جستجوی مقالات مرتبط با کلیدواژه « musculoskeletal system » در نشریات گروه « پزشکی »

 Functional electrical stimulation (FES) is a promising technique for rehabilitation and increasing the level of movement in paraplegic subjects. In this method, the movement in the hindlimbs can be restored by controlling the electrical current pulses and stimulating the intraspinal motor neurons or muscular fibers below the spinal lesion. In FES, functional control signals are received from a controller that creates a motor function for the paraplegic subject. By changing the pulse width or pulse amplitude of the current pulses (control input), the level of the contraction for generating the functional movement of the hindlimb joints can be altered. The electrodes are inserted into the spinal cord to stimulate the desired movement by stimulating the flexor and extensor muscles and motor neurons connected to the desired joint. Therefore, the superposition of torque in flexor and extensor muscles is applied to the musculoskeletal system and joint moves.

 In FES, a model of the musculoskeletal system that acts on simultaneous movement of the hip and knee joints (multi–joint) is used as the virtual patient. In general, the skeletal segment of the model consists of a planar swinging pendulum model of a two–link rigid robotic manipulator with nonlinear constraints on the hip and knee joint movements. A biarticular model of six muscles is used to generate the torques of the skeletal part of the model. Four muscles are considered for flexing and extending the hip and knee joints (one for flexing the joint and one for extending), and two biarticular muscles work on flexing the hip (knee) joint and extending the knee (hip) joint synergically. On the other hand, excellent tracking performance can be obtained with high precision, and the controllers can automatically switch between control inputs and the muscles by regulating the stimulation pulse width. The stimulation pulse width of muscles is continuous, nonsingular, with low chattering. The model dynamics can be assumed unknown and identified online without the controller's requirement for offline calibration. The controller robustly and rapidly switched the activation between the muscles to track the desired trajectory of the knee and hip joint. Various control methods, such as combining fuzzy adaptive or neural networks with classic sliding mode control, have generated FES control signals. Such hybrid methods have led to the chattering phenomenon, the control signal's singularity, and the controller's low speed outside and on the sliding surface.

 Rehabilitation movement in paralyzed limbs of paraplegic subjects based on FES in their muscles is associated with problems such as reflection in the spinal cord and unwanted movements, joint disturbances, fatigue, etc.

 The controller could automatically regulate the stimulation pulse width without considering the effect of the applied ground reaction force so that, by switching between muscles synergically, excellent tracking results were obtained in the presence of external unit step disturbance and muscle fatigue. The major challenges for developing an appropriate control method for stimulating paralyzed limbs include high–order nonlinear and time–varying properties of the neuromusculoskeletal system, spasms, and muscle fatigue. These drawbacks limit using prespecified stimulation patterns and open–loop control systems in the FES application.

Primary Immune Deficiencies are a group of heterogeneous disorders that involve the innate or acquired immune system, or a combination of them. The underlying disorder may be related to decreased levels or function, or a complete lack of one or more components of the immune system in general. These diseases can occur with a prevalence of about 1 in 10000 live births. According to the fourth update on the Iranian national registry of Primary Immune Deficiency in October 2018, the total number of registered PIDs in Iran are 3056 patients. However, it is supposed to be more prevalent and it seems increasing awareness shall reveal many new cases, especially in societies with prevalent consanguineous marriages like Iran. These disorders predispose patients to recurrent infections, autoimmunity and malignancy and can cause a huge burden on health care systems. This group of diseases has a wide range of symptoms, which quick recognition and timely treatment of them, can greatly reduce the complications of the disease. These symptoms may include recurrent or severe infections, failure to thrive, autoimmune disorders, as well as articular-skeletal manifestations. A variety of skeletal manifestations are seen in patients with primary immunodeficiency, among which septic arthritis caused by pyogenic bacteria or mycoplasma arthritis is the most common joint-bone manifestation. Joint and skeletal involvement is less commonly seen as a sign of primary immune defects. This issue is importance in reducing the cost of diseases and improving the patients’ quality of life. Our review attempted to introduce the most common manifestations of bone and joint in patients with primary immunodeficiency and available treatments for these manifestations. Because of the wide range of symptoms in these patients, it is recommended to observe the rare and suspicious manifestations in the patients with any atypical bone and joint presentations such as: recurrent septic arthritis, infection with unusual germs, immunodeficiency in their relatives, and any history of well-known red flags of PIDs. The Rheumatologist should consider these manifestations and think about the possibility of deficiency disorder.

Pain and problems of the upper limb musculoskeletal system in women after mastectomy are unpleasant and common complications that preventing it can affect the surgical outcomes. This study was performed with aim to evaluate the effect ofmassage therapy with and without bandaging on pain, edema and problems of upper extremity musculoskeletal system after modified radical mastectomy.

This clinical trial study was performed over 18 months (2018-2019) in Tabriz Imam Reza Hospital with participation of 90 women. The subjects were randomly divided into three groups of manual lymph drainage massage group, manual lymph drainage massage group + low pressure bandage and control group. Then, the intervention was trained to the patient and the intervention started the day after the surgery (doing daily at home). Demographic information, upper extremity physical tests and edema checklist were recorded before and after the intervention. Data were analyzed by SPSS software (version 19) and One-way ANOVA and X2tests. P<0.05 was considered statistically significant.

None of the variables were statistically significant before the intervention (p>0.05), whereas evaluation of the variables after the end of the intervention indicated that in variables such as edema (p=0.009), pain severity (p=0.003), Hawkins Kennedy (p=0.005), Jergason (p=0.003), Crossover (p=0.001), Falun (p=0.019), protonator (p=0.002) and isometric resistance (p=0.006), a statistically significant difference was observed between the groups. Also, the use of bandages after massage therapy has the best effect.

Rehabilitation measures such as massage therapy and bandaging immediately after massage therapy reduced the amount of lymph nodes edema, pain, and function of the musculoskeletal system of the hand after mastectomy.

Dentistry is a high risk profession according to musculoskeletal disorders. The aim of this study was to estimate the prevalence of these disorders in Iranian dentists using systematic review and meta-analysis.

National databases including; Magiran, IranMedex, Irandoc and international databases including; PubMed, Scopus, Web of science, ProQuest, web search engine Google scholar and the Eastern Mediterranean region base (IMEMR) with using keywords prevalence, musculoskeletal, dentists, and medical subject headings (Mesh), were searched. To assess the quality of cross-sectional studies, the JBI checklist (The Joanna Briggs Institute) was used. Considerably, heterogeneity between studies was assessed using the Cochran Q and I2 tests. Data analyzed using the random effects model.

A total of 12 studies with sample size n=1742 entered to the research. The point prevalence (during occupational), period prevalence (during one year) and prevalence during the seven-day of musculoskeletal disorders was estimated 73.4% (95% Confidence Interval (CI): 64.1-82.7), 77.3% (95% CI: 66.7-87.9) and 33.6% (95% CI: 6.5-60.8) respectively. The highest point prevalence 50% (95% CI: 43.8-56.3), period prevalence 63% (95% CI: 58.4-67.6) and during the seven- day prevalence 46.3% (95% CI: 7-85.6) of disorders was estimated in neck region.

The results show high prevalence of disorders in dentists, especially in the neck area. In order to reduce musculoskeletal disorders, resulting in the improvement of the level and quality of dentists' services, comprehensive plans should be designed and implemented at the national level.