Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 24
Filtrar
1.
IEEE Trans Image Process ; 30: 2276-2287, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33471764

RESUMEN

Higher Order Aberrations (HOAs) are complex refractive errors in the human eye that cannot be corrected by regular lens systems. Researchers have developed numerous approaches to analyze the effect of these refractive errors; the most popular among these approaches use Zernike polynomial approximation to describe the shape of the wavefront of light exiting the pupil after it has been altered by the refractive errors. We use this wavefront shape to create a linear imaging system that simulates how the eye perceives source images at the retina. With phase information from this system, we create a second linear imaging system to modify source images so that they would be perceived by the retina without distortion. By modifying source images, the visual process cascades two optical systems before the light reaches the retina, a technique that counteracts the effect of the refractive errors. While our method effectively compensates for distortions induced by HOAs, it also introduces blurring and loss of contrast; a problem that we address with Total Variation Regularization. With this technique, we optimize source images so that they are perceived at the retina as close as possible to the original source image. To measure the effectiveness of our methods, we compute the Euclidean error between the source images and the images perceived at the retina. When comparing our results with existing corrective methods that use deconvolution and total variation regularization, we achieve an average of 50% reduction in error with lower computational costs.


Asunto(s)
Ojo/diagnóstico por imagen , Procesamiento de Imagen Asistido por Computador/métodos , Modelos Biológicos , Errores de Refracción/diagnóstico por imagen , Ojo/fisiopatología , Humanos , Procedimientos Quirúrgicos Oftalmológicos , Errores de Refracción/fisiopatología , Errores de Refracción/terapia , Visión Ocular/fisiología
2.
Artículo en Inglés | MEDLINE | ID: mdl-32154240

RESUMEN

BACKGROUND: Spasticity of the upper extremity often occurs after injury to the upper motor neurons (UMN). This condition can greatly interfere with the hand positioning in space and the functional use of the arm, affecting many daily living activities including walking. As gait and balance involve the coordination of all segments of the body, the control of upper limbs movement is necessary for smooth motion and stability. The purpose of this study was to assess the effects of surgical interventions on upper extremity spasticity to gait patterns in three spastic patients, as a way to assess the effect on patient's mobility. METHODS: Three patients with an anoxic brain injury, upper extremity spasticity, and an altered gait participated in this study. A specific treatment plan based on the patient was tailored by the orthopedic hand surgeon to help release the contractures and spastic muscles. Three-dimensional gait analysis was performed before surgery, 3, 6, and 12 months postoperatively. During each experimental session, the patient walked at a self-selected pace in a straight line across four force plates embedded into the floor (Kistler®). Motion data were acquired using Vicon® Motion Capturing System. Spatiotemporal measurements as well as bilateral kinematics of the hip, knee and ankle were studied. The results from matched non-disabled controls were included as reference. RESULTS: Overtime, clinical assessment displayed recovery in hand functions and restored sensation in the fingers. Gait analysis results demonstrated overall improvements in spatiotemporal parameters, specifically in cadence and walking speed. Improvements in kinematics of the lower limbs were also evident. CONCLUSION: The results of this study indicated that, within a timeframe of one year, gait patterns improved in all patients. These observations suggest that, over time, upper limb surgery has the potential to improve the biomechanics of gait in spastic patients.

3.
Biomed Opt Express ; 9(11): 5583-5596, 2018 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-30460148

RESUMEN

The Ocular Photosensitivity Analyzer (OPA), a new automated instrument to quantify the visual photosensitivity thresholds (VPT) in healthy and light sensitive subjects, is described. The OPA generates light stimuli of varying intensities utilizing unequal ascending and descending steps to yield the VPT. The performance of the OPA was evaluated in healthy subjects, as well as light sensitive subjects with achromatopsia or traumatic brain injury (TBI). VPT in healthy, achromatopsia, and TBI subjects were 3.2 ± 0.6 log lux, 0.5 ± 0.5 log lux, and 0.4 ± 0.6 log lux, respectively. Light sensitive subjects manifested significantly lower VPT compared to healthy subjects. Longitudinal analysis revealed that the OPA reliably measured VPT in healthy subjects.

4.
J Biomech Eng ; 140(6)2018 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-29392289

RESUMEN

Percutaneous pedicle screw fixation (PPSF) is a well-known minimally invasive surgery (MIS) employed in the treatment of thoracolumbar burst fractures (TBF). However, hardware failure and loss of angular correction are common limitations caused by the poor support of the anterior column of the spine. Balloon kyphoplasty (KP) is another MIS that was successfully used in the treatment of compression fractures by augmenting the injured vertebral body with cement. To overcome the limitations of stand-alone PPSF, it was suggested to augment PPSF with KP as a surgical treatment of TBF. Yet, little is known about the biomechanical alteration occurred to the spine after performing such procedure. The objective of this study was to evaluate and compare the immediate post-operative biomechanical performance of stand-alone PPSF, stand-alone-KP, and KP-augmented PPSF procedures. Novel three-dimensional (3D) finite element (FE) models of the thoracolumbar junction that describes the fractured spine and the three investigated procedures were developed and tested under mechanical loading conditions. The spinal stiffness, stresses at the implanted hardware, and the intradiscal pressure at the upper and lower segments were measured and compared. The results showed no major differences in the measured parameters between stand-alone PPSF and KP-augmented PPSF procedures, and demonstrated that the stand-alone KP may restore the stiffness of the intact spine. Accordingly, there was no immediate post-operative biomechanical advantage in augmenting PPSF with KP when compared to stand-alone PPSF, and fatigue testing may be required to evaluate the long-term biomechanical performance of such procedures.


Asunto(s)
Análisis de Elementos Finitos , Fracturas por Compresión/cirugía , Cifoplastia , Vértebras Lumbares/cirugía , Fenómenos Mecánicos , Tornillos Pediculares , Vértebras Torácicas/cirugía , Fenómenos Biomecánicos , Fijación Interna de Fracturas , Vértebras Lumbares/lesiones , Estrés Mecánico , Vértebras Torácicas/lesiones , Resultado del Tratamiento
5.
Comput Methods Biomech Biomed Engin ; 20(13): 1412-1420, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28817960

RESUMEN

When treating thoracolumbar burst fractures (BF), short-segment posterior fixation (SSPF) represents a less invasive alternative to the traditional long-segment posterior fixation (LSPF) approach. However, hardware failure and loss of sagittal alignment have been reported in patients treated with SSPF. Including pedicle screws at the fracture level in SSPF constructs has been proposed to improve stiffness and reliability of the construct. Accordingly, the biomechanical performance of the proposed construct was compared to LSPF via a computational analysis. Pedicle screws at fracture level improved the performance of the short-segment construct. However, LSPF still represent a biomechanically superior option for treating thoracolumbar BF.


Asunto(s)
Fijación Interna de Fracturas , Vértebras Lumbares/fisiopatología , Vértebras Lumbares/cirugía , Tornillos Pediculares , Fracturas de la Columna Vertebral/fisiopatología , Fracturas de la Columna Vertebral/cirugía , Vértebras Torácicas/fisiopatología , Vértebras Torácicas/cirugía , Fenómenos Biomecánicos , Análisis de Elementos Finitos , Humanos , Presión , Reproducibilidad de los Resultados , Estrés Mecánico
6.
Accid Anal Prev ; 106: 315-326, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28692920

RESUMEN

Proper helmet fit is important for optimizing head protection during an impact, yet many motorcyclists wear helmets that do not properly fit their heads. The goals of this study are i) to quantify how a mismatch in headform size and motorcycle helmet size affects headform peak acceleration and head injury criteria (HIC), and ii) to determine if peak acceleration, HIC, and impact speed can be estimated from the foam liner's maximum residual crush depth or residual crush volume. Shorty-style helmets (4 sizes of a single model) were tested on instrumented headforms (4 sizes) during linear impacts between 2.0 and 10.5m/s to the forehead region. Helmets were CT scanned to quantify residual crush depth and volume. Separate linear regression models were used to quantify how the response variables (peak acceleration (g), HIC, and impact speed (m/s)) were related to the predictor variables (maximum crush depth (mm), crush volume (cm3), and the difference in circumference between the helmet and headform (cm)). Overall, we found that increasingly oversized helmets reduced peak headform acceleration and HIC for a given impact speed for maximum residual crush depths less than 7.9mm and residual crush volume less than 40cm3. Below these levels of residual crush, we found that peak headform acceleration, HIC, and impact speed can be estimated from a helmet's residual crush. Above these crush thresholds, large variations in headform kinematics are present, possibly related to densification of the foam liner during the impact.


Asunto(s)
Traumatismos Craneocerebrales/prevención & control , Dispositivos de Protección de la Cabeza/normas , Motocicletas , Aceleración/efectos adversos , Fenómenos Biomecánicos , Cabeza/fisiología , Dispositivos de Protección de la Cabeza/estadística & datos numéricos , Humanos
7.
Surg Endosc ; 31(11): 4805-4815, 2017 11.
Artículo en Inglés | MEDLINE | ID: mdl-28411340

RESUMEN

BACKGROUND: Laparoscopic training with visual force feedback can lead to immediate improvements in force moderation. However, the long-term retention of this kind of learning and its potential decay are yet unclear. METHODS: A laparoscopic resection task and force sensing apparatus were designed to assess the benefits of visual force feedback training. Twenty-two male university students with no previous experience in laparoscopy underwent relevant FLS proficiency training. Participants were randomly assigned to either a control or treatment group. Both groups trained on the task for 2 weeks as follows: initial baseline, sixteen training trials, and post-test immediately after. The treatment group had visual force feedback during training, whereas the control group did not. Participants then performed four weekly test trials to assess long-term retention of training. Outcomes recorded were maximum pulling and pushing forces, completion time, and rated task difficulty. RESULTS: Extreme maximum pulling force values were tapered throughout both the training and retention periods. Average maximum pushing forces were significantly lowered towards the end of training and during retention period. No significant decay of applied force learning was found during the 4-week retention period. Completion time and rated task difficulty were higher during training, but results indicate that the difference eventually fades during the retention period. Significant differences in aptitude across participants were found. CONCLUSIONS: Visual force feedback training improves on certain aspects of force moderation in a laparoscopic resection task. Results suggest that with enough training there is no significant decay of learning within the first month of the retention period. It is essential to account for differences in aptitude between individuals in this type of longitudinal research. This study shows how an inexpensive force measuring system can be used with an FLS Trainer System after some retrofitting. Surgical instructors can develop their own tasks and adjust force feedback levels accordingly.


Asunto(s)
Competencia Clínica , Retroalimentación Sensorial , Laparoscopía/educación , Adulto , Fenómenos Biomecánicos , Humanos , Masculino
8.
Comput Biol Med ; 78: 126-137, 2016 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-27697672

RESUMEN

Insulin-like growth factor-1 (IGF-1) is well-known for upregulating cell proliferation and biosynthesis of the extracellular matrix in the intervertebral disc (IVD). Pathological conditions, such as obesity or chronic kidney disease cause IGF-1 deficiency in plasma. How this deficiency impacts disc homeostasis remains unknown. Pro-anabolic approaches for the treatment of disc degeneration based on enhancing IGF-1 bioavailability to tissue-cells are considered, but knowledge of their effectiveness in enhancing cellular anabolism of a degenerated disc is limited. In this study, we developed a computational model for disc homeostasis specifically addressing the role of IGF-1 in modulating both extracellular matrix biosynthesis and cellularity in the IVD. This model was applied to investigate how changes in IGF-1 bioavailability, namely deficiency or enhancement of growth factor, affect disc health. In this study, it was found that IGF-1 deficiency mainly affects the biosynthesis of ECM components, especially in the most external regions of the IVD such as the cartilage endplates and the outer portion of annulus fibrosus. Also, a total of three approaches for increasing IGF-1 bioavailability as a therapy for degenerated IVDs were investigated. It was found that all these strategies are only beneficial to those disc regions receiving sufficient nutritional supply (i.e., the outmost IVD regions), while they exacerbate tissue degradation in malnourished regions (i.e., inner portion of the disc). This suggests that pro-anabolic growth factor-based therapies are limited in that their success strongly depends on an adequate nutritional supply to the IVD tissue, which is not guaranteed in degenerated discs.


Asunto(s)
Simulación por Computador , Factor I del Crecimiento Similar a la Insulina/metabolismo , Disco Intervertebral/fisiología , Modelos Biológicos , Disponibilidad Biológica , Biología Computacional , Matriz Extracelular/metabolismo , Homeostasis , Humanos , Factor I del Crecimiento Similar a la Insulina/fisiología , Disco Intervertebral/metabolismo
9.
J Orthop ; 13(3): 210-9, 2016 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-27408480

RESUMEN

BACKGROUND/AIMS: Loading during concurrent bending and compression associated with deadlift, hang clean and hang snatch lifts carries the potential for injury to the intervertebral discs, muscles and ligaments. This study examined the capacity of a newly developed spinal model to compute shear and compressive forces, and bending moments in lumbar spine for each lift. METHODS: Five male subjects participated in the study. The spine was modeled as a chain of rigid bodies (vertebrae) connected via the intervertebral discs. Each vertebral reference frame was centered in the center of mass of the vertebral body, and its principal directions were axial, anterior-posterior, and medial-lateral. RESULTS: The results demonstrated the capacity of this spinal model to assess forces and bending moments at and about the lumbar vertebrae by showing the variations among these variables with different lifting techniques. CONCLUSION: These results show the model's potential as a diagnostic tool.

10.
PLoS One ; 10(8): e0136137, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26301590

RESUMEN

Tobacco smoking is associated with numerous pathological conditions. Compelling experimental evidence associates smoking to the degeneration of the intervertebral disc (IVD). In particular, it has been shown that nicotine down-regulates both the proliferation rate and glycosaminoglycan (GAG) biosynthesis of disc cells. Moreover, tobacco smoking causes the constriction of the vascular network surrounding the IVD, thus reducing the exchange of nutrients and anabolic agents from the blood vessels to the disc. It has been hypothesized that both nicotine presence in the IVD and the reduced solute exchange are responsible for the degeneration of the disc due to tobacco smoking, but their effects on tissue homeostasis have never been quantified. In this study, a previously presented computational model describing the homeostasis of the IVD was deployed to investigate the effects of impaired solute supply and nicotine-mediated down-regulation of cell proliferation and biosynthetic activity on the health of the disc. We found that the nicotine-mediated down-regulation of cell anabolism mostly affected the GAG concentration at the cartilage endplate, reducing it up to 65% of the value attained in normal physiological conditions. In contrast, the reduction of solutes exchange between blood vessels and disc tissue mostly affected the nucleus pulposus, whose cell density and GAG levels were reduced up to 50% of their normal physiological levels. The effectiveness of quitting smoking on the regeneration of a degenerated IVD was also investigated, and showed to have limited benefit on the health of the disc. A cell-based therapy in conjunction with smoke cessation provided significant improvements in disc health, suggesting that, besides quitting smoking, additional treatments should be implemented in the attempt to recover the health of an IVD degenerated by tobacco smoking.


Asunto(s)
Degeneración del Disco Intervertebral/fisiopatología , Disco Intervertebral/efectos de los fármacos , Nicotina/efectos adversos , Fumar/efectos adversos , Cartílago/efectos de los fármacos , Cartílago/patología , Proliferación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Análisis de Elementos Finitos , Glicosaminoglicanos/biosíntesis , Humanos , Disco Intervertebral/fisiopatología , Degeneración del Disco Intervertebral/inducido químicamente , Modelos Teóricos , Oxígeno/metabolismo
11.
Clin Transl Sci ; 8(4): 290-7, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25996255

RESUMEN

HIV-positive patients have lower colon cancer screening rates and are at increased risk for colon adenocarcinoma. We tested a transdisciplinary prevention model to increase provider and patient adherence to screening colonoscopy. Of 1,339 HIV-positive patients with scheduled clinic appointments during the period September to November 2009, we identified 400 records of eligible patients ≥50 years and retrospectively reviewed for screening colonoscopy referral; if never referred, flagged for referral at next visit. Providers referred 43.5% (174/400) patients and 36.2% (63/174) kept appointment. Within 6 months before the study, 337 patients attended clinic and providers referred 18%. Note that 211/226 patients with flagged records attended clinic at least once during the study 6-month period and providers referred (43.6%). The referral rate for flagged records was significantly different from that for the prior 6 months (p < 0.0001). A randomized trial compared the efficacy of patient decision support versus usual care on screening adherence. Among patients randomized to intervention 17 (51.5%) compared to usual care only 16 (48.5%), intervention group showed significant adherence of 70.6% (12/17) versus 29.4% (5/16), (p = 0.024). In addition, intervention patients had good bowel preparation of 76.9% (10/13) versus usual care 23.1% (3/13), (p = 0.05). This transdisciplinary intervention model significantly increased provider and patient screening colonoscopy behavior.


Asunto(s)
Colonoscopía/estadística & datos numéricos , Infecciones por VIH/complicaciones , Cooperación del Paciente , Atención Primaria de Salud , Anciano , Neoplasias Colorrectales/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Derivación y Consulta
12.
Sports Biomech ; 14(1): 18-27, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25895607

RESUMEN

Tortuosity describes how twisted or how much curvature is present in an observed movement or path. The purpose of this study was to investigate the differences in segmental tortuosity between Star Excursion Balance Test (SEBT) reach directions. Fifteen healthy participants completed this study. Participants completed the modified three direction (anterior, posteromedial, posterolateral) SEBT with three-dimensional motion analysis using an 8 camera BTS Smart 7000DX motion analysis system. The tortuosity of stance limb retro-reflective markers was then calculated and compared between reach directions using a 1 × 3 ANOVA with repeated measures, while the relationship between SEBT performance and tortuosity was established using Pearson product moment correlations. Anterior superior iliac spine tortuosity was significantly greater (p < 0.001) and lateral knee tortuosity was lesser (p = 0.018) in the anterior direction compared to the posteromedial and posterolateral directions. In addition, second metatarsal tortuosity was greater in the anterior reach direction when compared to posteromedial direction (p = 0.024). Tortuosity is a novel biomechanical measurement technique that provides an assessment of segmental movement during common dynamic tasks such as the SEBT. This enhanced level of detail compared to more global measures of joint kinematic may provide insight into compensatory movement strategies adopted following lower extremity joint injury.


Asunto(s)
Extremidad Inferior/fisiología , Equilibrio Postural/fisiología , Adulto , Fenómenos Biomecánicos , Humanos , Movimiento , Proyectos Piloto , Estudios de Tiempo y Movimiento , Adulto Joven
13.
J Orthop ; 12(Suppl 1): S25-30, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26719625

RESUMEN

BACKGROUND/AIM: Restoration of gait mechanics after reconstruction have been associated with improved functional outcomes and increased longevity of the reconstruction. The goal of this study is to compare the gait mechanics of an allograft reconstruction of the distal femur to both metallic endoprosthetic reconstruction relative to normal control subjects. METHODS: Gait parameters were captured using motion capture system, and then analyzed and compared for patients with metallic endoprosthetic reconstructions, and patients with allograft reconstructions of the distal femur following resection of malignant bone tumor, with subjects having no history of musculoskeletal disorders serving as a control group. RESULTS: All reconstructed distal femurs following tumor resection resulted in decreased range of motion reflected in observed flexion/extension angles compared to the normal limbs. The allograft reconstructed knees demonstrated normal patterns of rotation whereas the metal subjects had abnormal patterns of rotation and statistically significant differences in rotational moments. CONCLUSION: Allograft distal femoral reconstruction after malignant excision remains a viable option for surgeons faced with problems associated with iatrogenic muscle, bone and soft tissue defects.

14.
J Biomech ; 48(2): 332-9, 2015 Jan 21.
Artículo en Inglés | MEDLINE | ID: mdl-25488135

RESUMEN

Insulin-like growth factor-1 (IGF-1) is a well-known anabolic agent in intervertebral discs (IVD), promoting both proteoglycan (PG) biosynthesis and cell proliferation. Accordingly, it is believed that IGF-1 plays a central role in IVD homeostasis. The IGF-mediated anabolic activity in IVD occurs when the growth factor, free from binding proteins (IGFBP), binds to IGF cell surface receptors (IGF-1R). Previous studies reported that, with aging, cellular expression of IGFBP increases, while that of IGF-1R decreases. Both changes in cellular signals are thought to be among the factors that are responsible for the age-related decline in IGF-mediated PG biosynthesis, which ultimately leads to disc degeneration. In this study, a computational model describing the role of IGF-1 in the homeostasis of IVD was deployed in a parametric analysis to investigate the effects of age-related changes in expression of IGF-1R and IGFBP on the IGF-mediated upregulation of PG biosynthesis and cellular proliferation. It was found that changes in the expression of IGF-1R and IGFBP mostly affected the nucleus pulposus, while in the most external disc regions (annulus fibrosus and cartilage endplates) the IVD homeostatic balance was unaltered. It was shown that a decrease of IGF-1R expression caused reduction of both PG levels and cell density in the tissue. In contrast, increase in IGFBP expression increased both PG and cell concentration, suggesting that such change in cellular signaling may be a plausible defense mechanism from age-related IVD degeneration.


Asunto(s)
Envejecimiento/metabolismo , Regulación de la Expresión Génica , Homeostasis , Factor I del Crecimiento Similar a la Insulina/metabolismo , Disco Intervertebral/citología , Disco Intervertebral/metabolismo , Modelos Biológicos , Transducción de Señal , Proliferación Celular/efectos de los fármacos , Análisis de Elementos Finitos , Humanos , Proteínas de Unión a Factor de Crecimiento Similar a la Insulina/metabolismo , Masculino , Receptor IGF Tipo 1/metabolismo
15.
J Biomech ; 47(10): 2269-76, 2014 Jul 18.
Artículo en Inglés | MEDLINE | ID: mdl-24856835

RESUMEN

The insulin-like growth factor-1 (IGF-1) is a well-known anabolic agent for intervertebral disc (IVD), promoting both proteoglycan (PG) biosynthesis and cell proliferation. Accordingly, it is believed that IGF-1 may play a central role in IVD homeostasis. Furthermore, the exogenous administration of IGF-1 has been proposed as a possible therapeutic strategy for disc degeneration. The objectives of this study were to develop a new computational framework for describing the mechanisms regulating IGF-mediated homeostasis in IVD, and to apply this numerical tool for investigating the effectiveness of exogenous administration of IGF-1 for curing disc degeneration. A diffusive-reactive model was developed for describing competitive binding of IGF-1 to its binding proteins and cell surface receptors, with the latter reaction initiating the intracellular signaling mechanism leading to PG production and cell proliferation. Because PG production increases cell metabolic rate, and cell proliferation increases nutritional demand, nutrients transport and metabolism were also included into the model, and co-regulated, together with IGF-1, IVD cellularity. The sustainability and the effectiveness of IGF-mediated anabolism were investigated for conditions of pathologically insufficient nutrient supply, and for the case of exogenous administration of IGF-1 to degenerated IVD. Results showed that pathological nutrients deprivation, by decreasing cellularity, caused a reduction of PG biosynthesis. Also, exogenous administration of IGF-1 was only beneficial in well-nourished regions of IVD, and exacerbated cell mortality in malnourished regions. These findings remark the central role of nutrition in IVD health, and suggest that adequate nutritional supply is paramount for achieving a successful IGF-based therapy for disc degeneration.


Asunto(s)
Matriz Extracelular/metabolismo , Factor I del Crecimiento Similar a la Insulina/metabolismo , Degeneración del Disco Intervertebral/tratamiento farmacológico , Degeneración del Disco Intervertebral/fisiopatología , Disco Intervertebral/fisiología , Unión Competitiva , Proliferación Celular , Supervivencia Celular , Simulación por Computador , Homeostasis , Humanos , Cinética , Modelos Teóricos , Prostaglandinas/química , Unión Proteica , Proteoglicanos/química , Transducción de Señal
16.
Biomech Model Mechanobiol ; 13(5): 945-59, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24352367

RESUMEN

The production of extracellular matrix (ECM) components of articular cartilage is regulated, among other factors, by an intercellular signaling mechanism mediated by the interaction of cell surface receptors (CSR) with insulin-like growth factor-1 (IGF-1). In ECM, the presence of binding proteins (IGFBP) hinders IGF-1 delivery to CSR. It has been reported that levels of IGF-1 and IGFBP in obese population are, respectively, lower and higher than those found in normal population. In this study, an experimental-numerical approach was adopted to quantify the effect of this metabolic alteration found in obese population on the homeostasis of femoral hip cartilage. A new computational model, based on the mechano-electrochemical mixture theory, was developed to describe competitive binding kinetics of IGF-1 with IGFBP and CSR, and associated glycosaminoglycan (GAG) biosynthesis. Moreover, a gait analysis was carried out on obese and normal subjects to experimentally characterize mechanical loads on hip cartilage during walking. This information was deployed into the model to account for effects of physiologically relevant tissue deformation on GAG production in ECM. Numerical simulations were performed to compare GAG biosynthesis in femoral hip cartilage of normal and obese subjects. Results indicated that the lower ratio of IGF-1 to IGFBP found in obese population reduces cartilage GAG concentration up to 18 % when compared to normal population. Moreover, moderate physical activity, such as walking, has a modest beneficial effect on GAG production. The findings of this study suggest that IGF-1/IGFBP metabolic unbalance should be accounted for when considering the association of obesity with hip osteoarthritis.


Asunto(s)
Cartílago Articular/fisiopatología , Cadera/fisiopatología , Obesidad/fisiopatología , Adulto , Fenómenos Biomecánicos , Simulación por Computador , Demografía , Fémur/fisiopatología , Análisis de Elementos Finitos , Marcha , Glicosaminoglicanos/metabolismo , Humanos , Proteínas de Unión a Factor de Crecimiento Similar a la Insulina/metabolismo , Factor I del Crecimiento Similar a la Insulina/metabolismo , Masculino , Análisis Numérico Asistido por Computador , Unión Proteica , Agua , Soporte de Peso , Adulto Joven
17.
Arch Phys Med Rehabil ; 93(7): 1138-46, 2012 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-22414490

RESUMEN

OBJECTIVE: To compare the impacts of Tai Chi, a standard balance exercise program, and a video game balance board program on postural control and perceived falls risk. DESIGN: Randomized controlled trial. SETTING: Research laboratory. PARTICIPANTS: Independent seniors (N=40; 72.5±8.40) began the training, 27 completed. INTERVENTIONS: Tai Chi, a standard balance exercise program, and a video game balance board program. MAIN OUTCOME MEASURES: The following were used as measures: Timed Up & Go, One-Leg Stance, functional reach, Tinetti Performance Oriented Mobility Assessment, force plate center of pressure (COP) and time to boundary, dynamic posturography (DP), Falls Risk for Older People-Community Setting, and Falls Efficacy Scale. RESULTS: No significant differences were seen between groups for any outcome measures at baseline, nor were significant time or group × time differences for any field test or questionnaire. No group × time differences were seen for any COP measures; however, significant time differences were seen for total COP, 3 of 4 anterior/posterior displacement and both velocity, and 1 displacement and 1 velocity medial/lateral measure across time for the entire sample. For DP, significant improvements in the overall score (dynamic movement analysis score), and in 2 of the 3 linear and angular measures were seen for the sample. CONCLUSIONS: The video game balance board program, which can be performed at home, was as effective as Tai Chi and the standard balance exercise program in improving postural control and balance dictated by the force plate postural sway and DP measures. This finding may have implications for exercise adherence because the at-home nature of the intervention eliminates many obstacles to exercise training.


Asunto(s)
Accidentes por Caídas/prevención & control , Equilibrio Postural/fisiología , Trastornos de la Sensación/rehabilitación , Taichi Chuan/métodos , Juegos de Video , Anciano , Anciano de 80 o más Años , Envejecimiento/fisiología , Antropometría , Ejercicio Físico/fisiología , Femenino , Estudios de Seguimiento , Evaluación Geriátrica/métodos , Humanos , Masculino , Satisfacción del Paciente , Proyectos Piloto , Medición de Riesgo , Trastornos de la Sensación/fisiopatología , Análisis y Desempeño de Tareas , Resultado del Tratamiento
18.
J Arthroplasty ; 27(3): 493.e9-493.e12, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21944370

RESUMEN

This case study presents a subject with a fused hip converted to total hip arthroplasty. Kinematic gait analysis was conducted on 3 occasions, presurgery, 4 months postsurgery, and 2.5 years postsurgery. Presurgery data showed decreased cadence and shorter step length; sound limb possessed increased hip, knee range of motion (ROM), and increased knee flexion during stance; the affected limb had minimal hip motion and normal knee ROM with abnormal pattern. At 4 months postsurgery, the sound limb showed decreased step length, whereas the affected limb showed increased knee extension during stance and increased hip ROM. Data obtained at 2.5 years postsurgery indicated decreased cadence and speed and increased ROM in both limbs. The total hip arthroplasty had provided relief of chronic back and affected hip pain and improved mobility. Gait-specific training is recommended.


Asunto(s)
Artroplastia de Reemplazo de Cadera/métodos , Marcha , Adulto , Femenino , Humanos , Cuidados Posoperatorios , Cuidados Preoperatorios
19.
Sports Biomech ; 10(4): 270-9, 2011 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22303780

RESUMEN

Coaches have identified the batter's weight shift as a critical component for promoting proper timing and balance in a baseball swing. Analysing the weight shift through maximum horizontal (Fx) and vertical (Fz) ground reaction forces (GRFs) of professional batters (N = 29; height = 185 +/- 6 cm; mass = 92 +/- 9 kg), the purpose of this study was to compare GRFs among swings against fastballs and changeups. General linear models were used to compare three conditions of interest: successful results against fastballs, successful results against changeups, and unsuccessful results against changeups. Batters had a similar loading mechanism and initial weight transfer from back foot to front foot regardless of pitch type, but peak front foot GRFx and GRFz occurred with significantly different magnitudes and at significantly different times, depending on the pitch type and hit result. Peak front foot GRFs were greater for successful swings against fastballs compared to both successful and unsuccessful swings against changeups. Peak front foot GRFs of unsuccessful swings against changeups occurred, on average, 15-20 ms earlier than successful swings against changeups and 30-35 ms earlier than successful swings against fastballs, quantifying how a changeup can disrupt the coordination of a hitter's weight shift.


Asunto(s)
Béisbol/fisiología , Movimiento/fisiología , Extremidad Superior/fisiología , Fenómenos Biomecánicos , Fenómenos Biofísicos/fisiología , Peso Corporal/fisiología , Humanos , Modelos Lineales , Masculino
20.
Clin Interv Aging ; 5: 173-80, 2010 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-20711436

RESUMEN

Although muscle power is an important factor affecting independence in older adults, there is no inexpensive or convenient test to quantify power in this population. Therefore, this pilot study examined whether regression equations for evaluating muscle power in older adults could be derived from a simple chair-rise test. We collected data from a 30-second chair-rise test performed by fourteen older adults (76 +/- 7.19 years). Average (AP) and peak (PP) power values were computed using data from force-platform and high-speed motion analyses. Using each participant's body mass and the number of chair rises performed during the first 20 seconds of the 30-second trial, we developed multivariate linear regression equations to predict AP and PP. The values computed using these equations showed a significant linear correlation with the values derived from our force-platform and high-speed motion analyses (AP: R = 0.89; PP: R = 0.90; P < 0.01). Our results indicate that lower-body muscle power in fit older adults can be accurately evaluated using the data from the initial 20 seconds of a simple 30-second chair-rise test, which requires no special equipment, preparation, or setting.


Asunto(s)
Actividades Cotidianas , Evaluación de la Discapacidad , Modelos Biológicos , Actividad Motora/fisiología , Fuerza Muscular/fisiología , Anciano , Anciano de 80 o más Años , Fenómenos Biomecánicos , Femenino , Humanos , Pierna/fisiología , Modelos Lineales , Masculino , Proyectos Piloto , Valor Predictivo de las Pruebas
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA