Abstract: Individuals with non-specific chronic low back pain may present altered movement patterns during functional activities. However, muscle behavior before and after performing a functional task with different load conditions is not yet fully understood. The aim of this study is to analyze lumbar muscle activity before and after performing the functional task of picking up and placing an object on the ground (with and without load) in individuals with nonspecific chronic low back pain. 20 subjects with nonspecific chronic low back pain and 20 healthy subjects participated in this study. A surface electromyography was performed in the ilio-costal, longissimus and multifidus muscles to evaluate lumbar muscle activity before and after performing the functional task of picking up and placing an object on the ground, with and without load. The symptomatic participants had greater lumbar muscle activation compared to the asymptomatic group, more evident in performing the task without load, with statistically significant difference (p = 0,033) between groups for the right multifidus muscle. This study showed that individuals with nonspecific chronic low back pain have higher muscle activation before and after performing a functional task compared to healthy participants.
Abstract: Along with the global aging of population, the number of people with somatic diseases is increasing, including such interrelated pathologies as obesity, osteoarthritis (OA) and osteoporosis (OP). The objective of the study is to examine the connection between body mass index (BMI), OA and bone mineral density (BMD) of lumbar spine, femoral neck and trabecular bone score (TBS) in postmenopausal women with OA. We have observed 359 postmenopausal women (50-89 years old) and divided them into four groups by age: 50-59 yrs, 60-69 yrs, 70-79 yrs and over 80 years old. In addition, according to the American College of Rheumatology (ACR) Clinical classification criteria for knee and hip OA, we divided them into 2 groups: group I – 117 females with symptomatic OA (including 89 patients with knee OA, 28 patients with hip OA) and group II –242 women with a normal functional activity of large joints. Analysis of data was performed taking into account their BMI, classified by World Health Organization (WHO). Diagnosis of obesity was established when BMI was above 30 kg/m2. In woman with obesity, a symptomatic OA was detected in 44 postmenopausal women (41.1%), a normal functional activity of large joints - in 63 women (58.9%). However, in women with normal BMI – 73 women, who account for 29.0% of cases, a symptomatic OA was detected. According to a chi-squared (χ2) test, a significantly higher level of BMI was detected in postmenopausal women with OA (χ2 = 5.05, p = 0.02). Women with a symptomatic OA had a significantly higher BMD of lumbar spine compared with women who had a normal functional activity of large joints. No significant differences of BMD of femoral necks or TBS were detected in either the group with OA or with a normal functional activity of large joints.
Abstract: Medical, social, and economic relevance of osteoporosis is caused by reducing quality of life, increasing disability and mortality of the patients as a result of fractures due to the low-energy trauma. This study is aimed to examine the associations of metabolic syndrome components, bone mineral density (BMD) and trabecular bone score (TBS) in menopausal women with non-vertebral fractures. 1161 menopausal women aged 50-79 year-old were examined and divided into three groups: A included 419 women with increased body weight (BMI - 25.0-29.9 kg/m2), B – 442 females with obesity (BMI >29.9 kg/m2)i and C – 300 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). BMD of lumbar spine (L1-L4), femoral neck, total body and forearm was investigated with usage of dual-energy X-ray absorptiometry. The bone quality indexes were measured according to Med-Imaps installation. All analyses were performed using Statistical Package 6.0. BMD of lumbar spine (L1-L4), femoral neck, total body, and ultradistal radius was significant higher in women with obesity and metabolic syndrome compared to the pre-obese ones (p
Abstract: Non-specific chronic low back pain (NSCLBP) is a common condition with no exact diagnosis and mechanism for its occurrence. Recently, different therapeutic exercises have taken into account to manage NSCLBP. So, the aim of this study has mainly been placed on comparing the effects of Pilates and Mackenzie exercises on quality of life (QOL) lumbar spine position sense (LSPS) in patients with NSCLBP. In this randomized clinical trial, 47 patients with NSCLBP were voluntarily divided into three groups of Pilates (n=16) (with mean age 37.1 ± 9.5 years, height 168.9 ± 7.4 cm, body mass 76.1 ± 5.9 k), McKenzie (n=15) (with mean age 42.7 ± 8.1 years, height 165.7 ± 6.8, body mass 74.1 ± 4.8 kg) and control (n=16) (with mean age 39.3 ± 9.8 years, height 168.1 ± 8.1 cm, body mass 74.2 ± 5.8 kg). Primary outcome included QOL and secondary was LSPS. Both variables were assessed by the WHOQOL-BREF questionnaires and electrogoniameter, respectively. The measurements were performed at baseline, following a 6-week intervention, and after a 4-week follow-up. The ANCOVA test at P < 0.05 was administrated to analyze the collected data using SPSS software. There was a statistically significant difference between experimental groups and the control group to improve QOL. But, no difference was seen regarding the effects of two exercises on LSPS (p < 0.05). Both Pilates and Mackenzie exercises demonstrated improvement in QOL after 6-week intervention and a 4-week follow-up while none of them considerably affected LSPS. Further studies are required to establish a supporting evidence for the effectiveness of two exercises on NSCLBP.
Abstract: Osteoporosis and obesity are widespread diseases in people over 50 years associated with changes in structure and body composition. Нigher body mass index (BMI) values are associated with greater bone mineral density (BMD). However, trabecular bone score (TBS) indirectly explores bone quality, independently of BMD. The aim of our study was to evaluate the relationship between the BMD and TBS parameters in Ukrainian men suffering from obesity. We examined 396 men aged 40-89 years. Depending on their BMI all the subjects were divided into two groups: Group I – patients with obesity whose BMI was ≥ 30 kg/m2 (n=129) and Group II – patients without obesity and BMI of < 30 kg/m2 (n=267). The BMD of total body, lumbar spine L1-L4, femoral neck and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS of L1- L4 was assessed by means of TBS iNsight® software installed on DXA machine (product of Med-Imaps, Pessac, France). In general, obese men had a significantly higher BMD of lumbar spine L1-L4, femoral neck, total body and ultradistal forearm (p < 0.001) in comparison with men without obesity. The TBS of L1-L4 was significantly lower in obese men compared to non-obese ones (p < 0.001). BMD of lumbar spine L1-L4, femoral neck and total body significantly differ in men aged 40-49, 50-59, 60-69, and 80-89 years (p < 0.05). At the same time, in men aged 70-79 years, BMD of lumbar spine L1-L4 (p=0.46), femoral neck (p=0.18), total body (p=0.21), ultra-distal forearm (p=0.13), and TBS (p=0.07) did not significantly differ. A significant positive correlation between the fat mass and the BMD at different sites was observed. However, the correlation between the fat mass and TBS of L1-L4 was also significant, though negative.
Abstract: Osteoporosis is one of the important problems in postmenopausal women due to an increased risk of sudden and unexpected fractures. This study is aimed to determine the connection between bone mineral density (BMD) and trabecular bone score (TBS) in Ukrainian women suffering from metabolic syndrome. Participating in the study, 566 menopausal women aged 50-79 year-old were examined and divided into two groups: Group A included 336 women with no obesity (BMI ≤ 29.9 kg/m2), and Group B – 230 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). Dual-energy X-ray absorptiometry was used for measuring of lumbar spine (L1-L4), femoral neck, total body and forearm BMD and bone quality indexes (last according to Med-Imaps installation). Data were analyzed using Statistical Package 6.0. A significant increase of lumbar spine (L1-L4), femoral neck, total body and ultradistal radius BMD was found in women with metabolic syndrome compared to those without obesity (p < 0.001) both in their totality and in groups of 50-59 years, 60-69 years, and 70-79 years. TBS was significantly higher in non-obese women compared to metabolic syndrome patients of 50-59 years and in the general sample (p < 0.05). Analysis showed significant positive correlation between body mass index (BMI) and BMD at all levels. Significant negative correlation between BMI and TBS (L1-L4) was established. Despite the fact that BMD indexes were significantly higher in women with metabolic syndrome, the frequency of vertebral and non-vertebral fractures did not differ significantly in the groups of patients.
Abstract: In the case of high-speed fighter aircrafts, seat ejection is designed mainly for the safety of the pilot in case of an emergency. Strong windblast due to the high velocity of flight is one main difficulty in clearing the tail of the aircraft. Excessive G-forces generated, immobilizes the pilot from escape. In most of the cases, seats are ejected out of the aircrafts by explosives or by rocket motors attached to the bottom of the seat. Ejection forces are primarily in the vertical direction with the objective of attaining the maximum possible velocity in a specified period of time. The safe ejection parameters are studied to estimate the critical time of ejection for various geometries and velocities of flight. An equivalent analytical 2-dimensional biomechanical model of the human spine has been modelled consisting of vertebrae and intervertebral discs with a lumped mass approach. The 24 vertebrae, which consists of the cervical, thoracic and lumbar regions, in addition to the head mass and the pelvis has been designed as 26 rigid structures and the intervertebral discs are assumed as 25 flexible joint structures. The rigid structures are modelled as mass elements and the flexible joints as spring and damper elements. Here, the motions are restricted only in the mid-sagittal plane to form a 26 degree of freedom system. The equations of motions are derived for translational movement of the spinal column. An ejection force with a linearly increasing acceleration profile is applied as vertical base excitation on to the pelvis. The dynamic vibrational response of each vertebra in time-domain is estimated.
Abstract: Transforaminal lumbar interbody fusion (TLIF) surgeries have nowadays became popular for treatment of degenerated spinal disorders. The interbody fusion technique like TLIF maintains load bearing capacity of the spine and a suitable disc height. Currently many techniques have been introduced to cure Spondylolisthesis. This surgery provides greater rehabilitation of degenerative spines. While performing this TLIF surgery existing methods use guideway, which is a troublesome surgery technique as the use of two separate instruments is required to perform this surgery. This paper presents a concept which eliminates the use of guideway. This concept also eliminates problems that occur like reverting the cage. The concept discussed in this paper also gives high accuracy while performing surgery.
Abstract: The purpose of this study is to identify human walking vertical force by using FFT power spectrum density from the experimental acceleration data of the human body. An experiment on human walking is carried out on a stationary floor especially paying attention to higher components of dynamic vertical walking force. Based on measured acceleration data of the human lumbar part, not only in-phase component with frequency of 2fw, 3fw, but also in-opposite-phase component with frequency of 0.5 fw, 1.5 fw, 2.5 fw where fw is the walking rate is observed. The vertical vibration of pedestrian bridge induced by higher components of human walking vertical force is also discussed in this paper. A full scale measurement for the existing pedestrian bridge with center span length of 33 m is carried out focusing on the resonance phenomenon due to higher components of human walking vertical force. Dynamic response characteristics excited by these vertical higher components of human walking are revealed from the dynamic design viewpoint of pedestrian bridge.
Abstract: Cole-Cole parameters of 40 post-menopausal women
are compared with their DEXA bone mineral density measurements.
Impedance characteristics of four extremities are compared; left and
right extremities are statistically same, but lower extremities are
statistically different than upper ones due to their different fat
content. The correlation of Cole-Cole impedance parameters to bone
mineral density (BMD) is observed to be higher for dominant arm.
With the post-menopausal population, ANOVA tests of the dominant
arm characteristic frequency, as a predictor for DEXA classified
osteopenic and osteoporic population around lumbar spine, is
statistically very significant. When used for total lumbar spine
osteoporosis diagnosis, the area under the Receiver Operating Curve
of the characteristic frequency is 0.830, suggesting that the Cole-Cole
plot characteristic frequency could be a useful diagnostic parameter
when integrated into standard screening methods for osteoporosis.
Moreover, the characteristic frequency can be directly measured by
monitoring frequency driven angular behavior of the dominant arm
without performing any complex calculation.
Abstract: Background: Muscle Energy Techniques (MET) have
been widely used by manual therapists over the past years, but still
limited research validated its use and there was limited evidence to
substantiate the theories used to explain its effects. Objective: To
investigate the effect of Muscle Energy Technique (MET) on anterior
pelvic tilt in patients with lumbar spondylosis. Design: Randomized
controlled trial. Subjects: Thirty patients with anterior pelvic tilt from
both sexes were involved, aged between 35 to 50 years old and they
were divided into MET and control groups with 15 patients in each.
Methods: All patients received 3sessions/week for 4 weeks where the
study group received MET, Ultrasound and Infrared, and the control
group received U.S and I.R only. Pelvic angle was measured by
palpation meter, pain severity by the visual analogue scale and
functional disabilities by the Oswestry disability index. Results: Both
groups showed significant improvement in all measured variables.
The MET group was significantly better than the control group in
pelvic angle, pain severity, and functional disability as p-value were
(0.001, 0.0001, 0.0001) respectively. Conclusion and implication: the
study group fulfilled greater improvement in all measured variables
than the control group which implies that application of MET in
combination with U.S and I.R were more effective in improving
pelvic tilting angle, pain severity and functional disabilities than
using electrotherapy only.
Abstract: Obesity and osteoporosis are the two diseases whose
increasing prevalence and high impact on the global morbidity and
mortality, during the two recent decades, have gained a status of
major health threats worldwide. Obesity purports to affect the bone
metabolism through complex mechanisms. Debated data on the
connection between the bone mineral density and fracture prevalence
in the obese patients are widely presented in literature. There is
evidence that the correlation of weight and fracture risk is sitespecific.
This study is aimed at determining the connection between
the bone mineral density (BMD) and trabecular bone score (TBS)
parameters in Ukrainian women suffering from obesity. We
examined 1025 40-89-year-old women, divided them into the groups
according to their body mass index: Group A included 360 women
with obesity whose BMI was ≥30 kg/m2, and Group B – 665 women
with no obesity and BMI of
Abstract: The aim of this study is to develop an anterior lumbar
interbody fusion (ALIF) PEEK cage suitable for Korean people. In this
study, CT images were obtained from Korean male (173cm, 71kg) and
3D Korean lumbar models were reconstructed based on the CT images
to investigate anatomical characteristics. Major design parameters of
anterior lumbar interbody fusion (ALIF) PEEK Cage were selected
using the morphological measurement information of the Korean
Lumbar models. Through finite element analysis and mechanical tests,
the developed ALIFPEEK Cage prototype was compared with the
Fidji Cage (Zimmer. Inc, USA) and it was found that the ALIF
prototype showed similar and/or superior mechanical performance
compared to the FidJi Cage. Also, clinical validation for the ALIF
PEEK Cage prototype was carried out to check predictable troubles in
surgical operations. Finally, it is considered that the convenience and
stability of the prototype was clinically verified.
Abstract: A novel hybrid model of the lumbar spine, allowing
fast static and dynamic simulations of the disc pressure
and the spine mobility, is introduced in this work. Our
contribution is to combine rigid bodies, deformable finite
elements, articular constraints, and springs into a unique model
of the spine. Each vertebra is represented by a rigid body
controlling a surface mesh to model contacts on the facet
joints and the spinous process. The discs are modeled using
a heterogeneous tetrahedral finite element model. The facet
joints are represented as elastic joints with six degrees of
freedom, while the ligaments are modeled using non-linear
one-dimensional elastic elements. The challenge we tackle
is to make these different models efficiently interact while
respecting the principles of Anatomy and Mechanics.
The mobility, the intradiscal pressure, the facet joint force and
the instantaneous center of rotation of the lumbar spine are
validated against the experimental and theoretical results of
the literature on flexion, extension, lateral bending as well as
axial rotation.
Our hybrid model greatly simplifies the modeling task and
dramatically accelerates the simulation of pressure within the
discs, as well as the evaluation of the range of motion and the
instantaneous centers of rotation, without penalizing precision.
These results suggest that for some types of biomechanical
simulations, simplified models allow far easier modeling and
faster simulations compared to usual full-FEM approaches
without any loss of accuracy.
Abstract: VACTERL association is a rare disorder with various
congenital malformations. The aetiology remains unknown.
Combination of at least three congenital anomalies of the following
criteria is required for diagnosis: vertebral defects, anal atresia,
cardiac anomalies, tracheo-esophageal fistula, renal anomalies, and
limb defects. The first case was 1-day old male neonate with multiple
congenital anomalies was bore from 28 years old mother. The mother
had history of pregnancy with lymphocyte therapy. His anomalies
included: defects in thoracic and lumbar vertebral, anal atresia,
bilateral hydronephrosis, atrial septal defect, and lower limb
abnormality. Other anomalies were cryptorchidism and nasal canal
narrowing. The second case was born with 32 weeks gestational age
from mother with history of pregnancy with lymphocyte therapy. He
had thoracic vertebral defect, cardiac anomalies and renal defect.
diagnosis based on clinical finding is VACTERL association. Early
diagnosis is very important to investigation and treatment of other
coexistence anomalies. VACTERL association in mothers with
history of pregnancy with lymphocyte therapy has suggested possibly
of relationship between VACTERL association and this method of
pregnancy.
Abstract: This paper describes a novel application of Fiber
Braggs Grating (FBG) sensors in the assessment of human postural
stability and balance on an unstable platform. In this work, FBG
sensor Stability Analyzing Device (FBGSAD) is developed for
measurement of plantar strain to assess the postural stability of
subjects on unstable platforms during different stances in eyes open
and eyes closed conditions on a rocker board. The studies are
validated by comparing the Centre of Gravity (CG) variations
measured on the lumbar vertebra of subjects using a commercial
accelerometer. The results obtained from the developed FBGSAD
depict qualitative similarities with the data recorded by commercial
accelerometer. The advantage of the FBGSAD is that it measures
simultaneously plantar strain distribution and postural stability of the
subject along with its inherent benefits like non-requirement of
energizing voltage to the sensor, electromagnetic immunity and
simple design which suits its applicability in biomechanical
applications. The developed FBGSAD can serve as a tool/yardstick to
mitigate space motion sickness, identify individuals who are
susceptible to falls and to qualify subjects for balance and stability,
which are important factors in the selection of certain unique
professionals such as aircraft pilots, astronauts, cosmonauts etc.
Abstract: A retrospective study was undertaken to record the
occurrence and pattern of fractures in small animals (dogs and cats)
from year 2005 to 2010. A total of 650 cases were presented in small
animal surgery unit out of which of 116 (dogs and cats) were
presented with history of fractures of different bones. A total of
17.8% (116/650) cases were of fractures which constituted dogs 67%
while cats were 23%. The majority of animals were intact. Trauma in
the form of road side accident was the principal cause of fractures in
dogs whereas as in cats it was fall from height. The ages of the
fractured dog ranged from 4 months to 12 years whereas in cat it was
from 4 weeks to 10 years. The femoral fractures represented 37.5%
and 25% respectively in dogs and cats. Diaphysis, distal metaphyseal
and supracondylar fractures were the most affected sites in dog and
cats. Tibial fracture in dogs and cats represented 21.5% and 10%
while humoral fractures were 7.9% and 14% in dogs and cats
respectively. Humoral condyler fractures were most commonly seen
in puppies aged 4 to 6 months. Fractured radius-ulna incidence was
19% and 14% in dogs and cats respectively. Other fractures recorded
were of lumbar vertebrae, mandible and metacarpals etc. The
management comprised of external and internal fixation in both the
species. The most common internal fixation technique employed was
Intramedullary fixation in long followed by other methods like stack
or cross pinning, wiring etc as per findings in the cases. The cast
bandage was used majorly as mean for external coaptation. The
paper discusses the outcome of the case as per the technique
employed.
Abstract: In this paper, the construction of a detailed spine
model is presented using the LifeMOD Biomechanics Modeler. The
detailed spine model is obtained by refining spine segments in
cervical, thoracic and lumbar regions into individual vertebra
segments, using bushing elements representing the intervertebral
discs, and building various ligamentous soft tissues between
vertebrae. In the sagittal plane of the spine, constant force will be
applied from the posterior to anterior during simulation to determine
dynamic characteristics of the spine. The force magnitude is
gradually increased in subsequent simulations. Based on these
recorded dynamic properties, graphs of displacement-force
relationships will be established in terms of polynomial functions by
using the least-squares method and imported into a haptic integrated
graphic environment. A thoracolumbar spine model with complex
geometry of vertebrae, which is digitized from a resin spine
prototype, will be utilized in this environment. By using the haptic
technique, surgeons can touch as well as apply forces to the spine
model through haptic devices to observe the locomotion of the spine
which is computed from the displacement-force relationship graphs.
This current study provides a preliminary picture of our ongoing
work towards building and simulating bio-fidelity scoliotic spine
models in a haptic integrated graphic environment whose dynamic
properties are obtained from LifeMOD. These models can be helpful
for surgeons to examine kinematic behaviors of scoliotic spines and
to propose possible surgical plans before spine correction operations.
Abstract: Hysitron TriboIndenterTM TI 950 system has been
used for studying the local viscoelastic properties of porcine
intervertebral disc end plate by means of nanoscale mechanical
dynamic analysis. The specimen of an endplate was cut from fresh
porcine vertebra dissected from 16 month animal. The lumbar spine
motion segments were dissected and 5 millimeter thick plates of
vertebral body, endplate and annulus fibrosus were prepared for
nanoindentation. The surface of the sample was kept in physiological
solution during nanoindentation experiment. We obtained mechanical
characteristics of different areas of native endplate (endplate middle
and vertebra and annulus fibrosus boundary).
Abstract: Breastfeeding has been receiving much attention of late. Prolonged sitting for breastfeeding often results in back pain of the mothers. This paper reports the findings of a study on the effect of some factors, especially lumbar support, on back pain of breastfeeding mothers. The results showed that the use of lumbar support can reduce back pain of breastfeeding mothers significantly. Back pain was found to increase with breastfeeding time and the rate of increase was lower when lumbar supports were used. When lumbar support thickness was increased gradually from zero (no support) to 11 cm., the degree of low back pain decreased; rapidly at first, then slowly, and leveled off when the thickness reached 9 cm. Younger mothers were less prone to back pain than older mothers. The implications of the findings are discussed.