Določanje narastišč in površin prečnih presekov mišic kolka s slik magnetne resonance za model HIPSTRESS : magistrsko delo

Mitić, Jovana (avtor), Kralj-Iglič, Veronika (mentor), Gošnak Dahmane, Raja (komentor), Puh, Urška (komentor), Matjačić, Zlatko (recenzent)

Uvod: Pri opisu biomehanskega stanja mišično-skeletnega sistema kolčnega sklepa določamo mehanske parametre, kot so sile in tlačne porazdelitve, ki delujejo v sklepu. Za ocenjevanje slednjega so primerni enostavni matematični modeli, kjer je človeško telo oblikovano kot sistem povezanih segmentov, katerih gibanje opravljajo mišice, ki jih povezujejo. Primer takšnih modelov je metoda HIPSTRESS. Namen: Neposredno izmeriti izvore in narastišča ter izračunati površine prečnih presekov mišic kolčnega sklepa, ki so pomembne za računanje porazdelitve rezultantne kolčne sile in za določanje kolčnega tlaka med stojo na eni nogi z metodo HIPSTRESS. Namen je bil tudi neposredno določiti geometrijske parametre s slik magnetne resonance in oceniti napako, ki jo naredimo, če kolčne sile in tlak računamo posredno s ponovnim skaliranjem referenčnih vrednosti glede na kostne strukture. Metode dela: Za merjenje izvorov, narastišč in površin prečnih presekov mišic kolčnega sklepa so bile uporabljene slike magnetne resonance pridobljene retrospektivno. Slikovni podatki so bili posneti v namene preiskovanja zgornjega dela stegnenice 17-letnega dečka, uporabljeni pa so bili podatki z zdrave strani. Koordinate mišičnih točk smo izmerili neposredno s slik magnetne resonance in s ponovnim skaliranjem podatkov validiranega modela HIPSTRESS glede na obliko medenice in zgornjega dela stegnenice. Rezultantno kolčno silo in porazdelitev kolčnega tlaka smo izračunali s tremi matematičnimi modeli metode HIPSTRESS. Rezultati: Ugotovili smo, da validirani model HIPSTRESS preceni vrednost kolčne sile za 16 % in vrh tlaka za 20?%, medtem ko enomišični model preceni silo za 9 % in vrh tlaka za 1 % v primerjavi z modelom HIPSTRESS z magnetno resonanco. Validirani model HIPSTRESS in enomišični model podcenita nagib nastale rezultantne kolčne sile za več kot 30 % in precenita položaj pola tlaka. Validirani model HIPSTRESS je normalizirane biomehanske parametre glede na telesno težo precenil za manj kot 20 % v primerjavi z modelom HIPSTRESS z magnetno resonanco. Ugotovili smo tudi dobro ujemanje med rezultantno kolčno silo in vrhom kontaktnega kolčnega tlaka, ki sta bila izračunana iz obeh modelov HIPSTRESS, ter dobro ujemanje obeh modelov z enomišičnim modelom. Pri tem smo ugotovili, da dodane mišice v modelu HIPSTRESS z magnetno resonanco bistveno ne prispevajo k vrednosti obremenitve kolčnega sklepa. Zaključek: Vsi trije modeli so med seboj primerljivi in se dobro ujemajo v izračunani rezultantni kolčni sili, vrhu kolčnega tlaka in obremenitvi kolčnega sklepa z dodanimi mišicami. V klinični praksi priporočamo model HIPSTRESS z magnetno resonanco za pridobivanje geometrijskih in biomehanskih podatkov, saj omogoča natančnejše izide merjenja, vendar je zaradi porabe časa trenutno uporaben na majhnem številu preiskovancev.

• Jezik: Slovenski jezik
• Ključne besede: magistrska dela, fizioterapija, kolčni sklep, metoda HIPSTRESS, magnetna resonanca, mišična narastišča, geometrijski parametri
• Vrsta gradiva: Magistrsko delo/naloga
• Tipologija: 2.09 - Magistrsko delo
• Organizacija: ZF - Zdravstvena fakulteta
• Kraj izida: Ljubljana
• Založnik: [J. Mitić]
• Leto izida: 2020
• Št. strani: 64 str., [11] str. pril
• PID: 20.500.12556/RUL-114253
• UDK: 615.8
• COBISS.SI-ID: 5781867
• Datum objave v RUL: 21.02.2020

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Determination of muscle insertions and cross-sectional areas of the hip from magnetic resonance images for HIPSTRESS model : master thesis

Izvleček

Introduction: When describing the biomechanical status of the musculoskeletal system of the hip joint, we determine the mechanical parameters as are forces and stresses that have an influence on joint. To evaluate the latter there are used simple mathematical models, in which the human body is formed as a system of connected segments managed by muscles that attach them. An example of such models is the HIPSTRESS method. Purpose: To directly measure the position of muscle attachment points and calculate the cross-sectional areas of hip joint muscles, important for calculating the distribution of the resultant hip force and for determining contact hip stress in position of one-leg stance using the HIPSTRESS method. The purpose was also to directly determine the geometric parameters from magnetic resonance images and to estimate the error we make when the hip forces and stresses are calculated indirectly by re-scaling the reference values with respect to bone structures. Methods: Magnetic resonance imaging was used retrospectively to measure origins, insertions and cross-sectional areas of the hip joint muscles. The image data was taken for the purpose of examining the proximal femora of a 17-year-old boy, and data from the healthy side was used. The input data on positions of muscle attachment points were assessed directly from magnetic resonance images, and by re-scaling the data of the aknowledged HIPSTRESS model according to the shape of pelvis and proximal femora. The resultant hip force and distribution of contact stress were calculated using three different mathematical models within the HIPSTRESS method. Results: We established that the validated HIPSTRESS model overestimates the value of hip force by 16 % and peak hip stress by 20 %, while one-muscle model overestimates force by 9 % and peak hip stress by 1 % in comparison to HIPSTRESS model with magnetic resonance. The validated HIPSTRESS model and one-muscle model underestimate the inclination of the resultant hip force and the position of the stress pole. The validated HIPSTRESS model overestimated with body weight normalized biomechanical parameters for less than 20 % compared to the HIPSTRESS model with magnetic resonance. We also established a good data match between the resultant hip force and peak contact hip stress, which were calculated from both HIPSTRESS models, and a good match between the HIPSTRESS models and one-muscle model. We found that the added muscles in the HIPSTRESS model with magnetic resonance did not significantly contribute to the value of the hip joint load. Conclusion: All three models are comparable to each other in calculated resultant hip force, peak hip stress and hip joint load with added muscles. In clinical practice, we recommend the HIPSTRESS model with magnetic resonance to evaluate geometric and biomechanical data, since it provides more accurate measurement outcomes, but it is currently usable on small number of included subjects due to time-consuming.

• Ključne besede: master's theses, physiotherapy, hip joint, HIPSTRESS method, magnetic resonance imaging, muscle attachment points, geometrical parameters