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Journal of Women's Health &... Jun 2002A general perception that women and men walk differently has yet to be supported by quantitative walking (gait) studies, which have found more similarities than... (Comparative Study)
Comparative Study
OBJECTIVES
A general perception that women and men walk differently has yet to be supported by quantitative walking (gait) studies, which have found more similarities than differences. Never previously examined, however, are pelvic and center of mass (COM) motions. We hypothesize the presence of gender differences in both pelvic obliquity (motion of the pelvis in the coronal plane) and vertical COM displacement. Quantifiable differences may have clinical as well as biomechanical importance.
METHODS
We tested 120 subjects separated into four groups by age and gender. Pelvic motions and COM displacements were recorded using a 3-D motion analysis system and averaged over three walking trials at comfortable walking speed. Data were plotted, and temporal values, pelvic angle ranges, and COM displacements normalized for leg length were quantitatively compared among groups.
RESULTS
Comparing all women to all men, women exhibited significantly more pelvic obliquity range (mean ISD): 9.4 +/- 3.5 degrees for women and 7.4 +/- 3.4 degrees for men (p = 0.0024), and less vertical COM displacement: 3.7 +/- 0.8% of leg length for women and 3.3 +/- 0.9% for men (p = 0.0056).
CONCLUSIONS
Stereotypically based gender differences were documented with greater pelvic obliquity and less vertical COM displacement in women compared with men. It is unclear if these differences are the intrinsic result of gender vs. social or cultural effects. It is possible that women use greater pelvic motion in the coronal plane to reduce their vertical COM displacement and, thus, conserve energy during walking. An increase in pelvic obliquity motion may be advantageous from an energy standpoint, but it is also associated with increased lumbosacral motion, which may be maladaptive with respect to the etiology and progression of low back pain.
Topics: Adult; Age Factors; Aged; Biomechanical Phenomena; Female; Gait; Hip Joint; Humans; Middle Aged; Pelvis; Probability; Prospective Studies; Range of Motion, Articular; Rotation; Sensitivity and Specificity; Sex Factors; Walking
PubMed: 12165162
DOI: 10.1089/15246090260137626 -
Journal of Gastrointestinal Surgery :... Oct 2018Retrorectal cysts make up a small but challenging group of pelvic masses, especially if they extend high into the pelvis. We present a case of successful robotic removal...
BACKGROUND
Retrorectal cysts make up a small but challenging group of pelvic masses, especially if they extend high into the pelvis. We present a case of successful robotic removal of a large retrorectal cyst.
METHODS
Video presentation of a robotic excision of a retrorectal mass.
RESULTS
We present a case of robotic removal of a large retrorectal mass extending up to the S3 vertebra.
DISCUSSION
Robotic approach is a very useful tool for successful removal of large pelvic masses that cannot be removed by traditional posterior or trans perineal approach.
Topics: Adult; Cysts; Female; Humans; Pelvis; Rectum; Robotic Surgical Procedures
PubMed: 29907936
DOI: 10.1007/s11605-018-3838-2 -
The Journal of Reproductive Medicine May 1989The presence of pelvic adhesions is implicated as a significant cause of pelvic pain, bowel obstruction and infertility in women. Laparoscopy has become an invaluable...
The presence of pelvic adhesions is implicated as a significant cause of pelvic pain, bowel obstruction and infertility in women. Laparoscopy has become an invaluable method for the evaluation and treatment of such adhesions. A prospective study was designed to correlate specific findings in the preoperative history and physical examination with the presence of adhesions seen at laparoscopy. Two hundred seventy-three consecutive patients undergoing laparoscopy were analyzed; pelvic adhesions were found in 99 (36.3%). At the time of laparoscopy the only historical predictor found to be associated with adhesive disease was previous pelvic surgery. Physical examination predictors associated with the presence of adhesions were uterine immobility, a right adnexal mass and right adnexal tenderness.
Topics: Female; Humans; Infertility, Female; Intestinal Obstruction; Laparoscopy; Pain; Pelvic Inflammatory Disease; Pelvis; Postoperative Complications; Probability; Risk Factors; Tissue Adhesions
PubMed: 2525188
DOI: No ID Found -
BioMed Research International 2020To correlate body weight, body mass index (BMI), and water-equivalent diameter ( ) and to assess size-specific dose estimates (SSDEs) based on body weight and BMI for...
BACKGROUND
To correlate body weight, body mass index (BMI), and water-equivalent diameter ( ) and to assess size-specific dose estimates (SSDEs) based on body weight and BMI for chest and abdomen-pelvic CT examinations.
METHODS
An in-house program was used to calculate , size-dependent conversion factor (), and SSDE for 1178 consecutive patients undergoing chest and abdomen-pelvic CT examinations. Associations among body weight, BMI, and were determined, and linear equations were generated using linear regression analysis of the first 50% of the patient population. SSDEs (SSDE and SSDE) were calculated based on body weight and BMI as surrogates on the second 50% of the patient population. Mean root-mean-square errors of SSDE and SSDE were computed with SSDE from the axial images as reference values.
RESULTS
Both body weight and BMI correlated strongly with for the chest ( = 0.85, 0.87, all < 0.001) and abdomen-pelvis ( = 0.85, 0.86, all < 0.001). Mean values of SSDE and SSDE based on the linear equations for body weight, BMI, and were in close agreement with SSDE from the axial images, with overall mean root-mean-square errors of 0.62 mGy (6.10%) and 0.57 mGy (5.65%), for chest, and 0.76 mGy (5.61%) and 0.71 mGy (5.22%), for abdomen-pelvis, respectively.
CONCLUSIONS
Both body weight and BMI, serving as surrogates, can be used to calculate SSDEs in the chest and abdomen-pelvis CT examinations, providing values comparable to SSDEs from the axial images, with an overall mean root-mean-square error of less than 0.76 mGy or 6.10%.
Topics: Abdomen; Body Mass Index; Body Size; Body Weight; Dose-Response Relationship, Radiation; Female; Humans; Male; Middle Aged; Pelvis; Radiation; Thorax; Tomography, X-Ray Computed
PubMed: 32733946
DOI: 10.1155/2020/6046501 -
The American Journal of Emergency... Nov 2000
Topics: Abdominal Pain; Child; Child Abuse, Sexual; Diagnosis, Differential; Female; Humans; Kidney; Pelvis; Tomography, X-Ray Computed
PubMed: 11103741
DOI: 10.1053/ajem.2000.16310 -
Seminars in Ultrasound, CT, and MR Oct 2008Acute pelvic pain in the female patient can have myriad presentations and, depending on the diagnosis, profound consequences. In the pregnant patient with pelvic pain or... (Review)
Review
Acute pelvic pain in the female patient can have myriad presentations and, depending on the diagnosis, profound consequences. In the pregnant patient with pelvic pain or bleeding, an ectopic pregnancy must be first excluded. Ultrasound is important in determining the size and location of the ectopic pregnancy, and presence of bleeding, which in turn helps guide treatment decisions. Subchorionic or subplacental bleeds in an intrauterine pregnancy may also present with vaginal bleeding with consequences dependent on gestational age and size of bleed. In the postpartum female suspected to have retained products of conception, sonographic findings may vary from a thickened endometrial stripe to an echogenic mass with associated marked vascularity, often mimicking an arterial-venous malformation. In the nonpregnant patient, early diagnosis and treatment of ovarian torsion can preserve ovarian function. Other causes of peritoneal irritation may also cause acute pelvic pain including a ruptured hemorrhagic cyst or ruptured endometrioma. When pelvic inflammatory disease is suspected, imaging is used to evaluate for serious associated complications including the presence of a tuboovarian abscess or peritonitis. While leiomyomas of the uterus are largely asymptomatic, a leiomyoma that undergoes necrosis, torsion or prolapse through the cervix may be associated with acute severe pain or bleeding. The imaging features of these and other important clinical entities in the female pelvis will be presented.
Topics: Diagnosis, Differential; Emergencies; Female; Genital Diseases, Female; Humans; Pelvic Pain; Pelvis; Pregnancy; Pregnancy Complications; Ultrasonography
PubMed: 18853841
DOI: 10.1053/j.sult.2008.06.006 -
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 -
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 -
Journal of Orthopaedic Surgery and... Nov 2023Unintended pelvic positional change is an acknowledged intra-operative problem for hip arthroplasty, seen commonly with procedures performed in the lateral position. If...
BACKGROUND
Unintended pelvic positional change is an acknowledged intra-operative problem for hip arthroplasty, seen commonly with procedures performed in the lateral position. If unrecognised, such changes can dramatically alter final acetabular component anteversion potentially resulting in suboptimal construct performance. It has previously been suggested that pelvic roll of just 13° may be enough to place an otherwise perfectly orientated cup outside of conventional ± 10° safe zones. Using the real-time tracking capacity of a commercially available optical navigation system, we aimed to accurately quantify pelvic roll occurring during total hip arthroplasties (THAs) performed in the decubitus position.
METHODS
Prospectively collected data for 107 consecutive, unilateral, THAs were interrogated to determine the magnitude of pelvic movement around a central longitudinal axis (i.e. AP roll). Correlation statistics with patient age and body mass index (BMI) were also calculated.
RESULTS
A mean pelvic roll of 9.5° was observed, being anterior in 96% of cases. Of these, 18.3% of hips had a magnitude of roll greater than 13°. There were no statistically significant independent correlations observed between age (p = 0.87) or BMI (p = 0.59) and mean roll.
CONCLUSIONS
Errors in achieving acetabular target version may result in numerous post-operative concerns including instability/dislocation, bearing wear, squeaking, range-of-movement limitation and increased revision rate. In a general cohort, our findings suggest a mean anterior pelvic roll during THA of nearly 10°. Without purposeful correction, this may cause substantial deviation from intended target positions. Future work is indicated to map changing pelvic roll during THA which is likely to follow a nonlinear trajectory. Level of evidence: IV. .
Topics: Humans; Arthroplasty, Replacement, Hip; Hip Prosthesis; Acetabulum; Pelvis; Hip Dislocation
PubMed: 37957756
DOI: 10.1186/s13018-023-04350-y -
IEEE Transactions on Neural Systems and... Sep 2017Pelvic movement is important to human locomotion as the center of mass is located near the center of pelvis. Lateral pelvic motion plays a crucial role to shift the...
Pelvic movement is important to human locomotion as the center of mass is located near the center of pelvis. Lateral pelvic motion plays a crucial role to shift the center of mass on the stance leg, while swinging the other leg and keeping the body balanced. In addition, vertical pelvic movement helps to reduce metabolic energy expenditure by exchanging potential and kinetic energy during the gait cycle. However, patient groups with cerebral palsy or stroke have excessive pelvic motion that leads to high energy expenditure. In addition, they have higher chances of falls as the center ofmass could deviate outside the base of support. In this paper, a novel control method is suggested using tethered pelvic assist device (TPAD) to teach subjects to walk with a specified target pelvic trajectory while walking on a treadmill. In this method, a force field is applied to the pelvis to guide it to move on a target trajectory and correctional forces are applied, if the pelvis motion has excessive deviations from the target trajectory. Three different experimentswith healthy subjects were conducted to teach them to walk on a new target pelvic trajectory with the presented control method. For all three experiments, the baseline trajectory of the pelvis was experimentally determined for each participating subject. To design a target pelvic trajectory which is different from the baseline, Experiment I scaled up the lateral component of the baseline pelvic trajectory, while Experiment II scaled down the lateral component of the baseline trajectory. For both Experiments I and II, the controller generated a 2-D force field in the transverse plane to provide the guidance force. In this paper, seven subjects were recruited for each experiment who walked on the treadmill with suggested control methods and visual feedback of their pelvic trajectory. The results show that the subjects were able to learn the target pelvic trajectory in each experiment and also retained the training effects after the completion of the experiment. In Experiment III, both lateral and vertical components of the pelvic trajectory were scaled down from the baseline trajectory. The force field was extended to three dimensions in order to correct the vertical pelvic movement as well. Three subgroups (force feedback alone, visual feedback alone, and both force and visual feedback) were recruited to understand the effects of force feedback and visual feedback alone to distinguish the results from Experiments I and II. The results showthat a trainingmethod that combines visual and force feedback is superior to the training methods with visual or force feedback alone. We believe that the present control strategy holds potential in training and correcting abnormal pelvic movements in different patient populations.
Topics: Adaptation, Physiological; Adult; Equipment Design; Equipment Failure Analysis; Exoskeleton Device; Female; Gait; Humans; Male; Pelvis; Physical Stimulation; Reproducibility of Results; Robotics; Sensitivity and Specificity; Stress, Mechanical; Walking; Young Adult
PubMed: 28287978
DOI: 10.1109/TNSRE.2017.2679607