Thesis (MHSc--Health Science) -- AUT University, 2009. / Includes bibliographical references. Also held in print ( leaves : ill. ; 30 cm.) in the Archive at the City Campus (T 617.572044 HAR)

Thesis (Ph.D. )--University of Delaware, 2006. / Principal faculty advisor: Cole Galloway, Dept. of Physical Therapy. Includes bibliographical references: (leaves 126-138). Also available in print.

Thesis (M.S.)--University of Delaware, 2006. / Principal faculty advisor: James C. Galloway, Dept. of Physical Therapy. Includes bibliographical references.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic at the Durban Institute of Technology, 2008. / Purpose Cricket fast bowlers are prone to the development of Myofascial pain syndrome and in particular active myofascial trigger points in their rotator cuff muscles of the shoulder joint (Scott, et al. 2001). This is due to the severe stresses placed upon the muscles, bones and joints of the shoulder as a result of the high velocity throwing action (Bartlett, et al.1996). In muscles containing active myofascial trigger points a decrease in the stretch range of motion as well as the maximal contractile force is noted, these two factors may negatively affect the speed at which a fast bowler deliver the ball (Travell, Simons and Simons, 1999). Dry needling is viewed as the most effective means of deactivating myofascial trigger points leading to in increase in both the contractile force and range of motion of the affected muscle, which could increase the speed at which the bowler delivers the ball (Wilks, 2003). The aim of the study was to determine the immediate effect of dry needling active myofascial trigger points of the rotator cuff on bowling speed in action cricket fast bowlers. Method The study consisted of 40 participants (randomly split into two equal groups of 20) each with shoulder pain of a myofascial origin. Group A (intervention group) received the dry needling intervention in their most tender active myofascial trigger point. While participants in Group B (control group) received no treatment. Bowling speeds were measured both before and after the intervention, to determine its effect on bowling speed. IV Data was entered into MS Exel spreadsheet and imported into SPSS version 15 (SPSS Inc.,Chicago, Iiiinois, USA), which was used for data analysis. Paticipants were evaluated on bowling speed, Algometer readings and Numerical pain rating Scale (NRS) both pre and post intervention. Participants were also asked if they believed the intervention increased, decreased or had no effect on their bowling speeds. Two sample t-test was used to compare baseline values between the groups. A repeated measure ANOVA was used to compare the rate of change of each outcome over time in the two groups. Pearson’s correlation analysis (intra-group) was used to assess the strength and magnitude of correlations of the changes in the outcomes. The McNemar – Bowker test and Weighted Cohen’s kappa statistics were calculated to assess agreement between perceived and actual levels of change. Results A significant treatment effect was observed in the intervention group were an increase in bowling speed, algometer readings as well a decrease in Numerical pain rating scale(NRS) scores was observed. There was also a perceived increase in the speed the participants delivered the ball in the intervention group. No significant changes were observed in the control group. The findings of this study indicate that dry needling as a treatment modality would be beneficial to fast bowlers in not only increasing their speeds but also the pain experienced as a result of active myofascial trigger points.

Orientador: Alberto Cliquet Junior / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-05T01:05:19Z (GMT). No. of bitstreams: 1 Sonego_DeniseAparecida_M.pdf: 6116885 bytes, checksum: e05be11ecadbb546cf9fad2e9270e754 (MD5) Previous issue date: 2005 / Resumo: Sistemas ópticos de captura dos movimento são recursos de medição para analisar o movimento articular. A proposta deste estudo foi de (1) comparar o sistema óptico de captura do movimento, com o goniômetro universal (em duas posições de medida: com os braços do goniômetro fechado e aberto) verificando a concordância intra e interexaxaminadores no movimento de abdução do ombro em indivíduos saudáveis e (2) verificar a aplicação do sistema óptico Qualisys, comparando casos patológicos com indivíduos normais. Dezessete indivíduos saudáveis foram avaliados. A análise do movimento foi instituída, utilizando o programa ¿Qview¿, e os dados exportados para o programa ¿Qtools 2.0¿ Três câmaras de vídeo com amostragem de 60 Hz foram utilizadas. Marcadores reflexíveis foram colocados em estruturas anatômicas, para a obtenção das coordenadas tridimensionais. Para verificar a concordância intra e interexaminadores no mesmo método, utilizou-se o coeficiente de correlação linear de Person, considerando (p < 0,05). Os resultados obtidos para o sistema de captura de movimento interexaminadores foram moderados (r>0,62). Para intra-examinadores, o coeficiente foi estatisticamente significante (r>0.92). Para verificar a aplicação do sistema óptico Qualisys, foi utilizado o teste de Mann-Whitney demonstrando as diferenças nos movimentos e amplitudes articulares entre ombros patológicos e normais / Abstract: Optical systems of motion capture are powerful resources of measurement to analyse the articular movement. The purpose of this study was (10 to compare the optical systems of motion capture with the universal goniometer used in two measurements; with the goniometer arms closed and opened; and to assess the agreement of intra and interexaminers in the shoulder¿s abduction movement in healthy individuals and (2) to verify the application of the Qualiys¿s optical system towards comparing pathological and healthy individual. Seventeen healthy individuals were evaluated. The movement analusis was done using ¿Qviews¿ software, the data exported to ¿Qtools 2.0¿ software. Three video cameras at 60 Hz sampling frequency were used. Reflexive marks were placed in anatomical structures, to obtain the three-dimensional coordinates. Person¿s linear correlation (p< 0.05) was used towards verifying agreement for intra and interexaminers. The interexaminers results were moderate (r>0,62). To intraexaminers result in the same method, was statistically significant (r> 0,92). Mann-Whitney test was used to verify the application of the Qualisys¿ optical system, demonstrating the differences in the movement and joint amplitudes both in pathological and normal shoulders / Mestrado / Pesquisa Experimental / Mestre em Cirurgia

Abstract Although nonoperative treatment is recognized as an effective treatment method for humeral shaft fractures, it is associated with an approximately 10% risk of nonunion and long-term impairments of the shoulder joint. There is a growing interest to treat even simple humeral shaft fractures operatively to avoid these problems. Intramedullary (IM) nailing has proven to be very effective in the treatment of femoral and tibial shaft fractures and the same method has been adopted for humeral shaft fractures. However, the results regarding union rate and shoulder joint function after antegrade insertion of an IM nail have been very controversial. The purpose of this study was to investigate fracture union, shoulder joint function and symptoms after antegrade IM nailing of humeral shaft fractures, to assess safety and results of IM nailing in pathological fractures, to evaluate the efficacy of exchange nailing and Ilizarov's technique in the treatment of nonunion after IM nailing and to find out, by comparing shoulder joint symptoms and function after antegrade IM nailing and dynamic compression (DC) plate fixation, whether antegrade access to the medullary cavity is the main reason behind shoulder joint problems. During the years 1987-1997, 126 humeral shaft fractures were operated upon in Oulu University Hospital using antegrade IM nailing. The nonunion rate was 22% and distraction of the fracture fragments was the most important risk factor associated with nonunion. The reoperation rate, for various reasons, was 25%. Shoulder joint pain and impairment of function was present in 37% of the patients. In the treatment of 18 pathological fractures IM nailing was a rapid and safe operation, associated with good pain relief. Exchange nailing of 13 cases of nonunion after IM nailing resulted in a union rate of 47% and this method is not useful in the humerus in contrast to tibial and femoral fractures. Permanent nonunion leaves the patient with severe impairment of the shoulder joint and a loose nail may lead to severe osteolysis of cortical bone. In complicated nonunion with poor bone quality, Ilizarov's technique, although associated with a high rate of minor complications and reoperations, worked well. When IM nailing was compared with DC plating it was found that there were no significant differences in shoulder pain, function scores, range-of-motion and strength. Antegrade insertion of the nail, if carried out properly, is probably not the main reason for shoulder joint impairment after IM nailing. Antegrade IM nailing of humeral shaft fractures is associated with several problems, e.g. shoulder joint impairment and difficulties in reconstruction after nonunion, and indications for this method may be exceptional, such as comminuted and pathological fractures.

Title of the thesis Comparison of muscle activity of selected muscles of shoulder girdle by PEMG examination among elite swimmers and influence of strength training Thesis aim Analyze and evaluate the influence of strength intervention on muscle activity of selected muscle groups by PEMG during swimming locomotion by crawl method in top swimmers. Methods Fifteen top swimmers specializing in the crawl style at the age of 18-28 years participated in this experiment. After determining pain in the area of the shoulder joint using VAS (Visual Analogue Scale) and the SFPS questionnaire (Swimmer's Functional Pain Scale), which reports about the swimming training, health and analgesic use, probands underwent a PEMG examination of 8 evaluated muscles. Subsequently, they simulated a 100m crawl race on VASA, where PEMG data was again captured. Subsequently, everyone carried out a force intervention program and then again underwent a simulation of the 100m crawl on VASA. The evaluation and processing of the obtained data was performed with the program MyoResearch XP Master Edition from Noraxon company with simultaneous video recording. Basic descriptive statistics, Magnitude Based Difference, ANOVA and Cohen D were used for statistical data processing. Results Muscle activity of the examined muscles increased...

In this study I reviewed 28 patients with brachial plexus lesions caused by shoulder dislocation. As far as can be established, this is the largest series reviewed in the literature to date. Contrary to most other reports, the neurological lesions involved the supraclavicular as well as the infraclavicular brachial plexus. The only part of the supraclavicular brachial plexus affected was the suprascapular nerve, and this always recovered spontaneously. Isolated axillary nerve lesions were found to have the poorest prognosis for spontaneous nerve recovery. All lesions that showed no recovery after 3 - 5 months were explored and had either a graft or a neurolysis. This study discusses the combinations of nerve lesions, their recovery and the indications for surgical intervention. I also suggest a classification perhaps more clinically relevant than the anatomical classification of Leffert and Seddon (1965).

The glenohumeral (GH) joint is the most mobile joint in the human body, but its mobility inherently increases the risk of instability. The humeral head sits in a shallow glenoid in the scapula like a golf ball sitting on a tee. The stability in this joint is provided by the rotator cuff muscles and tendons that actively pull the humerus back into the socket to prevent dislocation, especially during overhead motions. However, the rotator cuff is prone to tears, resulting in pain, loss of mobility, and recreational limitations. Surgical reattachment of the tendon to the bone is challenging due to the mechanical disparity between the two tissues, resulting in stress concentrations and a high risk of retear. Notably, the specialized tissue at the tendon-to-bone attachment, which facilitates stress transfer between tendon and bone in healthy joints, does not regenerate after surgical reattachment and healing, making tendon-to-bone repairs prone to re-tears. A comprehensive understanding of GH joint biomechanics is essential for developing early interventions to prevent rotator cuff injuries. Furthermore, improving tendon-to-bone fixation during rotator cuff repair is critical to improve post-surgery outcomes. In the last decade, bioinspired solutions have shown considerable promise for addressing several biomedical problems. This thesis draws bioinspiration from two animals that have evolved unique mechanical functions: (i) the bat shoulder joint, which facilitates repetitive overhead motions during flight and may offer insights into rotator cuff pathology and (ii) the curvature of python snake teeth, which enables secure grasping of prey without soft tissue tearing. In the first part of the thesis, the bat shoulder was studied for its unique characteristics relative to mice. Overhead motions in humans often lead to shoulder injuries, partly because the bony anatomy of the unstable GH joint places greater stress on the joint's surrounding soft tissues to stabilize these motions. Traditional animal models used to study shoulder pathology are quadrupeds, which lack the capacity for overhead motion. In contrast, bats consistently engage in overhead motion during flight, subjecting their shoulders to substantial loading throughout their relatively long lifespan. Remarkably, the biomechanical demands placed on a bat's shoulder are estimated to exceed those of a competitive swimmer’s by 45-fold, despite sharing similar coracoacromial arch anatomy with humans. We were inspired to study functional adaptations in the shoulders of bats that enable this overhead motion. We performed comparative anatomy studies of the shoulders of bats and mice, similarly-sized quadrupeds. By quantifying the constraints imposed by the bony anatomy, we identified adaptations of the shoulder, including the rotator cuff tendons, that allow bats to sustain overhead motion in a high stress, repeated loading environment, without injury. In the second part of the thesis, python teeth were used as inspiration to develop a repair device optimized to grasp the rotator cuff without tearing. Rotator cuff repair surgeries fail frequently, with 20-94% of the 600,000 repairs performed annually in the United States resulting in retearing of the rotator cuff. The most common cause of failure is sutures tearing through tendons at grasping points. To address this issue, we examined the specialized teeth of snakes of the Pythonoidea superfamily, which effectively grasp soft tissues without tearing. To apply this non-damaging and effective gripping approach to the surgical repair of tendons, we developed and optimized a python-tooth inspired array as an adjunct to current rotator cuff suture repair, and found that it nearly doubled repair strength. Integrated simulations, 3D printing, and ex vivo experiments revealed a relationship between tooth shape and grasping mechanics, and enabled optimization of a tooth array device to enhance rotator cuff repair to distribute stresses and increase tendon-bone contact. The efficacy of the approach was demonstrated via human cadaver tests, suggesting an alternative to traditional suturing paradigms that may reduce tendon re-tearing. Collectively, these studies contribute to a better understanding of the biomechanics of the GH joint and offer novel, bioinspired approaches for rotator cuff repair. The functional adaptations of bats provide insight into developing new approaches to treat GH joint instability, and a clinically relevant python-tooth inspired device can ultimately reduce the high rates of re-rupture currently observed in rotator cuff repair.

Forty-five males volunteered to serve as subjects to investigate the effects of limb velocity and limb preference on peak torque/body weight (PTBW), torque acceleration energy (TAE), average power (AVP), and endurance ratio (ER) at isokinetic speeds of 60 and 300 degrees/second during internal and external rotation of the shoulder. Standard Cybex warm-up and test protocol were used for both test conditions. Test/retest reliability estimates ranges from r=.60- .70. Repeated Measures ANOVA revealed significant limb speed and limb preference effects on PTBW, TAE, and AVP in both exercise speed or limb preference. The data illustrate a need for an internal/external shoulder rotation normative profile specific to limb speed and limb preference. / Master of Science