Trunk motion analysis: a systematic review from a clinical and methodological perspective

INTRODUCTION: This systematic literature review aims to check the current state of affairs of non-gait-related optoelectronic trunk movement analysis; results have been analyzed from a clinical and a methodological perspective. EVIDENCE ACQUISITION: Extensive research was performed on all papers published until December 31st, 2015, dealing with trunk movement analysis assessed by optoelectronic systems, excluding those related to gait. The research was performed on the 14th of January 2016 on three databases: Scopus, Science Direct and Pubmed. A reference search and expert consultation were also performed. EVIDENCE SYNTHESIS: Out of a total number of 8431 papers, 45 were deemed relevant: they included 1334 participants, 57.9% healthy, with age range 8-85. Few studies considered the whole trunk, and none focused on each vertebra independently: the trunk was almost always divided into three segments. Thirteen studies included 20 or more markers. Most of the papers focused mainly on the biomechanics of various movements; the lumbar area and low back pain were the most studied region and pathology respectively. CONCLUSIONS: This study has shown the relative scarcity of current literature focusing on trunk motion analysis. In clinical terms, results were sparse. The only quite well represented group of papers focused on the lumbar spine and pathologies, but the scarcity of individuals evaluated make the results questionable. The use of optoelectronic systems in the evaluation of spine movement is a growing research area. Nevertheless, no standard protocols have been developed so far. Future research is needed to define a precise protocol in terms of number and position of markers along the spine and movements and tasks to be evaluated

Is worsening renal function an ominous prognostic sign in patients with acute heart failure? The role of congestion and its interaction with renal function.

BACKGROUND: Worsening renal function (WRF), traditionally defined as an increase in serum creatinine levels ≥0.3 mg/dL, is a frequent finding in patients with acute heart failure (AHF) and has been associated with poorer outcomes in some but not all studies. We hypothesized that these discrepancies may be caused by the interaction between WRF and congestion in AHF patients. METHODS AND RESULTS: We measured serum creatinine levels on a daily basis during the hospitalization and assessed the persistence of signs of congestion at discharge in 599 consecutive patients admitted at our institute for AHF. They had a postdischarge mortality and mortality or AHF readmission rates of 13% and 43%, respectively, after 1 year. Patients were subdivided into 4 groups according to the development or not of WRF and the persistence of ≥1 sign of congestion at discharge. Patients with WRF and no congestion had similar outcomes compared with those with no WRF and no congestion, whereas the risk of death or of death or AHF readmission was increased in the patients with persistent congestion alone and in those with both WRF and congestion (hazard ratio, 5.35; 95% confidence interval, 3.0-9.55 at univariable analysis; hazard ratio, 2.44; 95% confidence interval, 1.24-4.18 at multivariable analysis for mortality; hazard ratio, 2.14; 95% confidence interval, 1.39-3.3 at univariable analysis; and hazard ratio, 1.39; 95% confidence interval, 0.88-2.2 at multivariable analysis for mortality and rehospitalizations). CONCLUSIONS: WRF alone, when detected using serial serum creatinine measurements, is not an independent determinant of outcomes in patients with AHF. It has an additive prognostic value when it occurs in patients with persistent signs of congestion

Soil microbial characteristics and mineral nitrogen availability as affected by olive oil waste water applied to cultivated soil.

Waste disposal is an urgent problem in those Italian areas devoted to olive oil production where a large amount of olive oil waste is produced in a short period of time. Given the high organic matter and macronutrient content of olive oil waste water, its use in agriculture could help to solve the disposal problem and, at the same time, to improve the physiochemical characteristics of intensely cultivated soils. However, olive oil waste water contains noteworthy quantities of phenols, which are toxic and have bacteriostatic activity. The effects of repeated spreading of olive oil waste water on alfalfa, on soil microbial properties, and on the availability of mineral nitrogen were determined. Doses of 0, 80, and 160 m3 ha−1 of olive oil waste water (OW) were spread over experimental plots sown with 3rd year alfalfa. Soil samples were collected at various intervals after OW application. The biomass, respiratory activity, metabolic quotient, mineralization index, and the potential nitrification activity (PNA) of the soil were measured. Polyphenol, organic carbon, and mineral nitrogen contents were measured on the same soil samples. In general, the spreading of OW caused slightly positive modifications to the soil microbial biomass and metabolic quotient. These modifications were temporary and disappeared as early as a few months after the treatment. The PNA, as well as the nitrate and nitrite contents, were lower in the treated plots during the vegetative cycle of alfalfa and after the last harvest, and appeared to be negatively correlated with polyphenols. The results of this experiment confirmed that the spreading of olive oil waste water on cultivated soil could be an eco‐compatible practice. Despite their origin, the OW had no toxic effects on the soil microflora, and in fact, stimulated growth and reproduction of cells. Only the PNA proved to be slightly reduced, but the yield was not negatively affected

Identification through movement analysis of chronic low back pain pathological spinal movements patterns and their sensibility to change during exercise treatment

INTRODUCTION: Chronic low back pain (CLBP) is a bio-psycho-social syndrome causing disability. While there are multiple imaging systems for the anatomical structures, in vivo movement evaluation has scarcely been performed.1Our aim was to pilot in a CLBP population a movement analysis protocol developed in healthy participants 2, and verify correlations with pain, disability and treatment effects. METHODS: We recruited a convenience sample of 10 CLBP patients who were referred for a group exercise therapy (strengthening, core stability, active stretching and postural re-education)3,4We used a non-invasive optoelectronic full spine evaluation according to a previously developed protocol 2. We analyzed anterior flexion, lateral bending and rotation movements, and collected Numerical Rating (NRS) and Oswestry (ODI) scales before and after treatment. We performed a qualitative analysis to identify possible abnormal movement patterns, that have been quantified through 3 or 4 points Likert scales: their inter-observers repeatability has been checked comparing three operators (1 expert and 2 students). A total score for each movement has then been calculated as well as its variations with treatment, and correlations with ODI and NRS. RESULTS: Comparing normal to pathological patterns (fig 1) we identified the following parameters: for all movements total Range of Motion, fluidity, symmetry, and pelvis center; we also added for lateral bending the lumbopelvic rhythm, for flexion and rotation the arrival overdrive, and for flexion the altered Anticipatory Postural Adjustments. Inter-operators repeatability resulted in a Cohen k 0.21-0.4 in 13% of parameters, 0.41-0.6 in 47%, 0.61-0.8 in 32% and 0.81-1 in 9%. With treatment, ODI and NRS improved and the total score decreased in all movements: flexion (p<0.01), bending (p<0.01) and rotation (p<0.0005). We did not find any correlation with ODI and NRS. DISCUSSION: In this study we have identified some reliable qualitative patterns of pathological movement in CLBP that showed to be sensible to treatment, even if not correlated to subjective scales like ODI and NRS. Future studies should check these preliminary results in wider populations and different treatments, while a quantification of these qualitative parameters is under development

Does Gait Kinematic Parameters Change as Functional Outcome Scales in Total Hip Arthroplasty Subjects after Rehabilitation?

Introduction Total hip arthroplasty (THA), is a routine, common surgical intervention;following surgery is usual practice a period of rehabilitation to recover strength, range of motion and walking ability of the operated limb. Many outcome scales (OS) have been developed to assess the improvements of the patients, but gait parameters have not been studied as possible outcome[ Research question For the statistical analysis a Student T and Wilcoxon signed ranks test were performed to test thevariation between T0 and T1. Spearman\u2019s Rho and Pearson\u2019s R were calculated to investigate a possible relationship between BI and MDA, with the gait analysis parameters. Results 12 subjects (4 females, 9 left hips) mean age 68\ub18 were included, the length of recovery was 17\ub16 days. Discussion Both OS and temporal and spatial GA parameters showed meaningful improvements between T0 and T1; these improvements have been clearly detected also with GA, that has rarely been performed before in such an acute phase. The correlation between the OS and the aforementioned GA parameters, may suggest a wider use of GA in this clinical context, as a useful tool to assess the function and improvements of this kind of population. In particular to tailor the rehabilitation treatment