No description available.

Objectives: To describe the relationship between sensorimotor function and walking in incomplete SCI. Methods: 25 subjects were assessed using Lower Extremity Motor (LEMS) and Pinprick (LEPS) scores, and 7 walking measures: FIM-Locomotor Score, Assistive Device Score, Walking Index for SCI, 10-metre Walk Test (10mWT), Timed Up and Go (TUG), Six-Minute Walk Test (6MWT) and Walking Mobility Scale. Results: Walking and sensorimotor function varied between subjects. Walking measures significantly correlated with LEMS and individual leg muscles but not LEPS. 21/22 ambulatory subjects had LEMS threshold>20. Non-ambulatory subjects didn’t achieve threshold. Not all subjects completed all walking measures: 10mWT: n=19; TUG: n=14, 6MWT: n=13. Most walking measures were significantly related. 10mWT and 6MWT were highly correlated. Subjects walking0.95 m/s didn’t reach predicted 6MWT. Conclusion: Lower extremity strength is important for walking and should be further examined with other factors in a range of subjects across different measures to fully understand these relationships.

Larger and stronger muscles are positively associated with bone strength in the growing skeleton; however, less is known about the role of muscle properties on bone strength later in life. The primary objective of this study was to examine the relationship between muscle cross sectional area (MCSA), muscle force and rate of torque development (RTD) with bone strength indices (bone strength index (BSI) and strength strain index (SSI)) in the radius of healthy middle-aged adults. All bone and muscle measurements were determined in the non-dominant forearm in a sample of 40 healthy adults (23 men, 17 women: mean age 49.5, SD 2.3 yrs). Peripheral quantitative computer tomography (pQCT) was used to scan the distal and shaft sites of the radius bone in the forearm. MCSA was determined from the forearm shaft scan. Forearm muscle force was measured by hand grip dynamometry and RTD was obtained from isometric wrist flexion from an isokinetic dynamometry protocol. Hierarchical regression analyses were used to identify whether muscle properties (MCSA, grip force, and RTD) independently predicted radius bone strength indices (BSI and SSI), after adjusting for the confounders of sex, height and weight. Steps of the regression models that included sex, height, weight and a muscle property explained between 66% and 71% of variance in distal radius BSI and between 74% and 78% variance of estimated bone strength (SSI) at the shaft site (all steps p<0.001). MCSA explained a significant amount of variance in BSI (R2=0.08; p<0.01) and SSI (R2=0.04; p<0.05) at the radius. Grip force was also a significant predictor of SSI (R2=0.05; p<0.01) but not distal radius BSI (R2=0.03; p=0.07). Conversely, RTD explained a significant amount of variance in bone strength at the distal radius (R2=0.04; p<0.05), but not at the shaft (R2=0.01; p=0.17). These cross sectional findings support the theory that regional muscle size, force, and rate of torque development are related to estimated bone strength in the forearm at midlife. Further research should focus on targeted interventions to help determine which muscle property elicits a greater osteogenic response to optimize bone strength at distal and shaft sites of the radius.

Purpose: To evaluate the course of recovery in fall-risk and functional status over the first year following a distal radius fracture (DRF), and evaluate differences in fall and fracture risk factors in women over the age of 50 years with a DRF compared to their non-fractured peers. Methods: Two cohorts of participants volunteered in two sub-studies of the thesis. The first was seventy-eight women recruited from a DRF Clinic within the first week after their fracture, and followed up in concert with standard clinic appointments at week three, nine, 12, 26, and 52 post-fracture. The second cohort consisted of women aged 50 years or older, with and without a recent distal radius fracture, being at least 6 months post-DRF, but no more than 2 years post-fracture. Seventy-seven women age 50-78 with (Fx, n = 32) and without (NFx = 45) a history of DRF were assessed on two occasions within 4 weeks apart using a battery of fall and fracture risk tools, including balance, mobility, gait speed, fracture risk assessment, as well as bone quality assessment using peripheral quantitative computer tomography (pQCT) and dual x-ray absorptiometry (DXA). Results: Fall-risk status (strength, balance, mobility) gradually improved over the first year post-fracture, with balance confidence remaining high even immediately post-fracture. In the second study, women with a recent DRF, compared to women without, demonstrated higher fall and fracture risk. Women with a recent DRF had lower bone and muscle strength in both the upper and lower extremities compared to the non-fractured controls, with no differences in DXA derived aBMD at the femoral neck or spine. Significance of findings: The results of these studies will help clinicians understand the normal course of functional recovery post-fracture, and assist in determining appropriate fall risk assessment and interventions for post-menopausal women at risk of fragility fracture. Results demonstrate the importance of studying women at risk of DRF as an important first indicator of bone fragility and risk of future fracture. These findings also strengthen the notion that DXA alone may not be the best predictor for fracture risk.

No description available.

Rationale: Chronic obstructive pulmonary disease (COPD) is not only a common lung disease but is a major cause of morbidity and mortality worldwide. Pulmonary rehabilitation (PR) helps optimize function and independence by increasing exercise capacity, reducing symptoms and improving health related quality of life (HRQL). Exercise training is certainly a key component of the PR programs; however, many of its aspects still need to be better defined such as optimal exercise assessment and training modality for these patients. The general purpose of this thesis was to generate new knowledge that could contribute to new strategies for exercise assessment and training in patients with COPD. Methods and results: This thesis is comprised of four independent studies. Thigh muscle strength, endurance and fatigue were compared between 42 patients with moderate to severe COPD and 53 healthy controls (Study I). Impaired thigh muscle strength and endurance in patients with COPD was found, except for muscle strength in knee extension in male patients. Female patients had higher fatigue index than female controls while no difference was found between male patients and controls. The six-minute walk test (6MWD) performed on a non-motorized treadmill (6MWD-T) was compared with the 6MWD performed in a corridor (6MWD-C) in 16 healthy elderly subjects (Study II). They performed twelve tests (six 6MWD-C and six 6MWD-T) on two different days in a randomized order. An average discrepancy was found between the two methods with the subjects walking a shorter distance on the non-motorized treadmill. However, the results showed good test-retest reliability between days and test repetitions. A systematic review (Study III) was done of studies that investigated the effects of an arm training program in patients with COPD. The findings of this review indicated that there is evidence that an arm training program improves arm exercise capacity, but its effects on dyspnea, arm fatigue and healthy-related quality of life is unclear. Finally, a two-armed randomized controlled trial examined the effects of an arm training program on arm function, arm exercise capacity, muscle strength, symptoms and HRQL in patients with COPD (Study IV). The groups were randomized to arm training or sham. Compared with the changes observed in the control group, the magnitude of change in the intervention group was greater for arm function, arm exercise capacity and muscle strength. There was no difference between groups in HRQL or symptoms. Conclusions: Upper extremity resistance training improves arm exercise capacity, arm function and muscle strength in patients with COPD. Training and assessment of upper and lower limb muscles should be included into PR programs. The 6MWD performed on a non-motorized treadmill may offer an alternative option to the standard 6MWD when a 30-meter corridor is not available.

No description available.

The progression of knee osteoarthritis (OA), the most common cause of physical disability in older adults, is influenced by muscular and biomechanical factors. Reliability of muscular and biomechanical measures, including knee muscle strength and limb alignment, is critical. Furthermore, conservative interventions that slow the course of OA disease progression and prevent disability are urgently needed. The objectives of this thesis were to: 1) investigate the reliability of measures of knee muscle strength and alignment in persons with knee OA, and 2) determine the influence of an exercise intervention targeting hip muscles on knee joint loading in those with medial knee OA. In the first study reliability of knee muscle strength measures was evaluated within one testing session in 40 persons with knee OA. Isometric and isokinetic peak torque values for the quadriceps and hamstring muscles demonstrated high degrees of intra-session reliability. Reliability of lower limb alignment measures was determined following a bone landmark-based approach with use of a computer program. Excellent reliability coefficients were found which compared favorably with reliability of manual measures from schematics of limb deformities drawn with AutoCAD® software. When the computer method was applied to 100 full-limb radiographs of persons with or at risk for knee OA, alignment measures demonstrated high inter- and intra-reader reliability. Hip muscle weakness may influence loading of the medial knee compartment. Hip abductor strength was evaluated in 40 individuals with medial compartment knee OA in comparison to a control group of 40 healthy older adults. The effect of an 8-week home-based hip abductor strengthening program on the knee adduction moment was also assessed in this group with knee OA, compared with the control group which received no intervention. Following the exercise program the OA group demonstrated improvements in hip abductor strength and functional performance on a sit-to-stand task. There were no changes in the knee adduction moment. Thus, hip muscle strengthening did not influence joint loading, but may improve function in persons with knee OA. Results from this thesis provide increased understanding of knee OA, from muscular and biomechanical perspectives, in the areas of measurement reliability and exercise intervention. / Thesis (Ph.D, Rehabilitation Science) -- Queen's University, 2008-09-25 01:29:13.675

Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic, Durban University of Technology, 2008. x, 52 leaves, Appendices A-E, [25] leaves. / To determine whether a relationship exists between core stability and bowling speed in Action Cricket bowlers. Methods: Thirty asymptomatic indoor Action Cricket fast and fast-medium bowlers were divided into two groups of 15 each, with Group A having well-developed core stability and group B having poorly-developed core stability. The concept of matched pairs was used for age and cricket experience in order to maintain homogeneity between the groups. The core stability and bowling speed of each participant was measured using a pressure biofeedback unit (PBU) and speed sports radar respectively. SPSS version 15.0 was used to analyse the data.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic at the Durban University of Technology, 2009 / Objectives: When we consider the body position of a field hockey player, the lumbar spine is always in a flexed position, which combined with rotational movements during various hitting and pushing techniques, increases the strain upon the spine and surrounding muscles, thus leading to low back pain. To determine the relationship between core strength and trunk extensor endurance relating to the incidence of acute low back pain in field hockey players. Project Design: The research project was in the form of a quantitative cross-sectional study, using human subjects. Setting: The research project occurred during the field hockey season (2008) with players who had acute low back pain. The players were clinically assessed and subdivided into necessary groups at the Chiropractic Day Clinic at the Durban Institute of Technology. Subjects: Adult, male patients, aged between 18 and 30 years of age, playing premier field hockey. Out of the thirty players, 12 players have played in the National u/21 squad, 7 players have played in a Junior National team and 11 players have played senior provincial field hockey. Outcome measure: This included three tests. Firstly, the absolute difference of pressure from the reference value of 70mmHg (prone) and 40mmHg (supine) was used as the outcome measure on a Pressure Biofeedback Unit and length of time (in seconds), a correct contraction of the core stability muscles was maintained. Secondly, the length of time (in seconds) for Trunk Extensor Endurance. Thirdly, repeated measures for NRS-101 and Quebec Back Pain Disability Scale for the duration of the research period. v Results: It was found that there was no statistical evidence or convincing trend to show that the training programmes (core stability and trunk extensor endurance) increased the subjects’ core strength or trunk extensor endurance in the time allocated, although there seemed to be a placebo effect in the Trunk Extensor Group, which showed improvement in some of the core stability outcomes. There was statistical evidence that the intervention (training programmes) reduced pain, according to the Quebec Back Pain Disability Scale (Quebec) score over time, and a non-significant trend suggested this according to the Numerical Rating Scale-101 (NRS). Since both groups’ NRS and Quebec scores were not significantly different at baseline, the difference can be attributed to the effect of the intervention. Conclusions: The results of this study found that the Trunk Extensor Endurance Group, that performed the trunk extensor endurance training programme, yielded better results in core stability and trunk extensor endurance. However, the Core Stability Group, that performed the core stability training programme, showed a quicker reduction in pain levels during the three week intervention period. Therefore, by combining both training programmes, future rehabilitation of athletes suffering from acute low back pain will be more successful. Sport performance of the athletes (field hockey players), through the proponents of swiss ball training, will also improve.