RU2238673C1 - Method for differential diagnostics of body posture disorders - Google Patents

Abstract

FIELD: medicine, orthopedics.

SUBSTANCE: the suggested method deals with visual analysis for disposition of spinal regional borders in frontal, sagittal and horizontal planes due to applying reference points for the above-mentioned borders right onto patient's body, analysis of the data obtained followed by establishing the diagnosis according to the presence or absence of parallelism in superior and inferior regional borders. Patient should be placed into the center of strictly horizontally located bottom area developed by mutually perpendicularly applied crossing lines passing through the middles of all its sides between two vertically located plumbs coming down to the centers of anterior and posterior sides of bottom area, and two measuring tapes fixed to the middle of left and right lateral sides of bottom area being parallel to plumbs. One should successively perform graphic registration of patient's body picture by making two photopictures at the front and at the rear in frontal projection. Patient should placed so that longitudinal line of bottom area should pass between patient's joined feet, and cross-sectional one - in projection of anterior edge of talocrural joint. Two photopictures should be made right-hand and left-hand in sagittal projection. Patient should be placed so that cross-sectional line should pass between feet and longitudinal one, correspondingly, in projection of anterior edge of talocrural joint. Pictures should be made if two plumbs are coincided in a viewfinder of registration device. Then come program analysis of the picture obtained to detect affected parallelism of horizontal lines of spinal regional borders. One should determine the value of total angular deviation and that of muscular shortening affecting the statics of corresponding region and at detecting the values of corresponding parameters being distinct against the norm one should diagnose affected body posture.

EFFECT: higher accuracy and information content of the method.

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Description

The invention relates to the field of medicine, orthopedics and can be used for the differential assessment of posture disorders.

The closest in technical essence to the proposed one is a method for diagnosing posture disorders (1), which consists in conducting a visual analysis of the relative position of the boundaries of the regions of the spine, including drawing landmark points of the border regions on the photo, R-gram or body of the patient, drawing horizontal lines through them and subsequent analysis of the obtained data with the preparation of a pathobiomechanical diagnosis. Moreover, visual diagnosis is carried out in several stages:

1 Assess the optimality of statics in general (by the location of the projection of the middle plumb relative to the patient's feet).

2 Estimate the balance of the muscles of the regions of the spine and limbs: by the location of the projection of the regional plumb relative to the middle of the lower border of the region;

- by the presence or absence of parallelism of the upper and lower boundaries of the region.

3 Determine the localization of the highest priority shortened muscle in a pathogenetically significant region (by the coincidence of the direction of muscle traction of the corresponding muscle and the direction of convergence of the region’s borders).

4 The localization of the priority relaxed muscle in the pathobiomechanically significant region is determined (by the coincidence of the direction of muscle stretching and the direction of mutual removal of the region’s borders).

5. Diagnose pathobiomechanically functional blocks (by localization in the places of attachment of pathogenetically significant shortened and relaxed muscles). Moreover, the assessment is carried out sequentially in the frontal, sagittal and horizontal planes, the data obtained are compared.

However, the known method is not sufficiently accurate and informative, since the requirements are not high enough for the conditions under which the image is recorded and information is read from the object of study - the patient’s body.

A new technical result is an increase in the accuracy and information content of the method by choosing the most optimal reference frame for the parameters.

The problem is solved by a new method of differential assessment of posture disorders, which consists in conducting a visual analysis of the location of the boundaries of the regions of the spine sequentially in the frontal, sagittal and horizontal planes by applying landmarks of the boundaries of the regions directly to the patient's body, analyzing the data and then making a diagnosis for the presence and absence parallelism of the upper and lower boundaries of the region, and the patient is placed in the center located strictly horizontally base flats formed by mutually perpendicular intersecting lines drawn on it passing through the middle of all its sides between two vertically located plumb lines, lowered to the centers of the front and rear sides of the base platform, and two measuring tapes fixed to the middle of the left and right sides of the base platform, located parallel to the plumb lines, and sequentially carry out a graphic registration of the image of the patient’s body, for which two photographs are taken in front and behind in the front th projection, positioning the patient so that the longitudinal line of the site passes between his connected feet, and the transverse - in the projection of the anterior edge of the ankle joint, and to the right and left in the sagittal projection, positioning the patient so that the transverse line runs between the feet, longitudinal respectively, in projections of the anterior edge of the ankle joint, and the pictures are performed subject to the combination of two plumb lines in the viewfinder of the recording device, then a program analysis of the image is carried out in order to detect nar sheniya parallel to the horizontal lines of the spine-regional borders, determine the value of the amount of deflection angles, as well as shortening of the muscles that affect the statics of the region, and the detection values of the respective parameters that differ from the norm, diagnose impaired posture.

The method is as follows.

In the case of a scoliotic disease, the patient is recommended to take an X-ray of the spine, in other cases, an examination is carried out without an X-ray. Symmetric key points are marked on the patient’s body that define the boundaries of the regions in the frontal and sagittal planes (Fig. 1), after which the patient is placed in the center of the base platform located strictly horizontally (1), formed by mutually perpendicular intersecting lines drawn through it, passing through the middle of all sides between two vertically located plumb lines (2, 3), lowered to the centers of the front and rear sides of the base, and two measuring tapes (4, 5) fixed to the middle of the left and right of the lateral sides of the base platform (1), parallel to the plumb lines, and graphically register the image of the patient’s body, for which two photographs are taken front and rear in the frontal projection, positioning the patient so that the longitudinal line of the platform runs between his connected feet, and the transverse - in the projection of the anterior edge of the ankle joint, and on the right and left in the sagittal projection, positioning the patient so that the transverse line runs between the feet, longitudinal, respectively, in projection of the anterior edge of the ankle joint, and the images are performed provided that two plumb lines are combined in the viewfinder of the recording device, then a program analysis of the image is carried out, for example, using Photoshop, for which the image points of the region’s borders, applied directly to the patient’s body, are connected horizontal and vertical lines, the violation of parallelism of the horizontal lines of the border-regions of the spine revealed in this case indicates the presence of statistical violations of one or another reg body ions, they also determine the exact value of the deviation angles and the difference in the distances between the lines, determine the zones of muscle shortening, affecting the statics of the corresponding region, and when identifying the values of the corresponding indicators that differ from the norm, posture disorder is diagnosed - depending on the magnitude of the change in values - scoliotic posture, hyperkyphosis, hyperlordosis, or a combination thereof.

Example. Patient Gorokholinskaya Renata, 10 years old, turned 12.05.03 to the orthopedic clinic with complaints of fatigue. A survey was carried out according to the proposed method (figure 2), based on the identified quantitative deviations (figure 3) in the frontal and sagittal planes of the cervical region, thoracic and lumbar regions, the diagnosis was made: kyphoscoliotic posture. It is recommended that: general massage, exercise therapy, SMT and wearing a corrective belt, selected on the basis of the identified violations for 3 months, then re-examination according to the proposed method, which resulted in a positive trend and a change in the values characterizing posture disorders, in particular a decrease their values are on average 30-40%. It is recommended to continue wearing the corrective belt for 2 months.

This method was tested in an orthopedic clinic, examined 23 patients with various types of posture disorders. Comparison of the diagnosis data obtained by the proposed method and, for example, using x-rays, revealed a complete correlation of the proposed method with known methods.

Thus, the method allows for a non-invasive examination of patients suffering from impaired posture, and can equally well be used to select posture correctors and evaluate the effectiveness of the treatment with little or no x-ray diagnostics.

The method involves determining the qualitative and quantitative characteristics of the violation of the optimality of the body statics as a whole, and its regions in the frontal, sagittal and horizontal planes, form maps of muscle imbalance, choose the most optimal method of rehabilitation treatment, including dynamic correctors.

Sources of information

1. Vasilieva L.V. Manual diagnosis and therapy St. Petersburg, 1999, p. 76 (prototype)

Claims (1)

The method of differential assessment of posture disorders, which consists in conducting a visual analysis of the location of the boundaries of the regions of the spine sequentially in the frontal, sagittal and horizontal planes by plotting landmarks of the boundaries of the regions directly on the patient’s body, analyzing the data and then making a diagnosis of the presence and absence of parallelism of the upper and lower the boundaries of the region, characterized in that the patient is placed in the center of the base located strictly horizontally, about developed by mutually perpendicular intersecting lines drawn on it, passing through the middle of all its sides between two vertically located plumb lines, lowered to the centers of the front and rear sides of the base platform, and two measuring tapes fixed to the middle of the left and right sides of the base platform, parallel to the plumb lines , and sequentially carry out a graphical registration of the image of the patient’s body, for which two photographs are taken in front and behind in the frontal projection, the patient so that the longitudinal line of the site passes between its connected feet, and the transverse - in the projection of the anterior edge of the ankle joint and to the right and left in the sagittal projection, positioning the patient so that the transverse line runs between the feet, the longitudinal - respectively, in the projection of the anterior edge of the ankle the joint, and the pictures are performed subject to the combination of two plumb lines in the viewfinder of the recording device, then a program analysis of the image is carried out in order to detect parallelism and horizontal lines of the border-regions of the spine, determine the amount of the sum of the deviation angles, as well as the shortening of the muscles that affect the statics of the corresponding region, and when identifying values of the corresponding indicators that differ from the norm, they diagnose a violation of posture.

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