Urinary incontinence in women

Review of health information technology usability study methodologies

The use of ultrasound imaging by physical therapists is growing in popularity. This commentary has 2 aims. The first is to introduce the concept of rehabilitative ultrasound imaging (RUSI), provide a definition of the scope of this emerging tool in regard to the physical therapy profession, and describe how this relates to the larger field of medical ultrasound imaging. The second aim is to provide an overview of basic ultrasound imaging and instrumentation principles, including an understanding of the various modes and applications of the technology with respect to neuromusculoskeletal rehabilitation and in relation to other common imaging modalities.

https://www.jospt.org/doi/pdfplus/10.2519/jospt.2007.2350

Rehabilitative Ultrasound Imaging: Understanding the Technology and Its Applications

Over the last decade, the use of portable ultrasound scanners has enhanced the concept of point of care ultrasound (PoC-US), namely, “ultrasound performed at the bedside and interpreted directly by the treating clinician.” PoC-US is not a replacement for comprehensive ultrasound, but rather allows physicians immediate access to clinical imaging for rapid and direct solutions. PoC-US has already revolutionized everyday clinical practice, and it is believed that it will dramatically change how ultrasound is applied in daily practice. However, its use and teaching are different from continent to continent and from country to country. This World Federation for Ultrasound in Medicine and Biology position paper discusses the current status and future perspectives of PoC-US. Particular attention is given to the different uses of PoC-US and its clinical significance, including within emergency and critical care medicine, cardiology, anesthesiology, rheumatology, obstetrics, neonatology, gynecology, gastroenterology and many other applications. In the future, PoC-US will be more diverse than ever and be included in medical student training.

Point of Care Ultrasound: A WFUMB Position Paper

Stability, continence and breathing: the role of fascia following pregnancy and delivery.

https://eprints.soton.ac.uk/66726/1/Lovegrove_Jones_et_al_2009.pdf

Mechanisms of Pelvic Floor Muscle Function and the Effect on the Urethra during a Cough

Ultrasound imaging of the pelvic floor carries diagnostically important information about the dynamic response of the pelvic floor muscles (PFM) to potentially incontinence-producing stress, which cannot be readily captured and assimilated by the observer during the scanning process. We presented an approach based on motion tracking quantitatively to analyze the dynamic parameters of PFM on the ano-rectal angle (ARA). Perineal ultrasonography was performed on 22 asymptomatic females and nine stress urinary incontinent (SUI) patients with a broad age distribution and parity. The ventral-dorsal and cephalad-caudad movements of the ARA were resolved and kinematic parameters, in terms of displacement, trajectory, velocity and acceleration, were analyzed. The results revealed the possible mechanisms of PFM responses to prevent the urine from incontinence in fast and stress events such as coughs. The statistical analyses showed that the PFM responses of the healthy subjects and the SUI patients are significantly different in both the supine and standing experiments.

Ultrasound Evaluation of Dynamic Responses of Female Pelvic Floor Muscles

Influence of pelvic floor muscle contraction on the profile of vaginal closure pressure in continent and stress urinary incontinent women.

We present the analysis of sequences of voluntarily and reflexly generated pelvic floor muscle (PFM) contractions on the urethra, vagina, and rectum. A succession of observations were taken of perineal ultrasound at a frequency of 3.5 MHz imaging using a curved linear array probe in the sagittal plane and the videos captured and stored. An edge extraction algorithm was used to outline the coordinates of the symphysis pubis, urethra, and rectum interfaces on a frame-by-frame basis for sequences of 10–20 s. During each PFM contraction, the trajectory of the boundary of each structure was evaluated, colour coded, and overlaid to characterize the sequential history of the ensuing movement. The resulting image analysis was focused to reveal the anatomical displacement of the urogenital structures, which enables the evaluation of their biomechanical parameters in terms of displacement, velocity, and acceleration at any point in time. On the basis of these observations, the biomechanical mechanisms of pelvic floor muscle responses to voluntary and reflex contractions can be identified. It is concluded that a considerable amount of new, potentially useful clinical information can be revealed from video recordings of perineal ultrasound using the image analysis approach proposed.

2D Ultrasound Image Processing in Identifying Responses of Urogenital Structures to Pelvic Floor Muscle Activity

A human-to-computer system that includes a wireless intra-oral module, a wireless coordinator and distributed wireless controllers, is presented. The state-of-the-art ZigBee protocol is employed to achieve reliable, low- power and cost-efficient wireless communication between the tongue, computer and controllers. By manipulating five buttons on the wireless intra-oral module using the tongue, the subject can control cursors, computer menus, wheelchair, lights, TV, phone and robotic devices. The system is designed to improve the life quality of patients with stroke and patients with spinal cord injury.

Qiyu Peng

Papers

Mechanisms of Pelvic Floor Muscle Function and the Effect on the Urethra during a Cough

Ultrasound Evaluation of Dynamic Responses of Female Pelvic Floor Muscles

Influence of pelvic floor muscle contraction on the profile of vaginal closure pressure in continent and stress urinary incontinent women.

2D Ultrasound Image Processing in Identifying Responses of Urogenital Structures to Pelvic Floor Muscle Activity

ZigBee-based Wireless Intra-oral Control System for Quadriplegic Patients