Displaying publications 1 - 20 of 105 in total

  1. Anderson PA, Morgan SL, Kreuger D, Zapalowski C, Tanner B, Jeray KJ, et al.
    J Clin Densitom, 2019 Aug 16.
    PMID: 31519473 DOI: 10.1016/j.jocd.2019.07.013
    This position development conference (PDC) Task Force examined the assessment of bone status in orthopedic surgery patients. Key questions included which orthopedic surgery patients should be evaluated for poor bone health prior to surgery and which subsets of patients are at high risk for poor bone health and adverse outcomes. Second, the reliability and validity of using bone densitometry techniques and measurement of specific geometries around the hip and knee before and after arthroplasty was determined. Finally, the use of computed tomography (CT) attenuation coefficients (Hounsfield units) to estimate bone quality at anatomic locations where orthopedic surgery is performed including femur, tibia, shoulder, wrist, and ankle were reviewed. The literature review identified 665 articles of which 198 met inclusion exclusion criteria and were selected based on reporting of methodology, reliability, or validity results. We recommend that the orthopedic surgeon be aware of established ISCD guidelines for determining who should have additional screening for osteoporosis. Patients with inflammatory arthritis, chronic corticosteroid use, chronic renal disease, and those with history of fracture after age 50 are at high risk of osteoporosis and adverse events from surgery and should have dual energy X-ray absorptiometry (DXA) screening before surgery. In addition to standard DXA, bone mineral density (BMD) measurement along the femur and proximal tibia is reliable and valid around implants and can provide valuable information regarding bone remodeling and identification of loosening. Attention to positioning, selection of regions of interest, and use of special techniques and software is required. Plain radiographs and CT provide simple, reliable methods to classify the shape of the proximal femur and to predict osteoporosis; these include the Dorr Classification, Cortical Index, and critical thickness. Correlation of these indices to central BMD is moderate to good. Many patients undergoing orthopedic surgery have had preoperative CT which can be utilized to assess regional quality of bone. The simplest method available on most picture archiving and communications systems is to simply measure a regions of interest and determine the mean Hounsfield units. This method has excellent reliability throughout the skeleton and has moderate correlation to DXA based on BMD. The prediction of outcome and correlation to mechanical strength of fixation of a screw or implant is unknown.
    Matched MeSH terms: Shoulder
  2. Collin P, Hervé A, Walch G, Boileau P, Muniandy M, Chelli M
    J Shoulder Elbow Surg, 2019 Aug 09.
    PMID: 31405717 DOI: 10.1016/j.jse.2019.03.002
    BACKGROUND: Results of anatomic shoulder arthroplasty for glenohumeral osteoarthritis with severe glenoid retroversion are unpredictable with a high rate of glenoid loosening. Reverse shoulder arthroplasty (RSA) has been suggested as an alternative, with good early results. We sought to confirm this at longer follow-up (minimum 5 years). The study hypothesis was that early results would endure over time.

    METHODS: We retrospectively reviewed all RSAs performed in 7 centers from 1998 to 2010. The inclusion criteria were primary glenohumeral osteoarthritis with B1, B2, B3, or C glenoid. Forty-nine shoulders in 45 patients fulfilled the criteria. Bone grafting was performed in 16 cases. Clinical outcomes were evaluated with the Constant score (CS) and shoulder range of motion.

    RESULTS: The mean total CS increased from 30 preoperatively to 68 points (P < .001) with significant improvements in all the subsections of the CS and range of motion. Scapular notching was observed in 20 shoulders (43%), grade 1 in 5 (11%), grade 2 in 7 (15%), grade 3 in 5 (11%), and grade 4 in 3 (6%). The glenoid bone graft healed in all the shoulders. Partial inferior lysis of the bone graft was present in 8 cases (50%). Scapular notching and glenoid bone graft resorption had no influence on the CS (P = .147 and P = .798).

    CONCLUSION: RSA for the treatment of primary glenohumeral osteoarthritis in patients with posterior glenoid deficiency and humeral subluxation without rotator cuff insufficiency resulted in excellent clinical outcomes at a minimum of 5 years of follow-up.

    Matched MeSH terms: Shoulder; Arthroplasty, Replacement, Shoulder
  3. Lui SK, Koh MM
    Med. J. Malaysia, 2019 Aug;74(4):333-334.
    PMID: 31424044
    Although post-stroke shoulder pain is a common medical complication among the stroke population, pseudotumor deltoideus which is non-malignant is rarely seen. This case report demonstrates a thorough history, physical examination followed by the relevant investigations are essential when managing a common post-stroke complication. We postulate that pseudotumor deltoideus is likely a pre-existing asymptomatic variant in our patient before the stroke and has presented symptomatically after the stroke due to the associated neurological and musculoskeletal impairments. As post-stroke shoulder pain is associated with unfavourable outcomes, it is important to recognise the underlying causes of post-stroke shoulder pain early and institute prompt appropriate treatment.
    Matched MeSH terms: Shoulder; Shoulder Pain
  4. Kwan MK, Chiu CK, Goh SH, Ng SJ, Tan PH, Chian XH, et al.
    Clin Spine Surg, 2019 Jul;32(6):256-262.
    PMID: 30640749 DOI: 10.1097/BSD.0000000000000769
    STUDY DESIGN: Retrospective study.

    OBJECTIVE: This study looked into whether crossbar can reliably measure Upper Instrumend Vertebra (UIV) tilt angle intraoperatively and accurately predict the UIV tilt angle postoperatively and at final follow-up.

    SUMMARY OF BACKGROUND DATA: Postoperative shoulder imbalance is a common cause of poor cosmetic appearance leading to patient dissatisfaction. There were no reports describing the technique or method in measuring the UIV tilt angle intraoperatively. Therefore, this study was designed to look into the reliability and accuracy of the usage of intraoperative crossbar in measuring the UIV tilt angle intraoperatively.

    METHODS: Lenke 1 and 2 Adolescent Idiopathic Scoliosis patients who underwent instrumented Posterior Spinal Fusion using pedicle screw constructs with minimum follow-up of 24 months were recruited for this study. After surgical correction, intraoperative UIV tilt angle was measured using a crossbar. Immediate postoperative and final follow up UIV tilt angle was measured on the standing anteroposterior radiographs.

    RESULTS: A total of 100 patients were included into this study. The reliability of the intraoperative crossbar to measure the optimal UIV tilt angle intraoperatively was determined by repeated measurements by assessors and measurement by different assessors. We found that the intra observer and inter observer reliability was very good with intraclass correlation coefficient values of >0.9. The accuracy of the intraoperative crossbar to measure the optimal UIV tilt angle intraoperatively was determined by comparing this measurement with the postoperative UIV tilt angle. We found that there was no significant difference (P>0.05) between intraoperative, immediate postoperative, and follow-up UIV tilt angle.

    CONCLUSIONS: The crossbar can be used to measure the intraoperative UIV tilt angle consistently and was able to predict the postoperative UIV tilt angle. It was a cheap, simple, reliable, and accurate instrument to measure the intraoperative UIV tilt angle.

    Matched MeSH terms: Shoulder
  5. Dabirrahmani D, Bokor D, Tarento T, Ahmad S, Appleyard R
    J Biomech Eng, 2019 Jun 08.
    PMID: 31175841 DOI: 10.1115/1.4043969
    As the use of glenoid suture anchors in arthroscopic and open reconstruction, for instability after Bankart lesions of the shoulder, increases, an emerging problem has been the incidence of glenoid rim fractures through suture drill holes. Very little is known regarding the effect of the Hill-Sachs lesion on the glenoid's susceptibility to fracture and how drill hole location can further affect this. This study used finite element modelling techniques to investigate the risk of fracture of the glenoid rim in relation to variable sized Hill-Sachs defects impacting on the anterior glenoid edge with suture anchor holes placed in varying positions. The distribution of Von Mises (VM) stresses and the Factor of Safety (FOS) for each of the configurations were calculated. The greatest peak in von Mises (VM) stresses was generated when the glenoid was loaded with a small Hill-Sachs lesion. The VM stresses were lessened and the FOS increased (reducing likelihood of failure) with increasing size of the Hill-Sachs lesion. Placement of the suture drill holes at 2mm from the glenoid rim showed the highest risk of failure; and when combined with a medium sized Hill-Sachs lesion, which matched the central line of the drill holes, a potentially clinically significant configuration was presented. The results of this study are useful in assisting the surgeon in understanding the interaction between the Hill-Sachs lesion size and the placement of suture anchors with the purpose of minimising the risk of subsequent rim fracture with new injury.
    Matched MeSH terms: Shoulder; Shoulder Joint
  6. Yeak RD, Daud H, Nizlan NM
    Chin. J. Traumatol., 2019 Jun;22(3):182-185.
    PMID: 31060897 DOI: 10.1016/j.cjtee.2019.03.004
    Acromioclavicular joint (ACJ) injury is a common shoulder injury. There are various techniques of ACJ reconstruction. Superficial infection after ACJ reconstruction is not an uncommon complication. However, osteomyelitis post ACJ reconstruction has never been highlighted as a possible complication. Our patient is a 31-year-old male who sustained a Rockwood 5 ACJ dislocation and had anatomical ACJ reconstruction with autogenous gracilis and semitendinosus graft. Our technique involved the anatomical reconstruction of the ACJ and the coracoclavicular ligament with the usage of two bioscrews and the temporary stabilisation of the ACJ with two k-wires. As in any orthopaedic surgery, infection is often disastrous especially when the surgery involves implants. It can be disastrous with high morbidity to the patient as well as a costly complication to treat. Therefore, we wish to highlight this case as despite its rarity, osteomyelitis can be devastating to the patient and should be prevented if possible.
    Matched MeSH terms: Shoulder Dislocation
  7. Tai KL, Ng YG, Lim PY
    PLoS ONE, 2019;14(5):e0217430.
    PMID: 31136594 DOI: 10.1371/journal.pone.0217430
    BACKGROUND: Despite evidence of physical (illness) and mental (stress) health problems, there appears to be a lack of studies or concern regarding occupational safety and health among educators in Malaysia.

    OBJECTIVE: To review the prevalence of illness, stress, and corresponding risk factors among educators in Malaysia.

    METHOD: Scopus, ProQuest, PubMed, ScienceDirect, CAB, and other computerized databases were searched according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify studies published between January 2013 and April 2019 on the prevalence and associated risk factors of illness and stress among educators (S1 Checklist). The keywords used included educator, teacher, lecturer, academic staff, teaching profession, university staff, academician, faculty, illness, injury, disease, pain, WMSD, dysphonia, hoarseness, stress, mental health, strain, health problem, disorder, and/or Malaysia. Selected studies were evaluated by quality assessment.

    RESULTS: Twenty-two articles fulfilled the eligibility criteria. The prevalence of illness and stress was determined for low back pain (33.3-72.9%); upper back pain (33.33-56.4%); neck/shoulder pain (40.4-80.1%); upper arm discomfort (91.3%); forearm pain (89.6%); wrist pain (16.7-93.2%); hip pain (13.2-40.9%); thigh discomfort (91.8%); lower leg discomfort (90.5%); knee pain (23.7-88.0%); ankle/feet pain (19.3-87.7%); elbow pain (3.5-13.0%); voice disorder (10.4-13.0%) and stress (5.5-25.9%). Sex, education level, teaching experience, quality of life, anxiety, depression, coping styles, and others were reported as associated risk factors across the studies.

    CONCLUSIONS: There appears to be a cause for concern regarding musculoskeletal disorders, voice disorder, and stress reported among educators in Malaysia. While most risk factors matched those reported in studies elsewhere, others such as school characteristics (school level, government or private school, and location [rural/urban]) have not been investigated.

    Matched MeSH terms: Shoulder Pain
  8. Lim MC, See PL, Wang SY, Wee AT, Tee UL
    Med. J. Malaysia, 2018 12;73(6):400-402.
    PMID: 30647212
    A 38-year-old female presented with a 10-month history of right shoulder pain with impingement symptoms. She was diagnosed on magnetic resonance (MR) imaging to have supraspinatus tendon tear and degenerative changes contributing to subacromial impingement. She also had lipoma arborescens of the subacromial-subdeltoid bursa, an uncommon condition in a particularly rare location. Lipoma arborescens is a benign intra-articular condition characterized by lipomatous proliferation of synovium with replacement of subsynovial tissue by mature adipocytes. It is typically a monoarticular process affecting the knee. Due to the presence of pathognomonic fat, diagnosis is usually straightforward with MR as the preferred imaging modality.
    Matched MeSH terms: Shoulder Impingement Syndrome; Shoulder Pain
  9. Abdul Rahim MF, Shaharudin S
    J Taibah Univ Med Sci, 2018 Dec;13(6):572-575.
    PMID: 31435380 DOI: 10.1016/j.jtumed.2018.08.001
    Objectives: This study aimed to determine isokinetic profiles of rotator cuff muscle strength and power in adolescent state-level weightlifters.

    Methods: Nineteen young state-level weightlifters performed concentric strength tests of the upper limbs using an isokinetic dynamometer. Peak torque/body weight was measured for each weightlifter in dominant and non-dominant limbs.

    Results: Peak torque/body weight was significantly different in external rotation (p  0.05). Time to peak torque in external rotation was less in the dominant than in the non-dominant limb. However, opposite results were obtained in external rotation, whereby time to peak torque was longer in the dominant limb compared to the non-dominant limb. Similarly, no significant difference was found between dominant and non-dominant limbs in terms of average power (p > 0.05).

    Conclusions: The findings of this study may help in establishing potential imbalance in variables of muscular contractions between dominant and non-dominant limbs of weightlifters. This may help to maximise performance and minimise potential shoulder injury.

    Matched MeSH terms: Shoulder Joint; Shoulder Injuries
  10. Kongcharoensombat W, Wattananon P
    Malays Orthop J, 2018 Nov;12(3):1-5.
    PMID: 30555639 DOI: 10.5704/MOJ.1811.001
    Introduction: The anterolateral acromion approach of the shoulder is popular for minimally invasive plate osteosynthesis (MIPO) technique. However, there are literatures describing the specific risks of injury of the axillary nerve using this approach. Nevertheless, most of the studies were done with Caucasian cadavers. So, the purpose of this study was to evaluate the risk of iatrogenic axillary nerve injury from using the anterolateral shoulder approach and further investigate the location of the axillary nerve, associated with its location and arm length in the Asian population that have shorter arm length compared to the Caucasian population. Materials and Methods: Seventy-nine shoulders in fourty-two embalmed cadavers were evaluated. The bony landmarks were drawn, and a vertical straight incision was made 5cm from tip of the acromion (anterolateral approach), to the bone. The iatrogenic nerve injury status and the distance between the anterolateral edge of the acromion to the axillary nerve was measured and recorded. Results: In ten of the seventy-nine shoulders, the axillary nerve were iatrogenically injured. The average anterior distance was 6.4cm and the average arm length was 30.2cm. The anterior distance and arm length ratio was 0.2. Conclusion: Our results demonstrated that the recommended safe zone at 5cm from tip of acromion was not suitable with Asian population due to shorter arm length, compared to Caucasian population. The location of axillary nerve could be predicted by 20% of the total arm-length.
    Matched MeSH terms: Shoulder
  11. Labao HC, Faller EM, Bacayo MFD
    Ann Glob Health, 2018 08 31;84(3):474-480.
    PMID: 30835403 DOI: 10.29024/aogh.2331
    BACKGROUND AND PURPOSE: Musculoskeletal disorders (MSDs) are alarmingly high among migrant workers in Malaysia. MSDs are the most prevalent occupational-related conditions in most parts of the world affecting function, productivity and overall health-related quality of life. Therefore, this study aims to determine the profile of Filipino migrant workers in Malaysia and their various musculoskeletal complaints.

    METHOD: This study utilized a quantitative, nonexperimental, cross-sectional research design. A total of 60 subjects were randomly selected after passing the study's sampling criteria. The Nordic Musculoskeletal Questionnaire (NMQ) was to used to determine common MSDs affecting the various regions in the body. The Demographic Pofile Sheet was provided to gather a subject's demographic characteristics.

    RESULTS: Filipino migrant workers mostly complain of pain in the low back area (60%) and shoulder pain (60%), followed by pain in the upper back (48.3%) and neck pain (45%) in the last 12 months. Household workers accounting for 73.3% of the subjects commonly complain of pain in the hips/thighs (78.9%), while workers in the service industry commonly complain of knee pain (39.1%).

    CONCLUSIONS: Results imply that Filipino migrant workers have a higher prevalence of shoulder and lower back pain in the last 12 months. Household workers are more susceptible to hip/thigh pain. Interventions focusing on ergonomics policy implementation, education on posture and lifting techniques and physical function is recommended. Further studies should consider the psychological and psychosocial aspects of migrant employment, which are known risk factors for MSDs.

    Matched MeSH terms: Shoulder; Shoulder Pain
  12. Arinima P, Ishak A
    Korean J Fam Med, 2018 Jul;39(4):266-269.
    PMID: 29972896 DOI: 10.4082/kjfm.17.0117
    A 16-year-old Malay boy presented to Kota Bharu Health Care Centre, Kelantan, with left shoulder pain after sustaining a fall. On further history taking, it was noted that the pain preceded the fall by 1 month. The early changes of osteosarcoma were visible on an X-ray during the initial presentation; however, this was missed by the primary care doctors. Three months later, the patient presented with persistent pain in the left shoulder and was diagnosed with osteosarcoma.
    Matched MeSH terms: Shoulder; Shoulder Pain
  13. Narayanan VL, Balasubramanian N
    Malays Orthop J, 2018 Jul;12(2):20-24.
    PMID: 30112124 DOI: 10.5704/MOJ.1807.004
    Introduction: Proximal humerus fracture fixation using plate osteosynthesis depends on the quality of the bone, design of the fixation devices and intra-operative soft tissue dissection. This study evaluates the functional outcome of minimally invasive percutaneous plate osteosynthesis using locking compression plate in proximal humerus fracture treatment. Materials and Methods: The study was conducted on 30 patients with complex proximal humerus fractures treated by minimally invasive percutaneous plate osteosynthesis using locking compression plate (PHILOS). There were 21 males and 9 females. The average age of our study group was 58.8 years. All the patients were evaluated at six weeks, three months, four months, six months and 12 months following surgery. Results: All patients had fracture union at an average of 13.2 weeks. The mean DASH score at the follow-up was 8.69 (2.5 to 17.16), the average range of flexion was 143.83 degrees (100 to 170 degrees) and abduction was 121.49 degrees (90 to 160 degrees). We had superficial infection in three patients which resolved with a short course of antibiotics. There was excellent outcome in 26 patients, good and fair in two patients each. Conclusion: Proximal humerus fractures treated with minimally invasive percutaneous plate osteosynthesis using locking compression plate with minimal soft tissue dissection, provides good functional outcome and early return of shoulder function.
    Matched MeSH terms: Shoulder; Shoulder Fractures
  14. Ganeshan M, Bujang MA, Soelar SA, Karalasingam SD, Suharjono H, Jeganathan R
    J Obstet Gynaecol India, 2018 Jun;68(3):173-178.
    PMID: 29895995 DOI: 10.1007/s13224-017-1000-9
    Aims: The aim of this study is to compare obstetric outcomes between overweight and class 1 obesity among pregnant women in their first pregnancy based on WHO's BMI cut-offs and the potential public health action points identified by WHO expert consultations specific for high-risk population such as Asians.

    Methods: This is a retrospective cohort review of data obtained from the Malaysian National Obstetrics and Gynaecology Registry between the year 2010 and year 2012. All women in their first pregnancy with a booking BMI in their first trimester were included in this study. The association between BMI classifications as defined by the WHO cut-offs and the potential public health action points identified by WHO expert consultations towards adverse obstetric outcomes was compared.

    Results: A total of 88,837 pregnant women were included in this study. We noted that the risk of adverse obstetric outcomes was significantly higher using the public health action points identified by WHO expert consultations even among the overweight group as the risk of stillbirths was (OR 1.2; 95% CI 1.0,1.4), shoulder dystocia (OR 1.9; 95% CI 1.2,2.9), foetal macrosomia (OR 1.8; 95% CI 1.6,2.0), caesarean section (OR 1.9; 95% CI 1.8,2.0) and assisted conception (OR 1.9; 95% CI 1.6,2.1).

    Conclusion: A specifically lower BMI references based on the potential public health action points for BMI classifications were a more sensitive predictor of adverse obstetric outcomes, and we recommend the use of these references in pregnancy especially among Asian population.

    Matched MeSH terms: Shoulder
  15. Ho W, Lin Seow L, Musawi A
    J Clin Transl Res, 2018 May 28;4(1):70-74.
    PMID: 30873496
    Background: The purpose of the present study was to investigate the effect of different viscosities of polyvinyl siloxane (PVS) impression materials on the accuracy of the stone die produced.

    Methods: A three-unit bridge master model was fabricated using cold-cure acrylic resin. Four combinations of different viscosities of PVS impression materials - regular body (monophase) alone, light body with regular body, light body with heavy body, and light body with putty - were used to make an impression of the master model. Ten impressions from each group were taken and Type IV gypsum stone was used to generate the dies. The dies were measured at the inter-abutment distance, occlusogingival length, and shoulder width with a measuring microscope and were compared with the master model using one-way analysis of variance and Tukey (honest significant difference) test.

    Results: Differences were found for inter-abutment distance between the master model and the light body with regular body and light body with putty dies (both P < 0.02). A difference was found for shoulder width between the master model and the regular body alone die (P = 0.01). No differences were found for occlusogingival distance (all P > 0.08).

    Conclusion: Results suggested inter-abutment distance was most accurate when using a PVS light body combination. Occlusogingival length was accurate using any of the studied PVS combinations, and shoulder width was more accurate when using the regular body PVS.

    Relevance for patients: These results should be considered when choosing the viscosity of the PVS to use for producing impressions of high accuracy and fabricating a well-fitting fixed prosthesis.

    Matched MeSH terms: Shoulder
  16. Kurnaz R, Ikizler M, Ozbayburtlu M, Gunes T
    Malays Orthop J, 2018 Mar;12(1):51-53.
    PMID: 29725515 DOI: 10.5704/MOJ.1803.012
    Proximal humerus fracture is a common arm trauma and rarely occurs with vascular injury which however is a serious complication. In this case report, we present a long segment dissection of the axillary and brachial arteries as a rare complication due to fragmented proximal humerus fracture and shoulder dislocation. An 80-year old female patient was seen at the emergency department. Radiograph examination has revealed a fragmented proximal humerus fracture besides dislocation of the head of humerus towards the axillary area. On vascular examination, acute arterial occlusion such as absence of radial and ulnar pulses were observed in her left hand. The patient was immediately taken to the operating room. The dissection included the entire segment approximately 20cm between the distal subclavian artery and the distal brachial artery. This injured segment was removed and a 6mm Polytetrafluroethylene (PTFE) graft with rings was interpositoned between subclavian and brachial arteries. This case is a rarity because of such a significant complication after a small injury. Axillary artery injuries caused by humeral neck fractures are rare but should not be missed by the physician.
    Matched MeSH terms: Shoulder Dislocation; Shoulder Fractures
  17. Bajuri MY, Boon HW
    Malays Orthop J, 2018 Mar;12(1):60-62.
    PMID: 29725518 MyJurnal DOI: 10.5704/MOJ.1803.015
    Bilateral clavicle fractures are not frequently seen. To treat these injuries surgically or non-surgically is still a debatable issue. Implant option for surgical management is also in doubt. We would like to share our experience in treating a patient with bilateral clavicle fracture surgically. He had excellent outcomes in terms of function and radiology. Surgical option for bilateral clavicle fractures promises excellent outcome in terms of early rehabilitation and return in function.
    Matched MeSH terms: Shoulder Fractures
  18. Rusli R, Haque MM, Saifuzzaman M, King M
    Traffic Inj Prev, 2018;19(7):741-748.
    PMID: 29932734 DOI: 10.1080/15389588.2018.1482537
    OBJECTIVE: Traffic crashes along mountainous highways may lead to injuries and fatalities more often than along highways on plain topography; however, research focusing on the injury outcome of such crashes is relatively scant. The objective of this study was to investigate the factors affecting the likelihood that traffic crashes along rural mountainous highways result in injuries.

    METHOD: This study proposes a combination of decision tree and logistic regression techniques to model crash severity (injury vs. noninjury), because the combined approach allows the specification of nonlinearities and interactions in addition to main effects. Both a scobit model and a random parameters logit model, respectively accounting for an imbalance response variable and unobserved heterogeneities, are tested and compared. The study data set contains a total of 5 years of crash data (2008-2012) on selected mountainous highways in Malaysia. To enrich the data quality, an extensive field survey was conducted to collect detailed information on horizontal alignment, longitudinal grades, cross-section elements, and roadside features. In addition, weather condition data from the meteorology department were merged using the time stamp and proximity measures in AutoCAD-Geolocation.

    RESULTS: The random parameters logit model is found to outperform both the standard logit and scobit models, suggesting the importance of accounting for unobserved heterogeneity in crash severity models. Results suggest that proportion of segment lengths with simple curves, presence of horizontal curves along steep gradients, highway segments with unsealed shoulders, and highway segments with cliffs along both sides are positively associated with injury-producing crashes along rural mountainous highways. Interestingly, crashes during rainy conditions are associated with crashes that are less likely to involve injury. It is also found that the likelihood of injury-producing crashes decreases for rear-end collisions but increases for head-on collisions and crashes involving heavy vehicles. A higher order interaction suggests that single-vehicle crashes involving light and medium-sized vehicles are less severe along straight sections compared to road sections with horizontal curves. One the other hand, crash severity is higher when heavy vehicles are involved in crashes as single vehicles traveling along straight segments of rural mountainous highways.

    CONCLUSION: In addition to unobserved heterogeneity, it is important to account for higher order interactions to have a better understanding of factors that influence crash severity. A proper understanding of these factors will help develop targeted countermeasures to improve road safety along rural mountainous highways.

    Matched MeSH terms: Shoulder
  19. Lim E, Lim R, Suhaimi A, Chan BT, Wahab AKA
    J Back Musculoskelet Rehabil, 2018;31(6):1041-1047.
    PMID: 30149436 DOI: 10.3233/BMR-171042
    BACKGROUND: Low frequency sound wave stimulation therapy has become increasingly popular in the rehabilitation fields, due to its ease, less fatiguing and time efficient application.

    OBJECTIVE: This 12-week pilot study examines the efficacy of applying low frequency sound wave stimulation (between 16-160 Hz) through both hands and feet on relieving pain and improving functional ability in patients with chronic back pain.

    METHODS: Twenty-three participants with chronic shoulder (eleven participants) or low back pain (twelve participants) underwent a 12-week vibration therapy program of three sessions per week. A low frequency sound wave device comprising four piezoelectric vibration-type tactile tranducers enclosed in separate 5-cm diameter circular plates, which generate sinusoidal vibratory stimuli at a frequency of 16-160 Hz, was used in this study. Primary outcome measure was pain sensation measured using the Visual Analogue Scale (P-VAS). The secondary outcome measures were pain-related disability measured using the pain disability index (PDI) and quality of life measured using the SF-12.

    RESULTS: At week 12, significant reductions in pain sensation and pain-related disability were observed, with mean reductions of 3.5 points in P-VAS and 13.5 points in the PDI scores. Sixty-five percent of the participants had a reduction of at least 3 points on the P-VAS score, while 52% participants showed a decrease of at least 10 points in the PDI score. Significant improvement was observed in the SF-12 physical composite score but not the mental composite score.

    CONCLUSIONS: The preliminary findings showed that passive application of low frequency sound wave stimulation therapy through both hands and feet was effective in alleviating pain and improving functional ability in patients with chronic back pain.

    Matched MeSH terms: Shoulder
  20. Teo Chuun, B., Dian Darina Indah, D., Darliana, M.
    This study is aimed at seat design optimization for high-speed train based on the Malaysians sitting anthropometry
    data focusing on seat fit parameters. An analysis of anthropometry data composed of 15 dimensions that are
    required in seat design was done with 50 male subjects. These data were collected through direct measuring
    methods with standard equipment. According to the Malaysian automotive seat fit parameters, the backrest width,
    backrest height, cushion width, and cushion length were established based on these anthropometric dimensions:
    interscye breadth (5th percentile female and 95th percentile male), hip breadth (95th percentile female), sitting
    shoulder height (5th percentile female), and buttock-popliteal length (5th percentile female), respectively. This
    study uses the CATIA software to design and analyse the proposed seat design. The fit parameters proposed for the
    new design are seat height, 380mm; cushion width, 450mm; backrest width, 450mm and backrest height, 850mm.
    The CATIA human activity analysis (based on Rapid Upper Limb Analysis, RULA) was also executed. From the study,
    the new conceptual seat design gives the most optimized fit when compared to the current seat.
    Matched MeSH terms: Shoulder
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