Analysis of postural asymmetry on sagittal plane between right and left side views using photogrammetry.

BACKGROUND: Postural asymmetry is natural and expected during postural assessment. Besides, there are conditions that exacerbate the difference between right and left side views, such as Idiopathic Scoliosis (IS). However, the photogrammetric postural assessment on sagittal plane is usually performed using only one side view. This study aimed testing if there are differences between the right and the left-side views in photogrammetric postural assessment of adults on sagittal plane. METHODS: Patients with and without scoliosis were assessed and were grouped into Control Group (CG) and Positive Adam's test Group (PAG) according to Adam's forward bending test. After screening, participants were assessed using the right and the left-side views according DIPA© protocol. Descriptive and inferential analysis were made using Paired t-Test and Independence Chi-square Test (χ2). RESULTS: Significant differences were found between right and left side views to knee angle and head position angle to overall sample. The mean difference was low, about 1° on head position and 2.6° on knee angle and did not affect the classification of body segments. CONCLUSION: We conclude that the postural assessment on sagittal plane of adults without IS can be performed using only one side view, becoming the photogrammetric postural assessment an easy-to-use tool.

Craniocervical Posture Assessed With Photogrammetry and the Accuracy of Palpation Methods for Locating the Seventh Cervical Spinous Process: A Cross-sectional Study.

OBJECTIVE: The purpose of this study was to compare craniocervical posture assessed by photogrammetry using 2 distinct palpation methods for locating the spinous process of the seventh cervical vertebra (C7SP). METHODS: This cross-sectional study was conducted in 2 phases. In phase I (n = 42), the assessor's accuracy in locating the C7SP using the flexion-extension and the modified thorax-rib static methods was compared to radiography. In phase II (n = 68), the craniocervical posture was analyzed with photogrammetry after palpation using the 2 methods. Neck pain intensity and disability were also determined. RESULTS: The accuracy in locating the C7SP was higher using the modified thorax-rib static method (67%, 95% confidence interval [CI], 55-79) compared to the flexion-extension method (38%, 95% CI, 26-50, P = .016). Lower values of the craniocervical angle were obtained with the flexion-extension method than the modified thorax-rib static method (mean difference = -1.1°, 95% CI, -1.6 to -0.6, P < .001). However, both palpation methods resulted in similar classifications of participants as with or without forward head posture (P = .096). Weak correlations were observed between the craniocervical angle and neck pain intensity (ρ = -0.088 and -0.099, respectively) and disability (ρ = -0.231 and -0.249, respectively). CONCLUSION: Craniocervical angles obtained using palpation methods with different accuracies were different, although the magnitude of the difference was insufficient to lead to different classifications of a forward head posture in adults with mild neck pain and disability. Craniocervical posture was weakly correlated with neck-pain intensity and disability.

Computerized photogrammetric assessment of postural alignment in visually impaired athletes.

OBJECTIVE: The aim of the study was to provide a computerized photogrammetric description of the postural alignment of visually impaired athletes. METHODS: Twenty-six athletes were evaluated. Athletes were asked to stand at easy with styrofoam balls placed on selected anatomical landmarks, and photographic images were acquired in four viewpoints. Postural Assessment Software (PAS/SAPO) was applied for image analysis. Body's angles and distances were calculated and transformed in absolute (nonnegative) values for analysis. Factor analysis was applied for data reduction. RESULTS: Absolute values of PAS/SAPO variables resulted in lower coefficient of variation (CV) than raw values (average of 57% versus 500%, respectively), which potentially enhances the comparative use of these measures. Head's forward positioning and rightward inclination were among the most prevalent postural deviation, being observed in more than 70% of the athletes. With respect to the magnitude of the deviation, large variability was observed in data derived from anterior/posterior compared with lateral viewpoint. For instance, head's rightward inclination (head horizontal alignment in the anterior view) achieved 2.9 ±â€¯2.5° (mean ±â€¯SD), with a CV of 86%, while head's forward positioning (C7 horizontal alignment in left viewpoint) reaches 42.7 ±â€¯6.6°, with a CV of only 16%. Factor analysis did not result in significant data reduction, although anterior body's angles and distances were identified as important sources of data variability. CONCLUSIONS: The PAS/SAPO values described here can be adopted as reference for future investigations of postural alignment in visually impaired athletes.

Concordance and Reliability of Photogrammetric Protocols for Measuring the Cervical Lordosis Angle: A Systematic Review of the Literature.

OBJECTIVE: The aim of this study was to examine and interpret the concordance, accuracy, and reliability of photogrammetric protocols available in the literature for evaluating cervical lordosis in an adult population aged 18 to 59 years. METHODS: A systematic search of 6 electronic databases (MEDLINE via PubMed, LILACS, CINAHL, Scopus, ScienceDirect, and Web of Science) located studies that assessed the reliability and/or concordance and/or accuracy of photogrammetric protocols for evaluating cervical lordosis, compared with radiography. Articles published through April 2016 were selected. Two independent reviewers used a critical appraisal tool (QUADAS and QAREL) to assess the quality of the selected studies. RESULTS: Two studies were included in the review and had high levels of reliability (intraclass correlation coefficient: 0.974-0.98). Only 1 study assessed the concordance between the methods, which was calculated using Pearson's correlation coefficient. To date, the accuracy of photogrammetry has not been investigated thoroughly. CONCLUSION: We encountered no study in the literature that investigated the accuracy of photogrammetry in diagnosing hyperlordosis of cervical spine. However, both current studies report high levels of intra- and interrater reliability. To increase the level of evidence of photogrammetry in the evaluation of cervical lordosis, it is necessary to conduct further studies using a larger sample to increase the external validity of the findings.

Procedures of assessment on the quantification of thoracic kyphosis and lumbar lordosis by radiography and photogrammetry: A literature review.

The quantification of thoracic kyphosis and lumbar lordosis can be assessed in different ways; among them radiography and photogrammetry. However, the assessment procedures are not consistent in the literature for either method. The objective of this study was to conduct a literature review about postural assessment through radiography and photogrammetry, for delineating the procedures for both methods. In total 38 studies were selected by an online search in the MEDLINE and LILACS databases with the keywords: radiograph and posture, postural alignment, photogrammetry or photometry or biophotogrammetry. For the radiographic method, the results showed divergences in arm positioning and in the calculation of thoracic and lumbar angles. The photogrammetry demonstrated differences in relation to the camera, tripod, plumb line and feet positioning, angle calculation, software utilization, and the use of footwear. Standardization is proposed for both methods to help establish normative values and comparisons between diagnoses.

Posture Alignment of Adolescent Idiopathic Scoliosis: Photogrammetry in Scoliosis School Screening.

OBJECTIVE: The objective of this study was to describe the posture patterns of adolescents diagnosed with adolescent idiopathic scoliosis (AIS) in a scoliosis school screening (SSS). METHODS: Two-dimensional photogrammetry was used to assess the posture of 37 adolescents diagnosed with scoliosis (scoliosis group, SG) (Cobb angle ≥10°) and 76 adolescents with a false positive diagnosis (false positive group, FPG) (Cobb angle <10°, angle of trunk rotation ≥7°). In total, 2562 10- to 14-year-old adolescents were enrolled in the SSS, which was performed in public schools in the cities of Amparo, Pedreira, and Mogi Mirim in the state of São Paulo, Brazil. Their posture was analyzed using Postural Analysis Software. Continuous variables were tested using Student t test, and categorical variables were tested using a χ2 test. The SG, FPG, simple curve group, and double curve group were all compared. Bivariate analysis was used to identify associations between postural deviations and scoliosis. The adopted significance level was α = .05. RESULTS: The SG (2.7 ± 1.9°) had greater shoulder obliquity than the FPG (1.9 ± 1.4°) (P = .010), and this deviation was associated with scoliosis (odds ratio [95% CI] P = 1.4 [1.1-1.8] 0.011). The SG had asymmetry between the right- and left-side lower limb frontal angle, shoulder sagittal alignment, and knee angle. The double curve group (3 ± 1.7°) presented a greater value of the vertical alignment of the torso than the simple curve group did (1.9 ± 1°; P = .032). CONCLUSIONS: Adolescents diagnosed with AIS in an SSS had greater shoulder obliquity and asymmetry between the right and left sides. Shoulder obliquity was the only postural deviation associated with AIS.

Reference Values for Human Posture Measurements Based on Computerized Photogrammetry: A Systematic Review.

OBJECTIVE: The main objective of this study was to review the literature to identify reference values for angles and distances of body segments related to upright posture in healthy adult women with the Postural Assessment Software (PAS/SAPO). METHODS: Electronic databases (BVS, PubMed, SciELO and Scopus) were assessed using the following descriptors: evaluation, posture, photogrammetry, physical therapy, postural alignment, postural assessment, and physiotherapy. Studies that performed postural evaluation in healthy adult women with PAS/SAPO and were published in English, Portuguese and Spanish, between the years 2005 and 2014 were included. RESULTS: Four studies met the inclusion criteria. Data from the included studies were grouped to establish the statistical descriptors (mean, variance, and standard deviation) of the body angles and distances. A total of 29 variables were assessed (10 in the anterior views, 16 in the lateral right and left views, and 3 in the posterior views), and its respective mean and standard deviation were calculated. Reference values for the anterior and posterior views showed no symmetry between the right and left sides of the body in the frontal plane. There were also small differences in the calculated reference values for the lateral view. CONCLUSION: The proposed reference values for quantitative evaluation of the upright posture in healthy adult women estimated in the present study using PAS/SAPO could guide future studies and help clinical practice.

Movilidad lumbopélvica en pacientes estreñidos tras la maniobra hemodinámica abdominal modificada / No disponible

Introducción: El estreñimiento funcional es la patología más frecuente en Gastroenterología. Recientes estudios aseveran una presencia del 78% de dolores referidos al aparato locomotor de origen visceral. Objetivos: Evaluar la Maniobra Hemodinámica abdominal modificada (MHAM) en pacientes estreñidos a través del Umbral de dolor a la presión (UDP) en los niveles dorsales T10,T11 y T12, inclinometría para la flexión lumbar, el test de extensibilidad Sit and Reach y la valoración postural del paciente con el programa SAPO. Material y Métodos: Ensayo clínico aleatorizado controlado, a doble ciego en 20 pacientes (n=20); Grupo Control (GC: n=10) y Grupo Experimental (GE: n=10). Resultados: Algometría T11: en el GE la diferencia media fue de 1,05 kg (IC95%=0,501 a 1,603; p=0,001; d Cohen= 0,84). Algometría T12: en el GE la diferencia fue 1,23 kg (IC95%=0,499 a 1,969; p=0,002 significativa; d Cohen=0,89). Inclinometría T12: en el GE se produjo un incremento medio de 10,4º (IC 95%=7,59 a 13,21º; p<0,001; d Cohen=0,94).Test Sit and Reach: en el GE el aumento medio fue de 3,47cm (IC95%= 2,35 a 4,58 cm; p<0,001; d Cohen=0,77). Conclusiones: La aplicación de la Maniobra Hemodinámica Abdominal Modificada en pacientes con estreñimiento funcional genera cambios inmediatos aumentando la tolerancia al dolor en las vértebras T11 y T12, aumentando la flexión lumbar y mejorando la extensibilidad de los miembros inferiores (AU)

No dispoible

Validation of the angular measurements of a new inertial-measurement-unit based rehabilitation system: comparison with state-of-the-art gait analysis.

BACKGROUND: Several rehabilitation systems based on inertial measurement units (IMU) are entering the market for the control of exercises and to measure performance progression, particularly for recovery after lower limb orthopaedic treatments. IMU are easy to wear also by the patient alone, but the extent to which IMU's malpositioning in routine use can affect the accuracy of the measurements is not known. A new such system (Riablo™, CoRehab, Trento, Italy), using audio-visual biofeedback based on videogames, was assessed against state-of-the-art gait analysis as the gold standard. METHODS: The sensitivity of the system to errors in the IMU's position and orientation was measured in 5 healthy subjects performing two hip joint motion exercises. Root mean square deviation was used to assess differences in the system's kinematic output between the erroneous and correct IMU position and orientation.In order to estimate the system's accuracy, thorax and knee joint motion of 17 healthy subjects were tracked during the execution of standard rehabilitation tasks and compared with the corresponding measurements obtained with an established gait protocol using stereophotogrammetry. RESULTS: A maximum mean error of 3.1 ± 1.8 deg and 1.9 ± 0.8 deg from the angle trajectory with correct IMU position was recorded respectively in the medio-lateral malposition and frontal-plane misalignment tests. Across the standard rehabilitation tasks, the mean distance between the IMU and gait analysis systems was on average smaller than 5°. CONCLUSIONS: These findings showed that the tested IMU based system has the necessary accuracy to be safely utilized in rehabilitation programs after orthopaedic treatments of the lower limb.

A systematic review of the angular values obtained by computerized photogrammetry in sagittal plane: a proposal for reference values.

OBJECTIVE: Reference values for postural alignment in the coronal plane, as measured by computerized photogrammetry, have been established but not for the sagittal plane. The objective of this study is to propose reference values for angular measurements used for postural analysis in the sagittal plane for healthy adults. METHODS: Electronic databases (PubMed, BVS, Cochrane, Scielo, and Science Direct) were searched using the following key words: evaluation, posture, photogrammetry, and software. Articles published between 2006 and 2012 that used the PAS/SAPO (postural assessment software) were selected. Another inclusion criterion was the presentation of, at least, one of the following measurements: head horizontal alignment, pelvic horizontal alignment, hip angle, vertical alignment of the body, thoracic kyphosis, and lumbar lordosis. Angle samples of the selected articles were grouped 2 by 2 in relation to an overall average, which made possible total average, variance, and SD calculations. RESULTS: Six articles were included, and the following average angular values were found: 51.42° ± 4.87° (head horizontal alignment), -12.26° ± 5.81° (pelvic horizontal alignment), -6.40° ± 3.86° (hip angle), and 1.73° ± 0.94° (vertical alignment of the body). None of the articles contained the measurements for thoracic kyphosis and lumbar lordosis. CONCLUSION: The reference values can be adopted as reference for postural assessment in future researches if the same anatomical points are considered.

Reliability of the craniocervical posture assessment: visual and angular measurements using photographs and radiographs.

OBJECTIVE: The purposes of this study were to determine the intrarater and interrater reliability of the craniocervical posture in a sagittal view using quantitative measurements on photographs and radiographs and to determine the agreement of the visual assessment of posture between raters. METHODS: One photograph and 1 radiograph of the sagittal craniocervical posture were simultaneously taken from 39 healthy female subjects. Three angles were measured on the photographs and 10 angles on the radiographs of 22 subjects using Alcimage software (Alcimage; Uberlândia, MG, Brazil). Two repeated measurements were performed by 2 raters. The measurements were compared within and between raters to test the intrarater and interrater reliability, respectively. Intraclass correlation coefficient and SEM were used. κ Agreement was calculated for the visual assessment of 39 subjects using photographs and radiographs between 2 raters. RESULTS: Good to excellent intrarater and interrater intraclass correlation coefficient values were found on both photographs and radiographs. Interrater SEM was large and clinically significant for cervical lordosis photogrammetry and for 1 angle measuring cervical lordosis on radiographs. Interrater κ agreement for the visual assessment using photographs was poor (κ = 0.37). CONCLUSION: The raters were reliable to measure angles in photographs and radiographs to quantify craniocervical posture with exception of 2 angles measuring lordosis of the cervical spine when compared between raters. The visual assessment of posture between raters was not reliable.

Efeito da reeducação postural global e do isostretchingem portadores de lombalgia crônica inespecífica atravésda biofotogrametria computadorizada / Effects of global posture re-education and isostretching in patients with chronic non-specific low back pain assessed by the computerized biophotogrametry method

O objetivo deste estudo foi quantificar os efeitos da ReeducaçãoPostural Global (RPG) e do Isostretching em portadoresde lombalgia crônica inespecífica (LCI) através do método daBiofotogrametria Computadorizada. 30 portadores de LCI foramacompanhados no Instituto Ortopédico de Palmas (IOP). Ospacientes foram submetidos a procedimentos como: avaliação fisioterápicaatravés do Instrumento de Avaliação da Coluna Vertebral,Escala Visual Analógica de Dor (EVA), Avaliação pelo método daBiofotogrametria Computadorizada antes da 1ª sessão e após trêsmeses de tratamento (2ª avaliação), e reavaliados após dois mesespós-tratamento (3ª avaliação). Os resultados obtidos através dotratamento com base na avaliação da Biofotogrametria Computadorizadaforam que não houve efeito estatisticamente significativodo fator Grupo, nem do fator Tempo, nem da interação entre osdois fatores (valor de p > 0,05) sobre as medidas de concavidadelombar ou convexidade torácica. Conclui-se que o método doRPG aumentou a concavidade lombar e diminuiu a convexidadetorácica quando os pacientes foram submetidos ao método daBiofotogrametria Computadorizada através da quantificação dascurvas fisiológicas da coluna vertebral. O método do Iso não alterouas curvas fisiológicas da coluna vertebral. Quando os dois métodosforam associados (Iso + RPG), a concavidade lombar diminuiu e aconvexidade torácica se manteve.

This study aimed at quantifying the effects of Global PostureRe-education (GPR) and Isostretching (Iso) in patients withchronic non-specific low back pain using the ComputerizedBiophotogrametry method. This research was performed in 30patients followed at the Orthopedic Institute of Palmas (IOP). Thepatients were submitted to Iso or GPR and to the following treatmentassessment procedures: physical therapy evaluation using theVertebral Column Instrument, Visual Analogic Pain Scale (EVA).The subjects were evaluated by Computerized Biophotogrametrybefore the 1st session and after three months of treatment, andre-evaluated two months after the final interventions. Treatmentresults, as judged from Computerized Biophotogrametry data, andconcerning lumbar concavity or thoracic convexity measurements,were not statistically significant with regard to the Group factor,the Time factor, or the interaction between these factors (value p >0.05). Thus we conclude that the GPR method tended to increaselumbar concavity and decreased thoracic convexity, according toComputerized Biophotogrametric data. The Iso method did notchange the physiologic curves of the vertebral column. When thetwo methods were associated (Iso + GPR), lumbar concavity decreasedand thoracic convexity was maintained. These different results,however, did not reach statistical significance.

Reliability of photogrammetry in the evaluation of the postural aspects of individuals with structural scoliosis.

PURPOSE: The purpose of this study was to investigate the reliability of photogrammetry in the measurement of the postural deviations in individuals with idiopathic scoliosis. METHODS: Twenty participants with scoliosis (17 women and three men), with a mean age of 23.1 ± 9 yrs, were photographed from the posterior and lateral views. The postural aspects were measured with CorelDRAW software. RESULTS: High inter-rater and test-retest reliability indices were found. It was observed that with more severity of scoliosis, greater were the variations between the thoracic kyphosis and lumbar lordosis measures obtained by the same examiner from the left lateral view photographs. A greater body mass index (BMI) was associated with greater variability of the trunk rotation measures obtained by two independent examiners from the right, lateral view (r = 0.656; p = 0.002). The severity of scoliosis was also associated with greater inter-rater variability measures of trunk rotation obtained from the left, lateral view (r = 0.483; p = 0.036). CONCLUSIONS: Photogrammetry demonstrated to be a reliable method for the measurement of postural deviations from the posterior and lateral views of individuals with idiopathic scoliosis and could be complementarily employed for the assessment procedures, which could reduce the number of X-rays used for the follow-up assessments of these individuals.

Reliability and validity of the photogrammetry for scoliosis evaluation: a cross-sectional prospective study.

OBJECTIVE: The purpose of this study was to investigate the reliability and validity of photogrammetry in measuring the lateral spinal inclination angles. METHODS: Forty subjects (32 female and 8 males) with a mean age of 23.4 +/- 11.2 years had their scoliosis evaluated by radiographs of their trunk, determined by the Cobb angle method, and by photogrammetry. The statistical methods used included Cronbach alpha, Pearson/Spearman correlation coefficients, and regression analyses. RESULTS: The Cronbach alpha values showed that the photogrammetric measures showed high internal consistency, which indicated that the sample was bias free. The radiograph method showed to be more precise with intrarater reliabilities of 0.936, 0.975, and 0.945 for the thoracic, lumbar, and thoracolumbar curves, respectively, and interrater reliabilities of 0.942 and 0.879 for the angular measures of the thoracic and thoracolumbar segments, respectively. The regression analyses revealed a high determination coefficient although limited to the adjusted linear model between the radiographic and photographic measures. It was found that with more severe scoliosis, the lateral curve measures obtained with the photogrammetry were for the thoracic and lumbar regions (R = 0.619 and 0.551). CONCLUSIONS: The photogrammetric measures were found to be reproducible in this study and could be used as supplementary information to decrease the number of radiographs necessary for the monitoring of scoliosis.

The role of misorientation and phosphorus content on grain growth and intergranular fracture in iron-carbon-phosphorus alloys.

The relationship between the crystallography of intergranular fracture and phosphorus segregation has been investigated in a Fe-0.06wt%P-0.002wt%C alloy aged for 1 h at temperatures between 600 degrees C and 1000 degrees C. Two novel techniques were devised for the investigation: first, electron back-scatter diffraction (EBSD) across the reconstructed fracture surface and, second, a combination of Auger electron spectroscopy, stereophotogrammetry and microscopy to measure phosphorus and carbon on fracture facets combined with EBSD measurements direct from the fracture surface. In total, 700 misorientations were measured from across the reconstructed fracture surface and in 'control' areas away from the fracture. It was found that Sigma 3s were in general more resistant to brittle fracture than were random boundaries, and it was suggested that alloys of this type could be grain boundary engineered to improve fracture resistance by a short anneal in the austenite region to increase the final proportion of Sigma 3s. Sixteen fracture facets yielded combined Auger/EBSD data. The combined Auger/EBSD methodology to acquire joint crystallographic and segregation information from facets was shown to be feasible, although laborious. There were significantly more [110] planes than any other type in the sample population of facets from which combined segregation/crystallography data had been collected. The data suggested that there was on average lower phosphorus segregation on fracture facets that were near [110] than on other intergranular fracture facets.

Respuesta de la pupila fetal en las anomalías del sistema nervioso / Pupil response in fetuses with nervous system anomalies

Objetivo: Estudiamos el estado pupilar basal y la respuesta de la pupila fetal al Doppler color (DC) en casos con malformaciones del sistema nervioso antes de las 23 semanas.Material y métodos: Las pupilas de 12 fetos con alguna malformación del sistema nervioso fueron estudiadas mediante ultrasonidos entre las semanas 16 y 23 de gestación. Las áreas de las pupilas e iris en situación basal y posterior al estímulo DC fueron comparadas con los datos de normalidad previamente publicados.Resultados: La gran mayoría de los fetos tenían alguno de los parámetros analizados anormales, sobre todo en el tipo de respuesta al DC y la cuantificación de ésta. Habitualmente las malformaciones del sistema nervioso presentan una respuesta inversa a la esperada y/o responden de forma exagerada.Conclusión: Estos resultados permiten utilizar este tipo de test en el estudio fetal de alta resolución que realizamos antes de las 22 semanas. Este reflejo fetal puede indicarnos el estado sináptico de una de las vías nerviosas fetales y el tono refléxico fetal. (AU)

Evolución de los perímetros del iris y de la pupila fetal durante la gestación / Evolution of the perimeters of the iris and of the fetal pupil throughout gestation

Objetivo: La actividad pupilar depende del sistema nervioso autónomo y su regulación llega a alcanzar el córtex cerebral. En este artículo se estudia la evolución funcional del iris fetal en condiciones basales.Sujetos y métodos: Se examinaron mediante ultrasonidos 192 pupilas de fetos humanos desde las semanas 15 hasta la 42. Las imágenes eran digitalizadas para la medición informática de los perímetros de la pupila y del iris.Resultados: El perímetro del iris presenta un progreso lineal durante la gestación. El perímetro de la pupila muestra una evolución variable. A partir de la semana 23, el perímetro pupilar con relación al del iris es menor al 30 por 100. Esta relación, perímetro pupilar/iris, presenta una variación estadísticamente significativa a lo largo de la gestación (test de Kruskal-Wallis).Conclusiones: La actividad pupilar manifiesta una integridad de determinadas vías neurológicas y puede permitir un nuevo control neurológico de los fetos humanos (AU)