Lors de la cicatrisation, plusieurs types cellulaires dont les kératinocytes et les fibroblastes ainsi que plusieurs facteurs de croissance jouent d’importants rôles. La cicatrisation cutanée peut aussi être activée par des facteurs exogènes, dont la stimulation électrique (SE). La SE peut moduler les fonctions fibroblastiques durant la cicatrisation. Le fibroblaste contribue de façon active à la cicatrisation en sécrétant différentes protéines (collagène, fibronectine, élastine) pour favoriser le comblement tissulaire. Les fibroblastes adoptent aussi un phénotype contractile en exprimant l’α-actine contribuant à la fermeture de la plaie. Notre hypothèse est que certaines de ces fonctions fibroblastiques pourraient être modulées par une stimulation électrique. Pour vérifier cette hypothèse nous avons utilisé une membrane biocompatible et conductrice à base de polyethylene terephthalate (PET) recouvert de polypyrrole (PPy). Les fibroblastes dermiques humains ont été cultivés sur ces membranes conducteurs, puis exposés ou non à un courant pulsé (PES) selon deux régimes : soit 10s PES suivi de 1200s de repos, ou 300s PES suivi de 600s de repos, durant 24 h. Deux intensités électriques ont été étudiées, 50 et 100 mV/mm. Nos travaux démontrent que la SE favorise l’adhésion, la prolifération et la migration des fibroblastes dermiques. Ces activités cellulaires sont consolidées par une sécrétion importante de FGF2 et d’α-SMA. Il est important de noter que l’effet de la SE favorise le changement phénotypique des fibroblastes en myo-fibroblastes grâce à la voie des Smad et de TGFβ/ERK. Nous avons aussi démontré que l’effet de la SE est maintenue à long terme et est transférable de la cellule mère vers les cellules filles. En effet après sous-culture les cellules expriment toujours de façon importante l’α-SMA. En conclusion, nous avons démontré que la stimulation électrique pulsée module positivement les fonctions cicatricielles des fibroblastes humains. Ces travaux démontrent pour la première fois les voies de signalisation (Smad et TGFβ/ERK) sollicitées par la SE pour activer les fibroblastes lors de la cicatrisation. Ces travaux suggèrent l’utilisation de la SE pour favoriser la guérison/cicatrisation des plaies. / During skin wound healing, cutaneous cells particularly fibroblasts and keratinocytes as well as several growth factors play important roles. Wound healing can be activated by exogenous factors, including electrical stimulation (ES). ES can also modulate fibroblast functions. Fibroblasts contribute to healing by secreting structural proteins (collagen, fibronectin, elastin) to repair the wound area. Fibroblasts also adopt a contractile phenotype expressing α-actin contributing to wound closure. The hypothesis of the thesis is that fibroblasts proliferate and transdifferentiate into myofibroblasts by sensing pulsed electrical signals and adjusting relevant signalling pathways. To test this hypothesis we used biocompatible polyethylene terephthalate (PET) fabrics coated with electrically conductive polypyrrole (PPy). Human dermal fibroblasts were cultured on these conductive fabrics and exposed to the optimized pulsed ES: either 10s PES in a period of 1200s, or 300s PES in 600s period, for a total of 24 hours. Two electric intensities were studied, 50 and 100 mV/ mm. Our work showed that the PES promoted the adhesion, proliferation and migration of dermal fibroblasts. These cellular activities were consolidated by an elevated level of fibroblast growth factor 2 (FGF2) and the high expression of α-smooth muscle actin (α-SMA). Important findings were that PES promoted the phenotypic change of fibroblasts to myofibroblasts, and such change was coordinated through the Smad and TGFβ/ERK pathways. It also demonstrated that the effect of PES was able to maintain for a long period of time after the end of stimulation, and was transferable from the mother cells to the daughter cells. Following subculture, the electrically stimulated fibroblasts still expressed significant amount of α-SMA. In conclusion, this thesis demonstrates that PES through conductive fabrics can activate the wound healing functions in human dermal fibroblasts. This work revealed for the first time that Smad and TGFβ/ERK pathways are required by the PES-induced fibroblasts-to-myofibroblasts differentiation. This work also demonstrated that the PES activated cells can survive in vivo. These studies suggest the application of the PES in promoting tissue regeneration and wound healing.

Literature (Beck, 1986:96; Beaver & Brewster, 2002:132; Piaget et al., 2009:1) indicates that the first two years of a baby’s life is a critical period for development. This period is seen as windows of opportunity for development. There is still controversy in the literature regarding if baby stimulation helps babies to reach their neuro-motor development milestones faster, and which type of stimulation is the most advantageous, namely group stimulation or individual stimulation. The first objective of this study was to determine the effect of different methods of stimulation on the motor development of babies between the ages of 3 – 9 months, and secondly to determine what the effect of stimulation administered by a primary caregiver have on the motor development of babies between the ages of 3 – 9 months. A pretest-posttest design was used based on an available random sample where the effect of motor stimulation in different stimulation groups was tested. For objective 1 the babies (N=42) was divided into three different groups and exposed to informal stimulation (n=14), group stimulation as part of a day care program (n=15) and individual stimulation (n=13) administered by a primary caregiver. A nonstandardised checklist was designed by the researcher, refined in a pilot study and completed by the facilitators of the group and individual stimulation programs in which the content of the motor stimulation program was described. During the pretesting phase the babies were tested by the researcher in order to determine their motor milestone developmental status by means of the Peabody Developmental Motor Scales-2-measuring instrument (PDMS-2). This measuring instrument consists of five sub-scales that are converted to a gross motor, fine motor and total motor quotient. After applying the stimulation programs for 12 weeks on a daily basis in the group stimulation and the formal individual stimulation programs, the same aspects of the babies’ motor development was tested again by the PDMS-2. The results showed that after 3 – 9 months old babies were exposed to formal stimulation programs and the data was adjusted for age in months, gender, other activities and pretest results, they did not reach their neuro-motor developmental milestones faster than the babies that were exposed to informal stimulation. The results also show that babies that received individual stimulation administered by a primary caregiver did not reach their milestones faster than babies that only received informal stimulation. However, it seems that individual stimulation administered by a primary caregiver is more beneficial than group stimulation. For objective 2 the subjects (N=27) was divided into two groups and were exposed to informal stimulation (n=14) and individual stimulation (n=13) administered by a primary caregiver. A co-variance of analysis was used and effect sizes were determined for the differences that occurred. The results showed that 3 – 9 months old babies that were exposed to a formal stimulation program did not reach their neuro-motor development milestones faster than babies that were exposed to informal stimulation, because the informal stimulation groups achieved significant (d > 0.2) higher scores for the gross motor (d > 0.24), fine motor (d > 0.27) and total motor quotient (d > 0.33). Individual stimulation showed nonsignificant higher mean values for the reflex (ẋ = 10.30), locomotion (ẋ = 9.16) and visual-motor integration sub-scales (ẋ = 9.45), while informal stimulation showed higher mean values for static balance (ẋ = 11.46) and grasping skills (ẋ = 10.21). The conclusion can be made that simulation whether informal, formal or in a group is beneficial to babies, but the baby must be ready for the specific stimulation. The success of informal stimulation depends on the parents’ knowledge and educational levels. Consequently the same results will not necessarily be achieved by parents that are from a less wealthy environment and that have fewer opportunities to obtain knowledge about the optimal stimulation of babies. / Thesis (M.A. (Kinderkinetics))--North-West University, Potchefstroom Campus, 2011

Background: Group Cognitive Stimulation Therapy (CST) has been found to be effective in improving cognitive functioning and quality of life in people with dementia. However, little is known about whether it would be effective if delivered in an individual format. Design: A small n within-subjects, repeated measures design was used, with participants acting as their own control, to assess whether Individual CST was beneficial for people with vascular dementia. Method: 27 research packs were distributed, 12 returned the opt-in slip, eight completed the therapy and five participants (with a diagnosis of vascular dementia) were included in this study. Participants completed a four-week baseline period, seven-weeks of Individual CST, followed by a four-week follow up period. Outcome variables were cognitive functioning (assessed at start of baseline and end of intervention), quality of life and self efficacy (assessed at start of baseline, start of intervention, end of intervention and end of follow up) and anxiety and depression (assessed weekly). Results: Cognitive functioning was maintained or improved in four out of five participants. Improvements tended to be in the memory and language domains but declined in the attention domain. Participant quality of life and anxiety and depression ratings were also maintained or improved following the intervention. Conclusion: This research suggests that Individual CST may be beneficial for people with vascular dementia in terms of maintaining or improving cognitive function, improving quality of life and mood. This has implications for the provision of future interventions for dementia. Further research is required to further build on these findings in addition to assessing cost-effectiveness before Individual CST is offered as a therapeutic option.

Würzburg, Universität, Thesis (doctoral), 2001.

Transcutaneous electrical stimulation (TNES) is a controversial treatment method for oropharyngeal dysphagia. Currently, few studies support the effectiveness of TNES for the treatment of dysphagia. This study examines the available research regarding the effectiveness of TNES for the treatment of oropharyngeal dysphagia. / text

Tissue engineering approaches have attempted to address some of the problems associated with articular cartilage defect repair, but grafts with sufficient functional properties have yet to reach clinical practice. Mechanical loads are properly controlled in the body to maintain the functional properties of articular cartilage. This inspires the inclusion of mechanical stimulation in any in vitro production of tissue engineered constructs for defect repair. This mechanical stimulation must improve the functional properties (both biochemical and structural) of engineered articular cartilage tissue. Only a few studies have applied more than two loading types to mimic the complex in vivo load/flow conditions. The general hypothesis of the present thesis proposes that the generation of functional articular cartilage substitute tissue in vitro benefits from load and fluid flow conditions similar to those occurring in vivo. It is specifically hypothesized that application of compression, shear and perfusion on chondrocyte-seeded constructs will improve their properties. It is also hypothesized that protein production of the cell-seeded constructs can be improved in a depth-dependent manner with some loading combinations. Thus, a hydromechanical stimulator system was developed that was capable of simultaneously applying compression, shear and perfusion. Functionality of system was tested by series of short-term pilot studies to optimize some of the system parameters. In these studies, agarose-chondrocytes constructs were stimulated for 2 weeks. Then, longer-term (21- 31 days) studies were performed to examine the effects of both mechanical (compression and dynamic shear) and hydromechanical (compression, dynamic shear and fluid flow) stimulation on glycosaminoglycan and collagen production. The effects of these loading conditions were also investigated for three layers of construct to find out if protein could be localized differently depth-wise. In one of the longer-term studies, the chosen mechanical and hydromechanical stimulation conditions increased total collagen production, with higher amount of collagen for hydromechanical compared with mechanical loading condition. However, their effectiveness in increasing total glycosaminoglycan production was inconclusive with the current loading regimes. The hydromechanically stimulated construct could localize higher collagen production to the top layer compared with middle and bottom layers. Some effectiveness of hydromechanical stimulation was demonstrated in this thesis. Future studies will be directed towards further optimization of parameters such as stimulation frequency and duration as well as fluid perfusion rate to produce constructs with more glycosaminoglycan and collagen.

Literature (Beck, 1986:96; Beaver & Brewster, 2002:132; Piaget et al., 2009:1) indicates that the first two years of a baby’s life is a critical period for development. This period is seen as windows of opportunity for development. There is still controversy in the literature regarding if baby stimulation helps babies to reach their neuro-motor development milestones faster, and which type of stimulation is the most advantageous, namely group stimulation or individual stimulation. The first objective of this study was to determine the effect of different methods of stimulation on the motor development of babies between the ages of 3 – 9 months, and secondly to determine what the effect of stimulation administered by a primary caregiver have on the motor development of babies between the ages of 3 – 9 months. A pretest-posttest design was used based on an available random sample where the effect of motor stimulation in different stimulation groups was tested. For objective 1 the babies (N=42) was divided into three different groups and exposed to informal stimulation (n=14), group stimulation as part of a day care program (n=15) and individual stimulation (n=13) administered by a primary caregiver. A nonstandardised checklist was designed by the researcher, refined in a pilot study and completed by the facilitators of the group and individual stimulation programs in which the content of the motor stimulation program was described. During the pretesting phase the babies were tested by the researcher in order to determine their motor milestone developmental status by means of the Peabody Developmental Motor Scales-2-measuring instrument (PDMS-2). This measuring instrument consists of five sub-scales that are converted to a gross motor, fine motor and total motor quotient. After applying the stimulation programs for 12 weeks on a daily basis in the group stimulation and the formal individual stimulation programs, the same aspects of the babies’ motor development was tested again by the PDMS-2. The results showed that after 3 – 9 months old babies were exposed to formal stimulation programs and the data was adjusted for age in months, gender, other activities and pretest results, they did not reach their neuro-motor developmental milestones faster than the babies that were exposed to informal stimulation. The results also show that babies that received individual stimulation administered by a primary caregiver did not reach their milestones faster than babies that only received informal stimulation. However, it seems that individual stimulation administered by a primary caregiver is more beneficial than group stimulation. For objective 2 the subjects (N=27) was divided into two groups and were exposed to informal stimulation (n=14) and individual stimulation (n=13) administered by a primary caregiver. A co-variance of analysis was used and effect sizes were determined for the differences that occurred. The results showed that 3 – 9 months old babies that were exposed to a formal stimulation program did not reach their neuro-motor development milestones faster than babies that were exposed to informal stimulation, because the informal stimulation groups achieved significant (d > 0.2) higher scores for the gross motor (d > 0.24), fine motor (d > 0.27) and total motor quotient (d > 0.33). Individual stimulation showed nonsignificant higher mean values for the reflex (ẋ = 10.30), locomotion (ẋ = 9.16) and visual-motor integration sub-scales (ẋ = 9.45), while informal stimulation showed higher mean values for static balance (ẋ = 11.46) and grasping skills (ẋ = 10.21). The conclusion can be made that simulation whether informal, formal or in a group is beneficial to babies, but the baby must be ready for the specific stimulation. The success of informal stimulation depends on the parents’ knowledge and educational levels. Consequently the same results will not necessarily be achieved by parents that are from a less wealthy environment and that have fewer opportunities to obtain knowledge about the optimal stimulation of babies. / Thesis (M.A. (Kinderkinetics))--North-West University, Potchefstroom Campus, 2011

Thesis (Ph.D.) -- McMaster University, 1999. / Includes bibliographical references (leaves 154-160). Also available via World Wide Web.

Thesis (M.Sc.). / Written for the School of Computer Science. Title from title page of PDF (viewed 2008/05/30). Includes bibliographical references.

Thesis (Ph. D.)--University of Washington, 2004. / Vita. Includes bibliographical references (leaves 89-108).