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Sensors (Basel, Switzerland) May 2023Joint quasi-stiffness has been often used to inform exoskeleton design. Further understanding of hip quasi-stiffness is needed to design hip exoskeletons. Of interest...
Joint quasi-stiffness has been often used to inform exoskeleton design. Further understanding of hip quasi-stiffness is needed to design hip exoskeletons. Of interest are wearer responses to walking speed changes with added mass of the exoskeleton. This study analyzed hip quasi-stiffness at 3 walking speed levels and 9 added mass distributions among 13 young and 16 middle-aged adults during mid-stance hip extension and late-stance hip flexion. Compared to young adults, middle-aged adults maintained a higher quasi-stiffness with a smaller range. For a faster walking speed, both age groups increased extension and flexion quasi-stiffness. With mass evenly distributed on the pelvis and thighs or biased to the pelvis, both groups maintained or increased extension quasi-stiffness. With mass biased to the thighs, middle-aged adults maintained or decreased extension quasi-stiffness while young adults increased it. Young adults decreased flexion quasi-stiffness with added mass but not in any generalizable pattern with mass amounts or distributions. Conversely, middle-aged adults maintained or decreased flexion quasi-stiffness with even distribution on the pelvis and thighs or biased to the pelvis, while no change occurred if biased to the thighs. In conclusion, these results can guide the design of a hip exoskeleton's size and mass distribution according to the intended user's age.
Topics: Young Adult; Middle Aged; Humans; Walking; Walking Speed; Hip Joint; Pelvis; Exoskeleton Device; Biomechanical Phenomena; Gait
PubMed: 37177721
DOI: 10.3390/s23094517 -
Acta Obstetricia Et Gynecologica... Aug 2016The purpose of the present study was to evaluate learning curves and short-term outcomes following laparoscopic surgery for early endometrial cancer in women of...
INTRODUCTION
The purpose of the present study was to evaluate learning curves and short-term outcomes following laparoscopic surgery for early endometrial cancer in women of different body mass index (BMI) classes.
MATERIAL AND METHODS
Data from 227 women planned for laparoscopic surgery for presumed stage I endometrial cancer were collected retrospectively from a Danish gynecologic oncology unit. Surgery included laparoscopic hysterectomy and bilateral salpingo-oophorectomy with or without pelvic lymphadenectomy (PLA).
RESULTS
Median length of operations was 60 min (range, 30-197) and 120 min (range, 60-230), depending on whether PLA was included. The median pelvic lymph node yield was 18 (range, 7-42). For staging with PLA there was a learning curve when measured as operative time as well as lymph node yield, and a level of proficiency was not reached after 40 operations. The women had a perioperative complication rate of 4.5% and a median hospital stay of one night. Postoperative complication rate was 12%, comprising vaginal cuff hematoma (3.1%), vaginal cuff rupture (0.9%), trocar hernia (1.3%), ureter lesion (0.4%), bowel lesion (0.4%), reoperation (0.9%) and other complications (4.5%). All peri- and postoperative outcomes were independent of BMI classes.
CONCLUSIONS
Our data suggest that laparoscopic surgery for early endometrial cancer is feasible and safe. With increasing surgeon's experience there is a significant decrease in operative time and increase in the number of lymph nodes harvested. In experienced hands, either operative time, complications or length of stay are not affected by increasing BMI, even when women are morbidly obese.
Topics: Adult; Aged; Aged, 80 and over; Body Mass Index; Carcinoma, Endometrioid; Clinical Competence; Endometrial Neoplasms; Female; Humans; Hysterectomy; Laparoscopy; Learning Curve; Lymph Node Excision; Middle Aged; Obesity; Operative Time; Ovariectomy; Pelvis; Postoperative Complications; Retrospective Studies; Salpingectomy; Treatment Outcome
PubMed: 27100141
DOI: 10.1111/aogs.12908 -
BMC Pregnancy and Childbirth Aug 2022To evaluate pelvic floor muscle strength using surface electromyography and risk factors for pelvic floor muscle strength in the early postpartum period.
OBJECTIVES
To evaluate pelvic floor muscle strength using surface electromyography and risk factors for pelvic floor muscle strength in the early postpartum period.
METHODS
This retrospective study included 21,302 participants who visited Fujian Maternity and Child Health Hospital from September 2019 to February 2022. All participants were assessed by medical professionals for general information and surface electromyography.
RESULTS
Univariate analysis indicated that age was inversely related to tonic and endurance contractions. In contrast, all the other variables, including education level, body mass index, neonatal weight, and number of fetuses, had a positive impact on rapid, tonic, and endurance contractions. Likewise, parity was also positively associated with rapid contractions. In addition, compared with vaginal delivery, cesarean section delivery had a protective effect on the amplitude of the three types of contractions. Stepwise regression analysis showed that both age and neonatal weight had a negative linear relationship with the amplitude of rapid, tonic and endurance contractions. In contrast, the amplitude of rapid, tonic and endurance contractions significantly increased as body mass index, parity (≤ 3), education level and gestational weight gain (endurance contractions only) increased. Participants with cesarean section delivery showed positive effects on rapid, tonic, and endurance contractions compared to participants with vaginal delivery.
CONCLUSIONS
We found that age, neonatal weight, vaginal delivery, episiotomy, and forceps delivery were risk factors for pelvic floor muscle strength; in contrast, body mass index, parity (≤ 3) and gestational weight gain had a positive relationship with pelvic floor muscle strength.
Topics: Cesarean Section; Child; China; Female; Gestational Weight Gain; Humans; Infant, Newborn; Muscle Contraction; Muscle Strength; Pelvic Floor; Pregnancy; Retrospective Studies; Risk Factors
PubMed: 35933360
DOI: 10.1186/s12884-022-04952-0 -
Revue Medicale de Liege Jul 2023An accessory and cavitated uterine mass (ACUM) is a rare anomaly with an embryological origin of dysfunctionning female gubernaculum. It is an accessory mass internally...
An accessory and cavitated uterine mass (ACUM) is a rare anomaly with an embryological origin of dysfunctionning female gubernaculum. It is an accessory mass internally lined with normal endometrium, separated from the uterine cavity and located near the insertion of the round ligament. ACUM's clinical manifestations are severe dysmenorrhea and/or chronic pelvic pain. It is a relatively unknown condition, which makes its diagnosis complicated and suggests a large differential diagnosis. We report the case of a 31-year-old female presenting with pelvic chronic pain and crippling dysmenorrhea. The initial work-up consists of a magnetic resonance imaging showing an interstitial lesion possibly corresponding to an ACUM. This supposition was then confirmed by histopathology.
Topics: Female; Humans; Adult; Dysmenorrhea; Pelvic Pain; Uterus; Diagnosis, Differential; Pelvis
PubMed: 37560956
DOI: No ID Found -
Journal of Orthopaedic Surgery (Hong... 2023The interaction between knee osteoarthritis and spinal deformity and knee flexion (KF) remains unclear. We aimed to clarify the relationship between KF in the standing...
The interaction between knee osteoarthritis and spinal deformity and knee flexion (KF) remains unclear. We aimed to clarify the relationship between KF in the standing position and the severity of spinal deformity and knee osteoarthritis. We analyzed older volunteers aged over years who participated in the musculoskeletal screening program. The participant's characteristics and standing radiographic parameters were assessed. After a preliminary analysis, a propensity score-matched model was established with adjustments for age, sex, and body mass index (BMI). Cases were divided into KF (knee angle [KA] ≥10°) and non-KF (KA <10°) groups. In a preliminary analysis of 252 cases (42 KF and 210 non-KF), there were significant differences in age and BMI between the KF and non-KF groups (all < 0.05). Using a one-to-one propensity score-matched analysis, 38 pairs of cases were selected. There were significantly higher values of C7 sagittal vertical axis, T1 pelvic angle, pelvic tilt, pelvic incidence minus lumbar lordosis, KA, ankle angle, and pelvic shift in the KF group than in the non-KF group (all < 0.05). In the KF group, 71.1% of the cases had severe spinal deformity (defined as marked deformity by the SRS-Schwab classification), and 31.6% had severe knee osteoarthritis (defined as a Kellgren Lawrence grade ≥3). Of the 31.6%, 7.9% were attributable to knee osteoarthritis alone, and 23.7% to both knee osteoarthritis and spinal deformity. This study clarified that compensatory changes due to spinopelvic malalignment, not due to knee osteoarthritis alone, mainly affected KF in the standing position.
Topics: Humans; Middle Aged; Aged; Standing Position; Osteoarthritis, Knee; Radiography; Lordosis; Pelvis
PubMed: 37039267
DOI: 10.1177/10225536231169575 -
Obstetrics and Gynecology Oct 2020To assess whether resting genital hiatus, perineal body, and total vaginal length measured intraoperatively at the conclusion of surgery are associated with prolapse...
OBJECTIVE
To assess whether resting genital hiatus, perineal body, and total vaginal length measured intraoperatively at the conclusion of surgery are associated with prolapse recurrence 2 years after native tissue pelvic organ prolapse reconstruction.
METHODS
This ancillary analysis of the OPTIMAL (Operations and Pelvic Muscle Training in the Management of Apical Support Loss) trial included women who had an immediate postoperative pelvic organ prolapse quantification (POP-Q) examination and 2-year follow-up. Primary outcome was bothersome bulge symptoms. Secondary outcomes were anatomic failure, surgical failure (either anatomic failure or bothersome bulge symptoms), and sexual function. Descriptive statistics assessed relationships between postprocedure POP-Q measures and these four outcomes. Multivariable models were fit to the data to control for baseline differences in bivariate comparisons. Receiver operating characteristic curves were generated to identify an optimal genital hiatus cut point associated with bothersome bulge, and this threshold was explored.
RESULTS
This analysis included 368 participants. Bivariate analyses identified age, body mass index, vaginal deliveries, baseline genital hiatus, perineal body, and advanced POP-Q stage (3 or higher vs 2) as clinically relevant variables to include in multivariable models. After adjusting for these variables, the association between immediate postoperative genital hiatus and bothersome bulge (adjusted odds ratio [aOR] 1.4; 95% CI 0.9-2.1) was not significant at the P<.05 level; however, immediate postoperative genital hiatus was associated with anatomic (aOR 1.6; 95% CI 1.1-2.3) and surgical failure (aOR 1.5; 95% CI 1.0-2.1). Immediate postoperative genital hiatus of 3.5 cm was the selected cutoff (area under the curve 0.58, 95% CI 0.50-0.66 from the bothersome bulge model). Women with genital hiatus 3.5 cm or greater were more likely to have anatomic and surgical failures at 2 years. No POP-Q measures were correlated with 2-year sexual function.
CONCLUSION
A larger immediate postoperative genital hiatus measurement of 3.5 cm or greater is not associated with bothersome bulge symptoms or sexual dysfunction but is associated with anatomic and surgical failures 2 years after native tissue vaginal reconstructive surgery.
Topics: Female; Follow-Up Studies; Gynecologic Surgical Procedures; Humans; Middle Aged; Outcome and Process Assessment, Health Care; Pelvic Floor; Pelvic Organ Prolapse; Postoperative Complications; Prognosis; Plastic Surgery Procedures; Recurrence; Risk Adjustment; Severity of Illness Index; Sexual Dysfunction, Physiological; Symptom Assessment
PubMed: 32925609
DOI: 10.1097/AOG.0000000000004043 -
PloS One 2017To establish the normal values of spino-pelvic alignment and to clarify the effect of age-related changes using large, community-based cohorts.
OBJECTIVES
To establish the normal values of spino-pelvic alignment and to clarify the effect of age-related changes using large, community-based cohorts.
METHODS
In this study, data from 1461 participants (466 men, 995 women) were analyzed. On lateral standing radiographs, the following parameters were measured: thoracic kyphosis (TK), lumbar lordosis (LL), pelvic tilt (PT), pelvic incidence (PI), and C7 sagittal vertical axis (SVA). All values are expressed as the mean±standard deviation. The Spearman rank correlation coefficient was used to examine correlations between variables of spino-pelvic parameters. Finally, we analyzed the relationship between age and spino-pelvic parameters. Therefore, we entered values for the body mass index (BMI), SVA, TK, and PI-LL into a multiple regression model to adjust for potential confounding factors.
RESULTS
The SVA, TK, and PT increased with age, and LL decreased with age. Regarding sex differences, the TK was statistically significantly larger in men than in women, and LL, PT, and PI were statistically significantly smaller in men than in women. Correlation coefficients between the SVA and TK, between the SVA and PI-LL, and between TK and PI-LL were none, strong, and weak, respectively. Results of multiple regression analysis between age and spino-pelvic parameters showed that the standardized partial regression coefficients for the SVA, TK, and PI-LL were 0.17, 0.30, and 0.23, respectively, in men and 0.29, 0.32, and 0.23, respectively, in women.
CONCLUSIONS
We found that all parameters were significantly associated with age in men and women. The SVA, TK, and PT increased with age, and LL decreased with age. Results of multiple regression analysis also demonstrated that the SVA, TK, and PI-LL are related to age. Indeed, the PI-LL value increased with age. In this study, a more excessive PI-LL mismatch was shown, indicating an increased risk of spinal malalignment. Differences in the absolute values of spino-pelvic parameters in each sex were small yet statistically significant. Thus, further study should be performed to corroborate this finding.
Topics: Adult; Aged; Aged, 80 and over; Body Mass Index; Female; Humans; Kyphosis; Lordosis; Lumbar Vertebrae; Male; Middle Aged; Pelvis; Postural Balance; Posture; Radiography; Sex Characteristics; Spine
PubMed: 28586366
DOI: 10.1371/journal.pone.0178697 -
Ultrasound in Obstetrics & Gynecology :... Jun 2021Pelvic floor muscle contractility (PFMC) may contribute to anal continence. The aim of this study was to assess the association between clinical and sonographic measures... (Observational Study)
Observational Study
OBJECTIVE
Pelvic floor muscle contractility (PFMC) may contribute to anal continence. The aim of this study was to assess the association between clinical and sonographic measures of PFMC and anal incontinence (AI) symptoms, after controlling for anal sphincter and levator ani muscle (LAM) trauma.
METHODS
This was a retrospective study of 1383 women assessed at a tertiary center between 2013 and 2016. All patients underwent an interview, including the St Mark's incontinence score (SMIS) in those who reported AI symptoms, a clinical examination, including assessment of PFMC using the modified Oxford scale (MOS), and four-dimensional translabial ultrasound (TLUS). Sonographic measures of PFMC, i.e. cranioventral shift of the bladder neck (BN) and reduction of anteroposterior (AP) diameter of the levator hiatus, were measured offline using ultrasound volumes obtained at rest and on maximum pelvic floor contraction. The reviewer was blinded to all clinical data.
RESULTS
Of the 1383 patients assessed during the study period, seven were excluded due to missing imaging data, leaving 1376 for analysis. Mean age of the participating women was 55 years and mean body mass index was 29 kg/m . AI was reported by 221 (16.1%) women, with a mean SMIS of 11.8. Mean MOS grade was 2.3. On TLUS, mean BN cranioventral shift was 5.9 mm and mean AP diameter reduction was 8.1 mm. LAM avulsion and significant external anal sphincter (EAS) defect were diagnosed in 24.8% and 8.7% patients, respectively. On univariate analysis, sonographic measures of PFMC were not associated with AI. Lower MOS grade was associated with symptoms of AI; however, statistical significance was lost on multivariate analysis.
CONCLUSION
Clinical and sonographic measures of PFMC were not significantly associated with AI symptoms after controlling for EAS and LAM trauma. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.
Topics: Fecal Incontinence; Female; Humans; Middle Aged; Muscle Contraction; Pelvic Floor; Retrospective Studies; Ultrasonography
PubMed: 32959435
DOI: 10.1002/uog.23128 -
Anatomical Record (Hoboken, N.J. : 2007) Apr 2017A broad pelvis is characteristic of most, if not all, pre-modern hominins. In at least some early australopithecines, most notably the female Australopithecus afarensis...
A broad pelvis is characteristic of most, if not all, pre-modern hominins. In at least some early australopithecines, most notably the female Australopithecus afarensis specimen known as "Lucy," it is very broad and coupled with very short lower limbs. In 1991, Rak suggested that Lucy's pelvic anatomy improved locomotor efficiency by increasing stride length through rotation of the wide pelvis in the axial plane. Compared to lengthening strides by increasing flexion and extension at the hips, this mechanism could avoid potentially costly excessive vertical oscillations of the body's center of mass (COM). Here, we test this hypothesis. We examined 3D kinematics of walking at various speeds in 26 adult subjects to address the following questions: Do individuals with wider pelves take longer strides, and do they use a smaller degree of hip flexion and extension? Is pelvic rotation greater in individuals with shorter legs, and those with narrower pelves? Our results support Rak's hypothesis. Subjects with wider pelves do take longer strides for a given velocity, and for a given stride length they flex and extend their hips less, suggesting a smoother pathway of the COM. Individuals with shorter legs do use more pelvic rotation when walking, but pelvic breadth was not related to pelvic rotation. These results suggest that a broad pelvis could benefit any bipedal hominin, but especially a short-legged australopithecine such as Lucy, by improving locomotor efficiency, particularly when carrying an infant or traveling in a foraging group with individuals of varying sizes. Anat Rec, 300:739-751, 2017. © 2017 Wiley Periodicals, Inc.
Topics: Biological Evolution; Biomechanical Phenomena; Female; Gait; Humans; Locomotion; Male; Pelvis; Walking
PubMed: 28297175
DOI: 10.1002/ar.23550 -
Asian Spine Journal Feb 2022This is a descriptive observational study.
STUDY DESIGN
This is a descriptive observational study.
PURPOSE
The objective of this study is to analyze and document the sagittal alignment of the spine and pelvis in normal Indian adult volunteers and compare these parameters with the study population of other races and ethnicities.
OVERVIEW OF LITERATURE
Given the importance of the spinopelvic parameters, there is a need to describe the parameters differentially in relation to the ethnicity of the studied individual. Very few reports have defined the normal physiological value. Ethnic differences are a significant factor not only when describing the anthropometric data but also when applying the findings to a different ethnic group. We have compared these values with other races and ethnicities so that we can know whether the principles of spinal fixation can be applied globally.
METHODS
In total, 100 participants were studied by using their anteroposterior and lateral radiographic images of whole of pelvic and spinal area. Additionally, various spinal and pelvic parameters were also measured. Subsequently, the outcomes were analyzed with respect to age, sex, and body mass index (BMI). The correlation between different parameters and differences in these parameters between Indians and other races/ethnicities along with population groups were also analyzed.
RESULTS
There was a significant increase in thoracic kyphosis (TK) from T1-T12 and T4-T12 with increasing age. Lumbar lordosis (LL), sacral translation (sagittal vertical axis), and pelvic tilt were significantly higher among females. Additionally, sacral slope (SS), pelvic incidence, C7 sagittal offset, and T9 sagittal offset were also higher in females. TK (T4-T12 and T1-T12), LL, SS, and pelvic incidence showed a significant correlation with BMI. As compared to European population, TK, segmental LL, and sacral translation were found to be significantly lesser in Indian population.
CONCLUSIONS
There is a statistically significant difference between Indians and other races/ethnicities and population groups with respect to TK, LL, and sacral translation. The values obtained can be considered as the physiological normal values for Indian population. Importantly, these values can serve as the reference values for future studies.
PubMed: 33957746
DOI: 10.31616/asj.2020.0301