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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
101

Glenohumeral internal rotation deficits in the overhead varsity level athlete

Chepeha, Judith Unknown Date
No description available.
102

Investigation of New Concepts and Solutions for Silicon Nanophotonics

Wang, Zhechao January 2010 (has links)
Nowadays, silicon photonics is a widely studied research topic. Its high-index-contrast and compatibility with the complementary metal-oxide-semiconductor technology make it a promising platform for low cost high density integration. Several general problems have been brought up, including the lack of silicon active devices, the difficulty of light coupling, the polarization dependence, etc. This thesis aims to give new attempts to novel solutions for some of these problems. Both theoretical modeling and experimental work have been done. Several numerical methods are reviewed first. The semi-vectorial finite-difference mode solver in cylindrical coordinate system is developed and it is mainly used for calculating the eigenmodes of the waveguide structures employed in this thesis. The finite-difference time-domain method and beam propagation method are also used to analyze the light propagation in complex structures. The fabrication and characterization technologies are studied. The fabrication is mainly based on clean room facilities, including plasma assisted film deposition, electron beam lithography and dry etching. The vertical coupling system is mainly used for characterization in this thesis. Compared with conventional butt-coupling system, it can provide much higher coupling efficiency and larger alignment tolerance. Two novel couplers related to silicon photonic wires are studied. In order to improve the coupling efficiency of a grating coupler, a nonuniform grating is theoretically designed to maximize the overlap between the radiated light profile and the optical fiber mode. Over 60% coupling efficiency is obtained experimentally. Another coupler facilitating the light coupling between silicon photonic wires and slot waveguides is demonstrated, both theoretically and experimentally. Almost lossless coupling is achieved in experiments. Two approaches are studied to realize polarization insensitive devices based on silicon photonic wires. The first one is the use of a sandwich waveguide structure to eliminate the polarization dependent wavelength of a microring resonator. By optimizing the multilayer structure, we successfully eliminate the large birefringence in an ultrasmall ring resonator. Another approach is to use polarization diversity scheme. Two key components of the scheme are studied. An efficient polarization beam splitter based on a one-dimensional grating coupler is theoretically designed and experimentally demonstrated. This polarization beam splitter can also serve as an efficient light coupler between silicon-on-insulator waveguides and optical fibers. Over 50% coupling efficiency for both polarizations and -20dB extinction ratio between them are experimentally obtained. A compact polarization rotator based on silicon photonic wire is theoretically analyzed. 100% polarization conversion is achievable and the fabrication tolerance is relatively large by using a compensation method. A novel integration platform based on nano-epitaxial lateral overgrowth technology is investigated to realize monolithic integration of III-V materials on silicon. A silica mask is used to block the threading dislocations from the InP seed layer on silicon. Technologies such as hydride vapor phase epitaxy and chemical-mechanical polishing are developed. A thin dislocation free InP layer on silicon is obtained experimentally. / QC20100705
103

Dimensionnement et réalisation d'un rotateur de polarisation à évolution de mode en optique intégrée sur verre / Design and realization of a mode evolution polarization rotator made by glass integrated optics technology

Jordan, Elodie 29 November 2016 (has links)
La création du premier laser en 1960 puis l’envol des télécommunications par fibres optique a généré le développement des circuits optiques intégrés. Ces derniers sont des solutions efficaces aux problèmes d’encombrement et d’instabilité. Un contrôle accru des signaux passe cependant par l’exploitation de la polarisation qui permet notamment d’augmenter les débits, de fiabiliser les signaux et de protéger les sources par une isolation optique. Cette dernière application fait partie d’un vaste projet mené par l’IMEP-LAHC en collaboration avec le laboratoire Hubert Curien de Saint-Etienne. L’isolateur sur verre comprend l’intégration d’un séparateur de polarisation, d’un rotateur Faraday et d’un rotateur réciproque de polarisation à 45°. L’objectif de ces travaux «était de démontrer la faisabilité de la dernière fonction. La réalisation s’est basée sur l’exploitation d’échanges d’ions assistés par un champ électrique (EAC). Une première étape a consisté à maîtriser les effets de bords inhérents aux EAC, afin de modeler le cœur d’un guide d’onde et incliner les axes neutres de polarisation. Ceci a été obtenu en cascadant deux EAC, le premier créant un guide d’indice de réfraction uniforme, le deuxième modelant son cœur. Le contrôle de la position des axes neutres a ainsi été démontrée pour la première fois dans cette technologie puisqu’une inclinaison à (46,6 ± 0,1)° en entrée et (42,3 ± 0,1)° en sortie a été mesurée. L’étude numérique du procédé de fabrication du rotateur réciproque a également été effectuée et l’adiabaticité du composant a été validé analytiquement. Une première réalisation a mis en évidence un problème de pertes élevées liées au dégazage des sels d’échange. Des pistes d’optimisation sont donc avancées. Une suggestion d’amélioration du rotateur Faraday est également présentée. Elle exploite les progrès obtenus sur les EAC et démontre la faisabilité de guides d’ondes à biréfringence négative. Finalement un procédé de fabrication de l’isolateur complet, compatible avec le budget thermique, est proposé. / The fabrication of the first laser in 1960 and the growth of fiber optics telecommunications have led to the development of integrated optics circuits. Theses lasts are efficient solutions to compacity and misalignment problems. Moreover, polarization management in integrated circuits enables to increase the data rate, to guaranty the signals reliability or to protect optical sources. The work presented here is dedicated to this last application, which is the motive of a long-term collaboration between IMEP-LAHC and the Hubert Curien institute in Saint-Etienne. Indeed, we proposed to fabricate a 45° reciprocal polarization rotator that is part of the optical isolator’s design, along with a polarization splitter and a Faraday rotator. We choose to use a field-assisted ion-exchange technique (FAIE). The implementation of the polarization rotator requires managing the side effects of the electrical field lines occurring during a FAIE. It allows controlling the waveguide core’s shape and thus the eigen axes tilt. It was obtained thanks to two cascaded FAIE. The first one, an Ag+/Na+ ion exchange, creates a high refractive index waveguide while the second one, a Na+/Na+ ion exchange, modifies the shape of the waveguide’s core. Measurements of the experimental polarization behavior are a first proof of a controlled tilt of eigen axes in this technology. Indeed, the waveguide exhibits a tilt of its eigen axes of (46.6 ± 0.1)° at the input and (42.3 ± 0.1)° at the output.The numerical study of the reciprocal rotator’s process has also been proposed and the adiabaticity of the design analytically validated. The first realization highlights high propagation losses that can linked to the degassing of the nitrate salts occurring during the FAIE. Possible improvements are thus suggested in the document.An enhancement of the Faraday rotator’s design is also proposed. It is obtained thanks to the fabrication of a waveguide exhibiting a negative birefringence whose design exploits the progress achieved in term of FAIE control. Eventually, a complete fabrication of the integrated isolator is proposed, taking into account the thermal budget of the various processes.
104

Avaliação morfofuncional do manguito rotador em indivíduos com instabilidade glenoumeral e lesão SLAP

Saccol, Michele Forgiarini 10 May 2013 (has links)
Made available in DSpace on 2016-06-02T20:18:20Z (GMT). No. of bitstreams: 1 5258.pdf: 7048287 bytes, checksum: a29ea2c867092740240721084371d1d4 (MD5) Previous issue date: 2013-05-10 / Universidade Federal de Minas Gerais / Athlete´s shoulder most frequent lesions are anterior shoulder instability and superior labrum anterior and posterior lesion ( SLAP), altering structures and functions of the shoulder joint, leading to impairments in sports activity. The aim of this thesis was to evaluate functional and supraspinatus morphological adaptations of shoulder in athletes with anterior instability and SLAP lesion. Three studies were developed. The first study investigated functional differences regarding clinical complaints and the scoring systems of American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) and the Athletic Shoulder Outcome Rating Scale (ASORS) in 249 athletes (153 with instability and 96 with SLAP lesion). The groups presented functional differences related mainly to sports activitiy and, even with more complaints of shoulder pain, SLAP lesion athlete´s tolerate more training hours compared to instability athletes. The second study evaluated isokinetic strenght and muscular control of shoulder rotators in four groups: instability group (n=10), instability control group (n=10), SLAP group (n=10) and SLAP control group (n=10). The torque steadiness and rotator cuff strength in 90 and 180°/s were evaluated. Athlete´s with anterior stability presented shoulder rotation weakness, while athletes with SLAP lesion showed higher torque fluctuation of shoulder internal rotation. The third study characterized the different fiber types of supraspinatus and shoulder function in those lesions. This study performed muscles biopsies in 10 athletes undergoing to arthroscopy repair of shoulder anterior instability and SLAP lesion. The volunteers were functionally evaluated with ASES and ASORS, and muscle samples were processed with histochemical reaction for myosin adenosine triphosphatase (mATPase). Muscles fibers were then characterized in type I, IIa, IIb and hybrid, and percentual and lesser diameter of each fiber type were calculated. In this study, volunteers presented evident functional limitations in sports activity and hypertrophy of all typees of muscles fibers. Most of the sample also presented a great number of type IIa and IIb in the supraspinatus muscle. In conjuction, those studies proves different functional and supraspinatus morphologic adaptations in athletes with anterior shoulder instability and SLAP lesion, justifying the need of different rehabilitations approaches. / As lesões mais frequentes presentes no ombro do atleta são a instabilidade anterior do ombro e a lesão do lábio glenoidal superior, anterior e posterior (Superior Labrum Anterior and Posterior- SLAP), que levam a alterações nas estruturas e funções do ombro, prejudicando a atividade esportiva. O objetivo desta tese foi avaliar as adaptações funcionais do ombro e morfológicas do músculo supraespinal em atletas com instabilidade anterior ou lesão SLAP. Para isso foram desenvolvidos três estudos. O primeiro estudo investigou as diferenças funcionais entre essas lesões por meio das queixas clínicas e os questionários do American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) e a Escala de Resultados do Ombro do Esportista (EROE), em 249 atletas (153 com instabilidade e 96 com lesão SLAP). Os grupos apresentaram diferenças funcionais relacionadas especialmente às atividades esportivas, de forma que mesmo apresentando mais queixas de dor, os atletas com lesão SLAP toleraram mais horas de treinamento comparado aos atletas com instabilidade. O segundo estudo avaliou o torque isocinético e o controle muscular dos rotadores do ombro de quatro grupos: grupo instabilidade (n=10), grupo controle da instabilidade (n=10), grupo SLAP (n=10) e grupo controle do SLAP (n=10). Foram avaliados o controle da flutuação do torque isométrico submáximo e o torque de rotadores em 90 e 180°/s. Os atletas com instabilidade anterior apresentaram fraqueza na rotação do ombro, enquanto atletas com lesão SLAP demonstraram alterações no controle da força de rotação medial. O terceiro estudo permitiu caracterizar os diferentes tipos de fibras musculares do músculo supraespinal, assim como as atividades funcionais do ombro em atleta com essas lesões. Para tanto, foram realizadas biópsias do músculo supraespinal em 10 atletas submetidos ao reparo artroscópico da instabilidade anterior ou lesão SLAP. Os voluntários foram avaliados funcionalmente por meio da escalas ASES e EROE e fragmentos do músculo foram processados pela reação histoenzimológicas para Adenosina Trifosfatase Miofibrilar (mATPase). As fibras musculares foram então classificadas em tipo I, IIa, IIb e híbridas, e a porcentagem e o diâmetro menor de cada tipo de fibra foram calculadas. Os resultados mostraram que os voluntários apresentaram limitações funcionais mais evidentes nas atividades esportivas e uma hipertrofia de todos os tipos de fibras musculares. Além disso, na maioria da amostra, houve um maior número de fibras do tipo IIa e IIb no músculo supraespinal. Em conjunto, esses estudos comprovam a existência de diferentes adaptações funcionais e morfológicas do músculo supraespinal em atletas com instabilidade anterior e lesão SLAP, o que justifica a necessidade de diferentes enfoques na reabilitação dessas lesões.
105

Bond Graph Model Of A Generalised Multiphase Electromagnetic Device With Magnetic Non-idealities

Rai, B Umesh 08 1900 (has links) (PDF)
The electromagnetic machines like the dc, induction, synchronous motor/generator and the transformer have an energy flow framework that is similar. All these machines deal with electrical energy in the electrical domain that is interfaced with the magnetic domain. Except for the transformer, the other machines also have one more energy interface i.e. with the mechanical domain. In all these machines, the magnetic domain acts as the silent energy manager. The electrical and the mechanical domain energies will have to pass through the magnetic domain and appropriately get routed. In recognition of the commonality of this pattern of energy flow, this thesis proposes a generalised model of a multiphase electromagnetic device wherein the dc machine, induction machine, synchronous machine and the transformers are special cases of the proposed generalised model. This is derived using bond graphs that is based on the underlining principle of Energy Flow rooted in the concept of Conservation of Energy. A model is a set of mathematical equations representing a physical system. A model is as good as a modeller understanding of the physical system and the underlying approximation he makes while writing down the equations describing the models behaviour to the stimulus. A modelling language tool, which can cut down the approximations made by using the power of identified analogous characteristics across the physical domain, can help make a model more close to real life situation. Bond Graph is such a modelling language which is powerful enough to model the non-linear, multi-disciplinary, hybrid continuous-discrete phenomena encountered in a real life physical system. Bond graphs as a modelling tool was introduced by Professor H.Paynter at Massachusetts Institute of Technology in 1959. The Bond Graph methodology is based on consideration of energy flows between the ports of the components of an engineering system. Bond Graph methodology enables one to develop a graphical model that is consistent with the first principle of energy conservation without having the need to start with establishing and reformulating equations. The derivation of a mathematical model from the graphical description is automated by software tools. As a consequence, a modeller using this methodology can focus on modelling of the physical system. In the graphical representation of bond graph the vertices of a bond graph denote subsystems, system components or elements, while the edges, called power bonds, represent energy flows between them. The nodes of a bond graph have power ports where energy can enter or exit. Bond graph models are developed in a hierarchical top-down or bottom-up approach by using component models or elements from model libraries. An electromagnetic machine is a black box having an assemblage of windings in iron resulting in a combination of input/output ports on shaft and electrical terminals. Abstraction of an machine model by a modeller matching the vision of the observer above is an ideal goal. Bond graph methodology is an appropriate tool for trying to reach this goal as it is based on object oriented modelling techniques. There have been few attempts to model electric machine in bond graph earlier. A well established DC motor bond graph has been widely used in all bond graph literature. But AC rotating machine being a higher order nonlinear system poses a tougher challenge. Here too, there have been few attempts in modelling AC machines. It is observed that majority of AC machine bond graph models have been built up from their mathematical models. But as the bond graph modelling technique is based on the unifying theory of energy exchange, better insight into the system is achievable if the model is conceptualised from its physical structure. This thesis starts from the basic theory of energy port to conceptualise the generalised model from physical correspondence. In this thesis a Rotating Electrical Machine is studied as a physical system. The energy ports inside this physical system is identified. When a physical system receives the energy through its energy port in one energy cycle, it processes this energy in one of the three ways. The received energy is converted into useful work or it is dissipated or stored. The storage can further be classified into two ways, either as kinetic energy or as potential energy. For a rotating electric machine the input-output port for energy exchange are either in electrical or mechanical domain depending on the class of the machine. The magnetic domain across all class of electromagnetic device acts as the energy manager. In order to capture the features of the energy jumping across the air gap in a rotating electrical machine, wherein the magnetic fields from spatially distributed windings of the stator and rotor interplay, an Axis Rotator (AR) element -a mathematical commutator, is introduced in this thesis as a new bond graph element. In a multiphase device, the energy from the various phases and spatial axes are transferred through the axis rotator element. The Axis Rotator is a critical element which helps distinguish between the various classes of electromagnetic devices. The defining features of the Axis Rotator helps in deriving the various special electromagnetic devices (such as the dc machine, induction machine, synchronous machine and the transformer) from the generalised model. The Axis Rotator exists in the magnetic domain. It naturally inherits the characteristics of the magnetic domain. The Axis Rotator as a bond graph element is complex. In a specific case of 3φ Induction Motor an alternative bond graph model with all integral elements is developed. By one to one correspondence with the AR bond graph model, the inner component of ’AR’ can be identified. Another advantage of using this model is that saturable and non-saturable magnetic permeance can be separated out, a useful feature in the nonlinear model discussed next. One of the most distinguishing features of the magnetic domain is the existence of Magnetic Hysteresis. Magnetic Hysteresis is a well understood and studied subject. But this physical process is wilfully ignored by the modelling community at large. The main reason for this is the difficulty of modelling a nonlinear phenomena. The bond graph modelling naturally allows the inclusion of such non-idealities within its framework. This thesis proposes the generalised model along with the inclusion of magnetic non-linearities and non-idealities into the model of the system. This inherent strength of bond graph model flows from the fact that the models in bond graph are developed from the first principles of energy conversation and the mathematical equations are derived later from the evolved graph. The tools that are available for bond graph simulation are not adequate for power electronics systems. The existing tools do not address space vectors and frame transformations. As a consequence it is difficult to simulate the electromagnetic device models developed in this thesis. The need for a bond graph tool to address vectors and frame transformations, a common occurrence in electric machines dynamic model study was acutely felt. This necessitated a support for handling complex data class from the underlying mathematical engine of the software. MATLAB/Simulink is the commonly available mathematical tool which has a support for complex variables. Therefore during the course of this research work a new software tool box was developed which meets the need of electromagnetic machines in particular and other engineering domains in general. For developing the new bond graph simulation software, the language extender approach was chosen, as it combines the capabilities of existing popular mathematical engine with its tested graphical frontend and the flexibility of combining different modelling technique like bond graph, block diagram, equations etc. It also ensures portability as they are compiled by interpreted language compiler of the mathematical engine and are thus independent of the computer operating system. C-MEX S-function methodology was used to develop the software as it has access to lower level functions and methods of the underlying mathematical engine. This helps in speeding up the software execution time alongwith the flexibility in defining new complex elements like the Nonlinear Axis Rotator. In conclusion, this thesis makes the following contributions: (i) The Axis rotator concept to handle space vectors and frame transformations, (ii) generalised model of the electromagnetic device, (iii) introduction of the saturation and hysteresis non-linearity in the magnetic domain, (iv) development of the bond graph toolbox to handle vector and frame transformations.
106

Návrh speciálního anténního rotátoru / Design of special antenna rotator

Půhoný, Jan January 2010 (has links)
This master's thesis deals with design electronics for an antenna rotator in two axis. There are designed and implemented drivers for two stepper motors. Was also designed and implemented control panel that allows manual control the rotator and remote control by PC via USB. At the same time created software for control panel and PC application for easy operation.
107

New electro-optical applications of liquid crystals: from beam steering devices and tunable lenses to negative refraction and field-induced dynamics of colloids

Pishnyak, Oleg 02 July 2009 (has links)
No description available.
108

Modifications in Early Rehabilitation Protocol after Rotator Cuff Repair : EMG Studies

Alenabi, Seyedeh Talia 12 1900 (has links)
La déchirure de la coiffe des rotateurs est une des causes les plus fréquentes de douleur et de dysfonctionnement de l'épaule. La réparation chirurgicale est couramment réalisée chez les patients symptomatiques et de nombreux efforts ont été faits pour améliorer les techniques chirurgicales. Cependant, le taux de re-déchirure est encore élevé ce qui affecte les stratégies de réhabilitation post-opératoire. Les recommandations post-chirurgicales doivent trouver un équilibre optimal entre le repos total afin de protéger le tendon réparé et les activités préconisées afin de restaurer l'amplitude articulaire et la force musculaire. Après une réparation de la coiffe, l'épaule est le plus souvent immobilisée grâce à une écharpe ou une orthèse. Cependant, cette immobilisation limite aussi la mobilité du coude et du poignet. Cette période qui peut durer de 4 à 6 semaines où seuls des mouvements passifs peuvent être réalisés. Ensuite, les patients sont incités à réaliser les exercices actifs assistés et des exercices actifs dans toute la mobilité articulaire pour récupérer respectivement l’amplitude complète de mouvement actif et se préparer aux exercices de résistance réalisés dans la phase suivante de la réadaptation. L’analyse électromyographique des muscles de l'épaule a fourni des évidences scientifiques pour la recommandation de beaucoup d'exercices de réadaptation au cours de cette période. Les activités sollicitant les muscles de la coiffe des rotateurs à moins de 20% de leur activation maximale volontaire sont considérés sécuritaires pour les premières phases de la réhabilitation. À partir de ce concept, l'objectif de cette thèse a été d'évaluer des activités musculaires de l'épaule pendant des mouvements et exercices qui peuvent théoriquement être effectués au cours des premières phases de la réhabilitation. Les trois questions principales de cette thèse sont : 1) Est-ce que la mobilisation du coude et du poignet produisent une grande activité des muscles de la coiffe? 2) Est-ce que les exercices de renforcement musculaire du bras, de l’avant-bras et du torse produisent une grande activité dans les muscles de la coiffe? 3) Au cours d'élévations actives du bras, est-ce que le plan d'élévation affecte l'activité de la coiffe des rotateurs? Dans notre première étude, nous avons évalué 15 muscles de l'épaule chez 14 sujets sains par électromyographie de surface et intramusculaire. Nos résultats ont montré qu’avec une orthèse d’épaule, les mouvements du coude et du poignet et même quelques exercices de renforcement impliquant ces deux articulations, activent de manière sécuritaire les muscles de ii la coiffe. Nous avons également introduit des tâches de la vie quotidienne qui peuvent être effectuées en toute sécurité pendant la période d'immobilisation. Ces résultats peuvent aider à modifier la conception d'orthèses de l’épaule. Dans notre deuxième étude, nous avons montré que l'adduction du bras réalisée contre une mousse à faible densité, positionnée pour remplacer le triangle d’une orthèse, produit des activations des muscles de la coiffe sécuritaires. Dans notre troisième étude, nous avons évalué l'électromyographie des muscles de l’épaule pendant les tâches d'élévation du bras chez 8 patients symptomatiques avec la déchirure de coiffe des rotateurs. Nous avons constaté que l'activité du supra-épineux était significativement plus élevée pendant l’abduction que pendant la scaption et la flexion. Ce résultat suggère une séquence de plan d’élévation active pendant la rééducation. Les résultats présentés dans cette thèse, suggèrent quelques modifications dans les protocoles de réadaptation de l’épaule pendant les 12 premières semaines après la réparation de la coiffe. Ces suggestions fournissent également des évidences scientifiques pour la production d'orthèses plus dynamiques et fonctionnelles à l’articulation de l’épaule. / Rotator cuff tear is one of the most common causes of shoulder pain and dysfunction. The operative repair has been widely performed for symptomatic patients and many efforts have been done to improve the surgical techniques. However, the re-tear rate is still high and this affects post-repair rehabilitation strategies. Post-surgical care should balance between the restriction imposed to protect the repaired tendon and the activities prescribed to restore range of motion and muscle strength. Frequently, early after rotator cuff repair, shoulder is immobilized in a sling or abduction orthosis, but this immobilization includes elbow and wrist joints as well. In this period that may last 4-6 weeks, only passive range of motion exercises are performed. After removing the immobilizer, patients are encouraged to do active assisted and active range of motion exercises respectively to regain the full active range of motion and be prepared for the resistance exercises in the following phase of rehabilitation. Electromyography of shoulder muscles has provided scientific basis for many of rehabilitation exercises during this period. Anecdotally, the activities of less than 20% of the maximal voluntary contraction of rotator cuff muscles are considered safe for the first phases of rehabilitation after rotator cuff repair. Using this concept, the aim of this dissertation is to evaluate the activity of shoulder musculature during some movements and exercises that can theoretically be performed during the early phases of rehabilitation. Three main questions of this thesis are: 1) Do elbow and wrist mobilizations highly activate rotator cuff muscles? 2) Do some resistance exercises of arm, forearm and chest muscles produce high activity in rotator cuff muscles? 3) During active arm elevation, does the plane of elevation affect rotator cuff activity? In our first study, we evaluated 15 shoulder muscles in 14 healthy subjects with both surface and indwelling EMG. Our results showed that while wearing a shoulder orthosis, elbow and wrist movements and even some resistance training involving these two joints, would minimally activate the rotator cuff muscles and can be considered safe. We also introduced some daily living tasks that can be performed safely during immobilization period. These findings may help to modify the design of current shoulder orthoses. In the second study, we also showed that resisted arm adduction against a low-density foam that replaced the hard wedge of orthosis would not highly activate the cuff muscles. In our final study, we evaluated the EMG of shoulder musculature during arm elevation tasks in 8 symptomatic patients with rotator cuff tears. We found that supraspinatus activity during arm elevation is significantly higher in abduction plane than in scaption and flexion planes in patients with rotator cuff tears. This suggested a plane sequences for active range of motion exercises during rehabilitation. The findings that are presented in this dissertation, suggest some modifications in the rehabilitation protocols during the first 12 weeks after rotator cuff repair. These suggestions also provide a scientific basis for producing more dynamic and functional shoulder orthoses.
109

Avaliação do uso do plasma rico em plaquetas no reparo da rotura do manguito rotador / Evaluation of platelet-rich plasma use in the repair of rotator cuff tear

Malavolta, Eduardo Angeli 16 January 2014 (has links)
O plasma rico em plaquetas (PRP) tem sido utilizado na ortopedia como método para melhorar a cicatrização tecidual. Existem poucos estudos com alto nível de evidência sobre o seu efeito no reparo do manguito rotador e os resultados são conflitantes, não havendo consenso sobre sua eficácia. O objetivo primário deste estudo foi avaliar o efeito do uso do PRP em pacientes submetidos ao reparo do manguito rotador por via artroscópica através da escala da University of California at Los Angeles (UCLA). A avaliação clínica através da escala de Constant-Murley, de dor através da escala visual analógica (EVA), a presença de rerroturas na análise da ressonância magnética (RM) e a ocorrência de complicações foram considerados desfechos secundários. Estudo prospectivo, randomizado, duplo-cego. Dois grupos com 27 pacientes (Grupo PRP e Grupo Controle) foram submetidos ao reparo artroscópico em fileira simples de âncoras, sendo que, no Grupo PRP, foi aplicado o concentrado de plaquetas ao final do procedimento. O PRP foi obtido por aférese, aplicado na consistência líquida, com adição de trombina autóloga. Foram incluídas apenas roturas de espessura completa do supraespinal com retração inferior a 30 mm. Os procedimentos foram realizados pelo mesmo cirurgião, entre setembro de 2008 e abril de 2012. Os desfechos foram avaliados através das escalas da UCLA, de Constant-Murley, EVA e pela RM, pré-operatoriamente e aos 3, 6 e 12 meses. A EVA foi aplicada adicionalmente no primeiro e sétimo dia. O nível de significância empregado foi de 5%. Os pacientes apresentaram melhora clínica significativa com o procedimento nos dois grupos (p < 0,001). Evoluíram de 13,63 ± 3,639 para 30,04 ± 4,528 no Grupo Controle e de 13,93 ± 4,649 para 32,30 ± 3,506 no Grupo PRP aos 12 meses (p = 0,046) de acordo com a escala da UCLA, com um poder de 84% e tamanho do efeito de 0,56. De acordo com a escala de Constant-Murley, os pacientes evoluíram de 47,37 ± 11,088 para 76,89 ± 13,198 no Grupo Controle e de 46,96 ± 11,937 para 83,26 ± 11,141 no Grupo PRP aos 12 meses (p=0,061). A avaliação aos 3 e 6 meses não demonstrou diferença significativa. A avaliação pela EVA não demonstrou diferença estatística em nenhum dos tempos de seguimento, evoluindo de 7,00 ± 1,939 no Grupo Controle e de 6,67 ± 1,617 no Grupo PRP no pré-operatório para 1,70 ± 2,127 e 1,04 ± 1,808, respectivamente, aos 12 meses (p = 0,220). Na análise pela RM, o Grupo Controle apresentou uma rerrotura completa e quatro parciais, enquanto o Grupo PRP apresentou duas rerroturas parciais (p = 0,42). Ocorreu um caso de rigidez articular em cada grupo (p = 1). O PRP obtido por aférese, aplicado na consistência líquida e com adição de trombina propiciou melhores resultados pela escala da UCLA aos 12 meses de pós-operatório / Platelet-rich plasma (PRP) has been used in orthopedics as a method to enhance tissue healing. There are few studies with a high level of evidence about its effect on rotator cuff repair, and the results are conflicting, with no consensus about its effectiveness. Clinical assessment as measured by the UCLA (University of California at Los Angeles) shoulder rating scale was established as the primary outcome. The secondary outcomes included clinical assessment on the Constant-Murley scale, pain as measured by a visual analog scale (VAS), the retear rate assessed by magnetic resonance imaging (MRI) and the complication rate. A prospective, randomized, doubleblind trial was conducted. Two groups of 27 patients (PRP Group and Control Group) were subjected to arthroscopic single-row repair. Liquid PRP prepared by apheresis was applied to the PRP Group at the end of the surgical procedure, with autologous thrombin. Complete supraspinatus tears with retraction less than 30 mm were included. The procedures were performed by the same surgeon between September 2008 and April 2012. Outcomes were assessed using UCLA and Constant-Murley scales, VAS and magnetic resonance imaging preoperatively and at 3, 6 and 12 months. The VAS was also applied on days one and seven. The significance level was 5%. The two groups of patients exhibited significant clinical improvement (p < 0.001). The score on the UCLA scale increased from 13.63 ± 3.639 to 30.04 ± 4.528 and from 13.93 ± 4.649 to 32.30 ± 3.506 in the Control and PRP groups, respectively, between the preoperative assessment and after 12 months (p=0.046), with a 84% power and a 0.56 effect size. The score on Constant-Murley scale increased from 47.37 ± 11.088 to 76.89 ± 13.198 in the Control Group and from 46.96 ± 11.937 to 83.26 ± 11.141 in the PRP Group (p = 0.061). Assessment at 3 and 6 months did not identify significant differences. The VAS did not statistically differ at any investigated timepoint and varied from 7.00 ± 1.939 and 6.67 ± 1.617 before surgery to 1.70 ± 2.127 and 1.04 ± 1.808 at the 12-month assessment in the Control and PRP groups, respectively (p = 0.220). The Control Group exhibited one case of complete and four of partial retears, and the Group PRP exhibited two cases of partial retears (p = 0.42). PRP prepared by apheresis, applied in the liquid state with thrombin, promoted better results on the UCLA scale 12 months after surgery
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L'évaluation en laboratoire et sur le terrain vers la prévention des blessures à l’épaule chez les athlètes de sports aquatiques et d’armée du bras

Gaudet, Sylvain 09 1900 (has links)
No description available.

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