The biomechanics of vibration and low back pain

This work is a review of the mechanical factors related to low back pain production in a vibration environment. The sitting posture is an extreme orientation for the lumbar intervertebral disc that 1) increases its internal pressure, 2) increases its anteroposterior shear flexibility, while: 3) decreasing its resistance to buckling instability and 4) stressing the posterior region of the disc. Vibration is an additional mechanical stressor. Several studies suggest that the following preventive measures be taken to reduce the risk of low back pain due to driving: 1) minimize the vibration reaching the driver, 2) avoid lifting or bending immediately following driving, and 3) walk around for a few minutes following driving. © 1993 Wiley-Liss, Inc.     

A persisting secular trend for body measurements in Dutch children. The Oosterwolde 11 study

To investigate whether the secular trend for growth in Dutch children still exists, the Oosterwolde I study of 1980 was repeated in 1989. A persisting secular trend was visible for height while the z scores of body proportions show no change during the past 10 years, which suggests that there is no change in the timing of puberty.     

上田法对脑瘫儿运动功能改善的疗效评价

目的　为了研究上田法与Vojta等法对脑瘫儿运动功能改善情况。方法　将 5 8例脑瘫儿 (包括 3岁以上及重症脑瘫儿 )分为年龄相同的两组 ,分别采用上田法与Vojta等法治疗 ,疗程≥ 1个月。 结果　上田组的坐位功能改善较Vojta组明显 (P <0 0 1)。在上田组中 ,3岁以上脑瘫儿治疗前、后总分平均为 (5 7 0 4± 31 92 )分和 (78 5 2± 2 0 83)分 ,重症脑瘫儿治疗前、后总分平均为 (10 5 4± 9 6 1)分和 (31 5 2± 15 0 3)分。而Vojta组中 ,3岁以上脑瘫儿治疗前、后总分平均为 (73 33± 31 86 )分和 (80 37± 2 4 76 )分 ,重症脑瘫儿治疗前、后总分平均为 (2 3 5 5± 2 1 98)分和 (2 9 33± 2 5 2 1)分。结论　上田法对脑瘫儿坐位功能改善优于Vojta等法 ,尤其对 3岁以上脑瘫儿及重症脑瘫儿效果更佳     

Permanent Postoperative Anosmia: A Serious Complication of Neurovascular Decompression in the Sitting Position

Summary  In posterior fossa surgery, the sitting position offers a number of advantages believed to outweigh complications such as air embolism and pneumatocephalus. For this reason, the sitting position is frequently used in neurovascular decompression for trigeminal neuralgia. Two years ago we reported on a previously undescribed complication: permanent postoperative anosmia. Following the recent occurrence of a second case, we conducted a nationwide survey to determine the frequency of this complication. Permanent postoperative anosmia following surgical procedures in the sitting position has been observed in 3 other institutions. In addition, the survey revealed that only 40% of German neurosurgeons still favor the sitting position for surgery of the posterior cranial fossa.  Considering that permanent anosmia severely reduces quality of life, and that it can be avoided by using another position, the sitting position for surgical procedures in the posterior fossa should be restricted to special cases (e.g., brain stem tumors).     

不同体位支气管镜检查的麻醉中气道通畅性的随机对照研究

目的对坐位及仰卧位支气管镜检查麻醉中气道通畅性进行研究。方法选取48例行不插管全麻下支气管镜检查的患者随机分为两组。其中24例行坐位下支气管镜检查,24例行仰卧位支气管镜检查,观察两组患者检查过程中气道的通畅性及生命体征变化。结果坐位支气管镜检查过程中到达隆突的平均时间更短,气道通畅性更好。外周血氧饱和度(Sp O2)降低、平均动脉压(MAP)升高和烦躁的发生率明显低于仰卧位。结论支气管镜检查麻醉可减轻患者不适感与恐惧感,但传统的仰卧位气管镜检查时麻醉可引起舌后坠,咽喉部塌陷、软腭和声带相关的重力可能造成上呼吸道的阻塞,不但给检查带来不便,同时也增加了相应的气道相关性风险及血流动力学不稳定,而坐位支气管镜检查可以通过保证气道通畅性,维持更为稳定的血流动力学状态,使该体位在支气管镜麻醉镇静中的应用更安全,更方便。     

Validity and reliability of wheelchair sitting posture measures using Coach’s Eye in abled subjects

People in wheelchairs spend a long time in the sitting position and often incur alignment problems resulting in neck and back pain. This study: (1) assessed the validity/reliability of Coach’s Eye (CE) smart device application, (2) examined the effect of seat to back support angle adjustments on head, neck, and shoulder posture in the sitting position, and (3) compared changes in cervical rotation at each back support angle. Abled subjects sat in a wheelchair with back support angles positioned at 90°, 100°, and 110°. CE, as well as ImageJ software, was used to analyze three angles: sagittal head angle (SHA), cervical angle (CVA), and shoulder angle (SA). There were highly significant differences for CVA and SA (p < 0.001) among the three seat to back support angles. Validity of CE was examined by correlating CE with ImageJ scores. CE had high validity for all angles (r = 0.99, 0.98, 0.99 respectively, p < 0.001). Inter-rater reliability for SHA, CVA, and SA was high (intraclass correlation coefficient [ICC] ranged from 0.95 to 0.99). Head (CVA) and shoulder (SA) alignment was closest to neutral posture with back support angles set at 110° and 90°, respectively.     

The effect of variability in maturational tempo and midparent height on variability in linear body measurements

Background: Information on the effect of variability in maturational tempo on variability in height attained at the same age is not readily available.

Aim: The study obtained this information from the data of the First Zurich Longitudinal Study.

Subjects and methods: Yearly measurements of standing height, sitting height and leg length, yearly assessments of bone age (RUS (Radius, Ulna and Short bones), TW3 method) and midparent height for 232 children from the First Zurich Longitudinal Growth Study are included in a correlational analysis.

Results: The course of the squared correlations of standing height, sitting height and leg length with attained RUS bone age, midparent height and both as a function of age are presented.

Conclusions: During puberty, up to 50% of the height variation in boys and 40% in girls is explained by maturational tempo.

Résumé. Arrière plan: L’information concernant l’effet de la variabilitè du rythme de la maturation sur celle de la stature á un âge donnè, n’est pas disponible.

But: Cette ètude a obtenu de l’information á partir de la première ètude longitudinale de Zurich.

Sujet0s y mèthodes: Une analyse de corrèlation est effectuèe á partir de mensurations annuelles de la stature, de la taille assis et de la longueur de la jambe, de contröles annuels de l’âge osseux (RUS, TW3) et de la stature mèdiale des parents pour 232 enfants de la première ètude de croissance de Zurich.

Résultats: On prèsente les valeurs des carrès des corrèlations pour la stature, la taille assis et la longueur de la jambe avec l’âge osseux atteint (RUS radius, ulna et os courts), avec la stature mèdiale des parents et les deux comme une fonction de l’âge.

Conclusions: Pendant la pubertè, jusqu’á 50% de la variation de la stature des garons et 40% de celle des filles, sont expliquès par le rythme de maturation.

Zusammenfassung. Hintergrund: Informationen über die Auswirkungen von Schwankungen im reifungsbedingten Wachstumstempo auf unterschiedliche im gleichen Alter erzielte Größen sind nicht in geeigneter Form verfügbar.

Ziel: Die vorliegende Arbeit versucht, Informationen zur angesprochenen Problematik aus den Daten der ersten Züricher Longitudinalstudie zu erlangen.

Inhalt und Methodik: Die jährlichen Daten aus Größenmessungen in den Positionen Stehen, Sitzen sowie Beinlänge und die jährlichen Bewertungsergebnisse der Knochenalter (RUS, TW3) als auch die Medium-Elterngrößen von 232 Kindern aus der ersten Züricher Longitudinalgrößenstudie werden in einer Wechselbeziehungsanalyse erfaßt.

Ergebnisse: Die Verläufe der quadrierten Verhältnisse von Steh-, Sitzgröße beziehungsweise Beinlänge mit denen von Knochenaltern nach RUS-Methode (Radius [Speiche], Ulna [Elle], Short bones [kleine Knochen]) beziehungsweise Medium-Elterngröße werden präsentiert. Beide Datenmengen werden außerdem als Funktionen des Alters dargestellt.

Schlußfolgerungen: Während des Stadiums der Pubertät lassen sich Größenunterschiede bei bis zu 50% der Jungen und bis zu 40% der Mädchen mit den Schwankungen im reifungsbedingten Wachstumstempo erklären.

Resumen. Antecedentes: No es fácil disponer de información acerca del efecto que tiene la variabilidad en el ritmo madurativo sobre la variabilidad estatural alcanzada a la misma edad.

Objetivo: El estudio obtuvo esta información a partir de los datos del Primer Estudio Longitudinal de Zurich (First Zurich Longitudinal Study).

Sujetos y métodos: Se han incluido en un análisis de correlaciones las medidas anuales de la estatura, la talla sentado y la longitud de la pierna así como las estimaciones anuales de la edad ósea (RUS, TW3) y la estatura media de los progenitores, de 232 niños del Primer Estudio Longitudinal de Zurich (First Zurich Longitudinal Study).

Resultados: Se presentan las variaciones de las correlaciones cuadráticas de la estatura, la talla sentado y la longitud de la pierna con la edad ósea alcanzada basada en el mètodo RUS (radio, ulna y huesos cortos), la estatura media de los progenitores y ambas en función de la edad.

Conclusiones: Durante la pubertad, hasta el 50% de la variación estatural de los chicos y el 40% de la de las chicas se explica por el ritmo madurativo.     

Correlates of sedentary behaviour in Asian adults: A systematic review

The objective of this study is to systematically review the evidence on correlates of sedentary behaviour (SB) among Asian adults. We searched for studies that examined individual, environmental, and political/cultural correlates of total and domain‐specific SB (transport, occupation, leisure, and screen time) in Asian adults published from 2000 onwards in nine scientific databases. Two reviewers independently screened identified references. Following quality assessment of included studies, we performed narrative synthesis that considered differences based on SB measurements, regions, and population characteristics (PROSPERO: CRD42018095268). We identified 13 249 papers of which we included 49, from four regions and 12 countries. Researchers conducted cross‐sectional analyses and most relied on SB self‐report for SB measurement. Of the 118 correlates studied, the following associations were consistent: higher age, living in an urban area (East Asia), and lower mental health with higher total SB; higher education with higher total and occupational SB; higher income with higher leisure‐time SB; higher transit density with higher total SB in older East Asians; and being an unmarried women with higher SB in the Middle East. We encourage more research in non‐high‐income countries across regions, further exploration of important but neglected correlates using longitudinal designs and qualitative research, and the use of objective instruments to collect SB data.     

Efficacy of wet-lab training versus surgical-simulator training on performance of ophthalmology residents during chopping in cataract surgery

AIM: To analyze whether wet-lab training(WLT) or surgical-simulator training(SST) is better for ophthalmology residents to master the chopping technique.METHODS: Sixty ophthalmology residents(in their second year) and three cataract surgeons participated in the study. The residents were randomly separated into two groups, WLT group and SST group. The residents in WLT group were asked to perform 10 trials of chopping using pig eyes and scored by the surgeons, and then they performed and scored using simulator for one time. The residents in SST group underwent 10 trials of chopping using simulator, and the simulator scored each trail. Then, this group were asked to perform the chopping using pig eyes and scored by the surgeons. At last, we investigated the residents’ satisfaction about the training.RESULTS: The demographic characteristics had no significant differences between the two groups. Recorded by the simulator, the residents in SST group got significantly higher overall score(83.90±1.31) than WLT group(78.73±1.92, P=0.03). And the residents in SST group got less corner area injured, and they spend less time than WLT group(P<0.05). Moreover, the residents in WLT group used more ultrasonic energy value than SST group(P=0.03). However, scored by the surgeons, the residents in two groups got nearly the same overall score. The residents in WLT group performed better on the frequencies of posterior capsule torn and incisional stress(P=0.03, 0.008, respectively). In the survey, the residents in two groups held the same opinion that the training was helpful and they strongly recommended this training. And all of them enjoyed the training, and enjoyed being randomized in their own group. However, with respect to the realistic character, the residents thought that WLT was better than SST(P<0.001).CONCLUSION: Both of the Eyesi surgical-stimulator and the wet-lab improve the residents’ chopping ability and each has its own advantages. The combination of the two training ways could be considered to be a part of the training curriculum for new residents.