No description available.

Thesis (Ph.D.)--University of Delaware, 2009. / Principal faculty advisor: Kurt T. Manal, Dept. of Mechanical Engineering. Includes bibliographical references.

Thesis (Ph. D.)--Oregon State University, 2002. / Includes bibliographical references (leaves 63-70).

No description available.

Diss. (sammanfattning) Uppsala : Univ., 2002. / Härtill 5 uppsatser.

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

by Cecilia Li Tsang Wai Ping. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1993. / Includes bibliographical references (leaves [175-185]). / ABSTRACT / AKNOWLEDGEMENTS / Chapter CHAPTER ONE --- INTRODUCTION / Chapter 1.1 --- INTRODUCTION --- p.1 / Chapter 1.2 --- AIMS OF STUDY --- p.3 / Chapter CHAPTER TWO --- RHEUMATOID ARTHRITIS / Chapter 2.1 --- DEFINITION --- p.4 / Chapter 2.2 --- PREVALENCE --- p.4 / Chapter 2.3 --- AETIOLOGY --- p.4 / Chapter 2.4 --- PATHOLOGY --- p.5 / Chapter 2.5 --- CLINICAL FEATURES OF RHEUMATOID ARTHRITIS IN HAND --- p.5 / Chapter 2.6 --- CRITERIA FOR DIAGNOSIS OF RHEUMATOID ARTHRITIS --- p.7 / Chapter CHAPTER THREE --- HAND DEFORMITIES IN RHEUMATOID ARTHRITIS / Chapter 3.1 --- THE HAND --- p.9 / Chapter 3.2 --- THE RHEUMATOID HAND --- p.13 / Chapter 3.4 --- CAUSES OF FLEXION CONTRACTURE AT THE PROXIMAL INTERPHALANEAL JOINT --- p.16 / Chapter CHAPTER FOUR --- SPLINTING FOR THE RHEUMATOID HAND / Chapter 4.1 --- SPLINTING IN RHEUMATOID ARTHRITIS --- p.19 / Chapter 4.2 --- SPLINTING FLEXION CONTRACTURES AT THE PROXIMAL INTERPHALANGEAL (PIP) JOINTS --- p.24 / Chapter 4.3 --- THE MECHANICAL ANALYSIS OF SPLINT DESIGN --- p.32 / Chapter CHAPTER FIVE --- HAND ASSESSMENT IN RHEUMATOID ARTHRITIS / Chapter 5.1 --- INTRODUCTION --- p.41 / Chapter 5.2 --- A REVIEW OF THE STANDARDISED HAND FUNCTION ASSESSMENT --- p.42 / Chapter 5.3 --- MEASUREMENT OF GRIP STRENGTHS --- p.48 / Chapter 5.4 --- MEASUREMENT OF ACTIVE RANGE OF MOTION OF FINGER JOINTS --- p.52 / Chapter CHAPTER SIX --- DEVELOPMENT OF HAND EVALUATION SYSTEM in RHEUMATOID ARTHRITIS / Chapter 6.1 --- INTRODUCTION --- p.56 / Chapter 6.2 --- AIMS OF STUDY --- p.56 / Chapter 6.3 --- DEVELOPMENT OF THE HAND EVALUATION SYSTEM --- p.57 / Chapter 6.4 --- A COMPARATIVE STUDY OF HAND GRIP ASSESSMENT TOOLS: THE JAMAR DYNAMOMETER AND THE REC PROTOTYPE GRIP ANALYSER --- p.58 / Chapter 6.5 --- A COMPARATIVE STUDY ON THE JEBSEN HAND FUNCTION TEST IN HONG KONG --- p.67 / Chapter 6.6 --- ASSESSMENT OF FUNCTIONAL RANGE OF MOTION --- p.77 / Chapter 6.7 --- CONCLUSION --- p.83 / Chapter CHAPTER SEVEN --- THE MAIN STUDY / Chapter 7.1 --- INTRODUCTION --- p.85 / Chapter 7.2 --- RESEARCH DESIGN --- p.85 / Chapter 7.3 --- DEFINITION OF VARIABLES --- p.86 / Chapter 7.4 --- SUBJECT SELECTION --- p.89 / Chapter 7.5 --- EXPERIMENTAL PROCEDURES --- p.89 / Chapter 7.6 --- PILOT STUDY --- p.91 / Chapter 7.7 --- STATISTICAL ANALYSIS OF DATA --- p.94 / Chapter CHAPTER EIGHT --- RESULTS / Chapter 8.1 --- RESULTS --- p.95 / Chapter 8.1.1 --- Age distribution --- p.96 / Chapter 8.1.2 --- Occupation --- p.98 / Chapter 8.1.3 --- Functional class --- p.98 / Chapter 8.1.4 --- Group characteristics --- p.99 / Chapter 8.1.5 --- Comparison of the effect of corrective splints on hand functions of clients --- p.100 / Chapter 8.1.6 --- Comparison of the effect of two types of corrective splintage on hand functions of clients --- p.103 / Chapter 8.2 --- SUMMARY --- p.113 / Chapter 8.2.1 --- Summary of findings --- p.113 / Chapter 8.2.2 --- Compliance and complication of the splint intervention programme --- p.114 / Chapter CHAPTER NINE --- DISCUSSION / Chapter 9.1 --- INTRODUCTION --- p.116 / Chapter 9.2 --- COMMENTS ON THE HAND EVALUATION PROTOCOL … --- p.117 / Chapter 9.3 --- DISCUSSIONS OF THE RESULTS OF THE PILOT STUDY --- p.121 / Chapter 9.4 --- DISCUSSION OF THE RESULTS OF THE MAIN STUDY --- p.125 / Chapter 9.5 --- IMPLICATION OF STUDY INTO OCCUPATIONAL THERAPY PRACTICE --- p.130 / Chapter 9.6 --- LIMITATION OF THE STUDY --- p.131 / Chapter 9.7 --- SUMMARY --- p.132 / Chapter CHAPTER TEN --- CONCLUSION AND RECOMMENDATIONS / Chapter 10.1 --- CONCLUSION --- p.134 / Chapter 10.2 --- RECOMMENDATIONS --- p.138 / Chapter 10.3 --- SUGGESTIONS FOR FURTHER RESEARCH --- p.139 / APPENDICES / REFERENCES

INTRODUCTION: Arthrofibrosis, which occurs in a substantial portion of the population, is a pathologic accumulation of scar tissue that presents in patients as a painful decrease in joint range of motion. Since an individual’s quality of life can be significantly impacted by arthrofibrosis and because there are limitations in current treatments, this thesis focuses on examining the use of the hormone relaxin to alleviate shoulder arthrofibrosis. METHODS: A set of 20 Sprague Dawley rats were given secondary shoulder contractures and separated into groups to examine the efficacy of relaxin using intravenous delivery, intra-articular delivery, and different treatment frequencies. The differences across groups were examined through mechanical range of motion testing as well as histologic sampling. RESULTS: Multiple doses of intra-articular injections of relaxin showed a complete return to the normal range of motion (P < 0.01) when compared with the surgical control, whereas other delivery methods and frequencies failed to show meaningful improvements. This was further confirmed in histologic analysis through the lack of fibrotic adhesions within the capsular space after multiple intra-articular relaxin treatments when compared with the surgical control. DISCUSSION: Although significant improvements to range of motion were seen after multiple doses of intra-articular relaxin, potential tissue degradation was also observed within the joint space after histologic examination. Further research is necessary to fully understand the proper dosing needed to avoid potential negative side effects caused by excess use of relaxin.

Introduction: Knee flexion contractures have a negative impact on function for patients with osteoarthritis (OA). Those with contracture treated with total knee arthroplasty (TKA) have more post-operative pain and worse outcome. Little knowledge is available about patient demographic factors or gene expression in the knee joint capsule in the setting of contracture and severe OA. // Methods: Subjects with primary severe knee OA awaiting a TKA were recruited. We collected subject demographic factors that may be associated with preoperative knee contracture. Subjects’ posterior knee capsule was harvested intraoperatively. Capsule histological analysis was performed using light microscopy. Gene expression analysis was performed using whole genome microarray and immunohistochemistry was used for protein production analysis comparing those with contracture to those without. // Results: Twenty subjects were recruited for the demographics portion of the study (13 contractures and 7 controls), and capsules from 12 subjects (6 contractures, 6 controls) were used for histology, microarray, and IHC analyses. Contracture subjects had longer duration of OA, reduced extension in the contralateral knee, and showed a trend toward elevated body mass index. Tissue cross-sectional areas of adipose, non-adipose and synovial tissues were not statistically different histologically between the two groups. There was increased expression in the contracture group for the genes CHAD, Cyr61, and Sox9. There was a corresponding increase in protein production for CHAD and Sox9. // Conclusions: Screening for OA duration and bilateral knee range of motion (ROM) could be functionally beneficial. When a knee joint contracture is present, correcting for the resulting leg length discrepancy pre- and post-operatively could improve patient outcome. Gene protein products linking capsular cells to the ECM can influence capsular fibrosis and potentially impact ROM.

Los trastornos mandibulares son alteraciones asociadas al dolor y disfunción de la Articulación Temporomandibular (ATM), a los músculos de la masticación, a la limitación del movimiento mandibular y a la presencia de un click articular. Entre estos trastornos se puede encontrar la hipomovilidad mandibular la cual se caracteriza por la incapacidad del paciente de abrir la boca con una amplitud normal. La hipomovilidad asociada a la contractura muscular tiene como tratamiento de primera opción el estiramiento pasivo, en esta técnica el paciente tiene que abrir la boca hasta el límite máximo, este movimiento debe ser realizado durante 5 o 6 veces al día. Este reporte de caso describe una paciente de 46 años de edad con Hipomovilidad Mandibular por contractura muscular, se describe la sintomatología, la evaluación clínica y el tratamiento propuesto. La evolución fue favorable; en un seguimiento de 5 semanas se logró el objetivo propuesto. / Mandibular disorders are disorders associated with the pain and dysfunction of the Temporomandibular Joint, the chewing muscles, the limitation of mandibular movement and the presence of a joint click. Among these disorders can be found mandibular hypomobility which is characterized by the patient's inability to open the mouth with a normal width. Passive stretching is the first option for hypomobility associated with muscle contraction. In this technique, the patient has to open the mouth to the maximum limit, this movement must be carried out 5 or 6 times a day. This case report describes a 46-year-old patient with Mandibular Hypomobility due to muscle contracture, the symptoms, the clinical evaluation and the proposed treatment are described. The evolution was favorable; in a 5-week follow-up, the proposed objective was achieved. / Trabajo académico