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Vitamin D deficiency and insufficiency are now seen as a contemporary health problem in Australia with possible widespread health effects not limited to bone health1. Despite this, the Vitamin D status (measured as serum 25-hydroxyvitamin D (25(OH)D)) of ambulatory adults has been overlooked in this country. Serum 25(OH)D status is especially important among this group as studies have shown a link between Vitamin D and fall risk in older adults2. Limited data also exists on the contributions of sun exposure via ultraviolet radiation and dietary intake to serum 25(OH)D status in this population. The aims of this project were to assess the serum 25(OH)D status of a group of older ambulatory adults in South East Queensland, to assess the association between their serum 25(OH)D status and functional measures as possible indicators of fall risk, obtain data on the sources of Vitamin D in this population and assess whether this intake was related to serum 25(OH)D status and describe sun protection and exposure behaviors in this group and investigate whether a relationship existed between these and serum 25(OH)D status. The collection of this data assists in addressing key gaps identified in the literature with regard to this population group and their Vitamin D status in Australia. A representative convenience sample of participants (N=47) over 55 years of age was recruited for this cross-sectional, exploratory study which was undertaken in December 2007 in south-east Queensland (Brisbane and Sunshine coast). Participants were required to complete a sun exposure questionnaire in addition to a Calcium and Vitamin D food frequency questionnaire. Timed up and go and handgrip dynamometry tests were used to examine functional capacity. Serum 25(OH)D status and blood measures of Calcium, Phosphorus and Albumin were determined through blood tests. The Mean and Median serum 25-Hydroxyvitamin D (25(OH)D) for all participants in this study was 85.8nmol/L (Standard Deviation 29.7nmol/L) and 81.0nmol/L (Range 22-158nmol/L), respectively. Analysis at the bivariate level revealed a statistically significant relationship between serum 25(OH)D status and location, with participants living on the Sunshine Coast having a mean serum 25(OH)D status 21.3nmol/L higher than participants living in Brisbane (p=0.014). While at the descriptive level there was an apparent trend towards higher outdoor exposure and increasing levels of serum 25(OH)D, no statistically significant associations between the sun measures of outdoor exposure, sun protection behaviors and phenotypic characteristics and serum 25(OH)D status were observed. Intake of both Calcium and Vitamin D was low in this sample with sixty-eight (68%) of participants not meeting the Estimated Average Requirements (EAR) for Calcium (Median=771.0mg; Range=218.0-2616.0mg), while eighty-seven (87%) did not meet the Adequate Intake for Vitamin D (Median=4.46ug; Range=0.13-30.0ug). This raises the question of how realistic meeting the new Adequate Intakes for Vitamin D is, when there is such a low level of Vitamin D fortification in this country. However, participants meeting the Adequate Intake (AI) for Vitamin D were observed to have a significantly higher serum 25(OH)D status compared to those not meeting the AI for Vitamin D (p=0.036), showing that meeting the AI for Vitamin D may play a significant role in determining Vitamin D status in this population. By stratifying our data by categories of outdoor exposure time, a trend was observed between increased importance of Vitamin D dietary intake as a possible determinant of serum 25(OH)D status in participants with lower outdoor exposures. While a trend towards higher Timed Up and Go scores in participants with higher 25(OH) D status was seen, this was only significant for females (p=0.014). Handgrip strength showed statistically significant association with serum 25(OH)D status. The high serum 25(OH)D status in our sample almost certainly explains the limited relationship between functional measures and serum 25(OH)D. However, the observation of an association between slower Time Up and Go speeds, and lower serum 25(OH)D levels, even with a small sample size, is significant as slower Timed Up and Go speeds have been associated with increased fall risk in older adults3. Multivariable regression analysis revealed Location as the only significant determinant of serum 25(OH)D status at p=0.014, with trends (p=>0.1) for higher serum 25(OH)D being shown for participants that met the AI for Vitamin D and rated themselves as having a higher health status. The results of this exploratory study show that 93.6% of participants had adequate 25(OH)D status-possibly due to measurement being taken in the summer season and the convenience nature of the sample. However, many participants do not meet their dietary Calcium and Vitamin D requirements, which may indicate inadequate intake of these nutrients in older Australians and a higher risk of osteoporosis. The relationship between serum 25(OH)D and functional measures in this population also requires further study, especially in older adults displaying Vitamin D insufficiency or deficiency.

Bibliographic identification IŠTOKOVÁ, Lucie. The influence of cochlear implant on vestibular function in adult patients. Prague: Charles University, 2nd Faculty of Medicine, Department of Rehabilitation and Sports Medicine, 2020. 58 p., Appendices. Thesis supervisor Mgr. Klára Kučerová. Abstract Severe hearing loss is standardly treated by cochlear implantation. Considering the anatomical proximity and interconnection to the vestibulocochlear nerve, it is possible to influence vestibular functions. The aim of this diploma thesis is to evaluate the effect of unilateral cochlear implantation on postural stability and vestibular function in adult patients with severe hearing loss caused postlingually. Eleven patients aged 28-72 were examined the day before surgery, the day after surgery, and on average 25 days after surgery. The evaluation consisted of short-form Dizziness Handicap Inventory (DHI), Timed Up and Go testing (TUG), static stabilometry and the perception of the subjective visual vertical (SVV) static and dynamic. Significant deterioration of TUG and SVV was recorded particularly immediately after surgery. In dynamic SVV, especially, when the field of view rotated to the left. Considerable results in stabilometry were only when standing on a hard surface with eyes closed. Improvements in TUG, SVV...

京都大学 / 新制・課程博士 / 博士(医学) / 甲第24135号 / 医博第4875号 / 新制||医||1060(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 近藤 尚己, 教授 川上 浩司, 教授 阪上 優 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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Dans ce manuscrit, nous proposons un système d'analyse automatique des mouvements 3D entemps réel permettant l'évaluation des capacités fonctionnelles chez les personnes âgées àdomicile. Dans un premier temps, l'objectif est de contribuer à maintenir l'indépendancefonctionnelle de cette population et permettre une détection précoce d'une décompensationmotrice pour faciliter une démarche de rééducation. Pour quantifier la qualité d'équilibre d'unsujet en temps réel, nous avons conçu un système en utilisant le capteur Kinect et permettantd'analyser un test clinique simple et validé en rééducation gériatrique: le Timed Up and Go (TUG).Trois expériences, réalisées dans des environnements hétérogènes (laboratoire, hôpital de jouret domicile) ont montré une bonne fiabilité de la mesure des paramètres identifiés. Ellespermettent notamment d'attribuer une note de contrôle moteur indiquant la fragilité motrice.Dans un second temps, nous avons proposé une chaîne de traitement vidéo permettantd'augmenter la robustesse d'analyse de différentes phases du TUG : détection automatique de laposition assise, segmentation du patient et extraction de 3 articulations du corps. Les résultats deces travaux nous permettent d'envisager plusieurs perspectives. Tout d'abord, nous pensonseffectuer des expérimentations sur une population plus large afin de confirmer la fiabilité dusystème. Puis, différentes améliorations techniques et ergonomiques seraient nécessaires pourfaciliter l'utilisation grand public. Enfin, il serait intéressant d'étendre la méthodologie proposéepour d'autres tests cliniques en vue de prolonger l'autonomie à domicile. / We propose in this manuscript a realtime3D movement analysis system for inhomefunctionalabilities assessment in aged adults. As a first step, the purpose is to maintain the functionalindependence of this population and to allow an earlier detection of a motor decompensation inorder to facilitate a rehabilitation process. To quantify the equilibrium quality of a subject, webuilt a system using the Kinect sensor in order to analyze a simple clinical test validated in geriatricrehabilitation: the Timed Up and Go (TUG). Three experiments conducted in heterogeneousenvironments (laboratory, day hospital and home) showed good measurement reliability of theidentified parameters. In particular, they allow to assign a motor control note indicating themotor frailty. Then, we proposed a video processing chain to increase the robustness of theanalysis of the various TUG phases: automatic detection of the sitting posture, patientsegmentation and three body joints extraction. The results of this work allow us to considerseveral perspectives. First, we believe conduct experiments on a larger population in order toconfirm the system reliability. Then, various technical and ergonomic improvements would benecessary to facilitate general public use. Finally, it would be interesting to extend the proposedmethodology for other clinical test to prolong the autonomy at home.

Title: The effect of chosen manual techniques on static and dynamic postural stability in physiotherapy students. Aims: The main aim of this study is to assess the effect of chosen manual techniques on participants' static and dynamic postural stability. Summary: The study was done from May to December 2019. A total of 100 subjects aged 19-38years took part in the study. Participants were randomly divided into two groups - experimental and control. Postural stability was measured by the following tests: Star Excursion Balance test, Unipedal Stance test, Timed Up and Go test and Sit to Stand test. These standardised measurements were taken before intervention, after intervention and a week from intervention. Experimental group undertook the intervention by manual techniques, which took 20 minutes. Outcomes were written into recording sheets. Final data were processed using Microsoft Excel 2013, IBM SPSS Statistics V26 and TIBCO Statistica 13.3.0. To calculate differences, the following statistical methods were used: Shapiro-Wilk test, independent T-test and Mann-Whitney U test. To measure effect size, Cohen's d was used. The level of statistical significance was determined to α = 0,05. The clinical significance was assessed by these levels: d = 0,2-0,49 (small effect), d = 0,5-0,79 (medium effect),...

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Syfte och frågeställningar Syftet med den här studien har varit att undersöka och jämföra kvinnor och män i åldersgrupperna 30-39 år respektive 40-49 år avseende antropometriska mått samt prestation på GIH:s hälsotester. En vidare målsättning var att undersöka om det förekom några skillnader mellan två separata testtillfällen. Frågeställningarna har varit om resultaten på hälsotesterna skiljer sig mellan könen, åldersgrupperna samt mellan två separata testtillfällen. Metod Totalt fullföljde 41 deltagare GIH:s hälsotester, av dem var 20 kvinnor och 21 män mellan 30-49 år. Det enda som krävdes för att delta var att man uppfattade sig själv som frisk. Personer som tidigare haft stroke, hjärtinfarkt eller opererats på grund av hjärtproblem har inte inkluderats, ej heller gravida och personer med ledbesvär. Testerna utfördes på LTIV (Laboratoriet för tillämpad idrottsvetenskap) mellan februari och mars 2016. Resultat Signifikanta skillnader mellan de två separata testtillfällena noterades för några av styrketesterna framför allt hos männen: axelpressar, handgrip och stolresningar. Mellan könen sågs signifikanta skillnader i de antropometriska måtten, samt i flera konditions- och styrketester. Bland dessa kunde signifikant högre värden ses för kvinnorna än för männen i ryggstyrketestet.  Signifikanta skillnader mellan åldersgrupperna 30-39 år och 40-49 år sågs näst intill endast för kvinnor. De yngre jämfört med de äldre kvinnorna presterade bättre i flera av testerna, de vägde mindre och hade mindre kroppsmått. Slutsats Det framkom vanligtvis inte några signifikanta skillnader mellan det första och andra testtillfället, med enstaka undantag. När så är fallet behövs bara ett test utföras initialt inför en period med exempelvis fysisk aktivitet som senare kanske ska följas upp med ett återtest. Skillnader mellan könen och olika åldersgrupper framkom i vissa tester men inte i alla. Resultaten i denna studie beror bland annat på urvalet av individer. Eftersom att syftet med den här studien har varit att endast utföra de tester som ingår i GIH:s hälsotester har inga tester lagts till eller exkluderats. I arbetet diskuteras bland annat hur optimala testerna är som ett mått på hälsa. För att effektivisera hälsotestundersökningar framöver behöver nödvändigtvis inte alla tester utföras.