Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 4 uppsatser.

Thesis (M.S.)--Humboldt State University, 2008. / Includes bibliographical references (leaves 49-58). Also available via Humboldt Digital Scholar.

Thesis (D.Phil.(Biokinetics, Sport and Leisure Sciences))--University of Pretoria, 2008. / Summary in English and Afrikaans. Includes bibliographical references.

Thesis (Ph. D.)--Oregon State University, 2006. / Blank pages 143 and 159 not microfilmed. Includes bibliographical references. Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Thesis (Ph. D.)--Oregon State University, 2006. / Blank pages 143 and 159 not microfilmed. Includes bibliographical references.

Thesis (M.Tech.: Homoeopathy)-Dept. of Homoeopathy, Durban University of Technology, 2006 xxxiii, 112 leaves : ill. / The purpose of this double-blind placebo-controlled study was to evaluate the relative and combined efficacy of the homoeopathic similimum, taken orally, and the topical application of a lotion made from the homoeopathic mother tinctures of Hypericum perforatum and Calendula officinalis in the treatment of venous leg ulcers. Venous hypertension in the lower limb, occurring from a variety of causes, leads to microcirculatory abnormalities which may permit the formation of a chronic ulcer (Zimmet, 1998). Venous leg ulcers are a cause of much debility, social isolation, depression, fears of loss of employment and income (Royal College of Nursing Institute, 1998). The mainstay of treatment at present is compression bandaging to reduce the venous pressure in the lower limb. Eighty percent of venous leg ulcers will heal within eight to twelve weeks with compression bandaging (Thomas, 1997). Homoeopathy is a system of medicine based on natural laws of healing, and recognizes the biophysical energy of an individual (also known as the vital force) as that which provides the normal protective defence mechanisms of the body, and is disturbed in disease, producing symptoms on the physical, mental and emotional levels (Vithoulkas, 1980). Many plants are known to have wound-healing properties (Curtis and Fraser, 2003). Calendula officinalis and Hypericum perforatum were considered the best plants in a homoeopathic lotion to be used on chronic venous leg ulcers, as they cover all the common problems associated with this type of wound, providing pain relief and anti-microbial activity (Lawless, 1995). In this study, homoeopathic mother tinctures of the herbs were used to make the lotion for topical application to the wounds.

Chronic exertional compartment syndrome (CECS) is a common problem within both military and athletic populations that can be difficult to diagnose. Furthermore, it is unclear what causes the development of CECS, particularly in the military population, as personnel undertake a variety of activities that can cause pain with CECS such as fast walking, marching and running. Chronic exertional compartment syndrome has been hypothesised to develop due to excessive muscle activity, foot pronation and abnormal biomechanics predominantly at the ankle. Treatment of CECS through running re-education to correct these abnormalities has been reported to improve symptoms. However no primary research has been carried out to investigate the biomechanical, muscle activation and clinical characteristics of military patients with CECS. The purpose of this thesis was to provide an original contribution to the knowledge through the exploration of these characteristics; and the development of insights into the development of CECS, with implications for prevention and treatment. Study one investigated the clinical characteristics of 93 service personnel with CECS. Plantar pressure variables, related to foot type and anterior compartment muscle activity, and ankle joint mobility were compared during walking between 70 cases and 70 controls in study two. Study three compared three-dimensional whole body kinematics, kinetics and lower limb muscle activity during walking and marching between 20 cases and 20 controls. Study four compared kinematics and lower limb muscle activity during running in a separate case-control cohort (n=40). Differences in electromyography (EMG) intensity during the gait cycle were compared in the frequency and time domain using wavelet analysis. All studies investigated subject anthropometry. Cases typically presented with bilateral, ‘tight’ or ‘burning’ pain in the anterior and lateral compartments of the lower leg that occurred within 10 minutes of exercise. This pain stopped all cases from exercising during marching and/or running. As such subsequent studies investigated the biomechanics of both ambulatory and running gaits. Cases in all case-control studies were 2-10 cm shorter; and were typically overweight resulting in a higher body mass index (BMI) than controls. There was strong evidence from study 3 that cases had greater relative stride lengths than controls during marching gait. This was achieved through an increase in ankle plantarflexion during late stance and a concomitant increase in the gastrocnemius medialis contraction intensity within the medium-high frequency wavelets. Given the differences in height observed, this may reflect ingrained alterations in gait resulting from military training; whereby all personnel are required to move at an even cadence and speed. These differences in stride length were also observed in walking and running gaits although to a lesser extent. There was no evidence from the EMG data that cases had greater tibialis anterior activation than controls during any activity tested, at any point in the gait cycle or in any frequency band. In agreement, there was also no evidence of differences between groups in plantar pressure derived measures of foot type, which modulate TA activity. Toe extensor - related plantar pressure variables also did not differ between groups. In summary, contrary to earlier theories, increased muscle activity of the anterior compartment musculature does not appear to be associated with CECS. The kinematic differences observed during running only partially matched the clinical observations previously described in the literature. Cases displayed less anterior trunk lean and less anterior pelvic tilt throughout the whole gait cycle and a more upright shank inclination angle during late swing (peak mean difference 3.5°, 4.1° and 7.3° respectively). However, no consistent differences were found at the ankle joint suggesting that running is unlikely to be the cause of CECS in the military; and that the reported success of biomechanical interventions may be due to reasons other than modifying pathological aspects of gait. In summary, the data presented in the thesis suggest that CECS is more likely to develop in subjects of shorter stature and that this is associated with marching at a constant speed and cadence. Biomechanical interventions for CECS, such as a change in foot strike or the use of foot orthotics, are unlikely to be efficacious for the military as personnel will continue to be required to march at prescribed speeds to satisfy occupational requirements. Preventative strategies that allow marching with a natural gait and/or at slower speeds may help reduce the incidence of CECS. The lack of association with foot type or muscle activity suggests that foot orthoses would not be a useful prevention strategy or treatment option for this condition.

Jumping is one of the common methods that flight capable birds use to initiate the take-off phase. Flapping-wing robots that can achieve jumping take-off similar to birds will be significantly valuable since they can reduce the workload of the wing in producing the instantaneous power required for take-off and enables remote operations as well. This thesis progresses the state of the art in leg based jumping systems for flapping-wing robots through a contribution to the fundamental understanding of jumping dynamics and the development of experimentally validated simulation tools. Three reference leg postures are identified from video analysis of a rook take-off: stand, crouch and extended. Birds often use different kinematic patterns for the leg flexion (stand to crouch) and extension (crouch to extended) phases. This is made possible by their multi degree of freedom (Dof) leg structure and complex, multi actuated muscle systems. As an alternative strategy, a conceptual design of a singly actuated jumping leg is proposed where a multi Dof segmented leg is linked to a single actuator. The structure is based on the avian leg and foot anatomy. The study identifies that a dynamically unstable jumping take-off using a tilt and jump approach enables a singly actuated robotic leg to achieve jumping performance similar to birds. A combination of analytical, numerical and physical modelling approaches is used in this study. A generic analytical jumping model is used to establish fundamental understanding of jumping dynamics. The study shows that the take-off dynamics of a jumping system can be idealised as an inelastic collision between the dynamic and static rigid bodies of the system. This provides a simpler way to understand jumping dynamics in general. A physical prismatic jumping model is fabricated principally for validation purposes. A motion capture system is used to quantitatively analyse the jumping kinematics of the model. The take-off velocities predicted through analytical and numerical models agree closely with the experimental data. A multi-segmented numerical simulation model is then developed based on the proposed singly actuated jumping leg design. In the same way an analytical model is developed. It is found that the singly actuated design concept with the assumption of massless segments greatly reduced the complexity of the multi-segmented analytical model. The proposed analytical approach and simulation tool are demonstrated by designing a multi-segmented jumping leg for an example robotic bird. The transparency of the approach enables the designer to understand how design parameters such as take-off weight, actuation properties, leg postures and sizes of the segments affect the take-off velocity. Numerical simulation analysis confirms that jumping performance similar to birds is achieved in the proposed singly actuated jumping legs with the integration of tilt and jump method. For the presented case study, the use of the dynamic tilting method improves the minimum achievable take-off angle from 73° to 12° with respect to the horizontal axis.

A Doença Pulmonar Obstrutiva Crônica (DPOC) é uma doença sistêmica prevenível e tratável que se caracteriza pela diminuição do fluxo aéreo não totalmente reversível, levando a intolerância ao exercício, interferindo na execução das atividades de vida diária e reduzindo a qualidade de vida dos pacientes. A reabilitação pulmonar é uma forma multidisciplinar de tratamento que tem como objetivo melhorar a qualidade de vida, aumentar a tolerância ao exercício, reduzindo os sintomas de fadiga e dispnéia. Já está bem demonstrado através de estudos controlados e randomizados a eficácia do treinamento da resistência para membros inferiores, porém existem dúvidas se trabalhar força e resistência de maneira combinada pode modificar os resultados. Objetivo: Comparar os treinamentos para os membros inferiores, de força e resistência com o de resistência, em pacientes portadores de DPOC que realizaram um programa de reabilitação pulmonar. Pacientes e métodos: Após a avaliação médica para confirmação do diagnóstico da doença, 27 pacientes, que participaram de um programa de reabilitação pulmonar, foram randomizados para um de dois grupos: o Grupo 1 (G1) (n=13) realizou apenas o treinamento de resistência dos membros inferiores, enquanto os pacientes do Grupo 2 (G2) (n=14), treinaram resistência e força combinadas para membros inferiores. As variáveis analisadas antes e após o treinamento foram obtidas através dos seguintes testes: teste de caminhada de seis minutos, teste de carga máxima, trabalho de caminhada, questionário Saint George de qualidade de vida, percepção de esforço pela escala de Borg, e circunferência de coxa e perna. Resultados: No teste de caminhada houve aumento da distância percorrida após o programa intragrupos [G1(distância pré: 343,38±136,11m vs. distância pós: 396,81±96,46; p=0,048)], e [G2 (distância pré: 367,28±125,11 vs. distância pós: 392,84±118,16, p=0,160)]. Nos testes de carga máxima obteve-se os seguintes resultados: G1 (extensão de joelhos pré: 32±13kg vs. peso pós: 38±14kg; p=0,016); (flexão de joelhos pré: 5,85±2,0kg vs. pós: 7,7±3,1kg; p=0,007); (flexão plantar direito pré: 20,75±4,78 repetições vs. pós:21,58±7,22 repetições; p=0,73), (flexão plantar esquerda pré:21,67±5,48 repetições vs. pós:20,92±7,36 repetições; p=0,74) e G2 (peso em extensão de joelhos pré: 33,43±16kg vs. peso pós: 44±16,40kg; p=0,0001); (flexão de joelhos pré: 5,23±3,19kg vs. pós: 7,92±3,75kg; p=0,0001); (flexão plantar direito pré: 20,17±5,82 repetições vs. pós: 29,33±11,59 repetições; p=0,001); (flexão plantar esquerda pré: 20,45±6,34 repetições vs. pós: 30,91±10,48 repetições; p=0,0001). Não foram observadas diferenças estatisticamente significativas no trabalho de caminhada tanto intragrupos quanto entre os grupos G1 e G2. Observou-se uma melhora com relação à qualidade de vida representada pela redução total de 21,77 pontos percentuais no G1 e 22,54 pontos percentuais no G2, sem diferença estatisticamente significativa entre os grupos. A percepção de dispnéia através da escala de Borg não mostra redução significativa tanto intragrupos quanto entre os grupos [ G1 (Borg pré: 4,27±2,71 vs. pós: 2,88±1,98; p=0,091)] e [G2 (Borg pré: 4,86±3,30 vs. pós: 3,79±2,63; p=0,24)]. Quando comparados os resultados após o programa entre os grupos (G1 e G2), houve diferença estatística no teste de carga máxima apenas no movimento de flexão plantar direita e esquerda, sendo na esquerda significativamente maior (G1 Δ: -0,75 repetições vs. G2 Δ: 10,46 repetições, p=0,001), nas demais variáveis estudadas não houve diferença estatística significativa. Conclusão: Nesta população estudada os dois grupos melhoraram a qualidade de vida e a força nos movimentos de flexão e extensão dos joelhos. No entanto, o treinamento combinado de força e resistência não se mostrou superior ao treinamento isolado da resistência para membros inferiores. / “Chronic Obstructive Pulmonary Diseases” is a systemic, preventable and treatable disease characterized by the decrease of the aerial flow not totally reversible, leading to exercise intolerance, interfering in daily activities and reducing the patients’ quality of life. Pulmonary rehabilitation is a multidisciplinary approach of treatment that aims to improve the patients’ quality of life, increasing exercise tolerance, decreasing the symptoms of tiredness and breathing difficulties. Controlled and randomized studies have already proved the effectiveness of leg resistance training. However, there are still doubts as to whether concomitant strength and resistance efforts can change the results. Objective: To establish whether resistance and strength training is superior to leg resistance training, in a pulmonary rehabilitation program. Patients and methods: After the medical evaluation in order to confirm the diagnosis of the disease, 27 patients were randomly divided into two groups: group 1 patients (G1) (13) were submitted only to leg resistance while, group 2 patients (G2) (14) trained concomitant resistance and strength tests. The variations analyzed before and after the training were achieved through the following tests: 6-min walk test, maximum load test, work walking, Saint George quality of life questionnaire, effort perception by the Borg scale, and thigh and calf measurement. Results: In the walking test there was increase in the distance covered after the grouping program [G1 (pre-distance: 343,38±136,11m vs. post-distance: 396,81±96,46; p=0,048)], and [G2 (pre-distance: 367,28±125,11 vs. post-distance: 392,84±118,16, p=0,160)]. The following results were obtained in the maximum load test: (knee pre-stretching: 32±13kg vs. post7 weight: 38±14kg; p=0,016); (knee pre-bending: 5,85±2,0kg vs. post: 7,7±3,1kg; p=0,007); (right sole pre-bending: 20,75±4,78 repetitions vs. post:21,58±7,22 repetitions; p=0,73), (left sole pre-bending:21,67±5,48 repetition vs. post:20,92±7,36 repetitions; p=0,74) and G2 (knee pre-stretching: 33,43±16kg vs. post-weight: 44±16,40kg; p=0,0001); (knee pre-bending: 5,23±3,19kg vs. post: 7,92±3,75kg; p=0,0001); (right sole pre-bending: 20,17±5,82 repetitions vs. post: 29,33±11,59 repetitions; p=0,001); (left sole pre-bending: 20,45±6,34 repetitions vs. post: 30,91±10,48 repetitions; p=0,0001). No statistically significant differences were observed in the walking exercise in both groups. Although an improvement was observed in the quality of life represented by the total decrease of 21,77% in G1 and 22,54% in G2, it does not demonstrate any statistically significant difference between the two groups. The breathing difficulty perception through the Borg scale does not show significant reduction in both groups [G1 (pre-Borg: 4,27±2,71 vs. post: 2,88±1,98; p=0,091)] e [G2 (pre-Borg: 4,86±3,30 vs. post: 3,79±2,63; p=0,24)]. When the results between the groups (G1 and G2) were compared after the program, statistically significant difference in the maximum load test was observed only in the right and left sole bending movement, expressively greater in the left one. (G1 Δ: - 0,75 repetitions vs. G2 Δ: 10,46 repetitions, p=0,001). In the other variations studied, no statistically significant difference was observed. Conclusion: Both groups studied had an improved their quality of life and their strength in the stretching and bending knee movements after the pulmonary rehabilitation program. Nevertheless, concomitant strength and resistance training did not seem superior to the isolated leg resistance training.

Introdução: A discrepância no comprimento dos membros inferiores (DCMI) está associada a alterações biomecânicas na marcha e a uma grande variedade de desordens ortopédicas, que incluem uma possível sobrecarga do tendão tibial posterior. Neste sentido, hipotetizamos que há associação entre a presença de DCMI e disfunção do TTP. Objetivo: O presente estudo foi realizado para comparar a frequência e a magnitude de DCMI em um grupo com e outro sem disfunção do tendão tibial posterior (DTTP), bem como para relacionar características clínicas com a presença da doença. Modelo do estudo: Estudo caso-controle. Método: O estudo envolveu 118 pacientes com diagnóstico de DTTP atendidos entre janeiro de 2009 e setembro de 2012 e 118 voluntários controles pareados por gênero e raça. Através de escanometria radiográfica ou tomográfica, a frequência da DCMI, assim como a média da DCMI absoluta e a média da DCMI relativa foram comparadas entre os dois grupos. Resultados: A prevalência da DCMI e as médias da DCMI absoluta e da DCMI relativa foram significativamente maiores no grupo de casos (94,9%, 5,64 mm e 7,36% respectivamente) do que no grupo controle (79,7%, 3,28 mm e 4,18% respectivamente) (p<0.001). Conclusões: Os resultados deste estudo demonstram haver uma relação entre a DCMI e a presença de DTTP. Devido a importantes alterações biomecânicas geradas pela DCMI, esta é possivelmente um fator predisponente para o desenvolvimento da DTTP. / Background: Leg length discrepancy (LLD) is associated with a variety of orthopedic disorders and biomechanical gait changes that involve possible overload of the posterior tibial tendon (PTT). In view of the biomechanical disturbances induced by LLD, an association may exist between LLD and PTT dysfunction (PTTD). Purpose: To compare the frequency and magnitude of LLD between subjects with and without PTTD and ascertain whether associations exist between clinical features and presence of dysfunction. Study design: Casecontrol study. Methods: A total of 118 patients with a diagnosis of PTTD were seen between January 2009 and September 2012 and compared to 118 sex- and race-matched volunteers. The frequency of LLD, the mean absolute LLD and the mean relative LLD were measured by conventional (radiographic) or CT scanography and compared between cases and controls. Results: The prevalence of LLD and mean absolute and relative LLD values were significantly greater in the case group (94.9%, 5.64 mm and 7.36% respectively) than in the control group (79.7%, 3.28 mm and 4.18% respectively) (p<0.001). Conclusion: The findings of this study demonstrate a relationship between LLD and PTTD. In light of the major biomechanical changes it induces, LLD may be a predisposing factor for development of PTTD.