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Physiotherapy goal setting in anterior cruciate ligament rehabilitation : an exploration of training, practice and beliefsAlexanders, Jenny January 2018 (has links)
Despite the growing interest into the role of physiotherapists providing psychological interventions within anterior cruciate ligament (ACL), literature surrounding goal setting practices within this field is minimal. The main purpose of this research was to explore physiotherapists' approaches, training and beliefs into goal setting practices used within ACL rehabilitation. The thesis consisted of seven chapters, two of which were empirical studies. The empirical chapters aimed to gain further insight into physiotherapists understanding on the psychological aspects of patients following ACL surgery, theoretical knowledge of goal setting, experiences of implementing goals, training received on goal setting and future training needs. Study four involved a UK cross sectional online survey of one hundred and twenty four physiotherapists (N=124). The survey provided an insight of perceptions and goal setting approaches used within ACL rehabilitation. These findings were further explored in study five which involved a UK semi-structured interview study including twenty four physiotherapists (N=24), using an inductive approach. Study five provided a much deeper understanding in to physiotherapist's goal setting practices, training and experiences within ACL rehabilitation and also revealed issues surrounding the initial consultation process. The research findings were conceptualised into a theoretical, innovative goal setting model. The goal of this model is to outline a multi-phase conceptual model of an appropriate ACL rehabilitation goal setting strategy for physiotherapists in an attempt to guide both practice, teaching and research.
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The effects of acute exercise and nutritional interventions on postprandial lipid metabolismO'Doherty, Alasdair Fraser January 2017 (has links)
Raised postprandial triglycerides (TG) is an independent risk factor for cardio-metabolic disorders. This is due, in part, to the increases in circulating remnant lipoproteins after TG have been transported for storage or hydrolysis. Raised TG, are also associated with an atherogenic lipoprotein phenotype (High TG, low high-density lipoprotein cholesterol (HDL-c) and small, dense low-density lipoprotein (LDL) particles). In addition, elevated TG contribute to ectopic storage of fatty acids in liver, adipose and muscle tissues, contributing to insulin resistance in all three tissues and consequent metabolic dysregulation. It is therefore paramount to prevent frequent and prolonged exposure to raised TG in the postprandial period, particularly in groups who are at increased risk of cardio-metabolic disease. The dyslipidaemic component of cardio-metabolic health can be inferred by assessing the capacity to breakdown and clear TG from circulation after high fat ingestion using an oral fat tolerance test (OFTT). The OFTT can also be used to assess the efficacy of interventions targeting reductions in postprandial TG. Exercise and nutritional interventions have been shown to alter postprandial TG excursions and provide insight in to underlying mechanisms of postprandial lipid metabolism. However, there are several topics within this area of research that require further clarification. These topics have been addressed within this thesis. The first experimental chapter of this thesis (chapter 3) aimed to investigate the repeatability of an OFTT (75g fat, 22g carbohydrate, 14g protein) designed to meet recommendations from an expert panel statement. This study also aimed to evaluate the repeatability of the postprandial response to an OFTT preceded by 1 hour of acute moderate intensity exercise (cycling at a work rate eliciting 90% oxygen consumption anaerobic threshold). After an overnight fast, 11 healthy adult male participants consumed OFTT meals on 4 separate occasions; 2 preceded by rest and 2 preceded by exercise. TG area under the curve (AUC) was calculated for each test and compared to the repeat condition using non-parametric Bland-Altman analysis. The 4-hour OFTT was repeatable in the rest condition, with 9 of 10 repeat measurements falling within ±15% of the median TG AUC (predefined as the upper limit of acceptable error). However, in the exercise condition repeatability was poor with only 2 of 11 repeat measurements falling within 15% of the median TG AUC. Adult offspring of type 2 diabetics (OT2D) show irregular TG responses to OFTT with high or low carbohydrate content, compared to healthy controls. Prior acute aerobic exercise may favourably influence these postprandial responses in OT2D. This feasibility study (Chapter 4) aimed to investigate the effects of carbohydrate content and acute exercise on TG AUC after OFTT in OT2D. On 4 separate days, 8 adult male OT2D ingested OFTTs with low (HFLC; 75g fat, 22g carbohydrate, 14g protein) or high (HFHC; 75g fat, 95g carbohydrate, 14 g protein) carbohydrate content. Participants rested or exercised (1-hour moderate intensity; 90% oxygen consumption at anaerobic threshold) the day before each OFTT. Recruitment to the single centre was slow, but participant adherence to the study was good. There were large effect sizes for lower TG AUC and incremental AUC (iAUC) in the HFHC with prior exercise. Insulin AUC was higher in HFHC conditions and there was a large effect size for lower insulin AUC in the exercise conditions. Given the large effect sizes observed for the effects of prior acute exercise on postprandial TGs, an adequately powered multi-centre study was deemed to be relevant and feasible. Consumption of strawberries appears to be beneficial in attenuating the postprandial lipaemic response to OFTT due to the high polyphenol content within strawberries. The mechanisms of this attenuation in postprandial lipaemia appear to be different from the mechanisms involved in exercise induced reductions in postprandial lipaemia. However, the combined effects of exercise and strawberry interventions in reducing postprandial lipaemic responses to OFTT has not been investigated. The final experimental chapter (Chapter 5) aimed to evaluate the combined effects of acute exercise and strawberry consumption on postprandial responses to OFTT (73g to 74g fat, 32g to 33g carbohydrate, 11g to 12g protein). On 4 separate days, ten overweight/obese males ingested OFTTs with 25g freeze dried strawberries or a placebo. Participants rested or exercised (40 minutes submaximal high intensity exercise, HIIE) the day before each OFTT. There was a 20% reduction in TG AUC in the exercise conditions and no differences in TG AUC in the strawberry conditions. This thesis offers key contributions to postprandial lipid metabolism research. First, the OFTT recommended by an expert panel statement is repeatable. Second, the variability observed in postprandial responses to OFTT with immediate prior exercise may explain the inconsistencies within the literature. Third, acute exercise showed a substantive effect in reducing TG AUC and iAUC with high carbohydrate OFTT in adult OT2D. These improvements could be explained by acute improvements in insulin sensitivity, however, a further adequately powered study is required to support the findings of this feasibility study. Finally, acute HIIE appears to be an effective strategy to reduce postprandial TG, but strawberry intake does not appear to improve postprandial TG.
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The utility of PlayerLoad™ in soccer : an examination of the reliability, validity, determinants and the within match patternsBarrett, Stephen Mark January 2016 (has links)
The aim of the thesis was to examine the utility of tri-axial accelerometer data (PlayerLoad™) during soccer, including its reliability, validity, and determinants, with special reference to potential implications for fatigue management and injury risk. The aims of the first experimental study (chapter 3) were to: 1) establish the test-retest reliability oftri-axial accelerometer data during a standardized bout of treadmill running; 2) examine the effect of accelerometer location upon PlayerLoad™ data; and 3) investigate the convergent validity of Player Load™ using heart rate and rate of pulmonary oxygen uptake (V0₂) as criterion measures of exercise intensity. Forty-four team-sports players performed two standardized incremental treadmill running tests (7-16 km·h⁻¹) 7 d apart. Players' V0₂ (n=20), heart rate (n=44), and tri-axial accelerometer data (n=44) were measured at both the scapulae (SCAP) and at the centre of mass (COM). A cumulative vector magnitude (PlayerLoad™ [PLvM]) together with individual-component planes of PlayerLoad™ (anterior-posterior PlayerLoad™ [PLAP ], medial-lateral PlayerLoad™ [PLML] and vertical Player Load™ [PLv]) were examined. PlayerLoad™ and its individual planes showed moderate to high test-retest reliability (ICC: 0.80-0.97; CV: 4.2-14.8%) at both unit locations. PlayerLoad™ was significantly higher at COM versus scapulae (223.4 ± 42.6 vs. 185.5 ± 26.3 au; p = 0.001). The percentage contributions of individual planes to PlayerLoad™ were higher for PLML at the COM (scapulae: 20.4 ± 3.8%; COM: 26.5 ± 4.9%; p = 0.001), but lower for PLv (scapulae: 55.7 ± 5.3%; COM: 49.5 ± 6.9%; p = 0.001). Between-subject correlations between PlayerLoad™ and V0₂, and between PlayerLoad™ and heart rate, were trivial to moderate (r = -0.43 to 0.33), whereas within-subject correlations were nearly perfect (r = 0.92 to 0.98). PlayerLoad™ had a moderate to high degree of test-retest reliability and demonstrated convergent validity with measures of exercise intensity on an individual basis. However, caution should be applied in making between-athlete contrasts in loading, and when using recordings from the scapulae to identify lower-limb movement patterns. Further research is required to investigate if multidirectional movements observed in team sports, such as soccer, effect the reliability of PlayerLoad™ Experimental study 2 (Chapter 4) aimed to examine the PLvM and the individual planars response to a 90-min laboratory controlled soccer match-play simulation. Five semi-professional and 15 university soccer players completed three trials (one familiarisation, two experimental) of SAFT⁹⁰ PlayerLoad™ and its individual planes were measured continuously using micromechanical-electrical systems (MEMS) positioned at the scapulae (SCAP) and near the centre of mass (COM). PlayerLoad™ and its individual planars showed moderate and high test-retest reliability at both locations (ICC: 0.80-0.99). No between-half differences in PLvM were observed; however, within-half increases were recorded at the COM, but only during the first half at the SCAP. Greater contributions to PLvM were provided by PLv and PLML when derived from the SCAP and COM, respectively. PLvM (COM: 1451 ± 168; SCAP: 1029 ± 113), PLAr (COM: 503 ± 99; SCAP: 345 ± 61), PLML (COM: 712 ± 124; SCAP: 348 ± 61) and PLv (COM: 797 ± 184; SCAP: 688 ± 124) were significantly greater at the COM compared to the SCAP. Player Load™ and its individual planes are reliable measures during SAFT⁹⁰ and detected within-match changes in movement strategy when the unit was placed at the COM, which may have implications for fatigue management. Inferring alterations in lower-limb movement strategies from MEMS units positioned at the SCAP should be undertaken with caution. Further research is warranted to examine the between-match variability of PlayerLoad™ and its individual planes during actual soccer match play. The principle aim of the third experimental study (Chapter 5) was to examine the within-match patterns of locomotor efficiency in professional soccer, determined as the ratio between tri-axial accelerometer data (PlayerLoad™) and locomotor activities. Secondary aims were to assess the between match variability and determinants of PlayerLoad™ during soccer match play. PlayerLoad™ and its individual planes were recorded during 86 competitive soccer matches in 63 English Championship players (574 match observations). PlayerLoad™, together with the locomotor activity (total distance covered [TDC]) were determined in 15-min segments. Locomotor efficiency was calculated using the ratio of PLvM and TDC (Player Load™ per metre). The proportion of variance explaining the within-match trends in PLvM, PLAr, PLML, PLv, and TDC was determined owing to matches, individual players, and positional role. PLvM, PLAr, PLML, PLv and TDC decreased after the initial 15-min match period (P=0.001; ƞ²=0.22-0.43, large effects). PL: TDC increased in the last 15 minutes of each half (P=0.001; ƞ²= 0.25, large effect). The variance in PLvM during soccer match-play was explained by individual players (63.9%; P=0.001) and between-match variation (21.6%; P=0.001), but not positional role (14.1 %; P= 0.36). Locomotor efficiency is lower during the latter stages of each half of competitive soccer match-play, a trend synonymous with observations of increased injury incidence and fatigue in these periods. Locomotor efficiency may be a valuable metric to identify fatigue and heightened injury risk during soccer training and match-play. In summary, Player Load™ has a moderate to high degree of test-retest reliability and near perfect convergent validity in comparison to HR and V02 at both the SCAP and COM during incremental treadmill running. Moderate to high test-retest reliability was further observed during SAFT⁹⁰ For both treadmill running and SAFT⁹⁰ , PlayerLoad™ was underestimated when worn at the SCAP in comparison to the COM, with different loading contributions observed in the three planes. Caution should be applied in making between-athlete contrasts in loading, and when using recordings from the SCAP to identify lower-limb movement patterns due to this underestimation. However, locomotor efficiency was lower during the latter stages of each half of SAFT⁹⁰ and competitive soccer match-play, a trend synonymous with observations of increased injury incidence and fatigue in these periods. Hence, locomotor efficiency may be a valuable metric to identify fatigue and heightened injury risk during soccer training and match-play.
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Carbohydrate metabolism during active and passive post-exercise recoveryPeters, Edith M January 1984 (has links)
It is known that light muscular activity performed during the immediate post-exercise recovery period, increases the rate at which lactate and protons are removed from the circulation. This study examined the effect which this light activity had on muscle glycogen and lactate levels, as well as the restoration of blood fuel and hormonal homeostasis. A further dimension of the study was to monitor the metabolic adaptations which took place in the inactive leg during light one-legged post-exercise activity. Eight subjects participated in this study. The testing procedure involved three phases: the assessment of each subject's maximal exercise capacity on the cycle ergometer; the imposition of an intense intermittent exercise protocol which was followed by a passive recovery of 90 minutes; and lastly, the repetition of the exhaustive intermittent protocol followed by a partially-active recovery phase during which the subject cycled with one leg at approximately 30 percent of two-legged VO2. max. for the first 45 minutes of the 90-minute recovery period. During the latter two phases, blood samples and muscle biopsies were taken at rest and during the post-exercise recovery. The light one-legged activity expedited the return of blood lactate and pH levels to basal values (p < 0,01), during the initial 30 minutes of recovery but slowed down the removal of lactate and protons during the latter 15 minutes of the active recovery. There were no significant differences in the blood glucose, pyruvate, alanine, and insulin levels during the different recovery protocols, but plasma glucagon levels were significantly lower <p<0,01) during the active recovery. The major finding was that glycogen resynthesis was not significantly <p>0,05) delayed as a result of activity during the immediate post-exercise period, but that muscle lactate levels were significantly lower in the passive leg than in the active leg after the first 45 minutes of the recovery period. As resynthesis of glycogen took place during the active recovery, this study appeared to indicate (i) that lactate oxidation was an important source of substrate during the initial 30 minutes of the active recovery (ii) that oxidation was possibly the primary fate of lactate during the active post-exercise recovery period and (iii) that intramuscular glyconeogenesis in the fast-twitch muscle fibres of the previously active legs was a distinct possibility. Apparent suprabasal production of lactate in the active fibres of the active leg during the latter stages of the active recovery, however, appeared to indicate partial reliance on exogenous glucose as substrate in these fibres during this stage of the recovery.
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The effects of amlodipine on exercise performance in mild to moderate essential hypertensivesGillies, Hunter Campbell January 1997 (has links)
The effect of the long acting dihydropyridine calcium channel antagonist, amlodipine, on the exercise performance of hypertensive patients is not known. The aim of this study was to determine the effects of amlodipine on maximal (MAX), prolonged submaximal (PSX) and on skeletal muscle function (SMF) in patients with mild hypertension. In a double-blind randomised crossover trial, ten physically active hypertensive patients performed i) graded exercise to exhaustion for determination of maximal oxygen consumption (VO₂ₘₐₓ), peak heart rate (HR) and systolic blood pressure (SBP); ii) PSX at 75% VO₂ₘₐₓ to determine, cardiorespiratory responses, cardiac output (Q), blood lactate [La], free fatty acid [FFA], glucose [G] concentrations and ratings of perceived exertion (RPE), and iii) tests of isometric SMF including maximal voluntary contraction (MVC) and time to fatigue (TTF) during repetitve isometric MVC's. Tests were performed following two week ingestion of amlodipine (5 mg daily) or placebo seperated by a two week washout period. Resting SBP was decreased following ingestion of amlodipine (142 ± 13 vs l33 ± 12 mmHg; vs placebo: [mean± SD]; P<0.05). However, VO₂ₘₐₓ ( 31 ± 5 vs 33 ± 5 mlO₂.kg.min⁻¹ ; amlodipine vs placebo), peak heart rate ( 167 ± 12 vs 165 ± l6b.min⁻¹;amlodipine vs placebo)and peak SBP(l8l ±21 vs 170± 16mmHg; amlodipine vs placebo) were not reduced following ingestion of amlodipine. Submaximal cycling time. VO₂, Q, BP, HR, ventilation, RPE, [FFA], [La] and [G] during PSX were unaltered following ingestion of amlodipine. Similarly ingestion of amlodipine did not alter tests of isometric SMF. These data suggest that: i) ingestion of amlodipine lowers resting SBP but does not alter the normal haemodynamic response during exercise; ii) MAX, PSX exercise performance and SMF are unaltered following ingestion of amlodipine in athletic hypertensive patients. These findings suggest that the regulatory mechanisms which maintain haemodynamic homeostasis during maximal and submaximal exercise are not influenced by ingestion of amlodipine in athletic hypertensive patients.
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A 12 week pre-season fitnes training programme for senior male high school rugby players : the effect of supervision on anthropometric, physiological and physical performance variablesClark, David Rodney January 1998 (has links)
The study comprises of two sections; i) a survey to determine the attitude towards fitness training for rugby and the current fitness training habits of elite high school rugby players in their penultimate year at school, ii) a training study on a sample of the same population group, to measure the effect of a 12 week fitness training programme, based on scientific principles, on anthropometric, physiological and performance variables. The training study also measured the efficacy of training supervision compared no supervision on these variables.
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The effects of sodium chloride ingestion on fluid balance and body fluid distribution during exerciseSanders, Barry January 1993 (has links)
The aim of the first experiment of this thesis was to determine whether the ingestion of a concentrated sodium chloride solution (100mEq/1) during exercise would expand the plasma volume when fluid was ingested at approximately half the rate at which it was being lost as sweat. Six male cyclists exercised for 90 minutes in the heat (32 ± 1 °C, 55 ± 5% RH) at 66 ± 1 % of VO₂ₘₐₓ while ingesting either no fluid CNF), water (W), or a saline CS) solution (100mEq/1). In the Wand S trials, subjects drank 400ml of the fluid immediately prior to commencing exercise, and 100ml of fluid every 10 minutes during exercise until 80 minutes. In the S trial sodium chloride was ingested in capsules. One capsule containing 0.585g of sodium chloride was ingested with every 100ml of water. At the end of the 90 minute exercise bout they rested in a sitting position for one hour in cool conditions (22 ± 1 °C and 70 ± 5% RH). After the initial drop in plasma volume due to the onset of exercise. plasma volume decreased progressively during the NF trial and was significantly less than the 10 minute value at 80 and 90 minutes (p<0.0033). At 40, 60, 80 and 90 minutes of exercise, the plasma volume in the NF trial was significantly less than in the W and the S trials (p<0.05). There was no significant difference between the W and the S trials at any time. Further, after the initial drop in plasma volume due to the onset of exercise. plasma volume did not decrease any further in either the W or the S trial. Plasma sodium concentrations in the NF and the S trial were significantly elevated at 40, 60, 80 and 90 minutes (p<0.0033). Plasma sodium concentration in the NF and the S trials were also significantly higher than in the W trial at 80 and 90 minutes of exercise (p<0.05). Since the ingestion of a sodium chloride solution containing 100mEq/1 did not have a beneficial effect on plasma volume and plasma sodium concentration, when fluid ingestion rates were approximately half of the rate of sweat loss, it is concluded the under these conditions, the ingestion of a concentrated sodium chloride beverage has no advantage over the ingestion of water. The aim of the second experiment of this thesis was to determine the effect of varying concentrations of sodium chloride ingestion on fluid balance, when the rate of fluid ingestion matched the sweat rate. Six male cyclists cycled for 4 hours at 55% of VO₂ₘₐₓ in mild conditions (20 ± 1°c and 70 ± 5% RH), while ingesting either a low salt (LS) (4.6 mEq/1), a medium salt (MS) (50 mEq/1) or a high salt (HS) (100 mEq/1) beverage. Each beverage also contained a glucose polymer in an 8% concentration (8g/100ml). The subjects ingested 400ml of beverage immediately prior to commencement of exercise, and 150ml of fluid every 10 minutes during exercise until 220 minutes. Sodium chloride in the MS and HS trials was given to the subjects as supplemental gel capsules so that the drink was palatable. At the end of exercise, subjects recovered in a sitting position for 30 minutes. At the end of the 4 hours of exercise, fluid loss via the urine was significantly greater in the LS and the MS trials than in the HS trial (p<0.05). As a result, the fluid deficits in the LS and the MS trials were significantly greater than the fluid deficit in the HS trial. There was no significant difference between the MS and the LS trials for urinary fluid loss. During the 4 hour exercise bout, plasma sodium concentrations in the LS, the MS and the HS trials were not significantly different from one another, nor were they significantly different from resting values. There was no significant difference in the rectal temperature response to exercise in the three trials. It can therefore be concluded that in conditions where fluid ingestion matches sweat rate, attenuation of urinary fluid loss to optimise fluid replacement, relies on the ingestion of sodium chloride in quantities greater than that lost in the sweat. Therefore, for the ingestion of sodium chloride in excess of that which is currently available in sports drinks to beneficial, fluid must be ingested in volumes matching sweat loss.
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Biochemical changes in athletes during marathon and ultra-marathon races, with special reference to the incidence and prevention of hypoglycaemiaMcArthur, Penelope S 13 July 2017 (has links)
Fats and carbohydrates are the major fuels utilized during exercise and it has been suggested that carbohydrate depletion is the cause of exhaustion during prolonged exercise lasting more than two hours. However, there is some disagreement in the literature as to whether this exhaustion is due either to muscle glycogen depletion or to hypoglycaemia secondary to liver glycogen depletion. I therefore undertook three studies to determine the roles of hypoglycaemia in explaining fatigue in marathon and ultra-marathon runners.
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An exploration of semantic memory in the temporal lobe epilepsy population following unilateral resectionEhsan, Sheeba January 2014 (has links)
Objectives: The aim of this thesis is to add to the knowledge base on semantic memory (SM) in temporal lobe epilepsy (TLE) following unilateral resection. Method: A systematically informed literature review was completed to identify existing literature. By reviewing the literature, a shortage of studies evaluating SM in this patient group was identified. It also highlighted disparity in objective measurement of SM. An under representation of subjective measurement via self-report was discovered, no apparent reason for this was identified. This literature review informed and provided the rationale behind a correlational study between objective and subjective assessment of SM. Using a case series methodology, SM was reviewed in a sample of 20 people with TLE who had undergone surgery. The aim was to compare self-reported SM difficulties with a standardised SM assessment. Self-report was also explored using content analysis to look at quality of life. Results: There was one significant finding with respect to self-report and neuropsychological tests, this was between self-reported problems with ‘understanding conversations’ and The 64-Naming Test, taken from the Cambridge Semantic Battery (Bozeat et al., 2000). Sensitive measures and sensitive questioning of SM were found to aid identification of changes in SM. In general, self-report ratings of memory were not significantly correlated with objective neuropsychological testing. Exploration of self-report data highlighted that an equal number of left (78%) and right TLE (73%) patients reported problems with SM. Five key themes were identified representing positive and negative factors post-surgery; emotional issues (65%) and adjustment issues (55%) predominated. Psychological issues seemed to reflect reports of depression more than anxiety. Discussion: Participants post-surgery were more sensitive to naming impairments than other forms of SM impairments. Self-report of naming impairments may indicate semantic processing difficulties, and therefore may be a valuable method to aid clinical assessment. Conclusions: Supplementing objective measurement with sensitive self-report assessment is useful in clinical practice.
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Biomechanical and psychological factors that distinguish fallers from non-fallers : a comparative study of transtibial amputees and able bodied individualsVanicek, Natalie Katja January 2009 (has links)
Transtibial amputees are at a higher risk of falling than age-matched able-bodied individuals. In order to make recommendations for falls prevention and treatment programmes, it is important to have a sound understanding of the underlying biomechanical function in persons at high risk of falling. While biomechanical differences between fallers and non-fallers have been identified in older adults, no research to date has specifically compared amputee fallers and non-fallers. The aim of this thesis was to undertake a biomechanical comparison of amputee and able-bodied fallers and non-fallers performing activities of daily living. A secondary aim was to investigate the effect of falls on balance confidence and quality of life and to determine whether a relationship existed between functional and psychological measures according to a person’s falls history. Twenty participants (11 transtibial amputees and 9 controls) took part in several studies including a kinematic and kinetic analysis of level walking, stair ascent and descent using a 3-step staircase. They also completed the Sensory Organisation Test (SOT) and Motor Control Test (MCT) on the NeuroCom EquiTest and their postural control was measured in static and dynamic conditions. Participants completed the MFES and SF-36 psychological instruments aimed at quantifying balance confidence and perceived quality of life, respectively. The first study investigated how falls were monitored by physiotherapists and the use of outcome measures in amputee rehabilitation in England. Shortcomings were identified in amputee rehabilitation in that physiotherapists did not monitor falls incidence regularly among their amputee patients and that there was no consensus on the types of recommended outcome measures. The second study explored the biomechanical differences between fallers and non-fallers during level walking and the findings indicated that the amputee fallers had a significantly larger vertical GRF with respect to body weight during loading on the affected limb (p=0.01) and consequently loaded their affected limb significantly more than the non-fallers (p = 0.03). The opposite finding was reported in the control group, where the non-fallers had significantly greater load rates compared to the fallers (p=0.02). The amputee fallers also had significantly different power profiles at the hip (power absorption in stance, p=0.01) and the ankle (power generation in pre-swing, p=0.04) during the transition from double to single support on the affected leg. In the third study, biomechanical differences were examined during stair ascent revealing that the fallers walked significantly faster up stairs than the non-fallers (p=0.05) in the amputee groups, while the opposite was observed in the control groups (p=0.03). Kinematic differences were revealed, such as significantly increased knee ROM in both groups of fallers when compared to their non faller counterparts (p=0.04 and p=0.05 for the amputee and control groups, respectively). The amputee fallers had significantly larger vertical GRF peaks (p=0.01 and p=0.00, respectively), decay rate (p=0.01), ankle plantarflexor moment (p=0.01) and knee joint powers (power absorption in pre- and mid-swing, p=0.00 and p=0.01, respectively) on the intact limb compared to the non-fallers. A forth study exploring gait patterns during stair descent revealed that some amputees used a modified stepping strategy during stair locomotion by adopting a ‘step to’ pattern. The fifth study used computerised dynamic posturography with the Neurocom Equitest to understand how fallers and non-fallers maintained postural control under static and dynamic conditions. The results demonstrated that the amputee fallers scored significantly better on the equilibrium score on the SOT when visual and somatosensory input was inaccurate (p=0.05) (indicating less postural sway). The amputee fallers also bore significantly more weight through their affected limb during destabilising backwards and forwards translations, while the amputee non-fallers bore more weight through their intact limb (p
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