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Strydom, Aliki Veruschka. "Extraction and biomedical application of peripheral blood stem cells in sheep and horses." Thesis, Stellenbosch : University of Stellenbosch, 2007. http://hdl.handle.net/10019.1/1146.
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Thesis (PhD (Physiological Sciences))--University of Stellenbosch, 2007.SUPERFICIAL digital flexor tendon injury has a serious negative impact on the competitive horse industry. Injured horses require up to a year of rest for recovery and likelihood of re-injury upon return to normal activity is as high as 80 %. Tendon healing requires (a) production of collagen by fibroblasts, to provide tensile strength and elasticity to the tendon, (b) minimisation of restrictive fibrosis, which compromises tendon gliding function and (c) minimisation of peritendinous adhesions. We review conventional treatments for tendon healing before exploring stem cell application as a therapeutic alternative. We promote the use of hematopoietic and mesenchymal stem cells derived from adult peripheral blood - as opposed to bone marrow-derived stem cells or embryonic stem cell sources - and review published research output in this regard. In conclusion, we outline our research objectives and present and discuss our results in the chapters that follow. Mononuclear cells - consisting of hematopoietic stem cells, mesenchymal stem cells and leucocytes – were isolated from the peripheral blood of sheep and horses through red blood cell lysis and blood plasma extraction. Cell counts and propidium iodide dye exclusion viability tests were conducted on the cell pellets. Sheep sub samples were tested for CD45 expression and horse sub samples for CD4 and CD11a/18 cell surface markers by flow cytometry for characterisation purposes. In both cases, separate sub samples were incubated with matched immunoglobulin (IgG) isotypes, conjugated to fluorescein isothiocyanate (FITC), to serve as controls. For the culture of mononuclear cells, 4.5 x 106 cells were selected for autologous sheep injections, 3 x 106 CD45- cells for allogeneic sheep injections (the latter excluding leucocytes that may induce an immune response) and 72 x 106 cells for horse injections. These cells were incubated with bromo-deoxyuridine (BrdU), cultured and subsets were extracted for a second round of cell counts and viability tests before being resuspended in blood plasma. For the horse samples an additional 1 x 106 mononuclear cells were incubated until reaching 60 % confluence and tested for myogenic differentiation. Low cell mortality and lack of fluorescence from IgG-FITC controls reflected effective protocols and a lack of false positive results. The fact that the equine cell population differentiated into myotubes verified the presence of mesenchymal stem cells in injections. We tested whether surgical incisions or collagenase injections best mimicked naturally occurring tendon injuries and compiled macroscopic and microscopic descriptions of tendon injury sites at seven weeks post-injury. The superficial digital flexor tendons of 27 sheep received an incision, a collagenase injection or a saline control injection. After one week a number of sheep were sacrificed while the remainder received further saline treatment and were sacrificed after another seven weeks. Tendons were examined through clinical observations, image analysis of maximum tendon diameter, mechanical testing and histological sectioning of affected tissues. Collagenase-induced injury resembled tendonitis more closely than surgically-induced injury. Collagenase-injured tendons (a) induced lengthier lameness in affected limbs, (b) were more swollen and difficult to palpate, (c) assumed the bow appearance characteristic of natural injury, (d) experienced extensive haemorrhage due to collagen lysis, (e) had decreased elasticity and capacity to carry loads and stress, (f) displayed decreased stiffness due to collagen fibre disruption and (g) developed severe inflammation. After seven weeks injured tendons displayed increased vascularisation in the areas of haemorrhage and in the adjacent collagen matrix. High inflammation rates and low collagen levels however still persisted. Collagenase injections were used to induce tendonitis in the superficial digital flexor tendons of 27 sheep. After one week these tendons received treatment with a control saline solution, autologous peripheral blood mononuclear cells (MNCs) or allogeneic peripheral blood CD45- MNCs. Healing rates were compared after a further seven week period by conducting ultrasonographic evaluations, clinical observations, image analyses of maximum tendon diameter, mechanical tests and histological investigations. Tendons treated with MNCs displayed an improvement in echogenicity and fibre linearity, higher and more organised collagen levels, stronger mechanical properties and less swelling. Although these improvements were not always significant, they provided strong evidence to suggest marked healing benefits over a longer time period. Collagenase injections were used to induce tendonitis in the superficial digital flexor tendons of four horses. After one week these tendons received treatment with either a control saline solution or autologous peripheral blood mononuclear cells (MNCs). Healing rates were compared after a further seven week period by conducting ultrasonographic evaluations, clinical observations, image analysis of maximum tendon diameter and histological investigations. Tendons treated with MNCs displayed significant improvements in fibre linearity in the direct vicinity of the lesion, as well as recovery rate thereof, and experienced less swelling when compared with their untreated counterparts. Healing trends suggested that, given a longer period of observation post-injury, more significant improvements may become apparent. Human adipose tissue is known be an easily accessible and high yielding source of multipotent mesenchymal stem cells. These stem cells could potentially be used for therapeutic advancement of tendon regeneration. Our first goal was to examine the in vitro myogenic differentiation potential of adipose-derived, adherent mononuclear cells (MNCs) from six adult sheep. The second goal was to characterise the population of cells isolated through various available ovine specific, non-mesenchymal stem cell surface markers, namely, CD1, CD31, CD34 and CD45. After incubation, only four of the six MNC cultures started to proliferate. These four cultures all exhibited high myogenic differentiation ability. The isolated cell populations did not express any of the non-mesenchymal stem cell specific cell surface markers. In conclusion, our data suggests that peripheral blood stem cells and adipose-derived stem cells are important candidate cell types for therapeutic application to improve tendon repair in horses and sheep. Sufficient time must be allowed following injury and prior to stem cell treatment (at least one month) and a controlled exercise program should be followed posttreatment. A larger sample size is required and at least six months of recovery before macroscopic and histological repair can be analysed more accurately and conclusively. Ultrasonography should be carried out on a continuous basis, as it is a non-invasive method of monitoring change over time.
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Grant, Cliff. "The safety and efficacy of intramuscular xylazine for pain relief in sheep and lambs." Title page, contents and abstract only, 2002. http://web4.library.adelaide.edu.au/theses/09MSB/09msbg7613.pdf.
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"April 2002" Bibliography: leaves 190-202. Examines the suitability of the [alpha] 2 adrenoreceptor agonist xylazine for providing safe and effective analgesia in 2 settings: for post-surgical pain in adult sheep used for biomedical research, and for routine husbandry procedures applied to lambs on farms, such as mulesing, tail-docking and castration. Concludes in setting 1 that intramuscular administration of xylazine was simple to perform yet was characterized by a rapid peak analgesic effect with a reasonable duration of action and minimal deleterious effects on cardiac output, blood pressure or arterial blood gases. In setting 2 the anti-nociceptive effects in lambs are of a similar magnitude and duration to those in adult sheep when the dose was scaled for body weight. A ranking of the relative painfulness of husbandry procedures was developed and used to assess the efficacy of intramuscular xylazine.
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Watts, Russell Edward. "Evaluation of DETA as a surface treatment to enhance neuronal attachment to a silicone-based substrate." Thesis, Georgia Institute of Technology, 2001. http://hdl.handle.net/1853/16905.
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Granger, Nicolas. "Effects of intraspinal transplantation of mucosal olfactory ensheathing cells in chronic spinal cord injury in domestic dogs." Thesis, University of Cambridge, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.608161.
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Leung, Ka-kit Gilberto, and 梁嘉傑. "Applications of self-assembling peptide nanofibre scaffold and mesenchymal stem cell graft in surgery-induced brain injury." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206347.
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Surgery-induced brain injury (SBI) refers to trauma caused by routine neurosurgical procedures that may result in post-operative complications and neurological deficits. Unlike accidental trauma, SBI is potentially subject to preemptive interventions at the time of surgery. SBI can cause bleeding, inflammation and the formation of tissue gaps. Conventional haemostatic techniques, though effective, are not necessarily conducive to healing. Inflammation and the absence of extracellular matrix in tissue gaps also hinder regeneration after SBI. This study investigated the applications of RADA16-I, a type I self-assembling peptide nanofibre scaffold (SAPNS), and mesenchymal stem cells (MSCs) in the treatment of SBI. Using animal SBI models, treatments were applied immediately and locally onto the operative fields, taking advantages of the haemostatic and cell-carrying properties of RADA16-I, the immune- modulatory effects of MSCs, and the earliest available therapeutic window for SBI.
There were three objectives. Objective 1 was to compare RADA16-I with conventional haemostatic methods, including electrocautery and fibrin sealant, in their effects on the brain’s acute cellular inflammatory response. The hypothesis was that RADA16-I would cause the same or a lesser degree of inflammation. This study showed that RADA16-I was superior to electrocautery, and was noninferior to conventional topical haemostats.
Objective 2 was to study the in vitro expansion of MSCs within RADA16-I in preparation for in vivo transplantation. The hypothesis was that the in vitro survival of MSCs would vary between different RADA16-I concentrations and culturing methods. This study showed that plating MSCs onto pre-buffered RADA16-I would protect the cells against RADA16-I’s intrinsic acidity and result in better initial survival. Subsequent integration with the RADA16-I hydrogel, however, was poor. Mixing the cells directly with RADA16-I caused initial cell loss but allowed better integration. RADA16-I at lower concentrations resulted in better survival but also more fragile hydrogels that were mechanically unfit for transplantation. Mixing MSCs with 0.5% RADA16-I for seven days represented a compromise between these competing factors.
Objective 3 was to study the in vivo effects of a MSC-RADA16-I implant on tissue reactions after SBI. The hypothesis was that the combinatorial therapy would result in less cellular inflammatory response than MSC alone or RADA16-I alone. Implants of pre-buffered 0.5% RADA16-I hydrogel, with or without cells, were found to cause less inflammation than control. MSCs in free suspension resulted in significantly more pronounced inflammation than when carried in RADA16-I. Supplementing RADA16-I with MSCs, however, did not confer additional benefit over RADA16-I alone.
The present study provided new preclinical evidence to support future clinical testing of RADA16-I as a novel surgical haemostat. It also demonstrated the feasibility of early intracerebral transplantation of RADA16-I hydrogel in the treatment of SBI. Whether RADA16-I and/or transplanted MSCs could modulate the brain’s inflammatory response after SBI require further investigations, which may include the search for the optimal ex vivo expansion technique and specifically tailored nanofibre scaffold. The translational applications of these findings would include the treatment of SBI over critical brain regions where trauma would cause severe functional deficits and where better healing would facilitate patient recovery.published_or_final_version
Anatomy
Doctoral
Doctor of Philosophy
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Basey, Adriana L. "Effects of a traditional and modified straight straight leg raise on EMG characteristics." Virtual Press, 1997. http://liblink.bsu.edu/uhtbin/catkey/1048378.
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The purpose of this study was to determine the vastus medialis oblique muscular electromyographical (EMG) activity during two therapeutic exercises: the modified straight leg raise and the traditional straight leg raise. Two subject groups of 10 subjects each, one with anterior knee pain (PHY) and the other group with no history of patellofemoral pathology (NORM), performed the traditional straight leg raise (SLR) and a modified straight leg raise with external hip rotation (MOD). Each subject performed an isometric maximum voluntary contraction and three trials of each of the two therapeutic exercises. The EMG variables analyzed were the percent of the maximum voluntary contraction for each muscle, vastus medialis oblique, vastus lateralis, and rectus femoris: the percent of the maximum voluntary contraction of the ratio between the vastus medialis oblique and the vastus lateralis; the percent of the maximum voluntary contraction for the integrated EMG for each muscle; and the percent of the maximum voluntary contraction for the root mean square for each muscle. The statistical analysis was conducted with two-way analysis of variance procedures. The statistical analysis revealed no significant differences; however, the data appeared to illustrate a trend toward more electromyographical activity in the vastus medialis oblique in the PHY subject group during the MOD therapeutic exercise. This suggests that the MOD therapeutic exercise may be able to isolate the vastus medialis oblique muscle in persons with anterior knee pain and allow them to regain strength and normal function earlier than with the use of the SLR therapeutic exercise.School of Physical Education
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Rodling, Wahlström Marie. "Severe cerebral emergency aspects of treatment and outcome in the intensive care patient /." Umeå Umeå universitet, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-21065.
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Aderem, Jodi. "The biomechanical risk factors associated with preventing and managing iliotibial band syndrome in runners : a systematic review." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/96803.
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Thesis (MScPhysio)--Stellenbosch University, 2015.ENGLISH ABSTRACT: Introduction: Iliotibial band syndrome (ITBS), an overuse injury, is the second most common running injury and the main cause of lateral knee pain in runners. Due to the increasing number of runners worldwide there has been an increase in its occurrence. Runners with ITBS typically experience symptoms just after heel strike at approximately 20°-30° of knee flexion (impingement zone) during the stance phase of running. A variety of intrinsic and extrinsic risk factors may be responsible for why some runners are more prone to developing symptoms during the impingement zone as opposed to others. Abnormalities in running biomechanics is an intrinsic risk factor which has been most extensively described in literature but little is known about its exact relationship to ITBS. Objectives: The purpose of this systematic review was to provide an up to date evidence synthesis of the biomechanical risk factors associated with ITBS. These risk factors may need to be considered in the prevention or management of ITBS in runners. A clinical algorithm is also presented. Methods: A systematic review with meta-analysis was conducted. An electronic search was performed in PubMed, PEDro, SPORTSDisc and Scopus of literature published up-until May 2014. Cross-sectional and cohort studies were eligible for inclusion if they evaluated the lower limb biomechanics of runners with ITBS or those who went onto developing it. All studies included in the review were methodologically appraised. Evidence was graded according to the level of evidence, consistency of evidence and the clinical impact. Data was described narratively using tables or narrative summaries where appropriate. A meta-analysis was conducted for biomechanical risk factors which were reported in at least two studies, provided that homogeneity in the outcomes and samples were present. Results: A total of 11 studies were included (1 prospective and 10 cross-sectional). Overall the methodological score of the studies was moderate. Increased peak hip adduction and knee internal rotation during the stance phase may predict the development of ITBS in female runners. These biomechanical risk factors may need to be screened for ITBS prevention, despite the evidence base being limited to a single study. Currently there is no conclusive evidence that any of the biomechanical parameters need to be considered when managing runners with ITBS. Stellenbosch University https://scholar.sun.ac.za iii Conclusion: Biomechanical differences may exist between runners with ITBS and those who may develop ITBS compared to healthy runners. Although a large variety of biomechanical risk factors were evaluated, the evidence base for screening or managing these risk factors for runners with ITBS is limited. This is due to a small evidence base, small clinical effect and heterogeneity between study outcomes and findings. Further prospective and cross-sectional research is required to ascertain if abnormalities in running biomechanics may be related to why runners develop ITBS or to ascertain which risk factors may be involved when managing these runners.
AFRIKAANSE OPSOMMING: Inleiding: Iliotibiale-band-sindroom (ITBS), ’n besering vanweë oormatige gebruik, is die tweede algemeenste hardloopbesering en die hoofoorsaak van laterale kniepyn by hardlopers. Namate die getal hardlopers wêreldwyd toeneem, neem die voorkoms van hierdie toestand ook toe. Hardlopers met ITBS ervaar tipies simptome ná die hakslag met die knie ongeveer 20-30° gebuig (die wrywingsone of “impingement zone”) gedurende die staanfase van hardloop. Verskeie intrinsieke en ekstrinsieke risikofaktore kan ’n rol speel in waarom sommige hardlopers meer geneig is as ander om gedurende die wrywingsone simptome te ervaar. Abnormaliteite in hardloopbiomeganika is ’n intrinsieke risikofaktor wat reeds omvattend in die literatuur beskryf is. Tog is weinig bekend oor presies hoe dit met ITBS verband hou. Oogmerke: Die doel van hierdie stelselmatige ondersoek was om ’n sintese te bied van die jongste bewyse van die biomeganiese risikofaktore van ITBS. Hierdie risikofaktore kan dalk oorweeg word om ITBS by hardlopers te voorkom of te bestuur. ’n Kliniese algoritme word ook aangebied. Metodes: ’n Stelselmatige ondersoek is met behulp van meta-ontleding onderneem. PubMed, PEDro, SPORTSDisc en Scopus is elektronies deurgesoek vir literatuur wat tot en met Mei 2014 verskyn het. Deursnee en kohortstudies is ingesluit indien dit gehandel het oor die biomeganika in die onderste ledemate van hardlopers wat ITBS het of later ontwikkel het. Alle studies wat deel was van die ondersoek is metodologies geëvalueer. Bewyse is aan die hand van bewysvlak, bewyskonsekwentheid en kliniese impak beoordeel. Data is narratief beskryf met behulp van tabelle of narratiewe opsommings waar dit toepaslik was. ’n Meta-ontleding is onderneem waar biomeganiese risikofaktore in minstens twee studies aangemeld is, mits daar homogeniteit in die uitkomste sowel as die steekproewe was. Resultate: Altesaam 11 studies is ingesluit (een prospektief en tien deursnee). Die metodologiese telling van die studies was oorwegend gemiddeld. Verhoogde spitsheupadduksie en interne knierotasie gedurende die staanfase kan op die ontwikkeling van ITBS by vrouehardlopers dui. Hierdie biomeganiese risikofaktore kan dalk nagegaan word vir ITBS-voorkoming, al was die bewysbasis beperk tot ’n enkele studie. Daar is tans geen afdoende bewys dat enige van die biomeganiese parameters oorweeg behoort te word in die bestuur van langafstandatlete met ITBS nie. Gevolgtrekking: Daar bestaan dalk biomeganiese verskille tussen hardlopers wat ITBS het of kan ontwikkel en gesonde hardlopers. Hoewel ’n groot verskeidenheid biomeganiese risikofaktore beoordeel is, is die bewysbasis vir die toets of bestuur daarvan by atlete met ITBS beperk. Dít is vanweë die klein hoeveelheid bewyse, die klein kliniese impak, en heterogeniteit tussen studie-uitkomste en bevindinge. Verdere prospektiewe en deursneenavorsing word vereis om te bepaal of abnormaliteite in hardloopbiomeganika ’n rol kan speel in waarom langafstandhardlopers ITBS ontwikkel, of om vas te stel watter risikofaktore ter sprake kan wees in die bestuur van hierdie hardlopers.
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Myer, Gregory D. "The effect of three selected exercises on electromyographic root mean square values and vastus medialis oblique to vastus lateralis ratio." Virtual Press, 1998. http://liblink.bsu.edu/uhtbin/catkey/1101588.
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The primary purpose of this study was to determine the ratio of activation between the VMO and VL while performing three selected knee exercises (drop squat, modified lateral squat, Muncie Method). Additionally, the data was analyzed to determine if a correlation existed between the muscle's activation rate per set and whether or not the rates are affected by Q-angle or gender. Twenty Ball State University subjects (10 male, 10 female) who were asymptomatic to Patellofemoral Syndrome (PFS), provided electroymyographic (EMG) data while performing the three selected exercises. A one-way ANOVA found no statistical significance (p=0.500) on any of the tested variables except the Drop Squat VL Root Mean Square (RMS). Significant correlations were found between: VL RMS to set number during drop squat, and VMO and VL RMS to set number during Muncie Method performance. Based on the results of this study, each of these exercises could be used to selectively strengthen the VMO in treatment of PFS.School of Physical Education
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Kelly, Patricia J. "Morphological changes of collagenase induced tendinitis of achilles rat tendons utilizing augmented soft tissue mobilization." Virtual Press, 1999. http://liblink.bsu.edu/uhtbin/catkey/1129629.
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Augmented Soft Tissue Mobilization (ASTM) is a new noninvasive technique utilized to treat chronic musculoskeletal injuries. The purpose of this study was to trace the morphological events in collagenase injured rat Achilles tendons during ASTM treatment and to observe passive occurrence of post treatment remodeling in tendons. Twelve groups of rats were divided into the following categories, A) control, B) sham surgery, C) ASTM only, D) ASTM/sham , E) tendinitis, F) ASTM/tendinitis 1 week, G) ASTM/tendinits 2 weeks H) ASTM/tendinits 3 weeks I) ASTM/tendinits 4 weeks, J) Post ASTM 5 weeks, K) Post ASTM 10 weeks, L) Post ASTM 15 weeks. One week after the last designated treatment, the Achilles tendons were harvested and then prepared for light microscopy, electron microscopy, and bifringence polarizing microscopy. An increase in fibroblast activation and proliferation was noted with the tendinitis, ASTM/tendinitis, and post groups. Ossification occurred in the core of the Achilles tendon in all of the ASTM groups. The presence of inflammatory cells was observed in the tendons and longitudinal remodeling of the collagen fibers did not occur.Department of Biology
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Zhao, Rongrong. "Chondroitinase ABC, anti-Nogo A, and rehabilitation in spinal cord injury." Thesis, University of Cambridge, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.610299.
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Skelton, Deborah. "The effects of hyperbaric oxygen therapy on acute ankle sprains /." Thesis, McGill University, 2000. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=31140.
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This study investigated the effects of hyperbaric oxygen (HBO) therapy on acute ankle injuries and determined if HBO therapy shortened time to recovery, decreased edema and pain, and increased range of motion and strength of the ankle. Subjects were randomly assigned to either an experimental (HBO) group (n = 4) or a control group (n = 4). All subjects received the same standardized physical therapy for lateral ankle sprains at the McGill Sport Medicine Clinic. The HBO group received 5 consecutive HBO treatments at 2.5 ATA for 90 minutes starting within 24 hours post injury. The control group received no HBO treatments. All subjects were evaluated by a physician within 24 hours of injury. All subjects suffered a second-degree lateral ankle sprain. Pain, range of motion, strength, volume displacement, and function were evaluated on the day of injury (Day 1), on Day 6 post injury, and on the day of return to play (Day RTP). There was no significant difference in time to return to play. However, the HBO group (25.5 +/- 11.6 days) did return 31% faster than the control group (36.8 +/- 19.4 days). There were no differences found between groups on the variables. There was a decrease in pain found over time (Day 1 was 57 mm, Day 6 was 18.5 mm, and Day RTP was 7 mm). The results of this study suggest that with treatment of HBO there is no effect on ankle sprains for return to play or improved function.
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Davis, Johan H. "Thoracolumbar injuries : short segment posterior instrumentation as standalone treatment - thoracolumbar fractures." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5351.
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Thesis (MMed (Surgical Sciences. Orthopaedic Surgery))--University of Stellenbosch, 2010.Objective: This research paper reports on the radiographic outcome of unstable thoracolumbar injuries with short segment posterior instrumentation as standalone treatment; in order to review rate of instrumentation failure and identify possible contributing factors. Background: Short segment posterior instrumentation is the treatment method of choice for unstable thoracolumbar injuries in the Acute Spinal Cord Injury Unit (Groote Schuur Hospital). It is considered adequate treatment in fracture cases with an intact posterior longitudinal ligament, and Gaines score below 7 (Parker JW 2000); as well as fracture dislocations, and seatbelt-type injuries (without loss of bone column - bearing integrity). The available body of literature often states instrumentation failure rates of up to 50% (Alanay A 2001, Tezeren G 2005). The same high level of catastrophic hardware failure is not evident in the unit researched. Methods: Sixty-five consecutive patients undergoing the aforementioned surgery were studied. Patients were divided into two main cohorts, namely the “Fracture group” (n=40) consisting of unstable burst fractures and unstable compression fractures; and the “Dislocation group” (n=25) consisting of fracture dislocations and seatbelt-type injuries. The groups reflect similar goals in surgical treatment for the grouped injuries, with reduction in loss of sagittal profile and maintenance thereof being the main aim in the fracture group, appropriately treated with Schantz pin constructs; and maintenance in position only, the goal in the dislocation group, managed with pedicle screw constructs. Data was reviewed in terms of complications, correction of deformity, and subsequent loss of correction with associated instrumentation failure. Secondly, factors influencing the aforementioned were sought, and stratified in terms of relevance. Results: Average follow up was 278 days for the fracture group and 177 days for the dislocation group (all patients included were deemed to have achieved radiological fusion – if fusion technique was employed). There was an average correction in kyphotic deformity of 10.25 degrees. Subsequent loss in sagittal profile averaged 2 degrees (injured level) and 5 degrees (thoracolumbar region) in the combined fracture and dislocation group. The only factor showing a superior trend in loss of reduction achieved was the absence of bone graft (when non-fusion technique was employed). Instrumentation complications occurred in two cases (bent connection rods in a Schantz pin construct with exaggerated loss in regional sagittal profile, and bent Schantz pins). These complications represent a 3.07% hardware failure in total. None of the failures were considered catastrophic. Conclusion: Short segment posterior instrumentation is a safe and effective option in the treatment of unstable thoracolumbar fractures as a standalone measure.
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Yuan, Tifei, and 袁逖飞. "Self-assembling peptide nanofiber scaffold treatment to acutely injured olfactory bulb." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B43816277.
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Tate, Matthew C. "The development of extracellular matrix based neural stem cell transplants for treatment of traumatic brain injury." Diss., Georgia Institute of Technology, 2002. http://hdl.handle.net/1853/20166.
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Robertson, William Brett. "Functional and radiological evaluation of autologous chondrocyte implantation using a type I/III collagen membrane: from single defect treatment to early osteoarthritis." University of Western Australia. Orthopaedics Unit, 2007. http://theses.library.uwa.edu.au/adt-WU2007.0172.
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[Truncated abstract] Hyaline articular cartilage is a highly specialised tissue consisting of chondrocytes embedded in a matrix of proteoglycan and collagens. Hyaline articular cartilage withstands high levels of mechanical stress and continuously renews its extracellular matrix. Despite this durability, mature articular cartilage is vulnerable to injury and disease processes that cause irreparable tissue damage. Native hyaline articular cartilage has poor regenerative capacity following injury, largely due to the tissue's lack of blood and lymphatic supply, as well as the inability of native chondrocytes to migrate through the dense extracellular matrix into the defect site. Articular cartilage injuries that fail to penetrate the subchondral bone plate evoke only a short-lived metabolic and enzymatic response, which fails to provide sufficient new cells or matrix to repair even minimal damage. Clinically, it has previously been accepted that treatment of such defects does not result in the restoration of normal hyaline articular cartilage, which is able to withstand the mechanical demands that are placed on the joint during every day activities of daily living. ... Historically, rehabilitation following ACI has not kept pace with the advances in cell culture and surgical technique. Subsequently, there exists a significant gap in knowledge regarding `best practice' in post operative rehabilitation following ACI. The importance of structured rehabilitation in ACI should not be underestimated when evaluating the clinical success of this chondral treatment. Patients should not be left to their own devices following ACI surgery, as the risk of damage to their implant (via delamination) is high if immediate postoperative movement is not controlled. Furthermore, the biological longevity and clinical success of the graft is dependent on a controlled and graduated return to ambulation and physical activity, and the biomechanical stimulation of the implanted chondrocytes.
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Bastos, Lopes Alves João Nuno. "Strategies to block inhibition and restore plasticity in the central nervous system after injury." Thesis, University of Cambridge, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.708968.
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Cross, Hugh. "The effectiveness of foot orthoses as a treatment for plantar ulceration in leprosy : a study of the efficacy, acceptability, appropriateness and implantation of a podiatric regimen." Thesis, Open University, 1996. http://oro.open.ac.uk/57618/.
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This was a holistic study. Four themes were investigated to demonstrate the effectiveness of orthotic intervention for plantar ulceration affecting leprosy impaired subjects in India. 1. Efficacy Efficacy was demonstrated, primarily, through analysis of data pertaining to a controlled trial. Thirty-seven subjects, presenting with leprosy impairments including anaesthesia and plantar ulceration, were fitted with orthoses and allocated to an experimental group. Thirty-four similar subjects, were not offered orthoses and were allocated to a control group. After 8 months 52% of the ulcers presented by Experimental group and 12% of the ulcers presented by the Control group had healed. The rationale supporting the prescription of orthoses was investigated using the EMED system. It was demonstrated that intervention with orthoses resulted in significantly lower sub pedal peak pressures than intervention with leprosy sandals. 2. Implementation and Sustain ability Ulcer assessment data from March 1994 to January 1995 were used to compare the effects of orthoses supplied by the investigator with orthoses supplied by an Indian technician. The service, evaluated on the strength of these findings, was considered to have been successfully implemented. The analysis of data, collected from January 1995 to December 1995, was used to explain why the service was not sustained at an acceptable level. 3. Acceptability Interview data were analysed to describe the attitudes of the subjects to the intervention (n = 46). Indications from the analysis were that neither ulcer status (healed or unresolved) nor group allocation (Experimental or Control) affected attitudes towards the intervention. A general indication was that the intervention was favourably endorsed. 4. Appropriateness Using the Delphi technique (n = 10), a consensus on indicators of "appropriate" impairment control measures was sought. Differences of opinion were not resolved, but group priorities were ranked and a polled response was recorded. The results of the study were similar to the criteria suggested by the Delphi contributors.
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Hastings, Erica, and University of Lethbridge Faculty of Arts and Science. "Environmental and pharmacological intervention following cortical brain injury." Thesis, Lethbridge, Alta. : University of Lethbridge, Faculty of Arts and Science, 2003, 2003. http://hdl.handle.net/10133/180.
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This thesis focuses on the effects of pharmacological and environmental interventions following perinatal prefrontal cortex lesions. Rats given postnatal day 3 medial prefrontal cortex lesions were provided with one of the following treatments: basic fibroblast growth factor (bFGF), complex-housing, tactile stimulation, or a combined treatment of both bFGF and tactile stimulation or bFGF and complex-housing. Rats given postnatal day 3 orbital prefrontal cortex lesions were housed in a complex environment. The findings of these studies suggest that bFGF, complex-housing or tactile stimulation are beneficial after early brain injury. The combined treatment of bFGF with complex-housing provides a synergistic effect, as the combined condition is more advantageous than bFGF alone. In contrast, the combined treatment of bFGF with tactile stimulation produced adverse effects. These results suggest that pharmacological and environmental manipulations change cortical plasticity and therefore functional recovery after neonatal cortical injury.xv, 177 leaves : ill. (some col.) ; 29 cm.
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Wong, Tak-chuen, and 王德銓. "Casting versus percutaneous pinning for extra-articular fracture distal radius in a Chinese elderly population: a prospective randomized controlled trial." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B45011539.
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Ebert, Jay Robert. "Post-operative load bearing rehabilitation following autologous chondrocyte implantation." University of Western Australia. School of Sport Science, Exercise and Health, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0196.
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[Truncated abstract] Autologous Chondrocyte Implantation (ACI) has shown early clinical success as a repair procedure to address focal articular cartilage defects in the knee, and involves isolating and culturing a patient's own chondrocytes in vitro and re-implantation of those cells into the cartilage defect. Over time, repair tissue can develop and remodel into hyaline-like cartilage. A progressive partial weight bearing (PWB) program becomes the critical factor in applying protection and progressive stimulation of the implanted cells, to promote best chondrocyte differentiation and development, without overloading the graft. The aim of this thesis was to investigate whether patients could replicate this theoretical load bearing model to possibly render the best quality tissue development. In addition, this proposed external load progression is only a means to loading the articular surface. Several factors, including those that may result from pathology, have the potential to influence gait patterns, and therefore, articular loading. The association between increasing external loads (ground reaction forces - GRF) and knee joint kinetics during partial and full weight bearing gait was, therefore, investigated in the ACI patient group, as was the contribution of other gait variables to these knee joint kinetics which may be modified by the clinician. Finally, current weight bearing (WB) protocols have been based on early ACI surgical techniques. With advancement in the surgical procedure and ongoing clinical experience, we employed a randomised controlled clinical trial to assess the effectiveness of an 'accelerated' load bearing program, compared with the traditionally 'conservative' post-operative protocol. ... Although similar spatio-temporal, knee kinematic and external loading parameters were observed between the traditional and accelerated rehabilitation groups, the accelerated group was 'more comparable' to the controls in their external knee adduction and flexion moments, where the traditional group had lower knee moments. Knee moments greatly affect knee articular loading, and large adduction moments have been related to poor clinical outcomes after surgery. Therefore, the return of normal levels may be ideal for graft stimulation, however, may overload the immature chondrocytes. Acceleration of the intensive rehabilitation program will enable the patient to return to normal activities earlier, whilst reducing time and expenses associated with the rehabilitative process, and may enhance long-term tissue development. However, continued follow-up is required to determine if there are any detrimental effects that may emerge as a result of the accelerated load bearing program, and assess the recovery of normal gait patterns and whether longer term graft outcomes are affected by the recovery time course of normal gait function, and/or abnormal loading mechanics in gait. Furthermore, analysis at all levels of PWB is needed to identify a more complete set of variables attributing to the magnitude of external knee joint kinetics and, therefore, knee articular loading, while the influence muscle activation patterns may have on articular loading needs to be investigated. This becomes critical when you consider loads experienced by the articular surface throughout the early post-operative period following ACI may be important to short- and long-term graft development.
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Girardin, Erika A. "Clinical outcomes of multiple ice treatments on signs and symptoms of exercised-induced muscle damage." Virtual Press, 2000. http://liblink.bsu.edu/uhtbin/catkey/1179132.
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The objective of this study was to determine the effect of multiple ice treatments on the signs and symptoms of exercise induced muscle damage. Twenty-four women performed vigorous eccentric exercise of elbow flexors to induce muscle damage. Subjects were randomly assigned into one of three groups(control, experimental group 1, experimental group 2). Experimental groups 1 and 2 received two and six ice bag treatments respectively for two consecutive days post exercise-induced muscle damage. Dependent variables included pain perception, resting arm angle, bicep, forearm, and wrist circumferences, elbow range of motion, and plasma concentrations of creatine kinase. Baseline measurements were obtained on day one and were repeated every 24 hours post-exercise for five days. No significant differences were observed between groups. The results of this study indicate that ice bag treatments do not have any affect on signs/symptoms of exercise-induced muscle damage.School of Physical Education
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郝東方. "踝關節扭傷的針灸治療文獻研究." HKBU Institutional Repository, 2010. http://repository.hkbu.edu.hk/etd_ra/1125.
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Lin, Zhen. "Chondrocyte : a target for the treatment of osteoarthritis." University of Western Australia. Orthopaedics Unit, 2007. http://theses.library.uwa.edu.au/adt-WU2007.0203.
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[Truncated abstract] Osteoarthritis (OA) is the most common form of arthritis, characterized by progressively degeneration of articular cartilage. Chondrocyte is the only cell type in articular cartilage tissue and responsible for cartilage matrix turnover. This thesis focuses on the biological and genetic behaviors of human chondrocyte and potential therapeutic strategies that target on chondrocyte. Chondrocytes have been used for the tissue-engineered cartilage construction, especially in articular cartilage repair. The technique of chondrocyte-base tissue engineering utilizes in vitro propagated chondrocytes combined with several manufactured biomaterials to regenerate cartilage tissue. Although these technologies have been successfully applied in clinic, the biological characteristics of chondrocyte during in vitro propagation and after implantation remain unclear. This thesis reviewed the present studies of chondrocyte biology and its potential uses in tissue engineering. Particularly, chondrocytes have been shown to de-differentiate into fibroblastic-cells when they are exposed to inflammatory conditions or cultured on monolayer in vitro. This thesis investigated the gene expression profile of chondrocytes when they are cultured and serially passaged on monolayer in vitro. Human chondrocytes obtained from OA patients were cultured up to passage 6. Twenty-eight chondrocyte associated genes were measured by Real-time PCR. The results showed that a number of genes were changed in expression levels at various stages of passage as indications of chondrocyte de-differentiation. Chondrocytes derived from OA patients or normal donors exhibited a very similar gene expression pattern. Interestingly, transcription factor Sox-9, which plays a key role in chondrogenesis remained unchanged with increasing passage number, indicating that the de-differentiation process of chondrocyte is reversible. This thesis also focused on the development of novel pharmacological approaches for OA that target on articular chondrocyte. The clinical feature, etiology, pathogenesis, diagnostic approaches, conventional and potential future treatments for OA were briefly reviewed in this thesis. ... The effects of natural compounds on chondrocyte gene expression, proteoglycan degradation and nitric oxide production were measured. The results showed that parthenolide, a NF-kB inhibitor, regulated chondrocyte function by suppressing the up-regulation of gene expression of inflammatory factors and matrix proteinases induced by lipopolysaccharide, and down-regulating COX-2 expression. Parthenolide was able to reduce proteoglycan degradation in human chondrocytes, but had no effect on nitric oxide production. These results suggest that parthenolide mediates inflammatory-activated NF-kB pathway, and subsequently reduces inflammatory response, prevents cartilage destruction and relieves pain, and hence may be useful for OA treatment.
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Myers, Kimberly S. "Rat tendon morphological changes due to augmented soft tissue mobilization at various pressures." Virtual Press, 1997. http://liblink.bsu.edu/uhtbin/catkey/1041917.
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Augmented soft tissue mobilization therapy (ASTM) is a newly developed massage technique. ASTM is applied with the aid of specifically designed, solid instruments and has been successfully used in the treatment of chronic tendinitis patients. In a study on collage nase -injure d rat Achilles tendons treated with ASTM, Davidson et. al (1997) reported gait improvement as well as fibroblasts proliferation and suggested ASTM may augment healing by the recruitment of fibroblast. The present study examined the morphological response of enzyme-induced rat Achilles tendons to 3 different ASTM pressure application: 1 newton; 2 newtons and 3 newtons. Collagenase-injured tendons exhibited disrupted and randomly arranged collagen fibers. Treatment applications were performed for 4 days for a total of 4 treatments. Morphological differences were demonstrated between groups in proportion to the ASTM treatment pressure application. The ASTM group treated with 3 newtons demonstrated the greatest mean fibroblast count (370.3 +/- 51.6). Further, electron microscopy revealed the presence of activated fibroblasts in the tendons of the 3 newtons, ASTM group. However, immunochemical staining comparisons of Type I and III collagen, fibroblast growth factor receptor, and insulin-like growth factor between groups were not remarkable.Department of Physiology and Health Science
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Wells, Lauren Michelle. "A comparative study of positive versus negative polarity in the treatment of acute ankle sprains utilizing high voltage electrogalvanic stimulation." Scholarly Commons, 1986. https://scholarlycommons.pacific.edu/uop_etds/2122.
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Electrical stimulation has long been used in the treatment of a variety of ailments. Its current uses range from muscle re-education and orthotic substitute to scoliosis management and edema control. I chose to study the effect of electrode polarity in high voltage electrogalvanic stimulation in the treatment of edema for several reasons. I had access to subjects because I was the only physical therapist at the Stockton Orthopedic Medical Group. High voltage electrogalvanic stimulation is a commonly used modality in treating edema (Brown, 1981). High voltage generators have a polarity switch, and the direction manual which accompanies the Electro-Med generator used by the Stockton Orthopedic Medical Group states that the negative pole should be used for edema reduction. (Instruction manual for high voltage Electrogalvanic Stimulator, 1977). However, the effect of electrode polarity on edema reduction has not been demonstrated, nor documented in the literature.
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Schriml, Carla M. "Exploring the impact of an imagery/relaxation program on athletes with a knee injury requiring surgery." Virtual Press, 2000. http://liblink.bsu.edu/uhtbin/catkey/1178349.
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The primary purpose of this study was to examine the impact of an imagery/relaxation program on athletes with a surgical knee injury. More specifically the study examined changes in state and trait anxiety, locus of control, and attitude/opinion as a result of the imagery/relaxation program. A qualitative design was used to allow for an in-depth examination into each participant's behavior. Since a qualitative design was utilized, the procedures were slightly different for each participant.The following is a general outline for the procedures used. One week prior to surgery the participant was taught progressive relaxation. One week post-surgery the participant was administered the STAI, LCRS, and ERAIQ. The participant was also given a different imagery/relaxation script each week to rehearse beginning one week post-surgery to 11 weeks post-surgery. The participant also completed journal worksheets weekly. At each session the researcher asked interview questions. Twelve weeks post-surgery the participant was given the STAI, LCRS, ERAIQ, and exit questionnaire. Due to the lack of adherence to the program there were no conclusive results.School of Physical Education
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Murrell, George Anthony Calvert St George Clinical School UNSW. "Nitric oxide and tendon healing." Awarded by:University of New South Wales. St George Clinical School, 2006. http://handle.unsw.edu.au/1959.4/31887.
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Nitric oxide is a small free radical generated by family of enzymes, the nitric oxide synthases. In a series of experiments performed over the last 15 years we showed that nitric oxide is induced by all three isoforms of nitric oxide synthase during tendon healing and that it plays a crucial beneficial role in restoring tendon function. In normal tendon we found very little nitric oxide synthase activity while in injured rat and human tendons nitric oxide synthase activity was expressed in healing fibroblasts in a temporal fashion. In healing rat Achilles tendon fibroblasts the first isoform to be expressed was endothelial nitric oxide synthase (eNOS), followed by inducible nitric oxide synthase (iNOS), and then brain or neuronal nitric oxide synthase (bNOS). Systemic inhibition of nitric oxide synthase activity decreased the cross sectional area and mechanical properties of the healing rodent Achilles tendons. Addition of nitric oxide via NO-flurbiprofen or NO-paracetamol enhanced rat Achilles tendon healing. Addition of nitric oxide to cultured human tendon cells via chemical means and via adenoviral transfection enhanced collagen synthesis, suggesting that one mechanism for the beneficial of nitric oxide on tendon healing might be via matrix synthesis. The final part of the work involved three randomized, double-blind clinical trials which evaluated the efficacy of nitric oxide donation via a patch in the management of the tendinopathy. In all three clinical trials there was a significant positive beneficial effect of nitric oxide donation to the clinical symptoms and function of patients with Achilles tendinopathy, tennis elbow and Achilles tendonitis.
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Zalgaonker, Mustafa. "Intravenous fluid resuscitation : surveillance of penetrating injury in the pre-hospital environment." Thesis, Cape Peninsula University of Technology, 2018. http://hdl.handle.net/20.500.11838/2738.
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Thesis (Master of Emergency Medical Care)--Cape Peninsula University of Technology, 2018.Physical injury is a major cause of premature death and disability worldwide (WHO, 2015). Mortality statistics for South Africa indicate that approximately half of all injury-related deaths were intentionally inflicted, often as a result of sharp-force injuries (Donson 2009). Cape Town is reputed to be a violent city (Nicol et al., 2014). Pre-hospital emergency care providers are often the first medical contact for injured patients. Previously, it was understood that high volume crystalloid administration would improve survival and was standardised in the management of shock (Santry & Alam 2010). However, over-administration of crystalloid fluid can cause patient harm by potentially worsening injuries and can be detrimental to a patients survival. Current evidence supports the practice of lower volume crystalloid intravenous fluid administration- permissive hypotension. Little is known about pre-hospital emergency care providers intravenous fluid management practices for penetrating injury. Injury surveillance data for victims of penetrating injury is also scarce with the majority of current data taken from mortality sources. Surveilling pre-hospital cases may yield opportunities for prevention from premature mortality and morbidity. The aim of this study is to undertake surveillance of penetrating injury and related intravenous fluid resuscitation in the pre-hospital emergency care environment. A prospective observational descriptive survey was conducted in the Cape Metropole1. Over three consecutive months, emergency care providers documented parameters related to mechanism of injury, scene vital signs, hospital vital signs, intravenous fluid resuscitation and basic patient demographic information for patients with penetrating injury. A predetermined inclusion and exclusion criteria was used to sample patients.
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Wilson, Timm. "Effects of a modified straight leg raise on strength and muscle activity of the vastus medialis oblique in patients with patellofemoral malalignment." Virtual Press, 1993. http://liblink.bsu.edu/uhtbin/catkey/865942.
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The purpose of this study was to determine the effectiveness of a modified sitting position straight leg raise on vastus medialis oblique (VMO) strength and EMG activity as compared to a traditional straight leg raise. A total of twenty-three subjects were recruited for this study. The subjects were randomly assigned to one of the following groups: (group I) modified straight leg raise (MSLR), and (group II) straight leg raise (SLR). The exercise program was three weeks long. University procedures for the protection of human subjects were followed. The subjects began with a 5 minute warm-up on a Cybex stationary bike set at 90 revolutions / minute. The subject then had electrodes placed on the Vastus Lateralis (VL) and Vastus Medialis Oblique (VMO). A Macintosh computer was used to record the EMG data. The subject then performed a standard Cybex test for knee flexion and extension. The Cybex dynamometer was placed at the knee joint line, the chair back tilt was at 85 degrees, the hip, chest, and thigh restraints were all fastened. The subjects in group I (Modified sitting SLR) and II (SLR) then returned the next day for their first rehabilitation lesson. Each subject group then participated in their respected exercise program for a total of three weeks. After three weeks of rehabilitation, the subjects retested using the same procedures followed in the pretest. A two tailed t-test was used to determine significance of the difference between means of the two groups. No significant differences were found between the two groups.School of Physical Education
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Forster, Lyn. "Feline amputees : gait adaptations and welfare implications." Thesis, Royal Veterinary College (University of London), 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.618289.
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This research focused on three areas of interest regarding feline amputees; owner perception of how their cats adapt to limb amputation, the possibility of phantom sensation, and changes in gait. In general owners felt their cats had an acceptable quality of life; however a proportion believed their cat experienced pain. Anecdotally, owners reported that their cats continued to attempt to use the missing limb following amputation. This prompted the investigation of noninnate forelimb behaviours potentially indicative of phantom sensation; such behaviours apparently persist for months or years after amputation. The impact of phantom sensation on feline welfare is not known, although in humans phantom sensation is a risk factor for phantom pain. Alterations in gait and posture in humans are associated with pain and osteoarthritis. The kinetic changes in feline gait were assessed using a pressure sensitive walkway; this provided its own challenges as the software was designed for large bipeds. As such, a proportion of this work was devoted to developing methods to reliably extract data for small quadrupeds. The results detail how feline amputees alter their weight distribution and paw placement when moving. Observation of amputee cats suggests that they move their limbs differently to those of normal cats, and this was confirmed in a kinematic study using markers to track the motion of each limb. Prior to this research very little was known about how cats coped with limb amputation. The results will better inform the veterinary profession and owners of feline amputees about expected changes, and potentially inform future work on the impact of limb amputation on the welfare of cats. On balance, although there may be some areas of concern, the welfare of cats is acceptable following amputation.
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馬中龍. "中醫中藥在治療「顱腦創傷後頭痛頭暈」的回顧性臨床研究." HKBU Institutional Repository, 2008. http://repository.hkbu.edu.hk/etd_ra/970.
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Hu, Ying. "Optic nerve regeneration in adult rat." University of Western Australia. School of Anatomy and Human Biology, 2007. http://theses.library.uwa.edu.au/adt-WU2007.0080.
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[Truncated abstract] There is limited intrinsic potential for repair in the adult human central nervous system (CNS). Dysfunction resulting from CNS injury is persistent and requires prolonged medical treatment and rehabilitation. The retina and optic nerve are CNSderived, and adult retinal ganglion cells (RGCs) and their axons are often used as a model in which to study the mechanisms associated with injury, neuroprotection and regeneration. In this study I investigated the effects of a variety of strategies on promoting RGC survival and axonal regeneration after optic nerve injury, including the use of reconstructed chimeric peripheral nerve (PN) grafts, gene therapy, and intraocular application of pharmacological agents and other factors . . . C3 transferase is an enzyme derived from Clostridium botulinum that inactivates Rho GTPase. Because SC myelin contains MAG and PN also contains CSPGs, I tested the effects of intraocular injection of a modified form of C3 (C3-11), provided by Dr Lisa McKerracher (CONFIDENTIAL data, under IP agreement with Bioaxone Therapeutic, Montreal) on RGC axonal regeneration into PN autografts. My results showed that there was significantly more RGC survival and axonal regeneration in PN autografts after repeated intraocular injection of C3. I also tested whether intraocular injections of CPT-cAMP and/or CNTF can act in concert with the C3 to further increase RGC survival and/or regeneration. Results showed that the effect of C3 and CPT-cAMP plus CNTF were synergistic and partially additive. The use of combination therapies therefore offers the best hope for robust and substantial regeneration. The overall results from my PhD project will help determine how best to reconstruct nerve pathways and use pharmacological interventions in the clinical treatment of CNS injury, hopefully leading to improved functional outcomes after neurotrauma.
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Khong, Pek-Lan, and 孔碧蘭. "Diffusion tensor MR imaging in the evaluation of treatment-induced white matter injury in childhood cancer survivors." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B38320666.
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Monteleone, Gina Marie. "The effects three different anterior knee pain treatments have on strength and performance." Virtual Press, 1999. http://liblink.bsu.edu/uhtbin/catkey/1129635.
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The purposes of this study is to determine: (a) the relationship between the dependant variables, (b) the relationship between the Borg pain scale and the performance tests, (c) the difference in performance between involved and uninvolved extremities, and (d) the effects of the three different therapeutic exercise treatments on selected performance tests and pain free isometric strength testing. Fifty subjects with physician diagnosed anterior knee pain (AKP), completed initial performance testing and 14 subjects completed initial testing, therapy and six weeks later final performance testing. The 14 subjects were randomly assigned to one of three therapeutic exercise treatment groups. The performance tests included; pain free isometric strength tests (90, 60, 45, and 15 degrees knee flexion), stair test, timed hop, triple hop, crossover hop, Figure 8 and Borg pain scale rating for each performance test. The results indicated a significant correlation between performance tests and pain free isometric strength tests. There was no relationship indicated between the performance tests, Borg pain scale ratings. The contrast between the injured and uninjured extremities performance test values of the fifty subjects that completed the initial testing indicated no significant (p< 0.05) difference. The results of this study indicated that there was no significant difference between the therapeutic exercise treatment groups. In conclusion, the three anterior knee pain treatments had no effect on strength and performance.School of Physical Education
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Shekede, Blessing Tatenda. "Bactericidal efficacy of wound gauze treated with chitosan nanomaterial hybrids of zinc, silver and copper on common wound bacteria." Thesis, Cape Peninsula University of Technology, 2018. http://hdl.handle.net/20.500.11838/2795.
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Thesis (Master of Applied Sciences in Chemistry)--Cape Peninsula University of Technology, 2018.Maintenance of optimum wound chemistry is important to ensure timely healing of a wound. Bacterial infections impair the process of wound healing by producing toxins that alter the chemical environment in and around the wound. The imbalance in the wound chemistry prolongs healing and opens doors to opportunistic infections. Bacteria have developed resistance to conventional bactericides hence, there is need for search of new bactericides that can control bacteria in and around the wound. Therefore, new chemical or biochemical bactericides, which are not resisted by the bacteria, can be explored to control bacterial life around the wound in a bid to maintain optimum wound healing chemistry. Materials such as chitosan, zinc oxide, copper oxide and silver have showed remarkable potential as both bactericidal and wound healing agents. In this work silver, zinc oxide, and copper oxide nanoparticles (NPs) and their chitosan composites (CH-NPs) were synthesized using the chemical reduction method and simple chelation respectively to produce nanoparticles of Ag, ZnO, and CuO as well as composites of CH-ZnO, CH-Ag, CH-CuO, and CH-ZnO-Ag-CuO. Formation of the NPs was confirmed by the exhibition of characteristic peaks in UV-Visible and Fourier Transform Infrared Resonance (FTIR) spectroscopy as well as X-ray diffraction. The nanoparticles (NPs) had optical and electronic band gaps in the range 1 to 5eV indicating their semi-conductive nature. X-ray diffraction (XRD) investigations depicted the crystalline structures of the NPs to be base-centred, face-centred, and hexagonal for Ag, CuO, and ZnO respectively. Transmission electron microscopy (TEM) studies exhibited spherical, hexagonal, and rod-shaped shapes for silver, copper oxide, zinc oxide NPs respectively. Electrochemical investigations of the pure NPs indicated the existence of both the adsorption and the diffusion controlled electron transfer processes at electrode surfaces as well as fast electron transfer rate as depicted by the charge transfer coefficient and standard rate constant parameter values. FTIR spectra of CH-NPs composites depicted new excitation bands absent in spectra of both chitosan and the NPs. The spectra also indicated the deformation and absence of the amine (-NH2) and hydroxyl bands (-OH) within the CH-NPs composites. UV-Visible spectroscopy investigations of the CH-NPs composites exhibited blue-shifts of the λmax with respect to the NPs. The FTIR and UV-Visible spectra confirmed the existence of bonding between the chitosan and the NPs. The optical band gap energies of all the CH-NPs composites fell within the range of 2.0 to 4.5 eV indicating that the CH-NPs fell in the category of the semi-conducting materials after chelating with the chitosan.
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Bueno, Cecília Zorzi 1984. "Desenvolvimento e análise das propriedades de membranas de quitosana e alginato contendo polihexametileno biguanida para o tratamento de lesões de pele." [s.n.], 2015. http://repositorio.unicamp.br/jspui/handle/REPOSIP/266039.
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Orientadores: Ângela Maria Moraes, Mara Elga Medeiros BragaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia Química
Made available in DSpace on 2018-08-27T00:41:42Z (GMT). No. of bitstreams: 1 Bueno_CeciliaZorzi_D.pdf: 3611429 bytes, checksum: 9eeaf42b72e5b1a4778cab231780d7c6 (MD5) Previous issue date: 2015
Resumo: As lesões de pele representam um grande desafio para os profissionais da saúde, sendo que os curativos mais modernos disponíveis atualmente são, em sua maioria, importados e de alto custo. Existe, assim, a necessidade de criar recursos mais acessíveis à população, os quais utilizem matérias-primas renováveis e sejam produzidos por meio de tecnologias simples e de baixo custo. A quitosana e o alginato são biopolímeros biocompatíveis, apresentam propriedades cicatrizantes e são abundantes na natureza, características estas que os tornam atrativos para a confecção de curativos de lesões de pele. A inclusão de agentes antimicrobianos, como polihexametileno biguanida (PHMB), aos curativos produzidos a partir destes biopolímeros pode levar a um melhor desempenho dos mesmos. Neste trabalho de tese, membranas densas e porosas de quitosana-alginato foram obtidas na presença de diferentes quantidades do tensoativo Pluronic F68. Os resultados obtidos mostraram que a inclusão de até 10% (m/m) de tensoativo provoca o aumento da porosidade (de 0,46 para 0,84), da espessura (de 0,08 para 0,50 mm), da rugosidade (de 1,27 para 21,20 µm), da capacidade de absorção de fluidos (de 14,22 para 21,27 g/g para NaCl a 0,9%) e de vapor d¿água (de 15,5 para 36,5%) e a diminuição da resistência à tração (de 31,1 para 1,1 MPa) e do alongamento na ruptura (de 4,0 para 2,0%) das membranas. Os materiais obtidos não se mostraram citotóxicos a fibroblastos de camundongos. O agente antimicrobiano PHMB foi incorporado às membranas por três diferentes métodos: adição à mistura polimérica, adsorção a partir de solução aquosa e impregnação mediada por CO2 supercrítico. A incorporação de PHMB por adição à mistura polimérica foi considerada como a mais satisfatória, pois não provocou alterações no aspecto e morfologia das membranas e resultou em altas eficiências de incorporação, variando entre 72 e 86 %. Observou-se também adequado controle da cinética de liberação, sendo que grande parte do antimicrobiano incorporado não foi liberada em tampão fosfato-salino (PBS), indicando alta afinidade entre o PHMB e a matriz de quitosana-alginato. As membranas apresentaram atividade antimicrobiana adequada, o que sugere que possam ser empregadas como barreira contra microrganismos comumente presentes em lesões de pele, tais como Staphylococcus aureus e Pseudomonas aeruginosa
Abstract: Skin lesions represent a great challenge for health professionals, since most of the existing modern wound dressings are imported and expensive. Therefore, there is a need to create more accessible products to the public, made from renewable raw materials and processed through simple and low cost technologies. Chitosan and alginate are biocompatible biopolymers that have healing properties and are abundant in nature, which are attractive characteristics to the production of wound dressings. The incorporation of antimicrobial agents, such as polyhexamethylene biguanide (PHMB), to these dressings can lead to a better performance. In this work, dense and porous chitosan-alginate membranes were obtained in the presence of different proportions of the surfactant Pluronic F68. It was noticed that inclusion of up to 10% (w/w) Pluronic F68 caused an increase in porosity (from 0.46 to 0.84), thickness (from 0.08 to 0.50 mm), roughness (from 1.27 to 21.20 µm), fluids absorption capacity (from 14.22 to 21.27 g/g for 0.9% NaCl) and water vapor absorption capacity (from 15.5 to 36.5%) and a decrease in tensile strength (from 31.1 to 1.1 MPa) and elongation at break (from 4.0 to 2.0%) of the membranes. The obtained materials were not toxic to mouse fibroblasts. The antimicrobial agent PHMB was incorporated to the membranes through three different methods: addition to the polymeric mixture, adsorption in aqueous solution and via supercritical fluid. The addition to the polymeric mixture was considered the most promising incorporation method, since it had high yields (between 72 and 86 %) and did not cause changes in the membranes aspect and morphology. Release kinetic studies in PBS showed that most of the PHMB loaded remained in the membranes, indicating high affinity between PHMB and the polymeric matrix. The obtained membranes showed adequate antimicrobial activity, having potential applicability as barriers against microorganims commonly found in skin wounds, such as Staphylococcus aureus and Pseudomonas aeruginosa
Doutorado
Engenharia Química
Doutora em Engenharia Quimica
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金家華. "手法治療肘外側疼痛的臨床及其相關文獻研究." HKBU Institutional Repository, 2008. http://repository.hkbu.edu.hk/etd_ra/951.
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Turnbull, Grant S. D. "The effectiveness of three treatment protocols in the treatment of iliotibial band friction syndrome." Thesis, 2010. http://hdl.handle.net/10321/549.
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Mini-dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Durban University of Technology, 2010.Iliotibial Band Friction Syndrome (ITBFS) is an overuse injury induced by friction of the iliotibial band (ITB) over the lateral epicondyle of the femur (LFE) with secondary inflammation. ITBFS is a prevalent condition and is the most common cause of lateral knee pain in long distance runners and cyclists. There are a significant number of aetiological factors related to ITBFS. As a result of this the general chiropractic approach to the treatment of ITBFS is multimodal and include interventions such as joint manipulation, cryotherapy, orthotics, massage, electrical stimulation, acupuncture type procedures and therapeutic exercise. Dry-needling is an effective therapy in the treatment of active Myofascial Trigger Points (MFTP’s) that are associated with ITBFS. However, the available literature suggests that to determine its efficacy, it should be performed in isolation. The association of sacroiliac joint dysfunction in ITBFS has also been addressed and are thought to co-exist and perpetuate one another. It is recommended that chiropractors include pelvic manipulation in their treatment protocol for ITBFS however there is a paucity of literature showing its effectiveness in the treatment of this condition. There appears to be a need for further research in the form of randomized controlled clinical trials with regard to chiropractic specific procedures, performed in isolation, in the treatment of ITBFS. Therefore this study aimed to add to the literature by assessing the effect of the sacroiliac joint manipulation and dry needling in the treatment of ITBFS. Objectives The study aimed to determine the comparative effectiveness of dry needling alone versus manipulation alone, as well as a combination of the two interventions in the treatment of ITBFS. Methods This study was a randomised, open label trial. 47 participants with ITBFS were divided into three groups, each group receiving a different intervention i.e.: group one received dry needling of the active MFTP’s in the Tensor Fascia Lata (TFL) and ITB, group two received sacroiliac joint manipulation, group three received a combination of the two interventions. Subjective measurements, in the form of the Numerical Pain Rating Scale-101 (NRS-101), and objective measurements, in the form of algometer readings in the TFL, ITB and Nobles Compression test as well as digital inclinometer readings of Modified Obers test, were utilised to determine the effects of the respective interventions. These measurements were recorded twice, once prior to commencing the treatment programme. These values were then evaluated to compare the efficacy of the different treatment interventions. Each participant received four treatments over a two week period. Results There were no statistically significant differences between the three treatment groups as they all seemed to parallel one another with regards to overall improvement in subjective and objective measurements (P<0.5). However on closer examination subtle differences between the groups were noted. An interesting endpoint is that the combination group did not fair the best throughout the study, which was contrary to the original hypothesis. The groups receiving only the single intervention appeared to fair marginally better over the combination group. A secondary endpoint that became evident during the study and on analysis of the data, was that hip joint instability must also be considered when treating ITBFS when there is concomitant sacroiliac joint dysfunction. Conclusion A decision needs to be made with regard to which intervention best suits the individual at the time. A combination therapy, which originally was thought to be the best treatment option, should possibly be reconsidered. Perhaps a single intervention of manipulation or dry needling should be decided upon. In totality, all intervention proved to be effective in the treatment of ITBFS.
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Farrimond, Claire. "The inter-examiner reliability and comparison of motion palpation findings of the knee joint in patellofemoral pain syndrome and asymptomatic knee joints." Thesis, 2010. http://hdl.handle.net/10321/583.
Full textAbstract:
Dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban University of Technology, 2010.Motion palpation is used to assess the functional status of a joint and is defined as “The manual palpation of bony structures and soft tissues, through pressure applied in various directions of joint motion to ascertain areas of joint hypomobility and hypermobility.” Motion palpation is a collection of manual examination procedures, used to identify the site and characteristics of altered joint motion and which has been an important part of chiropractic since its inception. One of the most important goals for any clinical instrument is for it to have good reliability and reproducibility, this is because the clinical value of a test must be demonstrated before the results are considered valid. The extent to which a repeated test will produce the same result when evaluating an unchanged characteristic is its reliability. Reliability is evaluated by multiple blinded measurements performed on a sample of subjects. Inter-examiner reliability evaluates the consistency of different examiners and is determined through repeated assessment by two or more raters. Objective The aim of this study was to determine the inter-examiner reliability of motion palpation of knee joints with patellofemoral pain syndrome and asymptomatic knee joints, and to compare the inter-examiner reliability of motion palpation between the two groups. Method This quantitative, inter-examiner, clinical reliability study, included 30 patients each with one knee with patellofemoral pain syndrome and one asymptomatic knee. Each patient had both of their knees motion palpated by three independent examiners blinded to which was the symptomatic knee. The examiners were senior student interns at the DUT Chiropractic Clinic. The motion palpation findings were recorded and statistically analyzed through the SPSS statistical package. Fleiss Kappa statistic was used to give a Kappa score for each direction of motion palpation and these scores evaluated the inter-examiner reliability of motion palpation in the symptomatic and the asymptomatic knee. A comparison of the inter-examiner reliability of motion palpation between the two groups was performed using a paired Wilcoxin signed ranks test. Results The Kappa scores for motion palpation ranged from -0.2081 to 0.1802 for the symptomatic knee joint and -0.2836 to 0.0339 for the asymptomatic knee. This shows poor agreement in both cases. There was no significant difference in Kappa values (p= 0.609) for the two groups for the Wilcoxin signed ranks test and the number of positive and negative ranks were similar. This indicates that the reliability of motion palpation in both groups was similar. Conclusion It was concluded that inter-examiner reliability of motion palpation of the knee joint was poor in knees with patellofemoral pain syndrome and in knees that were asymptomatic. Motion palpation was found to be equally reliable in both groups, indicating that motion palpation of a symptomatic joint does not improve its reliability. This research suggests that motion palpation should be used together with other diagnostic tests to identify patellofemoral pain syndrome as it is not a reliable tool when used in isolation.
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Payne, Liza. "The relative effectiveness of three treatment protocols in the treatment of medial tibial stress syndrome type II." Thesis, 2007. http://hdl.handle.net/10321/163.
Full textAbstract:
Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban University of Technology, 2007
144 leavesObjective: The aim of this study was to investigate the relative effectiveness of TENS, versus, needling, versus Electro-needling in the treatment of MTSS. First objective The first objective was to evaluate the effectiveness of TENS therapy on MTSS with respect to the patients subjective and objective responses to the treatment. Second Objective The second objective was to evaluate the effectiveness of needling therapy on MTSS, with respect to the patient’s subjective and objective responses to the treatment. Third Objective The third objective was to evaluate the effects of electro-needling on MTSS, with respect to the patients’ subjective and objective responses to the treatment. Fourth Objective The fourth objective was to integrate the subjective and objective data collected in order to determine the viability of each of the therapies in comparison to one another as treatment options of MTSS.
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Fish, Denham. "The effectiveness and relative effectiveness of combining a topical capsaicin cream and knee joint mobilization in the treatment of osteoarthritis of the knee." Thesis, 2002. http://hdl.handle.net/10321/2708.
Full textAbstract:
A dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, 2002.The purpose of this study was to determine the effectiveness and relative effectiveness of a topical Capsaicin cream and knee joint mobilization in the treatment of Osteoarthritis (OA) of the knee.
M
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"Regeneration of transition zone in bone tendon junction healing with cartilage interposition." Thesis, 2008. http://library.cuhk.edu.hk/record=b6074578.
Full textAbstract:
A direct bone tendon junction consists of four zones: tendon, uncalcified fibrocartilage, calcified fibrocartilage, and bone. The uncalcified and calcified fibrocartilage together forms the transition zone. This organization ensures a gradual transition in stiffness and material properties, and protects the junction from failure. Transition zone regeneration during bone tendon junction healing is important to restore this unique protective mechanism.Bone tendon junction repair is involved in many orthopaedic reconstructive procedures. Healing is observed to be slow. The junction often heals by fibrous tissue formation. Previous attempts to enhance bone tendon junction healing have resulted in increased bone formation. However, fibrocartilage transition zone is not restored.
This thesis describes a series of studies on transition zone regeneration in bone tendon junction healing using two partial patellectomy animal models. The healing process inside a bone trough was first studied and characterized. Little transition zone regeneration was observed except near the articular cartilage cut surface. The possibility of using articular cartilage to stimulate transition zone regeneration was explored. Both articular cartilage autograft and allogeneic cultured chondrocyte pellet implantations resulted in significantly increased fibrocartilage transition zone regeneration. Cell tracking indicated that the regenerated tissue likely originated from host cells. To elucidate the mechanism of stimulation by allogeneic cultured chondrocyte pellet, the role of cellular and matrix component needed to be differentiated. Freezing and rapid freeze thaw cycles permanently devitalized the allogeneic cultured chondrocyte pellet, but retained its structural integrity and matrix contents. Preliminary results indicated that implantation of the devitalized allogeneic cultured chondrocyte pellet could still increase fibrocartilage transition zone regeneration. Cellular activity seemed not to be essential for the stimulatory effect.
With further research and development, it is envisioned that a cartilage-based stimulation method for fibrocartilage transition zone regeneration in bone tendon junction healing will be developed for clinical application.
Wong Wan Nar, Margaret.
Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3423.
Thesis (M.D.)--Chinese University of Hong Kong, 2008.
Includes bibliographical references (leaves 216-231).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstracts in English and Chinese.
School code: 1307.
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Venning, Gregory. "A pilot study of the profile of injuries that presented to the student chiropractic sports council at the Pick 'n Pay 94.7 cycle challenge from 2002 to 2004." Thesis, 2008. http://hdl.handle.net/10210/987.
Full textAbstract:
Very little information exists about the acute presentation of overuse injuries specific to cycling. Although there are studies, mainly in the form of surveys, that do detail the incidence and prevalence of overuse injuries in cyclists or triathletes, they all take place weeks or even months after events or focus on a 1 year injury history. (Weiss 1985, Korkia et al. 1994, Wilber 1995, Manninen and Kallinen 1996 and Salai et al. 1999) The aim of this study was to describe the historical data obtained when patients presented to the Student Chiropractic Sports Council at the Pick ‘n Pay 94.7 Cycle Challenge from the years 2002 to 2004. The focus of the study was on the profile of injuries with which patients presented. This was a descriptive study of historical data obtained by students treating at the Pick ‘n Pay 94.7 Cycle Challenge from the year 2002 to 2004. The data was acquired in the form of SOAP (Subjective, Objective, Assessment, Plan) notes held by the Student Chiropractic Sports Council. The results of this study showed that the most common location of complaints were the anterior and posterior thigh. Musculotendinous strains were by far the most predominant injury with the hamstring being involved more commonly (33.8%) than any other muscle. Overall 72.8% of patients were diagnosed with musculotendinous strains. Further, the results also showed that 55.8% of patients complained of eck or back pain and 59.7% were diagnosed with cervical facet joint, thoracic facet joint, lumbar facet joint or sacroiliac joint dysfunction.Dr. S. Wilcox Dr M. Moodley
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Smith, Karen Louise Frandsen. "The role of and relationship between hamstring and quadriceps muscle myofascial trigger points in patients with patellofemoral pain syndrome." Thesis, 2012. http://hdl.handle.net/10321/721.
Full textAbstract:
Mini-dissertation submitted in partial compliance with the requirements for the
Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2012.Purpose: Patellofemoral Pain Syndrome is a common condition in all age groups, with a multifactorial etiology. This study aimed to investigate the association between the Quadriceps femoris muscle group, Hamstring muscle group and Adductor muscle group, and to establish the relationship between myofascial trigger points (MFTP’s) in these muscle groups and patellofemoral pain syndrome (PFPS). Methods: A cross-sectional, observational, quantitative non-intervention clinical assessment study was conducted at the Chiropractic Day Clinic at Durban University of Technology (DUT), to determine the extent of the PFPS, the MFTPs and thus the relationship between the two. The study included eighty patients with PFPS, who were recruited by convenience sampling. The results were captured using Microsoft excel and SPSS version 15.0 was used to analyze the data. Results: Quadriceps femoris muscle group MFTPs were noted in 92.5% of the patients (most prevalent being Vastus medialis TP1 (63.8%), Vastus lateralis TP1 (33.8%) and Vastus intermedius at 27,5%). Least common was Vastus lateralis TP2 only presenting in 2,5% of the patients. Hamstring muscle group MFTPs were found overall in 86.3% of patients (most prevalent being in Biceps femoris muscle (66%), and least prevalent being in Semitendinosus muscle (11,3%)). MFTPs were present in 64% overall of the Adductor muscle group (Adductor magnus muscle being the most common). Significant associations were made between the presence of MFTPs in the Vastus lateralis TP2 (p=0.00), Vastus medialis TP1 (p=0.046; 0.005; 0.004), the NRS and the PPSS. Also significant was the relationship between the NRS, PPSS and the Semimembranosus and Adductor magnus muscles indicated that these muscles were the most likely causes of pain even though they had fewer MFTPs than other comparable muscles. Conclusion: The outcomes of this study supports previous research indicating that an extensor dysfunction of the Quadriceps femoris muscle group may be of MFTP origin and indicates that other muscles in the thigh require further research indicating their role in the development of PFPS.
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Harris, Kelly Jayne. "The state of current knowledge regarding evidence-based conservative management of iliotibial band syndrome : a systematic review." Thesis, 2014. http://hdl.handle.net/10321/1103.
Full textAbstract:
Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2013.Background : It has become practically impossible for practitioners to remain current with clinical developments. Additionally the demand from patients and third party payors for quality evidence is increasing. A systematic review is one manner in which information can be graded, summarised and presented in a succinct format for use by practitioners, patients and third party payors. Objectives : To identify the current knowledge available on the conservative management of iliotibial band syndrome (ITBS) and to evaluate the scientific and methodological rigor of that knowledge. The systematic review of these studies identified the level and type of evidence that currently exists in the support of conservative management of ITBS and the specific interventions and combinations of interventions currently employed. Method : A systematic review of ITBS studies was conducted. ITBS studies were identified using key indexing terms (iliotibial band syndrome, treatment, conservative and intervention) on several databases (EBSCOhost, Google Scholar, Metalib, Pubmed, Science Direct and Springerlink), all studies were included up until the date of ethics approval (21st May 2012) . The gathered studies were screened for compliance with the inclusion criteria, and then reviewed by blinded independent reviewers (reviewer criteria included qualification, clinical experience, academic experience, research experience and discipline). Data collection and analysis : The reviewers rated the methodological rigour of the ITBS studies utilising an appropriate scale (e.g. PEDro Scale). Feedback was collated and analysed for discordance. Studies were then analysed, ranked and followed by a discussion in the context of their clinical outcomes, thus formulating a structured summary of the known clinical data with regards to the clinical management of ITBS. Results: The identified citations (4130) were screened and sorted by study type. This resulted in 167 citations that were reviewed by abstract for compliance with the inclusion criteria. A final total of 23 studies meet eligibility criteria. Eight articles reported on a combination of interventions, four discussed biomechanical and causative factors, and the remaining eleven articles investigated individual interventions in the treatment of ITBS. After review and analysis, combination interventions were supported by the strongest level of evidence, thus advocating the use of a combination of interventions in the management of ITBS in providing better clinical outcomes. Moderate evidence favoured the use of customised orthoses, injectable corticosteroids, phonophoresis and addressing biomechanical and causative factors. However, there was moderate evidence against the use of deep tissue frictions, as no improvement was found. This outcome suggests a need for further evidence to advocate the appropriateness of these interventions in clinical care of ITBS. Hip abductor strengthening and stretch therapy were found to have limited evidence. However, no evidence was found to support the application of active release technique, corrective neuromuscular approach, custom dry floatation cushions and talar joint manipulation in the management of ITBS. This latter outcome indicated a need for studies to investigate their appropriateness or inappropriateness in clinical care. Conclusion : The systematic review of ITBS studies revealed that use of a combination of conservative therapies was found to have the strongest level of evidence, which may indicate its appropriateness in the management of patients suffering from ITBS. Specific combinations of conservative therapies and the use of individual therapies require future research in order to better delineate their contribution to the management of ITBS. Randomised controlled trials are the gold standard for research, as they have the greatest level of methodological quality, and should be used where possible when investigating the efficiency of interventions in the treatment of ITBS. Studies, which were not randomised controlled trials, but adopted the principles of a randomised controlled trial structure, contributed positively towards the methodological rigor of these studies.
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Singh, Natasha. "An epidemiological analysis of traumatic cervical spine fractures at a referral spinal unit : a three-month study." Thesis, 2008. http://hdl.handle.net/10321/411.
Full textAbstract:
Dissertation submitted in partial compliance with the requirements for the
Master’s Degree in Technology: Chiropractic
Faculty: Health Sciences,
Durban University of Technology, 2009Aim To determine the profile of traumatic cervical spine fractures with respect to the epidemiology, clinical presentation, types of fractures, conservative and surgical intervention, short-term post-intervention (i.e. post-conservative and post-surgical) complications and short-term post-surgical rehabilitation of patients presenting at the Spinal Unit of King George V Hospital over a 12-week period. Methods Patients who presented to the King George V Hospital Spinal Unit from surrounding hospitals with traumatic cervical spine fractures were evaluated by the medical staff. Data concerning the epidemiology, clinical presentation, types of fractures, conservative and surgical intervention, short-term post-intervention (i.e. post-conservative and postsurgical) complications and short-term post-surgical rehabilitation data were recorded by the researcher. A p-value of <0.05 was considered as statistically significant. Appropriate statistical tests were applied to the hypothesis-testing objectives. These involved the Pearson’s Chi Square Tests for categorical variables or Fisher’s Exact Tests as appropriate where sample sizes were small. Paired t-tests were done to compare preand- post-surgical Frankel grading and Norton Pressure Sore Assessment scores. Results The number of patients who presented to the Spinal Unit over a 12-week period was 20, of this number 17 were males, three were females and all were black. Eleven patients were treated surgically while nine patients were treated conservatively. The most frequent aetiology of cervical spine fractures was motor vehicle accidents (n = 10) followed by falls (n = 9). The most common co-existing medical conditions were smoking (n = 7), HIV (n = 5), alcohol abuse (n = 3) and obesity (n = 3). The most frequent locations of cervical spine fractures were C2 (n = 6), C1 (n = 4) and the posterior column of C6 (n = 3), while dislocations occurred primarily at the C5-C6 levels (n = 5) of the lower cervical spine. Odontoid fractures (n = 6), Jefferson’s fractures (n = 4) and unilateral facet dislocations (n = 6) were the most common fractures and dislocations v observed. Head injuries (n = 4) and lower limb fractures (n = 3) were the most common extra-spinal fractures. All subjects who sustained head injuries also had associated C1 or C2 fractures. Neurological complications most frequently involved the upper limb where loss of motor function (n = 8) and weakness (n = 4) were observed. The majority of the patients (n = 8) reported a Frankel Grading of E. There were no significant associations between types of fracture and gender with the exception of fracture/dislocation observed in two females. There was a statistically significant difference in the NPSA score (p = 0.004). Conservative care utilized included soft collar (n = 6), cones calipers (n = 6), physiotherapy (n = 4), Minerva jacket (n = 4) and SOMI (sterno-occipital mandibular immobilization) brace (n = 1) while surgical intervention included anterior decompression (n = 8), anterior fusion (n = 8), allograft strut (n = 8), discectomy (n = 8), anterior cervical plating (n = 8), anterior screw fixation (n = 2), a transoral approach (n = 1) and a corpectomy (n = 1). The short-term post-conservative care complications observed in this study were an occipital pressure sore (n = 1), severe discomfort (n = 1) as well as severe neck pain (n = 1), while the short-term post-surgical complications were severe neck pain (n = 2), oral thrush (n = 1), pneumonia (n = 1), odynophagia (n = 1) and hoarseness (n = 1). Of the 11 patients who underwent cervical spine surgery, ten were sent for physiotherapy and one for occupational therapy. No significant associations were seen between the type of cervical spine fracture and the age of the subject. There was a significant association between fracture/dislocation and the female gender (p = 0.016). There was significant negative association between odontoid fracture and: anterior decompression, anterior fusion, allograft strut, discectomy and anterior cervical plating (p = 0.006). Conclusion The results of this study reflect the presentation and management of cervical spine fractures at a referral spinal unit of a public hospital in KwaZulu Natal. The impact of HIV and other co-existing medical conditions were not determined due to the small sample size in this study. Further epidemiological studies are required to be conducted in the Spinal Units of all South African public hospitals in order to confirm or refute the observation of this study.
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Sturgeon, Angela K. "Treatment of dog bite wounds by primary care and emergency department providers." 2009. http://proquest.umi.com/pqdweb?did=1694712601&sid=1&Fmt=2&clientId=3916&RQT=309&VName=PQD.
Full textAbstract:
Thesis (M.A.)--Northern Kentucky University, 2009.Made available through ProQuest. Publication number: AAT 1462294. ProQuest document ID: 1694712601. Includes bibliographical references (p. 40-42)
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"Augmentation of the osteotendinous junctional healing by biophysical stimulations: a partial patellectomy model in rabbits." Thesis, 2006. http://library.cuhk.edu.hk/record=b6074236.
Full textAbstract:
In summary, the biomechanical stimulations can augment osteotendinous healing processes by facilitating better fibrocartilagious transitional zone regeneration as well as the restoration of proprioceptions, and the early application showed the more beneficial effects. However, further experimental and clinical studies are still needed to explore the optimal timing, intensity, frequency, and duration of the proposed postoperative biomechanical stimulation protocols.LIPUS is a "non-contact" biomechanical stimulation, which can provide a direct mechanical stimulation through cavitation and acoustic microstreaming effects to improve tissue healing in a less-than-rigid biomechanical environment. So the mechanical stimulation induced from LIPUS could be applied immediately after surgery without worrying about the mechanical strain exceed the structural property at the osteotendinous healing interface in the early phase of repair. In this part of study, we also examined the effects of the regime of biomechanical stimulations applying immediately after repair on the osteotendinous healing interface. By using the same healing junction model, forty-two female New Zealand white rabbits were randomly divided into two groups; daily mechanical stimulation was applied immediately after surgery lasting up to post-operative 12 weeks on the healing interface in the treatment group. The regime of mechanical stimulations included by LIPUS was 20 minutes, 5 days per week for 4 weeks, followed by cyclic mechanical stimulation generated from quadriceps muscles induced by FES for 8 weeks. Results showed that early application of biomechanical stimulations on the osteotendinous healing interface were significantly better radiologically, histologically and biomechanically than that of not any or later application of the biomechanical stimulations during the osteotendinous healing processes when assessing at the same healing time point. In addition, the early application of biomechanical stimulations showed the better functional recovery in terms of the restoration of the proprioceptions, which an increased numbers of sensory nerve endings labeled by calcitonin gene-relate peptide (CGRP) was detected in the whole osteotendinous healing complex.
Sports or trauma injuries around osteotendinous junctions are common; treatments usually require surgical reattachment of the involved tendon to bone. Restoration of osteotendinous junction after repair is slow and difficult due to regenerating the intermitted fibrocartilage zone to connect two different characteristic tissues, tendon to bone. Although the factors influencing fibrocartilage zone regeneration and remodeling during osteotendinous repair are poorly understood, however, is believed that the mechanical environment plays an important role in such healing process. In present study, the effects of mechanical stimulation on osteotendinous healing process were examined, in the way of mechanical stimulations induced by biophysical stimulations, surface functional electric stimulation (FES) and low intensity pulsed ultrasound (LIPUS), applying on the patellar tendon to patellar bone healing interface in an established partial patellectomy model in rabbits.
The mechanotransductive stimulation linked to the transmission of forces across osteotendinous junction can be generated from its muscle contraction induced by FES. In the partial patellectomy model, thirty-five female New Zealand white rabbits were randomly divided into two groups with initial immobilization for 6 weeks, daily FES was applied to quadriceps muscles for 30 minutes, 5 days per week for 6 weeks in treatment group and compared with non-treatment control group at postoperative week 6, 12 and 18, radiologically, histologically and biomechanically. Results showed that FES-induced cyclic mechanical stimulation significantly increased new bone formation and its bone mineral density. An elevated expression of tenascin C and TGFbeta1; an increased proteoglycant stainability; mature fibrocartilage zone formation with better resumptions of biomechanical properties also observed on the osteotendinous healing interface, indicating that the post-operative programmed cyclic mechanical stimulation generated from its muscle contraction has beneficial effects on osteotendinous healing processes by facilitating the fibrocartilagious transitional zone regeneration.
by Wang Wen.
Advisers: Kai Ming Chan; Ling Qin.
Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1550.
Thesis (Ph.D.)--Chinese University of Hong Kong, 2006.
Includes bibliographical references (p. 159-175).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstracts in English and Chinese.
School code: 1307.
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"The effect of chiropractic adjustive therapy on the contractile strength of the hamstring muscle group in professional soccer players." Thesis, 2011. http://hdl.handle.net/10210/3717.
Full textAbstract:
M.Tech.Purpose: In soccer the re-injury rate of Hamstring muscle strains is between 12 and 14 percent. A previous or recent Hamstring injury is the most recognised risk factor for future injury. On recurrence of the injury, it tends to be more severe and disabling than the initial injury. Given the high recurrence rates, Hamstring injuries provide a significant challenge to the treating clinician. Knowledge surrounding optimal treatment and preventative measures is therefore critical (Hoskins and Pollard 2005). The aim of this study is to assess the effectiveness of lower lumbar spine segment adjustment, namely the L4/5 spinal level, in the contractile strength of the Hamstring muscle group in professional soccer players that have a history of a Hamstring strain. Design: Forty professional soccer players between the ages of 15 and 34 years with a history of a grade one or grade two Hamstring strain were considered for this study. Participants in this research were obtained from the University of Johannesburg inter-residence players and from the University of Johannesburg first soccer team. Two groups of twenty players were randomly assigned to one of two groups. Group A received spinal adjustive therapy (SAT) to the L4/5 spinal segment with an ultrasound treatment to their Hamstring muscle group and Group B will receive only the ultrasound treatment to the hamstring muscle group. Each participant was treated five times over a period of three weeks. Measurements: Before any intervention was given to either of the groups, Hamstring muscle contractile strength was first recorded using a Cybex system 2000. Hamstring contractile muscle strength measurements were taken again after the fifth treatment for both groups and compared to ascertain if there had been any change in the contractile strength of the Hamstring muscles. Results and Conclusion: Even though the two groups did not start at the same contractile strength for the Hamstring muscle in knee flexion, as measured a CCybex system 2000 possibly due to the selection criteria used in the study in terms of age and body weight of the participants, results showed that spinal adjustive therapy was more effective in improving the muscle contractile strength of the Hamstring muscle in knee flexion since there was a favourable difference in both Group A and Group B following intervention, but more so in Group A (in the once injured leg) which received spinal adjustive therapy due to a greater increase in the overall muscle contraction in the Hamstring muscle group. For the Chiropractic profession this opens huge potential with regards to the Chiropractic benefits and improving the functioning of professional soccer players.