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Dissertations / Theses on the topic 'Ambulation'
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Bartonek, Åsa. "Ambulation in persons with myelomeningocele /." Stockholm, 2001. http://diss.kib.ki.se/2001/91-628-4669-8/.
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Hurst, Craig A. "Locomotor-respiratory coupling during axillary-crutch ambulation." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ36472.pdf.
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Cannon, Jonathan Ambrose. "Ambivalent ambulation : fan pilgrimage and the itinerantextual cult film." Thesis, University of British Columbia, 2012. http://hdl.handle.net/2429/42064.
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Peripatetic by nature yet polymorphous in form, the topic of fan pilgrimage expresses a significant dearth in cult film and media scholarship. Whilst the concept of pilgrimage has been classically linked to religious duty and moral obligation, its ability to straddle both traditionalist and secularist rationales amidst increased globalisation makes such ambiguous mobility ripe for closer analysis. In this thesis, I will theorise fan pilgrimage using a series of itinerant fan taxonomies to recontextualise the role of the pilgrim and its function within select fan groups. Utilising the critical literature of Zygmunt Bauman, Victor Turner, and Roger C. Aden, respectively, Chapter 1 reevaluates ideas of community and reconfigures the spatiotemporal theories of performance articulated by Richard Schechner through fan pilgrimage and performative communitas. Chapter 2 explores how theories of play and everyday life create my first fan taxonomy: the ludic pilgrim. Via the play theory of Johan Huizinga and Roger Caillois as well as the theories of everyday life held by Erving Goffman, I argue for a correlation between play and costume through the case study of the otaku – i.e. fans of Japanese anime and manga. Chapter 3 employs fashion theory to subcultural style and reconsiders the value of the goth subculture and female vampire fandom by way of my second fan taxonomy: the subsartorial pilgrim. In Chapter 4, The Rocky Horror Picture Show serves as my main case study to theorise subcultural liveness during screenings of Rocky Horror and highlight my third fan taxonomy: the performative pilgrim. Examining the pilgrim as tourist through concepts such as fan tourism and flâneurism and by way of case studies such as Blade Runner, Disney theme parks, and The Lord of the Rings blockbuster trilogy, Chapter 5 unpacks my fourth fan taxonomy: the postmodern pilgrim. Finally, Chapter 6 recasts The Big Lebowski as a cult film that is primarily consumed by fans via Lebowski Fest. This chapter will elucidate how narrative, replay culture, and the documentary film The Achievers: The Story of the Lebowski Fans all reshape the meaning of Lebowski and spotlight its classification as an itinerantextual cult film.
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Roopchand, Sharmella. "The effect of unloading on overground ambulation in stroke clients." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0023/MQ50869.pdf.
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Buckland, Kenneth M. "A movement planning heuristic package for quadruped ambulation over rough terrain." Thesis, University of British Columbia, 1989. http://hdl.handle.net/2429/27827.
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Legged walking machines offer a number of advantages over conventional wheeled or tracked vehicles. They can reach terrain that is inaccessible to conventional vehicles, and they leave fewer traces of their crossing behind on terrain that has not been prepared for transportation. This thesis details the development of a heuristic package that can be used to determine the movement plan of a longitudinally oriented quadruped walking vehicle ambulating over rough terrain. An investigation of walking machine research to date revealed that such work had not been done for quadrupeds that adjust their attitude to follow the terrain. This terrain following strategy was employed in the development of these heuristics because it provides superior movement capabilities on sloped terrain. The heuristics were tested extensively on a variety of simulated terrain conditions. These conditions consisted of different combinations of underlying terrain attitudes and terrain roughness levels. The heuristics performed well during the simulations, and the simulated machine responded as the theoretical analysis had indicated.
During the course of this work, a number of new ideas related to quadruped ambulation were developed. These included how to generate the overall movement plan of a quadruped walking machine, how foothold locations can be guided to best facilitate smooth machine turning, how the speed of a walking machine can be maintained at consistent levels, and how to prevent any possibility of leg collisions. In addition, in-depth analyses were made on how stride length affects quadruped machine speed, what conditions force such machines to halt their forward movement, and how a practical machine should be designed.Applied Science, Faculty of
Electrical and Computer Engineering, Department of
Graduate
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Greene, Peter J. "Design and analysis of a knee and ankle flexing hybridorthosis for paraplegic ambulation." Thesis, University of Strathclyde, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.273398.
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Bogart, Martha A. Wiles. "Cardiac catheterization : the effects of early ambulation on patient comfort and groin complications /." free to MU campus, to others for purchase, 1998. http://wwwlib.umi.com/cr/mo/fullcit?p9901219.
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Denning, W. Matt. "The Influence of Ambulation Speed and Corresponding Mechanical Variables on Articular Cartilage Metabolism." BYU ScholarsArchive, 2014. https://scholarsarchive.byu.edu/etd/4034.
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During ambulation, lower-extremity joint angles and net moments influence knee joint load. It is unclear which mechanical variables most strongly correlate with acute articular cartilage (AC) catabolism in response to ambulation. Purpose: To determine which mechanical variables are most strongly correlated to acute AC catabolism, and to test the acute effect of ambulation speed on AC catabolism, while controlling for load frequency. Methods: 18 able-bodied subjects (9 male, 9 female; age = 23 ± 2 y; mass = 68.3 ± 9.6 kg; height = 1.70 ± 0.08 m) completed three separate ambulation sessions: slow (preferred walking speed), medium (+50% of walking speed), and fast (+100% of walking speed). For each session, subjects completed 4000 steps on an instrumented treadmill while ten high-speed cameras recorded synchronized video data. Various, discrete, three-dimensional joint kinematic and kinetic variables were averaged across 20 total stance phases (5 stance phases at 1000, 2000, 3000, and 4000 steps). Blood samples were collected pre-, post-, 30-min post-, and 60-min post-ambulation. Serum cartilage oligomeric matrix protein (COMP) concentration was determined using an enzyme-linked immunosorbent assay. A stepwise multiple linear regression analysis was used to evaluate the relationships between serum COMP change and lower-extremity joint angles and moments. A mixed model ANCOVA was used to evaluate serum COMP concentration between sessions across time. Results: Peak ankle inversion, knee extension, knee abduction, hip flexion, hip extension, and hip abduction moment, and knee flexion angle at impact, explained 61.4% of the total variance in serum COMP change (p < 0.001), due to ambulation. COMP concentration increased 28%, 18%, and 5% immediately after ambulation for the running, jogging, and walking sessions, respectively. All sessions were significantly different immediately post-ambulation (p < 0.01). Conclusion: Certain lower-extremity joint mechanics are associated with acute AC catabolism, due to ambulation. Several key mechanical variables (e.g., peak knee extension, knee abduction, and hip abduction moments) explain much regarding the variance in serum COMP increase. These lower-extremity variables can be used to predict acute AC catabolism, allowing researchers and clinicians to better predict and/or understand AC catabolism. Additionally, when load frequency is controlled, increased ambulation speed acutely results in increased AC catabolism. Ambulation speed does not, however, influence serum COMP elevation duration. Joint mechanics and load frequency appear to be responsible for the magnitude of COMP increase, while duration of COMP elevation post-ambulation is dictated by load frequency.
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Thomas, Elju Eldho. "Ambulation training of older subjects on a treadmill with an apparatus to relieve the body weight." Thesis, University of Strathclyde, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.435119.
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Herbold, Janet Anne. "Gait analysis following Total Knee Arthroplasty during Inpatient Rehabilitation: Can findings predict LOS, ambulation device, and discharge disposition?" Diss., NSUWorks, 2017. https://nsuworks.nova.edu/hpd_pt_stuetd/71.
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Background: Total knee arthroplasty (TKA) is the treatment of choice for end-stage knee osteoarthritis. Growth in the number of procedures performed annually in the United States is expected to increase steadily. Post-operative rehabilitation settings vary and include both institutional and community based physical therapy (PT) services. Despite access to PT, deficits in gait often persist for months and even years after surgery. Slow gait speed, asymmetrical walking patterns, and prolonged time in double-limb support following the TKA often lead to the need for an assistive device for walking and prolong the rehabilitation phase. Purpose: The purpose of this study is to analyze early gait during inpatient rehabilitation to quantify both the improvements made and deficits that remain in important gait variables. This study identifies predictor variables that contribute to the variance in discharge ambulation device use and IRF length of stay. Subjects: A convenience sample of 230 patients discharged to an IRF following a TKA (160 following a single TKA and 70 following a bilateral procedure) was used for this analysis. Method: Paired t-tests were used to compare temporal and spatial gait variables from the initial gait assessment compared to the discharge gait assessment in patients following single TKA to determine remaining deficits. Right vs left comparisons were made for patients following a bilateral procedure. A binary logistic regression was used to identify predictors associated with the need for a two-handed ambulation device at discharge. A multiple linear regression developed a model to assess predictors of the inpatient rehabilitation length of stay. Finally, a self-assessment to evaluate patient confidence with walking (mGES scale) was correlated to actual gait speed performed on the gait analysis in a sample of patients from our study population. Findings: Deficits in step length, step time and percent of single limb support remained in the involved limb compared to uninvolved limb at discharge from inpatient rehabilitation following single TKA; no limb differences between the right and left side were noted in patients after bilateral TKA. The discharge gait speed of 54.6 cm/sec for single TKA patients and discharge speed of 61.5 cm/sec for bilateral TKA patients is within the classification of limited community ambulators and making them appropriate for a home discharge. But despite improvement from admission to discharge, the gait speed for both groups in our study remain below the gait speed identified by prior studies 3-months following TKA surgery where speed reached 135 cm/sec. The need for a two-handed ambulation device, such as bilateral canes or a walker, was associated with slow walking speed and prior use of a device before surgery. A longer rehabilitation length of stay was associated with slower initial gait speed, lower motor FIM scores and reduced knee extension at admission. The mGES patient self-report conducted at the time of the discharge gait assessment showed a moderate correlation to the discharge gait speed; however, the pairing of the admission mGES with the admission gait speed was not significantly correlated.
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Chan, Ee Yuee. "Acute Pain Management after Total Knee Arthroplasty." Thesis, The University of Sydney, 2014. http://hdl.handle.net/2123/9906.
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Acute Pain Management after Total Knee Arthroplasty Abstract This thesis presents a body of work aimed at improving the acute pain management of patients after total knee arthroplasty (TKA). A randomized controlled trial (RCT) of 200 patients found that significant knee pain on movement 24 hours after surgery was reduced with single-injection (OR 0.30; 95% CI 0.12 to 0.74) or continuous (OR 0.21; 95% CI 0.08 to 0.51) femoral nerve block (FNB), compared with patient-controlled analgesia (PCA) opioid. Also, FNB required less opioid compared to PCA. There were no significant differences in ‘timed up and go’ between the three analgesic groups at all time-points. There was also no significant between group differences in the six-minute walk distance knee flexion range of motion, day achieved independent walking and self-reported physical function. A Cochrane systematic review pooling RCTs evaluating FNB with non-FNB included 45 eligible RCTs (2710 patients). Meta-analyses demonstrated that FNB resulted in less pain at rest and on movement during the first 72 hours after surgery compared to PCA opioid. At 24 hours, pain at rest was SMD -0.72 (95% CI -0.93 to -0.51), while pain on movement was SMD -0.94 (95% CI -1.32 to -0.55). Additionally, FNB provided similar analgesia compared with epidural or local infiltration analgesia, and continuous FNB provided better analgesia than single-injection FNB. A patient survey conducted in Singapore (N = 105) and replicated in Australia (N=171) revealed suboptimal management of acute pain after hospital discharge. Many patients experienced moderate to severe pain and had misperceptions on analgesia. Marked differences in pain experience, behaviors and perceptions of analgesics also existed between the two cohorts. Overall, the thesis provided evidence to guide the choice of postoperative analgesia after TKA. It also highlighted potential areas for improving pain management following hospital discharge and the need for culturally appropriate pain management strategies.
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Aminaka, Naoko. "Assessment of Movement Coordination Variability and Neuromuscular Characteristics During Stair Ambulation in those with and without Patellofemoral Pain Syndrome." University of Toledo / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1273771731.
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Roetter, Adam Daniel. "Compliant Prosthetic Knee Extension Aid: A Finite Elements Analysis Investigation of Proprioceptive Feedback During the Swing Phase of Ambulation." [Tampa, Fla] : University of South Florida, 2008. http://purl.fcla.edu/usf/dc/et/SFE0002647.
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Mandel, David Walter. "Comparison of Targeted Lower Extremity Strengthening and Usual Care Progressive Ambulation in Subjects Post-Liver Transplant: A Randomized Controlled Trial." Scholarly Repository, 2009. http://scholarlyrepository.miami.edu/oa_dissertations/333.
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Individuals with chronic liver disease experience progressive muscle wasting, weakness, fatigue, and decreased quality of life. Liver transplantation is the only treatment for end-stage liver disease with cirrhosis; however, muscle wasting, strength impairments, activity limitations, and health related quality of life do not return to the level of healthy adults. Currently there is no plan of care for rehabilitation of individuals post-liver transplantation. These individuals are only instructed to gradually increase walking and activity. Walking may increase lower extremity muscle strength; however, walking at a self-selected pace is less effective than resistance exercise. The purpose of this dissertation was to compare the benefits of a home exercise program of targeted lower extremity resistance exercise with benefits of progressive walking in individuals who have undergone liver transplantation. In Chapter 2 we performed a study to validate the ability of several outcome measures to detect changes in strength and activity performance in the population with liver disease and post-liver transplantation. The strength impairment measures of Grip Strength, Heel Rising, and Bridging along with activity limitation measures 30 Second Chair Stand and Six Minute Walk Test (6MWT) were able to differentiate strength and activity performance across levels of liver disease severity including post liver transplantation. Liver disease severity was moderately correlated with the strength impairment measures Bridging and Heel Rising but was not correlated with Grip strength. Liver disease severity was moderately correlated with 6MWT and 30-Second Chair-Stand but was not correlated with the SF-36 physical function scale. Strength impairment measures were strongly correlated with the activity limitation measures. Heel Rising and Bridging were strongly correlated with 30-Second Chair-Standing and 6MWT. Grip strength was moderately correlated with 30-Second Chair-Standing. In Chapter 3 we conducted a randomized controlled trial to assess the benefits of resistance exercise to progressive walking as a treatment plan for improving strength and activity performance in individuals post liver transplantation. We also examined the relationships of the change in muscle strength to the change in activity performance. Both the exercise and walking groups improved in strength and activity performance; however, the group performing the resistance exercise improved more. Bridging, 30 Second Chair Standing, Heel Rising, and 6MWT increased more for the exercise group than the walking group. Additionally, changes in strength were related to the changes in activity performance and health related quality of life. Bridging was correlated with Heel Rising, 30 Second Chair Standing, 6MWT, and the Chronic Liver Disease Questionnaire. In Chapter 4 we discuss the clinical relevance of the results of the studies described in the above chapters. We conclude Bridging, Heel Rising, 30 Second Chair Standing, and 6MWT are valid outcome measures to measure changes in strength and activity performance in the population with liver disease. Individuals post liver transplantation improve in strength and activity performance through progressive walking; however, the addition of resistance exercise to the current treatment plan is necessary for greater improvement. Additionally it is clinically relevant that this population was adherent to a home exercise program. Subjects adherent to the exercise program increased in strength and activity performance greater than subjects who were non-adherent.
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Fennell, Meredith A. "What is the Most Effective Type of Gait/Ambulation Physical Therapy Treatment for Patients with Parkinson’s Disease? A Systematic Review." Walsh University Honors Theses / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=walshhonors1524169116812503.
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King, Carolyn Ann. "The effect of neurodevelopmental treatment on gross motor function and ambulation in children with cerebral palsy, a series of single-subject studies." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq22331.pdf.
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Born, Beverly R. "Effect of computer practice of component gait training facts on choice of ambulation aid and gait pattern by physical therapist assistant students." Morgantown, W. Va. : [West Virginia University Libraries], 2003. http://etd.wvu.edu/templates/showETD.cfm?recnum=2999.
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Thesis (Ed. D.)--West Virginia University, 2003.Title from document title page. Document formatted into pages; contains vi, 79 p. : ill. Vita. Includes abstract. Includes bibliographical references (p. 54-58).
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Higgins, Jacob T. "ASSOCIATION OF SKELETAL MUSCLE AND PSYCHOLOGICAL RESPONSES TO IMMOBILITY AFTER MAJOR INJURY." UKnowledge, 2019. https://uknowledge.uky.edu/nursing_etds/41.
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The purpose of this dissertation was to explore the physical and psychological responses to the combination of major trauma (Injury Severity Score [ISS] > 15) and variable periods of immobility. Specific aims were to: 1) develop a conceptual model that illustrates physiological and psychological alterations that occur after injury and subsequent immobility, and their association with skeletal muscle responses and recovery; 2) evaluate daily measures of skeletal muscle strength (bicep and quadricep) using dynamometry and skeletal muscle (rectus femoris and biceps brachii) muscle thickness measured with ultrasound in patients after major trauma; and 3) assess the predictive ability of anxiety and depressive symptoms after traumatic injury on delayed ambulation (> 48 hours) following hospital admission.
Specific Aim 1 was addressed by development of a conceptual model to describe the association between injury responses, immobility and skeletal muscle after trauma based on a comprehensive review of the state of the science. This model guided the research reported in Aims 2 and 3. The second specific aim was addressed with the conduct of an observational study in which we evaluated daily skeletal muscle strength with dynamometry and muscle thickness with ultrasound to evaluate the impact of trauma and immobility on skeletal muscle in patients after major trauma (n = 19). Participants with delayed ambulation after trauma (more than 48 hours immobility) demonstrated significantly less muscle strength compared with those who had early ambulation (bicep: delayed ambulation 12.9 ± 3.8, early ambulation 17.7 ± 4.7, p = 0.004; quadriceps: delayed ambulation 9.9 ± 3.1, early ambulation 17.1 ± 4.6, p = 0.001). Muscle thickness was unchanged over time in those with delayed ambulation; however, in those who ambulated early, muscle thickness significantly increased by 0.17 cm (p = 0.008) from baseline to day 5. The third specific aim was addressed with data collected during the same observational study of patients after trauma (n = 19). Participants provided measures of anxiety and depressive symptoms at baseline. Anxiety was not a predictor of delayed ambulation; however, depressive symptoms increased the likelihood of delayed ambulation by 67% (Odds Ratio [OR]: 1.67, 95% CI: 1.02 – 2.72, p = 0.041).
Early ambulation was associated with significantly greater muscle strength and thickness as determined by dynamometry and muscle ultrasound, and depressive symptoms significantly increased the likelihood of delayed ambulation. Systematic evaluation of the association between trauma injury, immobility, skeletal muscle function and structure, and psychological state will provide an opportunity for the appropriate evaluation after injury and development of effective, tailored interventions to improve short- and long-term physiological and psychological recovery.
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Goodlich, Benjamin I. "Machine learning algorithms for the automatic detection and classification of physical activity in children with cerebral palsy who use mobility aids for ambulation." Thesis, Griffith University, 2019. http://hdl.handle.net/10072/389853.
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Background: Literature related to objective measurement of habitual physical activity (PA) disproportionately over represents children with Cerebral Palsy (CP) who are ambulant. Consequently, it is unknown if methods used to examine PA, such as machine learning models built on accelerometer data, are able to accurately detect PA in children with CP who use mobility aids for ambulation.
Objective: To develop and test machine learning models used for the automatic detection and classification of PA type in children with CP who use mobility aids for ambulation.
Methods: Eleven children and adolescents with CP, age 11±3yrs (range 6-16yrs); six females; Gross Motor Function Classification System (GMFCS) III: n=5 and IV: n=6 participated. Participants completed six PA trials of increasing intensity while wearing an ActiGraph GT3X+ accelerometer on the wrist, hip and thigh. PA trials included: supine rest, seated colouring, seated ball throwing, overground walking with a mobility aid, wheelchair propulsion and riding on a modified tricycle. Decision Tree (DT), Support Vector Machine (SVM) and Random Forest (RF) classifiers were trained on 40 features in the vector magnitude of raw acceleration signal using 5s non-overlapping windows. Performance was evaluated using leave-one-subject-out cross validation. Comparisons of performance were subsequently made between all single placement models, all combinations of two placement models, and models trained on data from all three placements.
Results: The best performing single-placement model was a RF classifier trained on wrist features, yielding an overall prediction accuracy of 79%. The best performing model built on a combination of two placements was a RF classifier trained on wrist and hip features, yielding an overall prediction accuracy of 92%. The combinations of multiple accelerometer placements were significantly more accurate than a single monitor alone. Models based on the combination of two placements were more accurate than those based on a combination of three placements; however, this difference was not significant.
Limitations: The PA protocol consisted of structured activity trials performed in a controlled, clinical environment. Thus, the performance of the models under free living conditions require further investigation. The sample size used may limit the generalisability and robustness of the findings given the variability in movement patterns of the population of interest.
Conclusions: Machine learning techniques afford robust and accurate classification of PA in children with CP who use mobility aids for ambulation (GMFCS III & IV) within a laboratory setting. This is significant, as it is the first study to develop methods for objectively measuring habitual PA in this population. Future research should investigate performance of the methods utilised in the current project in children engaged in free living conditions.Thesis (Masters)
Master of Medical Research (MMedRes)
School of Medical Science
Griffith Health
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Almeida, Elisângela Pinto Marinho de. "Efeito de um protocolo pós-operatório de mobilização precoce na recuperação funcional e nas complicações clínicas pós-operatórias de pacientes submetidos à cirurgia oncológica abdominal de grande porte." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5152/tde-20092016-154005/.
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Objetivos: O objetivo do presente estudo foi avaliar o efeito de um programa pósoperatório de mobilização precoce na capacidade funcional e na incidência de complicações clínicas em pacientes submetidos à cirurgia oncológica abdominal de grande porte, quando comparado a uma estratégia de reabilitação pósoperatória convencional. Desenho: Estudo fase III de superioridade, unicêntrico, randomizado e controlado. Local: Unidades de internação (enfermarias e Unidade de Terapia Intensiva) do Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, Brasil. Participantes: Pacientes adultos do Instituto do Câncer do Estado de São Paulo, submetidos à cirurgia oncológica abdominal de grande porte. Intervenção: Após assinarem o termo de consentimento livre e esclarecido e antes do procedimento cirúrgico, os pacientes foram aleatoriamente alocados para um protocolo de mobilização precoce pós-operatório, supervisionado, com treino aeróbico e resistido, que seguia um protocolo de progressão específico, realizado 2x/dia ou para um grupo controle, sem treino aeróbico e resistido específico, realizado 1x/dia. Desfecho primário: Inabilidade para atravessar o quarto do hospital ou andar três metros, sem ajuda de terceiros, na ocasião do 5° dia de pós-operatório. Resultados: Foram incluídos 108 pacientes na análise final; destes, 54 foram alocados no grupo intervenção e 54 no grupo controle. O desfecho primário ocorreu em 16,7% (95% Intervalo de confiança [IC] 7,9 - 29,3) dos pacientes do grupo submetido ao protocolo de mobilização precoce e em 38,9% (95% IC 25,9 - 53,1) dos pacientes do grupo controle (p= 0,010). Comparado com a reabilitação convencional, o protocolo de mobilização precoce no pós-operatório resultou em redução do risco absoluto do desfecho primário em 22,2% (95% IC 5,9 - 38,6) e um número necessário para tratar de 4,5 (95% IC 2,5 - 17,1). Conclusões: Um programa de mobilização precoce pós-operatório resultou em redução da perda funcional em pacientes submetidos à cirurgia oncológica abdominal de grande porte para tratamento do câncer quando comparado a um programa de reabilitação pós-operatória convencionalObjectives: The aim of this study was to evaluate the effect of early mobilization program performed in the postoperative in the functional capacity and incidence of clinical complications in patients undergoing major elective oncologic abdominal surgery. Design: Phase III, randomised, unicentric, controlled, parallel-group, superiority trial. Setting: Regular ward and Intensive Care Unit of Instituto do Cancer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, a tertiary oncology university hospital in Sao Paulo, Brazil. Participants: Adult patients with cancer who underwent major abdominal oncologic surgery were included. Interventions: After signing informed consent and before surgery, patients were randomly assigned to a group of early postoperative mobilization program, with a specific aerobic and resistance training twice a day or to a control group (standard rehabilitation care, once a day). Main outcome measure: Inability to cross the room or walk 3 meters without human assistance, at 5th postoperative day. Results: A total of 108 patients were included in the final analysis. Fifty four were randomized to the intervention group and 54 to standard group. The primary endpoint occurred in 16.7% (95% confidence interval [CI] 7,9 - 29,3) of patients in the intervention group and in 38.9% (95%CI 25,9 - 53,1) of patients in the standard group (p=.010). Compared to the standard group, the early mobilization program in postoperative resulted in an absolute risk reduction for the outcome of 22.2% (95%CI 5.9 - 38.6) and a number needed to treat of 4.5 (95%CI 2.5 - 17.1). Conclusions: An early mobilization program resulted in greater postoperative functional capacity in patients undergoing major cancer surgery compared with a standard rehabilitation Trial registration: NCT01693172
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Al-Zahrani, Khaled Sultan. "Analysis of the kinetic, kinematic and temporospatial parameters of gait, and their relationship to functional ambulation following total knee replacement using two different prosthetic designs." Thesis, University of Southampton, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.326745.
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Lobão, Andreia Filomena Monteiro. "Parto positivo: experiências maternas de posturas e movimento." Master's thesis, Universidade de Évora, 2022. http://hdl.handle.net/10174/31468.
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Objetivos: Descrever e analisar reflexivamente o processo de adquisição e
desenvolvimento de competências, comuns e específicas, para o exercício profissional
especializado em Enfermagem de Saúde Materna e Obstétrica.
Metodologia: Estágio realizado sob a metodologia de supervisão clínica. Assentou
numa prática baseada na evidência, utilizando-se como ferramenta a revisão integrativa
da literatura, associada à reflexão sobre a prática, através de dados recolhidos em
campo clínico.
Resultados: Foram adquiridas e desenvolvidas as competências necessárias à
prestação de cuidados de enfermagem especializados na área da especialidade. A
exploração da temática contribuiu para desenvolver competências que permitem
favorecer experiências de parto positivas , nas quais a mulher abraça a sua vivência de
forma mais ativa.
Conclusão: O conhecimento e competências adquiridas, contribuem para a assistência
humanizada, centrada na Mulher, tendo capacitado para a tomada de decisão baseada
na evidência científica e melhoria da qualidade dos cuidados. O aprofundar da temática
afiança que as posturas e movimentos contribuem para um parto positivo; Positive Birth: Maternal Experiences of Postures and Movement
ABSTRACT:
Objectives: Describe, reflect and analyze the process of acquiring and developing
common and specific competences for specialized professional practice in Maternal and
Obstetric Health Nursing.
Methodology: Internship performed under the methodology of clinical supervision. It
was reasoned on evidence-based practice, using as a tool the integrative literature
review, associated with reflection on practice, through data collected on clinical field.
Results: The necessary skills to provide specialized nursing care in the specialty area
were acquired and developed. The exploration of the theme contributed to develop skills
that allow for positive birth experiences in which the woman embraces her experience in
a more active way.
Conclusion: The knowledge and skills acquired contribute to humanized care, centered
on women, enabling decision-making based on scientific evidence and improving the
quality of care. The deepening of the theme ensures that postures and movements
contribute to a positive birth.
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Cerqueira, Telma Cristina Fontes. "Capacidade funcional de exercício em pacientes submetidos à eletroestimulação neuromuscular no pós-operatório de cirurgia cardíaca: um ensaio clínico randomizado." Pós-Graduação em Ciências da Saúde, 2018. http://ri.ufs.br/jspui/handle/riufs/8554.
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Background: The Neuromuscular electrical stimulation (NMES) is a potential resource to be
applied to patients in the immediate postoperative period of cardiothoracic surgery in order to
avoid functional loss, which often occurs even during a short period of hospitalization in the
Intensive Care Unit. Objective: To investigate the effects of NMES on functional exercise
capacity in cardiac surgery patients in the immediate postoperative period. Methods: In this
randomised, controlled, adult patients in the preoperative period of coronary artery bypass
grafting and cardiac valve replacement were randomly assigned to two groups: a control group,
subjected to the usual care of physical therapy, or intervention group, who underwent NMES
in the rectus femoris and gastrocnemius, bilaterally, for 60 minutes, for up to 10 sessions. The
primary outcome was distance walked, assessed through the Six-Minute Walk Test at
postoperative day 5. Secondary outcomes were walking speed; blood lactate after effort; muscle
strength, assessed through the extensor isometric strength, handgrip strength and Medical
Research Council scale; electrical muscle activity of the rectus femoris; functional
independence measure and quality of life, assessed through the Nottingham Health Profile, at
baseline (preoperative) and postoperative period. Statistical analyses were performed with
SPSS. The chi-square test, t-test, the analysis of variance and the effect size calculation were
performed. Results: The analysis included 45 patients, 23 in the NMES group and 22 in the
control. There was no statistically significant difference between groups on distance walked
(95% IC, -83,51 to 52,79, p=0,080), or walking speed, muscular strength, electrical muscle
activity, functional independence and quality of life. However, patients in the NMES group
preserve the extensor strength, the electrical muscle activity, muscle strength assessed through
Medical Research Council and blood lactate after the effort when compared to the rest. There
was a decrease in handgrip strengh, functional independence and decline in mobility assessed
through PSN, with no return to baseline values in 5PO, except for mobility in the NMES group,
which presented a return to preoperative values. Conclusion: The use of NMES has no effect
on functional exercise capacity in the cardiac surgery patients in the immediate postoperative
period, but was associated with preservation of muscle strength, recruitment of rectus femoris
motor units, and blood lactate after effort.Introdução: A eletroestimulação neuromuscular (EENM) se apresenta como um potencial recurso a ser utilizado no pós-operatório de cirurgia cardíaca com o objetivo de evitar o declínio de mobilidade funcional, que muitas vezes ocorre mesmo durante um curto período de internamento na Unidade de Terapia Intensiva. Objetivo: Avaliar os efeitos da EENM na capacidade funcional de exercício de pacientes no pós-operatório imediato de cirurgia cardíaca. Metodologia: Neste ensaio clínico randomizado, pacientes adultos, em pré-operatório de revascularização do miocárdio e implante de bioprótese valvar foram alocados em dois grupos: Grupo Controle, submetido aos cuidados usuais da fisioterapia; e Grupo Experimental, em que foi adicionada a aplicação da EENM, com a corrente FES (Functional Electrical Stimulation) no reto femoral e gastrocnêmio lateral bilateralmente, por 60 minutos em até 10 sessões durante a hospitalização. O desfecho primário foi a distância percorrida, avaliada através do Teste de caminhada de 6 minutos (TC6) no 5° dia pós-operatório (PO). Os desfechos secundários foram velocidade da marcha; lactimetria pré e após esforço; força muscular, avaliada a partir da dinamometria de extensão de joelho, escala do Medical Research Council (MRC) e preensão palmar; atividade eletromiográfica do músculo reto femoral; medida de independência funcional (MIF); e qualidade de vida através do Perfil de Saúde de Nottingham (PSN), avaliados no pré e pós-operatório. Para estatística foi utilizada o programa SPSS. Foi aplicado o teste t de Student, exato de Fisher, ANOVA e calculado o tamanho do efeito. Valores de p <0,05 indicaram significância estatística. Resultados: Foram incluídos na análise 45 pacientes, 23 pertencentes ao grupo EENM e 22 ao grupo controle. A EENM não teve efeito sobre a distância percorrida (95% IC, -83,51 a 52,79, p=0,080) no 5PO, nem mesmo sob velocidade de marcha no T10, força muscular, lactimetria, atividade eletromiográfica, independência funcional e qualidade de vida. O grupo EENM, porém, apresentou manutenção da força para extensão de joelho, da atividade eletromiográfica, força muscular global a partir do MRC e do lactato sanguíneo após o esforço quando comparado ao repouso, diferente do grupo controle. Houve queda da preensão palmar, independência funcional e do domínio habilidades físicas do PSN, sem retorno aos valores basais no 5PO, exceto para habilidades físicas no grupo EENM que apresentou retorno aos valores pré-operatórios. Conclusão: O uso da EENM não demonstrou efeito sobre a capacidade funcional de exercício de pacientes no pós-operatório de cirurgia cardíaca, porém foi associada à preservação de força muscular, recrutamento das unidades motoras do reto femoral e do lactato sanguíneo ao esforço.
Aracaju
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Nogueira, Debora Stripari Schujmann. "Impacto do nível de atividade física na funcionalidade de pacientes na unidade de terapia intensiva." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5170/tde-06092016-162425/.
Full textAbstract:
Introdução. A hospitalização tem sido associada com o declínio funcional. Em pacientes críticos, os efeitos da perda funcional na hospitalização podem perdurar por muito tempo após a alta hospitalar. Muitos fatores durante a estadia na Unidade de Terapia Intensiva podem ter potencial para influenciar a perda funcional após esse período. A hipótese do estudo foi que o nível de atividade e mobilidade durante o período na Unidade de Terapia Intensiva poderia ter mais impacto para o declínio funcional que outras variáveis. Objetivo. Investigar o impacto do nível de atividade física e outros fatores clínicos durante a estadia na Unidade de Terapia Intensiva como possíveis fatores preditivos e protetores do declínio funcional. Desenho do estudo. Estudo prospectivo observacional. Métodos. O estudo incluiu pacientes de uma Unidade de Terapia Intensiva do Hospital das Clínicas de São Paulo e foi aprovado pelo comitê de Ética da Instituição. Os critérios de inclusão foram idade maior que 18 anos, sem diagnósticos neurológicos, sem contra indicação para mobilização e Índice de Barthel maior que 80 pontos. Foram excluídos pacientes com estadia menor que quatro dias e óbito durante o estudo. Um acelerômetro no tornozelo do paciente foi usado para analisar o nível de atividade e mobilidade durante todo o período da internação na unidade intensiva. Foram avaliadas variáveis como idade, sexo, SAPS III, ventilação mecânica, medicações, comorbidades e motivo da admissão. A funcionalidade foi avaliada através do Índice de Barthel no momento da admissão e da alta. Os pacientes foram divididos no momento da alta da Terapia Intensiva em dois grupos: pacientes que eram funcionalmente dependentes (Índice de Barthel menor que 80 pontos) e independentes (maior que 80 pontos). Regressão logística e Odds Ratio foram usados para analisar os fatores de risco e de proteção para o declínio funcional. Resultados. Foram avaliados 62 pacientes com 57 ± 17 anos, 53% do sexo feminio, Índice de comorbidade de Charlson 3 (2-6), SAPS III 54 ± 13 pontos. 39% dos pacientes fizeram uso de ventilação mecânica durante 2,5 (1-4) dias. Os pacientes passaram 94 ± 4% do tempo da internação inativos, 6±3,7% em atividade leves e 87±9% deitados. 58% se tornaram funcionalmente dependentes. A análise do Odds Ratio mostrou que a idade aumentou em 23% (OR=1.23, CI95% 1,05-1,43) o risco de declínio funcional, e o tempo em inatividade em 227% (OR=3.27, CI95% 1,23-8,68). Ao contrário disso, o tempo gasto em atividades leves foi um fator de proteção para o declínio funcional (OR=0.50, CI95% 0,36-0,69). Limitações. O estudo foi realizado em apenas uma Unidade de Terapia Intensiva com pacientes clínicos e cirúrgicos. Para análise do acelerômetro foi usado um algoritmo já validado na literatura, porém para pacientes idosos saudáveis. Conclusão. Os resultados desse estudo oferecem as primeiras evidências que diferentes níveis de atividade física durante o período na Unidade de Terapia Intensiva foram relacionados a perda funcional nesse período. O único fator protetivo independente modificável foi a atividade física, mesmo que em níveis baixos. Portanto, a idade e a porcentagem do tempo em inatividade durante o período de internação na Unidade de Terapia Intensiva, foram fatores preditivos independentes para a perda funcional no momento da alta. Atividades leves, mostrou-se ser fator protetivo em pacientes na Unidade de Terapia IntensivaBackground. The hospitalization has been associated with adverse events such functional decline. In critical patients, this impairment can still for long time after hospital discharge. Many factors during the stay in intensive are unit could influence the functional decline. We hypothesized that the level of exercise and mobility during the period in intensive care unit could be more impact for functional decline than clinical characteristics. Objective. We aimed to investigate the impact of physical activity level and other clinical factors during intensive care unit stay as possible predictors and protectors of the functional decline in discharge moment. Design. This investigation was a prospective, observational study. Methods. This study included patients from an ICU, in Hospital das Clínicas of São Paulo, Brazil. This study was approved by the Ethics Committee. Study inclusion criteria were aging over than 18 years, without neurological pathology and contraindication for mobilization, Barthel Index >= than 80 points. Our exclusion criteria were less than 4 days in the ICU and death during the protocol. Accelerometry on the ankle was used to analyze activity during all the period in ICU. We also assessed age, sex, SAPS III, mechanical ventilation, drugs, comorbities and reason of ICU admission. We assessed functional status by BI in ICU discharge. For statistical analysis, we divided the patients in ICU discharge into two groups: who was functionally dependent (FD; BI <80points) and independent (FI; BI >=80 points). Logistic regressions and Odds Ratio were used to analyze predictive and protective factors of functional decline. Results. We analyzed 62 patients (57 ± 17 years, 53% male, Charlson Index 3 (2- 6), SAPS III 54 ± 13 points, 39% under mechanical ventilation during 2,5 (1-4) consecutive days. Patients spent 94 ± 4% of the time in inactivity, 6 ± 3,7% in light activities, and 87±9% lying. 58% of patients become FD. The age and percentage of time in inactivity were independent factors for functional decline. The Odds Ratio (OR) showed that age (OR=1.23, CI95% 1,05-1,43) and time in inactivity (OR=3.27, CI95% 1,23-8,68) were predictive factors for functional decline. On the other hand, time in light activity (OR=0.50, CI95% 0,36-0,69) was a protective factor for functional decline. Limitations. We analyzed a single ICU with clinical and surgery patients, we used validated algorithms for healthy subjects, specifically, elderly patients. CONCLUSIONS. The results of this study offer the first evidence that the different level of physical activity during ICU stay is related to functional loss in this period. Since inactivity is a risk factor, light activity is a protective factor for these patients. Therefore, physiotherapy intervention can focus on maintaining patient functionality, since physical activity is a modifiable factor in the ICU environment. With the goal of maintaining functionality, the only modifiable factor, in our study, was physical activity, even when in low level. So, the age and the percentage of time in inactivity during the stay in ICU were predictive factors for loss of functional independence in discharge moment. Perform light exercises during this moment proved to be a protective factor for functional loss in ICU patients
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Nickels, Marc. "Exercise interventions with critically ill patients in an Australian tertiary intensive care unit." Thesis, Queensland University of Technology, 2020. https://eprints.qut.edu.au/206174/1/Marc_Nickels_Thesis.pdf.
Full textAbstract:
This thesis investigated the physical impairments experienced by critically ill patients in intensive care. Clinicians’ perceptions regarding exercise with critically ill patients were explored, and medical records analysed to illustrate that despite clinicians’ positive perceptions regarding exercise, critically ill patients rarely completed exercise interventions whilst admitted to the intensive care unit. A preliminary randomised control trial was conducted that evaluated the effectiveness of an innovative in-bed cycling intervention. In-bed cycling with critically ill patients was found to be safe, feasible and acceptable to patients, families and clinicians. Promising patient outcomes were identified that justify a future multi-centre randomised control trial.
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Edén, Engström Britt. "Growth Hormone and Gender. Studies in Healthy Adults and in Patients with Growth Hormone Disorders." Doctoral thesis, Uppsala universitet, Institutionen för medicinska vetenskaper, 2001. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-1262.
Full textAbstract:
The use of a new, more sensitive immunoassay for growth hormone (GH) revealed that the serum levels in men were lower than expected in sera drawn ambulatory in the morning after an overnight fast and that the gender difference was more than 10 times greater than reported. These observations led to a more thorough study on the impact of gender and sex steroids on the levels of GH and other hormones in ambulatory morning samples and over a 24-hour period. Furthermore, the impact of gender was studied in GH deficient (GHD) patients and healthy young adults treated with GH, and in patients with acromegaly treated with octreotide. An 80-fold gender difference in the morning GH levels was observed in young individuals as a reaction to ambulation, with decreased levels in men and increased in women. Oral contraceptives (OCs) given to women further increased the morning GH levels. During the day, higher outputs of epinephrine and lower levels of GH were seen in the men, while no gender differences were seen at night. The gender difference in morning GH levels decreased with age due to opposite changes in men and women. Administration of 17β-estradiol (E2) via subcutaneous implants in postmenopausal women, which increased the E2-concentrations to luteal phase levels, had no effect on the morning GH levels, indicating that the different reactions to ambulation do not appear to result from a direct sex steroid effect alone. Short-term administration of GH to young, healthy adults resulted in larger effects on insulin-like growth factor I (IGF-I) and other key metabolic parameters in men than in women. The smallest response was noted in women taking OCs. The clinical studies involving long-term GH treatment of patients with GHD demonstrate a gender difference in GH responsiveness, with women being less sensitive than men, a fact which should have a therapeutic impact in patients with GH disorders. A further gender difference of therapeutic importance was observed in men and women with acromegaly. Long-term treatment with a slow-release formulation of octreotide resulted in higher IGF-I levels in the men, despite equal doses of the drug and similar levels of GH.
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Thuesen, Anna Helena, and Benjamin Lindahl. "Comparison of oxygen consumption while walking on treadmill wearing MBT Shoes versus Orthopedic Shoes : A treatise on shoe mass." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för rehabilitering, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-13695.
Full textAbstract:
Purpose: The purpose of this study was to investigate if there was any difference in energy expenditure (kcal/min) and oxygen consumption (VO2) between subjects walking with Masai Barefoot Technology ® (MBT) shoes and regular orthopedic shoes. The research hypothesis was that MBT shoes demand more energy expenditure than regular orthopedic shoes. Methods: Seven women aged 49-65 were recruited for the study. The subjects were tested in two sessions, with a minimum of two weeks in between each sesssion. On each test session the subjects walked with both MBT shoes and orthopedic shoes which were adjusted in mass (g) to match the mass of the MBT shoes. While the subjects walked on a treadmill, the oxygen consumption (VO2), heart rate (min-1) and self selected velocity (m/s) for each of the shoe types was measured. Results: Results showed that there is no significant difference in oxygen consumption (VO2) between the MBT and orthopedic shoes. Energy expenditure (kcal/min) was also calculated from the data and the results revealed that there is no significant differ-ence between MBT and orthopedic shoes in energy expenditure (kcal/min) either. The self selected velocity (m/s) between the two shoe types was also found to be insignificant. Conclusion: The results showed no significant difference between the shoes. This could indicate that the specific construction of the MBT shoe has no effect on the energy expenditure (kcal/min) of its user. This lack of difference may be due to the equal mass of the shoes, but since oxygen consumption (VO2) was not investigated in orthopedic shoes with different shoe masses, this conclusion cannot be confirmed. The self selected velocity (m/s) was found to be insignificant and this finding could suggest to that prolonged usage of the MBT shoe may diminish gait parameters dissimilarities during ambulation. This study should therefore be seen as a pilot study and further investigation in this area should be pursued.
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Ferrão, Ana Cristina Canhoto. "Mover para melhor nascer: liberdade de movimentos e posições verticais no primeiro estádio do trabalho de parto." Master's thesis, Universidade de Évora, 2016. http://hdl.handle.net/10174/19434.
Full textAbstract:
A Organização Mundial de Saúde destaca a deambulação e a adoção de posições verticais pela parturiente, como práticas demonstradamente benéficas, devendo ser estimuladas pela enfermeira obstetra na condução do trabalho de parto e parto normal, em situações de baixo risco obstétrico. O projeto preconizou a promoção da deambulação e o incentivo à adoção de posições verticais na fase ativa do trabalho de parto. As intervenções de enfermagem na promoção destas práticas foram avaliadas na equipa de enfermeiros obstetras do Serviço de Urgência Obstétrica e Ginecológica do Centro Hospitalar Barreiro-Montijo, Entidade Pública Empresarial e num grupo de parturientes, através da aplicação de questionários. As necessidades dos enfermeiros obstetras e das parturientes determinaram a realização de ações formativas e educacionais e a elaboração de materiais informativos de suporte à prática assistencial. A avaliação do projeto demonstrou que ainda existem práticas a serem melhoradas, sendo a sua continuidade vantajosa para profissionais e parturientes; ABSTRACT:
TITLE: Move to Better Birth - Freedom of Movement and Upright Positions in First Stage of Labor.
The World Health Organization highlights ambulation and adoption of vertical position by the woman, as demonstrated beneficial practices and should be encouraged by obstetric nurses in the conduct of obstetric labor and normal delivery, in low risk situations. The project advocated for the promotion of ambulation and encouragement for the adoption of vertical positions in the active phase of labor. Nursing interventions to promote these practices were evaluated in the obstetric nurses team of Obstetric and Gynecological Emergency Department from Hospital Center Barreiro-Montijo, Business Public Entity, and in a group of women in labor, through the use of questionnaires. The needs of obstetric nurses and women in labor determined the realization of training and educacional activities and the development of information materials to support the care practice. The project evaluation demonstrates that there are still practices to be improved, and its continuity being advantageous for professionals and women in labor.
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Lamb, Callum Douglas. "Mobility system for disabled people." Thesis, Queensland University of Technology, 1997.
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Lakhani, Shahzia A. "Preventing neuromuscular deconditioning in critically ill patients." Honors in the Major Thesis, University of Central Florida, 2011. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/456.
Full textAbstract:
Critically ill patients can be prescribed bed rest as a therapeutic intervention. Immobility from bed rest can cause neuromuscular deconditioning and weakness. Preventing immobility by implementing mobilization activities may prevent these complications from occurring. Currently, mobility protocols are lacking. The purpose of this literature review is to analyze the evidence related to mobilizing patients in the Intensive Care Unit (ICU). In the future, a standard mobility protocol should be instituted for critically ill patients indicating when and how to begin mobilization. The efficacy of mobility protocols relies on an interdisciplinary team for positive outcomes to prevent complications of inactivity and promote patient safety. Future implementation of mobilization can decrease patients' lengths of stay and extensive rehabilitation from inactivity. Nursing education, practice and research should focus on interventions to prevent complications of immobility by identifying mobilization techniques, safety approaches and the use of protocols.B.S.N.
Bachelors
Nursing
Nursing
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Christie, Breanne P. "Multisensory Integration of Lower-Limb Somatosensory Neuroprostheses: from Psychophysics to Functionality." Case Western Reserve University School of Graduate Studies / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=case1575564218875779.
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Matte, Roselene. "Repouso de três horas no leito após cateterismo cardíaco diagnóstico com introdutor 6 french não aumenta complicações decorrentes da punção arterial : ensaio clínico randomizado." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2013. http://hdl.handle.net/10183/97618.
Full textAbstract:
A despeito das evidências de que a redução do repouso no leito após cateterismo cardíaco diagnóstico sob abordagem transfemoral não aumenta as complicações decorrentes da punção arterial, esta prática ainda não está incoporada em muitos laboratórios de hemodinâmica (LH), principalmente em centros latino-americanos. Buscando preencher esta lacuna do conhecimento testou-se neste estudo se a redução do tempo de repouso no leito para três horas (GI), comparada a repouso de cinco horas (GC), não aumenta as complicações decorrentes da punção arterial após cateterismo cardíaco diagnóstico eletivo com introdutor 6 French e abordagem transfemoral. Foi conduzido um Ensaio clínico randomizado (ECR) no LH de um hospital público e universitário, região metropolitana, do Rio Grande do Sul no período de janeiro de 2011 a setembro de 2013. Foram incluídos pacientes adultos ambulatoriais. O GI deambulou três horas após a retirada do introdutor, e o GC após cinco horas. Todos pacientes permaneceram cinco horas na sala de observação onde foram observados a cada hora, pela equipe de enfermagem, e contatados por telefone em 24, 48 e 72 horas após a alta hospitalar. Foram avaliados os seguintes desfechos: hematoma, sangramento, hematoma retroperitoneal, pseudoaneurisma, formação de fístula arteriovenosa e reação vaso vagal Incluíram-se 730 pacientes: GI (n=367) e GC (n=363), média de idade de 62+11 anos. Durante a permanência dos pacientes na sala de observação do LH o hematoma foi a complicação mais observada em ambos os grupos, 12(3%) no GI e 13(4%) no GC (P=0,87); no GI 11(3%) pacientes apresentaram hematoma classificado como pequeno e 1(0,3%) apresentou hematoma classificado como grande; enquanto que no GC 11(3%) pacientes apresentaram hematoma classificado como pequeno e 2(0,6%) apresentaram hematoma classificado como grande; o sangramento ocorreu em 4(1%) dos pacientes no GI e 6(2%) no GC (P=0,51), tanto no GI como no GC a ocorrência de sangramento foi considerada menor. A reação vaso vagal ocorreu em 5(1,4%) pacientes no GI e 4(1,1%) pacientes no GC (P=0,75). Nos contatos em 24, 48 e 72 horas a equimose foi a complicação mais prevalente nos três períodos, para ambos os grupos, seguida pelo relato de dor no local da punção, para nenhuma das comparações foi observado significância estatistica. Apenas 1(0,3%) paciente do GC apresentou pseudoaneurisma no contato em 48 horas, necessitando retornar ao hospital para tratamento. Não foi observada nenhuma outra complicação durante todo o período do estudo. Os resultados deste estudo permitem concluir que a intervenção na redução do tempo de repouso para três horas após cateterismo cardíaco diagnóstico eletivo mostrou-se segura, sem aumento de complicações quando comparada aos pacientes que permaneceram em repouso de cinco horas.Despite evidence that point out that reduction of rest in bed time after diagnostic cardiac catheterization using transfemoral approach does not contribute to complications of arterial puncture, such practice was still not incorporated into several hemodynamic laboratories (HL), especially in Latin American centers. In order to fill this knowledge gap, this study presents a test for the reduction of rest in bed time of three hours (IG) compared to rest in bed time of five hours (CG), aiming at verifying if the time does not increase complications of arterial puncture after diagnostic cardiac catheterization using 6 French introducer and the transfemoral approach. A randomized clinical trial (RCT) was conducted at a HL in a public university hospital located in the metropolitan area of Rio Grande do Sul/Brazil, between January 2011 and September 2013. Adult outpatients were included in this trial. The IG remained three hours after the withdrawal of the 6 French introducer and the CG remained five hours in the ambulatory. All patients remained five hours in the observation room, being checked every one hour by the nursing staff and being contacted by telephone at 24, 48 and 72 hours after the discharge. The outcomes hematoma, bleeding, retroperitoneal hemorrhage, pseudoaneurysm, arteriovenous fistula and vasovagal response were assessed. For the study, 730 patients were included and separated into GI (n=367) and GC (n=363), mean age of 62 ± 11. While patients remained in the observation room in the HL, the hematoma was the most common complication observed in both groups, 12(3%) in IG and 13(4%) in CG (P=0.87); in IG, 11(3%) patients presented small hematoma and 1(0.3%) presented large hematoma; in CG, 11(3%) patients presented small hematoma and 2(0.6%) presented large hematoma; bleeding occurred in 4(1%) patients in IG and 6(2%) in CG (P=0.51); both IG and CG presented minor bleeding occurrences. The vasovagal response occurred in 5(1.4%) patients in IG and 4(1.1%) patients in CG (P=0.75). During telephone contacts at 24, 48 and 72 hours, ecchymosis was the most prevalent complication for the three periods in both groups, followed by pain at the puncture site. Statistical significance was not observed in any of the comparisons. Only 1(0.3%) patient in the CG had pseudoaneurysm within 48 hours after discharge and had to return to the hospital for treatment. No other complications were observed during the study period. The results of this study demonstrate that reducing the time of rest in bed for three hours after diagnostic cardiac catheterization proved to be a safe procedure, with no increase in complications when compared to patients who remained resting in bed for five hours.
Con relación a las evidencias de que la reducción del reposo en el lecho tras cateterismo cardíaco diagnóstico bajo abordaje transfemoral no aumenta las complicaciones decurrentes de la punción arterial, esta práctica aún no está incorporada en muchos laboratorios de hemodinámica (LH), principalmente en centros latinoamericanos. En la tentativa de rellenar este hueco del conocimiento se hizo un test en este estudio para saber si la reducción del tiempo de reposo en el leco para tres horas (GI), comparada a cinco horas (GC), no aumenta las complicaciones decurrentes de la punción arterial tras cateterismo cardíaco diagnóstico con introductor 6 French y vía transfemoral. Fue dirigido un Ensayo clínico randomizado (ECR) en LH de un hospital público y universitario, región metropolitana, de Río Grande del Sur en el periodo de enero de 2011 a septiembre de 2013. Fueron incluidos pacientes adultos ambulatoriales. GI deambuló tres horas luego de la retirada del introductor, y GC tras cinco horas. Todos los pacientes permanecieron cinco horas en la sala de observación donde fueron observados a cada hora, por el equipo de enfermería, y contactados por teléfono en 24, 48 y 72 horas tras el alta hospitalario. Fueron evaluados los siguientes resultados: hematoma, hemorragia, hematoma retroperitoneal, pseudoaneurisma, formación de fístula arteriovenosa, reacción vaso y vagal. Se incluyeron 730 pacientes en la sala de observación de LH, el hematoma fue la complicación más observada en ambos grupos, 12 (3%) GI y 13 (4%) GC (P=0,87); en GI 11(3%) pacientes presentaron hematoma clasificado como pequeño y 1(0,3%) presentó hematoma clasificado como grande; mientras que en GC 11(3%) pacientes presentaron hematoma clasificado como pequeño y 2 (0,6%) presentaron hematoma clasificado como grande; la hemorragia ocurrió en 4 (1%) de los pacientes en GI y 6 (2%) en GC (P=0,51), tanto en GI como en GC la ocurrencia de hemorragia fue considerada menor. La reacción vaso vagal ocurrió en 5 (1,4%) pacientes en GI y 4 (1,1%) pacientes en GC (P=0,75). En los contactos en 24, 48 y 72 horas la equimosis fue la complicación que más prevaleció en los tres periodos, para ambos grupos, seguida por el relato de dolor en el local de la punción, para ninguna de las comparaciones fue observada significancia estadística. 1 (0,3%) paciente de GC presentó pseudoaneurisma en el contacto en 48 horas, necesitando volver al hospital para tratamiento. No se observó ninguna otra complicación durante todo el periodo del estudio. Los resultados de este estudio permiten concluir que la intervención en la reducción del tiempo de reposo para tres horas luego de cateterismo cardíaco diagnóstico electivo es posible y segura, sin aumento de complicaciones cuando comparada a los pacientes que permanecieron en reposo de cinco horas.
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Gilson, Sheryl L. "Promoting Early Mobility of Patients in the Intensive Care Unit." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6433.
Full textAbstract:
Deconditioning occurs in critically ill patients as early as 4 days after entering the intensive care unit (ICU) resulting in a loss of up to 25% peripheral muscle tone and 18% body weight by the time the patient is discharged. Early mobility (EM) has been shown to reduce complications such as neuromuscular weakness, muscle wasting, pneumonia, and the effects of prolonged periods of time on the ventilator. No formal education on EM had been provided to nurses at the clinical site. The purpose of this project was to develop an educational program on EM to promote early ambulation of critically ill ICU patients. The theory of knowledge to action was used to guide the development of the educational program. The practice-focused question addressed whether an educational program would improve nurses' perceptions of their knowledge of EM and if they would promote the use of EM among ICU patients. After a literature review to identify evidence-based practices and a protocol on EM, an educational program was developed that included a 25-item Likert-style pretest and posttest to measure percent agreement with perceptions of knowledge gained and likelihood of behavior change related to the practice of EM. Participants included 60 ICU nurses. Results demonstrated improvement in perceptions of knowledge of EM (from 74% before education to 88% after) and in likelihood of behavior change related to EM (from 69% before education to 91% after). Findings may be used to integrate EM into the ICU setting to reduce complications such as neuromuscular weakness, muscle wasting, and pneumonia. Results may also include improved patient outcomes, reduced length of stay, and increased quality of life for patients and their families, and thereby promote positive social change.
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Clermont, Isabelle. "AMBULATOR NASCITUR NON FIT. On naît marcheur, on ne le devient pas." Thesis, Université Laval, 2009. http://www.theses.ulaval.ca/2009/26152/26152.pdf.
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McWhirter, Lynn. "Novel Oral Anticoagulants: Bedrest and Bleeding in Patients Undergoing Atrial Fibrillation Catheter Ablation." UNF Digital Commons, 2014. http://digitalcommons.unf.edu/etd/520.
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Atrial fibrillation (AF), the most common cardiac arrhythmia in persons over age 65, is associated with an increased stroke risk necessitating the need for long-term oral anticoagulation for risk reduction. With the introduction of direct thrombin and factor Xa inhibitors in the US since 2010, these novel oral anticoagulants (NOACs) are increasingly being prescribed, replacing the use of warfarin, a vitamin K antagonist. AF catheter ablation (CA), an elective procedure requiring femoral vascular access is a treatment for drug refractory and persistent AF. Bedrest, limb immobilization, and limited head of bed elevation are nursing measures utilized following femoral venous, and sometimes arterial, sheath removal and hemostasis. Limited research is available on the appropriate duration of bedrest to minimize bleeding complications associated with AF ablation in patients who use NOACs. The purpose of this quality improvement project was to compare and evaluate the effect of bedrest duration on post-procedure bleeding outcomes, urinary complaints, and back pain among patients taking NOACs while undergoing AFCA.
Thirty patients undergoing elective AFCA on NOACs were orally consented to participate in the study and placed on shortened (8 hours) or prolonged (>8 hours) bedrest following vascular hemostasis. Outcome measurements included bleeding after ambulation, back pain, and urinary complaints. Fifteen patients (50%) were on shortened bedrest and 15 (50%) were on prolonged bedrest. No statistically significant difference in bleeding, urinary complaints, or back pain were found. Since there is no clear advantage to prolonged bedrest for patients on NOACS after an AFCA procedure, clinicians should consider this when deciding on bedrest duration for their patients.
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Al-Mahyawi, Hussein. "Mise en scène de la déambulation et écriture de la ville dans un corpus d'oeuvres du XVIIIe siècle." Thesis, Tours, 2012. http://www.theses.fr/2012TOUR2005/document.
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Dans le premier versant du XVIIIe siècle, la présence de Paris dans les œuvres littéraires demeure sous-jacente ou est seulement suggérée par un simple regard qui reste généralement distant. C’est notamment le cas dans Le Diable boiteux de Lesage où la déambulation dans la ville reste subordonnée aux priorités visuelles (depuis un lieu surplombant, le diable montre à son élève les différents aspects de la ville). C’est avec Rousseau qu’une problématique nouvelle de la déambulation apparaît. Dans ses écrits autobiographiques (Les Confessions, Les Rêveries du promeneur solitaire), le narrateur met en scène cette déambulation dans son parcours même : les marches ou les promenades propices à la rêverie, à la méditation et à la remémoration. Avec Rétif de Bretonne (Les Nuits de Paris) et Louis-Sébastien Mercier (Tableau de Paris), Paris apparaît comme l’espace par excellence d’une errance féconde. La capitale française cesse d’être à l’arrière-plan et devient un objet d’écriture à part entièreIn the first half of the eighteenth century, the presence of Paris in the literary works remains underlying or is merely suggested by a single and generally distant glance. This is notably the case in Lesage’s novel The Lame Devil where the wandering in the city remains subordinate to visual priorities (from an overlooking place, the devil shows his learner different aspects of the city). It is with Rousseau that a new problem on ambulation emerges. In his autobiographical writings (Confessions, Reveries of a Solitary Walker), the narrator portrays this ambulation in his very career: walks or promenades inspiring daydreaming, conductive to meditation and recalling memories. With Rétif de la Bretonne (Parisian Nights) and Louis-Sébastien Mercier (Panorama of Paris), Paris seems to be the ideal place for a fertile wandering. The French capital ceases to be in the background and becomes a subject of writing in its own right
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Patterson, Kara Kathleen. "Characteristics of independent ambulation in chronic stroke survivors." 2006. http://link.library.utoronto.ca/eir/EIRdetail.cfm?Resources__ID=450684&T=F.
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SONG, YUN-TONG, and 宋雲通. "The feedback system for controlling ambulation loading in rehabilitation." Thesis, 1987. http://ndltd.ncl.edu.tw/handle/48643378604658566431.
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HSIEH, YI-HSIEN, and 謝易賢. "A Study of Functional Performance Among Different Ambulation Devices Elders." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/31702960476772991185.
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碩士國立臺北護理健康大學
長期照護研究所
105
With the increase of age, elderly people will suffer a gradual decline in ambulation-related functional performances (including grip strength, lower extremity muscle strength, balance, and walking capacity). The decline usually means decreased overall functional performance and lowering quality of life. Many studies have shown that ambulation devices can help maintain the walking capacity and abate the rate of declines in functional performance in senior population. There are a variety of ambulation devices, among which, regular cane, quad cane, and walker can be purchased without professional assessment and are therefore most prevalent. However, due to lack of professional intervention and knowledge of the features of different types of aids, elderly people may easily choose to use an unsuitable aid or suffer from injury resulting from improper use of the aid. The objective of this study is to investigate use of ambulation devices and functional performances among elderly people. To better understand the current use of ambulation devices in this population, this study also analyzes how age, gender, and fall experience are related to grip strength, Short Physical Performance Battery (SPPB) scores, and six-minute walking test (6MWT) score across users of different types of ambulation devices. A cross-section approach was adopted, and the participants were selected based on convenience sampling. The participants were 76 community-dwelling elderly people aged above 65 years old who had been using a ambulation device (including regular cane, quad cane, and walker) for at least one month. Their experience of using a ambulation device, fall experience before/after using the aid, and functional performances, including grip strength, SPPB scores, and 6MWT score were collected. Besides, the associations between demographic variables and functional performances among users of different types of aids were also analyzed. SPSS 19.0 was employed for data analysis. Results showed that regular cane was most common among the participants (42.1%), followed by quad cane (32.9%) and walker (25.0%). Most participants were in the age group of 75-84 years old (44.7%), female (52.6%), having elementary school education as their highest education degree (68.4%), and living with their family (90.8%). Among regular cane users, back pain and lower backbone joint diseases were most prevalent (68.8%); among quad cane users, stroke was the most common disease (72.0%); obese users constituted the majority (68.4%) of those using a walker. 77.6% of the participants used only one type of ambulation device. Most participants used the ambulation device in indoor environments (85.5%) outside their home and outdoor environments of the community (85.5%). Most users purchased the aid on their own (85.5%). 85.5% of the participants reported that they did not seek professional introduction or demonstration before using a ambulation device. After purchasing a ambulation device, 85.5% of the participants had never sought professional assessment of their usage of the ambulation device. 30.3% reported to have a fall experience before using a ambulation device. 35.5% still had a fall experience after using a ambulation device, and most of their falls occurred at home (44.4%). As to functional performance, quad cane users scored higher on right hand grip strength than walker users; regular cane users outperformed walker users in SPPB total score, SPPB balance score, and SPPB walking score. In the test of 6MWT, regular cane users showed a significantly higher performance than quad cane users and walker users. This study also found that the functional performances of ambulation device users did not vary by age, gender or fall experience before/after using a ambulation device. However, in the aspects of SPPB standing from a chair and 6MWT, male users and aid type were statistically significant. In both aspects, regular cane users showed the highest score, while walker users had the lowest. This study also found a slight increase in occurrence rate of falls after using a ambulation device among the participants, but the rate contrarily decreased among regular cane users. In terms of functional performance, walker users had the highest degree of disability, followed by quad cane users, with the degree of regular cane users being the lowest. This study investigates the association between ambulation device type and functional performances in elderly users. In the practical aspect, this study suggests that clinical workers should reinforce the correct concept of ambulation device use among community-dwelling elderly people and their family and provide appropriate intervention to ensure the safety of elderly people using a ambulation device. In the professional aspect, manufacturers of ambulation devices can design graphic instruction manuals that are easier to read for elderly users. Because ambulation devices can also be used as a training tool, future researchers can also explore the benefits of ambulation devices as a training tool.
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Lung, Chi-Wen, and 龍希文. "Effect of Foot Structural Morphology on Biomechanical Characteristics during Ambulation." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/64518108188595958627.
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博士國立陽明大學
醫學工程研究所
96
Medial longitudinal arch is composed of bones and soft tissues. It also played the one of important roles in the ambulation. The arch provides not only for the stability during stance phase of walking, but also for the connecting with the posterior and the anterior center-of-gravity position. The use of radiography to determine the high-arch foot and flatfoot has certain drawbacks such as exposure of radiations. Arch index (AI) can solve the problems; however, it does not allow clinicians to examine the bone alignment in the foot. On the other hand, the change of arch height of the human foot can change the contact times and region forces of plantar regions during walking, and finally lead to musculoskeletal injury. Understanding the arch bone alignments and plantar variables during ambulation could suggest new diagnostic and preventive method of foot injury. To investigate the correlations between the AI and bony alignments, this study comprised 57 young subjects (28 men and 29 women). Footprints were scanned using a flatbed scanner and the AI was then calculated. Radiographs were taken and the x-ray coordinate system was used to determine the position of the bones in the foot. Results showed that the measured AI averaged at 0.255 ± 0.067 (ranged from 0.050 to 0.407). The navicular height/foot breadth showed the strongest correlaions with the AI (r = 0.626). Therefore, AI was found to provide a simple quantitative mean of assessing the bone angles, especially in the calcaneal pitch angle inclination (r = 0.699). To show the spatio-temporal distribution of center of pressure (CoP) under high-arch, normal, and flatfoot subjects during walking, this study comprised three groups of young subjects who were the same condition of arch type in left and right foot. Each subject walked through the 10-meter walkway including a pressure plate which was used to calculate the CoP data. Results showed that the stance time of CoP on the mid-foot area of normal feet was significantly shortened comparing with both the high-arch and flatfoot feet; in the metatarsal region, the high-arch foot and flatfoot could be generating the different velocity to compensate the foot structure effect during walking. In the high-arch group, the heel off time was delayed during walking. In the flatfoot group, the initial contact time was also delayed. However, the regional force in the 3rd metatarsal of flatfoot group was increased during walking. Therefore, flatfoot could be at the higher risk for 3rd metatarsal stress fractures, indicating that foot type should be assessed when determining an individual's risk for metatarsal stress fractures. The finding of this study can help clinicians to determine an appropriate conservative treatment and to evaluate the treatment outcomes for people with high-arch and flat foot.
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Hsuan-JuHuang and 黃璇如. "The experience of recovery from ambulation disability among discharged elderly patients." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/02109008702821820829.
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碩士國立成功大學
護理學系
102
Chronic illness, hospitalization, and functional disability are common health issues among older adults. This study aims to discover the motivation and recovery of walking ability for the elderly with ambulation disabilities, after being discharged from the hospital. The study adopted the purposive sampling in an elderly clinic of a medical center in Tainan City to collect data. The inclusion criteria were: 1) age 65 or over; 2) mentally healthy; 3) without surgery during hospitalization; 5) decreasing in walking function during hospitalization and returning home for care; 6) continuing a follow-up in a clinic and walking again within 3 months after returning home. One-on-one interviews were conducted with the subjects who had a walking disability when leaving the hospital but currently recovered, in order to learn about their feels and experience. Both audio and verbatim recordings were used for collecting data. ATLAS.ti was employed for data analysis. There were four interviewees in total, including one male and three females, and their ages are between 73 and 87. “Adaptation” is the research result completed in the Taiwanese culture. This study found that the recovery of walking ability includes three factors such as adapting treatment, being independent, and agricultural adjustment act. The results suggest that the seniors, when returning home, often receive assistance from relatives and friends, especially from families.
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Shih, Yu-Ling, and 石佑翎. "Effects of Task-Oriented Ambulation Training in Long-Term Care Facilities." Thesis, 2002. http://ndltd.ncl.edu.tw/handle/27473709319002859655.
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碩士國立臺灣大學
物理治療學研究所
90
An important goal of physical therapy in the long-term care facilities is to maintain or improve ambulation ability of the residents. If the declination of ambulation ability is delayed, the burden of the care-givers in the long-term care facilities may be lessened and the quality of life of the residents may be improved. The purpose of this study was to investigate the effects of a four-week task-oriented physical therapy ambulation training on balance and gait function for residents in the long-term care facilities. Thirty subjects were recruited from three licensed long-term care facilities located in the Taipei area. Subjects met the following criteria: (1) agree to sign the informed consent, (2) able to stand with minimal support, (3) leg joints ranges of motion within 20% normal, (4) walking speed less than 50 m/min. The outcome measures included walking speed, timed get-up and go test, six-minute walking test, Berg balance scale and the Barthel index. The subjects were evaluated at baseline and then at the end of the fourth week following baseline. Fifteen subjects were randomly assigned into the training group and received task-oriented ambulation training three days per week, 30 minutes per day for four weeks after the baseline measure. Independent samples t test (with SPSS 10.0 for Windows) was used to determine whether there were significant difference in outcome measures between group, and the significant difference level was set at p< 0.05. Subjects in the training group (mean age = 71.2 years, 10 males, 5 females) and the control group (mean age = 76.3 years, 9 males, 6 females) were similar with respect to all baseline demographic and outcome measures (p>0.05). The results showed significant training effects on walking speed (p<0.0001), timed get-up and go test (p<0.05), and the six-minute walking test (p<0.05), but not on the Berg balance scale and the Barthel index. It is concluded that a four-week task-oriented ambulation training is an effective exercise program to improve the ambulation ability for the long-term care residents who had ambulation potential. The training was not oriented to the balance ability or the activities of daily living tasks, which explains the lack of significant improvements in these functions after training.
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Chu, Wen-Yueh, and 朱文玥. "The Biomechanics Effects of Walker Parameters on Frail Elderly Assisted Ambulation." Thesis, 2006. http://ndltd.ncl.edu.tw/handle/76571503655863431499.
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碩士國立陽明大學
復健科技輔具研究所
94
The Biomechanical Effects of Walker Parameters on Frail Elderly Assisted Ambulation Background: Walkers are used to help alleviate weight bearing loads on the lower extremities and provide stability for the geriatric population. Some epidemiologic data were found about the risk of walker related injuries. The common walker parameter options for the rehabilitation team are types of legs and height. The walker-dependent population is composed largely of individuals over 65 years old. Currently, there are no studies that investigate the effects of the types and height of walker on the frail elderly assisted ambulation. Objective: The purpose of this study is to analyze the biomechanics effects ( kinematics and kinetics) of walkers types and height on the frail elderly assisted ambulation. Design: within-subject comparisons. Participants: 2 intermediate frail(2 women) and 1 frail(1 man) elderly with a mean age of 83 years who matches the Fried frailty criteria. Methods: self-instrumented walker with exchangeable foot and type, motion capture analysis system, force plates and force transducer were used. Subjects were tested in walking trials, using 4-footed and 4-wheeled walker, with five different heights. Main outcome measures: gait pattern, load of upper extremities, horizontal force of lower and upper extremities, the system stability. Results: the gait patterns were different between 4-footed and wheeled walker but the height did not affect the gait pattern. The load of upper extremities increased with the walker height but no difference between two types of walker was found. The forward horizontal force of upper extremities was higher at 4-wheel walker but did not change with the height of walker compared with the 4-footed walker. The COM positions of system stability were different between the types of walker. Conclusion: height and types of walker have effects on frail elderly gait. The findings have implications that the unique effects of the walker parameter on frail elderly. This research may lead to more cautious the frail elderly assisted gait ambulation.
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Chang, Yu-Hsuan, and 張佑萱. "Development of a treadmill system to evaluate ambulation and balance ability." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/46300858427856459143.
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碩士國立陽明大學
物理治療暨輔助科技學系
98
Backgroung and purpose：Falls and fall-induced injuries are common events in elderly people. Due to medical improvement and decrement in mortality, aging population raise in the world. Some physiologic changes are related to aging, e.g. age-related changes in walking patterns. A large proportion of elderly falls occur when walking because of age-related changes in walking patterns, and it may induced potential postural balance control problem. Therefore, there’re a lot of studies focused on how to prevent falls and decrease injuries recently.Treadmill is an effective tool used to evaluate and train people who have problems in ambulation. Treadmill can measure basic parameters of gait, however, those parameters can only offer the information of whole body mobility but can’t provide any information about stability during walking.The purpose of this study was to develop a computer-based manual treadmill system to evaluate ambulation and balance ability. Methods：Sixty-two subjects were recruited in this study, including twenty-five healthy young adults, twenty-two healthy elderly people and fifteen faller elderly people. All people need to receive twice walking evaluation tests, and the elderly subjects have to receive questionnaires in addition. Statistical analysis：Independent sample t-test and chi-square were used to analyze all subjects’ basic data. Independent sample t-test was used to compare gait and COP measurements of adults and elderly groups. The statistically significant level was set at 0.05. Discussion：Although no significance was found between the healthy young and healthy elderly people in gait parameters, balance parameters all have significance (p<0.05). And significance were found between the healthy elder and faller elderly people in gait and balance parameters (p<0.05). Conclusion：Computer-based manual treadmill system can be used to evaluate ambulation and balance ability regardless of people in different age level.
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Elliott, David B., John Hotchkiss, Andy J. Scally, Richard J. Foster, and John G. Buckley. "Intermediate addition multifocals provide safe stair ambulation with adequate ‘short-term’ reading." 2015. http://hdl.handle.net/10454/8222.
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YesPurpose: A recent randomised controlled trial indicated that providing long-term multifocal wearers with a pair of distance single-vision spectacles for use outside the home reduced falls risk in active older people. However, it also found that participants disliked continually switching between using two pairs of glasses and adherence to the intervention was poor. In this study we determined whether intermediate addition multifocals (which could be worn most of the time inside and outside the home and thus avoid continual switching) could provide similar gait safety on stairs to distance single vision spectacles whilst also providing adequate ‘short-term’ reading and near vision. Methods: Fourteen healthy long-term multifocal wearers completed stair ascent and descent trials over a 3-step staircase wearing intermediate and full addition bifocals and progression-addition lenses (PALs) and single-vision distance spectacles. Gait safety/caution was assessed using foot clearance measurements (toe on ascent, heel on descent) over the step edges and ascent and descent duration. Binocular near visual acuity, critical print size and reading speed were measured using Bailey-Lovie near charts and MNRead charts at 40 cm. Results: Gait safety/caution measures were worse with full addition bifocals and PALs compared to intermediate bifocals and PALs. The intermediate PALs provided similar gait ascent/descent measures to those with distance single- vision spectacles. The intermediate addition PALs also provided good reading ability: Near word acuity and MNRead critical print size were better with the intermediate addition PALs than with the single-vision lenses (p < 0.0001), with a mean near visual acuity of 0.24 0.13 logMAR (~N5.5) which is satisfactory for most near vision tasks when performed for a short period of time. Conclusions: The better ability to ‘spot read’ with the intermediate addition PALs compared to single-vision spectacles suggests that elderly individuals might better comply with the use of intermediate addition PALs outside the home. A lack of difference in gait parameters for the intermediate addition PALs compared to distance single-vision spectacles suggests they could be usefully used to help prevent falls in older well-adapted full addition PAL wearers. A randomised controlled trial to investigate the usefulness of intermediate multifocals in preventing falls seems warranted.
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Leonard, Elaine M. K. "Treadmill versus floor ambulation in adults with hemiplegia changes in kinematic parameters /." 1997. http://catalog.hathitrust.org/api/volumes/oclc/37778710.html.
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Thesis (M.S.)--University of Wisconsin--Madison, 1997.Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 58-67).
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Huang, Hsin-Hui, and 黃心慧. "The Body-worn Ambulation Training Device with Visual Cues for Stroke Patients." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/frtrb7.
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碩士國立陽明大學
物理治療暨輔助科技學系
105
According to clinical experiences, the therapist must accompany patients to monitor and guide them to walk in a correct gait pattern while receiving training. Otherwise the patients may build an incorrect stepping habit, and in the long way may cause secondary injury. However, due to limited man power, therapists are not always available and the patients do not receive enough training. Thus, the patients recover slowly to a limited extend. In order for training disabled patients to recover quickly to their highest level in correct way, we previously developed two kinds of visual cue devices. One design is walker combined with visual cue to improve Parkinson disease patients’ walking performance, and the other design is quadricane / cane with visual cue to help hemiplegia stroke patients. Although our studies showed these devices do improve users’ performance, there are still some problems while visual cue attached on assistive devices. For example, users need to coordinate the device rather than their own walking habits and capability, the devices may be limited by the environment outdoor or even indoor. Therefore, we further develop a body-worn visual cue device in this study. The purpose of this study is to evaluate the functionality of the device for future clinical applications. Our concept of design utilizes the gait pattern to control the footswitch under the insoles. According to the on and off signal, the laser module will project the visual target in the appropriate timing. The experiment include 5 trails as baseline, usual training, spatial cue, spatial cue combined with temporal cue, wear device without cue. To forbidden the learning effect, the second to forth trails will assign randomly. We recruited 9 subjects, and all of them are chronic stroke patients. The result of this study finding that the spatial cue combined with temporal cue could help the subject to improve their gait symmetry ratio, and stance phase proportion of affected side. During the intervention, the step length of unaffected side enhanced 19% then baseline, and the swing time improve 84%. The stance phase proportion improved 11% in affected side. In addition, the spatial and temporal symmetry both improved in the same time. However, there are no enhancement in velocity and cadence. After much more practice and training, set velocity and cadence as long term goal might be the necessary work in the future study.
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You, Yu-Jyun, and 游宇君. "Correlation Between Postoperative Early Ambulation and Postoperative Recovery in Patients with Colorectal Cancer." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/13897798903733050315.
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碩士國立臺灣大學
護理學研究所
103
The patients with colorectal cancer usually suffer from multiple symptoms after surgery. Pain, nausea, vomit, abdominal fullness, low appetite, anxiety, depression and various postoperative complications are experienced by the patients . The symptoms not only cause the discomfort, prolong the postoperative recovery and hospitalization period, but also worsen the psychological condition. Early postoperative ambulation is thought to be a useful treatment to improve the postoperative recovery. But how it really works and how to apply on clinical condition remain unclear. The study aims to understand the correlation between postoperative ambulation and the recovery of patients with colorectal cancer. We conducted a longitudinal correlation study with a set of structured questionnaire survey with consecutive sampling in a medical center in Northern Taiwan. The population was postoperative patients with colorectal cancer. The questionnaire included: (1) Preoperative part: demographic profiles, Taiwan International Physical Activity Questionnaire (IPAQ), Hospital Anxiety & Depression Rating Scale (HADS); (2) Postoperative part: walking diary, physical symptoms scale and the heart-rate sensor ring were applied every day. HADS was recorded on the day before discharge. Data were analyzed by descriptive statistics and generalized estimating equation (GEE). Finally, 150 patients were recruited in 13 months. The results indicated that: (1) the higher the frequency of postoperative ambulation is, the time of flatus and tolerating to solid food is earlier, and the degree of physical symptoms and anxiety are lower; (2) the longer the distance of postoperative ambulation is, the time of tolerating to solid food is earlier, the hospitalization period is shorter, the degree of physical symptoms and anxiety are lower. In conclusion, the increase of frequency and distance of postoperative ambulation certainly lead to a better postoperative recovery. Further studies on the exact amount of ambulation are recommended for developing the clinical guidelines for this population.
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Tsai, Meng-Pin, and 蔡孟頻. "The effects of virtual reality training on community ambulation in patients with stroke." Thesis, 2006. http://ndltd.ncl.edu.tw/handle/33499115909401326670.
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碩士國立陽明大學
物理治療學系暨研究所
94
Background and Purpose: Cerebral vascular disease is defined as loss of brain function, resulting from an interference with blood supply to the brain. It is the third leading cause of death and the first leading cause for disability in Taiwan. Gait restoration has been recognized as a primary goal in stroke rehabilitation. In recent years, the emphasis has been extended to include the ability of community ambulation. In late 90’s, the improvement in computer technology have contributed to the development of virtual reality (VR). Virtual reality has been recommended in rehabilitation. However, previous studies mainly investigated the effects of VR on single motor function, the application of VR in rehabilitation to improve the gait ability in community is limited. The purpose of our study was to investigate the effect of virtual reality training on the community ambulation ability in patients with stroke. Methods: Twenty-four chronic stroke patients were recruited and randomly assigned to each group. Three subjects in control group did not complete the training. Twelve subjects in experimental group received treadmill training under virtual community environment. Nine subjects in control group received treadmill training. Subjects in both groups received 20 minutes, 3 times a week for 3 weeks training. All subjects received the pre-test, post-test, and follow up (1 month) assessments. The clinical functional ability, community ambulation ability, Activities Specific Balance Confidence Scale (ABC), and Walking Ability Questionnaire (WAQ) were used as the outcome measures. Friedman two-way analysis of variance by rank was used to examine within-group improvement at different time points. Wilcoxon signed ranks test was used for post hoc test. Mann-Whitney U test was used to examine the differences between groups. The significant level was set at p<0.05. Result: Subjects in experi- mental group improved significantly on community ambulation ability (p<0.01), ABC score (p<0.05), WAQ score (p<0.05) and clinical functional ability (p<0.01) at post-test. The improvements were also significantly at follow-up test. In control group, subjects improved significantly only on weighted community ambulation ability (p<0.05) and weighted clinical functional ability (p<0.05) at post-test and follow-up test. Compared between experimental and control group, subjects in experimental group demonstrated significantly greater improved only in ABC score at post-test (p<0.05). Discussion and Conclusion: Although no significance was found between the both groups on most of variables. Within-group improvement in community ambulation ability, falls self- efficacy, social limitation and clinical functional ability only observed in virtual reality group. Therefore, virtual reality with treadmill training can be applied to improve the community ambulation ability of patients with stroke. Clinical Relevance: Virtual reality with treadmill training is recommended to improve community ambulation ability in patients with stroke.
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Jian, Hung Shiuan, and 簡鴻暄. "The Study of Ambulation of Paraplegia Using a Reciprocating Gait Orthosis with Functional Electrical Stimulation." Thesis, 2000. http://ndltd.ncl.edu.tw/handle/58960752973850818476.
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碩士中原大學
醫學工程學系
88
Patients suffered from spinal cord injury with paraplegia can hardly recover to walk independently. They would need to use some special walking orthoses to support the body to walk properly. Traditionally, Long Leg Braces (LLB) are mostly used to train the patients to walk. Unfortunately, the results are not satisfied. In this study, we used latest Reciprocating Gait Orthosis (RGO) and combined the use of Functional Electrical Stimulation (FES). The combination provides larger support range and applies features of mechanical structures in walking assistant. The coordination of FES especially helps to restore the walking abilities that paralyzed patients lost. This study is to develop a walking orthosis with a FES, using a FES to stimulate specific muscles (quadriceps, hamstring) of paralyzed patients' lower limbs. It can achieve the benefits of physical therapeutics; on the other hand, paralyzed patients can achieve the purpose of walking. The FES is designed with control buttons on the walking orthosis. A patient can decide and control left or right leg that he desires to move to walk, and consequently accomplishes the purposes of walking control and speed via the control buttons. After the completion of the development and several practical tests of the new walking orthosis. A 25-years-old female paralyzed patient (T12 and L2 complete spinal cord injury) separately used traditional LLB, RGO, and RGO with FES to proceed with the training of walking rehabilitation and clinical assessment. After comparisons with heart rate difference (HRdifference), mean blood pressure difference (MBPdifference), walking speed, length of steps, number of steps and oxygen consumption before and after walking, the results show that usage of RGO and RGO with FES are both better than LLB. But, the differences between RGO and RGO with FES in HRdifference, MBPdifference, and walking speed are not significant, due to that the reaction of patient's right leg to electrical stimulation is relatively lower. In general, RGO can help the patient to achieve quicker and more independent walking; while the combination of RGO and FES can raise the effectiveness of RGO. These two walking orthoses are better than traditional LLB, they provide patients suffered from paraplegia with better choices.