scholarly journals Exposure to impacts across a competitive rugby season impairs balance and neuromuscular function in female rugby athletes

2020 ◽  
Vol 6 (1) ◽  
pp. e000740
Author(s):  
Stephanie E Black ◽  
Bruno Follmer ◽  
Rinaldo André Mezzarane ◽  
Gregory E P Pearcey ◽  
Yao Sun ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Low Cost ◽  
Objective Assessment ◽  
Assessment Tools ◽  
Neurological Deficits ◽  
Normative Values ◽  
Balance Performance ◽  
Head Impacts ◽  
Unstable Surface ◽  
Balance Board

ObjectivesWe used objective assessment tools to detect subtle neurological deficits that accompany repetitive and mild head impacts in contact sport across a season.MethodsFemale participants (n=13, 21±1.8 years old; 167.6±6.7 cm; 72.8±6.1 kg) completed assessments pre and post the varsity rugby season. A commercial balance board was used to assess static balance and response to dynamic postural challenge. Spinal cord excitability via the soleus H-reflex was assessed in both legs. Video analysis was used to identify head impact exposures.ResultsA total of 172 potential concussive events were verified across 11 athletes (15.6±11; 95% CI: 6.5 to 19.8). Balance performance was worse at post-season for total centre of pressure which increased by 26% in the double stance on a stable surface (t(12)=-2.33; p=0.03; d=0.6) and by 140% in the tandem stance on a foam surface (t(12)=-3.43; p<0.01; d=0.9). Despite that, dynamic postural performance was improved after the season (p<0.01). Spinal cord excitability in rugby athletes did not change across the season but deviated from normative values at baseline.ConclusionQuantitative measures revealed that exposure to impacts across a competitive rugby season impair balance in two specific stances in female rugby athletes. Tandem-leg stance on an unstable surface and double-leg stance on firm surface are useful assessment conditions when performed over a low-cost balance board, even without clinically diagnosed concussion.

Automating the Clinical Assessment of Independent Wheelchair Sitting Pivot Transfer Techniques

2021 ◽  
Vol 27 (3) ◽  
pp. 1-11
Author(s):  
Lin Wei ◽  
Cheng-Shiu Chung ◽  
Alicia M. Koontz
Keyword(s):  
Machine Learning ◽  
Low Cost ◽  
Objective Assessment ◽  
Assessment Tools ◽  
Assessment Instrument ◽  
Decision Threshold ◽  
Full Time ◽  
Test Set ◽  
Machine Learning Classifiers ◽  
Learning Classifiers

Background: Using proper transfer technique can help to reduce forces and prevent secondary injuries. However, current assessment tools rely on the ability to subjectively identify harmful movement patterns. Objectives: The purpose of the study was to determine the accuracy of using a low-cost markerless motion capture camera and machine learning methods to evaluate the quality of independent wheelchair sitting pivot transfers. We hypothesized that the algorithms would be able to discern proper (low risk) and improper (high risk) wheelchair transfer techniques in accordance with component items on the Transfer Assessment Instrument (TAI). Methods: Transfer motions of 91 full-time wheelchair users were recorded and used to develop machine learning classifiers that could be used to discern proper from improper technique. The data were labeled using the TAI item scores. Eleven out of 18 TAI items were evaluated by the classifiers. Motion variables from the Kinect were inputted as the features. Random forests and k-nearest neighbors algorithms were chosen as the classifiers. Eighty percent of the data were used for model training and hyperparameter turning. The validation process was performed using 20% of the data as the test set. Results: The area under the receiver operating characteristic curve of the test set for each item was over 0.79. After adjusting the decision threshold, the precisions of the models were over 0.87, and the model accuracies were over 71%. Conclusion: The results show promise for the objective assessment of the transfer technique using a low cost camera and machine learning classifiers.

scholarly journals Rapid Assessment of Age-Related Differences in Standing Balance

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Tobias Kalisch ◽  
Jan-Christoph Kattenstroth ◽  
Sebastian Noth ◽  
Martin Tegenthoff ◽  
Hubert R. Dinse
Keyword(s):  
Postural Sway ◽  
Low Cost ◽  
Rapid Assessment ◽  
Assessment Tools ◽  
Quiet Standing ◽  
Older Individuals ◽  
Balance Performance ◽  
Rotational Displacement ◽  
Healthy Older Adults ◽  
Age Related

As life expectancy continues to rise, in the future there will be an increasing number of older people prone to falling. Accordingly, there is an urgent need for comprehensive testing of older individuals to collect data and to identify possible risk factors for falling. Here we use a low-cost force platform to rapidly assess deficits in balance under various conditions. We tested 21 healthy older adults and 24 young adults during static stance, unidirectional and rotational displacement of their centre of pressure (COP). We found an age-related increase in postural sway during quiet standing and a reduction of maximal COP displacement in unidirectional and rotational displacement tests. Our data show that even low-cost computerized assessment tools allow for the comprehensive testing of balance performance in older subjects.

scholarly journals Low-cost assessment tools for the development of psychomotor competency in procedural surgical skills

2014 ◽  
Vol 5 (1) ◽  
pp. 17-19
Author(s):  
A. Doud ◽  
R. Dockter ◽  
D. Vetter ◽  
J. Rana ◽  
M. Koester ◽  
...  
Keyword(s):  
Clinical Judgment ◽  
Medical Training ◽  
Low Cost ◽  
Objective Assessment ◽  
Surgical Skills ◽  
Assessment Tools ◽  
Attractive Alternative ◽  
Cost Assessment ◽  
Alternative Means ◽  
Data Acquisition And Processing

Abstract. While didactic training is a crucial element of education in the health care profession, current technologies leveraging low cost data acquisition and processing may provide an attractive alternative means for rapid, objective assessment of the foundational skills. When these technologies are leveraged towards improving the procedural surgical skill set, there is a strong opportunity for enhancing current training practices. While the proctor will still play a crucial role in the refinement of clinical judgment, affordable options for rapid training of procedural skills may serve as an avenue to free an expert proctor to focus on the more nuanced elements of medical training. Here we propose and implement a system for the low cost assessment and training of procedural surgical skills. A knot-tying module and a tool articulation module were created using affordable sensing technologies, and initial validation with a trained clinician showed that the devices could discriminate correctly and poorly tied knots. The system lays the framework for a modular experiential component of skills development in the training of health professionals.

β-Mannosidosis: Myelin and oligodendrocyte lesions in brain and spinal cord

1984 ◽  
Vol 42 ◽  
pp. 694-695
Author(s):  
Kathryn L. Lovell ◽  
Margaret Z. Jones
Keyword(s):  
Spinal Cord ◽  
Nervous System ◽  
Genetic Disorder ◽  
Neurological Deficits ◽  
Axonal Spheroids ◽  
South Wales ◽  
Pendular Nystagmus ◽  
Myelin Deficits ◽  
Recessive Defect ◽  
Brain And Spinal Cord

Caprine β-mannosidosis, an autosomal recessive defect of glycoprotein catabolism, is associated with a deficiency of tissue and plasma -mannosidase and with tissue accumulation and urinary excretion of oligosaccharides, including the trisaccharide Man(β1-4)GlcNAc(βl-4)GlcNAc and the disaccharide Man(β1-4)GlcNAc. This genetic disorder is evident at birth, with severe neurological deficits including a marked intention tremor, pendular nystagmus, ataxia and inability to stand. Major pathological characteristics described in Nubian goats in Michigan and in Anglo-Nubian goats in New South Wales include widespread cytoplasmic vacuolation in the nervous system and viscera, axonal spheroids, and severe myelin paucity in the brain but not spinal cord or peripheral nerves. Light microscopic examination revealed marked regional variation in the severity of central nervous system myelin deficits, with some brain areas showing nearly complete absence of myelin and other regions characterized by the presence of 25-50% of the control number of myelin sheaths.

Impairment Tutorial: Neurological Impairment Evaluation: Overview of Sixth Edition Approaches

2008 ◽  
Vol 13 (2) ◽  
pp. 6-8
Author(s):  
Lorne Direnfeld ◽  
Christopher R. Brigham ◽  
Elizabeth Genovese
Keyword(s):  
Spinal Cord ◽  
Neurological Impairment ◽  
Diagnostic Techniques ◽  
Neurological Deficits ◽  
Sixth Edition ◽  
Pain Disability ◽  
Whole Person ◽  
Disability Questionnaire ◽  
Cervical Plating

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), does not provide a Diagnosis-based estimate of impairment due to syringomyelia, a disorder in which a cyst (syrinx), develops within the central spinal cord and destroys neural tissue as it expands. The AMA Guides, however, does provide an approach to rating a syringomyelia based on objective findings of neurological deficits identified during a neurological examination and demonstrated by standard diagnostic techniques. Syringomelia may occur after spinal cord trauma, including a contusion of the cord. A case study illustrates the rating process: The case patient is a 46-year-old male who fell backwards, landing on his upper back and head; over a five-year period he received a T5-6 laminectomy and later partial corpectomies of C5, C6, and C7, cervical discectomy C5-6 and C6-7; iliac crest strut graft fusion of C5-6 and C6-7; and anterior cervical plating of C5 to C7 for treatment of myelopathy; postoperatively, the patient developed dysphagia. The evaluating physician should determine which conditions are ratable, rate each of these components, and combine the resulting whole person impairments without omission or duplication of a ratable impairment. The article includes a pain disability questionnaire that can be used in conjunction with evaluations conducted according to Chapter 3, Pain, and Chapter 17, The Spine.

Rehabilitation of the canine patient following spinal cord injury: a practical guide

2021 ◽  
Vol 26 (1) ◽  
pp. 1-6
Author(s):  
Cheryl Corral
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injury ◽  
Neurological Deficits ◽  
Practical Guide ◽  
Cord Injury ◽  
Physical Therapies

This article forms part of a series exploring the rehabilitation of the canine shoulder, elbow, back, hip and stifle following injury or disease. Discussed here are different rehabilitation techniques used to address neurological deficits, pain and weakness following spinal injury, including physical therapies, electrotherapies and acupuncture.

scholarly journals Local Serpin Treatment via Chitosan-Collagen Hydrogel after Spinal Cord Injury Reduces Tissue Damage and Improves Neurologic Function

2020 ◽  
Vol 9 (4) ◽  
pp. 1221 ◽  
Author(s):  
Jacek M. Kwiecien ◽  
Liqiang Zhang ◽  
Jordan R. Yaron ◽  
Lauren N. Schutz ◽  
Christian J. Kwiecien-Delaney ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Tissue Damage ◽  
Low Dose ◽  
Dorsal Column ◽  
Neurological Deficits ◽  
Sustained Delivery ◽  
Post Surgery ◽  
Cord Injury ◽  
Anti Inflammatory

Spinal cord injury (SCI) results in massive secondary damage characterized by a prolonged inflammation with phagocytic macrophage invasion and tissue destruction. In prior work, sustained subdural infusion of anti-inflammatory compounds reduced neurological deficits and reduced pro-inflammatory cell invasion at the site of injury leading to improved outcomes. We hypothesized that implantation of a hydrogel loaded with an immune modulating biologic drug, Serp-1, for sustained delivery after crush-induced SCI would have an effective anti-inflammatory and neuroprotective effect. Rats with dorsal column SCI crush injury, implanted with physical chitosan-collagen hydrogels (CCH) had severe granulomatous infiltration at the site of the dorsal column injury, which accumulated excess edema at 28 days post-surgery. More pronounced neuroprotective changes were observed with high dose (100 µg/50 µL) Serp-1 CCH implanted rats, but not with low dose (10 µg/50 µL) Serp-1 CCH. Rats treated with Serp-1 CCH implants also had improved motor function up to 20 days with recovery of neurological deficits attributed to inhibition of inflammation-associated tissue damage. In contrast, prolonged low dose Serp-1 infusion with chitosan did not improve recovery. Intralesional implantation of hydrogel for sustained delivery of the Serp-1 immune modulating biologic offers a neuroprotective treatment of acute SCI.

Split spinal cord malformations in children

1998 ◽  
Vol 88 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Yusuf Ersşahin ◽  
Saffet Mutluer ◽  
Sevgül Kocaman ◽  
Eren Demirtasş
Keyword(s):  
Spinal Cord ◽  
Neurological Deficits ◽  
Single Type ◽  
Type I ◽  
Type Ii ◽  
Content Type ◽  
Spinal Lesion ◽  
The Mean ◽  
Fine Print

Object. The authors reviewed and analyzed information on 74 patients with split spinal cord malformations (SSCMs) treated between January 1, 1980 and December 31, 1996 at their institution with the aim of defining and classifying the malformations according to the method of Pang, et al. Methods. Computerized tomography myelography was superior to other radiological tools in defining the type of SSCM. There were 46 girls (62%) and 28 boys (38%) ranging in age from less than 1 day to 12 years (mean 33.08 months). The mean age (43.2 months) of the patients who exhibited neurological deficits and orthopedic deformities was significantly older than those (8.2 months) without deficits (p = 0.003). Fifty-two patients had a single Type I and 18 patients a single Type II SSCM; four patients had composite SSCMs. Sixty-two patients had at least one associated spinal lesion that could lead to spinal cord tethering. After surgery, the majority of the patients remained stable and clinical improvement was observed in 18 patients. Conclusions. The classification of SSCMs proposed by Pang, et al., will eliminate the current chaos in terminology. In all SSCMs, either a rigid or a fibrous septum was found to transfix the spinal cord. There was at least one unrelated lesion that caused tethering of the spinal cord in 85% of the patients. The risk of neurological deficits resulting from SSCMs increases with the age of the patient; therefore, all patients should be surgically treated when diagnosed, especially before the development of orthopedic and neurological manifestations.

Histopathology of experimental hematomyelia

1991 ◽  
Vol 75 (6) ◽  
pp. 911-915 ◽  
Author(s):  
Thomas H. Milhorat ◽  
David E. Adler ◽  
Ian M. Heger ◽  
John I. Miller ◽  
Joanna R. Hollenberg-Sher
Keyword(s):  
Spinal Cord ◽  
Tissue Injury ◽  
Central Canal ◽  
Microglial Cells ◽  
Neurological Deficits ◽  
Thoracic Spinal Cord ◽  
Content Type ◽  
Thoracic Spinal ◽  
Cellular Debris ◽  
Dorsal Columns

✓ The pathology of hematomyelia was examined in 35 rats following the stereotactic injection of 2 µl blood into the dorsal columns of the thoracic spinal cord. This experimental model produced a small ball-hemorrhage without associated neurological deficits or significant tissue injury. Histological sections of the whole spinal cord were studied at intervals ranging from 2 hours to 4 months after injection. In acute experiments (2 to 6 hours postinjection), blood was sometimes seen within the lumen of the central canal extending rostrally to the level of the fourth ventricle. Between 24 hours and 3 days, the parenchymal hematoma became consolidated and there was an intense proliferation of microglial cells at the perimeter of the lesion. The cells invaded the hematoma, infiltrated its core, and removed erythrocytes by phagocytosis. Rostral to the lesion, the lumen of the central canal was found to contain varying amounts of fibrin, proteinaceous material, and cellular debris for up to 15 days. These findings were much less prominent in the segments of the canal caudal to the lesion. Healing of the parenchymal hematoma was usually complete within 4 to 6 weeks except for residual hemosiderin-laden microglial cells and focal gliosis at the lesion site. It is concluded that the clearance of atraumatic hematomyelia probably involves two primary mechanisms: 1) phagocytosis of the focal hemorrhage by microglial cells; and 2) drainage of blood products in a rostral direction through the central canal of the spinal cord.

Operative management of traumatic cervical spine distraction and complete cord transection in a 3-year-old patient

2015 ◽  
Vol 15 (2) ◽  
pp. 214-219 ◽  
Author(s):  
Monica Salazar Davern ◽  
Sumeet Garg ◽  
Todd C. Hankinson
Keyword(s):  
Spinal Cord ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Cervical Spinal Cord ◽  
Young Patients ◽  
Operative Management ◽  
Neurological Deficits ◽  
Spinal Instability ◽  
Ethical Challenges ◽  
Vehicle Accident

This report describes the presentation and operative treatment of a 3-year-old boy who survived a motor vehicle accident that resulted in a C6–7 distraction injury, complete avulsion of the spinal cord, and gross spinal instability. Only 5%–10% of all spinal cord and vertebral column injuries occur in children. Survival after such an injury is exceptionally rare in very young patients and is associated with severe neurological deficits. The authors discuss the substantial ethical challenges involved in the care of a patient with this injury. To their knowledge, only two other cases of survival have been reported in pediatric patients following motor vehicle trauma resulting in complete injury to the lower cervical spinal cord.

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