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Xuan L, Lei L, Shao M, Han Q. Design and development of an intelligent wearing system for adolescent spinal orthotics. Med Biol Eng Comput 2024; 62:2653-2667. [PMID: 38653882 DOI: 10.1007/s11517-024-03082-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 03/21/2024] [Indexed: 04/25/2024]
Abstract
Adolescent idiopathic scoliosis is the deformity of the human spine in three-dimensional space. It is a disease with a long course and difficult to recover in a short time. Currently, spinal orthotic braces are an effective non-surgical treatment for this condition. However, existing spinal orthotic braces are still deficient. For example, existing spinal orthotics braces have no way of knowing how correct, effective, and comfortable a patient is wearing the orthotics. Based on distributed pressure monitoring technology, this paper conducts pressure acquisition and compensation research on spinal orthotics used by adolescent patients. After analyzing the principles of orthopedics and selecting monitoring points, this paper selects appropriate sensors and calibrates them. An intelligent wearable system for adolescent spinal orthotics was developed based on these findings. The experimental results show that the system can effectively monitor the process of patients wearing spinal orthotic braces. In addition, the system can compensate and visualize the pressure in real-time, so that doctors and patients can know the process and make judgments and adjustments.
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Affiliation(s)
- Liang Xuan
- School of Intelligent Manufacturing, Jianghan University, Wuhan, 430056, China.
- School of Mechanical Engineering and Automation, Northeastern University, Shenyang, 110819, China.
| | - Luo Lei
- School of Intelligent Manufacturing, Jianghan University, Wuhan, 430056, China
| | - Mengqi Shao
- School of Intelligent Manufacturing, Jianghan University, Wuhan, 430056, China
| | - Qingkai Han
- School of Mechanical Engineering and Automation, Northeastern University, Shenyang, 110819, China
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Li L, Wong MS. The application of machine learning methods for predicting the progression of adolescent idiopathic scoliosis: a systematic review. Biomed Eng Online 2024; 23:80. [PMID: 39118179 PMCID: PMC11308564 DOI: 10.1186/s12938-024-01272-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 07/22/2024] [Indexed: 08/10/2024] Open
Abstract
Predicting curve progression during the initial visit is pivotal in the disease management of patients with adolescent idiopathic scoliosis (AIS)-identifying patients at high risk of progression is essential for timely and proactive interventions. Both radiological and clinical factors have been investigated as predictors of curve progression. With the evolution of machine learning technologies, the integration of multidimensional information now enables precise predictions of curve progression. This review focuses on the application of machine learning methods to predict AIS curve progression, analyzing 15 selected studies that utilize various machine learning models and the risk factors employed for predictions. Key findings indicate that machine learning models can provide higher precision in predictions compared to traditional methods, and their implementation could lead to more personalized patient management. However, due to the model interpretability and data complexity, more comprehensive and multi-center studies are needed to transition from research to clinical practice.
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Affiliation(s)
- Lening Li
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Man-Sang Wong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
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Chen X, Ye Y, Zhu Z, Zhang R, Wang W, Wu M, Lu X, Yan B, Liang Q. Association between incorrect postures and curve magnitude of adolescent idiopathic scoliosis in china. J Orthop Surg Res 2024; 19:300. [PMID: 38760821 PMCID: PMC11100037 DOI: 10.1186/s13018-024-04767-z] [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: 01/19/2024] [Accepted: 04/29/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Despite advancements in school scoliosis screening (SSS), there are still no effective indicators to estimate the severity of spinal curvature. We aim to investigate the association between incorrect postures and curve magnitude of adolescent idiopathic scoliosis (AIS) among Chinese adolescents. METHODS In this SSS program, we examined the incorrect posture, Adam's forward bending test (FBT) results, and angle of trunk rotation (ATR) in adolescents. Those with suspected scoliosis were referred for a standing anteroposterior whole-spine radiography as outpatients. The radiographic data of 426 students with lateral Cobb angles were collected from 2016 to 2022 and the associations were studied using logistic regression (LR) models and receiver operating characteristic (ROC) curves. RESULTS Univariate LR revealed that female gender [odds ratio (OR) = 2.92, 95% confidence interval (CI) 1.67-5.09, P < 0.001], age 16-19y (OR = 2.83, 95%CI 1.10-7.28, P = 0.031), right shoulder height (OR = 2.15, 95%CI 1.23-3.75, P = 0.007), right scapula tilt (OR = 2.03, 95%CI 1.18-3.50, P = 0.010), right rib hump (OR = 1.88, 95%CI 1.23-2.85, P = 0.003), right thoracic rotation ≥ 5° (OR = 2.14, 95%CI 1.43-3.20, P < 0.001), and left thoracolumbar kyphosis (OR = 3.79, 95%CI 1.06-13.56, P = 0.041) were all significantly associated with the severity of the curve magnitude. Multivariate LR showed that female gender [adjusted OR (AOR) = 3.23, 95%CI 1.81-5.73, P < 0.001], those aged 16-19y (AOR = 5.08, 95%CI 1.86-13.91, P = 0.002), and with a right rib hump (AOR = 1.72, 95%CI 1.11-2.64, P = 0.015) presented with a higher risk of severe curve magnitude than men, those aged 7-12y, and without a rib hump, respectively. ROC curves further proved that sex, age, shoulder-height difference, scapula tilt, flat back, rib hump, angle of thoracic rotation were the risk predictors for curve magnitude. CONCLUSION Incorrect posture and ATR, especially the right rib hump, were significantly associated with the curve magnitude of AIS. Early screening for incorrect postures and ATR could be an effective and economical strategy to predict the severity of AIS through SSS in Chinese adolescents.
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Affiliation(s)
- Xiaosheng Chen
- Department of spine surgery, Shenzhen Second People's Hospital, the First Affiliated Hospital of Shenzhen University, Sungang west road, Futian district, Number 3002, Shenzhen, 518035, China
- Shenzhen Youth Spine Health Center, Shenzhen, China
| | - Yongyu Ye
- Department of Orthopedic Surgery, Guangdong Provincial People's Hospital, Southern Medical University, Guangzhou, China
| | - Zhixiang Zhu
- Department of spine surgery, Shenzhen Second People's Hospital, the First Affiliated Hospital of Shenzhen University, Sungang west road, Futian district, Number 3002, Shenzhen, 518035, China
- Shenzhen Youth Spine Health Center, Shenzhen, China
| | - Rui Zhang
- Department of spine surgery, Shenzhen Second People's Hospital, the First Affiliated Hospital of Shenzhen University, Sungang west road, Futian district, Number 3002, Shenzhen, 518035, China
- Shenzhen Youth Spine Health Center, Shenzhen, China
| | - Weijun Wang
- Shenzhen Youth Spine Health Center, Shenzhen, China
| | - Miaoling Wu
- Shenzhen Youth Spine Health Center, Shenzhen, China
| | - Xinhai Lu
- Shenzhen Youth Spine Health Center, Shenzhen, China
| | - Bin Yan
- Department of spine surgery, Shenzhen Second People's Hospital, the First Affiliated Hospital of Shenzhen University, Sungang west road, Futian district, Number 3002, Shenzhen, 518035, China.
- Shenzhen Youth Spine Health Center, Shenzhen, China.
| | - Qian Liang
- Department of spine surgery, Shenzhen Second People's Hospital, the First Affiliated Hospital of Shenzhen University, Sungang west road, Futian district, Number 3002, Shenzhen, 518035, China.
- Shenzhen Youth Spine Health Center, Shenzhen, China.
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Fan Y, Zheng H, Feng L, To MKT, Kuang GM, Yeung EHK, Cheung KMC, Liu L, Cheung JPY. Elasticity and cross-sectional thickness of paraspinal muscles in progressive adolescent idiopathic scoliosis. Front Pediatr 2024; 12:1323756. [PMID: 38516354 PMCID: PMC10954774 DOI: 10.3389/fped.2024.1323756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/22/2024] [Indexed: 03/23/2024] Open
Abstract
Objectives (1) Compare the cross-sectional thickness (CST) and shear wave speed (SWS) of paraspinal muscles (PSM) in adolescent idiopathic scoliosis (AIS) with and without curve progression; (2) investigate the relationship between CST/SWS and radiographic characteristics in AIS with curve progression; (3) compare the CST/SWS between AIS and non-scoliosis controls. Methods This cross-sectional study analyzed the CST and SWS of PSM in 48 AIS with mild to moderate curvature and 24 non-scoliosis participants. Participants with scoliosis greater than 45° of Cobb angles were excluded. The Change of Cobb angles within the last 6-months was retrieved to allocate AIS into progression and non-progression groups. The SWS and CST of multifidus; longissimus and iliocostalis of the major curve were measured using B-mode ultrasound image with an elastography mode. Discrepancies of the SWS (SWS-ratio: SWS on the convex side divided by SWS on the concave side) and CST (CST-ratio: CST on the convex side divided by CST on the concave side) at the upper/lower end and apical vertebrae were studied. Results A higher SWS at the apical vertebrae on the concave side of the major curve (multifidus: 3.9 ± 1.0 m/s vs. 3.1 ± 0.6 m/s; p < 0.01, longissimus: 3.3 ± 1.0 m/s vs. 3.0 ± 0.9 m/s; p < 0.01, iliocostalis: 2.8 ± 1.0 m/s vs. 2.5 ± 0.8 m/s; p < 0.01) was observed in AIS with curve progression. A lower SWS-ratio at apical vertebrae was detected with a greater vertebral rotation in participants with curve progression (multifidus [grade II]: 0.7 ± 0.1 vs. grade I: 0.9 ± 0.2; p = 0.03, longissimus [grade II]: 0.8 ± 0.2 vs. grade I: 1.1 ± 0.2; p < 0.01). CST was not different among the progressive, non-progressive AIS and non-scoliosis controls. Conclusions Increased SWS of PSM without change of CST was observed on the concave side of the major curve in participants with progressive AIS.
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Affiliation(s)
- Yunli Fan
- Department of Physiotherapy, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Haiping Zheng
- Department of Medical Imaging-Ultrasound Division, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Lin Feng
- Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Michael K T To
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Guan-Ming Kuang
- Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Eric H K Yeung
- Department of Physiotherapy, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Kenneth M C Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Li Liu
- Department of Medical Imaging-Ultrasound Division, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Jason P Y Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
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Liu R, Xie H, Wang Y, Wang Q, Xie X, Zhang X. Impact of unilateral mastectomy on body posture: A prospective longitudinal observational study. Asia Pac J Oncol Nurs 2024; 11:100336. [PMID: 38318426 PMCID: PMC10838699 DOI: 10.1016/j.apjon.2023.100336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/06/2023] [Indexed: 02/07/2024] Open
Abstract
Objective Unilateral mastectomy is known to induce postural alterations, yet the temporal development pattern of these changes remains elusive. This study aimed to explore the impact of unilateral mastectomy on body posture. Methods A prospective, longitudinal, observational study with a one-group repeated-measures design was conducted. Patients undergoing unilateral mastectomy were recruited from a university-affiliated hospital in Western China and monitored for 12 months post-surgery. A trained nurse assessed seven postural baseline parameters on the day of suture removal and at 3, 6, and 12 months after unilateral mastectomy. Two parameters were in the sagittal plane (forward head posture and trunk rotation angle), and five were in the coronal plane (neck tilt, shoulder asymmetry, scapular asymmetry, scapular asymmetry relative to the spine, and pelvic tilt). Results The final analysis included 159 patients. Baseline prevalence of most postural abnormalities ranged from 50.94% to 59.75%, with mean deviations between 2.74 and 4.51 mm. At 12 months post-mastectomy, prevalence and mean deviations increased by more than 30% and 3.50 mm, respectively, compared to baseline. Postural abnormalities increased gradually in the first 3 months, notably between the 3rd and 6th months, and slowed between the 6th and 12th months. On the mastectomy side, coronal plane abnormalities significantly increased within 12 months: earlobe to acromion distance (Wald χ2 = 45.283, P < 0.001), depressed shoulder height (Wald χ2 = 42.253, P < 0.001), depressed scapula height (Wald χ2 = 31.587, P < 0.001), scapula to spine distance (Wald χ2 = 45.283, P < 0.001), and elevated pelvic height (Wald χ2 = 48.924, P < 0.001). Conclusions Postural changes are common post-unilateral mastectomy, with prevalence and deviation increasing gradually, particularly between 3 and 6 months post-mastectomy. Early rehabilitation initiation is recommended to mitigate postural changes. Trial registration ChiCTR2000040897.
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Affiliation(s)
- Ruixia Liu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Hongmei Xie
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Breast Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Yuehua Wang
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Breast Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qiuzhou Wang
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Breast Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaofeng Xie
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Division of Head & Neck Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoxia Zhang
- Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
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Hart DA. Sex differences in musculoskeletal injury and disease risks across the lifespan: Are there unique subsets of females at higher risk than males for these conditions at distinct stages of the life cycle? Front Physiol 2023; 14:1127689. [PMID: 37113695 PMCID: PMC10126777 DOI: 10.3389/fphys.2023.1127689] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
Sex differences have been reported for diseases of the musculoskeletal system (MSK) as well as the risk for injuries to tissues of the MSK system. For females, some of these occur prior to the onset of puberty, following the onset of puberty, and following the onset of menopause. Therefore, they can occur across the lifespan. While some conditions are related to immune dysfunction, others are associated with specific tissues of the MSK more directly. Based on this life spectrum of sex differences in both risk for injury and onset of diseases, a role for sex hormones in the initiation and progression of this risk is somewhat variable. Sex hormone receptor expression and functioning can also vary with life events such as the menstrual cycle in females, with different tissues being affected. Furthermore, some sex hormone receptors can affect gene expression independent of sex hormones and some transitional events such as puberty are accompanied by epigenetic alterations that can further lead to sex differences in MSK gene regulation. Some of the sex differences in injury risk and the post-menopausal disease risk may be "imprinted" in the genomes of females and males during development and sex hormones and their consequences only modulators of such risks later in life as the sex hormone milieu changes. The purpose of this review is to discuss some of the relevant conditions associated with sex differences in risks for loss of MSK tissue integrity across the lifespan, and further discuss several of the implications of their variable relationship with sex hormones, their receptors and life events.
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Effects of cervicothoracic postures on the stiffness of trapezius muscles. Med Biol Eng Comput 2022; 60:3009-3017. [DOI: 10.1007/s11517-022-02655-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 08/09/2022] [Indexed: 10/14/2022]
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