The patient-rated wrist and hand evaluation was successfully translated to the Slovenian language.

BACKGROUND: The Patient-Rated Wrist and Hand Evaluation (PRWHE) is one of the widely used PROMs in the hand rehabilitation. PURPOSE: To develop the Slovenian version of the PRWHE (PRWHE-Slo) and to evaluate its psychometric properties. STUDY DESIGN: A single-centre observational prospective cohort study. METHODS: Fifty patients with distal radius fracture (DRF) were enrolled in the study. Construct validity was assessed by examining the correlations between the PRWHE-Slo and QuickDASH, EQ-5D-5L, wrist ROM, and grip strength. Reliability was evaluated by determining internal consistency (Cronbach...s alpha) and test-retest reliability (intraclass correlation coefficient (ICC)). The standard error of measurement (SEM) and the minimal detectable change (MDC) were determined. The responsiveness of the PRWHE-Slo was assessed with the effect size (ES) and standardised response mean (SRM). RESULTS: The Cronbach's alpha value of 0.96 and the ICC (95% CI) value of 0.95 showed excellent internal consistency and reliability for the total PRWHE-Slo score. When assessing construct validity of PRWHE-Slo, there was a strong positive correlation between all subscales and total scores of the PRWHE-Slo and the QuickDASH (r-values ranging from 0.72 to 0.83). The unrelated dimensions such as the function subscale of the PRWHE and the mobility and anxiety/depression subscales of the EQ-5D-5L were not statistically significantly correlated. Grip strength was moderately negatively correlated with all PRWHE subscales, whereas ROM showed no statistically significant correlations with any of the PRWHE-Slo subscales. SEM and MDC for the total PRWHE-Slo score were 5.40 and 14.97, respectively. The PRWHE-Slo proved to be highly responsive in DRF patients with SRM and ES values of 1.27 and 0.91, respectively. CONCLUSIONS: The psychometric analysis of this study shows the PRWHE-Slo to be reliable, valid, and responsive PROM for assessing pain and disability in patients after DRF.

Laser triangulation measurements of scoliotic spine curvatures.

BACKGROUND: The main purpose of this research was to develop a new method for differentiating between scoliotic and healthy subjects by analysing the curvatures of their spines in the cranio-caudal view. METHODS: The study included 247 subjects with physiological curvatures of the spine and 28 subjects with clinically confirmed scoliosis. The curvature of the spine was determined by a computer analysis of the surface of the back, measured with a non-invasive, 3D, laser-triangulation system. The determined spinal curve was represented in the transversal plane, which is perpendicular to the line segment that was defined by the initial point and the end point of the spinal curve. This was achieved using a rotation matrix. The distances between the extreme points in the antero-posterior (AP) and left-right (LR) views were calculated in relation to the length of the spine as well as the quotient of these two values LR/AP. All the measured parameters were compared between the scoliotic and control groups using the Student's t-Test in case of normal data and Kruskal-Wallis test in case of non-normal data. Besides, a comprehensive diagram representing the distances between the extreme points in the AP and LR views was introduced, which clearly demonstrated the direction and the size of the thoracic and lumbar spinal curvatures for each individual subject. RESULTS: While the distances between the extreme points of the spine in the AP view were found to differ only slightly between the groups (p = 0.1), the distances between the LR extreme points were found to be significantly greater in the scoliosis group, compared to the control group (p < 0.001). The quotient LR/AP was statistically significantly different in both groups (p < 0.001). CONCLUSIONS: The main innovation of the presented method is the ability to differentiate a scoliotic subject from a healthy subject by assessing the curvature of the spine in the cranio-caudal view. Therefore, the proposed method could be useful for human posture diagnostics as well as to provide a long-term monitoring of scoliotic spine curvatures in preventive and curative clinical practice at all levels of health care.

Determination of the human spine curve based on laser triangulation.

BACKGROUND: The main objective of the present method was to automatically obtain a spatial curve of the thoracic and lumbar spine based on a 3D shape measurement of a human torso with developed scoliosis. Manual determination of the spine curve, which was based on palpation of the thoracic and lumbar spinous processes, was found to be an appropriate way to validate the method. Therefore a new, noninvasive, optical 3D method for human torso evaluation in medical practice is introduced. METHODS: Twenty-four patients with confirmed clinical diagnosis of scoliosis were scanned using a specially developed 3D laser profilometer. The measuring principle of the system is based on laser triangulation with one-laser-plane illumination. The measurement took approximately 10 seconds at 700 mm of the longitudinal translation along the back. The single point measurement accuracy was 0.1 mm. Computer analysis of the measured surface returned two 3D curves. The first curve was determined by manual marking (manual curve), and the second was determined by detecting surface curvature extremes (automatic curve). The manual and automatic curve comparison was given as the root mean square deviation (RMSD) for each patient. The intra-operator study involved assessing 20 successive measurements of the same person, and the inter-operator study involved assessing measurements from 8 operators. RESULTS: The results obtained for the 24 patients showed that the typical RMSD between the manual and automatic curve was 5.0 mm in the frontal plane and 1.0 mm in the sagittal plane, which is a good result compared with palpatory accuracy (9.8 mm). The intra-operator repeatability of the presented method in the frontal and sagittal planes was 0.45 mm and 0.06 mm, respectively. The inter-operator repeatability assessment shows that that the presented method is invariant to the operator of the computer program with the presented method. CONCLUSIONS: The main novelty of the presented paper is the development of a new, non-contact method that provides a quick, precise and non-invasive way to determine the spatial spine curve for patients with developed scoliosis and the validation of the presented method using the palpation of the spinous processes, where no harmful ionizing radiation is present.

Measurement of spinal sagittal curvatures using the laser triangulation method.

The purpose of the first part of the study was to establish the variability of repeated measurements in different measuring conditions. In the second part, we performed in a large number of patients, a measurement of thoracic kyphosis and lumbar lordosis and compared them to age, gender, and level of nourishment. In the first part, measurements were performed on a plastic model of the back of a patient with a rigid and a normal spine. In the second part, 250 patients participated in the study (126 men and 124 women). For measuring spinal curvatures we used an apparatus for laser triangulation constructed at the Faculty of Mechanical Engineering, University of Ljubljana. A comparison of 30 repeated measurements was shown as the average value +/- 2 SD which included 95% of the results. Thirty repeated readings of one 3D measurement: thoracic kyphosis 41.2 degrees +/- 0.6 degrees, lumbar lordosis 4.4 degrees +/- 1.2 degrees; 30 measurements on a plastic model: thoracic kyphosis 36.8 degrees +/- 1.2 degrees, lumbar lordosis 30.9 degrees +/- 2.0 degrees; 30 measurements on a patient with a rigid spine: thoracic kyphosis 41.5 degrees +/- 2.4 degrees, lumbar lordosis 4.0 degrees +/- 1.8 degrees; 30 measurements on a patient with a normal spine: thoracic kyphosis 48.8 degrees +/- 7.4 degrees, lumbar lordosis 21.1 degrees +/- 4.4 degrees. The average size of thoracic kyphosis in 250 patients was 46.8 degrees (SD 10.1 degrees) and lumbar lordosis 31.7 degrees (SD 12.5 degrees). The angle size was statistically significantly correlated to gender (increased thoracic kyphosis and lumbar lordosis in women) and body mass index (increased thoracic kyphosis and lumbar lordosis in more nourished patients). Age was not significantly correlated to the observed angles. During measurements of the spinal angles it was important to pay attention to relaxation and the patient's position as well as to perform more measurements providing the average value. The age and the level of nourishment influence the size of the sagittal spinal angles. In the observed sample the effect of age was not confirmed.

The impact of anthropometric parameters on the incidence of low back pain.

Endogenic factors as one of possible reasons for low back pain were investigated and discussed in this study. The study included 122 male bus drivers, average age 44.2 years, average period of active service 24.4 years. The following anthropometric indexes have been calculated: Quetelet's index, percentage of body fat, relative body weight, Olivier's typologic index, Lorenz's constitution index and muscle index. According to inquiry form regarding history of low back pain the subjects were divided in two groups: 36 had no low back pain history and 76 had a history of recurrent low back pain. The results showed statistically nonsignificant differences in the anthropometric parameters and the calculated indexes between these two groups of subjects. The chosen subject sample showed that nutritional status, body build, constitution and muscular development are not associated with the incidence of low back pain.

Importance of intervertebral disc size in low back pain.

AIM: To compare two anthropometrical methods for measuring the intervertebral disc size with computer tomography measurements and to develop a new anthropometric method for calculating intervertebral disc area. METHODS: Intervertebral disc size was measured using computer tomography and two anthropometric methods (Colombini and modified Colombini) in a sample of 40 subjects. The new calculation for intervertebral disc size was developed and used in a sample of male bus drivers with (n=65) and without (n=30) anamnestic low back pain to asses clinical usefulness. RESULTS: The modified anthropometric method for intervertebral disc size assessment correctly predicted intervertebral disc size in 89% of the cases and the determination error was diminished to an average of 4.1% for level L4-L5 and 4.4% for level L5-S1. The average size of the intervertebral discs in 65 subjects with anamnestic lower back problems was significantly smaller than in the control group of 30 subjects having no such problems (p<0.001). CONCLUSION: The use of the presented formulas for the calculation of the intervertebral disc in L4-5 and L5-S1 areas from the data obtained by simple anthropometrical measurements is sufficiently reliable and accurate. The method is economical and harmless.

[Low back pain--what do we really know?]. / Krizobolja--sto stvarno znamo?

Low back pain is one of the most frequent health problems of contemporary people. Therapy is usually conservative and symptomatic because in the most part of cases the etiology remains unknown. Evidence based medicine is putting itself in front also in the field of low back pain diagnosis and treatment. The therapy for low back pain is thoroughly and scientifically rigorously analized by the professionals from the Cochrane Collaboration. There are still not published enough randomized controlled studies to conclude about the effectiveness of most frequently used physical therapy modalities. There is a necessity for additional researching in that field.