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1.
Medicine (Baltimore) ; 99(17): e19645, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32332608

RESUMEN

BACKGROUND: The Trachway Videolight Intubating Stylet is a video-assisted system with a rigid but malleable intubating stylet that facilitates endotracheal intubation. Minimizing cervical spine movement with manual in-line stabilization is essential for patients with cervical spine injuries such as multiple trauma. However, the intubation time of the Trachway Videolight Intubating Stylet and complications associated with intubation in patients with manual in-line stabilization in the neutral-head and head-lift positions remain unclear. METHODS: Patients (20-80 years old) who were scheduled to undergo surgery that required general anesthesia with tracheal intubation were randomly allocated to either a neutral-head (n = 62) or a head-lift position (n = 62) group. Manual in-line stabilization was performed to limit cervical spine mobility. We aimed to evaluate orotracheal intubation time and success rate in these 2 positions with the Trachway Videolight Intubating Stylet. RESULTS: Intubation was faster in the head-lift than in the neutral-head position (20 ±â€Š10 and 25 ±â€Š13 seconds, respectively, P = .000); intubation was equally successful in the 2 positions (96.8% vs 96.8%). Responses to intubation did not differ between positions (heart rate, P = .142; visual analog scale scores for throat soreness, P = .54). The only significant predictor of intubation time was the body mass index in the head-lift position group (P = .005). CONCLUSIONS: Intubation using the Trachway Videolight Intubating Stylet with manual in-line stabilization is faster in the head-lift position, and therefore preferable. However, if the head-lift position is not suitable, the neutral-head position is a sensible alternative, with comparable intubation success rate, heart rate change, and postoperative throat soreness.


Asunto(s)
Equipos y Suministros , Intubación Intratraqueal/instrumentación , Intubación Intratraqueal/métodos , Postura , Adulto , Anciano , Anciano de 80 o más Años , Anestesia/métodos , Femenino , Cabeza , Humanos , Masculino , Persona de Mediana Edad , Cuello , Factores de Tiempo , Adulto Joven
2.
J Cataract Refract Surg ; 46(4): 654-655, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32271306
3.
Int. j. morphol ; 38(2): 363-366, abr. 2020. tab
Artículo en Inglés | LILACS | ID: biblio-1056448

RESUMEN

Manual tests in clinical investigation must be supported by anatomical and physiological findings in order to obtain an objective information. The application of different mandibular positions in children obtains a variation in the 'hip rotators test' (p < 0.001). The possible relationships behind the muscle tone of the external rotators of the hips and the stomatognathic system are exposed, with special attention on the fascial tissue and its morphological characteristics. Despite these anatomical and physiological connections, there is no further evidence of a strong cause-effect relationship in this test.


Las pruebas manuales en la investigación clínica deben estar respaldadas por hallazgos anatómicos y fisiológicos para obtener una información objetiva. La aplicación de diferentes posiciones mandibulares en niños muestra una variación en la "prueba de rotadores de cadera" (p <0,001). Se exponen las posibles relaciones del tono muscular de los rotadores externos de las caderas y el sistema estomatognático, con especial atención en el tejido fascial y sus características morfológicas. A pesar de estas conexiones anatomofisiológicas, no existe una evidencia mayor de una relación importante causa-efecto en esta prueba.


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Sistema Estomatognático/anatomía & histología , Fascia/anatomía & histología , Cadera/fisiología , Tono Muscular , Postura
4.
Am J Phys Med Rehabil ; 99(4): 330-337, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32195716

RESUMEN

OBJECTIVE: The aims of the study were to investigate the kinetic effects of sit-to-stand training in various foot positions on the coronal plane in patients with strokes and to suggest appropriate exercises. DESIGN: Thirty-six poststroke subjects participated in this study. The subjects performed three sit-to-stand trials in the following foot positions: (a) symmetric foot positioning (symmetric), (b) affected foot placed to the side (asymmetric 1), and (c) and less affected foot placed to the side (asymmetric 2). They were asked to perform sit-to-stand training at a spontaneous velocity and remain standing for 5 secs, whereas the vertical ground reaction force was measured using force platforms. The activation of lower limb muscles was evaluated using surface electromyography, and the peak and mean vertical ground reaction force and weight-bearing symmetry ratio were evaluated using force platforms. RESULTS: Our results showed significant increases in the muscle activation, peak and mean vertical ground reaction force, and weight-bearing symmetry ratio of the lower limbs using the asymmetric 2 strategy (P < 0.05). CONCLUSIONS: Our results suggest that sit-to-stand training with the less affected foot placed to the side by the width of the subject's foot may be the most beneficial in the rehabilitation of patients with hemiparetic stroke.


Asunto(s)
Hemiplejía/rehabilitación , Posicionamiento del Paciente/métodos , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular/fisiopatología , Electromiografía , Femenino , Pie/fisiopatología , Hemiplejía/etiología , Hemiplejía/fisiopatología , Humanos , Cinética , Extremidad Inferior/fisiopatología , Masculino , Persona de Mediana Edad , Postura , Accidente Cerebrovascular/complicaciones , Soporte de Peso
5.
Rev Med Liege ; 75(3): 180-184, 2020 Mar.
Artículo en Francés | MEDLINE | ID: mdl-32157844

RESUMEN

Psychomotor disadaptation syndrome (PDS) was first described by the Geriatrics School of Dijon (France), three decades ago, under the name «psychomotor regression syndrome¼. Over time, the original clinical features remained unchanged. However, progress has been made in its pathophysiology understanding and care, hence the new name, PDS, appeared in the 1990s. The PDS is also called sub-cortico-frontal dysfunction syndrome since the 2000s. It corresponds to a decompensation of posture, gait and psychomotor automatisms, related to an alteration of the postural and motor programming, which is a consequence of sub-cortico-frontal lesions. The clinical features of PDS associate backward disequilibrium, nonspecific gait disorders and neurological signs (akinesia, reactional hypertonia, impaired reactive postural responses and protective reactions, etc.). Psychological disorders of PDS are a fear of standing and walking in its acute form (the post-fall syndrome), or a bradyphrenia and anhedonia in its chronic form. The PDS occurrence results from the combination of three factors implicated in the reduction in functional reserves related to the alteration of the sub-cortico-frontal structures: ageing, chronic afflictions and acute situations, which induce a decrease in cerebral blood flow. The PDS management must be multidisciplinary, including the physician, the physiotherapist, the psychologist, nurses and care assistants.


Asunto(s)
Accidentes por Caídas , Equilibrio Postural , Postura , Adaptación Fisiológica , Francia , Marcha , Humanos , Trastornos de la Sensación , Síndrome
7.
Med Sci Monit ; 26: e920208, 2020 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-32202262

RESUMEN

BACKGROUND Neck pain is reported by many laborers who are at risk of experiencing musculoskeletal disorders due to muscle stiffness and hypokinetics. This study examined the effects of a lower trapezius exercise program on neck pain patients. MATERIAL AND METHODS The design of this study was a randomized controlled trial. A total of 40 neck pain patients participated in this study. Screening tests were performed and assigned to experimental group (n=20) and control group (n=20) using randomization program. Both groups underwent a scapula and thoracic spine stabilization exercise program. In addition, the experimental group implemented the lower trapezius strengthening exercise program. All interventions were applied 3 times per week for 4 weeks. Visual Analogue Scale (VAS), Neck Disability Index (NDI), postural alignment, muscle thickness and contraction rate were compared to evaluate the effect on intervention. RESULTS Both groups showed significant differences in VAS, NDI, and postural alignment before and after intervention (P<0.05). In addition, the experimental group showed more significant difference in the amount of change in NDI and postural alignment values than the control group. The experimental group showed significant improvement in muscle thickness and contraction (P<0.05). CONCLUSIONS A lower trapezius strengthening exercise program is an effective method with clinical significance for reducing the level of neck dysfunction, and improving the postural alignment, muscle thickness, and contraction rate of the lower trapezius muscle.


Asunto(s)
Terapia por Ejercicio/métodos , Dolor de Cuello/terapia , Músculos Superficiales de la Espalda/fisiología , Adulto , Femenino , Humanos , Masculino , Músculo Esquelético/fisiopatología , Dimensión del Dolor/métodos , Postura , Resultado del Tratamiento
8.
Fisioterapia (Madr., Ed. impr.) ; 42(1): 5-16, ene.-feb. 2020. graf, tab
Artículo en Español | IBECS | ID: ibc-187810

RESUMEN

Objetivo: Establecer el efecto de un programa de intervención basado en el reaprendizaje motor sobre el control postural en adultos con hemiparesia. Material y método: Se realizó un ensayo clínico no aleatorizado, prospectivo, con grupo control y enmascaramiento simple. Se realizó un muestreo intencional de adultos de ambos sexos con hemiparesia de entre 18 y 60 años. Se analizaron 34 personas en el grupo control (intervención convencional) y 35 en el experimental (reaprendizaje motor orientado a la tarea). Ambos grupos recibieron programas de fisioterapia 3 veces a la semana durante 6 semanas. Se aplicaron las siguientes pruebas: escala de Tinetti, test de organización sensorial, Timed Get Up and Go, test del alcance funcional y evaluación de la calidad de patrones de movimiento básicos y selectivos. Se realizaron análisis de diferencias intramuestrales e intermuestrales. Resultados: Se encontró una diferencia promedio de 3cm en la prueba del alcance funcional (p=0,035) y de 2,43 puntos en la calidad de patrones de movimiento de miembros inferiores (p=0,011) a favor del grupo experimental. En las demás pruebas no hubo diferencias significativas (p>0,05). Conclusiones: El programa evaluado es más efectivo para mejorar el control postural antigravitatorio y la calidad de patrones selectivos de miembros inferiores, comparado con un programa fisioterapéutico convencional. Sin embargo, en el análisis intramuestral se evidenció que aquel produce cambios significativos en la estabilidad durante la marcha, el control postural antigravitatorio, el equilibrio, la organización sensorial y en la calidad de los patrones de movimiento de mano, miembro inferior, movilidad en sedente-arrodillado, bípedo, marcha, desplazamientos en bípedo y global


Objective: To establish the impact of an intervention programme based on motor relearning on postural control in adults with hemiparesis. Material and method: A prospective non-randomised single-masked clinical trial with control group was conducted. The sample was collected intentionally, and consisted of adults of both sexes with hemiparesis between 18 to 60 years old. Thirty-four individuals from the control group (conventional intervention) and 35 individuals from the experimental group (task-oriented motor re-learning) were analysed. Both groups were involved in physiotherapy programmes 3 times a week for 6 weeks. Tinetti Balance Scale, Sensory Organization Test, Timed Get Up and Go test, Functional Movement Assessment and quality of basic and selective movement patterns assessment were applied. Analysis of intra-sample and inter-sample differences was performed. Results: An average difference of 3cm was found in Functional Movement Assessment (P=.035) and 2.43 points in the quality of lower limb movement patterns (P=.011), in favour of the experimental group. The other tests did not show significant differences (P>.05). Conclusions: This programme is more effective at improving postural anti-gravitational control and the quality of selective lower limb patterns compared to a conventional physiotherapeutic programme. However, in the intra-sample analysis, it was evidenced that it produces significant changes in stability during gait, anti-gravitational postural control, balance, sensory organisation and in the quality of hand movement patterns, lower limb, seated mobility-kneeling, biped, walking, biped and global movements


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Paresia/terapia , Equilibrio Postural , Modalidades de Fisioterapia/instrumentación , Lesiones Encefálicas/rehabilitación , Rehabilitación Neurológica/métodos , Paresia/rehabilitación , Estudios Prospectivos , Postura/fisiología , Análisis de la Marcha/métodos
9.
Phys Ther ; 100(3): 554-563, 2020 03 10.
Artículo en Inglés | MEDLINE | ID: mdl-32043130

RESUMEN

Bones are the third most common site for cancer metastases, and the axial skeleton is the most frequent skeletal location. In a postmortem study, bone metastases were reported in 70% of breast and prostate cancer patients. Bone metastases from breast, lung, prostate, thyroid, and kidney cancers account for 80% of all bone metastases. Bone lesions exist in 60% of newly diagnosed multiple myeloma patients. With increasing numbers of people who have survived cancer, many patients with cancer and axial skeletal bony metastases will be seen by physical and occupational therapists. Guidelines are lacking on how to perform physical examinations and provide exercise programs for these patients without compromising the diseased spine. In this article, we discuss the available evidence for similar spinal conditions, the biomechanics of spinal load, and changes associated with posture and weight load. We provide recommendations on how to assess a patient's strength, how to strengthen without compromising the diseased spine, and how to teach patients to use correct body mechanics during mobility and activities of daily living.


Asunto(s)
Supervivientes de Cáncer , Compresión de la Médula Espinal/terapia , Neoplasias de la Columna Vertebral/secundario , Fracturas Espontáneas/etiología , Fracturas Espontáneas/prevención & control , Humanos , Inestabilidad de la Articulación/diagnóstico , Movimiento/fisiología , Postura/fisiología , Factores de Riesgo , Sensibilidad y Especificidad , Compresión de la Médula Espinal/complicaciones , Compresión de la Médula Espinal/diagnóstico , Fracturas de la Columna Vertebral/prevención & control , Neoplasias de la Columna Vertebral/diagnóstico por imagen , Columna Vertebral/fisiopatología , Soporte de Peso
10.
PLoS One ; 15(2): e0228422, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32027680

RESUMEN

This paper focuses on the application of machine learning algorithms for predicting spinal abnormalities. As a data preprocessing step, univariate feature selection as a filter based feature selection, and principal component analysis (PCA) as a feature extraction algorithm are considered. A number of machine learning approaches namely support vector machine (SVM), logistic regression (LR), bagging ensemble methods are considered for the diagnosis of spinal abnormality. The SVM, LR, bagging SVM and bagging LR models are applied on a dataset of 310 samples publicly available in Kaggle repository. The performance of classification of abnormal and normal spinal patients is evaluated in terms of a number of factors including training and testing accuracy, recall, and miss rate. The classifier models are also evaluated by optimizing the kernel parameters, and by using the results of receiver operating characteristic (ROC) and precision-recall curves. Results indicate that when 78% data are used for training, the observed training accuracies for SVM, LR, bagging SVM and bagging LR are 86.30%, 85.47%, 86.72% and 85.06%, respectively. On the other hand, the accuracies for the test dataset for SVM, LR, bagging SVM and bagging LR are the same being 86.96%. However, bagging SVM is the most attractive as it has a higher recall value and a lower miss rate compared to others. Hence, bagging SVM is suitable for the classification of spinal patients when applied on the most five important features of spinal samples.


Asunto(s)
Algoritmos , Conjuntos de Datos como Asunto/estadística & datos numéricos , Diagnóstico por Computador/métodos , Enfermedades de la Columna Vertebral/diagnóstico , Columna Vertebral/anomalías , Columna Vertebral/diagnóstico por imagen , Diagnóstico Diferencial , Humanos , Interpretación de Imagen Asistida por Computador/métodos , Modelos Logísticos , Aprendizaje Automático , Postura/fisiología , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Enfermedades de la Columna Vertebral/epidemiología , Máquina de Vectores de Soporte
11.
PLoS One ; 15(2): e0228638, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32045440

RESUMEN

OBJECTIVES: Hyperkyphosis is associated with restricted pulmonary function and posture, potentially contributing to poor sleep. A previous study reported older women with hyperkyphosis had worse self-reported sleep quality, but it is less clear if this association exists in men. We examined the association between hyperkyphosis and subjective and objective sleep quality in a cohort of older men. DESIGN: Longitudinal analysis of data from large cohort of older men participating in the Osteoporotic Fractures in Men Study (MrOS). SETTING: Community. PARTICIPANTS: We studied 754 men participants in MrOS who had kyphosis measured during the 3rd clinic visit (2007-2009) and future subjective and objective sleep quality assessed between 2009-2012 (an average of 2.9 years later). INTERVENTION: N/A. MEASUREMENTS: To measure kyphosis, 1.7 cm thick wooden blocks were placed under the participant's head to achieve a neutral spine position while lying supine on a DXA table. We collected data on both subjective (Pittsburgh Sleep Quality Index [PSQI], and Epworth Sleepiness Scale [ESS]) and objective (wrist actigraphy: Total Sleep Time [TST], Wake After Sleep Onset [WASO], Sleep Efficiency [SE], Sleep Onset Latency [SOL]; and polysomnography: Apnea Hypopnea Index [AHI]) sleep measurements. Those who required >3 blocks were considered hyperkyphotic (n = 145 or 19.2%). RESULTS: In unadjusted and multivariable analyses, men with hyperkyphosis did not report having worse self-reported sleep characteristics based on PSQI and ESS. Similarly, there were no significant associations between hyperkyphosis and objective sleep measures. When examined as a continuous predictor (blocks ranging from 0-8), results were no different. CONCLUSIONS: Although we hypothesized that poor posture in those with hyperkyphosis would interfere with sleep, in this sample of older men, worse kyphosis was not associated with self-reported or objectively measured poor sleep quality.


Asunto(s)
Cifosis/fisiopatología , Trastornos del Sueño-Vigilia/epidemiología , Sueño , Anciano , Anciano de 80 o más Años , Humanos , Cifosis/complicaciones , Masculino , Postura , Autoinforme
12.
PLoS One ; 15(2): e0217188, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32017765

RESUMEN

As part of its response to a perturbation, an animal often needs to reposition its body. Inertia acts to oppose the corrective motion, delaying the completion of the movement-we refer to this elapsed time as inertial delay. As animal size increases, muscle moment arms also increase, but muscles are proportionally weaker, and limb inertia is proportionally larger. Consequently, the scaling of inertial delays is complex. Our intent is to determine how quickly different sized animals can produce corrective movements when their muscles act at their force capacity, relative to the time within which those movements need to be performed. Here, we quantify inertial delay using two biomechanical models representing common scenarios in animal locomotion: a distributed mass pendulum approximating swing limb repositioning (swing task), and an inverted pendulum approximating whole body posture recovery (posture task). We parameterized the anatomical, muscular, and inertial properties of these models using literature scaling relationships, then determined inertial delay for each task across a large range of movement magnitudes and the full range of terrestrial mammal sizes. We found that inertial delays scaled with an average of M0.28 in the swing task and M0.35 in the posture task across movement magnitudes-larger animals require more absolute time to perform the same movement as small animals. The time available to complete a movement also increases with animal size, but less steeply. Consequently, inertial delays comprise a greater fraction of swing duration and other characteristic movement times in larger animals. We also compared inertial delays to the other component delays within the stimulus-response pathway. As movement magnitude increased, inertial delays exceeded these sensorimotor delays, and this occurred for smaller movements in larger animals. Inertial delays appear to be a challenge for motor control, particularly for bigger movements in larger animals.


Asunto(s)
Modelos Teóricos , Movimiento , Músculo Esquelético/fisiología , Tiempo de Reacción , Animales , Fenómenos Biomecánicos , Postura
13.
PLoS One ; 15(2): e0228816, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32045439

RESUMEN

BACKGROUND: Posture is influenced by many factors and dental occlusion seems to have its role on postural stabilization. Our rationale to perform the study was to find out if there are differences of static plantar pressure and stabilometric parameters depending on different dental conditions. METHODS: The observational study consisted in plantar pressure assessment and stabilometric analysis of 95 right-handed healthy volunteer subjects (mean age 22.94 ± 2.52 years) by using the PoData system. Each subject followed four measurements with open eyes: mandibular postural position, maximum intercuspation, biting on cotton rolls and maximum mouth opening. Plantar pressure was recorded on 1st and 5th metatarsal heads and heel, and was expressed as percentage of weight distribution on each foot. The recorded centre of pressure (CoP) parameters were: CoP path length, 90%confidence ellipse area and maximum CoP speed. Statistical analysis used repeated-measures ANOVA with Bonferroni posthoc analysis and Friedman test. RESULTS: Loading on the left 5th metatarsal head was significantly higher in maximum mouth opening condition when compared to maximum intercuspation and to biting on cotton rolls. The left heel loading was significantly lower in the maximum mouth opening in comparison to maximum intercuspation. The CoP path length and maximum CoP speed were significantly higher in maximum mouth opening compared to the other three conditions. Confidence ellipse area had significantly lower values in maximum intercuspation and in the biting on cotton rolls conditions compared to the mandibular postural position, and in maximum intercuspation compared to maximum mouth opening. CONCLUSION: In young adults with an optimum functional occlusion the static plantar pressure is influenced by the maximum mouth opening. An improved postural stability was recorded in maximum intercuspation (a condition used during swallowing) in comparison to mandibular postural position (a condition that allows relaxation of the masticatory muscles after functional moments).


Asunto(s)
Equilibrio Postural/fisiología , Presión , Adulto , Femenino , Humanos , Masculino , Músculos Masticadores/fisiología , Boca/fisiología , Postura/fisiología , Adulto Joven
14.
PLoS One ; 15(2): e0226915, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32027692

RESUMEN

Many experiments have documented the response of intraocular pressure (IOP) to postural change. External forces caused by gravitational orientation change produce a dynamic response that is encountered every day during normal activities. Tilting the body at a small downward angle is also relevant to studying the effects of hypogravity (spaceflight), including ocular changes. We examined data from 36 independent datasets from 30 articles on IOP response to postural change, representing a total population of 821 subjects (≥1173 eyes) with widely varying initial and final postures. We confirmed that IOP was well predicted by a simple quantity, namely the hydrostatic pressure at the level of the eye, although the dependence was complex (nonlinear). Our results show that posturally induced IOP change can be explained by hydrostatic forcing plus an autoregulatory contribution that is dependent on hydrostatic effects. This study represents data from thousands of IOP measurements and provides insight for future studies that consider postural change in relation to ocular physiology, intraocular pressure, ocular blood flow and aqueous humor dynamics.


Asunto(s)
Presión Intraocular/fisiología , Postura/fisiología , Adolescente , Adulto , Anciano , Humor Acuoso/fisiología , Presión Sanguínea/fisiología , Conjuntos de Datos como Asunto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
15.
J Physiol Anthropol ; 39(1): 4, 2020 Feb 21.
Artículo en Inglés | MEDLINE | ID: mdl-32085811

RESUMEN

BACKGROUND: Recently, attempts have been made to use the pulse rate variability (PRV) as a surrogate for heart rate variability (HRV). PRV, however, may be caused by the fluctuations of left ventricular pre-ejection period and pulse transit time besides HRV. We examined whether PRV differs not only from HRV but also depending on the measurement site. RESULTS: In five healthy subjects, pulse waves were measured simultaneously on both wrists and both forearms together with single-lead electrocardiogram (ECG) in the supine and sitting positions. Although average pulse interval showed no significant difference from average R-R interval in either positions, PRV showed greater power for the low-frequency (LF) and high-frequency (HF) components and lower LF/HF than HRV. The deviations of PRV from HRV in the supine and sitting positions were 13.2% and 7.9% for LF power, 24.5% and 18.3% for HF power, and - 15.0% and - 30.2% for LF/HF, respectively. While the average pulse interval showed 0.8% and 0.5% inter-site variations among the four sites in the supine and sitting positions, respectively, the inter-site variations in PRV were 4.0% and 3.6% for LF power, 3.8% and 4.7% for HF power, and 18.0% and 17.5% for LF/HF, respectively. CONCLUSIONS: These suggest that PRV shows not only systemic differences from HRV but also considerable inter-site variations.


Asunto(s)
Electrocardiografía/métodos , Frecuencia Cardíaca/fisiología , Análisis de la Onda del Pulso/métodos , Dispositivos Electrónicos Vestibles , Adulto , Femenino , Antebrazo/irrigación sanguínea , Humanos , Masculino , Postura/fisiología , Procesamiento de Señales Asistido por Computador , Muñeca/irrigación sanguínea , Adulto Joven
16.
Medicine (Baltimore) ; 99(8): e18787, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32080072

RESUMEN

RATIONALE: Facioscapulohumeral muscular dystrophy (FSHD) is the third most common muscular dystrophy, which is associated with facial, shoulder girdle, and paraspinal muscle atrophy. Most of the patients develop hypokyphosis and hyperlordosis in the course of the disease, to preserve standing posture. Corrective fusion is contraindicated in these patients as the surgery results with loss of compensatory hyperlordosis and leads to loss of trunk balance while standing. Although spinal fusion in neuromuscular scoliosis is a known treatment option, there are no studies in the literature on the spinal fusion of this specific patient group. PATIENT CONCERNS: In this case report we have presented a 66-year-old woman, who was admitted with back and abdominal pain, inability to sit straight, abdominal discomfort, and numbness in the lower extremities after prolonged sitting. DIAGNOSES: The patient developed severe hyperlordosis causing intra-abdominal disorders, radicular symptoms, and sitting discomfort due to FSHD. INTERVENTIONS: The patient underwent T2-S1 fusion and successful fusion was achieved. OUTCOMES: Individualized Neuromuscular Quality of Life Questionnaire (INQoL) was used to assess preoperative and 3 years postoperative functional outcomes. All domains and total score improved at the end of the follow-up period and successful fusion was verified radiologically. LESSONS: This case suggests that spinal fusion may provide functional improvement in carefully selected patient groups. Patient stratification considering spinal disability is required for further studies in this specific indication.


Asunto(s)
Lordosis/cirugía , Distrofia Muscular Facioescapulohumeral/fisiopatología , Fusión Vertebral/métodos , Anciano , Femenino , Humanos , Lordosis/etiología , Atrofia Muscular/etiología , Distrofia Muscular Facioescapulohumeral/complicaciones , Postura , Calidad de Vida , Sedestación , Resultado del Tratamiento
17.
J Oral Rehabil ; 47(5): 577-583, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31926028

RESUMEN

BACKGROUND: The pharyngeal phase is a particularly important clinical factor related to swallowing dysfunctions. Head and neck posture, as well as bolus volume, are important factors affecting the pharyngeal stages of normal swallowing. OBJECTIVE: The aim of our study was to identify the effects of sitting posture and bolus volume on the activation of swallowing-related muscles. MATERIALS AND METHODS: Twenty-four subjects participated in the study. The subjects were positioned in three sitting postures-slump sitting (SS), lumbo-pelvic upright sitting (LUS), and thoracic upright sitting (TUS). While sitting in the chair, the subject was instructed to swallow 10 and 20 mL of water. Surface electromyography (EMG) was used to measure the muscle activity of the supra-hyoid (SH) and infra-hyoid (IH) muscles. Also, sitting posture alignment (head, cervical and shoulder angle) was also performed. Data were analysed with a repeated measures analysis of variance (RMANOVA) using a generalised linear model. RESULTS: There was no significant difference in terms of the head angle (P = .395). However, significant differences were found in relation to the cervical angle (P < .001) and shoulder angle (P < .001). The TUS produced the lowest SH EMG activity (P = .001), in comparison to SS and LUS. The bolus volume for 20 mL showed greater SH and IH EMG activity (P < .001) than did the bolus volume for 10 mL. CONCLUSIONS: Correcting sitting posture from SS to TUS may better assist swallowing-related muscles with less effort, irrespective of the bolus volume.


Asunto(s)
Deglución , Sedestación , Electromiografía , Músculos del Cuello , Postura
18.
J Dent Educ ; 84(1): 5-12, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31977099

RESUMEN

Prolonged and static postures among dental workforce personnel may lead to work-related musculoskeletal disorders (WMSDs). The aim of this study was to determine whether feedback involving photography and self-assessment would improve dental educators' postures and accuracy of ergonomic self-assessment. This study used a randomized control design. The Modified-Dental Operator Posture Assessment Instrument (M-DOPAI) was used for all ergonomic evaluations over a four-week period at one U.S. dental school. At week 1, all 30 participating dental educators were photographed and completed an M-DOPAI without viewing the photographs. In weeks 2 and 3, the educators in the control group (N=15) completed an M-DOPAI without any additional photographs. The educators in the training group (N=15) had additional photographs taken and used the photographs to complete an ergonomic self-assessment with the principal investigator. From week 1 to week 4, the ergonomics training utilizing photography resulted in improvements in the dental educators' ergonomic scores but not the accuracy of their ergonomic self-assessments. All participants strongly agreed it was important for both dental students and dentists to understand proper ergonomics, properly apply proper ergonomics, and have accurate ergonomic self-assessment skills in clinical practice. Although these dental educators valued ergonomic principles, they lacked training in applying these principles with dental students. Without additional training in ergonomics and self-assessment, the development of these skills in dental students will be affected.


Asunto(s)
Retroalimentación , Enfermedades Musculoesqueléticas , Enfermedades Profesionales , Concienciación , Ergonomía , Humanos , Postura , Autoevaluación , Estudiantes de Odontología
19.
PLoS One ; 15(1): e0227370, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31900468

RESUMEN

Many dizzy patients express a hypersensitivity to visual motion and clutter. This study aims to investigate how exposure to rotating visual clutter affects ocular torsion, vertical skewing, body-sway, the autonomic pupillary response, and the subjective feeling of discomfort to the stimulation. Sixteen healthy subjects were exposed to 20 seconds rotational visual stimulation (72 deg/s; 50 deg visual field). Visual stimuli were comprised of black lines on a white background, presented at low and high intensity levels of visual clutter, holding 19 lines and 38 lines respectively. Ocular torsion and vertical skewing were recorded using the Chronos Eye Tracker, which also measured pupil size as a reflection of the autonomic response. Postural control was evaluated by measuring body-sway area on the Wii Balance Board. Values were compared to data retrieved 20 seconds before and after the optokinetic stimulation, as subjects viewed the stationary visual scene. The high intensity stimulus resulted in significantly higher torsional velocities. Subjects who were exposed to low intensity first exhibited higher velocities for both intensities. Both pupil size and body sway increased for the higher intensity to both the moving and stationary visual scene, and were positively correlated to torsional velocity. In conclusion, exposure to visual clutter was reflected in the eye movement response, changes in postural control, and the autonomic response. This response may hold clinical utility when assessing patients suffering from visual motion hypersensitivity, while also providing some context as to why some healthy people feel discomfort in visually cluttered surroundings.


Asunto(s)
Movimientos Oculares/fisiología , Percepción de Movimiento/fisiología , Equilibrio Postural/fisiología , Postura/fisiología , Adulto , Anciano , Femenino , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana Edad , Estimulación Luminosa , Rotación , Visión Ocular , Campos Visuales , Adulto Joven
20.
Nat Commun ; 11(1): 444, 2020 01 23.
Artículo en Inglés | MEDLINE | ID: mdl-31974376

RESUMEN

Networks of sensors placed on the skin can provide continuous measurement of human physiological signals for applications in clinical diagnostics, athletics and human-machine interfaces. Wireless and battery-free sensors are particularly desirable for reliable long-term monitoring, but current approaches for achieving this mode of operation rely on near-field technologies that require close proximity (at most a few centimetres) between each sensor and a wireless readout device. Here, we report near-field-enabled clothing capable of establishing wireless power and data connectivity between multiple distant points around the body to create a network of battery-free sensors interconnected by proximity to functional textile patterns. Using computer-controlled embroidery of conductive threads, we integrate clothing with near-field-responsive patterns that are completely fabric-based and free of fragile silicon components. We demonstrate the utility of the networked system for real-time, multi-node measurement of spinal posture as well as continuous sensing of temperature and gait during exercise.


Asunto(s)
Vestuario , Monitoreo Ambulatorio/instrumentación , Monitoreo Ambulatorio/métodos , Tecnología Inalámbrica , Suministros de Energía Eléctrica , Fenómenos Electromagnéticos , Diseño de Equipo , Ejercicio Físico/fisiología , Humanos , Rodilla , Postura/fisiología , Columna Vertebral/fisiología , Temperatura , Caminata/fisiología , Tecnología Inalámbrica/instrumentación
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