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Junji Katsuhira,1,2 Sumiko Yamamoto,3 Nodoka Machida,4 Yuji Ohmura,5 Masako Fuchi,6 Mizuho Ohta,7 Setsuro Ibayashi,7 Arito Yozu,8 Ko Matsudaira2 1Department of Prosthetics and Orthotics and Assistive Technology, Faculty of Medical Technology, Niigata University of Health and Welfare, Niigata, 2Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo, 3Graduate School of International University of Health and Welfare, Tokyo, 4International University of Health and Welfare, School of Health Sciences at Narita, Department of Physical Therapy, Chiba, 5International University of Health and Welfare, School of Health Sciences at Odawara, Department of Physical Therapy, Kanagawa, 6Department of Occupational Therapy, Kyusyu Nutrition Welfare University, Fukuoka, 7Seiai Rehabilitation Hospital, Fukuoka, 8Center for Medical Sciences, Ibaraki Prefectural University of Health Science, Ibaraki, Japan Purpose: The synergistic effects of a trunk orthosis and an ankle–foot orthosis (AFO) in stroke patients with a hemiplegic gait are unclear. We previously developed a trunk orthosis with joints providing resistive force (TORF) to modify malalignment of the trunk and pelvis and confirmed its positive effects in stroke patients during level walking without an AFO. The aim of the present study was to determine if this trunk orthosis and an AFO have synergistic effects during level walking in community-dwelling patients with chronic stroke. Methods: Twenty-eight community-dwelling stroke patients performed level walking at a self-selected speed with an AFO and again while wearing a TORF (TORF group) or a corset (control group). Spatiotemporal, kinematic, and kinetic data were recorded using a three-dimensional motion analysis system. Results: When compared with the control group, the TORF group showed significant increases in walking speed, number of steps on the paretic leg per minute, and

Keiko Yamada,1,2 Ko Matsudaira,3,4 Eizaburo Tanaka,1,5 Hiroyuki Oka,3 Junji Katsuhira,3,6 Hiroyasu Iso1 1Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, 2Center for Pain Management, Osaka University Hospital, Suita, Osaka, 3Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, 4Japan Labour Health & Welfare Organization, Tokyo, 5Hyogo Institute for Traumatic Stress, Kobe, 6Department of Prosthetics & Orthotics and Assistive Technology, Faculty of Medical Technology, Niigata University of Health and Welfare, Niigata, Japan Background: Responses to early-life adversity may differ by sex. We investigated the ­sex-specific impact of early-life adversity on chronic pain, chronic multisite pain, and somatizing tendency with chronic pain. Methods: We examined 4229 respondents aged 20–79 years who participated in the Pain Associated Cross-Sectional Epidemiological Survey in Japan. Outcomes were: 1) chronic pain prevalence, 2) multisite pain (≥3 sites) prevalence, and 3) multiple somatic symptoms (≥3 symptoms) among respondents with chronic pain related to the presence or absence of early-life adversity. Multivariable-adjusted odds ratios (ORs) were calculated with 95% confidence intervals using a logistic regression model including age, smoking status, exercise routine, sleep time, body mass index, household expenditure, and the full distribution of scores on the Mental Health Inventory-5. We further adjusted for pain intensity when we analyzed the data for respondents with chronic pain. Results: The prevalence of chronic pain was higher among respondents reporting the presence of early-life adversity compared with those reporting its absence, with multivariable ORs of 1.62 (1.22–2.15, p<0.01) in men and 1.47 (1.13–1.90, p<0.

Hiroyuki Oka,1 Ko Matsudaira,1 Tomoko Fujii,1 Norimasa Kikuchi,2,3 Yuri Haga,2 Takayuki Sawada,2,3 Junji Katsuhira,4 Takahiko Yoshimoto,5 Kayo Kawamata,1 Juichi Tonosu,6 Masahiko Sumitani,7 Satoshi Kasahara,7 Sakae Tanaka,8 1Department of Medical Research and Management for Musculoskeletal Pain, Faculty of Medicine, 22nd Century Medical & Research Center, University of Tokyo, Tokyo, 2Clinical Study Support, Inc., 3Department of Public Health, Aichi Medical University School of Medicine, Aichi, 4Department of Prosthetics & Orthotics and Assistive Technology, Faculty of Medical Technology, Niigata University of Health and Welfare, Niigata, 5Department of Rehabilitation, Kameda Medical Center, Chiba, 6Department of Orthopaedic Surgery, Kanto Rosai Hospital, Kanagawa, 7Department of Pain and Palliative Medicine, Faculty of Medicine, 8Department of Orthopaedic Surgery, University of Tokyo, Tokyo, Japan Objective: The generic STarT Back 5-item screening tool (STarT-G) is used to manage chronic pain in the lower back and elsewhere. This study evaluated the validity of the Japanese version of this generic screening tool. Materials and methods: Japanese participants between the ages of 20 and 64 years completed online surveys regarding pain. Survey reliability was assessed with internal consistency, as calculated using Cronbach’s alpha coefficients. Spearman’s correlation coefficients were used to evaluate concurrent validity between the STarT-G score and standard reference questionnaires. Associations between STarT-G scores and the presence of a disability due to chronic pain (DCP) were analyzed using receiver operator characteristic (ROC) curves. Results: Analyses ultimately included data obtained from 52,842 Japanese participants (54.4% male) with a mean (standard deviation) age of 47.7 (9.4) years. Approximately 1.5% of participants had DCP, and the mean STarT-G score was 1.2 (1.4). The Cronbach’s alpha coef

Junji Katsuhira,1,2 Ko Matsudaira,2 Hiroyuki Oka,2 Shinno Iijima,3 Akihiro Ito,3 Tadashi Yasui,4 Arito Yozu5 1Faculty of Medical Technology, Department of Prosthetics and Orthotics and Assistive Technology, Niigata University of Health and Welfare, Niigata, 2Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo, 3International University of Health and Welfare Hospital, Tochigi, 4Kawamura-Gishi Company, Ltd., Osaka, 5Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan Purpose: The effects of lumbosacral and spinal orthoses on low back pain and gait are not exactly clear. We previously developed a trunk orthosis with joints providing resistive force on low back load to decrease such load, and confirmed its positive effects during level walking in healthy young adults. Therefore, we aimed to determine the efficacy of this trunk orthosis during level walking in healthy elderly subjects.Methods: Fifteen community-dwelling elderly subjects performed level walking at a self-selected speed without an orthosis, with our orthosis, and with a lumbosacral orthosis. Kinematic and kinetic data were recorded using a three-dimensional motion analysis system, and erector spinae activity was recorded by electromyography.Results: When comparing the three conditions, our orthosis showed the following effects: it decreased the peak extension moment, increased the peak flexion moment, decreased the lateral bending angle, increased the peak thoracic extension angle, and had significantly lower erector spinae activity and significantly larger peak pelvic forward tilt angles.Conclusion: Our orthosis with joints providing resistive force decreased low back load and modified trunk and pelvis alignments during level walking in healthy elderly people. Keywords: biomechanics, orthosis, gait, low back pain, joint moment, motion analysis

Junji Katsuhira,1 Ko Matsudaira,2 Tadashi Yasui,3 Shinno Iijima,4 Akihiro Ito4 1Department of Nursing and Rehabilitation Science at Odawara, International University of Health and Welfare, Odawara, Kanagawa, 2Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo, 3Kawamura-Gishi Company, Ltd., Daito-shi, Osaka, 4Graduate School of International University of Health and Welfare, Otawara, Tochigi, Japan Purpose: Postural alignment of elderly people becomes poor due to aging, possibly leading to low-back pain and spinal deformity. Although there are several interventions for treating these conditions, no previous study has reported the effectiveness of a spinal orthosis or lumbosacral orthosis (LSO) in healthy elderly people without specific spinal deformity. We therefore developed a trunk orthosis to decrease low-back muscle activity while training good postural alignment through resistive force provided by joints with springs (here, called the ORF, which stands for orthosis with joints providing resistive force) as a preventive method against abnormal posture and low-back pain in healthy elderly persons. Patients and methods: Fifteen community-dwelling elderly men participated in this study. Participants stood freely for 10 seconds in a laboratory setting under three conditions: without an orthosis, with the ORF, and with an LSO. The Damen corset LSO was selected as it is frequently prescribed for patients with low-back pain. Postural alignment during static standing was recorded using a three-dimensional motion capture system employing infrared cameras. Two force plates were used to record center of pressure. Electromyograms were obtained for bilateral erector spinae (ES), left internal abdominal oblique, and right gluteus medius muscles. Results: Pelvis forward tilt angle tended to increase while wearing the ORF and decrease while wearing the LSO, but these results were not s