Made available in DSpace on 2016-12-06T17:07:02Z (GMT). No. of bitstreams: 1 FERNANDO WENDELSTEIN CANO Divulgar.pdf: 238601 bytes, checksum: e1d5eed97e664cc87e17bb107bb5450f (MD5) Previous issue date: 2014-09-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This study aims to evaluate the kinematic variables of the paretic lower limb (PLL) and non-paretic (NPLL) in the task of stair climbing in subjects with post-stroke hemiparesis and control subjects to compare and evaluate the relationship between the degree of motor recovery and muscle strength with the kinematic variables of the MIP. This study involved 12 subjects (59.3 ± 11.3 years) with chronic hemiparesis (57.3 ± 38.0 months post-stroke) and seven control subjects (59.0 ± 7.9 years). To characterize the structure and function of the lower limb (LL) were assessed degree of motor recovery (Fugl-Meyer), tone (Tardieu scale) and muscle strength of flexor / extensor of hip, knee and ankle (hand dynamometer - MICROFET®) and range of motion of ankle passive goniometry. In the activity domain of the ascent rate was evaluated, the Timed Up and Go Test, gait speed, the step test (ST), the level of confidence in climbing stairs with no handrail or the specific issues of Activities-specific Balance Confidence Scale (ABC) and the functional level to stair climbing by Functional Gait Assessment (FGA). To characterize the task of stair climbing temporal variables and joint angles of hip and knee kinematics were measured by with six markers, bilaterally. Data were acquired through eight cameras DMAS 7.0 of Spica Technology Corporation system, with a frequency of 100 Hz. Participants climbed a ladder with step alternated with three steps at 17cm high, 80cm wide and 28cm deep without handrail with or without assistance according to need as assessed by question 10 of the FGA. The comparison between the temporal and angular hip and knee kinematic variables in the LL paretic, non-paretic and control was performed by oneway ANOVA or nonparametric statistics, when indicated (Krushkal-Wallis or Mann-Whitney), with a significance level of 0,05. The duration of single support and maximum knee flexion in swing were lower in the paretic lower limb compared to controls and non-paretic lower limb, the latter being related to the degree of motor recovery and the strength of the knee flexors. The cadence was lower and the duration of the cycle was higher in subjects with hemiparesis compared to controls, and these variables related to strength of all muscle groups of the MIP with the exception of the hip extensors. The maximum flexion and maximum hip abduction in swing phase was higher in both lower limbs of subjects with hemiparesis compared to controls. Besides influencing the independence of the task, the cadence and the rise time, muscle strength seems to determine the strategies adopted during stair climbing. Treatment programs aimed at improving performance in stair climbing should seek strategies to improve knee flexion during the task and strengthening various muscle groups that influence the task. / Este estudo tem como objetivos avaliar as variáveis cinemáticas do membro Inferior parético (MIP) e não parético (MINP) na tarefa de subida de escadas em sujeitos com hemiparesia pós-AVE e comparar sujeitos controle e avaliar a relação entre o grau de recuperação motora e a força muscular com as variáveis cinemáticas do MIP. Participam deste estudo 12 sujeitos (59,3±11,3 anos) com hemiparesia crônica (57,3±38,0 meses pós-AVE) e sete sujeitos controle (59,0±7,9 anos). Para caracterizar a estrutura e função dos membros inferiores (MMII) foram avaliados grau de recuperação motora (Fugl-Meyer), tônus (escala Tardieu) e força muscular de flexores/extensores de quadril, joelho e tornozelo (dinamômetro manual - MICROFET®) e a amplitude de movimento de tornozelo por goniometria passiva. No domínio atividade foi avaliada a cadência da subida, o Timed Up and Go Test, a velocidade de marcha, o teste do degrau (TD), o nível de confiança em subir escadas com ou sem corrimão pelas questões específicas da Activities-Specific Balance Confidence Scale (ABC) e o nível funcional para a subida de escadas pelo Functional Gait Assessment (FGA). Para caracterizar a tarefa de subida de escada foram mensuradas as variáveis temporais e os ângulos articulares de quadril e joelho através da cinemática, com seis marcadores, bilateralmente. Os dados foram adquiridos através de oito câmeras do sistema DMAS 7.0 da Spica Technology Corporation, com frequência de 100 Hz. Os participantes subiram com passo alternado uma escada com três degraus de 17cm de altura, 80cm de largura e 28cm de profundidade sem corrimão, com ou sem auxilio segundo a necessidade avaliada pela questão 10 do FGA. A comparação entre as variáveis cinemáticas temporais e angulares do quadril e joelho dos MMII parético, não parético e controle foi realizada através da ANOVA oneway ou estatística não paramétrica, quando indicado (Krushkal-Wallis ou Mann-Withney), com nível de significância de 0,05. A duração do apoio simples e a máxima flexão do joelho no balanço foram menores no membro inferior parético comparado aos controles e ao membro inferior não parético, sendo a última relacionada com o grau de recuperação motora e a força de flexores de joelho. A cadência foi menor e a duração do ciclo foi maior nos sujeitos com hemiparesia comparado aos controles, sendo estas variáveis relacionadas à força de todos os grupos musculares do MIP com exceção dos extensores de quadril. A máxima flexão e máxima abdução do quadril na fase de balanço foi maior em ambos MMII dos sujeitos com hemiparesia comparados aos controles. Além de influenciar a independência na tarefa, a cadência e o tempo de subida, a força muscular parece determinar as estratégias adotadas durante a subida de escadas. Programas de tratamento visando à melhora do desempenho na subida de escada devem buscar estratégias para a melhora na flexão do joelho durante a tarefa e o fortalecimento dos vários grupos musculares que influenciam a tarefa.

The designed pension for elderly with care servise is situated in Měřín locality. It is the a bricked two-floor object with no cellars, made of POROTHERM system. The base zones are made of the plain concrete. Roof construction is solved by one-shell roof. The dimensions of the building are 41,35 x 33,15 meters.

The thesis is focused on the preparation of documentation project of new residential building with twenty flats. The building is located in Valašské Meziříčí. The building has four floors, which are used for housing and one underground technical floor with garage and cellar booths. The building is brick ceramic blocks Porotherm and it is covered with a flat roof. The drawings were processed in a computer program AutoCAD.

https://dc.etsu.edu/entc-2160-oer/1022/thumbnail.jpg

This project began with the measurement of the exterior stair at the East addition of Campbell Hall on the campus of the University of Virginia. The project continued with the design of nine different autonomous stairs, and nine stairs as buildings. Stairs are one of the most basic and complex elements of architecture. Stairs interconnect to all aspects of a building. Through ascension and descension our existence is modified. The 'eye of the stair' looks up and down into the well. It is like the 'eye of the storm', which allows us to see things calmly while everything outside the storm's eye is in motion. Through looking into the eye of the stair we see a stair's eye view. / Master of Architecture

Made available in DSpace on 2017-07-10T14:17:10Z (GMT). No. of bitstreams: 1 simas.pdf: 1840643 bytes, checksum: 95c5a43ded5855449c86bf6bf87f3e58 (MD5) Previous issue date: 2015-02-12 / The aim of this study was to analyze the effects of the physical exercise of climbing stairs in bone and cartilage histomorphometric parameters in rats submitted to a model of osteoporosis and immobilization. 36 Wistar rats were separated into six groups were used: G1, G2 and G3 groups were subjected to pseudo-oophorectomy; and G4, G5 and G6 to oophorectomy. After surgery, all groups remained 60-day rest and the rats G2, G3, G5 and G6 had the right hind limb (MPD) immobilized during 15 days, followed by remobilization same period, being free in the box to G2 and G5, and climb stairs in G3 and G6. At the end of the experiment, the rats were euthanized, their tibias removed bilaterally and submitted to histological routine. Morphometric analysis showed that there was a statistically significant decrease in area (p = 0.0178) and cortical thickness (p = 0.0024), thickness of articular cartilage (p = 0.0138) and epiphyseal plate were made (p = 0.0187), and the number of osteocytes (p <0.0001) and chondrocytes (p = 0.0006) as well as significant increase in the medullary canal (p = 0.0384) in immobilized limbs of ovariectomized rats. However, the stair climbing exercise was able to reverse the loss of bone cortex (area (F (5; 29) = 6.24, p = 0.0007) and thickness (F (5; 29) = 4.11 p = 0.0062)), cartilage (articular cartilage thickness (F (5; 29) = 13.88, p <0.0001) and epiphyseal plate (F (5; 29) = 14.72, p <0.0001)) and cellular (osteocytes (F (5; 29) = 14.55, p <0.0001) and chondrocytes (F (5; 29) = 10.16, p <0.0001)) resulting of oophorectomy associated with immobilization. It was also observed a significant decrease in trabecular thickness and area in the members subjected to immobilization, however, both as the free remobilization and climb stairs were able to recover from this loss. Morphological analysis of tibia articular cartilage, no changes in cell structure or organization of the rats not subjected to immobilization (G1 and G4) were verified by observing only considerable decrease in the thickness and number of chondrocytes in G4 (oophorectomized group) . In female rats that were free remobilization (G2 and G5), it was observed degeneration regions of articular cartilage with subchondral bone exposure, loss of cellular organization, discontinuity of tidemark, the presence of fissures and flocculation, as well as decreased number of chondrocytes. On the other hand, G2 female rats (pseudo-oophorectomized group, immobilized and free remobilization) showed some regions of granulation tissue (pannus). In rats subjected to exercise climb stairs (G3 and G6), there were repair signs of cartilaginous structures, the presence of clones and pannus. In G6 (oophorectomized group, remobilization and immobilized ladder), although it was observed subcortical invasion of blood vessels in the calcified zone, and increasing the amount of isogenous groups and the thickness of the calcified zone. From the results obtained in this study, it can be concluded that climbing stairs exercise was effective in the recovery process of bone and cartilage tissue damaged by immobilization on osteoporosis model by ovariectomy in rats. / O objetivo deste estudo foi analisar os efeitos do exercício físico de subida em escada sobre parâmetros histomorfométricos ósseos e cartilaginosos de ratas submetidas à um modelo de osteoporose e imobilização. Foram utilizadas 36 ratas Wistar separadas em seis grupos: G1, G2 e G3 submetidas à pseudo-ooforectomia; e G4, G5 e G6 à ooforectomia. Após a cirurgia, permaneceram 60 dias em repouso e as ratas de G2, G3, G5 e G6 tiveram o membro posterior direito (MPD) imobilizado por 15 dias, seguido pelo mesmo período em remobilização, sendo livres na caixa para G2 e G5, e de subida em escada para G3 e G6. Ao final do experimento, as ratas foram eutanasiadas, suas tíbias retiradas bilateralmente e submetidas à rotina histológica. Foram realizadas análises morfométricas, nas quais observou-se que houve diminuição estatisticamente significativa de área (p= 0,0178) e espessura cortical (p= 0,0024), espessura da cartilagem articular (p= 0,0138) e da placa epifisária (p= 0,0187), e do número de osteócitos (p < 0,0001) e condrócitos (p= 0,0006), como também aumento significativo do canal medular (p= 0,0384), em membros imobilizados de ratas ooforectomizadas. No entanto, o exercício de subida em escada foi capaz de reverter a perda óssea cortical (área (F (5;29) = 6,24; p= 0,0007) e espessura (F(5;29)=4,11; p= 0,0062)), cartilaginosa (espessura da cartilagem articular (F(5;29)=13,88; p<0,0001) e da placa epifisária (F(5;29)=14,72; p<0,0001)) e celular (osteócitos (F(5;29)=14,55; p<0,0001) e condrócitos (F(5;29)=10,16; p<0,0001)) decorrente da ooforectomia associada à imobilização. Observou-se também diminuição significativa de área e espessura trabecular nos membros submetidos à imobilização, contudo, tanto a remobilização livre como em escada foram capazes de recuperar essa perda. Nas análises morfológicas da cartilagem articular da tíbia, não foram verificadas mudanças de estrutura nem de organização celular das ratas não submetidas à imobilização (G1 e G4), observando-se apenas considerável diminuição na espessura e no número de condrócitos em G4 (grupo ooforectomizado). Nas ratas que ficaram em remobilização livre (G2 e G5), visualizou-se regiões de degeneração da cartilagem articular com exposição de osso subcondral, perda da organização celular, descontinuidade da tidemark, presença de fissuras e floculações, como também diminuição do número de condrócitos. No entanto em G2 (grupo pseudo-ooforectomizado, imobilizado e remobilização livre) algumas regiões apresentavam tecido de granulação (pannus). Nas ratas submetidas ao exercício de subida em escada (G3 e G6), havia sinais de reparação das estruturas cartilaginosas, com presença de clones e pannus. Em G6 (grupo ooforectomizado, imobilizado e remobilização em escada), observou-se ainda invasão de vasos sanguíneos subcorticais na zona calcificada, além de aumento da quantidade de grupos isógenos e da espessura da zona calcificada. A partir dos resultados obtidos neste estudo, pode-se concluir que o exercício de subida em escada mostrou-se efetivo no processo de recuperação dos tecidos ósseo e cartilaginoso danificados pela imobilização, em modelo de osteoporose por ooforectomia em ratas.

Hälsofrämjande arbete är ett betydelsefullt arbetsområde inom folkhälsoarbetet för att förbättra befolkningens hälsa. Hälsofrämjande arbete innebär kunskap om friskfaktorer och välbefinnande. Arbetet utgår från sju grundläggande principer, där delaktighet är en av dem. Arbetet kan utföras på många olika arenor och av olika aktörer. En aktör är anhörigkonsulenter som arbetar med tillexempel riskgruppen anhöriga till personer med alkohol/narkotikaberoende- eller missbruksproblematik. Syftet med studien var att undersöka hur anhörigkonsulenten upplever hälsofrämjande arbete. Fem enskilda intervjuer har genomförts med två anhörigterapeuter, en anhörigkonsulent, en samtalsbehandlare och en rådgivare. En manifest innehållsanalys har valts och tillämpats i denna studie, där resultatet har kategoriserat utifrån "Delaktighetstrappan". I resultatet framkommer det att anhörigkonsulenterna upplever sig arbeta hälsofrämjande utifrån "Delaktighetstrappans" steg: information, konsultation, dialog samt inflytande/delaktighet. Slutsatserna är att "Delaktighetstrappans" ovan nämnda begrepp betyder hälsofrämjande arbete och upplevs som eget hälsofrämjande arbetssätt bland anhörigkonsulenterna. Däremot berörs inte begreppet: medbeslutande, eftersom intervjumaterialet inte omfattar något som kan kategoriseras in i trappans sista steg och blir därav inte berört i studien. / Health Promotion is an important working area in Public Health to improve health in a population. It implies knowledge of Health Promoting factors and well-being. Health Promotion is based on seven basic principles, which participation is one of them. It can be performed in many different settings and by different actors. One of these actors is a relative consultant who works with a risk group, for example family members or relatives of a person with alcohol/narcotic abuse problem. The purpose of this study was to examine how the relative consultant experience Health Promotion. Five individual interviews have been carried out with two relative therapists, a relative consultant, a conversation processor and a counselor. A manifest content analysis has been selected and applied in this study, where the result has been categorized based on "Staircase of participation". The result shows that the relative consultants are experiencing that they are working to Promote Health to relatives, based on steps in "Staircase of participation": information, consultation, dialogue and influence/participation. The conclusions is that the above-mentioned concepts of "Staircase of participation" meaning Health Promotion work is perceived by the relative consultants as their own working methods to Promote Health. However not the concept of: co-decision, because the interview material does not include anything that can be categorized into the last step in the stairs and therefore it has not been addressed in the study.

The final thesis Centrum volnočasových aktivit is elaborated in a form of bulding plan containing all units by valid regulations. The designed object is placed on the plots number 1970 and 1980/1 in the cadastral area Zábřeh. The main bulding is conceived as the four floor building wiht the partial besement. The building is a brick of a comprehensive system based on the underlying belts. The roof is designed flat. This building is suitable for leisure activities, there are classrooms and space to relax in the café. On the top floor there are two separate apartments for the owners of the building. Built up area is 561 m2., Area 7896 m2 plots.

When cities grow larger the demand for more residential buildings and public transport increases. To be able to meet the demands and still make the city compact the interest for underground facilities grows. Underground facilities come with some drawbacks, one example is the evacuation where the people are expected to evacuate upwards. This master thesis is aiming to further develop the research done on the subject by examining the impact of winter clothing. Two tests were performed in Skrapan, which is 25 floors high. The participants went up for 22 of the floors and were recorded during the ascending. Some of the participants had a pulse watch and a breathing mask, which measured the oxygen consumption. The median for the walking speed varied between 0,81 m/s and 0,56 m/s with regular clothing and 0,78 m/s to 0,57 m/s with winter clothes. In the building codes it says that 0,6 m/s should be used when calculating evacuation times when ascending stairs. The heart rate did not change significantly between the two tests. However, the oxygen consumption was higher with the jacket on. The participants would not have been able to keep going for much longer than 5 minutes with their current pace. According to the results in this master thesis 0,6 m/s is too high because in the tests that were made the participants were physically active and still couldn’t keep that speed up for the whole test. Due to the test being two days in a row, almost all of the participants walked slower the second time. However, the ones that walked with winter clothes the second day walked more slowly than the ones with regular clothes compared to the first day. Therefore, it is safe to say that the clothes do affect the walking speed of evacuating people and that more clothes i.e. warm shoes or a hat will have an even greater impact. / I takt med att städerna växer, både till yta och befolkningsmängd, ökar behovet av infrastruktur bland annat inom kollektivtrafiken och transportvägar. Genom att bygga dessa anläggningar under marken går det att exploatera marken ovan till andra ändamål. Med undermarksanläggningar kommer vissa svårigheter, så som begränsade utrymningsmöjligheter. Riktlinjerna för utrymning uppåt är inte till för längre trappor, och är därför inte representativt för de nya användningsområdena. Vikten av att dimensionera utrymningsmöjligheterna utifrån vad dagens befolkning kan prestera är relevant för att säkerställa en trygg utrymning i händelse av en olycka. Examensarbetet inriktar sig därför på att vidareutveckla tidigare forskning om utrymning uppåt genom att undersöka hur gånghastigheterna i trappor påverkas av vinterkläder. Försök genomfördes med 21 personer under två dagar i ett av Skrapans utrymningstrapphus, där varje försöksperson fick gå en gång per dag. Mätmetoderna som användes var bland annat; pulsklocka, tidtagning, videoobservationer och andningsmask som mäter syreupptagningsförmågan. Medianen för gånghastigheten beräknades på varje våningsplan där de högsta värdet med vanliga kläder blev 0,81 m/s, 3 meter upp i trappan och det lägsta 0,56 m/s, 57 meter upp i trappan. Med vinterkläder blev motsvarande värden 0,78 m/s, 5 meter upp i trappan och 0,57 m/s, 33 meter upp i trappan. Enligt Boverkets allmänna råd om analytisk dimensionering ska den dimensionerande gånghastigheten i trappor sättas till 0,6 m/s. Denna riktlinje är inte godtagbar eftersom försökets urvalsgrupp hade svårt att hålla den hastigheten trots att majoriteten av försökspersonerna i examensarbetet var unga och i god kondition. Gånghastigheterna påverkades även av att försökstillfällena genomfördes dagarna efter varandra vilket gjorde att försökspersonerna inte hade möjlighet att återhämta sig helt mellan försöken. Dock var tidsskillnaden från första dagen till den andra större för de som gick med vinterkläder andra dagen än för de som gick med vanliga kläder andra dagen. Vilket visar på att försökspersonerna blivit påverkade av vinterkläderna och därför gått långsammare. Mätningarna av syreupptagningsförmågan hos försökspersonerna gav varierande resultat, mycket beroende på kön och om de hade vinterkläder på sig eller inte. Kvinnornas utnyttjande grad ökade från 70-85 % till 73-90 % av sin maximala syreförbrukning när de var iklädda vinterkläder. Jämfört med männens utnyttjande grad som sjönk från 63-85 % till 61-77 % vid användandet av vinterkläder. Försökspersonerna var nära sin maximala syreförbrukning, VO2,max, vilket tyder på att de inte skulle klara av att hålla samma tempo i en längre trappa. Männen skulle kunna hålla samma tempo i cirka 15 minuter medan kvinnorna som ligger på 90 % av sin kapacitet enbart skulle kunna hålla samma hastighet i cirka 5 minuter. Vilket är ett ytterligare tecken på att hastigheten i BBRAD är för hög i långa trappor.

Instrumentos descritivos de avaliação funcional para portadores de distrofia muscular de Duchenne são limitados, pois classificam e não qualificam e/ou quantificam o desempenho motor. OBJETIVO: Elaborar escala de avaliação funcional do subir e descer escada para portadores de distrofia muscular de Duchenne e analisar confiabilidade intra e inter-examinadores. MÉTODO: 1. Elaboração de guia de avaliação a partir de revisão da literatura. 2. Avaliação do subir e descer escada de 120 registros filmados de 30 crianças com DMD (5 a 11 anos), utilizando o guia. 3. Elaboração da escala considerando grau de dificuldade. 4. Avaliação por peritos e reajustes para geração da versão final da escala e seu manual. 5. Análise estatística utilizando Índice de Correlação Intra-Classe e Correlação de Kappa Ponderado. RESULTADOS: A escala abrange cinco fases para o subir e quatro para o descer escada. Deve ser aplicada por profissional treinado, conforme normas do manual. Encontrou-se classificação excelente na análise da confiabilidade intra e interexaminadores, com valores da Correlação de Kappa Ponderado (> 0.78) e ICC > (0.89), com p < 0.05 entre todas as fases. CONCLUSÃO: A escala pode ser utilizada como ferramenta de avaliação fisioterapêutica descritiva e quantitativa com excelente repetibilidade e reprodutibilidade / Descriptive instruments of functional evaluation for carriers of duchenne muscular dystrophy are limited, because, they classify and do not qualify and/or quantify the motor performance. OBJECTIVE: To elaborate a scale of functional evaluation of going up and down stairs for DMD carriers and to analyze the realibility intra and inter examiner. METHODS: Elaboration of an evaluation guide from the literature review. 2. Evaluation of 120 registers filmed from 30 children (5 to 11 years) with duchenne muscular dystrophy going up and down stairs, using the guide. 3. Elaboration of the scale considering the degree of difficulty. 4. Evaluation by connoisseurs and readjustments for generation of the final version of the scale and its manual. 5. Statistical analysis using Intra-class Correlation Coefficient and Weighed Kappa. RESULTS: The scale encloses five phases for going up and four for going down stairs. It has to be applied by a trained professional, as norms of the manual. It was found an excellent classification on the reliability analysis intra and inter examiner, with values of Weighed Kappa Coefficient (> 0.78) and ICC > (0.89), with p < 0.05 between all phases. CONCLUSION: The scale can be used as a tool of physical therapy evaluation descriptive and quantitative with excellent repeatability and reproducibility