Search results for: phantom limb
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 369

Search results for: phantom limb

369 Phantom Phenomena in Subjects after Limb Amutation Who Regularly Practice High Intensity Sports

Authors: Jolanta Uszko, Tomasz Wloch, Aneta Pirowska, Roman Nowobilski

Abstract:

Introduction: Phantom phenomena are often reported by subjects who have undergone limb amputation. Mostly, patients feel the amputated part of the limb as if it was still attached to the body. Two types of phantom phenomena: painless (phantom sensation) and painful (phantom pain) were described. Triggers of phantom sensations and phantom pain, as well as fully effective treatment, have not been clearly described yet. Purpose: To assess the influence of psychosocial factors and some clinical conditions on the occurrence of phantom phenomena in amputee athletes. Subjects: 21 men (age: 31 years, SD = 7.5 years) after lower or upper extremity amputation, who regularly performed high-intensity sports (Amp Football Team Players) were included to the study. Method and equipment: In the research, the following method and tools were used: Questionnaire [Pirowska] adapted for athletes with disabilities, Numerical Rating Scale (NRS) - for phantom pain assessment, McGill Pain Assessment Questionnaire (short version), Beck's Depression Inventory (BDI), State Trait Anxiety Inventory (STAI): X-1 and X-2, shortened version of The World Health Organization Quality of Life (WHOQOLBREFF). Results: In the study group, the lower leg amputations with traumatic etiology were predominant. Phantom sensations were present in all subjects. Half of the respondents claimed to experience phantom sensations at least once a day, paroxysmally. There was a prevalence of phantom sensations characterized as incomplete, immobile limb. Phantom pain was reported by over 85% of respondents. The nature of phantom pain was frequently described as stabbing, squeezing, shooting, pulsing, tiring. There was a significant correlation between phantom pain intensity and anxiety, quality of life, depressive tendencies, perception of phantom pain as the obstacle in daily functioning and intensity of the limb pain before amputation. Conclusions: The etiology of phantom phenomena is complex. Psychological factors seem to have a significant influence on the intensity of the phantom pain. Particular attention should be paid to patients who complain about persistent limb pain before the amputation. These are patients with an increased risk of the phantom pain of relatively high intensity.

Keywords: amputation, phantom pain, phantom sensations, adaptive sports

Procedia PDF Downloads 129
368 Simulation Of A Renal Phantom Using the MAG 3

Authors: Ati Moncef

Abstract:

We describe in this paper the results of a phantom of dynamics renal with MAG3. Our phantom consisted of (tow shaped of kidneys, 1 liver). These phantoms were scanned with static and dynamic protocols and compared with clinical data. in a normal conditions we use our phantoms it's possible to acquire a renal images when we can be compared with clinical scintigraphy. In conclusion, Renal phantom also can use in the quality control of a renal scintigraphy.

Keywords: Renal scintigraphy, MAG3, Nuclear medicine, Gamma Camera.

Procedia PDF Downloads 375
367 3D Printed Multi-Modal Phantom Using Computed Tomography and 3D X-Ray Images

Authors: Sung-Suk Oh, Bong-Keun Kang, Sang-Wook Park, Hui-Jin Joo, Jong-Ryul Choi, Seong-Jun Lee, Jeong-Woo Sohn

Abstract:

The imaging phantom is utilized for the verification, evaluation and tuning of the medical imaging device and system. Although it could be costly, 3D printing is an ideal technique for a rapid, customized, multi-modal phantom making. In this article, we propose the multi-modal phantom using 3D printing. First of all, the Dicom images for were measured by CT (Computed Tomography) and 3D X-ray systems (PET/CT and Angio X-ray system of Siemens) and then were analyzed. Finally, the 3D modeling was processed using Dicom images. The 3D printed phantom was scanned by PET/CT and MRI systems and then evaluated.

Keywords: imaging phantom, MRI (Magnetic Resonance Imaging), PET / CT (Positron Emission Tomography / Computed Tomography), 3D printing

Procedia PDF Downloads 549
366 Durable Phantom Production Identical to Breast Tissue for Use in Breast Cancer Detection Research Studies

Authors: Hayrettin Eroglu, Adem Kara

Abstract:

Recently there has been significant attention given to imaging of the biological tissues via microwave imaging techniques. In this study, a phantom for the test and calibration of Microwave imaging used in detecting unhealthy breast structure or tumors was produced by using sol gel method. The liquid and gel phantoms being used nowadays are not durable due to evaporation and their organic ingredients, hence a new design was proposed. This phantom was fabricated from materials that were widely available (water, salt, gelatin, and glycerol) and was easy to make. This phantom was aimed to be better from the ones already proposed in the literature in terms of its durability and stability. S Parameters of phantom was measured with 1-18 GHz Probe Kit and permittivity was calculated via Debye method in “85070” commercial software. One, three, and five-week measurements were taken for this phantom. Finally, it was verified that measurement results were very close to the real biological tissue measurement results.

Keywords: phantom, breast tissue, cancer, microwave imaging

Procedia PDF Downloads 326
365 The Biopsychosocial Effects of Amputation on Transtibial Amputees in Kwazulu-Natal

Authors: Riyona Chetty, Raisuyah Bhagwan, Nalini Govender

Abstract:

Background: A myriad of physical, psychosocial, and environmental sequelae are associated with limb loss. However, there is a paucity of empirical South African data, which focuses on these sequelae, how they interface with the amputee’s quality of life as well as the challenges they experience following amputation. Objective: This study sought to explore the biopsychosocial effects of amputation and how amputation affected the quality of life of transtibial amputees. Setting: Participants were recruited from a medical facility, under the KwaZulu-Natal Department of Health in South Africa. Methods: A qualitative approach guided this study. Data was collected using one-on-one interviews with 14 unilateral transtibial amputees. Data was analysed thematically. Results: Five broad themes emerged from the inquiry, which captured amputees’ experiences of phantom limb pain, body image disturbances, and their challenges related to adapting to daily activities. Participants also expressed the salience of familial support as well as the importance of psychological interventions to cope. Conclusion: The findings suggested that support networks and professional psychological intervention are imperative in facilitating successful adjustment to the amputation experience. Raising awareness of limb loss in both, rural and urban settings may help reduce the stigma attached to it. Contribution: Quality of life comprises several domains, namely physical, psychological, environmental, and social albeit limited local and international data exists regarding the environmental and social effects. This study brought to the fore the positive and negative effects of amputation in each domain, as well as various strategies that facilitate successful adjustment to amputation.

Keywords: amputation, quality of life, biopsychosocial, phantom limb pain, body image, support

Procedia PDF Downloads 24
364 Reproducibility of Dopamine Transporter Density Measured with I-123-N-ω-Fluoropropyl-2β-Carbomethoxy-3β-(4-Iodophenyl)Nortropane SPECT in Phantom Studies and Parkinson’s Disease Patients

Authors: Yasuyuki Takahashi, Genta Hoshi, Kyoko Saito

Abstract:

Objectives: The objective of this study was to evaluate the reproducibility of I-123-N-ω-fluoropropyl-2β-carbomethoxy-3β-(4- iodophenyl) nortropane (I-123 FP-CIT) SPECT by using specific binding ratio (SBR) in phantom studies and Parkinson’s Disease (PD) patients. Methods: We made striatum phantom originally and confirmed reproducibility. The phantom studies changed head position and accumulation of FP-CIT, each. And image processing confirms influence on SBR by 30 cases. 30 PD received a SPECT for 3 hours post injection of I-123 FP-CIT 167MBq. Results: SBR decreased in rotatory direction by the patient position by the phantom studies. And, SBR improved the influence after the attenuation and the scatter correction in the cases (y=0.99x+0.57 r2=0.83). However, Stage II recognized dispersion in SBR by low accumulation. Conclusion: Than the phantom studies that assumed the normal cases, the SPECT image after the attenuation and scatter correction had better reproducibility.

Keywords: 123I-FP-CIT, specific binding ratio, Parkinson’s disease

Procedia PDF Downloads 401
363 Estimation of Normalized Glandular Doses Using a Three-Layer Mammographic Phantom

Authors: Kuan-Jen Lai, Fang-Yi Lin, Shang-Rong Huang, Yun-Zheng Zeng, Po-Chieh Hsu, Jay Wu

Abstract:

The normalized glandular dose (DgN) estimates the energy deposition of mammography in clinical practice. The Monte Carlo simulations frequently use uniformly mixed phantom for calculating the conversion factor. However, breast tissues are not uniformly distributed, leading to errors of conversion factor estimation. This study constructed a three-layer phantom to estimated more accurate of normalized glandular dose. In this study, MCNP code (Monte Carlo N-Particles code) was used to create the geometric structure. We simulated three types of target/filter combinations (Mo/Mo, Mo/Rh, Rh/Rh), six voltages (25 ~ 35 kVp), six HVL parameters and nine breast phantom thicknesses (2 ~ 10 cm) for the three-layer mammographic phantom. The conversion factor for 25%, 50% and 75% glandularity was calculated. The error of conversion factors compared with the results of the American College of Radiology (ACR) was within 6%. For Rh/Rh, the difference was within 9%. The difference between the 50% average glandularity and the uniform phantom was 7.1% ~ -6.7% for the Mo/Mo combination, voltage of 27 kVp, half value layer of 0.34 mmAl, and breast thickness of 4 cm. According to the simulation results, the regression analysis found that the three-layer mammographic phantom at 0% ~ 100% glandularity can be used to accurately calculate the conversion factors. The difference in glandular tissue distribution leads to errors of conversion factor calculation. The three-layer mammographic phantom can provide accurate estimates of glandular dose in clinical practice.

Keywords: Monte Carlo simulation, mammography, normalized glandular dose, glandularity

Procedia PDF Downloads 157
362 Development of Ultrasounf Probe Holder for Automatic Scanning Asymmetric Reflector

Authors: Nabilah Ibrahim, Hafiz Mohd Zaini, Wan Fatin Liyana Mutalib

Abstract:

Ultrasound equipment or machine is capable to scan in two dimensional (2D) areas. However there are some limitations occur during scanning an object. The problem will occur when scanning process that involving the asymmetric object. In this project, the ultrasound probe holder for asymmetric reflector scanning in 3D image is proposed to make easier for scanning the phantom or object that has asymmetric shape. Initially, the constructed asymmetric phantom that construct will be used in 2D scanning. Next, the asymmetric phantom will be interfaced by the movement of ultrasound probe holder using the Arduino software. After that, the performance of the ultrasound probe holder will be evaluated by using the various asymmetric reflector or phantom in constructing a 3D image

Keywords: ultrasound 3D images, axial and lateral resolution, asymmetric reflector, Arduino software

Procedia PDF Downloads 529
361 Preparing a Library of Abnormal Masses for Designing a Long-Lasting Anatomical Breast Phantom for Ultrasonography Training

Authors: Nasibullina A., Leonov D.

Abstract:

The ultrasonography method is actively used for the early diagnosis of various le-sions in the human body, including the mammary gland. The incidence of breast cancer has increased by more than 20%, and mortality by 14% since 2008. The correctness of the diagnosis often directly depends on the qualifications and expe-rience of a diagnostic medical sonographer. That is why special attention should be paid to the practical training of future specialists. Anatomical phantoms are ex-cellent teaching tools because they accurately imitate the characteristics of real hu-man tissues and organs. The purpose of this work is to create a breast phantom for practicing ultrasound diagnostic skills in grayscale and elastography imaging, as well as ultrasound-guided biopsy sampling. We used silicone-like compounds ranging from 3 to 17 on the Shore scale hardness units to simulate soft tissue and lesions. Impurities with experimentally selected concentrations were added to give the phantom the necessary attenuation and reflection parameters. We used 3D modeling programs and 3D printing with PLA plastic to create the casting mold. We developed a breast phantom with inclusions of varying shape, elasticity and echogenicity. After testing the created phantom in B-mode and elastography mode, we performed a survey asking 19 participants how realistic the sonograms of the phantom were. The results showed that the closest to real was the model of the cyst with 9.5 on the 0-10 similarity scale. Thus, the developed breast phantom can be used for ultrasonography, elastography, and ultrasound-guided biopsy training.

Keywords: breast ultrasound, mammary gland, mammography, training phantom, tissue-mimicking materials

Procedia PDF Downloads 50
360 Investigation of Surface Electromyograph Signal Acquired from the around Shoulder Muscles of Upper Limb Amputees

Authors: Amanpreet Kaur, Ravinder Agarwal, Amod Kumar

Abstract:

Surface electromyography is a strategy to measure the muscle activity of the skin. Sensors placed on the skin recognize the electrical current or signal generated by active muscles. A lot of the research has focussed on the detection of signal from upper limb amputee with activity of triceps and biceps muscles. The purpose of this study was to correlate phantom movement and sEMG activity in residual stump muscles of transhumeral amputee from the shoulder muscles. Eight non- amputee and seven right hand amputees were recruited for this study. sEMG data were collected for the trapezius, pectoralis and teres muscles for elevation, protraction and retraction of shoulder. Contrast between the amputees and non-amputees muscles action have been investigated. Subsequently, to investigate the impact of class separability for different motions of shoulder, analysis of variance for experimental recorded data was carried out. Results were analyzed to recognize different shoulder movements and represent a step towards the surface electromyography controlled system for amputees. Difference in F ratio (p < 0.05) values indicates the distinction in mean therefore these analysis helps to determine the independent motion. The identified signal would be used to design more accurate and efficient controllers for the upper-limb amputee for researchers.

Keywords: around shoulder amputation, surface electromyography, analysis of variance, features

Procedia PDF Downloads 401
359 Relative Depth Dose Profile and Peak Scatter Factors Measurement for Co-60 Teletherapy Machine Using Chemical Dosimetry

Authors: O. Moussous, T. Medjadj

Abstract:

The suitability of a Fricke dosimeter for the measurement of a relative depth dose profile and the peak scatter factors was studied. The measurements were carried out in the secondary standard dosimetry laboratory at CRNA Algiers using a collimated 60Co gamma source teletherapy machine. The measurements were performed for different field sizes at the phantom front face, at a fixed source-to-phantom distance of 80 cm. The dose measurements were performed by first placing the dosimeters free-in-air at the distance-source-detector (DSD) of 80.5 cm from the source. Additional measurements were made with the phantom in place. The water phantom type Med-Tec 40x40x40 cm for vertical beam was used in this work as scattering martial. The phantom was placed on the irradiation bench of the cobalt unit at the SSD of 80 cm from the beam focus and the centre of the field coincided with the geometric centre of the dosimeters placed at the depth in water of 5 mm Relative depth dose profile and Peak scatter factors measurements were carried out using our Fricke system. This was intercompared with similar measurements by ionization chamber under identical conditions. There is a good agreement between the relative percentage depth–dose profiles and the PSF values measured by both systems using a water phantom.

Keywords: Fricke dosimeter, depth–dose profiles, peak scatter factors, DSD

Procedia PDF Downloads 226
358 Effective Virtual Tunnel Shape for Motion Modification in Upper-Limb Perception-Assist with a Power-Assist Robot

Authors: Kazuo Kiguchi, Kouta Ikegami

Abstract:

In the case of physically weak persons, not only motor abilities, but also sensory abilities are sometimes deteriorated. The concept of perception-assist has been proposed to assist the sensory ability of the physically weak persons with a power-assist robot. Since upper-limb motion is very important in daily living, perception-assist for upper-limb motion has been proposed to assist upper-limb motion in daily living. A virtual tunnel was applied to modify the user’s upper-limb motion if it was necessary. In this paper, effective shape of the virtual tunnel which is applied in the perception-assist for upper-limb motion is proposed. Not only the position of the grasped tool but also the angle of the grasped tool are modified if it is necessary. Therefore, the upper-limb motion in daily living can be effectively modified to realize certain proper daily motion. The effectiveness of the proposed virtual tunnel was evaluated by performing the experiments.

Keywords: motion modification, power-assist robots, perception-assist, upper-limb motion

Procedia PDF Downloads 219
357 Assessment of Hamstring, Lower Back and Upper Body Flexibility in War Disabled Individuals in Sri Lanka North and East Region

Authors: Esther Liyanage, Indrajith Liyanage, A. A. J. Rajaratne

Abstract:

During the 30 year civil war in Sri Lanka, a large number of individuals were injured and disabled. These disabilities have reduced their daily physical activities which may cause reduction in flexibility of upper limb, shoulder girdle, lower back and lower limb. Muscle flexibility is important for a healthy lifestyle. The main objective of the study was to assess the upper limb, shoulder girdle and lower back, hamstring flexibility of the intact lower limb in disabled individuals in the North and Eastern parts of Sri Lanka. Back saver sits and reach test and shoulder scratch test described in FITNESS GRAM was used in the study. A total of 125 disabled soldiers with lower limb disabilities were recruited for the study. Flexibility of the lower back and hamstring muscles of uninjured lower limb was measured using back saver sit and reach test described by Wells and Dillon (1952). Upper limb and shoulder girdle flexibility was assessed using shoulder stretch test. Score 0-3 was given according to the ability to reach Superior medial angle of the opposite scapula, top of the head or the mouth. The results indicate that 31 (24.8%) disabled soldiers have lower limb flexibility less than 8, 2 (1.6 % ) have flexibility of 8, 2 (1.6 %) have flexibility of 8.5, 11 ( 8.8% ) have flexibility of 9, 14 (11.2 %) have flexibility of 9.5, 23 (18.4 %) have flexibility of 10, 17 (13.6 %) have 10.5 flexibility, 13 (10.4%) have 11 flexibility, 2 (1.6%) have 11.5 flexibility, 10 (8 %) have flexibility of 12 and 3 (2.34 %) have flexibility of 12.5. Six disabled soldiers (4.8%) have upper limb flexibility of 2 and remaining 95.2% have normal upper limb flexibility (score 3). A reduction in the flexibility of muscles in lower body and lower limbs was seen in 25% disabled soldiers which could be due to reduction in their daily physical activities.

Keywords: disability, flexibility, rehabilitation, quality of life

Procedia PDF Downloads 436
356 A Comparison of TLD Measurements to MIRD Estimates of the Dose to the Ovaries and Uterus from Tc-99m in Liver

Authors: Karim Adinehvand, Bakhtiar Azadbakht, Amin Sahebnasagh

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Relation to high absorption fraction of Tc SESTAMIBI by internal organs in heart scan, and these organs are near to generation organs (Ovaries and uterus). In this study, Liver is specified as source organ. Method: we have set amount of absorbed fraction radiopharmaceutical in position of Liver in RANDO-phantom in form of elliptical surfaces, then absorbed dose to ovaries and uterus measured by TLD-100 that had set at position of these organs in RANDO-phantom. Calculation had done by MIRD method. Results from direct measurement and MIRD method are too similar. The absorbed dose to uterus and ovaries for Rest are 26.05µGyMBq-1, 17.23µGyMBq-1 and for Stress are 2.04µGyMBq-1, 1.35µGyMBq-1 respectively.

Keywords: absorbed dose, TLD, MIRD, RANDO-phantom, Tc-99m

Procedia PDF Downloads 532
355 The Existence of a Sciatic Artery in Congenital Lower Limb Deformities

Authors: Waseem Al Talalwah, Shorok Al Dorazi, Roger Soames

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Persistent sciatic artery is a rare anatomical vascular variation resulting from a lack of regression of the embryonic dorsal axial artery. The axial artery is the main artery supplying the lower limb during development in the first trimester. The current research includes 206 sciatic artery cases in 171 patients between 1864 and 2012. It aims to identify the risk factor of sciatic artery aneurysm in congenital limb anomalies. Sciatic artery aneurysm was diagnosed incidentally in amniotic band syndrome (ABS) existing with no congenital anomaly in 0.7% or with double knee in 0.7%, with the tibia in 0.7% and with hemihypertrophy or soft tissue hypertrophy in 1.4%. Therefore, the current study indicates a relationship the same gene responsible for the congenital limb deformities may be responsible for non-regression of the sciatic artery. Furthermore, pediatricians should refer cases of congenital limb anomalies for vascular evaluation prior to corrective surgical intervention.

Keywords: amniotic band syndrome, congenital limb deformities, double knee, sciatic artery, sciatic artery aneurysm , soft tissue hypertrophy

Procedia PDF Downloads 336
354 Assessment of Breast, Lung and Liver Effective Doses in Heart Imaging by CT-Scan 128 Dual Sources with Use of TLD-100 in RANDO Phantom

Authors: Seyedeh Sepideh Amini, Navideh Aghaei Amirkhizi, Seyedeh Paniz Amini, Seyed Soheil Sayyahi, Mohammad Reza Davar Panah

Abstract:

CT-Scan is one of the lateral and sectional imaging methods that produce 3D-images with use of rotational x-ray tube around central axis. This study is about evaluation and calculation of effective doses around heart organs such as breast, lung and liver with CT-Scan 128 dual sources with TLD_100 and RANDO Phantom by spiral, flash and conventional protocols. In results, it is showed that in spiral protocol organs have maximum effective dose and minimum in flash protocol. Thus flash protocol advised for children and risk persons.

Keywords: X-ray computed tomography, dosimetry, TLD-100, RANDO, phantom

Procedia PDF Downloads 444
353 Evolution of Cord Absorbed Dose during Larynx Cancer Radiotherapy, with 3D Treatment Planning and Tissue Equivalent Phantom

Authors: Mohammad Hassan Heidari, Amir Hossein Goodarzi, Majid Azarniush

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Radiation doses to tissues and organs were measured using the anthropomorphic phantom as an equivalent to the human body. When high-energy X-rays are externally applied to treat laryngeal cancer, the absorbed dose at the laryngeal lumen is lower than given dose because of air space which it should pass through before reaching the lesion. Specially in case of high-energy X-rays, the loss of dose is considerable. Three-dimensional absorbed dose distributions have been computed for high-energy photon radiation therapy of laryngeal and hypo pharyngeal cancers, using a coaxial pair of opposing lateral beams in fixed positions. Treatment plans obtained under various conditions of irradiation.

Keywords: 3D treatment planning, anthropomorphic phantom, larynx cancer, radiotherapy

Procedia PDF Downloads 516
352 Model Free Terminal Sliding Mode with Gravity Compensation: Application to an Exoskeleton-Upper Limb System

Authors: Sana Bembli, Nahla Khraief Haddad, Safya Belghith

Abstract:

This paper deals with a robust model free terminal sliding mode with gravity compensation approach used to control an exoskeleton-upper limb system. The considered system is a 2-DoF robot in interaction with an upper limb used for rehabilitation. The aim of this paper is to control the flexion/extension movement of the shoulder and the elbow joints in presence of matched disturbances. In the first part, we present the exoskeleton-upper limb system modeling. Then, we controlled the considered system by the model free terminal sliding mode with gravity compensation. A stability study is realized. To prove the controller performance, a robustness analysis was needed. Simulation results are provided to confirm the robustness of the gravity compensation combined with to the Model free terminal sliding mode in presence of uncertainties.

Keywords: exoskeleton- upper limb system, model free terminal sliding mode, gravity compensation, robustness analysis

Procedia PDF Downloads 111
351 Comparison of FNTD and OSLD Detectors' Responses to Light Ion Beams Using Monte Carlo Simulations and Exprimental Data

Authors: M. R. Akbari, H. Yousefnia, A. Ghasemi

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Al2O3:C,Mg fluorescent nuclear track detector (FNTD) and Al2O3:C optically stimulated luminescence detector (OSLD) are becoming two of the applied detectors in ion dosimetry. Therefore, the response of these detectors to hadron beams is highly of interest in radiation therapy (RT) using ion beams. In this study, these detectors' responses to proton and Helium-4 ion beams were compared using Monte Carlo simulations. The calculated data for proton beams were compared with Markus ionization chamber (IC) measurement (in water phantom) from M.D. Anderson proton therapy center. Monte Carlo simulations were performed via the FLUKA code (version 2011.2-17). The detectors were modeled in cylindrical shape at various depths of the water phantom without shading each other for obtaining relative depth dose in the phantom. Mono-energetic parallel ion beams in different incident energies (100 MeV/n to 250 MeV/n) were collided perpendicularly on the phantom surface. For proton beams, the results showed that the simulated detectors have over response relative to IC measurements in water phantom. In all cases, there were good agreements between simulated ion ranges in the water with calculated and experimental results reported by the literature. For proton, maximum peak to entrance dose ratio in the simulated water phantom was 4.3 compared with about 3 obtained from IC measurements. For He-4 ion beams, maximum peak to entrance ratio calculated by both detectors was less than 3.6 in all energies. Generally, it can be said that FLUKA is a good tool to calculate Al2O3:C,Mg FNTD and Al2O3:C OSLD detectors responses to therapeutic proton and He-4 ion beams. It can also calculate proton and He-4 ion ranges with a reasonable accuracy.

Keywords: comparison, FNTD and OSLD detectors response, light ion beams, Monte Carlo simulations

Procedia PDF Downloads 309
350 Creating a Virtual Perception for Upper Limb Rehabilitation

Authors: Nina Robson, Kenneth John Faller II, Vishalkumar Ahir, Arthur Ricardo Deps Miguel Ferreira, John Buchanan, Amarnath Banerjee

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This paper describes the development of a virtual-reality system ARWED, which will be used in physical rehabilitation of patients with reduced upper extremity mobility to increase limb Active Range of Motion (AROM). The ARWED system performs a symmetric reflection and real-time mapping of the patient’s healthy limb on to their most affected limb, tapping into the mirror neuron system and facilitating the initial learning phase. Using the ARWED, future experiments will test the extension of the action-observation priming effect linked to the mirror-neuron system on healthy subjects and then stroke patients.

Keywords: physical rehabilitation, mirror neuron, virtual reality, stroke therapy

Procedia PDF Downloads 396
349 Quantification of Learned Non-Use of the Upper-Limb After a Stroke

Authors: K. K. A. Bakhti, D. Mottet, J. Froger, I. Laffont

Abstract:

Background: After a cerebrovascular accident (or stroke), many patients use excessive trunk movements to move their paretic hand towards a target (while the elbow is maintained flexed) even though they can use the upper-limb when the trunk is restrained. This phenomenon is labelled learned non-use and is known to be detrimental to neuroplasticity and recovery. Objective: The aim of this study is to quantify learned non-use of the paretic upper limb during a hand reaching task using 3D movement analysis. Methods: Thirty-four participants post supratentorial stroke were asked to reach a cone placed in front of them at 80% of their arm length. The reaching movement was repeated 5 times with the paretic hand, and then 5 times with the less-impaired hand. This sequence was first performed with the trunk free, then with the trunk restrained. Learned non-use of the upper-limb (LNUUL) was obtained from the difference of the amount of trunk compensation between the free trunk condition and the restrained trunk condition. Results: LNUUL was significantly higher for the paretic hand, with individual values ranging from 1% to 43%, and one-half of the patients with an LNUUL higher than 15%. Conclusions: Quantification of LNUUL can be used to objectively diagnose patients who need trunk rehabilitation. It can be also used for monitoring the rehabilitation progress. Quantification of LNUUL may guide upper-limb rehabilitation towards more optimal motor recovery avoiding maladaptive trunk compensation and its consequences on neuroplasticity.

Keywords: learned non-use, rehabilitation, stroke, upper limb

Procedia PDF Downloads 210
348 Effective Dose and Size Specific Dose Estimation with and without Tube Current Modulation for Thoracic Computed Tomography Examinations: A Phantom Study

Authors: S. Gharbi, S. Labidi, M. Mars, M. Chelli, F. Ladeb

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The purpose of this study is to reduce radiation dose for chest CT examination by including Tube Current Modulation (TCM) to a standard CT protocol. A scan of an anthropomorphic male Alderson phantom was performed on a 128-slice scanner. The estimation of effective dose (ED) in both scans with and without mAs modulation was done via multiplication of Dose Length Product (DLP) to a conversion factor. Results were compared to those measured with a CT-Expo software. The size specific dose estimation (SSDE) values were obtained by multiplication of the volume CT dose index (CTDIvol) with a conversion size factor related to the phantom’s effective diameter. Objective assessment of image quality was performed with Signal to Noise Ratio (SNR) measurements in phantom. SPSS software was used for data analysis. Results showed including CARE Dose 4D; ED was lowered by 48.35% and 51.51% using DLP and CT-expo, respectively. In addition, ED ranges between 7.01 mSv and 6.6 mSv in case of standard protocol, while it ranges between 3.62 mSv and 3.2 mSv with TCM. Similar results are found for SSDE; dose was higher without TCM of 16.25 mGy and was lower by 48.8% including TCM. The SNR values calculated were significantly different (p=0.03<0.05). The highest one is measured on images acquired with TCM and reconstructed with Filtered back projection (FBP). In conclusion, this study proves the potential of TCM technique in SSDE and ED reduction and in conserving image quality with high diagnostic reference level for thoracic CT examinations.

Keywords: anthropomorphic phantom, computed tomography, CT-expo, radiation dose

Procedia PDF Downloads 190
347 Realistic Modeling of the Preclinical Small Animal Using Commercial Software

Authors: Su Chul Han, Seungwoo Park

Abstract:

As the increasing incidence of cancer, the technology and modality of radiotherapy have advanced and the importance of preclinical model is increasing in the cancer research. Furthermore, the small animal dosimetry is an essential part of the evaluation of the relationship between the absorbed dose in preclinical small animal and biological effect in preclinical study. In this study, we carried out realistic modeling of the preclinical small animal phantom possible to verify irradiated dose using commercial software. The small animal phantom was modeling from 4D Digital Mouse whole body phantom. To manipulate Moby phantom in commercial software (Mimics, Materialise, Leuven, Belgium), we converted Moby phantom to DICOM image file of CT by Matlab and two- dimensional of CT images were converted to the three-dimensional image and it is possible to segment and crop CT image in Sagittal, Coronal and axial view). The CT images of small animals were modeling following process. Based on the profile line value, the thresholding was carried out to make a mask that was connection of all the regions of the equal threshold range. Using thresholding method, we segmented into three part (bone, body (tissue). lung), to separate neighboring pixels between lung and body (tissue), we used region growing function of Mimics software. We acquired 3D object by 3D calculation in the segmented images. The generated 3D object was smoothing by remeshing operation and smoothing operation factor was 0.4, iteration value was 5. The edge mode was selected to perform triangle reduction. The parameters were that tolerance (0.1mm), edge angle (15 degrees) and the number of iteration (5). The image processing 3D object file was converted to an STL file to output with 3D printer. We modified 3D small animal file using 3- Matic research (Materialise, Leuven, Belgium) to make space for radiation dosimetry chips. We acquired 3D object of realistic small animal phantom. The width of small animal phantom was 2.631 cm, thickness was 2.361 cm, and length was 10.817. Mimics software supported efficiency about 3D object generation and usability of conversion to STL file for user. The development of small preclinical animal phantom would increase reliability of verification of absorbed dose in small animal for preclinical study.

Keywords: mimics, preclinical small animal, segmentation, 3D printer

Procedia PDF Downloads 341
346 Measurement of IMRT Dose Distribution in Rando Head and Neck Phantom using EBT3 Film

Authors: Pegah Safavi, Mehdi Zehtabian, Mohammad Amin Mosleh-Shirazi

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Cancer is one of the leading causes of death in the world. Radiation therapy is one of the main choices for cancer treatment. Intensity-modulated radiation therapy is a new type of radiation therapy technique available for vital structures such as the parathyroid glands. It is very important to check the accuracy of the delivered IMRT treatment because any mistake may lead to more complications for the patient. This paper describes an experiment to determine the accuracy of a dose measured by EBT3 film. To test this method, the EBT3 film on the head and neck of the Rando phantom was irradiated by an IMRT device and the irradiation was repeated twice. Finally, the dose designed by the irradiation system was compared with the dose measured by the EBT3 film. Using this criterion, the accuracy of the EBT3 film was evaluated. When using this criterion, a 95% agreement was reached between the planned treatment and the measured values.

Keywords: EBT3, phantom, accuracy, cancer, IMRT

Procedia PDF Downloads 117
345 Study of Human Upper Arm Girth during Elbow Isokinetic Contractions Based on a Smart Circumferential Measuring System

Authors: Xi Wang, Xiaoming Tao, Raymond C. H. So

Abstract:

As one of the convenient and noninvasive sensing approaches, the automatic limb girth measurement has been applied to detect intention behind human motion from muscle deformation. The sensing validity has been elaborated by preliminary researches but still need more fundamental study, especially on kinetic contraction modes. Based on the novel fabric strain sensors, a soft and smart limb girth measurement system was developed by the authors’ group, which can measure the limb girth in-motion. Experiments were carried out on elbow isometric flexion and elbow isokinetic flexion (biceps’ isokinetic contractions) of 90°/s, 60°/s, and 120°/s for 10 subjects (2 canoeists and 8 ordinary people). After removal of natural circumferential increments due to elbow position, the joint torque is found not uniformly sensitive to the limb circumferential strains, but declining as elbow joint angle rises, regardless of the angular speed. Moreover, the maximum joint torque was found as an exponential function of the joint’s angular speed. This research highly contributes to the application of the automatic limb girth measuring during kinetic contractions, and it is useful to predict the contraction level of voluntary skeletal muscles.

Keywords: fabric strain sensor, muscle deformation, isokinetic contraction, joint torque, limb girth strain

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344 An Extremely Rare Anatomical Vascular Variant of Lower Limb Arterial System - Duplication of Superficial Femoral Artery

Authors: Manik Sharma

Abstract:

Understanding the anatomy and normal anatomical variations of the lower limb arterial system is undeniably important not only to understand the pathology involving the vessels of the lower limb but also as a part of endovascular intervention and surgical planning in cases that demand them as a part of treatment. There have been very few cases of duplication of SFA cited in the literature, close to six worldwide and this being the seventh case in the world and first to be reported in the Indian population. We incidentally came across this normal variant during US lower limb (US-LL) duplex scan in a patient with claudicating pain in bilateral lower limbs hence suspected of having peripheral vascular disease. It was confirmed on CT-Peripheral Angiography (CT-PA), which was done successively.

Keywords: peripheral vascular disease, claudicating pain, normal anatomical variants, endovascular intervention, duplication, CT-peripheral angiography, duplex scan, Iohexol

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343 The Dose to Organs in Lumbar-Abdominal Computed Tomography Imaging Using TLD

Authors: M. Zehtabian, Z. Molaiemanesh, Z. Shafahi, M. Papie, M. Zahraie Moghaddam, M. Mehralizadeh, M. R. Vahidi, S. Sina

Abstract:

The introduction of CT scans has been a great improvement in diagnosis of different diseases. However, this imaging modality can expose the patients to cumulative radiation doses which may increase the risks of some health problems like cancer. In this study, the dose delivered to different organs in lumbar-abdominal imaging was measured by putting the TLD-100, and TLD-100H chips inside the Alderson Rando phantom. The lumbar-abdominal image of the phantom was obtained, while TLD chips were inside the holes of the phantom. According to the results obtained in this study using TLD-100 chips, the average dose received by liver, bladder, rectum, kidneys, and uterus were found to be 12.9 mSv, 8.9 mSv, 10.1 mSv, 11.0 mSv, 11.2 mSv, and 10.5 mSv respectively, while the measurements performed by TLD-100H show that the average dose to liver, bladder, rectum, kidneys, and uterus were found to be 12.4 mSv, 9.2 mSv, 9.5 mSv, 10.5 mSv, 10.7 mSv, and 9.9 mSv respectively. The results of this study indicates that the dose measured by the TLD-100H chips are in close agreement with those obtained by TLD-100.

Keywords: CT scan, dose, TLD-100, diagnosis

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342 Absorbed Dose Measurements for Teletherapy Prediction of Superficial Dose Using Halcyon Linear Accelerator

Authors: Raymond Limen Njinga, Adeneye Samuel Olaolu, Akinyode Ojumoola Ajimo

Abstract:

Introduction: Measurement of entrance dose and dose at different depths is essential to avoid overdose and underdose of patients. The aim of this study is to verify the variation in the absorbed dose using a water-equivalent material. Materials and Methods: The plastic phantom was arranged on the couch of the halcyon linear accelerator by Varian, with the farmer ionization chamber inserted and connected to the electrometer. The image of the setup was taken using the High-Quality Single 1280x1280x16 higher on the service mode to check the alignment with the isocenter. The beam quality TPR₂₀,₁₀ (Tissue phantom ratio) was done to check the beam quality of the machine at a field size of 10 cm x 10 cm. The calibration was done using SAD type set-up at a depth of 5 cm. This process was repeated for ten consecutive weeks, and the values were recorded. Results: The results of the beam output for the teletherapy machine were satisfactory and accepted in comparison with the commissioned measurement of 0.62. The beam quality TPR₂₀,₁₀ (Tissue phantom ratio) was reasonable with respect to the beam quality of the machine at a field size of 10 cm x 10 cm. Conclusion: The results of the beam quality and the absorbed dose rate showed a good consistency over the period of ten weeks with the commissioned measurement value.

Keywords: linear accelerator, absorbed dose rate, isocenter, phantom, ionization chamber

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341 Water Equivalent from the Point of View of Fast Neutron Removal Cross-Section

Authors: Mohammed Alrajhi

Abstract:

Radiological properties of gel dosimeters and phantom materials are often evaluated in terms of effective atomic number, electron density, photon mass attenuation coefficient, photon mass energy absorption coefficient and total stopping power of electrons. To evaluate the water equivalence of such materials for fast neutron attenuation 19 different types of gel dosimeters and phantom materials were considered. Macroscopic removal cross-sections for fast neutrons (ΣR cm-1) have been calculated for a range of ferrous-sulphate and polymeric gel dosimeters using Nxcom Program. The study showed that the value of ΣR/ρ (cm2.g-1) for all polymer gels were in close agreement (1.5- 2.8%) with that of water. As such, the slight differences in ΣR/ρ between water and gels are small and may be considered negligible. Also, the removal cross-section of the studied phantom materials were very close (~ ±1.5%) to that of water except bone (cortical) which had about 38% variation. Finally, the variation of removal cross-section with hydrogen content was studied.

Keywords: cross-section, neutron, photon, coefficient, mathematics

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340 The Effect of Body Positioning on Upper-Limb Arterial Occlusion Pressure and the Reliability of the Method during Blood Flow Restriction Training

Authors: Stefanos Karanasios, Charkleia Koutri, Maria Moutzouri, Sofia A. Xergia, Vasiliki Sakellari, George Gioftsos

Abstract:

The precise calculation of arterial occlusive pressure (AOP) is a critical step to accurately prescribe individualized pressures during blood flow restriction training (BFRT). AOP is usually measured in a supine position before training; however, previous reports suggested a significant influence in lower limb AOP across different body positions. The aim of the study was to investigate the effect of three different body positions on upper limb AOP and the reliability of the method for its standardization in clinical practice. Forty-two healthy participants (Mean age: 28.1, SD: ±7.7) underwent measurements of upper limb AOP in supine, seated, and standing positions by three blinded raters. A cuff with a manual pump and a pocket doppler ultrasound were used. A significantly higher upper limb AOP was found in seated compared with supine position (p < 0.031) and in supine compared with standing position (p < 0.031) by all raters. An excellent intraclass correlation coefficient (0.858- 0.984, p < 0.001) was found in all positions. Upper limb AOP is strongly dependent on body position changes. The appropriate measurement position should be selected to accurately calculate AOP before BFRT. The excellent inter-rater reliability and repeatability of the method suggest reliable and consistent results across repeated measurements.

Keywords: Kaatsu training, blood flow restriction training, arterial occlusion, reliability

Procedia PDF Downloads 171