<p>Syftet med studien var att undersöka fallrelaterad self-efficacy mätt med Falls Efficacy Scale (Swedish version) (FES(S)) samt att beräkna rekommenderade referensvärden för totalpoängen på FES(S) hos friska äldre män och kvinnor indelade i åldersgrupperna 65-75 år samt > 75 år. Vidare syftade studien till att undersöka om det fanns några skillnader i resultatet mellan åldersgrupperna samt mellan män och kvinnor.</p><p>Undersökningsgruppen bestod av totalt 70 individer över 65 års ålder, varav 45 var kvinnor och 25 var män. Testdeltagarna kontaktades via PRO i Uppsala. Även vänner och bekanta till författarna deltog i studien. Testdeltagarnas fallrelaterade self-efficacy undersöktes med hjälp av instrumentet FES(S), där testdeltagarna fick skatta hur säkra de känner sig på att utföra 13 olika vardagsaktiviteter utan att falla, maximal poäng 130.</p><p>Resultatet visade att det rekommenderade referensvärdet för totalpoängen på FES(S) blev 124 poäng för kvinnor i åldern 65-75 år och 126 poäng för män i samma ålder. För kvinnor > 75 år ålder blev det rekommenderade referensvärdet 118 poäng och för män 105 poäng. Det fanns en statistiskt signifikant skillnad för totalpoängen på FES(S) mellan de två åldersgrupperna, p=0,005. Ingen statistiskt signifikant skillnad kunde påvisas mellan könen, p=0,632. För att få fram mer generaliserbara referensvärden behövs ytterligare studier med ett mer representativt urval och en större undersökningsgrupp.</p>

The work presented in this dissertation was focused on developing an affordable, automated, upper extremity exercise system suitable for individuals with stroke and spinal cord injury (SCI). The three studies presented in this thesis demonstrated the efficacy of functional electrical stimulation-assisted exercise therapy (FES-ET). Furthermore a protocol was developed to implement FES-ET in participants homes via tele-rehabilitation. The protocol included the use of an improved version of the bionic glove, an FES device that enhanced hand grasp and release in SCI individuals in combination with a custom-built workstation that enabled task-oriented rehabilitation in the home setting, supervised over the Internet. In the course of these studies, an objective hand function assessment tool was developed to complement tele-supervised FES-ET and provide the therapist with an unbiased evaluation of the participants impairment. A major section of this dissertation is concerned with the development and testing of a novel exercise workstation named the ReJoyce (Rehabilitation Joystick for Computer Exercise), that can assess hand function electronically. The ReJoyce is an instrumented workstation that provides standardized upper extremity rehabilitation based on ADLs, in the guise of computer games played by manipulating attachments on the device. The three studies presented in this thesis focus on the scientific merits and the logistics of providing tele-supervised FES-ET with this workstation. The first study demonstrated the feasibility of treating and assessing individuals on the workstation who had recently suffered a stroke. The second study explored the relationship between the quantitative assessment of hand function with the workstation and two widely-used clinical tests. The last study involved daily, tele-supervised FES-ET or conventional exercises and therapeutic electrical stimulation (TES), maintained for 6 weeks, with SCI participants spread out over a large geographical area. FES-ET performed with the workstation resulted in statistically significant and clinically important improvements in hand function that were greater than those produced by the more conventional protocol. The results demonstrated the importance of including a range of exercises aimed at improving both strength and dexterity. It is concluded that tele-supervised FES-ET on a standardized workstation is feasible, effective and affordable in the current healthcare settin

The Ni-Fe-S C-cluster of carbon monoxide dehydrogenases (CODH), which catalyzes the reversible oxidation of CO to CO2, can be stabilized in four redox states: Cox, Cred1, Cint, and Cred2. The best-supported mechanism of catalysis involves a one-electron reductive activation of Cox to Cred1 and a catalytic cycle in which Cred1 binds and oxidizes CO, forming Cred2 and releasing CO2. Recently reported experiments appear to have disqualified this mechanism, as activation was concluded to require reduction to a C-cluster state more reduced than Cred1. The results presented in this dissertation suggest that the activation potential was milder than that required to reduce these clusters. The results support a mechanism in which Cred1 is the form of the cluster that reacts with CO. The structure of the active-site C-cluster in CO dehydrogenase from Carboxydothermus hydrogenoformans (CODHCh) includes a ??2-sulfide ion bridged to the Ni and unique Fe, while the same cluster in enzymes from Rhodospirillum rubrum (CODHRr) and Moorella thermoacetica (CODHMt) lack this ion. This difference was investigated by exploring effects of sulfide on activity and spectral properties. Sulfide partially inhibited CO oxidation activities of CODHRr and CODHMt. Adding sulfide to CODHMt in the Cred1 state caused the gav = 1.82 Electron Paramagnetic Resonance spectroscopy (EPR) signal to decline and new features to appear. Sulfide did not affect the gav = 1.86 signal from the Cred2 state. A model was developed in which sulfide binds reversibly to Cred1, inhibiting catalysis. The results also suggest that the substrate hydroxyl group bridges the Ni and unique Fe. A cysteine residue recently found to form a persulfide bond with the C-cluster was characterized. The Ser mutant of the persulfide-forming Cys316 was inactive and displayed no C-cluster EPR signals. Electronic absorption and metal analysis suggest that the C-cluster is absent in this mutant. The persulfide bond appears to be essential for either the assembly or stability of the C-cluster, and/or for eliciting the redox chemistry of the C-cluster required for catalytic activity.

Syftet med studien var att undersöka fallrelaterad self-efficacy mätt med Falls Efficacy Scale (Swedish version) (FES(S)) samt att beräkna rekommenderade referensvärden för totalpoängen på FES(S) hos friska äldre män och kvinnor indelade i åldersgrupperna 65-75 år samt &gt; 75 år. Vidare syftade studien till att undersöka om det fanns några skillnader i resultatet mellan åldersgrupperna samt mellan män och kvinnor. Undersökningsgruppen bestod av totalt 70 individer över 65 års ålder, varav 45 var kvinnor och 25 var män. Testdeltagarna kontaktades via PRO i Uppsala. Även vänner och bekanta till författarna deltog i studien. Testdeltagarnas fallrelaterade self-efficacy undersöktes med hjälp av instrumentet FES(S), där testdeltagarna fick skatta hur säkra de känner sig på att utföra 13 olika vardagsaktiviteter utan att falla, maximal poäng 130. Resultatet visade att det rekommenderade referensvärdet för totalpoängen på FES(S) blev 124 poäng för kvinnor i åldern 65-75 år och 126 poäng för män i samma ålder. För kvinnor &gt; 75 år ålder blev det rekommenderade referensvärdet 118 poäng och för män 105 poäng. Det fanns en statistiskt signifikant skillnad för totalpoängen på FES(S) mellan de två åldersgrupperna, p=0,005. Ingen statistiskt signifikant skillnad kunde påvisas mellan könen, p=0,632. För att få fram mer generaliserbara referensvärden behövs ytterligare studier med ett mer representativt urval och en större undersökningsgrupp.

The Ni-Fe-S C-cluster of carbon monoxide dehydrogenases (CODH), which catalyzes the reversible oxidation of CO to CO2, can be stabilized in four redox states: Cox, Cred1, Cint, and Cred2. The best-supported mechanism of catalysis involves a one-electron reductive activation of Cox to Cred1 and a catalytic cycle in which Cred1 binds and oxidizes CO, forming Cred2 and releasing CO2. Recently reported experiments appear to have disqualified this mechanism, as activation was concluded to require reduction to a C-cluster state more reduced than Cred1. The results presented in this dissertation suggest that the activation potential was milder than that required to reduce these clusters. The results support a mechanism in which Cred1 is the form of the cluster that reacts with CO. The structure of the active-site C-cluster in CO dehydrogenase from Carboxydothermus hydrogenoformans (CODHCh) includes a ??2-sulfide ion bridged to the Ni and unique Fe, while the same cluster in enzymes from Rhodospirillum rubrum (CODHRr) and Moorella thermoacetica (CODHMt) lack this ion. This difference was investigated by exploring effects of sulfide on activity and spectral properties. Sulfide partially inhibited CO oxidation activities of CODHRr and CODHMt. Adding sulfide to CODHMt in the Cred1 state caused the gav = 1.82 Electron Paramagnetic Resonance spectroscopy (EPR) signal to decline and new features to appear. Sulfide did not affect the gav = 1.86 signal from the Cred2 state. A model was developed in which sulfide binds reversibly to Cred1, inhibiting catalysis. The results also suggest that the substrate hydroxyl group bridges the Ni and unique Fe. A cysteine residue recently found to form a persulfide bond with the C-cluster was characterized. The Ser mutant of the persulfide-forming Cys316 was inactive and displayed no C-cluster EPR signals. Electronic absorption and metal analysis suggest that the C-cluster is absent in this mutant. The persulfide bond appears to be essential for either the assembly or stability of the C-cluster, and/or for eliciting the redox chemistry of the C-cluster required for catalytic activity.

No description available.

At the beginning of this project it was known that functional electrical stimulation (FES) rowing was technically feasible, but no studies on health benefits had been conducted and it was unclear what levels of fitness could be reliably attained by spinal cord injured (SCI) users. This thesis shows that training with the first-generation of the FES-rowing system (RowStim II), seven paraplegics achieved high V02peak values (21.0 - 27.9 ml-kg-1-min-1) and a significant (10%) increase in V02peak. This was also found to significantly improve insulin sensitivity and leptin levels but it had no significant effect on lipid profiles or body composition, possibly caused by technological limitations of the RowStim 11. However, training volumes were positively correlated with improvements in lipid profile and body composition. This motivated further technical development of the RowStim to enable paraplegics to train harder and longer. The development included a more stable seat configuration with redesigned trunk retaining straps, a rigid low friction carriage/brake system, improved leg stabiliser, improved stimulation control and a gravity-assisted return phase. This RowStim III has enabled paraplegics to participate in the British (2004, 2005 and 2006) and World Indoor Rowing Championships (2006). The rowers have achieved higher exercise intensities (26.8 -31.0 ml. kg- I .min-1) and increased exercise volumes (1,150 kcal-week-1) with the RowStim III. Such levels of physical activity, which are difficult to achieve for paraplegics using traditional exercises, are correlated with significant health benefits in the able-bodied. Preliminary results suggest that perfusion of the quadriceps muscle during FES-rowing might limit the exercise time in novice rowers. Other preliminary data from pressure mapping indicate that there is a dynamic pattern during FES-rowing, which might reduce the risk for pressure sores during FES-rowing. This thesis shows that FES-rowing is now a rapidly developing exercise modality, which has been shown to enable safe and well-tolerated exercise for individuals with SCI. It can offer unprecedented levels of cardiovascular fitness, competitive challenges and potentially important health benefits.

Stuttgart, Univ., Diss., 2006.

Submitted by RICARDO GOUVEIA TEODORO (ricardo.teodoro@unesp.br) on 2018-10-16T20:04:29Z No. of bitstreams: 1 Tese - Ricardo Gouveia Teodoro 13-10-2018.pdf: 17108638 bytes, checksum: 32a3e14ede25e327e8ff29fb9d267225 (MD5) / Approved for entry into archive by Cristina Alexandra de Godoy null (cristina@adm.feis.unesp.br) on 2018-10-18T12:11:00Z (GMT) No. of bitstreams: 1 teodoro_rg_dr_ilha.pdf: 17108638 bytes, checksum: 32a3e14ede25e327e8ff29fb9d267225 (MD5) / Made available in DSpace on 2018-10-18T12:11:00Z (GMT). No. of bitstreams: 1 teodoro_rg_dr_ilha.pdf: 17108638 bytes, checksum: 32a3e14ede25e327e8ff29fb9d267225 (MD5) Previous issue date: 2018-08-13 / A Estimulação Elétrica Funcional tem sido utilizada para auxiliar no restabelecimento de funções motoras em paraplégicos. Neste trabalho é proposto um procedimento experimental para identificar as incertezas politópicas de um modelo dinâmico do movimento do membro inferior, produzido por estimulação elétrica aplicada no quadríceps. Foram realizadas comparações entre controle em malha aberta e dois controladores em malha fechada. O projeto dos controladores foi baseado em desigualdades matriciais lineares (LMIs). Os resultados experimentais foram obtidos para 5 voluntários hígidos e 4 voluntários paraplégicos. Devido à incerteza dos parâmetros da planta, os resultados experimentais mostraram que o sinal de controle é incerto para um ponto de operação. Pela primeira vez aplicou-se controle chaveado com incerteza e estimulação elétrica para controlar o movimento do membro inferior. O controlador chaveado u_(σ,ξ) (t)apresentou o menor valor da derivada temporal da função de Lyapunov e compensou a incerteza do sinal de controle. / Functional Electrical Stimulation has been used to aid and restore motor functions in paraplegics. In this work, we propose an experimental procedure to identify the polytopic uncertainties of a dynamic model of the lower limb movement produced by electrical stimuli applied to the quadriceps. A comparison between open-loop control and two closed-loop controllers was performed. The controller design was based on linear matrix inequalities (LMIs). Experimental results were obtained for 5 healthy volunteers and 4 paraplegic volunteers. Due to plant parameters uncertainties, the experimental results showed that the control signal is uncertain for an operating point. For the first time, a robust switched controller and electrical stimulation were applied to control the movement of the lower limb. The switched controller u_(σ,ξ) (t)presented the smallest time-derivative value of the Lyapunov function and compensated the uncertainty in the control signal.

Orientador: Aparecido Augusto de Carvalho / Resumo: A Estimulação Elétrica Funcional tem sido utilizada para auxiliar no restabelecimento de funções motoras em paraplégicos. Neste trabalho é proposto um procedimento experimental para identificar as incertezas politópicas de um modelo dinâmico do movimento do membro inferior, produzido por estimulação elétrica aplicada no quadríceps. Foram realizadas comparações entre controle em malha aberta e dois controladores em malha fechada. O projeto dos controladores foi baseado em desigualdades matriciais lineares (LMIs). Os resultados experimentais foram obtidos para 5 voluntários hígidos e 4 voluntários paraplégicos. Devido à incerteza dos parâmetros da planta, os resultados experimentais mostraram que o sinal de controle é incerto para um ponto de operação. Pela primeira vez aplicou-se controle chaveado com incerteza e estimulação elétrica para controlar o movimento do membro inferior. O controlador chaveado u_(σ,ξ) (t)apresentou o menor valor da derivada temporal da função de Lyapunov e compensou a incerteza do sinal de controle. / Abstract: Functional Electrical Stimulation has been used to aid and restore motor functions in paraplegics. In this work, we propose an experimental procedure to identify the polytopic uncertainties of a dynamic model of the lower limb movement produced by electrical stimuli applied to the quadriceps. A comparison between open-loop control and two closed-loop controllers was performed. The controller design was based on linear matrix inequalities (LMIs). Experimental results were obtained for 5 healthy volunteers and 4 paraplegic volunteers. Due to plant parameters uncertainties, the experimental results showed that the control signal is uncertain for an operating point. For the first time, a robust switched controller and electrical stimulation were applied to control the movement of the lower limb. The switched controller u_(σ,ξ) (t)presented the smallest time-derivative value of the Lyapunov function and compensated the uncertainty in the control signal. / Doutor