Comparison of Gluteal Muscle Strengthening versus Conventional Isometrics in Pain Management of Piriformis Syndrome

Aim: To analyze the effectiveness of gluteal muscles strengthening in piriformis syndrome. Study design: Experimental study Place and duration of study: Department of Physiotherapy, Mayo Hospital, Lahore from 1st February 2019 to 31st July 2019. Methodology: Fifty patients presenting with piriformis syndrome were enrolled. They were divided in two groups. Control group received piriformis stretching, ultrasound and conventional isometrics. Experimental group received piriformis stretching, ultrasound and a gluteal strengthening program. The baseline parameters were assessed using the Visual Analogue Scale (VAS) and Manual Muscle Testing (MMT). Patients were treated for 40 minutes 3 times a week for 4weeks. Results: Reduction in intensity of pain as well as improvement in ROM was seen in both groups. There was significant improvement in lateral rotation of hip in experimental group, and as piriformis is also a lateral rotator of hip joint, hence improvement in range of lateral rotation shows that a gluteal strengthening program has significant in increasing ROM of joint. There was significant improvement in MMT grade of gluteal muscles comparatively in the experimental group. Conclusion: Experimental group showed improvements in decreasing pain and improvements in strength, with a significant improvement in lateral rotation shows that gluteal strengthening program can be used to treat pts with piriformis syndrome. Key words: Manual Muscle Testing, Visual analog scale

Exploring bio-parametric solution-based design process for an ephemeral pavilion

This research proposes an experimental design approach to design an ephemeral pavilion located at the Serpentine Gallery in London. The Serpentine Pavilions Programme functions as an experimentation laboratory and, at the same time, public and event spaces, enabling architects to expose their projects and work methodologies. Thus, the methods of Biomimicry and Parametric Design were combined to develop the pavilion. While the first one was used to create an ephemeral pavilion based on the Sartorius muscle, the second was responsible for generating the parametric model from a fast and intuitive manipulation code capable of exploring shape variations. This work explores the solution-based method approached by Badarnah (2012) based on a predefined problem (the pavilion project) and only after that seek some natural inspiration. Firstly, it was investigated the anatomy of the Sartorius muscle. Subsequently, with the domain of the solution, the parametric insertion of the shape was computationally performed. The anatomical study of the sartorius muscle revealed functions such as flexion, abduction, lateral rotation of the thigh, and medial rotation of the knee. Thus, the architectural choices reflect both its narrow and elongated morphology of the muscle and flexibility and rotation aspects. The pavilion also considered the previous Serpentine Pavilions regarding attributes such as area, height, and materials, which with other parameters may be changed using the code implemented in Grasshopper.

Three-Dimensional Kinematics of the Pelvis and Caudal Lumbar Spine in German Shepherd Dogs

Lumbosacral vertebral motion is thought to be a factor in the development of degenerative lumbosacral stenosis in German shepherd dogs. So far, few studies exist describing natural canine lumbosacral movement in vivo. Therefore, this investigation aims to achieve a detailed in vivo analysis of bone movement of the lumbosacral region to gain a better understanding of the origin of degenerative lumbosacral stenosis using three-dimensional non-invasive in vivo analysis of canine pelvic and caudal lumbar motion (at L6 and L7). Biplanar cineradiography of the pelvis and caudal lumbar spine of four clinically sound German shepherd dogs at a walk and at a trot on a treadmill was recorded. Pelvic and intervertebral motion was virtually reconstructed and analyzed with scientific rotoscoping. The use of this technique made possible non-invasive measurement of physiological vertebral motion in dogs with high accuracy. Furthermore, the gait patterns of the dogs revealed a wide variation both between individual steps and between dogs. Pelvic motion showed a common basic pattern throughout the stride cycle. Motion at L6 and L7, except for sagittal rotation at a trot, was largely asynchronous with the stride cycle. Intervertebral motion in all dogs was small with approximately 2–3° rotation and translations of approximately 1–2 mm. The predominant motion of the pelvis was axial rotation at a walk, whereas lateral rotation was predominant at a trot. L7 showed a predominance of sagittal rotation (with up to 5.1° at a trot), whereas lateral rotation was the main component of the movement at L6 (about 2.3° in both gaits). During trotting, a coupling of various motions was detected: axial rotation of L7 and the pelvis was inverse and was coupled with craniocaudal translation of L7. In addition, a certain degree of compensation of abnormal pelvic movements during walking and trotting by the caudal lumbar spine was evident.

In Vivo Kinematic Analysis of Bicruciate-Retaining Total Knee Arthroplasty Focused on Function of the ACL

uncertain. In this study, we performed an in vivo kinematic analysis of squat motion on level ground and on a downward slope in patients treated with BCR-TKA to examine the value of anterior cruciate ligament (ACL) preservation.Methods: The subjects were ten valgus knees that underwent TKA (BCR: 5 knees, CR: 5 knees) at our hospital. We evaluated in vivo kinematics of the knee using fluoroscopy and investigated the femoral component translation relative to the tibial component from extension to maximum flexion, and the rotation angle between the components under the two conditions. Statistical analysis was conducted by Mann-Whitney U test to compare the rotational angle, the location of lateral and medial contact points per flexion angle. Differences in these parameters between the BCR and CR groups across the flexion angles were compared by repeated measures ANOVA. Results: Rotation of the femoral component to the tibial component occurred gradually as flexion continued. On level ground, lateral rotation at 0° to 120° flexion was 14.5±1.95° in the BCR group and 7.9±0.47° in the CR group. Medial translation was 4.1±1.73mm in the BCR group and 2.5±1.64mm in the CR group, and lateral translation was 13.2±1.6mm in the BCR group and 7.1±1.74mm in the CR group. On a forward slope, lateral rotation was 12.7±1.45° in the BCR group and 7.57±0.47° in the CR group. Medial translation was 5.87±1.78mm in the BCR and 2.9±0.81mm in the CR, and lateral translation was 13.6±1.84mm in the BCR and 7.4±0.96mm in the CR.Conclusion: An in vivo kinetics analysis of deep flexion motion was conducted on level ground and on a forward slope to stress the ACL. Under both conditions, kinetics close to screw home movement were found in the BCR group and rotation was significantly larger than that in the CR group. The medial contact point between components was located significantly more anterior in the BCR group. In conclusion, BCR-TKA was found to have in vivo kinetics close to those of a normal knee, in comparison with CR-TKA.

Research on kinematics analysis of spherical single-cone PDC compound bit and rock breaking simulation verification

The single-cone bit has become the first choice for slim hole sidetracking and deep well drilling with its unique rock breaking method and high ROP (Rate Of Penetration), with its main failure mode being of early excessive wear of the cutting teeth. In order to improve the adaptability of single-cone bits to hard and highly abrasive formations, a spherical single-cone Polycrystalline Diamond Compact (PDC) compound bit is designed. According to the characteristics of the tooth profile, the way of tooth arrangement and the way of contact between the cutting teeth and the rock, the acceleration equation to the cutting teeth of the spherical single-cone PDC compound bit is established. The acceleration of the single-cone bit is verified by numerical simulation experiment of rock-breaking. The shaft inclination angle of the cone, the position and height of the PDC teeth, the radius of the PDC teeth, the lateral rotation angle and the front inclination angle on the acceleration are studied. The results show that as the shaft inclination angle increases, the bit transmission ratio gradually increases, and the harder the rock formation, the larger the transmission ratio of the single-cone bit; the shaft inclination angle and the position of the PDC tooth have a greater influence on the acceleration of the PDC tooth, and the radius, lateral rotation angle and front inclination angle of the PDC tooth have a small influence on the acceleration of the PDC tooth; rock properties have an impact on the acceleration of the cutting teeth, with the acceleration of the cutting teeth in hard rock formations being higher than that in soft rock formations; near the top of the cone, the absolute acceleration of the cutting teeth will fluctuate sharply and cause severe wear of the cutting teeth, so the tooth distribution in this area should be strengthened; on the premise that the bearing life of the single-cone bit is allowed, the value of the shaft inclination angle β can be approached to 70°. The relative error between the theoretical analysis results of the acceleration of the PDC cutter and the rock-breaking simulation experiment results is between −0.95% and −2.24%. This research lays a theoretical foundation for the dynamic research of spherical single-cone PDC compound bit.

Three-dimensional acetabular orientation during periacetabular osteotomy: a video analysis of acetabular rim position using an external fixator as navigation tool during reorientation procedure

Introduction Bernese periacetabular osteotomy is an effective procedure for treating acetabular dysplasia. However, limited visual control of the acetabular position during surgery may result in under- or overcorrection with residual dysplasia or femoroacetabular impingement. Thus, we wanted to find a simple method to control the effect of correction in the sagittal and coronal plane. Method The acetabular coordinates are shown by two perpendicular tubes of an external fixator mounted onto a third tube that is fixed to the acetabular fragment with two Schanz screws. This method enables the isolated acetabular reorientation in the coronal, sagittal, and transverse plane. In a sawbone pelvis model, the acetabular rim is marked with a copper wire and a silicon adherent. To show the radiographic effect on acetabular parameters and the rim position, we visualized correction in the coronal and sagittal plane under fluoroscopic control. Results Lateral rotation of the acetabular fragment had the highest impact on radiographic lateral coverage of the femoral head. But also ventral coverage increased during isolated lateral rotation. Anterior rotation showed almost no effect on lateral coverage and just a little effect on ventral coverage but caused severe total acetabular retroversion. Conclusion Three-dimensional control of the acetabular orientation during periacetabular osteotomy is important to avoid over- and under-correction. Isolated lateral rotation of the acetabular fragment should be the predominant direction of correction during periacetabular osteotomy. Ambitious anterior correction may be the main source for severe acetabular retroversion following periacetabular osteotomy.