Assessing the Effect of in-vitro Soft Tissue Thickness on Bone Mineral Density Using Dual-Energy X-ray Absorptiometry

Document Type : Original Article (s)

Authors

1 Associate Professor, Biosensor Research Center AND Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences AND Isfahan Osteoporosis Diagnosis Center, Isfahan, Iran

2 MSc Student, Department of Medical Physics, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

3 Isfahan Osteoporosis Diagnosis Center, Isfahan, Iran

4 Associate Professor, Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Bone mineral density (BMD) assessment by using dual-energy X-ray absorptiometry (DXA) plays an important role in diagnosis and treatment of osteoporosis. Variation in soft tissue thickness may cause probability errors in DXA bone values. The aim of this study was to assess the effect of soft tissue thickness on bone mineral.Methods: A spine phantom consisting of bone and soft tissue equivalents (Aluminum and Perspex respectively) was made to simulate different status of bone (normal, osteopenia and osteoporosis) and abdominal thicknesses. BMD measurements were performed by DXA using a Norland XR-46 on 45 patients. The statistical analysis for determining the BMD, bone mineral content (BMC), bone area (BA) measurements was done using SPSS software.Findings: According to Pearson correlation test, variation of soft tissue thickness had no statistically significant relation on BMD, BMC and BA (P > 0.05). But non-parametric regression determined soft tissue thickness had some effect on BMD and BMC (P < 0.05), but no statistically effect on BA (P > 0.05).Conclusion: Variation of soft tissue thickness had no considerable effect (less than1%) on bone mineral results, so errors arising from soft tissue thickness in DXA are negligible

Keywords

References

  1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology 2003; 61(1): 37-49.
  2. Doughty DB. Promoting continence: simple strategies with major impact. Ostomy Wound Manage 2003; 49(12): 46-52.
  3. Hunskaar S, Burgio K, Diokno A, Herzog AR, Hjalmas K, Lapitan MC. Epidemiology and natural history of urinary incontinence in women. Urology 2003; 62(4 Suppl 1): 16-23.
  4. Chiarelli P, Brown W, McElduff P. Leaking urine: prevalence and associated factors in Australian women. Neurourol Urodyn 1999; 18(6): 567-77.
  5. Price N, Dawood R, Jackson SR. Pelvic floor exercise for urinary incontinence: a systematic literature review. Maturitas 2010; 67(4): 309-15.
  6. Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 2010; 21(1): 5-26.
  7. Hay-Smith EJ, Herderschee R, Dumoulin C, Herbison GP. Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev 2011; (12): CD009508.
  8. Aksac B, Aki S, Karan A, Yalcin O, Isikoglu M, Eskiyurt N. Biofeedback and pelvic floor exercises for the rehabilitation of urinary stress incontinence. Gynecol Obstet Invest 2003; 56(1): 23-7.
  9. Castro RA, Arruda RM, Zanetti MR, Santos PD, Sartori MG, Girao MJ. Single-blind, randomized, controlled trial of pelvic floor muscle training, electrical stimulation, vaginal cones, and no active treatment in the management of stress urinary incontinence. Clinics (Sao Paulo) 2008; 63(4): 465-72.
  10. Dallosso HM, McGrother CW, Matthews RJ, Donaldson MM. The association of diet and other lifestyle factors with overactive bladder and stress incontinence: a longitudinal study in women. BJU Int 2003; 92(1): 69-77.
  11. Imamura M, Abrams P, Bain C, Buckley B, Cardozo L, Cody J, et al. Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence. Health Technol Assess 2010; 14(40): 1-188.
  12. Kirby M. Managing stress urinary incontinence -- a primary care issue. Int J Clin Pract 2006; 60(2): 184-9.
  13. Knight S, Laycock J, Naylor D. Evaluation of neuromuscular electrical stimulation in the treatment of genuine stress incontinence. Physiotherapy 1998; 84(2): 61-71.
  14. Kegel AH. Progressive resistance exercise in the functional restoration of the perineal muscles. Am J Obstet Gynecol 1948; 56(2): 238-48.
  15. Kegel AH. Stress incontinence of urine in women; physiologic treatment. J Int Coll Surg 1956; 25(4 Part 1): 487-99.
  16. National Collaborating Centre for Women's and Children's Health. Urinary incontinence: the management of urinary incontinence in women. London, UK: Royal College of Obstetricians and Gynaecologists (RCOG); 2006.
  17. Kamel DM, Thabet AA, Tantawy SA, Radwan MM. Effect of abdominal versus pelvic floor muscle exercises in obese Egyptian women with mild stress urinary incontinence: A randomised controlled trial. Hong Kong Physiotherapy Journal 2013; 31(1): 12-8.
  18. Terlikowski R, Dobrzycka B, Kinalski M, Kuryliszyn-Moskal A, Terlikowski SJ. Transvaginal electrical stimulation with surface-EMG biofeedback in managing stress urinary incontinence in women of premenopausal age: a double-blind, placebo-controlled, randomized clinical trial. Int Urogynecol J 2013; 24(10): 1631-8.
  19. Pages IH, Jahr S, Schaufele MK, Conradi E. Comparative analysis of biofeedback and physical therapy for treatment of urinary stress incontinence in women. Am J Phys Med Rehabil 2001; 80(7): 494-502.
  20. Sapsford R. The pelvic floor. Physiotherapy 2001; 87(12): 620-30.
  21. Sapsford RR, Hodges PW. Contraction of the pelvic floor muscles during abdominal maneuvers. Arch Phys Med Rehabil 2001; 82(8): 1081-8.
  22. Bo K, Stien R. Needle EMG registration of striated urethral wall and pelvic floor muscle activity patterns during cough, Valsalva, abdominal, hip adductor, and gluteal muscle contractions in nulliparous healthy females. Neurourol Urodyn 1994; 13(1): 35-41.
  23. Neumann P, Gill V. Pelvic floor and abdominal muscle interaction: EMG activity and intra-abdominal pressure. Int Urogynecol J Pelvic Floor Dysfunct 2002; 13(2): 125-32.
  24. Sapsford R, Markwell S, Clarke B. The relationship between urethral pressure and abdominal muscle activity. Australian Continence Journal 1998; 4: 102-10.
  25. Sapsford RR, Hodges PW, Richardson CA, Cooper DH, Markwell SJ, Jull GA. Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourol Urodyn 2001; 20(1): 31-42.
  26. Power RM. Embryological development of the levator ani muscle. Am J Obstet Gynecol 1948; 55(3): 367-81.
  27. Jones RC, Peng Q, Shishido K, Perkash I, Constantinou CE. 2D ultrasound imaging and motion tracking of pelvicfloor muscle (pelvic floor muscles) activity during abdominalmanoeuvres in stress urinary (SUI) women. Neurourol Urodyn 2006; 25(Special Issue): 596-7.
  28. Peng Q, Jones R, Shishido K, Constantinou CE. Ultrasound evaluation of dynamic responses of female pelvic floor muscles. Ultrasound Med Biol 2007; 33(3): 342-52.
  29. Kashanian M, Ali SS, Nazemi M, Bahasadri S. Evaluation of the effect of pelvic floor muscle training (PFMT or Kegel exercise) and assisted pelvic floor muscle training (APFMT) by a resistance device (Kegelmaster device) on the urinary incontinence in women: a randomized trial. Eur J Obstet Gynecol Reprod Biol 2011; 159(1): 218-23.
  30. Nojomi M, Baharvand P, Moradi LM, Patrick DL. Incontinence quality of life questionnaire (I-QOL): translation and validation study of the Iranian version. Int Urogynecol J Pelvic Floor Dysfunct 2009; 20(5): 575-9.
  31. Dumoulin C, Lemieux MC, Bourbonnais D, Gravel D, Bravo G, Morin M. Physiotherapy for persistent postnatal stress urinary incontinence: a randomized controlled trial. Obstet Gynecol 2004; 104(3): 504-10.
  32. Sriboonreung T, Wongtra-ngan S, Eungpinichpong W, Laopaiboon M. Effectiveness of pelvic floor muscle training in incontinent women at Maharaj Nakorn Chiang Mai Hospital: a randomized controlled trial. J Med Assoc Thai 2011; 94(1): 1-7.
  33. Hung HC, Hsiao SM, Chih SY, Lin HH, Tsauo JY. An alternative intervention for urinary incontinence: retraining diaphragmatic, deep abdominal and pelvic floor muscle coordinated function. Man Ther 2010; 15(3): 273-9.
Journal of Isfahan Medical School
Volume 34, Issue 378 - Serial Number 378
March and April 2016
Pages 347-354

Files

History

  • Receive Date: 13 December 2015
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics