The influence of smartphone use on spinal posture – A laboratory study

BackgroundSmartphones have become increasingly more popular and complicated tasks can be performed with these devices. However, the increasing use is associated with shoulder and neck pain, as well as with psychological addiction.Research questionDo different smartphone tasks lead to changes in spinal posture and pelvic position? Is there a relationship between smartphone addiction and changes in posture?MethodsA cross-sectional study including 50 participants was performed. Test subjects completed the Smartphone Addiction Scale and the SF-36 health questionnaire. Subjects spinal posture and pelvic position during different smartphone tasks were measured through a surface topography system. The different tasks were: standing in an upright position, simulating a phone call, texting with one or two hands during standing or while walking on a treadmill. Paired T-tests and ANOVA tests were performed to evaluate differences. The Kendall rank test was used to investigate the association between clinical scores and changes in spinal posture.ResultsAll smartphone tasks lead to a significant increase in thoracic kyphosis and trunk inclination during standing and while walking. A significant increased lumbar lordosis was also found. Texting with one or two hands correlated with increased surface rotation. No associations between smartphone addiction and changes of the spinal posture were reported.SignificanceThis represents the first surface topography study that investigated the influence of different smartphone tasks on the spinal posture and pelvic position during standing and while walking. With the results of this study we demonstrated that smartphone use leads to significant changes of sagittal and frontal spine parameters. Further research should focus on the evaluation of possible detrimental effects of long-term smartphone use on the spinal posture and on the development of preventive measures.     

特发性正常压力脑积水患者平衡稳定性特征

目的 观察特发性正常压力脑积水(iNPH)患者存在的姿势控制问题。     

Recurrent costs of HIV/AIDS-related health services in Rwanda: implications for financing

Objective To estimate recurrent costs per patient and costs for a national HIV/AIDS treatment programme model in Rwanda. Methods A national HIV/AIDS treatment programme model was developed. Unit costs were estimated so as to reflect necessary service consumption of people living with HIV/AIDS (PLWHA). Two scenarios were calculated: (1) for patients/clients in the year 2006 and (2) for potential increases of patients/clients. A sensitivity analysis was conducted to test the robustness of results. Results Average yearly treatment costs were estimated to amount to 504 US$ per patient on antiretroviral therapy (ART) and to 91 US$ for non‐ART patients. Costs for the Rwandan HIV/AIDS treatment programme were estimated to lie between 20.9 and 27.1 million US$ depending on the scenario. ART required 9.6 to 11.1 million US$ or 41–46% of national programme costs. Treatment for opportunistic infections and other pathologies consumed 7.1 to 9.3 million US$ or 34% of total costs. Conclusion Health Care in general and ART more specifically is unaffordable for the vast majority of Rwandan PLWHA. Adequate resources need to be provided not only for ART but also to assure treatment of opportunistic infections and other pathologies. While risk‐pooling may play a limited role in the national response to HIV/AIDS, considering the general level of poverty of the Rwandan population, no appreciable alternative to continued donor funding exists for the foreseeable future.     

Literature review on monitoring technologies and their outcomes in independently living elderly people

Purpose: To obtain insight into what kind of monitoring technologies exist to monitor activity in-home, what the characteristics and aims of applying these technologies are, what kind of research has been conducted on their effects and what kind of outcomes are reported. Methods: A systematic document search was conducted within the scientific databases Pubmed, Embase, Cochrane, PsycINFO and Cinahl, complemented by Google Scholar. Documents were included in this review if they reported on monitoring technologies that detect activities of daily living (ADL) or significant events, e.g. falls, of elderly people in-home, with the aim of prolonging independent living. Results: Five main types of monitoring technologies were identified: PIR motion sensors, body-worn sensors, pressure sensors, video monitoring and sound recognition. In addition, multicomponent technologies and smart home technologies were identified. Research into the use of monitoring technologies is widespread, but in its infancy, consisting mainly of small-scale studies and including few longitudinal studies. Conclusions: Monitoring technology is a promising field, with applications to the long-term care of elderly persons. However, monitoring technologies have to be brought to the next level, with longitudinal studies that evaluate their (cost-) effectiveness to demonstrate the potential to prolong independent living of elderly persons.

• Implications for Rehabilitation

• Insight was obtained of what kind of technologies exist to monitor activity of daily living, what their functionalities and outcomes of using these technologies are to prolong independent living of non-institutionalised elderly people.

• Five main groups of monitoring technologies exist with a wide range of functionalities. Research into the use of monitoring technologies is widespread but in its infancy, consisting mainly of small-scale studies and including few longitudinal studies.

• Research into the use of monitoring technologies demonstrated that the systems are able to monitor daily activities and have the potential of prolonging independent living of elderly people.

     

Assessing head and trunk symmetry during sleep using tri-axial accelerometers

Using two types of small, lightweight tri-axial accelerometers, we obtained evidence for the effectiveness of an approach for assessing head–trunk symmetrical or asymmetrical positions during sleep. First, we assessed the accuracy of our monitoring system in five healthy young adults (age range, 22–24 years). The participants wore acceleration monitors on the sternum and forehead; then spent 5?min in six different positions. Once accuracy was confirmed, we assessed head–trunk symmetry during night-time sleep in 10 healthy children (age range, 3–13 years) and 10 young adults (age range, 21–26 years) in their home environments. All participants wore the monitors during one night’s sleep in their homes. After computing head–trunk positions using the orientation data obtained by the accelerometers, head and trunk symmetry were evaluated. The head and trunk positions were correctly detected: the positional data from the trunk had 99% agreement, and the data from the head had 96% agreement. Both the young adults and children were observed to spend time with the head–trunk in asymmetric positions; however, the subjects changed position frequently so the asymmetrical postures were mobile. We concluded that the proposed monitoring system is a reliable and valid approach for assessing head–trunk symmetry during sleep at home.

• Implications for Rehabilitation

• We propose a head and trunk symmetry monitoring system using accelerometers.

• The proposed system could accurately identify head and trunk position.

• Asymmetrical positioning was seen in healthy participants but it was not immobile.

     

不同体位下指压不同穴位对脑卒中患者胫前肌和腓骨长、短肌的表面肌电影响

摘要 目的：优化指压穴位刺激法在脑卒中偏瘫治疗中的应用。 方法：30例偏瘫患者,分别在仰卧伸膝0°位和屈膝90°位下指压偏瘫侧足三里、足临泣穴,对比刺激即刻3s、停止刺激后第一个3s、第二个3s、第三个3s的胫前肌和腓骨长、短肌最大等长收缩的积分肌电值（iEMG）。 结果：①刺激前后比较：两种体位下,指压两个穴位,刺激即刻的iEMG明显高于刺激前（P<0.05）,停止刺激后的三个3s的iEMG呈逐渐下降趋势。②穴位间比较：两种体位下,均表现为指压足三里穴,胫前肌刺激即刻的iEMG、停止刺激后的三个3s的iEMG均明显高于足临泣穴（P<0.05）;指压足临泣穴,腓骨长、短肌刺激即刻的iEMG、停止刺激后的三个3s的iEMG均明显高于足三里穴（P<0.05）。③体位间比较：仰卧屈膝90°位指压两个穴位,胫前肌刺激即刻、停止刺激后第一个3s的iEMG明显高于伸膝0°位（P<0.05）;腓骨长、短肌刺激即刻的iEMG明显高于伸膝0°位（P<0.05）。 结论：①指压刺激偏瘫侧足三里、足临泣穴均可诱发偏瘫侧胫前肌和腓骨长、短肌收缩,且即刻效应和延续效应良好。②指压足三里穴对诱发胫前肌收缩的即刻效应和延续效应优于足临泣穴;指压足临泣穴对诱发腓骨长、短肌收缩的即刻效应和延续效应优于足三里穴。③仰卧屈膝90°位,指压刺激足三里、足临泣穴对诱发胫前肌和腓骨长、短肌收缩的即刻效应明显优于伸膝0°位,延续效应无明显差异。     

基于卷积神经网络的智能医疗护理研究

为了提高智能医疗护理水平,减少护理工作量,节约医院成本。提出一种基于卷积神经网络的病人体态行为特征提取算法,该算法采用双网络模型设计,包括病人检测网络模型和病人体态行为特征提取模型,应用该算法到病人体态行为检测系统中,从而实现对病人的识别监控,提高智能医疗护理水平。最后,通过开源框架平台,对病人行为检测系统进行测试,实验结果表明,测试数据集合越大,病人体态行为特征提取精度越高,对病人体态行为类别的平均识别率97.6%,从而验证了系统的有效性和正确性。     

“卧”的姿势、时位与禁忌文献研究

养生之诀,以卧为先。通过从"卧"的姿势、时位以及禁忌归纳整理古代养生文献,发现古人所言睡方,应以侧卧为宜,面生气之位而居,四时应晨起于寅卯时,夜卧于戌亥时;卧须有向包括:恒东而卧——万物以生,东西而卧——调补阴阳,四向而卧——以应四季,依季而卧——顺时针卧;卧的禁忌包括:趋避不良环境(勿卧窗脊下,卧处勿当风,卧勿对炉灯),趋避不当行为(卧须闭口,不可言语;卧勿覆首,旦须暖腹;卧勿饱食,亦不可久;卧勿湿头,脚踏勿高)。以此为方,才能获得健康的睡眠,达到养生延寿的效果。