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1.
Neurocirugia (Astur) ; 28(1): 41-46, 2017.
Artigo em Espanhol | MEDLINE | ID: mdl-27056605

RESUMO

INTRODUCTION: Pedestrian-vehicle collisions are a leading cause of death among motor vehicle accidents. Recently, pedestrian injury research has been increased, mostly due to the implementation of European and Japanese regulations. This research presents an analysis of the main head injury vehicle sources and injury mechanisms observed in the field, posteriorly the data are compared with the current pedestrian regulations. METHODS: The analysis has been performed through an epidemiologic transversal and descriptive study, using the Pedestrian Crash Data Study (PCDS) involving 552 pedestrians, sustaining a total of 4.500 documented injuries. RESULTS: According to this research, the hood surface is responsible for only 15,1% of all the head injuries. On the other hand, the windshield glazing is responsible for 41,8%. In case of sedan vehicles the head impact location exceeds what is expected in the current regulation, and therefore no countermeasures are applied. From all the head injuries sustained by the pedestrians just 20% have the linear acceleration as isolated injury mechanism, 40% of the injuries are due to rotational acceleration. CONCLUSIONS: In this research, the importance of the rotational acceleration as injury mechanism, in case of pedestrian-vehicle collision is highlighted. In the current pedestrian regulation just the linear acceleration is addressed in the main injury criteria used for head injury prediction.


Assuntos
Acidentes de Trânsito , Traumatismos Craniocerebrais/fisiopatologia , Pedestres , Aceleração , Acidentes de Trânsito/legislação & jurisprudência , Automóveis , Fenômenos Biomecânicos , Traumatismos Craniocerebrais/epidemiologia , Traumatismos Craniocerebrais/prevenção & controle , Estudos Transversais , Bases de Dados Factuais , Desenho de Equipamento , Europa (Continente) , Humanos , Japão , Manequins , Rotação , Estados Unidos/epidemiologia
2.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38925424

RESUMO

Osteoporosis weakens the structural strength of bone to such an extent that normal daily activity may exceed the capacity of the vertebra to bear this load. Vertebral fracture and deformity is a hallmark of osteoporosis. The detriment of trabecular bone properties alone cannot explain the occurrence of osteoporotic vertebral fracture. The ability of the spine to bear and resist loads depends on the structural capacity of the vertebrae, but also on loading conditions arising from activities of daily living or low-energy trauma. This review describes the mechanical properties of the vertebral bone, the structural load-bearing capacity of the various elements forming the spine, the neuromuscular control of the trunk, as well as the biomechanics of the loads to which the spine is subjected in relation to the presence of osteoporosis and the risk of vertebral fracture. A better understanding of biomechanical factors may help to explain both the high incidence of osteoporotic vertebral fractures and their mechanism of production. Consideration of these issues may be important in the development of prevention and management strategies.

3.
Rev Esp Cir Ortop Traumatol ; 67(2): 144-152, 2023.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-35809779

RESUMO

BACKGROUND: Calcaneal fractures can be high energy intra-articular injuries associated with joint depression. Challenges to fracture reduction include lateral wall blow out, medial wall overlap, comminution and central bone loss. Secondary deformity such as hindfoot varus alters foot biomechanics. Minimally invasive approaches with indirect reduction of the calcaneal tuberosity to maintain the reduction using posterior screws is routinely being used in the treatment of joint depression fractures. Biomechanically, optimum screw numbers and configuration is not known. Biomechanical studies have evaluated and proposed different screw configurations, however, it is not clear which configuration best controls varus deformity. This study aims to determine the optimum screw configuration to control varus deformity in Sanders 2B calcaneal fractures. METHODS: Sawbone models were prepared to replicate Sanders type 2-B fracture, with central bone loss and comminution. 0.5cm medial wedge of the calcaneal tuberosity was removed to create varus instability. After stabilising posterior facet with a single 4mm partial threaded screw, and applied an 8 hole contoured plate to stabilise the angle of Gissane, inserted one or two 7mm cannulated partially threaded Charlotte™ (Wright Medical Technology, Inc. 5677 Airline Road Arlington, TN) Headless Multi-use Compression (under image guidance) extra screws to control varus and subsidence deformity of the fracture. Coronal plane displacement of the dissociated calcaneal tuberosity fragment relative to the body when applying 5N, 10N and 20N force was measured in millimetres (mm). RESULTS: 2 screws inserted (one medial screw into the sustentaculum talus from inferior to superior and, one lateral screw into the long axis anterior process) provides the least displacement (0.88±0.390 at 5N and 1.7±1.251 at 20N) and the most stable construct (p<0.05) when compared to other configurations. A single medial screw into the sustentaculum tali (conf. 3) resulted in the least stable construct and most displacement (4.04±0.971 at 5N and 11.24±7.590 at 20N) (p<0.05). CONCLUSION: This study demonstrates the optimal screw configuration to resist varus in calcaneal fractures using minimally invasive techniques. Optimal stability is achieved using 2 screws; one located along the long axis of the calcaneus (varus control) and the other placed in the short axis directed towards the posterior facet of the calcaneus (control varus and subsidence). Further cadaver research would help evaluate optimal screw placement in simulated fractures to further assess reproducibility.


Assuntos
Traumatismos do Tornozelo , Traumatismos do Pé , Fraturas Ósseas , Fraturas Cominutivas , Hallux Varus , Traumatismos do Joelho , Humanos , Fixação Interna de Fraturas/métodos , Reprodutibilidade dos Testes , , Parafusos Ósseos
4.
Rev Esp Cir Ortop Traumatol ; 67(2): T144-T152, 2023.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36528297

RESUMO

BACKGROUND: Calcaneal fractures can be high energy intra-articular injuries associated with joint depression. Challenges to fracture reduction include lateral wall blow out, medial wall overlap, comminution and central bone loss. Secondary deformity such as hindfoot varus alters foot biomechanics. Minimally invasive approaches with indirect reduction of the calcaneal tuberosity to maintain the reduction using posterior screws is routinely being used in the treatment of joint depression fractures. Biomechanically, optimum screw numbers and configuration is not known. Biomechanical studies have evaluated and proposed different screw configurations, however, it is not clear which configuration best controls varus deformity. This study aims to determine the optimum screw configuration to control varus deformity in Sanders 2B calcaneal fractures. METHODS: Sawbone models were prepared to replicate Sanders type 2-B fracture, with central bone loss and comminution. 0.5 cm medial wedge of the calcaneal tuberosity was removed to create varus instability. After stabilising posterior facet with a single 4 mm partial threaded screw, and applied an 8 hole contoured plate to stabilise the angle of Gissane, inserted one or two 7 mm cannulated partially threaded CharlotteTM (Wright Medical Technology, Memphis, USA) Headless Multi-use Compression (under image guidance) extra screws to control varus and subsidence deformity of the fracture. Coronal plane displacement of the dissociated calcaneal tuberosity fragment relative to the body when applying 5 N, 10 N and 20 N force was measured in millimetres (mm). RESULTS: 2 screws inserted (one medial screw into the sustentaculum talus from inferior to superior and, one lateral screw into the long axis anterior process) provides the least displacement (0.88 ± 0.390 at 5 N and 1.7 ± 1.251 at 20 N) and the most stable construct (p < 0.05) when compared to other configurations. A single medial screw into the sustentaculum tali (conf. 3) resulted in the least stable construct and most displacement (4.04 ± 0.971 at 5 N and 11.24 ± 7.590 at 20 N) (p < 0.05). CONCLUSION: This study demonstrates the optimal screw configuration to resist varus in calcaneal fractures using minimally invasive techniques. Optimal stability is achieved using 2 screws; one located along the long axis of the calcaneus (varus control) and the other placed in the short axis directed towards the posterior facet of the calcaneus (control varus and subsidence). Further cadaver research would help evaluate optimal screw placement in simulated fractures to further assess reproducibility.


Assuntos
Traumatismos do Tornozelo , Traumatismos do Pé , Fraturas Ósseas , Fraturas Cominutivas , Traumatismos do Joelho , Humanos , Fixação Interna de Fraturas/métodos , Reprodutibilidade dos Testes , , Parafusos Ósseos
5.
Rev Esp Cir Ortop Traumatol ; 67(1): 50-55, 2023.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-35709951

RESUMO

BACKGROUND AND OBJECTIVE: Phalangeal fractures are the most common hand fractures. In the last years, intramedullary compression screw (IMHCS) for instable transverse or short oblique proximal P1 fractures have been described. Although both anterograde (intraarticular or trans-articular) and retrograde IMHCS techniques have shown good results, no comparison between anterograde and retrograde screw in P1 fractures has been published. We sought to determine stability with retrograde IMHCS and anterograde IMHCS, both trans-articular and intra-articular technique, in a cadaveric transverse proximal P1 fracture model, at two different levels. MATERIAL AND METHODS: We performed a biomechanical study in 30 fresh-frozen human cadaveric P1 fracture model. Fracture was performed at 9-mm from the metacarpo-phalangeal (MCP) joint in 15 specimens, whereas it was done at 15 mm in the other 15. In turn, in each group, five fractures were stabilized with an anterograde intra-articular IMHCS, five with anterograde trans-articular IMHCS and other five with retrograde IMHCS. RESULTS: Anterograde IMHCS fixation in 9-mm P1 fractures (both trans- and intra-articular technique, 62.74 N and 70.86 N, respectively) was found to be more stable than retrograde IMHCS one (32.72 N) (p = 0.022). Otherwise, retrograde IMHCS fixation was found to be more stable in more distal P1 fractures (90.52 N retrograde vs. 57.64 N trans-articular vs. 42.92 N intra-articular; p = 0.20). CONCLUSIONS: Anterograde IMHCS fixation in proximal transverse P1 bone cut in a cadaveric model provides more stability than retrograde IMHCS, while retrograde screw provides more stability when the bone cut is located more distal.


Assuntos
Fixação Intramedular de Fraturas , Fraturas Ósseas , Traumatismos da Mão , Humanos , Fraturas Ósseas/cirurgia , Parafusos Ósseos , Articulações , Cadáver , Fixação Intramedular de Fraturas/métodos , Fenômenos Biomecânicos , Fixação Interna de Fraturas/métodos
6.
Rev Esp Cir Ortop Traumatol ; 67(1): T50-T55, 2023.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36243394

RESUMO

BACKGROUND AND OBJECTIVE: Phalangeal fractures are the most common hand fractures. In the last years, intramedullary compression screw (IMHCS) for instable transverse or short oblique proximal P1 fractures have been described. Although both anterograde (intraarticular or trans-articular) and retrograde IMHCS techniques have shown good results, no comparison between anterograde and retrograde screw in P1 fractures has been published. We sought to determine stability with retrograde IMHCS and anterograde IMHCS, both trans-articular and intra-articular technique, in a cadaveric transverse proximal P1 fracture model, at two different levels. MATERIAL AND METHODS: We performed a biomechanical study in 30 fresh-frozen human cadaveric P1 fracture model. Fracture was performed at 9-mm from the metacarpo-phalangeal (MCP) joint in 15 specimens, whereas it was done at 15mm in the other 15. In turn, in each group, five fractures were stabilised with an anterograde intra-articular IMHCS, five with anterograde trans-articular IMHCS and other five with retrograde IMHCS. RESULTS: Anterograde IMHCS fixation in 9-mm P1 fractures (both trans- and intra-articular technique, 62.74N and 70.86N, respectively) was found to be more stable than retrograde IMHCS one (32.72N) (p=0.022). Otherwise, retrograde IMHCS fixation was found to be more stable in more distal P1 fractures (90.52N retrograde vs. 57.64N trans-articular vs. 42.92N intra-articular; p=0.20). CONCLUSIONS: Anterograde IMHCS fixation in proximal transverse P1 bone cut in a cadaveric model provides more stability than retrograde IMHCS, while retrograde screw provides more stability when the bone cut is located more distal.


Assuntos
Fixação Intramedular de Fraturas , Fraturas Ósseas , Traumatismos da Mão , Humanos , Fraturas Ósseas/cirurgia , Parafusos Ósseos , Articulações , Cadáver , Fixação Intramedular de Fraturas/métodos , Fenômenos Biomecânicos , Fixação Interna de Fraturas/métodos
7.
Cir Cir ; 91(6): 848-857, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38096874

RESUMO

The study of corneal biomechanics has become relevant in recent years due to its possible applications in the diagnosis, management, and treatment of various diseases such as glaucoma, keratorefractive surgery and different corneal diseases. The clinical biomechanical investigation has become of great importance in the setting of refractive surgery to identify patients at higher risk of developing iatrogenic ectasia. This review focuses on two of the technologies available for clinical use, the Ocular Response Analyzer (Reichert Ophthalmic Instruments, Buffalo, NY, USA) and the Corvis ST (Oculus Optikgergäte GmbH, Wetzlar, Germany). Both are non-contact tonometers that provided a clinical evaluation of corneal biomechanics. The fundamentals and main parameters of each device are described, as well as their use in eye surgery and the corneal biomechanical behavior in eye diseases. Finally, we will discuss the more recent Brillouin microscopy biomechanical analysis, and the integration Scheimpflug-based corneal tomography and biomechanical data with artificial intelligence to increase accuracy to detect risk of ectasia.


El estudio de la biomecánica corneal ha cobrado relevancia en los últimos años debido a sus posibles aplicaciones en el diagnóstico, el manejo y el tratamiento de diversas enfermedades, como glaucoma, cirugía queratorrefractiva y diferentes enfermedades corneales. La investigación de la biomecánica corneal es de mucha importancia en el contexto de cirugía refractiva, pues podría identificar pacientes en riesgo de desarrollar una ectasia corneal iatrogénica. Esta revisión se centra en dos de las tecnologías disponibles para uso clínico: el Ocular Response Analyzer (Reichert Ophthalmic Instruments, Buffalo, NY, EE. UU.) y el Corvis ST (Oculus Optikgergäte GmbH, Wetzlar, Alemania). Ambos son tonómetros de no contacto que proporcionan una evaluación clínica de la biomecánica corneal. Se describen los fundamentos y los principales parámetros de cada dispositivo, así como su uso en cirugía ocular y el comportamiento biomecánico corneal en las enfermedades oculares. Finalmente, se mencionan los dispositivos más recientes de análisis biomecánico, como la microscopía de Brillouin, así como la integración de los datos biomecánicos y topográficos basados en Scheimpflug con la inteligencia artificial para aumentar la precisión en la detección del riesgo de ectasias.


Assuntos
Inteligência Artificial , Glaucoma , Humanos , Fenômenos Biomecânicos , Dilatação Patológica , Córnea , Pressão Intraocular
8.
Rev Esp Cir Ortop Traumatol ; 67(3): 216-225, 2023.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36649756

RESUMO

INTRODUCTION AND OBJECTIVES: Distal femoral fractures represent a problem due to their high number of complications. The aim was to compare the results, complications and stability achieved with retrograde intramedullary nailing and the angular stable plate in the treatment of distal femoral diaphyseal fractures. MATERIAL AND METHOD: A clinical and experimental biomechanical study was carried out using finite elements. The results of the simulations allowed us to obtain the main results related to the stability of osteosynthesis. For clinical follow-up data, frequencies were used for qualitative variables, and Fisher's exact test and χ2 test were used to evaluate the significance of the different factors, with the condition of P<.05. RESULTS: In the biomechanical study, the retrograde intramedullar nails demonstrated superiority, obtaining lower values in terms of global displacement, maximum tension, torsion resistance, and bending resistance. In the clinical study, the rate of consolidation of the plates was lower than nails (77% vs. 96%, P=.02). The factor that most influenced the healing of fractures treated with plate were the central cortical thickness (P=.019). The factor that most influenced the healing of nail-treated fractures was the difference between the diameter of the medullary canal and the nail. CONCLUSIONS: Our biomechanical study shows that both osteosynthesis provide sufficient stability, but biomechanically behaves differently. Nails provide greater overall stability being preferable the use of long nails adjusted to the diameter of the canal. Plates form less rigid osteosynthesis, with little resistance to bending.

9.
Rev Esp Cir Ortop Traumatol ; 67(3): T216-T225, 2023.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36863523

RESUMO

INTRODUCTION AND OBJECTIVES: Distal femoral fractures represent a problem due to their high number of complications. The aim was to compare the results, complications and stability achieved with retrograde intramedullary nailing and the angular stable plate in the treatment of distal femoral diaphyseal fractures. MATERIAL AND METHOD: A clinical and experimental biomechanical study was carried out using finite elements. The results of the simulations allowed us to obtain the main results related to the stability of osteosynthesis. For clinical follow-up data, frequencies were used for qualitative variables, and Fisher's exact test and χ2 test were used to evaluate the significance of the different factors, with the condition of P<.05. RESULTS: In the biomechanical study, the retrograde intramedullar nails demonstrated superiority, obtaining lower values in terms of global displacement, maximum tension, torsion resistance, and bending resistance. In the clinical study, the rate of consolidation of the plates was lower than nails (77% vs. 96%, P=.02). The factor that most influenced the healing of fractures treated with plate were the central cortical thickness (P=.019). The factor that most influenced the healing of nail-treated fractures was the difference between the diameter of the medullary canal and the nail. CONCLUSIONS: Our biomechanical study shows that both osteosynthesis provide sufficient stability, but biomechanically behaves differently. Nails provide greater overall stability being preferable the use of long nails adjusted to the diameter of the canal. Plates form less rigid osteosynthesis, with little resistance to bending.

10.
Rehabilitacion (Madr) ; 56(3): 226-236, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-35523619

RESUMO

The main objective of the study is to analyse the scientific evolution of the research field of fibromyalgia and biomechanics. A search was carried out in Web of Science, from 1985 to 2021. With those results, a bibliometric map of keywords was created with VOSviewer. On top of that, scientific mapping and performance analysis were also conducted using SciMAT. A total of 233 articles from around the world were analysed, highlighting the production of the USA and Spain. The results show great diversity in topics with 54 different topics and 33 keywords. Although most of the topics found are not widely developed except the topics of physical activity and symptomatology. In conclusion, the study of fibromyalgia and biomechanics has generally grown over time.


Assuntos
Fibromialgia , Bibliometria , Fenômenos Biomecânicos , Humanos , Espanha
11.
Rehabilitacion (Madr) ; 56(3): 173-181, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-34511255

RESUMO

BACKGROUND AND OBJECTIVES: The aim of this study is to present a new virtual reality (VR) low cost application based on Leap Motion Controller (LMC) device for upper extremity motor rehabilitation after neurological pathology and to demonstrate its clinical feasibility by carrying out a pilot experience. MATERIAL AND METHODS: The LMC allows the interaction with virtual applications by capturing the patient's hand movements. A pilot study was carried out with 4 patients with upper limb impairment reflected with Upper Extremity Motor Score (UEMS) greater than 10. They were assessed using the Box and Block (BBT) and the writing task within the Jebsen-Taylor Hand Function (JTHF) before and after the intervention. RESULTS: All patients completed the 9-session, 30-min protocol divided into 3 sessions per week. They went from an average result of 38 (SD 20) blocks in BBT before the intervention to 44 (SD 21.72) after it. They went from 28.25 s (SD 8.61) to 26.75 s (SD 21.72) in the JTHF. Statistically significant differences were no found. The device usability was assessed by the QUEST scale, being the security, effectiveness and ease to use the aspects that patients considered to be a priority. CONCLUSIóN: A new VR development based on the LMC device is presented and the clinical feasibility of its application in neurological patients with upper limb involvement has been proven. A clinical study with a large sample size is needed to assess its potential clinical effectiveness as a treatment element.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Realidade Virtual , Terapia por Exercício/métodos , Humanos , Projetos Piloto , Reabilitação do Acidente Vascular Cerebral/métodos , Extremidade Superior
12.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33334722

RESUMO

INTRODUCTION: The purpose of this work is perform a biomechanical comparison of anatomic reconstruction of the anterior talofibular ligament (ATFL) with the intact ATFL. MATERIALS AND METHODS: We studied 18 fresh cadaveric ankles with intact ATFL. Each specimen was clinically assessed with the anterior drawer (AD) and varus tilt (VT) tests and the angular movement in the three spatial planes (axial, coronal and sagittal) was measured with an arthrometer using a sensor located in the talus. RESULTS: Statistically significant differences were found in the axial plane, between the intact ATFL versus the sectioned ATFL for AD test with p = 0.012, and for VT test with p = 0.013. Regarding the coronal plane, we also observed a statistically significant difference for VT test with p = 0.016. In the sagittal plane, there are no statistically significant differences in both maneuvers. No statistically significant differences were found when comparing the biomechanics of anatomic ligament reconstruction versus the intact ATFL. CONCLUSION: Autograft anatomic reconstruction of the ATFL showed biomechanical properties similar to those of the native ATFL, at the zero moment in a cadaveric model.

13.
Cir Cir ; 88(1): 41-48, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31967601

RESUMO

BACKGROUND: The mechanical fixation of the spine in patients with osteoporotic vertebral degeneration is a challenge for surgeons, the vertebrae selected to insert the screws may fail, endangering health and even patient's life. OBJECTIVE: The objective of the study was to study the effect of the variation of the bone density in the bone-screw interface from a three-dimensional model of the lumbar section. MATERIALS AND METHODS: The finite element method was used to model the behavior of the lumbar vertebral section when applying compression loads. RESULTS: The stresses between 2 and 3 MPa were located on the contact surface with the screw, both in the vertebral body and in the apophysis, being slightly higher in the vertebral body. CONCLUSIONS: Regardless of bone density, the contact zones between the screws are susceptible to bone tissue failure. The posterior half of the vertebral body was the most sensitive to high values of stress, while in the areas furthest from the axis of the screw stress tended to their minimum.


INTRODUCCIÓN: La fijación mecánica de la columna en pacientes con degeneración vertebral osteoporótica es un reto para los cirujanos, pues las vértebras seleccionadas para insertar los tornillos pueden fallar, poniendo en peligro la salud y la vida del paciente. OBJETIVO: Estudiar el efecto de la variación de la densidad ósea en la interfase hueso-tornillo, a partir de un modelo tridimensional de la sección lumbar. MATERIALES Y MÉTODOS: Se emplea el método de los elementos finitos para modelar el comportamiento de la sección vertebral lumbar al aplicar cargas de compresión. RESULTADOS: Los esfuerzos entre 2 y 3 MPa se ubicaron en la superficie de contacto con el tornillo, tanto en el cuerpo vertebral como en la apófisis, siendo ligeramente superiores en el cuerpo vertebral. CONCLUSIONES: Independientemente de la densidad ósea, las zonas de contacto entre el tornillo son susceptibles al fallo del tejido óseo, debido a que están próximos al esfuerzo de fallo óseo de 2.37 ± 1.14 MPa reportado en la literatura. La mitad posterior del cuerpo vertebral fue la más sensible a sufrir valores altos de esfuerzos, mientras que en las zonas más alejadas del eje del tornillo los esfuerzos tendieron a su magnitud mínima.


Assuntos
Densidade Óssea , Parafusos Ósseos , Osso e Ossos/diagnóstico por imagem , Imageamento Tridimensional/métodos , Vértebras Lombares/diagnóstico por imagem , Estresse Mecânico , Fenômenos Biomecânicos , Osso e Ossos/fisiopatologia , Análise de Elementos Finitos , Humanos , Vértebras Lombares/fisiopatologia , Osteoporose/complicações , Osteoporose/diagnóstico por imagem , Software , Fraturas da Coluna Vertebral , Fusão Vertebral/instrumentação , Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/cirurgia
14.
Arch Soc Esp Oftalmol (Engl Ed) ; 95(9): 429-438, 2020 Sep.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32576401

RESUMO

OBJECTIVE: To study the behaviour of the biomechanical properties of the cornea in DMEK (Descemet membrane endothelial keratoplasty). METHOD: Prospective longitudinal observational study. 21 pre and post-DMEK eyes. 3-month follow-up with the dynamic Scheimpflug Analyzer (Corvis ST, Oculus; Wetzlar, Germany). The following parameters were measured: IOPnc: non-corrected intraocular pressure (IOP), IOPb: IOP corrected by biomechanics, maximum deflection amplitude (DefA), CCT: central corneal pachymetry, flattening speed 1 and 2, peak distance, HC deformation amplitude: deformation amplitude in maximum concavity, integrated inverse concave radius, DAR 1 and 2: deformation amplitude at 1mm and 2mm from the corneal apex, respectively. ARTh: Ambrosial pachymetric ratio, SP1: stiffness parameter, CBI: Corvis Biomechanical index and the maximum inverse radius. Pre-operative and post-operative measurements were performed with a 3-month follow-up and compared with a paired sample t-test. RESULTS: There was a significant decrease in the IOPnc of 1.54±3mmHg (p<0.05), a significant increase in the post-surgical IOPb of 3.79±3.18mmHg (p<0.001), a significant pachymetric decrease of 164.4±91.35µm (p<0.001) after the intervention. All dynamic parameters of the Scheimpflug analyzer changed significantly after surgery (p<0.05), except the ARTh and IWC variables. CONCLUSIONS: Variables indicate a decrease in corneal strength post-DMEK, with an increase in IOPb, at least the first 3 months after surgery. This finding is especially relevant in the follow-up of patients with coexisting glaucoma.

15.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1559786

RESUMO

Introducción: El estudio de los patrones del movimiento técnico deportivo implica analizar sus componentes biomecánicos, teniendo en cuenta el carácter multifactorial del rendimiento deportivo. Objetivo: Describir la mecánica del movimiento del tiro penalti en futbolistas categorías sub-12 y sub-17. Métodos: Estudio cuasi experimental de orden correlativo. Se estudiaron ocho variables biomecánicas: centro de gravedad en sus dos ejes, inclinación corporal, ángulos femorotibial antes del contacto, ángulos femorotibial luego del contacto, velocidad, aceleración y acierto. Se seleccionaron dos grupos independientes de 30 futbolistas del género masculino, se clasificaron por categorías sub-12 y sub-17, y se analizó su rendimiento mediante videoanálisis. Resultados: Hubo diferencias significativas a favor de la categoría sub-17 en las variables centro de gravedad en el eje X (p = 0,000), en inclinación corporal (p = 0,000), en velocidad (p = 0,000), y en aceleración y acierto (p = 0,000); y diferencias no significativas en el resto (centro de gravedad eje Y: p = 0,267; ángulos femorotibial antes del contacto: p = 0,459; ángulos femorotibial luego del contacto: p = 0,446; y aciertos: p = 0,226). Conclusiones: Todos los rangos promedios sobresalieron en la categoría sub-17, excepto en la variable aciertos, lo que implicó una mayor velocidad y aceleración del pie durante la ejecución del tiro a penal. Sin embargo, la precisión, como componente coordinativo, resultó fundamental en la efectividad del disparo.


Introduction: The study of the patterns of technical sports movement involves analyzing its biomechanical components, taking into account the multifactorial nature of sports performance. Objective: To describe the mechanics of the movement of the penalty kick in U-12 and U-17 football players. Methods: Quasi-experimental study of a correlative order. Eight biomechanical variables were studied: center of gravity in its two axes, body inclination, femorotibial angles before contact, femorotibial angles after contact, speed, acceleration and success. Two independent groups of 30 male footballers were selected, classified by U-12 and U-17 categories, and their performance was analysed through video analysis. Results: There were significant differences in favor of the sub-17 category in the variables center of gravity on the X axis (p = 0.000), body inclination (p = 0.000), speed (p = 0.000), and acceleration and accuracy (p = 0.000); and non-significant differences in the rest (center of gravity Y-axis: p = 0.267; femorotibial angles before contact: p = 0.459; femorotibial angles after contact: p = 0.446; and correct answers: p = 0.226). Conclusions: All the average ranges stood out in the U-17 category, except in the variable hits, which implied a greater speed and acceleration of the foot during the execution of the penalty kick. However, accuracy, as a coordinating component, was fundamental in the effectiveness of the shot.

16.
Med. U.P.B ; 43(1): 2-10, ene.-jun. 2024. ilus, tab
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1531446

RESUMO

Objetivo: la mastectomía posterior al cáncer de seno produce diversas alteraciones posturales y biomecánicas en el plano frontal y sagital. Dichos cambios conducen a una cinemática alterada de la columna vertebral, desequilibrio muscular y alteración del soporte del peso del pie. Este estudio pretende describir las alteraciones de la baropodometría después de la mastectomía, con base en análisis baropodométricos de la presión media y la carga estática. Metodología: se realizó un estudio descriptivo correlacional. Las propiedades de carga del pie se identificaron en 17 mujeres mastectomizadas. Se utilizó una placa de presión Ecosanit Foot para medir la carga del pie en posición anatómica y con los pies juntos. Resultados: en el estudio participaron 17 mujeres mastectomizadas con una edad media de 54.16 años. Las pacientes reportaron una presión media significativamente mayor en la posición anatómica del lado dominante mastectomizado en comparación con el lado no dominante mastectomizado (227.2 ± 22.16 vs. 175.6 ± 14.95, p =0.05). No hubo diferencia significativa para la carga estática entre el lado dominante mastectomizado y el lado no dominante mastectomizado en la posición anatómica (52.43±4.069 vs. 49.69 ± 4.094, de forma respectiva). Conclusión: los resultados actuales de nuestro estudio evidenciaron la distribución desequilibrada del peso (vector carga en el pie) en pacientes después de la mastectomía. Por tanto, en este texto se describen las alteraciones posturales, musculares, y el desequilibrio estático y dinámico en pacientes con cáncer de seno.


Objective: mastectomy after breast cancer produces several postural and biomechanical alterations in the frontal and sagittal plane. Such changes lead to disturbed kinematics of the spine, muscle imbalance and altered foot weight bearing. This study aims to describe body balance alterations after mastectomy based on the baropodometric analysis of their mean pressure and static load. Methodology: a descriptive correlational research was carried out. Foot weight-bearing properties were identified in 17 patients who have undergone a mastectomy. An Ecosanit Foot pressure plate was used to measure foot load at anatomical position and keeping the feet together. Results: 17 female patients who had undergo mastectomy with a mean age of 54.16 years took part on the research. Patients who have had a dominant-side mastectomy demonstrated significant greater mean pressure at anatomical position when compared to those patients who have had a non-dominant side mastectomy (227.2 ± 22.16 versus 175.6 ± 14.95, p =0.05). There was no significant difference for static load between the patients who have had a dominant side mastectomy and patients who have had a non dominant side mastectomy at anatomical position (52.43 ± 4.069 versus 49.69 ± 4.094, respectively). Conclusion: the current results of our research showed the unbalanced weight distribution in patients after mastectomy. Consequently, it describes the postural and muscular alterations, and the static and dynamic imbalance in breast cancer patients.


Objetivo: A mastectomia após câncer de mama produz diversas alterações posturais e biomecânicas nos planos frontal e sagital. Tais mudanças levam a alteração da cinemática da coluna, desequilíbrio muscular e alteração do suporte de peso do pé. Este estudo tem como objetivo descrever as alterações baropodométricas após mastectomia, com base em análises baropodométricas de pressão média e carga estática. Metodologia: foi realizado estudo correlacional descritivo. Propriedades de carga nos pés foram identificadas em 17 mulheres mastectomizadas. Uma placa de pressão Ecosanit Foot foi usada para medir a carga do pé em posição anatômica e com os pés juntos. Resultados: participaram do estudo 17 mulheres mastectomizadas com idade média de 54,16 anos. Os pacientes relataram uma pressão média significativamente maior na posição anatômica do lado mastectomizado dominante em comparação ao lado mastectomizado não dominante (227,2 ± 22,16 vs. 175,6 ± 14,95, p =0,05). Não houve diferença significativa para a carga estática entre o lado mastectomizado dominante e o lado mastectomizado não dominante na posição anatômica (52,43 ± 4,069 vs. 49,69 ± 4,094, respectivamente). Conclusão: Os resultados atuais do nosso estudo mostraram distribuição de peso desequilibrada (carga vetorial no pé) em pacientes após mastectomia. Portanto, este texto descreve alterações posturais, musculares e desequilíbrio estático e dinâmico em pacientes com câncer de mama.


Assuntos
Humanos , Feminino
17.
Cir Cir ; 87(2): 190-195, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30768061

RESUMO

INTRODUCTION: Mini-implants are an alternative to traditional methods of anchorage in orthodontic treatment. However, there are still questions concerning their application, in particular, with the insertion angle. OBJECTIVE: To determine whether the angle of insertion of the mini-implant is a determining factor in their primary stability when they support orthodontic loads. MATERIALS AND METHODS: A finite element model (FEM) of tibia bone, spring and mini-implant was developed. The three-dimensional model of the rabbit tibia was constructed based on tomographic slices. The angles that were analyzed were 90°, 80°, 70°, 60°, 50°, 45°, 40°, and 30°. A horizontal force of 2 N applied to the head of the mini-implants was simulated. The von Mises stresses and displacements were determined using FEM. RESULTS: Von Mises stresses were lower for an insertion angle of 40° followed by 90° and 70°; likewise, the displacements of the mini-implants with respect to the spring were lower for the 40° angle followed by 90° and 70°, we found a statistically significant association between the insertion angle and displacement. CONCLUSION: All mini-implants underwent a degree of angulation and displacement; however, mini-implants inserted to the bone surface at 40° tend to have better primary stability, and they can withstand loads immediately.


INTRODUCCIÓN: Los miniimplantes son una alternativa para los métodos de anclaje tradicionales en el tratamiento de ortodoncia. Sin embargo, existen interrogantes referentes a su uso, en particular en cuanto al ángulo de inserción. OBJETIVO: ­Determinar si el ángulo de inserción es un factor determinante en la estabilidad primaria de los miniimplantes cuando soportan cargas. MÉTODO: Se desarrolló un modelo tridimensional de elementos finitos del conjunto tibia, miniimplante y resorte a partir de cortes tomográficos; finalmente, el resorte fue modelado empleando elementos de contacto. Las angulaciones analizadas fueron 90°, 80°, 70°, 60°, 50°, 45°, 40° y 30°. Una fuerza de 2 N fue aplicada a los implantes. Se determinaron los esfuerzos de von Mises y los desplazamientos empleando elementos finitos. RESULTADOS: Los esfuerzos de von Mises fueron menores para un ángulo de inserción de 40°, seguido por los de 90° y 70°; de igual forma, los desplazamientos en los miniimplantes con respecto al resorte fueron menores para un ángulo de 40°, seguido por los de 90° y 70°. CONCLUSIÓN: Todos los miniimplantes presentaron un cierto grado de angulación y desplazamiento, pero los ­insertados en la superficie ósea a 40° tienden a presentar mejor estabilidad primaria y pueden ser inmediatamente sometidos a carga.


Assuntos
Análise de Elementos Finitos , Modelos Anatômicos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Animais , Fenômenos Biomecânicos , Coelhos , Estresse Mecânico , Tíbia
18.
Braz. dent. sci ; 27(2): 1-12, 2024. ilus, tab
Artigo em Português | LILACS, BBO - odontologia (Brasil) | ID: biblio-1551332

RESUMO

Objective: In response to the demand for dental implants, extensive research has been conducted on methods for transferring load to the surrounding bone. This study aimed to evaluate the stresses on the peripheral bone, implants, and prostheses under scenarios involving of the following variables: prosthesis designs, vertical bone heights, load angles, and restorative materials. Material and Methods: Three implants were inserted in the premolar and molar regions (5-6-7) of the two mandibular models. Model 1 represented 0 mm marginal bone loss and Model 2 simulated 3 mm bone loss. CAD/CAM-supported materials, hybrid ceramic (HC), resin-nano ceramic (RNC), lithium disilicate (LiSi), zirconia (Zr), and two prosthesis designs (splinted and non-splinted) were used for the implant-supported crowns. Forces were applied vertically (90°) to the central fossa and buccal cusps and obliquely (30°) to the buccal cusps only. The stresses were evaluated using a three-dimensional Finite Element Analysis. Results: Oblique loading resulted in the highest stress values. Of the four materials, RNC showed the low stress in the restoration, particularly in the marginal area. The use of different restorative materials did not affect stress distribution in the surrounding bone. The splinted prostheses generated lower stress magnitude on the bone, and while more stress on the implants were observed. Conclusion: In terms of the stress distribution on the peri-implant bone and implants, the use of different restorative materials is not important. Oblique loading resulted in higher stress values, and the splinted prosthesis design resulted in lower stress (AU)


Objetivo: Em resposta à demanda por implantes dentários, extensa pesquisa foi realizada sobre métodos para transferir carga ao osso circundante. Este estudo buscou avaliar os estresses no osso periférico, implantes e próteses em cenários que envolvem as seguintes variáveis: designs de próteses, alturas ósseas verticais, ângulos de carga e materiais restauradores. Material e Métodos: Três implantes foram inseridos nas regiões dos pré-molares e molares (5-6-7) de dois modelos de mandíbula. O Modelo 1 representou perda óssea marginal de 0 mm e o Modelo 2 simulou perda óssea de 3 mm. Materiais suportados por CAD/CAM, cerâmica híbrida (HC), cerâmica nano-resina (RNC), dissilicato de lítio (LiSi), zircônia (Zr) e dois designs de próteses (sintetizadas e não-sintetizadas) foram utilizados para as coroas suportadas por implantes. Forças foram aplicadas verticalmente (90°) à fossa central e cúspides bucais e obliquamente (30°) apenas às cúspides bucais. Os estresses foram avaliados usando Análise de Elementos Finitos tridimensional. Resultados: Cargas oblíquas resultaram nos valores mais altos de estresse. Entre os quatro materiais, RNC mostrou baixo estresse na restauração, especialmente na área marginal. O uso de diferentes materiais restauradores não afetou a distribuição de estresse no osso circundante. Próteses sintetizadas geraram menor magnitude de estresse no osso, enquanto mais estresse nos implantes foi observado. Conclusão: Em termos de distribuição de estresse no osso peri-implantar e implantes, o uso de diferentes materiais restauradores não é crucial. Cargas oblíquas resultaram em valores mais altos de estresse, e o design de prótese sintetizada resultou em menor estresse. (AU)


Assuntos
Implantes Dentários , Prótese Dentária , Análise de Elementos Finitos , Fenômenos Biomecânicos
19.
Podium (Pinar Río) ; 18(2)ago. 2023.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1448881

RESUMO

El deporte como fenómeno social, se desarrolla en la actualidad simultáneamente con los adelantos de la ciencia y la tecnología; en este contexto, juega un papel importante la biomecánica que asegura las bases para un verdadero entrenamiento técnico, de ahí que el trabajo está dirigido al uso de la biomecánica en la técnica de pitcheo. Para dar respuesta a esta temática se concibe como objetivo aplicar estudios biomecánicos a la técnica de pitcheo en los lanzadores del equipo de béisbol La Isla de la Juventud. Se utilizaron como métodos el análisis de documentos, la revisión bibliográfica, la observación científica, la entrevista y la técnica del análisis de video con ayuda de un Dron; ello permitió medir magnitudes y valorar el comportamiento de las características que poseen los movimientos ejecutados por los lanzadores objeto de estudio. También, se emplearon dos técnicas de mediciones, una a través de la filmación y otra por procesamiento cinemático con el uso de los softwares como Tracker y Kinovea. La muestra estuvo conformada por ocho sujetos, distribuidos en tres atletas, dos entrenadores y tres investigadores; esto permitió determinar las características de la distancia de paso, ángulo que forma el brazo de lanzar con respecto a la cabeza, altura de la pelota y la velocidad de la pelota ejecutados por los lanzadores investigados.


O esporte, como fenômeno social, está se desenvolvendo simultaneamente com os avanços da ciência e da tecnologia; nesse contexto, a biomecânica desempenha um papel importante para garantir a base de um verdadeiro treinamento técnico, portanto, o trabalho visa ao uso da biomecânica na técnica de arremesso. Para responder a essa questão, o objetivo foi aplicar estudos biomecânicos à técnica de arremesso nos arremessadores do time de beisebol La Isla de la Juventud. Os métodos utilizados foram a análise de documentos, a revisão bibliográfica, a observação científica, a entrevista e a técnica de análise de vídeo com a ajuda de um drone, o que permitiu medir as magnitudes e avaliar o comportamento das características dos movimentos executados pelos arremessadores em estudo. Além disso, foram utilizadas duas técnicas de medição, uma por meio de filmagem e outra por meio de processamento cinemático com o uso de softwares como o Tracker e o Kinovea. A amostra foi composta por oito sujeitos, distribuídos em três atletas, dois técnicos e três pesquisadores, o que nos permitiu determinar as características da distância de arremesso, do ângulo do braço de arremesso em relação à cabeça, da altura da bola e da velocidade da bola executada pelos arremessadores investigados.


Sport as a social phenomenon, currently develops simultaneously with the advances of science and technology; in this context, biomechanics plays an important role that ensures the bases for true technical training; hence the work is directed to the use of biomechanics in throwing technique. To respond to this issue, the objective is to apply biomechanical studies to the throwing technique in the throwers of the La Isla de la Juventud baseball team. Document analysis, bibliographic review, scientific observation, interview and the technique of video analysis with the help of a drone were used as methods; this made it possible to measure magnitudes and assess the behavior of the characteristics of the movements executed by the throwers under study. Also, two measurement techniques were used, one through filming and the other by kinematic processing with the use of software such as Tracker and Kinovea. The sample consisted of eight subjects, divided into three athletes, two coaches and three researchers; this allowed to determine the characteristics of the throw distance, the angle formed by the throwing arm with respect to the head, the height of the ball, and the speed of the ball executed by the investigated throwers.

20.
Rev. bras. med. esporte ; 29: e2022_0536, 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1423508

RESUMO

ABSTRACT Introduction Although colleges and universities have improved their aerobic physical education systems, the teaching design has a partially scientific basis, requiring urgent updating. Objective Research means of scientific improvement to the aerobic physical education curriculum in colleges and universities. Methods A total of 594 students and 52 teacher questionnaires were collected to understand the background of the research. Four groups of athletes were selected for relevant data collection. A kinematic analysis with a reflective ball at different joints and limbs archived the main variables of the most demanded actions on a force measurement platform, which were combined with the athletes' data. Results Through the integration and analysis of the research results, this paper obtained a scientifically based training scheme with clear training objectives. It also displays a deeper understanding of the actual situation of teaching aerobic physical education in colleges and universities. Conclusion This paper designs a scientifically-based aerobics optimization scheme according to the characteristics of colleges and universities, addressing the real needs of students and promoting the improvement of aerobic physical education teaching in colleges and universities. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.


RESUMO Introdução Embora as faculdades e universidades tenham aprimorado seus sistemas de educação física aeróbica, o projeto do ensino não dispõe de um embasamento científico completo, necessitando de uma urgente atualização. Objetivo Pesquisar meios de aprimoramento científico ao currículo de educação física aeróbica em faculdades e universidades. Métodos Um total de 594 questionários de estudantes e 52 questionários de professores foram coletados para compreender o histórico da pesquisa. Quatro grupos de atletas foram selecionados para a coleta de dados relevantes. Uma análise cinemática com bola refletiva em diferentes articulações e membros, arquivou as principais variáveis das ações mais demandadas numa plataforma de medição de força, que foram combinados aos dados dos atletas. Resultados Através da integração e análise dos resultados da pesquisa, este trabalho obteve um esquema de treinamento com embasamento científico e objetivos claros de treinamento. Também exibe um entendimento mais profundo da situação real do ensino de educação física aeróbica nas faculdades e universidades. Conclusão Este documento projeta um esquema de otimização de aeróbica com embasamento científico de acordo com as características das faculdades e universidades, abordando as necessidades reais dos estudantes, promovendo a melhoria do ensino no curso de educação física aeróbica das faculdades e universidades. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.


RESUMEN Introducción Aunque los colegios y universidades han mejorado sus sistemas de educación física aeróbica, el proyecto de enseñanza no tiene una base científica completa, lo que requiere una actualización urgente. Objetivo Investigar los medios para mejorar científicamente el plan de estudios de educación física aeróbica en los colegios y universidades. Métodos Se recogieron un total de 594 cuestionarios de alumnos y 52 de profesores para conocer los antecedentes de la investigación. Se seleccionaron cuatro grupos de atletas para recoger los datos pertinentes. Un análisis cinemático con un balón reflectante en diferentes articulaciones y extremidades, archivó las principales variables de las acciones más demandadas en una plataforma de medición de fuerza, que se combinaron con los datos de los atletas. Resultados A través de la integración y el análisis de los resultados de la investigación, este trabajo obtuvo un esquema de formación con base científica y objetivos de formación claros. También muestra un conocimiento más profundo de la situación real de la enseñanza de la educación física aeróbica en los colegios y universidades. Conclusión Este trabajo diseña un esquema de optimización del aeróbic con base científica según las características de los colegios y universidades, atendiendo a las necesidades reales de los estudiantes, promoviendo la mejora de la enseñanza en el curso de educación física aeróbica en los colegios y universidades. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

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