Search results for: shoulder lesions

Authors: Orawan Vichiansan, J. Kraipoj, K.Phandech, P. Sirasaporn

Abstract:

Generally, frozen shoulder will improve over time, although it may take a long time up to year. The symptoms of frozen shoulder present by pain around shoulder and consequently limit range of motions. The effect of frozen shoulder leads to limit activities daily living life and high medical care cost. Physiotherapy is well known treatment for frozen shoulder but there was no data about the treatment of physiotherapy in frozen shoulder and length of follow up. Thus the aim of this study was to investigate physiotherapy program for frozen shoulder on range of motion and length of follow up. A retrospective study design was conducted. 469 medical records of patients with frozen shoulder were reviewed. These frozen shoulders were treated at physiotherapy unit, department of Rehabilitation last 3 years (January, 2014- December, 2016). The data consist of range of motions and length of follow up was recorded. The medical record of 183 males and 286 females with average aged 57.82±12.32 years were reviewed in this study. There was a statistically significant increase in shoulder flexion [mean difference 30.24 with 95%CI were [24.37-36.12], shoulder abduction [mean difference 34.93 with 95%CI were 27.8-42.0], shoulder internal rotation [mean difference 17.25 with 95%CI were 12.55-21.95] and shoulder external rotation [mean difference 17.71 with 95%CI were [13.07-22.36] respectively. In addition, the length of follow up averaged 84 days. In summary, the retrospective study show physiotherapy program likely to be benefit for patients with frozen shoulder in term of range of motion and short length of follow up.

Keywords: frozen shoulder, physiotherapy, range of motions, length of follow up

Procedia PDF Downloads 152

Authors: Didem Venus Yildiz, Murat Hocaoglu, Murat Dursun, Taner Akkan

Abstract:

The shoulder joint is a more complex structure than the hip or knee joints. In addition to the overall complexity of the shoulder joint, two different factors influence the insufficient outcome of shoulder replacement: the shoulder prosthesis design is far from fully developed and it is difficult to place these shoulder prosthesis due to shoulder anatomy. The glenohumeral joint is the most complex joint of the human shoulder. There are various treatments for shoulder failures such as total shoulder arthroplasty, reverse total shoulder arthroplasty. Due to its reverse design than normal shoulder anatomy, reverse total shoulder arthroplasty has different physiological and biomechanical properties. Post-operative achievement of this arthroplasty is depend on improved design of reverse total shoulder prosthesis. Designation achievement can be increased by several biomechanical and computational analysis. In this study, data of human both shoulders with right side fracture was collected by 3D Computer Tomography (CT) machine in dicom format. This data transferred to 3D medical image processing software (Mimics Materilise, Leuven, Belgium) to reconstruct patient’s left and right shoulders’ bones geometry. Provided 3D geometry model of the fractured shoulder was used to constitute of reverse total shoulder prosthesis by 3-matic software. Finite element (FE) analysis was conducted for comparison of intact shoulder and prosthetic shoulder in terms of stress distribution and displacements. Body weight physiological reaction force of 800 N loads was applied. Resultant values of FE analysis was compared for both shoulders. The analysis of the performance of the reverse shoulder prosthesis could enhance the knowledge of the prosthetic design.

Keywords: reverse shoulder prosthesis, biomechanics, finite element analysis, 3D printing

Procedia PDF Downloads 132

Authors: Chung-Ming Lo, Chung-Chien Lee

Abstract:

In many countries, the lifetime prevalence of shoulder pain is up to 70%. In America, the health care system spends 7 billion per year about the healthy issues of shoulder pain. With respect to the origin, up to 70% of shoulder pain is attributed to rotator cuff lesions This study proposed a computer-aided diagnosis (CAD) system to assist radiologists classifying rotator cuff lesions with less operator dependence. Quantitative features were extracted from the shoulder ultrasound images acquired using an ALOKA alpha-6 US scanner (Hitachi-Aloka Medical, Tokyo, Japan) with linear array probe (scan width: 36mm) ranging from 5 to 13 MHz. During examination, the postures of the examined patients are standard sitting position and are followed by the regular routine. After acquisition, the shoulder US images were drawn out from the scanner and stored as 8-bit images with pixel value ranging from 0 to 255. Upon the sonographic appearance, the boundary of each lesion was delineated by a physician to indicate the specific pattern for analysis. The three lesion categories for classification were composed of 20 cases of tendon inflammation, 18 cases of calcific tendonitis, and 18 cases of supraspinatus tear. For each lesion, second-order statistics were quantified in the feature extraction. The second-order statistics were the texture features describing the correlations between adjacent pixels in a lesion. Because echogenicity patterns were expressed via grey-scale. The grey-scale co-occurrence matrixes with four angles of adjacent pixels were used. The texture metrics included the mean and standard deviation of energy, entropy, correlation, inverse different moment, inertia, cluster shade, cluster prominence, and Haralick correlation. Then, the quantitative features were combined in a multinomial logistic regression classifier to generate a prediction model of rotator cuff lesions. Multinomial logistic regression classifier is widely used in the classification of more than two categories such as the three lesion types used in this study. In the classifier, backward elimination was used to select a feature subset which is the most relevant. They were selected from the trained classifier with the lowest error rate. Leave-one-out cross-validation was used to evaluate the performance of the classifier. Each case was left out of the total cases and used to test the trained result by the remaining cases. According to the physician’s assessment, the performance of the proposed CAD system was shown by the accuracy. As a result, the proposed system achieved an accuracy of 86%. A CAD system based on the statistical texture features to interpret echogenicity values in shoulder musculoskeletal ultrasound was established to generate a prediction model for rotator cuff lesions. Clinically, it is difficult to distinguish some kinds of rotator cuff lesions, especially partial-thickness tear of rotator cuff. The shoulder orthopaedic surgeon and musculoskeletal radiologist reported greater diagnostic test accuracy than general radiologist or ultrasonographers based on the available literature. Consequently, the proposed CAD system which was developed according to the experiment of the shoulder orthopaedic surgeon can provide reliable suggestions to general radiologists or ultrasonographers. More quantitative features related to the specific patterns of different lesion types would be investigated in the further study to improve the prediction.

Keywords: shoulder ultrasound, rotator cuff lesions, texture, computer-aided diagnosis

Procedia PDF Downloads 254

Authors: Reinaldo Biscaro, Luciano R. Ferreira, Leonardo C. Biscaro, Raphael C. Biscaro, Isabela S. Vasconcelos, Laura C. R. Ferreira, Cristiano M. Galhardi, Erica P. Baciuk

Abstract:

Introduction: The present study had the objective to present the profile of workers with shoulder disorders related to labor lawsuits in Brazil. The study analyzed the association between the worker’s health and the actions performed by the companies related to injured professional. The research method performed a retrospective, cross-sectional and quantitative database analysis. The documents of labor lawsuits with shoulder injury registered at the Regional Labor Court in the 15^th region (Campinas - São Paulo) were submitted to the medical examination and evaluated during the period from 2012 until 2015. The data collected were age, gender, onset of symptoms, length of service, current occupation, type of shoulder injury, referred complaints, type of acromion, associated or related diseases, company actions as CAT (workplace accident communication), compliance of NR7 by the organization (Environmental Risk Prevention Program - PPRA and Medical Coordination Program in Occupational Health - PCMSO). Results: From the 93 workers evaluated, there was a prevalence of men (58.1%), with a mean age of 42.6 y-o, and 54.8% were included in the age group 35-49 years. Regarding the length of work time in the company, 66.7% have worked for more than 5 years. There was an association between gender and current occupational status (p < 0.005), with predominance of women in household occupation (13 vs. 2) and predominance of unemployed men in job search situation (24 vs. 10) and reintegrated to work by judicial decision (8 vs. 2). There was also a correlation between pain and functional limitation (p < 0.01). There was a positive association of PPRA with the complaint of functional limitation and negative association with pain (p < 0.04). There was also a correlation between the sedentary lifestyle and the presence of PCMSO and PPRA (p < 0.04), and the absence of CAT in the companies (p < 0.001). It was concluded that the appearance or aggravation of osseous and articular shoulder pathologies in workers who have undertaken labor law suits seem to be associated with individual habits or inadequate labor practices. These data can help preventing the occurrence of these lesions by implementing local health promotion policies at work.

Keywords: work-related accidents, cross-sectional study, shoulder lesions, labor lawsuits

Procedia PDF Downloads 185

Authors: Narupon Kunbootsri, P. Sirasaporn

Abstract:

Frozen shoulder is a common problem present by pain and limit range of motion. The prevalence of frozen shoulder showed 18-31% of population. The effect of frozen shoulder lead to limit activities daily living life, high medical care cost and so on. Physiotherapy is one of the treatments for frozen shoulder but there was no data about the treatment of physiotherapy. Moreover, it is question about onset of symptom relate to physiotherapy program and obtaining physical modalities and delayed start physiotherapy program lead to delayed improvement. Thus the aim of this study was to investigate physiotherapy program for frozen shoulder relate to onset of symptom, range of motion and obtaining physical modalities. A retrospective study design was conducted. 182 medical records of patients with frozen shoulder were reviewed. These frozen shoulders were treated at physiotherapy unit, department of Rehabilitation last 3 years (January, 2014- December, 2016). The data consist of onset of symptom, range of motion and obtaining physical modalities were recorded. There was a statistically significant increase in shoulder flexion [mean difference 38.88 with 95%CI were [16.00-61.77], shoulder abduction [mean difference 48.47 with 95%CI were 16.07-90.59], shoulder internal rotation [mean difference 22.36 with 95%CI were 2.81-37.18] and shoulder external rotation [mean difference 32.12 with 95%CI were [(-2.47)-(46.91)]. In addition, the onset of symptom was 76.42±46.90 days. And the physical modalities used frequently were hot pack 14.8% and ultrasound diathermy 13.7%. In conclusion, the physiotherapy program including, hot pack and ultrasound diathermy seem to be useful for frozen shoulder. But onset of symptom is too long to start physiotherapy programs.

Keywords: frozen shoulder, range of motions, onset of symptom, physiotherapy, physical modality

Procedia PDF Downloads 258

Authors: S. Abbasi, M. R. Hadian, M. Abdolvahab, M. Jalili, S. H. Jalaei

Abstract:

Background: Rehabilitation treatments have significant role in reducing the disabilities of Cerebro Vascular Accident (CVA). Due to great role of upper limb in the function of individuals particularly in Activity of Daily Living and the effect of stability of shoulder girdle on hand function, the aim of this study was to study the effects of Progressive Resistive Exercise on shoulder extensor and abductor muscles isometric strengths in adult hemiplegic. Methods: 17 adult hemiplegics patients (50-70 yrs., mean 60/52, SD7/22); with RT side dominancy and 6 months after stroke, participated in this study. All procedures were approved by ethical committee of TUMS and written consents were also taken. Patients were familiarized with the procedure and shoulder extensor and abductor muscles isometric strengths were measured by dynamometer. Results: according to result to our study, shoulder extensor and abductor muscles isometric strengths showed Significant differences between mean scores of pre and post intervention (P<0/05). Progressive Resistive Exercise improved 34% shoulder extensor muscles isometric strength and 27% shoulder abductor muscle isometric strength. Conclusion: Results of our research showed that progressive resistive exercise approach is a useful method for increasing the isometric strength of shoulder extensor and abductor muscles. Therefore, it might be concluded that improvement of strength of shoulder muscles could result in stability in shoulder girdle and consequently might effect on hand function in hemiplegic patients.

Keywords: shoulder extensor muscles isometric strength, shoulder abductor muscles isometric strength, hemiplegic, physical therapy

Procedia PDF Downloads 299

Authors: Renjith George Pallivathukal, Preethy Mary Donald

Abstract:

Asymptomatic oral lesions are often ignored by the patients and usually will be identified only in advanced stages. Early detection of precancerous lesions is important for better prognosis. It is also important for the oral health care person to be aware of the regional prevalence of oral lesions in order to provide early care for the same. We conducted a retrospective study to assess the prevalence of oral lesions based on the information available from patient records in a teaching dental school. Dental records of patients who attended the department of Oral medicine and diagnosis between September 2014 and September 2016 were retrieved and verified for oral lesions. Results: The ages of the patients ranged from 13 to 38 years with a mean age of 21.8 years. The lesions were classified as white (40.5%), red (23%), ulcerated (10.5%), pigmented (15.2%) and soft tissue enlargements (10.8%). 52% of the patients were unaware of the oral lesions before the dental visit. Overall, the prevalence of lesions in dental patients lower to national estimates, but the prevalence of some lesions showed variations.

Keywords: oral mucosal lesion, pre-cancer, prevalence, soft tissue lesion

Procedia PDF Downloads 327

Authors: Omid Khaiyat, David Hawkes

Abstract:

Introduction: There remains a lack of information on sophisticated coordination patterns across shoulder girdle muscles. Considering the stability of the shoulder being heavily dependent on coordinated muscle activity during its wide-ranging movements, it is important that key intermuscular relationships are well-defined for a better understanding of underlying pathology. This study investigated shoulder intermuscular coordination during different planes of shoulder elevation. Materials and Methods: EMG was recorded from 14 shoulder muscles in 20 healthy participants during shoulder flexion, scapula plane elevation, abduction, and extension. Cross-correlation by means of Pearson Correlation Coefficient (PCC) was used to examine the coordination between different muscles and muscle groups. Results: Coordination between rotator cuff and deltoid muscle groups was significantly higher (p =0.020-0.035) during the initial (PCC) = 0.79) and final (PCC = 0.74) phases of elevation compared to the mid-range (PCC = 0.34). Furthermore, a high level of coordination (PCC = 0.89) was noted between the deltoid group and the adductor group (latissimus dorsi and teres major) during the initial stage of shoulder elevation. Conclusion: The destabilising force of the deltoid during the initial stage of shoulder elevation is balanced by coordinated activity of rotator cuff, latissimus dorsi, and teres major. This is also the case for the end-range of movement, where increased demand for stability again leads to higher coordination between the deltoid and rotator cuff muscle groups. Appreciation of the sophistication of normal shoulder function evidence-based rehabilitation strategies for conditions such as subacromial impingement syndrome or shoulder instability can be developed.

Keywords: shoulder, coordination, EMG, muscle activity, upper limb

Procedia PDF Downloads 139

Authors: D. Maneetham

Abstract:

The developed exoskeleton device has to control joints between shoulder and arm. Exoskeleton device can help patients with hemiplegia upper so that the patient can help themselves in their daily life. Exoskeleton device includes a robot arm wear that looks like the movement is similar to the normal arm. Exoskeleton arm is powered by the motor through the cable with a control system that developed to control the movement of the joint of a robot arm. The arm will include the shoulder, the elbow, and the wrist. The control system is used Arduino Mega 2560 controller and the operation of the DC motor through the relay module. The control system can be divided into two modes such as the manual control with the joystick mode and automatically control with the movement of the head by Gyro sensor. The controller is also designed to move between the shoulder and the arm movement from their original location. Results have shown that the controller gave the best performance and all movements can be controlled.

Keywords: exoskeleton arm, hemiplegia upper, shoulder and arm, stroke

Procedia PDF Downloads 331

Authors: Ozge Tahran, Sevgi Sevi Yesilyaprak

Abstract:

Objective: The aim of the study was to investigate the effect of the Wilk’s modified two different stretching exercises on posterior shoulder tightness, pain, and dysfunction in patients with subacromial impingement syndrome (SIS). Method: This study was carried out on 67 patients who have more than 15° difference in shoulder internal rotation range of motion between two sides and had been diagnosed as SIS. Before treatment, all patients were randomly assigned into three groups. Standard physiotherapy programme was applied to the Group 3 (n=23), standard physiotherapy program with Wilk’s modified cross-body stretching exercises were applied to Group 1 (n=22), and standard physiotherapy program with Wilk’s modified sleeper stretching exercises were applied to Group 2 (n= 23). All the patients received 20 sessions of physiotherapy during 4 weeks, 5 days in a week by a physiotherapist. The patients continued their exercises at home at the weekends. Pain severity, shoulder rotation range of motion, posterior shoulder tightness, upper extremity functionality with Constant and Murley Score (CMS) and disability level with The Disabilities of the Arm, Shoulder and Hand Score (QuickDASH) were evaluated before and after physiotherapy programme. Results: Before treatment, demographic and anthropometric characteristics were similar in groups and there was no statistical difference (p > 0.05). It was determined that pain severity decreased, shoulder rotation range of motion, posterior shoulder tightness, upper extremity functionality, and disability were improved after physiotherapy in both groups (p < 0.05). Group 1 and 2 had better results in terms of reduction of pain severity during activity, increase in shoulder rotation range of motion, posterior shoulder mobility and upper extremity functionality and improvement in upper extremity disability, compared to Group 3 (p < 0.05). Conclusion: Modified posterior shoulder stretching exercises in addition to standard physiotherapy programme is more effective for reduction of pain during activity, to improve shoulder rotation range of motion, posterior shoulder mobility, and upper extremity functionality in patients with SIS compared to standard physiotherapy programme alone.

Keywords: modified posterior shoulder stretching exercises, posterior shoulder tightness, shoulder complex, subacromial impingement syndrome

Procedia PDF Downloads 154

Authors: Ail Akbar Emamverdian, Neriman Özada, Atabak Rahimzadeh Ilkhchi, Zahra Emamverdian

Abstract:

The reverse shoulder prosthesis is an innovative procedure design to treat of (GH) joint problems with severe rotator cuff deficiency. The original reverse shoulder prosthesis was invented by France surgery in1985 and has been in clinical use in the United States in 2004. These prostheses consist of baseplate that attached to the glenoid, in order to hold a spherical component, and humeral part consist of polyethylene insert which is flat. This prosthesis is the ‘reverse’ configuration. The indications for the reverse prosthesis are: (1) treating failed hemi arthroplasty with irrecoverable rotator cuff tears, (2) relief of painful arthritis associated with cuff tear arthropathy, (3) instauration after tumor resection, (4) pseudo paralysis because of irrecoverable rotator cuff tears (5) some fractures of the shoulder which reverse shoulder prostheses is only the option for treatment. This prosthesis resulting in relief of pain and decreasing the range of motion in above indications. However, this prosthesis and its applications such as notching of the scapula, dislocation of the prosthesis parts and acromial stress fractures. In this article the reverse shoulder prostheses, indication has been reviewed. This study can make clear aspect of reverse shoulder prosthesis that can help to find some solution in future.

Keywords: prostheses, complications, reverse shoulder prosthesis, indications

Procedia PDF Downloads 252

Authors: Sujith Rajashekar Swamy, Meghana Rajashekara Swamy

Abstract:

Although T1-weighted gadolinium-enhanced imaging (T1-Gd) has its established clinical role in diagnosing brain lesions of infectious and metastatic origins, the use of post-contrast susceptibility-weighted imaging (SWI) has been understudied. This observational study aims to explore and compare the prominence of brain parenchymal lesions between T1-Gd and SWI-Gd images. A cross-sectional study design was utilized to analyze 58 patients with brain parenchymal lesions using T1-Gd and SWI-Gd scanning techniques. Our results indicated that SWI-Gd enhanced the conspicuity of metastatic as well as infectious brain lesions when compared to T1-Gd. Consequently, it can be used as an adjunct to T1-Gd for post-contrast imaging, thereby avoiding additional contrast administration. Improved conspicuity of brain lesions translates directly to enhanced patient outcomes, and hence SWI-Gd imaging proves useful to meet that endpoint.

Keywords: susceptibility weighted, T1 weighted, brain lesions, gadolinium contrast

Procedia PDF Downloads 90

Authors: Sally Salah El Menshawy, Ghada M. Ahmed GabAllah, Doaa Khedr M. Khedr

Abstract:

Background: Our study aims to detect the diagnostic role of DTI in the differentiation of salivary glands benign and malignant lesions. Results: Our study included 50 patients (25males and 25 females) divided into 4 groups (benign lesions n=20, malignant tumors n=13, post-operative changes n=10 and normal n=7). 28 patients were with parotid gland lesions, 4 patients were with submandibular gland lesions and only 1 case with sublingual gland affection. The mean fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of malignant salivary gland tumors (n = 13) (0.380±0.082 and 0.877±0.234× 10⁻³ mm² s⁻¹) were significantly different (P<0.001) than that of benign tumors (n = 20) (0.147±0.03 and 1.47±0.605 × 10⁻³ mm² s⁻¹), respectively. The mean FA and ADC of post-operative changes (n = 10) were (0.211±0.069 and 1.63±0.20× 10⁻³ mm² s⁻¹) while that of normal glands (n =7) was (0.251±0.034and 1.54±0.29× 10⁻³ mm² s⁻¹), respectively. Using ADC to differentiate malignant lesions from benign lesions has an (AUC) of 0.810, with an accuracy of 69.7%. ADC used to differentiate malignant lesions from post-operative changes has (AUC) of 1.0, and an accuracy of 95.7%. FA used to discriminate malignant from benign lesions has (AUC) of 1.0, and an accuracy of 93.9%. FA used to differentiate malignant from post-operative changes has (AUC) of 0.923, and an accuracy of 95.7%. Combined FA and ADC used to differentiate malignant from benign lesions has (AUC) of 1.0, and an accuracy of 100%. Combined FA and ADC used to differentiate malignant from post-operative changes has (AUC) of 1.0, and an accuracy of 100%. Conclusion: Combined FA and ADC can differentiate malignant tumors from benign salivary gland lesions.

Keywords: diffusion tensor imaging, MRI, salivary gland, tumors

Procedia PDF Downloads 79

Authors: Mohamed M. Mashaly, Ahmed M. F. El Shiwi

Abstract:

Background: Shoulder impingement syndrome is an encroachment of subacromial tissues, rotator cuff, subacromial bursa, and the long head of the biceps tendon, as a result of narrowing of the subacromial space. Activities requiring repetitive or sustained use of the arms over head often predispose the rotator cuff tendon to injury. Purpose: To compare between Combined effect therapeutic exercises and Shockwave therapy versus therapeutic exercises and phonophoresis in the treatment of shoulder impingement syndrome. Methods: Thirty patients diagnosed as shoulder impingement syndrome stage II Neer classification due to mechanical causes. Patients were randomly distributed into two equal groups. The first group consisted of 15 patients with a mean age of (45.46+8.64) received therapeutic exercises (stretching exercise of posterior shoulder capsule and strengthening exercises of shoulder muscles) and shockwave therapy (6000 shocks, 2000/session, 3 sessions, 2 weeks apart, 0.22mJ/mm^2) years. The second group consisted of 15 patients with a mean age of 46.26 (+ 8.05) received same therapeutic exercises and phonophoresis (3 times per week, each other day, for 4 consecutive weeks). Patients were evaluated pretreatment and post treatment for shoulder pain severity, shoulder functional disability, shoulder flexion, abduction and internal rotation motions. Results: Patients of both groups showed significant improvement in all the measured variables. In between groups difference the shock wave group showed a significant improvement in all measured variables than phonophoresis group. Interpretation/Conclusion: Combined effect of therapeutic exercises and shock wave were more effective than therapeutic exercises and phonophoresis on decreasing shoulder pain severity, shoulder functional disability, increasing in shoulder flexion, abduction, internal rotation in patients with shoulder impingement syndrome.

Keywords: shoulder impingement syndrome, therapeutic exercises, shockwave, phonophoresis

Procedia PDF Downloads 451

Authors: A-Reum Shin, Heon-Seock Cynn, Ji-Hyun Lee, Da-Eun Kim

Abstract:

Round shoulder posture (RSP) is a position of scapular protraction and elevation, which may appear as scapular winging, and humeral internal rotation. Flexed posture (FP) may also affect RSP because FP is characterized by hyperkyphosis, forward head posture, and height reduction. The aim of this study was to investigate the effect of scapular posterior tilting exercise with prone trunk extension on round shoulder posture, activities of lower trapezius and serratus anterior, flexed posture, and thoracic erector spinae activity in subjects with round shoulder posture. Fifteen subjects with round shoulder posture were recruited in this study. Activities of lower trapezius, serratus anterior and thoracic erector spinae were measured during both scapular posterior tilting exercise and scapular posterior tilting exercise with prone trunk extension using electromyography, and round shoulder posture and flexed posture were measured immediately after each exercises using caliper. When the prone trunk extension was applied, the round shoulder posture and flexed posture significantly decreased, activities of lower trapezius and thoracic erector spinae significantly increased (p < 0.05) compared with the scapular posterior tilting exercise alone. There was no significant difference in serratus anterior activity between two exercises. Thus, prone trunk extension could be effective method to improve round shoulder posture during scapular posterior tilting exercise in subjects with round shoulder posture.

Keywords: flexed posture, prone trunk extension, round shoulder posture, scapular posterior tilting

Procedia PDF Downloads 187

Authors: Isabella Schwartz, Ori Safran, Naama Karniel, Michal Abel, Adina Berko, Martin Seyres, Tamir Tsoar, Sigal Portnoy

Abstract:

Virtual Reality allows to manipulate the patient’s perception, thereby providing a motivational addition to real-time biofeedback exercises. We aimed to test the effect of manipulated virtual kinematic intervention on measures of active and passive Range of Motion (ROM), pain, and disability level in individuals with traumatic stiff shoulder. In a double-blinded study, patients with stiff shoulder following proximal humerus fracture and non-operative treatment were randomly divided into a non-manipulated feedback group (NM-group; N=6) and a manipulated feedback group (M-group; N=7). The shoulder ROM, pain, and the Disabilities of the Arm, Shoulder and Hand (DASH) scores were tested at baseline and after the 6 sessions, during which the subjects performed shoulder flexion and abduction in front of a graphic visualization of the shoulder angle. The biofeedback provided to the NM-group was the actual shoulder angle and the feedback provided to the M-group was manipulated so that 10° were constantly subtracted from the actual angle detected by the motion capture system. The M-group showed greater improvement in the active flexion ROM, with median and interquartile range of 197.1 (140.5-425.0) compared to 142.5 (139.1-151.3) for the NM-group (p=.046). Also, the M-group showed greater improvement in the DASH scores, with median and interquartile range of 67.7 (52.8-86.2) compared to 89.7 (83.8-98.3) for the NM-group (p=.022). Manipulated intervention is beneficial in individuals with traumatic stiff shoulder and should be further tested for other populations with orthopedic injuries.

Keywords: virtual reality, biofeedback, shoulder pain, range of motion

Procedia PDF Downloads 97

Authors: Nuralam Sam, Irawan Yusuf, Irfan Idris, Endi Adnan

Abstract:

The most case in the shoulder in the the adult is the frozen shoulder. It make an uncomfortable sensation which disturbance daily activity. The studies of frozen shoulder are still limited. This study used a true experimental pre and post test design with a group design. The participant underwent dextrose prolotherapy injection in the rotator cuff, intraarticular glenohumeral joint, long head tendon biceps, and acromioclavicular joint injections with 15% dextrose, respectively, at week 2, week 4, and week 6. Participants were followed for 12 weeks. The specific biomarker MMP and TIMP, ROM, DASH score were measured at baseline, at week 6, and week 12. The data were analyzed by multivariate analysis (repeated measurement ANOVA, Paired T-Test, and Wilcoxon) to determine the effect of the intervention. The result showed a significant decrease in The Disability of the Arm, Shoulder, and Hand (DASH) score in prolo injection patients in each measurement week (p < 0.05). While the measurement of Range of Motion (ROM), each direction of shoulder motion showed a significant difference in average each week, from week 0 to week 6 (p <0.05).Dextrose prolotherapy injection results give a significant improvement in functional outcome of the shoulder joint, and ROMand did not show significant results in assessing the specific biomarker, MMP-1, and TIMP-1 in tissue repair. This study suggestion an alternative to the use of injection prolotherapy in Frozen shoulder patients, which has fewer side effects and better effectiveness than the use of corticosteroid injections.

Keywords: frozen shoulder, ROM, DASH score, prolotherapy, MMP-1, TIMP-1

Procedia PDF Downloads 85

Authors: Rania A. R. Soudan, Easter Joury

Abstract:

Introduction: Psoriasis is a common chronic dermatologic disease. It may affect the mucous membranes. The presence of oral mucosal lesions has been a subject of controversy. The aim: To determine possible association between oral mucosal lesions and psoriasis, and to correlate the same with different types of psoriasis and severity of the disease. Materials and Methods: The oral mucosa was clinically examined in 100 randomly selected Syrian psoriatic patients presented to the Dermatological Diseases Hospital in Damascus University, Syria (February 2009 - December 2010), and in 100 matched controls. PASI index was used to evaluate the disease severity. Chi-square and Student t-test were used to compare differences between groups. Results: Oral mucosal lesions were observed in 72% of the psoriasis cases, while 46% of the control group’s subjects had oral lesions. Fissured tongue, geographic tongue, and red lesions were detected in 36%, 25%, and 7% of the examined psoriatics, respectively. These lesions were significantly more frequent in the psoriatics than in the controls. A correlation was found between furred tongue and the age of the psoriasis patients. However, an association was observed for fissured tongue, furred tongue with the severity of the disease, and for fissured tongue, white lesions, cheilitis with nail involvement. However, no correlation with the psoriasis types was recorded. Conclusion: Some oral mucosal lesions were associated with psoriasis, so these lesions may be considered as oral manifestations of this disease, and should be taken into account in new studies as possible predictors or markers of this dermatitis. Further studies are recommended to confirm these oral manifestations.

Keywords: psoriasis, tongue, mucosa, lesions

Procedia PDF Downloads 266

Authors: Somyoung Shin, Donghun Jeong, Yeoil Yun

Abstract:

South Korea continuously installed tunnels in consideration of the safety and operation efficiency, and the number of installed tunnels has doubled over the past ten years. The tunnel section is designed based on the guidelines, but the tunnel entrance becomes narrow due to dark adaptation and pressure. In fact, around 13% of traffic in expressways of Japan happens at the entrance, leading to congestion and rear-ends collision accidents. Therefore, this study aims to analyze the stability from the expansion of the shoulder width in the tunnel entrance by applying a virtual reality driving simulator in order to reduce the accidents that happen in the tunnel entrance. To compare the driving stability based on the changes in the width of the right shoulder under the same condition, a virtual reality driving simulator is used to conduct an experiment on 30 subjects in their 20s to 60s and to provide a more practical virtual reality driving environment, and an experiment map is designed based on actual roads as the background to conduct the experiment. The right shoulder is classified into 2.5m and 3.0m based on the design guidelines of the expressways and the road structure installation regulations. The experimenters' experiment order is decided randomly. As a result of analyzing the average speed, it was displayed as 100.73km/h when the shoulder width was 2.5m and 101.69km/h when the shoulder width was 3.0m and as a result of conducting t-test analysis, the p-value appeared as more than 0.05 in the significance level of 95%, so it was statistically insignificant. Also, as a result of analyzing the speed deviation between the average driving speed of the analyzed interval and the average driving speed upon entering the tunnel, it was displayed as 3.06km/h when the shoulder width was 2.5m and 1.87km/h when the shoulder width was 3.0m and as a result of conducting t-test analysis, the p-value appeared as less than 0.05 in the significance level of 95%, so it was statistically significant. This means that when the shoulder width is 3.0m, there is stability in terms of the driving stability compared to when it is 2.5m. Therefore, it is considered that when new roads are constructed in Korea, the right shoulder width should be installed as 3.0m to enhance the driving stability.

Keywords: driving stability, shoulder width, tunnel, virtual reality driving simulator

Procedia PDF Downloads 175

Authors: Aboli Dhanavade, Shweta Bhimnath, Rutuja Jumale, Ajay Nadargi

Abstract:

Security to any of our personal thing is our most basic need. It is not possible to directly apply that standard Human-computer—interaction approaches. Important usability goal for authentication system is to support users in selecting best passwords. Users often select text-passwords that are easy to remember, but they are more open for attackers to guess. The human brain is good in remembering pictures rather than textual characters. So the best alternative is being designed that is Graphical passwords. However, Graphical passwords are still immature. Conventional password schemes are also vulnerable to Shoulder-surfing attacks, many shoulder-surfing resistant graphical passwords schemes have been proposed. Next, we have analyzed the security and usability of the proposed scheme, and show the resistance of the proposed scheme to shoulder-surfing and different accidental logins.

Keywords: shoulder-surfing, security, authentication, text-passwords

Procedia PDF Downloads 331

Authors: Narupon Kunbootsri, J. Kraipoj, K. Phandech, P. Sirasaporn

Abstract:

Physiotherapy is one of the treatments for frozen shoulder but there was no data about the treatment of physiotherapy. Moreover, it is question about onset of symptom before physiotherapy program and obtaining physical modalities and delayed start physiotherapy program lead to delayed improvement. Thus the aim of this study was to investigate physiotherapy program for frozen shoulder on pain score, onset of symptom and obtaining physical modalities. A retrospective study design was conducted. 182 medical records of patients with frozen shoulder were reviewed. These frozen shoulders were treated at physiotherapy unit, department of Rehabilitation last 3 years (January, 2014- December, 2016). The data consist of onset of symptom, pain score and obtaining physical modalities were recorded. There was a statistically significant improve in pain score, pretreatment score mean 7.24±1.52 and the last follow up pain score mean 3.88± 1.0 [mean difference 3.18 with 95%CI were [2.45- 3.92]. In addition, the onset of symptoms was 145 days before obtaining physiotherapy program. The physical modalities used frequently were hot pack 14.8% and ultrasound diathermy 13.7%. In conclusion, the retrospective study show physiotherapy program including, hot pack and ultrasound diathermy seem to be useful for frozen shoulder in term of pain score. But onset of symptom is too long to start physiotherapy programs.

Keywords: frozen shoulder, physiotherapy, pain score, onset of symptom, physical modality

Procedia PDF Downloads 148

Authors: Amanpreet Kaur

Abstract:

Wavelet transform (WT) is a powerful statistical tool used in applied mathematics for signal and image processing. The different mother, wavelet basis function, has been compared to select the optimal wavelet function that represents the electromyogram signal characteristics of upper limb amputees. Four different EMG electrode has placed on different location of shoulder muscles. Twenty one wavelet functions from different wavelet families were investigated. These functions included Daubechies (db1-db10), Symlets (sym1-sym5), Coiflets (coif1-coif5) and Discrete Meyer. Using mean square error value, the significance of the mother wavelet functions has been determined for teres, pectorals, and infraspinatus around shoulder muscles. The results show that the best mother wavelet is the db3 from the Daubechies family for efficient classification of the signal.

Keywords: Daubechies, upper limb amputation, shoulder muscles, Symlets, Coiflets

Procedia PDF Downloads 214

Authors: Dechen Tshering Vogel, Johannes T. Heverhagen, Bernard Kiss, Spyridon Arampatzis

Abstract:

In addition to computed tomography (CT), contrast enhanced ultrasound (CEUS), and magnetic resonance imaging (MRI) are being increasingly used for imaging of renal lesions. The aim of this prospective study was to compare the classification of complex cystic renal lesions using the Bosniak classification with CEUS and MRI to CT. Forty-eight patients with 65 cystic renal lesions were included in this study. All participants signed written informed consent. The agreement between the Bosniak classifications of complex renal lesions ( ≥ BII-F) on CEUS and MRI were compared to that of CT and were tested using Cohen’s Kappa. Sensitivity, specificity, positive and negative predictive values (PPV/NPV) and the accuracy of CEUS and MRI compared to CT in the detection of complex renal lesions were calculated. Twenty-nine (45%) out of 65 cystic renal lesions were classified as complex using CT. The agreement between CEUS and CT in the classification of complex cysts was fair (agreement 50.8%, Kappa 0.31), and was excellent between MRI and CT (agreement 93.9%, Kappa 0.88). Compared to CT, MRI had a sensitivity of 96.6%, specificity of 91.7%, a PPV of 54.7%, and an NPV of 54.7% with an accuracy of 63.1%. The corresponding values for CEUS were sensitivity 100.0%, specificity 33.3%, PPV 90.3%, and NPV 97.1% with an accuracy 93.8%. The classification of complex renal cysts based on MRI and CT scans correlated well, and MRI can be used instead of CT for this purpose. CEUS can exclude complex lesions, but due to higher sensitivity, cystic lesions tend to be upgraded. However, it is useful for initial imaging, for follow up of lesions and in those patients with contraindications to CT and MRI.

Keywords: Bosniak classification, computed tomography, contrast enhanced ultrasound, cystic renal lesions, magnetic resonance imaging

Procedia PDF Downloads 115

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 403

Authors: Xiao Zhou, Kazuhiro Imai, Xiaoxuan Liu

Abstract:

Badminton is one type of racket sports that requires repetitive overhead motion, with the shoulder in abduction/external rotation and requires players to perform jumps, lunges, and quick directional changes. These characteristics could be stressful for body regions that may cause badminton injuries. Regarding racket players including badminton players, there have not been any studies that have utilized medical check-up to evaluate epidemiology and mechanism of injuries. In addition, epidemiology of badminton injury in school age badminton players is unknown. The first purpose of this study was to investigate the badminton injuries, physical fitness parameters, and intensity of shoulder pain using medical check-up so that the mechanisms of shoulder injuries might be revealed. The second purpose of this study was to survey the distribution of badminton injuries in elementary school age players so that injury prevention can be implemented as early as possible. The results of this study revealed that shoulder pain occurred in all players, and present shoulder pain players had smaller weight, greater shoulder external rotation (ER) gain, significantly thinner circumference of upper limbs and greater trunk extension. Identifying players with specific of these factors may enhance the prevention of badminton injury. This study also shows that there are high incidences of knee, ankle, plantar, and shoulder injury or pain in elementary school age badminton players. Injury prevention program might be implemented for elementary school age players.

Keywords: badminton injury, epidemiology, medical check-up, school age players

Procedia PDF Downloads 109

Authors: F. Bringby, A. Nordin, L. Björnådal, E. Svenungsson, C. Boström, H Alexanderson

Abstract:

Patients with systemic sclerosis (SSc) have reduced hand function and self-reported limitations in daily activities. Few studies have explored limitations in shoulder-arm mobility and muscle function, or if there are differences in physical function between diffuse cutaneous (dcSSc) and limited cutaneous (lcSSc) SSc. The purpose of this study was to describe objectively assessed shoulder-arm mobility, lower extremity muscle function and muscle endurance in SSc and evaluate possible differences between lcSSc and dcSSc. 121 patients with SSc were included in this cross sectional study. Shoulder-arm mobility were examined using the Shoulder Function Assessment Scale (SFA) including 5 tasks ,lower extremity muscle function was measured by Timed stands test (TST) and muscle endurance in shoulder- and hip flexors were assessed by the Functional Index 2 (FI-2). Patients with dcSSc had median SFA hand to back score 5 (4-6) and median “hand to seat” score of 5 (4-6) compared to patients with lcSSc with corresponding median values of 6 (4-6) and 6 (5-6) respectively (p<0.01-p<0.05). 50% of both patientsgroups had lower muscle function assessed by the TST compared to age- and gender matched reference values but there were no differences in TST between the two patient groups. There was no difference in FI-2 scores between dcSSc and lcSSc. The whole group had 40 (28-83) % and 38 (32-72) % of maximal FI-2 shoulder flexion score on the right and left sides, and 40 (23-63) % and 37 (23-62) % of maximal FI-2 hip flexion score on the right and left sides. Reference values for the FI-2 indicate that healthy individuals perform in mean 100 % of maximal score. Patients with dcSSc were more limited than patients with lcSSc. Patients with SSc have reduced muscle function compared to reference values. These results highlights the importance of assessing shoulder-arm mobility and muscle function as well as a need for further research to identify exercise interventions to target these limitations.

Keywords: diffuse, limited, mobility, muscle function, physical therapy, systemic sclerosis

Procedia PDF Downloads 366

Authors: Mohammed Moustafa, Khaled Ayad, Waleed Reda

Abstract:

Shoulder impingement syndrome is the most common disorder of the shoulder, resulting in functional loss and disability. Objective: This study was designed to compare between the effects of scapular muscle training versus rhythmic stabilization exercises in treatment of shoulder impingement syndrome. Methods: Thirty patients participated in this study; they were assigned randomly into two experimental groups. The first experimental group (A) consisted of 15 patients with a mean age (21.87±2.72) years; they received graduated rhythmic stabilization exercises and stretching of the posterior capsule. The second experimental group (B) consisted of 15 patients with a mean age (22.27±2.94) years; they received scapular muscle training exercises in addition to stretching of the posterior capsule. Treatment was given three times per week, every other day, for four consecutive weeks. Patients have been evaluated pretreatment and post treatment for shoulder pain severity and functional disability. Results: Both groups showed highly statistical significant reduction in pain severity and functional disability measured post-treatment when compared with their corresponding values in pretreatment assessment. Conclusion: Both of rhythmic stabilization exercises and scapular muscle training are effective interventions to reduce shoulder pain severity and functional disability.

Keywords: impingement syndrome, scapular exercises, rhythmic stabilization exercises, posterior capsule stretch

Procedia PDF Downloads 213

Authors: Aniqa Jabeen

Abstract:

The aim of this study was to evaluate the effectiveness of Tc-99m MIBI (Technetium 99-methoxy-iso-butyl-isonitrile) scintigraphy to differentiate malignancies from benign lesions, which were detected on planar bone scans. Materials and Methods: 59 patients with bone lesions were enrolled in the study. The scintigraphic findings were compared with the clinical, radiological and the histological findings. Each patient initially underwent a three-phase bone scan with Tc-99m MDP (Methylene Diphosphonate) and if evidence of lesion found, the patient then underwent a dynamic and static MIBI scintigraphy after three to four days. The MDP and MIBI scans were evaluated visually and quantitatively. For quantitative analysis count ratios of lesions and contralateral normal side (L/C) were taken by region of interests drawn on scans. The Student T test was applied to assess the significant difference between benign and malignant lesions p-value < 0.05 was considered significant. Result: The MDP scans showed the increase tracer uptake, but there was no significant difference between benign and malignant uptake of the radiotracer. However significant difference (p-value 0.015), in uptake was seen in malignant (L/C = 3.51 ± 1.02) and benign lesion (L/C = 2.50±0.42) on MIBI scan. Three of thirty benign lesions did not show significant MIBI uptake. Seven malignant appeared as false negatives. Specificity of the scan was 86.66%, and its Negative Predictive Value (NPV) was 81.25% whereas the sensitivity of scan was 79.31%. In excluding the axial metastasis from the lesions, the sensitivity of MIBI scan increased to 91.66% and the NPV also increased to 92.85%. Conclusion: MIBI scintigraphy provides its usefulness by distinguishing malignant from benign lesions. MIBI also correctly identifies metastatic lesions. The negative predictive value of the scan points towards its ability to accurately diagnose the normal (benign) cases. However, biopsy remains the gold standard and a definitive diagnostic modality in musculoskeletal tumors. MIBI scan provides useful information in preoperative assessment and in distinguishing between malignant and benign lesions.

Keywords: benign, malignancies, MDP bone scan, MIBI scintigraphy

Procedia PDF Downloads 374

Authors: Wangxu Xia

Abstract:

BACKGROUND BI-RADS 4 lesions raise the possibility of malignancy that warrant further clinical and radiologic work-up. This study aimed to evaluate the predictive performance of diffusion-weighted imaging(DWI) and microcalcifications on mammography for predicting malignancy of BI-RADS 4 lesions. In addition, the predictive performance of DWI combined with microcalcifications was alsocompared with the Kaiser score. METHODS During January 2021 and June 2023, 144 patients with 178 BI-RADS 4 lesions underwent conventional MRI, DWI, and mammography were included. The lesions were dichotomized intobenign or malignant according to the pathological results from core needle biopsy or surgical mastectomy. DWI was performed with a b value of 0 and 800s/mm2 and analyzed using theapparent diffusion coefficient, and a Kaiser score > 4 was considered to suggest malignancy. Thediagnostic performances for various diagnostic tests were evaluated with the receiver-operatingcharacteristic (ROC) curve. RESULTS The area under the curve (AUC) for DWI was significantly higher than that of the of mammography (0.86 vs 0.71, P<0.001), but was comparable with that of the Kaiser score (0.86 vs 0.84, P=0.58). However, the AUC for DWI combined with mammography was significantly highthan that of the Kaiser score (0.93 vs 0.84, P=0.007). The sensitivity for discriminating malignant from benign BI-RADS 4 lesions was highest at 89% for Kaiser score, but the highest specificity of 83% can be achieved with DWI combined with mammography. CONCLUSION DWI combined with microcalcifications on mammography could discriminate malignant BI-RADS4 lesions from benign ones with a high AUC and specificity. However, Kaiser score had a better sensitivity for discrimination.

Keywords: MRI, DWI, mammography, breast disease

Procedia PDF Downloads 22

Authors: Hakim Derradji, Abdelkader Yahi, Abdelmalek Sabrou, Nacer Tabet

Abstract:

Introduction: Cystic lesions located in the sellar and suprasellar region cause a diagnostic and therapeutic problem, given their location and their impact on neighboring structures. The patient's symptomatology varies from a simple headache to serious visual and endocrine disorders, involving the functional prognosis, sometimes even the vital prognosis. Surgery in this region remains a therapeutic challenge, and several surgical techniques have been described and used. Material and Methods: We treated 15 patients during the period from 2015 to 2022, whose clinical, biological, radiological, and therapeutic characteristics will be presented in detail in this work, and in whom the surgical technique differs from one case to another. Conclusion: We will discuss in this work the different techniques used to treat these lesions and the different objectives to be achieved for each case, as well as the complications and our conduct to be taken per and post-operative.

Keywords: cystic lesions, adenomas, sellar and suprasellar region, neuroendoscopy

Procedia PDF Downloads 65