Significant Differences In Asymmetry Research Articles

Applying 3D scanning to evaluate facial symmetry in Asian populations

BackgroundFacial symmetry enhances attractiveness, with various therapies available to improve it. However, trends in facial asymmetry remain unclear. This study evaluates differences between specific facial regions using 3D scanning to guide clinical treatment. MethodThe 3dMD face™ system (3dMD Ltd, USA) scanned 88 subjects' faces. Geomagic Wrap 2021 analyzed the left and right sides. Differences in eyebrow peaks, eyebrow tails, eye ends, and mouth corners were evaluated. ResultsMore subjects showed a drooping right side of the face in eyebrow peaks, eyebrow tails, eye ends, mouth corners, tubercula mentale, and mandibular margin positions. A higher proportion had deeper left nasolabial folds and marionette lines, while more had deeper right tear ducts and lateral chin depressions. More subjects exhibited a prominent right forehead and parotid masseter region, with a prominent left temporal and cheek region. Conclusion3D scanning effectively assesses facial asymmetry in clinical practice. Research indicates significant differences in asymmetry between facial regions. Evaluating these differences pre-treatment can guide the selection of therapeutic methods, improving facial asymmetry treatment. Level of Evidence3 (Diagnostic)

Lateralization of interictal temporal lobe hypoperfusion in lesional and non-lesional temporal lobe epilepsy using arterial spin labeling MRI

PurposeNon-invasive imaging studies play a critical role in the presurgical evaluation of patients with drug-resistant temporal lobe epilepsy (TLE), particularly in helping to lateralize the seizure focus. Arterial Spin Labeling (ASL) MRI has been widely used to non-invasively study cerebral blood flow (CBF), with somewhat variable interictal alterations reported in TLE. Here, we compare temporal lobe subregional interictal perfusion and symmetry in lesional (MRI+) and non-lesional (MRI-) TLE compared to healthy volunteers (HVs). MethodsTwenty TLE patients (9 MRI+, 11 MRI-) and 14 HVs under went 3 T Pseudo-Continuous ASL MRI through an epilepsy imaging research protocol at the NIH Clinical Center. We compared normalized CBF and absolute asymmetry indices in multiple temporal lobe subregions. ResultsCompared to HVs, both MRI+ and MRI- TLE groups demonstrated significant ipsilateral mesial and lateral temporal hypoperfusion, specifically in the hippocampal and anterior temporal neocortical subregions, with additional hypoperfusion in the ipsilateral parahippocampal gyrus in the MRI+ and contralateral hippocampus in the MRI- TLE groups. Contralateral to the seizure focus, there was significant relative hypoperfusion in multiple subregions in the MRI- compared to the MRI+ TLE groups. The MRI+ group therefore had significantly greater asymmetry across multiple temporal subregions compared to the MRI- TLE and HV groups. No significant differences in asymmetry were found between the MRI- TLE and HV groups. ConclusionWe found a similar extent of interictal ipsilateral temporal hypoperfusion in MRI+ and MRI- TLE. However, significantly increased asymmetries were found only in the MRI+ group due to differences in perfusion contralateral to the seizure focus between the patient groups. The lack of asymmetry in the MRI- group may negatively impact the utility of interictal ASL for seizure focus lateralization in this patient population.

Assessment of corneal biomechanics in anisometropia using Scheimpflug technology.

Purpose: To investigate the relationship between corneal biomechanical and ocular biometric parameters, and to explore biomechanical asymmetry between anisometropic eyes using the corneal visualization Scheimpflug technology device (Corvis ST). Methods: 180 anisometropic participants were included. Participants were divided into low (1.00≤△Spherical equivalent (SE) < 2.00D), moderate (2.00D≤△SE < 3.00D) and high (△SE ≥ 3.00D) anisometropic groups. Axial length (AL), keratometry, anterior chamber depth (ACD) and corneal biomechanical parameters were assessed using the OA-2000 biometer, Pentacam HR and Corvis ST, respectively. Results: The mean age of participants was 16.09 ± 5.64 years. Stress-Strain Index (SSI) was positively correlated with SE (r = 0.501, p < 0.001) and negatively correlated with AL (r = -0.436, p < 0.001). Some other Corvis ST parameters had weak correlation with SE or AL. Corneal biomechanical parameters except for time of first applanation (A1T), length of second applanation (A2L), deformation amplitude (DA), first applanation stiffness parameter (SPA1) and ambrosia relational thickness-horizontal (ARTh) were correlated with ametropic parameters (SE or AL) in multiple regression analyses. A1T, velocity of first applanation (A1V), time of second applanation (A2T), A2L, velocity of second applanation (A2V), corneal curvature radius at highest concavity (HCR), peak distance (PD), DA, deformation amplitude ratio max (2mm) (DAR), SPA1, integrated radius (IR), and SSI showed significant differences between fellow eyes (p < 0.05). There was no significant difference in asymmetry of corneal biomechanics among the three groups (p > 0.05). Asymmetry of some biomechanical parameters had weak correlation with asymmetry of mean corneal curvatures and ACD. However, asymmetry of corneal biomechanical parameters was not correlated with asymmetry of SE or AL (p > 0.05). Conclusion: More myopic eyes had weaker biomechanical properties than the contralateral eye in anisometropia. However, a certain linear relationship between anisometropia and biomechanical asymmetry was not found.

An objective study into the effects of an incline on naturally occurring lameness in horses.

The clinical examination of lame horses in real world settings often requires the use of sloped surfaces. This pilot study aimed to evaluate the effects of uphill and downhill locomotion on asymmetry in horses with naturally occurring lameness affecting forelimbs and hindlimbs. Ten horses (8-19 years) with forelimb lameness and eight horses (7-16years) with hindlimb lameness were fitted with inertial sensors at the poll, withers, sacrum and both tuber coxae. Data were collected whilst the horses were trotted in hand on a level surface (<0.7%), as well as up and down a minor slope of 2.4%. Data were collected for a minimum of 25 strides at each incline type. Effect of incline was compared using a repeated measures ANOVA and, where significant, a subsequent Bonferroni's multiple comparisons. Of the horses with hindlimb lameness, there were reductions in asymmetry seen during downhill locomotion when compared with trotting on the flat (flat: 6.6 ± 4.4mm to downhill: 1.9 ± 2.9mm; p = 0.015) and when compared with uphill locomotion (8.4 ± 4.3mm; p = 0.007). Horses with forelimb lameness showed no significant difference in asymmetry. However, there were considerable changes in poll asymmetry (>20mm) among conditions in individual horses. Two horses with hindlimb lameness and two horses with forelimb lameness switched asymmetry between left and right by changing incline. These results confirm that incline can be an influential factor in the assessment of lame horses. Further work is justified to elucidate the types of pathology associated with the most relevant changes in asymmetry which would allow the use of an incline to prioritise a list of differential diagnoses.

Upper Body Movement Symmetry in Reining Quarter Horses during Trot In-Hand, on the Lunge and during Ridden Exercise.

Simple SummaryVeterinary lameness examinations often include assessment of the horse while ridden. Movement symmetry data are commonly used to aid veterinary decision making in lame horses. Reference data are available for horses ridden in ‘English style’, but not specifically for horses ridden in ‘Western style’ with considerable differences in head–neck position, tack and riding style. Upper body movement symmetry was measured in thirty reining Quarter Horses (QHs) during trot in-hand, lunged and ridden by one experienced rider on reining-purpose riding surfaces. Movement was marginally more symmetrical in the ridden horse, with small differences of 1–5 mm. Typical for soft surfaces, movement asymmetry indicated reduced weight support with the limb on the inside of the circle and reduced pushoff with the opposite limb. The small but significant asymmetry differences between in-hand and ridden exercise in QHs ridden in ‘Western style’ necessitate further studies in lame horses. Particular focus should be put on investigating the role of ridden exercise for highlighting differences between specific lameness causes and weight bearing and pushoff forces with the lame limb on the inside or outside of the circle.Veterinary lameness examinations often comprise assessing ridden horses. Quantitative movement symmetry measurements can aid evidence-based decision making. While these are available for ‘English’ style riding, they are not for ‘Western’ style riding. This quantitative observational study quantified movement symmetry in reining Quarter Horses (QHs). Movement symmetry of the head, withers and sacrum (differences between minima, maxima and upward amplitudes) were quantified with inertial sensors in N = 30 medium/high level reining QHs during trot in-hand, on the lunge and ridden by one experienced rider (straight-line/circles) on reining-purpose riding surfaces. Mixed linear models for movement symmetry assessed the effects of ridden exercise and movement direction (fixed factors), stride time (covariate) and horse (random factor): single factors and two-way interactions with Bonferroni correction at p < 0.05. Three withers and pelvic parameters showed marginally more symmetrical movement when ridden (p ≤ 0.044; 1–5 mm differences). Three withers, three sacrum and one head parameter were significantly affected by movement direction (all p ≤ 0.026), five showed increased asymmetry on the inside rein, and two, quantifying vertical displacement maximum difference, showed the opposite. Riding QHs in ‘Western’ style showed small movement symmetry differences. Circular exercise confirmed increases in weight bearing asymmetry on the inside rein and in pushoff asymmetry on the outside rein. This should be further investigated for differentiating between different causes of lameness.

3D analysis of facial morphology in Dutch children with cancer

Facial 3D photographic images were obtained of children with a newly diagnosed malignancy. The resulting sample comprised 13 different cancer types. Patients were excluded if they had a known genetic cause of the cancer. Patients were compared to healthy controls, matched for sex, age and ethnic background. The degree of asymmetry and overall deviation of an individual's face from an age and sex typical control face were measured. A total of 163 patients of European descent were included. No significant difference in asymmetry between patients and controls could be identified. On average, patients deviated more from an age and sex typical face than the controls. This study shows that children with cancer deviate more than controls, possibly suggesting a higher prevalence of genetic anomalies within this group. The results suggest that this is not sufficient to discriminate patients from controls. Further research is necessary to explore the patterns of individual variation among the overall deviation of patients and controls.

Performance, asymmetry and biomechanical parameters in wheelchair rugby players

ABSTRACT The practice of the wheelchair rugby is becoming more and more worldwide. However, few biomechanical studies have focused on this sport. The aim of this study was to compare kinematic parameters of wheelchair rugby players, classified as defensive players (LP-D) versus offensive players (HP-O). Twenty-nine wheelchair rugby players (17 LP-D and 12 HP-O) performed a 20-m sprint test. The peak velocities, temporal parameters (propulsion phase time, deceleration phase time, cycle time and cycle frequencies) and asymmetries (the difference in peak velocities between the right and the left wheels) were measured at the acceleration and constant peak velocity phases of the sprint by an inertial measurement unit which was placed on each rear wheel. At the acceleration and constant peak velocity phases, peak velocities and cycle frequencies were higher in HP-O players than LP-D players. The deceleration phase times and the cycle times were higher in LP-D players than HP-O players. However, no significant difference in asymmetry was found between LP-D players and HP-O players. The HP-O players showed superior performance than the LP-D players, but they could be more exposed at risk of injury at their upper limbs than LP-D players.

Dynamic evaluation of toe–heel and medio-lateral load distribution and hoof landing patterns in sound, unshod Standardbred horses with toed-in, toed-out and normal hoof conformation

Dynamic load distribution and landing patterns play an important role in equine orthopaedics. The aim of this study was to analyse dynamic load distribution and hoof landing patterns of sound Standardbreds. Twenty-four sound, unshod Standardbreds were walked and trotted over a pressure plate to obtain the peak vertical force (PVF), vertical impulse (VI) and stance time (ST) of both forelimbs. Asymmetry indices between both forelimbs were calculated and the dynamic medio-lateral and toe–heel load distribution of the forelimbs were compared between normal, toed-in and toed-out horses. The hoof landing patterns were determined on the first loaded zone. Linear mixed models and Chi-square analysis were used for statistical analysis (α = 0.05). At walk and trot, there were no significant differences in asymmetry of PVF, VI and ST between normal (n = 9/24 horses), toed-in (n = 6/24 horses), and toed-out horses (n = 9/24 horses). In both forelimbs, a flat landing (39.6% and 70.8% at walk and trot, respectively) predominated over all hoof conformations. No significant association between hoof conformation and landing pattern was observed (P > 0.05). Toed-out horses had significantly higher loading of the medial zone at the end of the stance phase at walk than normal horses (P = 0.002). No other statistically significant differences in load distribution were observed (P > 0.05). In conclusion, flat landing was more common in Standardbred horses than previously described in Warmbloods, emphasising the need for breed-specific clinical reference data and biomechanical studies. Moreover, mild deviations in hoof conformation did not necessarily affect load distribution.

Asymmetry of P1 and vertebral arteries is not related to basilar tip aneurysm development or rupture

ObjectiveLately, morphological parameters of the surrounding vasculature aside from aneurysm size, specific for the aneurysm location, e.g., posterior cerebral artery angle for basilar artery tip aneurysms, could be identified to correlate with the risk of rupture. We examined further image-based morphological parameters of the aneurysm surrounding vasculature that could correlate with the growth or the risk of rupture of basilar artery tip aneurysms.MethodsData from 83 patients with basilar tip aneurysms (27 not ruptured; 56 ruptured) and 100 control patients were assessed (50 without aneurysms and 50 with aneurysms of the anterior circle of Willis). Anatomical parameters of the aneurysms were assessed and analyzed, as well as of the surrounding vasculature, namely the asymmetry of P1 and the vertebral arteries.ResultsPatients with basilar tip aneurysm showed no significant increase in P1 or vertebral artery asymmetry compared with the control patients or patients with aneurysms of the anterior circulation, neither was there a significant difference in asymmetry between cases with ruptured and unruptured aneurysms. Furthermore, we observed no significant correlations between P1 asymmetry and the aneurysm size or number of lobuli in the aneurysms.ConclusionWe observed no significant difference in aneurysm size, rupture, or lobulation associated with P1 or vertebral artery (surrounding vasculature) asymmetry. Therefore, the asymmetry of the surrounding vessels does not seem to be a promising morphological parameter for the evaluation of probability of rupture and growth in basilar tip aneurysms in future studies.

Brown and white egg-layer strain differences in fearfulness and stress measures

Different genetic lines of laying hens may show varying levels of fearfulness in response to stressful events or situations. It is important to select appropriate genetic strains when keeping hens in alternative housing systems to minimize health and production issues caused by fear and stress. In this study, data were obtained from two strains of Rhode Island Red (RIR1-2), two strains of White Plymouth Rock (WPR1-2) and three strains of White Leghorn (WL1-3) breeds. One hundred hens from each strain were used to compare strain differences in fear and stress responses. Each hen was scored for fearfulness based on her responses to the following tests: novel object, physical restraint, pencil, human reaction, inversion, and tonic immobility (TI). Stress was assessed based on physical asymmetry (ASYM) of the metatarsal and middle toe, and on corticosterone (CORT) concentrations in blood plasma and egg albumen. Differences between brown (RIR; WPR) and white (WL) egg layers were observed for all measures: WL had more head movements and took more time to right themselves during TI (P < 0.001), but higher flapping intensity was observed in RIR and WPR (P < 0.001). Hens in the WL strains also scored lower than RIR and WPR on the struggle test (P < 0.001), and had lower ASYM scores (P = 0.002) and concentrations of albumen CORT (P = 0.0065) and plasma CORT (P = 0.002), but scored higher during the remaining fear tests (P < 0.001). Differences among WL strains were also observed for all measures: WL2 had the most head movements and took the longest to right during TI (P < 0.001). During inversion, WP2 and RIR2 had the highest flapping intensity (P < 0.001) whereas WL2 and WL3 had the lowest flapping intensity (P < 0.001). There was variation among strains in plasma CORT, albumen CORT, and scores for the struggle test and pencil test. Only the WPR2 strain showed significant differences in ASYM (P < 0.001). Genetic strains of laying hens show clear variation between brown and white shell color varieties regarding fear and stress responses. Brown hens tend to actively avoid perceived threats whereas white hens use passive avoidance. Using several methods to test fear and stress to better understand individual birds’ responses to stressors will help to design breeding strategies to maximize hens’ success in alternative housing systems.

Inter-limb asymmetries are associated with decrements in physical performance in youth elite team sports athletes.

Actually, there is scarce literature looking for the relationship between inter-limb asymmetries and performance in youth elite team sports. The main purpose of this cross-sectional study was to examine the relationships between inter-limb asymmetries and physical performance in youth elite team-sports players. A secondary objective was to evaluate the presence of between-sexes differences in inter-limb asymmetries in elite youth team sports players. Eighty-one young elite team-sports athletes (age: u-14 to u-18) performed the star excursion balance test in the anterior direction (SEBT ANT), a single leg vertical countermovement jump test (SLCMJ), the one leg hop test for distance (OLHT), a 30 m sprint test, and the V-cut test. Inter-limb asymmetries were calculated for SEBT ANT, SLCMJ and OLHT. Pearson r was used to analyse the relationships between inter-limb asymmetries and physical performance. Results showed significant (p < 0.05) but small (r = 0.26) relationships between SLCMJ asymmetries and 30 m sprint time for the total group. Significant negative correlations with small to moderate magnitude of correlation were also found between SLCMJ asymmetries and SLCMJ performance on the lowest performing limb for the total group (p < 0.05; r = -0.26), males (p < 0.01; r = -0.48) and females (p < 0.05; r = -0.30). Moreover, significant negative correlations with moderate and large magnitude were also present between OLHT asymmetries and OLHT performance on the lowest performing limb for the total group (p < 0.01; r = -0.44), males (p < 0.01; r = -0.56) and females (p < 0.01; r = -0.64). No correlations were observed between asymmetries and either the V-cut test or SEBT ANT performance. No correlation were observed between SEBT ANT asymmetries and physical performance. In addition, when comparing asymmetry values between sexes there were no significant differences in vertical (p = 0.06) and horizontal (p = 0.61) jumping tests. However, there were significant differences in asymmetry between sexes in the ANT SEBT (p = 0.04). In conclusion, the current study indicated that jumping asymmetries were associated with decrements in sprint speed and jumping performance. Therefore, assessing inter-limb asymmetries would be recommended to improve training interventions for youth elite team-sports athletes.

Upper extremity function in the free living environment of adults with traumatic brachial plexus injuries

Transition of data acquisition out of the laboratory, into the real world offers a previously inaccessible perspective of physical function. This proves to be beneficial when assessing surgical intervention, especially after a traumatic brachial plexus injury (BPI) causing loss of motor function in an upper extremity (UE). Moving towards the use of real world data in clinical practice as an outcome measure, this study developed a method to report bilateral UE activity in patients with BPI. Three groups of ten subjects each participated in this study—healthy controls, subjects with traumatic BPI prior to surgical treatment (pre-), and subjects who had surgical reconstruction to treat BPI (post-). Subjects wore four activity monitors on bilateral forearms and upper arms for four days. Tri-axial acceleration data were used to calculate asymmetry indices for forearm and upper arm usage. Analysis revealed a bimodal distribution in the post- group, prompting division of this group into two subgroups based on injury type: pan-plexus and upper trunk. While median asymmetry indices at the forearm and upper arm were decreased in the post- group when compared to the pre- group, these differences were not significant. Compared to controls, the pre-surgery group (p < 0.0001, p < 0.0001) and post-surgery group with pan-plexus injuries (p = 0.0074, p = 0.0242) both exhibited statistically significant differences in forearm and upper arm asymmetry, respectively. Further investigation to establish clinically significant differences in asymmetry index is warranted. Importantly, analyzing the activity of UEs following treatment of a BPI provides objective real world evidence of function.

Using Unilateral Strength, Power and Reactive Strength Tests to Detect the Magnitude and Direction of Asymmetry: A Test-Retest Design.

The aims of the present study were to determine test-retest reliability for unilateral strength and power tests used to quantify asymmetry and determine the consistency of both the magnitude and direction of asymmetry between test sessions. Twenty-eight recreational trained sport athletes performed unilateral isometric squat, countermovement jump (CMJ) and drop jump (DJ) tests over two test sessions. Inter-limb asymmetry was calculated from both the best trial and as an average of three trials for each test. Test reliability was computed using the intraclass correlation coefficient (ICC), coefficient of variation (CV) and standard error of measurement (SEM). In addition, paired samples t-tests were used to determine systematic bias between test sessions and Kappa coefficients to report how consistently asymmetry favoured the same side. Within and between-session reliability ranged from moderate to excellent (ICC range = 0.70–0.96) and CV values ranged from 3.7–13.7% across tests. Significant differences in asymmetry between test sessions were seen for impulse during the isometric squat (p = 0.04; effect size = –0.60) but only when calculating from the best trial. When computing the direction of asymmetry across test sessions, levels of agreement were fair to substantial for the isometric squat (Kappa = 0.29–0.64), substantial for the CMJ (Kappa = 0.64–0.66) and fair to moderate for the DJ (Kappa = 0.36–0.56). These results show that when asymmetry is computed between test sessions, the group mean is generally devoid of systematic bias; however, the direction of asymmetry shows greater variability and is often inter-changeable. Thus, practitioners should consider both the direction and magnitude of asymmetry when monitoring inter-limb differences in healthy athlete populations.

Clinical and genetic Rett syndrome variants are defined by stable electrophysiological profiles

BackgroundRett Syndrome (RTT) is a complex neurodevelopmental disorder, frequently associated with epilepsy. Despite increasing recognition of the clinical heterogeneity of RTT and its variants (e.g Classical, Hanefeld and PSV(Preserved Speech Variant)), the link between causative mutations and observed clinical phenotypes remains unclear. Quantitative analysis of electroencephalogram (EEG) recordings may further elucidate important differences between the different clinical and genetic forms of RTT.MethodsUsing a large cohort (n = 42) of RTT patients, we analysed the electrophysiological profiles of RTT variants (genetic and clinical) in addition to epilepsy status (no epilepsy/treatment-responsive epilepsy/treatment-resistant epilepsy). The distribution of spectral power and inter-electrode coherence measures were derived from continuous resting-state EEG recordings.ResultsRTT genetic variants (MeCP2/CDLK5) were characterised by significant differences in network architecture on comparing first principal components of inter-electrode coherence across all frequency bands (p < 0.0001). Greater coherence in occipital and temporal pairs were seen in MeCP2 vs CDLK5 variants, the main drivers in between group differences. Similarly, clinical phenotypes (Classical RTT/Hanefeld/PSV) demonstrated significant differences in network architecture (p < 0.0001). Right tempero-parietal connectivity was found to differ between groups (p = 0.04), with greatest coherence in the Classical RTT phenotype. PSV demonstrated a significant difference in left-sided parieto-occipital coherence (p = 0.026). Whilst overall power decreased over time, there were no difference in asymmetry and inter-electrode coherence profiles over time. There was a significant difference in asymmetry in the overall power spectra between epilepsy groups (p = 0.04) in addition to occipital asymmetry across all frequency bands. Significant differences in network architecture were also seen across epilepsy groups (p = 0.044).ConclusionsGenetic and clinical variants of RTT are characterised by discrete patterns of inter-electrode coherence and network architecture which remain stable over time. Further, hemispheric distribution of spectral power and measures of network dysfunction are associated with epilepsy status and treatment responsiveness. These findings support the role of discrete EEG profiles as non-invasive biomarkers in RTT and its genetic/clinical variants.

Geometric Evaluation of the Effect of Prosthetic Rehabilitation on Facial Asymmetry in Patients with Unilateral Maxillectomy.

This study aimed (1) to geometrically evaluate areas of facial asymmetry in patients with two different types of maxillectomy defect compared to a control group, (2) to geometrically evaluate the effect of an obturator prosthesis on facial asymmetry, and (3) to investigate the correlation between three-dimensional (3D) deviation values and number of missing teeth. Facial data from 13 normal control participants and 26 participants with two types of maxillectomy defect (groups 1 and 2) were acquired with a noncontact 3D digitizer. Facial asymmetry was evaluated by superimposing a facial scan onto its mirror scan using 3D evaluation software. Facial scans with and without obturator prostheses were also superimposed to evaluate the obturator effect. The correlation between 3D deviation values and number of missing teeth was also evaluated. Statistical analyses were performed. Facial asymmetry was significantly different between the control group and each maxillectomy defect group (group 1: P < .0001 and P = .020 without and with obturator, respectively; group 2: P < .0001 for both conditions). There were no significant differences in asymmetry between groups 1 and 2 either without or with obturator (P = .457 and P = .980, respectively). There was a significant difference in the obturator effect between groups 1 and 2 (P = .038). 3D deviation values were positively correlated with number of missing teeth in group 1 (r = 0.594, P = .032), but not in group 2. A noncontact 3D digitizer and 3D deviation assessment were effective for analyzing facial data of maxillectomy patients. Obturators were effective for improving facial deformities in these patients.

Inter-eye Asymmetry of Optical Coherence Tomography Angiography Vessel Density in Bilateral Glaucoma, Glaucoma Suspect, and Healthy Eyes

To investigate inter-eye retinal vessel density asymmetry in healthy, glaucoma suspect, and mild-to-moderate glaucoma subjects, and its potential utility for early detection of glaucomatous damage. Cross-sectional study. In 153 subjects including 55 healthy, 32 glaucoma suspect, and 66 glaucoma subjects enrolled in the Diagnostic Innovations in Glaucoma Study (DIGS), vessel density was obtained from optical coherence tomography angiography (OCT-A) macular and optic nerve head scans. Thickness of peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell complex (mGCC) was measured with spectral-domain optical coherence tomography (SD-OCT) scans. Inter-eye asymmetry was calculated by taking the absolute value of difference in vessel density and thickness between the right and left eyes. Inter-eye retinal vessel density asymmetry parameters were significantly different among the 3 groups. Glaucoma suspects had significantly higher peripapillary and macular inter-eye vessel density asymmetries compared to healthy groups in univariate (1.1% vs 2.0%, P= .014 and 1.2% vs 2.5%, P= .027, respectively) and multivariate analyses (P= .007 and P= .038, respectively). No significant differences in asymmetry of thickness parameters were found between glaucoma suspect and healthy groups (all P > .718). However, significant differences in asymmetry of thickness parameters between glaucoma suspects and glaucoma patients (P < .01) were found for all parameters. Inter-eye vessel density asymmetry can be quantified by OCT-A measurement. Glaucoma suspects have significantly greater vessel density asymmetry than healthy eyes. Longitudinal studies are needed to better characterize the relationship of vessel density asymmetry with the development and progression of glaucoma.

Power And Bilateral Force Differences In Professional Soccer Players Regarding The Field Position

Each playing position in soccer is characterized by specific movement profile and different tactical requirements with respect to the ball. Many studies have assessed bilateral deficit through neuromuscular assessment of unilateral and bilateral exercises, however, bilateral comparison of force production (FP) during jump regarding the playing position (PP) in professional players has not been addressed, yet. PURPOSE: To find out differences in power and force production during the power tests with respect to the PP of elite soccer players. METHODS: 155 elite Czech soccer players (age = 24.9±4.8 years) were divided according to the PP into: goalkeepers (G), fullbacks (F), central defenders (CD), wide midfielders (WM), central midfielders (CM) and attackers (A).The players carried out three types of the vertical jump: countermovement jump with (CMJFA) and without arms (CMJ) and squat jump (SJ). The jump height (JH), FPduring the take-of phase and its difference between the legs were assessed by two force plates (KISTLER AG, Switzerland). The data were processed using MANOVA and Bonferronipost-hoc test. RESULTS: The greatest jump height in CMJFA, CMJ and SJ was achieved by Gs (43.57±4.02 cm, 38.41±3.76, 36.67±3.98cm). The worst results were found in As (430.65±4.79 cm, 35.24±4.52, 34.55±3.59 cm). MANOVA showed that the effect of field position on the JH was not significant (F15,447=0.84; p>0.05, η2=0.03). The greatest difference in FP between the limbs was measured in the CMJ test (0.13 N.kg-1, 9.0 %). The greatest difference was achieved by CD (0.15 N.kg-1, 10.3 %). Gs demonstrated the greatest difference in FP in the CMJFA test (0.10 N.kg, 7.0 %) while in the SJ test the highest values were achieved by WM (0.07 N.kg-1, 5.44 %). Despite differences in absolute values, no significant difference in asymmetry regarding the PPwas found (F15,447=1.15; p>0.05, η2=0.04). CONCLUSION: The highest jumps were achieved by goalkeepers who dispose of great power of limbs and take-off belongs to primary predispositions for their specific performance. We found the difference between the limbs 7.95 % in the CMJ regardless of PP. From an intra-individual perspective, we found strength deficiencies in the players which should be compensated with the aim to improve performance and reduce the risk of injury. Supported by PRVOUK P38.

An Ultrasound Investigation of Tongue Shape in Stroke Patients with Lingual Hemiparalysis

Stroke can cause hemilateral paresis of the tongue. The present study investigated the functional consequences of a lingual hemiparalysis on the symmetry and the grooving of the tongue in the coronal plane during the production of vowel-consonant-vowel sequences. The hypotheses were that, because of the lingual hemiparalysis, the stroke patients' tongue shapes would be (1) more asymmetrical and (2) less grooved than the tongues of the control speakers. The participants in this prospective data collection were 9 stroke patients with lingualhemiparalysis and 6 control speakers. All participants produced vowel-consonant-vowel sequences with the vowels [a, i, and u] and the target consonants [k, t, ∫, s, and r]. The tongue shape in the coronal plane was traced and measured. The outcome measures were asymmetry and midlingual concavity. The participants and controls were compared using repeated measures analyses of variance with posthoc Scheffé tests. There were no significant differences in asymmetry. There was significantly reduced midlingual concavity for the stroke patients (F[1,13]=8.78; P<.05). There was also a within-subjects effect for consonant (F[4, 50]=14.26; P<.01). Post hoc testing with Scheffé tests indicated that the consonant [k] had significantly lower grooving than the other consonant sounds (P<.05). The hemilateral paresis affected not the symmetry but the midlingual grooving. Residual ipsilateral innervation in the hemiparalyzed tongue may help patients compensate. More research is needed to assess the impact of the intrinsic deformation of the tongue on speech acceptability and intelligibility in patients with a lingual hemiparalysis.

호흡훈련이 뇌졸중 환자의 횡격막 비대칭에 미치는 영향

PURPOSE: The purpose of this study was to examine the effects of breathing retraining on asymmetry of diaphragm thickness in stroke patients. METHODS: This study was nonequivalent control group pre-post test design. Subjects were assigned to two different groups(intervention group=10, control group=12). Intervention group conducted breathing retraining program for six-week. Diaphragm thickness was assessed by ultrasound in B-mode with a 7.5 MHz linea probe. The collected data analyzed by Wilcoxon signed rank test and Mann-Whitney U test. RESULTS: The intervention group significantly increased diaphragm thickness ratio on paretic side but the control group showed no significant difference in diaphragm thickness ratio. The control group significantly increased asymmetry of diaphragm thickness, but intervention group showed no significant difference in asymmetry of diaphragm thickness. CONCLUSION: This study showed that breathing retraining increased diaphragm thickness ratio in stroke patients and prevent the increase of asymmetry in diaphragm thickness with stroke patients.

Decreased Accommodative Response in the Nondominant Eye of Patients With Intermittent Exotropia

To evaluate objectively the accommodative response in patients who have intermittent exotropia with a dominant eye. Observational cohort study. setting: Institutional. patients: One hundred thirty-three patients younger than 15 years, including 33 patients with intermittent exotropia and equal dominance, 54 patients with intermittent exotropia with a dominant eye, and 46 patients with orthotropia or exophoria of less than 10 prism diopters. observation: A Shin-Nippon NVision-K 5001 autorefractor was used to measure the accommodative response under binocular and monocular viewing conditions at 33 cm. Patients wore spectacles to achieve distant refractive errors within 0.50 diopter in both eyes. main outcome measures: Accommodative responses of each eye in binocular and monocular viewing conditions were compared between fellow eyes and groups. During binocular viewing, 65% of nondominant eyes showed an accommodative lag of more than 0.5 diopter, whereas 40% of dominant eyes showed an accommodative lead. In contrast, 77% of the eyes in the equal dominance group and 59% of the normal group showed an accommodative lag of less than 0.5 diopter. During binocular viewing, patients with dominant eye intermittent exotropia showed significantly more asymmetry in the accommodative response between both eyes than patients with equal dominance intermittent exotropia and normal controls (P = .001). During monocular viewing, there was no significant difference in asymmetry between the 3 groups (P = .059). Patients with intermittent exotropia with a dominant eye tend to have asymmetric accommodative responses between both eyes during binocular viewing, where the nondominant eye showed a decreased accommodative response.