Orientador: Marli Terezinha Cassamassimo Duarte / Resumo: As úlceras cutâneas crônicas de origem neuropática secundárias à hanseníase são de difícil resolução e onerosas ao sistema público de saúde e aos pacientes acometidos. Há coberturas de alta tecnologia para o tratamento das úlceras, entretanto, são de custo elevado. Desta forma, faz-se necessário identificar tratamento que possa ser usado nessa população, buscando minimizar ou regredir completamente a úlcera e que seja de baixo custo. Objetivo: Avaliar a viabilidade de um protocolo para uso da pomada de óxido de zinco nas concentrações a 20% e 25% comparada ao hidrogel, no tratamento de úlcera crônica de perna de pessoas com sequelas de hanseníase e propor instrumento de acompanhamento de pacientes em tratamento de úlceras crônicas. Método: Estudo clínico pragmático, do tipo piloto, randomizado com três braços paralelos, aberto em relação ao controle (hidrogel) e cego entre os dois grupos de intervenção, a saber: óxido de zinco a 20% e 25%. A população do estudo foi constituída por pacientes atendidos nos ambulatórios do Instituto Lauro de Souza Lima, portadores de úlceras de perna, que já concluíram o tratamento para a hanseníase e a amostra constituída por 12 pacientes com 36 úlceras. Como desfechos primários foram avaliadas as taxas de adesão, recrutamento e de eventos adversos. O desfecho secundário foi a avaliação da eficácia das intervenções por meio da avaliação inicial e evolução da úlcera, empregando-se a Pressure Ulcer Scale for Healing (PUSH) e a mediana da área em ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The chronic skin ulcers of neuropathic origin, secondary to leprosy, are difficult to heal and costly to the public health system and patients. There are high technology dressings for wound treatment, however, they are expensive. In this way, it is necessary to identify the treatment which can be applied to this population, seeking to minimize or completely reduce the ulcer at lower costs. Objective: To evaluate the viability of a protocol for the use of zinc oxide ointment at 20% and 25% concentrations compared to hydrogel, in the treatment of chronic leg ulcers of people with leprosy sequelae, and to suggest a follow-up instrument for patients under treatment of chronic ulcers. Method: This is a pragmatic, pilottype, randomized trial with three parallel segments, open to the control (hydrogel) and blind between the two intervention groups, namely: zinc oxide at 20 and 25%. The study population consisted of patients with leg ulcers, attended at the outpatient clinics of Lauro de Souza Lima Institute, who had already completed the treatment for leprosy, and the sample comprised 12 patients with 36 ulcers. Adherence, recruitment, and adverse event rates were assessed as primary outcomes. Evaluation of the efficacy of the interventions through the initial evaluation and evolution of the ulcer, using Pressure Ulcer Scale for Healing (PUSH), and median of the area in cm2, were assessed as secondary outcomes. Results: Four participants with 11 ulcers were included in the hydrogel ... (Complete abstract click electronic access below) / Mestre

The complexity in human movement has provided a theoretical challenge for movement scientists to comprehend the underlying processes controlling joint movements in a functional and goal-directed manner. Although there has been an increase in research on examining coordination in multi-articular actions, it is still in its infancy. The aim of this thesis was to examine the acquisition of coordination of a discrete multi-articular movement action from the theoretical perspective of Dynamical Systems Theory. Specifically, four different studies examined key research questions raised about understanding the coordination and control of a lower limb multi-articular interceptive action. The thesis concludes with a brief discussion on the key findings and the implications for practitioners in physical education pedagogy relating to a games teaching approach. A discrete multi-articular kicking action with specific task constraints (kicking over a height barrier and to different target positions) was utilised as a research vehicle to examine differences in coordination between three groups of participants: skilled, intermediates and novices. From group analysis, it was determined that skilled and intermediate groups demonstrated a functional coordination mode involving a restricted range of motion at the proximal joints and a larger range of motion at distal joints, mimicking a 'chip-like action' in soccer. In contrast, large range of joint motions throughout the kicking limb were seen for the novice participants who demonstrated a 'driving-like action'. Analysis of ball trajectory data confirmed that novice participants were not able to successfully project the ball over the height barrier. Findings from this study suggested that the observed range of motion is dependent on skill level and task constraints. Functional foot speed at ball contact to various target positions demonstrated by skilled and intermediate players further highlighted the possibility of using a model of learning focusing on coordination to examine progression through the different stages of learning. A multiple single-participant design was further used to investigate coordination of skilled players to determine if refined differences could be present at the skilled level of performance. Although global similarities in terms of the use of a chipping action in projecting the ball was found, differences in foot position for the non-kicking foot and centre of mass displacement near ball contact emphasised that even skilled individuals can demonstrate different coordination solutions to meet the same task goal. Such an observation highlights the concept of degeneracy in the control and coordination of human movement and also provides the impetus to further examine coordination changes in novice learners as a function of practice using multiple single-participant analysis. From the study, individual learners demonstrated different progression trends in terms of joint motion changes while achieving the same task goal. Intra-participant analysis showed how the ball can be projected accurately across the height barrier with both a 'scooping' and a 'chipping' action. When referenced to a model of learning (Newell, 1985), foot speed at ball contact was functionally manipulated by the novice participants to target positions with varying height and accuracy constraints by later stages of learning. It was further suggested that the dynamics of the learner prior to practicing the task could influence the eventual kicking action that emerged. To further investigate learning from a dynamical systems perspective, key features like transitions between preferred movement patterns and role of movement patterns variability in effecting such transitions, were examined. It was determined through the use of cluster analysis procedures that increased movement pattern variability was not a pre-requisite for a transition between preferred movement patterns across participants. Informational and intentional constraints can have a role to play in effecting the search for pathways of change in movement patterns especially in discrete trial-based multi-articular actions. This thesis has contributed novel knowledge regarding examining coordination changes for a selected discrete multi-articular lower limb action. Focusing on investigating changes in coordination has enabled a detailed examination on the process of change with practice and referencing these changes to a model of learning based on concepts in dynamical systems theory. Specifically, a greater understanding of the role of movement pattern variability and transitions between preferred movement patterns using refined cluster analysis procedures was an advancement of previous work in this area of study. In addition, the empirical findings provided theoretical support for a pedagogical approach, Nonlinear Pedagogy, based on key concepts in dynamical systems theory. Future studies should continue to examine coordination in multi-articular actions to provide theoretical, experimental and practical implications for understanding human movement.

Bibliography: leaves 216-231. / xvii, 231, [99] leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Examines the sliding capability of external fixators under load and describes the development and testing of an external fixator capable of providing axial cyclic motion to a fracture site while a patient is walking. / Thesis (M.D.)--University of Adelaide, Dept. of Orthopaedics and Trauma, 1999?

During heel-toe running, the vertical ground reaction force (VGRF) profile has both impact and active peaks. Although the mass-spring model (a single mass and a linear spring) is simple and useful to predict running characteristics, its simulation of VGRF profiles produces only a single peak rather than the double peak typically observed in running. In contrast, the mass-spring-damper model (two masses, two springs and a damper) produces a simulated force profile with two separate peak values. Running barefoot versus with shoes of varying stiffness produces VGRF profiles with quite different characteristics. The purpose of this study was to use the mass-spring and mass-spring-damper models to investigate the stiffness characteristics of human running in barefoot, hard-shoe and soft-shoe conditions. Ten recreational runners ran overground at 3.83 m/s and completed five trials of each footwear condition. Force data and two-dimensional kinematic data were recorded simultaneously at 1000 and 250 Hz respectively. Using the mass-spring model, vertical stiffnesses with the barefoot, hard-shoe and soft-shoe conditions were 27.6, 25.3 and 24.6 kN/m, respectively. Hard-shoe and soft-shoe material stiffnesses were about 150 and 100 kNm�����. Considering the leg and shoe as two springs in series, the leg's actual vertical stiffness could be estimated as 30 and 33 kNm����� for hard and soft-shoe conditions. The result suggested that runners increased their actual vertical stiffness with the sequence of barefoot, hard-shoe, and soft-shoe conditions. Using the mass-spring-damper model, the upper spring stiffness was relatively constant while the lower spring stiffness changed with footwear condition: 274, 136 and 126 kN/m, respectively. While it is mathematically convenient to model the leg and body with constant spring characteristics over time, physiologically it is likely that muscle-tendon stiffness does change during stance as muscle activity changes. This suggests that mass-spring models of running would be improved by time varying spring characteristics. Variable stiffness of the simple mass-spring model was tested using a smoothly varying stiffness function. This provided a significantly better force profile simulation for each of the footwear conditions than did the constant stiffness model. Further mass-spring-damper modeling may also be improved through incorporation of such time varying characteristics. / Graduation date: 2002

Fast medio-lateral movements, frequent in a number of sports activities, are associated with lower extremity injuries. These injuries may occur as a result of excessive musculoskeletal stresses on the joints and their associate structures. The purpose of this study was to investigate the effect of running speed and turning movement on the three-dimensional moments at the ankle, knee, and hip joints. Data were collected using video cameras and force plate. Eight male recreational basketball players were tested during slow (1.5 m/s), moderate (3.0 m/s), and fast running (4.5 m/s) and when cutting to the right or left (+60, +30, 0, -30, and -60��). The inverse dynamics approach was used to integrate the body segment parameter, kinematic and force plate data, and to solve the resultant joint moments. At the ankle joint, inversion/eversion, dorsi/plantar flexion, and internal/external rotation moments of the ankle joint increased with running speed (p<.05). At the knee joint, flexion/extension and abduction/adduction moments increased with running speed except flexion moment that decreased with running speed (p<.05). At the hip joint, internal/external rotation, flexion/extension, and abduction/adduction moments increased with running speed (p<.05). In medial cutting movements, greater abduction moments of the ankle, adduction moments of the knee and external rotation and adduction of the hip were found (p<.05). In lateral cutting movements, greater inversion and adduction moments of the ankle, abduction moments of the knee and hip were found (p<.05). These findings reinforce the intuitive notion that fast medio-lateral turning movements produce substantially greater musculoskeletal loading on the joint structures than does straight running and consequently have greater potential for inducing lower extremity injuries such as ankle sprain or anterior cruciate ligament injury. / Graduation date: 1999

Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2007.

I Sverige lider ca 50 000 personer av bensår vilket definieras som ”sår på ben och/eller fot nedom knät som ej läkt på 6 veckor”, ungefär hälften av dessa är venösa bensår. De flesta som drabbas av bensår är 65 år eller äldre. Syftet med denna studie var att beskriva patienters upplevelse av att leva med venösa bensår. Studien är baserad på en kvalitativ metod med en induktiv ansats. Data samlades in genom intervjuer från sex patienter och analyserades sedan med hjälp av innehållsanalys. Resultatet baseras på två kategorier; begränsat och bundet liv samt önskan att bli sedd. Dessa kategorier bildade temat; att vara hel men ändå inte. Utifrån denna studie kan personal som vårdar och behandlar bensårspatienter få ökad kunskap om hur patienter upplever att det är att leva med venösa bensår. Med hänsyn till detta vore det önskvärt att effektiva och välstrukturerade vårdrutiner utarbetas för att uppnå helhetssyn inom vården och behandlingen av bensårspatienter. / Approximately 50 000 people in Sweden are suffering from leg ulcers which is defined as "wounds on the legs and/or foot below the knee, which is not healed in 6 weeks", about half of them are venous leg ulcers. Most people who suffer from leg ulcers are 65 years or older. The purpose of this study was to describe patients' experiences of living with venous leg ulcers. The study is based on a qualitative method with an inductive approach. Data were collected through interviews from six patients and analyzed with help of content analyzing. The results are based on two different categories: limited and restricted life, and desire to be seen. These categories formed the theme; to be whole but still not. Based on this study, staff who care for and treat leg ulcer patients can increase knowledge about how patients feel it is to live with venous leg ulcers. Given this, it would be desirable that there are effective and well-structured care practices designed to achieve holistic healthcare and treatment of patients with leg ulcers.

En kvantitativ studie genomfördes som en mindre kartläggning på några orter i Skaraborg. Det framkom i studien att kontinuiteten av vårdpersonal vid behandling av bensår varierar. Kartläggningen genomfördes under en månads tid inom både primärvård och kommuners hemsjukvård. En grupp patienter hade få omläggare medan en annan grupp hade många som lade om bensåret. Nästan alla patienter med bensår i kommunens hemsjukvård hade en patientansvarig sjuksköterska. Av dessa hade en tredjedel träffat sin sjuksköterska under den kartlagda månaden. I primärvården hade drygt hälften av patienterna med bensår en patientansvarig sjuksköterska och majoriteten av dem hade träffat sin patientansvariga sjuksköterska under innevarande månad. Kommunens patienter blev huvudsakligen omlagda av undersköterskor medan primärvårdens patienter blev omlagda av distriktssköterskor och sjuksköterskor. / A quantitative study has been done, carrying out through a small survey in some places in thecounty of Skaraborg. During a month the survey was done in both the primary care and also inthe community care. It was found that the continuity of staff was varying. One sample ofpatients had few nursing staff taking care of the patient’s leg ulcer while another sample ofpatients had many care givers. Almost all patients in the community care had a nurse who wasresponsible for the patient’s leg ulcer. A third of the patients in the community had met theresponsible nurse during the month. At the primary care more than a half of the patients had anurse who was responsible for the patient’s leg ulcer and a majority of them had seen the nurseduring the month. The patients in the community for the most had been taken care of by theassistant nurse who had changed the bandage of the leg ulcer while in primary care, the patientshad been taken care of by a nurse or a district nurse.

This thesis presents a method for determining range of body motion for a walking machine with feet fixed on the ground. The darkling beetle was selected as the sample subject in this study. A closed form inverse kinematic solution is used to determine if a point in space is within range of body motion. An algorithm for tracing workspace boundary is also presented. The software, developed in Microsoft QuickC, has three main parts: (1) a module for searching the workspace contours and recording the contour points, (2) a plotting program for presentation of the workspace on the screen, (3) a module to determine ranges of roll, pitch and yaw for specified foot positions. The plotting program shows four views of the workspace, including front, top, and side views, and user specified axonometric projection. Body range of motion for a representative set of foot positions is presented and analyzed. Results are presented for normal resting height (10mm) and for 8mm and 12mm heights. Body range of motion for feet positioned for the alternating tripod gait is also presented. Ranges of roll, pitch and yaw have been determined and are discussed. / Graduation date: 1991

This thesis examines the influence on range-of-motion of beetle body of changes in leg segment parameters. From beetle's leg orientation, influence of the following leg segment parameters are investigated: coxa length, coxa twist and body-coxa joint. Kinematic equations are derived for legs of the beetle. Roots of quartic polynomials obtained while solving the kinematic equations are found by using the Bairstow (1966) numerical method. Inverse kinematic solutions are obtained for each leg and used to determine whether a point is within the body range of motion or not. An algorithm developed by Mason (1957) and Cordray (1957) for tracing closed boundaries is used to find ranges of motion of the body and feet. Changes in body range of motion caused by alteration in leg segment parameters are complex and not easy to explain. Similarities between changes in body range of motion and foot range of motion are observed. A great deal more work is necessary to fully understand the importance of observed changes. / Graduation date: 1992