Pharmacological target therapy of neuropathic pain and patient-reported outcomes in patients with chronic low back pain in Korea: Results from the NLBP Outcomes Research.

A number of studies have demonstrated an association of neuropathic pain and chronic low back pain (CLBP), but the outcome difference in each medical management is poorly understood. This study is aimed to investigate treatment patterns of neuropathic pain in CLBP patients and to explore patient-reported outcomes (PROs) including quality of life (QoL) and functional disability by treatment patterns.Data were extracted from the neuropathic low back pain (NLBP) outcomes research. It was a multicenter and cross-sectional study in which 1200 patients were enrolled at 27 general hospitals, from 2014 to 2015. Of total, 478 patients classified as neuropathic pain were used for this subgroup analysis. The patients were divided into 2 groups according to treatment patterns (with vs. without the targeted therapy [TT] of neuropathic pain). Demographic and clinical features were collected by chart reviews and PROs were measured by patient's survey. QoL was assessed by EuroQoL 5-dimension (EQ-5D) questionnaire. Functional disability was measured by the Quebec Back Pain Disability Scale (QBPDS). Multiple linear regression analyses were conducted to compare the PROs between TT group and non-targeted therapy (nTT) group.Among the NLBP patients (mean age 63years, female 62%), EQ-5D index, EuroQoL-Visual Analog Scale (EQ-VAS), and QBPDS Scores (mean ±â€Šstandard deviation) were 0.40 ±â€Š0.28, 54.98 ±â€Š19.98, and 46.03 ±â€Š21.24, respectively. Only 142 (29.7%) patients had pharmacological TT of neuropathic pain. Univariate analyses revealed no significant mean differences between TT group and nTT group in the EQ-5D index (0.41 ±â€Š0.27 and 0.39 ±â€Š0.28), EQ-VAS (56.43 ±â€Š18.17 and 54.37 ±â€Š20.69), and QBPDS (45.31 ±â€Š21.32 and 46.31 ±â€Š21.24). After adjustment with covariates, TT group had higher scores of EQ-5D index (ß = 0.07; P < 0.01) and EQ-VAS (ß = 4.59; P < 0.05) than the nTT group. The TT group's QBPDS score was lower than the nTT group, although its statistical significance still has not been reached (ß = -4.13; P = 0.07).We found that considerable proportion of the NLBP patients remains untreated or undertreated. Although TT group had significantly better QoL than nTT group, only 29.7% of NLBP patients had pharmacological TT. Therefore, clinicians should consider using TT for better QoL of neuropathic pain patients.

An SEMG computer interface using three myoelectric sites for proportional two-dimensional cursor motion control and clicking for individuals with spinal cord injuries.

We developed an alternative computer interface using surface electromyography (sEMG) for individuals with spinal cord injuries (SCI) to access a computer. We designed this interface to make a cursor move on a two-dimensional screen and to click using only three muscles for each subject. In addition, a user can voluntarily control cursor movement speed by modulating muscle contraction levels. Three SCI patients and 10 healthy subjects volunteered to evaluate the performance of this interface using Fitts' law test in a two-dimensional testing setup. The throughputs (TP) of our interface were 0.1962±0.0562 b/s for the SCI patients and 0.4356±0.0706 b/s for the healthy subjects. This interface could help SCI patients handle a wider range of activities such as browsing the Internet and communicating with others.

Development and evaluation of a assistive computer interface by SEMG for individuals with spinal cord injuries.

We developed an alternative computer interface using surface electromyography (sEMG) for individuals with spinal cord injuries (SCI) to access a computer. We designed this interface to make a cursor move on a two-dimensional screen and to click using only three muscles: the extensor carpi radialis (R-ECR) and extensor carpi ulnaris (R-ECU) of the right forearm and the extensor carpi radialis (L-ECR) of the left forearm. In addition, a user can voluntarily control cursor movement speed by modulating muscle contraction levels. One SCI patient and 5 healthy subjects volunteered to evaluate the performance of this interface using Fitts' law test in a two-dimensional testing setup. The throughputs (TP) of our interface were 0.2604 b/s for the SCI patient and 0.4295 ± 0.0600 b/s for the healthy subjects. This interface could help SCI patients handle a wider range of activities such as browsing the Internet and communicating with others.

Bimanual shoulder flexion system with surface electromyography for hemiplegic patients after stroke: A preliminary study.

A robot-assisted bimanual shoulder flexion rehabilitation system with surface electromyography (sEMG) for hemiplegic patients after stroke is presented as a preliminary study before clinical test. The assistive system driven by combination of bimanual mirror imaging motion and sEMG in order to induce continuous voluntary stimulation to muscle and nerve of the patients. In this paper, hardware design, controller with impedance compensation of actuator using disturbance observer (DOB) for back-drivable operation, and sEMG signal processing to obtain desired assistive torque are also reported. The performance of impedance compensation and assistive operation of the system with sEMG were verified by experiments with a healthy participant. This system is expected to help to recover functionality of neural/musculoskeletal system to hemiplegic patients.