Capturing the cervical spine shape: Angular measurements versus geometric morphometric methods.

The cervical spine manifests a wide shape variation. However, the traditional methods to evaluate the cervical spine curve were never tested against its actual shape. The study's main aim was to determine whether the shape classification of the cervical spine, based on traditional angular measurements, coincides with each other and with the shape captured by the 2D landmark-based geometric morphometric method. The study's second aim was to reveal the associations between the cervical spine shape and the demographic parameters, the head's position, and the spine's sagittal balance. CT scans of the cervical spine of 163 individuals were evaluated to achieve these goals. The shape was assessed by measuring the C2-C7 Cobb angle (CA), the C2-C7 posterior tangent angle (PTA), the curvedness of the arch, and by a 2D landmark-based geometric morphometric method. The position of the head and the sagittal balance of the spine were evaluated by measuring the foramen magnum-C2 Cobb angle (FMCA) and the T1 slope angle (T1SA), respectively. Based on the size of the angle measured, each individual was classified into one of the three cervical 'shape groups' (lordotic, straight, and kyphotic). We found that cervical lordosis was the dominant shape regardless of the measuring methods utilized (46.6%-54.6%), followed by straight neck (28.2%-30.1%), and kyphosis (15.3%-25.2%); however, about a third of the 163 individuals were classified into a different shape group using the CA and PTA methods. The cervical spine angle was sex-independent and age-dependent. The T1SA was significantly correlated with CA and PTA (r = 0.640 and r = 0.585, respectively; p < 0.001). In conclusion, the cervical spine shape evaluation is method-dependent and varies with age.

Forward step down test - clinical rating is correlated with joint angles of the pelvis and hip: an observational study.

BACKGROUND: Clinical methods for assessing quality of movement and functional tests are important to clinicians. Typical deviations from normal kinematics during the clinical test of Forward Step Down Test (FSDT) are pelvic tilt and hip adduction which are associated with the risk of knee pain. OBJECTIVES: (1) to examine the correlation between clinical assessment of the FSDT and joint angle measurements of pelvis, hip, knee and ankle joints in males and females; (2) to examine the differences in joint angles between individuals rated as good, fair or poor in a FSDT performance test. METHODS: Ninety-two healthy individuals performing FSDT were video-taped with two-dimensional digital video cameras. The clinical assessment of the FSDT was rated by two experienced physical therapists as good, fair, or poor based on a Crossley et al. (2011) validated scale. Measurements of pelvic drop, hip adduction and knee valgus were taken using Image J software. RESULTS: Out of 177 lower limbs, 74 (37 in each limb) were clinically rated as "good/fair" (41.80%) while 103 (52 in the dominant leg and 51 in the non-dominant leg) were rated as "poor" (58.19%). No significant differences were observed between dominant and non-dominant legs or between males and females in clinical rating of the FSDT. Pelvic drop angle was significantly higher and hip adduction angle was significantly lower for "poor" clinical rating compared to "good/fair" in both dominant and non-dominant legs (p < 0.001) in males and females. Females demonstrated higher pelvic drop, lower hip adduction and higher knee valgus angles compared with males (p < 0.05). CONCLUSIONS: This study showed that the clinical rating of FSDT is correlated with joint angle measurements suggesting that this assessment can be utilized in clinical practice. Individuals with poor quality performance of FSDT showed higher pelvic drop and hip adduction movement. Further studies examining different populations with diverse disorders or pathologies are essential.

Evolutionary roots of the risk of hip fracture in humans.

The transition to bipedal locomotion was a fundamental milestone in human evolution. Consequently, the human skeleton underwent substantial morphological adaptations. These adaptations are responsible for many of today's common physical impairments, including hip fractures. This study aims to reveal the morphological changes in the proximal femur, which increase the risk of intracapsular hip fractures in present-day populations. Our sample includes chimpanzees, early hominins, early Homo Neanderthals, as well as prehistoric and recent humans. Using Geometric Morphometric methods, we demonstrate differences in the proximal femur shape between hominids and populations that practiced different lifestyles. We show that the proximal femur morphology is a risk factor for intracapsular hip fracture independent of osteoporosis. Changes in the proximal femur, such as the shortening of the femoral neck and an increased anterolateral expansion of the greater trochanter, are associated with an increased risk for intracapsular hip fractures. We conclude that intracapsular hip fractures are a trade-off for efficient bipedal walking in humans, and their risk is exacerbated by reduced physical activity.

On the job training in the dissection room: from physical therapy graduates to junior anatomy instructors.

BACKGROUND:  The training of near-peer (NP) teachers and junior faculty instructors received major attention as a possible solution for the shortage of experienced anatomy instructors in faculties of medicine and health professions. Several studies described the training of NP teachers and junior instructors (≤ 2 years of teaching experience) using various methods. However, few publications include On the Job Training (OJT), which enables reflection and performance evaluation and encourages professionals to cope with their blind spots. Previous publications describing OJT did not include formal observation of the NP teacher or junior instructor. Therefore, this study aimed to present a novel approach to OJT inclusion during prosection laboratories based on the Lewinian experiential model. METHODS:  Eight physical therapy (PT) graduates were recruited as junior anatomy instructors into the prosection laboratories. All participated in a unique training program during two consecutive academic years (2017, 2018) and received OJT during the teaching sessions. Two questionnaires were filled out to evaluate the educational impact of the training program. Eighty-three first-year PT students participated in prosection laboratories in anatomy taught by junior instructors, and filled out a questionnaire evaluating the performance of both junior and senior instructors. In addition, we compared the final grades in anatomy obtained by students taught by senior instructors to the grades of those taught by junior instructors. RESULTS:  Each junior anatomy instructor participated in four OJT sessions. Based on self-reported measures, all professional and didactic aspects of the training program received a median score of 4.5 or higher on a five-point Likert scale. Students obtained similar grades in anatomy when taught by junior instructors compared with senior ones, and were similarly satisfied from the teaching performance of both senior and junior anatomy instructors. CONCLUSIONS:  OJT is applicable in a small-sized PT program facing a shortage of anatomy instructors. Including junior anatomy instructors in prosection laboratories for PT students is a viable solution to the shortage of experienced anatomy instructors. Further study, involving a larger cohort with a longer follow up will strengthen the preliminary results presented here.

New methods for sex estimation using sternum and rib morphology.

Sex estimation of skeletal remains is of great importance in the fields of physical and forensic anthropology. Since skeletons are often incomplete, it is essential to estimate sex from as many skeletal remains as possible. The aim of this study was to establish new methods for estimating sex using the morphology of the sternum and the fifth to ninth ribs. We considered two conditions of skeletal preservation: All skeletal elements measured are available, or only a single element is available. Traditional or virtual measurements were carried out on three samples: (1) A skeletal sample from the Hamann-Todd Human osteological collection, Cleveland Museum of Natural History, USA (N = 413), was used to create prediction equations for sex estimation. (2) A recent, CT-based sample from Israel (N = 33) was used to cross-validate the accuracy of the prediction equations. (3) A skeletal sample from the Anthropological Collection at Tel Aviv University (N = 15) was used to test the validity of the virtual measurements. Reliability and validity analyses were carried out via intraclass correlation coefficient analysis. Prediction equations for sex were created using logistic regression. The measurements were found to be highly reliable and valid. Success rates for sex estimation were high (> 80%) and correspond well between the skeletal and recent samples, especially for the left sixth, left eigth, and left ninth ribs. To conclude, measurements of the sternum and ribs are valuable for estimating sex and can be carried out using either traditional or virtual tools. Of all the skeletal elements examined in this study, the sternum, left sixth, left eighth, and left ninth ribs were found to be the most reliable skeletal elements for estimating the sex of an individual.