Clinical Motion Analysis in Double Knee Action Acquisition and Spinal Alignment Changes for Spine and Spinal Cord Disease Patients with Gait Disorder

概要

Age-related musculoskeletal disorders are getting a serious problem in Japan,
which has one of the highest rates of degenerative diseases of the spine and spinal cord
in the world. Since the loss of ambulation due to locomotor diseases could lead to
chronic diseases such as osteoporosis, obesity, hyperglycemia, and cardiopulmonary
complication, the reacquisition of a healthy gait is expected to help preserve the
locomotor system and improve healthy life expectancy in the aging population.
Therefore, appropriate rehabilitation and gait assessment are necessary to reacquire a
healthy gait.
There are several types of gait abnormalities associated with spine and spinal
cord diseases, which include pathological gaits such as a hyper-knee extension gait, and
gait difficulties due to postural abnormalities. Acquisition of compensatory gait is one
of the reasons for pathological gait. Effective training based on appropriate gait analysis
is required to regain a healthy gait. Rehabilitation for postoperative patients with spine
and spinal cord diseases has been a challenge. Conventional rehabilitation by
physiotherapists had difficulty to start functional rehabilitation immediately after
surgery. In addition to conventional rehabilitation, robot rehabilitation has been
introduced recently. Robot rehabilitation enables efficient functional training from the
acute stage. However, It has been also reported that passive robotic rehabilitation was
not superior to conventional rehabilitation because of the lack of learning through
appropriate feedback. On the other hand, active robot rehabilitation has the possibility
to provide gait training which enables the acquisition of a healthier gait.
In conventional gait evaluations, an improvement due to the acquisition of a
compensatory gait has also been considered a gait improvement. In that case, the result
of age-related changes due to pathological gait might lead to knee osteoarthritis and
other locomotive problems. Therefore, there is a need for rehabilitation and evaluation
aimed at acquiring a healthy gait that is not a compensatory gait. Therefore, the
evaluation of the effectiveness of rehabilitation also needs to be improved according to
the rehabilitation transformation. ...

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