Lecture Notes in Computational Vision and Biomechanics 29 Sofia Brandão Thuane Da Roza Isabel Ramos Teresa Mascarenhas Editors Women’s Health and Biomechanics Where Medicine and Engineering Meet Lecture Notes in Computational Vision and Biomechanics Volume 29 Series editors João Manuel R. S. Tavares, Porto, Portugal Renato Natal Jorge, Porto, Portugal Editorial Advisory Board Alejandro Frangi, Sheffield, UK Chandrajit Bajaj, Austin, USA Eugenio Oñate, Barcelona, Spain Francisco Perales, Palma de Mallorca, Spain Gerhard A. Holzapfel, Graz University of Technology, Austria J. Paulo Vilas-Boas, Porto, Portugal Jeffrey A. Weiss, Salt Lake City, USA John Middleton, Cardiff, UK Jose M. García Aznar, Zaragoza, Spain Perumal Nithiarasu, Swansea, UK Kumar K. Tamma, Minneapolis, USA Laurent Cohen, Paris, France Manuel Doblaré, Zaragoza, Spain Patrick J. Prendergast, Dublin, Ireland Rainald Löhner, Fairfax, USA Roger Kamm, Cambridge, USA Shuo Li, London, Canada Thomas J. R. Hughes, Austin, USA Yongjie Zhang, Pittsburgh, USA Theresearchrelatedtotheanalysisoflivingstructures(Biomechanics)hasbeenasourceof recent research in several distinct areas of science, for example, Mathematics, Mechanical Engineering, Physics, Informatics, Medicine and Sport. However, for its successful achievement, numerous research topics should be considered, such as image processing and analysis, geometric and numerical modelling, biomechanics, experimental analysis, mechanobiology and enhanced visualization, and their application to real cases must be developedandmoreinvestigationisneeded.Additionally,enhancedhardwaresolutionsand less invasivedevices aredemanded. Ontheotherhand,Image Analysis (ComputationalVision) isusedforthe extractionof high level information from static images or dynamic image sequences. Examples of applications involving image analysis can be the study of motion of structures from image sequences,shapereconstructionfromimages,andmedicaldiagnosis.Asamultidisciplinary area,ComputationalVisionconsiderstechniquesandmethodsfromotherdisciplines,suchas ArtificialIntelligence,SignalProcessing,Mathematics,PhysicsandInformatics.Despitethe many research projects in this area, more robust and efficient methods of Computational ImagingarestilldemandedinmanyapplicationdomainsinMedicine,andtheirvalidationin real scenarios is matterof urgency. ThesetwoimportantandpredominantbranchesofScienceareincreasinglyconsideredtobe stronglyconnectedandrelated.Hence,themaingoaloftheLNCV&Bbookseriesconsists oftheprovisionofacomprehensiveforumfordiscussiononthecurrentstate-of-the-artinthese fieldsbyemphasizingtheirconnection.Thebookseriescovers(butisnotlimitedto): (cid:129) (cid:129) Applications of Computational Vision and GridandHighPerformanceComputingfor Biomechanics ComputationalVisionandBiomechanics (cid:129) (cid:129) BiometricsandBiomedicalPatternAnalysis Image-basedGeometricModelingandMesh (cid:129) CellularImagingandCellularMechanics Generation (cid:129) ClinicalBiomechanics (cid:129) ImageProcessingandAnalysis (cid:129) ComputationalBioimagingandVisualization (cid:129) ImageProcessingandVisualizationin (cid:129) Biofluids ComputationalBiologyinBiomedicalImaging (cid:129) (cid:129) ImageUnderstanding DevelopmentofBiomechanicalDevices (cid:129) (cid:129) MaterialModels Device and Technique Development for (cid:129) BiomedicalImaging Mechanobiology (cid:129) DigitalGeometryAlgorithmsforComputa- (cid:129) MedicalImageAnalysis (cid:129) tionalVisionandVisualization MolecularMechanics (cid:129) (cid:129) ExperimentalBiomechanics Multi-ModalImageSystems (cid:129) (cid:129) Gait&PostureMechanics MultiscaleBiosensorsinBiomedicalImaging (cid:129) (cid:129) MultiscaleAnalysisinBiomechanics MultiscaleDevicesandBiomems (cid:129) NeuromuscularBiomechanics forBiomedicalImaging (cid:129) NumericalMethodsforLivingTissues (cid:129) MusculoskeletalBiomechanics (cid:129) NumericalSimulation (cid:129) SportBiomechanics (cid:129) Software Development on Computational (cid:129) VirtualRealityinBiomechanics (cid:129) VisionandBiomechanics VisionSystems More information about this series at http://www.springer.com/series/8910 fi ã So a Brand o Thuane Da Roza (cid:129) Isabel Ramos Teresa Mascarenhas (cid:129) Editors ’ Women s Health and Biomechanics Where Medicine and Engineering Meet 123 Editors SofiaBrandão Isabel Ramos Department ofRadiology, CHSJ-EPE, Department ofRadiology, CHSJ-EPE, Faculty ofMedicine Faculty ofMedicine University of Porto University of Porto Porto Porto Portugal Portugal and Teresa Mascarenhas Department ofObstetrics andGynecology, LAETA,INEGI, Faculty of Engineering CHSJ-EPE,Faculty ofMedicine University of Porto University of Porto Porto Porto Portugal Portugal Thuane DaRoza Department ofBiomechanics, Collegeof HealthandSport Science (CEFID) SantaCatarina State University (UDESC) Florianópolis Brazil ISSN 2212-9391 ISSN 2212-9413 (electronic) Lecture Notesin Computational Vision andBiomechanics ISBN978-3-319-71573-5 ISBN978-3-319-71574-2 (eBook) https://doi.org/10.1007/978-3-319-71574-2 LibraryofCongressControlNumber:2017959158 ©SpringerInternationalPublishingAG2018 Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeorpart of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission orinformationstorageandretrieval,electronicadaptation,computersoftware,orbysimilarordissimilar methodologynowknownorhereafterdeveloped. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publicationdoesnotimply,evenintheabsenceofaspecificstatement,thatsuchnamesareexemptfrom therelevantprotectivelawsandregulationsandthereforefreeforgeneraluse. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authorsortheeditorsgiveawarranty,expressorimplied,withrespecttothematerialcontainedhereinor for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictionalclaimsinpublishedmapsandinstitutionalaffiliations. Printedonacid-freepaper ThisSpringerimprintispublishedbySpringerNature TheregisteredcompanyisSpringerInternationalPublishingAG Theregisteredcompanyaddressis:Gewerbestrasse11,6330Cham,Switzerland Foreword ThisbookrelatestoissuesofWomen’sHealthandBiomechanics.Thebookbrings aninterdisciplinaryandmultidisciplinarycollaborativeresearchtoimproveclinical outcomes in different aspects of women´s life. Experts from several fields con- tributed with a wide range of topics that affect women’s health worldwide. The impactoftheeventsoccurringduringtheagingprocessinwomen’sbodyandinits psychological and social impact is covered. This book included chapters related to physical activity or technologic platformsto fulfill well-being and to treat physical and psychological diseases, cancer-related mastectomy and its impact on body posture, breast reconstruction and implants, the biomechanics of pregnancy, the disorders of the pelvic floor (postpartum, due to age or among female athletes), sexual satisfactionand the quality of life in women with urinary incontinence, and its rehabilitation. The chapters were elaborated considering the main body areas affected by the female life events, and, in this sense, this book gathers the major clinical and bioengineering perspectives from different professionals. Ihopethereadersofthisbookwillseethecomplexalterationswhichwomanare subjectedtoduringtheirlifeandwillbeabletousetheseconceptstounderstandthe clinical andbiomechanicalpracticeandtoolsdescribedhere,andperhapsinanear future to apply them in subject-specific scenarios. Asone oftheorganizers oftherelated conference “InternationalConference on Clinical and BioEngineering for Women’s Health (BioMedWomen)”, that took place on June 20–23, 2015, in Porto, Portugal, which was the genesis for the presentcontribution,Iwouldliketoexpressmypersonalgratitudefortheeditorsof this book and also to all authors for sharing their work and their knowledge in the context of the women’s health and well-being. Renato Natal Jorge University of Porto, Porto Portugal e-mail: [email protected] v Contents Part I Women’s Health Improving Women’s Health via the Biopsychosocial Model: Fibromyalgia as a Case Study to Explore Opportunities for Engineering Applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Heather Lynn Rogers Physical Activity and Women’s Mental Health . . . . . . . . . . . . . . . . . . . 15 Eluana Gomes, Raquel Costa, Tânia Bastos, Michel Probst and Rui Corredeira The Role of Ultrasound Imaging of Musculotendinous Structures in the Elderly Population . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Luis Carrão, Rute Santos, Margarida Espanha, Paulo Armada-da-Silva, Ana Amaral, Sandra Amado, Henrique A. Almeida, Paula Faria and António Veloso Part II Bridging Clinical and Biomechanical Aspects of Breast Surgery Diffusion-Weighted Breast Imaging: Beyond Morphology . . . . . . . . . . . 41 Luísa Nogueira, Rita G. Nunes, Sofia Brandão and Isabel Ramos The Effects of Mastectomy and Breast Reconstruction on Body Posture and Biomechanical Aspects . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Ana Paula Ribeiro, Thalissa Maniaes and Adriana Naomi Hamamoto The Role of Physiotherapy in Female Breast Cancer . . . . . . . . . . . . . . . 71 Soraia Cristina Tonon da Luz and Gesilani Júlia da Silva Honório Breast Implants: Far Beyond Just Aesthetic Surgery. . . . . . . . . . . . . . . 83 Nilza Ramião, Fabiana Zanata, Tomas Fortoul, Fabio X. Nahas, Lydia M. Ferreira, Pedro Martins, Antonio Augusto Fernandes, Maria da Luz Barroso and Diana Costa Santos vii viii Contents Part III The Biomechanics of the Reproductive Period Anthropometrics and Ergonomics in Pregnant Women . . . . . . . . . . . . . 97 Henrique A. Almeida, Rita M. T. Ascenso and Eunice Oliveira Increased Step Width During Walking as Pregnancy Progresses: Functional or Mechanical Adaptation? . . . . . . . . . . . . . . . . . . . . . . . . . 109 Wendy L. Gilleard Diastasis Recti During Pregnancy and Postpartum . . . . . . . . . . . . . . . . . 121 Patrícia Mota, Augusto Gil Pascoal, Cristiana Vaz, Filipa João, António Veloso and Kari Bø Biomechanical Analysis of the Damage in the Pelvic Floor Muscles During Childbirth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 Dulce Oliveira, Marco Parente, Teresa Mascarenhas and Renato Natal Jorge Part IV Clinical Approach on the Female Pelvic Floor Pelvic Floor in Female Athletes: From Function to Dysfunction . . . . . . 145 Alice Carvalhais, Thuane Da Roza and Cinara Sacomori Toward the Development of a Vaginal Finger-Cot Device for Measuring Pelvic Floor Muscles Strength . . . . . . . . . . . . . . . . . . . . . . . 155 Augusto Gil Pascoal, Patrícia Silva and Fátima Sancho Physiotherapeutic Diagnostic Process for Female Urinary Incontinence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 Bary Berghmans and Maura Seleme Psychological Morbidity, Sexual Satisfaction, Coping, and Quality of Life in Women with Urinary Incontinence in Rehabilitation Treatment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185 M. Graça Pereira, Susana Pedras and Cláudia Senra Part V Biomechanical Analysis of the Female Pelvic Floor Searching for the Tissue Mechanical Properties in Pelvic Floor Dysfunction by Computational Modeling . . . . . . . . . . . . . . . . . . . . . . . . 203 Elisabete Silva, Sofia Brandão, Marco Parente, Teresa Mascarenhas and Renato Natal Jorge Computational Analysis of Pelvic Floor Dysfunction . . . . . . . . . . . . . . . 217 Aroj Bhattarai, Ralf Frotscher and Manfred Staat Conclusion.... .... .... .... ..... .... .... .... .... .... ..... .... 231 Editors and Contributors About the Editors IsabelMariaRamos,MD,Ph.D.receivedherMDdegreefromtheFacultyofMedicineofthe UniversityofOporto.ShecompletedafellowshipatYaleUniversityin1989,andinthesameyear she received her Ph.D. from the University of Porto. Since 1990, she works in the Centro HospitalardeSãoJoão-EPE,inPorto,asDirectoroftheRadiologyDepartment,andsince2007, she accumulates with the autonomous unit of management. She was Chairman of the Quality Programme of the Centro Hospitalar de S. João-EPE for 5 years and Chairman of the AdministrationBoardin2003and2004. She is also Full Professor at the Faculty of Medicine of the University of Porto since 2001, besides of being in the past Chairman of the Faculty of Medicine Scientific Board and of the PostgraduateInstitute.SheisalsoamemberofthePortugueseMedicalAcademy. InthecontextofRadiologySocieties,shewasalready(Vice-)andPresidentofthePortuguese Society of Radiology,and amember oftheBoard (andPresident) ofthe Portuguese College of Radiology.From1996to2000,shewasamemberoftheBoardoftheEuropeanAssociationof RadiologyEducationCommittee.SheisalsoaPortugueserepresentativeatUnionEuropéennedes Médecins-Spécialistes(UEMS—Radiology)since1995. Sheis(co)-authorofmorethan200paperspublishedinPortugueseandinternationaljournals, ninechaptersinRadiologybooks,andperformedmorethan300lectures. In2016,shewasawardedthemedalofmeritofthePortugueseOrderofPhysicians. Sofia Brandão, RT, Ph.D. is a radiographer at the Centro Hospitalar de São João-EPE. She received her B.Sc. and Graduation in Radiological Sciences by the School of Allied Health SciencesofthePolytechnicInstitute,aPostgraduateandPh.D.inBiomedicalEngineeringbythe Faculty ofEngineering of theUniversityofPorto, andher M.Sc.inMedical Informatics bythe FacultyofMedicineoftheUniversityofPorto.Forthepast13years,sheisanAssistantProfessor attheCESPU,CRL—AdvancedInstituteofHealthSciences,inPorto.Herteachingactivitiesare developedindifferentB.Sc.andPostgraduatecoursesofHealthSciences. She is a member of the EFRS—European Federation of Radiographer Societies, and has participatedforseveraltimesasinvitedspeakerandmoderatorintheannualEuropeanCongressof Radiology(ECR)oftheEuropeanSocietyofRadiology(ESR),andalsoontheAnnualCongress oftheEuropeanSocietyforMagneticResonanceinMedicineandBiology(ESMRMB). The main research interest is the field of magnetic resonance (MR) imaging applications, namelyinbrain,breast,andpelvicMR,andalsopelvicMRIforcomputationalmodeling.Shehas participated in different Ph.D. and Postdoctoral Projects in the context of MRI protocol opti- mizationandacquisition. ix x EditorsandContributors Sofia Brandão has received a Training Scholarship at the University Hospital of Tübingen, which is an International Reference Center of Siemens Medical Systems, in 2003, and several awardsinnationalandinternationalconferences.Shehasover20peer-reviewedpublicationsand hasparticipatedinabookchapter.Furthermore,shehasperformedmorethan30talksontechnical aspectsofclinicalMRI,aswellasonimagingandcomputationalanalysisofthepelvicfloor. TeresaMascarenhasSaraiva,MD,Ph.D.receivedherMDandherPh.D.fromtheUniversityof Porto. Since 1992 she works in the Department of Obstetrics and Gynecology of the Centro Hospitalar de São João-EPE, in Porto, and since 2006 and she is Head of Department and AssociateProfessoroftheFacultyofMedicineoftheUniversityofPorto,respectively. In the context of Professional and Scientific Societies, she was already the European Representative,memberoftheScientificBoard,andPresidentoftheInternationalUrogynecological Association (IUGA), and was also a member of the Board of the European Urogynecological Association (EUGA). She was also founder of the Portuguese Section of Urogynecology of the PortugueseSocietyofGynecology. ProfessorMascarenhashasdevelopedrelevantresearchworkandhasreceivedseveralinterna- tionalandnationalawards.Sheis(co)-authorofmorethan200publications,includingbookchapter andscientificpapersinnationalorinternationaljournals,andhasmorethan400conferencepre- sentations.Shehasalsobeen(co-)supervisorofseveralM.Sc.,Ph.D,andPostdoctoralthesesinher researchfield,andisamemberoftheEditorialBoardoftwomajorInternationalJournalsinherareaof expertise. Thuane Da Roza, PT, Ph.D. is Professor of Obstetrics and Gynecology at the Santa Catarina State University (UDESC) with appointmentas Staffin theBiomechanics Laboratory of Health SciencesandSportsCenter.ShereceivedherB.Sc.andGraduationinPhysiotherapyScienceby theCollegeofHealthandSportScienceoftheUDESC,aM.Sc.andaPh.DinPhysicalActivity and Health by the Faculty of Sport at the University of Porto. She is currently completing a Postdoctoral fellowship at the College of Health and Sport Science, Florianópolis, Brazil, in conjunctionwiththeInstituteofScienceandInnovationinMechanicalandIndustrialEngineering ofFacultyofEngineeringoftheUniversityofPorto,Portugal. Shehasover30peer-reviewedpublications,hasparticipatedinabookchapter,andperformed over 50 lectures regarding pelvic floor function and biomechanics. The focus of her 10-years researchcareerhasbeenon3Dpelvicfloorstructureandfunction,throughcomputationalmod- eling,especiallyinfemaleathletes.Shewasthefirsttodemonstratetheeffectofacomprehensive pelvicfloormusclestrainingprogramonurinaryincontinencesymptomsinsportswomen,aswell as the differences in pelvic floor computational simulations between continent and incontinent athletes. Contributors Henrique A. Almeida School of Technology and Management, Polytechnic Institute of Leiria, Leiria, Portugal Sandra Amado CIPER – LBMF, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal; CDRSP, Polytechnic Institute of Leiria, Leiria, Portugal Ana Amaral ESTeS Coimbra, Polytechnic Institute of Coimbra, Coimbra, Portugal PauloArmada-da-Silva CIPER–LBMF,FacultyofHumanKinetics,University of Lisbon, Lisbon, Portugal