Design and Application of a New Artificial Intelligence Screening Program for Scoliosis

Objective — Intelligent Scoliosis screening Application (ISSAPP) is an intelligent scoliosis screening application based on back photos, which is used to determine the effectiveness and reliability of the new tool and reduce the cost of screening by comparing it with traditional physical examination. Method — To design and upgrade the measurement procedures for back photographs during physical examination, including the measurement of bilateral shoulder apex line and horizon plus angle, and the measurement of the angle between the thoracic apex line and horizon during Adams' spinal flexion experiment so as to determine the validity and reliability of measurement program tools. Results — The first and second versions of the designed AI measurement program were more sensitive than the traditional physical examination, Adams spinal flexion test, and lateral flexion instrument. The majority of patients who were tested positive using the measurement procedure tool met the requirements for diagnosis of scoliosis. Conclusions — This new AI based measurement and screening tool can be used for early detection of shoulder and thoracic malformation caused by scoliosis, which is a simple, convenient and sensitive early screening tool. Based on this development idea, an upgraded version can be further developed for early screening of scoliosis.

Construct validity and reliability of tests for sacroiliac dysfunction: standing flexion test (STFT) and sitting flexion test (SIFT)

Context Sacroiliac dysfunction is characterized by a hypomobility of the range of motion of the joint, followed by a positional change regarding the relationship between the sacrum and the iliac. In general, the clinical tests that evaluate the sacroiliac joint (SIJ) and its dysfunctions lack validity and reliability values. Objectives This article aims to evaluate the construct validity and intra- and inter-rater reliability of the standing flexion test (STFT) and sitting flexion test (SIFT). Methods In this prospective study, the sample consisted of 30 individuals of both sexes, and the evaluation team was composed of five researchers. The evaluations took place on two different days: first day, inter-rater reliability and construct validity; and second day, intra-rater reliability. The reference standard for the construct validity was 3-dimensional measurements obtained utilizing the BTS SMART-DX system. For statistical analysis, the percentage (%) agreement and the kappa statistic (K) were utilized. Results The construct validity was determined for STFT (70% agreement; K=0.49; p<0.01) and SIFT (56.7% agreement; K=0.29; p<0.05). The intra-rater reliability was determined for STFT (66.3% agreement; K=0.43; p<0.01) and SIFT (56.7% agreement; K=0.38; p<0.01). The inter-rater reliability was determined for STFT (10% agreement; K=−0.02; p=0.825) and SIFT (13.3% agreement; K=0.01; p=0.836). Conclusions The STFT confirmed the construct validity and was reliable when applied by the same rater to healthy people, even if the rater had no experience. It was not possible to achieve minimum scores using the SIFT either for construct validity or reliability. We suggest that further studies be conducted to investigate the measurement properties of palpatory clinical tests for SIJ mobility, especially in symptomatic patients.

Correlation between Core Strength and Stability with Body Mass Index among Postmenopausal Women.

Women in postmenopausal period of their life face various physical and physiological changes causing lack of estrogen and progesterone hormones, changes in the reproductive and genitals organs, vasomotor system in the body along with mood related symptoms such as anxiety, etc. Lifestyle, body fat distribution and anthropometric changes adds on to the bone strength in postmenopausal women. It may be a risk factor for osteoporotic fracture, cardiovascular, metabolic diseases, etc. Core strength and stability is greatly influenced by body composition and adiposity. The aim of the study was to correlate the core strength assessed with the Body Mass Index (BMI) among postmenopausal women. The objective of the study is to find the correlation between the core strength assessed with the Body Mass Index using 60° flexion test, Beiring Sorenson test and Unilateral Hip Bridge Endurance test among postmenopausal women with age ranging from 46-70 years. 96 healthy postmenopausal women in Karad city with a natural history of menopause were selected for the study. Based upon BMI values, the subjects were grouped as Underweight (<18.5 kg/m2), Normal weight (18.5-24.9 kg/m2), Overweight (25-29.9 kg/m2 and more). The outcome values for strength were correlated with the BMI of postmenopausal women. In the study, the Pearson correlation(r) was -0.361 and the P value was 0.0003 showing extremely significant correlation between the BMI and 60° Flexion test. For the Beiring Sorenson Test, the Pearson correlation value was -0.305 and the P value was 0.0025 showing very significant correlation between the BMI and Beiring Sorenson Test. Correlation of BMI and Unilateral Hip Bridge Endurance Test shows a Pearson Correlation value of -0.322 and the P value 0.0013 claiming very significant correlation between the BMI and Unilateral Hip Bridge Endurance Test. The study concludes that there is a significantly negative correlation between the core strength and stability with the Body Mass Index among postmenopausal women.

Spinal mobility in radiographic axial spondyloarthritis: criterion concurrent validity of classic and novel measurements

Background Limitations in spinal mobility are a characteristic feature of Axial Spondyloarthritis. Current clinical measurements of spinal mobility have shown low criterion-concurrent validity. This study sought to evaluate criterion-concurrent validity for a clinically feasible measurement method of measuring spine mobility using tri-axial accelerometers. Methods Fifteen radiographic-Spondyloarthritis patients were recruited for this study. Two postural reference radiographs, followed by three trials in forward, left and right lateral bending were taken. For all trials, three measurements were collected: tape (Original Schober’s, Modified Schober’s, Modified-Modified Schober’s, Lateral Spinal Flexion Test and Domjan Test), followed immediately by synchronized radiograph and accelerometer measurements at end range of forward and bilateral lateral flexion. The criterion-concurrent validity of all measurement methods was compared to the radiographic measures using Pearson’s correlation coefficients. A Bland-Altman analysis was conducted to assess agreement. Results In forward bending, the accelerometer method (r = 0.590, p = 0.010) had a stronger correlation to the radiographic measures than all tape measures. In lateral bending, the Lateral Spinal Flexion tape measure (r = 0.743, p = 0.001) correlated stronger than the accelerometer method (r = 0.556, p = 0.016). The Domjan test of bilateral bending (r = 0.708, p = 0.002) had a stronger correlation to the radiographic measure than the accelerometer method. Conclusions Accelerometer measures demonstrated superior criterion-concurrent validity compared to current tape measures of spinal mobility in forward bending. While a moderate correlation exists between accelerometer and radiographs in lateral bending, the Lateral Spinal Flexion Test and Domjan Test were found to have the best criterion-concurrent validity of all tests examined in this study.

Prospective, Multicenter Evaluation of a Polyherbal Supplement alongside Standard-of-Care Treatment for Mild Knee Osteoarthritis

Background. This study aimed to provide clinical information on general and joint performance from individuals taking Tregocel® (containing curcuminoid and extracts of the herbs Harpagophytum procumbens, Boswellia serrata, Apium graveolens, and Zingiber officinale) alongside a standard therapy of symptomatic mild knee osteoarthritis (OA). Methods. This was a multicenter, open-label, prospective, single-arm study, in which Tregocel® was supplemented for 36 weeks. Participants with symptomatic mild knee OA requiring pharmacologic treatment for pain were enrolled. Physical performance (6-minute walk test, WOMAC-pain and functional domain, and heel-thigh distance flexion test), general performance (WOMAC questionnaire), and VAS (Visual Analogue Scale) assessment of knee pain, as well as anti-inflammatory and analgesic medication consumption, were assessed. Results. Between January and April 2019, 107 participants were enrolled and analysed in per protocol population. Mean age was 59.7 (SD 10.8) years, and there were 68.2% women. Mean observation time was 291.1 (SD 7.7) days. Mean increase in 6MWT result observed at the end of the study was 26.0 (SD 30.4) m ( p < 0.001 ). Median VAS score decreased from 60.0 (IQR 50–72) mm at the beginning of the study to 21.0 (IQR 14–30) mm after 36 weeks of product administration ( p < 0.001 ). Regular knee OA medications were taken in 99.1% of subjects at baseline decreasing to 55.1% at the end of the Tregocel® supplementation. Conclusions. During Tregocel® supplementation, participants observed improved functional capacity confirmed in the distance in 6MWT and in the heel-thigh distance flexion test, decreased level of pain, and improved WOMAC scores for all domains.

Spinal Mobility in Radiographic Axial Spondyloarthritis: Criterion Concurrent Validity of Classic and Novel Measurements

Background: Limitations in spinal mobility are a characteristic feature of Axial Spondyloarthritis. Current clinical measurements of spinal mobility have shown low criterion-concurrent validity. This study sought to evaluate criterion-concurrent validity for a clinically feasible measurement method of measuring spine mobility using tri-axial accelerometers.Methods: 15 radiographic-Spondyloarthritis patients were recruited for this study. Two postural reference radiographs, followed by three trials in forward, left and right lateral bending were taken. For all trials, three measurements were collected: tape (Original Schober’s, Modified Schober’s, Modified-Modified Schober’s, Lateral Spinal Flexion Test and Domjan Test), followed immediately by synchronized radiograph and accelerometer measurements at end range of forward and bilateral lateral flexion. The criterion-concurrent validity of all measurement methods were compared to the radiographic measures using Pearson’s correlation coefficients. A Bland-Altman analysis was conducted to assess agreement.Results: In forward bending, the accelerometer method (r=0.590, p=0.010) had a stronger correlation to the radiographic measures than all tape measures. In lateral bending, the Lateral Spinal Flexion tape measure (r=0.743, p=0.001) correlated stronger than the accelerometer method (r=0.556, p=0.016). The Domjan test of bilateral bending (r=0.708, p=0.002) had a stronger correlation to the radiographic measure than the accelerometer method. Conclusions: Accelerometer measures demonstrated superior criterion-concurrent validity compared to current tape measures of spinal mobility in forward bending. While a moderate correlation exists between accelerometer and radiographs in lateral bending, the Lateral Spinal Flexion Test and Domjan Test were found to have the best criterion-concurrent validity of all tests examined in this study.