Thesis (M.S.M.E.)--University of Delaware, 2007. / Principal faculty advisors: Jian-Qiao Sun, Dept. of Mechanical Engineering; and Katherine Rudolph, Dept. of Physical Therapy. Includes bibliographical references.

Thesis (Ph.D.)--University of Delaware, 2008. / Principal faculty advisor: Sunil K. Agrawal, Dept. of Mechanical Engineering. Includes bibliographical references.

Thesis (M.A.)--University of North Carolina at Chapel Hill, 2005. / Includes bibliographical references (leaves 132-135).

Thesis (M.S.)--Montana State University--Bozeman, 2007. / Typescript. Chairperson, Graduate Committee: Michael E. Hahn. Includes bibliographical references (leaves 50-56).

Orientadores: Anamarli Nuccic Alberto Cliquet Jr / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-11T03:23:57Z (GMT). No. of bitstreams: 1 Casanova_ManuelaAmaralMucci_M.pdf: 2345728 bytes, checksum: f66ccc6bdf60b6250a95b5911fe73602 (MD5) Previous issue date: 2008 / Resumo: A Distrofia Miotônica tipo 1 é doença multisistêmica que afeta com freqüência o músculo estriado, repercutindo na marcha, a qual pode apresentar-se em um espectro, desde muito anormal a sutis alterações de difícil caracterização através da visão humana. O objetivo deste trabalho foi analisar as variáveis espaciais, temporais e cinemáticas da marcha de afetados pela doença. Desenhou-se estudo prospectivo do tipo caso (n = 10) e controles (n = 20); os sujeitos foram investigados quanto à clínica da marcha e submetidos ao teste de força muscular. Marcadores reflexivos foram fixados em membros superiores, inferiores, tronco e pelve. A marcha, com pés descalços, ocorreu em passarela de 6 metros, capturada por 6 câmeras. Foram coletadas e analisadas 3 amostras de cada participante através do Sistema Qualisys®. Utilizou-se o Teste Exato de Fisher e o Teste de Mann-Whitney para a comparação das variáveis demográficas entre os grupos e a estatística descritiva dos casos. Encontrou-se alterações laboratoriais nos 10 pacientes, embora 04 não tivessem clínica de marcha anormal. O comprimento da passada foi diminuído em 80% dos casos, cadência menor em 30% e velocidade lenta em 40%. Anormalidade no movimento do quadril foi observada em 100% dos pacientes, da pelve em 90% e do tornozelo em 70%. O exame laboratorial da marcha permitiu diagnosticar alterações precoces, antes do aparecimento de déficit muscular à oposição de força, como ocorreu em 2 casos. A disfunção da marcha em laboratório esteve associada à fraqueza muscular distal isoladamente em 40%; e em associação com déficit proximal e distal em outros 40% / Abstract: Myotonic Dystrophy type 1 is a multisystemic disease that frequently affects the striated muscle with repercussion on gait. Gait function may be very abnormal or exhibit subtle alterations of difficult characterization by the human eyes. With objective to analyse the spatiotemporal and kinematics variables parameters of gait in patients affected by the disease, a prospective study of type case (n = 10) and controls (n = 20) was designed. The subjects were investigated in relation to clinical aspects of gait and submitted to the muscular force test. Reflexive markers were affixed in the upper and lower extremities, trunk and pelvis. A barefooted gait was performed in a 6-meter runway and captured by 6 ProReflex cameras. Three samples of each patient were collected and analyzed by the Qualisys® System. The Exact Test of Fisher and the Mann-Whitney Test were used for comparison of demographic variables between the groups and a descriptive statistic for cases. Abnormalities were found in all 10 patients, although 4 had no clinical evidence of gait problems. Stride was diminished in 80% of the cases, cadence in 30% and slow speed in 40%. Gait dysfunction was observed in 100% of the patients¿ hips, 90% of pelvis and 70% of ankles. The laboratory examination of gait allows early detection of alterations, even before the appearance of muscular deficit by manual force opposition test as occurred in two cases. Gait dysfunction observed in the laboratory was associated with distal muscular weakness in 40% of the patients and in association with proximal and distal deficits in others 40% / Mestrado / Ciencias Biomedicas / Mestre em Ciências Médicas

Thesis (Ph.D.)--University of Wollongong, 2005. / Typescript. Includes bibliographical references: leaf 251-287.

Severe ankle injuries can result in ligament rupture or a fracture. A major problem after such injuries is limitation in mobility. Weight bearing tasks, such as walking, become a problem because of pain, deficits in joint range of motion and muscle strength. This thesis studies a key dilemma in early rehabilitation, whether to immobilise the ankle or allow joint motion to improve mobility outcomes. Studies have focused on two scenarios, severe ligament rupture, and unstable fractures managed through open reduction and internal fixation (ORIF). The analysis of gait outcomes was an important component of this thesis and a novel analytical method was developed to normalise gait velocity in the estimation of speed-dependent gait outcomes. A systematic review and meta-analysis was conducted including evidence to July 2014. The reporting and design of trials was universally poor. In the 6 weeks of recovery following ankle ORIF surgery, there was insufficient evidence that early ankle movements offered a benefit to mobility recovery compared with immobilisation in a cast. Ankle movements compared with immobilisation reduced the risk of venous thrombosis/thromboembolism. However, compared with cast immobilisation, the risk of deep and superficial surgical site infection and fixation-related complications were higher when ankle movements were permitted. To investigate the role of ankle supports in rehabilitation of walking after ORIF, two randomised cross-over studies were completed. In healthy participants with non-pathological gait, a walker boot induced gait abnormalities when compared with Tubigrip (elasticated bandage). There were no important differences in gait between a stirrup brace and Tubigrip. In people who had undergone ankle ORIF 6 weeks previously, a walker boot and to a lesser extent a stirrup brace offered improvements in gait symmetry and lower pain scores when compared with Tubigrip. Finally, a secondary analysis of the Collaborative Ankle Support Trial cohort (n=584) was conducted, which concluded that, in comparison to Tubigrip, 10 days of cast immobilisation provided greater probability of recovery of a range of mobility outcomes 4 weeks following injury. This thesis contributes evidence favouring a role for ankle immobilisation in improving mobility following severe ankle injury in adults. Clinicians should be aware of the benefits and risk of harms outlined, as well as the limitations in the current evidence base.

Although footwear has been recognised as a risk factor for falls in older people, it remains unclear as to which features of shoes are beneficial or detrimental to balance. This project aimed to systematically investigate the effects of common shoe features, namely: an elevated heel, a soft sole, a hard sole, a flared sole, a bevelled heel, a high-collar and a tread sole, on balance and gait in older community-dwelling people. The experimental shoes were compared to standard shoes in three studies examining: (i) standing balance, leaning balance and stepping in 29 older people, (ii) centre of mass (COM)-base of support (BOS) margins, vertical and braking loading rates, and perceived shoe comfort and stability in 11 young and 15 older people walking on even and uneven surfaces, and (iii) temporal-spatial gait variables, pelvis acceleration, and gait termination in 10 young and 26 older people, on level, irregular and wet surfaces. Elevated heel shoes impaired overall performance in functional tests of balance and stepping. They were also perceived as lacking comfort and stability and led to a conservative walking pattern characterised by increased step width and double-support time, reduced braking and vertical loading rates and medio-lateral (ML) pelvis accelerations on various surfaces. Soft sole shoes increased lateral COM-BOS margin and step width, indicating reduced ML walking stability. When wearing these shoes, subjects had longer total stopping times and on the wet surface, smaller step lengths and shoe/floor angles at heel strike, suggesting a potential risk of slipping. When wearing high-collar shoes, subjects had better balance as demonstrated by small but significant increases in lateral COM-BOS margin, double-support time and step width, and decreases in ML pelvis accelerations on varying surfaces and in total stopping time on the wet surface. Shoes with hard, flared or tread soles or a bevelled heel did not affect balance. In conclusion, providing that they are fitted, have adequate fastening and perhaps a slip-resistant sole, shoes with a low square heel, a sole of medium hardness (shore A-40) and a high-collar provide the greatest stability for older people when walking on dry, wet and irregular surfaces.

Thesis (Ph. D.)--Oregon State University, 2007. / Printout. Includes bibliographical references (leaves 86-88). Also available on the World Wide Web.

Thesis (Ph. D.)--University of Oregon, 2002. / Includes bibliographical references (leaves 178-188). Also available online.