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Tingsheng L, Chunshan L, Shudan Y, Xingwei P, Qiling C, Minglu Y, Lu C, Lihang W. Validation of Artificial Intelligence in the Classification of Adolescent Idiopathic Scoliosis and the Compairment to Clinical Manual Handling. Orthop Surg 2024; 16:2040-2051. [PMID: 38961674 PMCID: PMC11293916 DOI: 10.1111/os.14144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/31/2024] [Accepted: 06/05/2024] [Indexed: 07/05/2024] Open
Abstract
OBJECTIVE The accurate measurement of Cobb angles is crucial for the effective clinical management of patients with adolescent idiopathic scoliosis (AIS). The Lenke classification system plays a pivotal role in determining the appropriate fusion levels for treatment planning. However, the presence of interobserver variability and time-intensive procedures presents challenges for clinicians. The purpose of this study is to compare the measurement accuracy of our developed artificial intelligence measurement system for Cobb angles and Lenke classification in AIS patients with manual measurements to validate its feasibility. METHODS An artificial intelligence (AI) system measured the Cobb angle of AIS patients using convolutional neural networks, which identified the vertebral boundaries and sequences, recognized the upper and lower end vertebras, and estimated the Cobb angles of the proximal thoracic, main thoracic, and thoracolumbar/lumbar curves sequentially. Accordingly, the Lenke classifications of scoliosis were divided by oscillogram and defined by the AI system. Furthermore, a man-machine comparison (n = 300) was conducted for senior spine surgeons (n = 2), junior spine surgeons (n = 2), and the AI system for the image measurements of proximal thoracic (PT), main thoracic (MT), thoracolumbar/lumbar (TL/L), thoracic sagittal profile T5-T12, bending views PT, bending views MT, bending views TL/L, the Lenke classification system, the lumbar modifier, and sagittal thoracic alignment. RESULTS In the AI system, the calculation time for each patient's data was 0.2 s, while the measurement time for each surgeon was 23.6 min. The AI system showed high accuracy in the recognition of the Lenke classification and had high reliability compared to senior doctors (ICC 0.962). CONCLUSION The AI system has high reliability for the Lenke classification and is a potential auxiliary tool for spinal surgeons.
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Affiliation(s)
- Lu Tingsheng
- Department of Spine SurgeryBeijing Jishuitan Hospital Guizhou HospitalGuiyangChina
| | - Luo Chunshan
- Department of Spine SurgeryBeijing Jishuitan Hospital Guizhou HospitalGuiyangChina
| | - Yao Shudan
- Department of Spine SurgeryBeijing Jishuitan Hospital Guizhou HospitalGuiyangChina
| | - Pu Xingwei
- Department of Spine SurgeryBeijing Jishuitan Hospital Guizhou HospitalGuiyangChina
| | - Chen Qiling
- Department of Spine SurgeryBeijing Jishuitan Hospital Guizhou HospitalGuiyangChina
| | - Yang Minglu
- Department of Spine SurgeryBeijing Jishuitan Hospital Guizhou HospitalGuiyangChina
| | - Chen Lu
- Department of Spine SurgeryBeijing Jishuitan Hospital Guizhou HospitalGuiyangChina
| | - Wang Lihang
- Department of Spine SurgeryBeijing Jishuitan Hospital Guizhou HospitalGuiyangChina
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Chen K, Stotter C, Klestil T, Mitterer JA, Lepenik C, Nehrer S. Fully Automated Measurement of Cobb Angles in Coronal Plane Spine Radiographs. J Clin Med 2024; 13:4122. [PMID: 39064162 PMCID: PMC11278017 DOI: 10.3390/jcm13144122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/08/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
Background/Objectives: scoliosis is a three-dimensional structural deformity characterized by lateral and rotational curvature of the spine. The current gold-standard method to assess scoliosis is the measurement of lateral curvature of the spine using the Cobb angle in coronal plane radiographs. The interrater variability for Cobb angle measurements reaches up to 10°. The purpose of this study was to describe and assess the performance of a fully automated method for measuring Cobb angles using a commercially available artificial intelligence (AI) model trained on over 17,000 images, and investigate its interrater/intrarater agreement with a reference standard. Methods: in total, 196 AP/PA full-spine radiographs were included in this study. A reference standard was established by four radiologists, defined as the median of their Cobb angle measurements. Independently, an AI-based software, IB Lab SQUIRREL (version 1.0), also performed Cobb angle measurements on the same radiographs. Results: after comparing the readers' Cobb angle end vertebrae selection to the AI's outputs, 194 curvatures were considered valid for performance assessment, displaying an accuracy of 88.58% in end vertebrae selection. The AI's performance showed very low absolute bias, with a mean difference and standard deviation of differences from the reference standard of 0.16° ± 0.35° in the Cobb angle measurements. The ICC comparing the reference standard and the AI's measurements was 0.97. Conclusions: the AI model demonstrated good results in the determination of end vertebrae and excellent results in automated Cobb angle measurements compared to radiologists and could serve as a reliable tool in clinical practice and research.
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Affiliation(s)
- Kenneth Chen
- Department for Health Sciences, Medicine and Research, University for Continuing Education Krems, 3500 Krems, Austria; (K.C.); (C.S.); (T.K.); (C.L.)
- Department for Orthopedics and Traumatology, Landesklinikum Waidhofen/Ybbs, 3340 Waidhofen an der Ybbs, Austria
| | - Christoph Stotter
- Department for Health Sciences, Medicine and Research, University for Continuing Education Krems, 3500 Krems, Austria; (K.C.); (C.S.); (T.K.); (C.L.)
- Department for Orthopedics and Traumatology, Landesklinikum Baden-Mödling, 2340 Mödling, Austria
| | - Thomas Klestil
- Department for Health Sciences, Medicine and Research, University for Continuing Education Krems, 3500 Krems, Austria; (K.C.); (C.S.); (T.K.); (C.L.)
- Department for Orthopedics and Traumatology, Landesklinikum Baden-Mödling, 2340 Mödling, Austria
| | - Jennyfer A. Mitterer
- Michael-Ogon Laboratory for Orthopaedic Research, Orthopaedic Hospital Vienna-Speising, 1130 Vienna, Austria;
- II. Department of Pediatric Orthopaedics, Orthopaedic Hospital Vienna-Speising, 1130 Vienna, Austria
| | - Christopher Lepenik
- Department for Health Sciences, Medicine and Research, University for Continuing Education Krems, 3500 Krems, Austria; (K.C.); (C.S.); (T.K.); (C.L.)
| | - Stefan Nehrer
- Department for Health Sciences, Medicine and Research, University for Continuing Education Krems, 3500 Krems, Austria; (K.C.); (C.S.); (T.K.); (C.L.)
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Huang X, Luo M, Liu L, Wu D, You X, Deng Z, Xiu P, Yang X, Zhou C, Feng G, Wang L, Zhou Z, Fan J, He M, Gao Z, Pu L, Wu Z, Zhou Z, Song Y, Huang S. The Comparison of Convolutional Neural Networks and the Manual Measurement of Cobb Angle in Adolescent Idiopathic Scoliosis. Global Spine J 2024; 14:159-168. [PMID: 35622711 PMCID: PMC10676172 DOI: 10.1177/21925682221098672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
STUDY DESIGN Comparative study. OBJECTIVE To compare manual and deep learning-based automated measurement of Cobb angle in adolescent idiopathic scoliosis. METHODS We proposed a fully automated framework to measure the Cobb angle of AIS patients. Whole-spine images of 500 AIS individuals were collected. 200 digital radiographic (DR) images were labeled manually as training set, and the remaining 300 images were used to validate by mean absolute error (MAE), Pearson or spearman correlation coefficients, and intra/interclass correlation coefficients (ICCs). The relationship between accuracy of vertebral boundary identification and the subjective image quality score was evaluated. RESULTS The PT, MT, and TL/L Cobb angles were measured by the automated framework within 300 milliseconds. Remarkable 2.92° MAE, .967 ICC, and high correlation coefficient (r = .972) were obtained for the major curve. The MAEs of PT, MT, and TL/L were 3.04°, 2.72°, and 2.53°, respectively. The ICCs of these 3 curves were .936, .977, and .964, respectively. 88.7% (266/300) of cases had a difference range of ±5°, with 84.3% (253/300) for PT, 89.7% (269/300) for MT, and 93.0% (279/300) for TL/L. The decreased bone/soft tissue contrast (2.94 vs 3.26; P=.039) and bone sharpness (2.97 vs 3.35; P=.029) were identified in the images with MAE exceeding 5°. CONCLUSION The fully automated framework not only identifies the vertebral boundaries, vertebral sequences, the upper/lower end vertebras and apical vertebra, but also calculates the Cobb angle of PT, MT, and TL/L curves sequentially. The framework would shed new light on the assessment of AIS curvature.
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Affiliation(s)
- Xianming Huang
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Ming Luo
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
- Department of Spine Surgery and Musculoskeletal Tumor, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of China
- Key Laboratory of Big Data for Spinal Deformities, Chinese Academy of Medical Sciences, Beijing, China
| | - Limin Liu
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Diwei Wu
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Xuanhe You
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Zhipeng Deng
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Peng Xiu
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Xi Yang
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Chunguang Zhou
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Ganjun Feng
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Wang
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Zhongjie Zhou
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Jipeng Fan
- Chengdu Chengdian Goldisc Health Data Technology Co., Ltd, Chengdu, China
| | - Mingjie He
- Chengdu Chengdian Goldisc Health Data Technology Co., Ltd, Chengdu, China
| | - Zhongjun Gao
- Chengdu Chengdian Goldisc Health Data Technology Co., Ltd, Chengdu, China
| | - Lixin Pu
- Chengdu Chengdian Goldisc Health Data Technology Co., Ltd, Chengdu, China
- School of Automation Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhihong Wu
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- Beijing Key Laboratory for Genetic Research of Skeletal Deformity, Beijing, China
| | - Zongke Zhou
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Yueming Song
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Shishu Huang
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
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Günther F, Schober F, Hunger S, Schellnock J, Derlien S, Schleifenbaum S, Drossel WG, Heyde CE. Improving Home-Based Scoliosis Therapy: Findings From a Web-Based Survey. JMIR Rehabil Assist Technol 2023; 10:e46217. [PMID: 37540557 PMCID: PMC10439467 DOI: 10.2196/46217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Conservative scoliosis therapy in the form of assisted physiotherapeutic scoliosis exercises is supplemented by self-contained training at home, depending on the approach (eg, Schroth, the Scientific Exercises Approach to Scoliosis). Complex exercises, lack of awareness of the importance of training, and missing supervision by therapists often lead to uncertainty and reduced motivation, which in turn reduces the success of home-based therapy. Increasing digitalization in the health care sector offers opportunities to close this gap. However, research is needed to analyze the requirements and translate the potential of digital tools into concrete solution concepts. OBJECTIVE The aim of this study is to evaluate the potential for optimizing home-based scoliosis therapy in terms of motivation, assistive devices, and digital tools. METHODS In collaboration with the Institute of Physiotherapy at the Jena University Hospital, a survey was initiated to address patients with scoliosis and physical therapists. A digital questionnaire was created for each target group and distributed via physiotherapies, scoliosis forums, the Bundesverband für Skoliose Selbsthilfe e. V. newsletter via a link, and a quick response code. The survey collected data on demographics, therapy, exercise habits, motivation, assistive devices, and digital tools. Descriptive statistics were used for evaluation. RESULTS Of 141 survey participants, 72 (51.1%; n=62, 86.1%, female; n=10, 13.9%, male) patients with scoliosis with an average age of 40 (SD 17.08) years and 30 scoliosis therapists completed the respective questionnaires. The analysis of home-based therapy showed that patients with scoliosis exercise less per week (2 times or less; 45/72, 62.5%) than they are recommended to do by therapists (at least 3 times; 53/72, 73.6%). Patients indicated that their motivation could be increased by practicing together with friends and acquaintances (54/72, 75%), a supporting therapy device (48/72, 66.7%), or a digital profile (46/72, 63.9%). The most important assistive devices, which are comparatively rarely used in home-based therapy, included balance boards (20/72, 27.8%), wall bars (23/72, 31.9%), mirrors (36/72, 50%), and long bars (40/72, 55.6%). Therapists saw the greatest benefit of digital tools for scoliosis therapy in increasing motivation (26/30, 87%), improving home therapy (25/30, 83%), monitoring therapy progress (25/30, 83%), and demonstrating exercise instructions (24/30, 80%). CONCLUSIONS In this study, we investigated whether there is any potential for improvement in home-based scoliosis therapy. For this purpose, using online questionnaires, we asked patients with scoliosis and therapists questions about the following topics: exercise habits, outpatient and home-based therapy, motivation, supportive devices, and digital tools. The results showed that a lack of motivation, suitable training equipment, and tools for self-control leads to a low training workload. From the perspective of the patients surveyed, this problem can be addressed through community training with friends or acquaintances, a supportive therapy device, and digital elements, such as apps, with training instructions and user profiles.
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Affiliation(s)
- Florian Günther
- Department of Biomechatronics, Fraunhofer Institute for Machine Tools and Forming Technology IWU, Dresden, Germany
- Center for Research on Musculoskeletal Systems (ZESBO), Faculty of Medicine, Hospital of Orthopaedic Surgery, Traumatology and Plastic Surgery, University of Leipzig Medical Center, Leipzig, Germany
| | | | - Sandra Hunger
- Department of Biomechatronics, Fraunhofer Institute for Machine Tools and Forming Technology IWU, Dresden, Germany
| | - Julia Schellnock
- Scientific Field Functional Integration and System Integration, Fraunhofer Institute for Machine Tools and Forming Technology IWU, Dresden, Germany
| | - Steffen Derlien
- Institute for Physical and Rehabilitative Medicine, University Hospital Jena, Jena, Germany
| | - Stefan Schleifenbaum
- Department of Biomechatronics, Fraunhofer Institute for Machine Tools and Forming Technology IWU, Dresden, Germany
- Center for Research on Musculoskeletal Systems (ZESBO), Faculty of Medicine, Hospital of Orthopaedic Surgery, Traumatology and Plastic Surgery, University of Leipzig Medical Center, Leipzig, Germany
| | - Welf-Guntram Drossel
- Scientific Field Functional Integration and System Integration, Fraunhofer Institute for Machine Tools and Forming Technology IWU, Dresden, Germany
- Professorship Adaptronics and Lightweight Design, Technical University Chemnitz, Chemnitz, Germany
| | - Christoph-Eckhard Heyde
- Hospital of Orthopaedic Surgery, Traumatology and Plastic Surgery, University of Leipzig Medical Center, Leipzig, Germany
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Bottino L, Settino M, Promenzio L, Cannataro M. Scoliosis Management through Apps and Software Tools. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085520. [PMID: 37107802 PMCID: PMC10138677 DOI: 10.3390/ijerph20085520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/10/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023]
Abstract
Background: Scoliosis is curvature of the spine, often found in adolescents, which can impact on quality of life. Generally, scoliosis is diagnosed by measuring the Cobb angle, which represents the gold standard for scoliosis grade quantification. Commonly, scoliosis evaluation is conducted in person by medical professionals using traditional methods (i.e., involving a scoliometer and/or X-ray radiographs). In recent years, as has happened in various medicine disciplines, it is possible also in orthopedics to observe the spread of Information and Communications Technology (ICT) solutions (i.e., software-based approaches). As an example, smartphone applications (apps) and web-based applications may help the doctors in screening and monitoring scoliosis, thereby reducing the number of in-person visits. Objectives: This paper aims to provide an overview of the main features of the most popular scoliosis ICT tools, i.e., apps and web-based applications for scoliosis diagnosis, screening, and monitoring. Several apps are assessed and compared with the aim of providing a valid starting point for doctors and patients in their choice of software-based tools. Benefits for the patients may be: reducing the number of visits to the doctor, self-monitoring of scoliosis. Benefits for the doctors may be: monitoring the scoliosis progression over time, managing several patients in a remote way, mining the data of several patients for evaluating different therapeutic or exercise prescriptions. Materials and Methods: We first propose a methodology for the evaluation of scoliosis apps in which five macro-categories are considered: (i) technological aspects (e.g., available sensors, how angles are measured); (ii) the type of measurements (e.g., Cobb angle, angle of trunk rotation, axial vertebral rotation); (iii) availability (e.g., app store and eventual fee to pay); (iv) the functions offered to the user (e.g., posture monitoring, exercise prescription); (v) overall evaluation (e.g., pros and cons, usability). Then, six apps and one web-based application are described and evaluated using this methodology. Results: The results for assessment of scoliosis apps are shown in a tabular format for ease of understanding and intuitive comparison, which can help the doctors, specialists, and families in their choice of scoliosis apps. Conclusions: The use of ICT solutions for spinal curvature assessment and monitoring brings several advantages to both patients and orthopedics specialists. Six scoliosis apps and one web-based application are evaluated, and a guideline for their selection is provided.
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Affiliation(s)
- Lorella Bottino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Marzia Settino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Luigi Promenzio
- Pediatric Orthopaedics Department, Villa Serena for Children, 88100 Catanzaro, Italy
| | - Mario Cannataro
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
- Correspondence:
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Rockenfeller R, Müller A. Augmenting the Cobb angle: Three-dimensional analysis of whole spine shapes using Bézier curves. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 225:107075. [PMID: 35998481 DOI: 10.1016/j.cmpb.2022.107075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 07/15/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE The identification and classification of pathological spinal deformities poses a major challenge to any diagnostician. First, available medical images are usually two-dimensional projections, obscuring elaborated spatial information. Second, several measurement techniques with different thresholds for certain clinical syndromes make it difficult to classify measured results. Here, a method is presented to augment and standardize the analysis of spinal shapes in three dimensions. METHODS Regarding the first limitation, (semi-)automatic, three-dimensional segmentation techniques of medical images have already been developed. To overcome the second, we propose here a representation of the whole spine by a Bézier curve using the vertebral centers as control points. After normalization, a differential-geometric approach yields information on curvature and torsion at each spinal level as well as in between. RESULTS Based on literature data and multi-body simulations, we show how these quantities alter with individual posture and during motion. Robustness with respect to missing data is investigated. Approaches towards the identification of spinal disorders are motivated. CONCLUSION Our results emphasize the need for individualizable identification and classification of spinal deformities and give an outlook on how it might be achieved. The presented methodology constitutes the first fully three-dimensional analysis of spinal shapes, i.e. without the requirement of certain physiological planes (e.g. the sagittal plane) or landmarks (e.g. the apex vertebra).
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Affiliation(s)
| | - Andreas Müller
- Institute for Medical Engineering and Information Processing (MTI Mittelrhein), University Koblenz-Landau, Koblenz, Germany; Mechanical Systems Engineering, Swiss Federal Laboratories for Materials Science and Technology (EMPA), Duebendorf, Switzerland
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Maria NH, Siddiq QA. Letter to the Editor. Photographic assessment of adult spinal deformity. J Neurosurg Spine 2022; 36:523-524. [PMID: 34624845 DOI: 10.3171/2021.5.spine21737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Noor H Maria
- 1Punjab Institute of Neurosciences, Lahore, Pakistan
| | - Qurrat A Siddiq
- 2Postgraduate Medical Institute/Ameeruddin Medical College, Lahore, Pakistan
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Karpiel I, Ziębiński A, Kluszczyński M, Feige D. A Survey of Methods and Technologies Used for Diagnosis of Scoliosis. SENSORS (BASEL, SWITZERLAND) 2021; 21:8410. [PMID: 34960509 PMCID: PMC8707023 DOI: 10.3390/s21248410] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/04/2021] [Accepted: 12/09/2021] [Indexed: 02/07/2023]
Abstract
The purpose of this article is to present diagnostic methods used in the diagnosis of scoliosis in the form of a brief review. This article aims to point out the advantages of select methods. This article focuses on general issues without elaborating on problems strictly related to physiotherapy and treatment methods, which may be the subject of further discussions. By outlining and categorizing each method, we summarize relevant publications that may not only help introduce other researchers to the field but also be a valuable source for studying existing methods, developing new ones or choosing evaluation strategies.
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Affiliation(s)
- Ilona Karpiel
- Łukasiewicz Research Network—Institute of Medical Technology and Equipment, 118 Roosevelt, 41-800 Zabrze, Poland;
| | - Adam Ziębiński
- Department of Distributed Systems and Informatic Devices, Silesian University of Technology, 16 Akademicka, 44-100 Gliwice, Poland;
| | - Marek Kluszczyński
- Department of Health Sciences, Jan Dlugosz University, 4/8 Waszyngtona, 42-200 Częstochowa, Poland;
| | - Daniel Feige
- Łukasiewicz Research Network—Institute of Medical Technology and Equipment, 118 Roosevelt, 41-800 Zabrze, Poland;
- Department of Distributed Systems and Informatic Devices, Silesian University of Technology, 16 Akademicka, 44-100 Gliwice, Poland;
- PhD School, Silesian University of Technology, 2A Akademicka, 44-100 Gliwice, Poland
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Ketenci İE, Yanık HS, Erdoğan Ö, Adıyeke L, Erdem Ş. Reliability of 2 Smartphone Applications for Cobb Angle Measurement in Scoliosis. Clin Orthop Surg 2021; 13:67-70. [PMID: 33747380 PMCID: PMC7948049 DOI: 10.4055/cios19182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 04/20/2020] [Indexed: 11/06/2022] Open
Abstract
Background As mobile technology has evolved, smartphone applications have been used for radiographic angle measurements in daily clinical practice. This study aimed to assess the reliability of 2 smartphone applications (iPinPoint and Cobbmeter) in measuring scoliosis Cobb angles compared with picture archiving and communication system (PACS) tools. Methods Anteroposterior whole spinal digital radiographs of 50 patients were retrospectively analyzed. Four observers measured Cobb angles of predetermined major structural curves using the tools in the PACS software and 2 smartphone applications. The inter- and intraobserver reliabilty were measured using intraclass correlation coefficients (ICC). Results Very good interobserver agreement was seen with PACS, iPinPoint, and Cobbmeter measurements (ICC, 0.991, 0.980, and 0.991, respectively). Intraobserver reliability of the 4 observers was also very good for all techniques (ICC > 0.9 for all observers). Conclusions Both smartphone applications were reliable in measuring scoliosis Cobb angles, with reference to PACS tools. They may be useful when digital or manual mesurement tools are not available.
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Affiliation(s)
- İsmail Emre Ketenci
- Department of Orthopedics and Traumatology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
| | - Hakan Serhat Yanık
- Department of Orthopedics and Traumatology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
| | - Özgür Erdoğan
- Department of Orthopedics and Traumatology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
| | - Levent Adıyeke
- Department of Orthopedics and Traumatology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
| | - Şevki Erdem
- Department of Orthopedics and Traumatology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
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Harasymczuk P, Glowacki M, Wojtkow M. Reliability of a New Smartphone Accessory for Scoliosis Measurements. J Med Device 2020. [DOI: 10.1115/1.4048373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
BACKGROUND: Idiopathic scoliosis is the most common pathology of the children’s spine, identified as spine lateral curvature with Cobb angle greater than 10°. The rapid development of technology allows, even mobile devices, to perform a quick and cheap diagnosis ensuring an accuracy similar to the Bunnell scoliometer.
OBJECTIVE: The study aimed to validate the accuracy of a newly developed accessory for measuring the angle of trunk rotation (ATR) using mobile devices.
METHODS: ATR measurements were carried out on a group of 30 adults using 3 diagnostic tools: the Bunnell scoliometer, Scolioscreen, and mScolio designed by the authors. Scolioscreen and mScolio were used together with a smartphone and the Clinometer app. Three measurements were performed using each of the methods.
RESULTS: The greatest data discrepancy was obtained between the Bunnell scoliometer and Scolioscreen (-3.7°÷4.4°) and was twice larger than between the Bunnell scoliometer and mScolio (-1.8°÷2.1°). The excellent agreement was obtained for the mScolio device, where the concordance correlation coefficient was 0.9381 (95% CI of 0.9076÷0.9588) and the interclass correlation coefficient was 0.9501 (95% CI of 0.9242÷0.9671).
CONCLUSIONS: Tests showed excellent reliability and validity of ATR using the mScolio solution. Obtained results show excellent consistency between mScolio and the Brunnell scoliometer measurements.
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Affiliation(s)
- Piotr Harasymczuk
- Department of Paediatric Orthopaedics and Traumatology, Poznan University of Medical Sciences, 61-545 Poznan, Poland
| | - Maciej Glowacki
- Department of Paediatric Orthopaedics and Traumatology, Poznan University of Medical Sciences, 61-545 Poznan, Poland
| | - Magdalena Wojtkow
- Department of Department of Mechanics, Material and Biomedical Engineering, Wroclaw University of Science and Technology, 50-371 Wroclaw, Poland
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Abstract
Smartphones are increasingly incorporated with features such as sensors and high resolution cameras that empower their capabilities, enabling their use for varied activities including human posture assessments. Previous reviews have discussed methods used in postural assessment but none of them focused exclusively on mobile applications. This paper systematically reviews mobile applications proposed for analyzing human posture based on alignment of the body in the sagittal and coronal plane. The main digital libraries were searched, 26 articles published between 2010 and 2020 were selected, and 13 mobile applications were identified, classified and discussed. Results showed that the use of mobile applications to assist with posture assessment have been demonstrated to be reliable, and this can contribute to clinical practice of health professionals, especially the assessment and reassessment phases of treatments, despite some variations when compared to traditional methods. Moreover, in the case of image-based applications, we highlight the advantage that measurements can be taken with the assessor at a certain distance with respect to the patient’s position, which is an important function for assessments performed in pandemic times such as the outbreak of COVID-19.
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Assessment of Lumbar Lordosis Distribution with a Novel Mathematical Approach and Its Adaptation for Lumbar Intervertebral Disc Degeneration. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2020; 2020:7312125. [PMID: 32377225 PMCID: PMC7180428 DOI: 10.1155/2020/7312125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 01/09/2020] [Accepted: 02/04/2020] [Indexed: 11/21/2022]
Abstract
Introduction Low back pain and disc degeneration could be linked to global spinal geometry. Our study aimed to develop a reliable new mathematical method to assess the local distribution of total lumbar lordosis with a single numeric parameter and compare it with lumbar intervertebral disc degeneration using routine MRI scans. Methods An online, open access, easy-to-use platform for measurements was developed based on a novel mathematical approach using MRIs of 60 patients. Our Spinalyze Software can be used online with uploaded MRIs. Several new parameters were introduced and assessed to describe variation in segmental lordosis distribution with a single numerical value. The Pfirrmann grading system was used for the classification of lumbar intervertebral disc degeneration. Relationships were investigated between the grade categories of L1-S1 lumbar discs and the MRI morphological parameters with correlation analysis. Results Results confirm that the determination of measurement points and calculated parameters are reliable (ICCs and Pearson r values > 0.90), and these parameters were independent of gender. The digression percentage (K%), one of our new parameters, did not show a statistical relationship with the Cobb-angle. According to our results, the maximum deflection breaking-point of lumbar lordosis and its location can be different with the same Cobb-angle and the distribution of global lordosis is uneven because the shape of the lumbar lordosis is shifted downward and centered around the L4 lumbar vertebra. The interobserver reliability of the Pfirrmann grades reading was in the excellent agreement category (88.33% agreement percentage, 0.84 kappa), and digression percentage (K%) showed a significant negative correlation with all L1-S1 disc grades with increasing r correlation values. This means that the smaller the value of digression percentage (K%), the more the number of worn discs in the lower lumbar sections. Conclusions Spinalyze Software based on a novel mathematical approach provides a free, easy-to-use, reliable, and online measurement tool using standard MRIs to approximate the curvature of lumbar lordosis. The new reliable K% (digression percentage) is one single quantitative parameter to assess the local distribution of total lumbar lordosis. The results indicate that digression percentage (K%) may possibly be associated with the development of lumbar intervertebral disc degeneration. Further evaluation is needed to assess its behavior and advantage.
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The effect of added fat on the accuracy of Cobb angle measurements in CT SPR images: A phantom study. Radiography (Lond) 2020; 26 Suppl 2:S88-S93. [PMID: 32340911 DOI: 10.1016/j.radi.2020.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/02/2020] [Accepted: 04/06/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Adolescent idiopathic scoliosis (AIS) is a spinal deformity that mostly affects females aged between 10 and 17 years old. Cobb's method is the gold standard for assessing AIS. Being overweight is a common characteristic in AIS patients; therefore, the aim of this study is to investigate the effect fat mass has on the accuracy of Cobb angle measurements in 10-year-old female AIS patients. METHODS A purpose-built phantom representing an AIS patient was scanned after adding several thicknesses of lard fat (0,2,4 and 8 cm). The phantom was scanned in an antero-posterior position using the scout mode of the CT scanner. 18 observers performed Cobb angle measurements on the images. RESULTS The average Cobb angle at 0 cm of fat was 10.83° (SD = 3.06), at 2 cm it was 10.90° (SD = 3.16), at 4 cm it was 10.64° (SD = 3.06) and at 8 cm it was 10.88° (SD = 3.02). No significant difference was observed between the measurements at these thicknesses. CONCLUSION Cobb angle measurements are not affected by the presence of fat. IMPLICATIONS FOR PRACTICE When assessing overweight AIS patients, it not necessary to manipulate the acquisition parameters, which could lead to increased patient dose, in order to get more accurate Cobb angle measurement.
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Elfiky T, Patil N, Shawky M, Siam A, Ragab R, Allam Y. Oxford Cobbometer Versus Computer Assisted-Software for Measurement of Cobb Angle in Adolescent Idiopathic Scoliosis. Neurospine 2020; 17:304-311. [PMID: 32054147 PMCID: PMC7136097 DOI: 10.14245/ns.1938260.130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 11/04/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The objective was to compare Cobb angle measurements performed using an Oxford Cobbmeter and digital computer software (Surgimap) in a series of 83 adolescent idiopathic scoliosis (AIS) patients. METHODS Two independent observers measured the Cobb angles for 123 curves on 83 consecutive long radiographs of patients with AIS using both Oxford Cobbmeter and digital computer software (Surgimap). The measurements were repeated a week. Curves were classified according to the severity into mild, moderate, and severe. The results were statistically analyzed for intraobserver and interobserver reliability. RESULTS The mean Cobb angle was 48.12° ± 19.75° (range, 10.54°-110.76°). Globally the results of curve measurements were comparable between and within both observers using both methods, with small mean differences. According to intraclass correlation coefficient, there was high inter- and intraobserver high agreement for both methods. All readings were > 0.9. There was a good interobserver (κ = 0.745, 0.693) and a very good interobserver agreement (κ = 0.810, 0.804) for both methods for curve classification. However, poor agreement was observed as regards to the measurement time, being less with Oxford Cobbometer. CONCLUSION The results of this study indicate that the Surgimap digital computer software measurement is an equivalent measuring tool to the Oxford Cobbmeter in Cobb angle measurement. Both have high intra and interobserver agreement for measurement and for curve classification, with small measurement differences. Oxford Cobbmeter is advantageous in being quicker, and therefore it is the method of choice for manual measurement, where PACS (patient archiving and communication system) or digital system is not available.
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Affiliation(s)
- Tarek Elfiky
- Spine Unit, Elhadra University Hospital, Alexandria, Egypt
| | - Nirmal Patil
- Seth GS Medical College and KEM Hospital, Mumbai, India
| | - Mohamed Shawky
- Spine Unit, Elhadra University Hospital, Alexandria, Egypt
| | - Ahmed Siam
- Department of Orthopaedics, Helios Klinik Köthen, Köthen, Germany
| | - Raafat Ragab
- Spine Unit, Elhadra University Hospital, Alexandria, Egypt
| | - Yasser Allam
- Spine Unit, Elhadra University Hospital, Alexandria, Egypt.,SRH Wald-Klinikum Gera, Gera, Germany
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Moftian N, Hachesu PR, Pourfeizi HH, Samad-Soltani T, Aghazadeh N, Poureisa M, Salahzadeh Z. Newfangled Procedures Using X-ray to Determine the Cobb Angle in Patients with Scoliosis: An Updated Systematic Review. Curr Med Imaging 2020; 15:922-932. [PMID: 32008520 DOI: 10.2174/1573405614666180531073300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/09/2018] [Accepted: 05/24/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Scoliosis is a three-dimensional deformity of the spine. It is usually assessed by measuring Cobb angle. Nowadays, due to increasing effectiveness of image processing and machine vision, willingness to apply these methods has improved considerably in determining scoliosis of Cobb angle. METHODS In accordance with the PRISMA guideline, a broad electronic search of all English language literature was conducted on the topic through four databases, including MEDLINE, Web of Science, Scopus, and the Cochrane Library from 2012 (last search date from earlier review) to 30 March 2017. RESULTS Twelve studies were included. 90% labeled high-quality were selected for analysis. Eighty percent of the selected studies were published in the period between 2012 and 2017. Three new procedures were used to measure the Cobb angle. One study used automated procedure (7%), two studies used smartphone procedure (14%), and nine studies used the semiautomatic procedure of Cobb measurement (79%). Seven studies reported reproducibility and repeatability. Reproducibility range was 0.72 to 1 in reporting of ICC. Repeatability has a high range in three separated methods. CONCLUSION Computerized assessment method (Automatic and Semi-automatic) is most commonly performed in Cobb measurement. Semi-automatic is an effective measurement option for computerized assessment Cobb angle. There is no significant difference between manual, computer- based, and smartphone-based methods in described measures.
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Affiliation(s)
- Nazila Moftian
- Department of Health Information Technology, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Peyman Rezaei Hachesu
- Department of Health Information Technology, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Taha Samad-Soltani
- Department of Health Information Technology, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nasser Aghazadeh
- Image Processing Laboratory, Azarbaijan Shahid Madani University, Tabriz, Iran
| | - Masoud Poureisa
- Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Salahzadeh
- Department of Physiotherapy, Faculty of Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran
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González-Sánchez M, Cuesta-Vargas AI, Del Mar Rodríguez González M, Caro ED, Núñez GO, Galán-Mercant A, Belmonte JJB. Effectiveness of a muticomponent workout program integrated in an evidence based multimodal program in hyperfrail elderly patients: POWERAGING randomized clinical trial protocol. BMC Geriatr 2019; 19:171. [PMID: 31226936 PMCID: PMC6588921 DOI: 10.1186/s12877-019-1188-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 06/12/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Short-term and mid-term comparison of the efficacy of a multimodal program that incorporates a therapeutic workout program, medication review, diet adjustment and health education, in comparison to the standard medical practice in the improvement of the neuromuscular and physiological condition. Furthermore, it is intended to analyse the maintenance of these effects in a long-term follow-up (12 months) from the onset of the intervention. METHODS A randomized clinical trial of elderly frail patients drawn from the Clinical Management Unit "Tiro de Pichón", Health District of Malaga, will be included in the study (after meeting the inclusion / exclusion criteria) will be randomized in two groups: a control group that will undergo an intervention consistent of medication review + diet adjustment + health education (regular workout recommendations within a complete advice on healthy lifestyles) and an experimental group whose intervention will consist of a multimodal treatment: therapeutic workout program+ medication review+ diet adjustment + health education. The sociodemographic, clinical and tracing variables will be reflected at the beginning of the study. In addition, the follow-up variables will be gathered at the second and sixth months after the beginning of the treatment and at the third and sixth months after the treatment (follow-up). The follow-up variables that will be measured are: body mass index, general health condition, fatigue, frailty, motor control, attention- concentration- memory, motor memory, spatial orientation, grip strength, balance (static, semi-dynamic), gait speed and metabolomics. A descriptive analysis of the sociodemographic variables of the participants will be conducted. One-Factor ANOVA will be used for the Within-Subject analysis and as for the Between-Subject analysis, the outcome variables between both the groups in each moment of the data collection will be compared. DISCUSSION A multimodal program that incorporates a therapeutic workout program, medication review, diet adjustment and health education may be effective treatment to reduce the functional decline in elderly. The results of the study will provide information on the possible strengths and benefits in multimodal program in elderly. TRIAL REGISTRATION ClinicalTrials.gov NCT02772952 registered May 2017.
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Affiliation(s)
- Manuel González-Sánchez
- Department of Physiotherapy, Faculty of Health Sciences, Instituto de Investigación de Biomedicina de Malaga (IBIMA), Universidad de Malaga, Málaga, Spain
| | - Antonio Ignacio Cuesta-Vargas
- Department of Physiotherapy, Faculty of Health Sciences, Instituto de Investigación de Biomedicina de Malaga (IBIMA), Universidad de Malaga, Málaga, Spain.
- School of Clinical Science, Faculty of Health, Queensland University of Technology, QLD, Kelvin Grove, Australia.
| | - María Del Mar Rodríguez González
- Servicio Andaluz de Salud, Distrito Sanitario Málaga. CS. Tiro Pichón, Instituto de Investigación de Biomedicina de Malaga (IBIMA), Malaga, Spain
| | - Elvira Díaz Caro
- Servicio Andaluz de Salud, Distrito Sanitario Málaga. CS. Tiro Pichón, Instituto de Investigación de Biomedicina de Malaga (IBIMA), Malaga, Spain
| | - Germán Ortega Núñez
- Department of Physiotherapy, Faculty of Health Sciences, Instituto de Investigación de Biomedicina de Malaga (IBIMA), Universidad de Malaga, Málaga, Spain
- Servicio Andaluz de Salud, Distrito Sanitario Málaga. CS. Tiro Pichón, Instituto de Investigación de Biomedicina de Malaga (IBIMA), Malaga, Spain
- Department of Health Sciences, University of Jaen, Jaen, Spain
| | - Alejandro Galán-Mercant
- MOVE-IT Research group and Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy University of Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital University of Cádiz, Cádiz, Spain
| | - Juan José Bedoya Belmonte
- Servicio Andaluz de Salud, Distrito Sanitario Málaga. CS. Tiro Pichón, Instituto de Investigación de Biomedicina de Malaga (IBIMA), Malaga, Spain
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Smartphone applications in orthopaedic surgery: a review of the literature and application analysis. CURRENT ORTHOPAEDIC PRACTICE 2019. [DOI: 10.1097/bco.0000000000000745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
BACKGROUND Scoliosis is a common deformity, and its severity is usually assessed by measuring the Cobb angle on the spinal X-ray film. The measurement of the Cobb angle is an important basis for selecting therapeutic methods and evaluating therapeutic effects. To measure and calculate the scoliosis Cobb angle by end vertebra tilt angle method (tilt angle method) and assess its accuracy and usability. METHODS It is deduced that the Cobb angle is the sum of upper and lower end vertebra tilt angles through the law of plane geometry. The project included 32 patients with scoliosis who have received treatment in our hospital from June 2011 to July 2016, whose Cobb angles were measured at various segments (total 50). The measuring results of the tilt angle method and the classical method were compared, and the time spent for the measurement of the two groups was respectively recorded with an electronic stopwatch for comparison. The interference of line marking in imaging data pixel in the two groups was compared using Beyond Compare software. RESULTS The measuring results through PACS (picture archiving and communication systems) were regarded as the reference standard. There was no statistical difference for measuring the Cobb angle between the PACS method, end vertebra tilt angle method, and classical method. The end vertebra tilt angle method takes less measuring time than the classical method. The measuring error between the classical method and the tilt angle method showed no statistical significance for the difference. CONCLUSION The scoliosis Cobb angle can be measured accurately and rapidly using the principle of the Cobb angle being equal to the sum of tilt angles of the upper and lower end vertebra, where in the film data of imaging will not be easily contaminated. Under special conditions, the average measuring error is ± 3°.
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Galbusera F, Bassani T, Costa F, Brayda-Bruno M, Zerbi A, Wilke HJ. Artificial neural networks for the recognition of vertebral landmarks in the lumbar spine. COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING: IMAGING & VISUALIZATION 2018. [DOI: 10.1080/21681163.2016.1261370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Fabio Galbusera
- Laboratory of Biological Structures Mechanics, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Tito Bassani
- Laboratory of Biological Structures Mechanics, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Francesco Costa
- Department of Neurosurgery, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Marco Brayda-Bruno
- Department of Spine Surgery III, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Alberto Zerbi
- Department of Radiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Hans-Joachim Wilke
- Center for Trauma Research Ulm (ZTF), Institute of Orthopaedic Research and Biomechanics, Ulm University, Ulm, Germany
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Alsharif W, Davis M, Rainford L, Cradock A, McGee A. Validation of the educational effectiveness of a mobile learning app to improve knowledge about MR image quality optimisation and artefact reduction. Insights Imaging 2018; 9:721-730. [PMID: 29949036 PMCID: PMC6206384 DOI: 10.1007/s13244-018-0635-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 04/11/2018] [Accepted: 04/18/2018] [Indexed: 12/02/2022] Open
Abstract
Aim The aim was to design an app-based eLearning tool to provide radiographers with information about the physical basis of MR artefacts and practical elimination or/and minimisation strategies to optimise image quality, and to evaluate the impact of a smartphone app on radiographers’ knowledge. Methods The study used the comparison-experimental approach (pre- and post-test). Thirty-five MR radiographers independently reviewed a prepared series of MR images (n = 25). The participants were requested to identify image quality related errors, to specify error-correction strategies and to score how confident they were in their responses. Participants were then divided into experimental (n = 19) and control cohorts (n = 16). The app was provided to the experimental cohort for 3 months; after this period both cohorts re-reviewed the MR image datasets and repeated their identification of image quality errors. Results The results showed a statistically significant difference between control and experimental cohorts relative to participants’ pre- to post-test knowledge level. For the experimental cohort, years of experience, qualification and type of hospital were not associated with radiographer knowledge level and confidence in recognising the presence of an image quality error, naming the error and specifying appropriate correction strategies (p > 0.05). Conclusion The study identified the potential of the smartphone app as an effective educational tool to support MR radiographers’ knowledge in recognising and characterising MR image quality errors. Key Points • A high level of knowledge to optimise MR image quality is crucial. • Ongoing education in image quality optimisation is required. • The potential role of app as an effective educational tool is identified.
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Affiliation(s)
- Walaa Alsharif
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland. .,Faculty of Applied Medical Sciences, Taibah University, Madinah, Kingdom of Saudi Arabia.
| | - Michaela Davis
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - Louise Rainford
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - Andrea Cradock
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - Allison McGee
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
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Design and Testing of a Flexible Inclinometer Probe for Model Tests of Landslide Deep Displacement Measurement. SENSORS 2018; 18:s18010224. [PMID: 29342902 PMCID: PMC5796333 DOI: 10.3390/s18010224] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 12/25/2017] [Accepted: 01/11/2018] [Indexed: 11/30/2022]
Abstract
The physical model test of landslides is important for studying landslide structural damage, and parameter measurement is key in this process. To meet the measurement requirements for deep displacement in landslide physical models, an automatic flexible inclinometer probe with good coupling and large deformation capacity was designed. The flexible inclinometer probe consists of several gravity acceleration sensing units that are protected and positioned by silicon encapsulation, all the units are connected to a 485-comunication bus. By sensing the two-axis tilt angle, the direction and magnitude of the displacement for a measurement unit can be calculated, then the overall displacement is accumulated according to all units, integrated from bottom to top in turn. In the conversion from angle to displacement, two spline interpolation methods are introduced to correct and resample the data; one is to interpolate the displacement after conversion, and the other is to interpolate the angle before conversion; compared with the result read from checkered paper, the latter is proved to have a better effect, with an additional condition that the displacement curve move up half the length of the unit. The flexible inclinometer is verified with respect to its principle and arrangement by a laboratory physical model test, and the test results are highly consistent with the actual deformation of the landslide model.
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Kunkle WA, Madden M, Potts S, Fogelson J, Hershman S. Validity of a smartphone protractor to measure sagittal parameters in adult spinal deformity. Spine J 2017; 17:1559-1564. [PMID: 28818564 DOI: 10.1016/j.spinee.2017.06.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/07/2017] [Accepted: 06/16/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Smartphones have become an integral tool in the daily life of health-care professionals (Franko 2011). Their ease of use and wide availability often make smartphones the first tool surgeons use to perform measurements. This technique has been validated for certain orthopedic pathologies (Shaw 2012; Quek 2014; Milanese 2014; Milani 2014), but never to assess sagittal parameters in adult spinal deformity (ASD). This study was designed to assess the validity, reproducibility, precision, and efficiency of using a smartphone protractor application to measure sagittal parameters commonly measured in ASD assessment and surgical planning. PURPOSE This study aimed to (1) determine the validity of smartphone protractor applications, (2) determine the intra- and interobserver reliability of smartphone protractor applications when used to measure sagittal parameters in ASD, (3) determine the efficiency of using a smartphone protractor application to measure sagittal parameters, and (4) elucidate whether a physician's level of experience impacts the reliability or validity of using a smartphone protractor application to measure sagittal parameters in ASD. STUDY DESIGN/SETTING An experimental validation study was carried out. METHODS Thirty standard 36″ standing lateral radiographs were examined. Three separate measurements were performed using a marker and protractor; then at a separate time point, three separate measurements were performed using a smartphone protractor application for all 30 radiographs. The first 10 radiographs were then re-measured two more times, for a total of three measurements from both the smartphone protractor and marker and protractor. The parameters included lumbar lordosis, pelvic incidence, and pelvic tilt. Three raters performed all measurements-a junior level orthopedic resident, a senior level orthopedic resident, and a fellowship-trained spinal deformity surgeon. All data, including the time to perform the measurements, were recorded, and statistical analysis was performed to determine intra- and interobserver reliability, as well as accuracy, efficiency, and precision. Statistical analysis using the intra- and interclass correlation coefficient was calculated using R (version 3.3.2, 2016) to determine the degree of intra- and interobserver reliability. RESULTS High rates of intra- and interobserver reliability were observed between the junior resident, senior resident, and attending surgeon when using the smartphone protractor application as demonstrated by high inter- and intra-class correlation coefficients greater than 0.909 and 0.874 respectively. High rates of inter- and intraobserver reliability were also seen between the junior resident, senior resident, and attending surgeon when a marker and protractor were used as demonstrated by high inter- and intra-class correlation coefficients greater than 0.909 and 0.807 respectively. The lumbar lordosis, pelvic incidence, and pelvic tilt values were accurately measured by all three raters, with excellent inter- and intra-class correlation coefficient values. When the first 10 radiographs were re-measured at different time points, a high degree of precision was noted. Measurements performed using the smartphone application were consistently faster than using a marker and protractor-this difference reached statistical significance of p<.05. CONCLUSIONS Adult spinal deformity radiographic parameters can be measured accurately, precisely, reliably, and more efficiently using a smartphone protractor application than with a standard protractor and wax pencil. A high degree of intra- and interobserver reliability was seen between the residents and attending surgeon, indicating measurements made with a smartphone protractor are unaffected by an observer's level of experience. As a result, smartphone protractors may be used when planning ASD surgery.
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Affiliation(s)
- William Aaron Kunkle
- Department of Orthopedic Surgery, Broward Health Medical Center, 1600 South Andrews Ave, Fort Lauderdale, FL 33316, USA.
| | - Michael Madden
- Department of Orthopedic Surgery, Broward Health Medical Center, 1600 South Andrews Ave, Fort Lauderdale, FL 33316, USA
| | - Shannon Potts
- Department of Mathematics, University of Southern California, 3620 South Vermont Ave, KAP 104, Los Angeles, CA 90089, USA
| | - Jeremy Fogelson
- Department of Neurosurgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - Stuart Hershman
- Department of Orthopedic Surgery, Yawkey Center for Outpatient Care, Massachusetts General Hospital, 55 Fruit St, Suite 3A, Boston, MA 02114, USA
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Jung SH, Kwon OY, Jeon IC, Hwang UJ, Weon JH. Reliability and criterion validity of measurements using a smart phone-based measurement tool for the transverse rotation angle of the pelvis during single-leg lifting. Physiother Theory Pract 2017; 34:58-65. [DOI: 10.1080/09593985.2017.1368756] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sung-hoon Jung
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea
| | - Oh-yun Kwon
- Department of Physical Therapy of Health Science, Yonsei University, Wonju, South Korea
| | - In-cheol Jeon
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea
| | - Ui-jae Hwang
- Department of Physical Therapy of Health Science, Yonsei University, Wonju, South Korea
| | - Jong-hyuck Weon
- Department of Physical Therapy, Graduate School, Joongboo University, Geumsan, South Korea
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Datillo JR, Gittings DJ, Sloan M, Hardaker WM, Deasey MJ, Sheth NP. "Is There An App For That?" Orthopaedic Patient Preferences For A Smartphone Application. Appl Clin Inform 2017; 8:832-844. [PMID: 28885637 PMCID: PMC6220699 DOI: 10.4338/aci-2017-04-ra-0058] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 06/27/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patients are seeking out medical information on the Internet and utilizing smartphone health applications ("apps"). Smartphone use has exponentially increased among orthopaedic surgeons and patients. Despite this increase, patients are rarely directed to specific apps by physicians. No study exists querying patient preferences for a patient-centered, orthopaedic smartphone application. OBJECTIVES The purpose of this study is to 1) determine Internet use patterns amongst orthopaedic patients; 2) ascertain access to and use of smartphones; and 3) elucidate what features orthopaedic patients find most important in a smartphone application. METHODS We surveyed patients in an orthopaedic practice in an urban academic center to assess demographics, access to and patterns of Internet and Smartphone use, and preferences for features in a smartphone app. RESULTS A total of 310 surveys were completed. Eighty percent of patients reported Internet access, and 62% used the Internet for health information. Seventy-seven percent owned smartphones, 45% used them for health information, and 28% owned health apps. Only 11% were referred to an app by a physician. The highest ranked features were appointment reminders, ability to view test results, communication with physicians, and discharge instructions. General orthopaedic information and pictures or videos explaining surgery were the 2 lowest ranked features. Seventy-one percent of patients felt an app with some of the described features would improve their healthcare experiences, and 40% would pay for the app. CONCLUSIONS The smartphone is an under-utilized tool to enhance patient-physician communication, increase satisfaction, and improve quality of care. Patients were enthusiastic about app features that are often included in patient health portals, but ranked orthopaedic educational features lowest. Further study is required to elucidate how best to use orthopaedic apps as physician-directed educational opportunities to promote patient satisfaction and quality of care.
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Affiliation(s)
| | | | | | | | | | - Neil P Sheth
- Neil P. Sheth, MD, University of Pennsylvania, 800 Spruce Street, 1st Floor Cathcart Building, Philadelphia, PA 19107, USA,
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Cao JQ, Huang JH, Yuan T, Jia WT, Gao H. Intraoperative Correction of Femoral Rotational Deformity Using a Conventional Navigation System and a Smartphone: A Novel Technique. Surg Innov 2017. [PMID: 28639848 DOI: 10.1177/1553350617715373] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The intraoperatively rotational control of femoral shaft fractures treated with a closed intramedullary interlocking nailing is a challenging problem. A novel surgical technique that includes respective insertions of guidewires into the proximal and distal femur under the guidance of a 2-dimensional fluoroscopy-based navigation system and the measurements of the intersection angle subtended by the proximal and distal guidewires with the smartphone positional software has been designed to provide intraoperatively quantitative parameters of femoral rotation deformation. The comparison of these parameters with preoperative measurement values of the contralateral intact femur on computed tomography images was used to align the proximal and distal femur fragments based on periaxial rotation. The purpose of this study was to evaluate its clinical suitability. Ten adult patients with femoral shaft fractures were attempted to correct intraoperatively femoral rotational deformity using this novel technique. The additional operation time was 20.04 ± 3.27 minutes. The angle of femoral anteversion was 20.85° ± 4.22°, 38.14° ± 19.07°, and 22.77° ± 3.38° in the contralateral intact and preoperatively and postoperatively injured femur, respectively. The mean absolute difference between both limbs was preoperatively 21.55° ± 10.14° with a statistically significant difference ( P = .005) and postoperatively 3.24° ± 1.69° with no statistically significant difference ( P = .092). Our results showed this novel technique could become an effective tool to correct intraoperatively rotational malalignment of femoral fractures.
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Affiliation(s)
- Jia-Qing Cao
- 1 Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Jing-Huan Huang
- 1 Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Ting Yuan
- 1 Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Wei-Tao Jia
- 1 Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Hong Gao
- 1 Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
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Abstract
STUDY DESIGN A prospective study of a new technique. OBJECTIVE The aims of this study were to report a manual technique for measuring vertebral curves on digital spine radiographs, and to assess the agreement of this technique with that of digital software for measuring vertebral curves. SUMMARY OF BACKGROUND DATA Modern picture archiving and communication systems (PACS) typically include software for evaluating radiographic measurements. However, in the outpatient spine setting, patients may present with radiographs stored on a physical disc, which may not include software for measuring vertebral curves. Certain smartphone applications may be used to determine curve magnitude; however, the need exists for an accurate manual technique to measure vertebral curves on digital radiographs in the absence of available analytic software or smartphone technology. METHODS We prospectively reviewed anteroposterior and lateral spine radiographs of 24 spinal deformity patients. Two independent observers measured Cobb angles for: (1) the major coronal curve; (2) the thoracic kyphosis (T2-T12); and (3) the lumbar lordosis (T12-S1). Measurements were made: (1) digitally using our institution's PACS; and (2) by a manual technique, which involves placement of an adhesive Post-It note directly on the computer screen, transcribing the angle onto the Post-It note with a pencil, and measuring the angle with a handheld goniometer. Intraclass correlation coefficients (ICCs) were calculated to determine the agreement between the 2 methods. RESULTS For both observers, the agreement between the digital PACS and manual Post-It techniques was graded as excellent for both coronal and sagittal plane curves (all ICCs>0.9). Interobserver reliability between the 2 observers was also graded as excellent for both the PACS and Post-It techniques (all ICCs>0.9). CONCLUSIONS The Post-It technique for measuring Cobb angles demonstrated excellent agreement with the PACS system in our series of spinal deformity patients. Curves on digital radiographs can be accurately measured using a convenient manual technique.
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Pepe M, Kocadal O, Iyigun A, Gunes Z, Aksahin E, Aktekin CN. Use of the smartphone for end vertebra selection in scoliosis. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2017; 51:146-149. [PMID: 28077254 PMCID: PMC6197643 DOI: 10.1016/j.aott.2016.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 04/18/2016] [Accepted: 07/04/2016] [Indexed: 11/30/2022]
Abstract
Objectives The aim of our study was to develop a smartphone-aided end vertebra selection method and to investigate its effectiveness in Cobb angle measurement. Methods Twenty-nine adolescent idiopathic scoliosis patients' pre-operative posteroanterior scoliosis radiographs were used for end vertebra selection and Cobb angle measurement by standard method and smartphone-aided method. Measurements were performed by 7 examiners. The intraclass correlation coefficient was used to analyze selection and measurement reliability. Summary statistics of variance calculations were used to provide 95% prediction limits for the error in Cobb angle measurements. A paired 2-tailed t test was used to analyze end vertebra selection differences. Results Mean absolute Cobb angle difference was 3.6° for the manual method and 1.9° for the smartphone-aided method. Both intraobserver and interobserver reliability were found excellent in manual and smartphone set for Cobb angle measurement. Both intraobserver and interobserver reliability were found excellent in manual and smartphone set for end vertebra selection. But reliability values of manual set were lower than smartphone. Two observers selected significantly different end vertebra in their repeated selections for manual method. Conclusion Smartphone-aided method for end vertebra selection and Cobb angle measurement showed excellent reliability. We can expect a reduction in measurement error rates with the widespread use of this method in clinical practice. Level of evidence Level III, Diagnostic study
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Marchi L, Fortti F, Amaral R, Oliveira L, Nogueira-Neto J, Jensen R, Pimenta L. REPRODUCIBILITY AND EQUIVALENCE OF COBBMETER APPLICATION IN THE SAGITTAL EVALUATION OF THE SPINE. COLUNA/COLUMNA 2016. [DOI: 10.1590/s1808-185120161504165101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: This study aims to evaluate the reliability and equivalency of using the Cobbmeter application for iPhone compared to the manual measurement method in the analysis of the sagittal spinal alignment. Methods: Cross-sectional, prospective, single-center study that had 20 panoramic radiographs of the spine in lateral view, in a neutral standing position, analyzed blindly and randomly by three independent examiners in three different times. The parameters were pelvic incidence (PI), pelvic tilt (PT) and lumbar lordosis (LL). The statistical analysis was performed to measure the intraclass correlation coefficient (ICC) between the two measurement methods, in addition to measuring the intra and inter-evaluators reliability. Results: For reproducibility analysis, the intra-evaluators ICC using the application resulted in a Kappa (K) of 0.975 for the evaluation of pelvic incidence (PI) evaluation. For pelvic tilt (PT), the K value obtained was 0.981 and the K measured for lumbar lordosis (LL) analysis was 0.987. The inter-evaluators evaluation of reproducibility using the application resulted in a K value of 0.917 for PI, 0.930 for PT and 0.951 for LL. For the assessment of equivalency of methods, comparing the application to the standard method, with a goniometer and dermographic pencil, the K value found for PI was 0.873, for PV was 0.939 and for LL was 0.914. All values were significant (p<0.001) against the null hypothesis. Conclusion: This smartphone application is a valid and reliable instrument for measuring the angle involved in the sagittal balance of the spine. Furthermore, the results show that its applicability is not inferior to the manual method with goniometer and dermographic pencil.
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Affiliation(s)
| | | | | | | | | | | | - Luiz Pimenta
- Instituto de Patologia da Coluna, Brazil; University of California San Diego, USA
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Andrawis JP, Muzykewicz DA, Franko OI. Mobile Device Trends in Orthopedic Surgery: Rapid Change and Future Implications. Orthopedics 2016; 39:e51-6. [PMID: 26730684 DOI: 10.3928/01477447-20151228-01] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 05/04/2015] [Indexed: 02/03/2023]
Abstract
Mobile devices are increasingly becoming integral communication and clinical tools. Monitoring the prevalence and utilization characteristics of surgeons and trainees is critical to understanding how these new technologies can be best used in practice. The authors conducted a prospective Internet-based survey over 7 time points from August 2010 to August 2014 at all nationwide American Council for Graduate Medical Education-accredited orthopedic programs. The survey questionnaire was designed to evaluate the use of devices and mobile applications (apps) among trainees and physicians in the clinical setting. Results were analyzed and summarized for orthopedic surgeons and trainees. During the 48-month period, there were 7 time points with 467, 622, 329, 223, 237, 111, and 134 responses. Mobile device use in the clinical setting increased across all fields and levels of training during the study period. Orthopedic trainees increased their use of Smartphone apps in the clinical setting from 60% to 84%, whereas attending use increased from 41% to 61%. During this time frame, use of Apple/Android platforms increased from 45%/13% to 85%/15%, respectively. At all time points, 70% of orthopedic surgeons believed their institution/hospital should support mobile device use. As measured over a 48-month period, mobile devices have become an ubiquitous tool in the clinical setting among orthopedic surgeons and trainees. The authors expect these trends to continue and encourage providers and trainees to be aware of the limitations and risks inherent with new technology.
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Frank JA, Brill A, Kapila V. Mounted Smartphones as Measurement and Control Platforms for Motor-Based Laboratory Test-Beds. SENSORS 2016; 16:s16081331. [PMID: 27556464 PMCID: PMC5017495 DOI: 10.3390/s16081331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 08/08/2016] [Accepted: 08/15/2016] [Indexed: 11/16/2022]
Abstract
Laboratory education in science and engineering often entails the use of test-beds equipped with costly peripherals for sensing, acquisition, storage, processing, and control of physical behavior. However, costly peripherals are no longer necessary to obtain precise measurements and achieve stable feedback control of test-beds. With smartphones performing diverse sensing and processing tasks, this study examines the feasibility of mounting smartphones directly to test-beds to exploit their embedded hardware and software in the measurement and control of the test-beds. This approach is a first step towards replacing laboratory-grade peripherals with more compact and affordable smartphone-based platforms, whose interactive user interfaces can engender wider participation and engagement from learners. Demonstrative cases are presented in which the sensing, computation, control, and user interaction with three motor-based test-beds are handled by a mounted smartphone. Results of experiments and simulations are used to validate the feasibility of mounted smartphones as measurement and feedback control platforms for motor-based laboratory test-beds, report the measurement precision and closed-loop performance achieved with such platforms, and address challenges in the development of platforms to maintain system stability.
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Affiliation(s)
- Jared A Frank
- Department of Mechanical and Aerospace Engineering, NYU Tandon School of Engineering, Mechatronics and Control Laboratory, Brooklyn, NY 11201, USA.
| | - Anthony Brill
- Department of Mechanical and Aerospace Engineering, NYU Tandon School of Engineering, Mechatronics and Control Laboratory, Brooklyn, NY 11201, USA.
| | - Vikram Kapila
- Department of Mechanical and Aerospace Engineering, NYU Tandon School of Engineering, Mechatronics and Control Laboratory, Brooklyn, NY 11201, USA.
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Abstract
Recently, several technological advances have been introduced to mobile phones leading some people to refer to them as "smartphones." These changes have led to widespread consumer adoption. A similar adoption has occurred within the medical field and this revolution is changing the practice of medicine, including pathology. Several mobile applications have been published for dermatology, orthopedics, ophthalmology, neurosurgery, and clinical pathology. The applications are wide ranging, including mobile technology to increase patient engagement, self-monitoring by patients, clinical algorithm calculation, facilitation between experts to resource-poor environments. These advances have been received with mixed reviews. For anatomic pathology, mobile technology applications can be broken into 4 broad categories: (a) educational uses, (b) microscope with mobile phone, (c) mobile phone as microscope/acquisition device, and (d) miscellaneous. Using a mobile phone as an acquisition device paired with a microscope seems to be the most interesting current application because of the need for expert consultation with resource-poor environments. However, several emerging uses for mobile technology may become more prominent as the technology matures including image analysis, alternative light sources, and increased opportunities for clinician and patient engagement. The flexibility represented by mobile technology represents a burgeoning field in pathology informatics.
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Smartphone applications in paediatric radiology: availability and authority. Pediatr Radiol 2015; 45:1293-302. [PMID: 25824959 DOI: 10.1007/s00247-015-3327-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 01/10/2015] [Accepted: 02/24/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND With the widespread ownership of smartphones, many health care professionals question the degree to which medically related smartphone applications are reliable. OBJECTIVES To assess the variety of smartphone applications relating to paediatric radiology and the presence of health care professional involvement in their development. As a secondary objective, we explore whether there are gaps within the paediatric radiology app market. MATERIALS AND METHODS The most popular smartphone marketplaces (Apple iTunes App Store, Blackberry Mobile Market, Google Play Android Market, Nokia Ovi, Samsung and Microsoft Windows Marketplace) were searched for terms relating to paediatric radiology. Cost, review ratings, number of downloads, health care involvement and target audience were recorded. RESULTS Nine paediatric radiology applications were found in the Apple iTunes App Store and nine in the Google Play Android Market. The target audiences for all applications were health care professionals. None were available for patients or their caregivers. All applications were reported to have medical expertise in their development. CONCLUSION All paediatric radiology applications were developed with the aid of a health care professional. Due to the small number available online, there is a potential gap in the marketplace for further applications in this field, possibly aimed at patients and their families.
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Allam Y, El-Fiky T, Farghally MY, Al-Sabagh S, Siam AE. Comparison between Oxford Cobbmeter and digital Cobbmeter for measurement of Cobb angle in adolescent idiopathic scoliosis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015. [PMID: 26223745 DOI: 10.1007/s00586-015-4162-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to compare Cobb angle measurements performed using an Oxford Cobbmeter and digital Cobbmeter in a series of 20 adolescent idiopathic scoliosis (AIS) patients. METHODS Four observers measured major Cobb angles on 20 standing postero-anterior radiographs of AIS patients with both Oxford Cobbmeter and digital Cobbmeter (iPhone Cobbmeter Application). The measurements were repeated a week after the original measurements. RESULTS The mean Cobb angle in this study was 43.6° ± 23.62°. The mean measurement time for an observer to measure the 20 Cobb angles was 24.9 min for the smart phone compared with 25.6 min for the Oxford Cobbmeter. The 95 % confidence interval for differences between smart phone and Oxford Cobbmeter measurements on the same radiograph was ±3.68°. The intra-observer variability of the smart phone is equivalent to the Oxford Cobbmeter. The 95 % confidence intervals for inter-observer error were ±5° and ±5.8° for the smart phone and Oxford Cobbmeter, respectively. CONCLUSIONS We conclude that the smart phone with integrated Tiltmeter and Cobbmeter application is an equivalent Cobb measurement tool to the Oxford Cobbmeter. The advantages of smart phone are the accuracy of determining the most inclined vertebrae and accordingly more precise Cobb angle measurement. The new smart phones with these integrated applications may be really helpful to the spine surgeons, especially in hospitals where PACS or Oxford Cobbmeter is not available.
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Affiliation(s)
- Yasser Allam
- Spine Unit, Al-Hadra University Hospital, Alexandria University, Alexandria, Egypt
| | - Tarek El-Fiky
- Spine Unit, Al-Hadra University Hospital, Alexandria University, Alexandria, Egypt
| | | | - Sameh Al-Sabagh
- Spine Unit, Al-Hadra University Hospital, Alexandria University, Alexandria, Egypt
| | - Ahmed Ezzat Siam
- Spine Unit, Al-Hadra University Hospital, Alexandria University, Alexandria, Egypt.
- Department of Spinal Surgery and Scoliosis Center, Schön Klinik Vogtareuth, 20 Krankenhausstraße, 83569, Vogtareuth, Germany.
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Mazzuia ARDO, Machado DR, Fukumothi DK, Nunes LFB, Tucci Neto C, Jorge HMDH, Ortiz RT, Mattos CAD. Iphone app use to Cobb angle in adolescent idiopathic scoliosis: Does this apply? COLUNA/COLUMNA 2015. [DOI: 10.1590/s1808-185120151402145324] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
<sec><title>OBJECTIVE:</title><p> To validate a new method of measuring the Cobb angle for scoliosis from the mobile app CobbMeter to facilitate the evaluation and measurement in clinical practice.</p></sec><sec><title>METHODS:</title><p> Five observers with minimum experience of two years in the field performed radiographic measurements of Cobb angle in 24 radiographs of patients with adolescent idiopathic scoliosis through the CobbMeter. Observers performed serial measures on the images with the application, which were repeated after one month. The most experienced appraiser of the group, after measurements were made through the application, determined the Cobb angle in each radiography by the traditional method.</p></sec><sec><title>RESULTS:</title><p> The mean standard deviation by comparing the angles electronically and manually measured had no clinical significance. Although 40% of electronic measurements are outside the confidence interval when compared to manual measurements, this difference was insignificant in clinical practice.</p></sec><sec><title>CONCLUSIONS:</title><p> The CobbMeter is another alternative for measuring Cobb angle in scoliosis.</p></sec>
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Reliability and validity of inexpensive and easily administered anthropometric clinical evaluation methods of postural asymmetry measurement in adolescent idiopathic scoliosis: a systematic review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015; 25:450-66. [PMID: 25917824 DOI: 10.1007/s00586-015-3961-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 04/13/2015] [Accepted: 04/13/2015] [Indexed: 12/24/2022]
Abstract
PURPOSE As accurate and reproducible measurements of spinal curvature are crucial in the examination of patients with adolescent idiopathic scoliosis (AIS), this systematic review aims to report on the reliability and validity of a range of inexpensive and easily administered anthropometric methods of postural asymmetry measurement in an AIS population, to inform practice in a clinical setting. METHODS A systematic search of health research databases located studies assessing reliability and validity of inexpensive and easily administered anthropometric measures. RESULTS Fourteen studies satisfied eligibility criteria. The methodological quality of included studies ranged from low to high. Validity studies were of moderate to high quality. In total, nine clinically applicable, inexpensive and easily administered anthropometric methods were identified, for assessing AIS curvature. All methods demonstrated high to very high inter-observer and intra-observer reliability. Reported criterion validity of the scoliometer and 2D photographs, when compared to Cobb angle assessed from radiographs, ranged from low to very high. iPhone measurements correlated well with scoliometer measurements. 2D photography results had a moderate to high correlation with 3D topography results. CONCLUSIONS Overall, strong levels of evidence exist for iPhone and scoliometer measurements, with a high to very high reliability and moderate to very high validity. Moderate levels of evidence exist for scoliometer with mathematical formula and clinical examination with moderate and low validity, respectively. Limited evidence exists for aesthetic tools TRACE and AI and 2D photography. These results indicate there are accurate and reproducible anthropometric measures that are inexpensive and applicable in therapy settings to assess postural asymmetry; however, these only exist for measurement in the transverse plane, despite 3D characteristics of AIS. Further research is required into an inexpensive and easily administered method that can assess postural asymmetry in all anatomical planes.
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Wu G, Wang H, Ding R, Xue XH, Wu ZH, Qiu GX. Reliability of a novel Cobb protractor for measuring the Cobb angle of radiograph in scoliosis. CHINESE MEDICAL SCIENCES JOURNAL = CHUNG-KUO I HSUEH K'O HSUEH TSA CHIH 2015; 30:18-22. [PMID: 25837355 DOI: 10.1016/s1001-9294(15)30003-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To introduce a novel Cobb protractor and assess its reliability and rapidity for measuring Cobb angle in scoliosis patients. METHODS The novel Cobb protractor had two endplate markers. A measurement was performed just to align the two markers to each endplate of the curve. The Cobb angle on the posteroanterior radiographs of 24 patients clinically diagnosed with adolescent idiopathic scoliosis was measured by three orthopedic surgeons with both standard Cobb method and the new technique, and the time of measurement was recorded. Intraclass correlation coefficients (ICCs) were calculated to assess the reliability of the new method. RESULTS The time for a measurement with the new tool was approximately 10 seconds less than the time that used to finish a measurement with the standard method (P<0.05). The overall mean Cobb angle for the major curve of the 24 patients was 47.8°. The mean overall intraobserver and interobserver ICC was 0.971 and 0.971 for the Cobb method group, while the overall intraobserver ICC and the interobserver was 0.985 and 0.979 for the new tool group. CONCLUSIONS The novel Cobb protractor could perform quick measurement and measure almost all forms of radiographs. The Cobb protractor might be an ideal instrument to measure the Cobb angle.
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Affiliation(s)
- Gui Wu
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Hai Wang
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Ran Ding
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Xu-hong Xue
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Zhi-hong Wu
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Gui-xing Qiu
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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Cui X, Baker JM, Liu N, Reiss AL. Sensitivity of fNIRS measurement to head motion: an applied use of smartphones in the lab. J Neurosci Methods 2015; 245:37-43. [PMID: 25687634 DOI: 10.1016/j.jneumeth.2015.02.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 02/04/2015] [Accepted: 02/06/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Powerful computing capabilities in small, easy to use hand-held devices have made smart technologies such as smartphones and tablets ubiquitous in today's society. The capabilities of these devices provide scientists with many tools that can be used to improve the scientific method. METHOD Here, we demonstrate how smartphones may be used to quantify the sensitivity of functional near-infrared spectroscopy (fNIRS) signal to head motion. By attaching a smartphone to participants' heads during the fNIRS scan, we were able to capture data describing the degree of head motion. RESULTS Our results demonstrate that data recorded from an off-the-shelf smartphone accelerometer may be used to identify correlations between head-movement and fNIRS signal change. Furthermore, our results identify correlations between the magnitudes of head-movement and signal artifact, as well as a relationship between the direction of head movement and the location of the resulting signal noise. CONCLUSIONS These data provide a valuable proof-of-concept for the use of off-the-shelf smart technologies in neuroimaging applications.
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Affiliation(s)
- Xu Cui
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
| | - Joseph M Baker
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
| | - Ning Liu
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
| | - Allan L Reiss
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
- Department of Radiology, Stanford University School of Medicine
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Galán-Mercant A, Barón-López FJ, Labajos-Manzanares MT, Cuesta-Vargas AI. Reliability and criterion-related validity with a smartphone used in timed-up-and-go test. Biomed Eng Online 2014; 13:156. [PMID: 25440533 PMCID: PMC4265430 DOI: 10.1186/1475-925x-13-156] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 10/29/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The capacity to diagnosys, quantify and evaluate movement beyond the general confines of a clinical environment under effectiveness conditions may alleviate rampant strain on limited, expensive and highly specialized medical resources. An iPhone 4® mounted a three dimensional accelerometer subsystem with highly robust software applications. The present study aimed to evaluate the reliability and concurrent criterion-related validity of the accelerations with an iPhone 4® in an Extended Timed Get Up and Go test. Extended Timed Get Up and Go is a clinical test with that the patient get up from the chair and walking ten meters, turn and coming back to the chair. METHODS A repeated measure, cross-sectional, analytical study. Test-retest reliability of the kinematic measurements of the iPhone 4® compared with a standard validated laboratory device. We calculated the Coefficient of Multiple Correlation between the two sensors acceleration signal of each subject, in each sub-stage, in each of the three Extended Timed Get Up and Go test trials. To investigate statistical agreement between the two sensors we used the Bland-Altman method. RESULTS With respect to the analysis of the correlation data in the present work, the Coefficient of Multiple Correlation of the five subjects in their triplicated trials were as follows: in sub-phase Sit to Stand the ranged between r = 0.991 to 0.842; in Gait Go, r = 0.967 to 0.852; in Turn, 0.979 to 0.798; in Gait Come, 0.964 to 0.887; and in Turn to Stand to Sit, 0.992 to 0.877. All the correlations between the sensors were significant (p < 0.001). The Bland-Altman plots obtained showed a solid tendency to stay at close to zero, especially on the y and x-axes, during the five phases of the Extended Timed Get Up and Go test. CONCLUSIONS The inertial sensor mounted in the iPhone 4® is sufficiently reliable and accurate to evaluate and identify the kinematic patterns in an Extended Timed Get and Go test. While analysis and interpretation of 3D kinematics data continue to be dauntingly complex, the iPhone 4® makes the task of acquiring the data relatively inexpensive and easy to use.
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Affiliation(s)
| | | | | | - Antonio I Cuesta-Vargas
- Departamento de Psiquiatría y Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucia Tech, Cátedra de Fisioterapia y Discapacidad, Instituto de Biomedicina de Málaga (IBIMA), Grupo de Clinimetria (AE-14), Av/ Arquitecto Peñalosa s/n (Teatinos Campus Expansion), 29009 Málaga, Spain.
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Abstract
STUDY DESIGN This was a prospective blinded validity and reliability analysis. OBJECTIVE The aim of this study was validation and reliability evaluation of the Scoligauge iPhone app. BACKGROUND The scoliometer is used to clinically measure the rib hump in scoliosis as a means to evaluate the axial trunk rotation. The increasing availability of smartphone with built-in accelerometer led to the development of a vast number of applications to measure angles. Of these, the Scoligauge mimics a scoliometer. The aim of this study was to compare the validity of the Scoligauge iPhone application without an associated adapter with the traditional scoliometer and to test the reliability of the application in a clinical setting. METHODS Two observers measured the rib hump deformity on 34 consecutive patients with idiopathic scoliosis with an average Cobb angle of 24.2 ± 13.5 degrees (range, 4 to 65 degrees). Measurements were made with an iPhone without the adapter and with a scoliometer. The validity as well as the interobserver and intraobserver reliability were calculated using the intraclass coefficient (ICC) and the Bland-Altman test. RESULTS The mean difference between the scoliometer and the Scoligauge application was 0.4 degrees [95% confidence interval (CI) of ± 3.1 degrees] with an ICC of 0.947 (P < 0.001). The intraobserver and interobserver ICC were 0.961 (P < 0.001) and 0.901 (P < 0.001), respectively. The mean intraobserver difference was 0.0 degrees (95% CI of ± 2.7 degrees) and the mean interobserver difference was 0.1 degrees (95% CI of ± 4.4 degrees). CONCLUSIONS The intraobserver and interobserver reliability of the Scoligauge iPhone app, as well as its validity compared with the scoliometer, are excellent. The mean differences between measurements are small and clinically not significant. Thus, the Scoligauge application is valid for clinical evaluation even without special adapter. LEVEL OF EVIDENCE Level I (Diagnostic Study).
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Galán-Mercant A, Cuesta-Vargas AI. Mobile Romberg test assessment (mRomberg). BMC Res Notes 2014; 7:640. [PMID: 25217250 PMCID: PMC4167282 DOI: 10.1186/1756-0500-7-640] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 09/09/2014] [Indexed: 11/21/2022] Open
Abstract
Background The diagnosis of frailty is based on physical impairments and clinicians have indicated that early detection is one of the most effective methods for reducing the severity of physical frailty. Maybe, an alternative to the classical diagnosis could be the instrumentalization of classical functional testing, as Romberg test or Timed Get Up and Go Test. The aim of this study was (I) to measure and describe the magnitude of accelerometry values in the Romberg test in two groups of frail and non-frail elderly people through instrumentation with the iPhone 4®, (II) to analyse the performances and differences between the study groups, and (III) to analyse the performances and differences within study groups to characterise accelerometer responses to increasingly difficult challenges to balance. Methods This is a cross-sectional study of 18 subjects over 70 years old, 9 frail subjects and 9 non-frail subjects. The non-parametric Mann–Whitney U test was used for between-group comparisons in means values derived from different tasks. The Wilcoxon Signed-Rank test was used to analyse differences between different variants of the test in both independent study groups. Results The highest difference between groups was found in the accelerometer values with eyes closed and feet parallel: maximum peak acceleration in the lateral axis (p < 0.01), minimum peak acceleration in the lateral axis (p < 0.01) and minimum peak acceleration from the resultant vector (p < 0.01). Subjects with eyes open and feet parallel, greatest differences found between the groups were in the maximum peak acceleration in the lateral axis (p < 0.01), minimum peak acceleration in the lateral axis (p < 0.01) and minimum peak acceleration from the resultant vector (p < 0.001). With eyes closed and feet in tandem, the greatest differences found between the groups were in the minimum peak acceleration in the lateral axis (p < 0.01). Conclusions The accelerometer fitted in the iPhone 4® is able to study and analyse the kinematics of the Romberg test between frail and non-frail elderly people. In addition, the results indicate that the accelerometry values also were significantly different between the frail and non-frail groups, and that values from the accelerometer accelerometer increased as the test was made more complicated.
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Affiliation(s)
| | - Antonio I Cuesta-Vargas
- Departamento de Psiquiatría y Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucia Tech, Cátedra de Fisioterapia y Discapacidad, Instituto de Biomedicina de Málaga (IBIMA), Grupo de Clinimetria (AE-14) Málaga, Malaga, Spain.
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A comparison of the reliability of the trochanteric prominence angle test and the alternative method in healthy subjects. ACTA ACUST UNITED AC 2014; 19:97-101. [DOI: 10.1016/j.math.2013.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 07/24/2013] [Accepted: 07/30/2013] [Indexed: 11/22/2022]
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Jones A, Sealey R, Crowe M, Gordon S. Concurrent validity and reliability of the Simple Goniometer iPhone app compared with the Universal Goniometer. Physiother Theory Pract 2014; 30:512-6. [PMID: 24666408 DOI: 10.3109/09593985.2014.900835] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The aim of this study was to assess the concurrent validity and reliability of the Simple Goniometer (SG) iPhone® app compared to the Universal Goniometer (UG). DESIGN Within subject comparison design comparing the UG with the SG app. SETTING James Cook University, Townsville, Queensland, Australia. PARTICIPANTS Thirty-six volunteer participants, with a mean age of 60.6 years (SD 6.2). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Thirty-six participants performed three standing lunges during which the knee joint angle was measured with the SG app and the UG. RESULTS There were no significant differences in the measures of individual knee joint angles between the UG and the SG app. Pearson correlations of 0.96-0.98 and intraclass correlation coefficients of 0.97-0.99 (95% confidence interval: 0.95-1.00) were recorded for all measures. Using the Bland-Altman method, the standard error of the mean of the differences and the standard deviation of the mean of the differences were low. CONCLUSION The measurements from the SG iPhone® app were reliable and possessed concurrent validity for this sample and protocol when compared to the UG.
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Affiliation(s)
- Anne Jones
- Department of Physiotherapy, James Cook University , Townsville, Queensland , Australia
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Galán-Mercant A, Cuesta-Vargas AI. Differences in trunk accelerometry between frail and non-frail elderly persons in functional tasks. BMC Res Notes 2014; 7:100. [PMID: 24559490 PMCID: PMC3940296 DOI: 10.1186/1756-0500-7-100] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 02/18/2014] [Indexed: 11/10/2022] Open
Abstract
Background Physical conditions through gait and other functional task are parameters to consider for frailty detection. The aim of the present study is to measure and describe the variability of acceleration, angular velocity and trunk displacement in the ten meter Extended Timed Get-Up-and-Go test in two groups of frail and non-frail elderly people through instrumentation with the iPhone4® smartphone. Secondly, to analyze the differences and performance of the variance between the study groups (frail and non-frail). This is a cross-sectional study of 30 subjects aged over 65 years, 14 frail subjects and 16 non-frail subjects. Results The highest difference between groups in the Sit-to-Stand and Stand-to-Sit subphases was in the y axis (vertical vector). The minimum acceleration in the Stand-to-Sit phase was -2.69 (-4.17 / -0.96) m/s2 frail elderly versus -8.49 (-12.1 / -5.23) m/s2 non-frail elderly, p < 0.001. In the Gait Go and Gait Come subphases the biggest differences found between the groups were in the vertical axis: -2.45 (-2.77 /-1.89) m/s2 frail elderly versus -5.93 (-6.87 / -4.51) m/s2 non-frail elderly, p < 0.001. Finally, with regards to the turning subphase, the statistically significant differences found between the groups were greater in the data obtained from the gyroscope than from the accelerometer (the gyroscope data for the mean maximum peak value for Yaw movement angular velocity in the frail elderly was specifically 25.60°/s, compared to 112.8°/s for the non-frail elderly, p < 0.05). Conclusions The inertial sensor fitted in the iPhone4® is capable of studying and analyzing the kinematics of the different subphases of the Extended Timed Up and Go test in frail and non-frail elderly people. For the Extended Timed Up and Go test, this device allows more sensitive differentiation between population groups than the traditionally used variable, namely time.
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Affiliation(s)
| | - Antonio I Cuesta-Vargas
- Physiotherapy Department, Faculty of Health Sciences, IBIMA, Universidad de Malaga, Av/Arquitecto Peñalosa s/n (Teatinos Campus Expansion), 29009 Málaga, Spain.
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O'Reilly MK, Nason GJ, Liddy S, Fitzgerald CW, Kelly ME, Shields C. DOCSS: doctors on-call smartphone study. Ir J Med Sci 2013; 183:573-7. [PMID: 24338079 DOI: 10.1007/s11845-013-1053-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 12/03/2013] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Smartphones have revolutionised our demands for constant access to information. The usage of smartphones in the clinical setting is becoming widespread. The aim of our study was to assess smartphone ownership and usage across a cohort of interns. METHODS A voluntary novel questionnaire was distributed to interns in two university hospitals. Details regarding smartphone ownership and usage were assessed. Likert scales were utilised for analysis. RESULTS Sixty-one (74.4 %) interns responded to the survey. Sixty (98.4 %) owned a smartphone with iPhone(®) being the most popular (76.7 %). Fifty-five (91.6 %) interns have downloaded medical applications ('apps'), while 29 (52.3 %) reported paying for them. Regarding smartphone use on-call, 30 (50 %) interns agreed it aids diagnoses, 26 (43 %) agree it helped in interpreting laboratory values, 31 (51.7 %) agreed it helped in dosing of medication and 33 (55 %) agreed it was of assistance in medical emergency protocols. Forty-two (70 %), 42 (70 %) and 46 (76.7 %) interns agreed or strongly agreed smartphones have a positive influence on them in terms of levels of stress, confidence and level of knowledge, respectively. CONCLUSION Smartphone usage is widespread among our intern cohort. The introduction of hospital applications with local guidelines would be welcomed; however, this may require informed patient consent regarding their use.
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Affiliation(s)
- M K O'Reilly
- Department of Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
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Differences in trunk kinematic between frail and nonfrail elderly persons during turn transition based on a smartphone inertial sensor. BIOMED RESEARCH INTERNATIONAL 2013; 2013:279197. [PMID: 24369530 PMCID: PMC3863499 DOI: 10.1155/2013/279197] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 10/30/2013] [Accepted: 11/14/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Firstly, to, through instrumentation with the iPhone4 smartphone, measure and describe variability of tridimensional acceleration, angular velocity, and displacement of the trunk in the turn transition during the ten-meter Extended Timed-Get-up-and-Go test in two groups of frail and physically active elderly persons. Secondly, to analyse the differences and performance of the variance between the study groups during turn transition (frail and healthy). DESIGN This is a cross-sectional study of 30 subjects over 65 years, 14 frail subjects, and 16 healthy subjects. RESULTS Significant differences were found between the groups of elderly persons in the accelerometry (P < 0.01) and angular displacement variables (P < 0.05), obtained in the kinematic readings of the trunk during the turning transitions. The results obtained in this study show a series of deficits in the frail elderly population group. CONCLUSIONS The inertial sensor found in the iPhone4 is able to study and analyse the kinematics of the turning transitions in frail and physically active elderly persons. The accelerometry values for the frail elderly are lower than the physically active elderly, whilst variability in the readings for the frail elderly is also lower than the control group.
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Atkins LT, James CR, Sizer PS, Jonely H, Brismée JM. Reliability and concurrent criterion validity of a novel technique for analyzing hip kinematics during running. Physiother Theory Pract 2013; 30:210-7. [DOI: 10.3109/09593985.2013.830349] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Graham D, Suzuki A, Reitz C, Saxena A, Kuo J, Tetsworth K. Measurement of rotational deformity: using a smartphone application is more accurate than conventional methods. ANZ J Surg 2013; 83:937-41. [DOI: 10.1111/ans.12371] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2013] [Indexed: 11/28/2022]
Affiliation(s)
- David Graham
- Department of Orthopaedics; Wollongong Hospital; Wollongong New South Wales Australia
| | - Arnold Suzuki
- Department of Orthopaedics; Wollongong Hospital; Wollongong New South Wales Australia
| | - Christopher Reitz
- Department of Orthopaedics; Wollongong Hospital; Wollongong New South Wales Australia
| | - Akshat Saxena
- Department of Orthopaedics; Wollongong Hospital; Wollongong New South Wales Australia
| | - Judy Kuo
- Department of Radiology; Wollongong Hospital; Wollongong New South Wales Australia
| | - Kevin Tetsworth
- Department of Orthopaedic Surgery; Royal Brisbane and Women's Hospital; Herston Queensland Australia
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Galán-Mercant A, Cuesta-Vargas AI. Differences in Trunk Accelerometry Between Frail and Nonfrail Elderly Persons in Sit-to-Stand and Stand-to-Sit Transitions Based on a Mobile Inertial Sensor. JMIR Mhealth Uhealth 2013; 1:e21. [PMID: 25098977 PMCID: PMC4114465 DOI: 10.2196/mhealth.2710] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 07/09/2013] [Accepted: 07/30/2013] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Clinical frailty syndrome is a common geriatric syndrome, which is characterized by physiological reserve decreases and increased vulnerability. The changes associated to ageing and frailties are associated to changes in gait characteristics and the basic functional capacities. Traditional clinical evaluation of Sit-to-Stand (Si-St) and Stand-to-Sit (St-Si) transition is based on visual observation of joint angle motion to describe alterations in coordination and movement pattern. The latest generation smartphones often include inertial sensors with subunits such as accelerometers and gyroscopes, which can detect acceleration. OBJECTIVE Firstly, to describe the variability of the accelerations, angular velocity, and displacement of the trunk during the Sit-to-Stand and Stand-to-Sit transitions in two groups of frail and physically active elderly persons, through instrumentation with the iPhone 4 smartphone. Secondly, we want to analyze the differences between the two study groups. METHODS A cross-sectional study that involved 30 subjects over 65 years, 14 frail and 16 fit subjects. The participants were classified with frail syndrome by the Fried criteria. Linear acceleration was measured along three orthogonal axes using the iPhone 4 accelerometer. Each subject performed up to three successive Si-St and St-Si postural transitions using a standard chair with armrest. RESULTS Significant differences were found between the two groups of frail and fit elderly persons in the accelerometry and angular displacement variables obtained in the kinematic readings of the trunk during both transitions. CONCLUSIONS The inertial sensor fitted in the iPhone 4 is able to study and analyze the kinematics of the Si-St and St-Si transitions in frail and physically active elderly persons. The accelerometry values for the frail elderly are lower than for the physically active elderly, while variability in the readings for the frail elderly is also lower than for the control group.
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Affiliation(s)
- Alejandro Galán-Mercant
- Faculty of Health Sciences, Department of Physiotherapy, University of Malaga, Malaga, Spain
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Hsi RS, Hotaling JM, Hartzler AL, Holt SK, Walsh TJ. Validity and reliability of a smartphone application for the assessment of penile deformity in Peyronie's disease. J Sex Med 2013; 10:1867-73. [PMID: 23551808 DOI: 10.1111/jsm.12136] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Available methods to evaluate men with Peyronie's disease (PD) are limited by the inability to accurately and reproducibly measure penile deformity. AIM.: The study aims to evaluate the performance of a smartphone application for the measurement of penile curvature and narrowing. METHODS A smartphone application, the University of Washington Peyronie's Examination Network (UWPEN), was developed for this purpose. To assess penile curvature, 15 single cylinders of malleable penile prostheses were molded to varying curvature angles. Three blinded observers nonsequentially measured the angle of curvature for each prosthetic cylinder using a protractor, goniometer, and UWPEN. To assess girth narrowing, six clay models of the penile shaft were constructed to represent conditions of normal, partial hourglass, circumferential hourglass, and pencil narrowing. Girth was measured using a ruler and UWPEN by the same blinded observers. MAIN OUTCOME MEASURES Statistical analyses compared intertest, interobserver, and intraobserver reliability using the interclass correlation coefficient (ICC). An ICC above 0.75 indicates excellent reproducibility among measurements. RESULTS Intertest reliability for angle measurements yielded an ICC for the three methods of 1.000. Separately, the ICC for UWPEN vs. the goniometer and protractor was 0.999 and 0.999, respectively. The interobserver ICC for UWPEN, goniometer, and protractor was 0.998, 0.999, and 1.000, respectively. Intertest reliability for girth narrowing measurements yielded an ICC of 0.991. The interobserver ICC for girth narrowing for UWPEN and the ruler was 0.978 and 0.986, respectively. Intraobserver ICC for angle measurements and girth narrowing showed high reliability for all observers and methods. CONCLUSIONS The performance of UWPEN is comparable with and highly correlated with angle measurements obtained from the goniometer and protractor as well as with girth narrowing measurements obtained from a ruler. Measurements are reproducible among different observers. UWPEN may provide a noninvasive, accurate, reliable, and widely accessible method to characterize and track PD over time.
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Affiliation(s)
- Ryan S Hsi
- Department of Urology, University of Washington School of Medicine, Seattle, WA 98195, USA
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