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Cai S, Lin Y, Chen H, Huang Z, Zhou Y, Zheng Y. Automated analysis of pectoralis major thickness in pec-fly exercises: evolving from manual measurement to deep learning techniques. Vis Comput Ind Biomed Art 2024; 7:8. [PMID: 38625580 PMCID: PMC11021386 DOI: 10.1186/s42492-024-00159-6] [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: 12/05/2023] [Accepted: 03/22/2024] [Indexed: 04/17/2024] Open
Abstract
This study addresses a limitation of prior research on pectoralis major (PMaj) thickness changes during the pectoralis fly exercise using a wearable ultrasound imaging setup. Although previous studies used manual measurement and subjective evaluation, it is important to acknowledge the subsequent limitations of automating widespread applications. We then employed a deep learning model for image segmentation and automated measurement to solve the problem and study the additional quantitative supplementary information that could be provided. Our results revealed increased PMaj thickness changes in the coronal plane within the probe detection region when real-time ultrasound imaging (RUSI) visual biofeedback was incorporated, regardless of load intensity (50% or 80% of one-repetition maximum). Additionally, participants showed uniform thickness changes in the PMaj in response to enhanced RUSI biofeedback. Notably, the differences in PMaj thickness changes between load intensities were reduced by RUSI biofeedback, suggesting altered muscle activation strategies. We identified the optimal measurement location for the maximal PMaj thickness close to the rib end and emphasized the lightweight applicability of our model for fitness training and muscle assessment. Further studies can refine load intensities, investigate diverse parameters, and employ different network models to enhance accuracy. This study contributes to our understanding of the effects of muscle physiology and exercise training.
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Affiliation(s)
- Shangyu Cai
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China
| | - Yongsheng Lin
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China
| | - Haoxin Chen
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China
| | - Zihao Huang
- Department of Biomedical Engineering, the Hong Kong Polytechnic University, Hong Kong, 999077, China
| | - Yongjin Zhou
- School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, 518073, China.
| | - Yongping Zheng
- Department of Biomedical Engineering, the Hong Kong Polytechnic University, Hong Kong, 999077, China.
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Li X, Zhao J, Lv Q, Tian Y, Zhang L, Liu T. Electroacupuncture alleviates multifidus muscle injury by modulating mitochondrial function and Ca 2+ uptake. Anat Rec (Hoboken) 2023; 306:3060-3072. [PMID: 35235712 DOI: 10.1002/ar.24889] [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: 10/25/2021] [Revised: 12/23/2021] [Accepted: 01/19/2022] [Indexed: 11/11/2022]
Abstract
Multifidus muscles maintain the stability of the lumbar spine and play a crucial role in the pathogenesis of nonspecific lower back pain. Previous studies have shown that electroacupuncture (EA) can relieve the symptoms of low back pain and reduce injury to the lumbar multifidus muscles. In this study, a rat model of lumbar multifidus muscle injury was established by 0.05% bupivacaine injection and subsequently treated with EA at bilateral "Weizhong" (BL40) acupoints. Disruption of the function and structure of multifidus muscles, increased cytosolic Ca2+ in multifidus myocytes, and reduced mitochondrial fission and ATP production were observed in the model group. Additionally, increased expression of the mitochondrial calcium uniporter (MCU) promoted mitochondrial reuptake of Ca2+ , reversing the excessive increase in cytoplasmic Ca2+ . However, the excessive increase in MCU not only aggravated the increased cytoplasmic Ca2+ but also decreased the expression of the mitochondrial division proteins dynamin-related protein 1 (Drp1) and mitochondrial fission factor (MFF). EA inhibited the overexpression of MCU, promoted mitochondrial reuptake of Ca2+ , and reversed cytosolic Ca2+ overload. Furthermore, EA regulated the expression of the mitochondrial fission proteins Drp1 and MFF and promoted the production of ATP, helping the recovery of mitochondrial function after multifidus injury. Therefore, EA can protect against bupivacaine-induced mitochondrial dysfunction, possibly by attenuating MCU overexpression in the inner mitochondrial membrane and reducing Ca2+ overloading in muscle cells, thereby protecting mitochondrial function and maintaining the normal energy demand of muscle cells.
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Affiliation(s)
- Xia Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jun Zhao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Qiaoqiao Lv
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yuan Tian
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Li Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Tong Liu
- The Fifth Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Acupuncture and Rehabilitation, Guangdong Second Hospital of Traditional Chinese Medicine, Guangzhou, China
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Elliott-Burke T, Dillon T, Bailey J, Miller S, Joos R, Buros Stein A. Lumbar multifidus muscle ultrasound imaging: Is handheld technology reliable? Musculoskelet Sci Pract 2023; 65:102771. [PMID: 37182391 DOI: 10.1016/j.msksp.2023.102771] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Advancement in ultrasound imaging technology has led to the development of handheld devices that are more accessible to physical therapists due to decreased cost, reduced size, and improved ease of use relative to current established units. Physical therapists use ultrasound imaging of the lumbar multifidus muscle (LMM) to assist in rehabilitation of patients with lumbar pathology. OBJECTIVES To identify the inter-device reliability of measuring the LMM thickness during a sustained contraction when comparing handheld (Butterfly iQ+) and established (SonoSite M-Turbo) ultrasound units. A secondary purpose was to determine the reliability of a student physical therapist using both devices. DESIGN A reliability measurement study METHOD: A blinded examiner identified the LMM at the L4 vertebral level and measured the thickness of the contracted muscle utilizing both the handheld and established ultrasound devices. ICC values were calculated to determine the inter-device and intra-rater reliability. RESULTS The study included 42 healthy participants, 30 females and 12 males, with a mean age of 38.5 years. The inter-device reliability during a sustained LMM contraction was excellent (ICC = 0.92, 95% CI: 0.87-0.94) and the intra-rater reliability was good for both the handheld (ICC = 0.85, 95% CI: 0.73-0.92) and established (ICC = 0.89, 95% CI: 0.82-0.93) ultrasound units. CONCLUSION Results support the use of handheld ultrasound by physical therapists and students to measure the LMM thickness. Future studies could investigate the reliability of handheld ultrasound in a variety of musculoskeletal and pathological structures important to PT practice.
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Affiliation(s)
- Teresa Elliott-Burke
- Department of Physical Therapy, College of Health Sciences, Midwestern University, Downers Grove, IL, USA.
| | - Thomas Dillon
- Department of Physical Therapy, College of Health Sciences, Midwestern University, Downers Grove, IL, USA
| | - Jasmin Bailey
- Department of Physical Therapy, College of Health Sciences, Midwestern University, Downers Grove, IL, USA
| | - Shannon Miller
- Department of Physical Therapy, College of Health Sciences, Midwestern University, Downers Grove, IL, USA
| | - Rachel Joos
- Department of Physical Therapy, College of Health Sciences, Midwestern University, Downers Grove, IL, USA
| | - Amy Buros Stein
- Office of Research and Sponsored Programs, Midwestern University, Glendale, AZ, USA
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Perotti L, Stamm O, Mesletzky L, Vorwerg S, Fournelle M, Müller-Werdan U. Needs and Attitudes of Older Chronic Back Pain Patients towards a Wearable for Ultrasound Biofeedback during Stabilization Exercises: A Qualitative Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4927. [PMID: 36981835 PMCID: PMC10049307 DOI: 10.3390/ijerph20064927] [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: 12/21/2022] [Revised: 03/03/2023] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
Chronic back pain has a high prevalence, especially in older adults, and seriously affects sufferers' quality of life. Segmental stabilization exercise (SSE) is often used during physiotherapy to enhance core stability. The execution of SSE requires the selective contraction of deep abdominal and back muscles. Motor learning can be supported using ultrasound imaging as visual biofeedback. ULTRAWEAR is a mobile ultrasound system that provides deep learning-based biofeedback on SSE execution, which is currently under development. We interviewed 15 older chronic back pain patients (CBPPs) to investigate their pain management behavior, experience with SSE, as well as their needs and requirements for ULTRAWEAR. We also gathered information about future-usage scenarios. CBPPs reported a high willingness to use the system as a feedback tool both in physiotherapeutic practices and at home. The automated detection and evaluation of muscle contraction states was highlighted as a major benefit of the system compared to the more subjective feedback provided by traditional methods such as palpation. The system to be developed was perceived as a helpful solution to support learning about SSE.
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Affiliation(s)
- Luis Perotti
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | - Oskar Stamm
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | - Lisa Mesletzky
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | - Susan Vorwerg
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | - Marc Fournelle
- Department of Ultrasound, Fraunhofer Institute for Biomedical Engineering, 66280 Sulzbach, Germany
| | - Ursula Müller-Werdan
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
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Fuming Z, Weihui X, Jiajia Y, Shufeng L, Yiyi Z, Wenjian L, Yan L, Zhicheng L, Siyun Z, Yingmin Z, Yuyin W, Chuhuai W. Effect of m-health-based core stability exercise combined with self-compassion training for patients with non-specific chronic low back pain: study protocol for a randomized controlled trial. Trials 2022; 23:265. [PMID: 35392974 PMCID: PMC8989123 DOI: 10.1186/s13063-022-06258-0] [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: 07/04/2021] [Accepted: 03/29/2022] [Indexed: 11/28/2022] Open
Abstract
Background Non-specific chronic low back pain (NCLBP) has a high incidence, which has a significant impact on a patient’s body and mind and is a common condition affecting people’s quality of life. Core stability exercise (CSE) is a modestly effective treatment for NCLBP; however, CSE has only been shown to be a useful treatment option in the short term. Many clinical practice guidelines recommend the use of a biopsychosocial framework to guide the management of NCLBP. Self-compassion training (SCT) is a promising psychotherapy treatment option for NCLBP; however, there is still a lack of research on CSE combined with SCT. In this study, we will seek to determine whether CSE combined with SCT is an effective treatment option for patients with NCLBP compared to CSE alone. Methods In this study, we will randomize 166 adults with NCLBP to a combined SCT and CSE arm or a CSE alone arm (83 participants per group). Both interventions will consist of four weekly 1.5-h group sessions of CSE supplemented by home practice. The combined group protocol also includes 2 h of SCT before CSE. Interviewers masked to the treatment assignments will assess the outcomes at 4 and 16 weeks post-randomization. The primary outcomes are back pain disability (based on the Roland-Morris Disability Questionnaire) and pain intensity (NRS; average pain, worst pain, average pain) at 16 weeks. Discussion If SCT is found to enhance the effectiveness of CSE for patients with chronic back pain, the results of the study may promote the development of mind-body therapies for chronic low back pain. Trial registration Chinese Clinical Trial Registry ChiCTR2100042810. Registered on 21 January 2021
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Affiliation(s)
- Zheng Fuming
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Xiao Weihui
- Department of Psychology, Sun Yat-sen University, Guangzhou, 510006, China
| | - Yang Jiajia
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Liu Shufeng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zheng Yiyi
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Liang Wenjian
- Department of Psychology, Sun Yat-sen University, Guangzhou, 510006, China
| | - Li Yan
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Li Zhicheng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zhang Siyun
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zou Yingmin
- Department of Psychology, Sun Yat-sen University, Guangzhou, 510006, China
| | - Wang Yuyin
- Department of Psychology, Sun Yat-sen University, Guangzhou, 510006, China.
| | - Wang Chuhuai
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.
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Ultrasound Imaging as a Visual Biofeedback Tool in Rehabilitation: An Updated Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147554. [PMID: 34300002 PMCID: PMC8305734 DOI: 10.3390/ijerph18147554] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 06/29/2021] [Accepted: 07/13/2021] [Indexed: 12/29/2022]
Abstract
Rehabilitative ultrasound imaging (RUSI) is used by physical therapists as a feedback tool for measuring changes in muscle morphology during therapeutic interventions such as motor control exercises (MCE). However, a structured overview of its efficacy is lacking. We aimed to systematically review the efficacy of RUSI for improving MCE programs compared with no feedback and other feedback methods. MEDLINE, PubMed, SCOPUS and Web of Science databases were searched for studies evaluating efficacy data of RUSI to improve muscular morphology, quality, and/or function of skeletal muscles and MCE success. Eleven studies analyzing RUSI feedback during MCE were included. Most studies showed acceptable methodological quality. Seven studies assessed abdominal wall muscles, one assessed pelvic floor muscles, one serratus anterior muscle, and two lumbar multifidi. Eight studies involved healthy subjects and three studies clinical populations. Eight studies assessed muscle thickness and pressure differences during MCE, two assessed the number of trials needed to successfully perform MCE, three assessed the retain success, seven assessed the muscle activity with electromyography and one assessed clinical severity outcomes. Visual RUSI feedback seems to be more effective than tactile and/or verbal biofeedback for improving MCE performance and retention success, but no differences with pressure unit biofeedback were found.
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Lin S, Zhu B, Zheng Y, Huang G, Zeng Q, Wang C. Correction to: Effect of real-time ultrasound imaging for biofeedback on trunk muscle contraction in healthy subjects: a preliminary study. BMC Musculoskelet Disord 2021; 22:600. [PMID: 34193116 PMCID: PMC8247085 DOI: 10.1186/s12891-021-04429-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Shanshan Lin
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Bo Zhu
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510260, China
| | - Yiyi Zheng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Guozhi Huang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China
| | - Qing Zeng
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China
| | - Chuhuai Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.
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