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MANCUSO, GIUSEPPE. « Dissecting the pathogenesis of hereditary spastic paraplegia linked to SPG4 and SPG7 genes ». Doctoral thesis, Università degli Studi di Milano-Bicocca, 2011. http://hdl.handle.net/10281/20207.
Texte intégralRésumé :
The aim of this thesis is to analyze and characterize the function of two genes involved in Hereditary Spastic Paraplegia, SPG4 and SPG7, to dissect their role in the pathogenesis of the disease.
SPG4 encodes for Spastin, a microtubule severing protein involved in cytoskeletal dynamics and subcellular trafficking.
On the other hand, SPG7 encodes for Paraplegin, a subunit of the m-AAA protease complex. This protease plays a key role in inner membrane protein quality control and in specific substrate maturation.
Studying two genes with different function can shed light on common pathogenetic mechanisms in an etiologically complex disease such as Hereditary Spastic Paraplegia.
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Mungovan, Sean F., et n/a. « The Effect of Elevation and Venous Occlusion Pressure on Cardiovascular Function in Physically Active Men Who Are Paraplegic ». Griffith University. School of Physiotherapy and Exercise Science, 2004. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20040917.084824.
Texte intégralRésumé :
The purpose of the present investigation was to: 1) Determine the relationship between cardiac output (estimated using the acetylene rebreathing methodology) and oxygen consumption in a homogeneous group of men who are paraplegic. 2) Investigate whether lower limb elevation increases stroke volume and decreases heart rate at rest and during submaximal arm exercise. 3) Investigate whether the application of constant circumferential pneumatic pressure applied to dependent lower limbs increases stroke volume and decreases heart rate at rest and during submaximal arm exercise.
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Mungovan, Sean F. « The Effect of Elevation and Venous Occlusion Pressure on Cardiovascular Function in Physically Active Men Who Are Paraplegic ». Thesis, Griffith University, 2004. http://hdl.handle.net/10072/365190.
Texte intégralRésumé :
The purpose of the present investigation was to: 1) Determine the relationship between cardiac output (estimated using the acetylene rebreathing methodology) and oxygen consumption in a homogeneous group of men who are paraplegic. 2) Investigate whether lower limb elevation increases stroke volume and decreases heart rate at rest and during submaximal arm exercise. 3) Investigate whether the application of constant circumferential pneumatic pressure applied to dependent lower limbs increases stroke volume and decreases heart rate at rest and during submaximal arm exercise.Thesis (Masters)
Master of Philosophy (MPhil)
School of Physiotherapy and Exercise Science
Full Text
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Souza, Lúcia Inês Macedo de. « Investigação genética de duas novas doenças neurodegenerativas : síndrome de Spoan (Spastic Paraglegia with Optic Atrophy and Neuropathy) e SPG34 ». Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/41/41131/tde-06112008-164924/.
Texte intégralRésumé :
Estudamos duas grandes famílias com manifestações de doenças neurodegenerativas. Uma delas é originária do alto oeste do estado do Rio Grande do Norte e a outra, da região de São José do Rio Preto, SP. A primeira, uma extensa família com tradição de casamentos consangüíneos, apresenta 68 indivíduos afetados pela síndrome a qual nomeamos Spoan (Spastic Paraplegia, Optic Atrophy, Neuropathy). A mesma é uma doença neurodegenerativa de herança autossômica recessiva, caracterizada por atrofia óptica congênita, espasticidade, polineuropatia periférica axonal sensitivo-motora, sobressaltos à estimulação sonora, deformidades articulares e da coluna e disartria. Estes resultados foram publicados em 2005 no Ann Neurol. 57(5):730-7. Dando continuidade ao estudo, selecionamos 23 genes que tiveram todos os exons seqüenciados. Nenhuma mutação foi observada. Amostras de 65 afetados e seus parentes foram estudados para seis marcadores de microsatélite, totalizando 149 indivíduos genotipados. Cinqüenta SNPs foram investigados, o que nos permitiu reduzir a região candidata de 4.8 para 2.3Mb em 11q13, entre o SNP rs1939212 e o microssatélite D11S987. Para o marcador D11S1889, com alelos em homozigose para todo os pacientes, foi obtido um lod score máximo de 27 em .=0.0. Os resultados deste estudo se encontram em fase de submissão. A segunda família foi estudada pela equipe da Dra. Mayana Zatz há alguns anos. Nela, investigamos 12 indivíduos afetados e 12 normais. Dentre estes, sete, com idades entre 30 e 60 anos, foram clinicamente avaliados. A idade de início foi a partir da terceira década de vida, sendo a paraplegia espástica o único sintoma. Para o marcador DXS8057 localizado em Xq25 foi obtido um lod score máximo de 4.13 em .=0.0. Com o estudo de marcadores moleculares, delimitamos uma região candidata entre os marcadores DXS1001 e DXS8033, de cerca de 14Mb, e demonstramos a existência de um novo loco gênico no cromossomo X, por nós denominado SPG34. Os resultados deste estudo estão publicados no Neurogenet on line em 08/05/200We studied two large families with expressions of neurodegenerative diseases. One is from the high west of the state of Rio Grande do Norte and the other from São José do Rio Preto region, in São Paulo. The first, an extended family with a tradition of consanguineous marriages, has 68 individuals affected by the syndrome named by us Spoan (Spastic Paraplegia, Optic Atrophy, Neuropathy). The Spoan syndrome is a neurodegenerative disease, autosomal recessive, characterized by congenital Optic Atrophy, spasticity, axonal polyNeuropathy peripheral sensory-motor, shocks to the sound stimuli, joint and spine deformities, and dysarthria. These results were published in 2005 in Ann Neurol. 57 (5):730-7. Latter we analyzed 23 genes that were entirely sequenced. No mutation was observed. Samples of 65 affected and their relatives were studied for six microsatellite markers, totaling 149 individuals genotiped. Fifty single nucleotide polymorphisms (SNPs), located in the critical region, were also investigated, which allowed us to reduce the region for the SPOAN gene from 4.8 to 2.3 Mb, between the SNP rs1939212 and microsatellite D11S987 in 11q13. All patients are homozygous only at D11S1889, which two-point lod score with a Zmax of 27 at .=0.0 was obtained. The results of this study are being submitted. The second family was studied by Dr. Mayana Zatz group a few years ago. We investigated 12 affected and 12 normal relatives. Among these, seven patients, aged between 30 and 60 years, were clinically evaluated. The age of onset was from the third decade of life and disease showed behaviour very uniform, all affected showed Spastic Paraplegia as the only symptom. For the marker DXS8057, in Xq25, was obtained a maximum lod score of 4.13 at .=0.0. The candidate region was maped between the markers DXS1001 and DXS8033, about 14Mb and demonstrate the existence of a new gene locus on chromosome X, named by us SPG34. The results of this study were published in Neurogenet on line on may.08.2008.
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Oteyza, Andrés de [Verfasser], et Ludger [Akademischer Betreuer] Schöls. « Gene identification in Hereditary Spastic Paraplegias and characterization of Spastic Paraplegia type 58 (SPG58) / Andrés de Oteyza ; Betreuer : Ludger Schöls ». Tübingen : Universitätsbibliothek Tübingen, 2016. http://d-nb.info/1165236532/34.
Texte intégral
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Berry, Helen Russell. « Characterisation of cardiorespiratory responses to electrically stimulated cycle training in paraplegia ». Thesis, Connect to e-thesis. Edited version, 2008. http://theses.gla.ac.uk/386/.
Texte intégralRésumé :
Thesis (Ph.D.) - University of Glasgow, 2008.PhD. theses submitted to the Department of Mechanical Engineering, Faculty of Engineering, University of Glasgow. Edited version of thesis available, uncleared 3rd party copyright material removed. Includes bibliographical references. Print version also available.
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Santos, Leila Conceição Rosa dos. « Re dimensionando limitações e possibilidades : a trajetória da pessoa com lesão medular traumática ». Universidade de São Paulo, 2000. http://www.teses.usp.br/teses/disponiveis/7/7136/tde-02082007-112821/.
Texte intégralRésumé :
O estudo foi realizado com pessoas do sexo masculino e que viveram a experiência de sofrer um trauma que acarretou a lesão da medula espinal. Teve como objetivos: - compreender os significados que a pessoa atribui a sua experiência de ser lesado medular; - compreender a maneira como a dimensão atribuída ao significado de ser lesado medular se manifesta nas ações da pessoa; - desenvolver um modelo teórico representativo da experiência da pessoa que sofreu uma lesão traumática na medula espinal. Utilizou-se como referencial teórico o Interacionismo Simbólico e como referencial metodológico, a Teoria Fundamentada nos Dados. A estratégia para a obtenção dos dados foi a entrevista. Dos resultados emergiram dois fenômenos - Sobrevivendo ao Acidente e Vivendo uma Nova Realidade. Destes, identificou-se a categoria central - Re dimensionando limitações e possibilidades. A compreensão da experiência da pessoa que adquire uma lesão da medula espinal possibilitou reconhecer como as vivências, que ocorrem após a constatação da deficiência física, são percebidas por esses indivíduos, e como redimensionam os significados que vão atribuindo às situações diferentes que passam a vivenciar. O modelo teórico mostra que a experiência de ter se tornado um paraplégico ou um tetraplégico, é permeada pela vivência de limitações, e dependências, sentimentos e reações que vão sendo dimensionados e redimensionados à medida que vai re elaborando significados e valores, e desenvolvendo ações que lhe apontam possibilidades, as quais toma posse mediante as escolhas que faz para dar continuidade ou sentido à vida preservada, porém modificadaA study conducted with adult males who had undergone the experience of suffering trauma causing spinal cord injury (SCI). The aim was to: - understand the meaning patients gave to their experience of being an SCI bearer; - understand how the dimensions attributed to being a SCI bearer manifested itself in the person\'s behavior; - develop a theoretical model representative of the experience of the person who suffered SCI. The study used as a theoretical reference Symbolic Interactionism and used the Grounded Theory methodology. Data was collected through interviews. Two phenomena emerged from the findings: \"Surviving the Accident\" and \"Living a New Reality\". Of these the central category was identified as Re defining limits and possibilities. Understanding of the experience of SCI bearers made it possible to recognize how the events that occurred after the diagnosis of the physical deficiency is perceived by the persons and how they redefine the meaning attributed to the different situations they came to experience after suffering the acquired physical deficiency. The theoretical model reveals that the experience of having become a paraplegic or tetraplegic involved a lot of coping with limitations and dependency, emotions and reactions that go on being defined and redefined as the individual restructured values and developed actions that led to possibilities of overcoming, which were adopted through the choices made, so as to give continuity of meaning to the life that remained, although in its modified state
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Silva, Gelson Aguiar da. « Funcional independence of individuals With paraplegia in a rehabilitation program : results and associated factors ». Universidade Federal do CearÃ, 2006. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=389.
Texte intégralRésumé :
CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel SuperiorSpinal cord injury can convey constraints to individuals, but a rehabilitation program which evalueates the functional gain allows outpatient care during the rehabilitation process. The aim of the present research was to evaluate results obtained trough the administration of Functional Independence Measure (FIM scale) in paraplegic petients within rehabilitation programs, by connecting such results with the variables: age, gender, time, level and etiology of the lesion, classification of lesion according to the ASIA (American Spinal Injury Association) criterion, time of hosptalization, educational status and complications (pressure sores, heterotopic ossofication, spasticity and neuropathic pain). For such, a transversal quantitative retrospective descriptive study was proceeded by analyzing medical records and the scoresobtained with FIM scale. The investigations were done using spedific tests, through the SPOSS software (statistical Package for the Social Science), version 13 for Windws. Results demonstrated that among the variables there studied variables there is a direct correlation between age, time of lesion, motor level, time of hospitalization and hospitalization wich a companion and the independence gain (P< 0.05). Besides there is an inverse relation between the lession classification (AIS A, B, C, D, or E) and the functional gain (P< 0.05). Functional evaluation of people with spinal cord injury though MIF scale allows to fallow up functional gain in people within a rehabilitation program.
A lesÃo medular pode trazer limitaÃÃes ao indivÃduo, mas um programa de reabilitaÃÃo que avalie o ganho funcional permite o acompanhamento, ao longo do decurso de reabilitaÃÃo. O objetivo desta pesquisa foi avaliar os resultados obtidos com a aplicaÃÃo da Medida de IndependÃncia Funcional (MIF) em pessoas portadoras de paraplegia em programa de reabilitaÃÃo; associando tais achados com as variÃveis: idade, sexo, tempo, nÃvel e etiologia da lesÃo, classificaÃÃo da lesÃo segundo o critÃrio da ASIA (American Spinal Injury Association), tempo de hospitalizaÃÃo, escolaridade e complicaÃÃes (Ãlcera de pressÃo, ossificaÃÃo heterotÃpica, espasticidade e dor neuropÃtica). Para isso foi realizado um estudo quantitativo transversal, de natureza retrospectiva, de carÃter descritivo, com anÃlise de 228 prontuÃrios e da pontuaÃÃo obtida mediante a Escala MIF. As anÃlises foram feitas sob testes especÃficos com auxÃlio do software SPSS (Statistical Package for the Social Science), versÃo 13 para Windows. Os resultados mostraram que, dentre as variÃveis estudadas, hà uma relaÃÃo direta entre a idade, o tempo de lesÃo, nÃvel motor, tempo de internaÃÃo e a internaÃÃo com acompanhante e o ganho de independÃncia (p< 0,05). TambÃm hà uma relaÃÃo inversa entre a classificaÃÃo da lesÃo (AIS A, B, C, D ou E) e o ganho funcional (p< 0,05). A avaliaÃÃo funcional em pessoas portadoras de lesÃo medular, por meio da Escala de Medida de IndependÃncia Funcional, permite o acompanhamento do ganho funcional em pessoas submetidas a um programa de reabilitaÃÃo.
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Parodi, Livia. « Identification of genetic modifiers in Hereditary Spastic Paraplegias due to SPAST/SPG4 mutations Spastic paraplegia due to SPAST mutations is modified by the underlying mutation and sex Hereditary spastic paraplegia : More than an upper motor neuron disease ». Thesis, Sorbonne université, 2019. http://www.theses.fr/2019SORUS317.
Texte intégralRésumé :
Les Paraplégies Spastiques Héréditaires (PSHs) sont un groupe de maladies neurodégénératives rares qui surviennent suite à la dégénérescence progressive des voies corticospinales, entraînant une spasticité des membres inférieurs, signe distinctif de la pathologie. Elles se caractérisent par une extrême hétérogénéité qui concerne à la fois les facteurs génétiques et cliniques, ainsi que d’autres aspects de la maladie, tels que l’âge d’apparition et la sévérité des signes. Cette variabilité est typiquement observée chez les patients porteurs de mutations pathogènes dans SPAST, le gène le plus fréquemment muté dans les PSHs. Après avoir réuni une cohorte de 842 patients mutés dans SPAST, nous avons utilisé une combinaison de différentes approches de Séquençage de Nouvelle Génération (NGS) afin de mieux comprendre les causes de l’hétérogénéité observée chez les patients, afin d’identifier des facteurs génétiques responsables de variations de l’âge au début de la maladie. Les données résultantes du génotypage de l’ensemble du génome ont ainsi été utilisées pour effectuer des analyses d’association et de liaison qui, combinées aux données de séquençage de l’ARN, ont permis d’identifier différents variantes/gènes candidats, potentiellement impliqués comme facteurs modificateurs de l’âge de début des SPAST-PSHsHereditary Spastic Paraplegias (HSPs) are a group of rare, inherited, neurodegenerative disorders that arise following the progressive degeneration of the corticospinal tracts, leading to lower limbs spasticity, the disorder hallmark. HSPs are characterized by an extreme heterogeneity that encompasses both genetic and clinical features, extending to additional disorder’s features, such as age of onset and severity. This phenotypic variability is typically observed among HSP patients carrying pathogenic mutations in SPAST, the most frequently mutated HSP causative gene. After assembling a cohort of 842 SPAST-HSP patients, a combination of different Next Generation Sequencing approaches was used to dig deeper into the causes of the observed heterogeneity, especially focusing on the identification of age of onset genetic modifiers. Sequencing data resulting from Whole Genome Genotyping were used to perform both association and linkage analysis that, combined with RNA sequencing expression data, allowed to identify different candidate variants/genes, potentially acting as SPAST-HSP age of onset modifiers
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STRAPPAVECCIA, Silvia. « IMPIANTO AUTOLOGO DI CELLULE STAMINALI NOM (NASAL OLFACTORY MUCOSA) IN CANI PARAPLEGICI CRONICI [AUTOLOGOUS IMPLANT OF NASAL OLFACTORY MUCOSA (NOM) STEM CELLS IN CHRONIC PARAPLEGIC DOGS] ». Doctoral thesis, Università degli Studi di Camerino, 2007. http://hdl.handle.net/11581/401897.
Texte intégralRésumé :
La terapia delle lesioni spinali croniche dell'uomo rappresenta attualmente uno dei maggiori campi di interesse della ricerca scientifica. Tra le strategie sperimentali di ultima elaborazione, il trapianto di cellule staminali sta dimostrando notevoli potenzialita' per la cura di molte patologie del SNC. I modelli animali principalmente utilizzati per gli studi sperimentali sono i ratti, ma le dimensioni del midollo spinale in questa specie sono estremamente diverse da quelle dell'uomo, e le condizioni di laboratorio in cui i protocolli sperimentali vengono applicati sono molto differenti dalle condizioni accidentali delle lesioni umane. Il trauma spinale e' un'evenienza piuttosto frequente nel cane, ma molto spesso la terapia non viene effettuata precocemente o e' inefficace, cosi' da portare ad una condizione di paraplegia cronica. In questa specie l'eziopatogenesi delle lesioni e le dimensioni del midollo sono simili a quelle dell'uomo. Per tali ragioni il cane rappresenta un buon modello per lo studio delle terapie sperimentali nelle lesioni spinali croniche. Lo scopo del presente lavoro e' quello di verificare se l'impianto autologo di cellule staminali adulte di natura olfattoria sia in grado di ripristinare la deambulazione volontaria in cani paraplegici cronici. Sono stati inclusi nello studio 6 soggetti sottoposti alla nostra attenzione tra gennaio 2004 e dicembre 2005 per l'insorgenza di un grave trauma spinale compreso tra le vertebre T4 e L3. Trascorsi almeno due mesi dall'insorgenza della paraplegia, in ciascun cane e' stato effettuato il prelievo bioptico della mucosa nasale. Il campione e' stato quindi inviato nel laboratorio di riferimento, dove le cellule staminali sono state isolate e allestite su un apposito supporto. Nei mesi successivi tutti i 6 pazienti sono stati sottoposti all'impianto delle cellule autologhe, dopo esposizione chirurgica del segmento midollare leso e asportazione del tessuto cicatriziale. La fase post-operatoria e' stata dedicata all'esecuzione di intensi protocolli fisioterapici e di indagini cliniche e strumentali, finalizzate alla valutazione del recupero neurologico. I risultati ottenuti hanno evidenziato la presenza di un parziale ripristino delle capacita' deambulatorie in 3 soggetti, mentre i tracciati elettrofisiologici relativi ai Potenziali Evocati Somato-Sensoriali (PESS) non hanno subito alcuna variazione nel periodo successivo all'impianto. In un soggetto, deceduto spontaneamente per una patologia indipendente dalla condizione neurologica, e' stato possibile sottoporre il midollo spinale a valutazioni di tipo istologico e immunoistochimico. Queste hanno evidenziato la presenza, nel tratto midollare sede dell'impianto, di gruppi di neuroni-fibre dispersi all'interno di abbondante tessuto fibroso. Pur considerando l'esiguita' del numero dei soggetti inclusi nella ricerca, e in attesa di poter sottoporre ad indagini istologiche il midollo spinale di 5 di loro, si puo' concludere che l'impianto di cellule staminali di origine olfattoria nel midollo spinale di cani paraplegici cronici puo' presentare notevoli potenzialita' terapeutiche. The treatment of chronic spinal cord injuries in humans is, today, one of the most important fields of scientific research. Among the experimental strategies recently developed, stem cell transplants are demonstrating great potentiality for the cure of many central nervous system (CNS) pathologies. The most common animal models used in experimental studies are rats but the dimensions of the spinal cord of this species are quite different from those of the human, and the laboratory conditions in which the experimental protocols are applied do not resemble the accidental conditions of human injuries. Spinal cord injuries are relatively frequent in dogs but very often the therapy is not applied promptly or is not efficacious, and the result is a condition of chronic paraplegia. The etiopathogenesis of the injuries and the dimensions of the spine of the dog are similar to those of the human. For these reasons, the dog represents a good model for studying experimental treatment of chronic spinal cord injuries. The aim of this study is to verify whether the autologous implant of adult stem cells obtained from nasal olfactory mucosa (NOM) is able to restore voluntary ambulation in dogs with chronic paraplegia. This study concerns six subjects that we cared for between January 2004 and December 2005 after the onset of a serious spinal trauma in the area between the vertebrae T4 and L3. At least two months after the onset of paraplegia, a bioptic sample was taken from the nasal mucosa of each dog. The sample was sent to the reference laboratory where the stem cells were isolated and prepared on an appropriate scaffold. During the following months all six patients were subjected to the implant of autologous cells, after the surgical exposure of the injured segment of the spinal cord and the removal of scar tissue. The post-surgical phase was dedicated to intensive physiotherapy protocols and clinical and instrumental investigations, with the aim of evaluating the neurological recovery. The results obtained demonstrated the presence of a partial restoration of the ambulatory capacity in three subjects, while the electrophysiological pathways relative to the Somatosensory Evoked Potential (SSEPs) did not undergo any variation in the period following the implant. In the case of one dog, that died spontaneously from a pathology not connected with the neurological condition, it has been possible to carry out histological and immununohistochemical evaluations of the spinal cord. These have demonstrated the presence of groups of neuron-fibres dispersed inside abundant fibrous tissue in the area of the implant. While taking into consideration the small number of subjects included in the research and in anticipation of being able to subject the spinal cords of the other five dogs to histological investigations, we can nevertheless conclude that the implant of the stem cells of olfactory origin in the spinal cord of dogs with chronic paraplegia can offer outstanding therapeutic potential.
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Sullivan, Martin Joseph. « Paraplegic Bodies : Self and Society ». Thesis, University of Auckland, 1996. http://hdl.handle.net/2292/1917.
Texte intégralRésumé :
In this dissertation it is argued that humans constitute themselves as subjects in a complex of interrelationships between body, self, and society, The effects of these interrelationships are examined through the ways in which traumatic paraplegics constitute themselves as subjects following their accidents. Subsequent to paralysis there is a radical break in how paraplegics experience their bodies, in what they are physically able to do, and in the ways in which their bodies are interpreted socially, assigned meanings, and allocated space in which to do and be. Experiential accounts of paraplegia are presented as a means to exploring the implications of these changes in the ways paraplegics constitute themselves as subjects.
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Rakauskienė, Eglė. « Paraplegikų gyvenimo kokybės ypatumai ». Master's thesis, Lithuanian Academic Libraries Network (LABT), 2006. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2006~D_20060509_111958-31447.
Texte intégralRésumé :
Goal of the research is to analyze and evaluate the life quality of paraplegics. Object of research is life quality of paraplegics. Tasks of research: to evaluate the life quality of paraplegics according to age and physical activity; to evaluate the life quality of paraplegics according to level of medulla injury, duration of trauma; to analyze the expression of life quality components of paraplegics in gender aspect.
There are numerous researches analyzing the quality of life, but we could not find any research analyzing the life quality of paraplegics. Research of such character would enable to better clarify factors having impact on life quality of paraplegics depending on gender, age, level of medulla injury, duration of medulla injury, physical activity. In order to evaluate life quality according to a standard, extensive scientific research is needed.
Research was carried out in summer 2005 at the therapy and rehabilitation centre “Landšaftas” in Monsiškės, and in recreation centre “Balčio Šilas“. Research was conducted among 41 paraplegic: 29 men and 12 women. Quality of Life Questionnaire, 2001 was applied, and supplemented with questions from questionnaire of research on socialization of disabled by Williams (1994).
Summarizing the obtained research results one can state that life quality of paraplegics of younger age (21-40 years) is better than that of aged paraplegics (41-60 years). After life quality evaluation according to level and duration of medulla injure... [to full text]
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Courtois, Frédérique J. « Residual erectile capacity of paraplegic rats ». Thesis, McGill University, 1989. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=74335.
Texte intégralRésumé :
This series of studies was designed to investigate the residual erectile capacity of paraplegic rats. Results from human studies suggest that erectile capacity in paraplegic men may be maintained following psychogenic, but not reflexogenic, stimulation. Using an animal model to overcome methodological difficulties associated with human studies, reflexogenic stimulation was defined as local stimulation of the genitals, and psychogenic stimulation as stimulation of a key central structure. Results from higher CNS stimulation showed that electrical stimulation of the medial preoptic area of the hypothalamus reliably triggers penile responses in rats and elicits penile responses as a post-stimulation effect. Optimal stimulation parameters were identified and used to maximize the effect on spinal animals. The effect of central stimulation was then compared to that of local stimulation to examine whether truly sexual responses were elicited. Results demonstrated that central stimulation elicits primarily erectile responses with a few urine-marking responses. The two stimulation sources were then used to test the residual erectile capacity of paraplegic rats whose lesions interrupted the L6-S1 fibers. Results showed that a high proportion of animals (85%) indeed maintain erectile responses to central stimulation but lose reflex activity from the genital area. These results support the hypothesis under study and are discussed in terms of the neural substrates of erection and their implication at the human level.
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Voll, Juliana. « Recuperação funcional em dachshunds paraplégicos sem percepção de dor profunda submetidos à hemilaminectomia ». reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2010. http://hdl.handle.net/10183/31728.
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Lesões agudas da medula espinhal são de ocorrência comum em certas raças condrodistróficas como a Dachshund. Nessa raça, um desenvolvimento anormal do disco intervertebral causa uma precoce desidratação e mineralização do núcleo pulposo. Como conseqüência da degeneração discal, esses cães são propensos à extrusão discal aguda que resulta em lesão da medula espinhal contusiva e compressiva. A cirurgia descompressiva é o método de tratamento para cães com disfunção neurológica secundária à compressão da medula espinhal e o prognóstico para recuperação funcional é determinado principalmente pela severidade da lesão na medula espinhal. A perda da sensação de dor profunda em cães com doença do disco intervertebral indica lesão grave da medula espinhal e costuma ser considerada como um mau prognóstico. Existem poucos estudos com um número significativo de casos documentando a recuperação após cirurgia descompressiva em cães com ausência de percepção de dor profunda. A cirurgia raramente é recomendada se a percepção de dor profunda está ausente por mais de 48 horas, mas não foi comprovado um período de tempo mais preciso para tal recomendação. Este trabalho teve como objetivo avaliar a recuperação funcional dos membros pélvicos de cães da raça Dachshund paraplégicos com ausência de percepção de dor profunda por um período inferior e superior a 48 horas, devido à extrusão discal, submetidos à cirurgia descompressiva. Trinta cães paraplégicos foram distribuídos em dois grupos, sendo o primeiro formado por animais com ausência da sensação de dor profunda nos membros pélvicos por um período inferior a 48 horas e o segundo por um período superior a 48 horas. Em todos os pacientes foram realizados exame mielográfico e cirurgia descompressiva (hemilaminectomia). Posteriormente, esses animais foram submetidos a exame neurológico e avaliados quanto ao grau de locomoção e percepção de dor profunda. Apenas foram considerados recuperados os animais que demonstraram grau 3, 4 ou 5 de locomoção (paresia leve, ataxia ou exame neurológico normal). Os resultados comprovaram que pacientes com ausência de dor profunda devido à extrusão do disco intervertebral devem ser considerados candidatos à cirurgia descompressiva. O argumento de um prognóstico ruim, como afirmado em alguns estudos prévios, não se justifica baseado na duração da ausência de dor profunda antes do procedimento cirúrgico. O retorno da percepção de dor profunda dentro de 4 semanas pode ser associado com prognóstico favorável para retorno da locomoção (grau 3, 4 ou 5). A nova escala estabelecida dos graus de locomoção foi útil na avaliação da recuperação funcional de cães paraplégicos.Acute lesions of spinal cord are a common occurrence in certain chondrodystrophic breeds such as Dachshund. In this race, an abnormal development of the intervertebral disc causes an early dehydration and mineralization of the pulposus core. As a result of disc degeneration, these dogs are prone to acute disc extrusion, resulting in a compressive and contusive spinal cord injury. Surgical decompression is the treatment method for dogs with neurological dysfunction secondary to spinal cord compression and the prognosis for functional recovery is mainly determined by the severity of spinal cord injury. The loss of deep pain perception in dogs with IVDD indicates severe injury of the spinal cord and is often considered as a bad prognosis. There are few studies with a good number of cases documenting the recovery after decompressive surgery in dogs with no deep pain perception (DPP). Surgery is rarely recommended if DPP is absent for more than 48 hours, but an exact period of time for such a recommendation has not been clearly established. This study aims to evaluate the functional recovery of pelvic limbs of paraplegic Dachshund breed dogs paraplegic with no deep pain perception for a period inferior and superior to 48 hours due to disc extrusion and submitted to surgical decompression. Thirty dogs were divided into two groups; the first consists of paraplegic dogs with no sense of deep pain in the pelvic limbs for less than 48 hours and the second, formed by dogs more than 48 hours. All patients underwent to myelographic examination and surgical decompression (hemilaminectomy). Thereafter, these animals were submitted to neurological examination and evaluated about their degree of movement and deep pain perception. Only were considered as recovered animals that reached locomotion grade 3, 4 or 5. The results showed that patients with absence of deep pain due to intervertebral disc extrusion should be considered candidates for decompressive surgery. The argument of a poor prognosis, as stated in some previous studies, was not justified based on duration of deep pain absence before surgery. The return of deep pain perception within 4 weeks may be associated with favorable prognosis for return of locomotion (grade 3, 4 or 5). The established grade of movement degrees was useful in evaluating the functional recovery of paraplegic dogs.
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TUAL, PASCAL. « Paraplegie associee au htlv1 en guyane francaise ». Nantes, 1990. http://www.theses.fr/1990NANT019M.
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Bataweel, Adel Omar. « Lower limb orthotics inprovements for paraplegic mobility ». Thesis, University of Salford, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.700292.
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Holschbach, Jeannine Katharina [Verfasser]. « Frakturheilung bei Paraplegie im Rattenmodell / Jeannine Katharina Holschbach ». Hannover : Bibliothek der Tierärztlichen Hochschule Hannover, 2014. http://d-nb.info/1065206089/34.
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Porto, Isabela dos Passos. « Esporte e sexualidade em homens com paraplegia adquirida ». Universidade do Estado de Santa Catarina, 2015. http://tede.udesc.br/handle/handle/311.
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This study aimed to investigate the factors associated with sexual adjustment paraplegic men controlling the physical variables (functional independence) and psychological (estimated body and sexual and resilience), and even compare the sexual adjustment, estimates physical and sexual, sexual behavior and sexual function between practitioners men and not sport practitioners. It is a quantitative and analytical nature of research. Participated in the study, 60 men with paraplegia, 30 sports practitioners and 30 non-sports practitioners. To obtain the necessary data, we used a questionnaire with information about sociodemographic questions (age, education, injury time); questionnaire of physical and sexual esteem, resilience questionnaire; male sexual function questionnaire (SQ-M); Functional Independence Measure Questionnaire (MIF), semistructured questionnaire about sexual frequency, sexual desire and satisfaction, self perception of physical and psychological adjustment and sexual behavior. The data were analyzed through the use the Statistical Package program for Social Sciences (SPSS) version 20.0. The form of presentation of data consisted of descriptive statistics (absolute and relative frequencies, mean, median, standard deviation) and inferential (chi-square test, U of Mann Whitney test, of Spearman correlation test and analysis of multiple linear regression. ). It was adopted the p value <0.05. The average age of study participants was 34.8 years (SD = 8.5). It was observed that the sexual adjustment was significantly higher among the sport practitioner group (p = .001) as well as the variables of body esteem and sex (p = .002), resilience (p = .026) Functional Independence Measure (p = .014); QS-M scores (p = 0.001). With regard to sexual practices (vaginal, p = .001, anal sex, p = .001) frequency (p = .001) desire (p = .001) and sexual satisfaction (p = .001), also values were obtained higher among sports practitioners. The same result was found in the variables related to erection (p = .001) and orgasm (p = .009). There was a correlation between sex fit with the time of injury (r = 305, p <.005), resilience (r = .541, p <.005), body and sex estimates (r = .633, p <. 005), education (r = .254, p <.005) and functional Independence Measure (r = .322, p <.005). We note that the score of the body and sexual esteem questionnaire was positively correlated with the time of injury (r = .292, p <.005) vaginal sexual practice (r = .490, p <.005) sexual frequency (r =. 429, p <.005), sexual satisfaction (r = .528, p <.005), erection (r = .382, p <.005), ejaculation (r = .477, p <.005), orgasm (r = .492, p <.005), QS-M score (r = .627, p <.005). Sexual satisfaction was correlated with sexual modalities (vaginal sex r = .523, p <.005; anal sex r = .279, p <.005), sexual frequency (r = .602, p <.005), desire sexual (r = .477, p <.005), erection (r = .323, p <.005), ejaculation (r = .279, p <.005), orgasm (r = .306, p <.005 ) and QS-M score (r = .528, p <.005) sexual desire correlated with oral sex (r = .410, p <.005), and QS-M score (r = .292 p <.005). Multiple linear regression analysis showed the variables that were associated with sexual adjustment were resilience (p = .003), body esteem and sex (p = .001) and the sports practice (p = .002). The sports practice was the best predictor of sexual adjustment (R2 = .508).
Este estudo objetivou investigar os fatores associados ao ajuste sexual de homens paraplégico controlando as variáveis físicas (independência funcional) e psicológicas (estima corporal e sexual e resiliência), e ainda comparar o ajuste sexual, estima corporal e sexual, comportamento sexual e função sexual entre os homens praticantes e não praticantes de esporte. Trata-se de uma pesquisa de natureza quantitativa e analítica. Participaram do estudo, 60 homens com paraplegia, sendo 30 praticantes de esporte e 30 não praticantes de esporte. Para a obtenção dos dados necessários, utilizou-se um questionário contendo informações acerca das questões sociodemográficas (idade, escolaridade, tempo de lesão); questionário de estima corporal e sexual, questionário de resiliência; questionário de função sexual masculino (QS-M); questionário de medida de independência funcional (MIF), questionário semiestruturado sobre frequência sexual, desejo e satisfação sexual, auto percepção de ajuste físico e psicológico e comportamento sexual. Os dados foram analisados mediante o uso do programa Statistical Package for the Social Sciences (SPSS) versão 20.0. A forma de apresentação dos dados consistiu em estatística descritiva (frequências absolutas e relativas, média, mediana, desvio padrão) e inferencial (teste de qui-quadrado, teste U de Mann Whitney, teste de correlação de Spearman e análise de regressão linear múltipla.). Foi adotado o valor de p<0,05. A média de idade dos participantes deste estudo foi de 34,8 anos (dp=8,5). Observou-se que o ajuste sexual foi significativamente maior entre o grupo praticante de esporte (p=.001) assim como as variáveis de estima corporal e sexual (p=.002), resiliência (p=.026) medida de independência funcional (p=.014); escore QS-M (p=0,001). Com relação às práticas sexuais (sexo vaginal, p=.001; sexo anal, p=.001) frequência (p=.001) desejo (p=.001) e satisfação sexual (p=.001), também foram obtidos valores maiores entre os praticantes de esporte. O mesmo resultado foi encontrado nas variáveis referente à ereção (p=.001) e orgasmo (p=.009). Observou-se correlações entre o ajuste sexual com o tempo de lesão (r=305, p<.005), resiliência (r=.541, p<.005), estima corporal e sexual (r=.633, p<.005), escolaridade (r=.254, p<.005) e medida de independência funcional (r=.322, p<.005). Observamos que o escore do questionário de estima corporal e sexual se correlacionou positivamente com o tempo de lesão (r=.292, p<.005) prática sexual vaginal (r=.490, p<.005) frequência sexual (r=.429, p<.005), satisfação sexual (r=.528, p<.005), ereção (r=.382, p<.005), ejaculação (r=.477, p<.005), orgasmo (r=.492, p<.005), escore QS-M (r=.627, p<.005). A satisfação sexual se correlacionou com as modalidades sexuais (sexo vaginal r=.523, p<.005; sexo anal r=.279, p<.005), frequência sexual (r=.602, p<.005), desejo sexual (r=.477, p<.005), ereção (r=.323, p<.005), ejaculação (r=.279, p<.005), orgasmo (r=.306, p<.005) e escore QS-M (r=.528, p<.005) O desejo sexual se correlacionou com a prática de sexo oral (r=.410, p<.005), e escore QS-M (r=.292, p<.005). A análise de regressão linear múltipla apresentou as variáveis que estiveram associadas com o ajuste sexual foram a resiliência (p=.003) , estima corporal e sexual (p=.001) e a prática de esporte (p=.002). A prática de esporte foi o melhor preditor do ajuste sexual (R2=.508). Conclui-se que a prática de esporte influenciou no ajuste sexual, estimas corporal e sexual, função e comportamento sexual de homens com paraplegia adquirida.
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AITKACI, SADI. « Les paraplegies ischemiques post operatoires ». Limoges, 1989. http://www.theses.fr/1989LIMO0209.
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Lino, Sémebber Silva. « Modelagem e simulação de dispositivo manual auxiliar para mobilidade de cadeirantes com paraplegia por lesão medular ». Universidade Federal de Goiás, 2018. http://repositorio.bc.ufg.br/tede/handle/tede/8232.
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Extension or flexion movements of the body in a healthy individual are routine physical activity in daily life, necessary for its autonomy and independence.Injuries to the spinal cord and brain are the main causes of paraplegia, which makes it impossible for human locomotion with autonomy. The use of a wheelchair will help them into your daily horizontal mobility. But the possibility of using an orthotic device to allow it to increase the amplitude of the movements of extension or flexion will help in maintaining your bone density, improving your blood circulation and enlargement of muscle tone, involving tension in muscles, arteries and other tissues organic well as excessive involuntary reflex. Therefore, this study aims to present a mathematical model to describe the trajectory of nodes corresponding to the movable joints and upper extremity of a low cost orthosestic device, of the exoskeleton type, to be coupled in the wheelchair, using computer simulation to determine the variation of positions and velocities of these joints associated with the articulations of the hip and lower limbs of the paraplegic wheelchair user, when performing extension or flexion movements of the body segments, besides the simulation of a prototype developed in CAD. As for the main results of the research, first, there is the trajectory of the nodes with respect the mobile joints and upper end using the representation of Denavit-Hartenberg, generated graphically by numerical and computer simulation, in order to validate and make feasible the mechanical construction of the device. Then, as the variation of the positions and velocities of motor gasket associated with the user’s knee joint device, has its graphical representation plucked by multistep interactive Runge-Kuta 4th Order, using the Lagrange equations for numerical and computational simulation of the transmission system drive, with the application of a torque on the crank of the robotic mechanism proposed, thus confirming its usability, reliability and security. Finally, the development of a 3D virtual prototype device CAD. Therefore, the preparation and provision of this manual orthotic device developed to assist in the vertical mobility of the paraplegic with spinal cord injury, will improve physical, psychological health, functional independence and daily well-being, and helping them in their autonomy to support on the feet.
Os movimentos de extensão ou flexão corporal em um indivíduo saudável são atividades físicas rotineiras necessárias para sua autonomia e independência. As lesões da medula espinhal e do cérebro são as principais causas da paraplegia, que impossibilitam a locomoção humana com autonomia. O uso de uma cadeira de rodas os auxiliará em sua mobilidade horizontal diária. Mas a possibilidade de uso de um dispositivo ortético que lhe permita aumentar a amplitude dos movimentos de extensão ou flexão, contribuirá na manutenção da sua densidade óssea, melhorando sua circulação sanguínea e ampliação do tônus muscular, envolvendo tensão em músculos, artérias ou outros tecidos orgânicos além de reflexos involuntários excessivos. Por conseguinte, este estudo objetiva apresentar um modelo matemático para descrever a trajetória dos nós correspondentes as juntas móveis e extremidade superior de um dispositivo ortético manual de baixo custo, do tipo exoesqueleto, a ser acoplado na cadeira de rodas do paraplégico, usando-se de simulação computacional para determinar a variação das posições e velocidades dessas juntas associadas às articulações do seu quadril e membros inferiores, ao realizar movimentos de extensão ou flexão dos segmentos corporais, além da simulação de um protótipo desenvolvido em CAD. Quanto aos principais resultados decorrentes da pesquisa, primeiramente, obteve-se a trajetória dos nós referentes às juntas móveis e extremidade superior utilizando-se da representação de Denavit-Hartenberg, gerada graficamente por simulação numérico- computacional, no intuito de validar e viabilizar a construção mecânica do dispositivo. Em seguida, a variação das posições e velocidades da junta motora associada à articulação do joelho do usuário do dispositivo, teve sua representação gráfica tangida pelo método interativo multipasso de Runge-Kuta de 4ª ordem, usando-se das equações de Lagrange para simulação numérico-computacional do acionamento do sistema de transmissão, com a aplicação de um torque na manivela do mecanismo robótico proposto, confirmando assim, a sua usabilidade, confiabilidade e segurança. Por último, o desenvolvimento de um protótipo virtual 3D em CAD do dispositivo. Portanto, a confecção e disponibilização desse dispositivo ortético desenvolvido para auxiliar na mobilidade vertical do paraplégico com lesão medular, melhorará sua saúde física, psicológica, independência funcional e bem-estar diário, auxiliando-o na autonomia para apoiar sobre os pés.
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Vanoncini, Michele. « Improving sitting posture in paraplegia via functional electrical stimulation ». Thesis, University of Reading, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.494804.
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This study is an experimental investigation on the application of Functional Electrical Stimulation (FES) to the trunk muscles in paraplegic subjects. The aim is to improve trunk balance during reaching/grasping activities, and to explore a potential use of FES for the prevention of pressure sores. The research comprises three parts: the development of a model of the human trunk, the synthesis of closed loop controllers for the stimulation, and the use of FES for pressure sore prevention. Biomechanical models of the trunk, available from previous studies, are not appropriate for the synthesis of FES controllers. They are difficult to identify due to the high number of prameters, and hence cannot be taken into account the daily variations of the muscle response to the stimulation. This study proposes a novel approach, based on a simple model, which can be identified prior to any stimulation session. The investigation on automatic control of FES aims at trunk stabilisation and rejection of disturbances. Two regulators are considered: a Proportional Integral Derivative (PID) and a Linear Quadratic Regulator (LQR). The results show that a development by trial and error of a PID controller is feasible, and hence should be considered in practical applications. The study also shows that the simple model previously developed and be employed in the synthesis of an LQR controller. Finally, the study considers the stimulation of the trunk extensors as a tool for pressure sore prevention. This is a novel FES application, potentially more practical than the stimulation of the gluteal or quadriceps muscles, proposed by other authors. The experimental study described in this thesis shows that the stimulation of the trunk extensors can be used to induce a periodic change of the pressure distribution on the buttocks, and hence can potentially be employed as a tool for prevention.
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Tsang, Hiu Tung Hilda. « The molecular pathology of NIPA1 associated hereditary spastic paraplegia ». Thesis, University of Cambridge, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.611474.
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McNamee, J. « Investigating the molecular mechanisms of Hereditary Spastic Paraplegia neuropathies ». Thesis, University of Liverpool, 2018. http://livrepository.liverpool.ac.uk/3019569/.
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Hereditary spastic paraplegia (HSP) was first described in the late 1800s and has since become a term used to describe this relatively large, clinically and genetically diverse group of inherited neurodegenerative or neurodevelopmental disorders. HSPs are characterised by progressive lower limb spasticity and pyramidal weakness, caused by genetic mutations. This defining clinical feature is thought to be due to the progressive, length-dependent neuronal degeneration or axonopathy, which predominantly involves the lateral corticospinal tracts. Although unified by their defining clinical feature, HSPs are some of the most genetically diverse diseases. To date, 78 spastic gait disease-loci (SPG1-78) and 61 corresponding spastic paraplegia genes have been identified, and these are likely to increase further still. A critical step towards unravelling the complex molecular relationships in living systems is the mapping of protein-protein interactions. Proteins with similar functions and cellular localisations tend to cluster together within these networks, with the majority sharing at least one function. Proteins that interact with known disease-causing HSP proteins may in some cases also acquire mutations that contribute to specific HSP-related phenotypes. Therefore, identification of proteins that interact with known HSP proteins, or exist in common molecular complexes, may provide new insight into the molecular mechanisms fundamental to the pathogenesis of this group of disorders. The sequence-verified HSP ORFs generated were used to construct a collection of Y2H HSP bait and prey clones. The ‘traditional’ yeast two-hybrid system was then used to test a number of predicted binary interactions, using high-throughput targeted assays, whilst novel HSP interaction partners were identified using high-throughput library screens. Membrane-associated proteins are one of the most biologically important protein classes, with key roles in various cellular processes including cell signalling, molecular transport, metabolism and cell structure maintenance. However, detection of protein-protein interactions (PPIs) of membrane proteins is challenging, due to their hydrophobic nature and non-nuclear localisation, making them difficult to analyse using conventional interaction detection methods. As there is a significant number of membrane-associated HSP proteins, sequence-verified HSP ORFs were used to generate a collection of membrane yeast two-hybrid (MYTH) HSP bait clones. The MYTH system was used to investigate potentially novel interaction profiles for each of the membrane-associated HSP bait constructs, using the optimised high-throughput MYTH library screen approach. In total, 365 novel binary HSP interactions were identified in this study, increasing the complexity of the HSP interactome. This high-density, comprehensive HSP interactome can be used to inform future hypothesis-driven research, looking at the physiological mechanisms and functional relevance of these interactions, providing a greater understanding of the pathogenic mechanisms of HSP, as well as for the development of new strategies for therapeutic intervention.
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Azevedo, Eliza Regina Ferreira Braga Machado de. « Análise cinética e cinemática da marcha de indivíduos paraplégicos com e sem órtese de pé e tornozelo (AFO) ». [s.n.], 2011. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313761.
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Orientador: Alberto Cliquet JúniorDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A lesão medular tem como consequência a perda da mobilidade e sensibilidade abaixo do nível da lesão, gerando, portanto, a impossibilidade de andar. Essa perda de movimentos traz inúmeras consequências aos pacientes lesados medulares como osteoporose, atrofia muscular, espasticidade, infecções urinárias de repetição entre outras. E muitas destas consequências podem ser minimizadas com o treinamento de marcha realizado com a utilização de estimulação elétrica neuromuscular (EENM). Dessa forma, o objetivo da pesquisa foi descrever a marcha de paraplégicos completos utilizando EENM e avaliar os efeitos da ankle foot orthoses (AFO) do tipo rígida na marcha destes indivíduos. Dezesseis indivíduos, sendo dez participantes controle e seis paraplégicos completos realizaram avaliação cinética e cinemática da marcha com e sem AFO. Ambos os grupos realizaram as avaliações em duas etapas: com AFO e sem AFO. Sendo que o grupo de pacientes realizou a marcha sempre utilizando EENM nos músculos quadríceps e no nervo fibular. Foi utilizado sempre o mesmo calcado durante os testes. Foram utilizados como parâmetros espaço-temporais a velocidade média (m/s), a cadência (passos/min), o comprimento de passo (m) e a porcentagem da fase de apoio. Todas as variáveis apresentaram diferenças significativas entre grupos e uso ou não da AFO, com exceção da porcentagem da fase de apoio, que apenas apresentou diferença entre os grupos (p<0,001). Entre as variáveis cinemáticas do tornozelo no contato inicial houve diferença entre os grupos (p=0,026), na amplitude de movimento (ADM) no apoio a diferença foi significativa no uso ou não da AFO (p=0,01), entre grupos (p=0,02) e na interação entre os grupos e o uso ou não da AFO (p=0,008), e na ADM no balanço a diferença ocorreu entre o uso e não da AFO (p=0,002) e na interação entre grupos e uso ou não da AFO (p=0,007). As variáveis do joelho que apresentarão valores significativos entre o uso ou não da AFO foram o ângulo no contato inicial (p=0,002), a ADM no apoio (p=0,0001) e a flexão no impulso (p=0,018), entre os grupos a flexão no impulso (p<0,0001) e a máxima flexão no balanço (p<0,001) apresentaram valores significativos. No quadril as diferenças significativas ocorreram apenas entre os grupos para o contato inicial (p<0,0001), máxima extensão no apoio (p=0,002), a extensão no impulso (p=0,005) e a máxima flexão no balanço (p=0,001). Nas variáveis cinéticas do tornozelo foram avaliados o momento no choque de calcanhar e momento máximo flexor plantar, ambos apresentaram valores significativos entre grupos (p=0,012 e p=0,014) e apenas o momento no choque de calcanhar apresentou diferença entre o uso ou não da AFO (p=0,015). No joelho e quadril foram avaliados os momentos máximos flexor e extensor. Sendo que no joelho apenas o máximo momento extensor apresentou diferença entre os grupos (p=0,0002). No quadril os valores de momento flexor máximo foram significativos entre grupos (p<0,0001). Os resultados espaço-temporais sugerem que a marcha com AFO é mais eficaz para os paraplégicos completos. Além disso, a AFO promoveu uma maior proteção ao joelho do desses indivíduos e permitiu uma maior descarga mecânica no quadril podendo assim, prevenir a perda de massa óssea
Abstract: The spinal cord injury leads to the loss of mobility and sensibility below the injury level, causing the inability to walk. This loss of movement causes consequences for spinal cord injured patients such as osteoporosis, muscle atrophy, spasticity, repetitive urinary infections and others. Many of these consequences can be minimized by gait training with neuromuscular electrical stimulation (NMES). Thus, the objective of the research was to describe paraplegic gait with NMES and assess the influence of rigid AFO on these individuals gait. Sixteen individuals, ten control participants and six complete paraplegics went through kinetics and kinematics gait evaluation with and without AFO. The patients group performed the gait using NMES in quadriceps muscles and peroneal nerve. Both groups used the same shoes during the tests. Spatiotemporal variables assessed were velocity (m/s), cadence (steps per minute), step length (m) and percentage of stance time. All variables except for the percentage of stance time showed significant differences between groups and with and without AFO. In ankle joint kinematics, the initial contact was different between groups (p=0,026), range of motion (ROM) in stance was significant difference with and without AFO (p=0,01), between groups (p=0,02) and in the interaction between groups and with and without AFO (p=0,008), ROM in balance was different between with and without AFO (p=0,002) and in the interaction between groups and with and without AFO (p=0,007). The knee kinematics displayed significant changes between with and without AFO in initial contact (p=0,002), ROM in stance (p=0,0001) and flexion at toe-off (p=0,018), between groups difference was noted in flexion at toe-off (p<0,0001) and maximum flexion in balance (p<0,0001). The hip significant differences were only observed between groups in initial contact (p<0,0001), maximum extension in balance (p=0,002), extension at toe-off (p=0,005) and in maximum flexion in balance (p=0,001). Ankle joint kinetic variables assessed were the moment at load response and maximum plantar flexor moment, both displayed significant changes between groups (p=0,012 and p=0,014), only the moment at load response was different between with and without AFO (p=0,015). Knee and hip were assessed maximum flexor and extensor moments. Only the maximum knee extensor moment was significant different between groups (p=0,0002). Hip flexor moment values were significant between groups (p<0,0001). The spatiotemporal results suggest that the gait with AFO is more effective for complete paraplegics individuals. Furthermore, the AFO allowed a greater knee protection to these individuals and also yielded a higher mechanical loading on the hip, which can prevent the loss bone mass
Mestrado
Fisiopatologia Cirúrgica
Mestre em Ciências
25
Wilkinson, P. « A clinical, genetic and biochemical study of hereditary spastic paraplegia ». Thesis, University College London (University of London), 2007. http://discovery.ucl.ac.uk/1445184/.
Texte intégralRésumé :
The hereditary spastic paraplegias (HSPs) represent a clinically and genetically heterogeneous group of neurological disorders. The phenotype is classified as pure or uncomplicated when the spastic paraparesis occurs in isolation and complicated when there are significant additional neurological or other clinical features. Inheritance may be autosomal dominant, autosomal recessive or X-linked. Twenty families from the UK were identified with autosomal recessive HSP. Clinical analysis of affected individuals demonstrated a variety of different phenotypes with a slight preponderance of complicated cases. Genetic linkage analysis in the largest of these families identified linkage to the previously described SPG5A locus with a maximum LOD score of 4.84. Marker saturation analysis subsequently refined the locus to a 23.6cM region on chromosome 8q. In 6 of the remaining families linkage to the SPG7 locus could not be excluded. An affected individual from each of these families and 29 sporadic HSP cases were subsequently screened for SPG7 gene mutations using a combination of SSCP and sequencing. Three sporadic patients were found to have compound heterozygous SPG7 mutations, five of which were novel and one that had been described previously. Muscle biopsies in two of the patients with SPG7 mutations failed to demonstrate histological evidence of oxidative phophorylation defects but did reveal mitochondrial respiratory chain complex I-III defects in muscle and complex I deficiency in cultured myoblasts. A similar combination of SSCP and sequencing was used to screen a group of 12 families with early onset autosomal dominant HSP for SPG3A gene mutations. Only the previously reported R239C mutation was identified in one family suggesting that SPG3A mutations are relatively uncommon in this population. Genome wide linkage analysis in a consanguineous Bedouin family from Kuwait with a complicated HSP phenotype including cognitive impairment, dysarthria and distal amyotrophy identified linkage to a 22.8cM interval on chromosome 12 with a maximum LOD score of 5.1. No coding sequence mutations were identied in the KIF5A gene, associated with pure autosomal dominant HSP, located within this region. This interval has therefore been proposed as a novel locus for complicated autosomal recessive HSP (SPG26).
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Davoodi, Rahman. « Modeling and control of FES assisted standing-up in paraplegia ». Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape8/PQDD_0005/NQ39521.pdf.
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Hussain, Zakaria. « Intelligent Control Techniques for FES-Assisted Paraplegic Indoor Rowing Exercise ». Thesis, University of Sheffield, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.521966.
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Jaime, Ralf-Peter. « On the control of paraplegic standing using functional electrical stimulation ». Thesis, University of Glasgow, 2002. http://theses.gla.ac.uk/1591/.
Texte intégralRésumé :
This thesis is concerned with the restoration of upright standing after spinal cord injury (SCI) by the means of Functional Electrical Stimulation. In particular, the work presented in this thesis is concerned with unsupported standing, i.e. standing without any support by the arms for stabilisation. Firstly, the experimental apparatus and feedback control approach is described. Secondly, the experimental work is divided into three parts. The motivation, experimental setup and procedure as well as results and conclusions are given for each of them. The feasibility of the investigated approach was usually tested on a neurologically intact subject. The results were subsequently confirmed with a paraplegic subject. First the feasibility and fundamental limitations of unsupported standing were investigated. Assuming the subject as a single-link inverted pendulum, an improved fully dynamic control approach was employed in the first step, confirming existing results. Here, the voluntary influence by the central nervous system was minimised. However, it is naturally desirable to take advantage of the residual sensory-motor abilities of the paraplegic subject to ease the task of stabilising the body. Ankle stiffness control has been proposed in the literature to accomplish this task. Hitherto, ankle stiffness was provided by artificial actuators. In the second part we investigated the feasibility and limitations of ankle stiffness control by means of FES. The same single-link approach was employed as above. Ankle stiffness control by FES was used in the third part to enable paraplegic standing. Here, the subject was required to participate actively in the task of stable standing and, while doing so, behaving like a double-link inverted pendulum. It could be shown that FES-controlled ankle stiffness contributed crucially to the subject's ability to stand. The thesis concludes with propositions for future work.
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Bingley, Megan. « Characterisation of Spastin function in relation to hereditary spastic paraplegia ». Thesis, University of Sheffield, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.440916.
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Ulengin, Idil. « Atlastin Mediated Endoplasmic Reticulum Network Formation In Hereditary Spastic Paraplegia ». Research Showcase @ CMU, 2015. http://repository.cmu.edu/dissertations/576.
Texte intégralRésumé :
The endoplasmic reticulum is an extensive multifunctional membrane bound organelle present in all eukaryotic cells. It houses a wide array of essential processes including protein and lipid synthesis, drug detoxification and regulation of intracellular Ca+2 . This very large organelle is organized into morphologically distinct subdomains, presumably to maximize the efficiency of each of its many functions. Yet the ER is interconnected at hundreds of branchpoints. maintaining both luminal and membrane continuity. Despite its complex structure, the ER undergoes continuous membrane remodeling, which may enable it to adopt to environmental changes. Due to their extreme polarity and the long distances that need to be traversed by cellular constituents, neurons may rely more heavily than other cell types on the proper structure, function and dynamics of organelles such as the ER. In support of this idea, a number of neurological disorders are linked to mutations in genes whose products are proposed to structure the ER. In particular, mutations in the neuronal isoform of atlastin (ATL), a conserved dynamin-related GTPase implicated in homotypic ER membrane fusion and ER network formation, cause a motor neurological disorder called Hereditary Spastic Paraplegia (HSP). Determining the role of ATLs in ER morphology has obvious implications in the context of the neurodegeneration seen in Hereditary Spastic Paraplegia patients. To this end, in my thesis I worked on three projects. One focused on testing the hypothesis that disease mutations cause HSP because they disrupt neuronal ATL-1’s fusion-dependent ER structuring function. Using a cell-based assay for ATL-mediated ER network formation, I showed that neuronal ATL-1 can fully restore a branched ER network in HeLa cells depleted of endogenous ATL, and yet surprisingly, not all the disease mutations disrupt ER morphology. Furthermore, at least two disease variants, including that most commonly identified in patients, displayed wild type levels of activity in all assays, including a biochemical assay for membrane fusion. The second project tested the role of an N-terminal extension of ATL-1 that is highly conserved across vertebrate species. My results indicated that this extension was dispensable for ER structuring at least in non-neuronal cells. Therefore, the significant conservation observed within this region may reflect a regulatory role specific to neurons, an idea that remains to be tested. Lastly, I collaborated with James McNew and his group to investigate the precise role of the cytoplasmic C-terminal tail of ATL. Together we showed that the C-terminal tail is important for both the fusion and ER network formation functions of ATL. And yet in the context of less stable lipid bilayers, the requirement for the C-terminal tail during fusion was alleviated. Altogether, my findings reveal a discrepancy with the hypothesis that disease mutations disrupt ER morphology and highlight a gap in the understanding of the cause of ATL-1 linked SPG3A. The apparent lack of a requirement for a highly conserved N-terminal extension, as well as residues implicated in HSP, is surprising. It suggests that the ER in neurons might rely on a neuron specific factor that binds and regulates the fusion. Alternatively, ATL-1 may mediate an additional (non-ER fusion) function specific to neurons. Overall, my investigation reveals that there is more to be understood in terms of precise role (s) and regulation of ATL a well as the basis of SPG3A pathogenesis.
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ALVES, Silvia Rodrigues Cavalcanti. « Sentidos produzidos sobre a sexualidade por mulheres com paraplegia congênita ». Universidade Federal de Pernambuco, 2014. https://repositorio.ufpe.br/handle/123456789/10928.
Texte intégralRésumé :
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As pessoas com deficiência e as mulheres compõem grupos minoritários que historicamente foram alvo de discriminação. Dessa forma, quando a questão das pessoas com deficiência é somado à questão do gênero, essas sofrem uma dupla marginalização devido aos preconceitos sexuais e pelas dificuldades causadas pela deficiência, que ainda carrega um estigma social que se reflete em vários âmbitos da vida e, logo, também no plano da sexualidade. Assim, as pessoas com deficiência tendem a ser consideradas como homogêneas assexuadas. A falta de informação acerca da sexualidade de tais pessoas alimenta a crença de que deficiência e sexualidade são incompatíveis, sendo forte a ideia de que a pessoa com deficiência não vivencia sua sexualidade, principalmente, quando essa deficiência é a paraplegia, por envolver os membros inferiores (onde se localiza os órgãos genitais). Entretanto, há muito que se desconstruir sobre tais concepções, primeiramente, porque a sexualidade não se resume ao ato sexual nem se localiza unicamente nos órgãos sexuais. Além disso, não há nenhuma evidência que relacione a paraplegia (ou qualquer outro tipo de deficiência) à falta de desejo sexual. Percebe-se que há uma escassez de estudos que abordem conjuntamente as questões do gênero e da sexualidade das pessoas com deficiência, assim, a presente pesquisa volta-se para a constituição da subjetividade de mulheres com paraplegia congênita no que se refere aos sentidos construídos por elas sobre a sexualidade. Segundo Bock, Furtado e Teixeira (1996), a subjetividade é o mundo das ideias e das significações construídas internamente pelo sujeito a partir de sua constituição biológica, suas relações sociais e suas vivências. É importante ressaltar que gênero e sexualidade serão entendidos como construções sociais, visto que através desses conceitos se definem regras de comportamento para os indivíduos. Ademais, a sexualidade será compreendida como forma de ser, sentir e viver, composta por sentimentos, ações e pensamentos, algo descentralizado dos órgãos genitais (Louro, 2003). Considerar outros aspectos na discussão sobre a deficiência proporciona novas compreensões para o estudo do problema. Assim, o presente estudo teve como objetivo principal: Apreender os sentidos produzidos sobre a sexualidade por mulheres com paraplegia congênita. Para tanto, definiu-se os seguintes objetivos específicos: (i) analisar o discurso de tais mulheres sobre a vivência da própria sexualidade; (ii) identificar como as relações de gênero revelam-se no discurso dessas mulheres sobre o sentido atribuído à própria sexualidade. A presente pesquisa utilizou a abordagem qualitativa e participaram 3 (três) mulheres com paraplegia congênita. Para a coleta de dados foi utilizada a técnica do depoimento pessoal e a análise dos dados procedeu-se a partir da proposta dos “núcleos de significação” sistematizado por Aguiar e Ozella (2006). Os resultados mostraram que as participantes não se enxergam como pessoas incapazes de manter relações amorosas e compreendem que a deficiência não representa um impedimento para a vivência da sexualidade. Apesar dos tabus de gênero ainda constituir os sentidos atribuídos à própria sexualidade, é possível perceber que as participantes se mostram no processo de ressignificação de tais concepções.
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Belassian, Gaël André Jean-Marie. « Spécificités de l'angiopathie obstructive des membres inférieurs chez le blessé médullaire aspects sémiologiques, physiopathologiques et thérapeutiques / ». [S.l] : [s.n], 2004. http://www.scd.uhp-nancy.fr/docnum/SCDMED_T_2004_BELASSIAN_GAEL.pdf.
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Meijer, Inge A. « Genetic analysis of the hereditary spastic paraplegias ». Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=102811.
Texte intégralRésumé :
The Hereditary Spastic Paraplegias (HSP) comprise a group of neurodegenerative diseases characterized by progressive lower limb spasticity. This disease, with a prevalence ranging from 1 to 20 in 100,000 individuals, is currently untreatable. The neuropathological hallmark is axonal degeneration of motor neurons in the corticospinal tract. However, the mechanisms of pathogenesis underlying this neurodegeneration remain poorly understood. Over the last decade, genetic studies of HSP have identified 33 loci including 14 genes. The main objective of this dissertation was to identify and characterize genes in a large North American HSP cohort. Mutation analysis of the two most common genes implicated in HSP, SPG3 and SPG4, led to the detection of nine novel mutations, including an ancestral SPG4 mutation in five French Canadian families. This screen also allowed for the molecular characterization of the p.del436N mutation in SPG3, which suggests a previously unidentified dominant-negative mechanism. Furthermore, a novel deletion in the VPS9 domain of the ALS2 gene was identified in a family with severe infantile onset HSP. In addition, linkage analysis and whole genome scan efforts resulted in the successful mapping of two novel HSP loci, SPG27 and SAX1. SAX1 represents the first locus for autosomal dominant spastic ataxia, a complicated form of HSP, with a common ancestor in Newfoundland. Finally, a positional candidate gene strategy at the SPG8 locus identified three missense mutations in a novel gene encoding strumpellin. Two mutations failed to rescue an axonal phenotype induced by morpholino knock-down of the SPG8 gene in zebrafish. Our efforts to identify and characterize HSP genes determined the underlying genetic cause in 36% of our cohort. These genetic causes include two novel loci and a novel gene. The findings are a major contribution to the characterization of the pathophysiology of HSP and significantly broaden the knowledge in the field of motor neuron disease. Analysis of the 15 known HSP genes suggests a common disease mechanism involving disrupted axonal membrane protein trafficking. Unraveling this mechanism will elucidate the functional maintenance of neurons in the corticospinal tract and will facilitate the development of therapies for HSP and related diseases.
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Medina, Giovanna Ignácio Subirá 1981. « Avaliação clínica e radiográfica do ombro de pacientes lesados medulares em programa de reabilitação ». [s.n.], 2011. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313750.
Texte intégralRésumé :
Orientador: Alberto Cliquet JuniorDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A lesão da medula espinhal é uma afecção incapacitante e que é acompanhada de inúmeras complicações diretas e indiretas. No Brasil, ocorrem cerca de 6 a 8 mil novos casos por ano de LME e, desde o momento do trauma, os pacientes lesados medulares necessitam de cuidados direcionados que devem persistir mesmo após passados anos da lesão. A dor no ombro é o processo doloroso mais comum entre os pacientes com lesão medular que se queixam de dor nos membros superiores perfazendo 71% do total. Este é um estudo clínico e radiográfico que avaliou o ombro de pacientes tetraplégicos e paraplégicos que estavam em programa de reabilitação no Laboratório de Biomecânica e Reabilitação do Aparelho locomotor do Hospital das Clínicas da Faculdade de Ciências Médicas da Universidade Estadual de Campinas (UNICAMP). Os objetivos foram estabelecer a utilidade da radiografia como exame de triagem para dor no ombro de pacientes lesados medulares. Trinta e dois ombros de 16 pacientes foram avaliados clinica e radiograficamente. Os pacientes foram divididos em 2 grupos: paraplégicos e tetraplégicos. Um grupo controle de 16 indivíduos normais, voluntários, foi selecionado. Dor no ombro foi encontrada em 89% dos tetraplégicos e em 43% dos paraplégicos. O tempo desde a lesão variou de 1.5-22 anos (média 7.88 anos); a média de idade dos pacientes foi de 35 anos (variou de 21-57 anos). A medida da articulação acromioclavicular variou de 0.03-0.7cm para o lado direito e 0.15-0.7cm para o lado esquerdo, com média de 0.37cm e 0.41cm respectivamente. Não foi encontrada correlação alguma entre dor no ombro e sexo, idade ou tempo da lesão. Houve uma tendência a correlação entre dor no ombro e tipo de lesão, com tendência dos tetraplégicos em apresentar sintomas dolorosos. Na média, os tetraplégicos apresentaram menores medidas da articulação acromioclavicular. Com os dados deste estudo, não houve confirmação da hipótese de que achados radiográficos pudessem indicar risco de desenvolver dor no ombro em pacientes lesados medulares
Abstract: Spinal Cord injury is a very disabling condition that has many direct and indirect complications. In Brazil, there are around 6 to 8 thousand new cases each year and the patients need specific care from the moment of the lesion even through years after the SCI. Shoulder pain is the most common painful process among SCI patients that complaint of pain in the upper extremities, representing 71% of the total. This was a clinical and radiographic study which evaluated the shoulders of tetraplegic and paraplegic patients who attend the rehabilitation program of the Biomechanics and Locomotor-System Rehabilitation Laboratory of the University Hospital of the Faculty of Medical Sciences of the State University of Campinas (UNICAMP). The objective was to establish the usefulness of radiography as a screening exam for shoulder pain in spinal cord injured patients. Thirty two shoulders of sixteen patients were evaluated by clinical exam and radiography. Patients were divided into two groups: paraplegic and tetraplegic. A control group of 16 normal volunteer subjects was selected. Shoulder pain was reported in 89% of tetraplegic and 43% of paraplegic. The time of injury ranged from 1.5 - 22 years (mean 7.88 years); patients had a mean age of 35 years (range, 21-57 years). The acromioclavicular joint space ranged from 0.03-0.7cm on the right side and 0.15-0.7cm on the left side, with a mean of 0.37 and 0.41cm respectively. No correlation was found between shoulder pain and gender, age or time since injury. There was a trend to correlation between shoulder pain and type of injury with tetraplegic having a tendency to pain symptoms. On average, tetraplegic had smaller acromioclavicular joint. With this study we were not able to confirm the hypothesis that radiography could be used to predict risk factor for developing shoulder pain among SCI patients
Mestrado
Fisiopatologia Cirúrgica
Mestre em Ciências
35
Cavaçana, Natale. « Estudo genético-molecular de pacientes discordantes de Paraplegia Espástica Hereditária do tipo 4 ». Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/41/41131/tde-06032015-093012/.
Texte intégralRésumé :
As doenças neuromusculares incluem um grupo muito heterogêneo de patologias que atingem 1 em cada 1.000 indivíduos nascidos vivos. Dentre as doenças neuromusculares destacam-se as paraplegias espásticas hereditárias que acometem, aproximadamente, cerca de 1 em cada 10.000. As paraplegias espásticas hereditárias (PEH) são caracterizadas pela espasticidade e fraqueza muscular dos membros inferiores. São muito heterogêneas tanto em clínica como geneticamente. Diversas formas já foram descritas e a mais comum delas, acometendo por volta de 40% dos casos autossômicos dominantes, causada por mutações no gene SPAST (PEH do tipo 4 ou SPG4). Estudos de correlação genótipo: fenótipo têm mostrado que indivíduos da mesma família carregando a mesma mutação patogênica, podem ter quadro clínico muito distinto. A explicação para esta questão pode estar na procura por genes modificadores, no padrão de expressão, na análise proteômica (seja por ligantes a proteínas ou no dobramento das mesmas), ou em mecanismos epigenéticos. Além disso, em algumas formas observa-se uma diferença na porcentagem de pessoas afetadas de acordo com o sexo. Essa desproporção foi observada numa grande família de com PEH na qual existe um predomínio de afetados do sexo masculino. O objetivo do presente trabalho foi a análise de pacientes discordantes, ou seja, que possuam a mesma mutação, porém com quadro clínico discordante de uma grande família brasileira com SGP4. Para isso foi feito um estudo da abundância de transcritos (mRNA) e de genótipo (polimorfismos de base única) em relação a um fenótipo (sintomático ou assintomático). Os resultados sugerem que o principal sistema envolvido, que poderia explicar as diferenças entre os pacientes discordantes, é o sistema imune, com a principal atuação dos genes C2, HLA-DRB1 e LY6G6C. Esses genes podem ter papel protetor ou tóxico no desenvolvimento do quadro clínico dos pacientes analisadosThe hereditary spastic paraplegia (HSP) is characterized by muscle weakness and lower limb spasticity. They are very heterogeneous both clinically and genetically. Several forms have been described and the most common one, affecting around 40% of autosomal dominant cases, is caused by mutations in the SPAST gene (HSP type 4 or SPG4). Genotype: phenotype correlation studies have shown that affected individuals from the same family, who carry the same pathogenic mutation, can have very distinct phenotypes. The underlying explanation behind this clinical heterogeneity may be found in the search for modifier genes, in expression patterns observed proteomic analyses (either by protein binding or folding), or epigenetic mechanisms. As is observed in other motor neurodisease, there is a disproportion between the number of affected males and females, with males being the predominantly affected. The objective of this study was to analyze discordant patients, i.e., those that possess the same mutation, but show discordant phenotypes, from a large Brazilian family with SGP4. For this study, the abundance of transcripts (mRNA) and genotype (single nucleotide polymorphisms) relative to a phenotype (symptomatic or asymptomatic) were analyzed. The results suggest that the main system involved, which could explain the differences between discordant patients, is the immune system, with the main activity of C2, LY6G6C and HLA-DRB1 genes. These genes may have a protective or toxic role in the development of the analyzed patients\' clinical features
36
Kennedy, Paul. « Psychological aspects of spinal cord injury : behavioural approaches, emotional impact and coping strategies ». Thesis, University of Ulster, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.339313.
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KHODOR, MOUNZER. « Les paraplegies sequellaires d'un accident de decompression : a propos d'une observation chez un plongeur libanais ». Reims, 1990. http://www.theses.fr/1990REIMM058.
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CHENON, FRANCK. « Grossesse chez la tetraplegique et la paraplegique haute : a propos de huit cas ». Angers, 1994. http://www.theses.fr/1994ANGE1066.
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GUILLAUME, FREDERIC. « La syringomyelie post-traumatique : revue de la litterature internationale a propos de 5 observations ». Lyon 1, 1989. http://www.theses.fr/1989LYO1M043.
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TSAKANIAS, IFRAH JUDITH. « Effets de la distension du rectum sur le comportement vesico-spincterien du paraplegique central ». Montpellier 1, 1993. http://www.theses.fr/1993MON11002.
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Loscos, Monique. « Les lesions nerveuses peripheriques associees aux blessures medullaires : a propos de 22 cas d'une serie de 999 blesses medullaires suivis a l'hopital henry gabrielle entre 1969 et 1981 ». Lyon 1, 1988. http://www.theses.fr/1988LYO1M469.
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TOSELLI, DANIELLE. « Pratique de la plongee sub-aquatique en scaphandre autonome par les handicapes paraplegiques ». Aix-Marseille 2, 1992. http://www.theses.fr/1992AIX20118.
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Lau, En-Lieng. « Molecular analysis of the autosomal dominant spastic paraplegia type IV (SPG4) ». [S.l.] : [s.n.], 2001. http://deposit.ddb.de/cgi-bin/dokserv?idn=962848255.
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Kagawa, Takahiro, et Yoji Uno. « Gait pattern generation for a power-assist device of paraplegic gait ». IEEE, 2009. http://hdl.handle.net/2237/13886.
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Wester, Gry. « Distributive justice and the disabled, reflections on Ronald Dworkin's paraplegic case ». Thesis, University College London (University of London), 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.498493.
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Rochester, Lynn. « The influence of electrical stimulation on skeletal muscle in paraplegic subjects ». Thesis, University of Newcastle Upon Tyne, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.303382.
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Crosbie, W. John. « Biomechanical analysis of walking aid use in paraplegia and rheumatoid arthritis ». Thesis, University of Strathclyde, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.304898.
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Errico, Alessia. « Functional characterization of spastin and its role in hereditary spastic paraplegia ». Thesis, Open University, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.402841.
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Jailani, Rozita. « Analysis and control of FES-assisted paraplegic walking with wheel walker ». Thesis, University of Sheffield, 2011. http://etheses.whiterose.ac.uk/14989/.
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The number of people with spinal cord injury (SCI) is increasing every year and walking has been found to be the most exciting and important prospect to these patients to improve their quality of life. Many individuals with incomplete SCI have the potential to walk and everyone of them wants to try. Unfortunately up to now, there is less than one third of patients could walk again after SCI. Residual function, the orthotic support, energy expenditure, patient motivation and control technique are some of the factors that influence the walking outcome of spinal cord injured people. In this thesis, a series of studies are carried out to investigate the possibility of enhancing the performance of the functional electrical stimulation (PES) assisted paraplegic walking with wheel walker through the development and implementation of intelligent control technique and spring brake orthosis (SBO) with full utilization of the voluntary upper body effort. The main aim of this thesis is to enable individuals with complete paraplegia to walk again with maximum performance and the simplest approach as possible. Firstly, before simulation of the system can be made, it is important to select the right model to represent the actual plant. In this thesis, the development of a humanoid and wheel walker models are carried out using MSC.visualNastran4D (vN4D) software and this is integrated with Matlab Simulink® for simulation. The newly developed quadriceps and hamstrings muscle models from the series of experiments are used to represent subject muscles after comparison and validation with other two well-known muscle models are performed. Several experiments are conducted to investigate the effect of stimulation frequency and pulse-width in intermittent stimulation with isometric measurement from paraplegic subjects. The results from this work can serve as a guidance to determine the optimum stimulation parameters such as frequency and pulse-width to reduce muscle fatigue during PES application. The ability test is introduced to determine the maximum leg force that can be applied to the specific paraplegic subject during FES functional task with minimum chance of spasm and leg injury. Investigations are carried out on the control techniques implemented for FES walking with wheel walker. PID control and fuzzy logic control (FLC) are used to regulate the electrical stimulation required by the quadriceps and hamstrings muscles in order to perform the FES walking manoeuvre according to predefined walking trajectory. The body weight transfer is introduced to increase the efficiency of FES walking performance. The effectiveness of body weight transfer and control strategy to enhance the performance of FES walking and reduce stimulation pulses required is examined. Investigations are carried out on the effectiveness of spring brake orthosis (SBO) for FES assisted paraplegic walking with wheel walker. A new concept in hybrid orthotics provides solutions to the problems that affect current 'hybrid orthosis, including knee and hip flexion without relying on the withdrawal reflex or a powered actuator and foot-ground clearance without extra upper body effort. The use of SBO can also eliminate electrical stimulation pulses required by the hamstrings muscle for the same FES walking system. Further improvement of the FES walking system is achieved by introducing finite state control (FSC) to control the switching time between springs, brakes and electrical stimulation during FES assisted walking with wheel walker with the combInation of FLC to regulate the electrical stimulation required for the knee extension. The results show that FSC can be used to accurately control the switching time and improve the system robustness and stability.
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Bueno, Marly Machado Bento. « O CORPO COM PARAPLEGIA E TETRAPLEGIA ADQUIRIDA : UM ESTUDO SOBRE SEXUALIDADE ». Pontifícia Universidade Católica de Goiás, 2010. http://localhost:8080/tede/handle/tede/2163.
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Previous issue date: 2010-12-17The object of study of this report is the sexuality of men and women with acquired paraplegia and quadriplegia, who are members of the Association of People with Disabilities of the State of Goiás (Adfego). Its main purpose is to understand the social impacts of disabilities in their lives, and also to analyze how the rehabilitation process is and how are the challenges they face to survive with a new body. The research has a qualitative dimension, focusing on oral history, and it demonstrates possibilities of reflection in the scope of Social Service. According to Puhlmann (2000), human sexuality is still a theme full of myths and prejudices, and talking about sexuality means broaching power, prejudice, body interdiction, desire, passion, pleasure, life, death, control, gender, sin and the building of sexual roles. As such, the sexuality of disabled people, real social minorities who passes almost unnoticed by the eyes of society, needs to be rethought due to the segregation and prejudice they face. The number of people with paraplegia and quadriplegia rises day after day in Brazil. The 2000 census showed that 24.5 million Brazilians had some kind of disability, which is about 14.5% of the Brazilian population. Those numbers cannot be ignored. During the interviews, these people related their histories, how they became disabled and how they got to Adfego seeking rehabilitation. This essay is developed in three chapters. The first one indicates the first findings with explanations about the research, towards the data collection tools and the quantitative analysis, the empirical approach that characterizes Adfego, delineating Social Service in the institution and the means used in the research process. The second chapter examines the history of the body, beginning with the platonic vision, the influence of Plato s thought in the Middle Age, debating what was thought about the body at that time and today. Afterwards, it evaluates body and gender, willing a better comprehension of the body of men and women with paraplegia and quadriplegia, as well as their sexuality. The third chapter contemplates the concept of physical disability and sexuality, along with an analysis of the interviews, intending to ponder the challenges that these men and women face to survive after they became disabled.
Este trabalho tem como objeto de estudo a sexualidade de homens e mulheres com paraplegia e tetraplegia adquiridas, integrantes da Associação dos Deficientes Físicos do Estado de Goiás (Adfego), seu objetivo geral consiste em compreender os impactos sociais na vida dessas pessoas, além de analisar como se dá o seu processo de reabilitação e os desafios que enfrentam para sobreviverem com um novo corpo. A pesquisa possui eminentemente uma dimensão qualitativa com enfoque em história oral e apresenta possibilidades de reflexões sobre o tema no âmbito do Serviço Social. De acordo com Puhlmann (2000), a sexualidade humana ainda continua um tema repleto de mitos e preconceitos, e falar de sexualidade significa tratar de repressão, poder, preconceito, interdição do corpo, desejo, paixão, prazer, vida, morte, controle, gênero, pecado, construção de papéis sexuais. Dessa forma, busca-se repensar a sexualidade das pessoas com deficiência física, minorias sociais que permanecem quase invisíveis aos olhos da sociedade, ante a segregação que lhes é imposta, e que são alvo dos mais diversos preconceitos. A cada dia cresce o número de pessoas que adquire paraplegia e tetraplegia no Brasil. O censo 2000 apontou um total de 24,5 milhões de pessoas com algum tipo de deficiência, cerca de 14,5% da população brasileira, números que não podem ser desprezados. Durante as entrevistas, essas pessoas relataram suas histórias de vida, como adquiriram a deficiência física, e como buscaram a Adfego visando sua reabilitação. Esta dissertação está desenvolvida em três capítulos. O primeiro apresenta os apontamentos iniciais com explicações sobre a pesquisa, os instrumentos da coleta de dados e a análise qualitativa, o recorte empírico que caracteriza a Adfego, enfatizando o Serviço Social na instituição e os caminhos percorridos na realização da pesquisa. O segundo capítulo aborda a história do corpo, iniciando com a visão platônica e sua influência na Idade Média e ao longo desses períodos históricos até a contemporaneidade. Em seguida, apresenta uma breve reflexão sobre corpo e gênero, visando melhor compreensão do corpo de homens e mulheres com paraplegia e tetraplegia, bem como suas sexualidades. O terceiro capítulo contempla o conceito de deficiência física e sexualidade além da análise das entrevistas, procurando refletir sobre os desafios que essas pessoas enfrentam após a deficiência.