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/lp/de-gruyter/human-body-posture-as-a-source-of-information-about-selected-diseases-E6v64ieRek
- Publisher
- de Gruyter
- Copyright
- Copyright © 2016 by the
- ISSN
- 1895-9091
- eISSN
- 1896-530X
- DOI
- 10.1515/bams-2015-0029
- Publisher site
- See Article on Publisher Site
Abstract
The aim of the study is to present the differences between the human body posture (HBP) of healthy people and those suffering from specific disorders both those clearly connected with HBP (scoliosis, coxarthrosis) and those seemingly unrelated (e.g. depression). The study was conducted based on the results of photogrammetric measurements of patients standing in a relaxed posture, scanned with a PBE system (Photogrammetrical Body Explorer). Research was conducted over a group of 190 people. Patients were divided into six subgroups based on diagnosed disease entity: coxarthrosis, discopathy, scoliosis, depression, and chronic fatigue syndrome. A control group constituted of 36 healthy volunteers aged 1929 years, with no identified defects of body posture. To evaluate the differences between the HBP of healthy and sick people, an HBP model based on 29 parameters describing the HBP in three anatomical planes was created. The research showed significant differences in the HBP of healthy and sick people. The results of the analysis indicate that an objective assessment of the HBP can be a source of relevant information on the general health of the patient and may be a useful tool in the diagnosis of selected diseases. Keywords: anatomy trains; human body posture; photogrammetry; Photogrammetrical Body Explorer (PBE). functions, including maintaining a proper posture. Many injuries or pains in motor organs arise as a result of malfunction of some myofascial chains or their fragments [1]. There are reports indicating the existence of links between abnormalities in the myofascial system and functional disorders of internal organs [2] and other disease entities, e.g. depression [3] or mandible disorders [4, 5]. Myofascial chains are described by many different concepts [1, 68]. This study is based on the anatomy trains (AT) conception by Myers [8]. The idea of AT, due to its comprehensive nature, allows to analyze the static of the whole body. The aim of the present article is to demonstrate the differences of HBP of healthy and unwell people. Materials and methods The research was conducted on results of photogrammetric measurements of 190 people aged 1388 years. The patients were scanned in a relaxed standing posture with a PBE system (Photogrammetrical Body Explorer) [9]. Patients' data were selected from a database of Rehabilitation Center "Health." Patients were divided into six subgroups based on diagnosed disease entity: Chronic fatigue syndrome (CFS) Scoliosis Coxarthrosis (arthrosis of the hip) Discopathy Depression The healthy subgroup is a control group, constituted of 36 volunteers aged 1929 years, with no identified diseases and defects of body posture. The size of these groups is shown in Figure 1. To evaluate the differences between the HBP of healthy and sick people, a HBP model was created. This model is built on 29 angular parameters describing the HBP in three anatomical planes. These parameters are based on anthropometric points measured by PBE. They were chosen to match the skeletal points included in the four main ATs as closely as possible; the superficial back line (SBL), the superficial front line (SFL), the lateral line Introduction Human body posture (HBP) is described by different domains experts (physicians, physical therapists, and others) in several ways. One is to use the concept of myofascial chains, which are involved in a variety of body *Corresponding author: Miroslawa M. Dlugosz, The Faculty of Electrical Engineering, Automatics, Computer Science and Biomedical Engineering, Department of Automatics and Biomedical Engineering, AGH University of Science and Technology, 30-059 Krakow, Poland, E-mail: mmd@agh.edu.pl Wojciech Kurzydlo: Collegium Medicum at Jagiellonian University, 31-008 Krakow, Poland 20Dlugosz and Kurzydlo: HBP as a source of information about selected diseases Table 1:HBP model parameters in the sagittal plane. Parameter Value, ° 88 88 267 268 365 364 86 85 177 178 177 176 59 185 178 71 Figure 1:The size of patient groups according to diagnosed disease. HP_PP & y_YZ HL_PL & y_YZ RP_PP & P_HP_YZ RL_PL & PL_HL_YZ KTP_RP & RP_PP_YZ-1 KTL_RL & RL_PL_YZ-1 KPP_KTP & y_YZ KPL_KTL & y_YZ S_PP & y_YZ S_PL & y_YZ MD3_LP3 & y_YZ MD3_LL3 & y_YZ M_C7 & y_YZ G_C7 & y_YZ C7_S & y_YZ W_G & y_YZ at hy si on lth y is is ar th ro s ol io s ea is c Sc ox (LL), and the spiral line (SL). The positions of the measuring points assigned to the analyzed ATs are shown schematically in Figure 2. Tables 13 list the parameters of the HBP model and its values for healthy people in three anatomical planes. To find differences between the HBP of healthy people and those ep re s op FS Table 2:HBP model parameters in the coronal plane. Parameter Value, ° 178 179 176 183 141 142 90 180 RP_KPP & RP_PP_XY RL_KPL & RL_PL_XY S_PP & y_XY S_PL & y_XY MD3_LP3 & y_XY y & MD3_LL3_XY BL_BP & y_XY G_C7 & y_XY Table 3:HBP model parameters in the transverse plane. Parameter Value, ° 360 365 360 359 90 C7_M & PP_HP_XZ-1 PL_HL & C7_M_XZ-1 BP_BL & KPP_KPL_XZ-1 G_EP-EL & C7_M_XZ-1 C7_M & BL_BP_XZ Figure 2:Anthropometric points measured using the PBE system, designating the four main anatomy trains. EP-EL, Line joining the centers of the right and left eyes; W, center of the upper lip; BP/BL, right/left acromion; M, suprasternal notch; MD3, xiphoid process; LP3/LL3, costal margin right/left; KPP/KPL, anterior superior iliac spine right/left; HP/HL, front surface of the hallux right/left; G, occipital protuberance; C7, vertebra prominens; S, sacrum; KTP/KTL, posterior superior iliac spine right/left; RP/RL, right/left popliteal fossa; PP/PL, right/left calcaneus. suffering from specific disorders, we analyzed the correlation matrices of the parameters in each anatomical plane for the control group and the above-mentioned disease entities. Furthermore, we also examined the relationship between the parameters describing the HBP in all three planes of the body. For this purpose, we use the cluster analysis. Results The statistical analysis of the data indicated a strong correlation between the right and left sides of the body Dlugosz and Kurzydlo: HBP as a source of information about selected diseases21 in all anatomical planes for healthy people. For groups of patients with diagnosed disease entities, these relationships are considerably reduced. The values of some parameters describing the HBP in each group are significantly different. These differences, for selected parameters, are illustrated on interaction plots in Figures 39. Values of the C7_S & y_YZ parameter, which describes the inclination angle of the torso in sagittal plane, are completely different for the control group than for other patients (Figure 3). Figures 47 show the parameters describing the lower part of the body in sagittal and coronal planes. These parameters also have different values for healthy and sick people. However, for angles in the sagittal plane (Figures 4 Coxarthrosis Depression Discopathy Scoliosis RP_PP & PP_HP_YZ RL_PL & PL_HL_YZ Health CFS Figure 5:The average values (°) of the angle between lower thigh and foot at the left and right sides of the body in the sagittal plane, relative to disease entities. Coxarthrosis Depression Discopathy Scoliosis Health C7_S & y_YZ CFS RP_KPP & RP_PP_XY RL_KPL & RL_PL_XY Figure 3:The average values (°) of the inclination angle of the torso in the sagittal plane, relative to disease entities. Figure 6:The average values (°) of the inclination angle between thigh and lower thigh in the coronal plane at the left and right sides of the body, relative to disease entities. KTP_RP & RP_PP_YZ-1 KTL_RL & RL_PL_YZ-1 Figure 4:The average values (°) of the angle between thigh and lower thigh in the sagittal plane, at the left and right sides of the body, relative to disease entities. and 5), results obtained for the control group were similar to a group of people with depression. Differences between healthy people and other groups also occur in the upper part of the body, as shown in Figures 8 (in sagittal plane) and 9 (coronal plane). For more information about the differences between the HBP of healthy people and those suffering from specific disorders, in addition we performed hierarchical agglomerative clustering. In forming clusters, we used Euclidean distance as a measure of distance between objects. For the calculation of distances between clusters, we used the weighted pair-group method using arithmetic averages [10], due to suspected significant differences in cardinality of the respective clusters. 22Dlugosz and Kurzydlo: HBP as a source of information about selected diseases Coxarthrosis Depression Discopathy Scoliosis Health S_PP & y_YZ S_PL & y_YZ CFS MD3_LP3 & y_XY y & MD3_LL3_XY Figure 7:The average values (°) of the inclination angle between thigh and lower thigh in the coronal plane at the left and right sides of the body, relative to disease entities. Figure 9:The average values (°) of the inclination angle of the chest in the coronal plane at the left and right sides of the body, relative to disease entities. Coxarthrosis Depression Discopathy Scoliosis MD3_LP3 & y_YZ MD3_LL3 & y_YZ Health CFS Health Depression Scoliosis CFS Discopathy Coxarthrosis Figure 8:The average values (°) of the inclination angle of the chest in the sagittal plane at the left and right sides of the body, relative to disease entities. Figure 10:Classification of patient groups' dendrogram. The results of clustering are shown in a dendrogram in Figure 10. To determine the cutoff point, we used the chart of linkage distances (Figure 11). It was observed that a clear flattening of the graph occurs at a linkage distance equal to 8, which divides the group of patients into three clusters. With this division, results obtained for the control group are clearly outliers from the other analyzed groups. 45 40 35 30 25 20 15 10 5 0 0 1 2 3 Step 4 5 6 Discussion and conclusions The results of the analysis showed significant differences between the posture of healthy people and those suffering from specific disorders including those seemingly Figure 11:Plot of linkage distances across steps. Dlugosz and Kurzydlo: HBP as a source of information about selected diseases23 unrelated with HBP, like depression or CFS. It means that an objective assessment of the HBP can be a source of relevant information on the general patients' health. It can also be a useful tool in the diagnosis of various diseases and results presented in this paper form the basis for further research on this topic. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. Research funding: AGH University of Science and Technology grant no. 11.11.120.612. Employment or leadership: None declared. Honorarium: None declared. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Journal
Bio-Algorithms and Med-Systems – de Gruyter
Published: Mar 1, 2016