1
|
Yang CJ, Cheng PL, Huang YJ, Huang FH. Laryngeal Mask Airway as an Appropriate Option in Pediatric Laparoscopic Inguinal Hernia Repair: A Systematic Review and Meta-Analysis. J Pediatr Surg 2024; 59:660-666. [PMID: 38171956 DOI: 10.1016/j.jpedsurg.2023.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE To elucidate the safety and effectiveness of laryngeal mask airway (LMA) use in pediatric patients undergoing laparoscopic inguinal hernia repair. METHODS Studies were searched on the PubMed, EMBASE, and Cochrane Library databases. Only randomized controlled trials (RCTs) were included. Primary outcomes were major perioperative respiratory adverse events (PRAEs), namely laryngospasm, bronchospasm, desaturation, and aspiration. Secondary outcomes were minor PRAEs, anesthesia time, and recovery time. A meta-analysis was performed to calculate risk ratios (RR), weighted mean difference (WMD), and 95 % confidence intervals (CI) by using random effects models. RESULTS In total, 5 RCTs comprising 402 patients were included. Regarding major PRAEs, laryngospasm (RR: 0.43, 95 % CI: 0.12 to 1.47; p = 0.18), bronchospasm, and aspiration all demonstrated no difference between the laryngeal and endotracheal groups. Desaturation exhibited a trend, but this trend was not sufficiently supported with statistical evidence (p = 0.09). For minor PRAEs, fewer patients experienced incidence of cough after laryngeal mask use (RR: 0.27, 95 % CI: 0.11 to 0.67; p = 0.005). Other PRAE, namely hoarseness (p = 0.06), sore throat (RR: 1.88, 95 % CI: 0.76 to 4.66; p = 0.18), and stridor, did not differ between the 2 groups. Additionally, both anesthesia time (WMD: -6.88 min, 95 % CI: -11.88 to -1.89; p < 0.00001) and recovery time (WMD: -4.85 min, 95 % CI: -6.51 to -3.19; p < 0.00001) were shortened in the LMA group. CONCLUSION LMA used in pediatric laparoscopic inguinal hernia repair demonstrated no greater safety risks than endotracheal tube intubation did. Thus, anesthesiologists may shift from conventional endotracheal tube use to LMA use. Moreover, anesthesia and recovery times were shortened in the LMA group, which resulted in more efficient use of the operating room. Because of these benefits, LMA could be an appropriate option for pediatric patients undergoing laparoscopic inguinal hernia repair. LEVEL OF EVIDENCE Treatment Study, LEVEL III.
Collapse
Affiliation(s)
- Cheng-Jui Yang
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei City, Taiwan
| | - Po-Lung Cheng
- Department of Medical Education, Taipei Medical University Hospital, Taipei City, Taiwan
| | - Yan-Jiun Huang
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University Hospital, Taipei City, Taiwan; Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei City, Taiwan
| | - Fu-Huan Huang
- Division of Pediatric Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei City, Taiwan.
| |
Collapse
|
2
|
Cheng PL, Wu PH, Kao WY, Lai YT, Hsu JC, Chiou JF, Wu MH, Lee HL. Comparison of local ablative therapies, including radiofrequency ablation, microwave ablation, stereotactic ablative radiotherapy, and particle radiotherapy, for inoperable hepatocellular carcinoma: a systematic review and meta-analysis. Exp Hematol Oncol 2023; 12:37. [PMID: 37046292 PMCID: PMC10091829 DOI: 10.1186/s40164-023-00400-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/29/2023] [Indexed: 04/14/2023] Open
Abstract
Surgical intervention is the first-line treatment in well-selected hepatocellular carcinoma (HCC) patients. However, only a few patients are suitable to receive radical surgery. We conducted a systematic review and meta-analysis to evaluate local control among four local ablative therapies in inoperable HCC patients, including radiofrequency ablation therapy (RFA), microwave ablation therapy (MWA), stereotactic ablative radiotherapy (SABR), and particle radiotherapy. The primary outcome was the local control rate and the secondary were regional and distant progression rates, overall survival rate, and adverse events. We included twenty-six studies from PubMed, EMBASE, and Cochrane Library databases. MWA (p < 0.001) and particle radiotherapy (p < 0.001) showed better performance of local control compared to RFA, while SABR (p = 0.276) showed a non-significant trend. However, SABR (p = 0.002) and particle radiotherapy (p < 0.001) showed better performance than RFA in HCCs of ≥ 30 mm in size. MWA showed a similar result to RFA while SABR and particle radiotherapy showed a lower survival rate in the 2-, 3-, and 4-year overall survival rates. Our results indicate that MWA, SABR and particle radiotherapy were safe and no inferior to RFA in local control rate. Besides, the local control rates of SABR and particle radiotherapy are better than RFA in HCC of ≥ 30 mm in size. As a result, we suggested that MWA, SABR and particle radiotherapy to be effective alternatives to RFA for inoperable HCC. Moreover, the tumor size should be taken into consideration for optimal treatment selection between local ablative therapies.
Collapse
Affiliation(s)
- Po-Lung Cheng
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Medical Education, Taipei Medical University Hospital, Taipei, Taiwan
| | - Ping-Hsiu Wu
- Department of Radiation Oncology, Taipei Medical University Hospital, Wuxing street, No. 252, Taipei, 11031, Taiwan
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- TMU Proton Center, Taipei Medical University, Taipei, Taiwan
| | - We-Yu Kao
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan
- Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan
| | - Yen-Ting Lai
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jason C Hsu
- International PhD Program in Biotech and Healthcare Management, College of Management, Taipei Medical University, Taipei, Taiwan
- Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
- Clinical Data Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan
- Research Center of Health Care Industry Data Science, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Jeng-Fong Chiou
- Department of Radiation Oncology, Taipei Medical University Hospital, Wuxing street, No. 252, Taipei, 11031, Taiwan
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- TMU Proton Center, Taipei Medical University, Taipei, Taiwan
- The PhD Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University and Academia Sinica, Taipei, Taiwan
| | - Meng-Huang Wu
- Spine Division, Department of Orthopedics, Taipei Medical University Hospital, Wuxing street, No. 252, 11031, Taipei, Taiwan.
- Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Prospective Innovation Center, Taipei Medical University Hospital, Taipei, Taiwan.
- TMU Biodesign Center, Taipei Medical University, Taipei, Taiwan.
| | - Hsin-Lun Lee
- Department of Radiation Oncology, Taipei Medical University Hospital, Wuxing street, No. 252, Taipei, 11031, Taiwan.
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- TMU Proton Center, Taipei Medical University, Taipei, Taiwan.
- The PhD Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University and Academia Sinica, Taipei, Taiwan.
| |
Collapse
|
3
|
Cheng PL, Duh YC, Chen JJ, Huang FH. Laparoscopic Extraperitoneal Hernia Repair Versus Open Repair in Boys with Inguinal Hernia: A Meta-analysis. J Pediatr Surg 2023:S0022-3468(23)00090-8. [PMID: 36898876 DOI: 10.1016/j.jpedsurg.2023.01.054] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/25/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVE Pediatric inguinal hernia is a common surgical problem in boys. Open hernia repair surgery (OH) has been traditionally used to treat this condition, but it leads to complications, such as testicular complications. Laparoscopic hernia repair by using the extraperitoneal method (LHE) is performed through the percutaneous insertion of sutures and extracorporeal closure of patent vaginalis processus; thus, injury to spermatic cord structures is avoided. However, a meta-analysis comparing LHE and OH is lacking. METHODS PubMed, EMBASE, and Cochrane Library databases were searched for relevant studies. A meta-analysis of the retrieved studies was performed, and a random-effects model was used to calculate the pooled effect size. The primary outcome was testicular complications, including ascending testis, hydrocele, and testicular atrophy. The secondary outcomes were surgical metachronous contralateral inguinal hernia (MCIH), ipsilateral hernia recurrence, and operation time. RESULTS In total, 6 randomized controlled trials (RCTs) and 20 non-RCTs involving 17,555 boys were included. The incidence of ascending testis (risk ratio [RR]: 0.38, 95% confidence interval [CI]: 0.18-0.78; p = 0.008) and MCIH (RR: 0.17, 95% CI: 0.07-0.43; p = 0.0002) was significantly lower in LHE than in OH. The incidence of hydrocele, testicular atrophy, and ipsilateral hernia recurrence did not differ between LHE and OH. CONCLUSION Compared with OH, LHE led to fewer or equivalent testicular complications without increasing ipsilateral hernia recurrence. Moreover, MCIH incidence was lower in LHE than in OH. Hence, LHE could be a feasible choice with less invasiveness for inguinal hernia repair in boys. LEVEL OF EVIDENCE Treatment study, LEVEL III.
Collapse
Affiliation(s)
- Po-Lung Cheng
- Department of Medical Education, Taipei Medical University Hospital, Taipei City, Taiwan
| | - Yih-Cherng Duh
- Division of Pediatric Surgery, Department of Surgery, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, New Taipei City, Taiwan
| | - Jeng-Jung Chen
- Department of Pediatrics, Hsinchu Municipal MacKay Children's Hospital, Hsinchu City, Taiwan; Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu City, Taiwan
| | - Fu-Huan Huang
- Division of Pediatric Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei City, Taiwan.
| |
Collapse
|
4
|
Tam KW, Cheng PL, Loh EW, Chen JT. Reply to Letter to Editor concerning "Effects of preoperative oral carbohydrate on postoperative discomfort in patients undergoing elective surgery: a meta-analysis of randomized controlled trials". Langenbecks Arch Surg 2021; 406:2565-2566. [PMID: 34275014 DOI: 10.1007/s00423-021-02278-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Ka-Wai Tam
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.
- Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Road, Zhonghe District, New Taipei City, 23561, Taiwan.
- Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
| | - Po-Lung Cheng
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - El-Wui Loh
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
- Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Road, Zhonghe District, New Taipei City, 23561, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jui-Tai Chen
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
5
|
Cheng PL, Loh EW, Chen JT, Tam KW. Effects of preoperative oral carbohydrate on postoperative discomfort in patients undergoing elective surgery: a meta-analysis of randomized controlled trials. Langenbecks Arch Surg 2021; 406:993-1005. [PMID: 33629128 DOI: 10.1007/s00423-021-02110-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 02/01/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE Fasting is a standard preoperative procedure performed to prevent vomiting and pulmonary aspiration during anaesthesia and surgery. However, fasting can cause postoperative physical and psychological discomfort. Intake of oral carbohydrate (CHO) may mimic the intake of food, which prevents postoperative discomfort. We conducted a meta-analysis to evaluate the effect and safety of preoperative oral CHO in adult surgical patients. METHODS Randomized controlled trials (RCTs) were searched for in the PubMed, EMBASE, and Cochrane Library databases. A meta-analysis was performed to calculate a pooled effect size by using random-effects models. The satisfaction outcomes were mouth dryness, hunger, thirst, pain severity, duration of hospitalization, homeostatic model assessment for insulin resistance (HOMA-IR), and the incidence of postoperative nausea and vomiting. The safety outcomes were the incidence of aspiration and infection. RESULTS In total, 57 RCTs involving 5606 patients were included. The outcomes of mouth dryness, thirst, hunger, and pain were assessed by a 10-point visual analogue scale (0 = best, 10 = worst). The severity of mouth dryness (weighted mean difference [WMD]: -1.26, 95% CI: -2.36 to -0.15), thirst (WMD: -1.36, 95% CI: -2.05 to -0.67), hunger (WMD: -1.66, 95% CI: -2.53 to -0.80), pain (WMD: -0.68, 95% CI: -1.01 to -0.35), duration of hospitalization (WMD: -0.39 day, 95% CI: -0.66 to -0.12), and HOMA-IR (WMD: -1.80, 95% CI: -2.84 to -0.76) were significantly lower in the CHO group than in the control group. The incidence of postoperative nausea and vomiting did not differ between the CHO and control groups. No aspiration was recorded in any of the groups. CONCLUSIONS Preoperative CHO can alleviate patient's discomfort without safety concerns. Surgeons and anaesthesiologists should strongly promote preoperative CHO as a strategy to enhance recovery after surgery protocols.
Collapse
Affiliation(s)
- Po-Lung Cheng
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - El-Wui Loh
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.,Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Road, Zhonghe District, New Taipei City, 23561, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jui-Tai Chen
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ka-Wai Tam
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan. .,Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Road, Zhonghe District, New Taipei City, 23561, Taiwan. .,Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. .,Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
| |
Collapse
|
6
|
Wu P, Guo XS, Zhang X, Wu ZF, Wang RN, Li L, Liang M, Wang HL, Yan M, Qin ZX, Cheng PL, Jin CR, Yang MF, Wang YT, Li SJ. [Value of absolute quantification of myocardial perfusion by PET in detecting coronary microvascular disease in patients with non-obstructive coronaries]. Zhonghua Xin Xue Guan Bing Za Zhi 2020; 48:205-210. [PMID: 32234177 DOI: 10.3760/cma.j.cn112148-20191024-00652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the incidence of coronary microvascular disease (CMVD) between patients with non-obstructive and obstructive coronary arteries. Methods: We retrospectively analyzed 97 patients with angina pectoris, who underwent the absolute quantitative PET examination of myocardial perfusion and coronary anatomy examination within 90 days. All patients were divided into two groups: non-obstructive group (72 cases, no stenosis ≥50% in all three coronary arteries) and obstructive group (25 cases, at least one coronary stenosis ≥50%; and at least one coronary stenosis<50%). Quantitative parameters derived from PET including rest myocardial blood flow (RMBF), stress myocardial blood flow (SMBF), coronary flow reserve (CFR) and cardiovascular risk factors were compared between the two groups. CMVD was defined as CFR<2.90 and SMBF<2.17 ml·min(-1)·g(-1). Results: Incidence of CMVD was significant higher in the non-obstructive coronary arteries of the obstructive group than in the non-obstructive coronary arteries of non-obstructive group (47.1% (16/34) vs. 25.5% (55/216), χ(2)=6.738, P=0.009) while incidence of CMVD was similar between non-obstructive and obstructive patients ((44% (11/25) vs. 33.3% (24/72), χ(2)=0.915, P=0.339). RMBF ((0.83±0.14) ml·min(-1)·g(-1) vs. (0.82±0.17) ml·min(-1)·g(-1)), SMBF ((2.13±0.60) ml·min(-1)·g(-1) vs. (1.91±0.50) ml·min(-1)·g(-1)) and CFR (2.59±0.66 vs. 2.36±0.47) were similar between the two groups (all P>0.05). Conclusions: CMVD can occur in non-obstructive coronary arteries in both patients with non-occlusive coronary arteries and patients with obstructive coronary arteries. Prevalence of CMVD is significantly higher in patients with obstructive coronary arteries than in patients with non-obstructive coronary arteries. The CMVD severity is similar between the two groups.
Collapse
Affiliation(s)
- P Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Shanxi Key Laboratory of Molecular Imaging, Taiyuan 030001, China
| | - X S Guo
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Shanxi Key Laboratory of Molecular Imaging, Taiyuan 030001, China
| | - X Zhang
- Province-Ministry Co-construction Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan 030001, China
| | - Z F Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Shanxi Key Laboratory of Molecular Imaging, Taiyuan 030001, China
| | - R N Wang
- Province-Ministry Co-construction Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan 030001, China
| | - L Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Shanxi Key Laboratory of Molecular Imaging, Taiyuan 030001, China
| | - M Liang
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Shanxi Key Laboratory of Molecular Imaging, Taiyuan 030001, China
| | - H L Wang
- Province-Ministry Co-construction Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan 030001, China
| | - M Yan
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Shanxi Key Laboratory of Molecular Imaging, Taiyuan 030001, China
| | - Z X Qin
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Shanxi Key Laboratory of Molecular Imaging, Taiyuan 030001, China
| | - P L Cheng
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Shanxi Key Laboratory of Molecular Imaging, Taiyuan 030001, China
| | - C R Jin
- Department of cardiology, First Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - M F Yang
- Department of Nuclear Medicine, Beijing Chaoyang hospital, Capital Medical University, Beijing 100043, China
| | - Y T Wang
- Department of Nuclear Medicine, Third Affiliated Hospital of Soochow University (First People's Hospital of Changzhou), Changzhou 213003, China
| | - S J Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Shanxi Key Laboratory of Molecular Imaging, Taiyuan 030001, China
| |
Collapse
|
7
|
Cheng PL, Choi SH, Hsu YC. Hoffa fracture: should precautions be taken during fixation and rehabilitation? Hong Kong Med J 2009; 15:385-387. [PMID: 19801698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
A coronal fracture of a femoral condyle (Hoffa fracture) is an unusual injury and there are only a handful of reports discussing it. We report a case of a 52-year-old worker who fell from a height, suffering lower limb injuries, including a Hoffa fracture with comminution, and had problems with malunion during the postoperative period. Clinicians should be aware that rehabilitation programmes need to be tailored to the method of fixation used to manage this uncommon fracture pattern.
Collapse
Affiliation(s)
- P L Cheng
- Department of Orthopaedics and Traumatology, Princess Margaret Hospital, Laichikok, Kowloon, Hong Kong.
| | | | | |
Collapse
|
8
|
Cheng PL, Dumas GA, Smith JT, Leger AB, Plamondon A, McGrath MJ, Tranmer JE. Analysis of self-reported problematic tasks for pregnant women. Ergonomics 2006; 49:282-92. [PMID: 16540440 DOI: 10.1080/00140130500434929] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
The objective of this study was to identify major components of, and influential factors in, problematic tasks performed by pregnant women employed in education, health care and service areas. Seventy-two pregnant women were surveyed using specially designed questionnaires consisting of an Initial Survey, a Job Analysis Questionnaire and a Task Description Questionnaire. Forty-four subjects (60%) had difficulty performing at least one work task and reported 105 tasks that were problematic at work. Reaching above the head, bending forward, bending and twisting, pushing, repeating actions and working at a fast pace were identified as the task components requiring the greatest level of effort. Excessive effort, excessive time, getting tired, repetitive actions, stress and fear of injury were identified as factors that had strong associations with the six major task components. Findings of this study suggest that these task components and factors should be considered when designing, assigning or analysing tasks for working pregnant women.
Collapse
Affiliation(s)
- P L Cheng
- Department of Mechanical Engineering, Queen's University, Kingston, Ontario, Canada
| | | | | | | | | | | | | |
Collapse
|
9
|
Cheng PL, Dumas GA, Smith JT, Leger A, Plamondon A, McGrath MJ, Tranmer JE. Reproducibility of a task description questionnaire for working pregnant women. Work 2006; 26:389-97. [PMID: 16788258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
The objective of this study was to evaluate the reproducibility of a Task Description Questionnaire that was designed to investigate exposures to, and influential factors for, problematic tasks experienced by working pregnant women. The questionnaire comprised questions concerning 22 task components (covering working posture, manual material handling, work pace, prolonged postures and others), eight influential factors contributing to problematic tasks, discomfort (measured using a body map) and level of effort to perform the tasks. Reproducibility of the questionnaire was assessed by interviewing participants on two occasions one week apart for interviews at both 20 and 34 weeks of pregnancy. Eleven and 13 problematic tasks were reported by 21 working pregnant women at 20 and 34 weeks of pregnancy, respectively. These tasks were surveyed using the Task Description Questionnaire. Kappa statistics and correlation coefficients (supplemented by paired t-tests) were used to examine the reproducibility of responses to the questionnaire. The results showed that most of the variables were measured with very good or satisfactory reproducibility. The reproducibility of exposure to work posture was higher than that of exposure to manual material handling. There was no significant difference between test and retest means for the discomfort scores measured on the body map, except for the maximum discomfort score for the whole body in the 34 weeks survey. The study suggests that the questionnaire can be reliably used in the study of problematic tasks experienced by pregnant women. But an initial preview of the questions by the subjects and explanation of the questions given to the subjects by the interviewer may help to produce more reliable results.
Collapse
Affiliation(s)
- P L Cheng
- Department of Mechanical Engineering, Queen's University, Kingston, Ontario, Canada
| | | | | | | | | | | | | |
Collapse
|
10
|
Abstract
Electromagnetic motion tracking devices are increasingly used as a kinematic measuring tool. The aim of this study was to evaluate a long-range transmitter in an environment with a conventional force plate present in order to assess its suitability for further biomechanical applications. Using a calibration apparatus developed in our lab and Optotrack measurements, the performances of the Motion Star were evaluated. Positions and orientations were measured in a 140 x 80 x 120 cm(3) space centered on the force plate. Using a mathematical model developed at Queen's University, these data were calibrated. Errors on position and orientation were less than 150 mm and 10 degrees before calibration of the Motion Star, and less than 20mm and 2 degrees after calibration, with no differences between data collected with the force plate switched on/off. These errors did not depend on sensor orientation. Variability of the signal was small indicating minimal noise. Field distortion was the largest source of measurement error, which increased with the distance between the transmitter and the sensor and the proximity of the sensor to the force plate. Before its use for biomechanical analysis of lifting tasks and validation of dynamic models using force plate data, the data from electromagnetic motion tracking devices must be calibrated to decrease the errors due to electromagnetic field distortion.
Collapse
Affiliation(s)
- D Périé
- Research Center, Sainte-Justine Hospital, 3175 chemin de la Cote Sainte-Catherine, Montréal, Quebec, Canada H3T 1C5.
| | | | | | | |
Collapse
|
11
|
Abstract
OBJECTIVE This paper reports a method of using a multi-axis graph to represent the range of rotations at the hip and knee joints during gait for clinical evaluation of a patient's performance. DESIGN AND METHODS The multi-axis graph uses 12 symmetrically arranged axes to represent each component of range of rotations at the hip and knee joints of both legs. The range of joint rotations of thirteen normal subjects and two patients were measured using an electromagnetic motion tracking system with four foot switches. RESULTS The range of joint rotations of normal subjects shows a symmetrical star in the multi-axis graph. Abnormal function of a patient shows an asymmetrical star. CONCLUSIONS This representation provides a simple way to examine a patient's performance in a time effective manner. Relevance. In clinical practice, the multi-axis representation of joint rotations can be used as an initial evaluation of a patient's performance to identify problems for further investigation.
Collapse
Affiliation(s)
- P L Cheng
- School of Mechanical, Manufacturing and Medical Engineering, Queensland University of Technology, GPO Box 2434, 2 George Street, QLD 4001, Brisbane, Australia
| | | |
Collapse
|
12
|
Abstract
Three-dimensional joint rotations in human movement analysis have been mainly described by Euler/Cardan angles. Due to sequence dependence, each combination of three Euler/Cardan angles defines a single pattern of joint rotation. When the rotation pattern is unknown, it needs to be considered using a particular sequence of Euler/Cardan angles to represent joint rotations. In this paper a spherical rotation coordinate system is developed for describing three-dimensional joint rotations using a method of rotation involving two steps: a long axis rotation and a pure axial rotation. Two angles of the classical spherical coordinate system--longitude and latitude--are used to describe long axis rotations in this newly proposed coordinate system. The spherical rotation coordinate system uses a radial rotation angle to describe pure axial rotation of a limb segment whereas the classical spherical coordinate system uses a radial displacement to describe motion of a point. An application of the spherical rotation coordinate system is given to define three-dimensional rotations of the glenohumeral joint. A mathematical proof shows that the long axis rotation and axial rotation are sequence independent. Two numerical examples are investigated which demonstrate that the spherical rotation angles can be uniquely determined in both forward and inverse kinematics without considering sequences rotations.
Collapse
Affiliation(s)
- P L Cheng
- Department of Mechanical Engineering, Queen's University, Kingston, Ontario, Canada.
| |
Collapse
|
13
|
Pearcy MJ, Cheng PL. Three-dimensional clinical measurement of bilateral hip and knee rotations. Australas Phys Eng Sci Med 2000; 23:114-8. [PMID: 11210155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
This paper reports a technique of using an electromagnetic system to measure three-dimensional bilateral hip and knee joint rotations during walking and of using peak cross-correlation between rotation angles to describe the pattern of rotations. Three-dimensional rotations of thigh and shank during gait were recorded using five receivers of the electromagnetic system synchronised with four foot-switches. Thirteen normal subjects were tested on two separate occasions to examine repeatability of the measurements. The relationship between the rotations was represented as lags at peak cross-correlation. Twelve parameters of the lags at peak cross-correlation were calculated. The analysis showed that the joint rotation could be measured reliably and the cross-correlation analysis provided parameters that were generally suitable for defining characteristics of hip and knee joint rotations during gait.
Collapse
Affiliation(s)
- M J Pearcy
- School of Mechanical, Manufacturing and Medical Engineering Queensland University of Technology, Brisbane, Australia.
| | | |
Collapse
|
14
|
Abstract
This paper describes a new method of determining the axial rotation angle of a limb segment during three-dimensional movement. Instead of describing the three-dimensional rotation by a three-step rotation (Euler/Cardan angles), a one-step rotation (instantaneous screw axis), or a non-step rotation (floating axis method), the new method uses a two-step rotation to describe the three-dimensional rotation of the limb segment: the rotation of the long axis of the limb segment about a specific axis passing through the proximal joint centre and perpendicular to the long axis of the limb segment, and the axial rotation about the long axis. A short review of previous methods followed by a full description of the principle of the new method with detailed derivation of some important equations (Appendices), comparison with Euler/Cardan angles and a simple experimental demonstration are given in this paper. A method of solving the gimbal-lock problem when using this method is also proposed.
Collapse
Affiliation(s)
- P L Cheng
- Bioengineering Unit, University of Strathclyde, Glasgow, UK.
| | | | | |
Collapse
|
15
|
Abstract
Flexion/extension and abduction/adduction, two major parameters for the description of joint rotations, are used to define planer anatomical orientations of body segments. These two-dimensional definitions have been used extensively in the biomechanical literature for reporting and representing both two-dimensional and three-dimensional joint rotations. Whether these traditional two-dimensional measurements represent true joint rotations in three dimensions has not been investigated. A quantitative error analysis is presented to show how large an error can be produced in the flexion/extension and abduction/adduction angles when using two-dimensional measurements to represent three-dimensional joint rotations. The results indicate that for an out-of-plane flexion the error in abduction angle measured by previous methods increases with both flexion and initial abduction angle and become very sensitive when the flexion angle exceeds 40 degrees. Although the error can be less than 2 degrees for flexion below 20 degrees when the initial abduction angle is at 30 degrees, it can be as large as 9 degrees for 60 degrees of flexion with an initial 10 degrees of abduction; nearly double the real abduction angle. Therefore, two-dimensional measurements of flexion/extension and abduction/adduction can be erroneous and overestimated for a three-dimensional joint rotation. To overcome the problem new definitions are proposed for the true flexion/extension and abduction/adduction angles as two independent parameters for three-dimensional joint rotation.
Collapse
Affiliation(s)
- P L Cheng
- School of Mechanical, Manufacturing, and Medical Engineering, Queensland University of Technology, Brisbane, Australia.
| | | |
Collapse
|
16
|
Dai LY, Tu KY, Xu YK, Zhang WM, Cheng PL. Effects of discectomy on the stress distribution in the lumbar spine. Chin Med J (Engl) 1992; 105:944-8. [PMID: 1304466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The change of the stress distribution of the lumbar spine after discectomy was analysed by the three-dimensional finite element method. It was shown that the stress level in the posterior element was higher, but that in the anterior element was lower than before disc excision. The most significant change of the stress distribution was found in the trabecular bone of the vertebral body. It is considered that in discectomy the normal disc tissue should be preserved as much as possible to maintain good function of the spine.
Collapse
Affiliation(s)
- L Y Dai
- Department of Orthopaedics, Changzheng Hospital, Shanghai
| | | | | | | | | |
Collapse
|