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Lothery, Natasha D. "Muscle activation of the lumbar and hip extensors during the hyperextension and reverse hyperextension exercises." Virtual Press, 2004. http://liblink.bsu.edu/uhtbin/catkey/1306854.
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The purpose of this study was to investigate the differences in muscle activity of the lumbar and pelvic extensor muscles during the hyperextension and reverse hyperextension exercises. Fifteen healthy and weight-trained volunteers (8 women, 7 men) were recruited from a university setting. Electromyographic (EMG) activity of selected hip and trunk extensor muscles was recorded during the execution of a hyperextension and a reverse hyperextension. Three muscles were analyzed: lumbar erector spinae (ES), biceps femoris (BF) and gluteus maximus (GM). The amount of external load used by each individual was determined by equating the amount of torque produced at the hip joint for both exercises. Participants performed two trials of each exercise, and completed at least three repetitions within the eight-second data collection period. Peak integrated EMG (iEMG) activity was expressed as a percentage of maximal voluntary isometric contraction (%MVC). A two-way repeated measures analysis of variance (ANOVA) failed to demonstrate significant differences in %MVC activity between the two exercises, (p>0.05). A comparison of the hyperextension and reverse hyperextension exercises revealed that under similar loading conditions, there is no significant difference in muscle activity of the lumbar and hip extensor muscles.School of Physical Education
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Alshamari, Muhammed. "Low-dose computed tomography of the abdomen and lumbar spine." Doctoral thesis, Örebro universitet, Institutionen för hälsovetenskaper, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-48242.
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Radiography is a common radiologic investigation despite abundant evidence of its limited diagnostic value. On the other hand, computed tomography (CT) has a high diagnostic value and is widely considered to be among the most important advances in medicine. However, CT exposes patients to a higher radiation dose and it might therefore not be acceptable simply to replace radiography with CT, despite the powerful diagnostic value of this technique. At the expense of reduced CT image quality, which could be adjusted to the diagnostic needs, low-dose CT of abdomen and lumbar spine can be performed at similar dose to radiography. The aim of the current thesis project was to evaluate low-dose CT of the abdomen and lumbar spine and to compare it with radiography. The hypothesis was that CT would give better image quality and diagnostic information compared to radiography at similar dose levels. Firstly, the diagnostic accuracy of low-dose CT of the abdomen was evaluated. Results showed that low-dose CT of abdomen has a high sensitivity and specificity compared to radiography, i.e., it has higher diagnostic accuracy. Similar results were obtained from our systematic review. Secondly, in a phantom study, an ovine phantom was scanned at various CT settings. The image quality was evaluated to obtain a protocol for the optimal settings for low-dose CT of lumbar spine at 1 mSv. This new protocol was then used in a clinical study to assess the image quality of low-dose CT of the lumbar spine and compare it to radiography. Results showed that low-dose CT has significantly better image quality than radiography. Finally, the impact of Iterative reconstruction (IR) on image quality of lumbar spine CT was tested. Iterative reconstruction is a recent CT technique aimed to reduce radiation dose and/or improve image quality. The results showed that the use of medium strength IR levels in the reconstruction of CT image improves image quality compared to filtered back projection. In conclusion, low-dose CT of the abdomen and lumbar spine, at about 1 mSv, has better image quality and gives diagnostic information compared to radiography at similar dose levels and it could therefore replace radiography.
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Miller, Jacqueline Chantal. "Pharmacological characterisation and the immunohistochemical localisation of glutamate receptor subtypes in the lumbar region of the neonatal rat spinal cord." Thesis, University of Bristol, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.247861.
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Elfving, Britt. "Lumbar muscle fatigue and recovery : evaluation of electromyography in patients with long-term low-back pain and in healthy subjects /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-391-0/.
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Sánchez, Zuriaga Daniel. "Anatomía funcional del tronco. Valoración dinámica mediante técnicas no invasivas de la región lumbo-pélvica en personas sanas y pacientes con historia de dolor lumbar." Doctoral thesis, Universitat de València, 2006. http://hdl.handle.net/10803/9475.
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INTRODUCCIÓN Y OBJETIVO.En la literatura se han utilizado pruebas dinámicas sobre el movimiento de flexoextensióndel tronco para distinguir de manera objetiva entre sujetos sanos y pacientescon dolor lumbar de causa inespecífica. No tenemos constancia de estudio alguno quehaya registrado de manera simultánea los patrones de movimiento lumbo-pélvico y laactividad neuromuscular de la musculatura extensora de la espalda mediante técnicas noinvasivas, y los haya comparado entre distintos grupos de pacientes con dolor lumbar yalteraciones específicas de la anatomía de la región lumbo-pélvica.MATERIAL Y MÉTODOSParticiparon 50 sujetos sin antecedentes de dolor y 50 sujetos con dolor lumbar, de entrelos cuales se obtuvieron los diferentes grupos específicos. Durante ciclos estandarizadosde flexo-extensión del tronco se analizaron, siempre mediante técnicas no invasivas:· el movimiento de la cadera y la columna lumbar, mediante un electrogoniómetro tipoIsotrak que proporciona los grados de flexión.· la actividad eléctrica del músculo erector spinae, mediante un electromiógrafoinalámbrico de superficie tipo MESPEC 4000.Todos los datos registrados estaban sincronizados. Tras procesarlos y normalizarlos, seobtuvieron una serie de variables: actividad mioeléctrica y grados de flexión lumbar yde cadera medios en cada etapa del movimiento; rangos máximos de flexión de tronco,cadera y columna lumbar; tiempos de mantenimiento de la flexión lumbar y de caderapor encima del 90% de su máximo; duración, inicio y final del fenómeno de flexiónrelajacióndel erector espinal; índices de relajación sobre la actividad mioeléctrica de laflexión, la extensión y la flexo-extensión.Se constató la normalidad de las variables mediante el test de Kolmogorov-Smirnov, yla repetibilidad en el día y entre días de las medidas mediante el Coeficiente deCorrelación Intraclase y el Error Estándar de la Medida. Para ello, diez sujetos controlrepitieron las pruebas quince días después. Las diferencias significativas entre losgrupos se obtuvieron mediante los test de t de Student independiente y ANOVA de unfactor, con el test de Bonferroni como prueba post-hoc.RESULTADOSLa mayoría de pacientes mantuvieron el fenómeno de flexión-relajación del músculoerector spinae. Las variables de movimiento de la cadera, en todos los grupos depacientes, fueron similares a las de los sujetos sanos, mientras que la máxima flexióndel raquis lumbar y el tiempo que el raquis lumbar mantiene una flexión mayor del 90%de su máximo fueron menores en todos los grupos de pacientes. En pacientes conhistoria de dolor lumbar inespecífico se observó una alteración del patrón demovimiento lumbar y de la activación del erector spinae: tiempo de relajación muscular,índices de relajación y patrón de actividad mioeléctrica. En pacientes conespondilolistesis, sólo se observaron alteraciones en el patrón de movimiento lumbar,mientras que en pacientes con hernia discal y espondilitis anquilosante, sólo seobservaron alteraciones en la activación del erector spinae.DISCUSIÓNNuestros resultados han mostrado estrategias de movimiento en la flexo-extensión deltronco, específicas de cada alteración anatómica de la región lumbar, y que protegeríanel raquis de las cargas lesivas. Estas estrategias podrían explicarse según la anatomía yneurofisiología de la región lumbo-pélvica, a través del desencadenamiento de reflejosespinales o supraespinales. El estudio de estas estrategias de movimiento, además deaportarnos resultados inéditos en la literatura, puede tener diversas aplicaciones clínicasen campos como el diagnóstico de causas de dolor lumbar, la evaluación de técnicas detratamiento, el seguimiento de la evolución del paciente o la detección de simuladores.INTRODUCTION: Dynamic tests have been used to distinguish low back pain patientsfrom pain-free subjects. However, we couldn't find studies which compared lumbopelvicmotion and erector spinae activity patterns registered in a non-invasive waybetween different groups of patients with low back pain and specific alterations of thelumbo-pelvic anatomy.MATERIALS AND METHODS: 50 pain-free and 50 low back pain patients, withspecific groups of discal herniation, spondylolisthesis, bilateral sacroiliitis andankylosing spondylitis, were studied.Using non-invasive techniques the patterns of lumbo-pelvic motion andelectromyographic activity of the erector spinae were analyzed during standardizedtrunk flexion-extension cycles. All data were synchronized. Variables: averagemyoelectrical activity and degrees of lumbo-pelvic flexion at each stage of movement;maximum ranges of trunk, hip and spine flexion; time during which the subjects keptlumbar and hip flexion over 90% of their maximum; duration, start and end of erectorspinae relaxation; relaxation indexes of myoelectrical activity at flexion, extension andflexion-extension.Normal distribution and reliability of the variables were confirmed (Kolmogorov-Smirnov test, Intra-class Correlation Coefficient, Standard Error of Measurement).Statistically significant differences were shown by the Student t-test for independentmeasurements and one-factor ANOVA, with Bonferroni test for post-hoc testing.RESULTS: Most patients showed the flexion-relaxation phenomenon of the erectorspinae. Hip motion pattern showed no differences between any of the groups, whereasall patients' maximum ranges of lumbar flexion and times of lumbar flexion over 90%of its maximum in all the patients were lower than controls'. Unspecific low back painpatients showed alterations of lumbar motion and erector spinae activation patterns,whereas spondylolisthesis group showed only alterations of lumbar motion pattern anddiscal herniation and ankylosing spondylitis groups showed only alterations of erectorspinae activation.DISCUSSION: Our results show protective movement strategies during trunk flexionextension,specific of each lumbar anatomy alteration. Such strategies could beexplained according to the anatomy and neurophysiology of the lumbo-pelvic region, bymeans of spinal or supraspinal reflexes. Our method not only brings forwardunpublished data but also could have clinical applications: diagnose of low back paincauses, evaluation of treatment techniques, patients follow-up of simulators detection.
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Díaz, Rojas Fernanda Paz, and Olmedo Verónica Dianna Troncoso. "Resistencia de la Musculatura Flexora y Extensora de Columna, Nivel de Discapacidad e Intensidad del Dolor en Pacientes con Diagnóstico de Síndrome de Dolor Lumbar Puro." Tesis, Universidad de Chile, 2007. http://repositorio.uchile.cl/handle/2250/110680.
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Antay, Bedregal David Rolando, and Revello Julia Evelyn Camargo. "Asociación entre sobrecarga postural y dolor en la zona lumbar en choferes de una empresa de transporte público." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2018. http://hdl.handle.net/10757/622956.
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Objetivo: Determinar la asociación entre la sobrecarga postural y dolor lumbar en conductores de “combis” de una empresa de transporte público. Materiales y métodos: Se realizó un estudio de tipo transversal-analítico donde la muestra estuvo formada por 208 conductores de “combis”. Se utilizó los cuestionarios Nórdico de Kuorinka, Bus Drivers Job Demands Scale y Rapid Upper Limb Assessment (RULA). Se aplicó Regresión de Poisson con varianza robusta y se calcularon Razones de Prevalencia (RP) crudas y ajustadas con un IC 95%. Resultados: La prevalencia de dolor lumbar fue 79,33% y se encontró que existe asociación con la sobrecarga postural según RULA, nivel 3 (RP 1,44 [IC 95% 1,05-1,99]) y nivel 4 (RP 1,72 [IC 95% 1,27-2,32]) en comparación a los conductores con nivel 2, luego de ajustar por índice de masa corporal (IMC), edad de los conductores, años de trabajo como conductor y horas diaria de trabajo. Conclusiones: Los conductores que están sometidos a mayor sobrecarga postural tienen más probabilidad de presentar dolor lumbar.Aim: To determine the association between postural overload and low back pain in combis’ (van) drivers of a public transport company. Materials and Methods: A cross-sectional study among 208 “combi” drivers was conducted. Nordic Kuorinka Questionnaire, Bus Drivers Job Demands Scale, Rapid Upper Limb Assessment Scale (RULA) were administered. Poisson regression with robust variance and crude and adjusted Prevalence Ratios (PR) with 95% CI were compute. Results: The prevalence of low back pain was 79.33% and postural overload was associated with low back pain according to RULA, level 3 (PR 1.44 [95% CI 1.05-1.99]) and level 4 (PR 1.72 [IC 95% 1.27-2.32]) with respect to drivers with level 2, after adjustment for body mass index (BMI), age, years of work as a driver and daily hours of work. Conclusion: Drivers who had postural overload had more probability to present low back pain
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Lazarte, Argandoña Graciela Alejandra, and Parra Danai Barbara Eslava. "Prevalencia y factores asociados a la lumbalgia y discapacidad por dolor lumbar en vigilantes de Miraflores, Lima 2016." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2017. http://hdl.handle.net/10757/621858.
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Objetivos: Evaluar la prevalencia de dolor lumbar, la discapacidad provocada por este y sus factores asociados en trabajadores de vigilancia en un distrito de Lima, Perú.
Métodos: Se realizó un estudio transversal en vigilantes de Miraflores, Lima. El muestreo se realizó por conglomerados. El dolor lumbar se midió con el cuestionario Nórdico para dolor lumbar y la discapacidad lumbar se midió con el cuestionario de Oswestry. Adicionalmente se midió actividad física mediante la versión corta del Cuestionario Internacional de la Actividad Física (IPAQ-SF) y datos sociodemográficos. Se calculó la prevalencia de lumbalgia y además se calculó razones de prevalencia crudas y ajustadas con sus intervalos de confianza al 95% utilizando regresión de Poisson con varianza robusta.
Resultados: Se incluyeron 335 personas en el estudio. El 98% fueron hombres y la mediana de la edad en la población fue de 42 años (IQR: 21). El 55,8% presentó un nivel mínimo de actividad física, mientras que el 27,8 % realiza actividad física intensa. La prevalencia de dolor lumbar fue de 65,3% y la discapacidad fue 26,6%. Se encontró el tiempo sentado [ RPa: 2,21; IC95%=1,45-3,38] y la edad [RPa: 1,58; IC95%= 1,01-2,47] como factores asociados a la discapacidad.
Conclusión: Dos de cada tres vigilantes presentaron dolor lumbar y aproximadamente unos de cada cuatro presentaron discapacidad por dolor lumbar.Objective: Evaluate the prevalence of low back pain, the disability caused by this and the associated factor in watchmen in a district of Lima. Methods: It has been made a cross-sectional study of watchmen in Miraflores, Lima. The sampling was performed by clusters. The low back pain was measured by the Nordic questionnaire for low back pain and lumbar disability was measured with the Oswestry questionnaire. Additionally, the physical activity was measured by the short version of the International Questionnaire of Physical Activity (IPAQ-SF) and sociodemographic data. The prevalence of low back pain was calculated and the crude and adjusted prevalence ratios were calculated with their 95% confidence intervals using Poisson regression with robust variance. Results. The study includes 335 people. 98% were men, the median age was 42 (IQR:21). The 55.8% had a minimum level of physical activity. The prevalence of low back pain was 65.3% and the disability was 26.6%. the seated time was found [RPa: 2,21; IC95%=1,45-3,38] and age [RPa: 1,58; IC95%= 1,01-2,47] as factors associated with disability. Conclusion: Two out of three watchmen had low back pain and one in four had disability for low back pain.
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Douglas, Aaron Jack 1940. "THE ECONOMIC DETERMINANTS OF U.S.A. SOFTWOOD LOG EXPORTS FROM THE PACIFIC NORTHWEST REGION TO JAPAN; INTERNATIONAL ECONOMIC COOPERATION IN THE POSTWAR ERA (INVESTMENT, REGRESSION, ECONOMETRIC, CAPITAL, ELASTICITY, UNITED STATES)." Thesis, The University of Arizona, 1986. http://hdl.handle.net/10150/275573.
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Baker, Shawn A. "An analysis of timber trespass and theft issues in the Southern Appalachian region." Thesis, Virginia Tech, 2003. http://scholar.lib.vt.edu/theses/available/etd-05212003-153313.
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Alqhtani, Raee. "Developing a methodology to perform measurements of the multi-spinal regions and lumbar-hip complex kinematics during dominant daily tasks." Thesis, Cardiff University, 2016. http://orca.cf.ac.uk/100733/.
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Introduction: Quantitative data of spinal range of motion in vivo is essential to improve clinicians’ understanding of spinal pathologies, procedure of assessment and treatment. Accurate knowledge of physiological movement of lumbar spine regions, hip and the behaviour of each regional movement is important. Spine and hip motion play an essential role in daily functional activities, such as self-caring or performing occupational duties. Measuring the regional breakdown of spinal motion in three planes and describing the relative motion of different regions of the thoracolumbar (TL) spine can provide useful clinical information, which can be used in clinical procedure for spinal assessment. The relationship between the forward flexion (i.e. cardinal motion) and more functional tasks, such as lifting, stand-to-sit and sit-to-stand, as well as dividing the lumbar spine into more than one region, relative to the hip during these tasks, have not yet been established. Measuring the regional breakdown of spinal motions in three planes, as well as the relationship between lumbar spine and hip in sagittal plane, requires a multi-regional analysis system. Aims and objectives: The fundamental aim was to explore range of motion and velocity magnitudes in flexion, extension lifting, stand-to-sit and sit-to-stand tasks, using three lumbar regions relative to the hip, and to determine correlations and differences between flexion and other dominant functional tasks. An objective was to obtain an appropriate measurement system that is capable of measuring dynamic movement in ‘real time’ and examine its validity against a “gold standard” system and its reliability, by measuring the range of motion of multi-spinal regions. Also, to demonstrate the relative contribution of five regions from within the thoracolumbar and head-cervical regions in 3D. Methods: The selected system (tri-axial accelerometer sensors-(3A sensors)) was validated against a “gold standard” system (roll table (RT)) to demonstrate a correlation and root mean square errors (RMSEs) between the two devices. Reliability of the 3A sensors and the contribution of multi-spinal regions was assessed on 18 healthy participants. Two protocols were applied: in protocol one, two sensors were placed on the forehead and T1, to measure cervical ROM; in protocol two, six sensors were placed on the spinous processes of T1, T4, T8, T12, L3 and S1 to measure thoraco-lumbar regional range of motion. It also divided the lumbar spine as one single joint (S1 to T12) and as two regions (the upper (T12-L3) and lower (L3-S1)) and hip region. Data was gathered from 53 participants using four sensors attached to the skin over the S1, L3, T12 and lateral thigh. Two different statistical analyses were applied: one for analysing each particular region’s contribution, relative to the hip; and another to analyse the correlation between the kinematic profiles of flexion and three sagittally dominant functional tasks (lifting, stand-to-sit and sit-to-stand). Results: Validation of 3A accelerometer sensors system against the roll table revealed a strong correlation between the two systems average (ICC=.998 (95% CI=.993-.999)) and an acceptable rate of errors ranged from (2.54º (0.70%) to 5.01º (1.39%)). It also demonstrated the reliability of this system, when the ICC values for all regions were high with relatively small errors associated with a novel multi-regional clinical spinal motion system. The ICC values for all regions were found to be high, ranging from .88 and .99 with 95% CI ranged from .62 to .99 while errors values ranged from 0.4 to 5.2°. The additional movement information, gathered from a multi-regional breakdown, adds insight into the relative contributions to spinal movement. Significant differences existed between ROM of LLS and ULS across all movements (p < 0.05). A significant difference also existed between ULS-hip and LLS-hip ratio for the majority of tasks (p < 0.05), and between ULS and LLS velocity for the majority of tasks (p < 0.05). The findings from the lumbar spine as one region, underestimates the contribution of the lower lumbar and overestimates the contribution of the upper lumbar spine. Strong correlations for ROM are reported between forward flexion tasks and lifting for the LL spine (r = 0.83) and all regions during stand-to-sit and sit-to-stand (r = 0.70-0.73). No tasks were strongly correlated for velocity (r = 0.03-0.55). Conclusion: The validity and reliability of the accelerometer sensors system is evidence of its ability to measure spinal movement. Since it is inexpensive, small, portable and relatively easy to use, it could be a preferable system for clinical application. The data, from multi-spinal regions, provides a novel method for practitioners to focus on a greater number of regions, rather than measuring only the three main areas of the spine (cervical, thoracic and lumbar). Investigating the lumbar spine as only one region risks missing out important kinematic detail. Further, the methodology provides the potential to measure functionally unique kinematics from more complex functional tasks, rather than generalised findings from clinical assessments of simple flexion.
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Antunes, Marcelo. "Avaliação do efeito antinociceptivo da ablação neuropática e autonômica por radiofrequência em pacientes portadores de dor crônica Síndrome Dolorosa Complexa Regional do Tipo-I." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/17/17142/tde-23042018-172407/.
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Introdução- Pacientes portadores de Síndrome Dolorosa Complexa Regional- I (SDCRI) lombar apresentam componente autonômico simpático associado à dor lombar facetaria, são submetidos de forma rotineira à sequência de 4 bloqueios autonômicos associado ao bloqueio do ramo mediano facetário, implicando em 4 procedimentos ambulatoriais por paciente, por semestre. Este estudo visou avaliar a eficácia da realização de ablação por radiofrequência após a realização do bloqueio teste. Métodos- Após aprovação do Comitê de Ética em Pesquisa e consentimento, 25 pacientes portadores de SDCR-I em membros inferiores e dor articular facetária lombar associada foram de forma prospectiva, submetidos a: 1) 4 sessões com intervalos semanais de bloqueio do ramo mediano facetário lombar de L2 a L5 bilateral, associado ao bloqueio do gânglio simpático autonômico L3. Quando a dor atingisse graduação VAS= 4 cm, foi considerado necessário repetição dos procedimentos realizados, e este tempo correspondeu ao tempo de analgesia, sendo calculado o custo anual e efeitos adversos por paciente. Os mesmos pacientes foram submetidos posteriormente a: 1) Bloqueios testes simpático e facetário, seguido de: 2) ablação por radiofrequência (RF) do ramo mediano facetário lombar de L2 a L5 bilateral, com 45 V, 80 segundos, 80 oC, + ablação por RF do gânglio simpático lombar de L3-L4 do lado acometido, 45V, 80 oC, 80 segundos em cada nível acometido, sob sedação consciente, com midazolam e alfentanil por via venosa. Cada paciente atuou como seu próprio controle. Resultados- 21 pacientes participaram da avaliação final. Cada paciente foi submetido a uma sequência semestral de bloqueios, sendo o tempo de analgesia após término do quarto procedimento 5±1 meses, e o custo anual de R$ 15.000,00. Quando os mesmos pacientes foram submetidos à RF, o tempo de analgesia foi em média 15±2 meses (p<0,001), havendo economia no primeiro ano de realização de RF de 23% no custo final e de 32% a 36% nos anos subsequentes, calculado por extrapolação. Durante o período de analgesia, a capacidade para realização de atividades rotineiras e a qualidade de sono melhoraram. Não foram observados efeitos adversos. Discussão- A realização de RF resultou menor número de internações anuais, menor custo anual e maior comodidade para o paciente, com mesma eficácia durante período de analgesia.Introduction- Patients with Complex Regional Pain Syndrome type-I (CRPS-I) in lower members, often also present lumbar articular facetary pain, and are submitted as part of routine to a sequence of 4 weekly sympathetic blocks combined to facetary block, which sequence is usually repeated after six months for pain control. The study was designed to evaluate the efficacy of a test block followed by radiofrequency efficacy. Methods- After ethical approval and consent, 25 patients with CRPS-I in lower members were submitted to a 4-weekly sympathetic block at L3, combined to bilateral lumbar facetary block fromL2-L5. The sequence was repeated when pain VAS reached 4 cm, and this period was defined as time of analgesia. Thereafter, the same patients were submitted to a test block followed by radiofrequency (RF ablation of sympathetic ganglion L3 and L4 and bilateral ablation of facetary lumbar median branch from L2-L5), 45 V, 80 sec, 80 oC, under conscious sedation. Patients acted as their own control related to analgesia, routine activities, sleep and costs. Results: 21 patients completed the study. The analgesia time after the 4-block sequence was 5±1 months and the annual cost R$ 15.000,00 (USA$5000). The analgesia time after RF was 15±2 months (p<0.001) and the costs were reduced by 23% in the first year and 32%-36% in the following years extrapolation. Routine capacity and sleep at night were equally improved during analgesia for both treatments. There were no adverse effects. Discussion- Test block followed by RF resulted in 15 months of analgesia compared to 5 months for the routine technique of 4-blocks, in improved capacity and sleep comfort at night. Besides that, RF was costly effective, and reduced costs by 23% during the first year evaluation, followed by 32% to 36% cost reduction in following years, by extrapolation.
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Carvajal, Araya Jennifer Andrea. "Dolor, funcionalidad y calidad de vida en pacientes operados de hernia del núcleo pulposo lumbar en el Instituto Traumatológico bajo el régimen de garantías explícitas en salud." Tesis, Universidad de Chile, 2011. http://www.repositorio.uchile.cl/handle/2250/117252.
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El Síndrome de Dolor Lumbar (SDL) es actualmente uno de los síndromes más prevalentes en la población mundial. La Hernia del Núcleo Pulposo lumbar, una de las causas específicas de este síndrome, ha sido incluida dentro del Régimen de Garantías Explícitas en Salud (GES) en nuestro país. Esta investigación tuvo como objetivo describir el estado del dolor, la funcionalidad y la calidad de vida en pacientes beneficiarios del plan GES que reciben tratamiento quirúrgico para Hernia del Núcleo Pulposo lumbar en relación al estado previo a la cirugía. En este estudio, de tipo longitudinal panel, se evaluaron 31 pacientes, 18 hombres y 13 mujeres, operados en el Instituto Traumatológico durante el año 2011, un día previo a la cirugía, y 6 a 7 semanas posterior a ésta. La medición de las variables dolor, funcionalidad y calidad de vida se realizó a través de los instrumentos Escala Visual Análoga (EVA), Cuestionario de discapacidad de Oswestry, y Cuestionario de salud SF-36 v.2, respectivamente. Las variables fueron analizadas mediante estadística descriptiva entre ellas mínimo, máximo, media y porcentaje. Dentro de los resultados obtenidos en calidad de vida se encontró una variación de 49,9% para el Componente de Salud de Física y de 40,3% para el Componente de Salud Mental. En relación al dolor, este tuvo un promedio de disminución de 52,2%. En cuanto a la funcionalidad, el porcentaje de incapacidad tuvo una variación promedio de 64,2%. Después de la intervención quirúrgica, un 90,3% de la población presentó una disminución del dolor; un 84% presentó aumento de la funcionalidad y un 77% de los pacientes presentó aumento de la calidad de vida, con incremento de ambos componentes. El porcentaje de éxito de la cirugía en relación a la resolución de la sintomatología dolorosa registrado en la investigación coincidió con los datos mostrados por la literatura.Lumbar Pain Syndrome (SDL) is currently one of the most prevalent syndromes in the global population. The herniated lumbar Nucleus Pulposus, one of the specific causes of this syndrome, has been included in the Regime of Explicit Guarantees in Health (GES) in our country. This study aimed to describe the condition of pain, function and quality of life in patients beneficiaries of GES plan receiving surgical treatment for lumbar herniated Nucleus Pulposus regarding the status prior to surgery. In this study, longitudinal panel type, 31 patients were evaluated, 18 men and 13 women who were operated at the Trauma Institute during the year 2011. They were assessed one day prior to the surgery and 6 to 7 weeks after this. The variables measuring pain, function and quality of life was performed using the instruments Visual Analogue Scale (VAS), Oswestry Disability Questionnaire, and Health Questionnaire SF-36 v.2, respectively. The variables were analyzed through descriptive statistics including minimum, maximum, mean and percentage. Among the results of quality of life a variation of 49.9% was found for the Physical Health Component and 40.3% for the Mental Health Component. In relation to pain, an average of 52.2% decreased. In terms of functionality, the percentage of disability had an average variation of 64.2%. After surgery, 90.3% of the population showed a decrease in pain, a 84% increased functionality and 77% of patients improved the quality of life with an increase of both components. The success rate of surgery in relation to resolution of pain symptoms reported in the research coincided with the data shown in the literature.
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Fabiani, Muñoz Italo Antonino. "Prevalencia de patología músculo-esquelética reumatoidea en el CESFAM "Cristo vive", Santiago 2004 Chile." Tesis, Universidad de Chile, 2006. http://www.repositorio.uchile.cl/handle/2250/110645.
Full textAbstract:
El estudio es descriptivo de tipo transversal, no experimental, abarcando una muestra de 1600 fichas clínicas de personas mayores de 15 años obtenidas mediante muestreo aleatorio simple en el CESFAM “Cristo Vive”. Los resultados indicaron que las EMERs más prevalentes, en el centro de salud en referencia, fueron el Lumbago no especificado con una prevalencia global de 10,25%; lesión de hombro no especificada (Hombro doloroso) 4,05% y Gonartrosis (osteoartrosis de rodilla) 2,56%. Las hipótesis planteadas (H1; H2; H3) resultaron rechazadas al no encontrarse una asociación estadística significativa (p>0.05) entre las variables involucradas, aceptando las hipótesis H0 correspondientes a cada una, de no relación entre las variables: EMER más prevalentes y nivel educacional. Los datos de prevalencia hallados en la muestra estudiada, fueron cercanos a la bibliografía revisada, en otros casos, la prevalencia fue menor que la esperada, probablemente a que se consideró solo el año 2004 como criterio de inclusión.
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Abu, Bakar Aniza. "User response to thermal comfort of outdoor urbanspaces in hot-humid regions : with reference to Kuala Lumpur, Malaysia." Thesis, University of Nottingham, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.446384.
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Mendoza, Olivos Doris, and Aguilera Egda Edita Vasquez. "Cuidados culturales en el hogar del adulto maduro con problemas de lumbalgia-Pueblo Nuevo, Ferreñafe 2018." Bachelor's thesis, Universidad Católica Santo Toribio de Mogrovejo, 2019. http://tesis.usat.edu.pe/handle/usat/1698.
Full textAbstract:
Ésta investigación cualitativa con enfoque etnográfico, tuvo como objetivo describir, analizar y comprender los cuidados culturales en el hogar del adulto maduro con problemas de lumbalgia cuyo escenario fue el hogar de cada adulto maduro en el distrito de Pueblo Nuevo, provincia de Ferreñafe. Los sujetos de estudio fueron 13 adultos maduros que cumplieron los criterios de inclusión y la muestra se determinó con la técnica de saturación y redundancia; los datos obtenidos mediante observación participante, entrevista etnográfica y diario de campo, se procesaron según el análisis temático de Spradley, obteniendo 4 temas los cuales son remedios caseros y fármacos que utiliza el adulto para disminuir la lumbalgia, restricción de actividad en el adulto maduro con problemas de lumbalgia, razones para el incremento del dolor en el adulto maduro con lumbalgia y terapia para la lumbalgia que realiza los adultos maduros con o sin apoyo familiar. En toda la investigación se tuvo en cuenta los criterios de rigor ético y rigor científico. Resultados: El dolor lumbar en los adultos maduros restringe muchas actividades diarias como lavar, planchar, cocinar y para aliviarlo utilizan hierbas como el Boldo, Molle, Guanábana, Moringa, Hierba de Lucero, Eucalipto, Chancapiedra, Misha, Chuchuhuasi, Manzanilla y se realizan masajes con o sin apoyo de familiares utilizando crema de diclofenaco, pomada de Chuchuhuasi y pomada de molle. Conclusiones: aún persiste el uso de prácticas culturales siendo la más común el uso de hierbas y masajes. Pero requiere la intervención de enfermería para negociar algunas prácticas y restructurar la automedicación.Tesis
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Ortiz, Mallasen Víctor. "Estudio experimental sobre la eficacia de una intervención educativa individual en el dolor lumbar de cuidadores no profesionales de personas dependientes. Programa TRANSFE." Doctoral thesis, Universitat Jaume I, 2019. http://hdl.handle.net/10803/667826.
Full textAbstract:
Introducción: el cuidador no profesional está sometido a grandes sobrecargas
derivadas de sus funciones cuidadoras. Es vulnerable a padecer problemas que
merman su estado de salud, como el dolor lumbar. Objetivos: diseñar y evaluar la a efectividad de un programa de intervención educativa individualizada dirigido a cuidadores no profesionales de personas dependientes, en comparación con una intervención grupal estándar equivalente, en relación a el nivel de sobrecarga del cuidador, la presencia, grado e incapacidad por dolor lumbar, el apoyo social percibido y la calidad de vida relacionada con la salud.
Material y método: estudio experimental y longitudinal, de medida repetida a los 3 meses de la intervención.Introduction: the non-professional caregiver is subject to large overloads derived from their care functions. It is vulnerable to suffer problems that reduce your health, such as low back pain. Objectives: design and evaluate the effectiveness of an individualized educational intervention program aimed at non-professional caregivers of dependent persons, compared to an equivalent standard group intervention, in relation to the level of caregiver overload, the presence, degree and disability due to back pain, perceived social support and quality of life related to health.Material and methods: experimental and longitudinal study, repeated measure at 3 months after surgery
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Flores, Romero Jessica. "Determinación de la actividad antibacteriana “in vitro” del aceite esencial de Luma chequen (Molina) A. Gray “arrayán” frente a Streptococcus mutans." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2014. https://hdl.handle.net/20.500.12672/3690.
Full textAbstract:
El objetivo del presente estudio fue determinar la actividad antibacteriana del aceite esencial de Luma chequen (Molina) A. Gray “arrayan” frente a Streptococcus mutans. Se empleó el método de disco-difusión en agar. La cepa fue reactivada en placa de Tripticasa Soya Agar (TSA), incubada a 37 ºC por 24 horas en microaerofilia. Se tomaron 5 colonias y se transfirieron a un tubo de ensayo con 5 mL de caldo Müller-Hinton, incubada a 37 ºC por 6 horas en microaerofilia hasta obtener una turbidez equivalente al 0.5 de la escala de Mc Farland. El sembrado se realizó en 14 placas con agar Müller-Hinton mediante la técnica de difusión, utilizando el aceite esencial en concentraciones de 10, 50 y 100%, y se procedió a la incubación en microaerofilia a 37 ºC por 24 horas. El análisis estadístico se realizó con el programa STATA Versión 12. Las concentraciones al 10, 50 y 100% presentaron un halo de inhibición promedio de 6.28, 7.88 y 8.66 mm respectivamente, la diferencia de promedios entre estas tres concentraciones mostró diferencia estadísticamente significativa (P<0.05). Se concluye que las tres concentraciones del aceite esencial de Luma chequen (Molina) A. Gray “arrayan”, presentan actividad antibacteriana frente a Streptococcus mutans.--- The aim of this study was to determine the antibacterial activity of the essential oil of Luma chequen (Molina) A. Gray "myrtle" against Streptococcus mutans. The disk-diffusion method in agar was used. The strain was reactivated in Trypticase Soy agar plate (TSA), incubated at 37 °C for 24 hours in microaerophilic. 5 colonies were picked and transferred to a test tube with 5 mL of Mueller-Hinton broth, incubated at 37 °C for 6 hours under microaerophilic conditions until a turbidity equivalent to 0.5 Mc Farland scale. Seeding was performed on 14 plates with Mueller-Hinton agar by diffusion technique, using the essential oil in concentrations of 10, 50 and 100%, and the incubation proceeded in microaerophilic at 37 ºC for 24 hours. Statistical analysis was performed using STATA Version 12 program. Concentrations of 10, 50 and 100 % had a halo of inhibition average of 6.28, 7.88 and 8.66 mm respectively, the mean difference between these three concentrations showed statistically significant difference (P<0.05). We conclude that the three concentrations of the essential oil of Luma chequen (Molina) A. Gray "myrtle", exhibit antibacterial activity against Streptococcus mutans. Keywords: Streptococcus mutans, myrtle, antibacterial activity.
Tesis
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Huang, Xu Yi Wei, and 黃徐亦薇. "A standardized rat model of induced spinal injury at lumbar region." Thesis, 1995. http://ndltd.ncl.edu.tw/handle/56884092274985429152.
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Naidoo, Melanee. "The evaluation of normal radiographic measurements of the lumbar spine in young to middle aged Indian females in Durban." Thesis, 2008. http://hdl.handle.net/10321/378.
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Thesis (M.Tech.: Chiropractic)-Durban University of Technology, 2008To evaluate the lumbar lordosis, lumbosacral angle, lumbosacral disc angle, lumbosacral lordosis angle, intervertebral disc angles and heights, interpedicular distances, sagittal canal diameters and the lumbar gravity line (selected radiographic parameters) in young to middle aged Indian females in Durban. To determine any association between the selected radiographic parameters and the age of the subjects, weight, height and body mass index of the subjects, occupation, smoking, previous pregnancy and leg length inequality (selected anthropometric and demographic factors). Methods: Sixty healthy, asymptomatic, young to middle aged, Indian females were recruited for this study. All subjects underwent a case history, a physical examination and radiographic evaluation (AP and lateral views) of the lumbar spine. SPSS version 15.0 (SPSS Inc., Chicago, Ill, USA) was used to analyze the data. Results: The mean (± SD) of the lumbar lordosis, lumbosacral angle, lumbosacral disc angle and lumbosacral lordosis angle was 49º (± 6º), 39º (± 8º), 12º (± 5º) and 143.2º (± 5º) respectively. For the lumbar intervertebral disc angles at L1-L2, L2-L3, L3-L4, L4-L5 and L5- S1 levels, the mean (± SD) was 6º (± 2º), 8º (± 2º), 10º (± 3º), 12º (± 4º) and 12º (± 5º) respectively. The anterior and posterior intervertebral disc heights at the respective vertebral levels were: L1-L2: anterior: 8 mm (± 2), posterior 5 mm (± 2); L2-L3: anterior: 10 mm (± 2), posterior 5 mm (± 2); L3-L4: anterior: 12 mm (± 2), posterior 5 mm (± 2); L4-L5: anterior: 14 mm (± 3), posterior 5 mm (± 2) and L5-S1: anterior: 13 mm (± 4), posterior 6 mm (± 2). The mean (± SD) of the interpedicular distance at the L1, L2, L3, L4 and L5 vertebral levels was 23 mm (± 2), 24 mm (± 2), 25 mm (± 2), 27 mm (± 2) and 31 mm (± 3) respectively. For the sagittal canal diameter at the L1, L2, L3, L4 and L5 vertebral levels, the mean (± SD) was 20 mm (± 5), 21 mm (± 3), 21 mm (± 3), 21 mm (± 3) and 19 mm (± 3) respectively. The lumbar gravity line intersected the sacrum in 67.3% of the subjects. In 29.1% of the subjects, the lumbar gravity line passed anterior to the sacrum while in 3.6% of the subjects, it passed posterior to the sacrum. iv A significant association was found between lumbar lordosis and the height of the subjects in this study (p = 0.004). A decrease in the intervertebral disc height at L5-S1 was associated with smoking (p = 0.005). A decrease in the intervertebral disc height at L4-L5 was associated with previous pregnancy (p = 0.016). Body mass index of 26–30 kg.m-2 was significantly associated with an increase in the intervertebral disc angles at L3-L4 (p = 0.028) and L4-L5 (p = 0.031). A decrease in the L5-S1 intervertebral disc angle was also significantly associated with smoking (p = 0.023). There was a significant association between previous pregnancy and an increase in the intervertebral disc angle at L3-L4 (p = 0.016). A significant association was found between the age of the subjects and the L5-S1 intervertebral disc angle (p = 0.007). Specifically it was the 23–27 year group and 33–37 year group who were significantly different from each other (p = 0.033). Conclusion: Similarities and differences were found in the mean values of the radiographic parameters measured in this study and those reported in the literature. A number of the selected anthropometric and demographic factors were associated with some of the lumbar radiographic parameters. Further studies are required to establish the clinical significance of these findings.
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DeBeliso, Mark. "The effects of a lumbar support belt on radiographic characteristics of the lumbosacral spine." Thesis, 1997. http://hdl.handle.net/1957/33802.
Full textAbstract:
Study Design. This study investigated the effects of a lumbar support belt on lumbar disc deformation and joint angles. Trunk strength and endurance were also compared to disc deformation and joint angles to determine if any meaningful relationships existed.
Objective. The purpose of this study was to determine if back support belts relieve stresses encountered by the lumbar spine during lifting activities and thus reduce the risk of injury. Additionally, trunk strength and endurance measures were collected in order to determine if strong, well conditioned trunk musculature aids in the support of the lumbar spine.
Summary of Background Data. Low-back pain and injury are responsible for a major portion of lost work days and injury compensation claims. Back support belts have been proposed as a counter measure towards reducing low-back injuries in the industrial setting.
Methods. Twelve male subjects (average age, 49.7 years) performed two sessions of stoop type lifting with a loaded milk crate (11.5 kg), at a rate of 4 repetitions per minute, for a total 15 minutes per session in accordance with the NIOSH 1993 lifting
equation. The order of testing with and without a belt was randomized for the two
sessions. Fluoroscopic images were collected prior to and following both lifting sessions.
Fluoroscopic images were collected with the subjects positioned at the initiation (flexed
trunk), mid-range, and completion of the lift (erect standing). Images were imported into
Auto Cad where lumbar disc deformation and joint angles were measured by calculating
changes in position of adjacent vertebra (L3-4 and L4-5). A reduction of deformation was
deemed indicative of reduced stress. Trunk extension and flexion strength were measured
with a Kin Com isokinetic dynamometer. Trunk flexion endurance was measured via a 60
second curl-up test.
Results. Analysis of variance revealed that compressive and shear disc deformation were reduced while in the erect trunk posture for the support belt condition (p<.05). No significant reduction in disc deformation was detected while in flexed trunk postures for the support belt condition (p>.05). A significant inverse relationship was detected (p<05) between: abdominal strength and shear stress (flexed trunk positions), abdominal endurance and shear stress (erect trunk), and spinal erector strength and L4-L5
joint angle (erect trunk).
Conclusions. During stoop type lifting, support belts provide a measurable amount of stress reduction of the lumbar spine when the trunk is in the erect posture, with little effect during flexed trunk positions. Strong, well conditioned trunk musculature is associated with reduced stress on the lumbar spine.Graduation date: 1998
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Shefchyk, Susan J. "Interaction between the descending mesencephalic locomotor region pathway and high threshold reflex pathways in the control of lumbar alpha motoneurons during fictive locomotion in the cat." 1985. http://hdl.handle.net/1993/24364.
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Haven, Lisa. "A comparison of subregional lumber, plywood and log markets in the Douglas-fir region /." 1988. http://hdl.handle.net/1957/10986.
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Bederman, S. Samuel. "Patient Preferences, Referral Practices, and Surgeon Enthusiasm for Degenerative Lumbar Spinal Surgery." Thesis, 2010. http://hdl.handle.net/1807/24337.
Full textAbstract:
Degenerative disease of the lumbar spine (DDLS) is a common condition for which surgery is beneficial in selected patients. Wide variation in surgical referral and rates of surgery has been observed contributing to unequal access to care.
Our objectives were to examine (1) the variation in preferences for referral and surgery among surgeons, family physicians (FPs) and patients, (2) how FP referral practices compare with preferences and guideline recommendations, and (3) how the ‘enthusiasm’ of patients and physicians influence regional variation in surgical rates.
We used conjoint analysis in a mailed survey to elicit preferences based on clinical vignettes from surgeons, FPs and patients. A Delphi expert panel provided consensus guideline recommendations for surgical referral to compare with actual FP referral practices. Rates of surgery for DDLS, obtained from Ontario hospital discharge data, were used to quantify regional variation and regression models assessed the relationship with patient and physician enthusiasm.
We identified significant differences in preferences for referral and surgery between patients, FPs and surgeons. Surgeons placed high importance on leg-dominant symptoms while patients had high importance for quality of life symptoms (i.e. severity, duration, walking tolerance). Surgical referral practices were poorly predicted by individual FP preferences and guideline recommendations based on clinical factors alone. Variation in Ontario surgical rates was higher than that of hip or knee replacements and was highly associated with the enthusiasm of surgeons (p<0.008), rather than FPs or patients.
By appreciating the variation in preferences between patients and physicians, and exploring other non-clinical factors that influence referrals, we may be able to improve the efficiency of referrals and enhance the shared decision making process. With an understanding of the influence that surgeons have in driving variation in surgical rates, further research may allow us to direct strategies to improve access and allow for a more equitable delivery of care for patients suffering from DDLS.
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Li, Jingjing. "Production Structure, Input Substitution, and Total Factor Productivity Growth in the Softwood Lumber Industries in U.S. and Canadian Regions." Thesis, 2009. http://hdl.handle.net/1807/18812.
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This study uses a translog cost function to specify the production structures of the softwood lumber industry in three U.S. regions (the West Coast, the Inland, and the South), and four Canadian regions (Ontario, the British Columbia Coast, the British Columbia Interior and Quebec), from 1988 to 2005. First, two separate production models are specified and analyzed, one is a “U.S. model” for the U.S. regions, and the other is a “Canada model” for the Canadian regions. Second, all seven regions are included in one production model, a “U.S.-Canada model”. In the U.S.-Canada model, purchasing power parity over the Gross Domestic Product is used to convert cost and price data of Canada from Canadian into U.S. dollars. The Allen and Morishima elasticities of substitution, price elasticiteis of demand, rate of technical change, and total factor productivity growth are estimated in each model, and the results are presented and compared.
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Sweeney, Brendan. "Comparing Employment Relations in a Cross-Border Region: the Case of Cascadia's Forest Products Industry." Thesis, 2010. http://hdl.handle.net/1974/5692.
Full textAbstract:
In North America, deepening economic integration under free trade has led to the formation of several cross-border regions between Canada and the United States and such regions have become a significant focus for public policy research in Canada. A key question is whether, as a result of increased economic integration, there are tendencies towards policy and institutional convergence within cross-border regions; especially in areas viewed as critical in determining competitive economic advantage. One such area is employment relations. However, relatively little research has focused on how, or even if, employment relations are changing within cross-border regions.
Previous studies comparing differences and similarities in employment relations between Canada and the United States have tended to focus on one of three scales: the nation, the firm, or the individual workplace. Here, the focus is on employment relations within a cross-border region. Such regions often share similar economic and social characteristics. Thus, we might expect that if cross-national employment relations are becoming more similar due to deepening economic integration this would manifest most clearly at this scale.
The empirical focus is the forest products industry in the cross-border region of Cascadia, comprised of British Columbia, Washington state, and Oregon. Employment relations are compared across three components of the forest products industry: pulp and paper, solid wood processing, and logging. Data are organized around case studies of each component and focus on employment, wages, and productivity; the restructuring of firms and ownership; the labour movement; work practices, training, and the reproduction of the labour force. The dissertation concludes that employment relations in the pulp and paper and logging industries in Cascadia are becoming more similar cross-nationally, while those in solid wood processing are increasingly differentiated cross-nationally. Moreover, it concludes that employment relations in British Columbia’s solid wood processing and pulp and paper industry are becoming more similar, while employment relations in the PNW solid wood processing and pulp and paper industries are increasingly differentiated. The dissertation contributes to broader debates in economic geography by examining the tensions between national and sub-national political economic actors contribute to the production of scale and territory.Thesis (Ph.D, Geography) -- Queen's University, 2010-05-28 11:48:30.745
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Salisbury, David Seward. "Overcoming marginality on the margins: mapping, logging, and coca in the Amazon borderlands." Thesis, 2007. http://hdl.handle.net/2152/3162.
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The ecologically and culturally rich Amazonian border zones are increasingly targeted for development and the exploitation of natural resources, even as these zones often double as existing or proposed sites for the conservation of biodiversity and protection of indigenous lands. Governmental and Non-Governmental Organizations alike project their goals from central offices onto borderland landscapes assumed to be empty of local people but full of valuable resources, biodiversity or development potential. Simultaneously, loggers, miners, drug traffickers, and others operate illegally or quasi-legally within these border zones and, in the absence of a strong governmental presence, cultivate the borderland's reputation as a violent hinterland. Within this complex borderland reality, the local people (indigenous and non-indigenous), largely invisible to authorities, struggle to survive with subsistence strategies while either negotiating with illegal interlopers to supplement their income or resisting them for their very survival. The resulting landscape is a tangle of overlapping and competing concessions, conservation units, and indigenous territories whose contestation and resulting confusion advances the agenda of illegal extractivists and drug traffickers. This study highlights the continued importance of fieldwork in geography. Here, field-based research provides insight into the poorly understood borderlands of Peru and Brazil. Research used a combination of participatory methods, Geographic Information Systems, ethnography, document research, and remote sensing to analyze mapping, logging, and coca cultivation within four borderland watersheds. These data were combined with regional data on coca eradication, resource concessions, conservation units, and indigenous territories from both Brazil and Peru. Field-based results demonstrate these borderlands to be highly contested and poorly mapped with an exploitative and poorly managed timber industry and a dynamic front of coca cultivation contributing to social disruption and environmental degradation. More fieldwork is needed to generate the geographic information necessary for sustainable development and conservation planning and to help local people defend their territory from illegal operators and the imposition of state resource concessions. Ecological Economic Zoning is recommended as a participatory policy framework to improve geographic information and long term planning.text
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Romano, Osvaldo Aníbal. "El balance sagital lumbo-pélvico en la estenosis del conducto lumbosacro." Tesis, 2005. http://hdl.handle.net/10915/45449.
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Con los objetivos de evaluar la relación del balance sagital lumbopélvico con la estenosis del conducto lumbar degenerativo y de simplificar las mediciones del balance sagital lumbopélvico, se han evaluado radiográficamente pacientes con diagnóstico de estenosis de conducto lumbar degenerativo, asistidos en forma consecutiva durante los años 2002 y 2003, en el Hospital “Horacio Cestino” de Ensenada y en la práctica privada.
Se ha realizado una evaluación bibliográfica que permitió documentar y clasificar los distintos parámetros de medición del balance sagital lumbopélvicos en angulares, mediciones de distancias e índices según el procedimiento para obtenerlos, y clasificarlos en anatómicos y posicionales según su significación. Cada uno de ellos puede ser espinal, pélvico o de ambos.
Fueron evaluados 115 pacientes, edad media de 68,2 años (+ 9,8), 85 mujeres. Se consignó peso, talla, diabetes, artroplastía de cadera y tipo de manifestación clínica. Todos fueron evaluados con radiografías de 35 x 43 cm, en posición lateral con el paciente parado, incluyendo desde el cuerpo de L1 hasta las cabezas femorales.
Las radiografías evidenciaron además de los cambios degenerativos: escoliosis en 33, espondilolistesis degenerativa en 52 y espondilolistesis ístmica en 19, en 3 pacientes coexistieron listesis ístimcas y degenerativas en distintos niveles . En 12 casos hubo colapsos vertebrales y vértebra de transición.
En todos los pacientes se evaluaron los parámetros angulares: Morfología Pélvica, Ángulo Pélvico, Incidencia Pélvica, Versión Pelviana, Pendiente Sacra, Lordosis Lumbo Pélvica, Lumbo Sacra y Lumbar , Ángulo Lumbo Sacro y Ángulo Cestino, éste último no descrito anteriormente.
Se evaluaron las distancias del eje bicoxofemoral al sacro y la proyección vertical de L1, y se valoraron dos índices de traslación sacra: Porcentaje Lumbo Pélvico e Índice Sacro Pélvico. Los datos se volcaron a una planilla de Excel.
Los valores hallados se relacionaron con las variables de sexo, edad, enfermedades asociadas, clínica y hallazgos radiográficos. Se realizó el estudio estadístico por el Test de Student y Correlación de Pearson con ayuda de planillas de Excel y programa EPIDAT Versión 3.0.
Los datos se evaluaron con los de la bibliografía tanto para individuos sanos jóvenes y de la misma edad, como para estados patológicos.
El Balance Sagital Lumbo Pélvico en pacientes con estenosis del conducto lumbar evidenció alteración en los parámetros posicionales. Los parámetros anatómicos no se modificaron con la excepción de estenosis asociada a espondilolistesis ístmica. La Lordosis Lumbo Pélvica, el Ángulo Pélvico y la Versión Pelviana tuvieron valores inferiores a la población asintomática.
Se puede simplificar las mediciones del balance sagital sin perjuicio de valorarlo correctamente, dado que existe superposición de varios parámetros. Se sugieren tres alternativas de medición.
Los parámetros nuevos: Ángulo Cestino e Índice Sacro Pélvico, mostraron importante correlación con los restantes parámetros del balance lumbopélvico. El Ángulo C tiene relación matemática con la Morfología Pélvica, la Pendiente Sacra y el Ángulo Pélvico.
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Jaman, Ravina. "A retrospective cross-sectional survey of lumbo-sacral cases recorded at the D.U.T. Chiropractic Day Clinic (1995-2005)." Thesis, 2007. http://hdl.handle.net/10321/221.
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Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban University of Technology, 2007
xiii, 76, 13 leavesTo determine the prevalence and demographics of lumbo-sacral cases recorded at the D.U.T Chiropractic Day Clinic from 13th January 1995 to 30th November 2005. To identify the aetiology, common lumbo-sacral diagnoses, associated signs and symptoms, management and contra-indications to chiropractic treatment recorded on the initial consultation of patients with lumbo-sacral complaints.
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Mills, Jonathan Denis. "The effect of a 10-week training regimen on lumbo-pelvic stability, balance, agility and leg power in college and university-level female athletes." Thesis, 2003. http://hdl.handle.net/2429/14665.
Full textAbstract:
This study investigated the capacity of female athletes to improve stability within the lumbo-pelvic region, and quantified a relationship between lumbo-pelvic stability and athletic performance. Thirty participants were selected from university and college female volleyball and basketball teams and randomly assigned to either a treatment, pseudo-treatment, or no-treatment control group. The treatment and pseudo-treatment groups participated in distinct 10-week training regimens emphasizing recruitment of either the transversus abdominus and lumbar multifidus muscles of the lumbar spine or the rectus abdominis and external obliques of the abdomen. Lumbo-pelvic stability (Stabilizer pressure biofeedback unit), balance (static and dynamic Bass tests), agility (T-test), and leg power (Sargent's vertical jump test) were measured before and immediately after the 10-week study period. A combination of repeated measures ANOVA and nonparametric Friedman and Wilcoxon analyses identified significant differences between the improvements in lumbo-pelvic stability for both the treatment and pseudo-treatment groups relative to the control group. The agility and leg power of the treatment group improved relative to both the pseudo-treatment and the control groups. There were, however, no significant differences between the improvements of any of the groups on the static and dynamic balance measures. Pearson's product-moment correlation coefficient identified significant relationships between the measures of lumbo-pelvic stability and athletic performance, but, there were no significant correlations between the impovements in lumbo-pelvic stability and the improvements in athletic performance. The results of this study demonstrate that lumbo-pelvic stability can be improved through training, although the focus of training (local stability vs. global mobility) seems to account for little difference in the extent of this improvement. While athletes with the most stable lumbo-pelvic regions demonstrated the best scores for both agility and leg power, there was no correlation found between improvements in lumbo-pelvic stability and improvements in athletic performance. The findings of this study indicate that athletes can improve stability of the lumbo-pelvic region by participating in training regimens which focus on the recruitment of either local stability or global mobility muscles. However, improvements in athletic performance are not likely to occur as a result of improvements in lumbo-pelvic stability alone.