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Sample records for body vibration therapy

  1. Effects of Whole-Body Vibration Therapy in Patients with Fibromyalgia: A Systematic Literature Review

    PubMed Central

    Collado-Mateo, Daniel; Adsuar, Jose C.; Olivares, Pedro R.; del Pozo-Cruz, Borja; Parraca, Jose A.; del Pozo-Cruz, Jesus; Gusi, Narcis

    2015-01-01

    Objective. To review the literature on the effects of whole-body vibration therapy in patients with fibromyalgia. Design. Systematic literature review. Patients. Patients with fibromyalgia. Methods. An electronic search of the literature in four medical databases was performed to identify studies on whole-body vibration therapy that were published up to the 15th of January 2015. Results. Eight articles satisfied the inclusion and exclusion criteria and were analysed. According to the Dutch CBO guidelines, all selected trials had a B level of evidence. The main outcomes that were measured were balance, fatigue, disability index, health-related quality of life, and pain. Whole-body vibration appeared to improve the outcomes, especially balance and disability index. Conclusion. Whole-body vibration could be an adequate treatment for fibromyalgia as a main therapy or added to a physical exercise programme as it could improve balance, disability index, health-related quality of life, fatigue, and pain. However, this conclusion must be treated with caution because the paucity of trials and the marked differences between existing trials in terms of protocol, intervention, and measurement tools hampered the comparison of the trials. PMID:26351517

  2. Effects of 8-Prenylnaringenin and Whole-Body Vibration Therapy on a Rat Model of Osteopenia

    PubMed Central

    Hoffmann, Daniel B.; Griesel, Markus H.; Brockhusen, Bastian; Tezval, Mohammad; Komrakova, Marina; Menger, Bjoern; Wassmann, Marco; Stuermer, Klaus Michael; Sehmisch, Stephan

    2016-01-01

    Background. 8-Prenylnaringenin (8-PN) is the phytoestrogen with the highest affinity for estrogen receptor-α (ER-α), which is required to maintain BMD. The osteoprotective properties of 8-PN have been demonstrated previously in tibiae. We used a rat osteopenia model to perform the first investigation of 8-PN with whole-body vertical vibration (WBVV). Study Design. Ovariectomy was performed on 52 of 64 Sprague-Dawley rats. Five weeks after ovariectomy, one group received daily injections (sc) of 8-PN (1.77 mg/kg) for 10 weeks; a second group was treated with both 8-PN and WBVV (twice a day, 15 min, 35 Hz, amplitude 0.47 mm). Other groups received either only WBVV or no treatment. Methods. The rats were sacrificed 15 weeks after ovariectomy. Lumbar vertebrae and femora were removed for biomechanical and morphological assessment. Results. 8-PN at a cancer-safe dose did not cause fundamental improvements in osteoporotic bones. Treatment with 8-PN caused a slight increase in uterine wet weight. Combined therapy using WBVV and 8-PN showed no significant improvements in bone structure and biomechanical properties. Conclusion. We cannot confirm the osteoprotective effects of 8-PN at a cancer-safe dose in primary affected osteoporotic bones. Higher concentrations of 8-PN are not advisable for safety reasons. Adjunctive therapy with WBVV demonstrates no convincing effects on bones. PMID:26904278

  3. The effect of whole body vibration therapy on bone density in patients with thalassemia: A pilot study

    PubMed Central

    Fung, Ellen B.; Gariepy, Catherine A.; Sawyer, Aenor J.; Higa, Annie; Vichinsky, Elliott P.

    2013-01-01

    Patients with thalassemia (Thal) have low bone mass which can lead to fracture and decreased quality of life. There are no noninvasive anabolic therapies available to improve bone health in Thal. A longitudinal cross-over pilot trial was conducted to evaluate the effectiveness of low magnitude whole body vibration (WBV) therapy on bone in 18 patients with Thal (9 adults, 10 male, 22.1 10.7 years). Subjects were asked to stand on a vibrating platform (30 Hz, 0.3 g) for 20 min/day for 6 months. Areal bone mineral density (aBMD) by DXA and volumetric BMD by peripheral quantitative computed tomography (pQCT) was assessed at baseline, 6 and 12 months. Adherence in the first 3 months was greater when compared with the second 3 months (14 6 vs. 10 7 min/day, P=0.007). Intention to treat analysis revealed a significant increase in whole body BMC (2.6%; P = 0.021), BMC/Ht (2.6%, P = 0.02) and aBMD (1.3%; P = 0.036), as well as a net increase in serum markers of bone formation (Osteocalcin/CTx, P = 0.027) in the adult subjects. These preliminary findings suggest that vibration therapy may be an effective nonpharmacologic intervention in Thal. Future research is needed to confirm these findings in a larger sample for longer duration. PMID:22886910

  4. Bone mineral density, microarchitectural and mechanical alterations of osteoporotic rat bone under long-term whole-body vibration therapy.

    PubMed

    Xie, Pengfei; Tang, Zhurong; Qing, Fangzhu; Chen, Xuening; Zhu, Xiangdong; Fan, Yujiang; Yang, Xiao; Zhang, Xingdong

    2016-01-01

    Low-magnitude, high-frequency whole body vibration (WBV) is receiving increasing interest as a non-pharmacological anti-osteoporosis approach. However, the long-term effect of WBV therapy is seldom studied. In this study, the efficacy of 16-week WBV (0.3g, 30Hz) on bone mineral density (BMD), microarchitectural parameters and mechanical properties of ovariectomized rat femur were examined by in vivo peripheral quantitative computed tomography (pQCT), ex vivo micro-computed tomography (CT), dynamic mechanical analysis (DMA) and fracture test. To the best of our knowledge, 16 weeks of WBV administration (20min/day) is currently the longest duration on rodent. The longitudinal BMD change showed that positive effect of WBV on ovariectomized rat femoral neck diminished with prolonged administration duration. In addition, 16-week of WBV treatment was found to cause significantly reduction in the mean BMD, trabecular BMD (Tb.BMD), trabecular bone volume ration (BV/TV), trabecular number (Tb.N) and maximum load in femoral neck of ovariectomized rat. Metaphyseal Tb.BMD and BV/TV were also significantly decreased in WBV treated ovariectomized group than non-treated controls. Whole-femur DMA was demonstrated as a sensitive tool in distinguishing osteoporotic femur from healthy aged-matched controls, in terms of decreased storage modulus (E') and loss factor (tan ?). However, E' and tan ? are not enhanced by 16-week WBV treatment. Together, these findings indicate that administration duration played an important role in the effect of WBV. 16-week WBV may exacerbate trabecular bone loss in ovariectomized rat femur, especially in trabecular-rich femoral neck region. An optimal WBV protocol including administration duration should be established prior to long-term clinical practice. PMID:26398779

  5. Whole-body vibration perception thresholds

    NASA Astrophysics Data System (ADS)

    Parsons, K. C.; Griffin, M. J.

    1988-03-01

    This paper presents the results of a series of laboratory experiments concerned with perception thresholds for whole-body vibration. The nature of absolute perception thresholds is discussed and a method of determining vibration thresholds, based upon signal detection theory, is proposed. Thresholds of subjects exposed to x-, y- and z-axis sinusoidal vibration were determined for sitting and standing subjects (from 2 to 100 Hz). Perception thresholds have also been determined for supine subjects exposed to vertical ( x-axis) sinusoidal vibration (10-63 Hz). In additional experiments the effects of complex (e.g., random) vibration and the effects of duration on the perception thresholds were investigated. The relation between perception thresholds and vibration levels, said by subjects to be unacceptable if they occurred in their own homes, was investigated as well as the effects of subjects' personality and the visual and acoustic conditions in the laboratory. For the vertical vibration of seated subjects no significant differences were found between the responses of male and female subjects. Significant differences were found between perception thresholds for sitting and standing postures. The median threshold was approximately 001 m/s 2 r.m.s. between 2 and 100 Hz. Perception thresholds for x-axis and y-axis vibration were not significantly different in either sitting or standing subjects but significant differences in thresholds were found between sitting and standing positions for both x-axis and y-axis vibration. Subjects tended to be more sensitive to vibration when lying than when sitting or standing. The results suggested that the perception of random vibrations can be predicted from a knowledge of the perception of its component vibrations. The number of cycles of vibration did not affect perception thresholds for vibration durations of more than about 025 s. Some assessments suggested that vibration at more than twice the perception threshold may not be acceptable if it occurs in the home.

  6. Whole-body vibration exercise in postmenopausal osteoporosis

    PubMed Central

    Mieszkowski, Jan; Niespodzi?ski, Bart?omiej; Ciechanowska, Katarzyna

    2015-01-01

    The report of the World Health Organization (WHO) of 2008 defines osteoporosis as a disease characterized by low bone mass and an increased risk of fracture. Postmenopausal osteoporosis is connected to the decrease in estrogens concentration as a result of malfunction of endocrine ovarian function. Low estrogens concentration causes increase in bone demineralization and results in osteoporosis. Physical activity, as a component of therapy of patients with osteoporosis, has been used for a long time now. One of the forms of safe physical activity is the vibration training. Training is to maintain a static position or execution of specific exercises involving the appropriate muscles on a vibrating platform, the mechanical vibrations are transmitted to the body of the patient. According to the piezoelectric theory, pressure induces bone formation in the electrical potential difference, which acts as a stimulant of the process of bone formation. Whole body vibration increases the level of growth hormone and testosterone in serum, preventing sarcopenia and osteoporosis. The aim of this study was to review the literature on vibration exercise in patients with postmenopausal osteoporosis based on the PubMed and Medline database. While searching the database, the following key words were used postmenopausal osteoporosis and whole-body vibration exercise. PMID:26327887

  7. Vibration therapy: clinical applications in bone

    PubMed Central

    Thompson, William R.; Yen, Sherwin S.; Rubin, Janet

    2015-01-01

    Purpose of review The musculoskeletal system is largely regulated through dynamic physical activity and is compromised by cessation of physical loading. There is a need to recreate the anabolic effects of loading on the musculoskeletal system, especially in frail individuals who cannot exercise. Vibration therapy is designed to be a nonpharmacological analogue of physical activity, with an intention to promote bone and muscle strength. Recent findings Animal and human studies suggest that high-frequency, low-magnitude vibration therapy improves bone strength by increasing bone formation and decreasing bone resorption. There is also evidence that vibration therapy is useful in treating sarcopenia, which confounds skeletal fragility and fall risk in aging. Enhancement of skeletal and muscle strength involves regulating the differentiation of mesenchymal stem cells to build these tissues; mesenchymal stem cell lineage allocation is positively promoted by vibration signals. Summary Vibration therapy may be useful as a primary treatment as well as an adjunct to both physical and pharmacological treatments, but future studies must pay close attention to compliance and dosing patterns, and importantly, the vibration signal, be it low-intensity vibration (<1g) appropriate for treatment of frail individuals or high-intensity vibration (>1g) marketed as a training exercise. PMID:25354044

  8. Whole body vibration exercise: training and benefits.

    PubMed

    Dolny, Dennis G; Reyes, G Francis Cisco

    2008-01-01

    In recent years, it has been suggested that exercise using whole body vibration (WBV) platforms may increase muscle activity and subsequently enhance muscle performance in both acute and chronic conditions. WBV platforms produce frequencies ranging from 15-60 Hz and vertical displacements from ~1-11 mm, resulting in accelerations of ~2.2-5.1 g. Acute exposure to WBV has produced mixed results in terms of improving jump, sprint, and measures of muscle performance. With WBV training, younger fit subjects may not experience gains unless some type of external load is added to WBV exercise. However, sedentary and elderly individuals have demonstrated significant gains in most measures of muscle performance, similar with comparable traditional resistance exercise training programs. WBV training also has demonstrated gains in flexibility in younger athletic populations and gains or maintenance in bone mineral density in postmenopausal women. These promising results await further research to establish preferred WBV training parameters. PMID:18477873

  9. Action slips during whole-body vibration.

    PubMed

    Ishimatsu, Kazuma; Meland, Anders; Hansen, Tor Are S; Kåsin, Jan Ivar; Wagstaff, Anthony S

    2016-07-01

    Helicopter aircrew members engage in highly demanding cognitive tasks in an environment subject to whole-body vibration (WBV). Sometimes their actions may not be according to plan (e.g. action slips and lapses). This study used a Sustained Attention to Response Task (SART) to examine whether action slips were more frequent during exposure to WBV. Nineteen participants performed the SART in two blocks. In the WBV block participants were exposed to 17 Hz vertical WBV, which is typical of larger helicopter working environments. In the No-WBV block there was no WBV. There were more responses to the rare no-go digit 3 (i.e. action slips) in the WBV block, and participants responded faster in the WBV block. These results suggest that WBV influences response inhibition, and can induce impulsive responding. WBV may increase the likelihood of action slips, mainly due to failure of response inhibition. PMID:26611989

  10. Potential beneficial effects of whole-body vibration for muscle recovery after exercise.

    PubMed

    Kosar, Angela C; Candow, Darren G; Putland, Jessica T

    2012-10-01

    Whole-body vibration is an emerging strategy used by athletes and exercising individuals to potentially accelerate muscle recovery. The vibration elicits involuntary muscle stretch reflex contractions leading to increased motor unit recruitment and synchronization of synergist muscles, which may lead to greater training adaptations over time. Intense exercise training, especially eccentric muscle contractions, will inevitably lead to muscle damage and delayed onset muscle soreness, which may interfere with the maintenance of a planned training program. Whole-body vibration before and after exercise shows promise for attenuating muscle soreness and may be considered as an adjunct to traditional therapies (i.e., massage, cryotherapy) to accelerate muscle recovery. PMID:22130390

  11. Whole body vibration and cerebral palsy: a systematic review

    PubMed Central

    Duquette, Sean A.; Guiliano, Anthony M.; Starmer, David J.

    2015-01-01

    Purpose: The goal of this review is to evaluate the effects of whole body vibration on outcomes in patients with cerebral palsy. The findings in this review may help clinicians make evidence informed decisions on the use of whole body vibration for cerebral palsy. Methods: A systematic search was conducted on April 29, 2014.The following search terms were used to search of several databases: (whole body vibration OR whole-body vibration OR whole body-vibration OR WBV) AND (cerebral palsy). Articles that met the inclusion criteria were assessed using the Scottish intercollegiate guidelines network (SIGN) rating system to assess the methodology and bias of the articles for randomized control trials. Results: The search produced 25 articles, of which 12 duplicates were identified and removed. Another seven articles were not considered since they did not fit the inclusion criteria, leaving a total of five studies for review. Four of the articles analyzed the effects of WBV in children while the other study focused on adults with cerebral palsy. There was one low quality article, four acceptable quality articles and one high quality article when assessed using the SIGN criteria. Conclusions: It appears that whole body vibration has the potential to provide symptomatic relief for patients with cerebral palsy. Whole body vibration may improve spasticity, muscle strength and coordination. There is a lack of research to conclusively determine whether it does alter bone mineral density. PMID:26500358

  12. Wireless Network for Measurement of Whole-Body Vibration

    PubMed Central

    Koenig, Diogo; Chiaramonte, Marilda S.; Balbinot, Alexandre

    2008-01-01

    This article presents the development of a system integrated to a ZigBee network to measure whole-body vibration. The developed system allows distinguishing human vibrations of almost 400Hz in three axes with acceleration of almost 50g. The tests conducted in the study ensured the correct functioning of the system for the project's purpose.

  13. Absorption of Energy during Whole-Body Vibration Exposure

    NASA Astrophysics Data System (ADS)

    Lundstrm, R.; Holmlund, P.

    1998-08-01

    Absorbed power,PAbs, during exposure to vertical and horizontal whole-body vibration in sitting posture was measured using 15 male and 15 female subjects. Different experimental conditions were applied, such as vibration level (025-14 m/s2), frequency (113-80 Hz), body weight (54-93 kg), relaxed and erect upper body posture. Results show thatPAbswas strongly related to frequency of the vibration peaking, within the range of 4-6 Hz and below 25 Hz for vertical and horizontal directions respectively.PAbsincreased with acceleration level and body weight. If risk assessment is based on the assumption that the amount ofPAbs, independence of the frequency of the vibration, indicates a hazard, then the frequency weighting procedure in ISO-standard 2631 can be questioned. The ISO weighting for horizontal vibration seems to underestimate the risk for frequencies within the range of about 15-3 Hz and overestimate them above about 5 Hz. For the vertical direction the frequency weighting overestimates the risk for frequencies above about 6 Hz. The results also indicate a need for differential guidelines for females and males. Many types of vehicle produce whole-body vibration with frequencies in the range where the highestPAbswas observed. Although not yet thoroughly evaluated,PAbsmay be a better quantity for risk assessment than acceleration as specified in ISO 2631, since it also takes into account the dynamic force applied to the human body.

  14. Measurement of Whole-Body Vibration Exposure from Garbage Trucks

    NASA Astrophysics Data System (ADS)

    Maeda, S.; Morioka, M.

    1998-08-01

    Japanese garbage truck drivers are exposed to mechanical whole-body vibration during their work. Some drivers have suffered from low back pain from this vibration. However, there is no evidence of a relationship between the whole-body vibration from the garbage trucks and low back pain or occupational disease, due to the lack of investigations. A field study was conducted in order to characterize the health risks associated with garbage truck work. Three different types of truck were tested at different loadings and on different road surfaces, with the vibrations measured at the driver/seat interface (x,y, andz-axes). The vibrations were compared with the health risk guidance according to Annex B of ISO 2631-1 [1]. The findings of this study indicated that Japanese garbage truck drivers should not operate trucks for 2.5 h in a day, under current working conditions.

  15. Effects of Whole Body Vibration Training on Body Composition in Adolescents with Down Syndrome

    ERIC Educational Resources Information Center

    Gonzalez-Aguero, Alejandro; Matute-Llorente, Angel; Gomez-Cabello, Alba; Casajus, Jose A.; Vicente-Rodriguez, German

    2013-01-01

    The present study aimed to determine the effect of 20 weeks of whole body vibration (WBV) on the body composition of adolescents with Down syndrome (DS). Thirty adolescent with DS were divided into two groups: control and WBV. Whole body, upper and lower limbs body fat and lean body mass were measured with dual energy X-ray absorptiometry (DXA)…

  16. Effects of Whole Body Vibration Training on Body Composition in Adolescents with Down Syndrome

    ERIC Educational Resources Information Center

    Gonzalez-Aguero, Alejandro; Matute-Llorente, Angel; Gomez-Cabello, Alba; Casajus, Jose A.; Vicente-Rodriguez, German

    2013-01-01

    The present study aimed to determine the effect of 20 weeks of whole body vibration (WBV) on the body composition of adolescents with Down syndrome (DS). Thirty adolescent with DS were divided into two groups: control and WBV. Whole body, upper and lower limbs body fat and lean body mass were measured with dual energy X-ray absorptiometry (DXA)

  17. Vibration Suppression of Railway Car Body with Piezoelectric Elements

    NASA Astrophysics Data System (ADS)

    Hansson, Joel; Takano, Masayuki; Takigami, Tadao; Tomioka, Takahiro; Suzuki, Yasufumi

    A new method for improving riding comfort by reducing vertical flexural vibrations in railway car bodies using piezoelectric elements is studied in this paper. Piezoelectric elements are attached on the car body in order to convert vibration energy to electrical energy, which can be dissipated in a shunt circuit. Assuming the car body as an elastically supported Bernoulli-Euler beam, theoretical analysis and numerical simulations are carried out. The numerical results are supplemented by experiments on a 1:5 scale model of a Shinkansen vehicle. Both numerical and experimental results indicate that the method yields significant vibration suppression with only a small amount of added weight. Two types of shunt circuits; a single-mode circuit and a multi-mode circuit are studied.

  18. [Experience of antioxidants in combined therapy for vibration disease patients].

    PubMed

    Shilov, V V; Nikonova, S M; Lashina, E L

    2015-01-01

    The study proved important role of antioxidants in combined therapy for patients with vibration disease caused by general and local vibration. Findings are positive influence of thioctic acid on amelioration of pain and angiodystonia, supported by clinical and functional investigations. PMID:25895246

  19. Whole-body vibration dosage alters leg blood flow.

    PubMed

    Lythgo, Noel; Eser, Prisca; de Groot, Patricia; Galea, Mary

    2009-01-01

    The effect of whole-body vibration dosage on leg blood flow was investigated. Nine healthy young adult males completed a set of 14 random vibration and non-vibration exercise bouts whilst squatting on a Galileo 900 plate. Six vibration frequencies ranging from 5 to 30 Hz (5 Hz increments) were used in combination with a 2.5 mm and 4.5 mm amplitude to produce twelve 1-min vibration bouts. Subjects also completed two 1-min bouts where no vibration was applied. Systolic and diastolic diameters of the common femoral artery and blood cell velocity were measured by an echo Doppler ultrasound in a standing or rest condition prior to the bouts and during and after each bout. Repeated measures MANOVAs were used in the statistical analysis. Compared with the standing condition, the exercise bouts produced a four-fold increase in mean blood cell velocity (P<0.001) and a two-fold increase in peak blood cell velocity (P<0.001). Compared to the non-vibration bouts, frequencies of 10-30 Hz increased mean blood cell velocity by approximately 33% (P<0.01) whereas 20-30 Hz increased peak blood cell velocity by approximately 27% (P<0.01). Amplitude was additive to frequency but only achieved significance at 30 Hz (P<0.05). Compared with the standing condition, squatting alone produced significant increases in mean and peak blood cell velocity (P<0.001). The results show leg blood flow increased during the squat or non-vibration bouts and systematically increased with frequency in the vibration bouts. PMID:19125731

  20. Quantification of mouse in vivo whole-body vibration amplitude from motion-blur using x-ray imaging

    NASA Astrophysics Data System (ADS)

    Hu, Zhengyi; Welch, Ian; Yuan, Xunhua; Pollmann, Steven I.; Nikolov, Hristo N.; Holdsworth, David W.

    2015-08-01

    Musculoskeletal effects of whole-body vibration on animals and humans have become an intensely studied topic recently, due to the potential of applying this method as a non-pharmacological therapy for strengthening bones. It is relatively easy to quantify the transmission of whole-body mechanical vibration through the human skeletal system using accelerometers. However, this is not the case for small-animal pre-clinical studies because currently available accelerometers have a large mass, relative to the mass of the animals, which causes the accelerometers themselves to affect the way vibration is transmitted. Additionally, live animals do not typically remain motionless for long periods, unless they are anesthetized, and they are required to maintain a static standing posture during these studies. These challenges provide the motivation for the development of a method to quantify vibrational transmission in small animals. We present a novel imaging technique to quantify whole-body vibration transmission in small animals using 280 μm diameter tungsten carbide beads implanted into the hind limbs of mice. Employing time-exposure digital x-ray imaging, vibrational amplitude is quantified based on the blurring of the implanted beads caused by the vibrational motion. Our in vivo results have shown this technique is capable of measuring vibration amplitudes as small as 0.1 mm, with precision as small as  ±10 μm, allowing us to distinguish differences in the transmitted vibration at different locations on the hindlimbs of mice.

  1. Quantification of mouse in vivo whole-body vibration amplitude from motion-blur using x-ray imaging.

    PubMed

    Hu, Zhengyi; Welch, Ian; Yuan, Xunhua; Pollmann, Steven I; Nikolov, Hristo N; Holdsworth, David W

    2015-08-21

    Musculoskeletal effects of whole-body vibration on animals and humans have become an intensely studied topic recently, due to the potential of applying this method as a non-pharmacological therapy for strengthening bones. It is relatively easy to quantify the transmission of whole-body mechanical vibration through the human skeletal system using accelerometers. However, this is not the case for small-animal pre-clinical studies because currently available accelerometers have a large mass, relative to the mass of the animals, which causes the accelerometers themselves to affect the way vibration is transmitted. Additionally, live animals do not typically remain motionless for long periods, unless they are anesthetized, and they are required to maintain a static standing posture during these studies. These challenges provide the motivation for the development of a method to quantify vibrational transmission in small animals. We present a novel imaging technique to quantify whole-body vibration transmission in small animals using 280 ?m diameter tungsten carbide beads implanted into the hind limbs of mice. Employing time-exposure digital x-ray imaging, vibrational amplitude is quantified based on the blurring of the implanted beads caused by the vibrational motion. Our in vivo results have shown this technique is capable of measuring vibration amplitudes as small as 0.1?mm, with precision as small as??10 ?m, allowing us to distinguish differences in the transmitted vibration at different locations on the hindlimbs of mice. PMID:26248045

  2. Cognitive-Behavioral Body Image Therapy for Body Dysmorphic Disorder.

    ERIC Educational Resources Information Center

    Rosen, James C.; And Others

    1995-01-01

    Randomly assigned 54 body dysmorphic disorder (BDD) subjects to cognitive behavior therapy or no treatment. BDD symptoms were significantly decreased in therapy subjects and the disorder was eliminated in 82 percent of cases at posttreatment and 77 percent at follow-up. Subjects' overall psychological symptoms and self-esteem also improved. (RJM)

  3. An active head-neck model in whole-body vibration: vibration magnitude and softening.

    PubMed

    Rahmatalla, Salam; Liu, Ye

    2012-04-01

    An active head-neck model is introduced in this work to predict human-dynamic response to different vibration magnitudes during fore-aft whole-body vibration. The proposed model is a rigid-link dynamic system augmented with passive spring-damper tissue-like elements and additional active dampers that resemble the active part of the muscles. The additional active dampers are functions of the input displacement, velocity, and acceleration and are based on active control theories and a kd-tree data-searching scheme. Five human subjects exposed to random fore-aft vibration with frequency content of 0.5-10 Hz were tested under different vibration with magnitudes of 0.46 m/s(2), 1.32 m/s(2), and 1.66 m/s(2) rms. The results showed that the proposed model was able to reasonably capture the softening characteristics of the human head-neck response during fore-aft whole-body vibration of different magnitudes. PMID:22336196

  4. Modeling of Spinal Column of Seated Human Body under Exposure to Whole-Body Vibration

    NASA Astrophysics Data System (ADS)

    Tamaoki, Gen; Yoshimura, Takuya; Kuriyama, Kaoru; Nakai, Kazuma

    In vehicle systems occupational drivers might expose themselves to vibration for a long time. This may cause illness of the spinal column such as low back pain. Therefore, it is necessary to evaluate the influence of vibration to the spinal column. Thus the modeling of seated human body is conducted in order to evaluate the effect of whole-body vibration to the spinal column. This model has the spinal column and the support structures such as the muscles of the back and the abdomen. The spinal column is made by the vertebrae and the intervertebral disks that are considered the rigid body and the rotational spring and damper respectively. The parameter of this model is decided by the literature and the body type of the subject with respect to the mass and the model structure. And stiffness and damping parameters are searched by fitting the model simulation results to the experimental measured data with respect to the vibration transmissibilities from the seat surface to the spinal column and the head and with respect to the driving-point apparent mass. In addition, the natural modes of the model compare with the result of experimental modal analysis. The influence of the abdomen and the muscles of the back are investigated by comparing three models with respect to above vibration characteristics. Three model are the proposed model, the model that has the spinal column and the model that has the muscles of the back in addition to the spinal column.

  5. Whole body vibration in mountain-rescue operations

    NASA Astrophysics Data System (ADS)

    Alberti, E.; Chiappa, D.; Moschioni, G.; Saggin, B.; Tarabini, M.

    2006-12-01

    In mountain-rescue operations injured people are generally exposed to vibrations and shocks that can be potential causes of physical conditions worsening. Such vibrations can derive both from patient's body manipulations (e.g. when it is being loaded and immobilized on a stretcher) and from forces coming from the transport devices and vehicles. Despite the general feeling that during this kind of operations the levels of transmitted vibrations to the injured can be quite large and potentially dangerous, there is practically no study in literature providing reliable parameters (i.e. measurements) to support or dismiss these beliefs. This paper reports the results of a measurement campaign carried-out in order to outline, identify and quantify the excitations a human body is exposed to, during typical transportation phases related to mountain-rescue operations. The work mainly presents and discusses the experimental setup with the aim of focusing on the problems related to this kind of measurements; the results of the experimental campaign carried-out for the measurement of the vibrations undergone by a human body during a simulated rescue operation are presented and discussed as well. Such simulation includes three phases of transportation: on a hand-held stretcher, on an ambulance and on a helicopter. The work is not intended to supply a complete characterization and analysis of vibrations transmission during any rescue operation but just to provide a preliminary overview and to define a measurement method that can be applied for a more comprehensive characterization. With such aims measurements were carried out in on-field situations stated as "typical" by rescue experts and data then analyzed both with standard procedures and algorithms (e.g. ISO 2631s weighting curves) and with the commonly used statistical indexes; in the analysis it is important to be aware that standardized measurement procedures and indexes, created to verify comfort or health-risks of workers, might not fit the case of a generic patient who experienced a serious mountain accident. The work includes also a laboratory activity mainly related to mechanical characterization of the stretcher used in the field tests. The most interesting result of the study is the comparison of the vibration levels in the various rescue phases that, even when using different indicators, shows that the most critical issue is due to hand transportation despite the bad judgment usually expressed for helicopter flight.

  6. Mind-body therapies in integrative oncology.

    PubMed

    Elkins, Gary; Fisher, William; Johnson, Aimee

    2010-12-01

    There is growing interest in mind-body therapies as adjuncts to mainstream cancer treatment, and an increasing number of patients turn to these interventions for the control of emotional stress associated with cancer. Increased research funding has enabled many such interventions to be evaluated for their efficacy, including studies of mind-body interventions to reduce pain, anxiety, insomnia, anticipatory, and treatment-related nauseas, hot flashes, and improved mood. Mind-body treatments evaluated for their utility in oncology include relaxation therapies, biofeedback, meditation and hypnosis, yoga, art and music therapy, tai chi, and qigong. Although studies are not always methodologically sound and results mixed, a growing number of well-designed studies provide convincing evidence that mind-body techniques are beneficial adjuncts to cancer treatment. The evidence is sufficient to recommend further investigation and adoption of these techniques in mainstream oncology care. PMID:21116746

  7. Guidelines for Whole-Body Vibration Health Surveillance

    NASA Astrophysics Data System (ADS)

    POPE, M.; MAGNUSSON, M.; LUNDSTRÖM, R.; HULSHOF, C.; VERBEEK, J.; BOVENZI, M.

    2002-05-01

    There is strong epidemiological evidence that occupational exposure to WBV is associated with an increased risk of low back pain (LBP), sciatic pain, and degenerative changes in the spinal system, including lumbar intervertebral disc disorders. A prototype health surveillance scheme for WBV is presented in this paper. Surveillance is the collection, analysis, and dissemination of data for the purpose of prevention. The aims are to assess health status and diagnose vibration-induced disorders at an early stage, to inform the workers on the potential risk associated with vibration exposure, to give preventive advice to employers and employees and to control whether preventive measures which have been taken, were successful. It is suggested that a pre-placement health examination should be offered to each worker who will be exposed to WBV so as to make the worker aware of the hazards, to obtain baseline health data, and to identify medical conditions that may increase the risk due to WBV. The case history should focus on personal history, work history, and leisure activities involving driving of vehicles. The personal medical history should detail back pain complaints, disorders in the spine, any injuries or surgery to the musculoskeletal system. A physical examination on the lower back should be performed on workers who have experienced LBP symptoms over the past 12 months. The preplacement examination should be followed by periodic health reassessment with a regular interval according to the legislation of the country. It is suggested that periodic medical examination should be made available at least every 2 years to all workers who are exposed to WBV. Any change in vibration exposure at the workplace should be reported by the employer. If an increase in vibration exposure or a change in health status have occurred, the medical re-examination should be offered at shorter intervals at the discretion of the attending physician. There should be a periodic medical examination, which includes recording any change in exposure to WBV. The findings for the individual should be compared with previous examinations. Group data should also be compiled periodically. Medical removal may be considered along with re-placement in working practices without exposure to WBV. This paper presents opinions on health surveillance for whole-body vibration developed within a working group of partners funded on a European Community Network (BIOMED2 concerted action BMH4-CT98-3251: Research network on detection and prevention of injuries due to occupational vibration exposures). The health surveillance protocol and the draft questionnaire with explanation comments are presented for wider consideration by the science community and others before being considered appropriate for implementation.

  8. Stochastic many-body perturbation theory for anharmonic molecular vibrations

    SciTech Connect

    Hermes, Matthew R.; Hirata, So

    2014-08-28

    A new quantum Monte Carlo (QMC) method for anharmonic vibrational zero-point energies and transition frequencies is developed, which combines the diagrammatic vibrational many-body perturbation theory based on the Dyson equation with Monte Carlo integration. The infinite sums of the diagrammatic and thus size-consistent first- and second-order anharmonic corrections to the energy and self-energy are expressed as sums of a few m- or 2m-dimensional integrals of wave functions and a potential energy surface (PES) (m is the vibrational degrees of freedom). Each of these integrals is computed as the integrand (including the value of the PES) divided by the value of a judiciously chosen weight function evaluated on demand at geometries distributed randomly but according to the weight function via the Metropolis algorithm. In this way, the method completely avoids cumbersome evaluation and storage of high-order force constants necessary in the original formulation of the vibrational perturbation theory; it furthermore allows even higher-order force constants essentially up to an infinite order to be taken into account in a scalable, memory-efficient algorithm. The diagrammatic contributions to the frequency-dependent self-energies that are stochastically evaluated at discrete frequencies can be reliably interpolated, allowing the self-consistent solutions to the Dyson equation to be obtained. This method, therefore, can compute directly and stochastically the transition frequencies of fundamentals and overtones as well as their relative intensities as pole strengths, without fixed-node errors that plague some QMC. It is shown that, for an identical PES, the new method reproduces the correct deterministic values of the energies and frequencies within a few cm{sup −1} and pole strengths within a few thousandths. With the values of a PES evaluated on the fly at random geometries, the new method captures a noticeably greater proportion of anharmonic effects.

  9. Stochastic many-body perturbation theory for anharmonic molecular vibrations

    NASA Astrophysics Data System (ADS)

    Hermes, Matthew R.; Hirata, So

    2014-08-01

    A new quantum Monte Carlo (QMC) method for anharmonic vibrational zero-point energies and transition frequencies is developed, which combines the diagrammatic vibrational many-body perturbation theory based on the Dyson equation with Monte Carlo integration. The infinite sums of the diagrammatic and thus size-consistent first- and second-order anharmonic corrections to the energy and self-energy are expressed as sums of a few m- or 2m-dimensional integrals of wave functions and a potential energy surface (PES) (m is the vibrational degrees of freedom). Each of these integrals is computed as the integrand (including the value of the PES) divided by the value of a judiciously chosen weight function evaluated on demand at geometries distributed randomly but according to the weight function via the Metropolis algorithm. In this way, the method completely avoids cumbersome evaluation and storage of high-order force constants necessary in the original formulation of the vibrational perturbation theory; it furthermore allows even higher-order force constants essentially up to an infinite order to be taken into account in a scalable, memory-efficient algorithm. The diagrammatic contributions to the frequency-dependent self-energies that are stochastically evaluated at discrete frequencies can be reliably interpolated, allowing the self-consistent solutions to the Dyson equation to be obtained. This method, therefore, can compute directly and stochastically the transition frequencies of fundamentals and overtones as well as their relative intensities as pole strengths, without fixed-node errors that plague some QMC. It is shown that, for an identical PES, the new method reproduces the correct deterministic values of the energies and frequencies within a few cm-1 and pole strengths within a few thousandths. With the values of a PES evaluated on the fly at random geometries, the new method captures a noticeably greater proportion of anharmonic effects.

  10. Effects of whole body vibration training on body composition in adolescents with Down syndrome.

    PubMed

    Gonzlez-Agero, Alejandro; Matute-Llorente, Angel; Gmez-Cabello, Alba; Casajs, Jos A; Vicente-Rodrguez, Germn

    2013-05-01

    The present study aimed to determine the effect of 20 weeks of whole body vibration (WBV) on the body composition of adolescents with Down syndrome (DS). Thirty adolescent with DS were divided into two groups: control and WBV. Whole body, upper and lower limbs body fat and lean body mass were measured with dual energy X-ray absorptiometry (DXA) before and after 20 weeks of WBV training. Repeated measures of ANOVA adjusting by height, weight and Tanner stage were used to analyze possible group by time interactions on body composition. The adjusted percentages of change in body composition were also compared between control and WBV groups. No group by time interactions were found for any variable, but the WBV group showed a higher reduction in body fat at the upper limbs (p<0.05), and a tendency toward higher percent increase in whole body lean body mass. Overall, a 20-week WBV training is not enough by itself for increasing lean body mass in adolescents with DS, but it might be helpful for improving body composition in this population. Its relationship with health and autonomy enhances the importance of these results. PMID:23474995

  11. Acute Effects of Loaded Whole Body Vibration Training on Performance

    PubMed Central

    Pojskic, Haris; Pagaduan, Jeffrey; Uzicanin, Edin; Babajic, Fuad; Muratovic, Melika; Tomljanovic, Mario

    2015-01-01

    Background: The application of whole body vibration (WBV) as a warm-up scheme has been receiving an increasing interest among practitioners. Objectives: The aim of this study was to determine the effect of loaded and unloaded WBV on countermovement jump, speed and agility. Patients and Methods: Twenty-one healthy male college football players (age: 20.14 ± 1.65 years; body height: 179.9 ± 8.34 cm; body mass: 74.4 ± 13.0 kg; % body fat: 9.45 ± 4.8) underwent randomized controlled trials that involved standing in a half squat position (ST), ST with 30% of bodyweight (ST + 30%), whole body vibration at f = 50 Hz, A = 4 mm (WBV), and WBV with 30% bodyweight (WBV + 30% BW) after a standardized warm-up. Post measures of countermovement jump, 15-m sprint, and modified t-test were utilized for analyses. Results: One way repeated measures ANOVA revealed a significant difference in the countermovement jump performance, F (3, 60 = 9.06, η2 = 2.21, P = 0.000. Post-hoc showed that WBV + 30% BW posted significant difference compared to (P = 0.008), ST + 30% BW (P = 0.000) and WBV (P = 0.000). There was also a significant difference in the sprint times among interventions, F (3, 60) = 23.0, η2 = 0.865, P = 0.000. Post hoc showed that WBV + 30% BW displayed significantly lower time values than ST (P = 0.000), ST + 30% BW (P = 0.000) and WBV (P = 0.000). Lastly, there was a significant difference in the agility performance across experimental conditions at F(2.01, 40.1) = 21.0, η2 = 0.954, P = 0.000. Post hoc demonstrated that WBV have lower times than ST (P = 0.013). Also, WBV + 30% BW posted lower times compared to ST (P = 0.000), ST + 30% (P = 0.000) and WBV (P = 0.003). Conclusions: Additional external load of 30% bodyweight under WBV posted superior gains in countermovement jump, speed and agility compared to unloaded WBV, loaded non-WBV and unloaded non-WBV interventions. PMID:25883774

  12. A multiple scales approach to sound generation by vibrating bodies

    NASA Technical Reports Server (NTRS)

    Geer, James F.; Pope, Dennis S.

    1992-01-01

    The problem of determining the acoustic field in an inviscid, isentropic fluid generated by a solid body whose surface executes prescribed vibrations is formulated and solved as a multiple scales perturbation problem, using the Mach number M based on the maximum surface velocity as the perturbation parameter. Following the idea of multiple scales, new 'slow' spacial scales are introduced, which are defined as the usual physical spacial scale multiplied by powers of M. The governing nonlinear differential equations lead to a sequence of linear problems for the perturbation coefficient functions. However, it is shown that the higher order perturbation functions obtained in this manner will dominate the lower order solutions unless their dependence on the slow spacial scales is chosen in a certain manner. In particular, it is shown that the perturbation functions must satisfy an equation similar to Burgers' equation, with a slow spacial scale playing the role of the time-like variable. The method is illustrated by a simple one-dimenstional example, as well as by three different cases of a vibrating sphere. The results are compared with solutions obtained by purely numerical methods and some insights provided by the perturbation approach are discussed.

  13. Analysis of non-linear response of the human body to vertical whole-body vibration.

    PubMed

    Tarabini, Marco; Solbiati, Stefano; Moschioni, Giovanni; Saggin, Bortolino; Scaccabarozzi, Diego

    2014-01-01

    The human response to vibration is typically studied using linear estimators of the frequency response function, although different literature works evidenced the presence of non-linear effects in whole-body vibration response. This paper analyses the apparent mass of standing subjects using the conditioned response techniques in order to understand the causes of the non-linear behaviour. The conditioned apparent masses were derived considering models of increasing complexity. The multiple coherence function was used as a figure of merit for the comparison between the linear and the non-linear models. The apparent mass of eight male subjects was studied in six configurations (combinations of three vibration magnitudes and two postures). The contribution of the non-linear terms was negligible and was endorsed to the change of modal parameters during the test. Since the effect of the inter-subject variability was larger than that due to the increase in vibration magnitude, the biodynamic response should be more meaningfully modelled using a linear estimator with uncertainty rather than looking for a non-linear modelling. PMID:25105223

  14. Signal Processing Methods for Removing the Effects of Whole Body Vibration upon Speech

    NASA Technical Reports Server (NTRS)

    Bitner, Rachel M.; Begault, Durand R.

    2014-01-01

    Humans may be exposed to whole-body vibration in environments where clear speech communications are crucial, particularly during the launch phases of space flight and in high-performance aircraft. Prior research has shown that high levels of vibration cause a decrease in speech intelligibility. However, the effects of whole-body vibration upon speech are not well understood, and no attempt has been made to restore speech distorted by whole-body vibration. In this paper, a model for speech under whole-body vibration is proposed and a method to remove its effect is described. The method described reduces the perceptual effects of vibration, yields higher ASR accuracy scores, and may significantly improve intelligibility. Possible applications include incorporation within communication systems to improve radio-communication systems in environments such a spaceflight, aviation, or off-road vehicle operations.

  15. [The effect of whole-body vibration: an unrecognized medical problem].

    PubMed

    Bogadi-Sare, A

    1993-09-01

    Exposure to whole-body vibration is a growing concern in industry, traffic and in other branches of the economy. This harmful physical factor endangers work efficiency and human health not only at work but also in everyday life, in public transportation and even at home. In spite of increasing exposure to vibrations, our medical practice does not pay adequate attention to the health effects of whole-body vibration. The paper deals with the basic characteristics of vibration (frequency, amplitude, velocity and acceleration), its adequate evaluation (effective or weighted average value, peak values, rating and weighting procedure of vibration measurement) and exposure (vibration direction, exposure time, transmission and dissipation). In industry and traffic, vibrations present complex oscillatory motions, characterized by a wide frequency spectrum, variable amplitude and acceleration, and different directions. To assess the harmful effects of vibration, the International Organization for Standardization (ISO) has proposed three standards for acceptable human exposure to whole-body vibration: fatigue-decreased proficiency boundary, exposure limit and reduced comfort boundary. Quantitative parameters of vibration for some vehicles, and for constructional, industrial and agricultural machinery are also given. The most pronounced long-term effect of whole-body vibration is damage to the spine. The spinal region most frequently affected is the lumbar part, where spinal deformation, lumbago and sciatica can develop. The possible cause of spinal damage could be mechanical overload and metabolic changes of the intervertebral disc. Other organ systems, such as peripheral and autonomic nervous, vestibular, vascular, digestive and female reproductive systems are also liable to become affected. Risk assessment of chronic health effects is based on the appropriate evaluation of whole-body vibration exposure and individual response. Health risk increases with the intensity and duration of vibration exposure. The concomitant factors are forced sitting posture and heavy physical work. Human response to whole-body vibration depends on factors promoting the development of degenerative changes such as constitution, previous spine disease and young age. The main problems in diagnosing whole-body vibration syndrome are differentiation of vibration induced disorders from age dependent changes of the spine and lack of a specific diagnostic method for assessing those changes. Therefore, only permanent medical surveillance can guarantee proper assessment of the damage induced by whole-body vibration. For vibration exposed workers preplacement and periodic examinations are recommended. Those should include a basic medical examination and an X-ray of the spine, or at least of its lumbar part. PMID:8311700

  16. A Comparison of Whole-Body Vibration and Resistance Training on Total Work in the Rotator Cuff

    PubMed Central

    Hand, Jason; Verscheure, Susan; Osternig, Louis

    2009-01-01

    Abstract Context: Whole-body vibration machines are a relatively new technology being implemented in the athletic setting. Numerous authors have examined the proposed physiologic mechanisms of vibration therapy and performance outcomes. Changes have mainly been observed in the lower extremity after individual exercises, with minimal attention to the upper extremity and resistance training programs. Objective: To examine the effects of a novel vibration intervention directed at the upper extremity as a precursor to a supervised, multijoint dynamic resistance training program. Design: Randomized controlled trial. Setting: National Collegiate Athletic Association Division IA institution. Patients or Other Participants: Thirteen female student-athletes were divided into the following 2 treatment groups: (1) whole-body vibration and resistance training or (2) resistance training only. Intervention(s): Participants in the vibration and resistance training group used an experimental vibration protocol of 2 60 seconds at 4 mm and 50 Hz, in a modified push-up position, 3 times per week for 10 weeks, just before their supervised resistance training session. Main Outcome Measure(s): Isokinetic total work measurements of the rotator cuff were collected at baseline and at week 5 and week 10. Results: No differences were found between the treatment groups (P > .05). However, rotator cuff output across time increased in both groups (P < .05). Conclusions: Although findings did not differ between the groups, the use of whole-body vibration as a precursor to multijoint exercises warrants further investigation because of the current lack of literature on the topic. Our results indicate that indirectly strengthening the rotator cuff using a multijoint dynamic resistance training program is possible. PMID:19771284

  17. Stereotactic body radiation therapy for liver tumors.

    PubMed

    Maingon, P; Nouhaud, ; Mornex, F; Crhange, G

    2014-01-01

    Recent improvements in radiation therapy delivery techniques provide new tools to treat patients with liver-confined disease, either with hepatocellular carcinoma or liver metastases. An appropriate selection of the patients made during a multidisciplinary specialized tumour board is mandatory. It should be based on the disease extension, an accurate evaluation of the comorbidities and the liver functions. The added value of this approach has to be evaluated in well-designed trials, alone or in combination with other treatments such as surgery, local treatments, chemoembolization and/or chemotherapy with or without targeted agents. Stereotactic body radiation therapy should be applied under strict conditions of expertise of the radiation oncology departments, including equipment and educational training programmes. However under these conditions, preliminary results seems highly encouraging in terms of local control and tolerance but should be confirmed in large controlled prospective trials. PMID:24958684

  18. Possible Mechanisms of Low Back Pain due to Whole-Body Vibration

    NASA Astrophysics Data System (ADS)

    Pope, M. H.; Wilder, D. G.; Magnusson, M.

    1998-08-01

    The investigators describe their multifaceted approach to the study of the relationship between whole-body vibration and low back pain.In vitroexperiments, using percutaneous pin-mounted accelerometers have shown that the natural frequency is at 4·5 Hz. The frequency response was affected by posture, seating, and seat-back inclination. The response appears to be largely determined by the rocking of the pelvis. Electromyographic studies have shown that muscle fatigue occurs under whole body vibration. After whole body vibration exposure the muscle response to a sudden load has greater latency. Vehicle driving may be a reason for low back pain or herniated nucleus pulposus. Prolonged seating exposure, coupled with the whole body vibration should be reduced for those recovering from these problems. Vibration attenuating seats, and correct ergonomic layout of the cabs may reduce the risks of recurrence.

  19. Effects of whole body vibration training on body composition, skeletal muscle strength, and cardiovascular health

    PubMed Central

    Park, Song-Young; Son, Won-Mok; Kwon, Oh-Sung

    2015-01-01

    Whole body vibration training (WBVT) has been used as a supplement to conventional exercise training such as resistance exercise training to improve skeletal muscle strength, specifically, in rehabilitation field. Recently, this exercise modality has been utilized by cardiovascular studies to examine whether WBVT can be a useful exercise modality to improve cardiovascular health. These studies reported that WBVT has not only beneficial effects on muscular strength but also cardiovascular health in elderly and disease population. However, its mechanism underlying the beneficial effects of WBVT in cardiovascular health has not been well documented. Therefore, this review highlighted the impacts of WBVT on cardiovascular health, and its mechanisms in conjunction with the improved muscular strength and body composition in various populations. PMID:26730378

  20. Effects of whole body vibration training on body composition, skeletal muscle strength, and cardiovascular health.

    PubMed

    Park, Song-Young; Son, Won-Mok; Kwon, Oh-Sung

    2015-12-01

    Whole body vibration training (WBVT) has been used as a supplement to conventional exercise training such as resistance exercise training to improve skeletal muscle strength, specifically, in rehabilitation field. Recently, this exercise modality has been utilized by cardiovascular studies to examine whether WBVT can be a useful exercise modality to improve cardiovascular health. These studies reported that WBVT has not only beneficial effects on muscular strength but also cardiovascular health in elderly and disease population. However, its mechanism underlying the beneficial effects of WBVT in cardiovascular health has not been well documented. Therefore, this review highlighted the impacts of WBVT on cardiovascular health, and its mechanisms in conjunction with the improved muscular strength and body composition in various populations. PMID:26730378

  1. Whole-body vibration training improves the walking ability of a moderately impaired child with cerebral palsy: a case study

    PubMed Central

    Yabumoto, Tamotsu; Shin, Sohee; Watanabe, Tsuneo; Watanabe, Yusuke; Naka, Toru; Oguri, Kazuo; Matsuoka, Toshio

    2015-01-01

    [Purpose] Strength training is recommended for children with cerebral palsy. However, it is difficult for moderately impaired children with cerebral palsy, who require crutches for ambulation, to participate in this type of training. The purpose of this study was to investigate whether whole-body vibration training is an effective method of strengthening in a moderately impaired child with cerebral palsy. [Subject and Methods] This report describes an 8-year-old Japanese boy with cerebral palsy, who was ambulatory with crutches. The subject participated in physical therapy twice a week for 5 weeks. Whole-body vibration training was selected to complement the standing practice. The patients crutch-walking ability, gross motor function, and spasticity were evaluated. [Results] The number of steps and walking duration were reduced in a 5-m walk test with crutches and gross motor function was improved. Further, the spasticity was reduced. [Conclusion] Whole-body vibration training is an effective physical therapy intervention in moderately impaired children with cerebral palsy, who are unable to walk without crutches. PMID:26504349

  2. Experimental Evidence of the Tonic Vibration Reflex during Whole-Body Vibration of the Loaded and Unloaded Leg

    PubMed Central

    Zaidell, Lisa N.; Mileva, Katya N.; Sumners, David P.; Bowtell, Joanna L.

    2013-01-01

    Increased muscle activation during whole-body vibration (WBV) is mainly ascribed to a complex spinal and supraspinal neurophysiological mechanism termed the tonic vibration reflex (TVR). However, TVR has not been experimentally demonstrated during low-frequency WBV, therefore this investigation aimed to determine the expression of TVR during WBV.  Whilst seated, eight healthy males were exposed to either vertical WBV applied to the leg via the plantar-surface of the foot, or Achilles tendon vibration (ATV) at 25Hz and 50Hzfor 70s. Ankle plantar-flexion force, tri-axial accelerations at the shank and vibration source, and surface EMG activity of m. soleus (SOL) and m. tibialis anterior (TA) were recorded from the unloaded and passively loaded leg to simulate body mass supported during standing.  Plantar flexion force was similarly augmented by WBV and ATV and increased over time in a load- and frequency dependent fashion. SOL and TA EMG amplitudes increased over time in all conditions independently of vibration mode. 50Hz WBV and ATV resulted in greater muscle activation than 25Hz in SOL when the shank was loaded and in TA when the shank was unloaded despite the greater transmission of vertical acceleration from source to shank with 25Hz and WBV, especially during loading. Low-amplitude WBV of the unloaded and passively loaded leg produced slow tonic muscle contraction and plantar-flexion force increase of similar magnitudes to those induced by Achilles tendon vibration at the same frequencies. This study provides the first experimental evidence supporting the TVR as a plausible mechanism underlying the neuromuscular response to whole-body vibration. PMID:24386466

  3. Acute effects of stochastic resonance whole body vibration

    PubMed Central

    Elfering, Achim; Zahno, Jasmine; Taeymans, Jan; Blasimann, Angela; Radlinger, Lorenz

    2013-01-01

    AIM: To investigate the acute effects of stochastic resonance whole body vibration (SR-WBV) training to identify possible explanations for preventive effects against musculoskeletal disorders. METHODS: Twenty-three healthy, female students participated in this quasi-experimental pilot study. Acute physiological and psychological effects of SR-WBV training were examined using electromyography of descending trapezius (TD) muscle, heart rate variability (HRV), different skin parameters (temperature, redness and blood flow) and self-report questionnaires. All subjects conducted a sham SR-WBV training at a low intensity (2 Hz with noise level 0) and a verum SR-WBV training at a higher intensity (6 Hz with noise level 4). They were tested before, during and after the training. Conclusions were drawn on the basis of analysis of variance. RESULTS: Twenty-three healthy, female students participated in this study (age = 22.4 2.1 years; body mass index = 21.6 2.2 kg/m2). Muscular activity of the TD and energy expenditure rose during verum SR-WBV compared to baseline and sham SR-WBV (all P < 0.05). Muscular relaxation after verum SR-WBV was higher than at baseline and after sham SR-WBV (all P < 0.05). During verum SR-WBV the levels of HRV were similar to those observed during sham SR-WBV. The same applies for most of the skin characteristics, while microcirculation of the skin of the middle back was higher during verum compared to sham SR-WBV (P < 0.001). Skin redness showed significant changes over the three measurement points only in the middle back area (P = 0.022). There was a significant rise from baseline to verum SR-WBV (0.86 0.25 perfusion units; P = 0.008). The self-reported chronic pain grade indicators of pain, stiffness, well-being, and muscle relaxation showed a mixed pattern across conditions. Muscle and joint stiffness (P = 0.018) and muscular relaxation did significantly change from baseline to different conditions of SR-WBV (P < 0.001). Moreover, muscle relaxation after verum SR-WBV was higher than after sham SR-WBV (P < 0.05). CONCLUSION: Verum SR-WBV stimulated musculoskeletal activity in young healthy individuals while cardiovascular activation was low. Training of musculoskeletal capacity and immediate increase in musculoskeletal relaxation are potential mediators of pain reduction in preventive trials. PMID:24147265

  4. Nonlinear dual-axis biodynamic response of the semi-supine human body during longitudinal horizontal whole-body vibration

    NASA Astrophysics Data System (ADS)

    Huang, Ya; Griffin, Michael J.

    2008-04-01

    The resonance frequencies in frequency response functions of the human body (e.g. apparent mass and transmissibility) decrease with increasing vibration magnitude. This nonlinear biodynamic response is found with various sitting and standing postures requiring postural control. The present study measured the apparent mass of the body in a relaxed semi-supine posture with two types of longitudinal horizontal vibration (in the z-axis of the semi-supine body): (i) continuous random excitation (0.25-20 Hz) at five magnitudes (0.125, 0.25, 0.5, 0.75 and 1.0 ms -2 rms); (ii) intermittent random excitation (0.25-20 Hz) alternately at 0.25 and 1.0 ms -2 rms. With continuous random vibration, the dominant primary resonance frequency in the median normalised apparent mass decreased from 3.7 to 2.4 Hz as the vibration magnitude increased from 0.125 to 1.0 ms -2 rms. A nonlinear response was apparent in both the horizontal ( z-axis) apparent mass and the vertical ( x-axis) cross-axis apparent mass. With intermittent random vibration, as the vibration magnitude increased from 0.25 to 1.0 ms -2 rms, the median resonance frequency of the apparent mass decreased from 3.2 to 2.5 Hz whereas, with continuous random vibration over the same range of magnitudes, the resonance frequency decreased from 3.4 to 2.4 Hz. The median change in the resonance frequency (between 0.25 and 1.0 ms -2 rms) was 0.6 Hz with the intermittent random vibration and 0.9 Hz with the continuous random vibration. With intermittent vibration, the resonance frequency was higher at the high magnitude and lower at the low magnitude than with continuous vibration at the same magnitudes. The responses were consistent with passive thixotropy being a primary cause of nonlinear biodynamic responses to whole-body vibration, although reflex activity of the muscles may also have an influence.

  5. Whole-body vibration applied during upper body exercise improves performance.

    PubMed

    Marín, Pedro J; Herrero, Azael J; Milton, John G; Hazell, Tom J; García-López, David

    2013-07-01

    Whole-body vibration (WBV) training has exercisers perform static and dynamic resistance training exercises on a ground-based platform. Exposure to WBV exposure has demonstrated benefits and no effect on lower body strength, power, and performance. The aim of this study was to determine if WBV exposure (50 Hz, 2.51 mm) has any potentiating effects postexercise by measuring the kinematic variables of a set of upper body elbow-extensor exercise (70% one-repetition maximum [1RM]) to volitional exhaustion. Sixteen recreationally active students (12 male and 4 female) performed 3 different experimental conditions on separate days. Each condition had the subjects perform 1 set of elbow-extension exercise to fatigue with 1 of 3 WBV treatments: WBV simultaneously during the set (AE); 60 seconds after application of WBV for 30 seconds (RE); and no WBV (CTRL). Kinematic parameters of each repetition were monitored by linking a rotary encoder to the highest load plate. The mean velocity and acceleration throughout the set and perceived exertion were analyzed. A significant increase (p < 0.05) was observed in the mean velocity for the whole set in the AE condition vs. the CTRL condition. The mean acceleration was significantly higher (p < 0.05) in the AE condition in comparison with RE (increased by 45.3%) and CTRL (increased by 50.4%) conditions. The positive effect induced by WBV on upper-limb performance is only achieved when the stimulus is applied during the exercise. However, WBV applied 60 seconds before upper body exercise results in no benefit. PMID:23085972

  6. Apparent Mass and Absorbed Power during Exposure to Whole-Body Vibration and Repeated Shocks

    NASA Astrophysics Data System (ADS)

    MANSFIELD, N. J.; HOLMLUND, P.; LUNDSTRM, R.

    2001-11-01

    Exposure to mechanical shocks might pose a greater health risk than exposure to continuous vibration. Previous studies have investigated subjective responses, muscle activity or transmission of vibration to the spine or head during shock. If there is a difference between biomechanic responses of the seated body to shocks when compared to continuous vibration, then this may indicate a more, or less, hazardous vibration waveform. This paper presents measurements of apparent mass and absorbed power during exposure to random vibration, repeated shocks and combinations of shocks and random vibration. Eleven male and 13 female subjects were exposed to 15 vibration conditions generated using an electro-dynamic shaker. Subjects were exposed to five 20 s acceleration waveforms with nominally identical power spectra (random vibration, equally spaced shocks, unequally spaced shocks, random combined with equally spaced shocks, random combined with unequally spaced shocks) at each of 05, 10 and 15 m/s2r.m.s. The general shapes of the apparent mass or absorbed power curves were not affected by stimulus type, indicating that the biomechanical response of the body is fundamentally the same when exposed to shocks or random vibration. Two non-linear effects were observed: apparent mass resonance frequencies were slightly higher for exposure to shocks; apparent mass and absorbed power resonance frequencies decreased with increases in vibration magnitude for each stimulus type. It is concluded that the two non-linear mechanisms operate simultaneously: a stiffening effect during exposure to shocks and a softening effect as vibration magnitudes increase. Total absorbed powers were greatest for shock stimuli and least for random vibration.

  7. N-body:Many-body QM:QM vibrational frequencies: Application to small hydrogen-bonded clusters

    NASA Astrophysics Data System (ADS)

    Howard, J. Coleman; Tschumper, Gregory S.

    2013-11-01

    We present an efficient method for reproducing CCSD(T) (i.e., the coupled-cluster method with single, double and perturbative connected triple excitations) optimized geometries and harmonic vibrational frequencies for molecular clusters with the N-body:Many-body QM:QM technique. In this work, all 1-body through N-body interactions are obtained from CCSD(T) computations, and the higher-order interactions are captured at the MP2 level. The linear expressions from the many-body expansion facilitate a straightforward evaluation of geometrical derivative properties (e.g., gradients and Hessians). For (H2O)n clusters (n = 3-7), optimized structures obtained with the 2-body:Many-body CCSD(T):MP2 method are virtually identical to CCSD(T) optimized geometries. Harmonic vibrational frequencies calculated with this 2-body:Many-body approach differ from CCSD(T) frequencies by at most a few cm-1. These deviations can be systematically reduced by including more terms from the many-body expansion at the CCSD(T) level. Maximum deviations between CCSD(T) and 3-body:Many-body CCSD(T):MP2 frequencies are typically only a few tenths of a cm-1 for the H2O clusters examined in this work. These results are obtained at a fraction of the wall time of the supermolecular CCSD(T) computation, and the approach is well-suited for parallelization on relatively modest computational hardware.

  8. Nonlinear dual-axis biodynamic response of the semi-supine human body during vertical whole-body vibration

    NASA Astrophysics Data System (ADS)

    Huang, Ya; Griffin, Michael J.

    2008-04-01

    Nonlinear biodynamic responses are evident in many studies of the apparent masses of sitting and standing subjects in static postures that require muscle activity for postural control. In the present study, 12 male subjects adopted a relaxed semi-supine posture assumed to involve less muscle activity than during static sitting and standing. The supine subjects were exposed to two types of vertical vibration (in the x-axis of the semi-supine body): (i) continuous random vibration (0.25-20 Hz) at five magnitudes (0.125, 0.25, 0.5, 0.75, and 1.0 m s -2 rms); (ii) intermittent random vibration (0.25-20 Hz) alternately at 0.25 and 1.0 m s -2 rms. With continuous random vibration, the dominant primary resonance frequency in the median normalised apparent mass decreased from 10.35 to 7.32 Hz as the vibration magnitude increased from 0.125 to 1.0 m s -2 rms. This nonlinear response was apparent in both the vertical ( x-axis) apparent mass and in the horizontal ( z-axis) cross-axis apparent mass. As the vibration magnitude increased from 0.25 to 1.0 m s -2 rms, the median resonance frequency of the apparent mass with intermittent random vibration decreased from 9.28 to 8.06 Hz whereas, over the same range of magnitudes with continuous random vibration, the resonance frequency decreased from 9.62 to 7.81 Hz. The median change in the resonance frequency (between 0.25 and 1.0 m s -2 rms) was 1.37 Hz with the intermittent random vibration and 1.71 with the continuous random vibration. With the intermittent vibration, the resonance frequency was higher at the high magnitude and lower at the low magnitude than with continuous vibration of the same magnitudes. The response was typical of thixotropy that may be a primary cause of the nonlinear biodynamic responses to whole-body vibration.

  9. Nonlinearity in apparent mass and transmissibility of the supine human body during vertical whole-body vibration

    NASA Astrophysics Data System (ADS)

    Huang, Ya; Griffin, Michael J.

    2009-07-01

    Resonance frequencies evident in the apparent mass and the transmissibility of the human body decrease with increasing vibration magnitude, but the mechanisms responsible for this nonlinearity have not been established. This experiment was designed to explore the effects of body location on the nonlinearity of the body in supine postures. In a group of 12 male subjects, the apparent mass and transmissibility to the sternum, upper abdomen, and lower abdomen were measured in three postures (relaxed semi-supine, flat supine and constrained semi-supine) with vertical random vibration (0.25-20 Hz) at seven vibration magnitudes (nominally 0.0313, 0.0625, 0.125, 0.25, 0.5, 0.75, and 1.0 ms -2 rms). In all three postures, the apparent mass resonance frequencies and the primary peak frequencies in the transmissibilities to the upper and lower abdomen decreased with increases in vibration magnitude from 0.25 to 1.0 ms -2 rms. Nonlinearity generally apparent in transmissibility to the abdomen was less evident in transmissibility to the sternum and less evident in transmissibilities to the abdomen at vibration magnitudes less than 0.125 ms -2 rms. The nonlinearity was more apparent in the flat supine posture than in the semi-supine postures. The findings are consistent with the nonlinearity being associated with the response of soft tissues, more likely a consequence of passive thixotropy than muscle activity.

  10. Varying whole body vibration amplitude differentially affects tendon and ligament structural and material properties.

    PubMed

    Keller, Benjamin V; Davis, Matthew L; Thompson, William R; Dahners, Laurence E; Weinhold, Paul S

    2013-05-31

    Whole Body Vibration (WBV) is becoming increasingly popular for helping to maintain bone mass and strengthening muscle. Vibration regimens optimized for bone maintenance often operate at hypogravity levels (<1G) and regimens for muscle strengthening often employ hypergravity (>1G) vibrations. The effect of vibratory loads on tendon and ligament properties is unclear though excessive vibrations may be injurious. Our objective was to evaluate how tendon gene expression and the mechanical/histological properties of tendon and ligament were affected in response to WBV in the following groups: no vibration, low vibration (0.3G peak-to-peak), and high vibration (2G peak-to-peak). Rats were vibrated for 20 min a day, 5 days a week, for 5 weeks. Upon sacrifice, the medial collateral ligament (MCL), patellar tendon (PT), and the Achilles Tendon (AT) were isolated with insertion sites intact. All tissues were tensile tested to determine structural and material properties or used for histology. Patellar tendon was also subjected to quantitative RT-PCR to evaluate expression of anabolic and catabolic genes. No differences in biomechanical data between the control and the low vibration groups were found. There was evidence of significant weakness in the MCL with high vibration, but no significant effect on the PT or AT. Histology of the MCL and PT showed a hypercellular tissue response and some fiber disorganization with high vibration. High vibration caused an increase in collagen expression and a trend for an increase in IGF-1 expression suggesting a potential anabolic response to prevent tendon overuse injury. PMID:23623311

  11. Fluid dynamic aspects of cardiovascular behavior during low-frequency whole-body vibration

    NASA Technical Reports Server (NTRS)

    Nerem, R. M.

    1973-01-01

    The behavior of the cardiovascular system during low frequency whole-body vibration, such as encountered by astronauts during launch and reentry, is examined from a fluid mechanical viewpoint. The vibration characteristics of typical manned spacecraft and other vibration environments are discussed, and existing results from in vivo studies of the hemodynamic aspects of this problem are reviewed. Recent theoretical solutions to related fluid mechanical problems are then used in the interpretation of these results and in discussing areas of future work. The results are included of studies of the effects of vibration on the work done by the heart and on pulsatile flow in blood vessels. It is shown that important changes in pulse velocity, the instantaneous velocity profile, mass flow rate, and wall shear stress may occur in a pulsatile flow due to the presence of vibration. The significance of this in terms of changes in peripheral vascular resistance and possible damage to the endothelium of blood vessels is discussed.

  12. Display strobing: An effective countermeasure against visual blur from whole-body vibration

    NASA Astrophysics Data System (ADS)

    Adelstein, Bernard D.; Kaiser, Mary K.; Beutter, Brent R.; McCann, Robert S.; Anderson, Mark R.

    2013-11-01

    Crews and equipment in aerospace vehicles, including spacecraft at launch, can be exposed to significant vibration. Prior to this study, we examined the ability of vibrating observers to read alphanumeric symbology on stationary (i.e., non-vibrating) flight-relevant display formats and noted performance degradation with increasing vibration amplitude and decreasing font size. Here we test the efficacy of a display strobing countermeasure for the reading decrements caused by the same 12-Hz whole-body vibration in the surge (chest-to-spine) direction applied in our prior studies. To produce the strobe countermeasure, we triggered the backlight of a stationary liquid crystal diode (LCD) display panel to flash in synchrony with the 12-Hz vibration of the observer's seat while experimentally varying both the strobe duty cycle and phase angle between the strobe onset and the vibration cycle zero-crossings. Strobing proved an effective countermeasure, restoring reading error rates during 0.7g (6.9 m/s2 half-amplitude) whole-body vibration to levels indistinguishable from those achieved under the non-strobed (equivalent luminance) non-vibrating baseline condition and improving response times although not fully to the baseline. While we noted differences in the "preferred" phase angle of individual observers, on average, no overall effect of phase angle was detected. Likewise, no effect was seen for the two duty cycles and their respective equivalent luminance levels. Further studies are needed to determine the efficacy of strobing for multi-axis and multi-frequency vibration, and for displays with moving images.

  13. Effect of 6 weeks of whole body vibration training on total and segmental body composition in healthy young adults.

    PubMed

    Rubio-Arias, J A; Esteban, P; Martínez, F; Ramos-Campo, D J; Mendizábal, S; Berdejo-Del-Fresno, D; Jiménez-Díaz, J F

    2015-12-01

    The applied use of new technologies to enhance performance and improve health has been increasing. Initially, whole body vibration training (WBVT) was used as system to improve elite athlete performance. However, this is also used to improve body composition, especially there is a great attention on the effectiveness of WBVT to reduce fat and body weight, with a potential increase in muscle tissue. The aim of this study was to investigate the effects of a 6-week vibration-training program on total and segmental body composition in a group of physically healthy participants. The final study sample included 64 healthy young adults. Subjects were randomly allocated into the control group (CG: n = 26; 16 males and 10 females) and the experimental group (EGWBVT: n = 38; 19 males and 19 females). The program lasted six weeks with a frequency of three sessions per week and each session varied in intensity. There were not found statistically significant differences in any of the body composition variables analysed. This study suggests that a six-week vibration-training program with an increasing intensity (7.2 g-32.6 g) in healthy young adults that are not overweight did not alter total and segmental body composition. PMID:26690036

  14. Effect of Whole-Body Vibration on Speech. Part 2; Effect on Intelligibility

    NASA Technical Reports Server (NTRS)

    Begault, Durand R.

    2011-01-01

    The effect on speech intelligibility was measured for speech where talkers reading Diagnostic Rhyme Test material were exposed to 0.7 g whole body vibration to simulate space vehicle launch. Across all talkers, the effect of vibration was to degrade the percentage of correctly transcribed words from 83% to 74%. The magnitude of the effect of vibration on speech communication varies between individuals, for both talkers and listeners. A worst case scenario for intelligibility would be the most sensitive listener hearing the most sensitive talker; one participant s intelligibility was reduced by 26% (97% to 71%) for one of the talkers.

  15. [Lung cancer: Stereotactic body radiation therapy and surgery].

    PubMed

    Antoni, D; Srour, I; Mornex, F

    2015-10-01

    Stereotactic body radiation therapy for lung cancer is now well established for patients who are not eligible to surgery. These patients can benefit from a curative treatment, which is a new therapeutic indication. Protocols are effective and well tolerated even for the most fragile patients. Three randomized trials comparing stereotactic body radiation therapy and surgery failed due to poor accrual. However, taking into account the favourable available data, the choice of stereotactic body radiation therapy in first intention arises. The treatment decision has to be discussed in a multidisciplinary way, while considering the opinion of the patient, who must be clearly informed about the principle of both therapeutic options. PMID:26358983

  16. Body awareness therapy for patients with fibromyalgia and chronic pain.

    PubMed

    Gard, Gunvor

    2005-06-17

    There are several therapies designed to increase body awareness. They are commonly known as body awareness therapies (BAT) and include Basic BAT, Mensendieck and Feldenkrais therapy. A focus on emotions is important in all these therapies. In this article the aim and development of Basic BAT is described together with evaluations of treatments including Basic BAT. Multidisciplinary studies have shown that Basic BAT can increase health-related quality of life and cost-effectiveness. However Basic BAT needs to be further studied in relation to patients with fibromyalgia (FM) and chronic pain. Studies so far indicate that Basic BAT has positive effects. PMID:16012065

  17. Effect of Whole Body Vibration on Skin Blood Flow and Nitric Oxide Production

    PubMed Central

    Feland, J. Brent; Johnson, A. Wayne; Mack, Gary W.; Mitchell, Ulrike H.

    2014-01-01

    Background: Vascular dysfunction due to hyperglycemia in individuals with diabetes is a factor contributing to distal symmetric polyneuropathy (DSPN). Reactive oxygen species reduce the bioavailability of nitric oxide (NO), a powerful vasodilator, resulting in reduced circulation and nerve ischemia. Increases in blood NO concentrations and circulation have been attributed to whole body vibration (WBV). The purpose of this study was to the determine the effects of low-frequency, low-amplitude WBV on whole blood NO concentrations and skin blood flow (SBF) in individuals with symptoms of DSPN. Methods: Ten patients with diabetes and impaired sensory perception in the lower limbs participated in this crossover study. Each submitted to 2 treatment conditions, WBV and sham, with a 1-week washout period between. Blood draws for NO analysis and laser Doppler imager scans of SBF were performed before, immediately after, and following a 5-minute recovery of each of the treatments. Results: Low-frequency, low-amplitude WBV significantly increased SBF compared to the sham condition (F2,18 = 5.82, P = .0115). Whole blood NO concentrations did not differ between the WBV and sham conditions immediately or 5 minutes after treatment (F2,18 = 1.88, P = .1813). Conclusions: These findings demonstrate that patients with diabetes respond to WBV with increased SBF compared to the sham condition. The implication is that WBV is a potential nonpharmacological therapy for neurovascular complications of diabetes. PMID:24876449

  18. Vibration Suppression of Car-Body Tilting Vehicle Using Air Springs with Antiroll Damper

    NASA Astrophysics Data System (ADS)

    Tanifuji, Katsuya; Saito, Mitsuru; Soma, Hitoshi; Ishii, Takumi; Kajitani, Yasushi

    In recent years, air-spring-type tilting vehicles, which use air springs as the car-body tilt mechanism, have been employed, even in Shinkansen trains, to increase the operation speed on curved sections. On a test train running at a speed of about 300 km/h with the tilt mechanism, however, it was found that the car-body roll and lateral vibrations increased in compound curves where the plane and vertical curves overlapped. In this study, an analytical model of the air-spring-type tilting vehicle is developed, and a numerical simulation is carried out to clarify the high-speed curving behavior in a compound curve. Then an antiroll damper, which is installed between the car-body and the existing anti-rolling device, is examined as a countermeasure to reduce car-body vibration. As a result, it is shown that the vibration occurring in the compound curve is caused by the centrifugal force generated by the passage of the train on the vertical curve and the imbalance in stiffness between the left and right air springs during tilting. It is also shown that an antiroll damper has a potential to suppress the increase in car-body vibration in compound curves.

  19. Investigation of the transmission of fore and aft vibration through the human body.

    PubMed

    Demić, Miroslav; Lukić, Jovanka

    2009-07-01

    Understanding the behavior of human body under the influence of vibration is of great importance for the optimal motor vehicle system design. Therefore, great efforts are being done in order to discover as many information about the influence of vibration on human body as possible. So far the references show that the major scientific attention has been paid to vertical vibration, although intensive research has been performed lately on the other sorts of excitation. In this paper, the results of the investigation of behavior of human body, in seated position, under the influence of random fore and aft vibration are shown. The investigation is performed by the use of an electro-hydraulic simulator, on a group of 30 healthy male occupants. Experiments are performed in order to give results to improve human body modeling in driving conditions. Excitation amplitudes (1.75 and 2.25 m/s(2) rms) and seat backrest conditions (with and without inclination) were varied. Data results are analyzed by partial coherence and transfer functions. Analyses have been performed and results are given in detail. The results obtained have shown that the human body under the influence of random excitations behaves as a non-linear system and its response depends on spatial position. Obtained results give necessary data to define structure and parameters of human biodynamic model with respect to different excitation and seat backrest position. PMID:18632087

  20. Body Awareness: a phenomenological inquiry into the common ground of mind-body therapies

    PubMed Central

    2011-01-01

    Enhancing body awareness has been described as a key element or a mechanism of action for therapeutic approaches often categorized as mind-body approaches, such as yoga, TaiChi, Body-Oriented Psychotherapy, Body Awareness Therapy, mindfulness based therapies/meditation, Feldenkrais, Alexander Method, Breath Therapy and others with reported benefits for a variety of health conditions. To better understand the conceptualization of body awareness in mind-body therapies, leading practitioners and teaching faculty of these approaches were invited as well as their patients to participate in focus groups. The qualitative analysis of these focus groups with representative practitioners of body awareness practices, and the perspectives of their patients, elucidated the common ground of their understanding of body awareness. For them body awareness is an inseparable aspect of embodied self awareness realized in action and interaction with the environment and world. It is the awareness of embodiment as an innate tendency of our organism for emergent self-organization and wholeness. The process that patients undergo in these therapies was seen as a progression towards greater unity between body and self, very similar to the conceptualization of embodiment as dialectic of body and self described by some philosophers as being experienced in distinct developmental levels. PMID:21473781

  1. Body Awareness: a phenomenological inquiry into the common ground of mind-body therapies.

    PubMed

    Mehling, Wolf E; Wrubel, Judith; Daubenmier, Jennifer J; Price, Cynthia J; Kerr, Catherine E; Silow, Theresa; Gopisetty, Viranjini; Stewart, Anita L

    2011-01-01

    Enhancing body awareness has been described as a key element or a mechanism of action for therapeutic approaches often categorized as mind-body approaches, such as yoga, TaiChi, Body-Oriented Psychotherapy, Body Awareness Therapy, mindfulness based therapies/meditation, Feldenkrais, Alexander Method, Breath Therapy and others with reported benefits for a variety of health conditions. To better understand the conceptualization of body awareness in mind-body therapies, leading practitioners and teaching faculty of these approaches were invited as well as their patients to participate in focus groups. The qualitative analysis of these focus groups with representative practitioners of body awareness practices, and the perspectives of their patients, elucidated the common ground of their understanding of body awareness. For them body awareness is an inseparable aspect of embodied self awareness realized in action and interaction with the environment and world. It is the awareness of embodiment as an innate tendency of our organism for emergent self-organization and wholeness. The process that patients undergo in these therapies was seen as a progression towards greater unity between body and self, very similar to the conceptualization of embodiment as dialectic of body and self described by some philosophers as being experienced in distinct developmental levels. PMID:21473781

  2. Effects of whole-body vibrations on sensory motor system performance in man.

    PubMed

    Gauthier, G M; Roll, J P; Martin, B; Harlay, F

    1981-08-01

    The effects of whole body vibration (WBV) were studied on subjects trained to perform on tasks involving blindfolded arm positioning (proprioceptive tasks), tracking of visual targets and control of static and dynamic torques. Subjects were vibrated in a seated position by means of a hydraulic jack. The vibration used (0.1 G at floor level and 18 Hz) was that occasionally encountered on medium-size cruising helicopter. The seat was that of a heliccopter pilot whose foam cushion was 6 cm thick with a density of 26 kg/m3. Systematic past-pointing was observed for both arm flexion and extension. Foot and arm visual tracking precision, as determined by position and velocity errors, increased in both directions. Static and dynamic control, rated by torque holding stability and torque amplitude precision, were also significantly altered compared to pre-stimulus readings. The results are interpreted in relation to current knowledge of the effects of vibration induced at spinal, vestibular, and central nervous system levels. It is concluded that the proprioceptive system through which vibration-induced afferents enter the neurological networks is the common denominator for the observed alterations of the position, velocity, and force controls. Our observations suggest that particular care should be taken in helicopters and other vibrating vehicles to prevent vibration from reaching muscular masses, especially those involved in motor tasks. PMID:7259700

  3. A rapid procedure for obtaining time-average interferograms of vibrating bodies

    NASA Astrophysics Data System (ADS)

    Rapoport, Eliezer; Bar, Doron; Shiloh, Klara

    1991-04-01

    A method for vibrational analysis by time-average holographic interferometry was developed, based on conventional holography, and especially suitable for laboratories not equipped with ESPI system. It overcomes the main drawback of conventional time-average rocording: the inhibitively cumbersome procedure which requires recording a new hologram for each set of vibrational parameters. Only one holographic recording of the tested object at rest is needed, and image processing techniques are used to construct time-average holographic pictures of the vibrating body over any desired frequency (and amplitude) range. The method is simple, almost as rapid as ESPI (approaching real time), yielding pictures of good quality and fine details with resolution limited by that of the TV camera used. The method was applied to, and is demonstrated in the determination of vibrational modes of jet-engine blades.

  4. HIV Can Persist in Body Despite Drug Therapy

    MedlinePLUS

    ... 156929.html HIV Can Persist in Body Despite Drug Therapy Scientists find virus replicates in lymphoid tissue ... when blood tests of HIV patients on antiretroviral drugs show no sign of the AIDS-causing virus, ...

  5. Controlled whole-body vibration training reduces risk of falls among community-dwelling older adults.

    PubMed

    Yang, Feng; King, George A; Dillon, Loretta; Su, Xiaogang

    2015-09-18

    The primary purpose of this study was to systematically examine the effects of an 8-week controlled whole-body vibration training on reducing the risk of falls among community-dwelling adults. Eighteen healthy elderlies received vibration training which was delivered on a side alternating vibration platform in an intermittent way: five repetitions of 1 min vibration followed by a 1 min rest. The vibration frequency and amplitude were 20 Hz and 3.0mm respectively. The same training was repeated 3 times a week, and the entire training lasted for 8 weeks for a total of 24 training sessions. Immediately prior to (or pre-training) and following (or post-training) the 8-week training course, all participants' risk of falls were evaluated in terms of body balance, functional mobility, muscle strength and power, bone density, range of motion at lower limb joints, foot cutaneous sensation level, and fear of falling. Our results revealed that the training was able to improve all fall risk factors examined with moderate to large effect sizes ranging between 0.55 and 1.26. The important findings of this study were that an 8-week vibration training could significantly increase the range of motion of ankle joints on the sagittal plane (6.4 at pre-training evaluation vs. 9.6 at post-training evaluation for dorsiflexion and 45.8 vs. 51.9 for plantar-flexion, p<0.05 for both); reduce the sensation threshold of the foot plantar surface (p<0.05); and lower the fear of falling (12.2 vs. 10.8, p<0.05). These findings could provide guidance to design optimal whole-body vibration training paradigm for fall prevention among older adults. PMID:26189095

  6. THE ACUTE EFFECT OF WHOLE BODY VIBRATION TRAINING ON FLEXIBILITY AND EXPLOSIVE STRENGTH OF YOUNG GYMNASTS

    PubMed Central

    Kirialanis, P.; Mellos, V.

    2014-01-01

    The purpose of this study was to examine the acute effect of a single bout of whole body vibration (WBV) on flexibility and explosive strength of lower limbs in young artistic gymnasts. Thirty-two young competitive gymnasts volunteered to participate in this study, and were allocated to either the vibration group or traditional body weight training according to the vibration protocol. The vibration intervention consisted of a single bout of eccentric and concentric squatting movements on a vibration platform that was turned on (vibration group: VG n = 15), whereas the traditional body weight (no vibration) group performed the same training protocol with the WBV device turned off (NVG: n= 17). Flexibility (sit and reach test) and explosive strength tests [squat jump (SJ), counter movement jump (CMJ), and single leg squat (right leg (RL) and left leg (LL))] were performed initially (pre-test), immediately after the intervention (post-test 1), and 15 minutes after the end of the intervention programme (post-test 15). Four 2x3 ANOVAs were used to examine the interaction between group (VG vs NVG) and time (pre, post 1, and post 15) with respect to examined variables. The results revealed that a significant interaction between group and time was found with respect to SJ (p < 0.05). However, no significant interaction between group and time was found with respect to flexibility, CMJ, RL and LL after the end of the intervention programme (p > 0.05). Further, the percentage improvement of the VG was significantly greater in all examined variables compared to the NVG. This study concluded that WBV training improves flexibility and explosive strength of lower limbs in young trained artistic gymnasts and maintains the initial level of performance for at least 15 minutes after the WBV intervention programme. PMID:25177103

  7. The acute effect of whole body vibration training on flexibility and explosive strength of young gymnasts.

    PubMed

    Dallas, G; Kirialanis, P; Mellos, V

    2014-08-01

    The purpose of this study was to examine the acute effect of a single bout of whole body vibration (WBV) on flexibility and explosive strength of lower limbs in young artistic gymnasts. Thirty-two young competitive gymnasts volunteered to participate in this study, and were allocated to either the vibration group or traditional body weight training according to the vibration protocol. The vibration intervention consisted of a single bout of eccentric and concentric squatting movements on a vibration platform that was turned on (vibration group: VG n = 15), whereas the traditional body weight (no vibration) group performed the same training protocol with the WBV device turned off (NVG: n= 17). Flexibility (sit and reach test) and explosive strength tests [squat jump (SJ), counter movement jump (CMJ), and single leg squat (right leg (RL) and left leg (LL))] were performed initially (pre-test), immediately after the intervention (post-test 1), and 15 minutes after the end of the intervention programme (post-test 15). Four 2x3 ANOVAs were used to examine the interaction between group (VG vs NVG) and time (pre, post 1, and post 15) with respect to examined variables. The results revealed that a significant interaction between group and time was found with respect to SJ (p < 0.05). However, no significant interaction between group and time was found with respect to flexibility, CMJ, RL and LL after the end of the intervention programme (p > 0.05). Further, the percentage improvement of the VG was significantly greater in all examined variables compared to the NVG. This study concluded that WBV training improves flexibility and explosive strength of lower limbs in young trained artistic gymnasts and maintains the initial level of performance for at least 15 minutes after the WBV intervention programme. PMID:25177103

  8. Mind-body therapies for the management of pain.

    PubMed

    Astin, John A

    2004-01-01

    This paper reviews the evidence for mind-body therapies (eg, relaxation, meditation, imagery, cognitive-behavioral therapy) in the treatment of pain-related medical conditions and suggests directions for future research in these areas. Based on evidence from randomized controlled trials and in many cases, systematic reviews of the literature, the following recommendations can be made: 1) multi-component mind-body approaches that include some combination of stress management, coping skills training, cognitive restructuring and relaxation therapy may be an appropriate adjunctive treatment for chronic low back pain; 2) multimodal mind-body approaches such as cognitive-behavioral therapy, particularly when combined with an educational/informational component, can be an effective adjunct in the management of rheumatoid and osteoarthritis; 3) relaxation and thermal biofeedback may be considered as a treatment for recurrent migraine while relaxation and muscle biofeedback can be an effective adjunct or stand alone therapy for recurrent tension headache; 4) an array of mind-body therapies (eg, imagery, hypnosis, relaxation) when employed pre-surgically, can improve recovery time and reduce pain following surgical procedures; 5) mind-body approaches may be considered as adjunctive therapies to help ameliorate pain during invasive medical procedures. PMID:14668653

  9. Whole-body vibration and health effects in the agricultural machinery drivers.

    PubMed

    Futatsuka, M; Maeda, S; Inaoka, T; Nagano, M; Shono, M; Miyakita, T

    1998-04-01

    Recently farm mechanization has been widespread and developing rapidly, in particular riding farm machines are increasingly used in paddy fields in Japan. We have no information available on the actual situation regarding whole-body vibration on the seats of these farm machines from the standpoint of labour protection. Measurement and evaluation of whole-body vibration was performed on the seats of popular riding agricultural machineries. Whole-body vibration on the seats of combine harvesters and wheel tractors exceeded exposure limits and the fatigue-decreased proficiency boundary limit of 8 hr and also shortened the reduced comfort boundary limits of ISO 2631 (1985). Some combines, tractors and carieers had only less than one hour exposure duration as compared with the ISO 2631-1 standard (1997). On the other hand a questionnaire was also performed on the subject of agricultural machine operators. Any specific injury or other effects, i.e. low back injuries were not found among the group of operators as compared with those in non-operator farmers. It seems to be difficult to find out the health effects of whole-body vibration itself, because there may be a lot of causes, i.e. working posture, operating heavy materials, in farm working conditions. PMID:9583309

  10. Whole body vibration and posture as risk factors for low back pain among forklift truck drivers

    NASA Astrophysics Data System (ADS)

    Hoy, J.; Mubarak, N.; Nelson, S.; Sweerts de Landas, M.; Magnusson, M.; Okunribido, O.; Pope, M.

    2005-06-01

    A cross-sectional study was conducted to investigate the risks from whole-body vibration and posture demands for low back pain (LBP) among forklift truck (forklift) drivers. Using a validated questionnaire, information about health history was obtained over a period of two weeks in face-to-face interviews. The forklift drivers were observed in respect of their sitting posture, including frequency with which different positions were adopted (bending, leaning and twisting) and postural analyses were conducted using the OWAS and RULA techniques. Forklift vibrations at the seat (exposure) were measured in the three orthogonal axes ( x-fore and aft, y-lateral and z-vertical) under actual working conditions according to the recommendations of ISO 2631-1. The results showed that LBP was more prevalent amongst forklift drivers than among non-drivers and driving postures in which the trunk is considerably twisted or bent forward associated with greatest risk. Furthermore, forklift drivers showed to be exposed to acceptable levels of vibration in the x- and y-directions (i.e., below the EU Physical Agents Directive on Vibration Exposure recommended action level—0.5 m/s 2), but not in the z-direction. There were indications that whole-body vibration acts associatively with other factors (not independently) to precipitate LBP.

  11. The effects of whole-body vibration on human biodynamic response.

    PubMed

    Smith, S D

    1995-01-01

    The objective of vibration research at the Armstrong Laboratory includes the expansion and improvement of the measurement, quantification, analysis, and modeling of human vibration response. The driving-point impedance and transmissibility techniques have been expanded and are rigorously applied in the research efforts. Driving-point impedance is defined as the ratio between the transmitted force and input velocity at the point of load application. Transmissibility is typically defined as the ratio between the acceleration level measured at some location on the body and the input acceleration at the seat. These two ratios are used to assess the magnitude and frequency location of resonance behaviors where maximum motions occur in the body. From these data, analytical models are developed which can simulate the motions and coupling behaviors, and predict the stiffness and damping characteristics of the affected anatomical structures. The ultimate goal of the research is to provide new and improved data and modeling capability for revising exposure standards and for developing equipment design guidelines and criteria for improving tolerance and reducing physiological consequences. This paper describes the results of recent studies conducted to identify the biodynamic behavior of major anatomical structures affected by seated whole-body vibration, to develop an analytical model for simulating human vibration response, and to apply the model to evaluate the effects of seat cushion materials on the transmission/attenuation pathways. PMID:11538949

  12. Measurement of whole-body vibration exposure from speed control humps

    NASA Astrophysics Data System (ADS)

    Khorshid, E.; Alkalby, F.; Kamal, H.

    2007-07-01

    The main objective of speed control humps is to introduce shocks and high vibration levels when a car passes over them if its speed is higher than the allowable limit. Hump geometry is a major factor in altering the level of these shocks and specifying the speed limit. However, there is no study of the relationship between whole body vibration due to passing over a speed control hump and lower back pain or occupational diseases. In this study, an experimental investigation is conducted to evaluate health risks associated with different geometry speed control humps. Vibration levels and shocks are measured by a seat pad accelerometer placed under the driver's seat to evaluate hazard risks on the human body's lower back. The assessment is based on two standard methods of measuring whole body vibration: the British standard BS 6841 and the new ISO/DIS standard 2631-5. These methods are used to assess the effects of vehicle type, passenger location in the vehicle, vehicle speed, and speed control hump geometry. It was found that circular speed control humps currently installed on many public roads should be modified in order to eliminate hazards. Two newly designed speed humps were proved to be less hazardous than circular speed control humps.

  13. Spectral composition of a measuring signal during measurements of vibration rates of a moving body

    NASA Technical Reports Server (NTRS)

    Daynauskas, I. A. I.; Slepov, N. N.

    1973-01-01

    Cybernetics diagnostics of machines and mechanisms using the spectral approach is discussed. The problem of establishing the accuracy of determination of the spectral composition is investigated. In systems with rectilinear or rotary movement, the vibrations appear in the form of movement rate vibrations, which are equivalent to frequency modulation of the signal, in proportion to the mean movement rate of the body. The case of a harmonic signal which reproduces and analyzes the characteristics of the frequency modulated signal is discussed. Mathematical models are developed to show the relationships of the parameters.

  14. On the significance of body mass and vibration magnitude for acceleration transmission of vibration through seats with horizontal suspensions

    NASA Astrophysics Data System (ADS)

    Blüthner, Ralph; Hinz, Barbara; Menzel, Gerhard; Schust, Marianne; Seidel, Helmut

    2006-12-01

    Seats with horizontal suspensions can help to reduce detrimental effects of whole-body vibration (WBV) on health, comfort and performance. Two seats were used to examine the effect of body mass and WBV-magnitude on the transmission of WBV from the seat base to the cushion. Both seats have suspension in the x-direction while Seat 2 has suspension also in the y-direction. Twelve subjects with a body mass ranging from 59.0 to 97.3 kg volunteered for the study. A set of anthropometric characteristics was acquired. Three magnitudes of WBV were used with a truck-like signal (Seat 1, 0.3-0.59 m s -2w d-weighted rms values at the seat base, x-direction) and a tractor-like signal (Seat 2, 0.55-1.09 m s -2w d-weighted rms values at the seat base, x-direction, 0.52-1.07 m s -2w d-weighted rms values, y-direction). The magnitude of WBV had a significant effect on the transmissibility characterized by SEAT-values. A significant influence of the body mass on SEAT-values was found for the y-direction only. Other anthropometric characteristics proved to be more important for the prediction of SEAT values by multiple regressions. There was no significant correlation of SEAT-values, x-direction, with the body mass. Other anthropometric characteristics enabled a satisfactory prediction of SEAT values also for x-direction in several cases. Tests with only two subjects of extreme body mass are not suited to obtain comparable and representative results required for a comparison of different seats with a suspension in the x-direction. The effect of the WBV-magnitude on the WBV-transmissibility should be considered with the design, testing and application of suspended seats.

  15. Mind-Body Therapies and Osteoarthritis of the Knee.

    PubMed

    Selfe, Terry Kit; Innes, Kim E

    2009-11-01

    Osteoarthritis of the knee is a major cause of disability among adults worldwide. Important treatment options include nonpharmacologic therapies, and especially symptom management strategies in which patients take an active role. Among these, mind-body therapies may have particular promise for alleviating the distressful symptoms associated with osteoarthritis of the knee. However, systematic reviews are lacking. The objective of this paper is to review English-language articles describing clinical studies evaluating the effects of patient-driven mind-body therapies on symptoms of knee osteoarthritis. Eight studies, representing a total of 267 participants, met the inclusion criteria. Interventions included tai chi, qigong, and yoga. Collectively, these studies suggest that specific mind-body practices may help alleviate pain and enhance physical function in adults suffering from osteoarthritis of the knee. However, sample sizes are small, rigorous investigations are few, and the potential benefits of several mind-body therapies have not yet been systematically tested. Additional high-quality studies are needed to clarify the effects of specific mind-body therapies on standardized measures of pain, physical function, and related indices in persons with osteoarthritis of the knee, and to investigate possible underlying mechanisms. PMID:21151770

  16. Mind-Body Therapies and Osteoarthritis of the Knee

    PubMed Central

    Selfe, Terry Kit; Innes, Kim E.

    2010-01-01

    Osteoarthritis of the knee is a major cause of disability among adults worldwide. Important treatment options include nonpharmacologic therapies, and especially symptom management strategies in which patients take an active role. Among these, mind-body therapies may have particular promise for alleviating the distressful symptoms associated with osteoarthritis of the knee. However, systematic reviews are lacking. The objective of this paper is to review English-language articles describing clinical studies evaluating the effects of patient-driven mind-body therapies on symptoms of knee osteoarthritis. Eight studies, representing a total of 267 participants, met the inclusion criteria. Interventions included tai chi, qigong, and yoga. Collectively, these studies suggest that specific mind-body practices may help alleviate pain and enhance physical function in adults suffering from osteoarthritis of the knee. However, sample sizes are small, rigorous investigations are few, and the potential benefits of several mind-body therapies have not yet been systematically tested. Additional high-quality studies are needed to clarify the effects of specific mind-body therapies on standardized measures of pain, physical function, and related indices in persons with osteoarthritis of the knee, and to investigate possible underlying mechanisms. PMID:21151770

  17. On the Health Risk of the Lumbar Spine due to Whole-Body VIBRATIONTHEORETICAL Approach, Experimental Data and Evaluation of Whole-Body Vibration

    NASA Astrophysics Data System (ADS)

    Seidel, H.; Blthner, R.; Hinz, B.; Schust, M.

    1998-08-01

    The guidance on the effects of vibration on health in standards for whole-body vibration (WBV) does not provide quantitative relationships between WBV and health risk. The paper aims at the elucidation of exposure-response relationships. An analysis of published data on the static and dynamic strength of vertebrae and bone, loaded with various frequencies under different conditions, provided the basis for a theoretical approach to evaluate repetitive loads on the lumbar spine (internal loads). The approach enabled the calculation of equivalentwith respect to cumulative fatigue failurecombinations of amplitudes and numbers of internal cyclic stress. In order to discover the relation between external peak accelerations at the seat and internal peak loads, biodynamic data of experiments (36 subjects, three somatotypes, two different posturesrelaxed and bent forward; random WBV,aw, r.m.s. 14 ms-2, containing high transients) were used as input to a biomechanical model. Internal pressure changes were calculated using individual areas of vertebral endplates. The assessment of WBV was based on the quantitative relations between peak accelerations at the seat and pressures predicted for the disk L5/S1. For identical exposures clearly higher rates of pressure rise in the bent forward compared to the relaxed posture were predicted. The risk assessment for internal forces considered the combined internal static and dynamic loads, in relation to the predicted individual strength, and Miner's hypothesis. For exposure durations between 1 min and 8 h, energy equivalent vibration magnitudes (formula B.1, ISO 2631-1, 1997) and equivalent vibration magnitudes according to formula B.2 (time dependence over-energetic) were compared with equivalent combinations of upward peak accelerations and exposure durations according to predicted cumulative fatigue failures of lumbar vertebrae. Formula B.1 seems to underestimate the health risk caused by high magnitudes, formula B.2 is recommended for the evaluation of such conditions.

  18. Whole body vibration compared to conventional physiotherapy in patients with gonarthrosis: a protocol for a randomized, controlled study

    PubMed Central

    2010-01-01

    Background Osteoarthritis (OA) is the most common degenerative arthropathy. Load-bearing joints such as knee and hip are more often affected than spine or hands. The prevalence of gonarthrosis is generally higher than that of coxarthrosis. Because no cure for OA exists, the main emphasis of therapy is analgesic treatment through either mobility or medication. Non-pharmacologic treatment is the first step, followed by the addition of analgesic medication, and ultimately by surgery. The goal of non-pharmacologic and non-invasive therapy is to improve neuromuscular function, which in turn both prevents formation of and delays progression of OA. A modification of conventional physiotherapy, whole body vibration has been successfully employed for several years. Since its introduction, this therapy is in wide use at our facility not only for gonarthrosis, but also coxarthrosis and other diseases leading to muscular imbalance. Methods/Design This study is a randomized, therapy-controlled trial in a primary care setting at a university hospital. Patients presenting to our outpatient clinic with initial symptoms of gonarthrosis will be assessed against inclusion and exclusion criteria. After patient consent, 6 weeks of treatment will ensue. During the six weeks of treatment, patients will receive one of two treatments, conventional physiotherapy or whole-body-vibration exercises of one hour three times a week. Follow-up examinations will be performed immediately after treatment and after another 6 and 20 weeks, for a total study duration of 6 months. 20 patients will be included in each therapy group. Outcome measurements will include objective analysis of motion and ambulation as well as examinations of balance and isokinetic force. The Western Ontario and McMaster Universities Arthritis Index and SF-12 scores, the patients' overall status, and clinical examinations of the affected joint will be carried out. Discussion As new physiotherapy techniques develop for the treatment of OA, it is important to investigate the effectiveness of competing strategies. With this study, not only patient-based scores, but also objective assessments will be used to quantify patient-derived benefits of therapy. Trial registration Deutsches Register Klinischer Studien (DRKS) DRKS00000415 Clinicaltrials.gov NCT01037972 EudraCT 2009-017617-29 PMID:20565956

  19. An exploratory study of whole-body vibration exposure and dose while operating heavy equipment in the construction industry.

    PubMed

    Cann, Adam P; Salmoni, Alan W; Vi, Peter; Eger, Tammy R

    2003-12-01

    Whole-body vibration measurements were recorded for various types of heavy equipment used within the construction industry. The purpose of these measurements was to provide more information about the potential levels of whole-body vibration experienced by equipment operators in the construction industry, as well as to identify types of equipment warranting further research. In total, 67 pieces of equipment were tested from 14 different equipment types. Testing took place at various construction sites including corporate, public, and residential work projects. Measurements were made (following the 1997 International Standards Organization's 2631-1 whole-body vibration standards) for 20-minute testing periods using a Larson Davis HVM100 vibration monitor and a triaxial accelerometer. The mobile equipment tested was associated with greater levels of whole-body vibration than the stationary equipment. When whole-body vibration levels were compared to the International Standards Organization's 2631-1 standards, wheel loaders, off-road dump trucks, scrapers, skid steer vehicles, backhoes, bulldozers, crawler loaders, and concrete trowel vehicles exceeded the recommendations based on measured vibration dose values. Further research incorporating larger sample sizes and controlled testing conditions is required to better understand the levels of exposure experienced by operators as well as the amount to which seating, terrain, mobility, and vehicle structure might affect whole-body vibration. PMID:14612296

  20. The transmission of vertical vibration through seats: Influence of the characteristics of the human body

    NASA Astrophysics Data System (ADS)

    Toward, Martin G. R.; Griffin, Michael J.

    2011-12-01

    The transmission of vibration through a seat depends on the impedance of the seat and the apparent mass of the seat occupant. This study was designed to determine how factors affecting the apparent mass of the body (age, gender, physical characteristics, backrest contact, and magnitude of vibration) affect seat transmissibility. The transmission of vertical vibration through a car seat was measured with 80 adults (41 males and 39 females aged 18-65) at frequencies between 0.6 and 20 Hz with two backrest conditions (no backrest and backrest), and with three magnitudes of random vibration (0.5, 1.0, and 1.5 m s -2 rms). Linear regression models were used to study the effects of subject physical characteristics (age, gender, and anthropometry) and features of their apparent mass (resonance frequency, apparent mass at resonance and at 12 Hz) on the measured seat transmissibility. The strongest predictor of both the frequency of the principal resonance in seat transmissibility and the seat transmissibility at resonance was subject age, with other factors having only marginal effects. The transmissibility of the seat at 12 Hz depended on subject age, body mass index, and gender. Although subject weight was strongly associated with apparent mass, weight was not strongly associated with seat transmissibility. The resonance frequency of the seat decreased with increases in the magnitude of the vibration excitation and increased when subjects made contact with the backrest. Inter-subject variability in the resonance frequency and transmissibility at resonance was less with greater vibration excitation, but was largely unaffected by backrest contact. A lumped parameter seat-person model showed that changes in seat transmissibility with age can be predicted from changes in apparent mass with age, and that the dynamic stiffness of the seat appeared to increase with increased loading so as to compensate for increases in subject apparent mass associated with increased sitting weight.

  1. Good Vibrations – Effects of Whole Body Vibration on Attention in Healthy Individuals and Individuals with ADHD

    PubMed Central

    Fuermaier, Anselm B. M.; Tucha, Lara; Koerts, Janneke; van Heuvelen, Marieke J. G.; van der Zee, Eddy A.; Lange, Klaus W.; Tucha, Oliver

    2014-01-01

    Objectives Most of the current treatment strategies of ADHD are associated with a number of disadvantages which strengthen the need for alternative or additional approaches for the treatment of ADHD. In this respect, Whole Body Vibration (WBV) might be interesting as it was found to have beneficial effects on a variety of physiological measures. The present study explored the effects of WBV on attention of healthy individuals and adults diagnosed with ADHD. Methods Eighty-three healthy individuals and seventeen adults diagnosed with ADHD participated in the study. WBV treatment was applied passively, while participants were sitting on a chair which was mounted on a vibrating platform. A repeated measure design was employed in order to explore potential effects of WBV treatment on attention within subjects. Attention (i.e. inhibitory control) was measured with a color-word interference paradigm. Results A period of two minutes of WBV treatment had significant beneficial effects of small to medium size on attention of both healthy individuals and adults with ADHD. The effect of WBV treatment on attention did not differ significantly between groups. Conclusions WBV was demonstrated to improve cognitive performance of healthy individuals as well as of individuals with ADHD. WBV treatment is relatively inexpensive and easy to apply and might therefore be of potential relevance for clinical use. The application of WBV treatment as a cognitive enhancement strategy and as a potential treatment of cognitive impairments is discussed. PMID:24587412

  2. Effects of different amplitudes (high vs. low) of whole-body vibration training in active adults.

    PubMed

    Martínez-Pardo, Esmeraldo; Romero-Arenas, Salvador; Alcaraz, Pedro E

    2013-07-01

    The aim of this study was to evaluate the effects of two different amplitudes of whole-body vibrations on the development of strength, mechanical power of the lower limb, and body composition. Thirty-eight recreationally active participants took part in the study. Participants were divided in two experimental groups (low amplitude group [GL] = 2 mm; high amplitude group [GH] = 4 mm) and a control group. The experimental groups performed an incremental vibratory training, 2 days per week during 6 weeks. The frequency of vibration (50 Hz), time of work (60 seconds), and time of rest (60 seconds) were constant for GL and GH groups. All the participants were on the platform in a static semi-squat position. Maximum isokinetic strength, body composition, and performance in vertical jumps (squat and countermovement jumps) were evaluated at the beginning and at the end of the training cycle. A significant increase of isokinetic strength was observed in GL and GH at angular velocities of 60°.s(-1), 180°.s(-1) and 270°.s(-1). Total lean mass was significantly increased in GH (0.9 ± 1.0 kg). There were no significant changes in the total fat mass in any of the groups. Significant changes were not observed in different variables (height, peak power, and rate of force development) derived from the vertical jumps for any of the groups submitted to study. The vibration training, whatever the amplitude, produced significant improvements in isokinetic strength. However, high vibration amplitude training presents better adaptations for hypertrophy than the training with low vibration amplitude. In this sense, GH would be a better training if the practitioners want to develop both strength and hypertrophy of the lower limbs. PMID:23096064

  3. Survey of Technical Preventative Measures to Reduce Whole-Body Vibration Effects when Designing Mobile Machinery

    NASA Astrophysics Data System (ADS)

    DONATI, P.

    2002-05-01

    Engineering solutions to minimize the effects on operators of vibrating mobile machinery can be conveniently grouped into three areas: Reduction of vibration at source by improvement of the quality of terrain, careful selection of vehicle or machine, correct loading, proper maintenance, etc.Reduction of vibration transmission by incorporating suspension systems (tyres, vehicle suspensions, suspension cab and seat) between the operator and the source of vibration.Improvement of cab ergonomics and seat profiles to optimize operator posture. These paper reviews the different techniques and problems linked to categories (2) and (3). According to epidemiological studies, the main health risk with whole-body vibration exposure would appear to be lower back pain. When designing new mobile machinery, all factors which may contribute to back injury should be considered in order to reduce risk. For example, optimized seat suspension is useless if the suspension seat cannot be correctly and easily adjusted to the driver's weight or if the driver is forced to drive in a bent position to avoid his head striking the ceiling due to the spatial requirement of the suspension seat.

  4. Theoretical relationship between vibration transmissibility and driving-point response functions of the human body

    NASA Astrophysics Data System (ADS)

    Dong, Ren G.; Welcome, Daniel E.; McDowell, Thomas W.; Wu, John Z.

    2013-11-01

    The relationship between the vibration transmissibility and driving-point response functions (DPRFs) of the human body is important for understanding vibration exposures of the system and for developing valid models. This study identified their theoretical relationship and demonstrated that the sum of the DPRFs can be expressed as a linear combination of the transmissibility functions of the individual mass elements distributed throughout the system. The relationship is verified using several human vibration models. This study also clarified the requirements for reliably quantifying transmissibility values used as references for calibrating the system models. As an example application, this study used the developed theory to perform a preliminary analysis of the method for calibrating models using both vibration transmissibility and DPRFs. The results of the analysis show that the combined method can theoretically result in a unique and valid solution of the model parameters, at least for linear systems. However, the validation of the method itself does not guarantee the validation of the calibrated model, because the validation of the calibration also depends on the model structure and the reliability and appropriate representation of the reference functions. The basic theory developed in this study is also applicable to the vibration analyses of other structures.

  5. Mind body therapies in rehabilitation of patients with rheumatic diseases.

    PubMed

    Del Rosso, Angela; Maddali-Bongi, Susanna

    2016-02-01

    Mind body therapies (MBT) share a global approach involving both mental and physical dimensions, and focus on relationship between brain, mind, body and behavior and their effects on health and disease. MBT include concentration based therapies and movement based therapies, comprising traditional Oriental practices and somatic techniques. The greatest part of rheumatic diseases have a chronic course, leading to progressive damages at musculoskeletal system and causing physical problems, psychological and social concerns. Thus, rheumatic patients need to be treated with a multidisciplinary approach integrating pharmacological therapies and rehabilitation techniques, that not should only aim to reduce the progression of damages at musculoskeletal system. Thus, MBT, using an overall approach, could be useful in taking care of the overall health of the patients with chronic rheumatic diseases. This review will deal with different MBT and with their effects in the most common chronic rheumatic diseases (Rheumatoid Arthritis, Ankylosing Spondylitis, Fibromyalgia Syndrome). PMID:26850811

  6. Evaluation of lumbar vertebra injury risk to the seated human body when exposed to vertical vibration

    NASA Astrophysics Data System (ADS)

    Ayari, H.; Thomas, M.; Dor, S.; Serrus, O.

    2009-03-01

    The objective of this research is to numerically determine the levels of vibration not to exceed accordingly to the corresponding dynamic stresses in the lumbar rachis when exposed to whole-body vibrations in order to identify the risk of adverse health effect to which professional heavy equipment drivers are particularly prone. A parametric finite element model of the lumbar rachis is generated in order to compute the modal parameters, the dynamic stresses and forces under harmonic excitations in a seated posture. The stress analysis reveals that the areas exposed to the highest fracture risk are the cancellous bone of the vertebral body as well as the vertebral endplate when vertical vibrations are transmitted from a seat to the lumbar spine of a driver. An injury risk factor has been developed in order to estimate the risk of adverse health effect arising from mechanical vibrations. It is shown that the injury risk factor increases with the age and consequently that the excitation amplitude must be limited to lower levels when age increases.

  7. Analysis of damped vibrations of thin bodies embedded into a fractional derivative viscoelastic medium

    NASA Astrophysics Data System (ADS)

    Rossikhin, Yury A.; Shitikova, Marina V.

    2013-04-01

    Damped vibrations of elastic thin bodies, such as plates and circular cylindrical shells, embedded into a viscoelastic medium, the rheological features of which are described by fractional derivatives, are considered in the present article. Besides the forces of viscous friction, a thin body is subjected to the action of external forces dependent on the coordinates of the middle surface and time. The boundary conditions are proposed in such a way that the governing equations allow the Navier-type solution. The Laplace integral transform method and the method of expansion of all functions entering into the set of governing equations in terms of the eigenfunctions of the given problem are used as the methods of solution. It is shown that as a result of such a procedure, the systems of equations in the generalized coordinates could be reduced to infinite sets of uncoupled equations, each of which describes damped vibrations of a mechanical oscillator based on the fractional derivative Kelvin-Voigt model.

  8. Numerical Simulation of Planar and Axisymmetric Unsteady Flows Over Vibrating Bodies

    NASA Astrophysics Data System (ADS)

    Venkat, N. Kolluru

    1991-02-01

    Engineering applications of unsteady boundary layers are numerous and of great importance in hydro and aero dynamics. Relatively little research however is focussed on understanding the flow structure if the perturbations in the flow are caused by the motion of flexible boundaries rather than by time dependent variations in the flow itself. A model is therefore developed to examine the hydrodynamic characteristics of external laminar flow over an arbitrarily shaped body, a portion of which is subjected to harmonic motion. A vorticity-stream function formulation of the Navier-Stokes equations is used. A boundary fitted coordinate system is adopted to allow accurate modeling in the presence of the time dependent motion of the body surface. The flow equations are solved using a Thompson Tri Diagonal Finite Difference Algorithm. Inviscid-viscous interaction theory is used to split the model domain and save computational time. The model is tested by comparison to selected numerical, experimental or analytical results for flow over a cavity, boundary layer flow along a flat plate and time dependent flow in a channel with wavy walls. The model is then applied to predict the flow over a flat plate and circular cylinder with a section forced in simple harmonic motion. The nonlinear response of the flow is investigated for various Reynolds numbers, Re, Strouhal number, St, (ratio of the flow advective time scale to the plate or cylinder oscillation period), vibration amplitude ration, bf{H _ 0} (vibration amplitude divided by plate or cylinder vibrating section length) and the vibration mode number, n. The time varying friction (bf{C_ f}) and pressure ( bf{C_ p}) coefficients along the vibrating plate and cylinder are analyzed using Fast Fourier Transform techniques (FFT). Model results show that for low St and bf {H_ 0} the response of the external flow to the plate vibration amplitude is linear and there is little up or downstream influence. For high St, Re and bf{H_ 0} significant nonlinear energy transfer, as evidenced by the existence of higher harmonics in the downstream pressure wave, occurs between the flow and the plate. The nonlinear energy transfer is controlled by the convective acceleration term near the vibrating surface. Model results also show that the vibrating section can be modeled as a series of distributed source-sink pairs. In the case of axisymmetric flow, the bf{C_ p} and bf{C_ f } distribution along the cylinder surface qualitatively resembles planar flow results.

  9. Three-dimensional modeling of supine human and transport system under whole-body vibration.

    PubMed

    Wang, Yang; Rahmatalla, Salam

    2013-06-01

    The development of predictive computer human models in whole-body vibration has shown some success in predicting simple types of motion, mostly for seated positions and in the uniaxial vertical direction. The literature revealed only a handful of papers that tackled supine human modeling in response to vertical vibration. The objective of this work is to develop a predictive, multibody, three-dimensional human model to simulate the supine human and underlying transport system in response to multidirectional whole-body vibration. A three-dimensional dynamic model of a supine human and its underlying transport system is presented in this work to predict supine-human biodynamic response under three-dimensional input random whole-body vibration. The proposed supine-human model consists of three interconnected segments representing the head, torso-arms, and pelvis-legs. The segments are connected via rotational and translational joints that have spring-damper components simulating the three-dimensional muscles and tissuelike connecting elements in the three x, y, and z directions. Two types of transport systems are considered in this work, a rigid support and a long spinal board attached to a standard military litter. The contact surfaces between the supine human and the underlying transport system are modeled using spring-damper components. Eight healthy supine human subjects were tested under combined-axis vibration files with a magnitude of 0.5?m/s2 (rms) and a frequency content of 0.5-16?Hz. The data from seven subjects were used in parameter identification for the dynamic model using optimization schemes in the frequency domain that minimize the differences between the magnitude and phase of the predicted and experimental transmissibility. The predicted accelerations in the time and frequency domains were comparable to those gathered from experiments under different anthropometric, input vibration, and transport conditions under investigation. Based on the results, the proposed dynamic model has the potential to be used to provide motion data to drive a detailed finite element model of a supine human for further investigation of muscle forces and joint dynamics. The predicted kinematics of the supine human and transport system would also benefit patient safety planners and vibration suppression designers in their endeavors. PMID:23699722

  10. Passive control of vortex induced vibration in internal flow using body shape

    NASA Astrophysics Data System (ADS)

    SnchezSanz, M.; Velazquez, A.

    2011-10-01

    We present a concept for passive control of vortex induced vibration (VIV) that uses the body shape of a prismatic body as the control parameter in 2D internal flow. We consider that the Reynolds number based on the prism cross section height is 200 and that the blockage ratio of the channel is 2.5. The working fluid is water and the solid-to-fluid density ratio is 1, so that the prism presents neutral buoyancy and the body shape parameter ? acts as the only control parameter. Two very different fluid dynamics regimes are observed depending on ? with an abrupt transition between them for ? = ? c , where ? c represents a critical value obtained numerically. For ? < ? c the cylinder oscillation is controlled by vortex shedding and represents a typical case of vortex induced vibration. For ? > ? c the oscillation is a mixture of galloping and vortex induced vibration that causes the prism motion to shift from a stable periodic motion to a highly irregular pattern. The physical explanation for the change of regime is given based on the cylinder equation of motion.

  11. Equal sensation curves for whole-body vibration expressed as a function of driving force

    NASA Astrophysics Data System (ADS)

    Mansfield, Neil J.; Maeda, Setsuo

    2005-06-01

    Previous studies have shown that the seated human is most sensitive to whole-body vertical vibration at about 5 Hz. Similarly, the body shows an apparent mass resonance at about 5 Hz. Considering these similarities between the biomechanical and subjective responses, it was hypothesized that, at low frequencies, subjective ratings of whole-body vibration might be directly proportional to the driving force. Twelve male subjects participated in a laboratory experiment where subjects sat on a rigid seat mounted on a shaker. The magnitude of a test stimulus was adjusted such that the subjective intensity could be matched to a reference stimulus, using a modified Bruceton test protocol. The sinusoidal reference stimulus was 8-Hz vibration with a magnitude of 0.5 m/s2 rms (or 0.25 m/s2 rms for the 1-Hz test); the sinusoidal test stimuli had frequencies of 1, 2, 4, 16, and 32 Hz. Equal sensation contours in terms of seat acceleration showed data similar to those in the literature. Equal sensation contours in terms of force showed a nominally linear response at 1, 2, and 4 Hz, but an increasing sensitivity at higher frequencies. This is in agreement with a model derived from published subjective and objective fitted data. .

  12. Acute Whole-Body Vibration does not Facilitate Peak Torque and Stretch Reflex in Healthy Adults

    PubMed Central

    Yeung, Ella W.; Lau, Cheuk C.; Kwong, Ada P.K.; Sze, Yan M.; Zhang, Wei Y.; Yeung, Simon S.

    2014-01-01

    The acute effect of whole-body vibration (WBV) training may enhance muscular performance via neural potentiation of the stretch reflex. The purpose of this study was to investigate if acute WBV exposure affects the stretch induced knee jerk reflex [onset latency and electromechanical delay (EMD)] and the isokinetic knee extensor peak torque performance. Twenty-two subjects were randomly assigned to the intervention or control group. The intervention group received WBV in a semi-squat position at 30° knee flexion with an amplitude of 0.69 mm, frequency of 45 Hz, and peak acceleration of 27.6 m/s2 for 3 minutes. The control group underwent the same semii-squatting position statically without exposure of WBV. Two-way mixed repeated measures analysis of variance revealed no significant group effects differences on reflex latency of rectus femoris (RF) and vastus lateralis (VL; p = 0.934 and 0.935, respectively) EMD of RF and VL (p = 0.474 and 0.551, respectively) and peak torque production (p = 0.483) measured before and after the WBV. The results of this study indicate that a single session of WBV exposure has no potentiation effect on the stretch induced reflex and peak torque performance in healthy young adults. Key Points There is no acute potentiation of stretch reflex right after whole body vibration. Acute whole body vibration does not improve mus-cle peak torque performance in healthy young adults. PMID:24570602

  13. Influence of Combined Whole-Body Vibration Plus G-Loading on Visual Performance

    NASA Technical Reports Server (NTRS)

    Adelstein, Bernard D.; Beutter, Brent Robert; Kaiser, Mary K.; McCann, Robert S.; Stone, Leland S.; Anderson, Mark R.; Renema, Fritz; Paloski, William H.

    2009-01-01

    Recent engineering analyses of the integrated Ares-Orion stack show that vibration levels for Orion crews have the potential to be much higher than those experienced in Gemini, Apollo, and Shuttle vehicles. Of particular concern to the Constellation Program (CxP) is the 12 Hz thrust oscillation (TO) that the Ares-I rocket develops during the final 20 seconds preceding first-stage separation, at maximum G-loading. While the structural-dynamic mitigations being considered can assure that vibration due to TO is reduced to below the CxP crew health limit, it remains to be determined how far below this limit vibration must be reduced to enable effective crew performance during launch. Moreover, this "performance" vibration limit will inform the operations concepts (and crew-system interface designs) for this critical phase of flight. While Gemini and Apollo studies provide preliminary guidance, the data supporting the historical limits were obtained using less advanced interface technologies and very different operations concepts. In this study, supported by the Exploration Systems Mission Directorate (ESMD) Human Research Program, we investigated display readability-a fundamental prerequisite for any interaction with electronic crew-vehicle interfaces-while observers were subjected to 12 Hz vibration superimposed on the 3.8 G loading expected for the TO period of ascent. Two age-matched groups of participants (16 general population and 13 Crew Office) performed a numerical display reading task while undergoing sustained 3.8 G loading and whole-body vibration at 0, 0.15, 0.3, 0.5, and 0.7 g in the eyeballs in/out (x-axis) direction. The time-constrained reading task used an Orion-like display with 10- and 14-pt non-proportional sans-serif fonts, and was designed to emulate the visual acquisition and processing essential for crew system monitoring. Compared to the no-vibration baseline, we found no significant effect of vibration at 0.15 and 0.3 g on task error rates (ER) or response times (RT). Significant degradations in both ER and RT, however, were observed at 0.5 and 0.7 g for 10-pt, and at 0.7 g for 14-pt font displays. These objective performance measures were mirrored by participants' subjective ratings. Interestingly, we found that the impact of vibration on ER increased with distance from the center of the display, but only for vertical displacements. Furthermore, no significant ER or RT aftereffects were detected immediately following vibration, regardless of amplitude. Lastly, given that our reading task required no specialized spaceflight expertise, our finding that effects were not statistically distinct between our two groups is not surprising. The results from this empirical study provide initial guidance for evaluating the display readability trade-space between text-font size and vibration amplitude. However, the outcome of this work should be considered preliminary in nature for a number of reasons: 1. The single 12 Hz x-axis vibration employed was based on earlier load-cycle models of the induced TO environment at the end of Ares-I first stage flight. Recent analyses of TO mitigation designs suggest that significant concurrent off-axis vibration may also occur. 2. The shirtsleeve environment in which we tested fails to capture the full kinematic and dynamic complexity of the physical interface between crewmember and the still-to-bematured helmet-suit-seat designs, and the impact these will have for vibration transmission and consequent performance. 3. By examining performance in this reading and number processing task, we are only assessing readability, a first and necessary step that in itself does not directly address the performance of more sophisticated operational tasks such as vehicle-health monitoring or manual control of the vehicle.

  14. Modelling resonances of the standing body exposed to vertical whole-body vibration: Effects of posture

    NASA Astrophysics Data System (ADS)

    Subashi, G. H. M. J.; Matsumoto, Y.; Griffin, M. J.

    2008-10-01

    Lumped parameter mathematical models representing anatomical parts of the human body have been developed to represent body motions associated with resonances of the vertical apparent mass and the fore-and-aft cross-axis apparent mass of the human body standing in five different postures: 'upright', 'lordotic', 'anterior lean', 'knees bent', and 'knees more bent'. The inertial and geometric parameters of the models were determined from published anthropometric data. Stiffness and damping parameters were obtained by comparing model responses with experimental data obtained previously. The principal resonance of the vertical apparent mass, and the first peak in the fore-and-aft cross-axis apparent mass, of the standing body in an upright posture (at 5-6 Hz) corresponded to vertical motion of the viscera in phase with the vertical motion of the entire body due to deformation of the tissues at the soles of the feet, with pitch motion of the pelvis out of phase with pitch motion of the upper body above the pelvis. Upward motion of the body was in phase with the forward pitch motion of the pelvis. Changing the posture of the upper body had minor effects on the mode associated with the principal resonances of the apparent mass and cross-axis apparent mass, but the mode changed significantly with bending of the legs. In legs-bent postures, the principal resonance (at about 3 Hz) was attributed to bending of the legs coupled with pitch motion of the pelvis in phase with pitch motion of the upper body. In this mode, extension of the legs was in phase with the forward pitch motion of the upper body and the upward vertical motion of the viscera.

  15. Stereotactic Body Radiation Therapy in Spinal Metastases

    SciTech Connect

    Ahmed, Kamran A.; Stauder, Michael C.; Miller, Robert C.; Bauer, Heather J.; Rose, Peter S.; Olivier, Kenneth R.; Brown, Paul D.; Brinkmann, Debra H.; Laack, Nadia N.

    2012-04-01

    Purpose: Based on reports of safety and efficacy, stereotactic body radiotherapy (SBRT) for treatment of malignant spinal tumors was initiated at our institution. We report prospective results of this population at Mayo Clinic. Materials and Methods: Between April 2008 and December 2010, 85 lesions in 66 patients were treated with SBRT for spinal metastases. Twenty-two lesions (25.8%) were treated for recurrence after prior radiotherapy (RT). The mean age of patients was 56.8 {+-} 13.4 years. Patients were treated to a median dose of 24 Gy (range, 10-40 Gy) in a median of three fractions (range, 1-5). Radiation was delivered with intensity-modulated radiotherapy (IMRT) and prescribed to cover 80% of the planning target volume (PTV) with organs at risk such as the spinal cord taking priority over PTV coverage. Results: Tumor sites included 48, 22, 12, and 3 in the thoracic, lumbar, cervical, and sacral spine, respectively. The mean actuarial survival at 12 months was 52.2%. A total of 7 patients had both local and marginal failure, 1 patient experienced marginal but not local failure, and 1 patient had local failure only. Actuarial local control at 1 year was 83.3% and 91.2% in patients with and without prior RT. The median dose delivered to patients who experienced local/marginal failure was 24 Gy (range, 18-30 Gy) in a median of three fractions (range, 1-5). No cases of Grade 4 toxicity were reported. In 1 of 2 patients experiencing Grade 3 toxicity, SBRT was given after previous radiation. Conclusion: The results indicate SBRT to be an effective measure to achieve local control in spinal metastases. Toxicity of treatment was rare, including those previously irradiated. Our results appear comparable to previous reports analyzing spine SBRT. Further research is needed to determine optimum dose and fractionation to further improve local control and prevent toxicity.

  16. Transverse vibration and buckling of a cantilevered beam with tip body under constant axial base acceleration

    NASA Technical Reports Server (NTRS)

    Storch, J.; Gates, S.

    1983-01-01

    The planar transverse bending behavior of a uniform cantilevered beam with rigid tip body subject to constant axial base acceleration was analyzed. The beam is inextensible and capable of small elastic transverse bending deformations only. Two classes of tip bodies are recognized: (1) mass centers located along the beam tip tangent line; and (2) mass centers with arbitrary offset towards the beam attachment point. The steady state response is studied for the beam end condition cases: free, tip mass, tip body with restricted mass center offset, and tip body with arbitrary mass center offset. The first three cases constitute classical Euler buckling problems, and the characteristic equation for the critical loads/accelerations are determined. For the last case a unique steady state solution exists. The free vibration response is examined for the two classes of tip body. The characteristic equation, eigenfunctions and their orthogonality properties are obtained for the case of restricted mass center offset. The vibration problem is nonhomogeneous for the case of arbitrary mass center offset. The exact solution is obtained as a sum of the steady state solution and a superposition of simple harmonic motions.

  17. Whole-body vibration and ergonomic study of US railroad locomotives

    NASA Astrophysics Data System (ADS)

    Johanning, Eckardt; Landsbergis, Paul; Fischer, Siegfried; Christ, Eberhard; Göres, Benno; Luhrman, Raymond

    2006-12-01

    US locomotive operators have exposure to multi-axis whole-body vibration (WBV) and shocks while seated. This study assessed operator-related and ergonomic seating design factors that may have confounding or mitigating influence on WBV exposure and its effects. Vibration exposure was measured according to international guidelines (ISO 2631-1; 1997); ergonomic work place factors and vibration effects were studied with a cross-sectional survey instrument distributed to a randomly selected group of railroad engineers ( n=2546) and a control group; and during vehicle inspections. The survey response rate was 47% for the RR engineers ( n=1195) and 41% for the controls ( n=323). Results of the mean basic vibration measurements were for the x, y, z-direction and vector sum 0.14, 0.22, 0.28 and 0.49 m/s 2 respectively; almost all crest factors (CF), MTVV and VDV values were above the critical ratios given in ISO 2631-1. The prevalence of serious neck and lower back disorders among locomotive engineers was found to be nearly double that of the sedentary control group without such exposure. Railroad engineers rated their seats mostly unacceptable regarding different adjustment and comfort aspects (3.02-3.51; scale 1=excellent to 4=unacceptable), while the control group rated their chairs more favorably (1.96-3.44). Existing cab and seat design in locomotives can result in prolonged forced awkward spinal posture of the operator combined with WBV exposure. In a logistic regression analysis, time at work being bothered by vibration (h/day) was significantly associated with an increased risk of low back pain, shoulder and neck pain, and sciatic pain among railroad engineers. Customized vibration attenuation seats and improved cab design of the locomotive controls should be further investigated.

  18. The Influence of Whole-Body Vibration on Creatine Kinase Activity and Jumping Performance in Young Basketball Players

    ERIC Educational Resources Information Center

    Fachina, Rafael; da Silva, Antnio; Falco, William; Montagner, Paulo; Borin, Joo; Minozzo, Fbio; Falco, Diego; Vancini, Rodrigo; Poston, Brach; de Lira, Claudio

    2013-01-01

    Purpose: To quantify creatine kinase (CK) activity changes across time following an acute bout of whole-body vibration (WBV) and determine the association between changes in CK activity and jumping performance. Method: Twenty-six elite young basketball players were assigned to 3 groups: 36-Hz and 46-Hz vibration groups (G36 and G46, respectively)

  19. The Influence of Whole-Body Vibration on Creatine Kinase Activity and Jumping Performance in Young Basketball Players

    ERIC Educational Resources Information Center

    Fachina, Rafael; da Silva, Antônio; Falcão, William; Montagner, Paulo; Borin, João; Minozzo, Fábio; Falcão, Diego; Vancini, Rodrigo; Poston, Brach; de Lira, Claudio

    2013-01-01

    Purpose: To quantify creatine kinase (CK) activity changes across time following an acute bout of whole-body vibration (WBV) and determine the association between changes in CK activity and jumping performance. Method: Twenty-six elite young basketball players were assigned to 3 groups: 36-Hz and 46-Hz vibration groups (G36 and G46, respectively)…

  20. Body Percept Change in Obese Females after Weight Reduction Therapy.

    ERIC Educational Resources Information Center

    Collins, John K.; And Others

    1983-01-01

    Measured video-image representations of body size for 68 females undergoing weight reduction counseling. All judged themselves significantly more obese than they actually were. After therapy, more realistic estimates of their physiques ensued. Dropouts saw themselves as significantly more obese than those who graduated from the program. (JAC)

  1. Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder

    ERIC Educational Resources Information Center

    Greenberg, Jennifer L.; Markowitz, Sarah; Petronko, Michael R.; Taylor, Caitlin E.; Wilhelm, Sabine; Wilson, G. Terence

    2010-01-01

    The onset of appearance-related concerns associated with body dysmorphic disorder (BDD) typically occurs in adolescence, and these concerns are often severe enough to interfere with normal development and psychosocial functioning. Cognitive behavioral therapy (CBT) is an effective treatment for adults with BDD. However, no treatment studies

  2. Modular Cognitive-Behavioral Therapy for Body Dysmorphic Disorder

    ERIC Educational Resources Information Center

    Wilhelm, Sabine; Phillips, Katharine A.; Fama, Jeanne M.; Greenberg, Jennifer L.; Steketee, Gail

    2011-01-01

    This study pilot tested a newly developed modular cognitive-behavioral therapy (CBT) treatment manual for body dysmorphic disorder (BDD). We tested feasibility, acceptability, and treatment outcome in a sample of 12 adults with primary BDD. Treatment was delivered in weekly individual sessions over 18 or 22 weeks. Standardized clinician ratings…

  3. Modular Cognitive-Behavioral Therapy for Body Dysmorphic Disorder

    ERIC Educational Resources Information Center

    Wilhelm, Sabine; Phillips, Katharine A.; Fama, Jeanne M.; Greenberg, Jennifer L.; Steketee, Gail

    2011-01-01

    This study pilot tested a newly developed modular cognitive-behavioral therapy (CBT) treatment manual for body dysmorphic disorder (BDD). We tested feasibility, acceptability, and treatment outcome in a sample of 12 adults with primary BDD. Treatment was delivered in weekly individual sessions over 18 or 22 weeks. Standardized clinician ratings

  4. Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder

    ERIC Educational Resources Information Center

    Greenberg, Jennifer L.; Markowitz, Sarah; Petronko, Michael R.; Taylor, Caitlin E.; Wilhelm, Sabine; Wilson, G. Terence

    2010-01-01

    The onset of appearance-related concerns associated with body dysmorphic disorder (BDD) typically occurs in adolescence, and these concerns are often severe enough to interfere with normal development and psychosocial functioning. Cognitive behavioral therapy (CBT) is an effective treatment for adults with BDD. However, no treatment studies…

  5. Acute Effects of Whole Body Vibration on Inhibition in Healthy Children

    PubMed Central

    den Heijer, Anne E.; Groen, Yvonne; Fuermaier, Anselm B. M.; van Heuvelen, Marieke J. G.; van der Zee, Eddy A.; Tucha, Lara; Tucha, Oliver

    2015-01-01

    Objectives Whole Body Vibration (WBV) is a passive exercise method known to have beneficial effects on various physical measures. Studies on adults furthermore demonstrated beneficial effects of WBV treatment on cognition (e.g. inhibition). The present study replicated these findings in healthy children and examined acute effects of WBV treatment on inhibition. Methods Fifty-five healthy children (aged 8–13) participated in this within-subject design study. WBV treatment was applied by having the children sit on a chair mounted to a vibrating platform. After each condition (vibration vs. non-vibration), inhibition was measured by using the Stroop Color-Word Interference Test. Repeated measures analyses were applied in order to explore the effects of WBV treatment on inhibition, and correlations were computed between the treatment effect and participant characteristics in order to explore individual differences in treatment sensitivity. Results Three-minute WBV treatments had significant beneficial effects on inhibition in this sample of healthy children. Especially the repeated application (three times) of WBV treatment appeared beneficial for cognition. Stronger WBV treatment effects were correlated with higher intelligence and younger age, but not with symptoms of Attention Deficit Hyperactivity Disorder (ADHD). Conclusions This study demonstrates that especially repeated WBV treatment improves inhibition in healthy children. As this cognitive function is often impaired in children with developmental disorders (e.g. ADHD), future studies should further explore the effects, working mechanism and potential applicability of WBV treatment for this target group. PMID:26524188

  6. The multi-body system modelling of the Gough-Stewart platform for vibration control

    NASA Astrophysics Data System (ADS)

    Cheng, Yuan; Ren, Gexue; Dai, Shiliang

    2004-04-01

    This paper studies the dynamics and control of the Gough-Stewart platform for vibration control of a flexible supporting structure. The problem arises from a large radio telescope in which the astronomical equipment is mounted on a platform to be stabilized by a Gough-Stewart platform, while the base platform of the mechanism itself is carried by a vibrating cable-car that moves along flexible cables. As the base platform is not fixed on the ground, the reaction force caused by the motion of the stabilized platform will lead to perturbation on the base platform, and will induce vibration of the whole system. To study the feasibility for vibration control, this paper models the Stewart parallel mechanism as a multi-body systems with an elastically restrained base platform by the Newton-Euler method and proposes a PD control law based on the position prediction of the two platforms. Control simulations are carried out with the simulated wind excitations. The control effects are evaluated by comparing the root-mean-square responses of the stabilized platform.

  7. Benefits of helmet-mounted display image stabilisation under whole-body vibration.

    PubMed

    Wells, M J; Griffin, M J

    1984-01-01

    The effects of whole-body vertical vibration in the range 2.5-25 Hz on visual performance with two types of raster scan helmet-mounted display have been determined. The benefit of an image stabilisation system on numeral reading performance during vibration was also assessed with both display systems. Increases in mean reading time of over 130%/m . s-2 R.M.S. and increases in percentage reading error of more than 30%/m . s-2 R.M.S. were recorded with unstabilised displays. With vertical and horizontal image stabilisation, these decrements in performance were reduced to less than 40%/m . s-2 R.M.S. increase in reading time and less than 10%/m . s-2 R.M.S. increase in reading error. Data on the transmission of vibration from the seat to the head and from the head to the helmet were also obtained. These indicate a relation between biodynamic behaviour and visual performance during vibration. PMID:6696690

  8. Flow-Induced Vibrations of Prismatic Bodies and Grids of Prisms

    NASA Astrophysics Data System (ADS)

    Naudascher, E.; Wang, Y.

    1993-05-01

    Flow-induced transverse, torsional, streamwise, and plunging vibrations of prismatic bodies and grids composed of prisms are reviewed for a wide range of cross-sectional shapes and angles of incidence. For flow at zero incidence, rectangular prisms are susceptible to three kinds of vortex-induced excitation, in addition to galloping and wake breathing, depending on their chord-to-thickness ratio. These include leading-edge vortex shedding (LEVS), impinging leading-edge vortices (ILEV), and trailing-edge vortex shedding (TEVS). A prism with elongated cross-section typical of elements of a trashrack or a headlight screen, which is free to vibrate in the transverse direction, may be excited by different harmonics of ILEV for incidence angles up to 13° and by alternate-edge vortex shedding (AEVS) for larger angles. Excitation by ILEV diminishes drastically with increases of the degree of turbulence in the approach flow. If a rectangular prism of elongated section has a degree of freedom in the longitudinal direction, on the other hand, it may undergo violent plunging vibrations, excited by AEVS, for incidence angles of about 13° and larger. Rounding the leading and trailing edges amplifies this excitation. As demonstrated by a practical example, serious vibrations can be avoided if the grid or trashrack is stiff enough, so that the maximum reduced velocity stays below the critical values marking the onsets of all the possible sources of excitation.

  9. Can an iPod Touch be used to assess whole-body vibration associated with mining equipment?

    PubMed

    Wolfgang, Rebecca; Di Corleto, Luke; Burgess-Limerick, Robin

    2014-11-01

    The cost and complexity of commercially available whole-body vibration measurement devices is a barrier to the systematic collection of the information required to manage this hazard. The potential for a consumer electronic device to be used to estimate whole-body vibration was assessed by collecting 58 simultaneous pairs of acceleration measurements in three dimensions from a fifth-generation iPod Touch and gold standard whole-body vibration measurement devices, while a range of heavy mining equipment was operated at three surface coal mines. The results suggest that accelerometer data gathered from a consumer electronic device are able to be used to measure whole-body vibration amplitude with 95% confidence of 0.06 m s(-2) root mean square for the vertical direction (1.96 standard deviation of the constant error). PMID:25106947

  10. Effect of whole-body vibration warm-up on bat speed in women softball players.

    PubMed

    Dabbs, Nicole C; Brown, Lee E; Coburn, Jared W; Lynn, Scott K; Biagini, Matt S; Tran, Tai T

    2010-09-01

    Whole-body vibration (WBV) may enhance human performance via augmented muscular strength and motor function if used before performance. Because warm-up is a crucial aspect of preparation for performance, it remains unknown if WBV may enhance bat speed. The purpose of this study was to investigate the effect of WBV warm-up on bat speed. Eleven National Collegiate Athletic Association division I and 11 recreationally trained female softball players volunteered to participate. Subjects randomly performed 3 different warm-up conditions consisting of WBV alone, dry swings alone (DS), and WBV with dry swings (WBVDS). Whole-body vibration was performed on a pivotal vibration platform at a frequency of 25 Hz and an amplitude of 13 mm for one 30-second bout. Thirty seconds after each warm-up condition, 5 maximal bat swings were recorded. There was no significant (p > 0.05) difference between groups by training status, and there was no significant (p > 0.05) difference between WBV (42.39 +/- 9.83 mph), DS (40.45 +/- 11.00 mph), or WBVDS (37.98 +/- 12.40 mph) conditions. These results indicate that WBV warm-up may be used in place of DS to achieve similar bat speeds. Future research should investigate different combinations of WBV warm-up using various frequencies, durations, amplitudes, and rest times. PMID:20683351

  11. What is the most effective posture to conduct vibration from the lower to the upper extremities during whole-body vibration exercise?

    PubMed Central

    Tsukahara, Yuka; Iwamoto, Jun; Iwashita, Kosui; Shinjo, Takuma; Azuma, Koichiro; Matsumoto, Hideo

    2016-01-01

    Background Whole-body vibration (WBV) exercise is widely used for training and rehabilitation. However, the optimal posture for training both the upper and lower extremities simultaneously remains to be established. Objectives The objective of this study was to search for an effective posture to conduct vibration from the lower to the upper extremities while performing WBV exercises without any adverse effects. Methods Twelve healthy volunteers (age: 22–34 years) were enrolled in the study. To measure the magnitude of vibration, four accelerometers were attached to the upper arm, back, thigh, and calf of each subject. Vibrations were produced using a WBV platform (Galileo 900) with an amplitude of 4 mm at two frequencies, 15 and 30 Hz. The following three postures were examined: posture A, standing posture with the knees flexed at 30°; posture B, crouching position with no direct contact between the knees and elbows; and posture C, crouching position with direct contact between the knees and elbows. The ratio of the magnitude of vibration at the thigh, back, and upper arm relative to that at the calf was used as an index of vibration conduction. Results Posture B was associated with a greater magnitude of vibration to the calf than posture A at 15 Hz, and postures B and C were associated with greater magnitudes of vibration than posture A at 30 Hz. Posture C was associated with a vibration conduction to the upper arm that was 4.62 times and 8.26 times greater than that for posture A at 15 and 30 Hz, respectively. Conclusion This study revealed that a crouching position on a WBV platform with direct contact between the knees and elbows was effective for conducting vibration from the lower to the upper extremities. PMID:26793008

  12. Effect of Seating on Exposures to Whole-Body Vibration in Vehicles

    NASA Astrophysics Data System (ADS)

    PADDAN, G. S.; GRIFFIN, M. J.

    2002-05-01

    The vibration isolation efficiency of seating has been evaluated in 100 work vehicles in 14 categories (cars, vans, lift trucks, lorries, tractors, buses, dumpers, excavators, helicopters, armoured vehicles, mobile cranes, grass rollers, mowers and milk floats). Seat isolation efficiency, expressed by the SEAT value, was determined for all seats (67 conventional seats and 33 suspension seats) from the vertical acceleration measured on the floors and on the seats of the vehicles.For most categories of vehicle, the average SEAT value was less than 100%, indicating that the average seat provided some attenuation of vibration. However, there were large variations in SEAT values between vehicles within categories. Two alternative vibration frequency weightings (Wb from BS 6841, 1987; Wk from ISO 2631, 1997) yielded SEAT values that differed by less than 6%. Overall, the SEAT values determined by two alternative methods (the ratio of r.m.s. values and the ratio of vibration dose values) differed by less than 45% when using weighting Wb, although larger differences may be expected in some situations. The median SEAT value for the suspension seats was 846%; the median SEAT value for the conventional seats was 869% (based on weighting Wb and the ratio of r.m.s. values).Predicted SEAT values were obtained assuming that each seat could be interchanged between vehicles without altering its transmissibility. The calculations suggest that 94% of the vehicles investigated might benefit from changing the current seat to a seat from one of the other vehicles investigated. Although the predictions are based on assumptions that will not always apply, it is concluded that the severity of whole-body vibration exposures in many work environments can be lessened by improvements to seating dynamics.

  13. Low back pain and association with whole body vibration among military armoured vehicle drivers in Malaysia.

    PubMed

    Rozali, A; Rampal, K G; Shamsul Bahri, M T; Sherina, M S; Shamsul Azhar, S; Khairuddin, H; Sulaiman, A

    2009-09-01

    A cross sectional study was conducted among military armoured vehicle drivers in the two largest mechanized battalions with the objective to determine the prevalence of low back pain (LBP), and its association with whole body vibration (WBV) and other associated factors. A self-administered questionnaire and Human Vibration Meter were used in this study. A total of 159 respondents participated in this study and 102 (64.2%) of them were subjected to WBV measurement. One-hundred-and-seventeen respondents complained of LBP for the past 12 months giving a prevalence of 73.6%. The prevalence of LBP among tracked armoured vehicle drivers was higher (81.7%) as compared to wheeled armoured vehicle drivers (67.0%). The mean acceleration at Z-axis in tracked armoured vehicles (1.09 +/- 0.26 ms(-2)) and wheeled armoured vehicles (0.33 +/- 0.07 ms) were the dominant vibration directions. The mean estimated vibration dose value (eVDV) for eight-hour daily exposure at Z-axis (19.86 +/- 4.72 ms(-1.75)) in tracked armoured vehicles showed the highest estimation. Based on the European Vibration Directive (2002), the mean eVDV at Z-axis in tracked armoured vehicles exceeded exposure action value (EAV) (> 9.1 ms(-1.75), but did not exceed exposure limit value (ELV) (<21.0 ms(-1.75)). Logistic regression analysis revealed that only driving in forward bending sitting posture (OR = 3.63, 95% CI 1.06-12.42) and WBV exposure at X-axis (OR = 1.94, 95% CI 1.02-3.69) were significant risk factors to LBP. Preventive measures should be implemented to minimize risk of WBV and to improve ergonomic postures among drivers. PMID:20527267

  14. Complementary therapies for reducing body weight: a systematic review.

    PubMed

    Pittler, M H; Ernst, E

    2005-09-01

    The prevalence of obesity is increasing at an alarming rate and a plethora of complementary therapies are on offer claiming effectiveness for reducing body weight. The aim of this systematic review is to critically assess the evidence from randomized controlled trials (RCTs) and systematic reviews of complementary therapies for reducing body weight. Literature searches were conducted on Medline, Embase, Amed, and the Cochrane Library until January 2004. Hand-searches of relevant medical journals and bibliographies of identified articles were conducted. There were no restrictions regarding the language of publication. Trial selection, quality assessment and data abstraction were performed systematically and independently by two authors. Data from RCTs and systematic reviews, which based their findings on the results of RCTs, were included. Six systematic reviews and 25 additional RCTs met our inclusion criteria and were reviewed. The evidence related to acupuncture, acupressure, dietary supplements, homeopathy and hypnotherapy. Except for hypnotherapy, Ephedra sinica and other ephedrine-containing dietary supplements the weight of the evidence is not convincing enough to suggest effectiveness. For these interventions, small effects compared with placebo were identified. In conclusion, our findings suggest that for most complementary therapies, the weight of the evidence for reducing body is not convincing. Hypnotherapy, E. sinica and other ephedrine-containing dietary supplements may lead to small reductions in body weight. However, the intake of E. sinica and ephedrine is associated with an increased risk of adverse events. Interventions suggesting positive effects in single RCTs require independent replication. PMID:15925954

  15. a Modal Analysis of Whole-Body Vertical Vibration, Using a Finite Element Model of the Human Body

    NASA Astrophysics Data System (ADS)

    Kitazaki, S.; Griffin, M. J.

    1997-02-01

    A two-dimensional model of human biomechanical responses to whole-body vibration has been developed, by using the finite element method. Beam, spring and mass elements were used to model the spine, viscera, head, pelvis and buttocks tissue in the mid-sagittal plane. The model was developed by comparison of the vibration mode shapes with those previously measured in the laboratory. At frequencies below 10 Hz, the model produced seven modes which coincided well with the measurements. The principal resonance of the driving point response at about 5 Hz consisted of an entire body mode, in which the head, spinal column and the pelvis move almost rigidly, with axial and shear deformation of tissue beneath the pelvis occurring in phase with a vertical visceral mode. The second principal resonance at about 8 Hz corresponded to a rotational mode of the pelvis, with a possible contribution from a second visceral mode. A shift of the principal resonance of the driving point response, when changing posture, was achieved only by changing the axial stiffness of the buttocks tissue. It is suggested that an increase in contact area between the buttocks and the thighs and the seat surface, when changing posture from erect to slouched, may decrease the axial stiffness beneath the pelvis, with a non-linear force-deflection relationship of tissue resulting in decreases in the natural frequencies. A change in posture from erect to slouched also increased shear deformation of tissue beneath the pelvis in the entire body mode, and the natural frequency was decreased as a result of the much lower shear stiffness of tissue compared to the axial stiffness.

  16. Influence of pelvic position and vibration frequency on muscle activation during whole body vibration in quiet standing

    PubMed Central

    Kim, Joong-Hwi; Seo, Hye-Jung

    2015-01-01

    [Purpose] The purpose of this study was to investigate muscle activation related to postural stability depending on the pelvic position and frequency of whole body vibration (WBV) during quiet standing, and to identify the most effective training conditions that elicit the highest neuromuscular responses. [Subjects and Methods] Eighteen healthy subjects voluntarily participated in this single-group, repeated-measures study in which surface electromyography (EMG) data for the upper trapezius, rectus abdominis, external oblique abdominis, erector spinae, gluteus maximus, rectus femoris, semitendinosus, and medial gastrocnemius were collected at three frequencies (0?Hz, 10?Hz, and 20?Hz) of WBV and three pelvic positions (neutral, anterior tilt, posterior tilt) for each subject during quiet standing. [Results] The EMG activities of all the recorded muscles showed significant differences between the three frequencies of WBV and three pelvic positions during quiet standing. [Conclusion] The study findings suggest that a higher WBV frequency (20?Hz) should be used to strengthen most muscles, and that using the posterior pelvic tilt during WBV is much more effective at strengthening and training muscles related to core stability. PMID:25995555

  17. Mind-body Therapies for Menopausal Symptoms: A Systematic Review

    PubMed Central

    Innes, Kim E; Selfe, Terry Kit; Vishnu, Abhishek

    2010-01-01

    Objective To systematically review the peer-reviewed literature regarding the effects of self-administered mind-body therapies on menopausal symptoms. Methods To identify qualifying studies, we searched 10 scientific databases and scanned bibliographies of relevant review papers and all identified articles. The methodological quality of all studies was assessed systematically using predefined criteria. Results Twenty-one papers representing 18 clinical trials from 6 countries met our inclusion criteria, including 12 randomized controlled trials (N=719), 1 non-randomized controlled trial (N=58), and 5 uncontrolled trials (N=105). Interventions included yoga and/or meditation-based programs, tai chi, and other relaxation practices, including muscle relaxation and breath-based techniques, relaxation response training, and low frequency sound-wave therapy. Eight of the nine studies of yoga, tai chi, and meditation-based programs reported improvement in overall menopausal and vasomotor symptoms; six of seven trials indicated improvement in mood and sleep with yoga-based programs, and four studies reported reduced musculoskeletal pain. Results from the remaining nine trials suggest that breath-based and other relaxation therapies also show promise for alleviating vasomotor and other menopausal symptoms, although intergroup findings were mixed. Most studies reviewed suffered methodological or other limitations, complicating interpretation of findings. Conclusions Collectively, findings of these studies suggest that yoga-based and certain other mind-body therapies may be beneficial for alleviating specific menopausal symptoms. However, the limitations characterizing most studies hinder interpretation of findings and preclude firm conclusions regarding efficacy. Additional large, methodologically sound trials are needed to determine the effects of specific mind-body therapies on menopausal symptoms, examine long-term outcomes, and investigate underlying mechanisms. PMID:20167444

  18. Whole-Body Vibrations Do Not Elevate the Angiogenic Stimulus when Applied during Resistance Exercise

    PubMed Central

    Beijer, sa; Rosenberger, Andr; Blck, Birgit; Suhr, Frank; Rittweger, Jrn; Bloch, Wilhelm

    2013-01-01

    Knowledge about biological factors involved in exercise-induced angiogenesis is to date still scanty. The present study aimed to investigate the angiogenic stimulus of resistance exercise with and without superimposed whole-body vibrations. Responses to the exercise regimen before and after a 6-week training intervention were investigated in twenty-six healthy male subjects. Serum was collected at the initial and final exercise sessions and circulating levels of matrix metalloproteinases (MMP) -2 and -9, Vascular Endothelial Growth Factor (VEGF) and endostatin were determined via ELISA. Furthermore, we studied the proliferative effect of serum-treated human umbilical vein endothelial cells in vitro via BrdU-incorporation assay. It was found that circulating MMP-2, MMP-9, VEGF and endostatin levels were significantly elevated (P<0.001) from resting levels after both exercise interventions, with higher post-exercise VEGF concentrations in the resistance exercise (RE) group compared to the resistive vibration exercise (RVE) group. Moreover, RE provoked increased endothelial cell proliferation in vitro and higher post-exercise circulating endostatin concentrations after 6 weeks of training. These effects were elusive in the RVE group. The present findings suggest that resistance exercise leads to a transient rise in circulating angiogenic factors and superimposing vibrations to this exercise type might not further trigger a potential signaling of angiogenic stimulation in skeletal muscle. PMID:24260349

  19. Time domain detection of shocks and impacts in whole-body vibration.

    PubMed

    Brammer, Anthony J; Roddan, George; Morrison, James B

    2010-01-01

    A method for detecting shocks and impacts in whole-body vibration time histories has been developed that is suitable for implementation as a computer algorithm. The procedure consists of comparing the magnitudes of a higher-order mean value and the impulsiveness calculated for successive time segments of the acceleration-time history. The indicators were the ratio of the 12th-order root mean value to the root mean square RMT/RMS, and the impulsiveness corresponding to a cumulative probability value of 0.97, I(0.97) (i.e., the magnitude of the positive and negative excursions exceeded 3% of the time divided by 2RMS). Both indicators have a value of 2.16 for random vibration with a Gaussian amplitude distribution, and deviate from this value when the motion possesses other characteristics. For seat motion in the Z-direction analyzed using frequency weighting W(b), and time segments of ~20 s, shocks and impacts could be identified when RMT/RMS ? 2.5, and I(0.97) ? 2.6. A subjective visual classification of 160 exposures to vibration recorded in a range of military vehicles operating under different conditions was performed by a jury of two observers. The subjective classification agreed with computer identification of shocks and impacts in 94% of the cases. PMID:20953070

  20. Whole body vibration exposure in heavy earth moving machinery operators of metalliferrous mines.

    PubMed

    Vanerkar, A P; Kulkarni, N P; Zade, P D; Kamavisdar, A S

    2008-08-01

    As mining operations get mechanized, the rate of profit generation increases and so do the rate of occupational hazards. This study deals with one such hazard - occupational vibration. The present study was carried out to determine the whole body vibration (WBV) exposure of the heavy earth moving machinery (HEMM) operators in two types of metalliferous mines in India, when they were engaged in the mining activity. Cross-comparison was done of the vibration dose value (VDV) for HEMM operators as well as each type of mine. The VDV for the shovel operator in bauxite mine was observed to be 13.53 +/- 5.63 m/s(7/4) with 25% of the readings higher than the prescribed limit whereas in iron ore mine VDV for dumper operator was 10.81 +/- 3.44 m/s(7/4) with 14.62% readings on the higher side. Cross-comparison of the VDV values for bauxite and iron ore mines revealed that it was 9.57 +/- 4.93 and 8.21 +/- 5.12 m/s(7/4) with 21.28 and 14.95% of the readings on the higher side respectively. The Student's t test level was found to be insignificant for both type of mines, indicating that the WBV exposure is not dependent on the type of mine but is dependent on the working condition and type of HEMM in operation. PMID:17874194

  1. Exposure to whole-body vibration in open-cast mines in the Barents region

    PubMed Central

    Burström, Lage; Hyvärinen, Ville; Johnsen, Magnar; Pettersson, Hans

    2016-01-01

    Objectives We aimed to measure and evaluate whole-body vibration (WBV) exposure among drivers of mining vehicles in the Barents region. Study design In the period from November 2012 to August 2014, this cross-sectional study was carried out at 3 mines in Finland, Norway and Sweden as part of the MineHealth project. Methods Measurements of WBV were conducted on the surface of the driver's seat during normal work in accordance with international standards. Personal data on daily exposure times were collected by a questionnaire. Results Measurements were conducted on 95 different mining vehicles both as root mean square (RMS) value and vibration dose value (VDV) representing different manufacturers, models and capacities. Of the 453 miners who answered the questionnaire, 232 indicated that they were exposed to WBV during their working day. The results show that the mean daily exposure time varies between 1.9 and 6.7 h for different vehicles. The calculated mean A(8) could be found in an interval between 0.2 and 1.0 m/s2 and the corresponding 8-h VDV fell between 7 and 17 m/s1.75. Conclusions Exposure to WBV among operators of mining vehicles may be a serious health and safety problem in the mines studied. The employers ought, therefore, take active steps to reduce exposure in accordance with the European vibration directive. Moreover, since some groups of drivers are exposed to vibration that is close to or exceeds the exposure limit values, the employer should take immediate action to reduce exposure below these values. PMID:26864832

  2. Characterization and calibration of piezoelectric polymers: in situ measurements of body vibrations.

    PubMed

    Kappel, Marcel; Abel, Markus; Gerhard, Reimund

    2011-07-01

    Piezoelectric polymers are known for their flexibility in applications, mainly due to their bending ability, robustness, and variable sensor geometry. It is an optimal material for minimal-invasive investigations in vibrational systems, e.g., for wood, where acoustical impedance matches particularly well. Many applications may be imagined, e.g., monitoring of buildings, vehicles, machinery, alarm systems, such that our investigations may have a large impact on technology. Longitudinal piezoelectricity converts mechanical vibrations normal to the polymer-film plane into an electrical signal, and the respective piezoelectric coefficient needs to be carefully determined in dependence on the relevant material parameters. In order to evaluate efficiency and durability for piezopolymers, we use polyvinylidene fluoride and measure the piezoelectric coefficient with respect to static pressure, amplitude of the dynamically applied force, and long-term stability. A known problem is the slow relaxation of the material towards equilibrium, if the external pressure changes; here, we demonstrate how to counter this problem with careful calibration. Since our focus is on acoustical measurements, we determine accurately the frequency response curve--for acoustics probably the most important characteristic. Eventually, we show that our piezopolymer transducers can be used as a calibrated acoustical sensors for body vibration measurements on a wooden musical instrument, where it is important to perform minimal-invasive measurements. A comparison with the simultaneously recorded airborne sound yields important insight of the mechanism of sound radiation in comparison with the sound propagating in the material. This is especially important for transient signals, where not only the long-living eigenmodes contribute to the sound radiation. Our analyses support that piezopolymer sensors can be employed as a general tool for the determination of the internal dynamics of vibrating systems. PMID:21806230

  3. Characterization and calibration of piezoelectric polymers: In situ measurements of body vibrations

    NASA Astrophysics Data System (ADS)

    Kappel, Marcel; Abel, Markus; Gerhard, Reimund

    2011-07-01

    Piezoelectric polymers are known for their flexibility in applications, mainly due to their bending ability, robustness, and variable sensor geometry. It is an optimal material for minimal-invasive investigations in vibrational systems, e.g., for wood, where acoustical impedance matches particularly well. Many applications may be imagined, e.g., monitoring of buildings, vehicles, machinery, alarm systems, such that our investigations may have a large impact on technology. Longitudinal piezoelectricity converts mechanical vibrations normal to the polymer-film plane into an electrical signal, and the respective piezoelectric coefficient needs to be carefully determined in dependence on the relevant material parameters. In order to evaluate efficiency and durability for piezopolymers, we use polyvinylidene fluoride and measure the piezoelectric coefficient with respect to static pressure, amplitude of the dynamically applied force, and long-term stability. A known problem is the slow relaxation of the material towards equilibrium, if the external pressure changes; here, we demonstrate how to counter this problem with careful calibration. Since our focus is on acoustical measurements, we determine accurately the frequency response curve - for acoustics probably the most important characteristic. Eventually, we show that our piezopolymer transducers can be used as a calibrated acoustical sensors for body vibration measurements on a wooden musical instrument, where it is important to perform minimal-invasive measurements. A comparison with the simultaneously recorded airborne sound yields important insight of the mechanism of sound radiation in comparison with the sound propagating in the material. This is especially important for transient signals, where not only the long-living eigenmodes contribute to the sound radiation. Our analyses support that piezopolymer sensors can be employed as a general tool for the determination of the internal dynamics of vibrating systems.

  4. Orientation of bluff body for designing efficient energy harvesters from vortex-induced vibrations

    NASA Astrophysics Data System (ADS)

    Dai, H. L.; Abdelkefi, A.; Yang, Y.; Wang, L.

    2016-02-01

    The characteristics and performances of four distinct vortex-induced vibrations (VIVs) piezoelectric energy harvesters are experimentally investigated and compared. The difference between these VIV energy harvesters is the installation of the cylindrical bluff body at the tip of cantilever beam with different orientations (bottom, top, horizontal, and vertical). Experiments show that the synchronization regions of the bottom, top, and horizontal configurations are almost the same at low wind speeds (around 1.5 m/s). The vertical configuration has the highest wind speed for synchronization (around 3.5 m/s) with the largest harvested power, which is explained by its highest natural frequency and the smallest coupled damping. The results lead to the conclusion that to design efficient VIV energy harvesters, the bluff body should be aligned with the beam for low wind speeds (<2 m/s) and perpendicular to the beam at high wind speeds (>2 m/s).

  5. Body fat distribution, the menopause transition, and hormone replacement therapy.

    PubMed

    Tchernof, A; Poehlman, E T; Desprs, J P

    2000-02-01

    Endocrine changes resulting from the menopause transition dramatically modify women's hormonal milieu. The consequences of these changes not only lead to cessation of reproduction and accompanying symptoms in women, but also dramatically impact long-term health. Loss of estrogen has been associated with the development of cardiovascular disease. Central distribution and accumulation of adipose tissue, and the concomitant insulin resistant dyslipidemic state have emerged as important components of a cluster of metabolic abnormalities that are strongly related to coronary heart disease. Thus, estrogen deficiency may affect cardiovascular disease risk by mediating changes in body fat distribution. This article is an update of the literature in the area of menopause, hormone replacement therapy, and body fat distribution. Cross-sectional studies using anthropometric measurements of abdominal fat distribution most often failed to detect an effect of the menopause transition that was independent of advancing age and degree of obesity. The use of radiologic techniques such as DEXA and computed tomography, however, led to the conclusion that the menopause transition accelerates the selective deposition of intra-abdominal fat. Available longitudinal data also support an increase in central body fatness occurring with menopause. Most intervention trials on hormone replacement therapy and body fat distribution showed that the treatment prevented the increase in central adiposity that was noted in postmenopausal women receiving no treatment or placebo. These results are supported by retrospective studies that showed a lower WHR in hormone users vs non-users. Mechanisms potentially explaining the menopause-related acceleration in abdominal fat accumulation include changes in regional adipose tissue metabolism in the face of a positive energy imbalance. As some inconsistencies were found among studies, further investigations using longitudinal and intervention designs, as well as more precise methodologies to measure body fat distribution, are needed to clearly establish the effects of menopause and hormone replacement on abdominal body fat distribution and the concomitant increase in cardiovascular disease risk. PMID:10705099

  6. sEMG during Whole-Body Vibration Contains Motion Artifacts and Reflex Activity

    PubMed Central

    Lienhard, Karin; Cabasson, Aline; Meste, Olivier; Colson, Serge S.

    2015-01-01

    The purpose of this study was to determine whether the excessive spikes observed in the surface electromyography (sEMG) spectrum recorded during whole-body vibration (WBV) exercises contain motion artifacts and/or reflex activity. The occurrence of motion artifacts was tested by electrical recordings of the patella. The involvement of reflex activity was investigated by analyzing the magnitude of the isolated spikes during changes in voluntary background muscle activity. Eighteen physically active volunteers performed static squats while the sEMG was measured of five lower limb muscles during vertical WBV using no load and an additional load of 33 kg. In order to record motion artifacts during WBV, a pair of electrodes was positioned on the patella with several layers of tape between skin and electrodes. Spectral analysis of the patella signal revealed recordings of motion artifacts as high peaks at the vibration frequency (fundamental) and marginal peaks at the multiple harmonics were observed. For the sEMG recordings, the root mean square of the spikes increased with increasing additional loads (p < 0.05), and was significantly correlated to the sEMG signal without the spikes of the respective muscle (r range: 0.54 - 0.92, p < 0.05). This finding indicates that reflex activity might be contained in the isolated spikes, as identical behavior has been found for stretch reflex responses evoked during direct vibration. In conclusion, the spikes visible in the sEMG spectrum during WBV exercises contain motion artifacts and possibly reflex activity. Key points The spikes observed in the sEMG spectrum during WBV exercises contain motion artifacts and possibly reflex activity The motion artifacts are more pronounced in the first spike than the following spikes in the sEMG spectrum Reflex activity during WBV exercises is enhanced with an additional load of approximately 50% of the body mass PMID:25729290

  7. Typical whole body vibration exposure magnitudes encountered in the open pit mining industry.

    PubMed

    Howard, Bryan; Sesek, Richard; Bloswick, Don

    2009-01-01

    According to recent research, a causal link has been established between occupational exposure to whole body vibration and an increased occurrence of low back pain. To aid in the further development of an in-house health and safety program for a large open pit mining facility interested in reducing back pain among its operators, whole body vibration magnitudes were characterized for a range of jobs. Specifically, thirty-five individual jobs from five different areas across the facility were evaluated for tri-axial acceleration levels during normal operating conditions. Tri-axial acceleration magnitudes were categorized into thirteen job groups. Job groups were ranked according to exposure and compared to the ISO 2631-1 standard for health risk assessment. Three of the thirteen job groups produced tri-axial acceleration magnitudes below the ISO 2631-1 low/moderate health caution limit for a twelve hour exposure. Six of the thirteen job groups produced exposures within the moderate health risk range. Four job groups were found to subject operators to WBV acceleration magnitudes above the moderate/high health caution limit. PMID:20037244

  8. Whole body vibration training in patients with COPD: A systematic review.

    PubMed

    Gloeckl, Rainer; Heinzelmann, Inga; Kenn, Klaus

    2015-08-01

    In recent years, several studies have shown that whole body vibration training (WBVT) may be a beneficial training mode in a variety of chronic diseases and conditions such as osteoporosis, fibromyalgia, multiple sclerosis, or chronic low back pain. However, a systematic review on the effects of WBVT in patients with chronic obstructive pulmonary disease (COPD) has not been performed yet. An extensive literature search was performed using various electronic databases (PubMed, Embase, LILACS, and PEDro). They were searched from inception until September 20, 2014, using key words like "COPD" and "whole body vibration training." A total of 91 studies could be identified and were screened for relevance by two independent reviewers. Six studies were included in a qualitative analysis. Trials studied either the effects of WBVT versus an inactive control group, versus sham WBVT, during an acute COPD exacerbation or as a modality on top of conventional endurance and strength training. All randomized trials reported a significantly superior benefit on exercise capacity (6-minute walking distance) in favor of the WBVT group. Although there are only few studies available, there is some preliminary evidence that WBVT may be an effective exercise modality to improve functional exercise capacity in patients with COPD. PMID:25904085

  9. Effects of quadriceps strength after static and dynamic whole-body vibration exercise.

    PubMed

    Bush, Jill A; Blog, Gabriel L; Kang, Jie; Faigenbaum, Avery D; Ratamess, Nicholas A

    2015-05-01

    Numerous studies have shown performance benefits including whole-body vibration (WBV) as a training modality or an acute exercise protocol when used as a component of the resistance training program. Some studies have indicated that performing dynamic exercises as compared with static position exercises while exposed to WBV might be beneficial; however, evidence is lacking. Thus, the purpose of this study was to determine if an acute bout of dynamic versus static squats performed during WBV results in increase in quadriceps force production by means of dynamic isokinetic knee extension and flexion exercise. Nonresistance-trained healthy young men and women (N = 21) of 18-25 years participated in 4 protocols with 2-week rest in-between. Protocol 1 consisted of 5 sets of 10 dynamic squats without vibration; Protocol 2: 5 sets of 30-second static squats without vibration; Protocol 3: 5 sets of 10 dynamic squats with 30-Hz WBV for a total of 2.5 minutes; and Protocol 4: 5 sets of 30-second static squats with 30-Hz WBV for a total of 2.5 minutes. Prestrength tests (1 set of 4 repetitions at 100 s(-1) for the knee extension exercise) was performed within 5 minutes of starting each protocol, and poststrength testing was performed within 1 minute of completing each protocol. Strength outcomes were analyzed by repeated measures analysis of variance with a significance level set at p ? 0.05. A significant decrease in strength was observed after dynamic and static squats without WBV (p = 0.002); an increase in strength after dynamic squats with WBV (p = 0.003); and a decrease in strength after static squats with WBV (p = 0.003). The inclusion of WBV to dynamic resistance exercise can be an added modality to increase strength. Whole-body vibration can have varied effects in altering muscle strength in untrained individuals according to the type of resistance training performed. As a dynamic squat with WBV seems to immediately potentiate neuromuscular functioning, the combination of dynamic exercises and WBV could be used as a potential warm-up procedure before resistance exercise. PMID:25268289

  10. Effects of Short-Period Whole-Body Vibration of 20 Hz on Selected Blood Biomarkers in Wistar Rats.

    PubMed

    Monteiro, Milena de Oliveira Bravo; de Sá-Caputo, Danúbia da Cunha; Carmo, Fernanda Santos do; Bernardo, Raquel Mattos; Pacheco, Raphaelle; Arnóbio, Adriano; Guimarães, Carlos Alberto Sampaio; Bernardo, Luciana Camargo; Santos-Filho, Sebastião David; Asad, Nasser Ribeiro; Unger, Marianne; Marin, Pedro Jesus; Bernardo-Filho, Mario

    2015-08-31

    There is a growing interest in the use of vibration generated by oscillating/vibratory platforms - also known as whole-body vibration (WBV) - for achieving therapeutic, preventative and/or physical performance goals. This study investigated the effects of vibration generated by an oscillating platform on the concentration of blood biomarkers in rats. Wistar rats (n = 8) were divided in 2 groups, sedated and individually positioned on an oscillating platform. The experimental group (EG) was subjected to vibrations of 20 Hz for one min per day for one week while the control group (CG) experienced no vibration. Samples of heparinized whole blood were drawn by cardiac puncture for biochemical analysis. Concentrations of total cholesterol, triglycerides, HDL, LDL, VLDL, glucose, CK, albumin, alkaline phosphates, TGP, TGO, γGT, lipase, amylase, urea and creatinine were determined. White blood cell count and a platelet hemogram were also performed. Following seven sessions of exposure to the vibration, a significant (P < 0.05) reduction in γGT, VLDL and leukocytes was found. A weekly 1-min/day exposure of 20 Hz vibration can was shown to alter the concentrations of selected blood biomarkers in rats. The action mechanism associated with these effects seems highly complex, but the findings might contribute to the understanding of these mechanisms related to the exposure to 20 Hz vibration. PMID:26211644

  11. Inference-Based Therapy for Body Dysmorphic Disorder

    PubMed Central

    Taillon, Annie; OConnor, Kieron; Dupuis, Gilles; Lavoie, Marc

    2013-01-01

    Body dysmorphic disorder (BDD) is a debilitating disorder characterized by an excessive pre-occupation with an imagined or very slight defect in ones physical appearance. Despite the overall success of cognitive behavioural therapy (CBT) in treating BDD, some people do not seem to benefit as much from this approach. Those with high overvalued ideation (OVI), for instance, have been shown to not respond well with CBT. The purpose of this study was to evaluate the efficacy of an inference-based therapy (IBT) in treating BDD. IBT is a cognitive intervention that was first developed for obsessivecompulsive disorder with high OVI, but whose focus on beliefs can also apply to a BDD population. IBT conceptualizes BDD obsessions (e.g., I feel like my head is deformed) as idiosyncratic inferences arrived at through inductive reasoning processes. Such primary inferences represent the starting point of obsessional doubt and the treatment focuses on addressing the faulty inferences that maintain the doubt. Thirteen BDD participants, of whom 10 completed, underwent a 20-week IBT for BDD. The participants improved significantly over the course of therapy, with large diminutions in BDD and depressive symptoms. OVI also decreased throughout therapy and was not found to be related to reduction in BDD symptoms. Although a controlled-trial comparing CBT with IBT is needed, it is proposed that IBT constitutes a promising treatment alternative for BDD especially in cases where OVI is high. PMID:21793103

  12. Gastrointestinal Toxicities With Combined Antiangiogenic and Stereotactic Body Radiation Therapy

    PubMed Central

    Pollom, Erqi L.; Deng, Lei; Pai, Reetesh K.; Brown, J. Martin; Giaccia, Amato; Loo, Billy W.; Shultz, David B.; Le, Quynh Thu; Koong, Albert C.; Chang, Daniel T.

    2016-01-01

    Combining the latest targeted biologic agents with the most advanced radiation technologies has been an exciting development in the treatment of cancer patients. Stereotactic body radiation therapy (SBRT) is an ablative radiation approach that has become established for the treatment of a variety of malignancies, and it has been increasingly used in combination with biologic agents, including those targeting angiogenesis-specific pathways. Multiple reports have emerged describing unanticipated toxicities arising from the combination of SBRT and angiogenesis-targeting agents, particularly of late luminal gastrointestinal toxicities. In this review, we summarize the literature describing these toxicities, explore the biological mechanism of action of toxicity with the combined use of antiangiogenic therapies, and discuss areas of future research, so that this combination of treatment modalities can continue to be used in broader clinical contexts. PMID:26068491

  13. Review and Uses of Stereotactic Body Radiation Therapy for Oligometastases

    PubMed Central

    Alongi, Filippo; Filippi, Andrea Riccardo; Ricardi, Umberto; Scorsetti, Marta

    2012-01-01

    In patients with proven distant metastases from solid tumors, it has been a notion that the condition is incurable, warranting palliative care only. The term oligometastases was coined to refer to isolated sites of metastasis, whereby the entire burden of disease can be recognized as a finite number of discrete lesions that can be potentially cured with local therapies. Stereotactic body radiation therapy (SBRT) is a novel treatment modality in radiation oncology that delivers a very high dose of radiation to the tumor target with high precision using single or a small number of fractions. SBRT is the result of technological advances in patient and tumor immobilization, image guidance, and treatment planning and delivery. A number of studies, both retrospective and prospective, showed promising results in terms of local tumor control and, in a limited subset of patients, of survival. This article reviews the radiobiologic, technical, and clinical aspects of SBRT for various anatomical sites. PMID:22723509

  14. Gastrointestinal Toxicities With Combined Antiangiogenic and Stereotactic Body Radiation Therapy.

    PubMed

    Pollom, Erqi L; Deng, Lei; Pai, Reetesh K; Brown, J Martin; Giaccia, Amato; Loo, Billy W; Shultz, David B; Le, Quynh Thu; Koong, Albert C; Chang, Daniel T

    2015-07-01

    Combining the latest targeted biologic agents with the most advanced radiation technologies has been an exciting development in the treatment of cancer patients. Stereotactic body radiation therapy (SBRT) is an ablative radiation approach that has become established for the treatment of a variety of malignancies, and it has been increasingly used in combination with biologic agents, including those targeting angiogenesis-specific pathways. Multiple reports have emerged describing unanticipated toxicities arising from the combination of SBRT and angiogenesis-targeting agents, particularly of late luminal gastrointestinal toxicities. In this review, we summarize the literature describing these toxicities, explore the biological mechanism of action of toxicity with the combined use of antiangiogenic therapies, and discuss areas of future research, so that this combination of treatment modalities can continue to be used in broader clinical contexts. PMID:26068491

  15. A model analysis of internal loads, energetics, and effects of wobbling mass during the whole-body vibration.

    PubMed

    Yue, Z; Mester, J

    2002-05-01

    The internal loads, energetics, and the effects of wobbling mass during the whole-body vibration are studied in terms of analysis and comparison of two models: one is a system of four degrees-of-freedom with rigid and wobbling masses in both lower body and upper body (Model A), while the other one (Model B) is a system of three degrees-of-freedom with a rigid upper body and is otherwise identical to Model A. The main findings are the following: (1) The wobbling mass in the upper body is able to reduce the total internal load on the rigid mass of the upper body considerably. (2) "Partial" internal loads on a certain part of the body may be even larger than the total load on the same part of the body because of the phase differences among the partial loads. Therefore, a full consideration of safety during the whole-body vibration has to take not only the total, but also all the partial internal loads into account. (3) The fluctuation of power input and the fluctuation of mechanical energy could be much larger than the fluctuation of dissipation rate. (4) For frequencies higher than the resonance frequency range, the amplitude of the oscillation of the centre of mass of the body is so reduced that only the change of elastic potential energy dominates in the change of mechanical energy. Thus, a simple picture of energy flow is obtained as follows: for approximately one half of the oscillation period, the energy flows from the vibrator into the human body and is mainly stored in the muscle-tendon system, while for the remaining approximate half of the period, the energy flows from the muscle-tendon system back to the vibrator with a slightly smaller amount because a small part of the flown-in energy has been dissipated. PMID:11955503

  16. Uncertainty in the evaluation of occupational exposure to whole-body vibration

    NASA Astrophysics Data System (ADS)

    Pinto, Iole; Stacchini, Nicola

    2006-12-01

    Uncertainties associated with field assessments of daily exposure to whole-body vibration (WBV) have been investigated in four categories of work vehicles (fork lift trucks, wheel loaders, garbage trucks, buses) in different working conditions. A total of 50 vehicles were included in the study. WBV exposures were measured in different field conditions in marble quarries, marble laboratories, dockyards, paper mills, transportation and public utilities: over 700 individual vibration measurements were analysed to quantify relevant uncertainty components due to changes in the operators' working methods, variations in the characteristics and conditions of the machines, changes in the characteristics of the travelling surface, uncertainty in the evaluation of exposure duration, and systematic errors due to measurement equipment. The methods used in the study to calculate measurement uncertainties are in accordance with the ISO publication "Guide to the Expression of Uncertainty in Measurement". The study made it possible to isolate major sources of uncertainty in field assessment of daily exposures to WBV. The investigation revealed that, in all the field conditions, differences in the characteristics of the machines and/or in working cycles were the most relevant uncertainty components. The overall relative uncertainty p in WBV field assessment was in the range 14% < p<32%, whereas the relative uncertainty caused by transducer and measurement equipment in a correctly calibrated system is less than 4%.

  17. The Effects of Whole Body Vibration on Mobility and Balance in Parkinson Disease: a Systematic Review

    PubMed Central

    Sharififar, Sharareh; Coronado, Rogelio A.; Romero, Sergio; Azari, Hassan; Thigpen, Mary

    2014-01-01

    Whole body vibration (WBV) is a contemporary treatment modality that holds promise as an exercise training method in healthcompromised individuals. A growing number of studies on individuals with Parkinson Disease are examining whether WBV improves balance and functional mobility. However, interpreting WBV studies is challenging since there is variability in the manner in which WBV intervention is conducted. The primary goal of this systematic review was to investigate the effect of WBV on improving mobility and balance as measured by a battery of clinical tests, in patients with Parkinson disease. Studies based on WBV parameters were characterized and a systematic search of peer-reviewed literature in five major databases was conducted. Randomized-controlled trials investigating the effects of WBV in patients with a Parkinson diagnosis and no cognitive impairment were included. A total of six publications met the inclusion criteria. Overall, studies demonstrated mixed results in favor of WBV for improving balance or mobility. The majority of studies seem to suggest a favorable benefit following WBV for mobility and balance, but not when compared to other active intervention or placebo. There was variability in the manner in which WBV intervention was applied. Variations among the six studies included: duration of intervention and rest, follow-up period, type of control groups, frequency of vibration, number of treatment sessions and sex distribution of subjects. Future research is needed to investigate the effects of different types of equipment and treatment dosage in individuals with Parkinson disease. PMID:25031483

  18. Whole Body Vibration at Different Exposure Frequencies: Infrared Thermography and Physiological Effects

    PubMed Central

    Sonza, Anelise; Robinson, Caroline C.; Achaval, Matilde; Zaro, Milton A.

    2015-01-01

    The aim of this study was to investigate the effects of whole body vibration (WBV) on physiological parameters, cutaneous temperature, tactile sensitivity, and balance. Twenty-four healthy adults (25.3 ± 2.6 years) participated in four WBV sessions. They spent 15 minutes on a vibration platform in the vertical mode at four different frequencies (31, 35, 40, and 44 Hz) with 1 mm of amplitude. All variables were measured before and after WBV exposure. Pressure sensation in five anatomical regions and both feet was determined using Von Frey monofilaments. Postural sway was measured using a force plate. Cutaneous temperature was obtained with an infrared camera. WBV influences the discharge of the skin touch-pressure receptors, decreasing sensitivity at all measured frequencies and foot regions (P ≤ 0.05). Regarding balance, no differences were found after 20 minutes of WBV at frequencies of 31 and 35 Hz. At 40 and 44 Hz, participants showed higher anterior-posterior center of pressure (COP) velocity and length. The cutaneous temperature of the lower limbs decreased during and 10 minutes after WBV. WBV decreases touch-pressure sensitivity at all measured frequencies 10 min after exposure. This may be related to the impaired balance at higher frequencies since these variables have a role in maintaining postural stability. Vasoconstriction might explain the decreased lower limb temperature. PMID:25664338

  19. The effects of whole body vibration on mobility and balance in Parkinson disease: a systematic review.

    PubMed

    Sharififar, Sharareh; Coronado, Rogelio A; Romero, Sergio; Azari, Hassan; Thigpen, Mary

    2014-07-01

    Whole body vibration (WBV) is a contemporary treatment modality that holds promise as an exercise training method in health-compromised individuals. A growing number of studies on individuals with Parkinson Disease are examining whether WBV improves balance and functional mobility. However, interpreting WBV studies is challenging since there is variability in the manner in which WBV intervention is conducted. The primary goal of this systematic review was to investigate the effect of WBV on improving mobility and balance as measured by a battery of clinical tests, in patients with Parkinson disease. Studies based on WBV parameters were characterized and a systematic search of peer-reviewed literature in five major databases was conducted. Randomized-controlled trials investigating the effects of WBV in patients with a Parkinson diagnosis and no cognitive impairment were included. A total of six publications met the inclusion criteria. Overall, studies demonstrated mixed results in favor of WBV for improving balance or mobility. The majority of studies seem to suggest a favorable benefit following WBV for mobility and balance, but not when compared to other active intervention or placebo. There was variability in the manner in which WBV intervention was applied. Variations among the six studies included: duration of intervention and rest, follow-up period, type of control groups, frequency of vibration, number of treatment sessions and sex distribution of subjects. Future research is needed to investigate the effects of different types of equipment and treatment dosage in individuals with Parkinson disease. PMID:25031483

  20. Whole-body vibration-induced muscular reflex: Is it a stretch-induced reflex?

    PubMed Central

    Cakar, Halil Ibrahim; Cidem, Muharrem; Sebik, Oguz; Yilmaz, Gizem; Karamehmetoglu, Safak Sahir; Kara, Sadik; Karacan, Ilhan; Trker, Kemal S?tk?

    2015-01-01

    [Purpose] Whole-body vibration (WBV) can induce reflex responses in muscles. A number of studies have reported that the physiological mechanisms underlying this type of reflex activity can be explained by reference to a stretch-induced reflex. Thus, the primary objective of this study was to test whether the WBV-induced muscular reflex (WBV-IMR) can be explained as a stretch-induced reflex. [Subjects and Methods] The present study assessed 20 healthy males using surface electrodes placed on their right soleus muscle. The latency of the tendon reflex (T-reflex) as a stretch-induced reflex was compared with the reflex latency of the WBV-IMR. In addition, simulations were performed at 25, 30, 35, 40, 45, and 50?Hz to determine the stretch frequency of the muscle during WBV. [Results] WBV-IMR latency (40.5 0.8?ms; 95% confidence interval [CI]: 39.041.9?ms) was significantly longer than T-reflex latency (34.6 0.5?ms; 95% CI: 33.635.5?ms) and the mean difference was 6.2?ms (95% CI of the difference: 4.77.7?ms). The simulations performed in the present study demonstrated that the frequency of the stretch signal would be twice the frequency of the vibration. [Conclusion] These findings do not support the notion that WBV-IMR can be explained by reference to a stretch-induced reflex. PMID:26310784

  1. Human head-neck models in whole-body vibration: effect of posture.

    PubMed

    Wang, Yang; Rahmatalla, Salam

    2013-02-22

    This work presents passive and muscle-based models to predict the biodynamical response of the human head-neck under fore-aft and combined-axis whole-body vibration considering four head-neck postures: neutral, flexion, lateral flexion, and lateral rotation. The passive model consists of one link, a three-rotational-degrees-of-freedom joint, and traditional spring-mass-damper elements. The muscle-based model is similar to the passive model but has additional muscle components. The additional muscle component comprises spring-mass-damper elements to capture the effects of changes in displacement, velocity, acceleration, and jerk. Eleven male participants were tested under white-noise random vibration input signals at the seat level with a frequency range of 0.5-10Hz and magnitudes of 1.5m/s(2) RMS for the fore-aft condition and 1.0m/s(2) RMS in each direction for the combined-axis condition. The proposed models were able to reasonably predict the frequency content and acceleration of the head-neck for the postures under investigation, with the muscle-based model performing better. PMID:23290314

  2. Changes in postural sway frequency and complexity in altered sensory environments following whole body vibrations.

    PubMed

    Dickin, D Clark; McClain, Matthew A; Hubble, Ryan P; Doan, Jon B; Sessford, David

    2012-10-01

    Studies assessing whole body vibration (WBV) have produced largely positive effects, with some neutral, on postural control with frequencies between 25 and 40 Hz. However no conclusive evidence indicates that 25-40 Hz elicits the optimal beneficial effects. To address this issue, a larger range of vibration intensity (10-50 Hz at peak-to-peak amplitudes of 2 and 5mm) was employed while increasing the postural complexity (altered somatosensory and/or visual information) to assess acute effects of 4-min of WBV on postural control. Twelve healthy young adults underwent postural assessment at four time intervals (prior to, immediately following and 10 and 20 min post WBV). Findings revealed both postural sway frequency and sway complexity/regularity were affected by WBV. Baseline posture demonstrated increased sway frequency (p=.04) following WBV with no changes in sway complexity. When the support surface was altered, changes in both the frequency and complexity of sway were elicited (p=.027, .002, respectively). When both somatosensory and visual information were altered delayed improvements in postural control were elicited (p=.05 and .01, for frequency and complexity, respectively). Given the differential acute effects as a function of postural task complexity, future longitudinal studies could determine the overall training effect on sway frequency and complexity. PMID:22516837

  3. Optimal whole-body vibration settings for muscle strength and power enhancement in human knee extensors.

    PubMed

    Petit, Pierre-David; Pensini, Manuela; Tessaro, Jol; Desnuelle, Claude; Legros, Patrick; Colson, Serge S

    2010-12-01

    This study compared the effects of 6-week whole-body vibration (WBV) training programs with different frequency and peak-to-peak displacement settings on knee extensor muscle strength and power. The underlying mechanisms of the expected gains were also investigated. Thirty-two physically active male subjects were randomly assigned to a high-frequency/high peak-to-peak displacement group (HH; n=12), a low-frequency/low peak-to-peak displacement group (LL; n=10) or a sham training group (SHAM; n=10). Maximal voluntary isometric, concentric and eccentric torque of the knee extensors, maximal voluntary isometric torque of the knee flexors, jump performance, voluntary muscle activation, and contractile properties of the knee extensors were assessed before and after the training period. Significant improvement in knee extensor eccentric voluntary torque (P<0.01), knee flexor isometric voluntary torque (P<0.05), and jump performance (P<0.05) was observed only for HH group. Regardless of the group, knee extensor muscle contractile properties (P<0.05) were enhanced. No modification was observed for voluntary muscle activation or electrical activity of agonist and antagonist muscles. We concluded that high-frequency/high peak-to-peak displacement was the most effective vibration setting to enhance knee extensor muscle strength and jump performance during a 6-week WBV training program and that these improvements were not mediated by central neural adaptations. PMID:20801671

  4. Whole Body Vibration Exercises and the Improvement of the Flexibility in Patient with Metabolic Syndrome

    PubMed Central

    Sá-Caputo, Danúbia da Cunha; Ronikeili-Costa, Pedro; Carvalho-Lima, Rafaelle Pacheco; Bernardo, Luciana Camargo; Bravo-Monteiro, Milena Oliveira; Costa, Rebeca; de Moraes-Silva, Janaina; Paiva, Dulciane Nunes; Machado, Christiano Bittencourt; Mantilla-Giehl, Paula; Arnobio, Adriano; Marin, Pedro Jesus; Bernardo-Filho, Mario

    2014-01-01

    Vibrations produced in oscillating/vibratory platform generate whole body vibration (WBV) exercises, which are important in sports, as well as in treating diseases, promoting rehabilitation, and improving the quality of life. WBV exercises relevantly increase the muscle strength, muscle power, and the bone mineral density, as well as improving the postural control, the balance, and the gait. An important number of publications are found in the PubMed database with the keyword “flexibility” and eight of the analyzed papers involving WBV and flexibility reached a level of evidence II. The biggest distance between the third finger of the hand to the floor (DBTFF) of a patient with metabolic syndrome (MS) was found before the first session and was considered to be 100%. The percentages to the other measurements in the different sessions were determined to be related to the 100%. It is possible to see an immediate improvement after each session with a decrease of the %DBTFF. As the presence of MS is associated with poorer physical performance, a simple and safe protocol using WBV exercises promoted an improvement of the flexibility in a patient with MS. PMID:25276434

  5. Whole body vibration exercises and the improvement of the flexibility in patient with metabolic syndrome.

    PubMed

    Sá-Caputo, Danúbia da Cunha; Ronikeili-Costa, Pedro; Carvalho-Lima, Rafaelle Pacheco; Bernardo, Luciana Camargo; Bravo-Monteiro, Milena Oliveira; Costa, Rebeca; de Moraes-Silva, Janaina; Paiva, Dulciane Nunes; Machado, Christiano Bittencourt; Mantilla-Giehl, Paula; Arnobio, Adriano; Marin, Pedro Jesus; Bernardo-Filho, Mario

    2014-01-01

    Vibrations produced in oscillating/vibratory platform generate whole body vibration (WBV) exercises, which are important in sports, as well as in treating diseases, promoting rehabilitation, and improving the quality of life. WBV exercises relevantly increase the muscle strength, muscle power, and the bone mineral density, as well as improving the postural control, the balance, and the gait. An important number of publications are found in the PubMed database with the keyword "flexibility" and eight of the analyzed papers involving WBV and flexibility reached a level of evidence II. The biggest distance between the third finger of the hand to the floor (DBTFF) of a patient with metabolic syndrome (MS) was found before the first session and was considered to be 100%. The percentages to the other measurements in the different sessions were determined to be related to the 100%. It is possible to see an immediate improvement after each session with a decrease of the %DBTFF. As the presence of MS is associated with poorer physical performance, a simple and safe protocol using WBV exercises promoted an improvement of the flexibility in a patient with MS. PMID:25276434

  6. Strength training with superimposed whole body vibration does not preferentially modulate cortical plasticity.

    PubMed

    Weier, Ashleigh T; Kidgell, Dawson J

    2012-01-01

    Paired-pulse transcranial magnetic stimulation (TMS) was used to investigate 4 wks of leg strength training with and without whole body vibration (WBV) on corticospinal excitability and short-latency intracortical inhibition (SICI). Participants (n = 12) were randomly allocated to either a control or experimental (WBV) group. All participants completed 12 squat training sessions either with (WBV group) or without (control group) exposure to WBV (f = 35 Hz, A = 2.5 mm). There were significant (P < 0.05) increases in squat strength and corticospinal excitability and significant (P < 0.05) reductions in SICI for both groups following the 4 wk intervention. There were no differences detected between groups for any dependant variable (P > 0.05). It appears that WBV training does not augment the increase in strength or corticospinal excitability induced by strength training alone. PMID:22654645

  7. Vibration Therapy to Prevent Bone Loss and Falls: Mechanisms and Efficacy.

    PubMed

    Beck, Belinda R

    2015-12-01

    A considerable volume of evidence has accumulated to suggest that whole-body vibration (WBV) may have a therapeutic role to play in the prevention of osteoporotic fracture, particularly for individuals who are unable to tolerate vigorous exercise interventions. There is moderate to strong evidence that WBV will prevent falls (likely due to enhanced neuromuscular function), but also some indication that the effects of WBV do not outstrip those of targeted exercise. Animal data indicates that WBV will also improve bone mass, including preventing loss due to hormone withdrawal, disuse and glucocorticoid exposure. Human trials, however, have produced equivocal outcomes for bone. Positive trends are apparent at the hip and spine, but shortcomings in study designs have limited statistical power. The mechanism of the vibration effect on bone tissue is likely to be mechanical coupling between an oscillating cell nucleus and the cytoskeleton. More robust dose-response human data are required before therapeutic guidelines can be developed. PMID:26456496

  8. Effects of muscular strength, exercise order, and acute whole-body vibration exposure on bat swing speed.

    PubMed

    Reyes, G F Cisco; Dickin, D Clark; Dolny, Dennis G; Crusat, Nolan J K

    2010-12-01

    The purposes for this study were to investigate effects of acute whole-body vibration (WBV) exposure and exercise order on bat speed and to examine relationship between muscular strength and bat speed. All participants were recreationally trained men (n = 16; 22 ± 2 years; 181.4 ± 7.4 cm; 84.7 ± 9 kg), with previous baseball experience and were tested for 1 repetitive maximum (1RM) strength in squat and bench press. Subjects then participated in 4 randomized sessions on separate days, each consisting of 3 sets of 5 bat swings. Exercises (upper and lower body dynamic and static movements related to bat swing) with or without WBV exposure were performed after sets 1 and 2. Trials were as follows: no-exercise Control (CTRL), upper body followed by lower body exercises without WBV (Arm-Leg NOVIB), upper body followed by lower body exercises with WBV (Arm-Leg VIB), and lower body followed by upper body exercises with WBV (Leg-Arm VIB). Bat speed was recorded during each swing and averaged across sets. Statistical analyses were performed to assess differences across sets and trials. Linear regressions analyzed relationship between strength and bat speed. A significant relationship existed between bat speed and lower body strength (r = 0.406, p = 0.008) but not for upper body strength. The exercise order of Arm-Leg VIB significantly increased bat speed by 2.6% (p = 0.02). Performing identical order of exercises without vibration (Arm-Leg NOVIB) significantly decreased bat speed by 2% (p = 0.039). It was concluded that adding vibration exposure to total-body exercises can provide acute enhancements in bat speed. Additionally, leg strength was shown to influence bat speed suggesting that increasing leg strength may enhance bat speed. PMID:21088545

  9. Whole-body vibration training effect on physical performance and obesity in mice.

    PubMed

    Huang, Chi-Chang; Tseng, Tzu-Ling; Huang, Wen-Ching; Chung, Yi-Hsiu; Chuang, Hsiao-Li; Wu, Jyh-Horng

    2014-01-01

    The purpose of this study was to verify the beneficial effects of whole-body vibration (WBV) training on exercise performance, physical fatigue and obesity in mice with obesity induced by a high-fat diet (HFD). Male C57BL/6 mice were randomly divided into two groups: normal group (n=6), fed standard diet (control), and experimental group (n=18), fed a HFD. After 4-week induction, followed by 6-week WBV of 5 days per week, the 18 obese mice were divided into 3 groups (n=6 per group): HFD with sedentary control (HFD), HFD with WBV at relatively low-intensity (5.6 Hz, 0.13 g) (HFD+VL) or high-intensity (13 Hz, 0.68 g) (HFD+VH). A trend analysis revealed that WBV increased the grip strength in mice. WBV also dose-dependently decreased serum lactate, ammonia and CK levels and increased glucose level after the swimming test. WBV slightly decreased final body weight and dose-dependently decreased weights of epididymal, retroperitoneal and perirenal fat pads and fasting serum levels of alanine aminotransferase, CK, glucose, total cholesterol and triacylglycerol. Therefore, WBV could improve exercise performance and fatigue and prevent fat accumulation and obesity-associated biochemical alterations in obese mice. It may be an effective intervention for health promotion and prevention of HFD-induced obesity. PMID:25317067

  10. On the relationship between whole-body vibration exposure and spinal health risk.

    PubMed

    Seidel, Helmut

    2005-07-01

    A conceptual framework provides the possibility to identify factors determining the effects of whole-body vibration (WBV) on the spine and the internal stress-strain relationships. Epidemiological studies were critically evaluated with respect to their significance for the derivation of quantitative exposure-effect relationships. The approach of deriving such relationships from a comparison with self-generated accelerations during daily activities was considered as unsuited. Trunk muscle activity and control with apparently identical accelerations of body parts during self-generated and forced motions differ widely. Simple biodynamic models coupled with experimental in vivo and in vitro data permitted a preliminary deduction of quantitative relationships between WBV and spinal health with the consideration of individual factors and exposure conditions. Examples of anatomy-based verified finite element models and their application are provided. Such models are considered as a very promising instrument. They can be used to assess quantitatively preventive measures and design. Future research needs concern the examination of (1) the nonlinearity of biodynamics, (2) the effects of WBV in x- and y-axes, (3) the strength of the spine for shear, (4) the contact parameters between the seat and man, (5) the significance of postures and muscle activity, and (6) material properties of spinal structures. PMID:16100914

  11. Whole-Body Vibration Training Effect on Physical Performance and Obesity in Mice

    PubMed Central

    Huang, Chi-Chang; Tseng, Tzu-Ling; Huang, Wen-Ching; Chung, Yi-Hsiu; Chuang, Hsiao-Li; Wu, Jyh-Horng

    2014-01-01

    The purpose of this study was to verify the beneficial effects of whole-body vibration (WBV) training on exercise performance, physical fatigue and obesity in mice with obesity induced by a high-fat diet (HFD). Male C57BL/6 mice were randomly divided into two groups: normal group (n=6), fed standard diet (control), and experimental group (n=18), fed a HFD. After 4-week induction, followed by 6-week WBV of 5 days per week, the 18 obese mice were divided into 3 groups (n=6 per group): HFD with sedentary control (HFD), HFD with WBV at relatively low-intensity (5.6 Hz, 0.13 g) (HFD+VL) or high-intensity (13 Hz, 0.68 g) (HFD+VH). A trend analysis revealed that WBV increased the grip strength in mice. WBV also dose-dependently decreased serum lactate, ammonia and CK levels and increased glucose level after the swimming test. WBV slightly decreased final body weight and dose-dependently decreased weights of epididymal, retroperitoneal and perirenal fat pads and fasting serum levels of alanine aminotransferase, CK, glucose, total cholesterol and triacylglycerol. Therefore, WBV could improve exercise performance and fatigue and prevent fat accumulation and obesity-associated biochemical alterations in obese mice. It may be an effective intervention for health promotion and prevention of HFD-induced obesity. PMID:25317067

  12. Energy Expenditure and Substrate Oxidation in Response to Side-Alternating Whole Body Vibration across Three Commonly-Used Vibration Frequencies

    PubMed Central

    Fares, Elie-Jacques; Charrière, Nathalie; Montani, Jean-Pierre; Schutz, Yves; Dulloo, Abdul G.; Miles-Chan, Jennifer L.

    2016-01-01

    Background and Aim There is increasing recognition about the importance of enhancing energy expenditure (EE) for weight control through increases in low-intensity physical activities comparable with daily life (1.5–4 METS). Whole-body vibration (WBV) increases EE modestly and could present both a useful adjuvant for obesity management and tool for metabolic phenotyping. However, it is unclear whether a “dose-response” exists between commonly-used vibration frequencies (VF) and EE, nor if WBV influences respiratory quotient (RQ), and hence substrate oxidation. We aimed to investigate the EE-VF and RQ-VF relationships across three different frequencies (30, 40, and 50Hz). Methods EE and RQ were measured in 8 healthy young adults by indirect calorimetry at rest, and subsequently during side-alternating WBV at one of 3 VFs (30, 40, and 50 Hz). Each frequency was assessed over 5 cycles of intermittent WBV (30s vibration/30s rest), separated by 5 min seated rest. During the WBV participants stood on the platform with knees flexed sufficiently to maintain comfort, prevent transmission of vibration to the upper body, and minimise voluntary physical exertion. Repeatability was assessed across 3 separate days in a subset of 4 individuals. In order to assess any sequence/habituation effect, an additional group of 6 men underwent 5 cycles of intermittent WBV (30s vibration/30s rest) at 40 Hz, separated by 5 min seated rest. Results Side-alternating WBV increased EE relative to standing, non-vibration levels (+36%, p<0.001). However, no differences in EE were observed across VFs. Similarly, no effect of VF on RQ was found, nor did WBV alter RQ relative to standing without vibration. Conclusion No relationship could be demonstrated between EE and VF in the range of 30-50Hz, and substrate oxidation did not change in response to WBV. Furthermore, the thermogenic effect of intermittent WBV, whilst robust, was quantitatively small (<2 METS). PMID:26974147

  13. Modular CognitiveBehavioral Therapy for Body Dysmorphic Disorder

    PubMed Central

    Wilhelm, Sabine; Phillips, Katharine A.; Fama, Jeanne M.; Greenberg, Jennifer L.; Steketee, Gail

    2011-01-01

    This study pilot tested a newly developed modular cognitivebehavioral therapy (CBT) treatment manual for body dysmorphic disorder (BDD). We tested feasibility, acceptability, and treatment outcome in a sample of 12 adults with primary BDD. Treatment was delivered in weekly individual sessions over 18 or 22 weeks. Standardized clinician ratings and self-report measures were used to assess BDD and related symptoms pre- and posttreatment and at 3- and 6-month follow-ups. At posttreatment, BDD and related symptoms (e.g., mood) were significantly improved. Treatment gains were maintained at follow-up. A relatively low drop-out rate, high patient satisfaction ratings, and patient feedback indicated that the treatment was highly acceptable to patients. To our knowledge, this represents the first test of a broadly applicable, individual psychosocial treatment for BDD. PMID:22035991

  14. Recall radiation dermatitis by sorafenib following stereotactic body radiation therapy.

    PubMed

    Hsieh, Chen-Hsi; Lin, Shih-Chiang; Shueng, Pei-Wei; Kuo, Deng-Yu

    2014-01-01

    We report on a 63-year-old man with a history of hepatitis B virus-related hepatocellular carcinoma with a thrombus extending into the inferior vena cava, who received image-guided stereotactic body radiation therapy (SBRT) with helical tomotherapy, followed by sorafenib. A total tumor dose of 48 Gy was delivered by 6 fractions within 2 weeks. The tumor responded dramatically, and the patient tolerated the courses well. Ten days after SBRT, sorafenib (200 mg), at 1.5 tablets twice a day, was prescribed. One week later, grade 2 recall radiation dermatitis subsequently developed in the previous SBRT off-target area. SBRT followed by sorafenib for the treatment of a portal vein thrombosis provided effective results, but the potential risk of enhanced adverse effects between radiation and sorafenib should be considered with caution, especially under a SBRT scheme. PMID:24971021

  15. [Equipment and positioning technologies in stereotactic body radiation therapy].

    PubMed

    Marchesi, V; Dedieu, V; Lacornerie, T; Buchheit, I

    2014-01-01

    Strereotactic body radiation therapy needs adapted or dedicated equipment to allow fulfilling the particular conditions of the stereotactic treatments: submillimetric accuracy during the treatment delivery, high doses for a reduced number of sessions. This kind of treatment can be either performed using delivery equipment conceived and dedicated to the technique, or performed on conventional machines adapted to meet the criteria. Contrary to intracranial treatments, the positioning of the target volume raises new difficulties, mainly due to the diversity of localization to treat and also due to inter- and intrafraction movements that can occur. To reduce these effects that could affect the irradiation accuracy, positioning or movement compensation, mostly due to respiration, tools have been developed. PMID:24837350

  16. Definition of a Range of Idealized Values to Characterize Seated Body Biodynamic Response Under Vertical Vibration

    NASA Astrophysics Data System (ADS)

    Boileau, P.-.; Wu, X.; Rakheja, S.

    1998-08-01

    While a considerable quantity of data has been published on driving-point mechanical impedance, apparent mass and seat-to-head transmissibility magnitude and phase characteristics of seated subjects under vertical whole-body vibration, significant variation is known to exist between various data sets. Such variations may be partly attributed to differences associated with the methodology, experimental conditions or subject population used by various investigators to determine the biodynamic response characteristics. As part of this study, various published data sets on driving-point mechanical impedance, apparent mass and seat-to-head transmissibility, are identified for which the experimental conditions are reported to fall within a prescribed range of conditions for subjects maintaining an erect seated posture without backrest support, while the feet are supported on a vibrating platform. Only those data sets are considered for which the magnitude of vertical sine and/or random excitation is reported to have been maintained below 5 m/s-2. A further screening of the data sets defining the magnitude and phase responses of each function is performed by eliminating all data representing outliers in the 05-20 Hz frequency range. On that basis, mean and envelopes of the magnitude and phase responses associated with each function are derived in the 05-20 Hz frequency range, representing the most probable values likely applicable under the predefined range of conditions. The resulting range of idealized values on the magnitude and phase responses are based on 8 and 7 data sets respectively for driving-point mechanical impedance and apparent mass, while only 4 and 3 data sets respectively were left to define the seat-to-head transmissibility magnitude and phase.

  17. Effect of whole body vibration frequency on neuromuscular activity in ACL-deficient and healthy males.

    PubMed

    Giombini, A; Menotti, F; Laudani, L; Piccinini, A; Fagnani, F; Di Cagno, A; Macaluso, A; Pigozzi, F

    2015-09-01

    Whole-body vibration (WBV) has been shown to enhance muscle activity via reflex pathways, thus having the potential to contrast muscle weakness in individuals with rupture of the anterior cruciate ligament (ACL). The present study aimed to compare the magnitude of neuromuscular activation during WBV over a frequency spectrum from 20 to 45 Hz between ACL-deficient and healthy individuals. Fifteen males aged 284 with ACL rupture and 15 age-matched healthy males were recruited. Root mean square (RMS) of the surface electromyogram from the vastus lateralis in both limbs was computed during WBV in a static half-squat position at 20, 25, 30, 35, 40 and 45 Hz, and normalized to the RMS while maintaining the half-squat position without vibration. The RMS of the vastus lateralis in the ACL-deficient limb was significantly greater than in the contralateral limb at 25, 30, 35 and 40 Hz (P<0.05) and in both limbs of the healthy participants (dominant limb at 25, 30, 35, 40 and 45 Hz, P<0.05; non dominant limb at 20, 25, 30, 35, 40 and 45 Hz, P<0.05). The greater neuromuscular activity in the injured limb compared to the uninjured limb of the ACL-deficient patients and to both limbs of the healthy participants during WBV might be due to either augmented excitatory or reduced inhibitory neural inflow to motoneurons of the vastus lateralis through the reflex pathways activated by vibratory stimuli. The study provides optimal WBV frequencies which might be used as reference values for ACL-deficient patients. PMID:26424928

  18. Effect of whole body vibration frequency on neuromuscular activity in ACL-deficient and healthy males

    PubMed Central

    Giombini, A; Menotti, F; Piccinini, A; Fagnani, F; Di Cagno, A; Macaluso, A; Pigozzi, F

    2015-01-01

    Whole-body vibration (WBV) has been shown to enhance muscle activity via reflex pathways, thus having the potential to contrast muscle weakness in individuals with rupture of the anterior cruciate ligament (ACL). The present study aimed to compare the magnitude of neuromuscular activation during WBV over a frequency spectrum from 20 to 45 Hz between ACL-deficient and healthy individuals. Fifteen males aged 284 with ACL rupture and 15 age-matched healthy males were recruited. Root mean square (RMS) of the surface electromyogram from the vastus lateralis in both limbs was computed during WBV in a static half-squat position at 20, 25, 30, 35, 40 and 45 Hz, and normalized to the RMS while maintaining the half-squat position without vibration. The RMS of the vastus lateralis in the ACL-deficient limb was significantly greater than in the contralateral limb at 25, 30, 35 and 40 Hz (P<0.05) and in both limbs of the healthy participants (dominant limb at 25, 30, 35, 40 and 45 Hz, P<0.05; non dominant limb at 20, 25, 30, 35, 40 and 45 Hz, P<0.05). The greater neuromuscular activity in the injured limb compared to the uninjured limb of the ACL-deficient patients and to both limbs of the healthy participants during WBV might be due to either augmented excitatory or reduced inhibitory neural inflow to motoneurons of the vastus lateralis through the reflex pathways activated by vibratory stimuli. The study provides optimal WBV frequencies which might be used as reference values for ACL-deficient patients. PMID:26424928

  19. Effects of whole body vibration on outer hair cells' hearing response to distortion product otoacoustic emissions.

    PubMed

    Moussavi-Najarkola, Seyyed-Ali; Khavanin, Ali; Mirzaei, Ramazan; Salehnia, Mojdeh; Akbari, Mehdi

    2012-05-01

    Whole body vibration (WBV) is one of the most vexing problems in industries. There is a debate about the effect of WBV exposure on hearing system as vibration-induced hearing loss. The purpose of this study was to investigate outer hair cells' (OHCs') hearing response hearing response to distortion product otoacoustic emissions (DPOAEs) in rabbits exposed to WBV. It was hypothesized that the DPOAE response amplitudes (A(dp)) in rabbits exposed to WBV would be lower than those in control rabbits not exposed to WBV. New Zealand white (NZW) rabbits as vibration group (n = 6, exposed to WBV in the z-axis at 4-8 Hz and 1.0 ms(-2) root mean square for 8 h per day during five consecutive days) and NZW rabbits as control group (n = 6, not exposed to any WBV) were participated. A(dp) and noise floor levels (L(nf)) were examined on three occasions: day 0 (i.e., baseline), day 8 (i.e., immediately 1 h after exposure), and day 11 (i.e., 72 h following exposure) with f(2) frequencies ranging from 500 to 10,000 Hz and primaries L(1) and L(2) levels of 65 and 55 dB sound pressure level, respectively. Main effects were statistically found to be significant for group, time, and frequency (p < 0.05). DPOAE amplitudes were significantly larger for rabbits exposed to WBV, larger on day 8 and larger for mid to high f(2) frequencies (at and above 5,888.50 Hz). Main effects were not statistically found to be significant for ear (p > 0.05). Also, four statistically significant interactions including time by ear, time by frequency, group by frequency, and group by time were detected (p < 0.05). Contrary to the main hypothesis, DPOAE amplitudes were significantly larger for rabbits exposed to WBV. WBV exposure significantly led to enhanced mean A(dp) at mid to high frequencies rather than at low ones. PMID:22549335

  20. Regorafenib-induced transverse myelopathy after stereotactic body radiation therapy.

    PubMed

    Tian, Sibo; Nissenblatt, Michael; Goyal, Sharad

    2014-12-01

    Stereotactic body radiation therapy (SBRT) delivers large doses of radiation with great accuracy, but is known to have deleterious effects on the vascular compartment of irradiated tissues. Combining SBRT with targeted anti-angiogenesis agents, while able to increase therapeutic efficacy, may unexpectedly precipitate vascular-based toxicities. In this report, we describe a patient with colon cancer who developed transverse myelopathy from regorafenib 2 years after receiving SBRT for three metastatic liver lesions. Regorafenib (Stivarga), formerly BAY 73-4506, (Bayer HealthCare Pharmaceuticals, Montville, NJ) is a multiple receptor tyrosine kinase inhibitor with anti-angiogenic effects used in metastatic colon cancer. Its most common side effects are fatigue, diarrhea and hypertension. However, severe neurologic toxicity has not been previously recognized. Here, we illustrate a case in which the patient developed hyperalgesia and radicular pain 2 weeks after starting regorafenib. Several studies report an increased neurological toxicity when angiogenesis inhibitors are given after radiation therapy, and we postulate that the angioinhibitory effects of regorafenib accelerated subclinical microvascular injury from SBRT. This unexpected toxicity may be clinically relevant when giving targeted angiogenesis inhibitors after SBRT. PMID:25436137

  1. Regorafenib-induced transverse myelopathy after stereotactic body radiation therapy

    PubMed Central

    Tian, Sibo; Nissenblatt, Michael

    2014-01-01

    Stereotactic body radiation therapy (SBRT) delivers large doses of radiation with great accuracy, but is known to have deleterious effects on the vascular compartment of irradiated tissues. Combining SBRT with targeted anti-angiogenesis agents, while able to increase therapeutic efficacy, may unexpectedly precipitate vascular-based toxicities. In this report, we describe a patient with colon cancer who developed transverse myelopathy from regorafenib 2 years after receiving SBRT for three metastatic liver lesions. Regorafenib (Stivarga), formerly BAY 73-4506, (Bayer HealthCare Pharmaceuticals, Montville, NJ) is a multiple receptor tyrosine kinase inhibitor with anti-angiogenic effects used in metastatic colon cancer. Its most common side effects are fatigue, diarrhea and hypertension. However, severe neurologic toxicity has not been previously recognized. Here, we illustrate a case in which the patient developed hyperalgesia and radicular pain 2 weeks after starting regorafenib. Several studies report an increased neurological toxicity when angiogenesis inhibitors are given after radiation therapy, and we postulate that the angioinhibitory effects of regorafenib accelerated subclinical microvascular injury from SBRT. This unexpected toxicity may be clinically relevant when giving targeted angiogenesis inhibitors after SBRT. PMID:25436137

  2. Automated fiducial marker planning for thoracic stereotactic body radiation therapy

    NASA Astrophysics Data System (ADS)

    Gibbs, Jason D.; Rai, Lav; Wibowo, Henky; Tsalyuk, Serge; Anderson, Eric D.

    2012-02-01

    Stereotactic body-radiation therapy (SBRT) has gained acceptance in treating lung cancer. Localization of a thoracic lesion is challenging as tumors can move significantly with breathing. Some SBRT systems compensate for tumor motion with the intrafraction tracking of targets by two stereo fluoroscopy cameras. However, many lung tumors lack a fluoroscopic signature and cannot be directly tracked. Small radiopaque fiducial markers, acting as fluoroscopically visible surrogates, are instead implanted nearby. The spacing and configuration of the fiducial markers is important to the success of the therapy as SBRT systems impose constraints on the geometry of a fiducial-marker constellation. It is difficult even for experienced physicians mentally assess the validity of a constellation a priori. To address this challenge, we present the first automated planning system for bronchoscopic fiducial-marker placement. Fiducial-marker planning is posed as a constrained combinatoric optimization problem. Constraints include requiring access from a navigable airway, having sufficient separation in the fluoroscopic imaging planes to resolve each individual marker, and avoidance of major blood vessels. Automated fiducial-marker planning takes approximately fifteen seconds, fitting within the clinical workflow. The resulting locations are integrated into a virtual bronchoscopic planning system, which provides guidance to each location during the implantation procedure. To date, we have retrospectively planned over 50 targets for treatment, and have implanted markers according to the automated plan in one patient who then underwent SBRT treatment. To our knowledge, this approach is the first to address automated bronchoscopic fiducialmarker planning for SBRT.

  3. Role of stereotactic body radiation therapy for hepatocellular carcinoma.

    PubMed

    Sanuki, Naoko; Takeda, Atsuya; Kunieda, Etsuo

    2014-03-28

    The integration of new technologies has raised an interest in liver tumor radiotherapy, with literature evolving to support its efficacy. These advances, particularly stereotactic body radiation therapy (SBRT), have been critical in improving local control or potential cure in liver lesions not amenable to first-line surgical resection or radiofrequency ablation. Active investigation of SBRT, particularly for hepatocellular carcinoma (HCC), has recently started, yielding promising local control rates. In addition, data suggest a possibility that SBRT can be an alternative option for HCC unfit for other local therapies. However, information on optimal treatment indications, doses, and methods remains limited. In HCC, significant differences in patient characteristics and treatment availability exist by country. In addition, the prognosis of HCC is greatly influenced by underlying liver dysfunction and treatment itself in addition to tumor stage. Since they are closely linked to treatment approach, it is important to understand these differences in interpreting outcomes from various reports. Further studies are required to validate and maximize the efficacy of SBRT by a large, multi-institutional setting. PMID:24696597

  4. a Decade of Improvement in Whole-Body Vibration and Low Back Pain for Freight Container Tractor Drivers

    NASA Astrophysics Data System (ADS)

    Nishiyama, K.; Taoda, K.; Kitahara, T.

    1998-08-01

    The authors' study in 1983 revealed that the whole-body vibration of the tractor units of freight containers was most hazardous in the back-to-chest directions (x-axis). The allowable exposure time was considerably shorter than that for heavy duty trucks. The low back pain (LBP) among the drivers seemed to be due to the long working hours and the ergonomically unsound tractor design, as well as the vibration. A preventative measure was the introduction of a tractor cab suspended by an air spring instead of a steel spring. In 1992, a follow-up field study was conducted. A personal vibration exposure meter developed by us measured the whole-body vibration on eight tractors. Eighty-nine triplets matched with the age and the years of driving tractors answered a questionnaire evaluation of the ergonomics of their tractor units.The comparison of the newest steel suspension vehicles to the old ones produced by the same motor company revealed that in thex-axis the vibration level had decreased by as much as 4 to 9 dB. Some tractors showed an increase in vibration in the buttocks-to-head direction (z-axis). However, such adverse changes seemed not to affect evaluations according to the fatigue-decreased proficiency boundary (FDP) and the exposure limit (EL) recommended in ISO 2631-1978. The present models, regardless of the type of suspension, changed the direction of the most hazardous vibration from thex-axis to thez-axis. However, the effect of the air-suspension was not so remarkable as expected. Among 40% of drivers seemed to exceed the FDP boundary during a day.The questionnaire study showed an improvement in the ergonomic evaluation of the tractors. The air suspension models seemed to induce less LBP than the steel suspension models.

  5. Professional Soccer Player Neuromuscular Responses and Perceptions to Acute Whole Body Vibration Differ from Amateur Counterparts.

    PubMed

    Cloak, Ross; Lane, Andrew; Wyon, Matthew

    2016-03-01

    Acute whole body vibration (WBV) is an increasingly popular training technique amongst athletes immediately prior to performance and during scheduled breaks in play. Despite its growing popularity, evidence to demonstrate its effectiveness on acute neuromuscular responses is unclear, and suggestions that athlete ability impacts effectiveness warrant further investigation. The purpose of this study was to compare the neuromuscular effects of acute WBV and perceptions of whether WBV is an effective intervention between amateur and professional soccer players. Participants were 44 male soccer players (22 professional and 22 amateur; age: 23.1 ± 3.7 years, body mass: 75.6 ± 8.8 kg and height: 1.77 ± 0.05 m). Participants in each group were randomly assigned to either an intervention of 3 x 60 s of WBV at 40 Hz (8mm peak-to-peak displacement) or control group. Peak knee isometric force, muscle activation and post activation potentiation (PAP) of the knee extensors along with self-report questionnaire of the perceived benefits of using the intervention were collected. A three-way ANOVA with repeated measures revealed professional players demonstrated a significant 10.6% increase (p < 0.01, Partial Eta(2) = 0.22) in peak knee isometric force following acute WBV with no significant differences among amateur players. A significant difference (p < 0.01, Partial Eta(2) = 0.16) in PAP amongst professional players following acute WBVT was also reported. No significant differences amongst amateur players were reported across measurements. Results also indicated professional players reported significantly stronger positive beliefs in the effectiveness of the WBV intervention (p < 0.01, Partial Eta(2) = 0.27) compared to amateur players. Acute WBV elicited a positive neuromuscular response amongst professional players identified by PAP and improvements in knee isometric peak force as well as perceived benefits of the intervention, benefits not found among amateur players. Key pointsAcute WBV improves knee extensor peak isometric force output and PAP amongst professional and not amateur soccer playersProfessional players perceived acute WBV as more beneficial to performance than amateur playersIsometric strength,vibration intensity and duration appear to influence results amongst players of different playing levels. PMID:26957927

  6. Professional Soccer Player Neuromuscular Responses and Perceptions to Acute Whole Body Vibration Differ from Amateur Counterparts

    PubMed Central

    Cloak, Ross; Lane, Andrew; Wyon, Matthew

    2016-01-01

    Acute whole body vibration (WBV) is an increasingly popular training technique amongst athletes immediately prior to performance and during scheduled breaks in play. Despite its growing popularity, evidence to demonstrate its effectiveness on acute neuromuscular responses is unclear, and suggestions that athlete ability impacts effectiveness warrant further investigation. The purpose of this study was to compare the neuromuscular effects of acute WBV and perceptions of whether WBV is an effective intervention between amateur and professional soccer players. Participants were 44 male soccer players (22 professional and 22 amateur; age: 23.1 ± 3.7 years, body mass: 75.6 ± 8.8 kg and height: 1.77 ± 0.05 m). Participants in each group were randomly assigned to either an intervention of 3 x 60 s of WBV at 40 Hz (8mm peak-to-peak displacement) or control group. Peak knee isometric force, muscle activation and post activation potentiation (PAP) of the knee extensors along with self-report questionnaire of the perceived benefits of using the intervention were collected. A three-way ANOVA with repeated measures revealed professional players demonstrated a significant 10.6% increase (p < 0.01, Partial Eta2 = 0.22) in peak knee isometric force following acute WBV with no significant differences among amateur players. A significant difference (p < 0.01, Partial Eta2 = 0.16) in PAP amongst professional players following acute WBVT was also reported. No significant differences amongst amateur players were reported across measurements. Results also indicated professional players reported significantly stronger positive beliefs in the effectiveness of the WBV intervention (p < 0.01, Partial Eta2 = 0.27) compared to amateur players. Acute WBV elicited a positive neuromuscular response amongst professional players identified by PAP and improvements in knee isometric peak force as well as perceived benefits of the intervention, benefits not found among amateur players. Key points Acute WBV improves knee extensor peak isometric force output and PAP amongst professional and not amateur soccer players Professional players perceived acute WBV as more beneficial to performance than amateur players Isometric strength,vibration intensity and duration appear to influence results amongst players of different playing levels PMID:26957927

  7. Whole body vibration induces forepaw and hind paw behavioral sensitivity in the rat.

    PubMed

    Baig, Hassam A; Guarino, Benjamin B; Lipschutz, Daniel; Winkelstein, Beth A

    2013-11-01

    Whole body vibration (WBV) has been linked to neck and back pain, but the biomechanical and physiological mechanisms responsible for its development and maintenance are unknown. A rodent model of WBV was developed in which rats were exposed to different WBV paradigms, either daily for 7 consecutive days (repeated WBV) or two single exposures at Day 0 and 7 (intermittent WBV). Each WBV session lasted for 30?min and was imposed at a frequency of 15?Hz and RMS platform acceleration of 0.56??0.07?g. Changes in the withdrawal response of the forepaw and hind paw were measured, and were used to characterize the onset and maintenance of behavioral sensitivity. Accelerations and displacements of the rat and deformations in the cervical and lumbar spines were measured during WBV to provide mechanical context for the exposures. A decrease in withdrawal threshold was induced at 1 day after the first exposure in both the hind paw and forepaw. Repeated WBV exhibited a sustained reduction in withdrawal threshold in both paws and intermittent WBV induced a sustained response only in the forepaw. Cervical deformations were significantly elevated which may explain the more robust forepaw response. Findings suggest that a WBV exposure leads to behavioral sensitivity. PMID:23832376

  8. Effects of whole body vibration on hormonal & functional indices in patients with multiple sclerosis

    PubMed Central

    Ebrahimi, Ali; Eftekhari, Elham; Etemadifar, Masoud

    2015-01-01

    Background & objectives: Multiple sclerosis (MS) is a neurodegenerative disease, which affects the patients mobility, and exercise training is considered to be beneficial for these patients. The aim of this study was to determine the effects of 10 wk of low intensity exercise and whole body vibration (WBV) training on fatigue, quality of life, functional and physical indices, and serum levels of ghrelin, leptin, and testosterone in MS patients. Methods: Thirty four MS patients with mild to moderate disability were recruited and randomly divided into two groups, the training group (n=17) and control group (n=17). Patients in the training group did low intensity exercise and WBV training programme three times a week for 10 wk. The control group continued their routine life. Intended variables like expanded disability status scale (EDSS), fatigue, quality of life, functional and physical indices consisted of balance, walking speed, functional mobility, functional muscle endurance, and walking endurance, and serum levels of ghrelin, leptin, and testosterone were measured before and after the protocol. Results: Thirty subjects completed the study (23 females, 7 males; mean age =38.80 9.50 yr). Statistical analysis demonstrated that EDSS in the WBV training group was significantly decreased (P=0.01), balance (P=0.01), and walking endurance significantly increased (P=0.01) in MS patients (P<0.05). Interpretation & conclusions: The results suggest that low intensity exercise and WBV training have some beneficial impact on functional and physical indices of MS patients. PMID:26609037

  9. Computation of trunk muscle forces, spinal loads and stability in whole-body vibration

    NASA Astrophysics Data System (ADS)

    Bazrgari, B.; Shirazi-Adl, A.; Kasra, M.

    2008-12-01

    Whole-body vibration has been indicated as a risk factor in back disorders. Proper prevention and treatment management, however, requires a sound knowledge of associated muscle forces and loads on the spine. Previous trunk model studies have either neglected or over-simplified the trunk redundancy with time-varying unknown muscle forces. Trunk stability has neither been addressed. A novel iterative dynamic kinematics-driven approach was employed to evaluate muscle forces, spinal loads and system stability in a seated subject under a random vertical base excitation with 1 g peak acceleration contents. This iterative approach satisfied equations of motion in all directions/levels while accounting for the nonlinear passive resistance of the ligamentous spine. The effect of posture, co-activity in abdominal muscles and changes in buttocks stiffness were also investigated. The computed vertical accelerations were in good agreement with measurements. The input base excitation, via inertial and muscle forces, substantially influenced spinal loads and system stability. The flexed posture in sitting increased the net moment, muscle forces and passive spinal loads while improving the trunk stability. Similarly, the introduction of low to moderate antagonistic coactivity in abdominal muscles increased the passive spinal loads and improved the spinal stability. A trade-off, hence, exists between lower muscle forces and spinal loads on one hand and more stable spine on the other. Base excitations with larger peak acceleration contents substantially increase muscle forces/spinal loads and, hence, the risk of injury.

  10. Two way assessment of other physical work demands while measuring the whole body vibration magnitude

    NASA Astrophysics Data System (ADS)

    Tiemessen, Ivo J. H.; Hulshof, Carel T. J.; Frings-Dresen, Monique H. W.

    2008-03-01

    Direct observation, instead of using self-administered questionnaires might give more reliable and specific information about physical work demands at the workplace. This information is of use in a population already at risk of developing low back pain (LBP) due to whole body vibration (WBV) exposure. The aims of this study are to assess the WBV exposure in an exposed population and to assess other physical work demands in two ways, by direct observation and with the use of a self-administered questionnaire. We therefore assessed the WBV magnitude and 5 WBV-related physical work demands by using the PalmTrac system and a self-administered questionnaire in a group of drivers ( N=10). The main findings are 7 out of 10 drivers are exceeding the EU action value. About 50% of the drivers under-estimated the time 'bending', 60% the time 'walking+standing' and 60% over-estimated the time when 'lifting.' We concluded that 7 drivers from this group are at risk of developing LBP and substantial differences exists for the 5 physical work demands comparing the PalmTrac method with the questionnaire. Direct observational assessment in WBV measurements yields extra information. This is useful for preventive activities necessary as drivers are exceeding the EU action value.

  11. Changes in apparent body orientation and sensory localization induced by vibration of postural muscles - Vibratory myesthetic illusions

    NASA Technical Reports Server (NTRS)

    Lackner, J. R.; Levine, M. S.

    1979-01-01

    Human experiments are carried out which support the observation of Goodwin (1973) and Goodwin et al. (1972) that vibration of skeletal muscles can elicit illusory limb motion. These experiments extend the class of possible myesthetic illusions by showing that vibration of the appropriate muscles can produce illusory body motion in nearly any desired direction. Such illusory changes in posture occur only when visual information about body orientation is absent; these changes in apparent posture are sometimes accompanied by a slow-phase nystagmus that compensates for the direction of apparent body motion. During illusory body motion a stationary target light that is fixated will appear to move with the body at the same apparent velocity. However, this pattern of apparent body motion and conjoint visual - defined as propriogyral illusion - is suppressed if the subject is in a fully illuminated environment providing cues about true body orientation. Persuasive evidence is thus provided for the contribution of both muscle afferent and touch-pressure information to the supraspinal mechanisms that determine apparent orientation on the basis of ongoing patterns of interoceptive and exteroceptive activity.

  12. Comparison of the apparent masses and cross-axis apparent masses of seated humans exposed to single- and dual-axis whole-body vibration

    NASA Astrophysics Data System (ADS)

    Mansfield, Neil J.; Maeda, Setsuo

    2006-12-01

    Humans are exposed to whole-body vibration in many types of environment. In almost all cases, the vibration to which the human is exposed comprises multi-axis vibration, such that vibration occurs in all directions simultaneously. Despite the complex nature of vibration to which humans are exposed in the workplace, almost all laboratory studies investigating the biomechanical response of the person have been completed using single-axis simulators. This paper presents a study whereby 15 male subjects were exposed to single-axis whole-body vibration in the x-, y- and z-directions and dual-axis vibration in the xy-, xz-, and yz-directions using a 6 degree-of-freedom vibration simulator. All vibration magnitudes were 0.4 ms -2 rms in each axis. Acceleration and force was measured in the x-, y-, and z-direction during all trials. Subjects sat in two postures ('back-on' and 'back-off') on a flat rigid seat. Apparent masses measured using single-axis and dual-axis vibration stimuli showed comparable results; similarly, cross-axis apparent masses (i.e. the ratio of the force in one direction to the acceleration in another direction) were almost identical for the single- and dual-axis vibration stimuli. All results were in agreement with data previously published using single-axis vibration. In most cases, the peaks in the apparent mass and the cross-axis apparent mass occurred at a slightly lower frequency for the dual-axis vibration than for the single-axis vibration. It is hypothesised that this change is due to a nonlinear effect, analogous to that which occurs with increasing vibration magnitude for single-axis vibration.

  13. Muscle activity, cross-sectional area, and density following passive standing and whole body vibration: A case series

    PubMed Central

    Masani, Kei; Alizadeh-Meghrazi, Milad; Sayenko, Dimitry G.; Zariffa, Jose; Moore, Cameron; Giangregorio, Lora; Popovic, Milos R.; Catharine Craven, B.

    2014-01-01

    Objective To investigate the effects of intermittent passive standing (PS) and whole body vibration (WBV) on the electromyography (EMG) activity, cross-sectional area, and density of lower extremity muscles in individuals with chronic motor complete spinal cord injury (SCI). Design Case series. Methods Seven adult men with chronic (?2 years), thoracic motor complete (AIS AB) SCI completed a 40-week course of thrice-weekly intermittent PS-WBV therapy, in a flexed knee posture (160), for 45 minutes per session at a frequency of 45Hz and 0.60.7mm displacement using the WAVE Pro Plate, with an integrated EasyStand standing frame. EMG was measured in major lower extremity muscles to represent muscle activity during PS-WBV. The cross-sectional area and density of the calf muscles were measured using peripheral quantitative computed tomography at the widest calf cross-section (66% of the tibia length) at pre- and post-intervention. All measured variables were compared between the pre- and post-intervention measurements to assess change after the PS-WBV intervention. Results PS-WBV acutely induced EMG activity in lower extremity muscles of SCI subjects. No significant changes in lower extremity EMG activity, muscle cross-sectional area, or density were observed following the 40-week intervention. Conclusions Although acute exposure to PS-WBV can induce electrophysiological activity of lower extremity muscles during PS in men with motor complete SCI, the PS-WBV intervention for 40 weeks was not sufficient to result in enhanced muscle activity, or to increase calf muscle cross-sectional area or density. PMID:25059652

  14. To Compare the Effect of Vibration Therapy and Massage in Prevention of Delayed Onset Muscle Soreness (DOMS)

    PubMed Central

    Imtiyaz, Shagufta; Veqar, Zubia; Shareef, M.Y.

    2014-01-01

    Objectives: To compare the effects of vibration therapy and massage in prevention of DOMS. Methods: Pre-test and Post-test Control-Group Design was used, 45 healthy female non athletic Subjects were recruited and randomly distributed to the three groups (15 subject in each group). After the subjects initial status was measured experimental groups received vibration therapy (50 Hz vibration for five minutes) or massage therapy (15 minutes) intervention and control group received no treatment, just prior to the eccentric exercise. Subjects were undergoing the following measurements to evaluate the changes in the muscle condition: muscle soreness (pain perception), Range of Motion (ROM), Maximum Isometric Force (MIF), Repetition maximum (RM), Lactate dehydrogenase (LDH) and Cretain Kinase (CK) level. All the parameters except LDH, CK and 1RM were measured before, immediately post intervention, immediately post exercise, 24 hours post exercise, 48 hours post exercise and 72 hours post exercise. LDH, CK and 1 RM were measured before and 48 hours post exercise. Result: Muscle soreness was reported to be significantly less for experimental (vibration and massage) group (p=0.000) as compared to control group at 24, 48, and 72 hours of post-exercise. Experimental and control group did not show any significant difference in MIF immediate (p=0.2898), 24 hours (p=0.4173), 48 hours (p=0.752) and 72 hours (p=0.5297) of post-exercise. Range of motion demonstrated significant recovery in experimental groups in 48 hours (p=0.0016) and 72 hours (p=0.0463). Massage therapy showed significant recovery in 1RM (p=0.000) compared to control group and vibration therapy shows significantly less LDH level (p=0.000) 48 hours of post exercise compare to control group. CK at 48 hours of post exercise in vibration group (p=0.000) and massage group showed (p=0.002) significant difference as compared to control group. Conclusion: Vibration therapy and massage are equally effective in prevention of DOMS. Massage is effective in restoration of concentric strength (1 RM). Yet vibration therapy shows clinically early reduction of pain and is effective in decreasing the level of LDH in 48 hours post exercise periods. PMID:24596744

  15. Study of the effects of age and body mass index on the carotid wall vibration: extraction methodology and analysis.

    PubMed

    Yousefi Rizi, Fereshteh; Setarehdan, Seyed Kamaledin; Behnam, Hamid; Alizadeh Sani, Zahra

    2014-07-01

    This study aims to non-invasively extract the vibrations of the carotid wall and evaluate the changes in the carotid artery wall caused by age and obesity. Such evaluation can increase the possibility of detecting wall stiffness and atherosclerosis in its early stage. In this study, a novel method that uses a phase-tracking method based on the continuous wavelet transform calculates the carotid wall motion from the ultrasound radio frequency signals. To extract the high-frequency components of the wall motion, wall vibration, the empirical mode decomposition was then used. The posterior wall (intima-media) motion and vibration were extracted for 54 healthy volunteers (mean age: 33.87 14.73 years), including 13 overweight subjects (body mass index > 25) and 14 female participants using their radio frequency signals. The results showed that the dominant frequency of the wall vibration correlates with age (r = -0.5887, p < 0.001) and body mass index (r = -0.4838, p < 0.001). The quantitative analysis further demonstrated that the dominant frequency of the vibration in the radial direction of the carotid wall decreases by age and is lower in overweight subjects. Besides, the peak-to-peak amplitude of the wall vibration showed significant correlations with age (r = -0.5456, p < 0.001) and body mass index (r = -0.5821, p < 0.001). The peak-to-peak amplitude also decreases by age and is lower in overweight subjects. However, there were no significant correlations between these features of the wall vibrations and systolic/diastolic blood pressure and sex. Our proposed measures were certified using the calculated arterial stiffness indices. The average power spectrum of the elderly subjects'wall motion in the frequency range of the wall vibration (>100 Hz) is decreased more in comparison with the young subjects. Our results revealed that the proposed method may be useful for detecting the stiffness and distortion in the carotid wall that occur prior to wall thickening caused by age as an early-stage atherosclerotic sign. PMID:24972787

  16. Stereotactic Body Radiation Therapy in Recurrent Hepatocellular Carcinoma

    SciTech Connect

    Huang, Wen-Yen; Jen, Yee-Min; Lee, Meei-Shyuan; Chang, Li-Ping; Chen, Chang-Ming; Ko, Kai-Hsiung; Lin, Kuen-Tze; Lin, Jang-Chun; Chao, Hsing-Lung; Lin, Chun-Shu; Su, Yu-Fu; Fan, Chao-Yueh; Chang, Yao-Wen

    2012-10-01

    Purpose: To examine the safety and efficacy of Cyberknife stereotactic body radiation therapy (SBRT) and its effect on survival in patients of recurrent hepatocellular carcinoma (HCC). Methods and Materials: This was a matched-pair study. From January 2008 to December 2009, 36 patients with 42 lesions of unresectable recurrent HCC were treated with SBRT. The median prescribed dose was 37 Gy (range, 25 to 48 Gy) in 4-5 fractions over 4-5 consecutive working days. Another 138 patients in the historical control group given other or no treatments were selected for matched analyses. Results: The median follow-up time was 14 months for all patients and 20 months for those alive. The 1- and 2-year in-field failure-free rates were 87.6% and 75.1%, respectively. Out-field intrahepatic recurrence was the main cause of failure. The 2-year overall survival (OS) rate was 64.0%, and median time to progression was 8.0 months. In the multivariable analysis of all 174 patients, SBRT (yes vs. no), tumor size ({<=}4 cm vs. >4 cm), recurrent stage (stage IIIB/IV vs. I) and Child-Pugh classification (A vs. B/C) were independent prognostic factors for OS. Matched-pair analysis revealed that patients undergoing SBRT had better OS (2-year OS of 72.6% vs. 42.1%, respectively, p = 0.013). Acute toxicities were mild and tolerable. Conclusion: SBRT is a safe and efficacious modality and appears to be well-tolerated at the dose fractionation we have used, and its use correlates with improved survival in this cohort of patients with recurrent unresectable HCC. Out-field recurrence is the major cause of failure. Further studies of combinations of SBRT and systemic therapies may be reasonable.

  17. Whole-Body Vibration and Rehabilitation of Chronic Diseases: A Review of the Literature

    PubMed Central

    Chanou, Konstantina; Gerodimos, Vassilis; Karatrantou, Konstantina; Jamurtas, Athanasios

    2012-01-01

    The objectives of the study were to review the current literature and findings on the effects of whole-body vibration (WBV) as a training method on performance and its ability to aid in the rehabilitation of chronic diseases (neurological, musculoskeletal or metabolic conditions). Six electronic databases were searched. The combination of the search terminology used included WBV and several neurological, musculoskeletal and metabolic conditions. Twenty six papers were found to be relevant for this review and were included for critical evaluation with regards to sample characteristics, research intervention and methodology. Most studies were conducted on patients diagnosed with neurological conditions (n = 15) while less were performed on patients suffering from musculoskeletal (n = 7) or metabolic (n = 4) disorders. Comparisons were difficult to draw on because of the different pathologies and the differences in the methodology of each study. Some of the observed methodological flaws included limitations in relation to insufficient randomisation, lack of sample homogeneity (size, age variability) and poor blinding in most studies. No consensus could be reached as to whether WBV is more effective than other interventions or no intervention at all, while the additional effects that WBV may have in relation to other interventions could not be assumed. Nevertheless, chronic WBV training seems to only improve strength in neurological patients while balance and mobility improves only in patients suffering from musculoskeletal or metabolic but not from neurological conditions. Although WBV did not prove to be more effective compared to other training methods, it can be used, in some cases, as a less fatiguing and less time-consuming method to enhance physical capabilities. Future research should focus on the effectiveness of WBV in relation to no treatment at all, and to age. Key pointsChronic WBV training seems to only improve strength in neurological patients while balance and mobility improves only in patients suffering from musculoskeletal or metabolic conditions.WBV did not prove to be more effective than other interventions, while the positive effects of WBV in relation to no intervention at all could not be established.No consensus could be reached as to which vibration type is more effective.WBV training could be used as a safe, less fatiguing and less time-consuming type of exercise for patients with neurologic conditions instead of other more demanding interventions. PMID:24149191

  18. The Effect of a Single Session of Whole-Body Vibration Training in Recreationally Active Men on the Excitability of the Central and Peripheral Nervous System

    PubMed Central

    Chmielewska, Daria; Piecha, Magdalena; B?aszczak, Edward; Krl, Piotr; Smykla, Agnieszka; Juras, Grzegorz

    2014-01-01

    Vibration training has become a popular method used in professional sports and recreation. In this study, we examined the effect of whole-body vibration training on the central nervous system and muscle excitability in a group of 28 active men. Subjects were assigned randomly to one of two experimental groups with different variables of vibrations. The chronaximetry method was used to evaluate the effect of a single session of whole-body vibration training on the excitability of the rectus femoris and brachioradialis muscles. The examination of the fusing and flickering frequencies of the light stimulus was performed. An increase in the excitability of the quadriceps femoris muscle due to low intensity vibrations (20 Hz frequency, 2 mm amplitude) was noted, and a return to the initial values was observed 30 min after the application of vibration. High intensity vibrations (60 Hz frequency, 4 mm amplitude) caused elongations of the chronaxy time; however, these differences were not statistically significant. Neither a low intensity vibration amplitude of 2 mm (frequency of 20 Hz) nor a high intensity vibration amplitude of 4 mm (frequency of 60 Hz) caused a change in the excitability of the central nervous system, as revealed by the average frequency of the fusing and flickering of the light stimulus. A single session of high intensity whole-body vibration did not significantly decrease the excitability of the peripheral nervous system while the central nervous system did not seem to be affected. PMID:25114735

  19. Whole-Body Vibration Training and Its Application to Age-Related Performance Decrements: An Exploratory Analysis.

    PubMed

    Hawkey, Adam; Griffiths, Katie; Babraj, John; Cobley, James N

    2016-02-01

    Hawkey, A, Griffiths, K, Babraj, J, and Cobley, JN. Whole-body vibration training and its application to age-related performance decrements: an exploratory analysis. J Strength Cond Res 30(2): 555-560, 2016-Middle age is associated with a pronounced decline in power and flexibility. Whilst whole-body vibration training (WBVT) improves performance in a range of populations, whether WBVT can improve muscle power and flexibility in a middle-aged population is not known. The present study aimed to determine the influence of 5 weeks progressive WBVT in middle-aged (45-55 years) and younger (20-30 years) recreationally active females. Participants in each age group were randomly allocated to an intervention (WBVT) or control group. The WBVT groups trained for 5 weeks on a vibration platform, while the control groups performed identical exercises, with no vibration. Prior to, and after, the 5-week study vertical countermovement jump (VCMJ) and range of motion (ROM) performance were measured. WBVT significantly (p = 0.001) improved VCMJ performance when compared to the control groups. This improvement was significantly (p = 0.001) greater in the middle-aged compared with the younger WBVT group. WBVT significantly (p = 0.001) improved ROM irrespective of age. Taken together, these results suggest that WBVT can off-set age related performance decrements, which has therapeutic implications for musculoskeletal aging. Therefore, WBVT could be undertaken to minimise age-related performance deterioration in middle-aged female populations. PMID:26244828

  20. The impact of self-reported exposure to whole-body-vibrations on the risk of disability pension among men: a 15 year prospective study

    PubMed Central

    2010-01-01

    Background Whole-body-vibrations are often associated with adverse health effect but the long term effects are less known. This study investigates the association between occupational exposures to whole-body vibrations, and subsequent transition to disability pension. Methods A total of 4215 male employees were followed up for subsequent disability pension retirement. Exposure to whole-body-vibration was self-reported while new cases of disability pension were retrieved from a national register. Results The hazard ratio (HR) for disability pension retirement among men exposed to whole-body-vibrations was 1.61 (95% confidence interval (CI) 1.07-2.40) after adjustment for age, smoking habits, BMI, physical job demands and awkward work postures. In our model, with the available explanatory variables, 5.6% of the male disability pension cases were attributable to whole-body-vibrations. Conclusions Exposure to whole-body-vibrations predicts subsequent disability pension retirement. Continued reduction of whole-body-vibrations may reduce the number of new cases of disability pension. PMID:20525268

  1. Stereotactic Body Radiation Therapy Boost in Locally Advanced Pancreatic Cancer

    SciTech Connect

    Seo, Young Seok; Kim, Mi-Sook; Yoo, Sung Yul; Cho, Chul Koo; Yang, Kwang Mo; Yoo, Hyung Jun; Choi, Chul Won; Lee, Dong Han; Kim, Jin; Kim, Min Suk; Kang, Hye Jin; Kim, YoungHan

    2009-12-01

    Purpose: To investigate the clinical application of a stereotactic body radiation therapy (SBRT) boost in locally advanced pancreatic cancer patients with a focus on local efficacy and toxicity. Methods and Materials: We retrospectively reviewed 30 patients with locally advanced and nonmetastatic pancreatic cancer who had been treated between 2004 and 2006. Follow-up duration ranged from 4 to 41 months (median, 14.5 months). A total dose of 40 Gy was delivered in 20 fractions using a conventional three-field technique, and then a single fraction of 14, 15, 16, or 17 Gy SBRT was administered as a boost without a break. Twenty-one patients received chemotherapy. Overall and local progression-free survival were calculated and prognostic factors were evaluated. Results: One-year overall survival and local progression-free survival rates were 60.0% and 70.2%, respectively. One patient (3%) developed Grade 4 toxicity. Carbohydrate antigen 19-9 response was found to be an independent prognostic factor for survival. Conclusions: Our findings indicate that a SBRT boost provides a safe means of increasing radiation dose. Based on the results of this study, we recommend that a well controlled Phase II study be conducted on locally advanced pancreatic cancer.

  2. Functional Genomics in the Study of Mind-Body Therapies

    PubMed Central

    Niles, Halsey; Mehta, Darshan H.; Corrigan, Alexandra A.; Bhasin, Manoj K.; Denninger, John W.

    2014-01-01

    Background Mind-body therapies (MBTs) are used throughout the world in treatment, disease prevention, and health promotion. However, the mechanisms by which MBTs exert their positive effects are not well understood. Investigations into MBTs using functional genomics have revolutionized the understanding of MBT mechanisms and their effects on human physiology. Methods We searched the literature for the effects of MBTs on functional genomics determinants using MEDLINE, supplemented by a manual search of additional journals and a reference list review. Results We reviewed 15 trials that measured global or targeted transcriptomic, epigenomic, or proteomic changes in peripheral blood. Sample sizes ranged from small pilot studies (n=2) to large trials (n=500). While the reliability of individual genes from trial to trial was often inconsistent, genes related to inflammatory response, particularly those involved in the nuclear factor-kappa B (NF-?B) pathway, were consistently downregulated across most studies. Conclusion In general, existing trials focusing on gene expression changes brought about by MBTs have revealed intriguing connections to the immune system through the NF-?B cascade, to telomere maintenance, and to apoptotic regulation. However, these findings are limited to a small number of trials and relatively small sample sizes. More rigorous randomized controlled trials of healthy subjects and specific disease states are warranted. Future research should investigate functional genomics areas both upstream and downstream of MBT-related gene expression changesfrom epigenomics to proteomics and metabolomics. PMID:25598735

  3. Alternative to traditional stretching methods for flexibility enhancement in well-trained combat athletes: local vibration versus whole-body vibration.

    PubMed

    Kurt, C

    2015-09-01

    This study aimed to compare the effect of local vibration (LV) and whole body vibration (WBV) on lower body flexibility and to assess whether vibration treatments were more effective than traditionally used static and dynamic stretching methods. Twenty-four well-trained male combat athletes (age: 22.7 ± 3.3 years) performed four exercise protocols - LV (30 Hz, 4 mm), WBV (30 Hz, 4 mm), static stretching (SS), and dynamic stretching (DS) - in four sessions of equal duration 48 hours apart in a randomized, balanced order. During a 15-minute recovery after each protocol, subjects performed the stand and reach test (S&R) at the 15th second and the 2(nd), 4(th), 6(th), 8(th), 10(th) and 15(th) minute. There was a similar change pattern in S&R scores across the 15-minute recovery after each protocol (p = 0.572), remaining significantly elevated throughout the recovery. A significant main protocol effect was found for absolute change in S&R scores relative to baseline (p = 0.015). These changes were statistically greater in LV than WBV and DS. Changes in SS were not significantly different from LV, but were consistently lower than LV with almost moderate effect sizes. After LV, a greater percentage of subjects increased flexibility above the minimum detectable change compared to other protocols. Subjects with high flexibility (n = 12) benefited more from LV compared with other methods (effect size ≥ 0.862). In conclusion, LV was an effective alternative exercise modality to acutely increase lower extremity flexibility for well-trained athletes compared with WBV and traditional stretching exercises. PMID:26424926

  4. Alternative to traditional stretching methods for flexibility enhancement in well-trained combat athletes: local vibration versus whole-body vibration

    PubMed Central

    2015-01-01

    This study aimed to compare the effect of local vibration (LV) and whole body vibration (WBV) on lower body flexibility and to assess whether vibration treatments were more effective than traditionally used static and dynamic stretching methods. Twenty-four well-trained male combat athletes (age: 22.7 ± 3.3 years) performed four exercise protocols – LV (30 Hz, 4 mm), WBV (30 Hz, 4 mm), static stretching (SS), and dynamic stretching (DS) – in four sessions of equal duration 48 hours apart in a randomized, balanced order. During a 15-minute recovery after each protocol, subjects performed the stand and reach test (S&R) at the 15th second and the 2nd, 4th, 6th, 8th, 10th and 15th minute. There was a similar change pattern in S&R scores across the 15-minute recovery after each protocol (p = 0.572), remaining significantly elevated throughout the recovery. A significant main protocol effect was found for absolute change in S&R scores relative to baseline (p = 0.015). These changes were statistically greater in LV than WBV and DS. Changes in SS were not significantly different from LV, but were consistently lower than LV with almost moderate effect sizes. After LV, a greater percentage of subjects increased flexibility above the minimum detectable change compared to other protocols. Subjects with high flexibility (n = 12) benefited more from LV compared with other methods (effect size ≥ 0.862). In conclusion, LV was an effective alternative exercise modality to acutely increase lower extremity flexibility for well-trained athletes compared with WBV and traditional stretching exercises. PMID:26424926

  5. Acute effects of unilateral whole body vibration training on single leg vertical jump height and symmetry in healthy men

    PubMed Central

    Shin, Seungho; Lee, Kyeongjin; Song, Changho

    2015-01-01

    [Purpose] The aim of the present study was to investigate the acute effects of unilateral whole body vibration training on height and symmetry of the single leg vertical jump in healthy men. [Subjects] Thirty males with no history of lower limb dysfunction participated in this study. [Methods] The participants were randomly allocated to one of three groups: the unilateral vibratory stimulation group (n=10), bilateral vibratory stimulation group (n=10), and, no vibratory stimulation group (n=10). The subjects in the unilateral and bilateral stimulation groups participated in one session of whole body vibration training at 26 Hz for 3 min. The no vibratory stimulation group subjects underwent the same training for 3 min without whole body vibration. All participants performed the single leg vertical jump for each lower limb, to account for the strong and weak sides. The single leg vertical jump height and symmetry were measured before and after the intervention. [Results] The single leg vertical jump height of the weak lower limb significantly improved in the unilateral vibratory stimulation group, but not in the other groups. The single leg vertical jump height of the strong lower limb significantly improved in the bilateral vibratory stimulation group, but not in the other groups. The single leg vertical jump symmetry significantly improved in the unilateral vibratory stimulation group, but not in the other groups. [Conclusion] Therefore, the present study found that the effects of whole body vibration training were different depending on the type of application. To improve the single leg vertical jump height in the weak lower limbs as well as limb symmetry, unilateral vibratory stimulation might be more desirable. PMID:26834381

  6. Mind-body therapies: evidence and implications in advanced oncology practice.

    PubMed

    Mayden, Kelley D

    2012-11-01

    The idea that thoughts and emotions influence health outcomes is an ancient concept that was initially abandoned by Western medicine researchers. Today, researchers are showing a renewed interest in the interactions of the mind and body and the role these interactions play in disease formation and recovery. Complementary and alternative interventions, such as mind-body therapies, are increasingly being used by cancer survivors for disease prevention, immune system enhancement, and symptom control. Traditional training has not been structured to provide advanced practitioners with an in-depth knowledge of the clinical applications of mind-body therapies. The aim of this article is to acquaint the reader with common mind-body modalities (meditation/mindfulness-based stress reduction, relaxation therapy, cognitive-behavioral therapy, hypnosis, biofeedback, music therapy, art therapy, support groups, and aromatherapy) and to examine important evidence in support of or against their clinical application. PMID:25031967

  7. Mind-Body Therapies: Evidence and Implications in Advanced Oncology Practice

    PubMed Central

    Mayden,, Kelley D.

    2012-01-01

    The idea that thoughts and emotions influence health outcomes is an ancient concept that was initially abandoned by Western medicine researchers. Today, researchers are showing a renewed interest in the interactions of the mind and body and the role these interactions play in disease formation and recovery. Complementary and alternative interventions, such as mind-body therapies, are increasingly being used by cancer survivors for disease prevention, immune system enhancement, and symptom control. Traditional training has not been structured to provide advanced practitioners with an in-depth knowledge of the clinical applications of mind-body therapies. The aim of this article is to acquaint the reader with common mind-body modalities (meditation/mindfulness-based stress reduction, relaxation therapy, cognitive-behavioral therapy, hypnosis, biofeedback, music therapy, art therapy, support groups, and aromatherapy) and to examine important evidence in support of or against their clinical application. PMID:25031967

  8. The Effects of Whole-Body Vibration on the Cross-Transfer of Strength

    PubMed Central

    Goodwill, Alicia M.; Kidgell, Dawson J.

    2012-01-01

    This study investigated whether the use of superimposed whole-body vibration (WBV) during cross-education strength training would optimise strength transfer compared to conventional cross-education strength training. Twenty-one healthy, dominant right leg volunteers (21 3 years) were allocated to a strength training (ST, m = 3, f = 4), a strength training with WBV (ST + V, m = 3, f = 4), or a control group (no training, m = 3, f = 4). Training groups performed 9 sessions over 3 weeks, involving unilateral squats for the right leg, with or without WBV (35?Hz; 2.5?mm amplitude). All groups underwent dynamic single leg maximum strength testing (1RM) and single and paired pulse transcranial magnetic stimulation (TMS) prior to and following training. Strength increased in the trained limb for the ST (41%; ES = 1.14) and ST + V (55%; ES = 1.03) groups, which resulted in a 35% (ES = 0.99) strength transfer to the untrained left leg for the ST group and a 52% (ES = 0.97) strength transfer to the untrained leg for the ST + V group, when compared to the control group. No differences in strength transfer between training groups were observed (P = 0.15). For the untrained leg, no differences in the peak height of recruitment curves or SICI were observed between ST and ST + V groups (P = 1.00). Strength training with WBV does not appear to modulate the cross-transfer of strength to a greater magnitude when compared to conventional cross-education strength training. PMID:23365521

  9. Effects of whole body vibration on strength and jumping performance in volleyball and beach volleyball players.

    PubMed

    Prez-Turpin, J A; Zmijewski, P; Jimenez-Olmedo, J M; Jov-Tossi, M A; Martnez-Carbonell, A; Surez-Llorca, C; Andreu-Cabrera, E

    2014-08-01

    The primary aim of this study was to examine the effects of 6-week strength training with whole body vibration (WBV) on leg strength and jumping performance in volleyball and beach volleyball players. Twenty-three sub-elite male volleyball (VB; n=12) and beach volleyball players (BVB; n=11) aged 21.23.0 years were divided into two groups and subjected to 6 weeks of strength training (three one-hour sessions per week): (I) 12 players (6 VB and 6 BVB players) underwent training with WBV (30-40 Hz, 1.7-2.5 mm, 3.0-5.7 g), and (II) 11 players (6 VB and 5 BVB players) underwent traditional strength training. Squat jump (SJ) and countermovement squat jump (CMJ) measurements by the Ergo Tester contact platform and maximum leg press test (1RM) were conducted. Three-factor (2 time x 2 WBV use x 2 discipline) analysis of variance for SJ, CMJ and 1RM revealed a significant time main effect (p<0.001), a WBV use effect (p<0.001) and a discipline effect (p<0.001). Significantly greater improvements in the SJ (p<0.001) and CMJ (p<0.001) and in 1RM (p<0.001) were found in the WBV training groups than in traditional training groups. Significant 3-way interaction effects (training, WBV use, discipline kind) were also found for SJ, CMJ and 1RM (p=0.001, p<0.001, p=0.001, respectively). It can be concluded that implementation of 6-week WBV training in routine practice in volleyball and beach volleyball players increases leg strength more and leads to greater improvement in jump performance than traditional strength training, but greater improvements can be expected in beach volleyball players than in volleyball players. PMID:25187676

  10. Hypofractionated stereotactic body radiation therapy (SBRT) for limited hepatic metastases

    SciTech Connect

    Katz, Alan W. . E-mail: alan_katz@urmc.rochester.edu; Carey-Sampson, Madeleine; Muhs, Ann G.; Milano, Michael T.; Schell, Michael C.; Okunieff, Paul

    2007-03-01

    Purpose: To evaluate the feasibility and efficacy of hypofractionated stereotactic body radiation therapy (SBRT) for the treatment of liver metastases. Methods and Materials: The records of 69 patients with 174 metastatic liver lesions treated with SBRT between April 2001 and October 2004 were reviewed. The most common primary tumors were colorectal (n = 20), breast (n = 16), pancreas (n = 9), and lung (n = 5). The mean number of lesions treated per patient was 2.5 (range, 1-6). The longest diameter of the lesions ranged in size from 0.6 to 12.2 cm (median, 2.7 cm). Dose per fraction ranged from 2 Gy to 6 Gy, with a median total dose of 48 Gy (range, 30-55 Gy). Dose was prescribed to the 100% isodose line (IDL), with the 80% IDL covering the gross tumor volume with a minimum margin of 7 mm. Results: The median follow up was 14.5 months. Sixty patients were evaluable for response based on an abdominal computed tomography scan obtained at a minimum of 3 months after completion of SBRT. The actuarial overall infield local control rate of the irradiated lesions was 76% and 57% at 10 and 20 months, respectively. The median overall survival time was 14.5 months. The progression-free survival rate was 46% and 24% at 6 and 12 months, respectively. None of the patients developed Grade 3 or higher toxicity. Conclusion: Hypofractionated SBRT provides excellent local control with minimal side effects in selected patients with limited hepatic metastases.

  11. Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

    PubMed Central

    Kunos, Charles A.; Fabien, Jeffrey M.; Shanahan, John P.; Collen, Christine; Gevaert, Thierry; Poels, Kenneth; Van den Begin, Robbe; Engels, Benedikt; De Ridder, Mark

    2015-01-01

    Physicians considering stereotactic ablative body radiation therapy (SBRT) for the treatment of extracranial cancer targets must be aware of the sizeable risks for normal tissue injury and the hazards of physical tumor miss. A first-of-its-kind SBRT platform achieves high-precision ablative radiation treatment through a combination of versatile real-time imaging solutions and sophisticated tumor tracking capabilities. It uses dual-diagnostic kV x-ray units for stereoscopic open-loop feedback of cancer target intrafraction movement occurring as a consequence of respiratory motions and heartbeat. Image-guided feedback drives a gimbaled radiation accelerator (maximum 15 x 15 cm field size) capable of real-time ±4 cm pan-and-tilt action. Robot-driven ±60° pivots of an integrated ±185° rotational gantry allow for coplanar and non-coplanar accelerator beam set-up angles, ultimately permitting unique treatment degrees of freedom. State-of-the-art software aids real-time six dimensional positioning, ensuring irradiation of cancer targets with sub-millimeter accuracy (0.4 mm at isocenter). Use of these features enables treating physicians to steer radiation dose to cancer tumor targets while simultaneously reducing radiation dose to normal tissues. By adding respiration correlated computed tomography (CT) and 2-[18F] fluoro-2-deoxy-ᴅ-glucose (18F-FDG) positron emission tomography (PET) images into the planning system for enhanced tumor target contouring, the likelihood of physical tumor miss becomes substantially less1. In this article, we describe new radiation plans for the treatment of moving lung tumors. PMID:26131774

  12. Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy.

    PubMed

    Kunos, Charles A; Fabien, Jeffrey M; Shanahan, John P; Collen, Christine; Gevaert, Thierry; Poels, Kenneth; Van den Begin, Robbe; Engels, Benedikt; De Ridder, Mark

    2015-01-01

    Physicians considering stereotactic ablative body radiation therapy (SBRT) for the treatment of extracranial cancer targets must be aware of the sizeable risks for normal tissue injury and the hazards of physical tumor miss. A first-of-its-kind SBRT platform achieves high-precision ablative radiation treatment through a combination of versatile real-time imaging solutions and sophisticated tumor tracking capabilities. It uses dual-diagnostic kV x-ray units for stereoscopic open-loop feedback of cancer target intrafraction movement occurring as a consequence of respiratory motions and heartbeat. Image-guided feedback drives a gimbaled radiation accelerator (maximum 15 x 15 cm field size) capable of real-time 4 cm pan-and-tilt action. Robot-driven 60 pivots of an integrated 185 rotational gantry allow for coplanar and non-coplanar accelerator beam set-up angles, ultimately permitting unique treatment degrees of freedom. State-of-the-art software aids real-time six dimensional positioning, ensuring irradiation of cancer targets with sub-millimeter accuracy (0.4 mm at isocenter). Use of these features enables treating physicians to steer radiation dose to cancer tumor targets while simultaneously reducing radiation dose to normal tissues. By adding respiration correlated computed tomography (CT) and 2-[(18)F] fluoro-2-deoxy-?-glucose ((18)F-FDG) positron emission tomography (PET) images into the planning system for enhanced tumor target contouring, the likelihood of physical tumor miss becomes substantially less. In this article, we describe new radiation plans for the treatment of moving lung tumors. PMID:26131774

  13. Acute and Chronic Whole-Body Vibration Exercise does not Induce Health-Promoting Effects on The Blood Profile

    PubMed Central

    Theodorou, Anastasios A.; Gerodimos, Vassilis; Karatrantou, Konstantina; Paschalis, Vassilis; Chanou, Konstantina; Jamurtas, Athanasios Z.; Nikolaidis, Michalis G.

    2015-01-01

    Whole-body vibration (WBV) exercise is an alternative, popular and easy exercise that can be followed by general public. Therefore, the aim of the present study was to investigate the influence of acute and chronic WBV exercise on health-related parameters. Twenty-eight women were allocated into a control group (n=11, mean ±SEM: age, 43.5 ±1.5 yr; body mass, 66.1 ±3.1 kg; height, 160.6 ±1.5 cm) and a vibration group (n=17, mean ±SEM: age, 44.0 ±1.0 yr; body mass, 67.1 ±2.2 kg; height, 162.5 ±1.5 cm). After baseline assessments, participants of the experimental group performed WBV training 3 times/week for 8 weeks. Before and after the chronic WBV exercise, the participants of the vibration group performed one session of acute WBV exercise. Blood chemistry measurements (hematology, creatine kinase, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, C-reactive protein, glucose, insulin, triacylglycerols, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein A1, apolipoprotein B and lipoprotein, thiobarbituric-acid reactive substances, protein carbonyls, total antioxidant capacity, uric acid, albumin and bilirubin) were assessed pre-exercise and post-exercise at the first and eighth week of WBV exercise in both control and vibration groups. The results failed to support any effect of both acute and chronic WBV exercise on biochemical health-related parameters. However, it seems that WBV exercise is a safe way of training without a negative impact on muscle and liver functionality. PMID:26240654

  14. Acute and Chronic Whole-Body Vibration Exercise does not Induce Health-Promoting Effects on The Blood Profile.

    PubMed

    Theodorou, Anastasios A; Gerodimos, Vassilis; Karatrantou, Konstantina; Paschalis, Vassilis; Chanou, Konstantina; Jamurtas, Athanasios Z; Nikolaidis, Michalis G

    2015-06-27

    Whole-body vibration (WBV) exercise is an alternative, popular and easy exercise that can be followed by general public. Therefore, the aim of the present study was to investigate the influence of acute and chronic WBV exercise on health-related parameters. Twenty-eight women were allocated into a control group (n=11, mean SEM: age, 43.5 1.5 yr; body mass, 66.1 3.1 kg; height, 160.6 1.5 cm) and a vibration group (n=17, mean SEM: age, 44.0 1.0 yr; body mass, 67.1 2.2 kg; height, 162.5 1.5 cm). After baseline assessments, participants of the experimental group performed WBV training 3 times/week for 8 weeks. Before and after the chronic WBV exercise, the participants of the vibration group performed one session of acute WBV exercise. Blood chemistry measurements (hematology, creatine kinase, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, C-reactive protein, glucose, insulin, triacylglycerols, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein A1, apolipoprotein B and lipoprotein, thiobarbituric-acid reactive substances, protein carbonyls, total antioxidant capacity, uric acid, albumin and bilirubin) were assessed pre-exercise and post-exercise at the first and eighth week of WBV exercise in both control and vibration groups. The results failed to support any effect of both acute and chronic WBV exercise on biochemical health-related parameters. However, it seems that WBV exercise is a safe way of training without a negative impact on muscle and liver functionality. PMID:26240654

  15. The ISO standard: Guide for the evaluation of human exposure to whole-body vibration

    NASA Technical Reports Server (NTRS)

    Vongierke, H. E.

    1975-01-01

    The international guideline is discussed in terms of safety and human tolerance. Charts for equal subjective vibration intensity, subjective judgement of equal fatigue, and severe discomfort boundaries are included.

  16. Low back pain in drivers: The relative role of whole-body vibration, posture and manual materials handling

    NASA Astrophysics Data System (ADS)

    Okunribido, O. O.; Magnusson, M.; Pope, M. H.

    2006-12-01

    A cross-sectional study was conducted to investigate the relative role of whole-body vibration (WBV), posture and manual materials handling (MMH) as risk factors for low back pain (LBP). Using a validated questionnaire, information about health history, posture and MMH performed was obtained from 394 workers who drove vehicles as part of their job (according to seven predefined occupational groups) and 59 who did not. The intention was to reflect a wide range of exposures with the lower end of the exposure spectrum defined as that of non-manual workers who do not drive as part of their job. Based on the questionnaire responses and direct measurements of vibration exposure, personal aggregate measures of exposure were computed for each of the respondents, i.e., total vibration dose (TVD), posture score (PS) and manual handling score (MHS). Odds ratios (and 95% confidence intervals) for back pain were obtained from logistics regression models and log-linear backward elimination analysis was performed. The findings showed that 'combined exposure' due to posture and one or both of vibration and MMH, rather than the individual exposure to one of the three factors (WBV, posture, MMH) is the main contributor of the increased prevalence of LBP.

  17. Individual and combined effects of noise-like whole-body vibration and parathyroid hormone treatment on bone defect repair in ovariectomized mice.

    PubMed

    Matsumoto, Takeshi; Sato, Daisuke; Hashimoto, Yoshihiro

    2016-01-01

    The effectiveness of intermittent administration of parathyroid hormone and exposure to whole-body vibration on osteoporotic fracture healing has been previously investigated, but data on their concurrent use are lacking. Thus, we evaluated the effects of intermittent administration of parathyroid hormone, whole-body vibration, and their combination on bone repair in osteoporotic mice. Noise-like whole-body vibration with a broad frequency range was used instead of conventional sine-wave whole-body vibration at a specific frequency. Mice were ovariectomized at 9?weeks of age and subjected to drill-hole surgery in the right tibial diaphysis at 11?weeks. The animals were divided into four groups (n?=?12 each): a control group, and groups treated with intermittent administration of parathyroid hormone, noise-like whole-body vibration, and both. From postoperative day 2, the groups treated with intermittent administration of parathyroid hormone and groups treated with both intermittent administration of parathyroid hormone and noise-like whole-body vibration were subcutaneously administered parathyroid hormone at a dose of 30?g/kg/day. The groups treated with noise-like whole-body vibration and groups treated with both intermittent administration of parathyroid hormone and noise-like whole-body vibration were exposed to noise-like whole-body vibration at a root mean squared acceleration of 0.3g and frequency components of 45-100?Hz for 20?min/day. Following 18?days of interventions, the right tibiae were harvested, and the regenerated bone was analyzed by micro-computed tomography and nanoindentation testing. Compared with the control group, callus volume fraction was 40% higher in groups treated with intermittent administration of parathyroid hormone and 73% higher in groups treated with both intermittent administration of parathyroid hormone and noise-like whole-body vibration, and callus thickness was 35% wider in groups treated with both intermittent administration of parathyroid hormone and noise-like whole-body vibration. Indentation modulus was 46% higher in groups treated with noise-like whole-body vibration and 43% higher in groups treated with both intermittent administration of parathyroid hormone and noise-like whole-body vibration, and hardness was 31% higher in groups treated with both intermittent administration of parathyroid hormone and noise-like whole-body vibration compared with the control group. There was no interaction between the two treatments for both structure and mechanical indexes. The main effects of intermittent administration of parathyroid hormone and noise-like whole-body vibration on bone repair included increased bone formation and enhanced mechanical function of regenerated bone, respectively. The combined treatment resulted in further regeneration of bone with high indentation modulus and hardness, suggesting the therapeutic potential of the combined use of noise-like whole-body vibration and intermittent administration of parathyroid hormone for enhancing osteoporotic bone healing. PMID:26586525

  18. Acute bone response to whole body vibration in healthy pre-pubertal boys.

    PubMed

    Harrison, R; Ward, K; Lee, E; Razaghi, H; Horne, C; Bishop, N J

    2015-06-01

    The skeleton responds to mechanical stimulation. We wished to ascertain the magnitude and speed of the growing skeleton's response to a standardised form of mechanical stimulation, vibration. 36 prepubertal boys stood for 10 minutes in total on one of two vibrating platforms (high (>2 g) or low (<1 g) magnitude vibration) on either 1, 3 or 5 successive days (n=12 for each duration); 15 control subjects stood on an inactive platform. Blood samples were taken at intervals before and after vibration to measure bone formation (P1NP, osteocalcin) and resorption (CTx) markers as well as osteoprotegerin and sclerostin. There were no significant differences between platform and control groups in bone turnover markers immediately after vibration on days 1, 3 and 5. Combining platform groups, at day 8 P1NP increased by 25.1% (CI 12.3 to 38.0; paired t-test p=0.005) and bone resorption increased by 10.9% (CI 3.6 to 18.2; paired t-test p=0.009) compared to baseline. Osteocalcin, osteoprotogerin and sclerostin did not change significantly. The growing skeleton can respond quickly to vibration of either high or low magnitude. Further work is needed to determine the utility of such "stimulation-testing" in clinical practice. PMID:26032203

  19. Characterization of the frequency and muscle responses of the lumbar and thoracic spines of seated volunteers during sinusoidal whole body vibration.

    PubMed

    Baig, Hassam A; Dorman, Daniel B; Bulka, Ben A; Shivers, Bethany L; Chancey, Valeta C; Winkelstein, Beth A

    2014-10-01

    Whole body vibration has been postulated to contribute to the onset of back pain. However, little is known about the relationship between vibration exposure, the biomechanical response, and the physiological responses of the seated human. The aim of this study was to measure the frequency and corresponding muscle responses of seated male volunteers during whole body vibration exposures along the vertical and anteroposterior directions to define the transmissibility and associated muscle activation responses for relevant whole body vibration exposures. Seated human male volunteers underwent separate whole body vibration exposures in the vertical (Z-direction) and anteroposterior (X-direction) directions using sinusoidal sweeps ranging from 2 to 18?Hz, with a constant amplitude of 0.4?g. For each vibration exposure, the accelerations and displacements of the seat and lumbar and thoracic spines were recorded. In addition, muscle activity in the lumbar and thoracic spines was recorded using electromyography (EMG) and surface electrodes in the lumbar and thoracic region. Transmissibility was determined, and peak transmissibility, displacement, and muscle activity were compared in each of the lumbar and thoracic regions. The peak transmissibility for vertical vibrations occurred at 4?Hz for both the lumbar (1.55??0.34) and thoracic (1.49??0.21) regions. For X-directed seat vibrations, the transmissibility ratio in both spinal regions was highest at 2?Hz but never exceeded a value of 1. The peak muscle response in both spinal regions occurred at frequencies corresponding to the peak transmissibility, regardless of the direction of imposed seat vibration: 4?Hz for the Z-direction and 2-3?Hz for the X-direction. In both vibration directions, spinal displacements occurred primarily in the direction of seat vibration, with little off-axis motion. The occurrence of peak muscle responses at frequencies of peak transmissibility suggests that such frequencies may induce greater muscle activity, leading to muscle fatigue, which could be a contributing mechanism of back pain. PMID:25010637

  20. Low-magnitude high-frequency loading, by whole-body vibration, accelerates early implant osseointegration in ovariectomized rats.

    PubMed

    Liang, Yong-Qiang; Qi, Meng-Chun; Xu, Jiang; Xu, Juan; Liu, Hua-Wei; Dong, Wei; Li, Jin-Yuan; Hu, Min

    2014-12-01

    Osteoporosis deteriorates jaw bone quality and may compromise early implant osseointegration and early implant loading. The influence of low?magnitude, high?frequency (LMHF) vibration on peri?implant bone healing and implant integration in osteoporotic bones remains poorly understood. LMHF loading via whole?body vibration (WBV) for 8 weeks has previously been demonstrated to significantly enhance bone?to?implant contact, peri?implant bone fraction and implant mechanical properties in osteoporotic rats. In the present study, LMHF loading by WBV was performed in osteoporotic rats, with a loading duration of 4 weeks during the early stages of bone healing. The results indicated that 4?week LMHF loading by WBV partly reversed the negative effects of osteoporosis and accelerated early peri?implant osseointegration in ovariectomized rats. PMID:25270245

  1. Low-magnitude high-frequency loading, by whole-body vibration, accelerates early implant osseointegration in ovariectomized rats

    PubMed Central

    LIANG, YONG-QIANG; QI, MENG-CHUN; XU, JIANG; XU, JUAN; LIU, HUA-WEI; DONG, WEI; LI, JIN-YUAN; HU, MIN

    2014-01-01

    Osteoporosis deteriorates jaw bone quality and may compromise early implant osseointegration and early implant loading. The influence of low-magnitude, high-frequency (LMHF) vibration on peri-implant bone healing and implant integration in osteoporotic bones remains poorly understood. LMHF loading via whole-body vibration (WBV) for 8 weeks has previously been demonstrated to significantly enhance bone-to-implant contact, peri-implant bone fraction and implant mechanical properties in osteoporotic rats. In the present study, LMHF loading by WBV was performed in osteoporotic rats, with a loading duration of 4 weeks during the early stages of bone healing. The results indicated that 4-week LMHF loading by WBV partly reversed the negative effects of osteoporosis and accelerated early peri-implant osseointegration in ovariectomized rats. PMID:25270245

  2. Whole-body Vibration Exposure Intervention among Professional Bus and Truck Drivers: A Laboratory Evaluation of Seat-suspension Designs.

    PubMed

    Blood, Ryan P; Yost, Michael G; Camp, Janice E; Ching, Randal P

    2015-01-01

    Long-term exposure to seated whole-body vibration (WBV) is one of the leading risk factors for the development of low back disorders. Professional bus and truck drivers are regularly exposed to continuous WBV, since they spend the majority of their working hours driving heavy vehicles. This study measured WBV exposures among professional bus and truck drivers and evaluated the effects of seat-suspension designs using simulated field-collected data on a vibration table. WBV exposures were measured and compared across three different seat designs: an air-ride bus seat, an air-ride truck seat, and an electromagnetically active (EM-active) seat. Air-ride seats use a compressed-air bladder to attenuate vibrations, and they have been in operation throughout the transportation industry for many years. The EM-active seat is a relatively new design that incorporates a microprocessor-controlled actuator to dampen vibration. The vibration table simulated seven WBV exposure scenarios: four segments of vertical vibration and three scenarios that used field-collected driving data on different road surfaces-a city street, a freeway, and a section of rough roadway. The field scenarios used tri-axial WBV data that had been collected at the seat pan and at the driver's sternum, in accordance with ISO 2631-1 and 2631-5. This study found that WBV was significantly greater in the vertical direction (z-axis) than in the lateral directions (x-and y-axes) for each of the three road types and each of the three types of seats. Quantitative comparisons of the results showed that the floor-to-seat-pan transmissibility was significantly lower for the EM-active seat than for either the air-ride bus seat or the air-ride truck seat, across all three road types. This study also demonstrated that seat-suspension designs have a significant effect on the vibrations transmitted to vehicle operators, and the study's results may prove useful in designing future seat suspensions. PMID:25625530

  3. Effects of Whole Body Vibration and Resistance Training on Bone Mineral Density and Anthropometry in Obese Postmenopausal Women

    PubMed Central

    Zaki, Moushira Erfan

    2014-01-01

    Objective. The aim of this study was to evaluate the impact of two exercise programs, whole body vibration and resistance training on bone mineral density (BMD) and anthropometry in obese postmenopausal women. Material and Methods. Eighty Egyptian obese postmenopausal women were enrolled in this study; their age ranged from 50 to 68 years. Their body mass index ranged (3036?kg/m2). The exercise prescription consisted of whole body vibration (WBV) and resistance training. Bone mineral density (BMD) and anthropometrical parameters were measured at the beginning and at the end of the study. Changes from baseline to eight months in BMD and anthropometric parameters were investigated. Results. BMD at the greater trochanter, at ward's triangle, and at lumbar spine were significantly higher after physical training, using both WBV and resistive training. Moreover, both exercise programs were effective in BMI and waist to the hip ratio. Simple and multiple regression analyses showed significant associations between physical activity duration and BMD at all sites. The highest values of R2 were found for the models incorporating WBV plus BMI. Conclusion. The study suggests that both types of exercise modalities had a similar positive effect on BMD at all sites in obese postmenopausal women. Significant association was noted between physical activity and anthropometric variables and BMD measures at all sites. PMID:25136473

  4. Immediate changes in temporomandibular joint opening and pain following vibration therapy: a feasibility pilot study

    PubMed Central

    Muir, Brad; Brown, Courtney; Brown, Tara; Tatlow, Dionne; Buhay, Jeremy

    2014-01-01

    Objective The purpose of this pilot study was to determine the scientific and process feasibility in an effort to direct future larger trials. Methods: Scientific Feasibility: Twelve subjects were randomly allocated to an intervention and a control group. The intervention protocol consisted of intraoral vibration therapy on the muscles of mastication bilaterally for a period of 1 minute per muscle. Process Feasibility: Several feasibility outcomes were examined including recruitment and retention rates and consent. Results: Scientific Feasibility: Large effect sizes were generated for both mouth opening and VAS in favour of the intervention group. Process Feasibility: a recruitment ratio of 2.3 respondents to 1 participant was determined, along with a retention to loss ratio of 13:1 and a consent to loss ratio of 12:0. Conclusion: Scientific Feasibility: The scientific results should be interpreted with caution due to the small sample sizes employed. The study seems to support the scientific feasibility of a future larger single treatment trial. Process Feasibility: Recruitment and retention rates and ratios seem to support future studies. Utilizing the feasibility results of the current study to direct a future larger multiple treatment trial consistent with other comparable TMD studies however is limited. PMID:25550672

  5. EMG and Heart Rate Responses Decline within 5 Days of Daily Whole-Body Vibration Training with Squatting

    PubMed Central

    Rosenberger, André; Liphardt, Anna-Maria; Bargmann, Arne; Müller, Klaus; Beck, Luis; Mester, Joachim; Zange, Jochen

    2014-01-01

    In this study, we examined the acute effects of a 5-day daily whole-body vibration (WBV) training on electromyography (EMG) responses of the m. rectus femoris and m. gastrocnemius lateralis, heart rate (HR, continuously recorded), and blood lactate levels. The purpose of the study was to investigate the adaptation of muscle activity, heart rate and blood lactate levels during 5 days of daily training. Two groups of healthy male subjects performed either squat exercises with vibration at 20 Hz on a side alternating platform (SE+V, n = 20, age  = 31.9±7.5 yrs., height  = 178.8±6.2 cm, body mass  = 79.2±11.4 kg) or squat exercises alone (SE, n = 21, age  = 28.4±7.3 years, height  = 178.9±7.4 cm, body mass  = 77.2±9.7 kg). On training day 1, EMG amplitudes of the m. rectus femoris were significantly higher (P<0.05) during SE+V than during SE. However, this difference was no longer statistically significant on training days 3 and 5. The heart rate (HR) response was significantly higher (P<0.05) during SE+V than during SE on all training days, but showed a constant decline throughout the training days. On training day 1, blood lactate increased significantly more after SE+V than after SE (P<0.05). On the following training days, this difference became much smaller but remained significantly different. The specific physiological responses to WBV were largest on the initial training day and most of them declined during subsequent training days, showing a rapid neuromuscular and cardiovascular adaptation to the vibration stimulus. PMID:24905721

  6. Descriptive analysis of combine cabin vibrations and their effect on the human body

    NASA Astrophysics Data System (ADS)

    Hostens, I.; Ramon, H.

    2003-09-01

    All on- and off-road vehicles are exposed to vibrations caused by unevenness of road or soil profile, moving elements within the machine or implements. A higher prevalence of low back pain is found in drivers of off-road machinery than in other drivers. In this study, significantly higher levels of low-frequency vibrations are found in the cabin of a combine, driving at high speed (20 km/h) on a concrete surface, compared to driving slower on field road. Comfort values indicate that injury can result from long-term driving on the field as well as on a concrete road. As seats with suspension systems are the main transmission paths of vibration towards the spine of the driver, their vibration attenuating characteristics play an important role in comfort assessment. The resonant frequency of seats with passive suspension system, used in agricultural machinery, lies in the low-frequency range most excited in agricultural machinery. A seat with air suspension is found to attenuate better frequencies above 4 Hz and provide more comfort to the driver than a seat with a mechanical suspension.

  7. Measuring airborne components of seismic body vibrations in a Middle-Asian sand-dwelling Insectivora species, the piebald shrew (Diplomesodon pulchellum).

    PubMed

    Volodin, Ilya A; Zaytseva, Alexandra S; Ilchenko, Olga G; Volodina, Elena V; Chebotareva, Anastasia L

    2012-08-15

    Self-produced seismic vibrations have been found for some subterranean rodents but have not been reported for any Insectivora species, although seismic sensitivity has been confirmed for blind sand-dwelling chrysochlorid golden moles. Studying the vocal behaviour of captive piebald shrews, Diplomesodon pulchellum, we documented vibrations, apparently generated by the whole-body wall muscles, from 11 (5 male, 6 female) of 19 animals, placed singly on a drum membrane. The airborne waves of the vibratory drumming were digitally recorded and then analysed spectrographically. The mean frequency of vibration was 160.5 Hz. This frequency matched the periodicity of the deep sinusoidal frequency modulation (159.4 Hz) found in loud screech calls of the same subjects. The body vibration was not related to thermoregulation, hunger-related depletion of energy resources or fear, as it was produced by well-fed, calm animals, at warm ambient temperatures. We hypothesize that in the solitary, nocturnal, digging desert piebald shrew, body vibrations may be used for seismic exploration of substrate density, to avoid energy-costly digging of packed sand for burrowing and foraging. At the same time, the piercing quality of screech calls due to the deep sinusoidal frequency modulation, matching the periodicity of body vibration, may be important for agonistic communication in this species. PMID:22837458

  8. A Galerkin method for the estimation of parameters in hybrid systems governing the vibration of flexible beams with tip bodies

    NASA Technical Reports Server (NTRS)

    Banks, H. T.; Rosen, I. G.

    1985-01-01

    An approximation scheme is developed for the identification of hybrid systems describing the transverse vibrations of flexible beams with attached tip bodies. In particular, problems involving the estimation of functional parameters are considered. The identification problem is formulated as a least squares fit to data subject to the coupled system of partial and ordinary differential equations describing the transverse displacement of the beam and the motion of the tip bodies respectively. A cubic spline-based Galerkin method applied to the state equations in weak form and the discretization of the admissible parameter space yield a sequence of approximating finite dimensional identification problems. It is shown that each of the approximating problems admits a solution and that from the resulting sequence of optimal solutions a convergent subsequence can be extracted, the limit of which is a solution to the original identification problem. The approximating identification problems can be solved using standard techniques and readily available software.

  9. Effects of whole-body vibration training on explosive strength and postural control in young female athletes.

    PubMed

    Fort, Azahara; Romero, Daniel; Bagur, Caritat; Guerra, Myriam

    2012-04-01

    This study aimed to evaluate the effectiveness of a whole-body vibration training program to improve neuromuscular performance in young elite female athletes. Twenty-three women basketball players (14-18 years old) were randomly assigned to a control group (CG, n = 11) or to a whole-body vibration group (WBVG, n = 12). During the study period, both groups continued their usual training program, but the WBVG also underwent a 15-week vibration training program. We analyzed the countermovement jump test (CMJ), the 1-leg hop test for the right leg and for the left leg, and the single-limb standing balance for both legs and with eyes open and closed at 3 time points: before training (T1), after an 8-week training period (T2), and after a further 7-week training period (T3). Compared with the CG, CMJ increased significantly in the WBVG from T1 to T2 (6.47%, p < 0.001), T1 to T3 (10.07%, p = 0.005), and T2 to T3 (3.38%, p < 0.001). One-leg hop test for the right and left legs also showed significantly higher values in WBVG from T1 to T2 (10.12%, p < 0.001 and 9.63%, p = 0.002, respectively) and T1 to T3 (14.17%, p = 0.001 and 15.17%, p = 0.004, respectively). Lateral deviation of the center of pressure in the closed eyes test decreased significantly in WBVG for both right and left leg, from T1 to T2 (-22.20%, p = 0.043 and -34.77%, p < 0.001, respectively) and from T1 to T3 (-33.14%, p = 0.027 and -33.58%, p = 0.043, respectively) compared with the CG. In conclusion, our results show that a 15-week whole-body vibration training program improves explosive strength and postural stability in adolescent female basketball players. PMID:22446665

  10. Prevalence and pattern of occupational exposure to whole body vibration in Great Britain: findings from a national survey

    PubMed Central

    Palmer, K.; Griffin, M.; Bendall, H.; Pannett, B.; Coggon, D.

    2000-01-01

    OBJECTIVESTo estimate the number of workers in Great Britain with significant occupational exposure to whole body vibration (WBV) and to identify the common sources of exposure and the occupations and industries where such exposures arise.?METHODSA postal questionnaire was posted to a random community sample of 22194 men and women of working age. Among other things, the questionnaire asked about exposure to WBV in the past week, including occupational and common non-occupational sources. Responses were assessed by occupation and industry, and national prevalence estimates were derived from census information. Estimates were also made of the average estimated daily personal dose of vibration (eVDV).?RESULTSFrom the 12907 responses it was estimated that 7.2million men and 1.8million women in Great Britain are exposed to WBV at work in a 1week period if the occupational use of cars, vans, buses, trains, and motor cycles is included within the definition of exposure. The eVDV of >374000 men and 9000women was estimated to exceed a proposed British Standard action level of 15ms-1.75. Occupations in which the estimated exposures most often exceeded 15ms-1.75 included forklift truck and mechanical truck drivers, farm owners and managers, farm workers, and drivers of road goods vehicles. These occupations also contributed the largest estimated numbers of workers in Great Britain with such levels of exposure. The highest estimated median occupational eVDVs were found in forklift truck drivers, drivers of road goods vehicles, bus and coach drivers, and technical and wholesale sales representatives, among whom a greater contribution to total dose was received from occupational exposures than from non-occupational ones; but in many other occupations the reverse applied. The most common sources of occupational exposure to WBV are cars, vans, forklift trucks, lorries, tractors, buses, and loaders.?CONCLUSIONSExposure to whole body vibration is common, but only a small proportion of exposures exceed the action level proposed in British standards, and in many occupations, non-occupational sources are more important than those at work. The commonest occupational sources of WBV and occupations with particularly high exposures have been identified, providing a basis for targeting future control activities.???Keywords: whole body vibration; population; prevalence; exposure PMID:10810108

  11. Cognitive Behavior Therapy with Body Image Exposure for Bulimia Nervosa: A Case Example

    ERIC Educational Resources Information Center

    Delinsky, Sherrie S.; Wilson, G. Terence

    2010-01-01

    Cognitive behavior therapy (CBT) is an effective treatment for bulimia nervosa (BN). However, among patients with BN, symptom improvement is more pronounced for behavioral eating symptoms (i.e., bingeing and purging) than for body image disturbance, and the persistence of body image disturbance is associated with relapse. The need for more

  12. Cognitive Behavior Therapy with Body Image Exposure for Bulimia Nervosa: A Case Example

    ERIC Educational Resources Information Center

    Delinsky, Sherrie S.; Wilson, G. Terence

    2010-01-01

    Cognitive behavior therapy (CBT) is an effective treatment for bulimia nervosa (BN). However, among patients with BN, symptom improvement is more pronounced for behavioral eating symptoms (i.e., bingeing and purging) than for body image disturbance, and the persistence of body image disturbance is associated with relapse. The need for more…

  13. Psychophysical relationships characterizing human response to whole-body sinusoidal vertical vibration

    NASA Technical Reports Server (NTRS)

    Leatherwood, J. D.; Dempsey, T. K.

    1976-01-01

    An experimental investigation determined that the psychophysical relationships between subjective discomfort evaluations to vibratory stimuli and subjective evaluations of the intensity of vibratory stimuli can be expressed in a linear fashion. Furthermore, significant differences were found to exist between discomfort and intensity subjective response for several but not all discrete frequencies investigated. The implication of these results is that ride quality criteria based upon subjective evaluation of vibration intensity should be applied cautiously in the development of criteria for human comfort.

  14. Numerical assessment of fore-and-aft suspension performance to reduce whole-body vibration of wheel loader drivers

    NASA Astrophysics Data System (ADS)

    Fleury, Grard; Mistrot, Pierre

    2006-12-01

    While driving off-road vehicles, operators are exposed to whole-body vibration acting in the fore-and-aft direction. Seat manufacturers supply products equipped with fore-and-aft suspension but only a few studies report on their performance. This work proposes a computational approach to design fore-and-aft suspensions for wheel loader seats. Field tests were conducted in a quarry to analyse the nature of vibration to which the driver was exposed. Typical input signals were recorded to be reproduced in the laboratory. Technical specifications are defined for the suspension. In order to evaluate the suspension vibration attenuation performance, a model of a sitting human body was developed and coupled to a seat model. The seat model combines the models of each suspension component. A linear two-degree-of-freedom model is used to describe the dynamic behaviour of the sitting driver. Model parameters are identified by fitting the computed apparent mass frequency response functions to the measured values. Model extensions are proposed to investigate postural effects involving variations in hands and feet positions and interaction of the driver's back with the backrest. Suspension design parameters are firstly optimized by computing the seat/man model response to sinusoidal acceleration. Four criteria including transmissibility, interaction force between the driver's back and the backrest and relative maximal displacement of the suspension are computed. A new suspension design with optimized features is proposed. Its performance is checked from calculations of the response of the seat/man model subjected to acceleration measured on the wheel loader during real work conditions. On the basis of the computed values of the SEAT factors, it is found possible to design a suspension that would increase the attenuation provided by the seat by a factor of two.

  15. Synchronization of Two Homodromy Rotors Installed on a Double Vibro-Body in a Coupling Vibration System

    PubMed Central

    Fang, Pan; Hou, Yongjun; Nan, Yanghai

    2015-01-01

    A new mechanism is proposed to implement synchronization of the two unbalanced rotors in a vibration system, which consists of a double vibro-body, two induction motors and spring foundations. The coupling relationship between the vibro-bodies is ascertained with the Laplace transformation method for the dynamics equation of the system obtained with the Lagrange’s equation. An analytical approach, the average method of modified small parameters, is employed to study the synchronization characteristics between the two unbalanced rotors, which is converted into that of existence and the stability of zero solutions for the non-dimensional differential equations of the angular velocity disturbance parameters. By assuming the disturbance parameters that infinitely approach to zero, the synchronization condition for the two rotors is obtained. It indicated that the absolute value of the residual torque between the two motors should be equal to or less than the maximum of their coupling torques. Meanwhile, the stability criterion of synchronization is derived with the Routh-Hurwitz method, and the region of the stable phase difference is confirmed. At last, computer simulations are preformed to verify the correctness of the approximate solution of the theoretical computation for the stable phase difference between the two unbalanced rotors, and the results of theoretical computation is in accordance with that of computer simulations. To sum up, only the parameters of the vibration system satisfy the synchronization condition and the stability criterion of the synchronization, the two unbalanced rotors can implement the synchronization operation. PMID:25993472

  16. Benefits of Whole-Body Vibration with an Oscillating Platform for People with Multiple Sclerosis: A Systematic Review

    PubMed Central

    Santos-Filho, Sebastião David; Cameron, Michelle H.; Bernardo-Filho, Mario

    2012-01-01

    The objective of this work was to investigate the effects of whole-body vibration on people with multiple sclerosis (MS). PubMed, CINAHL and Scopus databases were systematically searched for studies on the use of whole-body vibration (WBV) exercise in people with MS. These searches were supplemented with material identified in the references and in the authors' personal files. A qualitative analysis was performed to summarize the findings. Five studies with a total of seventy-one subjects were identified. All of these studies had small numbers of subjects (3–25), and two of the studies had no control groups. Some investigations have shown significant improvements of the muscle strength, of the functional mobility, and of the timed get up and go test in patients with MS. The number of publications found in the databanks searched is small, and in general, they have limitations in the design of protocols with a weakness to the interpretation of the findings. However, the analysis of the findings in these studies permits to conclude that some papers indicate that WBV exercises could benefit patients with MS. In addition, we suggest further larger scale investigations with controlled parameters and well-designed protocols into the effects of WBV exercises in people with MS. PMID:22685660

  17. Benefits of whole-body vibration with an oscillating platform for people with multiple sclerosis: a systematic review.

    PubMed

    Santos-Filho, Sebastião David; Cameron, Michelle H; Bernardo-Filho, Mario

    2012-01-01

    The objective of this work was to investigate the effects of whole-body vibration on people with multiple sclerosis (MS). PubMed, CINAHL and Scopus databases were systematically searched for studies on the use of whole-body vibration (WBV) exercise in people with MS. These searches were supplemented with material identified in the references and in the authors' personal files. A qualitative analysis was performed to summarize the findings. Five studies with a total of seventy-one subjects were identified. All of these studies had small numbers of subjects (3-25), and two of the studies had no control groups. Some investigations have shown significant improvements of the muscle strength, of the functional mobility, and of the timed get up and go test in patients with MS. The number of publications found in the databanks searched is small, and in general, they have limitations in the design of protocols with a weakness to the interpretation of the findings. However, the analysis of the findings in these studies permits to conclude that some papers indicate that WBV exercises could benefit patients with MS. In addition, we suggest further larger scale investigations with controlled parameters and well-designed protocols into the effects of WBV exercises in people with MS. PMID:22685660

  18. A non-resonant, frequency up-converted electromagnetic energy harvester from human-body-induced vibration for hand-held smart system applications

    NASA Astrophysics Data System (ADS)

    Halim, Miah A.; Park, Jae Y.

    2014-03-01

    We present a non-resonant, frequency up-converted electromagnetic energy harvester that generates significant power from human-body-induced vibration, e.g., hand-shaking. Upon excitation, a freely movable non-magnetic ball within a cylinder periodically hits two magnets suspended on two helical compression springs located at either ends of the cylinder, allowing those to vibrate with higher frequencies. The device parameters have been designed based on the characteristics of human hand-shaking vibration. A prototype has been developed and tested both by vibration exciter (for non-resonance test) and by manual hand-shaking. The fabricated device generated 110 ?W average power with 15.4 ?W cm-3 average power density, while the energy harvester was mounted on a smart phone and was hand-shaken, indicating its ability in powering portable hand-held smart devices from low frequency (<5 Hz) vibrations.

  19. Contribution of individual components of a job cycle on overall severity of whole-body vibration exposure: a study in Indian mines.

    PubMed

    Mandal, Bibhuti B; Mansfield, Neil J

    2016-01-01

    Drivers of earth-moving machines are exposed to whole-body vibration (WBV). In mining operations there can be a combination of relatively high magnitudes of vibration and long exposure times. Effective risk mitigation requires understanding of the main aspects of a task that pose a hazard to health. There are very few published studies of WBV exposure from India. This paper reports on a study that considered the contribution of the component phases of dumper operations, on the overall vibration exposure of the drivers. It shows that vibration magnitudes are relatively high, and that haulage tasks are the main contributor to the exposure. It is recommended that driver speed, haul road surfaces and vehicle maintenance/selection are optimized to ensure minimization of vibration. If this is not sufficient, operation times might need to be reduced in order to ensure that the health guidance caution zone from Standard No. ISO 2631-1:1997 is not exceeded. PMID:26652833

  20. Biological-based optimization and volumetric modulated arc therapy delivery for stereotactic body radiation therapy

    SciTech Connect

    Diot, Quentin; Kavanagh, Brian; Timmerman, Robert; Miften, Moyed

    2012-01-15

    Purpose: To describe biological-based optimization and Monte Carlo (MC) dose calculation-based treatment planning for volumetric modulated arc therapy (VMAT) delivery of stereotactic body radiation therapy (SBRT) in lung, liver, and prostate patients. Methods: Optimization strategies and VMAT planning parameters using a biological-based optimization MC planning system were analyzed for 24 SBRT patients. Patients received a median dose of 45 Gy [range, 34-54 Gy] for lung tumors in 1-5 fxs and a median dose of 52 Gy [range, 48-60 Gy] for liver tumors in 3-6 fxs. Prostate patients received a fractional dose of 10 Gy in 5 fxs. Biological-cost functions were used for plan optimization, and its dosimetric quality was evaluated using the conformity index (CI), the conformation number (CN), the ratio of the volume receiving 50% of the prescription dose over the planning target volume (Rx/PTV50). The quality and efficiency of the delivery were assessed according to measured quality assurance (QA) passing rates and delivery times. For each disease site, one patient was replanned using physical cost function and compared to the corresponding biological plan. Results: Median CI, CN, and Rx/PTV50 for all 24 patients were 1.13 (1.02-1.28), 0.79 (0.70-0.88), and 5.3 (3.1-10.8), respectively. The median delivery rate for all patients was 410 MU/min with a maximum possible rate of 480 MU/min (85%). Median QA passing rate was 96.7%, and it did not significantly vary with the tumor site. Conclusions: VMAT delivery of SBRT plans optimized using biological-motivated cost-functions result in highly conformal dose distributions. Plans offer shorter treatment-time benefits and provide efficient dose delivery without compromising the plan conformity for tumors in the prostate, lung, and liver, thereby improving patient comfort and clinical throughput. The short delivery times minimize the risk of patient setup and intrafraction motion errors often associated with long SBRT treatment delivery times.

  1. A summary of current Bureau research into the effects of whole-body vibration and shock on operators of underground mobile equipment

    SciTech Connect

    Love, A.C.; Unger, R.L.; Bobick, T.G.; Fowkes, R.S.

    1992-01-01

    This report discusses current research by the U.S. Bureau of Mines on the effects of whole-body vibration (WBV) and shock on underground mobile equipment operators. The highlights of a comprehensive literature review of WBV, shock, and seating are presented. Factors discussed include health and physiological effects, comfort, performance, and fatigue. Vibration data were collected from shuttle cars and ramcars at several underground coal mines in Pennsylvania, Ohio, and Illinois. The data were formatted so that they could be used to drive the Bureau's motion platform, and to compare them with ANSI S3-1979, Guide for the Evaluation of Human Exposure to Whole-Body Vibration. Human subject testing in the Bureau's vibration research laboratory evaluated the effects of two different seat angles and of the presence or absence of vibration and of foam padding on heart rate, blood pressure, and subjective discomfort. Only vibration significantly increased heart rate and systolic and mean blood pressures. Vibration and a steel seat had a significant effect on subjective discomfort. The apparatus used for these tests and the experimental procedures are described in detail. Recommendations are made for additional research on the exposure of underground mining machine operators to WBV and shock.

  2. Microcirculation of skeletal muscle adapts differently to a resistive exercise intervention with and without superimposed whole-body vibrations.

    PubMed

    Beijer, sa; Degens, Hans; Weber, Tobias; Rosenberger, Andr; Gehlert, Sebastian; Herrera, Frankyn; Kohl-Bareis, Matthias; Zange, Jochen; Bloch, Wilhelm; Rittweger, Jrn

    2015-11-01

    Whole-body vibration (WBV) training is commonly practiced and may enhance peripheral blood flow. Here, we investigated muscle morphology and acute microcirculatory responses before and after a 6-week resistive exercise training intervention without (RE) or with (RVE) simultaneous whole-body vibrations (20 Hz, 6 mm peak-to-peak amplitude) in 26 healthy men in a randomized, controlled parallel-design study. Total haemoglobin (tHb) and tissue oxygenation index (TOI) were measured in gastrocnemius muscle (GM) with near-infrared spectroscopy (NIRS). Whole-body oxygen consumption (VO2 ) was measured via spirometry, and skeletal muscle morphology was determined in soleus (SOL) muscle biopsies. Our data reveal that exercise-induced muscle deoxygenation both before and after 6 weeks training was similar in RE and RVE (P = 0.76), although VO2 was 20% higher in the RVE group (P < 0.001). The RVE group showed a 14%-point increase in reactive hyperaemia (P = 0.007) and a 27% increase in blood volume (P < 0.01) in GM after 6 weeks of training. The number of capillaries around fibres was increased by 15% after 6 weeks training in both groups (P < 0.001) with no specific effect of superimposed WBV (P = 0.61). Neither of the training regimens induced fibre hypertrophy in SOL. The present findings suggest an increased blood volume and vasodilator response in GM as an adaptation to long-term RVE, which was not observed after RE alone. We conclude that RVE training enhances vasodilation of small arterioles and possibly capillaries. This effect might be advantageous for muscle thermoregulation and the delivery of oxygen and nutrients to exercising muscle and removal of carbon dioxide and metabolites. PMID:25041226

  3. The acute effects of different training loads of whole body vibration on flexibility and explosive strength of lower limbs in divers

    PubMed Central

    Paradisis, G; Kirialanis, P; Mellos, V; Argitaki, P; Smirniotou, A

    2015-01-01

    The purpose of this study was to examine the acute effects of different vibration loads (frequency and amplitude) of whole-body vibration (WBV) on flexibility and explosive strength of lower limbs in springboard divers. Eighteen male and female divers, aged 19 ± 2 years, volunteered to perform 3 different WBV protocols in the present study. To assess the vibration effect, flexibility and explosive strength of lower limbs were measured before (Pre), immediately after (Post 1) and 15 min after the end of vibration exposure (Post 15). Three protocols with different frequencies and amplitudes were used in the present study: a) low vibration frequency and amplitude (30 Hz/2 mm); b) high vibration frequency and amplitude (50 Hz/4 mm); c) a control protocol (no vibration). WBV protocols were performed on a Power Plate platform, whereas the no vibration divers performed the same protocol but with the vibration platform turned off. A two-way ANOVA 3 x 3 (protocol × time) with repeated measures on both factors was used. The level of significance was set at p < 0.05. Univariate analyses with simple contrasts across time were selected as post hoc tests. Intraclass coefficients (ICC) were used to assess the reliability across time. The results indicated that flexibility and explosive strength of lower limbs were significantly higher in both WBV protocols compared to the no vibration group (NVG). The greatest improvement in flexibility and explosive strength, which occurred immediately after vibration treatment, was maintained 15 min later in both WBV protocols, whereas NVG revealed a significant decrease 15 min later, in all examined strength parameters. In conclusion, a bout of WBV significantly increased flexibility and explosive strength in competitive divers compared with the NVG. Therefore, it is recommended to incorporate WBV as a method to increase flexibility and vertical jump height in sports where these parameters play an important role in the success outcome of these sports. PMID:26424927

  4. The acute effects of different training loads of whole body vibration on flexibility and explosive strength of lower limbs in divers.

    PubMed

    Dallas, G; Paradisis, G; Kirialanis, P; Mellos, V; Argitaki, P; Smirniotou, A

    2015-09-01

    The purpose of this study was to examine the acute effects of different vibration loads (frequency and amplitude) of whole-body vibration (WBV) on flexibility and explosive strength of lower limbs in springboard divers. Eighteen male and female divers, aged 19 ± 2 years, volunteered to perform 3 different WBV protocols in the present study. To assess the vibration effect, flexibility and explosive strength of lower limbs were measured before (Pre), immediately after (Post 1) and 15 min after the end of vibration exposure (Post 15). Three protocols with different frequencies and amplitudes were used in the present study: a) low vibration frequency and amplitude (30 Hz/2 mm); b) high vibration frequency and amplitude (50 Hz/4 mm); c) a control protocol (no vibration). WBV protocols were performed on a Power Plate platform, whereas the no vibration divers performed the same protocol but with the vibration platform turned off. A two-way ANOVA 3 x 3 (protocol × time) with repeated measures on both factors was used. The level of significance was set at p < 0.05. Univariate analyses with simple contrasts across time were selected as post hoc tests. Intraclass coefficients (ICC) were used to assess the reliability across time. The results indicated that flexibility and explosive strength of lower limbs were significantly higher in both WBV protocols compared to the no vibration group (NVG). The greatest improvement in flexibility and explosive strength, which occurred immediately after vibration treatment, was maintained 15 min later in both WBV protocols, whereas NVG revealed a significant decrease 15 min later, in all examined strength parameters. In conclusion, a bout of WBV significantly increased flexibility and explosive strength in competitive divers compared with the NVG. Therefore, it is recommended to incorporate WBV as a method to increase flexibility and vertical jump height in sports where these parameters play an important role in the success outcome of these sports. PMID:26424927

  5. Menopause, the metabolic syndrome, and mind-body therapies

    PubMed Central

    Innes, Kim E.; Selfe, Terry Kit; Taylor, Ann Gill

    2009-01-01

    Cardiovascular disease risk rises sharply with menopause, likely due to the coincident increase in insulin resistance and related atherogenic changes that together comprise the metabolic or insulin resistance syndrome, a cluster of metabolic and hemodynamic abnormalities strongly implicated in the pathogenesis and progression of cardiovascular disease. A growing body of research suggests that traditional mind-body practices such as yoga, tai chi, and qigong may offer safe and cost-effective strategies for reducing insulin resistance syndrome-related risk factors for cardiovascular disease in older populations, including postmenopausal women. Current evidence suggests that these practices may reduce insulin resistance and related physiological risk factors for cardiovascular disease; improve mood, well-being, and sleep; decrease sympathetic activation; and enhance cardiovagal function. However, additional rigorous studies are needed to confirm existing findings and to examine long-term effects on cardiovascular health. PMID:18779682

  6. Spinal metastases: Is stereotactic body radiation therapy supported by evidences?

    PubMed

    De Bari, Berardino; Alongi, Filippo; Mortellaro, Gianluca; Mazzola, Rosario; Schiappacasse, Luis; Guckenberger, Matthias

    2016-02-01

    Stereotactic body radiotherapy (SBRT) is becoming widely adopted in the treatment of primary and secondary tumors. Spinal bone metastases are frequently discovered in cancer patients, and in the past have been usually treated with a palliative goal. Nevertheless, in some particular clinical settings, such as oligometastatic patients and/or those with a long life expectancy, spinal SBRT could be considered a valid therapeutic option to obtain long-lasting palliation and, when possible, with a curative goal. This review aims to summarize available clinical and dosimetric data of published studies about spinal SBRT. PMID:26597017

  7. Additive effect of repeated bouts of individualized frequency whole body vibration on postural stability in young adults.

    PubMed

    Dickin, D Clark; Heath, Jacqueline E

    2014-08-01

    Whole body vibration (WBV) has been shown to improve force and power output as well as flexibility and speed, with improvements suggested to result from reduced electromechanical delays, improved rate of force development, and sensitivity of muscle spindles. Fixed frequency studies on postural control have been somewhat equivocal; however, individualized frequency protocols have shown promising results in other motor tasks. To assess this, 18 healthy young adults experienced three 4-minute WBV sessions with postural control assessed before vibration, after multiple exposures, and during recovery, with altered levels of sensory information available to the participants. Sway velocity, sway path length, and sway area were assessed in each environment. Study findings revealed that stability was impacted following WBV, with more challenging environments eliciting improvements persisting for 20 minutes. When the environment was less challenging, postural stability was impaired; however, the effects dissipated quickly (10-20 min). It was determined that exposure to individualized frequency WBV served to impair postural control when the challenge was low, but resulted in heightened stability when the overall challenge was high and vestibular information was needed for stability. PMID:24603631

  8. Random Whole Body Vibration over 5 Weeks Leads to Effects Similar to Placebo: A Controlled Study in Parkinson's Disease

    PubMed Central

    Gaßner, Heiko; Janzen, Annette; Schwirtz, Ansgar; Jansen, Petra

    2014-01-01

    Background. Random whole body vibration (WBV) training leads to beneficial short-term effects in patients with Parkinson's disease (PD). However, the effect of WBV lasting several weeks is not clear. Objectives. The aim of this study was to assess a random WBV training over 5 weeks in PD. Methods. Twenty-one participants with PD were allocated to either an experimental or a placebo group matched by age, gender, and Hoehn&Yahr stage. The WBV training consisted of 5 series, 60 s each. In the placebo group, vibration was simulated. The primary outcome was the change of performance in Functional reach test (FRT), step-walk-turn task, biomechanical Gait Analysis, Timed up and go test (TUG), and one leg stance. Findings. In most of the parameters, there was no significant interaction of “time∗group.” Both groups improved significantly in Gait parameters, TUG, and one leg stance. Only in the FRT [F(1,15) = 8.397; P < 0.05] and in the TUG [F(1,15) = 4.971; P < 0.05] the experimental group performed significantly better than the placebo group. Conclusions. Random WBV training over 5 weeks seems to be less effective than reported in previous studies performing short-term training. The slight improvements in the FRT and TUG are not clinically relevant. PMID:25371843

  9. Development of a Protocol for Epidemiologal Studies of Whole-Body Vibration and Musculoskeletal Disorders of the Lower Back

    NASA Astrophysics Data System (ADS)

    Magnusson, M. L.; Pope, M. H.; Hulshof, C. T. J.; Bovenzi, M.

    1998-08-01

    It seems evident from a large number of studies that there is a positive relationship between exposure to whole body vibration (WBV) and the occurrence of low back pain. There are existing standards for evaluating the human exposure to WBV, which are based on other factors than the effect of musculoskeletal disorders. Several national and international standards also exist for evaluating human exposure to WBV. The exposure limit values or health guidance caution zones included in some of these standards are not or only to a limited extent based on systematic epidemiological investigations. It has not yet been possible to establish a clear exposure-response relationship. There are many confounding or contributing factors which influence the hazards to workers caused by exposure to WBV. Reliable methods for the detection and prevention of injury due to vibration exposure at work, alone or in combination with other risk factors, need to be implemented. The aim of this paper was to design a protocol and a questionnaire for conducting collaborative studies of WBV and musculoskeletal back disorders. The protocol will be tested in a pilot study before it will be used in multi-center studies.

  10. Whole-Body Vibration Partially Reverses Aging-Induced Increases in Visceral Adiposity and Hepatic Lipid Storage in Mice

    PubMed Central

    van Dijk, Theo H.; Havinga, Rick; van der Zee, Eddy A.; Groen, Albert K.; Reijngoud, Dirk-Jan; Bakker, Barbara M.; van Dijk, Gertjan

    2016-01-01

    At old age, humans generally have declining muscle mass and increased fat deposition, which can increase the risk of developing cardiometabolic diseases. While regular physical activity postpones these age-related derangements, this is not always possible in the elderly because of disabilities or risk of injury. Whole-body vibration (WBV) training may be considered as an alternative to physical activity particularly in the frail population. To explore this possibility, we characterized whole-body and organ-specific metabolic processes in 6-month and 25-month old mice, over a period of 14 weeks of WBV versus sham training. WBV training tended to increase blood glucose turnover rates and stimulated hepatic glycogen utilization during fasting irrespective of age. WBV was effective in reducing white fat mass and hepatic triglyceride content only in old but not in young mice and these reductions were related to upregulation of hepatic mitochondrial uncoupling of metabolism (assessed by high-resolution respirometry) and increased expression of uncoupling protein 2. Because these changes occurred independent of changes in food intake and whole-body metabolic rate (assessed by indirect calorimetry), the liver-specific effects of WBV may be a primary mechanism to improve metabolic health during aging, rather than that it is a consequence of alterations in energy balance. PMID:26886917

  11. Whole-Body Vibration Partially Reverses Aging-Induced Increases in Visceral Adiposity and Hepatic Lipid Storage in Mice.

    PubMed

    Reijne, Aaffien C; Ciapaite, Jolita; van Dijk, Theo H; Havinga, Rick; van der Zee, Eddy A; Groen, Albert K; Reijngoud, Dirk-Jan; Bakker, Barbara M; van Dijk, Gertjan

    2016-01-01

    At old age, humans generally have declining muscle mass and increased fat deposition, which can increase the risk of developing cardiometabolic diseases. While regular physical activity postpones these age-related derangements, this is not always possible in the elderly because of disabilities or risk of injury. Whole-body vibration (WBV) training may be considered as an alternative to physical activity particularly in the frail population. To explore this possibility, we characterized whole-body and organ-specific metabolic processes in 6-month and 25-month old mice, over a period of 14 weeks of WBV versus sham training. WBV training tended to increase blood glucose turnover rates and stimulated hepatic glycogen utilization during fasting irrespective of age. WBV was effective in reducing white fat mass and hepatic triglyceride content only in old but not in young mice and these reductions were related to upregulation of hepatic mitochondrial uncoupling of metabolism (assessed by high-resolution respirometry) and increased expression of uncoupling protein 2. Because these changes occurred independent of changes in food intake and whole-body metabolic rate (assessed by indirect calorimetry), the liver-specific effects of WBV may be a primary mechanism to improve metabolic health during aging, rather than that it is a consequence of alterations in energy balance. PMID:26886917

  12. Wearable ballistocardiography: preliminary methods for mapping surface vibration measurements to whole body forces.

    PubMed

    Wiens, Andrew; Etemadi, Mozziyar; Klein, Liviu; Roy, Shuvo; Inan, Omer T

    2014-01-01

    The recent resurgence of ballistocardiogram (BCG) measurement and interpretation technologies has led to a wide range of powerful tools available for unobtrusively assessing mechanical aspects of cardiovascular health at home. Researchers have demonstrated a multitude of modern BCG measurement modalities, including beds, chairs, weighing scales, and wearable approaches. However, many modalities produce significant variations in the morphology of the measured BCG, creating confusion in the analysis and interpretation of the signals. This paper creates a framework for comparing wearable BCG measurements to whole body measurements--such as taken with a weighing scale system--to eventually allow the same analysis and interpretation tools that have been developed for whole body systems to be applied in the future to wearable systems. To the best of our knowledge, it represents the first attempt to morphologically compare vertical acceleration recordings measured on different locations on the torso to whole body displacements measured by BCG instrumentation. PMID:25571158

  13. Wearable Ballistocardiography: Preliminary Methods for Mapping Surface Vibration Measurements to Whole Body Forces

    PubMed Central

    Wiens, Andrew; Etemadi, Mozziyar; Klein, Liviu; Roy, Shuvo; Inan, Omer T.

    2015-01-01

    The recent resurgence of ballistocardiogram (BCG) measurement and interpretation technologies has led to a wide range of powerful tools available for unobtrusively assessing mechanical aspects of cardiovascular health at home. Researchers have demonstrated a multitude of modern BCG measurement modalities, including beds, chairs, weighing scales, and wearable approaches. However, many modalities produce significant variations in the morphology of the measured BCG, creating confusion in the analysis and interpretation of the signals. This paper creates a framework for comparing wearable BCG measurements to whole body measurements—such as taken with a weighing scale system—to eventually allow the same analysis and interpretation tools that have been developed for whole body systems to be applied in the future to wearable systems. To the best of our knowledge, it represents the first attempt to morphologically compare vertical acceleration recordings measured on different locations on the torso to whole body displacements measured by BCG instrumentation. PMID:25571158

  14. Myoelectric Response of Back Muscles to Vertical Random Whole-Body Vibration with Different Magnitudes at Different Postures

    NASA Astrophysics Data System (ADS)

    BLTHNER, R.; SEIDEL, H.; HINZ, B.

    2002-05-01

    Back muscle forces contribute essentially to the whole-body vibration-induced spinal load. The electromyogram (EMG) can help to estimate these forces during whole-body vibration (WBV). Thirty-eight subjects were exposed to identical random low-frequency WBV (07, 10 and 14 m/s-2 r.m.s. weighted acceleration) at a relaxed, erect and bent forward postures. The acceleration of the seat and the force between the seat and the buttocks were measured. Six EMGs were derived from the right side of the m. trapezius pars descendens, m. ileocostalis lumborum pars thoracis, m. ileocostalis lumborum pars lumborum; m. longissimus thoracis pars thoracis, m. longissimus thoracis pars lumborum, and lumbar multifidus muscle. All data were filtered for anti-aliasing and sampled with 1000 Hz. Artefacts caused by the ECG in the EMG were identified and eliminated in the time domain using wavelets. The individually rectified and normalized EMGs were averaged across subjects. The EMGs without WBV exhibited characteristic patterns for the three postures examined. The coherence and transfer functions indicated characteristic myoelectric responses to random WBV with several effects of posture and WBV magnitude. A comprehensive set of transfer functions from the seat acceleration or the mean normalized input force to the mean processed EMG was presented.The results can be used for the development of more sophisticated models with a separate control of various back muscle groups. However, the EMG-force relationship under dynamic conditions needs to be examined in more detail before the results can be implemented. Since different reflex mechanisms depending on the frequency of WBV are linked with different types of active muscle fibres, various time delays between the EMG and muscle force may be necessary.

  15. Whole-body vibration training reduces arterial stiffness, blood pressure and sympathovagal balance in young overweight/obese women.

    PubMed

    Figueroa, Arturo; Gil, Ryan; Wong, Alexei; Hooshmand, Shirin; Park, Song Y; Vicil, Florence; Sanchez-Gonzalez, Marcos A

    2012-06-01

    Obesity is associated with early cardiovascular dysfunction and reduced muscle strength. Whole-body vibration (WBV) training may improve arterial function and muscle strength. The effects of WBV training on arterial stiffness (brachial-ankle pulse wave velocity, baPWV), wave reflection (augmentation index, AIx), brachial systolic blood pressure (bSBP), aortic systolic blood pressure (aSBP), heart rate variability, and muscle strength (one-repetition maximum, 1RM) were examined in 10 young (21 ± 2 year) overweight/obese women (body mass index, BMI = 29.9 ± 0.8 kg m(-2)). Participants were randomized to a 6-week WBV training or non-exercising control (CON) period in a crossover design. WBV training (3 days × week) consisted of static and dynamic squats and calf raises with vibration intensity at 25-30 Hz and 1-2 mm amplitude (2.83-4.86 G). There were significant (P<0.05) decreases in baPWV (-0.9 ± 0.3 m s(-1)), AIx (-8.0 ± 2.2 %), bSBP (-5.3 ± 1.5 mm Hg), aSBP (-5.2 ± 2.1 mm Hg), low-frequency power (-0.13 ± 0.05 nu) and sympathovagal balance (LF/HF, -0.42 ± 0.16) after WBV training compared with CON. Significant (P<0.05) increases in high-frequency power (HF, 0.19 ± 0.04 nu) and leg extension 1RM (8.2 ± 2.3 kg) occurred after WBV training compared with CON. Six weeks of WBV training decreased systemic arterial stiffness and aSBP via improvements in wave reflection and sympathovagal balance in young overweight/obese normotensive women. WBV training may benefit arterial function and muscle strength in deconditioned individuals who cannot perform conventional exercise. PMID:22357522

  16. a Body Mass Dependent Mechanical Impedance Model for Applications in Vibration Seat Testing

    NASA Astrophysics Data System (ADS)

    BOILEAU, P.-.; RAKHEJA, S.; WU, X.

    2002-05-01

    A three degree-of-freedom model is proposed to predict the biodynamic responses of the seated human body of different masses. A baseline model is initially derived to satisfy both the mean apparent mass and seat-to-head transmissibility responses proposed in ISO/DIS 5982:2000 applicable for mean body mass of 75 kg. The validity of the resultant generic mass dependent model is verified by comparing the apparent mass and driving-point mechanical impedance responses computed for total body masses of 55, 75 and 90 kg with the range of idealized values proposed for body masses within the 49-93 kg range. Considering the lack of data that could be found to define the apparent mass/mechanical impedance of subjects with different body masses when applying the experimental conditions defined in ISO/DIS 5982:2000, an attempt is made to adapt the parameters of the base model to fit the measured apparent mass data applicable to groups of automobile occupants within different mass ranges. This is achieved through constrained parametric optimization which consists of minimizing the sum of squared errors between the computed response and the mean apparent mass data measured for automobile occupants within four mass groups: less than 60 kg, 605-705 kg, 705-80 kg and above 80 kg. The results show a reasonably good agreement between the model responses and the measured apparent mass data, particularly at frequencies below 10 Hz. The results suggest that the proposed mass dependent model can effectively predict the apparent mass responses of automobile occupants over a wide range of body masses and for two different postures: passenger (hands-in-lap) and driver (hands-on-steering wheel) postures.

  17. Cognitive-behavioral therapy for body dysmorphic disorder: a review of its efficacy

    PubMed Central

    Prazeres, Anglica M; Nascimento, Antnio L; Fontenelle, Leonardo F

    2013-01-01

    The aim of this study was to review the efficacy of different methods of cognitive and/or behavioral therapies used to treat body dysmorphic disorder. We evaluated all case series, open studies, controlled trials, and meta-analyses of cognitive and/or behavioral treatment approaches to body dysmorphic disorder published up to July 2012, identified through a search in the PubMed/Medline, PsycINFO, ISI Web of Knowledge, and Scopus databases. Our findings indicate that individual and group cognitive behavioral therapies are superior to waiting list for the treatment of body dysmorphic disorder. While the efficacy of cognitive therapy is supported by one controlled trial, utility of behavioral therapy is suggested by one open study and one controlled relapse prevention follow-up study. There is a pressing need to conduct head-to-head studies, with appropriate, active, control treatment groups, in order to examine further the efficacy of cognitive and/or behavioral therapies for body dysmorphic disorder. PMID:23467711

  18. [Evaluation of the therapeutic response after stereotactic body radiation therapy for liver tumors].

    PubMed

    Janoray, G; Barillot, I; Calais, G

    2014-01-01

    Stereotactic body radiation therapy takes more and more an important place in the therapeutic arsenal of primitive and secondary liver tumours. The administration of ablative radiation doses can result in specific changes to both the tumour and the healthy hepatic parenchyma, relative to conventional radiation therapy, making the assessment of local changes after stereotactic body radiation therapy, in terms of local control and reaction of healthy tissue, often difficult. It is mandatory to standardize and simplify our evaluation criteria to benefit from a better understanding of the effectiveness of this new treatment modality and allow better reproducibility of available imaging exams. This article presents a literature review of the various radiological changes observed after stereotactic body radiation therapy for liver tumours according to the multiple assessment methods used to determine local control. From the data available, we recommend using modified RECIST criteria proposed by the American Association for the Study of Liver Diseases (AASLD), as objective and relevant criteria of local control after stereotactic body radiation therapy for liver tumours. PMID:24811896

  19. Lack of effect of lovastatin therapy on the parameters of whole-body cholesterol metabolism.

    PubMed Central

    Goldberg, I J; Holleran, S; Ramakrishnan, R; Adams, M; Palmer, R H; Dell, R B; Goodman, D S

    1990-01-01

    The effects of lovastatin therapy on the parameters of body cholesterol metabolism were explored in nine hypercholesterolemic patients. Long-term cholesterol turnover studies were performed before therapy, and were repeated after 15 mo of lovastatin therapy (40 mg/d) while continuing on therapy. The major question addressed was whether a reduction in plasma cholesterol level with lovastatin would be associated with a reduction in the whole-body production rate of cholesterol or with the sizes of exchangeable body cholesterol pools as determined by the three-pool model of cholesterol turnover. The mean plasma cholesterol level decreased 19.4% (from 294 to 237 mg/dl), and low-density lipoprotein cholesterol decreased 23.8% (from 210 to 159 mg/dl) with lovastatin therapy. Changes in high-density lipoprotein cholesterol level were not significant. The cholesterol production rate did not change significantly with therapy (1.09 +/- 0.10 [mean +/- S.D.] vs. 1.17 +/- 0.09 g/d). By comparison, colestipol and niacin treatment in three other subjects more than doubled the cholesterol production rate (1.14 +/- 0.28 vs. 2.42 +/- 0.34 g/d). Thus, hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibition by lovastatin at the therapeutic dose used here did not change the steady-state rate of whole-body cholesterol synthesis. Despite the changes in plasma cholesterol levels, no significant changes were seen in the values of M1, of M3 or of Mtot, the sizes of the pools of rapidly, of slowly, and of total body exchangeable cholesterol. Conclusion: lovastatin therapy to lower plasma cholesterol does not lead to corresponding reductions in body cholesterol pools or to a reduction in the rate of whole-body cholesterol synthesis. In the new steady state that exists during long-term lovastatin therapy, along with increased expression of the genes for HMG-CoA reductase and the LDL receptor, the body compensates for the effects of the drug so that cholesterol production rate and tissue pool sizes are not changed from pretreatment values. PMID:2394831

  20. [Stereotactic body radiation therapy in the management of liver tumours].

    PubMed

    Jacob, J; Nguyen, F; Deutsch, E; Mornex, F

    2014-10-01

    Stereotactic radiotherapy is a high-precision technique based on the administration of high doses to a limited target volume. This treatment constitutes a therapeutic progress in the management of many tumours, especially hepatic ones. If surgery remains the standard local therapy, stereotactic radiotherapy is first dedicated to inoperable patients or unresectable tumours. Patients with moderately altered general status, preserved liver function and tumour lesions limited in number as in size are eligible to this technique. Results in terms of local control are satisfying, regarding primary tumours (notably hepatocellular carcinomas) as metastases stemming from various origins. If treatment protocols and follow-up modalities are not standardized to this day, iconographic acquisition using four-dimensional computed tomography, target volumes delineation based on morphological and/or metabolic data, and image-guided radiotherapy contribute to an oncologic efficacy and an improved sparing of the functional liver. The purpose of this literature review is to report the results of the main works having assessed stereotactic radiotherapy in the management of primary and secondary liver tumours. Technical particularities of this radiation modality will also be described. PMID:25195113

  1. Insulin Therapy and Body Weight, Body Composition and Muscular Strength in Patients with Type 2 Diabetes Mellitus

    PubMed Central

    Gin, H.; Rigalleau, V.; Perlemoine, C.

    2010-01-01

    Aims. To determine the progression of body weight (BW) and body composition (BC) in patients with type 2 diabetes mellitus (T2D) on insulin therapy and the consequences on muscle strength (MS) as a reflect of free fat mass increases. Research design and methods. We analysed BC using air displacement plethysmography and MS by hand grip dynamometry in 40 T2D before and after three (M3) and six months (M6) of insulin therapy. Results. at baseline HbA1c was 9.76 ±1.6% and BW was stable with fat mass (FM) 28 ± 10.7 kg; and fat free mass (FFM) 52.4 ± 11 kg; at M6, HbA1c improved to 7.56 ± 0.8%; insulin doses tended to increase. BW gain at M6 was + 3.2 ± 4.2 kg and with an increase of only 25% by M3; it was composed of FM, whereas FFM was unchanged. MS did not increase on insulin therapy. Conclusions. In T2D, BW gain was composed exclusively of FM with no improvement in MS. PMID:20721344

  2. Sporadic Inclusion Body Myositis: new insights and potential therapy

    PubMed Central

    Machado, Pedro; Dimachkie, Mazen M.; Barohn, Richard J.

    2014-01-01

    Purpose of the review To describe new insights and developments in the pathogenesis, diagnosis and treatment of sporadic inclusion body myositis (IBM). Recent findings Various hypothesis about the pathogenesis of IBM continue to be investigated, including autoimmune factors, mitochondrial dysfunction, protein dyshomeostasis, altered nucleic acid metabolism, myonuclear degeneration and the role of the myostatin pathway. Serum autoantibodies against cytosolic 5? nucleotidase 1A have been identified in IBM showing moderate diagnostic performance. The differential diagnostic value of histopathological features, including different protein aggregates, continues to be evaluated. MRI may also be of monitoring value in IBM. New therapeutic strategies are being tested in IBM patients, namely the up-regulation of the heat shock response and the antagonism of myostatin. Summary Recent important advances have occurred in IBM. These advances, including recent and ongoing clinical trials, may lead to earlier diagnosis and improved understanding and treatment of the disease. Despite improved knowledge, IBM continues to be a puzzling disease and the pathogenesis remains to be clarified. An interdisciplinary, bench to bedside translational research approach is crucial for the successful identification of novel treatments for this debilitating, currently untreatable disorder. PMID:25159931

  3. Vibrational investigation of calcium-silicate cements for endodontics in simulated body fluids

    NASA Astrophysics Data System (ADS)

    Taddei, Paola; Modena, Enrico; Tinti, Anna; Siboni, Francesco; Prati, Carlo; Gandolfi, Maria Giovanna

    2011-05-01

    Calcium-silicate MTA (Mineral Trioxide Aggregate) cements have been recently developed for oral and endodontic surgery. This study was aimed at investigating commercial (White ProRoot MTA, White and Grey MTA-Angelus) and experimental (wTC-Bi) accelerated calcium-silicate cements with regards to composition, hydration products and bioactivity upon incubation for 1-28 days at 37 C, in Dulbecco's Phosphate Buffered Saline (DPBS). Deposits on the surface of the cements and the composition changes during incubation were investigated by micro-Raman and ATR/FT-IR spectroscopy, and pH measurements. Vibrational techniques disclosed significant differences in composition among the unhydrated cements, which significantly affected the bioactivity as well as pH, and hydration products of the cements. After one day in DPBS, all the cements were covered by a more or less homogeneous layer of B-type carbonated apatite. The experimental cement maintained a high bioactivity, only slightly lower than the other cements and appears a valid alternative to commercial cements, in view of its adequate setting time properties. The bioactivity represents an essential property to favour bone healing and makes the calcium-silicate cements the gold standard materials for root-apical endodontic surgery.

  4. Comparison of selective head cooling therapy and whole body cooling therapy in newborns with hypoxic ischemic encephalopathy: short term results

    PubMed Central

    At?c?, Aytu?; elik, Yal?n; Gla??, Selvi; Turhan, Ali Haydar; Okuyaz, etin; Sungur, Mehmet Ali

    2015-01-01

    Aim: In this study, it was aimed to investigate which method was superior by applying selective head cooling or whole body cooling therapy in newborns diagnosed with moderate or severe hypoxic ischemic encephalopathy. Materials and Method: Newborns above the 35th gestational age diagnosed with moderate or severe hypoxic ischemic encephalopathy were included in the study and selective head cooling or whole body cooling therapy was performed randomly. The newborns who were treated by both methods were compared in terms of adverse effects in the early stage and in terms of short-term results. Ethics committee approval was obtained for the study (06.01.2010/35). Results: Fifty three babies diagnosed with hypoxic ischemic encephalopathy were studied. Selective head cooling was applied to 17 babies and whole body cooling was applied to 12 babies. There was no significant difference in terms of adverse effects related to cooling therapy between the two groups. When the short-term results were examined, it was found that the hospitalization time was 34 (765) days in the selective head cooling group and 18 (757) days in the whole body cooling group and there was no significant difference between the two groups (p=0.097). Four patients in the selective head cooling group and two patients in the whole body cooling group were discharged with tracheostomy because of the need for prolonged mechanical ventilation and there was no difference between the groups in terms of discharge with tracheostomy (p=0.528). Five patients in the selective head cooling group and three patients in the whole body cooling group were discharged with a gastrostomy tube because they could not be fed orally and there was no difference between the groups in terms of discharge with a gastrostomy tube (p=0.586). One patient who was applied selective head cooling and one patient who was applied whole body cooling died during hospitalization and there was no difference between the groups in terms of mortality (p=0.665). Conclusions: There is no difference between the methods of selective head cooling and whole body cooling in terms of adverse effects and short-term results. PMID:26078694

  5. Deconstructing the Mirror's Reflection: Narrative Therapy Groups for Women Dissatisfied with Their Body

    ERIC Educational Resources Information Center

    Duba, Jill D.; Kindsvatter, Aaron; Priddy, Constance J.

    2010-01-01

    Women facing middle age and beyond are pressured by a cultural ideal of slimness. The authors review literature pertaining to the factors affecting the societal perceptions of body image and address relevant counseling interventions, specifically, group therapy based on narrative theory, that are aimed at this population.

  6. Mind-body therapies and control of inflammatory biology: A descriptive review.

    PubMed

    Bower, Julienne E; Irwin, Michael R

    2016-01-01

    The use of mind-body therapies, including Tai Chi, Qigong, yoga, and meditation, has grown steadily in recent years. These approaches have been shown to be effective in reducing symptoms and improving quality of life, and research has begun to examine the impact of these therapies on biological processes, including inflammation. A review of 26 randomized controlled trials was conducted to describe the effects of mind-body therapies (MBTs) on circulating, cellular, and genomic markers of inflammation. This qualitative evaluation showed mixed effects of MBTs on circulating inflammatory markers, including CRP and IL-6, and on measures of stimulated cytokine production. More consistent findings were seen for genomic markers, with trials showing decreased expression of inflammation-related genes and reduced signaling through the proinflammatory transcription factor NF-κB. Potential mechanisms for these effects are discussed, including alterations in neuroendocrine, neural, and psychological and behavioral processes. PMID:26116436

  7. Antipyretic Therapy in Critically Ill Patients with Sepsis: An Interaction with Body Temperature

    PubMed Central

    Zhang, Zhongheng; Chen, Lin; Ni, Hongying

    2015-01-01

    Background and Objective The effect of antipyretic therapy on mortality in patients with sepsis remains undetermined. The present study aimed to investigate the role of antipyretic therapy in ICU patients with sepsis by using a large clinical database. Methods The multiparameter intelligent monitoring in intensive care II (MIMIC- II) database was employed for the study. Adult patients with sepsis were included for analysis. Antipyretic therapy included antipyretic medication and external cooling. Multivariable model with interaction terms were employed to explore the association of antipyretic therapy and mortality risk. Main Results A total of 15,268 patients fulfilled inclusion criteria and were included in the study. In multivariable model by treating temperature as a continuous variable, there was significant interaction between antipyretic therapy and the maximum temperature (Tmax). While antipyretic therapy had no significant effect on mortality in low temperature quintiles, antipyretic therapy was associated with increased risk of death in the quintile with body temperature >39C (OR: 1.29, 95% CI: 1.041.61). Conclusion Our study shows that there is no beneficial effect on reducing mortality risk with the use of antipyretic therapy in ICU patients with sepsis. External cooling may even be harmful in patients with sepsis. PMID:25822614

  8. Acute effect of whole body vibration on isometric strength, squat jump, and flexibility in well-trained combat athletes

    PubMed Central

    Pekünlü, E

    2015-01-01

    The purpose of this study was to investigate the effect of whole body vibration (WBV) training on maximal strength, squat jump, and flexibility of well-trained combat athletes. Twelve female and 8 male combat athletes (age: 22.8 ± 3.1 years, mass: 65.4 ± 10.7 kg, height: 168.8 ± 8.8 cm, training experience: 11.6 ± 4.7 years, training volume: 9.3 ± 2.8 hours/week) participated in this study. The study consisted of three sessions separated by 48 hours. The first session was conducted for familiarization. In the subsequent two sessions, participants performed WBV or sham intervention in a randomized, balanced order. During WBV intervention, four isometric exercises were performed (26 Hz, 4 mm). During the sham intervention, participants performed the same WBV intervention without vibration treatment (0 Hz, 0 mm). Hand grip, squat jump, trunk flexion, and isometric leg strength tests were performed after each intervention. The results of a two-factor (pre-post[2] × intervention[2]) repeated measures ANOVA revealed a significant interaction (p = 0.018) of pre-post × intervention only for the hand grip test, indicating a significant performance increase of moderate effect (net increase of 2.48%, d = 0.61) after WBV intervention. Squat jump, trunk flexion, and isometric leg strength performances were not affected by WBV. In conclusion, the WBV protocol used in this study potentiated hand grip performance, but did not enhance squat jump, trunk flexion, or isometric leg strength in well-trained combat athletes. PMID:26060334

  9. An Updated Review of Epidemiologic Studies on the Relationship Between Exposure to Whole-Body Vibration and Low Back Pain

    NASA Astrophysics Data System (ADS)

    Bovenzi, M.; Hulshof, C. T. J.

    1998-08-01

    The aim of this paper is to update the information on the epidemiologic evidence of the adverse health effects of whole-body vibration (WBV) on the spinal system by means of a review of the epidemiologic studies published between 1986 and 1996. In a systematic search of epidemiologic studies of low back pain (LBP) disorders and occupations with exposure to WBV, 37 articles were retrieved. The quality of each study was evaluated according to criteria concerning the assessment of vibration exposure, assessment of health effects, and methodology. The epidemiologic studies reaching an adequate score on each of the above mentioned criteria, were included in the final review. A meta-analysis was also conducted in order to combine the results of independent epidemiologic studies. After applying the selection criteria, 16 articles reporting the occurrence of LBP disorders in 19 WBV-exposed occupational groups, reached a sufficient score. The study design was cross-sectional for 13 occupational groups, longitudinal for 5 groups and of case-control type for one group. The main reasons for the exclusion of studies were insufficient quantitative information on WBV exposure and the lack of control groups. The findings of the selected studies and the results of the meta-analysis of both cross-sectional and cohort studies showed that occupational exposure to WBV is associated with an increased risk of LBP, sciatic pain, and degenerative changes in the spinal system, including lumbar intervertebral disc disorders. Owing to the cross-sectional design of the majority of the reviewed studies, this epidemiologic evidence is not sufficient to outline a clear exposure-response relationship between WBV exposure and LBP disorders. Upon comparing the epidemiological studies included in this review with those conducted before 1986, it is concluded that research design and the quality of exposure and health effect data in the field of WBV have improved in the last decade.

  10. Optimization of Car Body under Constraints of Noise, Vibration, and Harshness (NVH), and Crash

    NASA Technical Reports Server (NTRS)

    Kodiyalam, Srinivas; Yang, Ren-Jye; Sobieszczanski-Sobieski, Jaroslaw (Editor)

    2000-01-01

    To be competitive on the today's market, cars have to be as light as possible while meeting the Noise, Vibration, and Harshness (NVH) requirements and conforming to Government-man dated crash survival regulations. The latter are difficult to meet because they involve very compute-intensive, nonlinear analysis, e.g., the code RADIOSS capable of simulation of the dynamics, and the geometrical and material nonlinearities of a thin-walled car structure in crash, would require over 12 days of elapsed time for a single design of a 390K elastic degrees of freedom model, if executed on a single processor of the state-of-the-art SGI Origin2000 computer. Of course, in optimization that crash analysis would have to be invoked many times. Needless to say, that has rendered such optimization intractable until now. The car finite element model is shown. The advent of computers that comprise large numbers of concurrently operating processors has created a new environment wherein the above optimization, and other engineering problems heretofore regarded as intractable may be solved. The procedure, shown, is a piecewise approximation based method and involves using a sensitivity based Taylor series approximation model for NVH and a polynomial response surface model for Crash. In that method the NVH constraints are evaluated using a finite element code (MSC/NASTRAN) that yields the constraint values and their derivatives with respect to design variables. The crash constraints are evaluated using the explicit code RADIOSS on the Origin 2000 operating on 256 processors simultaneously to generate data for a polynomial response surface in the design variable domain. The NVH constraints and their derivatives combined with the response surface for the crash constraints form an approximation to the system analysis (surrogate analysis) that enables a cycle of multidisciplinary optimization within move limits. In the inner loop, the NVH sensitivities are recomputed to update the NVH approximation model while keeping the Crash response surface constant. In every outer loop, the Crash response surface approximation is updated, including a gradual increase in the order of the response surface and the response surface extension in the direction of the search. In this optimization task, the NVH discipline has 30 design variables while the crash discipline has 20 design variables. A subset of these design variables (10) are common to both the NVH and crash disciplines. In order to construct a linear response surface for the Crash discipline constraints, a minimum of 21 design points would have to be analyzed using the RADIOSS code. On a single processor in Origin 2000 that amount of computing would require over 9 months! In this work, these runs were carried out concurrently on the Origin 2000 using multiple processors, ranging from 8 to 16, for each crash (RADIOSS) analysis. Another figure shows the wall time required for a single RADIOSS analysis using varying number of processors, as well as provides a comparison of 2 different common data placement procedures within the allotted memories for each analysis. The initial design is an infeasible design with NVH discipline Static Torsion constraint violations of over 10%. The final optimized design is a feasible design with a weight reduction of 15 kg compared to the initial design. This work demonstrates how advanced methodology for optimization combined with the technology of concurrent processing enables applications that until now were out of reach because of very long time-to-solution.

  11. Control Group Design: Enhancing Rigor in Research of Mind-Body Therapies for Depression

    PubMed Central

    Kinser, Patricia Anne; Robins, Jo Lynne

    2013-01-01

    Although a growing body of research suggests that mind-body therapies may be appropriate to integrate into the treatment of depression, studies consistently lack methodological sophistication particularly in the area of control groups. In order to better understand the relationship between control group selection and methodological rigor, we provide a brief review of the literature on control group design in yoga and tai chi studies for depression, and we discuss challenges we have faced in the design of control groups for our recent clinical trials of these mind-body complementary therapies for women with depression. To address the multiple challenges of research about mind-body therapies, we suggest that researchers should consider 4 key questions: whether the study design matches the research question; whether the control group addresses performance, expectation, and detection bias; whether the control group is ethical, feasible, and attractive; and whether the control group is designed to adequately control for nonspecific intervention effects. Based on these questions, we provide specific recommendations about control group design with the goal of minimizing bias and maximizing validity in future research. PMID:23662111

  12. The Metabolic Syndrome and Mind-Body Therapies: A Systematic Review

    PubMed Central

    Anderson, Joel G.; Taylor, Ann Gill

    2011-01-01

    The metabolic syndrome, affecting a substantial and increasing percentage of the worldwide population, is comprised of a cluster of symptoms associated with increased risk of type 2 diabetes, cardiovascular disease, and other chronic conditions. Mind-body modalities based on Eastern philosophy, such as yoga, tai chi, qigong, and meditation, have become increasingly popular worldwide. These complementary therapies have many reported benefits for improving symptoms and physiological measures associated with the metabolic syndrome. However, clinical trial data concerning the effectiveness of these practices on the syndrome as a whole have not been evaluated using a systematic and synthesizing approach. A systematic review was conducted to critically evaluate the data from clinical trials examining the efficacy of mind-body therapies as supportive care modalities for management of the metabolic syndrome. Three clinical trials addressing the use of mind-body therapies for management of the metabolic syndrome were identified. Findings from the studies reviewed support the potential clinical effectiveness of mind-body practices in improving indices of the metabolic syndrome. PMID:21773016

  13. Effects of a 6-week periodized squat training with or without whole-body vibration upon short-term adaptations in squat strength and body composition.

    PubMed

    Lamont, Hugh S; Cramer, Joel T; Bemben, Debra A; Shehab, Randa L; Anderson, Mark A; Bemben, Michael G

    2011-07-01

    The purpose of this study was to examine the effects of a 6-week, periodized squat training program, with or without whole-body low-frequency vibration (WBLFV), applied before and between sets to 1RM squat strength and body composition. Thirty men aged between 20 and 30 years with at least 6 months of recreational weight training experience completed the study. Subjects were randomly assigned to either 1 of 2 training groups or to an active control group (CON). Group 1 (CON; n = 6) did not participate in the training protocol but participated only in testing sessions. Group 2 (SQTV, n = 13) performed 6 weeks of squat training while receiving WBLFV (50 Hz), before, and in-between sets. The third group (SQT, n = 11) performed 6 weeks of squat training only. Subjects completed 12 workouts with variable loads (55-90% one repetition maximum [1RM]) and sets (), performing squats twice weekly separated by 72 hours. The RM measures were recorded on weeks (W) 1, 3, and 7. During the second workout of a week, the load was reduced by 10-15%, with "speed squats" performed during the final 3 weeks. Rest periods in between sets were set at 240 seconds. The WBLFV was applied while subjects stood on a WBLFV platform holding an isometric quarter squat position (knee angle 135 ± 5°). Initially, WBLFV was applied at 50 Hz for 30 seconds at low amplitude (peak-peak 2-4 mm). A rest period of 180 seconds followed WBLFV exposure before the first set of squats. The WBLFV was then applied intermittently (3 × 10 seconds) at 50 Hz, high amplitude (peak-peak, 4-6 mm) at time points, 60, 120, and 180 seconds into the 240-second rest period. Total body dual x-ray absorptiometry scans were performed at W0 (week before training) and W7 (week after training). Measures recorded included total body mass (kg), total body lean mass (TLBM, kg), trunk lean mass (kg), leg lean mass (kg), total body fat percentage, trunk fat percentage, and leg fat percentage (LF%). Repeated-measures analysis of variance and analysis of covariance revealed 1RM increased significantly between W1-W3, W3-W7, and W1-W7 for both experimental groups but not for control (p = 0.001, effect size [ES] = 0.237, 1 - β = 0.947). No significant differences were seen for %Δ (p > 0.05). Significant group by trial and group effects were seen for TLBM, SQTV > CON at W7 (p = 0.044). A significant main effect for time was seen for LF%, W0 vs. W7 (p = 0.047). No other significant differences were seen (p > 0.05). "Practical trends" were seen favoring "short-term" neuromuscular adaptations for the SQTV group during the first 3 weeks (p = 0.10, ES = 0.157, 1 - β = 0.443, mean diff; SQTV week 3 4.72 kg > CON and 2.53 kg > SQT). Differences in motor unit activation patterns, hypertrophic responses, and dietary intake during the training period could account for the trends seen. PMID:21572357

  14. Low-Magnitude Whole-Body Vibration Does Not Enhance the Anabolic Skeletal Effects of Intermittent PTH in Adult Mice

    PubMed Central

    Lynch, Michelle A.; Brodt, Michael D.; Stephens, Abby L.; Civitelli, Roberto; Silva, Matthew J.

    2013-01-01

    Whole-body vibration (WBV) is a low-magnitude mechanical stimulus that may be anabolic for bone, yet we recently found that WBV did not improve bone properties in adult mice. Because intermittent parathyroid hormone (PTH) enhances the anabolic effects of high-magnitude skeletal loading, we sought to determine the skeletal effects of WBV in combination with PTH. Seven-month old male BALB/c mice were assigned to six groups (n = 1314/group) based on magnitude of applied acceleration (0, 0.3 G) and PTH dose (0, 10, 40 ?g/kg/day). Mice were exposed to WBV (0.3 G, 90 Hz, sine wave) or sham loading (0 G) for 15 min/day, 5 days/wk for 8 weeks. Vehicle or hPTH(134) was administered prior to each WBV session. Whole-body bone mineral content increased by ~5% from 0 to 8 weeks in the 40 ?g/kg PTH group only, independent of WBV loading. Similarly, PTH treatment increased tibial cortical bone volume by ~5% from 0 to 8 weeks, independent of WBV loading. Neither PTH nor WBV stimulated trabecular bone formation. Consistent with the cortical bone effect, tibias from the 40 ?g/kg PTH group had significantly greater ultimate force and energy to failure than tibias in the 0 and 10 ?g/kg PTH groups, independent of WBV treatment. In summary, 8 weeks of intermittent PTH treatment increased cortical bone volume and strength in adult male BALB/c mice. Daily exposure to low-magnitude WBV by itself did not improve skeletal properties and did not enhance the PTH effect. There was no WBV-PTH synergy in this preclinical study. PMID:21337386

  15. Effect of stochastic resonance whole body vibration on functional performance in the frail elderly: A pilot study.

    PubMed

    Kessler, Jessica; Radlinger, Lorenz; Baur, Heiner; Rogan, Slavko

    2014-01-01

    The aim of this pilot study was to evaluate the feasibility and the effect size of a four-week stochastic resonance whole body vibration (SR-WBV) intervention on functional performance and strength in frail elderly individuals. Twenty-seven participants have been recruited and randomly distributed in an intervention group (IG) and a sham group (SG). Primary outcomes were feasibility objectives like recruitment, compliance and safety. Secondary outcomes were short physical performance battery (SPPB), isometric maximum voluntary contraction (IMVC) and isometric rate of force development (IRFD). The intervention was feasible and safe. Furthermore it showed significant effects (p=0.035) and medium effect size (0.43) within the IG in SPPB. SR-WBV training over four weeks with frail elderly individuals is a safe intervention method. The compliance was good and SR-WBV intervention seems to improve functional performance. Further research over a longer time frame for the strength measurements (IMVC and IRFD) is needed to detect potential intervention effects in the force measurements as well. Clinical Trial register: NTC01704976. PMID:25042993

  16. Combined whole-body vibration training and l-citrulline supplementation improves pressure wave reflection in obese postmenopausal women.

    PubMed

    Wong, Alexei; Alvarez-Alvarado, Stacey; Jaime, Salvador J; Kinsey, Amber W; Spicer, Maria T; Madzima, Takudzwa A; Figueroa, Arturo

    2016-03-01

    Postmenopausal women have increased wave reflection (augmentation pressure (AP) and index (AIx)) and reduced muscle function that predispose them to cardiac diseases and disability. Our aim was to examine the combined and independent effects of whole-body vibration training (WBVT) and l-citrulline supplementation on aortic hemodynamics and plasma nitric oxide metabolites (NOx) in postmenopausal women. Forty-one obese postmenopausal women were randomized to 3 groups: l-citrulline, WBVT+l-citrulline and WBVT+Placebo for 8 weeks. Brachial and aortic systolic blood pressure, diastolic blood pressure, AP, AIx, AIx adjusted to 75 beats/min (AIx@75), and NOx were measured before and after 8 weeks. All groups similarly decreased (P < 0.05) brachial and aortic pressures as well as AP, and similarly increased (P < 0.05) NOx levels. AIx and AIx@75 decreased (P < 0.01) in the WBVT+l-citrulline and WBVT+Placebo groups, but not in the l-citrulline group. The improvement in AIx@75 (-10.5% ± 8.8%, P < 0.05) in the WBVT+l-citrulline group was significant compared with the l-citrulline group. l-Citrulline supplementation and WBVT alone and combined decreased blood pressures. The combined intervention reduced AIx@75. This study supports the effectiveness of WBVT+l-citrulline as a potential intervention for prevention of hypertension-related cardiac diseases in obese postmenopausal women. PMID:26863234

  17. The effects of whole body vibration on static balance, spinal curvature, pain, and disability of patients with low back pain

    PubMed Central

    Yang, Jinmo; Seo, Dongkwon

    2015-01-01

    [Purpose] The purpose of this study was to investigate the impact of whole body vibration (WBV) on static balance, spinal curvature, pain, and the disability of patients with chronic lower back pain. [Subjects and Methods] The subjects were of 40 patients, who were randomly assigned to WBV and control groups. Twenty-five minutes of lumbar stability training and 5 minutes of WBV were conducted for the WBV group, and 30 minutes of lumbar stability training was conducted for the control group. The training was conducted three times per week for a total of 6 weeks. Static balance, spinal curvature, pain, and disability were measured before and after the intervention. [Results] After the intervention, the WBV group showed a significant differences in static balance, spinal curvature, pain, and disability. The control group presented significant differences in pain, and disability. In the comparison of the two groups, the WBV group showed more significant improvements in the fall index and pain. [Conclusion] WBV can be recommended for the improvement of the balance ability and pain of chronic lower back pain patients. PMID:25931735

  18. Tumor cells, but not endothelial cells, mediate eradication of primary sarcomas by stereotactic body radiation therapy.

    PubMed

    Moding, Everett J; Castle, Katherine D; Perez, Bradford A; Oh, Patrick; Min, Hooney D; Norris, Hannah; Ma, Yan; Cardona, Diana M; Lee, Chang-Lung; Kirsch, David G

    2015-03-11

    Cancer clinics currently use high-dose stereotactic body radiation therapy as a curative treatment for several kinds of cancers. However, the contribution of vascular endothelial cells to tumor response to radiation remains controversial. Using dual recombinase technology, we generated primary sarcomas in mice with targeted genetic mutations specifically in tumor cells or endothelial cells. We selectively mutated the proapoptotic gene Bax or the DNA damage response gene Atm to genetically manipulate the radiosensitivity of endothelial cells in primary soft tissue sarcomas. Bax deletion from endothelial cells did not affect radiation-induced cell death in tumor endothelial cells or sarcoma response to radiation therapy. Although Atm deletion increased endothelial cell death after radiation therapy, deletion of Atm from endothelial cells failed to enhance sarcoma eradication. In contrast, deletion of Atm from tumor cells increased sarcoma eradication by radiation therapy. These results demonstrate that tumor cells, rather than endothelial cells, are critical targets that regulate sarcoma eradication by radiation therapy. Treatment with BEZ235, a small-molecule protein kinase inhibitor, radiosensitized primary sarcomas more than the heart. These results suggest that inhibiting ATM kinase during radiation therapy is a viable strategy for radiosensitization of some tumors. PMID:25761890

  19. Developing, Maintaining, and Using a Body of Knowledge for the Massage Therapy Profession

    PubMed Central

    Sefton, JoEllen M.; Shea, Michael; Hines, Chip

    2011-01-01

    Background: The diverse field of massage therapy has lacked a formal body of knowledge to serve as a practice and educational foundation and to guide future development. This deficit has hampered the growth of the profession and its acceptance and recognition by the medical and allied health care community. Purpose: To provide massage therapists, bodyworkers, physicians, educators, and associated allied health care professionals in the United States with a description of the purpose and development of the massage therapy body of knowledge (MTBOK) and recommendations for its future development and utilization. Methods: Professional groups in the massage therapy community came together and established a task force to develop a body of knowledge for the profession. Five groups became the stewards for this effort. A nationwide search produced a task force of eight volunteers from diverse areas of the profession charged with the responsibility of researching and developing the MTBOK document. Review of documents, curricula, state laws and regulations, certification exam content, interviews, and public comment resulted in the development of the MTBOK. During development multiple opportunities for comment and discussion by stakeholders (public) were provided in an effort to create a professional consensus. Results: The resulting MTBOK document establishes professional descriptions of the field; scope of practice; knowledge, skills, and abilities for entry-level massage therapists; and definitions for terminology to insure standardization, in order to provide a foundation for future discussion and growth. Conclusions: The MTBOK fulfills the goal for which it was developed, to serve as a foundation for the growth and development of the massage therapy profession as a whole. A living document, it should continue to evolve and grow with the profession. Maintenance and continued stewardship of this document by the massage therapy community is vital for continued professional progress. PMID:22016755

  20. Spanish Society of Radiation Oncology clinical guidelines for stereotactic body radiation therapy in lymph node oligometastases.

    PubMed

    Conde-Moreno, A J; Lopez-Guerra, J L; Macias, V A; Vázquez de la Torre, M L; Samper Ots, P; San José-Maderuelo, S; Pastor Peidro, J; López-Torrecilla, J; Expósito-Hernández, J

    2016-04-01

    Data in the literature support the existence of a state of limited metastases or oligometastases. Favorable outcomes have been observed in selected patients with such oligometastases that are treated with local ablative therapies, which include surgical extirpation, stereotactic body radiation therapy (SBRT), and radiofrequency ablation. The role of SBRT in the setting of lymph node oligometastases is still emerging but the early results for local control are promising. However, the biggest challenge is to identify patients who will benefit from treatment of their oligometastatic disease with local aggressive therapy. Patients are initially categorized based upon examination of the initial biopsy, location, stage, and previous treatments received. Appropriate patient management with SBRT requires an understanding of several clinicopathological features that help to identify several subsets of patients with more responsive tumors and a good tolerance to SBRT. In an effort to incorporate the most recent evidence, here the Spanish Society of Radiation Oncology presents guidelines for using SBRT in lymph node oligometastases. PMID:26329294

  1. Vertical and dual-axis vibration of the seated human body: Nonlinearity, cross-axis coupling, and associations between resonances in transmissibility and apparent mass

    NASA Astrophysics Data System (ADS)

    Zheng, Guangtai; Qiu, Yi; Griffin, Michael J.

    2012-12-01

    The vertical apparent mass of the human body exhibits nonlinearity, with the principal resonance frequency reducing as the vibration magnitude increases. Measures of the transmission of vibration to the spine and the pelvis have suggested complex modes are responsible for the dominant resonance during vertical excitation, but the modes present with dual-axis excitation have not been investigated. This study was designed to examine how the apparent mass and transmissibility of the human body depend on the magnitude of vertical excitation and the addition of fore-and-aft excitation, and the relation between the apparent mass and the transmissibility of the body. The movement of the body (over the first, fifth and twelfth thoracic vertebrae, the third lumbar vertebra, and the pelvis) in the fore-and-aft and vertical directions (and in pitch at the pelvis) was measured in 12 male subjects sitting with their hands on their laps during random vertical vibration excitation (over the range 0.25-20 Hz) at three vibration magnitudes (0.25, 0.5 and 1.0 m s-2 rms). At the highest magnitude of vertical excitation (1.0 m s-2 rms) the effect of adding fore-aft vibration (at 0.25, 0.5, and 1.0 m s-2 rms) was investigated. The forces in the vertical and fore-and-aft directions on the seat surface were also measured so as to calculate apparent masses. Resonances in the apparent mass and transmissibility to the spine and pelvis in the fore-and-aft and vertical directions, and pitch transmissibility to the pelvis, shifted to lower frequencies as the magnitude of vertical excitation increased and as the magnitude of the additional fore-and-aft excitation increased. The nonlinear resonant behaviour of the apparent mass and transmissibility during dual-axis vibration excitation suggests coupling between the principal mode associated with vertical excitation and the cross-axis influence of fore-and-aft excitation. The transmissibility measures are consistent with complex modes contributing to motion of the body at the principal resonance: pitch motions of the upper thoracic and lumbar spine, and vertical and fore-aft motion of the pelvis and spine. The mode varies with the magnitude of vertical and fore-and-aft excitation.

  2. Effects of Levothyroxine Replacement or Suppressive Therapy on Energy Expenditure and Body Composition

    PubMed Central

    Kolobova, Irina; Smeraglio, Anne; Peters, Dawn; Purnell, Jonathan Q.; Schuff, Kathryn G.

    2016-01-01

    Background: Thyrotropin (TSH)-suppressive doses of levothyroxine (LT4) have adverse effects on bone and cardiac function, but it is unclear whether metabolic function is also affected. The objective of this study was to determine whether women receiving TSH-suppressive LT4 doses have alterations in energy expenditure or body composition. Methods: This study was a cross-sectional comparison between three groups of women: 26 women receiving chronic TSH-suppressive LT4 doses, 80 women receiving chronic replacement LT4 doses, and 16 untreated euthyroid control women. Subjects underwent measurements of resting energy expenditure (REE), substrate oxidation, and thermic effect of food by indirect calorimetry; physical activity energy expenditure by accelerometer; caloric intake by 24-hour diet recall; and body composition by dual X-ray absorptiometry. Results: REE per kilogram lean body mass in the LT4 euthyroid women was 6% lower than that of the LT4-suppressed group, and 4% lower than that of the healthy control group (p = 0.04). Free triiodothyronine (fT3) levels were directly correlated with REE, and were 10% lower in the LT4 euthyroid women compared with the other two groups (p = 0.007). The groups of subjects did not differ in other measures of energy expenditure, caloric intake, or body composition. Conclusions: LT4 suppression therapy does not adversely affect energy expenditure or body composition in women. However, LT4 replacement therapy is associated with a lower REE, despite TSH levels within the reference range. This may be due to lower fT3 levels, suggesting relative tissue hypothyroidism may contribute to impaired energy expenditure in LT4 therapy. PMID:26700485

  3. Does whole-body vibration training in the horizontal direction have effects on motor function and balance of chronic stroke survivors? A preliminary study

    PubMed Central

    Lee, GyuChang

    2015-01-01

    [Purpose] The objective of this study was to investigate the effects of whole-body vibration (WBV) in the horizontal direction on the motor function and balance of chronic stroke survivors. [Subjects and Methods] This study was a randomized controlled trial. Twenty-one individuals with chronic stroke from an inpatient rehabilitation center participated in the study. The participants were allocated to either the WBV training group or the control group. The WBV training group (n = 12) received whole-body vibration delivered in the horizontal direction (15 min/day, 3 times/week, 6 wks) followed by conventional rehabilitation (30 min/day, 5 times/week, 6 wks); the control group (n = 9) received conventional rehabilitation only (30 min/day, 5 times/week, 6 wks). Motor function was measured by using the Fugl-Meyer assessment, and balance was measured by using the Berg Balance Scale (BBS) and the Timed Up and Go (TUG) test before and after the interventions. [Results] After the interventions, all variables improved significantly compared with the baseline values in the WBV training group. In the control group, no significant improvements in any variables were noted. In addition, the BBS score in the WBV training group increased significantly compared with that in the control group. [Conclusion] WBV training with whole-body vibration delivered in the horizontal direction may be a potential intervention for improvement of motor function and balance in patients who previously experienced a stroke. PMID:25995573

  4. Whole-body vibration decreases the proliferative response of TCD4+ cells in elderly individuals with knee osteoarthritis

    PubMed Central

    Tossige-Gomes, R.; Avelar, N.C.P.; Simo, A.P.; Neves, C.D.C.; Brito-Melo, G.E.A.; Coimbra, C.C.; Rocha-Vieira, E.; Lacerda, A.C.R.

    2012-01-01

    The aim of this study was to investigate the effect of adding whole-body vibration (WBV; frequency = 35 to 40?Hz; amplitude = 4?mm) to squat training on the T-cell proliferative response of elderly patients with osteoarthritis (OA) of the knee. This study was a randomized controlled trial in which the selected variables were assessed before and after 12 weeks of training. Twenty-six subjects (72 5 years of age) were divided into three groups: 1) squat training with WBV (WBV, N = 8); 2) squat training without WBV (N = 10), and 3) a control group (N = 8). Women who were ?60 years of age and had been diagnosed with OA in at least one knee were eligible. The intervention consisted of 12 uninterrupted weeks of squatting exercise training performed 3 times/week. Peripheral blood mononuclear cells were obtained from peripheral blood collected before and after training. The proliferation of TCD4+ and TCD8+ cells was evaluated by flow cytometry measuring the carboxyfluorescein succinimidyl ester fluorescence decay before and after the intervention (?). The proliferative response of TCD4+ cells (P = 0.02, effect size = 1.0) showed a significant decrease (23%) in the WBV group compared to the control group, while there was no difference between groups regarding the proliferative response of TCD8+ cells (P = 0.12, effect size = 2.23). The data suggest that the addition of WBV to squat exercise training might modulate T-cell-mediated immunity, minimizing or slowing disease progression in elderly patients with OA of the knee. PMID:22948377

  5. Optimal frequency, displacement, duration, and recovery patterns to maximize power output following acute whole-body vibration.

    PubMed

    Adams, Jessica B; Edwards, David; Serravite, Daniel H; Serviette, Daniel; Bedient, Abby M; Huntsman, Emy; Jacobs, Kevin A; Del Rossi, Gianluca; Roos, Bernard A; Signorile, Joseph F

    2009-01-01

    Power is an important component of general health, fitness, and athletic performance. Traditional overload techniques require considerable time, intensity, and volume of training. Whole-body vibration (WBV) is a potentially less time-consuming method for increasing power performance than traditional training. However, the exact protocols that can maximize power output have not yet been identified. Eleven healthy men, aged 32.3 +/- 4.1 years, and 9 healthy women, aged 29.1 +/- 3.5 years, performed countermovement jumps (CMJs) of maximal volition to assess peak power pre and post (immediately and at 1, 5, and 10 minutes) randomized WBV stimuli set at different frequency (30, 35, 40, and 50 Hz), displacement (2-4 vs. 4-6 mm), and duration (30, 45, and 60 seconds) combinations. Repeated-measures analysis of variance on peak power normalized to initial power (nPP) revealed no significant effects attributable to duration of stimulus. However, high frequencies were more effective when combined with high displacements, and low frequencies were more effective in conjunction with low displacements (p < 0.05). Additionally, the greatest improvements in nPP occurred at 1 minute posttreatment, with significant improvements lasting through 5 minutes posttreatment (p < 0.05). Optimal acute effects can be attained using as little as 30 seconds of WBV, and they are highest from 1 to 5 minutes posttreatment. Additionally, high frequencies were most effective when applied in conjunction with high displacements, whereas low frequencies were most effective when applied in conjunction with low displacements. PMID:19057405

  6. Effect of whole-body vibration for 3 months on arterial stiffness in the middle-aged and elderly

    PubMed Central

    Lai, Chung-Liang; Chen, Han-Yu; Tseng, Shiuan-Yu; Liao, Wan-Chun; Liu, Bing-Tang; Lee, Meng-Chih; Chen, Hsin-Shui

    2014-01-01

    Background Cardiovascular disease (CVD) is a common problem of middle-aged and older adults. Increased arterial stiffness is a CVD risk factor. Whole-body vibration (WBV) is a simple and convenient exercise for middle-aged and older adults; however, there have been few studies investigating the effect of WBV on arterial stiffness. This study mainly investigated the effect of WBV on arterial stiffness in middle-aged and older adults. Methods A total of 38 (21 women and 17 men) middle-aged and elderly subjects (average age, 61.9 years) were randomly divided into the WBV group and the control group for a 3-month trial. The WBV group received an intervention of 30 Hz and 3.2 g WBV in a natural full standing posture at a sports center. The brachialankle pulse wave velocity (baPWV), a marker of systemic arterial stiffness, and blood pressure and heart rate were measured before and after the intervention. Results After 3 months, there were no significant changes in blood pressure or heart rate in both groups. However, the bilateral baPWV was significantly reduced in the WBV group (decreased by 0.65 m/second [P=0.014]; 0.63 m/second [P=0.041] in either side), but not in the control group. The comparison between the two groups was not statistically significant. Conclusion This study found that 3 months of WBV had a positive effect on arterial stiffness in middle-aged and older adults and could therefore be regarded as a supplementary exercise. Larger-scale studies are needed to confirm the effects of WBV in the future. PMID:24872684

  7. Evaluation of an occupational health intervention programme on whole?body vibration in forklift truck drivers: a controlled trial

    PubMed Central

    Hulshof, C T J; Verbeek, J H A M; Braam, I T J; Bovenzi, M; van Dijk, F J H

    2006-01-01

    Objectives To evaluate process and outcome of a multifaceted occupational health intervention programme on whole?body vibration (WBV) in forklift truck drivers. Methods An experimental pretest/post?test control group study design. The authors trained occupational health services (OHS) in the experimental group in the use of the programme. OHS in the control group were asked to deliver care as usual. In total, 15 OHS, 32 OHS professionals, 26 companies, and 260 forklift drivers were involved. Post?test measurements were carried out one year after the start of the programme. Results Baseline data before the start of the programme showed no difference between experimental and control group. Results of the outcome evaluation indicate a slight, although not statistically significant, reduction of WBV exposure in the experimental group (p?=?0.06). Process evaluation revealed a positive influence on company policy toward WBV, attitude and intended behaviour of forklift drivers, and a trend towards an increase in knowledge of OHS professionals and company managers. The number of observed control measures with a major impact (levelling of surface and reduction of speed) was rather low. In those cases where control measures had been taken, there was a significant reduction in WBV exposure. This limited effect of the programme might be caused by the short period of follow up and the dropout of participants. The feasibility and the usefulness of the programme within the OHS setting were rated good by the participants. Conclusions This programme to decrease WBV exposure was partially effective. Significant effects on intermediate objectives were observed. More research on the effectiveness of intervention in the field of WBV is needed. PMID:16551762

  8. The Fate of Mrs Robinson: Criteria for Recognition of Whole-Body Vibration Injury as AN Occupational Disease

    NASA Astrophysics Data System (ADS)

    HULSHOF, C. T. J.; VAN DER LAAN, G.; BRAAM, I. T. J.; VERBEEK, J. H. A. M.

    2002-05-01

    Several recently published critical reviews conclude that there is strong epidemiological evidence for a relationship between occupational exposure to whole-body vibration (WBV), low back pain (LBP) and back disorders. Whether this exposure is only a modest or a substantial risk factor for the onset and recurrence of LBP is still a matter of debate. In spite of this controversy, four European Union countries have decided to recognize and compensate LBP and certain spinal disorders as an occupational disease. In this paper, we review the criteria currently in use for the recognition of this occupational disease. A search of the literature was performed; additional information was obtained in work visits to national occupational disease institutes in Germany, France and Belgium, in annual reports and national statistics on occupational diseases. Belgium was the first country to add WBV injury to the official list of occupational diseases (1978), followed by Germany (1993), the Netherlands (1997), and France (1999). The incidence of newly recognized cases in 1999 varied considerably: 763 in Belgium, 269 in France, 16 in Germany, and 10 reported cases in the Netherlands. The findings of this review indicate that significant differences exist in the established and applied diagnostic and exposure criteria in the four EU countries. This is illustrated by the case of Mrs Robinson, a 41-year-old forklift driver with LBP, who would probably get recognition and compensation in the Netherlands and Belgium but would be rejected in France and Germany. The development of uniform internationally accepted criteria is recommended, also from an epidemiological point of view, as many data are collected in the process of recognition of this occupational disease.

  9. Single-dose effects of whole body vibration on quadriceps strength in individuals with motor-incomplete spinal cord injury.

    PubMed

    Bosveld, Rick; Field-Fote, Edelle C

    2015-11-01

    Context Paresis associated with motor-incomplete spinal cord injury (SCI) impairs function. Whole body vibration (WBV) may increase strength by activating neuromuscular circuits. Objective We assessed effects of a single session of WBV on lower extremity strength in individuals with motor-incomplete SCI. Design A single-session blinded randomized controlled trial. Setting Rehabilitation research laboratory. Participants Subjects (n=25; age 49.712.5 years) had chronic SCI (>1 year) and were able to stand for at least 45 seconds. Interventions Subjects were randomized either to WBV (n=13) consisting of four 45-second bouts with 1-minute intervening rest periods (frequency: 50Hz, amplitude: 2mm) or to sham electrical stimulation (n=12). Outcome measures Maximal voluntary isometric quadriceps force was measured with a fixed dynamometer. A modified Five-Time-Sit-To-Stand (FTSTS) test was used to assess functional lower extremity strength. Measures were made at pre-test, immediate post-test, and delayed post-test 20 minutes later. Results At immediate post-test, change in voluntary isometric force in the WBV group was 1.12kg greater than in the sham group. The within-group change for the WBV group was significant with a moderate effect size (P=0.05; ES=0.60). No force-related changes were observed in the sham group. The modified FTSTS scores improved in both groups, suggesting that this measure was subject to practice effects. Conclusion Evidence from the present study suggests that even a single session of WBV is associated with a meaningful short-term increase in quadriceps force-generating capacity in persons with motor-incomplete SCI. The multi-session use of WBV as part of a strengthening program deserves exploration. PMID:25664489

  10. Whole-body vibration decreases the proliferativeb response of TCD4(+) cells in elderly individuals with knee osteoarthritis.

    PubMed

    Tossige-Gomes, R; Avelar, N C P; Simo, A P; Neves, C D C; Brito-Melo, G E A; Coimbra, C C; Rocha-Vieira, E; Lacerda, A C R

    2012-12-01

    The aim of this study was to investigate the effect of adding whole-body vibration (WBV; frequency = 35 to 40 Hz; amplitude = 4 mm) to squat training on the T-cell proliferative response of elderly patients with osteoarthritis (OA) of the knee. This study was a randomized controlled trial in which the selected variables were assessed before and after 12 weeks of training. Twenty-six subjects (72 5 years of age) were divided into three groups: 1) squat training with WBV (WBV, N = 8); 2) squat training without WBV (N = 10), and 3) a control group (N = 8). Women who were ?60 years of age and had been diagnosed with OA in at least one knee were eligible. The intervention consisted of 12 uninterrupted weeks of squatting exercise training performed 3 times/week. Peripheral blood mononuclear cells were obtained from peripheral blood collected before and after training. The proliferation of TCD4+ and TCD8+ cells was evaluated by flow cytometry measuring the carboxyfluorescein succinimidyl ester fluorescence decay before and after the intervention (?). The proliferative response of TCD4+ cells (P = 0.02, effect size = 1.0) showed a significant decrease (23%) in the WBV group compared to the control group, while there was no difference between groups regarding the proliferative response of TCD8+ cells (P = 0.12, effect size = 2.23). The data suggest that the addition of WBV to squat exercise training might modulate T-cell-mediated immunity, minimizing or slowing disease progression in elderly patients with OA of the knee. PMID:22948377

  11. CASE-CONTROL STUDY OF LOW-BACK PAIN PRESENTING FOR MRI, WITH SPECIAL RELATION TO WHOLE-BODY VIBRATION

    PubMed Central

    Palmer, KT; Harris, EC; Griffin, MJ; Bennett, J; Reading, I; Sampson, M; Coggon, D

    2009-01-01

    Objectives To investigate risk factors for low-back pain (LBP) presenting for magnetic resonance imaging (MRI), with special focus on whole-body vibration (WBV). Methods A case-control approach was used. The study population comprised working-aged subjects from a catchment area for radiology services. Cases were a consecutive series referred for a lumbar MRI because of LBP. Controls were age- sex-matched subjects X-rayed for other reasons. Subjects were questioned about physical factors loading the spine, psychosocial factors, driving, personal characteristics, mental health, and certain beliefs about LBP. Exposure to WBV was assessed by six measures, including weekly duration of professional driving, hours driven at a spell, and current r.m.s. A(8). Associations with WBV were examined with adjustment for age, sex, and other potential confounders. Results Altogether, 252 cases and 820 controls were studied, including 185 professional drivers. Strong associations were found with poor mental health and belief in work as a causal factor for LBP, and with occupational sitting for ≥3 hours while not driving. Associations were also seen with taller stature, consulting propensity, BMI, smoking history, fear-avoidance beliefs, frequent twisting, low decision latitude and low support at work. However, associations with the six metrics of WBV were weak and not statistically significant, and no exposure-response relationships were found. Conclusions We found little evidence of a risk from professional driving or WBV. Drivers were substantially less heavily exposed to WBV than in some earlier surveys. Nonetheless, it seems that at the population level, WBV is not an important cause of LBP referred for MRI. PMID:18853063

  12. Effects of combining whole-body vibration with exercise on the consequences of detraining on muscle performance in untrained adults.

    PubMed

    Osawa, Yusuke; Oguma, Yuko

    2013-04-01

    This study investigated whether whole-body vibration (WBV) coupled with low-velocity exercise (EX) for 13 weeks retains muscle performance gains after 5 weeks of subsequent detraining compared with the results of an identical EX program without WBV. Thirty-two untrained healthy adults (22-49 years of age) were randomly assigned to groups that performed EX with or without WBV (EX-WBV and EX, respectively; n = 16 per group). The following outcome variables were evaluated: countermovement jump height; maximal isometric, concentric, and eccentric knee extension strengths; local muscular endurance; and lumbar extension torque before, during, and after the 13-week training period, and after 5 weeks of detraining. Compared with the EX group, significantly higher increases in countermovement jump height and isometric and concentric knee extension strengths were detected in the EX-WBV group after the 13-week training period. However, detraining caused significant declines in these 3 muscle performance tests only in the EX-WBV group (-4.8, -10.2, and -17.2%, respectively), resulting in no significant differences between the test and control groups after the detraining period. After detraining, all examined variables showed significantly better performance compared with pretraining (p < 0.05) and did not significantly differ from midtraining (7 weeks) in both groups (p > 0.05). These results suggest that muscle strength in the lower extremities, particularly isometric and concentric contractions, and muscle power might be more susceptible to short-term detraining effects when exercise is combined with WBV. Thus, it is necessary to perform regular exercise to maximize the benefits of WBV on muscle strength and power during the early stages of training in previously untrained individuals. PMID:22739330

  13. Stereotactic Body Radiation Therapy for Patients With Lung Cancer Previously Treated With Thoracic Radiation

    SciTech Connect

    Kelly, Patrick; Balter, Peter A.; Rebueno, Neal; Sharp, Hadley J.; Liao Zhongxing; Komaki, Ritsuko; Chang, Joe Y.

    2010-12-01

    Purpose: Stereotactic body radiation therapy (SBRT) provides excellent local control with acceptable toxicity for patients with early-stage non-small cell lung cancer. However, the efficacy and safety of SBRT for patients previously given thoracic radiation therapy is not known. In this study, we retrospectively reviewed outcomes after SBRT for recurrent disease among patients previously given radiation therapy to the chest. Materials and Methods: A search of medical records for patients treated with SBRT to the thorax after prior fractionated radiation therapy to the chest at The University of Texas M. D. Anderson Cancer Center revealed 36 such cases. The median follow-up time after SBRT was 15 months. The endpoints analyzed were overall survival, local control, and the incidence and severity of treatment-related toxicity. Results: SBRT provided in-field local control for 92% of patients; at 2 years, the actuarial overall survival rate was 59%, and the actuarial progression-free survival rate was 26%, with the primary site of failure being intrathoracic relapse. Fifty percent of patients experienced worsening of dyspnea after SBRT, with 19% requiring oxygen supplementation; 30% of patients experienced chest wall pain and 8% Grade 3 esophagitis. No Grade 4 or 5 toxic effects were noted. Conclusions: SBRT can provide excellent in-field tumor control in patients who have received prior radiation therapy. Toxicity was significant but manageable. The high rate of intrathoracic failure indicates the need for further study to identify patients who would derive the most benefit from SBRT for this purpose.

  14. Therapy monitoring of skeletal metastases with whole-body diffusion MRI.

    PubMed

    Padhani, Anwar R; Makris, Andreas; Gall, Peter; Collins, David J; Tunariu, Nina; de Bono, Johann S

    2014-05-01

    Current methods of assessing tumor response at skeletal sites with metastatic disease use a combination of imaging tests, serum and urine biochemical markers, and symptoms assessment. These methods do not always enable the positive assessment of therapeutic benefit to be made but instead provide an evaluation of progression, which then guides therapy decisions in the clinic. Functional imaging techniques such as whole-body diffusion magnetic resonance imaging (MRI) when combined with anatomic imaging and other emerging "wet" biomarkers can improve the classification of therapy response in patients with metastatic bone disease. A range of imaging findings can be seen in the clinic depending on the type of therapy and duration of treatment. Successful response to systemic therapy is usually depicted by reductions in signal intensity accompanied by apparent diffusion coefficient (ADC) increases. Rarer patterns of successful treatment include no changes in signal intensity accompanying increases in ADC values (T2 shine-through pattern) or reductions in signal intensity without ADC value changes. Progressive disease results in increases in extent/intensity of disease on high b-value images with variable ADC changes. Diffusion MRI therapy response criteria need to be developed and tested in prospective studies in order to address current, unmet clinical and pharmaceutical needs for reliable measures of tumor response in metastatic bone disease. PMID:24510426

  15. DOSE-RESPONSE Relationships Between Whole-Body Vibration and Lumbar Disk DISEASEA Field Study on 388 Drivers of Different Vehicles

    NASA Astrophysics Data System (ADS)

    Schwarze, S.; Notbohm, G.; Dupuis, H.; Hartung, E.

    1998-08-01

    In a longitudinal study, the dose-response relationships between long term occupational exposure to whole-body vibration and degenerative processes in the lumbar spine caused by the lumbar disks were examined. From 1990 to 1992, 388 vibration-exposed workers from different driving jobs were examined medically and by lumbar X-ray. For each individual, a history of all exposure conditions was recorded, and a cumulative vibration dose was calculated allowing comparisons between groups of low, middle, and high intensity of exposure. 310 subjects were selected for a follow-up four years later, of whom 906% (n=281) agreed to participate. In comparing the exposure groups, the results indicate that the limit value ofazw(8h)=08 m/s2should be reviewed. The best fit between the lifelong vibration dose and the occurrence of a lumbar syndrome was obtained by applying a daily reference ofazw(8h)=06 ms2as a limit value. The results became more distinct still when only those subjects were included in the statistical analysis who had had no lumbar symptoms up to the end of the first year of exposure. The prevalence of lumbar syndrome is 155 times higher in the highly exposed group when compared to the reference group with low exposure (CI95%=124/195). Calculating the cumulative incidence of new cases of lumbar syndrome in the follow-up period yields a relative risk ofRRMH=137 (CI95%=086/217) for the highly exposed group. It is concluded that the limit value for the calculation of an individual lifelong vibration dose should be based on a daily reference exposure ofazw(8h)=06 m/s2. With increasing dose it is more and more probable that cases of lumbar syndrome are caused by exposure to vibration.

  16. Acceptance-Based Exposure Therapy for Body Dysmorphic Disorder: A Pilot Study.

    PubMed

    Linde, Johanna; Rck, Christian; Bjureberg, Johan; Ivanov, Volen Z; Djurfeldt, Diana Radu; Ramner, Jonas

    2015-07-01

    Body dysmorphic disorder (BDD) is an often severe, chronic, and disabling disorder, and although some controlled trials of cognitive behavior therapy (CBT) have shown efficacy, the body of evidence is still limited. The condition is generally considered difficult to treat, and further research to determine the effectiveness of psychological treatments for BDD is needed. The present study is the first to evaluate an acceptance-based therapy for BDD. In total, 21 patients received a 12-week group treatment consisting of weekly sessions of psychoeducation, acceptance and defusion practice, and exposure exercises to foster acceptance of internal discomfort and to strengthen the patients' committed purposeful actions. The primary outcome was BDD symptomatology (measured on the BDD-YBOCS) assessed by a psychiatrist before and after treatment and at 6months follow-up. The secondary outcomes were self-rated BDD symptoms, psychological flexibility, depressive symptoms, quality of life, and disability. Reductions in BDD symptomatology from pre- to posttreatment were significant and showed a large effect size, d=1.93 (95% CI 0.82-3.04). At posttreatment, 68% of the participants showed clinically significant improvement in the primary outcome variable. Treatment gains were maintained at 6months follow-up. The treatment also resulted in significant improvements in all secondary outcomes. The dropout rate was low; 90.5% of the participants completed treatment. This study suggests that acceptance-based exposure therapy may be an efficacious and acceptable treatment for BDD that warrants further investigation in larger controlled trials. PMID:26163707

  17. Emergence of Stereotactic Body Radiation Therapy and Its Impact on Current and Future Clinical Practice

    PubMed Central

    Timmerman, Robert D.; Herman, Joseph; Cho, L. Chinsoo

    2014-01-01

    Stereotactic body radiation therapy (SBRT) is generally a tumor-ablative radiation modality using essential technologies capable of accurately and precisely damaging the target with a high dose while geometrically sparing innocent normal tissues. The intent, conduct, and tissue biology are all dramatically distinct from conventionally fractionated radiotherapy such that new understanding is required for its optimization. It is most practical, tolerable, and tumoricidal in its most potent form treating tumors in the lung and liver. However, it is increasingly being used for tumors adjacent to bowels and nervous tissue, albeit with somewhat less ablative potency. Its strengths include high rates of tumor eradication via a noninvasive, convenient outpatient treatment. Its weakness relates to the possibility of causing difficult-to-manage toxicity (eg, ulceration, stenosis, fibrosis, and even necrosis) that may occur considerably later after treatment, particularly in the vicinity of the body's many tubular structures (eg, organ hila, bowel). However, clinical trials in a variety of organs and sites have shown SBRT to result in good outcomes in properly selected patients. Given its short course, lack of need for recovery, and favorable overall toxicity profile, there is great hope that SBRT will find a prominent place in the treatment of metastatic cancer as a consolidative partner with systemic therapy. With considerable published experience, available required technologies and training, and many patients in need of local therapy, SBRT has found a place in the routine cancer-fighting arsenal. PMID:25113761

  18. The Effects of Mind-Body Therapies on the Immune System: Meta-Analysis

    PubMed Central

    Morgan, Nani; Irwin, Michael R.; Chung, Mei; Wang, Chenchen

    2014-01-01

    Importance Psychological and health-restorative benefits of mind-body therapies have been investigated, but their impact on the immune system remain less defined. Objective To conduct the first comprehensive review of available controlled trial evidence to evaluate the effects of mind-body therapies on the immune system, focusing on markers of inflammation and anti-viral related immune responses. Methods Data sources included MEDLINE, CINAHL, SPORTDiscus, and PsycINFO through September 1, 2013. Randomized controlled trials published in English evaluating at least four weeks of Tai Chi, Qi Gong, meditation, or Yoga that reported immune outcome measures were selected. Studies were synthesized separately by inflammatory (n?=?18), anti-viral related immunity (n?=?7), and enumerative (n?=?14) outcomes measures. We performed random-effects meta-analyses using standardized mean difference when appropriate. Results Thirty-four studies published in 39 articles (total 2, 219 participants) met inclusion criteria. For inflammatory measures, after 7 to 16 weeks of mind-body intervention, there was a moderate effect on reduction of C-reactive protein (effect size [ES], 0.58; 95% confidence interval [CI], 0.04 to 1.12), a small but not statistically significant reduction of interleukin-6 (ES, 0.35; 95% CI, ?0.04 to 0.75), and negligible effect on tumor necrosis factor-? (ES, 0.21; 95% CI, ?0.15 to 0.58). For anti-viral related immune and enumerative measures, there were negligible effects on CD4 counts (ES, 0.15; 95% CI, ?0.04 to 0.34) and natural killer cell counts (ES, 0.12, 95% CI ?0.21 to 0.45). Some evidence indicated mind-body therapies increase immune responses to vaccination. Conclusions Mind-body therapies reduce markers of inflammation and influence virus-specific immune responses to vaccination despite minimal evidence suggesting effects on resting anti-viral or enumerative measures. These immunomodulatory effects, albeit incomplete, warrant further methodologically rigorous studies to determine the clinical implications of these findings for inflammatory and infectious disease outcomes. PMID:24988414

  19. Changes in circulating angiogenic factors after an acute training bout before and after resistance training with or without whole-body-vibration training

    NASA Astrophysics Data System (ADS)

    Beijer, Åsa; Degens, Hans; May, Francisca; Bloch, Wilhelm; Rittweger, Joern; Rosenberger, Andre

    2012-07-01

    Both Resistance Exercise and Whole-Body-Vibration training are currently considered as countermeasures against microgravity-induced physiological deconditioning. Here we investigated the effects of whole-body vibration superimposed upon resistance exercise. Within this context, the present study focuses on changes in circulating angiogenic factors as indicators of skeletal muscle adaption. Methods: Twenty-six healthy male subjects (25.2 ± 4.2 yr) were included in this two-group parallel-designed study and randomly assigned to one of the training interventions: either resistance exercise (RE) or resistance vibration exercise (RVE). Participants trained 2-3 times per week for 6 weeks (completing 16 training sessions), where one session took 9 ± 1 min. Participants trained with weights on a guided barbell. The individual training load was set at 80% of their 1-Repetition-Maximum. Each training session consisted of three sets with 8 squats and 12 heel raises, following an incremental training design with regards to weight (RE and RVE) and vibration frequency (RVE only). The vibration frequency was increased from 20 Hz in the first week till 40 Hz during the last two weeks with 5-Hz weekly increments. At the first and 16 ^{th} training session, six blood samples (pre training and 2 min, 5 min, 15 min, 35 min and 75 min post training) were taken. Circulating levels of vascular endothelial growth factor (VEGF), Endostatin and Matrix Metalloproteinases -2 and -9 (MMPs) were determined in serum using Enzyme-linked Immunosorbent Assays. Results: MMP-2 levels increased by 7.0% (SE = 2.7%, P < 0.001) within two minutes after the exercise bout and then decreased to 5.7% below baseline (SE = 2.4%, P < 0.001) between 15 and 75 minutes post exercise. This response was comparable before and after the training programs (P = 0.70) and also between the two intervention groups (P = 0.42). Preliminary analyses indicate that a similar pattern applies to circulating MMP-9, VEGF and Endostatin levels. Conclusion: The present findings suggest 1) that resistance exercise, both with and without superimposed vibration, leads to a transient rise in circulating angiogenic factors, 2) which is not altered after a period of resistance exercise with or without vibration.

  20. Analysis of weekly complete blood counts in patients receiving standard fractionated partial body radiation therapy

    SciTech Connect

    Yang, F.E.; Ignacio, L.; Houghton, A.

    1995-10-15

    Hematopoiesis is among the most sensitive systems in the body to radiation. Routine complete blood counts (CBCs) are common in clinical radiotherapy practice. Only a few studies have attempted to characterize the behavior of peripheral blood levels during partial body radiation therapy with field sizes smaller than those used in hemibody or total nodal irradiation. Such information is needed to identify which patients are at risk for cytopenia and require close monitoring. Low CBC levels during radiation therapy are likely to be the result of other medical problems that cancer patients face. Regional irradiation with small field sizes (<40% of total body marrow) typically used in clinical radiotherapy is unlikely to be the cause of marrow depression significant enough to warrant medical intervention. Blood levels taken during the first week of treatment (Week 1) can be used to determine risks of developing critical nadirs. Localized breast and prostate cancer patients are unlikely to require routine CBCs if initial levels are normal. Routine CBC levels on all radiation oncology patients without other reasons for hematopoietic depression requires reevaluation, as millions of dollars are spent on unnecessary testing. If weekly CBC blood levels are avoided in localized breast and prostate cancer patients, this alone could potentially results in a savings of as much as $40 million a year nationally. 35 refs., 4 figs., 3 tabs.

  1. Stereotactic Ablative Body Radiation Therapy for Octogenarians With Non-Small Cell Lung Cancer

    SciTech Connect

    Takeda, Atsuya; Sanuki, Naoko; Eriguchi, Takahisa; Kaneko, Takeshi; Department of Respirology, Ofuna Chuo Hospital, Kanagawa ; Morita, Satoshi; Handa, Hiroshi; Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa ; Aoki, Yousuke; Oku, Yohei; Kunieda, Etsuo

    2013-06-01

    Purpose: To retrospectively investigate treatment outcomes of stereotactic ablative body radiation therapy (SABR) for octogenarians with non-small cell lung cancer (NSCLC). Methods and Materials: Between 2005 and 2012, 109 patients aged ≥80 years with T1-2N0M0 NSCLC were treated with SABR: 47 patients had histology-unproven lung cancer; 62 patients had pathologically proven NSCLC. The prescribed doses were either 50 Gy/5 fractions for peripheral tumors or 40 Gy/5 fractions for centrally located tumors. The treatment outcomes, toxicities, and the correlating factors for overall survival (OS) were evaluated. Results: The median follow-up duration after SABR was 24.2 (range, 3.0-64.6) months. Only limited toxicities were observed, except for 1 grade 5 radiation pneumonitis. The 3-year local, regional, and distant metastasis-free survival rates were 82.3%, 90.1%, and 76.8%, respectively. The OS and lung cancer-specific survival rates were 53.7% and 70.8%, respectively. Multivariate analysis revealed that medically inoperable, low body mass index, high T stage, and high C-reactive protein were the predictors for short OS. The OS for the operable octogenarians was significantly better than that for inoperable (P<.01). Conclusions: Stereotactic ablative body radiation therapy for octogenarians was feasible, with excellent OS. Multivariate analysis revealed that operability was one of the predictors for OS. For medically operable octogenarians with early-stage NSCLC, SABR should be prospectively compared with resection.

  2. Body fluid changes during hypertonic lactated saline solution therapy for burn shock.

    PubMed

    Shimazaki, S; Yoshioka, T; Tanaka, N; Sugimoto, T; Onji, Y

    1977-01-01

    The body fluid changes of 12 burn patients treated with Hypertonic Lactate Saline solution (HLS group) were compared with 26 burn patients receiving isotonic therapy (iso Na group). 1) Total infusion volume during the first 48 hours postburn in the HLS group was only one-half to two-thirds of that in the iso Na group, although the sodium loads were nearly equal. 2) HLS therapy maintained sufficient functional extracellular fluid volume (f-ECFV) in the shock period and protected the excess increase of f-ECFV in the postresuscitative period, in contradistinction to the iso Na group. In this paper, some clinical problems such as a rapid shift of ECF water into the ICF space and hypernatremia following HLS administration are discussed. PMID:833904

  3. Long duration measurements of whole-body vibration exposures associated with surface coal mining equipment compared to previous short-duration measurements.

    PubMed

    Burgess-Limerick, Robin; Lynas, Danellie

    2016-05-01

    Previous measurements of whole-body vibration associated with earth-moving equipment at surface coal mines have highlighted the significance of the hazard. Considerable variability in measurement amplitudes, even within the same equipment type operated at the same site, has been noted. However, the measurements have previously been undertaken for relatively short durations. Fifty-nine measurements were collected from a range of earth-moving equipment in operation at a surface coal mine. Measurement durations ranged from 100-460 min (median = 340 min). The results indicate that the measurements previously observed are not an artifact of the relatively short durations and confirm that operators of dozers and off-road haul trucks, in particular, are frequently exposed to vertical whole-body vibration levels which lie within, or above, the Health Guidance Caution Zone defined by ISO2631.1. Further investigations are justified to identify opportunities for reducing operators' exposure to high amplitude vibrations. PMID:26771238

  4. Vibration disease.

    PubMed

    Kkosy, T

    1989-04-01

    Today, in this age of technology, vibration caused by machinery is an almost universal hazard. Vibration transferred from a machine to the human body may cause discomfort, a reduction of performance, and even injury. Vibratory manual tools may cause damage to the circulatory system of the upper extremities (Raynaud's syndrome), to the peripheral nerves (peripheral neuropathy), and to the bones and joints (aseptic necrosis, fatigue fractures, degenerative joint disease). Vehicles and machines causing floor vibration cause degenerative disc disease of the lumbar spine. The pathogenesis of vibration injuries is still not completely clear and there is no effective treatment. Some of the abnormalities are irreversible and may cause permanent decrease of working ability, and even unemployment. This is why prevention is so important. Prevention is complex, including technical and organizational measures, use of individual protective clothing and footwear, and medical supervision both before and during employment. Workers who are exposed to vibration should be protected against other aggravating factors such as cold and noise, etc. Vibration-induced injuries are recognized in law in many countries as grounds for financial compensation. Their cost to industry is rising and, unless a means of prevention or cure is found, will continue to do so in the foreseeable future. PMID:2661029

  5. 4π Noncoplanar Stereotactic Body Radiation Therapy for Centrally Located or Larger Lung Tumors

    SciTech Connect

    Dong, Peng; Lee, Percy; Ruan, Dan; Long, Troy; Romeijn, Edwin; Low, Daniel A.; Kupelian, Patrick; Abraham, John; Yang, Yingli; Sheng, Ke

    2013-07-01

    Purpose: To investigate the dosimetric improvements in stereotactic body radiation therapy for patients with larger or central lung tumors using a highly noncoplanar 4π planning system. Methods and Materials: This study involved 12 patients with centrally located or larger lung tumors previously treated with 7- to 9-field static beam intensity modulated radiation therapy to 50 Gy. They were replanned using volumetric modulated arc therapy and 4π plans, in which a column generation method was used to optimize the beam orientation and the fluence map. Maximum doses to the heart, esophagus, trachea/bronchus, and spinal cord, as well as the 50% isodose volume, the lung volumes receiving 20, 10, and 5 Gy were minimized and compared against the clinical plans. A dose escalation study was performed to determine whether a higher prescription dose to the tumor would be achievable using 4π without violating dose limits set by the clinical plans. The deliverability of 4π plans was preliminarily tested. Results: Using 4π plans, the maximum heart, esophagus, trachea, bronchus and spinal cord doses were reduced by 32%, 72%, 37%, 44%, and 53% (P≤.001), respectively, and R{sub 50} was reduced by more than 50%. Lung V{sub 20}, V{sub 10}, and V{sub 5} were reduced by 64%, 53%, and 32% (P≤.001), respectively. The improved sparing of organs at risk was achieved while also improving planning target volume (PTV) coverage. The minimal PTV doses were increased by the 4π plans by 12% (P=.002). Consequently, escalated PTV doses of 68 to 70 Gy were achieved in all patients. Conclusions: We have shown that there is a large potential for plan quality improvement and dose escalation for patients with larger or centrally located lung tumors using noncoplanar beams with sufficient quality and quantity. Compared against the clinical volumetric modulated arc therapy and static intensity modulated radiation therapy plans, the 4π plans yielded significantly and consistently improved tumor coverage and critical organ sparing. Given the known challenges in central structure dose constraints in stereotactic body radiation therapy to the lung, 4π planning may increase efficacy and reduce toxicity.

  6. Whole-body vibration improves functional capacity and quality of life in patients with severe chronic obstructive pulmonary disease (COPD): a pilot study

    PubMed Central

    Braz Jnior, Donato S; Dornelas de Andrade, Armle; Teixeira, Andrei S; Cavalcanti, Clssyo A; Morais, Andr B; Marinho, Patrcia EM

    2015-01-01

    Background Exercise intolerance is a common development in patients with chronic obstructive pulmonary disease (COPD). There is little data on the use of an isolated program using vibration platform training on functional capacity in these patients, which is an area that deserves investigation. Aim To investigate the effect of training on a vibrating platform (whole-body vibration [WBV]) on functional performance and quality of life of subjects with COPD. Methods A randomized controlled crossover pilot study with eleven subjects with COPD (forced expiratory volume in 1 second [FEV1]% predicted =14.6311.14; forced vital capacity [FVC]% predicted =48.8415.21; FEV1/FVC =47.3911.63) underwent a 12-week WBV training program. Participants were randomized into the intervention group (IG) undergoing three sessions per week for a total of 12 weeks and control group (CG) without intervention. We evaluated the 6-minute walk test (6MWT), distance walked (DW), duration of the walk (TW), and index of perceived exertion (IPE), quality of life using St Georges Respiratory Questionnaire (SGRQ) and developed a 12-week program of training on a vibrating platform. Results The mean age was 62.918.82 years old (72.7% male). The DW increased at the end of training with a difference between groups of 75 m; all domains of the SGRQ improved at the end of training. The effect size Cohens d ranged from small to large for all the measured results. Conclusion These preliminary results suggest that WBV may potentially be a safe and feasible way to improve functional capacity in the 6MWT of patients with COPD undergoing a training program on the vibrating platform as well as in all domains of the SGRQ quality of life. However, further studies with a larger number of patients are needed to establish the long-term effect on functional capacity and quality of life in these patients. PMID:25624756

  7. Vibrational spectroscopy characterization of low level laser therapy on mammary culture cells: a micro-FTIR study

    NASA Astrophysics Data System (ADS)

    Magrini, Taciana D.; Villa dos Santos, Nathalia; Pecora Milazzotto, Marcella; Cerchiaro, Giselle; da Silva Martinho, Herculano

    2011-03-01

    Low level laser therapy (LLLT) is an emerging therapeutic approach for several clinical conditions. The clinical effects induced by LLLT presumably go from the photobiostimulation/photobioinibition at cellular level to the molecular level. The detailed mechanism underlying this effect is still obscure. This work is dedicated to quantify some relevant aspects of LLLT related to molecular and cellular variations. This goal was attached by exposing malignant breast cells (MCF7) to spatially filtered light of a He-Ne laser (633 nm) with 28.8 mJ/cm2 of fluency. The cell viability was evaluated by microscopic observation using Trypan Blue viability test. The vibrational spectra of each experimental group (micro- FTIR technique) were used to identify the relevant biochemical alterations occurred due the process. The red light had influence over RNA, phosphate and serine/threonine/tyrosine bands. Light effects on cell number or viability were not detected. However, the irradiation had direct influence on metabolic activity of cells.

  8. Seven Day Insertion Rest in Whole Body Vibration Improves Multi-Level Bone Quality in Tail Suspension Rats

    PubMed Central

    Zhang, Rui; Gong, He; Zhu, Dong; Gao, Jiazi; Fang, Juan; Fan, Yubo

    2014-01-01

    Objective This study aimed to investigate the effects of low-magnitude, high-frequency vibration with rest days on bone quality at multiple levels. Methods Forty-nine three-month-old male Wistar rats were randomly divided into seven groups, namely, vibrational loading for X day followed by X day rest (VLXR, X?=?1, 3, 5, 7), vibrational loading every day (VLNR), tail suspension (SPD), and baseline control (BCL). One week after tail suspension, rats were loaded by vibrational loading (35 Hz, 0.25 g, 15 min/day) except SPD and BCL. Fluorescence markers were used in all rats. Eight weeks later, femora were harvested to investigate macromechanical properties, and micro-computed tomography scanning and fluorescence test were used to evaluate microarchitecture and bone growth rate. Atomic force microscopy analyses and nanoindentation test were used to analyze the nanostructure and mechanical properties of bone material, respectively. Inductively coupled plasma optical emission spectroscopy was used for quantitative chemical analyses. Results Microarchitecture, mineral apposition rate and bone formation rate and macromechanical properties were improved in VL7R. Grain size and roughness were significantly different among all groups. No statistical difference was found for the mechanical properties of the bone material, and the chemical composition of all groups was almost similar. Conclusions Low-magnitude, high-frequency vibration with rest days altered bone microarchitecture and macro-biomechanical properties, and VL7R was more efficacious in improving bone loss caused by mechanical disuse, which provided theoretical basis and explored the mechanisms of vibration for improving bone quality in clinics. PMID:24637608

  9. Effect of Fractionation in Stereotactic Body Radiation Therapy Using the Linear Quadratic Model

    SciTech Connect

    Yang, Jun; Philadelphia Cyberknife, Havertown, Pennsylvania ; Lamond, John; Philadelphia Cyberknife, Havertown, Pennsylvania ; Fowler, Jack; Lanciano, Rachelle; Philadelphia Cyberknife, Havertown, Pennsylvania ; Feng, Jing; Brady, Luther; Philadelphia Cyberknife, Havertown, Pennsylvania

    2013-05-01

    Purpose: To examine the fractionation effect of stereotactic body radiation therapy with a heterogeneous dose distribution. Methods: Derived from the linear quadratic formula with measurements from a hypothetical 2-cm radiosurgical tumor, the threshold percentage was defined as (α/β{sub tissue}/α/β{sub tumor}), the balance α/β ratio was defined as (prescription dose/tissue tolerance*α/β{sub tumor}), and the balance dose was defined as (tissue tolerance/threshold percentage). Results: With increasing fractions and equivalent peripheral dose to the target, the biological equivalent dose of “hot spots” in a target decreases. The relative biological equivalent doses of serial organs decrease only when the relative percentage of its dose to the prescription dose is above the threshold percentage. The volume of parallel organs at risk decreases only when the tumor's α/β ratio is above the balance α/β ratio and the prescription dose is lower than balance dose. Conclusions: The potential benefits of fractionation in stereotactic body radiation therapy depend on the complex interplay between the total dose, α/β ratios, and dose differences between the target and the surrounding normal tissues.

  10. Assessing combined exposures of whole-body vibration and awkward posture--further results from application of a simultaneous field measurement methodology.

    PubMed

    Raffler, Nastaran; Hermanns, Ingo; Sayn, Detlef; Gres, Benno; Ellegast, Rolf; Rissler, Jrg

    2010-01-01

    The drivers of ten vehicles (tram, helicopter, saloon car, van, forklift, two mobile excavators, wheel loader, tractor, elevating platform truck) were studied with regard to the combined exposures of whole-body vibration and awkward posture during occupational tasks. Seven degrees of freedom (DOFs), or body angles, were recorded as a function of time by means of the CUELA measuring system (Computer-assisted registration and long-term analysis of musculoskeletal workloads) for the purpose of posture assessment. The vibrational exposure is expressed as the vector sum of the frequency-weighted accelerations in the three Cartesian coordinates; these were recorded simultaneously with the posture measurement. Based upon the percentage of working time spent under different workloads, a scheme is proposed for classification of the two exposures into three categories. In addition, a risk of adverse health effects classified as low, possible or high can be assigned to the combination of the two exposures. With regard to posture, the most severe exposure was measured for the drivers of the wheel loader and for the tractor driver, whereas the lowest exposure was measured for the helicopter pilots and van drivers. With regard to the combination of whole-body and posture exposures, the tractor driver and the elevating platform truck driver exhibited the highest workloads. PMID:20953080

  11. Stereotactic body radiation therapy salvage reirradiation of radiorecurrent prostatic carcinoma relapsed in the prostatic bed.

    PubMed

    Arcangeli, Stefano; Gambardella, Pasquale; Agolli, Linda; Monaco, Alessia; Dognini, Jessica; Regine, Giovanni; Donato, Vittorio

    2015-01-01

    A 67-year-old man presented with a slow increase of prostate-specific antigen value after radical prostatectomy and postoperative radiotherapy for prostate cancer. The patient had received 3D conformal radiotherapy to a total dose of 66 Gy in 33 fractions of 2 Gy each on the prostatic bed. Three years later, a macroscopic local failure was diagnosed at the apical region. The patient could not receive androgenic deprivation therapy or other types of treatment owing to comorbid conditions. Thus, stereotactic body radiation therapy with helical image-guided tomotherapy was administered. The total dose was 30 Gy in 5 consecutive fractions of 6 Gy each to the site of the local failure. The treatment was preceded by a transperineal-guided injection of a self-absorbable hydrogel into the prostatic bed, between rectum and bladder, in order to preserve the rectal wall, which already had received significant doses from the first radiation course. Radiation therapy was well-tolerated. After a follow-up period of 6 months, the patient remains healthy, and there has been no further evidence of metastatic spread or recurrence. PMID:25721678

  12. Thrombotic Microangiopathy In Metastatic Melanoma Patients Treated with Adoptive Cell Therapy and Total Body Irradiation

    PubMed Central

    Tseng, Jennifer; Citrin, Deborah E.; Waldman, Meryl; White, Donald E.; Rosenberg, Steven A.; Yang, James C.

    2014-01-01

    Background Thrombotic microangioapathy (TMA) is a complication that developed in some patients receiving 12 Gy total body irradiation in addition to lymphodepleting preparative chemotherapy prior to infusion of autologous tumor infiltrating lymphocytes (TIL) with high-dose aldesleukin (IL-2). This paper describes the incidence, presentation and course of radiation-associated TMA. Methods The data for patients with metastatic melanoma who received ACT with TIL plus aldesleukin following myeloablative chemotherapy and 12 Gy total body irradiation was examined, looking at patient characteristics and the natural history of TMA. Results The median time to presentation was approximately 8 months after completing TBI. The estimated cumulative incidence of TMA was 31.2% (median follow-up of 24 months). Noninvasive criteria for diagnosis included newly elevated creatinine levels, new-onset hypertension, new-onset anemia, microscopic hematuria, thrombocytopenia, low haptoglobin and elevated lactate dehydrogenase values. Once diagnosed, patients were managed with control of their hypertension with multiple agents and supportive red blood cell transfusions. TMA typically stabilized or improved and no patient progressed to dialysis. TMA was associated with a higher probability of an anti-tumor response. Conclusions Thrombotic microangiopathy occurs in approximately a third of patients treated with a lymphodepleting preparative chemotherapy regimen with total body irradiation prior to autologous T-cell therapy. The disease has a variable natural history, however no patient developed end-stage renal failure. Successful management with supportive care and aggressive hypertension control is vital to the safe application of a systemic therapy that has shown curative potential for patients with disseminated melanoma. PMID:24474396

  13. Assessment of whole-body vibration exposures and influencing factors for quarry haul truck drivers and loader operators

    PubMed Central

    Mayton, Alan G.; Jobes, Christopher C.; Gallagher, Sean

    2015-01-01

    To further assess vibration exposure on haul trucks (HTs) and front-end wheel loaders (FELs), follow-up investigations were conducted at two US crushed stone operations. The purpose was to: 1) evaluate factors such as load/no-load conditions, speed, load capacity, vehicle age, and seat transmissibility relative to vibration exposure; 2) compare exposure levels with existing ISO/ANSI and EUGPG guidelines. Increasing HT speed increased recorded vibration at the chassis and seat as expected. Neither vehicle load nor vehicle speed increased transmissibility. Increasing HT size and age did show transmissibility decreasing. HT dominant-axis wRMS levels (most often the y-axis, lateral or side-to-side direction) were predominantly within the health guidance caution zone (HGCZ). However, several instances showed vibration dose value (VDV) above the exposure limit value (ELV) for the ISO/ANSI guidelines. VDV levels (all dominant x-axis or fore-aft) were within and above the HGCZ for the EUGPG and above the HGCZ for ISO/ANSI guidelines. PMID:26361493

  14. Effects of whole-body vibration training on physical function, bone and muscle mass in adolescents and young adults with cerebral palsy.

    PubMed

    Gusso, Silmara; Munns, Craig F; Colle, Patrícia; Derraik, José G B; Biggs, Janene B; Cutfield, Wayne S; Hofman, Paul L

    2016-01-01

    We performed a clinical trial on the effects of whole-body vibration training (WBVT) on muscle function and bone health of adolescents and young adults with cerebral palsy. Forty participants (11.3-20.8 years) with mild to moderate cerebral palsy (GMFCS II-III) underwent 20-week WBVT on a vibration plate for 9 minutes/day 4 times/week at 20 Hz (without controls). Assessments included 6-minute walk test, whole-body DXA, lower leg pQCT scans, and muscle function (force plate). Twenty weeks of WBVT were associated with increased lean mass in the total body (+770 g; p = 0.0003), trunk (+410 g; p = 0.004), and lower limbs (+240 g; p = 0.012). Bone mineral content increased in total body (+48 g; p = 0.0001), lumbar spine (+2.7 g; p = 0.0003), and lower limbs (+13 g; p < 0.0001). Similarly, bone mineral density increased in total body (+0.008 g/cm(2); p = 0.013), lumbar spine (+0.014 g/cm(2); p = 0.003), and lower limbs (+0.023 g/cm(2); p < 0.0001). Participants reduced the time taken to perform the chair test, and improved the distance walked in the 6-minute walk test by 11% and 35% for those with GMFCS II and III, respectively. WBVT was associated with increases in muscle mass and bone mass and density, and improved mobility of adolescents and young adults with cerebral palsy. PMID:26936535

  15. Effects of whole-body vibration training on physical function, bone and muscle mass in adolescents and young adults with cerebral palsy

    PubMed Central

    Gusso, Silmara; Munns, Craig F; Colle, Patrícia; Derraik, José G B; Biggs, Janene B; Cutfield, Wayne S; Hofman, Paul L

    2016-01-01

    We performed a clinical trial on the effects of whole-body vibration training (WBVT) on muscle function and bone health of adolescents and young adults with cerebral palsy. Forty participants (11.3–20.8 years) with mild to moderate cerebral palsy (GMFCS II–III) underwent 20-week WBVT on a vibration plate for 9 minutes/day 4 times/week at 20 Hz (without controls). Assessments included 6-minute walk test, whole-body DXA, lower leg pQCT scans, and muscle function (force plate). Twenty weeks of WBVT were associated with increased lean mass in the total body (+770 g; p = 0.0003), trunk (+410 g; p = 0.004), and lower limbs (+240 g; p = 0.012). Bone mineral content increased in total body (+48 g; p = 0.0001), lumbar spine (+2.7 g; p = 0.0003), and lower limbs (+13 g; p < 0.0001). Similarly, bone mineral density increased in total body (+0.008 g/cm2; p = 0.013), lumbar spine (+0.014 g/cm2; p = 0.003), and lower limbs (+0.023 g/cm2; p < 0.0001). Participants reduced the time taken to perform the chair test, and improved the distance walked in the 6-minute walk test by 11% and 35% for those with GMFCS II and III, respectively. WBVT was associated with increases in muscle mass and bone mass and density, and improved mobility of adolescents and young adults with cerebral palsy. PMID:26936535

  16. Opening toward life: Experiences of basic body awareness therapy in persons with major depression

    PubMed Central

    Danielsson, Louise; Rosberg, Susanne

    2015-01-01

    Although there is a vast amount of research on different strategies to alleviate depression, knowledge of movement-based treatments focusing on body awareness is sparse. This study explores the experiences of basic body awareness therapy (BBAT) in 15 persons diagnosed with major depression who participated in the treatment in a randomized clinical trial. Hermeneutic phenomenological methodology inspired the approach to interviews and data analysis. The participants’ experiences were essentially grasped as a process of enhanced existential openness, opening toward life, exceeding the tangible corporeal dimension to also involve emotional, temporal, and relational aspects of life. Five constituents of this meaning were described: vitality springing forth, grounding oneself, recognizing patterns in one's body, being acknowledged and allowed to be oneself, and grasping the vagueness. The process of enhanced perceptual openness challenges the numbness experienced in depression, which can provide hope for change, but it is connected to hard work and can be emotionally difficult to bear. Inspired by a phenomenological framework, the results of this study illuminate novel clinical and theoretical insight into the meaning of BBAT as an adjunctive approach in the treatment of depression. PMID:25956354

  17. Therapist guided internet based cognitive behavioural therapy for body dysmorphic disorder: single blind randomised controlled trial

    PubMed Central

    Andersson, Erik; Mataix-Cols, David; Lichtenstein, Linn; Alström, Katarina; Andersson, Gerhard; Ljótsson, Brjánn; Rück, Christian

    2016-01-01

    Objectives To evaluate the efficacy of therapist guided internet based cognitive behavioural therapy (CBT) programme for body dysmorphic disorder (BDD-NET) compared with online supportive therapy. Design A 12 week single blind parallel group randomised controlled trial. Setting Academic medical centre. Participants 94 self referred adult outpatients with a diagnosis of body dysmorphic disorder and a modified Yale-Brown obsessive compulsive scale (BDD-YBOCS) score of ≥20. Concurrent psychotropic drug treatment was permitted if the dose had been stable for at least two months before enrolment and remained unchanged during the trial. Interventions Participants received either BDD-NET (n=47) or supportive therapy (n=47) delivered via the internet for 12 weeks. Main outcome measures The primary outcome was the BDD-YBOCS score after treatment and follow-up (three and six months from baseline) as evaluated by a masked assessor. Responder status was defined as a ≥30% reduction in symptoms on the scale. Secondary outcomes were measures of depression (MADRS-S), global functioning (GAF), clinical global improvement (CGI-I), and quality of life (EQ5D). The six month follow-up time and all outcomes other than BDD-YBOCS and MADRS-S at 3 months were not pre-specified in the registration at clinicaltrials.gov because of an administrative error but were included in the original trial protocol approved by the regional ethics committee before the start of the trial. Results BDD-NET was superior to supportive therapy and was associated with significant improvements in severity of symptoms of body dysmorphic disorder (BDD-YBOCS group difference −7.1 points, 95% confidence interval −9.8 to −4.4), depression (MADRS-S group difference −4.5 points, −7.5 to −1.4), and other secondary measures. At follow-up, 56% of those receiving BDD-NET were classed as responders, compared with 13% receiving supportive therapy. The number needed to treat was 2.34 (1.71 to 4.35). Self reported satisfaction was high. Conclusions CBT can be delivered safely via the internet to patients with body dysmorphic disorder. BDD-NET has the potential to increase access to evidence based psychiatric care for this mental disorder, in line with NICE priority recommendations. It could be particularly useful in a stepped care approach, in which general practitioner or other mental health professionals can offer treatment to people with mild to moderate symptoms at low risk of suicide. Trial registration ClinicalTrials.gov ID: NCT02010619. PMID:26837684

  18. Whole body vibration improves osseointegration by up-regulating osteoblastic activity but down-regulating osteoblast-mediated osteoclastogenesis via ERK1/2 pathway.

    PubMed

    Zhou, Yi; Guan, Xiaoxu; Liu, Tie; Wang, Xinhua; Yu, Mengfei; Yang, Guoli; Wang, Huiming

    2015-02-01

    Due to the reduction in bone mass and deterioration in bone microarchitecture, osteoporosis is an important risk factor for impairing implant osseointegration. Recently, low-magnitude, high-frequency (LMHF) vibration (LM: <1g; HF: 20-90Hz) has been shown to exhibit anabolic, but anti-resorptive effects on skeletal homeostasis. Therefore, we hypothesized that LMHF loading, in terms of whole body vibration (WBV), may improve implant fixation under osteoporotic status. In the in vivo study, WBV treatment (magnitude: 0.3g, frequency: 40Hz, time: 30min/12h, 5days/week) was applied after hydroxyapatite-coated titanium implants were inserted in the bilateral tibiae of ovariectomized rats. The bone mass and the osteospecific gene expressions were measured at 12weeks post implantation. In the in vitro study, the cellular and molecular mechanisms underlying osteoblastic and osteoclastic activities were fully investigated using various experimental assays. Micro-CT examination showed that WBV could enhance osseointegration by improving microstructure parameters surrounding implants. WBV-regulated gene levels in favor of bone formation over resorption may be the reason for the favorable adaptive bone remolding on bone-implant surface. The in vitro study showed that vibration (magnitude: 0.3g, frequency: 40Hz, time: 30min/12h) up-regulated osteoblast differentiation, matrix synthesis and mineralization. However, mechanically regulated osteoclastic activity was mainly through the effect on osteoblastic cells producing osteoclastogenesis-associated key soluble factors, including RANKL and M-CSF. Osteoblasts were therefore the direct target cells during the mechanotransduction process. The ERK1/2 pathway was demonstrated to play an essential role in vibration-induced enhancement of bone formation and decreased bone resorption. Our data suggests that WBV was a helpful non-pharmacological intervention for improving osseointegration under osteoporosis. PMID:25304090

  19. Non-invasive therapy to reduce the body burden of aluminium in Alzheimer's disease.

    PubMed

    Exley, Christopher; Korchazhkina, Olga; Job, Deborah; Strekopytov, Stanislav; Polwart, Anthony; Crome, Peter

    2006-09-01

    There are unexplained links between human exposure to aluminium and the incidence, progression and aetiology of Alzheimer's disease. The null hypothesis which underlies any link is that there would be no Alzheimer's disease in the effective absence of a body burden of aluminium. To test this the latter would have to be reduced to and retained at a level that was commensurate with an Alzheimer's disease-free population. In the absence of recent human interference in the biogeochemical cycle of aluminium the reaction of silicic acid with aluminium has acted as a geochemical control of the biological availability of aluminium. This same mechanism might now be applied to both the removal of aluminium from the body and the reduced entry of aluminium into the body while ensuring that essential metals, such as iron, are unaffected. Based upon the premise that urinary aluminium is the best non-invasive estimate of body burden of aluminium patients with Alzheimer's disease were asked to drink 1.5 L of a silicic acid-rich mineral water each day for five days and, by comparison of their urinary excretion of aluminium pre-and post this simple procedure, the influence upon their body burden of aluminium was determined. Drinking the mineral water increased significantly (P<0.001) their urinary excretion of silicic acid (34.3 +/- 15.2 to 55.7 +/- 14.2 micromol/mmol creatinine) and concomitantly reduced significantly P=0.037) their urinary excretion of aluminium (86.0 +/- 24.3 to 62.2 +/- 23.2 nmol/mmol creatinine). The latter was achieved without any significant (P>0.05) influence upon the urinary excretion of iron (20.7 +/- 9.5 to 21.7 +/- 13.8 nmol/mmol creatinine). The reduction in urinary aluminium supported the future longer-term use of silicic acid as non-invasive therapy for reducing the body burden of aluminium in Alzheimer's disease. PMID:16988476

  20. General strategy for the protection of organs at risk in IMRT therapy of a moving body

    SciTech Connect

    Abolfath, Ramin M.; Papiez, Lech

    2009-07-15

    We investigated protection strategies of organs at risk (OARs) in intensity modulated radiation therapy (IMRT). These strategies apply to delivery of IMRT to moving body anatomies that show relative displacement of OAR in close proximity to a tumor target. We formulated an efficient genetic algorithm which makes it possible to search for global minima in a complex landscape of multiple irradiation strategies delivering a given, predetermined intensity map to a target. The optimal strategy was investigated with respect to minimizing the dose delivered to the OAR. The optimization procedure developed relies on variability of all parameters available for control of radiation delivery in modern linear accelerators, including adaptation of leaf trajectories and simultaneous modification of beam dose rate during irradiation. We showed that the optimization algorithms lead to a significant reduction in the dose delivered to OAR in cases where organs at risk move relative to a treatment target.

  1. The relationship between body weight and inflammation: Lesson from anti-TNF-? antibody therapy.

    PubMed

    Peluso, Ilaria; Palmery, Maura

    2016-01-01

    Obesity is associated with many pathological conditions. Tumor Necrosis Factor-? (TNF-?) is one of the key mediators of inflammation involved in the obesity-related insulin resistance development. We aim to review the human evidence useful to clarify the relationship between inflammation and body weight, with particular reference to TNF-?. Genetic polymorphisms and epigenetic factors, such as diet, could affect TNF-? activity. TNF-? is associated with obesity, but also with anorexia and cachexia. Despite the role of TNF-? in obesity-related diseases, anti-TNF-? antibody therapy is associated with an increase in adiposity. In conclusion the reviewed results suggest that inflammation is more likely a consequence rather than a cause of obesity. PMID:26472017

  2. High-frequency and low-magnitude whole body vibration with rest days is more effective in improving skeletal micro-morphology and biomechanical properties in ovariectomised rodents.

    PubMed

    Ma, Renshi; Zhu, Dong; Gong, He; Gu, Guishan; Huang, Xu; Gao, Jia zi; Zhang, Xizheng

    2012-01-01

    We explored the optimal regime in preventing or treating bone loss, using ovariectomised rodents loaded by mechanical stimuli with rest days during the loading cycle. Eighty-four Sprague-Dawley rats, aged 6 months, were randomly divided into 7 groups after bilateral ovariectomy. Mechanical vibration with 1-day rest (ML1R), with 3-day rest (ML3R), with 5-day rest (ML5R), with 7-day rest (ML7R), daily loading (DL), comparing the ovariectomised group (OVX) with baseline (BCL) measurements. After a recovery of one week, all the rodents were loaded daily by whole body vibration at 35 Hz and 0.25 g for 15 minutes. Eight weeks later, a three-point bending test of the radius and micro-CT scanning of the femoral head were performed after animal sacrifice. Large improvements in biomechanical properties occurred in all the experimental groups for failure load, elastic modulus and deflection, while a significantly enhanced efficacy was detected in ML7R compared with daily loading (p<0.05). In micro-CT scanning, bone volume fraction, trabecular thickness, number and separation were improved by the regime in all experimental groups, while ML7R showed a significant improvement over daily loading (p<0.05). Early bone loss in human subjects may be improved by high-frequency and low-magnitude whole body vibration with rest days or daily stimuli. Mechanical stimulus with a 7-day rest was more effective in improving biomechanical properties and micro-morphology compared with daily loading. This may have clinical implications in relation to the prevention and treatment of hip fractures, and in postoperative management following hip arthroplasty. PMID:22344486

  3. Outcomes and toxicities of stereotactic body radiation therapy for non-spine bone oligometastases

    PubMed Central

    Owen, Dawn; Laack, Nadia N.; Mayo, Charles S.; Garces, Yolanda I.; Park, Sean S.; Bauer, Heather J.; Nelson, Kathryn; Miller, Robert W.; Brown, Paul D.; Olivier, Kenneth R.

    2015-01-01

    Purpose Stereotactic body radiation therapy (SBRT) is being applied more widely for oligometastatic disease. This technique is now being used for non-spine bony metastases in addition to liver, spine, and lung. However, there are few studies examining the toxicity and outcomes of SBRT for non-spine bone metastases. Methods and Materials Between 2008 and 2012, 74 subjects with oligometastatic non-spine bony metastases of varying histologies were treated at the Mayo Clinic with SBRT. A total of 85 non-spine bony sites were treated. Median local control, overall survival, and progression-free survival were described. Acute toxicity (defined as toxicity <90 days) and late toxicity (defined as toxicity ?90 days) were reported and graded as per standardized Common Toxicity Criteria for Adverse Events 4.0 criteria. Results The median age of patients treated was 60 years. The most common histology was prostate cancer (31%) and most patients had fewer than 3 sites of disease at the time of simulation (64%). Most of the non-spine bony sites lay within the pelvis (65%). Dose and fractionation varied but the most common prescription was 24 Gy/1 fraction. Local recurrence occurred in 7 patients with a median time to failure of 2.8 months. Local control was 91.8% at 1 year. With a median follow-up of 7.6 months, median SBRT specific overall survival and progression-free survival were 9.3 months and 9.7 months, respectively. Eighteen patients developed acute toxicity (mostly grade 1 and 2 fatigue and acute pain flare); 9 patients developed grade 12 late toxicities. Two patients developed pathologic fractures but both were asymptomatic. There were no late grade 3 or 4 toxicities. Conclusions Stereotactic body radiation therapy is a feasible and tolerable treatment for non-spine bony metastases. Longer follow-up will be needed to accurately determine late effects. PMID:24890360

  4. Adult Polyglucosan Body Disease (APBD): Anaplerotic diet therapy (Triheptanoin) and demonstration of defective methylation pathways.

    PubMed

    Roe, Charles R; Bottiglieri, Teodoro; Wallace, Mary; Arning, Erland; Martin, Alan

    2010-01-01

    APBD is a rare disorder most often affecting adults of Ashkenazi Jewish origin due to partial deficiency of the glycogen brancher enzyme (GBE). It is characterized by progressive involvement of both the central and peripheral nervous systems and deposition of amylopectin-like polyglucosan bodies. There have been no metabolic derangements that might suggest effective therapy nor have there been any clinical improvements for control of its relentless progression. The APBD patients, in this study, experienced stabilization of disease progression, and limited functional improvement in most patients with dietary triheptanoin. Due to a plateau in clinical improvement, the reduced plasma creatinine and methionine levels prompted evaluation of other plasma methylation intermediates in this complex integrated pathway system: decreased S-adenosylmethionine (SAM) (p<0.002), increased S-adenosylhomocysteine (p<0.001), elevated creatine (p=0.001) and increased free choline (p<0.001). Plasma levels of homocysteine and guanidinoacetate were normal. Impaired metabolism of choline and creatine may relate to the progressive dysmyelination and progressive muscle weakness associated with APBD. The partial deficiency of GBE appears to produce a secondary energy deficit possibly related to inadequate reserves of normal glycogen for efficient degradation to free glucose. Dysfunctional regulation of glycogen synthase (GS) may result in continued synthesis and deposition of polyglucosan bodies. This investigation has demonstrated, for the first time, arrest of clinical deterioration with limited functional recovery with triheptanoin diet therapy and the existence of significant derangement of methylation pathways that, when corrected, may lead to even greater therapeutic benefits. PMID:20655781

  5. Complementary and alternative medicine and mind-body therapies for treatment of irritable bowel syndrome in women.

    PubMed

    Magge, Suma S; Wolf, Jacqueline L

    2013-11-01

    Irritable bowel syndrome (IBS) is a common gastrointestinal disorder, characterized by chronic or recurrent abdominal pain with constipation, diarrhea and/or an alternation of the two, and often bloating. Complementary and alternative medicine (CAM) consists of a group of medical treatments that are not commonly considered to be a part of traditional medicine. CAM is commonly used for difficult-to-treat chronic medical conditions. Many patients choose CAM because there are only a limited number of treatments available for IBS or because they would like to have a 'natural therapy'. Mind-body therapies for IBS have proven efficacy, but have not been well accepted by patients or practitioners for treatment. This article reviews the use of CAM and mind-body therapies in IBS, with a focus on probiotics, acupuncture, herbal medicines and psychological therapies. PMID:24161308

  6. The tolerance of gastrointestinal organs to stereotactic body radiation therapy: what do we know so far?

    PubMed Central

    Thomas, Tarita O.; Hasan, Shaakir; Small, William; Herman, Joseph M.; Lock, Michael; Kim, Edward Y.; Mayr, Nina A.; Teh, Bin S.

    2014-01-01

    As stereotactic body radiation therapy (SBRT) for gastrointestinal (GI) gains popularity, there is a need to optimize doses and fractionation to minimize GI toxicity. GI organs that have classically developed radiation-induced toxicity include the liver & biliary system, small bowel, esophagus, and rectum. While the literature quantifies dose restrictions for these organs under standard fractionation, there is limited data regarding toxicity with the ablative dose schedules used in SBRT. We conducted a review of the literature to identify prospective and retrospective studies that detail GI toxicities when SBRT was employed. Based on the literature, the median SBRT dose for abdominal and thoracic tumors ranged from 24 to 60 Gy, at 5 to 25 Gy per fraction. The respective observed frequencies of grade 3 and 4 toxicities for the liver, biliary system, small bowel, and esophagus were variable among different studies. Typically, patients who suffered grade 3 and 4 toxicities were more likely to have had some form of systemic therapy as well. The effect of dose, fractionation, timing, and volume on GI toxicities has been described in the literature but more data is necessary to develop uniform treatment guidelines for SBRT. PMID:24982772

  7. Validity of Current Stereotactic Body Radiation Therapy Dose Constraints for Aorta and Major Vessels.

    PubMed

    Xue, Jinyu; Kubicek, Gregory; Patel, Ashish; Goldsmith, Benjamin; Asbell, Sucha O; LaCouture, Tamara A

    2016-04-01

    Understanding dose constraints for critical structures in stereotactic body radiation therapy (SBRT) is essential to generate a plan for optimal efficacy and safety. Published dose constraints are derived by a variety of methods, including crude statistics, actuarial analysis, modeling, and simple biologically effective dose (BED) conversion. Many dose constraints reported in the literature are not consistent with each other, secondary to differences in clinical and dosimetric parameters. Application of a dose constraint without discriminating the variation of all the factors involved may result in suboptimal treatment. This issue of Seminars in Radiation Oncology validates dose tolerance limits for 10 critical anatomic structures based on dose response modeling of clinical outcomes data to include detailed dose-volume metrics. This article presents a logistic dose-response model for aorta and major vessels based on 238 cases from the literature in addition to 387 cases from MD Anderson Cancer Center at Cooper University Hospital, for a total of 625 cases. The Radiation Therapy Oncology Group (RTOG) 0813 dose-tolerance limit of Dmax = 52.5Gy in 5 fractions was found to have a 1.2% risk of grade 3-5 toxicity, and the Timmerman 2008 limit of Dmax = 45Gy in 3 fractions had 2.3% risk. From the model, the 1% and 2% risk levels for D4cc, D1cc, and D0.5cc are also provided in 1-5 fractions, in the form of a dose-volume histogram (DVH) Risk Map. PMID:27000510

  8. 4D VMAT, gated VMAT, and 3D VMAT for stereotactic body radiation therapy in lung

    NASA Astrophysics Data System (ADS)

    Chin, E.; Loewen, S. K.; Nichol, A.; Otto, K.

    2013-02-01

    Four-dimensional volumetric modulated arc therapy (4D VMAT) is a treatment strategy for lung cancers that aims to exploit relative target and tissue motion to improve organ at risk (OAR) sparing. The algorithm incorporates the entire patient respiratory cycle using 4D CT data into the optimization process. Resulting treatment plans synchronize the delivery of each beam aperture to a specific phase of target motion. Stereotactic body radiation therapy treatment plans for 4D VMAT, gated VMAT, and 3D VMAT were generated on three patients with non-small cell lung cancer. Tumour motion ranged from 1.4-3.4 cm. The dose and fractionation scheme was 48 Gy in four fractions. A B-spline transformation model registered the 4D CT images. 4D dose volume histograms (4D DVH) were calculated from total dose accumulated at the maximum exhalation. For the majority of OARs, gated VMAT achieved the most radiation sparing but treatment times were 77-148% longer than 3D VMAT. 4D VMAT plan qualities were comparable to gated VMAT, but treatment times were only 11-25% longer than 3D VMAT. 4D VMAT's improvement of healthy tissue sparing can allow for further dose escalation. Future study could potentially adapt 4D VMAT to irregular patient breathing patterns.

  9. Body composition and energy expenditure in thyroidectomized patients during short-term hypothyroidism and thyrotropin-suppressive thyroxine therapy.

    PubMed

    Wolf, M; Weigert, A; Kreymann, G

    1996-02-01

    Thyroid hormone levels are a major determinant of energy balance and are thought to modify body composition by their effects on metabolism of lipids, carbohydrate and protein. The present study evaluates changes of body composition and basal energy expenditure (BEE) in thyroidectomized patients studied during short-term profound hypothyroidism while off all thyroid hormone before diagnostic whole-body (131)I-imaging and while on thyrotropin-suppressive thyroxine therapy. Basal energy expenditure was assessed by indirect calorimetry, and four-point body impedance analysis was used to estimate body composition. Patients were compared with healthy controls matched with respect to sex, age, height and weight. Compared to healthy controls the percentages of body water and body cell mass were significantly lower while the percentage of fat was significantly higher in patients during short-term hypothyroidism. Weight did not change significantly when patients were put on thyroxine treatment, but body fat (-0.95 +/- 2.25 kg, p < 0.01) decreased while body water (+0.94 +/- 1.31 kg, p < 0.01) and body cell mass (+0.9 +/- 2.5 kg, p < 0.05) increased. With thyroxine replacement, body composition was not significantly different between patients and controls. Compared to healthy controls, BEE was significantly lower in patients without thyroxine replacement (5265 +/- 766 kJ/24h vs 6362 +/- 992 kJ/24h; p < 0.001). With thyroxine treatment, BEE increased (6492 +/- 967 kJ/24h) but was not significantly different from the controls (p > 0.05). Neither body composition nor BEE was significantly different in a subgroup of thyroxine-treated patients with free triiodothyronine or thyroxine values above the normal range. In conclusion, both body composition and energy expenditure showed significant changes when patients were deprived of thyroid hormone. However, no evidence of excess metabolic effects of thyroid hormone during thyrotropin-suppressive thyroxine therapy was found. PMID:8630514

  10. An analytic model of the in-line and cross-axis apparent mass of the seated human body exposed to vertical vibration with and without a backrest

    NASA Astrophysics Data System (ADS)

    Zheng, Guangtai; Qiu, Yi; Griffin, Michael J.

    2011-12-01

    During vertical excitation of the seated human body there are vertical and fore-and-aft forces at the seat that are influenced by contact with a backrest, so it is desirable to take into account the effect of a backrest when developing models of the seated human body. Initially, a seven degree-of-freedom multi-body dynamic model was developed for the human body sitting with an upright posture unsupported by a backrest and exposed to vertical vibration. The model was optimized to fit the vertical apparent mass and the fore-and-aft cross-axis apparent mass measured on a seat. The model was then extended by the addition of vertical and fore-and-aft reaction forces to the upper lumbar spine to model the interaction between the human body and a backrest. By minimizing the least square error between experimental data and the analytical solution of the apparent masses on the seat and at the back, the human body model was able to represent both the vertical apparent mass and the fore-and-aft cross-axis apparent mass on the seat and at the back. Parameter sensitivity studies showed that the vertical apparent mass and the fore-and-aft cross-axis apparent mass on the seat and the backrest were all highly sensitive to the axial stiffness of the tissue beneath the pelvis. Pitch motion of the upper-body contributed to the vertical apparent mass and the fore-and-aft cross-axis apparent mass on the seat. The apparent mass at the back was more sensitive to the stiffness and damping of the lower back than the properties of the upper back.

  11. Esophageal Dose Tolerance to Hypofractionated Stereotactic Body Radiation Therapy: Risk Factors for Late Toxicity

    SciTech Connect

    Stephans, Kevin L.; Djemil, Toufik; Diaconu, Claudiu; Reddy, Chandana A.; Xia, Ping; Woody, Neil M.; Greskovich, John; Makkar, Vinit; Videtic, Gregory M.M.

    2014-09-01

    Purpose: To identify factors associated with grade ≥3 treatment related late esophageal toxicity after lung or liver stereotactic body radiation therapy (SBRT). Methods and Materials: This was a retrospective review of 52 patients with a planning target volume within 2 cm of the esophagus from a prospective registry of 607 lung and liver SBRT patients treated between 2005 and 2011. Patients were treated using a risk-adapted dose regimen to a median dose of 50 Gy in 5 fractions (range, 37.5-60 Gy in 3-10 fractions). Normal structures were contoured using Radiation Therapy Oncology Group (RTOG) defined criteria. Results: The median esophageal point dose and 1-cc dose were 32.3 Gy (range, 8.9-55.4 Gy) and 24.0 Gy (range, 7.8-50.9 Gy), respectively. Two patients had an esophageal fistula at a median of 8.4 months after SBRT, with maximum esophageal point doses of 51.5 and 52 Gy, and 1-cc doses of 48.1 and 50 Gy, respectively. These point and 1-cc doses were exceeded by 9 and 2 patients, respectively, without a fistula. The risk of a fistula for point doses exceeding 40, 45, and 50 Gy was 9.5% (n=2/21), 10.5% (n=2/19), and 12.5% (n=2/16), respectively. The risk of fistula for 1-cc doses exceeding 40, 45, and 50 Gy was 25% (n=2/9), 50% (n=2/4), and 50% (n=2/4), respectively. Eighteen patients received systemic therapy after SBRT (11 systemic chemotherapy, and 6 biologic agents, and 1 both). Both patients with fistulas had received adjuvant anti-angiogenic (vascular endothelial growth factor) agents within 2 months of completing SBRT. No patient had a fistula in the absence of adjuvant VEGF-modulating agents. Conclusions: Esophageal fistula is a rare complication of SBRT. In this series, fistula was seen with esophageal point doses exceeding 51 Gy and 1-cc doses greater than 48 Gy. Notably, however, fistula was seen only in those patients who also received adjuvant VEGF-modulating agents after SBRT. The potential interaction of dose and adjuvant therapy should be considered when delivering SBRT near the esophagus.

  12. Ride quality and international standard ISO 2631 (Guide for the evaluation of human exposure to whole-body vibration)

    NASA Technical Reports Server (NTRS)

    Allen, G. R.

    1975-01-01

    The evolution of the standard, which is aimed at promoting research and production of more data, and providing some design guidance, is outlined and its contents summarized. Some of the assumptions and information on which it is based are analyzed. Its application to vehicle ride quality is considered in the context of the safety, efficiency and comfort of crew and passengers. The importance of establishing the precise criteria against which vibration limits are required is underlined, particularly the difficulties of first defining comfort and then postulating appropriate levels. Some current and future work related to improving the standard is outlined and additional suggestions offered.

  13. Progressive-overload whole-body vibration training as part of periodized, off-season strength training in trained women athletes.

    PubMed

    Jones, Margaret T

    2014-09-01

    The purpose was to examine the effects of progressive-overload, whole-body vibration (WBV) training on strength and power as part of a 15-week periodized, strength training (ST) program. Eighteen collegiate women athletes with ?1 year of ST and no prior WBV training participated in the crossover design. Random assignment to 1 of the 2 groups followed pretests of seated medicine ball throw (SMBT), single-leg hop for distance (LSLH, RSLH), countermovement jump (CMJ), 3 repetition maximum (3RM) front squat (FS), pull-up (PU), and 3RM bench press (BP). Whole-body vibration was two 3-week phases of dynamic and static hold body weight exercises administered 2 dwk in ST sessions throughout the 15-week off-season program. Total WBV exposure was 6 minutes broken into 30-second bouts with 60-second rest (1:2 work-to-relief ratio). Exercises, frequency, and amplitude progressed in intensity from the first 3-week WBV training to the second 3-week phase. Repeated-measures analysis of variances were used to analyze the SMBT, CMJ, LSLH, RSLH, FS, PU, and BP tests. Alpha level was p ? 0.05. Front squat, LSLH, and RSLH increased (p = 0.001) from pre- to posttest; FS increased from mid- to posttest. Pull-up increased (p = 0.008) from pre- to posttest. Seated medicine ball throw and BP showed a trend of increased performance from pre- to posttest (p = 0.11). Two 3-week phases of periodized, progressive-overload WBV + ST training elicited gains in strength and power during a 15-week off-season program. Greatest improvements in performance tests occurred in the initial WBV phase. Implementing WBV in conjunction with ST appears to be more effective in the early phases of training. PMID:24936902

  14. A whole-body pharmacokinetic model for the early assessment of targeted radionuclide therapy agents

    NASA Astrophysics Data System (ADS)

    Grudzinski, Joseph J.

    Early assessment of targeted radionuclide therapy (TRT) agent effectiveness based on its pharmacokinetic (PK) properties could provide a means to expedite agent development or rejection. A whole-body PK model was developed that not only simplifies the complex radiation dosimetry and physiology of TRT but also provides criteria for normal tissue and tumor PK parameters that achieve effective TRT while limiting toxicity. Because biologically effective dose (BED) may be more of a relevant quantity than absorbed dose for establishing tumor response relationships, the model was expanded to include BED. The model consisted of two coupled normal body compartments and one decoupled tumor compartment. Differential equations were used to develop an equation that predicted TRT efficacy. PK scenarios were created by pairing normal body influx and efflux parameters with a range of tumor influx and efflux parameters. Each PK scenario yielded a maximum delivered tumor absorbed dose that limited the whole body dose to 2 Gy. The dose rate and repair rate were used for BED. The relationships between the tumor influx-to-efflux ratio (k34:k 43), central compartment efflux-to-influx ratio (k12:k 21), central elimination (ke1), and tumor repair rate (mu), and tumor BED were investigated. The model was used to find the PK parameters for NM404 and FLT within a xenograft model. The TCC of both Compartment 1 and tumor were fit to the equations of the model using Levenberg-Marquardt. The parameter errors were propagated into dosimetry uncertainties. Sensitivity functions were derived for each PK parameter that described the change in TCC as a result of a change in the PK parameter value at each time. Cramer-Rao Lower Bounds (CRLB) theory was used to derive optimal sampling schedules based on the sensitivity of the derived PK parameters. The experimental and optimal sampling schedules were compared by running simulations that measured the precision and accuracy of the measured PK parameters. The TRT PK model that was developed has the capability of predicting effectiveness when PK parameters are known. This work also represents a step in the direction of establishing relative PK criteria of when the BED formalism is more applicable than absorbed dose for TRT.

  15. Whole Body Vibration Exercise Protocol versus a Standard Exercise Protocol after ACL Reconstruction: A Clinical Randomized Controlled Trial with Short Term Follow-Up.

    PubMed

    Berschin, Gereon; Sommer, Bjrn; Behrens, Antje; Sommer, Hans-Martin

    2014-09-01

    The suitability and effectiveness of whole body vibration (WBV) exercise in rehabilitation after injury of the anterior cruciate ligament (ACL) was studied using a specially designed WBV protocol. We wanted to test the hypothesis if WBV leads to superior short term results regarding neuromuscular performance (strength and coordination) and would be less time consuming than a current standard muscle strengthening protocol. In this prospective randomized controlled clinical trial, forty patients who tore their ACL and underwent subsequent ligament reconstruction were enrolled. Patients were randomized to the whole body vibration (n=20) or standard rehabilitation exercise protocol (n=20). Both protocols started in the 2(nd) week after surgery. Isometric and isokinetic strength measurements, clinical assessment, Lysholm score, neuromuscular performance were conducted weeks 2, 5, 8 and 11 after surgery. Time spent for rehabilitation exercise was reduced to less than a half in the WBV group. There were no statistically significant differences in terms of clinical assessment, Lysholm score, isokinetic and isometric strength. The WBV group displayed significant better results in the stability test. In conclusion, preliminary data indicate that our whole body vibration muscle exercise protocol seems to be a good alternative to a standard exercise program in ACL-rehabilitation. Despite of its significant reduced time requirement it is at least equally effective compared to a standard rehabilitation protocol. Key pointsIn this prospective randomized controlled clinical trial, we tested the hypothesis if WBV leads to superior short term results regarding neuromuscular performance (strength and coordination) and would be less time consuming than a current standard muscle strengthening protocol in forty patients who underwent ACL reconstruction.Time spent for rehabilitation exercise was reduced to less than a half in the WBV group as compared to the standard exercise group. Both protocols showed no differences regarding clinical assessment, Lysholm score, isokinetic and isometric strength.Despite a more than 50% reduction in time spent for exercise sessions, the WBV group achieved significant better results in the stability test.In conclusion, the presented WBV program can be considered as a practical alternative to a standard exercise program during ACL-rehabilitation. PMID:25177185

  16. Whole Body Vibration Exercise Protocol versus a Standard Exercise Protocol after ACL Reconstruction: A Clinical Randomized Controlled Trial with Short Term Follow-Up

    PubMed Central

    Berschin, Gereon; Sommer, Björn; Behrens, Antje; Sommer, Hans-Martin

    2014-01-01

    The suitability and effectiveness of whole body vibration (WBV) exercise in rehabilitation after injury of the anterior cruciate ligament (ACL) was studied using a specially designed WBV protocol. We wanted to test the hypothesis if WBV leads to superior short term results regarding neuromuscular performance (strength and coordination) and would be less time consuming than a current standard muscle strengthening protocol. In this prospective randomized controlled clinical trial, forty patients who tore their ACL and underwent subsequent ligament reconstruction were enrolled. Patients were randomized to the whole body vibration (n=20) or standard rehabilitation exercise protocol (n=20). Both protocols started in the 2nd week after surgery. Isometric and isokinetic strength measurements, clinical assessment, Lysholm score, neuromuscular performance were conducted weeks 2, 5, 8 and 11 after surgery. Time spent for rehabilitation exercise was reduced to less than a half in the WBV group. There were no statistically significant differences in terms of clinical assessment, Lysholm score, isokinetic and isometric strength. The WBV group displayed significant better results in the stability test. In conclusion, preliminary data indicate that our whole body vibration muscle exercise protocol seems to be a good alternative to a standard exercise program in ACL-rehabilitation. Despite of its significant reduced time requirement it is at least equally effective compared to a standard rehabilitation protocol. Key points In this prospective randomized controlled clinical trial, we tested the hypothesis if WBV leads to superior short term results regarding neuromuscular performance (strength and coordination) and would be less time consuming than a current standard muscle strengthening protocol in forty patients who underwent ACL reconstruction. Time spent for rehabilitation exercise was reduced to less than a half in the WBV group as compared to the standard exercise group. Both protocols showed no differences regarding clinical assessment, Lysholm score, isokinetic and isometric strength. Despite a more than 50% reduction in time spent for exercise sessions, the WBV group achieved significant better results in the stability test. In conclusion, the presented WBV program can be considered as a practical alternative to a standard exercise program during ACL-rehabilitation. PMID:25177185

  17. Stereotactic body radiation therapy planning with duodenal sparing using volumetric-modulated arc therapy vs intensity-modulated radiation therapy in locally advanced pancreatic cancer: A dosimetric analysis

    SciTech Connect

    Kumar, Rachit; Wild, Aaron T.; Ziegler, Mark A.; Hooker, Ted K.; Dah, Samson D.; Tran, Phuoc T.; Kang, Jun; Smith, Koren; Zeng, Jing; Pawlik, Timothy M.; Tryggestad, Erik; Ford, Eric; Herman, Joseph M.

    2013-10-01

    Stereotactic body radiation therapy (SBRT) achieves excellent local control for locally advanced pancreatic cancer (LAPC), but may increase late duodenal toxicity. Volumetric-modulated arc therapy (VMAT) delivers intensity-modulated radiation therapy (IMRT) with a rotating gantry rather than multiple fixed beams. This study dosimetrically evaluates the feasibility of implementing duodenal constraints for SBRT using VMAT vs IMRT. Non–duodenal sparing (NS) and duodenal-sparing (DS) VMAT and IMRT plans delivering 25 Gy in 1 fraction were generated for 15 patients with LAPC. DS plans were constrained to duodenal D{sub max} of<30 Gy at any point. VMAT used 1 360° coplanar arc with 4° spacing between control points, whereas IMRT used 9 coplanar beams with fixed gantry positions at 40° angles. Dosimetric parameters for target volumes and organs at risk were compared for DS planning vs NS planning and VMAT vs IMRT using paired-sample Wilcoxon signed rank tests. Both DS VMAT and DS IMRT achieved significantly reduced duodenal D{sub mean}, D{sub max}, D{sub 1cc}, D{sub 4%}, and V{sub 20} {sub Gy} compared with NS plans (all p≤0.002). DS constraints compromised target coverage for IMRT as demonstrated by reduced V{sub 95%} (p = 0.01) and D{sub mean} (p = 0.02), but not for VMAT. DS constraints resulted in increased dose to right kidney, spinal cord, stomach, and liver for VMAT. Direct comparison of DS VMAT and DS IMRT revealed that VMAT was superior in sparing the left kidney (p<0.001) and the spinal cord (p<0.001), whereas IMRT was superior in sparing the stomach (p = 0.05) and the liver (p = 0.003). DS VMAT required 21% fewer monitor units (p<0.001) and delivered treatment 2.4 minutes faster (p<0.001) than DS IMRT. Implementing DS constraints during SBRT planning for LAPC can significantly reduce duodenal point or volumetric dose parameters for both VMAT and IMRT. The primary consequence of implementing DS constraints for VMAT is increased dose to other organs at risk, whereas for IMRT it is compromised target coverage. These findings suggest clinical situations where each technique may be most useful if DS constraints are to be employed.

  18. Mathematical equations and system identification models for a portable pneumatic bladder system designed to reduce human exposure to whole body shock and vibration

    NASA Astrophysics Data System (ADS)

    Aziz Ayyad, Ezzat

    A mathematical representation is sought to model the behavior of a portable pneumatic foam bladder designed to mitigate the effects of human exposure to shock and whole body random vibration. Fluid Dynamics principles are used to derive the analytic differential equations used for the physical equations Model. Additionally, combination of Wiener and Hammerstein block oriented representation techniques have been selected to create system identification (SID) block oriented models. A number of algorithms have been iterated to obtain numerical solutions for the system of equations which was found to be coupled and non-linear, with no analytic closed form solution. The purpose is to be able to predict the response of such system due to random vibrations and shock within reasonable margin of error. The constructed models were found to be accurate within accepted confidence level. Beside the analytic set of physical equations model representation, a linear SID model was selected to take advantage of the available vast amount of mathematical tools available to further analyze and redesign the bladder as a dynamic system. Measured field-test and lab test data have been collected from several helicopter and land terrain vehicle experiments. Numerous excitation and response acceleration measurement records were collected and used to prove the agreement with predictions. The estimation of two selected models were later applied to standard metrics in the frequency domain realization and compared with measurement responses. The collected test records are obtained from measured data at the US Army fields and facilities and at UNLV-CMEST environmental lab. The emerged models have been validated for conformity with actual accelerometer measurement responses and found within accepted error tolerance that is in both time and frequency domains. Further, standard metrics have been used to further confirm the confidence in the validation results. When comparing model prediction with the already proven pneumatic bladder system effectiveness both equally proves that bladder performance exceeds metrics standard to reduce human exposure to shock and random vibrations.

  19. Critical Appraisal of Volumetric Modulated Arc Therapy in Stereotactic Body Radiation Therapy for Metastases to Abdominal Lymph Nodes

    SciTech Connect

    Bignardi, Mario; Cozzi, Luca; Fogliata, Antonella; Lattuada, Paola; Mancosu, Pietro; Navarria, Piera; Urso, Gaetano; Vigorito, Sabrina; Scorsetti, Marta

    2009-12-01

    Purpose: A planning study was performed comparing volumetric modulated arcs, RapidArc (RA), fixed beam IMRT (IM), and conformal radiotherapy (CRT) with multiple static fields or short conformal arcs in a series of patients treated with hypofractionated stereotactic body radiation therapy (SBRT) for solitary or oligo-metastases from different tumors to abdominal lymph nodes. Methods and Materials: Fourteen patients were included in the study. Dose prescription was set to 45 Gy (mean dose to clinical target volume [CTV]) in six fractions of 7.5 Gy. Objectives for CTV and planning target volume (PTV) were as follows: Dose{sub min} >95%, Dose{sub max} <107%. For organs at risk the following objectives were used: Maximum dose to spine <18 Gy; V{sub 15Gy} <35% for both kidneys, V{sub 36Gy} <1% for duodenum, V{sub 36Gy} <3% for stomach and small bowel, V{sub 15Gy} <(total liver volume - 700 cm{sup 3}) for liver. Dose-volume histograms were evaluated to assess plan quality. Results: Planning objectives on CTV and PTV were achieved by all techniques. Use of RA improved PTV coverage (V{sub 95%} = 90.2% +- 5.2% for RA compared with 82.5% +- 9.6% and 84.5% +- 8.2% for CRT and IM, respectively). Most planning objectives for organs at risk were met by all techniques except for the duodenum, small bowel, and stomach, in which the CRT plans exceeded the dose/volume constraints in some patients. The MU/fraction values were as follows: 2186 +- 211 for RA, 2583 +- 699 for IM, and 1554 +- 153 for CRT. Effective treatment time resulted as follows: 3.7 +- 0.4 min for RA, 10.6 +- 1.2 min for IM, and 6.3 +- 0.5 min for CRT. Conclusions: Delivery of SBRT by RA showed improvements in conformal avoidance with respect to standard conformal irradiation. Delivery parameters confirmed logistical advantages of RA, particularly compared with IM.

  20. Voxel-Based Dose Reconstruction for Total Body Irradiation With Helical TomoTherapy

    SciTech Connect

    Chao Ming; Penagaricano, Jose; Yan Yulong; Moros, Eduardo G.; Corry, Peter; Ratanatharathorn, Vaneerat

    2012-04-01

    Purpose: We have developed a megavoltage CT (MVCT)-based dose reconstruction strategy for total body irradiation (TBI) with helical TomoTherapy (HT) using a deformable registration model to account for the patient's interfraction changes. The proposed technique serves as an efficient tool for delivered dose verification and, potentially, plan adaptation. Methods and Materials: Four patients with acute myelogenous leukemia treated with TBI using HT were selected for this study. The prescription was 12 Gy, 2 Gy/fraction, twice per day, given at least 6 h apart. The original plan achieved coverage of 80% of the clinical target volume (CTV) by the 12 Gy isodose surface. MVCTs were acquired prior to each treatment. Regions of interest were contoured on each MVCT. The dose for each fraction was calculated based on the MVCT using the HT planned adaptive station. B-spline deformable registration was conducted to establish voxel-to-voxel correspondence between the MVCT and the planning CT. The resultant deformation vector was employed to map the reconstructed dose from each fraction to the same point as the plan dose, and a voxel-to-voxel summed dose from all six fractions was obtained. The reconstructed dose distribution and its dosimetric parameters were compared with those of the original treatment plan. Results: While changes in CTV contours occurred in all patients, the reconstructed dose distribution showed that the dose-volume histogram for CTV coverage was close (<1.5%) to that of the original plan. For sensitive structures, the differences between the reconstructed and the planned doses were less than 3.0%. Conclusion: Voxel-based dose reconstruction strategy that takes into account interfraction anatomical changes using MVCTs is a powerful tool for treatment verification of the delivered doses. This proposed technique can also be applied to adaptive TBI therapy using HT.

  1. The Role of Stereotactic Body Radiation Therapy for Pancreatic Cancer: A Single-Institution Experience

    PubMed Central

    Moningi, Shalini; Dholakia, Avani S.; Raman, Siva P.; Blackford, Amanda; Cameron, John L.; Le, Dung T.; De Jesus-Acosta, Ana M. C.; Hacker-Prietz, Amy; Rosati, Lauren M.; Assadi, Ryan K.; Dipasquale, Shirl; Pawlik, Timothy M.; Zheng, Lei; Weiss, Matthew J.; Laheru, Daniel A.; Wolfgang, Christopher L.; Herman, Joseph M.

    2015-01-01

    Background Stereotactic body radiation therapy (SBRT) is a promising option for patients with pancreatic cancer (PCA); however, limited data support its efficacy. This study reviews our institutional experience of SBRT in the treatment of locally advanced (LAPC) and borderline resectable (BRPC) PCA. Methods Charts of all PCA patients receiving SBRT at our institution from 2010 to 2014 were reviewed. Most patients received pre-SBRT chemotherapy. Primary endpoints included overall survival (OS) and local progression-free survival (LPFS). Patients received a total dose of 2533 Gy in five fractions. Results A total of 88 patients were included in the analysis, 74 with LAPC and 14 with BRPC. The median age at diagnosis was 67.2 years, and median follow-up from date of diagnosis for LAPC and BRPC patients was 14.5 and 10.3 months, respectively. Median OS from date of diagnosis was 18.4 months (LAPC, 18.4 mo; BRPC, 14.4 mo) and median PFS was 9.8 months (95 % CI 8.012.3). Acute toxicity was minimal with only three patients (3.4 %) experiencing acute grade ?3 toxicity. Late grade ?2 gastrointestinal toxicity was seen in five patients (5.7 %). Of the 19 patients (21.6 %) who underwent surgery, 79 % were LAPC patients and 84 % had margin-negative resections. Conclusions Chemotherapy followed by SBRT in patients with LAPC and BRPC resulted in minimal acute and late toxicity. A large proportion of patients underwent surgical resection despite limited radiographic response to therapy. Further refinements in the integration of chemotherapy, SBRT, and surgery might offer additional advancements toward optimizing patient outcomes. PMID:25564157

  2. Stereotactic body radiation therapy in the treatment of oligometastatic prostate cancer

    PubMed Central

    Ahmed, Kamran A.; Barney, Brandon M.; Davis, Brian J.; Park, Sean S.; Kwon, Eugene D.; Olivier, Kenneth R.

    2013-01-01

    Purpose/objective(s): To report outcomes and toxicity for patients with oligometastatic (?5 lesions) prostate cancer (PCa) treated with stereotactic body radiation therapy (SBRT). Materials/methods: Seventeen men with 21 PCa lesions were treated with SBRT between February 2009 and November 2011. All patients had a detectable prostate-specific antigen (PSA) at the time of SBRT, and 11 patients (65%) had hormone-refractory (HR) disease. Treatment sites included bone (n = 19), lymph nodes (n = 1), and liver (n = 1). For patients with bone lesions, the median dose was 20 Gy (range, 824 Gy) in a single fraction (range, 13). All but two patients received some form of anti-androgen therapy after completing SBRT. Results: Local control (LC) was 100%, and the PSA nadir was undetectable in nine patients (53%). The first post-SBRT PSA was lower than pre-treatment levels in 15 patients (88%), and continued to decline or remain undetectable in 12 patients (71%) at a median follow-up of 6 months (range, 224 months). Median PSA measurements before SBRT and at last follow-up were 2.1 ng/dl (range, 0.1336.4) and 0.17 ng/dl (range, <0.1140), respectively. Six (55%) of the 11 patients with HR PCa achieved either undetectable or declining PSA at a median follow-up of 4.8 months (range, 2.26.0 months). Reported toxicities included one case each of grade 2 dyspnea and back pain, there were no cases of grade ?3 toxicity following treatment. Conclusion: We report excellent LC with SBRT in oligometastatic PCa. More importantly, over half the patients achieved an undetectable PSA after SBRT. Further follow-up is necessary to assess the long-term impact of SBRT on LC, toxicity, PSA response, and clinical outcomes. PMID:23346551

  3. Spine stereotactic body radiation therapy plans: Achieving dose coverage, conformity, and dose falloff.

    PubMed

    Hong, Linda X; Shankar, Viswanathan; Shen, Jin; Kuo, Hsiang-Chi; Mynampati, Dinesh; Yaparpalvi, Ravindra; Goddard, Lee; Basavatia, Amar; Fox, Jana; Garg, Madhur; Kalnicki, Shalom; Tom, Wolfgang A

    2015-01-01

    We report our experience of establishing planning objectives to achieve dose coverage, conformity, and dose falloff for spine stereotactic body radiation therapy (SBRT) plans. Patients with spine lesions were treated using SBRT in our institution since September 2009. Since September 2011, we established the following planning objectives for our SBRT spine plans in addition to the cord dose constraints: (1) dose coverageprescription dose (PD) to cover at least 95% planning target volume (PTV) and 90% PD to cover at least 99% PTV; (2) conformity index (CI)ratio of prescription isodose volume (PIV) to the PTV < 1.2; (3) dose falloffratio of 50% PIV to the PTV (R(50%)); (4) and maximum dose in percentage of PD at 2 cm from PTV in any direction (D(2cm)) to follow Radiation Therapy Oncology Group (RTOG) 0915. We have retrospectively reviewed 66 separate spine lesions treated between September 2009 and December 2012 (31 treated before September 2011 [group 1] and 35 treated after [group 2]). The ?(2) test was used to examine the difference in parameters between groups. The PTV V(100% PD) ? 95% objective was met in 29.0% of group 1 vs 91.4% of group 2 (p < 0.01) plans. The PTV V(90% PD) ? 99% objective was met in 38.7% of group 1 vs 88.6% of group 2 (p < 0.01) plans. Overall, 4 plans in group 1 had CI > 1.2 vs none in group 2 (p = 0.04). For D(2cm), 48.3% plans yielded a minor violation of the objectives and 16.1% a major violation for group 1, whereas 17.1% exhibited a minor violation and 2.9% a major violation for group 2 (p < 0.01). Spine SBRT plans can be improved on dose coverage, conformity, and dose falloff employing a combination of RTOG spine and lung SBRT protocol planning objectives. PMID:25498838

  4. Estimated Risk Level of Unified Stereotactic Body Radiation Therapy Dose Tolerance Limits for Spinal Cord.

    PubMed

    Grimm, Jimm; Sahgal, Arjun; Soltys, Scott G; Luxton, Gary; Patel, Ashish; Herbert, Scott; Xue, Jinyu; Ma, Lijun; Yorke, Ellen; Adler, John R; Gibbs, Iris C

    2016-04-01

    A literature review of more than 200 stereotactic body radiation therapy spine articles from the past 20 years found only a single article that provided dose-volume data and outcomes for each spinal cord of a clinical dataset: the Gibbs 2007 article (Gibbs et al, 2007(1)), which essentially contains the first 100 stereotactic body radiation therapy (SBRT) spine treatments from Stanford University Medical Center. The dataset is modeled and compared in detail to the rest of the literature review, which found 59 dose tolerance limits for the spinal cord in 1-5 fractions. We partitioned these limits into a unified format of high-risk and low-risk dose tolerance limits. To estimate the corresponding risk level of each limit we used the Gibbs 2007 clinical spinal cord dose-volume data for 102 spinal metastases in 74 patients treated by spinal radiosurgery. In all, 50 of the patients were previously irradiated to a median dose of 40Gy in 2-3Gy fractions and 3 patients developed treatment-related myelopathy. These dose-volume data were digitized into the dose-volume histogram (DVH) Evaluator software tool where parameters of the probit dose-response model were fitted using the maximum likelihood approach (Jackson et al, 1995(3)). Based on this limited dataset, for de novo cases the unified low-risk dose tolerance limits yielded an estimated risk of spinal cord injury of ≤1% in 1-5 fractions, and the high-risk limits yielded an estimated risk of ≤3%. The QUANTEC Dmax limits of 13Gy in a single fraction and 20Gy in 3 fractions had less than 1% risk estimated from this dataset, so we consider these among the low-risk limits. In the previously irradiated cohort, the estimated risk levels for 10 and 14Gy maximum cord dose limits in 5 fractions are 0.4% and 0.6%, respectively. Longer follow-up and more patients are required to improve the risk estimates and provide more complete validation. PMID:27000514

  5. Acute effects of whole-body vibration on peak isometric torque, muscle twitch torque and voluntary muscle activation of the knee extensors.

    PubMed

    Jordan, M; Norris, S; Smith, D; Herzog, W

    2010-06-01

    The purpose of this investigation was to compare the acute effects of whole-body vibration (WBV) with a static squat on resting muscle twitch torque, peak isometric torque and voluntary muscle activation of the knee extensors during an isometric maximal voluntary contraction (MVC). Twenty-four healthy, strength-trained males were recruited for this randomized, cross-over design investigation. The WBV treatment consisted of three sets of 60 s of vibration (30 Hz, +/-4 mm) while standing in a semi-squat position. Voluntary muscle activation, peak isometric torque during MVC and resting muscle twitch torque (RTT) through percutaneous femoral nerve stimulation were obtained before and following the treatment. Change in peak isometric torque, voluntary muscle activation and the RTT were calculated as the difference between pre- and post-treatment values. There was no observable post-activation potentiation of muscle twitch torque or enhancement in voluntary muscle activation or peak isometric torque. However, decreases in the peak isometric torque (P=0.0094) and voluntary muscle activation (P=0.0252) were significantly smaller post WBV interventions compared with the control treatment. Based on the current data, it is unclear whether or not this was attributable to the effects of WBV but further research into this possibility is warranted. PMID:19602188

  6. Obesity Increases the Risk of Chest Wall Pain From Thoracic Stereotactic Body Radiation Therapy

    SciTech Connect

    Welsh, James; Thomas, Jimmy; Shah, Deep; Allen, Pamela K.; Wei, Xiong; Mitchell, Kevin; Gao, Song; Balter, Peter; Komaki, Ritsuko; Chang, Joe Y.

    2011-09-01

    Purpose: Stereotactic body radiation therapy (SBRT) is increasingly being used to treat thoracic tumors. We attempted here to identify dose-volume parameters that predict chest wall toxicity (pain and skin reactions) in patients receiving thoracic SBRT. Patients and Methods: We screened a database of patients treated with SBRT between August 2004 and August 2008 to find patients with pulmonary tumors within 2.5 cm of the chest wall. All patients received a total dose of 50 Gy in four daily 12.5-Gy fractions. Toxicity was scored according to the NCI-CTCAE V3.0. Results: Of 360 patients in the database, 265 (268 tumors) had tumors within <2.5 cm of the chest wall; 104 (39%) developed skin toxicity (any grade); 14 (5%) developed acute pain (any grade), and 45 (17%) developed chronic pain (Grade 1 in 22 cases [49%] and Grade 2 or 3 in 23 cases [51%]). Both skin toxicity and chest wall pain were associated with the V{sub 30}, or volume of the chest wall receiving 30 Gy. Body mass index (BMI) was also strongly associated with the development of chest pain: patients with BMI {>=}29 had almost twice the risk of chronic pain (p = 0.03). Among patients with BMI >29, diabetes mellitus was a significant contributing factor to the development of chest pain. Conclusion: Safe use of SBRT with 50 Gy in four fractions for lesions close to the chest wall requires consideration of the chest wall volume receiving 30 Gy and the patient's BMI and diabetic state.

  7. The effects of whole-body vibration exercise on isokinetic muscular function of the knee and jump performance depending on squatting position

    PubMed Central

    Kim, Jaeyuong; Park, Yunjin; Seo, Yonggon; Kang, Gyumin; Park, Sangseo; Cho, Hyeyoung; Moon, Hyunghoon; Kim, Myungki; Yu, Jaeho

    2016-01-01

    [Purpose] The purpose of this study was to investigate the effects of whole-body vibration exercise (WBVE) on isokinetic muscular function of the knee and jump performance depending on different squatting positions. [Subjects] The subjects were 12 healthy adult men who did not exercise regularly between the ages of 27 and 34. [Methods] WBVE was performed with high squat position (SP), middle SP, and low SP. Before and after the intervention, isokinetic muscular function of the knees and jump performance were measured. [Results] Knee flexion peak torque at 60°/s and total work at 180°/s were significantly increased after implementing WBVE. Jump height also significantly increased after completing the exercise at all positions in comparison with the pre-exercise programs. [Conclusion] The results of this study suggest that SP during WBVE is an important factor stimulating positive effects on muscular function. PMID:26957749

  8. Radiobiological mechanisms of stereotactic body radiation therapy and stereotactic radiation surgery

    PubMed Central

    Kim, Mi-Sook; Kim, Wonwoo; Park, In Hwan; Kim, Hee Jong; Lee, Eunjin; Jung, Jae-Hoon; Cho, Lawrence Chinsoo

    2015-01-01

    Despite the increasing use of stereotactic body radiation therapy (SBRT) and stereotactic radiation surgery (SRS) in recent years, the biological base of these high-dose hypo-fractionated radiotherapy modalities has been elusive. Given that most human tumors contain radioresistant hypoxic tumor cells, the radiobiological principles for the conventional multiple-fractionated radiotherapy cannot account for the high efficacy of SBRT and SRS. Recent emerging evidence strongly indicates that SBRT and SRS not only directly kill tumor cells, but also destroy the tumor vascular beds, thereby deteriorating intratumor microenvironment leading to indirect tumor cell death. Furthermore, indications are that the massive release of tumor antigens from the tumor cells directly and indirectly killed by SBRT and SRS stimulate anti-tumor immunity, thereby suppressing recurrence and metastatic tumor growth. The reoxygenation, repair, repopulation, and redistribution, which are important components in the response of tumors to conventional fractionated radiotherapy, play relatively little role in SBRT and SRS. The linear-quadratic model, which accounts for only direct cell death has been suggested to overestimate the cell death by high dose per fraction irradiation. However, the model may in some clinical cases incidentally do not overestimate total cell death because high-dose irradiation causes additional cell death through indirect mechanisms. For the improvement of the efficacy of SBRT and SRS, further investigation is warranted to gain detailed insights into the mechanisms underlying the SBRT and SRS. PMID:26756026

  9. Histopathologic tumor response after induction chemotherapy and stereotactic body radiation therapy for borderline resectable pancreatic cancer

    PubMed Central

    Chuong, Michael D.; Frakes, Jessica M.; Figura, Nicholas; Hoffe, Sarah E.; Shridhar, Ravi; Mellon, Eric A.; Hodul, Pamela J.; Malafa, Mokenge P.; Springett, Gregory M.

    2016-01-01

    Background While clinical outcomes following induction chemotherapy and stereotactic body radiation therapy (SBRT) have been reported for borderline resectable pancreatic cancer (BRPC) patients, pathologic response has not previously been described. Methods This single-institution retrospective review evaluated BRPC patients who completed induction gemcitabine-based chemotherapy followed by SBRT and surgical resection. Each surgical specimen was assigned two tumor regression grades (TRG), one using the College of American Pathologists (CAP) criteria and one using the MD Anderson Cancer Center (MDACC) criteria. Overall survival (OS) and progression free survival (PFS) were correlated to TRG score. Results We evaluated 36 patients with a median follow-up of 13.8 months (range, 6.1-24.8 months). The most common induction chemotherapy regimen (82%) was GTX (gemcitabine, docetaxel, capecitabine). A median SBRT dose of 35 Gy (range, 30-40 Gy) in 5 fractions was delivered to the region of vascular involvement. The margin-negative resection rate was 97.2%. Improved response according to MDACC grade trended towards superior PFS (P=061), but not OS. Any neoadjuvant treatment effect according to MDACC scoring (IIa-IV vs. I) was associated with improved OS and PFS (both P=0.019). We found no relationship between CAP score and OS or PFS. Conclusions These data suggest that the increased pathologic response after induction chemotherapy and SBRT is correlated with improved survival for BRPC patients.

  10. Whole body correction of mucopolysaccharidosis IIIA by intracerebrospinal fluid gene therapy

    PubMed Central

    Haurigot, Virginia; Marc, Sara; Ribera, Albert; Garcia, Miguel; Ruzo, Albert; Villacampa, Pilar; Ayuso, Eduard; Aor, Snia; Andaluz, Anna; Pineda, Mercedes; Garca-Fructuoso, Gemma; Molas, Maria; Maggioni, Luca; Muoz, Sergio; Motas, Sandra; Ruberte, Jess; Mingozzi, Federico; Pumarola, Mart; Bosch, Fatima

    2013-01-01

    For most lysosomal storage diseases (LSDs) affecting the CNS, there is currently no cure. The BBB, which limits the bioavailability of drugs administered systemically, and the short half-life of lysosomal enzymes, hamper the development of effective therapies. Mucopolysaccharidosis type IIIA (MPS IIIA) is an autosomic recessive LSD caused by a deficiency in sulfamidase, a sulfatase involved in the stepwise degradation of glycosaminoglycan (GAG) heparan sulfate. Here, we demonstrate that intracerebrospinal fluid (intra-CSF) administration of serotype 9 adenoassociated viral vectors (AAV9s) encoding sulfamidase corrects both CNS and somatic pathology in MPS IIIA mice. Following vector administration, enzymatic activity increased throughout the brain and in serum, leading to whole body correction of GAG accumulation and lysosomal pathology, normalization of behavioral deficits, and prolonged survival. To test this strategy in a larger animal, we treated beagle dogs using intracisternal or intracerebroventricular delivery. Administration of sulfamidase-encoding AAV9 resulted in transgenic expression throughout the CNS and liver and increased sulfamidase activity in CSF. High-titer serum antibodies against AAV9 only partially blocked CSF-mediated gene transfer to the brains of dogs. Consistently, anti-AAV antibody titers were lower in CSF than in serum collected from healthy and MPS IIIAaffected children. These results support the clinical translation of this approach for the treatment of MPS IIIA and other LSDs with CNS involvement. PMID:23863627

  11. Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder: A Pilot Study.

    PubMed

    Greenberg, Jennifer L; Mothi, Suraj Sarvode; Wilhelm, Sabine

    2016-03-01

    Body dysmorphic disorder (BDD) is a relatively common and severe disorder that typically onsets in adolescence, but often goes unrecognized. Despite BDD's severity and early onset, treatment outcome research on adolescent BDD is scarce. Cognitive-behavioral therapy is the gold-standard psychosocial treatment for BDD in adults and has shown promise in adolescents. The current study examined the development and testing of a new CBT for adolescents with BDD. We tested feasibility, acceptability, and treatment outcome in a sample of 13 adolescents (mean age 15.23years, range: 13-17) with primary BDD. Treatment was delivered in 12-22 weekly individual sessions. Standardized clinician ratings and self-report measures were used to assess BDD and related symptoms pre- and posttreatment and at 3- and 6-months follow-up. At posttreatment, BDD and related symptoms (e.g., insight, mood) were significantly improved. Scores on the Yale-Brown Obsessive Compulsive Scale for BDD indicated a 50% (intent-to-treat) and 68% (completer) improvement in BDD symptoms. Seventy-five percent of adolescents who started treatment and 100% of completers were considered treatment responders. Treatment gains were maintained at follow-up. High patient satisfaction ratings and patient feedback indicated that treatment was acceptable. This represents the largest study of a psychosocial treatment for adolescent BDD. PMID:26956653

  12. Increased Body Mass Index during Therapy for Childhood Acute Lymphoblastic Leukemia: A Significant and Underestimated Complication

    PubMed Central

    Atkinson, Helen C.; Marsh, Julie A.; Rath, Shoshana R.; Kotecha, Rishi S.; Gottardo, Nicholas G.; Cole, Catherine H.; Choong, Catherine S.

    2015-01-01

    Objective & Design. We undertook a retrospective review of children diagnosed with acute lymphoblastic leukemia (ALL) and treated with modern COG protocols (n = 80) to determine longitudinal changes in body mass index (BMI) and the prevalence of obesity compared with a healthy reference population. Results. At diagnosis, the majority of patients (77.5%) were in the healthy weight category. During treatment, increases in BMI z-scores were greater for females than males; the prevalence of obesity increased from 10.3% to 44.8% (P < 0.004) for females but remained relatively unchanged for males (9.8% to 13.7%, P = 0.7). Longitudinal analysis using linear mixed-effects identified associations between BMI z-scores and time-dependent interactions with sex (P = 0.0005), disease risk (P < 0.0001), age (P = 0.0001), and BMI z-score (P < 0.0001) at diagnosis and total dose of steroid during maintenance (P = 0.01). Predicted mean BMI z-scores at the end of therapy were greater for females with standard risk ALL irrespective of age at diagnosis and for males younger than 4 years of age at diagnosis with standard risk ALL. Conclusion. Females treated on standard risk protocols and younger males may be at greatest risk of becoming obese during treatment for ALL. These subgroups may benefit from intervention strategies to manage BMI during treatment for ALL. PMID:26101530

  13. Increased Body Mass Index during Therapy for Childhood Acute Lymphoblastic Leukemia: A Significant and Underestimated Complication.

    PubMed

    Atkinson, Helen C; Marsh, Julie A; Rath, Shoshana R; Kotecha, Rishi S; Gough, Hazel; Taylor, Mandy; Walwyn, Thomas; Gottardo, Nicholas G; Cole, Catherine H; Choong, Catherine S

    2015-01-01

    Objective & Design. We undertook a retrospective review of children diagnosed with acute lymphoblastic leukemia (ALL) and treated with modern COG protocols (n = 80) to determine longitudinal changes in body mass index (BMI) and the prevalence of obesity compared with a healthy reference population. Results. At diagnosis, the majority of patients (77.5%) were in the healthy weight category. During treatment, increases in BMI z-scores were greater for females than males; the prevalence of obesity increased from 10.3% to 44.8% (P < 0.004) for females but remained relatively unchanged for males (9.8% to 13.7%, P = 0.7). Longitudinal analysis using linear mixed-effects identified associations between BMI z-scores and time-dependent interactions with sex (P = 0.0005), disease risk (P < 0.0001), age (P = 0.0001), and BMI z-score (P < 0.0001) at diagnosis and total dose of steroid during maintenance (P = 0.01). Predicted mean BMI z-scores at the end of therapy were greater for females with standard risk ALL irrespective of age at diagnosis and for males younger than 4 years of age at diagnosis with standard risk ALL. Conclusion. Females treated on standard risk protocols and younger males may be at greatest risk of becoming obese during treatment for ALL. These subgroups may benefit from intervention strategies to manage BMI during treatment for ALL. PMID:26101530

  14. Stereotactic body radiation therapy for abdominal oligometastases: a biological and clinical review

    PubMed Central

    2012-01-01

    Advances in imaging and biological targeting have led to the development of stereotactic body radiation therapy (SBRT) as an alternative treatment of extracranial oligometastases. New radiobiological concepts, such as ceramide-induced endothelial apoptosis after hypofractionated high-dose SBRT, and the identification of patients with oligometastatic disease by microRNA expression may yet lead to further developments. Key factors in SBRT are delivery of a high dose per fraction, proper patient positioning, target localisation, and management of breathingrelated motion. Our review addresses the radiation doses and schedules used to treat liver, abdominal lymph node (LN) and adrenal gland oligometastases and treatment outcomes. Reported local control (LC) rates for liver and abdominal LN oligometastases are high (median 2-year actuarial LC: 61 -100% for liver oligometastases; 4-year actuarial LC: 68% in a study of abdominal LN oligometastases). Early toxicity is low-to-moderate; late adverse effects are rare. SBRT of adrenal gland oligometastases shows promising results in the case of isolated lesions. In conclusion, properly conducted SBRT procedures are a safe and effective treatment option for abdominal oligometastases. PMID:22852764

  15. Interinstitutional Variations in Planning for Stereotactic Body Radiation Therapy for Lung Cancer

    SciTech Connect

    Matsuo, Yukinori; Takayama, Kenji; Nagata, Yasushi . E-mail: nag@kuhp.kyoto-u.ac.jp; Kunieda, Etsuo; Tateoka, Kunihiko; Ishizuka, Naoki; Mizowaki, Takashi; Norihisa, Yoshiki; Sakamoto, Masato; Narita, Yuichiro; Ishikura, Satoshi; Hiraoka, Masahiro

    2007-06-01

    Purpose: The aim of this study was to assess interinstitutional variations in planning for stereotactic body radiation therapy (SBRT) for lung cancer before the start of the Japan Clinical Oncology Group (JCOG) 0403 trial. Methods and Materials: Eleven institutions created virtual plans for four cases of solitary lung cancer. The created plans should satisfy the target definitions and the dose constraints for the JCOG 0403 protocol. Results: FOCUS/XiO (CMS) was used in six institutions, Eclipse (Varian) in 3, Cadplan (Varian) in one, and Pinnacle3 (Philips/ADAC) in one. Dose calculation algorithms of Clarkson with effective path length correction and superposition were used in FOCUS/XiO; pencil beam convolution with Batho power law correction was used in Eclipse and Cadplan; and collapsed cone convolution superposition was used in Pinnacle3. For the target volumes, the overall coefficient of variation was 16.6%, and the interinstitutional variations were not significant. For maximal dose, minimal dose, D95, and the homogeneity index of the planning target volume, the interinstitutional variations were significant. The dose calculation algorithm was a significant factor in these variations. No violation of the dose constraints for the protocol was observed. Conclusion: There can be notable interinstitutional variations in planning for SBRT, including both interobserver variations in the estimate of target volumes as well as dose calculation effects related to the use of different dose calculation algorithms.

  16. Culturally Adapted Cognitive Behavioral Therapy for Body Dysmorphic Disorder: Case Examples

    PubMed Central

    Weingarden, Hilary; Marques, Luana; Fang, Angela; LeBlanc, Nicole; Buhlmann, Ulrike; Phillips, Katharine A.; Wilhelm, Sabine

    2014-01-01

    Individuals with Body Dysmorphic Disorder (BDD) have distressing or impairing preoccupations with imagined or slight defects in their appearance (e.g., nose too big). BDD is a severe psychiatric disorder often associated with high rates of suicidality as well as social and occupational impairment (Phillips, Coles et al., 2005). Researchers have only recently begun to investigate psychological treatments for BDD, with available data suggesting that cognitive behavioral therapy (CBT) appears efficacious for BDD (Williams, Hadjistavropoulos, & Sharpe, 2006). To our knowledge, however, there are no reports of whether CBT for BDD can be effectively generalized to ethnic minority and other special populations. The current report suggests specific modifications within the CBT for BDD framework that might improve the effectiveness and retention rates of CBT among ethnic minority patients with BDD. Specifically, the present study describes the cases of Ben*, a 40-year-old, Jewish, married male, and John, a 30-year-old, African American, single male, both with a primary diagnosis of BDD. Various treatment techniques were used to make the course of CBT more culturally responsive. This case report illustrates the challenges and benefits of integrating cultural variables into a CBT framework for BDD, and it highlights the need for more work in this area. PMID:25346783

  17. Stereotactic Body Radiation Therapy for Low- to Intermediate-risk Prostate Adenocarcinoma

    PubMed Central

    2015-01-01

    The aim of the present study was to evaluate the efficacy and toxicity of stereotactic body radiation therapy (SBRT) for low- to intermediate-risk prostate adenocarcinoma. Thirty-nine patients were retrospectively reviewed. The SBRT was delivered using the CyberKnife with the fiducial tracking method combined with In-tempo imaging. The gross target volume, which included the prostate only, was delineated on the fused CT/MRI scans. The prescription dose was delivered every other day as 5 fractions of 7.5 Gy. Venous blood was obtained before and after SBRT to assess the prostate-specific antigen (PSA) level. Toxicity was evaluated using the CTCAE, v4.03. The median follow-up time was 30.0 months. The median initial PSA level was 7.7 ng/mL. PSA levels decreased in all patients treated with SBRT, and after 5 months, the median PSA was less than 2 ng/mL. The rate of overall 3-yr actuarial biochemical failure free survival was 93.9%. Acute side effects were generally comparable with those of previous studies. The PSA change and toxicity after SBRT for low- to intermediate-risk prostate adenocarcinoma indicates favorable biochemical responses and tolerable levels of toxicity. Additionally short course treatment may produce cost benefit and convenience to patients. PMID:26028922

  18. Cognitive-Behavioral Therapy for Youth with Body Dysmorphic Disorder: Current Status and Future Directions

    PubMed Central

    Phillips, Katharine A.; Rogers, Jamison

    2011-01-01

    SYNOPSIS Body dysmorphic disorder (BDD), a distressing or impairing preoccupation with nonexistent or slight defect(s) in appearance, usually begins during early adolescence and appears to be common in youth. BDD is characterized by substantial impairment in psychosocial functioning and markedly high rates of suicidality. Cognitive-behavioral therapy (CBT) tailored to BDDs unique features is the best tested and most promising psychosocial treatment for adults with BDD. CBT has been used for youth with BDD, but it has not been systematically developed for or tested in this age group, and there is a pressing need for this work to be done. This article focuses on CBT for BDD in adults and youth, possible adaptations for youth, and the need for treatment research in youth. We also discuss BDDs prevalence, clinical features, how to diagnose BDD in youth, recommended pharmacotherapy for BDD (serotonin-reuptake inhibitors), and treatments that are not recommended (surgery and other cosmetic treatments). PMID:21440856

  19. Failure Mode and Effect Analysis for Delivery of Lung Stereotactic Body Radiation Therapy

    SciTech Connect

    Perks, Julian R.; Stanic, Sinisa; Stern, Robin L.; Henk, Barbara; Nelson, Marsha S.; Harse, Rick D.; Mathai, Mathew; Purdy, James A.; Valicenti, Richard K.; Siefkin, Allan D.; Chen, Allen M.

    2012-07-15

    Purpose: To improve the quality and safety of our practice of stereotactic body radiation therapy (SBRT), we analyzed the process following the failure mode and effects analysis (FMEA) method. Methods: The FMEA was performed by a multidisciplinary team. For each step in the SBRT delivery process, a potential failure occurrence was derived and three factors were assessed: the probability of each occurrence, the severity if the event occurs, and the probability of detection by the treatment team. A rank of 1 to 10 was assigned to each factor, and then the multiplied ranks yielded the relative risks (risk priority numbers). The failure modes with the highest risk priority numbers were then considered to implement process improvement measures. Results: A total of 28 occurrences were derived, of which nine events scored with significantly high risk priority numbers. The risk priority numbers of the highest ranked events ranged from 20 to 80. These included transcription errors of the stereotactic coordinates and machine failures. Conclusion: Several areas of our SBRT delivery were reconsidered in terms of process improvement, and safety measures, including treatment checklists and a surgical time-out, were added for our practice of gantry-based image-guided SBRT. This study serves as a guide for other users of SBRT to perform FMEA of their own practice.

  20. Mixed quantum/classical theory of rotationally and vibrationally inelastic scattering in space-fixed and body-fixed reference frames

    SciTech Connect

    Semenov, Alexander; Babikov, Dmitri

    2013-11-07

    We formulated the mixed quantum/classical theory for rotationally and vibrationally inelastic scattering process in the diatomic molecule + atom system. Two versions of theory are presented, first in the space-fixed and second in the body-fixed reference frame. First version is easy to derive and the resultant equations of motion are transparent, but the state-to-state transition matrix is complex-valued and dense. Such calculations may be computationally demanding for heavier molecules and/or higher temperatures, when the number of accessible channels becomes large. In contrast, the second version of theory requires some tedious derivations and the final equations of motion are rather complicated (not particularly intuitive). However, the state-to-state transitions are driven by real-valued sparse matrixes of much smaller size. Thus, this formulation is the method of choice from the computational point of view, while the space-fixed formulation can serve as a test of the body-fixed equations of motion, and the code. Rigorous numerical tests were carried out for a model system to ensure that all equations, matrixes, and computer codes in both formulations are correct.

  1. The Study of External Dose Rate and Retained Body Activity of Patients Receiving 131I Therapy for Differentiated Thyroid Carcinoma

    PubMed Central

    Zhang, Haiying; Jiao, Ling; Cui, Songye; Wang, Liang; Tan, Jian; Zhang, Guizhi; He, Yajing; Ruan, Shuzhou; Fan, Saijun; Zhang, Wenyi

    2014-01-01

    Radiation safety is an integral part of targeted radionuclide therapy. The aim of this work was to study the external dose rate and retained body activity as functions of time in differentiated thyroid carcinoma patients receiving 131I therapy. Seventy patients were stratified into two groups: the ablation group (A) and the follow-up group (FU). The patients’ external dose rate was measured, and simultaneously, their retained body radiation activity was monitored at various time points. The equations of the external dose rate and the retained body activity, described as a function of hours post administration, were fitted. Additionally, the release time for patients was calculated. The reduction in activity in the group receiving a second or subsequent treatment was more rapid than the group receiving only the initial treatment. Most important, an expeditious method was established to indirectly evaluate the retained body activity of patients by measuring the external dose rate with a portable radiation survey meter. By this method, the calculated external dose rate limits are 19.2, 8.85, 5.08 and 2.32 μSv·h−1 at 1, 1.5, 2 and 3 m, respectively, according to a patient’s released threshold level of retained body activity <400 MBq. This study is beneficial for radiation safety decision-making. PMID:25337944

  2. The study of external dose rate and retained body activity of patients receiving 131I therapy for differentiated thyroid carcinoma.

    PubMed

    Zhang, Haiying; Jiao, Ling; Cui, Songye; Wang, Liang; Tan, Jian; Zhang, Guizhi; He, Yajing; Ruan, Shuzhou; Fan, Saijun; Zhang, Wenyi

    2014-01-01

    Radiation safety is an integral part of targeted radionuclide therapy. The aim of this work was to study the external dose rate and retained body activity as functions of time in differentiated thyroid carcinoma patients receiving 131I therapy. Seventy patients were stratified into two groups: the ablation group (A) and the follow-up group (FU). The patients' external dose rate was measured, and simultaneously, their retained body radiation activity was monitored at various time points. The equations of the external dose rate and the retained body activity, described as a function of hours post administration, were fitted. Additionally, the release time for patients was calculated. The reduction in activity in the group receiving a second or subsequent treatment was more rapid than the group receiving only the initial treatment. Most important, an expeditious method was established to indirectly evaluate the retained body activity of patients by measuring the external dose rate with a portable radiation survey meter. By this method, the calculated external dose rate limits are 19.2, 8.85, 5.08 and 2.32 μSv·h-1 at 1, 1.5, 2 and 3 m, respectively, according to a patient's released threshold level of retained body activity <400 MBq. This study is beneficial for radiation safety decision-making. PMID:25337944

  3. Feasibility of non-coplanar tomotherapy for lung cancer stereotactic body radiation therapy.

    PubMed

    Yang, Wensha; Jones, Ryan; Lu, Weiguo; Geesey, Constance; Benedict, Stanley; Read, Paul; Larner, James; Sheng, Ke

    2011-08-01

    To quantify the dosimetric gains from non-coplanar helical tomotherapy (HT) arcs for stereotactic body radiation therapy (SBRT) of lung cancer, we created oblique helical arcs by rotating patient's CT images. Ten, 20 and 30 degrees of yaws were introduced in the treatment planning for a patient with a hypothetical lung tumor at the upper, middle and lower portion of the right lung, and the upper and middle left lung. The planning target volume (PTV) was 43 cm(3). 60 Gy was prescribed to the PTV. Dose to organs at risk (OARs), which included the lungs, heart, spinal cord and chest wall, was optimized using a 2.5 cm jaw, 0.287 pitch and modulation factor of 2.5. Composite plans were generated by dose summation of the resultant plans. These plans were evaluated for its conformity index (R(x)) and percentile volume of lung receiving radiation dose of x Gy (V(x)). Conformity index was defined by the ratio of x percent isodose volume and PTV. The results show that combination of non-coplanar arcs reduced R(50) by 4.5%, R(20) by 26% and R(10) by 30% on average. Non-coplanar arcs did not affect V(20) but reduced V(10) and V(5) by 10% and 24% respectively. Composite of the non-coplanar arcs also reduced maximum dose to the spinal cord by 20-39%. Volume of chest wall receiving higher than 30 Gy was reduced by 48% on average. Heart dose reduction was dependent on the location of the PTV and the choice of non-coplanar orientations. Therefore we conclude that non-coplanar HT arcs significantly improve critical organ sparing in lung SBRT without changing the PTV dose coverage. PMID:21728387

  4. Phase 1 Clinical Trial of Stereotactic Body Radiation Therapy Concomitant With Neoadjuvant Chemotherapy for Breast Cancer

    SciTech Connect

    Bondiau, Pierre-Yves; Courdi, Adel; Bahadoran, Phillipe; Chamorey, Emmanuel; Queille-Roussel, Catherine; Lallement, Michel; Birtwisle-Peyrottes, Isabelle; Chapellier, Claire; Pacquelet-Cheli, Sandrine; Ferrero, Jean-Marc

    2013-04-01

    Purpose: Stereotactic body radiation therapy (SBRT) allows stereotactic irradiation of thoracic tumors. It may have a real impact on patients who may not otherwise qualify for breast-conserving surgery. We conducted a phase 1 trial that tested 5 dose levels of SBRT concomitant with neoadjuvant chemotherapy (NACT) before to surgery. The purpose of the current dose escalation study was to determine the maximum tolerable dose of SBRT in the treatment of breast cancer. Methods and Materials: To define toxicity, we performed dermatologic examinations that included clinical examinations by 2 separate physicians and technical evaluations using colorimetry, dermoscopy, and skin ultrasonography. Dermatologic examinations were performed before NACT, 36 and 56 days after the beginning of NACT, and before surgery. Surgery was performed 4 to 8 weeks after the last chemotherapy session. Efficacy, the primary endpoint, was determined by the pathologic complete response (pCR) rate. Results: Maximum tolerable dose was not reached. Only 1 case of dose-limiting toxicity was reported (grade 3 dermatologic toxicity), and SBRT was overall well tolerated. The pCR rate was 36%, with none being observed at the first 2 dose levels, and the highest rate being obtained at dose level 3 (25.5 Gy delivered in 3 fractions). Furthermore, the breast-conserving surgery rate was up to 92% compared with an 8% total mastectomy rate. No surgical complications were reported. Conclusions: This study demonstrates that SBRT can be safely combined with NACT. Regarding the efficacy endpoints, this trial showed promising results in terms of pCR rate (36%) and breast-conserving rate (92%). The findings provide a strong rationale for extending the study into a phase 2 trial. In view of the absence of correlation between dose and pCR, and given that the data from dose level 3 met the statistical requirements, a dose of 25.5 Gy in 3 fractions should be used for the phase 2 trial.

  5. A review of stereotactic body radiotherapy – is volumetric modulated arc therapy the answer?

    SciTech Connect

    Sapkaroski, Daniel Osborne, Catherine; Knight, Kellie A

    2015-06-15

    Stereotactic body radiotherapy (SBRT) is a high precision radiotherapy technique used for the treatment of small to moderate extra-cranial tumours. Early studies utilising SBRT have shown favourable outcomes. However, major disadvantages of static field SBRT include long treatment times and toxicity complications. Volumetric modulated arc therapy (VMAT) and intensity modulated radiotherapy (IMRT) may potentially mitigate these disadvantages. This review aims to assess the feasibility of emerging VMAT and IMRT-based SBRT treatment techniques and qualify which offers the best outcome for patients, whilst identifying any emerging and advantageous SBRT planning trends. A review and synthesis of data from current literature up to September 2013 was conducted on EMBASE, Medline, PubMed, Science Direct, Proquest central, Google Scholar and the Cochrane Database of Systematic reviews. Only full text papers comparing VMAT and or IMRT and or Static SBRT were included. Ten papers were identified that evaluated the results of VMAT/IMRT SBRT. Five related to medically inoperable stage 1 and 2 non-small-cell lung cancer (NSCLC), three to spinal metastasis, one related to abdominal lymph node malignancies, with the final one looking at pancreatic adenocarcinoma. Overall treatment times with VMAT were reduced by 66–70% for lung, 46–58% for spine, 42% and 21% for lymph node and pancreatic metastasis respectively, planning constraints were met with several studies showing improved organs at risk sparing with IMRT/VMAT to static SBRT. Both IMRT and VMAT were able to meet all planning constraints in the studies reviewed, with VMAT offering the greatest treatment efficiency. Early clinical outcomes with VMAT and IMRT SBRT have demonstrated excellent local control and favourable survival outcomes.

  6. Hypothalamic leptin gene therapy reduces body weight without accelerating age-related bone loss.

    PubMed

    Turner, Russell T; Dube, Michael; Branscum, Adam J; Wong, Carmen P; Olson, Dawn A; Zhong, Xiaoying; Kweh, Mercedes F; Larkin, Iske V; Wronski, Thomas J; Rosen, Clifford J; Kalra, Satya P; Iwaniec, Urszula T

    2015-12-01

    Excessive weight gain in adults is associated with a variety of negative health outcomes. Unfortunately, dieting, exercise, and pharmacological interventions have had limited long-term success in weight control and can result in detrimental side effects, including accelerating age-related cancellous bone loss. We investigated the efficacy of using hypothalamic leptin gene therapy as an alternative method for reducing weight in skeletally-mature (9 months old) female rats and determined the impact of leptin-induced weight loss on bone mass, density, and microarchitecture, and serum biomarkers of bone turnover (CTx and osteocalcin). Rats were implanted with cannulae in the 3rd ventricle of the hypothalamus and injected with either recombinant adeno-associated virus encoding the gene for rat leptin (rAAV-Leptin, n=7) or a control vector encoding green fluorescent protein (rAAV-GFP, n=10) and sacrificed 18 weeks later. A baseline control group (n=7) was sacrificed at vector administration. rAAV-Leptin-treated rats lost weight (-42%) while rAAV-GFP-treated rats gained weight (142%) during the study. At study termination, rAAV-Leptin-treated rats weighed 17% less than rAAV-GFP-treated rats and had lower abdominal white adipose tissue weight (-80%), serum leptin (-77%), and serum IGF1 (-34%). Cancellous bone volume fraction in distal femur metaphysis and epiphysis, and in lumbar vertebra tended to be lower (P<0.1) in rAAV-GFP-treated rats (13.5 months old) compared to baseline control rats (9 months old). Significant differences in cancellous bone or biomarkers of bone turnover were not detected between rAAV-Leptin and rAAV-GFP rats. In summary, rAAV-Leptin-treated rats maintained a lower body weight compared to baseline and rAAV-GFP-treated rats with minimal effects on bone mass, density, microarchitecture, or biochemical markers of bone turnover. PMID:26487675

  7. Generalizable Class Solutions for Treatment Planning of Spinal Stereotactic Body Radiation Therapy

    SciTech Connect

    Weksberg, David C.; Palmer, Matthew B.; Vu, Khoi N.; Rebueno, Neal C.; Sharp, Hadley J.; Luo, Dershan; Yang, James N.; Shiu, Almon S.; Rhines, Laurence D.; McAleer, Mary Frances; Brown, Paul D.; Chang, Eric L.

    2012-11-01

    Purpose: Spinal stereotactic body radiation therapy (SBRT) continues to emerge as an effective therapeutic approach to spinal metastases; however, treatment planning and delivery remain resource intensive at many centers, which may hamper efficient implementation in clinical practice. We sought to develop a generalizable class solution approach for spinal SBRT treatment planning that would allow confidence that a given plan provides optimal target coverage, reduce integral dose, and maximize planning efficiency. Methods and Materials: We examined 91 patients treated with spinal SBRT at our institution. Treatment plans were categorized by lesion location, clinical target volume (CTV) configuration, and dose fractionation scheme, and then analyzed to determine the technically achievable dose gradient. A radial cord expansion was subtracted from the CTV to yield a planning CTV (pCTV) construct for plan evaluation. We reviewed the treatment plans with respect to target coverage, dose gradient, integral dose, conformality, and maximum cord dose to select the best plans and develop a set of class solutions. Results: The class solution technique generated plans that maintained target coverage and improved conformality (1.2-fold increase in the 95% van't Riet Conformation Number describing the conformality of a reference dose to the target) while reducing normal tissue integral dose (1.3-fold decrease in the volume receiving 4 Gy (V{sub 4Gy}) and machine output (19% monitor unit (MU) reduction). In trials of planning efficiency, the class solution technique reduced treatment planning time by 30% to 60% and MUs required by {approx}20%: an effect independent of prior planning experience. Conclusions: We have developed a set of class solutions for spinal SBRT that incorporate a pCTV metric for plan evaluation while yielding dosimetrically superior treatment plans with increased planning efficiency. Our technique thus allows for efficient, reproducible, and high-quality spinal SBRT treatment planning.

  8. Acceptable Toxicity After Stereotactic Body Radiation Therapy for Liver Tumors Adjacent to the Central Biliary System

    SciTech Connect

    Eriguchi, Takahisa; Takeda, Atsuya; Sanuki, Naoko; Oku, Yohei; Aoki, Yousuke; Shigematsu, Naoyuki; Kunieda, Etsuo

    2013-03-15

    Purpose: To evaluate biliary toxicity after stereotactic body radiation therapy (SBRT) for liver tumors. Methods and Materials: Among 297 consecutive patients with liver tumors treated with SBRT of 35 to 50 Gy in 5 fractions, patients who were irradiated with >20 Gy to the central biliary system (CBS), including the gallbladder, and had follow-up times >6 months were retrospectively analyzed. Toxicity profiles, such as clinical symptoms and laboratory and radiologic data especially for obstructive jaundice and biliary infection, were investigated in relation to the dose volume and length relationship for each biliary organ. Results: Fifty patients with 55 tumors were irradiated with >20 Gy to the CBS. The median follow-up period was 18.2 months (range, 6.0-80.5 months). In the dose length analysis, 39, 34, 14, and 2 patients were irradiated with >20 Gy, >30 Gy, >40 Gy, and >50 Gy, respectively, to >1 cm of the biliary tract. Seven patients were irradiated with >20 Gy to >20% of the gallbladder. Only 2 patients experienced asymptomatic bile duct stenosis. One patient, metachronously treated twice with SBRT for tumors adjacent to each other, had a transient increase in hepatic and biliary enzymes 12 months after the second treatment. The high-dose area >80 Gy corresponded to the biliary stenosis region. The other patient experienced biliary stenosis 5 months after SBRT and had no laboratory changes. The biliary tract irradiated with >20 Gy was 7 mm and did not correspond to the bile duct stenosis region. No obstructive jaundice or biliary infection was found in any patient. Conclusions: SBRT for liver tumors adjacent to the CBS was feasible with minimal biliary toxicity. Only 1 patient had exceptional radiation-induced bile duct stenosis. For liver tumors adjacent to the CBS without other effective treatment options, SBRT at a dose of 40 Gy in 5 fractions is a safe treatment with regard to biliary toxicity.

  9. Flattening filter-free linac improves treatment delivery efficiency in stereotactic body radiation therapy.

    PubMed

    Prendergast, Brendan M; Fiveash, John B; Popple, Richard A; Clark, Grant M; Thomas, Evan M; Minnich, Douglas J; Jacob, Rojymon; Spencer, Sharon A; Bonner, James A; Dobelbower, Michael C

    2013-01-01

    Stereotactic body radiation therapy (SBRT) employs precision target tracking and image-guidance techniques to deliver ablative doses of radiation to localized malignancies; however, treatment with conventional photon beams requires lengthy treatment and immobilization times. The use of flattening filter-free (FFF) beams operating at higher dose rates can shorten beam-on time, and we hypothesize that it will shorten overall treatment delivery time. A total of 111 lung and liver SBRT cases treated at our institution from July 2008 to July 2011 were reviewed and 99 cases with complete data were identified. Treatment delivery times for cases treated with a FFF linac versus a conventional dose rate linac were compared. The frequency and type of intrafraction image guidance was also collected and compared between groups. Three hundred and ninety-one individual SBRT fractions from 99 treatment plans were examined; 36 plans were treated with a FFF linac. In the FFF cohort, the mean ( standard deviation) treatment time (time elapsed from beam-on until treatment end) and patient's immobilization time (time from first alignment image until treatment end) was 11.44 ( 6.3) and 21.08 ( 6.8) minutes compared to 32.94 ( 14.8) and 47.05 ( 17.6) minutes for the conventional cohort (p < 0.01 for all values). Intrafraction-computed tomography (CT) was used more often in the conventional cohort (84% vs. 25%; p < 0.05), but use of orthogonal X-ray imaging remained the same (16% vs. 19%). For lung and liver SBRT, a FFF linac reduces treatment and immobilization time by more than 50% compared to a conventional linac. In addition, treatment with a FFF linac is associated with less physician-ordered image guidance, which contributes to further improvement in treatment delivery efficiency. PMID:23652246

  10. A review of stereotactic body radiotherapy – is volumetric modulated arc therapy the answer?

    PubMed Central

    Sapkaroski, Daniel; Osborne, Catherine; Knight, Kellie A

    2015-01-01

    Stereotactic body radiotherapy (SBRT) is a high precision radiotherapy technique used for the treatment of small to moderate extra-cranial tumours. Early studies utilising SBRT have shown favourable outcomes. However, major disadvantages of static field SBRT include long treatment times and toxicity complications. Volumetric modulated arc therapy (VMAT) and intensity modulated radiotherapy (IMRT) may potentially mitigate these disadvantages. This review aims to assess the feasibility of emerging VMAT and IMRT-based SBRT treatment techniques and qualify which offers the best outcome for patients, whilst identifying any emerging and advantageous SBRT planning trends. A review and synthesis of data from current literature up to September 2013 was conducted on EMBASE, Medline, PubMed, Science Direct, Proquest central, Google Scholar and the Cochrane Database of Systematic reviews. Only full text papers comparing VMAT and or IMRT and or Static SBRT were included. Ten papers were identified that evaluated the results of VMAT/IMRT SBRT. Five related to medically inoperable stage 1 and 2 non-small-cell lung cancer (NSCLC), three to spinal metastasis, one related to abdominal lymph node malignancies, with the final one looking at pancreatic adenocarcinoma. Overall treatment times with VMAT were reduced by 66–70% for lung, 46–58% for spine, 42% and 21% for lymph node and pancreatic metastasis respectively, planning constraints were met with several studies showing improved organs at risk sparing with IMRT/VMAT to static SBRT. Both IMRT and VMAT were able to meet all planning constraints in the studies reviewed, with VMAT offering the greatest treatment efficiency. Early clinical outcomes with VMAT and IMRT SBRT have demonstrated excellent local control and favourable survival outcomes. PMID:26229679

  11. Novel Technique for Hepatic Fiducial Marker Placement for Stereotactic Body Radiation Therapy

    SciTech Connect

    Jarraya, Hajer; Chalayer, Chloé; Tresch, Emmanuelle; Bonodeau, Francois; Lacornerie, Thomas; Mirabel, Xavier; Boulanger, Thomas; Taieb, Sophie; Kramar, Andrew; Lartigau, Eric; Ceugnart, Luc

    2014-09-01

    Purpose: To report experience with fiducial marker insertion and describe an advantageous, novel technique for fiducial placement in the liver for stereotactic body radiation therapy with respiratory tracking. Methods and Materials: We implanted 1444 fiducials (single: 834; linked: 610) in 328 patients with 424 hepatic lesions. Two methods of implantation were compared: the standard method (631 single fiducials) performed on 153 patients from May 2007 to May 2010, and the cube method (813 fiducials: 610 linked/203 single) applied to 175 patients from April 2010 to March 2013. The standard method involved implanting a single marker at a time. The novel technique entailed implanting 2 pairs of linked markers when possible in a way to occupy the perpendicular edges of a cube containing the tumor inside. Results: Mean duration of the cube method was shorter than the standard method (46 vs 61 minutes; P<.0001). Median numbers of skin and subcapsular entries were significantly smaller with the cube method (2 vs 4, P<.0001, and 2 vs 4, P<.0001, respectively). The rate of overall complications (total, major, and minor) was significantly lower in the cube method group compared with the standard method group (5.7% vs 13.7%; P=.013). Major complications occurred while using single markers only. The success rate was 98.9% for the cube method and 99.3% for the standard method. Conclusions: We propose a new technique of hepatic fiducial implantation that makes use of linked fiducials and involves fewer skin entries and shorter time of implantation. The technique is less complication-prone and is migration-resistant.

  12. Dose Escalated Liver Stereotactic Body Radiation Therapy at the Mean Respiratory Position

    SciTech Connect

    Velec, Michael; Moseley, Joanne L.; Dawson, Laura A.; Brock, Kristy K.

    2014-08-01

    Purpose: The dosimetric impact of dose probability based planning target volume (PTV) margins for liver cancer patients receiving stereotactic body radiation therapy (SBRT) was compared with standard PTV based on the internal target volume (ITV). Plan robustness was evaluated by accumulating the treatment dose to ensure delivery of the intended plan. Methods and Materials: Twenty patients planned on exhale CT for 27 to 50Gy in 6 fractions using an ITV-based PTV and treated free-breathing were retrospectively evaluated. Isotoxic, dose escalated plans were created on midposition computed tomography (CT), representing the mean breathing position, using a dose probability PTV. The delivered doses were accumulated using biomechanical deformable registration of the daily cone beam CT based on liver targeting at the exhale or mean breathing position, for the exhale and midposition CT plans, respectively. Results: The dose probability PTVs were on average 38% smaller than the ITV-based PTV, enabling an averagestandard deviation increase in the planned dose to 95% of the PTV of 4.02.8Gy (95%) on the midposition CT (P<.01). For both plans, the delivered minimum gross tumor volume (GTV) doses were greater than the planned nominal prescribed dose in all 20 patients and greater than the planned dose to 95% of the PTV in 18 (90%) patients. Nine patients (45%) had 1 or more GTVs with a delivered minimum dose more than 5Gy higher with the midposition CT plan using dose probability PTV, compared with the delivered dose with the exhale CT plan using ITV-based PTV. Conclusions: For isotoxic liver SBRT planned and delivered at the mean respiratory, reduced dose probability PTV enables a mean escalation of 4Gy (9%) in 6 fractions over ITV-based PTV. This may potentially improve local control without increasing the risk of tumor underdosing.

  13. Breast Cancer and Menopausal Hormone Therapy by Race/Ethnicity and Body Mass Index.

    PubMed

    Chlebowski, Rowan T; Anderson, Garnet L; Aragaki, Aaron K; Prentice, Ross

    2016-02-01

    In analyses combining estrogen with or without progestin, some observational studies describe minimal breast cancer risk in obese and black women. Therefore, we examined these suggested interactions in the two Women's Health Initiative (WHI) randomized hormone therapy trials. The estrogen plus progestin trial entered 16 608 postmenopausal women with a uterus, while the estrogen trial entered 10 736 postmenopausal women with prior hysterectomy. Hazard ratios (HRs), 95% confidence intervals (CIs), and P values from log-rank x(2) statistics were estimated from Cox proportional hazards models with subgroup analyses based on tests of interaction. All statistical tests were two-sided. Estrogen plus progestin statistically significantly increased breast cancer incidence (HR = 1.28, 95% CI = 1.11 to 1.48, P < .001), with hazard ratios greater than 1 in all body mass index (BMI) subgroups (P interaction = .58) and hazard ratios greater than 1 in black and white women (P interaction = .96). In contrast, estrogen alone statistically significantly decreased breast cancer incidence (HR = 0.79, 95% CI = 0.65 to 0.90, P = .02), with hazard ratios lower than 1 in all BMI subgroups (P interaction = .86) and hazard ratios lower than 1 in black and white women, where analyses with limited numbers suggest somewhat greater reduction in black women (P interaction = .09). In summary, estrogen plus progestin and estrogen alone have opposite effects on breast cancer incidence, with no statistically significant interactions by race/ethnicity or BMI. Therefore, observational studies should not combine these two regimens when examining breast cancer risk. PMID:26546117

  14. Modular Cognitive-Behavioral Therapy for Body Dysmorphic Disorder: A Randomized Controlled Trial

    PubMed Central

    Wilhelm, Sabine; Phillips, Katharine A.; Didie, Elizabeth; Buhlmann, Ulrike; Greenberg, Jennifer L.; Fama, Jeanne M.; Keshaviah, Aparna; Steketee, Gail

    2014-01-01

    There are few effective treatments for body dysmorphic disorder (BDD) and a pressing need to develop such treatments. We examined the feasibility, acceptability, and efficacy of a manualized modular cognitive-behavioral therapy for BDD (CBT-BDD). CBT-BDD utilizes core elements relevant to all BDD patients (e.g., exposure, response prevention, perceptual retraining) and optional modules to address specific symptoms (e.g., surgery seeking). Thirty-six adults with BDD were randomized to 22 sessions of immediate individual CBT-BDD over 24 weeks (n = 17) or to a 12-week waitlist (n = 19). The Yale-Brown Obsessive-Compulsive Scale Modified for BDD (BDD-YBOCS), Brown Assessment of Beliefs Scale, and Beck Depression Inventory-II were completed pre-treatment, monthly, post-treatment, and at 3- and 6-month follow-up. The Sheehan Disability Scale and Client Satisfaction Inventory (CSI) were also administered. Response to treatment was defined as ? 30% reduction in BDD-YBOCS total from baseline. By week 12, 50% of participants receiving immediate CBT-BDD achieved response versus 12% of waitlisted participants (p = 0.026). By post-treatment, 81% of all participants (immediate CBT-BDD plus waitlisted patients subsequently treated with CBT-BDD) met responder criteria. While no significant group differences in BDD symptom reduction emerged by week 12, by post-treatment CBT-BDD resulted in significant decreases in BDD-YBOCS total over time (d = 2.1, p <0.0001), with gains maintained during follow-up. Depression, insight, and disability also significantly improved. Patient satisfaction was high, with a mean CSI score of 87.3% (SD = 12.8%) at post-treatment. CBT-BDD appears to be a feasible, acceptable, and efficacious treatment that warrants more rigorous investigation. PMID:24680228

  15. Probabilities of Radiation Myelopathy Specific to Stereotactic Body Radiation Therapy to Guide Safe Practice

    SciTech Connect

    Sahgal, Arjun; Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON ; Weinberg, Vivian; Ma, Lijun; Chang, Eric; Chao, Sam; Muacevic, Alexander; Gorgulho, Alessandra; Soltys, Scott; Gerszten, Peter C.; Ryu, Sam; Angelov, Lilyana; Gibbs, Iris; Wong, C. Shun; Larson, David A.

    2013-02-01

    Purpose: Dose-volume histogram (DVH) results for 9 cases of post spine stereotactic body radiation therapy (SBRT) radiation myelopathy (RM) are reported and compared with a cohort of 66 spine SBRT patients without RM. Methods and Materials: DVH data were centrally analyzed according to the thecal sac point maximum (Pmax) volume, 0.1- to 1-cc volumes in increments of 0.1 cc, and to the 2 cc volume. 2-Gy biologically equivalent doses (nBED) were calculated using an {alpha}/{beta} = 2 Gy (units = Gy{sub 2/2}). For the 2 cohorts, the nBED means and distributions were compared using the t test and Mann-Whitney test, respectively. Significance (P<.05) was defined as concordance of both tests at each specified volume. A logistic regression model was developed to estimate the probability of RM using the dose distribution for a given volume. Results: Significant differences in both the means and distributions at the Pmax and up to the 0.8-cc volume were observed. Concordant significance was greatest for the Pmax volume. At the Pmax volume the fit of the logistic regression model, summarized by the area under the curve, was 0.87. A risk of RM of 5% or less was observed when limiting the thecal sac Pmax volume doses to 12.4 Gy in a single fraction, 17.0 Gy in 2 fractions, 20.3 Gy in 3 fractions, 23.0 Gy in 4 fractions, and 25.3 Gy in 5 fractions. Conclusion: We report the first logistic regression model yielding estimates for the probability of human RM specific to SBRT.

  16. Dosimetric evaluation of simultaneous integrated boost during stereotactic body radiation therapy for pancreatic cancer.

    PubMed

    Yang, Wensha; Reznik, Robert; Fraass, Benedick A; Nissen, Nicholas; Hendifar, Andrew; Wachsman, Ashley; Sandler, Howard; Tuli, Richard

    2015-01-01

    Stereotactic body radiation therapy (SBRT) provides a promising way to treat locally advanced pancreatic cancer and borderline resectable pancreatic cancer. A simultaneous integrated boost (SIB) to the region of vessel abutment or encasement during SBRT has the potential to downstage otherwise likely positive surgical margins. Despite the potential benefit of using SIB-SBRT, the ability to boost is limited by the local geometry of the organs at risk (OARs), such as stomach, duodenum, and bowel (SDB), relative to tumor. In this study, we have retrospectively replanned 20 patients with 25Gy prescribed to the planning target volume (PTV) and 33~80Gy to the boost target volume (BTV) using an SIB technique for all patients. The number of plans and patients able to satisfy a set of clinically established constraints is analyzed. The ability to boost vessels (within the gross target volume [GTV]) is shown to correlate with the overlap volume (OLV), defined to be the overlap between the GTV + a 1(OLV1)- or 2(OLV2)-cm margin with the union of SDB. Integral dose, boost dose contrast (BDC), biologically effective BDC, tumor control probability for BTV, and normal tissue complication probabilities are used to analyze the dosimetric results. More than 65% of the cases can deliver a boost to 40Gy while satisfying all OAR constraints. An OLV2 of 100cm(3) is identified as the cutoff volume: for cases with OLV2 larger than 100cm(3), it is very unlikely the case could achieve 25Gy to the PTV while successfully meeting all the OAR constraints. PMID:25445989

  17. Vertebral Compression Fracture (VCF) After Spine Stereotactic Body Radiation Therapy (SBRT): Analysis of Predictive Factors

    SciTech Connect

    Cunha, Marcelo V.R.; Al-Omair, Ameen; Atenafu, Eshetu G.; Masucci, Giuseppina Laura; Letourneau, Daniel; Korol, Renee; Yu, Eugene; Howard, Peter; Lochray, Fiona; Costa, Leodante B. da; Fehlings, Michael G.; Sahgal, Arjun; Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario

    2012-11-01

    Purpose: Vertebral compression fractures (VCFs) are increasingly observed after spine stereotactic body radiation therapy (SBRT). The aim of this study was to determine the risk of VCF after spine SBRT and identify clinical and dosimetric factors predictive for VCF. The analysis incorporated the recently described Spinal Instability Neoplastic Score (SINS) criteria. Methods and Materials: The primary endpoint of this study was the development of a de novo VCF (ie, new endplate fracture or collapse deformity) or fracture progression based on an existing fracture at the site of treatment after SBRT. We retrospectively scored 167 spinal segments in 90 patients treated with spine SBRT according to each of the 6 SINS criteria. We also evaluated the presence of paraspinal extension, prior radiation, various dosimetric parameters including dose per fraction ({>=}20 Gy vs <20 Gy), age, and histology. Results: The median follow-up was 7.4 months. We identified 19 fractures (11%): 12 de novo fractures (63%) and 7 cases of fracture progression (37%). The mean time to fracture after SBRT was 3.3 months (range, 0.5-21.6 months). The 1-year fracture-free probability was 87.3%. Multivariate analysis confirmed that alignment (P=.0003), lytic lesions (P=.007), lung (P=.03) and hepatocellular (P<.0001) primary histologies, and dose per fraction of 20 Gy or greater (P=.004) were significant predictors of VCF. Conclusions: The presence of kyphotic/scoliotic deformity and the presence of lytic tumor were the only predictive factors of VCF based on the original 6 SINS criteria. We also report that patients with lung and hepatocellular tumors and treatment with SBRT of 20 Gy or greater in a single fraction are at a higher risk of VCF.

  18. The Use of Gated and 4D CT Imaging in Planning for Stereotactic Body Radiation Therapy

    SciTech Connect

    D'Souza, Warren D. . E-mail: wdsou001@umaryland.edu; Nazareth, Daryl P.; Zhang Bin; Deyoung, Chad; Suntharalingam, Mohan; Kwok, Young; Yu, Cedric X.; Regine, William F.

    2007-07-01

    The localization of treatment targets is of utmost importance for patients receiving stereotactic body radiation therapy (SBRT), where the dose per fraction is large. While both setup or respiration-induced motion components affect the localization of the treatment volume, the purpose of this work is to describe our management of the intrafraction localization uncertainty induced by normal respiration. At our institution, we have implemented gated computed tomography (CT) acquisition with an active breathing control system (ABC), and 4-dimensional (4D) CT using a skin-based marker and retrospective respiration phase-based image sorting. During gated simulation, 3D CT images were acquired corresponding to end-inhalation and end-exhalation. For 4D CT imaging, 3D CT images were acquired corresponding to 8 phases of the respiratory cycle. In addition to gated or 4D CT images, we acquired a conventional free-breathing CT (FB). For both gated and 4D CT images, the target contours were registered to the FB scan in the planning system. These contours were then combined in the FB image set to form the internal target volume (ITV). Dynamic conformal arc treatment plans were generated for the ITV using the FB scan and the gated or 4D scans with an additional 7-mm margin for patient setup uncertainty. We have described our results for a pancreas and a lung tumor case. Plans were normalized so that the PTV received 95% of the prescription dose. The dose distribution for all the critical structures in the pancreas and lung tumor cases resulted in increased sparing when the ITV was defined using gated or 4D CT images than when the FB scan was used. Our results show that patient-specific target definition using gated or 4D CT scans lead to improved normal tissue sparing.

  19. Dosimetric comparison of patient setup strategies in stereotactic body radiation therapy for lung cancer

    SciTech Connect

    Wu Jianzhou; He, Tongming T.; Betzing, Christopher; Fuss, Martin; D'Souza, Warren D.

    2013-05-15

    Purpose: In this work, the authors retrospectively compared the accumulated dose over the treatment course for stereotactic body radiation therapy (SBRT) of lung cancer for three patient setup strategies. Methods: Ten patients who underwent lung SBRT were selected for this study. At each fraction, patients were immobilized using a vacuum cushion and were CT scanned. Treatment plans were performed on the simulation CT. The planning target volume (PTV) was created by adding a 5-mm uniform margin to the internal target volume derived from the 4DCT. All plans were normalized such that 99% of the PTV received 60 Gy. The plan parameters were copied onto the daily CT images for dose recalculation under three setup scenarios: skin marker, bony structure, and soft tissue based alignments. The accumulated dose was calculated by summing the dose at each fraction along the trajectory of a voxel over the treatment course through deformable image registration of each CT with the planning CT. The accumulated doses were analyzed for the comparison of setup accuracy. Results: The tumor volume receiving 60 Gy was 91.7 {+-} 17.9%, 74.1 {+-} 39.1%, and 99.6 {+-} 1.3% for setup using skin marks, bony structures, and soft tissue, respectively. The isodose line covering 100% of the GTV was 55.5 {+-} 7.1, 42.1 {+-} 16.0, and 64.3 {+-} 7.1 Gy, respectively. The corresponding average biologically effective dose of the tumor was 237.3 {+-} 29.4, 207.4 {+-} 61.2, and 258.3 {+-} 17.7 Gy, respectively. The differences in lung biologically effective dose, mean dose, and V20 between the setup scenarios were insignificant. Conclusions: The authors' results suggest that skin marks and bony structure are insufficient for aligning patients in lung SBRT. Soft tissue based alignment is needed to match the prescribed dose delivered to the tumors.

  20. The prevalence and correlates of mind-body therapy practices in patients with acute coronary syndrome

    PubMed Central

    Leung, Yvonne W.; Tamim, Hala; Stewart, Donna E.; Arthur, Heather M.; Grace, Sherry L.

    2010-01-01

    Summary Objectives While the benefits of mind-body therapy (MBT) for cardiac secondary prevention continues to be investigated, the prevalence of such practices by cardiac patients is not well known. The aim of this study was to quantitatively examine the prevalence of MBT practice and its sociodemographic, clinical, psychosocial and behavioral correlates among patients with acute coronary syndrome (ACS). Methods Six hundred and sixty-one ACS in-patients (75% response rate) recruited from three hospitals completed a demographic survey, and clinical data were extracted from charts. Four hundred and sixty five patients (81% retention rate; 110 (23.7%) female) responded to an 18-month post-discharge survey that queried about MBT use and its correlates. Results One hundred and sixty-three (35.1%) ACS patients practised MBT in their lifetime, and 118 (25.4%) were currently practising. MBT users were more often women (OR = 2.98), non-white (OR = 2.17), had higher levels of education (OR = 2.22), past smokers (OR = 3.33), reported poorer mental health (OR =2.15), and engaged in more exercise (OR = 1.65). Conclusion One-third of ACS patients practised some form of MBT. The greater MBT practice among female ACS patients is noteworthy, given their generally lower physical activity and lower receipt of evidence-based treatments including cardiac rehabilitation. In addition, there is some evidence that MBT can promote mental well-being, and thus such practice might reduce risk related to negative affect in cardiac patients. PMID:19186341

  1. Tumor cells but not endothelial cells mediate the eradication of primary sarcomas by stereotactic body radiation therapy#

    PubMed Central

    Moding, Everett J.; Castle, Katherine D.; Perez, Bradford A.; Oh, Patrick; Min, Hooney D.; Norris, Hannah; Ma, Yan; Cardona, Diana M.; Lee, Chang-Lung; Kirsch, David G.

    2015-01-01

    Cancer clinics currently use high-dose stereotactic body radiation therapy as a curative treatment for several kinds of cancers. However, the contribution of vascular endothelial cells to tumor response to radiation remains controversial. Using dual-recombinase technology, we generated primary sarcomas in mice with targeted genetic mutations specifically in tumor cells or endothelial cells. We selectively mutated the proapoptotic gene Bax or the DNA damage–response gene Atm to genetically manipulate the radiosensitivity of endothelial cells in primary soft tissue sarcomas. Bax deletion from endothelial cells did not affect radiation-induced cell death in tumor endothelial cells or sarcoma response to radiation therapy. Although Atm deletion increased endothelial cell death after radiation therapy, deletion of Atm from endothelial cells failed to enhance sarcoma eradication. In contrast, deletion of Atm from tumor cells increased sarcoma eradication by radiation therapy. These results demonstrate that tumor cells, rather than endothelial cells, are critical targets that regulate sarcoma eradication by radiation therapy. Treatment with BEZ235, a small-molecule protein kinase inhibitor, radiosensitized primary sarcomas more than hearts. These results suggest that inhibiting ATM kinase during radiation therapy is a viable strategy for radiosensitization of some tumors. PMID:25761890

  2. [Power of music that moves mind and body--music therapy in the Hansen's disease sanatorium in Japan].

    PubMed

    Fukamizu, Yuu; En, Junichiro; Kano, Tatsuo; Arikawa, Isao

    2009-02-01

    Average age of residents living in National sanatorium Hoshizuka-Keiaien where people have past history of Hansen disease is around 80 years old at present, and many of them spend their whole days in watching TV or sleeping almost alone in their rooms. Therefore music therapy was introduced in order to improve their daily activities in our sanatorium. Singing, listening to music, playing the musical instruments, and dancing were performed, either in a group or individually. Reactivation of their brain function such as recollection, sense of unity and relaxation were expected. Improvement of cardiopulmonary function was also expected. Solidarity and relaxed state were observed by being with the other participants in the group therapy. For example, when using musical instruments, some participants with hesitation tried to use their instruments, and had good performance. They seemed to be satisfied and became confident with the musical instruments. Then their confidence and satisfaction activated the group. After the sessions, mutual conversation increased. These processes obtained a synergy effect, which means that a group affects of individuals at first and next alteration of individual behavior influences the group. We could observe a better effect in their motivation and activity in their daily life in the individual therapy. The music therapy was applied to the senior participants by the music therapist in this study. The participants could easily reinforce their mind and body through this therapy. Music therapy will be continued for the improvement of quality of life of residents in the sanatorium. PMID:19227147

  3. Impact of L-citrulline supplementation and whole-body vibration training on arterial stiffness and leg muscle function in obese postmenopausal women with high blood pressure.

    PubMed

    Figueroa, Arturo; Alvarez-Alvarado, Stacey; Ormsbee, Michael J; Madzima, Takudzwa A; Campbell, Jeremiah C; Wong, Alexei

    2015-03-01

    Aging is associated with increased arterial stiffness (pulse wave velocity, PWV) and muscle strength/mass loss. Exercise training alone is not always effective to improve PWV and lean mass (LM) in older women. To investigate the independent and combined effects of whole-body vibration training (WBVT) and L-citrulline supplementation on PWV and muscle function in women, forty-one postmenopausal women aged 58 3 years and body mass index (34 2 kg/m(2)) were randomly assigned to the following groups: WBVT, L-citrulline, and WBVT + L-citrulline for 8 weeks. WBVT consisted of four leg exercises three times weekly. Aortic (cfPWV) and leg (faPWV) PWV, leg LM index, leg strength, and body fat percentage (BF%) were measured before and after the interventions. WBVT + L-citrulline decreased cfPWV (-0.91 0.21 m/s, P < 0.01) compared to both groups. All interventions decreased faPWV (P < 0.05) similarly. Leg LM index increased (2.7 0.5%, P < 0.001) after WBVT + L-citrulline compared with L-citrulline. Both WBVT interventions increased leg strength (~37%, P < 0.001) compared to L-citrulline while decreased BF% (~2.0%, P < 0.01). Reductions in cfPWV were correlated with increases in leg LM index (r = -0.63, P < 0.05). Our findings suggest that leg muscle strength and arterial stiffness can be improved after WBVT, but its combination with L-citrulline supplementation enhanced benefits on aortic stiffness and leg LM. Therefore, WBVT + L-citrulline could be an intervention for improving arterial stiffness and leg muscle function in obese postmenopausal women with prehypertension or hypertension, thereby reducing their cardiovascular and disability risk. PMID:25636814

  4. [Positron emission tomography and stereotactic body radiation therapy for lung cancer: From treatment planning to response evaluation].

    PubMed

    Bibault, J-E; Oudoux, A; Durand-Labrunie, J; Mirabel, X; Lartigau, ; Kolesnikov-Gauthier, H

    2015-12-01

    Stereotactic body radiation therapy is the standard treatment for inoperable patients with early-stage lung cancer. Local control rates range from 80to 90% 2years after treatment. The role of positron emission tomography in patient selection is well known, but its use for target definition or therapeutic response evaluation is less clear. We reviewed the literature in order to assess the current state of knowledge in this area. PMID:26476702

  5. Vibration manual

    NASA Technical Reports Server (NTRS)

    Green, C.

    1971-01-01

    Guidelines of the methods and applications used in vibration technology at the MSFC are presented. The purpose of the guidelines is to provide a practical tool for coordination and understanding between industry and government groups concerned with vibration of systems and equipments. Topics covered include measuring, reducing, analyzing, and methods for obtaining simulated environments and formulating vibration specifications. Methods for vibration and shock testing, theoretical aspects of data processing, vibration response analysis, and techniques of designing for vibration are also presented.

  6. Spatial and dose–response analysis of fibrotic lung changes after stereotactic body radiation therapy

    SciTech Connect

    Vinogradskiy, Yevegeniy; Diot, Quentin; Kavanagh, Brian; Schefter, Tracey; Gaspar, Laurie; Miften, Moyed

    2013-08-15

    Purpose: Stereotactic body radiation therapy (SBRT) is becoming the standard of care for early stage nonoperable lung cancers. Accurate dose–response modeling is challenging for SBRT because of the decreased number of clinical toxicity events. As a surrogate for a clinical toxicity endpoint, studies have proposed to use radiographic changes in follow up computed tomography (CT) scans to evaluate lung SBRT normal tissue effects. The purpose of the current study was to use local fibrotic lung regions to spatially and dosimetrically evaluate lung changes in patients that underwent SBRT.Methods: Forty seven SBRT patients treated at our institution from 2003 to 2009 were used for the current study. Our patient cohort had a total of 148 follow up CT scans ranging from 3 to 48 months post-therapy. Post-treatment scans were binned into intervals of 3, 6, 12, 18, 24, 30, and 36 months after the completion of treatment. Deformable image registration was used to align the follow up CT scans with the pretreatment CT and dose distribution. Areas of visible fibrotic changes were contoured. The centroid of each gross tumor volume (GTV) and contoured fibrosis volume was calculated and the fibrosis volume location and movement (magnitude and direction) relative to the GTV and 30 Gy isodose centroid were analyzed. To perform a dose–response analysis, each voxel in the fibrosis volume was sorted into 10 Gy dose bins and the average CT number value for each dose bin was calculated. Dose–response curves were generated by plotting the CT number as a function of dose bin and time posttherapy.Results: Both fibrosis and GTV centroids were concentrated in the upper third of the lung. The average radial movement of fibrosis centroids relative to the GTV centroids was 2.6 cm with movement greater than 5 cm occurring in 11% of patients. Evaluating dose–response curves revealed an overall trend of increasing CT number as a function of dose. The authors observed a CT number plateau at doses ranging from 30 to 50 Gy for the 3, 6, and 12 months posttherapy time points. There was no evident plateau for the dose–response curves generated using data from the 18, 24, 30, and 36 months posttherapy time points.Conclusions: Regions of local fibrotic lung changes in patients that underwent SBRT were evaluated spatially and dosimetrically. The authors found that the average fibrosis movement was 2.6 cm with movement greater than 5 cm possible. Evaluating dose–response curves revealed an overall trend of increasing CT number as a function of dose. Furthermore, our dose–response data also suggest that one of the possible explanations of the CT number plateau effect may be the time posttherapy of the acquired data. Understanding normal tissue dose–response is important for reducing toxicity after SBRT, especially in cases where larger tumors are treated. The methods presented in the current work build on prior quantitative studies and further enhance the understanding of normal lung dose–response after SBRT.

  7. Her Body Speaks: The Experience of Dance Therapy for Women Survivors of Child Sexual Abuse.

    ERIC Educational Resources Information Center

    Mills, Letty J.; Daniluk, Judith C.

    2002-01-01

    This qualitative, phenomenological study explores the experiences of dance therapy for 5 women who had been sexually abused as children. Using in-depth, largely unstructured interviews, the women reflect on their dance therapy experiences: and on their perceptions of the role of these experiences in their psychological healing. (Contains 46

  8. Dosimetric effects on small-field beam-modeling for stereotactic body radiation therapy

    NASA Astrophysics Data System (ADS)

    Cho, Woong; Kim, Suzy; Kim, Jung-In; Wu, Hong-Gyun; Jung, Joo-Young; Kim, Min-Joo; Suh, Tae-Suk; Kim, Jin-Young; Kim, Jong Won

    2015-02-01

    The treatment planning of stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) requires high accuracy of dosimetric data for small radiation fields. The dosimetric effects on the beam-modeling process of a treatment planning system (TPS) were investigated using different measured small-field data sets. We performed small-field dosimetry with three detectors: a CC13 ion chamber, a CC01 ion chamber, and an edge detector. Percentage depth doses (PDDs) and dose profiles for field sizes given by 3 × 3 cm2, 2 × 2 cm2, and 1 × 1 cm2 were obtained for 6 MV and 15 MV photon beams. Each measured data set was used as data input for a TPS, in which a beam-modeling process was implemented using the collapsed cone convolution (CCC) algorithm for dose calculation. The measured data were used to generate six beam-models based on each combination of detector type and photon energy, which were then used to calculate the corresponding PDDs and dose profiles for various depths and field sizes. Root mean square differences (RMSDs) between the calculated and the measured doses were evaluated for the PDDs and the dose profiles. The RMSDs of PDDs beyond the maximum dose depth were within an accuracy of 0.2-0.6%, being clinically acceptable. The RMSDs of the dose profiles corresponding to the CC13, the CC01, and the edge detector were 2.80%, 1.49%, and 1.46% for a beam energy of 6 MV and 2.34%, 1.15%, and 1.44% for a beam energy of 15 MV, respectively. The calculated results for the CC13 ion chamber showed the most discrepancy compared to the measured data, due to the relatively large sensitive volume of this detector. However, the calculated dose profiles for the detectors were not significantly different from another. The physical algorithm used in the beam-modeling process did not seem to be sensitive to blurred data measured with detectors with large sensitive volumes. Each beam-model was used to clinically evaluate lung and lymphatic node SBRT plans, yielding almost equal dose distributions for the treatment targets, while the mean doses related to the organs at risk (OARs) deviated by approximately 0.7-1.2%. The use of the measured data sets from different detectors for the beam-modeling process still provided acceptable dose distributions with accuracies within 2%.

  9. Dosimetric effects of rotational offsets in stereotactic body radiation therapy (SBRT) for lung cancer

    SciTech Connect

    Yang, Yun; Catalano, Suzanne; Kelsey, Chris R.; Yoo, David S.; Yin, Fang-Fang; Cai, Jing

    2014-04-01

    To quantitatively evaluate dosimetric effects of rotational offsets in stereotactic body radiation therapy (SBRT) for lung cancer. Overall, 11 lung SBRT patients (8 female and 3 male; mean age: 75.0 years) with medially located tumors were included. Treatment plans with simulated rotational offsets of 1°, 3°, and 5° in roll, yaw, and pitch were generated and compared with the original plans. Both clockwise and counterclockwise rotations were investigated. The following dosimetric metrics were quantitatively evaluated: planning target volume coverage (PTV V{sub 100%}), max PTV dose (PTV D{sub max}), percentage prescription dose to 0.35 cc of cord (cord D{sub 0.35} {sub cc}), percentage prescription dose to 0.35 cc and 5 cc of esophagus (esophagus D{sub 0.35} {sub cc} and D{sub 5} {sub cc}), and volume of the lungs receiving at least 20 Gy (lung V{sub 20}). Statistical significance was tested using Wilcoxon signed rank test at the significance level of 0.05. Overall, small differences were found in all dosimetric matrices at all rotational offsets: 95.6% of differences were < 1% or < 1 Gy. Of all rotational offsets, largest change in PTV V{sub 100%}, PTV D{sub max}, cord D{sub 0.35} {sub cc}, esophagus D{sub 0.35} {sub cc}, esophagus D{sub 5} {sub cc}, and lung V{sub 20} was − 8.36%, − 6.06%, 11.96%, 8.66%, 6.02%, and − 0.69%, respectively. No significant correlation was found between any dosimetric change and tumor-to-cord/esophagus distances (R{sup 2} range: 0 to 0.44). Larger dosimetric changes and intersubject variations were observed at larger rotational offsets. Small dosimetric differences were found owing to rotational offsets up to 5° in lung SBRT for medially located tumors. Larger intersubject variations were observed at larger rotational offsets.

  10. Salvage Stereotactic Body Radiation Therapy (SBRT) for Local Failure After Primary Lung SBRT

    SciTech Connect

    Hearn, Jason W.D. Videtic, Gregory M.M.; Djemil, Toufik; Stephans, Kevin L.

    2014-10-01

    Purpose: Local failure after definitive stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer (NSCLC) is uncommon. We report the safety and efficacy of SBRT for salvage of local failure after previous SBRT with a biologically effective dose (BED) of ≥100 Gy{sub 10}. Methods and Materials: Using an institutional review board–approved lung SBRT registry, we identified all patients initially treated for early-stage NSCLC between August 2004 and January 2012 who received salvage SBRT for isolated local failure. Failure was defined radiographically and confirmed histologically unless contraindicated. All patients were treated on a Novalis/BrainLAB system using ExacTrac for image guidance, and received a BED of ≥100 Gy{sub 10} for each SBRT course. Tumor motion control involved a Bodyfix vacuum system for immobilization along with abdominal compression. Results: Of 436 patients treated from August 2004 through January 2012, we identified 22 patients with isolated local failure, 10 of whom received SBRT for salvage. The median length of follow-up was 13.8 months from salvage SBRT (range 5.3-43.5 months). Median tumor size was 3.4 cm (range 1.7-4.8 cm). Two of the 10 lesions were “central” by proximity to the mediastinum, but were outside the zone of the proximal bronchial tree. Since completing salvage, 3 patients are alive and without evidence of disease. A fourth patient died of medical comorbidities without recurrence 13.0 months after salvage SBRT. Two patients developed distant disease only. Four patients had local failure. Toxicity included grade 1-2 fatigue (3 patients) and grade 1-2 chest wall pain (5 patients). There was no grade 3-5 toxicity. Conclusions: Repeat SBRT with a BED of ≥100 Gy{sub 10} after local failure in patients with early-stage medically inoperable NSCLC was well tolerated in this series and may represent a viable salvage strategy in select patients with peripheral tumors ≤5 cm.

  11. Hormone replacement therapy, body mass index and asthma in perimenopausal women: a cross sectional survey

    PubMed Central

    Real, F Gmez; Svanes, C; Bjrnsson, E H; Franklin, K; Gislason, D; Gislason, T; Gulsvik, A; Janson, C; Jgi, R; Kiserud, T; Norbck, D; Nystrm, L; Torn, K; Wentzel?Larsen, T; Omenaas, E

    2006-01-01

    Background Hormone replacement therapy (HRT) and obesity both appear to increase the risk of asthma. A study was undertaken to investigate the association of HRT with asthma and hay fever in a population of perimenopausal women, focusing on a possible interaction with body mass index (BMI). Methods A postal questionnaire was sent to population based samples in Denmark, Estonia, Iceland, Norway, and Sweden in 19992001, and 8588 women aged 2554?years responded (77%). Pregnant women, women using oral contraceptives, and women <46?years were excluded. Analyses included 2206 women aged 4654?years of which 884 were menopausal and 540 used HRT. Stratified analyses by BMI in tertiles were performed. Results HRT was associated with an increased risk for asthma (OR 1.57 (95% CI 1.07 to 2.30)), wheeze (OR 1.60 (95% CI 1.22 to 2.10)), and hay fever (OR 1.48 (95% CI 1.15 to 1.90)). The associations with asthma and wheeze were significantly stronger among women with BMI in the lower tertile (asthma OR 2.41 (95% CI 1.21 to 4.77); wheeze OR 2.04 (95% CI 1.23 to 3.36)) than in heavier women (asthma: pinteraction?=?0.030; wheeze: pinteraction?=?0.042). Increasing BMI was associated with more asthma (OR 1.08 (95% CI 1.05 to 1.12) per kg/m2). This effect was only found in women not taking HRT (OR 1.10 (95% CI 1.05 to 1.14) per kg/m2); no such association was detected in HRT users (OR 1.00 (95% CI 0.92 to 1.08) per kg/m2) (pinteraction?=?0.046). Menopause was not significantly associated with asthma, wheeze, or hay fever. Conclusions In perimenopausal women there is an interaction between HRT and BMI in the effects on asthma. Lean women who were HRT users had as high a risk for asthma as overweight women not taking HRT. It is suggested that HRT and overweight increase the risk of asthma through partly common pathways. PMID:16244093

  12. Single- versus Multifraction Stereotactic Body Radiation Therapy for Pancreatic Adenocarcinoma: Outcomes and Toxicity

    SciTech Connect

    Pollom, Erqi L.; Alagappan, Muthuraman; Eyben, Rie von; Kunz, Pamela L.; Fisher, George A.; Ford, James A.; Poultsides, George A.; Visser, Brendan C.; Norton, Jeffrey A.; Kamaya, Aya; Cox, Veronica L.; Columbo, Laurie A.; Koong, Albert C.; Chang, Daniel T.

    2014-11-15

    Purpose: We report updated outcomes of single- versus multifraction stereotactic body radiation therapy (SBRT) for unresectable pancreatic adenocarcinoma. Methods and Materials: We included 167 patients with unresectable pancreatic adenocarcinoma treated at our institution from 2002 to 2013, with 1-fraction (45.5% of patient) or 5-fraction (54.5% of patients) SBRT. The majority of patients (87.5%) received chemotherapy. Results: Median follow-up was 7.9 months (range: 0.1-63.6). The 6- and 12-month cumulative incidence rates (CIR) of local recurrence for patients treated with single-fraction SBRT were 5.3% (95% confidence interval [CI], 0.2%-10.4%) and 9.5% (95% CI, 2.7%-16.2%), respectively. The 6- and 12-month CIR with multifraction SBRT were 3.4% (95% CI, 0.0-7.2%) and 11.7% (95% CI, 4.8%-18.6%), respectively. Median survival from diagnosis for all patients was 13.6 months (95% CI, 12.2-15.0 months). The 6- and 12- month survival rates from SBRT for the single-fraction group were 67.0% (95% CI, 57.2%-78.5%) and 30.8% (95% CI, 21.9%-43.6%), respectively. The 6- and 12- month survival rates for the multifraction group were 75.7% (95% CI, 67.2%-85.3%) and 34.9% (95% CI, 26.1%-46.8%), respectively. There were no differences in CIR or survival rates between the single- and multifraction groups. The 6- and 12-month cumulative incidence rates of gastrointestinal toxicity grade ≥3 were 8.1% (95% CI, 1.8%-14.4%) and 12.3% (95% CI, 4.7%-20.0%), respectively, in the single-fraction group, and both were 5.6% (95% CI, 0.8%-10.5%) in the multifraction group. There were significantly fewer instances of toxicity grade ≥2 with multifraction SBRT (P=.005). Local recurrence and toxicity grade ≥2 were independent predictors of worse survival. Conclusions: Multifraction SBRT for pancreatic cancer significantly reduces gastrointestinal toxicity without compromising local control.

  13. Dose-Volume Metrics Associated With Radiation Pneumonitis After Stereotactic Body Radiation Therapy for Lung Cancer

    SciTech Connect

    Matsuo, Yukinori; Shibuya, Keiko; Nakamura, Mitsuhiro; Narabayashi, Masaru; Sakanaka, Katsuyuki; Ueki, Nami; Miyagi, Ken; Norihisa, Yoshiki; Mizowaki, Takashi; Nagata, Yasushi; Hiraoka, Masahiro

    2012-07-15

    Purpose: To identify dose-volume factors associated with radiation pneumonitis (RP) after stereotactic body radiation therapy (SBRT) for lung cancer. Methods and Materials: This study analyzed 74 patients who underwent SBRT for primary lung cancer. The prescribed dose for SBRT was uniformly 48 Gy in four fractions at the isocenter. RP was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v.3. Symptomatic RP was defined as grade 2 or worse. Optimal cut-offs dividing the patient population into two subgroups based on the incidence of symptomatic RP were sought using the following dose-volume metrics: PTV volume (ml), mean lung dose (Gy), and V5, V10, V15, V20, V25, V30, V35, and V40 (%) of both lungs excluding the PTV. Results: With a median follow-up duration of 31.4 months, symptomatic RP was observed in 15 patients (20.3%), including 1 patient with grade 3. Optimal cut-offs for pulmonary dose-volume metrics were V25 and V20. These two factors were highly correlated with each other, and V25 was more significant. Symptomatic RP was observed in 14.8% of the patients with V25 <4.2%, and the rate was 46.2% in the remainder (p = 0.019). PTV volume was another significant factor. The symptomatic RP rate was significantly lower in the group with PTV <37.7 ml compared with the larger PTV group (11.1% vs. 34.5%, p = 0.020). The patients were divided into three subgroups (patients with PTV <37.7 ml; patients with, PTV {>=}37.7 ml and V25 <4.2%; and patients with PTV {>=}37.7 ml and V25 {>=}4.2%); the incidence of RP grade 2 or worse was 11.1%, 23.5%, and 50.0%, respectively (p = 0.013). Conclusions: Lung V25 and PTV volume were significant factors associated with RP after SBRT.

  14. Quantifying Rigid and Nonrigid Motion of Liver Tumors During Stereotactic Body Radiation Therapy

    SciTech Connect

    Xu, Qianyi; Hanna, George; Grimm, Jimm; Kubicek, Gregory; Pahlajani, Niraj; Asbell, Sucha; Fan, Jiajin; Chen, Yan; LaCouture, Tamara

    2014-09-01

    Purpose: To quantify rigid and nonrigid motion of liver tumors using reconstructed 3-dimensional (3D) fiducials from stereo imaging during CyberKnife-based stereotactic body radiation therapy (SBRT). Methods and Materials: Twenty-three liver patients treated with 3 fractions of SBRT were used in this study. After 2 orthogonal kilovoltage images were taken during treatment, the 3D locations of the fiducials were generated by the CyberKnife system and validated using geometric derivations. A total of 4824 pairs of kilovoltage images from start to end of treatment were analyzed. For rigid motion, the rotational angles and translational shifts were reported by aligning 3D fiducial groups from different image pairs, using least-squares fitting. For nonrigid motion, we quantified interfractional tumor volume variations by using the proportional volume derived from the fiducials, which correlates to the sum of interfiducial distances. The individual fiducial displacements were also reported (1) after rigid corrections and (2) without angle corrections. Results: The proportional volume derived by the fiducials demonstrated a volume-increasing trend in the second (101.9% ± 3.6%) and third (101.0 ± 5.9%) fractions among most patients, possibly due to radiation-induced edema. For all patients, the translational shifts in left-right, anteroposterior, and superoinferior directions were 2.1 ± 2.3 mm, 2.9 ± 2.8 mm, and 6.4 ± 5.5 mm, respectively. The greatest translational shifts occurred in the superoinferior direction, likely due to respiratory motion from the diaphragm. The rotational angles in roll, pitch, and yaw were 1.2° ± 1.8°, 1.8° ± 2.4°, and 1.7° ± 2.1°, respectively. The 3D individual fiducial displacements with rigid corrections were 0.2 ± 0.2 mm and increased to 0.5 ± 0.4 mm without rotational corrections. Conclusions: Accurate 3D locations of internal fiducials can be reconstructed from stereo imaging during treatment. As an effective surrogate to tumor motion, fiducials provide a close estimation of both rigid and nonrigid motion of liver tumors. The reported displacements could be further utilized for tumor margin definition and motion management in conventional linear accelerator–based liver SBRT.

  15. Stereotactic Body Radiation Therapy for Oligometastases to the Lung: A Phase 2 Study

    SciTech Connect

    Nuyttens, Joost J.; Voort van Zyp, Noëlle C.M.G. van der; Verhoef, Cornelis; Maat, A.; Klaveren, Robertus J. van; Holt, Bronno van der; Aerts, Joachim; Hoogeman, Mischa

    2015-02-01

    Purpose: To assess, in a phase 2 study, the efficacy and toxicity of stereotactic body radiation therapy for oligometastases to the lung in inoperable patients. Methods and Materials: Patients with lung metastases were included in this study if (1) the primary tumor was controlled; (2) patients were ineligible for or refused surgery and chemotherapy; and (3) patients had 5 or fewer metastatic lesions in no more than 2 organs. Large peripheral tumors were treated with a dose of 60 Gy (3 fractions), small peripheral tumors with 30 Gy (1 fraction), central tumors received 60 Gy (5 fractions), and mediastinal tumors or tumors close to the esophagus received 56 Gy (7 fractions). Results: Thirty patients with 57 metastatic lung tumors from various primary cancers were analyzed. The median follow-up was 36 months (range, 4-60 months). At 2 years, local control for the 11 central tumors was 100%, for the 23 peripheral tumors treated to 60 Gy it was 91%, and for the 23 tumors treated in a single 30-Gy fraction it was 74% (P=.13). This resulted in an overall local control rate at 1 year of 79%, with a 2-sided 80% confidence interval of 67% to 87%. Because the hypothesized value of 70% lies within the confidence interval, we cannot reject the hypothesis that the true local control rate at 1 year is ≤70%, and therefore we did not achieve the goal of the study: an actuarial local control of the treated lung lesions at 1 year of 90%. The 4-year overall survival rate was 38%. Grade 3 acute toxicity occurred in 5 patients. Three patients complained of chronic grade 3 toxicity, including pain, fatigue, and pneumonitis, and 3 patients had rib fractures. Conclusions: The local control was promising, and the 4-year overall survival rate was 38%. The treatment was well tolerated, even for central lesions.

  16. High-dose MVCT image guidance for stereotactic body radiation therapy

    SciTech Connect

    Westerly, David C.; Schefter, Tracey E.; Kavanagh, Brian D.; Chao, Edward; Lucas, Dan; Flynn, Ryan T.; Miften, Moyed

    2012-08-15

    Purpose: Stereotactic body radiation therapy (SBRT) is a potent treatment for early stage primary and limited metastatic disease. Accurate tumor localization is essential to administer SBRT safely and effectively. Tomotherapy combines helical IMRT with onboard megavoltage CT (MVCT) imaging and is well suited for SBRT; however, MVCT results in reduced soft tissue contrast and increased image noise compared with kilovoltage CT. The goal of this work was to investigate the use of increased imaging doses on a clinical tomotherapy machine to improve image quality for SBRT image guidance. Methods: Two nonstandard, high-dose imaging modes were created on a tomotherapy machine by increasing the linear accelerator (LINAC) pulse rate from the nominal setting of 80 Hz, to 160 Hz and 300 Hz, respectively. Weighted CT dose indexes (wCTDIs) were measured for the standard, medium, and high-dose modes in a 30 cm solid water phantom using a calibrated A1SL ion chamber. Image quality was assessed from scans of a customized image quality phantom. Metrics evaluated include: contrast-to-noise ratios (CNRs), high-contrast spatial resolution, image uniformity, and percent image noise. In addition, two patients receiving SBRT were localized using high-dose MVCT scans. Raw detector data collected after each scan were used to reconstruct standard-dose images for comparison. Results: MVCT scans acquired using a pitch of 1.0 resulted in wCTDI values of 2.2, 4.7, and 8.5 cGy for the standard, medium, and high-dose modes respectively. CNR values for both low and high-contrast materials were found to increase with the square root of dose. Axial high-contrast spatial resolution was comparable for all imaging modes at 0.5 lp/mm. Image uniformity was improved and percent noise decreased as the imaging dose increased. Similar improvements in image quality were observed in patient images, with decreases in image noise being the most notable. Conclusions: High-dose imaging modes are made possible on a clinical tomotherapy machine by increasing the LINAC pulse rate. Increasing the imaging dose results in increased CNRs; making it easier to distinguish the boundaries of low contrast objects. The imaging dose levels observed in this work are considered acceptable at our institution for SBRT treatments delivered in 3-5 fractions.

  17. Reproducibility of Tumor Motion Probability Distribution Function in Stereotactic Body Radiation Therapy of Lung Cancer

    SciTech Connect

    Zhang Fan; Medical Physics Graduate Program, Duke University, Durham, North Carolina ; Hu Jing; Kelsey, Chris R.; Yoo, David; Yin Fangfang; Medical Physics Graduate Program, Duke University, Durham, North Carolina ; Cai Jing

    2012-11-01

    Purpose: To evaluate the reproducibility of tumor motion probability distribution function (PDF) in stereotactic body radiation therapy (SBRT) of lung cancer using cine megavoltage (MV) images. Methods and Materials: Cine MV images of 20 patients acquired during three-dimensional conformal (6-11 beams) SBRT treatments were retrospectively analyzed to extract tumor motion trajectories. For each patient, tumor motion PDFs were generated per fraction (PDF{sub n}) using three selected 'usable' beams. Patients without at least three usable beams were excluded from the study. Fractional PDF reproducibility (R{sub n}) was calculated as the Dice similarity coefficient between PDF{sub n} to a 'ground-truth' PDF (PDF{sub g}), which was generated using the selected beams of all fractions. The mean of R{sub n}, labeled as R{sub m}, was calculated for each patient and correlated to the patient's mean tumor motion rang (A{sub m}). Change of R{sub m} during the course of SBRT treatments was also evaluated. Intra- and intersubject coefficient of variation (CV) of R{sub m} and A{sub m} were determined. Results: Thirteen patients had at least three usable beams and were analyzed. The mean of R{sub m} was 0.87 (range, 0.84-0.95). The mean of A{sub m} was 3.18 mm (range, 0.46-7.80 mm). R{sub m} was found to decrease as A{sub m} increases following an equation of R{sub m} = 0.17e{sup -0.9Am} + 0.84. R{sub m} also decreased slightly throughout the course of treatments. Intersubject CV of R{sub m} (0.05) was comparable to intrasubject CV of R{sub m} (range, 0.02-0.09); intersubject CV of A{sub m} (0.73) was significantly greater than intrasubject CV of A{sub m} (range, 0.09-0.24). Conclusions: Tumor motion PDF can be determined using cine MV images acquired during the treatments. The reproducibility of lung tumor motion PDF decreased exponentially as the tumor motion range increased and decreased slightly throughout the course of the treatments.

  18. Effects of bioDensity Training and Power Plate Whole-Body Vibration on Strength, Balance, and Functional Independence in Older Adults.

    PubMed

    Smith, Derek T; Judge, Stacey; Malone, Ashley; Moynes, Rebecca C; Conviser, Jason; Skinner, James S

    2016-01-01

    Reduced strength, balance, and functional independence diminish quality of life and increase health care costs. Sixty adults (82.2 4.9 years) were randomized to a control or three 12-week intervention groups: bioDensity (bD); Power Plate (PP) whole-body vibration (WBV); or bD+PP. bD involved one weekly 5-s maximal contraction of four muscle groups. PP involved two 5-min WBV sessions. Primary outcomes were strength, balance, and Functional Independence Measure (FIM). No groups differed initially. Strength significantly increased 22-51% for three muscle groups in bD and bD+PP (P < .001), with no changes in control and PP. Balance significantly improved in PP and bD+PP but not in control or bD. bD, PP, and bD+PP differentially improved FIM self-care and mobility. Strength improvements from weekly 5-min sessions of bD may impart health/clinical benefits. Balance and leg strength improvements suggest WBV beneficially impacts fall risk and incidence. Improved FIM scores are encouraging and justify larger controlled trials on bD and bD+PP efficacy. PMID:26215362

  19. Effect of combining passive muscle stretching and whole body vibration on spasticity and physical performance of children and adolescents with cerebral palsy

    PubMed Central

    Tupimai, Teeraporn; Peungsuwan, Punnee; Prasertnoo, Jitlada; Yamauchi, Juinichiro

    2016-01-01

    [Purpose] This study evaluated the immediate and short-term effects of a combination of prolonged passive muscle stretching (PMS) and whole body vibration (WBV) on the spasticity, strength and balance of children and adolescents with cerebral palsy. [Subjects and Methods] A randomized two-period crossover trial was designed. Twelve subjects with cerebral palsy aged 10.6 ± 2.4 years received both PMS alone as a control group (CG) and a combination of PMS and WBV as an experimental group (EG). After random allocation to the trial schedules of either EG-CG or CG-EG, CG received prolonged PMS while standing on a tilt-table for 40 minutes/day, and EG received prolonged PMS for 30 minutes, followed by 10 minutes WBV. Both CG and EG received the treatment 5 days/week for 6 weeks. [Results] Immediately after one treatment, EG resulted in better improvement in scores on the Modified Ashworth Scale than CG. After the 6-week intervention, EG also showed significantly decreased scores on the Modified Ashworth Scale compared to CG. Both CG and EG showed significantly reduced the performance times in the five times sit to stand test, and EG also showed significantly increased scores on the pediatric balance scale. [Conclusion] This study showed that 6 weeks of combined prolonged PMS and WBV had beneficial effects on the spasticity, muscle strength and balance of children and adolescents with CP. PMID:26957720

  20. Effects of an eight-week whole body vibration on lower extremity muscle tone and function in children with cerebral palsy.

    PubMed

    Cheng, Hsin-Yi Kathy; Yu, Yu-Chun; Wong, Alice May-Kuen; Tsai, Yung-Shen; Ju, Yan-Ying

    2015-03-01

    The aim of this study was to evaluate the effect of an eight-week whole body vibration (WBV) on lower extremity spasticity and ambulatory function in children with cerebral palsy with a complete crossover design. Sixteen participants aged 9.2 (2.1) years participated in this study. Half of the participants received a 10-min WBV, 3 times a week for 8 weeks. Then a 4-week washout period followed, after which they received a sham WBV 3 times a week for 8 weeks. The other half received the intervention in a reversed order. The participants were evaluated via variables measuring range-of-motion, muscle tone, and ambulatory function before, immediately after, 1 day after, and 3 days after each intervention. Repeated-measures analyses revealed significant beneficial effects on most variables expect the passive range-of-motion measurement. Significant correlations were found between timed up-and-go and relaxation index, and between timed up-and-go and six-minute walk test. The results suggested that an 8-week WBV intervention normalized muscle tone, improved active joint range and enhanced ambulatory performance in children with cerebral palsy for at least 3 days. These indicated that regular WBV can serve as an alternative, safe, and efficient treatment for these children in both clinical and home settings. PMID:25575288

  1. Measurements of the equivalent whole-body dose during radiation therapy by cytogenetic methods

    NASA Astrophysics Data System (ADS)

    Durante, Marco; Yamada, Shigeru; Ando, Koichi; Furusawa, Yoshiya; Kawata, Tetsuya; Majima, Hideyuki; Nakano, Takashi; Tsujii, Hirohiko

    1999-05-01

    Estimates of equivalent whole-body dose following partial body exposure can be performed using different biophysical models. Calculations should be compared with biodosimetry data, but measurements are complicated by mitotic selection induced in target cells after localized irradiation. In this paper we measured chromosomal aberrations in peripheral blood lymphocytes during radiotherapy, and estimated the equivalent whole-body dose absorbed, by using the novel technique of interphase chromosome painting. Premature chromosome condensation was induced in stimulated lymphocytes by incubation in calyculin A, and slides were hybridized in situ with whole-chromosome DNA probes specific for human chromosomes 2 and 4. Reciprocal exchanges were used to estimate the equivalent whole-body dose, based on individual pre-treatment in vitro calibration curves. Equivalent whole-body dose increased as a function of the number of fractions, and reached a plateau at high fraction numbers. Chromosomal aberration yields were dependent on field size, tumour position and concurrent chemotherapy. Results suggest that interphase chromosome painting is a simple technique able to give a reliable estimate of the equivalent whole-body dose absorbed during therapeutic partial-body irradiation.

  2. Six-Dimensional Correction of Intra-Fractional Prostate Motion with CyberKnife Stereotactic Body Radiation Therapy

    PubMed Central

    Lei, Siyuan; Piel, Nathaniel; Oermann, Eric K.; Chen, Viola; Ju, Andrew W.; Dahal, Kedar N.; Hanscom, Heather N.; Kim, Joy S.; Yu, Xia; Zhang, Guowei; Collins, Brian T.; Jha, Reena; Dritschilo, Anatoly; Suy, Simeng; Collins, Sean P.

    2011-01-01

    Large fraction radiation therapy offers a shorter course of treatment and radiobiological advantages for prostate cancer treatment. The CyberKnife is an attractive technology for delivering large fraction doses based on the ability to deliver highly conformal radiation therapy to moving targets. In addition to intra-fractional translational motion (leftright, superiorinferior, and anteriorposterior), prostate rotation (pitch, roll, and yaw) can increase geographical miss risk. We describe our experience with six-dimensional (6D) intra-fraction prostate motion correction using CyberKnife stereotactic body radiation therapy (SBRT). Eighty-eight patients were treated by SBRT alone or with supplemental external radiation therapy. Trans-perineal placement of four gold fiducials within the prostate accommodated X-ray guided prostate localization and beam adjustment. Fiducial separation and non-overlapping positioning permitted the orthogonal imaging required for 6D tracking. Fiducial placement accuracy was assessed using the CyberKnife fiducial extraction algorithm. Acute toxicities were assessed using Common Toxicity Criteria v3. There were no Grade 3, or higher, complications and acute morbidity was minimal. Ninety-eight percent of patients completed treatment employing 6D prostate motion tracking with intra-fractional beam correction. Suboptimal fiducial placement limited treatment to 3D tracking in two patients. Our experience may guide others in performing 6D correction of prostate motion with CyberKnife SBRT. PMID:22655248

  3. Mechanical Ventilation Weaning in Inclusion Body Myositis: Feasibility of Isokinetic Inspiratory Muscle Training as an Adjunct Therapy

    PubMed Central

    Campos, Josu Felipe; Daher, Leandro Possidente; Ventura, Alex; do Prado, Pollyana Zamborlini; Brasil, Daniele; Mendona, Debora; Lugon, Jocemir Ronaldo

    2014-01-01

    Inclusion body myositis is a rare myopathy associated with a high rate of respiratory complications. This condition usually requires prolonged mechanical ventilation and prolonged intensive care stay. The unsuccessful weaning is mainly related to respiratory muscle weakness that does not promptly respond to immunosuppressive therapy. We are reporting a case of a patient in whom the use of an inspiratory muscle-training program which started after a two-week period of mechanical ventilation was associated with a successful weaning in one week and hospital discharge after 2 subsequent weeks. PMID:25147743

  4. Systematic measurements of whole-body dose distributions for various treatment machines and delivery techniques in radiation therapy

    SciTech Connect

    Haelg, Roger A.; Besserer, Juergen; Schneider, Uwe

    2012-12-15

    Purpose: Contemporary radiotherapy treatment techniques, such as intensity-modulated radiation therapy and volumetric modulated arc therapy, could increase the radiation-induced malignancies because of the increased beam-on time, i.e., number of monitor units needed to deliver the same dose to the target and the larger volume irradiated with low doses. In this study, whole-body dose distributions from typical radiotherapy patient plans using different treatment techniques and therapy machines were measured using the same measurement setup and irradiation intention. Methods: Individually calibrated thermoluminescent dosimeters were used to measure absorbed dose in an anthropomorphic phantom at 184 locations. The dose distributions from 6 MV beams were compared in terms of treatment technique (3D-conformal, intensity-modulated radiation therapy, volumetric modulated arc therapy, helical TomoTherapy, stereotactic radiotherapy, hard wedges, and flattening filter-free radiotherapy) and therapy machine (Elekta, Siemens and Varian linear accelerators, Accuray CyberKnife and TomoTherapy). Results: Close to the target, the doses from intensity-modulated treatments (including flattening filter-free) were below the dose from a static treatment plan, whereas the CyberKnife showed a larger dose by a factor of two. Far away from the treatment field, the dose from intensity-modulated treatments showed an increase in dose from stray radiation of about 50% compared to the 3D-conformal treatment. For the flattening filter-free photon beams, the dose from stray radiation far away from the target was slightly lower than the dose from a static treatment. The CyberKnife irradiation and the treatment using hard wedges increased the dose from stray radiation by nearly a factor of three compared to the 3D-conformal treatment. Conclusions: This study showed that the dose outside of the treated volume is influenced by several sources. Therefore, when comparing different treatment techniques, the dose ratios vary with distance to the isocenter. The effective dose outside the treated volume of intensity-modulated treatments with or without flattening filter was 10%-30% larger when compared to 3D-conformal radiotherapy. This dose increase is much lower than the monitor unit scaled effective dose from a static treatment.

  5. Importance of sleep stage- and body position-dependence of sleep apnoea in determining benefits to auto-CPAP therapy.

    PubMed

    Sériès, F; Marc, I

    2001-07-01

    The influence of sleep stage- and body position-dependence of sleep apnoea on treatment efficacy and compliance between conventional continuous positive airway pressure (CPAP) and auto CPAP therapy was evaluated. Thirty-three newly treated sleep apnoea hypopnoea syndrome (SAHS) patients were randomly allocated to conventional or auto-CPAP therapy. Six patients of each treatment group were classified as having sleep stage- and body position-dependent obstructive breathing abnormalities according to the results of the baseline sleep study. After 3 weeks of treatment, the Epworth sleepiness score tended to be higher (p = 0.08) and the ability to stay awake lower (p = 0.02) in patients with dependent breathing abnormalities treated with fixed CPAP, than in the other patients. The effective pressure/time index was significantly lower in sleep stage- and body position-dependent patients treated with fixed CPAP, than in the other patients (p = 0.02). The number of hours the machine was turned on and a positive pressure applied, tended to be smaller in dependent patients treated with fixed CPAP than in independent patients of this treatment group and in patients treated with auto-CPAP. A night-to-night variability index (VI) of positive pressure changes was obtained in the auto-CPAP group. This index significantly decreased with time in the dependent patients while it remained unchanged in the independent group. It is concluded that auto-continuous positive airway pressure may have specific indications in a subset of obstructive sleep apnoea patients with sleep stage- and body position dependent nocturnal breathing abnormalities. PMID:11510790

  6. Mild Increases in Body Temperature Could Improve Anticancer Therapy | Physical Sciences in Oncology

    Cancer.gov

    One of the consistent characteristics of human solid tumors is that they exert a significant outward pressure that inhibits the ability of drugs to reach the inner recesses of the tumor. Most solid tumors are also hypoxic, that is, the oxygen concentration deep inside tumors is much lower than is normal in human tissues, and this hypoxia also works against many anticancer therapies.

  7. Whole-Body Vibration as a Modality for the Rehabilitation of Peripheral Neuropathies: Implications for Cancer Survivors Suffering from Chemotherapy-Induced Peripheral Neuropathy

    PubMed Central

    Savelberg, Hans H.C.M.; Vreugdenhil, Gerard; Mischi, Massimo; Schep, Goof

    2015-01-01

    The objective was to study the effect of whole-body vibration (WBV) on strength, balance and pain in patients with peripheral neuropathies and to consider its significance for the rehabilitation of patients suffering from chemotherapy-induced peripheral neuropathy (CIPN). Using a broad search strategy, PubMed was searched for clinical trials on WBV interventions aimed at improving strength, balance or pain in patients with peripheral neuropathies, which were published in English until 5th June 2014. The search was performed by the first author and generated a total of 505 results, which yielded 5 articles that met the inclusion criteria, being studies: i) published in English; ii) involving adult human subjects peripheral neuropathies; iii) evaluating the effect of WBV as a therapeutic intervention; and iv) reporting findings for at least one of the following outcomes: strength, balance or pain. Methodological quality of included studies was assessed independently by first and second author, using the physiotherapy evidence database scale. The overall methodological quality of included studies was low. Two studies found a beneficial effect of WBV on neuropathic pain, but another study failed to find the same effect. One study found significant improvements in both muscle strength and balance, while another study found improvements only in some, but not all, of the applied tests to measure muscle strength and balance. The results of this literature search suggest insufficient evidence to assess the effectiveness for the effects of WBV on neuropathic pain, muscle strength and balance in patients with peripheral neuropathies. More high-quality trials are needed to guide the optimization of rehabilitation programs for cancer survivors with CIPN in particular. PMID:26779309

  8. The effects of passive warm-up vs. whole-body vibration on high-intensity performance during sprint cycle exercise.

    PubMed

    Avelar, Nbia C P; Costa, Sidney J; da Fonseca, Sueli F; Tossige-Gomes, Rosalina; Gripp, Fernando J; Coimbra, Cndido C; Lacerda, Ana C R

    2012-11-01

    The purpose of this study was to compare the effects of passive warm-up (PW), whole-body vibration (WBV), and control (C) on high-intensity performance during sprint cycle exercise. Six recreationally trained men performed a 30-second sprint cycle test after the 3 aforementioned conditions; each test was carried out on a different day after balanced-order experimental tests. The WBV consisted of 5 minutes of squats associated with WBV (45 Hz, 2 mm). The PW consisted of 30 minutes of PW using a thermal blanket on the thighs and legs (35 W). The C consisted of 30 minutes of no warm-up with the subject lying down. Motor neuron excitability from the vastus lateralis muscle, evaluated by electromyography (EMG), was determined before exercise at rest and during sprint cycle exercise. Blood lactate levels (BLs), evaluated by spectroscopy, and muscle temperature (MT) of the thigh, estimated indirectly by measuring skin temperature, were determined at following time points: before exercise at rest (before and after experimental conditions), immediately, and 3 minutes after the 30-second sprint cycle test. Peak power, relative power, relative work, time of peak power, and pedaling cadence were significantly higher in the WBV compared with that for C (p < 0.05). Although MT was significantly greater in PW compared with that in WBV and C before exercise (p < 0.01), no significant differences were observed between the experimental conditions for BL immediately after sprint cycle exercise (p = 0.35) and in EMG during sprint cycle exercise (p = 0.16). Thus, it is plausible to suggest WBV as a method for an acute increase in high-intensity performance during sprint cycle exercise for athletes immediately before competition or training. PMID:22293678

  9. Whole-body vibration and resistance exercise prevent long-term hindlimb unloading-induced bone loss: independent and interactive effects.

    PubMed

    Li, Zhili; Tan, Cheng; Wu, Yonghua; Ding, Ye; Wang, Huijuan; Chen, Wenjuan; Zhu, Yu; Ma, Honglei; Yang, Honghui; Liang, Wenbin; Jiang, Shizhong; Wang, Desheng; Wang, Linjie; Tang, Guohua; Wang, Jun

    2012-11-01

    Skeletal unloading induced by disuse or immobilization causes a decrease in bone mass and strength. We investigated the relationship between whole-body vibration (WBV) and resistance exercise (RE) in preventing bone loss induced by 8-week hindlimb unloading in young male rats. Sixty male Wistar rats were assigned randomly to 6 groups: age-matched control group (CON, n=10), hindlimb unloading group (HU, n=10), hindlimb unloading+standing group (HU+ST, n=10), hindlimb unloading+WBV group (HU+WBV, n=10), hindlimb unloading+RE group (HU+RE, n=10) and hindlimb unloading+WBV+RE group (HU+WBV+RE, n=10). After 8-week hindlimb unloading, micro-CT scanning and three-point bending test were performed in the femur. Sera were collected for analysis of bone formation and resorption markers. Compared with HU group, WBV, RE and the combination of WBV and RE (WBV+RE) significantly improved (P<0.01) one repetition maximum (1RM) (expressed as the percentage change from baseline, HU: -23%, HU+WBV: 21%, HU+RE: 48%, HU+WBV+RE: 51%), and maintained (P<0.05) cancellous volumetric bone mineral density (vBMD) and trabecular structure. No difference of cortical vBMD was found among all groups (P>0.05). WBV had no effects on biomechanical properties of the femur diaphysis (P>0.05). RE and WBV+RE significantly increased maximum load and cross-sectional moment of inertia of the femur diaphysis in hindlimb unloading rats (P<0.05). There was an interaction between WBV and RE in improving cancellous bone. These results demonstrate that WBV and RE interactively maintain cancellous structure and vBMD, and independently partially mitigate the reduction of bone strength in long-term hindlimb unloading rats. PMID:22371114

  10. Influence of Whole-Body Vibration Training Without Visual Feedback on Balance and Lower-Extremity Muscle Strength of the Elderly: A Randomized Controlled Trial.

    PubMed

    Tseng, Shiuan-Yu; Lai, Chung-Liang; Chang, Kai-Ling; Hsu, Pi-Shan; Lee, Meng-Chih; Wang, Chun-Hou

    2016-02-01

    The purpose of this study was to investigate the influence of whole-body vibration (WBV) training without visual feedback on balance and lower-extremity muscle strength in the elderly.Elderly subjects who did not exercise regularly participated in this study. Subjects were randomly divided into a WBV with eyes open group, a visual feedback-deprived plus WBV (VFDWBV) group, and a control group (0?Hz, eyes open). WBV training was provided over a 3-month period, 3 times per week for 5 min each session. Balance performance was measured with the limits of stability test, and muscle strength was measured with an isokinetic dynamometer.A total of 45 elderly subjects with an average age of 69.22??3.97 years, divided into a WBV group (n?=?14), a VFDWBV group (n?=?17), and a control group (n?=?14), completed the trial. Statistically significant differences were found in the balance performance of the 3 groups at different time points (time group interaction: F?=?13.213, P?

  11. Systematic measurements of whole-body imaging dose distributions in image-guided radiation therapy

    SciTech Connect

    Haelg, Roger A.; Besserer, Juergen; Schneider, Uwe

    2012-12-15

    Purpose: The full benefit of the increased precision of contemporary treatment techniques can only be exploited if the accuracy of the patient positioning is guaranteed. Therefore, more and more imaging modalities are used in the process of the patient setup in clinical routine of radiation therapy. The improved accuracy in patient positioning, however, results in additional dose contributions to the integral patient dose. To quantify this, absorbed dose measurements from typical imaging procedures involved in an image-guided radiation therapy treatment were measured in an anthropomorphic phantom for a complete course of treatment. The experimental setup, including the measurement positions in the phantom, was exactly the same as in a preceding study of radiotherapy stray dose measurements. This allows a direct combination of imaging dose distributions with the therapy dose distribution. Methods: Individually calibrated thermoluminescent dosimeters were used to measure absorbed dose in an anthropomorphic phantom at 184 locations. The dose distributions from imaging devices used with treatment machines from the manufacturers Accuray, Elekta, Siemens, and Varian and from computed tomography scanners from GE Healthcare were determined and the resulting effective dose was calculated. The list of investigated imaging techniques consisted of cone beam computed tomography (kilo- and megavoltage), megavoltage fan beam computed tomography, kilo- and megavoltage planar imaging, planning computed tomography with and without gating methods and planar scout views. Results: A conventional 3D planning CT resulted in an effective dose additional to the treatment stray dose of less than 1 mSv outside of the treated volume, whereas a 4D planning CT resulted in a 10 times larger dose. For a daily setup of the patient with two planar kilovoltage images or with a fan beam CT at the TomoTherapy unit, an additional effective dose outside of the treated volume of less than 0.4 mSv and 1.4 mSv was measured, respectively. Using kilovoltage or megavoltage radiation to obtain cone beam computed tomography scans led to an additional dose of 8-46 mSv. For treatment verification images performed once per week using double exposure technique, an additional effective dose of up to 18 mSv was measured. Conclusions: Daily setup imaging using kilovoltage planar images or TomoTherapy megavoltage fan beam CT imaging can be used as a standard procedure in clinical routine. Daily kilovoltage and megavoltage cone beam computed tomography setup imaging should be applied on an individual or indication based protocol. Depending on the imaging scheme applied, image-guided radiation therapy can be administered without increasing the dose outside of the treated volume compared to therapies without image guidance.

  12. Daptomycin combinations as alternative therapies in experimental foreign-body infection caused by meticillin-susceptible Staphylococcus aureus.

    PubMed

    El Haj, Cristina; Murillo, Oscar; Ribera, Alba; Vivas, Mireia; Garcia-Somoza, Dolors; Tubau, Fe; Cabellos, Carmen; Cabo, Javier; Ariza, Javier

    2015-08-01

    Whilst levofloxacin (LVX) in combination with rifampicin (RIF) is considered the optimal treatment for prosthetic joint infection (PJI) caused by meticillin-susceptible Staphylococcus aureus (MSSA), no therapeutic alternatives have been accurately evaluated. Based on the high effectiveness of the combination of daptomycin (DAP) plus RIF against meticillin-resistant S. aureus (MRSA) in this setting, in this study the efficacy of DAP+RIF and DAP+LVX combinations was tested as alternative therapies for foreign-body infections (FBIs) caused by MSSA. A tissue-cage infection model was performed using an MSSA strain. Male Wistar rats were treated for 7 days with LVX, DAP, RIF or the combinations LVX+RIF, DAP+RIF and DAP+LVX. Antibiotic efficacy was evaluated by bacterial counts from tissue cage fluid (TCF) and the cure rate was determined from adhered bacteria. Resistance was screened. Monotherapies were less effective than combinations (P<0.05), and resistance to DAP and RIF emerged. DAP+RIF (decrease in bacterial counts in TCF, -4.9logCFU/mL; cure rate, 92%) was the most effective therapy (P<0.05). There were no differences between LVX+RIF (-3.4logCFU/mL; 11%) and DAP+LVX (-3.3logCFU/mL; 47%). No resistant strains appeared with combined therapies. In conclusion, the combinations DAP+RIF and DAP+LVX showed good efficacy and prevented resistance. DAP+RIF provided higher efficacy than LVX+RIF. These DAP combinations were efficacious alternatives therapies for MSSA FBI. Further studies should confirm whether DAP+RIF may be useful as a first-line therapy in the setting of PJI caused by MSSA. PMID:26051988

  13. Proton Arc Reduces Range Uncertainty Effects and Improves Conformality Compared With Photon Volumetric Modulated Arc Therapy in Stereotactic Body Radiation Therapy for Non-Small Cell Lung Cancer

    SciTech Connect

    Seco, Joao; Gu, Guan; Marcelos, Tiago; Kooy, Hanne; Willers, Henning

    2013-09-01

    Purpose: To describe, in a setting of non-small cell lung cancer (NSCLC), the theoretical dosimetric advantages of proton arc stereotactic body radiation therapy (SBRT) in which the beam penumbra of a rotating beam is used to reduce the impact of range uncertainties. Methods and Materials: Thirteen patients with early-stage NSCLC treated with proton SBRT underwent repeat planning with photon volumetric modulated arc therapy (Photon-VMAT) and an in-house-developed arc planning approach for both proton passive scattering (Passive-Arc) and intensity modulated proton therapy (IMPT-Arc). An arc was mimicked with a series of beams placed at 10° increments. Tumor and organ at risk doses were compared in the context of high- and low-dose regions, represented by volumes receiving >50% and <50% of the prescription dose, respectively. Results: In the high-dose region, conformality index values are 2.56, 1.91, 1.31, and 1.74, and homogeneity index values are 1.29, 1.22, 1.52, and 1.18, respectively, for 3 proton passive scattered beams, Passive-Arc, IMPT-Arc, and Photon-VMAT. Therefore, proton arc leads to a 30% reduction in the 95% isodose line volume to 3-beam proton plan, sparing surrounding organs, such as lung and chest wall. For chest wall, V30 is reduced from 21 cm{sup 3} (3 proton beams) to 11.5 cm{sup 3}, 12.9 cm{sup 3}, and 8.63 cm{sup 3} (P=.005) for Passive-Arc, IMPT-Arc, and Photon-VMAT, respectively. In the low-dose region, the mean lung dose and V20 of the ipsilateral lung are 5.01 Gy(relative biological effectiveness [RBE]), 4.38 Gy(RBE), 4.91 Gy(RBE), and 5.99 Gy(RBE) and 9.5%, 7.5%, 9.0%, and 10.0%, respectively, for 3-beam, Passive-Arc, IMPT-Arc, and Photon-VMAT, respectively. Conclusions: Stereotactic body radiation therapy with proton arc and Photon-VMAT generate significantly more conformal high-dose volumes than standard proton SBRT, without loss of coverage of the tumor and with significant sparing of nearby organs, such as chest wall. In addition, both proton arc approaches spare the healthy lung from low-dose radiation relative to photon VMAT. Our data suggest that IMPT-Arc should be developed for clinical use.

  14. Perceived outcomes of music therapy with Body Tambura in end of life care – a qualitative pilot study

    PubMed Central

    2014-01-01

    Background In recent years, music therapy is increasingly used in palliative care. The aim of this pilot study was to record and describe the subjective experiences of patients and their relatives undergoing music therapy with a Body Tambura in a German hospice and to develop hypotheses for future studies. Methods In a qualitative interview pilot study, data collection and analyses were performed according to the methodological framework of grounded theory. We included German-speaking patients, or relatives of patients, receiving end of life care in an inpatient hospice setting. Results 11 persons consisting of 8 patients (age range 51–82 years, 4 male and 4 female) and 3 relatives were treated and interviewed. All patients suffered from cancer in an advanced stage. The most often described subjective experiences were a relaxing and calming effect, sensations that the body feels lighter, and the generation of relaxing images and visualizations. Family members enjoyed listening to the music and felt more connected with the sick family member. Conclusion Patient reported beneficial aspects. The small sample size could be seen as a limitation. Assessment instruments measuring relaxation, stress, quality of life and should be included in future quantitative studies. PMID:24708801

  15. Adaptive Liver Stereotactic Body Radiation Therapy: Automated Daily Plan Reoptimization Prevents Dose Delivery Degradation Caused by Anatomy Deformations

    SciTech Connect

    Leinders, Suzanne M.; Breedveld, Sebastiaan; Méndez Romero, Alejandra; Schaart, Dennis; Seppenwoolde, Yvette; Heijmen, Ben J.M.

    2013-12-01

    Purpose: To investigate how dose distributions for liver stereotactic body radiation therapy (SBRT) can be improved by using automated, daily plan reoptimization to account for anatomy deformations, compared with setup corrections only. Methods and Materials: For 12 tumors, 3 strategies for dose delivery were simulated. In the first strategy, computed tomography scans made before each treatment fraction were used only for patient repositioning before dose delivery for correction of detected tumor setup errors. In adaptive second and third strategies, in addition to the isocenter shift, intensity modulated radiation therapy beam profiles were reoptimized or both intensity profiles and beam orientations were reoptimized, respectively. All optimizations were performed with a recently published algorithm for automated, multicriteria optimization of both beam profiles and beam angles. Results: In 6 of 12 cases, violations of organs at risk (ie, heart, stomach, kidney) constraints of 1 to 6 Gy in single fractions occurred in cases of tumor repositioning only. By using the adaptive strategies, these could be avoided (<1 Gy). For 1 case, this needed adaptation by slightly underdosing the planning target volume. For 2 cases with restricted tumor dose in the planning phase to avoid organ-at-risk constraint violations, fraction doses could be increased by 1 and 2 Gy because of more favorable anatomy. Daily reoptimization of both beam profiles and beam angles (third strategy) performed slightly better than reoptimization of profiles only, but the latter required only a few minutes of computation time, whereas full reoptimization took several hours. Conclusions: This simulation study demonstrated that replanning based on daily acquired computed tomography scans can improve liver stereotactic body radiation therapy dose delivery.

  16. The Effects of Gonadotropin Replacement Therapy on Metabolic Parameters and Body Composition in Men with Idiopathic Hypogonadotropic Hypogonadism.

    PubMed

    Bayram, F; Elbuken, G; Korkmaz, C; Aydogdu, A; Karaca, Z; Cakır, I

    2016-02-01

    Testosterone replacement therapy (TRT) in idiopathic hypogonadotrophic hypogonadism (IHH) slows the process of metabolic syndrome (MetS), diabetes mellitus, and cardiovascular diseases by its inversing effects on insulin resistance, dyslipidemia, and blood pressure. Since there are not enough data regarding the effects of gonadotropin replacement therapy (GRT), we aimed to investigate the impact of GRT on MetS parameters in IHH patients. Sixteen patients with IHH and 20 age and body mass index (BDI)-matched healthy controls were enrolled into the study. Patients were evaluated at baseline and 6 months after the GRT. Sex hormones, insulin like growth factor-1, prolactin, insulin, C-reactive protein (CRP), homocysteine, and lipid levels were measured at baseline and after the treatment. Anthropometric measurements, including BMI, body fat ratio (BFR), fat free mass (FFM), waist circumference, and waist-to-hip ratio (WHR), were also performed. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index was calculated. Body fat ratio, triglyceride, HOMA-IR, and CRP levels were higher, whereas bone age, fat free mass, and creatinine levels were lower in the patients with hypogonadism. HOMA-IR indices and basal insulin levels decreased significantly after 6 months of GRT compared with baseline levels. Triglyceride levels, and BFRs diminished significantly by an accompanying decline in WHR. FFM of the patients increased following the GRT. No significant changes were detected in CRP, homocysteine, total and LDL-cholesterol levels. Similar to TRT, hCG treatment decreases HOMA-IR, triglyceride levels, BFR and WHRs, and increases FFM in patients with IHH. PMID:26485362

  17. NOTE: Individual radiation therapy patient whole-body phantoms for peripheral dose evaluations: method and specific software

    NASA Astrophysics Data System (ADS)

    Alziar, I.; Bonniaud, G.; Couanet, D.; Ruaud, J. B.; Vicente, C.; Giordana, G.; Ben-Harrath, O.; Diaz, J. C.; Grandjean, P.; Kafrouni, H.; Chavaudra, J.; Lefkopoulos, D.; de Vathaire, F.; Diallo, I.

    2009-09-01

    This study presents a method aimed at creating radiotherapy (RT) patient-adjustable whole-body phantoms to permit retrospective and prospective peripheral dose evaluations for enhanced patient radioprotection. Our strategy involves virtual whole-body patient models (WBPM) in different RT treatment positions for both genders and for different age groups. It includes a software tool designed to match the anatomy of the phantoms with the anatomy of the actual patients, based on the quality of patient data available. The procedure for adjusting a WBPM to patient morphology includes typical dimensions available in basic auxological tables for the French population. Adjustment is semi-automatic. Because of the complexity of the human anatomy, skilled personnel are required to validate changes made in the phantom anatomy. This research is part of a global project aimed at proposing appropriate methods and software tools capable of reconstituting the anatomy and dose evaluations in the entire body of RT patients in an adapted treatment planning system (TPS). The graphic user interface is that of a TPS adapted to obtain a comfortable working process. Such WBPM have been used to supplement patient therapy planning images, usually restricted to regions involved in treatment. Here we report, as an example, the case of a patient treated for prostate cancer whose therapy planning images were complemented by an anatomy model. Although present results are preliminary and our research is ongoing, they appear encouraging, since such patient-adjusted phantoms are crucial in the optimization of radiation protection of patients and for follow-up studies.

  18. Increased Bowel Toxicity in Patients Treated With a Vascular Endothelial Growth Factor Inhibitor (VEGFI) After Stereotactic Body Radiation Therapy (SBRT)

    SciTech Connect

    Barney, Brandon M.; Markovic, Svetomir N.; Laack, Nadia N.; Miller, Robert C.; Sarkaria, Jann N.; Macdonald, O. Kenneth; Bauer, Heather J.; Olivier, Kenneth R.

    2013-09-01

    Purpose: Gastrointestinal injury occurs rarely with agents that affect the vascular endothelial growth factor receptor and with abdominal stereotactic body radiation therapy (SBRT). We explored the incidence of serious bowel injury (SBI) in patients treated with SBRT with or without vascular endothelial growth factor inhibitor (VEGFI) therapy. Methods and Materials: Seventy-six patients with 84 primary or metastatic intra-abdominal lesions underwent SBRT (median dose, 50 Gy in 5 fractions). Of the patients, 20 (26%) received VEGFI within 2 years after SBRT (bevacizumab, n=14; sorafenib, n=4; pazopanib, n=1; sunitinib, n=1). The incidence of SBI (Common Terminology Criteria for Adverse Events, version 4.0, grade 3-5 ulceration or perforation) after SBRT was obtained, and the relationship between SBI and VEGFI was examined. Results: In the combined population, 7 patients (9%) had SBI at a median of 4.6 months (range, 3-17 months) from SBRT. All 7 had received VEGFI before SBI and within 13 months of completing SBRT, and 5 received VEGFI within 3 months of SBRT. The 6-month estimate of SBI in the 26 patients receiving VEGFI within 3 months of SBRT was 38%. No SBIs were noted in the 63 patients not receiving VEGFI. The log–rank test showed a significant correlation between SBI and VEGFI within 3 months of SBRT (P=.0006) but not between SBI and radiation therapy bowel dose (P=.20). Conclusions: The combination of SBRT and VEGFI results in a higher risk of SBI than would be expected with either treatment independently. Local therapies other than SBRT may be considered if a patient is likely to receive a VEGFI in the near future.

  19. Monitoring temperature of a heating needle and surrounding blood during interventional whole body hyperthermia therapy

    NASA Astrophysics Data System (ADS)

    Xiang, Shi-Hai; Liu, Jing; Zhou, Yi-Xin; Yan, Xiao-Ming

    2007-11-01

    Recent studies confirmed the feasibility of interventional whole body hyperthermia (IWBH) through directly heating the blood flow via minimally invasive heating needles. Among the factors to determine successful IWBH, a most challenging task is to in situ monitor the temperatures of the heating needle and the blood running across it. In this paper, an indirect method was developed which can approximately measure the temperatures of the needle while performing its heating role. Meanwhile, the information acquired in the simulated experiments and theoretical analyses was combined to evaluate the temperature variation of the blood during IWBH. Finally, the measurement errors of this method were discussed and the significance of adopting IWBH for efficiently raising the body-core temperature was demonstrated. This study also raised quite a few new fundamental issues related to the heat transfer of large blood vessels.

  20. Behavior Therapy

    MedlinePLUS

    ... Email Print Share Behavior Therapy for Children with ADHD Page Content Article Body Behavior Therapy Has 3 ... using both medication and behavior therapy to treat attention-deficit/hyperactivity disorder (ADHD) . This is known as a multimodal treatment ...

  1. Medical borderlands: engineering the body with plastic surgery and hormonal therapies in Brazil

    PubMed Central

    Edmonds, Alexander; Sanabria, Emilia

    2014-01-01

    This paper explores medical borderlands where health and enhancement practices are entangled. It draws on fieldwork carried out in the context of two distinct research projects in Brazil on plastic surgery and sex hormone therapies. These two therapies have significant clinical overlap. Both are made available in private and public healthcare in ways that reveal the class dynamics underlying Brazilian medicine. They also have an important experimental dimension rooted in Brazil's regulatory context and societal expectations placed on medicine as a means for managing women's reproductive and sexual health. Off-label and experimental medical use of these treatments is linked to experimental social use: how women adopt them to respond to the pressures, anxieties and aspirations of work and intimate life. The paper argues that these experimental techniques are becoming morally authorized as routine management of women's health, integrated into mainstream Ob-Gyn healthcare, and subtly blurred with practices of cuidar-se (self-care) seen in Brazil as essential for modern femininity. PMID:25175295

  2. Prospective Longitudinal Assessment of Quality of Life for Liver Cancer Patients Treated With Stereotactic Body Radiation Therapy

    SciTech Connect

    Klein, Jonathan; Dawson, Laura A.; Jiang, Haiyan; Kim, John; Dinniwell, Rob; Brierley, James; Wong, Rebecca; Lockwood, Gina; Ringash, Jolie

    2015-09-01

    Purpose: To evaluate quality of life (QoL), an important outcome owing to poor long-term survival, after stereotactic body radiation therapy (SBRT) to the liver. Methods and Materials: Patients (n=222) with hepatocellular carcinoma (HCC), liver metastases, or intrahepatic cholangiocarcinoma and Child-Pugh A liver function received 24-60 Gy of 6-fraction image-guided SBRT. Prospective QoL assessment was completed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (QLQ-C30) and/or Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep, version 4) questionnaires at baseline and 1, 3, 6, and 12 months after treatment. Ten HCC patients with Child-Pugh B liver function were also treated. Results: The QLQ-C30 was available for 205 patients, and 196 completed the FACT-Hep. No difference in baseline QoL (P=.17) or overall survival (P=.088) was seen between the HCC, liver metastases, and intrahepatic cholangiocarcinoma patients. Appetite loss and fatigue measured by the QLQ-C30 clinically and statistically worsened by 1 month after treatment but recovered by 3 months. At 3 and 12 months after treatment, respectively, the FACT-Hep score had improved relative to baseline in 13%/19%, worsened in 36%/27%, and remained stable in 51%/54%. Using the QLQ-C30 Global Health score, QoL improved in 16%/23%, worsened in 34%/39%, and remained stable in 50%/38% at 3 and 12 months, respectively. Median survival was 17.0 months (95% confidence interval [CI] 12.3-19.8 months). Higher baseline scores on both FACT-Hep and QLQ-C30 Global Health were associated with improved survival. Hazard ratios for death, per 10-unit decrease in QoL, were 0.90 (95% CI 0.83-0.98; P=.001) and 0.88 (95% CI 0.82-0.95; P=.001), respectively. Tumor size was inversely correlated with survival. Conclusions: Liver SBRT temporarily worsens appetite and fatigue, but not overall QoL. Stereotactic body radiation therapy is well tolerated and warrants comparison against other liver-directed therapies.

  3. Whole-body Vibration Exposure of Drill Operators in Iron Ore Mines and Role of Machine-Related, Individual, and Rock-Related Factors

    PubMed Central

    Chaudhary, Dhanjee Kumar; Bhattacherjee, Ashis; Patra, Aditya Kumar; Chau, Nearkasen

    2015-01-01

    Background This study aimed to assess the whole-body vibration (WBV) exposure among large blast hole drill machine operators with regard to the International Organization for Standardization (ISO) recommended threshold values and its association with machine- and rock-related factors and workers' individual characteristics. Methods The study population included 28 drill machine operators who had worked in four opencast iron ore mines in eastern India. The study protocol comprised the following: measurements of WBV exposure [frequency weighted root mean square (RMS) acceleration (m/s2)], machine-related data (manufacturer of machine, age of machine, seat height, thickness, and rest height) collected from mine management offices, measurements of rock hardness, uniaxial compressive strength and density, and workers' characteristics via face-to-face interviews. Results More than 90% of the operators were exposed to a higher level WBV than the ISO upper limit and only 3.6% between the lower and upper limits, mainly in the vertical axis. Bivariate correlations revealed that potential predictors of total WBV exposure were: machine manufacturer (r = 0.453, p = 0.015), age of drill (r = 0.533, p = 0.003), and hardness of rock (r = 0.561, p = 0.002). The stepwise multiple regression model revealed that the potential predictors are age of operator (regression coefficient β = −0.052, standard error SE = 0.023), manufacturer (β = 1.093, SE = 0.227), rock hardness (β = 0.045, SE = 0.018), uniaxial compressive strength (β = 0.027, SE = 0.009), and density (β = –1.135, SE = 0.235). Conclusion Prevention should include using appropriate machines to handle rock hardness, rock uniaxial compressive strength and density, and seat improvement using ergonomic approaches such as including a suspension system. PMID:26929838

  4. Modelling the effects of exposure to whole-body vibration on low-back pain and its long-term consequences for sickness absence and associated work disability

    NASA Astrophysics Data System (ADS)

    Burdorf, A.; Hulshof, C. T. J.

    2006-12-01

    BackgroundExposure to whole-body vibration (WBV) is a well-known risk factor for the occurrence of low-back pain (LBP). Little is known about the long-term course of back pain in workers exposed to WBV and the consequences for (temporary) disability, due to lack of cohort studies with sufficiently long follow-up periods. MethodsA systematic review of the literature was performed to assess associations between exposure to WBV and LBP, sickness absence due to low-back disorders and permanent disability. A meta-analysis was used to estimate the prevalences of LBP and sickness absence due to low-back disorders in occupational populations, depending on relevant exposure characteristics. These prevalences were converted into probabilities for transitions between no complaints, LBP, sickness due to LBP, and disability. A Markov model was applied to evaluate a hypothetical cohort of workers without LBP at the start of the cohort and a follow-up of 40 years (40 cycles of 1 year) to reflect a long-life career with continuous exposure to WBV. ResultsIn this hypothetical cohort it was estimated that among workers with the highest exposure to WBV on average about 47 weeks of their working life were lost due to sick leave because of LBP, which is approximately 2.5% of their working life. When all workers on prolonged sick leave for 52 weeks would remain disabled for the rest of their working life, a maximum of 23.4% of their working life could be lost due to high WBV exposure. Among workers without or low exposure to WBV the corresponding losses were 0.8% and 7.8%, respectively. ConclusionThe approach to assess years of work lost due to an occupational exposure may provide a more adequate description for stakeholders than the traditional measures of relative risk or attributable risk fraction. The concept of work years lost may also facilitate a better appreciation of the potential benefits of preventive measures.

  5. Relationship between hormone replacement therapy use with body fat distribution and insulin sensitivity in obese postmenopausal women.

    PubMed

    Sites, C K; Brochu, M; Tchernof, A; Poehlman, E T

    2001-07-01

    The aim of this study was to compare the effect of hormone replacement therapy (HRT) on insulin resistance and central adiposity in obese postmenopausal women. Forty-five obese postmenopausal women (16 HRT users and 29 nonusers), with a mean age of 56.6 +/- 5.3 years and duration of current, continuous HRT use of 4.7 +/- 2.9 years, were included in the study. Subjects were studied using oral glucose tolerance tests, euglycemic clamping, dual photon x-ray absorptiometry, computed tomography, doubly labeled water, and treadmill testing. Insulin sensitivity, total fat, visceral fat, subcutaneous abdominal fat, thigh muscle attenuation, daily physical activity energy expenditure, peak oxygen consumption (Vo(2)) were measured. HRT users had lower body weight (88.0 +/- 11.0 v 98.2 +/- 15.0 kg, P =.05), lower body mass index (33.1 +/- 3.5 v 36.8 +/- 5.2 kg/m(2), P =.05), lower fat mass (38.3 +/- 7.3 v 44.1 +/- 10 kg, P =.05), less visceral adipose tissue (157 +/- 47 v 211 +/- 81 cm(2); P =.05), and higher peak Vo(2) (21.1 +/- 4.6 v 17.6 +/- 2.2 mL/kg/min, P =.001) than nonusers. After adjustment for total fat, we noted a trend for decreased visceral adipose tissue in HRT users (P =.09). After adjustment for peak Vo(2), the decreased visceral adipose tissue persisted in HRT users (P <.01). Insulin sensitivity per kilogram of lean body mass did not differ between HRT users (0.51 +/- 0.22 mmol/kg/min) and nonusers (0.49 +/- 0.22 mmol/kg/min). It was concluded that obese postmenopausal women using HRT have a more favorable body composition and fat distribution pattern than nonusers. Although visceral adipose tissue is decreased in HRT users, insulin sensitivity does not differ between HRT users and nonusers. PMID:11436191

  6. Multimodal mind/body group therapy for chronic depression: a pilot study.

    PubMed

    Little, Suzanne A S; Kligler, Benjamin; Homel, Peter; Belisle, Shoshana S; Merrell, Woodson

    2009-01-01

    Chronic depression is a highly debilitating psychobiological disorder that affects mind, body, and spirit. The need for effective integrative treatments for depression is fueled by high recurrence and relapse rates, as well as growing consumer demand for natural and holistic approaches that recognize depression is a systemic problem. A 24-week multimodal group treatment program was piloted to assess whether psychoeducation, lifestyle modification, meditation, and mind/body skills training would reduce symptomatology and improve overall balance and well-being in nonmedicated patients with moderate depression. The group treatment was conducted in a healing space associated with an academic integrative medicine center. Fourteen adult patients (mean age = 51.7 years) participated in two treatment groups (seven patients per group). Treatment efficacy was evaluated by changes on the Beck Depression Inventory (BDI-II), the primary outcome measure, completed at pretreatment (week zero), posttreatment (week 12), and two follow-up points (weeks 16 and 24). Positive affect and overall well-being were assessed using the Symptom Checklist-90 Revised, the Life Orientation Test, the Short Form Health Survey-12, and the Psychological Well-Being Index. Comparisons of pretreatment and posttreatment scores on the BDI-II showed a clinically significant decline in depressed mood and negative affect (P < .001), as well as significant improvement across the positive affect and well-being measures. This outcome, which was statistically sustained for six months, suggests that a multimodal holistic mind/body group approach can benefit a segment of the chronically depressed population. PMID:19913759

  7. Assessment of organ specific neutron equivalent doses in proton therapy using computational whole-body age-dependent voxel phantoms

    PubMed Central

    Jarlskog, Christina Zacharatou; Lee, Choonik; Bolch, Wesley E.; Xu, X. George

    2009-01-01

    Proton beams used for radiotherapy will produce neutrons when interacting with matter. The purpose of this study was to quantify the equivalent dose to tissue due to secondary neutrons in pediatric and adult patients treated by proton therapy for brain lesions. Assessment of the equivalent dose to organs away from the target requires whole-body geometrical information. Furthermore, because patient geometry depends on age at exposure, age-dependent representations are also needed. We implemented age-dependent phantoms into our proton Monte Carlo dose calculation environment. We considered 8 typical radiation fields, 2 of which had been previously used to treat pediatric patients. The other 6 fields were additionally considered to allow a systematic study of equivalent doses as a function of field parameters. For all phantoms and all fields, we simulated organ specific equivalent neutron doses and analyzed for each organ (1) the equivalent dose due to neutrons as a function of distance to the target; (2) the equivalent dose due to neutrons as a function of patient age; (3) the equivalent dose due to neutrons as a function of field parameters; and (4) the ratio of contributions to secondary dose from the treatment head versus the contribution from the patient’s body tissues. This work reports organ specific equivalent neutron doses for up to 48 organs in a patient. We demonstrate quantitatively how organ equivalent doses for adult and pediatric patients vary as a function of patient’s age, organ, and field parameters. Neutron doses increase with increasing range and modulation width but decrease with field size (as defined by the aperture). We analyzed the ratio of neutron dose contributions from the patient and from the treatment head, and found that neutron equivalent doses fall off rapidly as a function of distance from the target, in agreement with experimental data. It appears that for the fields used in this study, the neutron dose lateral to the field is smaller than the reported scattered photon doses in a typical intensity modulated photon treatment. Most importantly, our study shows that neutron doses to specific organs depend considerably on the patient’s age and body stature. The younger the patient, the higher the dose deposited due to neutrons. Given the fact that the risk also increases with decreasing patient age, this factor needs to be taken into account when treating pediatric patients of very young ages and/or of small body size. The neutron dose from a course of proton therapy treatment (assuming 70 Gy in 30 fractions) could potentially (depending on patient’s age, organ, treatment site and area of CT scan) be equivalent to up to ∼30 CT scans. PMID:18199910

  8. [Vibration-assisted music therapy reduces pain and promotes relaxation of para- and tetraplegic patients. A pilot study of psychiatric and physical effects of simultaneous acoustic and somatosensory music stimulation as pain management].

    PubMed

    Mariauzouls, C; Michel, D; Schiftan, Y

    1999-11-01

    Pain is a well known phenomenon in posttraumatic spinal cord injuries. Nearly 10% of the patients develop most severe, invalidizing, as a rule neurogenic pain conditions that are hardly accessible to conventional therapies. A pilot study was therefore conducted with 10 paraplegics and tetraplegics suffering chronic pain, investigating how vibration supported music therapy with the Musica Medica method affected pain experience, tension/relaxation and well-being. In addition to subjective experience, we measured physiological parameters (finger tip skin temperature, electrodermal activity, heart rate, respiration frequency) during the therapy sessions. All patients had a high acceptance of the method which throughout the group had brought about an increase in relaxation and well-being as well as a decrease of pain experience. The autonomic nervous system variables correlated with relaxation and in addition pointed to an activating impact of the therapy chosen. PMID:10627970

  9. Hypothesizing the body's genius to trigger and self-organize its healing: 25 years using a standardized neurophysics therapy

    PubMed Central

    Ross, Sara N.; Ware, Ken

    2013-01-01

    We aim for this contribution to operate bi-directionally, both as a “bedside to bench” reverse-translational fractal physiological hypothesis and as a methodological innovation to inform clinical practice. In 25 years using gym equipment therapeutically in non-research settings, the standardized therapy is consistently observed to trigger universal responses of micro to macro waves of system transition dynamics in the human nervous system. These are associated with observably desirable impacts on disorders, injuries, diseases, and athletic performance. Requisite conditions are therapeutic coaching, erect posture, extremely slow movements in mild resistance exercises, and executive control over arousal and attention. To motivate research into the physiological improvements and in validation studies, we integrate from across disciplines to hypothesize explanations for the relationships among the methods, the system dynamics, and evident results. Key hypotheses include: (1) Correctly-directed system efforts may reverse a system's heretofore misdirected efforts, restoring healthier neurophysiology. (2) The enhanced information processing accompanying good posture is an essential initial condition. (3) Behaviors accompanying exercises performed with few degrees of freedom amplify information processing, triggering destabilization and transition dynamics. (4) Executive control over arousal and attention is essential to release system constraints, amplifying and complexifying information. (5) The dynamics create necessary and in many cases evidently sufficient conditions for the body to resolve or improve its own conditions within often short time periods. Literature indicates how the human system possesses material self-awareness. A broad explanation for the nature and effects of the therapy appears rooted in the cascading recursions of the systems' dynamics, which appear to trigger health-fostering self-reorganizing processes when this therapy provides catalytic initial conditions. PMID:24312056

  10. Hypothesizing the body's genius to trigger and self-organize its healing: 25 years using a standardized neurophysics therapy.

    PubMed

    Ross, Sara N; Ware, Ken

    2013-01-01

    We aim for this contribution to operate bi-directionally, both as a "bedside to bench" reverse-translational fractal physiological hypothesis and as a methodological innovation to inform clinical practice. In 25 years using gym equipment therapeutically in non-research settings, the standardized therapy is consistently observed to trigger universal responses of micro to macro waves of system transition dynamics in the human nervous system. These are associated with observably desirable impacts on disorders, injuries, diseases, and athletic performance. Requisite conditions are therapeutic coaching, erect posture, extremely slow movements in mild resistance exercises, and executive control over arousal and attention. To motivate research into the physiological improvements and in validation studies, we integrate from across disciplines to hypothesize explanations for the relationships among the methods, the system dynamics, and evident results. Key hypotheses include: (1) Correctly-directed system efforts may reverse a system's heretofore misdirected efforts, restoring healthier neurophysiology. (2) The enhanced information processing accompanying good posture is an essential initial condition. (3) Behaviors accompanying exercises performed with few degrees of freedom amplify information processing, triggering destabilization and transition dynamics. (4) Executive control over arousal and attention is essential to release system constraints, amplifying and complexifying information. (5) The dynamics create necessary and in many cases evidently sufficient conditions for the body to resolve or improve its own conditions within often short time periods. Literature indicates how the human system possesses material self-awareness. A broad explanation for the nature and effects of the therapy appears rooted in the cascading recursions of the systems' dynamics, which appear to trigger health-fostering self-reorganizing processes when this therapy provides catalytic initial conditions. PMID:24312056

  11. Stereotactic body radiation therapy for prostate cancer: is the technology ready to be the standard of care?

    PubMed

    Zaorsky, Nicholas G; Studenski, Matthew T; Dicker, Adam P; Gomella, Leonard; Den, Robert B

    2013-05-01

    Prostate cancer is the second most prevalent solid tumor diagnosed in men in the United States and Western Europe. Stereotactic body radiation therapy (SBRT) is touted as a superior type of external beam radiation therapy (EBRT) for the treatment of various tumors. SBRT developed from the theory that high doses of radiation from brachytherapy implant seeds could be recapitulated from advanced technology of radiation treatment planning and delivery. Moreover, SBRT has been theorized to be advantageous compared to other RT techniques because it has a treatment course shorter than that of conventionally fractionated EBRT (a single session, five days per week, for about two weeks vs. eight weeks), is non-invasive, is more effective at killing tumor cells, and is less likely to cause damage to normal tissue. In areas of the US and Europe where there is limited access to RT centers, SBRT is frequently being used to treat prostate cancer, even though long-term data about its efficacy and safety are not well established. We review the impetus behind SBRT and the current clinical evidence supporting its use for prostate cancer, thus providing oncologists and primary care physicians with an understanding of the continually evolving field of prostate radiation therapy. Studies of SBRT provide encouraging results of biochemical control and late toxicity. However, they are limited by a number of factors, including short follow-up, exclusion of intermediate- and high-risk patients, and relatively small number of patients treated. Currently, SBRT regimens should only be used in the context of clinical trials. PMID:23218442

  12. Dosimetric Implications of an Injection of Hyaluronic Acid for Preserving the Rectal Wall in Prostate Stereotactic Body Radiation Therapy

    SciTech Connect

    Chapet, Olivier; Udrescu, Corina; Tanguy, Ronan; Ruffion, Alain; Fenoglietto, Pascal; Sotton, Marie-Pierre; Devonec, Marian; Colombel, Marc; Jalade, Patrice; Azria, David

    2014-02-01

    Purpose: This study assessed the contribution of ahyaluronic acid (HA) injection between the rectum and the prostate to reducing the dose to the rectal wall in stereotactic body radiation therapy (SBRT). Methods and Materials: As part of a phase 2 study of hypofractionated radiation therapy (62 Gy in 20 fractions), the patients received a transperineal injection of 10 cc HA between the rectum and the prostate. A dosimetric computed tomographic (CT) scan was systematically performed before (CT1) and after (CT2) the injection. Two 9-beam intensity modulated radiation therapy-SBRT plans were optimized for the first 10 patients on both CTs according to 2 dosage levels: 5 6.5 Gy (PlanA) and 5 8.5 Gy (PlanB). Rectal wall parameters were compared with a dosevolume histogram, and the prostaterectum separation was measured at 7 levels of the prostate on the center line of the organ. Results: For both plans, the average volume of the rectal wall receiving the 90% isodose line (V90%) was reduced up to 90% after injection. There was no significant difference (P=.32) between doses received by the rectal wall on CT1 and CT2 at the base of the prostate. This variation became significant from the median plane to the apex of the prostate (P=.002). No significant differences were found between PlanA without HA and PlanB with HA for each level of the prostate (P=.77, at the isocenter of the prostate). Conclusions: HA injection significantly reduced the dose to the rectal wall and allowed a dose escalation from 6.5 Gy to 8.5 Gy without increasing the dose to the rectum. A phase 2 study is under way in our department to assess the rate of acute and late rectal toxicities when SBRT (5 8.5 Gy) is combined with an injection of HA.

  13. Verification of Planning Target Volume Settings in Volumetric Modulated Arc Therapy for Stereotactic Body Radiation Therapy by Using In-Treatment 4-Dimensional Cone Beam Computed Tomography

    SciTech Connect

    Takahashi, Wataru; Yamashita, Hideomi; Kida, Satoshi; Masutani, Yoshitaka; Sakumi, Akira; Ohtomo, Kuni; Nakagawa, Keiichi; Haga, Akihiro

    2013-07-01

    Purpose: To evaluate setup error and tumor motion during beam delivery by using 4-dimensional cone beam computed tomography (4D CBCT) and to assess the adequacy of the planning target volume (PTV) margin for lung cancer patients undergoing volumetric modulated arc therapy for stereotactic body radiation therapy (VMAT-SBRT). Methods and Materials: Fifteen lung cancer patients treated by single-arc VMAT-SBRT were selected in this analysis. All patients were treated with an abdominal compressor. The gross tumor volumes were contoured on maximum inspiration and maximum expiration CT datasets from 4D CT respiratory sorting and merged into internal target volumes (ITVs). The PTV margin was isotropically taken as 5 mm. Registration was automatically performed using “pre-3D” CBCT. Treatment was performed with a D95 prescription of 50 Gy delivered in 4 fractions. The 4D tumor locations during beam delivery were determined using in-treatment 4D CBCT images acquired in each fraction. Then, the discrepancy between the actual tumor location and the ITV was evaluated in the lateral, vertical, and longitudinal directions. Results: Overall, 55 4D CBCT sets during VMAT-SBRT were successfully obtained. The amplitude of tumor motion was less than 10 mm in all directions. The average displacements between ITV and actual tumor location during treatment were 0.41 ± 0.93 mm, 0.15 ± 0.58 mm, and 0.60 ± 0.99 mm for the craniocaudal, left-right, and anteroposterior directions, respectively. The discrepancy in each phase did not exceed 5 mm in any direction. Conclusions: With in-treatment 4D CBCT, we confirmed the required PTV margins when the registration for moving target was performed using pre-3D CBCT. In-treatment 4D CBCT is a direct method for quantitatively assessing the intrafractional location of a moving target.

  14. Ketone Body Therapy Protects From Lipotoxicity and Acute Liver Failure Upon Ppar? Deficiency.

    PubMed

    Pawlak, Michal; Baug, Eric; Lalloyer, Fanny; Lefebvre, Philippe; Staels, Bart

    2015-08-01

    Acute liver failure (ALF) is a severe and rapid liver injury, often occurring without any preexisting liver disease, which may precipitate multiorgan failure and death. ALF is often associated with impaired ?-oxidation and increased oxidative stress (OS), characterized by elevated levels of hepatic reactive oxygen species (ROS) and lipid peroxidation (LPO) products. Peroxisome proliferator-activated receptor (PPAR)? has been shown to confer hepatoprotection in acute and chronic liver injury, at least in part, related to its ability to control peroxisomal and mitochondrial ?-oxidation. To study the pathophysiological role of PPAR? in hepatic response to high OS, we induced a pronounced LPO by treating wild-type and Ppar?-deficient mice with high doses of fish oil (FO), containing n-3 polyunsaturated fatty acids. FO feeding of Ppar?-deficient mice, in contrast to control sunflower oil, surprisingly induced coma and death due to ALF as indicated by elevated serum alanine aminotransferase, aspartate aminotransferase, ammonia, and a liver-specific increase of ROS and LPO-derived malondialdehyde. Reconstitution of PPAR? specifically in the liver using adeno-associated serotype 8 virus-PPAR? in Ppar?-deficient mice restored ?-oxidation and ketogenesis and protected mice from FO-induced lipotoxicity and death. Interestingly, administration of the ketone body ?-hydroxybutyrate prevented FO-induced ALF in Ppar?-deficient mice, and normalized liver ROS and malondialdehyde levels. Therefore, PPAR? protects the liver from FO-induced OS through its regulatory actions on ketone body levels. ?-Hydroxybutyrate treatment could thus be an option to prevent LPO-induced liver damage. PMID:26087172

  15. Image-Guided Robotic Stereotactic Body Radiation Therapy for Liver Metastases: Is There a Dose Response Relationship?

    SciTech Connect

    Vautravers-Dewas, Claire; Dewas, Sylvain; Bonodeau, Francois; Adenis, Antoine; Lacornerie, Thomas; Penel, Nicolas; Lartigau, Eric; Mirabel, Xavier

    2011-11-01

    Purpose: To evaluate the outcome, tolerance, and toxicity of stereotactic body radiotherapy, using image-guided robotic radiation delivery, for the treatment of patients with unresectable liver metastases. Methods and Material: Patients were treated with real-time respiratory tracking between July 2007 and April 2009. Their records were retrospectively reviewed. Metastases from colorectal carcinoma and other primaries were not necessarily confined to liver. Toxicity was evaluated using National Cancer Institute Common Criteria for Adverse Events version 3.0. Results: Forty-two patients with 62 metastases were treated with two dose levels of 40 Gy in four Dose per Fraction (23) and 45 Gy in three Dose per Fraction (13). Median follow-up was 14.3 months (range, 3-23 months). Actuarial local control for 1 and 2 years was 90% and 86%, respectively. At last follow-up, 41 (66%) complete responses and eight (13%) partial responses were observed. Five lesions were stable. Nine lesions (13%) were locally progressed. Overall survival was 94% at 1 year and 48% at 2 years. The most common toxicity was Grade 1 or 2 nausea. One patient experienced Grade 3 epidermitis. The dose level did not significantly contribute to the outcome, toxicity, or survival. Conclusion: Image-guided robotic stereotactic body radiation therapy is feasible, safe, and effective, with encouraging local control. It provides a strong alternative for patients who cannot undergo surgery.

  16. Ketone body therapy: from the ketogenic diet to the oral administration of ketone ester

    PubMed Central

    Hashim, Sami A.; VanItallie, Theodore B.

    2014-01-01

    Ketone bodies (KBs), acetoacetate and β-hydroxybutyrate (βHB), were considered harmful metabolic by-products when discovered in the mid-19th century in the urine of patients with diabetic ketoacidosis. It took physicians many years to realize that KBs are normal metabolites synthesized by the liver and exported into the systemic circulation to serve as an energy source for most extrahepatic tissues. Studies have shown that the brain (which normally uses glucose for energy) can readily utilize KBs as an alternative fuel. Even when there is diminished glucose utilization in cognition-critical brain areas, as may occur early in Alzheimer’s disease (AD), there is preliminary evidence that these same areas remain capable of metabolizing KBs. Because the ketogenic diet (KD) is difficult to prepare and follow, and effectiveness of KB treatment in certain patients may be enhanced by raising plasma KB levels to ≥2 mM, KB esters, such as 1,3-butanediol monoester of βHB and glyceryl-tris-3-hydroxybutyrate, have been devised. When administered orally in controlled dosages, these esters can produce plasma KB levels comparable to those achieved by the most rigorous KD, thus providing a safe, convenient, and versatile new approach to the study and potential treatment of a variety of diseases, including epilepsy, AD, and Parkinson’s disease. PMID:24598140

  17. Ketone body therapy: from the ketogenic diet to the oral administration of ketone ester.

    PubMed

    Hashim, Sami A; VanItallie, Theodore B

    2014-09-01

    Ketone bodies (KBs), acetoacetate and ?-hydroxybutyrate (?HB), were considered harmful metabolic by-products when discovered in the mid-19th century in the urine of patients with diabetic ketoacidosis. It took physicians many years to realize that KBs are normal metabolites synthesized by the liver and exported into the systemic circulation to serve as an energy source for most extrahepatic tissues. Studies have shown that the brain (which normally uses glucose for energy) can readily utilize KBs as an alternative fuel. Even when there is diminished glucose utilization in cognition-critical brain areas, as may occur early in Alzheimer's disease (AD), there is preliminary evidence that these same areas remain capable of metabolizing KBs. Because the ketogenic diet (KD) is difficult to prepare and follow, and effectiveness of KB treatment in certain patients may be enhanced by raising plasma KB levels to ?2 mM, KB esters, such as 1,3-butanediol monoester of ?HB and glyceryl-tris-3-hydroxybutyrate, have been devised. When administered orally in controlled dosages, these esters can produce plasma KB levels comparable to those achieved by the most rigorous KD, thus providing a safe, convenient, and versatile new approach to the study and potential treatment of a variety of diseases, including epilepsy, AD, and Parkinson's disease. PMID:24598140

  18. Testosterone therapy for men

    MedlinePLUS

    Testosterone replacement therapy; Androgen therapy; Androgen replacement therapy; Testosterone deficiency - replacement ... TESTOSTERONE AND YOUR BODY Testosterone is a hormone made by the testicles in men. It is the ...

  19. a Comparison of Evaluations and Assessments Obtained Using Alternative Standards for Predicting the Hazards of Whole-Body Vibration and Repeated Shocks

    NASA Astrophysics Data System (ADS)

    Lewis, C. H.; Griffin, M. J.

    1998-08-01

    There are three current standards that might be used to assess the vibration and shock transmitted by a vehicle seat with respect to possible effects on human health: ISO 2631/1 (1985), BS 6841 (1987) and ISO 2631-1 (1997). Evaluations have been performed on the seat accelerations measured in nine different transport environments (bus, car, mobile crane, fork-lift truck, tank, ambulance, power boat, inflatable boat, mountain bike) in conditions that might be considered severe. For each environment, limiting daily exposure durations were estimated by comparing the frequency weighted root mean square (i.e., r.m.s.) accelerations and the vibration dose values (i.e.,VDV), calculated according to each standard with the relevant exposure limits, action level and health guidance caution zones. Very different estimates of the limiting daily exposure duration can be obtained using the methods described in the three standards. Differences were observed due to variations in the shapes of the frequency weightings, the phase responses of the frequency weighting filters, the method of combining multi-axis vibration, the averaging method, and the assessment method. With the evaluated motions, differences in the shapes of the weighting filters results in up to about 31% difference in r.m.s. acceleration between the “old” and the “new” ISO standard and up to about 14% difference between BS 6841 and the “new” ISO 2631. There were correspondingly greater differences in the estimates of safe daily exposure durations. With three of the more severe motions there was a difference of more than 250% between estimated safe daily exposure durations based on r.m.s. acceleration and those based on fourth power vibration dose values. The vibration dose values provided the more cautious assessments of the limiting daily exposure duration.

  20. Whole Body Periodic Acceleration Is an Effective Therapy to Ameliorate Muscular Dystrophy in mdx Mice

    PubMed Central

    Altamirano, Francisco; Perez, Claudio F.; Liu, Min; Widrick, Jeffrey; Barton, Elisabeth R.; Allen, Paul D.; Adams, Jose A.; Lopez, Jose R.

    2014-01-01

    Duchenne muscular dystrophy (DMD) is a genetic disorder caused by the absence of dystrophin in both skeletal and cardiac muscles. This leads to severe muscle degeneration, and dilated cardiomyopathy that produces patient death, which in most cases occurs before the end of the second decade. Several lines of evidence have shown that modulators of nitric oxide (NO) pathway can improve skeletal muscle and cardiac function in the mdx mouse, a mouse model for DMD. Whole body periodic acceleration (pGz) is produced by applying sinusoidal motion to supine humans and in standing conscious rodents in a headward-footward direction using a motion platform. It adds small pulses as a function of movement frequency to the circulation thereby increasing pulsatile shear stress to the vascular endothelium, which in turn increases production of NO. In this study, we examined the potential therapeutic properties of pGz for the treatment of skeletal muscle pathology observed in the mdx mouse. We found that pGz (480 cpm, 8 days, 1 hr per day) decreased intracellular Ca2+ and Na+ overload, diminished serum levels of creatine kinase (CK) and reduced intracellular accumulation of Evans Blue. Furthermore, pGz increased muscle force generation and expression of both utrophin and the carboxy-terminal PDZ ligand of nNOS (CAPON). Likewise, pGz (120 cpm, 12 h) applied in vitro to skeletal muscle myotubes reduced Ca2+ and Na+ overload, diminished abnormal sarcolemmal Ca2+ entry and increased phosphorylation of endothelial NOS. Overall, this study provides new insights into the potential therapeutic efficacy of pGz as a non-invasive and non-pharmacological approach for the treatment of DMD patients through activation of the NO pathway. PMID:25181488

  1. Evaluation of Rotational Errors in Treatment Setup of Stereotactic Body Radiation Therapy of Liver Cancer

    SciTech Connect

    Cao Minsong; Lasley, Foster D.; Das, Indra J.; DesRosiers, Colleen M.; Slessinger, Eric D.; Cardenes, Higinia R.

    2012-11-01

    Purpose: To evaluate the dosimetric impact of rotational setup errors in stereotactic body radiotherapy (SBRT) treatment of liver tumors and to investigate whether translational shifts can compensate for rotation. Methods and Materials: The positioning accuracy in 20 patients with liver malignancies treated with SBRT was reevaluated offline by matching the patients' cone-beam computed tomography (CT) scans (n=75) to the planning CT scans and adjusting the 3 rotational angles (pitch, roll, and yaw). Systematic and random setup errors were calculated. The dosimetric changes caused by rotational setup errors were quantified for both simulated and observed patient rotations. Dose distributions recalculated on the rotated CT scans were compared with the original planned doses. Translational corrections were simulated based on manual translational registration of the rotated images to the original CT scans. The correction efficacy was evaluated by comparing the recalculated plans with the original plans. Results: The systematic rotational setup errors were -0.06 Degree-Sign {+-} 0.68 Degree-Sign , -0.29 Degree-Sign {+-} 0.62 Degree-Sign , and -0.24 Degree-Sign {+-} 0.61 Degree-Sign ; the random setup errors were 0.80 Degree-Sign , 1.05 Degree-Sign , and 0.61 Degree-Sign for pitch, roll, and yaw, respectively. Analysis of CBCT images showed that 56.0%, 14.7%, and 1.3% of treated fractions had rotational errors of >1 Degree-Sign , >2 Degree-Sign , and >3 Degree-Sign , respectively, in any one of the rotational axes. Rotational simulations demonstrated that the reduction of gross tumor volume (GTV) coverage was <2% when rotation was <3 Degree-Sign . Recalculated plans using actual patient roll motions showed similar reduction (<2%) in GTV coverage. Translational corrections improved the GTV coverage to within 3% of the original values. For organs at risk (OAR), the dosimetric impact varied case by case. Conclusion: Actual rotational setup errors in SBRT for liver tumors are relatively small in magnitude and are unlikely to affect GTV coverage significantly. Translational corrections can be optimized to compensate for rotational setup errors. However, caution regarding possible dose increases to OAR needs to be exercised.

  2. The body electric: a long view of electrical therapy for functional neurological disorders.

    PubMed

    McWhirter, Laura; Carson, Alan; Stone, Jon

    2015-04-01

    The use of electricity in medical treatment has always been technology-driven, rather than aetiology-driven; as new techniques have appeared, clinicians have quickly looked to try them in the treatment of all sorts of conditions where existing treatment options are limited. Functional disorders--as identified anachronistically in our analysis--have been key contenders for emerging electrical treatments: with Leyden jars, with galvanic and electromagnetic machines, and more recently with TMS and TENS. Parallels can be drawn with the history of electrical treatments for migraine and headache (Koehler and Boes, 2010). Regardless of the mode of delivery of electricity, stimulating a limb to produce movement has repeatedly been found to aid and assist recovery in functional motor disorders. This may also be true of non-electrical methods: we have found benefits using both therapeutic sedation and explanatory demonstration of a positive Hoover's sign as therapeutic methods of demonstrating normal movement in functionally weak limbs (Stone et al., 2014). Each surge in enthusiasm for new electrical treatments has been followed by questions about the nature of the disorder and validity of the treatment response. Physicians have tended to attribute therapeutic success initially to powerful biological or even metaphysical effects, but with time and experience these explanations have been replaced by views that the treatment works through suggestion and placebo. Discomfort with these conclusions has in the past discouraged ongoing development of electrical treatments, even if the end result for patients has been encouraging. In Edwards's Bayesian model, functional motor and sensory symptoms are hypothesized to arise when 'pathologically precise prior beliefs' mediated by attentional processes cause experience of symptoms via a hierarchy of false inferences (Edwards, 2012). It can be argued that use of TMS or peripheral stimulation to produce movement of a functionally weak limb has the specific potential to modulate pathological expectations. To reject these treatments as no more than placebo may mean missing an unusual opportunity to manipulate key elements in the mechanism of the disorder. However, changes to these 'priors' may also be dependent upon patient expectations, and as we see through history, this may only happen if the patient believes there is an actual neuromodulatory effect. This may give rise to significant ethical issues in that the treatment may well directly benefit patients but only if they are (mis)informed that there is an underlying biological rationale. We conclude that modern trials of TMS in functional disorders are part of a repeating cycle of experimentation recurring since the mid-18th century. We suspect that emerging technology, including transcranial direct current stimulation, will follow a similar pattern of experimentation, speculation and marginalization. We suggest that considering our modern efforts in a historical context could aid our ability to further expand and maintain our use of electrical therapies that have proven helpful in the past for patients with functional disorders. PMID:25711123

  3. Vibrational Coupling

    SciTech Connect

    2011-01-01

    By homing in on the distribution patterns of electrons around an atom, a team of scientists team with Berkeley Lab's Molecular Foundry showed how certain vibrations from benzene thiol cause electrical charge to "slosh" onto a gold surface (left), while others do not (right). The vibrations that cause this "sloshing" behavior yield a stronger SERS signal.

  4. VIBRATION COMPACTION

    DOEpatents

    Hauth, J.J.

    1962-07-01

    A method of compacting a powder in a metal container is described including the steps of vibrating the container at above and below the resonant frequency and also sweeping the frequency of vibration across the resonant frequency several times thereby following the change in resonant frequency caused by compaction of the powder. (AEC)

  5. Use of gentamicin sulfate-impregnated sponges as adjuvant therapy for the treatment of chronic foreign body associated sternal osteomyelitis in a dog.

    PubMed

    Wainberg, Shannon H; Brisson, Brigitte A; Hayes, Galina M; Mackenzie, Shawn

    2015-11-01

    A 2-year-old Labrador retriever dog was referred for evaluation of parasternal chronic draining sinus tracts associated with sternal osteomyelitis secondary to the presence of a residual wooden foreign body. The use of gentamicin-impregnated collagen sponges as adjunctive therapy to osteomyelitis treatment is reported herein. PMID:26538672

  6. Vibrating superconductors

    NASA Astrophysics Data System (ADS)

    Esquinazi, Pablo

    1991-11-01

    This review is concerned with effects in the energy dissipation and elastic modulus of superconductors vibrating in a magnetic field. The physics of superconducting vibrating reeds and reeds made of superconducting suspensions is thoroughly described as well as the main features observed in other oscillators applied to flux pinning studies. It is argued that among the diversity of methods to study superconducting and pinning properties as a function of magnetic field and temperature, the vibrating reed technique is one of the most sensitive due to the accurate measurement of frequency and dissipation with feasible magnetometry applications. Results of the elastic coupling between the flux line lattice and the atomic lattice in high- and low- T c superconductors obtained with the vibrating reed are summarized as well as the behavior of vibrating type II superconductors near their lower critical field. Results from mechanical measurements in high-temperature superconductors are reviewed, which support the model of thermally activated depinning and vortex diffusion.

  7. Is Stereotactic Body Radiation Therapy an Attractive Option for Unresectable Liver Metastases? A Preliminary Report From a Phase 2 Trial

    SciTech Connect

    Scorsetti, Marta; Arcangeli, Stefano; Tozzi, Angelo; Comito, Tiziana; Alongi, Filippo; Navarria, Pierina; Mancosu, Pietro; Reggiori, Giacomo; Fogliata, Antonella; Torzilli, Guido; Tomatis, Stefano; Cozzi, Luca

    2013-06-01

    Purpose: To evaluate the feasibility of high-dose stereotactic body radiation therapy (SBRT) in the treatment of unresectable liver metastases. Methods and Materials: Patients with 1 to 3 liver metastases, with maximum individual tumor diameters less than 6 cm and a Karnofsky Performance Status of at least 70, were enrolled and treated by SBRT on a phase 2 clinical trial. Dose prescription was 75 Gy on 3 consecutive days. SBRT was delivered using the volumetric modulated arc therapy by RapidArc (Varian, Palo Alto, CA) technique. The primary end-point was in-field local control. Secondary end-points were toxicity and survival. Results: Between February 2010 and September 2011, a total of 61 patients with 76 lesions were treated. Among the patients, 21 (34.3%) had stable extrahepatic disease at study entry. The most frequent primary sites were colorectal (45.9%) and breast (18%). Of the patients, 78.7% had 1 lesion, 18.0% had 2 lesions, and 3.3% had 3 lesions. After a median of 12 months (range, 2-26 months), the in-field local response rate was 94%. The median overall survival rate was 19 months, and actuarial survival at 12 months was 83.5%. None of the patients experienced grade 3 or higher acute toxicity. No radiation-induced liver disease was detected. One patient experienced G3 late toxicity at 6 months, resulting from chest wall pain. Conclusions: SBRT for unresectable liver metastases can be considered an effective, safe, and noninvasive therapeutic option, with excellent rates of local control and a low treatment-related toxicity.

  8. SU-E-J-89: Motion Effects On Organ Dose in Respiratory Gated Stereotactic Body Radiation Therapy

    SciTech Connect

    Wang, T; Zhu, L; Khan, M; Landry, J; Rajpara, R; Hawk, N

    2014-06-01

    Purpose: Existing reports on gated radiation therapy focus mainly on optimizing dose delivery to the target structure. This work investigates the motion effects on radiation dose delivered to organs at risk (OAR) in respiratory gated stereotactic body radiation therapy (SBRT). A new algorithmic tool of dose analysis is developed to evaluate the optimality of gating phase for dose sparing on OARs while ensuring adequate target coverage. Methods: Eight patients with pancreatic cancer were treated on a phase I prospective study employing 4DCT-based SBRT. For each patient, 4DCT scans are acquired and sorted into 10 respiratory phases (inhale-exhale- inhale). Treatment planning is performed on the average CT image. The average CT is spatially registered to other phases. The resultant displacement field is then applied on the plan dose map to estimate the actual dose map for each phase. Dose values of each voxel are fitted to a sinusoidal function. Fitting parameters of dose variation, mean delivered dose and optimal gating phase for each voxel over respiration cycle are mapped on the dose volume. Results: The sinusoidal function accurately models the dose change during respiratory motion (mean fitting error 4.6%). In the eight patients, mean dose variation is 3.3 Gy on OARs with maximum of 13.7 Gy. Two patients have about 100cm{sup 3} volumes covered by more than 5 Gy deviation. The mean delivered dose maps are similar to plan dose with slight deformation. The optimal gating phase highly varies across the patient, with phase 5 or 6 on about 60% of the volume, and phase 0 on most of the rest. Conclusion: A new algorithmic tool is developed to conveniently quantify dose deviation on OARs from plan dose during the respiratory cycle. The proposed software facilitates the treatment planning process by providing the optimal respiratory gating phase for dose sparing on each OAR.

  9. Poster — Thur Eve — 32: Stereotactic Body Radiation Therapy for Peripheral Lung Lesion: Treatment Planning and Quality Assurance

    SciTech Connect

    Wan, Shuying; Oliver, Michael; Wang, Xiaofang

    2014-08-15

    Stereotactic body radiation therapy (SBRT), due to its high precision for target localizing, has become widely used to treat tumours at various locations, including the lungs. Lung SBRT program was started at our institution a year ago. Eighteen patients with peripheral lesions up to 3 cm diameter have been treated with 48 Gy in 4 fractions. Based on four-dimensional computed tomography (4DCT) simulation, internal target volume (ITV) was delineated to encompass the respiratory motion of the lesion. A margin of 5 mm was then added to create the planning target volume (PTV) for setup uncertainties. There was no expansion from gross tumour volume (GTV) to clinical target volume (CTV). Pinnacle 9.6 was used as the primary treatment planning system. Volumetric modulated arc therapy (VMAT) technique, with one or two coplanar arcs, generally worked well. For quality assurance (QA), each plan was exported to Eclipse 10 and dose calculation was repeated. Dose volume histograms (DVHs) of the targets and organs at risk (OARs) were then compared between the two treatment planning systems. Winston-Lutz tests were carried out as routine machine QA. Patient-specific QA included ArcCheck measurement with an insert, where an ionization chamber was placed at the centre to measure dose at the isocenter. For the first several patients, and subsequently for the plans with extremely strong modulation, Gafchromic film dosimetry was also employed. For each patient, a mock setup was scheduled prior to treatments. Daily pre- and post-CBCT were acquired for setup and assessment of intra-fractional motion, respectively.

  10. Stereotactic Body Radiation Therapy for Primary, Recurrent, and Metastatic Tumors in the Head-and-Neck Region

    SciTech Connect

    Siddiqui, Farzan; Patel, Mehul; Khan, Mumtaz; McLean, Scott; Dragovic, Jadranka; Jin, J.-Y.; Movsas, Benjamin; Ryu, Samuel

    2009-07-15

    Purpose: To determine the feasibility, safety, and efficacy of stereotactic body radiation therapy (SBRT), also known as radiosurgery, in patients with head-and-neck cancers. Methods and Materials: Patients with pathologically proven malignant lesions in the head-and-neck region were treated using single-dose SBRT (S-SBRT) or fractionated SBRT (F-SBRT). Radiation doses were either single-fraction 13-18 Gy for S-SBRT or 36-48 Gy in five to eight fractions for F-SBRT. Response evaluation was based on clinical examinations and computed tomography/magnetic resonance imaging scans. Pre- and post-SBRT tumor dimensions were measured in three axes, and tumor volumes were calculated. Response evaluation also was performed using World Health Organization criteria. Results: Fifty-five lesions were treated in 44 patients (25 men, 19 women). There were three groups of patients: those with primary (n = 10), recurrent (n = 21), and metastatic tumors (n = 13). The predominant histologic type was squamous cell carcinoma (n = 33). The majority of lesions were treated using F-SBRT (n = 37). Based on radiographic and clinical assessment, a 77% (complete + partial response) response rate was noted. Percentage of reduction in tumor volume was 52% {+-} 38% based on follow-up scans in 24 patients. Tumor control rates at 1 year were 83.3% and 60.6% in the primary and recurrent groups, respectively. Median overall survival was 28.7, 6.7, and 5.6 months for the primary, recurrent, and metastatic groups, respectively. Radiation Therapy Oncology Group Grade 1-2 mucositis was noted in all patients treated for oropharyngeal or laryngeal lesions. Conclusions: The SBRT in single or fractionated doses offers a viable treatment option for selected patients with primary, recurrent, and metastatic head-and-neck cancers with functional preservation.

  11. MO-G-BRE-09: Validating FMEA Against Incident Learning Data: A Study in Stereotactic Body Radiation Therapy

    SciTech Connect

    Yang, F; Cao, N; Young, L; Howard, J; Sponseller, P; Logan, W; Arbuckle, T; Korssjoen, T; Meyer, J; Ford, E

    2014-06-15

    Purpose: Though FMEA (Failure Mode and Effects Analysis) is becoming more widely adopted for risk assessment in radiation therapy, to our knowledge it has never been validated against actual incident learning data. The objective of this study was to perform an FMEA analysis of an SBRT (Stereotactic Body Radiation Therapy) treatment planning process and validate this against data recorded within an incident learning system. Methods: FMEA on the SBRT treatment planning process was carried out by a multidisciplinary group including radiation oncologists, medical physicists, and dosimetrists. Potential failure modes were identified through a systematic review of the workflow process. Failure modes were rated for severity, occurrence, and detectability on a scale of 1 to 10 and RPN (Risk Priority Number) was computed. Failure modes were then compared with historical reports identified as relevant to SBRT planning within a departmental incident learning system that had been active for two years. Differences were identified. Results: FMEA identified 63 failure modes. RPN values for the top 25% of failure modes ranged from 60 to 336. Analysis of the incident learning database identified 33 reported near-miss events related to SBRT planning. FMEA failed to anticipate 13 of these events, among which 3 were registered with severity ratings of severe or critical in the incident learning system. Combining both methods yielded a total of 76 failure modes, and when scored for RPN the 13 events missed by FMEA ranked within the middle half of all failure modes. Conclusion: FMEA, though valuable, is subject to certain limitations, among them the limited ability to anticipate all potential errors for a given process. This FMEA exercise failed to identify a significant number of possible errors (17%). Integration of FMEA with retrospective incident data may be able to render an improved overview of risks within a process.

  12. Stereotactic Body Radiation Therapy in Centrally and Superiorly Located Stage I or Isolated Recurrent Non-Small-Cell Lung Cancer

    SciTech Connect

    Chang, Joe Y. Balter, Peter A.; Dong Lei; Yang Qiuan; Liao Zhongxing; Jeter, Melenda; Bucci, M. Kara; McAleer, Mary F.; Mehran, Reza J.; Roth, Jack A.; Komaki, Ritsuko

    2008-11-15

    Purpose: To evaluate the efficacy and adverse effects of image-guided stereotactic body radiation therapy (SBRT) in centrally/superiorly located non-small-cell lung cancer (NSCLC). Materials and Methods: We delivered SBRT to 27 patients, 13 with Stage I and 14 with isolated recurrent NSCLC. A central/superior location was defined as being within 2 cm of the bronchial tree, major vessels, esophagus, heart, trachea, pericardium, brachial plexus, or vertebral body, but 1 cm away from the spinal canal. All patients underwent four-dimensional computed tomography-based planning, and daily computed tomography-on-rail guided SBRT. The prescribed dose of 40 Gy (n = 7) to the planning target volume was escalated to 50 Gy (n = 20) in 4 consecutive days. Results: With a median follow-up of 17 months (range, 6-40 months), the crude local control at the treated site was 100% using 50 Gy. However, 3 of 7 patients had local recurrences when treated using 40 Gy. Of the patients with Stage I disease, 1 (7.7%) and 2 (15.4%) developed mediastinal lymph node metastasis and distant metastases, respectively. Of the patients with recurrent disease, 3 (21.4%) and 5 (35.7%) developed mediastinal lymph node metastasis and distant metastasis, respectively. Four patients (28.6%) with recurrent disease but none with Stage I disease developed Grade 2 pneumonitis. Three patients (11.1%) developed Grade 2-3 dermatitis and chest wall pain. One patient developed brachial plexus neuropathy. No esophagitis was noted in any patient. Conclusions: Image-guided SBRT using 50 Gy delivered in four fractions is feasible and resulted in excellent local control.

  13. Daily Alignment Results of In-Room Computed Tomography-Guided Stereotactic Body Radiation Therapy for Lung Cancer

    SciTech Connect

    Ikushima, Hitoshi; Balter, Peter; Komaki, Ritsuko; Hunjun, Sandeep; Bucci, M. Kara; Liao Zhongxing; McAleer, Mary F.; Yu, Zhiqian H.; Zhang, Yongbin; Chang, Joe Y.; Dong, Lei

    2011-02-01

    Purpose: To determine the extent of interfractional setup errors and day-to-day organ motion errors by assessing daily bone alignment results and changes in soft tissue tumor position during hypofractionated, in-room computed tomography (CT)-guided stereotactic body radiation therapy (SBRT) of lung cancer. Methods and Materials: Daily alignment results during SBRT were analyzed for 117 tumors in 112 patients. Patients received 40-50 Gy of SBRT in four to five fractions using an integrated CT-LINAC system. The free-breathing CT scans acquired during treatment setup were retrospectively realigned to match with each of the bony references and the gross tumor volume (GTV) defined on the reference CT by rigid-body registration, and the daily deviations were calculated. Results: The mean magnitude ({+-} SD) three-dimensional shift from the initial skin marks to the final bone-aligned positions was 9.4 {+-} 5.7 mm. The mean daily GTV deviation from the bone position was 0.1 {+-} 3.8 mm in the anterior-posterior direction, -0.01 {+-} 4.2 mm in the superior-inferior direction, and 0.2 {+-} 2.5 mm in the lateral direction. A clinically noteworthy trend (net change >5 mm in any direction) in GTV position relative to the bone was observed in 23 cases (20%). Conclusions: Soft tissue target position can change significantly beyond the motion envelope defined in the original internal target volume in four-dimensional CT-based treatment planning for SBRT of lung cancer. Additional margin should be considered for adequate coverage of interfractional changes.

  14. Stereotactic Body Radiation Therapy for Re-irradiation of Persistent or Recurrent Non-Small Cell Lung Cancer

    SciTech Connect

    Trovo, Marco; Minatel, Emilio; Durofil, Elena; Polesel, Jerry; Avanzo, Michele; Baresic, Tania; Bearz, Alessandra; Del Conte, Alessandro; Franchin, Giovanni; Gobitti, Carlo; Rumeileh, Imad Abu; Trovo, Mauro G.

    2014-04-01

    Purpose: To retrospectively assess toxicity and outcome of re-irradiation with stereotactic body radiation therapy (SBRT) in patients with recurrent or persistent non-small cell lung cancer (NSCLC), who were previously treated with radical radiation therapy (50-60 Gy). The secondary endpoint was to investigate whether there are dosimetric parameter predictors of severe radiation toxicity. Methods and Materials: The analysis was conducted in 17 patients with “in-field” recurrent/persistent centrally located NSCLC, who underwent re-irradiation with SBRT. SBRT consisted of 30 Gy in 5 to 6 fractions; these prescriptions would be equivalent for the tumor to 37.5 to 40 Gy, bringing the total 2-Gy-per-fraction cumulative dose to 87 to 100 Gy, considering the primary radiation therapy treatment. Actuarial analyses and survival were calculated by the Kaplan-Meier method, and P values were estimated by the log-rank test, starting from the date of completion of SBRT. Dosimetric parameters from the subgroups with and without grade ≥3 pulmonary toxicity were compared using a 2-tailed Student t test. Results: The median follow-up was 18 months (range, 4-57 months). Only 2 patients had local failure, corresponding to a local control rate of 86% at 1 year. The Kaplan-Meier estimates of overall survival (OS) rates at 1 and 2 years were 59% and 29%, respectively; the median OS was 19 months. Four patients (23%) experienced grade 3 radiation pneumonitis, and 1 patient developed fatal pneumonitis. One patient died of fatal hemoptysis 2 months after the completion of SBRT. Unexpectedly, heart maximum dose, D5 (minimum dose to at least 5% of the heart volume), and D10 were correlated with risk of radiation pneumonitis (P<.05). Conclusions: Re-irradiation with SBRT for recurrent/persistent centrally located NSCLC achieves excellent results in terms of local control. However, the high rate of severe toxicity reported in our study is of concern.

  15. Re-irradiation with stereotactic body radiation therapy as a novel treatment option for isolated local recurrence of pancreatic cancer after multimodality therapy: experience from two institutions

    PubMed Central

    Wild, Aaron T.; Hiniker, Susan M.; Chang, Daniel T.; Tran, Phuoc T.; Khashab, Mouen A.; Limaye, Maneesha R.; Laheru, Daniel A.; Le, Dung T.; Kumar, Rachit; Pai, Jonathan S.; Hargens, Blaire; Sharabi, Andrew B.; Shin, Eun Ji; Zheng, Lei; Pawlik, Timothy M.; Wolfgang, Christopher L.; Koong, Albert C.

    2013-01-01

    Limited treatment options exist for isolated local recurrence of pancreatic ductal adenocarcinoma (PDA) following surgical resection accompanied by neoadjuvant or adjuvant chemoradiation therapy (CRT). While select patients are eligible for re-resection, recurrent lesions are often unresectable. Stereotactic body radiation therapy (SBRT) represents a possible minimally invasive treatment option for these patients, although published data in this setting are currently lacking. This study examines the safety, efficacy, and palliative capacity of re-irradiation with SBRT for isolated local PDA recurrence. All patients undergoing SBRT at two academic centers from 2008-2012 were retrospectively reviewed to identify those who received re-irradiation with SBRT for isolated local recurrence or progression of PDA after previous conventionally fractionated CRT. Information regarding demographics, clinicopathologic characteristics, therapies received, survival, symptom palliation, and toxicity was obtained from patient charts. Kaplan-Meier statistics were used to analyze survival and the log-rank test was used to compare survival among patient subgroups. Eighteen patients were identified. Fifteen had previously undergone resection with neoadjuvant or adjuvant CRT, while 3 received definitive CRT for locally advanced disease. Median CRT dose was 50.4 Gy [interquartile range (IQR), 45.0-50.4 Gy] in 28 fractions. All patients subsequently received gemcitabine-based maintenance chemotherapy, but developed isolated local disease recurrence or progression without evidence of distant metastasis. Locally recurrent or progressive disease was treated with SBRT to a median dose of 25.0 Gy (range, 20.0-27.0 Gy) in 5 fractions. Median survival from SBRT was 8.8 months (95% CI, 1.2-16.4 months). Despite having similar clinicopathologic disease characteristics, patients who experienced local progression greater than vs. less than 9 months after surgery/definitive CRT demonstrated superior median survival (11.3 vs. 3.4 months; P=0.019) and progression-free survival (10.6 vs. 3.2 months; P=0.030) after SBRT. Rates of freedom from local progression at 6 and 12 months after SBRT were 78% (14 of 18 patients) and 62% (5 of 8 patients), respectively. Effective symptom palliation was achieved in 4 of 7 patients (57%) who reported symptoms of abdominal or back pain prior to SBRT. Five patients (28%) experienced grade 2 acute toxicity; none experienced grade ≥3 acute toxicity. One patient (6%) experienced grade 3 late toxicity in the form of small bowel obstruction. In conclusion, re-irradiation with hypofractionated SBRT in this salvage scenario appears to be a safe and reasonable option for palliation of isolated local PDA recurrence or progression following previous conventional CRT. Patients with a progression-free interval of greater than 9 months prior to isolated local recurrence or progression may be most suitable for re-irradiation with SBRT, as they appear to have a better prognosis with survival that is long enough for local control to be of potential benefit. PMID:24294505

  16. Modulation of Total Body Irradiation Induced Life Shortening by Systemic Intravenous MnSOD-Plasmid Liposome Gene Therapy

    PubMed Central

    Epperly, Michael W.; Smith, Tracy; Wang, Hong; Schlesselman, James; Franicola, Darcy; Greenberger, Joel S.

    2008-01-01

    To determine whether systemic administration of MnSOD-PL protected mice from the acute hematopoietic syndrome as well as delayed death following total body irradiation (TBI), C57BL/6J mice received intravenously 100?l liposomes containing 100?g of human MnSOD-transgene plasmid 24 hours prior to 9.5 Gy or 1.0 Gy. The dose of 9.5 Gy was lethal to 42% of irradiated control female and 74% of irradiated control male mice respectively at 30 days with bone marrow hypocellularity consistent with the hematopoietic syndrome. A statistically significant increase in survival was detected in MnSOD-PL treated compared to 9.5 Gy irradiated control female mice out to 400 days, and in male mice out to 340 days. The incidence of tumors was similar between surviving groups. Between 350 to 600 days, outcome was similar for both MnSOD-PL treated and control irradiated groups consistent with aging with no difference in gross or microscopic pathologic evidence of tumors. Male and female mice receiving 1.0 Gy TBI showed irradiation induced life shortening after 120 days that was decreased by MnSOD-PL administration, and was associated with no increase in rate of tumor associated death. Therefore, systemic MnSOD-PL radioprotective gene therapy is not associated with a detectably higher incidence of late carcinogenesis. PMID:19024650

  17. Red Shell: Defining a High-Risk Zone of Normal Tissue Damage in Stereotactic Body Radiation Therapy

    SciTech Connect

    Yang, Jun; Fowler, Jack F.; Lamond, John P.; Lanciano, Rachelle; Feng Jing; Brady, Luther W.

    2010-07-01

    Purpose: To define a volume of tissue just outside of the clinical target volume (CTV) or planning target volume (PTV) in stereotactic body radiation therapy (SBRT) that receives doses appreciably above the tolerance level and in which other critical tissue structures must be avoided. Methods and Materials: We define the tissue between the borders of the CTV and PTV as the Inner Red Shell. The tissue surrounding the PTV that receives higher than the local tissue tolerance is defined as the Outer Red Shell. Contributing factors to the volume of the Red Shell include the prescription dose, dose gradient and PTV size, together with the type of tissue and its tolerance are discussed. An illustrative example and two clinical cases are reported. Results: The volume of Red Shell increases with higher prescription dose, slower dose fall-off, larger PTV volume, and higher tissue radiosensitivity. Avoidance of proximal critical serial organs may alter the volume and shape of the Red Shell after repeated, detailed treatment planning. Conclusion: Rather than defining tolerance and toxicity as simply a dose level received by the tissues, the volume of tissue receiving risk levels above tolerance can be quantified as the 'cost' of SBRT. This concept may be adopted in other techniques offering ablative and high-dose gradients. Further consideration should be given to collecting clinical data for refining the choice of constraint doses, especially in parts of the brain, lung, liver, and kidney.

  18. Qigong as a Traditional Vegetative Biofeedback Therapy: Long-Term Conditioning of Physiological Mind-Body Effects

    PubMed Central

    Matos, Luís Carlos; Sousa, Cláudia Maria; Gonçalves, Mário; Gabriel, Joaquim; Machado, Jorge; Greten, Henry Johannes

    2015-01-01

    A contemporary understanding of Chinese Medicine (CM) regards CM diagnosis as a functional vegetative state that may be treated by vegetative reflex therapies such as acupuncture. Within this context, traditional mind-body exercises such as Qigong can be understood as an attempt to enhance physiological proprioception, by combining a special state of “awareness” with posture, movement, and breath control. We have formerly trained young auditing flutists in “White Ball” Qigong to minimize anxiety-induced cold hands and lower anxiety-induced heart rate. Functional changes occurred 2–5 min after training and were observed over the whole training program, allowing the children to control their symptoms. In our current work, we report that warm fingers and calm hearts could be induced by the children even without Qigong exercises. Thus, these positive changes once induced and “conditioned” vegetatively were stable after weeks of training. This may show the mechanism by which Qigong acts as a therapeutic measure in disease: positive vegetative pathways may be activated instead of dysfunctional functional patterns. The positive vegetative patterns then may be available in critical stressful situations. Qigong exercise programs may therefore be understood as an ancient vegetative biofeedback exercise inducing positive vegetative functions which are added to the individual reactive repertoire. PMID:2613