Hideki Arakawa

Bio: Hideki Arakawa is an academic researcher from University of Miyazaki. The author has contributed to research in topics: Medicine & Stage (stratigraphy). The author has an hindex of 1, co-authored 9 publications receiving 1 citations.

Total Knee Arthroplasty Improved Locomotive Syndrome in Knee Osteoarthritis Patients: A Prospective Cohort Study Focused on Total Clinical Decision Limits Stage 3

Abstract: Purpose The purpose of this study is to investigate the treatment efficacy of total knee arthroplasty (TKA) on locomotive syndrome (LS) focusing on total clinical decision limit (CDL) stage 3 leading to revealing the motor function indicators that can predict LS improvement in knee osteoarthritis patients who had received TKA. Methods This prospective cohort study was conducted in 47 patients evaluated as total CDL stage 3 before TKA who received primary TKA on the operated side and were diagnosed with Kellgren-Lawrence grade 2, 3, or 4 knee osteoarthritis on the nonoperated side. LS was evaluated using stand-up test, two-step test, and 25-Question Geriatric Locomotive Function Scale. In addition, the motor function indicators which could predict the LS improvement were examined. All assessments were conducted before TKA and three months after TKA. Results Of the 47 subjects who were evaluated to be in total CDL stage 3 before TKA, 13 patients (27.7%) were determined to show improvements in total CDL. From the result of the decision tree analysis, when the CDL of the two-step test before TKA was 1 or less, the improvement rate was 83.3%. Even if the CDL of the two-step test before TKA was higher than 1 and if the 3 m-Timed Up and Go test (3m-TUG) before TKA was 9.6 or less, the improvement rate was 50%. Conclusions As of three months after surgery, TKA can improve LS in about 30% of knee osteoarthritis patients. A two-step test before TKA and 3m-TUG before TKA can be used as motor function indicators to predict LS improvement. This study provides useful information for setting the goal for rehabilitation prior to surgery.

Relationship between whether the planned discharge destination is decided and locomotive syndrome for admitted patients in psychiatric long-term care wards

Abstract: Objective We focused on locomotive syndrome as a low physical function factor that may prevent patients with psychiatric disease from being discharged. The purpose of this study is to clarify the factors, including locomotive syndrome, that prevent discharge from psychiatric long-term care wards. Method We enrolled 74 patients who were admitted to psychiatric long-term care wards at three different hospitals in Japan. Nurses or medical social workers in the ward were asked whether the planned discharge destination had been decided, and patients were categorized into a decided group and an undecided group. Outcome measures were age, sex, F code in the ICD-10 Classification of Mental and Behavioral Disorders, length of stay, chlorpromazine equivalent dose of antipsychotics, locomotive syndrome test scores (25-question GLFS, two-step test, stand-up test), and Barthel Index. Results Based on the multivariate logistic regression analysis results, the length of stay and the two-step test score significantly explained the difference between the two groups. The odds ratio of a length of stay greater than 10 years was 8.42 times that of a length of stay less than 2 years (P=0.012, 95% CI=1.59, 44.53). Regarding the twostep test, the odds ratio for obtaining stage 2 was 10.62 times that for obtaining stage 0 (P=0.013, 95% CI=1.65, 68.23). Conclusion Those who with longer length of stays and lower two-step test scores tended not to be decided the planned discharge destination.

A Hand-Worn Inertial Measurement Unit for Detection of Bat-Ball Impact during Baseball Hitting.

Abstract: Swinging a baseball bat at a pitched ball takes less than half of a second. A hitter uses his lower extremities to generate power, and coordination of the swing motion gradually transfers power through the trunk to the upper extremities during bat–ball impact. The most important instant of the baseball swing is at the bat–ball impact, after which the direction, speed, height, and distance of the hit ball determines whether runs can be scored. Thus, analyzing the biomechanical parameters at the bat–ball impact is useful for evaluating player performance. Different motion-capture systems use different methods to identify bat–ball impact. However, the level of accuracy to detect bat–ball impact is not well documented. The study aim was to examine the required accuracy to detect bat–ball impact timing. The results revealed that ±2 ms accuracy is required to report trunk and hand kinematics, especially for higher-order time-derivatives. Here, we propose a new method using a hand-worn inertial measurement unit to accurately detect bat–ball impact timing. The results of this study will be beneficial for analyzing the kinematics of baseball hitting under real-game conditions.

Exploring whole-body kinematics when eating real foods with the dominant hand in healthy adults

Abstract: Despite the importance of eating movements to the rehabilitation of neurological patients, information regarding the normal kinematics of eating in a realistic setting is limited. We aimed to quantify whole-body three-dimensional kinematics among healthy individuals by assessing movement patterns in defined phases while eating real food with the dominant hand in a seated position. Our cross-sectional study included 45 healthy, right-hand dominant individuals with a mean age of 27.3 ± 5.1 years. Whole-body kinematics (joint angles of the upper limb, hip, neck, and trunk) were captured using an inertial sensor motion system. The eating motion was divided into four phases for analysis: reaching, spooning, transport, and mouth. The mean joint angles were compared among the phases with Friedman’s analysis of variance. The maximum angles through all eating phases were 129.0° of elbow flexion, 32.4° of wrist extension, 50.4° of hip flexion, 6.8° of hip abduction, and 0.2° of hip rotation. The mean shoulder, elbow, and hip joint flexion angles were largest in the mouth phase, with the smallest being the neck flexion angle. By contrast, in the spooning phase, the shoulder, elbow, and hip flexion were the smallest, with the largest being the neck flexion angle. These angles were significantly different between the mouth and spooning phases (p < 0.008, Bonferroni post hoc correction). Our results revealed that characteristic whole-body movements correspond to each phase of realistic eating in healthy individuals. This study provides useful kinematic data regarding normal eating movements, which may inform whole-body positioning and movement, improve the assessment of eating abilities in clinical settings, and provide a basis for future studies.

Comparison of the Psychometric Characteristics of the Functional Independence Measure, 5 Item Barthel Index, and 10 Item Barthel Index in Patients with Stroke

Abstract: Objectives: To compare the reliability, validity, and responsiveness of the motor subscale of the functional independence measure (FIM), the original 10 item Barthel index (BI), and the 5 item short form BI (BI-5) in inpatients with stroke receiving rehabilitation. Methods: 118 inpatients with stroke at a rehabilitation unit participated in the study. The patients were tested with the FIM motor subscale and original BI at admission to the rehabilitation ward and before discharge from the hospital. The distribution, internal consistency, concurrent validity, and responsiveness of each measure were examined. Results: The BI and FIM motor subscale showed acceptable distribution, high internal consistency (α coefficient ≥ 0.84), high concurrent validity (Spearman's correlation coefficient, rs ≥ 0.92, intraclass correlation coefficient (ICC) ≥ 0.83), and high responsiveness (standardised response mean ≥ 1.2, p < 0.001). The BI-5 exhibited a notable floor effect at admission but this was not found at discharge. The BI-5 showed acceptable internal consistency at admission and discharge (α coefficient ≥ 0.71). The concurrent validity of the BI-5 was poor to fair at admission (rs = 0.74, ICC ≤ 0.55) but was good at discharge (rs ≥ 0.92, ICC ≥ 0.74). It is noted that the responsiveness of the BI-5 was as high as that of the BI and the FIM motor subscale. Conclusions: The results showed that the BI and FIM motor subscale had very acceptable and similar psychometric characteristics. The BI-5 appeared to have limited discriminative ability at admission, particularly for patients with severe disability; otherwise the BI-5 had very adequate psychometric properties. These results may provide information useful in the selection of activities of daily living measures for both clinicians and researchers.

HURWA robotic-assisted total knee arthroplasty improves component positioning and alignment – A prospective randomized and multicenter study

Abstract: The objective of this study was to compare the radiologic and clinical outcomes of HURWA robotic-assisted total knee arthroplasty (TKA) to those of conventional TKA.A total of 150 patients were randomized into two groups - 73 and 77 patients underwent robotic-assisted TKA and conventional TKA, respectively. Preoperative and postoperative Western Ontario McMaster University Osteoarthritis Index (WOMAC) score, Hospital for Special Surgery (HSS) score, 36-item Short Form Health Survey (SF-36) score, Knee Society Score (KSS) and range of motion (ROM) were obtained and compared between these two groups. The preoperative and postoperative hip-knee-ankle (HKA) angle and the rate of HKA≤3° in the two groups were also compared.The postoperative mean HKA angle was 1.801° ​± ​1.608° of varus for the robotic-assisted TKA group and 3.017° ​± ​2.735° of varus for the conventional TKA group; these values were significantly different. The alignment rate for mechanical axis lower than 3° in the robotic-assisted TKA group and the conventional TKA group were 81.2% and 63.5%, respectively. Patients undergone robotic-assisted TKA or conventional TKA had similarly improved knee flexion and functional recovery reflected by WOMAC score, HSS score, SF-36 score and KSS.HURWA robotic-assisted TKA is a safe and effective, resulting in better alignment for mechanical axis than conventional TKA. The improvement in knee flexion and functional recovery after HURWA robotic-assisted TKA were similar to those after conventional TKA. However, longer follow-up is needed to determine whether the improved alignment of mechanical axis will produce better long-term clinical outcomes.Recently, the robotic-assisted TKA system has been introduced to clinical practice for TKA. Several robotic-assisted TKA systems, including CASPAR, Tsolution, ROSA, ROBODOC and Mako, have been implemented into clinical application.However, the clinical application of these robotic systems was limited due to their technical complexity, insufficient versatility and increased operative time. Until now, there are still no robotic-assisted TKA systems approved by the National Medical Products Administration of China. Therefore, more robotic-assisted TKA systems need to be designed and improved, particularly in China. Through our randomized, multicenter, single blind and parallel controlled trial, we showed that HURWA robot-assisted TKA system is a safe and effective system for TKA, which had improved knee flexion.

Development of a Novel Approach for Detection of Equine Lameness Based on Inertial Sensors: A Preliminary Study

Abstract: Both as an aid for less experienced clinicians and to enhance objectivity and sharp clinical skills in professionals, quantitative technologies currently bring the equine lameness diagnostic closer to evidence-based veterinary medicine. The present paper describes an original, inertial sensor-based wireless device system, the Lameness Detector 0.1, used in ten horses with different lameness degrees in one fore- or hind-leg. By recording the impulses on three axes of the incorporated accelerometer in each leg of the assessed horse, and then processing the data using custom-designed software, the device proved its usefulness in lameness identification and severity scoring. Mean impulse values on the horizontal axis calculated for five consecutive steps above 85, regardless of the leg, indicated the slightest subjectively recognizable lameness, increasing to 130 in severe gait impairment. The range recorded on the same axis (between 61.2 and 67.4) in the sound legs allowed a safe cut-off value of 80 impulses for diagnosing a painful limb. The significance of various comparisons and several correlations highlighted the potential of this simple, affordable, and easy-to-use lameness detector device for further standardization as an aid for veterinarians in diagnosing lameness in horses.

Biomechanical effect of metal augment and bone graft on cup stability for acetabular reconstruction of total hip arthroplasty in hip dysplasia: a finite element analysis

Abstract: Different methods of acetabular reconstruction with total hip arthroplasty (THA) for Crowe II and III of adult developmental dysplasia of the hip (DDH) acetabular bone defect have been implemented clinically. However, the biomechanical effect of different augmented materials for acetabular reconstruction in THA on shell stability has never been discussed.In the present study, autologous bone graft (BG)and metal (Ti6Al4V) augment (MA) were simulated with several acetabular bone defect models of DDH in THA. The contact pressure and micromotion between the shell and host bone were measured for evaluating the shell stability using a finite element method.The peak contact stress between shell and host bone was higher in the MA situation (12.45 vs 8.71 MPa). And the load transfer path was different, for BG models, the high local contact stresses were found at the junction of bone graft and host bone while for MA models the concentrated contact stresses were at the surface of MA. The peak relative micromotion between shell and host bone was higher in the MA situation (12.61 vs 11.13 µm). However, the peak micromotion decreased in the contact interface of MA and cup compared to the BG models.The higher micromotion was found in MA models, however, enough for bone ingrowth, and direct stronger fixation was achieved in the MA-cup interface. Thus, we recommended the MA can be used as an option, even for Crowe III, however, the decision should be made from clinical follow-up results.

A cutoff value for body composition on the severity of locomotive syndrome in Japanese older women: A cross-sectional study.

Abstract: We aimed to investigate the relationship between body compositions and locomotive syndrome in older women and derive body composition cutoff values to evaluate locomotive syndrome severity. In total, 236 women were included in this study. The percentage of body fat and skeletal muscle mass index was measured using multi-frequency bioelectrical impedance analysis. The locomotive syndrome severity (stage 0-3) was determined using the standup test, the two-step test, and a self-administered questionnaire. The receiver operating characteristic curve analysis indicated that the cutoff value for body fat percentage was 33.1% for locomotive syndrome stage 1 in women. This finding may aid in designing exercise and nutritional interventions to prevent locomotive syndrome in older women.