Analyse biomécanique des pieds SACH et Seattle-Light durant la locomotion chez les personnes âgées amputées du membre inférieur

In North America and Europe, the elderly represent the largest percentage of individuals with a below the knee amputation. The purpose of this thesis was to compare two types of prosthetic feet, the Solid Ankle Cushion Heel (SACH) foot and the Seattle Light (SEAT-L) foot in a group of elderly unilateral below knee amputees (EBKA) during walking at a natural cadence. Ten EBKA aged 70.4 « 9.5 years and 18 healthy elderly (HE) subjects aged 70.8 « 7.0 years participated in this study; selection criteria required that the EBKA demonstrate sufficient locomotor potential in order to benefit from the SEAT-L foot's energy return capability. The EBKA underwent an initial gait evaluation with the SACH foot, this was followed by an eight session gait retraining program specific to the SEAT-L foot. Upon completion of the gait program, the EBKA underwent a final gait evaluation with the SEAT-L foot. In order to serve as a reference group, the 18 HE subject's gait was also evaluated once."--Résumé abrégé par UMI

Aspects of postural alignment and postural control relevant for the evaluation and the treatment of idiopathic scoliosis patients

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal

Ambulatory monitoring of activity levels of individuals in the sub-acute stage following stroke: a case series

<p>Abstract</p> <p>Background</p> <p>There is an important need to better understand the activities of individual patients with stroke outside of structured therapy since this activity is likely to have a profound influence on recovery. A case-study approach was used to examine the activity levels and associated physiological load of patients with stroke throughout a day.</p> <p>Methods</p> <p>Activities and physiologic measures were recorded during a continuous 8 hour period from 4 individuals in the sub-acute stage following stroke (ranging from 49 to 80 years old; 4 to 8 weeks post-stroke) in an in-patient rehabilitation hospital.</p> <p>Results</p> <p>Both heart rate (p = 0.0207) and ventilation rate (p < 0.0001) increased as intensity of activity increased. Results revealed individual differences in physiological response to daily activities, and large ranges in physiological response measures during 'moderately' and 'highly' therapeutic activities.</p> <p>Conclusion</p> <p>Activity levels of individuals with stroke during the day were generally low, though task-related changes in physiologic measures were observed. Large variability in the physiological response to even the activities deemed to be greatest intensity suggests that inclusion of such extended measurement of physiologic measures may improve understanding of physiological profile that could guide elements of the physical therapy prescription.</p

Analyse biomécanique des pieds SACH et Seattle-Light durant la locomotion chez les personnes âgées amputées du membre inférieur

In North America and Europe, the elderly represent the largest percentage of individuals with a below the knee amputation. The purpose of this thesis was to compare two types of prosthetic feet, the Solid Ankle Cushion Heel (SACH) foot and the Seattle Light (SEAT-L) foot in a group of elderly unilateral below knee amputees (EBKA) during walking at a natural cadence. Ten EBKA aged 70.4 « 9.5 years and 18 healthy elderly (HE) subjects aged 70.8 « 7.0 years participated in this study; selection criteria required that the EBKA demonstrate sufficient locomotor potential in order to benefit from the SEAT-L foot's energy return capability. The EBKA underwent an initial gait evaluation with the SACH foot, this was followed by an eight session gait retraining program specific to the SEAT-L foot. Upon completion of the gait program, the EBKA underwent a final gait evaluation with the SEAT-L foot. In order to serve as a reference group, the 18 HE subject's gait was also evaluated once."--Résumé abrégé par UMI

The effects of hypoxia on muscle deoxygenation and recruitment in the flexor digitorum superficialis during submaximal intermittent handgrip exercise

Abstract Background Decreased oxygenation of muscle may be accentuated during exercise at high altitude. Monitoring the oxygen saturation of muscle (SmO2) during hand grip exercise using near infrared spectroscopy during acute exposure to hypoxia could provide a model for a test of muscle performance without the competing cardiovascular stresses that occur during a cycle ergometer or treadmill test. The purpose of this study was to examine and compare acute exposure to normobaric hypoxia versus normoxia on deoxygenation and recruitment of the flexor digitorum superficialis (FDS) during submaximal intermittent handgrip exercise (HGE) in healthy adults. Methods Twenty subjects (11 M/9 F) performed HGE at 50% of maximum voluntary contraction, with a duty cycle of 2 s:1 s until task failure on two occasions one week apart, randomly assigned to normobaric hypoxia (FiO2 = 12%) or normoxia (FiO2 = 21%). Near-infrared spectroscopy monitored SmO2, oxygenated (O2Hb), deoxygenated (HHb), and total hemoglobin (tHb) over the FDS. Surface electromyography derived root mean square and mean power frequency of the FDS. Results Hypoxic compared to normoxic HGE induced a lower FDS SmO2 (63.8 ± 2.2 vs. 69.0 ± 1.5, p = 0.001) and both protocols decreased FDS SmO2 from baseline to task failure. FDS mean power frequency was lower during hypoxic compared to normoxic HGE (64.0 ± 1.4 vs. 68.2 ± 2.0 Hz, p = 0.04) and both decreased mean power frequency from the first contractions to task failure (p = 0.000). Under both hypoxia and normoxia, HHb, tHb and root mean square increased from baseline to task failure whereas O2Hb decreased and then increased during HGE. Arterial oxygen saturation via pulse oximetry (SpO2) was lower during hypoxia compared to normoxia conditions (p = 0.000) and heart rate and diastolic blood pressure only demonstrated small increases. Task durations and the tension-time index of HGE did not differ between normoxic and hypoxic trials. Conclusion Hypoxic compared to normoxic HGE decreased SmO2 and induced lower mean power frequency in the FDS, during repetitive hand grip exercise however did not result in differences in task durations or tension-time indices. The fiber type composition of FDS, and high duty cycle and intensity may have contributed greater dependence on anaerobiosis

Mean (± 1 standard deviation) HR (left axis) and VR (right axis) for each participant

<p><b>Copyright information:</b></p><p>Taken from "Ambulatory monitoring of activity levels of individuals in the sub-acute stage following stroke: a case series"</p><p>http://www.jneuroengrehab.com/content/4/1/41</p><p>Journal of NeuroEngineering and Rehabilitation 2007;4():41-41.</p><p>Published online 26 Oct 2007</p><p>PMCID:PMC2174493.</p><p></p> Statistical analysis was conducted using the data of the group as a whole. Though individual differences were observed, overall, the Kruskal-Wallis non-parametric analysis of variance revealed that both HR (black square; p = 0.0207) and VR (black circle; p < 0.0001) generally increased as AC increased HR and VR increased. For participant S2, the standard deviations for both HR and VR in ACare small and therefore the SD bars do not extend beyond the size of the symbol used in the figure. For all participants, there were no differences for both HR (p = 0.1858) and VR (p = 0.5225) between the two lowest activity levels (AC, AC). For HR there was no difference between ACand AC(p = 0.8874). HR for ACwas significantly greater than for AC(p = 0.0105) and AC(p = 0.0396); there was no statistical difference (p = 0.094) between ACand AC. VR was significantly greater for ACthan for AC(p = 0.0018) and AC(p = 0.0186), and VR for ACwas significantly greater than for AC(p = 0.0107)

Potential advantages, barriers, and facilitators of implementing a cognitive orthosis for cooking for individuals with traumatic brain injury : the healthcare providers’ perspective

Purpose Considering the key role of health care providers in integrating assistive technologies into clinical settings (e.g., in/outpatient rehabilitation) and home, this study explored the care providers’ perspectives on benefits, barriers and facilitators to the implementation of the Cognitive Orthosis for coOking (COOK) for adults with traumatic brain injury (TBI) within clinical contexts and homes. Methods Using a qualitative descriptive approach, semi-structured individual interviews and focus groups were carried out with experienced care providers of adults with TBI (n = 30) in Ontario-Canada. Qualitative analysis based on the Miles et al approach was used. Results According to the participants, COOK could potentially be used with individuals with cognitive impairments (TBI and non-TBI) to increase safety and independence in meal preparation and support healthcare providers. However, limited access to funding, clients’ lack of motivation/knowledge, and the severity of their cognitive and motor impairments were perceived as potential barriers. Facilitators to the use of COOK include training sessions, availability of private/provincial financing, and comprehensive assessments by a clinical team prior to use. Conclusions Health care providers’ perspectives will help develop implementation strategies to facilitate the adoption of COOK within homes and clinical contexts for individuals with TBI and improve the next version of this technology

Characterizing the profiles of patients with acute concussion versus prolonged post-concussion symptoms in Ontario

Abstract Identifying vulnerability factors for developing persisting concussion symptoms is imperative for determining which patients may require specialized treatment. Using cross-sectional questionnaire data from an Ontario-wide observational concussion study, we compared patients with acute concussion (≤ 14 days) and prolonged post-concussion symptoms (PPCS) (≥ 90 days) on four factors of interest: sex, history of mental health disorders, history of headaches/migraines, and past concussions. Differences in profile between the two groups were also explored. 110 patients with acute concussion and 96 patients with PPCS were included in our study. The groups did not differ on the four factors of interest. Interestingly, both groups had greater proportions of females (acute concussion: 61.1% F; PPCS: 66.3% F). Patient profiles, however, differed wherein patients with PPCS were significantly older, more symptomatic, more likely to have been injured in a transportation-related incident, and more likely to live outside a Metropolitan city. These novel risk factors for persisting concussion symptoms require replication and highlight the need to re-evaluate previously identified risk factors as more and more concussions occur in non-athletes and different risk factors may be at play