Introduction/problématique : En post-AVC, il est fréquent d'observer l'hyperactivité involontaire du muscle droit antérieur du quadriceps (DAQ) attribué, à tort ou à raison, au phénomène de spasticité, puisque les outils d'évaluation utilisés en clinique pour mesurer ce phénomène ont démontré certaines lacunes métrologiques. Des études récentes montrent que le seuil du réflexe d'étirement tonique (SRET) serait plus fiable pour quantifier la spasticité. Par contre, le SRET est développé pour évaluer la spasticité durant des mouvements passifs. Or, la spasticité fluctue avec les différentes vitesses de marche. Préalablement à la mesure du SRET du DAQ lors de la marche, il est nécessaire de mieux comprendre le taux d'utilisation musculaire (TUM) du muscle en activité fonctionnelle. L'engagement cible du présent projet est de déterminer le TUM du muscle DAQ du membre inférieur atteint/non-atteint d'hyperactivité musculaire à différentes vitesses de marche. Méthodologie : La population cible concernait des participants post-AVC (n=5) déambulant et présentant de la spasticité au muscle DAQ. Le TUM (%) a été calculé via des données recueillies sur le muscle DAQ (bilatéralement), à l'aide de l'électromyographie de surface (EMGs), au cours de trois vitesses de marche (lente, normale, rapide). Résultats : Le TUM (%) du DAQ atteint de spasticité diminue de manière plus marquée avec l'augmentation de la vitesse de marche (32.11 % d'augmentation à vitesse lente versus 17.64 % d'augmentation à vitesse rapide). Il a été remarqué une différence clinique de 51 % du TUM entre le membre atteint/non-atteint de spasticité à vitesse de marche lente, 18% à vitesse normale et > 1 % à vitesse rapide. Finalement, il a été observé une taille d'effet moyenne (d : 0.67) entre les TUM du DAQ atteint/non-atteint à vitesse de marche lente et faible à vitesse normale et rapide (d : 0.39 et 0.001 respectivement). Conclusion : Cette étude tend à supporter les observations des praticiens en réadaptation selon laquelle une augmentation de la vitesse de marche améliorerait la fonction des membres inférieurs en contexte d'hyperactivité musculaire attribuée à la spasticité. Cependant, ces résultats vont à l'encontre du concept de vélodépendance attribuable à la spasticité qui devrait se traduire sur le plan clinique par une augmentation de l'hyperactivité musculaire lors de vitesse de marche rapide. Les qualités métrologiques des tests cliniques demeurent problématiques ; en effet, la nécessité d'identifier la spasticité par une approche plus rigoureuse reste pertinente. La vitesse de marche lente serait-elle la plus appropriée pour identifier la spasticité avec la méthode du SRET au niveau du DAQ durant la marche, en post-AVC? / Introduction/problem: It is common, post-stroke, to observe involuntary hyperactivity of the rectus femoris (RF) muscle, limiting gait patterns and generally attributed, rightly or wrongly, to spasticity because the assessment tools used in the clinic to measure this phenomenon have shown certain metrological shortcomings. Recent studies show that the Tonic Stretch Reflex Threshold (TSRT) would be more reliable to quantify spasticity, despite the fact that it was developed to assess this during passive movements. However, spasticity is likely to fluctuate with different walking speeds. Prior to measuring the TSRT of the RF while walking, it is necessary to better understand the functional significance of its muscular utilization rate (MUR). The target commitment of this project is to determine the MUR of the RF muscle of the lower limb with/without muscle hyperactivity at different walking speeds. Methodology: The target population concerns post-stroke ambulatory participants (n=5) presenting spasticity in the DAQ muscle of the lower limb. The MUR (%) was calculated from data collected on the RF muscle (bilaterally), using surface electromyography (EMGs), at three different walking speeds (slow, normal, fast). Results: The MUR (%) of the RF decreases more markedly for the limb with spasticity at increased walking speed (32.11% at slow speed compared to 17.64% at fast speed). A clinical difference of 51% of the MUR between the affected/unaffected limb is noted at slow walking speed, compared to > 1% at fast walking speed. Finally, a medium effect size (d: 0.67) is observed between the TUM of the DAQ, with and without spasticity, at slow walking speed. Conclusion: This study tends to support the observations of rehabilitation practitioners to the effect that an increase in walking speed would improve the function of the lower limbs in the context of muscular hyperactivity attributed to spasticity. On the other hand, these results go against the concept of velocity-dependence attributable to spasticity, which should translate clinically into an increase in muscle hyperactivity during fast walking. The metrological qualities of clinical tests are problematic; in fact, the need to identify spasticity by a more qualified approach remains relevant. Would slow walking speed be the most appropriate to identify spasticity with the SRET method at the DAQ level during gait, post-stroke?

One of the factors contributing to motor vehicle crashes is lack of sufficient friction at the tire-pavement interface. Although the relationship between surface friction and roadway safety has long been recognized, attempts to quantify the effect of pavement skid resistance on wet accident rates have produced inconsistent results. This thesis analyzes the relationships between skid resistance, accident, and traffic data for the state of Virginia. The correlation between wet skid resistance measured with a locked-wheel trailer using a smooth tire and wet accident rates is examined. Additionally, the influence of traffic volumes on accident rates is considered. The research used accident and skid data from the Virginia wet accident reduction program as well as from sections without pre-identified accident or skid problems. The wet accident data was aggregated in 1.6 km (1 mi) sections and divided by the annual traffic to obtain wet accident rates. The minimum skid number measured on each of these sections was then obtained and added to the database. Regression analyses indicated that there is statistically significant effect of skid resistance on wet accident rate; the wet accident rate increases with decreasing skid numbers. However, as expected, skid resistance alone does a poor job of modeling the variability in the wet accident rates. In addition, the wet accident rate also decreases with increasing traffic volume. Based on the data studied, a target skid number (SN(64)S) of 25 to 30 appears to be justified. / Master of Science

L’accident vasculaire cérébral (AVC) peut provoquer d’importants déficits cognitifs, moteurs et une diminution de la capacité aérobie des survivants. Bien que l’évaluation clinique de cette fonction soit importante, les résultats obtenus pourraient être influencés par un phénomène de familiarisation chez les gens ayant subi un AVC sans déficiences cognitives. Cet effet n’est cependant pas connu chez les survivants d’un AVC ayant des déficits cognitifs malgré le fait qu’ils soient fréquents. Les objectifs de cette étude sont de documenter pour les survivants d’un AVC en phase chronique avec déficits cognitifs, 1) la fidélité test-retest des résultats d’une évaluation de la capacité aérobie maximale, 2) l’effet de pratique sur les résultats d’un test à l’effort maximal, et 3) la relation entre l’effet de pratique et la capacité cognitive générale. MÉTHODOLOGIE : 21 participants (12 hommes, 64,3 ± 8,0 ans) ayant des dysfonctions cognitives vasculaires issues d’un AVC plus de six mois avant la première évaluation (44,9 ± 36,2 mois) ont réalisé deux évaluations de la capacité aérobie maximale limitées par les symptômes. Ces tests ont été effectués dans les mêmes conditions à une semaine d’intervalle (9,0 ± 6,8 jours). La présence de déficiences cognitives a été documentée par la batterie de test proposée par le National Institute of Neurological Disorders and Stroke - Canadian Stroke Network (NINDS-CSN) Vascular Cognitive Impairment Harmonization Standards et le Mini-Mental Status Examination (MMSE) a été administré pour évaluer la capacité cognitive générale des participants. RÉSULTATS : La fidélité test-retest de la consommation d’oxygène pic (VO2pic) était excellente (ICC2,1 = 0,94, CI95% = 0,86 – 0,98). Bien qu’aucune différence systématique n’a été observée pour la VO2pic entre les deux évaluations de la capacité aérobie maximale, les différences individuelles semblaient cependant être reliées à la fonction cognitive générale mesurée par le MMSE (rho = 0,485; P < 0,026). La fréquence cardiaque pic (FCpic) du deuxième test aérobie maximal est inférieure au premier (120,0 ± 19,1bpm vs 128,3 ± 20,8bpm; P = 0,001). CONCLUSION : La VO2pic peut être évaluée de façon fidèle et sécuritaire chez les survivants d’un AVC en phase chronique avec déficits cognitifs. De plus, il semble que les survivants dont les capacités cognitives sont moins affectées répondent différemment que les individus cognitivement moins déficients. Cependant, une étude approfondie est nécessaire afin de déterminer si cette différence est due aux déficiences cognitives en soi ou au protocole d’évaluation de la condition cardiopulmonaire.

Problématique : Considérant le rôle de l’activité physique dans la récupération fonctionnelle et le maintien de l’autonomie après un accident vasculaire cérébral (AVC), plusieurs études ont souligné la nécessité de développer des approches favorisant la pratique de celle-ci chez les personnes ayant subi un AVC. Il apparait toutefois que l’évolution du niveau d’activité physique pendant la trajectoire de réadaptation post-AVC n’est pas optimale. Plusieurs études récentes rapportent que les personnes ayant subi un AVC présentent un faible niveau d’activité physique. Objectif : Caractériser l’évolution du niveau d’activité physique basée sur la marche chez les patients victimes d’un AVC et explorer les variables qui influencent sa pratique. Méthodologie : Il s’agit d’une étude descriptive corrélationnelle comportant deux temps de mesure, soit lorsque les participants sont éligibles à l’étude (temps 1) et lors de leur congé de réadaptation fonctionnelle intensive en institution (temps 2). Les données ont été recueillies auprès d’un échantillon de 8 participants ayant subi un AVC et étant admis à l’IRDPQ. Dans le cadre de l’objectif 1, des tests de Wilcoxon ont été réalisés afin de déterminer l’évolution du niveau d’activité physique basée sur la marche lors de la réadaptation intensive en institution. Pour répondre à l’objectif 2, des corrélations de Spearman ont été utilisées pour déterminer la relation entre les différentes variables (endurance à la marche, vitesse de marche confortable, équilibre, endurance cardiorespiratoire, indépendance fonctionnelle et auto-efficacité) et le niveau d’activité physique basée sur la marche après un AVC (nombre de pas/jour et temps actif). Résultats/conclusion : À l’exception du nombre de pas et du temps actif, toutes les variables ont démontré une amélioration significative lors de la réadaptation intensive en établissement. Bien qu’aucune corrélation ne se soit avérée significative, c’est l’âge qui semble le plus lié au temps actif (r=0,57 ; p=0,14) et au nombre de pas (r=0,43 ; p=0,29) au temps 1. Au temps 2, c’est l’équilibre qui semble le plus lié au nombre de pas (r=0,66 ; p=0,08) et au temps actif (r=0,51 p=0,20). Beaucoup d’éducation et de sensibilisation restent à faire afin que les gens soient plus actifs au quotidien et cumulent un plus grand nombre de pas. / Background: Given the role of physical activity (PA) in recovering and maintaining functional autonomy after a stroke, many studies have highlighted the need to develop approaches that encourage stroke patients to physical activity. Despite these recommendations, studies have shown limited increase in PA during stroke rehabilitation, leading to lower level of PA in stroke survivors compared to age-matched healthy subjects. PA in the post-stroke rehabilitation phase is far from optimal, with many recent studies reporting that stroke patients do not get enough physical activity. Objective: Characterize the evolution of walking activity in stroke patients and explore factors that influence regular walking. Methodology: A descriptive correlation study was conducted with two assessment times: first at admission in the study (time 1) and second at discharge functional rehabilitation in center (time 2). Data were collected from a sample of eight stroke patients admitted to Institut de réadaptation en déficience physique de Québec (IRDPQ). To meet the study’s first objective, Wilcoxon tests were carried out to determine how walking activity progressed during the intensive rehabilitation phase at the institute. To meet the second objective, Spearman correlations were used to determine the relationship between different variables (walking endurance, comfortable walking speed, balanced, cardiorespiratory endurance, functionnal independence, self-efficcacy) and the level of walking activity after a stroke (number of step/day and active time). Results/conclusion: Except for the number of steps and minutes of walking, all variables significantly improved during the intensive rehabilitation phase at the institute. Although no correlation was significant, age seems to be the factor most closely linked to minutes of walking (r=0.57 p=0.14) and number of steps (r=0.43 p=0.29) at time 1. At time 2, balance was most closely linked to the number of steps (r=0.66 p=0.08) and walking time (r=0.51 p=0.20). Considerable education and awareness-raising are still needed to encourage stroke survivors to be more active on a daily basis.

published_or_final_version / abstract / Transport Policy and Planning / Master / Master of Arts in Transport Policy and Planning

published_or_final_version / abstract / Geography / Master / Master of Philosophy

No description available.

Workshop educators have a legal duty with regard to health and safety in the school workshop for the protection of the learners in their care. It is expected of the workshop educators to look after the learners placed in their care as a conscientious and solicitous parent would. The workshop educator's discretion and conduct should always be based on predictable and preventable action. Because learners cannot possibly have the discernment of adults concerning more or less dangerous situations, the workshop educator should make provision for this possibility in the health and safety management of the school workshop. Common law principles such as duty of care, predictability and preventability, in addition to requirements for delictual liability (an act, unlawfulness, fault, causality and damage) demarcate and elucidate the role of the workshop educator who is responsible for the safety management of the school workshop. Workshop educators should ascertain that they are familiar with all these principles. A literature survey was undertaken with regard to these matters. Although workshop educators are responsible for the health and safety of the learners in their care, the literature survey revealed that health and safety in workshops in general is addressed and made compulsory by legislation, but that the specific needs of the school workshop are not adequately addressed. The aims of the empirical research were to determine: • the functioning of health and safety management in the contemporary school workshop and • to what extent the workshop educator is equipped for his duty of care responsibility with regards to the health and safety of the learners placed in his care. Questions were asked on the knowledge and execution of health and safety rules laid down by legislation, as well as the knowledge and execution of safety rules which are not necessarily laid down by legislation. Questions on safety rules devised by the respondents to improve the health and safety in the school workshop were also included in the questionnaire. The empirical study lead to the following: • The respondents seemed to have a reasonable knowledge of general health and safety rules laid down by legislation but in questions asked to verify the above mentioned answers, it seemed that the respondents were in some cases ignorant about these health and safety rules. Some of the respondents seem to ignore the safety rules in the execution of the health and safety rules. • A small number of the respondents seem to have a good knowledge of health and safety rules which are not necessarily laid down by legislation. • Quite a number of the respondents reported health and safety rules specifically devised for school workshops by their respective schools. Specific recommendations have been made and a model for health and safety management in the school workshop has been devised. This model should lead to better health and safety management in the school workshop and should thus ensure a safer school workshop for learners. / Thesis (Ph.D. (Education))--Potchefstroom University for Christian Higher Education, 2003.

No description available.

<p>General Aviation (GA) is a category of aircraft operations, exclusive of all military and commercial operations. According to Federal Aviation Administration (FAA), fixed-wing aircraft (also known as airplanes) account for 76.2% of all the estimated registered GA fleet in the United States. Out of all the GA accidents that the National Transportation Safety Board (NTSB) investigated in 2017, 87.7% of the accidents involved fixed-wing aircraft. The NTSB reports on all GA accidents and records the accident details in their database. The NTSB database has an abundance of accident data, but the data is not always logically complete and has missing information. Many researchers have conducted several studies to provide GA fixed-wing accident causation using the NTSB accident data. The quantitative analyses conducted by the researchers focused on a chain of events approach and identified the most frequent events in accidents. However, these studies provided little insight into why the events in the accidents happened. In contrast, the qualitative analyses conducted an in-depth study of limited accidents from the NTSB database. This approach helps in providing new findings but is difficult to apply to large scale datasets. Therefore, our understanding of GA fixed-wing accident causation is limited. This research uses a state-based approach, developed by Rao (2016), to provide a potentially better understanding of causes for GA fixed-wing accidents. I analyzed 10,500 fixed-wing accidents in 1982–2017 that involved inflight loss of control (LOC-I) using the state-based approach. I investigated the causes of LOC-I using both a conventional approach and a state-based approach. I analyzed fatal, non-fatal and overall LOC-I accidents in three timeframes: 1989–1998, 1999–2008 and 2008–2017. This multi-year analysis helped in discerning changes in the causation trends in the last three decades. A mapping of the LOC-I state definition to the NTSB codes helped in identifying 2350 more accidents in the database that were not discernible using the conventional approach. The conventional analysis revealed “directional control not maintained” as the top cause for the LOC-I accidents, which provides little information about how loss of control happened in accidents. The state-based analysis highlighted some important findings that contribute to LOC-I accidents that were not discernible using the conventional approach. The state-based analysis identified preflight mechanical issue as one of the new causes for LOC-I with a presence in 5.1% of LOC-I accidents in 2009–2017. It also helped in inferring some of the missing information in the accident data by modeling the accidents in a logical order. Using the logic rules in the state-based approach, I inferred that the pilot’s tendency to hit objects or terrain caused loss of control in 19.9% of LOC-I accidents in 2009–2017. Further, the logic rules helped in inferring that 7.5% of LOC-I accidents in 2009–2017 involved hazardous condition of an aircraft before the start of flight. A comparison of the findings from state-based approach with the GAJSC (General Aviation Joint Steering Committee) safety enhancements revealed that the state-based approach encompassed all the potential issues addressed in the safety enhancements. Additionally, a state-based analyses of larger datasets of fatal and non-fatal accidents suggested some new potential issues (such as improper maintenance) that were not explicitly addressed in the GAJSC safety enhancements. </p>