• Title/Summary/Keyword: supine

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A Smart Setup for Craniospinal Irradiation

  • Peterson, Jennifer L.;Vallow, Laura A.;Kim, Siyong;Casale, Henry E.;Tzou, Katherine S.
    • Progress in Medical Physics
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    • v.24 no.4
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    • pp.230-236
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    • 2013
  • Our purpose is to present a novel technique for delivering craniospinal irradiation in the supine position using a perfect match, field-in-field (FIF) intrafractional feathering, and simple forward-optimization technique. To achieve this purpose, computed tomography simulation was performed with patients in the supine position. Half-beam, blocked, opposed, lateral, cranial fields with a collimator rotation were matched to the divergence of the superior border of an upper-spinal field. Fixed field parameters were used, and the isocenter of the upper-spinal field was placed at the same source-to-axis distance (SAD), 20 cm inferior to the cranial isocenter. For a lower-spinal field, the isocenter was placed 40 cm inferior to the cranial isocenter at a constant SAD. Both gantry and couch rotations for the lower-spinal field were used to achieve perfect divergence match with the inferior border of the upper-spinal field. A FIF technique was used to feather the craniospinal and spinal-spinal junction daily by varying the match line over 2 cm. The dose throughout the target volume was modulated using the FIF simple forward optimization technique to obtain homogenous coverage. Daily, image-guided therapy was used to assure and verify the setup. This supine-position, perfect match craniospinal irradiation technique with FIF intrafractional feathering and dose modulation provides a simple and safe way to deliver treatment while minimizing dose inhomogeneity.

The effects of scanning position on evaluation of cerebral atrophy level: assessed by item response theory

  • Mahsin, Md;Zhao, Yinshan
    • Communications for Statistical Applications and Methods
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    • v.23 no.6
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    • pp.531-541
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    • 2016
  • Cerebral atrophy affects the brain and is a common feature of patients with mild cognitive impairment or Alzheimer's diseases. It is evaluated by the radiologist or reader based on patient's history, age and the space between the brain and the skull as indicated by magnetic resonance (MR) images. A total of 70 patients were scanned in the supine and prone positions before three radiologist assessed their atrophy level. This study examined the radiologist's assessment of the cerebral atrophy level using a graded response model of item response theory (IRT). A graded response model (GRM) is fitted to our data and then item-fit and person-fit statistics are evaluated to assess the fitted model. Our analysis found that the cerebral atrophy level is better discriminated by readers in the prone position because all item slopes were greater than 2 at this position, versus the supine position where all the slope parameters were less than 1. However, the thresholds are very similar for the first reader and are quite different for the second and third readers because the scanning position affects readers differently as the category threshold estimates vary considerably between the readers..

Pulmonary Function Index Comparisons Depending on Various Postures of Stroke Patients

  • Lee, Kyung-Soo;Lee, Myung-Mo
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.1
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    • pp.43-51
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    • 2019
  • PURPOSE: To prevent secondary complications from decreased pulmonary functions and promote neurological recovery, identification of respiratory capacity change patterns depending on different postures of stroke patients and investigation of their properties are needed for active rehabilitation. Therefore, this study was conducted to investigate the changes in vital capacity in response to different positions and to implement the results as clinical data. METHODS: A respiratory function test was administered to 52 patients with stroke in the sitting, supine, paretic side lying, and non-paretic side lying positions. Pulmonary function indexes used for comparison were forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), forced expiratory flow 25-75% (FEF 25-75%), and maximum voluntary ventilation (MVV). One-way repeated ANOVA was used for analysis, and post hoc analysis was conducted using least significant difference (LSD). RESULTS: All pulmonary function indexes were measured in the order of sitting, paretic side lying, supine, and non-paretic side lying positions. Excluding the FEF25-75% and MVV of the supine compared with the paretic side lying position, all other pulmonary function indexes differed significantly (p<.05). CONCLUSION: There are differences in pulmonary function indexes depending on different postures of stroke patients, and the study showed that the non-paretic side lying position yielded the greatest effect on lung ventilation mechanisms. Based on these results, appropriate postures need to be considered during physical therapy interventions for stroke patients.

Effect of Trunk Inclination Angles on Trunk Muscle Activity and Subjective Difficulties During Supine Bridge Exercise with a Suspension Device

  • Kim, Jwa-Jun;Park, Se-Yeon
    • PNF and Movement
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    • v.18 no.3
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    • pp.315-321
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    • 2020
  • Purpose: Recent studies have indicated that applying different inclination angles and suspension devices could be a useful way of performing exercises that include the co-activation of the trunk muscles. Present study was to examine the influences of changes in the inclination angle during trunk muscle activity while engaging in a bridge exercise with a suspension device. Methods: 18 healthy, physically active male volunteers completed three trunk inclination angles (15°, 30°, and 45°) for bridge exercise variations. The surface electromyography responses of the rectus abdominis, internal oblique (IO), erector spinae (ES), and rectus femoris (RF), as well as the subjective difficulty (Borg RPE score), were investigated during these bridge exercises. Results: The bridge with a 45° inclination angle suspension significantly increased the muscular activities of the RA and RF and increased the Borg RPE scores (p<0.05). The bridge with a 15° suspension significantly elevated the ES activities when compared to the other conditions. Conclusion: The present study demonstrated that a higher inclination angle could not activate the overall trunk muscles during the bridge exercise. The RA and RF produced greater activation during the bridge exercise with the higher inclination angle. On the other hand, the activities of the erector spine were greater during the bridge exercise with the lower inclination angle. The present study suggests that applying a low trunk inclination angle for the supine bridge exercise is suitable for activating the erector spine muscles.

The Effect of Position Change on Comfort and Bleeding after Transarterial Chemoembolization (간동맥 화학색전술 후 체위변경이 안위와 출혈합병증에 미치는 영향)

  • Kang, Jung Sun;Park, Seong Yeon;Kim, Eun Ok
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.1
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    • pp.5-15
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    • 2010
  • Purpose: The purpose of this study was to examine the effect of position change on the level of comfort and occurrence of bleeding after transarterial chemoembolization. Methods: This study was the nonequivalent control group non-synchronized design. The experimental group was positioned in supine with 15-30 degree Semi-folwer's position for 2 hours and then changed supine position alternatively to 30 degree lateral positioning in turn per hour for 2 hours. For the control group, 6 hour supine positions without any position change were applied. Results: The level of discomfort of the control group was scored higher level than that of the experimental group. There was no significant differences in back pain and the degrees of voiding difficulty. There were no significant differences in the incidence of bleeding complication between the two groups. Conclusion: The position change in patients after transarterial chemoembolization could be applied without any severe side effects such as bleeding complication, but it was revealed to be effective in reducing the level of discomfort.

Usefulness of Scan Position Change on Dual Time Point PET-CT in Pancreas Cancer (췌장암 Dual Time Point PET/CT 검사에서 Scan Position Change의 유용성 평가)

  • Chang, Boseok;Kim, Jae Ho
    • Journal of the Korean Society of Radiology
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    • v.10 no.5
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    • pp.299-305
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    • 2016
  • Despite of the development of medical equipments and technology. Pancreatic cancer has maked high false positive rate and low survival rate compared to other cancers. Therefore, early catch of pancreatic cancer is the only way to enhance the viability. It is important to find the exact location of the pancreas cancer in early stage. The method of optimum scan for early detection of pancreatic cancer on PET/CT exam is proposed. Examined the anatomical region that potentially can be missing from the supine position of ordinary pet/ct exam. The characteristics and usefulness of angle variation ($0^{\circ}$, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$, $90^{\circ}$) of patients scan position is analyzed. The proposed scan method (named JJ-projection) is bringing advantage of anatomical discrimination by separating stomach, liver, gallbladder duodenum and pancreas. ROC curve analysis is shows to advantage of the JJ-Projection method. The sensitivity has increased 4.6% than the supine delay scan method, the results sensitivity has increased from 91% to 95.2%. The specificity has increased from 75.1% to 84%. Compared with the results observed in cancer by biological biopsy, The accuracy has increased from 86.8% to 94.1%.

Technical Improvement for Spine Radiography by Comparing Scoliotic and Lordotic Angle with Different Positioning Methods (촬영자세별 척추측만각과 척추전만각의 비교 분석에 따른 개선 방안)

  • Jung, Jae-Yeon;Son, Soon-Yong;Lee, Jong-Seok;Yoo, Beong-Gyu
    • Journal of radiological science and technology
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    • v.34 no.4
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    • pp.263-269
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    • 2011
  • Since the spine radiography were explained differently at every several hospitals and textbooks. the technique has not been accurately defined and interfered each other. We would like to define the most appropriate positioning for clinical cases, and reference books, by comparing scoliotic angle and lordotic angle. From Mar 2009 to Sep 2011, 85 patient cases were studied, who had not been undergone surgical treatment among spondylopathy patients. Scoliotic angle and lordotic angle were measured, using Cobb's method. We analyzed statistically using t-test(SPSS 18), and evaluated spine general radiography position. Moreover, we researched on the actual condition at 10 university hospitals in Seoul. The results of scoliotic angle measurement, the value at erect position showed 20.98% higher than supine position, and it has statistical significance (p<.01). In lordotic angle measurement, the value at neutral holding position represented 29.3% higher than supine position, and it also has statistical significance(p<.01). The results of clinical survey, supine posine(70.0%) took much higher possession than erect position(30.0%). In conclusion, compare to supine position, erect position shows increased scoliotic and lordotic angle. It was agreed with the importance of clinical erect position radiography, which gravity affects. So clinical radiologist must recognize the difference, and conduct an accurate study.

Evaluated the L-spine Magnetic Resonance Imaging for the Scanning Method of the Lateral Recumbent Position with to the Embarrassed Control of the Acute Low Back Pain (자기공명검사에서 통증제어가 불가능한 급성 요통 환자의 옆으로 누운 자세에 대한 영상평가)

  • Lee, Jaeheun;Lee, Jaeseung;Im, Inchul
    • Journal of the Korean Society of Radiology
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    • v.8 no.5
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    • pp.255-260
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    • 2014
  • The acute lumbar pain patients who were unavoidable to take MRI examination were made to take altered lateral recumbent position. they were also not able to control their painfulness and to be in supine position. In this study, it is supposed to increase success rate of the MRI examination through taking the altered lateral recumbent position in using spine and body matrix coil. This altered position made relaxing lumber pain and fatigue for the patients who suffered from sever lumber pain. In these reasons, it decreases the motion artifacts through correcting uncomfortable posture. As a result, qualitative analysis for the image quality was estimated to have average points of supine position A group(lateral recumbent position) of normal candidates and B group(lateral recumbent position) of the abnormal candidates who have sever pain at 4.64, 3.44, and 3.40, respectively. In conclusion, while qualitative analysis in the examination with supine position of the normal patients had significantly high points, the qualitative analysis in the examination with lateral recumbent position of the normal patients and abnormal patients who had sever lumbar pain was almost same. In addition, it was judged that radiologists' imagery interpretation had no other problems in the image evaluation of B group who had acute lumbar pain of abnormal patients. Hereupon, if this technique becomes generalized for the patients who suffer from supine position in the examination, it is supposed to be useful in medical field.

The effect of patient position on dose in radiation therapy of liver cancer (환자 자세가 간의 방사선 치료 시 선량에 미치는 영향)

  • Jung, Won Seok;Kim, Ju Ho;Kim, Young Jae;Shin, Ryung Mi;Oh, Jeong Hun;Jeong, Geon A;Jo, Jun Young;Kim, Gi Chul;Choi, Tae Kyu
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.1-9
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    • 2014
  • Purpose : To analyze tumor's movement and volume change from changing position in order to minimize movement caused by breathing. Materials and Methods : We conducted survey of 14 patients with HCC(Hepatocellular carcinoma). Patient immobilization device was made in two ways(Supine position, prone position) and from image acquisition, tumor's movement, volume and dose are analyzed. Results : The mean movement of target(LR, Left-right) in supine position and prone position was $2.76{\pm}1.25mm$, $2.21{\pm}0.93mm$. AP(Anterior-posterior) and SI(Superior-inferior) was $4.02{\pm}1.63mm$, $11.56{\pm}3.08mm$, $3.36{\pm}1.17mm$, $7.45{\pm}1.96mm$. Treatment volume was decreased and normal liver volume was increased in prone position. Conclusion : We could reduce the margin of the treatment volume by minimizing the movement of liver caused by breathing. Especially in prone position, it is considered to be able to decrease the movement of the liver and increase normal liver volume.

Effects of Different Knee Flexion Angles According to Three Positions on Abdominal and Pelvic Muscle Activity During Supine Bridging

  • Lim, One-Bin;Kim, Ki-Song
    • Physical Therapy Korea
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    • v.20 no.4
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    • pp.1-8
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    • 2013
  • This study analyzes how different knee flexion angles affect the abdominal and pelvic muscle activity during supine bridging. Twenty healthy subjects participated in the study. We used surface electromyography (EMG) to measure how three different knee flexion angles ($100^{\circ}$, $70^{\circ}$, and $40^{\circ}$) affected the activity of the transverse abdominis/internal oblique (TrA/IO), external oblique (EO), biceps femoris (BF), rectus femoris (RF), and gluteus maximus (GM) muscles on the dominant side during supine bridging. The one-way repeated analysis of variance (ANOVA) was used to determine the statistical significance of TrA/IO, EO, BF, RF and GM muscle activity and the GM/BF activity ratio. For the TrA/IO, EO, BF, and GM muscles, supine bridging with different knee flexion angles resulted in significant differences in abdominal and pelvic muscle activity. For the TrA/IO muscles, the post-hoc test demonstrated that muscle activity significantly increased at $40^{\circ}$ compared to $70^{\circ}$; however, there were no significant differences between $100^{\circ}$ and $70^{\circ}$ or $100^{\circ}$ and $40^{\circ}$. For the EO muscle, the post-hoc test demonstrated that muscle activity significantly increased at $40^{\circ}$ compared to $100^{\circ}$ and $70^{\circ}$; no significant difference was observed between angles $100^{\circ}$ and $70^{\circ}$. For the BF muscle, the post-hoc test demonstrated that muscle activity significantly increased according to the knee flexion angle ($40^{\circ}$ > $70^{\circ}$ > $100^{\circ}$). For the GM muscle, the post-hoc test demonstrated that muscle activity significantly increased according to the knee flexion angle ($100^{\circ}$ > $70^{\circ}$ > $40^{\circ}$). However, for the RF muscle, there was no significant difference. Additionally, the GM/BF activity ratio significantly increased according to the knee flexion angle ($100^{\circ}$ > $70^{\circ}$ > $40^{\circ}$). From these results, we can conclude that bridging with a knee flexion of $100^{\circ}$ can strengthen the GM muscle, whereas bridging with a knee flexion of $40^{\circ}$ is recommended to strengthen the IO, EO, and BF muscles. We can also conclude that knee flexion angles should be modified during supine bridging to increase the muscle activity of different target muscles.