Biomedical subjects

A Tokuhiro

Publications and source records attributed to A Tokuhiro.

8 recordsLinked to original sources

PubMed1997

A survey of wheelchair use by paraplegic individuals in Japan. Part 1: Characteristics of wheelchair cushions.

The characteristics of wheelchair cushions used by 218 paraplegic patients who lived independent lives were surveyed to clarify the present state of wheelchair cushioning for pressure sore prevention in Japan. Out of 586 cushions surveyed, 91.0% were ready-made and the rest were custom-made. The outstanding popularity of polyurethane foam ready-made cushions (76.3%) suggested that insufficient consideration was taken in the selection of cushions. Custom-made cushions displayed unique modifications to relieve contact pressure or to stabilize sitting posture, which should be systematically provided for all patients. The variety of cushion types and the frequent dissatisfaction with cushions seen in patients with current pressure sores suggested a strong demand for the effective prescription of cushions. Furthermore, 30% of all cushions had had an excessively prolonged use, indicating insufficient follow-up. A medical system including deliberate prescription and regular follow-up of wheelchair cushions should be established for the effective prevention of pressure sores.

Adolescent↗

PubMed1997

A survey of wheelchair use by paraplegic individuals in Japan. Part 2: Prevalence of pressure sores.

A cross-sectional survey was done to clarify the incidence of pressure sores in 218 self-supported Japanese paraplegic patients and to determine effective measures for prevention. The majority of patients (85.7%) had previous pressure sores, and 46.3% had undergone multiple surgeries. Some patients (17.9%) were still suffering from persistent sores which commonly developed at the ischial tuberosities, suggesting insufficiency of self-care practice during wheelchair activities. Sensory disturbance over the seating surface, urinary incontinence, and general complications were seen in 85.8%, 49.5%, and 18.8% of total subjects, respectively. They were seen as risk factors for pressure sores, but only urinary incontinence clearly increased the current pressure sore prevalence. Nevertheless, both self-care practice and sports activities, seen in 85.3% and 36.2% of total subjects, respectively, contributed to greatly reduce the incidence. A patient education system including acquisition of basic knowledge and proper technique should be established to promote effective prevention of pressure sores in Japan.

Adolescent↗

PubMed1997

Survey of above knee (A/K) prostheses currently used in the Chugoku-Shikoku district of Japan.

To determine the extent to which recent advances in biomechanical technology have been implemented and to evaluate these new technologies, 84 unilateral above knee (A/K) amputees and their prostheses were surveyed in the Chugoku-Shikoku district of Japan, especially in regard to the types, sockets and components of A/K prostheses currently in use. Background factors such as age and sex of the A/K amputees and the period after amputation were also surveyed. Of the 84 amputees surveyed, 74 (88.1%) were over 40 years old and 40 (47.6%) were over 60 years old. There were 10 women (11.9%) and 74 men (88.1%). The period after amputation was under 25 years in 58 (69.0%) cases. Regarding the type of A/K prostheses, one-third of the prostheses was of the exoskeletal type and two-thirds were of the endoskeletal type. Although the endoskeletal type is becoming more popular recently, elderly A/K amputees tend to use the exoskeletal type. Thirty-one (36.9%) had plug-fit sockets which are preferable for those who follow the Japanese practice of sitting on the floor, especially for elderly amputees. Thirty-seven (44.0%) had a lock-knee, 27 (73.0%) of which were used by amputees over 60 years old. Seventy-three (86.9%) had a single-axis ankle which is generally considered to be the most stable ankle. Thus, the most common combination of prosthetic components for elderly A/K amputees was the plug-fit socket, lock-knee joint and single-axis ankle.

Adult↗

PubMed1995

Kinesiological study of push-up motion using a three-dimensional floor reaction on a force plate.

To find an effective way to handle wheelchairs, 3-dimensional floor reactions of the hand and angular deviation of the elbow and wrist joints during push-up motion were studied in 10 healthy men. The push-up was carried out using 3 hand positions (fist, finger and palm) and a push-up device. In all hand positions, anteroposterior force (Fx) and the mediolateral force (Fy) appeared after the vertical force (Fz). The end point of Fx and Fy was observed before that of Fz. Among the 4 different hand positions, Fx and Fy appeared first in the palm, followed by the finger and fist positions, and lastly in the push-up devices. The results indicate that the more unstable pushing-up the body is, the earlier and longer Fx and Fy are. Thus, Fx and Fy are considered to be good indicators of body balance during the push-up motion. The elbow joint showed a hyperextended position only when using the palm position in the maintenance phase. The wrist joint showed palmar flexion only when using the fist position.

Adult↗

PubMed1993

Spinal cord injuries in Okayama Prefecture: an epidemiological study '88-'89.

An epidemiological survey of spinal cord injury in Okayama Prefecture was carried out by reviewing the registration lists contained in the Law for the Welfare of the Physically Disabled. The authors computed the annual incidence of spinal cord injuries (SCI) in Okayama Prefecture (April 1988-March 1989) to be 49.0 (28.6 for traumatic cases) per one million inhabitants from a population of 1,920,000. In addition, distribution by age, aetiology, paralysis level and residential area were investigated.

Adolescent↗

PubMed1993

Stump problems in traumatic amputation.

Stump problems in amputations resulting from employment related injuries were investigated in 397 cases in the Chugoku and Shikoku districts of Japan between 1987 and 1991. Ninety-seven patients (24%) had stump problems which interfered the prosthetic fitting. Stump problems of the upper extremity were seen in about 9% (17 amputees), two thirds of which were skin troubles. Stump problems of the lower extremity were seen in about 37% (80 amputees). Certain complaints were associated with specific methods of amputation; abnormal keratosis in Syme's amputation, equinus deformity in Chopart's amputation, reduced muscle power in above the knee (A/K) amputation and joint dysfunction in below the knee (B/K) amputation. Adequate prosthetic fitting was achieved by the modification of the socket and alignment in almost all amputees with stump problems. In only two cases, Chopart's amputation required subsequent Syme's amputation due to equinus deformity with abnormal keratosis. In almost every case, stump problems are avoidable by means of surgeons' deliberate evaluation of the affected limb and adequate choice of the amputation level.

Accidents, Occupational↗

PubMed1991

Gait analysis of slope walking: a study on step length, stride width, time factors and deviation in the center of pressure.

Determination was made of step length, stride width, time factors and deviation in the center of pressure during up- and downslope walking in 17 healthy men between the ages of 19 and 34 using a force plate. Slope inclinations were set at 3, 6, 9 and 12 degrees. At 12 degrees, walking speed, the product of step length and cadence, decreased significantly (p less than 0.01) in both up- and downslope walking. The most conspicuous phenomenon in upslope walking was in cadence. The steeper the slope, the smaller was the cadence. The most conspicuous phenomenon in downslope walking was in step length. The steeper the slope, the shorter was the step length.

Adult↗

PubMed1985

Electromyographic kinesiology of lower extremity muscles during slope walking.

To investigate the phasic activity of the lower extremity muscles during up- and downslope walking, five muscles of ten healthy men were examined by telemetered electromyography (EMG). The muscles were the tibialis anterior (TA), gastrocnemius (Gc), rectus femoris (RF), semitendinosus (St) and gluteus maximus (GM). The inclination of the slope was 3, 6, 9 and 12 degrees. EMG of the muscles and the time factors of a walking cycle were recorded by a 12-channel polygraph simultaneously. In upslope walking, the duration of TA, St and GM activity was longer and that of RF activity was shorter than in level walking. The phasic pattern of Gc in upslope walking was the same as in level walking. In downslope, the duration of Gc and RF activity was longer than on the level. St showed biphasic activities. The phasic pattern of TA and GM was nearly the same as in level walking. The phasic activity of the muscles altered with an inclination over 6 degrees in upslope, and over 3 degrees in downslope. The findings indicate that the muscles stabilize the knee and ankle joint much more in slope walking than in level walking, and in slope walking they also exert themselves to elevate or lower the body weight.

Adult↗