• Journal of Korean Neurosurgical Society
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• v.62 no.5
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• pp.561-566
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• 2019

Objective : Functional outcomes have traditionally been evaluated and compared using subjective surveys, such as visual analog scores (VAS), the Oswestry disability index (ODI), and Short Form-36 (SF-36), to assess symptoms and quality of life. However, these surveys are limited by their subjective natures and inherent bias caused by differences in patient perceptions of symptoms. The Fitbit $Charge^{(R)}$ (Fitbit Inc., San Francisco, CA, USA) provides accurate and objective measures of physical activity. The use of this device in patients after laminectomy would provide objective physical measures that define ambulatory function, activity level, and degree of recovery. Therefore, the present study was conducted to identify relationships between the number of steps taken by patients per day and VAS pain scores, prognoses, and postoperative functional outcomes. Methods : We prospectively investigated 22 consecutive patients that underwent laminectomy for spinal stenosis or a herniated lumbar disc between June 2015 and April 2016 by the same surgeon. When patients were admitted for surgery and first visited after surgery, preoperative and postoperative functional scores were recorded using VAS scores, ODI scores, and SF-36. The VAS scores and physical activities were recorded daily from postoperative day (POD) 1 to POD 7. The relationship between daily VAS scores and daily physical activities were investigated by simple correlation analysis and the relationship between mean number of steps taken and ODI scores after surgery was subjected to simple regression analysis. In addition, Wilcoxon's signed-rank test was used to investigate the significance of pre-to-postoperative differences in VAS, ODI, and SF-36 scores. Results : Pre-to-postoperative VAS (p<0.001), ODI (p<0.001), SF-36 mental composite scores (p=0.009), and SF-36 physical composite scores (p<0.001) scores were found to be significantly different. Numbers of steps taken from POD 1 to POD 7 were negatively correlated with daily VAS scores (r=-0.981, p<0.001). In addition, the mean number of steps from POD 3 to POD 7 and the decrease in ODI conducted one month after surgery were statistically significant (p=0.029). Conclusion : Wearable devices are not only being used increasingly by consumers as lifestyle devices, but are also progressively being used in the medical area. This is the first study to demonstrate the usefulness of a wearable device for checking patient physical activity and predicting pain and prognosis after laminectomy. Based on our experience, the wearable device used to provide measures of physical activity in the present study has the potential to provide objective information on pain severity and prognosis.

• Korean Journal of Agricultural and Forest Meteorology
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• v.12 no.4
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• pp.307-316
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• 2010

Complex terrain refers to irregular surface properties of the earth that influence gradients in climate, lateral transfer of materials, landscape distribution in soils properties, habitat selection of organisms, and via human preferences, the patterning in development of land use. Complex terrain of mountainous areas represents ca. 20% of the Earth's terrestrial surface; and such regions provide fresh water to at least half of humankind. Most major river systems originate in such terrain, and their resources are often associated with socio-economic competition and political disputes. The goals of the TERRECO-IRTG focus on building a bridge between ecosystem understanding in complex terrain and spatial assessments of ecosystem performance with respect to derived ecosystem services. More specifically, a coordinated assessment framework will be developed from landscape to regional scale applications to quantify trade-offs and will be applied to determine how shifts in climate and land use in complex terrain influence naturally derived ecosystem services. Within the scope of TERRECO, the abiotic and biotic studies of water yield and quality, production and biodiversity, soil processing of materials and trace gas emissions in complex terrain are merged. There is a need to quantitatively understand 1) the ecosystem services derived in regions of complex terrain, 2) the process regulation occurred to maintain those services, and 3) the sensitivities defining thresholds critical in stability of these systems. The TERRECO-IRTG is dedicated to joint study of ecosystems in complex terrain from landscape to regional scales. Our objectives are to reveal the spatial patterns in driving variables of essential ecosystem processes involved in ecosystem services of complex terrain region and hence, to evaluate the resulting ecosystem services, and further to provide new tools for understanding and managing such areas.