Correct muscular activation of the body segments during an overhand throw is achieved when movement originates in the larger and more proximal legs and trunk and moves sequentially to the smaller, distal segments of the shoulder and arm. This sequence permits angular velocity to transfer progressively through the throw as part of an open kinetic chain. The athlete can summate angular velocity and segmental forces only if he is able to create a separation between the body segments during the movement pattern, and this separation is thus essential to effective segmental sequencing for activation of the trunk muscles to occur separately from distal segment motion. Limited mobility of the shoulder and scapula during the kinematic sequence will limit the ability of that segment to receive and contribute to the angular velocity of its proximal neighbors and to apply its own muscle torque to the throwing implement. This may result in compensatory motion of the proximal muscle groups to meet the demands placed on the body. To establish a link between compensatory activation of the trunk muscles and mobility in the rotator cuff and to apply this relationship to the pattern of the overhand throw, activity in the latissimus dorsi and external oblique/quadratus lumborum muscles was measured using surface electromyography in 40 college-age participants during arm flexion and lateral shoulder rotation. Muscle activation was recorded both before and after mobilization of relevant throwing muscles through targeted functional exercise. Results showed no significant change but suggested a general decrease in the level of peak muscle activation after participants engaged shoulder exercises. This is indicative of a downward trend in compensatory trunk activation during the initiation of shoulder motion. An increase in overall trunk muscle activity was also observed after exercise, which may imply a simultaneous engagement of the proximal throwing muscles in response to shoulder motion.

Neurons in the spinal cord do not spontaneously regenerate, which often leads to debilitating injuries. One method proposed to promote axonal regeneration is the injection of viruses carrying genes for growth factors into the injured spinal cord. One such virus, the adeno-associated virus (AAV), has shown promise in gene therapy medical research. However, injecting AAV into rhesus macaques with C7 spinal cord hemisection lesions actually leads to motor neuron loss in the gray matter of the spinal cord, rather than contributing to the preservation or regeneration of axons. This unexpected result highlights the necessity of further testing with therapeutic approaches for axon regeneration in nonhuman primate models before moving into clinical trials. It is possible that an immune-related T cell response to the AAV-transfected cells causes this motor neuron loss. T cells are white blood cells that play a role in attacking cells infected with viruses. It is unknown whether such a response of the immune system to respond with an up-regulation of T cells may be taking place over a relatively short period (weeks) or over many months. This question was tested here: T cells were stained in spinal cord sections caudal (below) the lesion in the spinal cord and near AAV injection sites to determine whether there was a greater quantity of T cells in these areas compared to the subject’s baseline levels. Subjects that had AAV therapeutic injections and that were examined 6 months after the injection were found to have greater quantities of T cells than those who did not have injections containing AAV. It was also found that the AAV-injected subjects examined only 6 weeks post injection did not have greater quantities of T cells than control subjects. These results suggest that there may be a delayed immune response to the AAV injections in nonhuman primates with spinal cord injury, which occurs over a period of months. Pinpointing the mechanism that causes this cell death would allow researchers to create a safer therapeutic that could promote axonal growth in people with spinal cord injuries.

Self-care can be seen as not only critical for individual professionals, but also for the growth of the helping professions and the quality of care which clients receive. The purpose of this study was to investigate use of career-sustaining behaviors and the levels of professional quality of life in music therapy professionals. This study investigated research questions regarding use of career sustaining behaviors and levels of professional quality of life, the relationship between these variables, the differences in the use of career sustaining behavior by demographics, and the use of music as a self-care strategy. An online survey was sent to all professional members of the American Music Therapy Association. A total of 403 participants were included in the study for the purposes of data analysis. Findings from the study indicate that music therapy professionals are in the average to low ranges for burnout and secondary traumatic stress. However, a portion of the sample was identified to be at risk for these factors. Differences existed in the use of career sustaining behaviors between demographic variables, indicating self-care behaviors vary among professionals. The field of music therapy should further investigate these areas to best provide opportunities for professional self-care.

Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder that affects women’s menstrual cycles, androgen (male hormones) levels, and cysts on the ovaries. This endocrine disorder has various symptoms, with insulin resistance as a hallmark symptom. Approximately 65-70% of women with PCOS have insulin resistance and hyperinsulinemia, whether or not they are overweight, obese, or lean (Marshall & Dunaif, 2012). Many women with PCOS struggle to lose weight because their excess weight is related to nutrition, lifestyle factors, and imbalanced hormones. Understanding PCOS as a metabolic disorder with nutritional implications led to investigating the potential benefit of having registered dietitian nutritionists (RDN) as part of the healthcare team of women with PCOS. We developed a survey based on the literature on PCOS, diet/nutrition interventions, and the role of RDNs in the healthcare team of PCOS women of childbearing age. Only childbearing-age women (18–44) diagnosed with PCOS were eligible to complete the survey. The survey was designed as a needs assessment to determine if women with PCOS are routinely referred to RDNs for support; whether or not such support is beneficial; and what gaps in knowledge or misconceptions about nutrition and PCOS exist among participants. Most importantly, it was designed to examine if women understand how nutrition relates to managing their PCOS symptoms and future disease risks. The data from this survey shows the need for RDNs on the healthcare team of women with PCOS and gives us an understanding of nutrition education interventions that could be developed for future studies. Understanding how RDNs play a role in symptom management could lead to a better quality of life for women with PCOS.

Massage is often recommended to athletes to facilitate recovery and attenuate DOMS. The purpose of this study was to investigate the effects of massage on perceived muscle soreness and pain, inflammatory and immune markers, ROM, and mood state. Fourteen, recreationally active, women participated in a randomized crossover design study, consisting of 1) 60 min. full body massage following unaccustomed exercise and 2) 60 min. of rest. following unaccustomed exercise. Perceived muscle soreness and pain, active range of motion (ROM), mood state, along with blood concentrations of interleukin-6 (IL-6), C-reactive protein (CRP), creatine kinase (CK), and neutrophil count (NC), was assessed at baseline, 4hrs, and 24hrs following both treatment and control conditions. The aims of this study were 1) to decrease the effects of delayed onset muscle soreness (DOMS), and increase time to recover, and 2) to investigate the effect of massage vs. passive rest on inflammatory and immune markers within the blood. We hypothesized 1) an increase in ROM, a decrease in perceived physical soreness and perceived physical pain, as a result of the massage, compared to control, and 2) a decrease in blood plasma inflammatory markers, CRP, NC, CK, and IL-6, as a result of the massage, compared to control. We found massage following exercise to 1) significantly decreased perceived pain (p=0.001), 2) significantly increased immune iv markers (WBC (p=0.012) and NC (p=0.012)), and 3) significantly decreased ROM (p=0.02), compared to control. Massage had no impact on inflammatory markers (IL-6, CRP, and CK), or mood.

The overall purpose of the present study was to examine the strategies used by older adults with regard to both foot placement and hand contact location as they enter (ingress) and exit (egress) a vehicle. A cross-sectional study was used to identify and, in turn, examine the participants’ ingress and egress strategies in relation to their physical mobility and other characteristics. All participants had a valid driver’s license and they completed the following: 1) demographic (self-report) questionnaires; 2) clinical measures of physical mobility (i.e. Timed Up and Go, Berg Balance Scale, One Legged Stance test, Rapid Pace Walk test). A physical mobility index was also developed using these clinical measures. During both ingress and egress, older drivers were more likely to use one-foot strategies, which are considered less stable. Participants who used one-foot ingress and egress strategies had better overall physical mobility. The armrest location was used by the majority of older drivers for both ingress and egress, and is used most often during one-foot strategies. Participants who used multiple hand contact locations during ingress/egress had lower physical mobility than participants who used a single hand contact location or made no contact with the vehicle. Finally, the results from this study can inform educational materials targeting this population and determining design changes to the automobile that can prevent injuries to older drivers. / Thesis / Master of Health Sciences (MSc)

The purpose of this study is to determine the effects of increased resistance training frequency on strength and hypertrophy in trained individuals. Six Studies were deemed eligible based on the inclusion exclusion criteria. The inclusion criteria for this review were healthy trained individuals. “Trained” refers to over one year of resistance training experience. Exclusion Criteria were study’s that examined either untrained or obese individuals as participants. The evidence indicates a dose-response trend in frequency. Resistance training each muscle group twice a week may be superior compared to once per week. Further more, resistance training each muscle group three times a week may enhance hypertrophy and strength adaptations even more compared to either once or twice a week. Recovery of the muscle may be reached in approximately 72 hours or 3 days. Mechanisms that may correlate to this phenomenon could be related to the more frequent elevations in muscle protein synthesis and physiological anabolic hormones. These results may help develop more specific guidelines in programming for intermediate to advanced athletes as well as lead way to more research on acute training variable manipulation.

<p><strong>Purpose:</strong></p> <p>The purpose of this study was to determine what cut-off of the Orebro Musculoskeletal Pain Screening Questionnaire score will best differentiate workers with acute musculoskeletal injuries at-risk for delayed return to work (greater than 3 months), in a population of workers of less than 3 weeks injury duration.</p> <p><strong>Study Design:</strong></p> <p>Retrospective cohort design, using a sample of convenience.</p> <p><strong>Methods:</strong></p> <p>A sample of 259 consecutive WCB patients seeking assessment and treatment at a multidisciplinary rehabilitation facility were reviewed, with 152 meeting the inclusion criteria of having sustained a soft tissue injury within 3 weeks of initial assessment. Descriptive statistics, tests of difference between Time 1 and Time 2 OMPSQ scores and Receiver Operator Characteristic curves were generated. The method of determining predictive ability of the OMPSQ at two points in time was by means of ROC analysis.</p> <p><strong>Results:</strong></p> <p>This study determined that the OMPSQ is moderately predictive of failure to achieve timely return to work (RTW) in a population of injured workers with acute musculoskeletal soft tissue injuries, when assessed two-weeks after treatment is initiated, and less predictive at the initial intake into treatment. Delayed RTW was defined as those workers who had not returned to their pre-injury job full time by 90 days, due to reduced functional ability as it related to their pre-injury occupation.</p> <p><strong>Conclusions:</strong></p> <p>This study demonstrates that there is variability in cut-off scores across studies. Future research should attempt to define cut-off scores as they relate to the population , outcome, condition and time-frame of interest . <strong></strong></p> / Master of Science Rehabilitation Science (MSc)

<p>It is well established that physical activity can improve aspects of physical fitness in individuals with spinal cord injury (SCI). Despite reports of declining health and fitness post-discharge from rehabilitation, there is a limited amount of research exploring exercise status or interventions during this period. The purpose of this dissertation was to investigate the integration of structured exercise into the rehabilitation process following SCI, and to optimize the exercise prescription in the community setting. Findings from the first study indicated that exercise is well tolerated among individuals with sub-acute SCI; performance of a peak exercise test on an arm ergometer was feasible for all injury types. At this stage post-injury, interventions should be mindful of the greater risk of orthostatic intolerance in individuals with complete tetraplegia and focus on building task specific self-efficacy. The second study involved a direct referral and physical activity counselling intervention post-discharge. Adherence rates were excellent among those participants who received the intervention suggesting that this model of care can facilitate adherence to community exercise after discharge.</p> <p>The final two studies took place in the community. Several modes of adapted exercise were compared and findings indicated that while there were no differences in measures of physiological intensity or enjoyment between the different modes, arm-only exercise was perceived as safer than passive hybrid (arm and leg) exercise. Further, the validity of using ratings of perceived exertion (RPE) to attain prescribed exercise intensity was established. The efficacy of the physical activity guidelines for improving fitness in adults with SCI were evaluated in a community-based randomized controlled trial and the results revealed that the guidelines were effective in improving both aerobic capacity and muscle strength. Taken together, this series of studies describes a model of care that links rehabilitation with community exercise and suggests options for sustained engagement.</p> / Doctor of Philosophy (PhD)

Despite a marked increase in the use of digital games among older persons, there is insufficient research that provides insight into the gaming experiences of this population. A major demographic shift within the senior gaming market has ushered in a new perspective on the use of digital games as a tool for physical and cognitive health, and improved socialization. It is proposed that individual notions of play, which are developed over the life course, influence digital game play engagement and interaction preferences, and contribute to well-being. This study explored how self-perceptions of play over the course of the senior gamer’s life influence digital game engagement. Because the emerging area of senior gaming lacks theoretical structure, grounded theory methodology was employed. A qualitative study based on semi-structured interviews of aging gamers was conducted. A total of forty participants (age 44 to 77 with a digital gameplay average of 11 hours per week) were identified and interviewed with the aid of an interview guide. Designed with a life course perspective in mind, this guide sought to explore each participant’s perception of play, personal forms of play throughout their life, and the role of digital games as a component of play in old age. Transcription and analysis (open, axial, and selective coding utilizing the method of constant comparisons) was employed throughout the entire interview process. Findings indicated that digital gaming is a valued form of play and a means for play continuity. An analysis of emergent themes led to the development of a theory that emphasizes three domains: ability, motivation, and experience. Two theoretical models that represent the static and dynamic nature of these domains within the life of a gamer demonstrate the theory. This theory provides understanding of the key factors that influence gameplay, which has the potential of being applied toward the development of better age- and ability-appropriate digital games for aging gamers.