1
|
Tanamachi K, Kuwahara W, Okawada M, Sasaki S, Kaneko F. Relationship between resting-state functional connectivity and change in motor function after motor imagery intervention in patients with stroke: a scoping review. J Neuroeng Rehabil 2023; 20:159. [PMID: 37980496 PMCID: PMC10657492 DOI: 10.1186/s12984-023-01282-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/12/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUND In clinical practice, motor imagery has been proposed as a treatment modality for stroke owing to its feasibility in patients with severe motor impairment. Motor imagery-based interventions can be categorized as open- or closed-loop. Closed-loop intervention is based on voluntary motor imagery and induced peripheral sensory afferent (e.g., Brain Computer Interface (BCI)-based interventions). Meanwhile, open-loop interventions include methods without voluntary motor imagery or sensory afferent. Resting-state functional connectivity (rs-FC) is defined as a significant temporal correlated signal among functionally related brain regions without any stimulus. rs-FC is a powerful tool for exploring the baseline characteristics of brain connectivity. Previous studies reported changes in rs-FC after motor imagery interventions. Systematic reviews also reported the effects of motor imagery-based interventions at the behavioral level. This study aimed to review and describe the relationship between the improvement in motor function and changes in rs-FC after motor imagery in patients with stroke. REVIEW PROCESS The literature review was based on Arksey and O'Malley's framework. PubMed, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science were searched up to September 30, 2023. The included studies covered the following topics: illusion without voluntary action, motor imagery, action imitation, and BCI-based interventions. The correlation between rs-FC and motor function before and after the intervention was analyzed. After screening by two independent researchers, 13 studies on BCI-based intervention, motor imagery intervention, and kinesthetic illusion induced by visual stimulation therapy were included. CONCLUSION All studies relating to motor imagery in this review reported improvement in motor function post-intervention. Furthermore, all those studies demonstrated a significant relationship between the change in motor function and rs-FC (e.g., sensorimotor network and parietal cortex).
Collapse
Affiliation(s)
- Kenya Tanamachi
- Department of Physical Therapy, Graduate School of Health Sciences, Tokyo Metropolitan University, 7-2-10 Higashi-Ogu, Arakawa-Ku, Tokyo, Japan
- Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Wataru Kuwahara
- Department of Physical Therapy, Graduate School of Health Sciences, Tokyo Metropolitan University, 7-2-10 Higashi-Ogu, Arakawa-Ku, Tokyo, Japan
- Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Megumi Okawada
- Department of Physical Therapy, Graduate School of Health Sciences, Tokyo Metropolitan University, 7-2-10 Higashi-Ogu, Arakawa-Ku, Tokyo, Japan
- Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Shun Sasaki
- Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Fuminari Kaneko
- Department of Physical Therapy, Graduate School of Health Sciences, Tokyo Metropolitan University, 7-2-10 Higashi-Ogu, Arakawa-Ku, Tokyo, Japan.
- Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan.
| |
Collapse
|
2
|
Ito D, Kawakami M, Kuwahara W, Yamada Y, Kondo K, Tsuji T. Parameter mapping of hemiplegic shoulder electrical stimulation for motor function: A scoping review. NeuroRehabilitation 2023:NRE220301. [PMID: 37424478 DOI: 10.3233/nre-220301] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
BACKGROUND Electrical stimulation (ES) of the shoulder is effective in treating subluxation and shoulder pain. However, few studies have reported on ES of the hemiplegic shoulder with motor function as an outcome; thus, the method remains unclear. OBJECTIVE We aimed to map the existing evidence and identify the parameters for ES of the hemiplegic shoulder for motor function in stroke patients. METHODS A literature search was performed through PubMed and Scopus to retrieve original articles from 1975 to March 2023 using the terms "stroke", "shoulder", and "electricity". We selected studies in which ES was performed on hemiplegic shoulders after stroke, parameters were described, and upper extremity motor functional assessment was included as an outcome. The extracted data included study design, phase, sample size, electrode position, parameters, intervention period, evaluation frequency, outcomes, and results. RESULTS Of the 449 titles identified, 25 fulfilled the inclusion and exclusion criteria. Nineteen were randomized controlled trials. The most common electrode positions and parameters (frequency and pulse width) were over the posterior deltoid and the supraspinatus (upper trapezius) muscles, 30 Hz, and 250μs, respectively. The intervention period was 30-60 minutes per day, 5-7 days per week, for 4-5 weeks in over half of the studies. CONCLUSION Stimulation positions and parameters for electrical stimulation of the hemiplegic shoulder are inconsistent. Whether ES represents a significant treatment option remains unclear. Establishing universal ES methods is necessary to improve the motor function of hemiplegic shoulders.
Collapse
Affiliation(s)
- Daisuke Ito
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Michiyuki Kawakami
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Wataru Kuwahara
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yuka Yamada
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kunitsugu Kondo
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
3
|
Yamamoto R, Sasaki S, Kuwahara W, Kawakami M, Kaneko F. Effect of exoskeleton-assisted Body Weight-Supported Treadmill Training on gait function for patients with chronic stroke: a scoping review. J Neuroeng Rehabil 2022; 19:143. [PMID: 36544163 PMCID: PMC9768983 DOI: 10.1186/s12984-022-01111-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 11/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Therapeutic exercise for gait function using an exoskeleton-assisted Body Weight Supported Treadmill Training (BWSTT) has been identified as a potential intervention that allows for task-based repetitive training with appropriate kinematics while adjusting the amount of body weight support (BWS). Nonetheless, its effect on gait in patients with stroke in the chronic phase are yet to be clarified. The primary aim of this scoping review was to present the status of effectiveness of exoskeleton-assisted BWSTT in patients with chronic stroke. The secondary aims were to summarise intervention protocols, types and functions of BWSTT exoskeletal robotic devices currently used clinically. METHOD AND RESULTS Articles were accessed and collected from PubMed, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science databases, which were completed in October 2020. Articles were included if the subjects were adults with stroke in the chronic phase (onset ≥ 6 months) and if they utilised a robotic exoskeleton with treadmill and body weight support and investigated the efficacy of gait exercise. A total of 721 studies were identified, of which 11 randomised controlled trials were selected. All included studies were published from 2008 to 2020. Overall, 309 subjects were enrolled; of these, 241 (156 males, 85 females) participated. Walking outcome measures were used more often to evaluate the functional aspects of gait than to evaluate gait independence. In 10 of 11 studies, showed the effectiveness of exoskeleton robot-assisted BWSTT in terms of outcomes contributing to improved gait function. Two studies reported that exoskeleton-assisted BWSTT with combination therapy was significantly more effective in improving than exoskeleton-assisted BWSTT alone. However, no significant difference was identified between the groups; compared with therapist-assisted BWSTT groups, exoskeleton-assisted BWSTT groups did not exhibit significant change. CONCLUSION This review suggests that exoskeleton-assisted BWSTT for patients with chronic stroke may be effective in improving walking function. However, the potential may be "to assist" and not because of using the robot. Further studies are required to verify its efficacy and strengthen evidence on intervention protocols.
Collapse
Affiliation(s)
- Rieko Yamamoto
- grid.26091.3c0000 0004 1936 9959Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shjinjuku, Tokyo, Japan ,grid.268446.a0000 0001 2185 8709Department of Artificial Environment, Safety, Environment and System Engineering, Yokohama National University Graduate School of Environment and Information Sciences, 79-7, Tokiwadai, Hodogaya, Yokohama, Japan ,grid.39158.360000 0001 2173 7691Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Japan
| | - Shun Sasaki
- grid.26091.3c0000 0004 1936 9959Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shjinjuku, Tokyo, Japan ,Division of Health Promotion, ARCE Inc., Sagamihara, Japan
| | - Wataru Kuwahara
- grid.26091.3c0000 0004 1936 9959Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shjinjuku, Tokyo, Japan ,grid.265074.20000 0001 1090 2030Department of Physical Therapy, Graduate School of Health Sciences, Tokyo Metropolitan University, 7-2-10 Higashi-Oku, Arakawa-ku, Tokyo, Japan
| | - Michiyuki Kawakami
- grid.26091.3c0000 0004 1936 9959Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shjinjuku, Tokyo, Japan
| | - Fuminari Kaneko
- grid.26091.3c0000 0004 1936 9959Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shjinjuku, Tokyo, Japan ,grid.265074.20000 0001 1090 2030Department of Physical Therapy, Graduate School of Health Sciences, Tokyo Metropolitan University, 7-2-10 Higashi-Oku, Arakawa-ku, Tokyo, Japan
| |
Collapse
|
4
|
Kuwahara W, Miyawaki Y, Kaneko F. Impact of the Upper Limb Physiotherapy on Behavioral and Brain Adaptations in Post-Stroke Patients. JRM 2022. [DOI: 10.20965/jrm.2022.p0718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Many stroke patients suffer from motor impairments due to paralysis, and consequently, motor paralysis of upper limbs seems to be particularly prone to residual impairment compared to that of lower limbs. Although ‘learned non-use’ that by managing reasonably well using only the unaffected upper limb in their actions, the patients can achieve their desired behavior, and these success experiences strengthen this pattern of behavior can be interpreted as a post-stroke adaptation, physiotherapy may lead to poor recovery of motor impairment. This review article discusses the impact of upper limb physiotherapy after stroke on behavioral/brain adaptations. Our previous studies demonstrated that patients with severe post-stroke sensorimotor impairments in a chronic phase might have abnormal functional connectivity. To prevent such adaptation after stroke, upper limb physiotherapy is important. In rehabilitation practices, hyper-adaptation has been often observed in not only behavioral but also brain changes. Although several studies are reporting clinical efficacy in patients with moderate to mild paralysis, there might be no effective treatment for patients with severe motor paralysis. To overcome these serious problems, we have developed a novel approach, kinesthetic illusion induced by visual stimulation (KINVIS) therapy. We showed that the effects of KINVIS therapy with therapeutic exercise on upper limb motor functions were mediated by spasticity, and functional connectivity in the brain was also changed with the improvement of motor function after KINVIS therapy. Brain changes underlying behavioral changes need to be more examined, and the adaptation of stroke patients needs to be clarified in detail.
Collapse
|
5
|
Kuwahara W, Sasaki S, Yamamoto R, Kawakami M, Kaneko F. The effects of robot-assisted gait training combined with non-invasive brain stimulation on lower limb function in patients with stroke and spinal cord injury: A systematic review and meta-analysis. Front Hum Neurosci 2022; 16:969036. [PMID: 36051968 PMCID: PMC9426300 DOI: 10.3389/fnhum.2022.969036] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/19/2022] [Indexed: 11/29/2022] Open
Abstract
Objective: This study aimed to investigate the effect of robot-assisted gait training (RAGT) therapy combined with non-invasive brain stimulation (NIBS) on lower limb function in patients with stroke and spinal cord injury (SCI). Data sources PubMed, Cochrane Central Register of Controlled Trials, Ovid MEDLINE, and Web of Science were searched. Study selection Randomized controlled trials (RCTs) published as of 3 March 2021. RCTs evaluating RAGT combined with NIBS, such as transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), for lower limb function (e.g., Fugl-Meyer assessment for patients with stroke) and activities (i.e., gait velocity) in patients with stroke and SCI were included. Data extraction Two reviewers independently screened the records, extracted the data, and assessed the risk of bias. Data synthesis A meta-analysis of five studies (104 participants) and risk of bias were conducted. Pooled estimates demonstrated that RAGT combined with NIBS significantly improved lower limb function [standardized mean difference (SMD) = 0.52; 95% confidence interval (CI) = 0.06–0.99] but not lower limb activities (SMD = −0.13; 95% CI = −0.63–0.38). Subgroup analyses also failed to find a greater improvement in lower limb function of RAGT with tDCS compared to sham stimulation. No significant differences between participant characteristics or types of NIBS were observed. Conclusion This meta-analysis demonstrated that RAGT therapy in combination with NIBS was effective in patients with stroke and SCI. However, a greater improvement in lower limb function and activities were not observed using RAGT with tDCS compared to sham stimulation.
Collapse
Affiliation(s)
- Wataru Kuwahara
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Physical Therapy, Graduate School of Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Shun Sasaki
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Rieko Yamamoto
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Artificial Environment, Safety, Environment and System Engineering, Graduate School of Environment and Information Sciences, Yokohama National University, Kanagawa, Japan
| | - Michiyuki Kawakami
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Fuminari Kaneko
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Physical Therapy, Graduate School of Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
- *Correspondence: Fuminari Kaneko
| |
Collapse
|
6
|
Kuwahara W, Nakanishi K, Kurumadani H, Shimada N, Asaeda M, Deie M, Adachi N, Sunagawa T. Total knee arthroplasty for patients with medial knee osteoarthritis improves trunk movement during gait. J Back Musculoskelet Rehabil 2021; 33:727-734. [PMID: 31796661 DOI: 10.3233/bmr-181383] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Previous studies have indicated that the kinematics of the knee joint affect the trunk and pelvis during gait. However, the factors that influence trunk movement in knee osteoarthritis patients during gait after surgery remain unclear. OBJECTIVE To examine the effect of total knee arthroplasty (TKA) on trunk movement during gait by comparing knee osteoarthritis patients with healthy controls. METHODS Fourteen medial knee osteoarthritis patients who underwent initial unilateral TKA and 11 controls participated in this study. Knee and hip joint flexion and trunk and pelvic tilts during gait were acquired using a three-dimensional motion analysis system. Knee joint range of motion, pain, and kinematic data were collected preoperatively and 1 year postoperatively for knee osteoarthritis patients. RESULTS Knee extension limitation and pain significantly improved postoperatively compared with preoperative stages. Preoperatively, the peak anterior trunk tilt during the stance phase was significantly larger in osteoarthritis patients than in controls. The peak anterior trunk tilt during the stance phase was significantly smaller postoperatively than at preoperative stages. CONCLUSIONS These results suggest that after TKA, the trunk movements of knee osteoarthritis patients were approximately equal to those of controls, with improvement in clinical outcomes such as knee extension limitation and pain.
Collapse
Affiliation(s)
- Wataru Kuwahara
- Health Sciences Major, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan.,Department of Rehabilitation, Hayashi Hospital, Hiroshima 730-0029, Japan
| | - Kazuyoshi Nakanishi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
| | - Hiroshi Kurumadani
- Laboratory of Analysis and Control of Upper Extremity Function, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
| | - Noboru Shimada
- Department of Rehabilitation, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Makoto Asaeda
- Department of Rehabilitation, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Masataka Deie
- Department of Orthopaedic Surgery, Aichi Medical University, Aichi 480-1195, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
| | - Toru Sunagawa
- Laboratory of Analysis and Control of Upper Extremity Function, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
| |
Collapse
|
7
|
Ishii Y, Ishikawa M, Hayashi S, Kanemitsu M, Omoto T, Kurumadani H, Kuwahara W, Date S, Deie M, Adachi N, Sunagawa T. The correlation between osteoarthritis stage and the effect of the lateral wedge insole for 3 months on medial meniscus extrusion in the knee joint. Knee 2021; 28:110-116. [PMID: 33333466 DOI: 10.1016/j.knee.2020.11.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 10/23/2020] [Accepted: 11/16/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Medial meniscus extrusion (MME) leads to symptomatic knee osteoarthritis (OA) due to increased mechanical stress. MME increases with weight-bearing, and the difference in MME between non-weight-bearing and weight-bearing status (ΔMME) is a factor that causes greater MME. The lateral wedge insole (LWI) is an ideal approach for decreasing the amount of ΔMME associated with the reduction of medial loading stress in the early stage of knee OA. However, the effect of the LWI for 3 months on the ΔMME and its response to OA stage have not been elucidated. OBJECTIVE To investigate the effects of the LWI for 3 months on MME and the ΔMME in each stage of OA. METHODS Participants were divided into three groups: no intervention with the LWI (control group; n = 9) and intervention with the LWI in early OA (early OA group: Kellgren-Lawrence (K/L) stage = 2, n = 17) and late OA (late OA group: K/L stage > 2, n = 13). MME was evaluated using ultrasound, and the ΔMME was obtained as the difference in MME from non-weight-bearing and weight-bearing conditions. These measurements were performed at two time points: the initial office visit as a baseline and post-3 months. RESULTS The weight-bearing MME and ΔMME values post-3 months were significantly decreased compared with those at baseline in the early OA group but not in the control or late OA groups. CONCLUSIONS The use of the LWI for 3 months decreased weight-bearing MME and ΔMME values, and its effectiveness was more pronounced in the early stage of knee OA.
Collapse
Affiliation(s)
- Yosuke Ishii
- Health Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Masakazu Ishikawa
- Department of Artificial Joints and Biomaterials, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Seiju Hayashi
- Department of Orthopedic Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Munekazu Kanemitsu
- Department of Orthopedic Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takenori Omoto
- Department of Orthopedic Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroshi Kurumadani
- Health Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Wataru Kuwahara
- Health Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shota Date
- Health Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masataka Deie
- Department of Orthopedic Surgery, Aichi Medical University, Aichi, Japan
| | - Nobuo Adachi
- Department of Orthopedic Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Toru Sunagawa
- Health Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
8
|
Kuwahara W, Kurumadani H, Tanaka N, Nakanishi K, Nakamura H, Ishii Y, Ueda A, Deie M, Adachi N, Sunagawa T. Correlation between spinal and pelvic movements during gait and aggravation of low back pain by gait loading in lumbar spinal stenosis patients. J Orthop Sci 2019; 24:207-213. [PMID: 30322623 DOI: 10.1016/j.jos.2018.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 08/17/2018] [Accepted: 09/04/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Lumbar alignment of posterior or anterior tilts affects the exacerbation and remission of symptoms of lumbar spinal stenosis patients. This study aimed to clarify the correlation between spinal and pelvic movements during gait and the aggravation of low back pain after gait loading in lumbar spinal stenosis patients. METHODS A total of 29 patients with lumbar spinal stenosis completed leg and low back pain assessments and gait analysis before and after gait loading tests. Patients were divided into leg and low back pain change (n = 8), leg pain only change (n = 12), and non-change (n = 9) groups based on the differences of leg and low back pain between before and after the tests. Peak kinematic values of the anterior tilts of the trunk, thoracic spine, lumbar spine, and pelvis during the stance phase were obtained via three-dimensional gait analysis. RESULTS In the leg and low back pain change group, the anterior lumbar and pelvic tilts were larger after than before the tests; however, in the leg pain only change and non-change groups, only the anterior lumbar tilt was larger after than before the tests. Anterior lumbar tilt before and after the tests negatively correlated with the aggravation of low back pain, and an increase in the anterior pelvic tilt positively correlated with the aggravation of low back pain. CONCLUSIONS In lumbar spinal stenosis patients, smaller anterior lumbar tilt and larger anterior pelvic tilt during gait loading may affect the aggravation of low back pain by gait loading. Increasing in lumbar lordosis during gait might be one of the factors leading to low back pain in lumbar spinal stenosis patients.
Collapse
Affiliation(s)
- Wataru Kuwahara
- Health Sciences Major, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
| | - Hiroshi Kurumadani
- Laboratory of Analysis and Control of Upper Extremity Function, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Nobuhiro Tanaka
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Kazuyoshi Nakanishi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Haruka Nakamura
- Department of Rehabilitation, Kibinomori Rehabilitation Hospital, 1-30-1, Kibinomori-Minami, Oamishirasato-shi, Chiba, 299-3241, Japan
| | - Yosuke Ishii
- Health Sciences Major, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Akio Ueda
- Health Sciences Major, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Masataka Deie
- Department of Orthopaedic Surgery, Aichi Medical University, 1-1 Yazakokarimata, Nagakute-shi, Aichi, 480-1195, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Toru Sunagawa
- Laboratory of Analysis and Control of Upper Extremity Function, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| |
Collapse
|
9
|
Fujita N, Yamasaki N, Eto K, Asaeda M, Kuwahara W, Imagita H. Oxygen therapy may worsen the survival rate in rats with monocrotaline-induced pulmonary arterial hypertension. PLoS One 2018; 13:e0204254. [PMID: 30235299 PMCID: PMC6147559 DOI: 10.1371/journal.pone.0204254] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 09/04/2018] [Indexed: 12/26/2022] Open
Abstract
Although oxygen therapy rapidly improves arterial oxygen saturation in idiopathic pulmonary arterial hypertension, the effects of chronic administration of oxygen are unknown. The purpose of the present study was to investigate the effects of chronic oxygen therapy on the histological changes and survival rate in rats with idiopathic pulmonary arterial hypertension. Idiopathic pulmonary arterial hypertension was induced by monocrotaline injection. The rats were then randomly assigned to receive or not receive oxygen therapy (O2 group and non-O2 group, respectively). The rats in the O2 group were exposed to a high (90%) oxygen environment from day 17 following injection of monocrotaline, when hypoxemia was first observed. The pulmonary arteriole walls were significantly thicker in monocrotaline-injected rats than in saline-injected rats as vehicle on day 19 and were significantly thicker in the rats that received oxygen therapy than in the rats that did not. Right ventricular inflammations were significantly higher in monocrotaline-injected rats than in saline-injected rats on day 19 and were significantly higher in the rats that received oxygen therapy than in the rats that did not. By day 20 after injection of monocrotaline, the survival rate was significantly lower in the rats that received oxygen therapy than in those that did not. Superoxide dismutase activity in the lungs was higher in monocrotaline-injected rats than in saline-injected rats on day 19 after monocrotaline injection and was also higher in the saline-injected rats that received oxygen therapy than in the saline-injected rats that did not. No interaction was detected between monocrotaline injection and oxygen therapy. These results suggest that chronic oxygen therapy worsens the histological changes and survival rate in idiopathic pulmonary arterial hypertension. The fact that degradation of the histological changes and survival rate was accompanied by increase in superoxide dismutase activity suggests that antioxidant capacity may contribute to the degradation.
Collapse
Affiliation(s)
- Naoto Fujita
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedicine and Health Sciences, Hiroshima University, Kasumi, Minami-ku, Hiroshima, Japan
- * E-mail:
| | - Natsuki Yamasaki
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedicine and Health Sciences, Hiroshima University, Kasumi, Minami-ku, Hiroshima, Japan
| | - Kanako Eto
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedicine and Health Sciences, Hiroshima University, Kasumi, Minami-ku, Hiroshima, Japan
| | - Makoto Asaeda
- Sports Medical Center, Hiroshima University Hospital, Kasumi, Minami-ku, Hiroshima, Japan
| | - Wataru Kuwahara
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedicine and Health Sciences, Hiroshima University, Kasumi, Minami-ku, Hiroshima, Japan
| | - Hidetaka Imagita
- Graduate School of Health Sciences, Kio University, Umaminaka, Koryo-cho, Kitakatsuragi-gun, Nara, Japan
| |
Collapse
|
10
|
Asaeda M, Deie M, Fujita N, Kono Y, Terai C, Kuwahara W, Watanabe H, Kimura H, Adachi N, Sunagawa T, Ochi M. Gender differences in the restoration of knee joint biomechanics during gait after anterior cruciate ligament reconstruction. Knee 2017; 24:280-288. [PMID: 28173988 DOI: 10.1016/j.knee.2017.01.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 12/09/2016] [Accepted: 01/02/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND The aim of our study was to evaluate the effects of gender on recovery of knee joint biomechanics over the stance phase of gait after reconstruction of the anterior cruciate ligament (ACL). METHODS Gait parameters and knee joint kinematics and kinetics were compared in 32 patients (16 male and 16 female) who underwent ACL reconstruction for a unilateral ACL deficiency, with comparison to an age-, height-, and weight-matched Control group. Knee flexion, adduction and tibial rotation angles were measured and knee extension and abduction moment was calculated by inverse dynamics methods. RESULTS Females exhibited more tibial external rotation, in both the Control and ACL groups (P<0.05), which was not changed after ACL reconstruction. Prior to reconstruction, sagittal plane biomechanics were changed, in both males and females, compared to the Control groups (P<0.05). These abnormal sagittal plane mechanics were recovered at 12months, but not six months post-reconstruction. CONCLUSIONS We identified gender-based differences in tibial rotation that influenced the kinematics and kinetics of the knee over the stance phase of gait, both pre-operatively and post-ACL reconstruction. Evaluation of biomechanical effects of ACL injury, before and after reconstruction, should be separately evaluated for females and males.
Collapse
Affiliation(s)
- Makoto Asaeda
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Masataka Deie
- Department of Orthopedic surgery, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| | - Naoto Fujita
- Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Yoshifumi Kono
- Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Chiaki Terai
- Department of Rehabilitation, Nagoya University Hospital, 65 Tsuruma-cho, Showa-Ku, Nagoya, Aichi 466-8550, Japan
| | - Wataru Kuwahara
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Hodaka Watanabe
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Hiroaki Kimura
- Department of Rehabilitation, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Toru Sunagawa
- Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Mitsuo Ochi
- Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| |
Collapse
|
11
|
Kuwahara W, Deie M, Fujita N, Tanaka N, Nakanishi K, Sunagawa T, Asaeda M, Nakamura H, Kono Y, Ochi M. Characteristics of thoracic and lumbar movements during gait in lumbar spinal stenosis patients before and after decompression surgery. Clin Biomech (Bristol, Avon) 2016; 40:45-51. [PMID: 27821273 DOI: 10.1016/j.clinbiomech.2016.10.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 10/25/2016] [Accepted: 10/29/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although gait analysis has been previously conducted for lumbar spinal stenosis patients, the vertebral segmental movements, such as of the thoracic and lumbar regions, and whether the spinal movement during gait changes after decompression surgery remain unclear. METHODS Ten patients with lumbar spinal stenosis and 10 healthy controls participated. Clinical outcomes were assessed using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire and Visual Analogue Scale. Spinal kinematic data of the participants during gait were acquired using a three-dimensional motion analysis system. The trunk (whole spine), thoracic, and lumbar flexion and pelvic tilting values were calculated. Spinal kinematic data and clinical outcomes were collected preoperatively and 1month postoperatively for the patients. FINDINGS Compared to that observed preoperatively, the clinical outcomes significantly improved at 1month postoperatively. In the standing position, the preoperative lumbar extension of the patients was significantly smaller than that of the controls. Moreover, during gait, the lumbar flexion relative to the standing position of the patients was smaller than that of the controls preoperatively, and increased at 1month postoperatively. The sum of the thoracic and lumbar flexion values during gait negatively correlated with the score for leg pain. INTERPRETATION The epidural pressure of lumbar spinal stenosis patients is known to be higher than that of normal subjects during gait, and to decrease during walking with lumbar flexion. Preoperatively, smaller thoracic and lumbar flexion movements during gait relative to the standing position cannot decrease epidural pressure; as a result, severe leg pain might be induced.
Collapse
Affiliation(s)
- Wataru Kuwahara
- Health Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masataka Deie
- Department of Orthopaedic Surgery, Aichi Medical University, Aichi, Japan.
| | - Naoto Fujita
- Department of Musculoskeletal Functional Research and Regeneration, Hiroshima University, Hiroshima, Japan
| | - Nobuhiro Tanaka
- Department of Orthopaedic Surgery, Hiroshima University, Hiroshima, Japan
| | | | - Toru Sunagawa
- Department of Analysis and Control of Upper Extremity Function, Hiroshima University, Hiroshima, Japan
| | - Makoto Asaeda
- Health Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Haruka Nakamura
- Health Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yoshifumi Kono
- Department of Rehabilitation, Hiroshima University Hospital, Hiroshima, Japan
| | - Mitsuo Ochi
- Department of Orthopaedic Surgery, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
12
|
Asaeda M, Deie M, Shimada N, Orita N, Iwaki D, Kono Y, Terai C, Kuwahara W, Okamoto T, Watanabe H, Ochi M. Gait analysis after medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|