv Aging 2016; 11:1589-1597. [PMID: 27877028 PMCID: PMC5108480 DOI: 10.2147/cia.s108033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The effects of lumbosacral and spinal orthoses on low back pain and gait are not exactly clear. We previously developed a trunk orthosis with joints providing resistive force on low back load to decrease such load, and confirmed its positive effects during level walking in healthy young adults. Therefore, we aimed to determine the efficacy of this trunk orthosis during level walking in healthy elderly subjects. METHODS Fifteen community-dwelling elderly subjects performed level walking at a self-selected speed without an orthosis, with our orthosis, and with a lumbosacral orthosis. Kinematic and kinetic data were recorded using a three-dimensional motion analysis system, and erector spinae activity was recorded by electromyography. RESULTS When comparing the three conditions, our orthosis showed the following effects: it decreased the peak extension moment, increased the peak flexion moment, decreased the lateral bending angle, increased the peak thoracic extension angle, and had significantly lower erector spinae activity and significantly larger peak pelvic forward tilt angles. CONCLUSION Our orthosis with joints providing resistive force decreased low back load and modified trunk and pelvis alignments during level walking in healthy elderly people.
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Affiliation(s)
- Junji Katsuhira
- Faculty of Medical Technology, Department of Prosthetics and Orthotics and Assistive Technology, Niigata University of Health and Welfare, Niigata; Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo
| | - Ko Matsudaira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo
| | - Shinno Iijima
- International University of Health and Welfare Hospital, Tochigi
| | - Akihiro Ito
- International University of Health and Welfare Hospital, Tochigi
| | | | - Arito Yozu
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
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Katsuhira J, Matsudaira K, Yasui T, Iijima S, Ito A. Efficacy of a trunk orthosis with joints providing resistive force on low-back load in elderly persons during static standing. Clin Interv Aging 2015; 10:1413-20. [PMID: 26366062 PMCID: PMC4562746 DOI: 10.2147/cia.s85294] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Postural alignment of elderly people becomes poor due to aging, possibly leading to low-back pain and spinal deformity. Although there are several interventions for treating these conditions, no previous study has reported the effectiveness of a spinal orthosis or lumbosacral orthosis (LSO) in healthy elderly people without specific spinal deformity. We therefore developed a trunk orthosis to decrease low-back muscle activity while training good postural alignment through resistive force provided by joints with springs (here, called the ORF, which stands for orthosis with joints providing resistive force) as a preventive method against abnormal posture and low-back pain in healthy elderly persons. Patients and methods Fifteen community-dwelling elderly men participated in this study. Participants stood freely for 10 seconds in a laboratory setting under three conditions: without an orthosis, with the ORF, and with an LSO. The Damen corset LSO was selected as it is frequently prescribed for patients with low-back pain. Postural alignment during static standing was recorded using a three-dimensional motion capture system employing infrared cameras. Two force plates were used to record center of pressure. Electromyograms were obtained for bilateral erector spinae (ES), left internal abdominal oblique, and right gluteus medius muscles. Results Pelvis forward tilt angle tended to increase while wearing the ORF and decrease while wearing the LSO, but these results were not significant compared to no orthosis. Thorax extension angle and thorax angle on pelvis coordinate system significantly increased while wearing the ORF compared to the other two conditions. ES activity significantly decreased while wearing the ORF compared to the other two conditions. Internal oblique activity was significantly smaller while wearing the LSO than with no orthosis. Center of pressure did not significantly differ among the conditions. Conclusion The ORF significantly improved trunk alignment and decreased ES activity in healthy elderly subjects during static standing.
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Affiliation(s)
- Junji Katsuhira
- Department of Nursing and Rehabilitation Science at Odawara, International University of Health and Welfare, Odawara, Kanagawa, Japan
| | - Ko Matsudaira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo, Japan
| | - Tadashi Yasui
- Kawamura-Gishi Company, Ltd., Daito-shi, Osaka, Japan
| | - Shinno Iijima
- Graduate School of International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Akihiro Ito
- Graduate School of International University of Health and Welfare, Otawara, Tochigi, Japan
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Won SH, Kim JC, Oh DW. Effects of a novel walking training program with postural correction and visual feedback on walking function in patients with post-stroke hemiparesis. J Phys Ther Sci 2015; 27:2581-3. [PMID: 26357443 PMCID: PMC4563319 DOI: 10.1589/jpts.27.2581] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 05/15/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to elucidate the effects of a novel walking training program with postural correction and visual feedback on walking function in patients with post-stroke hemiparesis. [Subjects] Sixteen subjects were randomly allocated to either the experimental group (EG) or the control group (CG), with eight subjects in each. [Methods] EG and CG subjects performed a 30-min treadmill walking training exercise twice daily for 2 weeks. EG subjects also underwent postural correction using elastic bands and received visual feedback during walking. The 10-m walk test was performed, and gait parameters were measured using a gait analysis system. [Results] All parameters showed significant main effects for the group factor and time-by-group interactions. Significant main effects for the time factor were found in the stride length and stance phase ratios. [Conclusion] The novel walking training program with postural correction and visual feedback may improve walking function in patients with post-stroke hemiparesis.
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Affiliation(s)
- Sang Hee Won
- Department of Sports Science, The Graduate School, Chonbuk National University, Republic of Korea
| | - Jae Cheol Kim
- Department of Sports Science, College of Sports Science, Chonbuk National University, Republic of Korea
| | - Duck-Won Oh
- Department of Physical Therapy, College of Health Science, Cheongju University, Republic of Korea
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