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Thesis (Ph. D)--Oregon State University, 1984. / Typescript (photocopy). Includes bibliographical references (leaves 80-89). Also available online.

Lower Extremity Lymphedema is a chronic condition of characterized by swelling of body part. It is typically treated with Complex Decongestive Therapy (CDT) to reduce volume. While volume reduction is the primary goal of the treatment, third party payers often require the presence of activity limitations in order to qualify for coverage. The purpose of this dissertation was to identify the types of impairments and functional limitations that occur in this population. A second goal was to determine if volume reduction from CDT is sufficient to resolve the impairments and activity limitations associated with lymphedema, or if traditional physical therapy is necessary to resolve them. In Chapter 2, we performed a study to validate several tools to measure the change in volume that occurred with CDT. Also, a reliability study was performed on the Perometer. The results of this study found that the Perometer had excellent test-retest reliability ( ICC = .99) and that the change measured by the Perometer agreed better with the change measured by the "gold standard" water displacement method, (ICC = .99) than did the change measured by the circumferential tape method (ICC = .92). In Chapter 3, we conducted a cross sectional analysis to determine the baseline impairments and activity limitations associated with lower limb lymphedema. Subjects scored below normal values in all measures of impairments and activity limitations including active range of motion to ankle dorsiflexion and knee flexion, Heel Rise, 30 Second Chair test, Berg Balance Score (BBS), Limits of Stability (LOS), Extended Timed Get Up and Go (ETGUG), Limitation in Mobility Activities Test (LIMAT) and SF-36 Medical Outcomes Study (SF-36). Subjects with severe vs. moderate lymphedema demonstrated scored significantly worse on all tests except ETGUG. Limb Volume was correlated at a fair level with all impairment and activity limitation measures except SF36 which produced a strong correlation. Impairment measures correlated strongly with activity limitations. In Chapter 4, we performed a longitudinal study to address several questions. Were reductions in limb volume related to improvements in impairments and activity limitations? What proportion of subjects completing 2- weeks of CDT continued to have balance impairments or activity limitations severe enough to increase the risk of falling? In subjects at increased risk of falling, does a 4-week standard physical therapy intervention produce improvements in both impairments and the activity limitations? The change in limb volume was significant after the 2 week CDT intervention. However, the loss of volume was not strongly associated with an improvement in impairments or an increase in function over the two week or additional 4 week treatment intervention. Traditional physical therapy intervention produced significant improvements in activity limitations and body function impairments. In Chapter 5, we discussed the clinical and health care policy implications of this research. It was determined that the standard CDT treatment protocol was not sufficient to address impairments and activity limitations other than edema in subjects with lower limb lymphedema. A comprehensive evaluation of these patients requires a traditional physical therapy examination in addition to the volume evaluation to assess the associated impairments and activity limitations. Third party payer coverage guidelines require that the patient be educated to maintain the reduction in limb volume achieved by CDT. This study found a worsening of the edema occurred 4 weeks after termination of the CDT. Policy guidelines were originally developed for individuals with upper extremity lymphedema and may need to be modified for subjects with lower limb edema because of substantial differences in the types of impairments and limitations in mobility and function that occur when the lower limb is involved.

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There is limited understanding of the relationship between physical activity (PA), mobility and psychological constructs for the prevention/management of osteoporosis fractures in older adult women. PURPOSE: To examine PA patterns and the relationship of PA to mobility, psychological constructs and osteoporosis fracture risk. METHODS: Participants (N=41, ages 70-92, BMI 27.2 (6.1)) completed a general questionnaire, the ABC balance scale, MHLOC locus of control scale, as well as completing mobility tests (TUG and STS). PA was assessed using 5 day pedometry and accelerometry (Biotrainer Pro). RESULTS: The average PA was very low (energy expenditure 225.4 (152.9) kcals/day; activity time 101.8 (42.3) min; step count 4,516 (3,227)). The mobility scores were within the acceptable range (TUG 9.2 (3.8) s; STS 14.2 (6.4) s). Correlations with physical activity: TUG (p<0.05); ABC (p<0.05); Powerful MHLOC (p<0.01, p<0.05). No significant correlations with Internal MHLOC. CONCLUSION: Sedentary PA patterns correlated to poor mobility, low balance confidence and greater fracture risk. Pedometry and accelerometry measured PA demonstrated the importance of multiple methods of PA assessment in understanding the lifestyles of this population. The results aid in identification of factors that can be modified to enhance the quality of life of this population. / October 2008

Terahertz time-domain spectroscopy (THz-TDS) is a powerful non-contact optical technique for characterizing materials and sub-picosecond dynamic behavior in the far-infrared region (100 GHz --- 10 THz) of the electromagnetic spectrum. As a young field (less than 25 years old), the terahertz spectral properties of many materials and physical processes remain unexplored. One of the most interesting, and fundamentally important, uncharacterized phenomena is the phase behavior of condensed matter systems. Normal ( n)-alkanes are molecules of particular interest since they are linear, straight-chain hydrocarbons that are structurally simple and have melting points near room temperature. Using a custom designed spectrometer and sample cell, we characterize the terahertz optical properties of various liquid branched and n-alkanes (C5H12 - C16H34) and use this as the basis to conduct imaging studies of a two-component surfactant/octane system to discern the content across the boundary layer. This prefaced our characterization of the phase behavior of longer n-alkanes where we observed novel temperature-dependent absorption features in the equilibrium non-liquid phases of n-tricosane (C23H48) through n-hexacosane (C26H54). These spectroscopic features have never previously been observed in non-polar (infrared inactive) materials, and provide new insight into the crystallization dynamics of organic molecular solids.

Plasmon resonances control the electromagnetic near field and far field properties of various metallic nanostructures (e.g. nanoparticles, nanoshells, metallic thin films). The enhanced electromagnetic near field, strongest at the surface of the nanostructures, has been successfully exploited for a variety of surface enhanced spectroscopies. Visible and near-IR surface enhanced Raman spectroscopy (SERS) is an example of such surface enhanced spectroscopic technique that has attracted substantial attention due to its huge enhancement factors (&sim; 108-109) and wide range of applications. However, surface enhanced Infrared absorption (SEIRA) spectroscopy, complementary to SERS, has not received nearly the same attention because engineering the necessary strong near fields in the mid-IR is challenging. This thesis is an effort for developing rationally designed Au nanoshell based substrates for SEIRA and for combining SERS and SEIRA to unify the field of surface enhanced vibrational spectroscopy for comprehensive biochemical sensing applications. Specifically, this thesis describes the utilization of inteparticle junction hot spots for SEIRA. Aggregates of near---IR resonant nanoshells with naturally occurring junction hot spots are demonstrated to be excellent SEIRA substrates with high enhancement factors (103-104 ). Applications of SEIRA in conjunction with SERS (exploiting near fields from single particle plasmon of nanoshells) is demonstrated for a variety of biologically relevant processes such as adsorption, local orientation and binding of adenine and adeninemonophosphate (AMP) on Au nanoshell surface, intercalation of ibuprofen in hybrid lipid membranes, and lipid transfer/exchange between hybrid lipid bilayers and vesicles. Finally, the random aggregate geometry for SEIRA is elegantly extended into 2D periodic array of nanoshells that truly unifies SERS and SEIRA on a common single substrate by simultaneously enhancing both Raman and Infrared signals in two diverse frequency regimes with high spectral sensitivity.

In this thesis, I present the absorption and scattering properties of single gold nanoparticles. I performed scanning electron microscopy (SEM) correlated dark-field scattering studies of gold nanorods (AuNRs). I found polarization-dependent scattering of a single AuNR. I studied the dependence of surface plasmon resonance (SPR) linewidth on both the refractive index of a surrounding medium and the adsorption of thiol groups onto the surface of AuNRs. I found that the SPR wavelength (lambdamax) shifts to longer wavelength when increasing the refractive index of the surrounding medium, while the SPR linewidth remains almost constant when increasing the refractive index of the surrounding environment. I also found that SPR wavelength shifts to longer wavelength as thiol groups bind to the surface of a single AuNR and that the SPR linewidth is broadened. I carried out photothermal imaging of gold nanospheres. The successful imaging of gold nanospheres down to 10 nm, which cannot be studied by conventional scattering-based methods, was achieved with a signal to noise (S/N) ratio of &sim;35. I studied the size dependence of the photothermal signal of gold nanospheres with diameters ranging from 30 to 250 nm. The experimental results showed a very good agreement with Mie calculations for absorption of nanospheres. I further investigated polarization-dependent photothermal imaging of single AuNRs. It is observed that both gold nanowires and AuNRs show a polarization dependence in photothermal imaging. I utilized polarized photothermal imaging to determine the orientation of AuNRs. By selecting either the longitudinal or the transverse SPR mode, I precisely determined the orientation of individual AuNRs. Correlating SEM with photothermal images, the orientations of AuNRs were accurately measured. Most notably, I determined the orientation of an AuNR by exciting the transverse SPR mode which is not achievable by conventional scattering-based techniques.

Ower primary school children.

Department of physical education and sports in the universities South India