Body Alignment Research Articles

Sagittal body alignment in a sitting position in children is not affected by the generalized joint hypermobility

Back pain may be related to an improper sitting position. The aim of the study was to assess the sagittal curvatures of the spine in a sitting position in children with generalized joint hypermobility (GJH). The study included 302 children aged 8–14 years. The sagittal curvatures of the spine (sacral slope, lumbar lordosis, thoracic kyphosis with its lower and upper part) were assessed using the Saunders digital inclinometer. In order to assess GJH a 9-point Beighton scale was used. The study revealed no significant differences (p > 0.05) in sagittal curvatures of the spine in a relaxed sitting position between children with and without GJH. Regardless of the occurrence of GJH, kyphotic alignment of the spine was noted in a relaxed sitting. GJH does not affect the position of the trunk in a sagittal plane in a relaxed sitting position in children aged 8–14 years. A relaxed sitting position in children with and without GJH is characterized by a kyphotic position of the spine caused by an improper position of pelvis and lumbar segment of the spine.

Simple Asana: Yoga and the Elderly

Yoga is becoming very popular among young people, however it is also exceptionally beneficial for the elderly to improve mobility, strength and combat chronic ailments. It is an alternative form of medicine and can be ancillary tool for treating pain, cardiovascular issues, weight problems, depression, sleep disorders and many more. The practice goal of yoga is to challenge oneself but not be overwhelmed, develop inner awareness without judgement. In contrast to many other programs it does not involve strenuous workouts or expensive equipment and is not competitive. The simple form involves series of static positions that use isometric contraction and relaxation of different muscle groups to create specific body alignments with coordinated breathing and deep meditative relaxation. The best yoga practice for elderly or a person with limitations are that uses supporting props as blankets, pillows or chairs during asana to overcome the limitations that are coordinated with breathing exercise and meditation.

체육계열 전공 대학생의 필라테스 경험과 인식 변화에 대한 현상학적 연구

The purpose of this study is to explore the meaning and value of pilates experience for the college students majoring in sport. Also, we compared the awareness on pilates before and after student participation. Using phenomenological research methods, authors conducted in-depth interviews with 10 college students majoring in sport. Regarding the research question 1, the most important meanings and values of pilates participation that students found were a) experiencing frustration while participating in pilates, b) understanding my body movement, c) the increased interest in body alignment, and d) building teaching skills through pilates. For the second research question, we tried to compare the awareness on pilates before and after the participation. The participants treat pilates as less-approachable genre because of high-cost. However, after they grasp the basics of pilates through participation, they recognized that pilates is actually an approachable sports. In addition, before the participation, students did not hesitate to link pilates with celebrities, it was consider as something to do with flexibility. However, after they experienced the exercise, participants realized that it is more about training their muscles. With more insights on the perception of pilates experience for college students majoring in sport, it is possible to make a better curriculum for those who are interested in this exercise.

자세교정 운동 프로그램을 통한 신체 정렬의 변화가 청소년의 건강관련체력에 미치는 영향에 관한 분석

This study carried out physical strength tests of muscle strength, cardiorespiratory endurance, quick adaptation and flexibility of the adolescent in the growth phase among factors of PAPS(Physical Activity Promotion System) before and after the posture correction exercise program, in order to prov ide exercise program for correct body alignment of the adolescent in the growth phase and to improve the quality of life of the adolescent in the growth phase by identifying the health physical strength factors that may be improved through correct posture. 17 adolescents with unstable posture were divided into a stretching exercise group and a small tool core exercise group for 8 weeks and received a group exercise for 60 minutes twice a week and a personal home training program once a week. As a result, flexibility showed statistically significant difference in the stretching group, quick adaptation in the small tool core exercise group(p<.05). In light of this, complex training focusing on the core muscle, the trunk stabilizing muscle, should be developed in order to improve the health physical strength of the adolescent.

20대 여대생의 경추 전만 각도에 따른 부위별 신체조성 및 신체균형 비교·분석

The purpose of this study is to analyze the angle of cervical vertebral lordosis and body composition and body balance by parts of female college students in their twenties who were judged only by cervical hyperplasia and cervical vertebral hyperplasia to prevent pain and injuries that may occur in incorrect postures, and to correct body alignment and body balance. We intend to provide basic data in developing exercise programs according to the characteristics of each group for balance. When the results are summarized, it can be seen that the muscle mass of the trunk is an important part in the balance of the body of those with an abnormal cervical lordosis. Therefore, based on the results of this study, the importance of developing a customized exercise program that can improve the cervical vertebral angle and body balance ability for those with an abnormal cervical lordosis angle is suggested.

Failure to achieve pelvic balance following hip replacement surgery may be a risk factor for development of degenerative scoliosis

IntroductionIn the global alignment of body, the pelvis and spine are strictly and mutually connected. Our hypothesis was that failure to achieve pelvic balance following hip replacement surgery (THA) may be a risk factor for development of degenerative scoliosis. MethodsA retrospective case control study was conducted. Patients who underwent THA followed by spine surgery primarily because of scoliosis (scoliosis group) were compared to patients who only underwent THA (no scoliosis group). Any patient in either group who had spine surgery prior to THA was excluded. Propensity score matching was utilized to match the two groups on age, gender and etiology for THA. ResultsA total of78 patients (39 in each group) were included in the study. The mean age was 63 years in scoliosis group and 64 years in no scoliosis group. The most common etiologies for THA were osteoarthritis, fracture and avascular necrosis. The mean pelvic obliquity as measured by the O’Brien method was 2.9° (0.2–6.5) in scoliosis group and 1.1° (0–4.5) in no scoliosis group. This difference in pelvic obliquity between the two groups was statistically significant (p < 0.01). The mean time interval between THA and spine surgery was 9.5 years. The mean follow-up in scoliosis group was 12 years and 6 years in no scoliosis group. ConclusionAltered pelvic parameters following hip surgery may be a contributing factor in the development of thoracolumbar scoliosis. Our data showed that a small change in pelvic balance following THA could pose a risk for developing degenerative scoliosis.

Amplitude of the magnetic anomaly vector in the interpretation of total-field anomaly at low magnetic latitudes

We propose the use of the amplitude of the magnetic anomaly vector (amplitude data) for qualitative interpretation of large areas at low magnetic latitudes. The amplitude data are weakly dependent on the magnetization direction. Hence, the amplitude data require no prior knowledge of the source magnetization direction. The amplitude data produce maxima over the causative sources, allowing the definition of the horizontal projections of the sources. This characteristic is attractive for interpretation at low magnetic latitudes because at these regions the interpretation of the total-field anomaly is not straightforward. We compute the amplitude data using the equivalent-layer technique to transform the total-field anomaly into the three orthogonal components of the magnetic anomaly vector. We analyze the results of tests in synthetic data simulating a main geomagnetic field at high, mid and low latitudes, with sources ranging from symmetric to elongated forms, including a dipping source. These sources, that give rise to the simulated anomalies, have both induced and strong remanent magnetizations. By comparing the amplitude data with the total gradient, we show that the amplitude data locate the horizontal projections of the sources. Thus, the amplitude data can be used to delineate the boundaries of the sources. We apply both the amplitude data and the total gradient to a real total-field anomaly over a large area of the Amazonian Craton, northern Brazil, located at low magnetic latitudes. The amplitude data show a better performance in delineating geologic bodies that are in agreement with the outcropping intrusions in the geologic map. Moreover, the amplitude data revealed new geologic bodies that were not present in the geologic map. The clear alignment of these new bodies with the outcropping intrusions suggested the continuity of these intrusions in depth. This result is a step forward in understanding this area for which the geology is poorly known. Hence, the amplitude data can provide an apparent-geologic map especially in areas at low latitudes with remanently magnetized bodies.

Evaluation of complete-arch implant scanning with 5 different intraoral scanners in terms of trueness and operator experience

Statement of problemThe intraoral scanning of the edentulous arch might be challenging for an inexperienced operator because of the large mucosal area and the use of scan bodies. PurposeThe purpose of this ex vivo study was to compare the trueness of 5 intraoral scanners in replicating implant scan bodies and soft tissues in an edentulous maxilla and to investigate the effects of operator experience. Material and methodsThe maxilla was resected from a fresh cadaver, 5 implants placed, and a reference scan made. Eight scans were made by experienced operators and 8 by an inexperienced operator with each scanner (iTero Element 2, Medit i500, Primescan, TRIOS 3, TRIOS 4). The implant platform deviation was measured after complete surface alignment and after scan body alignment. Deviation data were analyzed with a generalized linear mixed model (α=.05). ResultsAfter complete surface alignment, the mean ±standard deviation implant platform deviation was higher for the inexperienced operator (421 ±25 μm) than for experienced ones (191 ±12 μm, P<.001) for all scanners. After scan body alignment, no significant differences were found between operators for Element 2, Primescan, and TRIOS 3. The experienced operators produced a lower deviation for TRIOS 4 (35 ±3.3 μm versus 54 ±3.1 μm, P<.001), but higher deviation for i500 (68 ±4.1 μm versus 57 ±3.6 μm, P<.05). The scanner ranking was Element 2 (63 ±4.1 μm), i500 (57 ±3.6 μm, P=.443), TRIOS 4 (54 ±3.1 μm, P=.591), TRIOS 3 (40 ±3.1 μm, P<.01), Primescan (27 ±1.6 μm, P<.001) for the inexperienced operator and i500 (68 ±4.1 μm), Element 2 (58 ±4.0 μm, P=.141), TRIOS 3 (41 ±2.8 μm, P<.001), TRIOS 4 (35 ±3.3 μm, P=.205), Primescan (28 ±1.8 μm, P=.141) for the experienced operators. ConclusionsMucosal alignment greatly overestimated the platform deviation. The intraoral scanners showed different trueness during the complete-arch implant scanning. The operator experience improved the trueness of the edentulous mucosa but not implant platform deviation.

Biomechanical Description of Zapateado Technique in Flamenco.

The main purpose of this study was to identify a dancer’s body alignment while performing flamenco footwork to provide a detailed description that could be used by flamenco practitioners: teachers, instructors and students of different levels of advancement. The zapateado technique performed by a professional flamenco dancer was analyzed. The biomechanical analysis was based on 30 cycles composed of six repeating sequences of strikes. Kinematic recordings were performed using a Vicon system, while the measurement of the ground reaction forces (GRF) was accomplished with a Kistler force plate. The following parameters were analyzed: the time of each foot strike, the maximal value of the vertical component of GRF normalized to body weight (BW) for subsequent footwork steps, the impulse of the GRF and the kinematics of pelvis and lower limb joints, and an exemplary waveform view of the sound of footwork strikes was shown. The average values of the vertical component of GRF ranged between 0.6 and 2.7 BW. The maximal anterior pelvic tilt was 29°, with a 6° range of motion (RoM). This mobility was accompanied by 20° hip RoM and by ~40° knee RoM throughout flexion. The conclusions provide practical information that a teacher and flamenco student should receive.

Heading variations resolve the heading-direction ambiguity in vertical-beam radar observations of insect migration

ABSTRACT Vertical-beam entomological radars provide precise measurements of the body alignment of individual overflying insects but are unable to distinguish which of the two axial directions the insect is heading towards. Insects migrating at altitude typically show common alignment, although with a broad spread. We show here that when observations from multiple individual insects are available, and the insects have airspeeds of about 2 ms–1 or greater, the spread in heading directions allows the heading ambiguity to be resolved (though at the sample rather than the individual level). A vector analysis of radar-measured track direction, track speed, and heading will provide consistent results for all the insects in a sample only when the heading direction is chosen correctly. With the heading then resolved, the analysis can continue to estimation of representative values for the airspeed of the insects in the sample and for the speed and direction of the wind they were flying in. This general approach can be implemented in two different ways, which we term the ‘cluster’ and ‘projection’ methods. When applied to an intense migration of large insects, probably moths, these methods produced highly consistent results from hour to hour and from one 150 m height interval to the next. Simulations show that the methods are not liable to directional bias and reveal when they are rendered ineffective by small sample sizes or low insect airspeeds; they also indicate that the cluster method handles small sample sizes better than the projection method, and its use is therefore recommended. A comparison with two previously proposed methods that use meteorological data to resolve the ambiguity shows that the new methods are more reliable. Use of this objective means of resolving the heading ambiguity will increase confidence in radar-based studies of the orientation behaviour of insect migrants and their responses to cues like sky illumination patterns, the Earth’s magnetic field, and wind.

8주간의 자세교정 운동 프로그램을 통한 신체 정렬의 변화에 영향을 미치는 생활습관 자세의 공헌도에 관한 분석

8주간의 자세교정 운동 프로그램을 통한 신체 정렬의 변화에 영향을 미치는 생활습관 자세의 공헌도에 관한 분석

Collective motion enhances chemotaxis in a two-dimensional bacterial swarm

In a dilute liquid environment in which cell-cell interaction is negligible, flagellated bacteria, such as Escherichia coli, perform chemotaxis by biased random walks alternating between run-and-tumble. In a two-dimensional crowded environment, such as a bacterial swarm, the typical behavior of run-and-tumble is absent, and this raises the question whether and how bacteria can perform chemotaxis in a swarm. Here, by examining the chemotactic behavior as a function of the cell density, we showed that chemotaxis is surprisingly enhanced because of cell crowding in a bacterial swarm, and this enhancement is correlated with increase in the degree of cell body alignment. Cells tend to form clusters that move collectively in a swarm with increased effective run length, and we showed analytically that this resulted in increased drift velocity toward attractants. We also explained the enhancement by stochastically simulating bacterial chemotaxis in a swarm. We found that cell crowding in a swarm enhances chemotaxis if the cell-cell interactions used in the simulation induce cell-cell alignment, but it impedes chemotaxis if the interactions are collisions that randomize cell moving direction. Therefore, collective motion in a bacterial swarm enhances chemotaxis.

The effects of distance on pointing comprehension in shelter dogs.

The Object Choice Task is a methodology that has been increasingly popular for several decades and many strong claims have been made regarding the differential results between species. However, many studies use differing methodologies and individuals with systematically different backgrounds, which makes any comparisons suspect. One of the methodological differences that has been shown to result in differing responses is distance, both between the objects, and between the object and the gesture. Here, we systematically test these differences with a sample of shelter dogs and note the potential mechanisms underlying the results. Dogs were more successful if the objects were further apart (Distal Object) or the point was very close to the object (Proximal Cue). Success in both of these conditions can be most parsimoniously explained by mechanistic strategies, i.e. strategies that do not rely on mental representation or communicative mechanisms. We also note the results of some pilot data suggesting a non-communicative mechanism (body alignment through touch) by which shelter dogs and other animals may successfully respond when the objects and gestures are distant. We argue that the only point type that likely relies on communicative mechanisms is when the objects are close together, but the point is distant the condition in which dogs are least successful. Future research should take into consideration that individual dogs may use different strategies, or may switch between strategies, and note that all point-following is not necessarily indicative of communicative comprehension.

Turning preference in dogs: North attracts while south repels.

It was shown earlier that dogs, when selecting between two dishes with snacks placed in front of them, left and right, prefer to turn either clockwise or counterclockwise or randomly in either direction. This preference (or non-preference) is individually consistent in all trials but it is biased in favor of north if they choose between dishes positioned north and east or north and west, a phenomenon denoted as "pull of the north". Here, we replicated these experiments indoors, in magnetic coils, under natural magnetic field and under magnetic field shifted 90° clockwise. We demonstrate that "pull of the north" was present also in an environment without any outdoor cues and that the magnetic (and not topographic) north exerted the effect. The detailed analysis shows that the phenomenon involves also "repulsion of the south". The clockwise turning preference in the right-preferring dogs is more pronounced in the S-W combination, while the counterclockwise turning preference in the left-preferring dogs is pronounced in the S-E combination. In this way, south-placed dishes are less frequently chosen than would be expected, while the north-placed dishes are apparently more preferred. Turning preference did not correlate with the motoric paw laterality (Kong test). Given that the choice of a dish is visually guided, we postulate that the turning preference was determined by the dominant eye, so that a dominant right eye resulted in clockwise, and a dominant left eye in counterclockwise turning. Assuming further that magnetoreception in canines is based on the radical-pair mechanism, a "conflict of interests" may be expected, if the dominant eye guides turning away from north, yet the contralateral eye "sees the north", which generally acts attractive, provoking body alignment along the north-south axis.

Comparison of Postural Alignment of Osteopenic and Osteoporotic Women With Healthy Menopausal

Purpose: Menopause in women causes problems, including osteoporosis due to hormonal changes. Besides, osteoporosis in postmenopausal women may be associated with musculoskeletal disorders followed by changes in the alignment of the body, especially the spine. Therefore, this study aimed to compare the posture of osteopenic, osteoporotic, and healthy menopausal women. Methods: This was a cross-sectional study conducted on postmenopausal women (age range, 45-65 years) referred to the Endocrinology and Rheumatology Clinic of Guilan University of Medical Sciences. Using the purposive sampling method, 90 people were selected as the study sample from this population and divided into three groups of 30 people: osteopenic, osteoporotic, and healthy. Then, the three groups were evaluated for body alignment (forward head, unequal shoulder, rounded shoulder, kyphosis, lordosis, and lower limb alignment). The obtained data were analyzed using ANOVA and the Scheffe Post Hoc test at the significance level of 0.05, in SPSS v. 22. Results: The osteopenic and osteoporotic menopausal women significantly differed from the healthy menopause women in the following measures: forward head angle, curved neck angle, unequal shoulder (P=0.003), kyphosis, lordosis, varus knee, flat foot (P=0.006), and pelvic tilt (P=0.001). Conclusion: According to the results, the decrease in bone density at the osteopenic and osteoporotic levels can affect the postural alignment of the head, shoulders, and neck and the curvature of the spine in postmenopausal women in the three study groups. Therefore, more attention should be paid to the postural evaluation and screening of people prone to osteoporosis, to provide preventive training programs and exercises to improve their physical condition

Feedback cues improve the alignment and technique of children performing ACL injury prevention exercises

ObjectivesThe appropriateness of neuromuscular training exercises across different age groups has not yet been investigated, particularly in younger children. The purpose of this study was to determine which neuromuscular training exercises can be performed with proper neutral alignment in various age groups.MethodsSeven exercises were selected for evaluation in children ranging from 8 to 17 years of age who were recruited from schools and youth sports organisations. Participants completed two trials of each exercise and were judged on maintaining neutral body alignment after receiving visual/verbal instruction on the first trial and feedback cues on the second trial. Three evaluators judged each exercise, which was deemed as correct when at least two evaluators agreed that neutral alignment was maintained. Comparisons were made across ages and between sex using the χ² test or Fisher’s exact test. The proportions of participants who performed the exercise correctly were also compared before and after feedback cues were provided.ResultsA total of 360 participants were evaluated (8–11 years: 165, 54% female; 12–15 years: 136, 40% female, 16–17 years: 59, 53% female). There were no significant differences in performance across ages and sex for nearly all exercises. The majority of children were not able to complete the exercises with proper alignment. The use of feedback cues significantly increased the proportion of participants who correctly completed the exercise (p<0.001).ConclusionsThese results demonstrate the importance of training coaches and physical education teachers to provide cues that reinforce proper technique during anterior cruciate ligament injury prevention exercises. Children should perform common neuromuscular training exercises with feedback on proper technique.Level of evidenceIV (case series).

RETRACTED: Visualization system of orthopedic personalized orthosis based on FPGA and sensor

The orthosis improves the function of enhancing the body's alignment, repair the damaged region, improve the prevention or deformation, protect the joint or limb, controlled restriction and pain relief, and provide feedback to the body power and the external device. Smart sensors can communicate with different digital network parameters and develop their applications in industrial, medical, and related fields. Plastic surgeons and orthosis must use intelligent sensors to control and monitor all patient parameters to improve and hope in life, accurate and reliable results. The sensors on the orthopedic devices, such as tools and equipment, are useful to report on the device's development and the patient's body. Smart sensors, monitors, blood pressure, anesthesia conveyor, sleep apnea machine, oxygen concentrator, temperature, kidney dialysis machines, and a fluid management system are used. Wireless smart sensors and Field Programmable Gate Array (FPGA) are orthopedic patients' data sent immediately within the orthopedic implant. And to reduce the risk of effective ways to improve patient care, potential applications of these sensors are to monitor the pressure for reducing the failure of the internal temperature and tissue necrosis and transplantation. The proposed sensor and FPGA proved to be successful in the orthopedic field for better care of patients.

A novel multi-study intervention investigating the short and long term effects of a posture bra on whole body and breast kinematics

BackgroundPoor standing posture has been reported in women with larger breasts, increasing the risk of back pain. Whilst breast reduction surgery can improve posture, conservative measures such as special bras may offer short or long-term relief of symptoms without surgical intervention. Research questionThis study aimed to utilise a multi-study intervention to investigate the short and long-term kinematic effects of wearing a posture bra. MethodsStudy one utilised biomechanics and physiotherapy expertise to modify the design of a prototype bra to improve posture and breast kinematics; resulting in a second-generation posture bra. To test this bra, 24 females were randomly assigned to control and intervention groups. The control group wore their everyday bra; the intervention group wore the generation 2 posture bra in place of their everyday bra for three months. Pre and post intervention, posture (spine curvature, scapula position, whole body alignment) and breast kinematics were assessed during sitting, standing and walking. Short-term effects of the posture bra were compared to an everyday bra and no bra (study two), whilst the long-term effects were compared using the no bra condition (study three). ResultsBiomechanical intervention improved posture and breast kinematics in a prototype posture bra resulting in a second-generation prototype. Pre-intervention, the generation 2 posture bra significantly improved scapula retraction by 6° during both sitting and standing, but also increased deviation of whole body alignment compared to everyday bra and no bra conditions. During walking the posture bra reduced breast motion by 17 % compared to the everyday bra. Following the three-month wearer intervention, scapula depression significantly improved in the intervention group. SignificanceA biomechanically informed posture bra was able to effectively support the breasts and improve scapula position without compromising spinal curvature, reducing the risk of musculoskeletal pain associated with poor posture.

Postural and craniocervical dysfunctions and their relationship to the voice of women with cervical pain

Introduction: Altered body alignment may contribute to the onset of muscle hypertension in the cervical region. Alterations in the cervical region can generate several complications, including pain and hypertension during phonation. Objective: To relate the postural with functional alterations of the craniocervical region and the voice of women complaining of musculoskeletal pain in the cervical region. Methods: Case study with ten women complaining of cervical pain. Assessments: Craniocervical Dysfunction Index, photogrammetry, maximum vowel phonation time of the vowel /a/, and sound pressure level. Results: Craniocervical Dysfunction Index: 100% dysfunction. Maximum phonation time /a/: 100% decreased. There was a moderate significant positive correlation between these variables. Photogrammetry: all participants presented alterations in the calculated alignments. Sound pressure level: 90% altered. Conclusion: There were postural and functional dysfunctions in the craniocervical region and vocal alteration, suggesting that vocal imbalances are more related to functional than postural alterations of the craniocervical region.

Experience in Clinical Operation of New Rotating Gamma System (RGS) for Cranial Stereotactic Radiosurgery

The objective of this study is to develop a quality assurance program to implement for the new Rotating Gamma System (RGS) in stereotactic surgery. Our experience supports the reliability of the operation of the hardware and software pertaining to RGS to deliver precise treatment to patients. This rotating gamma system with thirty Cobalt-60 sources with an initial total activity of 7465.5 Ci is in operation as the second unit in the USA. The source body and collimator body are synchronously rotating during the treatment procedure with a precise alignment. The radiation exposure is controlled by ON/OFF switches, which are automatically regulated by the computerized control system along with the precision table movement. Machine parameters such as output constancy, radiation isocentricity, alignment of collimator and source bodies, the accuracy of table positioning coordinate system, operation of the ON/OFF switches are independently verified as a part of pre-treatment quality assurance procedure using Ion chambers and Gaf-chromic film. Consistency of the Full Width at Half Maximum (FWHM), Penumbra 80-20% (P80-20%) are monitored periodically. Point dose to an acrylic phantom is calculated in Infini Superplan 4.2.118, and the dose is compared to the measured value. Periodic end-to-end testing is performed to verify the geometrical positioning of the shots and evaluating the MRI fiducials. End-to-End tests and other complicated patient plans are monitored using MAX-HD Head SRS dosimetric Phantom analysis. The interlock tests are performed before the commencement of the treatment as a part of a quality assurance procedure. Mechanical and radiation geometrical iso-center for all collimators (Diameter: 18mm, 14mm, 8mm, and 4mm) with all gamma angles (70, 90, and 100) are less than 0.16mm. Error in output factors(OF) and alignment of collimator and source body ratio(ACSR) is within 0.511±0.393% and 1.527±1.168% on average, respectively. FWHM and P80-20% for each collimator are within an acceptable range in comparison to the acceptance and commissioning data. The verification of the delivered point dose is found to be less than 4.7%. Patient treatment on this unit started on April 22, 2019 and up to date, 125 patients have been treated successfully. Fifty or more cases with multiple metastasis have been treated, and patients with a single metastasis, Trigeminal neuralgia, Meningioma, schwannoma, Acoustic Neuroma have completed treatment. The downtime of the system is minimal. With sub-millimeter accuracy, this new rotating gamma system is accurate, reliable, and shows safe delivery of the radiation dose for cranial stereotactic radiosurgery. A periodic Quality assurance procedure is important to assure the proper monitoring of this dynamic system.