Orientador: Ricardo Machado Leite de Barros / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação Fisica / Made available in DSpace on 2018-08-06T05:36:56Z (GMT). No. of bitstreams: 1 Sarro_KarineJacon_M.pdf: 1466736 bytes, checksum: 68b9038a388d75b1c8d0f9182d905811 (MD5) Previous issue date: 2003 / Resumo: A respiração, em especial a fase da ventilação, é um ato dinâmico dependente da ação coordenada dos músculos respiratórios e da movimentação das estruturas osteo-articulares da caixa torácica. O presente trabalho objetiva propor e avaliar uma metodologia baseada em videogrametria para a análise experimental quantitativa da movimentação da caixa torácica durante a respiração bem como variáveis descritoras da movimentação da mesma. Para tanto, foi utilizado um sistema de análise cinemática tridimensional de movimentos (Dvideow) para obter a descrição das trajetórias espaciais de 38 marcadores fixados sobre referências anatômicas na caixa torácica de 14 sujeitos saudáveis. A partir das coordenadas tridimensionais dos marcadores as seguintes variáveis experimentais puderam ser obtidas: a) descrição das trajetórias espaciais dos marcadores de superfície a partir de um sistema para análise cinemática de movimentos; b) variação das distâncias ântero-posteriores (DAP) e transversais (DT) da caixa torácica, obtida através do cálculo das distâncias lineares entre os marcadores; c) evolução temporal de quatro ângulos articulares obtidos entre as costelas e diferentes sistemas de coordenadas, representando a movimentação das costelas, e análise da correlação destas variáveis; d) comportamento dos espaços intercostais, obtido através do cálculo das distâncias entre os marcadores adjacentes. A avaliação da metodologia proposta foi feita a partir dos seguintes testes: a) análise da acurácia do sistema de análise cinemática nas condições de aplicação da metodologia; b) análise da sensibilidade das variáveis experimentais aos erros do sistema de medida; c) análise da variabilidade intra-examinador dos resultados devido ao reposicionamento dos marcadores em dias diferentes. Os resultados referentes à metodologia mostraram uma acurácia de 2,4 mm, gerando erros máximos de 2 graus nas variáveis angulares. Os valores médios da DAP e da DT encontrados foram compatíveis com a literatura estudada. A variação relativa da DT e da DAP foi significativamente maior (p<0,05) durante a respiração em capacidade vital (CV) que em volume corrente (VC). As costelas 3 a 5 apresentaram variação da DAP significativamente menor que as costelas 9 e 10. Os ângulos a (movimento do par de costelas no plano quasi-sagital) e q (angulação da costela direita em relação à esquerda) apresentaram variação coerente com os ciclos respiratórios. A variação do ângulo a foi significativamente maior nas costelas 1, 2, 3, 5 e 6 em relação às costelas 9 e 10 durante respiração em CV. Os resultados da correlação entre os movimentos das costelas permitiram identificar dois padrões distintos: todas as costelas movimentando-se em concordância de fase (padrão 1), onde enquadraram-se 8 sujeitos, e costelas movimentando-se em oposição de fase (padrão 2), onde enquadraram-se 6 sujeitos. Em relação às distâncias intercostais, estas foram significativamente maiores nos espaços de 1 a 4, os quais também apresentaram maior variabilidade. De maneira geral, a metodologia e as variáveis apresentadas foram capazes de identificar e descrever a movimentação dos componentes osteo-articulares da caixa torácica durante a respiração, contribuindo para a discussão deste problema na literatura / Abstract: Breathing is a dynamic action depending on the coordination of respiratory muscles contraction and the rib cage motion. This work proposes and evaluates a methodology based on videogrammetry for the quantitative experimental analysis of rib cage motion and the descriptive variables of this motion during breathing. Using a 3D kinematics analysis system (Dvideow), the trajectory of 38 landmarks fixed on the rib cage of 14 healthy subjects was obtained, and the following variables were calculated: a) description of spatial trajectories of landmarks; b) variation of the lateral (DT) and anterior-posterior (DAP) distances of the rib cage at the level of the 10 upper ribs, described by the linear distances of the markers in function of time; c) time evolution of four joint angles, obtained between the ribs and different coordinate systems representing rib movements and the analysis of the correlation of these movements; d) intercostal distances, obtained calculating the distances between adjacent landmarks. The methodology was evaluated by the following tests: a) analysis of the system accuracy; b) analysis of the sensibility of the variables to the system errors; c) analysis of the intra-examinator variability of the results for landmarks repositioning. It was obtained an accuracy of 2.4 mm, inducing errors of about 2 degrees on angular variables. The mean values of DAP and DT were consistent with literature. DAP and DT coefficient of variation was significantly higher (p<0.05) during vital capacity (CV) than quite breathing (VC). The 3rd to 5th ribs presented DAP variation significantly smaller than 9th and 10th ribs. Angles a (representing the motion of the pair of ribs at quasi-sagital plane) and q (representing the angle between right and left ribs) presented variation coherent with respiratory cycle. The variation of a was significantly higher at 1st, 2nd, 3rd, 5th and 6th ribs in relation to 9th and 10th ribs during CV. The results about the correlation between the motion of the ribs were able to identify two patterns of motion: all the ribs moving in phase (pattern 1), representing 8 subjects, and the last 3 ribs moving in opposite phase (pattern 2), representing 6 subjects. In relation to intercostals distances, spaces 1 to 4 were significantly higher and presented the highest variability. Concluding, the methodology and the variables proposed were able to identify and describe the motion of the rib cage components during breathing, contributing for the discussion of this matter at the literature / Mestrado / Mestre em Educação Física

Two issues hindering the clinical application of image-guided transcostal focused ultrasound surgery (FUS) are the organ motion caused by cardiac and respiratory movements and the presence of the ribcage. Intervening ribs absorb and reflect the majority of ultrasound energy excited by an acoustic source, resulting in insufficient energy delivered to the target organs of the liver, kidney, and pancreas. Localized hot spots also exist at the interfaces between the ribs and soft tissue and in highly absorptive regions such as the skin. The aim of this study is to assess the effects of transmitted beam distortion and frequency-dependent rib heating during trans-costal FUS, and to propose potential solutions to reduce the side effects of rib heating and increase ultrasound efficacy. Direct measurements of the transmitted beam propagation were performed on a porcine rib cage phantom, an epoxy rib cage phantom and an acoustic absorber rib cage phantom, in order of their similarities to the human rib cage. Finite element analysis was used to investigate the rib cage geometry, the position of the target tissue relative to the rib cage, and the geometry and operating frequency of the transducer. Of particular importance, frequency-dependent heating at the target and the intervening ribs were estimated along with experimental verification. The ratio of ultrasonic power density at the target and the ribs, the time-varying spatial distribution of temperature, and the ablated focus of each sonication are regarded as key indicators to determine the optimal frequency. Following that, geometric rib-sparing was evaluated by investigating the operation of 2D matrix arrays to optimize focused beam shape and intensity at target. Trans-costal FUS is most useful in treating tumours that are small and near the surface of the abdominal organs, such as the liver, kidney and pancreas. However, for targets deep inside these organs, severe attenuation of acoustic energy occurs, suggesting that pure ultrasound thermal ablation with different heating patterns will have limited effects in improving the treatment efficacy. Results also demonstrate that the optimal ultrasound frequency is around 0.8 MHz for the configurations considered, but that it may shift to higher frequencies with changes in the axial and lateral positions of the tumours. In this work, I aimed to reduce the side effects of rib heating and increase the ultrasound efficacy at the focal point in trans-costal treatment. However, potential advanced techniques need to be explored for further enhanced localized heating in trans-costal FUS.

Orientador: Ricardo Machado Leite de Barros / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Educação Fisica / Made available in DSpace on 2018-08-09T17:18:56Z (GMT). No. of bitstreams: 1 Sarro_KarineJacon_D.pdf: 1134388 bytes, checksum: b567c37751844e9b74d352b031f141d7 (MD5) Previous issue date: 2007 / Resumo: O presente trabalho teve como objetivo propor e validar um novo método para análise cinemática tridimensional da movimentação da caixa torácica durante a respiração e mostrar uma aplicação do mesmo. A análise cinemática foi utilizada para descrever a movimentação tridimensional das costelas durante a respiração. As coordenadas 3D de marcadores posicionados sobre as costelas e vértebras foram utilizadas para calcular as distâncias transversais e ântero-posteriores da caixa torácica e a orientação das costelas em função do tempo. O método identificou um sinal coerente com o ciclo respiratório para todas as distâncias calculadas e também para os ângulos das costelas ao redor de um eixo quasi-transversal representando os movimentos de elevação e abaixamento das costelas. Também foi capaz de medir a maior variação das distâncias ântero-posteriores e transversais da caixa torácica durante respirações em capacidade vital quando comparadas a respirações em volume corrente. Foram realizados testes para avaliar variáveis relacionadas aos erros de medição do sistema de análise cinemática utilizado. Imagens de ressonância magnética do tronco foram utilizadas para calcular a movimentação relativa entre os marcadores de superfície e as costelas (deslizamento de pele). Os resultados revelaram um erro sistemático abaixo de 1 mm e um desvio padrão experimental de 2,5 mm, o que gerou erros máximos de 2º na medição da variação angular das costelas. A movimentação relativa média entre os marcadores, assumida como a distância entre o marcador e a costela em capacidade pulmonar total menos a distância entre o marcador e a costela em capacidade residual funcional, foi igual a 3,9 mm, valor menor que os relatados na literatura para os membros inferiores ou coluna vertebral. Esses resultados validam o método, mostrando a viabilidade em se usar a análise cinemática para avaliar movimentações das costelas acima de 2º. Uma vez validado, o método foi aplicado a um grupo de sujeitos saudáveis e distinguiu alguns sujeitos com movimentação paradoxal das costelas. Aplicado a um grupo de nadadores, foi capaz de evidenciar alterações nos movimentos respiratórios desse grupo, identificando maior variação angular das costelas e maior correlação entre as curvas dos ângulos das costelas (p<0,05) quando comparado ao grupo controle. Os nadadores também apresentaram maior correlação entre a variação angular das costelas e os volumes parciais do tronco, reforçando o potencial da metodologia em identificar alterações nos padrões respiratórios. Concluindo, este estudo validou o uso da análise cinemática 3-D para avaliar a movimentação das costelas e a coordenação entre elas durante a respiração bem como evidenciou seu potencial na identificação de diferentes comportamentos da movimentação das costelas, mostrando que a prática de natação induziu um padrão otimizado de movimentação da caixa torácica / Abstract: The present work aimed to propose and validate a novel method to the 3D kinematical analysis of the rib cage motion during breathing and to show an example of application. The kinematical analysis was used to describe the 3D motion of the ribs during breathing. The 3D coordinates of surface markers positioned on the ribs, sternum and vertebrae were used to calculate the transversal and anterior-posterior distances of the rib cage and the orientation of the ribs in function of time. The method identified a signal coherent with the breathing cycle for all the distances measured and for the angles of the ribs around the quasi-transversal axis representing the upward and downward movements of the ribs. The method was also able to identify the higher variation of the transversal and anterior-posterior distances of the rib cage during breathing at vital capacity when compared with breathing at tidal volume. Some tests were performed to evaluate variables related to the measurement errors of the system. Magnetic resonance images of the trunk were used to calculate the relative motion between the surface markers and the ribs (soft tissue artifact). The results revealed less than 1 mm of systematic error and a experimental standard deviation of 2.5 mm, which generate maximal errors of 2º on the angular variation of the ribs. The soft tissue artifact was assumed as the distance between the marker and the rib at total lung capacity minus the distance between the marker and the rib at functional residual capacity, and the absolute mean value found was 3.9 mm. This value is smaller than that one found in the kinematics of other segments. The method was applied in a group of swimmers and a control group of non-athletes and was able to distinguish subjects with a paradoxal movement and showed that swimmers presented greater angular variation for all ribs, and greater correlation between the curves of the rib angles (p<0.05). The swimmers also presented higher correlation between the angular variation of the ribs and the variation of the separate volumes of the trunk. In conclusion, this study has validated the use of 3-D kinematic analysis to evaluate the movement of the ribs and their coordination during breathing as well as has shown its potential to identify differences in the behavior of the ribs motion, showing that swimming training induced an optimized pattern of motion of the rib cage / Doutorado / Biodinamica do Movimento Humano / Doutor em Educação Física

La sécurité routière est un enjeu majeur de santé publique et de protection des personnes. D'après l'organisation mondiale de la santé (OMS), près de 1,2 millions de personnes meurent chaque année dans le monde suite à des accidents de la route (2015). D’après des données accidentologiques, 36,7% des blessures graves ont pour origine des lésions au thorax (Page et collab., 2012). La biomécanique en sécurité passive a pour rôle d'améliorer notre compréhension du corps humain dans le but de construire de meilleurs outils pour évaluer le risque de blessure.Les modèles numériques d'être humain sont employés pour simuler virtuellement les conditions d'un accident. Aujourd'hui, ils sont de plus en plus utilisés par les constructeurs automobiles et équipementiers pour mieux comprendre les mécanismes lésionnels. Cependant, ils n’existent que dans certaines tailles et ne prennent alors pas en compte les variations morphologiques observées dans la population.L'imagerie médicale 3D donne accès aux géométries des différentes structures anatomiques composant le corps humain. Les hôpitaux regorgent aujourd'hui de quantités d'images 3D couvrant une très large partie de la population en termes d'âge, de corpulence et de sexe.L’objectif global de cette thèse est de modéliser statistiquement la géométrie 3D de la cage thoracique à partir d'images médicales afin de personnaliser un modèle numérique de corps humain pour simuler par éléments finis des conditions de choc automobile. Le premier objectif est d’élaborer un protocole de segmentation une base de CT-scans de manière à obtenir des données géométriques adaptées à la construction d’un modèle statistique de forme de la cage thoracique.Le deuxième objectif est de construire un modèle statistique de forme de la cage thoracique, en prenant en compte sa structure articulée.Le troisième objectif est d’utiliser le modèle statistique de la cage thoracique pour déformer un modèle numérique d’être humain, de manière à étudier l’influence de certains paramètres sur le risque de blessure. / Road safety is a major issue of public health and personal safety. According to the World Health Organization (WHO), nearly 1.2 million people die each year worldwide due to road accidents (2015). According to accident data, 36.7% of serious injuries are caused by thoracic injuries (Page et al., 2012). The aim of biomechanics in passive safety is to improve our understanding of the human body in order to build better tools for assessing the risk of injury.Numerical human body models are used to virtually simulate the conditions of an accident. Today, they are increasingly used by car manufacturers and equipment manufacturers to better understand injury mechanisms. However, they exist only in few sizes and do not take into account the morphological variations observed in the population.3D medical imaging gives access to the geometries of the different anatomical structures that make up the human body. Today, hospitals are full of 3D images covering a very large part of the population in terms of age, body size and sex.The overall objective of this thesis is to statistically model the 3D geometry of the rib cage from medical images in order to personalize a numerical human body model to simulate car crash conditions.The first objective is to develop a segmentation process based on CT-scans in order to obtain geometric data adapted to the construction of a statistical model of shape of the rib cage.The second objective is to build a statistical model of the shape of the rib cage, taking into account its articulated structure.The third objective is to use the statistical model of the rib cage to deform a numerical human body model, in order to study the influence of certain parameters on the risk of injury.

En Union Européenne les accidents frontaux font 28% des accidents routiers et sont responsables de 49% de mortalité, les fractures thoraciques étant la cause principale de décès. Les modèles en éléments finis du corps humain sont un outil important pour la simulation de chocs réels et la prédiction des risques d'endommagement. Cette thèse a permis de développer un modèle simple en éléments finis de la cage thoracique suffisamment souple d'utilisation et facilement paramétrable. Ce modèle est validé expérimentalement avant d'être utilisé pour une étude paramétrique. Cette étude a permis de caractériser l'influence de différents paramètres structurels et géométriques sur le comportement de la cage thoracique sous chargement dynamique. Le travail réalisé au cours de cette thèse est divisé en trois parties : Modélisation de la cage thoracique entière avec des éléments finis de type poutre dont les propriétés mécaniques sont déterminées à partir d'essais de flexion trois points sur des segments de côtes et complétées par des éléments de la littérature, Validation du modèle dont les résultats sont suffisamment proches des résultats des essais de chargement dynamique antéro-postérieur menés par Vezin et Berthet [Vez09], Etude paramétrique sur l'influence paramètres, géométrie des sections droites et géométrie globale de la cage thoracique (inclinaison des côtes, forme et taille globale de la cage thoracique). A partir de cette étude nous trouvons que le module d'Young et l'épaisseur du cortical ont une influence identique sur la raideur globale de la cage thoracique ainsi que sur la rotation et la déformation des côtes. Avec l'augmentation de ces deux paramètres la rigidité du thorax augmente et le taux de compression maximal diminue. D'autre part les côtes tournent plus et se déforment moins. La raideur des liaisons costo-verterbales a une influence directe sur la rotation latérale qui diminue avec l'augmentation de cette raideur alors que les déformations augmentent ; tandis que la raideur globale de la cage thoracique est légèrement modifiée. L'inclinaison des côtes est le facteur ayant la plus grande influence sur la déformation des côtes et donc sur le risque d'endommagement : plus les côtes sont proches de la direction de chargement la raideur de la cage thoracique augmente et la déformation des côtes augmente / In the European Union, 28% of road accidents are frontal impacts which provoke 49% of fatalities where the thoracic fractures are the main cause of death. The finite element models of the human body are an important tool for the simulation of real impacts and the prediction of damage. This thesis has led to develop a rib cage simplified finite element model sufficiently flexible and easily customizable. First, this model is experimentally validated and then used in a parametric study. This study allowed us to characterize the influence of different structural and geometric parameters on the behavior of the rib cage under dynamic loading. This work is divided into three parts : Modeling the rib cage using beam elements whose mechanical properties are determined by three-point bending tests on rib segments and supplemented from literature, Validating the model by simulating the anteroposterior dynamic loading tests led by Vezin and Berthet [Vez09], Performing a parametric study on the influence of the mechanical parameters (Young modulus, stiffness of costo-vertebral joints), the geometry of the rib sections and the overall geometry of the rib cage (ribs slope, shape and overall size of the rib cage). This study permitted to find that Young modulus and the thickness of the cortical have the same influence on the overall stiffness of the chest as well as on the rotation and deformation of the ribs. By increasing these parameters, the stiffness of the chest increases and the maximum compression ratio decreases. Besides, we'll find more rotation and less deformation of the ribs. The stiffness of the costoverterbal joints has a direct influence on the lateral rotation : it will decrease by increasing of the stiffness while deformation will increase. However, the overall stiffness of the chest is slightly modified by modifying the costovertebral joint stiffness. The initial inclination of the ribs accordingly to the load direction has the greatest influence on the deformation of the ribs and therefore on the damage risk. When the ribs are closer to the loading direction, the stiffness of the rib cage and the deformation of the ribs increases