<strong>Introduction:</strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> The true etiology of pelvic organ p...<strong>Introduction:</strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> The true etiology of pelvic organ prolapse and urinary incontinence and variations observed among individuals are not entirely understood. Tactile (stress) and ultrasound (anatomy, strain) image fusion may furnish new insights into the female pelvic floor conditions. This study aimed to explore imaging performance and clinical value of vaginal tactile and ultrasound image fusion for characterization of the female pelvic floor. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A novel probe with 96 tactile and 192 ultrasound transducers was designed. Women scheduled for a urogynecological visit were considered eligible for enrollment to observational study. Intravaginal tactile and ultrasound images were acquired for vaginal wall deformations at probe insertion, elevation, rotation, Valsalva maneuver, voluntary contractions, involuntary relaxation, and reflex pelvic muscle contractions. Biomechanical mapping has included tactile/ultrasound imaging and functional imaging. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Twenty women were successfully studied with the probe. Tactile and ultrasound images for tissues deformation as well as functional images were recorded. Tactile (stress) and ultrasound (strain) images allowed creation of stress-strain maps for the tissues of interest in absolute scale. Functional images allowed identification of active pelvic structures and their biomechanical characterization (anatomical measurements, contractive mobility and strength). Fusion of the modalities has allowed recognition and characterization of levator ani muscles (pubococcygeal, puborectal, iliococcygeal), perineum, urethral and anorectal complexes critical in prolapse and/or incontinence development. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Vaginal tactile and ultrasound image fusion provides unique data for biomechanical characterization of the female pelvic floor. Bringing novel biomechanical characterization for critical soft tissues/structures may provide extended scientific knowledge and improve clinical practice.</span></span></span></span>展开更多
Background: Quantitative biomechanical characterization of pelvic supportive structures and functions in vivo is thought to provide insight into pathophysiology of pelvic organ prolapse (POP). An innovative approach—...Background: Quantitative biomechanical characterization of pelvic supportive structures and functions in vivo is thought to provide insight into pathophysiology of pelvic organ prolapse (POP). An innovative approach—vaginal tactile imaging—allows biomechanical mapping of the female pelvic floor to quantify tissue elasticity, pelvic support, and pelvic muscle functions. The Vaginal Tactile Imager (VTI) records high definition pressure patterns from vaginal walls under an applied tissue deformation and during pelvic floor muscle contractions. Objective: To explore an extended set of 52 biomechanical parameters for differentiation and characterization of POP relative to normal pelvic floor conditions. Methods: 96 subjects with normal and POP conditions were included in the data analysis from multi-site observational, case-controlled studies;42 subjects had normal pelvic floor conditions and 54 subjects had POP. The VTI, model 2S, was used with an analytical software package to calculate automatically 52 biomechanical parameters for 8 VTI test procedures (probe insertion, elevation, rotation, Valsalva maneuver, voluntary muscle contractions in 2 planes, relaxation, and reflex contraction). The groups were equalized for subject age and parity. Results: The ranges, mean values, and standard deviations for all 52 VTI parameters were established. 33 of 52 parameters were identified as statistically sensitive (p 0.05;t-test) to the POP development. Among these 33 parameters, 11 parameters show changes (decrease) in tissue elasticity, 8 parameters show deteriorations in pelvic support and 14 parameters show weakness in muscle functions for POP versus normal conditions. Conclusions: The biomechanical mapping of the female pelvic floor with the VTI provides a unique set of parameters characterizing POP versus normal conditions. These objectively measurable biomechanical transformations of pelvic tissues, support structures, and functions under POP may be used in future research and practical applications.展开更多
The pelvis plays a significant role in creating smooth and efficient motion during gait. In this study, an orthosis is designed to support pelvis motion of patients with the inability to walk. This assistive device is...The pelvis plays a significant role in creating smooth and efficient motion during gait. In this study, an orthosis is designed to support pelvis motion of patients with the inability to walk. This assistive device is un-powered and consists of only passive elements. By focusing on the motion of the lower extremities during treadmill walking, a 3D dynamic model of the human body is simulated through a coupled optimization process. Based on two approaches of direct and inverse dynamics, the optimization problems are defined to derive optimum structural parameters of the pelvic orthosis. The optimization results of the direct dynamics problem indicate good matches between the optimized time plots of pelvis rotations with corresponding desired ones. Moreover, by solving the inverse dynamics problem, the minimum value of torque vector of the hip joint of the stance leg during a gait cycle is obtained. Furthermore, by utilizing a prototype of the orthosis, preliminary experiments are conducted on a normal user to validate the model and to investigate the feasibility of using the device for rehabilitation. For this purpose, the rotational movements of the pelvis and energy consumption of the subject in two cases with and without the device are compared during gait on a treadmill. Decreased energy consumption and the compliant motion of the pelvis while using the device verify simulation results and confirm the favorable performance of the assistive device for pelvic support during walking rehabilitation.展开更多
文摘<strong>Introduction:</strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> The true etiology of pelvic organ prolapse and urinary incontinence and variations observed among individuals are not entirely understood. Tactile (stress) and ultrasound (anatomy, strain) image fusion may furnish new insights into the female pelvic floor conditions. This study aimed to explore imaging performance and clinical value of vaginal tactile and ultrasound image fusion for characterization of the female pelvic floor. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A novel probe with 96 tactile and 192 ultrasound transducers was designed. Women scheduled for a urogynecological visit were considered eligible for enrollment to observational study. Intravaginal tactile and ultrasound images were acquired for vaginal wall deformations at probe insertion, elevation, rotation, Valsalva maneuver, voluntary contractions, involuntary relaxation, and reflex pelvic muscle contractions. Biomechanical mapping has included tactile/ultrasound imaging and functional imaging. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Twenty women were successfully studied with the probe. Tactile and ultrasound images for tissues deformation as well as functional images were recorded. Tactile (stress) and ultrasound (strain) images allowed creation of stress-strain maps for the tissues of interest in absolute scale. Functional images allowed identification of active pelvic structures and their biomechanical characterization (anatomical measurements, contractive mobility and strength). Fusion of the modalities has allowed recognition and characterization of levator ani muscles (pubococcygeal, puborectal, iliococcygeal), perineum, urethral and anorectal complexes critical in prolapse and/or incontinence development. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Vaginal tactile and ultrasound image fusion provides unique data for biomechanical characterization of the female pelvic floor. Bringing novel biomechanical characterization for critical soft tissues/structures may provide extended scientific knowledge and improve clinical practice.</span></span></span></span>
文摘Background: Quantitative biomechanical characterization of pelvic supportive structures and functions in vivo is thought to provide insight into pathophysiology of pelvic organ prolapse (POP). An innovative approach—vaginal tactile imaging—allows biomechanical mapping of the female pelvic floor to quantify tissue elasticity, pelvic support, and pelvic muscle functions. The Vaginal Tactile Imager (VTI) records high definition pressure patterns from vaginal walls under an applied tissue deformation and during pelvic floor muscle contractions. Objective: To explore an extended set of 52 biomechanical parameters for differentiation and characterization of POP relative to normal pelvic floor conditions. Methods: 96 subjects with normal and POP conditions were included in the data analysis from multi-site observational, case-controlled studies;42 subjects had normal pelvic floor conditions and 54 subjects had POP. The VTI, model 2S, was used with an analytical software package to calculate automatically 52 biomechanical parameters for 8 VTI test procedures (probe insertion, elevation, rotation, Valsalva maneuver, voluntary muscle contractions in 2 planes, relaxation, and reflex contraction). The groups were equalized for subject age and parity. Results: The ranges, mean values, and standard deviations for all 52 VTI parameters were established. 33 of 52 parameters were identified as statistically sensitive (p 0.05;t-test) to the POP development. Among these 33 parameters, 11 parameters show changes (decrease) in tissue elasticity, 8 parameters show deteriorations in pelvic support and 14 parameters show weakness in muscle functions for POP versus normal conditions. Conclusions: The biomechanical mapping of the female pelvic floor with the VTI provides a unique set of parameters characterizing POP versus normal conditions. These objectively measurable biomechanical transformations of pelvic tissues, support structures, and functions under POP may be used in future research and practical applications.
文摘The pelvis plays a significant role in creating smooth and efficient motion during gait. In this study, an orthosis is designed to support pelvis motion of patients with the inability to walk. This assistive device is un-powered and consists of only passive elements. By focusing on the motion of the lower extremities during treadmill walking, a 3D dynamic model of the human body is simulated through a coupled optimization process. Based on two approaches of direct and inverse dynamics, the optimization problems are defined to derive optimum structural parameters of the pelvic orthosis. The optimization results of the direct dynamics problem indicate good matches between the optimized time plots of pelvis rotations with corresponding desired ones. Moreover, by solving the inverse dynamics problem, the minimum value of torque vector of the hip joint of the stance leg during a gait cycle is obtained. Furthermore, by utilizing a prototype of the orthosis, preliminary experiments are conducted on a normal user to validate the model and to investigate the feasibility of using the device for rehabilitation. For this purpose, the rotational movements of the pelvis and energy consumption of the subject in two cases with and without the device are compared during gait on a treadmill. Decreased energy consumption and the compliant motion of the pelvis while using the device verify simulation results and confirm the favorable performance of the assistive device for pelvic support during walking rehabilitation.
