Development of Force-Feedback Technology for Training Clinicians to Deliver Manual Cervical Distraction

2013 ◽  
Author(s):  
Maruti Ram Gudavalli ◽  
Vikas Yadav ◽  
Robert Vining ◽  
Michael Seidman ◽  
Stacie Salsbury ◽  
...  
Keyword(s):  
Neck Pain ◽  
Head And Neck ◽  
Force Feedback ◽  
Controlled Trial ◽  
Three Dimensional ◽  
Traction Force ◽  
Simulated Patients ◽  
Traction Forces ◽  
Force Transducers ◽  
Graphical Feedback

Objective: Neck pain is a prevalent musculoskeletal (MSK) complaint and costly societal burden. Doctors of chiropractic (DCs) provide manual therapies for neck pain patients to relieve discomfort and improve physical function. Manual cervical distraction (MCD) is a chiropractic procedure for neck pain. During MCD, the patient lies face down on a specially designed chiropractic table. The DC gently moves the head and neck in a cephalic direction while holding a gentle broad manual contact over the posterior neck, to create traction effects. MCD traction force profiles vary between clinicians making standardization of treatment delivery challenging. This paper reports on a bioengineering technology developed to provide clinicians with auditory and graphical feedback on the magnitude of cervical traction forces applied during MCD to simulated patients during training for a randomized controlled trial (RCT). Methods: The Cox flexion-distraction chiropractic table is designed with a moveable headpiece. The table allows for long axis horizontal movement of the head and neck, while the patient’s trunk and legs rest on fixed table sections. We instrument-modified this table with three-dimensional force transducers to measure the traction forces applied by the doctor. Motion Monitor software collects data from force transducers. The software displays the magnitude of traction forces graphically as a function of time. Real-time audible feedback produces a steady tone when measured traction forces are <20N, no tone when forces range between 20–50N, and an audible tone when forces exceed 50N. Peer debriefing from simulated patients reinforces traction force data from the bioengineering technology. Results: We used audible and graphical feedback to train and certify DCs to apply traction forces to the cervical spine of simulated patients within three specific ranges. This technology supports a RCT designed to assess the ability of clinicians to deliver MCD within specified force ranges to patients randomized to different force dosages as an intervention. Future applications may include training chiropractic students and clinicians to deliver the MCD treatment.

scholarly journals Three-Dimensional Quantification of Cellular Traction Forces and Mechanosensing of Thin Substrata by Fourier Traction Force Microscopy

PLoS ONE ◽  
2013 ◽  
Vol 8 (9) ◽  
pp. e69850 ◽  
Author(s):  
Juan C. del Álamo ◽  
Ruedi Meili ◽  
Begoña Álvarez-González ◽  
Baldomero Alonso-Latorre ◽  
Effie Bastounis ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Traction Force ◽  
Traction Force Microscopy ◽  
Traction Forces ◽  
Force Microscopy

scholarly journals Effectiveness of an educational and physical program in reducing accompanying symptoms in subjects with head and neck pain: a workplace controlled trial

2011 ◽  
Vol 12 (3) ◽  
pp. 339-345 ◽  
Author(s):  
Eugenia Rota ◽  
Andrea Evangelista ◽  
Giovannino Ciccone ◽  
Luca Ferrero ◽  
Alessandro Ugolini ◽  
...  
Keyword(s):  
Neck Pain ◽  
Head And Neck ◽  
Controlled Trial ◽  
Accompanying Symptoms ◽  
Physical Program

Neck and Scapula-Focused Exercise Training on Patients With Nonspecific Neck Pain: A Randomized Controlled Trial

2018 ◽  
Vol 27 (5) ◽  
pp. 403-412 ◽  
Author(s):  
Taha Ibrahim Yildiz ◽  
Elif Turgut ◽  
Irem Duzgun
Keyword(s):  
Exercise Training ◽  
Neck Pain ◽  
Controlled Trial ◽  
Intervention Group ◽  
Three Dimensional ◽  
Neck Disability Index ◽  
Control Group ◽  
Scapular Kinematics ◽  
Neck Disability ◽  
Tracking Device

Objectives:The purpose of this study was to investigate the effects of additional 6-week scapular stabilization training in patients with nonspecific neck pain (NNP).Materials and Methods:A total of 30 patients with NNP were randomly allocated to the study. Fifteen participants in the intervention group received neck-focused exercise and scapular stabilization training, whereas 15 participants in the control group received neck-focused exercise training. All groups were evaluated at baseline and after 6 weeks of rehabilitation. The pain intensity on the neck was measured with the visual analog scale (VAS). The self-reported disability status was measured with the neck disability index (NDI). Three-dimensional scapular kinematics were recorded during dynamic shoulder elevation trials using an electromagnetic tracking device, and data were further analyzed at 30°, 60°, 90°, and 120° of humerothoracic elevations.Results:Comparisons revealed that, regardless of the received treatment, after 6 weeks of training both groups showed significant improvements in VAS (P < .001) and NDI (P < .001) scores. Both VAS and NDI outcomes have a large effect size (r = .618 andr = .619, respectively). For scapular kinematics, there were no group differences, especially for scapular upward–downward rotation and anterior–posterior tilt (P > .05). However, in the intervention group, the scapula was more externally rotated at 120° humerothoracic elevation (P = .04).Conclusion:Findings of this study showed that both manual therapy and active interventions, including neck-focused exercise and scapular stabilization training, are effective in decreasing pain and disability level in patients with NNP. More comprehensive studies with longer follow-up durations are needed to better understand the potential effects of scapular stabilization training in patients with NNP.

scholarly journals Training and certification of doctors of chiropractic in delivering manual cervical traction forces: Results of a longitudinal observational study

2014 ◽  
Vol 28 (2) ◽  
pp. 130-138 ◽  
Author(s):  
Maruti Ram Gudavalli ◽  
Robert D. Vining ◽  
Stacie A. Salsbury ◽  
Christine M. Goertz
Keyword(s):  
Observational Study ◽  
Computer Software ◽  
Traction Force ◽  
Simulated Patients ◽  
Traction Forces ◽  
Certification Process ◽  
Longitudinal Observational Study ◽  
Asymptomatic Volunteers ◽  
Cervical Traction ◽  
Training Protocol

Objective Doctors of chiropractic (DCs) use manual cervical distraction to treat patients with neck pain. Previous research demonstrates variability in traction forces generated by different DCs. This article reports on a training protocol and monthly certification process using bioengineering technology to standardize cervical traction force delivery among clinicians. Methods This longitudinal observational study evaluated a training and certification process for DCs who provided force-based manual cervical distraction during a randomized clinical trial. The DCs completed a 7-week initial training that included instructional lectures, observation, and guided practice by a clinical expert, followed by 3 hours of weekly practice sessions delivering the technique to asymptomatic volunteers who served as simulated patients. An instrument-modified table and computer software provided the DCs with real-time audible and visual feedback on the traction forces they generated and graphical displays of the magnitude of traction forces as a function of time immediately after the delivery of the treatment. The DCs completed monthly certifications on traction force delivery throughout the trial. Descriptive accounts of certification attempts are provided. Results Two DCs achieved certification in traction force delivery over 10 consecutive months. No certification required more than 3 attempts at C5 and occiput contacts for 3 force ranges (0–20 N, 21–50 N, and 51–100 N). Conclusions This study demonstrates the feasibility of a training protocol and certification process using bioengineering technology for training DCs to deliver manual cervical distraction within specified traction force ranges over a 10-month period.

scholarly journals Effect of a cervical collar on head and neck acceleration profiles during emergency spinal immobilisation and extrication procedures in elite football (soccer) players: protocol for a randomised, controlled cross-over trial

2021 ◽  
Vol 7 (4) ◽  
pp. e001157
Author(s):  
Michael J Callaghan ◽  
Tom Hughes ◽  
John Davin ◽  
Russell Hayes ◽  
Neil Hough ◽  
...  
Keyword(s):  
Head And Neck ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Three Dimensional ◽  
Angular Acceleration ◽  
Random Order ◽  
Cervical Collar ◽  
Spinal Immobilisation ◽  
Randomised Controlled

When immobilisation after a cervical spine or head injury is required, the role of the rigid cervical collar is unclear and controversial. There is a need for further studies investigating the use of a rigid cervical collar when head and neck trauma occurs in sport. This study will compare present practice (immobilisation with a cervical collar) to the same procedure without a collar during a simulated spinal immobilisation and extraction scenario from the field of play to the side-line in football (soccer). It will use a prospective cohort within-subjects cross over randomised, controlled trial design. Healthy participants will assume the role of players with a head or neck injury. Clinical practitioners will perform the immobilisation and extrication procedure according to current clinical guidelines. Three dimensional linear and angular acceleration profiles of the head and torso will be measured and the time taken to complete the procedure. The interventions will be a ‘cervical collar’ or ‘no collar’ in random order. Data from the IMUs will be transferred wirelessly to a computer for analysis. Accordingly, within-subject differences between each condition (collar vs no collar) will be assessed with parametric or non-parametric inferential statistics. Statistical significance will be set at p<0.05.Trial registration number:ISRCTN16515969

scholarly journals A new 3D finite element-based approach for computing cell surface tractions assuming nonlinear conditions

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249018
Author(s):  
Silvia Hervas-Raluy ◽  
Maria Jose Gomez-Benito ◽  
Carlos Borau-Zamora ◽  
Mar Cóndor ◽  
Jose Manuel Garcia-Aznar
Keyword(s):  
Inverse Problem ◽  
Finite Element ◽  
Three Dimensional ◽  
Traction Force ◽  
Nonlinear Material ◽  
Problem Solver ◽  
Microfluidic Chips ◽  
Traction Forces ◽  
Force Microscopy ◽  
Material Formulation

Advances in methods for determining the forces exerted by cells while they migrate are essential for attempting to understand important pathological processes, such as cancer or angiogenesis, among others. Precise data from three-dimensional conditions are both difficult to obtain and manipulate. For this purpose, it is critical to develop workflows in which the experiments are closely linked to the subsequent computational postprocessing. The work presented here starts from a traction force microscopy (TFM) experiment carried out on microfluidic chips, and this experiment is automatically joined to an inverse problem solver that allows us to extract the traction forces exerted by the cell from the displacements of fluorescent beads embedded in the extracellular matrix (ECM). Therefore, both the reconstruction of the cell geometry and the recovery of the ECM displacements are used to generate the inputs for the resolution of the inverse problem. The inverse problem is solved iteratively by using the finite element method under the hypothesis of finite deformations and nonlinear material formulation. Finally, after mathematical postprocessing is performed, the traction forces on the surface of the cell in the undeformed configuration are obtained. Therefore, in this work, we demonstrate the robustness of our computational-based methodology by testing it under different conditions in an extreme theoretical load problem and then by applying it to a real case based on experimental results. In summary, we have developed a new procedure that adds value to existing methodologies for solving inverse problems in 3D, mainly by allowing for large deformations and not being restricted to any particular material formulation. In addition, it automatically bridges the gap between experimental images and mechanical computations.

Traction modelling in train dynamics

2018 ◽  
Vol 233 (4) ◽  
pp. 382-395 ◽  
Author(s):  
Qing Wu ◽  
Maksym Spiryagin ◽  
Peter Wolfs ◽  
Colin Cole
Keyword(s):  
Three Dimensional ◽  
Traction Force ◽  
Traction Forces ◽  
Traction Control ◽  
Control Schemes ◽  
Table Model ◽  
Variable Friction ◽  
Train Dynamics ◽  
Force Reduction ◽  
Dynamics Simulations

This paper presents five locomotive traction models for the purpose of train dynamics simulations, such as longitudinal train dynamics simulations. Model 1 is a look-up table model with a constant force limit to represent the adhesion limit without modelling the wheel–rail contact. Model 2 is improved from Model 1 by empirically simulating locomotive sanding systems, variable track conditions and traction force reduction due to curving. Model 3 and Model 4 have included modelling of the wheel–rail contact and traction control. Model 3 uses a two-dimensional locomotive model while Model 4 uses a three-dimensional locomotive. Model 5 is based on Model 2 and developed to simulate hybrid locomotives. Demonstrative simulations are presented for the case of longitudinal train dynamics. The results show that the consideration of locomotive sanding systems, variable track conditions and traction force reduction have evident implications on the simulated traction forces. There can be up to 30% difference in the simulated traction forces. Simulated traction forces by models that consider the wheel–rail contact are about 10–15% lower than those simulated by models without consideration of the wheel–rail contact. This is mainly due to the variable friction in the wheel–rail contact and conservative traction control schemes.

Three-Dimensional Exoscopic Temporal Bone Resections for Advanced Head and Neck Cancer

2020 ◽  
Author(s):  
Mallory J. Raymond ◽  
Roberto M. Soriano ◽  
Ryan Belcher ◽  
C. Arturo Solares
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Temporal Bone ◽  
Neck Cancer ◽  
Three Dimensional ◽  
Advanced Head

A Novel Virtual Reality Technique (Cervigame®) Compared to Conventional Proprioceptive Training to Treat Neck Pain: A Randomized Controlled Trial

2019 ◽  
Vol 9 (3Jun) ◽  
Author(s):  
I Rezaei ◽  
M Razeghi ◽  
S Ebrahimi ◽  
S Kayedi ◽  
A Rezaeian Zadeh
Keyword(s):  
Virtual Reality ◽  
Visual Analogue Scale ◽  
Neck Pain ◽  
Analogue Scale ◽  
Controlled Trial ◽  
Neck Disability Index ◽  
Repeated Measure ◽  
Balance Test ◽  
Proprioceptive Training ◽  
Neck Disability

Background: Despite the potential benefits of virtual reality technology in physical rehabilitation, only a few studies have evaluated the efficacy of this type of treatment in patients with neck pain.Objective: The aim of this study was to compare the effects of virtual reality training (VRT) versus conventional proprioceptive training (CPT) in patients with neck pain.Methods: Forty four participants with nonspecific chronic neck pain were randomly assigned to VRT or CPT in this assessor-blinded clinical trial. A novel videogame called Cervigame® was designed for VRT. It comprises of 50 stages divided into unidirectional and two-directional stages ordered from easy to hard. CPT consisted of eye-follow, gaze stability, eye-head coordination and position and movement sense training. Both groups completed 8 training sessions over 4 weeks. Visual analogue scale score, neck disability index and Y-balance test results were recorded at baseline, immediately after and 5 weeks post-intervention. Mixed repeated measure ANOVA was used to analyze differences between mean values for each variable at an alpha level of 0.05.Results: There were significant improvements in all variables in both groups immediately after and 5 weeks after the intervention. Greater improvements were observed in the visual analogue scale and neck disability index scores in VRT group, and the results for all directions in Y-balance test were similar in both groups. No side effects were reported.Conclusion: Improvements in neck pain and disability were greater in VRT than CPT group. Cervigame® is a potentially practical tool for rehabilitation in patients with neck pain.

Sign in / Sign up

Export Citation Format

Share Document