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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.

Rigidity is one of the cardinal symptoms in Parkinson's disease, along with Bradykinesia, tremor and postural instability. Rigidity in PD has been understudied, but its pathophysiological basis remains unclear. Various types of neurophysiological and biomechanical approach have been developed in order to investigate the neural control of muscle tone. A common approach is to observe the sensitivity of muscle resistance in response to stretch velocity or displacement [Kamper, Rea, He]. A recent study on elbow flexors in patients with spasticity and rigidity showed a velocity dependent increase in reactive torque in both groups [Lee H, et al). Even though this Study shows a correlation between elbow flexors and velocity, it doesn't discuss the role of elbow extensors. We studied the rigidity response in the elbow of both arms to different speed movements in 12 patients suffering from Parkinson's disease ON or OFF medication. The purpose of this study was to look at both elbow flexion and extension and show that quantitative measures of rigidity and movement disorders in subjects with Parkinson's disease correlate with the currently used clinical evaluations and also find the correlation between velocity and both elbow extension and flexion at the same time. Elbow was flexed and extended by means of a robotic arm,under four different speeds. The resistance to movement was recorded with a torque sensor and EMG of two elbow muscles; Biceps and Triceps; was recorded while the subjects were attempting to relax. The patients were also examined by physicians and their elbow rigidity and muscle tone and Parkinson's disease stage was evaluated and a Universal score in the categories of UPDRS, MMSE, and CAPIT was assigned for each arm of each individual. In the end we will argue that there is a very strong correlation between speed and elbow Extension and Flexion, muscle activity and the rigidity presented in each arm. We will also present the correlation between the robotic torque measurement and the clinical scores given to each subject.

Title: Effect of strength training with vascular occlusion on the forearm flexor muscle strength. Aims: The aim is to determine the effect of vascular occlusion on maximum isometric strength of forearm muscles. Methodology: The research group of 8 volunteers underwent six weeks of exercise program for upper limb (UL). The exercise program was different for each upper limb. Probands practiced one UL with vascular occlusion and second one without vascular occlusion. The research group was measured maximal isometric strength of forearm muscles before the 6-week exercise block, after 3 weeks of training and after completion of the cycle. All measurements were carried out in the laboratory climbing walls FTVS UK. The results were statistically evaluated using test ANOVA with repeated measurement. Results: The results of examining the impact of vascular occlusion to increase muscle strength flexor forearm in this thesis confirmed. Testing did not find significant differences in absolute strength or relative strength between exercise with vascular occlusion and exercise without vascular occlusion. Absolute strength at exercise with vascular occlusion averaged before exercise program 422 N, after the completion of 461 N. Absolute strength at exercise without vascular occlusion averaged before exercise...

Resumo: Nesta pesquisa foram investigados aspectos anatômicos e biométricos da face flexora dos dígitos de 20 novilhas mestiças da raça Nelore, com idades entre 24 e 36 meses, criadas em sistema extensivo. O material foi proveniente de matadouro sob Fiscalização do Serviço de Inspeção Oficial e mantido sob congelamento a -18°C até o momento da dissecação. Após tricotomia e limpeza das regiões distais ao metacarpo e metatarso, as faces palmar e plantar dos dígitos foram dissecadas in natura e as estruturas anatômicas identificadas e medidas com auxílio de paquímetro universal. As mensurações foram feitas em milímetros (mm) e incluíram o comprimento, a largura e a espessura das estruturas anatômicas digitais. A técnica de dissecação in natura foi considerada útil para a execução deste estudo e as estruturas identificadas e mensuradas incluíram os ligamentos acessórios distais dos paradígitos, ligamentos anulares palmares e plantares, bainha digital tendínea, ligamentos anulares proximais e distais, ligamentos interdigitais distais, tendões flexores digitais superficiais e profundos e a manica flexoria. Os dados biométricos obtidos indicam diferenças (p≤0,05) entre membros, antímeros e dígitos, especialmente nas estruturas anatômicas localizadas distalmente. Devido à escassez de estudos biométricos sobre o assunto, os achados deste trabalho podem servir como valores de referência para a faixa etária de novilhas avaliadas e contribuir em pesquisas morfológicas futuras / Abstract: In the present work anatomic and biometric studies of the distal aspect in the flexor aspect of digits were carried out for 20 cross-breed heifer of Nelore breed aging around 24-36 months raised in an extensive regiment. The materials came from shamble under the Official Fiscalization of Inspect Service and were kept under freezing at -18°C until dissection. After the clipper and cleaning the distal areas, from metacarpus to metatarsus, the structures were dissected and measured by using a universal caliper rule (mm) on length (proximal-distal), widht (abaxial-axial) and thickness (dorso-palmar or dorso-plantar). The dissected structures included the paradigits distal accessories ligaments, palmar and plantar annular ligaments and tendon digital sheath, proximal and distal annular ligaments, interdigital distal ligament, superficial digital flexor tendon and deep digital flexor tendon and manica flexoria. The measured data indicate differences (p≤0,05) among the limb, right, left and respective digits mainly in the more distal analyzed structures. Due to scarcity of biometric studies about this topic, the data found in this work might be useful as a reference for the analyzed group, as well in the anatomic detailed structures which are essential to understanding many of the pathological process of locomotor apparatus in cattle / Orientador: José Wanderley Cattelan / Coorientador: Silvana Martinez Baraldi Artoni / Banca: Julio Carlos Canola / Banca: Claudia Acosta Duarte / Mestre

Context: There has been recent speculation that the intrinsic muscles of the foot may play a larger role in lower extremity control and injury than previously believed. Multiple studies have shown that certain intrinsic muscles increase in size and strength after transitioning to minimalist shoe running, theoretically decreasing injury risk. There are currently no studies that examine the effect that training barefoot has in other athletic populations. Objective: Our purpose was to compare the intrinsic and extrinsic foot muscle size and strength in gymnasts (who predominantly train barefoot) and cheerleaders (who predominantly train shod). Another purpose was to measure time to stability for both groups shod and unshod. Design: Observational study. Setting: Human Performance Laboratory. Participants: 16 collegiate gymnasts (height = 159.3 ± 4.9cm, weight = 56.7 ± 4.3kg) and 16 collegiate cheerleaders (height = 161.9 ± 5.4cm, weight = 58.7 ± 7.1kg) volunteered for this study. Main Outcome Measure(s): The muscle size of 6 intrinsic and extrinsic muscles of the foot were measured using ultrasound, toe flexor strength, as assessed using a custom-made dynamometer, and time to stability following a drop landing, as assessed using ground reaction force data collected with force plates. Results: There were no significant group differences in great toe flexor strength (p = 0.274), lateral toe flexor strength (p = 0.824), or any of the time to stability conditions (p = 0.086 – 0.90). Only one muscle, fibularis longus, was significantly bigger in gymnasts than cheerleaders (p = 0.017) Conclusions: Our findings suggest that the barefoot training of gymnasts may not have as large of an impact on the foot musculature and strength as running barefoot or in minimalist shoes has on these factors.

As the incidence of diagnosed carpal tunnel syndrome continues to increase, an understanding of the mechanism(s) of insult to the median nerve which leads to its development becomes ever more imperative. Knowledge of the exact cause of CTS could lead to improved diagnostic and treatment methods, or more importantly, to better preventative measures. The goal of this study was to investigate movements and interactions of structures within the carpal tunnel during wrist flexion and hand loading in order to obtain information about a specific mechanism of insult to the median nerve. Symptomatic and normal subjects were compared to observe differences in the interactions of the median nerve and its surrounding structures. A new methodology was developed to facilitate the evaluation of these populations.

Carpal tunnel syndrome is a frequently encountered chronic peripheral nerve entrapment disorder caused by mechanical insult to the median nerve, which may occur from impingement by the surrounding digital flexor tendons and the tunnel boundaries. Anatomic finite element models of the carpal tunnel provide a method to evaluate the potential contact stresses that may develop on the median nerve between the digital flexor tendons and tunnel boundaries. Realistic finite element simulations are dependent upon the use of physiologically accurate material properties. The purpose of this work was to ascertain material properties for the digital flexor tendons, median nerve and transverse carpal ligament to inform finite element simulations. The compressive mechanical behavior of the digital flexor tendons, median nerve and transverse carpal ligament was characterized under functionally relevant axial tensile loads. These properties can now be implemented into full scale finite element models of the carpal tunnel to evaluate the mechanism of insult to the median nerve leading to the development of carpal tunnel syndrome.

Spinal cord injury (SCI) manifests signs of spasticity, plantar flexor (PF) hyperreflexia and ankle clonus, and deficits in motor function. In individuals with motor-incomplete SCI (MISCI), ankle clonus may limit independent walking function. Ankle clonus is attributed to enhanced soleus stretch reflex (SSR) excitability due to decreased supraspinal input and maladaptive reorganization of spinal reflex circuitry. We explored these questions: 1. What are the biomechanical, clinical, and neurophysiologic correlates of ankle clonus? 2. Does locomotor training improve ankle clonus and walking function? 3. Will operant conditioning-based interventions that increase tibialis anterior activation or decrease soleus reflex excitability improve ankle motor control and walking function? In Chapter 2 we compared Ankle Clonus Drop Test (Drop Test) measures with clinical and neurophysiologic measures. Drop Test measures were highly reliable and exhibited moderate to strong correlations with clinical and neurophysiologic measures. Analysis of EMG activity during clonus revealed a predominant pattern of antagonist coactivation. In Chapter 3 we investigated the effects of locomotor training on PF and quadriceps spasticity, and walking function. We assessed responsiveness of the PF reflex threshold angle, a Drop Test measure of PF spasticity. PF and quadriceps spasticity decreased after locomotor training and were moderately correlated with increased walking speed. The PF reflex threshold angle measure discriminated between individuals with and without clonus. In Chapter 4 we compared the effects of two operant-conditioning based interventions to, (1) increase TA EMG activation (TA↑) and (2) decrease SOL H-reflex amplitude during active dorsiflexion (SOL↓), on reflex modulation, ankle motor control, and walking function. Each intervention improved walking function; however, modulated the variables in unique ways. TA↑ improved deficits of strength and range of motion, and SOL↓ improved modulation of SSR and SOL/TA coactivation. In Chapter 5 we discussed implications of our conclusions: (1) Drop Test ankle clonus measures are valid, reliable, and responsive; (2) antagonist coactivation was predominant during ankle clonus; (3) in individuals with chronic MISCI, locomotor training decreased PF and quadriceps spasticity and improved walking function; and (4) an operant conditioning-based intervention to either increase TA strength or decrease SOL reflex excitability improved spinal reflex modulation and walking function.

Flexor tendon injuries in zone II of the hand (i.e. between the distal volar crease and the distal interphalangeal joint) can be costly for both the afflicted individual and society because of the high cost of a long rehabilitation period, complicated by tendon ruptures or scarring with adhesion formation, causing impaired range of motion. The aim of the present thesis was to characterize more fully the deep flexor tendon, the tendon sheath and their response to injury in a rabbit model in order to find potential targets to improve the outcome of repair. The intrasynovial rabbit deep flexor tendon differed from the extrasynovial peroneus tendon in the expression of collagens and transforming growth factor-β1 gene expression. Differences were also found in collagen III and proteoglycans between regions of the flexor tendon subjected to either compressive or tensile load. After laceration and subsequent repair of the flexor tendon, a shift in collagen gene expression from type I to type III occurred. Proteoglycans were generally increased with the notable exception of decorin, a potential inhibitor of the profibrotic transforming growth factor-β1 which was markedly increased during the first two weeks after repair in tendon tissue but remained unaltered in the sheaths. Both vascular endothelial growth factor and basic fibroblast growth factor mRNA levels remained essentially unaltered, whereas insulin-like growth factor-1 increased later in the healing process, suggesting potential beneficial effects of exogenous addition, increasing tendon strength through stimulating tenocyte proliferation and collagen synthesis. Matrix metalloproteinase-13 mRNA levels increased and remained high in both tendon and sheath, whereas there was only a transient increase of matrix metalloproteinase-3 mRNA in tendon. We could also demonstrate a significant increase of the proportion of myofibroblasts, mast cells and neuropeptide containing nerve fibers in the healing tendon tissue, all components of the profibrotic myofibroblast-mast cell-neuropeptide pathway. / Biomolecular aspects of flexor tendon healing