The effect of viewing a virtual environment through a head-mounted display on balance

Publication date: Available online 10 June 2016
Source:Gait & Posture
Author(s): Maxime T. Robert, Laurent Ballaz, Martin Lemay
IntroductionIn the next few years, several head-mounted displays (HMD) will be publicly released making virtual reality more accessible. HMD are expected to be widely popular at home for gaming but also in clinical settings, notably for training and rehabilitation. HMD can be used in both seated and standing positions; however, presently, the impact of HMD on balance remains largely unknown. It is therefore crucial to examine the impact of viewing a virtual environment through a HMD on standing balance.ObjectivesTo compare static and dynamic balance in a virtual environment perceived through a HMD and the physical environment. The visual representation of the virtual environment was based on filmed image of the physical environment and was therefore highly similar.DesignThis is an observational study in healthy adults.ResultsNo significant difference was observed between the two environments for static balance. However, dynamic balance was more perturbed in the virtual environment when compared to that of the physical environment.ConclusionsHMD should be used with caution because of its detrimental impact on dynamic balance. Sensorimotor conflict possibly explains the impact of HMD on balance.



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In vivo kinematic study of the tarsal joints complex based on fluoroscopic 3D-2D registration technique

Publication date: Available online 10 June 2016
Source:Gait & Posture
Author(s): M.D. Chen Wang, Xiang Geng, Shaobai Wang, M.D. Xin Ma, M.D. Xu Wang, M.D. Jiazhang Huang, M.D. Chao Zhang, M.S. Li Chen, Junsheng Yang, Kan Wang
The tarsal bones articulate with each other and demonstrate complicated kinematic characteristics. The in vivo motions of these tarsal joints during normal gait are still unclear. Seven healthy subjects were recruited and fourteen feet in total were tested in current study. Three dimensional models of the tarsal bones were first created using CT scanning. Corresponding local 3D coordinate systems of each tarsal bone was subsequently established for 6DOF motion decompositions. The fluoroscopy system captured the lateral fluoroscopic images of the targeted tarsal region whilst the subject was walking. Seven key pose images during the stance phase were selected and 3D to 2D bone model registrations were performed on each image to determine joint positions. The 6DOF motions of each tarsal joint during gait were then obtained by connecting these positions together. The TNJ (talo-navicular joint) exhibited the largest ROMs (range of motion) on all rotational directions with 7.39±2.75°of dorsi/plantarflexion, 21.12±4.68°of inversion/eversion, and 16.11±4.44°of internal/external rotation. From heel strike to midstance, the TNJ, STJ (subtalar joint), and CCJ (calcaneao-cuboid joint) were associated with 5.97°, 5.04°, and 3.93°of dorsiflexion; 15.46°, 8.21°, and 5.82°of eversion; and 9.75°, 7.6°, and 4.99°of external rotation, respectively. Likewise, from midstance to heel off, the TNJ, STJ, and CCJ were associated with 6.39, 6.19°, and 4.47°of plantarflexion; 18.57°, 11.86°, and 6.32°of inversion and 13.95°, 9.66°, and 7.58°of internal rotation, respectively. In conclusion, among the tarsal joints, the TNJ exhibited the greatest rotational mobility. Synchronous and homodromous rotational motions were detected for TNJ, STJ, and CCJ during the stance phase.



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The effect of viewing a virtual environment through a head-mounted display on balance

Publication date: Available online 10 June 2016
Source:Gait & Posture
Author(s): Maxime T. Robert, Laurent Ballaz, Martin Lemay
IntroductionIn the next few years, several head-mounted displays (HMD) will be publicly released making virtual reality more accessible. HMD are expected to be widely popular at home for gaming but also in clinical settings, notably for training and rehabilitation. HMD can be used in both seated and standing positions; however, presently, the impact of HMD on balance remains largely unknown. It is therefore crucial to examine the impact of viewing a virtual environment through a HMD on standing balance.ObjectivesTo compare static and dynamic balance in a virtual environment perceived through a HMD and the physical environment. The visual representation of the virtual environment was based on filmed image of the physical environment and was therefore highly similar.DesignThis is an observational study in healthy adults.ResultsNo significant difference was observed between the two environments for static balance. However, dynamic balance was more perturbed in the virtual environment when compared to that of the physical environment.ConclusionsHMD should be used with caution because of its detrimental impact on dynamic balance. Sensorimotor conflict possibly explains the impact of HMD on balance.



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In vivo kinematic study of the tarsal joints complex based on fluoroscopic 3D-2D registration technique

Publication date: Available online 10 June 2016
Source:Gait & Posture
Author(s): M.D. Chen Wang, Xiang Geng, Shaobai Wang, M.D. Xin Ma, M.D. Xu Wang, M.D. Jiazhang Huang, M.D. Chao Zhang, M.S. Li Chen, Junsheng Yang, Kan Wang
The tarsal bones articulate with each other and demonstrate complicated kinematic characteristics. The in vivo motions of these tarsal joints during normal gait are still unclear. Seven healthy subjects were recruited and fourteen feet in total were tested in current study. Three dimensional models of the tarsal bones were first created using CT scanning. Corresponding local 3D coordinate systems of each tarsal bone was subsequently established for 6DOF motion decompositions. The fluoroscopy system captured the lateral fluoroscopic images of the targeted tarsal region whilst the subject was walking. Seven key pose images during the stance phase were selected and 3D to 2D bone model registrations were performed on each image to determine joint positions. The 6DOF motions of each tarsal joint during gait were then obtained by connecting these positions together. The TNJ (talo-navicular joint) exhibited the largest ROMs (range of motion) on all rotational directions with 7.39±2.75°of dorsi/plantarflexion, 21.12±4.68°of inversion/eversion, and 16.11±4.44°of internal/external rotation. From heel strike to midstance, the TNJ, STJ (subtalar joint), and CCJ (calcaneao-cuboid joint) were associated with 5.97°, 5.04°, and 3.93°of dorsiflexion; 15.46°, 8.21°, and 5.82°of eversion; and 9.75°, 7.6°, and 4.99°of external rotation, respectively. Likewise, from midstance to heel off, the TNJ, STJ, and CCJ were associated with 6.39, 6.19°, and 4.47°of plantarflexion; 18.57°, 11.86°, and 6.32°of inversion and 13.95°, 9.66°, and 7.58°of internal rotation, respectively. In conclusion, among the tarsal joints, the TNJ exhibited the greatest rotational mobility. Synchronous and homodromous rotational motions were detected for TNJ, STJ, and CCJ during the stance phase.



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Genetic, Clinical, and Pathologic Backgrounds of Patients with Autosomal Dominant Alport Syndrome.

Genetic, Clinical, and Pathologic Backgrounds of Patients with Autosomal Dominant Alport Syndrome.

Clin J Am Soc Nephrol. 2016 Jun 8;

Authors: Kamiyoshi N, Nozu K, Fu XJ, Morisada N, Nozu Y, Ye MJ, Imafuku A, Miura K, Yamamura T, Minamikawa S, Shono A, Ninchoji T, Morioka I, Nakanishi K, Yoshikawa N, Kaito H, Iijima K

Abstract
BACKGROUND AND OBJECTIVES: Alport syndrome comprises a group of inherited heterogeneous disorders involving CKD, hearing loss, and ocular abnormalities. Autosomal dominant Alport syndrome caused by heterozygous mutations in collagen 4A3 and/or collagen 4A4 accounts for <5% of patients. However, the clinical, genetic, and pathologic backgrounds of patients with autosomal dominant Alport syndrome remain unclear.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective analysis of 25 patients with genetically proven autosomal dominant Alport syndrome and their family members (a total of 72 patients) from 16 unrelated families. Patients with suspected Alport syndrome after pathologic examination who were referred from anywhere in Japan for genetic analysis from 2006 to 2015 were included in this study. Clinical, laboratory, and pathologic data were collected from medical records at the point of registration for genetic diagnosis. Genetic analysis was performed by targeted resequencing of 27 podocyte-related genes, including Alport-related collagen genes, to make a diagnosis of autosomal dominant Alport syndrome and identify modifier genes or double mutations. Clinical data were obtained from medical records.
RESULTS: The median renal survival time was 70 years, and the median age at first detection of proteinuria was 17 years old. There was one patient with hearing loss and one patient with ocular lesion. Among 16 patients who underwent kidney biopsy, three showed FSGS, and seven showed thinning without lamellation of the glomerular basement membrane. Five of 13 detected mutations were reported to be causative mutations for autosomal recessive Alport syndrome in previous studies. Two families possessed double mutations in both collagen 4A3 and collagen 4A4, but no modifier genes were detected among the other podocyte-related genes.
CONCLUSIONS: The renal phenotype of autosomal dominant Alport syndrome was much milder than that of autosomal recessive Alport syndrome or X-linked Alport syndrome in men. It may, thus, be difficult to make an accurate diagnosis of autosomal dominant Alport syndrome on the basis of clinical or pathologic findings. No modifier genes were identified among the known podocyte-related genes.

PMID: 27281700 [PubMed - as supplied by publisher]

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RIN2 syndrome: Expanding the clinical phenotype.

RIN2 syndrome: Expanding the clinical phenotype.

Am J Med Genet A. 2016 Jun 8;

Authors: Rosato S, Syx D, Ivanovski I, Pollazzon M, Santodirocco D, De Marco L, Beltrami M, Callewaert B, Garavelli L, Malfait F

Abstract
Biallelic defects in the RIN2 gene, encoding the Ras and Rab interactor 2 protein, are associated with a rare autosomal recessive connective tissue disorder, with only nine patients from four independent families reported to date. The condition was initially termed MACS syndrome (macrocephaly, alopecia, cutis laxa, and scoliosis), based on the clinical features of the first identified family; however, with the expansion of the clinical phenotype in additional families, it was subsequently coined RIN2 syndrome. Hallmark features of this condition include dysmorphic facial features with striking, progressive facial coarsening, sparse hair, normal to enlarged occipitofrontal circumference, soft redundant and/or hyperextensible skin, and scoliosis. Patients with RIN2 syndrome present phenotypic overlap with other conditions, including EDS (especially the dermatosparaxis and kyphoscoliosis subtypes). Here, we describe a 10th patient, the first patient of Caucasian origin and the oldest reported patient so far, who harbors the previously identified homozygous RIN2 mutation c.1878dupC (p. (Ile627Hisfs*7)). Besides the hallmark features, this patient also presents problems not previously associated with RIN2 syndrome, including cervical vertebral fusion, mild hearing loss, and colonic fibrosis. We provide an overview of the clinical findings in all reported patients with RIN2 mutations and summarize some of the possible pathogenic mechanisms that may underlie this condition. © 2016 Wiley Periodicals, Inc.

PMID: 27277385 [PubMed - as supplied by publisher]

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The effect of viewing a virtual environment through a head-mounted display on balance

Publication date: Available online 10 June 2016
Source:Gait & Posture
Author(s): Maxime T. Robert, Laurent Ballaz, Martin Lemay
IntroductionIn the next few years, several head-mounted displays (HMD) will be publicly released making virtual reality more accessible. HMD are expected to be widely popular at home for gaming but also in clinical settings, notably for training and rehabilitation. HMD can be used in both seated and standing positions; however, presently, the impact of HMD on balance remains largely unknown. It is therefore crucial to examine the impact of viewing a virtual environment through a HMD on standing balance.ObjectivesTo compare static and dynamic balance in a virtual environment perceived through a HMD and the physical environment. The visual representation of the virtual environment was based on filmed image of the physical environment and was therefore highly similar.DesignThis is an observational study in healthy adults.ResultsNo significant difference was observed between the two environments for static balance. However, dynamic balance was more perturbed in the virtual environment when compared to that of the physical environment.ConclusionsHMD should be used with caution because of its detrimental impact on dynamic balance. Sensorimotor conflict possibly explains the impact of HMD on balance.



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