Monitoring Improvement in Infantile Cerebral Palsy Patients Using the 4DBODY System-A Preliminary Study.

Monitoring the patient's condition during rehabilitation is the key to success in this form of treatment. This is especially important in patients with infantile cerebral palsy (ICP). Objective assessment can be achieved through modern optical measurement techniques. The 4DBODY system allows to capture dynamic movement with high accuracy. Eight patients with ICP participated in the study. The group underwent therapy lasting seven days using neurodevelopmental treatment (NDT) and functional training (FT). The patients' condition was monitored by the 4DBODY system. The measurements were taken three times: before the therapy, after, and then again after one week. We have developed the Trunk Mobility in the Frontal Plane Index (TMFPI) for its assessment. The results were compared with a score obtained using the Gross Motor Function Measure scale (GMFM 88). An improvement of the TMFPI parameter was observed in five patients, inconsistent results in two and deterioration in one. The reference GMFM score was higher in all patients relative to pre-treatment values. We found that surface scanning with the 4DBODY system allows to precisely track body movement in ICP patients. The decrease in the TMFPI parameter reflects the improvement in the dysfunction of body alignment, balance and symmetry of movement on the L and R body side.

Decreased Vertical Trunk Inclination Angle and Pelvic Inclination as the Result of Mid-High-Heeled Footwear on Static Posture Parameters in Asymptomatic Young Adult Women.

The influence of high-heel footwear on the lumbar lordosis angle, anterior pelvic tilt, and sacral tilt are inconsistently described in the literature. This study aimed to investigate the impact of medium-height heeled footwear on the static posture parameters of homogeneous young adult standing women. Heel geometry, data acquisition process, as well as data analysis and parameter extraction stage, were controlled. Seventy-six healthy young adult women with experience in wearing high-heeled shoes were enrolled. Data of fifty-three subjects were used for analysis due to exclusion criteria (scoliotic posture or missing measurement data). A custom structured light surface topography measurement system was used for posture parameters assessment. Three barefoot measurements were taken as a reference and tested for the reliability of the posture parameters. Two 30-degree wedges were used to imitate high-heel shoes to achieve a repeatable foot position. Our study confirmed the significant (p < 0.001) reduced vertical balance angle and pelvis inclination angle with large and medium-to-large effects, respectively, due to high-heel shoes. No significant differences were found in the kyphosis or lordosis angles. High-heeled shoes of medium height in young asymptomatic women can lead to a straightening effect associated with a reduced vertical balance angle and decreased pelvic inclination.

Monitoring of spine curvatures and posture during pregnancy using surface topography - case study and suggestion of method.

BACKGROUND: Low back and pelvic pain is one of the most frequently reported disorders in pregnancy, however etiology and pathology of this problem have not been fully determined. The relationship between back pain experienced during pregnancy and posture remains unclear. It is challenging to measure reliably postural and spinal changes at the time of pregnancy, since most imaging studies cannot be used due to the radiation burden. 3D shape measurement, or surface topography (ST), systems designed for posture evaluation could potentially fill this void. A pilot study was conducted to test the potential of monitoring the change of spine curvatures and posture during pregnancy using surface topography. A single case was studied to test the methodology and preliminarily assess the usefulness of the procedure before performing a randomized trial. The apparatus used in this study was metrologically tested and utilized earlier in scoliosis screening. CASE PRESENTATION: The subject was measured using a custom-made structured light illumination scanner with accuracy of 0.2 mm. Measurement was taken every 2 weeks, between 17th and 37th week of pregnancy, 11 measurements in total. From the measurement the thoracic kyphosis and lumbar lordosis angles, and vertical balance angle were extracted automatically. Custom-written software was used for analysis. Oswestry Low Back Pain Disability Questionnaire (ODI) was done with every measurement. The values were correctly extracted from the measurement. The results were: 50.9 ± 2.4° for kyphosis angle, 58.1 ± 2.1° for lordosis angle and 4.7 ± 1.7° for vertical balance angle. The registered change was 7.4° in kyphosis angle, 8.4° in lordosis angle and 5.5° in vertical balance angle. The calculated ODI values were between moderate disability and severe disability (22 to 58 %). CONCLUSIONS: This case study presents that surface topography may be suitable for monitoring of spinal curvature and posture change in pregnant women. The ionizing radiation studies are contraindicated during pregnancy. Surface topography data connected with information from pain level questionnaires allows to investigate the connection between changes in posture and back pain.

Posture and low back pain during pregnancy - 3D study.

OBJECTIVES: Back pain is a common complaint of pregnant women. The posture, curvatures of the spine and the center of gravity changes are considered as the mechanisms leading to pain. The study aimed to assess spinal curvatures and static postural characteristics with three-dimensional surface topography and search for relationships with the occurrence of back pain complaints among pregnant women. MATERIAL AND METHODS: The study was conducted from December 2012 to February 2014. Patients referred from University Clinic of Gynecology and Obstetrics were examined outpatient at the Posture Study Unit of Department of Orthopaedics and Traumatology. Sixty-five women at 4-39 weeks of pregnancy were assessed and surveyed with Oswestry Disability Index; posture was evaluated using surface topography. RESULTS: The study confirmed that difficulties in sitting and standing are significant in the third trimester of the pregnancy. The overall tendency for significant lumbar curvature changes in pregnant women was not confirmed. Major changes in sagittal trunk inclination in relation to the plumb line were not observed in the study group. CONCLUSIONS: The issue regarding how the pregnancy causes changes in spinal curvature and posture remains open for further studies. Presented method of 3D surface topography can reveal postural changes, but that requires several exams of each subject and strict follow-up of the series of cases.

Application of multi-resolution 3D techniques in crime scene documentation with bloodstain pattern analysis.

In forensic documentation with bloodstain pattern analysis (BPA) it is highly desirable to obtain non-invasively overall documentation of a crime scene, but also register in high resolution single evidence objects, like bloodstains. In this study, we propose a hierarchical 3D scanning platform designed according to the top-down approach known from the traditional forensic photography. The overall 3D model of a scene is obtained via integration of laser scans registered from different positions. Some parts of a scene being particularly interesting are documented using midrange scanner, and the smallest details are added in the highest resolution as close-up scans. The scanning devices are controlled using developed software equipped with advanced algorithms for point cloud processing. To verify the feasibility and effectiveness of multi-resolution 3D scanning in crime scene documentation, our platform was applied to document a murder scene simulated by the BPA experts from the Central Forensic Laboratory of the Police R&D, Warsaw, Poland. Applying the 3D scanning platform proved beneficial in the documentation of a crime scene combined with BPA. The multi-resolution 3D model enables virtual exploration of a scene in a three-dimensional environment, distance measurement, and gives a more realistic preservation of the evidences together with their surroundings. Moreover, high-resolution close-up scans aligned in a 3D model can be used to analyze bloodstains revealed at the crime scene. The result of BPA such as trajectories, and the area of origin are visualized and analyzed in an accurate model of a scene. At this stage, a simplified approach considering the trajectory of blood drop as a straight line is applied. Although the 3D scanning platform offers a new quality of crime scene documentation with BPA, some of the limitations of the technique are also mentioned.

The time effectiveness of three-dimensional telediagnostic postural screening of back curvatures and scoliosis.

BACKGROUND: Postural screening remains a powerful tool that can be used to identify children and adolescents with scoliosis or sagittal plane deformities. The aim of this study was to assess the time effectiveness of implemented telediagnostic screening procedures. MATERIALS AND METHODS: Medical images (virtual objects) of acquired clouds of points of 100 subjects of both sexes were chosen at random from the database and used for parametric evaluation for this study. This study was performed using a newly developed three-dimensional (3D) back surface topography measurement system for posture and scoliosis using a structured light method. The duration of each step of therapist/nurse/physician-assisted 3D assessment was measured independently with a stopwatch. Two configurations of PC computers and Internet connections were used to test the time effectiveness. Scoliotic postures were detected using cutoff values of angle of trunk rotation, Posterior Trunk Symmetry Index, and Deformity in the Axial Plane Index indices. RESULTS: The overall assessment of all subjects consumed from 2 h 55 min 55 s to 3 h 18 min 59 s dependent on PC and Internet connection configuration. Average examination time per subject ranged from 2 min 43 s to 4 min 51 s, respectively. The virtual landmarking and report generation times were dependent on the PC configuration (p<0.001). Our study confirmed satisfactory time effectiveness of the implemented telediagnostic postural screening procedure. We assume that it may influence the cost-effectiveness of the screening, which is usually mentioned as an important factor for recommendations against postural school screening. Relatively fast Internet connection and a medium-level PC configuration are sufficient for achieving a reasonably short time of 3D posture assessment of a virtual object representing a real subject's back surface. CONCLUSIONS: The efficiency of remote assessment of exact 3D surface topography can be used in large-scale studies for posture and scoliosis epidemiology.

Telediagnostic 3D school screening of back curvatures and posture using structured light method - pilot study.

BACKGROUND: Several studies consider the school scoliosis screening as controversial. Many authors postulate to improve its clinical effectiveness. AIM: Authors assumed that three dimensional telediagnostic surface topography measurements allowing measuring several postural deformity indexes and angles of curvatures in sagittal plane may enhance current practice. The study was designed to determine usefulness of school screening back evaluation performed utilizing the three dimensional telediagnostic measurement system. METHODS: The measurement module is based on structured light method using "3D Orthoscreen" system. The technique for 3D image acquisition of back shape is based on temporal phase shifting and Gray codes. Measurement data was securely archived for remote access by investigator over the secure Internet connection. Acquired "images" were transferred to Telediagnostic Center for clinical evaluation. Spine parameters and deformation indexes like Posterior Trunk Symmetry Index (POTSI), Deformity in the Axial Plane Index (DAPI), kyphosis and lordosis angle were measured. The preliminary study was performed in 2 selected schools (basic and middle schools). The study was approved by Bioethical Committee. Clouds of points representing back topography of assessed subjects were acquired at schools in March and May 2011 and stored for remote evaluation and analysis. RESULTS: 758 children averagely aged 11.1 years (from 5 to 16), 387 females and 371 males, were examined. Their average body mass was 45.13 kg [16-105; STD 16.4] and average height was 151.43 cm, [110-192; STD 18.3]. The average values of back assessment parameters were as follows: POTSI 15.97% [0-73.4; STD 10.3]; DAPI 0.88% [0-5.9; STD 0.76]; kyphosis angle 10.19° [0-32; STD 5.82]; and lordosis angle 32,82° [0-56; STD 9.86]. CONCLUSION: Technical and clinical issues of the practical implementation allowed to elaborate preliminary protocol for cohort studies addressed to subject (i.e. parents acceptance of examination of undressed back) and technical issues (i.e. upload data and retrieval, network transfer velocity). Postural telediagnostics was found sufficiently feasible for further implementation of remote, cohort 3D back shape evaluations including school screening. Permanently saved 3D data allow monitoring back surface of the individual subjects.

Automatic recognition of surface landmarks of anatomical structures of back and posture.

Faulty postures, scoliosis and sagittal plane deformities should be detected as early as possible to apply preventive and treatment measures against major clinical consequences. To support documentation of the severity of deformity and diminish x-ray exposures, several solutions utilizing analysis of back surface topography data were introduced. A novel approach to automatic recognition and localization of anatomical landmarks of the human back is presented that may provide more repeatable results and speed up the whole procedure. The algorithm was designed as a two-step process involving a statistical model built upon expert knowledge and analysis of three-dimensional back surface shape data. Voronoi diagram is used to connect mean geometric relations, which provide a first approximation of the positions, with surface curvature distribution, which further guides the recognition process and gives final locations of landmarks. Positions obtained using the developed algorithms are validated with respect to accuracy of manual landmark indication by experts. Preliminary validation proved that the landmarks were localized correctly, with accuracy depending mostly on the characteristics of a given structure. It was concluded that recognition should mainly take into account the shape of the back surface, putting as little emphasis on the statistical approximation as possible.