Diss. (sammanfattning) Stockholm : Karol. inst., 2000. / Härtill 5 uppsatser.

A dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree of Master of Science in Physiotherapy. Johannesburg, 2014 / Cycling has grown in popularity as a sport and is rated as one of the top 15 most popular sports in South Africa with more than 420 000 participants. Cyclists spend long continuous hours on the bicycle in an awkward position, which leads to unique overuse injuries. Overuse injuries in cyclists have been estimated to be as high as 85% with lower back and pelvis pain (LBPP) among the most common. The lower back and pelvis is the foundation the cyclist use for powering and controlling the bicycle and optimal functioning thereof is essential for optimal comfort and performance in cycling. The prolonged forward flexed position of the cyclist on the bicycle is regarded as one of the main contributors to LBPP in cyclists. Cyclists with LBPP are known to assume a position of greater lumbar flexion compared to those without but the reason for this has not been extensively explored. The purpose of this study was therefore to not only establish the prevalence of LBPP in cyclists in South Africa, but also identify factors associated with it in cyclists. The factors were considered in three broad categories: (1) training methods used, (2) intrinsic functioning of the cyclist and (3) bicycle set-up. Intrinsic and bicycle set-up factors included were those proposed to influence the forward-backward and side-to-side position of the cyclist on the bicycle and thereby lead to the development of LBPP in cyclists. The study had a cross-sectional descriptive design and comprised of two parts: a questionnaire (survey) investigating the prevalence of LBPP in cyclists together with the training methods used, and a physical assessment of the factors proposed to be associated with LBPP in cyclists. All cyclists belonging to cycling clubs registered with Cycling South Africa were invited to complete the online survey. From there, cyclists could indicate willingness to undergo a physical assessment which was done in the greater Gauteng area. The physical assessment included the following measurements: the lumbar curvature on the bicycle in all three handlebar positions, strength of gluteus maximus and gluteus medius, extensibility of the hamstring muscle group, control of lumbar movement in the direction of flexion, neurodynamics, active straight leg raise for load transfer, one leg stance test for lateral shift of the pelvis, leg-length discrepancy and bicycle set-up (saddle height, set-back and angle, handlebar height, forward reach, cleat position). The study revealed a lifetime prevalence of 65% for LBPP among cyclists in South Africa. Of the factors assessed, only the lumbar curvature in the brake lever position i.e. flexion of the lumbar spine (p=0.03) and the weakness of gluteus medius (Gmed) (p=0.05) were significantly related to LBPP in cyclists. This study was the first to assess the relationship between so many different factors and LBPP in cyclists, and the largest of its kind in cycling. Understanding the relationship between these factors and LBPP in cyclists can guide the development of preventative strategies and interventions with the aim of reducing the occurrence and recurrence of LBPP in cyclists and limiting the impact thereof.

Yip Yin Bing. / "July 1999." / Thesis (Ph.D.)--Chinese University of Hong Kong, 1999. / Includes bibliographical references (p. 163-177). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese. / Yip Yin Bing.

by Wan Yu Kwan. / Thesis submitted in: December 1999. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 112-125). / Abstracts in English and Chinese. / Acknowledgement --- p.2 / Abstract --- p.3 / Table of Contents --- p.5 / Chapter Chapter 1 - --- Introduction --- p.7 / Chapter 1.1 --- Contribution of lifting techniques on risk assessment and training on manual materials handling --- p.7 / Chapter 1.2 --- Objectives --- p.12 / Chapter 1.3 --- Hypotheses --- p.12 / Chapter 1.4 --- Significance of Study --- p.13 / Chapter Chapter 2 - --- Literature Review --- p.14 / Chapter 2.1 --- Societal concerns on employee compensation --- p.14 / Chapter 2.2 --- Etiology of low back injury --- p.15 / Chapter 2.2.1 --- Compression forces on vertebral joints --- p.16 / Chapter 2.2.2 --- Shear forces on vertebral joints --- p.17 / Chapter 2.3 --- Lifting techniques --- p.18 / Chapter 2.3.1 --- Effect of lifting techniques on curvature of the spine --- p.22 / Chapter 2.3.2 --- Importance of leg muscles in manual lifting --- p.22 / Chapter 2.4 --- Prediction of low back injury in manual lifting --- p.24 / Chapter 2.4.1 --- Compression forces and moments --- p.26 / Chapter 2.4.2 --- Balance control --- p.29 / Chapter 2.4.3 --- Application of Surface electromyography in ergonomics --- p.31 / Chapter Chapter 3 - --- Method --- p.34 / Chapter 3.1 --- Subject recruitment --- p.34 / Chapter 3.2 --- Equipment --- p.35 / Chapter 3.2.1 --- Force platform --- p.35 / Chapter 3.2.2 --- Motion analysis system --- p.37 / Chapter 3.2.3 --- Surface electromyography --- p.38 / Chapter 3.3 --- Maximum voluntary contraction test --- p.40 / Chapter 3.3.1 --- MVC of vastus medialis --- p.41 / Chapter 3.3.2 --- MVC of medial gastrocnemius --- p.42 / Chapter 3.3.3 --- MVC of erector spinae --- p.43 / Chapter 3.4 --- Lifting techniques --- p.44 / Chapter 3.5 --- Experimental procedures --- p.48 / Chapter 3.6 --- Statistical analysis --- p.53 / Chapter Chapter 4 - --- Results and Dicussion --- p.54 / Chapter 4.1 --- No. of cases in the study --- p.54 / Chapter 4.2 --- Phases of lifting --- p.55 / Chapter 4.3 --- Process time --- p.56 / Chapter 4.4 --- Trunk inclination angles --- p.62 / Chapter 4.5 --- Hip joint angles --- p.67 / Chapter 4.6 --- Knee joint angles --- p.73 / Chapter 4.7 --- Center of mass of box --- p.79 / Chapter 4.8 --- Muscle activities --- p.84 / Chapter Chapter 5 - --- Conclusion --- p.109 / Chapter Chapter 6 - --- References --- p.112

No description available.

Dor facial atípica (DFA) é uma condição álgica crônica destacada pela etiopatogenia ainda desconhecida e pela característica rebelde aos tratamentos vigentes. O objetivo deste estudo é avaliar o limiar e padrões de excitabilidade cortical de doentes com DFA através de Estimulação Magnética Transcraniana (EMT) e compará-los a controles saudáveis, além de avaliar a eficácia terapêutica da EMT repetitiva (EMTr) ativa em doentes com DFA comparados à EMTr placebo. Durante o período de março de 2010 a dezembro de 2013 foram avaliados 29 doentes com DFA - os quais preencheram os critérios segundo a classificação proposta pela Associação Internacional de Cefaleia (2004) - e 28 controles saudáveis. A avaliação foi iniciada com a investigação da excitabilidade cortical bilateral. Em seguida, os doentes foram aleatorizados em dois grupos (ativo e placebo) para o tratamento com EMTr sobre o córtex motor primário na área de representação da face, esquematizado da seguinte forma: cinco sessões consecutivas para a fase de indução, e uma sessão semanal (pelo período de oito semanas) para a de manutenção; frequência excitatória de 10Hz; 80% do limiar motor de repouso; e 3000 pulsos no total por sessão. Os doentes foram avaliados quanto às características dolorosas no momento basal, no dia sete após a semana de indução, e nos dias 21, 30 e 60 para acompanhamento na fase de manutenção. Em todas as avaliações, utilizou-se os seguintes questionários validados para a língua portuguesa: Inventário Breve de Dor; DN4, Inventário de Sintomas de Dor Neuropática, Questionário de descritores breve de dor McGill e Questionário de qualidade de vida SF-36. Os doentes do grupo ativo e placebo apresentaram excitabilidade cortical inicial diferenciada em relação aos controles nos padrões de inibição e facilitação intracortical (p < 0,001). Ao final da última avaliação, os doentes do grupo ativo apresentavam padrões de excitabilidade cortical mais próximos dos controles do que os doentes do grupo placebo, embora sem significância estatística. Não houve diferença entre os grupos ativo e placebo em todas as avaliações quanto às características de dor e de qualidade de vida, sendo que ambos apresentaram melhora da dor. Conclui-se que há diferenças neurofisiológicas entre os doentes com DFA e os controles, e que isso pode ser modificado através do EMTr. A ausência de efeito terapêutico da EMTr neste estudo indica que mais estudos utilizando-se outros parâmetros para a verificação da eficácia da EMTr na DFA são necessários / Atypical facial pain (AFP) is a chronic condition with unknown physiopathology and refractory characteristics to the gold standard treatment. The aim this study was to compare the patterns of cortical excitability between AFP and health subjects (HS), and to assess the analgesic effect of repetitive transcranial magnetic stimulation (rTMS) in AFP patients. Twenty-eight HS and 29 patients with AFP were included according to the IHS criteria (2004). Participants underwent a cortical excitability battery bilaterally in the primary motor cortex (M1) representation of the masseter muscle. They were then randomized into active and sham rTMS groups. rTMS was performed over the contralateral motor cortex in the representation area of the face daily for a week and weekly for eight weeks in a total of 13 sessions (5 induction and 8 maintenance sessions). All participants received 10 Hz rTMS, at 80% of the rest motor threshold (total of 3000 pulses per session). Sham rTMS was performed with an identical sham coil that emitted a similar sound to the active one. Patients were clinically assessed at baseline, after the induction phase (one week) and after 21, 30 and 60 days after the beginning of the study. Evaluations included the following validated questionnaires to the Brazilian Portuguese language: brief pain inventory; DN-4; Neuropathic pain symptoms inventory, McGill pain questionnaire brief version and quality of life questionnaire SF-36. At the baseline assessment, patients with AFP showed defective intracortical excitability inhibition and facilitation (p < 0.001) compared to HS. After the final evaluation, the patients from the active group had cortical excitability patterns closer to HS than the patients from the sham group, although there was no significant difference. There was no difference between patients that underwent active and sham rTMS about their pain characteristics and quality of life; both had pain improvement. In conclusion, there are neurophysiological differences between patients with AFP and HS, which could be modified with rTMS. The absence of a therapeutic effect of rTMS on pain in this study indicates the need of more research with other TMS parameters to check the efficacy of rTMS in AFP

No description available.

Dor facial atípica (DFA) é uma condição álgica crônica destacada pela etiopatogenia ainda desconhecida e pela característica rebelde aos tratamentos vigentes. O objetivo deste estudo é avaliar o limiar e padrões de excitabilidade cortical de doentes com DFA através de Estimulação Magnética Transcraniana (EMT) e compará-los a controles saudáveis, além de avaliar a eficácia terapêutica da EMT repetitiva (EMTr) ativa em doentes com DFA comparados à EMTr placebo. Durante o período de março de 2010 a dezembro de 2013 foram avaliados 29 doentes com DFA - os quais preencheram os critérios segundo a classificação proposta pela Associação Internacional de Cefaleia (2004) - e 28 controles saudáveis. A avaliação foi iniciada com a investigação da excitabilidade cortical bilateral. Em seguida, os doentes foram aleatorizados em dois grupos (ativo e placebo) para o tratamento com EMTr sobre o córtex motor primário na área de representação da face, esquematizado da seguinte forma: cinco sessões consecutivas para a fase de indução, e uma sessão semanal (pelo período de oito semanas) para a de manutenção; frequência excitatória de 10Hz; 80% do limiar motor de repouso; e 3000 pulsos no total por sessão. Os doentes foram avaliados quanto às características dolorosas no momento basal, no dia sete após a semana de indução, e nos dias 21, 30 e 60 para acompanhamento na fase de manutenção. Em todas as avaliações, utilizou-se os seguintes questionários validados para a língua portuguesa: Inventário Breve de Dor; DN4, Inventário de Sintomas de Dor Neuropática, Questionário de descritores breve de dor McGill e Questionário de qualidade de vida SF-36. Os doentes do grupo ativo e placebo apresentaram excitabilidade cortical inicial diferenciada em relação aos controles nos padrões de inibição e facilitação intracortical (p < 0,001). Ao final da última avaliação, os doentes do grupo ativo apresentavam padrões de excitabilidade cortical mais próximos dos controles do que os doentes do grupo placebo, embora sem significância estatística. Não houve diferença entre os grupos ativo e placebo em todas as avaliações quanto às características de dor e de qualidade de vida, sendo que ambos apresentaram melhora da dor. Conclui-se que há diferenças neurofisiológicas entre os doentes com DFA e os controles, e que isso pode ser modificado através do EMTr. A ausência de efeito terapêutico da EMTr neste estudo indica que mais estudos utilizando-se outros parâmetros para a verificação da eficácia da EMTr na DFA são necessários / Atypical facial pain (AFP) is a chronic condition with unknown physiopathology and refractory characteristics to the gold standard treatment. The aim this study was to compare the patterns of cortical excitability between AFP and health subjects (HS), and to assess the analgesic effect of repetitive transcranial magnetic stimulation (rTMS) in AFP patients. Twenty-eight HS and 29 patients with AFP were included according to the IHS criteria (2004). Participants underwent a cortical excitability battery bilaterally in the primary motor cortex (M1) representation of the masseter muscle. They were then randomized into active and sham rTMS groups. rTMS was performed over the contralateral motor cortex in the representation area of the face daily for a week and weekly for eight weeks in a total of 13 sessions (5 induction and 8 maintenance sessions). All participants received 10 Hz rTMS, at 80% of the rest motor threshold (total of 3000 pulses per session). Sham rTMS was performed with an identical sham coil that emitted a similar sound to the active one. Patients were clinically assessed at baseline, after the induction phase (one week) and after 21, 30 and 60 days after the beginning of the study. Evaluations included the following validated questionnaires to the Brazilian Portuguese language: brief pain inventory; DN-4; Neuropathic pain symptoms inventory, McGill pain questionnaire brief version and quality of life questionnaire SF-36. At the baseline assessment, patients with AFP showed defective intracortical excitability inhibition and facilitation (p < 0.001) compared to HS. After the final evaluation, the patients from the active group had cortical excitability patterns closer to HS than the patients from the sham group, although there was no significant difference. There was no difference between patients that underwent active and sham rTMS about their pain characteristics and quality of life; both had pain improvement. In conclusion, there are neurophysiological differences between patients with AFP and HS, which could be modified with rTMS. The absence of a therapeutic effect of rTMS on pain in this study indicates the need of more research with other TMS parameters to check the efficacy of rTMS in AFP

Approximately one in five adults in the United States experiences chronic pain. Over the last 50 years, spinal cord stimulation has become increasingly recognized as a minimally invasive, efficacious treatment modality for the management of chronic pain. The authors report a case study of a 46-year-old female in the first documented spinal cord stimulation simultaneously targeting intractable neuropathic and visceral pain caused by post-laminectomy syndrome and chronic pancreatitis, respectively. This case study demonstrates near-total relief of the patient's neuropathic low back/leg pain and visceral epigastric pain, showing evidence of potential clinical usefulness for spinal cord stimulation as a treatment option in patients who present with a combination of visceral and somatic pain symptoms.

This research was executed as three separate studies. Study 1 focused on the perception of pain and the semantic aspects of pain. Study 2 focused on the measurement of acute pain and mood states. Study 3 focused on the psychological treatment of cancer pain. In Study 1 a group of 66 Setswana-speaking adults were required to describe what they saw, what happened, and what would be the outcome with respect to three visually presented pain scenes using The Pain Apperception Test (PAT) A qualitative analysis of their responses shows that pain is experienced as an all encompassing experience affecting all aspects of their lives, such as the physical, emotional, social, and economic. This was found to be true, irrespective of gender and age with the exception of economic issues. A qualitative analysis of their responses to the Pain Eliciting Incidents Questionnaire (PEIQ) reveals that the Setswana pain descriptors are classifiable according to the three dimensions of pain namely, the sensory-discriminative, affective-motivational, and cognitive-evaluative. Sludy 2 applied the Profile of Mood States (POMS) preoperatively to a group of 58 female laparotomy (gynaecological) patients. These patients were also tested post-operatively with the Visual Analogue Scale (VAS) and the Wisconsin Brief Pain Questionnaire (WBPQ) as pain measures. The pain measures were taken at no medication and at the peak of medication. Factor analysis could not confirm the validity of the six POMS scales. These scales also did not show correlations with post-operative pain. Correlations between the pain measures showed acceptable reliability and validity of the VAS and the WBPQ. In Study 3 three groups of 15 cancer patients each, suffering from chronic pain, were treated over a period of two weeks with either cognitive behavioural therapy plus medication, reassurance therapy plus medication, or medication only. Comparison of before and after treatment pain measures showed that both cognitive behavioural therapy and reassurance therapy had a beneficial effect. Follow-up results three months later showed that the beneficial effect of reassurance therapy did not persist. Patients treated with cognitive behavioral therapy still showed the beneficial effects thereof. / Psychology / D. Litt. et Phil. (Psychology)