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Deep Vein Thrombosis, a potentially fatal event, occurs when a blood clot forms within the deep veins of the body. This most frequently manifests in the lower extremities. The goal of this research was to build an inexpensive device that could apply therapeutic compressive pressure to the lower leg to aid in the prevention of deep vein thrombosis using only mechanical input from the user. Several different prototypes were designed and built with varying degrees of success. Characterization of the final prototype required calibration of pressure and force measurement sensors. Additionally, a mathematical model was developed in order to predict how changes in the design of the device, as well as differing sizes and shapes of lower legs, would impact the amount of applied pressure. The predictions of this mathematical model were found to be substantially larger when compared against empirical data. However, there is evidence to indicate that the final prototype could be minimally altered to apply ample therapeutic pressure. / Bioengineering

A "Tutor Manual" was developed to facilitate the small group learning experience in the laboratory and tutorial component of the introductory Anatomy and Physiology Nursing course at McMaster University. The manual included a comprehensive discussion of the information and important concepts in the laboratory and tutorial sessions, and provided guidelines on how to facilitate the group effectively in its consideration of the topics. Theoretical educational concepts were considered in the development of this manual, including: lifelong learning; principles of adult learning; the use of small-group discussion in teaching and learning; the role of the facilitator: and the use of objectives. / Thesis / Master of Science (Teaching)

Participatory ergonomics (PE) is a macroergonomics approach in which the end-users actively participate in developing and implementing the technology. PE can be an effective method for involving front-line workers in analyzing and redesigning their own jobs. PE can be used at the macro-level, the micro-level, or somewhere in between. At the macro-level, the focus of the PE program is across an entire organization or work system. At the micro-level, the focus of a PE approach is on a particular task, workstation, or product. A major benefit for using PE is that workers are more likely to accept changes to their job if they participate in the redesign. Furthermore, workers' motivation, job satisfaction, and knowledge are enhanced through the participatory process. There are many case studies that describe successful PE approaches. These studies, however, lack a control group or comparison group and so changes in the workplace (e.g., a reduction of musculoskeletal injury) cannot be attributed directly to the interventions resulting from the PE program with certainty. Quantifying the effects of PE is difficult because of problems in trying to isolate variables. Confounding variables are often difficult to contain. This study quantified some of the effects of PE by utilizing a controlled experimental design in the laboratory in which participants analyzed and redesigned a manual material handling job. The effects of this PE approach were quantified by measuring a reduction of risk factors associated with the job and by measuring a lift index of the lifting task that indicates a risk for injury. Many authors state or infer that some degree of ergonomics training should be given to the participants in a PE approach. However, the effects of providing ergonomics training to participants in these types of participatory approaches are unclear. This research evaluates the effects of providing the participants with basic ergonomics instruction relevant to the job being evaluated and redesigned. Also, this research suggests if the NIOSH lifting equation can be an effective tool in a participatory ergonomics approach in the redesign of a manual material handling job that involves lifting tasks. A 2-factor, between-subjects design was used. Participants consisted of 32 volunteers (16 males and 16 females). Only individuals that have had no prior ergonomics knowledge were considered for the subject pool. Participants performed a simulated manual material handling job in the laboratory. After performing the job, some subjects were given ergonomics training and/or instructed on how to use the NIOSH lifting equation for manual lifting tasks. The participants were then asked to redesign the original job. The participants' redesigns were compared to the redesigns of the control subjects (who received no ergonomics instruction and did not use the NIOSH lifting equation). The subjects who received the ergonomics instruction identified significantly more risk factors in the original job and eliminated significantly more risk factors in the redesign than the control subjects. The subjects who learned and used the NIOSH lifting equation also identified significantly more risk factors in the original job but did not eliminate significantly more risk factors in the redesign. The subjects who received the ergonomics instruction and who used the NIOSH lifting equation were not shown to have an advantage over the subjects who received the ergonomics instruction alone. The group that received the ergonomics training performed optimally with respect to the other experimental groups. Implications for participatory ergonomics approaches are discussed. / Master of Science

PURPOSE: The purpose of this study was twofold: 1. To select and develop two laboratory approaches for teaching basic woodworking technology to students in agricultural mechanics. 2. To compare student performances of the two laboratory approaches both on the college level and on the high school level. PROCEDURES: The development phase of this study involved the selection and preparation of desired student behavioral outcomes, curriculum, content and materials, two laboratory teaching methods, and student performance measuring instruments for basic woodworking technology. One trial comparison experiment was conducted on the college level with two matched groups of juniors enrolled in agricultural mechanics at Virginia Polytechnic Institute. Each group consisted of eight students. One experiment was conducted on the high school level with two matched groups, each consisting of six high school sophomores. The project-oriented laboratory teaching method was selected for use by the control groups of each experiment. The method used by the experimental groups in both experiments was the "timed-learning experience laboratory method." This method was developed by the writer. CONCLUSIONS: The following conclusions were formulated from the data collected in the experiments: 1. In the college experiment the students taught by the "timed-learning experience laboratory method" had a greater average percentage of gain on both the written and the laboratory test than the students taught by the project-oriented method. 2. In the high school experiment the students taught by the "timed-learning experience laboratory method” had a greater average percentage of gain on both the writtten and the laboratory test than the students taught by the project oriented method. / M.S.

O Diabetes Mellitus (DM) é uma doença de grande prevalência, e um dos principais problemas de saúde pública em todo o mundo, tendo como complicações o déficit no desempenho funcional dos membros inferiores, que podem interferir na manutenção do equilíbrio, além de ser um forte preditor de limitações funcionais. Os indivíduos acometidos pelo diabetes apresentam predisposição à redução da mobilidade da articulação tíbio-társica. A terapia manual é frequentemente utilizada com a finalidade de melhorar a amplitude de movimento. O objetivo do estudo foi avaliar o efeito agudo da terapia manual na mobilidade articular do tornozelo de pacientes diabéticos. Foram avaliados 40 voluntários, de ambos os sexos com média de idade de 59,35±7,85 anos, portadores de DM tipo 2 com limitação da amplitude da articulação tíbio-társica, divididos em dois grupos: grupo Sham (GS), submetido a tratamento simulado e follow up de sete dias, e grupo intervenção (GI), submetido a intervenção manual manipulativa e follow up de sete dias. A análise da amplitude de movimento articular foi efetuada por meio de goniometria digital, e a descarga estática de peso avaliada por baropodometria computadorizada com olhos abertos e fechados. A distribuição dos dados foi avaliada pelo teste de normalidade de Shapiro-Wilk. Diante de uma distribuição normal e relacionada, foram utilizados os testes ANOVA seguido de pós-hoc de TuKey. Para as variáveis que apresentaram distribuição não normal, foi utilizado o teste Kruskal-Wallis, seguido do pós-hoc de Dunn. Foi utilizado software estatístico SAS e considerado nível de significância de 5%. Os resultados demonstraram aumento da amplitude de movimento articular, nas flexões plantares e dorsiflexões, direita e esquerda, do GI entre o momento inicial e os momentos pós-manipulação, bem como após sete dias da intervenção terapêutica (follow-up). Também houve diferença significativa entre o GI quando comparado ao GS nos momentos pós e follow-up. Com relação ao efeito clínico da intervenção ao longo do tempo, a análise intragrupo mostrou que no GS não ocorreu diferença entre os registros de amplitude de movimento comparando-se o momento pré-intervenção com os registros subsequentes (pós e follow-up), tanto para os movimentos de flexão plantar como de dorsiflexão, em ambos os lados. Em relação a descarga de peso plantar estática verificou-se alteração de valores registrados para o pico de pressão total no pé, dos lados direito e esquerdo no GI, entre os momentos pós-intervenção imediata e na aferição 7 dias após a intervenção manipulativa (follow-up), para registro com olhos abertos. Com relação às comparações intragrupos ao longo do tempo (pré, pós-intervenção e follow-up), foi observada diferença significativa para a condição amplitude de deslocamento anteroposterior (DAP) com olhos abertos do GI, observando-se incremento após a intervenção e redução no followup. Diante dos resultados obtidos, pode-se inferir que a intervenção aguda com terapia manual produz incremento da amplitude articular do tornozelo de indivíduos diabéticos. / Diabetes Melittus (DM) is a disease of great incidence, and one of the main public health problems worldwide, having as complications the deficit in the functional performance of the lower limbs, which can interfere in the maintenance of the balance, besides being a Strong predictor of functional limitations. Individuals affected by diabetes are predisposed to reduce the mobility of the tibial-tarsal joint. Manual therapy is often used for the purpose of improving range of motion. The objective of this study is to evaluate the acute effect of manual therapy on ankle joint mobility in diabetic patients. 40 volunteers, aged 59,35±7,85 years, DM type 2 and tibial-tarsal joint amplitude limitation, of both genders were recruited, divided into two groups: group 1 (Sham: submitted to evaluations and follow up of seven days), and group 2 (intervention: submitted to the evaluations, manipulative manual intervention, with follow up of seven days). The analysis of joint range of motion was acessed by digital goniometry and the static discharge of weight was evaluated by baropodometry computed with open and closed eyes. After tabulation of variables, the Shapiro-Wilk normality test was applied to analyze the distribution. Before a normal and related distribution, ANOVA followed by Tukey post-hoc tests were used. For the variables that presented a non-normal distribution, the Kruskal-Wallis test was used, followed by the Dunn post-hoc test. For the variables that presented a non-normal distribution, the Kruskal-Wallis test was used, followed by the Dunn post-hoc test. The SAS software was used and a significance level of 5% was considered. The results showed an increase in joint range of motion, in the right and left dorsiflexions of the GI between the initial moment and the postmanipulation moments, as well as after seven days of the follow-up. There was also a significant difference between GI when compared to GS in the post and follow-up moments. Regarding the clinical effect of the intervention over time, the intragroup analysis showed that in GS there was no difference between the amplitude of movement registers comparing the pre-intervention moment with the subsequent records (post and follow-up), even for plantar and dorsiflexion flexion movements on both sides. In relation to static plantar weight discharge, there was a change in recorded values for the peak of total foot pressure, on the right and left sides of the GI, between the moments after the immediate intervention and in the measurement 7 days after the manipulative intervention (follow -up), for registration with open eyes. Regarding intra-group comparisons over time (pre, post-intervention and followup), a significant difference was observed for the condition amplitude of anteroposterior displacement (DAP) with open eyes of the GI, observing an increase after intervention and reduction in the follow-up. In view of the obtained results, it can be inferred that the acute intervention with manual therapy produces an increase in the joint amplitude of the ankle of diabetic individuals

O protocolo de avaliação miofuncional orofacial MBGR é utilizado para avaliação de aspectos morfológicos e funcionais do sistema estomatognático, entretanto, sua publicação não contempla descrições sobre a forma de aplicação, o que facilitaria a utilização e obtenção de resultados com maior reprodutibilidade por diferentes avaliadores. A presente pesquisa teve por objetivo desenvolver um manual de orientações para a aplicação do Protocolo de Avaliação Miofuncional Orofacial MBGR. Para isto, foi desenvolvido um tutorial interativo piloto, por meio de um programa executável, contendo a descrição da aplicação de todos os aspectos contemplados no protocolo MBGR, bem como imagens estáticas e dinâmicas ilustrativas. O conteúdo descritivo foi elaborado por pesquisadoras do grupo em que o projeto está inserido a partir de um roteiro previamente adotado na clínica escola do curso de Fonoaudiologia da Faculdade de Odontologia de Bauru, abordando literatura pertinente selecionada por meio de consulta às bases de dados Lilacs, Pubmed, Web of Science, Science Direct, Medline, Scielo e Cochrane, de acordo com os critérios de inclusão e exclusão adotados. O manual será disponibilizado após o processo de validação e possibilitará a padronização dos procedimentos avaliativos na área de motricidade orofacial, contemplados no referido protocolo. / The MBGR orofacial myofunctional evaluation protocol is used to evaluate morphological and functional aspects of the stomatognathic system, however, its publication does not contemplate descriptions on the form of application, which would facilitate the use and obtaining of results with greater reproducibility by different evaluators. The present research aimed to develop a manual of guidelines for the application of the MBF Orofacial Myofunctional Assessment Protocol. For this, an interactive pilot tutorial was developed, through an executable program, containing the description of the application of all the aspects contemplated in the MBGR protocol, as well as illustrative static and dynamic images. The descriptive content was elaborated by researchers of the group in which the project is inserted from a script previously adopted in the school clinic of the speech therapy course of the Faculty of Dentistry of Bauru, addressing pertinent literature selected through consultation with Lilacs databases, Pubmed, Web of Science, Science Direct, Medline, Scielo and Cochrane, according to the inclusion and exclusion criteria adopted. The manual will be made available after the validation process and will enable the standardization of the evaluation procedures in the area of orofacial motricity, contemplated in the mentioned protocol.

Máquinas manuais são utilizadas em diversos processos, como na usinagem mecânica. Apesar da existência de máquinas automatizadas, com boa precisão e conformidade, as máquinas manuais de usinagem possuem baixo custo inicial e alta flexibilidade de produção, sendo empregadas para produção de lotes pequenos ou peças únicas, como protótipos ou peças empregadas em pesquisas científicas. O operador humano possui mais flexibilidade que qualquer sistema automatizado por ter a capacidade de tomar decisões. O posicionamento da ferramenta de usinagem através de uma mesa linear com parafuso e porca, acionada manualmente com um manípulo, exige perícia do operador e impacta no custo final das peças produzidas. Um dispositivo robótico acoplado ao mecanismo de posicionamento poderia trabalhar em cooperação com o operador humano, sendo utilizado como um recurso optativo para auxiliá-lo na tarefa de posicionamento. Atuadores passivos do tipo freio são seguros para a manipulação humana direta e naturalmente estáveis ao manter uma posição estática, além de baratos e simples. Sendo controlado por computador e com a posição desejada facilmente programável, o freio eliminaria a preocupação do operador com o posicionamento crítico, permitindo concentrar-se em outros detalhes do trabalho de usinagem ao delegar a tarefa de posicionamento ao freio. Literatura ou índices de desempenho escassos e iniciais foram encontrados sobre a utilização de freios neste contexto. Desta forma, este trabalho estuda os mecanismos típicos de máquinas manuais de usinagem e de freios por atrito, propondo então algoritmos de controle e avaliando seu desempenho. Desenvolveu-se dois tipos de controladores para lidar com as fortes não linearidades do atrito e fatores estocásticos do mesmo: um primeiro que utiliza pré-alimentação de um modelo do atuador e um segundo que tenta diminuir a influência de perturbações no posicionamento final diminuindo a velocidade do sistema nas imediações da posição desejada de frenagem. Um protótipo foi montado e permitiu avaliar experimentalmente os algoritmos, que apresentaram bons índices de desempenho que confirmam seu potencial de utilização, baseados em trabalhos anteriores e normas técnicas de tolerâncias gerais. / Manual machines are those with minimum or non-existent automation, being employed in many processes, like in the mechanical machining, where the operator have the task to position a machining tool to manufacture pieces. Despite the existence of automated machines, with good precision and production regularity in its produced pieces, the manual machines has low initial cost and high production flexibility, being used for the production of small or unique batches, like prototypes or pieces for scientific research. The human operator has greater flexibility than any automated system as it has the ability to make decisions. The positioning of the machining tool, thru a linear work table with screw and nut, manually operated by a hand wheel, requires operator skills which impacts the final cost of the manufactured pieces. A robotic device coupled to the positioning mechanism would work in cooperation with the human operator, being used as a resource to help with the task of positioning. Passive actuators, like brakes, are safe for human direct manipulation and naturally stable to maintain a position, despite being simple and cheap. Being computer-controlled, with the desired position easily programmable, the brake would eliminate the operators worry with the positioning task, leaving it to the brake. This work studies typical machine mechanisms of manual machines and friction brakes, leading to the development and evaluation of control algorithms. Two main types of feedback controllers were developed to deal with the brakes hard nonlinearities of friction and stochastic factors: one that uses a feedforward model to compensate for modeled disturbances and a second that tries to lower the disturbances influence by lowering the velocity nearby the desired position. A prototype were built and allowed to experimentally evaluate the proposed algorithms, which presented good performance in relation to early works and tolerance standards.

A migrânea está relacionada às disfunções das estruturas da coluna cervical, impulsos aferentes desse local podem ser facilitadores ou mesmo gatilhos da dor. Tratamentos com manipulação cervical isolada e combinada a medicação já foram testados, porém os resultados são conflitantes. O objetivo desse trabalho foi avaliar o efeito adicional da fisioterapia ao tratamento medicamentoso da migrânea na frequência, intensidade e duração da dor de cabeça. Foram inclusas mulheres com migrânea, na faixa etária de 18 e 55 anos, com mínimo de 06 dias de dor por mês, e que apresentasse dor na região craniocervical através do relato. Cinquenta mulheres foram igualmente randomizadas para um dos dois grupos de tratamento, Grupo Fisioterapia (terapia manual + medicação) e Grupo Controle (medicação). O diagnóstico de migrânea foi realizado por uma única neurologista, segundo a Classificação Internacional de Cefaleias. Foram realizadas 12 sessões de terapia manual, duas vezes por semana, durante 50 minutos, por uma única fisioterapeuta. A avaliação, a reavaliação e follow-up foram cegos. Os desfechos primários de frequência, intensidade e duração da dor de cabeça, foram avaliados por meio do diário de dor; e secundários, Limiar de dor por pressão (Algômetro), incapacidade relacionada à cefaleia (Migraine disability assessment program) e a coluna cervical (Neck disability índex), Patient Health Questionnaire eight-item depression scale (PHQ-8), alodinia com Allodynia Sympton Checklist (ASC- /12) e satisfação com Patients Global Impression of Change Scale (PGIC). A análise foi realizada por intenção de tratamento e foi utilizado o Modelo Linear de efeitos mistos e para atribuir relevância clínica o Effect size (ES) e Mínima mudança importante (MID). Não foram observadas diferenças entre os grupos na avaliação inicial. O GF apresentou redução de 37% na frequência de dias de dor de cabeça comparado ao GC que apresentou 22% (p<0.05 e ES 0,4) e (p<0.05 e ES 0,3) respectivamente. Não foram observadas diferenças clínicas significativas entre os grupos na duração e na intensidade da dor de cabeça. Também foi observado aumento significativo (p<0,05) do limiar de dor por pressão, bem como maior satisfação e percepção de mudança da doença ao paciente (p<0,05) no GF em comparação ao GC. Não foram observadas diferenças significativas nos demais parâmetros avaliados. A redução do limiar de dor dos músculos cervicais com o tratamento fisioterapêutico promoveu um efeito benéfico adicional ao medicamentoso, com maior redução da frequência de dias de dor de cabeça e maior satisfação e percepção de melhora dos pacientes. REBEC nº RBR-6kvx74 / Migraine is related to disorders of the cervical spine structures, afferent impulses that location can be facilitators or even triggers pain. Treatments with cervical manipulation alone and combined medication have been tested, but results are conflicting. The aim of this study was to evaluate the additional effect of physical therapy to drug treatment of migraine in frequency, intensity and duration of headache. Women with migraine were included, aged 18 to 55 years, with a minimum of 06 days of pain per month and report of pain in the craniocervical region. Fifty women were equally randomized to one of the two treatment groups, Physiotherapy Group (manual therapy and medication) and control group (medication). The diagnosis of migraine was performed according to the International Classification of headache by a single neurologist. All subjects received similar medications. 12 sessions of manual therapy, twice per week, during for 50 minutes, were done by same physical therapist. The assessment, revaluation and follow-up were blind. The primary endpoints of frequency, intensity and duration of headache were evaluated through diary pain, and secondary endpoints like pain threshold pressure (algometer), headache related disability (Migraine disability assessment program) and cervical spine (Neck disability index), patient Health Questionnaire eight- item depression scale (PHQ-8), with the severity of Allodynia Sympton Checklist (ASC-12) and patients Global Impression of Change Scale to assess satisfaction and perception of patient changes as its disease condition. The analysis was by intention to treat and we used the linear mixed effects model. To assign the clinical relevance Effect size (ES) and Minimum important change (MID) were used. No differences between groups were observed at baseline. The PG showed a 37% reduction in the frequency of headache days compared to GC showed that 22 % (p<0.05 to ES0.4) and (p<0.05 to ES0.3) respectively. No clinically significant differences were observed between groups regarding the duration and intensity of the headache. Significant increase (p<0.05) pain threshold pressure was also observed, as well as greater satisfaction and changing perception of the disease to the patient (p<0.05) in the PG compared with the CG. No significant differences were observed in the other parameters. The reduction of the pain threshold of cervical muscles with physical therapy promoted a beneficial additional effect to medication, with greater reduction in frequency of headache days and greater satisfaction and perceived improvement of patients. REBEC no RBR - 6kvx74