ABSTRACT
Background: Neck pain, one of the most common musculoskeletal diseases, affects 222 million people worldwide. The cervical range of motion (CROM) is a tool used to assess the neck's state across three movement axes: flexo-extension, rotation, and lateral flexion. People with neck pain often have a reduced CROM, and they feel pain at the end-range and/or accompany neck movements with compensatory trunk movements. Virtual reality (VR) setups can track the movement of the head and other body parts in order to create the sensation of immersion in the virtual environment. Using this tracking position information, a CROM assessment can be performed using a VR setup that may be carried out autonomously from the user's home. The objectives of this study were to develop a VR experience that could be used to perform a CROM assessment, and to evaluate the intra-rater and inter-rater reliability of the CROM measures guided by this VR experience. To the best of our knowledge, a study of this type has not been carried out before. Materials & Methods: A total of 30 asymptomatic adults were assessed using a VR device (HTC Vive Pro Eye™). Two raters provided support with the VR setup, and the participants were guided by the VR experience as they performed the movements. Each rater tested each subject twice, in random order. In addition to a head-mounted display (HMD), a tracker located on the subject's back was used to measure trunk compensatory movements. The CROM was estimated using only the HMD position and this measurement was corrected using the tracker data. The mean and standard deviation were calculated to characterize the CROM. To evaluate the reliability, the interclass correlation coefficients (ICC) were calculated for intra-rater and inter-rater analysis. The standard error of measurement and minimum detectable change were also calculated. The usability of the VR system was measured using the Spanish version of the System Usability Scale. Results: The mean CROM values in each axis of movement were compatible with those described in the literature. ICC values ranged between 0.86 and 0.96 in the intra-rater analysis and between 0.83 and 0.97 in the inter-rater analysis; these values were between good and excellent. When applying the correction of the trunk movements, both the intra-rater and inter-rater ICC values slightly worsened except in the case of the lateral flexion movement, where they slightly improved. The usability score of the CROM assessment/VR system was 86 points, which is an excellent usability score. Conclusion: The reliability of the measurements and the usability of the system indicate that a VR setup can be used to assess CROM. The reliability of the VR setup can be affected by slippage of the HMD or tracker. Both slippage errors are additive, i.e., only when the sum of these two errors is less than the compensatory movement do the measurements improve when considering the tracker data.
Subject(s)
Cervical Vertebrae , Neck Pain , Adult , Humans , Neck Pain/diagnosis , Reproducibility of Results , Neck , Range of Motion, ArticularABSTRACT
Este e-book tem como objetivo trazer um compêndio de relatos de experiência relacionados à gestão de saúde do Estado de Goiás. Cada capítulo traz a descrição dos projetos desenvolvidos no âmbito da Secretaria de Estado da Saúde de Goiás, que são vinculados aos objetivos estratégicos do órgão. Estes projetos têm como objetivo fortalecer as ações estratégicas para otimizar o planejamento do Sistema Único de Saúde
This e-book aims to bring a compendium of experience reports related to health management in the State of Goiás. Each chapter brings a description of the projects developed within the scope of the State Department of Health of Goiás, which are linked to the strategic objectives of the agency. These projects aim to strengthen strategic actions to optimize the planning of the Unified Health System
Subject(s)
Health Management , Public Health Administration , State Health Plans , Health Programs and Plans , Social Control Policies , Health Services Administration , Crew Resource Management, Healthcare , Health PolicyABSTRACT
The foveal avascular zone (FAZ) is the capillary-free area in the central macula with high photoreceptor density and metabolic activity. In the present study we measured the superficial and deep macular foveal avascular zone (sFAZ, dFAZ) in the eyes of healthy adults of both sexes of various ages ranging from 10 to 69 years using optical coherence tomography angiography (OCT-A) in order to evaluate the influence of gender and age on FAZ size. A cross-sectional study was carried out in 240 eyes of 120 healthy subjects, OCT-A was performed by means of a Topcon swept source OCT. sFAZ and dFAZ areas were measured using the IMAGEnet6 software package. Subjects were grouped by age (six groups) and gender. The mean⯱â¯sd age of the subjects was 39.2⯱â¯17.4 years (50% women, 50% men), ranging from 10 to 69 years. The overall mean sFAZ size in women (0.297⯱â¯0.110â¯mm2) was significantly larger (pâ¯=â¯0.002) than in men (0.254⯱â¯0.098â¯mm2). Similarly, the overall mean dFAZ in women (0.322⯱â¯0.111â¯mm2) was significantly larger (pâ¯<â¯0.001) than in men (0.273⯱â¯0.099). However, when analyzed by age group, these gender differences appeared only in groups younger than 20 years old and older than 50 years old. Men did not show differences among the six age groups. In women, for both sFAZ and dFAZ, the 20-29 year old group had a smaller FAZ size than the 50-59 year old group. In conclusion for both sFAZ and dFAZ, women have larger areas than men, but this occurs only in the young and old age groups. In men, age does not seem to influence the size of the FAZ, but in women, both sFAZ and dFAZ were significantly smaller in younger than in older ages. These results suggest that retinal changes in retinal structure caused by aging may be different in woman than in men, probably reflecting the more hormonal variations known to exist with age in women.
Subject(s)
Aging , Fluorescein Angiography/methods , Fovea Centralis/diagnostic imaging , Retinal Vessels/diagnostic imaging , Tomography, Optical Coherence/methods , Visual Acuity , Adolescent , Adult , Age Factors , Aged , Capillaries/diagnostic imaging , Child , Cross-Sectional Studies , Female , Fundus Oculi , Healthy Volunteers , Humans , Male , Middle Aged , Sex Factors , Young AdultABSTRACT
INTRODUCTION: The Voice Handicap Index has been shown to be a valid instrument for assessing self-perceived handicap associated with dysphonia. OBJECTIVES: To test the psychometric properties of the Spanish version of the VHI-30 (Voice Handicap Index) and its shortened version VHI-10. SUBJECTS AND METHOD: The original VHI-30 was translated into Spanish and was completed by 232 dysphonic patients and 38 non-dysphonic individuals. Prospective instrument validation was performed. RESULTS: Results showed high test-retest reliability, and high item-total correlation for both Spanish VHI-30 and VHI-10. Internal consistency demonstrated a Cronbach's alpha of 0.93 and 0.86, respectively, and a significant correlation was found between the VHI scores and the patients' self-rated dysphonic severity. CONCLUSIONS: The present study supports the use of Spanish versions of VHI-30 and VHI-10 because of their validity and reliability.
Subject(s)
Disability Evaluation , Language , Surveys and Questionnaires , Translations , Voice Disorders/diagnosis , Adult , Feasibility Studies , Female , Humans , Male , SpainABSTRACT
Introducción y objetivos: El índice de incapacidad vocal (Voice Handicap Index) es un instrumento válido para la valoración del menoscabo asociado a la disfonía que percibe el paciente. El objetivo es valorar las propiedades psicométricas de la versión castellana del VHI-30 y su versión abreviada VHI-10. Sujetos y método: El VHI-30 original se tradujo al idioma español y lo contestaron 232 pacientes con disfonía y 38 sujetos sanos. Se realizó una validación prospectiva del instrumento. Resultados: Se encuentra una alta fiabilidad test-retest y altas correlaciones ítem-total tanto para el VHI-30 como para el VHI-10. La coherencia interna demuestra valores alfa de Cronbach de 0,93 y 0,86 respectivamente, y se encontró una correlación significativa entre las puntuaciones del VHI y la valoración de los pacientes de la severidad de su disfonía. Conclusiones: El presente estudio apoya el uso de las versiones en español del VHI-30 y del VHI-10 por su validez y fiabilidad
Introduction: The Voice Handicap Index has been shown to be a valid instrument for assessing self-perceived handicap associated with dysphonia. Objectives: To test the psychometric properties of the Spanish version of the VHI-30 (Voice Handicap Index) and its shortened version VHI-10. Subjects and method: The original VHI-30 was translated into Spanish and was completed by 232 dysphonic patients and 38 non-dysphonic individuals. Prospective instrument validation was performed. Results: Results showed high test-retest reliability, and high item-total correlation for both Spanish VHI-30 and VHI-10. Internal consistency demonstrated a Cronbachs alpha of 0.93 and 0.86, respectively, and a significant correlation was found between the VHI scores and the patients self-rated dysphonic severity. Conclusions: The present study supports the use of Spanish versions of VHI-30 and VHI-10 because of their validity and reliability
Subject(s)
Humans , Male , Female , Adult , Voice Disorders/diagnosis , Translations , Surveys and Questionnaires , Language , Disability Evaluation , Feasibility Studies , SpainABSTRACT
Sulcus vocalis, vergetures, mucosal bridges, and cysts as intracordal lesions constitute a group of great diagnostic difficulty. We present 6 patients in whom microlaryngoscopy was the final diagnostic step in the evaluation of a lesion not recognized in the initial evaluation. The criteria selected were as follows: Severe GRABS. Stroboscopic parameters: glottal chink without mass lesion, asymmetry of amplitude, and irregularity of vibration, or when discrepancy between examination and quality of the voice exists. Acoustic and aerodynamic measures that demonstrate severe dysphonia. High scores on the Voice Handicap Index. We recommend carrying out a diagnostic microlaryngoscopy examination where the cause of dysphonia is unclear.
Subject(s)
Laryngoscopy/methods , Microsurgery/instrumentation , Voice Disorders/diagnosis , Adult , Female , Humans , Male , Postoperative Care , Preoperative Care , Sound Spectrography , Vocal Cords/physiopathologyABSTRACT
Los sulcus vocalis, vergetures, puentes mucosos y quistes son lesiones intracordales que constituyen un grupo de lesiones de difícil diagnóstico. Presentamos a 6 pacientes en los que la microlaringoscopia fue el paso diagnóstico definitivo en la evaluación de una lesión que no había sido apreciada en la evaluación en el consultorio. Los criterios para indicar una microlaringoscopia directa diagnóstica son altas puntuaciones del índice GRABS; los defectos de cierre glótico sin lesión tipo masa y la asimetría de fase y amplitud entre las ondas mucosas de ambas cuerdas; la desproporción entre los hallazgos de la estroboscopia o la endoscopia con la intensidad percibida de la disfonía; la disfonía severa objetivada mediante análisis acústico y aerodinámico, y las puntuaciones altas en el índice de incapacidad vocal. Recomendamos la realización de una microlaringoscopia diagnóstica en los casos de disfonía de origen incierto
Sulcus vocalis, vergetures, mucosal bridges, and cysts as intracordal lesions constitute a group of great diagnostic difficulty. We present 6 patients in whom microlaryngoscopy was the final diagnostic step in the evaluation of a lesion not recognized in the initial evaluation. The criteria selected were as follows: Severe GRABS. Stroboscopic parameters: glottal chink without mass lesion, asymmetry of amplitude, and irregularity of vibration, or when discrepancy between examination and quality of the voice exists. Acoustic and aerodynamic measures that demonstrate severe dysphonia. High scores on the Voice Handicap Index. We recommend carrying out a diagnostic microlaryngoscopy examination where the cause of dysphonia is unclear
