A 3D Spine and Full Skeleton Model for Opto-Electronic Stereo- Photogrammetric Multi-Sensor Biomechanical Analysis in Posture and Gait

Quantitative functional evaluation of spine is highly desirable in posture and movement analysis. Given the complexity of the spine biomechanical system, very few studies outline the behaviour of the spine in posture and movement analysis. During a research lasting 25 years, a complete three‐dimensional (3D) parametric biomechanical skeleton model including a 3D full spine model based on the measurements of the positions of suitable body landmarks labelled by passive markers has been implemented. Around this model, a fully dedicated 3D opto‐electronic stereo‐photogrammetric system named Global Opto‐electronic Approach for Locomotion and Spine (GOALS) has been developed. Depending on different analysis purposes, the model can work at different stages of complexity. The model can integrate seamlessly data deriving from multiple measurement devices, such as 3D stereo‐photogrammetric systems, force platforms, surface electro‐myography and foot pressure maps. In addition to single‐trial analysis, the possibility to assess and to extract mean behaviours either for posture or for cyclical tasks (e.g. multiple strides in gait) has been included. The aim of this paper is to describe the current level of development of the GOALS system and its versatility as a clinical tool. To this purpose, examples of multi‐factorial quantitative functional descriptions of paradigmatic cases are presented

Corrective Bracing for Severe Idiopathic Scoliosis in Adolescence: Influence of Brace on Trunk Morphology

Aim. The aim of the work was to study whether wearing a corrective brace by adolescent girls with severe idiopathic scoliosis can influence external shape of the trunk. Methods. Comparison of clinical deformity of two groups of girls matched for age and Cobb angle: group (1) of 23 girls, aged 14.9 ± 1.3 years, Cobb angle 55.0° ± 6.8°, who refused surgical treatment and have been wearing Chêneau brace for more than 6 months, compared with group (2) of 22 girls, aged 14.1 ± 1.8 years, Cobb angle 59.7° ± 14.6° never treated with corrective bracing. Clinical deformity was assessed with the Bunnell scoliometer (angle of trunk rotation ATR) and surface topography (posterior trunk symmetry index POTSI and Hump Sum HS). Results. The ATR in the primary curvature was 11.9° ± 3.4° (5°–18°) in group 1 versus 15.1° ± 5.6° (6°–25°) in group 2 (P = 0.027). The HS was 16.8° ± 3.8 versus 19.2° ± 4.6, respectively, P = 0.07. The POTSI value did not differ between groups. Conclusion. Girls with Cobb angle above 45 degrees, who have been subjected to brace treatment, revealed smaller clinical deformity of their back comparing to nontreated girls having similar radiological curvatures

The Bottom-Up Rise Strength Transfer in Elderly After Endurance and Resistance Training: The BURST

The phenomenon of strength gain is highly relevant for sarcopenia and clinical aspect linked to aging. Recent advancements drive the interest toward the exercise-related cross-talk between distant tissues. We demonstrated the cross-talk between lower and upper limbs, we named the Bottom-Up Rise Strength Transfer (BURST), mainly linked to endurance training. In our opinion, this effect can be mainly related to systemic factors, likely circulating myokines and extracellular vesicles (recently defined in terms of “exerkines” and “exersomes”) whit an eventual concomitant reduction of a sub-clinical chronic inflammation. The neuronal mechanisms, even if to our sight less likely involved in this adaptation, need to be deeply investigated. Further studies are needed to better characterize the exercise-related BURST, concerning the specificity of different protocols and the underlying physiological mechanisms

Estimation of the stress related to conservative scoliosis therapy: an analysis based on BSSQ questionnaires

BACKGROUND: Adolescent girls treated with a brace for scoliosis are submitted to prolonged stress related to both the disease and the therapy. Currently proposed quality of life questionnaires are focused on the outcome of therapy. Bad Sobernheim Stress Questionnaire (BSSQ) enables monitoring of patients being under treatment with a brace or exercises. The aim of the study was to assess the stress level in conservatively managed scoliotic girls using BSSQ. MATERIALS AND METHODS: 111 girls, aged 14,2 ± 2,2 years, mean Cobb angle of the primary curve 42,8° ± 17,0° and mean Bunnell angle of 11,4° ± 4,5° were examined with two versions of BSSQ (Deformity and Brace). The analysis considered the type of treatment, curve location, correlation of the total score with age, Cobb angle and Bunnell rotation angle. RESULTS: The BSSQ Deformity revealed the median of 17 points in patients managed with exercises (from 4 to 24 points), 18 in patients managed with a brace (from 8 to 24 points) and 12 in patients before surgery (from 3 to 21 points). Braced patients who completed both questionnaires (n = 50) revealed significantly higher score with BSSQ Deformity (median = 18) comparing to BSSQ Brace (median = 9). There was a correlation between the total score of BSSQ Deformity and the Cobb angle (r = -0,34), Bunnell primary curve rotation (r = -0,34) and Bunnell sum of rotation (r = -0,33) but not with the age of patients. CONCLUSION: Scoliotic adolescents managed with exercises and brace suffered little stress from the deformity. The brace increased the level of stress over the stress induced by the deformity. The stress level correlated with clinical deformity (Bunnell angle), radiological deformity (Cobb angle) and the type of treatment (exercises, bracing, surgery). Bad Sobernheim Stress Questionnaires are simple and helpful in the management of girls treated conservatively for idiopathic scoliosis

3D Stereophotogrammetric Quantitative Evaluation of Posture and Spine Proprioception in Subacute and Chronic Nonspecific Low Back Pain

The literature shows that low back pain causes a reduced lumbar range of movement, affecting patients’ proprioception and motor control. Nevertheless, studies have found that proprioception and motor control of the spine and posture are vague and individually expressed even in healthy young adults. This study aimed to investigate the standing posture and its modifications induced by an instinctive self-correction manoeuvre in subacute and chronic nonspecific low back pain (NSLBP) patients to clarify how NSLBP relates to body upright posture, proprioception, and motor control and how these are modified in patients compared to healthy young adults (121 healthy young adults: 57 females and 64 males). A cohort of 83 NSLBP patients (43 females, 40 males) were recruited in a cross-sectional observational study. Patients’ entire body posture, including 3D spine shape reconstruction, was measured using a non-ionising 3D optoelectronic stereophotogrammetric approach. Thirteen quantitative biomechanical parameters describing the nature of body posture were computed. The statistical analysis was performed using multivariate methods. NSLBP patients did not present an altered proprioception and motor control ability compared to healthy young adults. Furthermore, as for healthy subjects, NSLBP patients could not focus and control their posture globally. Proprioception and motor control in natural erect standing are vague for most people regardless of gender and concurrent nonspecific low back pain. Self-correction manoeuvres improving body posture and spine shape must be learned with specific postural training focusing on the lumbar spine

The Measurement of Health-Related Quality of Life of Girls with Mild to Moderate Idiopathic Scoliosis—Comparison of ISYQOL versus SRS-22 Questionnaire

This study aimed to compare the Italian Spine Youth Quality of Life Questionnaire (ISYQOL-PL) versus the Scoliosis Research Society-22 (SRS-22) questionnaire scores evaluating the validity of the concurrent and known-groups. Eighty-one girls (mean age 13.5 ± 1.8 years) with idiopathic scoliosis (IS) with a mean Cobb angle of 31.0 (±10.0) degrees were examined, all treated with a corrective TLSO brace for an average duration of 2.6 (±1.9) years. The patients’ scores were compared as follows: (1) age: ≤13 years vs. >13 years); (2) scoliosis severity: mild (Cobb angle 10–30°) vs. moderate (Cobb angle > 30°); (3) single curve pattern vs. double curve pattern. Lin’s concordance correlation coefficient was used to evaluate the strength of the association between ISYQOL-PL and SRS-22 scores. t-tests were applied to assess if the ISYQOL-PL measure and SRS-22 total score were significantly different in the different groups of patients. The concurrent validity analysis showed a moderate correlation (Lin pccc = 0.47). The ISYQOL-PL showed a significantly better quality of life in mild than moderate scoliosis. The severity of scoliosis but not the age or the curve pattern demonstrated a direct statistically significant effect on patients’ quality of life only when evaluated using the ISYQOL-PL