Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 37

Search results for: lumbar spine.

37 Spine Evaluation Device with Visual Feedback

Authors: T. Hirata, G. H. Yokoyama, L. H. M. Duque

Abstract:

The posteroanterior manipulation technique is usually include in the procedure of the lumbar spine to evaluate the intervertebral motion according to mechanical resistance. The mechanical device with visual feedback was proposed that allows one to analysis the lumbar segments mobility “in vivo" facilitating for the therapist to take its treatment evolution. The measuring system uses load cell and displacement sensor to estimate spine stiffness. In this work, the device was tested by 2 therapists, female, applying posteroanterior force techniques to 5 volunteers, female, with frequency of approximately 1.2-1.8 Hz. A test-retest procedure was used for 2 periods of day. The visual feedback results small variation of forces and cycle time during 6 cycles rhythmic application. The stiffness values showed good agreement between test-retest procedures when used same order of maximum forces.

Keywords: Biomechanics, lumber spine stiffness, intervertebral manipulation device, visual feedback

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36 Construction and Validation of a Hybrid Lumbar Spine Model for the Fast Evaluation of Intradiscal Pressure and Mobility

Authors: Ali Hamadi Dicko, Nicolas Tong-Yette, Benjamin Gilles, François Faure, Olivier Palombi

Abstract:

A novel hybrid model of the lumbar spine, allowing fast static and dynamic simulations of the disc pressure and the spine mobility, is introduced in this work. Our contribution is to combine rigid bodies, deformable finite elements, articular constraints, and springs into a unique model of the spine. Each vertebra is represented by a rigid body controlling a surface mesh to model contacts on the facet joints and the spinous process. The discs are modeled using a heterogeneous tetrahedral finite element model. The facet joints are represented as elastic joints with six degrees of freedom, while the ligaments are modeled using non-linear one-dimensional elastic elements. The challenge we tackle is to make these different models efficiently interact while respecting the principles of Anatomy and Mechanics. The mobility, the intradiscal pressure, the facet joint force and the instantaneous center of rotation of the lumbar spine are validated against the experimental and theoretical results of the literature on flexion, extension, lateral bending as well as axial rotation. Our hybrid model greatly simplifies the modeling task and dramatically accelerates the simulation of pressure within the discs, as well as the evaluation of the range of motion and the instantaneous centers of rotation, without penalizing precision. These results suggest that for some types of biomechanical simulations, simplified models allow far easier modeling and faster simulations compared to usual full-FEM approaches without any loss of accuracy.

Keywords: Hybrid, modeling, fast simulation, lumbar spine.

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35 Bone Mineral Density and Trabecular Bone Score in Ukrainian Men with Obesity

Authors: Vladyslav Povoroznyuk, Anna Musiienko, Nataliia Dzerovych, Roksolana Povoroznyuk

Abstract:

Osteoporosis and obesity are widespread diseases in people over 50 years associated with changes in structure and body composition. Нigher body mass index (BMI) values are associated with greater bone mineral density (BMD). However, trabecular bone score (TBS) indirectly explores bone quality, independently of BMD. The aim of our study was to evaluate the relationship between the BMD and TBS parameters in Ukrainian men suffering from obesity. We examined 396 men aged 40-89 years. Depending on their BMI all the subjects were divided into two groups: Group I – patients with obesity whose BMI was ≥ 30 kg/m2 (n=129) and Group II – patients without obesity and BMI of < 30 kg/m2 (n=267). The BMD of total body, lumbar spine L1-L4, femoral neck and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS of L1- L4 was assessed by means of TBS iNsight® software installed on DXA machine (product of Med-Imaps, Pessac, France). In general, obese men had a significantly higher BMD of lumbar spine L1-L4, femoral neck, total body and ultradistal forearm (p < 0.001) in comparison with men without obesity. The TBS of L1-L4 was significantly lower in obese men compared to non-obese ones (p < 0.001). BMD of lumbar spine L1-L4, femoral neck and total body significantly differ in men aged 40-49, 50-59, 60-69, and 80-89 years (p < 0.05). At the same time, in men aged 70-79 years, BMD of lumbar spine L1-L4 (p=0.46), femoral neck (p=0.18), total body (p=0.21), ultra-distal forearm (p=0.13), and TBS (p=0.07) did not significantly differ. A significant positive correlation between the fat mass and the BMD at different sites was observed. However, the correlation between the fat mass and TBS of L1-L4 was also significant, though negative.

Keywords: Bone mineral density, trabecular bone score, obesity, men.

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34 Concept of Transforaminal Lumbar Interbody Fusion Cage Insertion Device

Authors: Sangram A. Sathe, Neha A. Madgulkar, Shruti S. Raut, S. P. Wadkar

Abstract:

Transforaminal lumbar interbody fusion (TLIF) surgeries have nowadays became popular for treatment of degenerated spinal disorders. The interbody fusion technique like TLIF maintains load bearing capacity of the spine and a suitable disc height. Currently many techniques have been introduced to cure Spondylolisthesis. This surgery provides greater rehabilitation of degenerative spines. While performing this TLIF surgery existing methods use guideway, which is a troublesome surgery technique as the use of two separate instruments is required to perform this surgery. This paper presents a concept which eliminates the use of guideway. This concept also eliminates problems that occur like reverting the cage. The concept discussed in this paper also gives high accuracy while performing surgery.

Keywords: Degenerative disc diseases, pedicle screw, spine, spondylolisthesis, transforaminal lumbar interbody fusion.

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33 Simulating Dynamics of Thoracolumbar Spine Derived from Life MOD under Haptic Forces

Authors: K. T. Huynh, I. Gibson, W. F. Lu, B. N. Jagdish

Abstract:

In this paper, the construction of a detailed spine model is presented using the LifeMOD Biomechanics Modeler. The detailed spine model is obtained by refining spine segments in cervical, thoracic and lumbar regions into individual vertebra segments, using bushing elements representing the intervertebral discs, and building various ligamentous soft tissues between vertebrae. In the sagittal plane of the spine, constant force will be applied from the posterior to anterior during simulation to determine dynamic characteristics of the spine. The force magnitude is gradually increased in subsequent simulations. Based on these recorded dynamic properties, graphs of displacement-force relationships will be established in terms of polynomial functions by using the least-squares method and imported into a haptic integrated graphic environment. A thoracolumbar spine model with complex geometry of vertebrae, which is digitized from a resin spine prototype, will be utilized in this environment. By using the haptic technique, surgeons can touch as well as apply forces to the spine model through haptic devices to observe the locomotion of the spine which is computed from the displacement-force relationship graphs. This current study provides a preliminary picture of our ongoing work towards building and simulating bio-fidelity scoliotic spine models in a haptic integrated graphic environment whose dynamic properties are obtained from LifeMOD. These models can be helpful for surgeons to examine kinematic behaviors of scoliotic spines and to propose possible surgical plans before spine correction operations.

Keywords: Haptic interface, LifeMOD, spine modeling.

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32 Development of Anterior Lumbar Interbody Fusion (ALIF) PEEK Cage Based On the Korean Lumbar Anatomical Information

Authors: Chang Soo Chon, Cheol Woong Ko, Han Sung Kim

Abstract:

The aim of this study is to develop an anterior lumbar interbody fusion (ALIF) PEEK cage suitable for Korean people. In this study, CT images were obtained from Korean male (173cm, 71kg) and 3D Korean lumbar models were reconstructed based on the CT images to investigate anatomical characteristics. Major design parameters of anterior lumbar interbody fusion (ALIF) PEEK Cage were selected using the morphological measurement information of the Korean Lumbar models. Through finite element analysis and mechanical tests, the developed ALIFPEEK Cage prototype was compared with the Fidji Cage (Zimmer. Inc, USA) and it was found that the ALIF prototype showed similar and/or superior mechanical performance compared to the FidJi Cage. Also, clinical validation for the ALIF PEEK Cage prototype was carried out to check predictable troubles in surgical operations. Finally, it is considered that the convenience and stability of the prototype was clinically verified.

Keywords: Interbody fusion, PEEK, implant, finite element analysis, lumbar, spine.

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31 Bone Mineral Density and Trabecular Bone Score in Ukrainian Women with Obesity

Authors: Vladyslav Povoroznyuk, Nataliia Dzerovych, Larysa Martynyuk, Tetiana Kovtun

Abstract:

Obesity and osteoporosis are the two diseases whose increasing prevalence and high impact on the global morbidity and mortality, during the two recent decades, have gained a status of major health threats worldwide. Obesity purports to affect the bone metabolism through complex mechanisms. Debated data on the connection between the bone mineral density and fracture prevalence in the obese patients are widely presented in literature. There is evidence that the correlation of weight and fracture risk is sitespecific. This study is aimed at determining the connection between the bone mineral density (BMD) and trabecular bone score (TBS) parameters in Ukrainian women suffering from obesity. We examined 1025 40-89-year-old women, divided them into the groups according to their body mass index: Group A included 360 women with obesity whose BMI was ≥30 kg/m2, and Group B – 665 women with no obesity and BMI of <30 kg/m2. The BMD of total body, lumbar spine at the site L1-L4, femur and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS of L1- L4 was assessed by means of TBS iNsight® software installed on our DXA machine (product of Med-Imaps, Pessac, France). In general, obese women had a significantly higher BMD of lumbar spine, femoral neck, proximal femur, total body and ultradistal forearm (p<0.001) in comparison with women without obesity. The TBS of L1-L4 was significantly lower in obese women compared to nonobese women (p<0.001). The BMD of lumbar spine, femoral neck and total body differed to a significant extent in women of 40-49, 50- 59, 60-69 and 70-79 years (p<0.05). At same time, in women aged 80-89 years the BMD of lumbar spine (p=0.09), femoral neck (p=0.22) and total body (p=0.06) barely differed. The BMD of ultradistal forearm was significantly higher in women of all age groups (p<0.05). The TBS of L1-L4 in all the age groups tended to reveal the lower parameters in obese women compared with the nonobese; however, those data were not statistically significant. By contrast, a significant positive correlation was observed between the fat mass and the BMD at different sites. The correlation between the fat mass and TBS of L1-L4 was also significant, although negative. Women with vertebral fractures had a significantly lower body weight, body mass index and total body fat mass in comparison with women without vertebral fractures in their anamnesis. In obese women the frequency of vertebral fractures was 27%, while in women without obesity – 57%.

Keywords: Bone mineral density, trabecular bone score, obesity, women.

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30 Associations between Metabolic Syndrome and Bone Mineral Density and Trabecular Bone Score in Postmenopausal Women with Non-Vertebral Fractures

Authors: Vladyslav Povoroznyuk, Larysa Martynyuk, Iryna Syzonenko, Liliya Martynyuk

Abstract:

Medical, social, and economic relevance of osteoporosis is caused by reducing quality of life, increasing disability and mortality of the patients as a result of fractures due to the low-energy trauma. This study is aimed to examine the associations of metabolic syndrome components, bone mineral density (BMD) and trabecular bone score (TBS) in menopausal women with non-vertebral fractures. 1161 menopausal women aged 50-79 year-old were examined and divided into three groups: A included 419 women with increased body weight (BMI - 25.0-29.9 kg/m2), B – 442 females with obesity (BMI >29.9 kg/m2)i and C – 300 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). BMD of lumbar spine (L1-L4), femoral neck, total body and forearm was investigated with usage of dual-energy X-ray absorptiometry. The bone quality indexes were measured according to Med-Imaps installation. All analyses were performed using Statistical Package 6.0. BMD of lumbar spine (L1-L4), femoral neck, total body, and ultradistal radius was significant higher in women with obesity and metabolic syndrome compared to the pre-obese ones (p<0.001). TBS was significantly higher in women with increased body weight compared to obese and metabolic syndrome patients. Analysis showed significant positive correlation between waist circumference, triglycerides level and BMD of lumbar spine and femur. Significant negative association between serum HDL level and BMD of investigated sites was established. The TBS (L1-L4) indexes positively correlated with HDL (high-density lipoprotein) level. Despite the fact that BMD indexes were better in women with metabolic syndrome, the frequency of non-vertebral fractures was significantly higher in this group of patients.

Keywords: Bone mineral density, trabecular bone score, metabolic syndrome, fracture.

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29 Screening Post-Menopausal Women for Osteoporosis by Complex Impedance Measurements of the Dominant Arm

Authors: Fırat Matur, Yekta Ülgen

Abstract:

Cole-Cole parameters of 40 post-menopausal women are compared with their DEXA bone mineral density measurements. Impedance characteristics of four extremities are compared; left and right extremities are statistically same, but lower extremities are statistically different than upper ones due to their different fat content. The correlation of Cole-Cole impedance parameters to bone mineral density (BMD) is observed to be higher for dominant arm. With the post-menopausal population, ANOVA tests of the dominant arm characteristic frequency, as a predictor for DEXA classified osteopenic and osteoporic population around lumbar spine, is statistically very significant. When used for total lumbar spine osteoporosis diagnosis, the area under the Receiver Operating Curve of the characteristic frequency is 0.830, suggesting that the Cole-Cole plot characteristic frequency could be a useful diagnostic parameter when integrated into standard screening methods for osteoporosis. Moreover, the characteristic frequency can be directly measured by monitoring frequency driven angular behavior of the dominant arm without performing any complex calculation.

Keywords: Bio-impedance spectroscopy, bone mineral density, characteristic frequency, osteoporosis, receiver operating curve.

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28 Factors Affecting Low Back Pain during Breastfeeding of Thai Women

Authors: N. Klinpikul, P. Srichandr, N. Poolthong, N. Thavarungkul

Abstract:

Breastfeeding has been receiving much attention of late. Prolonged sitting for breastfeeding often results in back pain of the mothers. This paper reports the findings of a study on the effect of some factors, especially lumbar support, on back pain of breastfeeding mothers. The results showed that the use of lumbar support can reduce back pain of breastfeeding mothers significantly. Back pain was found to increase with breastfeeding time and the rate of increase was lower when lumbar supports were used. When lumbar support thickness was increased gradually from zero (no support) to 11 cm., the degree of low back pain decreased; rapidly at first, then slowly, and leveled off when the thickness reached 9 cm. Younger mothers were less prone to back pain than older mothers. The implications of the findings are discussed.

Keywords: back pain, breastfeeding, lumbar support

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27 Bone Mineral Density and Frequency of Low-Trauma Fractures in Ukrainian Women with Metabolic Syndrome

Authors: Vladyslav Povoroznyuk, Larysa Martynyuk, Iryna Syzonenko, Liliya Martynyuk

Abstract:

Osteoporosis is one of the important problems in postmenopausal women due to an increased risk of sudden and unexpected fractures. This study is aimed to determine the connection between bone mineral density (BMD) and trabecular bone score (TBS) in Ukrainian women suffering from metabolic syndrome. Participating in the study, 566 menopausal women aged 50-79 year-old were examined and divided into two groups: Group A included 336 women with no obesity (BMI ≤ 29.9 kg/m2), and Group B – 230 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). Dual-energy X-ray absorptiometry was used for measuring of lumbar spine (L1-L4), femoral neck, total body and forearm BMD and bone quality indexes (last according to Med-Imaps installation). Data were analyzed using Statistical Package 6.0. A significant increase of lumbar spine (L1-L4), femoral neck, total body and ultradistal radius BMD was found in women with metabolic syndrome compared to those without obesity (p < 0.001) both in their totality and in groups of 50-59 years, 60-69 years, and 70-79 years. TBS was significantly higher in non-obese women compared to metabolic syndrome patients of 50-59 years and in the general sample (p < 0.05). Analysis showed significant positive correlation between body mass index (BMI) and BMD at all levels. Significant negative correlation between BMI and TBS (L1-L4) was established. Despite the fact that BMD indexes were significantly higher in women with metabolic syndrome, the frequency of vertebral and non-vertebral fractures did not differ significantly in the groups of patients.

Keywords: Bone mineral density, trabecular bone score, metabolic syndrome, fracture.

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26 The Effects of Pilates and McKenzie Exercises on Quality of Life and Lumbar Spine Position Sense in Patients with Low Back Pain: A Comparative Study with a 4-Week Follow-Up

Authors: Vahid Mazloum, Mansour Sahebozamani, Amirhossein Barati, Nouzar Nakhaee, Pouya Rabiei

Abstract:

Non-specific chronic low back pain (NSCLBP) is a common condition with no exact diagnosis and mechanism for its occurrence. Recently, different therapeutic exercises have taken into account to manage NSCLBP. So, the aim of this study has mainly been placed on comparing the effects of Pilates and Mackenzie exercises on quality of life (QOL) lumbar spine position sense (LSPS) in patients with NSCLBP. In this randomized clinical trial, 47 patients with NSCLBP were voluntarily divided into three groups of Pilates (n=16) (with mean age 37.1 ± 9.5 years, height 168.9 ± 7.4 cm, body mass 76.1 ± 5.9 k), McKenzie (n=15) (with mean age 42.7 ± 8.1 years, height 165.7 ± 6.8, body mass 74.1 ± 4.8 kg) and control (n=16) (with mean age 39.3 ± 9.8 years, height 168.1 ± 8.1 cm, body mass 74.2 ± 5.8 kg). Primary outcome included QOL and secondary was LSPS. Both variables were assessed by the WHOQOL-BREF questionnaires and electrogoniameter, respectively. The measurements were performed at baseline, following a 6-week intervention, and after a 4-week follow-up. The ANCOVA test at P < 0.05 was administrated to analyze the collected data using SPSS software. There was a statistically significant difference between experimental groups and the control group to improve QOL. But, no difference was seen regarding the effects of two exercises on LSPS (p < 0.05). Both Pilates and Mackenzie exercises demonstrated improvement in QOL after 6-week intervention and a 4-week follow-up while none of them considerably affected LSPS. Further studies are required to establish a supporting evidence for the effectiveness of two exercises on NSCLBP.

Keywords: Pilates, Mackenzie, proprioception, low back pain, physical health.

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25 Obesity and Bone Mineral Density in Patients with Large Joint Osteoarthritis

Authors: Vladyslav Povoroznyuk, Anna Musiienko, Nataliia Zaverukha, Roksolana Povoroznyuk

Abstract:

Along with the global aging of population, the number of people with somatic diseases is increasing, including such interrelated pathologies as obesity, osteoarthritis (OA) and osteoporosis (OP). The objective of the study is to examine the connection between body mass index (BMI), OA and bone mineral density (BMD) of lumbar spine, femoral neck and trabecular bone score (TBS) in postmenopausal women with OA. We have observed 359 postmenopausal women (50-89 years old) and divided them into four groups by age: 50-59 yrs, 60-69 yrs, 70-79 yrs and over 80 years old. In addition, according to the American College of Rheumatology (ACR) Clinical classification criteria for knee and hip OA, we divided them into 2 groups: group I – 117 females with symptomatic OA (including 89 patients with knee OA, 28 patients with hip OA) and group II –242 women with a normal functional activity of large joints. Analysis of data was performed taking into account their BMI, classified by World Health Organization (WHO). Diagnosis of obesity was established when BMI was above 30 kg/m2. In woman with obesity, a symptomatic OA was detected in 44 postmenopausal women (41.1%), a normal functional activity of large joints - in 63 women (58.9%). However, in women with normal BMI – 73 women, who account for 29.0% of cases, a symptomatic OA was detected. According to a chi-squared (χ2) test, a significantly higher level of BMI was detected in postmenopausal women with OA (χ2 = 5.05, p = 0.02). Women with a symptomatic OA had a significantly higher BMD of lumbar spine compared with women who had a normal functional activity of large joints. No significant differences of BMD of femoral necks or TBS were detected in either the group with OA or with a normal functional activity of large joints.

Keywords: Bone mineral density, BMD, body mass index, BMI, obesity, overweight, postmenopausal women, osteoarthritis.

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24 Modelling of a Stress-Strain State of Screws of Transpedicular Spine Fixation System

Authors: Oleksandr Poliakov, Genadiy Olinichenko, Yevgen Pashkov, Vadym Kramar, Mykhaylo Kalinin

Abstract:

For maintenance of a spine stability during the postoperative period a transpedicular fixing of its elements is often used. Usually the transpedicular systems are formed of rods which as a result form a design of the frame type, fastening by screws to vertebras. Such design should be rigid and perceive loadings operating from the spine without essential deformations. From the perfection point of view of known designs their stress whole, and each of elements, in particular is of interest. In this study the modeling of the transpedicular screw is performed and estimation of its deformations taking into account interaction with a vertebra body having variable structure is made.

Keywords: Spine, screw, stress-strain state, transpedicular fixation system, vertebra

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23 Long-Term Study for the Effect of Ovariectomy on Rat Bone - Use of In-Vivo Micro-CT -

Authors: Dae Gon Woo, Chang Yong Ko, Tae Woo Lee, Han Sung Kim, Beob Yi Lee

Abstract:

In the present study, changes of morphology and mechanical characteristics in the lumbar vertebrae of the ovariectomised (OVX) rat were investigated. In previous researches, there were many studies about morphology like volume fraction and trabecular thickness based on Micro - Computed Tomography (Micro - CT). However, detecting and tracking long-term changes in the trabecular bone of the lumbar vertebrae for the OVX rat were few. For this study, one female Sprague-Dawley rat was used: an OVX rat. The 4th Lumbar of the OVX rat was subjected to in-vivo micro-CT. Detecting and tracking long-term changes could be investigated in the trabecular bone of the lumbar vertebrae for an OVX rat using in-vivo micro-CT. An OVX rat was scanned at week 0 (just before surgery), at week 4, at week 8, week 16, week 22 and week 56 after surgery. Finite element (FE) analysis was used to investigate mechanical characteristics of the lumbar vertebrae for an OVX rat. When the OVX rat (at week 56) was compared with the OVX rat (at week 0), volume fraction was decreased by 80% and effective modulus was decreased by 75%.

Keywords: OVX rats, Trabecular bone, In-vivo Micro-CT, FE analysis

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22 Uniformity of Dose Distribution in Radiation Fields Surrounding the Spine using Film Dosimetry and Comparison with 3D Treatment Planning Software

Authors: Sadegh Masoudi , Vahid Fayaz , Hassan Zandi, Asieh Tavakol

Abstract:

The overall penumbra is usually defined as the distance, p20–80, separating the 20% and 80% of the dose on the beam axis at the depth of interest. This overall penumbra accounts also for the fact that some photons emitted by the distal parts of the source are only partially attenuated by the collimator. Medulloblastoma is the most common type of childhood brain tumor and often spreads to the spine. Current guidelines call for surgery to remove as much of the tumor as possible, followed by radiation of the brain and spinal cord, and finally treatment with chemotherapy. The purpose of this paper was to present results on an Uniformity of dose distribution in radiation fields surrounding the spine using film dosimetry and comparison with 3D treatment planning software.

Keywords: Absorbed Dose , Spine , Radiotherapy, 3D treatment planning software

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21 Pain and Lumbar Muscle Activation before and after Functional Task in Nonspecific Chronic Low Back Pain

Authors: Lídia E. O. Cruz, Adriano P. C. Calvo, Renato J. Soares, Regiane A. Carvalho

Abstract:

Individuals with non-specific chronic low back pain may present altered movement patterns during functional activities. However, muscle behavior before and after performing a functional task with different load conditions is not yet fully understood. The aim of this study is to analyze lumbar muscle activity before and after performing the functional task of picking up and placing an object on the ground (with and without load) in individuals with nonspecific chronic low back pain. 20 subjects with nonspecific chronic low back pain and 20 healthy subjects participated in this study. A surface electromyography was performed in the ilio-costal, longissimus and multifidus muscles to evaluate lumbar muscle activity before and after performing the functional task of picking up and placing an object on the ground, with and without load. The symptomatic participants had greater lumbar muscle activation compared to the asymptomatic group, more evident in performing the task without load, with statistically significant difference (p = 0,033) between groups for the right multifidus muscle. This study showed that individuals with nonspecific chronic low back pain have higher muscle activation before and after performing a functional task compared to healthy participants.

Keywords: Chronic low back pain, functional task, lumbar muscles, muscle activity.

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20 The Effect of Screw Parameters on Pullout Strength of Screw Fixation in Cervical Spine

Authors: S. Ritddech, P. Aroonjarattham, K. Aroonjarattham

Abstract:

The pullout strength had an effect on the stability of plate screw fixation when inserted in the cervical spine. Nine different titanium alloy bone screws were used to test the pullout strength through finite element analysis. The result showed that the Moss Miami I can bear the highest pullout force at 1,075 N, which causes the maximum von Mises stress at 858.87 MPa, a value over the yield strength of titanium. The bone screw should have large outer diameter, core diameter and proximal root radius to increase the pullout strength.

Keywords: Pullout strength, Screw parameter, Cervical spine, Finite element analysis.

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19 Local Dynamic Mechanical Properties of Native Porcine Endplate

Authors: J. Sepitka, J. Lukes, J. Reznicek

Abstract:

Hysitron TriboIndenterTM TI 950 system has been used for studying the local viscoelastic properties of porcine intervertebral disc end plate by means of nanoscale mechanical dynamic analysis. The specimen of an endplate was cut from fresh porcine vertebra dissected from 16 month animal. The lumbar spine motion segments were dissected and 5 millimeter thick plates of vertebral body, endplate and annulus fibrosus were prepared for nanoindentation. The surface of the sample was kept in physiological solution during nanoindentation experiment. We obtained mechanical characteristics of different areas of native endplate (endplate middle and vertebra and annulus fibrosus boundary).

Keywords: nanoindentation, DMA, endplate, cartilage

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18 Metal Streak Analysis with different Acquisition Settings in Postoperative Spine Imaging: A Phantom Study

Authors: N. D. Osman, M. S. Salikin, M. I. Saripan

Abstract:

CT assessment of postoperative spine is challenging in the presence of metal streak artifacts that could deteriorate the quality of CT images. In this paper, we studied the influence of different acquisition parameters on the magnitude of metal streaking. A water-bath phantom was constructed with metal insertion similar with postoperative spine assessment. The phantom was scanned with different acquisition settings and acquired data were reconstructed using various reconstruction settings. Standardized ROIs were defined within streaking region for image analysis. The result shows increased kVp and mAs enhanced SNR values by reducing image noise. Sharper kernel enhanced image quality compared to smooth kernel, but produced more noise in the images with higher CT fluctuation. The noise between both kernels were significantly different (P <0.05) with increment of noise in the bone kernel images (mean difference = 54.78). The technical settings should be selected appropriately to attain the acceptable image quality with the best diagnostic value.

Keywords: Computed tomography, metal streak, noise, CT fluctuation.

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17 Influence of Calcium Intake Level to Osteoporptic Vertebral bone and Degenerated Disc in Biomechanical Study

Authors: Dae Gon Woo, Ji Hyung Park, Chi Hoon Kim, Tae Woo Lee, Beob Yi Lee, Han Sung Kim

Abstract:

The aim of the present study is to analyze the generation of osteoporotic vertebral bone induced by lack of calcium during growth period and analyze its effects for disc degeneration, based on biomechanical and histomorphometrical study. Mechanical and histomorphological characteristics of lumbar vertebral bones and discs of rats with calcium free diet (CFD) were detected and tracked by using high resolution in-vivo micro-computed tomography (in-vivo micro-CT), finite element (FE) and histological analysis. Twenty female Sprague-Dawley rats (6 weeks old, approximate weight 170g) were randomly divided into two groups (CFD group: 10, NOR group: 10). The CFD group was maintained on a refmed calcium-controlled semisynthetic diet without added calcium, to induce osteoporosis. All lumbar (L 1-L6) were scanned by using in vivo micro-CT with 35i.un resolution at 0, 4, 8 weeks to track the effects of CFD on the generation of osteoporosis. The fmdings of the present study indicated that calcium insufficiency was the main factor in the generation of osteoporosis and it induced lumbar vertebral disc degeneration. This study is a valuable experiment to firstly evaluate osteoporotic vertebral bone and disc degeneration induced by lack of calcium during growth period from a biomechanical and histomorphometrical point of view.

Keywords: Calcium free diet, Disc degeneration, Osteoporosis, in-vivo micro-CT, Finite element analysis, Histology.

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16 Quality Evaluation of Compressed MRI Medical Images for Telemedicine Applications

Authors: Seddeq E. Ghrare, Salahaddin M. Shreef

Abstract:

Medical image modalities such as computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), X-ray are adapted to diagnose disease. These modalities provide flexible means of reviewing anatomical cross-sections and physiological state in different parts of the human body. The raw medical images have a huge file size and need large storage requirements. So it should be such a way to reduce the size of those image files to be valid for telemedicine applications. Thus the image compression is a key factor to reduce the bit rate for transmission or storage while maintaining an acceptable reproduction quality, but it is natural to rise the question of how much an image can be compressed and still preserve sufficient information for a given clinical application. Many techniques for achieving data compression have been introduced. In this study, three different MRI modalities which are Brain, Spine and Knee have been compressed and reconstructed using wavelet transform. Subjective and objective evaluation has been done to investigate the clinical information quality of the compressed images. For the objective evaluation, the results show that the PSNR which indicates the quality of the reconstructed image is ranging from (21.95 dB to 30.80 dB, 27.25 dB to 35.75 dB, and 26.93 dB to 34.93 dB) for Brain, Spine, and Knee respectively. For the subjective evaluation test, the results show that the compression ratio of 40:1 was acceptable for brain image, whereas for spine and knee images 50:1 was acceptable.

Keywords: Medical Image, Magnetic Resonance Imaging, Image Compression, Discrete Wavelet Transform, Telemedicine.

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15 Defining of the Shape of the Spine Using Moiré Method in Case of Patients with Scheuermann Disease

Authors: Petra Balla, Gabor Manhertz, Akos Antal

Abstract:

Nowadays spinal deformities are very frequent problems among teenagers. Scheuermann disease is a one dimensional deformity of the spine, but it has prevalence over 11% of the children. A traditional technology, the moiré method was used by us for screening and diagnosing this type of spinal deformity. A LabVIEW program has been developed to evaluate the moiré pictures of patients with Scheuermann disease. Two different solutions were tested in this computer program, the extreme and the inflexion point calculation methods. Effects using these methods were compared and according to the results both solutions seemed to be appropriate. Statistical results showed better efficiency in case of the extreme search method where the average difference was only 6,09⁰.

Keywords: Spinal deformity, picture evaluation, moiré method, Scheuermann disease, curve detection, moiré topography.

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14 Effect of Muscle Energy Technique on Anterior Pelvic Tilt in Lumbar Spondylosis Patients

Authors: Enas Elsayed Abutaleb, Mohamed Taher Eldesoky, Shahenda Abd El Rasol

Abstract:

Background: Muscle Energy Techniques (MET) have been widely used by manual therapists over the past years, but still limited research validated its use and there was limited evidence to substantiate the theories used to explain its effects. Objective: To investigate the effect of Muscle Energy Technique (MET) on anterior pelvic tilt in patients with lumbar spondylosis. Design: Randomized controlled trial. Subjects: Thirty patients with anterior pelvic tilt from both sexes were involved, aged between 35 to 50 years old and they were divided into MET and control groups with 15 patients in each. Methods: All patients received 3sessions/week for 4 weeks where the study group received MET, Ultrasound and Infrared, and the control group received U.S and I.R only. Pelvic angle was measured by palpation meter, pain severity by the visual analogue scale and functional disabilities by the Oswestry disability index. Results: Both groups showed significant improvement in all measured variables. The MET group was significantly better than the control group in pelvic angle, pain severity, and functional disability as p-value were (0.001, 0.0001, 0.0001) respectively. Conclusion and implication: the study group fulfilled greater improvement in all measured variables than the control group which implies that application of MET in combination with U.S and I.R were more effective in improving pelvic tilting angle, pain severity and functional disabilities than using electrotherapy only.

Keywords: Anterior pelvic tilt, lumbar spondylosis, muscle energy technique exercise, palpation meter.

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13 Computer-aided Lenke Classification of Scoliotic Spines

Authors: Neila Mezghani, Philippe Phan, Hubert Labelle, Carl Eric Aubin, Jacques de Guise

Abstract:

The identification and classification of the spine deformity play an important role when considering surgical planning for adolescent patients with idiopathic scoliosis. The subject of this article is the Lenke classification of scoliotic spines using Cobb angle measurements. The purpose is two-fold: (1) design a rulebased diagram to assist clinicians in the classification process and (2) investigate a computer classifier which improves the classification time and accuracy. The rule-based diagram efficiency was evaluated in a series of scoliotic classifications by 10 clinicians. The computer classifier was tested on a radiographic measurement database of 603 patients. Classification accuracy was 93% using the rule-based diagram and 99% for the computer classifier. Both the computer classifier and the rule based diagram can efficiently assist clinicians in their Lenke classification of spine scoliosis.

Keywords: Scoliosis, Lenke model, decision-rules, computer aided classifier.

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12 Modelling of a Biomechanical Vertebral System for Seat Ejection in Aircrafts Using Lumped Mass Approach

Authors: R. Unnikrishnan, K. Shankar

Abstract:

In the case of high-speed fighter aircrafts, seat ejection is designed mainly for the safety of the pilot in case of an emergency. Strong windblast due to the high velocity of flight is one main difficulty in clearing the tail of the aircraft. Excessive G-forces generated, immobilizes the pilot from escape. In most of the cases, seats are ejected out of the aircrafts by explosives or by rocket motors attached to the bottom of the seat. Ejection forces are primarily in the vertical direction with the objective of attaining the maximum possible velocity in a specified period of time. The safe ejection parameters are studied to estimate the critical time of ejection for various geometries and velocities of flight. An equivalent analytical 2-dimensional biomechanical model of the human spine has been modelled consisting of vertebrae and intervertebral discs with a lumped mass approach. The 24 vertebrae, which consists of the cervical, thoracic and lumbar regions, in addition to the head mass and the pelvis has been designed as 26 rigid structures and the intervertebral discs are assumed as 25 flexible joint structures. The rigid structures are modelled as mass elements and the flexible joints as spring and damper elements. Here, the motions are restricted only in the mid-sagittal plane to form a 26 degree of freedom system. The equations of motions are derived for translational movement of the spinal column. An ejection force with a linearly increasing acceleration profile is applied as vertical base excitation on to the pelvis. The dynamic vibrational response of each vertebra in time-domain is estimated.

Keywords: Biomechanical model, lumped mass, seat ejection, vibrational response.

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11 Rehabilitation Robot in Primary Walking Pattern Training for SCI Patient at Home

Authors: Taisuke Sakaki, Toshihiko Shimokawa, Nobuhiro Ushimi, Koji Murakami, Yong-Kwun Lee, Kazuhiro Tsuruta, Kanta Aoki, Kaoru Fujiie, Ryuji Katamoto, Atsushi Sugyo

Abstract:

Recently attention has been focused on incomplete spinal cord injuries (SCI) to the central spine caused by pressure on parts of the white matter conduction pathway, such as the pyramidal tract. In this paper, we focus on a training robot designed to assist with primary walking-pattern training. The target patient for this training robot is relearning the basic functions of the usual walking pattern; it is meant especially for those with incomplete-type SCI to the central spine, who are capable of standing by themselves but not of performing walking motions. From the perspective of human engineering, we monitored the operator’s actions to the robot and investigated the movement of joints of the lower extremities, the circumference of the lower extremities, and exercise intensity with the machine. The concept of the device was to provide mild training without any sudden changes in heart rate or blood pressure, which will be particularly useful for the elderly and disabled. The mechanism of the robot is modified to be simple and lightweight with the expectation that it will be used at home.

Keywords: Training, rehabilitation, SCI patient, welfare, robot.

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10 Bone Mineral Density and Quality, Body Composition of Women in the Postmenopausal Period

Authors: Vladyslav Povoroznyuk, Oksana Ivanyk, Nataliia Dzerovych

Abstract:

In the diagnostics of osteoporosis, the gold standard is considered to be bone mineral density; however, X-ray densitometry is not an accurate indicator of osteoporotic fracture risk under all circumstances. In this regard, the search for new methods that could determine the indicators not only of the mineral density, but of the bone tissue quality, is a logical step for diagnostic optimization. One of these methods is the evaluation of trabecular bone quality. The aim of this study was to examine the quality and mineral density of spine bone tissue, femoral neck, and body composition of women depending on the duration of the postmenopausal period, to determine the correlation of body fat with indicators of bone mineral density and quality. The study examined 179 women in premenopausal and postmenopausal periods. The patients were divided into the following groups: Women in the premenopausal period and women in the postmenopausal period at various stages (early, middle, late postmenopause). A general examination and study of the above parameters were conducted with General Electric X-ray densitometer. The results show that bone quality and mineral density probably deteriorate with advancing of postmenopausal period. Total fat and lean mass ratio is not likely to change with age. In the middle and late postmenopausal periods, the bone tissue mineral density of the spine and femoral neck increases along with total fat mass.

Keywords: Osteoporosis, bone tissue mineral density, bone quality, fat mass, lean mass, postmenopausal osteoporosis.

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9 Human Walking Vertical Force and Vertical Vibration of Pedestrian Bridge Induced by Its Higher Components

Authors: M. Yoneda

Abstract:

The purpose of this study is to identify human walking vertical force by using FFT power spectrum density from the experimental acceleration data of the human body. An experiment on human walking is carried out on a stationary floor especially paying attention to higher components of dynamic vertical walking force. Based on measured acceleration data of the human lumbar part, not only in-phase component with frequency of 2fw, 3fw, but also in-opposite-phase component with frequency of 0.5 fw, 1.5 fw, 2.5 fw where fw is the walking rate is observed. The vertical vibration of pedestrian bridge induced by higher components of human walking vertical force is also discussed in this paper. A full scale measurement for the existing pedestrian bridge with center span length of 33 m is carried out focusing on the resonance phenomenon due to higher components of human walking vertical force. Dynamic response characteristics excited by these vertical higher components of human walking are revealed from the dynamic design viewpoint of pedestrian bridge.

Keywords: Simplified method, Human walking vertical force, Higher component, Pedestrian bridge vibration.

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8 Bio-Psycho-Social Consequences and Effects in Fall-Efficacy Scale in Seniors Using Exercise Intervention of Motor Learning According to Yoga Techniques

Authors: Milada Krejci, Martin Hill, Vaclav Hosek, Dobroslava Jandova, Jiri Kajzar, Pavel Blaha

Abstract:

The paper declares effects of exercise intervention of the research project “Basic research of balance changes in seniors”, granted by the Czech Science Foundation. The objective of the presented study is to define predictors, which influence bio-psycho-social consequences and effects of balance ability in senior 65 years old and above. We focused on the Fall-Efficacy Scale changes evaluation in seniors. Comprehensive hypothesis of the project declares, that motion uncertainty (dyskinesia) can negatively affect the well-being of a senior in bio-psycho-social context. In total, random selection and testing of 100 seniors (30 males, 70 females) from Prague and Central Bohemian region was provided. The sample was divided by stratified random selection into experimental and control groups, who underwent input and output testing. For diagnostics the methods of Medical Anamnesis, Functional anthropological examinations, Tinetti Balance Assessment Tool, SF-36 Health Survey, Anamnestic comparative self-assessment scale were used. Intervention method called "Life in Balance" based on yoga techniques was applied in four-week cycle. Results of multivariate regression were verified by repeated measures ANOVA: subject factor, phase of intervention (between-subject factor), body fluid (within-subject factor) and phase of intervention × body fluid interaction). ANOVA was performed with a repetition involving the factors of subjects, experimental/control group, phase of intervention (independent variable), and x phase interaction followed by Bonferroni multiple comparison assays with a test strength of at least 0.8 on the probability level p < 0.05. In the paper results of the first-year investigation of the three years running project are analysed. Results of balance tests confirmed no significant difference between females and males in pre-test. Significant improvements in balance and walking ability were observed in experimental group in females comparing to males (F = 128.4, p < 0.001). In the females control group, there was no significant change in post- test, while in the female experimental group positive changes in posture and spine flexibility in post-tests were found. It seems that females even in senior age react better to incentives of intervention in balance and spine flexibility. On the base of results analyses, we can declare the significant improvement in social balance markers after intervention in the experimental group (F = 10.5, p < 0.001). In average, seniors are used to take four drugs daily. Number of drugs can contribute to allergy symptoms and balance problems. It can be concluded that static balance and walking ability of seniors according Tinetti Balance scale correlate significantly with psychic and social monitored markers.

Keywords: Exercises, balance, seniors 65+, health, mental and social balance.

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