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Neurorehabilitation using a voluntary driven exoskeletal robot improves trunk function in patients with chronic spinal cord injury: a single-arm study

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Neural Regeneration Research 2022年第2期17卷 427-432页

作者： Hiroki Okawara Syoichi Tashiro Tomonori Sawada Keiko Sugai Kohei Matsubayashi Michiyuki Kawakami Satoshi Nori Osahiko Tsuji Narihito Nagoshi Morio Matsumoto Masaya Nakamura Department of Orthopaedic Surgery Keio University School of MedicineTokyoJapan Department of Rehabilitation Medicine Keio University School of MedicineTokyoJapan Department of Orthopedic Surgery National Hospital OrganizationMurayama Medical CenterTokyoJapan

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.

关键词： body weight-supported treadmill training gait disorders hybrid assistive limb neurologic neurophysiotherapy postural balance precision medicine robot-assisted gait training robotics spinal cord injury trunk

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“OMINO”: A Modern Approach to Postural Standing Reeducation through Breathing Techniques

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Health 2024年第5期16卷 383-394页

作者： Maria Chiara Patriarca Medicine and Rehabilitation Department Faculty of Medicine and Surgery Catholic University of Holy Heart Rome Italy

Postural problems are very common, which is why plenty of Techniques have been created to solve them: Mezieres Technique (including muscle chains), RPG (Global Postural Re-Education, including pelvic diaphragm), Pilates Method (including core muscles), Bobath Concept (including COG, center of gravity) and Yoga. In this work, I show a new way of treating and solving postural problems. I am basing this physiotherapy approach on a new Image I created. Every patient can use it for every correction and change in posture. I called the new Image: “OMINO (little man)”. “Postural Card” could be a good work to make “OMINO” possible. “OMINO” is immediately understandable and, using “OMINO POCKET INSTRUCTIONS”, it can be easily done. Contribution of paper: • trunk is a vital element for any kind of rehabilitation;• “Core stability” is the key to activating the trunk. • Doing “OMINO” means working on “core stability”;• “OMINO” makes rehabilitation simple for the patient.

关键词： trunk Core Stability “OMINO” Patient Rehabilitation

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Corticoreticular tract lesion in children with developmental delay presenting with gait dysfunction and trunk instability

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Neural Regeneration Research 2017年第9期12卷 1465-1471页

作者： Yong Min Kwon Jessica Rose Ae Ryoung Kim Su Min Son Department of Physical Medicine and Rehabilitation College of Medicine Yeungnam University Department of Orthopedic Surgery College of Medicine Stanford University

The corticoreticular tract （CRT） is known to be involved in walking and postural control. Using diffusion tensor tractography （DTT）, we investigated the relationship between the CRT and gait dysfunction, includ- ing trunk instability, in pediatric patients. Thirty patients with delayed development and 15 age-matched, typically-developed （TD） children were recruited. Fifteen patients with gait dysfunction （bilateral trunk instability） were included in the group A, and the other 15 patients with gait dysfunction （unilateral trunk instability） were included in the group B. The Growth Motor Function Classification System, Functional Ambulation Category scale, and Functional Ambulation Category scale were used for measurement of functional state. Fractional anisotropy, apparent diffusion coefficient, fiber number, and tract integrity of the CRT and corticospinal tract were measured. Diffusion parameters or integrity of corticospinal tract were not significantly different in the three study groups. However, CRT results revealed that both CRTs were disrupted in the group A, whereas CRT disruption in the hemispheres contralateral to clinical mani- festations was observed in the group B. Fractional anisotropy values and fiber numbers in both CRTs were decreased in the group A than in the group TD. The extents of decreases of fractional anisotropy values and fiber numbers on the ipsilateral side relative to those on the contralateral side were greater in the group B than in the group TD. Functional evaluation data and clinical manifestations were found to show strong correlations with CRT status, rather than with corticospinal tract status. These findings suggest that CRT status appears to be clinically important for gait function and trunk stability in pediatric patients and DTT can help assess CRT status in pediatric patients with gait dysfunction.

关键词： nerve regeneration corticoreticular tract corticospinal tract gait trunk diffusion tensor trunk Control Measurement Scale Functional Ambulation Category Growth Motor Function Classification System cerebral palsy motor neural regeneration

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Association between cardiopulmonary bypass time and 90-day postoperative mortality in patients undergoing arch replacement with the frozen elephant trunk: a retrospective cohort study

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Chinese Medical Journal 2019年第19期132卷 2325-2332页

作者： Jun Zheng Shang-Dong Xu You-Cong Zhang Kai Zhu Hui-Qiang Gao Kai Zhang Xiu-Feng Jin Tong Liu Center of Cardiac Surgery Beijing Aortic Disease CenterBeijing Institute of HeartLung and Blood Vessel DiseaseBeijing Anzhen HospitalCapital Medical UniversityBeijing 100029China Center of Cardiology Beijing Institute of HeartLung and Blood Vessel DiseaseBeijing Anzhen HospitalCapital Medical UniversityBeijing 100029China

Background:The aortic arch replacement and cardiopulmonary bypass(CPB)are both associated with the early mortality after cardiothoracic surgery.This study aimed to investigate the relationship between CPB time and 90-day post-operative mortality in patients undergoing aortic arch surgery using the frozen elephant trunk(FET)technique with selective ante-grade cerebral perfusion(SACP).Methods:We retrospectively reviewed data of 377 adult patients undergoing aortic arch surgery via FET with SACP from July 1,2017 to December 31,2018 at Beijing Anzhen Hospital.The baseline characteristics,intra-operative data,and post-operative data were collected.Univariate and multivariate Cox regression analyses were used to determine independent predictors of 90-day postoperative mortality.Results:The 90-day post-operative mortality was 13.53%.The 78.51%of patients were men.There were 318(84.35%)type A aortic dissections and 28(7.43%)aortic aneurysms.Among those,264(70.03%)were emergency operations.Median CPB time was 202.0(176.0,227.0)min.Multivariate Cox regression analysis revealed that CPB time was independently associated with 90-day post-operative mortality after adjusting confounding factors(hazard ratio:1.21/10 min increase in CPB time,95%confidence interval:1.15–1.27,P<0.001).Kaplan-Meier analysis based on CPB time tertiles revealed that the top tertile(median 236.0 min)was associated with reduced survival rate compared with middle and bottom tertiles(P<0.001).Each sub-group analysis based on the complexity of the underlying disease process showed similar associations between CPB time and 90-day post-operative mortality.Conclusions:CPB time remains a significant factor in determining 90-day post-operative mortality in patients undergoing aortic arch surgery using FET with SACP.Surgeons should be aware of the relationship between CPB time and 90-day post-operative mortality during operative procedures and avoid extended CPB time as far as possible.

关键词： Aortic arch replacement Moderate hypothermia circulatory arrest Selective ante-grade cerebral perfusion Frozen elephant trunk Cardiopulmonary bypass time Mortality

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Bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome: A case report

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World Journal of Clinical Cases 2019年第21期7卷 3639-3648页

作者： Yuan-Yuan Sun Guo-Ming Zhang You-Bin Zhang Xin Du Mao-Long Su Department of Ultrasound Xiamen Cardiovascular Hospital Xiamen UniversityXiamen 361000Fujian ProvinceChina Department of Cardiology Xiamen Cardiovascular Hospital Xiamen UniversityXiamen 361000Fujian ProvinceChina Department of Radiology Zhongshan Hospital Xiamen UniversityXiamen 361000Fujian ProvinceChina

BACKGROUND We report a rare case of numbness in the right hand,finally diagnosed as bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome and explain the cause of these diseases.CASE SUMMARY The patient was a 65-year-old woman.She complained of dizziness,numbness and weakness of the right hand for 6 mo.She was diagnosed with bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome by ultrasound,enhanced computed tomography,computed tomography angiography and other examinations.Considering the surgical risks,the patient refused the aberrant right subclavian artery stent implantation and was discharged.We hypothesize that these two kinds of deformity and right subclavian steal syndrome may not occur by accident and result from multiple malformations.CONCLUSION Bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome is rare.This case reminds interventional radiologists of the possibility of these abnormalities before surgery.

关键词： Bilateral common carotid artery common trunk Aberrant right subclavianartery Right subclavian steal syndrome Case report

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Pulmonary arterial stent for pulmonary trunk stenosis after size-mismatched lung transplantation

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Chinese Medical Journal 2019年第10期132卷 1247-1249页

作者： Fei Xiao Chao-Yang Liang Wen-Hui Chen Min Li Xin-Cao Tao He Chen Jing-Yu Chen Department of Thoracic Surgery China-Japan Friendship Hospital Beijing 100029 China Department of Lung Transplantation China-Japan Friendship Hospital Beijing 100029 China Department of Pulmonary and Critical Care Medicine China-Japan Friendship Hospital Beijing 100029 China Department of Radiology China-Japan Friendship Hospital Beijing 100029 China

To the Editor: Appropriate donor-to-recipient size matching is of crucial importance in lung transplantation. Although tailoring of the lung has been described as a successful means of overcoming size disparities, its merits and demerits remain unclear. Here, we present a case of recurrent hypoxemia after unmatched single lung transplantation.

关键词： pulmonary trunk stenosis Pulmonary arterial lung transplantation

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Motion Analysis of trunk Using Simplified Human Model in Sagittal Plane

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Transactions of Nanjing University of Aeronautics and Astronautics 2018年第1期35卷 20-27页

作者： Masato Kawaguchi Shoichiro Takehara Division of Mechanical Engineering Graduate School of Science and TechnologySophia University Department of Engineering and Applied Sciences Sophia University

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.

关键词： human dynamics trunk simulation human body vehicles

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Neuromuscular trunk activation patterns in back pain patients during one-handed lifting

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World Journal of Orthopedics 2017年第2期8卷 142-148页

作者： Juliane Mueller Tilman Engel Stephan Kopinski Frank Mayer Steffen Mueller University Outpatient Clinic Sports Medicine and Sports OrthopaedicsUniversity of Potsdam

AIM To analyze neuromuscular activity patterns of the trunk in healthy controls(H) and back pain patients(BPP) during one-handed lifting of light to heavy loads. METHODS After assessment of back pain(graded chronic pain scale according to von Korff) all subjects(n = 43) performed a warm-up(treadmill walking). Next, subjects were instructed to lift 3 × a 20 kg weight placed in front of them(with both hand) onto a table(height: 0.75 m). Subsequently, all subjects lifted with one hand(left-side, 3 repetitions) a weight of 1 kg(light), 10 kg(middle) and 20 kg(heavy) in random order from the ground up onto the table left of them. trunk muscle activity was assessed with a 12-lead EMG(6 ventral/6 dorsal muscles; 4000 Hz). EMG-RMS(%) was averaged over the 3 repetitions and analyzed for the whole one-handed lifting cycle, then normalized to RMS of the two-handed lifting. Additionally, the mean(normalized) EMG-RMS of four trunk areas [right/left ventral area(VR/VL); right/left dorsal area(DR/DL)] was calculated. Data were analyzed descriptively(mean ± SD) followed by student's t-test comparing H and BPP(α = 0.05). With respect to the unequal distribution of subjects in H and BPP, a matched-group analysis was conducted. Seven healthy controls were gender- and age-matched(group H_(matched)) to the 7 BPP. In addition, task failure was calculated and compared between H/H_(matched) vs BPP using χ~2. RESULTS Seven subjects(3m/4f; 32 ± 7 years; 171 ± 7 cm; 65 ± 11 kg) were assigned to BPP(pain grade ≥ 2) and 36(13m/23f; 28 ± 8 years; 174 ± 10 cm; 71 ± 12 kg) to H(pain grade ≤ 1). H and BPP did not differ significantly in anthropometrics(P > 0.05). All subjects were able to lift the light and middle loads, but 57% of BPP and 22% of H were not able to lift the heavy load(all women). χ~2 analysis revealed statistically significant differences in task failure between H vs BPP(P = 0.03). EMG-RMS ranged from 33% ± 10%/30% ± 9%(DL, 1 kg) to 356% ± 148%/283% ± 80%(VR, 20 kg) in H/BPP with no statistical difference between groups regardle

关键词： Lifting Core trunk EMG MISPEX

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Does not acupuncture at nerve trunk belong to acupuncture of traditional Chinese medicine?

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World Journal of Acupuncture-Moxibustion 2019年第1期29卷 33-36页

作者：徐晶贾春生河北中医学院针灸推拿学院

With the reason that its therapeutic effect is related to neurotomy, acupuncture at nerve trunk is taken as an independent therapy from acupuncture of traditional Chinese medicine(TCM) in aspect of its origination and development. Through acupuncture literature study, the authors consulted many acupuncture therapies that is related to nerve trunk from ancient time to present. In association with current progress of mechanism study of acupuncture, it is believed that acupuncture at nerve trunk has been the therapy in the scope of acupuncture from the ancient time, rather than an independent acupuncture therapy out of the scope of acupuncture in TCM.

关键词： Acupuncture Nerve trunk Acupuncture of traditional Chinese medicine

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Wooden foreign body impalement through the right shoulder region–an unusual penetrating injury:A case report

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World Journal of Orthopedics 2022年第12期13卷 1064-1068页

作者： Abhay Harsh Kerketta Ritesh Kumar Seelora Sahu Jayanta Kumar Laik Manoj Kumar Rajak Department of Joint Replacement and Orthopaedics Tata Main HospitalSinghbhum 831001JharkhandIndia Department of Anaesthesiology Tata Main HospitalJamshedpur 831001JharkhandIndia

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.

关键词： Impaling Wooden Foreign body Sharp object trunk Case report

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