Posture Analysis Research Articles

Evaluation of the sagittal vertical axis with postural and 3D motion analyses in lumbar spinal stenosis

BackgroundSagittal balance, commonly impaired in lumbar spinal stenosis (LSS) patients, is typically assessed using the sagittal vertical axis (SVA) with EOS imaging. However, to limit X-ray exposure and medical costs, it could be interesting to evaluate the capacity of quantified motion analysis to estimate the 3D modeling of SVA in patients with symptomatic LSS.MethodsAn estimation of the SVA in patients with LSS was performed with 3D motion analysis. SVA and “C7_PSI” (orthogonal horizontal distance between the vertical lines through the markers of the C7 vertebra and the middle of the posterosuperior iliac spine) were measured on 37 LSS patients using EOS radiography and postural and 3D motion analysis, respectively. Multiple stepwise linear regressions were performed with EOS SVA according to age, body mass index, C7_PSI and/or postural variables.ResultsA highly significant relationship was found between SVA and C7_PSI, mediolateral amplitude of CoP displacements and age (adjusted R²=0.69, p < 0.0001). While the postural analysis did not reveal significant relationships, the model using 3D parameters revealed significant relationships between radiographic SVA and C7_PSI and age (adjusted R²=0.65, p < 0.0001). 3D motion parameters with or without postural parameters may explain more than 65% of the variance seen in EOS imaging performed on LSS patients.ConclusionsThese promising results in LSS patients suggest that the estimation of SVA with 3D motion analysis offers an alternative to EOS. In addition, SVA could be assessed at rest and during dynamic tasks.Trial registrationThis study has been published in Clinical Trial registration (reference NCT03194607).

Correlation of psychosocial factors with pain, posture, function, and disability in chronic mechanical neck pain patients: a cross-sectional study

BackgroundChronic neck pain is a common musculoskeletal condition that has an impact on the function and quality of life of an individual. Psychosocial factors along with the physical factors may have an impact on the perception of pain. Hence, the study aimed to find the correlation of psychosocial factors with pain, posture, function, and disability in chronic mechanical neck pain patients.MethodA cross-sectional study using a convenient sampling method was conducted in 55 chronic mechanical neck pain patients. The pain was assessed using numerical pain rating scale (NPRS), pain pressure threshold (PPT) using a pressure algometer, kinesiophobia using Tampa Scale for Kinesiophobia (TSK), pain catastrophizing using Pain Catastrophizing Scale, Posture analysis was done by various postural angle and flexicurve, cervical muscle endurance was tested using the craniocervical flexion test, cervical proprioception was measured using head repositioning accuracy test and Neck disability index was used to score disability.ResultA significant positive correlation was found between TSK and NDI (r = 0.34, p = 0.01). There is a negative correlation of PTT (right sternocleidomastoid) with Kinesiophobia (r = − 0.35, p = 0.008). There is a moderate positive correlation between posture (shoulder angle on the left side) and TSK (r = 0.3, p = 0.02).ConclusionThe study concludes that psychosocial factors not only have a significant role but are correlated to pain, posture, function, and disability in patients with chronic mechanical neck pain.

The application of improved DTW algorithm in sports posture recognition

Sports posture recognition plays a crucial role in modern sports science and training. Posture recognition and analysis plays a positive role in improving sports quality and ensuring sports safety. However, existing recognition technologies still have poor recognition and accuracy in large amounts of posture data. Therefore, to further improve the performance of the existing posture recognition techniques, this study assumes that postures during movement can be effectively represented through the time series of skeletal key points, and the local similarity of these postures can be captured through the Dynamic Time Warping (DTW) algorithm. Based on this assumption, the existing DTW algorithm is improved by introducing the K-Nearest Neighbor (KNN) algorithm and combining it with Principal Component Analysis (PCA) for feature dimensionality reduction. A novel algorithmic model for postures recognition is proposed. The experimental results showed that the improved algorithm performed well in postures recognition rate and accuracy. Especially, when the k value was 5, the recognition rate reached up to 89%, and the accuracy reached 87%. Compared with the existing algorithm, the improved KNN-DTW algorithm has significant improvement in accuracy and computational efficiency. In summary, the new algorithm shows significant advantages in terms of accuracy and stability, providing a powerful tool for the analysis of athletic postures in the field of sports. Meanwhile, this research result has important application prospects in fields such as sports training, sports medicine, and virtual reality.

Analysis of poor work postures during morning care operations of intensive care unit nurses: a field research

BackgroundPoor working postures in morning care operations contribute significantly to work-related muscle fatigue and low back pain among ICU (Intensive Care Unit, ICU) nurses. However,there are few field studies on the relationship between Poor working postures and work-related muscle fatigue, low back pain among ICU nurses.ObjectiveThis study aims to assess the frequency and degree of posture hazards associated with poor working postures during morning care operations of ICU nurses.MethodsTwo ICUs in a Grade-A tertiary hospital in Hunan Province were randomly selected for the field study in May–June 2021 research. The image data of the participating nurses’ morning care work postures were collected by observation method and image recording method, and the postural hazard level was assessed by the two-person interpretation method of the work posture analysis system. The mean and standard deviation, frequency and percentage were used for the basic statistical description, and the general linear model multivariate Hotelling’s T2 test was used to calculate the Hotelling’s T2 and F statistics to explore the pattern of change in the postural hazard score curves.ResultsA total of 45 nurses were observed during morning care operations, resulting in 47.8 h of video data and 34,428 effective static operation posture pictures. Among these pictures, 21,166 (61.5%) depicted poor working postures. Nurses spent up to 7 min and 30 s maintaining a challenging posture during oral care, with the highest postural hazard score (M = 2.2, SD = 0.3) observed during defecation care. Each patient requires a total of 25–30 min of oral care per day.The Hotelling’s T2 test indicated that the change curve of the postural hazard score in each step revealed the largest second-order F value, F = 52.931, P < 0.001.DiscussionICU nurses frequently adopt poor working postures during morning care operations. Further research should focus on optimizing safe working postures to prevent or minimise detrimental occupational hazards resulting from poor working postures.Research on occupational low back pain among ICU nurses can help them work more efficiently, and thereby improving their nursing level.

Influence of hip prosthesis position on postoperative gait in symptomatic hip osteoarthritis secondary to hip dysplasia patients after primary total hip arthroplasty: a short-term follow-up study

BackgroundThe aim of this study was to analyze the influence of the positioning of the components of total hip arthroplasty (THA) evaluated by the acetabular anteversion (AA) and femoral anteversion (FA) angle on postoperative gait in patients with symptomatic hip osteoarthritis secondary to hip dysplasia undergoing THA.MethodsBetween May 2023 and May 2024, patients with symptomatic hip osteoarthritis secondary to hip dysplasia (Crowe Type I and IV) who underwent THA were enrolled in the study. The AA angle and FA angle were measured by computer tomography (CT). Gait data were determined by using the Dynamic Right Gait & Posture analysis system. The relationship between FA, AA and gait data was analyzed by Pearson correlation test, subgroup Pearson correlation test, multiple linear regression.ResultsA total of 40 patients (45hips) were included in the study. Compared with preoperative, the patient’s postoperative foot progression angle, foot contact angle, plantarflexion velocity, swing foot speed, gait velocity, cadence, stride length were significantly improved. Preoperative FA is significantly different from postoperative FA (P < 0.05), while the difference between preoperative and postoperative AA is not significant. BMI, Crowe Type, AA were related to change of cadence. The less the postoperative AA of patients, and the more the cadence in the postoperative gait of patients.ConclusionOur study showed that THA could improve the gait function of patients with symptomatic hip osteoarthritis secondary to hip dysplasia. Adjusting AA lower could obtain a much more postoperative cadence.

A comparative effectiveness study of usual care, simple Chuna manual therapy, and complex Chuna manual therapy for the treatment of pelvic biomechanical lesions in patients with non-acute low back pain: a protocol for multicenter, randomized controlled trial

BackgroundChuna manual therapy (CMT), a Korean manual therapy technique predominantly used for treating low back pain (LBP) and related disorders, lacks well-conceived research focusing on its comparative effectiveness, safety, and economic evaluation, particularly with respect to complex CMT with established CMT diagnostic algorithms. This study aims to illustrate a protocol for a randomized clinical study for comparative effectiveness and cost-effectiveness of complex CMT with simple CMT and usual care.MethodsThis is a protocol for a three-armed, multicenter, assessor-blinded, pragmatic, randomized controlled trial study. A total of 81 patients suffering from non-acute LBP with pelvic biomechanical lesions (PBL), characterized by a pain duration of at least two weeks and a Numeric Rating Scale (NRS) score of 5 or higher, will be recruited from two Korean medicine hospitals. These participants will be randomly assigned to one of three groups: complex CMT plus usual care (UC; n = 27), simple CMT plus UC (n = 27), or UC groups (n = 27). They will undergo treatment for 4 weeks, and follow-up assessments will be performed 8 weeks after treatment completion. The primary outcome will be the NRS score of LBP, and secondary outcomes will include the Oswestry Disability Index, Patient Global Impression of Change, credibility and expectancy questionnaire, three-dimensional posture analysis indicators, quality of life assessment, economic evaluation, and safety assessments.DiscussionThis will be the first study to assess the comparative effectiveness, safety, and cost-effectiveness of complex CMT compared to UC and simple/complex CMT in patients with LBP and PBL. We will also analyze useful diagnostic methods to help in clinical practice for CMT diagnosis.Trial registrationClinical Research Information Service (CRIS), KCT0009210. Registered on February 28, 2024.

Work Posture Analysis in The Chips Frying Section Using Workplace Ergonomic Risk Assessment Method

U.D. Keripik Mustika is a small and medium enterprise (SME) that processes yam raw materials into special snacks in great demand for consumption and souvenirs. According to observations, the worker experienced pain complaints during frying in the shoulder area, arms, back, waist, hands, and feet. The complaint experienced by this worker was due to the worker's posture that had to stand and bend slightly with the position of the hands continuously mixing for 7 hours a day and done manually repeatedly over long periods. This is if left, then the worker will suffer musculoskeletal disorders (MSDs). The research was conducted using the WERA method (Workplace Ergonomic Risk Assessment), which explains the development of ergonomic risk assessment at the workplace to detect physical risk factors associated with musculoskeletal disorders (MSDs). The spread of the Nordic Body Map questionnaire on frying workers showed pain complaints from an unergonomic working posture. The study results were obtained from Employee 1, with a physical indicator score of 39 (Medium), and Employee 2, with a physical indicator score of 37 (Medium). Therefore, there is a need for improvement of the work facilities or the worker's posture. Based on the assessment results, the researchers suggested additional facilities for workers to design standing aids that reduce pain in the leg muscles and complaints of Musculoskeletal Disorders (MSDs).

Postural analysis of adolescent young athletes in different sports branches

The effects of posture on athletic performance have been the focus of attention of many researchers and the importance of body posture in achieving success has become undeniable. This study aimed to perform the postural evaluation of adolescent youth athletes who are trained in basketball, soccer, volleyball, and swimming branches. A total of 88 adolescent athletes (32 boys and 56 girls) with an average age of ±12.37 years, an average height of ±1.58 cm, an average body weight of ±48.2 kg, an average BMI of ±18.19 and an average training age of ±2.06 years from football, volleyball, and swimming branches actively active in Manisa and Bursa provinces participated in the study. Posture analysis of the athletes was performed using the Apecs-AI Posture Evaluation and Correction System® mobile posture application. The data obtained from the athletes were evaluated with the NewYork Posture Assessment Test (NYPD). The data obtained from the study were analyzed using the SPSS 22.0 package program. One-way Analysis of Variance (ANOVA) was used for independent samples. According to the results of the analysis, there was a significant difference between training age and NYPD scores according to branches (p&lt;.05). Significance was found between NYPD and body axis scores in volleyball and soccer athletes (p&lt;.05). There was no difference between NYPD and other variables in swimming and basketball. As a result, it is thought that the effect of the training age variable on posture structures differs specifically according to the branches, and posture is negatively affected as the training age increases in volleyball and soccer players.

Thread plate posture analysis for screw rolling adjustment design

Abstract This research focuses on process design of the adjustment of movable thread plate and fixed thread plate in the screw rolling machine during production. By observing some key dimensions of the threaded screw, one can determine the movement amount and the rotation direction of the adjustment screw bars mechanism of the fixed thread plate that required for the specified size of this type of screw. One establishes a relationship from the adjustment of the screw bars mechanism to the fixed thread plate posture. It can be seen that the formed screw size deviations will lead the machine operator to adopt one of the proposed process to achieve the posture adjustment of the fixed thread plate. While the screw specification deviations do not conform to the standard ones, the operator just need to find out the error type of the formed screw and measures its specification to follow one of the proposed formulas, then the wrong thread plate posture can be modified to the correct posture under operator’s adjustment. The method addressed in this research can not only reduce the operational difficulty of screw thread rolling machine but also can reduce the trial-and-error processes in traditional operation methods.

The Relationship between Sleep Quality and Posture: A Study on University Students.

The aim of this study is to investigate body posture, physical exercises, head-neck relationship, and sleep quality among university students. A total of 96 students, with an average age of 20.86 ± 1.24 years and an average BMI of 23.41 ± 2.56, voluntarily participated in the study. The REEDCO Posture Evaluation (RPE) was used to assess the participants' body posture scores. Head and neck measurements were taken using the Apecs-AI Posture Evaluation and Correction System® (Apecs Posture Analysis Pro Plus Version 8.2.6). Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Pearson correlation analysis indicated that increased caffeine consumption was associated with poorer sleep quality (r = 0.267, p < 0.05). Additionally, increased participation in physical activities was associated with improved sleep quality, with those engaging in sports having better sleep quality scores (r = -0.278, p < 0.05). As physical activity increased, REEDCO scores decreased (r = -0.423, p < 0.05), while scores for right head (r = 0.210, p < 0.05) and left head (r = 0.247, p < 0.05) increased. Significant negative correlations were found between REEDCO scores and right head (r = -0.296, p < 0.05) and left head (r = -0.463, p < 0.05) scores. In conclusion, due to the limited number of studies investigating head-neck relationships and sleep quality, definitive conclusions cannot be drawn; further and more comprehensive research is needed.

Analysis of Human Body Posture During Ice Sports Based on Deep Learning

Analysis of Human Body Posture During Ice Sports Based on Deep Learning

Artificial Intelligence for the Evaluation of Postures Using Radar Technology: A Case Study.

In the last few decades, major progress has been made in the medical field; in particular, new treatments and advanced health technologies allow for considerable improvements in life expectancy and, more broadly, in quality of life. As a consequence, the number of elderly people is expected to increase in the following years. This trend, along with the need to improve the independence of frail people, has led to the development of unobtrusive solutions to monitor daily activities and provide feedback in case of risky situations and falls. Monitoring devices based on radar sensors represent a possible approach to tackle postural analysis while preserving the person's privacy and are especially useful in domestic environments. This work presents an innovative solution that combines millimeter-wave radar technology with artificial intelligence (AI) to detect different types of postures: a series of algorithms and neural network methodologies are evaluated using experimental acquisitions with healthy subjects. All methods produce very good results according to the main parameters evaluating performance; the long short-term memory (LSTM) and GRU show the most consistent results while, at the same time, maintaining reduced computational complexity, thus providing a very good candidate to be implemented in a dedicated embedded system designed to monitor postures.

The effect of proprioceptive vestibular rehabilitation on sensory-motor symptoms and quality of life.

Peripheral vestibular hypofunction (PVH) is characterized by balance and gait disorders and vestibulo-autonomic findings. The vestibular system and proprioceptive system work together to regulate sensorimotor functions. Vestibular exercises are effective in PVH, but their superiority over each other is still unclear. This study aims to examine the effect of proprioceptive vestibular exercises on patients with PVH. 30 individuals with unilateral PVH were assigned to 3 groups. Group 1 received proprioceptive vestibular rehabilitation, group 2 received standard vestibular rehabilitation. Both groups were given standard vestibular exercises as home exercises. No exercise was applied to the group 3. Patients were evaluated in terms of balance, functional mobility, posture, sensory profile, and quality of life. Although there was a significant intra-group difference in balance, functional mobility, and quality of life results in all groups (p < 0.05), the difference between groups was generally in favor of group 1 (p < 0.05). There was a significant difference between the groups in the posture analysis results (p < 0.05), while there was a significant difference in the 1st group (p < 0.05). There was a significant difference between the groups in the results of sensory sensitivity, sensory avoidance, and low recording (p < 0.05). There was no significant difference between the groups in sensory-seeking results (p > 0.05). There was a significant difference in quality of life between and within groups (p < 0.05). Proprioceptive vestibular rehabilitation is an effective method in PVH. We think that our study will guide clinicians and contribute to the literature. NCT04687371.

Gait pathology presented with developmental dysplasia of the hip: a control case study

A well-known and long-term complication of developmental dysplasia of the hip (DDH) is improper gait pattern, early regressive joint disorder, and permanent pain. It can affect the family's psychological, social, and functional parts. This study planned to resolve foot posture and gait analysis across patients with developmental hip dysplasia and correlate it with the control group. Case-control studies determine the main results. We correlated the gait analysis results on the Zebris FDM platform. The case included candidates with DDH under conservative treatment with an abduction brace and a control group with healthy participants. This study was conducted at King Abdullah Specialized Children Hospital, Riyadh, in the Kingdom of Saudi Arabia. This research enclosed 445 outcomes with DDH and 168 for the control category. The Sign test presented a significant diversity in Zebris FDM outcomes between DDH and the control group, especially in left foot external rotation with a p-value of 0.01 (left hip mean of 4.53, n=445, SD 8.78). A significant variation was present in step width, stance phase on both legs, single support, load response, swing phase, pre-swing, and a double support p-value of 0.00 (p&lt;0.05). W-sitting was preferred in 256 (n=445, 58%) of the DDH results and by 61 (n=168, 36%) from the control group. This study's outcomes presented a greater risk of pronation on the left foot and gait alteration on the right lower limb. The gait investigation presented a clear description of its patterns in paediatrics with DDH. Analyzing the gait among the DDH and the control group demonstrated a variation in each gait outcome from Zebris FDM platform software. DDH has a negative response on the gait pattern and foot posture, this is a great consequence presented in connection with Saudi applicants. Keywords: FDM, DDH, gait, control group, Kingdom of Saudi Arabia

Retraction Note: Optical image enhancement based on convolutional neural networks for key point detection in swimming posture analysis

Retraction Note: Optical image enhancement based on convolutional neural networks for key point detection in swimming posture analysis

Postural analysis and ergonomic intervention of unorganized workers in indian construction sectors.

In India's fast-growing economy, the construction sector offers significant developments with huge employment opportunities but poses risks due to poor working environments and uncomfortable postures. Traditional methods, such as manual material handling, can lead to health hazards and musculoskeletal disorders such as overexertion, low back pain, etc. The purpose of this study was to analyze the working postures of unorganized employees engaged in residential buildings using Ergofellow software and to recommend changes in their unsafe working postures. Participants' working positions were video recorded and the postures were analyzed using Rapid Upper Limb Assessment (RULA), Rapid Entire Body Assessment (REBA) and Ovako Working Posture Analysis (OWAS). Paired sample t-tests were used to analyze significant differences between the RULA and REBA scores after the ergonomic interventions were implemented. From the analysis of RULA, REBA and OWAS, the working postures showed a high risk of potential injury and required an immediate change in employees' working postures. The RULA and REBA scores were subsequently lower after the ergonomic interventions, which were based on ergonomic and safety principles. The paired sample t-tests with p-values of less than 0.05 demonstrated decreased risks after ergonomic interventions. Working postures of the construction workers exposed to musculoskeletal disorders were examined and the ergonomic interventions were implemented. According to the recommendations, working positions were changed, and employee well-being was enhanced by reduced operational risks.

A Mobile based Decision Support System for Postural Evaluation of Agricultural Activities with Rapid Entire Body Assessment (REBA)

Agriculture is an unorganized sector and it is a very high drudgery prone profession due to the absence of awareness and entry of advanced agricultural technologies. Many farming activities and operations are carried out by farm workers in the agriculture sector, where they are subject to very poor working conditions which can lead to physical and mental stress. Workers in agriculture experience musculoskeletal disorders in various body parts throughout various agricultural operations. These problems are caused by heavy work loads, repetitive movements, uncomfortable postures, prolonged periods of time spent in neutral or unsupported positions and the use of conventional equipment and implements that are not ergonomically built. The ergonomic risk factors present in the workplace can be examined using various evaluation instruments to ascertain the workers abilities and drawbacks. The work-related risks are measured using the scientifically validated posture assessment instruments. Rapid entire body assessment (REBA) is a technique that assess a person’s complete body including wrists, fore arms, elbows, shoulders, neck, trunk, back, legs and knees. It uses a systematic process to find the postural musculoskeletal disorders and risks associated with the job tasks. A mobile application is developed to assess the agricultural activities on the basis of physiological analysis and postural analysis using REBA ergonomics technique. The application evaluates the drudgery involved in the agricultural work by using physical assessment followed by postural ergonomics methods and provide recommendation of correct posture to avoid developing musculoskeletal disorders.

Posture, balance and gait in axial spondyloarthritis: a case-control study.

Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that primarily involves the axial skeleton but may also present with peripheral joint involvement and extra-articular involvement. The present study aims to quantitatively analyze posture, balance, and gait parameters in patients with axSpA and and assess associated factors. This cross-sectional case-control study included 51 axSpA patients (30 males, 21 females; mean age 40.94 ± 10.48 years) and 51 age- and sex-matched healthy controls. In patients with axSpA, the Ankylosing Spondylitis Disease Activity Score CRP, the Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Metrology Index(BASMI), the Maastrich Ankylosing Spondylitis Enthesitis Score(MASES), and the Ankylosing Spondylitis Quality of Life(ASQoL) scale were used. For postural analysis, DIERS formetric (Diers GmbH, Schlangenbad, Germany) videoraster- stereography device was utilized. HUR SmartBalance BTG4 (HUR-labs Oy, Kokkola, Finland) balance platform was used for postural balance and limit of stability (LOS) measurement. Participants were evaluated using Berg Balance Scale (BBS), Functional Reach Test (FRT) and Timed Up and Go Test (TUG). The Zebris FDM type 3 (Zebris Medical GmbH, Germany) walking platform was used to measure the spatiotemporal parameters of the participants. Comparison of postural parameters showed that sagittal imbalance and cervical depth distance were increased in the axSpA group than in the healthy participants (p < 0.004). Comparison of functional balance parameters showed that BBS and FRT scores were significantly lower (p < 0.001) in the axSpA group than in the control group, while TUG scores were significantly higher (p < 0.001). The LOS values, which evaluate dynamic balance were significantly lower, indicating impairment, in the axSpA group. In the measurement of postural sway, which indicates static balance, all 23 subparameters were found to be similar. When analyzing the spatiotemporal gait parameters, in the axSpA group compared with those in the control group; Foot angles (p= 0.028) and stride width (p = 0.004) were increased, whereas step lengths (p = 0.004) and stride lengths (P = 0.004) were decreased. In the axSpA group the gait speed was decreased (p = 0.004). When axSpA was analyzed separately as radiographic and nonradiographic axSpA, similar findings were observed in posture, balance, and gait parameters. No significant difference was observed. We found that the clinical assessments most closely associated with posture, balance, and gait analyses were BBS, FRT, TUG, and BASFI.

Analysis of posture and carrying loads in agricultural activities performed by farm women

Analysis of posture and carrying loads in agricultural activities performed by farm women

Postural and spinal stability analysis for different floor sitting styles

In contrast to Western countries, traditional floor-seating cultures are prevalent in Korea, Japan, the Middle East, and Africa, where sitting on the floor in static positions such as squatting, kneeling, or sitting cross-legged is common. Most studies on sitting posture have predominantly focused on chair sitting in Western cultures, resulting in a cultural bias. This study aimed to investigate the effects of different cushion types (floor and traditional cushions of 3-cm, 5-cm, and 8-cm thickness) and seating postures (cross-legged, mother's leg, and kneeling) on measures of postural stability, trunk muscle activity, rotational spinal stability, and subjective postural stability in an Asian population. Forty right-hand and right-foot-dominant volunteers who did not experience activity-limiting back pain in the past 12 months were recruited. Multivariate analyses of variance (MANOVA) and ANOVA with a repeated-measures design were employed to assess the within-subject effects of the cushion type and seating posture. An alpha value of 0.05 was set for statistical significance. The results of this study suggest that preventing lordosis posture, seating on the floor, and maintaining a kneeling posture may reduce the loss of balance and trunk muscle fatigue. These results emphasize the need for additional ergonomic studies that focus on the seating traditions of Asian cultures.