Prevención de patologías de la columna vertebral

En esta revisión bibliográfica, llevada a cabo a través de una búsqueda en distintas bases de datos (PubMed, SportDiscus, Scielo) así como en revistas tales como Elsevier y buscadores como Google, se busca la evidencia referente a las patologías de la columna vertebral en la infancia así como programas educativos de prevención y tratamiento y el papel que puede desempeñar la educación física en las patologías de la columna vertebral en general y de la hiperlordosis específicamente. La literatura existente debía estar comprendida entre los años 2005g2015. Como visión global de esta revisión, podríamos decir que los problemas de espalda en la niñez son muy habituales pese a producirse en menor número que en poblaciones adultas y que, actualmente, siguen considerándose como un desafío clínico debido a que, en la mayoría de las veces, vienen acompañadas de patologías más complejas. Dentro de los problemas más prevalentes se encuentran algunos como la hiperlordosis, el genu valgum, el desequilibrio entre los hombros, la inclinación pélvica lateral, la escoliosis, la rotación del tronco y la hipercifosis torácica, entre otros. Se exponen, además de los problemas más habituales de columna vertebral en la niñez, las posibles causas, diversos programas de prevención e intervención y, finalmente, se exponen la importancia que tienen la educación postural, el papel del profesor de educación física en la prevención, detección y tratamiento de dichas patologías así como el papel vital que puede desarrollar la educación física en dichos niños. ABSTRACT This literature review was carried out through a search in different databases (PubMed, SportDiscus, Scielo) as well as in magazines such as Elsevier and, finally, in Google. Evidences related to the pathologies of the spine in children as well as educational programs for the prevention and treatment were searched. The role that educational programs can play in the prevention of the spine pathologies in general and specifically in the hyperlordosis was also analyzed. Literature review period was from 2005 till 2015. Results showed that back problems in childhood are very common although the prevalence is lower than in adults. The fact that these pathologies come normally associated with other more important problems, makes spine diseases a medical challenge. Within the most prevalent problems we can find hyperlordosis, genu valgum, lateral pelvic tilt, scoliosis, trunk rotation, uneven shoulders and chest’s hipercifosis, among others. Most common problems of vertebral column in the childhood, the possible causes, different programs of prevention and intervention were also reviewed. Importance of postural education in schools as well as the figure of the physical education teacher in the prevention, detection and treatment were analyzed.

Methodology for registration of distended recutms in pelvic CT studies

Purpose: Accurate delineation of the rectum is of high importance in off-line adaptive radiation therapy since it is a major dose-limiting organ in prostate cancer radiotherapy. The intensity-based deformable image registration (DIR) methods cannot create a correct spatial transformation if there is no correspondence between the template and the target images. The variation of rectal filling, gas, or feces, creates a noncorrespondence in image intensities that becomes a great obstacle for intensity-based DIR. Methods: In this study the authors have designed and implemented a semiautomatic method to create a rectum mask in pelvic computed tomography (CT) images. The method, that includes a DIR based on the demons algorithm, has been tested in 13 prostate cancer cases, each comprising of two CT scans, for a total of 26 CT scans. Results: The use of the manual segmentation in the planning image and the proposed rectum mask method (RMM) method in the daily image leads to an improvement in the DIR performance in pelvic CT images, obtaining a mean value of overlap volume index = 0.89, close to the values obtained using the manual segmentations in both images. Conclusions: The application of the RMM method in the daily image and the manual segmentations in the planning image during prostate cancer treatments increases the performance of the registration in presence of rectal fillings, obtaining very good agreement with a physician's manual contours.

Methodology for registration of distended rectums in pelvic CT studies

Purpose: Accurate delineation of the rectum is of high importance in off-line adaptive radiation therapy since it is a major dose-limiting organ in prostate cancer radiotherapy. The intensity-based deformable image registration (DIR) methods cannot create a correct spatial transformation if there is no correspondence between the template and the target images. The variation of rectal filling, gas, or feces, creates a noncorrespondence in image intensities that becomes a great obstacle for intensity-based DIR. Methods: In this study the authors have designed and implemented a semiautomatic method to create a rectum mask in pelvic computed tomography (CT) images. The method, that includes a DIR based on the demons algorithm, has been tested in 13 prostate cancer cases, each comprising of two CT scans, for a total of 26 CT scans. Results: The use of the manual segmentation in the planning image and the proposed rectum mask method (RMM) method in the daily image leads to an improvement in the DIR performance in pelvic CT images, obtaining a mean value of overlap volume index = 0.89, close to the values obtained using the manual segmentations in both images. Conclusions: The application of the RMM method in the daily image and the manual segmentations in the planning image during prostate cancer treatments increases the performance of the registration in presence of rectal fillings, obtaining very good agreement with a physician's manual contours.

Pelvic Floor Muscle Training Included in a Pregnancy Exercise Program Is Effective in Primary Prevention of Urinary Incontinence: A Randomized Controlled Trial

AIMS: To investigate the effect of pelvic floor muscle training (PFMT) taught in a general exercise class during pregnancy on the prevention of urinary incontinence (UI) in nulliparous continent pregnant women. METHODS: This was a unicenter two armed randomized controlled trial. One hundred sixty-nine women were randomized by a central computer system to an exercise group (EG) (exercise class including PFMT) (n = 73) or a control group (CG) (n = 96). 10.1% loss to follow-up: 10 from EG and 7 from CG. The intervention consisted of 70-75 sessions (22 weeks, three times per week, 55-60 min/session including 10 min of PFMT). The CG received usual care (which included follow up by midwifes including information about PFMT). Questions on prevalence and degree of UI were posed before (week 10-14) and after intervention (week 36-39) using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). RESULTS: At the end of the intervention, there was a statistically significant difference in favor of the EG. Reported frequency of UI [Never: CG: 54/60.7%, EG: 60/95.2% (P < 0.001)]. Amount of leakage [None: CG: 45/60.7%, EG: 60/95.2% (P < 0.001)]. There was also a statistically significant difference in ICIQ-UI SF Score between groups after the intervention period [CG: 2.7 (SD 4.1), EG: 0.2 (SD 1.2) (P < 0.001)]. The estimated effect size was 0.8. CONCLUSION: PFMT taught in a general exercise class three times per week for at least 22 weeks, without former assessment of ability to perform a correct contraction was effective in primary prevention of UI in primiparous pregnant women.