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Sensors (Basel, Switzerland) Sep 2021Postural disorders, their prevention, and therapies are still growing modern problems. The currently used diagnostic methods are questionable due to the exposure to side...
Postural disorders, their prevention, and therapies are still growing modern problems. The currently used diagnostic methods are questionable due to the exposure to side effects (radiological methods) as well as being time-consuming and subjective (manual methods). Although the computer-aided diagnosis of posture disorders is well developed, there is still the need to improve existing solutions, search for new measurement methods, and create new algorithms for data processing. Based on point clouds from a Time-of-Flight camera, the presented method allows a non-contact, real-time detection of anatomical landmarks on the subject's back and, thus, an objective determination of trunk surface metrics. Based on a comparison of the obtained results with the evaluation of three independent experts, the accuracy of the obtained results was confirmed. The average distance between the expert indications and method results for all landmarks was 27.73 mm. A direct comparison showed that the compared differences were statically significantly different; however, the effect was negligible. Compared with other automatic anatomical landmark detection methods, ours has a similar accuracy with the possibility of real-time analysis. The advantages of the presented method are non-invasiveness, non-contact, and the possibility of continuous observation, also during exercise. The proposed solution is another step in the general trend of objectivization in physiotherapeutic diagnostics.
Topics: Algorithms; Back; Biomechanical Phenomena; Models, Anatomic; Posture
PubMed: 34640745
DOI: 10.3390/s21196425 -
International Journal of Environmental... Jul 2023Surgeons are highly exposed to work-related musculoskeletal disorders (WMSDs). The objective of this review was to summarize the WMSD prevalence by body area with and... (Meta-Analysis)
Meta-Analysis Review
Surgeons are highly exposed to work-related musculoskeletal disorders (WMSDs). The objective of this review was to summarize the WMSD prevalence by body area with and without assistive devices. The underlying question was whether there is an effect of assistive device use (robot, video, or other) during surgery on WMSD prevalence by body area among surgeons, regardless of their specialty. The systematic review was conducted according to the PRISMA guidelines. The Google Scholar, Pubmed/Medline, and ScienceDirect databases were scanned to identify relevant studies. The article selection, review, critical appraisal, and data extraction were performed by two authors independently. Among the 34,854 unique identified records, 77 studies were included. They were divided into two groups: 35 focused on robotic- and video-assisted surgery (RVAS) and 48 concerning surgery without video/robotic assistance (WAS) (6 studies evaluated the prevalence for both groups). WMSD prevalence was reported for 13 body areas: the neck, back, upper back, mid-back, lower back, shoulders, elbows, wrists, fingers, thumbs, hips, knees, and ankles. The results showed that WMSD prevalence was significantly higher (unpaired -test, < 0.05) for RVAS in the shoulders (WAS: 28.3% vs. RVAS: 41.9%), wrists (WAS: 20.9% vs. RVAS: 31.5%), and thumbs (WAS: 9.9% vs. RVAS: 21.8%). A meta-analysis was performed for 10 body areas (with 4 areas including more than 25 studies). No sufficient data were available for the mid-back, thumbs, or hips. A high heterogeneity (Cochran's Q test and I statistic) was observed. A random-effects model revealed that the highest worldwide prevalence was in the neck (WAS: 41% and RVAS: 45.3%), back (WAS: 37.7% and RVAS: 49.9%), lower back (WAS: 40.0% and RVAS: 37.8%), and shoulders (WAS: 27.3% and RVAS: 41.4%). Future work could focus on work environment design, particularly the positioning and adjustment of equipment, and on postural analysis to reduce the appearance of WMSDs. Recommendations are proposed for future reviews and meta-analyses.
Topics: Humans; Prevalence; Occupational Diseases; Musculoskeletal Diseases; Back; Surgeons; Risk Factors
PubMed: 37510651
DOI: 10.3390/ijerph20146419 -
Dermatology Online Journal Mar 2020A widespread form of eruptive collagenomas in a 12-year-old man is presented for the impressive iconography, challenging differential diagnosis, and histopathological...
A widespread form of eruptive collagenomas in a 12-year-old man is presented for the impressive iconography, challenging differential diagnosis, and histopathological considerations associated with such rare connective tissue disorders. Syndromic forms should be carefully investigated for the different course and prognosis. Treatment is a major unsolved issue as aesthetic concerns are significant, especially in young adults.
Topics: Back; Biopsy; Coloring Agents; Connective Tissue Diseases; Dermis; Fibroblasts; Humans; Male; Nevus; Skin Neoplasms; Young Adult
PubMed: 32609447
DOI: No ID Found -
International Journal of Environmental... Oct 2022Neck pain and lower back pain are commonly reported by military pilots. That is why the answers to the following questions are important: (1) which part of the back... (Meta-Analysis)
Meta-Analysis Review
Neck pain and lower back pain are commonly reported by military pilots. That is why the answers to the following questions are important: (1) which part of the back (neck or lumbar spine) is more likely to be painful in military pilots as a result of high G-force, and (2) what intervention methods do pilots use as countermeasures for back pain resulting from high G-force? To answer these questions, the literature was searched in the following online databases: MEDLINE, PubMed, and Embase. A meta-analysis of eleven studies on pain in the neck-spine in fighter pilots vs. transport pilots showed pooled pulled OR = 1.69 (95% CI 1.25 to 2.29, I = 32%, -value = 0.21); this outcome is consistent with most of the published results. A meta-analysis of five studies on pain in the lumbar spine (lower back) did not show a difference between fighter pilots vs. transport pilots with OR = 1 (95% CI 0.83 to 1.19, I = 0%, -value = 0.96). The meta-analysis showed that of the two spinal segments evaluated, it was the cervical spine that showed more soreness in tactical fighter pilots. Prevention of lumbar and neck injuries should be combined with individual lumbar and neck support, as well as increasing back muscle strength through training.
Topics: Humans; Military Personnel; Occupational Diseases; Lumbosacral Region; Lumbar Vertebrae; Neck Pain
PubMed: 36293993
DOI: 10.3390/ijerph192013413 -
Pain Physician Sep 2021Percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) has been increasingly used to treat degenerative lumbar disease in recent years. However, there... (Comparative Study)
Comparative Study Meta-Analysis
Comparison of Clinical Outcomes and Complications Between Percutaneous Endoscopic and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Degenerative Lumbar Disease: A Systematic Review and Meta-Analysis.
BACKGROUND
Percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) has been increasingly used to treat degenerative lumbar disease in recent years. However, there are still controversies about whether PE-TLIF is superior to minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).
OBJECTIVES
To compare clinical outcomes and complications of PE-TLIF and MIS-TLIF in treating degenerative lumbar disease.
STUDY DESIGN
A systematic review and meta-analysis.
METHODS
A comprehensive search of online databases including PubMed, Embase, and the Cochrane Library was performed to identify related studies reporting the outcomes and complications of PE-TLIF and MIS-TLIF for degenerative lumbar disease. The clinical outcomes were assessed by the Visual Analog Scale and Oswestry Disability Index. In addition, the operative time, intraoperative blood loss, time to ambulation, length of hospital stay, fusion rate, and surgery-related complications were summarized. Forest plots were constructed to investigate the results.
RESULTS
A total of 28 studies involving 1,475 patients were included in this meta-analysis. PE-TLIF significantly reduced operative time, intraoperative blood loss, time to ambulation, and length of hospital stay compared to MIS-TLIF. Moreover, PE-TLIF was superior to MIS-TLIF in the early postoperative relief of back pain. However, there were no significant differences in medium to long-term clinical outcomes, fusion rate, and incidence of complications between PE-TLIF and MIS-TLIF.
LIMITATIONS
The current evidence is heterogeneous and most studies included in this meta-analysis are nonrandomized controlled trials.
CONCLUSIONS
The present meta-analysis indicates that medium to long-term clinical outcomes and complication rates of PE-TLIF were similar to MIS-TLIF for the treatment of degenerative lumbar disease. However, PE-TLIF shows advantages in less surgical trauma, faster recovery, and early postoperative relief of back pain.
Topics: Endoscopy; Humans; Lumbar Vertebrae; Lumbosacral Region; Minimally Invasive Surgical Procedures; Spinal Fusion
PubMed: 34554684
DOI: No ID Found -
BMJ (Clinical Research Ed.) Jan 2024To summarize the breadth and quality of evidence supporting commonly recommended early childhood autism interventions and their estimated effects on developmental...
OBJECTIVE
To summarize the breadth and quality of evidence supporting commonly recommended early childhood autism interventions and their estimated effects on developmental outcomes.
DESIGN
Updated systematic review and meta-analysis (autism intervention meta-analysis; Project AIM).
DATA SOURCES
A search was conducted in November 2021 (updating a search done in November 2017) of the following databases and registers: Academic Search Complete, CINAHL Plus with full text, Education Source, Educational Administration Abstracts, ERIC, Medline, ProQuest Dissertations and Theses, PsycINFO, Psychology and Behavioral Sciences Collection, and SocINDEX with full text, , and ClinicalTrials.gov.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Any controlled group study testing the effects of any non-pharmacological intervention on any outcome in young autistic children younger than 8 years.
REVIEW METHODS
Newly identified studies were integrated into the previous dataset and were coded for participant, intervention, and outcome characteristics. Interventions were categorized by type of approach (such as behavioral, developmental, naturalistic developmental behavioral intervention, and technology based), and outcomes were categorized by domain (such as social communication, adaptive behavior, play, and language). Risks of bias were evaluated following guidance from Cochrane. Effects were estimated for all intervention and outcome types with sufficient contributing data, stratified by risk of bias, using robust variance estimation to account for intercorrelation of effects within studies and subgroups.
RESULTS
The search yielded 289 reports of 252 studies, representing 13 304 participants and effects for 3291 outcomes. When contributing effects were restricted to those from randomized controlled trials, significant summary effects were estimated for behavioral interventions on social emotional or challenging behavior outcomes (Hedges’ g=0.58, 95% confidence interval 0.11 to 1.06; P=0.02), developmental interventions on social communication (0.28, 0.12 to 0.44; P=0.003); naturalistic developmental behavioral interventions on adaptive behavior (0.23, 0.02 to 0.43; P=0.03), language (0.16, 0.01 to 0.31; P=0.04), play (0.19, 0.02 to 0.36; P=0.03), social communication (0.35, 0.23 to 0.47; P<0.001), and measures of diagnostic characteristics of autism (0.38, 0.17 to 0.59; P=0.002); and technology based interventions on social communication (0.33, 0.02 to 0.64; P=0.04) and social emotional or challenging behavior outcomes (0.57, 0.04 to 1.09; P=0.04). When effects were further restricted to exclude caregiver or teacher report outcomes, significant effects were estimated only for developmental interventions on social communication (0.31, 0.13 to 0.49; P=0.003) and naturalistic developmental behavioral interventions on social communication (0.36, 0.23 to 0.49; P<0.001) and measures of diagnostic characteristics of autism (0.44, 0.20 to 0.68; P=0.002). When effects were then restricted to exclude those at high risk of detection bias, only one significant summary effect was estimated—naturalistic developmental behavioral interventions on measures of diagnostic characteristics of autism (0.30, 0.03 to 0.57; P=0.03). Adverse events were poorly monitored, but possibly common.
CONCLUSION
The available evidence on interventions to support young autistic children has approximately doubled in four years. Some evidence from randomized controlled trials shows that behavioral interventions improve caregiver perception of challenging behavior and child social emotional functioning, and that technology based interventions support proximal improvements in specific social communication and social emotional skills. Evidence also shows that developmental interventions improve social communication in interactions with caregivers, and naturalistic developmental behavioral interventions improve core challenges associated with autism, particularly difficulties with social communication. However, potential benefits of these interventions cannot be weighed against the potential for adverse effects owing to inadequate monitoring and reporting.
Topics: Humans; Back
PubMed: 38216220
DOI: 10.1136/bmj-2023-076773 -
Turkish Journal of Medical Sciences Feb 2022The aim of this cadaveric study was to investigate the erector spinae plane block (ESPB) in lumbar region and to elucidate the possible mechanisms of action of these...
BACKGROUND
The aim of this cadaveric study was to investigate the erector spinae plane block (ESPB) in lumbar region and to elucidate the possible mechanisms of action of these injections in lumbar radicular pain by means of detecting expected dye dispersion to the neural structures.
METHODS
Ultrasound-guided lumbar ESPB was performed in three formaldehyde-embalmed human cadavers. For this purpose, a 10 mL of methylene blue was injected into the fascial space between the L4 transverse process and the erector spinae muscles. T hen, the cadavers were dissected, the cephalocaudal and lateral spread of the dye was examined, and the involvement of the dorsal rami, dorsal root ganglia and ventral rami were analyzed. The distribution into the epidural space was also evaluated.
RESULTS
The involvement of the dorsal rami was found to extend up to the T12 level and down to the L5 spinal nerves. Although dye dispersion was detected on the dorsal root ganglion in all specimens, it was found to be limited to one or two levels, unlike the dorsal rami. In half of the specimens, distribution to the ventral ramus and posterior epidural space was observed.
Topics: Humans; Animals; Female; Nerve Block; Lumbosacral Region; Chickens; Thoracic Vertebrae; Cadaver
PubMed: 34773689
DOI: 10.3906/sag-2107-83 -
African Journal of Paediatric Surgery :... 2021There are some common genetic heritages between human and mammals. Human tail, though rare is one of the most noticeable. Till the date, around 60 cases reported in the...
There are some common genetic heritages between human and mammals. Human tail, though rare is one of the most noticeable. Till the date, around 60 cases reported in the literature. A true human tail is a benign vestigial caudal cutaneous structure composed of adipose, connective tissue, muscle, vessels and nerves. A true human tail can be distinguished from a pseudotail as the latter is commonly associated with underlying spinal dysraphism, which requires specialised management. We report a case series of four caudal appendages. Two clients were infants, while others two were toddler and presented with cutaneous appendage arising from the lumbosacral region. Out of four, only one had associated spinal dysraphism and neurological manifestation while others did not have spinal dysraphism and neurological manifestation. The appendage was removed by the surgical excision. Clinicians should emphasise the use of 'true tail' and 'pseudo-tail' as the specific disparate terms as the clinical, radiological and histological findings of these conditions differs significantly, along with the management strategies and outcomes.
Topics: Female; Humans; Infant; Neurosurgical Procedures; Sacrococcygeal Region; Spinal Dysraphism
PubMed: 33595541
DOI: 10.4103/ajps.AJPS_48_20 -
Scientific Reports Oct 2020Vibrotactile displays worn on the back can be used as sensory substitution device. Often vibrotactile stimulation is chosen because vibration motors are easy to...
Vibrotactile displays worn on the back can be used as sensory substitution device. Often vibrotactile stimulation is chosen because vibration motors are easy to incorporate and relatively cheap. When designing such displays knowledge about vibrotactile perception on the back is crucial. In the current study we investigated distance perception. Biases in distance perception can explain spatial distortions that occur when, for instance, tracing a shape using vibration. We investigated the effect of orientation (horizontal vs vertical), the effect of positioning with respect to the spine and the effect of switching vibration motors on sequentially versus simultaneously. Our study includes four conditions. The condition which had a horizontal orientation with both vibration motors switching on sequentially on the same side of the spine was chosen is the baseline condition. The other three conditions were compared to this baseline condition. We found that distances felt longer in the vertical direction than in the horizontal direction. Furthermore, distances were perceived to be longer when vibration motors were distributed on both sides of the spine compared to when they were on the same side. Finally, distances felt shorter when vibration motors were switched on simultaneously compared to sequentially. In the simultaneous case a distance of 4 cm was not clearly perceived differently than a distance of 12 cm. When designing vibrotactile displays these anisotropies in perceived distance need to be taken into account because otherwise the intended shape will not match the perceived shape. Also, dynamically presented distances are more clearly perceived than static distances. This finding supports recommendations made in previous studies that dynamic patterns are easier to perceive than static patterns.
Topics: Adult; Anisotropy; Back; Discrimination, Psychological; Female; Humans; Male; Physical Stimulation; Space Perception; Spine; Touch; Touch Perception; Vibration; Young Adult
PubMed: 33087741
DOI: 10.1038/s41598-020-74835-x -
Sensors (Basel, Switzerland) Feb 2023The purpose of this study was to develop peak ground reaction force (pGRF) and peak loading rate (pLR) prediction equations for high-impact activities in adult subjects...
The purpose of this study was to develop peak ground reaction force (pGRF) and peak loading rate (pLR) prediction equations for high-impact activities in adult subjects with a broad range of body masses, from normal weight to severe obesity. A total of 78 participants (27 males; 82.4 ± 20.6 kg) completed a series of trials involving jumps of different types and heights on force plates while wearing accelerometers at the ankle, lower back, and hip. Regression equations were developed to predict pGRF and pLR from accelerometry data. Leave-one-out cross-validation was used to calculate prediction accuracy and Bland-Altman plots. Body mass was a predictor in all models, along with peak acceleration in the pGRF models and peak acceleration rate in the pLR models. The equations to predict pGRF had a coefficient of determination (R) of at least 0.83, and a mean absolute percentage error (MAPE) below 14.5%, while the R for the pLR prediction equations was at least 0.87 and the highest MAPE was 24.7%. Jumping pGRF can be accurately predicted through accelerometry data, enabling the continuous assessment of mechanical loading in clinical settings. The pLR prediction equations yielded a lower accuracy when compared to the pGRF equations.
Topics: Adult; Male; Humans; Acceleration; Accelerometry; Ankle Joint; Back; Research Design
PubMed: 36850844
DOI: 10.3390/s23042246