The objective of this study was to investigate the influence of cyclic loading on the extensibility of hamstring muscle-tendon units in vivo.Study Design: A test-retest randomised controlled trial with repeated measures was undertaken.Background: Stretching has been commonly promoted to increase the passive extensibility of the muscle-tendon units, yet the mechanism behind its proposed effects remains ambiguous. In vivo studies of stretching have mostly been limited to the viscoelastic characteristic of stress-relaxation. Few studies have investigated the characteristic of creep. Animal and cadaver in vitro creep experiments have consistently shown increases in the length of the soft tissues, with associated changes in their resistance and stiffness. These results however, might not be representative of human muscle-tendon units under in vivo conditions. Additionally, those in vivo human studies that have investigated creep phenomenon have contrasting results. To date, no known in vivo study has examined passive cyclic loading of human hamstrings to a constant load level.Method: Using a repeated measures design the extensibility of the hamstring muscles were assessed by a passive knee extension test (PKE) to maximal stretch tolerance using a KinCom® dynamometer. Those participants in the intervention group underwent 45 continuous passive cyclic loadings as the KinCom® dynamometer moved the knee joint into extension until torque reached 85% of maximal passive resistance torque measured in the passive knee extension test. The control group sat quietly relaxed during the intervention period. Measurements of hamstring passive extensibility using the PKE test were repeated at the end of the intervention.Results: Following the intervention, the PKE test showed for the cyclic loading group there was a significant (p < 0.05) increase in both maximal passive resistance torque (mean 23%) and knee joint angle (mean 6.3%). A significant (p < 0.05) decrease in passive resistance torque (mean 11.8%) when re-measured at the baseline position of maximal passive knee angle was observed. A significant increase (p < 0.05) was found for passive stiffness over the final 10% of the knee torque-angle curve. No significant difference (p > 0.05) was found for passive stiffness for the full (100%) of the torque-angle curve. Of the control group, no significant differences (p > 0.05) were observed for all variables of the PKE test. Analysis of cycle one compared to forty-five of the cyclic loading intervention procedure showed a significant (p < 0.05) increase in both passive knee joint angle (mean 5.2%) and passive stiffness (mean 28.6%) over the final 10% of the knee joint torque-angle. No significant difference (p > 0.05) was found for passive stiffness across the full (100%) knee joint torque-angle.Conclusion: The findings of the current study demonstrated that after cyclic loading the hamstring muscles lengthened and became stiffer over the final gained range of knee joint motion. Although the current study cannot determine the mechanism behind the changes in the variables of interest, these findings do provide some evidence that most likely a combination of altered stretch tolerance and local mechanical effects within the muscle-tendon unit, i.e. creep lengthening were responsible.

This thesis uncovers the rational and Romantic assumptions about the relationship between objects and identity that are embedded in occupational therapy, and critiques current practice from that perspective. It is based on an initial assumption that there is in fact a relationship between people's identity and the objects they make, have, use and are associated with. This assumption is explored through an interpretive examination of the fields of literature that are commonly identified as informing occupational therapy, supplemented by selected popular literature. The exploration takes a philosophical approach, guided by notions from philosophical hermeneutics, including pre-understandings, the hermeneutic circle and fusion of horizons. The conclusion reached is that people informed by Western philosophies interpret the identity meanings of objects in both rational and Romantic ways. To inform the study, the nature of rationalism and Romanticism are then explained, and the implications of these philosophical traditions in relation to objects and identity are teased out. This interpretation is guided by a history of ideas methodology, which entails approaching historical texts from a new perspective, in this case the identity meanings of objects. Thus informed, occupational therapy literature, primarily that published in Britain between 1938 and 1962 is examined from the perspective of objects and identity. What is revealed is that rational and Romantic understandings of objects, and of patients' and their own identity are clearly discernible. Such understandings afforded early occupational therapists both ways to organise their growing knowledge of the therapeutic application of crafts and the transformative outcomes of occupational therapy intervention. Gradually however, factors both internal and external to the profession served to undermine therapists' Romanticism. Primary amongst these were World War II, which saw a redeployment of occupational therapists from mental health to physical rehabilitation settings; advances in rehabilitative medicine, which brought a reduction in secondary complications and the adoption of teamwork; and the development of new practice areas including domestic rehabilitation using gadgets to enhance function and pre-vocational rehabilitation. As a result, tensions between rational and Romantic understandings crystallised around two long-standing controversies. These were whether or not craft equipment such as weaving looms should be adapted to serve specific remedial purposes, and whether it was the process of making a crafted object or the quality of the finished product that was more important. In the event, these contested ideologies became largely irrelevant as craftwork was sidelined from mainstream practice. With it, occupational therapists' Romantic vision of transforming people's lives through creative activity also slipped away. Several reasons for this loss of one of the profession's founding philosophies are proposed. They include the substantial absence of the professions' philosophical foundations from its education, and the paucity of theory and research methodologies that might have informed the nature and process of transformative change that earlier occupational therapists had observed and reported. The thesis concludes by arguing for the importance of recovering a balance between rationalism and Romanticism. A call to action is issued, addressing change in educational practice, concerted research effort to identify and articulate transformative processes within occupational therapy, and political action focusing on the inclusion of Romantic perspectives within policy and strategic documents.

Dissertation submitted to the Department of Chiropractic in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, 2006. / Myofascial pain syndrome (MPS) is defined as the sensory, motor and autonomic symptoms caused by myofascial trigger points (MFTPs), or hyperirritable spots within skeletal muscles that are associated with palpable nodules in a taut band. The fact that MFTPs have been described in the literature for acupuncturists, anaesthesiologists, chronic pain managers, dentists, family practitioners, gynaecologists, neurologists, nurses, orthopaedic surgeons, paediatricians, physical therapists, physiologists, rheumatologists and veterinarians is evidence of the syndrome’s clinical importance. As a result of a large amount of research, a large number of different treatments have been shown to be clinically effective in the treatment of MFTP. These treatments include amongst others: - Ischaemic compression. - Myofascial manipulation. - Spray and stretch. - Ultrasound. - Transcutaneous electrical nerve stimulation. - Dry needling. As can be seen from the above, it is important to be able to treat MPS effectively because it is such a common disorder. According to Schneider an effective treatment is needed for MPS, despite the array of treatments available to a clinician. Han and Harrison agree that more studies are required to determine the efficacy of these treatments. The aim of this study is to evaluate the relative effectiveness of Myofascial Trigger point Manipulation (MFTPM) as compared to Proprioceptive Neuromuscular Facilitative (PNF) stretching in the treatment of active Myofascial Trigger Points (MFTPs) in the trapezius muscle (TP 1 and/or TP 2) in terms of subjective and objective clinical findings. The study required a total of 60 patients, which following acceptance were then randomly divided into two groups of 30, with an equal number of male patients in Group one (MFTPM) and two (PNF), and female patients in Group one and Group two. Each patient had four consultations (three treatments and one follow up visit) in a two week period. Subjective and Objective Data was recorded at each consultation prior to the treatment. Subjective measurements (Numerical Pain Rating Scale and Short Form McGill Pain Questionnaire) were taken prior to the treatment at all four visits. Objective measurements (Cervical Range of Motion Meter and Algometer) were also taken prior to the treatment at all four visits, except for Algometer readings which were taken at the initial consultation and the fourth treatment only. SPSS version 11.5 was used for analysis of data (SPSS Inc, Chicago, Ill, USA). Baseline comparisons were done between treatment groups using Pearson’s chi square tests or Fisher’s exact tests as appropriate for categorical variables, and student’s t-tests for quantitative normally distributed variables. Treatment effect was assessed with repeated measures ANOVA. A significant time by group interaction indicated a significant differential treatment effect. A p value <0.05 designated statistical significance. The direction of the treatment effect was assessed with profile plots. Evaluation of data collected from both groups showed a significant improvement in terms of objective and subjective clinical findings to a value of p=< 0.001. There was no statistical difference between the two groups in terms of objective and subjective clinical findings, although a trend was shown when looking at the objective findings that suggest that MFTPM was more effective than PNF stretching. The sample population was drawn from a very homogenous group of people (i.e. SARS call centre), in order to achieve greatest emphasis on clinical outcomes. This process however limits the clinical applicability of the results and thus will not always be applicable to all patients within the population. It is therefore the researcher’s conclusion that there is no statistical difference between MFTPM and PNF stretching in terms of objective and subjective clinical findings. Both treatment modalities have been shown to be equally effective in the treatment of subacute active TPs in the upper tarpezius. There is a definite trend when looking at the objective data that may support the hypothesis that MFTPM is as effective as, if not more effective than PNF stretching. It is of the opinion of the author that a larger sample size is needed to make it clinically significant.

This thesis uncovers the rational and Romantic assumptions about the relationship between objects and identity that are embedded in occupational therapy, and critiques current practice from that perspective. It is based on an initial assumption that there is in fact a relationship between people's identity and the objects they make, have, use and are associated with. This assumption is explored through an interpretive examination of the fields of literature that are commonly identified as informing occupational therapy, supplemented by selected popular literature. The exploration takes a philosophical approach, guided by notions from philosophical hermeneutics, including pre-understandings, the hermeneutic circle and fusion of horizons. The conclusion reached is that people informed by Western philosophies interpret the identity meanings of objects in both rational and Romantic ways. To inform the study, the nature of rationalism and Romanticism are then explained, and the implications of these philosophical traditions in relation to objects and identity are teased out. This interpretation is guided by a history of ideas methodology, which entails approaching historical texts from a new perspective, in this case the identity meanings of objects. Thus informed, occupational therapy literature, primarily that published in Britain between 1938 and 1962 is examined from the perspective of objects and identity. What is revealed is that rational and Romantic understandings of objects, and of patients' and their own identity are clearly discernible. Such understandings afforded early occupational therapists both ways to organise their growing knowledge of the therapeutic application of crafts and the transformative outcomes of occupational therapy intervention. Gradually however, factors both internal and external to the profession served to undermine therapists' Romanticism. Primary amongst these were World War II, which saw a redeployment of occupational therapists from mental health to physical rehabilitation settings; advances in rehabilitative medicine, which brought a reduction in secondary complications and the adoption of teamwork; and the development of new practice areas including domestic rehabilitation using gadgets to enhance function and pre-vocational rehabilitation. As a result, tensions between rational and Romantic understandings crystallised around two long-standing controversies. These were whether or not craft equipment such as weaving looms should be adapted to serve specific remedial purposes, and whether it was the process of making a crafted object or the quality of the finished product that was more important. In the event, these contested ideologies became largely irrelevant as craftwork was sidelined from mainstream practice. With it, occupational therapists' Romantic vision of transforming people's lives through creative activity also slipped away. Several reasons for this loss of one of the profession's founding philosophies are proposed. They include the substantial absence of the professions' philosophical foundations from its education, and the paucity of theory and research methodologies that might have informed the nature and process of transformative change that earlier occupational therapists had observed and reported. The thesis concludes by arguing for the importance of recovering a balance between rationalism and Romanticism. A call to action is issued, addressing change in educational practice, concerted research effort to identify and articulate transformative processes within occupational therapy, and political action focusing on the inclusion of Romantic perspectives within policy and strategic documents.

The objective of this study was to investigate the influence of cyclic loading on the extensibility of hamstring muscle-tendon units in vivo.Study Design: A test-retest randomised controlled trial with repeated measures was undertaken.Background: Stretching has been commonly promoted to increase the passive extensibility of the muscle-tendon units, yet the mechanism behind its proposed effects remains ambiguous. In vivo studies of stretching have mostly been limited to the viscoelastic characteristic of stress-relaxation. Few studies have investigated the characteristic of creep. Animal and cadaver in vitro creep experiments have consistently shown increases in the length of the soft tissues, with associated changes in their resistance and stiffness. These results however, might not be representative of human muscle-tendon units under in vivo conditions. Additionally, those in vivo human studies that have investigated creep phenomenon have contrasting results. To date, no known in vivo study has examined passive cyclic loading of human hamstrings to a constant load level.Method: Using a repeated measures design the extensibility of the hamstring muscles were assessed by a passive knee extension test (PKE) to maximal stretch tolerance using a KinCom® dynamometer. Those participants in the intervention group underwent 45 continuous passive cyclic loadings as the KinCom® dynamometer moved the knee joint into extension until torque reached 85% of maximal passive resistance torque measured in the passive knee extension test. The control group sat quietly relaxed during the intervention period. Measurements of hamstring passive extensibility using the PKE test were repeated at the end of the intervention.Results: Following the intervention, the PKE test showed for the cyclic loading group there was a significant (p < 0.05) increase in both maximal passive resistance torque (mean 23%) and knee joint angle (mean 6.3%). A significant (p < 0.05) decrease in passive resistance torque (mean 11.8%) when re-measured at the baseline position of maximal passive knee angle was observed. A significant increase (p < 0.05) was found for passive stiffness over the final 10% of the knee torque-angle curve. No significant difference (p > 0.05) was found for passive stiffness for the full (100%) of the torque-angle curve. Of the control group, no significant differences (p > 0.05) were observed for all variables of the PKE test. Analysis of cycle one compared to forty-five of the cyclic loading intervention procedure showed a significant (p < 0.05) increase in both passive knee joint angle (mean 5.2%) and passive stiffness (mean 28.6%) over the final 10% of the knee joint torque-angle. No significant difference (p > 0.05) was found for passive stiffness across the full (100%) knee joint torque-angle.Conclusion: The findings of the current study demonstrated that after cyclic loading the hamstring muscles lengthened and became stiffer over the final gained range of knee joint motion. Although the current study cannot determine the mechanism behind the changes in the variables of interest, these findings do provide some evidence that most likely a combination of altered stretch tolerance and local mechanical effects within the muscle-tendon unit, i.e. creep lengthening were responsible.

Thesis (MHSc--Health Science) -- Auckland University of Technology, 2002. / Also held in print (80 leaves, col. ill., 30 cm.) in North Shore Theses Collection (T 612.76 TRE).

Thesis (M. Phil.)--University of Sydney, 2009. / Title from title screen (viewed September 25, 2009) Submitted in fulfilment of the requirements for the degree of Master of Philosophy to the Faculty of Medicine. Includes bibliographical references. Also available in print form.

Thesis (M.S.)--Brigham Young University. Dept. of Exercise Sciences, 2004. / Includes bibliographical references (p. 53-58).

Thesis (M. Ed.)--Bowling Green State University, 2005. / Includes bibliographical references (leaves 38-44). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Thesis (M. Ed.)--Bowling Green State University, 2005. / Includes bibliographical references (leaves 38-44).