In people with neuromotor deficits of trunk and lower extremities, maintaining and regaining balance is a difficult task. Many undergo rehabilitation to improve their movement capabilities, health, and overall interactions with their environment. Rehabilitation consists of a set of interventions designed to improve the individual’s mobility and independence. These strategies can be passive, active or task-specific and are dependent on the type of injury, how the individual progresses, and the intensity of the activity. Some of the common rehabilitation interventions to strengthen muscles and improve coordination are accomplished either by the manual assistance of a physical therapist, bodyweight suspension systems or through robotic-assisted training. There are several types of rehabilitation robotic systems and robotic control strategies.However, there are few robotic studies that compare their robotic device’s control strategy to common rehabilitation interventions. This dissertation introduces robotic strategies centered around rehabilitation ones and characterizes human motion in response to the robotic forces. Two cable-driven robotic systems are utilized to implement the robotic controllers for different tasks. Further details of the two cable-driven systems are discussed in Chapter 1. The validation and evaluation of these robotic strategies for standing rehabilitation is discussed in Chapter 2. A case study of a robotic training paradigm for individuals with spinal cord injury is presented in Chapter 3. Chapter 4 introduces a method to redistribute individuals’ weight using pelvic lateral forces. Chapter 5 and 6 characterizes how young and older groups respond to external perturbations during their sit-to-stand motion. This dissertation presents robotic strategies that can be implemented as rehabilitation interventions. It also presents how individuals’ biomechanics and muscle responses may change depending on the force control paradigm.These robotic strategies can be utilized by training individuals to improve their reactive and active balance control and thus reduce their risk of falling.

Submitted in partial compliance with the requirements for the Master's Degree in Technology : Chiropractic, Durban University of Technology, Durban, South Africa, 2015. / Introduction: Symptoms associated with large breasts result from bra strap chafing, poor body posture, headaches, neck, shoulder, thoracic and lower back pain. There is a paucity of literature quantifying objective data regarding the effect of breast size on posture. Therefore correct bra sizing may improve posture, however this is undetermined. This study aimed to investigate the effect of bra correction on selected postural parameters in order to determine its relevance in a clinical setting. Methodology: Sixty five females who met the inclusion criteria had the following parameters recorded: age, height, weight, body mass index, occupation, and underbust and overbust bra size. An anterior-posterior, right and left lateral digital photographs were taken before and after bra correction. These were then processed using the Posture Pro software. The data was analysed using the latest version of SPSS. The results were presented by means of standard deviations and ranges and differences between pre and post measures were performed with an ANOVA. Results: It was found that there was no correlation between changes in any of the four parameters from pre to post correction, which changed significantly with postural correction (4/43 post correction significant readings) and the demographic variables. Most participants changed to a larger cup sizes after correction which is in line with Greenbaum, (2003) who found that participants tend to buy a smaller bra size. In this study 3% of the study population changed to a bigger cup size and 97% wore bras that were too tight. Similar to the findings of Wood eta/., (2008) who found that 70% of the study population wore bras that are too small and 10% wore bras that were too big. Conclusion: In the study on effect of incorrect bra size on selected postural parameters it was found the there were four parameters that changed significantly with p<O, 05 [ANOVA]. Further investigation needs to be done on a larger sample size, age group range, BMI and different demographic. / PDF copy unavailable. please refer to hard copy for full text information / M

Múltiples revisiones científicas han intentado determinar los factores pronósticos en la evolución del latigazo cervical sin llegar a un consenso. Nuestros resultados se han obtenido tras 8 años de estudio en pacientes controlados desde la primera visita en el servicio de Medicina Física y Rehabilitación del Hospital de Mataró. Se han utilizado escalas de valoración fáciles de cumplimentar y cuantificar para poder obtener los resultados en el mismo momento de la consulta. Este hecho es importante, ya que la mayoría de las escalas que se identifican en los artículos publicados son poco prácticas en la consulta diaria por la dificultad que conllevan en su cumplimentación y valoración. Los factores pronósticos que hemos identificado en nuestra muestran han sido: la edad, la presencia de “vértigos”, la intensidad del dolor cervical inicial valorada mediante la escala analógica visual y el grado de funcionalidad cervical inicial valorado mediante el Northwick Park Hospital Neck Pain Questionnaire.

Thesis (Ph. D.)--University of Washington, 1996. / Vita. Includes bibliographical references (leaves [93]-100).

Despite extensive research into musculoskeletal disorders (MSDs) they continue to plague workers. Manual materials handling (MMH), in particular the concurrence of load manipulation and awkward body posture, has been identified as a key factor in the onset of MSDs. Only a few studies have looked at the interaction between manipulation tasks and working posture during assembly tasks and as a result their relationship has not been widely explored. Assessing the stresses resulting from individual task factors and body posture in isolation and adding them together may be too simplified to estimate an overall risk profile, since this does not take into account that there may be a non-linear interaction in strain responses when manipulation task and body posture interact. Therefore, the present study investigated biophysical, physiological and psychophysical responses to combined tasks, rather than individual tasks of body posture and manipulative tasks. The objective of the research was to establish the interactive effects of constrained body postures and manipulative tasks and to identify whether a cumulative or compensatory reaction occurs during this interaction. Nine conditions were assessed in a laboratory setting, which included combinations of three working postures (standing, sitting and stooping) and three assembly tasks (torque wrenching, precision and no task). Thirty-six subjects were required to complete all nine conditions, with each condition lasting ninety seconds. Muscle activity was recorded for seven muscles from the upper extremity, trunk and lower extremity regions and was complemented by physiological (heart rate, tidal volume, minute ventilation, oxygen consumption, energy expenditure and breathing frequency) and psychophysical (body discomfort) data. At the completion of all nine conditions subjects completed a retrospective psychophysical rating questionnaire pertaining to discomfort felt during the conditions. Responses obtained for the different task and posture combinations revealed compensatory reactions (additive > combined) for most of the conditions assessed for the biomechanical and physiological responses. In the majority of cases for muscle activity, no significant differences were found between the combined and the additive effects (p < 0.05), while for the physiological responses there were mostly significant differences observed. Psychophysical responses indicated that there was a significant difference overall between the additive and combined effects. The results of this study demonstrate that in order to identify risk areas, manipulation tasks and constrained working postures may be considered either in isolation and added together (additive) or as a combined task, since there were very few significant differences observed between these two effects. Further studies are required, however, to provide conclusive evidence.

Осанка – привычное положение туловища в пространстве, поза, обусловленная конституционными, наследственными факторами, зависящая от тонуса мышц, состояния связочного аппарата, выраженности физиологических изгибов позвоночника. По данным мировой статистики 34-50% детей имеют разную степень нарушений осанки, а по данным ВОЗ – 80% детей и подростков имеют низкий уровень физической активности. Целью данной работы было разработать и оценить влияния программы физической реабилитации, с использованием йоги в гамаках, на степень выраженности нарушений осанки у детей младшего школьного возраста. В исследовании приняло участие 20 детей с такими нарушениями осанки как: плоская спина, плоско-вогнутая спина, сутулость, круглая спина. В качестве методов исследования степени выраженности нарушений осанки использовались: визуальный осмотр – асимметрия треугольников талии, высоты плеч и лопаток, измерение глубины шейного и поясничного лордозов, и вычисление плечевого индекса; функциональные тесты – силовая выносливость мышц спины и пресса, тест на определение подвижности позвоночника; динамометрия и координационный тест. Согласно полученным результатам, предложенная программа позволила снизить степень выраженности нарушений осанки и улучшить физическую подготовленность детей с нарушениями осанки. Так же результаты позволили подтвердить, что нарушения осанки у детей младшего дошкольного возраста поддаются физической реабилитации с использованием йоги в гамаках и могут успешно корректироваться данным методом. / Posture is the habitual position of the body in space, a posture determined by constitutional, hereditary factors, depending on muscle tone, the state of the ligamentous apparatus, and the severity of the physiological curves of the spine. According to world statistics, 34-50% of children have varying degrees of posture disorders, and according to WHO, 80% of children and adolescents have a low level of physical activity. The purpose of this work was to develop and evaluate the effects of a physical rehabilitation program using yoga in hammocks on the severity of posture disorders in children of primary school age. The study involved 20 children with such posture disorders as: flat back, flat-concave back, stoop, round back. As methods for studying the severity of postural disorders, the following were used: visual examination - asymmetry of the triangles of the waist, the height of the shoulders and shoulder blades, measuring the depth of the cervical and lumbar lordosis, and calculating the shoulder index; functional tests - strength endurance of the muscles of the back and press, a test to determine the mobility of the spine; dynamometry and coordination test. According to the results obtained, the proposed program allowed to reduce the severity of posture disorders and improve the physical fitness of children with posture disorders. The results also confirmed that posture disorders in children of primary preschool age are amenable to physical rehabilitation using yoga in hammocks and can be successfully corrected by this method.

Dynamic postural control requires regulating body alignment to achieve postural stability and orientation during functional movements. This ability may be impaired in people with neuromotor disorders, challenging them in performing daily activities. Conventional training strategies, such as muscle strengthening, joint locking, and proprioceptive training, are known to improve posture control. However, providing sufficiently rich intervention and maintaining high training intensity can be labor-intensive and expensive. Therefore, novel technologies are being explored to overcome the challenges. Robot-assisted training is an emerging technology in posture rehabilitation. To maximize motor improvement, the assist-as-needed strategy is widely used in robotic platforms to provide adaptive assistance based on patients' functional ability. A prevailing paradigm employing the assist-as-needed strategy is the boundary-based assist-as-needed (BAAN) controller, which provides assistive forces when the center of mass moves beyond the stability boundary. This dissertation investigates the mechanisms underlying the efficacy of BAAN force fields and explores novel approaches to enhance the therapeutic effectiveness of BAAN robotic posture training protocols. In Chapter 1, we outline the research background and introduce the main content of the following chapters in this dissertation. We also describe two cable-driven robotic platforms with BAAN controllers: the Robotic Upright Stand Trainer (RobUST) for standing posture training and the Trunk Support Trainer (TruST) for sitting posture training. In Chapter 2, we present a study using the RobUST platform to investigate how the BAAN force field impacts muscle synergy in the lower limbs during standing posture training. This pilot study provides insights into understanding the neuromuscular basis of the BAAN robotic rehabilitation strategy and helps explain its effectiveness. In Chapter 3, we present a deep learning-based dynamic boundary design for the BAAN controller. We conducted a controlled experiment with 20 healthy subjects using the TruST platform to test the dynamic boundary's effectiveness. This study highlights the clinical potential of the dynamic boundary design in BAAN robotic training. Extended reality (XR) technology, including Virtual reality (VR) and augmented reality (AR), is gaining popularity in posture rehabilitation. XR has the potential to be combined with BAAN robotic training protocols to maximize postural control improvement. In Chapter 4, we conducted a randomized control experiment with sixty-three healthy subjects to compare the effectiveness of TruST intervention combined with VR or AR against TruST training alone. This study provides novel insights into the added value of XR to BAAN robot-assisted training and the differences between AR and VR when integrated into robotic training protocols. Motor skills acquired through BAAN robot-assisted training necessitate consistent follow-up practice for long-term maintenance. However, due to portability limitations, BAAN robot-assisted training faces challenges in providing follow-up training after high-intensity in-lab robotic interventions. In Chapter 5, we present a remote XR rehabilitation system with markerless motion tracking for sitting posture training. This remote XR framework holds promise as an adjunctive training approach to complement existing BAAN robot-assisted training methods, maximizing motor improvements.

Submitted in partial compliance with the requirements for the Master of Technology: Chiropractic, Durban University of Technology, 2014. / Background: Poor balance is a risk factor for injury in adolescent sport including soccer. Despite the rapid growth in female adolescent soccer especially in South Africa, the association between balance and injury in this population has not been fully explored. This study aimed to determine the relationship between injury and balance. Static and dynamic balance was monitored as sway index (SI) and limits of stability direction control (LOSDC). Objectives: The objectives of this study were to determine the body mass index of adolescent female soccer players; to determine the prevalence of injury in adolescent female soccer players; to determine static balance as revealed by the sway index (SI); to determine dynamic stability as revealed by limits of stability direction control (LOSDC) and to correlate body mass index (BMI) to sway index and limits of stability. Method: Eighty adolescent female soccer players, between the ages of fourteen and eighteen, were recruited through convenience sampling from schools in the eThekwini district of KwaZulu-Natal. After obtaining informed consent and assent, participants completed questionnaires and were scheduled for the balance and BMI assessments. The objective data for each participant consisted of height, weight, Sway Index (SI) and Limits of Stability Direction Control (LOSDC) readings, measured using a stadiometer, electronic scale and Biodex Biosway Balance System (Biodex Medical Systems Inc., Shirley, New York) respectively. The subjective and objective data were analyzed using SPSS version 21.0 (SPSS Inc. Chicago, Ill, USA). Statistical tests included descriptive statistics using frequency and cross-tabulation. Inferential statistics using t-tests and Pearson’s correlations at a significance level of 0.05 was also incorporated. The testing of hypotheses was performed using Fisher’s Exact tests for nominal data and ordinal data. A p value of < 0.05 was considered as statistically significant. The statistical analysis also included Odds Ratio calculations. Results: The mean body mass index of the injured participants was 23.54±3.56 kg/m2 and the mean body mass index of the uninjured participants was 23.00±4.63. Only 27.5% of the participants sustained an injury. Injured participants performed poorly on average in the SI assessment involving their eyes open when standing on a soft surface. The results were similar for the LOSDC in the overall, right, left, backward-right and backward-left directions. However, there were no significant correlations calculated. Significant relationships existed between BMI and the SI assessments in the injured participants which involved standing on a firm surface with their eyes open (p = 0.05), their eyes closed when also standing on a firm surface (p = 0.05), their eyes open when standing on a soft surface (p = 0.02), and their eyes closed when standing on a soft surface (p = 0.04). A significant relationship also existed between BMI and LOS right direction control (p = 0.02). Conclusion: This research paper revealed that the body mass index as investigated in this study is similar to other studies involving female adolescents; soccer injury as investigated in this study is similar to other studies involving female adolescents; poor static and dynamic balance is not associated with injury in adolescent female soccer players and lastly, body mass index is linked to the balance of an individual.

Thesis (MScSportSc)--University of Stellenbosch, 2002. / ENGLISH ABSTRACT: Postural deformities are a commonly encountered problem among children. Most of the aches and pains of adults are the result, not of injuries, but of the long-term effects of distortions in posture or alignment that have their origins in childhood or adolescence. Television, video entertainment, motorized transportation, fast food and lack of regular physical activity contribute to the poor physical condition of children. School screening for scoliosis is mandated in schools in 26 states of the United States (US) for children between 10 and 16 years of age. Previous studies conducted in the US found that 160 out of 1000 people suffer from scoliosis. This means that scoliosis is as prevalent as hypertension or diabetes mellitus (Boachie-Adjei & Lonner, 1996). Identification of postural deformities at an early stage makes early treatment possible, which may, in future, prevent serious postural abnormalities. The American Academy of Orthopedic Surgeons approved the implementation of screening programs in schools in 1974 (Lonstein, 1988). Few studies have included the entire musculoskeletal system. The purpose of this study was to determine the prevalence of postural deformities among children aged 11 to 13 years in selected primary schools in the Western Cape. The study also proposes to investigate factors that may influence the prevalence rate of postural deformities. These factors included age, gender, school district, weight, height, BMI (Body Mass Index), fat%, waist-hip ratio, and physical activity. Letters were sent to 15 primary schools within a 30km radius of Stellenbosch. This region included Stellenbosch, Strand, and Kuilsrivier. Four schools replied, giving permission to conduct the study at their schools. The sample (N=288, mean age=12.36, SD=0.92) consisted of 78 scholars from grade five; 104 scholars form grade six; and 106 scholars from grade seven. Of the total number of scholars examined (288), 154 were boys, and 134 were girls. Only children with parental consent were allowed to participate in the study. Anthropometric measures included stature, mass, skinfoids (two-site skinfoid), waist- and hip circumferences and trochanterion leg length. Level of physical activity and family history of deformities were obtained by means of a questionnaire. The New York Posture Test was used for postural evaluation (Bloomfield et aI., 1994:320; Reedeo Inc., 2001. This Posture Test was designed for the screening of 13 categories of deformities. Using a "see-through" posture grid, lateral and posterior examinations were performed. The "Adam's position" (forward bending) was used for further scoliosis evaluation. Quantitative data was analyzed, using Statistica (Statsoft, 2001) and classification tree methodology (Breiman et aI., 1993). The anthropometric results indicated that the subjects had a mean stature of 1.54m, mass of 47.48kg, BMI of 19.75, waist-hip ratio of 0.79 and fat% (Lohman, 1987) of 21.35%. The prevalence of postural deformities was as follows: Lordosis, 70%; Kyphosis, 57%; Uneven shoulders, 55%; Inclined trunk, 43%; Winged scapulae, 42%; Pronated feet, 30%; Flat feet, 30%; Flat chest, 29%; Forward head, 28%; Protruding abdomen, 28%; Uneven hips, 11%; Scoliosis, 10%; and Twisted head, 1%. Uneven hips, scoliosis and twisted head were not considered for statistical purposes, because of their low incidence compared to the other deformities. The factors that influenced the prevalence rate of deformities the most were BMI and fat%. A higher BMI and fat% resulted in a higher prevalence rate in most deformities. The prevalence rate of postural deformities in this study was considerably high. Sedentary lifestyles of children (watching television, computer games, junk food and physical inactivity) were a contributing factor in the high prevalence rate of postural deformities. It is known that overweight and sedentary behavior of children is increasing and this could pose an alarming concern to the health of a child. Also, if a significant correlation does exist between the prevalence of postural deformities and conditions such as back pain, the high prevalence rate reported in this study is a matter of concern. / AFRIKAANSE OPSOMMING: Postuurafwykings is "n algemene probleem wat dikwels onder kinders voorkom. Baie van die skete en pyne by volwassenes spruit nie uit beserings nie, maar vanuit langtermyn gevolge van swak postuur wat huloorsprong uit die kinderjare het. Televisie, videospeletjies, vervoer per motor, kitskos en gebrek aan fisieke aktiwiteit dra by tot die swak fisieke kondisie van kinders. Evalueringsprogramme in skole word in 26 state in die Verenigde State van Amerika (VSA) toegepas vir kinders tussen die ouderdomme van 10 en 16 jaar. Vorige studies in die VSA het getoon dat 160 uit 1000 mense skoliose het (Boachie-Adjei & Lonner, 1996). Dit beteken dat skoliose net so veel voorkom soos hipertensie of diabetes mellitus. Identifikasie van postuurafwykings op "n vroeë stadium maak vroeë behandeling moontlik, wat in die toekoms ernstige postuurafwykings kan voorkom. Die "American Academy of Orthopedie Surgeons" het reeds in 1974 die implementering van assesseringsprogramme goedgekeur (Lonstein, 1988). Volgens navorsing het slegs "n beperkte aantal studies die hele spierskeletale stelsel geëvalueer. Die doel van hierdie studie was om die voorkoms van postuurafwykings by kinders tussen die ouderdomme van 11 en 13 jaar in geselekteerde Wes-Kaapse skole te bepaal. Die studie het ook faktore wat "n invloed op die voorkoms van postuurafwykings kan hê, ingesluit. Hierdie faktore het onder andere ouderdom, geslag, skool, gewig, lengte, LMI (Liggaamsmassa-indeks), vet%, middel-heup-ratio en fisieke aktiwiteit ingesluit. Uitnodigingsbriewe is na 15 laerskole binne "n 30km radius vanaf Stellenbosch gestuur. Dit het ingesluit Stellenbosch, Strand, en Kuilsrivier. Vier skole het toestemming verleen om die studie by die betrokke skole te loods. Die steekproef (N=288, gemiddelde ouderdom = 12.36, SD=0.92) het bestaan uit 78 leerlinge uit graad vyf; 104 leerlinge uit graad ses en 106 leerlinge uit graad sewe. Uit die totale aantal leerlinge wat geëvalueer is, was daar 154 seuns en 134 dogters. Antropometriese metings het die volgende ingesluit: lengte, gewig, velvoue (twee-velvou meting), middel- en heupomtrekke en trochanterion beenlengte. Fisieke aktiwiteitsvlak en familiegeskiedenis van postuurafwykings is bepaal met behulp van "n vraelys. Die "New York Posture Tesf' is gebruik vir postuurevaluasie (Bloomfield et al., 1994:320; Reedco Inc., 2001). Hierdie toets is ontwerp vir die evaluering van 13 deformiteite. Die kinders is vanuit 'n posterior en anterior aansig ge-evalueer met behulp van 'n "deurskynende" postuurruitnet (grid). Die "Adam's-" toets (vooroorbuig-toets) is gebruik vir verdere evaluering van skoliose. Statistica (StatSoft, 2001) en klassifikasieboom-metodologie (Breiman et al., 1993) is gebruik vir statistiese ontleding. Die proefpersone het 'n gemiddelde lengte van 1.54m, gewig van 47.48kg, LMI van 19.75, middel-heup-ratio van 0.79 en vet% (Lohman, 1987) van 21.35% gehad. Die voorkoms van die onderskeie postuurafwykings was as volg: Lordose,70%; Kifose, 57%; Ongelyke skouers, 55%; Romp na posterior gebuig, 43%; Gevleuelde skapulas, 42%; Voetpronasie, 30%; Plat voete, 30%; Plat bors, 29%; Protraksie: skedel, 28%; Uitstaan buik, 28%; Ongelyke heupe, 11%; Skoliose, 10%; en Gekantelde hoof, 1%. Ongelyke heupe, skoliose en gekantelde hoof het minder voorgekom in vergelyking met die ander deformiteite, daarom is die deformiteite nie vir statistiese analise in aammerking gebring nie. LMI en vet% was die faktore wat die voorkoms van postuurafwykings die meeste beïnvloed het. 'n Hoër LMI en vet% het 'n toenemende voorkoms in meeste deformiteite veroorsaak. Die voorkoms van postuurafwyking in hierdie studie was hoog. Sedentêre leefwyses van kinders (TV, rekenaarspeletjies, gemorskos, en fisieke onaktiwiteit) het bygedra tot die hoë voorkoms. Die voorkoms van oorgewig en sedentêre leefwyses is besig om te verhoog by kinders en kan ernstige gevolge vir die gesondheid van die kind inhou. Indien daar 'n betekenisvolle korrelasie tussen die voorkoms van postuurafwykings en kondisies soos rugpyn is, dan blyk die hoë voorkoms, wat in hierdie studie gevind is, 'n bron van bekommernis te wees. Postuurevalueringsprogramme is 'n effektiewe metode vir die vroeë identifikasie van postuurafwykings, aangesien dit vroeë identifikasie en konserwatiewe behandeling moontlik maak.

Whilst literature exists describing prevalence and theories about mechanisms of development of deformity, there is a distinct lack of research that examines how deformity can be measured despite it being an area of identified need. This study established the inter- and intra-rater reliability of the Goldsmith Index of Body Symmetry and examined the relevance of the information it provides within the context of a comprehensive postural assessment for individuals with cerebral palsy in conjunction with a commonly used clinical assessment ... Results demonstrated that high index levels were not exclusively associated with people with windswept deformity. Postural patterns of windsweeping, frog leg (abducting) and scissor (adducting) postures and hip extension were found to occur in all categories, suggesting that asymmetry is not confined to one particular postural pattern. Clinically observable changes were identified through comparison of the supine evaluation and index scores. The flexibility of postural components (or the ability to correct asymmetry) in a supine position for the SD categories demonstrated wide variation. However, subjects in the 3+SD groupings had fixed scoliosis and the majority (83%) also had fixed pelvic obliquity and rotation. All other subjects up to the 3SD category had flexible pelvic obliquity and rotation. No definitive differences in postural components between groups were identified in sitting positions, which was attributed to the influence of gravity on the body in an upright posture. Examination of sitting ability and index level did not demonstrate any relationship, suggesting that greater independence in sitting is not necessarily associated with a lower Goldsmith Index. The study highlighted that assessment of posture is complex, and that no single tool provides the answers required to manage a person’s posture. It demonstrates the need for clinicians to be aware that subjective clinical assessment may not be sufficient to adequately assess and detect changes in posture, and that the Goldsmith Index of Body Symmetry provides objective data that can be used as a powerful adjunct in interpreting clinical assessment and supporting the evaluation of clinical interventions.