Diese Arbeit beschreibt verzögert detektierten Fußfrakturen bei 47 Polytraumapatienten, die im Zeitraum zwischen 01.01.2000 und 31.12.2004 aufgrund eines Polytraumas in der Klinik für Unfall-, Wiederherstellungs- und Plastische Chirurgie der Universität Leipzig behandelt wurden. 30 Patienten wurden mittels Fragebogen, davon 19 klinisch und radiologisch nachuntersucht. Für die Ermittlung des Outcome der Patienten wurden der AOFAS- Mittel- und -Rückfuß, HSS-, HS-, und der SF - 36 Fragebogen verwand. Zusätzlich erfolgten native Röntgenaufnahmen der Füße in 3 Ebenen und bei Calcaneusfrakturen nach Broden. Die Gründe für eine verzögerte Diagnose von Fußverletzungen wurden eruiert und die klinischen und im Outcome relevanten Läsionen extrahiert. Probleme welche im prioritätsorientierten Behandlungsablauf auftraten und Folgen für die Lebensqualität der Patienten hatten wurden ermittelt. Die Resultate der Scores wurden mittels T- Test und linearer Regression auf Allgemeingültigkeit und hinsichtlich den singulären Einfluss der verzögerten Detektion der Fraktur nachuntersucht. Die Ergebnisse dieser Arbeit zeigen, dass polytraumatisierte Patienten einem hohen Risiko unterliegen, dass eine Fraktur eines Fußknochens verzögert detektiert wird. Diese Verzögerung führt in 14,4 % der Fälle zu einer Änderung der Therapie. Eine erhöhte Rate an Komplikation während der Behandlung oder einen signifikant negativen Einfluss auf das Outcome der Patienten konnte nicht festgestellt werden. Die Zeitdauer bis diese erkannt wird hat einen negativen Einfluss auf das Outcome der Patienten. Abweichungen im Outcome sowie Komplikationen und Probleme in der Therapie traten in 4,8 % der Fälle auf.

Past research on the acceleration phase in sprint running has concentrated on the kinematics of sprint blocks set-up and the initial steps after exiting the sprint blocks. In contrast, there has been limited research on the ground reaction forces (GRF) generated during the initial post-block foot contacts. These initial foot contacts in sprinting are important for optimising performance in the initial acceleration phase of sprinting. However, little is known about the GRF elite sprinters generate during the initial foot contacts and how these GRF characteristics relate to performance. It is the anterior-posterior (A-P) GRF that are of most importance as they indicate the sprinter’s motion from the start to the finish line. This thesis investigates the A-P GRF of the first two foot contacts of the sprint start after leaving the blocks. The participants included seventeen male and six female sprinters with a mean age of 22.6 (SD 4.4 years). Seventeen of the sprinters had competed at international/national level competitions and six at recreational/amateur level competitions. The athletes were classified as senior male elite (SME), senior female elite (SFE), junior male elite (JME) and senior male recreational (SMR). The sprinters were instructed to perform block starts at maximal effort to produce the fastest time over 5 metres on a 30 metre indoor laboratory track. Timing gates were used to record 5 metre times and two strain gauge force plates were placed in series to collect GRF data from the first two foot contacts after leaving the starting blocks. From the GRF data, braking time, maximum A-P braking force, A-P braking impulse, propulsive time, maximum A-P propulsive force, A-P propulsive impulse and A-P contact impulse were determined for each trial. The A-P propulsive phase constituted greater than 90% of the total contact time, had approximately twice the magnitude of the maximum force of the braking phase and accounted for more than 95% of the total contact impulse across the four groups of sprinters. The SME group produced a significantly larger A-P propulsive impulse on the first and second steps compared to the SFE (p less than 0.05 and p less than 0.05 respectively), JME (not significant and p less than 0.05 respectively) and SMR (p less than 0.05 and p less than 0.05 respectively) groups. The SME group’s maximum A-P propulsive force was significantly larger on the first and second steps than the SFE (p less than 0.05 and p less than 0.05 respectively), JME (p less than 0.05 and p less than 0.05 respectively) and SMR (p less than 0.05 and p less than 0.05 respectively) groups. The SME group’s propulsive time on the first and second steps was not significantly different compared to the SFE (both not significant) but was significantly shorter compared to the JME (p less than 0.05 and p less than 0.05 respectively) and SMR (p less than 0.05 and p less than 0.05 respectively) groups. The maximum A-P propulsive force correlated strongly with 5 metre time for the first step (rs = -0.670, p less than 0.01), second step (rs = -0.621, p less than 0.01) and the addition of the first and second steps (rs = -0.678, p less than 0.01) across all the sprinters. Whereas, the A-P propulsive impulse correlated strongly with 5 metre time for the first step (rs = -0.525, p less than 0.01), second step (rs = -0.592, p less than 0.01) and the addition of the first and second steps (rs = -0.584, p less than 0.01). Three A-P GRF patterns were observed during the first and second foot contacts of the sprinters examined in this study. A braking-propulsive (B-P) pattern was the most frequently observed followed by a propulsive-braking-propulsive (P-B-P) and a no braking (NB) pattern 82.7%, 15.4% and 1.9% respectively. The P-B-P and NB patterns, which have not been described previously, appeared most frequently in the least experienced sprinters. In the past, some sprinters and their coaches have tried to minimise the braking phase and maximise the propulsive phase of the first two foot contacts after exiting the blocks during sprinting. This study suggests that increasing the maximum propulsive force is the best way to increase performance over the first 5 metres of the acceleration phase. The research also suggests that there will be little benefit gained from trying to increase performance by focusing on the braking phase during these first two steps after exiting the blocks. As such, sprinters and coaches should focus their attention primarily on producing a large A-P propulsive force during the first two steps of a sprint.

People with diabetes are at a greater risk of burn injuries than those without diabetes. This stems from the epidemiological profiles of the conditions and the effects of morbidities associated with diabetes. Both conditions share some similarities in terms of metabolic alterations and suboptimal immune functions which may result in poor outcomes for patients. For that reason, it is reasonable to deduce that patients with diabetes are a challenging group to manage in burns units. However, this deduction should be taken cautiously because of lack of supporting evidence. Accordingly and after consulting with clinical experts, the research in this portfolio investigated the association between diabetes and burn injuries. In particular, two different aspects of this association were investigated in two individual quantitative and descriptive inquiries. The first was a case note review of patients hospitalised with a principal diagnosis of a foot burn injury in a large tertiary hospital in South Australia from 1999 to 2004. The second study investigated management of diabetes in burns units treating adults. This study is an e-mail survey of clinical leaders of burns units in Australia, New Zealand, Hong Kong and the United Kingdom. The clinical leaders were approached indirectly through key liaison persons in each identified unit. In the first study, outcomes for twelve subjects with and fifty-two without diabetes were described using descriptive and non-parametric statistics. In the second study, descriptive frequencies and content analysis were adopted to analyse twenty-nine responses from seventeen out of thirty burns units which participated in the study. Supporting findings in the literature, the first study showed that burn injuries among subjects with diabetes were mainly resulted from household devices. There were no statistically significant differences between subjects with and without diabetes in terms of size and depth of burn injuries and treatment received. In spite of this, there was a statistically significant association between diabetes and the experience of local post-burn complications and longer duration of hospitalisation. The second study indicated that more than twenty-five percent of the respondents believed that multidisciplinary centres should only occasionally be involved in the process of care. Participants reported that the individual profile of each patient plays a major role in determining the management of diabetes. Additionally, it was found that the insulin sliding scale was commonly used in the management of diabetes in burns units. The association between diabetes and a burn injury is a serious issue in terms of health and cost. This association need be addressed firstly and most importantly at the prevention level; secondly through proper management of both diabetes and burns. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1285462 / Thesis (D.Nurs.)--Population Health and Clinical Practice, 2007.

The objective of this study was to investigate the intra-rater (within day & between days) and inter-rater reliability of foot/ankle water volumetry in healthysubjects.Study design: Repeated measures design with 2 raters.Background: Physiotherapists more often aim to reduce swelling in the acute phase of soft tissue injury. Reduction in swelling will hasten the healing process. Therefore swelling forms an important outcome measure that is worth studying during the healing process to determine the efficacy of the intervention. Though there are different methods available to measure extremity swelling, water displacement method is widely used in physiotherapy studies. Although water volumetry has been used to assess the reduction in swelling over time, there is paucity of reliability studies that have assessed the between-days reliability.Methods: Thirty normal subjects with asymptomatic ankles were measured by 2 raters. Three repeated foot volume measurements were performed by each of the rater using water volumetry during a single test session. The same procedure was repeated approximately at the same time on the 3rd day and 5th day following the 1st measurement day by the same raters on the same subjects. The raters were blinded to each other's measurements. The order for rater's volumetric measurement on each subject on each day was determined by a random chart produced by SPSS. The reliability was measured in terms of systematic bias (Paired t test & Bland & Altman's plot), absolute reliability (Limits of Agreement [LOA] & Standard Error of Measurement [SEM]) and relative reliability (Intraclass Correlation Coefficient [ICC]).Results: There was no systematic bias between any of the trials within day/between days or between raters. The intra-rater reliability within day as calculated by ICC; LOA and SEM were 0.99, ±10ml and ±3.5ml respectively and for between days reliability the values were 0.99 (ICC), ±20ml (LOA) and ±7ml (SEM) and for interrater reliability the values were 0.99 (ICC), ±13ml (LOA) and ±5ml (SEM). The results demonstrated that water volumetry method was highly reliable within day and between days for both the raters; and highly reliable between raters.Conclusion: Water volumetry is a highly reliable method for measuring foot/ankle volume repeatedly on different days. The random error range in milliliters (ml) as estimated by the absolute reliability indices provides the practical use of this method in a clinical/research setting.

Past research on the acceleration phase in sprint running has concentrated on the kinematics of sprint blocks set-up and the initial steps after exiting the sprint blocks. In contrast, there has been limited research on the ground reaction forces (GRF) generated during the initial post-block foot contacts. These initial foot contacts in sprinting are important for optimising performance in the initial acceleration phase of sprinting. However, little is known about the GRF elite sprinters generate during the initial foot contacts and how these GRF characteristics relate to performance. It is the anterior-posterior (A-P) GRF that are of most importance as they indicate the sprinter’s motion from the start to the finish line. This thesis investigates the A-P GRF of the first two foot contacts of the sprint start after leaving the blocks. The participants included seventeen male and six female sprinters with a mean age of 22.6 (SD 4.4 years). Seventeen of the sprinters had competed at international/national level competitions and six at recreational/amateur level competitions. The athletes were classified as senior male elite (SME), senior female elite (SFE), junior male elite (JME) and senior male recreational (SMR). The sprinters were instructed to perform block starts at maximal effort to produce the fastest time over 5 metres on a 30 metre indoor laboratory track. Timing gates were used to record 5 metre times and two strain gauge force plates were placed in series to collect GRF data from the first two foot contacts after leaving the starting blocks. From the GRF data, braking time, maximum A-P braking force, A-P braking impulse, propulsive time, maximum A-P propulsive force, A-P propulsive impulse and A-P contact impulse were determined for each trial. The A-P propulsive phase constituted greater than 90% of the total contact time, had approximately twice the magnitude of the maximum force of the braking phase and accounted for more than 95% of the total contact impulse across the four groups of sprinters. The SME group produced a significantly larger A-P propulsive impulse on the first and second steps compared to the SFE (p less than 0.05 and p less than 0.05 respectively), JME (not significant and p less than 0.05 respectively) and SMR (p less than 0.05 and p less than 0.05 respectively) groups. The SME group’s maximum A-P propulsive force was significantly larger on the first and second steps than the SFE (p less than 0.05 and p less than 0.05 respectively), JME (p less than 0.05 and p less than 0.05 respectively) and SMR (p less than 0.05 and p less than 0.05 respectively) groups. The SME group’s propulsive time on the first and second steps was not significantly different compared to the SFE (both not significant) but was significantly shorter compared to the JME (p less than 0.05 and p less than 0.05 respectively) and SMR (p less than 0.05 and p less than 0.05 respectively) groups. The maximum A-P propulsive force correlated strongly with 5 metre time for the first step (rs = -0.670, p less than 0.01), second step (rs = -0.621, p less than 0.01) and the addition of the first and second steps (rs = -0.678, p less than 0.01) across all the sprinters. Whereas, the A-P propulsive impulse correlated strongly with 5 metre time for the first step (rs = -0.525, p less than 0.01), second step (rs = -0.592, p less than 0.01) and the addition of the first and second steps (rs = -0.584, p less than 0.01). Three A-P GRF patterns were observed during the first and second foot contacts of the sprinters examined in this study. A braking-propulsive (B-P) pattern was the most frequently observed followed by a propulsive-braking-propulsive (P-B-P) and a no braking (NB) pattern 82.7%, 15.4% and 1.9% respectively. The P-B-P and NB patterns, which have not been described previously, appeared most frequently in the least experienced sprinters. In the past, some sprinters and their coaches have tried to minimise the braking phase and maximise the propulsive phase of the first two foot contacts after exiting the blocks during sprinting. This study suggests that increasing the maximum propulsive force is the best way to increase performance over the first 5 metres of the acceleration phase. The research also suggests that there will be little benefit gained from trying to increase performance by focusing on the braking phase during these first two steps after exiting the blocks. As such, sprinters and coaches should focus their attention primarily on producing a large A-P propulsive force during the first two steps of a sprint.

Tez (Yüksek Lisans) - Süleyman Demirel Üniversitesi, Sağlık Bilimleri Enstitüsü, Anatomi Anabilim Dalı, 2004. / Bibliyografya var.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 4 uppsatser.

Diss. Luleå : Luleå tekniska universitet, 2007. / Härtill 4 uppsatser.

Thesis (Ph. D.)--Victoria University (Melbourne, Vic.), 2008. / Includes bibliographical references.