Compensatory spinopelvic motions with and without a handheld task following a perturbation in standing between subjects with and without chronic low back pain.
- 作者列表："Sung PS","Schalk BM","Latuszek N","Hosmer E
BACKGROUND:A handheld task-related compensation strategy could be used to avoid injuries in subjects with chronic low back pain (LBP). Those who suffer with LBP demonstrate reduced spinopelvic motion; however, there is a lack of understanding on dynamic mobility with a handheld task. RESEARCH QUESTION:Are there differences in three-dimensional spinopelvic motions following a treadmill-induced perturbation in subjects with LBP while considering a handheld task? METHODS:Twenty-five subjects (11 female and 14 male) with LBP and 38 control subjects (15 female and 23 male) participated in the study. Each group was introduced to walking perturbations (0.86 m/sec, velocity in 0.1 sec) with and without a handheld tray in a standing position. The induced trip allowed subjects to recover by walking forward for a 5 second duration while the spinopelvic angles were measured during the trip and the subsequent recovery period. RESULTS:There was no significant group difference in the three-dimensional (3D) spinopelvic motions while holding or not holding a tray. However, the groups demonstrated a significant interaction on tray usage with 3D motions in the spinopelvic regions (F = 13.46, p = 0.001). The sagittal plane motion was significantly minimized with a handheld task for both the lumbar spine and pelvis in the LBP group. SIGNIFICANCE:The LBP group demonstrated minimized lumbar and pelvic motions in the sagittal plane, which underpins their concern to reduce motion while holding a tray. The significant interaction between groups on tray usage for spinopelvic compensation represents a strategy for avoiding injuries. Further studies are required to determine strategies to enhance lumbopelvic integration with handheld tasks in individuals with LBP.
背景: 手持式任务相关补偿策略可用于避免慢性下腰痛 (LBP) 受试者的损伤。那些患有LBP的人表现出脊柱骨盆运动减少; 然而，缺乏对手持任务的动态移动性的理解。 研究问题: 在考虑手持任务时，患有LBP的受试者在跑步机诱导扰动后三维脊柱骨盆运动是否存在差异？ 方法: 25名LBP受试者 (11名女性和14名男性) 和38名对照受试者 (15名女性和23名男性) 参与研究。每组被引入行走扰动 (0.86米/秒，速度在0.1秒)，有或没有手持托盘处于站立位置。诱导的行程允许受试者通过向前行走5秒持续时间来恢复，同时在行程和随后的恢复期期间测量棘骨盆角。 结果: 在保持或不保持托盘的情况下，三维 (3D) 骨盆运动没有显著的组差异。然而，这些组在托盘使用上与脊柱骨盆区域的3D运动表现出显著的相互作用 (f = 13.46，p = 0.001)。在LBP组中，腰椎和骨盆的矢状面运动在手持任务下显著最小化。 显著性: LBP组在矢状面显示了最小化的腰椎和骨盆运动，这支持了他们在拿着托盘时减少运动的关注。组之间的显著相互作用对spinopelvic补偿的托盘使用代表了避免伤害的策略。需要进一步的研究来确定在患有LBP的个体中增强腰骶部整合与手持任务的策略。
METHODS:OBJECTIVES:The aim was to evaluate the image quality and sensitivity to artifacts of compressed sensing (CS) acceleration technique, applied to 3D or breath-hold sequences in different clinical applications from brain to knee. METHODS:CS with an acceleration from 30 to 60% and conventional MRI sequences were performed in 10 different applications in 107 patients, leading to 120 comparisons. Readers were blinded to the technique for quantitative (contrast-to-noise ratio or functional measurements for cardiac cine) and qualitative (image quality, artifacts, diagnostic findings, and preference) image analyses. RESULTS:No statistically significant difference in image quality or artifacts was found for each sequence except for the cardiac cine CS for one of both readers and for the wrist 3D proton density (PD)-weighted CS sequence which showed less motion artifacts due to the reduced acquisition time. The contrast-to-noise ratio was lower for the elbow CS sequence but not statistically different in all other applications. Diagnostic findings were similar between conventional and CS sequence for all the comparisons except for four cases where motion artifacts corrupted either the conventional or the CS sequence. CONCLUSIONS:The evaluated CS sequences are ready to be used in clinical daily practice except for the elbow application which requires a lower acceleration. The CS factor should be tuned for each organ and sequence to obtain good image quality. It leads to 30% to 60% acceleration in the applications evaluated in this study which has a significant impact on clinical workflow. KEY POINTS:• Clinical implementation of compressed sensing (CS) reduced scan times of at least 30% with only minor penalty in image quality and no change in diagnostic findings. • The CS acceleration factor has to be tuned separately for each organ and sequence to guarantee similar image quality than conventional acquisition. • At least 30% and up to 60% acceleration is feasible in specific sequences in clinical routine.
METHODS:BACKGROUND:The main surgical techniques for spontaneous basal ganglia hemorrhage include stereotactic aspiration, endoscopic aspiration, and craniotomy. However, credible evidence is still needed to validate the effect of these techniques. OBJECTIVE:To explore the long-term outcomes of the three surgical techniques in the treatment of spontaneous basal ganglia hemorrhage. METHODS:Five hundred and sixteen patients with spontaneous basal ganglia hemorrhage who received stereotactic aspiration, endoscopic aspiration, or craniotomy were reviewed retrospectively. Six-month mortality and the modified Rankin Scale score were the primary and secondary outcomes, respectively. A multivariate logistic regression model was used to assess the effects of different surgical techniques on patient outcomes. RESULTS:For the entire cohort, the 6-month mortality in the endoscopic aspiration group was significantly lower than that in the stereotactic aspiration group (odds ratio (OR) 4.280, 95% CI 2.186 to 8.380); the 6-month mortality in the endoscopic aspiration group was lower than that in the craniotomy group, but the difference was not significant (OR=1.930, 95% CI 0.835 to 4.465). A further subgroup analysis was stratified by hematoma volume. The mortality in the endoscopic aspiration group was significantly lower than in the stereotactic aspiration group in the medium (≥40-<80 mL) (OR=2.438, 95% CI 1.101 to 5.402) and large hematoma subgroup (≥80 mL) (OR=66.532, 95% CI 6.345 to 697.675). Compared with the endoscopic aspiration group, a trend towards increased mortality was observed in the large hematoma subgroup of the craniotomy group (OR=8.721, 95% CI 0.933 to 81.551). CONCLUSION:Endoscopic aspiration can decrease the 6-month mortality of spontaneous basal ganglia hemorrhage, especially in patients with a hematoma volume ≥40 mL.
METHODS:OBJECTIVE:The primary purpose of this study was to evaluate the effectiveness of a three-dimensional (3D) software tool (smart planes) for displaying fetal brain planes, and the secondary purpose was to evaluate its accuracy in performing automatic measurements. MATERIAL AND METHODS:This prospective study included singleton fetuses with a gestational age (GA) greater than 18 weeks. Transabdominal two-dimensional ultrasound (2DUS) and 3D smart planes images were respectively used to obtain the basic planes of the fetal brain, with five parameters measured. The images, by either two-dimensional (2D) manual or 3D automatic operation, were reviewed by two experienced sonographers. The agreements between two measurements were analyzed. RESULTS:A total of 226 cases were included. The rates of successful detection by automatic display were as high as 80%. There was substantial agreement between the measurements of the biparietal diameter, head circumference and transcerebellar diameter, but poor agreement between the measurements of cisterna magna and lateral ventricle width. CONCLUSIONS:Smart Planes might be valuable for the rapid evaluation of fetal brain, because it simplifies the evaluation process. However, the technology requires improvement. In addition, this technology cannot replace the conventional manual US scans; it can only be used as an additional approach.