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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Multi-Segment Foot Coordination of the Treated Clubfoot

Whited, Amy 23 November 2015 (has links)
Idiopathic congenital clubfoot can be treated either operatively (comprehensive surgical release (CSR)) or conservatively (ponseti technique (PCT)). This thesis compared the mid-term outcomes after CSR and PCT treatments to a typically developing sample. A Dynamical Systems Analysis (DSA) approach and a multi-segment foot model were used to examine group differences in multi-segment foot and lower extremity kinematics, kinetics, coordination and coordination variability during walking. Ten children with clubfoot treated with PCT and seven children with clubfoot treated with CSR were evaluated retrospectively and compared to ten typically developing children. Multi-segment foot and lower extremity kinematic (240 Hz) and kinetic (1080 Hz) data were collected while participants walked barefoot at a fixed walking velocity (1.0 m/s-1 ±5%). Sagittal plane metatarsophalangeal (MTP) and three-dimensional (3D) forefoot-rearfoot, ankle, knee and hip joint range of motion (ROM) during stance and 3D ankle, knee and hip peak joint moments during push-off were calculated. A modified vector coding technique was used to quantify the multi-segment foot and lower extremity coordination and coordination variability throughout stance for forefoot-rearfoot inversion/eversion (Ff-Rf), rearfoot inversion/eversion–tibial internal/external rotation (Rf-Tib) and femur-tibia internal/external rotation (Fem-Tib) couples. Reduced MTP and forefoot-rearfoot ROM was observed in the CSR group while the PCT group demonstrated values comparable to CTR. Sagittal plane ankle ROM was similar between groups however, the CSR group demonstrated reduced frontal plane ROM compared to PCT. Peak ankle plantar flexion moment was reduced in the last 50% of stance in the clubfoot groups. The CSR group demonstrated greater knee and hip moments compared to CTR and PCT. The PCT group demonstrated lessor peak ankle eversion, knee external rotation and knee valgus moments compared to CTR. No significant differences were observed in Ff-Rf, Rf-Tib and Fem-Tib coordination and coordination variability throughout stance between the groups. PCT and CSR gait was characterized by restricted multi-segment foot motion and abnormal lower extremity joint moments; suggesting mild residual deformity. Despite residual deformity, the coordination and coordination variability results indicate that the PCT and CSR groups are not functionally limited and demonstrate similar multi-segment foot and lower extremity movement patterns as CTR.
2

Inter-Segment Coordination Variability Post Anterior Cruciate Ligament Reconstruction

Kelly, Devin K. 23 November 2015 (has links)
INTER-SEGMENT COORDINATION VARIABILITY POST ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION SEPTEMBER 2015 DEVIN K. KELLY, B.S., UNIVERSITY OF MASSACHUSETTS AMHERST M.S., UNIVERSITY OF MASSACHUSETTS AMHERST Directed by: Dr. Joseph Hamill There is an increased risk for ipsilateral graft rupture and contralateral ACL rupture following ACL reconstruction surgery (ACLR) despite return to sport clearance. The reason for this increased risk is not well understood. Previous literature has shown that decreased coordination variability is indicative of an injured system regardless of the absence of pain. PURPOSE: To quantify inter-segment coordination variability during three portions of the stance phase of gait in athletes at three progressive time points post-surgery compared to the contralateral limb (NI) and healthy controls. METHODS: Three-dimensional kinematic and kinetic data were collected for 10 ACLR and 10 healthy athletes matched for age, gender, and activity level. The ACLR group was measured at 4 weeks, 12 weeks, and when cleared to run post-surgery. Kinematic data were used in a modified vector coding technique to determine inter-segment coordination variability of lower extremity couples of interest. Statistical significance was determined using two factor multivariate ANOVAs (limb x visit) for early (1-33%), mid (34-66%), and late (67-100%) stance with alpha level set at .05. Tukey post-hoc tests were performed where appropriate. RESULTS: ACLR athletes have decreased inter-segment coordination variability of the involved lower extremity during the late stance phase of gait compared to both the contralateral limb and healthy controls at 4 weeks post-surgery. By 12 weeks post-surgery there were improvements in joint function as exemplified by inter-segment coordination variability of the ACLR involved limb becoming similar to the healthy control limb. CONCLUSION: Inter-segment coordination variability during late stance in the present study is not an indication for the increased risk for ipsilateral graft rupture and contralateral ACL rupture in ACLR athletes.

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