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1
Heywood, Jane. "Attitudes and beliefs of military physiotherapists and their influence on the management of chronic low back pain in military personnel." Thesis, University of Portsmouth, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.555153.
Повний текст джерелаАнотація:
Aims: This study aims to explore the attitudes and beliefs of military physiotherapists and how these influence the management of military patients presenting with low back pain. The Armed Services require personnel who are physically fit and able to deploy operationally to inhospitable areas, including Afghanistan. Low back pain is a common condition, but within the Armed Services it can lead to medical downgrading, non-deployability and in extreme cases to medical discharge. Methods: The study was a mixed methods study undertaken in two phases. Phase 1 was a quantitative study, which utilised a valid and reliable measure of health care provider's attitudes and beliefs about functional expectations for chronic low back pain patients, the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS). Demographic data was also collected, which included; gender, rank, age range, physiotherapy experience (years), physiotherapy qualification to practice, military service (years), post registration training completed, post registration training being undertaken and self-reported number of patients seen monthly with low back pain. Statistical analysis was undertaken on the results to explore whether a statistically significant correlation existed between questionnaire score and any of the demographic factors identified. Phase 2 was a qualitative study in which semi-structured interviews were undertaken with 16 military physiotherapists. Whilst phase 1 would provide information relating to what beliefs the physiotherapists held Phase 2 would allow exploration of why these attitudes and beliefs prevailed. The transcripts were analysed using a method of thematic content analysis. Results: Results from phase 1 yielded 83 completed questionnaires, a response rate of 91 %. The military physiotherapists obtained a mean score of 50.78 (SD= 10.12) with scores ranging from 29 to 79. Higher scores on the HC-PAIRS indicate a greater acceptance of the notion that LBP is equated with disability. These results indicate the military physiotherapists were neutral to the acceptance of LBP as a legitimate cause of disability among military personnel. The results of non-parametric testing using Spearman's rho indicated a statistically significant correlation at the 0.05 level (2 tailed) between He-PAIRS score and length of military service, indicating an association between higher scores and greater length of military service. Analysis of semi-structured interviews undertaken in phase 2 resulted in the identification of six themes these were; military culture, occupational issues, continuing professional development, clinical reasoning, need for cure and labelling the patient. The importance of understanding the occupational demands on their patients were considered highly significant by all of the military physiotherapists interviewed. However, there appeared generally poor knowledge of the biopsychosocial model in the management of low back pain and over reliance on the medical model. Three quarters (12/16) of the military physiotherapists interviewed expressed frustration in their management of patients with low back pain. Similarly, the military physiotherapists displayed a poor awareness of current evidence based clinical guidelines for the management of low back pain. Conclusions: The results from phase 1 indicated that military physiotherapists, with the greatest length of military service were most likely to accept disability and reduced functional expectations as a consequence of chronic low back pain. In phase 2 the themes, military culture and occupational issues were significant in influencing the military physiotherapist's clinical management. The highly physical and arduous nature of military occupations resulted in investigative procedures being requested at an earlier stage than is recommended in the current evidence- based guidelines. Justification for early investigations was provided on the basis of the unique occupational factors combined with requirement to optimise the number of military personnel able to deploy operationally. The Armed Services are a hierarchal organisation; the structure should be utilised to improve the management of low back pain in military personnel. This would benefit both patients and the Armed Services, by reducing the disability caused by low back pain, whilst increasing number of operationally deployable service personnel.
2
Levy, Nicole. "Exploration of the clinical potential of a new lower limb biofeedback modality for treatment, diagnosis and assessment : a 4 month study." Thesis, University of Strathclyde, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.502288.
Повний текст джерелаАнотація:
Financial constraints are constantly being put upon the rehabilitation team to prove validity of treatment and continuation of therapy (Sheldon R 2004). There are increasing demands for empirical proof of efficacy of treatment. It was thought that this device may provide a means of measurement that would help to show validity of treatment and enhance treatment method. The SmartStep™ device was 5 used to assess all incoming patients in a busy private physiotherapy clinic and the subsequent collected data was analysed. The use of the SmartSep device was compared to not using the SmartStep device and using the SmartStep device with added biofeedback. A total of 24 patients were included in the active part of the trial. Fifteen female patients with an average age of 46.7 years (range 18 - 83 years) and 9 male patients with an average age of 51.2 years (range 17 - 83 years). T tests were used to compare the controlling group with the active groups and to compare if added benefit was achieved by adding biofeedback. Though not statistically viable because of the poor confidence factor, a trend could be seen that showed greater change when the device is added and an even greater change when the biofeedback was added.
3
Stasinopoulos, Dimitrios I. "Cyriax physiotherapy : a supervised exercise programme and Biopton light for the treatment of lateral epicondylitis." Thesis, Leeds Beckett University, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.423827.
Повний текст джерелаАнотація:
Lateral epicondylitis (LE) is one of the most common lesions of the arm. Physiotherapy is a conservative treatment that is usually recommended for LE patients and a wide array of physiotherapy treatments is used. Two of the most common physiotherapy treatments for LE are Cyriax physiotherapy and supervised exercise programmes. More recently physiotherapists are able to use a new modality called polarised polychromatic non-coherent light (Bioptron light) for the management of LE. The clinical value of these treatments for LE is not known. The aim of this project was to investigate the clinical use and clinical effectiveness of Cyriax physiotherapy, a supervised exercise programme and polarised polychromatic non-coherent light (Bioptron light) for the treatment of LE. Systematic review (Chapter 2) found that there was strong evidence for the short-term effectiveness of acupuncture for LE. It also found that there was strong evidence that four physiotherapy modalities, low power laser light, ultrasound, extracorporeal shock wave therapy, and pulsed electromagnetic field therapy were not effective treatments for the management of LE. There was insufficient evidence available for other treatments used for LE, such as iontophoresis and home exercise programmes, to judge their effectiveness. Chapter 2 recommended that more evidence is needed for Cyriax physiotherapy, supervised exercise programmes and polarised polychromatic non-coherent light (Bioptron light). It is necessary to establish optimal protocols for these treatments before a suitable clinical trial can be designed. A critical literature review (Chapter 3) found that treatment protocols for Cyriax physiotherapy, supervised exercise programmes and polarised polychromatic non-coherent light (Bioptron light) were mainly derived from the views of advocates of these treatments, based on their personal experience. Two preliminary clinical studies were conducted to pilot the use of treatment protocols derived from the critical review in Chapter 3 on overuses injuries that were similar to LE and were regularly presented to the clinic (Chapter 4). In the first study (section 4.3) Cyriax physiotherapy did not reduce the pain in patellar tendinopathy, while the supervised exercise programme did. In the second study (section 4.4) polarised polychromatic non-coherent light (Bioptron light) reduced nocturnal pain and paraesthesia in carpal tunnel syndrome (CTS). The findings of these two pilot studies should be interpreted cautiously because the number of patients included in the patellar tendinopathy was small and in the CTS study it was not possible to attribute changes to the light per se because the study lacked a control group. Before the effectiveness of these protocols could be tested, a questionnaire survey was conducted to establish the current clinical practices of these physiotherapy treatments for LE. This survey was based on the self-reporting of chartered physiotherapists in Athens using these treatments in their clinical practice (Chapter 5). It may be confidently assumed that the results of the questionnaire present a representative view of current clinical practice of Cyriax physiotherapy, a supervised exercise programme and polarised polychromatic non-coherent light (Bioptron light) on LE at least as these treatments are applied in Athens. How much this reflects usage in the rest of the Greece, Europe, or even the world, is yet to be seen by extending the research. When the effectiveness of Cyriax physiotherapy, a supervised exercise programme and polarised polychromatic non-coherent light (Bioptron light) for LE was compared, the three treatments reduced pain and improved function at the end of the treatment and at any of the follow-up time points (Chapter 6). Whether this is due to placebo effects is not known. The supervised exercise programme produced the largest effect in the short, intermediate and long term (Chapter 6). This finding suggests that, of the three treatments, the supervised exercise programme should be used as a first treatment option when physiotherapists manage LE patients (Chapter 6; Chapter 7). If this is not possible, Cyriax physiotherapy and polarised polychromatic non-coherent light (Bioptron light) may be suitable (Chapter 6; Chapter 7). Although the three treatments are promising interventions for the management of patients with LE, further research is warranted to investigate and confirm the effectiveness of Cyriax physiotherapy, supervised exercise programmes and polarised polychromatic non-coherent light (Bioptron light) in the treatment of impairment and disability resulting from LE.
4
Thomson, Diane. "An ethnography of physiotherapy practice : a contextual exploration into the social construction of practice." Thesis, University of East Anglia, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.426841.
Повний текст джерелаАнотація:
Background Unpredictability, time constraints and having to constantly adapt to new situations characterise modem physiotherapy practice such that everyday clinical situations can be seen to have no easy and unambiguous solutions. Physiotherapists' practice has not yet been explored in the U.K. and their voices not yet heard, as they cope with increasing workloads in the day to day realities of busy hospital departments and their continuing professional development needs. Methodology and Design An eight months in-depth investigation into a team of NHS physiotherapists' construction of their day to day practice, viewed from a social constructionist stance, was carried out. The chosen paradigm for this study was ethnography as it embraces the importance of context related to time and the person. Analysis and Findings A systematic analysis of coding, categorising and identification of themes was carried out. All observations with the participants were followed up from a reflexive stance in the quest for a co-constituted account. Four main building blocks were identified as major contributors to the construction of the team's practice: the team's relationships with their patients, their negotiation and meaning of their food activities, their use of humour and their response to the visit from the inspectors from the Commission for Health Improvement. The institutional hierarchy and the demand for leadership skills in the senior therapist were the most potent parameters of the team's practice arena. Conclusions Contrasting themes have been presented as a way to explain the everyday world of this team's practice. The senior therapists had to manage the differing requirements of training the juniors alongside their own expectation of excellence. Propositional and craft knowledge have to complement each other more and critical reflexive dialogues are a powerful vehicle to achieve this, but the bi-annual rotations put this potential at risk. Hierarchical stances within a department can 'blur' issues by deflecting the juniors' expertise.
5
Stephenson, Richard Christopher. "Paradigm challenges to physiotherapy practice taking a complexity theory approach." Thesis, University of East Anglia, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.405908.
Повний текст джерела
6
Beery, Otniel. "A comparative study between two leading manual therapy approaches." Thesis, Anglia Ruskin University, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.417182.
Повний текст джерела
7
Tijou, Imogen. "Treatment adherance : the contribution of different mechanisms." Thesis, University of Southampton, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.439376.
Повний текст джерела
8
Waters, Anna Gabriela. "The role of confidence in rehabilitation and the recovery of motor performance." Thesis, Cardiff Metropolitan University, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.421671.
Повний текст джерела
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Griffiths, Stephanie. "Evaluating referral appropriateness in primary care extended scope physiotherapists through the development of referral criteria for rotator cuff tears." Thesis, Manchester Metropolitan University, 2013. http://e-space.mmu.ac.uk/315674/.
Повний текст джерелаАнотація:
Background: The ability of primary care Extended Scope Physiotherapists (ESPs) to refer appropriate patients to secondary care has not been adequately examined. Also referrals for shoulder surgery from secondary care ESPs have been shown to be misdirected in comparison to other specialties. Barriers to referral have not been investigated but the literature suggests that referral criteria may improve appropriate referrals. The high prevalence of rotator cuff disease, its impact on pain and disability, and the lack of agreement between surgeons about when to operate indicate that there is a strong case for the development of surgical referral criteria for rotator cuff tear pathology. Method: The thesis has three stages of study. First a national survey of 99 primary care ESPs was undertaken to determine conversion to surgery rates, barriers to referral and the use of referral criteria. Secondly a national Delphi study with 20 shoulder surgeons was undertaken and surgical referral criteria for rotator cuff tear were developed. Thirdly after development, the criteria were tested on a convenience sample of 9 ESPs using 3 vignette case studies. Results: Primary care ESPs have a mean conversion rate of 74%. There was not enough data to show differences between subspecialist groups. Most barriers to specialist referral were associated with commissioning rather than issues pertaining to the primary care environment. 50% of ESPs reported using referral criteria which may explain why barriers to referral were relatively low. Surgical referral criteria for rotator cuff tear were developed. Key areas of consensus were: severity of pain, functional limitation, identification of fat atrophy and agreement for a trial of physiotherapy before referral. When referral criteria were piloted on a surgical candidate 33% of the ESPs changed their referral behaviour appropriately. Conclusion: ESPs in primary care have shown mean conversion rates of 74%. Surgical referral criteria to improve the appropriateness of rotator cuff tear referrals have shown promising results when piloted. Implications: In future referral criteria may have the potential to improve the appropriateness of rotator cuff referrals and may be beneficial as a benchmark against which ESPs can independently demonstrate the appropriateness and quality of the care they provide.
10
Carless, David. "Mental health and physical activity in recovery." Thesis, University of Bristol, 2003. http://hdl.handle.net/1983/261d3734-2195-480d-aef8-64dde3fed29e.
Повний текст джерела
11
Metcalfe, Caroline Jane. "An investigation of patients' expectations of outpatient physiotherapy for peripheral musculoskeletal conditions and their effect on treatment outcome." Thesis, University of Hull, 2003. http://hydra.hull.ac.uk/resources/hull:8473.
Повний текст джерелаАнотація:
Little or no research has been conducted to explore patients' expectations of physiotherapy, or the effect that pre-conceived expectations might have on the outcome of treatment. This thesis aimed to fill that void. Stage one involved a review of the literature to develop a conceptual framework and understanding of expectations and how they may affect outcome. Stage two explored the evidence regarding the role of patients' expectations of physiotherapy and the impact that such expectations may have on the outcome of treatment. Three studies were carried out (1) a Delphi study with physiotherapists; (2) exploratory interviews with patients; and (3) the development and testing of a questionnaire. Stage three examined the relationship between patients' expectations of benefit and the outcome of physiotherapy using a postal survey of patients, with upper or lower limb musculoskeletal problems. Stage four consisted of a randomised-controlled trial aimed at determining whether manipulation of patients' expectations of benefit could influence treatment outcome in patients with non-traumatic knee problems. The results from stage one suggested that patient expectations were likely to be associated with patients' previous experiences of physiotherapy, anecdotal knowledge, preferences, expectation of benefit, time related issues, such as duration of condition (chronicity), educational level and work status. In stage two, the Delphi study with thirteen physiotherapists, resulted in a list of factors, ranked in order of importance, that they believed may influence the outcome of physiotherapy. The list concurred with the literature. Twelve patients were then interviewed. They generally had a positive view of physiotherapy, understood why they needed to have physiotherapy, but had limited knowledge of what physiotherapy is, what physiotherapists do or what level of involvement that they would have in their treatment. Their knowledge came mainly from first-hand or anecdotal experience of physiotherapy. Finally, a questionnaire was developed to gather information on patients' expectations and tested on 18 patients. The survey in stage three (n=289) found statistically significant positive relationships (p<0.002) between expectations of benefit before treatment and trauma, upper limb problems, locus of control and satisfaction with the health care received so far. Furthermore, negative relationships were found between the expectations variable and duration of condition and previous experience of physiotherapy. A statistically significant positive relationship (p<0.004) was also found between expectations of benefit and treatment outcome in terms of change in functional disability, perceived improvement, change in health status and satisfaction. Finally, 95 patients with nontraumatic knee problems participated in the randomised controlled trial in stage four. However, the results found no evidence that the intervention, through changes In expectations or locus of control, improved the outcome of physiotherapy. The research carried out in this thesis appears to support the notion that the characteristics that patients demonstrate in terms of their beliefs, perceptions and cognitions appear to have some influence on the course of their physiotherapy. The findings suggest that physiotherapists need to be more aware of the psychological attributes of their patients as well as the effect that their intervention (communication, handling and therapeutic) has on their patients' beliefs, perceptions and cognitions. However, further research is needed to determine whether, and by what means, patients' expectations can be influenced to improve the outcome of physiotherapy.
12
Henderson, Bernadette. "Experienced cardiorespiratory physiotherapists' understandings of their interactive behaviours with chronically breathless patients." Thesis, University of Brighton, 2011. https://research.brighton.ac.uk/en/studentTheses/a532f5d8-1368-4708-8fed-22d9a3d612fd.
Повний текст джерелаАнотація:
The physiotherapist-patient interaction is the medium through which physiotherapy is practiced. However, to date little physiotherapy research literature reports on physiotherapists' interactive behaviours in clinical practice. The objectives of this study were to explore, interpret and describe experienced cardiorespiratory physiotherapists' understandings of their interactive behaviours when treating chronically breathless patients and to make recommendations for practice. The study is located in the interpretive research paradigm. It has adopted a hermeneutic phenomenological approach underpinned by a relativist ontological stance and Gadamerian philosophy (1975/2004). Five experienced cardiorespiratory physiotherapists' were video recorded in a natural treatment setting with a chronically breathless patient. Data were generated through a video-cued recall and reflection, and a follow-up interview with each physiotherapist. Three themes were derived from the physiotherapists' accounts: 'Creating a facilitative space', 'Accessing and attending to your world' and 'Sharing my world'. These were considered to be key dimensions of physiotherapists' understandings of their interactive behaviours. The concept of 'Merging Worlds - facilitating the journey to a shared understanding and purpose, and safe achievement of purpose' draws together these key dimensions and represents the nature of the interactional behaviours of experienced physiotherapists when managing chronically breathless patients. The challenge of explicating tacit practice knowledge was observed during the process of data generation. This issue was considered alongside the thematic interpretation and the concept of 'Merging Worlds' to inform the development of a new model of physiotherapy practice: Mindful, Reciprocal Interaction. A series of questions to facilitate explication of, and critical reflection on interactive behaviours were developed for use by physiotherapists to enhance their interactive behaviours during encounters with patients. The findings of this study provide new knowledge for physiotherapy practice.
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Houweling, Taco August Wilhelm. "Description of outcomes, patient experiences and related costs of care in low back pain patients undergoing chiropractic treatment in the UK." Thesis, University of Portsmouth, 2013. https://researchportal.port.ac.uk/portal/en/theses/description-of-outcomes-patient-experiences-and-related-costs-of-care-in-low-back-pain-patients-undergoing-chiropractic-treatment-in-the-uk(fc402d9b-0521-4b42-a57b-43ee7f641238).html.
Повний текст джерелаАнотація:
Rationale: The prevalence of low back pain and associated costs to society are high. Despite this, the number of studies investigating observational data on the quality and costs of care in routine health care services, such as chiropractic, is relatively small in comparison to the clinical trial evidence available on the effectiveness and cost-effectiveness of manual therapies for low back pain. Objective: To document the quality and cost of care in low back pain patients undergoing routine chiropractic care in the United Kingdom. Design: Prospective single cohort multi-centre study. Participants: A sample of 120 chiropractors and 421 patients. Methods: Following the development of a data collection instrument and a pilot study, patients suffering from low back pain were recruited by chiropractic clinics in the United Kingdom. Information was recorded using a patient self-report questionnaire at baseline prior to the initial consultation, and participants were mailed a follow-up questionnaire at three months. Health outcomes, patient experiences of the process and safety of care, and related costs in the intervening three month period were documented. Results: Four hundred and twenty-one patients formed the baseline sample, and 238 (57%) of these returned the follow-up questionnaire at three months. Statistically significant change scores (p = 0.0001) were seen for the health status measures including the Roland-Morris Disability Questionnaire, Bournemouth Questionnaire, EuroQol-5D and bothersomeness scale. One hundred and sixty-eight of 238 (70%) patients reported a clinically significant improvement on the Perceived Global Effect scale, and 73 (31%) of these were considered recovered anytime during the study period using definitions of recovery (i.e. acceptable quality of life, no disability and no pain for a whole month). One hundred and twenty-nine (54%) of patients at follow-up rated chiropractic care for their low back condition as ‘very helpful’. The number of patients rating the process of care (i.e. time and explanations given by chiropractor as well involvement in decisions about care) as ‘very good’ ranged from 157 to 168 (66% to 71% respectively of the patients at follow-up). One hundred and twenty-five (52%) of patients at follow-up reported adverse events of care (i.e. worsening of their back pain, stiffness, soreness and/or general discomfort immediately or shortly after the chiropractic treatment visits); however, only 13 (5%) of these reported that they were unable to carry on with their usual activities and/or work as a result of these events. On average, the total cost of care was £481.83 (95% CI = 333.17 to 639.42) per patient. Lost productivity resulting from time away from work was the most important contributor to these costs (59.6%). The cost of chiropractic visits was the second most important contributor, which accounted for nearly one-third of total costs (32.8%). Other health care usage including general practitioner visits, medical procedures and diagnostic imaging were responsible for a small proportion of total costs ranging from 0.4% to 1.6%. Conclusions: This programme of research is the first prospective study conducted in routine chiropractic practice simultaneously documenting information about health outcomes and patient experiences and costs of care. Patients improved markedly within the first three months of care and expressed high satisfaction with the chiropractic treatment and consultation they received. Chiropractic care was relatively safe, with common yet benign adverse events that had little influence on activities of daily living. Taken overall, patients receiving chiropractic care reported improvement at arguably reasonable cost, suggesting this approach to the health care of patients with low back pain be considered in the wider context of health care delivery in the United Kingdom.
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Phillips, Bethan E. "Resistance-exercise training : the effects on muscle function, body composition and risk factors for chronic disease with ageing." Thesis, University of Nottingham, 2012. http://eprints.nottingham.ac.uk/12796/.
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Araújo, Luize Bueno de. "Análise de desenvolvimento neuropsicomotor de crianças de zero a três anos em centros de educação infantil." reponame:Repositório Institucional da UFPR, 2013. http://hdl.handle.net/1884/30434.
Повний текст джерелаАнотація:
Orientadora : Profª. Drª. Vera Lúcia IsraelDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências Biológicas, Programa de Pós-Graduação em Educação Física. Defesa: Curitiba, 11/03/2013
Bibliografia : fls. 78-91
Área de concentração: Exercício e esporte
Resumo: O presente estudo teve como objetivo analisar o desenvolvimento neuropsicomotor de crianças de zero a três anos de idade frequentadoras de Centros de Educação Infantil (CEI's) do Ensino Público e verificar os fatores de risco associados ao desenvolvimento das mesmas. A pesquisa é caracterizada como estudo observacional, analítico, transversal. Participaram do estudo 77 crianças de zero a três anos de idade, matriculadas nos CEI's públicos do Município de Matinhos/PR. A abordagem do desenvolvimento infantil foi contextual, por meio de avaliação fisioterapêutica lúdica com Teste de Triagem de Denver II, também foram realizadas avaliações complementares do estado nutricional, por meio das medidas antropométricas. Para análise foi realizada uma regressão logística utilizando como seleção de modelo Logit com resposta binária e método Stepwise (Backward). O desenvolvimento neuropsicomotor encontrou-se dentro dos parâmetros de normalidade em 68,8% (n=53) e com riscos de atrasos em 31,2% (n=24). Na escala utilizada a área de melhor desempenho foi a motora fina - adaptativa (3,75%) e a mais questionável foi da linguagem (57,5%). Quanto à avaliação nutricional foi acurado que 48% (n=37) das crianças estavam eutróficas e 52% (n=40) apresentaram algum risco nutricional, sendo que 1 criança (1,3%) apresentou desnutrição pregressa, 25 crianças (32,5%) tiveram risco de sobrepeso e 14 crianças (18,2%) apresentaram obesidade. Na análise, pela regressão logística, verificou-se que o baixo peso ao nascer (OR= 181), a renda familiar mensal (OR=9) e a ausência do pai (OR=34) são fatores estatisticamente significantes sobre o risco de atrasos em seu desenvolvimento. Este estudo reforça a natureza sistêmica e multifatorial do desenvolvimento e comprova a necessidade de acompanhamento e monitoramento, especialmente em crianças com condições desfavoráveis, uma vez que a intensa neuroplasticidade nos primeiros anos de vida, a interação entre indivíduo, ambiente e tarefa, bem como a suscetibilidade à estimulação, repercutirão em mudanças no comportamento motor. Nota-se que é preciso um aprofundamento na investigação nos resultados para minimizar o risco de atraso no desenvolvimento neuropsicomotor das crianças participantes, afim de que se tenha uma estimulação adequada no desenvolvimento infantil, tanto na família quanto nas instituições de educação infantil.
Abstract: The present study aimed to analyse the neuropsychomotor development of children aged zero to three years attending the Early Childhood Education Centers (ERC's) of the public education and to check the risk factors associated with the development of the child. The research is characterized as observational, analytical, cross. The study included 77 children aged zero to three years, enrolled in public ERC's of Matinhos/PR. The approach of development was contextual, through playful physical therapy evaluation with Denver Screening Test II, it was also carried out further assessments of nutritional status (anthropometric measures). For analysis it was performed logistic regression using as model selection Logit with binary response and stepwise method (backward). Neuropsychomotor development was found within normal limits in 68.8% (n = 53) and with risks of delays in 31.2% (n = 24). In the used scale, the area with the best performance was the fine motor - Adaptive (3.75%) and the more questionable was language (57.5%). As for nutritional assessment it was ascertained that 48% (n = 37) of the children were normal weight and 52% (n = 40) showed some nutritional risk, and 1 child (1.3%) showed stunted, 25 children (32, 5%) were at risk for overweight and 14 children (18.2%) were obese. In logistic regression analysis it was found that low birth weight (OR = 181), the monthly household income (OR = 9) and the absence of the father (OR = 34) are statistically significant factors on the risk of delays in its development. This study reinforces the systemic and multifactorial nature of development and demonstrates the need for tracking and monitoring, especially in children with unfavorable conditions, since the intense neuroplasticity in early life, the interaction between individual, task and environment, as well as susceptibility to stimulation, reflects on changes in motor behavior. It was noticed that it's necessary a deeper investigation in the results to minimize the risk of neuropsychomotor developmental delay in children, so that an adequate stimulation on children's development may be reached, both in the family and in the educational institutions.
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Sexton, Mary. "Patient-centredness : a conceptual framework for musculoskeletal physiotherapy." Thesis, University of Brighton, 2011. https://research.brighton.ac.uk/en/studentTheses/7b5f1fd2-cfdd-47ba-b05f-f5d4d12d96e1.
Повний текст джерелаАнотація:
Introduction The centrality of the patient to health care has been increasingly recognised both politically and professionally. Patient-centred care has become synonymous with high-quality care and a number of studies have reinforced patient's desire for, and the positive impact of the approach. Although the concept emerged over 30 years ago, it is still not clear what it is, upon what theories it is based, or how to measure it. Whilst the concept has been explored within medicine, nursing and other allied health professions, within physiotherapy there has only been minimal discussion. The aim of this research was to explore the meaning of patient-centred care in relation to low back pain, from the perspective of musculoskeletal physiotherapists. Methods Purposive sampling was initially used to select participants. Subsequently theoretical sampling was adopted whereby analysis of the data informed the sample selection. Nine musculoskeletal physiotherapists agreed to participate in the study. They ranged in experience from five to 25 years. Individual semi- structured interviews were adopted as the method of data collection. The interviews were audio taped and then transcribed verbatim. Analysis broadly followed the Grounded Theory approach outlined by Strauss and Corbin (1990). It consisted of a process of open, axial and selective coding. Constant comparative analysis resulted in the identification with a core category and three inter-related sub-categories and the development of a substantive theory of patient-centred care.
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Пасенко, Марина Володимирівна. "Фізична реабілітація осіб працездатного віку після ампутації нижньої кінцівки на рівні гомілки". Master's thesis, Київ, 2018. https://ela.kpi.ua/handle/123456789/26870.
Повний текст джерелаАнотація:
Магістерська дисертація викладена на 123 сторінках, літературних джерел 53; рис.13, табл. 5., додаток 1.
Проблема фізичної реабілітації осіб працездатного віку, після ампутації нижньої кінцівки на рівні гомілки, визначається значними локомоторними порушеннями, що обмежують людину в пересуванні, самообслуговуванні, порушенні постави, та, як наслідок вираженим обмеженням життєдіяльності. Таким чином, потреба у розроблені новітніх удосконалених підходів до фізичної реабілітації людей на тлі дедалі більшого збільшення відсотка людей з такою проблемою доводить актуальність обраної теми.
Зв’язок роботи з науковими програмами, планами, темами.
Магістерська робота виконана відповідно до плану НДР «Розробка технологій фізичної терапії та технічних засобів її здійснення», Державний реєстраційний номер № 0117 U 002938 кафедри біобезпеки і здоров’я людини НТУУ «КПІ ім. Сікорського»
Мета роботи: розробити та визначити ефективність програми фізичної реабілітації осіб працездатного віку після ампутації нижньої кінцівки на рівні гомілки.
Завдання: За даними літератури вивчити досвід використання програм фізичної реабілітації для осіб працездатного віку після ампутації нижньої кінцівки на рівні гомілки; визначити функціональний стан осіб працездатного віку після ампутації нижньої кінцівки на рівні гомілки; розробити програму фізичної реабілітації для осіб працездатного віку після ампутації нижньої кінцівки на рівні гомілки та перевірити її ефективність.
Об’єкт дослідження: процес фізичної реабілітації осіб працездатного віку після ампутації нижньої кінцівки на рівні гомілки.
Предмет дослідження: зміст та структура програми фізичної реабілітації осіб з ампутацією нижньої кінцівки на рівні гомілки.
Методи дослідження: аналіз науково – методичної літератури та інформаційних джерел; клінічні методи дослідження (контент – аналіз історій хвороби, огляд, анкетування); візуально – аналогова шкала болю, тестування сили м’язів, шкали Ловетта є шестибальний тест для оцінки м’язової сили, анкета SF 36 – оцінка якості життя тест Бханнон; інструментальні методи дослідження (гоніометрія, антропометрія); педагогічні методи дослідження – педагогічні експерименти, спостереження, методи математичної статистики.
Наукова новизна роботи отриманих даних:
- вивчені функціональні особливості кукси у осіб працездатного віку після ампутації нижньої кінцівки на рівні гомілки, що відкрило можливості для розробки програми фізичної реабілітації на ранньому, пізньому післяопераційному та відновлювальному періодах;
- доповнено існуючі програми фізичної реабілітації осіб працездатного віку після ампутації нижньої кінцівки на рівні гомілки, лімфодренажним масажем, кінезіотейпуванням, ортезуванням та холодотерапією;
- підтверджено дані про позитивний вплив запропонованих методів і засобів фізичної реабілітації на осіб після ампутацією нижньої кінцівки на рівні гомілки.
Матеріали, подані у звіті, можуть бути використані в діяльності спеціалізованих лікувальних і реабілітаційних закладів, медичних центрах, фітнес-центрах, на практичних заняттях студентів вищих навчальних закладів з фізичного виховання і спорту, кафедрах фізичної терапії, ерготерапії.
В результаті проведених досліджень показники больових відчуттів на ранньому післяопераційному періоді становили у контрольній групі – = 8,1 бали (S=0,3 бали), в основній – = 8,0 бали (S=0,2 бали), p>0,05 та на пізньому післяопераційному періоді після проведеної програми реабілітації склали в контрольній групі – = 6,3 бали (S=0,3 бали) та значно знизилися в основній групі – = 3,7 бали (S=0,1 бали), p<0,05.
За результатами дослідження було опубліковано 1 стаття та 1 тези. Отримано акт впровадження результатів в практику Актив центр.The master's dissertation is presented on 123 pages, 53 literary sources; 8 Figures, 4 Tables, 1 Annex. The problem of physical rehabilitation of persons of working age, after amputation of the lower limb at the level of the leg, disturbance of posture, reduction of reserve capacity of the organism, tolerance to physical activity and, as a result of the expressed limitation of life. So, the need of developing newest improved approaches to physical rehabilitation of people against the background of an increasing number in the percentage of people with such problem proves the relevance of the chosen topic. Relationship of work with scientific programs, plans, themes. Master's work is performed in accordance with the research plan "Development of technologies of physical therapy and technical funds of their implementation" № 0117 U 002938 of 01.04.2017 of the Department of Biosafety and Health of NTUU "KPI Sikorsky ". Purpose: to develop and determine the effectiveness of the program of physical rehabilitation for persons of working age after amputation of the lower limb at the level of the leg. Objective: study the experience of using physical rehabilitation programs for persons of working age after amputation of the lower limb at the level of the leg according to the literature; determine the functional state of working-age people after amputation of the lower limb at the level of the leg; to develop a program of physical rehabilitation for persons of working age after amputation of the lower limb at the level of the lower leg and check its effectiveness. Object of research: the process of physical rehabilitation of persons of working age after amputation of the lower limb at the level of the leg. Subject of research: the content and structure of the program of physical rehabilitation for persons with lower limb amputation at the level of the leg. Methods of research: analysis of scientific and methodical literature and information sources; clinical research methods (content - analysis of medical records, review, questionnaires); visually - analog scale of pain, muscle strength testing, Lovetta scale - six-point test for muscle strength assessment, SF 36 questionnaire - Bhannon's quality of life test; instrumental research methods (goniometry, anthropometry); pedagogical methods of research - pedagogical experiments, observations, methods of mathematical statistics. Scientific novelty of the received data: - Were studied the functional features of the stump of people of the working age after the amputation of the lower limb at the level of the leg, which opened the possibilities for developing a program of physical rehabilitation in the early, late postoperative and recovery periods; - supplemented existing programs of physical rehabilitation for persons of working age after amputation of the lower limb at the level of the leg, lymph drainage massage, kinesiotherapy, orthosis and cold therapy; - confirmed data on the positive effect of the proposed methods and means of physical rehabilitation for persons after the lower limb amputation at the level of the shin is. The materials presented in the work can be used in the activities of specialized medical and rehabilitation institutions, medical centers, fitness centers, practical classes of students of higher education institutions in physical education and sports, departments of physical therapy, ergotherapy. As a result of the conducted research, the indicators of pain sensation in the early postoperative period were in the control group = 8.1 points (S = 0.3 points), in the main = 8.0 points (S = 0.2 points), p > 0,05 and in the late postoperative period after the rehabilitation program, they were in the control group = 6.3 points (S = 0.3 points) and significantly decreased in the main group = 3.7 points (S = 0.1 points), p > 0,05. According to the results of the study, 1 article and 1 thesis were published. An act of implementation of the results in the "Active Center" practice has been received.
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Hussler, Roland. "Pédagogie somatopsychique et enseignement de la masso-kinéthérapie." Thesis, Strasbourg, 2015. http://www.theses.fr/2015STRAG051/document.
Повний текст джерелаАнотація:
La présente étude a pour objet de questionner le concept de pédagogie somatopsychique en formation initiale de masso-kinésithérapie, d'en explorer les fondements théoriques, de réfléchir à une démarche pédagogique pour la mettre en œuvre et d'interroger les conditions de cette mise en œuvre. Une méthodologie basée sur des enquêtes menées auprès d’étudiants et d’instituts de formation en masso-kinésithérapie sur le territoire français a permis de recueillir des informations sur les conditions optimales de mise en place d’un tel enseignement. Les résultats montrent l’intérêt d’un enseignement structuré qui peut contribuer à développer, dés le début du cursus de formation en masso-kinésithérapie, une posture d’éducateur en santé facilitant in fine l’autonomisation du patient quant à la gestion de sa problématique de santéThis study is designed to question the concept of somatopsychic pedagogy in initial training of physiotherapy, to explore the theoretical foundations, to reflect on a pedagogical approach to implement the strategy and to examine the conditions of this implementation. A methodology based on surveys conducted among students and training institutes in physiotherapy on the French territory allowed to gather information on the optimum conditions for establishment such a teaching. The results show the interest of a structured teaching which can help to develop, in the beginning of the curriculum for training in physiotherapy, a health educator posture facilitating ultimately empowering the patient with respect to the management of his health problem
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Lemaire, Alexandra. "Lombalgies chroniques : évaluation des facteurs mécaniques des membres inférieurs au moyen des relations moment-vitesse." Thesis, Le Mans, 2014. http://www.theses.fr/2014LEMA1024/document.
Повний текст джерелаАнотація:
La lombalgie est un problème de santé public induisant de nombreuses répercussions sur le plan économique et social. Le passage à la chronicité concerne moins de 10% des lombalgies, mais représente 85% des coûts liés à la prise en charge de cette pathologie. Dans ce contexte, il parait indispensable de pouvoir optimiser les programmes de réentrainement à l’effort du lombalgique chronique afin de les rendre le plus efficace et le plus pertinent possible. Ce travail de thèse a pour objectif d’évaluer les facteurs mécaniques des membres inférieurs au moyen des relations moment-vitesse dans des conditions isocinétiques. Dans une première étude, nous avons évalué les muscles extenseurs du genou et les muscles fléchisseurs et extenseurs du tronc chez des sujets lombalgiques et des sujets sains. Nous avons, ainsi mis en évidence une faiblesse significative au niveau de la force et de la puissance des muscles extenseurs du genou chez les sujets lombalgiques associée à la faiblesse musculaire du tronc classiquement évoquée pour cette population. Après avoir mis en place, dans une seconde étude, un protocole d’évaluation permettant d’établir des relations moment- et puissance-vitesse pour les muscles extenseurs et fléchisseurs de la hanche, nous avons évalué la force et la puissance de ces groupes musculaires chez des sujets lombalgiques. Les résultats ont, comme pour la première étude, mis en avant une faiblesse significative au niveau de la force et de la puissance de ces groupes musculaires, par rapport à des sujets sains, avec un déficit plus marqué au niveau des extenseurs, comme pour le tronc. L’ensemble des résultats obtenus dans le cadre de ce travail de thèse démontre qu’il est important de proposer un travail de force et de puissance au niveau des membres inférieurs pour les patients lombalgiques chroniques afin de mieux lutter contre le syndrome de déconditionnement qui touche l’ensemble des chaines musculaires des patientsLow back pain is a public health problem inducing economical and social consequences. Chronicity involves less than 10% of low back pain, but represents 85% of the total costs related to this pathology. In this context, it seems essential to optimize chronic low back pain rehabilitation programs to make them more effective and relevant. The purpose of this phD was then to evaluate lower limbs mechanical factors using torque- and power-velocity relationships. In a first study, knee extensors muscles and trunk flexor and extensor muscles were evaluated in chronic low back pain and healthy subjects. A significant knee extensor strength and power weakness weas observed for chronic low back pain subjects, associated with the typical trunk weakness referred to this population. The second study focused on establishing a protocol allowing assessing hip flexor and extensor torque- and power-velocity relationships. This protocol was then applied to evaluate flexor and extensor hip muscles in chronic low back pain subjects. Results, in accordance with the first study, highlighted a significant strength and power weakness for hip muscle groups in chronic low back pain relative to healthy subjects, with a greater hip extensor deficit, as it is generally observed for the trunk.In conclusion, these different studies showed the importance of proposing torque and power lower limbs rehabilitation for chronic low back pain patients to better fight against the deconditioning syndrome that affects all muscular chains in this population
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Mills, Hayley. "A mixed method investigation into the perception and measurement of success in the Healthwise Exercise Referral Scheme." Thesis, University of Gloucestershire, 2008. http://eprints.glos.ac.uk/3173/.
Повний текст джерела
21
Zaenker, Pierre. "Effets de l'entraînement à haute intensité associé au renforcement musculaire sur les capacités physiques et la qualité de vie chez les patients atteints de sclérose en plaques." Thesis, Strasbourg, 2017. http://www.theses.fr/2017STRAJ047/document.
Повний текст джерелаАнотація:
Après avoir été contre-indiquée, l’activité physique prend une place de plus en plus importante dans la prise en charge de la sclérose en plaques (SEP). L’entraînement à intensité faible ou modérée est largement documenté, contrairement à la haute intensité. Ce travail s’est intéressé aux effets de l’entraînement en intervalle à haute intensité combiné au renforcement musculaire durant 12 semaines chez 26 patients atteints de SEP. Nos résultats indiquent que la consommation pic d’oxygène, la puissance maximale tolérée, la force isocinétique des quadriceps et ischio-jambiers, ainsi que la qualité de vie sont améliorées. Les femmes présentent des améliorations plus importantes et plus nombreuses que les hommes, cependant le niveau de handicap ne semble pas limiter les améliorations. Notre travail a permis de démontrer que l’entraînement en intervalle à haute intensité combiné au renforcement musculaire est bien toléré et permet des améliorations des capacités physiques et de la qualité de vieAfter being contraindicated, physical activity take an increasingly important place in the management of multiple sclerosis (MS). The training at mild to moderate intensity is widely documented, contrary to the high intensity training. This work has focused on the effects of high intensity interval training combined with resistance training during 12 weeks in 26 MS patients. Our results show that peak oxygen consumption, maximum tolerated power, isokinetic muscle strength in both quadriceps and hamstrings and quality of life are improved. Women show more important and more numerous improvements than men, however, the disability level does not seem to limit improvements. Our work has demonstrated that high intensity interval training combined with resistance training is well tolerated and allows physical capacities and quality of life improvements
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Aning, Jonathan. "Critique of fourier transform infrared microspectroscopy applications to prostate pathology diagnosis." Thesis, Cranfield University, 2010. http://dspace.lib.cranfield.ac.uk/handle/1826/5626.
Повний текст джерелаАнотація:
Prostate cancer is a biologically heterogenous disease with considerable variation in
clinical aggressiveness. Gleason grade, the universally accepted method for
classification of prostate cancer, is subjective and gives limited predictive information
regarding prostate cancer progression. There is a clinical need for an objective, reliable
tool to help pathologists improve current prostate tissue analysis methods and better
assess the malignant potential of prostate tumours. Fourier Transform Infrared (FTIR)
microspectroscopy is a powerful bioanalytical technique that uses infrared light to
interrogate biological tissue. The studies detailed in this thesis examine the ability of
FTIR combined with multivariate analysis to discriminate between benign,
premalignant and malignant prostate pathology in snap frozen, paraffinated and
deparaffinated tissue.
Prostate tissue was collected during and after urological procedures performed between
2005 and 2008. The tissue was analysed utilising a bench top FTIR system in point and
image mapping modes. The histology under interrogation was identified by a uro-
pathologist. Multivariate analysis was applied to the spectral dataset obtained. FTIR
performance was evaluated.
FTIR was able to reproducibly discriminate between benign and malignant prostate
tissue in a pilot study. Cross validated diagnostic algorithms, constructed from the
spectral dataset in this experiment, achieved sensitivities and specificities of 95% and
89% respectively.
FTIR analysis of transverse paraffinated and deparaffinated radical prostatectomy
sections achieved good differentiation of the benign, premalignant and malignant
pathology groups. However the performance of diagnostic algorithms constructed from
this dataset under cross validation was poor.
The work in this thesis illustrates the potential of FTIR to provide an objective method
to assist the pathologist in the assessment of prostate samples. The limitations of the
technique and directions for future work are presented.
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Gates, Andrew R. C. "Blood flow studies using nuclear magnetic resonance imaging." Thesis, University of Cambridge, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.260496.
Повний текст джерела
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Theodorakou, Chrysoula. "Radiation doses in complex diagnostic procedures." Thesis, Queen Mary, University of London, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.416625.
Повний текст джерела
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Golemati, Spiretta. "Motion analysis of atherosclerotic plaque from b-mode ultrasound." Thesis, Imperial College London, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.396015.
Повний текст джерела
26
Growcott, Ellena Jacqueline. "Regulatory roles of cAMP-specific phosphodiesterase type 4 enzymes in human pulmonary smooth muscle cells." Thesis, Imperial College London, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.440538.
Повний текст джерела
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Cleasen, Stefan. "A verification and display system for multiple modality DICOM 3.0 objects." Thesis, Imperial College London, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.391942.
Повний текст джерела
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Cole, Mary Janet. "Fluorescence lifetime imaging for biomedical applications." Thesis, Imperial College London, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.393718.
Повний текст джерела
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Callister, Matthew Eric James. "Thioredoxin and the inflammatory response." Thesis, Imperial College London, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.414905.
Повний текст джерела
30
Holden, Simon John. "The measurement of the dielectric properties of mammalian tissue in-vivo up to 20.05 GHZ." Thesis, Brunel University, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.435754.
Повний текст джерела
31
Vickers, Jonathan Paul. "Medical image analysis incorporating knowledge and feedback." Thesis, Coventry University, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.399523.
Повний текст джерела
32
Goodband, John H. "Novel applications using neural networks and liquid metals in radiation therapy." Thesis, Coventry University, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.439109.
Повний текст джерела
33
Taffler, Sean. "The use of the Hilbert Spectrum in the analysis of electromyographic signals and its application in the development of myoelectric prosthesis controllers." Thesis, University of Oxford, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.393789.
Повний текст джерела
34
Zhang, Yongyue. "Model-based approaches to brain MR image segmentation." Thesis, University of Oxford, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.393516.
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35
Xiao, Guofang. "3-D free-hand ultrasound imaging and image analysis of the breast." Thesis, University of Oxford, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.393987.
Повний текст джерела
36
Garnett, Matthew Romney. "The nuclear magnetic resonance investigation of traumatic brain injury." Thesis, University of Oxford, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.393513.
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37
Gear, Jonathan. "Polymer gels for dosimetry in targeted radionuclide therapy." Thesis, Institute of Cancer Research (University Of London), 2009. http://publications.icr.ac.uk/10124/.
Повний текст джерелаАнотація:
This thesis Presents an investigation into the use of polymer gel dosimeters for analysis in targeted radionuclide therapy (TRT). The project aims to establish viability, technical issues, and potential uses of polymer gel dosimetry when incorporating radioisotopes. The thesis begins by outlining the current status of TRT and the need for accurate dosimetry. The inaccuracies of the dosimetry methods being employed are highlighted, as is the requirement of a "gold standard" method for dosimetry quality assurance. Polymer gel dosimeters are porposed as a possible means of achieving this. As a research topic in its own right an introduction into polymer gel dosimeters is given with a detailed description of their development and current uses in external beam radiotherapy. In the thesis polymer gel dosimeters are used in conjunction with MR and a detailed description of the MR techniques used is also given. Monte Carlo simulations are currently considered the best method to determine absorbed dose from a known activity distribution. A Monte Carlo user code written for EGSnrc has been developed to verify and validate polymer gel dosimetry. Details of the Monte Carlo code are given and comparisons made with published data. The accuracy of poymer gel dosimetry is susceptible to many factors and use with internal isotopes may introduce further technical issues. These are investigated in a number of small experiments and comparison made with external beam irradiation. A method for using polymer gel dosimeters with internal isotopes is developed and verified by comparing dose measurements and distributions with that calculated using the Monte Carlo code. Comparisons with various SPECT based dosimetry techniques have been made for geometrical phantoms of both uniform and non-uniform distributions. Methods for comparing and analysing 3D dose maps have also been investigated and the results from these experiments discussed. The thesis concludes with a case study, whereby polymer gel dosimeters are used for analysis of a specific patient situation. A patient synopsis is given with details of an anatomical phantom based on that patient. Polymer gel and SPECT based dosimetry is performed and the clinical significance of the findings discussed.
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Mohseni, Hamid R. "ERP source tracking and localization from single trial EEG MEG signals." Thesis, Cardiff University, 2010. http://orca.cf.ac.uk/54898/.
Повний текст джерелаАнотація:
Electroencephalography (EEG) and magnetoencephalography (MEG), which are two of a number of neuroimaging techniques, are scalp recordings of the electrical activity of the brain. EEG and MEG (E/MEG) have excellent temporal resolution, they are easy to acquire, and have a wide range of applications in science, medicine and engineering. These valuable signals, however, suffer from poor spatial resolution and in many cases from very low signal to noise ratios. In this study, new computational methods for analyzing and improving the quality of E/MEG signals are presented. We mainly focus on single trial event-related potential (ERP) estimation and E/MEG dipole source localization. Several methods basically based on particle filtering (PF) are proposed. First, a method using PF for single trial estimation of ERP signals is considered. In this method, the wavelet coefficients of each ERP are assumed to be a Markovian process and do not change extensively across trials. The wavelet coefficients are then estimated recursively using PF. The results both for simulations and real data are compared with those of the well known Kalman Filtering (KF) approach. In the next method we move from single trial estimation to source localization of E/MEG signals. The beamforming (BF) approach for dipole source localization is generalized based on prior information about the noise. BF is in fact a spatial filter that minimizes the power of all the signals at the output of the filter except those that come from the locations of interest. In the proposed method, using two more constraints than in the classical BF formulation, the output noise powers are minimized and the interference activities are stopped.
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Alex, Aneesh. "Multispectral three-dimensional optical coherence tomography." Thesis, Cardiff University, 2010. http://orca.cf.ac.uk/54164/.
Повний текст джерелаАнотація:
A spectral-domain OCT system operating at 1300 nm wavelength region, capable of acquiring 47,000 A-lines/s, was designed and developed. Its axial and transverse resolutions were ∼ 6 µm and ∼15 µm respectively. OCT images of human skin were obtained in vivo using three OCT systems, in order to find the optimal wavelength region for dermal imaging. 800 nm OCT system provided better image contrast over other two wavelength regions. Meanwhile, 1300 nm wavelength region was needed to obtain information from deeper dermal layers. To determine the effect of melanin pigmentation on OCT, images were taken from subjects with different ethnic origins. Interestingly, melanin pigmentation was found to have little effect on penetration depth in OCT. In vitro tumour samples, comprising samples with different degrees of dysplasia, were imaged at 800 nm, 1060 nm and 1300 nm wavelength regions to find the capability of OCT to diagnose microstructural changes occurring during tumour progression. 800 nm OCT system was capable to detect the malignant changes with higher contrast than other wavelength regions. However, higher wavelength regions were required to penetrate deeper in densely scattering tumour samples at advanced stages. OCT system operating at 1060 nm was combined with a photoacoustic imaging (PAT) system to obtain complementary information from biological tissues. This multimodal OCT/PAT system demonstrated its potential to deliver microstructural information based on optical scattering and vascular information based on optical absorption in living mice and human skin. The results indicate OCT as a promising imaging modality that can have profound applications in several areas of clinical diagnostic imaging.
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Ravindranathan, Devi. "Photoplethysmography for the evaluation of diabetic autonomic neuropathy." Thesis, Cardiff University, 2009. http://orca.cf.ac.uk/54981/.
Повний текст джерелаАнотація:
The aim of this study was to determine if photoplethysmography (PPG) could be used to analyse the foot microvascular changes caused by diabetic autonomic neuropathy. The digital PPG signals were collected from 37 healthy volunteers (Group I), 35 diabetic patients (Group II), and 38 diabetic patients with sensory neuropathy (Group III) and analysed using MAT LAB. Prominent spectral peaks with sidebands were obtained at both the high frequency (HF) and the low frequency (LF) end of the Fourier spectrum of these PPG signals. Previous studies of microcirculation have shown that both are sympathetically and parasympathetically mediated and hence are a good measure of the autonomic activity. In the HF analysis, the heart rate (HR) response from 13 participants in Group III was severely reduced and significantly different from the responses obtained from the other two groups. However the responses from remaining 25 participants had similar characteristics to those of Group II. Hence the HF analyses failed to both statistically and objectively differentiate between the diabetics with and without neuropathy. The spectral density for the frequency bandwidth of 3-20 cpm was significantly reduced in the neuropathic group, compared to the other two groups. A Statistically significant difference was observed in the spectral densities calculated from Group II and III, though no difference could be established between Groups I and III. The LF analysis of this bandwidth differentiated between Groups II and III with a sensitivity of 84% and specificity of 61%. Activities at the LF end of the spectrum mostly represent the sympathetic control as opposed to the HR variability that is mostly a measure of the parasympathetic control. These results suggest that sympathetic dysfunction possibly precedes parasympathetic dysfunction and that PPG can assess the changes in the skin microcirculation due to sympathetic damage with moderate success.
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Nazarpour, Kianoush. "Brain signal analysis in space-time-frequency domain : an application to brain computer interfacing." Thesis, Cardiff University, 2008. http://orca.cf.ac.uk/54718/.
Повний текст джерелаАнотація:
In this dissertation, advanced methods for electroencephalogram (EEG) signal analysis in the space-time-frequency (STF) domain with applications to eye-blink (EB) artifact removal and brain computer interfacing (BCI) are developed. The two methods for EB artifact removal from EEGs are presented which respectively include the estimated spatial signatures of the EB artifacts into the signal extraction and the robust beamforming frameworks. In the developed signal extraction algorithm, the EB artifacts are extracted as uncorrelated signals from EEGs. The algorithm utilizes the spatial signatures of the EB artifacts as priori knowledge in the signal extraction stage. The spatial distributions are identified using the STF model of EEGs. In the robust beamforming approach, first a novel space-time-frequency/time-segment (STF-TS) model for EEGs is introduced. The estimated spatial signatures of the EBs are then taken into account in order to restore the artifact contaminated EEG measurements. Both algorithms are evaluated by using the simulated and real EEGs and shown to produce comparable results to that of conventional approaches. Finally, an effective paradigm for BCI is introduced. In this approach prior physiological knowledge of spectrally band limited steady-state movement related potentials is exploited. The results consolidate the method.
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Cosker, Darren. "Animation of a hierarchical image based facial model and perceptual analysis of visual speech." Thesis, Cardiff University, 2005. http://orca.cf.ac.uk/56003/.
Повний текст джерелаАнотація:
In this Thesis a hierarchical image-based 2D talking head model is presented, together with robust automatic and semi-automatic animation techniques, and a novel perceptual method for evaluating visual-speech based on the McGurk effect. The novelty of the hierarchical facial model stems from the fact that sub-facial areas are modelled individually. To produce a facial animation, animations for a set of chosen facial areas are first produced, either by key-framing sub-facial parameter values, or using a continuous input speech signal, and then combined into a full facial output. Modelling hierarchically has several attractive qualities. It isolates variation in sub-facial regions from the rest of the face, and therefore provides a high degree of control over different facial parts along with meaningful image based animation parameters. The automatic synthesis of animations may be achieved using speech not originally included in the training set. The model is also able to automatically animate pauses, hesitations and non-verbal (or non-speech related) sounds and actions. To automatically produce visual-speech, two novel analysis and synthesis methods are proposed. The first method utilises a Speech-Appearance Model (SAM), and the second uses a Hidden Markov Coarticulation Model (HMCM) - based on a Hidden Markov Model (HMM). To evaluate synthesised animations (irrespective of whether they are rendered semi automatically, or using speech), a new perceptual analysis approach based on the McGurk effect is proposed. This measure provides both an unbiased and quantitative method for evaluating talking head visual speech quality and overall perceptual realism. A combination of this new approach, along with other objective and perceptual evaluation techniques, are employed for a thorough evaluation of hierarchical model animations.
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Kenny, Gerard. "The dialectical dance : a heuristic exploration of the spiritual healer's journey." Thesis, University of the West of England, Bristol, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.572858.
Повний текст джерелаАнотація:
This study sets out to explore and describe the process of becoming a spiritual healer. The research question is motivated by my contact with spiritual healers at a time of ill health and seeks to understand how the five participants presented here became healers. I do this through employing Moustakas's (1990) methodology of Heuristic Inquiry. One of the central tenants of this methodology is that it explicitly acknowledges the importance of the lived experience of the researcher as a guiding and mediating presence in the research process. The research explores how the healers' stories and experiences elicited and illuminated a response within me. The combination of the healers' accounts, and my experience of them, created a dialectical movement within the research which shaped how the research unfolded. Consequently the research illustrates how the investigation into the experience of becoming a spiritual healer, facilitated the internal search within me to understand the question. It offers an overarching theme that understanding the complexity and challenges of bringing dialectical opposites into balance may be one way of appreciating a healer's journey. This overarching theme is explored and expressed through sub themes of wound and shadow, leap of faith, love, shaman in the world, the body, death and transformation.
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Woodward, Robert Sidney. "An investigation of spiritual healing in a Camphill Community setting with children who have special needs." Thesis, University of the West of England, Bristol, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.573680.
Повний текст джерелаАнотація:
The aim of this thesis is to critically investigate spiritual healing in a Camphill Community setting with children who have special needs. The research methodology comprises two in-depth instrumental case studies. This methodology takes into account the complex multifaceted context of the Camphill setting. Moreover in the Literature Review I also identify three key contextual 'themes' in which the study is located, namely Spiritual Healing, Spirituality, and Holistic Health and Social Care, which run like red threads throughout this inquiry. My research participants were selected from pupils at Norwood Camphill School on the basis that they were below sixteen years of age, that they might be likely to benefit in some way from this complementary therapy, and that they were already known to be willing to receive healing or else considered likely to be willing to do so. Originally three participants were identified, but in the course of the study it was agreed that two would be sufficient given the quantity and richness of the data generated. Both participants were diagnosed as having autistic spectrum disorders and severe learning difficulties. Data was constructed by respondents within Norwood and also by the parents/guardians of the children. A third-party observer and myself in my dual-role of healer/researcher contributed data from the children's observed responses to their individual healing sessions. These were arranged in block- periods within the three school terms over the course of the Healing Year. The sessions were also videoed, providing an invaluable source of audio- visual data. All the qualitative data was rigorously analysed through a process of thematic analysis and data triangulation to reveal emerging and emergent themes. Each case study is unique to each participant but both are structured within the same five-stage design framework. Subsequently the two cases were compared through the strategy of Cross-Case Analysis and Synthesis. As the study is naturalistic and exploratory in nature it does not seek to establish any direct causal links between healing and any progress shown by the participants over the Healing Year. Nonetheless it does provide a unique and detailed presentation of their individual responses within the healing sessions. Although the study is grounded in a particular philosophical context underpinned by Rudolf Steiner's anthroposophy (or spiritual-science) and the curative education based upon it, my hope is that it will encourage further robust inquiries in the field of Healing Research with vulnerable and special children. The study is suggestive of some potential benefits for such children, including those on the autistic spectrum, and in a wide variety of educational and health and social care contexts.
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Mitchell, Claire. "The development of new imaging strategies of human tumour vasculature." Thesis, University of Manchester, 2010. http://www.manchester.ac.uk/escholar/uk-ac-man-scw:123697.
Повний текст джерела
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Naeini, Mandana Rafiei. "Low-noise measurement techniques for brain function imaging by electrical impedance tomography." Thesis, University of Manchester, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.488642.
Повний текст джерелаАнотація:
In neurosciences, there is a great need to improve methods for direct imaging of functional activity in the nervous system of the brain. Such activities occur on a time scale of the order of 10 milliseconds. No portable system exists to measure these activities non-invasively with sufficient temporal resolution and with sensitivity to the deepest regions of the brain. Electrical Impedance Tomography (EIT), as a non-invasive means for fast imaging of impedance changes during neural activity, has the promise to be highly portable, to give information on the deepest regions of the brain, and is already applied routinely in other medical applications such as breast imaging. For this technique to 'follow' the human brain's processing cycle for individual stimuli, a temporal resolution of much less than 1 second is required. The sensitivity and spatial resolution of EIT can be enhanced significantly by increasing the measurementSNR. It has been suggested that an EIT system with measurement s~nsitivity of 80 dB is required for the measurement of impedance changes in the brain occurring directly due to neural function. For this application, the University of Manchester is developing a 32channel EIT system, fElTER, with temporal resolution of 100 frames per second and SNR of 80 dB, operating over the current excitation frequency range from 10 kHz to 100 kHz. In this thesis, a modular single-channel EIT system is designed to investigate ways of achieving the high performance requirements of the fEITER system. It uses digital waveform synthesis, a 16-bit DAC and subsequent reconstmction filter, to drive the improved Howland current source. The voltage is measured using an instmmentation amplifier followed by an anti-aliasing filter and a 16-bit ADC, prior to digital PSD where the amplitude and phase information of the measured voltage is obtained. In this system the digital parts are implemented in an FPGA. The design considerations to achieve the required performance related to each module are discussed prior to design, implementation and testing related to each module in a separate chapter. The resulting single-channel EIT system operates in the frequency range of 10 kHz to 100 kHz in steps of 10 kHz. The SNR perfoffilance of the developed system is 77 dB and it has the potential of achieving 100 frames per second image acquisition for the 32-channel fEITER system.
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Hardie, Donald. "Non-linear modelling of microwave soft-tissue ablation using the finite element method." Thesis, Heriot-Watt University, 2006. http://hdl.handle.net/10399/2077.
Повний текст джерелаАнотація:
Reliable and accurate information regarding the heat distribution inside biologica.I tissue due to microwave thennal ablation is essential for the design and optimization of safe therapeutic applicators and for the development of experiments, which aim to investigate their effects. To date, very few finite element models (FEM) have been developed to describe and illustrate electric field penetration, specific absorption rate (SAR) and temperature distribution in biological tissue due to microwave ablation probes. A coupled field finite elemerit analysis model that accounts for the temperature dependent conductivity and blood perfusion changes has not, as yet, been developed for ablation type devices. Although it is widely acknowledged that accounting for temperature dependent phenomena may affect the outcome ofthese models, the effect has not yet been assessed for microwave tumour ablation (MTA). This thesis aims to develop an improved non-linear coupled field electromagnetic and thermal FE model of microwave ablation, incorporating temperature dependent electrical and thermal properties of, ex-vivo bovine liver. Measurements of temperature dependent ex-vivo bovine liver electrical permittivity are made and their effect. presented. Temperature dependent thennal properties of the tissue are limited. to temperatures below phase change. Therefore, a theoretical tissue model for going changes in phase is also presented. The FE model of microwave ablation is based on a 2.45 GHz minimally invasive dielectric loaded monopole antenna
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Alonzi, Roberto. "Evaluation of the oxygenation and vascularity of prostate cancer using magnetic resonance imaging." Thesis, University College London (University of London), 2008. http://discovery.ucl.ac.uk/1444256/.
Повний текст джерелаАнотація:
The outcome of radical treatment for prostate cancer is appreciably influenced by the presence of hypoxia. Oxygenation status may therefore be another underlying biological parameter, beyond the classic prognostic factors (age, clinical stage, Gleason score and prostate specific antigen), that predicts for treatment failure in this malignancy. Angiogenesis plays a pivotal role in the growth, invasion, metastasis and survival of prostate tumours. Measurements of angiogenesis have been linked with clinical and pathological stage, histological grade and the potential for metastasis formation. They also provide prognostic information and have been correlated with disease-specific survival and progression after treatment. Magnetic resonance imaging techniques are capable of detecting the molecular, biochemical, physiological and metabolic changes that occur due to pathological processes within tissues. Experiments presented in this thesis have sought to evaluate the ability of Dynamic Contrast Enhanced MRI (DCE-MRI), Dynamic Susceptibility Contrast MRI (DSC-MRI), Intrinsic Susceptibility Weighted MRI (also known as Blood Oxygen Level Dependent (BOLD) MRI) and Diffusion Weighted Imaging (DWI) to characterise the oxygenation and vascular status of prostate tumours in animal models and in patients with prostate cancer. This research has demonstrated the feasibility of hypoxia imaging in prostate cancer. Although MRI can not precisely map tissue p02, the combination of BOLD-MRI and dynamic susceptibility contrast MRI provides a valuable surrogate and predicts the pattern of hypoxia, as determined by pimonidazole immunohistochemistry, with reasonable accuracy. The research has also shown that prostate cancer responds to carbogen gas breathing and that androgen deprivation causes profound vascular collapse within one month of starting therapy. These findings should help in the rational design of future studies that aim to target tumour vasculature and combat tumour hypoxia in prostate cancer.
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Reid, C. "Spectroscopic methods for medical diagnosis at terahertz wavelengths." Thesis, University College London (University of London), 2009. http://discovery.ucl.ac.uk/17571/.
Повний текст джерелаАнотація:
Terahertz (THz) radiation lies between the microwave and infrared regions of the electromagnetic spectrum. THz radiation excites intermolecular interactions and is non-ionising making it a viable tool for medical imaging. This thesis describes the development and validation of spectroscopic methods for diagnosis of tissue pathologies at THz wavelengths. Theoretical techniques were developed to determine the origin of the contrast seen in THz images of biological tissue. Specific biological tissues investigated in this thesis were colonic tissues with the aim of determining the origin of contrast between healthy and diseased tissue in THz images. This thesis investigates the interaction of THz radiation with matter using simple tissue phantoms made from five biologically relevant materials: water, methanol, lipid, sucrose and gelatin. Phantoms are designed to imitate the spectroscopic properties of tissue at specific wavelengths where physical properties of the phantom, such as concentration and homogeneity, can be accurately controlled. The frequency-dependent absorption coefficients, refractive indices and Debye relaxation times of the pure compounds were measured and used as prior knowledge in the different theoretical methods for the determination of concentration. Three concentration analysis methods were investigated, a) linear spectral decomposition, b) spectrally averaged dielectric coefficient method and c) the Debye relaxation coefficient method. These methods were validated on phantoms by determining the concentrations of the phantom chromophores and comparing to the known composition. Two-component phantoms were made comprising water with methanol, lipid, sucrose or gelatin. Two different three-component phantoms were created; one with water, methanol and sucrose and a second with water, gelatin and lipid. The accuracy and resolution of each method was determined to assess the potential of each method as a tool for medical diagnosis at THz wavelengths. Finally, the spectroscopic methods were applied to measurements of ex-vivo colon tissues containing cancerous and dysplastic regions. Statistical analysis of the reflected time-domain waveforms demonstrated good distinction between healthy and diseased tissues with an estimated sensitivity of 89.2% and specificity of 78.3%.
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Gilad, Ori. "Preliminary studies in imaging neuronal depolarization in the brain with electrical or magnetic detection impedance tomography." Thesis, University College London (University of London), 2008. http://discovery.ucl.ac.uk/1444179/.
Повний текст джерелаАнотація:
Electrical impedance Tomography (EIT) is a novel medical imaging method which has the potential to provide the revolutionary advance of a method to image fast neural activity non-invasively. by imaging electrical impedance changes over milliseconds which occur when neuronal ion channels open during activity. These changes have been estimated to be c.1% locally in cerebral cortex, if measured with applied current below 100Hz. The purpose of this work was to determine if such changes could be reproducibly recorded in humans non invasive First, a novel recessed electrode was designed and tested to determine to enable a maximal current of 1mA to be applied to the scalp without causing painful skin sensation. Modelling indicated that this produced a peak current density of 0.3A/m2 in underlying cortex, which was below the threshold for stimulation. Next, the signal-to-noise ratio of impedance changes during evoked visual activity was investigated in healthy volunteers with current injected with scalp electrodes and recording of potential by scalp electrodes (Low Frequency EIT) or magnetic field by magnetoencephalography (Magnetic Detection EIT). Numerical FEM simulations predicted that resistivity changes of 1% in the primary7 visual cortex translate into scalp voltage changes of IjiV (0.004%) and external magnetic field changes of 30fT (0.2%) and were independently validated in saline filled tanks. In vivo, similar changes with a signal-to-noise ratio of 3 after averaging for 10 minutes were recorded for both methods the main noise sources were background brain activity and the current source. These studies with non-invasive scalp recording have, for the first time, demonstrated the existence of such changes when measured non-invasively. These are unfortunately too low to enable reliable imaging within a realistic recording time but support the view that such imaging could be possible in animal or human epileptic studies with electrodes placed on the brain or non-invasively following technological improvements this further work is currently in progress.