Bakgrund: En femtedel av de som drabbas av ryggmärgsskada är kvinnor. Det finns lite forskning som belyser kvinnors upplevelse av sexualitet efter ryggmärgsskada som orsakat tetraplegi eller paraplegi. Syfte: Att beskriva kvinnors upplevelse av sexualitet efter förvärvad ryggmärgsskada. Metod: En litteraturöversikt enligt Friberg (2012) har genomförts. Tio vetenskapliga artiklar valdes ut varav sex artiklar med kvalitativ design, två med kvantitativ design och två artiklar med mixad metod. Databaserna Cinahl Complete, Pubmed och Nursing & Allied Health database användes för att söka artiklarna. Artiklarna lästes och analyserades avseende likheter och skillnader i resultat, teori, perspektiv och metod (Friberg, 2012). Likheter färgkodades och delades in i teman. Resultat: Litteraturöversikten resulterade i fem teman. I temat självbild framkom att ryggmärgsskadan förändrade den sexuella identiteten, kroppsuppfattningen och självförtroendet. I temat information framkom hur kvinnorna upplevde information och hur den var bristfällig. I temat sex och intimitet framkom det hur kvinnorna reviderade sina förväntningar på sex. I temat relationer och den sociala miljön beskriver kvinnorna hur de upplevde att de uppfattades av samhället samt svårigheter att etablera och bibehålla intima relationer. I temat fysiska barriärer och praktiska hinder framkom olika kroppsliga aspekter som påverkade sexualiteten. Diskussion: Resultatet diskuterades utifrån Roy’s adaptionsmodell (Roy, 2009). Sjuksköterskans pedagogiska funktion, kvinnornas upplevelse av information, peer learning och hur internet kan användas för att tillmötesgå kvinnornas behov av information diskuterades. Ryggmärgsskadans påverkan på relationer samt singelskapets betydelse för den ryggmärgsskadade kvinnans sexualitet lyftes. Samhällets normer och hur dessa påverkar kvinnans självbild har beskrivits. / Background: One-fifth of those who suffer from spinal cord injury are women. There is little research that illustrates women's experience of sexuality after spinal cord injury that caused paraplegia or tetraplegia. Aim: To describe the women's experience of sexuality after acquired spinal cord injury. Method: A literature review according to Friberg (2012) has been conducted. Ten scientific articles were selected, six of which were of qualitative design, two with quantitative design and two articles with mixed method. The databases Cinahl Complete, Pubmed and Nursing & Allied Health database were used to search the articles. The articles were read and analyzed regarding similarities and differences in results, theory, perspective and methodology (Friberg, 2012). Similarities were color-coded and divided into themes. Results: The literature review resulted in five themes. In the theme self-esteem it was found that spinal cord injury changed the sexual identity, body perception and self-esteem. The theme information revealed how the women experienced information and how the information was perceived as inadequate. The theme sex and intimacy revealed how women revised their expectations for the intercourse. The theme relations and the social environment describe how the women experienced that they were perceived by society as well as difficulties in establishing and maintaining intimate relationships. In the theme of physical barriers and practical barriers, various bodily aspects that influenced sexuality emerged. Discussion: The result was discussed based on Roy’s adaptation model (Roy, 2009). Nurse’s educational function, the women’s experience of information, peer learning and how the internet could be used to meet the women’s need for information was discussed. The effect a spinal cord injury had on relationships, as well as being a single woman with a spinal cord injury and its effect on sexuality was also discussed. Norms of the society and how these affect the woman’s self-image are described.

Magister Scientiae (Physiotherapy) - MSc(Physio) / Spinal cord injury is a devastating condition, and its consequences impact on many facets of an individual's life. Activities of daily living such as personal care and housework might be difficult to perform post injury. The majority of spinal cord injury patients receive hospital-based rehabilitation to address these consequences. The normal length of hospital stay among spinal cord injury patients ranges from three to twelve months, and an increased length of stay are caused by development of secondary complications such as pressure sores, urinary tract infection and respiratory infection. The purpose of this study was to determine factors affecting length of hospital stay for individuals with spinal cord injuries at Kanombe Military Hospital in Rwanda. To achieve this, a retrospective study, utilising a quantitative approach was used. The records of individuals with spinal cord injuries discharged from the hospital between 1st January1996 and 31st December 2007 were reviewed to collect data. A data gathering instrument was developed by the researcher and there after used to capture the relevant information from the patients' folders. Information collected included demographic data, information relating to the injury, occurrence of medical complications and length of hospital stay. One hundred and twenty four medical folders of patients discharged from 1st January 1996 to 31st December 2007 at Kanombe Military Hospital were reviewed for data extraction. The Statistical Package for Social Sciences (SPSS) version 16.0 for windows was used to analyse the data. Both descriptive and inferential statistics were determined in SPSS. Associations were made between demographic factors and occurrence of secondary medical complications with length of hospital stay. These were computed by means of chi-square tests. One level of significance, alpha set at 5% was used throughout. The linear regression analysis was used to determine factors affecting the length of stay. / South Africa

It is vital that people with spinal cord injury (SCI) maintain a physically active lifestyle to promote lifelong health and well-being. Yet despite these benefits, within hospital rehabilitation and upon discharge into the community, people with SCI are largely inactive. Physiotherapists in SCI rehabilitation have been identified as the healthcare professionals (HCPs) ideally placed to promote a physically active lifestyle. However, to successfully engage people with SCI in physical activity (PA), physiotherapists have to manage their hopes and expectations of SCI rehabilitation. With all this in mind, the purpose of this thesis was to explore the role of PA for people with SCI in hospital rehabilitation and in the community. The first aim of this research was to explore the barriers, benefits and facilitators of PA for people with SCI. The second aim was to examine how hopes and expectations are managed by the physiotherapists in SCI rehabilitation and by health practitioners in a community-based leisure time physical activity (LTPA) setting. The third aim was to propose improvement to LTPA promotion for people with SCI. These aims were addressed through: 1) a meta-synthesis of the qualitative literature to identify the barriers, benefits and facilitators of LTPA for people with SCI; 2) an examination of the role of LTPA in SCI rehabilitation; and 3) an exploration of experiences of participants with SCI, and their trainers in a new type of LTPA; activity-based rehabilitation (ABR). Framed by interpretivism, data were analysed by thematic analysis and dialogical narrative analysis. This thesis has made an original and significant contribution to the literature by revealing a deep understanding of factors that constrain and facilitate physically active lifestyles for people with SCI. For example, this research has uniquely demonstrated the role of pleasure in facilitating continued engagement in LTPA. Furthermore, this thesis identified that despite valuing the role of PA for people with SCI, active promotion of PA remains largely absent from physiotherapy practice. The dilemmas of promoting PA for the physiotherapists in SCI centres included a lack of training and education in health promotion and a concern over the false hope of recovery from LTPA opportunities such as ABR. To try and avoid false hope of recovery, the physiotherapists drew upon the therapeutic plot of acceptance and employed therapeutic actions to guide patients towards realistic hopes and expectations. An identification of three narrative types operating in ABR did reveal that some clients were exercising in the hope to walk again. However, the trainers were not preoccupied with acceptance as they also tried to avoid false hopes of ABR. In light of these findings there are several practical recommendations for people with SCI, HCPs such as physiotherapists, the health care system and other health practitioners in community based LTPA opportunities. These practical implications are aimed at improving PA promotion and reducing the barriers to PA for people with SCI. For example, there is a need for more effective knowledge translation across the macro, meso and micro fields. At the macro level meaningful guidelines on PA for people with SCI need to be developed and embedded into UK and Ireland policies if they are to be received and utilised by physiotherapists in SCI rehabilitation and health practitioners in the community. At the meso and micro level appropriate training and education need to be delivered to physiotherapists on PA and SCI to equip them with sufficient knowledge to prescribe and promote PA. Furthermore, the knowledge on PA shared with physiotherapists needs to include the diversity of LTPA opportunities available to people with SCI including ABR. Closer communication and engagement should be implemented at the micro level between physiotherapists in SCI centres and the health practitioners working in community initiatives such as ABR to confront issues regarding hope. In addition to knowledge translation practices, there needs to be support within the healthcare system to facilitate a physically active lifestyle for people with SCI. Equally, a more critical attitude to PA promotion is called for in terms of the possible adverse consequences.

Orientador: José Irineu Gorla / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Educação Física / Made available in DSpace on 2018-08-22T01:59:14Z (GMT). No. of bitstreams: 1 Campana_MateusBetanho_D.pdf: 3388404 bytes, checksum: 432df691d254238467a9dc1e6a82596a (MD5) Previous issue date: 2013 / Resumo: A Lesão da Medula Espinhal (LME) e considerada uma das mais graves incapacidades que podem acometer uma pessoal, podendo causar complicações motoras, sensitivas, metabólicas e psicossociais. Auto-eficácias, que pode ser definida como a convicção que uma pessoa tem em poder realizar certos comportamentos, e um dos fatores que auxiliam no processo de reabilitação da pessoa com LME na medida em que o convívio com outras pessoas que passam por situação semelhante promove a troca de informações e experiências e a imagem de incapacidade vai se transformando em uma imagem de potencialidade e produtividade, frente às experiências motoras significativas vivenciadas nesse novo corpo, alem de reduzir a morbidade e a mortalidade por doenças secundaria decorrentes da LME. O objetivo desse estudo foi trazer para o contexto brasileiro um instrumento de medida para avaliar a Auto-eficácias numa população de pessoas com LME no Brasil. Para isso traduzimos, adaptamos culturalmente e validamos a Moorong Self-Efficacy Scale (MSES) para o português no Brasil através da Analise Fatorial Exploratória. O processo de tradução e adaptação cultural seguiu as recomendações do guideline proposto por Beaton, Bombardier e Guillemin (2002). A partir da validação da MSES, que ocorreu através da Analise Fatorial Exploratória numa amostra não probabilística de 71 sujeitos com LME, pudemos encontrar uma solução composta por 4 fatores que explicavam 65,25% da variância da escala. Acreditamos que a versão em português do Brasil da MSES possa ser utilizada em uma população de homens que praticam atividade física regular, podendo contribuir para que haja um melhor juízo sobre a Auto-eficácias das pessoas com LME no Brasil. Recomendamos que a escala devesse passar por outros processos de validação para ser utilizada em outras populações, como homens e mulheres não praticantes de atividade física / Abstract: Spinal Cord Injury (SCI) is considered one of the most severe disabilities that can affect a person, and may cause motor, sensory, metabolic and psychosocial dysfunctions. Self-efficacy, which can be defined as the belief that a person has to be able to perform certain behaviors, is one of the factors that assist in the rehabilitation of people with SCI once that the socializing with others who go through similar situation promotes the exchange of information and experience and the image of disability is transformed into an image of potentiality and productivity in the face of significant motor experiences lived in this new body, reducing morbidity and mortality from secondary diseases resulting from SCI. The aim of this study was to bring to the Brazilian context a measurement tool to assess Self-Efficacy in a population of persons with SCI in Brazil. For that we translate, culturally adapted and validated the Moorong Self-Efficacy Scale (MSES) to Brazilian Portuguese through an Exploratory Factor Analysis. The process of translation and cultural adaptation followed the guideline proposed by Beaton, Bombardier and Guillemin (2002). From the validation of MSES, which occurred through Exploratory Factor Analysis in a non-probabilistic sample of 71 subjects with SCI, we found a solution composed by 4 factors that explained 65.25% of scale's variance. We believe that the Brazilian version of MSES MSEs can be used in a population of men who have regular physical activity, helping to have a better judgment on the Self-Efficacy of people with SCI in Brazil. We recommend that the scale should go through other processes of validation for use in other populations, such as men and women are not physically active / Doutorado / Atividade Fisica Adaptada / Doutor em Educação Física

Orientador: Edison Duarte / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação Física / Made available in DSpace on 2018-08-24T08:35:02Z (GMT). No. of bitstreams: 1 Paranhos_VivianMariadosSantos_M.pdf: 1343045 bytes, checksum: c0fc2e5a6fd994aa302b9869101ed399 (MD5) Previous issue date: 2014 / Resumo: Considerada atualmente um problema de saúde pública, as lesões na medula espinhal na população aumentam a cada ano e com ela muitos problemas que irão acompanhar o indivíduo ao longo de toda a vida. Algumas dúvidas surgem ao trabalhar com essas pessoas pelos profissionais nutricionistas, visto as alterações fisiológicas decorrentes da lesão. Como calcular o gasto energético total diário e especificar, com maior precisão, as necessidades de calorias totais e de macronutrientes (proteínas, lipídeos, carboidratos e todas as vitaminas e minerais)? Como calcular esse gasto em atletas com lesão medular usuários de cadeira de rodas em suas práticas esportivas? O método comumente empregado para cálculo de gasto energético como a fórmula de Harris-Benedict, por exemplo, elaborada para indivíduos hígidos. Outro método utilizado para esse tipo de avaliação é o de calorimetria indireta, bastante preciso, porém inviável muitas vezes, quer pelo custo, quer pela dificuldade de aplicação. Esse estudo teve como o objetivo analisar o gasto energético basal através de um método de calorimetria indireta em atletas usuários de cadeira de rodas e comparar os resultados com a fórmula comumente utilizada (Harris-Benedict) buscando comparar os valores apresentados entre esses dois métodos. O estudo foi realizado com 14 indivíduos praticantes da modalidade de rugby em cadeira de rodas, com lesão da medula espinhal cervical (C5-C7), do gênero masculino, com idade entre 25 e 36 anos. Observou-se uma correlação significativa de 0,58 entre a comparação dos dois métodos e concordância significativa com intervalo de confiança entre eles de +154,3 kcal/dia até -115,5 kcal/dia. No entanto a fórmula de Harris & Benedict não prevê e não calcula o gasto relacionado à espasmos musculares, comum nessa população, dentre outras especificidades. Concluiu-se que a calorimetria indireta é um método mais preciso, validado e mais indicado para essa população quando comparado à fórmula de predição de Harris & Benedict, devido as especificidades da lesão da medula espinhal / Abstract: Currently considered a public health problem , injuries to the spinal cord in the population increase every year and with it many problems that will accompany the individual throughout life . Some questions arise when working with these people by professional nutritionists , since the physiological changes resulting from injury. How to calculate the total daily energy expenditure and to specify more precisely the needs of total calories and macronutrients ( proteins , lipids , carbohydrates and all the vitamins and minerals) ? How to calculate this expense in athletes with spinal cord injury wheelchair users in their sports practices ? The common method for calculating energy expenditure as the Harris-Benedict formula , for example , designed to healthy individuals . Another method used for this type of assessment is to indirect calorimetry quite accurate , but often impractical , either by cost or by the difficulty of implementation . This study aimed to analyze the basal energy expenditure through a method of indirect calorimetry in athletes of wheelchair users and compare the results with the commonly used formula ( Harris -Benedict ) trying to compare the values ??presented between these two methods . The study was conducted with 14 subjects practicing the sport of rugby in wheelchairs with cervical spinal cord ( C5 - C7 ) , male , aged between 25 and 36 years. There was a significant correlation of 0.58 between the two methods and a significant agreement with a confidence interval between them +154.3 kcal / day to -115.5 kcal / day. However the formula of Harris & Benedict does not provide and does not calculate the expense related to muscle , spasms common in this population , among other specifics . It was concluded that indirect calorimetry is a more accurate , validated and most appropriate method for this population when compared to the prediction formula of Harris & Benedict , because the specifics of spinal cord injury / Mestrado / Atividade Fisica Adaptada / Mestra em Educação Física

Magister Scientiae (Physiotherapy) - MSc(Physio) / A spinal cord injury causes a major impact on the life of individuals who experience it. From the impact of the accident or disease causing spinal cord damage, one is left immobile, insensitive to touch and dysfunction of the urinal and anal organs, which in turn leaves bowel, bladder and sexual functions in jeopardy. These impairments and activity limitations restrict or exclude the individual from participation in everyday social interaction. There is also a perceived stigma from society, depending on the response from the surrounding physical and social environment. The aim of the current study was to explore the most valued constructs of quality of life among persons with spinal cord injury in in a Tanzania rural area. The study objectives were to deduce the participants’ own understanding of quality of life and exploration of its constructs in all domains of life namely physical, social, economic and environmental with consideration to the barriers and facilitators. A qualitative study design is employed in which a sample of 15 persons with spinal cord injury living in three selected districts of the rural Kilimanjaro region, were purposefully selected. Environmental observations and semi structured interviews were conducted in the home of each participant. Transcriptions were done verbatim before translation from Kiswahili (national language) to English by the researcher then back translated by two professional translators (Appendix M, page 145). The whole translated sample was compiled, proof read by the researcher several times; and major pre-determined themes were assembled by content analysis, parallel to a generation of sub themes to form the results part of this study. The findings of the current study showed that the most valued facilitators of Quality of life are support from family and friends, having faith in God, socioeconomic connections, income generating activities and an accessible home and environment.Barriers to quality of life were inaccessible environments, unreliable social support, and lack of empowerment, negative psychological traits such as anger, fear and worries that resulted from negative community actions, beliefs and attitudes (social environment). Such findings generate a package of intrinsic issues of concern from persons with spinal cord injury which adds to the body of knowledge pertaining to quality of life and spinal cord injury. The results from the current study indicate that persons with SCI in the selected rural area are partially satisfied with their current life due to various psychosocial, economic and environmental barriers. This dissatisfaction could be used as one of the major indications of poorly perceived quality of life. The researcher recommends that a comprehensive rehabilitation program should assess and take account of subjective needs from the client’s perspective to achieve better quality of life. Due to a known fact that the infrastructure of the rural area is complex, with a number of physical barriers, which further affects participation of persons with spinal cord injury in their communities, resolute social and political actions are necessary to rectify such environments to make it accessible for all.

As doenças de disco intervertebrais (DDIV) representam a maior parte de atendimentos neurológicos e são responsáveis pela maioria dos casos de paralisia em cães. Os tratamentos utilizados atualmente não demonstram resultados satisfatórios em pacientes com manifestações neurológicas mais graves. A fim de promover recuperação nervosa e motora, além de melhora na qualidade de vida, o presente trabalho objetivou criar um protocolo, através de um ensaio duplo cego, associando cirurgia descompressiva e transplante alogênico de células-tronco (CT) derivadas da membrana amniótica em cães com DDIV crônica. As mesmas células já foram caracterizadas anteriormente como mesenquimais fetais e apresentaram-se seguras para aplicação. Foram selecionados oito cães, onde quatro já passaram por cirurgia e receberam três aplicações epidurais de células-tronco. Os outros quatro animais foram submetidos à cirurgia descompressiva e divididos aleatoriamente (teste duplo cego) em dois grupos: \"cirurgia + placebo\", o qual recebeu apenas solução fisiológica; e \"cirurgia + CT\", que recebeu a terapia celular. Durante o procedimento cirúrgico, foi realizado a aplicação por gotejamento sobre a lesão, e após quinze e quarenta e cinco dias foram realizadas outras duas aplicações, via epidural. Os animais passaram por acompanhamento quinzenal e foram reavaliados três meses após o procedimento cirúrgico, através de exames funcionais e ressonância magnética. Alguns animais apresentaram melhora neurológica significativa, como a recuperação da nocicepção e capacidade de se manter em estação. Apesar da necessidade de mais estudos, até o presente momento, a terapia celular apresentou-se factível e sem efeitos prejudiciais aos animais. / Intervertebral disc (IVD) diseases represent the majority of neurological attendance and are responsible for the most cases of paralysis in dogs. Treatments currently used do not show satisfactory results in patients with more severe neurological manifestations. In order to promote nerve and motor recovery, as well as improve quality of life, the present study aims to create a protocol, using double-blind test method, associating spinal decompression surgery and allogeneic transplantation of amniotic membrane-derived stem cells (AMSCs) in dogs with chronic IVD diseases. Those were previously characterized as fetal mesenchymal cells and were safe for application. Eight dogs were selected, where four have already gone through surgery and received 3 epidural applications of stem cells. The other four animals were submitted to spinal decompression surgery and randomly divided into two groups (double blind test): \"surgery + placebo\", which received only physiological solution; and \"surgery + AMSCs\", which receive cell therapy. During the surgical procedure, a drip application was performed on the lesion and after fifteen and forty five days another two applications were made via epidural. Animals were monitored biweekly and were reassessed three months after surgery, by functional tests and magnetic resonance exams. Some animals presented significant neurological improvement, such as the recovery of nociception and ability to remain on station. Despites the need further studies, until the present moment, cell therapy has been feasible and has no harmful effects on animals.

A regeneração de danos às células nervosas do sistema nervoso central (SNC) é limitada devido aos fatores intrínsecos ao próprio nicho celular. A cicatriz glial, a liberação de inibidores de crescimento axonal, e a ação fagocítica dos astrócitos são fatores que limitam essa regeneração, coibindo os processos de reestruturação axonal. As lesões medulares causam um grande impacto na vida de seus portadores e de seus familiares. O uso das células tronco surgiu como uma alternativa viável ao tratamento das lesões medulares em humanos e animais. No entanto, apesar das tentativas terapêuticas em animais apresentarem resultados animadores, os ensaios clínicos realizados em humanos carecem de estudos mais aprofundados, e ainda não apresentaram resultados satisfatórios. O presente trabalho propôs a avaliação clínica do uso de células tronco da polpa dentária humana em cães com lesão medular crônica, e o uso das células tronco do epitélio olfatório de coelhos em coelhos com lesão medular induzida por hemissecção medular dorsal. Três cães foram submetidos à intervenção cirúrgica e avaliados através de teste comportamental e de ressonância magnética por imagem. Seis coelhos foram submetidos à técnica cirúrgica de hemissecção medular dorsal, e foram transplantados com células tronco do epitélio olfatório de coelhos e avaliados através de histologia e imunohistoquímica. As células-tronco do epitélio olfatório de coelhos foram rastreadas na medula espinhal dos animais 20 dias após a realização da terapia celular, confirmando o sucesso do transplante. A expressão da proteína fluorescente verde (GFP) através da imunohistoquímica comprovam o sucesso do transplante celular. O caso clínico canino um apresentou uma melhora clínica acentuada, pulando de um escore 4 para um escore de 8 em um curto espaço de tempo, mas não apresentou melhora nos exames de ressonância magnética. O caso clínico canino dois apresentou melhora clínica, embora a ressonância magnética mostrasse uma piora na situação da medula espinhal. E nosso caso clínico canino três apresentou mínima melhora clínica, sem alteração na imagem pré e pós operatória. Os dados obtidos com este estudo comprovam que a terapia celular com células tronco na lesão medular podem ser benéficas, no entanto ainda não representam uma cura para as lesões medulares crônicas. / The regeneration of damaged nerve cells of the central nervous system (CNS) is limited due to factors intrinsic to the own cell niche. The glial scar, the release of axonal growth inhibitors, and the phagocytic action of astrocytes are factors that limit this regeneration, deterring axonal restructuring. The spinal cord injuries cause a great impact on the lives of sufferers and their families. The use of stem cells has emerged as a viable alternative to the treatment of spinal cord injuries in humans and animals. However, despite attempts therapies in animals show encouraging results, clinical trials performed in humans require further study, and have not had satisfactory results. This paper proposed the clinical use of stem cells from human dental pulp in dogs with chronic spinal cord injury, and the use of stem cells from the rabbit olfactory epithelium in rabbits with spinal cord injury induced by dorsal hemisection. Three dogs underwent surgery and evaluated by behavioral test and magnetic resonance imaging. Six rabbits underwent surgical technique for spinal cord dorsal hemisection and were transplanted with stem cells from the olfactory epithelium of rabbits and evaluated by histology and immunohistochemistry. Stem cells of the olfactory epithelium of rabbits were traced in the spinal cord of animals 20 days after the completion of cell therapy, confirming the success of transplantation. Green fluorescent protein (GFP) tracked by immunohistochemical evidence the success of cell transplantation. The canine clinical case one presented a marked clinical improvement, jumping from a score of 4 to a score of 8 in a short time, but there was no improvement in magnetic resonance imaging. The canine clinical case two showed clinical improvement, although the MRI showed a worsening situation in the spinal cord. And our canine clinical case 3 showed minimal clinical improvement, no change in image pre-and postoperatively. The data obtained from this study show that cell therapy with stem cells in spinal cord injury may be beneficial, but still not a cure for chronic spinal cord injuries.

Following a spinal cord injury (SCI), the paralyzed extremities undergo muscle atrophy and decrease in bone mineral density (BMD) due in part to the loss of physiological loading. It is crucial to prevent musculoskeletal deterioration so the population is less susceptible to fractures, and could take advantage of stem cell treatment if it becomes available. Functional electrical stimulation (FES) has been shown to advantageously train the paralyzed extremities. However, there is a risk of fracture during FES due to low BMD of individuals with SCI. Therefore, the forces generated during FES need to be modeled so researchers and clinicians safely administer this intervention. The purpose of this project was to develop a biomechanical or mathematical model to estimate the internal compressive and shear forces at the distal femur, a common fracture site for individuals with SCI during FES. Therefore, a two-dimensional static model was created of the lower extremity in the supine and seated positions. The compressive and shear forces at the distal femur were estimated for both positions during FES. These internal compressive and shear forces estimated at the distal femur by the supine model were compared to those estimated by the standing model. Also, for the seated model, the compressive and shear forces at the distal femur estimated by a tetanic muscle contraction were compared to those estimated by a doublet muscle contraction. Finally, the supine model was validated using experimental testing. The primary findings are 1) the standing model estimated more compressive force and less shear force at the distal femur compared to the supine model when position and quadriceps muscle force remain constant and 2) for the seated model, a tetanic quadriceps muscle contraction predicts greater compressive and shear at the distal femur compared to a doublet muscle contraction. Also the validation testing revealed a 3.4% error between the supine model and the experimental testing. These models provide valuable insights into the internal forces at the distal femur during FES for those with SCI.

No description available.