<p>Sammanfattning: Bassängträning är en vanlig träningsmetod som många patienter efterfrågar. Fördelar med att träna i varmt vatten är bland annat vattnets tyngdavlastande effekt samt värmens smärtlindrande och muskelavslappnande effekt. Efterfrågan på bassängträning är ibland större än tillgången, vilket kan innebära att sjukgymnasten behöver prioritera vilka patienter som ska få tillgång till bassäng. Tydliga och jämlika rutiner och riktlinjer vid bassängträning behöver finnas. I samband med arbete för att ta fram riktlinjer vid bassängträning är det också viktigt att ha kunskap om patienternas egna upplevelser och behov för att kunna förbättra rehabiliteringen. En enkätundersökning genomfördes med syfte att beskriva hur patienterna upplever bassängträningen, vilka mål de har och hur målet med träningen bestäms samt uppnås. Syftet var också att undersöka vilka faktorer patienterna anser som viktiga för bassängträningens kvalitet. Resultaten visar att de vanligaste målen vid bassängträning är ökad rörlighet och minskad smärta. Nästan alla patienter har varit delaktiga att sätta målen och en övervägande del av patienterna anser att de till stor del uppnår målen. Positiva effekter som upplevs med bassängträningen är fysiska förbättringar och psykiskt välbefinnande. Patienterna anser att det som är viktigast för bassängträningens kvalitet är att ha bra och utbildad personal samt att få gå kontinuerligt på bassängträning.</p>

Sammanfattning: Bassängträning är en vanlig träningsmetod som många patienter efterfrågar. Fördelar med att träna i varmt vatten är bland annat vattnets tyngdavlastande effekt samt värmens smärtlindrande och muskelavslappnande effekt. Efterfrågan på bassängträning är ibland större än tillgången, vilket kan innebära att sjukgymnasten behöver prioritera vilka patienter som ska få tillgång till bassäng. Tydliga och jämlika rutiner och riktlinjer vid bassängträning behöver finnas. I samband med arbete för att ta fram riktlinjer vid bassängträning är det också viktigt att ha kunskap om patienternas egna upplevelser och behov för att kunna förbättra rehabiliteringen. En enkätundersökning genomfördes med syfte att beskriva hur patienterna upplever bassängträningen, vilka mål de har och hur målet med träningen bestäms samt uppnås. Syftet var också att undersöka vilka faktorer patienterna anser som viktiga för bassängträningens kvalitet. Resultaten visar att de vanligaste målen vid bassängträning är ökad rörlighet och minskad smärta. Nästan alla patienter har varit delaktiga att sätta målen och en övervägande del av patienterna anser att de till stor del uppnår målen. Positiva effekter som upplevs med bassängträningen är fysiska förbättringar och psykiskt välbefinnande. Patienterna anser att det som är viktigast för bassängträningens kvalitet är att ha bra och utbildad personal samt att få gå kontinuerligt på bassängträning.

Techn. Hochsch., Diss.--Aachen, 2000.

Orientador: Margareth Castro Ozelo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-26T23:10:22Z (GMT). No. of bitstreams: 1 Pinto_GlendaFeldbergAndrade_M.pdf: 9864752 bytes, checksum: 5d43b3d80ecd27b3c366ad3012943bbc (MD5) Previous issue date: 2015 / Resumo: A hemofilia é uma doença hemorrágica hereditária ligada ao cromossomo X caracterizada pela deficiência do fator VIII (hemofilia A) ou fator IX (hemofilia B). As principais manifestações clínicas da hemofilia são as hemorragias articulares (hemartroses) e musculares (hematomas). Os sangramentos recorrentes frequentemente provocam comprometimentos musculoesqueléticos que desencadeiam a artropatia hemofílica e causam limitações na capacidade funcional desses pacientes. O presente estudo tem como objetivo avaliar o efeito das atividades aquáticas visando melhorar a capacidade funcional dos pacientes com hemofilia. Este estudo foi do tipo intervenção, com pacientes com hemofilia do Hemocentro da UNICAMP, maiores de 6 anos e que apresentassem pelo menos um dos joelhos afetados. Os pacientes selecionados foram avaliados pré- e pós-intervenção através dos instrumentos de avaliação clínica desenvolvidos e validados para hemofilia, incluindo o escore funcional de hemofilia (Functional Independence Score, FISH), o escore de saúde articular na hemofilia (Haemophilia Joint Health Score - HJHS), o questionário de atividades funcionais para pacientes hemofílicos (Haemophilia Activities List, HAL), ou questionário de atividades funcionais para pacientes com menos de 18 anos (Pediatric Haemophilia Activities List, PedHAL). Foi utilizado a eletromiografia de superfície (EMGs) dos músculos da coxa bilateralmente (vasto lateral, vasto medial e bíceps femoral), avaliação da força muscular através da célula de carga dos músculos extensores e flexores e avaliação eletromiográfica da atividade funcional de levantar e sentar. A atividade aquática consistiu na realização de pelo menos 24 sessões do protocolo de hidroterapia desenvolvido e realizado no serviço de fisioterapia do Hemocentro da UNICAMP, ou como alternativa os pacientes foram encaminhados para frequentar pelo menos 24 aulas regulares de natação. O período médio da atividade aquática foi de 12 semanas. Trinta e dois pacientes entre 6 e 40 anos (mediana: 12 anos), com diagnóstico de hemofilia (22 A grave, 9 B grave e 1 A moderada), sem atividades físicas regulares, foram incluídos. Trinta pacientes haviam iniciado a profilaxia secundária ou terciária, por diferentes razões, durante o ano anterior à intervenção aquática. Do total, 11 pacientes realizaram hidroterapia e 21 natação. A comparação de variáveis numéricas pré- e pós-intervenção no grupo de hidroterapia ou natação mostrou diferença estatisticamente significativa para as variáveis: escore de saúde articular (HJHS), para hidroterapia (p=0,006) e natação (p=0,001); escore funcional (FISH) somente para a hidroterapia (p=0,021); PedHAL para hidroterapia (p=0,022) e natação (p=0,001); HAL para hidroterapia (p=0,038) e natação (p=0,024). Em relação aos resultados obtidos através da eletromiografia, primeiramente da força muscular obtido através da célula de carga, é importante notar a ausência de melhora significativa da força muscular no grupo de pacientes que realizou a hidroterapia, principalmente ao compararmos com os dados observados no grupo da natação, onde houve melhora significativa em todos os músculos analisados. Em seguida, em relação à amplitude do sinal eletromiográfico, observamos a melhora do sinal de todos os músculos avaliados após a intervenção hidroterápica e natação, exceto para o músculo vasto medial D no grupo da hidroterapia. Na avaliação da atividade funcional foi observada diferença significativa somente para natação e forte tendência para hidroterapia. Podemos concluir nesse estudo, que um programa de atividade aquática funcional (hidroterapia ou natação), com frequência de 24 sessões, mesmo quando realizado em pacientes com hemofilia que apresentavam comprometimento em membros inferiores, foi eficaz com melhora significativa na saúde articular, além de melhora na funcionalidade, com aumento da força muscular analisada em membros inferiores / Abstract: Haemophilia is an inherited bleeding disorder X-linked, characterized by a decreased activity or lack of clotting factors VIII (haemophilia A) or IX (haemophilia B). The main clinical manifestations of haemophilia are bleeding into the joints (haemarthroses) and in the muscles (haematomas). The current bleeding often causes musculoskeletal impairments that trigger haemophilic arthropathy and promoting functional capacity limitations in these patients. The purpose of this study was to evaluate the effect of the functional aquatic activities in order to improve the functional capacities of patients with haemophilia. It was used the surface electromyography assessment to evaluate the responses of muscle function before and after functional aquatic activities. This study was the intervention type with patients selected from the haemophilia sector of Hemocentro UNICAMP diagnosed with haemophilia, within the predetermined criteria, over the aged of 6 years. After the selection, the assessment tools consisted of: Functional Independence Score (FISH), Haemophilia Joint Health Score (HJHS), the Haemophilia Activities List (HAL), PedHAL which is a version for children and adolescents aged 8 to 17 years and evaluation by surface electromyography of the thigh muscles (vastus lateralis, vastus medialis and femoral biceps), muscular strength assessment by surface electromyography of the extensor and flexor muscles and functional activity by surface electromyography to get up and sit down. We included in this study the institution of an aquatic protocol to reproduce functional improvements in patients with haemophilia. Thirty-two PWH (23 sHA, 8 sHB and 1mHA), aged 6 to 40 years (12(6-40y)), without previous regular physical activity, were enrolled in this evaluation. 30/32 patients started secondary or tertiary prophylaxis for different reasons, during the year before taking off the aquatic intervention. Later the initial evaluation, the patients underwent functional aquatics activities in our service (hydrotherapy) and as an alternative for patients who were unable to attend our service, these were referred to swimming, an aggregate of 24 sessions around 3 months. Later on the intervention, patients were reassessed for comparison of pre and post-intervention. For statistical analysis, we used the paired Wilcoxon test and unpaired for comparison of mathematical variables and Fisher's exact test for categorical variables. The comparison of numerical variables between hydrotherapy and pre and post-intervention, swimming showed statistically significant deviations in the variables, health joint score (p = 0.006 and p = 0.001) respectively, running score (FISH) (p = 0.021) solely for the hydrotherapy, PedHAL (Sum score) (p = 0.022 and p = 0.001) for hydrotherapy and swimming. In relation to the results obtained through the electromyography, firstly to muscle strength obtained through the load cell, it is important to note the lack of significant improvement in muscle strength in the group of patients who performed hydrotherapy, especially when compared with the data observed in the swimming group, where there has been significant improvement in all muscles tested. Then, in relation to the electromyographic signal amplitude, significant signal improvement was observed in all muscles evaluated after hydrotherapy and swimming intervention except for the vastus medialis (right) in the hydrotherapy group. To sum up, we conclude that a functional aquatic activity program (hydrotherapy or swimming), with frequency of 24 sessions, even when performed in patients with haemophilia who presented commitment in lower limbs, was effective with significant improvement in joint health, and addition to improvement in functionality, with increased muscle strength assessed in lower limbs / Mestrado / Clinica Medica / Mestra em Clínica Médica

The dissertation focuses on regenerating and adapting a part of the Prinshof Medical District. The site is identified as an abandoned, left-over space which is located adjacent to the Apies River in Pretoria's urban context. The site's forgotten natural and historical layers, formerly part of the historical Hove's Drift, and the chronological narrative of the Apies River, are investigated in this study. A regenerative water design method is used to catalyse these lost layers in the aim of cultivating a functional and poetic water-conscious design intervention. The programme proposes the creation of a hydrotherapy centre for use by the surrounding institutions in the Prinshof Medical District as part of the continuing narrative for the site and that of the Apies River respectively. Regenerative Biohistoric Waterscapes is able to synthesise the river's natural, historical, and Modern infrastructure narratives and contribute an alternative meaning towards the eco-systemic understanding of the river's potential for Pretoria's future generations. / Hierdie verhandeling konsentreer op die hernuwing en aanpassing van 'n gedeelte van die Prinshof Mediese Distrik. Hierdie terrain is ge?dentifiseer as verlate, 'n oorblewende spasie wat gele? is langs die Apies Rivier in Pretoria se stedelike konteks. Hierdie terrain se vergete natuurlike en historiese agtergrond, voorheen gedeelte van die geskiedkundige Hove's Drif, en die kronologiese relaas van die Apies Rivier, word in die verhandeling ondersoek. n' Hernieude water ontwerpte metode gebruik om hierdie verlore agtergrond gedeeltes in te sluit met die doelwit om 'n funksionele en kunstige water bewuste ontwerp te winkel. Hierdie program stel die skepping voor van 'n hydroterapeutiese sentrum vir die gebruik deur die omliggende inrigtings in die Prinshof Mediese Distrik as deel van die deurlopende relaas vir die terrain en die Apies Rivier onderskeidelik. Die Hiernieude Biohistoriese Waterterrein sal die rivier se natuurlike, historiese en moderne infrastruktuur saamvoeg en sal tot 'n alternatiewe betekenis bydra met betrokking tot n' eko-sistemiese begrip van die rivier se potentsiaal vir Pretoria se toekomstige nageslagte. / Mini Dissertation (MArch (Prof))--University of Pretoria, 2016. / Architecture / MArch (Prof) / Unrestricted

Athletes use a wide range of interventions to promote recovery from strenuous exercise, but few data are available regarding the efficacy of such practices. OBJECTIVE: To examine the effectiveness of commonly used interventions [Rest, light exercise (AR), contrast therapy (CT) and cryotherapy (CR)] during recovery between bouts of intense exercise. We tested the hypothesis that hydrotherapy interventions (CT and CR) would induce favorable physiological and/or psychological alterations such that performance would be improved versus AR and Rest. METHODS: In Study I, 12 active men (25-35 yrs; VO2peak = 46±3 ml·kg-1·min-1; mean±SD) performed 5 consecutive days of HI exercise (4-6 bouts x 30 sec 'all out' Wingate Tests, with 4-min recovery, each day). After each training session, subjects either rested for 20 min (CON, n=6) or completed a CT protocol (n=6) that consisted of alternating cold (10°C) and hot (40°C) tubs using a 4x2:3 min ratio. Performance measures [Peak (Wmax) and mean (Wmean) power, VO2peak, and a 250 kJ Time Trial (TT)] were assessed before and after the HIT. In Study II, 9 active men (29±6 yr, VO2peak = 44±8 ml·kg-1·min-1) performed 3 exercise trials separated by 1 wk. Each trial consisted of 3 x 50 KJ time trials(~100-120%VO2peak) with a different 20-min recovery period [CON, AR (cycling@ SOW) or CR (cold tub@ 10°C)] between rides each week. Venous blood samples were obtained after each recovery period, and analyzed for lactate, interleukin-6, neutrophils, and lymphocytes. Questionnaires designed to assess exercise preparedness were also completed daily in both studies. RESULTS: In Study I, Wmax and TT performance improved after 5 d of HI exercise (time effect, P<0.05), but there were no differences between groups (Wmax-CT: Post: 1310±45 vs Pre: 1215±86; CON: Post: 1343±54 vs Pre: 1220±74 W: TT-CT: Post: 15.8±0.6 vs Pre: 16.7±0.7; Rest: Post: 18.1±1.0 vs Pre: 18.8±1.2 min, means±SEM). In Study II, TT performance averaged 118±10 sec for bout 1 and was 8% and 14% slower during bouts 2 (128±11 sec) and 3 (134±11 sec), respectively, with no difference between treatments (Time effect, P≤0.05). Blood lactate was lower after AR compared to CR and Rest, and neutrophils and lymphocytes were higher and lower respectively (P≤0.05), after CR (8.7±1.3 and 1.4±0.2 x 109cells/L) versus AR (7.1±1.0 and 1.6±0.1) and Rest (6.7±0.7 and 1.6±0.1). With respect to the psychological measurements, the CT and CR groups in both studies reported feeling more revitalized after each treatment session and greater preparedness for subsequent exercise (Treatment effect, P≤.05). CONCLUSIONS: Exercise performance during repeated bouts of intense cycling was not influenced by the type of recovery intervention employed, either during a single session or over the course of a 5 d training session. CR caused greater perturbations in blood immune markers and most notably, hydrotherapy interventions created the perception that subjects were better prepared for subsequent exercise. / Thesis / Master of Science (MS)

Aims: To explore and inform current water immersion recovery practice of high performance athletes; and to compare recovery interventions of 5 minutes cold water immersion, warm water immersion and passive rest, in trained subjects, following intense exercise replicating the demands of game-sports. Methods: Study 1: In a repeated measures design, a measurement approach for use in the evaluation of water immersion efficacy was piloted. The within-day and between-day reliability of surface electromyelography (sEMG), particularly functional wavelet analysis, was evaluated in human lower limb muscles. Functional wavelet analysis provides the opportunity to measure neuromuscular function at the greatest level of detail by differentiating the relative intensity of low and high frequency motor unit recruitment. On 2 consecutive days (Trial 1 & Trial 2), 12 participants performed 3x5 second isometric 80% maximal voluntary contractions (MVC) on a Biodex® dynamometer in each of 150 ankle plantarflexion, 200 knee extension and 200 knee flexion. sEMG was obtained from the medial gastrocnemius (MG), vastis medialis (VM), vastis lateralis (VL) and biceps femoris (BF) muscles. Joint position and force production were controlled. Electrodes remained in situ during each trial. Electrodes were removed upon completion of Trial 1 and replaced in the same position the next day for Trial 2. Simultaneous sEMG metrics for intervals of consistent force production were compared between contractions in Trial 1 and Trial 2 (between-day) and contractions within Trial 2 (within-day). Study 2: 11 trained participants completed the 90 minute Loughborough Intermittent Shuttle Test (LIST). Five minutes of COLD water immersion (8.8 ± 0.30C), WARM water immersion (35.1 ± 1.80C) and REST were compared in a repeated measures randomised cross over design. Recovery was evaluated at 2, 4 and 24 hours post exercise using circulating markers of muscle damage, muscle dynamometry, drop jump and repeated single leg hop performance tests and perceived recovery. Study 3: Current water immersion practice of high performance athletes, practice implications stemming from this study’s findings, and the rationale were explored. In a purposive, theoretical sampling approach of expert consultation, 8 professionals advising internationally competing athletes on water immersion recovery practice were provided with a research brief of this project in advance of a scribed, semi-structured interview. Participants were of Sports Coach, Strength & Conditioning Coach and Sports Physiotherapist professions with a minimum of 5 years’ experience working with internationally competing athletes; and differed in international location and sporting disciplines.

Thesis (Ph. D.)--University of Alberta, 1998. / "Spring 1998." Includes bibliographical references (p. 253-269). Also issued online.

Thesis (Ph. D.)--University of Washington, 2004. / Vita. Includes bibliographical references (leaves 56-68).

Background: Rheumatoid arthritis (RA) is a chronic inflammatory joint disease. Physical activity is a cornerstone in the treatment. Hydrotherapy is an appreciated alternative for many patients. Quantitative research has been made in the area but to the authors’ knowledge, no qualitative studies have been made. Purpose: To explore and analyse the experiences of hydrotherapy among a group of people with RA with a focus on the impacts of the exercise form. Design and method: Explorative, descriptive qualitative design. Semi-structured interviews with five people with RA. A qualitative content analysis was chosen to process data. Results: Three themes were identified: The pros of exercising in water; The cons of exercising in water; When hydrotherapy is especially important. These themes contain eight categories: Effects; Important in implementation; Positive attributes of the pool; Community; Negative attributes of the pool; Availability; Bad periods; Disease severity; Konklusion: The informants especially highlighted the exercise effects, social aspects and the properties of water as pros. The hard pool floor and the inavailability were the primary cons experienced. Hydrotherapy seemed particularly incentivized when coupled with high disease severity. This study can serve as a foundation when choosing a physical activity intervention for this group. Future studies with similar purposes should include a larger sample.