Epidemiological studies consistently report that muscular strains are a primary injury type in rugby union with the majority of the strains occurring to the quadricep and hamstring musculature. Recently it has been suggested that poor eccentric muscular strength is a precursor to hamstring and quadriceps strains during intermittent sports that require rapid acceleration and deceleration. Despite the high incidence of these muscle injuries in Rugby Union there has been little research into the possible mechanisms involved. Thus, the purpose of this study was to measure the physiological and perceptual responses during a simulated Rugby Union laboratory protocol and further, to identify changes in muscle recruitment patterns and muscle strength over time by comparing this protocol to a continuous, constant load protocol covering the same distance. The experimental condition (EXP) required university level players to perform 80 minutes of simulated rugby union play in a laboratory setting (on a walkway of 22m) which was compared to that of a control condition (CON) which involved subjects covering the same distance, at a constant speed of 4.2km.h-1 on a treadmill. Physiological, biophysical and perceptual responses were measured pre-, at half-time and post-protocol. Heart rate was significantly (p<0.01) greater as a result of EXP in comparison to the CON. Electromyography (EMG) of the vastus medialis was significantly (p<0.01) greater during the CON protocol. The EXP condition elicited higher iEMG activity in the hamstring musculature at all time intervals. In addition the iEMG of the semitendinosus decreased significantly (p<0.01) as a result of the EXP protocol. Peak eccentric knee extensors (EXT) (-13.19%) and flexors (FLEX) (-12.81%) torque decreased significantly during the experimental protocol. After passive half-time (236.67 + 56.27Nm (EXT) and 173.89 + 33.3NM (FLEX)) and at the end of the protocol (220.39 + 55.16Nm and 162.89 + 30.66Nm) reduced relative to pre protocol (253.89 + 54.54Nm and 186.83 + 33.3Nm). Peak eccentric knee extensors did not change during the control protocol. „Central‟ and ‟Local” Rating of Perceived Exertion values were significantly (P<0.01) greater during the EXP protocol with an increased incidence of hamstring discomfort and perceived pain (5 out of 10). The EXP protocol resulted in significantly (p<0.01) increased incidence of delayed onset muscle soreness (DOMS). In conclusion, a stop-start laboratory protocol elicited increased heart rate, negatively impacted on muscle activity of the hamstrings, decreased eccentric strength in the lower limb musculature, resulted in increased ratings of „Central‟ and „Local‟ exertion and increased pain perception and increased incidence of DOMS. Thus, a stop-start rugby specific laboratory protocol has a negative impact on performance. Due to the specificity of the protocol being designed to match the demands of competitive match play it is expected that these changes in heart rate, muscle activity and strength, particularly eccentric strength, will impact negativity on performance during rugby match play and increase the likelihood of injury

Made available in DSpace on 2014-06-11T19:23:40Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-12-11Bitstream added on 2014-06-13T20:50:47Z : No. of bitstreams: 1 mattos_lhl_me_botfmvz.pdf: 829995 bytes, checksum: 73939ace7310759bbb3cd6221db93211 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Este projeto teve como objetivo avaliar os efeitos da fototerapia na cicatrização do tendão usando diodos superluminosos fixados em 890nm. Foram induzidas lesões cirúrgicas de 0,2cm de largura x 0,5cm de comprimento, realizadas no segundo terço do Tendão Flexor Digital Superficial de 10 ovelhas saudáveis que foram divididos em dois grupos: grupo tratado com diodos superluminosos com o comprimento de onda acima mencionado e grupo controle, tratado com placebo. A Cinesioterapia foi realizada em ambos os grupos. Os exames ultrassonográficos Modo B e Doppler foram realizados durante os primeiros 14 dias após a cirurgia e, em seguida, nos dias 21 e 28, a fim de avaliar o processo de cicatrização do tendão. A biópsia foi realizada no dia 28 para avaliar a neovascularização e o padrão tendão de fibra no exame histopatológico. Ausência de claudicação e uma melhoria significativa (p < 0,05) na dor após palpação foram observadas no grupo tratado. Além disso, no modo B foi evidenciada uma redução significativa do edema (p < 0,05) nestes animais. Não foi encontrada diferença estatística em relação à evolução da lesão. Houve diferença histológica (p < 0,05) para a neovascularização no grupo tratado. Fototerapia com diodos superluminosos de 890nm minimiza os efeitos do processo inflamatório / This project aimed to evaluate the effects of phototherapy on tendon healing using superluminous diodes set at 890nm. Surgical lesions were induced by 0.2 cm wide x 0.5 cm long, made in the second third of the superficial digital flexor tendon of 10 healthy sheep were divided into two groups: group treated with superluminous diodes with the wavelength mentioned above and control group treated with placebo. The Kinesiotherapy was performed in both groups. The B mode ultrasound examination and Doppler were performed during the first 14 days after surgery and then on days 21 and 28, to evaluate the healing of the tendon. A biopsy was performed on day 28 to evaluate neovascularization and tendon fiber pattern on histopathological examination. No lameness and a significant improvement (p <0.05) in pain after palpation were observed in the treated group. Furthermore, in the mode B was observed a significant reduction in edema (p <0.05) in these animals. No statistical difference was found in relation to the evolution of the lesion. Significant difference was seen (p <0.05) for neovascularization in the treated group. Phototherapy with 890nm superluminous diodes minimizes the effects of the inflammatory process

Objetivo: comparar fixação transversa de enxertos tendinosos solidarizados versus não-solidarizados e entre duas posições rotacionais diferindo 90 graus entre si em túnel ósseo. Métodos: trinta e seis sistemas de fixação de tendões quádruplos bovinos em osso porcino foram confeccionados e divididos em quatro grupos de acordo com duas posições rotacionais de enxerto (diferindo 90◦) e presença ou não de solidarização. Em ensaio de tração, os dados de força e deslocamento nos pontos de falha (força máxima Fmax e primeiro pico válido Fp) e ponto de medida 445N foram medidos, comparados e utilizados para o cálculo de rigidez. Foram contabilizados os picos intermediários válidos. Resultados: os grupos “à cavaleiro” apresentaram maior força de ponto de falha com todos os parâmetros (p < 0,05) e maior rigidez com o uso de ponto de força máxima (P < 0,05). Nos grupos transfixantes, o grupo com solidarização apresentou maior Fmax e Fp (Fmax de 1555,4N ± 408 versus 1135,2 ± 448,7, Fp de 1539,9N ± 400,8 versus 950,5N ± 599,8). A quantidade de picos intermediários foi maior no grupo transfixante sem solidarização. Conclusão: A posição “à cavaleiro” apresentou maior Fmax, Fp e rigidez. Com a solidarização, o grupo transfixante obteve melhor resposta à tração. / Purpose: To make comparison between sewed and not sewed and between two different rotational positions of transverse fixed tendon graft inside bone tunnel. Methods: Thirty-six quadrupled bovine tendon grafts fixation systems in porcine femurs models were divided into four groups concerning rotational positioning inside de bone tunnel and the presence of sewing through the tendon sections. By measuring displacement and load at the resistance limit, first validated peak and 445N point, the groups were compared and the rigidity was achieved. The intermediate validated peaks were observed. Results: looped positioned groups showed higher fail points levels than the transfixed groups using all parameters (p<0,05), as well as greater rigidity when using the maximum load as fail parameter. In transfixed tendons groups, the sewed tendon group showed greater Fmax and Fp (Fmax 1555,4N ± 408 versus 1135,2N ± 448,7 and Fp 1539,9N ± 400,8 versus 950,5N ± 599,8), p<0,05. Intermediate peaks incidence was greater in the not-sewed/not-looped (transfixed) group Conclusion: looped positioned group gave better results: greater Fmax, Fp, and rigidity. The transfixed tendons group had better response to tensile load when sewed.

Objetivo: comparar fixação transversa de enxertos tendinosos solidarizados versus não-solidarizados e entre duas posições rotacionais diferindo 90 graus entre si em túnel ósseo. Métodos: trinta e seis sistemas de fixação de tendões quádruplos bovinos em osso porcino foram confeccionados e divididos em quatro grupos de acordo com duas posições rotacionais de enxerto (diferindo 90◦) e presença ou não de solidarização. Em ensaio de tração, os dados de força e deslocamento nos pontos de falha (força máxima Fmax e primeiro pico válido Fp) e ponto de medida 445N foram medidos, comparados e utilizados para o cálculo de rigidez. Foram contabilizados os picos intermediários válidos. Resultados: os grupos “à cavaleiro” apresentaram maior força de ponto de falha com todos os parâmetros (p < 0,05) e maior rigidez com o uso de ponto de força máxima (P < 0,05). Nos grupos transfixantes, o grupo com solidarização apresentou maior Fmax e Fp (Fmax de 1555,4N ± 408 versus 1135,2 ± 448,7, Fp de 1539,9N ± 400,8 versus 950,5N ± 599,8). A quantidade de picos intermediários foi maior no grupo transfixante sem solidarização. Conclusão: A posição “à cavaleiro” apresentou maior Fmax, Fp e rigidez. Com a solidarização, o grupo transfixante obteve melhor resposta à tração. / Purpose: To make comparison between sewed and not sewed and between two different rotational positions of transverse fixed tendon graft inside bone tunnel. Methods: Thirty-six quadrupled bovine tendon grafts fixation systems in porcine femurs models were divided into four groups concerning rotational positioning inside de bone tunnel and the presence of sewing through the tendon sections. By measuring displacement and load at the resistance limit, first validated peak and 445N point, the groups were compared and the rigidity was achieved. The intermediate validated peaks were observed. Results: looped positioned groups showed higher fail points levels than the transfixed groups using all parameters (p<0,05), as well as greater rigidity when using the maximum load as fail parameter. In transfixed tendons groups, the sewed tendon group showed greater Fmax and Fp (Fmax 1555,4N ± 408 versus 1135,2N ± 448,7 and Fp 1539,9N ± 400,8 versus 950,5N ± 599,8), p<0,05. Intermediate peaks incidence was greater in the not-sewed/not-looped (transfixed) group Conclusion: looped positioned group gave better results: greater Fmax, Fp, and rigidity. The transfixed tendons group had better response to tensile load when sewed.

As patologias apresentadas por algumas estruturas e a necessidade de aumento da capacidade de carga de outras fizeram com que diversas técnicas fossem desenvolvidas para o reforço de vigas de concreto armado. Uma delas é a incorporação e protensão de cabos externos. O grande diferencial desta técnica quando comparada às demais é o seu caráter ativo. Ou seja, por meio da protensão é possível aplicar forças de forma a diminuir o nível de tensões atuantes sobre a estrutura. Neste trabalho, é apresentado um amplo estado-da-arte sobre este tipo de reforço. São descritas algumas obras realizadas com esta técnica e relatados e analisados alguns ensaios em vigas protendidas com cabos externos. Diversos métodos de cálculo de vigas protendidas com cabos não aderentes são apresentados. É mostrado, também, um procedimento para previsão da forma de ruína de vigas protendidas com cabos externos. Foi feito um estudo experimental, ensaiando-se 3 vigas de concreto armado reforçadas por meio da protensão de cordoalhas engraxadas. Os resultados dos ensaios são analisados e comparados com previsões teóricas feitas a partir dos métodos de cálculo estudados e com resultados de ensaios em vigas reforçadas com outras técnicas. Do estudo realizado, foi possível comprovar os benefícios da protensão não só no que se refere à resistência ao momento fletor, mas também ao esforço cortante. / Many techniques for concrete beams strengthening have been developed along the years. Among them, prestressing of external tendons, which presents a major difference when compared to the others: controlled forces can be applied to reduce undesirable stresses in the structure. This work presents a state-of-the-art review on this technique. Some methods proposed to estimate the flexural capacity of beams prestressed with unbonded tendons are reviewed. It is also shown a procedure to predict the failure mode of the beams. Three reinforced concrete beams were strengthened by prestressing of external strands and tested. Results are analyzed and compared with both theoretical predictions and other test results of beams strengthened by alternative techniques. From the research, the benefits of prestressing on improving the flexural capacity and the shear strength of reinforced concrete beams could be confirmed.

Este estudo avaliou a efetividade de uma nova membrana bioabsorvível com propriedades mecânicas e químicas mais adequadas para o uso em tendões. A avaliação foi realizada em coelhos submetidos a reconstrução da porção gastrocnêmia do tendão calcâneo. Foi feita uma avaliação prévia das propriedades mecânicas da membrana com uso de dinamômetro digital que demonstrou capacidade de deformação elástica mínima de 100%. Todos os coelhos foram submetidos a tenotomia e reparo da porção gastrocnêmia do tendão direito, após isso foram randomicamente separados em grupos envelopado com membrana e controle. A extração foi realizada nos seguintes períodos: sete, 14 e 28 dias. A avaliação foi realizada através da macroscopia, histologia, mensuração objetiva do colágeno à luz polarizada pelo image-J®, mensuração de glicosaminoglicanos sulfatados e expressão gênica de proteoglicanos. Na avaliação macroscópica o grupo com membrana apresentou menos aderência e melhor direcionamento das fibras e tecido mais homogêneo em 14 e 28 dias, p=0,02 e 0,03 respectivamente. Na histologia a Classificação de Watkins modificada apresentou as seguintes médias: 14,67±0,42 membrana e 12,67±0,56 sem membrana, p=0,03 em 14 dias, e 19,88±0,83 membrana e 17,25±0,62 sem membrana, p=0,02 em 28 dias. Na mensuração do colágeno as médias dos valores de cinza(mvc) o colágeno tipo III foram de 17,97±1,83 membrana e 12,63±1,07 sem membrana p=0,03 em 14 dias. Para o colágeno tipo I as médias foram de 2,41±0,33mvc membrana e 1,31±0,18mvc sem membrana p=0,01 em 14 dias e 7,30±0,63mvc membrana e 2,92±0,32mvc sem membrana p < 0,0001 em 28 dias. A média dos GAGs foi avaliada em três porções do tendão, proximal, central e distal, em ug/mg de tecido seco. Em sete dias apresentou diferença significativa apenas na porção distal 0,80±0,04 com e 0,38±0,04 sem membrana para condroitin-sulfato em 14 dias não apresentou diferenças entre os grupos. O dermatan-sulfato apresentou diferença estatisticamente significante em 7 dias apenas na porção central 0,42±0,09 com membrana e 1,29±0,67 sem membrana p=0,02. Em 14 dias não foram observadas diferenças entre os grupos. Houve grande variabilidade na expressão gênica no teste das amostras com beta-Actina e GAPDH levando a resultados inconclusivos ou não variação entre os grupos que pode sugerir não variabilidade na expressão gênica dos GAGs no período de 28 dias. Os dados fornecidos por esse trabalho mostram que a envelopagem com a membrana bioabsorvível promoveu aceleração dos processos cicatriciais da porção gastrocnêmia do tendão calcâneo de coelhos / This study assessed the effectiveness of a new absorbable membrane, that presents mechanical and chemical features more suitable to tendons, in rabbit tendons. Before the animal model assessments a mechanical study of the membrane was carried out demonstrating that the minimal capability for elastic deformation of the membrane was more than 100%. All rabbits underwent to tenotomy and reconstruction of the right gastrocnius tendons, thereafter they were randomly divided in tendon wrapped by the membrane and control groups. Extraction was performed in the following periods of time: seven, 14 and 28 days. Assessments used macroscopy, histology, objective collagen assessment by using polarized light and Image-J® program in mean of gray values(mgv), sulphated glycosaminoglycans, genetic expression of proteoglycans. In the macroscopic 14 and 21-day assessments the membrane group presented less adherences p=0.02 and p=0.03 respectively. The modified Watkins classification: 14,67±0,42 membrane and 12,67±0,56 without membrane p=0,03 for 14 days; 19,88±0,83 membrane and 17,25±0,62 without membrane p=0,02 for 28 days. The type III collagen were 17,97±1,83 membrane and 12,63±1,07 without membrane p=0,029 for 14 days. For type I collagen were 2,41±0,33 membrane and 1,31±0,18 without membrane p=0,01 for 14 days and 7,30±0,63 memebrane and 2,92±0,32 without membrane p < 0,0001 for 28 days. The glycosaminoglycans were measured in 3 tendon portions, distal, central and proximal, by using ug/mg of dry tissue. In seven days just the distal part presented statistical differences 0,80±0,04 membrane and 0,38±0,04 without membrane, for 14 days no differences were found for Chondroitin-Sulphate. For Dermatan-Sulphate the central part of the tendon 0,42±0,09 and 1,29±0,67 p=0,02, for 14 days no differences were found. There was high variability for beta-actin and GAPDH for the samples in 28 days with inconclusive results that may mean no variability in gene expression of GAGs at this time period. Results as mentioned above demonstrated that the wrapped tendons by the new membrane presented acceleration in the healing processes for gastrocnemius tendons of New Zealand Rabbits

Trotz intensiver Forschung im Rahmen der Bänder- und Sehnenerkrankungen gelten bestimmte Fragestellungen hinsichtlich Erkrankungs- sowie Heilungsmechanismen als unbeantwortet. Verschiedenste Konzepte des Tissue Engineerings sollen helfen entsprechende Fragen zu beantworten und moderne Therapiekonzepte zu etablieren. Für grundlegende Untersuchungen zur Biologie der Tenogenese sowie zum Wirkmechanismus applizierter mesenchymaler Stromazellen (MSC), gewinnt die Anwendung von dezellularisiertem Sehnengewebe immer mehr an Bedeutung. Zudem erscheint der Einsatz dezellularisierter Sehnen- und Bandkonstrukte zur Wiederherstellung der betreffenden erkrankten Organe sehr vielversprechend. In der vorliegenden Arbeit sollte der Grundstein zur Entwicklung eines in vitro-Modells auf Grundlage equiner Beugesehnen gelegt werden. Primäres Ziel war es, ein optimales Dezellularisierungsprotokoll für intakte equine Beugesehnen (oberflächliche und tiefe Beugesehne) zu etablieren. Um die Zytokompatibilität der dezellularisierten Sehnen zu überprüfen, erfolgte nach Präparation von Sehnenstreifen die Besiedlung mit equinen MSC mit Kontrolle des Besiedlungserfolges. Materialien und Methoden: Oberflächliche und tiefe Beugesehnen (OBS und TBS) des Pferdes (n = 6) wurden nach vier verschiedenen Protokollen dezellularisiert. In zwei Protokollen (Protokolle A und B) erfolgte zunächst die Anwendung von Gefrier-Auftau- Zyklen mit anschließender Lagerung in hypertoner Lösung. Protokoll A sah danach eine Inkubation in 1 % Triton X 100 und Protokoll B eine Inkubation in 1 % Sodium-Dodecyl-Sulfat (SDS) enthaltender Lösung vor. Die beiden anderen Protokolle (Protokolle C und D) sahen ein Verbringen in hypertone Lösung ohne vorherige Gefrierzyklen vor. Anschließend erfolgte bei Protokoll C die Inkubation in Triton X 100 und bei Protokoll D die Inkubation in SDS enthaltender Lösung. Die Effektivität der angewandten Dezellularisierungsprotokolle wurde durch histologischer Färbung, Zellzählung nach Kollagenaseverdau, DNA-Quantifizierung und transmissionselektronenmikroskopischer Untersuchung ermittelt. Nach Evaluierung der Effektivität der Protokolle wurden oberflächliche Beugesehnen nach den Protokollen A und B dezellularisiert (n=3). Nach Präparation von Sehnenstreifen in definierter Größe erfolgte die Besiedelung mit Eisenoxid-markierten equinen MSC. Der Besiedlungserfolg wurde mit verschiedenen histologischen und Fluoreszenzfärbungen (Fluoreszenzmikroskopie) und MRT-Untersuchung kontrolliert. Die Prüfung auf statistische Unterschiede zwischen den Protokollen erfolgte mit dem Friedman-Test und im Falle eines statistisch signifikanten Unterschieds mit dem Wilcoxon-Rang-Test. Das Signifikanzniveau wurde mit p < 0,05 festgelegt. Die Auswertung des Besiedlungserfolges erfolgte deskriptiv. Ergebnisse: Für alle angewandten Protokolle konnte ein signifikanter Dezellularisie-rungseffekt in beiden Sehnenstrukturen (OBS und TBS) gezeigt werden. Die Anzahl der vitalen Zellen nach Kollagenaseverdau sowie die histologisch ermittelte Zellzahl der dezellularisierten Sehnen belief sich in Abhängigkeit des jeweiligen Dezellularisie-rungsprotokolls und der Sehne (OBS und TBS) auf 1 bis 21 % (Median) des nativen Gewebes. Der ermittelte DNA-Gehalt nach Anwendung der mit Gefrier-Auftau-Zyklen kombinierten Protokollen A und B entsprach < 24 % (Median) des nativen Gewebes. Die Anwendung der Protokolle C und D führte zu einem DNA-Gehalt von < 47 % (Median). Die Auswertung der transmissionselektronenmikroskopischen Untersuchung zeigte ebenfalls eine effektive Dezellularisierung des Sehnengewebes bei Erhalt der Struktur der extra-zellulären Matrix. Nach Anwendung der Protokolle A und B konnte wiederum tendenziell eine bessere Effektivität der Dezellularisierung festgestellt werden. Eine gelungene Besiedlung der Sehnenstreifen mit equinen MSC konnte anhand der mikroskopischen Untersuchung und MRT-Untersuchung gezeigt werden. Das beobachtete Zellwachstum bei beibehaltender Vitalität der Zellen sprechen für eine gute Zytokompatibilität. Die nach Protokoll A dezellularisierten und besiedelten Sehnenstreifen ließen ein besseres Zellwachstum über eine Kulturdauer von 14 Tagen erkennen. In der vorliegenden Arbeit konnte eine effektive Dezellularisierung von intakten equinen Beugesehnen gezeigt werden. Anhand der Ergebnisse der Besiedlung erwies sich die Dezellularisierung nach Protokoll A (Gefrier-Auftau-Zyklen und Triton X 100) als vielversprechende Grundlage zur Entwicklung eins in vitro Modells auf Grundlage dezellularisierter equiner Beugesehnen.

Rotator cuff injuries cause pain, disability, and loss of shoulder function in over 17 million individuals in the United States that result in over 500,000 surgeries performed annually, though with alarming failure rates of 20-94% (Colvin et al., 2012; Galatz et al., 2004; Harryman et al., 1991; Jain et al., 2014; Mather et al., 2013; Oh et al., 2007; Vitale et al., 2007; Yamaguchi et al., 2006). These surgeries involve repair or reconstruction of the damaged rotator cuff tendon(s) along with enlargement of the subacromial space by debriding the overlying bone (acromion) and removing the subacromial bursa (Beard et al., 2018; Burkhart et al., 2016; Dines et al., 2006; Lo & Burkhart, 2003; Rossi & Ranalletta, 2020). The subacromial bursa is a synovial-like tissue that is situated between the acromion and the tendons of the rotator cuff. This tissue has been long understood to serve a primarily mechanical role by providing cushioning and protecting from friction-wear from the acromion on the underlying tendons. More recently, the identification of a robust vascular network within the bursa, a resident population of mesenchymal stem cells, and inflammatory responsiveness to rotator cuff pathology have supported the existence of a biological role of this tissue in addition to its mechanical one (Blevins et al., 1997; Gotoh et al., 1998, 2001; Põldoja et al., 2017; Rathbun & Macnab, 1970; Steinert et al., 2015; Yepes et al., 2007). These observations make surgical excision of the bursa problematic, given our current lack of understanding of the implications of removing the bursa on the biological response to tendon injury. Therefore, the goals of this dissertation were three-fold: (1) to determine the role of the subacromial bursa in the rotator cuff tendon response to injury and healing, (2) to interrogate patterns of cellular crosstalk between the subacromial bursa and the rotator cuff following injury, and (3) to demonstrate therapeutic potential of targeting the subacromial bursa for modulating inflammation and improving tendon healing.Motivated by clinically observed phenotypic changes in the subacromial bursa with rotator cuff pathology, the profiles of human bursa and rotator cuff tendon tissues were assessed using histology, proteomics, and transcriptomics. This data set, analyzed in the context of patient demographics and diagnoses, revealed distinct bursa proteomes according to tissue phenotype (i.e., fibrous, vascular, or fatty), patient age, and presence of a tear in the underlying rotator cuff. These results suggested the presence of crosstalk between the rotator cuff and the bursa that had not been previously appreciated. Employing multiple methods of validation, including histology, microcomputed tomography, gene expression, and flow cytometry, the rat bursa was established as an appropriate animal model of the human bursa. Therefore, we used the rat model to investigate the role of the bursa in tendon injury response and healing; tendon injuries were created surgically with or without a subsequent repair to study healing and responses to injury, respectively. The role of the bursa in the response to injury was assessed using gene expression, transcriptomics, and histology. The bursa promoted inflammatory gene expression in the injured supraspinatus but resolved inflammatory gene expression in the intact infraspinatus. The role of the bursa in tendon healing was assessed using gene expression, histology, microcomputed tomography, and tensile mechanical testing of the cuff tendons. Consistent with responses during the inflammatory phase of healing, the bursa promoted expression of genes related to aberrant, scar-mediated healing in the supraspinatus, whereas it promoted tenogenic and tendon extracellular matrix gene expression in the intact infraspinatus. Mechanical testing demonstrated that the bursa protected the infraspinatus from the inflammatory environment caused by the supraspinatus injury but had a limited functional effect on the healing supraspinatus. Microcomputed tomography also indicated bursa-dependence in cortical and trabecular bone remodeling following tendon injury. Cross-talk between the bursa and the tendon was then studied in a novel tissue explant co-culture platform using gene expression and nitric oxide release as outcome measures. These experiments revealed that the activated bursa engaged in immunomodulation of tendon fibroblast responses to inflammatory stimulus. The in vitro platform also established the glucocorticoid dexamethasone as a viable therapeutic candidate for bursa-targeted treatment based on its capacity to regulate the bursa’s response to an inflammatory stimulus and enhance the bursa’s immunomodulatory potential. Therefore, in the final component of this thesis, dexamethasone was delivered via PLGA microspheres in vivo to the bursa to modulate the post-injury inflammatory response in the supraspinatus and the infraspinatus tendons. Results supported the therapeutic potential of this treatment approach to improve rotator cuff healing outcomes. This body of work demonstrated a robust involvement of the bursa in rotator cuff responses to injury, with distinct roles in the underlying injured and intact tendons. This work also established, for the first time, the immunomodulatory capacity of the activated bursa and provided strong evidence against the clinical practice of bursectomy. Finally, use of sustained-release dexamethasone to dampen the inflammatory responses to rotator cuff injury offers a new direction for harnessing the inherent properties of the subacromial bursa therapeutically for improved rotator cuff tendon healing.

<p dir="ltr">Post-tensioned concrete is a popular structural system in modern bridge design, allowing for longer bridge spans and the construction of curved, spliced, and segmental girders. When designed and constructed properly, post-tensioned concrete can offer improved durability over reinforced concrete as it is more resistant to cracking. However, corrosion of prestressing strands can compromise the integrity of post-tensioned construction. Grouting has been the primary method of providing corrosion protection to the prestressing strands. However, grouting of tendons presents numerous limitations and results in multiple problems in practice. As a result, there has been increased interest in the use of unbonded tendons. Corrosion protection can still be achieved in unbonded tendons through the use of flexible fillers such as grease and microcrystalline wax. Limited research has been conducted on unbonded tendons, and no known research exists regarding the behavior of unbonded tendons subject to torsion. The objective of this research was to investigate the torsional behavior and strength of unbonded post-tensioned bridge girders. The scope of work included testing six specimens to investigate the difference in behavior between bonded and unbonded tendons as well as the influence of internal versus external ducts. The influence of transverse reinforcement was also considered.</p>

La douleur à l’épaule touche environ 20% de la population. Parmi les douleurs à l’épaule, la tendinopathie de la coiffe des rotateurs est l’atteinte la plus fréquente. À ce jour, les mécanismes impliqués dans la rémission de la tendinopathie sont encore peu connus. Ce projet visait à évaluer l’efficacité d’une intervention axée sur l’entrainement moteur et évaluer l’impact de cette intervention sur la distance acromiohumérale (DAH). Vingt-cinq participants souffrant d’une tendinopathie de la coiffe des rotateurs ont pris part à une intervention axée sur l’entrainement moteur. L’intervention comptait dix traitements en physiothérapie en plus d’un programme d’exercices à domicile et s’échelonnait sur six semaines. À la suite de l’intervention, les participants souffrant de tendinopathie ont vu leur niveau de douleur et d’incapacité diminuer significativement. De plus, la DAH a augmenté significativement lors de l’élévation du membre supérieur. Les résultats de cette étude démontrent un potentiel de l’utilisation de l’entrainement moteur en physiothérapie dans le traitement des tendinopathies de la coiffe des rotateurs. / Shoulder pain affects more than 20% of the population. Amongst shoulder pathologies, rotator cuff (RC) tendinopathy is the more prevalent cause of pain. However, little is known about the underlying mechanisms that lead to healing of such pathology. The current project aimed at assessing the efficacy of a physiotherapy intervention centered on movement training and assessing the impact of such intervention on the acromiohumeral distance (AHD). Twenty-five subjects suffering from unilateral RC tendinopathy underwent the intervention. The intervention consisted of ten supervised physiotherapy sessions and a home exercise program over a 6-week period. Following the intervention there was a significant decrease in pain and disability levels. Further, a significant increase in AHD during arm elevation was observed. The results of the present study suggest potential for motor training as a useful approach in physiotherapy for the treatment of RC tendinopathies.