<b><span style="font-family:Verdana;">Background</span></b><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="f...<b><span style="font-family:Verdana;">Background</span></b><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">: </span></b></span></span></span></span><span><span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">Active rehabilitation of the paralyzed limb is necessary for functional recovery from upper limb paralysis after stroke. In particular, the </span><span style="font-family:Verdana;">amount of training is very important, and robot rehabilitation is useful. Howev</span><span style="font-family:Verdana;">er, most conventional robots are expensive, large, and stationary. We have d</span><span style="font-family:Verdana;">eveloped Rehabili-Mouse, a new tabletop rehabilitation robot that is compact and portable. The purpose of this study was to conduct paralyzed upper limb training for a patient after stroke using Rehabili-Mouse and to examine its effect.</span></span></span></span></span></span><span><span><span><span><span style="font-family:;" "=""> </span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Case</span></b></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">: </span></b></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The patient was a 44-year-old man who had left-sided paresis after a right cerebral infarction, 3 months after onset. The training was carried out between February 2021 and March 2021 at Oyu Rehabilitation Hot</span></span></span></span></span><span><span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">spring Hospital. The training was 20 minutes of Rehabili-Mouse in addition to 40 minutes of usual occupational therapy and performed five times a week </span><span style="font-family:Verdana;">for four weeks. Upper limb functions were evaluated before and after the t</span><span style="font-family:Verdana;">raining, and two questionnaires of patient satisfaction with the device and the training were administered after the completion of the training. Upper limb function improved. The patient’s satisfaction with the device was poor, but his satisfaction with the training was good.</span></span></span></span></span></span><span><span><span><span><span style="font-family:;" "=""> </span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Discussion</span></b></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">: </span></b></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Training for the paralyzed upper limb after stroke using Rehabili-Mouse improved upper limb function and satisfied the trained patient. We plan to increase the number of cases and conduct further studies.</span></span></span></span></span>展开更多
Coronal shear fractures of the femoral neck (CSFF) are the most challenging to treat among proximal femur fractures, directly affecting the life expectancy of patients with osteoporosis. However, an adequate osteosynt...Coronal shear fractures of the femoral neck (CSFF) are the most challenging to treat among proximal femur fractures, directly affecting the life expectancy of patients with osteoporosis. However, an adequate osteosynthesis method has not been elucidated yet. This study investigated the displacement direction of the femoral head fragment and its effect on the bone using finite element method. A finite element model for CSFF was developed from CT image data of a patient with osteoporosis using Mechanical Finder (ver. 11). Subsequently, finite element analyses were performed on six osteosynthesis models under maximum load applied during walking. The compressive stresses, tensile stresses, and compressive strains of each model were examined. The results suggested that the compressive and tensile stress distributions were concentrated on the anterior side of the femoral neck. Compressive strain distribution in the femoral head and neck was concentrated in four areas: at the tip of the blade or lag screw, the anteroinferior side of the blade or lag screw near the fracture site, and the upper right and lower left near the junction of the blade or lag screw and nail. Thus, the distribution of both these stresses revealed that the femoral head fragment was prone to anterior and inferior displacement. Distribution of compressive strains revealed the direction of the stress exerted by the osteosynthetic implant on the bone. The same results were observed in all osteosynthetic implants;thus, the findings could lay the foundation for developing methods for placing osteosynthetic implants less prone to displacement and the osteosynthetic implants themselves. In particular, the study provides insight into the optimal treatment of CSFF.展开更多
Background: Degeneration of the intervertebral disc is one of the causes of kyphosis. Several biomechanical studies have investigated the mechanisms of development of spinal deformity using simulation models. Realisti...Background: Degeneration of the intervertebral disc is one of the causes of kyphosis. Several biomechanical studies have investigated the mechanisms of development of spinal deformity using simulation models. Realistic musculoskeletal models are helpful for investigating the pathophysiology and changes in internal forces in patients with kyphosis. However, the association between intervertebral disc pressure and kyphosis has not been fully elucidated to date. Purpose: To calculate intervertebral disc pressure in elderly women with kyphosis using a novel and precise thoracolumbar three-dimensional musculoskeletal model. Materials and Method: Ten female patients with a mean age of 80.0 ± 6.5 years who visited our hospital for medical examination of osteoporosis were included. The subjects were divided into the normal and kyphosis groups depending on their sagittal vertical axis. Intervertebral disc pressures in the thoracic and lumbar spines of subjects were analyzed by inverse dynamics analysis using a novel three-dimensional musculoskeletal model, and were compared between the groups. Result: Significant differences in lumbar lordosis (LL) were observed between the two groups. Furthermore, the kyphosis group was older and shorter. In the kyphosis group, the upper thoracic vertebrae (T1 - T6) showed significantly higher intervertebral pressure than the normal group. Conclusion: Intervertebral disc pressure in the thoracic and lumbar spines of patients with spinal deformities was evaluated using a novel thoracolumbar three-dimensional musculoskeletal model. Using this novel model with separated thoracic spine and modified muscle path reflecting actual physiological curvature, disc pressure closer to the realistic condition was obtained. Intervertebral disc pressure in the upper thoracic spine in the kyphosis group was significantly increased compared with that in the normal group. Moreover, intervertebral disc pressures in the upper thoracic spine correlated negatively with LL.展开更多
文摘<b><span style="font-family:Verdana;">Background</span></b><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">: </span></b></span></span></span></span><span><span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">Active rehabilitation of the paralyzed limb is necessary for functional recovery from upper limb paralysis after stroke. In particular, the </span><span style="font-family:Verdana;">amount of training is very important, and robot rehabilitation is useful. Howev</span><span style="font-family:Verdana;">er, most conventional robots are expensive, large, and stationary. We have d</span><span style="font-family:Verdana;">eveloped Rehabili-Mouse, a new tabletop rehabilitation robot that is compact and portable. The purpose of this study was to conduct paralyzed upper limb training for a patient after stroke using Rehabili-Mouse and to examine its effect.</span></span></span></span></span></span><span><span><span><span><span style="font-family:;" "=""> </span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Case</span></b></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">: </span></b></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The patient was a 44-year-old man who had left-sided paresis after a right cerebral infarction, 3 months after onset. The training was carried out between February 2021 and March 2021 at Oyu Rehabilitation Hot</span></span></span></span></span><span><span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">spring Hospital. The training was 20 minutes of Rehabili-Mouse in addition to 40 minutes of usual occupational therapy and performed five times a week </span><span style="font-family:Verdana;">for four weeks. Upper limb functions were evaluated before and after the t</span><span style="font-family:Verdana;">raining, and two questionnaires of patient satisfaction with the device and the training were administered after the completion of the training. Upper limb function improved. The patient’s satisfaction with the device was poor, but his satisfaction with the training was good.</span></span></span></span></span></span><span><span><span><span><span style="font-family:;" "=""> </span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Discussion</span></b></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">: </span></b></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Training for the paralyzed upper limb after stroke using Rehabili-Mouse improved upper limb function and satisfied the trained patient. We plan to increase the number of cases and conduct further studies.</span></span></span></span></span>
文摘Coronal shear fractures of the femoral neck (CSFF) are the most challenging to treat among proximal femur fractures, directly affecting the life expectancy of patients with osteoporosis. However, an adequate osteosynthesis method has not been elucidated yet. This study investigated the displacement direction of the femoral head fragment and its effect on the bone using finite element method. A finite element model for CSFF was developed from CT image data of a patient with osteoporosis using Mechanical Finder (ver. 11). Subsequently, finite element analyses were performed on six osteosynthesis models under maximum load applied during walking. The compressive stresses, tensile stresses, and compressive strains of each model were examined. The results suggested that the compressive and tensile stress distributions were concentrated on the anterior side of the femoral neck. Compressive strain distribution in the femoral head and neck was concentrated in four areas: at the tip of the blade or lag screw, the anteroinferior side of the blade or lag screw near the fracture site, and the upper right and lower left near the junction of the blade or lag screw and nail. Thus, the distribution of both these stresses revealed that the femoral head fragment was prone to anterior and inferior displacement. Distribution of compressive strains revealed the direction of the stress exerted by the osteosynthetic implant on the bone. The same results were observed in all osteosynthetic implants;thus, the findings could lay the foundation for developing methods for placing osteosynthetic implants less prone to displacement and the osteosynthetic implants themselves. In particular, the study provides insight into the optimal treatment of CSFF.
文摘Background: Degeneration of the intervertebral disc is one of the causes of kyphosis. Several biomechanical studies have investigated the mechanisms of development of spinal deformity using simulation models. Realistic musculoskeletal models are helpful for investigating the pathophysiology and changes in internal forces in patients with kyphosis. However, the association between intervertebral disc pressure and kyphosis has not been fully elucidated to date. Purpose: To calculate intervertebral disc pressure in elderly women with kyphosis using a novel and precise thoracolumbar three-dimensional musculoskeletal model. Materials and Method: Ten female patients with a mean age of 80.0 ± 6.5 years who visited our hospital for medical examination of osteoporosis were included. The subjects were divided into the normal and kyphosis groups depending on their sagittal vertical axis. Intervertebral disc pressures in the thoracic and lumbar spines of subjects were analyzed by inverse dynamics analysis using a novel three-dimensional musculoskeletal model, and were compared between the groups. Result: Significant differences in lumbar lordosis (LL) were observed between the two groups. Furthermore, the kyphosis group was older and shorter. In the kyphosis group, the upper thoracic vertebrae (T1 - T6) showed significantly higher intervertebral pressure than the normal group. Conclusion: Intervertebral disc pressure in the thoracic and lumbar spines of patients with spinal deformities was evaluated using a novel thoracolumbar three-dimensional musculoskeletal model. Using this novel model with separated thoracic spine and modified muscle path reflecting actual physiological curvature, disc pressure closer to the realistic condition was obtained. Intervertebral disc pressure in the upper thoracic spine in the kyphosis group was significantly increased compared with that in the normal group. Moreover, intervertebral disc pressures in the upper thoracic spine correlated negatively with LL.
