This diploma thesis focuses on two conditions that typically occure in childhood - poor posture and developmental coordination disorder. The theoretical part summarizes recent information on these diseases focusing on their etiology, prevalence, prognosis, methods of assessment, diagnosis and treatment. The main aim of the practical part was to evaluate the motor control of treated children with poor posture in comparison with children from the general population. The research group (13 children, mean age 9.85 years) and control group (16 children, mean age 9.94 years) were assessed using Movement Assessment Battery for Children 2. We found no significant difference between motor skills of treated children with poor posture and motor skills of children representing the general population. We also analysed whether treated children with poor posture reported less physical activity compared with the general population. By gathering data from questionnaires (completed by parents of tested children), no statistically significant difference was found. The difference was neither detected in test of posture and postural functions, where we investigated how poor posture of treated children can influence the results of the test. Powered by TCPDF (www.tcpdf.org)

Med en ökad användning av digitala enheter i samhället ser vi också att fler drabbas av hållningsrelaterade hälsobekymmer. Ungdomar är särskilt drabbade även om de i många fall är omedvetna om det, men knappt ingen forskning fokuserar på den här målgruppen och deras behov. Den forskning som tagits fram är inte heller överens hur man på bästa sätt löser problematiken med hållning. Syftet med studien är därför att göra ungdomar mer medvetna om sin kroppshållning samt ta reda på hur digital design på bästa sätt kan motivera ungdomar att förbättra sin kroppshållning. För att ta reda på detta ställdes följande fråga: ”Hur kan en digital designlösning utformas för att skapa medvetenhet kring ungdomars kroppshållning, samt hjälpa att förbättra deras kroppshållning på ett underhållande och icke störande sätt?”. Studien genomfördes med metoden Konceptdriven Designforskning som inkluderar skapandet av en konceptuell prototyp förankrad i tidigare forskning. Prototypen består av en bärbar sensor som mäter hållning och en applikation i form av ett spel där användaren kan se sin hållning i realtid samt aktivt träna sin hållning. Prototypen värderades sedan genom en digital enkätundersökning. I resultatet framgick att designlösningen kunde tänkas användas av deltagarna, samt hjälpa att förbättra deras hållning eftersom den gjorde användaren mer medveten om sin kroppshållning. Många deltagare trodde att spelet kunde bidra med motivation och göra hållningsträningen mer underhållande men att fler spel-funktioner krävs för att behålla användarens intresse under en längre tid. Deltagarna ansåg att konceptet i sin helhet inte var störande men att mer tydlig feedback krävs för att indikera bra/dålig hållning. Utifrån detta resultat kan slutsatsen dras att konceptet i teorin kan skapa medvetenhet kring ungdomars kroppshållning och hjälpa de att träna den på ett underhållande sätt som inte är störande, men att mer studier och designarbete krävs för att komma fram till det bästa sättet att ge användaren feedback om sin hållning samt göra konceptet mer attraktivt att använda ur ett långsiktigt perspektiv. / With the increased use of digital devices in society, we can see that more people are affected by posture related health issues. Adolescents are especially affected although in many cases they are unaware of it, but hardly any research focuses on this group and their needs. The research that has been done also does not agree on how to best solve the problem with posture. The purpose of this study is therefore to make young people more aware of their posture and to find out how digital design can be used in the best way to motivate young people to improve their posture. To find this out, the following question was formed: “How can a digital design solution be formed to create awareness about young people's posture and help improve their posture in an entertaining and non-disturbing way”. The study was carried out with the method Concept driven design research which includes the creation of a conceptual prototype grounded in previous research. The prototype consists of a portable sensor that measures posture and an application in the form of a game where the user can see their posture in real time and actively train their posture. The prototype was then evaluated through a digital survey. The results showed that the participants could consider using the design solution and that it helped to improve their posture as it made the user more aware of their posture. Many participants thought that the game could contribute with motivation and make posture training more entertaining, but that more gaming features are required to keep the user's interest for a longer period. The participants felt that the concept as a whole was not disruptive, but that more clear feedback is required to indicate good/bad posture. Based on this result, it can be concluded that the concept in theory can create awareness of young people's posture and help them to exercise it in an entertaining way that is not disturbing, but that further studies and design work is needed to come up with the best way to give the user feedback on their posture and to make the concept more attractive to use from a long-term perspective.

Thesis (MScEng (Mechanical and Mechatronic Engineering))--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: The In the Physiotherapy Division of the Faculty of Health Sciences on the Tygerberg Hospital Campus of the University of Stellenbosch, the challenge arose to develop a portable, affordable and yet accurate 3D measurement machine for the assessment of posture in school children in their classroom environment. Currently Division already uses a state-of-the-art VICON commercial medical measuring machine to measure human posture in 3D in their physiotherapy clinic, but the system is not portable and is too expensive to cart around to different places for testing. To respond to this challenge, this Master’s thesis designed and analyzed a machine and its supporting system through both research on stereo-vision methodologies and empirical appraisal in the field. In the development process, the research was required to overcome the limitations posed by small image resolutions and lens distortions that are typical of cheap cameras. The academic challenge lay in the development of an error prediction model through Jacobian derivation and Error Propagation Law, to predict uncertainties of angular measurement calculated by the system. The research culminated in a system that is comparable in accuracy to the VICON within 3mm, and that has 1.5mm absolute accuracy within its own system for a measurement volume radius of 2.5 m. As such, the developed error model is an exact predictor of the angular error to within 0.02° of arc. These results, for both system accuracy and the error model, exceed the expectations on the basis of the initial challenge of the system. The development of the machine was successful in providing a prototype tool that is suitable for commercial development for use by physiotherapists in human posture measurement and assessment. In its current incarnation, the machine will also serve the Engineering Faculty as the most fundamental form of a three-dimensional measuring apparatus using only basic theories and algorithms of stereo-vision, thereby providing a basic experimental platform from which further scientific research on the theory and application of computer vision can be conducted. / AFRIKAANSE OPSOMMING: Die Fisioterapie Afdeling van die Fakulteit Gesondheidswetenskappe op die Tygerberg kampus van die Universiteit van Stellenbosch gebruik ’n allernuutste VICON kommersiële mediese meettoestel om menslike postuur in drie dimensies te meet. Vanuit hierdie Afdeling het die uitdaging ontstaan om ’n draagbare, bekostigbare, maar tog akkurate, drie-dimensionele meetapparaat geskik vir die meet van die postuur van skoolkinders in die klaskamer te ontwikkel. In aanvaarding van hierdie uitdaging, het hierdie Magistertesis ’n toestel en ondersteuningstels ontwerp en ontleed deur beide navorsing in stereo-visie metodiek en terplaatse beoordeling. In die ontwikkelingsproses moes die navorsing die beperkings wat deur klein-beeld resolusie en lens-distorsie (tipies van goedkoop kameras) meegebring word, oorkom. Die akademiese uitdaging lê in die ontwikkeling van ’n voorspellende foutmodel deur van die Jacobianse-afleiding en die Fout Propageringswet gebruik te maak om onsekerheid van hoeksberekening deur die stelsel te voorspel. Die navorsing het gelei tot ’n stelsel wat binne 3mm vergelykbaar is in akkuraatheid met dié van die VICON en ook 1.5mm absolute interne akkuraatheid het in ’n meet-volume radius van 2.5m radius. Die ontwikkelde foutmodel is dus ’n presiese voorspeller van hoekfout tot binne 0.02° van boog. Die resultate met betrekking tot beide die akkuraatheid en die foutmodel het die oorspronklike verwagtinge van die uitdaging oortref. Die ontwikkeling was suksesvol in die skep van ’n prototipe-toestel geskik vir kommersiële ontwikkeling, vir gebruik deur fisioterapeute in die meting en evaluering van menslike postuur. Die stelsel is in sy fundamentele vorm, deur die gebruik van slegs basiese teorieë en algoritmes van stereo-visie, funksioneer as ’n drie-dimensionele meetapparaat. In die fundamentele vorm sal die stelsel die Ingenieursfakulteit dien as ’n basiese eksperimentele platform waarop verdere wetenskaplike navorsing in die teorie en toepassing van rekenaar-visie gedoen kan word.

La scoliose idiopathique (SI) est une déformation tridimensionnelle (3D) de la colonne vertébrale et de la cage thoracique à potentiel évolutif pendant la croissance. Cette déformation 3D entraîne des asymétries de la posture. La correction de la posture est un des objectifs du traitement en physiothérapie chez les jeunes atteints d’une SI afin d’éviter la progression de la scoliose, de réduire les déformations morphologiques et leurs impacts sur la qualité de vie. Les outils cliniques actuels ne permettent pas de quantifier globalement les changements de la posture attribuables à la progression de la scoliose ou à l’efficacité des interventions thérapeutiques. L’objectif de cette thèse consiste donc au développement et à la validation d’un nouvel outil clinique permettant l’analyse quantitative de la posture auprès de personnes atteintes d’une SI. Ce projet vise plus spécifiquement à déterminer la fidélité et la validité des indices de posture (IP) de ce nouvel outil clinique et à vérifier leur capacité à détecter des changements entre les positions debout et assise. Suite à une recension de la littérature, 34 IP représentant l’alignement frontal et sagittal des différents segments corporels ont été sélectionnés. L’outil quantitatif clinique d’évaluation de la posture (outil 2D) construit dans ce projet consiste en un logiciel qui permet de calculer les différents IP (mesures angulaires et linéaires). L’interface graphique de cet outil est conviviale et permet de sélectionner interactivement des marqueurs sur les photographies digitales. Afin de vérifier la fidélité et la validité des IP de cet outil, la posture debout de 70 participants âgés entre 10 et 20 ans atteints d'une SI (angle de Cobb: 15º à 60º) a été évaluée à deux occasions par deux physiothérapeutes. Des marqueurs placés sur plusieurs repères anatomiques, ainsi que des points de référence anatomique (yeux, lobes des oreilles, etc.), ont permis de mesurer les IP 2D en utilisant des photographies. Ces mêmes marqueurs et points de référence ont également servi au calcul d’IP 3D obtenus par des reconstructions du tronc avec un système de topographie de surface. Les angles de Cobb frontaux et sagittaux et le déjettement C7-S1 ont été mesurés sur des radiographies. La théorie de la généralisabilité a été utilisée pour déterminer la fidélité et l’erreur standard de la mesure (ESM) des IP de l’outil 2D. Des coefficients de Pearson ont servi à déterminer la validité concomitante des IP du tronc de l’outil 2D avec les IP 3D et les mesures radiographiques correspondantes. Cinquante participants ont été également évalués en position assise « membres inférieurs allongés » pour l’étude comparative de la posture debout et assise. Des tests de t pour échantillons appariés ont été utilisés pour détecter les différences entre les positions debout et assise. Nos résultats indiquent un bon niveau de fidélité pour la majorité des IP de l’outil 2D. La corrélation entre les IP 2D et 3D est bonne pour les épaules, les omoplates, le déjettement C7-S1, les angles de taille, la scoliose thoracique et le bassin. Elle est faible à modérée pour la cyphose thoracique, la lordose lombaire et la scoliose thoraco-lombaire ou lombaire. La corrélation entre les IP 2D et les mesures radiographiques est bonne pour le déjettement C7-S1, la scoliose et la cyphose thoracique. L’outil est suffisamment discriminant pour détecter des différences entre la posture debout et assise pour dix des treize IP. Certaines recommandations spécifiques résultents de ce projet : la hauteur de la caméra devrait être ajustée en fonction de la taille des personnes; la formation des juges est importante pour maximiser la précision de la pose des marqueurs; et des marqueurs montés sur des tiges devraient faciliter l’évaluation des courbures vertébrales sagittales. En conclusion, l’outil développé dans le cadre de cette thèse possède de bonnes propriétés psychométriques et permet une évaluation globale de la posture. Cet outil devrait contribuer à l’amélioration de la pratique clinique en facilitant l’analyse de la posture debout et assise. Cet outil s’avère une alternative clinique pour suivre l’évolution de la scoliose thoracique et diminuer la fréquence des radiographies au cours du suivi de jeunes atteints d’une SI thoracique. Cet outil pourrait aussi être utile pour vérifier l’efficacité des interventions thérapeutiques sur la posture. / Idiopathic scoliosis (IS) is characterized by three-dimensional (3D) deformity of the spine and rib cage which can increase during growth. The morphologic changes of the trunk result in posture asymmetries. Correction of posture is an important goal of physiotherapy interventions among persons with IS to prevent scoliosis progression, to reduce morphologic deformities and their impact on quality of life. Currently, there are no tools that globally quantify changes in posture that may be attributable to scoliosis progression or to treatment effectiveness, that are usable in a clinical setting. The objective of this thesis was thus to develop and validate a new clinical quantitative posture assessment tool among persons with IS. More specifically, this project aims to determine reliability and concurrent validity of posture indices (PI) of this new tool and to verify their capacity to detect changes between standing and sitting positions. We conducted a literature review and selected 34 PI representing frontal and sagittal alignment of the different body segments. We constructed a software-based quantitative posture assessment tool to calculate different PI (angular and linear measurements). The software has a user-friendly graphical interface and allows calculation of PI from a set of markers selected interactively on digital photographs. For the reliability and validity studies, standing posture of 70 participants aged 10 to 20 years old with IS (Cobb angle: 15º to 60º) was assessed on two occasions by two physiotherapists. Markers placed on several bony landmarks as well as natural reference points (eyes, ear lobe, etc.) were used to measure the PI from photographs with the 2D tool and to calculate 3D PI obtained from trunk reconstructions with a surface topography system. Frontal and sagittal Cobb angles and trunk list were also calculated on radiographs. The generalizability theory was used to estimate the reliability and standard error of measurement (SEM) of PI of the 2D tool. Pearson correlation coefficients served to estimate concurrent validity of the 2D trunk PI with corresponding 3D PI and with those obtained from radiographs. Fifty participants were assessed for the comparative study between standing and sitting positions. We compared the average values of each PI in standing and long sitting positions using paired t-tests. Our results show a good level of reliability for the majority of PI of the 2D tool. Correlation between 2D and 3D PI was good for shoulder, scapula, trunk list, waist angles, thoracic scoliosis and pelvis but fair to moderate for thoracic kyphosis, lumbar lordosis and thoracolumbar or lumbar scoliosis. The correlation between 2D and radiograph measurements was good for trunk list, thoracic scoliosis and thoracic kyphosis. Our tool can detect differences between standing and sitting posture for ten out of thirteen PI. A few recommendations specific to this work are: camera height should be adjusted according to the subject’s height; training of judges is important to maximize accuracy in placement of markers; and measurement of sagittal vertebral curves may be facilitated by using markers mounted on pins. In conclusion, the tool developed in this thesis has good psychometric properties to evaluate posture. This tool should contribute to clinical practice by facilitating the analysis of standing and sitting posture. This tool may also be a good alternative to monitor thoracic scoliosis progression in a clinical setting and may contribute to a reduction in the use of x-rays in the follow-up of youths with thoracic IS. It may also be useful to verify the effectiveness of therapeutic interventions on posture.

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal.

Le système vestibulaire et le cortex moteur participent au contrôle de la posture, mais la nature de leurs interactions est peu documentée. Afin de caractériser les interactions vestibulo-corticales qui sous-tendent le contrôle de l’équilibre en position debout, l’activité électromyographique (EMG) du soléaire (SOL), du tibial antérieur (TA) et du péronier long (PERL) de la jambe droite a été enregistrée chez 14 sujets sains. La stimulation galvanique vestibulaire (GVS) a été appliquée avec la cathode derrière l’oreille droite ou gauche à différents intervalles inter-stimulus (ISIs) avant ou après la stimulation magnétique transcrânienne induisant des potentiels moteurs évoqués (MEPs) au niveau des muscles enregistrés. Lorsque que la cathode était à droite, une inhibition des MEPs a été observée au niveau du SOL à un ISI de 40 et 130 ms et une facilitation des MEPS a été observée au niveau TA à un ISI de 110 ms. Lorsque la cathode était à gauche, une facilitation des MEPs a été observée au niveau du SOL, du TA et du PERL à un ISI de 50, -10 et 0 ms respectivement. L’emplacement de ces interactions sur l’axe neural a été estimé en fonction des ISIs et en comparant l’effet de la GVS sur les MEPs à son effet sur l’EMG de base et sur le réflexe-H. Selon ces analyses, les modulations observées peuvent avoir lieu au niveau spinal ou au niveau supraspinal. Ces résultats suggèrent que les commandes de la voie corticospinale peuvent être modulées par le système vestibulaire à différents niveaux de l’axe neuronal. / The vestibular system and the motor cortex are involved in the control of posture but the nature of their interactions is poorly documented. To characterize vestibulo-cortical interactions underlying the control of balance during quiet standing, the electromyographic activity (EMG) of the soleus (SOL), tibialis anterior (TA) and peroneus longus (PERL) of the right leg was recorded in 14 healthy subjects. Bipolar galvanic vestibular stimulation (GVS) was applied with the cathode behind the right or left ear at various inter-stimulus intervals (ISI) before and after transcranial magnetic stimulation eliciting motor evoked potentials (MEP) in the muscles recorded. When the cathode was on the right, MEP in the SOL were inhibited at 40 and 130 ms while MEP were facilitated in TA at 110 ms. When the cathode was on the left, MEP were facilitated in the SOL at 50 ms, in TA at -10 ms and in PERL at 0 ms. The localization of these interactions along the neural axis was estimated according to the ISI and by comparing the effect of the GVS on the MEP to its effect on the background EMG and on the SOL H-reflex. Based on these analyses, the observed modulations of MEP observed could have occurred at spinal or supraspinal level. These results suggest that the corticospinal output may be modulated by the vestibular system at different levels of the neural axis.

Title: The Level of Postural Maturation of Children in Athletic-preparatory Schools Author: Terezie Janečková Objective: There are more and more athletic-preparatory schools in athletic units and clubs nowadays. Athletic-preparatory school means a group of five or six-year-old children with one or two training lessons per week. Czech athletic association wants to spread an interest in athletics among parents and their children, to find athletic talents as soon as possible and develop them by this way. The recruitment of children at this age already exists in many sports, but it is new in athletics in the Czech Republic. But that does not go for everyone that this sport training at preschool age is the appropriate and healthy way for a child motor development. I would like to evaluate the influence of athletic-preparatory schools on the child motor development. Due to the fact that there are no tests to apply for this purpose in literaure, we have to compose our own set of tests, which are used in physiotherapy. The theoretic part of the work is a bibliographic search of accessible information about postural maturation and motor development. The experimental part of the work is an evaluation of the level of postural maturation of children in athletic-preparatory schools before their start of regular...

Thetheoretical part ofthisDiploma Thesis dealswithmotoricsystem and body posture and looksintomatteroffaultyposture. Itisfocused on causesoffaultypostureofpre-schoolagechildren and on importanceofphysicalactivity to children'sorganism. TheResearch part monitors incidence ofpoorposture in twoclassesofKindergarten Praha Kolovraty and examinestheimpactofregularphysicalactivity on the body postureofpre-schoolagechildren. Keywords Motoricsystem Body posture Faultyposture Pre-schoolage Preventivemedicalequalizeexercising

Title: The evaluation of the head posture of children playing piano Aims: The aim of this work was the evaluation of an influence of playing the piano on school age children who had played piano for 4 or 5 years. Methods: 46 probands participated in the research, out of which 23 children represented the research group and 23 children represented the control group. Probands head movements were observed while playing a piece of their own choice without the aid of musical notesfirstly in a relaxed seated position and secondly in aadjusted seated position according to Brugger. Probands from the control group undertook the same observations, but without playing the piano. During the observations of the relaxed and adjusted seating position, probands looked directly to the front of them while their head position and their eyes remained still. The TrackIR tool (Natural Point Company) was used to conduct the measurements of the head movements. Results: The conclusion derived from the results is that piano playing from 4 to 5 years does not have a negative influence on the head posture of the children who play the instrument for 4 or 5 years. Key words: piano playing, head posture with preference, TrackIR, variations of head posture in time.

L’ensemble de ce travail doctoral avait pour objectif d’optimiser les effets des programmes d’activités physiques pour prévenir les chutes chez les personnes âgées institutionnalisées. Le contrôle postural et la locomotion étant fondamentaux dans la prévention des chutes, il convient de les stimuler régulièrement par une pratique physique adaptée. Par ailleurs, l’amélioration de la sensibilité cutanée plantaire peut permettre d’améliorer le contrôle postural et la locomotion. Même si les bénéfices potentiels d'une stimulation des afférences cutanées plantaires par la pratique d’exercices pieds nus sont multiples, l’intérêt de cette modalité de pratique des activités physiques à destination des personnes âgées reste à démontrer. Deux groupes de personnes âgées ont ainsi dû suivre le même programme d’activités physiques, pieds-nus pour un groupe et en portant des chaussures pour l’autre groupe. Les principaux résultats ont révélé qu’un programme d’activités physiques pratiqué pieds nus améliorait davantage la sensibilité cutanée plantaire et le contrôle postural qu’un programme pratiqué avec des chaussures. Malgré l’avancée en âge, le système sensori-moteur semble toujours bénéficier d’une certaine plasticité. Ce système sensori-moteur peut être stimulé en sollicitant notamment les mécanorécepteurs cutanés plantaires. Les effets d’un programme d’activités physiques peuvent également être optimisés en plaçant les séances au moment de la journée le plus approprié. En évaluant l’influence du moment de pratique au cours de la journée, nous avons pu montrer qu’un programme d’activités physiques réalisé l’après-midi provoquait des effets positifs plus marqués qu’un programme réalisé le matin. De manière surprenante, le contrôle postural des sujets qui s’entraînaient l’après-midi s’améliorait principalement le matin, au moment de la journée où il est le plus efficace chez les personnes âgées. Ces adaptations seraient en phase avec le moment de la journée où les fonctions cognitives sont également optimales, c’est-à-dire le matin. / The main purpose of these researches was to optimize the effects of physical activity programs to prevent falls among institutionalized older adults. Postural control and gait are essential in preventing falls and should be regularly promoted by an appropriate physical practice. In addition, improving plantar cutaneous sensitivity can improve postural control and gait. Even though there are further potential benefits of stimulating plantar afferences by performing barefoot exercises, the effects of this modality of physical activity for the elderly remains unclear. Two groups of older adults were involved in the same physical activity program, barefoot for one group and while wearing shoes for the other. The main results revealed that a program of physical activity with barefoot exercises improved plantar cutaneous sensitivity and postural control to a greater extent than while wearing shoes. Despite advancement of aging, the sensorimotor system still seems to benefit from plasticity which can be stimulated by exercising barefoot and increasing somatosensory information from the foot. The time of day when people exercise can also influence the optimization of physical performance and enhance the effectiveness of a physical activity program. By assessing the influence of exercising at different times of day, we showed that training in the afternoon provided greater benefits on postural control than morning training. Surprisingly, postural control was mainly improved in the morning and did not improve when participants exercised in the morning. The postural control system would have benefited from an enhanced motor potential (acquired through afternoon training which optimized the musculoskeletal adaptations) only at the time of day when cognitive functions are optimal, i.e., in the morning.