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Mitsutake T, Nakazono H, Shiozaki T, Fujita D, Sakamoto M. Changes in vestibular-related responses to combined noisy galvanic vestibular stimulation and cerebellar transcranial direct current stimulation. Exp Brain Res 2024; 242:99-108. [PMID: 37966504 DOI: 10.1007/s00221-023-06731-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023]
Abstract
Vestibular nuclei and cerebellar function comprise vestibular neural networks that control vestibular-related responses. However, the vestibular-related responses to simultaneous stimulation of these regions are unclear. This study aimed to examine whether the combination of noisy galvanic vestibular stimulation (nGVS) and cerebellar transcranial direct current stimulation (ctDCS) using a complex transcranial electrical stimulation device alters vestibular-dominant standing stability and vestibulo-ocular reflex (VOR) function. The center of foot pressure (COP) sway and VOR of participants (28 healthy, young adults) were assessed under four conditions of transcranial electrical stimulation using nGVS and ctDCS. The COP was calculated with the participant standing on a soft-foam surface with eyes closed using a force plate to evaluate body sway. VOR measurements were collected via passive head movements and fixation on a target projected onto the front wall using a video head impulse test (vHIT). VOR gain was calculated in six directions using a semicircular canal structure based on the ratio of eye movement to head movement. The nGVS + ctDCS and nGVS + sham ctDCS conditions decreased COP sway compared to the sham nGVS + ctDCS and sham nGVS + sham ctDCS conditions. No significant differences were observed in the main effect of stimulation or the interaction of stimulation and direction on the vHIT parameters. The results of this study suggest that postural stability may be independently affected by nGVS. Our findings contribute to the basic neurological foundation for the clinical application of neurorehabilitation using transcranial electrical stimulation of the vestibular system.
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Affiliation(s)
- Tsubasa Mitsutake
- Department of Physical Therapy, Faculty of Medical Science, Fukuoka International University of Health and Welfare, 3-6-40 Momochihama, Sawara-Ku, Fukuoka, 814-0001, Japan.
| | - Hisato Nakazono
- Department of Occupational Therapy, Faculty of Medical Science, Fukuoka International University of Health and Welfare, Fukuoka, Japan
| | - Tomoyuki Shiozaki
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Nara, Japan
| | - Daisuke Fujita
- Department of Physical Therapy, Faculty of Medical Science, Fukuoka International University of Health and Welfare, 3-6-40 Momochihama, Sawara-Ku, Fukuoka, 814-0001, Japan
| | - Maiko Sakamoto
- Education and Research Centre for Community Medicine, Faculty of Medicine, Saga University, Saga, Japan
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van Zandwijk JK, Schuurmann RCL, Haken BT, Stassen CM, Geelkerken RH, de Vries JPPM, Simonis FFJ. Endograft position and endoleak detection after endovascular abdominal aortic repair with low-field tiltable MRI: a feasibility study. Eur Radiol Exp 2023; 7:82. [PMID: 38123829 PMCID: PMC10733271 DOI: 10.1186/s41747-023-00395-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/11/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Abdominal aortic endoleaks after endovascular aneurysm repair might be position-dependent, therefore undetectable using supine imaging. We aimed to determine the feasibility and benefit of using a low-field tiltable magnetic resonance imaging (MRI) scanner allowing to study patients who can be imaged in both supine and upright positions of endoleaks. METHODS Ten EVAR patients suspected of endoleak based on ultrasound examination were prospectively included. MRI in upright and supine positions was compared with routine supine computed tomography angiography (CTA). Analysis was performed through (1) subjective image quality assessment by three observers, (2) landmark registration between MRI and CTA scans, (3) Euclidean distances between renal and endograft landmarks, and (4) evaluation of endoleak detection on MRI by a consensus panel. Statistical analysis was performed by one-way repeated measures analysis of variance. RESULTS The image quality of upright/supine MRI was inferior compared to CTA. Median differences in both renal and endograft landmarks were approximately 6-7 mm between upright and supine MRI and 5-6 mm between supine MRI and CTA. In the proximal sealing zone of the endograft, no differences were found among all three scan types (p = 0.264). Endoleak detection showed agreement between MRI and CTA in 50% of the cases, with potential added value in only one patient. CONCLUSIONS The benefit of low-field upright MRI for endoleak detection was limited. While MRI assessment was non-inferior to standard CTA in detecting endoleaks in selected cases, improved hardware and sequences are needed to explore the potential of upright MRI in patients with endoleaks. RELEVANCE STATEMENT Upright low-field MRI has limited clinical value in detecting position-dependent endoleaks; improvements are required to fulfil its potential as a complementary modality in this clinical setting. KEY POINTS • Upright MRI shows potential for imaging endoleaks in aortic aneurysm patients in different positions. • The image quality of upright MRI is inferior to current techniques. • Upright MRI complements CTA, but lacks accurate deformation measurements for clinical use. • Advancements in hardware and imaging sequences are needed to fully utilise upright MRI capabilities.
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Affiliation(s)
- Jordy K van Zandwijk
- Magnetic Detection & Imaging, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
- Department of Vascular Surgery, Medisch Spectrum Twente, Enschede, The Netherlands.
| | - Richte C L Schuurmann
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Groningen, The Netherlands
- Multimodality Medical Imaging Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Bennie Ten Haken
- Magnetic Detection & Imaging, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Chrit M Stassen
- Department of Radiology, Ziekenhuisgroep Twente, Hengelo, The Netherlands
| | - Robert H Geelkerken
- Department of Vascular Surgery, Medisch Spectrum Twente, Enschede, The Netherlands
- Multimodality Medical Imaging Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Jean-Paul P M de Vries
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Frank F J Simonis
- Magnetic Detection & Imaging, Technical Medical Centre, University of Twente, Enschede, The Netherlands
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Endo Y, Miura M. Differences in the center of pressure movement during standing with running shoes of different constructions: A cross-sectional study. J Orthop 2023; 45:43-47. [PMID: 37841906 PMCID: PMC10570558 DOI: 10.1016/j.jor.2023.09.014] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 09/14/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023] Open
Abstract
Purpose This study examined the differences in the center of pressure movement in a one-leg standing position with bare feet, thin-soled shoes, and thick-soled shoes. Methods In total, 21 male university students participated in this study. The task involved standing on one leg with the dominant foot for 30 s, and the center of pressure movement was measured using a grab coder (G-620; ANIMA, Tokyo, Japan). Three shoe-wearing states, including bare feet, thin-soled shoes, and thick-soled shoes, with the eyes closed and open in each condition. Statistical analysis was performed, with the significance level set as 5%. Results In the multiple comparison results, the anteroposterior (AP) locus length, AP locus length per second, and maximum amplitude in the AP direction were significantly larger with thick-soled shoes than with bare feet in the closed eyes state. The locus length per unit area was significantly smaller with the thick-soled shoes than with the barefoot condition. Other items did not differ significantly between the shoe-wearing states. Conclusion Thick-soled shoes caused a greater center of pressure movement in the AP direction in the static one-leg standing position than did the barefoot state. Our findings suggest that the condition with thick-soled shoes was more unstable in static environments.
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Affiliation(s)
- Yasuhiro Endo
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Japan
| | - Masashi Miura
- Tokyo Rehabilitation Service Co., Ltd., Michinoku Rehabilitation Home-Visit Nursing Station, Aoba, Japan
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Bonnet CT, Singh T, Barela JA. Benefits associated with the standing position during visual search tasks. Exp Brain Res 2023; 241:187-99. [PMID: 36416923 DOI: 10.1007/s00221-022-06512-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 11/14/2022] [Indexed: 11/24/2022]
Abstract
The literature on postural control highlights that task performance should be worse in challenging dual tasks than in a single task, because the brain has limited attentional resources. Instead, in the context of visual tasks, we assumed that (i) performance in a visual search task should be better when standing than when sitting and (ii) when standing, postural control should be better when searching than performing the control task. 32 and 16 young adults participated in studies 1 and 2, respectively. They performed three visual tasks (searching to locate targets, free-viewing and fixating a stationary cross) displayed in small images (visual angle: 22°) either when standing or when sitting. Task performance, eye, head, upper back, lower back and center of pressure displacements were recorded. In both studies, task performance in searching was as good (and clearly not worse) when standing as when sitting. Sway magnitude was smaller during the search task (vs. other tasks) when standing but not when sitting. Hence, only when standing, postural control was adapted to perform the challenging search task. When exploring images, and especially so in the search task, participants rotated their head instead of their eyes as if they used an eye-centered strategy. Remarkably in Study 2, head rotation was greater when sitting than when standing. Overall, we consider that variability in postural control was not detrimental but instead useful to facilitate visual task performance. When sitting, this variability may be lacking, thus requiring compensatory movements.
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Fukuoka R, Yamada Y, Kataoka M, Yokoyama Y, Yamada M, Narita K, Nakahara T, Fukuda K, Jinzaki M. Estimating right atrial pressure using upright computed tomography in patients with heart failure. Eur Radiol 2022; 33:4073-4081. [PMID: 36576542 PMCID: PMC10182146 DOI: 10.1007/s00330-022-09360-8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Upright computed tomography (CT) can detect slight changes particularly in the superior vena cava (SVC) volume in healthy volunteers under the influence of gravity. This study aimed to evaluate whether upright CT-based measurements of the SVC area are useful for assessing mean right atrial pressure (mRAP) in patients with heart failure. METHODS We performed CT in both standing and supine positions to evaluate the SVC (directly below the junction of the bilateral brachiocephalic veins) and inferior vena cava (IVC; at the height of the diaphragm) areas and analyzed their relationship with mRAP, measured by right heart catheterization in 23 patients with heart failure. RESULTS The median age of enrolled patients was 60 (51-72) years, and 69.6% were male. The median mRAP was 3 (1-7) mmHg. The correlations between the standing position SVC and IVC areas and mRAP were stronger than those in the supine position (SVC, ρ = 0.68, p < 0.001 and ρ = 0.43, p = 0.040; IVC, ρ = 0.57, p = 0.005 and ρ = 0.46, p = 0.026; respectively). Furthermore, the SVC area in the standing position was most accurate in identifying patients with higher mRAP (> 5 mmHg) (SVC standing, area under the receiver operating characteristic curve [AUC] = 0.91, 95% confidence interval [CI], 0.77-1.00; SVC supine, AUC = 0.78, 95% CI, 0.59-0.98; IVC standing, AUC = 0.77, 95% CI, 0.55-0.98; IVC supine, AUC = 0.72, 95% CI, 0.49-0.94). The inter- and intraobserver agreements (evaluated by intraclass correlation coefficients) for all CT measurements were 0.962-0.991. CONCLUSIONS Upright CT-based measurement of the SVC area can be useful for non-invasive estimation of mRAP under the influence of gravity in patients with heart failure. KEY POINTS • This study showed that the superior vena cava (SVC) area in the standing position was most accurate in identifying patients with heart failure with higher mean right atrial pressure. • Upright computed tomography-based measurements of the SVC area can be a promising non-invasive method for estimating mean right atrial pressure under the influence of gravity in patients with heart failure. • Clinical management of patients with heart failure based on this non-invasive modality may lead to early assessment of conditional changes and reduced hospitalization for exacerbation of heart failure.
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Affiliation(s)
- Ryoma Fukuoka
- Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan.,Department of Cardiology, School of Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita, Chiba, Japan
| | - Yoshitake Yamada
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan.
| | - Masaharu Kataoka
- Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan.,The Second Department of Internal Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Yoichi Yokoyama
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Minoru Yamada
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Keiichi Narita
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Takehiro Nakahara
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan.
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Yamada Y, Chubachi S, Yamada M, Yokoyama Y, Tanabe A, Matsuoka S, Niijima Y, Murata M, Fukunaga K, Jinzaki M. Comparison of Lung, Lobe, and Airway Volumes between Supine and Upright Computed Tomography and Their Correlation with Pulmonary Function Test in Patients with Chronic Obstructive Pulmonary Disease. Respiration 2022; 101:1110-1120. [PMID: 36353776 PMCID: PMC9811423 DOI: 10.1159/000527067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/10/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Correlations between upright CT and pulmonary function test (PFT) measurements, and differences in lung/lobe/airway volumes between supine and standing positions in patients with chronic obstructive pulmonary disease (COPD) remain unknown. OBJECTIVES The study aimed to evaluate correlations between lung/airway volumes on both supine and upright CT and PFT measurements in patients with COPD, and compare CT-based inspiratory/expiratory lung/lobe/airway volumes between the two positions. METHODS Forty-eight patients with COPD underwent both conventional supine and upright CT in a randomized order during inspiration and expiration breath-holds, and PFTs within 2 h. We measured the lung/lobe/airway volumes on both CT. RESULTS The correlation coefficients between total lung volumes on inspiratory CT in supine/standing position and PFT total lung capacity and vital capacity were 0.887/0.920 and 0.711/0.781, respectively; between total lung volumes on expiratory CT in supine/standing position and PFT functional residual capacity and residual volume, 0.676/0.744 and 0.713/0.739, respectively; and between airway volume on inspiratory CT in supine/standing position and PFT forced expiratory volume in 1 s, 0.471/0.524, respectively. Inspiratory/expiratory bilateral upper and right lower lobe, bilateral lung, and airway volumes were significantly higher in the standing than supine position (3.6-21.2% increases, all p < 0.05); however, inspiratory/expiratory right middle lobe volumes were significantly lower in the standing position (4.6%/15.9% decreases, respectively, both p < 0.001). CONCLUSIONS Upright CT-based volumes were more correlated with PFT measurements than supine CT-based volumes in patients with COPD. Unlike other lobes and airway, inspiratory/expiratory right middle lobe volumes were significantly lower in the standing than supine position.
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Affiliation(s)
- Yoshitake Yamada
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan,*Yoshitake Yamada,
| | - Shotaro Chubachi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan,**Shotaro Chubachi,
| | - Minoru Yamada
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Yoichi Yokoyama
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Akiko Tanabe
- Department of Clinical Laboratory, Keio University Hospital, Tokyo, Japan
| | - Shiho Matsuoka
- Department of Clinical Laboratory, Keio University Hospital, Tokyo, Japan
| | - Yuki Niijima
- Office of Radiation Technology, Keio University Hospital, Tokyo, Japan
| | - Mitsuru Murata
- Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan,***Masahiro Jinzaki,
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Xu M, Motomura G, Ikemura S, Yamaguchi R, Kawano K, Yamamoto N, Tanaka H, Ayabe Y, Nakashima Y. Posterior Pelvic Tilt in the Standing Position Might Be Associated with Collapse Progression in Post-Collapse Stage Osteonecrosis of the Femoral Head. Orthop Surg 2022; 14:3201-3208. [PMID: 36250579 PMCID: PMC9732624 DOI: 10.1111/os.13544] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 08/29/2022] [Accepted: 09/13/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Excessive pelvic tilt has been reported to impair the biomechanical loading of the hip joint. However, the influence of pelvic tilt in osteonecrosis of the femoral head (ONFH) remains unclear. This study aims to assess whether sagittal pelvic posture in the standing position correlates with progression of femoral head collapse in post-collapse stage ONFH. METHODS This is a single-center retrospective study. We investigated 107 patients (107 hips; 73 males and 34 females; mean age, 48 years) diagnosed with Association of Research Circulation Osseous (ARCO) stage III ONFH at the first visit and who subsequently underwent surgical treatment in our institution from July 2016 to December 2020. The sagittal pelvic posture in the standing position before surgery was quantified as the angle formed by the anterior pelvic plane and the vertical z-axis in the sagittal view (APP angle). An APP angle <0° indicated posterior pelvic tilt. Progression of femoral head collapse was calculated as collapse speed. The following factors potentially associated with collapse speed were evaluated by exploratory data analysis followed with multiple linear regression analysis: sex, age, BMI, etiology, pelvic incidence, contralateral hip condition, time interval between the first visit and surgery, size of necrotic lesion, location of necrotic lesion, and APP angle. RESULTS As ONFH progressed from ARCO stage IIIA to stage IV, APP angle decreased significantly and continuously (stage IIIA, -0.2° ± 5.5°; stage IIIB, -3.7° ± 5.8°; stage IV, -7.1° ± 6.4°). The factors significantly associated with collapse speed were size of necrotic lesion (p = 0.0079), location of necrotic lesion (p = 0.0190), and APP angle (p < 0.0001). APP angle showed a negative correlation with collapse speed (r = -0.40, p < 0.0001). After stratifying by size of necrotic lesion (<50% and ≥50% involvement) and location of necrotic lesion (JIC type C1 and C2), a significant negative correlation was observed between APP angle and collapse speed in each group (JIC type C1 with <50% involvement, r = -0.69, p < 0.0001; JIC type C1 with ≥50% involvement, r = -0.58, p = 0.0475; JIC type C2 with <50% involvement, r = -0.51, p = 0.0124; JIC type C2 with ≥50% involvement, r = -0.39, p = 0.0286). CONCLUSIONS Our results suggest that posterior pelvic tilt in the standing position occurred as ONFH progressed from ARCO stage IIIA to stage IV, which might be associated with progression of femoral head collapse in ONFH.
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Affiliation(s)
- Mingjian Xu
- Department of Orthopaedic Surgery, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Goro Motomura
- Department of Orthopaedic Surgery, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Satoshi Ikemura
- Department of Orthopaedic Surgery, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Ryosuke Yamaguchi
- Department of Orthopaedic Surgery, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Koichiro Kawano
- Department of Orthopaedic Surgery, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Noriko Yamamoto
- Department of Orthopaedic Surgery, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Hidenao Tanaka
- Department of Orthopaedic Surgery, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Yusuke Ayabe
- Department of Orthopaedic Surgery, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
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Katsura K, Nakamura T, Sasagawa T. Is the Rate of Change in Posterior Pelvic Tilt After Total Hip Arthroplasty Constant? Arthroplast Today 2022; 15:147-152. [PMID: 35586612 PMCID: PMC9108515 DOI: 10.1016/j.artd.2022.03.021] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 03/25/2022] [Indexed: 11/26/2022] Open
Abstract
Background The purpose of this study was to evaluate the age-related change in pelvic sagittal inclination in the standing position after total hip arthroplasty (THA). This study hypothesized that the rate of progression of posterior tilt is not constant. Material and methods We measured sacral slope and pelvic tilt in 36 patients who were followed up for more than 10 years after unilateral primary THA. Results The posterior pelvic tilt in the standing position progressed significantly in the first year after THA and then progressed slowly. However, there was a tendency to accelerate again for those older than 75 years. Posterior pelvic tilt tended to progress rapidly after surgery in patients with femoral neck fractures and subchondral fractures of the femoral head. Conclusions In patients older than 75 years and those with fragility fractures, postoperative pelvic tilt in the standing position tends to be greater, suggesting that the use of a large head or dual mobility system should be considered.
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Affiliation(s)
- Kagawa Katsura
- Department of Orthopaedic Surgery, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Takuya Nakamura
- Department of Orthopaedic Surgery, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Takeshi Sasagawa
- Department of Orthopaedic Surgery, Toyama Prefectural Central Hospital, Toyama, Japan
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Muth-Seng C, Huneidi M, Heidsieck C, Laporte S, Le Coz JY, Gille O, Skalli W. Personalised gravitational loading of the cervical spine from biplanar X-rays for asymptomatic and clinical subjects in neutral standing position. Clin Biomech (Bristol, Avon) 2022; 92:105577. [PMID: 35042094 DOI: 10.1016/j.clinbiomech.2022.105577] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/07/2022] [Accepted: 01/09/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND As a leading cause of disability with a high societal and economic cost, it is crucial to better understand risk factors of neck pain and surgical complications. Getting subject-specific external loading is essential for quantifying muscle forces and joint loads but it requires exertion trials and load cells which are uncommon in clinical settings. METHODS This paper presents a method to compute the gravitational loading at four levels of the cervical spine (C3C4, C4C5, C5C6, C6C7) in neutral standing position from biplanar radiographs exclusively. The resulting load was decomposed in local disc frames and its components were used to compare different populations: 118 asymptomatic subjects and 46 patients before and after surgery (anterior cervical discectomy and fusion or total disc replacement). Comparisons were performed at C6C7 and the upper level adjacent to surgery. FINDINGS Significant changes in gravitational loading were observed with age in healthy subjects as well as in patients after surgery and have been associated with changes in posture. INTERPRETATION This approach quantifies the influence of postural changes on gravitational loading on the cervical spine. It represents a simple way to obtain necessary input for muscle force quantification models in clinical routine and to use them for patient evaluation. The study of the subsequent subject-specific spinal loading could help further the understanding of cervical spine biomechanics, degeneration mechanisms and complications following surgery.
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Affiliation(s)
- Christophe Muth-Seng
- Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, F-75013, Paris, France.
| | - Maxime Huneidi
- Service de chirurgie orthopédique et traumatologique, Groupe Hospitalier Pellegrin, CHU de Bordeaux, Bordeaux 33076, France
| | - Cécile Heidsieck
- Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, F-75013, Paris, France
| | - Sébastien Laporte
- Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, F-75013, Paris, France
| | - Jean-Yves Le Coz
- Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, F-75013, Paris, France
| | - Olivier Gille
- Service de chirurgie orthopédique et traumatologique, Groupe Hospitalier Pellegrin, CHU de Bordeaux, Bordeaux 33076, France
| | - Wafa Skalli
- Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, F-75013, Paris, France
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Gimenez MM, Fitz FF, de Azevedo Ferreira L, Bortolini MAT, Lordêlo PVS, Castro RA. Pelvic floor muscle function differs between supine and standing positions in women with stress urinary incontinence: an experimental crossover study. J Physiother 2022; 68:51-60. [PMID: 34952814 DOI: 10.1016/j.jphys.2021.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 01/28/2021] [Revised: 04/12/2021] [Accepted: 12/10/2021] [Indexed: 02/08/2023] Open
Abstract
QUESTION In women with stress urinary incontinence, how does pelvic floor muscle (PFM) function differ between supine and standing when assessed using manometry, vaginal palpation, dynamometry and electromyography? DESIGN An experimental crossover study. PARTICIPANTS A total of 101 women with stress urinary incontinence were included. INTERVENTION The PFM evaluations were performed and compared in supine and standing positions. The participants were assigned to either Group 1 (assessments in supine followed by standing) or Group 2 (assessments in standing followed by supine). OUTCOME MEASURES The primary outcome was the PFM pressure during the maximum voluntary contraction (MVC). Secondary outcomes were the measures of PFM pressure at rest; PFM function (PERFECT scheme); active and passive forces (dynamometry); and PFM electromyography (EMG) activity. RESULTS The mean MVC pressure was significantly lower in standing (MD -7 cmH2O, 95% CI -10 to -4). The mean PFM resting pressure was higher in standing (7 cmH2O, 95% CI 5 to 10). Three measures of PFM function derived from vaginal palpation were better in supine than in standing. The PFM active and the passive forces measured using dynamometry were higher in standing (0.18 kgf, 95% CI 0.16 to 0.20). The resting EMG activity was higher in standing than in supine (MD 3.6 μV, 95% CI 2.6 to 4.5), whereas EMG activity during MVC was higher in supine than standing (MD -8.7 μV, 95% CI -12.5 to -4.8). CONCLUSION The pressure and EMG activity during MVC, and PFM function were lower in standing. The resting pressure, the passive and active forces of the PFM and the resting EMG activity of the PFM were higher in standing.
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Affiliation(s)
| | - Fátima Faní Fitz
- Department of Gynecology, Universidade Federal de São Paulo, São Paulo, Brazil
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Mastwyk S, McClelland J, Cooper MM, Frawley HC. Pelvic floor muscle function in the standing position in women with pelvic floor dysfunction. Int Urogynecol J 2021; 33:2435-2444. [PMID: 34825921 DOI: 10.1007/s00192-021-05003-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/15/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Clinical assessment of the pelvic floor muscles (PFMs) in a standing position may provide a more valid representation of PFM function experienced by patients in daily life than assessment in the lying position. The primary aim of this study was to examine PFM function in a standing versus a lying position in parous women with any type of urinary incontinence and/or pelvic organ prolapse. METHODS In this exploratory cross-sectional study, participant symptom status was determined using the Australian Pelvic Floor Questionnaire. Pelvic floor muscle function was assessed in standing and lying positions with a randomised order of testing. The primary outcome measure was vaginal squeeze pressure (VSP) using intra-vaginal manometry. Secondary outcomes included vaginal resting pressure, total PFM work and digital muscle testing. The difference between PFM function in a standing position compared with a lying position was analysed using paired t test or Wilcoxon's signed rank test. RESULTS Vaginal squeeze pressure assessed with manometry was higher in a standing than in a lying position (p = 0.001): standing (mean [SD]) 24.90 [12.67], lying 21.15 [14.65]. In contrast, PFM strength on digital muscle testing was lower in a standing position than in a lying position. CONCLUSIONS This study has demonstrated that PFM function in a standing position is different from that in a lying position in women with pelvic floor dysfunction. Whether the higher VSP observed in a standing position reflects a true difference in strength between positions, or a higher pressure reading due to incorrect PFM contraction technique in a standing position is uncertain. Further research with larger cohorts and a measurement tool that can accurately distinguish a rise in intra-vaginal pressure from PFM contraction rather than increasing intra-abdominal pressure is required to confirm this difference, and the clinical significance of any difference.
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Affiliation(s)
- Sally Mastwyk
- Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
| | - Jodie McClelland
- Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | | | - Helena C Frawley
- Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia.,Allied Health Research, The Royal Women's Hospital, Melbourne, Australia.,Allied Health Research, Mercy Hospital for Women, Melbourne, Australia
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Chen C, Min L, Sun M, Weng W, Wang W. Abnormal femur rotation in patients with recurrent patellar dislocation: A study on upright standing three-dimensionally reconstructed EOS images. Knee 2021; 32:131-9. [PMID: 34474224 DOI: 10.1016/j.knee.2021.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 03/23/2021] [Accepted: 08/09/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The measurements of lower extremity rotational deformities in patients with recurrent patellar dislocation (RPD) in the standing position are available with the application of the EOS imaging system. The aim of our case-control study was to identify the differences on the femur rotation between the supine and standing positions, and to investigate the differences of anatomical and functional femur rotation between RPD patients and controls. METHODS Thirty-five lower extremities affected by RPD from 30 patients and 27 intact lower extremities from 27 controls with acute meniscus tear or anterior cruciate ligament injury were recruited. Anatomical femoral anteversion (AFA), functional femoral anteversion (FFA), femorotibial rotation (FTR) and distal femoral torsion (DFT) of all subjects were measured with the EOS imaging system. Computed tomography scans were carried out to analyze the AFA and FFA in the supine position in PRD patients. The differences in FFA between supine and standing position and in AFA, FTR and DFT between RPD and controls were analyzed. The predictor importance of each variable on RPD was observed after cluster analysis. RESULTS The EOS images were available in all subjects. The FFA was significantly smaller in the standing position than in the supine position (P < 0.05) in RPD patients. When comparing with the controls, RPD patients showed higher AFA, FTR and DFT (P < 0.05) but comparable FFA (P < 0.05). The cluster model prompted that FTR and DFT had higher predictor importance than AFA. CONCLUSION Larger AFA but comparable FFA in patients with RPD than the controls in an upright standing position suggested more internally rotated distal femur in the RPD patients. AFA may be inadequate and FFA should also be considered while planning the treatment for RPD. DFT and FTR should be taken into consideration when evaluating the abnormalities in femur rotation in RPD patients.
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Oshima M, Aoyama K. Comparison of standing stability with different doses in epidural fentanyl among post-cesarean delivery women: a prospective trial. Braz J Anesthesiol 2021; 72:479-483. [PMID: 34293411 PMCID: PMC9373625 DOI: 10.1016/j.bjane.2021.06.022] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 06/15/2021] [Accepted: 06/26/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The study purpose was to determine the safety and efficacy of different doses of epidural fentanyl plus local anesthetics on ambulation for patients who had elective cesarean delivery. METHODS A prospective study at a single community hospital used posturography to compute Sway area for assessment of standing stability [ISRCTN14517337]. Continuous epidural infusion of 0.2% ropivacaine containing either 2.5 mcg.mL-1 (Group 1, n = 8) or 5 mcg.mL-1 fentanyl (Group 2, n = 8) was randomly assigned to an individual and started at a rate of 5 mL.h-1 postoperatively and continued for 48 hours after cesarean delivery in addition to standing acetaminophen and ibuprofen. Posturography measured with SYMPACK™ was used to compute Sway area for investigation of standing stability. The unpaired t-test was used to compare continuous variables between groups. Analysis of variance (ANOVA) was used to assess differences of Sway area measured repeatedly within groups. RESULTS Participants' demographics, pain status, and leg motor function one day after cesarean delivery were not different between groups. Sway area in Group 1 was not different across three repeated measurements. Sway area of Group 2 on postoperative day 1, with epidural analgesia, was significantly higher than at the baseline (4.1 ± 2.8 vs. 3.1 ± 1.1 cm2, p < 0.05). CONCLUSIONS Because both low and high concentrations of epidural fentanyl allowed participants to ambulate with the same pain effect, the lower concentration of continuous epidural fentanyl (2.5 mcg.mL-1 at 5 mL.h-1) is warranted to avoid potential adverse events during ambulation after cesarean delivery.
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Affiliation(s)
- Masayuki Oshima
- Department of Anesthesia, Kobari General Hospital, Chiba, Japan.
| | - Kazuyoshi Aoyama
- The Hospital for Sick Children, Department of Anesthesia and Pain Medicine, Toronto, Canada
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Muraoka H, Suzuki T. Effects of trunk anterior tilt and knee joint flexion angle changes on muscle activity in the lower limb muscles. J Phys Ther Sci 2021; 33:472-479. [PMID: 34177111 PMCID: PMC8219598 DOI: 10.1589/jpts.33.472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/26/2021] [Indexed: 11/30/2022] Open
Abstract
[Purpose] We examined the effects of trunk anterior tilt angle (TA) and knee flexion
angle (KA) on lower limb muscle activity. [Participants and Methods] Twenty-eight healthy
male participants (age, 24.7 ± 4.7 years) performed nine standing tasks with different TA
and KA. The participants were instructed to remain still during each task. The nine
standing tasks were randomly performed while measurements of muscle activity were obtained
for seven muscles: gluteus maximus (GMAX), medial hamstrings (MH), lateral hamstrings
(LH), rectus femoris (RF), vastus lateralis (VL), medial gastrocnemius (MG), and soleus
(SOL). The activities of these muscles were normalized using isometric grade 3 of the
manual muscle testing (isoMMT3). The intra-rater reliability for the mean values of the
muscle activities measured with the isoMMT3 (intra-class correlation coefficient with 95%
confidence interval) was confirmed using equation ICC (1,3). [Results] GMAX, MH, LH, RF,
and MG were affected by both TA and KA, whereas VL was affected by KA, and SOL was
affected by TA. [Conclusion] Our findings may facilitate a better understanding of the
changes in muscle activity of the lower limb muscles due to differences in TA and KA.
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Affiliation(s)
- Hideaki Muraoka
- Department of Rehabilitation, Kansai Medical University Kuzuha Hospital: 4-1 Kusuha Hanazono-cho, Hirakata city, Osaka 573-1121, Japan
| | - Toshiaki Suzuki
- Graduate School of Health Sciences, Graduate School of Kansai University of Health Science, Japan
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Shen K, Lin L, Feng E, Zhang Y, Xiao L, Lin F, Li Z. Influence of sagittal degenerative spondylolisthesis on anteversion of the acetabular component in total hip arthroplasty. Orthopade 2021; 50:664-73. [PMID: 33580282 DOI: 10.1007/s00132-021-04069-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/13/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Degenerative lumbar spondylolisthesis (DSPL), as opposed to other degenerative spinal conditions, is disregarded in the assessment of hip stability after total hip arthroplasty (THA). This study aimed to determine whether patients with DSPL have different acetabular anteversion compared to patients with normal spine before and following THA. METHODS Preoperative and postoperative 6‑month lateral pelvic radiographs in standing and sitting positions from 91 patients who underwent primary THA were retrospectively compared for spinopelvic parameters between patients with DSPL (n = 31) and with normal spine (n = 34). RESULTS Compared to control patients in the standing position, patients with DSPL had significantly increased preoperative pelvic tilt (24° in DSPL vs. 8° in controls; p < 0.01), pelvic-femoral angle (194° in DSPL vs. 174° in controls; p < 0.05), decreased lumbar lordosis (35° in DSPL vs. 43° in controls; p < 0.05), increased postoperative pelvic tilt (22° in DSPL vs. 7° in controls; p < 0.01), pelvic-femoral angle (187° in DSPL vs. 179° in controls; p < 0.05), and acetabular anteversion (31° in DSPL vs. 23° in controls; p < 0.05). Preoperative (p = 0.181) and postoperative (p = 0.201) sitting pelvic tilt did not differ. There were positive correlations between preoperative standing pelvic tilt and postoperative standing acetabular anteversion, pelvic-femoral angle, and combined sagittal index (CSI) in DSPL (R2 = 0.8416; R2 = 0.9180; R2 = 0.9459, respectively, p < 0.01) and in controls (R2 = 0.6872; R2 = 0.6176; R2 = 0.7129, respectively, p < 0.01). CONCLUSION While the imbalance of seated sagittal plane is usually insignificant and compensable, the mechanism by which DSPL patients achieve a standing posture is different from control patients, with more hip extension and posterior tilt of the pelvis. Special attention should be paid to the risk of impingement caused by the increase of acetabular anteversion in the postoperative standing position.
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Carvalho LB, Chambers B, Borschmann K, Kaffenberger T, Churilov L, Thijs V, Bernhardt J. Occlusive Disease and Upright Activity in Acute Ischemic Stroke. J Stroke Cerebrovasc Dis 2021; 30:105604. [PMID: 33476962 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105604] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/26/2020] [Accepted: 01/03/2021] [Indexed: 10/22/2022] Open
Abstract
The impact of out-of-bed upright activity on outcomes in ischemic stroke patients with severe extra- and intracranial stenosis or occlusion is unknown. Using ultrasound findings from a cohort recruited to A Very Early Rehabilitation Trial (AVERT) which compared higher dose very early mobilisation (VEM) to usual care (UC), we aimed to explore the association between occlusive disease and 3-month outcomes and occlusive disease-by-mobilisation treatment interactions. Participants with ischemic stroke, with carotid and transcranial Doppler ultrasounds performed ≤1 week after admission, were included in this single centre substudy in Melbourne, Australia. Reports were retrospectively reviewed to determine the degree of stenosis or presence of occlusion in the relevant arterial territory. Stenosis ≥70% extracranial or ≥50% intracranial were classified as severe or occlusion. Overall, 19% (n = 36/191) had occlusive disease in the affected circulation. About 40% (n = 14/36) with occlusive disease and 51% (n = 79/155) without had a 3-month favourable outcome (mRS 0-2) (adjusted OR0.53, CI0.17-1.67). Fourteen percent (n = 5) with occlusive disease and 4% (n = 6) without died by 3 months (adjusted OR2.52, CI0.6-10.7). Fifty percent (n = 11/22) of UC (adjusted OR0.86, CI0.23-3.2) and 21% (n = 3/14) of VEM participants (adjusted OR0.16, CI0.01-2.7) with occlusive disease had a favourable outcome. Almost 30% (n = 4) VEM participants with occlusive disease died (adjusted OR3.99, CI0.69-22.9) compared to 5% (n = 1) UC participants with occlusive disease (adjusted OR0.45, CI0.02-8.6), however numbers were small. No stenosis-by-treatment interactions were found. High quality prospective studies are needed to help guide decision making about when patients with occlusive disease should commence upright activity in acute stroke.
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Affiliation(s)
- Lilian B Carvalho
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Australia; NHMRC Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery, Australia.
| | - Brian Chambers
- Department of Neurology, Austin Health, Australia; Department of Medicine, University of Melbourne, Australia
| | - Karen Borschmann
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Australia; NHMRC Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery, Australia; St Vincent's Hospital, Melbourne, Australia
| | - Tina Kaffenberger
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Australia
| | - Leonid Churilov
- Department of Medicine (Austin Health) and Melbourne Brain Centre at Royal Melbourne Hospital, Melbourne Medical School, University of Melbourne, Australia
| | - Vincent Thijs
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Australia; Department of Neurology, Austin Health, Australia
| | - Julie Bernhardt
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Australia; NHMRC Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery, Australia
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Garcia AFS, Dória RGS, Arantes JA, Reginato GM, Neubauer FG, Ribeiro G. Intravenous Regional Limb Perfusion in Standing and Recumbent Horses: A Comparative Radiographic Study. J Equine Vet Sci 2021; 98:103373. [PMID: 33663721 DOI: 10.1016/j.jevs.2021.103373] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 12/18/2020] [Accepted: 12/28/2020] [Indexed: 10/22/2022]
Abstract
Although pharmacokinetic studies of drugs administered by intravenous regional limb perfusion (IRLP) to treat equine orthopedic infections suggest efficient drug distribution in the limbs, it remains unclear whether drug perfusion is affected by the position of the horse during the procedure. This study compared the perfusion of a radiopaque contrast into tissues of the extremities of horses maintained in standing and recumbent positions during an IRLP. Radiopaque contrast was administered through IRLP into the cephalic vein of 10 healthy adult horses under general anesthesia and right lateral recumbency (RG) or under sedation and standing (SG). The same animals were used in both groups, respecting a two-week washout period. Sequential radiographic images were performed immediately at the beginning of contrast administration (T0) and after 10, 20, 30, 40, and 50 minutes. Tourniquets were removed after 30 minutes. The time required for the contrast to reach the hooves was compared between groups. Contrast reached the hooves faster in SG (114 ± 15 seconds) compared with RG (236 ± 29 seconds) (P < 0.5). SG showed more uniform perfusion of the limb vessels, whereas RG showed more deposition of the contrast in the lateral digital vein, with smaller amounts reaching the hooves. From T10 onward, soft tissue radiopacity increased, albeit more markedly in standing than in recumbent animals, remaining until T50. Contrast radiography evidenced that IRLP performed in standing position leads to a quicker and more uniform perfusion of the vasculature and a more noticeable diffusion to the tissues than in recumbent horses.
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Affiliation(s)
| | - Renata G S Dória
- Faculty of Animal Science and Food Engineering, Department of Veterinary Medicine, University of São Paulo (USP), Pirassununga, São Paulo, Brazil
| | - Julia A Arantes
- Faculty of Animal Science and Food Engineering, Department of Veterinary Medicine, University of São Paulo (USP), Pirassununga, São Paulo, Brazil
| | - Gustavo M Reginato
- Faculty of Animal Science and Food Engineering, Department of Veterinary Medicine, University of São Paulo (USP), Pirassununga, São Paulo, Brazil
| | | | - Gesiane Ribeiro
- United Metropolitan Colleges (FMU), São Paulo, São Paulo, Brazil.
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Lima CRG, Pavão SL, de Campos AC, Rocha NACF. Sit-to-stand movement in childrenwith cerebral palsy and relationships with the International classification of functioning, disability and health: A systematic review. Res Dev Disabil 2020; 107:103804. [PMID: 33160191 DOI: 10.1016/j.ridd.2020.103804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 06/09/2020] [Accepted: 10/16/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Studying sit-to-stand (STS) in children with Cerebral Palsy addressing the domains of ICF allows determining the factors influencing STS in this population. AIMS To systematically review the literature on STS in children with CP, identifying which ICF domains have been assessed and how they relate to sit-to-stand. METHODS AND PROCEDURES A literature search was conducted in electronic databases by combining the keywords (child OR children OR adolescent) AND ("Cerebral Palsy") AND (sit-to-stand). We included cross-sectional articles published in English, that assessed STS movements in children with CP up to 18 years old. OUTCOMES AND RESULTS 25 articles met the inclusion criteria. All of them assessed Body Functions and Structure. According to them, body alignment, muscle strength and postural sway affect STS movement. Six studies related Activity and Participation with STS, demonstrating that worse scores in scales that evaluate activities and participation are related to the poorer STS execution. Contextual factors were addressed in 15 studies: children's age, bench height, manipulation of sensory information and mechanical restriction impact the way children execute STS. CONCLUSION AND IMPLICATIONS Contextual factors and Body Functions and Structure impact the STS in children with CP. However, few studies have evaluated the participation of these children. Based on the theoretical framework of the ICF, it is important that future studies evaluate functional tasks in children with CP and the components that can affect them. The adoption of the biopsychosocial model strengthens the understanding of functioning, which can contribute to rehabilitation planning.
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Affiliation(s)
- Camila Resende Gâmbaro Lima
- Federal University of Sao Carlos. Department of Physical Therapy. Laboratory of Analysis of Childhood Development. Rod Washington Luis, Km 235, 13565-905, São Carlos, SP, Brazil.
| | - Silvia Leticia Pavão
- Federal University of Sao Carlos. Department of Physical Therapy. Laboratory of Analysis of Childhood Development. Rod Washington Luis, Km 235, 13565-905, São Carlos, SP, Brazil
| | - Ana Carolina de Campos
- Federal University of Sao Carlos. Department of Physical Therapy. Laboratory of Analysis of Childhood Development. Rod Washington Luis, Km 235, 13565-905, São Carlos, SP, Brazil
| | - Nelci Adriana Cicuto Ferreira Rocha
- Federal University of Sao Carlos. Department of Physical Therapy. Laboratory of Analysis of Childhood Development. Rod Washington Luis, Km 235, 13565-905, São Carlos, SP, Brazil
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Koliogiannis VKA, Brandlhuber M, Messerschmidt V, Stahl R, Melcher C, Schinner R, Birkenmaier C, Ricke J, Baur-Melnyk A. Is the EOS imaging system as accurate as conventional radiography in grading osteoarthritis of the knee? Eur Radiol 2021; 31:3491-7. [PMID: 33119811 DOI: 10.1007/s00330-020-07187-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 07/02/2020] [Accepted: 08/12/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The EOS imaging system allows for the acquirement of long-leg radiographic images in a standing position without stitching artifacts or projection bias and at a comparatively low-radiation-dose exposure. The aim of our study was to compare the accuracy of EOS images of the lower limb to conventional radiographs (CR) of the knee in a.p. view for the grading of osteoarthritis (OA). METHODS One hundred forty-two patients who had undergone EOS of the lower limb and radiography of the knee on the same day were included. For the grading of OA, the Kellgren and Lawrence score (KL) score and the Osteoarthritis Research Society International (OARSI) system were used. Additionally, the joint space was measured and compared between the two techniques. EOS images were compared to conventional anteroposterior radiographs of the knee which constitute the gold standard. RESULTS Measurements of the joint space showed very good intra-class correlation. The calculated weighted kappa for the KL score of EOS versus CR was excellent. The comparison of the different parameters of the OARSI score showed superb weighted kappa scores between 0.9 and 0.96 (α < 0.001) for the parameters osteophytes and joint space narrowing. The parameter deformity showed a good agreement between EOS and radiographs (sensitivity 93.6%; specificity 100%). For the sclerosis parameter, an overall sensitivity of 71.3% and a specificity of 99.3% were calculated. CONCLUSIONS The grading of OA using the KL score as well as the quantitative assessment of joint space width can be performed on EOS images in a.p. view as reliably as on CR. Subchondral sclerosis of the lateral and medial femur condyle or tibia is sometimes not as evident on EOS images. KEY POINTS • Grading of OA may be performed as reliably with EOS images in a.p. view as with conventional radiographs in a.p. view. • EOS can be safely used for primary assessment of osteoarthritis of the knee. • In the preoperative setting for knee replacement surgery, conventional radiographs in two or three planes of the knee should still be acquired in addition to long-leg EOS images.
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Yamada Y, Yamada M, Yokoyama Y, Tanabe A, Matsuoka S, Niijima Y, Narita K, Nakahara T, Murata M, Fukunaga K, Chubachi S, Jinzaki M. Differences in Lung and Lobe Volumes between Supine and Standing Positions Scanned with Conventional and Newly Developed 320-Detector-Row Upright CT: Intra-Individual Comparison. Respiration 2020; 99:598-605. [PMID: 32640453 DOI: 10.1159/000507265] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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: 01/03/2020] [Accepted: 03/16/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND No clinical studies to date have compared unilateral lung or lobe volumes between the supine and standing positions. OBJECTIVES To compare lung/lobe volumes on computed tomography (CT) between these two positions and evaluate the correlation between the total lung volume and total lung capacity (TLC) on pulmonary function tests (PFTs). METHODS Thirty-two asymptomatic volunteers underwent both conventional CT (supine position) and upright CT (standing position), during deep inspiration breath-hold, and PFTs on the same day. We measured lung/lobe volumes on CT in each position. Paired t tests were used for statistical analysis. RESULTS The volumes of the total lung (10.9% increase), right lung (10.3% increase), right upper lobe (8.6% increase), right lower lobe (14.6% increase), left lung (11.6% increase), left upper lobe (7.1% increase), and left lower lobe (16.0% increase) were significantly greater in the standing position than in the supine position (all p < 0.0001). The right middle lobe volume was similar between the two positions (p = 0.16). Intraclass correlation coefficients for agreement between total lung volumes on CT in the supine/standing positions and the TLC on PFT were 0.891/0.938, respectively. CONCLUSIONS While the volumes of the bilateral upper and lower lobes and bilateral lungs were significantly greater in the standing than in the supine position, with lower lobes showing larger changes, the right middle lobe volume did not change significantly between positions. The total lung volume on upright CT in the standing position was more similar to TLC on PFT than that in the supine position.
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Affiliation(s)
- Yoshitake Yamada
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan,
| | - Minoru Yamada
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Yoichi Yokoyama
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Akiko Tanabe
- Department of Clinical Laboratory, Keio University Hospital, Tokyo, Japan
| | - Shiho Matsuoka
- Department of Clinical Laboratory, Keio University Hospital, Tokyo, Japan
| | - Yuki Niijima
- Office of Radiation Technology, Keio University Hospital, Tokyo, Japan
| | - Keiichi Narita
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Takehiro Nakahara
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Mitsuru Murata
- Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shotaro Chubachi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
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Shakya R, Karmacharya RM, Shrestha R, Shrestha A. Varicose veins and its risk factors among nurses at Dhulikhel hospital: a cross sectional study. BMC Nurs 2020; 19:8. [PMID: 32042263 PMCID: PMC6998362 DOI: 10.1186/s12912-020-0401-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 01/28/2020] [Indexed: 11/18/2022] Open
Abstract
Background Women in nursing professions are at high risk for developing varicose veins as it requires physical work and prolonged standing. The aim of the study is to estimate the current prevalence of varicose veins among nurses at Dhulikhel Hospital and assess its risk factors. Methods A cross sectional study was carried out among 181 female nurses from different clinical settings of Dhulikhel Hospital. A structured questionnaire was administered to gather the demographic, work related and medical history information. The participants underwent Doppler ultrasound for varicose veins confirmation. Varicose veins was defined as Doppler finding of reflux or vein diameter equal or greater than 5 mm. Results A total of 181 nurses participated in this study and 83 (46%) had varicose veins. The mean standing time was 4.28 (0.8) hours /day, mean sitting time was 1.28 (0.6) hours/day, mean walking time was 2.37 (0.8) hours/day. In the adjusted model the odds of having varicose veins was 27 times greater with every 1 hour increase in standing time per day (adjusted OR: 27.44; 95% CI 4.09–180.77; p-value <0.00). Conclusions Varicose veins was prevalent among nurses’ at Dhulikhel Hospital. Prolonged standing was found to be a significant factor for varicose veins.
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Affiliation(s)
- Regan Shakya
- 1Department of Physiotherapy, Kathmandu University School of Medical Sciences/Dhulikhel Hospital, Kavre, Dhulikhel, Nepal
| | - Robin Man Karmacharya
- 2Department of Cardiovascular Surgery, Kathmandu University School of Medical Sciences/Dhulikhel Hospital, Kavre, Dhulikhel, Nepal
| | - Rojina Shrestha
- 1Department of Physiotherapy, Kathmandu University School of Medical Sciences/Dhulikhel Hospital, Kavre, Dhulikhel, Nepal
| | - Archana Shrestha
- 3Department of Community Programs, Kathmandu University School of Medical Sciences/Dhulikhel Hospital, Kavre, Dhulikhel, Nepal
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Della Valle E, Sirico F, Cacciatore F, Palermi S, Marcantonio R, Spera R. Worksite Energy Cost Assessment in Non-surgical versus Surgical Medical Residency Programs. Int J Occup Environ Med 2019; 10:216-217. [PMID: 31586386 PMCID: PMC6820313 DOI: 10.15171/ijoem.2019.1617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 08/30/2019] [Indexed: 11/09/2022]
Affiliation(s)
| | - Felice Sirico
- Department of Public Health, University of Naples "Federico II", Italy
| | - Francesco Cacciatore
- Department of Translational Medical Sciences, University of Naples "Federico II", Italy
| | - Stefano Palermi
- Department of Public Health, University of Naples "Federico II", Italy
| | | | - Rocco Spera
- Department of Public Health, University of Naples "Federico II", Italy
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Pruttikul P, Maneesrisajja T, Urusopon P, Pluemvitayaporn T, Piyaskulkaew C, Kunakornsawat S, Kittithamvongs P. Comparison of Segmental Mobility in Lumbar Extension Radiographs between a New Technique ("Fulcrum Bending Position") and Conventional Standing Position in Spondylolisthesis Patients. Asian Spine J 2019; 13:960-966. [PMID: 31352726 PMCID: PMC6894980 DOI: 10.31616/asj.2018.0299] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 04/13/2019] [Indexed: 11/23/2022] Open
Abstract
Study Design Cross-sectional study. Purpose This was carried out to evaluate the benefit of a ‘fulcrum bending position’ compared with the standing position for evaluation of sagittal translation and sagittal rotation in symptomatic patients with spondylolisthesis. Overview of Literature In lumbar X-ray, the standing position is the most common position used in determining abnormalities in lumbar movement. Lack of standardized method is one of the pitfalls in this technique. We hypothesized that the new technique, that is, fulcrum bending position, may reveal a higher translation and rotation in spondylolisthesis patients. Methods The extension lumbar radiographs of 36 patients with low-grade spondylolisthesis were included in the analysis and measurement. Sagittal translation and sagittal rotation were measured in both the routine standing position and in our new technique, the fulcrum bending position, which involves taking lateral cross-table images in the supine position wherein the patient lies on a cylindrical pipe to achieve maximum passive back extension by the fulcrum principle. Results Results of the measurement of sagittal translation in both positions revealed that compared with the extension standing position, the fulcrum bending position achieved a statistically significant increase of 1.57 mm in translation of the vertebra position (95% confidence interval [CI], 0.52–2.61; p=0.004). The measurement of sagittal rotation in both positions revealed that when compared with the extension standing position, the fulcrum bending position achieved a statistically significant increase of 3.47° in the rotation of the vertebra (95% CI, 1.64–5.30; p<0.001). Conclusions For evaluation of both sagittal translation and sagittal rotation in symptomatic patients with spondylolisthesis, compared with the extension standing position, the fulcrum bending position can achieve an increased change in magnitude. Our technique, that is, the fulcrum bending position, may offer an alternative method in the detection or exclusion of pathological mobility in patients with spondylolisthesis.
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Affiliation(s)
- Pritsanai Pruttikul
- Center of Excellence in Orthopaedics, Lerdsin General Hospital, Bangkok, Thailand
| | | | - Para Urusopon
- Department of Radiology, Lerdsin General Hospital, Bangkok, Thailand
| | | | - Chaiwat Piyaskulkaew
- Center of Excellence in Orthopaedics, Lerdsin General Hospital, Bangkok, Thailand
| | - Sombat Kunakornsawat
- Center of Excellence in Orthopaedics, Lerdsin General Hospital, Bangkok, Thailand
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Abstract
BACKGROUND Postural control is classically described as being based on the visual, vestibular, and proprioceptive musculo-articular sensory systems. The influence of mandibular proprioception on postural stabilization remains controversial. Most previous studies analyzed how postural stability is influenced by partial changes in mandibular proprioception (dental occlusion and jaw position). RESEARCH QUESTION In the present experiment, we asked whether drastic mandibular changes, resulting from orthognathic surgery (including dental, joint and muscular efferents), modify postural control. METHODS The analyzes were performed in 22 patients tested before, and 2.5 months, after orthognathic surgery for treatment of dysmorphic jaws. Experiments were performed under 4 experimental conditions: 2 visual conditions: Eyes Open (EO) and Eyes Closed (EC), and 2 occlusal conditions: Occlusion (OC: mandible positioned by the contact of the teeth), and Rest Position (RP: mandible positioned by the muscles without tooth contact). The analyses focused on head orientation in the frontal plane and on postural stabilization in a static task, consisting of standing upright. RESULTS The results show that, 2.5 months after orthognathic surgery, head orientation in the frontal plane was improved, since patient's external intercanthal lines became closer to the true horizontal line when they were tested EC and in OC condition. Postural responses, based on the wavelet transformation data, highlight an improvement in maintaining an upright stance for all the tested sensory conditions. However, such improvement was greater in the EC and RP conditions. SIGNIFICANCE These results show, for the first time, that after drastic mandibular changes, the weight of proprioceptive cues linked to the mandibular system may be so enhanced that it may constitute a new reference frame to orient the head in space, in darkness, and improve static postural stabilization, even in the presence of visual cues.
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Affiliation(s)
- M Paya-Argoud
- Aix Marseille Univ, CNRS, EFS, ADES, Faculté de Médecine, Bâtiment A, Boulevard Pierre Dramard, 13344, Marseille, France.
| | - C Tardieu
- Aix Marseille Univ, CNRS, EFS, ADES, Faculté de Médecine, Bâtiment A, Boulevard Pierre Dramard, 13344, Marseille, France; Assistance Publique Hopitaux de Marseille, pôle d'Odontologie, Hôpital de la Timone, 264 rue Saint Pierre, 13005, Marseille, France.
| | - F Cheynet
- Assistance Publique Hopitaux de Marseille, service de Chirurgie Maxillo-faciale, Hopital de la Conception, 147 Boulevard Baille, 13005, Marseille, France.
| | - A Raskin
- Aix Marseille Univ, CNRS, EFS, ADES, Faculté de Médecine, Bâtiment A, Boulevard Pierre Dramard, 13344, Marseille, France; Assistance Publique Hopitaux de Marseille, pôle d'Odontologie, Hôpital de la Timone, 264 rue Saint Pierre, 13005, Marseille, France.
| | - L Borel
- Aix Marseille Univ, CNRS, LNSC, Marseille, France.
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Rampal V, Rohan PY, Saksik R, Wicart P, Skalli W. Assessing 3D paediatric foot morphology using low-dose biplanar radiography: Parameter reproducibility and preliminary values. Orthop Traumatol Surg Res 2018; 104:1083-1089. [PMID: 30253989 DOI: 10.1016/j.otsr.2018.07.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 04/09/2018] [Revised: 07/10/2018] [Accepted: 07/25/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The physical examination and weight-bearing radiography are the two main available methods for assessing the feet and lower limbs. The anatomy and function of these two structures interact with each other. These two assessment methods are affected by subjectivity and projection bias. Low-dose biplanar radiography (LDBR) is now a promising alternative for evaluating the lower limbs in children. At present, however, the foot cannot be assessed using LDBR. The objective of this study was to work towards developing a new method for 3D radiographic analysis of the paediatric foot during weight-bearing, first by determining the reproducibility of landmarks defined by LDBR then by reporting the values of the calculated radiographic parameters. HYPOTHESIS A new radiographic method based on LDBR can be used to obtain a 3D evaluation of the foot in paediatric patients. PATIENTS AND METHODS Two biplanar radiographs in perpendicular planes were obtained simultaneously in a standardised position using the EOS system (EOS® Imaging, Paris, France) in each of 10 healthy children. To assess measurement uncertainty, two observers performed 3D reconstructions of each of the 10 feet three times (60 reconstructions). The standard error of reproducibility of the anatomic landmarks and clinical parameters was computed. Measurement uncertainty was then estimated based on the 95% confidence interval (95%CI). To obtain reference values, the mean±SD of each variable was computed after checking that the data were normally distributed. RESULTS Reproducibility was high for the anatomical landmarks of interest, calcaneal pitch angle, tibio-calcaneal angle on the lateral view, and first metatarsal pitch angle (95%CI<5%). The values of these angles in the study population are reported. DISCUSSION AND CONCLUSION The data reported here pave the way towards developing new parameters for describing 3D foot morphology and for simultaneously assessing the lower limb and foot in the standing position. LEVEL OF EVIDENCE I.
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Affiliation(s)
- Virginie Rampal
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, 151, boulevard de l'hôpital, 75013 Paris, France; Service d'orthopédie pédiatrique, hôpitaux pédiatriques de Nice CHU Lenval, 57, avenue de la Californie, 06000 Nice, France.
| | - Pierre-Yves Rohan
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, 151, boulevard de l'hôpital, 75013 Paris, France
| | - Rebekah Saksik
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, 151, boulevard de l'hôpital, 75013 Paris, France
| | - Philippe Wicart
- Service d'orthopédie pédiatrique, Hôpital Necker-Enfants Malades, 149, rue de Sèvres, 75015 Paris, France
| | - Wafa Skalli
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, 151, boulevard de l'hôpital, 75013 Paris, France
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Bakouny Z, Assi A, Yared F, Khalil N, Mansour E, Yaacoub JJ, Skalli W, Ghanem I. Combining acetabular and femoral morphology improves our understanding of the down syndrome hip. Clin Biomech (Bristol, Avon) 2018; 58:96-102. [PMID: 30064043 DOI: 10.1016/j.clinbiomech.2018.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 07/18/2018] [Accepted: 07/23/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hip instability is frequent in patients with Down syndrome. Recent studies have suggested that skeletal hip alterations are responsible for this instability; however, there are currently no studies simultaneously assessing femoral and acetabular anatomy in subjects with Down syndrome in the standing position. The aim was to analyze the three-dimensional anatomy of the Down syndrome hip in standing position. METHODS Down syndrome subjects were age and sex-matched to asymptomatic controls. All subjects underwent full body biplanar X-rays with three-dimensional reconstructions of their pelvises and lower limbs. Parameter means and distributions were compared between the two groups. FINDINGS Forty-one Down syndrome and 41 control subjects were recruited. Acetabular abduction (mean = 52° [SD = 9°] vs. mean = 56° [SD = 8°]) and anteversion (mean = 14° [SD = 8°] vs. mean = 17.5° [SD = 5°]) as well as posterior acetabular sector angle (mean = 91° [SD = 7°] vs. mean = 94° [SD = 7°]) were significantly lower in Down syndrome subjects compared to controls (P < 0.01). Anterior acetabular sector angle (mean = 62° [SD = 10°] vs. mean = 59° [SD = 7°]; P < 0.01) was significantly higher in Down syndrome compared to controls. The distributions of acetabular anteversion (P = 0.002;V = 0.325), femoral anteversion (P = 0.004;V = 0.309) and the instability index (P < 0.001;V = 0.383) were significantly different between the two groups, with subjects with Down syndrome having both increased anteversion and retroversion for each of these parameters. INTERPRETATION Subjects with Down syndrome were found to have a significantly altered and more heterogeneous anatomy of their proximal hips compared to controls. This heterogeneity suggests that treatment strategies of hip instability in Down syndrome should be subject-specific and should rely on the understanding of the underlying three-dimensional anatomy of each patient.
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Yamasaki H, Komasawa N, Yonehara S, Minami T. Comparison of sitting and standing position for central venous catheter insertion: A crossover simulation trial. Am J Emerg Med 2018; 36:1714-1715. [PMID: 29395768 DOI: 10.1016/j.ajem.2018.01.075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 01/23/2018] [Indexed: 10/18/2022] Open
Affiliation(s)
| | | | - Shugo Yonehara
- Department of Anesthesiology, Osaka Medical College, Japan
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Lazennec JY, Folinais D, Bendaya S, Rousseau MA, Pour AE. The global alignment in patients with lumbar spinal stenosis: our experience using the EOS full-body images. Eur J Orthop Surg Traumatol 2016; 26:713-24. [PMID: 27573076 DOI: 10.1007/s00590-016-1833-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 08/02/2016] [Indexed: 01/17/2023]
Abstract
Lumbar stenosis is frequently observed and treated by spine surgeons. The extent of neurological decompression and the potential spinal fixation are the basic concerns when surgery is planned. But this segmented approach to the problem is sometimes insufficient due to the complex functional situations induced by a sagittal imbalance of the patient and the combination of pathologies known as hip-spine or knee-spine syndromes. A total of 373 consecutive patients included from our EOS and clinical data base. Patients were divided in two groups. Group A included patients presenting exclusive spinal issues (172 cases) out of whom 117 (68 %) had sagittal imbalance. Among 201 patients with associated lower limbs issues (group B), 122 (61 %) had sagittal imbalance. The perception of imbalance was noticed in 54 % (93 cases) in group A and 57 % (115 cases) in group B. In the global series of 239 imbalanced cases, the key point was a spine issue for 165 patients (the 117 patients with only spine problems and 48/122 cases with combined spine and lower limbs problems). But in the patients with combined spine and lower limbs problems, we individualized hip-spine syndromes (24/122 patients) and knee-spine syndromes (13/122 patients). In some cases, (37/122 patients) the anatomical and functional situations were more complex to characterize a spine-hip or a hip-spine problem. The EOS full-body images provide new information regarding the global spinal and lower limbs alignment to improve the understanding of the patient functional posture. This study highlights the importance of the lower limb evaluation not only as compensatory mechanism of the spinal problems but also as an individualized parameter with its own influence on the global balance analysis. Level of evidence IV diagnostic case series.
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Affiliation(s)
- Jean Yves Lazennec
- Department of Orthopaedic and Trauma Surgery, Pitié-Salpétrière hospital Assistance Publique - Hopitaux de Paris, UPMC, Paris, France. .,Biomechanics Lab (LBM), Arts et Metiers Paris-Tech, Paris, France. .,Department of Anatomy, UPMC, Paris, France.
| | | | - Samy Bendaya
- Rothschild Hospital Assistance Publique - Hopitaux de Paris, Paris, France
| | - Marc Antoine Rousseau
- Biomechanics Lab (LBM), Arts et Metiers Paris-Tech, Paris, France.,Avicenne Hospital Assistance Publique - Hopitaux de Paris, Bobigny, France
| | - Aidin Eslam Pour
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
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Valenzuela S, Miralles R, Santander H, Bull R, Cordova R, Celhay I, Cavada G, Gutiérrez MF. Effects of breathing type on electromyographic activity of respiratory muscles at different body positions. Cranio 2016; 35:110-115. [PMID: 27077252 DOI: 10.1080/08869634.2016.1159384] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM To compare the effect of breathing type on the activity of respiratory muscles at different body positions. METHODOLOGY Two groups of 20 subjects each, one with upper costal and the other with costodiaphragmatic breathing, were studied. Electromyographic activity of sternocleidomastoid (SCM), diaphragm (DIA), external intercostal (EIC), and latissimus dorsi (LAT) muscles was recorded at standing and lateral decubitus positions during swallowing and maximal voluntary clenching. RESULTS All muscles showed higher activity during standing in upper costal breathing subjects except the SCM muscle. EIC activity was higher during standing in the costodiaphragmatic breathing group. Subjects with upper costal breathing showed higher DIA activity than subjects with costodiaphragmatic breathing at both body positions and higher SCM activity at lateral decubitus position, whereas, EIC activity was only higher during swallowing. CONCLUSIONS Subjects with upper costal breathing presented higher respiratory effort than subjects with costodiaphragmatic breathing, being most prominent at the lateral decubitus position.
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Affiliation(s)
- Saúl Valenzuela
- a Faculty of Dentistry , Institute for Research in Dental Sciences, University of Chile , Santiago , Chile.,b Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile
| | - Rodolfo Miralles
- b Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile
| | - Hugo Santander
- b Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile
| | - Ricardo Bull
- b Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile
| | - Rosa Cordova
- a Faculty of Dentistry , Institute for Research in Dental Sciences, University of Chile , Santiago , Chile.,b Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile.,c Faculty of Medicine , Diego Portales University , Santiago , Chile
| | - Isabel Celhay
- b Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile
| | - Gabriel Cavada
- d Faculty of Medicine, Public Health School , University of Chile , Santiago , Chile
| | - Mario Felipe Gutiérrez
- a Faculty of Dentistry , Institute for Research in Dental Sciences, University of Chile , Santiago , Chile.,b Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile
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Melam GR, Buragadda S, Alhusaini A, Alghamdi MA, Alghamdi MS, Kaushal P. Effect of Different Positions on FVC and FEV1 Measurements of Asthmatic Patients. J Phys Ther Sci 2014; 26:591-3. [PMID: 24764640 PMCID: PMC3996428 DOI: 10.1589/jpts.26.591] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 11/15/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of our study was to investigate the effect of different positions on pulmonary function test (PFT) values such as forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) of asthmatic patients .[Subjects and Methods] Thirty subjects with severe asthma aged between 20-39 years were enrolled after they had signed a written consent. Subjects were selected using the inclusion criteria, and PFT were randomly administered. Spirometer measurements (FVC, FEV1) were taken in the supine, side lying on right, side lying on left, sitting and standing positions. Each measurement was taken three times, and the average values were analyzed. [Results] One- way analysis of variance (ANOVA) and Tukey's Test (post hoc) for pair- wise comparison indicated that there was a significant difference in the FEV1 values of the asthmatic patients however a significant difference was obtained between standing and supine positions. There was also a significant difference in the FVC values between the standing and supine lying position in the pair -wise comparison. [Conclusion] This study showed standing is the best position for measuring FEV1 and FVC of asthmatic subjects. The more upright the position, the higher the FEV1 and FVC will be.
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Affiliation(s)
- Ganeswara Rao Melam
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
| | - Syamala Buragadda
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
| | - Adel Alhusaini
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
| | | | - Mansour Saleh Alghamdi
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
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