This thesis explored the current context of aquatic rehabilitative practices in Canada. More specifically, three inter-related topics on Aquatic Therapy (AT) and Aquatic Physical Therapy (APT) in Canada were examined: 1) the development of knowledge, training and expertise on APT and AT, 2) recognition and acceptance of cultural and social authority on AT and APT (Starr, 1982), and 3) the practitioners’ perceptions of barriers to practicing and participation in aquatic therapy. Semi-structured qualitative interviews were conducted with seven (7) stakeholders including Ontario aquatic physical therapists, aquatic therapists, instructors on aquatic therapy and members of the College of Physiotherapy of Ontario (CPO) and the Canadian Physiotherapy Association (CPA). Interviews were complimented with open-ended questionnaires sent to Chairs of Physical Therapy programs in seven Canadian Universities. Our research identified the most common means of acquiring knowledge on aquatic rehabilitative practices was through University Physiotherapy program curriculum; private training courses; and in-house within facilities where aquatic therapists and aquatic physical therapists are employed. This thesis also examined facilitators/barriers to practicing and receiving aquatic therapy and aquatic physical therapy. Through critical analysis, this thesis reflected on the ways in which social and cultural authority (Starr, 1982) are constructed within the field of aquatic therapy (AT) and aquatic physical therapy (APT). Recommendations and areas for future research included specialized training courses by scope of practice, and increased in-pool practicum training within Physiotherapy programs in Canada.

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Nugaros skausmas yra plačiai paplitęs, tai – didžiulė socialinė, psichologinė ir ekonominė problema. 15 – 20% suaugusiųjų nugaros skausmą patiria bent kartą per metus, o 70 – 80% bent kartą gyvenime. Iš visų žmonių, kenčiančių nugaros skausmą, 5 – 10% jaučia lėtinį skausmą. Ši problema kamuoja apie 40% visų dirbančių žmonių ir tai yra viena iš dažniausių nedarbingumo priežasčių. Kineziterapija vandenyje yra efektyvus skausmo ir judamojo – atramos aparato kontrolės metodas. Darbo tikslas yra nustatyti nugaros skausmo, stuburo paslankumo, laikysenos ir liemens raumenų ištvermės kitimą taikant kineziterapiją vandenyje. Tikslui pasiekti buvo iškelti uždaviniai: nustatyti skausmo, laikysenos, stuburo paslankumo, pilvo, nugaros ir šoninių liemens raumenų ištvermės kitimą taikant kineziterapiją vandenyje, bei nustatyti ir įvertinti tiriamųjų gyvenseną. Iškėlėme hipotezę, kad po kineziterapijos vandenyje sumažės nugaros skausmas, padidės stuburo paslankumas ir liemens raumenų ištvermė, bei pagerės laikysena. Tyrime dalyvavo 14 nugaros skausmus patiriančių žmonių: 5 vyrai ir 9 moterys (amžiaus vidurkis 32±6,9 m.). Kineziterapijos vandenyje užsiėmimai vyko LKKA baseine, 2 kartus per savaitę. Vieno užsiėmimo trukmė – 45 min. Buvo registruojamas skausmas (po kiekvieno užsiėmimo), vertinama laikysena (2 kartus); stuburo paslankumas ir liemens raumenų ištvermė buvo matuojami tyrimo pradžioje ir kas 10 savaičių (4 kartus). Gauti duomenys parodė, kad daugiau kaip pusė tiriamųjų laisvalaikį... [toliau žr. visą tekstą] / Back pain is a common problem and one of enormous social, psychologic, and economic burden. 15 – 20% of adult population experience back pain at least once in a year, and 70 – 80% experience back pain at least once in the lifetime. Meanwhile 5 – 10% suffers from chronic back pain. Back pain afflicts about 40% of working population and is a major cause of disability in the adult working population. Aquatic therapy is an effective way for controling back pain and muscle – sceletal features. The objective of this research is to define the effects of aquatic therapy on back pain, back mobility, posture and trunk muscle endurance. In order to obtain the objective we came up with the next targets: to measure the variation of posture, back mobility, trunk muscle, back pain when applying aquatic therapy and to estimate and assess the lifestyle of the participants. We hypothesized that aquatic therapy will reduce back pain, increase back mobility, trunk muscle endurance and improve posture. 14 people with back pain participated in the research (5 men and 9 women) with the average age of 32±6,9 years. Aquatic therapy sessions were held twice a week in the swimming pool of Lithuanian Academy of Physical Education. It took 45 minutes for a session. The next measures have been taken: pain (after each session), posture evaluation (2 times), back mobility and trunk muscle endurance have been measured in the beginning of the research and every 10 weeks (4 times). Data analysis identified... [to full text]

XXI amžiuje skausmas yra rimta problema. Vis daugiau jaunų žmonių skundžiasi nugaros skausmais. Nugaros skausmai dėl mažo fizinio aktyvumo, netaisyklingos laikysenos yra viena labiausiai paplitusių ligų. Iškėlėm hipotezę, kad pratimai vandenyje pagerins vaikų stuburo paslankumą ir laikyseną. Tyrimas buvo atliktas LKKA baseine. Tyrime dalyvavo 12 vaikų, iš jų 10 berniukų ir 2 mergaitės. Tiriamųjų amžiaus vidurkis buvo 10,88 ± 2,10 metų, svorio - 46,2 ± 1,54 kg, ūgio vidurkis 156,9 ± 2,04 cm. Tiriamiesiems 8 mėnesius 2 kartus per savaitę po 1 valandą buvo taikoma KT vandenyje. KT pagrindą sudarė tempimo, atsipalaidavimo, liemens raumenų pratimai bei pratimai laikysenai gerinti. Buvo vertinama tiriamųjų laikysena, stuburo paslankumas, liemens raumenų statinė ištvermė bei gyvensenos ypatumai. Visi minėti rodikliai registruoti 3 kartus ( KT pradžioje, KT viduryje ir KT pabaigoje). Darbo tikslas – nustatyti vaikų, kuriems buvo taikyta KT vandenyje, stuburo paslankumo, raumenų ištvermės ir laikysenos pokyčius. Iškelti uždaviniai: nustatyti ir palyginti vaikų liemens raumenų ištvermę, stuburo paslankumą, laikyseną prieš ir po kineziterapijos vandenyje, bei nustatyti ir įvertinti vaikų gyvensenos ypatumus. Tyrimo rezultatai parodė, kad pratimai vandenyje patikimai (p<0,05) padidino liemens raumenų (pilvo, nugaros, kairės bei dešinės pusės) ištvermę, stuburo paslankumą, pagerino pečių, liemens ir pilvo laikyseną. Taip pat nustatėme, jog vaikų fizinis aktyvumas nėra pakankamas, nes... [toliau žr. visą tekstą] / Pain is a very serious problem in the 21st century. More and more young people complain of backache. Because of reducing amount of physical activities, incorrect posture, backache is one of the most common diseases. A hipothesy is that exercises in water will improve spine flexibility and children posture will improve as well. A research was made in LKKA swimming pool. 12 children – 10 boys and 2 girls – took part in this research. The average age of those who were researched was 10,88 ± 2,10 years, the average weight 46,2 ± 1,54 kg and height 156,9 ± 2,04 cm. They were in physiotherapy in water for 8 months 1 hour twise a week. Aquatic therapy consisted of posture, stretch, relaxing exercises and exercises for waist muscles. Posture, spine flexibility, waist muscles static endurance and particularities of lifestyle of the researched people was evaluated. All indicators are mentioned three times (in the beginning, in the middle and at the end of physiotherapy in water). The purpose is to find spine flexibility, muscle endurance and posture changes of kids who were in physiotherapy in water. Targets: to measure and assess children‘s trunk muscle endurance, back mobility and posture before and after aquatic therapy; to assess the lifestyle of the participants. The research results showed that exercises in the water increased waist muscles (stomach, back, left and right side) endurance, spine flexibility, improved shoulder, waist and stomach posture. Moreover, we realised that... [to full text]

Tyrimo objektas: tiriamųjų funkcinė būklė. Tyrimo tikslas: įvertinti skirtingų kineziterapijos programų poveikį pacientų, kuriems endoprotezuotas klubo sąnarys, funkcinei būklei. Hipotezė: kineziterapija salėje bei kineziterapija vandenyje turės didesnį poveikį pacientų, kuriems endoprotezuotas klubo sąnarys, funkcinei būklei, nei tik kineziterapija salėje. Uždaviniai: 1. Įvertinti pacientų, kuriems taikyta kineziterapija salėje, funkcinės būklės kaitą. 2. Įvertinti pacientų, kuriems taikyta kineziterapija salėje ir kineziterapija vandenyje, funkcinės būklės kaitą. 3. Palyginti skirtingų kineziterapijos metodų efektyvumą. Tyrimo metodika: Tyrimas atliktas VŠĮ ,,Tulpė“ ir AB Birštono sanatorija ,,Versmė“. Trisdešimt tiriamųjų – asmenų, kuriems buvo atliktas klubo sąnario endoprotezavimas, – suskirstyti atsitiktine tvarka į dvi grupes po 15 ligonių. Vienai grupei buvo taikoma kineziterapija salėje, o kitai grupei – kineziterapija salėje ir vandenyje. Taikant šias priemones buvo pildomas tyrimo protokolas reabilitacijos eigoje: 1. Skausmui vertinti naudota VAS skalė (analoginė skausmo skalė); 2. Klubo sąnario judesių amplitudei vertinti naudotas goniometras; 3. Šlaunies apimčiai išmatuoti naudota centimetrinė juostelė; 4 . Funkciniam mobilumui ir griuvimo rizikai nustatyti naudotas ,,Stoti ir eiti“ testas; 5. Klubo sąnario funkcijai nustatyti naudota Harris Hip skalė. Visi matavimai atlikti I-ą dieną atvykus ir po 18 reabilitacijos dienų. Įvertinus abiejų grupių tiriamųjų... [toliau žr. visą tekstą] / The object of the Thesis: functional state for persons with endoprosthetic hip joint. The aim of the Thesis: to assess the effect of different physiotherapy methods on the functional state for persons with endoprosthetic hip joint. Hypothesis: Physiotherapy combined with aquatic therapy had a greater impact on persons functional status than only physiotherapy in the gym. The tasks of the Thesis: 1. To assess the effect of physiotherapy on the functional state for persons with endoprosthetic hip joint. 2. To asses the effect of physiotherapy combined with aquatic therapy on the functional state for persons with endoprosthetic hip joint. 3. To compare the effectiveness of different physiotherapy methods. The methods of the Thesis: The study was performed in ,,Tulpė“ sanatorium and sanatorium ,,Versmė“ in Birštonas. Thirty research subjects - persons with endoprosthetic hip joint – were randomly divided into two groups with 15 patients in each. One group received physiotherapy, the other – physiotherapy compared with aquatic therapy. While applying these modalities, a research protocol was completed during the rehabilitation: 1. VAS scale to assess pain; 2. Goniometer was used to assess the range of hip joint motions; 3. Measuring tape was used to assess thigh volume; 4. ,,Stand up and go“ test was used to assess functional mobility and risks of falls; 5. Harris Hip scale was used to assess joint function. All measurements were performed 1 day after arrival and 18 day after... [to full text]

Orientador: Sara Teresinha Olalla Saad / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T08:39:07Z (GMT). No. of bitstreams: 1 Zanoni_CamilaTatiana_M.pdf: 24918367 bytes, checksum: abb28cb6b7289665d1fb2d038126541e (MD5) Previous issue date: 2014 / Resumo: A doença falciforme é uma doença genética, que resulta em falcização das hemácias, desencadeando fenômenos de vaso-oclusão, episódios de dor e lesão de órgãos. O comprometimento ósseo é a manifestação clínica mais comum, podendo causar deficiências crônicas e progressivas, como a necrose avascular da cabeça femoral, principal causa de deformidade de quadril nestes pacientes, levando a distúrbios na marcha e limitação de dor, nível de atividade e função. Raros são os estudos encontrados na literatura sobre a atuação da fisioterapia como recurso capaz de prevenir e tratar as disfunções do aparelho locomotor presentes nos indivíduos portadores de doença falciforme. O objetivo deste estudo foi avaliar e comparar o efeito de dois programas de fisioterapia para pacientes portadores de doença falciforme visando diminuir a dor musculoesquelética em região do quadril e coluna lombar e aumentar a funcionalidade desses pacientes. Um dos programas foi a fisioterapia convencional realizada em solo, comparado com um protocolo de exercícios realizados em piscina aquática. A pesquisa teve início com a avaliação dos voluntários a partir de escalas funcionais (Escala LEFS ¿ Lower Extremity Functional Scale; Questionário Algofuncional de Lequesne e Índice de Incapacidade de Oswestry), medida da amplitude de movimento articular (ADM) de flexão e extensão do tronco, flexão, extensão, adução e abdução do quadril, avaliação da força muscular (FM) de flexores e extensores do tronco, flexores, extensores, adutores e abdutores do quadril através de célula de carga e eletromiografia de superfície (EMGs) dos músculos iliocostais, longuíssimo dorsal, glúteo máximo, glúteo médio e tensor da fáscia lata. A amostra final foi constituída por 10 voluntários, randomizados para dois grupos diferentes: fisioterapia aquática (FA) e fisioterapia convencional (FC). O Grupo FA foi composto por cinco voluntários com mediana de idade de 42 (25-67) anos. O Grupo FC foi composto por cinco voluntários com mediana de idade de 49 (43-59) anos. Após a randomização, os voluntários dos dois grupos foram submetidos à intervenção com duração de doze semanas, sendo duas sessões semanais, totalizando 24 sessões. Após a intervenção, os pacientes foram reavaliados para comparação dos resultados pré e pós intervenção. Para a análise estatística foi utilizado o teste ANOVA para medidas repetidas com transformação por postos. O nível de significância adotado foi de 5% (p<0,05). A comparação de medidas numéricas entre os dois grupos ao longo do tempo mostrou diferença estatisticamente significativa após a intervenção para as variáveis: índice de Lequesne (p=0,0217), índice de Incapacidade de Oswestry (p=0,0112), ADM de extensão do tronco (p=0,0320), FM de flexão do tronco (p=0,0459) e FM de extensão (p=0,0062) e abdução (p=0,0257) do quadril. As variáveis Escala LEFS, ADM de flexão do tronco, ADM de flexão, extensão, adução e abdução do quadril, FM de extensão do tronco, FM de flexão e adução do quadril e todas as variáveis de EMGs não apresentaram diferença estatisticamente significativa. Esses resultados sugerem que a fisioterapia parece ser um recurso capaz de prevenir e tratar as disfunções musculoesqueléticas de pacientes com doença falciforme, independentemente da técnica utilizada / Abstract: Sickle cell disease is a genetic disease that results in sickling of red blood cells, triggering phenomena of vaso-occlusion episodes of pain and organ damage. Bone involvement is the most common clinical manifestation, may cause chronic and progressive disorders such as avascular necrosis of the femoral head, leading cause of hip deformity in these patients, leading to disturbances in gait and limitation of pain, level of activity and function. There are few studies in the literature on the role of physiotherapy as a resource capable of preventing and treating disorders of the locomotor system present in individuals with sickle cell disease. The aim of this study was to evaluate and compare the effect of two physical therapy programs for patients with sickle cell disease to decrease musculoskeletal pain in the hip and lower back and increase the functionality of these patients. One of the programs was conventional physical therapy in the soil compared with a protocol of exercises performed in swimming pool. The research began with an evaluation of the volunteers the from functional scales (Scale LEFS ¿ Lower Extremity Functional Scale; Lequesne¿s Algofunctional Questionnaire and Oswestry Disability Index), measuring the range of motion (ROM) in flexion and extension of the trunk, flexion, extension, adduction and abduction of the hip, the assessment of muscle strength (MS) of the trunk flexors and extensors, flexors, extensors, adductors and hip abductors through load cell and surface electromyography (SEMG) of iliocostalis, dorsal longissimus, gluteus maximus, gluteus medius and tensor fasciae latae. The final sample consisted of 10 volunteers, randomized to two different groups: aquatic physiotherapy (AP) and conventional physiotherapy (CP). The AP group was composed of five volunteers with a median age of 42 (25-67) years. The CP group consisted of five volunteers with a median age of 49 (43-59) years. After randomization, subjects from both groups underwent intervention for twelve week, with two sessions per week, totaling 24 sessions. After the intervention, patients were reassessed for comparison of pre-and post-intervention results. For statistical analysis ANOVA was used for repeated measures with transformation stations. Significance was established at the 5% level (p<0,05). The comparison of numerical values between the two groups over time showed a statistically significant difference after the intervention for the variables Lequesne index (p=0,0217), Oswestry Disability Index (p=0,0112), trunk extension ROM (p=0,0320), ROM trunk flexion (p=0,0459) and MS extension (p=0,0062) and abduction (p=0,0257) of the hip. The variables Scale LEFS, trunk flexion ROM, ROM of flexion, extension, adduction and hip abduction, extension of MS trunk, MS flexion and hip adduction and all SEMG variables showed no statistically significant difference. These results suggest that physical therapy seems to be a resource capable of preventing and treating musculoskeletal dysfunctions of patients with sickle cell disease, regardless of the technique used / Mestrado / Clinica Medica / Mestra em Clínica Médica

Made available in DSpace on 2017-07-10T14:17:04Z (GMT). No. of bitstreams: 1 Regina Kunz.pdf: 2633664 bytes, checksum: ba62a763b7744580d9ca3b1f84d6f021 (MD5) Previous issue date: 2014-02-26 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Immobilization is a therapeutic modality that is used in the treatment of musculoskeletal disorders, which often cause tissue morphological changes, and which can be reversed by remobilization. This study examined the effects of immobilization and remobilization on morphological parameters of the ankle joint and the soleus and tibialis anterior muscles of Wistar rats. Eighteen male rats had their right hind limb immobilized for 15 days. They were divided into the following 3 groups: G1, simply immobilized; G2, remobilized freely for 14 days; and G3, remobilized by exercises in water, performed on alternate days with progression in terms of the time and number of exercises. The contralateral limb was used as control. After the experimental period, the ankle, right (immobilized/remobilized) and left (control) joints, and the soleus and tibialis anterior muscles were processed for analysis using light microscopy. For the analysis of the ankle, three fields of distinct interest were identified in the sagittal section as follows: P1, anterior articular extremity (near the phalanges); P2, middle region of the joint; P3, posterior articular extremity. Histomorphometry revealed no significant differences between the groups and members, control and imobilized/remobilized, in terms of the number of chondrocytes and the thickness of the articular cartilage of the tibia and the talus. The morphological analysis of G1 showed the most significant degenerative lesions in the talus, such as exposure of the subchondral bone, flocculation and cracks between the middle and anterior regions of the articular cartilage, as well as the synovial membrane. Remobilization by exercises in water showed positive effects on the recovery of the ankle joint, compared with free remobilization. In the muscles, immobilization produced significant changes in the morphometric parameters of the soleus; in the tibialis anterior it only caused a change in muscle mass. However, there were changes in the morphology of the tibialis anterior, which showed polymorphic fibers and necrosis, as well as changes in the connective tissue. Swimming, combined with jumping in water, increased the smallest diameter of the fiber of the soleus muscle. Both free remobilization, and remobilization using exercises, increased the mass and the length of the tibialis anterior muscle, as well as its morphology / A imobilização é uma modalidade terapêutica utilizada no tratamento de distúrbios musculoesqueléticos que com frequencia causa alterações morfológicas teciduais, as quais podem ser revertidas pela remobilização. Este estudo analisou o efeito da imobilização e da remobilização sobre parâmetros morfológicos da articulação talocrural e dos músculos sóleo e tibial anterior de ratos Wistar. Foram utilizados 18 ratos machos, que tiveram seu membro posterior direito imobilizado por 15 dias, e divididos em 3 grupos: G1, somente imobilizados; G2, remobilizados livremente por 14 dias; e G3, remobilizados em meio aquático por 14 dias, realizados em dias alternados com progressão de tempo e série dos exercícios. O membro contralateral foi utilizado como controle. Após o período experimental, as articulações talocrurais, direitas (imobilizadas/remobilizadas) e esquerdas (controle), e os músculos sóleo e tibial anterior foram processados para análises em microscopia de luz. Para a análise da articulação talocrural, nos cortes sagitais foram identificados três campos de interesse distintos, sendo: P1, extremidade articular anterior (próxima as falanges); P2, região média da articulação; P3, extremidade articular posterior. A histomorfometria não revelou diferenças significativas entre os grupos e os membros, controle e imobilizado/remobilizado, no número de condrócitos e na espessura da cartilagem articular da tíbia e do tálus. A análise morfológica de G1 evidenciou lesões degenerativas mais significativas no tálus, como exposição do osso subcondral, floculações e fissuras, entre as regiões anterior e média da cartilagem articular; bem como na membrana sinovial. A remobilização por exercícios em meio aquático, apresentou efeitos positivos na recuperação da articulação do tornozelo, quando comparada com a remobilização livre. Nos músculos, a imobilização produziu alterações significativas sobre os parâmetros histomorfométricos do sóleo e, no tibial anterior, causou alteração somente na massa muscular. No entanto, verificou-se alterações na sua morfologia, que apresentou fibras polimórficas e em necrose, assim como alterações no tecido conjuntivo. A natação combinada com o salto em meio aquático aumentaram o menor diâmetro da fibra do músculo sóleo. Tanto a remobilização livre quanto por associação dos exercícios aumentaram a massa e o comprimento muscular do tibial anterior, bem como melhoraram seus aspectos morfológicos